19-1839ORDINANCE NO. 19-1$39
AN ORDINANCE OF THE CITY OF DENTON, A TEXAS HOME-RULE MUNICIPAL
CORPORATION, AUTHORIZING THE APPROVAL OF A THIRD AMENDMENT TO A
PROI'�SSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF DENTON AND HAZEN
AND SAWYER, P.C., AMENDING THE CONTRACT APPROVED BY CITY COUNCIL ON
JULY 21, 2015, IN THE NOT-TO-EXCCCD AMOUNT OF $427,368, AMENDED BY
AMENDMENTS 1-2 APPROVED BY CITY COUNCIL; SAID THIRD AMENDMENT TO
PROVIDE ADDITIONAL DESIGN AND CONSTRUCTION ADMINISTRATION SERVICES
FOR HICKORY CREEK BASIN PEAK FLOW DCTCNTION FACILITY, WCST PEAK FLOW
STORAGE BASIN AND PEAK FLOW PUMP STATION, AND HICKORY CREEK LIFT
STATION R�CONSTRUCTION DESIGN; PROVIDING FOR THE EXPENDITURE OF FUNDS
THEREFOR; AND PROVIDING AN EFFECTIVE DATE (FILE 5768 — PROVIDING FOR AN
ADDITIONAL THIRD AMENDMENT EXPENDITURE AMOUNT NOT-TO-EXCEED $470,449,
WITH THC TOTAL CONTRACT AMOUNT NOT-TO-�XCEED $1,202,814),
WHEREAS, on July 21, 2015, by Ordinance No. 2015-205, the City awarded a contract to
Hazen and Sawyer, P.C. in the amount of $427,368 for the I Iickory Creek Detention Facility project
(HCDF); and
WHEREAS, the additional fees under the proposed Third Amendment are fair and reasonable
and are consistent with and not higher than the recommended practices and fees applicable to the
Provider's profession and such fees do not exceed the maximum provided by law; NOW,
7'HEREFORE,
THE COUNCIL OF TIIE CITY OF DENTON HER�BY ORDAINS:
SECTION 1. The Third Amendment, increasing the amount of the contract between the City
and Hazen and Sawyer, P.C., which is on file in the of'Cce of the Purchasing Agent, in the amount of
Four Hundred Seventy Thousand Four Hundred Porty Nine and 00/100 ($470,449) Dollars, is hereby
approved and the expenditure of funds therefor is hereby authorized in accordance with said
amendment. The total contract amount increases to $1,202,814.
SECTIO
N 2. This ordinance shall become effective immediately upon its passage and
approval. �
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Aye Nay
Mayor Chris Watts: _ w,� ITIT _
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Gerard Hudspeth, District 1: w„���
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Keely G. Briggs, District 2: �� �`
Jesse Davis, District 3: w'�,�" mmmmmm
John Ryan, District 4: _mm�� .
Abstain Absent
Deb Armintor, At Large Place 5: ��,�` �
Paul Meltzer, At Large Place 6: ���� �
PASSED AND APPROVED this the ��j����� day of �����"�`�",�'�"; � 2019.
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C� �l�Cw." ATTS, MAYOR
ATTEST:
ROSA RIOS, CITY SECRETARY
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APPROVED AS TO LEGAL FORM:
AARON LEAL, CITY ATTORNEY
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Docusign City Counci) Transmitta) Coversheet
PSA 5768
File Name Design of Hickory Creek Basin Peak Flow Dentention Fac'
Purchasing Contact �ane Rogers
City Counci) Target Date AUgUst 13, 2019
Piggy Back Option Not Applicable
Contract Expiration "�A
Ordinance 19-1839
lity Amendment
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DocuSign Envelope ID: 03A7C792-6FC4-48D7-8DB3-B406F1 BFAD6A
THIRD AMENDMENT TO CONTRACT
BY AND BETWEEN THE CITY OF DENTON, TEXAS
AND HAZEN AND SAWYER P.C.
Contract 5768
THE STATE OF TEXAS §
COUNTY OF DENTON §
THIS THIRD AMENDMENT TO CONTRACT 5768 ("Amendment") by and
between the City of Denton, Texas ("City") and Hazen and Sawyer P.C. ("Consultant"); to
that certain contract executed on July 21, 2015, in the original not-to-exceed amount of
$427,368 (the "Original Agreement"); amended on Apri105, 2016 in the additional amount
of $112,758 aggregating a not-to-exceed amount of $540,126 (the "First Amendment");
amended on February 07, 2017 in the additional amount of $192,239 aggregating a not-to-
exceed amount of $732,365 (the "Second Amendment"); (collectively, the Original
Agreement, the First Amendment, and the Second Amendment are the "Agreement" ) are
for services related to the Hickory Street Basin Peak Flow Detention Facility project.
WHEREAS, the City deems it necessary to further expand the services provided by
Consultant to the City pursuant to the terms of the Agreement, and to provide an addition
to the design contract in a not-to-exceed amount of $89,905 and construction
administration services in a not-to-exceed amount of $380,544 with this Amendment for
an aggregate not-to-exceed amount of $1,202,814
FURTHERMORE, the City deems it necessary to further expand the goods/services
provided by CONSULTANT to the City;
NOW THEREFORE, the City and Consultant (hereafter collectively referred to as the
"Parties"), in consideration of their mutual promises and covenants, as well as for other
good and valuable considerations, do hereby AGREE to the following Amendment, which
amends the following terms and conditions of the said Agreement, to wit:
l. The additional services described in Exhibit "A" of this Amendment, attached
hereto and incorporated herein for all purposes, for addition to the design contract
and additional construction administration services described in Exhibit "B" of this
amendment attached hereto and incorporated herein for all purposes for Hickory
Street Basin Peak Flow Detention Facility Project, are hereby authorized to be
performed by Consultant. For and in consideration of the additional services to be
performed by Consultant, the Owner agrees to pay, based on the cost estimate
details attached as Exhibit "A" and Exhibit "B" to this Amendment, a total fee,
including reimbursement for non-labor expenses an amount not to exceed
$470,449.
5768 Contract — Amendment # 3 Page 1 of 2
DocuSign Envelope ID: 03A7C792-6FC4-48D7-8DB3-B406F1 BFAD6A
2. This Amendment modifies the Agreement amount to provide an additional
$470,449 for the additional services with a revised aggregate not to exceed total of
$1,202,814.
The Parties hereto agree, that except as specifically provided for by this Amendment, that
all of the terms, covenants, conditions, agreements, rights, responsibilities, and obligations
of the Parties, set forth in the Agreement remain in full force and effect.
IN WITNESS WHEREOF, the City and the Consultant, have each executed this
Amendment electronically, by anci�t���t�eir respective duly authorized representatives
and officers on this date .
"CITY"
CITY OF DENTON, TEXAS
A Texas Municipal Corporation
�DocuSigned 6y:
By� �D�4C �ki(,t,w�cun,
TODD HIL A�'��°�4MANAGER
ATTEST:
ROSA RIOS, CITY SECRETARY
B�7; DocuSigned by:
�'a�. iZ:.oz
1CSCA8C5E175493_.
THIS AGREEMENT HAS BEEN
BOTH REVIEWED AND APPROVED
as to financial and operational
obligations and business terms.
DocuSigned by:
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TITLE
Frank Pugsley
PRINTED NAME
Water Utilities Director
Water Utilities
DEPARTMENT
"CONSULTANT"
Hazen and Sawyer P.C.
—DocuSigned by:
By: r,�,a.�i�,�,V'a �aSSa a.�t,
AUTHORIZED �����; TITLE
ATTEST:
APPROVED AS TO LEGAL FORM:
AARON LEAL CITY ATTORNEY
DocuS�'igned 6y:
Ma� �P.iA�.IwA�
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By' 7/25/2019
Page 2 of 2
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Apri130, 2019
Ha��n and Sawy�r
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P.S. Arora, PE
Director of Wastewater Utilities
City of Denton
901-A Texas Street
Denton, TX 76209
Re: Construction Management Services Amendment
Hickory Creek Lift Station
Hickory Creek Detention Facility & Pecan Creek West Peak Flow Pump Station
Dear Mr. Arora:
At your request, Hazen has prepared a scope and level of effort to perform construction administration
services for both the Hickory Creek Lift Station and the Hickory Creek Detention Facility & Pecan Creek
West Peak Flow Pump Station as an amendment to Contract #5718.
The Hickory Creek Lift Station is a new 11 million gallon per day (mgd) submersible lift station and
includes a new electrical building, yard piping, and site work within the confines of the existing Hickory
Creek Lift Station. The construction ofthe lift station is scheduled for 270 days (9 months). This project
has bid and is ready for construction.
The Hickory Creek Detention Facility consists of a new 24-mgd submersible pump station with a 3.5
million gallon storage tank along with electrical, odor control, yard piping, and site work. The Pecan
Creek West Peak Flow Pump Station consists of 24-mgd submersible pump station along with electrical,
yard piping and site work at a second site. Both the detention facility and pump station will be bid as one
contract. The construction schedule for the Hickory Creek Detention Facility & Pecan Creek West Peak
Flow Pump Station project is estimated at 540 days (18 months).
Hazen will perform construction administration services for both projects. The construction
administration includes review of submittals, request for information (RFIs), pay requests, and other
construction administrative activities described in the scope below.
100 Hickory Creek Lift Station - Construction Administration Services
Hazen will provide 9 months of construction administration services in the role of Engineer as described
in the Contract Documents for the Hickory Creek Lift Station:
Preconstruction Conference — Conduct preconstruction conference to address key contract
elements, schedule, progress payments, change orders, record drawings, shop drawing
submittals, and other coordination issues. Hazen will provide agenda and meeting minutes.
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2. Construction Progress Meetings — Conduct up to nine (9) construction progress meetings to
review construction progress. Hazen will provide agenda and meeting minutes.
3. Additional Site Visits — Hazen will provide additional site visits, not including construction
progress meetings, to observe the progress and the quality of work and for coordination of the
work. Hazen will provide up to 8 additional site visits.
4. Monthly Pay Request Review — Hazen will review and comment on up to 9 monthly and final
Progress Payment based on the observations of the performed work.
5. Submittal Review — Review shop drawings and material submittals for conformance with the
requirements of the Contract Documents. It is anticipated that Hazen will review and respond
to a total of up to 65 shop drawing submittals.
6. Request for Information (RFIs) — Hazen will review the Contractor's RFIs and prepare a
response in accordance with the Contract Documents. Hazen will provide interpretation and
communicate intent if information is not addressed in the Contract Documents. It is
anticipated that Hazen will review and respond up to a total of 30 RFIs.
Field and Change Orders — Hazen will provide responses to contract modifications and assist
in the negotiations with the Contractor to determine the cost and time impacts of changes to the
Contract Documents. Hazen will review up to 10 field orders and work change directives.
Hazen will prepare up to three change orders.
Project Closeout — Hazen will provide assistance with startup and testing of the lift station,
site visit to develop punch list, and perform other project closeout requirements. Hazen will
archive all the construction information and provide electronic copy of DVD.
Record Drawings — Hazen will revise the construction drawings in accordance with the
information furnished by Contractor, reflecting changes made during construction. Hazen will
provide one full-size (22"x34") and one half-size (11"x17") bound set and one electronic copy
in PDF format.
Meetings:
• Pre-Construction Meeting
• Construction Progress Meetings (9 meetings)
Deliverables
Electronic copy of all construction administrative correspondence and submittals
Record drawings
200 Hickory Creek Detention Facility & Pecan Creek West Peak Flow Pump Station - Construction
Administration Services
Hazen will provide 18 months of construction administration services in the role of Engineer as described
in the Contract Documents for the Hickory Creek Detention Facility & Pecan Creek West Peak Flow
Pump Station:
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1. Preconstruction Conference — Conduct preconstruction conference to address key contract
elements, schedule, progress payments, change orders, record drawings, shop drawing
submittals, and other coordination issues. Hazen will provide agenda and meeting minutes.
2. Construction Progress Meetings — Conduct up to eighteen (18) construction progress
meetings to review construction progress. Hazen will provide agenda and meeting minutes.
3. Additional Site Visits — Hazen will provide additional site visits, not including construction
progress meetings, to observe the progress and the quality of work and for coordination of the
work. Hazen will provide up to 10 additional site visits.
4. Monthly Pay Request Review — Hazen will review and comment on up to 18 monthly and
final Progress Payment based on the observations of the performed work.
5. Submittal Review — Review shop drawings and material submittals for conformance with the
requirements of the Contract Documents. It is anticipated that Hazen will review and respond
to a total of up to 85 shop drawing submittals.
6. Request for Information (RFIs) — Hazen will review the Contractor's RFIs and prepare a
response in accordance with the Contract Documents. Hazen will provide interpretation and
communicate intent if information is not addressed in the Contract Documents. It is
anticipated that the Hazen will review and respond up to a total of 75 RFIs.
Field and Change Orders — Hazen will provide responses to contract modifications and assist
in the negotiations with the Contractor to determine the cost and time impacts of changes to the
Contract Documents. Hazen will review up to 20 field orders and work change directives.
Hazen will prepare up to six change orders.
Project Closeout — Hazen will provide assistance with startup and testing of the two lift
stations, odor control and storage tank, site visit to develop punch list, and perform other
project closeout requirements. Hazen will archive all the construction information and provide
electronic copy of DVD.
Record Drawings — Hazen will revise the construction drawings in accordance with the
information furnished by Contractor, reflecting changes made during construction. Hazen will
provide one full-size (22"x34") and one half-size (11"x17") bound set and one electronic copy
in PDF format.
Meetings:
• Pre-Construction Meeting
• Construction Progress Meetings (18 meetings)
Deliverables
Electronic copy of all construction administrative correspondence and submittals
Record drawings
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Exclusions
The following items are excluded from Hazen's Scope of Work:
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1. Excludes onsite construction observation, such as, but not limited to storage tank pier
foundation system, storage tank construction, pump station construction and electrical
buildings and systems.
2. Excludes coordination with independent materials testing laboratory
3. Excludes review and approval of Contractor substitutions
4. Excludes preparation of a facility standard operating procedures or separate operations
and maintenance manual except for transferring those supplied by the Contractor.
Excludes factory witness testing
Excludes development of formal start-up or maintenance plans of pump station and tank
during construction outside of the guidance provided as part of the design documents
Schedule
The schedule is dependent on the construction contractors. Since the notice to proceed has not be granted
to the Contractor, below is an anticipated project schedule:
M ilestone Date
Hickory Creek Lift Station
Anticipated Notice To Proceed May 2019
Anticipated Final Completion February 2020
Hickory Creek Detention Facility &
Pecan Creek West Peak Flow Pump Station
Bidding May 2019
Anticipated Notice To Proceed July 2019
Anticipated Final Completion January 2021
Very truly yours,
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Scott A. Hardy, PE, PMP
Senior Associate
Enclosure: Draft Level of Effort
cc: Chamindra Dassanayake, PhD, PE, Brandt Miller, PE
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DocuSign Envelope ID: 03A7C792-6FC4-48D7-8DB3-B406F1 BFAD6A
Exhibit �
CONFLICT OF INTEREST QUESTIONNAIRE -
For vendor or other person doina business with local aovernmental enti
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
FORM CIQ
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.
Name of vendor who has a business relationship with local governmental entity. Hazen and Sawyer, P. C.
� 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 oriqinally filed questionnaire was incomplete or inaccurate.)
Name of local government officer about whom the information in this section is being disclosed.
Chamindra Dassanayake, PhD PE
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 Goveinment Code. Attach additional pages to this Form CIQ as necessasy.
A. Is the local goveinment 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 goveinment officer
named in this section AND the taxable income is not received from the local goveinmental entity?
� Yes � No
C. Is the filer of this questionnaire employed by a crnporation or other business entity with respect to which the local govemment officer seives 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 goveinment officer named in this section.
None
QI have no Conflict of Interest to disclose.
DocuSigned by:
r,�,a.�i�,�,V'a �aSS a.�t,
'��fi�4� �-doing business with the goveinmental entity
7/26/2019
Date
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Certificate Of Completion
Envelope Id: 03A7C7926FC448D78DB3B406F1BFAD6A Status: Completed
Subject: Please DocuSign: City Council Contract 5768 Design of Hickory Creek Basin Peak Amendment No. 3
Source Envelope:
Document Pages: 10 Signatures: 6 Envelope Originator:
Certificate Pages: 6 Initials: 1 Monisa Rogers
AutoNav: Enabled 901 B Texas Street
Envelopeld Stamping: Enabled Denton, TX 76209
Time Zone: (UTC-06:00) Central Time (US & Canada) Monisa.Rogers@cityofdenton.com
IP Address: 129.120.6.150
Record Tracking
Status: Original
7/16/2019 11:10:09 AM
Signer Events
Monisa Rogers
mon isa. rogers@cityofdenton.com
Senior Buyer
City Of Denton
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Lori Hewell
lori. hewel I@cityofdenton.com
Purchasing Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Mack Reinwand
mack.reinwand@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Chamindra Dassanayake
cdassanayake@hazenandsawyer.com
Vice President
Hazen and Sawyer
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 7/26/2019 9:50:19 AM
ID:9031855f-130d-45c8-a05a-03086c8c7454
Holder: Monisa Rogers
Monisa. Rogers@cityofdenton.com
Signature
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Using IPAddress: 129.120.6.150
���
Signature Adoption: Pre-selected Style
Using IPAddress: 129.120.6.150
Using IPAddress: 129.120.6.150
�o s�yoea ny:
(�,�,auhiv�,�.V�a �aSSaan,au�a.�t,
DEF52433A6C0487...
Signature Adoption: Pre-selected Style
Using IPAddress: 66.196.204.74
Location: DocuSign
Timestamp
Sent: 7/16/2019 11:27:42 AM
Viewed: 7/16/2019 11:28:00 AM
Signed: 7/16/2019 11:31:35 AM
Sent: 7/16/2019 11:31:37 AM
Viewed: 7/16/2019 2:39:26 PM
Signed: 7/16/2019 2:40:07 PM
Sent: 7/16/2019 2:40:09 PM
Viewed: 7/25/2019 11:58:48 AM
Signed: 7/25/2019 12:01:29 PM
Sent: 7/25/2019 12:01:31 PM
Resent: 7/26/2019 9:26:52 AM
Viewed: 7/26/2019 9:50:19 AM
Signed: 7/26/2019 9:51:33 AM
Signer Events
Frank Pugsley
frank.pugsley@cityofdenton.com
Water Utilities Director
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 7/29/2019 2:19:31 PM
ID:27d2f2dd-04ba-45a0-afdb-8ba7a96a5194
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
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)
Electronic Record and Signature Disclosure:
Accepted: 7/25/2017 11:02:14 AM
I D: 57619fbf-2aec-4b 1 f-805d-6bd7d9966f21
Rosa Rios
rosa.rios@cityofdenton.com
City Secretary
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 8/15/2019 11:36:23 AM
ID:391084c5-8cee-4976-b7af-2121aed380ff
Mack Reinwand
mack.reinwand@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Certified Delivery Events
Signature
�oo��s�yoea ny:
�V'AJn,�C �I�S�t,�
22943FE13318483...
Signature Adoption: Pre-selected Style
Using IPAddress: 129.120.6.150
Using IPAddress: 129.120.6.150
�000�s�yoea by:
�0�,0�, C�I�AU,
B776C711BAOD454...
Signature Adoption: Pre-selected Style
Using IPAddress: 129.120.6.150
oo��s�yoea ny:
' I�a�. �,.aa
t�-1CSCASCSE175493...
Signature Adoption: Pre-selected Style
Using IPAddress: 129.120.6.150
�000�s�yoea by:
M..c�- �einwand.
7F9D328BF0204E5...
Signature Adoption: Pre-selected Style
Using IPAddress: 129.120.6.150
Signature
Status
Status
Status
Status
Timestamp
Sent: 7/26/2019 9:51:35 AM
Resent: 7/29/2019 2:16:11 PM
Viewed: 7/29/2019 2:19:31 PM
Signed: 7/29/2019 2:19:59 PM
Sent: 7/29/2019 2:20:02 PM
Resent: 8/2/2019 8:33:20 AM
Resent: 8/2/2019 8:36:13 AM
Viewed: 8/15/2019 9:44:43 AM
Signed: 8/15/2019 9:45:54 AM
Sent: 8/15/2019 9:45:57 AM
Viewed: 8/15/2019 9:56:06 AM
Signed: 8/15/2019 9:56:13 AM
Sent: 8/15/2019 9:56:16 AM
Viewed: 8/15/2019 11:36:23 AM
Signed: 8/15/2019 11:37:00 AM
Sent: 8/15/2019 11:37:05 AM
Viewed: 8/1 5/201 9 4:04:13 PM
Signed: 8/15/2019 4:04:44 PM
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Carbon Copy Events
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Paralegal
City of Denton
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Sherri Thurman
sherri.thurman@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)
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)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
P.S. Arora
P.S.Arora@cityofdenton.com
Director Wastewater Utility
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events
Notary Events
Envelope Summary Events
Envelope Sent
Certified Delivered
Signing Complete
Completed
Status
� �,
� �,
Signature
Signature
Status
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Timestamp
Sent: 7/16/2019 11:31:37 AM
Sent: 7/16/2019 11:31:38 AM
Sent: 8/15/2019 9:56:16 AM
Viewed: 8/20/2019 9:03:30 AM
Sent: 8/15/2019 11:37:03 AM
Viewed: 8/15/2019 11:56:19 AM
Timestamp
Timestamp
Timestamps
8/15/2019 11:37:05 AM
8/15/2019 4:04:13 PM
8/15/2019 4:04:44 PM
8/15/2019 4:04:44 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Chamindra Dassanayake, Frank Pugsley, Todd Hileman, Rosa Rios
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 pocuSign, Inc.
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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
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DocuSign system you will have the ability to download and print any documents we send to you
through your pocuSign 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
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required notices and disclosures electronically from us and you will no longer be able to use your
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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 pocuSign 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.
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 pocuSign 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 pocuSign 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
O eratin S stems: Windows2000? or WindowsXP?
Browsers (for SENDERS): Internet Ex lorer 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
rox 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 RECEIl'T 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.