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6778 - Informal Amendment 2 Executed Docusign Transmittal Coversheet File Name Purchasing Contact Contract Expiration $'%&" %&$##! 0$7(5,$/60$1$*(0(17',9,6,21x%7(;$6675((7x'(17217(;$6 x)$; “Dedicated to Quality and Service” www.cityofdenton.com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ǆŚŝďŝƚϭ ZĞƐƉŽŶĚĞŶdĞĐŚůŝŶĞ͕/ŶĐ͘ ŝƚǇ͕^ƚĂƚĞ &ŽƌƚtŽƌƚŚ͕dy /&ϲϳϳϴͲWƌŝĐŝŶŐ^ŚĞĞƚĨŽƌKsZ,EhEZ'ZKhE/^dZ/hd/KEdZE^&KZDZ^ dŚĞƌĞƐƉŽŶĚĞŶƚƐŚĂůůĐŽŵƉůĞƚĞƚŚĞĨŽůůŽǁŝŶŐǇĞůůŽǁͲŚŝŐŚůŝŐŚƚĞĚƐĞĐƚŝŽŶƐ͕ǁŚŝĐŚĚŝƌĞĐƚůǇĐŽƌƌĞƐƉŽŶĚƚŽƚŚĞƐƉĞĐŝĨŝĐĂƚŝŽŶƐ͘dŚĞĐŽŶƚƌĂĐƚŽƌƐŚĂůůŶŽƚŵĂŬĞĐŚĂŶŐĞƐƚŽƚŚŝƐĨŽƌŵĂƚ͘ 3URGXFW3URSRVDO3ULFLQJ)2%'(67,1$7,21 ITEM EST ANNUAL QTY UOM DESCRIPTION 2020 3rd Qtr Unit Pricing Section A: OVERHEAD - POLEMOUNTED TRANSFORMERS 11 EA TRANSFORMER, .5 kVA 120/208 $ 759.00 210 EA TRANSFORMER, 10 kVA 120/240V $ 907.00 312 EA TRANSFORMER, 15 kVA 120/240V $ 1,221.00 430 EA TRANSFORMER, 25 kVA 120/240V $ 1,302.00 518 EA TRANSFORMER, 50 kVA 120/240V $ 1,876.00 610 EA TRANSFORMER, 75 kVA 120/240V $ 2,851.00 71 EA TRANFORMER, 10kVA 240/480V $ 1,073.00 81 EA TRANSFORMER, 15 kVA 240/480V $ 1,507.00 91 EA TRANSFORMER, 25 kVA 240/480V $ 1,549.00 10 1 EA TRANSFORMER, 75 kVA 240/480V $ 3,004.00 11 1 EA TRANSFORMER, 100kVA 120/240V $ 4,054.00 12 1 EA TRANSFORMER, 100kVA 240/480V $ 3,932.00 13 1 EA TRANSFORMER, 167kVA 120/240V $ 5,867.00 14 1 EA TRANSFORMER, 167kVA 240/480V $ 4,890.00 15 1 EA TRANSFORMER, 50 kVA 277/480V $ 2,196.00 16 EA Standard price deduct for transformers supplied without required tank mounted Lightning Arrester assembly, coiled High Voltage lead and wildlife protector: $55.00 17 Transformer Manufacturer: _______Howard Industries 18 Only NEW parts & equipment are used in the manufacture of supplied transformers: YES or NO Yes 19 Authorized Distributor by Manufacturer? YES or NO Yes 20 WK Delivery can be made within ______ weeks of receipt of order.10-18 weeks TOTAL 3URGXFW3URSRVDO3ULFLQJ)2%'(67,1$7,21 ITEM EST ANNUAL QTY UOM DESCRIPTION 2020 3rd Qtr Unit Pricing Section B: UNDERGROUND - PADMOUNTED SINGLE-PHASE TRANSFORMERS 21 5 EA 50kVA PMT, 240/120V $ 2,504.00 22 12 EA 75kVA PMT, 240/120V $ 2,954.00 23 5 EA 100kVA PMT, 240/120V $ 3,647.00 24 21 EA 167kVA PMT, 240/120V $ 5,269.00 25 1 EA 15kVA PMT, 480/240V $ 1,972.00 26 1 EA 25kVA PMT, 240/120V $ 2,077.00 27 1 EA 25kVA PMT, 480/240V $ 2,109.00 28 1 EA 100kVA PMT, 480/240V $ 3,793.00 29 1 EA 167kVA PMT, 480/240V $ 5,440.00 30 1 EA 50kVA DELTA, 12.47kV DELTA HV 240/120V $ 3,011.00 TOTAL ǆŚŝďŝƚϭ ZĞƐƉŽŶĚĞŶdĞĐŚůŝŶĞ͕/ŶĐ͘ ŝƚǇ͕^ƚĂƚĞ &ŽƌƚtŽƌƚŚ͕dy /&ϲϳϳϴͲWƌŝĐŝŶŐ^ŚĞĞƚĨŽƌKsZ,EhEZ'ZKhE/^dZ/hd/KEdZE^&KZDZ^ dŚĞƌĞƐƉŽŶĚĞŶƚƐŚĂůůĐŽŵƉůĞƚĞƚŚĞĨŽůůŽǁŝŶŐǇĞůůŽǁͲŚŝŐŚůŝŐŚƚĞĚƐĞĐƚŝŽŶƐ͕ǁŚŝĐŚĚŝƌĞĐƚůǇĐŽƌƌĞƐƉŽŶĚƚŽƚŚĞƐƉĞĐŝĨŝĐĂƚŝŽŶƐ͘dŚĞĐŽŶƚƌĂĐƚŽƌƐŚĂůůŶŽƚŵĂŬĞĐŚĂŶŐĞƐƚŽƚŚŝƐĨŽƌŵĂƚ͘ 3URGXFW3URSRVDO3ULFLQJ)2%'(67,1$7,21 ITEM EST ANNUAL QTY UOM DESCRIPTION 2020 3rd Qtr Unit Pricing Section C: UNDERGROUND - PADMOUNTED THREE-PHASE TRANSFORMERS 31 6 EA TRANSFORMER, 3PH. UG 150 kVA 208Y/120V $ 9,266.00 32 3 EA TRANSFORMER, 3PH. UG 225 kVA 208Y/120V $ 11,068.00 33 1 EA TRANSFORMER, 3 PH UG 225kVA 240/120D $ 11,372.00 34 1 EA TRANSFORMER, 3PH. UG 225 kVA 480Y/277V $ 11,885.00 35 6 EA TRANSFORMER, 3PH. UG 300 kVA 208Y/120V $ 11,754.00 36 8 EA TRANSFORMER, 3PH. UG500kVA 208Y/120V $ 14,964.00 37 15 EA TRANSFORMER, 3PH. UG 300 kVA 480Y/277V $ 11,667.00 38 12 EA TRANSFORMER, 3PH. UG 500 kVA 480Y/277V $ 15,993.00 39 5 EA TRANSFORMER, 3PH. UG 1000 kVA 480Y/277V $ 25,107.00 40 2 EA TRANSFORMER, 3PH. UG 1500 kVA 480Y/277V $ 32,545.00 41 1 EA TRANSFORMER, 3PH. UG 2000 kVA 480Y/277V $ 40,661.00 42 1 EA TRANSFORMER, 3PH. UG 2500kVA 480Y/277V $ 55,526.00 43 1 EA TRANSFORMER, 3PH. UG 3000kVA 480Y/277V $ 59,461.00 44 1 EA TRANSFORMER, 3 PH. UG 75kVA 208Y/120V $ 8,161.00 45 1 EA TRANSFORMER, 3 PH. UG 112.5kVA 208y/120V $ 9,283.00 46 1 EA TRANSFORMER, 3 PH.UG 750kVA 208Y/120V $ 22,777.00 47 1 EA TRANSFORMER, 3 PH. UG 1000kVA 208Y/120V $ 29,648.00 48 1 EA TRANSFORMER, 3 PH.UG 112.5kVA 480Y/277V $ 8,965.00 49 1 EA TRANSFORMER, 3 PH. UG 150kVA 480Y/277V $ 10,037.00 50 1 EA TRANSFORMER, 3 PH. UG 750kVA 480Y/277V $ 21,795.00 51 1 EA TRANSFORMER, 3 PH. UG DELTA 300kVA 240/120V $ 13,166.00 52 2 EA TRANSFORMER, 3PH UG 2000 kVA 13200 DELTA 2400 $ 47,138.00 53 Single-Phase PMT Manufacturer:Howard Industries 54 Three-Phase PMT Manufacturer:Howard Industries 55 Only NEW parts & equipment are used in the manufacture of supplied transformers: (YES or NO): Yes 56 Authorized Distributor by Manufacturer? (YES or NO):Yes 57 Number of weeks for delivery:6-24 weeks TOTAL 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 Certificate Of Completion Envelope Id: E9456322203F492D963232A8C7CD5BEA Status: Completed Subject: ***Purchasing Approval*** 6778-Amendment 2 Source Envelope: Document Pages: 5 Signatures: 3 Envelope Originator: Certificate Pages: 5 Initials: 0 Crystal Westbrook AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) 901B Texas Street Denton, TX 76209 crystal.westbrook@cityofdenton.com IP Address: 198.49.140.104 Record Tracking Status: Original 7/16/2020 8:32:01 PM Holder: Crystal Westbrook crystal.westbrook@cityofdenton.com Location: DocuSign Signer Events Signature Timestamp Crystal Westbrook crystal.westbrook@cityofdenton.com Buyer City of Denton Security Level: Email, Account Authentication (None) Completed Using IP Address: 198.49.140.104 Sent: 7/16/2020 8:34:02 PM Viewed: 7/16/2020 8:34:09 PM Signed: 7/16/2020 8:39:37 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Nathan Chan nathan.chan@techline-inc.com Inside Sales Techline, Inc. Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 75.17.248.26 Sent: 7/16/2020 8:39:39 PM Viewed: 7/17/2020 8:12:25 AM Signed: 7/17/2020 1:44:46 PM Electronic Record and Signature Disclosure: Accepted: 7/17/2020 8:12:25 AM ID: 24c74f9d-49ee-4b52-b31b-9f83db18be7e Crystal Westbrook crystal.westbrook@cityofdenton.com Buyer City of Denton Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.49.140.104 Sent: 7/17/2020 1:44:47 PM Viewed: 7/17/2020 2:24:36 PM Signed: 7/17/2020 2:24:42 PM 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 Carbon Copy Events Status Timestamp Dustin Rolfe dustin.rolfe@cityofdenton.com Security Level: Email, Account Authentication (None) Sent: 7/17/2020 2:24:43 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Cheyenne Defee cheyenne.defee@cityofdenton.com Contract Administrator City of Denton Security Level: Email, Account Authentication (None) Sent: 7/17/2020 2:24:44 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp Wotary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 7/17/2020 2:24:44 PM Certified Delivered Security Checked 7/17/2020 2:24:44 PM Signing Complete Security Checked 7/17/2020 2:24:44 PM Completed Security Checked 7/17/2020 2:24:44 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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