HomeMy WebLinkAbout04-11-16 Martin L. King Splash ParkV
Ala
i" cilit:ies Ltd
q cari�(Ortlt Company
TURNKEY QUOTATION
PROJECT NAME: MARTIN L. KING SPLASH PARK
OWNER: CITY OF LA PORTE, TEXAS
DATE: 2/29/2016
Restroom Facilities Limited (RFL), the Nation's leading specialized restroom design/build firm
since 1988, offers to furnish and install, per plans and specifications, subject to our attached
Scope of Work, and the Standard Terms and Conditions of Sale, which become part of our offer
to sell.
BUYBOARD CONTRACT 423.13
RFL BASE MODEL #AB212DF @ $ 65,265.30
INSTALL @ $ 9,000.00
TOTAL WITH BUYBOARD DISCOUNT @ $ 74,265.30
FREIGHT, CRANE, BOND @ $ 8,923.00
TOTAL BUYBOARD W/ FREIGHT AND CRANE @ $ 83,188.30
Note: You must itemize your purchasing document as shown in this quote.
Payment terms: 50% installment with order; 40% in progress billings during construction; and
balance of 10% upon completion of delivery and installation, no retention. Payment of 90%
must be received by RFL prior to scheduling of delivery and installation. Thank you for
considering RFL as your restroom specialist for this project.
HOW WE WORK
If you are the apparent low just simply send us a letter of intent and we will begin the
construction drawings. Once plans have been approved and engineer stamped, the
manufacturing process begins. Typically, the construction time frame is approximately 90-120
days and begins with execution of sales order and receipt of approved submittals, color
selections and progress payments. In -plant inspection reports and certifications will be provided
by an independent inspection agency. The client must prepare the site in accordance with the
"Scope of Work by Client" attached and coordinate any required on site inspections. After the
site prep has been completed, our crew arrives to perform the installation. They will verify
elevation, offsets, location, and access.
Exclusions:
A. Sidewalks beyond building slab.
Initial Initial Page 1 of 8
1707 Colt Circle, Marble Falls, Texas 78654 0 Phone: 512.222,5454 0 www.restroomfacilities.com
B. Site issues beyond the control of RFL.
C. Damage to existing improvements.
D. Protection of existing utilities, landscaping, and improvements.
E. If required per geotech report, footing, piers, and/or select fill labor and materials to be
provided by others.
F. Excavation and backfill.
CLIENT'S SCOPE OF WORK
TURNKEY INSTALLATION OF RESTROOM BUILDING WITH ATTACHED SLAB
1. SURVEY STAKES:
Provide ten foot offset stakes and locate front corners of building, existing utilities, and
inverts within the area of construction. Locate and mark final slab elevation.
2. SUBGRADE PAD:
Preparing the site is fairly simple. Detailed instructions to prepare the building site are
as follows:
2.1. Excavate down ten inches below the finish floor elevation (the slab is eight inches
thick on top of a two inch sand bed).
2.2. If soils are poor, it may be necessary to import six inches of Class II base rock,
and pour for a footing and/or piers. (This is not necessary if native soils will
compact)
2.3. Compact to 95%, or to local code requirement.
2.4. Compact one foot over in all directions (over build).
2.5. Supply approximately five cubic yards of clean sand, on side of site, for fine
grading.
2.6. Excavate and backfill trenches up to and within building pad for RFL supplied
underground utility service kits.
2.7. Provide water and inspection for RFL supplied underground sewer kit.
2.8. Depending on weather, all irrigation should be turned off prior to delivery to allow
the surrounding soils to dry and bear the weight of the truck and crane.
2.9. Check comer locations against plans for proper sizing.
2.10. Verify finish floor elevation for concrete slab (shipped fully attached to the
building.)
2.11. Excavate one foot perimeter footing if required by local code to specified depth.
3. SITE ACCESS AND STORAGE:
Provide suitable safe clear access to allow a crane (up to 110 tons), and the building on
a semi -trailer (up to 40 tons) to reach site (14' width, 70' length, and 14' in height). If
path to site is over existing utilities, sidewalks, or other damageable areas, proper
marking, plating or other appropriate protection must be provided by CLIENT. CLIENT is
responsible for removing any overhead obstructions (i.e. power lines, trees). This
proposal provides for a 110 ton crane with access to within 25' of the building pad. The
initial initial Page 2 of 8
1707 Colt Circle, Marble Falls, Texas 78654 0 Phone; 512.222.5454 0 wwvv.restroomfacilities.com
proposal is based on four (4) hours of crane time. If access is limited a larger crane may
be required. All additional crane costs shall be borne by the CLIENT. A direct route to
the project site is assumed. Should routes be altered due to road closures or
restrictions, additional fees may apply.
4. UTILITIES:
Bring water, sewer, and power (if applicable) utilities into point of connection Christy
boxes (supplied by RFL), within six feet of the building line at the location shown on our
plan.
4.1. Water: RFL will furnish and install a water point of connection (isolation valve),
from mechanical chase to a Christy box six feet from the building line. CLIENT
must connect service to valve.
4.2. Sewer: RFL will furnish and install a sewer point of connection from mechanical
chase to a Christy box six feet from the building line. CLIENT must connect
service.
4.3. Electrical: (when this option is chosen) RFL will furnish and install a PVC conduit
and a Christy box to the point of connection six feet from the building line.
CLIENT to pull the electrical service line through the conduit and connect to the
main panel lugs inside the building. All electrical inside the building will be
furnished and installed by RFL, except as noted above in exclusions.
4.4. If the utilities are not available when we depart the site, testing and minor leaks
will be the responsibility of the CLIENT.
4.5. A minimum 1'/2" line with 25 gpm at 60 psi pressure minimum is required to
ensure that water closets will operate as designed. If this is not available an
auxiliary holding tank may be required.
5. SPECIAL CONDITIONS AND COSTS:
If specifications by owner require any testing or special inspections, costs, if any, shall
be borne by CLIENT.
6. PERMITS AND FEES:
All building permits and fees shall be borne by CLIENT.
7. INSPECTIONS:
It is very important that the CLIENT understand that our costs are based upon fast track
construction and that delays for inspection are an impediment to the timely completion of
the project. We seek the full cooperation of the CLIENT and local building officials or
project inspectors in accomplishing this end. We require that all inspections be
scheduled with adequate notice to ensure that the underground plumbing and electrical
work is approved prior to placement of building. We require that final inspection and
acceptance by owner and building officials be performed immediately following RFL's
completion of installation. We also require final inspection and acceptance immediately
following RFL's conclusion of any correction items.
Af�lnitial Initial Page 3 of 8
{( 1707 Colt Circle, Marble Falls, Texas 78654 0 Phone: 512.222.5454- 0 4v mrestroornfaciIities.corn
8. SITE CLEANUP AND DEBRIS REMOVAL:
CLIENT shall provide an on -site trash bin for disposal of one pick up load of debris. All
excess spoils shall be responsibility of CLIENT. All rough and final grading shall be by
CLIENT.
9. SOILS INFORMATION:
Even though the building department may not require an official soils report, it is always
a good idea to obtain one. Our slab requires a minimum allowable soil bearing pressure
of 1,000 psf. This value needs to be confirmed, on site, by the owner, or through the
owner's contractor, and not by RFL. The need to obtain a soils report is only a
recommendation by RFL. Ultimately, it is up to the owner and the local jurisdiction to
decide whether or not to pursue evaluating the soils beyond the generally conservative
assumptions given in current applicable codes.
STANDARD TERMS AND CONDITIONS OF SALE
LINKAGE:
These Terms and Conditions of Sale shall apply and form a part of the Company's Offer
to Sell and supersede all other expressed or implied terms and be linked to our
Agreement for work whether or not signed by the Purchaser.
2. ACCEPTANCE:
Unless otherwise expressly stated herein, the Company's Offer supersedes all previous
quotations and expires, unless accepted by purchaser, within thirty (30) days from date
of Offer. None of the Terms and Conditions contained in this quotation may be added
to, modified, superseded or otherwise altered except by a written instrument signed by
the President of the Company. Each shipment to buyer from the Company shall be
deemed to be only under these Terms and Conditions of Sale, which shall become part
of our Offer to Sell, notwithstanding any Terms and Conditions that may be contained in
any purchase order or other form of the buyer, notwithstanding the shipment,
acceptance of payment or similar act of the Company. All Purchase Orders when
accepted by the Company at 1707 Colt Circle, Marble Falls, Texas 78654, will be in
accordance with the Laws of the State of Texas. All orders are subject to review by the
Company in accordance with the Company's Offer to Sell before final acceptance is
authorized. All disputes shall be governed by applicable Texas Law and all claims shall
be filed and litigated in Burnet County, Texas, with the prevailing party recovering
attorney's fees.
PRICES:
Sales tax is not required provided the structure is installed by RFL. All Use taxes, and
applicable in plant taxes, permits and fees are paid for by RFL. If payment is not made
by client in accordance with the Contract Terms, interest will be charged at the rate of
Initial Initial Page 4 of 8
1707 Colt Circle, Marble Falls, Texas 78654 0 Phone: 512.222.5454 0 www.restroornfacilities.com
1-1/2% (one and one/half percent) per month until paid. If an order is accepted by the
Company, and a delivery date is accepted by the Client, and delivery is delayed by the
Client, payment of all but 10% is due upon completion at the Point of Manufacture. A
1-1/2% (one and one/half percent) per month added fee shall be due for each month the
shipment is delayed.
4. TERMINATION:
Purchaser shall be responsible for costs of work performed which will include overhead
and profit. Contract may not be cancelled once production has commenced.
TITLE AND LIEN RIGHTS:
All Products remain the personal property of the Company, whether or not affixed to any
other real property or structure, until the price (including any notes given therefore) of the
equipment has been fully paid in cash. The Company shall, in the event of the
purchaser's default, have the right to enter upon any premises and repossess such
structures and equipment wherever it may be located.
6. LACHES:
Failure of the Company to exercise any right or remedy under this contract shall not be
deemed a waiver of such right, nor shall any lien or other right of the Company be lost or
impaired by laches or in any manner or by any act or failure to act.
7. LIMITATION OF LIABILITY:
Under no circumstances, unless stated in our Offer to Sell or bid, shall the Company
have any liability for liquidated damages, for collateral, consequential special damages,
loss of profits, loss of production, delay in the progress of construction, whether resulting
from delays in delivery, performance, breach of warranty, due to lack of timely
performance in reviewing and approving shop drawings, completing site preparation or
lack of payment in accordance with the terms set forth herein. The aggregate total
liability of the Company under the contract, whether for breach of warranty or otherwise
shall in no event exceed the contract price. Buyer agrees to indemnity and holds
harmless the Company from all claims by third parties which extend beyond the
foregoing limitations on the Company's liability.
8. DELIVERY:
Except as may be otherwise specified in the attached Offer, delivery will be F.O.B. point
of manufacture. Time of delivery is an estimate only. The Company shall in no event be
liable for delays caused by fires, acts of God, strikes, labor difficulties, acts of
Government or military, delays in transportation or procurement of materials or causes of
any kind beyond the Company's immediate control. If building is ready for shipment and
Customer delays said shipment, Company shall store the facility at the point of
manufacturing and charge 1-1/2% (one and one/half percent) per month as a storage
A ,Initial Initial Page 5 of 8
1707 Colt Circle, Marble Falls, Texas 78654 0 Phone: 512.222.5154 0 Nrm.restroomfacilities.com
charge. If shipment arrives and site is not ready, Owner shall pay any off -site storage
fees as applicable.
9. WARRANTY:
All Products produced by the company are warranted to the purchaser to be free from
defects in material, workmanship and title. The Company will replace or repair, at its
option, defects in workmanship or any part which is proven defective within one year
from delivery. This warranty applies only where the Company has been notified in
writing of the defect within the warranty period and where any equipment has been
properly operated and maintained in accordance with the Company's instructions: the
Company having no responsibility for abuse, neglect or improper storage. Should any
issues arise where additional work must be performed RFL retains the right to perform
this work at the earliest opportunity. Should it be necessary to have this work performed
by others due to the nature of the work or a conflict in scheduling, RFL must be notified
48 hours in advance in writing and given the opportunity to perform said work. Should it
be necessary to have this work performed by others a written estimate must be
approved by RFL in advance of any work being undertaken. The Company assigns any
and all warranties for fixtures, appliances, and other equipment manufactured by others
to said other manufacturer. Due to its nature, concrete is prone to settling and cracking.
Minor cracking in the concrete is normal and is not the responsibility of RFL. We use
high quality 304 stainless steel in our products and under certain conditions and/or
improper maintenance stainless steel may rust. Minor rust spots or discoloration are not
the responsibility of RFL. The foregoing shall constitute the said liability of the Company
and the sole remedy to the purchaser. Company's warranties as set forth in this
paragraph are exclusive and are in lieu of, and purchaser hereby waives all other
warranties, expressed or implied, including without limitation, any implied warranties or
merchantability and fitness. This warranty shall be void if payment in full for the project
is not received by the Company in accordance with these Terms and Conditions of Sale.
10. CREDIT:
(Deposit and Progress Payments)
11. MUNICIPAL AND FEDERAL GOVERNMENT AGENCIES:
Orders may require deposits or progress payments. If buyer's financial situation justifies
such action, the Company may at its election require payment in advance or cancel the
order as to any unshipped item and require payment of its reasonable cancellation
charges. If the buyer delays completion of manufacture or a delay in shipment, the
Company shall require payment according to the percentage of completion. In the event
of the default of the buyer, the Company is entitled to the full amount due including
reasonable attorneys fees, costs, storage, expenses of physical recovery, and interest at
1-1/2% (one and one/half percent) per month.
Initial Initial Page 6 of 8
1707 Colt Circle, Marble Falls, Texas 78654 0 Phone: 512.222.5454 0 wwvv.restroomfacilities.com
12. CLIENTS AND NON -GOVERNMENT AGENCIES:
Orders may require deposits or advance payment as well as progress payments subject
to the buyer's credit worthiness in accordance with the Company's applicable credit
policies. Breach of any payment terms shall accelerate full payment which shall be due
the balance of the contract amount including change orders.
Initial Initial Page 7 of 8
1707 Colt Circle, Marble Falls, Texas 78654 • Phone: 512.222.5454 • www.restroomfacilities.com
Restroom Facilities Limited
John P tman, President
Client Name
Name d Title
Date
Date
-5-,/,Z-,O�6
Oinitial Initial Page 8 of 8
1707 Colt Cirelc, Marble Falls, Texas 78654 0 Phone: 512,222.5454 0 www.rest:roonifacilities.com
City of La Porte
PERFORMANCE BOND
MKL SPLASH PARK RESTROOM
STATE OF TEXAS
COUNTY OF HARRIS
KNOW ALL PERSONS BY THESE PRESENTS:
Section 00611
Performance Bond Form
Bond #4402546
That Restroom Facilities, Ltd., 1707 Colt Circle, Marble Falls, TX 78654
Hereinafter called Principal, and
SureTec Insurance Company, 1330 Post Oak Blvd., Suite 1100, Houston, TX 77056
Hereinafter called Surety, are held and firmly bound unto the City of La Porte, hereinafter called
Owner, in the full and just sum of
Eighty Three Thousand One Hundred Eighty Eight and 30/ 100 Dollars,
($ $83.188.30) good and lawful money of the United States of America for the payment of
which well and truly to be made, the said Principal and Surety hereby jointly and severally bind
ourselves, heir, executors, administrators, successors and assigns firmly by these presents.
WHEREAS, the Principal has entered into a certain written contract with the Owner, Agreement
dated April 11, 2016 , to which contract is hereby referred to and made a part
hereof as fully and to the same extent as if copied at length herein.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said
principal shall faithfully perform said Contract and shall in all respects duly and faithfully observe
and perform all and singular the covenants, conditions and agreements in and by said contract
agreed and covenanted by the Principal to be observed and performed, and according to the
true intent and meaning of said Contract and the drawings, and Specifications hereto annexed,
then this obligation shall be void; otherwise to remain in full force and effect;
PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253
of the Texas Government Code as amended and all liabilities on this bond shall be determined
in accordance with the provisions of said Chapter to the same extent as if it were copied at
length herein.
Surety, for value received, stipulates and agrees that no change, extension of time, alteration or
addition to the terms of the contract, or to work performed there under, or the plans,
specifications, or drawings, accompanying the same, shall in anyway affect its obligation on this
bond, and it does hereby waive notice of any such change, extension of time, alteration or
addition to the terms of the contract, or the work to be performed there -under.
PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall
abridge the right of any beneficiary hereunder, whose claim may be unsatisfied.
City of La Porte
Section 00611
Performance Bond Form
IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this instrument
this 14th day of April 2016
PRINCIPAL:
Restroom Facilities, Ltd.
By: I — e�l�
Title: oh . Putman Jr., President
Address: 1707 Colt Circle, Marble Falls, TX 78654
SURETY:
SureTec Insurance Company
By.�7�0`
Title:_Eva O. Urnmer, Attorney -in -Fact
Address: 1330 Post Oak Blvd., Suite 1100, Houston, TX 77056
NOTE: Date of Bond must not be prior to date of Agreement. If Contractor is Partnership, all
partners should execute Bond.
City of La Porte Section 00612
Payment Bond Form
1. Corporate principals to provide the following certificates:
CERTIFICATE AS TO CORPORATE PRINCIPAL
19
I,11L& C,4- _, (name) certify that I am secretary) Y
(title) of(company name) which is named as principal in the
within foregoing Bond, that JQ4 g (WT%4.►) AIL , (name of person executing
bond) who signed the said Bond on behalf of the principal, was then
_OM5 AL4. (title of person executing bond) of said principal; that I know
his/her signature and that his/her signature is therefore genuine; and the Bond was duly signed,
sea le , and atteste for and in behalf of said Corporation by authority of its governing body.
//yJv J- CwfW
Print Name
(Corporate Seal - required if a Corporation)
Subscribed and Sworn before me this�day of Y'k , 20L�
TILLER
0 #11748987
Notary Public O MY Commission Expires
M$rch 28, 2020
2. Surety shall provide a current power of attorney.
3. Date of Bond and surety power-of-attomey must not be dated prior to date of Agreement.
4. Surety companies executing bonds must appear on the Treasury Departments' most current
list (Circular 570 amended) and be authorizes to transact business in the State of Texas.
POA N: 4221112
SureTec Insurance Company
LIMITED POWER OF ATTORNEY
Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents
make, constitute and appoint
John R. Ward, Eva O. Limmer, Douglas Moore, Allyson Dean, Emily Mikeska
its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge
and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the
conditions of contracts and consents of surety for:
Fifteen Million and 001100 Dollars ($15,000,000.00)
and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate
seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the
premises. Said appointment shall continue in force until 12/31/16 and is made under and by authority of the following
resolutions of the Board of Directors of the SureTec Insurance Company:
Be it Resolved that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is
hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on
behalf of the Company subject to the following provisions:
Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or
any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20'A of April,
1999.)
In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal
to be hereto affixed this 9th day of February, A.D. 2015
SURETEC INSURANCE COMPANY
S�t�ANp6
(u r X '� By
w w i D= John oz Jr: resideni
State of Texas ss: 7�t 5 ff� 1
County of Harris . �' �0' /
On this 9th day of February, A.D. 2015 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he
resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above
instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the
Board of Directors of said Company; and that he signed his name thereto by like order.
�w JACQUELYN MALDONADO
Notary Public
State of Texas
My Comm. Exp. 5/18/2017 Jacq elyn Maldonado, Notary Public
My commission expires May 18, 2017
1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy
of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set
out in the Power of Attorney are in full force and effect.
Given under my hand and the seal of said Company at Houston, Texas this 14th day of April 2016 A.D.
M. Bre t Beaty, Assistant §ecretary
Any instrument issued in excess of the penalty stated above is totally void and without any validity.
For verification of the authority of this power you may call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST.
City of La Porte
PAYMENT BOND
MLK SPLASH PARK RESTROOM
STATE OF TEXAS
COUNTY OF HARRIS
KNOW ALL PERSONS BY THESE PRESENTS:
Section 00612
Payment Bond Form
Bond #4402546
That Restroom Facilities, Ltd., 1707 Colt Circle, Marble Falls, TX 78654
Hereinafter called Principal, and
SureTec Insurance Company, 1330 Post Oak Blvd., Suite 1100, Houston, TX 77056
Hereinafter called Surety, are held and firmly bound unto the City of La Porte, hereinafter called
Owner, in the full and just sum of
Fly Three Thousand One Hundred Eighty Eight and 30/100 Dollars,
($ 83,188.30 ) good and lawful money of the United States of America for the payment of
which well and truly to be made, the said Principal and Surety hereby jointly and severally bind
ourselves, heir, executors, administrators, successors and assigns firmly by these presents.
WHEREAS, the Principal has entered into a certain written contract with the Owner, Agreement
dated the 11 day of April , 2016 , to which contract is
hereby referred to and made a part hereof as fully and to the same extent as if copied at length
herein.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said
Principal shall pay all claimants supplying labor and material to him or a subcontractor in the
prosecution of the work provided for in said contract, then, this obligation shall be void;
otherwise to remain in full force and effect;
PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253
of the Texas Government Code as amended and all liabilities on this bond shall be determined
in accordance with the provisions of said Chapter to the same extent as if it were copied at
length herein.
Surety, for value received, stipulates and agrees that no change, extension of time, alteration or
addition to the terms of the contract, or to the work performed thereunder, or the specifications
or drawings accompanying the same, shall in anyway effect its obligation on this bond and it
does hereby waive notice of any such change, extension of time, alteration or addition to the
terms of the contract, or to the work to be performed thereunder.
PROVIDED, FURTHER, that no final settlement between the Owner and the Contractor shall
abridge the right of any beneficiary hereunder, whose claim may be unsatisfied.
City of La Porte
Section 00612
Payment Bond Form
IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this instrument
this 14th day of April 20 16
PRINCIPAL:
Restroom Facilities, Ltd.
By: , , /---- — - -
Title: Joh M. Putman Jr., President
Address: 1707 Colt Circle
Marble Falls, TX 78654
SURETY:
SureTec Insurance Company
By:�� .
Title: Eva O. Limmer, Attorney -in -Fact
Address: 1330 Post Oak Blvd., Suite 1100
Houston_, TX 77056
NOTE: Date of Bond must not be prior to date of Agreement. If Contractor is Partnership, all
partners should execute Bond.
City of La Pone Section 00612
Payment Bond Form
1. Corporate principals to provide the following certificates:
CERTIFICATE AS TO CORPORATE PRINCIPAL
I, CIY—, (name) certify that I am secretary/
09
(title) of 14ri t #, 60"r (company name) which is named as principal in the
within foregoing Bond, that ..�Ol�%t-F (�tJ1--•J 1, (name of person executing
bond) who signed the said Bond on behalf of the principal, was then
kn&nnj. (title of person executing bond) of said principal; that I know
his/her signature and that his/her signature is therefore genuine; and the Bond was duly signed,
!and attesteV for and in behalf of said Corporation by authority of its governing body.
Si
Print Name
(Corporate Seal - required if a Corporation)
Subscribed and Sworn before me this�-day of !'l , 20
�i ��Y a TAhdMY MILLER
ID #11748987
Notary Public ar MY Commission Expires
March 28, 2020
2. Surety shall provide a current power of attorney.
3. Date of Bond and surety power -of -attorney must not be dated prior to date of Agreement.
4. Surety companies executing bonds must appear on the Treasury Departments' most current
list (Circular 570 amended) and be authorizes to transact business in the State of Texas.
PoA #: 4221112
SureTec Insurance Company
LIMITED POWER OF ATTORNEY
Know AU Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents
make, constitute and appoint
John R. Ward, Eva O. Urnmer, Douglas Moore, Allyson Dean, Emily Mikeska
its true and lawful Attorney -in -fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge
and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the
conditions of contracts and consents of surety for:
Fifteen Million and 00/100 Dollars ($15,000,000.00)
and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate
seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney -in -Fact may do in the
premises. Said appointment shall continue in force until 12/31/16 and is made under and by authority of the following
resolutions of the Board of Directors of the SureTec Insurance Company:
Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and is
hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on
behalf of the Company subject to the following provisions:
Attorney -in -Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attomey-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or
any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 10'* of April,
1999.)
In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and ;tc corporate seal
to be hereto affixed this 9th day of February, A.D. 2015
^ SURETEC INSURAI 1s:E COMPANY
SVRANCF /.
441. 9 :� �'f By: - -- —
John kdox Jr:,i-'resident
State of Texas ss: � //
County of Harris ..
On this 9th day of February, A.D. 2015 before me personally came John Knox Jr., to me known, who, being by me duly sworn, did depose and say, that he
resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above
instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the
Board of Directors of said Company; and that he signed his name thereto by like order.
JACOLIELYN MALDONADO
Notary Public v `
State of Texas
My Comm. Exp. 5/18/2017 Jacq elyn Maldonado, Notary Public
My commission expires May 18, 2017
1, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy
of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set
out in the Power of Attorney are in full force and effect
Given under my hand and the seal of said Company at Houston, Texas this 14th day of Aril 2016 , A.D.
M. Bre t Beaty, Assistant ecretary
Any Instrument issued in excess of the penalty stated above Is totally void and without any validity.
For verification of the authority of this power you may call (713) 811-0800 any business day between 8:00 am and 5:00 pm CST.
SureTec Insurance Company
THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION
Statutory Complaint Notice
To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to
make a complaint at: 1-866-732-0099. You may also write to the Surety at:
SureTec Insurance Company
9737 Great Hills Trail, Suite 320
Austin, Tx 78759
You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or
complaints at 1-800-252-3439. You may write the Texas Department of Insurance at
PO Box 149104
Austin, TX 78714-9104
Fax#: 512-475-1771
PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should
contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance.
Terrorism Risks Exclusion
The Bond to which this Rider is attached does not provide coverage for, and the surety shall not be liable for, losses
caused by acts of terrorism, riot, civil insurrection, or acts of war.
Exclusion of Liability for
Mold, Mycotoxins, Fungi & Environmental Hazards
The Bond to which this Rider is attached does not provide coverage for, and the surety thereon shall not be liable for,
molds, living or dead fungi, bacteria, allergens, histamines, spores, hyphae, or mycotoxins, or their related products or
parts, nor for any environmental hazards, bio-hazards, hazardous materials, environmental spills, contamination, or
cleanup, nor the remediation thereof, nor the consequences to persons, property, or the performance of the bonded
obligations, of the occurrence, existence, or appearance thereof.
Rev. 1-1-06
CONFLICT OF INTEREST QUESTIONNAIRE FORMA 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.
OFFICE USE ONLY
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who
Date Received
has a business relationship as defined by Section 176.001(1-a) with a focal 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 Cade.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An
offense under this section is a misdemeanor.
1J Name of vendor who has a business relationship with local governmental entity.
2
Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated
completed questionnaire with the appropriate filing authority not later than the 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
4J 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
CIO 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 F-1 No
5 1 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.
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
T!� (C
Signature vendor 600ing business with the governmental entity Date
Form provided by Texas(thics Commission www.ethics.state.tx.us Revised 11130l2015
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1 of 1
Complete Nos. 1- 4 and 6 9 there are interested parties.
OFFICE USE ONLY
Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
2016-39374
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
CorWorth / Restroom Facilities Ltd.
Marble Falls, TX United States
Date Filed:
04/3.3/2016
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of La Porte, TX
Date Acknowledged:
4 - a � - I U
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.
4112016
Design / Build
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest (check applicable)
Controlling
Intermediary
Putman, John
Marble Falls, TX United States
X
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.
=TAMMYMILLER
r �f--
/\ a, �(2 "11� Sig nat a of authorized'agent of contracting business entity
1f
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said c JQ)p4, i t.c:kYY-,cu-, - C61 'Jil nl , this the 6;� JQ 1 ` day of AI yL ,
20to certify which, witness my hand and seal of office.
MILLER
ID #11748987
aTAMMY
My Commission Expires
March 28, 2020 k
.�kw.C,M, ^^ ereS��n _
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.645