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HomeMy WebLinkAboutRes 16-02 Authorizing an Agreement with RJN Group for Monitoring Sanitary Sewer TOWN OF WESTLAKE RESOLUTION NQ. 16-02 A RESOLUTION OF THE TOWN COUNCIL OF THE TOWN OF WESTLAKE, TEXAS, ENTERING INTO AN AGREEMENT WITH RJN GROUP, INC., FOR FLOW MONITORING SERVICE OF SANITARY SEWER AT A COST OF APPROXIMATELY $39,271; AND AUTFI4RIZING THE TOWN MANAGER TO EXECUTE THE AGREEMENT OF BEHALF OF THE TOWN OF WESTLAKE, TEXAS. WHEREAS, the owns 48.5 %of the flow capacity in the N-1 sewer line; and WHEREAS, the Town of Westlake and City of Southlake have been warking with the trinity River Authority to assume the N-1 sewer line; and WHEREAS, Westlake desires to work with the City of Southlake to transfer ownership of the N-1 sewer line to the Trinity River Authority; and WHEREAS, the transfer to TRA is contingent upon a satisfactorily reducing Westlake's collection system contributing to increased groundwater intrusion; and WHEREAS, the Town Council finds that the proposed additional analysis provides sound infrastructure maintenance and planning; and VVHEREAS, the Town Council finds that the proposed sewer line flow monitoring is necessary far the transfer; and WHEREAS, the cost for the flow analysis is included in the adopted FY 2015/2016 budget; and WHEREAS, the Town Council finds that t�le proposed additional analysis benefits the public and is in the best interest of the public. NOW, THEREFORE, BE IT RESOLVED BY THE TC)WN COUNCIL �F THE TOWN OF WESTLAKE, TEXAS: SECTION 1: All matters stated in the Recitals above are found to be true and correct and are incorporated herein by reference as if copied in their entirety. SECTION 2: The Town Council of the Town of Westlake hereby approves the contract with RJN Group, Inc., far Engineering Services, attached as Exhibit "A", and further authorizes the Town Manager to execute the agreement on behalf of the Town of Westlake, Texas. SECTION 3: If any portion af this Resolution shali, for any reason, be declared invalid Resolution 16-02 Page 1 of 9 by any court of competent jurisdiction, such invalidity shall not affect the remaining provisions hereof and the Council hereby determines that it would have adopted this Resolution withaut the invalid provision. SECTION 4: That this resolution shall become effective from and after its date of passage. PASSED AND APPROVED ON THIS ZSth DAY OF JANUARY,2416. ,? � �� �,�"��''�.�e.���,� ,,�°'t�`,����'=�. Laura Wheat, Mayor ATTEST: � � � � � ^^ � r � a ,,f � � '� �`�'� � � � //�}1� Kell Edwat-�s, own Secretary Thomas E. ryi e`r, own Manager �� APPROV , A.;� TO�; �p`���� ��cS'�, '� '� '�� �. � .:�� ��� � �� : . m � L. St t n Low , n torney ���'CAS Resolution 16-02 Page 2 af 9 EXHIBIT"A" AGREEMENT BETWEEN TOWN OF WESTLAKE,TEXAS AND RJN GROUP,INC THIS AGREEMENT made this ,��� day of ��a�� t��c�=��` �_�� ; 2016 by and between the TOWN of WESTLAKE, TEXAS, hereinafter called TOWN and R�GROUP,INC., with an office in Dallas,Texas hereinafter called ENGINEER. WHEREAS, the Town of Westlake, Texas hereinafter hereby engages the ENGINEER, to perform professional services to provide Sewer Flow Monitoring service within the wastewater collection system of the Town. WHEREAS, the ENGINEER desires to perform such services to the TOWN in accordance with the terms and conditions of the AGREEMENT. NOW, THEREFORE, in consideration of the above recitals, the mutual promises and covenants hereinafter set forth,the parties hereto agree as follows: Section I-Basic Services of ENGINEER The specific services which the ENGINEER agrees to fi.irnish are as indicated in the Attachment A "Scope of Services" which is hereby incorporated by reference and made part of this AGREEMENT. Changes in the indicated Scope of Services shall be subject to renegotiation and implemented through an Amendment of this AGREEMENT. Section II-Future Services of ENGINEER The ENGINEER is available to furnish and perform, under an Amendment or a separately negotiated ab eement, future services to supplement this work. Resolution 16-02 Page 3 of 9 Section III- Schedule of Services A. Completion Time For those services described in Section I, the ENGINEER shall make every reasonable effort to schedule rnanpower and service elements in a diligent manner. It is recognized by both parties that actions of regulatory agencies and/ar others may affect the final project schedule. The services described shall be performed as weather and other physical conditions permit. The ENGINEER shall not be liable to the TOWN, if delayed in, or prevented from performing the work as specified herein through any cause or causes beyond the control of the ENGIlVEER and not caused by his own fault or negligence. Attachment B "Schedule of Services"is hereby incorporated by reference and made part of this AGREEMENT. Section N-Payment for Services Payment to the ENGINEER shall be made as follows: A. Payment far Services The TOWN recognizes that time is of the essence with respect to payment of the ENGINEER's invoices, and that timely payment is a material part of the consideration of this AGREEMENT. Payment for services rendered shall be made to the ENGINEER at the end of each month's billing cycle upon presentation of the ENGINEER's monthly statement. ENGINEER will provide to the TOWN a detailed statement of tasks by classification and reimbursement expenses. Total payment shall not exceed aforestated amounts without prior authorization by the TOWN. If the TOWN objects to all or any portion of an invoice, the TOWN shall so notify the ENGINEER within ten (10) calendar days of the invoice date, identify the cause of disagreement, and pay when due that portion of the invoice, if any,not in dispute. TOWN has the right to appeal ar ask for clarification of any ENGINEER's billing within ten (10) days of date of billing. Until said appeal is resolved, or clarification is issued, no interest will accrue. The TOWN shall exercise reasonableness in contesting any invoice or portion thereof. Section V-Services to be Provided by the TOWN A. Authorization to Proceed The TOWN shall authorize the ENGINEER to proceed prior to the ENGINEER starting work. B. Access to Facilities and Properiy The TOWN shall make its system facilities and properties available and accessible for inspection by ENGINEER and arrange for access to make all pravisions for the ENGINEER to enter upon public property as required for the ENGINEER to perform his services. Resolution 16-02 Page 4 of 9 C. Prompt Notice The TOWN shall give prompt written notice to ENGINEER whenever TOWN observes or otherwise becomes aware of any development that affects the scape or timing af ENGINEER's services, or any defect in the service or work of the ENGINEER or Contractors in order that the ENGINEER may take prompt, effective measures, which in the ENGINEER's opinion, will minimized the consequences of a defect. D. Compensation of a Cost Not to Exceed For basic services, as enumerated in Section I, the TOVVN shall pay the ENGINEER a maximum not to exceed cost of $32,776A0. Payments as described hereinafter shall represent fuil compensatian to the ENGINEER for all payroll costs, expenses, current overhead, profit, and all other casts in connection with the performance of these services. The ENGINEER, if requested, shall provide documentation to the TOWN of all costs in connection with the performance of these services, and as further described in Attachment C. E. Chan�es of Scope In the event additional services are required through changes in the scope of the Project, or other unusual or unforeseen circumstances are encountered, ar for other consulting services, ENGINEER shall, upon written authorization by the TOWN, perform the additional services as mutually agreed by both parties by supplemental agreement. If renegotiated terms cannot be agreed to, the TOWN agrees that the ENGINEER has an absolute right to terminate the AGREEMENT. Section VI-Construction Cost and O�inions of Cost A. The ENGINEER shall submit to the TOWN an opinion of the probable cost required to construct work recommended, designed, or specified by the ENGINEER. The ENGINEER is not a construction cost estimatar ar construction contractar, nor should the ENGINEER's act of rendering an opinion of probable construction costs be considered equivalent to the nature and extent of service a construction cost estimator or construction contractor would provide. The ENGINEER's opinion will be based solely upon its own experience with construction. This requires the ENGINEER to make a number of assumptions as to actual conditions that will be encountered on site; the specific decisions of other design professionals engaged; the means and methods of construction the contractor will employ; the cost and extent of labor, equipment and materials the contractor will employ; contractor's techniques in determining prices and market conditions at the time, and other factors over which the ENGINEER has no control. Given the assumptions which must be made, the ENGINEER cannot guarantee the accuracy of its opinions of cost, and, in recognition of that fact, the TOWN waives any claim against the ENGINEER relative to the accuracy of the ENGINEER's opinion of probable construction cost. If prior to the Bidding or Negotiation Phase, TOWN wishes greater assurance as to Total Project or Construction Costs,TOWN shall employ an independent cost estimator. Resolutian 16-02 Page 5 of 9 Section VII-General Considerations A. Standard of Practice Services performed by the ENGINEER under this AGREEMENT will be conducted in a manner cansistent with that level of care and skill ordinarily exercised by members of the profession currently practicing in the same locality under similar conditians. No other representation, expressed or implied, and no warranty or guarantee is included or intended in this AGREEMENT, or in any report, opinion, document or otherwise. B. Survival All obligations arising prior to the termination of this AGREEMENT and all provisions of this AGREEMENT allocating responsibility or liability between the TOVVN and the ENGINEER shall survive the completion of the services hereunder and the termination of this AGREEMENT. C. Ownership of Instruments of Service All reports, plans, specifications, field data, field notes, laboratory test data, calculations, estimates and other documents prepared by the ENGINEER as instruments of service shall remain the property of the TOWN. The ENGINEER shall retain these records for a period of five (5) years following submission of his or her report, during which period they will be made available to the TOWN at all reasonable times. If the TOWN wishes the ENGINEER to retain documents far a longer period of time, the TOWN shall so specify in advance, in writing, and shall pay in a timely manner all charges agreed to for the ENGINEER's maintenance of such documents beyond the time period otherwise prevailing. D. Reuse of Documents All documents including Drawings and Specifications prepared or furnished by the ENGINEER (and ENGINEER's independent professional associates and consultants) pursuant to this AGREEMENT are instruments of service in respect of the Project and ENGINEER shall retain an interest therein whether or not the Project is completed. TOWN may make and retain copies for information and reference in connection with the use and occupancy of the Project or on any other project. Any reuse without written verification or adaptation by ENGINEER for the specific purpose intended will be at TOWN's sole risk and without liability or legal exposure to ENGINEER's independent professional associates or consultants, and TOWN shall indemnify and hold harmless ENGINEER and ENGINEER's independent professional associates and consultants from all clairns, damages, losses and expenses including attorneys' fees arising fram or resulting therefram. Any such verification or adaptation will entitle ENGINEER to further compensation at rates to be agreed upon by TOWN and ENGINEER. E. Termination of Services This AGREEMENT may be terminated in whole or part in writing by either party in the event of substantial failure by the other party to fulfill its obligations under this AGREEMENT through no fault of the terminating party. Such termination may not be effected unless the other party is given not less than 10 days written notice(delivered by certified mail,return receipt requested) of intent to terminate and an opportunity for consultation with the terminating party and 10 days to cure such substantial failure. Irrespective of which party shall effect termination or the cause therefore,the TOWN shall within Resolution 16-02 Page 6 of 9 forty-five (45) calendar days of termination remunerate the ENGINEER for services rendered and costs incurred, in accordance with the ENGINEER's prevailing fee schedule and expense reimbursement policy. Service shall include those rendered to the time of termination, as well as those associated with termination itself, such as demobilizing, modifying schedules, reassigning personnel, and so on. Costs shall include those incurred to the time of termination, as well as those associated with termination and post-termination activities. Such costs shall not include payments to third parties engaged by the ENGINEER for services not yet performed. The TOWN may terminate this AGREEMENT with or without cause or reason. Upon receipt of ° a notice of termination from TOWN, the ENGINEER shall promptly discontinue all services affected {unless the notice directs otherwise) and deliver or otherwise make available to the TOWN {subject to "Reuse of Documents" provisions) all data, drawings, specifications, reports, estirnates, summaries, and other information and materials accumulated by the ENGINEER in performing this AGREEMENT,whether completed or in progress. F. Controlling Law and Disputes If any of the provisions of this AGREEMENT are invalid under any applicable statute or rule of law, they are, to that extent, deemed omitted. However, the TOWN and the ENGINEER will in good faith attempt to replace an invalid or unenforceable provision with one that is valid and enforceable, and which comes as close as possible to expressing or achieving the intent of the original provision. This AGREEMENT shall be governed by the laws of the State of Arkansas Pulaski County. The parties agree that they shall reasonably attempt to resolve any disputes regarding the interpretation of this AGREEMENT by informal negotiation, the final resolution of which disputes shall require the agreement of both parties. G. Successors and Assi�ns The TOWN and the ENGINEER each binds itself and its partners, successors, executars, administrators, assigns and legal representatives to the other party to this AGREEMENT and to the partners, successars, executors, administrators, assigns and legal representatives of such other party, in respect to all covenants,agreements,and obligations of this AGREEMENT. Neither the TOWN nor the ENGINEER shall assign, sublet or transfer any rights under ar interest in (including, but without Iimitation, moneys that may become due or moneys that are due) this AGREEMENT without the written consent of the other. Unless specifically stated to the contrary in any written consent to an assignment,no assignment will release or discharge the assigner from any duty or responsibility under this AGREEMENT. Nothing contained in this paragraph shall prevent the ENGINEER from employing such independent consultants, associates, and subcontractors as it may deem appropriate to assist it in the performance of services hereunder. The ENGINEER's use of others for additional services shall not be unreasonably restricted by the TOWN provided the ENGINEER notifies the TOWN in advance. Nothing herein shall be construed to give any rights or benefits hereunder to anyone other than the TOWN and the ENGINEER, and all duties and responsibilities undertaken herein will be for the sole and exclusive benefit of the TOWN and the ENGINEER and not for the benefit of any other party. H. Dispute Resolution All claims, disputes or controversies arising from, or in relation to, the interpretation, application or enforcement of this AGREEMENT shall be decided through mediation or arbitration Resolution 16-02 Page 7 of 9 whichever is mutually agreed upon by TOWN and ENGINEER. I. Insurance During the course of performance of these services, RJN GROUP, INC. will maintain the following minimum insurance coverages: Type of Covera�e Limits of Liabilitv Workers' Compensation Statutory Employers' Liability $500,000 Each Accident Commercial General Liability Bodily Injury and $1,000,000 Combined Single Limit Property Damage Automobile Liability: Bodily Injury and $1,000,000 Combined Single Limit Property Damage Professional Liability Insurance $1,000,000 Each Claim Resolution 16-Q2 Page 8 of 9 IN WITNESS THEREOF, the parties hereto have caused this AGREEMENT to be executed this `�_';�`.� day of � �.a�F�, � ,,,.�� , 2016. For the TOWN: ,� ��F �FS -�11�—�Y�� ,,�i� �O.�y,.._•...... T{4 �,t " � ,a � . �'�.m Thomas E. Brymer, n anager � : . �; � � T�`X A5 ATTEST: ��-- �.�` ���` �����.�F�-�� �,..r��-��..>� �{� For the ENGINEER: Kelly�iwar �, 'I'own Secretary RJN GROUP, INC. �� � � Name Senior Vice President Title ATTEST• �. Attachment A—Scope of Services Attachment B— Schedule of Services Attachment C—Compensation Attachment D—Flow Monitoring Map Resolution 16-02 Page 9 of 9 CERTIFICATE OF INTERESTED PARTIES FORnn 1295 �of� Compiete Nos.1-4 and 6 if there are interested parcies. OFFICE USE t�NLY Compiete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2016-9136 RJN Group, Inc. Dalias,TX United States oate Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 02104/2016 being filed. Town of Westlake Date Acknowiedged: g Pravide 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 ser�ices to be provided under the contract. 16-02 Flow Monitoring/Engineering Services 4 Nature of interest(check applicable) Name of interested Party City,State,Country(place of husiness) Controlling intermediary Kelso, Hugh Dallas,TX United States X Plymale, Paul Dallas,TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT 1 swear,or af8rm,under penalty of perjury,that the above disclosure is true and correct. ,��!�`�;�±�M,%�, CHERYL D.TEAMES /� ��,�4'� :•: r,� *; MY COMMISSION EXPIRES Signatur of authorized agent of contracting business entity '�"',%����°�`NOVEMBER 30,2017 Sworn to and subscribed before me,by the said l.t ����__,this the�day of 201�,to certify which,witness my hand and seal of office. . 1 �t� �S .�J ,1 S re of officer administering oath Printed name of officer administering oath TiUe of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.34944 PROPOSAL FOR ENGINEERING SERVICES SANITARY SEWER FLOW MONITORING ATTACHMENT A SCOPE OF SERVICES A. SCOPE OF SERVICES The Services to be provided under this PROPOSAL shall consist of Sanitary Sewer Flow Monitoring and Infiltration and Inflow (UI) Analysis and report to complement the City's CMOM efforts. Flow Monitorin� A.1.1 Project Administration The Engineer shall coordinate the overall work of the project to include all field inspections and engineering analysis. The Engineer shall provide monthly progress reports that will show the percent completion of each task. A bi-monthly progress meeting with the City' Representative will be conducted. A.1.2 Field Verification Prior to beginning the flow monitaring project, the Engineer will verify sewer]ine interconnectivity and sewer flow direction at various locations across the collection system to confirm proposed sewer shed delineations and understand impact of the sewers upstream of proposed flow monitoring locations. The Engineer shall conduct field investigations to verify the suitability of each potential monitoring location. A.1.3 Flow Monitoring Services Prior to installing flow monitors, the Engineer will develop a flow monitoring plan. The flow monitoring plan will include the preliminary monitoring sites selected from a review of the City's existing sewer maps. These sites will be based on a distribution of approximately 30,000 to 60,000 linear feet per flow monitor. Special attention areas or split flow conditions may require additional flow monitors. Potential flow monitoring sites will be identified with consideration given to basin size, evidence of surcharging, overflow locations, projected maintenance activities, and other factors. Potential and alternate sites will be inspected and the site hydraulics evaluated. The Engineer shall conduct field investigations to verify the suitability of each potential monitoring location. The field investigations will verify sewer line interconnectivity and sewer flow direction in various loca�ions across the collection system and in the proposed meter locations. The Engineer shall prepare a site investigation sheet for each selected Attachment A Page 1 of 3 Res 16-02 site and shall submit to the City' Representative. After approval of the recommended sites, the Engineer shall install and maintain the meters for a 60-day period. The Engineer shall also select rain gauge monitoring sites and install continuous recording rain gauges. Flow monitoring will be performed utilizing up to 4 ADS or equal monitors capable of measuring both depth and velocity of flow. A total of 1 tipping bucket rain gauges will be used for the study. The tipping bucket gauges will be installed to obtain rainfall distribution data. A.1.4 Flow Data Management During the flow monitoring study, flow data will be continually reviewed and analyzed in order to assess the accuracy and quality of the data. A.1.5 Flow Data Analysis A.1.5.1 Rainfall Relationship Adequate rainfall will be necessary to establish the relationship between peak inflow and rainfall intensity. This relationship will be used to determine the impact on the collection system during wet weather and high groundwater conditions. A correlation of flow and rainfall intensity will be made using the area-coefficient method of analysis. It is anticipated that a minimum of three storm events that do not cause surcharging of the collection system will be recorded during the 60-day monitoring period. Data from the continuously recording rainfall gauges will be used to establish the intensity of rainfall and duration for each storm event. The Thiessen Method far rainfall distribution analysis will be used. For each monitoring site, data developed as part of the analysis will include: - Average Dry Weather Diurnal Curve Flows for weekdays and weekends - Rainfall/Wet Weather Wastewater Flow Correlations for selected storm events during the monitoring period - Design peak inflow rate at the design storm event - Capacity analysis at the monitoring sites A.1.5.2 Based on the flow data analysis the various basins will be ranked according to their inflow contribution and infiltration contribution. The I&I ratings shall be used to develop a prioritization for each basin. Using the various rankings, the ENGINEER shall provide the CITY'S REPRESENTATIVE with a recommendation for the basins in which to perform SSES activities. Attachment A Page 2 of 3 Res 16-02 A.1.5.3 Incorporate flow analysis and flow projections will be summarized in Technical Memorandum (TM-lA) and submitted to the CITY'S REPRESENTATIVE for review. --END-- Attachment A Page 3 of 3 Res 16-02 PROPOSAL FOR ENGINEERING SERVICES SANITARY SEWER FLOW MONITORING ATTACHMENT B In signing this Agreement, the TOWN grants ENGINEER specific authorization to proceed under this Agreement. The Schedule for the Flow Monitoring Services will be coordinated with the Town. A site investigation will be performed on each proposed meter site to determine if each site is hydraulically and structurally suitable for installation of a meter. The site investigation and meter installation may take up to 4 days. The proposed monitoring duration is 60 days. The I/I analysis and Report will be completed approximately 3-6 weeks after the termination of the monitoring period. The TOWN will be kept informed if the schedule is subject to change. ENGINEER shall submit a detailed project schedule within two (2)weeks of the Notice to Proceed,which shall be made part of this agreement. 1 Res 16-02 PROPOSAL FOR ENGINEERING SERVICES SANITARY SEWER FLOW MONITORING ATTACHMENT C In consideration of the services to be performed under this Agreement, ENGINEER shall be paid as per the following compensation schedule: Note: Price based on using 4 Flow Meters: TASK � UNITS RATE TOTAL Management and Supervision 1 Lump Sum $4,960 $4,960 Flow Meter Investigation / Installation 4 Meters $1,289 $5,156 Rain Gauge Investigation / Installation 1 Gauge(s) $549 $549 Flow Monitoring Period 240 Meter-Days $81 $19,440 RG Monitoring Period 60 Gauge-Days $28 $1,706 I/I Analysis and Report 1 Lump Sum $7,460 $7,460 Grand Total = $39,271 Note: If only 3 meters are required, the following compensation schedule is applicable: TASK � UNITS RATE TOTAL Management and Supervision 1 Lump Sum $4,868 $4,868 Flow Meter Investigation/ Installation 3 Meters $1,289 $3,867 Rain Gauge Investigation/ Installation 1 Gauge(s) $549 $549 Flow Monitoring Period 180 Meter-Days $81 $14,580 RG Monitoring Period 60 Gauge-Days $28 $1,706 I/I Analysis and Report 1 Lump Sum $7,206 $7,206 Grand Total = $32,776 1 Res 16-02 Flow Monitoring ��� � Town of Westlake N \ �_, W� ` E _ �\ NORTHWESTISD �1l �' � �, --...., � : ......_.,..__.., � '� O ���� U \ l` .;' � ....' ���\\ �:� -"_ � O� V � � � , �� ��� ���� � J � v� , � � _ SO � �� � ��� Y U �,. � Q I � � a �� � , w ,;;,,,,, � ��-� � � � � z ,�,,,,,,�,,,� �,�� _ �,,,,,,��„ , , — J � � �A "ca F- � o � D V � a � O � � Z � �� � �v , � � a '�� 0� ��. ti � � �, � I � Q ��—���' � `9c`� �� � �� a �VD. � . �� � PRIVATE O� ��� N \ �/ �.6RPy„' � P � °o�i o ' G,� � 6P`��.�- -�' �w �i� � � o�� � _ / � `�' \ av % H��'H n ��� BROKEN BEND DR � � VG ° a •�--�-- �— � �� � ��>' �GO��� �U � 'P� � RI � O SW o� � OAKS � � � -a �(� `_> �G VVL-03 � C/RC q/� I "'° � `"° �F " V� W NG I � BROKEN BENDJ R g CITY LIMIT � COVE C w (I� I m o ° HIDDEN �-...., ..53 - _ � �_ .. . � ��J�� � SPRINGS � O ¢ � �L RO _ o C K O o "9L -9 II CT. s� � ~ _ o O DOVE t�t��V w o uUi J a v�=i .. Q U� � � LL � m w tn U � � F � U J Q U� w�� THRU -� � FAIR AKS DR w �o � � 0 �� p � Q LL U LL �`s J � DOVE R ° a � � a — I 3 __ � C U W C �y � \\ e i' ROBIN Q w j / � � ____ _ __..._�___ J h� z U � Z -O �N � � J Q � � �o � 2 � � —� . � W � z MOCKINGBIRD 2 � O�� Y I U � A� 9�� � NAVASOTA SOUTHLAKE CITY LIMITS � . IN DR. I � Legend �� - � R I G��� �P�� • Meter Sites Qv�N • Manholes - Q� s Sewer Lines � Basins Resolution 16-02 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2016-9136 RJN Group, Inc. Dallas, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 02/04/2016 being filed. Town Of Westlake Date Acknowledged: 02/15/2016 g Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. 16-02 Flow Monitoring/Engineering Services Nature ofinterest 4 Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Plymale, Paul Dallas,TX United States X Kelso, Hugh Dallas,TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is , and my date of birth is My address is , , , , (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of ,on the day of ,20 (month) (year) Signature of authorized agent of contracting business entity (Dedarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.34944