21-184021-1840
ORDINANCE NO.
AN ORDINANCE OF THE CITY OF DENTON, A TEXAS HOME -RULE MUNICIPAL
CORPORATION, AUTHORIZING THE CITY MANAGER TO EXECUTE A PROFESSIONAL
SERVICES AGREEMENT WITH HAZEN AND SAWYER, P.C., TO PROVIDE REGULATORY
PERMITTING/APPROVAL SUPPORT, PROCESS EVALUATION, DESIGN SERVICES,
BIDDING ASSISTANCE, CONSTRUCTION ADMINISTRATION, AND
COMMISSIONING/STARTUP SUPPORT FOR THE PECAN CREEK WATER RECLAMATION
PLANT EFFLUENT FILTER IMPROVEMENTS; PROVIDING FOR THE EXPENDITURE OF
FUNDS THEREFOR; AND PROVIDING AN EFFECTIVE DATE (RFP 7574-005 —
PROFESSIONAL SERVICES AGREEMENT FOR DESIGN SERVICES AWARDED TO HAZEN
AND SAWYER, P.C., IN THE NOT -TO -EXCEED AMOUNT OF $576,124.00).
WHEREAS, on March 23, 2021, the City Council approved a pre -qualified engineer list for
Water and Wastewater (Ordinance 21-546), and the professional services provider (the "Provider")
mentioned in this ordinance is being selected as the most highly qualified on the basis of its
demonstrated competence and qualifications to perform the proposed professional services; and
WHEREAS, the fees under the proposed contract are fair and reasonable and are consistent
with, and not higher than, the recommended practices and fees published by the professional
associations applicable to the Provider's profession, and such fees do not exceed the maximum
provided by law; NOW, THEREFORE,
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS:
SECTION 1. The City Manager, or their designee, is hereby authorized to enter into an
agreement with to Hazen and Sawyer, P.C., to provide professional engineering services for the City
of Denton, a copy of which is attached hereto and incorporated by reference herein.
SECTION 2. The City Manager, or their designee, is authorized to expend funds as required
by the attached contract.
SECTION 3. The City Council of the City of Denton, hereby expressly delegates the
authority to take any actions that may be required or permitted to be performed by the City of Denton
under this ordinance to the City Manager of the City of Denton, or their designee.
SECTION 4. The findings in the preamble of this ordinance are incorporated herein by
reference.
SECTION 5. This ordinance shall become effective immediately upon its passage and
approval.
The motion to approve this ordinance was made by -54S e- ; 5 and
seconded by ; 0..¢1 1�3 �G�C-- This ordinance was passed and approved by
the following vote [? -
Mayor Gerard Hudspeth:
Vicki Byrd, District l:
Brian Beck, District 2:
Jesse Davis, District 3:
Alison Maguire, District 4:
Deb Armintor, At Large Place 5:
Paul Meltzer, At Large Place 6:
Aye Nay
Abstain Absent
PASSED AND APPROVED this the } �� day of SCVA-f(ln\DzC , 2021.
GERARD HUDSPETH, MAYOR
ATTEST:
ROSA RIOS, CITY SECRETARY
APPROVED AS TO LEGAL FORM:
CATHERINE CLIFTON, INTERIM CITY ATTORNEY
Digitallystgned by Mamella Lunn
DN: do=com, dr—cityofdenton, doodad,
oo=Department Users and Groups,
�i �ou=General Government, ou=Legal,
cn=Marcella Lunn,
emai €=M a rcel Ia.Lun n @cityofdenton.com
BY: Date: 2021.08.1014:45:31 -05'00'
DocuSign Envelope ID: 1D658C65-B789-4BD9-AQQF-BAC1D179F714
C Cl
ITY
OF
DENTON
Docusign City Council Transmittal Coversheet
PSA
7574-005
File Name
PECAN CREEK EFFLUENT FILTER
Purchasing Contact
Crystal Westbrook
City Council Target Date
SEPTEMBER 14, 2021
Piggy Back Option
Not Applicable
Contract Expiration
N/A
Ordinance
21-1840
E
DocuSign Envelope ID: 1D658C65-B788-4BD9-A00F-BAC1 D179F714
A. Invoice and Payment
(1) The Engineer shall provide the City sufficient documentation, including but not
limited to meeting the requirements set forth in the PROJECT schedule as set
forth in Attachment A to reasonably substantiate the invoices.
(2) The ENGINEER will issue monthly invoices for all work performed under this
AGREEMENT. Invoices for the uncontested performance of the particular
services are due and payable within 30 days of receipt by City.
(3) Upon completion of services enumerated in Section 1, the final payment of any
balance for the uncontested performance of the services will be due within 30
days of receipt of the final invoice.
(4) In the event of a disputed or contested billing, only that portion so contested will
be withheld from payment, and the undisputed portion will be paid. The CITY
will exercise reasonableness in contesting any bill or portion thereof. No
interest will accrue on any contested portion of the billing until mutually resolved.
(5) If the CITY fails to make payment in full to ENGINEER for billings contested in
good faith within 60 days of the amount due, the ENGINEER may, after giving 7
days' written notice to CITY, suspend services under this AGREEMENT until
paid in full. In the event of suspension of services, the ENGINEER shall have
no liability to CITY for delays or damages caused the CITY because of such
suspension of services.
SECTION 4
Obligations of the Engineer
A. General
The ENGINEER will serve as the CITY's professional engineering representative under
this AGREEMENT, providing professional engineering consultation and advice and
furnishing customary services incidental thereto.
B. Standard of Care
The ENGINEER shall perform its services:
(1) with the professional skill and care ordinarily provided by competent engineers
practicing in the same or similar locality and under the same or similar
circumstances and professional license; and
(2) as expeditiously as is prudent considering the ordinary professional skill and
care of a competent engineer.
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 916118
Page 2 of 18
DocuSign Envelope ID: 10658C65-B788-4BD9-AOOF-BAC1D179F714
or quality of the completed work on the PROJECT or to determine, in general, if
the work on the PROJECT is being performed in a manner indicating that the
PROJECT, when completed, will be in accordance with the AGREEMENT
Documents, nor shall anything in the AGREEMENT Documents or this
AGREEMENT between CITY and ENGINEER be construed as requiring
ENGINEER to make exhaustive or continuous on-site inspections to discover
latent defects in the work or otherwise check the quality or quantity of the work
on the PROJECT. If the ENGINEER makes on-site observation(s) of a
deviation from the AGREEMENT Documents, the ENGINEER shall inform the
CITY.
(3) When professional certification of performance or characteristics of materials,
systems or equipment is reasonably required to perform the services set forth in
the Scope of Services, the ENGINEER shall be entitled to rely upon such
certification to establish materials, systems or equipment and performance
criteria to be required in the AGREEMENT Documents.
F. Opinions of Probable Cost, Financial Considerations, and Schedules
(1) The ENGINEER shall provide opinions of probable costs based on the current
available information at the time of preparation, in accordance with
Attachment A.
(2) In providing opinions of cost, financial analyses, economic feasibility projections,
and schedules for the PROJECT, the ENGINEER has no control over cost or
price of labor and materials; unknown or latent conditions of existing equipment
or structures that may affect operation or maintenance costs; competitive
bidding procedures and market conditions; time or quality of performance by
third parties; quality, type, management, or direction of operating personnel; and
other economic and operational factors that may materially affect the ultimate
PROJECT cost or schedule. Therefore, the ENGINEER makes no warranty
that the CITY's actual PROJECT costs, financial aspects, economic feasibility,
or schedules will not vary from the ENGINEER's opinions, analyses, projections,
or estimates.
G. Construction Progress Payments
Recommendations by the ENGINEER to the CITY for periodic construction progress
payments to the construction contractor will be based on the ENGINEER's knowledge,
information, and belief from selective sampling and observation that the work has
progressed to the point indicated. Such recommendations do not represent that
continuous or detailed examinations have been made by the ENGINEER to ascertain that
the construction contractor has completed the work in exact accordance with the
AGREEMENT Documents; that the final work will be acceptable in all respects; that the
ENGINEER has made an examination to ascertain how or for what purpose the
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 916118
Page 4 of 18
DocuSign Envelope ID: 1DS58C65-B788-4BD9-AOOF-BAC1D179F714
J. INSURANCE
(1) ENGINEER'S INSURANCE
a. Commercial General Liability — the ENGINEER shall maintain
commercial general liability (CGL) and, if necessary, commercial
umbrella insurance with a limit of not less than $1,000,000.00 per each
occurrence with a $2,000,000.00 aggregate. If such Commercial General
Liability insurance contains a general aggregate limit, it shall apply
separately to this PROJECT or location.
The CITY shall be included as an additional insured with all rights
of defense under the CGL, using ISO additional insured
endorsement or a substitute providing equivalent coverage, and
under the commercial umbrella, if any. This insurance shall apply
as primary insurance with respect to any other insurance or self-
insurance programs afforded to the CITY. The Commercial
General Liability insurance policy shall have no exclusions or
endorsements that would after or nullify: premises/operations,
prod uctslcompleted operations, contractual, personal injury, or
advertising injury, which are normally contained within the policy,
unless the CITY specifically approves such exclusions in writing.
ii. ENGINEER waives all rights against the CITY and its agents,
officers, directors and employees for recovery of damages to the
extent these damages are covered by the commercial general
liability or commercial umbrella liability insurance maintained in
accordance with this AGREEMENT.
b. Business Auto — the ENGINEER shall maintain business auto liability
and, if necessary, commercial umbrella liability insurance with a limit of
not less than $1,000,000 each accident. Such insurance shall cover
liability arising out of "any auto", including owned, hired, and non -owned
autos, when said vehicle is used in the course of the PROJECT. If the
engineer owns no vehicles, coverage for hired or non -owned is
acceptable.
ENGINEER waives all rights against the CITY and its agents,
officers, directors and employees for recovery of damages to the
extent these damages are covered by the business auto liability or
commercial umbrella liability insurance obtained by ENGINEER
pursuant to this AGREEMENT or under any applicable auto
physical damage coverage.
c. Workers' Compensation —
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 916/18
Page 6 of 18
ENGINEER shall maintain workers
DocuSign Envelope ID: 1D658C65-B788-4BD9-A00E-BAC1D179F714
f. Insurers for all policies must be authorized to do business in the State of
Texas and have a minimum rating of A:V or greater, in the current A.M.
Best Key Rating Guide or have reasonably equivalent financial strength
and solvency to the satisfaction of Risk Management.
g. Any deductible or self insured retention in excess of $25,000.00 that
would change or alter the requirements herein is subject to approval by
the CITY in writing, if coverage is not provided on a first -dollar basis. The
CITY, at it sole discretion, may consent to alternative coverage
maintained through insurance pools or risk retention groups. Dedicated
financial resources or letters of credit may also be acceptable to the
CITY.
h. Applicable policies shall each be endorsed with a waiver of subrogation
in favor of the CITY as respects the PROJECT.
The CITY shall be entitled, upon its request and without incurring
expense, to review the ENGINEER's insurance policies including
endorsements thereto and, at the CITY's discretion; the ENGINEER may
be required to provide proof of insurance premium payments.
j. Lines of coverage, other than Professional Liability, underwritten on a
claims -made basis, shall contain a retroactive date coincident with or
prior to the date of the AGREEMENT. The certificate of insurance shall
state both the retroactive date and that the coverage is claims -made.
k. Coverages, whether written on an occurrence or claims -made basis,
shall be maintained without interruption nor restrictive modification or
changes from date of commencement of the PROJECT until final
payment and termination of any coverage required to be maintained after
final payments.
The CITY shall not be responsible for the direct payment of any
insurance premiums required by this AGREEMENT.
m. Sub consultants and subcontractors to/of the ENGINEER shall be
required by the ENGINEER to maintain the same or reasonably
equivalent insurance coverage as required for the ENGINEER. When
sub consultants/subcontractors maintain insurance coverage,
ENGINEER shall provide CITY with documentation thereof on a
certificate of insurance.
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 9!6118
Page 8 of 18
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shall engage in any discriminatory employment practice. No person shall, on
the grounds of race, sex, sexual orientation, age, disability, creed, color, genetic
testing, or national origin, be refused the benefits of, or be otherwise subjected
to discrimination under any activities resulting from this AGREEMENT.
(2) Americans with Disabilities Act (ADA) Compliance: ENGINEER and
ENGINEER's agents shall not engage in any discriminatory employment
practice against individuals with disabilities as defined in the ADA.
SECTION 5
Obligations of the City
A. City -Furnished Data
ENGINEER may rely upon the accuracy, timeliness, and completeness of the information
provided by the CITY.
B. Access to Facilities and Property
The CITY will make its facilities accessible to the ENGINEER as required for the
ENGINEER's performance of its services. The CITY will perform, at no cost to the
ENGINEER, such tests of equipment, machinery, pipelines, and other components of the
CITY's facilities as may be required in connection with the ENGINEER's services. The
CITY will be responsible for all acts of the CITY's personnel.
C. Advertisements, Permits, and Access
Unless otherwise agreed to in the Scope of Services, the CITY will obtain, arrange, and
pay for all advertisements for bids; permits and licenses required by local, state, or federal
authorities; and land, easements, rights-of-way, and access necessary for the
ENGINEER's services or PROJECT construction.
D. Timely Review
The CITY will examine the ENGINEER's studies, reports, sketches, drawings,
specifications, proposals, and other documents; obtain advice of an attorney, insurance
counselor, accountant, auditor, bond and financial advisors, and other consultants as the
CITY deems appropriate; and render in writing decisions required by the CITY in a timely
manner in accordance with the PROJECT schedule prepared in accordance with
Attachment A.
E. Prompt Notice
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 9/6118
Page 10 of 18
DocuSign Envelope ID: 1D658C65-8788-4BD9-AOOF-BAC1D179F714
1. CITY's Insurance
(1) The CITY may maintain property insurance on certain pre-existing structures
associated with the PROJECT.
(2) The CITY may secure Builders Risklinstallation insurance at the replacement
cost value of the PROJECT. The CITY may provide ENGINEER a copy of the
policy or documentation of such on a certificate of insurance.
J. Litigation Assistance
The Scope of Services does not include costs of the ENGINEER for required or requested
assistance to support, prepare, document, bring, defend, or assist in litigation undertaken
or defended by the CITY. In the event CITY requests such services of the ENGINEER, this
AGREEMENT shall be amended or a separate agreement will be negotiated between the
parties.
K. Changes
The CITY may make or approve changes within the general Scope of Services in this
AGREEMENT. If such changes affect the ENGINEER's cost of or time required for
performance of the services, an equitable adjustment will be made through an amendment
to this AGREEMENT with appropriate CITY approval.
SECTION 6
General Legal Provisions
A. Authorization to Proceed
ENGINEER shall be authorized to proceed with this AGREEMENT upon receipt of a
written Notice to Proceed from the CITY.
B. Reuse of Project Documents
All designs, drawings, specifications, documents, and other work products of the
ENGINEER, whether in hard copy or in electronic form, are instruments of service for this
PROJECT, whether the PROJECT is completed or not. Reuse, change, or alteration by
the CITY or by others acting through or on behalf of the CITY of any such instruments of
service without the written permission of the ENGINEER will be at the CITY's sole risk.
The CITY shall own the final designs, drawings, specifications and documents.
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 916118
Page 12 of 18
DocuSign Envelope ID: 11D658C65-6788-46D9-A00F-BAC1 D1 79F714
IN ACCORDANCE WITH TEXAS LOCAL GOVERNMENT CODE SECTION 271.944,
THE ENGINEER SHALL INDEMNIFY OR HOLD HARMLESS THE CITY AGAINST
LIABILITY FOR ANY DAMAGE COMMITTED BY THE ENGINEER OR ENGINEER'S
AGENT, CONSULTANT UNDER CONTRACT, OR ANOTHER ENTITY OVER WHICH
THE ENGINEER EXERCISES CONTROL TO THE EXTENT THAT THE DAMAGE IS
CAUSED BY OR RESULTING FROM AN ACT OF NEGLIGENCE, INTENTIONAL
TORT, INTELLECTUAL PROPERTY INFRINGEMENT, OR FAILURE TO PAY A
SUBCONTRACTOR OR SUPPLIER. CITY IS ENTITLED TO RECOVER ITS
REASONABLE ATTORNEY'S FEES IN PROPORTION TO THE ENGINEER'S
LIABILITY.
G. Assignment
Neither party shall assign all or any part of this AGREEMENT without the prior written
consent of the other party.
H. Jurisdiction
The law of the State of Texas shall govern the validity of this AGREEMENT, its
interpretation and performance, and any other claims related to it. The venue for any
litigation related to this AGREEMENT shall be Denton County, Texas.
I. Severability and Survival
If any of the provisions contained in this AGREEMENT are held for any reason to be
invalid, illegal, or unenforceable in any respect, such invalidity, illegality, or unenforceability
will not affect any other provision, and this AGREEMENT shall be construed as if such
invalid, illegal, or unenforceable provision had never been contained herein. Sections 5.F.,
6.B., 6.D., 65., 6.H., and 6.1. shall survive termination of this AGREEMENT for any cause.
J. Observe and Comply
ENGINEER shall at all times observe and comply with all federal and State laws and
regulations and with all City ordinances and regulations which in any way affect this
AGREEMENT and the work hereunder, and shall observe and comply with all orders, laws
ordinances and regulations which may exist or may be enacted later by governing bodies
having jurisdiction or authority for such enactment. No plea of misunderstanding or
ignorance thereof shall be considered. ENGINEER AGREES TO DEFEND, INDEMNIFY
AND HOLD HARMLESS CITY AND ALL OF ITS OFFICERS, AGENTS AND
EMPLOYEES FROM AND AGAINST ALL CLAIMS OR LIABILITY ARISING OUT OF
THE VIOLATION OF ANY SUCH ORDER, LAW, ORDINANCE, OR REGULATION,
WHETHER IT BE BY ITSELF OR ITS EMPLOYEES.
K. Immigration Nationality Act
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 916118
Page 14 of 18
DocuSign Envelope ID: 1 D658C65-B788-4BD9-AOOF-BAC1 D179F714
at the time the Engineer submits the signed contract. The Texas Ethics Commission
has adopted rules requiring the business entity to file Form 1295 electronically with the
Commission.
Engineer will be required to furnish a Certificate of Interest Parties before the contract is
awarded, in accordance with Government Code 2252.908.
The contractor shall:
1. Log onto the State Ethics Commission Website at:
https://www.ethics.state.tx.us/whatsnew/elf_info_form 1295. htm
2. Register utilizing the tutorial provided by the State
3. Print a copy of the completed Form 1295
4. Enter the Certificate Number on page 2 of this contract.
5. Complete and sign the Form 1295
6. Email the form to purchasing@cityofdenton.com with the contract number in the
subject line. (EX: Contract 1234 — Form 1295)
The City must acknowledge the receipt of the filed Form 1295 not later than the 30th
day after Council award. Once a Form 1295 is acknowledged, it will be posted to the
Texas Ethics Commission's website within seven business days.
O. Prohibition Against Personal Interest In Contracts
No officer, employee, independent consultant, or elected official of the City who is
involved in the development, evaluation, or decision-making process of the performance
of any solicitation shall have a financial interest, direct or indirect, in the Contract
resulting from that solicitation as defined in the City's Ethic Ordinance 18-757 and in the
City Charter chapter 2 article XI(Ethics). Any willful violation of this section shall
constitute impropriety in office, and any officer or employee guilty thereof shall be
subject to disciplinary action up to and including dismissal. Any violation of this
provision, with the knowledge, expressed or implied, of the Contractor shall render the
Contract voidable by the City. The Engineer shall complete and submit the City's
Conflict of Interest Questionnaire.
P. Agreement Documents
This AGREEMENT, including its attachments and schedules, constitutes the entire
AGREEMENT, which supersedes all prior written or oral understandings, and may only be
changed by a written amendment executed by both parties. This AGREEMENT may be
executed in one or more counterparts and each counterpart shall, for all purposes, be
deemed an original, but all such counterparts shall together constitute but one and the
same instrument. The following attachments and schedules are hereby made a part of
this AGREEMENT:
Attachment A - Scope of Services, Compensation, Project Schedule, Location Map
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 916118
Page 16 of 18
DocuSign Envelope 1D: 1 D658C65-B788-4BD9-AOOF-BAC1 D1 79F714
THIS AGREEMENT HAS BEEN
BOTH REVIEWED AND APPROVED
as to financial and operational obligations and
business terms.
Docuftned by:
C�
FFR6ARRS17�RFdAA
SIGNATURE
Stephen D. Gay
Director, water utilities
TITLE
water utilities
DEPARTMENT
City of Denton, Texas
Standard Agreement for Engineering Related Design Services
Revised Date: 916118
Page 18 of 18
DocuSign Envelope ID: 1D658C65-B788-4BD9-A00E-BAC1D179F714
Hazen
Scope Item Assumptions:
• Design of the filters is to be incorporated into the bid package for the digester cover,
valves and aeration basin diffusor replacement.
• The City staff will provide comments to the ENGINEER on the 90% drawings and
specifications. Turnaround time on comments is assumed to be within 1 week.
• The City and ENGINEER staff will attend the 90% submittal workshop.
• No City permitting services are provided.
• No civil design services are included.
• Submittals shall include one (1) electronic copy of CAD files and word documents, one pdf
electronic copy of entire bid set, and three (3) sets of bound 8 1/2 -inch by 11 -inch
specifications and three sets of half size (11 -inch by 17 -inch) drawings (hard copy)
Meetings:
• One (1) 1 -hour kick-off meeting
• One (1) milestone review workshop
Deliverables:
• 90% Design submittal
• Signed and sealed bid set
• Comment log with responses to City comments
Task 110 TCEQ Permitting
The ENGINEER will develop sign and sealed drawings and specifications to submit to TCEQfor approval
of the installation of cloth media filters at the Pecan Creek WRP. ENGINEER will respond and address
one round of comments.
Task 120 Bid Phase Services
The ENGINEER will perform additional work specifically related to bidding the effluent filters within
the bid package for the digester cover, valves and aeration basin diffusers and will perform the
following tasks:
• Respond to Bidder Inquiries
• Preparation of technical addenda content
• Prepare a conformed set of contract documents including the issued addenda.
Scope Item Assumptions:
• Assumption from digester cover, valve and aeration basin diffuser replacement apply.
Revised July 6, 2021 Page 2 of 4
DocuSign Envelope ID: 10658C65-B788-4BD9-A00E-BAC1D179F714
Hazen
• Construction duration is expected to extend from 9 months to 12 months, including for
construction of filters.
• City to arrange for a site inspector to continuously monitor the progress of construction.
• Total number of additional submittals is estimated at 20. Submittal review assumes 25%
resubmittal.
• Review and respond to 15 RFIs.
• The City will process applications/ estimates for payments to Contractor.
• The City will conduct the substantial completion inspection and final completion
inspection with the ENGINEER.
• Construction submittals, RFIs and Meeting Minutes will be managed in Procore Document
Management System for documentation and review workflow.
Meetings:
• Addition of three (3) monthly progress meetings
• Two (2) one-hour site visits (can be conducted following monthly progress meetings)
• One (1) two-hour punch list walkthrough site visit
Deliverables:
• RFI responses
• Change order review comments
• Submittal review and comments
• Record drawings
• Meeting agenda, sign -in sheet, and meeting minutes
Revised July 6, 2021 Page 4 of 4
DocuSign Envelope ID: 1D658C65-B788-4BD9-AOOF-BAC1D179F714
Exhibit CiQ
CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIO
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. HAZEN AND SAWYER, P.C.
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 1 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?
LJ E7
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 riot received from the local governmental entity?
0 Yes 0 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
X❑ I have no Conflict of Interest to disclose.
5 noouSigned by:
8/9/2021
A t -doing business with the governmental entity Date