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7291 - Contract Executed Docusign City Council Transmittal Coversheet File Name Purchasing Contact City Council Target Date Piggy Back Option Contract Expiration Ordinance DocuSign Envelope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ocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 IN WITNESS WHEREOF, the parties of these presents have executed this agreement in the year and day first above written. THIS AGREEMENT HAS BEEN BOTH REVIEWED AND APPROVED as to financial and operational obligations and business terms. _______________ ________________ SIGNATURE PRINTED NAME __________________________________ TITLE __________________________________ DEPARTMENT CITY OF DENTON, TEXAS BY: _____________________________ TODD HILEMAN CITY MANAGER ATTEST: ROSA RIOS, CITY SECRETARY BY: _______________________________ APPROVED AS TO LEGAL FORM: AARON LEAL, CITY ATTORNEY BY: _______________________________ SUPPLIER BY: ______________________________ AUTHORIZED SIGNATURE Printed Name:__________________________ Title:_________________________________ _____________________________________ PHONE NUMBER _____________________________________ EMAIL ADDRESS ______________________________________ TEXAS ETHICS COMMISSION 1295 CERTIFICATE NUMBER DocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 ## ## " # !$ GENERAL TERMS Terms of payment are as follows: 100% upon shipment, 0 % upon receipt of approved final O&M manuals, and 0% upon start-up, testing and acceptance by Owner, not to exceed ninety (90) days from shipment, for payment within thirty (30) days of invoice, -- % discount, net thirty (30) days. This quotation is subject to change or withdrawal without notice, and subject to acceptance within thirty (30) days by Buyer. If accepted by the Buyer, this Proposal shall become a binding contract only when approved and signed by an authorized officer of the Seller, at its office in Waller, Waller County, Texas, and may then be modified by written agreement only. No statements or understanding relating to the subject matter, other than those set forth herein, shall be binding on WwaterTech, Inc. (WTI). All orders, contracts and quotations are submitted contingent upon occurrence of strikes, accidents, fire, riots, war, and Acts of God, and any other causes beyond our control. In the event of strikes in our plants or in the plants of our supplier, we may withdraw this Proposal if, in our opinion, such strikes may result in the following: 1, Delay in the delivery of materials and supplies. 2. Cancellation by suppliers of materials and supplies. 3. Increase prices for materials, supplies and labor. Quoted shipment or delivery dates are based upon current production schedules of the specified equipment, after receipt of all approved drawings, together with complete technical data necessary for proper application and “state-of-the-art” engineering, as required by the Project. WTI, will deliver drawings for approval in a timely manner commensurate with the original concept of completion, as conceived by the Owners and/or Engineers. WTI, will not be liable for liquidated damages or other penalties, either direct or indirect, for failure to perform within these estimated dates. The Standard Conditions of Sale printed on the attached side of this sheet, unless expressly accepted herein, are part of this Quotation. Any provisions in the Purchase Order, which are in conflict with or in addition to the provisions provided herein, shall be come part of the contract only if affirmatively accepted in writing by Buyer and Seller. END DocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 STANDARD CONDITIONS OF SALE 1) ACCEPTANCE This contract is subject to credit approval by the Seller (WwaterTech, Inc.) prior to acceptance. In the event of insolvency or other financial difficulty on the part of the Buyer, the Seller may withhold or require payment in advance or seek such other security, as it deems necessary. 2) PAYMENT Buyer agrees to pay Seller interest at the highest legal rate on any amount unpaid from maturity and Buyer further agrees to pay Seller all collection or attorney’s fees and court costs incurred; under no conditions will credit be extended beyond ninety (90) days without the applicable statutory and common laws liens being filed. 3) CANCELLATION In the event Buyer cancels the contract or any part thereof, Buyer agrees to reimburse Seller for any costs incurred; including engineering time expended on the pre-approval and approval drawings as well as shop drawings and direct labor with overhead burden, materials and other costs incurred through the date of cancellation, plus a margin of 10% of the contract amount. 4) TAXES Buyer will pay Seller, in addition to the price stated, the amount of any applicable sales, and gross receipts or other tax which may be imposed on this transaction by the Federal, State, County or Municipal government and any subdivision thereof. 5) TITLE AND RISK OF LOSS Full risk of loss (including transportation, delays, damages and/or losses) shall pay to Buyer upon delivery of products to the F.O.B. point or at the time of installation, if provided for in the contract. Seller retains title, for security purposes only, to all products whether attached to realty or other property, until fully paid for in cash; and the Buyer agrees to perform all acts, which may be necessary to perfect and assure retention of title in the Seller. In the case of failure by the Buyer to make any payment when due, it is expressly understood that it shall be optional with the Seller to take exclusive possession of the products supplied wherever found and remove same without legal process, and that any payments which may have been made on account of same shall be retained by the company as liquidated damages, without prejudice to its right or recovery for further damage it may suffer from any cause. 6) WARRANTY AND LIMITATION OF REMEDY AND LIABILITY A. Seller warrants only that the products and parts manufactured by Seller, when shipped, and the work performed by Seller (including installations, construction and start-up) when performed, will meet all applicable specifications and other specific product and work requirements (including those of performance), if any, of this agreement, and will be free from defects in material and workmanship. All claims for defective or non-conforming (both hereinafter called defective) products or parts under this warranty shall be made in writing immediately upon discovery, and in any event, within one (1) year from shipment of the applicable item unless Seller specifically assumes installation, construction or start-up responsibility, in all claims for defective or non-conforming work shall be made in writing immediately upon discovery, and in any event, within one (1) year from completion of the applicable work by Seller, such date to be determined exclusive of instruction, start-up and inspection work done pursuant to the contract; provided, however, all claims for defective products and parts shall be made in writing no later than eighteen (18) months after shipment. Defective and non-conforming items must be held for Seller’s inspection and returned to the original F.O.B. point upon request. THE FOREGOING IN EXPRESSLY IN LIEU OF OTHER WARRANTIES WHATSOEVER, EXPRESS, IMPLIED AND SATUTORY, INCLUDING, WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MECHANTABILITY AND FITNESS. B. Any act of the Buyer to alter, modify, or install equipment in a manner contrary to the instructions furnished by the Seller shall serve to void the Seller’s warranty on those items altered, modified or improperly installed. C. Upon Buyer’s submission of a claim as provided herein and substantiation, Seller shall at the option either repair or replace its product, part or work at the original F.O.B. point of delivery or to refund an equitable portion of the purchase price. D. Notwithstanding the foregoing provisions of this WARRANTY AND LIABILITY Clause, it is specifically understood that products and parts not manufactured and work not performed by Seller are warranted to the extent and in the manner that the same are warranted to Seller by Seller’s vendors, and then only to the extent is reasonably able to enforce such warranty. In enforcing such warranty, it is understood Seller shall have no obligation to initiate litigation unless Buyer undertakes to pay all costs and expenses therefor, including, but not limited to, attorney’s fees, and indemnifies Seller against any liability to Seller’s vendors arising out of such litigation. E. THE FOREGOING IS SELLER’S ONLY OBLIGATION AND BUYER’S EXLUSIVE REMEDY FOR BREACH OF WARRANTY AND, EXCEPT FOR GROSS NEGLIGENCE AND WILLFUL MISCONDUCT. THE FOREGOING IS BUYER’S EXCLUSIVE REMEDY AGAINST SELLER FOR ALL CLAIMS ARISING HEREUNDER OR RELATING HERETO WHETHER SUCH CLAIMS ARE BASED ON BREACH OF CONTRACT, TORS (INCLUDING NEGLIGENCE AND STRICT LIABILITY) OR OTHER THEORIES. BUYER’S FAILURE TO SUBMIT A CLAIM AS PROVIDED ABOVE SHALL SPECIFICALLY WAIVE ALL CLAIMS FOR DAMAGES OR OTHER RELIEF, INCLUDING, BUT NOT LIMITED TO, CLAIMS BASED ON LATENT DEFECTS. IN NO EVENT SHALL BUYER BE ENTITLES TO INCIDENTAL OR CONSEQUENTIAL DAMAGES. ANY ACTION BY BUYER ARISING HEREUNDER OR RELATING HERETO, WHETHER BASED ON BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE AND STRICT LIABILITY) OR OTHER THEORIES, MUST BE COMMENCED WITHIN ONE (1) YEAR AFTER THE CAUSE OF ACTION ACCRUES OR IT SHALL BE BARRED. 7) PATENTS Should the equipment proposed herein incorporate a patent or a concept that results in a patent or a patent application, title to such patent or concept resulting therefrom shall be retained in full ownership by WwaterTech, Inc. (WTI) and shall be the sole property of WTI. 8) BACKCHARGES Seller will not accept any charge for modification, servicing, adjustment or for nay other item without authority in the form of a written order issued from the office of WTI, in Waller, Texas, in advance of doing the work. 9) TERMS OF AGREEMENT The acceptance of this order shall be upon the terms and conditions specified herein which shall take precedence and represent the final agreement between Buyer and Seller notwithstanding any inconsistent, contradictory or other and further terms and conditions contained in Buyer’s purchase order or other document furnished by Buyer in connection with this order, whether such document or documents are exchanged simultaneously with this order or prior to subsequent thereto. DocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 4757247572QUOTATION #QUOTATION # ttĂƚĞƌdĞĐŚ͕ŝŶĐ͘ ϯϭϬϰtĂƐŚŝŶŐƚŽŶ^ƚƌĞĞƚ͕tĂůůĞƌ͕dyϳϳϰϴϰ PH: ;ϵϯϲͿϯϳϮͲϱϮϳϮ November 2ϱ͕ 2019 Denton Water ProductionCustomer : Gill GilbertAttn : email : FOB Factory, PP & AddFreight : ϭϬƚŽϭϮtĞĞŬƐ**Lead Time (after Dwg Approval): ***Terms :EĞƚϯϬĂǇƐWĞƌƚƚĂĐŚĞĚ No State Taxes Included Unless StatedTaxes : Total:$ Contact : Please reference quote number when ordering. Final part numbers may change after engineering. Please provide ship to and bill to with order. * Engineering time may be required. ** Lead time starts after engineering drawing approval. Notes: BASIN #1 - EAST SIDE LONG COLLECTOR (CRASHED UNIT) ONLY CHAIN AND ATTACHMENT LINKS CHAIN, NCS-720-S, 6" PITCH,09.5 FT STRAND,AVG UTS>7500 LB10000275-058 $1ϱϴ.26EA116 $1ϴ͕ϯϱϴ.16 KIT, NCS-720-S,F22-8 ATTACHMENT LINK,W/ PIN & CLIP10000274-001 $Ϯϭ͘ϳϰEA116 $2,ϱϮϭ͘ϴϰ FLOOR WEAR STRIP AND NEW HARDWARE WEAR STRIP, 3/8" X 2-5/8" X 120.00" LONG, UHMW-PE, 1 HOLE & 3 SLOTS10000286-001 $4ϵ͘ϮϲEAϭϭϮ $ϱ͕ϱϭϳ͘ϭϮ HARDWARE KIT, WEARSTRIP, CONCRETE FLOOR (1 KIT / STRIP)10001040-001 $ϭϬ͘ϬϲSETϭϭϮ $ϭ͕ϭϮϲ͘ϳϮ RETURN RAIL WEAR STRIP AND NEW HARDWARE WEAR STRIP, 3/8" X 2-5/8" X 120.00" LONG, UHMW-PE, 1 HOLE & 3 SLOTS10000286-001 $4ϵ͘ϮϲEAϭϬϬ $ϰ͕ϵϮϲ͘ϬϬ HARDWARE KIT, WEARSTRIP, RETURN RAIL (1 KIT / STRIP)10000066-005 $ϭϭ͘ϳϱSETϭϬϬ $ϭ͕ϭϳϱ͘ϬϬ FLIGHT ASSEMBLIES - W/NSF WEAR SHOES BASIC C CHANNEL FLIGHT10000573-036 $ϮϬϵ͘ϴϮEA55 $ϭϭ͕ϱϰϬ͘ϭϬ 3X8 C-CHANNEL SQUEEGEE FLIGHT - BARE FLIGHT10001208-011 $Ϯϯϳ͘ϳϴEAϲ $ϭ͕ϰϮϲ͘ϲϴ SQUEEGEES, BACKER PLATES AND ATTACHMENT HARDWARE $ϲϵϬ͘ϴϱϲ $ϰ͕ϭϰϱ͘ϭϬ RETURN WEAR SHOE, 3"X3"X4.5"X0.5",BLUE ( WTP )PA6/6, W/LUG10000595-001 $ϭϬ͘ϯϰEAϮϯϮ $Ϯ͕ϯϵϴ͘ϴϴ CARRY WEAR SHOE, 3"X3"X5.5"X0.5",BLUE ( WTP )PA6/610000711-001 $ϭϭ͘ϮϵEAϮϯϮ $Ϯ͕ϲϭϵ͘Ϯϴ FILLER BLOCK, POLYPROPYLENE,BLUE, WTP10000370-002 $ϭϭ͘ϱϬEAϮϯϮ ΨϮ͕ϲϲϴ͘ϬϬ HARDWARE KIT, 10 HOLE SET, ENGLISH, 316 SS10000160-010 $ϯϰ͘ϮϱEAϭϭϲ $ϯ͕ϵϳϯ͘ϬϬ UPGRADE TO ALL ULTRA FLIGHTS IS $5,750 FOR LONGITUDINAL (1) UNIT OPTIONAL ITEMS FOR CONSIDERATION STUB SHAFT, W/UHMW-PE BEARING (IF LOOSE UNIT IS DAMAGED)10000353-XXX $ϭ͕ϱϲϮ͘ϴϳEA1 $1,ϱϲϮ͘ϴϳ ANCHOR, 1 - 8 X 10 1/2/6EMB, 316SS (NEED 2 FOR MOUNTING)650-23148-16C 42 $ϲϱ͘ϲϵEA2$1ϯϭ͘ϯϴ KIT, STUB SHAFT, ENG HDW, 316SS, (JACKING BOLTS AND END CAP BOLT)10001020-001 $2ϱ͘ϵϱEA1$2ϱ͘ϵϱ SPKT, 17T, 720, FOR STUB SHAFT (PER SPROCKET)10000200-001 $ϰϱϵ͘ϲϭEAϰ Ψϭ͕ϴϯϴ͘ϰϰ KIT, STUB SHAFT BEARING REPLACEMENT (PER KIT)10000406-001 $2ϰϲ͘ϱϴEAϰ $ϵϴϲ͘ϱϮ Qty 940-349-7506940-349-7627Phone : / Fax: Denton Water Production - RefurbishmentRe : Extended For our Standard Terms and Conditions go to brentwoodindustries.com/terms/ / *Engineering Time :EŽŶĞZĞƋƵŝƌĞĚ Part No.Unit Price ^ds,K>dContact: 3ϭϬϰt^,/E'dKE^dAddress: WALLER TX 77484City / State / Zip: WWATERTECH,INC. - HOUSTONCompany: U/MItemDescription BRENTWOOD / POLYCHEM MANUFACTURER’S REP IN YOUR AREA Phone:;ϵϯϲͿϯϳϮͲϱϮϳϮEmail:ƐŚŽůƚ@wwatertechinc.com There will be a 20% restocking charge on all returned items, at a minimum, & non-shelf items cannot be returned for credit. Components cannot be returned after 90 days of shipment. POLYCHEM HAS A $1,000.00 MINIMUM ORDER - Note Quotes are valid for 30 days Please Email or Fax Your Order to Our Reading PA Office *** Contigent on Credit Approval Ψϱ͕ϳϱϬ͘ϬϬ ϳϮ͕ϲϵϭ͘Ϭϰ DocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 4758247582QUOTATION #QUOTATION # ttĂƚĞƌdĞĐŚ͕/ŶĐ͘ ϯϭϬϰtĂƐŚŝŶŐƚŽŶ^ƚ͕͘tĂůůĞƌdyϳϳϰϴϰ PH: ;ϵϯϲͿϯϳϮͲϱϮϳϮ November 2ϱ, 2019 Denton Water ProductionCustomer : Gill GilbertAttn : email : FOB Factory, PP & AddFreight : ϭϬƚŽϭϮtĞĞŬƐ**Lead Time (after Dwg Approval): ***Terms :Net 30 DaysƉĞƌĂƚƚĂĐŚĞĚ No State Taxes Included Unless StatedTaxes : Contact : Total:$ϵ͕Ϯϭϲ͘ϵϬ Please reference quote number when ordering. Final part numbers may change after engineering. Please provide ship to and bill to with order. * Engineering time may be required. ** Lead time starts after engineering drawing approval. Notes: BASIN #1 CROSS COLLECTOR ONLY CHAIN, NCS-720-S, 6" PITCH, 4.5 FT STRAND,AVG UTS>7500 LB10000275-059 $ϳϴ͘ϵϴEA44 $ϯ͕ϰϳϱ͘ϭϮ KIT, NCS-720-S,F22-8 ATTACHMENT LINK,W/ PIN & CLIP10000274-001 $Ϯϭ͘ϳϰEA44 $ϵϱϲ͘ϱϲ FLIGHT ASSEMBLIES FLIGHTS, FRP 3"X8"X5'9"10000573-056 $ϱϰ͘ϵϲEA22 $ϭ͕ϮϬϵ͘ϭϮ RETURN WEAR SHOE, 3"X3"X4.5"X0.5",BLUE ( WTP )PA6/6, W/LUG10000595-001 $ϭϬ͘ϯϰEA44 $ϰϱϰ͘ϵϲ CARRY WEAR SHOE, 3"X3"X5.5"X0.5",BLUE ( WTP )PA6/610000711-001 $ϭϭ͘ϮϵEA44 $ϰϵϲ͘ϳϲ FILLER BLOCK 3"X 8" C-CHANNEL FLIGHT, POLYPROPYLENE,BLUE, WTP10001039-002 $ϭϭ͘ϱϬSET44 $ϱϬϲ͘ϬϬ HARDWARE KIT,C-CHANNELFLIGHT, 10 HOLE SET, ENGLISH, 316 SS10000150-010 $2ϵ͘ϬϰEA44 $1,Ϯϳϳ͘ϳϲ WEAR STRIP AND HARDWARE WEAR STRIP, 3/8" X 2-5/8" X 120.00" LONG, UHMW-PE, 1 HOLE & 3 SLOTS10000286-001 $4ϵ͘ϮϲEA14 $ϲϴϵ͘ϲϰ HARDWARE KIT, WEARSTRIP, RETURN RAIL (1 KIT / STRIP)10000066-005 $ϭϭ͘ϳϱSET6$ϳϬ͘ϱϬ HARDWARE KIT, WEARSTRIP, CONCRETE FLOOR (1 KIT / STRIP)10001040-001 $ϭϬ͘ϬϲSET8 ΨϴϬ͘ϰϴ Qty 940-349-7506940-349-7627Phone : / Fax: Denton Lake Ray Roberts - Cross CollectorRe : Extended For our Standard Terms and Conditions go to brentwoodindustries.com/terms/ / *Engineering Time :EŽŶĞZĞƋƵŝƌĞĚ Part No.Unit Price STEVE HOLTContact: 3104 WASHINGTON ST.Address: (936) 372-5272Phone:sholt@wwatertechinc.comEmail: WALLER TX 77484City / State / Zip: WWATERTECH,INC. - HOUSTONCompany: U/MItemDescription BRENTWOOD / POLYCHEM MANUFACTURER’S REP IN YOUR AREA There will be a 20% restocking charge on all returned items, at a minimum, & non-shelf items cannot be returned for credit. Components cannot be returned after 90 days of shipment. POLYCHEM HAS A $1,000.00 MINIMUM ORDER - Note Quotes are valid for 30 days Please Email or Fax Your Order to Our Reading PA Office *** Contigent on Credit Approval DocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 ϰϳϱϵϲZϭϰϳϱϵϲZϭYhKdd/KEηYhKdd/KEη ƌĞŶƚǁŽŽĚ/ŶĚƵƐƚƌŝĞƐ͕/ŶĐ͘ ϱϬϬ^ƉƌŝŶŐZŝĚŐĞƌŝǀĞ͕ZĞĂĚŝŶŐWϭϵϲϭϬ W,͗ϲϭϬ͘ϯϰϳ͘ϴϱϴϲ :ĂŶƵĂƌǇϭϳ͕ϮϬϮϬ ĞŶƚŽŶtĂƚĞƌWƌŽĚƵĐƚŝŽŶƵƐƚŽŵĞƌ͗ 'ŝůů'ŝůďĞƌƚƚƚŶ͗ Őŝůů͘ŐŝůďĞƌƚΛĐŝƚǇŽĨĚĞŶƚŽŶ͘ĐŽŵĞŵĂŝů͗ &K͕&ĂĐƚŽƌǇ͕WWΘ&ƌĞŝŐŚƚ͗ ϭϬƚŽϭϮtĞĞŬƐΎΎ>ĞĂĚdŝŵĞ ;ĂĨƚĞƌǁŐƉƉƌŽǀĂůͿ ͗ EĞƚϯϬĂǇƐΎΎΎdĞƌŵƐ͗ EŽ^ƚĂƚĞdĂǆĞƐ/ŶĐůƵĚĞĚhŶůĞƐƐ^ƚĂƚĞĚdĂǆĞƐ͗ dŽƚĂů͗ΨϭϬ͕ϰϱϬ͘ϬϬ ŽŶƚĂĐƚ͗ZǇĂŶWƵƚƚͲWŚ͗ϲϭϬͲϯϰϳͲϴϲϲϯͬĞŵĂŝů͗ZǇĂŶ͘WƵƚƚΛďƌĞŶƚǁŽŽĚŝŶĚƵƐƚƌŝĞƐ͘ĐŽŵ WůĞĂƐĞƌĞĨĞƌĞŶĐĞƋƵŽƚĞŶƵŵďĞƌǁŚĞŶŽƌĚĞƌŝŶŐ͘&ŝŶĂůƉĂƌƚŶƵŵďĞƌƐŵĂǇĐŚĂŶŐĞĂĨƚĞƌĞŶŐŝŶĞĞƌŝŶŐ͘WůĞĂƐĞƉƌŽǀŝĚĞƐŚŝƉƚŽĂŶĚďŝůůƚŽǁŝƚŚŽƌĚĞƌ͘ ΎŶŐŝŶĞĞƌŝŶŐƚŝŵĞŵĂǇďĞƌĞƋƵŝƌĞĚ͘ΎΎ>ĞĂĚƚŝŵĞƐƚĂƌƚƐĂĨƚĞƌĞŶŐŝŶĞĞƌŝŶŐĚƌĂǁŝŶŐĂƉƉƌŽǀĂů͘ EŽƚĞƐ͗ &/>^Zs/ͲWZͲ/E^d>>d/KEDd/E'ϭϬϵϵϵϵϵϵͲϬϬϵϭ Ψϯ͕ϴϱϬ͘ϬϬϭ Ψϯ͕ϴϱϬ͘ϬϬ ;ϭͿ dZ/W͕;ϭͿzKE^/d͕;ϮͿdZs>z^ Ks/E>h^D>^͕,Kd>͕dZs>K^d^͕>>yWE^^ &/>^Zs/Ͳ&/E>dE</E^Wd/KEϭϬϵϵϵϵϵϵͲϬϬϵϮ Ψϲ͕ϲϬϬ͘ϬϬϭ Ψϲ͕ϲϬϬ͘ϬϬ &KZϮ>KE'/dh/E>K>>dKZ^EϭZK^^K>>dKZ ;ϭͿ dZ/W͕;ϮͿz^KE^/d͕;ϮͿdZs>z^ Ks/E>h^D>^͕,Kd>͕dZs>K^d^͕>>yWE^^ /d/KE>z^ZΨϭϵϮϱWZzt,E/E>h/Ed,^DdZ/W W>^>>Ktd>^ddtKt<^͛EKd/dK^,h>&/>^Zs/ dKZYh^d&/>^Zs/͕W>^KDW>dZYh^d&KZD t/>>s/^hZZEds/>/>/dz&dZZ/WdK&WKEZYh^d&KZD YƚǇ ϵϰϬͲϯϰϵͲϳϱϬϲϵϰϬͲϯϰϵͲϳϲϮϳWŚŽŶĞ͗ͬ&Ăǆ͗ ĞŶƚŽŶ>ĂŬĞZĂǇZŽďĞƌƚƐͲ&ŝĞůĚ^ĞƌǀŝĐĞZĞ͗ ǆƚĞŶĚĞĚ &ŽƌŽƵƌ^ƚĂŶĚĂƌĚdĞƌŵƐĂŶĚŽŶĚŝƚŝŽŶƐŐŽƚŽ ďƌĞŶƚǁŽŽĚŝŶĚƵƐƚƌŝĞƐ͘ĐŽŵͬƚĞƌŵƐͬ ͬ ΎŶŐŝŶĞĞƌŝŶŐdŝŵĞ͗EŽŶĞZĞƋƵŝƌĞĚ WĂƌƚEŽ͘hŶŝƚWƌŝĐĞ />>,>>ZK&dŽŶƚĂĐƚ͗ ϯϵϬϭǭ/ZWKZd&ZtzĚĚƌĞƐƐ͗ ;ϴϭϳͿϯϱϴͲϬϱϱϭWŚŽŶĞ͗ďŚĂůůĐƌŽĨƚΛǁǁĂƚĞƌƚĞĐŚŝŶĐ͘ĐŽŵŵĂŝů͗ t>>ZdyϳϳϰϴϰŝƚǇͬ^ƚĂƚĞͬŝƉ͗ ttdZd,͕ /E͘Ͳ,Kh^dKEŽŵƉĂŶǇ͗ hͬD/ƚĞŵ ĞƐĐƌŝƉƚŝŽŶ ZEdtKKͬWK>z,DDEh&dhZZ͛^ZW/EzKhZZ There will be a 20% restocking charge on all returned items, at a minimum, & non-shelf items cannot be returned for credit. Components cannot be returned after 90 days of shipment. POLYCHEM HAS A $1,000.00 MINIMUM ORDER - Note Quotes are valid for 30 days WůĞĂƐĞŵĂŝůŽƌ &ĂǆzŽƵƌKƌĚĞƌ ƚŽKƵƌZĞĂĚŝŶŐ WKĨĨŝĐĞ &RQWLJHQWRQ&UHGLW$SSURYDO DocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 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: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 Certificate of Interested Parties Electronic Filing In 2015, the Texas Legislature adopted House Bill 1295, which added section 2252.908 of the Government Code. The law states that the City may not enter into this contract unless the Contractor submits a disclosure of interested parties (Form 1295) to the City at the time the Contractor submits the signed contract. The Texas Ethics Commission has adopted rules requiring the business entity to file Form 1295 electronically with the Commission. Contractor will be required to furnish a Certificate of Interest Parties before the contract is awarded, in accordance with Government Code 2252.908. The contractor shall: 1. Log onto the State Ethics Commission Website at : https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm 2. Register utilizing the tutorial provided by the State 3. Print a copy of the completed Form 1295 4. Enter the Certificate Number on page 2 of this contract. 5. Complete and sign the Form 1295 6. Email the form to purchasing@cityofdenton.com with the contract number in the subject line. (EX: Contract 1234 – Form 1295) The City must acknowledge the receipt of the filed Form 1295 not later than the 30th day after Council award. Once a Form 1295 is acknowledged, it will be posted to the Texas Ethics Commission’s website within seven business days. DocuSign Envelope ID: 666FE1E6-2921-44CD-B1E6-B7832BC5B183 Certificate Of Completion Envelope Id: 666FE1E6292144CDB1E6B7832BC5B183 Status: Completed Subject: Please DocuSign: City Council Contract 7291 Water Treatment Sludge Removal Repair Source Envelope: Document Pages: 10 Signatures: 6 Envelope Originator: Certificate Pages: 6 Initials: 1 Lori Hewell AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) 901B Texas Street Denton, TX 76209 lori.hewell@cityofdenton.com IP Address: 129.120.6.150 Record Tracking Status: Original 1/24/2020 4:50:10 PM Holder: Lori Hewell lori.hewell@cityofdenton.com Location: DocuSign Signer Events Signature Timestamp Lori Hewell lori.hewell@cityofdenton.com Purchasing Manager City of Denton Security Level: Email, Account Authentication (None) Completed Using IP Address: 129.120.6.150 Sent: 1/24/2020 4:57:56 PM Viewed: 1/24/2020 4:58:11 PM Signed: 1/24/2020 5:04:11 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: 1/24/2020 5:04:13 PM Viewed: 1/24/2020 5:04:46 PM Signed: 1/24/2020 5:04:57 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: 129.120.6.150 Sent: 1/24/2020 5:04:59 PM Viewed: 1/24/2020 5:16:44 PM Signed: 1/24/2020 5:19:18 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Steve Holt sholt@wwatertechinc.com President WwaterTech, Inc. Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 107.133.190.186 Sent: 1/24/2020 5:19:20 PM Resent: 1/27/2020 7:33:09 AM Resent: 1/27/2020 4:29:30 PM Viewed: 1/27/2020 4:31:30 PM Signed: 1/27/2020 4:34:36 PM Electronic Record and Signature Disclosure: Accepted: 1/27/2020 4:31:30 PM ID: ff52c26d-3bdf-4775-b4dc-c6a09108c178 Signer Events Signature Timestamp Frank Pugsley frank.pugsley@cityofdenton.com Water and Wastewater Utilities Director Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 47.185.158.73 Signed using mobile Sent: 1/27/2020 4:34:38 PM Viewed: 1/27/2020 5:34:10 PM Signed: 1/27/2020 5:34:28 PM Electronic Record and Signature Disclosure: Accepted: 1/27/2020 5:34:10 PM ID: 16034491-7fd4-4ff0-93d0-96e59b522797 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: 1/27/2020 5:34:31 PM Viewed: 2/5/2020 9:18:21 AM Signed: 2/5/2020 9:18:51 AM 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: 129.120.6.150 Sent: 2/5/2020 9:18:54 AM Viewed: 2/5/2020 9:39:49 AM Signed: 2/5/2020 9:39:56 AM 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: 2/5/2020 9:39:58 AM Viewed: 2/6/2020 9:09:48 AM Signed: 2/6/2020 9:10:26 AM Electronic Record and Signature Disclosure: Accepted: 2/6/2020 9:09:48 AM ID: e476dd3d-c5f1-4946-b129-aed7e5a825fa In Ierson Signer Events Signature Timestamp Editor DeliverI Events Status Timestamp Igent DeliverI Events Status Timestamp IntermediarI DeliverI Events Status Timestamp Certified DeliverI Events Status Timestamp CarIon CopI Events Status Timestamp Cheyenne Defee cheyenne.defee@cityofdenton.com Contract Administrator City of Denton Security Level: Email, Account Authentication (None) Sent: 1/24/2020 5:04:13 PM Electronic Record and Signature Disclosure: CarIon CopI Events Status Timestamp Not Offered via DocuSign Cathy Aldrich caldrich@wwatertechinc.com Security Level: Email, Account Authentication (None) Sent: 1/24/2020 5:19:20 PM Viewed: 1/27/2020 8:08:30 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Sherri Thurman sherri.thurman@cityofdenton.com City of Denton Security Level: Email, Account Authentication (None) Sent: 1/27/2020 5:34:30 PM 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: 2/5/2020 9:18:54 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Zolaina Parker Zolaina.Parker@cityofdenton.com City of Denton Security Level: Email, Account Authentication (None) Sent: 2/5/2020 9:18:54 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Hector Ortiz Hector.Ortiz@cityofdenton.com Security Level: Email, Account Authentication (None) Sent: 2/6/2020 9:10:29 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Iitness Events Signature Timestamp IotarI Events Signature Timestamp Envelope SummarI Events Status Timestamps Envelope Sent Hashed/Encrypted 2/6/2020 9:10:29 AM Certified Delivered Security Checked 2/6/2020 9:10:29 AM Signing Complete Security Checked 2/6/2020 9:10:29 AM Completed Security Checked 2/6/2020 9:10:29 AM IaIment 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. 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