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2009-244ORDINANCE NO. Od ~J AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING AN ANNUAL CONTRACT FOR THE INSTALLATION OF ROADWAY PAVEMENT MARKINGS FOR THE CITY OF DENTON TRAFFIC DEPARTMENT; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR; AND PROVIDING AN EFFECTIVE DATE (BID 4383-ANNUAL CONTRACT FOR INSTALLATION OF ROADWAY PAVEMENT MARKINGS AWARDED TO STRIPING PLUS, INC. IN THE ANNUAL ESTIMATED AMOUNT OF $204,450). WHEREAS, the City has solicited, received and tabulated competitive bids for the purchase of necessary materials, equipment, supplies or services in accordance with the procedures of State law and City ordinances; and WHEREAS, the City Manager or a designated employee has reviewed and recommended that the herein described bids are the lowest responsible bids for the materials, equipment, supplies or services as shown in the "Bid Proposals" submitted therefor; and WHEREAS, the City Council has provided in the City Budget for the appropriation of funds to be used for the purchase of the materials, equipment, supplies or services approved and accepted herein; NOW, THEREFORE, THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS: SECTION 1. The numbered items in the following numbered bids for materials, equipment, supplies, or services, shown in the "Bid Proposals" on file in the office of the City Purchasing Agent, are hereby accepted and approved as being the lowest responsible bids for such items: BID NUMBER VENDOR AMOUNT 4383 Striping Plus, Inc. Exhibit A SECTION 2. By the acceptance and approval of the above numbered items of the submitted bids, the City accepts the offer of the persons submitting the bids for such items and agrees to pur- chase the materials, equipment, supplies or services in accordance with the terms, specifications, standards, quantities and for the specified sums contained in the Bid Invitations, Bid Proposals, and related documents. SECTION 3. Should the City and the winning bidder(s) wish to enter into a formal written agreement as a result of the acceptance, approval, and awarding of the bids, the City Manager or his designated representative is hereby authorized to execute a written contract in accordance with the terms, conditions, specifications, standards, quantities and specified sums contained in the Bid Proposal and related documents and to extend that contract as determined to be advantageous to the City of Denton. SECTION 4. By the acceptance and approval of the above enumerated bids, the City Council hereby authorizes the expenditure of funds therefor in the amount and in accordance with the approved bids. SECTION 5. This ordinance shall become effective immediately upon its passage and approval. PASSED AND APPROVED this 1~ day of AM& '2009. MARK 'A,BU4&OUOIS, MAYOR ATTEST: JENNIFER WALTERS, CITY SECRETARY BY. APPROVED AS TO LEGAL FORM: ANITA BURGESS, CITY ATTORNEY BY: 3-ORD- 438 EXHIBIT A BID #4383 DATE: September 10, 2009 Annnal Contract for Installation of Roadwav Pavement Markings Item UOM Descri tion Principle Place of Business: Vendor Striping Plus, Inc. Grand Prairie, TX 1 20,000 LF 4" White Thermoplastic Install $0.38 2 26,000 LF 4" White Paint Install $0.14 3 95,000 LF 4" Yellow Thermoplastic Install $0.38 4 80,000 LF 4" Yellow Paint Install $0.14 5 35,000 LF 4" Removal $0.23 6 115,000 LF 4" Prep $0.08 7 40,000 LF 4" Sealer $0.08 8 30,000 LF 6" White Thermoplastic Install $0.48 9 5,000 LF 6" Removal $0.28 10 10,000 LF 6" Prep $0.10 11 2,500 LF 6" Sealer $0.10 12 15,000 LF 8" White Termoplastic Install $0.55 13 3,500 LF 18" White Paint Install $0.28 14 7,500 LF 8" Removal $0.33 15 15,000 LF 8" Prep $0.12 16 6,500 LF 8" Sealer $0.12 17 4,000 LF 24" White Thermoplastic Install $3.00 18 500 LF 24" Yellow Thermoplastic Install $3.00 19 3,000 LF 24" Remove $1.00 20 4,000 LF 24" Prep $0.35 21 2,000 LF 24" Sealer $0.35 22 100 EA Yield Line 16"x24" Triangle White Thermoplastic Install $6.00 23 20 EA Yield Line 16"x24" Triangle Remove $2.00 EXHIBIT A BID #4383 DATE: September 10, 2009 Annual Cantrnet for Installation of Roadwav Pavement Markings Item UOM Descri tion Vendor Striping Plus, Inc. Principle Place of Business: Grand Prairie, TX 24 100 EA Yield Line 16"x24" Triangle Prep $0.70 25 100 EA Yield Line 16"x24" Triangle Sealer $0.70 Symbol, 6' Preform Straight Arrow $95 00 26 5 EA White Large Install . 27 2 EA Symbol, 6" Preform Straight Arrow $6.00 Remove 28 5 EA Symbol, 6" Preform Straight Arrow $6.00 Pre Symbol, 6" Preform Straight Arrow $6 00 29 5 EA Sealer . 30 5 EA Symbol, 5'6" Preform Turn Arrow $95.00 White Large Install 31 2 EA Symbol, 5'6" Preform Turn Arrow $6.00 Remove 32 5 EA Symbol, 5'6" Preform Turn Arrow $6.00 Pre 33 5 EA Symbol, 5'6" Preform Turn Arrow $6.00 Sealer 34 5 EA Symbol, 8" Preform Straight Arrow $150.00 White Large Install Symbol, 8' Preform Straight Arrow $8 00 35 5 EA Remove . Symbol, 8' Preform Straight Arrow $8 00 36 5 EA Pre . Symbol, 8' Preform Straight Arrow $8 00 37 5 EA Sealer . 38 10 EA Symbol, 8' Preform Turn Arrow $180.00 White Large Install 39 10 EA Symbol, 8' Preform Turn Arrow $8.00 Remove 40 10 EA Symbol, 8' Preform Turn Arrow $8.00 Pre 41 10 EA Symbol, 8' Preform Turn Arrow $8.00 Sealer 42 5 EA Symbol, 9'6" Preform Straight $150.00 Arrow Install 43 5 EA Symbol, 9'6" Preform Straight $8.00 Arrove Remove 44 5 EA Symbol, 9'6" Preform Straight $8.00 Arrow Pre EXHIBIT A BID #4383 DATE: September 10, 2009 Annnal Cantrnet for Installation of Roadwav Pavement Markings or iiiiiii( lus, Inc. 7 Principle Place of Business: Grand Prairie, TX 45 5 EA Symbol, 9'6" Preform Straight $8.00 Arrow Sealer 46 5 EA Symbol, 12' Preform Straight $170.00 Arrow Install Symbol, 12' Preform Straight $10 00 47 2 EA Arrow Remove . 48 5 EA Symbol, 12' Preform Straight $10.00 Arrow Pre Symbol, 12' Preform Straight $10 00 49 5 EA Arrow Sealer . 50 10 EA Symbol, 13' Preform Combo Arrow $325.00 Install 51 5 EA Symbol, 13' Preform Combo Arrow No Bid Remove Symbol, 13' Preform Combo Arrow $15 00 52 10 EA Prep . 53 10 EA Symbol, 13' Preform Combo Arrow $15.00 Sealer 54 5 EA "Only" Word 8' Preform Install $230.00 55 5 EA "Only" Word 8' Remove $8.00 56 5 EA "Only" Word 8' Prep $8.00 57 5 EA "Only" Word 8' Sealer $8.00 58 5 EA "Stop" Word 8' Preform Install $230.00 59 2 EA "Stop" Word 8' Remove $8.00 60 5 EA "Stop" Word 8' Prep $8.00 61 5 EA "Stop" Word 8' Sealer $8.00 62 5 EA "Ahead" Word 8' Perform Install $285.00 63 2 EA "Ahead" Word 8' Remove $8.00 64 5 EA "Ahead" Word 8' Prep $8.00 65 5 EA "Ahead" Word 8' Sealer $8.00 66 5 EA "Yield" Word 8' Preform Install $240.00 EXHIBIT A BID #4383 DATE: September 10, 2009 Annual Contract for Installation of Roadwav Pavement Markings Item UOM Descri tion Vendor Striping Plus, Inc. Principle Place of Business: Grand Prairie, TX 67 2 EA "Yield" Word 8' Remove $8.00 68 5 EA "Yield" Word 8' Prep $8.00 69 5 EA "Yield" Word 8' Sealer $8.00 70 10 EA Symbol, 4' Preform Bike Lane $315.00 Install 71 5 EA Symbol, 4' Preform Bike Lane $10.00 Remove 72 10 EA Symbol, 4' Preform Bike Lane Prep $10.00 73 10 EA Symbol, 4' Preform Bike Lane $10.00 Sealer 74 20 EA Symbol, 6' Preform Bike Lane $350.00 Install 75 20 EA Symbol, 6' Preform Bike Lane $12.00 Remove 76 20 EA Symbol, 6' Preform Bike Lane Prep $12.00 77 20 EA Symbol, 6' Preform Bike Lane $12.00 Sealer 78 30 EA Symbol, "RXR Kit 6'-16"x20' $435.00 Preform Install 79 30 EA Symbol, "RXR Kit 6'-16"x20' $25.00 Remove 80 30 EA Symbol, "RXR Kit 6'-16"x20' Prep $25.00 81 30 EA Symbol, "RXR Kit 6'-16"x20' $20.00 Sealer 82 2,400 EA RPM-A/A Type II Install Concrete $2.95 83 2,300 EA RPM-A/A Type II Install Asphalt $2.95 84 2,100 EA RPM-C/R Type II Install Concrete $2.95 85 2,000 EA RPM-C/R Type II Install Asphalt $2.95 86 20 EA RPM-BB Type II Install Concrete $4.00 87 21 EA RPM-B/B Type II Install Asphalt $4.00 88 25,000 EA RPM Removal $0.25 EXHIBIT A BID #4383 DATE: September 10, 2009 Annual C'nntrnet for Installation of Roadway Pavement Markings Descri tion UOM Item Vendor ii i Striping Plus, Inc. Principle Place of Business: Grand Prairie, TX 89 6 EA Word - 3 number/letters 8' $75.00 Thermoplastic install 90 6 EA Word - 3 number/letters 8' $8.00 Thermoplastic remove 91 6 EA Word - 3 number/letters 8' $8.00 Thermo lastic Sealer 92 6 EA Word - 3 number/letters 8' $8.00 Thermo lastic Pre 93 6 EA Word - 4 number/letters 8' $100.00 Thermoplastic Install 94 6 EA Word - 4 number/letters 8' $10.00 Thermoplastic Remove 95 6 EA Word - 4 number/letters 8' $10.00 Thermoplastic Sealer 96 6 EA Word - 4 number/letters 8' $10.00 Thermoplastic Pre Shipment can be made in _ days from 180 receipt of order. Bidder is an authorized distributor, by the mfg. and is authorized to sell to the City. YES YES NO N/A RECT OCT-1 5 2009 CONTRACT BY AND BETWEEN CITY OF DENTON, TEXAS AND STRIPING PLUS, INC. . JZ, BID NO. 4383 ANNUAL CONTRACT FOR ROADWAY PAVEMENT MARKINGS w~ THIS CONTRACT is made and entered into this 6th day of October A.D., 2009, by and between Striping Plus, Inc. a corporation, whose address is 2469 Doreen Street Grand Prairie, TX: 75050, hereinafter referred to as "Contractor," and the CITY.OF DENTON, TEXAS, a home rule municipal corporation,'hereinafter referred to as "City," to be effective upon approval of the Denton City Council and subsequent execution of this Contract by the Denton City Manager or his duly authorized designee. For and in consideration of the covenants and agreements contained herein, -and for the mutual benefits to be obtained hereby, the parties agree as follows: I. SCOPE OF SERVICES Contractor shall provide all labor, supervision, materials and equipment necessary for installation of roadway pavement markings. These products and services shall be provided in accordance with the Specifications for Bid -4383 Annual Contract for Installation of Roadway Pavement Markings, a copy of which is attached hereto and incorporated herein as Exhibit "A" (or on file in the office of the Purchasing Agent), and the Contractor's Bid in response thereto, a copy of which is attached hereto and incorporated herein for all purposes as Exhibit "B". The Contract consists of this written agreement and the following items which are attached hereto and incorporated herein by reference: (a) Specifications for Bid 4383 ;(Exhibit "A" or on file in the office of the Purchasing Agent). (b) Contractor's Bid. (Exhibit "B"); (c) Insurance Requirements. (Exhibit "C"); (d) Form CIO - Conflict of Interest Questionnaire (Exhibit "D"). _ These documents make up the Contract documents and what is called for by one shall be as binding as if called for by all. In the event of an inconsistency or conflict in any of the provisions of the Contract documents, the inconsistency or conflict shall be resolved by giving precedence first to the written agreement then to the contract documents in the order in which they are listed above. These documents shall be referred to collectively as "Contract Documents." Bid 4383 Annual Contract for Installation of Roadway Pavement Markings . II. TIME OF COMPLETION Contractor agrees and covenants that all work hereunder shall be complete within N/A ( ) days following notice to proceed from City. Or III. TERM OF CONTRACT The initial term of this Contract shall be one year from date of contract execution unless otherwise stated. IV. WARRANTY Contractor warrants and covenants to City that all goods and services provided by Contractor, Contractor's subcontractors, and agents under the Agreement shall be free of defects and produced and performed in a skillful and workmanlike manner and shall comply with the specifications for said goods and services as set forth in this Agreement and the Bid Specifications attached hereto and incorporated herein as Exhibit "A"(or on file in the office of the Purchasing Agent). Contractor warrants that the goods and services provided to City under this Agreement shall be free from defects in material and workmanship, for a period of one (1) year commencing on the date that City issues final written acceptance of the project. V. PAYMENT Payments hereunder shall be made to Contractor following city's acceptance of the work and within thirty (30) days of receiving Contractor's invoice for the products and services delivered. Total compensation under this contract shall not exceed the sum of the unit price per line item on bid proposal form. Contractor recognizes that- this Contract shall commence upon the effective date herein and continue in full force and effect until termination in accordance with its provisions. Contractor and City herein recognize that the continuation of any contract after the close of any given fiscal year of the City of Denton, which fiscal year ends on September 30th of each year, shall be subject to Denton City Council approval. In the event that the Denton City Council does not approve the appropriation of funds for this contract, the Contract shall terminate at the end of the fiscal year for which funds were appropriated and the parties shall have no further obligations hereunder. VI. PROTECTION AGAINST ACCIDENT TO EMPLOYEES AND THE PUBLIC Contractor shall at all times exercise reasonable precautions for the safety of employees and others on or near the work and shall comply with all applicable provisions of Federal, State, and Municipal safety laws. The safety precautions actually taken and the adequacy thereof shall be the sole responsibility of the Contractor. Contractor shall indemnify City for any and all losses arising out of or related to a breach of this duty by Contractor pursuant to paragraph VIII. INDEMNIFICATION and paragraph IX. COMPLIANCE WITH APPLICABLE LAWS set forth herein. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings U L _~II l~ VII. r LOSSES FROM NATURAL CAUSES Unless otherwise specified, all loss or damage to Contractor arising out of the nature of the work to be done, or from the action of the elements, or from any unforeseen circumstances in the prosecution of the same, or from unusual obstructions or difficulties which may be encountered in the prosecution of the work, shall be sustained and borne by the Contractor at its own cost and expense. VIII. INDEMNIFICATION Contractor shall release, defend, indemnify and hold the City, its elected officials, officers and employees harmless from and against all claims, damages, injuries (including death), property damages (including loss of use), losses, demands, suits, judgments and costs, including attorney's fees and expenses, in any way arising out of, related to, or resulting from the services provided by Contractor under this Agreement or caused by the negligent act or omission or the intentional act or omission of Contractor, its officers, agents, employees, subcontractors, licensees, invitees or any other third parties for whom Contractor is legally responsible (hereinafter "Claims"). Contractor is expressly required to defend City against all -such Claims. In the event the City is a named parry to a suit arising out of the subject matter of this Contract, the City shall have reasonable input into the selection of defense counsel to be retained by Contractor in fulfilling its obligation hereunder to defend and indemnify City. City reserves the right to provide a portion or all of its own defense; however, City is under no obligation to do so. Any such action by City is not to be construed as a waiver of Contractor's obligation to defend City or as a waiver of Contractor's obligation to indemnify City pursuant to this Contract. Contractor shall retain defense counsel within seven (7) business days of City's written notice that City is invoking its right to indemnification under this Contract. If Contractor fails to retain counsel within such time period, City shall have the right to retain defense counsel on its own behalf, and Contractor shall be liable for all costs incurred by City. Ix. COMPLIANCE WITH APPLICABLE LAWS Contractor shall at all times observe and comply with all Federal, State and local laws, ordinances and regulations including all amendments and revisions thereto, which in any manner affect Contractor or the work, and shall indemnify and save harmless City against any claim related to or arising from the violation of any such laws, ordinances and regulations whether by Contractor, its employees, officers, agents, subcontractors, or representatives. If Contractor observes that the work is at variance therewith, Contractor shall promptly notify City in writing. X. VENUE The laws of the State of Texas shall govern the interpretation, validity, performance and enforcement of this Contract. The parties agree that this Contract is performable in Denton County, Texas, and that exclusive venue shall lie in Denton County, Texas. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings XI. ASSIGNMENT AND SUBLETTING Contractor agrees to retain control and to give full attention to the fulfillment of this Contract, that this Contract shall not be assigned or sublet without the prior written consent of City; and that no part or feature of the work will be sublet to anyone objectionable to City. Contractor further agrees. that the subletting of any portion or feature of the work, or materials required in the performance.of this Contract, shall not relieve Contractor from its full obligations to City as provided by this Contract. XII. INDEPENDENT CONTRACTOR Contractor covenants and agrees that Contractor is an independent contractor and not an officer, agent, servant or employee of City; that Contractor shall have exclusive control of and exclusive right to control the details of the work performed hereunder and all persons performing same, and shall be responsible for the acts and omissions of its officers, agents, employees, contractors, subcontractors and consultants; that the doctrine of respondeat superior shall not apply as between City and Contractor, its officers, agents, employees; contractors, subcontractors and consultants, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Contractor. XIII. INSURANCE AND CERTIFICATES OF INSURANCE Contractor shall. procure and maintain for the duration of the contract insurance coverage as set forth in the Insurance Requirements marked Exhibit "C" attached hereto and incorporated herein by reference. Contractor shall provide a signed insurance certificate verifying that they have obtained the required insurance coverage prior to the effective date of this Contract. XIV. HINDRANCES AND DELAYS No claims shall be made by Contractor for damages resulting from hindrances or delays from any cause during the progress of any portion of the work embraced in this Contract. XV. AFFIDAVIT OF NO PROHIBITED INTEREST Contractor acknowledges and represents it is aware of all applicable laws, City Charter, and City Code of Conduct regarding prohibited interests and that the existence of a prohibited interest at any time will render the Contract voidable. Contractor has executed the Affidavit of No Prohibited Interest, attached and incorporated herein as Exhibit "D". XVI. SEVERABILITY The provisions of this Contract are severable. If any paragraph, section, subdivision, sentence, clause, or phrase of this Contract is for any reason held to be contrary to the law or contrary to any rule or regulation having the force and effect of the law, such decisions shall not affect the remaining portions of the Contract. However, upon the occurrence of such event, either party may terminate this Bid 4383 Annual Contract for Installation of Roadway Pavement Markings Ss-, Contract by giving the other party thirty (30) days written notice. XVII. TERMINATION City may, at its option, with or without cause, and without penalty or prejudice to any other remedy it may be entitled to at law, or in equity or otherwise under this Contract, terminate further work under this contract, in whole or in part by giving at least thirty (30) days prior written notice thereof to Contractor with the understanding that all services being terminated shall cease upon the date such notice is received. XVIII. ENTIRE AGREEMENT This Contract and its attachments embody the entire agreement between the parties and may only be modified in writing if executed by both parties. XIX. CONTRACT INTERPRETATION Although this Contract is drafted by City, should any part be in dispute, the parties agree that the Contract shall not be construed more favorably for either party. XX. SUCCESSORS AND ASSIGNS This Contract shall be binding upon the parties hereto, their successors, heirs, personal representatives and assigns. XXI. HEADINGS The headings of this Contract are for the convenience of reference only and shall not affect in any manner any of the terms and conditions hereof. XXII. RIGHT TO AUDIT The OWNER shall have the "night to audit and make copies of the books, records and computations pertaining to this agreement. The CONTRACTOR shall retain such books, records, documents and other evidence pertaining to this agreement during the contract period and five years thereafter, except if an audit is in progress or audit findings are yet unresolved, in which case records shall be kept until all audit tasks are completed and resolved. These books, records, documents and other evidence shall be available, within 10 business days of written request. Further, the CONTRACTOR shall also require all Subcontractors, material suppliers, and other payees to retain all books, records, documents and other evidence pertaining to this agreement, and to allow the OWNER similar access to those documents. All books and records will be made available within a 50 mile radius of the City of Denton. The cost of the audit will be borne by the OWNER unless the audit reveals an overpayment of 1% or greater. If an overpayment of 1% or greater occurs, the reasonable cost of the audit, including any travel costs, must be borne by the CONTRACTOR which must be payable within five business days of receipt of an invoice. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings Failure to comply with the provisions of this section shall be a material breach of this contract and shall constitute, in the OWNER'S sole discretion, grounds for termination thereof. Each of the terms "books" "records" "documents" and "other evidence" as used above shall be construed to include drafts and electronic files, even if such drafts or electronic files are subsequently used to generate or prepare a final printed document. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings IN WITNESS WHEREOF, the parties of these presents have executed this agreement in.the year and day first above written. CONTRACTOR BY: O ER (SIGNATURE) Date: ' Name: ti. L;. Kroepiii Title: President MAILING ADDRESS (~~t • 733->~rc~ PHONE NUMBER FAX. , NUMBER ~qdp sa)' R. C. KV06PI a .1dow>1.0 ' President PRINTED NAME CITY OFD NTON TE BY: CITY MANAGE D TE: /l y D ' ART ' NTAL APPROVAL APPROVED AS TO LEGAL FORM ANITA BURGESS, CITY ATTORNEY BY: DATE: Bid 4383 Annual Contract for Installation of Roadway Pavement Markings (f~ - RECD AUG 2 4 2009 ~ - s Purchasing Department 901-B Texas St Denton, TX 76209 (940) 349-7100 www.dentonpurchasing.com Bid #4383 Annual Contract For Installation of Roadway Pavement Markin s BIDS DUE: SEPTEMBER 10, 2009 2:00 P.M. Bid. submitted by:' C'Ompahy Name CITY OF DENTON ANNUAL CONTRACT FOR INSTALLATION OF ROADWAY PAVEMENT MARKINGS TOTAL ITEM QTY. TDESCRIPTION UMT PRICE AMOUNT 1 20,000 LF 4" White Thermoplastic Install s 3e? 74©0i 2 26,000. LF 4" White Paint Install • 1 6 qa 3 94000 LF 4"Yellow Thermo antic Install 4 80,000 LF. 4" Yellow Paint Install a l y / 5 35,000 LF 4" Removal 0. 6 114000 LF 4" Prep 06? o2 0 0,- 7 40,000 LF 4"Sealer O~ ~0 8 30,000 LF 6" White Thermoplastic Install • I 9 5;000 LF 6" Removal v29 t9 0- 10 10,000 LF 6" Prep r l C90- 11 2,500 LF 6" Sealer • I - 12 15,000 LF - 8" White Thermoplastic Install r 5. 13 3,500 LF 8" White Paint Install a 9'00- 14 7,500 LF 8" Removal 7-57 15 14000 LF 8" Prep o /s2 -c f-06 e 16 6,500 LF 8" Sealer 0 17 4,000 LF 24" White Thermoplastic Install , Q 1.2, OD - 18 500 LF 24" Yellow Thermoplastic I nstall 3, L9 0 1 c9 19 3,000 LF 240 Remove /00 400000 20 4,000 LF 24"Prep Z7 o& 21 2,000 LF 24" S eater . -7-5, ®0- 22 100 EA Yield Line 16'x24" Tria e Whi teThem-o lastic Install '00- 600, 23 20 EA Yield Line 16'x24" Triangle Remove . 00 q91 24 100 EA Yield Line 16'x24" Triangle Pre 70 70- 25 100 EA Yield Line 16'x24" Triangle Sealer / 0- a Install 7-✓ , 26 5 EA bol, 6' Preform Straight Arrow White Larg PAGE 1 OF BID #4383 Bidder's Initials CITY OF DENTON ANNUAL CONTRACT FOR INSTALLATION OF ROADWAY PAVEMENT MARKINGS 11 ft OEM TOTAL ITEM QTY. UOM DESCRIPTION UNIT PRICE AMOUNT 27 2 EA Symbol, 6 Preform Straight Arrow Remove E e0 28 5 EA Symbol, 6' Preform Straight Arrow Prep . (3 d 30, 29 5 EA symbd, 6' Preform Strai t Arrow Sealer B • 30 5 EA Symbol, 66' Preform Tum Arrow White Large Install '1-5,00 ? 31 2 EA symbol, 5'6' Preform Tum Arrow Remove 6.00 32 5 EA Symbol, 66' Preform Tum Arrow Prep 20, 33 5 EA Symbol, 5'6' Preform Turn Arrow Sealer ~p 0 0 34 5 EA Symbol, 8 Preform Straight Arrow White Large Install , 00 7,50 e 35 5 EA Symbol, 8 Preform Straight Arrow Rerrove 36 5 EA Symbol, 8' Preform Straight Arrow Prep 00 oo 37 5 EA Symbol, 8' Preform Straight Arrow Sealer 7, 0 O s 38 10 EA Symbol, 8' Preform Tum Arrow White Larg a Install Be- IDD / 900 39 10 EA Symbol, 8' Preform Tum Arrow Remove Yc 0 0 40 10 EA Symbol, 8' Preform Tum Arrow Prep • ® a 41 10 EA Symbol, 8' Preform Turn Arrow Seal er e 42 5 EA Symbol, 9'6' Preform Straight Arrow Install 7,-F0 43 5 EA Symbol, 9'6' Preform Straight Arrow Remove O 0 Q s 44 5 -EA Symbol, 9'6' Preform Straight Arrow Prep 91,00 o 45 5 EA Symbol, 9'6' Preform Straight Arrow Sealer A 46 5 EA Symbol, 12' Preform Straight Arrow Install 70d00 gS'Pe 47 2 EA Symbol, 12 Preform Straight Arrow Remove A9.00 CJ • 48 5 EA Symbol, 12' Preform Strai ht Arrow Pre /0.00. Q s 49 5 EA Symbol, 12 Preform Straight Arrow Sealer /19'(90 50 10 EA symbol, 13' Preform combo Arrow i nstall DO • 51 5 EA Symbol, 13' Preform Combo Arrow Remove PAGE 2 OF BID #4383 Bidder's Initials CITY OF DENTON ANNUAL CONTRACT FOR- INSTALLATION OF ROADWAY PAVEMENT MARKINGS MEN= Simeon TOTAL ITEM QTY. -UOM DESCRIPTION UwT PRICE AMOUNT - 52 10 EA Symbol, 1 S Preform Combo Arrow Prep /S7 0 0 /30. 53 10 EA Symbol, 1 a Preform Con-bo Arrow Sealer /-S.00 ~S 0-- 54 5 EA "ony Word 9 Preform Install 0.0 0. /,~D• 55 5 EA "Only" Word 9 Remove 0.00 56 5 EA "Onl word 9 Prep L/ Olt 57 5 EA "Only" Word 8' Sealer X oo 58 5 EA "stop" Word 8' Preform Install 230-01) 59 2 EA "Stop" Word 8' Remove 1,00 rp • .60 5 EA "Stop" Word 9 Prep 61 5 EA "Stop" Word 8' Sealer 8 0 62 5 EA "Ahead" Word 8" Preform Install p~~ ~~J • 63 2 EA "Ahead" Word 8' Remove 64 5 EA "Ahead" Word 8" Prep O 'l 65 5 EA "Ahead" Word 8" Sealer ~Q B • 66 5 EA "Yield" Word & Preform Install 67 2 EA "Yield" Word & Remove d • ©o f !Q ' 68 5 EA "Yield" Word 8" Prep B © D 69 5 EA "Veld" Words Sealer Q qO 70 10 EA Symbol, 4' Preform Bike Lane Instal I 71 5 EA Symbol, 4' Preform Bike Lane Remove /19,00 ~0 72 10 EA Symbol, V Preform Bike Lane Prep 0.00 too. 73 10 EA Symbol, 4' Preform Bike Lane Sealer 74 20 EA Symbol, 6 Preform Bike Lane Install -5"0. 00 Q (9 0, 75 20 EA Symbol, 5 Preform Bike Lane Remove 0 0 '0~- q D ! 76 20 EA Symbol, 6 Preform Bike Lane Prep 0 0 q 77 20 EA Symbol, 6 Preform Bike Lane Sealer f 00 PAGE 3 OF BID #4383 Bidder's Initials CITY OF DENTON ANNUAL CONTRACT FOR INSTALLATION OF ROADWAY PAVEMENT MARKINGS MEMNON- i TOTAL ITEM QTY. UOM DESCRIPTION UNIT PRICE AMOUNT 78 30 EA Syn t of "RXR lit 5-16" )20' Preform Install . (90 79 30 EA synt)ol "RXR Kt 6-16"x20' Remove `COQ 80 30 EA Symbol "RXR Kt 6-16W U Prep SD- 8'f 30 EA Symbol "RXR Kjt 6'-16")QO' Sealer Q, d 0 ~Q Q,. 82 2,400 EA RPM - A/A Type 11 Install Concrete 9 7019. 83 2,300 EA RPM - A/A Type 11 Install Asphalt 7o05. 52. 84 2,100 EA RPM - C/R Type I I Install Concrete 2. 9 ! S? 85 -2,000 EA RPM - C/R Type 11 Install Asphalt ~(Q 196 86 20 EA RPM -13/13 Type 11 Install Concrete 41(90 WOO 87 21 EA RPM - B/B Type 11 Install Asphalt 4(00 8y, 88 25,000 EA RPM Removal 89 6 EA Word-3 number/letters g Thermoplastic Install 7r 90 6 EA Word-3 nunnber/letters 8' Thermo asbc Remove 8. o Q 10. 91 6 EA Word-3 number/letters 8' Thermoplastic Sealer ~.QO ~0 .92 6 EA Word-3 number/letters 8' Thermoplastic Prep O e ~ • 93 6 EA Word4 number/letters 8' Thermoplastic I rtstall ®B . 94 6 EA Word-4 number/letters 8' Thermoplastic Remove 95 6 EA Word-4 number/letters 8' Thermoplastic Sealer (9 ,o v 96 6 EA Word-4 nurnbu/letters Thermoplastic Prep Shipment can be made in edays from receipt of order. *Prices shag be bid F.O.B. Denton cZO e-15 'in case of calculation error, unit pricing shall prevail. Bidder is an authorized distributor, by them ufacturer, and is authorized to sell to the City YES NO N/A of Denton? Date Signature of Authorized Representative Company Name PAGE 4 OF BID #4383 Bidder's Initials CITY OF DENTON ANNUAL CONTRACT FOR INSTALLATION OF ROADWAY PAVEMENT MARKINGS The undersigned agrees this bid becomes the property of the City of Denton after the official opening. The undersigned affirms he has familiarized himself with the local conditions under which the work is to be performed; satisfied himself of the conditions of delivery, handling and storage of equipment and all other matters that may be incidental to the work, .before submitting a bid. The undersigned agrees, if this bid is accepted, to fumish any acid all items/services upon which prices are offered, at the price(s) and upon the terms and conditions contained in the Specifications. The period for acceptance of this Bid Proposal will be sixty (60) calendar days unless a different period is noted by the bidder. The undersigned affirms that they are duly authorized to execute this contract, that this bid has not been prepared in collusion with any other Bidder, nor any employee of the City of Denton, and that the contents of this bid have not been communicated to any other bidder or to any employee of the City of Denton prior to the official opening of this bid. Vendor hereby assigns to purchaser any and all claims for overcharges associated with this contract which arise under the antitrust laws of the United States, 15 USCA Section 1 et seg., and which arise under the antitrust laws of the State of Texas, Tex. Bus. & Com. Code, Section 15.01, et seg. The undersigned affirms that they have read and do understand the specifications and any attachments contained in this bid package. NAME AND ADDRESS OF COMPANY: AUTHORIZED PRESE TATIVE: (AP/CZJ ~Nc• Signature 4~4 . .1 Jr, mlz ee4,) .f%• Date Name ~41-4111-11k 6611daV Title ~r Ct 1*efi~e,,47- Tel. No. 33 Fax No. Email. c1 ~voo~c~ sT~i /;V, r l.,cl . e4ly COMPANY IS: Busin ss included in a Corporate Income Tax Return? /YES NO Corporation organized & existing under the laws of the State of C~ /4--f Partnership consisting of Individual trading as Principal offices are in the city of PAGE 5 OF BID #4383 Bidder's Initials CITY OF DENTON _ y ANNUAL CONTRACT FOR INSTALLATION OF ROADWAY PAVEMENT MARKINGS COMPLETE SET OF ORIGINAL AND ONE (1) COPY OF EXECUTED BID PROPOSAL MUST BE RECEIVED IN THE PURCHASING DEPARTMENT AT 901-B TEXAS ST, DENTON, TX 76209 ON OR BEFORE SEPTEMBER 1.0, 2009 AT 2:00 P.M. QUESTIONS REGARDING SPECIFICATIONS MUST BE SUBMITTED IN WRITING TO THE PURCHASING OFFICE FIVE (5) WORKING DAYS PRIOR TO THE BID OPENING. ALL QUESTIONS SUBMITTED AFTER THAT DATE WILL NOT BE CONSIDERED TO ENSURE ALL BIDDERS ARE GIVEN EQUAL ACCESS TO THE INFORMATION PROVIDED. All questions regarding the bid and purchasing process should be directed to: KAREN SMITH, SENIOR UTILITY BUYER Email: Karen.Smith@cityofdenton.com Phone: (940) 349-7100 Fax: (940) 349-7302 Directions to the Purchasing Department can be accessed atwww.dentonourchasing:com (Click on "Directions to our Office") All bids, including a "NO BID", are due in the Purchasinq Department by the due date, in sealed envelopes or boxes. All bids must be clearly marked with the name of the Company submitting the bid, the Bid Number and Date and Time of opening on the outside of the envelope/box. Original bid must be clearly marked "ORIGINAL" and contain all original signatures. All proposal pages must be initialed or signed where indicated. All bids will be publicly opened at the date and time listed above or as soon thereafter as practical. The City of Denton does not accept faxed bids. Any bid received after the date and/or hour set for bid openinq will be returned unopened. If bids/proposals are sent by mail to the Purchasing Department, the bidder shall be responsible for actual delivery of the bid to the Purchasing Department before the advertised date and hour for opening of bids. If mail is delayed either in the postal service or in the internal mail system of the City of Denton beyond the date and hour set for the bid opening, bids thus delayed will not be considered and will be returned unopened. Bids may be withdrawn at any time prior to.the official opening. Alterations made before opening time, must be initialed by bidder guaranteeing authenticity. Any attempt to negotiate or give information on the contents of this bid with the City of Denton or its representatives prior to award shall be grounds for disqualification. After the official opening, bids become the property of the City of Denton and may not be amended, altered or withdrawn without the recommendation of the Purchasing Agent: The approval of the City Council is required for public works projects. The City of Denton reserves the right to accept or reject in part or in whole any bids submitted, unless denied by the bidder; and to waive any technicalities for the best interest of the City. Any submitted article deviating from the specifications must be identified and have full descriptive data accompanying same, or it will not be considered. Submitted bids shall remain in force for a sixty (60) day period after opening or until award is made; whichever comes first. In case of default after bid acceptance, the City of Denton may at its option hold the accepted bidder or contractor liable for any and all resultant increased costs as a penalty for such default. The City of Denton will award the bid to the lowest responsible bidder while complying with all current state and local laws. The City of Denton is exempt from Federal Excise and State Sales Tax; therefore, tax must not be included in this bid. PAGE 6 OF BID #4383 Bidder's initials EXHIBIT C CITY OF DENTON INSURANCE REQUIREMENTS FOR CONTRACTORS Bidder's attention is directed to the insurance requirements below. It is highly recommended that bidders confer with their respective insurance carriers or brokers to determine in advance of Bid submission the availability of insurance certificates and endorsements as prescribed and provided herein. If an apparent low bidder fails to comply strictly with the insurance requirements, that bidder may be disqualified from award of the contract. Upon bid award, all insurance requirements shall become contractual obligations, which the successful bidder shall have a duty to maintain throughout the course of this contract. STANDARD PROVISIONS: Without limiting any of the other obligations or liabilities of the Contractor, the Contractor shall provide and maintain until the contracted work has been completed and accepted by the City of Denton, Owner, the minimum insurance coverage as indicated hereinafter. As soon as practicable after notification of bid award, Contractor shall file with the Purchasing Department satisfactory certificates of insurance, containing the bid number and title of the project. Contractor may, upon written request to the Purchasing Department, ask for clarification of any insurance requirements at any time; however, Contractors are strongly advised to make such requests prior to bid opening, since the insurance requirements may not be modified or waived after bid opening unless a written exception has been submitted with the bid. Contractor shall not commence any work or deliver any material until he or she receives notification that the contract has been accepted, approved, and signed by the City of Denton. All insurance policies proposed or obtained in satisfaction of these requirements shall comply with the following general specifications; and shall be maintained in compliance with these general specifications throughout the duration of the Contract, or longer, if so noted: • Each policy shall be issued by a company authorized to do business in the State of Texas with an A.M. Best Company rating of at least A. • Any deductibles or self-insured retentions shall. be declared in the bid proposal. If requested by the City, the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect to the City,- its officials, agents, employees and volunteers; or, the. contractor shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. • Liability policies shall be endorsed to provide the following: • Name as additional insured the City of Denton, its Officials, Agents, Employees and volunteers. • That such insurance is primary to any other insurance available to the additional insured with respect to claims covered under the policy and that this insurance applies separately to each insured against whom claim is made or Bid 4383 Annual Contract for Installation of Roadway Pavement Markings EXHIBIT C suit is brought. The inclusion of more than one insured shall not operate to increase the insurer's limit of liability. • Cancellation: The City requires 30 day written notice should any of the policies described on the certificate be cancelled or materially changed before the expiration date. • Should any of the required insurance be provided under a claims-made form, Contractor shall maintain such coverage continuously throughout the term of this contract and, without lapse, for a period of three years beyond the contract expiration, such that occurrences arising during the contract term which give rise to claims made after expiration of the contract shall be covered. • Should any of the required insurance be provided under a form of coverage that includes a general annual aggregate limit providing for claims investigation or legal defense costs to be included in the general annual aggregate limit, the Contractor shall either double the occurrence limits or obtain Owners and Contractors Protective Liability Insurance. • Should any required insurance lapse during the contract term, requests for payments originating after such lapse shall not be processed until the City receives satisfactory evidence of reinstated coverage as required by this contract, effective as of the lapse date. If insurance is not reinstated, City may, at its sole option, terminate this agreement effective on the date of the lapse. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings EXHIBIT C SPECIFIC ADDITIONAL INSURANCE REQUIREMENTS: All insurance policies proposed or obtained in satisfaction of this Contract shall additionally comply • with the following marked specifications, and shall be maintained in compliance with these additional specifications throughout the duration of the Contract, or longer, if so noted: [X ] A. General Liability Insurance: General Liability insurance with combined single limits of not less than $500,000.00shall be provided and maintained by the Contractor. The policy shall be written on an occurrence basis either in a single policy or in a combination of underlying and umbrella or excess policies. If the Commercial General Liability form (ISO Form CG 0001 current edition) is used: • Coverage A shall include premises, operations, products, and completed operations, independent contractors, contractual liability covering this contract and broad form property damage coverage. • Coverage B shall include personal injury. • Coverage C, medical payments, is not required. If the Comprehensive General Liability form (ISO Form GL 0002 Current Edition and ISO Form GL 0404) is used, it shall include at least: • Bodily injury and Property Damage Liability for premises, operations, products and completed operations, independent contractors and property damage resulting from explosion, collapse or underground (XCU) exposures. • Broad form contractual liability (preferably by endorsement) covering this contract, personal injury liability and broad form property damage liability. [X] Automobile Liability Insurance: Contractor shall provide Commercial Automobile Liability insurance with Combined Single Limits (CSL) of not less than $300,000.00 either in a single.policy or in a combination of basic and umbrella or excess policies. The policy will include bodily injury and property damage liability arising out of the operation, maintenance and use of all . automobiles and mobile equipment used in conjunction with this contract. Satisfaction of the above requirement shall be in the form of a policy endorsement for: • any auto, or • all owned, hired and non-owned autos. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings EXHIBIT C [X] Workers Compensation Insurance Contractor shall purchase and maintain Worker's Compensation insurance which, in addition to meeting the minimum statutory requirements for issuance of such insurance, has Employer's Liability limits of at least $100,000 for each accident, $100,000 per each employee, and a $500,000 policy limit for occupational disease. The City need not be named as an "Additional Insured" but the insurer shall agree to waive all rights of subrogation against the City, its officials, agents, employees and volunteers for any work performed for the City by the Named Insured. For building or construction projects, the Contractor shall comply with the provisions of Attachment 1 in accordance with §406.096 of the Texas Labor Code and rule 28TAC 110.110 of the Texas Worker's Compensation Commission (TWCC). [ ] Owner's and Contractor's Protective Liability Insurance The Contractor shall obtain, pay for and maintain at all times during the prosecution of the work under this contract, an Owner's and Contractor's Protective Liability insurance policy naming the City as insured for property damage and bodily injury which may arise in the prosecution of the work or Contractor's operations under this contract. Coverage shall be on an "occurrence" basis, and the policy shall be issued by the same insurance company that carries the Contractor's liability insurance. Policy limits will be at least combined bodily injury and property damage per occurrence with a aggregate. [ ] Fire Damage Legal Liability Insurance Coverage is required if Broad form General Liability is not provided or is unavailable to the contractor or if a contractor leases or rents a portion of a City building. Limits of not less than - each occurrence are required. [ ] Professional Liability Insurance Professional liability insurance with limits not less than per claim with respect to negligent acts, errors or omissions in connection with professional services is required under this Agreement. [ ] Builders' Risk Insurance Builders'. Risk Insurance, on an All-Risk form for 100% of the completed value shall be provided. Such policy shall include as "Named Insured" the City of Denton and all subcontractors as their interests may appear. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings EXHIBIT C [ ] Commercial Crime Provides coverage for the theft or disappearance of cash or checks, robbery inside/outside the premises, burglary of the premises, and employee fidelity. The employee fidelity portion of this coverage should be written on a "blanket" basis to cover all employees, including new hires. This type insurance should -be required if the contractor has access to City funds. Limits of not less than each occurrence are required. [ ] Additional Insurance Other insurance may be required on an individual basis for extra hazardous contracts and specific service agreements. If such additional insurance is required for a specific contract, that requirement will be described in the "Specific Conditions" of the contract specifications. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings EXHIBIT C ATTACHMENT 1 [X] Worker's Compensation Coverage for Building or Construction Projects for Governmental Entities A. Definitions: Certificate of coverage ("certificate ")-A copy of a certificate of insurance, a certificate of authority to self-insure issued by the commission, or a coverage agreement (TWCC-81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation insurance coverage for the person's or entity's employees providing services on a project, for the duration of the project. Duration of the project - includes the time from the beginning of the work on the project until the contractor's/person's work on the project has been completed and accepted by the governmental entity. Persons providing services on the project ("subcontractor" in §406.096) - includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project, regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees. This includes, without limitation, independent contractors, subcontractors, leasing companies, motor carriers, owner-operators, employees of any such entity, or employees of any entity which furnishes persons to provide services on the project. "Services" include, without limitation, providing, hauling, or delivering equipment or materials, or providing labor, transportation, or other service related to a project. "Services" does not include activities unrelated to the project, such as food/beverage vendors, office supply deliveries, and delivery of portable toilets. B. The contractor shall provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any overage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all employees of the Contractor providing services on the project, for the duration of the project. C. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. D. If the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project, the contractor must, prior to the end of the coverage period, file a new certificate of coverage with the. governmental entity showing that coverage has been extended. E. The contractor shall obtain from each person providing services on a project, and provide to the governmental entity: 1) a certificate of coverage, prior to that person beginning work on the project, so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project; and Bid 4383 Annual Contract for Installation of Roadway Pavement Markings EXHIBIT C L: - 2) no later than seven days after receipt by the contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project. F. The contractor shall retain all required certificates of coverage for the duration of the project and for one year thereafter. G. The contractor shall notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the contractor knew or should have known, of any change that materially affects-the provision of coverage of any person providing services on the project. H. The contractor shall post on each project site a notice, in the text, form and manner prescribed by the Texas Workers' Compensation Commission, informing all persons - providing services on the project that they are required to be covered, and stating how -a person may verify coverage and report lack of coverage. 1. The contractor shall contractually require each person with whom it contracts to provide services on a project, to: 1) provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all of its employees providing services on the project, for the duration of the project; 2) provide to the contractor, prior to that person beginning work on the project, a certificate of coverage showing that coverage is being provided for all employees of the person providing services on the project, for the duration of the project; 3) provide the contractor, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; 4) obtain from each other person with whom it contracts, and provide to the contractor: a) certificate of coverage, prior to the other person beginning work on the project; and b) a new certificate of coverage showing extension of coverage, prior to the end of the coverage period, if the coverage period shown on the current certificate of coverage. ends during the duration of the project; 5) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; 6) notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and Bid 4383 Annual Contract for Installation of Roadway Pavement Markings EXHIBIT C 23 7) contractually require each person with whom it contracts, to perform as required by paragraphs (1) - (7), with the certificates of coverage to be provided to the person for whom they are providing services. J. By signing this contract or providing or causing to be provided a certificate of coverage, the contractor is representing to the governmental entity that all employees of the contractor who will provide services on the project will be covered by workers' compensation coverage for the duration of the project, that the coverage will be based on proper reporting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self-insured, with the commission's Division of Self-Insurance Regulation. Providing false or misleading information may subject the contractor to administrative penalties, criminal penalties, civil penalties, or other civil actions. K. The contractor's failure to comply with any of these provisions is a breach of contract by the contractor which entitles the governmental entity to declare the contract void if the contractor does not remedy the breach within ten days after receipt *of notice of breach from the governmental entity. Bid 4383 Annual Contract for Installation of Roadway Pavement Markings 41 EXHIBIT D .CDNFLICT OF INTEREST QUESTIONNAIRE FORM CIQ -Tor vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. OFFICE USE ONLY This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a Date Received person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 1 Name of person 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 Ph business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3 Name of local government officer with whom filer has an employment or business relationship. Name of Officer This section, (item 3 including subparts A, B, C & D), must be completed for each officer with whom the filer 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 filer of the questionnaire? Yes 0 No B. Is the filer of the questionnaire 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? F-1 Yes o 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 10 percent or more? 0 Yes F-1 No D. Describe each affiliation or business relationship. 4 Signature of person doing business with the governmental entity Date Adopted 06/29/2007 Bid 4383 Annual Contract for Installation of Roadway Pavement Markings -~ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MWDDffM PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SIG/INSURANCE SOLUTIONS GROUP ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 7540 N.E. LOOP 820 SUITE 100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR NORTH RICHLAND HILLS TX 76180 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (817) 354-6800 INSURERS'AFFORDING COVERAGE NAIC # INSURED INSURER A STRIPING PLUS, INC INSURER B 2469 DOREEN STREET to INSURER C: GRAND PRAIRIE TX 75050- INSURER D: L- I INSURER I COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION A GENERAL UABILITY 60379399 01/17/2009 01/17/2010 EACH OCCURRENCE $ X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE a OCCUR MED EXP (Arw one person) $ 5,000 1,000, X comrRAcTI lAT. PERSONAL&ADV INJURY $ X xcl i GENERAL AGGREGATE $ 2, 00,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000 POLICY X PRO- LOC A AUTOMOBILE LIABI 60379399 01/17/2009 01/17/2010 COMBINED SINGLE LIMIT X ANY AUTO (Ea accidenQ $ 1,000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULEDAUTOS (Per person) $ X HIRED AUTOS BODILY INJURY (Per a=WefM $ X NON-OWNED AUTOS X DRIVE OTHER CAR PROPERTY DAMAGE $ (Per a=Weq GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG A EXCESSIUMBRELLA LIABILITY 60379399 01/17/2009 01/17/2010 EACH OCCURRENCE $ X OCCUR CLAIMS MADE AGGREGATE S 2000000 S DEDUCTIBLE RX RETENTION S 'S 10,000 B WORKERS COMPENSATION AND SRZA 18855-09 01/17/2009 01/17/2010 X WC1I WIT 0 EMPLOYERS' UABIUTY EL EACH ACCIDENT $ 1,000,000 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ If yes, desatbe under EL DISEASE - POLICY LIMIT $ 1,0000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSHAS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS THE CITY OF DENTON IT'S OFFICIALS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED D] A~_, INS DON ENERAL LIABILITYUTO LIABILITY ADN EXCESS LAIBILITY POLICIES.. SURANCE IS P Y AND NONCONTRIBUTORY. AIV=R_OF SUB OGATION IN FAVOR OF THE CITY OF DENTON ON ALL POLICIE . CERTIFICATE HOLDER CANCELLATION AI 001052 / SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH_J=EXPIRATION THE CITY OF DENTOlV- t-, ~;J O Z 1 ~ TETHEREOF, THE ISSUING INSURER W! L `/DAYS WRITTEN 901 B TEXAS STREET I / NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL DENTON TX 76209 7 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR BID 4383 0 3 A 13 {3 ~ REPRESENTATIVES. a J. l ~~F I jt6e7)R4D REPRESENTATIVE ACORD 26 (2001108) Fax: (940)349-7302 © ACORD CORPORATION 1988