REBid Packet 26-91 Labor for Concrete Parking Lot - Robert Chavira Sports Complex 2.0.pdf

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REBID Labor for Concrete Parking Lot at RBC Sports Complex
Solicitation number
BID 26-91
Issued by
Upton County, Texas

About this file

Summary

This is a Request for Competitive Sealed Bid (ReBid #26-91) issued by Val Verde County for construction labor services at the Robert "Bob" Chavira Sports Complex in Del Rio, Texas. The project involves furnishing all labor, equipment, supervision, and incidentals necessary to construct a concrete parking lot including driveways, curbs, gutters, and sidewalks, with all materials to be supplied by Val Verde County. The scope of work encompasses roadway and parking lot construction, drainage improvements, concrete flatwork, and associated appurtenances in accordance with Texas Department of Transportation (TxDOT) Standard Specifications. Key dates include a pre-bid meeting scheduled for August 20, 2026 at 9:00 A.M. at the Val Verde County Courthouse, with sealed bids due by Thursday, September 3, 2026 at 2:00 P.M. (CST). Questions must be submitted by August 25, 2026, with responses posted by August 28, 2026. Site inspection is highly recommended, and the contract completion date will be determined at a pre-construction meeting following contract award. Liquidated damages are assessed at $100.00 per day for delays beyond the contract completion date.

The contract will be awarded to the responsive, responsible bidder submitting the lowest and best bid. A bid bond equal to five percent (5%) of the total bid amount is required for bids exceeding $100,000.00, with alternative forms including certified checks, bank drafts, or U.S. Government Bonds accepted. The successful bidder must provide Performance and Payment Bonds each equal to 100% of the contract price from an approved Texas-permitted surety company within 30 days of award and before work commences. Insurance requirements include Commercial General Liability ($2,000,000 general aggregate, $1,000,000 per occurrence), Automobile Liability ($1,000,000 combined single limit), Worker's Compensation as required by Texas statute, and Excess/Umbrella Liability ($1,000,000 per occurrence). Val Verde County must be listed as an Additional Insured and Certificate Holder. The contractor assumes all responsibility for jobsite safety, OSHA compliance, utility protection, and site cleanup, with any damages to utilities repaired at the contractor's expense. All work must conform to applicable local, state, and federal codes and ordinances, and a one-year warranty on labor and workmanship is required from the date of acceptance.

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REQUEST FOR COMPETITIVE SEALED BID

REBID #26-91

LABOR FOR CONCRETE PARKING LOT

AT ROBERT “BOB” CHAVIRA SPORTS COMPLEX

VAL VERDE COUNTY

DEL RIO, TX 78840

Bid Due Date & Time

Thursday, September 3rd, 2026

2:00 P.M. (CST)

SUBMIT SEALED BIDS TO:

Melissa Vasquez

Purchasing Agent

Val Verde County

509 E. Gibbs Street

Del Rio, TX 78840

SECTION 1.0 - GENERAL INFORMATION

Val Verde County is accepting competitive sealed bids from construction companies to construct a concrete parking lot to include driveways, curbs, gutters, and sidewalks for the Robert “Bob” Chavira Sports Complex in Del Rio, TX, 78840. This bid is for labor only and all material will be supplied by Val Verde County.

1.01 – PRE-BID MEETING

A pre-bid meeting will be held on August 20, 2026 at 9:00 A.M. Meeting will be held at the Val Verde County Courthouse, 3rd Floor Conference Room at 400 Pecan St., Del Rio TX, 78840. Attending the meeting is highly recommended. All pre-bid meeting attendees will receive the Q&A and addenda’s if applicable, by email and they will be posted on the following website: www.valverdecounty.texas.gov.

1.02 – QUESTIONS

Submit all questions to Carlos Velarde, P.E. at cvelarde@valverdecounty.texas.gov or you may call (830) 774-7569.

Questions are due by 4:30 P.M. on August 25, 2026 and responses will be posted by 4:30 P.M. on August 28, 2026.

Questions may also be submitted in writing on CivCast’s website at www.civcastusa.com. Responses and addenda’s if applicable will be posted on both Val Verde County’s website and Civcast’s website by August 24, 2026.

1.03 – SUBMITTAL INSTRUCTIONS

Please submit one (1) original copy of your sealed bid and all related documents required. All bids shall be sealed, addressed, and delivered to Val Verde County Purchasing Department, 509 E. Gibbs St., Del Rio, Texas 78840 by Thursday, September 3rd, 2026 at 2:00 P.M. (CST) at which time and place will be publicly opened and read aloud. It is the bidder’s responsibility to see that the bid arrives on time. Late bids will not be accepted and will be returned unopened.

Please mark the outer envelope: “BID 26-91 Labor for Concrete Parking Lot at Robert “Bob” Chavira Sports Complex”

1.04 – INSPECTION OF SITE

Each bidder should visit the site of the proposed work and should become acquainted with the existing conditions and facilities, the difficulties and restrictions pertaining to the performance of the contract. The bidder should thoroughly examine and become familiar with the drawings, technical specifications and all other contract documents. The contractor by the execution of the contract shall in no way be relieved of any obligation under it due to failure to receive or examine any form or legal document or to visit the site or the conditions existing at the site. The County will be justified in rejecting any claim based on lack of inspection of the site prior to the bid.

1.05 – AWARD OF CONTRACT

The contract will be awarded to a responsive, responsible Bidder submitting the lowest and best bid. The bidder selected will be notified at the earliest possible date. Val Verde County reserves the right to reject any and/or all bids and to waive any informality in bids received where such rejection or waiver is in its interest.

Val Verde County reserves the right to consider as unqualified to do the work any bidder who does not habitually perform with his own forces the major portions of the work involved in construction of the improvements embraced in this contract.

1.06 – BONDS

A bid bond in the amount of five percent (5%) of the bid issued by an acceptable surety is required with each bid that exceeds $100,000.00. A certified check or bank draft payable to Val Verde County or negotiable U.S. Government Bonds (as par value) may be submitted in lieu of the Bid Bond.

The successful bidder must be able to provide a Performance Bond and/or a Payment Bond each in the amount of 100% of the contract price from an approved Surety Company holding a permit from the State of Texas to act as Surety and acceptable according to the latest list of companies holding certificates of authority from the Secretary of Treasury of the http://www.valverdecounty.texas.gov/ mailto:cvelarde@valverdecounty.texas.gov http://www.civcastusa.com/

United States, or other Surety or Sureties acceptable the Owner, (https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html#g), within 30 days from an awarded contract and before the commencement of work, if applicable.

1.07 - PROJECT COMPLETION

Once contract has been signed by both parties, completion date is determined at a Pre-Construction meeting and will begin from the effective date of executed contract or Notice to Proceed.

1.08 – LIQUIDATED DAMAGES

Time is of the essence in the performance of the contract. Because such damages for delay would be difficult and costly to determine, liquidated damages for delay (but not as a penalty) shall be paid to Owner in the amount of $100.00 for each day that expires after the contract time for substantial completion.

SECTION 2.0 - TERMS AND CONDITIONS

2.01 Failure to comply with all the Instructions and Conditions may subject the bid to rejection. The Terms and

Conditions, the Specifications and Scope of Work will form part of the contractual agreement between Val Verde County and the successful bidder.

2.02 The successful offeror submitting bids will be notified by Letter of Award which will be conditioned upon entering in to a contract acceptable to the County.

2.03 The bid specifications indicate the minimum standard of quality, performance or other pertinent characteristics required. All variations and exceptions from minimum specifications must be attached to the bid on a separate page.

2.04 All bids will be valid until a contract has been awarded. All bids will be publicly read aloud at the date and time specified in the public notice.

2.05 Bids may be held by Val Verde County for the purpose of reviewing the bids and investigating the bidder’s qualifications prior to contract award.

2.06 The County reserves the right to waive technical irregularities in the form of the bid which do not alter the quality or quantity of the services, and the County may reject any and/or all bids when it is in the best interest of the County to do so.

2.07 This agreement is subject to Texas law, including but not limited to, the Procurement Code, the Texas Public Works

Minimum Wage Act and all federal and state laws, rules and regulations pertaining to equal employment opportunity. The rights and obligations set forth herein are to be construed and interpreted according to said laws, regardless of whether they are expressly set forth herein. Should any provision herein be found to be unenforceable; it will not affect the legality or enforceability of the remainder of the formal contract, so long as the basic intent and object of this agreement is not undermined by the elimination of the objectionable provision(s). The bidder agrees to comply with state laws and rules applicable to workers' compensation benefits for its employees. If the bidder fails to comply with the Workers' Compensation Act and applicable rules when required to do so, the formal contract may be terminated immediately by the contracting agency.

2.08 The bidder will save and hold the County harmless from all suits, actions, claims, losses and expenses, including attorney's fees brought on account of any injuries or damages sustained by any employee or person, including wrongful death, or damage to property as a result of any negligence, misconduct or omission by the bidder or employee or agent thereof connected in any way with bidder's performance under the formal contract.

2.09 It is expressly agreed and understood that the offeror is not authorized to act as an agent of the County or to enter into any contract on behalf of the County. It is also acknowledged that the offeror, its agents and employees, by virtue of award of this proposal, are not entitled to any fringe benefits available to the employees of Val Verde County.

https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html#g https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html#g

2.10 Award of the bid will not be altered, changed or amended except by an instrument in writing executed by the parties hereto.

2.11 Upon award, the agreement between offeror and the County will be governed by the laws of the State of Texas and enforced in the County of Val Verde.

2.12 After award, bids are subject to public inspection. Any confidential or proprietary information should be marked as such with a brief explanation as to why. Entire bids may not be considered proprietary. All material submitted will become the property of Val Verde County and will not be returned.

2.13 The Contractor will be required to carry and provide to Val Verde County a Certificate of Insurance with the following requirements.

a. Commercial General Liability:

General Aggregate $2,000,000 Personal Injury $1,000,000

Each Occurrence (Bodily Injury & Property Damage) $1,000,000

b. Automobile Liability:

Bodily Injury:

Each Person $1,000,000 Each Accident $1,000,000 Property Damage:

Each Accident $1,000,000 Combined Single Limit $2,000,000

c. Worker’s Compensation: As required by Texas State Statute.

d. Excess or Umbrella Liability:

Per Occurrence $1,000,000 General Aggregate $1,000,000

e. Contractor’s Pollution Liability:

Each Occurrence $1,000,000

General Aggregate $1,000,000

Val Verde County must be listed as an Additional Insured and a Certificate Holder. Proof of coverage must be provided to the County before the commencement of the job.

SECTION 3.0 – SCOPE OF WORK AND TECHNICAL SPECIFICATIONS

3.01 - GENERAL DESCRIPTION

The Work covered by this Contract consists of furnishing all labor, equipment, materials (unless otherwise noted), supervision, and incidentals necessary to construct roadway and parking lot improvements at Del Rio Middle School in

Del Rio, Texas, in accordance with the Contract Documents, Drawings, and applicable standards.

The project generally includes roadway and parking lot construction, drainage improvements, concrete flatwork, and associated appurtenances.

All work shall conform to the latest edition of the Texas Department of Transportation (TxDOT) Standard Specifications for Construction and Maintenance of Highways, Streets, and Bridges, and any applicable special provisions.

3.02 - CONTRACTOR RESPONSIBILITIES

The Contractor shall:

• Provide all labor, supervision, equipment, and incidentals necessary to complete the Work

• Verify all field conditions prior to construction

• Coordinate with Owner to minimize disruption to school operations

• Maintain safe access for school personnel and emergency vehicles at all times

• Be fully responsible for jobsite safety and compliance with OSHA and applicable regulations

• Provide traffic control in accordance with the Texas Manual on Uniform Traffic Control Devices (TMUTCD)

• Protect existing utilities and improvements; repair any damage at Contractor’s expense

• Maintain site cleanliness and remove debris regularly

• Comply with all curing procedures and installation requirements for concrete work

• Ensure all work meets required compaction, alignment, and grade tolerances

3.03 - GENERAL NOTES

The Base Bid shall include all work necessary for completion of the roadway and parking lot improvements, excluding major earthwork operations.

Mobilization and Demobilization

• Transport of personnel, materials, and equipment

• Establishment of staging and laydown areas

Roadway and Parking Lot Construction

• Construction in accordance with project plans, including base and surface improvements

Drainage and Concrete Improvements

• Installation of drainage structures, curbs, sidewalks, ramps, and related features as shown in the plans

LABOR ONLY CONSTRUCTION ITEMS

Furnishing labor, supervision, and equipment only for installation of Owner-supplied materials.

TxDOT Item 450 – Pedestrian Railing

• Installation, alignment, and anchoring per plans and specifications

TxDOT Item 464 – Corrugated Metal Pipe (24”)

• Installation including trenching, bedding, placement, and backfilling

TxDOT Item 467 – Safety End Treatment (24”)

• Installation of end treatments in accordance with TxDOT standards

TxDOT Item 506 – Temporary Erosion Control

• Installation, maintenance, and removal of erosion control measures

TxDOT Item 529 – Concrete Curb and Gutter

• Forming, placement, finishing, jointing, and curing

Concrete pavement and driveways (6” Reinforced)

• Reinforcement: #4 bars @ 12” on center each way

• Keyway installation as per details provided, doweled and sawcut joints (tools and consumables provided by bidder)

• Complete installation per plans and concrete curing

TxDOT Item 531 – Sidewalks, Islands, and Separators

• Measured by square yard

• Includes forming, placement, finishing, and curing

Elevated Sidewalks

• Construction per project plans and details

Concrete Ramps (ADA Compliant)

• Installation in compliance with ADA and project requirements

• Includes detectable warning surfaces where specified

Fence Removal

• Removal and disposal of existing fencing as required for construction

QUALITY CONTROL AND TESTING

• Compaction testing shall be performed to verify compliance with specifications, paid by owner

• Concrete shall meet specified strength requirements

• Contractor shall coordinate with Owner or testing agency

• Any deficient work shall be corrected at no additional cost

MEASUREMENT AND PAYMENT

• Work shall be measured and paid in accordance with applicable TxDOT bid items

• Unit price items shall include all labor, equipment, and incidentals

• Lump sum items shall include full compensation for complete work

PROJECT CLOSEOUT

• Final grading and site cleanup

• Removal of temporary controls unless otherwise directed

• Final inspection and acceptance by Owner

WARRANTY

A. The Contractor shall guarantee all labor, workmanship and materials supplied by the Contractor for a period of one (1) year from date of acceptance.

B. Repairs made necessary due to faulty workmanship shall be made promptly by the Contractor at the Contractor’s expense.

CODES AND STANDARDS

The Offeror is to conform to all local, state, and federal codes and ordinances.

DISCREPANCIES

It is the intent of this bid that all work must be completed and all material must be furnished in accordance with the generally accepted practice of the area. In the event of any discrepancies between the plans and specifications or doubts as to the meaning and intent of any portion of the bid, the Owner shall define what is intended to apply to the work.

3.04 - SITE CONDITIONS

EXAMINATION OF SITE

Bidder shall visit the project site. A pre-bid meeting will be held on August 20, 2026; 9:00 A.M. at Val Verde County Courthouse, 3rd Floor Conference Room at 400 Pecan St., Del Rio Tx, 78840 in Val Verde County. Failure to attend a pre-bid meeting or visit the project site will in no way relieve the successful Bidder from the responsibility of completing the project in accordance to project specifications and to submission of bid. Bidder will be responsible for any and/or all additional cost to the Owner.

UTILITIES

The Contractor’s attention is directed to the fact that other underground utility lines may exist of which the Owner is not aware. It is the Contractor’s obligation to locate and familiarize himself with all utilities and to provide for their safety.

Damage to utilities will be repaired at the Contractor’s expense.

3.05 – INSPECTION

A. Do not allow any of the work in this section to be covered or enclosed until it has been inspected, tested and approved by the Owner or Owner’s Representative.

3.06 – INSPECTION AND ACCEPTANCE

PRELIMINARY INSPECTION

When all initial construction is done and all incidentals necessary, the Contractor shall request the Owner to perform a walk-through to visually check and inspect the foundation. At this time the Owner and the Contractor will discuss repairs that may need to take place and create a punch list.

FINAL INSPECTION

After preliminary inspection has taken place and all items from the punch list have been corrected, repaired and completed by the Contractor, the Contractor and the Owner will again walk-through to visually check and inspect. An acceptance form will follow from the Owner to the Contractor.

3.07 – CLEAN UP AND ADJUSTING

REMOVAL OF SITE DEBRIS

The Contractor shall:

1. Make final cleanup of all parts of work.

2. Remove all construction material and equipment.

3. Prepare the site in an orderly and finished appearance.

4. Remove from site any rock or extra dirt that resulted from this and restore site to its original condition.

5. The Contractor will be required to remove all construction debris from the site. Final clean up by the Contractor must be acceptable to the Owner.

SECTION 4.0 – BIDS

A. All bids must be submitted on the forms provided and are subject to all requirements of the Bid Documents, including the Drawings.

B. All bids submitted shall be valid for a period of sixty (60) calendar days from the date of the bid opening.

C. Bid documents, including but not limited to the bid, the contractor’s certifications, local opportunity plan, and the statement of the bidder’s qualifications, shall be sealed in an envelope and clearly labeled with the words "Bid Documents”, the project bid number, name of bidder and the date and time of bid opening.

D. The County may consider as irregular any bid on which there is an alteration of or departure from the bid form and, at its option, may reject any irregular bid.

E. If a contract is awarded, it will be awarded to a responsive, responsible bidder on the basis of the lowest and best bid and the selected alternate bid items, if any. The contract will require the completion of the work in accordance with the contract documents.

ALTERNATE BID ITEMS

No alternate bids or bid items will be considered unless they are specifically requested in the technical specifications.

BID MODIFICATIONS PRIOR TO BID OPENING

Any bidder may modify its bid by submitting a modification or supplemental bid at any time prior to the scheduled closing time for receipt of bids, provided such modification or supplemental bid is received by the locality prior to the closing time.

The modification or supplemental bid should not reveal the original bid price but should provide only the addition, subtractions or other modifications to the original bid so that the final prices or terms will not be known by the locality until the sealed bid is open.

BID BONDS

A. A bid bond in the amount of five percent (5%) of the bid issued by an acceptable surety shall be submitted with each bid for contracts greater than $100,000.00. A certified check or bank draft payable to the locality or negotiable U.S. Government Bonds (as par value) may be submitted in lieu of the Bid Bond.

B. The bid bond or its comparable will be returned to the bidder as soon as practical after the opening of bids.

STATEMENT OF BIDDERS QUALIFICATIONS

Each bidder shall submit on the form furnished for that purpose a statement of the bidder's qualifications. Val Verde County shall have the right to take such steps as it deems necessary to determine the ability of the bidder to perform its obligations under the contract, and the bidder shall furnish Val Verde County all such information and data for this purpose as it may request. The right is reserved to reject any bid where an investigation of the available data does not satisfy Val Verde County that the bidder is qualified to carry out properly the terms of the contract.

WITHDRAWAL OF BIDS

Bidder may withdraw the bid before the time fixed for the opening of bids, by communicating its purpose in writing to Val Verde County. Upon receipt of such notice, the unopened bid will be returned to the bidder. The bid guaranty of any bidder withdrawing his bid will be returned promptly.

BID PROPOSAL

REBID 26-91 LABOR FOR CONCRETE PARKING LOT

ROBERT “BOB” CHAVIRA SPORTS COMPLEX

VAL VERDE COUNTY, TEXAS

DATE:

Gentlemen:

Having carefully examined the Specifications, the undersigned Bidder hereby proposes to supply all necessary items listed at the quantities shown for each item on the following bid schedule.

The bid schedule attached lists the various divisions of materials in the Specifications. Bid quantities must be shown in Words and Figures for each item listed in the Proposal, and in the event of a discrepancy, the words shall control.

Receipt is hereby acknowledged of the following addenda to the Contract Documents:

Addendum No. 1 dated Received

Addendum No. 2 dated Received

Addendum No. 3 dated Received

Bidder agrees to supply all of the materials listed in the proposal and as described in the Specifications, for the following quantities:

The following changes are hereby made a part of the specifications for BID 26-89 Concrete Parking Lot for Robert “Bob”

Chavira Sports Complex contract.

The Vendor shall acknowledge receipt of this clarification on the face of the envelope in which he submits his bid and by signing this addendum and attaching it to his bid proposal

Name Date

Title

STATEMENT OF BIDDER'S QUALIFICATIONS

All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized.

If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information it desires.

Date:

Bidder (Legal Name of Firm):

Date Organized:

Address :

Date Incorporated

Federal ID Number: ____________________________

Number of Years in contracting business under present name

List all other names under which your business has operated in the last 10 years:

Work Presently Under Contract:

Contract Amount $ Completion Date

Type of work performed by your company:

Total Staff employed by Firm (Break down by Managers and Trades on separate sheet):

Have you ever failed to complete any work awarded to you? Yes No (If yes, please attach summary of details on a separate sheet. Include brief explanation of cause and resolution)

Have you ever defaulted on a contract? Yes No (If yes, please attach summary of details on a separate sheet.)

Has your organization had any disbarments or suspensions that have been imposed in the past five years or that was still in effect during the five-year period or is still in effect? Yes No (If yes, list and explain; such list must include disbarments and suspensions of officers, principals, partners, members, and employees of your organization.)

List the projects most recently completed by your firm (include project of similar importance):

Project Amount $ Mo/Yr. Completed

Major equipment available for this contract:

Are you in compliance with all applicable EEO requirements? Yes No (If no, please attach summary of details on a separate sheet.))

Bank References:

Address: Contact Name:

City & State: _____________________ Zip: ____________________ Phone Number:

Credit available: $

Has the firm or predecessor firm been involved in a bankruptcy or reorganization? Yes No (If yes, please attach summary of details on a separate sheet.)

List on a sheet attached hereto all judgements, claims, arbitration proceedings, or suits pending or outstanding against bidder over the last five (5) years with amount of claim and brief description.

List on a sheet attached hereto all lawsuits or requested arbitration with regard to construction contracts which bidder has initiated within the last five (5) years and brief explanation of claim and outcome.

Attach resume(s) for the principal member(s) of your organization, including the officers as well as the proposed superintendent for the project.

Signed this ______ day of _______________________, 20____.

Signature

Printed Name and Title

Company Name

NOTARY STATEMENT

______________________________, being duly sworn, says that he/she is the _________ of Position/Title

___________________ _____, and hereby swears that the answers to the foregoing questions and all statements therein Firm Name contained are true and correct. He/she hereby authorizes and requests any person, firm, or corporation to furnish any information requested City/County of _____________________ in verification of the recitals comprising this Statement of Bidder's Qualifications.

Subscribed and sworn before me this _________day of _______ ___, 20____.

Notary Public My Commission Expires: _______________ Signature

Printed Name

NONCOLLUSION AFFIDAVIT OF PRIME BIDDER

State of Texas )

County of )

, being first duly sworn, deposes and says that:

(1) He or She is of , the Bidder that has submitted the attached Bid;

(2) He or She is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid;

(3) Such Bid is genuine and is not a collusive or sham Bid;

(4) Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with another Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix an overhead, profit or cost element of the Bid price or the Bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against

(Local Public Agency) or any person interested in the proposed Contract; and

(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affiant.

(Signed)

Title

Subscribed and sworn to me this day of .

By:

Notary Public

My commission expires

Revised 1/1/2021 Form provided by Texas Ethics Commission www.ethics.state.tx.us

CONFLICT OF INTEREST QUESTIONNAIRE

For vendor doing business with local governmental entity (Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021)

FORM CIQ

This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.

This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).

By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.

A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor.

OFFICE USE ONLY

Date Received

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

Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)

3 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)(2)(A). Also describe any family relationship with the local government officer.

Complete subparts A and B for each employment or business relationship described. Attach 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 other 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.

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).

Signature of vendor doing business with the governmental entity

Date

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.statutes.legis.state.tx.us/

Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.

Local Government Code § 176.001(1-a): "Business relationship" means a 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 conflicts 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 of the 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 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.

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 a local government officer of that local governmental entity, or a family member of the officer, 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 filed 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 writing 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 relationship with a local government officer.

Form W-9 (Rev. March 2024)

Department of the Treasury

Internal Revenue Service

Request for Taxpayer Identification Number and Certification

Go to www.irs.gov/FormW9 for instructions and the latest information.

Give form to the requester. Do not send to the IRS.

Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.

1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2.)

2 Business name/disregarded entity name, if different from above.

3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes.

Individual/sole proprietor C corporation S corporation Partnership Trust/estate

LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)

Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner.

Other (see instructions)

3b If on line 3a you checked “Partnership” or “Trust/estate,” or checked “LLC” and entered “P” as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions

4 Exemptions (codes apply only to certain entities, not individuals;

see instructions on page 3):

Exempt payee code (if any)

Exemption from Foreign Account Tax

Compliance Act (FATCA) reporting code (if any)

(Applies to accounts maintained outside the United States.)

5 Address (number, street, and apt. or suite no.). See instructions. Requester’s name and address (optional)

6 City, state, and ZIP code

7 List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a

TIN, later.

Note: If the account is in more than one name, see the instructions for line 1. See also What Name and

Number To Give the Requester for guidelines on whose number to enter.

Social security number or

Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue

Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.

General Instructions Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

What’s New Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the “LLC” box and enter its appropriate tax classification.

New line 3b has been added to this form. A flow-through entity is required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow-through entity in which it has an ownership interest. This change is intended to provide a flow-through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065).

Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they

Cat. No. 10231X Form W-9 (Rev. 3-2024)

Employer identification number

Sign Signature of

Here U.S. person Date

P ri n t o r ty p e

S e e S p e c if ic I n s tr u c ti o n s o n p a g e http://www.irs.gov/FormW9 http://www.irs.gov/FormW9

Page 2 Form W-9 (Rev. 3-2024) must obtain your correct taxpayer identification number (TIN), which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following.

• Form 1099-INT (interest earned or paid).

• Form 1099-DIV (dividends, including those from stocks or mutual funds).

• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds).

• Form 1099-NEC (nonemployee compensation).

• Form 1099-B (stock or mutual fund sales and certain other transactions by brokers).

• Form 1099-S (proceeds from real estate transactions).

• Form 1099-K (merchant card and third-party network transactions).

• Form 1098 (home mortgage interest), 1098-E (student loan interest), and 1098-T (tuition).

• Form 1099-C (canceled debt).

• Form 1099-A (acquisition or abandonment of secured property).

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN.

Caution: If you don’t return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later.

By signing the filled-out form, you:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued);

2. Certify that you are not subject to backup withholding; or

3. Claim exemption from backup withholding if you are a U.S. exempt payee; and

4. Certify to your non-foreign status for purposes of withholding under chapter 3 or 4 of the Code (if applicable); and

5. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting is correct. See What Is FATCA Reporting, later, for further information.

Note: If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien;

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States;

• An estate (other than a foreign estate); or

• A domestic trust (as defined in Regulations section 301.7701-7).

Establishing U.S. status for purposes of chapter 3 and chapter 4 withholding. Payments made to foreign persons, including certain distributions, allocations of income, or transfers of sales proceeds, may be subject to withholding under chapter 3 or chapter 4 of the Code (sections 1441–1474). Under those rules, if a Form W-9 or other certification of non-foreign status has not been received, a withholding agent, transferee, or partnership (payor) generally applies presumption rules that may require the payor to withhold applicable tax from the recipient, owner, transferor, or partner (payee). See Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities.

The following persons must provide Form W-9 to the payor for purposes of establishing its non-foreign status.

• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the disregarded entity.

• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the grantor trust.

• In the case of a U.S. trust (other than a grantor trust), the U.S. trust and not the beneficiaries of the trust.

See Pub. 515 for more information on providing a Form W-9 or a certification of non-foreign status to avoid withholding.

Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person (under Regulations section 1.1441-1(b)(2)(iv) or other applicable section for chapter 3 or 4 purposes), do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. 515). If you are a qualified foreign pension fund under Regulations section 1.897(l)-1(d), or a partnership that is wholly owned by qualified foreign pension funds, that is treated as a non-foreign person for purposes of section 1445 withholding, do not use Form W-9. Instead, use Form W-8EXP (or other certification of non-foreign status).

Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a saving clause. Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items.

1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions.

4. The type and amount of income that qualifies for the exemption from tax.

5. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if their stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first Protocol) and is relying on this exception to claim an exemption from tax on their scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption.

If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233.

Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 24% of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include, but are not limited to, interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third-party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding.

You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return.

Payments you receive will be subject to backup withholding if:

1. You do not furnish your TIN to the requester;

2. You do not certify your TIN when required (see the instructions for Part II for details);

3. The IRS tells the requester that you furnished an incorrect TIN;

4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only); or

5. You do not certify to the requester that you are not subject to backup withholding, as described in item 4 under “By signing the filled-out form” above (for reportable interest and dividend accounts opened after 1983 only).

Page 3 Form W-9 (Rev. 3-2024)

Certain payees and payments are exempt from backup withholding.

See Exempt payee code, later, and the separate Instructions for the Requester of Form W-9 for more information.

See also Establishing U.S. status for purposes of chapter 3 and chapter 4 withholding, earlier.

What Is FATCA Reporting?

The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all U.S. account holders that are specified U.S. persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code, later, and the Instructions for the Requester of Form W-9 for more information.

Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you are no longer tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account, for example, if the grantor of a grantor trust dies.

Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.

Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.

Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties.

Specific Instructions

Line 1

You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return.

If this Form W-9 is for a joint account (other than an account maintained by a foreign financial institution (FFI)), list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. If you are providing Form W-9 to an FFI to document a joint account, each holder of the account that is a U.S. person must provide a Form W-9.

• Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name.

Note for ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040 you filed with your application.

• Sole proprietor. Enter your individual name as shown on your Form 1040 on line 1. Enter your business, trade, or “doing business as” (DBA) name on line 2.

• Partnership, C corporation, S corporation, or LLC, other than a disregarded entity. Enter the entity’s name as shown on the entity’s tax return on line 1 and any business, trade, or DBA name on line 2.

• Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. Enter any business, trade, or DBA name on line 2.

• Disregarded entity. In general, a business entity that has a single owner, including an LLC, and is not a corporation, is disregarded as an entity separate from its owner (a disregarded entity).

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