Power Plant Bridge Inspection and PER RFQ.pdf

CITY OF SEGUIN TEXAS

REQUEST FOR QUALIFICATIONS

PROFESSIONAL SERVICES

FOR THE

POWER PLANT BRIDGES INSPECTION AND PRELIMINARY

ENGINEERING REPORT

RFQ #AF-2026-62

ISSUED BY THE CITY OF SEGUIN

CAPITAL PROJECTS/ENGINEERING DEPARTMENT

CITY OF SEGUIN PURCHASING DEPARTMENT

PROPOSALS MUST BE SUBMITTED NO LATER THAN:

September 15, 2026 3:00 p.m. (Local Time)

Date Issued: August 19, 2026

Table of Contents

1. GENERAL INFORMATION

1.A. Background

1.B. Scope of Work

1.C. Quantity

1.D. Regulations

1.F. Procuring and Contracting Agency

1.F.1. Point of Contact

1.F.2. Contract Administration

1.G. Definitions

1.H. Clarification of Specifications and Requirements

2. PREPARING and SUBMITTING PROPOSAL

2.A. Evaluation and Selection

2.B. Incurring Costs

2.C. Submitting the Proposal

2.D. Proposal Organization and Format

3. PROPOSAL REQUIREMENTS

3.A. Proposal Signature Cover Page & Firm Introduction

3.B. Organizational Qualifications

3.B.1. Communication

3.B.2. Qualifications, Proposed Organization and Staffing for the Project

3.B.3. Firm’s Experience in the last five (5) years with similar projects

3.C. Staff Qualifications

3.D. Technical Approach

3.D.1. Project Description and Understanding

3.D.2. Project Oversight and Quality Control

3.D.3. Project Schedule/Timeline

3.D.4. Project Deliveries

3.E. Proposer Data Sheet

3.F. Reference Data Sheet

4. PROPOSER SELECTION and AWARD PROCESS

4.A. Proposal Scoring and Selection

4.B. Evaluation Criteria

4.C. Interviews

4.D. Proposer Selection and Award

4.E. Right to Reject Proposal and Negotiate Contract Terms

4.F. Contract

4.G. Expenses

4.H. Insurance

5. CITY RESPONSIBILITIES

6. CONSULTANT RESPONSIBILITIES

7. CONSULTANT PERSONNEL REPLACEMENT

8. WORK HOURS and LOCATION

9. STANDARD CONTRACT, CONDITIONS and REQUIREMENTS

10. RESTRICTIONS ON LOBBYING ACTIVITY

11. ATTACHMENT A - PROPOSER DATA SHEET

12. ATTACHMENT B - REFERENCE DATA SHEET

13. EXHIBIT A - INSURANCE REQUIREMENTS

14. EXHIBIT B - CERTIFICATE OF INTERESTED PARTIES

15. EXHIBIT C - CONFLICT OF INTEREST QUESTIONNAIRE

17. EXHIBIT D - CERTIFICATION REGARDING LOBBYING

18. EXHIBIT E - INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF

LOBBYING ACTIVITIES

*Exhibits are required contract documents to be provided by the proposer selected to design the project.

CAPITAL PROJECTS/ENGINEERING

4 | P a g e POWER PLANT BRIDGES INSPECTION AND PRELIMINARY ENGINEERING REPORT – REQUEST FOR QUALIFICATIONS

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1. GENERAL INFORMATION

The City of Seguin (CITY) is soliciting statements of qualifications (SOQ) from qualified consulting firms that are capable of providing professional services relating to inspection of bridges and evaluation and innovative alternatives for bridge design or bridge replacement.

The CONSULTANT will provide inspection of bridge class structures. The project approach will be developed in coordination with the CITY which will provide feedback on the removal or replacement of the bridge class structures.

1.A. Background In 2005, voters of the City of Seguin approved bonds for extension of utilities to the power plant, as well as structural improvements to the facility. In 2009, a lease agreement was authorized between the City of Seguin and Lake Seguin Hydro-Electric Partners, LLC. The lease agreement states that the City shall provide bridge(s) over Mays Creek. The two bridge class structures are identified as off-system bridges in that they are located on City property.

Figure 1: Power Plant Bridge Locations

1.B. Scope of Work The Scope of Work shall include bridge inspections which meet State and Federal Requirements. The proposed project process and deliverables shall evaluate and address the following tasks relevant to the project for the City of Seguin.

The following is the anticipated scope of work:

- Bridge Inspection Record (2) in accordance with National Bridge Inspection Standards (NBIS)

- Bridge Inventory Record Sketch (2)

- Load Rating Verification

- Maintenance recommendations

- Preliminary Engineering Report with alternatives to maintain the Power Plant and site improvements without the use of bridge class structures.

Bridge #1 (North)

Bridge #2 (South)

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1.C. Quantity The City anticipates awarding a contract to one (1) firm to provide Power Plant Bridges Inspection and Preliminary Engineering Report.

1.D. Regulations

All work must be performed in compliance with all applicable city, state, and federal laws and regulations.

1.F. Procuring and Contracting Agency

1.F.1. Point of Contact City of Seguin issues this Request for Qualifications (RFQ) and the Purchasing Manager is the sole point of contact during the solicitation and selection process.

Ashley Bruns, Purchasing Manager ABruns@seguintexas.gov

1.F.2. Contract Administration Capital Projects/Engineering for the City of Seguin will administer the contract resulting from this RFQ.

The contract administrator is:

Melissa Reynolds, P.E. Office: 830.386.2594 Assistant City Manager/City Engineer Email: mreynolds@seguintexas.gov Development Services Center Website: www.seguintexas.gov 108 E. Mountain Street, Seguin, Texas 78155

1.G. Definitions The following definitions are used in this RFQ:

• “CONSULTANT” – means the firm selected from this RFQ

• “DEPARTMENT” or “CITY” – means the City of Seguin

• “PLAN” – means the Walnut Branch Regional Wetlands Analysis and Dam Emergency Plan

• “PROPOSER” or “FIRM” – means a firm submitting a proposal in response to this RFQ

• “RFQ” – means Request for Qualifications

• “STATE” – means the State of Texas

1.H. Clarification of Specifications and Requirements

If additional information is necessary to assist the Proposer in interpreting these specifications, questions will be via email as follows:

Name: Ashley Bruns, Purchasing Manager Email: ABruns@seguintexas.gov

Subject: “PROFESSIONAL SERVICES FOR THE POWER PLANT BRIDGES INSPECTION

AND PRELIMINARY ENGINEERING REPORT”

Questions must be received by September 8, 2026, by 3:00 p.m. local time to be included in addendum.

RFQ Timetable (some dates subject to change):

Event Date

− RFQ Issued 08/19/2026 − All Proposer’s Questions due by 09/08/2026 − Proposer Q & A Addendum issued 09/11/2026

− WRITTEN PROPOSAL DEADLINE 09/15/2026

− Evaluation/Interview Process (estimate) 10/01/2026 − Consultant Contract Negotiation (estimate) 10/15/2026 − Contract Award (estimate) 11/03/2026 http://www.seguintexas.gov/

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− Final Deliverables (estimate) 03/15/2027

2. PREPARING and SUBMITTING PROPOSAL

2.A. Evaluation and Selection Evaluation and selection of a consultant will be based on the information submitted in the proposal, references, and interview(s) process. Proposers should respond clearly and completely to all requirements. Failure to respond completely may be the basis for rejecting a proposal. Elaborate proposals (e.g., expensive artwork) beyond requirements of this RFQ are not necessary or desired.

2.B. Incurring Costs

City is not liable for any costs incurred by the Proposer in replying to this RFQ.

2.C. Submitting the Proposal Sealed Statements of Qualifications will be received by the City of Seguin electronically through http://www.bidnetdirect.com/texas/cityofseguin until 3:00 P.M., Tuesday, September 15, 2026 for Professional Services for the Power Plant Bridges Inspection and Preliminary Engineering Report at 3:00 P.M. in the City Council Chambers, the name of all Firms submitting a Statement will be read publicly but no contents of the Statements will be disclosed.

2.D. Proposal Organization and Format

Proposals must be organized with the following headings. Each heading should be separated by tabs or otherwise clearly marked.

The SOQ must contain:

1) Proposal Signature Cover Page & Firm Introduction (signed by Firm’s Primary Engineer)

2) Organizational Qualifications (communication, preferred skills, firms experience)

3) Staff Qualifications (minimum skills and experience)

4) Technical Specifications (project description, oversight, timeline, deliverables)

5) Proposer Data Sheet (ATTACHMENT A)

6) Reference Data Sheet (ATTACHMENT B)

7) Copy of current certificate of insurance for professional liability

8) Statement of Conflicts of Interest (if any) the service provider or key employees may have regarding these services, and a plan for mitigating the conflict(s). Note that City/County may in its sole discretion determine whether or not a conflict disqualifies a firm, and/or whether or not a conflict mitigation plan is acceptable.

9) Form Conflict of Interest Questionnaire (enclosed). Texas Local Government Code chapter 176 requires that any vendor or person who enters or seeks to enter into a contract with a local government entity disclose in the Questionnaire Form CIQ the vendor or person’s employment, affiliation, business relationship, family relationship or provision of gifts that might cause a conflict of interest with a local government entity. Questionnaire form CIQ is included in the RFQ and must be submitted with the response

10) Certification Regarding Lobbying - Disclosure of Lobbying Activities (enclosed). Certification for Contracts, Grants, Loans, and Cooperative Agreements is included in the RFQ and must be submitted with the response

11) Form 1295 (enclosed). All contracts and contract amendments, extensions, or renewals executed will require the completion of Form 1295 “Certificate of Interested Parties” pursuant to Government Code § 2252.908. Form 1295 must be completed by the awarded vendor at time of signed contract submission. Form 1295 is included in this RFQ for your information. Form 1295 requires the inclusion of an “unsworn declaration” which includes, among other things, the date of birth and address of the authorized representative signing the form.

http://www.bidnetdirect.com/texas/cityofseguin

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12) Required Contract Provisions (if applicable). Applicable provisions (if applicable) must be included in all contracts executed as a result of this RFQ.

3. PROPOSAL REQUIREMENTS

Proposer shall respond to the RFQ as follows:

3.A. Proposal Signature Cover Page & Firm Introduction

• Provide name and address of the organization

• Business tenure and incorporation background

• Identify a designated contact in organization with telephone number, fax number, and e-mail address

• Certify that sufficient resources in personnel, equipment, and time are available and can be committed to the City

3.B. Organizational Qualifications 3.B.1. Communication

• Firm’s ability to effectively communicate both written and orally with individuals of all technical levels

• Include what forms/methods of communication will be used for this project for management of design.

3.B.2. Qualifications, Proposed Organization and Staffing for the Project

• Firm’s proposed organizational chart for the project

• Description of responsibilities for all proposed staff

• Names and resumes of key staff proposed

• Time commitments of proposed staff

3.B.3. Firm’s Experience in the last five (5) years with similar projects

• Identify projects of a similar nature with which the team has had direct experience. Be specific on why the referenced projects are similar to this project, including but not limited to project location, description, date of implementation, services provided by your firm for the project, and client contact information. Include a link to project photos/deliverables if available.

3.C. Staff Qualifications Identify specific firm “team members” to be committed to the project. Describe how their experience is related to the project and indicate what their role(s) in the project will be. Include the consultant team’s general depth of experience and knowledge, and the applicability to the project. Identify the principal supervisory and management staff, including partners, managers, other supervisors and specialists, who would be assigned to these services. Indicate whether each person is registered or licensed to practice in Texas. Provide information on the experience of each person.

3.D. Technical Approach

3.D.1. Project Description and Understanding

• Illustrate your understanding of the scope of work and related project activities

• List projects of a similar nature with which the team has had direct experience

• Describe involvement with similar projects concerning functional requirements, development, and project planning

• Be specific and identify project dates and results

3.D.2. Project Oversight and Quality Control

• Describe ability to communicate with City staff

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• Describe availability to provide project oversight after normal business hours if necessary

• Describe internal quality assurance/quality control processes for project deliverables

• Describe ability to provide periodic review of all materials developed

3.D.3. Project Schedule/Timeline

• Describe timeline for project milestones

• Provide implementation timeline recommendation

• Indicate ability to begin work on the project within thirty (30) days of the contract award

• Describe availability to provide management and/or periodic inspections during implementation

3.D.4. Project Deliveries

• Firm’s history in completing deliverables on schedule

• Describe project deliverables

• Describe any innovative approach proposed to address existing challenges, topography, right of way constrains, natural features, access, permitting, etc… to complete design of the project, if necessary.

3.E. Proposer Data Sheet

• ATTACHMENT A (see page 13)

3.F. Reference Data Sheet

• ATTACHMENT B (see page 14)

4. PROPOSER SELECTION and AWARD PROCESS

4.A. Proposal Scoring and Selection A review panel comprised of City staff will review and rate each written proposal based on the criteria of this

RFQ. Top scoring firms may be asked to schedule an interview with the evaluation panel.

Responding to this RFQ constitutes understanding and agreement to the methods of the rating matrix, evaluation, and selection process.

4.B. Evaluation Criteria Proposals submitted in response to this RFQ will be evaluated based on the following criteria:

Criteria Weight

General Quality and Adequacy of Response 15% − Completeness and thoroughness − Understanding the project − Responsiveness to terms and conditions

Organization, Personnel and Experience 45%

− Qualifications of personnel − Past record and experience of personnel − Past record and experience of firm − Familiarity with drainage, dams and stream bank projects and associated policies/ ordinances/Federal and State laws and regulations

Technical Approach (Quality of Package Provided) 40%

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− Project approach and Innovative concepts − Clarity and organization in concept development − Understanding of the cause of the problem − Quality and quantity of services to be rendered − Proposed schedule

MAXIMUM SCORE 100%

4.C. Interviews Interviews may be conducted subsequent to the receipt and rating of the written proposal by the review panel.

If conducted, interviews will allow the selected Proposer an opportunity to clarify their proposal. Each proposer selected to interview will be asked the same questions and scored on responses to the questions during the interview. Interview request refusal will result in rejection of Proposer’s proposal irrespective of scoring.

4.D. Proposer Selection and Award Proposer selection and award will be granted based on the recommendation by the review panel following the rating and interview process (if conducted).

4.E. Right to Reject Proposal and Negotiate Contract Terms The City reserves the right to reject any and all proposals. The City reserves the right to negotiate the terms of the contract, including reimbursement rates with the selected Consultant prior to entering into a contract.

If contract negotiations cannot be concluded successfully with the highest scoring Proposer, the City may negotiate a contract with the next highest scoring Proposer and so on until an agreement is reached.

4.F. Contract

• Negotiations − After selection of a Consultant based on qualifications, the City will then enter into negotiations as to the terms of the contract, all aspects of services, and the compensation to be paid to the Consultant.

• Inability to Reach Agreement − In the event the negotiation between the most qualified Consultant(s) selected and the City cannot be completed as a result of an inability to reach agreement on the fee or services or the scope of work to be performed, then at the option of the City, the contract may be awarded to the next most qualified Consultant. Negotiations will continue in this sequence until a contract is finalized, or all responses are rejected.

• City Council Approval − The final contract will be submitted to the City Council for approval.

• Final Contract − The selected Consultant will be required to assume responsibility for all services offered in its response, whether or not such services are provided by a partnership arrangement. The successful Consultant will be considered the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from the contract.

− The successful Consultant will be required to enter into the contract with the City.

− This RFQ and the successful Consultant’s response, or any part thereof, may be incorporated into and made a part of the final contract. The City reserves the right to negotiate the terms and conditions of the contract with the successful Consultant.

● Upon the award of this contract, profit (either %/actual cost) must be identified and negotiated as a separate element of the price for any contract in excess of $50,000.

4.G. Expenses

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Covered expenses will be paid on a reimbursement basis in accordance with the RFQ.

4.H. Insurance Prior to beginning work, the successful Consultant shall have on file with the City of Seguin a Certificate of

Liability Insurance form covering worker’s compensation, commercial general liability, professional liability, and business auto, listing the City as an additional insured in accordance with Exhibit A.

5. CITY RESPONSIBILITIES

a) Provide guidance and coordination

b) Provide available archive information as needed and/or available

c) Note: No Average Daily Traffic (ADT) data is available

6. CONSULTANT RESPONSIBILITIES

a) Federal and State unemployment insurance coverage

b) Standard worker’s compensation insurance coverage

c) Compliance with all Federal and State tax laws and withholding requirements

d) Duration of contract period provide:

− Periodic consultation with City staff − Periodic review of all project materials developed − Project plan and schedule − Monthly status reports − Schedule project meetings with City staff (to include potential public meetings outside of normal business hours) − Project permits − PS & E (if necessary, including misc. specs) − Final version of WETLAND ANALYSIS AND DAM EMERGENCY PLAN in electronic format

7. CONSULTANT PERSONNEL REPLACEMENT

• Replacement of selected consultant personnel shall require the approval of the City.

• Replacement personnel shall have comparable qualifications and be provided at the contracted rate.

• Any request by the consultant to replace a team member shall be done in writing to the City.

− A resume for the proposed replacement must be submitted to the City for review.

− The City may reject the proposed replacement if qualifications and/or reference(s) of past working performance are deemed questionable or unfavorable.

• If the City determines the selected consultant is unable to perform satisfactorily or communicate effectively, the City may, at its discretion, remove consultant immediately from the contact.

• If the consultant is removed and the City did not initiate the request, the firm has five (5) working days to provide a replacement. There shall be no charge to the City for the first five (5) working days of the replacement.

8. WORK HOURS and LOCATION

• Services shall be provided during normal business hours unless otherwise approved and coordinated with the City.

• Normal business hours are Monday through Friday from 8:00 am through 5:00 pm excluding holidays.

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• Consultant may be required to work on weekends, evenings, and holidays. The City will not pay an overtime rate for this service. All hours shall be billed at the hourly rate quoted.

9. STANDARD CONTRACT, CONDITIONS and REQUIREMENTS

The successful Proposer and the City will enter into a contract for the services described in this RFQ. Failure of the successful Proposer to accept the obligations of a contractual agreement may result in a cancellation of award.

10. RESTRICTIONS ON LOBBYING ACTIVITY

The City is committed to maintaining fair and open competition as required by local, state, and federal laws and statutes. Every effort is made to maintain the highest level of ethical conduct in every aspect of the procurement process. Sharp business practice or high-pressure tactics will not be tolerated. Qualification and selection of vendors is based on those vendors who share the same high standards of ethical conduct.

Proponents are strictly prohibited from directly or indirectly communicating with City Council members regarding the Proponent’s qualifications or any other matter related to the eventual award of a contract for the services requested under this RFP. Proponents are prohibited from contacting City staff members or selection committee members regarding their qualifications or the award of a contract unless in response to an inquiry initiated by a staff or committee member. Any violation will result in immediate disqualification of the Proponent from the selection process.

Upon issuance of the RFP, all proponent communications and requests for clarification or objections shall be directed in writing to Ashley Bruns, Purchasing Manager, for response, determination, and dissemination to all proponents. Any communication by proponents or their representatives toward other city officers or employees regarding this RFP or the award of a contract are prohibited and will constitute grounds for disqualification of a proponent.

A lobbyist or a proponent or any of their agents may not do any act or refrain from any act for the express purpose and intent of placing any City official under personal obligation to the lobbyist or proponent.

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11. ATTACHMENT A - PROPOSER DATA SHEET

FIRM NAME:

ADDRESS:

CITY: STATE:

FEDERAL EMPLOYER IDENTIFICATION NUMBER:

OR SOCIAL SECURITY NUMBER (if sole proprietorship):

CORPORATION: [ ] YES [ ] NO

PROPOSAL CONTACT PERSON:

TITLE:

PHONE: FAX NUMBER:

EMAIL:

MAILING ADDRESS WHERE REIMBURSEMENTS ARE TO BE MAILED AND NAME OF BILLING

CONTACT:

NAME:

TITLE:

PHONE: FAX NUMBER:

EMAIL:

IS THE FIRM SUBMITTING THIS PROPOSAL AN IDIVIDUAL? [ ] YES [ ] NO

IF YES, HAS THE INDIVIDUAL BEEN EMPLOYEED BY A STATE AGENCY AT ANY TIME

DURING THE PAST TWO (2) YEARS? [ ] YES [ ] NO

IF YES, IN COMPLIANCE WITH TEXAS GOVERNMENT CODE 2254.033, PLEASE ATTACH A

SEPARATE SHEET TO EXPLAIN:

− The nature of the previous employment with the State − The date the employment terminated − The annual rate of compensation for the employment at the time of termination

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12. ATTACHMENT B - REFERENCE DATA SHEET

(reproduce sheet as necessary)

PROVIDE AT LEAST THREE REFERENCES (references should include):

− Client Name − Location (city, state) − Contact Person − Telephone Number − Information on contracted services similar to this RFQ

CLIENT NAME:

CITY: STATE:

CONTACT PERSON: TITLE:

PHONE NUMBER:

PROJECT NAME:

PROJECT START DATE: PROJECT END DATE:

SUMMARY OF CONTRACTED SERVICES (include project involvement, principal firm, multi-firm collaboration, sub-consultant(s):

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13. EXHIBIT A - INSURANCE REQUIREMENTS AND INDEMNITY

The Vendor will procure and maintain at its expense insurance with insurance companies authorized to do business in the State of Texas, covering all operations under this Agreement, whether performed by the Vendor or its agents, subcontractors or employees. Before commencing the work the Vendor will furnish to the City an original certificate or certificates in a form satisfactory to the City, showing that Vendor has complied with this paragraph.

The Vendor shall not cause any insurance policy to be cancelled or permit it to lapse, and all insurance policies shall include an endorsement to the effect that the insurance policy shall not be subject to cancellation or to a reduction in the required limits of liability or amounts of insurance until notice has been mailed to the City of Seguin, ATTN: Director of Finance, P.O. Box 591, Seguin, TX 78156-0591. The notice shall state the date when such cancellation or reduction shall be effective. The cancellation date shall not be less than thirty (30) days after such notice.

Commercial general liability insurance will be written with the City as an additional insured and will be endorsed to provide a waiver of the carrier’s right of subrogation against the City. The types and amounts of insurance required are set forth below:

TYPE AMOUNTS

1. Workers' Compensation Statutory

2. Commercial General Liability Insurance to include coverage for the following:

a. Premises/Operations

b. Independent Contractors

c. Products/Completed Operations

d. Personal Injury

e. Contractual Liability

f. Professional Liability (when applicable)

$1,000,000 per occurrence $2,000,000 aggregate

3. Business Automobile Liability

a. Owned/leased vehicles

b. Non-owned vehicles

c. Hired Vehicles

$1,000,000 per occurrence

4. Errors and Omissions (when applicable)

$1,000,000 per occurrence or claim $2,000,000 aggregate For the willful or negligent acts or omissions of any officers, employees, or agents thereof.

5. Cyber (when applicable)

$2,000,000

The stated limits of insurance are minimum only. They do not limit the Vendor’s indemnity obligation, and it will be the Vendor’s responsibility to determine what limits are adequate. These limits may be met by basic policy limits or any combination of basic limits and umbrella limits. The City’s acceptance of certificates of insurance that do not comply with these requirements in any respect does not release the Vendor from compliance with these requirements.

THE VENDOR WILL INDEMNIFY, HOLD HARMLESS AND DEFEND THE CITY AND ITS EMPLOYEES, AGENTS, OFFICERS, AND SERVANTS FROM ANY AND ALL LAWSUITS, CLAIMS, DEMANDS AND CAUSES OF ACTION OF ANY KIND ARISING FROM THE NEGLIGENT OR INTENTIONAL ACTS ERRORS OR OMISSIONS OF THE VENDOR, ITS OFFICERS, EMPLOYEES OR AGENTS. THIS WILL INCLUDE, BUT NOT BE LIMITED TO, THE AMOUNTS OF JUDGMENTS, PENALTIES, INTEREST, COURT COSTS, REASONABLE LEGAL FEES, AND ALL OTHER EXPENSES INCURRED BY THE CITY ARISING IN FAVOR OF ANY PARTY, INCLUDING THE AMOUNTS OF ANY DAMAGES OR AWARDS RESULTING FROM CLAIMS DEMANDS AND CAUSES OF ACTION FOR PERSONAL INJURIES, DEATH OR

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DAMAGES TO PROPERTY ALLEGED OR ACTUAL INFRINGEMENT OF PATENTS, COPYRIGHTS, AND TRADEMARKS AND WITHOUT LIMITATION BY ENUMERATION, ALL OTHER CLAIMS, DEMANDS, OR CAUSES OF ACTION OF EVERY CHARACTER OCCURRING, RESULTING, OR ARISING FROM ANY NEGLIGENT OR INTENTIONAL WRONGFUL ACT, ERROR OR OMISSION OF THE VENDOR OR ITS AGENTS OR EMPLOYEES. THIS OBLIGATION BY THE VENDOR WILL NOT BE LIMITED BY REASON OF THE SPECIFICATION OF ANY PARTICULAR INSURANCE

COVERAGE REQUIRED UNDER THIS AGREEMENT.

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14. EXHIBIT B - CERTIFICATE OF INTERESTED PARTIES

FORM 1295

Complete No. 1 – 4 and 6 if there are interested parties Complete Nos. 1, 2, 3, 5 and 6 if there are no interested parties

OFFICE USE ONLY

1. Name of business entity filling form and the city, state and country of the business entity place of business.

2. Name of governmental entity or state agency that is party to the contract of which the form is being filled

3. Provide the identification number used by the governmental entity or state agency to track or identify the contract and provide a description of the goods or services to be provided under the contract.

4. Name of Interested Party City, State, Country (place of business)

Nature of Interest (check applicable) Controlling Intermediary

5. Check only if there is NO interested party

6. AFFIDAVIT I swear or affirm, under penalty of perjury, that the above disclosure is true and correct.

Signature of authorized agent or contracting business entity

AFFIX NOTARY STAMP / SEAL ABOVE

Sworn to and subscribed before me, by the said________________________________, this the ____________ day of_______________, 20______, to certify which, witness my hand and seal of office.

Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath

ADD ADDITIONAL PAGES AS NECESSARY

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15. EXHIBIT C - CONFLICT OF INTEREST QUESTIONNAIRE

FORM CIQ

For vendor 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 filled in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.00 (1.a.) with local government entity and the vendor meet requirements under Section 176.006 (a)

By law this questionnaire must be filled with records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement of the 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.

OFFICE USE ONLY

1. Name of vendor who has a business relationship with local governmental entity.

2. Check this box if you are filling an update to a previously filed questionnaire. (The law requires that you file an update completed questionnaire with the appropriate filing authority no later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate).

3. Name of local government officer about whom the information is being disclosed.

Name of Officer

4. Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attached additional pages to this Form CIQ as necessary.

A. Is the local government officer, or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor?

Yes No

B. Is the vendor receiving or likely to receive taxable income, other than investment income from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity?

Yes No

5. Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or owner business entity with respect to which the local government officer serves as an officer or director or holds an ownership interest of one percent or more.

6. Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003 (a)(2)(B), excluding gifts described in Section 176.003 (a.1)

7.

Signature of vendor doing business with the governmental entity Date

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CONFLICT OF INTEREST QUESTIONNAIRE

For vendor doing business with local governmental entity

A complete copy of Chapter 176 of the Local Government Code may be found at http://www.statues.legis.state.tx.us/ Docs/LG/htm/LG176.htm. For easy reference, below are some of the sections cited on this form.

Local Government Code § 176.001 (1-a): “Business relationship” means connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on:

(A) a transaction that is subject to rate or fee regulation by a federal, state or local governmental entity or an agency of a federal, state or local governmental entity;

(B) a transaction conducted at a price and subject to terms available to the public; or

(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by and reporting to that agency.

Local Government Code § 176.003(a)(2)(A) and (B)

(a) A local government officer shall file a conflict disclosure statement with respect to a vendor if:

(2) the vendor

(A) has an employment or other business relationship with the local government officer or a family member or officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that

(i) a contract between the local governmental entity and vendor has been executed;

or

(ii) the local governmental entity is considering entering into a contract with the vendor

(B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than $100 in the 12-month period preceding the date the officer become aware that:

(i) a contract between the local governmental entity and vendor has been executed; or

(ii) the local governmental entity is considering entering into a contract with the vendor.

Local Government Code § 176.006(a) and (a-1)

(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and:

(1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);

(2) has given local government officer of the local government entity, or a family member of the office, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003 (a-1); or

(3) has a family relationship with a local government officer of that local governmental entity.

(a-1) The completed conflict of interest questionnaire must be filled with the appropriate records administrator not later than the seventh business day after the later of:

(1) the date that the vendor

(A) begins discussions or negotiations to enter into a contract with the local governmental entity; or

(B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another wiring related to a potential contract with the local governmental entity; or

(2) the date the vendor becomes aware:

(A) of an employment or other business relationship with a local government officer; or a family member of the officer, described by Subsection (a);

(B) that the vendor has given one or more gifts described by Subsection (a); or

(C) of a family member relationship with a local government officer.

http://www.statues.legis.state.tx.us/

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17. EXHIBIT D - CERTIFICATION REGARDING LOBBYING

(To be submitted with each bid or offer exceeding $100,000)

The undersigned certifies, to the best of his or her knowledge and belief, that:

(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.

(c) The undersigned shall require that the language paragraph 1 and 2 of this anti-lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995).

The Contractor, ___________________, certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any.

Signature of Contractor’s Authorized Official

Printed Name and Title of Contractor’s Authorized Official

Date

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18. EXHIBIT E - INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING

ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.

4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

5. If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.

6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.

8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFQ) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., “RFQ-

DE-90-001.”

9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the reporting entity identified in item 4 to influence the covered Federal action.

(b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Initial (MI).

11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503

Approved by OMB 0348-0046

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Disclosure of Lobbying Activities

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352

(See reverse for public burden disclosure)

Type of Federal Action:

a. contract

____ b. grant

c. cooperative agreement

d. loan

e. loan guarantee

f. loan insurance

Status of Federal Action:

a. bid/offer/application

_____ b. initial award

c. post-award

Report Type:

a. initial filing

_____ b. material change

Name and Address of Reporting Entity:

____ Prime _____ Subawardee

Tier______, if Known:

Congressional District, if known:

If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime:

Congressional District, if known:

Federal Department/Agency:

7. Federal Program Name/Description:

CFDA Number, if applicable: __________________

Federal Action Number, if known:

9. Award Amount, if known:

10. a. Name and Address of Lobbying Registrant

(if individual, last name, first name, MI):

b. Individuals Performing Services (including address if different from No. 10a)

(last name, first name, MI):

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11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Signature: __________________________________

Print Name: _________________________________

Title: _______________________________________

Telephone No.: ____________ Date: _____________

Federal Use Only

Authorized for Local Reproduction

Standard Form - LLL (Rev. 7-97)