7420- Change Order 1 Executed
Docusign City Council Transmittal Coversheet
File Name
Purchasing Contact
City Council Target Date
Piggy Back Option
Contract Expiration
Ordinance
DocuSign Envelope ID: 7371F8F1-1D76-400C-BDF5-239911716B3D
RFP
Not Applicable
7420
Hickory Substation Duct Bank Amendment 1
Christa Christian
N/A
JUNE 8, 2021
21-1070
Contractor:
655 E. Main St.Lewisville, TX 75067
Matt Leazer, Estimator
Driskell Tubbs, VP
CHANGE ORDER NO.1
7420 PO #:
3/1/2021 9/12/2021
Date Prepared:4/6/21
Contract BID Amount:772,734.00$
5% Contingency Amount:38,636.70$
811,370.70$
Prior Approved CAA's:
Available Contingency:38,636.70$
38,636.70$ 15 Work Days
Contingency Remaining:0.00$ 195
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
-$
-$ -$
-$ -$
-$ -$
$0.00
1 LF 125 35 1,090.00$ 38,636.70$
2
-$ -$
$38,636.70
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
-$
-$
$0.00
1 LF 125 90 1,090.00$ 97,613.30$
LS 1 5,625.00$ 5,625.00$
LS 1 4,950.00$ 4,950.00$
LS 1 715.00$ 715.00$
ls 1 1,872.00$ 1,872.00$
$110,775.30
$149,412.00
772,734.00$
811,370.70$
Hickory Substation TM Duct Bank $38,636.70
$110,775.30
$922,146.00
100.00%
19.34%
Reason for
Requested Change
Order:
Total Change Order over original Bid:
Original BID/Contract Amount:
Total CO's :
% of CAA approved to-date :
TOTAL OTHER FUNDED NEW ITEMS:
TOTAL CO AMOUNT:
Total CAA's :
Original Total Not to Exceed Amount:
Revised Contract Amount:
NEW ITEMS OF WORK
TOTAL OTHER FUNDED QTY CHANGES:
60" x .075" Steel Casing BOC w/ Temp Pavement
Trench Excavation Protection
IFB#
CIP/ENG#
This CAA Request:
772,734.00$
This CO Other Funding Request:
180
110,775.30$
This CO Days Request:
Total NTE Amount :
Original Contract Days:
Total Change Request:149,412.00$
CITY OF DENTON CHANGE ORDER FORM
City of Denton - Capital Projects
401 N. Elm Street
Denton, TX 76201
QUANTITY CHANGES TO EXISTING ITEMS
NTP Date:
Contingency funds are used at City's discretion per contract spec language
Mark Zimmerer, Project Manager
Hickory Substation TM Duct Bank
Prior Approved Other Funded CO's:-$
TOTAL CAA QTY CHANGES:
NEW ITEMS OF WORK
Description of work
Current Contract Amount w CO's:
PROJECT SCOPE AND REASON FOR CHANGE
New Contract Days:
Project Scope
included in Contract:
60" x .075" Steel Casing BOC w/ Temp Pavement
CONTINGENCY ALLOWANCE AUTHORIZED (CAA) CONTRACT CHANGES
John Burns Construction
Company of Texas, INC
OTHER FUNDED CONTRACT CHANGES (CO)
TOTAL CAA NEW ITEMS:
Install 125 LF of 60" x 0.75" steel casing by open cut (BOC) with temp paving. Casing is to be supplied
by others. The steel casing will be installed and capped for the for the proposed water line on
Bonnie Brae.
QUANTITY CHANGES TO EXISTING ITEMS
Approved CO Days:
The steel casing must be installed prior to the electrical duct bank packages. The contractor who
was to install the water line and casing defaulted and John Burn will install the steel casing.
Project Complete Date:
Project:
Extra time to pave separate lanes vs all at once
Relocate Existing Water Pipe
Revised engineered traffic control plan
Description of work
DocuSign Envelope ID: 7371F8F1-1D76-400C-BDF5-239911716B3D
13.653%
Signatory Lines will be updated by Purchasing if required
SUBMITTED BY:_______________________________
ACCEPTED BY EXECUTIVE MANAGER OF UTILITIES _______________________________
ACCEPTED BY CONTRACTOR: ____________________________________________________________
Name, Title
CITY MANAGER:_______________________________
ATTEST: CITY SECRETERY _______________________________
PURCHASING:_______________________________
APPROVED AS TO LEGAL FORM:_______________________________
THE AFOREMENTIONED CHANGE, AND WORK AFFECTED THEREBY,
Project Manager
Percent Changes over NTE:
Signature
IS SUBJECT TO ALL CONTRACT STIPULATIONS AND COVENANTS.
Signature
Signature
Signature
Signature
Signature
Contractor Name Project Name - Phase CO#1 180,511.70
DocuSign Envelope ID: 7371F8F1-1D76-400C-BDF5-239911716B3D
Executive Vice PresidentDriskoll Tubbs
SINCE 1906
WE ARE AN EQUAL OPPORTUNITY CONTRACTOR
john burns
construction company
of Texas, Inc.
P.O. BOX 1117
LEWISVILLE, TEXAS 75067
METRO (972) 434-6789
FAX NO (972) 221-8301
DRISKOLL TUBBS MIKE BORSTAD CLAUDIA THOMAS JEROME P. KAMRADT
Executive Vice President Vice President - Operations Secretary Treasurer
January 27, 2021
Attn: Mark Zimmerer
RE: 60” Steel Casing Install
Dear Mr. Zimmerer,
We are pleased to submit this proposal for construction of the following described work:
Description of Work: 60” Steel Casing
Location: Denton, Texas
Quantities and Prices: SEE ATTACHED SHEETS FOR BREAKOUT OF UTILITIES
Notes:
1. In accordance with the Home Builders Association’s memo, we are not including State Sales Tax on the material on
this project when the work is located in public right of way and easements. In event that there should be a reversal of the
State Comptroller’s ruling which would cause tax to be paid, we reserve the right to submit you a bill for the tax. State
sales tax is excluded from our bid.
2. We exclude the following: testing of our compaction and concrete; sleeves of any type; all overhead and underground
franchise utility (telephone, gas, CATV, etc.) new installations, removals and/or relocations, except as indicated in bid
items; demolition of existing site features, except as indicated in bid items; grass, landscape and irrigation removals or
replacements.
3. Bonds are not included in our bid. Trench safety is included in our price.
4. Our bid includes haul off of our utility spoils.
5. Our price includes excavation, required materials, backfill and embedment as required for the installation of our
utilities.
6. We specifically exclude all water, waste water, storm sewer, gas, irrigation and irrigation repairs, trench drains, and
landscape (including seeding, sodding and hydromulch) work from our bid, unless otherwise noted.
7. Erosion control systems are excluded from our quote. We will remove and replace devices installed by others, to
perform our work, and provide advance documentation notice. All design, maintenance, final removals, SWPPP, NOI,
NOT and other documentation is by others.
8. Should contaminated soils be discovered, work shall be stopped. We specifically exclude any haul off and or site
remediation. We will recommence work when the site has been deemed clear and free of hazardous materials.
9. We do not include dewatering more than what one 2” pump will handle. Any dewatering measures greater than that
will be considered a change order.
DocuSign Envelope ID: 7371F8F1-1D76-400C-BDF5-239911716B3D
SINCE 1906
WE ARE AN EQUAL OPPORTUNITY CONTRACTOR
***
This proposal is based on Plans prepared by Freese and Nichols dated 1/17/20. Our price is valid for 60 days after the
date on the letterhead of this proposal.
Plumbing fees, all permits, impact, pro-rata fees and city permit fees are not included in our price.
JBCCO is committed to following all applicable standards set by the Occupational Safety and Hazard Administration
(OSHA), Contractor acknowledges that JBCCO will follow the Fall Protection Standard 29 CFR 1926.501(b)(7)
Subpart M as related to excavations, which states,
Each employee at the edge of an excavation 6 feet (1.8m) or more in depth shall be protected from falling by guardrail
systems, fences, or barricades when the excavations are not readily seen because of plant growth or other visual barrier.
OSHA Interpretation: 2The fall protection requirements in paragraph (b)(7)(ii) would not normally apply, since trenches
usually are narrow and long, and so are not normally similar to "a well, pit, or shaft."
Each employee at the edge of a well, pit, shaft, and similar excavation 6 feet (1.8m) or more in depth shall be protected
from falling by guardrail systems, fences, barricades, or covers.
Under these provisions, if the trench is not readily visible because of plant growth or other visual barrier, fall protection
is required. Unless the trench is obscured from view, there is no requirement for fall protection to be provided. JBCCO
will not use fall protection unless it meets the criteria above as stated in 1926.501(b)(7)(ii) Subpart M of the 29 CFR
1926 OSHA Construction Standards.
This contract is subject to the Federal Contract Compliance of the United States Department of Labor under Executive
Order # 11246, dated September, 1965.
This proposal is on a unit price basis. This proposal is also based on all engineering, grades and alignments being
furnished by the owner and/or general contractor, together with all necessary permits from the City, County, State or
other interested parties. We exclude field engineering and layout for our work.
This proposal or contract is subject to cancellation if a National Emergency should cause materials to become
unavailable.
Sincerely,
Matt Leazer
Lead Estimator
DocuSign Envelope ID: 7371F8F1-1D76-400C-BDF5-239911716B3D
"' "' ~ c-.:
I N 0
I 0 8 N I Q_
0
"' Q_
I
"" ""' Q_
I w z z 0 CD I c= "' 0 z:
FUTIJR£·--
RIS£R POLE
STA 1+!.i0.2,5-----,
BEGIN DUCT BANK A-1
' , ~
FUTIJR£ TRANSMISSION--...:._'-
DUCT BANK IMPROV£M£NTS ~,
I [STA ~+;~4/BANK B-1 ""''
_-_L ----"------....!!.t._oa0 ""' ..... :~ ' PROP DUCT BANK
B-1 C£NT£RUN£
______,;
NOT£:
1. ALL O£SIGNA T£0 FUTIJR£ WORK WILL B£ BUlL T
WITH TH£ NEXT CONSTRUCTION £NGIN££RING
PLANS (C£P) SUBMITTAL.
FUTIJR£ 42•
WATERUN£
FUTIJR£ R. 0. W.--"""'
WITH BONN/£ BRA£
NEW IMPROV£M£NTS
EX R.O.W.
EX B.O.C.
STA 3+47.19 DUCT BANK A =------,.
STA 246+63.89 PROP BONN/£ BRA£ ST
N 7128742.607
£2378219.695
r-PI<:?OP DUCT BANK 60• STEEL CAS1NG'
A-1 C£NT£RUN£ FOR FUTIJR£ 42•
WATER UN£
BY OTHERS
STA 10+00.170----'
£NO DUCT BANK B-1
BEGIN DUCT BANK B-2
r:--I
~-1
EX R.O. ---------·---
----EXSE:ciJR:ITY.:::...::;tl tm
SCREEN WALL
FUTIJR£ f BOI!rN/£·--.J .
B~£STR££T ~u
Cl
I
"'
II
I I
I
.-J'Rf'JP I ~.o.w.
I
I
I
~l~'ll R.Ol W.
I
I
I
I
I
I I
B.O.C.
WALL
FOOTPRINT
'h>-11----1.4-1---PROP 10' SIDEWALK ct
. . . l .,
,4 .•
. · ..
' .
PU£1UC UTiliTY I
£ASfM£NT :
I I
10f:45.59 DUcriBANK B =
STA 248+44.89 PRlf BONN/£ BRA£ ST
N 712Blj3.607
£ 23782/9.618 :
WALL I PROP DUCT
FOOTPRINT I BANK AB-2
PROP DU~T BANK :
A-2 CO(T£RUN£ I
lPRtlP DUCT I
/1 1:1.4NK AB-11 I
I I
---i-1 --.~......j-1--f
STA 4+50.00
£NO DUCT BANK A-2
~-FUTIJR£ TRANSMISSION
DUCT BANK IMPROV£M£NTS
I I lk=: ======~I FUTURE HICKORY
GIS SUBSTATION I : I\_ "11=;1=5 -"jj'=-~~
LP11?itP DUCT BA~K B-2 STA 11+5p.oo
ctNpUN£ END DUCT:
I BANK B-~
I I \
I I \
I I \
____!!:t\a I \
\. ~STA 1~+19.00 £NO DUCT BANK C-2
\_PROP \OISTR/BUTI~
OUC~ANK C-2 1
CENrEfUN£ I
I I
I I
I I
I I
~-FUTIJR£ TRANSMISSION
DUCT BANK IMPROV£M£NTS
V STA 1+30.86
' BEGIN DUCT BANK C
' FUTIJR£ ~ DUCT&<M<
/\ PROP DUCT BANK 0
C£NTERUN£
I PROP oucT------'-_
I
I
BANK 0-1 y.._
I
tnp
~
GRAPHIC SCALE
20 0 10 20 40 --------
",l
I
I
~ ' STA 2+90.01 £NO DUCT BANK C
I _ .. I . I. I
I
..... ..J .. I
• I
PRl"JP 3' SIDEWALK
£AS£M£NT
PROP DUCT~ '-
BANKO\ ~,-,,
Duct Bank Plan with Future Bonnie Brae
-~'--- -.....,;2:.:j=O:____
' ..
21
DocuSign Envelope ID: 7371F8F1-1D76-400C-BDF5-239911716B3D
Certificate Of Completion
Envelope Id: 7371F8F11D76400CBDF5239911716B3D Status: Completed
Subject: Please DocuSign: City Council Contract 7420, Amendment 1
Source Envelope:
Document Pages: 6 Signatures: 7 Envelope Originator:
Certificate Pages: 6 Initials: 1 Christa Christian
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
Christa.Christian@cityofdenton.com
IP Address: 198.49.140.104
Record Tracking
Status: Original
5/4/2021 8:13:15 AM
Holder: Christa Christian
Christa.Christian@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Christa Christian
christa.christian@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.104
Sent: 5/4/2021 8:32:49 AM
Viewed: 5/4/2021 8:32:57 AM
Signed: 5/4/2021 8:35:03 AM
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: 198.49.140.10
Sent: 5/4/2021 8:35:05 AM
Viewed: 5/5/2021 9:35:04 AM
Signed: 5/5/2021 9:39:48 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Mark Zimmerer
mark.zimmerer@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 5/5/2021 9:39:50 AM
Viewed: 5/5/2021 10:12:04 AM
Signed: 5/5/2021 10:12:55 AM
Electronic Record and Signature Disclosure:
Accepted: 5/5/2021 10:12:04 AM
ID: d4be1f1d-c733-4d73-a177-f68c2b9702eb
Marcella Lunn
marcella.lunn@cityofdenton.com
Deputy City Attorney
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 68.185.202.16
Sent: 5/5/2021 10:12:57 AM
Viewed: 5/5/2021 12:44:30 PM
Signed: 5/5/2021 12:45:23 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Signer Events Signature Timestamp
Driskoll Tubbs
dtubbs@jbcco.com
Executive Vice President
John Burns Construction Co. of Texas Inc.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 168.61.214.201
Sent: 5/5/2021 12:45:26 PM
Viewed: 5/6/2021 7:53:40 AM
Signed: 5/6/2021 12:40:43 PM
Electronic Record and Signature Disclosure:
Accepted: 5/6/2021 7:53:40 AM
ID: d25094eb-ed0d-4189-83ac-cabd27c6f2e1
Antonio Puente
Antonio.Puente@cityofdenton.com
DME General Manager
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 174.246.135.239
Signed using mobile
Sent: 5/6/2021 12:40:46 PM
Viewed: 5/6/2021 3:15:34 PM
Signed: 5/6/2021 3:15:58 PM
Electronic Record and Signature Disclosure:
Accepted: 5/6/2021 3:15:34 PM
ID: 83b3b6b6-6bbb-48f0-b925-bdbfd5250c13
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.10
Sent: 5/6/2021 3:16:01 PM
Viewed: 6/9/2021 11:42:46 AM
Signed: 6/9/2021 11:42:58 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Sara Hensley
sara.hensley@cityofdenton.com
Interim City Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 6/9/2021 11:43:03 AM
Viewed: 6/9/2021 12:53:08 PM
Signed: 6/9/2021 12:53:15 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Rosa Rios
rosa.rios@cityofdenton.com
City Secretary
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 6/9/2021 12:53:17 PM
Viewed: 6/9/2021 1:15:51 PM
Signed: 6/9/2021 1:16:36 PM
Electronic Record and Signature Disclosure:
Accepted: 6/9/2021 1:15:51 PM
ID: fae9f478-b495-426b-b3b6-c683d58ddc97
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
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 5/4/2021 8:35:05 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Gretna Jones
gretna.jones@cityofdenton.com
Legal Secretary
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 6/9/2021 11:43:02 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
City Secretary Office
citysecretary@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Sent: 6/9/2021 1:16:39 PM
Viewed: 6/9/2021 1:25:25 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 5/4/2021 8:32:49 AM
Certified Delivered Security Checked 6/9/2021 1:15:51 PM
Signing Complete Security Checked 6/9/2021 1:16:36 PM
Completed Security Checked 6/9/2021 1:16:39 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. 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.
Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Mark Zimmerer, Driskoll Tubbs, Antonio Puente, Rosa Rios
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.