1-Contract Documents and Specifications.pdf

CITY OF WESTERVILLE

FINANCE DEPARTMENT: BUILDING & GROUNDS DIVISION

Contract Documents and Specifications for the

City Hall and Justice Center Grounds Maintenance Services

Project No. 2025-501

Project Type: Request for Quotations (RFQ)

Closing Date and Time Wednesday, December 3, 2025

5:00 PM

Submit To:

Electronic Submissions https://westerville.bonfirehub.com/opportunities/210356

Point of Contact for Written Questions:

Eric Beverly Facilities Maintenance Manager Finance Department Bids@westerville.org https://westerville.bonfirehub.com/opportunities/210356 mailto:Bids@westerville.org

FINANCE DEPARTMENT: BUILDING & GROUNDS DIVISION

City Hall and Justice Center Grounds Maintenance Services Project No. 2025-501

ADMINISTRATIVE OFFICIALS

Monica Dupee City Manager Matt Yoder Director of Finance Andrew Winkel Director of Law

MEMBERS OF COUNCIL

Michael Heyeck Council Chair Megan Reamsnyder Vice-Chair Kenneth L. Wright Mayor Coutanya Coombs Vice-Mayor Aaron Glasgow Member David Grimes Member Jeff Washburn Member

November 12, 2025

CITY OF WESTERVILLE

FINANCE DEPARTMENT

64 E. WALNUT STREET

WESTERVILLE, OHIO 43081

CHECKLIST

Quoters are urged to complete this checklist to confirm that all required documents are included with their quotation. Failure to submit the listed documents may result in disqualification of the quotation.

Name Type # Files Requirement Included with Quote Provide

Later Price Form

(Quoter signature required.)

File Type:

PDF (.pdf)

1 Required

Experience Record File Type:

PDF (.pdf)

1 Optional (needed within two (2) business days of the closing time)

Noncollusion Affidavit

File Type:

PDF (.pdf)

1 Optional (needed prior to the issuance of the NOTICE TO

PROCEED)

Personal Property Tax Affidavit

File Type:

PDF (.pdf)

1 Optional (needed prior to the issuance of the NOTICE TO

PROCEED)

PUBLIC NOTICE

Quotations for the City Hall and Justice Center Grounds Maintenance Services (Project No. 2025-501) will be received by the City of Westerville, Ohio until the closing date and time of 5:00 p.m. (local time) on Wednesday, December 3, 2025.

The work in accordance with the Contract Documents and Specifications, dated November 12, 2025, and any addenda thereto, includes all labor, materials, supervision, equipment, services, and expertise required to accomplish the high-touch grounds maintenance services needed for the Westerville City Hall Complex and Westerville Justice Center, including, but not limited to, weed control, bed cleanup, mulching, shrub maintenance, and litter removal.

The Contract Documents and Specifications are available at no cost via the City’s Bonfire Procurement Portal at: https://westerville.bonfirehub.com/opportunities/210356. Vendors new to the City’s Bonfire Procurement Portal will need to create a FREE Bonfire account.

A non-mandatory Pre-Quotation Conference will be held on Wednesday, November 19, 2025, at 11:00 a.m.

(local time) for all quoters. Quoters may join via a video call link:https://meet.google.com/hoa-ueju-gny Or dial: (US) +1 386-603-2633 PIN: 990 832 860#

No bonds, either a bid bond or performance/payment bond will be required.

No quoters may withdraw their quotation for a period of 60 days after the actual closing date and time.

The City reserves the right not to award a contract and to reject any or all quotations and to waive any informalities and irregularities. Subject to the right of the City not to award a contract and to reject any or all quotations, the City will award a Contract to the quoter submitting the lowest and best quotation, taking into consideration accepted alternates.

Point of Contact for Written Questions:

Eric Beverly Facilities Maintenance Manager Finance Department Bids@westerville.org

Advertise: November 12, 2025 https://meet.google.com/hoa-ueju-gny mailto:Bids@westerville.org

21 South State Street

Westerville, Ohio 43081

INFORMATION FOR QUOTERS

PREPARATION AND DELIVERY OF QUOTATIONS

Quotations will be received by the City of Westerville, Ohio, until the closing date and time of 5:00 p.m.

(local time), Wednesday, December 3, 2025.

Quotations must be submitted in electronic format ONLY in accordance with the below submission instructions.

Submission Instructions for Electronic Quotations

Electronic quotations must be uploaded at:

https://westerville.bonfirehub.com/opportunities/210356

Please review the Checklist and note the type and number of files allowed. The maximum upload file size is

1000 MB.

Quoters will not be able to prepare a submission unless they submit 'Yes' for their Intent to Bid.

As uploading large documents may take significant time, depending on the size of the file(s) and Internet connection speed, it is recommended that the quoter allow sufficient time before closing time to begin the upload process and finalize their submission.

Each item of requested information will only be visible to the City after the closing time.

The quoter will receive an email confirmation receipt with a unique confirmation number once they finalize their submission.

Minimum system requirements: Microsoft Edge, Google Chrome, or Mozilla Firefox. Javascript must be enabled. Browser cookies must be enabled.

Need Help with an Electronic Submission?

The City of Westerville uses a Bonfire portal for accepting quotations digitally. Please contact Bonfire at Support@GoBonfire.com for technical questions related to your submission or contact the City’s Procurement Manager at Thomas.Patterson@westerville.org for general questions related to your submission.

General Instructions for Electronic Quotations

All quotations must be submitted on the forms provided. All blank spaces shall be filled in, in ink or typed, in figures. The quoter shall provide unit prices and/or lump sum prices on the Price Form. Each quoter must quote on all items and alternates contained in the Price Form. All quotations not in conformity with this notice may be considered informal and may be rejected. Failure to furnish all information requested on the Price Form or other documents requested may result in disqualification of the quotation.

It is the sole responsibility of the quoter to see that their quotation is received by the proper time.

Quoters are urged to submit with their quotation a completed Experience Record form.

BONDS

No bonds, either a bid bond or performance bond will be required.

CONTRACT

The quoter to whom the award is made will be required to execute a written contract with the City of Westerville, Ohio as required by the City Manager.

SCOPE OF WORK; TERM

Work under this Contract shall consist of the items contained in the Contract Documents and Specifications, including all incidentals necessary to fully complete said work in accordance with the Contract Documents and Specifications. Prices quoted shall include all trades, materials, equipment, fuel, labor, expertise, supervision, delivery, services, overhead, profit, and any other cost or expense, in connection with or incidental to, the performance of that portion of the work to which the prices apply.

The initial Contract will cover work over a one (1) year period beginning January 1, 2026, and ending December 31, 2026. This period will include one (1) Contract Season/Year: 2026. The work for each Contract Season/Year will commence dependent on growing conditions or as directed by the City. At the City’s option, the Contract may be renewed for up to four (4) additional one (1) year periods (2027 Contract Season/Year, 2028 Contract Season/Year, 2029 Contract Season/Year, and 2030 Contract Season/Year) with a history of good performance. All terms and conditions (including pricing) shall remain unchanged from the initial Contract and shall be in full force and effect. The award of the Contract for 2026, 2027, 2028, 2029 and 2030 are subject to appropriation of funds approved by the Westerville City Council.

The option to renew, if exercised, will be executed in the form of a renewal letter to be issued not sooner than ninety (90) days prior to the expiration of the current contract period, nor later than the final day of the current contract period.

NONDISCRIMINATION IN EMPLOYMENT

The contractor (successful quoter) agrees that in the hiring of employees for the performance of work under this contract or any subcontract, no contractor, subcontractor, or any person acting on their behalf shall, by reason of race, color, religion, sex, national origin, age, familial status, military status, disability, pregnancy, sexual orientation, gender identity, or gender expression, or any prohibition provided by federal or state law, discriminate against any citizen of the State in the employment of labor or workers who are qualified and available to perform the work to which the employment relates, nor shall the contractor, subcontractor, or any person acting on their behalf, in any manner, discriminate against or intimidate any employee hired for the performance of work under this contract on account of race, color, religion, sex, national origin, age, familial status, military status, disability, pregnancy, sexual orientation, gender identity, or gender expression, or any prohibition provided by federal or state law.

INTERPRETATION

The Contract Documents and Specifications contain the provisions required for the City Hall and Justice Center Grounds Maintenance Services. Information obtained from an officer, agent, or employee of the City or any other person shall not affect the risks or obligations assumed by the contractor or relieve the contractor from fulfilling any of the conditions of the contract.

If any person contemplating submitting a quotation for the proposed project is in doubt as to the true meaning of any part of the Contract Documents and Specifications, they may submit a written request for an interpretation thereof to either the Point of Contact identified in the Contract Documents and Specifications or the Project Portal.

The Q&A period for this opportunity ends at 5:00 p.m. (local time) on Friday, November 21, 2025.

The person submitting the request will be responsible for its prompt delivery. Any interpretation of the Contract Documents and Specifications will be made only by Addendum duly issued, a minimum of 72 hours prior to the closing date and time. The City will endeavor to have a copy of such Addendum delivered to each person receiving a set of Contract Documents and Specifications; however, it is ultimately the quoters’s responsibility to check the responsibility to check the City’s Procurement Portal (https://westerville.bonfirehub.com/opportunities/210356) for verification of any issued addenda. The awarding authority will not be responsible for any other explanations or interpretations of the Contract Documents and Specifications.

PERSONAL PROPERTY TAX AFFIDAVIT AND NONCOLLUSION AFFIDAVIT

The successful quoter will be required to execute and submit a completed Noncollusion Affidavit and a completed Personal Property Tax Affidavit, as included in the Contract Documents and Specifications prior to the issuance of the Notice to Proceed. Quoters are urged to include these documents with their quotation.

COMPLIANCE

In performing the work, the contractor shall comply with all applicable laws, rules, regulations, codes and ordinances, including but not limited to the U.S. Department of Labor “Safety and Health Regulations for Construction” identified as Chapter XVII of Title 29, Code of Federal Regulations (CFR) Part 1926 (formerly Part 1518) and subsequent amendments.

REJECTION

The City of Westerville, Ohio, reserves the right not to award a contract and to reject any or all quotations and to waive any irregularities in quoting.

TAXES

Materials to be incorporated in the work may be purchased by the contractor free of Ohio State sales tax.

The successful quoter will be required to withhold all City income taxes due or payable under the provisions of the Income Tax Ordinance, for wages, salaries, and commissions paid to its employees and further agrees that any of its subcontractors shall be required to agree to withhold any such City income taxes due under said chapter for services performed under this contract.

PRICE; TERM

Quotations are to be good for sixty (60) days after the actual closing date and time. The City may hold the quotations for sixty (60) days after the actual quotation closing date and time, and may award the contract at any time during that period. Should there be reasons why the contract cannot be awarded within the specified period; the time may be extended by mutual agreement between the City and the quoter.

INDEMNITY

The Contractor shall indemnify and hold harmless the City of Westerville, Ohio, from all suits, claims, damages, losses and expense, including attorney fees, arising out of or resulting from the performance of the work including royalties or infringement of patents that may be involved in the use of equipment, machinery, supplies or material, and the Contractor shall undertake to defend, at his own expense, any and all suits brought against the City of Westerville, by reasons of the things above specified.

The Contractor and the Contractor’s subcontractors shall secure and maintain Liability and Property Damage Insurance (1) in an amount not less than One Million Dollars ($1,000,000) for bodily injuries, including wrongful death, to any one person, subject to the same limit for each person, in an amount not less than Two Million Dollars ($2,000,000) for bodily injury damages for any one accident; and (2) in an amount not less than One Million Dollars ($1,000,000) for property damages on account of one accident and in an amount of Two Million Dollars ($2,000,000) for damages for all accidents. Greater amounts shall apply, where required by law. If the Contractor and the Contractor’s subcontractors maintain higher limits than the minimums shown above, the City shall be entitled to coverage for the higher limits.

The Insurance policies secured in compliance with the above requirements shall bear endorsements extending automatic coverage on all operations of the Contractor incidental to the performance of the work to be done under this Contract, whether such operations are listed in the insurance contracts or not, and whether the work is being done at the site of the project or not. The City shall be named as an additional insured. The Contractor will be required to submit a Certificate of Insurance and a current Worker’s Compensation Certificate to the City prior to the execution of the Agreement.

PUBLIC RECORDS

In entering into a contract with the City (or responding to a City solicitation), all Contractors are hereby notified that all bids, proposals, quotations, RFI responses, agreements, invoices, correspondence and any other documents submitted to the City become public property and are subject to public disclosure in accordance with Ohio Public Records Law. All public records will be made available upon request, at the earliest time permitted by law.

TERMINATION

The City reserves the right to terminate the contract in whole or in part for default (termination due to the Contractor’s failure to perform satisfactorily) or convenience (termination due to the best interests of the City). After 10 days from delivery of a written notice to the Contractor, the City may, without cause and without prejudice to any other right or remedy, elect to terminate the contract. In such case, the Contractor shall be paid for work executed, goods delivered and accepted, and any expense sustained plus reasonable profit, unless such termination was due to the act or conduct of the Contractor.

GENERAL SPECIFICATIONS

21 South State Street

Westerville, OH 43081

City Hall and Justice Center Grounds Maintenance Services

The City Hall and Justice Center Maintenance Services agreement shall be in effect for an initial one

(1) year period beginning January 1, 2026, and ending December 31, 2026. This period will include one (1) Contract Season/Year: 2026. The work for each Contract Season/Year will commence dependent on growing conditions or as directed by the City. At the City’s option, the Contract may be renewed for up to four (4) additional one (1) year periods (2027 Contract Season/Year, 2028 Contract Season/Year, 2029 Contract Season/Year, and 2030 Contract Season/Year) with a history of good performance. All terms and conditions (including pricing) shall remain unchanged from the initial Contract and shall be in full force and effect. The award of the Contract for 2026, 2027, 2028, 2029 and 2030 are subject to appropriation of funds approved by the Westerville City Council.

The City will accept monthly billing for work completed.

The Contractor may request of the City additional rate and price adjustments at reasonable times (no more than once per year) on the basis of unusual changes in its cost of operations, such as revised laws, ordinances, or regulations, addition or subtraction of service areas, and changes of location of delivery sites. Any changes shall be mutually agreed to by the City and the Contractor.

The City may request of the Contractor additional rate and price adjustments at reasonable times (no more than once per year) on the basis of unusual changes in its cost of operations, such as revised laws, ordinances, or regulations, addition or subtraction of service areas, and changes of location of delivery sites. Any changes shall be mutually agreed to by the City and the Contractor.

The Contractor shall consult with the Facilities Maintenance Manager concerning scheduling and details of all work. The Contractor shall have a competent person in charge of its work at all times to whom the Facilities Maintenance Manager may issue directives, and who shall accept and act upon such directives.

The City shall be notified by email prior to arriving each working day when maintenance is going to be performed within the City. Email contact information for work notification will be provided to the Successful Quoter/Contractor. Failure to notify the City will result in the contractor being found in noncompliance with the Contract. Any change in the Contractor’s contact person shall be reported to the City prior to the change.

The Contractor shall be totally responsible for any and all traffic control and safety measures necessary, and shall coordinate these measures with the City of Westerville Police Division. The Contractor shall be solely responsible for worker, pedestrian, and vehicular safety and control. The Contractor shall provide all necessary warning devices, barricades, and ground personnel needed to give safety, protection, and warning to all persons and vehicles in the working area. The closing of public streets shall not be permitted without written consent of the City Police Division. Traffic control shall be accomplished in conformance with applicable Federal, State and City codes.

All personnel that the Contractor employs must be properly trained to perform the required job and tasks and must be neat in appearance. Sleeved shirts, respectable shorts or trousers must be worn. Drinking or under the influence of alcoholic beverages or the use of illegal drugs will not be tolerated. Any employee found to be unprofessional or offensive in any manner will be asked by the City to be removed from the crew.

Working hours shall be between 8:00 a.m. and 5:00 p.m., Monday through Friday, excluding State and Federal holidays. Saturday, Sunday, and holiday work may be permitted under exceptional circumstances at the discretion and written approval of the Facilities Maintenance Manager.

Invoices indicating the invoice number, date, and line item cost shall be submitted monthly and will be paid reflecting work completed within 30 days, if work meets City standards. Invoices will reflect partial payments of the lump sum from the Price Form. The City shall approve invoicing upon completion and inspection by the Facilities Maintenance Manager, or designee.

Equipment used must be in good working order and shall comply with proper safety standards.

The proper equipment must be used to do the job properly and it must be removed from the job site when employees leave the site each working day. Equipment left during the day unattended must be secured safely to protect any site users and is the responsibility of the Contractor for theft or damage.

The Successful Quoter/Contractor shall upon request present copies of SDS for chemicals used and copies of all application records. Any sub-contractors shall be stated up front and approved prior to awarding the contract.

Cleanup: All walks, streets, paths, courts, curbs and any other hard surfaces must be swept or blown free of all debris immediately after each service.

Damages: Any damage to turf or plant material is the responsibility of the Contractor to repair. The City must be notified immediately of any damage to plants or other landscape features, etc., all such damages must be repaired/replaced to the owner’s satisfaction in a timely fashion.

GROUNDS MAINTENANCE SPECIFICATIONS

21 South State Street

Westerville, OH 43081

City Hall and Justice Center Grounds Maintenance Services

A. Weed control: Landscape beds, tree rings, and hard surfaces shall be maintained weed free for the entire season starting March 1st and running to October 31st for each authorized year of the contract. Weekly visits are recommended to maintain beds and hard surfaces and keep weed free. Post emergent herbicides can be applied along with manual removal methods. All hard surfaces will be kept clear of application chemicals. The City reserves the right to exclude any areas from treatment. Newly planted and seeded areas are excluded from treatment until approved by the Facilities Maintenance Manager. Damage caused by unapproved applications will be corrected at the contractor's expense. Damages to any hard surfaces, turf or plant material will be the responsibility of the contractor to repair or replace.

B. Bed cleanup: Landscape beds shall include cutting all ornamental grasses back to a height of 6” to 8” during the winter months of November through February.

Ornamental grasses to be maintained the entire season starting March 1st and running to October 31st. At any time ornamental grasses become too heavy to stand on their own it may become necessary to cut back 50% prior to November. Perennial plant pruning and deadheading as needed per type of plant material. All remaining work including all leaves and trash shall be removed prior to mulching.

C. Mulching: Shall include cut edging for all beds, excluding tree rings, and new mulch shall be maintained at a net depth of 2”. The mulch shall be triple processed black aged hardwood mulch. No ground pallets are to be used. Mulching shall be completed between April 1st and May 15th for each authorized year of the contract.

D. Shrubs: Shall be pruned as needed to maintain an orderly appearance . All shrubs and plant material shall be maintained to prevent plant material from encroaching curbs, walks, benches, water hydrants etc. Any deadwood or unwanted volunteer plant material removed. If rejuvenation pruning is required it will be completed by City staff.

E. Litter: During weekly maintenance visits all trash should be removed from landscape beds.

DESCRIPTIONS

21 South State Street

Westerville, OH 43081

City Hall and Justice Center Grounds Maintenance Services

ITEM #1 ‐ CITY HALL

1. Westerville City Hall Complex (21/29 S. State Street) A. Weed Control

1. Weed free for the entire season starting March 1st and running to October 31st

2. Includes all hard surfaces

B. Bed cleanup

1. Leaves to be removed in spring and fall

2. Ornamental grasses to be maintained the entire season

C. Mulching 1.Completed between April 1st and May 15th

2.Net 2 inches (triple processed black) D. Shrubs

1. As needed spring and fall

2. As needed mid-June to mid-August

E. Litter

1. Litter free for the entire season starting March 1st and running to October 31st

ITEM #2 ‐JUSTICE CENTER

1. Westerville Justice Center (229 Huber Village Boulevard) A. Weed Control

1. Weed free for the entire season starting March 1st and running to October 31st

2. Includes all hard surfaces

B. Bed cleanup

1. Leaves to be removed in spring and fall

2. Ornamental grasses to be maintained the entire season

C. Mulching 1.Completed between April 1st and May 15th

2.Net 2 inches (triple processed black) D. Shrubs

1. As needed spring and fall

2. As needed mid-June to mid-August

E. Litter

1. Litter free for the entire season starting March 1st and running to October 31st

PRICE FORM

City Hall and Justice Center Grounds Maintenance Services Project No. 2025-501

TO THE CITY OF WESTERVILLE, OHIO, having carefully examined the site of the work, the Contract Documents and Specifications, Information to Quoters, General Specifications, Grounds Maintenance Specifications, Descriptions, and other documents for the proposed work, and being familiar with all of the conditions surrounding the City Hall and Justice Center Grounds Maintenance Services (Project No. 2025-501) including the availability of materials and labor, Quoter hereby agrees to perform all work in strict accordance with the Contract Documents and Specifications to the complete satisfaction of the City, within the time specified for the cost per season unit prices set forth below. The wording on this Price Form shall be used throughout, without change, alteration, or addition. Words take precedence over figures in all items. All Quoters must complete all Items.

The prices set forth shall include all trades, materials, equipment, fuel, labor, expertise, supervision, delivery, services, overhead, profit, and appurtenances necessary for the performance of the work to which the prices apply.

The City reserves the right to award any or all quotations, as the best interests of the City require.

QUOTER MUST SIGN THIS PRICE FORM - SIGNATURE LINE ON PAGE # 14

Please indicate the COST PER SEASON/UNIT PRICE and TOTAL for each item listed below.

ITEM #1

CITY HALL

COST PER SEASON/UNIT PRICE

1. Westerville City Hall Complex (21/29 S. State Street) $

BID ITEM #1 TOTAL (Sum of Line 1) $ (In Figures) and /100 dollars (In Words)

ITEM #2

JUSTICE CENTER

COST PER SEASON/UNIT PRICE

1. Westerville Justice Center (229 Huber Village Boulevard) $

BID ITEM #2 TOTAL (Sum of Line 1) $ (In Figures) and /100 dollars (In Words)

By submission of this quotation, each quoter certifies, and in case of a joint quotation, each party thereto certifies as to their own organization, that this quotation has been arrived at independently, without consultation, communication, or agreement as to any matter relating to this quotation with any other quoter or with any competitor.

QUOTER COMPANY NAME (Type/Print):

ADDRESS (Type/Print):

NAME (Type/Print):

SIGNATURE:

TITLE (Type/Print):

PHONE NUMBER: FAX NUMBER:

E-MAIL ADDRESS:

QUOTER’S WEBSITE:

DATE SIGNED:

EXPERIENCE RECORD

As part of the City’s investigation to determine the lowest and best quotation, the quoter is required to state the character of previous work, identify a minimum of 3 references, and provide such other information as will enable the City to determine responsibility; including number of years that the quoter has been in existence, number of years operating experience providing grounds maintenance services, suitability of the quoter’s plant, equipment, and staffing for the work. Name, address, telephone number, and email address required for all references. Quoter are urged to include a completed Experience Record form with their quotation. If not included with the quotation, a completed Experience Record form shall be submitted to the City within two (2) business days of the Closing Date and Time. Attach additional pages as needed.

EXPERIENCE RECORD CONTINUED

NONCOLLUSION AFFIDAVIT

State of:

County of:

BID Identification: City Hall and Justice Center Grounds Maintenance Services

CONTRACTOR:

Being first duly sworn, deposes as says that he/she is:

of (sole owner, a partnership, president etc.) (name of company) the party making the foregoing BID; that such BID is not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization, or corporation; that such BID is genuine and not collusive or sham; that said BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham BID, and has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to put in a sham BID, or that anyone shall refrain from bidding; that said BIDDER has not in any manner, directly or indirectly, sought by agreement, communication or conference with anyone to fix the BID price of said BIDDER or of any other BIDDER, or to fix any overhead, profit, or cost element of such BID price, or of that of any other BIDDER, or to secure any advantage against the OWNER awarding the Contract or anyone interested in the proposed Contract; that all statements contained in such BID are true; and, further, that said BIDDER has not, directly or indirectly, submitted his BID price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid and will not pay any fee in connection therewith, to any corporation, partnership, company, association, organization, BID depository, or to any member or agent thereof, or to any other individual except to such person or persons as have a partnership or other financial interest with said BIDDER in its general business.

Signed:

Subscribed and sworn to before me this

Day of , 20

Seal of Notary

PERSONAL PROPERTY TAX AFFIDAVIT

Re:

To:

FOR

THE CITY OF WESTERVILLE, OHIO

(SECTION 5719.042 ORC)

City Hall and Justice Center Grounds Maintenance Services

Director of Finance, City of Westerville, Ohio

State of:

County of:

By (Bidder):

Address:

Affiant:

Title:

being first duly sworn, says that on , it (check at left of paragraph 1 or 2; if 2, fill in the appropriate data):

1. Was not charged with any delinquent personal property taxes on the general tax list of personal property of Franklin and Delaware Counties

2. Was charged with delinquent personal property taxes on the general tax list of personal property of Franklin and/or Delaware Counties and the amount due and unpaid delinquent taxes, penalties, and interest are:

Tax Penalties Interest

FRANKLIN COUNTY $ $ $

DELAWARE COUNTY $ $ $

That this Affidavit shall be incorporated into the Contract between the undersigned and the City of Westerville.

Signed:

Subscribed and sworn to before me this

Day of , 20

Seal of Notary

Item #1-1: Westerville City Hall Complex (21/29 S. State Street)

Item #2-1: Westerville Justice Center (229 Huber Village Boulevard)

CITY OF WESTERVILLE

Project No. 2025-501