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6530 Mosaic assignment to Univar 111119 executed MATERIALS MANAGEMENT DIVISION • 901-B TEXAS STREET • DENTON, TEXAS 76209 940.349.7100 • FAX 940.349.7302 “Dedicated to Quality and Service” www.cityofdenton.com Assignment of Contract #6530 FOR VALUE RECEIVED, Mosaic Global Sales, LLC (“Assignor”) hereby assigns and otherwise transfers to Univar Solutions USA, Inc. (“Assignee”) all rights, title and interest held by Assignor in and to the “Contract” described as follows (this “Assignment”): Contract approved November 14, 2017, by and between the City of Denton, Texas, a home rule municipal corporation and Mosaic Global Sales, a Limited Liability Corporation, concerning Water and Wastewater Chemicals; said Contract being in the original not to exceed amount of $ 121,000. Assignor warrants and represents that said Contract is in full force and effect and is fully assignable. Assignor further warrants that it has the full right and authority to transfer said Contract and that Contract rights herein transferred are free of liens, encumbrances and adverse claims. Said Contract has not been modified and remains on the terms and conditions originally contained therein. If said Contract has been modified, then all modifications to said Contract are attached hereto and made a part hereof. Assignor grants, bargains, sells, conveys, transfers, assigns and delivers all of its rights, interests, obligations and duties under the Contract to Assignee. Assignee fully assumes and agrees to perform all remaining covenants, duties, and obligations of Assignor under the Contract in strict accordance with the terms and conditions of the Contract and agrees to indemnify and hold Assignor harmless from any claim or demand resulting from non-performance by Assignee. Assignor agrees that Assignee shall be entitled to all monies remaining to be paid under the Contract, which rights are also assigned hereunder. The City of Denton’s obligations to make payment to Assignee shall only be effective following the date this Assignment becomes effective. In the event that a dispute arises between Assignor and Assignee as to the allocation or division of any payments payable or paid to Assignor of Assignee, such dispute shall be resolved strictly between Assignor and Assignee. This Assignment shall become effective as of the date the Consent to Assignment is executed by the City of Denton after this Assignment is executed by the Assignor and Assignee and shall be binding upon and inure to the benefit of the Assignor and Assignee, their heirs, administrators, successors and assigns. IN WITNESS WHEREOF the Assignor and Assignee execute and affix their respective approval and signature on this Assignment on the dates herein set forth. DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 MATERIALS MANAGEMENT DIVISION • 901-B TEXAS STREET • DENTON, TEXAS 76209 940.349.7100 • FAX 940.349.7302 “Dedicated to Quality and Service” www.cityofdenton.com Dated: _________________ ___________________________ Assignor Dated: _________________ ___________________________ Assignee Consent to Assignment of Contract In accordance with the provisions of the Contract, the City of Denton hereby consents to the Assignment of Contract affirming that no modification of the Contract is made or intended, except as noted hereinabove, and that Assignee is now and hereafter substituted for Assignor. The Assignee shall provide to the City of Denton the following documentation before the Assignment of Contract shall become effective: (1) a completed substitute W-9 form, and (2) a certificate of insurance which meets or exceeds the insurance requirements of the Contract. Enclosed: City of Denton substitute W-9 form Contract # 6530 Dated: _________________ Approved by: Lori Hewell Purchasing Manager City of Denton 901B Texas Street Denton, Texas 940-349-7100 lori.hewell@cityofdenton.com DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 11/12/2019 11/19/2019 11/19/2019 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 Tax ID/Social Security #: Individual/ Sole Proprietor Partnership Limited Liability Corporation Other Please specify: Exempt Payee Business Type :Equipment Rental/Lease (A-9)Royalties (A-2) Medical/Health Care (A-6) Merchandise- Goods Only (A-7) Merchandise & Services (A-7)Legal Firm/Attorney (A-C) Proceeds from Real Estate Purchases (S) Type of Organization:Female Owned Non Profit Historically Underutilized Business City of Denton Purchasing 901-B Texas St. Denton, TX 76209 Phone: (940) 349-7100 Fax: (940) 349-7302 www.dentonpurchasing.com Authorized Signature:____________________________ Printed Name:_______________________________________ Mailing Address: Consultant/Prof Fees (A-7) Company Name: Real Estate Rental/Lease (A1) Check appropriate box for federal tax classification (required): Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxtaxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because (a) I am exempt from backup witholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a US citizen or other U.S. person-for fededral tax purposes as defined at the bottom of this page*. *Definition of a U.S. Person-For Federal Tax purposes, you are considered a U.S. person if you are: (a) an individual who is a U.S. citizen or U.S. resident (b) a partnership, corporation, company, or association created or organized in the United States or under the laws of the United States (c) an estate (other than a foreign estate), or (d) a domestic trust (as defined in Regulations Section 301.7701-7). C Corporation Minority Owned Name as shown on your income tax return: Substitute W-9 Form The IRS requires all vendors to complete a W-9 Form. The information on this form must be filled out, signed and submitted by a vendor representative. All information must be completed before a purchase order or payment will be issued. Services Only (A- 7) Contact Name: Address: Phone Number: Fax Number: S Must designate C or S Email: Website: COD Page 1 9/23/2011 4. I unsderstand that I must disclose any conflict of interest in accordance with Section 176.006 (a-1) of the Local Government Code. DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 Remit Address (if different from above) Email: List Products and/or Services Interested in Bidding: For Internal Use Only Requesting Department: Date: Purchasing Signature: Date: ACH Information-Voluntary I (we) authorize the City of Denton to deposit payments into the checking account listed. The authority remains in effect until the City of Denton has received written notification from me of termination in time to allow reasonable opportunity to act on it, or until the City of Denton has sent me written notice of termination of the agreement. Bank Name : ABA Routing#: Contact Name : Bank Account# Vendor Number Company Name: Contact Name: Address: ACH Email : Phone Number: Phone Number: Fax Number: Fax Number: Vendor Change Refund New Vendor Vendor Signature __________________________ Print Name/Title ____________________________ Date _____________________________________ Department Representative (Printed Name) ________________________________________________________ ACH Email : Vendor Information Not Required for W-9 Form COD Page 2 9/23/2011 DocuSign Envelope ID: E7F34F72-8F0A-4AF7-83B7-D153E124F5A7 Certificate Of Completion Envelope Id: E7F34F728F0A4AF783B7D153E124F5A7 Status: Completed Subject: Please DocuSign: 6530 Mosaic assignment to Univar 111119.pdf, 6530 MOSAIC EXECUTED 110717 VALID... Source Envelope: Document Pages: 30 Signatures: 3 Envelope Originator: Certificate Pages: 5 Initials: 0 Monisa Rogers AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) 901B Texas Street Denton, TX 76209 Monisa.Rogers@cityofdenton.com IP Address: 129.120.6.150 Record Tracking Status: Original 11/12/2019 1:50:54 PM Holder: Monisa Rogers Monisa.Rogers@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) Signature Adoption: Pre-selected Style Using IP Address: 129.120.6.150 Sent: 11/12/2019 2:09:13 PM Viewed: 11/12/2019 4:15:40 PM Signed: 11/12/2019 4:16:02 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Don Jernstrom FSA.Group@mosaicco.com Technical Services Manager Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 216.4.16.33 Sent: 11/12/2019 4:16:03 PM Resent: 11/19/2019 12:19:01 PM Viewed: 11/19/2019 12:29:24 PM Signed: 11/19/2019 12:54:34 PM Electronic Record and Signature Disclosure: Accepted: 11/19/2019 12:29:24 PM ID: 9ceaab1f-b109-401e-862e-ecf19da66427 Sara Cauthen sara.cauthen@univarsolutions.com Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 172.85.19.2 Sent: 11/19/2019 12:54:36 PM Viewed: 11/19/2019 2:03:18 PM Signed: 11/19/2019 2:04:01 PM Electronic Record and Signature Disclosure: Accepted: 11/19/2019 2:03:18 PM ID: 202efee7-33be-404b-91a8-c067d9c07b1c In Person 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 Kristy Dulkoski kristy.dulkoski@mosaicco.com Security Level: Email, Account Authentication (None) Sent: 11/19/2019 2:04:03 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Shawn Gray shawn.gray@mosaicco.com Security Level: Email, Account Authentication (None) Sent: 11/19/2019 2:04:04 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Don Jerstrom don.jerstrom@mosaicco.com Security Level: Email, Account Authentication (None) Sent: 11/19/2019 2:04:04 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 11/19/2019 2:04:04 PM Certified Delivered Security Checked 11/19/2019 2:04:04 PM Signing Complete Security Checked 11/19/2019 2:04:04 PM Completed Security Checked 11/19/2019 2:04:04 PM Payment 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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