7178 - Informal Amendment 1 Exeucted - Midwest
Docusign Transmittal Coversheet
File Name
Purchasing Contact
Contract Expiration
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
7178 - Kennel and Veterinary Supplies
March 17, 2025
Kayla Clark
Procurement
901 B Texas St., Denton, TX 76209 (940) 349-7100
OUR CORE VALUES
Inclusion Collaboration Quality Service Strategic Focus Fiscal Responsibility
June 27, 2024
Ms. Jennifer Flickinger
Midwest Veterinary Supply, Inc.
21467 Holyoke Ave.,
Lakeville, MN 55044
jennifer.flickinger@midwestvet.net
Re: 7178 - Kennel and Veterinary Supplies
Dear Ms. Flickinger,
Thank you for being such a valued partner. By signing this Amendment below, COD and Midwest
Veterinary Supply, Inc. agree that the Contract is hereby deemed amended to the updated Schedule
of Charges, as shown in Attachment A.
Except as amended by this Amendment, the Contract is not otherwise amended and all other terms
and conditions of the Contract remain in full force and effect, as amended hereby. This Amendment
may be executed in any number of counterparts, each of which shall be deemed an original and all of
which together shall constitute one and the same instrument. Signatures transmitted electronically
shall have the same effect as the delivery of original signatures.
The City of Denton reserves the right to re-evaluate pricing as the market conditions change and can
ask your firm to provide updated proposed pricing, including, but not limited to, a decrease in
pricing, as a result of any such change.
We look forward to future business with your firm.
Regards,
____________________________ ___________________________
Kayla Clark, Buyer Jennifer Flickinger
Procurement or Authorized Representative
City of Denton Midwest Veterinary Supply,
Inc.
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
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DATE
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CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
1
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
350.10070.2 DIPQUICK 1 FIXATIVE TEAL 500ml 1.00 EA 24.0000 24.00
J0322A1
350.10072.2 DIPQUICK 2 STAIN RED 500ml 1.00 EA 27.0000 27.00
J0322A2
350.10074.2 DIPQUICK 3 COUNTER STAIN BLUE 1.00 EA 27.8500 27.85
J0322A3 500ml
733.67500.3 PILL WRAP 56 SERV 1.00 EA 10.2300 10.23
191.32060.3 CEPHALEXIN CAPS 500mg 500ct 1.00 BO 38.3300 38.33
(KEFLEX)
000.12017.2 MVET LOCK COLLAR W/TAB 35cm 1.00 EA 5.7330 5.73
(CLIC TYPE) (22"-26")
193.12358.3 CLAVACILLIN DROPS 50mg/15ml 1.00 EA 11.9300 11.93
(AMOX & CLAV POT ORAL SUS)
562.30804.3 CHLORHEXIDINE Q SCRUB 2% 1.00 EA 47.1500 47.15
GAL
193.13291.3 DEXMEDESED INJ .5mg/ml 10ml 1.00 EA 113.2200 113.22
(DEXMEDETOMIDINE HYDRO)
724.35120.3 EPI-OTIC ADVANCED 8oz 1.00 BO 11.7200 11.72
191.45670.3 GABAPENTIN TABS 600mg 500ct 1.00 BO 23.4400 23.44
(NEURONTIN)
000.50052.3 MVET ISOPROPYL ALCOHOL 70% 1.00 BO 4.2780 4.28
QUART
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
ATTACHMENT A
QUOTE PAGE
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DATE
B S
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CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
2
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
193.50382.2 MONOSWIFT PS 2/0 PFS1 36" 1.00 EA 60.7300 60.73
PS0943 VIOLET 12ct
193.50383.2 MONOSWIFT PS 3/0 PFS1 36" 1.00 EA 60.7300 60.73
PS0942 VIOLET 12ct
000.12016.2 MVET LOCK COLLAR W/TAB 30cm 1.00 EA 4.4190 4.42
(CLIC TYPE)(18"-22.25")
000.07011.2 MVET 2" COHESIVE WRAP 1.00 PK 38.0604 38.06
NEON COLOR PK 36 ROLLS/BOX
751.79995.2 SYR 1cc LL 100ct 1.00 BX 40.6200 40.62
BD >
193.75805.2 SYR 10cc LS 100ct 1.00 BX 24.3700 24.37
SURVET
193.75860.2 SYR 5cc LL 100ct 1.00 BX 21.8100 21.81
SURVET
193.75880.2 SYR 60cc LL 25ct 1.00 BX 23.0200 23.02
SURVET
349.12100.3 DOLOREX INJ 10mg/ml 50ml C-IV 1.00 BO 190.9000 190.90
(BUTORPHANOL)
193.40620.3 KETAMINE 100mg/ml 10ml CIII(N) 1.00 EA 7.3200 7.32
DECHRA LABEL
578.01561.5 FORTIFLORA CANINE CHEW TABS 1.00 CA 298.1400 298.14
PRO PLAN PROBIOTIC 6x90ct
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
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DATE
B S
I H
L I
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T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
3
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
573.00211.4 OK STERI STRIPS 4" 250ct 1.00 BX 16.8000 16.80
193.69001.3 RESCUE CONCENTRATE 5 GAL PAIL 1.00 EA 180.9400 180.94
193.00132.2 RESCUE PUMP 5 GAL 1oz PER PUMP 1.00 EA 7.5100 7.51
001.38721.2 STERILIZATION POUCH 3.5"X9" 1.00 EA 8.2100 8.21
200ct
193.00181.2 GARDEN HOSE GUN 1.00 EA 12.7500 12.75
193.75960.2 SYR TB 1cc LS NO NDL 100ct 1.00 BX 16.4600 16.46
SURVET
193.75940.2 SYR 3cc LL 22gaX3/4" 100ct 1.00 BX 14.1600 14.16
SURVET
191.47640.3 HYDROXYZINE HCL TABS 25mg 1.00 BO 2.4500 2.45
100ct (ATARAX)
266.62000.3 NUTRI-CAL 4.25oz 1.00 TB 9.5000 9.50
349.87000.3 TRI-HEART PLUS 68mcg 10X6ct 1.00 BX 142.8000 142.80
BLUE UP TO 25lbs
349.87020.3 TRI-HEART PLUS 136mcg 10x6ct 1.00 BX 191.8000 191.80
GREEN 26-50lbs
349.87040.3 TRI-HEART PLUS 272mcg 10X6ct 1.00 EA 249.9000 249.90
BROWN 51-100lbs
191.19000.3 AZITHROMYCIN ORL PWD 100mg/5ml 1.00 BO 3.0000 3.00
15ml (ZITHROMAX)
191.19040.3 AZITHROMYCIN ORL PWD 200mg/5ml 1.00 BO 2.8900 2.89
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
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DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
4
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
30ml (ZITHROMAX)
885.10390.3 DIROBAN 50mg w/DILUENT 5pk 1.00 EA 275.0000 275.00
349.56030.1 NOBIVAC CANINE 1-DAPPv 25X1ds 1.00 PK 91.7500 91.75
349.56620.1 NOBIVAC 3-RABIES 5X10ds 1.00 PK 78.5000 78.50
349.56500.1 NOBIVAC FELINE 1-HCP 25X1ds 1.00 PK 76.5000 76.50
349.56420.1 NOBIVAC INTRA-TRAC 3 25X1ds 1.00 PK 93.5000 93.50
578.20025.5 CANINE EN HOSPITAL PACK 25lb 1.00 EA 36.7000 36.70
475.20065.2 INSTRUMENT CLEANER/LUBE GAL 1.00 EA 32.2400 32.24
3-710
000.19074.2 MVET SURGICAL DRAPE 30"X30" 1.00 EA 9.6300 9.63
W/4"X.75" FENESTRATIN GREEN
000.36316.2 MVET GERMAN 6.75" MAYO 1.00 EA 18.4644 18.46
SCISSORS STRAIGHT
000.36318.2 MVET ROCHESTER CARMALT 1.00 EA 21.2400 21.24
6.25" GERMAN CURVED
000.19076.2 MVET SURGICAL DRAPE 30"X30" 1.00 EA 9.5940 9.59
W/7"X1.25" FENESTRATION GREEN
000.19074.2 MVET SURGICAL DRAPE 30"X30" 1.00 EA 9.6300 9.63
W/4"X.75" FENESTRATIN GREEN
000.19050.2 MVET SURGICAL TOWEL 18"X33" 1.00 EA 2.7540 2.75
BLUE
000.36308.2 MVET 4.75" ADSON BROWN GERMAN 1.00 EA 19.3600 19.36
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
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T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
5
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
000.36463.2 MVET 5.5" GERMAN OLSEN HEGAR 1.00 EA 57.8220 57.82
NEEDLE HOLDER TUNGSTEN CARBIDE
193.62406.3 PRAZIQUANTEL INJ 50ml 1.00 EA 382.4200 382.42
(BIMEDA LABEL)
350.11151.2 SODA LIME 3lb BAG 1.00 BG 8.4000 8.40
J0553
015.36102.2 SYR ALLISON 35ml 50ct LS 1.00 EA 17.3200 17.32
NO NDL #111-7435
001.12214.2 SYR 50-60cc ELS w/CAP 25ct 1.00 EA 13.1500 13.15
EXEL
552.50000.4 SPAY HOOK 8" 1.00 EA 17.8500 17.85
2-28131 *DS*
191.57350.3 PREDNISONE TABS 10mg 1000ct 1.00 BO 28.5000 28.50
(ORASONE)
001.09042.2 GLOVES SURGICAL LATEX PF 6.5 1.00 EA 40.6600 40.66
50ct ENCORE SENSI-TOUCH
295.92200.2 VICRYL 4/0 SH1 27" VIOLET 36ct 1.00 BX 214.6600 214.66
J310H
052.01006.3 MAX & MOLLY 500g (17.64oz) 1.00 EA 19.9800 19.98
FREEZE DRIED BEEF LIVER TREAT
001.14305.2 GOWN ISOLATION YELLOW 50ct 1.00 EA 66.7500 66.75
733.93000.3 CLEVOR .3ml PRE-FILLED DROPPER 1.00 EA 125.4800 125.48
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
6
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
5pk
349.65100.3 PANACUR GRANULES CANINE 1lb 1.00 EA 403.3500 403.35
FENBENDAZOLE
349.99990.3 MEASURING SCOOP & DISPENSING 1.00 EA .0000 .00
BAGS FOR PANACUR GRANULES
191.26890.3 BUPRENORPHINE INJ .3mg/ml CIII 1.00 BX 84.8800 84.88
5x1ml VIALS (PAR)
349.12100.3 DOLOREX INJ 10mg/ml 50ml C-IV 1.00 BO 190.9000 190.90
(BUTORPHANOL)
515.00719.3 CARPRIEVE INJ 50mg/ml 50ml 1.00 EA 137.2500 137.25
CARPROFEN
046.15000.2 COOL CARE PLUS 15.5oz 1.00 EA 8.3400 8.34
ANDIS
000.36307.2 MVET 5.5" KELLY HEMOSTAT 1.00 EA 20.6080 20.61
CURVED GERMAN
562.57205.3 NOROCILLIN SUSPENSION 250ml 1.00 EA 20.2400 20.24
PROCAINE PEN-G
052.50310.3 OPTIXCARE EYE LUBE PLUS 20gm 1.00 TB 8.7700 8.77
EA
053.59000.3 PYRANTEL PAMOATE QT 1.00 EA 22.2400 22.24
ORAL-PRO LABEL
001.14168.2 SILVER NITRATE STICKS 100ct 1.00 BG 18.3100 18.31
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
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DATE
B S
I H
L I
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T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
7
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
DUKAL
001.14801.2 GLOVES EXAM NITRILE PF SM 1.00 EA 6.5100 6.51
200ct
004.40200.3 LACTATED RINGERS 1000ml 1.00 BG 6.5600 6.56
000.71050.4 MVET SHARPS CONTAINER 1.00 EA 4.0388 4.04
RED 4qt SM W/CHIMNEY TOP
475.00214.2 SCALPEL BLADE SS 15 STERILE 1.00 EA 36.8700 36.87
4-315 100ct MILTEX
193.00186.2 RESCUE LID FOR FOAMER 1.00 EA 3.3900 3.39
BLUE
193.17556.3 EPINEPHRINE INJ 1:1000 50ml 1.00 EA 29.1100 29.11
586.00010.3 MAROPITANT 16mg 1x4ct 1.00 EA 11.1800 11.18
(MAROPITANT TABLET)
586.00012.3 MAROPITANT 24mg 1x4ct 1.00 EA 11.5700 11.57
(MAROPITANT TABLET)
586.00014.3 MAROPITANT 60mg 1x4ct 1.00 EA 21.1000 21.10
(MAROPITANT TABLET)
191.52005.3 METOCLOPRAMIDE INJ 5mg/ml 2ml 1.00 BO 32.7400 32.74
25ct (REGLAN)
191.55010.3 ONDANSETRON INJ 2mg/ml 20ml 1.00 BO 3.1600 3.16
(ZOFRAN)
193.59751.3 OXYTOCIN 100ml (BIMEDA LABEL) 1.00 EA 9.0100 9.01
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
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DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
8
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
586.00016.3 MAROPITANT 160mg 1x4ct 1.00 EA 24.5700 24.57
(MAROPITANT TABLET)
191.09010.3 ALLOPURINOL TABS 300mg 100ct 1.00 BO 4.3000 4.30
(ZYLOPRIM)
193.11050.3 COSEQUIN CAPS FOR CATS 80ct 1.00 BO 13.4800 13.48
000.00507.2 MVET BOSTON ROUND W/YORKER 1.00 EA 18.2070 18.21
2oz 50ct
247.80005.3 TRIZULTRA+KETO FLUSH 12oz 1.00 EA 18.2500 18.25
295.90000.2 VICRYL 6/0 P1 18" UNDYED 12ct 1.00 BX 203.9600 203.96
J489G
900.00005.3 VETIGEL HEMOSTATIC GEL 5ml SYR 1.00 EA 80.0000 80.00
2ct
900.00007.3 VETIGEL HEMOSTATIC GEL 5ml SYR 1.00 EA 200.0000 200.00
5ct
900.00009.3 VETIGEL HEMO GEL ACCESSORIES 1.00 EA 20.0000 20.00
2ct (PRECISION TIPS & ADAPTER)
577.31105.3 CEFPODERM TABS 200mg 100ct 1.00 EA 67.9700 67.97
(CEFPODOXIME PROXETIL)
193.11052.3 COSEQUIN FOR CATS SOFT CHEWS 1.00 EA 7.5200 7.52
60ct
193.52952.2 NDL HYPO 18gaX1.5" RW 100ct 1.00 EA 4.1100 4.11
ENGAUGE
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
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DATE
B S
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L I
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O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
9
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
193.52962.2 NDL HYPO 20gaX1" RW 100ct 1.00 EA 4.1100 4.11
ENGAUGE
193.59270.2 NDL HYPO 22gaX.1" RW 100ct 1.00 EA 4.1100 4.11
ENGAUGE
193.52880.2 NDL PH 22gaX3/4" RW 100ct 1.00 BX 7.4300 7.43
SURVET
193.07730.3 CARPROVET CHEWABLE TABS 75mg 1.00 EA 68.3400 68.34
180ct CARPROFEN
191.35540.3 CLINDAMYCIN CAPS 300mg 100ct 1.00 BO 10.5900 10.59
(CLEOCIN)
153.00608.3 FELIWAY SPRAY 219ml 1.00 BO 57.3700 57.37
PROFESSIONAL PACK
193.33270.3 ISOSPIRE (ISOFLURANE) 250ml 1.00 EA 30.9000 30.90
INHALATION ANESTHETIC
349.65620.3 PANACUR SUSPENSION GAL 1.00 GA 389.5500 389.55
FENBENDAZOLE
153.90040.3 THUNDEREASE PHEROMONE SPRAY 1.00 EA 22.4900 22.49
60ml
749.20000.3 FATAL-PLUS SOL. 250ml C-II(N) 1.00 BO 104.0000 104.00
PENTOBARBITAL SODIUM
578.00328.5 FELINE HYDRA CARE 6X12ct 1.00 CA 59.9400 59.94
DRY VET SUPPLEMENTS
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
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DATE
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CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
10
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
578.01561.5 FORTIFLORA CANINE CHEW TABS 1.00 CA 298.1400 298.14
PRO PLAN PROBIOTIC 6x90ct
080.00064.2 BREATHING BAG 2 LITER 7/8 BUSH 1.00 EA 16.5900 16.59
NECK BICKFORD
553.00001.3 CERENIA INJ 10mg/ml 20ml 1.00 EA 210.8000 210.80
885.10380.3 CONVENIA 10ml 1.00 EA 423.5000 423.50
191.42390.3 DOXYCYCLINE HYCLATE TABS 1.00 BO 20.5200 20.52
100mg 500ct (VIBRA-TABS)
001.14803.2 GLOVES EXAM NITRILE PF LG 1.00 EA 6.5100 6.51
200ct
001.14802.2 GLOVES EXAM NITRILE PF MED 1.00 EA 6.5100 6.51
200ct
515.50005.3 LOXICOM INJ 5mg/ml 20ml 1.00 EA 112.1900 112.19
MELOXICAM
000.02030.2 MVET BASIC CLEAR COLLAR 25cm 1.00 EA 3.3480 3.35
(15.5"-19")
733.67500.3 PILL WRAP 56 SERV 1.00 EA 10.2300 10.23
562.80852.3 REVERTIDINE 5mg/ml 10ml 1.00 EA 118.3300 118.33
(ATIPAMEZOLE HYDROCHLORIDE)
321.55000.2 SYR ORAL W/CAP 1cc CLEAR 1.00 EA 16.8500 16.85
W/BLUE PLUNGER 50ct
321.55004.2 SYR ORAL W/CAP 3cc CLEAR 1.00 EA 17.5900 17.59
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
11
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
W/BLUE PLUNGER 50ct
432.00191.2 BREATHING BAG 3 LITER 1.00 EA 40.0000 40.00
432.00215.2 BREATHING BAG 1 LITER 1.00 EA 40.0000 40.00
432.00192.2 BREATHING BAG 4 LITER 1.00 EA 40.0000 40.00
350.60901.2 SHARPS CONTAINER .5 LITER 1.00 EA 3.0000 3.00
J0886A
470.00018.4 AUTOCLAVE TAPE LF 1/2"X60yd 1.00 EA 3.6600 3.66
COMPLY STEAM INDICATOR TAPE
350.10698.2 IV EXTENSION SET W/T SM BORE 1.00 EA 5.9000 5.90
J0467E 5.5" NEEDLELESS
350.05483.2 BREATHING BAG 2 LITER 1.00 EA 32.0000 32.00
J0249R2
193.03705.3 ATROPINE SULFATE 1/120gr 100ml 1.00 BO 23.7500 23.75
.54mg/ML
350.78725.2 ELASTIC ADHESIVE BANDAGE 2" 1.00 EA 14.5000 14.50
J1030A 6ct
001.10700.2 ELASTIKON 1"X2.5yd 12ct 1.00 BX 26.2800 26.28
5172 >
193.17556.3 EPINEPHRINE INJ 1:1000 50ml 1.00 EA 29.1100 29.11
000.06061.2 MVET WHITE POROUS TAPE 1" 1.00 BX 12.5764 12.58
12ct
000.06062.2 MVET WHITE POROUS TAPE 2" 1.00 BX 12.4936 12.49
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
12
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
6ct
586.00014.3 MAROPITANT 60mg 1x4ct 1.00 EA 21.1000 21.10
(MAROPITANT TABLET)
578.00328.5 FELINE HYDRA CARE 6X12ct 1.00 CA 59.9400 59.94
DRY VET SUPPLEMENTS
191.26890.3 BUPRENORPHINE INJ .3mg/ml CIII 1.00 BX 84.8800 84.88
5x1ml VIALS (PAR)
350.11122.2 CENTRIFUGE TUBES DISP 15ml 1.00 BX 17.7000 17.70
J0546A CONICAL POLYSTYR 100ct
193.50388.2 MONOSWIFT PS 0 PFSL 36" VIOLET 1.00 EA 60.4900 60.49
PS0987 12ct
015.36100.2 SYR ALLISON 12ml 100ct LS 1.00 EA 16.8600 16.86
NO NDL
432.00191.2 BREATHING BAG 3 LITER 1.00 EA 40.0000 40.00
193.69003.3 RESCUE CONCENTRATE 55 GAL ** 1.00 EA 1646.0000 1646.00
DRUM
666.00018.3 AMOXI & CLAV.POT.OS-DROPS 15ML 1.00 EA 13.9400 13.94
50/12.5 MG (62.5MG/M)
191.19000.3 AZITHROMYCIN ORL PWD 100mg/5ml 1.00 BO 3.0000 3.00
15ml (ZITHROMAX)
350.70000.3 BARIUM SULFATE SUSPENSION 16oz 1.00 BG 17.8000 17.80
J1350
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
13
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
000.20007.2 MVET THERMOMETER COVERS 1.00 EA 2.6010 2.60
100's ADI
052.50310.3 OPTIXCARE EYE LUBE PLUS 20gm 1.00 TB 8.7700 8.77
EA
555.00250.3 TERRAMYCIN OPHTH OINT 1/8oz 1.00 TB 18.4000 18.40
349.87000.3 TRI-HEART PLUS 68mcg 10X6ct 1.00 BX 142.8000 142.80
BLUE UP TO 25lbs
349.87020.3 TRI-HEART PLUS 136mcg 10x6ct 1.00 BX 191.8000 191.80
GREEN 26-50lbs
349.87040.3 TRI-HEART PLUS 272mcg 10X6ct 1.00 EA 249.9000 249.90
BROWN 51-100lbs
000.19074.2 MVET SURGICAL DRAPE 30"X30" 1.00 EA 9.6300 9.63
W/4"X.75" FENESTRATIN GREEN
715.75197.2 BLACK BREATHING BAG .5 LITER 1.00 EA 17.2600 17.26
*DS*
193.13211.3 DEXIUM SP INJ 4MG 100ml 1.00 EA 31.7800 31.78
DEXAMETHASONE
000.05959.2 MVET COVER SLIPS GLASS 22X22 1.00 BX 2.1988 2.20
1OZ (APROX 156CT)
191.47650.3 HYDROXYZINE HCL TABS 25mg 1.00 BO 11.9100 11.91
500ct (ATARAX)
191.47670.3 HYDROXYZINE HCL TABS 50mg 1.00 BO 2.5300 2.53
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
14
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
100ct (ATARAX)
193.13214.3 DEXAMETHASONE INJ 2mg 100ml 1.00 BO 8.0600 8.06
001.09042.2 GLOVES SURGICAL LATEX PF 6.5 1.00 EA 40.6600 40.66
50ct ENCORE SENSI-TOUCH
885.10390.3 DIROBAN 50mg w/DILUENT 5pk 1.00 EA 275.0000 275.00
193.69008.3 RESCUE TB WIPES 6"X7" 160ct 1.00 EA 14.6100 14.61
DISINFECTANT
193.69020.3 RESCUE WIPES 11"X12" 160ct 1.00 EA 42.0600 42.06
BUCKET DISINFECTANT
366.03529.4 GAUZE SPONGE DERMACEA 3"X3" 1.00 EA 41.0500 41.05
4PLY 4000ct
193.75860.2 SYR 5cc LL 100ct 1.00 BX 21.8100 21.81
SURVET
130.40095.2 BOSTON ROUND AMBER .5oz w/20mm 1.00 EA .9800 .98
ORAPAC INSERT & 1ml ORAL SYR
000.12015.2 MVET LOCK COLLAR W/TAB 25cm 1.00 EA 3.2850 3.29
(CLIC TYPE) (15.5"-19")
000.40003.2 MVET PLASTIC DISPENS BAG 12X9 1.00 EA 11.7576 11.76
I HEART MY PET 100ct
366.60900.4 SYR ORAL 1cc 100ct 1.00 BX 17.0700 17.07
193.75823.2 SYR 10cc ELS 100ct 1.00 EA 24.4000 24.40
SURVET
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
15
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
193.75940.2 SYR 3cc LL 22gaX3/4" 100ct 1.00 BX 14.1600 14.16
SURVET
193.75855.2 SYR 3cc LS 100ct 1.00 BX 12.2800 12.28
SURVET
193.49492.3 MICONAHEX+TRIZ MOUSSE 7.1oz 1.00 EA 16.8700 16.87
733.88103.2 SIMPLERA OTIC SOLUTION 10X1ml 1.00 EA 139.6200 139.62
751.79995.2 SYR 1cc LL 100ct 1.00 BX 40.6200 40.62
BD >
712.45025.3 DIAGEL CAT 6X1ml 1.00 EA 74.6200 74.62
NEW FORMULA
712.45020.3 DIAGEL KITTEN 6X.5ml 1.00 EA 69.6200 69.62
NEW FORMULA
053.59000.3 PYRANTEL PAMOATE QT 1.00 EA 22.2400 22.24
ORAL-PRO LABEL
578.16220.5 CANINE AND/OR FELINE CN 1.00 CA 54.6700 54.67
CRITICAL NUTRITION 24x5.5oz
578.01536.5 FORTIFLORA SA PRO FELINE 1.00 CA 125.9400 125.94
30X1gm 6ct SYNBIOTIC ACTION
193.02352.3 CLAVACILLIN TABS 125mg 210ct 1.00 EA 117.2200 117.22
(AMOXICILLIN/CLAV.POT.)
193.02354.3 CLAVACILLIN TABS 250mg 210ct 1.00 EA 193.0400 193.04
(AMOXICILLIN/CLAV.POT.)
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
16
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
193.02356.3 CLAVACILLIN TABS 375mg 210ct 1.00 EA 275.8300 275.83
(AMOXICILLIN/CLAV.POT.)
193.02350.3 CLAVACILLIN TABS 62.5mg 210ct 1.00 EA 63.2600 63.26
(AMOXICILLIN/CLAV.POT.)
193.13291.3 DEXMEDESED INJ .5mg/ml 10ml 1.00 EA 113.2200 113.22
(DEXMEDETOMIDINE HYDRO)
198.26000.2 FECAL LOOP DUAL END 100ct 1.00 EA 12.9700 12.97
DISP FOR ADULT & PUPPY
193.50382.2 MONOSWIFT PS 2/0 PFS1 36" 1.00 EA 60.7300 60.73
PS0943 VIOLET 12ct
266.62000.3 NUTRI-CAL 4.25oz 1.00 TB 9.5000 9.50
302.00002.3 SOLUTIONKITS - GABAPENTIN 1.00 EA 82.0000 82.00
191.19000.3 AZITHROMYCIN ORL PWD 100mg/5ml 1.00 BO 3.0000 3.00
15ml (ZITHROMAX)
191.19040.3 AZITHROMYCIN ORL PWD 200mg/5ml 1.00 BO 2.8900 2.89
30ml (ZITHROMAX)
321.55000.2 SYR ORAL W/CAP 1cc CLEAR 1.00 EA 16.8500 16.85
W/BLUE PLUNGER 50ct
470.00369.4 VETBOND 3ml APPLICATOR BOTTLE 1.00 BO 22.2000 22.20
193.13291.3 DEXMEDESED INJ .5mg/ml 10ml 1.00 EA 113.2200 113.22
(DEXMEDETOMIDINE HYDRO)
475.20065.2 INSTRUMENT CLEANER/LUBE GAL 1.00 EA 32.2400 32.24
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
17
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
3-710
004.75900.3 SIMBADOL INJ 1.8mg/ml CIII 1.00 BO 305.2500 305.25
10ml (BUPRENORPHINE)
350.05414.2 MINI GELPI RETRACTOR 5.5" 1.00 EA 39.0000 39.00
J0240ME ECON *SO*
266.20100.3 FECASOL GAL 1.00 GA 39.3800 39.38
562.80852.3 REVERTIDINE 5mg/ml 10ml 1.00 EA 118.3300 118.33
(ATIPAMEZOLE HYDROCHLORIDE)
193.69003.3 RESCUE CONCENTRATE 55 GAL ** 1.00 EA 1646.0000 1646.00
DRUM
080.00100.2 F-AIR CANISTER 1.00 EA 5.7500 5.75
193.13340.3 DEXTROSE SOLUTION 50% 500ml 1.00 BO 3.6100 3.61
349.56030.1 NOBIVAC CANINE 1-DAPPv 25X1ds 1.00 PK 91.7500 91.75
349.56500.1 NOBIVAC FELINE 1-HCP 25X1ds 1.00 PK 76.5000 76.50
349.56420.1 NOBIVAC INTRA-TRAC 3 25X1ds 1.00 PK 93.5000 93.50
193.75823.2 SYR 10cc ELS 100ct 1.00 EA 24.4000 24.40
SURVET
193.75805.2 SYR 10cc LS 100ct 1.00 BX 24.3700 24.37
SURVET
193.75940.2 SYR 3cc LL 22gaX3/4" 100ct 1.00 BX 14.1600 14.16
SURVET
193.43111.3 LIDOCAINE HCL INJ 2% 100ml 1.00 BO 2.9900 2.99
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
QUOTE PAGE
QUOTE #
DATE
B S
I H
L I
L P
T T
O O
CUSTOMER PURCHASE ORDER NO.SHIP VIA TERMS SLMN
SPECIAL INSTRUCTIONS >
ITEM NO.DESCRIPTION QTY. ORDERED U/M PRICE AMOUNT
SUB - TOTAL TOTAL DISCOUNTS SHIPPING & HANDLING FREIGHT MISCELLANEOUS TAX TOTAL
MIDWEST VETERINARY SUPPLY, INC
18
21467 HOLYOKE AVENUE
22544272LAKEVILLE, MN 55044
6/25/24
0029495
LINDA MCNATT ANIMAL CARE #LINDA MCNATT ANIMAL CARE
901 TEXAS ST STE B 3717 N ELM ST
AND ADOPTION CENTER AND ADOPTION CENTER
U.S.A.U.S.A.
quote NET 30 DAYS 275
193.40620.3 KETAMINE 100mg/ml 10ml CIII(N) 1.00 EA 7.3200 7.32
DECHRA LABEL
193.08855.3 CHLORHEXIDINE SOLUTION 2% GAL 1.00 GA 9.7800 9.78
000.19074.2 MVET SURGICAL DRAPE 30"X30" 1.00 EA 9.6300 9.63
W/4"X.75" FENESTRATIN GREEN
15170.29 .00 .00 .00 .00 .00 15170.29
DENTON, TX 762094354 DENTON, TX 762077701
U.S.A.
Phone: (800)328-2975
Fax: (952)894-5407
Docusign Envelope ID: 53BC289D-402F-4D98-9C64-041995F37AE6
CONFLICT OF INTEREST QUESTIONNAIRE
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: 53BC289D-402F-4D98-9C64-041995F37AE6
MIDWEST VETERINARY SUPPLY, INC.
X
None
X
X
X
7/31/2024
X
Certificate Of Completion
Envelope Id: 53BC289D402F4D989C64041995F37AE6 Status: Completed
Subject: ***Purchasing Approval*** 7178 - Kennel and Veterinary Supplies- informal line amendment
Source Envelope:
Document Pages: 21 Signatures: 3 Envelope Originator:
Certificate Pages: 6 Initials: 2 Kayla Clark
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
901B Texas Street
Denton, TX 76209
kayla.clark@cityofdenton.com
IP Address: 198.49.140.10
Record Tracking
Status: Original
6/27/2024 7:23:48 AM
Holder: Kayla Clark
kayla.clark@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Kayla Clark
kayla.clark@cityofdenton.com
Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.10
Sent: 6/27/2024 7:34:32 AM
Viewed: 6/27/2024 7:34:42 AM
Signed: 6/27/2024 7:34:49 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: 198.49.140.104
Sent: 6/27/2024 7:34:51 AM
Viewed: 6/27/2024 7:47:24 AM
Signed: 6/27/2024 8:05:23 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Colleen Sachse
Colleen.sachse@midwestvet.net
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 75.73.98.44
Sent: 6/27/2024 8:05:25 AM
Resent: 7/1/2024 6:38:35 AM
Resent: 7/2/2024 1:11:07 PM
Resent: 7/5/2024 9:27:16 AM
Resent: 7/11/2024 1:14:39 PM
Resent: 7/15/2024 7:43:34 AM
Resent: 7/16/2024 7:42:10 AM
Resent: 7/22/2024 11:09:50 AM
Resent: 7/29/2024 8:44:52 AM
Resent: 7/29/2024 8:52:11 AM
Resent: 7/31/2024 7:21:37 AM
Resent: 7/31/2024 7:39:42 AM
Resent: 7/31/2024 8:02:50 AM
Viewed: 7/31/2024 8:05:52 AM
Signed: 7/31/2024 8:07:41 AM
Electronic Record and Signature Disclosure:
Accepted: 7/31/2024 8:05:52 AM
ID: aa338a0d-b36c-459d-b025-192337595572
Signer Events Signature Timestamp
Nikki Sassenus
Nikki.Sassenus@cityofdenton.com
Director of Animal Services
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 7/31/2024 8:07:43 AM
Resent: 8/5/2024 12:21:56 PM
Resent: 8/6/2024 8:03:13 AM
Viewed: 8/6/2024 8:15:29 AM
Signed: 8/6/2024 8:16:12 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Kayla Clark
kayla.clark@cityofdenton.com
Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 8/6/2024 8:16:14 AM
Viewed: 8/6/2024 8:18:53 AM
Signed: 8/6/2024 8:19:01 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
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
Procurement Administration Supervisor
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 8/6/2024 8:19:03 AM
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 6/27/2024 7:34:32 AM
Envelope Updated Security Checked 7/1/2024 6:38:35 AM
Envelope Updated Security Checked 7/1/2024 6:38:35 AM
Envelope Updated Security Checked 7/1/2024 6:38:35 AM
Envelope Updated Security Checked 7/31/2024 7:39:41 AM
Envelope Updated Security Checked 7/31/2024 7:39:41 AM
Envelope Updated Security Checked 7/31/2024 7:39:41 AM
Envelope Updated Security Checked 7/31/2024 8:02:48 AM
Envelope Updated Security Checked 7/31/2024 8:02:48 AM
Certified Delivered Security Checked 8/6/2024 8:18:53 AM
Signing Complete Security Checked 8/6/2024 8:19:01 AM
Completed Security Checked 8/6/2024 8:19:03 AM
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 1:59:03 PM
Parties agreed to: Colleen Sachse
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.