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2016-12-22
Regular 2016 Term THE STATE OF TEXAS § COUNTY OF CALHOUN § Held December 22, 2016 BE IT REMEMBERED, that on this 22nd day of December, A.D., 2016 there was begun and holden in the Commissioners' Courtroom in the County Courthouse in the City of Port Lavaca, said County and State, at 10:00 A.M., a Regular Term of the Commissioners' Court within said County and State, and there were present on this date the following members of the Court, to -wit: Michael J. Pfeifer Roger C. Galvan Vern Lyssy Neil Fritsch Kenneth W. Finster Anna Goodman Desiree Garza County Judge Commissioner, Precinct #1 Commissioner, Precinct #2 Commissioner, Precinct #3 Commissioner, Precinct #4 County Clerk Deputy County Clerk Thereupon the following proceedings were had: Commissioner Galvan gave the Invocation. Commissioner Finster led the Pledge to the US Flag and Commissioner Fritsch led the Pledge to the Texas Flag. Consider and take necessary action to accept donations to Calhoun County. Commissioner Lyssy made a motion to accept a donation of $144,383.40 from Formosa Plastics. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. JPMorflahphaSe Bahk, N.A. 50-937/213 FORMOSA PLASTICS CORPORATION, TEXAS Syracuse, NY P.O. BOX 510, POINT COMFORT, TX 77978 F30 NOT VAUD AFTER 6 MONTHS CHECK DATE CHECK NO. 12/21/16 30124613 ONE HUNDREb'F6Z2TY FOUR THOUSAND THREE HUNDRED EIGHTY THREE 40/100 DOLLARS ONLY AMOUNT $144,383.40 PNYTOTHIE COUNTY OF CAtftOljk ;Or 61ER`0�,'COUNTY COURTHOUSE NEX 202 S ANN,�,J$T PORT LAVACA, TX 77979 rL....i .. ......... *See Other Side For Opening Instructions* FORMOSA PLASTICS CORPORATION, TEXAS P.O. BOX 510 Formosa pla-dw POINT COMFORT, TX 77978 COUNTY OF CALHOUN COUNTY COURTHOUSE ANNEX II 202 S ANN ST PORT LAVACA, TX 77979 I..... ............. I Hear presentation on Applicant for County Extension Agent —AG and Natural Resources position from Mr. Donnie Montemayor of the Texas A & M Agril-ife Extension Service and take any action deemed necessary. (MP) Commissioner Fritsch made a motion to accept the nomination of Geri Kline to fill the position of County Extension Agent-Ag and Natural Resources. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. From: Barbara Moretich <Barbam.Moretich@ag.tamu.edu> Sent: Friday, December 16, 2016 2:05 PM To: Susan Riley Cc: Donnie Montemayor Subject: Commissioners Court Agenda Importance: High Good afternoon Susan, Mr. Montemayor has asked me to secure a place on the Commissioners Court Agenda to present the applicant for the County Extension Agent-Ag and Natural Resources position. He would like the applicant to start at the beginning of January. Can we get on the agenda for Thursday, December 22nd with this email? Barbara Moretich District Office Manager Texas A&M Agri Life Extension Service 10345 Hwy 44 Corpus Christi, TX 78406-1402 Ph: 361.265.9203 ext 213 FAX: 361.265.9434 Consider and take necessary action on contract between Calhoun County and K & T Construction Company, Inc. for the Calhoun County EMS Station, Calhoun County Precinct 4, Seadrift, Texas and authorize County Judge to sign. (MP) Commissioner Finster made a motion to approve contract between Calhoun County and K &T Construction Company, Inc. for the Calhoun County EMS Station, Calhoun County Precinct 4, Seadrift, Texas and authorize County Judge to sign. Commissioner Galvan seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. f Agenda Item for Commissioners' Court — Thursday, December 22, 2016 g Consider and take necessary action on contract between Calhoun County and K & T Construction Company, Inc. for the Calhoun County EMS Station, Calhoun County Precinct 4, Seadrift, Texas and authorize the County Judge to sign. G&W LETTER OF TRANSMITTAL ENGINEERS, INC. 205 W. LIVE OAK PORT LAVACA, TEXAS 77979 (361)552-4509 TO: Mr. Shannon Salyer Counsel to Commissioner's Court 211 S. Ann Street, Suite 304 Port Lavaca, Texas 77979 GENTLEMEN: WE ARE SENDING YOU XXXXATTACHED UNDER SEPARATE COVER THE FOLLOWING ITEMS: SHOP DRAWINGS PRINTS PLANS SAMPLES SPECIFICATIONS ORIGINALS COPY OF LETTER CADD FILES CHANGE ORDER OTHER (pc6,4rock- /004 REMARKS: 40 AS REQUESTED FOR REVIEW AND COMMENT APPROVED AS SUBMITTED APPROVED AS NOTED RETURNED FOR CORRECTIONS PRINTS RETURNED AFTER LOAN RESUBMIT _ COPIES FOR APPR SUBMIT COPIES FOR DISTRIB RETURN _ CORRECTED PRINTS APPROVED FOR CONSTRUCTION Please review contract as soon as possible. The contract approval Is on the agenda for Commissioner's Court on the 22nd. Please contact Peggy Hall upon your approval of contract. She said that she would pick up contract from you and get copies for Commissioner's Court approval. Thank you and have a pleasant afternoon. COPY TO: Peggy Hall, Calhoun County Assistant Auditor SIGNED: If enclosures are not as noted, kindly notify us at once. DOCUMENT NO. 00500 AGREEMENT BETWEEN OWNER AND CONTRACTOR THIS AGREEMENT is dated as of the 8th day of December in the year 2016, by and between CALHOUN COUNTY (hereinafter called OWNER) and K & T CONSTRUCTION CO., INC. (hereinafter called CONTRACTOR). OWNER and CONTRACTOR, in consideration of the mutual covenants hereinafter set forth, agree as follows: .01 THE WORK: CONTRACTOR shall complete all Work as specified or indicated in the Contract Documents. The Work is generally described as follows: CALHOUN COUNTY EMS STATION, CALHOUN COUNTY PRECINCT 4, SEADRIFT, TEXAS .02 ENGINEER: The Project has been designed by G & W Engineers, Inc., 205 West Live Oak, Port Lavaca, Texas, 77979, who is hereinafter called ENGINEER and who will assume all duties and responsibilities and will have the rights and authority assigned to ENGINEER in the Contract Documents in connection with completion of the Work in accordance with the Contract Documents. .03 CONTRACT TIMES: a. Calendar Days The Work shall be complete and ready for final payment in accordance with Paragraph 14.07 of the General Conditions within 180 Calendar Days after the date when the Contract Times commence to run. b, Rain Days CONTRACTOR may be allowed an adjustment to the CONTRACT Times for "rain days", which are defined as follows. 1. Any day(s) in which rainfall occurs prior to 12:00 p.m. (noon), of such quantity that, in the opinion of OWNER's representative, would prevent a safe working environment for CONTRACTOR at the construction site. 00500-1 AGREEMENT BETIVEEN OWNER AND CONTRACTOR Calhoun County EMS Station, Calhoun County Precinct 4, Seadtill, TX (File 9045.014) 2. Any day(s) following the above described "rain day(s)" in which the condition of the constriction site, in the opinion of OWNER's representative, is not conducive to providing CONTRACTOR with a safe working environment at the site. OWNER shall only consider an adjustment in Contract Times if CONTRACTOR submits a written request for "rain days" to OWNER's representative for review, by 10:00 a.m. on the Monday following the week in which the day(s) occurred. Failure to submit such a written request shall be a representation by CONTRACTOR that additional days are not warranted. OWNER's representative shall review all requests when submitted and will have final on site determination for "rain days". Disagreements between CONTRACTOR and OWNER's representative shall be submitted to OWNER. C. Liquidated Damages OWNER and CONTRACTOR recognize that time is of the essence in this Agreement and that OWNER will suffer financial loss if the Work is not substantially complete within the time specified in paragraph .03.a above, plus any extensions thereof allowed in accordance with Article 12 of the General Conditions. They also recognize the delays, expense and difficulties involved in proving in a legal proceeding the actual loss suffered by OWNER if the Work is not substantially complete on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that, as liquidated damages for delay (but not as a penalty), CONTRACTOR shall pay OWNER THREE HUNDRED DOLLARS ($300.00) for each day that expires after the time specified in paragraph .03.a. CONTRACTOR hereby agrees that said sum per day is a fair estimate of the pecuniary damages which will be sustained by OWNER in the event that the Work is not complete within the agreed time, or within extensions of time properly granted in accordance with the Contract Documents. Said sum shall be considered as liquidated damages only and not a penalty, said damage being caused by loss of timely use of the Work other injury difficult to quantify. For purposes of applying this liquidated damages clause, the CONTRACTOR agrees to waive as against the OWNER any defense to enforcement of said clause based on any of the following claims: (1) that the clause is a penalty; (2) that the daily amount stated in the clause is not a reasonable estimate and approximation as of the time of contracting of OWNER's actual damages; (3) that the damages caused to OWNER by reason of delay were not difficult to estimate at the time of contracting. 00500-2 AGREEMENT BETWEEN OWNER AND CONTRACPOR Calhoun County EMS Station, Calhoun County Precinct 4, Seadrift, TX (File 9045.014) .04 CONTRACT PRICE: OWNER shall pay CONTRACTOR for performance of the Work in accordance with the Contract Documents in current funds as per CONTRACTOR's proposal which forms a part of this contract. In no event shall the amounts payable pursuant to this Contract exceed $579,000.00, being the Total Base Bid, plus the amount of any duly authorized change orders or contract amendments executed by OWNER. .05 PAYMENT PROCEDURE: CONTRACTOR shall submit Applications for Payment in accordance with Article 14 of the General Conditions unless otherwise amended by the Contract Documents. Applications for Payment shall also include all required documentation indicated in Division 1 - General Requirements, Section 01025 of these Specifications. ENGINEER shall process Applications as provided in the General Conditions. a. Progress Payments OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR's Applications for Payment as recommended by ENGINEER and as provided below. All progress payments will be on the basis of the progress of the Work measured by the schedule of values provided for in Article 2 of the General Conditions. 1. Progress payments will be in an amount equal to the percentage indicated below, but, in each case, less the aggregate of payments previously made and less such amounts as ENGINEER shall determine, or OWNER may withhold in accordance with Paragraph 14.02.13.5 of the General Conditions. A. 90% of the Work completed (with the balance being retainage) B. 90% (with the balance being retainage) of materials and equipment not incorporated in the Work (but delivered, suitably stored and accompanied by documentation satisfactory to OWNER as provided in Paragraph 14.02.A.I of the General Conditions). 2. Request for Payments All requests for payments shall be divided into materials costs and labor/equipment costs. All requests for material payment shall be accompanied by CONTRACTOR's paid invoice for the material in accordance with Article 14.02.A.I of the General Conditions. 00500-3 AGREEn4ENT BETWEEN OWNER AND CONTRACTOR Calhoun County EMS Station, Calhoun County Precinct 4, SeadriR, TX(Pile 9045 014) b. Final Payment Upon final completion and acceptance of the Work in accordance with Paragraph 14.07 of the General Conditions, OWNER shall pay the remainder of the Contract Price as recommended by ENGINEER as provided in said paragraph. .06 CONTRACTOR's REPRESENTATIONS: In order to induce OWNER to enter into this Agreement, CONTRACTOR makes the following representations: a. CONTRACTOR has examined and carefully studied the Contract Documents (including the Addenda listed in paragraph 7 herein) and the other related data identified in the Bidding Documents including "technical data." b. CONTRACTOR has visited the site and become familiar with and is satisfied as to the general, local and site conditions that may affect cost, progress, performance or furnishing of the Work. C. CONTRACTOR is familiar with and is satisfied as to all federal, state and local Laws and Regulations that may affect cost, progress, performance and furnishing of the Work. d. CONTRACTOR has carefully studied all reports of explorations and tests of subsurface conditions at or contiguous to the site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the site (except Underground Facilities) which have been identified in the Supplementary Conditions as provided in Paragraph 4.02.A of the General Conditions. CONTRACTOR accepts the determination set forth in the Supplementary Conditions to the extent of the "technical data" contained in such reports and drawings upon which CONTRACTOR is entitled to rely as provided in Paragraph 4.02.A of the General Conditions. CONTRACTOR acknowledges that such reports and drawings are not Contract Documents and may not be complete for CONTRACTOR's purposes. CONTRACTOR acknowledges that OWNER and ENGINEER do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Contract Documents with respect to Underground Facilities at or contiguous to the site. CONTRACTOR has obtained and carefully studied (or assumes responsibility for having done so) all such additional supplementary examinations, investigations, explorations, tests, studies and data concerning conditions (surface, subsurface and underground facilities) at or contiguous to the site or otherwise which may affect cost, progress, performance or furnishing of the Work or which relate to any aspect of the means, methods, techniques, sequences and procedures of construction to be employed by CONTRACTOR and safety precautions and programs incident thereto. CONTRACTOR does not consider that any additional 00500-4 AGREEMENT RE rWEEN OWNER AND CONTRACTOR Calhoun County EMS Station, Calhoun County Precinct 4, Seaddlt, TX (Pile 9N5.014) examinations, investigations, explorations, tests, studies or data are necessary for the performance and furnishing of the Work at the Contract Price, within the Contract Times and in accordance with the other terms and conditions of the Contract Documents. e. CONTRACTOR is aware of the general nature of the Work to be performed by OWNER and others at the site that relates to the Work as indicated in the Contract Documents. f. CONTRACTOR has correlated the information known to CONTRACTOR, information and observations obtained from visits to the site, reports and drawings identified in the Contract Documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. g. CONTRACTOR has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that CONTRACTOR has discovered in the Contract Documents and the written resolution thereof by ENGINEER is acceptable to CONTRACTOR, and the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for furnishing and performing of the Work. .07 CONTRACT DOCUMENTS: The Contract Documents which comprise the entire Agreement between OWNER and CONTRACTOR are attached to this Agreement, made a part hereof and consists of the following: a. This Agreement. b. Exhibits to this Agreement. C. CONTRACTOR's Proposal. d. Performance, Payment and other Bonds. e. Notice of Award. f. Notice to Proceed. g. General Conditions. h. General Conditions of Submitting Sealed Bids to Calhoun County, Texas. i. Supplementary Conditions. j. Technical Specifications. 00500-5 AGREEMENT BETWEEN OWNER AND CONTRACTOR CA.,. Connty EMS Swtion, CA.. County Precinct 4, Se.ddp, TX (File 9045.014) .08 k. Drawings numbered & titled for the different areas of work as indicated below: SHEET NO. DATE DESCRIPTION COVER C-1 09/30/16 SITE PLAN C-2 09/30/16 SITE GRADING AND DRAINAGE PLAN C-3 09/30/16 SITE DETAIL SHEET A-2 10/05/16 FLOOR PLAN A-3 10/05/16 SCHEDULE / DETAILS A-4 10/05/16 SCHEDULE / DETAILS A5.0 10/05/16 TAS DETAILS A5.1 10/05/16 TAS DETAILS A5.2 10/05/16 TAS DETAILS A5.3 10/05/16 TAS DETAILS A5.4 10/05/16 TAS DETAILS S-1 09/30/16 BUILDING ELEVATIONS S-2 09/30/16 FOUNDATION PLAN S-3 09/30/16 FOUNDATION SECTIONS S-4 09/30/16 FOUNDATION SECTION AND DETAILS P-1 09/30/16 WATER FLOOR PLAN -RISER DIAGRAM P-2 09/30/16 SEWER LINE PLAN -RISER DIAGRAM M-1 09/30/16 MECHANICAL FLOOR PLAN AE-I 09/30/16 ELECTRICAL NOTES / SPECIFICATIONS AE-2 09/30/16 SITE PLAN ELECTRICAL AE-3 09/30/16 POWER PLAN AE-4 09/30/16 LIGHTING PLAN AE-5 09/30/16 POWER ONE LINE & PANEL SCHEDULES 0-1 09/30/16 PAVING DETAILS - ALTERNATE /OWNER'S OPTION 1. Addendum numbers One 1 to One 1 inclusive in. The following of which may be delivered or issued after the Effective Date of the Agreement and are not attached hereto: All Written Amendments and other documents amending, modifying or supplementing the Contract Documents pursuant to Paragraph 3.04 of the General Conditions. There are no Contract Documents other than those listed above in this Article 8, The Contract Documents may only be altered, amended or repealed in accordance with the appropriate provisions of Article 3 of the General Conditions. MISCELLANEOUS: a. Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. No assignment by a party hereto of any rights under or interests in the Contract Documents will be binding on another party hereto without the written consent of the party sought to be bound; and, specifically but without limitation, moneys that may become due and moneys that are due may not be assigned without such AGREEMENT BETWEEN OWNER AND CONTRACTOR Calhoun County EA4S Station, Calhoun County Precinct 4, Seadrift, TX (File 9045.0)4) consent(except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Contract Documents. C. OWNER and CONTRACTOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect to all covenants, agreements and obligations contained in the Contract Documents. d. Any provision or part of the Contract Documents held to be void or unenforceable under any Law or Regulation shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon OWNER and CONTRACTOR, who agree that the Contract Documents shall be reformed to replace such stricken provision or part thereof with a valid and enforceable provision that comes as close as possible to expressing the intention of the stricken provision. IN WITNESS WHEREOF, the parties hereto have signed this Agreement in triplicate. One counterpart each has been delivered to OWNER, CONTRACTOR and ENGINEER. All portions of the Contract Documents have been signed or identified by OWNER and CONTRACTOR or by ENGINEER on their behalf. OWNER: CALHOUN COUNTY BY: 6�� iwW4 chael J. Pf ' e , PojWty Judge ATTEST: 1 CONTRACTOR: K & T CONSTRUCTION CO., INC BY �' Scott Strnadel, Secretary/Treasure ATTEST: `" W" ADDRESS: 211 S. Ann, Suite 301 ADDRESS: 903 N. John Stockbauer Dr. Port Lavaca, Texas 77979 Victoria, Texas 77901 PHONE: (361) 553-4600 PHONE: (361) 576-1244 FAX: (361) 553-4444 FAX: (361) 576-1250 END OF DOCUMENT 00500-7 AGREEMENT BETWEEN OWNER AND CONTRACTOR Calhoun Connly EMS Station, Calhoun County Precinct 4, Seadrip, TX (File 9045 014) M PROPOSAL l VhSA \rkW C0) y\L . hereinafter called "BIDDER", (Legal Firm Name) is submitting this Proposal for Furnishing and Performing the Work specified herein as CALHOUN COUNTY EMS STATION, CALHOUN COUNTY PRECINCT 4, SEADRIFT, TEXAS This PROPOSAL is Submitted to CALHOUN COUNTY, hereinafter called "OWNER". L Terms used in this PROPOSAL are defined in the General Conditions or Document No. 00120 - Instructions to Bidders and shall have the meanings indicated in the General Conditions or Instructions. 2. BIDDER proposes and agrees, if this BID is accepted, to enter into an Agreement with OWNER in the form included in the Contract Documents to furnish and perform all WorIc as specified or indicated in the Contract Documents for the Bid Price and within the Bid Times indicated in this BID and in accordance with the other terms and conditions of the Contract Documents, 3. BIDDER accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to Bidders, including without limitation those dealing with the disposition of Bid Security. This BID will remain subject to acceptance for Sixty (60) Calendar Days after the Bid Opening. BIDDER shall sign and deliver the required number of counterparts of the Agreement, including all required documents indicated by the Bidding Requirements, within Fifteen (15) Calendar Days after the date of OWNER's Notice of Award. 4. In submitting this BID, BIDDER represents, as more fully set forth in the Agreement, that: a. BIDDER has examined and carefully studied the Bidding Documents and the following Addenda, receipt of all which is hereby acknowledged: (List Addenda by Addendum Number and Date): Addendum No.: 01 Date Received: /Z7-1 I to b, BIDDER has visited the site and is familiar and satisfied with the general, local and site conditions that may affect cost, progress, and furnishing and performing the Work. C. BIDDER is familiar and satisfied with all federal, state and local Laws and Regulations that may affect cost, progress, and furnishing and performing the Work. 00300-1 d. BIDDER is aware of the general nature of work, if any, to be performed by OWNER (or others) at the site in .relation to the Work for which this BID is submitted. C. BIDDER has correlated the information known to BIDDER, information and observations obtained from visits to the site, reports and drawings identified in the Contract Documents and all additional examinations, investigations, explorations, tests, studies and data with the Contract Documents. f. BIDDER has given ENGINEER written notice of all conflicts, errors, ambiguities or discrepancies that BIDDER has discovered in the Contract Documents, and the written resolution thereof by ENGINEER is acceptable to BIDDER, and the Contract Documents. are generally sufficient to indicate and convey understanding of all terms and conditions for furnishing and performing the Work for which this BID is submitted. g. This BID is GENUINE and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted in conformity with any agreement or rules of any group, association, organization or corporation BIDDER has not.directly or indirectly induced or solicited any other BIDDER to submit a false or sham BID. BIDDER has not. solicited or induced any person, firm or corporation to refrain from bidding. BIDDER has not sought by collusion to obtain for itself any advantage over any other BIDDER or over OWNER. 5. BIDDER agrees to complete the Work in accordance with the Contract Documents. a. BIDDER acknowledges that the amounts are to be shown in both words and figures, and in case of discrepancy, the amount in words shall govern. b. BIDDER acknowledges that the quantities are not guaranteed and final payment will be based on the actual quantities.detennined as provided in the Contract Documents. C. BIDDER acknowledges that, at OWNER'S option and/or at OWNER's request, any of the quantities may be deleted, reduced, or increased based upon the respective Unit Prices. d. 'BIDDER acknowledges that Unit and Lump Sum Prices have been computed in accordance with paragraph 11.03.B of the General Conditions. C. BIDDER agrees to furnish all necessary labor, superintendence, plant, machinery, equipment, tools, materials, insurance, services and all other requirements deemed necessary to complete the items of Work indicated on the following pages for the specific dollar amounts stated. 00300-2 Base Bid BID BID DESCRIPTION OF ITEM WITH UNIT ITEM QTY. UNIT PRICE WRITTEN IN WORDS ------------------------------------------------------------------------------------------- 1. 1 LS For mobilization and insurance costs associated with the project in accordance with the specifications for a lump sum price of 2, 3. 011 Dollar and _ _ Cents. 1 LS Furnishing material, labor and equipment for the construction of the EMS building that includes but not limited to structural fill, fotmdation, 6 foot wide concrete aprons, building structure, overhead doors, exterior doors and windows, all as per plans and specifications for a lump sum price of Dollars and Cents. 1 LS Furnishing material, labor and equipment for the construction of the interior rooms of the EMS facility that includes but not limited to plumbing, plumbing fixtures water heater; air conditioning, and ldtchen appliances, all as per plans and specifications for a lump sum price of a",�-� Dollars and Cents. Mi7IiMIi1►7111 $3;0Ooo $1VI) DoC) 00300-3 BID BID ➢ESCRIPTION OF ITEM WITH UNIT ITEM QTY. UNIT PRICE WRITTEN IN WORDS BI➢ AMOUNT 4. 1 LS Furnishing material, labor and equipment for the installation of the electrical components on the interior of the EMS facility and power line to the sewage treatment plant, all as per plans and specifications for a lump sum price of Dollars �70100 0 and Cents. 0 5. 1 LS Furnishing material, labor and equipment for the installation of the generator with transfer switch, all as per plans and specifications for a lump sum price of 6. 1 LS For obtaining permits, furnshing and installation of an on -site sewage treatment system to serve five employees (300 GPD) with sprinlder system disposal area and sewer lines to the building. Reference On -Site Sewage Facility Design attached at the end of the Specifications. The system shall be complete and ready to operate as per plans and specifications for a lump sum price of and Cents. $ Z 0 4 00300-4 BID BID DESCRIPTION OF ITEM WITH UNIT ITEM QTY. UNIT PRICE WRITTEN INWORDS BID AMOUNT LS Furnishing materials, labor and equipment for the construction of the 2 course asphaltic treatment with 10" crushed limestone base driveway and parking lot (approx. 15,650 SF) and 2" cold laid asphalt with 8" crushed Imestone between S.H. 185 and property ROW (approx. 1,280 SF), as per plans and specifications for a lump sum price of �n n `�tk�i/1„�.�Y DoIlars and Cents. 000 LS Furnishing material, labor and equipment for the site grading including drainage ditches and seeding of exposed areas, end treatments for existing (18") culvert at S.H. 185 and and treatments for on -site 12" culvert, as per plans and,specifications for a lump sum price of and Cents. 9. 1 LS Furnishing materials, labor and equipment for implementation, enforcement, and maintenance of TPDES requirements for duration of project (SWPPP) for a lump sum price of and C ts. $L BOO O\ Total Pse Bid�beir�Items 1 thru &ove, is: +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ 00300-5 ADDENDUM NO.1 (November 17 2016) Co oun County ENIS Staden, CnIoun County Notinot 4, Senddfi.T (Htl No. 9M5.014) OWNER'S OPTION'S BID BID DESCRIPTION OF ITEM WITH UNIT ITEM QTY, UNIT PRICE WRITTEN IN WORDS BID AMOUNT ---------------------------------------------------------------------------------------------------------------------------------- 01, 1 LS Cost for furnishing material, labor and equipment for the installation of 2" hot mix asphalt and 8" crushed limestone driveway and parking lot (approx. 16,930 SF) in lieu of Bid Item No. 7, as per plans and specifications for a lump sum price of OD and Cents. $19, 00J 02. 1 LS Cost for furnishing material, labor and equipment for the installation of a concrete driveway and parking lot (approx. 16,930 SF) in lieu of Bid Item No. 7 above, as per plans and specification for a lump so rice of U�N and Cents. $ SSA 00 G +++++++++++++++++++++++++++++++++++++++++t+++++++++++++++++++++++++++ 6. BIDDER agrees that the Work shall be completed and ready for final payment in accordance with Paragraph 14.07 of the General Conditions within /c',b Calendar Days after the date when the Contract Times commences to run. BIDDER accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work within the times specified in the Agreement. The following documents are attached to and made a condition of this BID a. Required Bid Security in the form ofjl�D b. Document No. 00412 — Certificate of Interested Parties (Form 1295) C. A tabulation of Subcontractors, Suppliers and other persons and organizations required to be identified in the BID. d. Document No. 00415 - CONTRACTOR's Corporate Resolution. e: Document No. 00416 - Noncollusion Affidavit f. Document No. 60420 - Bidders Qualification Statement. 00300-6 ADDENDUM NO 1 (November 17 20161 Calhoun Coomp EMS Smiion, CaNwn C¢uvry Precinu A, S.&M, T (File No. 9N5.014) 0 S. Communications about this BID shall be directed to BIDDER's address indicated below. SUBMITTED this 3n day of H OV ft be r 2016. Authorized Signature Name: Title: Attesting Signature: N/& U �� Name: jclr( Title: e Legal Firm Name: Business Address: b, Inc. Phone Number: 361 5-10 I ZA4 Facsimile Number: b7 (P 125D E-Mail Address: @56-11oWl, h 4- State of Incorporation, if applicable: State Contractor License No.: '7 - 20 50 2 4 9 - g END OF DOCUMENT 00300-7 Performance Bond Bond No. 2222045 Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. CONTRACTOR (Name and Address): K & T Construction Company, Inc. 903 N. John Stockbauer Drive Victoria, TX 77901 OWNER (Name and Address): Calhoun County 211 S. Ann Street, Suite 301 Port Lavaca, TX 77979 SURETY (Name and Address of Principal Place of Business): North American Specialty Insurance Company 650 Elm Street Manchester, NH 03101 CONTRACT Date: December 8, 2016 Amount: ($579,000.00 ) Five Hundred Seventy Nine Thousand Dollars and 00/100 Description (Name and Location): Calhoun County EMS Station, Calhoun County Precinct 4, Seadrift, Texas BOND Date (Not earlier than Contract Date): December 13, 2016 Amount: ($579,000.00 ) Five Hundred Seventy Nine Thousand Dollars and 00/100 Modifications to this Bond Form: one Surety and Contractor, intending to be legally bound hereby, subject to the terms printed on the reverse side hereof, do each cause this Performance Bond to be duty executed on its behalf by its authorized officer, agent or representative. CONTRACTOR AS PRINCIPAL % (Corp. Seal) GnstrK ouc' n Com Signature: Name and Title:. ,, 'i SURETY Company: (Corp. Seal) North American Specialty;lnsu �n a Company Signature: /°z- ra% _ Name and Title: Rita G. Gulizo -- ATney-ln-Fact (Attach Power of Attorney) (Space is provided below for signatures of additional parties, if required.) CONTRACTOR AS Company: Signature: T Name and Title: SURETY Company: Signature: — Name and Title: EJCDC No. 1910-28-A (1996 Edition) Originally prepared through the joint efforts of die Surety Association of America, Engineers Joint Contract Documents Committee, the Contractors of America, and die American Instate of Architects. (Corp. Seal) tie1 G 0 � r rcia%d Ga7t�ral /� 4 00610-1 I, The CONTRACTOR and die Surety, joimry and severalty, hind themselves, their 'Itzita; execmmrx, administrators. Successors and assign to the Owner fat die performance of die Contract, which in int:otpotated herein by reference. 2. I( the CONTRACTOR performs the Contract, the Surety and the CONTRACTOR have no obligation under this Bond, MOW to participate In oomfemrers as provided it) paragraph 3.1. 3. if then is lot OWNER Defaull, the Surety's obligation order this Bond shall arise after; 11. The OWNER has notified the CONTRACTOR and the Surety at the addresses described Inparagnpb 10Wow, that the OWNER is curehdeting deafer€ng a CONTRACTOR Default and has requested and attempted to &range a confeticom with tote CONTRACTOR and the Surety to be held rat hater dun film days after receipt of such rasim to dismiss methods of performing the Contract. If the OWNER, the CONTRACTOR and the Surety agree, do CONTRACTOR shalt he allowed a reasonable time to perform the Contract, but such tot agreement shall rat waive the OWNER's right, if any, subsequently in declare a CONTRACTOR Default; end 3.2. The OWNER has declared a CONTRACTOR Default and formafty terminated use CONTRACrOR's eight to complete the Contract. Such CONTRACTOR Debut shall not be declared earlier than twenty days after the CON -TRACTOR and the Surely have received notice as provided in Paragraph 3.1; end 3.3. The OWNER has agreed to pay the Balance of the Contract price to: 3.3, 1. The Surety in aecordaisce with the terns of the Conran; 3.12 Another contractor selected pure mil to paragraph 4.3 to perform the Conuaet- 4. When the OWNER bill satisfied the conditions of paragraph 3, the Surety shalt promptly and at the Surety's expense take one of the following actions: 4.1. Arrange for die CONTRACTOR, with consent of the OWNER, to perform and complete the Centracr, or 4.2. Underake to perform and complete the Contract itself, through is agents or through independent coabactors; or 4.3. Obtain bids or negotiated proposals from qualified contractors acceplabie to the OWNER for a contract for performance and completion of true Contract, arrange for a contract to be prepared for execution by the OWNER and the Contractor selected with the OWNWs concurrenx, to be severed with performance, and payment bads excrorat by a qualified surety equivalent in the Bonds issued on the Contract, and pay to the OWNER die amount Of damages as described in paragraph 6 In excess of die Balance of die Contract Price incurred by rho OWNER resulting from the CONTRACTOR Default; or 4.4. Waive AS right to perform and complete, arrange for completion, or obtain a new contractor and with reasonable promptness under the c€rcurnsunces; 4.4.1 AOer investigation, delcmdria the Amount for which it may be,table to like OWNER and, as span as practicable after the amount is determined. lender payment therefor to the OWNER; or 4A.2 Deny liability in whole or in part and notify the OWNER citing reasons therefor. 5. If the Surely does not proceed as provided in paragraph 4 with reasonable promputrss, the Solely shall be deemed Lobe in default on this Bond fifteen days after receipt of an additional written notice from the OWNER to the Surety demanding War the Surety Million Its obligations under this Bond, and the OWNER shall be emitted to enforce any remedy available to die OWNER. If the So" proceed; as provided io paragraph 4-4, and the OWNER refuses the payment tendered or the Surety has divided pliability, in whole or In pan, wilhoat further notice the OWNER shalt be emitted to enforce any remedy available to the OWNER. 6, After the OWNER has terminated the CONTRACICirs right to complete the COMM, and if rho Surety elects to act under paragraph 4.1, 4.2, or 4.3 above, then the responsibilities of the Surety to dice OWNER shall nix be greater than OWN of the CONTRACTOR under the Contract, and fhe responsibilities of the OWNER to the Sleety staff hall beSmaller doin those of the OWNER under the Contract. To a limit of the amountof ddb Rural, but subject to conandit rem by dam OWNER of the Eaenteo of the Contract Price to mitigation of costs and damages on the Contract, the Surety is obligated withoelduphicafmn far: 6.1- The responsibilities of the CONTRACTOR for correction of defective Work and oompedon of the Contact; 6.2. Additional legal, design prefcasional and delay costs rauldng ham We CONTRACTOR'S Default, and resulting fross the seder or failure to act of the Surety under paragraph 4; ant 6-3, Liquidated damages, or if no liquidated damages are apeofsed in the Contract, actual datfurps caused by delayed performance or con - performance of the CONTRACTOR, 7. The Surety shall not be liable to the OWNER or others for obligations of the CONTRACTOR that are unrelated to the Contract, and the Balance of rho Contract Price shalt na be reduced or 1el off on Amason orally such unrelated obligsdnm. No right of action shall aceruo on Otis Bond to any person or entity other than the OWNER or its heirs, executers, administrators, or sumessa rs. S. The Surety hereby, waives noilm of any change, including changes of dma, to the Contract or to related Mlhatmracts, purchase orders and other obligations. 4. Any proceeding, legal or equitable, under this Bond may be Instltuted In any court of competent jurisdiction in the location in which the Work or part of the Work is located anal shalt be insdoited within two years after CONTRACTOR Defaatt or within two years after dheCONTRACI'OR eeasod working or within two years after du Suety rednses or faits m perfomr is obligadm under this Bond, wh€elsever occurs first. If the provisions of this paragraph are void or prohibited by law, the mbdmum period of limitation available to si muss as a defense in the jurisdiction of the suit shall he applicable. 10. Notice to the Surety, the OWNER or the CONTRACTOR shall be mailed or delivered m the address Shawn on the signamre page. if. When this Bond has been furnished to comply with a statutory or other legal requreftnt in the location where the Contract was be performed, any provision in this Bond conflicting with said Statutory or legal rcquhomeat shag be deemed deleted hem from and provisions confoms€ng to such statutory or other legal requirement shall he deemed €acotpntared here€m The Intent is dial this Bond shalt be oonsuved as a statutory bond and not as a common law bad. 12. Definitions. t2. i lialatce of die Contract price: The total arauntpayabie by the OWNER to the CONTRACTOR under the Contract after sit proper adjustments have been made, Including allowance to the CONTRACTOR of any amounts received or to be received by the OWNER In settlement of Insurance or other Claim; for damages tq which the CONTRACTOR is emitted, reduced by all valid and proper payments made to or on behalf of the CONTRACTOR order the Contract. 12.2, Contract: The agreemeot between die OWNER aM the CONTRACTOR Identified on the signamre page. €acmdiag all Contract Documents and changes thereto. 12.3. CONTRACTOR Default=Failure afdie CONTRACTOR, wiitGk hot txither been remedied nor waived, to perform or otherwise to Comply with the mrrr t of die Contract. 12A. OWNER M(aulr lrailure of the OWNER, which has neidier been remedied norwaived, to pay the CONTRACTOR as required by the Contract of in perform and complete or comply with the older temis thereof. (FOR INFORMATION ONLY --Name, Address and'Pelephone) AGENT or BROKER: OWNER'S REPRESIENTATIVE (Prigineer or other party): Bowen Miclette & Britt Insurance A enc , LLC. 1111 N. Loo p West, Suite 400 Houston, TX 77008 (713) 880-7100, 006i0-2 Payment Bond Bond No. 2222045 Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. CONTRACTOR (Name and Address): SURETY (Name and Address of Principal Place K & T Construction Company, Inc. of Business): 903 N. John Stockbauer Drive North American Specialty Insurance Company Victoria, TX 77901 650 Elm Street OWNER (Name and Address): Manchester, NH 03101 Calhoun County 211 S. Ann Street, Suite 301 Port Lavaca, TX 77979 CONTRACT Date: December 8, 2016 Amount: ($579,000.00 ) Five Hundred Seventy Nine Thousand Dollars and 00/100 Description (Name and Location): Calhoun County EMS Station, Calhoun County Precinct 4, Seadrift, Texas BOND Date (Not earlier than Contract Date): December 13, 2016 Amount:($579,000.00 ) Five Hundred Seventy Nine Thousand Dollars and 00/100 Modifications to this Bond Form: Item 6 Is Deleted In Its Entirety Surety and Contractor, intending to be legally bound hereby, subject to the terms printed on the reverse side hereof, do each cause this Payment Bond to be duly executed on its behalf by its authorized officer, agent, or representative. CONTRACTOR AS PRINCIPAL Company: (Corp. Seat) K & T Construe ' Corrpalty I Signature: �-- C� Name and Title: na��a See i SURETY Company: (Corp. Seal) North American Specialty In nee Company Signature: GS Name and Title: Rita G. Gulizo Attorney -in -Fact (Attach Power of Attorney) (Space is provided below for signatures of additional parties, if required.) CONTRACTOR AS PRI r°�t}11uTYjrG` 1+1�'y�' ; SURETY Company: L SEAL xl (Corp. Seal) Company: (Corp. Seal) Signature: AN" "•'"� Signature: Name and Title: ��'�ruv�ONumot��ao"` Name and Title: EJCDC No. 1910-28-B ``,\\511tY IIltlil///I // co ' (1996 Edition) �p_�` , Originally prepared through the joint efforts of the Surety Association of America, Engineers Joint Contract Documents Committee, the Assoera%d'Gait W onttan{ors of America, the American Institute of Architects, the American Subcontractors Association, and the Associated Specialty Contractors U p •� 00620-1 1. The CONTRACTOR and the Surety, jointly and Severalty, bimdthamisai a. their delta. executom adminisaatnni, wtxeamrs and assigns to Ira OWNER to pay for tabor, materials and equipment furnidhed for use in the perfwmntce of the Construct, which is Incorporated herein by referennce. 2. With respect td the OWNER, this Obligation shall be unit and Vold if the CONTRACTOR: 2.1. Prompdy mattes payment, directly or indirectly, far pit stuns due Claimants, and 2.2. D81ands, indemnifks and holds harmless the OWNER from all claims, demands, liens or suits by airy person or entity who famished labor, materials Or equipment for use in the performance of the Contract, provided the OWNER has promptly twdfled the CONTRACTOR and the Surety (at the addseases described in paragraph 12) of any claims, demands, Was or nits and tondcmd defense of Such claims, demands, liens Or suits to die CONTRACTOR and the Surety, and provided theta is an OWNER Default, 3. With respect to Claimants, this Obligation shall be twit Sid void if the CONTRACTOR pmmpdy makes peyaseak dieetly or Indirectly, for all mass due. 4. The surety chat have an obDgadon to Claimants under tots BOW untie 4.1, Claimants who are employed by O, have a direct contract with the CONTRACTOR have given tottc to the Surety (at the addresses described in paragraph 12) and arm a copy, or t,dw &,"f, to the OWNER, stating that a claim is being made under this Bond and, with substantial Steamy, the amount Of the claim, 4.2. Claimants who do not have a dirnxt contract with The CONTRACTOR[ I. Nava furnished written notice to the CONTRACTOR and snot a copy, or notice thereof, to the OWNER, within 90 days after having last performed labor Or last famished [arterials or equipment included in the claim Stalin, with substantial accuracy, the amount of the claim and the name of the parry. to whom the materials wean furnished or supplied or for whom the labor was done or performed; aid 2. Have either received a rejection in whale or in pot from the CONTRACTOR, or not received within 30 days of famishing the above thmiee any communication from The CONTRACTOR by which the CONTRACTOR had indicated the claim will be paid tiredly Or Indirectly; and 3. Not having been paid within the above 30 days, have suit a written notice to the Surety aid rem a copy, or+Voice!hereof. to the OWNEE, stating that a claim Is being made under US Bond aid enclosing a copy Of the prevlons written notice famished to the CONTRACTOR. 5, if a notice required by paragraph 4 is given by the OWNER to the CONTRACTOR or to she Surety, that is sufficient compliance. 6. When the Claimant has sadviled the conditions Of paragraph 4, Ike Surety shall promptly and at the Surety's cxpeme take the following scdOns: 6.1. Seed an answer to the Claimant, whh a copy m the OWNER, within 45 days after receipt of On claim, stating the anumnts that are undisputed and the basis forehallenging any amounts that are disputed, 6.2. Pay or arrange for payment of my waihapused amounts. 7. The Surety's total obligation shall lwt exceed the amount of tits Band, aid the amount of this Bond shall be credited for any payumm merle in goad Win by the Surety. 8. Amounts owed by the OWNER to the CONTRACTOR under the Contract shell be used for die performance of the Contract and to sadaty claims, it Any. trader any Performance Bond. By the CONTRACTOR fumithdag aid the OWNER accepdng this Bond, they agree drat all fiends lamed by the CONTRACTOR in the performance of the Contract am dedicated to satisfy obligations of &a CONTRACTOR and she Surety wader this Boaz[, Subject to the OWNEWs priority to use tte foods for the completion of the Work, 9. The Surety s(Wl not be late to the OWNER. Claimants w others for Obligations of the CONTRACTOR that am unrelated so the C.owwaot. The OWNER Shall Sot be[ WeforpaymemofaayeeetaorvVenresofairyCldmawandershisBold,and Shall have Order this Bond an obligations to matte payments to, give nadeas on behaif of. or otherwise have obligatlons to Claimants coder this Road. to, The Surety body Valves notice of any change, including changes of time, to thin Contract or to related Subcontracts, purchase orders and other obligations, It. NO suit Or action shall be commenced by* Claimant under this Bond Other thus lii ac0urt txmyneknl ju[isdietian in the 10CatOn In which the Work orpart of the Work is located or after the expiration atone year from the data (1) on which die Claimant gave the notice required by paragraph 4.1 or paragraph 4.2.3, or (2) on which the Ins! Iabnr Or seMce was parfonsied by "ras or the last materials or equipment were furnished by anyone under the Cum strac ton Connotes, Iles, whicheverof (1) Or M first Occurs. If dte provisions of this paragraph arc void or prohibited by law, die minimum period of fimiradon available to Swedes as a defense in the Jurisdiction of the suit shall be applicable. 12. Notice to the Surety, Ilia OWNER Or the CONTRACTOR shall be mailed or delivered tithe addressee shown on the Signature page. Actual teoeiptoP nndce by Surety, she OWNER or the CONTRACTOR, however accomplished, shall be sofficlem compliance as of the date readved as the address shown on the signature per• 13, When this Band has been famished to comply with a statutory or other legal requirement in she location where the Contract was to be performed, any provision In this Bond wh(fie ft with said statutory or legal requirement shall be deemed dlatad lierefiom and provisions conforming to such statutory or Other legal requirement tall be deemed bmoip acted heroin. The intent is, that this Bond shall be construed as a Statutory Bond and tot as a common law bmnd. 14. Upon request of Say poison or entity appearing to be a potential beneficiary Of this Band, the CONTRACTOR shalt promptly furnish a copy Of this Bond Or $ball permlta copy to be trade. 15, DEFMMNS 15,11, Claimant: An individual or entity having a direct contract with the CONTRACTOR or with a Subcontractor of the CONTRACTOR to furnish labor, materials or equipment for use in the performance of the contract. The intent of this Bond shall be to include wit out limitation In the arms 'Iatwr, raatotiaN or equipment' that pat of water, gas, power, light, heat, Of, gasoiiow, telephone Service Or rental equipment used in the Contract, amishocmral and engineering services required for performance of the Work of the CONTRACTOR and the CONTRACTOR's Subcontractors, and all Other items for which a mccbanic's lion may be asserted in the jurisdiction where the labor, materials orequipment were furnished. 15.2. Contract: The agreement between the OWNER and the CONTRACTOR Identified On the Signature page, including all Contract Documents and thsages pthereM. I5.3, OWNER Defaull; Failure of the OWNER, which has neither been remedied nor waived, to pay the CONTRACTOR ar required by tte Contract or to perform and complete or comply with the other terms thereof. (POR INFORMATION ONLY --Marne, Address and Telephone) AGENCY or BROKER: OWNER'S REPRESENTATIVE (Engiater or outer party): Bowen, Miclette & Britt Insurance Agency, LLC. 1111 N. Loop West, Suite 400 Houston, TX 77008 (713) 880-7100, 0g620.2 NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, THAT North American Specialty Insurance Company, a corporation duly organized and existing under laws of the State of New Hampshire, and having its principal office in the City of Manchester, New Hampshire, and Washington International Insurance Company, a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg, Illinois, each does hereby make, constitute and appoint: RITA G. GULIZO and SUSAN D. ZAPALOWSKI JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its act and deed, bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies, as surety, on contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION ($50,000,000.00) DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9`h of May, 2012: "RESOLVED, that any two of the Presidents, any Managing Director, any Senior Vice President, any Vice President, any Assistant Vice President, the Secretary or any Assistant Secretary be, and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings and all contracts of surety, and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached." ,,s,, `twTYj p/ /� wmnuinmx�anpv pg, / 7/! / /(IONgt/ �ti e+Q�y� $y dr," onr SEAL :oE Steven P. Anderson, Senior Via President of%shington lnternrtionA insurance Company BE Fi,1W3 m�m; &Senior vice President ofNorih American Specialty Insurance Company sm �1'........... Michael A.Ito Tor ice ressente as mgton oerma ono moron ompany rxrvw & Stnlor Vla Prwltlent ofttorlM1 Am<dcan Specialty auurana Company IN WITNESS WHEREOF, North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 27th day of August 2015 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook SS: On this 27th day of August , 2015 , before me, a Notary Public personally appeared Steven P. Anderson , Senior Vice President of Washington International insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A. Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above Power of Attorney as officers, of and acknowledged said instrument to be the voluntary act and deed of their respective companies. =STATE [NO(1ABYPUBLIC,OIS M. Kenny, Notary Pnbnc:,i>� 2017 I, Jeffrev Goldberg ,the duly elected Assistant Secretary of North American Specialty Insurance Company and.Washidg(on,.; International Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power ofAttomey'given by gaid;Norl American Specialty Insurance Company and Washington International Insurance Company, which is still in full force and @ff8�s' , '•,r,' IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Companies this 13th day ///oJJJf December c7 Jeffrey Goldberg, Vice Pruident & Assistant Secretary of , 1 1 � tvashu, non international insurance Company&North Amerieah Specialty Nsomuce Company North American Specialty Insurance Company Washington International Insurance Company TEXAS CLAIMS INFORMATION IMPORTANT NOTICE ADVISO IMPORTANTE In order to obtain information or make a complaint: Para obtener informacion o para someter un queja: You may contact Jim Carpenter, Vice President — Claims at 1-800.338-0753 You may call Washington International Insurance Company and/or North American Specialty Insurance Company's toll -free number for information or to make a complaint at: 1.800.338.0753 You may also write to Washington International Insurance Company and/or North American Specially Insurance Company at the following address: 475 N. Martingale Road Suite 850 Schaumburg, IL 60173 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance: P.O. Box 149104 Austin, TX 78714-9104 Fax: (512) 490-1007 Web: http://www.tdi.state.tx.us Email: ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should first contact the Washington International Insurance Company and/or North American Specially Insurance Company. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. Puede comunicarse con Jim Carpenter, Vice President — Claims, at 1-800-338-0753 Usted puede Ilamr at numero de telefono gratis de Washington international Insurance Company and/or North American Specialty Insurance Company's para informacion o para someter una queja at: 1-800.338.0753 Usted tambien puede escribir a Washington International Insurance Company and/or North American Specialty Insurance Company al: 475 N. Martingale Road Suite 850 Schaumburg, IL 60173 Puede escribir at Departmento de Seguros de Texas para obtener informacion acerca de companies, coberturas, derechos o quejas at: 1.800-252-3439 Puede escribir at Departmento de Seguros de Texas: P.O. Box 149104 Austin, TX 78714-9104 Fax: (512)475-1771 Web: htto://www.tdi.state.tx.us Email: ConsumerProtection@tdi.state.tx.us DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiene una dispute concerniente a su prima o a un reclamo, dabs comunicarse con at Washington International Insurance Company and/or North American Specially Insurance Company primero. Si no se resuelve la dispute, puede entonces comunicarse con at Departmento de Seguros de Texas. UNA ESTE AVISO A SU POLIZA Este aviso es solo para proposito de infromacion y no se converts an parte o condicion del documento adjunto. K15TCO-2 OP ID: KR AIR® CERTIFICATE OF LIABILITY INSURANCE DATE 12115/201 YY, 12/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poficy(les) must be endorsed. If SUBROGATION 15 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A. statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement s . PRODUCER GSM insurors-Victors P&C P. 0. Box 2447 Victoria, TX 77902 CONTACT AM.E` PHONE .:(AIC,Nu Ee11:—.------._—___ [FAX No), E.MAL INSURER(S,j AFFORDING COVERAGe NATO _ INSURERA _CNA Insurance Company . _ 02186 .. __....-......._. _ _ INSURED K&T Construction Company, Inc INSURER 8: Torus 26496__ 903John Stockbauer Victoria, TX 77905 _ mas sURERC:ContinentalCualty Cc T 20443 INSURER D: INSURER Ea INSURERF: .COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH. RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBki-�- L _ -_-- TYPE OF INSURANCE D n---------- pODCY NUMeEft PO4CYEPF MMIDD V Y POLICY EXP--_T_----— MIDDIVYYY LIMITS A GENERAL LIABILITY X I COMMERCIAL GENERAL LIABILITY I CLAIM8MAOEL�OCCUR 6014239302 09/15/2016 09/1612017 EACH OCCURRENCE $ 1,000,00. D GE TO RENTED PREMISES En ecwrtence $ 1 OO,OO _MED. EXP IAn Y one person. S _5,00_ PERSONAL &AOV INJURY $ 1,000,00 __ GENERAL AGGREGAlk $ 2,000,00 GEHL AGGREGATE -POLICY LIMITAPPUES PER: FxPRO LOC _ PRODUCTS-COMP/OP AGO $ 2,000,00 -- $ A AUTOMOBILE LIABILITY X ANY AUTO AUTOWNED SCHEDULED NON�OWNED HIRED AUTOS AUTOS 6014239316 09/15/2016 09/16/2017 COMSINED-SINGLE LIMIT (Ea acci e 1-00000 , , �, BODILY INJURY (Per person) $ -- —rd) �BODILY INJURY (Pei aecidenl} _. S PROPERTY DAMAGE �4� R E 1 $ $ A X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE 6014239347 09/1612016 09116/2017 EACH OCCURRENCE 2,000,00 .AGGREGATE _$ $ 2,000,00 DED X. RETENTIONS 10,00 $ A WORKERS AND EMPLOYERS'LAeiL COMPENSATION YIN ANYPROPRIETORIPARTNEWSXECUTIVE ❑ I OFFICEM SNIDE EXCLUDED'! ,(MendaloryinNH) If yyes describe under OES�RIPTION OF OPERATIONS below. NJA 16014335589 , i i 1 09/15/2016 09/16/2017 X WCSTL OTH- 6LEACHACCIDENT $ 600,00 E.L. DISEASE -EA EMPLOYEE --___....._.— $ 60000 E.L. DISEASE- POLICY LIMB $ 600,000 B C. Excess Liability Builders Risk 182933JI62ALI 13011132278 , 09116/2016 0612012016 09116/2017 06/20/2017 Limit 8,000,00 Limit 6,000,00 DESCRIPTION OF OPERATION51 LOCATIONS I VEHICLES (Attach ACORD 101, AdJltlonet Remarks Schodala, If more space Is roqulred) Project; Calhoun. County EMS Station, Calhoun County Precinct 4, Seadrift, Tx see notes CALHCNT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Calhoun County and Calhoun County Employees AUTHORIZED REPRESENTATIVE 211 S. Ann St, $rd Floor, Ste 301 Port Lavaca, TX 77979 ©1988-2010 ACORD CORPORATION. All riahts reserved. K&TCO.2 OP ID: KR ACOR" lh .- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 1211512016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE: HOLDER.. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the poiicy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement. on this certificate does not confer rights to the certificate holder in lieu of such endorsement s ; PRODUCER GSM Insurors-VIGtora P&C P. O, Box 2447 Victoria, TX 77902 CONTACT :NAME: PNONE E t PA . H l_ — � --- -MAIL _ADDREsc: INSURER($1 AFFOft01NG COVERAGE _ NAICp __ 1N_SUREBA CNA InBuranoe Cotnpa __ _ 02186 __ -_ INSURED K&T COnStYUEtIOn Company, Intl 903 John Stockbouer Victoria, TX 77905 INSURERB;TOrus 25496 _ iysuRERcIContinentalCasual Co - --- - - 20443 - INSURER D: INSURER E ---- INSURER -�— —� _ ---� COVERAGES CERTIFICATENIIMRFR- RFVI.RIntJ NI IMRFP- THIS IS TO CERTIFY THAT THE. POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS -MAY CERTIFICATE Be ISSUED OR MAY .PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INRR TYPE OF INSURANCE ' DT 11?POLICY NUMBER POLICY M ICY EFF POLICY OLIC EXP _ LIMIT A GENERAL LIABILITY �= COMMERCIAL GENERAL LIABILITY ��coca CLAIMS MADE l A 1. OCCUR ! ! ! 6014239302 09/16/2016 0911512017 EACH OCCURRENCE i$ 1,000,00 DAA MA11ET .RENTED o ur a co $ 100,00 MED EXP LAny one erson 1 $ _ 6100 PERSONAL &ADVINJURYs 1,000,00. GENERAL AGGREGATE $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER; PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY X PRO-. I I LOC $1 A AUTOMOBILE XAY LIABILITY Auio COMBINED SINGLE LIMIT lEa.ceidIntl _ 1,000,00 BODILY INJURY (Per percent '$ — ALLOWNED SCHEDULED' AUTOS �. _. AUTOS HIRED AUTOS AlU1TNOSWNED P--' BOOBY INJURY (Per ecGden[) pp RA TY EnATMAGE $ )( UMBRELLA LIAR X -{CLAIMS-MADE OCCUR EACHO_CCURRENCE___ 2,000,00 AGGREGATE _S $ A EXCESS LIAR 6014239347 09/16/2018 09/16/2017 ED X RETENTION 10000WORKERS _ _ _2,6_0.0,00__ § A IANOEMPLOYER3ELABLTY YIN oN ANY PROPRIETORIPARTNER/EXECUTIVE ❑ OPFICERIMEMBER EXCLUDEDi (Mandatory In NNI ITy dasent.ender 'DE SCRIPTION OF OPERATIONS below NIA 6014335589 091161201610911612017 f X WGY`ATU- tlEH- EL. EACH ACCIDENT_ $ 500,00 EL_DISEASE, EA EMPLOYEE $ 500,00 E.L. DISEASE -POLICY LIMIT I $ 500,00 B ;Excess Liability 82933,1162ALI 09/16/2016 09/16/2017 Limit 8,000,00 C puilders Risk 3011132278 05/20/2016 05/20/2017 Limit 51000100 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES tAltach ACORO 101, Additional Remarks Schodule, R mom space Is mqulred) Project: Calhoun County EMS Station, Calhoun County Precinct, 4, Seadrift, Tx see notes G & W Engineers; Inc. 205 W Live Oak Port Lavaca, TX 77979 G&WENA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 019118-2010 ACORD CORPORATION. All CERTIFICATE OF INTERESTED PARTIES FORM 1295 1ef1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-141156 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. K & T Construction Co., Inc. Victoria, TX United States Date Filed: 11130/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 2016 EMS Station Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Tomanek, Larry Victoria, TX United States X Strnadel, Scott EI Campo, 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. coPY.. a°fo Jeri E Gan: � My Commisocx•Exr: 9 v 09/2412016 `'"�"t`r"" • Signature of aut orized agent of contracting business entity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me, by the said lJ C U (J Ul r n�'L� , this the , f ^� V day of f4OVM bfi,Y, 20to certify which, witness my hand and seal of office. Jar( E l�aruc oFFize,uana ig' ature of officer administers oath Printed name of officer administering oath Title of officer adnAViistering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us version v1.u.zr / CERTIFICATE OF INTERESTED PARTIES FORM 3.295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-141156 Date Filed: 11/30/2016 Date Acknowledged: 12/29/2016 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. K & T Construction Co., Inc. Victoria, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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 services, goods, or other property to be provided under the contract, 2016 EMS Station 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Tomanek, Larry Victoria, TX United States X Strnadel, Scott El Campo, 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. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 Consider and take necessary action to award bids for Asphalts, Oils and Emulsions for the period beginning January 1, 2017 and ending June 30, 2017. (MP) Commissioner Lyssy made a motion to award the bid for Asphalts, Oils and Emulsions for the period beginning January 1, 2017 and ending June 30, 2017 to all low bidders for all precincts. P2 Emulsions, LLC was awarded the bid for Primer Oil. Martin Asphalt Co. was awarded the bid for AC-5. Cleveland Asphalt Products, Inc. was awarded the bid for RC250. Cleveland Asphalt Products, Inc. was awarded the bid for CRS-2. Martin Asphalt Co. was awarded the bid for CRS-2P. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Agenda Item for Commissioners' Court —Thursday,, December 22, 2016 Consider and take necessary action to award bids for Asphalts, Oils and Emulsions for the period beginning January 1, 2017 and ending June 30, 2017. Commissioners' Court, December 22, 2016 —Agenda Item #6 6. Consider and Take Necessary Action to award bids for Asphalts, Oils and Emulsions for the period beginning January 1, 2017 and ending June 30, 2017. Each Asphalt, Oils and Emulsions bid was individually discussed and awarded as follows: PRIMER OIL: P2 Emulsions LLC-AII Precincts $1.45 Gallon Demurrage is $80 Per Hour After 2 Free Hours 5,000 Gallons Minimum Order AC-5: Martin Asphalt Co. - All Precincts $1.44 Gallon Demurrage is $60 Per Hour After 2 Free Hours 5,000 Gallons Minimum Order RC250: Cleveland Asphalt Products Inc. - All Precincts $2.50 Gallon Demurrage is $80 Per Hour After 2 Free Hours 5,000 Gallons Minimum Order CRS-2: Cleveland Asphalt Products Inc. - All Precincts $1.30 Gallon Demurrage is $80 Per Hour After 2 Free Hours 5,000 Gallons Minimum Order CRS-2P: Martin Asphalt Co. - All Precincts $1.66 Gallon Demurrage is $60 Per Hour After 2 Free Hours 5,000 Gallons Minimum Order r r N N CO M � �5 O o O T O - 0 v 00 now 0 O O O = x v x a E N E v N E li N IL � w N m - 0 U N Q N a V N 5E =av xLL xQ° w CL Of 09 0p a"2 0p a , ON O w E J E N N E E ;c € G 12 0 12 0 E C O C C N (6 U 0 m F� h F f z z a w m a a r r N N M M O O O o O T - S.- 0 oc o m O O = a = O m a E LLry LLaw NK N Nv— ¢�2 age 5E =ate xLL xaa d rE oa o9=0 op o0 mo a m E m E E m f9 NE 4 NEE E E m mS o rng M2-E€ 2i O yy O C E ryyry o U a�.Cc xe W N N DO N jp 00 mo. 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W Zvi Oui Z Z O O Q c� Q (D e co C IL 0- 4 � z z LU LU o n a n r 0 `N 0 C N N N N N O 2 O a 2 d o LL N LL N oma aLL aaa E =a O =a O'er m a� aEa-- o f o E E p c_ o,G E o N G N C E ry y N O Ol 0 0 e E2 T- m Eo 0 Eo o0 Y LL7 mo 0� Noo � �NiO P Z z O 0 S Q Q = cD cD m 6 64 yq v v VE z z occ w w a a CERTIFICATE OF INTERESTED PARTIES FQR1y 1295 left 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. CERTIFICATIONOF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-13B493 - P2 Emulsions Elm Mott, TX United States Date Filed: 11fl8/2016 2 Name of governmental enkiry or state agency Yhat is a parry to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. the contract, and provide a Asphalts, Oils and Emulsions Asphalt Emulsion Products 4 Name of Interested Party City, State, Country (place of business) Nature of interest • (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. X 6 - - 1 swear, a m, under penalty of perju that the CNEGiYL AWN HELMS above disclosure is true and correct. 'Notary ID : 129119014 T My Commission Expires • -.---- September 10, 2020 C,., y� ' ,page o4aut onied agent o contracting 5 business entity AFFIX NOTARY STAMP / SEAL ABOVE \ 1 1 Sworn to and subscribed before me, by the said ` 3CAi n.,0 —& `-1co , this the , tic7 � day of KILOV�' VYV I o 20ALIL_, to certify which, wimess my hand and seal of office, Signature of jiicer administering oath Printed name_ f officer administering oath Title of officer r lministedng oath Forms provided by Texas Ethics Commission , www.ethics.state.tmos Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of l Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-138493 Date Filed: 11/18/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. P2 Emulsions Elm Mott, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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 services, goods, or other property to be provided under the contract. Asphalts, Oils and Emulsions Asphalt Emulsion Products - 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 t el l 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-140305 Martin Asphalt Company HOUSTON, TX United States Date Filed: 11/28/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Asphalts, Oils & Emulsions Asphalts & Emulsions Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary MARTIN ASPHALT COMPANY Houston, 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. \axur„ FtiaR!',aoeaa VICTORIA ELf?A6ETtf eSPINO ;.6°i� °;Notary Public, State at Texas ?�,'• '° Comm. Ex 03-74-2020 A, ��9/C OF KO\C44W i sires `-�,,,,,,e,o Notaly ID 13056037Q Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP I SEAL ABOVE Sworn to and subscribed before me, by the said `SACIL J 4a —3 , this the day of 20 i b , to certify which, witness my hand and seal of office. *,gnaru,,,ruff dministering oath Printed name of offic r administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-140305 Date Filed: 11/28/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Martin Asphalt Company HOUSTON, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. Asphalts, Oils & Emulsions Asphalts & Emulsions the contract, and provide a 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary MARTIN ASPHALT COMPANY Houston, 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. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-139402 Cleveland Asphalt Products Shepherd, TX United States Date Filed: 11/22/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 1-1-2017 Asphalt, Oils, and Emulsions 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 AFF,)DVIT gl IC � I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. `$ti ......... I . 1.9 `v-` f °��vr.h� �N•NF 1•'tt y ,. �43 , *Y# �F ignature of authorized gent of contracting business entity '<0 A(fij)X NOT*PA /��SF1�L ABOVE Sworn to and subscribed before me, by the said CLAYTON MOORE this the 22nd day of NOVEMBER, 20 11 6 , to certify which, witness my hand and seal of office. 1t�iCflj� C1 A Cy L f L„� MICHELLE RENEE GRIFFIN ACCOUNTING Signature of o icei administerinigb4th Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-139402 Date Filed: 11/22/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Cleveland Asphalt Products Shepherd, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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 services, goods, or other property to be provided under the contract. 1-1-2017 Asphalt, Oils, and Emulsions 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 Ky�\ 1 Y 1 V) d H m Z ; om 0 3 O ;^ o J u� o oN � N s > 'om m W C c r E O o a u Q Z m L Q 0 u m Y txy O V J = avo o a to Z £ a o o A Z O a �VJ% X N 1 �Z J a` L !— 0 Y 0 LL Q (n _j m u a o Z J E-j�0 > ui Z �. `o Nr J m mvi d, r (A a.W u Q >N m m >12 w > x x x S S o a a avi a w O G 1Y C LLI C al C al d 'n N I N a� w w u � ° YI Q ¢ Q ¢ Q wt x/ � x I x x x b • d b x x x x x u w a w u O c _ c LLI c al L 1Y IL d N N N I N 'S d yl v w w u ° a a a a a 9 5 a l � n 6 N N N N N > 0 > > y > o o 'o 0 0 x x x x x v v d v d d d v d O C y C L C C N 0 i o b > > i al LLI al LLI o w (•fJI "I v v a � y o ¢ a a a a m , a b M N N N N N v v d d v d v v Oe c° LLI L LLI c c al LLI a �y a "'I v v � v o N O la la O la O la o 'a x xo x x x \Ia0 6I 6 6I 6 c u 1 V m � N _• N N N N a O d 0 v d 0 a v 0 v d 0 v d 0 m m m m m 3 12 ry a ry e m £ E In E N E E y E E E E 'c u E 'c u •� y� 'c E 'c a o a o K a u o� u 8 2 0 0 Y 0 E CERTIFICATE OF INTERESTED PARTIES I FORM 1295 L OFl I Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, S. 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. 2016-138493 P2 Emulsions Elm Mott, 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 being filed. 11/18/2016 Calhoun County Date Acknowledged: 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 services, goods, or other property to he provided under the contract. Asphalts, Oils and Emulsions Asphalt Emulsion Products 4 Name of Interested Party City,State, Country (place of business) Nature of interest • (check applicable) Controlling I Tntermediary 5 Check only if there is NO Interested Party. X 6 -.. 1 swear/a m, under penalty of periu that the above disclosure is true and correct. CHERYL ANN HELMS 'Notary ID n 1291190114 s°�N�PUk" My Commission Expires z September 10. 2020 _ S',f tore don oozed agent o contracting business entity ' AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said i,_�y A �tir V--C A x , this the �y 1,. � 0 � day of �1M0V<'.yi1J- 0 20 iL_, to certify which, witness my hand and seal of office, Cher�u t helms tv�s��.rv, Signature of Nicer administering oath Printed namt' f officer administering oath Title of officer 0ministering oath Forms provided by Texas Ethics Commission . www.emicS.State.lx.us Version V1.Uz I r VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: P c,f ^ Il)- S / OA✓S Z ,C, L Address: / 6 S Remittance Address: _57 �rI Telephone: 2 G/— Z9 7,7 -C�? Fax: a S �i - aad i ✓ 6_?3 7 Email: _A a2 Signature of Authorized Representative: Printed name of Authorized Rep: ORDER — CONTACT INFORMATION Order Contact Name & Title: .Sp P1 '�F Order Contact Telephone: Order Contact Fax: Order Contact Email: Return this form with your bid. P weft 2 Emulsion Plants, L.L.C. 516 S. McLennan Loop Elm Mott, Texas 76640 Phone (254) 829-0330 Fax (254) 829-0337 p2emulsions(o)sbcglobal.net Salesman:David Williams Cell:361-877-2584 Product Price Sheet for County; Effective P2 Prime "Lucky 7—RTU"...$1.20/GalIon ....... $1.45/Gallon.......... $1.40Gallon Premixed, ready to use P2 "Tack 41- RTU" ............$1.65 Gallon ...... $1.90 Gallon ........... $1.85 Gallon Premixed, ready to use P2 "Prime 11 Concentrate"..$1.99/GalIon ...... $2.24/Gallon.......... $2.19/Gallon Mixes with 6 parts water to make a prime, 4 parts water to make a tack P2 Stabilizer .................... $2.44/Gallon......... $2.69/Gallon.......... $2.64/Gallon Asphalt Base Stabilizer P2 Rejuvenator ................ $2.47/Gallon......... $2.72/Gallon.......... $2.67/Gallon Asphalt Rejuvenator CWE-2................................ $2.74/Gal Ion.........$2.99/Gallon..........$2.94/Gal Ion All Weather Chip Seal Emulsion CWP (Cold Weather Patch)..$2.74/Gallon....... $2.99/Gallon.......... $2.94/Gallon Year Round Pot Hole Patch Emulsion R.O.0............................. $2.57/Gallon......... $2.82/Gallon.......... $2.77/Gal Ion "Road Over Coat" for Chip Seal Roads *All P2 products are Proprietary/Sole Source products formulated without voc's, and to fulfill TxDOT 300.2 particle charge procedure T59. Note: Positive/Cationic material. DO NOT CONTAMINATE WITH DIESEL. Demurrage (trucking charge): First 2 hours free, $80.00 per hour there after. Pump Charge (trucking charge): $80.00 if needed. Minimum Tanker Delivery: 5,000 Gallons. Smaller Quantities Available, Subject to Freight Differential. CONTAINERS AVAILABLE FOR CUSTOMER CONVENIENCE when doing smallerjobs than a tanker amount: "Tote" Containers (275 gallons size each) cost $129.00 per container. "Drum" Containers (55 gallons size each) cost $26.00 per drum. Containers are re -usable and can be rinsed out, brought back, and be re -filled at customer discretion. Containers priced separate and sold only with orders for material. *NOTE: In the event of national crisis or war, affecting extreme changes in petroleum pricing, P2 reserves the right to change quoted or bid prices with 30 days proper written notice. 1 i Y h E �y 0 = �m n C ti V 03 m a W Y c ct E a N Z G m o 2 0 W o UN �O , Q '9q y n a o r QS Y pa: y Q aEza Z o :7 LN a o J �RUH 2. v '6 R V Q a�a�0 o > CMS Y �N m m x x S x x a LL i � � IL � �) � u � 'd �l y d •.I n n `w 'V n `a a `a � d i n `a •� O u S e i S si n x x x x g 5 3 v a` c e a o 0 y) 0 x 0 x 0 x `a a a 'd •�' n `a a `a d J a N N N N N c v V LLl �l � l9 •� L7 . �I l9 �I ) (9 �i) M C a nn1I1 `S� 9 i 3 `,i�I a a LLI u a v 3 ;il a) ` JI of % .4 1 A � E a v a a a 'a p a o `m o a o C a o E a o a A o jl 3 E N 5 E E 'E u E 'E �j E 'E w rj x E 'E V o E 'E u o CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of l 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-140305 Martin Asphalt Company HOUSTON, TX United States Date Filed: 11/28/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the Identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. the contract, and provide a Asphalts, Oils & Emulsions Asphalts & Emulsions 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary MARTIN ASPHALT COMPANY Houston, 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. VICTORIA ELIZABETH ESPINO `,OgIS..n -a o' Notary Public, State of Texas ':,.';/� Comm. Expires 03-14-2020 v tEf, J a ��,,,,�„�,.� NOfety ID 130580370 Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said -:5 [,)L• %�C+s>ti 1 , this the V� �{ day of h�audrszt- 20 1 b , to certify which, witness my hand and seal of office. i , II''nn V,&n(`/&PLqo t/�J f ignature of off' a ministeringoath Printed name of offic r administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 J VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: Address: -Oiteji� AtVal,,41 , . e-W- / 52 lt,'- Remittance Address: 40, '114 9,06-1 Telephone: Fax: 28Nf Email:-51j)^1141f1AA �S.,vds14L 00g, II Signature of Authorized Representative: Printed name of Authorized Rep:. -TAeiL /J/ih.*& ORDER - CONTACT INFORMATION x Order Contact Name & Title: 1ALil- 1J;�s�« o/9 W Order Contact Telephone: 10 4L - t soyf Order Contact Fax: -0-3!�o Order Contact Email•IJi`difh���= Return this form with your bid. C 0 H Z 0 Z 1 LA Z 0 J M W N J 0 J I— Ln Z �a �a Z O w Y m W Z 30 p FK- ei w U� a Y N✓ V ? j O N rl C( :.1 Z t 0 m a w m rg Z V 0 0° n w m s.+ 073 Q O W U m Y W U = m o ry (L a = 2Z n H L o ~ 3 a L W ^ Y Q 2 z c a J X '6 V a i o o LL Ro m a RW, 1 a W C R C O G/ Z> 2 1 v W Om W N mN y o ywj c J 'E Q S 7 ,-i pO Q W > U0IL fn } 2 a _ = o O = LL o LL O LL LLI O b O. d a �NI c NI cn 2 b n •Y n 0 x x vt off =o ri Vl 'oH M d H y ca o y ro x N x y° F 00 H 00 O w OO CDO O N N N IX _ o y b s x o Y oabi w y y � b b o c LL _ c LL LLI cN`I �N`I cNLLI � � I. a x Y T-- 0 a 0 O ar0-I p f/} b ro N 00 ri o a fy o 0 v o o Io 0 0 oI 00 OO O OO c0 O a`. N.00 N iF IX IX O IX i i Tl9 a b ^w S u` LLI u i9Nl ObN) I-NIU1 Nl s o. 'CA n cp n w` 00 O a 0 O a ri a ,� O Q Q �O .4 ri O 5 d` m ri H y ro o m ry O o ro I1 y o0 H i I n s I C to Gv Qyu H} C7' N C9' O �} Lo 6r CD O I a co O C O(y� 0 0 o � 0 u X< y a b LL Sa b LLI N nJm xcv dNI y� n co y 0 a 0 O a 0 a ri a pI a o N i ri Z O y (tl 00 10 o �y uca ex �yo 66 ��pyy, d O N O' O V3 O lsi C7) n. c0 O eD 000 00 Odd{ N Ui N N N 12 12 # x° y x y Ik y O b C� b C LL C b C Ik a y t� N N LL NI C NIl9 `b b U) n v c O b N O a O `fl a a 1-1O a r a r S. ri ; 'n o ro 0 e v •-� x I x N y I y f 'U �y O 6I O W I O OI a O co coN 00 N N N v„I N N v v a a v m 0 N= m 0 w 0 m E b 0 W E w 0 pp °. E m m E L= In = E o N E ry 2 E :° ry E n. E c �j E 'c N E 'c N , E 'c E 'c o a o o o u o b F- Y CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-139402 Cleveland Asphalt Products Shepherd, TX United States Date Filed: 11/22/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 1-1-2017 Asphalt, Oils, and Emulsions 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 AFF`IE1 VIT (1)iCy''.., I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. ,. qJ .. t�'•. e i •po wMz Oc. ��`tgnature of authorized gent of contracting d •. • +lot � business endty � ' ��' ANF)X NOTf(tjf.0• 6EAL ABOVE "r'rr�nn,n,,,��d ,. sworn to and subscribed before me, by the said CLAYTON MOORE this the 22nd day of NOVEMBER, 20 16 _, to certify which, witness my hand and seal of office. xh�A4 MICHELLE RENEE GRIFFIN ACCOUNTING gnature of officer administerinfg/Uth Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: CLEVELAND ASPHALT PRODUCTS, INC Address: P.O.BOX 1449 SHEPHERD, TEXAS 77371 PAYMENTS ONLY , Remittance Address: DEPARTMENT NUMBER 936: P.O.Bx 4652 Hnnstnn taxav77710-4652 OTHER CORRESPONDENCE: P.O.BOX 1449, SHEPHERD, TEXAS 77371 Telephone: 800 -334-017 7 Email: ccmcapco@msn.com Signature of Authorized Representative: Printed name of Authorized Rep: CLAYTON MOORE ORDER — CONTACT INFORMATION Order Contact Name & Title: FREIDA D. ORTIZ, OFFICE MANAGER MICHELLE GRIFFIN, ACOUNTING Order Contact Telephone: 800-334-0177 Order Contact Fax: 936-628-6602 Order Contact Email: capcoasphalt @msn.com Return this form with your bid. ebi 0 a N W H O tp N x J 0 a ,Fan z O F- y E Ca pO N LL G 0 W w C7 N 2 O O 0 a a a a � c a ul � ��j� c a LLI a e e LL LLI w o y O I v e I a s h a a (a x `Ia x p la x x la x v a ' o aai C1 w w a s a pL 0 111 0 'o 0 0 16 w` � ry `a `w `4t`�lry`ajgl I Ij C. NI NI a QI S A LLI LLI LLI LLI a c� � � `a i' a � a `a N x m x I u c n 1a� a n `a a a a a y E a a a a 9 a � 5�C3 a 3 a 5 a 5 N S S I S S 2 a N N N N N 12 o e LLI nI LLI LLI ` 'I `w Y `u Y Y Y Y F v a v a a a 0 a 0 a 0 A a 0 a 0 a C E 'E o S E `V E N= E a E o u E c a o V E 'E o E E 'c u o E c u o a Y 0 w m Z v a F CERTIFICATE OF INTERESTED PARTIES FORM 1295 lofl 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-139484 Gulf Coast Asphalt Company Houston, TX United States Date Filed: 11/22/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 2017-01-16 Asphalt Materials Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFI — - - I swear, or affirm, under penalty of perjury, that �ptPPva�e,, GEORGIA A EDGAR :_"Notary Public, State of Texas y'a':*V Comm. Expires 01.13.2019 �!!„40PIX11` Notary ID 11448374 the above disclosure is true and correct. Signature of aulh agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE �/ Swor and subscrib of re me, by the so I , this the (,., ��� ap day of U V I t , 20, to ce fy whit , witness�ty han nd seal f office. (--JAww- ignat of officer ad finis[ ng Printed nailne of offic r administering oath Title of officer administering oath Forms provided by Texas Ethi Com fission www.ethics.state.tx.us version V1.0.2I/ VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor N Address: Remittance Address: ff I/' Telephone: 9'3r% - ula - 33/D Fax: Email: JMa�il�C,�SI� AC6l(Om Signature of Authorized Represer Printed name of Authorized Rep: ORDER — CONTACT INFORMATION ��•• '. /i_, Order Contact Name &Title: LYANY CGYjyj h G, Of Joe ,Ua nq I)a,Ve 1239-ya6 10, Order Contact Telephone: 113-39a -6m- 7Is -303 -`ASK6 Order Contact Fax: Order Contact Email: C •Cow` Return this form with your bid. Consider and take necessary action to award bids for Road Materials for the period beginning January 1, 2017 and ending June 30, 2017. (MP) Commissioner Lyssy made a motion to award bids for Road Materials for the period beginning January 1, 2017 and ending June 30, 2017 to all low bidders for all precincts. There was no award for Asphalt Patch #1801. Vulcan materials was awarded the bid for PE 5 Aggregate for all Precincts. 4 C Services, Inc. was awarded the bid for Item 247, Limestone-3/4 inch to Dust for all Precincts. 4 C Services, Inc. was awarded the bid for Item 249, Type A Limestone, Grade 3 (1 112 inch) for all Precincts. Rexco, Inc. was awarded the bid for Item 249, Type B (Flexible Processed Base), Grade 3: (MIN PI 6) for all Precincts. Martin Marietta Materials was awarded the bid for Item 302, Type PE (Topping Rock), Grade 3 for Precincts 1, 2, 3, and 4-S. Vulcan Materials Co. SW Division was awarded the bid for Item 302, Type PE (Topping Rock) Grade 3 for Precinct 4-P. Martin Marietta Materials was awarded the bid for Item 302, Type PE (Topping Rock), Grade 4 for Precincts 1, 2, 3, and 4-S. Vulcan Materials Co. SW Division was awarded the bid for Item 302, Type PE (Topping Rock), Grade 4 for Precinct 4-P. Vulcan Materials Co. SW Division was awarded the bid for Item 330, Type D (Pre -Mix Limestone). Quality Hot Mix was awarded the bid for Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy Fritsch, Finster and Judge Pfeifer all voted in favor. 417 Agenda Item for Commissioners' Court —Thursday, December 22, 2016 Consider and take necessary action to award bids for Road Materials for the period beginning January 1, 2017 and ending June 30, 2017. Commissioners' Court, December 22, 2016—Agenda Item #7 7. Consider and Take Necessary Action to award bids for Road Materials for the period beginning January 1, 2017 and ending June 30, 2017. Each Road Material was individually discussed and awarded as follows: Asphalt Patch, #1801: No Award due to one Vendor not returning Form 1295, one Vendor having an incorrect Form 1295, and one Vendor bidding on an alternate product. If this product is ordered, 3 quotes (2 from the vendors that returned a bid on #1801) must be taken for Asphalt Patch #1801 and purchasing from the vendor with the lowest quote on said product. All three written quotes must be attached to PO when the PO is submitted for payment. Purchasing Policy is to be followed. Quotes must be gotten from: (1) Dawn Chemical Corporation, (2) Interstate Products, Inc., and (3) One other Vendor. PE 5 Aggregate Precinct 1: $61.60/Ton — Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 2: $62.35/Ton — Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 3: $63.90/Ton — Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 4-P: $62.35/Ton —Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 4-S: $62.35/Ton —Vulcan Materials Co SW Division (24 Tons Minimum Load) Item 247, Limestone-3/4 Inch to Dust Precinct 1: $24.25/Ton —4 C Services Inc. (25 Tons Minimum Load) Precinct 2: $24.25/Ton —4 C Services Inc. (25 Tons Minimum Load) Precinct 3: $24.25/Ton —4 C Services Inc. (25 Tons Minimum Load) Precinct 4-P: $25.00/Ton —4 C Services Inc. (25 Tons Minimum Load) Precinct 4-S: $25.00/Ton —4 C Services Inc. (25 Tons Minimum Load) Item 249, Type A Limestone, Grade 3 [1'/: Inchl Precinct 1: $24.25/Ton — 4 C Services Inc. (25 Tons Minimum Load) Precinct 2: $24.25/Ton — 4 C Services Inc. (25 Tons Minimum Load) Precinct 3: $25.25/Ton —4 C Services Inc. (25 Tons Minimum Load) Precinct 4-P: $25.00/Ton — 4 C Services Inc. (25 Tons Minimum Load) Precinct 4-S: $25.00/Ton — 4 C Services Inc. (25 Tons Minimum Load) Item 249, Type B (Flexible Processed Base), Grade 3:(MIN PI 6) Precinct 1: $19.50/Ton — Rexco Inc. (25 Tons Minimum Load) Precinct 2: $19.25/Ton — Rexco Inc. (25 Tons Minimum Load) Precinct 3: $22.25/Ton — Rexco Inc. (25 Tons Minimum Load) Precinct 4-P: $22.25/Ton — Rexco Inc. (25 Tons Minimum Load) Precinct 4-S: $20.25/Ton — Rexco Inc. (25 Tons Minimum Load) Item 302, Type PE (Topping Rock), Grade 3 Precinct 1: $58.05/Ton — Martin Marietta Materials (24 Tons Minimum Load) Precinct 2: $58.65/Ton — Martin Marietta Materials (24 Tons Minimum Load) Precinct 3: $60.30/Ton — Martin Marietta Materials (24 Tons Minimum Load) Precinct 4-P: $59.35/Ton —Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 4-5: $57.75/Ton — Martin Marietta Materials (24 Tons Minimum Load) PAGE 1 OF 2 Item 302, Type PE (Topping Rock), Grade 4 Precinct 1: $58.55/Ton — Martin Marietta Materials (24 Tons Minimum Load) Precinct 2: $59.15/Ton — Martin Marietta Materials (24 Tons Minimum Load) Precinct 3: $60.80/Ton — Martin Marietta Materials (24 Tons Minimum Load) Precinct 4-P: $59.35/Ton —Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 4-S: $58.25/Ton — Martin Marietta Materials (24 Tons Minimum Load Item 330, Type D (Pre -Mix Limestone) Precinct 1: $75.60/Ton —Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 2: $76.35/Ton — Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 3: $77.90/Ton — Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 4-P: $76.35/Ton — Vulcan Materials Co SW Division (24 Tons Minimum Load) Precinct 4-S: $76.35/Ton — Vulcan Materials Co SW Division (24 Tons Minimum Load) Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement Precinct 1: $84.00/Ton —Quality Hot Mix (25 Tons Minimum Load) Precinct 2: $84.50/Ton — Quality Hot Mix (25 Tons Minimum Load) Precinct 3: $84.00/Ton — Quality Hot Mix (25 Tons Minimum Load) Precinct 4-P: $85.00/Ton —Quality Hot Mix (25 Tons Minimum Load) Precinct 4-S: $85.00/Ton — Quality Hot Mix (25 Tons Minimum Load) PAGE 2 OF 2 n r r 0 0 0 N N N O O O M M M n r r 0 0 0 N N N � U a D w 0 z0 Uz a LU 2P _~ LU Q U� QO �:w FU IL IL oL) zz U U N N N a a M I/1 v) m w m m 0 s 0 z z z 3 v p a O � 6 = = T Y LLo_coA K v0 m- drt pa v mm.c o'd' IU altioLL mn-10 oQv aWOZ `o- a c 0 c v m y Nm z0. 0.N Io i'Uv O¢� � O N 0 �N d 0� U o Zv ttJFN E�� N E`I:h p Z j - li II A is 3 LL t N y M $LL U�..a U"'0 o (0oK o pQ ) w d W Y d d t t v a 'o I'2)'v gdvU o aLLLLv io�c ZWN Z fn CO Zip II s m UJJ U aMM A uX7 p¢�c fi5aa=_ 'o ui�d O O 0 Q J ¢ J Q J (7 ¢ 0 U Q na Ina Ina � o I(On CC m i z z z o� Ir w a a a r r r 0 0 0 N N N O O O M M M O n n r 0 0 0 N N N < CO U a cl W 0 ZO ozz a W F = ~ Q U� zz H� QO U U U Ul UI N 0 M a a (J1 M v w m v v v m 0 0 3 z z z z � � 0 Z a a c Y LL ooc �0�0 a Os dca ry Op cmmrn ov 10 O Q d N 0 :.: O` U N p� a` 0 t O N N m #Nw 0M0O mbUv O¢W 2aNw M,d 0.0 a ti to 1��3 Za m F.N E�f9 mym E�m 0 Z0t Z5 A li Oo O O LL mam m>.d¢ ylO LU ZWN o 0 N ZaMmv ol0�0 F-aa �77� Zlp llt aJ .00JJO .OMM ) O O 0 Q J Q J Q J U' Q CJ Ina Ina In a o c0 Inn M N N N z z z ow (K � a a a r r r 0 0 0 N N N O O o M M M n n n 0 0 0 N N N � U a w Uz Of ZO a WFU S~ LU Q U� a0 �� wU as oc zz U � U UI a 0 a UI M N N w v m m d m m o 0 0 3 z z z 0 0 O 0—= I_ Z n Y LL O C O �j N 0 3 c 3o v a vmmt day gp Emmm ov ED OMo.@ �jW c_v I ` itof J Y cMv U moo- m� v aLLw cN-ONO ��0� oo Za CO F N E M M w O it V 0 Z7 € li l -&M o.KOOLL SIT 0 it E o.�d¢ nyli,, �naffm M.�.... 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OFFICE USE ONLY Complete Nos, 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-132712 Vulcan Construction Materials LLC San Antonio, TX United States Date Filed: 11/03/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Road Materials supply aggregate materials 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary Vulcan Materials Company Birmingham, AL United States X 5 Check only if there is NO Interested Parry. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty oflterjury, that the above disclosure is true and correct. ADELA WHIT@ . "iiba•., f Texas ` '= public, c NoiarY Expires Exp , mstone My Commimission +E;o° October 20, 2016 S ature of authorized agent of ntracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Swprn to and subscribed before me, by the said '—- ��� ptii (1LS( '?,. ,this the \ D day of 20 to certify which, witness my hand and seal of office. Dr(f CiA 1� - � ht'WA- AA 6� Signature of officer administering oath Printed name of officer administering oath Title of officer admir9tering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-132712 Date Filed: 11/03/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Vulcan Construction Materials LLC San Antonio, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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 services, goods, or other property to be provided under the contract. Road Materials supply aggregate materials 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Vulcan Materials Company Birmingham, AL 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. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 3.295 lofl 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-141646 4C Services, Inc Seadrift, TX United States Date Filed: 11/30/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 010117 Transportation and Sale of Gravel Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary Carpenter, Eric Seadrift, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that theabove disclosure is true and,vorrect. Signature of auth ed agent of contractip usiness entity AFFIX NOTARY STAMP / SEAL ABOVE sworn to and subscribed before me, by the said `;` m , this the I day of 20 r, , to certify which, witness my hand and seal of office. — ` Cto IsPLEYyCmisson ExpiresJanuary 21, 2018 L%M t�., a A£Nt J Signature of officer -administering -oath-- Printed name o officer adm nistering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 left Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-141646 Date Filed: 11/30/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 4C Services, Inc Seadrift, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. 010117 Transportation and Sale of Gravel the contract, and provide a 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Carpenter, Eric Seadrift, 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. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-141719 Rexco, Inc. Port Lavaca, TX United States Date Filed: 12/01/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. the contract, and provide a Road Materials Aggregate 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. `spar ot� LEAN STRANDS My Commission Expires August 12, 2018 Signaru`re of authorized agent of contracting business entity M,1 AF -y1�l Sworn o and subscribed before me, by the said --f�P S�(�l,l ✓t'\ this the 20 ' , to certify which, witness my hand and seal of office. )--... �I , day of Leah Stl,.4 gnature 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 V1.0.277 CERTIFICATE OF INTERESTED PARTIES FoRm 1295 Intl Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-141719 Date Filed: 12/01/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Rexco, Inc. Port Lavaca, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being tiled. Calhoun County 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 services, goods, or other property to he provided under the contract. Road Materials Aggregate 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 3.295 lofl 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-141063 Martin Marietta San Antonio , TX United States Date Filed: 11/29/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Road Materials 010117 - 063017 Road Materials, Contract Date 010117 thru 063017 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct, A&OL•OC-!0'/tt'NII00 AYNiI !D 31Y19.011MN A W10M wi3s a Aanr Signature of authorized absht of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE M1 Sworn to and subscribed before me, by the said ( G 'P rid, I, , this the day of LWj i A ° 20 LQ , to certify which, wimee s my hand and seal of office. Sigma r f officer a inistering oath Printed a of officer administering oath Title of officer administering oath / � Fqtorf§ provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-141063 Date Filed: 11/29/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Martin Marietta San Antonio , TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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 services, goods, or other property to be provided under the contract. Road Materials 010117 - 063017 Road Materials, Contract Date 010117 thru 063017 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 left 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-134928 Quality Hot Mix, Inc. El Campo, TX United States Date Filed: 11/09/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Road Materials Bid Road Materials Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary Snyder, Jeffrey El Campo, 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. i Nolary Public, State of Texa;la, qA11- A— ' 1,Q;_ tH My Commi>sion Expires '`siFoitii;x' October 4, 2018 Signature auth zed gent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE n C ,,I Sworn to and subscribed before me, by the said J ✓i U �r , this the _G day of N uveW ()9 r, 20 , to cer ity which, witness my hand and seal of office. 'l ak (( NN IInn'' Signature of officer administering oath tinted name of officer administering oath Title of officer administerindloath Forms provided by Texas Ethics Commission www.ethics.state.tx.us version v1.D.21 i CERTIFICATE OF INTERESTED PARTIES FORM 1295 l ul l Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-134928 Date Filed: 11/09/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Quality Hot Mix, Inc. El Campo, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County 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 services, goods, or other property to be provided under the contract. Road Materials Bid Road Materials 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Snyder, Jeffrey El Campo, 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. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.2// LAILHUUN CUU►V I Y, I LAA.5 ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: DAWN CHEMICAL CORPORATION MIKEST GEORGE 3325 W KIEHNAU MILWAUKEE WI 53217 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1 - Fairgrounds Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity 1 ' 90 = '43 %Ar-9 per each 5 Gallon Pail �� = S , 'LGper each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 11 1/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min P16) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature : /' <ic-ba Date of Bid: !%-z 3 "-/4 Notes: siM / re?5-' clE /! Return this form with your bid. re'�ht A107_,Zirc1a4d eX PAGE 1 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: DAWN CHEMICAL CORPORATION MIKE ST GEORGE 3325 W KIEHNAU MILWAUKEE WI 53217 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 - Six Mile Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1— 3 = 11111�,57,'o per each 5 Gallon Pail Quantity =4rJ� • ZD per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid Package and fuflv understands and has followed all s eci ications and general conditions. Authorized Signature &Title &0'&_ "".��I2 Type Name & Title of Authorized Signature: Date of Bid: //— Z 3 —/L Notes: Return this form with your bid. �re<d )- I- NeD T jn c t(td -X PAGE 2 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: DAWN CHEMICAL CORPORATION MIKE ST GEORGE 3325 W KIEHNAU MILWAUKEE WI 53217 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1-143 #5-7, 4�'D per each 5 Gallon Pail Quantity 4 per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature: Date of Bid: // "% h l6 Notes:IVGL /�'LGS�e Return this form with your bid. 7 rlo7` iheltt1- PAGE 3 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: DAWN CHEMICAL CORPORATION MIKE ST GEORGE 3325 W KIEHNAU MILWAUKEE WI 53217 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-13 -Port O'Connor Area -Stockpile or Jobsites Asphalt Patch, #1801 Quantity 14per each 5 Gallon Pail Quantity,=s`�,!—� per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch) per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name&Title of Authorized Signature: Date of Bid: /I�2'r Ib Notes: GL PrfC_& Return this form with your bid. 7C i?-ht A/07-..L ✓1C—It �G PAGE 4 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: DAWN CHEMICAL CORPORATION MIKE ST GEORGE 3325 W KIEHNAU MILWAUKEE WI 53217 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - Seadrift Area -Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1— = ,&57.190 per each 5 Gallon Pail Quantity �f`F =R .5`�.2-4er each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch) per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bfd Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature Date of Bid: //— 2- 3 — /b Notes: r Return this form with your bid. PAGE 5 of 5 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: Address: /2�' �, ,S32-flr� Remittance Address: ?Ca ) 70 V -7 lweza 3 2!7 Telephone: 911�4 - 122-0 3CJ3y Fax: Yly 11/5Y Email: Signature of Authorized Representative Printed name of Authorized Rep: /'l ` c h a le-1 6' 'elfy iro ORDER - CONTACT INFORMATION Order Contact Name & Title: Order Contact Telephone: rA9 - .32.7 - 3,0,-32 Order Contact Fax: q l q - 2 26r- / Order Contact Email: Al' kr (C d a, wa may►, e�In i'c-g0 - C cmyq Return this form with your bid. CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: Interstate Products Inc 6561 Palmer Park Circle Suite A Sarasota, FL 34238 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1- Fairgrounds Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = 1.34'Sb per each 5 Gallon Pail Quantity `-' `'I =1,,A q � q I per each 5 Gallon Pail Quantity S— i = 10, VS per each 5 Gallon Pail Quantity '9*- 14'7 per each 5 Gallon Pail PE5Aggregate perTon; Minimum Load Item 247, Limestone-3/41nch to Dust perTon; Minimum Load Item 249, Type A Limestone, Grade 3111/2Inch] perTon; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) perTon; Minimum Load Item 302,Type PE (Topping Rock), Grade 3 perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 perTon; Minimum Load Item 330,Type D (Pre -Mix Limestone) perTon; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement perTon; Minimum Load The undersigned affirms that they are duly authorized to partnership, or individual has read the entire n'f vtt3rtian t Authorized Signature & Title: Type Name & Title of Authorized Signature: KtC)+ br Date of Bid: I 1 "-2pf- f (I Notes: bid and that this company, corporation, firm, Return this form with your bid. PAGE 1 of 5 CALHOUN COUNTY. TEXAS Vendor's Name and Adddress: Interstate Products Inc 6561 Palmer Park Circle Suite A Sarasota, FL 34238 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE -1F HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 - Six Mile Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = /.3t, SG per each 5 Gallon Pail Quantity _ q.°t I per each 5 Gallon Pail Quantity s — I _ 10-7,66 per each 5 Gallon Pail Quantity 1 J 4' _ �� � per each 5 Gallon Pall PE 5 Aggregate perTon; Minimum Load Item 247, Limestone-3/41nch to Dust perTon; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement perTon; Minimum Load The undersigned affirms that they are duly partnership, or Individual has read the enti Authorized Signature & Title: to execute this bid and that this company, corporation, firm, Type Name & Title of Authorized Sl&ature : K iew Date of Bid: //-a c-16 Notes: Return this form with your bid. PAGE 2 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: Interstate Products Inc 6561 Palmer Park Circle Suite A Sarasota, FL 34238 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - stockpile or Jobsites Asphalt Patch,#1801 Quantity 1 per each 5 Gallon Pall Quantity per each 5 Gallon Pail Quantity .5 i = G ' 10- per each 5 Gallon Pali Quantity15M per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4Inch to Dust perTon; Minimum Load Item 249, Type A Limestone, Grade 3 [11/21nch] perTon; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min P16) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade.3 perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 perTon; Minimum Load Item 330, Type D (Pre -Mix Limestone) perTon; Minimum Load item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to ad &cfraoe and fuBv understands and has followed all � Authorized Signature & Title: Type Name & Title of Authorized Signature: 1<10+4-1-- Date of Bid: I lid%" 16 Notes: 1 Return this form with your bid. PAGE 3 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: Interstate Products Inc 6561 Palmer Park Circle Suite A Sarasota, FL 34238 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites Asphalt Patch,#1801 Quantity 1 = 3 ,5JCn per each 5Gallon Pall Quantity 'A % .Il qF N I per each 5 Gallon Pail Quantity S �L _ C�* • 05 per each 5 Gallon Pail Quantity (2 ti— = 9 41, Wper each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/41nch to Dust per Ton; Minimum Load item 249, Type A Limestone, Grade 3 [11/2Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to partnership, or individual has read the entire inuita ri �ar?fi aecMcations and General conditions. , Authorized Signature & Title: Type Name & Title of Authorized Signature: 1'00 F- Date of Bid: // -) c _/ 6 Notes: bid and that this company, corporation, firm, Return this form with your bid. PAGE 4 of 5 CALHOUN COUNTY. TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Aciddress: Interstate Products Inc 6561 Palmer Park Circle Suite A Sarasota, FL 34238 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - Seadrift Area - Stockpile orJobsites Asphalt Patch, #1801 Quantity 1 = - 5� per each 5 Gallon Pail Quantity = / ) * W per each S Gallon Pail Quantity = c^ , 0 per each S Gallon Pail Quantity= 4147pereach 5 Gallon Pail PE 5 Aggregate perTon; Minimum Load Item 247, Limestone-3/4 Inch to Dust perTon; Minimum Load Item 249, Type A Limestone, Grade 3 (11/2Inch) perTon; Minimum Load Item 249, Type 8 (Flexible Processed Base), Grade 3:(Min P16) perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 perTon; Minimum Load Item 330, Type D (Pre -Mix Limestone) perTon; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement perTon; Minimum Load The undersigned affirms that they are duty authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire d#0kafly n to Bid Package and fully understands and has Laftwed all Authorized Signature & Title: Type Name & Title of Authorized Signature : 1< f e /+ I l< EW,6;6Q-6- 7- Date of Bid: 11-9-9 - / & Notes: Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 2016-140709 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Interstate Products, Inc Sarasota, FL United States Date Filed: 11/29/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Texas Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Calhoun County Road Materials Asphalt Patch #1801 4 Name of Interested Party - City,State, Country (Place of business) Nature of interest (check applicable) Controlling Intermediary Calhoun County Port Lavaca, TX United States X 5 Check only if there is NO Interested Party. 6 AFFID I Q t wear, or affirm, u derp ty of perjury, th. t�e above disclosure is true and correct. �J �7❑ RUTHBUCHMRN ,gyp Notary Public - State of Florida • Commission # GG 029856 My Comm. Expires Sep 13. 2020 Signature of authorized agent of 0," Bonded through National Notary Assn. co rat`in usiness entity A F N TRY STAMP/SEAL ABOVE Sworn to and subscribed before me, by the said , this the r� q— day of P ever\bC✓, 204(n. to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: Address: Remittance Address: :2G7A-V /'12D 8 LD cTS F / ki C, A6 M, 2 N 2y Cik2G t.&;— Uvtr DTA -9 4PA Telephone: Tb0 - 0 t/- 72 Y C-' K 7- a q G Fax: �Oo Ll q 0 "6 3D--q Email: �,U7Z�25T f7� p%��TS , CC Signature of Authorized Representative: Printed name of Authorized Rep: ORDER — CONTACT INFORMATION Order Contact Name & Title: Order Contact Telephone: Order Contact Fax: q�© Order Contact Email: AJ02M • W 61�IX Return this form with your bid. CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PTI PAVEMENT REPAIR PRODUCTS CO 9603 PENNINGTON LN MISSOURI CITY TX 77459 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Item Precinct 1 - Fairgrounds Area - Stockpile or Jobsites (Bid Asphalt Patch, #1801 Q0e I P"p AL- iio__rAa0q5_ t f7 iT 1 p 1 ;� oa.G ao p-- IL IT', Quantity 2 1 =4116, a b per each 5 Gallon Pail 56 Quantity -I' =4 9 q, a b per each 5 Gallon Pail Quantity ., �- + _* �') �'�,°U per each 5 Gallon Pail Quantity1 0-3+ =f%aRb per each 5Gallon Pall PE5Aggregate per Ton; Minimum Load Item 247, Limestone-3/41nch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rack), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) perTon; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Pagkaae and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature: nxyiA Date of Bid: 11- ) q - 3011 Notes: Return this form with your bid. PAGE 1 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PTI PAVEMENT REPAIR PRODUCTS CO 9603 PENNINGTON LN MISSOURI CITY TX 77459 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 - Six Mile Area - Stockpile or Jobsites q _ y, Asphalt Patch, #1801 lXO 6?i �+��'�'r { �� �� } li T f OaL a p II"rp, Quantity 1 = I �' b� per each 5 Gallon Pail Quantity 3 6 = cl 9. do per each 5 Galion Pail Qd Quantity '7 a = `I H• per each 5 Gallon Pail Quantity 103 =VT •Oe per each 5Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the a ire Invitation to Bid Packa a and Lull understands and has ollowed all specifications and aeneral conditions. I , Authorized Signature & Title: Type Name & Title of Authorized Signature 6UVk C Date of Bid: Notes: Return this form with your bid. PAGE 2 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PTI PAVEMENT REPAIR PRODUCTS CO 9603 PENNINGTON LN MISSOURI CITY TX 77459 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE -IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - Stockpile or Jobsites Asphalt Patch, #1801 Pv o` i4q 4Li'o-r nc_70_Z. _ l 2,6 )�D quantity 1 = (` 14. °d per each 5 Gallon Pail Quantity i 9.O a per each 5 Gallon Pail Quantity •?ol per each 5 Gallon Pail Quantity 1 u S = q a Ob per each 5 Gallon Pail PE 5 Aggregate perTon; Minimum Load Item 247, Limestone-3/4 Inch to Dust perTon; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] perTon; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 perTon; Minimum Load Item 330, Type D (Pre -Mix Limestone) perTon; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement perTon; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and ful►v understands and has followed all Authorized Signature & Title: Type Name & Title of Authorirze�c,, Date of Bid:—[ t— a-�j ^ ULL 1 V Notes: Return this form with your bid. PAGE 3 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PTI PAVEMENT REPAIR PRODUCTS CO 9603 PENNINGTON LN MISSOURI CITY TX 77459 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites �f "y Asphalt Patch, #1801 4-I�`� I IWtt� 1FA-S r?QTC ` � � rl `7— }� Quantity 1 = 16- o- per each 5 Gallon Pail Quantity q1, "a per each 5 Gallon Pail Quantity -7 a = 1_) • 0o per each 5 Gallon Pail Quantity [ (% = R per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signf ture : �� Date of Bid: 11 `01-9 — � � t7 Notes: Return this form with your bid. PAGE 4 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PTI PAVEMENT REPAIR PRODUCTS CO 9603 PENNINGTON LN MISSOURI CITY TX 77459 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Irte'�m Precinct 4-S - Seadrift Area - Stockpile or Jobsites Asphalt Patch, #1801 O voTt y/ k-L7e-rt-kaqC- as�`�Qtf� PIS VIT 7 Quantity 1 = $ I) �' 1,0 per each 5 Gallon Pail Quantity �L=1 41r1.66 per each 5 Gallon Pail Quantity 7 A =� q'-( 00 per each 5 Gallon Pail Quantity�= D .00 per each 5 Gallon Pail PE5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invi Lion to Bid Packa a and fully understands and has ollowed all specifications and general conditions., Authorized Signature & Title: Type Name & Titleof iAiuthorized Sign ture I : _ Date of Bid: l 1 .` tl ^ J2 ( b Notes: Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 lofl 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-140891 PTI Pavement Repair Products Missouri City, TX United States Date Filed: 11/29/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 1/112017 thru 6/30/2017 Asphalt Patch, #1801 and similar 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Jennings, David Missouri City, 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. a" Notary ` Notary 10 if 12f,�?3995 My commissmn. upIres 2.[ December 28. 2019 (Or,�-J "+no,."'� Signature 'orvuthorized agent of contrvting business enti AFFIX NOTARY STAMP / SEAL ABOVE """ ,�,,�� InJ . day of r� Sworn to and subscribed before me, by the said C`� �)A I this the (� �!— h 2011-11_, to certify which, witness my hand and seal of office. G, Signature of officer administering oath Panted name of officer administering oath Title of GWer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: Address: t�ccv�I��nT Re - q 603 't?aaYt 1'YXAT7n Ln issovr°, e tTy ` Remittance Address: <A-t Xe- Telephone: Fax: 0- 9 - -j d�. d' -78-1-16�3 Email: �Da�G© c---ra it # oG-i -rkL� ✓t1:�- � 14le-7- Signature of Authorized Representative: a2z / Printed name of Authorized Rep: I l aV �� :1-e I n 01 s ORDER - CONTACT INFORMATION Order Contact Name & Title:: � 1_J O'ytG-3-e— A t YV0 Order Contact Telephone: l a g / �7 3 c� a' Order Contact Fax: (0)- 9_ �_ -7 7 ? L/ e/20-3 ow Order Contact Email: Return this form with your bid. r, install, long-lasting repair material can be applied in warm or cooler 3ed with FastPatch Kicker (accelerator) to ermanent repair that is ready for traffic in a Id of time. DPR has ex( ze-thaw resistant. Easil ough level surfaces. MI reduce traffic interrup ttons;, ellent adhesion, absorbs impact mal site preparation and fast )ns. The product is completely fewl,P; W FastPatch DPR _ Asphalt Repair Kit Easy -to -apply kit for distressed pavement repair (DPR) applications on asphalt. It contains a unique polymer blend of renewable and recycled materials for long lasting repairs. All kits feature recycled content, FastPa green components, easy -to -open pail, for disi and pouch packaging to reduce waste, climat( form a Topping Sand Colors shorty and ist and ult cure tit Return -to -Service Time 43 odorle Less than 45 minutes +e• d1 Recommended. Climate Suitable fo r warm and cooler climates. Roadway Long term repair option for colder climates. Kicker recommended for cooler conditions. QE p7o Product Info 100%Solids Parking L No VOCs (No Odor) Cures Faster Elastometric Cold Applied Warehou: Green Components _ _ VV W V C 0 Walkway, r' T, 2016 wilhunjue Valiap wmpmy. mr;ffhi. Mahad. Fasu'ahi sa - imdemwkof Offanmfte Bcly Comca%. Technical Data Sheet w W V C O Distributed by: PTI Pavement Repair Products 281.778.3223 Partnering through service, innovation, and integrity FastPatch DPR Kit Distressed Pavement Repair DESCRIPTION FastPatch DPR is an easy -to -apply, long-lasting repair material for distressed pavement. It is supplied in complete, ready - to -use kits with a polymer blend of recycled and renewable materials. Each kit comes with two color options of Gray or Black, and topping sand to blend repair areas with the surrounding pavement. It can be applied in warm conditions, or in cooler conditions with the aid of FastPatch Kicker accelerator, to form a permanent repair that is quickly ready for traffic. WHERE TO USE • Roadways—spalls, wheel path areas, approaches and departures • Parking Lots —holes, walkways, broken areas • Warehouses —floors, spalls, loading areas • Sidewalks —trip hazards, walkways, "repair instead of replace' FEATURES AND BENEFITS • EBsyto•Apply—Mix with cordless drill, pour, & finish in minutes • Lasting Repair —Excellent adhesion & absorbs impact • Open to Traffic Quickly —Reduce traffic interruptions • Recycled & Renewable Materials —Sustainable sources • Odorless-100% solids & suitable for indoor applications • Freeze -Thaw Resistant —Long term repair for colder climates Tvoical Properties: PACKAGING COLORS 5-gallon kit Gray or Black YIELD 5-gallon kit - 3.0 US gal (11 Liters) SHELF LIFE 1 year when properly stored. STORAGE Store and ship this product in a clean, dry, low - humidity, shaded or covered environment at 60- 90° F (15.320 C). TECHNICAL INFORMATION VOC, Ibsigal IBM, ASTM 0 2369 0 Viscosity, cps, ASTM 0 4878, mixed Soo Service Temperature, ° F V Cl -30 to 170 04 to 77) Potiffe, min., 70° F (21 ° C) 9 minutes Set Torre In Mau, 700 F (21 ° Cl 12 minutes Tack Free Torre In Mesa, 700 F (21 ° C) 30 minutes Tensile Strength, ASTM 0 412 1100 psi Elongation, ASTM 11412 60% Hardness, Shore A, ASTM 0 2240 BOA Adhesion, ASTM 0 7234 800 psi, 100% substrate failure Sat Time - TOW. OF I•C) Set Torre (min.) With Optional FastPatch Kicker (11 oz.) 110 (401 7 3 75(21) 30 18 40(101 80 40 Process Parameters: Ratio by Volume 1 to 1 (resin to ISO) Application Temp ° F (° CI 40 to 105 (4 to 40) Application Method Mechanical mix & pour Recommended Thickness > 114 in. (0.635 cm) Recommended Repair Area <161t211.49m2I. APPLICATION PAVEMENT PREPARATION 1. Pavement must be structurally sound (200psi or greater according to ASTM 072341, clean (ASTM 042581, and dry (less than 5%, ASTM E1907). 2. Moisture or all in rBpair areas will result in poor adhesion. Apply product only if surface is dry and ambient temperature is 5° F (30 Cl above dew point. 3. Remove all contaminants le.g., oil, dust, sand, moisture) from surface for proper adhesion. 4. For maximum adhesion, profile surface according to ICRI Guide 0373Z to a minimum of CSP 3, by abrasive blasting. 5. Shape spall perimeter into a square by saw cut, 13 inches (2.54.1.6 cod deep. Hammer 115 It) repair area and remove debris. Remove all loose tabor. Exposed non-moving rebar can remain. Maximum recommended repair size is less than 16 ft' (1.4901. 6. Use a minimum 120 PSI continuously dry compressed air to blow out loose debris, dirt and dust prior to applying product. Moist pavement can be torched dry. If moisture returns immediately after torching, stop and do not install FastPatch in this area. 7. Use a steel bristle brush to remove dirt on vertical and horizontal pavement surfaces. Use a minimum 120 PSI continuously dry compressed air to blow out repair area, prior to applying product. 8. As necessary, plug all gaps or joints surrounding the repair area withfoam. 9. Protect surrounding surfaces to the repair area with tape to prevent contamination. 10.Pdming all surfaces with POLYPrime is recommended to strengthen bonding Surface and maximize adhesion. Refer to primer TOS sheets for detailed instructions. 11.Honor all moving joints or moving cracks in the repair area by saw -cuffing after FastPatch has cured or installing form board during application. Joints or cracks without movement do not require honoring. Contact manufacture for more details. 0TRERMATERIAIS 1. Previously installed polymer materials most be tested to determine hest method of preparation for acceptable adhesion. Typically, methods will include solvent cleaning, abrading, and vacuuming surfaces. 2. Avoid installing FastPatch on bare ground, dirt, grass or other non- structural surfaces. Applications surfaces must be dry. PROCESSING 1. Precondition Kits to 70OF (21 °C) for 24 hours before use. 2. For colder temperture conditions, use FastPatch Kicker to shorten cure time. Kits can he heated up to 100°F (38°C) to speed cure at colder temperatures. 3. Store all components at 70OF (21°CI while preparing repair area and during application. Cold kits will not flow or level properly, and cure time will he slow. 4. Check that primed surfaces are ready for application before mixing and applying Fastpatch. 5. Protect surfaces around the repair area with tape to prevent contamination of surrounding surface. 6. Place mixing station a short distance from the application area. 7. Wear gloves and safety glasses while mixng and applying material. 8. Attach a clean, "eggbeater -style" mixing paddle to a mechanical drill with a minimum of 50ORPM. 9. Use entire kit and do not divide. APPLICATION 1. Remove contents of FastPatch kit and leave aggregate in the bucket. 2. Open Part A package and pour over aggregate. Mix 3 minutes. 3. OPTION 1: For gray, mix Part B with aggregate mixture. OPTION 2: For black, add BLACK pigment to aggregate mixture then add Part B. OPTION 3: For speeding system, add FastPatch Kicker to aggregate mixture then add Part B. FastPatch Kicker is sold separately, and recommended in cold weather. 4. Mix for 2 minutes. Scrape sides and bottom while mixing. MATERIAL WILL NOT SET IF POORLY MIXED. Signs of poor mixing include dark swirls and tacky material that does not solidify. 5. Immediately pour in area. Level to surrounding surface. 6. After 10 minutes, sprinkle NATURAL or BLACK topping sand to match surrounding surfaces. 7. Material is typically ready for traffic in 1-hour at 70OF 1210C). Calder temperatures will slow cure. Warmer temperatures will speed cure. SKID RESISTANCE: It is the responsibility of the Applicator to ensure product meets minimum skid resistance requirements. Refer to the agency or and -user friction management policy or specifications to determine minimum skid resistance and test method requirements. Aggregate (Sand, pumice, flint) can be added topically at the gel stage or Fastpatch can he ground, sanded or abraded to achieve any necessary skid resistant texture. CLEANING & MAINTENANCE Clean equipment with POLYGuik' Cleaner or acetone immediately after use. Cured material must he removed mechanically. HEALTH AND SAFETY Before handling, you should become familiar with the Material Safety Data Sheet (MSDS) regarding the risks and safe use of this product. To obtain an MSDS please call 800 333 9826 or send an email to: msds@wilvaco.com. Distributed by: PTI Pavement Repair Products www.pavepatch.com 281.778.3223 TEST RESULTS ARE TO BE CONSIDERED AS REPRESENTATIVE OF CURRENT PRODUCTION AND SHOULD NOT BE TREATED AS SPECIFICATIONS. WHILE ALL THE INFORMATION PRESENTED IN THIS DOCUMENT IS BELIEVED TO BE RELIABLE AND TO REPRESENT THE BEST AVAILABLE DATA ON THESE PRODUCTS, NO GUARANTEE, WARRANTY, OR REPHESENTATION IS MAX INTENDED, OR IMPLIED AS TO THE CORRECTNESS OR SUFFICIENCY BE ANY INFORMATION, OR AS TO THE SUITABILITY OF ANY CHEMICAL COMPOUNDS FOR ANY PARTICULAR USE, OR THAT ANY CHEMICAL COMPOUNDS OR USE THEREOF ARE NOT SUBJECT TO A CLAIM BY A THIRD PARTY FOR INFRINGEMENT OF ANY PATENT OR OTHER INTELLECTUAL PROPERTY RIGHT. EACH USER SHOULD CONDUCT A SUFFICIENT INVESTIGATION TO ESTABLISH THE SUITABILITY OF ANY PRODUCT FOR ITS INTENDED USE. PROPER APPLICATION IS THE RESPONSILBITY OF THE USER. AS WITH ANY PRODUCT THE USE OF THE THIS PRODUCT IN A GIVEN APPLICATION MUST BE TESTED ONCLUDING BUT NOT UNITED TO FIELD TESTINGI IN ADVANCE BY THE USER TO DETERMINE SUITIBILITY. TESTING IS THE REOUIREMENT OF BOTH ENGINEERS AND CONTRACTORS ALIKE. WVCO DOES NOT WARRANT THE APPUCATIDN UNDER ANY OR ALL CIRCUMSTANCES. WILLAMETTE VALLEY COMPANY www.wilvaco.com info@wilvaco.com DIVISIONS WESTERN DIVISION 1075 Arrowsmith Street PO Box 2280 Eugene, OR 97402 Tel 541 A84.9621 www.POLYGUIK.com www.SPIKEFAST.com EASTERN DIVISION 6662 Marbut Road Lithonia, GA 30068 Tel 888.878.9826 MIDWEST DIVISION 1549 Hwy 2 Two Harbors, MN 55616 Tel 218.834.3922 PRECISION TECHNOLOGIES DIVISION 675 McKinley Street Eugene, OR 97402 Tel 641.484.2368 www.pre-tee.com SOUTHERN DIVISION 100 Dixie Mae Drive PO Box 4450 Pineville, Louisiana 71361 Tel 318.640.5077 SUBSIDIARIES CANADIAN WILLAMETTE 19081- 27" Avenue Surrey BC V3S 51`1 Tel. 800.663.4298 ECLECTIC PRODUCTS INC. Corporate Office 1075 Arrowsmith Street Eugene, OR 97402 Tel 641.284.4667 www.eclecticproducts.com IDAHO MILL &GRAIN 445 North 430 West Hwy PO Box188 Malad City, Idaho 83252 Tel 208.766.2206 TAPEL WILLAMETTE LTD. SA. AV. Estero La Posada 3625 Parque Industrial Coronet Coronet, Chile Tel 011.56A I2.928.100 www.tapel.cl E6WTA Revision Data: March 2014 C.ALHUUIV LUUIV I Yr I tAAJ ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: 4C SERVICES INC PO BOX 699 SEADRIFT TX 77983 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1 - Fairgrounds Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to DustN, as perTon; Minimum Load Item 249, Type A Limestone, Grade 3 (1 1/2 Inch) S q n r per Ton; Minimum Load OC Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all s ecifications and general conditions. n Authorized Signature & Title: Type Name & Title of Authorized Signature: erne- �ccgeajrr — 1ye6 Date of Bid: Ii/3o%ICo Notes: Return this form with your bid. PAGE 1 of 5 L/4LP1UU1VLUU►VIYj ICAHJ ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: 4C SERVICES INC PO BOX 699 SEADRIFT TX 77983 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 - Six Mile Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust nnU O� / . 0-per Ton; Minimum Load a 5- Item 249, Type A Limestone, Grade 3 11 21nch yp ( / ] r� a5 4Lt(• per Ton; Minimum Load 57 Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature: f%ric earU vtkr - PMS Date of Bid: II/M/1(" Notes: s Return this form with your bid. PAGE 2 of 5 L/4Lf7VUIV LUUIV I r, I L:AAa ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: 4C SERVICES INC PO BOX 699 SEADRIFT TX 77983 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area -Stockpile orJobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust• s per Ton; Minimum Load 025- Item 249, Type A Limestone, Grade 3 [11/2 Inch] 5 ���� per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorize( Date of Bid: Notes: Return this form with your bid. PAGE 3 of 5 LAL►7VU►V LUUIV ► Y, ► L:AA3 ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: 4C SERVICES INC PO BOX 699 SEADRIFT TX 77983 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust nnC_ d JI per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 (11/2Inch] 0?5 0-0 �JS per Ton; Minimum Load �t Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid Package and fully understands and has followed all specifications and general conditions . " _ Authorized Signature & Title: v �7 Type Name & Title of/Authorized Signature : �'L is�MectiYr — I"ft5 Date of Bid: Jl / �lk Notes: Return this form with your bid. PAGE 4 of 5 LALY►UUIV LUU►V► Yj ►CAA3 ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: 4C SERVICES INC PO BOX 699 SEADRIFT TX 77983 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - Seadrift Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust �rr77S� per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/21nch] c� O(-, per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: �L f — Type Name & Title of Authorized Signature: Z r Date of Bid: 1/f30 Notes: Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-141646 4C Services, Inc Seadrift, TX United States Date Filed: 11/30/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 010117 Transportation and Sale of Gravel Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Carpenter, Eric Seadrift, 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 disclosurZtrue orrect. 11� Signature of auth 99ed agent of contracts usiness entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said l� '1.r1.4 �� l_dail).z� , this the I day of k7PCv..�aw 20to certify which, witness my hand and seal of office ;ow`YP CATHY EPLEY ® My Commission Expires January 21, 2018 t � A l 'c �i�QN i t�lr Signature o offieer-adinistegay-oatFr-- Printedname offic r at nlstering oath Tttle of officer admn5 termg oath T a Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: 9C AC, Address: ISod III I;r 11 �SearQ� �+,T '29293 Remittance Address: F0 d&x 6`l9 5eJ,aV'+ ,T ??983 Telephone: 9?7 R161 aZ3el7 Fax: Email: �cacpen c "e �LSeN��e• caM Signature of Authorized Representative:61 Printed name of Authorized Rep: 9;-. ��enlpr ORDER — CONTACT INFORMATION Order Contact Name & Title: el0.yso2 (�f Order Contact Telephone: 979 a?Iy oo36 Order Contact Fax: Order Contact Email: Return this form with your bid. {.HL/7UU/V t'UU1V J ►, t CAHJ ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: MARTIN MARIETTA MATERIALS 5710 W HAUSMAN RD STE 121 SAN ANTONIO TX 78249 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1 - Fairgrounds Area -Stockpile orJobsites Asphalt Patch, H1801 Quantity NQ BI�Q per each 5 Gallon Pail Quantity RO�v +D per each 5 Gallon Pail Quantity hIQ BI= per each 5 Gallon Pail QuantityNf) RID_ per each 5 Gallon Pail PE 5 Aggregate NO BI®per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust pp�� I O Byer Ton; Minimum Load Item 249, Type A Limestone, Grade 3 (11/21nch] NO__STDerTon; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min P16) -No BI1pr Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 �1 �IyV_ O5' per Ton; Minimum Load �',µl Item 302, Type PE (Topping Rock), Grade 4 U � per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) .. per Ton; Minimum Load 1 (V Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement NO BID per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title Date of Return this form with your bid. PAGE 1 of 5 ILALPIVUIV LLIUIV I r, I CAAJ ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: MARTIN MARIETTA MATERIALS 5710 W HAUSMAN RD STE 121 SAN ANTONIO TX 78249 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item 2 - Six Mile Area - Stockpile or Jobsites g�Precinct EJID Asphalt Patch, #1801 Quan#9 = per each 5 Gallon Pail Quantity per each 5 Gallon Pail Quantity per each 5 Gallon Pail Quantity B - per each 5 Gallon Pail PE5Aggregate NO BIyTerTon; Minimum Load BID Item 247, Limestone-3/4 Inch to Dust N® per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch] D Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) PPper —Dvepgr Ton; Minimum Load 'yt�` � 5up Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load 1 RN I� 2 4 Item 302, Type PE (Topping Rock), Grade 4 J �• per Ton; Minimum Load I "N 330, Type D Limestone) I u • Load 2I — I Item (Pre -Mix per Ton; Minimum Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: � IlVkM- Type Name & Title of Autthhgriz/e_d Signature: 911 � Date of Bid: I �91 1 I 169 Notes: Return this formwithyour bid. PAGE 2 of 5 LALr1VU/V C.VUIVJ r, ICA/43 ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: MARTIN MARIETTA MATERIALS 5710 W HAUSMAN RD STE 121 SAN ANTONIO TX 78249 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity N`-1 BID per each 5 Gallon Pail QuantityNJO BM per each 5 Gallon Pail Quantity i l-O--BID__ per each 5 Gallon Pail Quantity, O B per each 5 Gallon Pail PE5Aggregate "'� per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust E�NO Pw 0 BlDper Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch] per Ton; Minimum Load Item 249, Type B yp (Flexible Processed Base), Grade 3: (Min PI 6 ) py� NO BID per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 n/yI O • O per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 `�' O'� per Ton; Minimum Load ��� I �' 7* Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load L"!' Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement CVO BIPer Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid Package and fully understands and has followed aU Authorized Signature & Title: Type Name & Date of Bid: M Return this form with your bid.. PAGE 3 of 5 %.PiLnvvry I.VLr►V I 11 ►GAIAJ ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: MARTIN MARIETTA MATERIALS 5710 W HAUSMAN RD STE 121 SAN ANTONIO TX 78249 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites NOI BI Asphalt Patch, #1801 Quantity = per each 5 Gallon Pail Quantigla = per each 5 Gallon Pail Quantity — per each 5 Gallon Pail Quantity per each 5 Gallon Pail PE 5Aggregate NO BID per Ton; Minimum Load Item 247, Limestone-3/4 inch to Dust erTon; Minimum Load Item 249, Type A Limestone, Grade 3 (11/2 Inch) NO BID Per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) BB Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 /r ^�NO Ul o •/Vjf�, per Ton; Minimum Load v" 1 �+ V O E Item 302, Type PE (Topping Rock), Grade 4 •' per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) I I ql�_ Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement NO BID NO BID erTon; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid Package and fully nunderstands and has followed all s ecifications and general conditions. �ykvv r"vW Authorized Signature & Title: p� Type Name & Title of Authorized Signature: W Date of Bid: I 12q jlG Notes: QQQia't/' 070 Return this form with your bid. PAGE 4 of 5 1.11iLi+7VU1V LUUIV I T j I CAHJ ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: MARTIN MARIETTA MATERIALS 5710 W HAUSMAN RD STE 121 SAN ANTONIO TX 78249 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - Seadrift Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantit ��YqPp°°qq,.= per each 5 Gallon Pail Quantit= per each 5 Gallon Pail Quantity= per each 5 Gallon Pail Qt uanti= per each 5 Gallon Pail PE 5 Aggregate Ra NO Mer Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust NO BID perTon; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch] NO 13ID per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min Pi 6) 140 perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 '//) ' 7'7�[� + t . I perTon; Minimum Load `4t Item 302, Type PE (Topping Rock), Grade 4 —I�,�u,' v. perTon; Minimum Load I t" Item 330, Type D (Pre -Mix Limestone) !•perTon; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement INO BID perTon; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name Date of Bid i R �I Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1or1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-141063 Martin Marietta San Antonio , TX United States Date Filed: 11/29/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Road Materials 010117 - 063017 Road Materials, Contract Date 010117 thru 063017 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. L69014•lgvfl•trllb0Mrsrrocrartl:lVIE1canwl3s •v.�anr Signature of authorized ab4t of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said l5ck this the _C2� day ofm le M, to certify which, witn my hand and seal of office. ;[(0, 0c k e t 0 f o igeraInistering oath Printed a of officer administering oath Title of officer administering oath 59"Afs provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: gad'l MvV`' SJA Address: �116 V' • I I nAm I d • S IV " 12' Remittance Address: Telephone: 2 l 0 2 09 Fax: 216209 Email: Ill)U arciu�(, 7 7 �2fl win, Whs i-toos 152W7W 0 70 0 lP mgt.nwoff 1• coil Signature of Authorized Representative: n ✓f'!� Printed name of Authorized Rep:-��au�� ORDER—rCONTACT INFORMATION Order Contact Name&Title: L� ��' InWc,� Order Contact Telephoner 2 I •2- g° 4 70 Order Contact Fax: 4 o Order Contact Email: 11*w - arawt ma ra-inma Return this form with your bid. CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PRIHODA GRAVEL CO 1210 MEADOW CREEK DR EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1- Fairgrounds Area -Stockpile or Jobsites Asphalt Patch, R1801 Quantity i = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Dmestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) �7 l �8. 95 per Ton; Minimum Load o_4 T DN 5 Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature: HAI'rh n N 0 Date of Bid: t1 x 2 0/4 Notes: Return this form with your bid. OwNeR PAGE 1 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PRIHODA GRAVEL CO 1210 MEADOW CREEK DR EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 -Six Mile Area - Stockpile or Jobsites Asphalt Patch, il1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load a? `I` fO tV5 Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Tittle of Authorized Signature Date of Bid: /V/OJ.1 a DIG Return this form with your bid. PAGE 2 of S CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PRIHODA GRAVEL CO 1210 MEADOW CREEK DR EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2616 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - Stockpile or Jobsites Asphalt Patch, H1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Galion Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) nn d 5o ^ L per Ton; Minimum Load q 7 ON $ Item 302,Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330,Type D (Pre -Mix Limestone) per Ton; Minimum Load item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature: 1-1 N Th Date of Bid: llov.T Di l t, Notes: Return this form with your bid. PAGE 3 of 5 L14Lr1vu1v LUUIV► r, 1tAA.1 ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PRIHODA GRAVEL CO 1210 MEADOW CREEK DR EL CAMPO TX 7767 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE Aggregate perTon; Minimum Load Item 247, Limestone-3/4 Inch to Dust perTon; Minimum Load Item 249, Type A Limestone, Grade 3 [11/21nch] perTon; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min Pi 6) ./ ! 5-perTon; Minimum Load `f / "V5 Item 302, Type PE (Topping Rock), Grade 3 perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 perTon; Minimum Load Item 330, Type D (Pre -Mix Limestone) perTon; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement perTon; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid Package and fuNv understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature: d),Jrlr0 h Date of Bid: h 6-4 _ 7 z 0 I (. Notes: X Return this form with your bid. PAGE 4 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: PRIHODA GRAVEL CO 1210 MEADOW CREEK DR EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - Seadrift Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity i = per each 5 Gallon Pail = per each 5 Galion Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] _ per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) 19.75 per Ton; Minimum Load 1� -/ _/_0 N_S Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type 0, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and hos followed all Authorized Signature & Title: Type Name & Title of Authorized Signature : f-lo-th c Date of Bid: No tl b of 0 14 Notes: Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 left. 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-133740 prihoda el campo , 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 11/07/2016 being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract road material bids Jan.12017 thru june 30 2017 road material bids for Calhoun County Tx. 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, thhat the above disclosure is true and correct. lt2o"L� Pa4' Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE j� `� -I,n� �( Sworn to and subscribed before me, by the said U l r 1 O Y� t-t Y r t OC' a, this the day of ' "�V e rY) �Q r 20 , to certify which, witness my hand and seal of office. I -e,-F a 5 ere 5�, "o Q- UY- Nco{ 0,YH Signature of officer administering oath Printed name of officer administering oath Tide of offic r administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: t Address: 1 M I Remittance Address: Telephone: % 17 - /.5-G Fax: ! 79 _' _J -q - s/v? `- 0 Email: Signature of Authorized Representative: Printed name of Authorized Rep: A D `y hod a ORDER - CONTACT INFORMATION Order Contact Name & Title: Order Contact Telephone:ce119 ! "I - 7.'3 9- - 77,41 o g, ce 9 / 9.a3 s12� Order Contact Fax: VI q I - q 3 7" - 57a 4 Order Contact Email: Return this form with your bid. CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: QUALITY HOT MIX JEFF SNYDER PO BOX 1244 EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1- Fairgrounds Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 - per each 5 Gallon Pail Quantity - per each 5 Gallon Pail Quantity per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate 0 W per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust a q , l j per Ton; Minimum Load a�' J7Vlt 9 Item 249, Type A Limestone, Grade 3 [11/2Inch) I )q,j 5 per Ton; Minimum Load tOn s Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) 0 U per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 A U wper Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 00 %lj. per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) n l o uper Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement A i .6 o per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed a0 Authorized Signature & Title: Type Name & Title of Authorized Signature : -1 ny (IQ P I IY.e;r! P44- Date of Bid: -icy I t E Notes: �, j dv v� f if �;'J v Return this form with your bid. PAGE 1 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS — INVITATION TO BID Vendor's Name and Adddress: QUALITY HOT MIX JEFF SNYDER PO BOX 1244 EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 - Six Mile Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity per each 5 Gallon Pail Quantity= C per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate " g ' per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load &N S Item 249, Type A Limestone, Grade 3 111/2 Inch] per Ton; Minimum Load hOrIS Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) U - per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 aUj per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 —Am U per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) �b% coo per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement 64.�o per Ton; Minimum Load d) -)Z✓! S The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Packa a and fully understands and has ollowed all sped fications and general conditions. n ] Authorized Signature & Title: Type Name & Title of Authorized Signature : l Date of Bid: 1 i k Louis Notes: Return this form with your bid. PAGE 2 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: QUALITY HOT MIX JEFF SNYDER PO BOX 1244 EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity=per each 5 Gallon Pail Quantity = ��� ��(��( ������''111111 per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate 11 t/IX per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust nih Pq-7 i per Ton; Minimum Load Jqfy"K Item 249, Type A Limestone, Grade 3 [11/2Inch] 4 _ per Ton; Minimum Load rrLA �^) 7 Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) �; N O t per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 I 6 [G per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 � tP per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) pp rr,0 q Uper Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement 8UO per Ton; Minimum Load tuns The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature : J ll-" Date of Bid: It to i i (. Notes: Return this form with your bid. res PAGE 3 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: QUALITY HOT MIX JEFF SNYDER PO BOX 1244 EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity = pper each 5 Gallon Pail Quantity I V = CCU( per each 5 Gallon Pail Q,�Fuantity = per each 5 Gallon Pail PE 5 Aggregate M 031 per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust J6, 00 per Ton; Minimum Load C� J Item 249, Type A Limestone, Grade 3 [11/2 Inch] 6.0 6 per Ton; Minimum Load O(i � j Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) A I V E U per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 _q0_1 I per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 0 b tj per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) pp I per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement r C/(1 per Ton; Minimum Load d' The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signatul Type Name & Title of Date of Bid: Return this form with your bid. PAGE 4 of S CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: QUALITY HOT MIX JEFF SNYDER PO BOX 1244 EL CAMPO TX 77437 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - Seadrift Area -Stockpile or Jobsites - Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity per each 5 Gallon Pail Quantity per each 5 Gallon Pail Quantity = per each 5 Gallon Pail j PE5Aggregate 1y6 .D/U per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load <2 4 }ZPA ) Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) ADC per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 u k per Ton; Minimum Load !! Item 302, Type PE (Topping Rock), Grade 4 IVY , per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) Ql] 1(A per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement nn 85 .o0 per Ton; Minimum Load d) r1S The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all Authorized Signature & Title: Type Name & Title of Authorized Signature : v Se ,,\ J" V t Date of Bid: I I I (6 (( 6 Notes: EV4 r) � M 0 FA Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES 1295 FORM loft 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-134928 Quality Hot Mix, Inc. El Campo, TX United States Date Filed: 11/09/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Road Materials Bid Road Materials Nature of interest 4 Name of Interested Party City, State, Country (Place of business) (check applicable) Controlling I Intermediary Snyder, Jeffrey El Campo, 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. i _ .` , Notary Public, Sta?e cf Texa; ' � Expires ',. My Commission october4, 2018 Signature oath zed gent of contracting business entity AFFIX NOTARY STAMP I SEAL ABOVE Sworn to and subscribed before me, by the said J c , this the day of N ovp,4 ! 20 , to ce ify which, witness my hand and seat of office. jd� r-'LiL r n' Signature of officer administering oath rioted name of officer administering oath Title of officer administerincyoath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: Address: � d vw y 19uy E, Cg,ry,y o i-X 7? y 3 7 Remittance Address: sc? Vnz Telephone: 179 S-L(3 q�do Fax: g `Z Q "3 �Z 8 g Email: ?,(1m'q' @ WC 2C - viL, (]' 1- Signature of Authorized Representative: Ih Printed name of Authorized Rep: SQ, t ever ORDER — CONTACT INFORMATION Order Contact Name & Title: -3 WSon 't-Ct45 Order Contact Telephone: �t79 Su3 411" 47cl GWO Order Contact Fax: �'L7 2 143 S-� I � Order Contact Email: Return this form with your bid. CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: REXCO INC 1104 MILDRED DR PORT LAVACA TX 77979 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1- Fairgrounds Area -Stockpile or Jobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) _ Irf, 0 r J per Ton; Minimum Load V"ms Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330,Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has fotlowed a0 s ecifications and general conditions. Authorized Signature & Title: Type Name & Title of Authorized Signature: ;)JC2 n n J, Date of Bid: ad - I Notes: Return this form with your bid. 1-0, V,0' PAGE 1 of 5 CALHOUN COUNTY, TEXAS Vendor's Name and Adddress: REXCO INC 1104 MILDRED DR PORT LAVACA TX 77979 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 -Six Mile Area -Stockpile orJobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each S Gallon Pail = per each 5 Gallon Pall = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) /,� r �� /. 2J / per Ton; Minimum Load 2J JOh S Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all specifications and General conditions. Authorized Signature & Title: Type Name & Title of Authorized Signature: Date of Bid: Notes: Return this form with your bid. V PAGE 2 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: REXCO INC 1104 MILDRED DR PORT LAVACA TX 77979 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pail Quantity = per each 5 Gallon Pall Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) -�77 2, F perTon; Minimum Load 2S OIDq f• Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual hos read the entire Invitation to Bid Package and fully understands and has followed all peclfications and general conditions. Authorized Signature & Title: Type Name & Title of Authorized Signature: ` Pe - Date of Bid: )2:-1 1 � Notes: Return this form with your bid. VP, PAGE 3 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: REXCO INC 1104 MILDRED DR PORT LAVACA TX 77979 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites Asphalt Patch, #1801 Quantity 1 = per each 5 Gallon Pall Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pall Quantity = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) �1 +r �L..oc ?S per Ton; Minimum Load ,CS �6h r. Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fulI understands and has followed all specifications and general conditions. Authorized Signature & Title: Type Name & Title of Authorized Signature V ) S Date of Bid: —1— 1 � Notes: Return this form with your bid. Vp PAGE4of5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: REXCO INC 1104 MILDRED DR PORT LAVACA TX 77979 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - SeadriftArea -Stockpile or Jobsites Asphalt Patch, #1801 Quantity Quantity Quantity Quantity 1 = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5 Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) per Ton; Minimum Load ZJ 1017 S Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid Package and fully understands and has followed all s ecifications and general conditions. Authorized Signature & Title: Type Name & Title of Authorized Signature I,Z�J�tt Date of Bid: 2_1 -I iv Notes: ✓P Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 Soft 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-141719 Rexco,Inc. Port Lavaca, TX United States Date Filed: 12/01/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. the contract, and provide a Road Materials Aggregate 4 Name of Interested Party City, State, Country (place of business) Nature of Interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFIDAVIT 1 swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. ° LEAH STRAWS "� My Commission Expires August 12, 2018 Signa ure of authorized agent of contracting business entity Sworn o and subscribed before me, by the said I�-t4I S K�<K�1./t'1 this the 20 �, to certify which, witness my hand and seal of office. s day of LL&J'AXA:2 Le-411,5fl-A gnature 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 V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name:w,__ Address: JJ� `IY 1 j" h r;,A LL Remittance Address: Telephone: 36 I—" — S3T) Fax: D36(? Email: Signature of Authorized Representative: K ! - Printed name of Authorized Rep: V-)VN-k ORDER — CONTACT INFORMATION Order Contact Name & Title: Order Contact Telephone: j)-3 Order Contact Fax: �0I — ')- - Order Contact Email: iCti<peJ . C. Return this form with your bid. CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: VULCAN CONSTRUCTION MATERIALS LLC PO BOX 791550 SAN ANTONIO TX 78279 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 1 -Fairgrounds Area -Stockpile or Jobsites Asphalt Patch, #1801 (� Quantity 1 = per each 5 Gallon Pail l Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each Gallon Pail PE5Aggregate �� �4 Minimum Load perTon; Item 247, Limestone-3/4 Inch to Dust by perTon; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) perTon; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 �p S� � perTon; Minimum Load Type PE Rock), Grade 4 pp (oO �O �(- Item 302, (Topping per Ton; Minimum Load Limestone) A Mt-2—perTon; Item 330, Type D (Pre -Mix Minimum Load' Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement tJ per Ton; Minimum Load The undersigned affirms that they are duly auth ized to execute this bid and that this company, corporation, firm, partnership, or individual has read the ektire Intiltbtion to Bid Package and fully understands and has followed all _ Authorized Signature & Title: UiY� 1 f �a, Type Name& Title of Authorized Signature: 'SAes Date of Bid: k` �Z)-k to Notes: Return this form with your bid. PAGE 1 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: VULCAN CONSTRUCTION MATERIALS LLC PO BOX 791550 SAN ANTONIO TX 78279 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 2 - Six Mile Area - Stockpile or Jobsites Asphalt Patch, #1801 l Quantity 1 = per each 5 Gallon Pail ,J Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail �� PE5Aggregate per Ton; Minimum Load Item 247, Limestone-3/4 inch to Dust fJ per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2Inch] t per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) 1J per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 5C�3 1 Ton; Load per Minimum Item 302, Type PE (Topping Rock), Grade 4 y� 1 per Ton; Minimum Load rim Limestone) ai35 Item 330, Type D (Pre -Mix per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement N� per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the gntire Invil6tiLon to Bid Package and Cuffy understands and has Lollowed all s ecifications and general conditions . Authorized Signature & Title: SA 4@ M S \ ' 1 - . Type Name & Title of Authorized Signature: V S LAr QS M!6 r`. Date of Bid: ��'�0—Lto Notes: Return this form with your bid. PAGE 2 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: VULCAN CONSTRUCTION MATERIALS LLC PO BOX 791550 SAN ANTONIO TX 78279 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 3 - Olivia Area - Stockpile or Jobsites Asphalt Patch, #1801 p (� Iv Quantity 1 = per each 5 Gallon Pail t Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate q� �/� Ton; Minimum Load O S OF per Item 247, Limestone-3/4Inch to Dust N l per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] 1 per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) ! �J per Ton; Minimum Load Item 302, Type PE Rock), Grade 3 j� 4 OSIs (Topping 1�� per Ton; Minimum Load \ Item 302, Type PE (Topping Rock), Grade 4 to l J per Ton; Minimum Load O�Lj \ \ DnS Item 330, Type D Limestone) �0 ins (Pre -Mix per Ton; Minimum Load \ Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement (\�— V per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read tke entire lnvfttion to Bid Package and fully understands and has followed all Authorized Signature & Title: rp� �LQS r Type Name & Title of Authorized Signature: 10S LCS S CJQ S mq V, _ Date of Bid: kk_\ O —k\0 Notes: Return this form with your bid. PAGE 3 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: VULCAN CONSTRUCTION MATERIALS LLC PO BOX 791550 SAN ANTONIO TX 78279 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-P - Port O'Connor Area - Stockpile or Jobsites Asphalt Patch, #1801 { Quantity 1 = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail PE 5 Aggregate 1 a3S per Ton; Minimum Load \ ons Item 247, Limestone-3/4 Inch to Dust per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [1 1/2 Inch] /(L� 1 per Ton; Minimum Load Item 249, Type B (Flexible Processed Base), Grade 3:(Min Pi 6) Q per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 �`3S per Ton; Minimum Load OL� bfis Item 330, Type D (Pre -Mix Limestone) �� per Ton; Minimum Load -C Dr N Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement NY U per Ton; Minimum Load The undersigned affirms that they are,.duly autf sized to execute this bid and that this company, corporation, firm, partnership, or individual has read flip bnation to Bid Pa and fully understands and has followed all Authorized Signature & Title: [ yft l / W- SCA ps m Type Name & Title of Authorized Signature: Q-Qn o' b A -.i So k e� n� 1�1 Date of Bid: ky kO -k �D Notes: Return this form with your bid. PAGE 4 of 5 CALHOUN COUNTY, TEXAS ROAD MATERIALS - INVITATION TO BID Vendor's Name and Adddress: VULCAN CONSTRUCTION MATERIALS LLC PO BOX 791550 SAN ANTONIO TX 78279 You are invited to submit a bid on the below items to: Michael Pfeifer, County Judge, Calhoun County Courthouse 211 S. Ann St, 3rd Floor, Room 301,Port Lavaca, TX 77979 Bid Period: January 1, 2017 thru June 30, 2017 Bids Due: 10:00 AM, Thursday, December 1, 2016 READ AND FOLLOW SPECIFICATIONS AND GENERAL CONDITIONS PLEASE TYPE - IF HANDWRITTEN, MUST BE IN INK AND LEGIBLE Bid Item Precinct 4-S - Seadrift Area - Stockpile or Jobsites Asphalt Patch, #1801 n \ j ram, Quantity 1 per each 5 Gallon Pail Quantity = per each 5 Gallon Pail Quantity = per each 5 Gallon Pail = per each 5 Gallon Pail PE 5 Aggregate 11Quantity V�_s per Tj on; Minimum Load �L� _oils Item 247, Limestone-3/4 Inch to Dust Q per Ton; Minimum Load Item 249, Type A Limestone, Grade 3 [11/2 Inch] per Ton; Minimum Load _ 1�I Item 249, Type B (Flexible Processed Base), Grade 3:(Min PI 6) fv I Q per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 3 per Ton; Minimum Load Item 302, Type PE (Topping Rock), Grade 4 q �) 1 —' per Ton; Minimum Load Item 330, Type D (Pre -Mix Limestone) to per Ton; Minimum Load Item 334, Type D, Hot Mix Cold Laid Asphalt Concrete Pavement-� per Ton; Minimum Load The undersigned affirms that they are duly authorized to execute this partnership, or individual has read the ntire Invit6ogn to Bid Pack specifications and general conditions.1 Authorized Signature & Title: Type Name &` Title of Authorized Signature: U S Date of Bid: \L'ko-k�0 that this company, corporation, firm, r Return this form with your bid. PAGE 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-132712 Vulcan Construction Materials LLC San Antonio, TX United States Date Filed: 11/0312016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identity the contract, and provide a description of the services, goods, or other property to be provided under the contract. Road Materials supply aggregate materials 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Vulcan Materials Company Birmingham, AL United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of erjury, that the above disclosure is true and correct. ADELA WHITE Notary Public. Stole of Texos `- My Commission Expires '��;9iF o;;%�.�•` October 20, 2018 S ature of authorized agent of nlracting business entity rum• AFFIX NOTARY STAMP / SEAL ABOVE \ j `` Swgrn to and subscribed before me, by the said QJCQT %4\OU( C\PS , this the ` day of 6^^ V DU , 20 \ to certify which, witness my hand and seal of office.. '` Drif0/4 � & I I d elk U. Signature o fficer administering oath Printed name of officer administering oath Title of officer admIrfitering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 a VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: Address: -A`ll SS Remittance Address: _ 9.0 . �3iA j \i Telephone: Sa'A- 3SV-1 Fax: �\O S44- 35S S Email: Signatt Printec ORDER — CONTACT INFORMATION Order Contact Name & Title: Order Contact Telephone: Order Contact Fax: Order Contact Email: Return this form with your bid. Consider and take necessary action to award bids for Insecticides for Mosquito Control for the period beginning January 1, 2017 and ending December 31, 2017. (MP) Commissioner Lyssy made a motion to award bids for Insecticides for Mosquito Control for the period beginning January 1, 2017 and ending December 31, 2017 to all low bidders for all precincts. Target Specialty Products was awarded the bid for Mineral Oil, 50 Gallon Drum for all Precincts. Target Specialty Products was awarded the bid for Mineral Oil, 55 Gallon Drum for all Precincts. Adapco, Inc. was awarded the bid for Mineral Oil, 275 Gallon Tote for all Precincts. Univar USA was awarded the bid for Malathion, 55 Gallon Drum for all Precincts. Univar USA was awarded the bid for Malathion, 260 Gallon Tote for all Precincts. Univar USA was awarded the bid for 30-30 ULV 2 x 2.5 Gallon Case. Adapco, Inc. was awarded the bid for 30-30 ULV 5 Gallon Pail for all Precincts. Univar USA was awarded the bid for 30-30 ULV 30 Gallon Drum for all Precincts. Univar USA was awarded the bid for 30-30 ULV 55 Gallon Drum for all Precincts. Univar USA was awarded the bid for 30-30 ULV 275 Gallon Tote for all Precincts. Adapco, Inc. was awarded the bid for 31-66 ULV 4 x 1 Gallon Case for all Precincts. Target Specialty Products was awarded the bid for 31-66 ULV 2 x 2.5 Gallon Case for all Precincts. Target Specialty Products was awarded the bid for 31-66 ULV 30 Gallon Drum for all Precincts. Target Specialty Products was awarded the bid for 20-20 2 x 2.5 Gallon Case for all Precinccts. Target Specialty Products was awarded the bid for 4-4 ULV 2 x 2.5 Gallon Case for all Precincts. Target Specialty Products was awarded the bid for 4-4 ULV 30 Gallon Drum for all Precincts. Target Specialty Products was awarded the bid for 4-4 ULV 55 Gallon Drum for all Precincts. Adapco, Inc. was awarded the bid for 4-4 ULV 275 Gallon Tote for all Precincts. Adapco, Inc. was awarded the bid for 4-8 2 x 2.5 Gallon Case for all Precincts. Adapco, Inc. was awarded the bid for 4-8 30 Gallon Tote for all Precincts. Adapco, Inc. was awarded the bid for 4-8 275 Gallon Tote for all Precincts. Adapco, Inc. was awarded the bid for Deltagard or Equivalent 2 x 2.5 Gallon Case for all Precincts. Adapco, Inc. was awarded the bid for Deltagard or Equivalent 30 Gallon Drum for all Precincts. Target Specialty Products was awarded the bid for 1.5 ULV 55 Gallon Drum for all Precincts. Univar USA was awarded the bid for Altosid 30 Day Briquets or Equivalent 400 per Case for all Precincts. Adapco, Inc. was awarded the bid for Altosid XR Extended Residual Briquets or Equivalent 220 per Case for all Precincts. Adapco, Inc. was awarded the bid for Fourstar Sustained Release 45/90/180 Day Microbial Briquets or Equivalent 45 Day-200 Case for all Precincts. Adapco, Inc. was awarded the bid for Fourstar Sustained Release 45/90/180 Day Microbial Briquets or Equivalent 90 Day-200 Case for all Precincts. Adapco, Inc. was awarded the bid for Fourstar Sustained Release 45/90/180 Day Microbial Briquets or Equivalent 180 Day-200 Case for all Precincts. Univar USA was awarded the bid for Summit BTI Briquets or Equivalent 100 per Case for all Precincts. Adapco, Inc. was awarded the bid for Sustain MBG Biological Larvicide or Equivalent 40 lb. bag for all Precincts. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. �g Agenda Item for Commissioners' Court —Thursday,, December 22, 2016 Consider and take necessary action to award bids for Insecticides for Mosquito Control for the period beginning January 1, 2017 and ending December 31, 2017. COMMISSIONERS' COURT, DECEMBER 22, 2016—Agenda Item #8 8. Consider and Take Necessary Action to award bids for Insecticides for Mosquito Control for the period beginning January 1, 2017 and ending December 31, 2017. Each Insecticide for Mosquito Control was individually discussed and awarded as follows: • Mineral Oil: 50 Gallon Drum ($300.00) — All Precincts — Awarded to Target Specialty Products 55 Gallon Drum ($352.00) —All Precincts — Awarded to Target Specialty Products 275 Gallon Tote ($1,743.50) —AII Precincts — Awarded to Adapco Inc. • Malathion: 55 Gallon Drum ($2,805.00)—All Precincts —Awarded to Univar USA 260 Gallon Tote ($12,610.00) — All Precincts — Awarded to Univar USA • 30-30 ULV: 2 x 2.5 Gallon Case ($277.45) — Awarded to Univar USA 5 Gallon Pail ($286.25) —All Precincts —Awarded to Adapco Inc. 30 Gallon Drum ($1,664.70)—All Precincts —Awarded to Univar USA 55 Gallon Drum ($3,051.95) —All Precincts —Awarded to Univar USA 275 Gallon Tote ($15,259.75) — All Precincts — Awarded to Univar USA • 31-66 ULV: 4x1 Gallon Case ($517.72) — All Precincts — Awarded to Adapco Inc. 2 x 2.5 Gallon Case ($475.50) —AII Precincts — Awarded to Target Specialty Products 30 Gallon Drum ($2,792.70) — All Precincts — Awarded to Target Specialty Products • 20-20: 2 x 2.5 Gallon Case ($775.00) — All Precincts —Awarded to Target Specialty Products • 4-4 ULV: 2 x 2.5 Gallon Case ($92.40) —All Precincts — Awarded to Target Specialty Products 30 Gallon Drum ($537.00) — All Precincts —Awarded to Target Specialty Products 55 Gallon Drum ($935.00) —AII Precincts — Awarded to Target Specialty Products 275 Galion Tote ($4,254.25) —AII Precincts — Awarded to Adapco Inc. • 4-8: 2 x 2.5 Gallon Case ($165.00) —AII Precincts — Awarded to Adapco Inc. 30 Gallon Tote ($990.00) —AII Precincts —Awarded to Adapco Inc. 275 Gallon Tote (8,800.00)—All Precincts —Awarded to Adapco, Inc. • Deltagard or Equivalent: 2 x 2.5 Gallon Case ($897.50) — All Precincts —Awarded to Adapco Inc. 30 Gallon Drum ($5,210.40) —AII Precincts —Awarded to Adapco Inc. • 1.5 ULV: 55 Gallon Drum ($1,619.20) — All Precincts — Awarded to Target Specialty Products • Altosid 30 Day Briquets or Equivalent: 400 Per Case ($448.00) —AII Precincts —Awarded to Univar USA • Altosid XR Extended Residual Briquets or Equivalent: 220 Per Case ($710.60) —All Precincts— Awarded to Adapco Inc. • Fourstar Sustained Release 45/90/180 Day Microbial Briquets or Equivalent: 45 Day -- 200 Case ($256.19) — All Precincts —Awarded to Adapco Inc. 90 Day -- 200 Case ($426.12) — All Precincts —Awarded to Adapco Inc. 180 Day -- 200 Case ($669.17)— All Precincts — Awarded to Adapco Inc. • Summit BTI Briquets or Equivalent: 100 Per Case ($69.50) —AII Precincts —Awarded to Univar USA • Sustain MBG Biological Larvicide or Equivalent: 40 LB Bag ($206.00) —AII Precincts —Awarded to Adapco Inc. AWARD BID TABULATION FOR INSECTICIDES FOR MOSQUITO CONTROL BY UNIT SIZE ---------------- **** In the event of Tie Bids, the (winning bid is determined per the iTexas Local Government Code i Calhoun County, Texas 262.027(b). )- ---PRECINCTS ----� I TABULATION - INSECTICIDES MOSQUITO- ALL I CT For Period Beginning JANUARY 1 2017 and Ending DECEMBER 31, 2017 Award Yellow Highlight TabulationAwarded the Bid Page 1 of 2 BID ITEM UNIT ADAPCO INC TARGET SPECIALTY PRODUCTS UNIVAR USA CLARKE MOSQUITO CONTROL PRODUCTS INC Mineral Oil 50 Gallon Drum $337.00 ($6.74/Gal): $300.00 ($6.00/Gal) $329.50 ($6.59/Gal) Clarke's Bid was received Late. Bid was Due December 1st. 55 Gallon Drum $354.20 ($6.44/Gal) $352.00 ($6.40/Gal) No Bid Bid was Received December 2nd MALATHION 275 Gallon Tote 55 Gallon Drum $1,743.50 ($6.34/Gal) $2,805.00 ($51.00/Gal) $1,746.25 ($6.35/Gal) No Bid No Bid $2,805.00 ($51.00/Gal) Bid was returned unopened Tie Bids -Award determined by drawing in Commissioners'court 4 or more 55 Gallon Drums $2,805.00 ($51.00/Gal) No Bid $2,805.00 ($51:00/Gal) 260 Gallon Tote $12,610.00 ($48.50/Gal) No Bid $12,610.00 ($4850/Gal) 30-30 ULV 4 or more 260 Gallon Totes 2 x 2.5 Gallon Case $12,610.00 ($48.50/Gal) No Bid $294.70 ($58.94/Gal) $12,610.00 ($48!50/Gal) $277.45 ($55 49/Gal). 5 Gallon Pail $286.25 ($57.25/Gal) No Bid No Bid 30 Gallon Drum $1,691.40 ($56.38/Gal) $1,768.20 ($58.94/Gal) $1,664.70 ($55:49/Gal) 55 Gallon Drum No Bid $3,209.25 ($58.35/Gal) $3,051.95 ($5549/Gal) 31-66 ULV 275 Gallon Tote 30 Gallon Drum $15,312.00 ($55.68/Gal) $4,042.20 ($134.74/Gal) $15,969.25 ($58.07/Gal) $2,792.70 1($93.09/Gal), $15,259.75 ($5549/Gal) $3,746.70 ($124.89/Gal) 4 x I Gallon Case $517.72 ($129.43/Gal) No Bid No Bid 20-20 4-4 ULV 2 x 2.5 Gallon Case 2 x 2.5 Gallon Case 2 x 2.5 Gallon Case $781.15 ($156.23/Gal) $94.45 ($18.89/Gal) $475.50 ($95.10/Gal) ': $775.00 ($155.00/Gal) ! $92.40 ($18.48/Gal) Bid Aqua Kontrol 30-30 For 20-20 $673.75 ($134.75/Gal) No Bid 30 Gallon Drum No Bid - $537.00 `: ($17.90/Gal) - No Bid 55 Gallon Drum $970.20 ($17.64/Gal) $935.00 ($17.00/Gal). $951.50 ($17.30/Gal) 275 Gallon Tote 1 $4254.25 ($15.47/6al) $4,521.00 ($16.44/Gal) $4,757.50 ($17.30/Gal) Calhoun County, Texas BID TABULATION ® INSECTICIDES FOR MOSQUITOCONTROL ® ALL PRECINCTS For Period Beginning JANUARY 12017 and Ending DECEMBER 31, 2017 Page 2 of 2 CLARKE MOSQUITO CONTROL BID ITEM UNIT ADAPCO INC TARGET SPECIALTY PRODUCTS UNIVAR USA PRODUCTS INC 4-8 5 Gallon Pail No Bid No Bid No Bid 2 x 2.5 Gallon Case $165.00 ($33.00/Gal) 30 Gallon Tote $990.00 ($33.00/Gal) No Bid No Bid 275 Gallon Tote $8,800.00 ($32.00/Gal) No Bid No Bid DELTAGARD or Equivalent 2 x 2.5 Gallon Case $897.50 ($179.50/Gal). No Bid No Bid 30 Gallon Drum $5,220.40 ($173.68/Gal) ULV MOSQUITO MASTER 412 OR EQUIVALENT 55 Gallon Drum No Bid No Bid No Bid 1.5 ULV 2 X 2.5 Gallon Case No Bid No Bid No Bid 30 Gallon Drum No Bid No Bid No Bid 55 Gallon Drum No Bid $1,619.20..($29.44/Gal) No Bid ALTOSID 30 DAY BRIQUETS $448.00 Tie Bids -Award determined by drawing in Manufacturer Rebates May Apply Commissioners'Court 400 Per Case See Enclosed Brochure $448.00 $448.00. ALTOSID XR EXTENDED RESIDUAL BRIQUETS - Altosid XR Briquets $710.60 Tie Bids -Award determined by drawing in Manufacturer Rebates May Apply Commissioners Court 220 Per Case See Enclosed Brochure $710.60 $710.60 $256.19 FOURSTAR SUSTAINED RELEASE 45 Manufacturer Rebates May Apply. DAY MICROBIAL BRIQUETS 45 Day --- 200 Per Case See Enclosed Brochure No Bid No Bid $426.12 FOURSTAR SUSTAINED RELEASE 90 Manufacturer Rebates May Apply DAY MICROBIAL BRIQUETS 90 Day --- 200 Per Case See Enclosed Brochure No Bid No Bid $669.17 FOURSTAR SUSTAINED RELEASE 180 Manufacturer Rebates May Apply. DAY MICROBIAL BRIQUETS 180 --- 200 Per Case See Enclosed Brochure No Bid No Bid SUMMIT BTI BRIQUETS 100 Per Case $71.09 $71.60 $69.50 SUSTAIN MBG BIOLOGICAL LARVICIDE - iAquabac4000 Equivalent 40 LB Bag j $206.00 ($5.15/lb). $280.00 ($7.00/lb) No Bid 1 INSECTICIDES FOR MOSQUITO CONTROL WITH ACTIVE INGREDIENTS LISTED r-----------------� !**** In the event of Tie Bids, the winning bid is determined per the !Award Tabulation - !Texas Local Government Code !Tie Bids -Award was determined by 262-027ro):_ _._._ _ _.!draw;nginCommissioners'Coart Calhoun County, Texas ) I TABULATION - INSECTICIDES FOR MOSQUIT TALL PRECINCTS Yellow Highlight = Awarded the Bid Page 1 of 3 For Period Beginning JANUAKY i zui i ana tnamg umor-m r-m s-i, cu-i BID ITEM ACTIVE INGREDIENTS ADAPCO INC TARGET SPECIALTY PRODUCTS UNIVAR USA CLARKE MOSQUITO CONTROL PRODUCTS INC MINERAL OIL- CALPAR 80 N or BVA 13 Paraffin oils, petroleum, catalytic dewaxed light 100% $337.00 / 50 Gal Drum ($6.74/Gal) Clarke's Bid was received Late. MINERAL OIL- CALPAR 80 N or BVA 13 Paraffin oils, petroleum, catalytic dewaxed light 100% $354.20 / 55 Gal Drum ($6.44/Gal) Bid was Due December 1st. MINERAL OIL- CALPAR BO N or BVA 13 Paraffin oils, petroleum, catalytic dewaxed light 100% $1,743.50 / 275 Gal Tote ($6.34/Gal) Bid was Received December 2nd MINERAL OIL-BVA-13 Severely Hydro -treated Paraffinic Oil 100% $300.00/50 Gal Drum ($6.00/Gaq Bid was returned unopened MINERAL OIL-BVA-13 Severely Hydro -treated Paraffinic Oil 100% $352.00/55 Gal Drum ($6.40/Gaq '. MINERAL OIL-BVA-13 Severely Hydro -treated Paraffinic Oil 100% $1,746.25 / 275 Gal Tote ($6.35/Gal) MINERAL OIL- MAX PAR G2 Base Oils MALATHION - FYFANON ULV MOSQUITO Hydrotreated Distillate, Heavy/Light Paraffin 0-100% Malathion 96.5% Other 3.5% $2,805.00/55 Gal Drum ($51.00/Gaq $2,805.00 / 4 or more 55 Gal Drums $329.50 / 50 Gal Drum ($6.59/Gal) j$2,805.00 /'55 Gal Drum ($51.00/Gal)y' $2,805.00 / 4 or more 55 Gal Drums MALATHION - FYFANON ULV MOSQUITO 30-30 ULV - PERMANONE 30-30 Malathion 96.5% Other 3.5% Permethrin 30% Piperonyl Butoxide 30% Other 40% $12,610.00/260 Gal Tote ($48.50/Gal) $12,610.00 / 4 or more 260 Gal Totes $286 25 / 5 Gal Pail ($57.25/Gal) $12,610.00/.260 Gal Tote ($48.50/Gal) $12,610.00 / 4 or more 260 Gal Totes 30-30 ULV - PERMANONE 30-30 Permethrin 30% Piperonyl Butoxide 30% Other 40% $1,691.40 / 30 Gal Drum ($56.38/Gal) 30-30 ULV - PERMANONE 30-30 Permethrin 30% Piperonyl Butoxide 30% other 40% $15,312.00 / 275 Gal Tote ($55.68/Gal) 30-30 ULV - EVOLUER 30-30 ULV Permethrin 30%Piperonyl Butoxide 30% Other 40% $294.70 / 2X2.5 Gal Case ($58.94/Gal) 30-30 ULV-EVOLUER 30-30 ULV Permethrin 30% Piperonyl Butoxide 30% Other 40% $1,768.20/ 30 Gal Drum ($58.94/Gal) 30-30 ULV-EVOLUER 30-30 ULV Permethrin 30% Piperonyl Butoxide 30% Other 40% $3,209.25/ 55 Gal Drum ($58.35/Gal) - 30-30 ULV-EVOLUER 30-30 ULV Permethrin 30%Piperonyl Butoxide 30% Other 40% $15,969.25 / 275 Gal Tote ($58.07/Gal) 30-30 ULV - KONTROL 30-30 CONCENTRATE Permethrin 30% Piperonyl Butoxide 30% Other 40% ':$277.45 / 2%2.5 Gal Case ($55.49/Gaq 30-30 ULV- KONTROL 30-30 CONCENTRATE Permethrin 30% Piperonyl Butoxide 30% Other 40% $1,664.70/30 Gal Drum ($55.49/Gal), '.. 30-30 ULV - KONTROL 30-30 CONCENTRATE Permethrin 30% Piperonyl Butoxide 30% Other 40% 1$3,051.95 /55 Gal Drum. ($55.49/Gal) 30-30 ULV - KONTROL 30-30 CONCENTRATE 31-66 ULV - Permanone 31-66 Permethrin 30%Piperonyl Butoxide 30% Other 40% Permethrin 31.28% Piperonyl Butoxide 66%other 2.72% $4,042.20/30 Gal Drum ($134.74/Gaq $15,259.75 /275 Gal Tote ($55.49/Gal): 31-66 ULV-Permanone 31-66 Permethrin 31.28% Piperonyl Butoxide 66%Other 2.72% $517.7214x1 Gal Case ($129.43/Gal) 31-66 ULV - Evoluer 31-66 ULV Permethrin 31.28% Piperonyl Butoxide 66%Other 2.72% $2,792.70 / 30 Gal Drum ($93.09/Gal):. 31-66 ULV - Evoluer 31-66 ULV Permethrin 31.28% Piperonyl Butoxide 66%Other 2.72% $475.50 / 2x2.5 Gal Case ($95.10/Gaq: 31-66 ULV Permethrin 31,28% Piperonyl Butoxide 66%Other 2.72% 1 $3,746.70/ 30 Gal Drum ($124.89/Gal) Calhoun County, Texas BID TABULATION ® INSECTICIDES IT CONTROL L PRECINCTS For Period Beoinnina JANUARY 1 2017 and Ending DECEMBER 31, 2017 Page 2 of 3 CLARKE MOSQUITO CONTROL BID ITEM ACTIVE INGREDIENTS ADAPCO INC TARGET SPECIALTY PRODUCTS UNIVAR USA PRODUCTS INC 20-20 - Aquareslin Permethrin 20.6%Piperonyl Butoxide 20.6%Other 58.8% $781.15 / 2x2.5 Gal Case ($156.23/Gal) 20-20 -AQUALUER 20-20 ULV Permethrin 20.6% Piperonyl Butoxide 20.6%Other 58.8% $775.00 / 2x2.5 Gal Case ($155.00/Gal) Bid Aqua Kontrol 30-30 Instead 20-20 Permethrin 20.6%Piperonyl Butoxide 20.6%Other 58.8% $673.75 / 2x2.5 Gal Case ($134.75/Gal) 4-4ULV -Pursuit 4-44.6^Active Permethrin 4% Piperonyl Butoxide 4% Other 92% $94.45/ 2x2.5 Gal Case ($18.89/Gal) 4-4ULV -Pursuit 4-44.6^Active Permethrin 4% Piperonyl Butoxide 4% Other 92% $970.20/55 Gal Drum ($17.64/Gal) 4-4ULV -Pursuit 4-44.6AActive Permethrin 4% Piperonyl Butoxide 4% Other 92% $4,254.25/ 275 Gal Tote ($15.47/Gal) 4-4 ULV - EVOLUER 4-4 ULV Permethrin 4% Piperonyl Butoxide 4% Other 92.% $92.40 / 2x2.5 Gal Case ($18.48/Gal) 4-4 ULV - EVOLUER 4-4 ULV Permethrin 4% Piperonyl Butoxide 4% Other 92.% $537.00 / 30 Gal Drum ($17.90/Gal) 4-4ULV -EVOLUER 4-4 ULV Permethrin 4% Piperonyl Butoxide 4% Other 92.% $935.00/55 Gal Drum ($17.00/Gal) r 4-4ULV -EVOLUER 4-4 ULV Permethrin 4% Piperonyl Butoxide 4% other 92.% $4,521.00/275 Gal Tote ($16.44/Gal) 4-4ULV-KONTROL4-4 Permethrin 4.6% Piperonyl Butoxide 4.6% Other 90.8% $951.50/55 Gal Drum ($17.30/Gal) 4-4ULV -KONTROL 4-4 Permethrin 4.6% Piperonyl Butoxide 4.6% Other 90.8% $4,757.50/ 275 Gal Tote ($17.30/Gal) 4-8 - Permanone 4-8 Ready to Use Permethrin 3.98% Piperonyl Butoxide 8.48%Other 87.54% $165.00 / 2x2.5 Gal Case ($33.00/Gal) 4-8 - Permanone 4-8 Ready to Use Permethrin 3.98%Piperonyl Butoxide 8.48%Other 87.54% $990.00 / 30 Gal Tote ($33.00/Gal) 4-8 - Permanone 4-8 Ready to Use Permethrin 3.98%Piperonyl Butoxide 8.48%Other 87.54% $8,800.00 / 275 Gal Tote ($32.00/Gal) DELTAGARD Public Health Insecticide Deltamethrin 2%Other 98% $897.50 / 2x2.5 Gal Case ($179.50/Gal) DELTAGARD Public Health Insecticide Deltamethrin 2%Other 98% $5,210,40 / 30 Gal Drum ($173.68/Gal) ULV MOSQUITO MASTER 412 OR EQUIVALENT Chlorpyrifos 12%; Permethrin 4%; Other 84% NO BID NO BID NO BID 1.5 ULV - Vectofos 1.5 ULV Chlorpyrifos 19.36%Other 80.64% $1,619.20 / 55 Gal Drum ($29.44/Gat) $448.00 / Case (400 Per Case) Manufacturer Rebates May Apply ALTOSID 30 DAY BRIQUETS (S) Methoprene 8.62%Other 91.38% See Enclosed Brochure $448.00 / Case (400 Per Case) $448.00:/ Case (400 Per Case) $710.60 / Case (220 Per Case) ALTOSID XR EXTENDED RESIDUAL BRIQUETS - Manufacturer Rebates May Apply Altosid XR Briquets (S) Methoprene 2.1%Other 97.9% See Enclosed Brochure $710.60 / Case (220 Per Case) $710.60 / Case (220 Per Case) Calhoun County, Texas BID TABULATION - INSECTICIDES FOR MOSQUITOCONTROL - LL PRECINCTS For Period Beginning JANUARY 1 2017 and Ending DECEMBER 31, 2017 Page 3 of 3 BID ITEM ACTIVE INGREDIENTS ADAPCO INC TARGET SPECIALTY PRODUCTS UNIVAR USA CLARKE MOSQUITO CONTROL PRODUCTS INC $256.19 / Case (200 Per Case) FOURSTAR SUSTAINED RELEASE 45 DAY Bacillus sphaericus 6%Bacillus thuringiensis subspecies Manufacturer Rebates May Apply MICROBIAL BRIQUETS israelensis 1%Other 93% :See EnclosedBrochure $426.12 / Case (200 Per Case) FOURSTAR SUSTAINED RELEASE 90 DAY Bacillus sphaericus 6% Bacillus thuringiensis subspecies Manufacturer Rebates May Apply MICROBIAL BRIQUETS israelensis l%Other 93% See Enclosed` Brochure $669.17 / Case (200 Per Case) FOURSTAR SUSTAINED RELEASE 180 DAY Bacillus sphaericus 6%Bacillus thuringiensis subspecies Manufacturer Rebates May Apply MICROBIAL BRIQUETS israelensis l%Other 93% See Enclosed Brochure Bacillus thuringiensis subspecies israelensis serotype H-14 SUMMIT BTI BRIQUETS 10.31%Other 89.69% $71.09 / Case (100 Per Case) $71.60 / Case (100 Per Case) $69.50 / Case (100 Per Case) SUSTAIN MBG BIOLOGICAL LARVICIDE - Bacillus thuringiensis subspecies naelensis serotype H-14 5,71% Aquabac4006 Equivalent Other 94.29% $206.00/40Ile Bag ($5.15/lb) Bacillus thuringiensis, subspecies israelensis, strain AM 65-52, SUSTAIN MBG BIOLOGICAL LARVICIDE - Sustain fermentation solids, spores, & Insecticides toxins 2.80%, MBG Equivalent Other 97.20% $280.00 /40lb Bag ($7.00/lb) CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-139988 Target Specialty Products Houston, TX United States Date Filed: 11/27/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Insecticides for Mosq. Control Insecticides for Mosquito Control 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Myers, John Reading, PA United States X Gelting, Bruce Reading, PA United States X Ferguson, Todd Santa Fe Springs, CA United X North, Hilary Reading, PA United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under enal of er u that the above disclosure is true and correct. P ty P jury, atyfitS#grl PUB/ N� }� Signature of authorized agent of contracting business entity p-9�F OF A� AFFIX NOTARY STAMP 1 SE"AL ABI�YP296gi 4p, 03-p3'TT P Q Sworn to and subscribed before me,tiii theAid John MlChaPI NiChnis , this the -, ' day of 20__Z_ to certify which, witness my hand and seal of office. Siffmature 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 V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1af1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-139988 Target Specialty Products Houston, TX United States Date Filed: 11/27/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County Date Acknowledged: 01/18/2017 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. the contract, and provide a Insecticides for Mosq. Control Insecticides for Mosquito Control 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Myers, John Reading, PA United States X Gelting, Bruce Reading, PA United States X Ferguson, Todd Santa Fe Springs, CA United X North, Hilary Reading, PA 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. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www,ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-140456 ADAPCO, Inc. SANFORD, FL United States Date Filed: 11/28/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County, TX Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to be provided under the contract. the contract, and provide a Mosquito Control Insecticides Mosquito Control Insecticides Nature of interest 4 Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Special Professional Products, Inc. Sanford, FL 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. W "THRYN A RUSSELL ` • MY COMMISSION #FF061805 Sin a of authorized agent of contracting 1",!e"r to*A EXPIRES December 7, 2017 9 9 business entity 9 b' �Wl aaa•6r5o Ftoridat4otarySewlcexom AFFIX NOTARY STAMP /SEAL ABOVE -H Sworn to and subscribed before me, by the said ,f .a Ca rtr '7f; v 0-i6EJ-0—J , this the ` day of Ida r`•"'''' ° 20�_, to certify which, witness my hand and seal of office. cYH""Ily t1- t! 5� e7 L- h-91ffiid-ftke 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 V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 Intl Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-140456 Date Filed: 11/28/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. ADAPCO, Inc. SANFORD, FL United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County, TX 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 services, goods, or other property to be provided under the contract. Mosquito Control Insecticides Mosquito Control Insecticides 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) controlling I Intermediary Special Professional Products, Inc. Sanford, FL 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. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-138395 Univar ES Houston, TX United States Date Filed: 11/18/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun county Date Acknowledged: 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 services, goods, or other property to be provided under the contract. vector control products mosquito control 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary - 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. t� STEPHANIE M. SIMNACHER _�, •, My Notaly ID # 130380640 EXpW $aptamber23, 2019 Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE /� Sworn to and subscribed before me, by the said ` Y', i'�t ✓e � ` /O / this the day of 0 '3e- 20�'l.f) , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath l �2_ Forms provided by Texas Ethics Commission www.ethics.state.tx.us version vi.u.zr r CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-138395 Date Filed: 11/18/2016 Date Acknowledged: 01/18/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Univar ES Houston, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. calhoun county 3 Provide the identification number used by the governmental entity or state agency to track or identify description of the services, goods, or other property to he provided under the contract. vector control products mosquito control the contract, and provide a 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CALHOUN COUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL INVITATION TO BID 1ANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form Mineral Oil Calpar 80 N or BVA 13 Price Per Unit/Gallon 50 Gallon Drum $337.00 /per 50 Gallon Drum ( $6.74 per Gallon) 55 Gallon Drum $354.20 /per 55 Galion Drum ($6.44 per Gallon) 275 Gallon Tote $1,743.50 /per 275 Gallon Tote ($6.34 per Gallon) Malathion Fyfanon ULV Price Per Unit/Gallon 55 Gallon Drum $2,805.00 /per 55 Gallon Drum ( $51.00 per Galion) 4 or more 55 Gallon Drums $2,805.00 /per 55 Gallon Drum ( $51.00 per Gallon) 260 Gallon Tote $12,610.00 /per 260 Gallon Tote ($48.50 per Gallon) 4 or more 260 Gallon Totes $12,610.00 /per 260 Gallon Tote ( $48.50 per Gallon) 30-30 ULV Permanone 30-30 Active Ingredients: Permethrin 30%; Piperonyi Butoxide 3076; Other 40% Price Per Unit/Gallon 5 gl Pail Pail 5 2*-2.5-Gallon Case $286.25 /per CjLsa- 2 *4r5-Gallon ( $57.25 per Gallon) 30 Gallon Drum $1,691.40 /per 30 Gallon Drum ( $56.38 per Gallon) 55 Gallon Drum No Bid /per 55 Gallon Drum 275 Gallon Tote $15,312.00 /per 275 Gallon Tote 31-66 ULV Permanone31-66 Active Ingredients: Permethrin 31.28%, Piperonyl Butoxide 66%, Other 2.72% Price Per Unit/Gallon ( No Bid per Gallon) ($55.68/0l per Gallon) 30 Galion Drum $4,042.20 /per 30 Gallon Drum ( $134.74 per Gallon) 4 X 1 Gallon Case $617.72 /per Case - 41 Gallon ( $129.43 per Gallon) Page 1 of 4 CALHOUN COUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL OURG"O INVITATION TO BID JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form 20-20 Aquareslin t- List Insecticide Name Active Ingredients: Permethrin 20.6%; Piperonyl Butoxide 20.6916; Other 58.8% Price Per Unit/Gallon 2 x 2.5 Gallon Case $781.15 /per Case - 2 x 2.5 Gallon ( $156.23 per Gallon) 4-4 U LV Pursuit 4-4 4.6A Active t List Insecticide Name Active Ingredients: Permethrin 4%; Piperonyl Butoxide 4%; Other 92% Price Per Unit/Gallon 2 x 2.5 Gallon Case $94.45 /per Case- 2 x 2.5 Gallon ( $18.89 per Gallon) 30 Gallon Drum No Bid /per 30 Gallon Drum ( No Bid per Gallon) 55 Gallon Drum $970.20 /per 55 Galion Drum ( $17.64 per Gallon) 275 Gallon Tote $4,254.25 /per 275 Gallon Tote ( $15.47 per Gallon) 4-8 Permanone 4-8 Ready to Use <- List Insecticide Name Active Ingredients: Permethrin 3.98%; Piperonyl Butoxide 8.48%; Other 87.54% Price Per Unit/Gallon 2x2.5 gl Case Per 2x2.5 gl Case S4aAer1-Pail $165.00 /per5 Galion Pall ( $33.00 per Gallon) 30 Gallon Tote $990.00 /per 30 Galion Tote ( $33.00 per Galion) S7 totem Ga $8 800.00 /per 6S•glltom-Drum. ( $32.00 per Gallon) rd OR Equivalent Deltagard Public Health Insecticide List insecticide Equivalent .d;e..«• ow. nth.. oaw- Price Per Unit/Gallon 2 x 2.5 Gallon Case 30 gl drum ULV Mosauito Master 412 OR E Price Per Unit/Gallon 55 Galion Drum $897.50 /per Case - 2 x 2.5 Gallons ( $179.50 per Gallon) $5,210.40 /drum 30 gl drum ( $173.68 per Gallon) uivalent List Insecticide Equivalent m A4f? nth., RAN_ No Bid /per 55 Galion Drum ( No Bid per Gallon) Page 2 of 4 CALHOUN COUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL CP GID INVITATION TO BID JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form 1.5 ULV List Insecticide Name Active Ingredients: Chlorpyrifos 19.36%; Other 80.64% Price Per Unit/Gallon 2 x 2.5 Gallon Case No Bid 30 Galion Drum No Bid 55 Gallon Drum No Bid Altosid 30 Dav Briquets OR Price Per Case /per Case - 2 x 2.5 Gallons ( No Bid per Galion) /per 30 Gallon Drum ( No Bid per Gallon) /per 55 Gallon Drum ( No Bid per Gallon) 400 Per Case $448.00 /per case — List Insecticide Name Manufacturer rebates may apply, please see enclosed All Clear Rewards Brochure for details. 2017 Program forthcoming. Altosid XR Extended Residual Briquets OR Equivalent List Insecticide Name Anfl• Inn.cdinnle• M aA.+k- . 11W--. nfh.r 07 UW_ Price Per Case 220 Per Case $710.60 /per case Manufacturer rebates may apply, please see enclosed All Clear Rewards Brochure for details. 2017 Program forthcoming. Fourstar Sustained Release 4S/90/180 Day Microbial Briquets OR Equivalent , List Insecticide Name Price Per Case 45 Day ----- 200 Per Case $256.19 /per case 90 Day ----- 200 Per Case $426.12 /per case 180 Day-----200 Per Case $669.17 /per case Manufacturer rebates may apply, please see enclosed All Clear Rewards Brochure for details. 2017 Program forthcoming. Summit BTI Briquets OR Equivalent List Insecticide Name Price Per Case 100 Per Case $71.09 /per case Page 3 of 4 CALHOUN COUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL CP INVITATION TO BID 01 JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form Sustain MBG Biological Larvicide OR Eauivalent Aauabac400G Eauivalent � List Insecticide Name Price Per Bag 40 lb Bag $206.00 /per bag $5.15/lb ► A request for a bid item does not guarantee that the bid item will be ordered by Calhoun County during the bid period. ► All charges must be included in bid price. ► No other charges may be added to the bid price when invoiced unless noted as an exception on the bid form. Exceptions may disqualify the bid. LIST ANY EXCEPTIONS TO THE GIVEN BID SPECIFICATIONS: None The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bfd package and fully understands and has followed ail speciR Ations and general conditions. Company Name: ADAPCO, Inc. Address: 550 Aero Ln. Authorized Signature & Title: Type Name & Title of Authorized Date of Bid: November 28, 2016 FL 32771 Authorized Remember to include the New Requirement: Form 1295 [see page 5 of the General Conditions) Page 4 of 4 CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of l 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-140456 ADAPCO, Inc. SANFORD, FL United States Date Filed: 11/28/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County, TX Date Acknowledged: 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 services, goods, or other property to be provided under the contract. Mosquito Control Insecticides Mosquito Control Insecticides Nature of interest 4 Name of Interested Party City,State, Country (place of business)(check applicable) Controlling I Intermediary Special Professional Products, Inc. Sanford, FL 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. '" KATHRYN A RUSSELL )� MY COMMISSION #FF067605 L �� Si na a of authorized agent of contracting business enti er r.^�• EXPIRES December 7, 2017 9 9 9 entity (401)09E•0159 Flaritlallote Wlce.com AFFIX NOTARY STAMP /SEAL ABOVE Sworn to and subscribed before me, by the said �A.Snry iR t,Ut1FS�l� , this the :Z g day of N� v �6�,' � 20 14 to certify which, witness my hand and seal of office. it J 16, m/�Y/w /l /[ ISs�7t �ivrh9cr 1�%i �Ar �of officer administering oathofficer 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 V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: ADAPCO, Inc. Address: 550 Aero Ln. Sanford, FL 32771 Remittance Address: PO Box 931574 Atlanta, GA 31193-1574 Telephone: 800-367-0659 Fax: 866-330-9888 Email: bids@myadapco.com Signature of Authorized Representative: Printed name of Authorized Rep: Jason Trumbetta ORDER — CONTACT INFORMATION Order Contact Name & Title: Ksenia Cruey - Customer Service Representative Order Contact Telephone: 877-250-6509 Order Contact Fax: 866-330-9888 Order Contact Email: orders@myadapco.com Return this form with your bid. CALHOUN COUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL INVITATION TO BID JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form Mineral Oil BVA-13 Price Per Unit/Gallon 50 Gallon Drum $300.00 /per 50 Galion Drum 6.00 per Gallon) 55 Galion Drum $352.00 /per 55 Gallon Drum 6.40 per Gallon) 275 Gallon Tote $1,746.25 /per 275 Galion Tote ( 6.35 per Gallon) Malathion Active Ingredients: Malathion 96.5%; Other 3.5% Price Per Unit/Gallon 55 Gallon Drum NO BID /per 55 Gallon Drum (NO BID per Gallon) 4 or more 55 Gallon Drums NO BID /per 55 Gallon Drum (NO BID per Gallon) 260 Gallon Tote NO BID /per 260 Gallon Tote (NO BID per Galion) 4 or more 260 Gallon Totes NO BID /per 260 Gallon Tote (NO BID per Gallon) 30-30 ULV Evoluer 30-30 ULV Active Ingredients: Permethrin 30%; Piperonyl Butoxide 30%; Other 40% Price Per Unit/Gallon 2x2.5 Gallon Case $ 294.70 /per Case - 2 x 2.5 Gallon ( $58.94 per Gallon) 30 Galion Drum $ 1,768.20 /per 30 Gallon Drum ( $58.94 per Gallon) 55 Gallon Drum $ 3 2()g.25 /per 55 Gallon Drum ( $58.35 per Gallon) 275 Gallon Tote $A 5.969.25 /per 275 Gallon Tote 58.07 per Gallon) 31-66 ULV Evoluer 31-66 ULV Active Ingredients: Permethrin 31.28%; Piperonyl Butoxide 66%; Other 2.72% Price Per Unit/Gallon 30 Gallon Drum $2,792.70 /per 30 Gallon Drum ( $93.09 per Gallon) ' ^ '.� vd o.,w. $ 475.50 /per Case -44-4aallen ( $95.10 per Gallon) 2x2.5 Gallon Case 2x2.5 Gallon Page i of 4 CALHOUN COUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL INVITATION TO BID JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form 20-20 Aqualuer 20-20 ULV List Insecticide Name Active Ingredients: Permethrin 20.6916; Piperonyl Butoxide 20.6%; Other 58.8% Price Per Unit/Gallon 2 x 2.5 Gallon Case $775.00 - /per Case - 2 x 2.5 Gallon ( 155.00 per Gallon) 4-4 ULV Evoluer 4-4 ULV List Insecticide Name Active Ingredients: Permethrin 4%; Piperonyl Butoxide 4%; Other 92% Price Per Unit/Galion 2 x 2.5 Gallon Case $ 92.40 /per Case - 2 x 2.5 Gallon ( 18.48 per Gallon) 30 Gallon Drum $ 537.00 /per 30 Gallon Drum ( 17.90 per Galion) 55 Gallon Drum $ 935.00 /per 55 Gallon Drum ( 17.00 per Gallon) 275 Gallon Tote $4,521.00 /per 275 Gallon Tote ( $16.44 per Gallon) 4-8 . List Insecticide Name Active Ingredients: Permethrin 3.98%; Piperonyl Butoxide 8.4891o; Other 87.54% Price Per Unit/Gallon 5 Gallon Pail NO BID /per5 Galion Pail ( NO BID per Galion) 30 Gallon Tote NO BID /per 30 Gallon Tote ( NO BID perGallon) 55 Gallon Drum NO BID /per 55 Gallon Drum( NO BID per Galion) OR Equivalent r List Insecticide Equivalent Price Per Unit/Gallon 2 x 2.5 Gallon Case NO BID /per Case- 2 x 2.5 Gallons ( NO BID per Gallon) ULV Mosquito Master 412 OR Equivalent List Insecticide Equivalent Artivp Inaradipntc. rhinrnvrlfne 499.• Permethrin A9L• nthar A&W Price Per Unit/Gallon 55 Gallon Drum NO BID /per 55 Gallon Drum ( NO BID per Gallon) Page 2 of 4 CALHOUN COUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL 1 iI INVITATION TO BID PIN JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form 1.5 ULV Vectofos 1.5 ULV List Insecticide Name Active Ingredients: Chlorpyrifos 19.36%; Other 80.64% Price Per Unit/Gallon 2 x 2.5 Gallon Case NO BID /per Case - 2 x 2.5 Gallons (NO BID per Gallon) 30Gallon Drum NO BID /per 30 Gallon Drum (NO BID per Gallon) 55 Gallon Drum $1,619.20 /per 55 Gallon Drum ($29.44 per Gallon) Altosid 30 Day Briquets OR Equivalent Altosid 30-Day Briquets « List Insecticide Name Active Ingredients: (S) Methoprene 8.62%; Other 91.38% Price Per Case 400 Per Case $448.00 /per case Altosid XR Extended Residual Briquets OR Equivalent Altosid XR Briquets —List Insecticide Name Active Ingredients: (S) Methoprene 2.1%; Other 97.9% Price Per Case 220 Per Case $710.60 /per case Fourstar Sustained Release 45/90/180 Day Microbial Briquets OR Equivalent —List Insecticide Name Price Per Case 45 Day--- 200 Per Case NO BID /per case 90 Day -- 200 Per Case NO BID /per case 180 Day----200 Per Case NO BID /per case Summit BTI Briquets OR Equivalent Summit BTI Briquets List Insecticide Name Active Ingredients: Bacillus thuringiensis subspecies israelensis serotype H-1410.31%; Other 89.69% Price Per Case 100 Per Case $71.60 /per case Page 3 of 4 'CALHOUN COUNTY, TEXAS INSECTICIDES FOR MOSQUITO CONTROL INVITATION TO BID JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form Sustain MBG Biological Larvicide OR Equivalent Sustain MBG List Insecticide Name Price Per Bag 40 lb Bag $280.00 /per bag No A request for a bid Item does not guarantee that the bid item will be ordered by Calhoun County during the bid period. ► All charges must be included in bid price. ► No other charges may be added to the bid price when invoiced unless noted as an exception on the bid form. Exceptions may disqualify the bid. LIST ANY EXCEPTIONS TO THE GIVEN BID SPECIFICATIONS: The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individual has read the entire Invitation to Bid nackaae and fully understands and has followed all so"fttions and general conditions. Company Name: Target Specialty Products Address: 'I ZZb N. Post UaK Ko., Houston I A t tubb Authorized signature & Title: 14- ,r14 Vector Business Manager Type Name & Title of Authorized Signature: Mike Nichols Vector Business Manager Date of Bid: 11 /28/2016 Remember to include the New Requirement: Form 1295 (seepage 5 of the General Conditions) Page 4 of 4 CERTIFICATE OF INTERESTED PARTIES 1295 FORM loft 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-139988 Target Specialty Products Houston, TX United States Date Filed: 11/27/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County iDate Acknowledged: 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 services, goods, or other property to be provided under the contract. Insecticides for Mosq. Control - Insecticides for Mosquito Control 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary Myers, John Reading, PA United States X Gelting, Bruce Reading, PA United States X Ferguson, Todd Santa Fe Springs, CA United X North, Hilary Reading, PA 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. 4`GF@6tppf V PU �: OO m e Nr }Q e A Signature of authorized agent of contracting business entity 97 1 a tle f OF P x AFFIX NOTARY STAMP I SI AL A6i)VF296q�� o q� f'p� Pkp 03_p3.b� 4e Sworn to and subscribed before meb�ilr thesaid,� John Mirhael NIChOIs ,this the ,2�" day ofV�"0 , 20_4k__, to certify which, witness my hand and seal of office. t (—(LS(70�Mr1 c— Si ature of officer administering oath Printed name of officer administering oath Tide of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: Target Specialty Products Address: 1225 N. Post Oak Rd. Houston, TX 77055 Remittance Address: PO Box 14084 Reading, PA 19612-3848 Telephone: (800)901-9746 or (713)682-4411 Fax: (713)682-4374 Email: mike.nichols(iltarget-specialty.com Signature of Authorized Representative: Printed name of Authorized Rep: Mike Nichols ORDER — CONTACT INFORMATION Order Contact Name & Title: Jeff Bastian, Office Manager (Houston) Order Contact Telephone: (800) 901-9746 or (713) 682A411 Order Contact Fax: (713) 682-4374 Order Contact Email: jeffrey.bastian@target-specialty.com Return this form with your bid. INVITATION TO BID J,4IUUAItI( 1, 2017 thru ®ECEMBER 31, 2017 ® BID FORM MUST BE TYPED -- PLEASE TYPE ® 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form Mineral oil Price Per Unit/Gallon 50 Gallon Drum 321 , 5-!9 /per 50 Gallon Drum ( G , 5-9 per Gallon) 55 Gallon Drum /per 55 Gallon Drum ( per Gallon) 275 Gallon Tote /per 275 Gallon Tote ( per Gallon) Malathion Active Ingredients: Malathion 96.5%; Other 3.5% Price Per Unit/Gallon 55 Gallon Drum 5 , of /per 55 Gallon Drum ( S- toD per Gallon) 4 or more 55 Gallon Drums /per 55 Gallon Drum ( 5—/,ob per Gallon) 260 Gallon Tote /ai (P/y/, Q O /per 260 Gallon Tote ( / �i 5y per Gallon) 4 or more 260 Gallon Totes (,(/� O . 00 /per 260 Gallon Tote ( ` per Gallon) 30-30 ULV - lion}, I 3o- 3o Active Ingredients: Permethrin 30%; Piperonyl Butoxide 30%; Other 40% Price Per Unit/Gallon 2 x 2.5 Gallon Case � /per Case - 2 x 2.5 Gallon ( per Gallon) 30 Gallon Drum 70 /per 30 Gallon Drum (S� `�T per Gallon) 55 Gallon Drum �, p �7/ , cj S /per 55 Gallon Drum (S^ . qV per Gallon) 275 Galion Tote /Z 25-' , 7<� /per 275 Gallon Tote per Gallon) 31-66 ULV Active Ingredients: Permethrin 31.28%; Piperonyl Butoxide 66%; Other 2.72% Price Per Unit/Gallon 30 Gallon Drum Z , 7O /per 30 Gallon Drum (1.2 V. per Gallon) 4 X 1 Gallon Case /per Case- 41 Gallon ( per Gallon) Page 1 of 4 - i • • A i� i h ice♦ '_ `I L i� �� i l�l ! j :� i j� (' ��1 1 ;�. INVITATION TO BID JANUARY 1, 2017 thru DECEMBER 31, 2017 ® BID FORM MUST BE TYPED -- PLEASE TYPE ® 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form 20=2e— 3 r -3 0 A ctAcF-3 0 '3-0 ( Spe r, v {-es Pg `E) , List Insecticide Name n-a.... i---,. a:,... a... n.......,.at,.:.. 9n C01. n:....-.....d o.,a....:A^ 9n Co%. n+k— 94 Qo% Price Per Unit/Gallon 2 x 2.5 Gallon Case 1073, 7� /per Case - 2 x 2.5 Gallon ( 13 Y, ? per Gallon) 4-4 ULV < List Insecticide Name Active Ingredients: Permethrin 4%; Piperonyl Butoxide 4%; Other 92% Price Per Unit/Gallon 2 x 2.5 Gallon Case /per Case- 2 x 2.5 Gallon ( per Gallon) 30 Gallon Drum /per 30 Gallon Drum ( per Gallon) 55 Gallon Drum �j'S—�, SO /per 55 Gallon Drum per Gallon) 17,3 v 275 Gallon Tote/Per 275 Gallon Tote ( 3 J per Gallon) y�s7.5o 4-S t- List Insecticide Name Active Ingredients: Permethrin 3.98%; Piperonyl Butoxide 8.488%; Other 87.54% Price Per Unit/Gallon Y / z 5 Gallon Pail /per 5 Galion Pail ( per Gallon) 30 Galion Tote /per 30 Gallon Tote ( per Gallon) 55 Gallon Drum /per 55 Gallon Drum ( per Gallon) Deltagard OR Equivalent List Insecticide Equivalent Active Ingredients: Deltamethrin 2%; Other 98% Price Per Unit/Gallon 2 x 2.5 Gallon Case /per Case - 2 x 2.5 Gallons ( per Gallon) ULV Mosquito Master 412 OR Equivalent List Insecticide Equivalent Active Ingredients: Chlorpyrifos 12%; Permethrin 4%; Other 84% Price Per Unit/Gallon / 55 Galion Drum /per 55 Gallon Drum ( per Gallon) Page 2 of 4 CALI=OUN COUNT` 9EXAS - WSECTMDES FOR M OSQU U O CONTROL 0j" INVITATION TO BID JANUARY 1. 2017 thru DECEMBER 31, 2017 BID FORM MUST BE TYPED -- PLEASE TYPE D> 5 Copies of the Material Safety Data Sheets for each item laid on Must Be Returned with this Bid Form 1,5 ULV List Insecticide Name Active Ingredients: Chlorpyrifos 19.36%; Other 80.64% Price Per Unit/Gallon Price Per Case 2)(2.5 Gallon Case 30 Gallon Drum 55 Gallon Drum Briquets OR Equivalent /per Case - 2 is 2.5 Gallons /per 30 Gallon Drum /per 55 Gallon Drum 400 Per Case yG/g, t7t7 /per case Altosid XR Extended Residual Briquets OR Equivalent Price Per Case 220 Per Case 7 / 0. (e 0 /per case ( per Gallon) ( per Gallon) ( per Gallon) Eourstar Sustained Release 45/90/180 Day Microbial Briquets OR Equivalent Active Ingredients: Bacillus sphaericus 6%; Bacillus thuringiensis subspecies israelensis 1%; Other 93% Price Per Case /) 9 45 Day ----- 200 Per Case j ( /per case 90 Day ----- 200 Per Case /per case 180 Day-----200 Per Case /per case Summit Biz Price Per Case ets OR Equivalent 100 Per Case (,�, / .5 U /per case F List Insecticide Name t List Insecticide.Name � List Insecticide Name � List Insecticide Name Page 3 of 4 CALHOUNCOUNTY, TEXAS -INSECTICIDES FOR MOSQUITO CONTROL t� CV( INVITATION TO BID JANUARY 1, 2017 thru DECEMBER 31, 2017 ► BID FORM MUST BE TYPED -- PLEASE TYPE ► 5 Copies of the Material Safety Data Sheets for each item bid on Must Be Returned with this Bid Form Sustain MBG Biological Larvicide OR Equivalent List Insecticide Name Isis serotype Price Per Bag , /i 26 40 lb Bag /per bag `/ ► A request for a bid item does not guarantee that the bid item will be ordered by Calhoun County during the bid period. ► All charges must be included in bid price. ► No other charges may be added to the bid price when invoiced unless noted as an exception on the bid form. Exceptions may disqualify the bid. LIST ANY EXCEPTIONS TO THE GIVEN BID SPECIFICATIONS: —o The undersigned affirms that they are duly authorized to execute this bid and that this company, corporation, firm, partnership, or individualhas read the entire Invitation to Bid package and fully understands and has followed all soecffications and general conditions. Company Name: U ki ( m12 6 Ld: Address: LKU2- 07e //9'00-�- L/-/ Authorized Signature & Title: S Type Name & Title of Authorized Signature: M;49 lL 4- 22 6 <6lf s Date of Bid: 11 1 7 16 Remember to include the New Requirement: Form 1295 (see page 5 of the General Conditions) Page 4 of 4 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft Complete Nos, i - 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-138395 Univar ES Houston, TX United States Date Filed: 11/18/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. calhoun county Date Acknowledged: 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 services, goods, or other property to be provided under the contract. vector control products mosquito control 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Parry. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. s . "' STEPHANIE M. SIMNACHER— € My NotaryID#13038WO 44 �`�'„ ¢ t)y,tF Expka9 58pfan16er23, 2019 Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said � l%qy` C �(t'�' ` 1� y this the day of N of e,v�ib•e. 20,to certify which, witness my hand and seat of office. y�GI QM ► QI l9(G�- SLCAD-h;le Slwt mot e r rat �e a' h'� to a 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 V1.0.277 VENDOR INFORMATION Please Type. If handwritten, must be in ink and legible Vendor Name: U)l ( V&2 (4 s Address: T 0.2- <</I 0 r'I-IIJ6/S C Remittance Address: Telephone: — G /�T -� 7& / A Fax: / —c Y5— 153( xcroe Email: M✓yk. OnI nY-7% 6A5.41 CID vet Signature of Authorized Representative: Printed name of Authorized Rep: MIl YlG 7—Hd�W V — ORDER — CONTACT INFORMATION Order Contact Name & Title: my-(L u yCZ(U / Order Contact Telephone: Zce �— Order Contact Fax: a S5-/� ' Order ContactEmail:l2�f��/� Return this form with your bid. Consider and take necessary action to authorize County Treasurer to apply for County Credit Card for newly elected Commissioners and newly elected Sheriff on the first business day of January, 2017. (MP) Commissioner Finster made a motion to authorize County Treasurer to apply for County Credit Card for newly elected Commissioners and newly elected Sheriff on the first business day of January, 2017. Credit Limit is to be $5,000. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Consider and take necessary action on Preliminary Plat and Drainage Plan of Original Townsite of Port O'Connor Outlot 4, Outblock 21, Resubdivision No. 1. (KF) Commissioner Finster made a motion to approve the Preliminary Plat and Drainage Plan of Original Townsite of Port O'Connor Outlot 4, Outblock 21, Resubdivision No. 1. Commissioner Galvan seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Kenneth W. Finster County Commissioner County of Calhoun Precinct 4 December 15, 2016 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: Please place the following item on the Commissioners' Court Agenda for December 22, 2016. • Consider and take necessary action to approve the Preliminary Plat and Drainage Plan of Original Townsite of Port O'Connor Outlot 4, Outblock 30, Resubdivision No. 1. Sincerely, Kenneth W. Finster KWF/at P.O. Box 177 — Seadrift, Texas 77983 — email: kfinster@calhouncotx.org — (361) 785-3141 — Fax (361) 785-5602 December 15, 2016 Kenneth Finster Calhoun County Commissioner Precinct 4 P.O. Box 177 Seadrift, TX 77983 RE: Original Townsite of Port O'Connor Outlot 4, Outblock 30, Resubdivision No. 1(USI job S21885-Posey) Dear Commissioner Finster, Please consider this letter as my request to have the following items placed on the December 22, 2016 Commissioner's Court agenda: Consider and take necessary action to approve the Preliminary Plat and Drainage Plan of Original Townsite of Port O'Connor Outlot 4, Outblock 30, Resubdivision No.1. If I can provide additional information please do not hesitate to contact me. Si erely, Ve T rryT. uddick, R.P.L.S. C.E.O. 2004 N. Commerce Street • Victoria • Texas 77901 • Office (361) 578-9837 • Fax (361) 576-9924 104 E. French Street • Cuero • Texas 77954 • Office (361) 277-9061 • Fax (361) 277-9063 12675 Silicon Drive • San Antonio • Texas 78249 • Office (210) 267-8654 • Fax (210) 267-8704 gg 5�5ii ti�@3y'n yygo€ S&y a€ d' U EEy Qy€ jy§ryp�jy4W pu3 u?u9 N 2n'n tt Q�o o� �a�'a3 a yg�fpo aQg73Wg7,� rP� LL § e ul Mli 3o�g a w so w � °w O_ °Sau C�$� a wga °z "gw CO o m F U b S gw �aa S°ms gp� d m Q Y t rc o 3� i5 j O8 aE a 83 'o� o FY S 00 R os b of O o O �$€� `�w � z8 W °g� �m w €40� £oo g mF U ygyo �gqq§ la-R`s rc bwaw �5 w G53 s SS 3 m €o �f� ¢ o °E �sw R� z p =9oob €3o $ osa y E@a n3'a os w� }- ,z 0� osLLw z �g�s6 $e 2c�n Z O �� z3 d$ s�� 00 '3 5 €�i'3u$ odd N kn N 44c a J '6 BYaol rc S'�S€orF b as as kg 0 E� w£ q q. $ 4a`�g8R�bgG �_ 4�mo "'<so wQ 0 o 5 �`g z �?_ H Z Consider and take necessary action on Preliminary Plat and Drainage Plan of Port O'Connor Outlot 4, Outblock 30, Resubdivision No. 1. (KF) Commissioner Finster made a motion to approve the Preliminary Plat and Drainage Plan of Port O'Connor Outlot 4, Outblock 30, Resubdivision No. 1. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Kenneth W. Finster County Commissioner County of Calhoun Precinct 4 December 15, 2016 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: Please place the following item on the Commissioners' Court Agenda for December 22, 2016. • Consider and take necessary action to approve the Preliminary Plat and Drainage Plan of Original Townsite of Port O'Connor Outlot 4, Outblock 21, Resubdivision No. 1. Sincerely, X yu.V(W, Jyr� Kenneth W.Finster KWF/at P.O. Box 177 —Seadrift, Texas 77983 —email: kfinster@cathouncotx.org — (361) 785-3141 —Fax (361) 785-5602 December 15, 2016 Kenneth Finster Calhoun County Commissioner Precinct 4 P.O. Box 177 Seadrift, TX 77983 RE: Original Townsite of Port O'Connor Outlot 4, Outblock 21, Resubdivision No. 1 (USI job 521542.01-Dollar General) Dear Commissioner Finster, Please consider this letter as my request to have the following items placed on the December 22, 2016 Commissioner's Court agenda: Consider and take necessary action to approve the Preliminary Plat and Drainage Plan of Original Townsite of Port O'Connor Outlot 4, Outblock 21, Resubdivision No.1. If I can provide additional information please do not hesitate to contact me. Sin erely, T rryT. Ru dick, R.P.L.S. C.E.O. 2004 N. Commerce Street • Victoria • Texas 77901 • Office (361) 578-9837 • Fax (361) 576-9924 104 E. French Street • Cuero • Texas 77954 • Office (361) 277-9061 • Fax (361) 277-9063 12675 Silicon Drive • San Antonio • Texas 78249 • Office (210) 267-8654 • Fax (210) 267-8704 s $M M � k .sM Ya 9 . � �� � � F��°w§ �& Q �Si� • imp m �u 3 gg H a��s3gsco€ °sE ss R qw gem- °Emm AI mGIU"3 .0-4.9 r O..$Ta_'a x33 Qg _ T s �w . �$ 8 Boa �i Y O O y O I K QO£ °° 5 bbb t 1§$32 RR E 1'I 4z d IE3E8 x 9ga Mr r ° EE33$ I Z z °k 4 0OQ3 g00 ¢I 66 dHK I � j —.. — - mmw Ion I of g 1 I I. �LLU 2. 3 5 h.axsz xl 1 - I JOO Ob w W JO ,g�.,.�m., % a t - - gLL. r I zo � 1 __-I -I � I I I z I� 13 00 mo 0 0I 9' ianp 3 I§ O fill I 3p I I m3o �€i .tr]'WS M.CO.6C9ZN �j. ZSz i ✓✓�d 2 _ Gilt Uw @ 1 NiI , m®g5a11 gig! 1Rga EI Flii'm ,00'ws �gao,Ncszx I �'� .8 Ory 8 9 'R$$ a€:,ipl!�or°AY h I a 43d`r£6'i F'Aa"9 G 3im'b'�m p �Jpq ��4ax �abEsm gQSBBm.. {'cd� 4 s' i i��1�2o4SAe r o mc�ID�s��a§use o ^ z ffig .&M £z 1 10 $ Pg m$ 3 odSF^aer 6 3o s� naa �9o�oa �s �rvS, Edcm ^m 9^ s w R A Rids . pSdfr.F£ �m n AG 4"'., a iO q }F^ _5 { qqq yy Fd�R`'P d4 -1 F24 ife C§ip bomz�`ma �a m R m3t^.3 §i i UULLgF( L;tNtKAI v� ,j � PORT O'CONNOR, TEXAS Ve1land �` N�, DOLLAR GENERAL' GRADING PLAN ENGIN EERING, dL1c Consider and take necessary action on Master Services Agreement with Commerce Bank for Commerce Vantage Card Service AP Card program via Visa for electric payment of vendor accounts payable and authorize the County Judge to sign. (MP) Commissioner Lyssy made a motion to approve Master Services Agreement with Commerce Bank for Commerce Vantage Card Service AP Card program via Visa for electric payment of vendor accounts payable and authorize the County Judge to sign. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. From: Cindy Mueller<cindy.mueller@calhouncotx.org> Sent: Wednesday, December 07, 2016 1:47 PM To: 'Susan Riley' Cc: rhonda kokena; 'Simpson, Chris'; shannon salyer; Desiree Garza; Josie Sampson; Jerry Pickett; Kenny Finster; mike Pfeifer; neil fritsch; roger galvan; vern lyssy Subject: Agenda Item Request Attachments: Calhoun County Texas Card Only CommerceVantage MSA Contract Package.pdf; Calhoun County 1295.pdf; Auditor Overview of Commerce Bank CommerceVantage AP Card Program.pdf Please place the following item on the agenda for December 22, 2016: • CATNA on Master Services Agreement with Commerce Bank for CommerceVantage Card Service AP Card program via Visa for electronic payment of vendor accounts payable and authorize the County Judge to sign. Document Processing Notes: Signature pagesforCountyJudge are 2t 10, 13 and 14. Signature of county treasurer and county auditor on pages 14 and 15. Attest of clerk on page 15, Treasurer complete and sign pages 16 and 17 (one for jVlMC, one for, county). Cindy Mueller Calhoun County Auditor 202 S. Ann, Suite B Port Lavaca, TX 77979 Phone 361.553.4610 Fax 361.553.4614 Josie Sampson From: Cindy Mueller <cindy.mueller@calhouncotx.org> Sent: Wednesday, January 11, 2017 5:00 PM To: Josie Sampson Subject: 12/22/16 minutes agenda item 12 Attachments: CommerceVantage MSA.pdf Josie, Attached is the contract with all signatures. Cindy Mueller Calhoun County Auditor 202 S. Ann, Suite B Port Lavaca, TX 77979 Phone 361.553.4610 Fax 361.553.4614 Overview of Commerce Bank CommerceVantage AP Card Program o Vendors who meet large volume criteria are contacted by Commerce Bank to participate by receiving payments electronically. Vendor pays fee to Commerce Bank to use program. o County and MMC would upload electronic check register to Commerce Bank secure site when invoices are paid for participating vendors. Commerce Bank sends notification to vendors that payments are available. o Once a week Commerce Bank will post one EFT from the county bank account for the amount of payments retrieved by vendors. Bank float is about 10 days (same as paper check). o IBC charges the county 21 cents for every check cleared and only 11 cents for every EFT processed. Each paper check eliminated would save bank service fees, postage, envelope and check stock costs. o The potential revenue share for the county is 1%of annual net invoices paid through the program, direct deposited monthly. o Designated program administrator(s) (i.e., county treasurer and county auditor) will have complete access to the secure site to upload payment files and monitor vendor activity. 12/7/2016 County Auditor/Aud1 is Commerce Bank COMMERCEVANTAGIr' MASTER SERVICES AGREEMENT CONFIDENTIAL THIS COMMERCEVANTAGE'" MASTER SERVICES AGREEMENT ("Master Services Agreement" or "Agreement") is made and entered into as of the Effective Date by and between Commerce Bank, a Missouri bank and trust company ("Commerce") and Calhoun County, Texas and its subsidiaries and affiliates ("Customer"). For purposes of this Agreement and the Service Agreement(s) attached hereto (as defined below), Commerce and Customer may sometimes be referred to herein individually as a "Party" and collectively as the "Parties." 1. DEFINITIONS. As used in this Agreement and any Service Agreements attached hereto, the following terms have the definitions ascribed to them and include the plural as well as the singular: 1.1 "ACH" means Automated Clearing House, which is the electronic network governed by the National Automated Clearing House Association (NACHA) Operating Rules. 1.2 "Administrator" means, individually and collectively, one or more employees and/or a third party provider of Customer who are designated by Customer to assist Commerce in the administration of the Service(s). 1.3 "Charges" has the meaning provided inSection 10. .. . .._. 1.4 "Customer" means Customer and any of its officers, directors, employees and agents who utilize the Services. 1.5 "Customer Account" means one or more commercial bank accounts established and maintained by Customer wherein Customer authorizes Commerce to debit by means of an automated clearing house (ACFI) transaction to facilitate Supplier Payments and AP Automation Fees, if any, or credit monthly revenue share payments. 1.6 "Disbursement Account" means an account maintained and owned by Commerce and will be used by Commerce to disburse Payments on behalf of Customer for pre -funded transactions pursuant to a Payment Instruction and related Documentation. 1.7 "Document" or "Documentation" means the documentation given to Customer by Commerce to enable Customer to access and use the Service(s) including, but not limited to, electronic or printed versions of the Customer Responsibilities Manual, if applicable, user guides, instructions, policies, procedures, specifications, product standards and guidelines. 1.8 "Effective Date" shall be defined as set forth in Section 19. 1.9 "Indemnification Law" means any law (including, without limitation, any statute, regulation, ordinance, rule or any budget law or case law) applicable to Customer (whether federal, state, local or otherwise) that has the effect of limiting or restricting Customer's power, right or authority to undertake, or make payment pursuant to, any obligation to contractually indemnify third parties. 1.10 "Losses" means the aggregate of (a) any liability, loss, claim, settlement payment, cost, expense, interest, award, judgment, damages, diminution in value, fines, fees, penalties or other charges for which indemnification may be sought hereunder and (b) any court filing or other fees or costs, investigative costs, attorney's fees and costs, witness and professional fees and any other fee and cost associated with the successful assertion of a claim for indemnification hereander. 1.11 "Master Services Agreement" or "Agreement" means the CommerceVantage Master Services Agreement, any Service Agreement(s) attached hereto, all Addenda from time to time executed by the Parties and attached hereto, and all amendments to the foregoing. 1.12 "Payment" means the settlement of a Payment Instruction by Commerce using funds from a Disbursement Account and/or through a line of credit at Commerce. The term "Payment" as used in this Agreement does not imply that Supplier has taken the funds, but rather Payment has been made available to Supplier using one of the payment methods described in the Service Agreement(s). 1.13 "Payment Instruction" means a Customer initiated and approved file request for Payment to Customer's Supplier(s) initiated through Commerce's systems. 1,14 "Program" means the CommerceVantage Program administered by Commerce as set forth in this Agreement. 0112015 1 fA, Commerce Bank CONFIDENTIAL 1.15 "Public Record Law" means any state's law which provides that Customer's contracts are open and available to the public. 1.16 "Services" shall have the meaning as described in Section 2 and as further defined in the Service Agreement(s). 1.17 "Service Agreement" means the agreement(s) attached hereto and incorporated herein, in which Customer may use under the Program. 1.18 "Supplier" means any entity or person that has entered into a contract with Customer pursuant to which such entity provides goods or services to or on behalf of Customer. 2. INTRODUCTION. Commerce will provide Customer with a payment solution that shall be used in accordance with the terms and conditions of this Master Services Agreement, the applicable Service Agreement(s), and any other Documentation or materials that are made a part thereof, or are incorporated therein by reference, or are generally available to the users of the Services. The Documentation (e.g. user guides, manuals, technical information, etc.) may be modified from time to time by Commerce and/or Commerce's third party providers. If applicable, this Master Services Agreement shall supersede and replace any other Commerce Bank Commercial Card Agreement, ActiveFunds Agreement, Accounts Payable Agreement or ControlPay/EIPP Buyer Participation Agreement previously entered into by Customer and shall be the controlling document that governs all Services, whether existing at the time this Master Services Agreement is executed or entered into at a future date by Customer. Commerce may utilize outside service providers and agents in the performance of all or any of the Services. 3. SERVICES; SUPPLIER INFORMATION AND DATA; SET-UP. 3.1 Use of the Services. Customer may elect to use one or more of the Services, as evidenced by the Service Agreement(s) attached hereto, during implementation or at a future date. Customer agrees that it will also review and comply with the relevant provisions of the Documentation, as the same may be amended from time to time. Customer may from time to time allow any of its subsidiaries and affiliated entities, (each individually an "Affiliated Entity" and collectively the "Affiliated Entities") to utilize the Program pursuant to the terms and conditions of this Agreement. Customer understands and agrees that it is and shall remain solely liable and responsible for all its own performance obligations and those of any and all Affiliated Entities whom it allows to participate in the Program. 3.2 Supplier Information and Data. Customer shall provide Commerce with required Supplier information, which may vary depending the Service(s) elected, to facilitate Commerce's creation of the initial Supplier profile. Commerce will also provide Customer with standard data exchange formats and transmission protocols, along with requirements and testing processes. If any of these requirements are not met, Commerce shall no longer be bound to provide the Services elected by Customer or shall be authorized to deliver (as a complete and finished work product) whatever portion of the Services that can reasonably be performed under the circumstances. 3.3 Set -Up and On -Boarding. Customer acknowledges that Commerce is relying upon Customer to perform its industry standard screening on the Suppliers paid using this Program. Customer represents that each Supplier to whom it will send payment is an established Supplier or has been independently verified by Customer. Commerce and Customer will cooperate to establish the authorized Suppliers for payment, the payment terms of such Suppliers and any other requested Supplier information. Customer will provide Commerce with all such identifying information regarding its Suppliers as Commerce may deem to be required, to enable Commerce to fidfrll its legal and regulatory obligations with respect to each Supplier that Customer intends to pay through the Program. Commerce makes no representation or warranties concerning the accuracy or completeness of any Supplier information supplied by Customer or the validity or accuracy of any Payment Instruction. Commerce shall have no responsibilities or obligations to Customer based on the actions or inactions of the Suppliers with respect to Customer. 4. PROGRAM ADMINISTRATOR. Promptly after the Effective Date of this Agreement, Customer shall designate one or more Administrator(s) to assist Commerce with initial set-up and administration of the Services. Customer must execute and deliver proper documentation authorizing said Administrator to act for and on behalf of Customer. Customer shall be responsible for all transactions initiated or authorized by an Administrator or system user. Customer agrees that Commerce will not be liable for losses arising from or as a result of the negligence or willful misconduct of Customer's Administrator, including but not limited to an Administrator's or system user's failure to properly enter and/or transmit Payment Instruction. If Customer or an Administrator permits any person or entity other than the documented Administrator to perform any duty or o1l2n15 ;,;;j Commerce Bank CONFIDENTIAL responsibility of the Administrator, Customer shall be deemed to have authorized that person to act as an Administrator and perform duties of an Administrator. The Administrator shall undertake the following duties on behalf of Customer: (i) the Administrator shall have. the responsibilities assigned in the Program Administrator Delegation document provided by Customer to Commerce; (ii) the Administrator shall familiarize themselves with the basic functionality of the Service(s), including but not limited to, Payment Instruction processing and approval, Payment log status and posted transactions examination, and Payment settlement procedures; and (iii) the Administrator shall act as the primary point of contact between Customer and Commerce. S. ELECTION OF INTERNET SYSTEMS. The Parties acknowledge that they intend to establish procedures for the transmission of information and data over the Internet in connection with Customer's access and use of the Services. Customer understands and accepts the risks inherent in the use of the Internet, including the potential for the risk of loss. Customer acknowledges that data transmitted over the Internet, in secure formats or otherwise, may be intercepted by third parties and that data sent over the Internet is not guaranteed to arrive, be on -time or be accurate and that missing, delayed or incorrect data may result in errors in processing and paying Payment Instructions and may present other problems for Customer's business. Commerce shall not be liable to Customer based on or arising out of the failure of any data transmitted over the Internet to arrive in a timely manner (or at all) or be complete and accurate or for any acts by third persons who wrongfully intercept such data. Customer shall be responsible for any costs associated with making its internal systems compatible with the system(s) used to provide the Service(s), if any. Use of the Internet with any system will require a company ID, user name and password. Customer acknowledges that Commerce is entitled to rely on the use of the company ID, user name and password as authorization for any transaction initiated using the Internet. Customer is responsible for all transactions initiated or authorized using the Internet with any system. The password Customer selects is for its use and protection. Customer agrees to: (a) not disclose the password or otherwise make it available to anyone else; (b) use the password as instructed; (c) be liable for the password and for its use, as described in the Service Agreement(s) and/or other Documentation. 6. PAYMENTS. Customer will utilize the selected Internet system to process a Payment Instruction. Customer will submit Payment Instructions following the procedures described in the Documentation, as amended from time to time. The Payment Instruction will include, but not be limited to, Supplier information and specific dollar amounts to be paid to each Supplier. All Payment Instructions must be submitted for payment in U.S. currency (USD). 6.1 Sole Responsibility. Customer shall be solely responsible for determining the accuracy, validity and approval of all Payment Instructions. Customer agrees that if Customer or its Administrator approves a Payment Instruction, Customer is irrevocably obligated to fund said Payment in respect of such Payment Instruction. Commerce shall not be responsible for and shall be held harmless by Customer from and against any Losses arising out of or relating to any delay in making or failure to make any Payment to any Supplier by reason of (i) the failure or delay of Customer or the Supplier to remit any required Supplier information; (ii) any instructions by Customer to withhold Payment from that Supplier; (iii) any failure by Customer to timely approve any Payment Instruction or timely provide funding in respect of any Payment Instruction; (iv) the inaccuracy or incompleteness of any Supplier information or instructions provided by Customer or Supplier; or (v) if applicable, lack of funds in Customer's Account or Disbursement Account. Commerce's sole responsibility hereunder shall be the receipt and processing Payment Instructions and the remittance of Payments on behalf of Customer pursuant to instructions issued by Customer in accordance with this Agreement. 6.2 Authorization. Customer authorizes Commerce to make Payments in accordance with Customer's Payment Instructions. Commerce is entitled to conclusively rely on the Payment Instructions given by Customer's Administrator, even if such instructions are incorrect. Customer further acknowledges and agrees that once a Payment Instruction has been delivered to Commerce, Customer acknowledges and agrees that a Payment Instruction cannot be reversed. 7. CUSTOM SERVICES. Customer may from time to time request that Commerce provide it with custom development, reporting or other services. All such requests for services shall be evidenced by a statement of work executed by Customer and Commerce. Customer agrees to pay to Commerce all fees associated with such custom services. 8. FINANCIAL STATEMENTS. From time to time, Commerce may request and Customer shall produce financial records relating to the financial condition of Customer. Customer shall produce such records not later than thirty (30) days following such request. 9. TITLE & OWNERSHIP OF INTELLECTUAL PROPERTY. Commerce and/or the relevant Commerce third parry providers or agents shall retain title and ownership to all software code utilized by Customer in connection with the terms of 0112015 3 „g Commerce Bank CONFIDENTIAL this Agreement, including all rights to patents, copyrights, hademarks and trade secrets. No rights in or to any such intellectual property shall accrue to Customer. Customer agrees not to sell, transfer, publish, disclose, display or otherwise make available to others any of the software code, documentation or other materials relating to the software and agrees to use said software according to the provisions contained in any license agreement between Customer and the system provider. Customer may not modify, reverse engineer or decompile any of such Intellectual Property nor make any derivative works thereof. The terms of this Section shall survive any termination or expiration of this Agreement. 10. CHARGES. Customer shall pay to Commerce all fees, charges and other amounts due to Commerce, if any, incurred in the use of the Service(s) and pursuant to this Master Services Agreement, any Service Agreement(s) attached hereto and the attached Schedules (collectively, "Charges"). Fees may be subject to change from time to time by Commerce upon ninety (90) days' prior written notice. 11. DISPUTES. All disputes and claims concerning a Supplier's performance or non-performance of their obligations shall be resolved between Customer and the relevant Supplier. Commerce shall have no liability or responsibility to mediate or resolve any such dispute or claim and Commerce makes no representations or warranties regarding the acceptability of any Party's performance of its obligations. Customer's beliefs that it is due a credit or other compensation from a Supplier or other dispute with Supplier shall not affect Customer's irrevocable obligations to fund a Payment in respect to a Payment Instructions and pay all Charges associated with each Service. 12. INDEMNITY. 12.1 Customer Obligation. To the extent permitted under the Indemnification Laws, Customer agrees to defend, indemnify and hold harmless Commerce and its officers, directors, agents and employees from and against any and all claims by third parties (including, without limitation, Customer's Suppliers or its Administrators) and all casts (including reasonable attorneys' fees), expenses and liabilities incurred by Commerce in connection with such claims, arising from or as a result of the establishment and use of the Services, provided that such claims are not the result of or connected with the gross negligence or willful misconduct of Commerce or the violation by Commerce of any law or regulation relating to the Services. Customer acknowledges that the pricing provided in the Card Service Schedule is based on including this indemnification. 12.2 Commerce Obligation. Commerce agrees to defend, indemnify and hold harmless Customer and its officers, directors, agents and employees from and against any and all claims by third parties (including reasonable attorneys' fees), expenses and liabilities incurred by Customer in connection with such claims, arising from or as a result of the gross negligence or willful misconduct of Commerce, provided that such claims are not the result of, or connected with, the gross negligence, or willful misconduct of Customer or the violation by Customer of any law or regulation relating to the Services. 12.3 Limitation of Commerce Obligation. In no event shall the amount of Commerce's obligation under Section 12.2 exceed the maximum amount that Customer would be legally permitted, under the Indemnification Laws in effect as of the date of the event giving rise to such obligation of Commerce, to pay or contractually incur (whichever amount is lower) under Section 12.1 as of such date. 13. TERM AND TERMINATION. 13.1 Term. This Agreement shall remain in full force and effect until terminated by either Party as herein set forth. Either Party may terminate this Agreement or any Service Agreement at any time, with or without cause, upon thirty (30) days' prior written notice. Termination of the Master Services Agreement shall automatically terminate all Service Agreements. 13.2 Termination. Notwithstanding the foregoing, Commerce or Customer shall have the right to terminate this Agreement immediately and without notice, upon the occurrence of any one or more of the following events: (i) Dissolution or liquidation of the other Party; or (ii) Insolvency of the other Party; or the institution by or against the other Party of any bankruptcy or insolvency proceeding; or the appointment of a receiver or trustee for the other Party; or the other Party enters into an arrangement with, or for the benefit of, its creditors; or (iii) Any material adverse change in the financial condition of the other Party; or (iv) Any default hereunder, or breach of the obligations undertaken herein or in any Service Agreement, or in any other agreement by and between the Parties hereto; or (v) Upon the occurrence of any event in any agreement which would allow Commerce to declare any indebtedness owing by Customer due and payable in full; or (vi) A change in the ownership of Customer, or a sale of all or substantially all of Customer's assets; or 0112M ;;p Commerce Bank CONFIDENTIAL (vii) If either Party is hereafter prohibited by law from performing or contracting for the Services. Commerce will not be responsible or liable in any manner for any Losses incurred by Customer in respect of any breach of contract which may arise out of any termination of this Agreement pursuant to this Section. 14. DISCLAIMER AND LIMITATION OF LIABILITY. COMMERCE DOES NOT MAKE OR GIVE, AND HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES, REPRESENTATIONS OR CONDITIONS, BOTH EXPRESSED OR IMPLIED, ARISING BY STATUTE OR OTHERWISE IN LAW, OR FROM A COURSE OF DEALING OR USAGE OF TRADE, INCLUDING, BUT NOT LIMITED TO, ANY IMPLIED WARRANTY, REPRESENTATION OR CONDITION OF MERCHANTABLITY, MERCHANTABLE QUALITY OR FITNESS FOR ANY PURPOSE, PARTICULAR, SPECIFIC OR OTHERWISE OR ANY WARRANTY OF TITLE OR NON -INFRINGEMENT, FOR ANY OF THE PRODUCTS, PROCESSING, SERVICES, PROGRAMS, SPECIFICATIONS, STANDARDS, SOFTWARE, HARDWARE OR FIRMWARE CREATED, SUPPLIED, REQUIRED, LICENSED OR APPROVED BY COMMERCE OR REFERENCED IN THIS AGREEMENT. WITHOUT LIMITING CUSTOMER'S RIGHT TO INDEMNIFICATION AS SET FORTH IN SECTION 12 OF THIS AGREEMENT, CUSTOMER ACKNOWLEDGES AND UNDERSTANDS THAT COMMERCE'S LIABILITY RELATED TO ANY CLAIM ASSOCIATED WITH THIS AGREEMENT IS LIMITED TO ACTUAL DAMAGES SUSTAINED BY CUSTOMER THAT ARE A DIRECT RESULT OF COMMERCE'S FAILURE TO ABIDE BY THIS AGREEMENT. CUSTOMER MUST BRING ANY ACTION WITH RESPECT TO SUCH CLAIM WITHIN ONE (1) YEAR AFTER IT AROSE. TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, THE PARTIES HEREBY ACKNOWLEDGE AND AGREE THAT NEITHER PARTY NOR ANY OF ITS RESPECTIVE REPRESENTATIVES SHALL BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, PUNITIVE OR CONSEQUENTIAL DAMAGES BASED ON BREACH OF CONTRACT, BREACH OF WARRANTY, TORT, STRICT LIABILITY OR OTHER LEGAL THEORY, EVEN IF ANY OF SUCH PERSONS HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. EACH OF THE PARTIES HERETO IRREVOCABLY WAIVES, TO THE MAXIMUM EXTENT PERMITTED BY LAW ALL RIGHT TO TRIAL BY JURY IN ANY ACTION, PROCEEDING OR COUNTERCLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT OR ANY OF THE TRANSACTIONS CONTEMPLATED HEREBY. 15. NOTICE AND COMMUNICATION. All notices hereunder shall be in writing and shall be deemed duly given when personally delivered, when delivered by recognized overnight courier, or three (3) days after mailing if sent by certified or registered United States mail, return receipt requested, postage prepaid, to the appropriate Party at the address set forth below, or at such other address as the applicable Party may indicate from time to time in writing. Notice hereunder shall be sent: Commerce: Customer: Commerce Bank Calhoun County, Texas Attn: Commercial Products Attn: Cindy Mueller, Calhoun County Auditor 811 Main Street, KCCOMPROD 202 S. Ann, Suite B Kansas City, Missouri 64105 Port Lavaca, TX 77979 16. ELECTRONIC RECORDS. Customer agrees that this Agreement and all paper records related to the transaction with which this document is a part and whether or not the paper records were submitted in advance of, contemporaneously with or subsequent to, the execution of this document may, at the option of the Commerce, be converted by any digital or electronic method or process to an electronic record or subsequently further converted or migrated to another electronic record format or electronic storage medium. Customer further agrees that upon conversion to an electronic record as authorized herein such electronic record shall be the record of the transaction and the electronic record shall have the same legal force and effect as the paper documents from which it was converted. Customer waives any legal requirement that any documents digitally or electronically converted be embodied, stored, or reproduced in a tangible media. Customer further agrees that a printed or digitally reproduced copy of the electronic record shall be given the same legal force and effect as a signed writing. In addition, Customer authorizes and agrees to destruction of the paper documents by Commerce upon conversion of the paper documents to a digital or electronic record. 17. CONFIDENTIALITY. Commerce and Customer will keep strictly confidential and will not use or disclose to any third parry or to any employee, officer, director or agent (except on a need to know basis) for any purpose whatsoever (other than as contemplated herein or for a business evaluation of the Program performed by either Party) all or any portion of the contents of the Program, including but not limited to, any of the terms of, conditions of or other facts concerning the Services, pricing, materials, processes and any written or oral information furnished by Commerce or by Customer which is either nonpublic, 0112015 AV „0, Commerce Bank CONFIDENTIAL confidential or proprietary in nature unless such use or disclosure is lawfully permitted or is mutually agreed upon in writing by Customer and Commerce; provided, however, Customer understands and acknowledges that affiliates of Commerce and vendors of Commerce will assist in the implementation and maintenance of, and provision of various services under, the Program, therefore Customer authorizes Commerce to share any information that it obtains from Customer with its affiliates and vendors if needed to perform periodical financial, operational and regulatory reviews and audits. Information may also be shared with any regulators having jurisdiction over Commerce or its affiliates. In the event Customer is subject to a Public Record Law, Customer shall comply with the provisions of this Confidentiality paragraph only to the extent that such compliance is in accordance with the applicable Public Record Law. 18. MISCELLANEOUS PROVISIONS. 18.1 Compliance with Applicable Laws and Re€nrlations. Customer acknowledges that Commerce is a regulated financial institution and that Customer must provide any information and records regarding its Suppliers, Customer's identity, business, and operations, and other matters that may be requested from time to time by Commerce in order to enable it to perform periodic financial, operational and regulatory reviews and to comply with any applicable laws or regulatory requirements, including but not limited to the USA Patriot Act and The Office of Foreign Assets and Control (OFAC). In addition, Customer acknowledges that all transactions initiated through the Program are subject to possible limitations under applicable laws and regulations, including the rules issued by OFAC, and that no Payments which violate any such laws and regulations can be made using the Services. 18.2 Taxes. Customer acknowledges and agrees that Commerce: (i) is not responsible for calculating VAT, retail sales, withholding or other taxes associated with a Payment Instruction; and (ii) is not responsible for collecting or reporting taxes owed to any Party or authority associated with a Payment Instruction. As between Commerce and Customer, Customer shall calculate and pay all taxes, duties, levies, tariffs or similar charges of any kind (including withholding or value added taxes) imposed by any federal, state, local or other governmental entity with respect to any Payment Instructions processed under this Agreement for goods or services provided to Customer. Customer shall hold Commerce harmless from any and all Losses arising from any failure by Customer or any Supplier to collect or pay any such taxes, duties, levies, tariffs or similar charges. 18.3 No Implied Waivers. The rights of any Parry under any provision of this Agreement shall not be affected by its prior failure to require the performance by the other Party under such provision or any other provision of this Agreement, nor shall the waiver by any Parry of a breach of any provision hereof constitute a waiver of any succeeding breach of the same or any other provision or constitute a waiver of the provision itself A waiver of any right or obligation hereunder must be in writing and signed by the Parties to this Agreement. 18.4 Remedies. In the event that either Party breaches or violates any of the obligations contained in this Agreement, and in addition to the rights and remedies otherwise provided in this Agreement, the other Party shall be entitled to exercise any right or remedy available to it either at law or in equity, including without limitation, termination of this Agreement, damages. and injunctive relief. The exercise of any right or remedy shall be cumulative. 18.5 Complete Agreement Amendments. This Agreement constitutes the complete understanding between Customer and Commerce with respect to the subject matter hereof and all prior oral or written communications and agreements with respect thereto are superseded. No alteration, amendment or modification of any of the terms and conditions of this Agreement shall be valid unless made pursuant to any instrument in writing signed by both Parties. 18.6 Authority. The execution and delivery of this Agreement by Customer and the performance hereof by Customer have been duly authorized by all necessary corporate action on the part of Customer. Customer shall provide to Commerce, as Commerce may request from time to time, such documentation relating to Customer's authority to contract for the Services. 18.7 Binding_ Agreement; Benefit. The Documents shall be binding upon and inure to the benefit of the Parties hereto and their respective legal representatives, permitted successors and permitted assigns. Except as agreed to in writing by the Parties, this Agreement, as well as any applicable Service Agreement shall not be deemed to be entered into for the benefit of any other person, third party beneficiary or entity, and no other person, third -parry beneficiary or entity shall have the right against Commerce or Customer under this Agreement or any part thereof. 18.8 Assignment. Neither Party shall sell, assign or transfer this Agreement or any part thereof without the prior written consent of the other Party; provided, however, Commerce may, without the consent of Customer assign any or all of its rights and obligations under this Agreement to its parent, any subsidiary (of Commerce or its parent), or any affiliate (of Commerce or its parent) or to any other Parry pursuant to a merger, acquisition, consolidation, reorganization, or a sale of all or any portion of its assets. 0112016 6 'kip CONFIDENTIAL Bank CONFIDENTIAL 18.9 Force Mai core. Commerce shall not be in default of this Agreement to the extent That performance of its obligations is delayed or prevented by reason of any act of God, war, terrorism, fire, explosion, flood, act of government or any act or omission of a third party, including, but not limited to, telecommunications carriers and utilities or any other matter beyond its reasonable control. 18.10 Severability. The invalidity or unenforoeability, of any one or more portions, sentences, clauses or paragraphs in this Agreement shall not affect the validity or enforceability of the remaining portions of this Agreement or any part thereof. 18.11 Independent Contractors. Customer and Commerce acknowledge and agree that they intend to create an independent contractor relationship between them under this Agreement Accordingly, Customer and Commerce agree that: (i) nothing contained in this Agreement will be construed to make either Customer or Commerce, an agent of the other; (Pi) neither Customer nor Commerce shall have any authority under this Agreement to bind, obligate, or otherwise commit the other to any other agreement or transaction for any purpose whatsoever; and (iii) this Agreement does not create or evidence any partnership, joint venture, franchise, or other business organization between the Customer and Commerce. 18.12.Press Releases and Publicity. Neither Party will use other Party's name in press releases, product brochures and annual reports indicating that the Parties are doing business with each other without the prior written approval by the other Party before release; provided, however, Commerce may use Customer's name, Cust(mer-provided logo, and general industry/business description in Commerce's customer listings and in its sales presentations without obtaining Customer's prior consent. 18.13 Headings and Language. headings are inserted for convenience of reference only and do not constitute part of this Agreement. 18.14 Survive : Notwithstanding anything to the contrary herein, Sections 5, 6, 9, 11, 12, 14, 15, 16, 17 and 18 shall survive the termination of this Agreement. 19. EFFECTIVE DATE. Notwithstanding anything else contained herein to the contrary, this Agreement and any Service Agreements attached hereto will be subject to Commerce performing due diligence and credit investigations and will be effective only upon execution by Commerce as of the date shown below (the "Effective Date") and/or the date shown on any Service Agreements) attached hereto. 20, EXECUTION IN COUNTERPARTS. This Agreement may be executed in any number of counterparts, each of which shall be an original, but all of which taken together shall constitute one and the same agreement. Delivery of an executed counterpart of this Agreement by facsimile or other electronic means shall have the same force and effect as the delivery of an original executed counterpart of this Agreement. Any Party delivering an executed counterpart of this Agreement by facsimile or other electronic means shall also deliver an original executed counterpart, but the failure to do so shall not affect the validity, enforceability or binding effect of this Agreement. IN WITNESS WHEREOF, this Master Services Agreement has been executed by the duty authorized officers of the Parties hereto. Commerce Bank PrintedName: Meeame: C /`�• Q I,fJ{1 ��� Title: 1 �' VI tit I w d, o Effective Date: IZIlluLP o1/2n15 Calhoun County, Texas By: Print dNam. Pfeifer Title: County Judgo A% ,F Commerce Bank CommerceVantage'" Card Service CONFIDENTIAL THIS COMMERCEVANTAGE"' CARD SERVICE AGREEMENT ("Card Service") is made and entered into as of the Effective Date shown below by and between Commerce Bank ("Commerce") and Calhoun County, Texas and its subsidiaries and affiliates ("Customer"). Commerce and Customer agree that the Services referenced herein shall be performed in accordance with these Service Agreements, the Master Services Agreement attached hereto and any other Documentation. Commerce shall be responsible only for performing those Services expressly referenced in this Service Agreement and implemented by Customer. Terms used herein, which are defined in the Master Service Agreement, shall have the meanings given to them in the Master Service Agreement. CommerceVantage` Card Service — Commercial Cards, AP Cards and/or Private Network Accounts (Credit Transactions) CommerceVantage Card Services will facilitate payment to Customer's Suppliers by assigning AP Cards and/or Private Network Accounts to Customer and/or issuing Commercial Cards to Employee Cardholders ("Card Service"). 1. DEFINITIONS. These additional terms, as used in this Card Service Agreement, and any other Service Agreement, shall have the following meanings and include the plural as well as the singular: 1.1 "AP Card" means the Visa or MasterCard account numbers associated with the AP Cards issued by Commerce to Customer or its Administrator without an associated plastic under the Program. The operating rules, established by card companies, shall govern the services offered. 1.2 "Cardholder Agreement" means that agreement delivered to each Employee Cardholder which governs the use of the Commercial Cards, as amended from time to time. 1.3 "Commercial Card" means the Visa's or MasterCard" Commercial Card and the numbers associated with the Commercial Card issued by Commerce to Employee Cardholder. The operating rules, established by card companies, shall govern the services offered. 1.4 "Employee Cardholders" means, collectively, those designated officers, directors, agents and employees of Customer. 1.5 "Network Transaction" means the payment transaction where Commerce is only the AP Card issuer (issues AP Card account numbers to Customer) and does not control fees associated with acceptance of a card transaction by the Supplier. 1.6 "Private Network Account" means the Commerce Bank Private Network card account number associated with the Commerce Bank Private Network Account issued by Commerce to Customer or its Administrator without an associated plastic under the Program. The operating rules, established by Commerce, shall govern the services offered. 1.7 "Private Network Transaction" means the payment transaction where Commerce is both the Private Network Account issuer (issues Private Network Account numbers to Customer) and the acquirer (has limited banking relationship with merchant) and controls the fees associated with the transaction. 1.8 "Unauthorized Charge" means the use of a Commercial Card, AT Card, and/or Private Network Account, by a person, other than the Customer, who does not have actual, implied or apparent authority for such use, and from which the Customer receives no benefit. 2. COMMERCIAL CARDS; AP CARDS; AND/OR PRIVATE NETWORK ACCOUNTS a. Commerce shall issue AP Cards and/or Private Network Accounts to the Customer, provided that a Payment Instruction has been made by an Administrator in the form required by Commerce; and/or Commerce shall issue a Commercial Card to each Employee Cardholder designated by Customer, provided that (i) each such designated Employee Cardholder has a business or commercial purpose for the Commercial Card, and (ii) a card issuance request has been made by an Administrator in the form required by Commerce. b. Each Commercial Card shall be valid for the term indicated thereon, unless such Commercial Card has been canceled by Commerce pursuant to the provisions of this Card Service Agreement or at the request of Customer. c. Commerce acknowledges the ability of Customer to revoke any authority given to an Administrator, at Customer's discretion upon proper notice to Commerce; provided, however, that Customer shall remain liable for all charges made to each Commercial Card, AP Card and/or Private Network Account as provided in this Card Service Agreement. d. Commerce acknowledges the ability of Customer and/or its Administrator to cancel the Commercial Card issued to any one or more Employee Cardholder(s), at Customer's discretion upon proper notice to Commerce; provided, however, Customer and/or its Administrator shall take all reasonable actions necessary to retrieve the Commercial Card issued to Employee Cardholder or terminated Employee Cardholder and shall immediately destroy the retrieved Commercial Card. e. If a Private Network Transaction is utilized to pay Customer's Supplier, Commerce will agree to pay Customer's Suppliers 0112015 A& 1 Commerce Bank CONFIDENTIAL so long as the Supplier meets certain underwriting criteria, enters into a limited merchant agreement with Commerce, and provides Commerce with requested account information and documentation. Should the Supplier fail to meet any of the above, Commerce may reject or terminate said Supplier and upon notification to Customer Commerce will no longer be responsible for payment under this Program. f. Customer acknowledges that the Private Network Transactions are not Visa transactions and Customer has no recourse against Visa regarding any Private Network Transactions or any other claims arising from the Private Network Accounts. Customer shall indemnify Visa and hold Visa and its members harmless from and against claims, liabilities, losses, and expenses arising from or in connection with the Private Network Accounts. 3. BILLING PROCEDURES. Central Billed Accounts: Except as otherwise provided herein, Customer shall be liable for all charges made to each Commercial Card, AP Card and/or Private Network Account. Charges shall be set forth on an electronic billing statement and shall be paid by Customer within the time period provided in the Card Service Schedule, attached hereto and incorporated herein by this reference, and as set forth herein. Commerce shall have no duty or obligation to inquire into the nature of any transaction charged by a Customer or Employee Cardholder (e.g., whether such transaction was for a business or personal use). 4. LINE OF CREDIT. Commerce will establish a maximum line of credit amount for Customer. a. All amounts charged to the Commercial Cards, AP Cards and/or Private Network Accounts together with any fees and charges owed to Commerce by Customer in connection with the Card Service, may not exceed, in the aggregate, the line of credit amount unless Commerce in its sole discretion authorizes such charges. So long as the line of credit facility has not been terminated and/or demand has not been made by Commerce, advances under this line of credit may continue to be made, repaid and re -borrowed as provided for herein. b. Commerce may, at any time in its sole discretion, increase the amount of Customer's line of credit temporarily or for an extended period without prior notice. c. Commerce may, at any time in its sole discretion, decrease the amount of Customer's line of credit upon thirty (30) days' prior written notice to Customer; provided, further, Customer agrees that if any amounts are outstanding on the Commercial Cards, AP Cards and/or Private Network Accounts which exceed the adjusted line of credit amount, Customer will immediately pay Commerce such excess amounts. d. Collateral securing other obligations with Commerce, if any, will also secure this line of credit. 5. TERMINATION. a. All Commercial Cards, AP Cards and/or Private Network Accounts shall be deemed canceled effective upon termination of this Agreement or as otherwise provided herein, and all amounts outstanding under such Commercial Cards, AP Cards and/or Private Network Accounts shall automatically become immediately due and payable in full by Customer without further notice. b. Commerce may terminate this Service Agreement immediately if Customer fails to make any payment when due under this line of credit or any other Service Agreement. 6. REPORTING. Commerce will, either directly or indirectly through its Suppliers, receive data from the transactions made with the Commercial Cards, AP Cards and/or Private Network Accounts; such data will be delivered to Customer as specified herein. Commerce shall have no responsibility or liability for the capture, transmission, grouping, reporting, categorizing or any other act performed or required to be performed in connection with the foregoing data that Customer's Suppliers are transmitting at the point of sale. 7. CUSTOMER LIABILITY. Except as noted below, Customer shall be solely liable for the payment of all charges incurred in the use of Commercial Cards, AP Cards and/or Private Network Accounts. a. Customer shall not be responsible for an Unauthorized Charge that is a result of the use of a stolen AP Card and/or Private Network Account if the AP Card and/or Private Network Account are reported stolen via telephone as provided in this Agreement below, within ninety (90) days after the Unauthorized Charge occurred. If the AP Card and/or Private Network Account are not reported stolen within such time frame, Customer shall be liable for all charges associated with the stolen AP Card and/or Private Network Account. b. Customer shall not be liable for the payment of Commercial Card charges if the Commercial Card charges: (i) are waived as set forth in Visa Waiver of Liability or MasterCard Zero Liability documentation, as amended from time to time; (ii) were made after the original closure request date for a Commercial Card where the request by Customer was made in accordance with the terms of this Agreement during normal business hours; or (iii) were Unauthorized Charges as set forth in the Cardholder Agreement. c. It is further understood and agreed that when a chargeback (the reversal of a card transaction previously credited to a vendor account), chargeback fee or any other charges to Customer's vendor occurs, including, but not limited to, loss relating to vendor disputes and vendor processing fees (collectively "Charges"), Commerce will seek payment from vendor's account. Provided, however, if the Charges are aresult of a Private Network Transaction and vendor does not have 01/2015 9 AV♦ Commerce Bank CONFIDENTIAL sufficient Rinds in its account to cover the Charges, then the total amount due from vendor shalt be deemed on "Uncollected Vendor DebP'. Customer agrees that Commerce shall not be geld responsible for any Uncollected Vendor Debt. If applicable, Commerce may reverse any provisional credit or seek reimbursement from Customer. d. Notification of loss, stolen or possible unauthorized use of a Commercial Card, AP Card and/or Private Network Account, should be communicated to Commerce at 800-892-7104 immediately. Communications with Commerce concerning disputed billings shall be made by mail to Commercial Card Services, 811 Main Street, lianas City, Missouri 64105 or by phone at 800-892-7104. IN WITNESS WHEREOF, this Card Service Solution has been executed by the duly authorized officers of the Parties hereto. Commerce Bank k B Printed Name: iv --I �+,^O�OYywl- 'Title: tl p� � Il � �Wt S d ao ._— Effective Date: �G�I'M"f 01/2016 10 Calhoun County, Texas By: d Printed Name; Michael J. Pfeifer Title: County Judge _ e.. ";i Commerce Bank Card Service Schedule CONFIDENTIAL 1 B : $0�- $833,333 $0 - $9,999,999 1. .34% $833,334 + $10,000,000 + 1.36% Total Monthly Net Volume is calculated using AP Card volume only I) Volume calculations exclude credits, cash advances, fraudulent transaction amounts and volume qualifying under 1% interchange. 2) AP Card Volume qualifying at Large Ticket Interchange (LTI) will be paid at 0.40%. 3) Average monthly transaction amount is defined as gross purchase volume divided by total transaction count. 4) Customer shall have ninety (90) days from statement date to notify Commerce of any revenue share payment errors. 5) Commerce reserves the right to withhold, suspend or modify revenue share payment for the following reasons: a) If Customer's average Interchange Rate falls below 2.25% b) If Interchange Rates become significantly altered by Visa and / or MasterCard e) If monthly volume contain fraudulent transactions d) If monthly revenue share payment is less than $10 e) If any accounts become delinquent (central billed accounts only) 6) Commerce may adjust the revenue sharing percentages, as provided below, at the end of each calendar quarter following the Agreement Effective Date a) Adjustments are based on the U.S. Prime Rate, as published in The Wall Street Journal "Money Rates" column on the last business day of the month immediately preceding the first day of the applicable billing cycle b) Adjustments to revenue share based on Prime Rate fluctuations are not applicable while Prime Rate remains at, or below, the established 4.00% floor c) When the Prime Rate exceeds 4.00%, Commerce will adjust the revenue share percent payable using the grid below. Commerce will use the same grid to determine subsequent revenue share adjustments should the Prime Rate increase or decrease from any newly established Prime Rate level in future quarters d) The Established Prime Rate at the time of this contract is 3.50%. weekly3 Da kik`K 0.50% ..,.., *_ 0.010% 0112015 11 �•,� Commerce Bank 1. CONFIDENTIAL Commerce will generate a billing statement on a periodic basis as outlined below. All amounts owing on the Commercial Card and/or Payment Cards including fees and charges, shall be due and payable in full on a grace period as outlined below, after the date of such statement. If applicable, the statement will be transmitted to the Employee Cardholder or to Customer via U.S. Mail or made available by an alternative means as agreed upon by both parties. Card & Private Network Card) AutoPay Late Fee for Central Bill For each payment not received by the payment due date shown on the billing statement, a late fee will be charged. The late fee for Accounts the respective Commercial Card and Payment Cards will be 2.5% of the amount past due. Visa and MasterCard purchases, cash withdrawals and cash advances made in currencies other than U.S. Dollars will be converted to U.S. Dollars under regulations established by Visa International and MasterCard International. Visa conversion will be at a rate selected by Visa from the range of rates available in wholesales currency markets for the applicable central processing date, which may vary from the rate Visa itself receives, or the government -mandated rate in effect for the applicable central processing date. MasterCard conversion into will be selected by MasterCard, typically either a govemment-mandated rate or a wholesale rate Iuternafional Service Fee provided to MasterCard. Conversion to U.S. Dollars may occur on a date other than the date of the transaction. Therefore, the conversion rate may be different from the rate in effect at the time of the transaction. Customer agrees to pay the converted amount, plus an international service fee in the amount of 2% of the transaction amount on purchases and 1% on cash withdrawals and cash advances. For purchases, cash withdrawals and cash advances made in U.S. dollars outside of the United States and its territories, you agree to pay the transaction amount plus a 1%service assessment fee. Cancellation Fee $5,000 fee if Customer terminates this Agreement prior to one (1) year from the Effective Date. ACH Return $29 each after first occurrence Phone Payment $15 each after first occurrence $2 per statement afterthree occurrences Statement Reprinting Free through certain sofrware products selected by Customer. For information, copies or other reports not specified in this Schedule, Commerce may charge Customer such fees as Customer and Other Commerce may agree from time to time. AP File Layouts Standard —No Charge Custom— in those instances where this effort will generate a cost over $3,000, Commerce will obtain a price quote for Customer. Reconciliation Reports Customized Programming Standard —No Charge Custom— Commerce will obtain a price quote for Customer. Other Custom Programming Commerce will obtain a price quote for Customer unless development is mutually agreed upon by Customer and Commerce. Development hours, beyond the initial 20 hours, are typically charged at a rate of $150.00 per hour. Commerce uses a `train the trainer' model. Initial training for Program Administrators (in person, WebEx or by phone) is at no charge. Additional training for Program Administrators via WebEx or by phone is at no additional charge. Sof nvare Training B is the Bank's intention that the Program Administrator will train the cardholders and systems users on reporting and maintenance applications. If further training by Commerce is required for the cardholders and system users (in -person, WebEx or by Phone), Commerce will charge $250 per hour. Appropriate advance notice is required for training. [Signature Page To Follow] 01/2015 12 g Commerce Bank CONFIDENTIAL IN WITNESS WHERLOF, this Card Service Schedule has been executed by the duly authorized officers of the Parties hereto. Cunmmcee! Bank Printed N}ame:,MI��A]�I Title: S/ V, V E u I 7wO) r _w7 � / Effective Date: ' W 0112015 13 Calhoun County, Texas Printed Name: Miehael J. Pfeifer Title: County Judge go Commerce Bank Certificate of Authority and W-9 for a Government Organization Customer Name ("Organization") Taxpayer Identification Number (TIN) Calhoun County, Texas 74-6001923 Address City, State, Zip 202 S, Ann, Ste B Port Lavaca, TX 77979 The undersigned certifies that he/she is the duly elected and qualified Secretary Assistant Secretary, or Clerk of the Organization; that the following resolutions, or substantively similar resolutions, have been duly adopted by the Governing Board/Goveming Body of the Organization pursuant to its bylaws and the power and authority granted by such resolutions and/or bylaws remain in full force and effect and have not been amended or revoked; that the officers listed below have been granted the requisite power and authority to transact business as described herein ("Authorized Person(s)"), and that the specimen signature(s) of the Authorized Person(s) below are true and genuine. RESOLVED, that any one of the Authorized Persons) may from time to time appoint an Administrator to assist Commerce Bank ("Commerce") in the administration of the Account(s) or Programs as provided in the applicable Agreement (each such term as defined in the Agreement). FURTHER RESOLVED, Commerce is authorized to act upon these representations and resolutions until written notice of revocation is delivered to Commerce, and Commerce is authorized to presume the authority described herein shall apply with equal force and effect to the successors in office of the officers named herein. Indicate authorization for each Officer by checking the appropriate boxes below Name of Authorized Person(s) Title Signature(s) Section (Credit) Section (Pre -Funded) Rhonda S. Kokena County Treasurer Cv� - ,Ki Q4,J 0 ❑ Cindy Mueller County Auditor LQmkj 0 ❑ ❑ ❑ ❑ ❑ -section A —Credit Prnarams: Commercial Cards/AP Cards/Private Network Accounts/Claims Payments FURTHER RESOLVED, that any one of the Authorized Person(s) designated above is authorized to establish credit card accounts (with or without an associated plastic card)("Accounts') with Commerce, to incur debt (in the form of a line of credit established by Commerce for the Organization) associated with the Accounts, to pledge property as security for repayment of amounts due Commerce, and to execute all documents to effectuate this purpose which he/she may deem necessary and proper, including without limitation any application, agreement, Master Services Agreement or other documentation requested by Commerce (each an "Agreement") to open the Accounts. FURTHER RESOLVED, that any one of the foregoing named officers of this Corporation may from time to time request Commerce issue Commercial Cards, AP Cards and/or Private Network Accounts to any one person in connection with any of the Accounts. Section a —Pre-Funded Programs: ActiveFunds/AP Cards/Private Network Accounts/Claims Payments/AP Automation (Full Process & Pay; Invoice Automation & Pay; or Payment Hub)/Merchant Bankcard/General Banking Services FURTHER RESOLVED, that any one of the Authorized Person(s) designated above is authorized to establish an ActiveFunds, AP Card, Private Network Accounts, Claims Payments, and/or AP Automation program (each a "Program"), and other general banking services with Commerce, including, but not limited to Merchant Bankcard services, and to execute all documents to effectuate this purpose which helshe may deem necessary and proper, including without limitation any agreement, Master Services Agreement, Merchant Agreement or other documentation requested by Commerce (each an "Agreement") to establish a Program or general banking service. 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 numberto be issued to me), and 2.1 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 failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3.1 am a U.S. citizen or other U.S. person (including a U.S. resident alien). 4. 1 am exempt from FATCA reporting. 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 of underreporting interest or dividends on your tax return. For further instructions, go towww.trs.gov. The IRS does not require your consent to any provision IN ITNESS EOF, I have signed my name as of the date written below. } 12-22-2016 Signa ure of S rotary, Assistant Secretary or Clerk Date ItAw ;i Commerce Bank ,_,, Program Administrator Delegation The CommerceVantage—Master Service Agreement, dated 12-22-2016 between Commerce Bank ("Commerce") and Calhoun County, Texas states: Program Administrator. Customer, upon signing this Agreement, shall designate one or more of its employees and/or third party provider (individually and collectively, the "Administrator ") to assist Commerce in the administration of the Program. In accordance with the above, the individuals listed below are designated as Administrator(s), for Calhoun County, Texas. Each hereby is authorized to conduct the Program Administrator duties for this company by authority of this letter including, but not limited to, submitting Payment Instructions to issue Card Service Payments and/or other payment types. Individual Signature Rhonda S. Kokena, County Treasurer L Cindy Mueller, County Auditor Aw,� L4&-77 Signature of Authorize Pers Print Name Michael J. Pfeifer Title County Judge Date 12-22-2016 11/2013 ELECTRONIC PAYMENT AUTHORIZATION 413p1 Commerce Bank This electronic payment authorization by Calhoun County, Texas ("Customer") authorizes Commerce Bank ("Commerce") to initiate debit and credit entries and to initiate, if necessary, adjustments for any entries in error to the checking account indicated held at the depository financial institution named below, herein referred to as "Depository", and to debit and/or credit the same to such account. Both parties acknowledge that the origination of ACH transactions to Customer's account must comply with the provisions of all U.S. laws, rules and regulations, including, but not limited to, the National Automated Clearing House Association (NACHA) rules. Vendor Payments (Debit) Depository (Bank) Name: International Bank of Commerce Revenue Share Payments (Credit) Depository (Bank) Name: International Bank of Commerce City & State: Port Lavaca, Texas City & State: Routing/Transit # Account #: Account Title: AP Automation Fees (Debit) m Check here if fees not applicable Depository (Bank) Name: City & State: Routing/Transit #: Account #: Account Title: Port Lavaca, Texas Routing/Transit #: Account #: Account Title: This authority is to remain in full force and effect until Commerce has received written notification from Customer of its termination in such time and in such manner as to afford Commerce and Depository a reasonable opportunity to act on it. In no event shall such termination be effective as to entries processed prior to receipt of such notice. Commerce reserves the right to terminate this authorization at any time. Calhoun County, Texas (Customer) By: Signature Print Name: Rhonda S. Kokena Title: County Treasurer Date: Address: 202 S. Ann, Ste A Port Lavaca, TX 77979 Commerce Bank Address: Commerce Bank Attn: Client Care Team P.O. Box 411036 Kansas City, MO 64179-9640 Telephone: 1-800-892-7104 Fax:1-816-760-7935 ELECTRONIC PAYMENT AUTHORIZATION eAk (wi Commerce Bank This electronic payment authorization by Calhoun County, Texas ("Customer") authorizes Commerce Bank ("Commerce") to Initiate debit and credit entries and to initiate, if necessary, adjustments for any entries in error to the checking account indicated held at the depository financial institution named below, herein referred to as "Depository", and to debit and/or credit the same to such account. Both parties acknowledge that the origination of ACH transactions to Customer's account must comply with the provisions of all U.S. laws, rules and regulations, including, but not limited to, the National Automated Clearing House Association (NACHA) rules. Vendor Payments (Debit) Depository (Bank) Name: International Bank of Commerce City & State: Port Lavaca, Texas Routing/Transit #: Account #: Account Title: AP Automation Fees (Debit) ix Check here if fees not applicable Depository (Bank) Name: City & State: Routing/Transit #: Account #: Account Title: Revenue Share Payments (Credit) Depository (Bank) Name: International Bank of Commerce City & State: Port Lavaca, Texas Routingfrransit #: Account Title: This authority is to remain in full force and effect until Commerce has received written notification from Customer of its termination in such time and in such manner as to afford Commerce and Depository a reasonable opportunity to act on it. In no event shall such termination be effective as to entries processed prior to receipt of such notice. Commerce reserves the right to terminate this authorization at any time. Calhoun County, Texas (C omet By: V a� Sign ture Print Name: Rhonda S. Kokena Title: County Treasurer Date: d—'( Address: 202 S. Ann, Ste A Port Lavaca, TX 77979 Commerce Bank Address: Commerce Bank Attn: Client Care Team P.O. Box 411036 Kansas City, MO 64179-9640 Telephone: 1-800-892-7104 Fax: 1-816-760-7935 aT1�tu� 0."e �N1W eaua f� •MYMXBIMK w 41W mammas a oaoausYae seYsaoe. _ +ooa000aaoa CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of1 Complete Nos. 1-4 and 6ifthore are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and.6 if there are no interested parties. CERTIFICATIONOFFILING 2 Name of business entity filing form; and the city, state and country of the business,entity's place - certificate Number: of business. 2016-106051 Commerce Sank Kansas City, MO united States Date Filed: 2 Name of governmental entity or state agency that is:a party to the contract for which the form is 08/30/2016 being flied. County of Calhoun; TX Date Acknowledged: 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 services, goods, or other property to be provided under the contract. 2016 Commerce Vantage Master Commerce Vantage Master Service Agreement for electronic VISA payments for AP Nature of interest 4 Name of Interested Party City, state, Country (place of business) (checkappiieable) Controlling Intermediary 5 Check only ifthere is No Interested Party. 6 AFFID ®0 DEC �®®® I swear, or affirm, under penalty of perju hat the above disclosure is true and correct: ignature of authorized agen contractingbusiness entity `$7t 0F1�f'po RFFIX iQ�r®s�Q�%�f IS A84VE tttttttll®89`�� this the day of` p hb Sworn to and subscribed before me, by the said _Setvl- whfnN , 20�to certify which, witness my hand and seat at office. p, �'` i ..k,rwr'AYIU 'r e:. t n', 'tiflll7.J3yiwi�E%�15 'CnrhiG t'S'� R7Trw'y. i&Coip ignature of officer administering oath Pri-nt—ed name of officer administering oath TNe of office skamg oath ........._.._ ... .._ - xicrainn V9 0 277 Forms provided by Texas Ethics Commission CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of l Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-106051 Date Filed: 08/30/2016 Date Acknowledged: 01/12/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Commerce Bank Kansas City, MO United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. County of Calhoun, TX 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 services, goods, or other property to be provided under the contract. 2016 Commerce Vantage Master Commerce Vantage Master Service Agreement for electronic VISA payments for AP 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of , 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 Consider and take necessary action to accept a Texas Association of Counties (TAC) check in the amount of $1,534.76 for employee participation in Health Risk Assessments and Sonic Boom incentives to be used for the Calhoun County Health & Wellness Program. (VL) Commissioner Lyssy made a motion to accept a Texas Association of Counties (TAC) check in the amount of $1,534.76 for employee participation in Health Risk Assessments and Sonic Boom incentives to be used for the Calhoun County Health & Wellness Program. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Vern L Calhoun County Commissioner, Precinct #2 �PTC Of 5812 FM 1090 sus re N Port Lavaca, TX 77979 (p OJi LhrY 06 CPO December 7, 2016 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: O)IS (361) 552-9656 Fax (361) 553-6664 Please place the following item on the Commissioners' Court Agenda for December 22, 2016 • Consider and take necessary to accept a.Texas Association of Counties check in the amount of $1534.76 for employee participation in Health Risk Assessments and Sonic Boom Incentives to be used for the Calhoun County Health & Wellness Program Sincerely, G- Vern Lyss VL/Ij TAC-HEALTH and EMPLOYEE BENEFITS POOL CHECK DATE CHECK NOr I. \ I \ 2 6 2 8 ,' ; 11/22/2016 002628 � ' VENDORID VENDOR NAME { ACCOUNTNUMBERCAI HOUN Calhoun nunty DATE INVOICE NO. DESCRIPTION '.:. -{� AMOUNT 11/22/2016 CALHOUN2016 J $1,634.76 I r J $1,534 76 ��-��-- 2628 N sI s o � FROST BANK TEXAS ASSOCIATION OF COUNTIES 30sm4o w o ' HEALTH and EMPLOYEE BENEFITS POOL 8 E+ z P.O. BOX 2131 * * AUSTIN, TX. 78768 (512) 478-8753 Ooneal ' DATE AMOUNT" ',.. 11/22/2016 $1,634.76 E PAY One Thousand five Hundred Thirty Four Dollars and 76 Cents VOID AFTER 180. DAYS} TO THE 1 Calhoun County M ORDER { TAC-HEALTH and EMPLOYEE BENEFITS POOL ' r 1 ` C 1 , $C%l %%�%% Calhoun County ' � I i 1 TO REORDJ=R CALL: (706) 327-9550 00000000000005398 W14SFOO1015M 05/14 Consider and take necessary action on request by Healthy Fit Committee to conduct a "Biggest Loser" type weight loss competition for all County Employees beginning January 16, 2017. Prizes will be in the form of pre -paid cards and subject to withholding tax. It will be funded thru the Wellness Committee Fund. (VL) Commissioner Lyssy made a motion to approve request by Healthy Fit Committee to conduct a "Biggest Loser" type weight loss competition for all County employees beginning January 16, 2017. Prizes will be in the form of pre -paid cards and subject to withholding tax. It will be funded thru the Wellness Committee Fund. Commissioner Galvan seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 December 15, 2016 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: 9 aGhrr Ui cn4��a 9) (361) 552-9656 Fax (361) 553-6664 Please place the following item on the Commissioners' Court Agenda for December 22, 2016 e Consider and take necessary to allow the Healthy Fit Committee to conduct a "Biggest Loser" type weight loss competition for all County employees beginning January 16, 2017, Prizes will be in the form of pre -paid cards and subject to withholding tax. It will be funded thru the Wellness Committee Fund. Vern Lyssy VL/Ij I'.�IN;n_ti�N �.our+Tv EmP.LoiV�E�E?$? RULES: Consider and take necessary action on insurance settlement from Texas Association of Counties in the amount of $1,300 for damage to a jail cell on 10/9/16. (MP) Commissioner Fritsch made a motion to accept insurance settlement from Texas Association of Counties in the amount of $1,300 for damage to a jail cell on 10/9/16. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. 0 From: Candice Villarreal <candice.villarreal@calhouncotx.org> Sent: Friday, December 09, 2016 10:35 AM To: susan.riley@calhouncotx.org Cc: michael. pfeifer; Roger Galvan; vern.lyssy@calhouncotx.org; neil.fritsch@calhouncotx.org; Kenneth Finster; cindy.mueller@calhouncotx.org; michelle.velasquez@calhouncotx.org Subject: Agenda Item - Insurance Settlement - Jail Cell Damage Attachments: 100916 Jail Cell Damage TAC ck.pdf; Est_HL1933_from_Cornerstone_Institutional_LLC_4468.pdf Susan, Please add the following agenda item for Commissioners Court on December 22nd • Consider and take necessary action on insurance settlement from Texas Association of Counties in the amount of $1,300 for damage to a Jail cell on 10/9/16. Thankyou, Candice Villarreal Calhoun County Auditors Office Phone. (361)553-4612 Fax. (361) 553-4614 catidice.villart-eal@calhouncotx.org TEXAS ASSOCIATION OF COUNTIES RISK MANAGEMENT POOL -CLAIMS WMI 11/23/2016 PR20161640-1 11/23/2016 PR20161640-1 Jail Cell Damage Deductible i s 22988 p s o o ; + + TEXAS ASSOCIATION OF COUNTIES MANAGEMENT POOL -CLAIMS .+�LIM Ina FROST BANK - 30 9m4o F - .RISK 1210 SANANTONIO STREET €� —1 * '* AUSTIN, TX 78701 Ir (512)478-9753 DATE _ -AMOUNT - - -11/23/2016-'$1,300.00. .._.E PAY ONE THOUSAND. THREE HUNDRED AND 00 / 100 DOLLARS-. - V�ID 11 Pl80 DAYS - � _ a TO THE Calhoun County - .N ORDER OF' 211 S Ann St Port Lavaca, TX 77979-0203 I TEXAS ASSOCIATION OF COUNTIES RISK MANAGEMENT POOL -CLAIMS Calhoun County 211 S Ann St Port Lavaca; TX 77979-4203 TO REORDER CALL: (706)327.9550 W14$F001014M 10/14 CORNERSTONE Cornerstone Institutional, LLC Name / Address Calhoun County Adult Detention Center Michelle Velasquez 302 West Live Oak Street Port Lavaca, Texas 77979 Estimate Date Estimate # 10/31/2016 . HL-1933 Ship To Calhoun County Adult Detention Center Trial= Mitchell 302 West Live Oak Street Port Lavaca, TX 77979 Terms Project Net 30 Description Qty Rate Total Repair to Threshold for Safety Padding- 1 3,800.00 3,800.00 Provide materials, labor and one mobilization in order to replace the padded threshold -size 32" length by 7" Wide. The threshold area will then be re -sanded and have top coat re -applied. Please note, top coat sealer may not be an exact match to existing top coat currently in the facility. Pricing is valid for 60 days from date on quote. Any applicable permits/license fees and applications are not included and will be completed by others. Heather Lang Manager, Cornerstone Institutional, LLC Subtotal $3,800.00 d.b.a. Conerstone, Service & Supply Sales Tax �Q.�%� $0.00 (256) 560-4245 - Office (256) 431-9812 - Mobile Mang@comerstonedetention.com Irttp://N w .comerstonedetention.com Total $3,800.00 NOTICE OF DISCLAIMER: The information contained in this message and any attachment thereto is intended for the sole use of Clabora Holding Inc. its subsidiaries, its employees and its clients (or the individuals and/or entities listed above). If you are not the intended recipient, you are hereby notified that any use, disclosure, dissemination, distribution or copying of this e-mail and any attachment(s) is strictly prohibited. Please reply to the sender that you received this transmission in error and then delete it. Accept reports of the following County Offices: Calhoun Tax Assessor/Collector County Treasurer County Sheriff — November 2016 District Clerk County Clerk Justices of the Peace #1, #2, 3, #4, #5 — November 2016 County Auditor Floodplain Administration Extension Service Adult Detention Center SHP Medical Judge Pfeifer made the motion to approve reports from the above highlighted offices. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. SHERIFF'S OFFICE MONTHLY REPORT NOV. 2016 BAIL BOND FEE $ 945.00 CASH BOND $ 500.00 CIVIL FEE $ 393.12 JP#1 $ 315.00 JP#2 $ 2,004.40 JP#3 $ 832.00 JP#5 $ 282.10 TOTAL: $ 5,271.62 9 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/2/2016 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2016 ACCOUNTNUMBER ACCOUNTNAME AMOUNT CR 1000-001-45011 FINES 3,579.75 CR 1000-001-44190 SHERIFF'S FEES 620.82 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 19.80 CHILD SAFETY 0.00 TRAFFIC 34.99 ADMINISTRATIVE FEES 189.90 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44361 TOTAL ADMINISTRATIVE FEES 244.69 CR 1000-001-44010 CONSTABLE FEES -SERVICE 300.00 CR 1000-001-44061 JP FILING FEES 175.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 1,300.40 TOTAL FINES, ADMIN. FEES & DUE TO STATE $6,220.66 CR 2670-001-44061 COURTHOUSE SECURITY FUND $78.55 CR 2720-001-44061 JUSTICE COURT SECURITY FUND $26.18 CR 2719-001-44061 JUSTICE COURT TECHNOLOGY FUND $104.73 CR 2699-001-44061 JUVENILE CASE MANAGER FUND $0.26 STATE ARREST FEES DPS FEES 98.25 P&W FEES 0.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 98.25 CR 7070-999-20610 CCC-GENERAL FUND 104.73 CR 7070-999-20740 CCC-STATE 942.55 DR 7070-999-10010 1,047.28 CR 7860-999-20610 STF/SUBC-GENERAL FUND 17.47 CR 7860-999-20740 STF/SUBC-STATE 331.89 DR 7860-999-10010 349.36 CR 7950-999-20610 TP-GENERAL FUND 125.17 CR 7950-999-20740 TP-STATE 125.17 DR 7950-999-10010 250.34 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 2.10 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 39.90 DR 7480-999-10010 42.00 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/2/2016 COURT NAME: JUSTICE OF PEACE NO. 1 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2016 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 5.24 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 47.13 DR 7865-999-10010 52.37 CR 7970-999-20610 TUFTA-GENERAL FUND 99.95 CR 7970-999-20740 TL/FTA-STATE 199.89 DR 7970-999-10010 299.84 CR 7505-999-20610 JPAY- GENERAL FUND 16.41 CR 7505-999-20740 JPAY-STATE 147.66 DR 7505-999-10010 164.07 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 10.47 CR 7857-999-20740 JURY REIMB. FUND- STATE 94.26 DR 7857-999-10010 104.73 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.15 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.- STATE 1.35 DR 7856-999-10010 1.50 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 42.03 DR 7998-999-10010 42.03 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 70.00 DR 7403-999-22889 70.00 TOTAL (Distrib Req to OperAcct) $8,952.15 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0.00 OUT -OF -COUNTY SERVICE FEE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 0.00 WATER SAFETY FINES 4.25 TOTAL DUE TO OTHERS $4.25 TOTAL COLLECTED -ALL FUNDS $8,956.40 LESS: TOTAL TREASUER'S RECEIPTS $8,956.40 REVISED 03/04/16 OVER/(SHORT) $0.00 Page 2 of 2 CALH®UN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 450 A 42706 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Hope Kurtz Address: Title: Justice of the Peace, Pct. 1 City: State: Zip: Phone: ACCOUNT NUMBER DESCRIPTION AMOUNT 7541-999-20759-999 JP1 Monthly Collections - Distribution $8,952.15 NOVEMBER 2016 V# 967 TOTAL 8,952.15 Signature of Official Date MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/1/2016 COURT NAME: JUSTICE OF PEACE NO.2 MONTH OF REPORT: 0 YEAR OF REPORT: 2016 ACCOUNTNUMBER ACCOUNTNAME AMOUNT CR 1000-001-45012 FINES 4,962.80 CR 1000-001-44190 SHERIFF'S FEES 983.01 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 39.60 CHILD SAFETY 0.00 TRAFFIC 66.46 ADMINISTRATIVE FEES 1,213.90 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44362 TOTAL ADMINISTRATIVE FEES 1,318.96 CR 1000-001-44010 CONSTABLE FEES -SERVICE 600.00 CR 1000-001-44062 JP FILING FEES 282.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 1,662.03 TOTAL FINES, ADMIN. FEES & DUE TO STATE $9,808.80 CR 2670-001-44062 COURTHOUSE SECURITY FUND $135.59 CR 2720-001-44062 JUSTICE COURT SECURITY FUND $45.20 CR 2719-001-44062 JUSTICE COURT TECHNOLOGY FUND $180.78 CR 2699-001-44062 JUVENILE CASE MANAGER FUND $5.00 STATE ARREST FEES DPS FEES 142.62 P&W FEES 1.04 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 143.66 CR 7070-999-20610 CCC-GENERAL FUND 180.74 CR 7070-999-20740 CCC-STATE 1,626.66 DR 7070-999-10010 1,807.40 CR 7860-999-20610 STF/SUBC-GENERAL FUND 32.76 CR 7860-999-20740 STF/SUBC-STATE 622.43 DR 7860-999-10010 655.19 CR 7950-999-20610 TP-GENERAL FUND 143.90 CR 7950-999-20740 TP-STATE 143.89 DR 7950-999-10010 287.79 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 2.40 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 45.60 DR 7480-999-10010 48.00 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/1/2016 COURT NAME: JUSTICE OF PEACE NO.2 MONTH OF REPORT: 0 YEAR OF REPORT: 2016 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 9.04 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 81.35 DR 7865-999-10010 90.39 CR 7970-999-20610 TUFTA-GENERAL FUND 108.08 CR 7970-999-20740 TL/FTA-STATE 216.16 DR 7970-999-10010 324.24 CR 7505-999-20610 JPAY - GENERAL FUND 27.11 CR 7505-999-20740 JPAY-STATE 244.02 DR 7505-999-10010 271.13 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 18.08 CR 7857-999-20740 JURY REIMB. FUND- STATE 162.69 DR 7857-999-10010 180.77 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS.- GEN FUND 0.28 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS.- STATE 2.55 DR 7856-999-10010 2.83 CR 7998-999-20740 TRUANCY PREV/DIV FUND - STATE 80.27 DR 7998-999-10010 80.27 CR 7403-999-22889 ELECTRONIC FILING FEE - STATE 80.00 DR 7403-999-10010 80.00 TOTAL (Distrib Req to OperAcct) $14,147.03 DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 370.50 OUT -OF -COUNTY SERVICE FEE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 192.10 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $562.60 TOTAL COLLECTED -ALL FUNDS $14,709.63 LESS: TOTAL TREASUER'S RECEIPTS $14,709.63 REVISED 03/04/16 OVER/(SHORT) $0.00 Page 2 of 2 CALHOUN DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 460 A 42706 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Address: Title: City: State: Zip: Phone: CalvinAnaerle Justice of the Peace, Pct. 2 ACCOUNT NUMBER DESCRIPTION AMOUNT 7542.999.20759-999 JP2 Monthly Collections - Distribution $14,147.03 0 2016 V# 967 Signature of Official Date TOTAL 14,147.03 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/9/2016 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2016 ACCOUNT NUMBER ACCOUNT NAME AMOUNT CR 1000-001-45013 FINES 3,032.58 CR 1000-001-44190 SHERIFF'S FEES 713.53 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 0.00 CHILD SAFETY 0.00 TRAFFIC 44.82 ADMINISTRATIVE FEES 94.90 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44363 TOTAL ADMINISTRATIVE FEES 139.72 CR 1000-001-44010 CONSTABLE FEES -SERVICE 150.00 CR 1000-001-44063 JP FILING FEES 55,00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44145 SCHOOL CROSSING/CHILD SAFETY FEE 0.00 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 CR 1000-999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0.00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0.00 CR 1000-999-20770 DUE TO JP COLLECTIONS ATTORNEY 1,179.52 TOTAL FINES, ADMIN. FEES & DUE TO STATE $5,270.35 CR 2670-001-44063 COURTHOUSE SECURITY FUND $74.18 CR 2720-001-44063 JUSTICE COURT SECURITY FUND $24.73 CR 2719-001-44063 JUSTICE COURT TECHNOLOGY FUND $100.09 CR 2699-001-44063 JUVENILE CASE MANAGER FUND $5.00 STATE ARREST FEES DPS FEES 58.49 P&W FEES 1.46 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 59.95 CR 7070-999-20610 CCC-GENERAL FUND 99.99 CR 7070-999-20740 CCC-STATE 899.93 DR 7070-999-10010 999.92 CR 7860-999-20610 STF/SUBC-GENERAL FUND 22.42 CR 7860-999-20740 STF/SUBC-STATE 425.89 DR 7860-999-10010 448.31 CR 7950-999-20610 TP-GENERAL FUND 164.12 CR 7950-999-20740 TP-STATE 164.11 DR 7950-999-10010 328.23 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.60 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 11.40 DR 7480-999-10010 12.00 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/9/2016 CR 7865-999-20610 CR 7865-999-20740 CR 7970-999-20610 CR 7970-999-20740 CR 7505-999-20610 CR 7505-999-20740 CR 7857-999-20610 CR 7857-999-20740 CR 7856-999-20610 CR 7856-999-20740 CR 7998-999-20740 CR 7403-999-22889 REVISED 03/04/16 COURT NAME: JUSTICE OF PEACE NO. 3 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2016 CRIM-SUPP OF IND LEG SVCS-GEN FUND 4.40 CRIM-SUPP OF IND LEG SVCS-STATE 39.59 DR 7865-999-10010 43.99 TL/FTA-GENERAL FUND 129.07 TL/FTA-STATE 258.15 DR 7970-999-10010 387.22 JPAY - GENERAL FUND 14.00 JPAY - STATE 125.98 DR 7505-999-10010 139.98 JURY REIMB. FUND- GEN. FUND 9.60 JURY REIMB. FUND- STATE 86.42 150 DR 7857-999-10010 DR 7856-999-10010 DR 7998-999-10010 DR 7403-999-10010 MOO CIVIL JUSTICE DATA REPOS.- GEN FUND 0.15 CIVIL JUSTICE DATA REPOS.- STATE 1.34 1.49 TRUANCY PREVENT/DIVERSION FUND 32.25 32.25 ELECTRONIC FILING FEE TOTAL (Distrib Req to OperAcct) DUE TO OTHERS (Distrib Req Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMI 0.00 OUT -OF -COUNTY SERVK 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINE; 190.40 WATER SAFETY FINES 0.00 20.00 $8,043.70 TOTAL DUE TO OTHERS $190.40 TOTAL COLLECTED -ALL FUNDS $8,234.10 LESS: TOTAL TREASUER'S RECEIPTS $8,234.10 OVER/(SHORT) $0.00 Page 2 of 2 12-05-16;16:55 ;From:Calhoun County JP4 To:5534444 ;3617852179 # 2/ 4 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/l/2016 COURT NAME: JUSTICE OF PEACE NO.4 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2016 ACCOUNT NUMBER ACCOUNT NAME AMOUNT OR 1000-001-45014 FINES 3,344.10 OR 1000-001-44190 SHERIFF'S FEES 171,85 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 9.90 CHILD SAFETY 0.00 TRAFFIC 43.66 ADMINISTRATIVE FEES 333.00 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001 44364 TOTAL ADMINISTRATIVE FEES 386.46 OR 1000-001-44010 CONSTABLE FEES -SERVICE 225.00 CR 1000-001-44064 JP FILING FEES 50.00 OR 1000.001.44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 OR 1000-001.44145 SCHOOL CROSSING/CHILD SAFETY FEE 0100 CR 1000-999-20741 DUE TO STATE -DRIVING EXAM FEE 0.00 OR 1000.999-20744 DUE TO STATE-SEATBELT FINES 0.00 CR 1000-999-20745 DUE TO STATE -CHILD SEATBELT FEE 0,00 CR 1000-999-20746 DUE TO STATE -OVERWEIGHT FINES 0,00 OR 1000.999-20770 DUE TO JP COLLECTIONS ATTORNEY 66.10 TOTAL FINES, ADMIN. FEES & DUE TO STATE $4,242.51 OR 2670-001-44064 COURTHOUSE SECURITY FUND $110.33 CR 2720.001-44064 JUSTICE COURT SECURITY FUND $30.78 CR 2719-001-44064 JUSTICE COURT TECHNOLOGY FUND $147.08 OR 2699-001.44064 JUVENILE CASE MANAGER FUND $0.00 STATEARREST FEES DPS FEES 7.00 P&W FEES 5.00 TABC FEES 0.00 OR 7020-999-20740 TOTAL STATE ARREST FEES 12.00 CR 7070-999-20610 CCC-GENERAL FUND 147.08 CR 7070-999-20740 CCC-STATE 1323.73 DR 7070-999.10010 1,470.81 OR 7860-999-20610 STF/SUBC-GENERAL FUND 21.78 OR 7860.999-20740 STFISUBC-STATE 413.83 DR 7860-999-10010 435.61 OR 7950-999-20610 TP-GENERAL FUND 122.13 OR 7950-999-20740 TP-STATE 122,13 DR 7950-999-10010 244.26 CR 7480-999.20610 CIVIL INDIGENT LEGAL-GEN, FUND 0.60 OR 7480-999.20740 CIVIL INDIGENT LEGAL -STATE 11.40 DR 7480-999-10010 12.00 Page 1 of 2 12-05-16;16:55 ;From:Calhoun County JP4 To:5534444 ;3617852179 # 3/ 4 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 12/1/2016 COURT NAME; JUSTICE OF PEACE NO.4 MONTH OF REPORT: NOVEMBER YEAR OF REPORT: 2016 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 7.35 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 66.19 DR 7865-999-10010 73.64 CR 7970-999-20610 TLIFTA-GENERAL FUND 10.00 CR 7970-999-20740 TUFTA-STATE 20.00 DR 7970-999-10010 30.00 CR 7505-999-20610 JPAY - GENERAL FUND 22.06 CR 7505-999-20740 JPAY - STATE 198 56 DR 7505-999-10010 220.62 CR 7857-999-20610 JURY REIMB. FUND-GEN. FUND 14.71 CR 7857-999-20740 JURY REIMB. FUND- STATE 132.37 DR 7857-999-10010 147.08 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS . GEN FUND 0.24 CR 7856.999-20740 CIVIL JUSTICE DATA REPOS: STATE 2.21 DR 7856.999-10010 gqg CR 7998-999-20740 TRUANCY PREV/DIV FUND - STATE 73.54 DR 7998-999-70010 73.54 CR 7403-999-22889 ELECTRONIC FILING FEE 20.00 DR 7403-999-10010 20.00 TOTAL (Dist►ib Req to OperAcct) $7,278.60 DUE TO OTHERS (Distrlb Rep Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 527.00 OUT -OF -COUNTY SERVICE FEE 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 370.60 WATER SAFETY FINES 0 00 TOTAL DUE TO OTHERS $897.60 TOTAL COLLECTED -ALL FUNDS $8,176.20 LESS: TOTAL TREASUER'S RECEIPTS $8,176.20 REVISED 03/04/16 OVER/(SHORT) $0.00 Page 2 of 2 12-05-16;16:55 ;From:Calhoun County JP4 To:5534444 ;3617852179 # 4/ 4 PAYEE Name: Address: City: State: Zip: Phone: CALHOUN COUNTY 201 West Austin Calhoun County Oper. Acct. DISTRIBUTION REQUEST DR# 480 A 42705 PAYOR Official: Wesley Hunt Title: Justice of the Peace, Pct, 4 12-08-16;09:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 2/ 7 Monay Distribution Report CALHOUN COUNTY JPS NOVEMBER EDITED Receipt Cauae/Defendant Oeflea\Amounts Total 375996 1611-0160-SC 11.02-2019 SFEE 75.00 IEEE 6.00 FILI 25.00 UFF 10.00 116.00 BOERM, HAROLD EUGENE JR „ Company Check �. 375921 ..:. 56;00=0311Y-;SS=03:-2016'J9N2.02-:TFC,..:,•..': 1.50 ,;CCC "':.: •20:;02; p'CHS.'y. .. '1.80- 'SAF: 520.00 .... 0o':_.�JCSF.':�. 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CrOdi C: Chid' .. i _'i ..'' ;. ,: ...: SVBC'. . `30, 00. .TPDF'.:.',.2.U'0:'.'Db'@:..;>.['.'9::90' 375936 1611-0354 11-29-2016 J9F 4.00 TFC 3.00 CCC 40.00 CHS 3.00 LAP• 5.00 250.00 OUSLEY, KASH MELVIN TV 4.00 JC9F 1.00 JPAY 6.00 IDP 2.00 MVP 0.10 Credit Card SUBC 30,00 TRDF 2.00 PINE 149,90 12-08-16;09:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 3/ 7 Money Diotribucion Report CALHOUN COUNTY JPS NOVEMBER EDITBD Type Cade Description Count Ret i od Di b d M y T C le The following totals represent - Cash And Checks Collected COST CCC CONSOLIDATED COURT COSTS 6 22.00 198.02 220.02 COST CHS COURTHOUSE SECURITY 6 16.50 0.00 16.50 COST DPSC DPS FAILURE TO APPEAR /OMNI FEES 1 9.90 20.10 30.00 COST 1DF INDIGENT DEPGMSE FUND 6 1.10 9.90 11.00 COST JCSF JUSTICE COURT SECURITY FUND 6 5.50 6.00 5.50 COST JPAY ,JUDGE PAY RAISE FEE 6 3.30 29.70 33.00 COST JSF JUROR SERVICE FUND 6 2.20 19.82 22.02 COST LAP SHERIPP'S FEE 4 20.00 0.00 20.00 COST MVF MOVING VIOLATION FEE 4 0.03 0.32 0.25 COST PWAF TEXAS PARKS & WILDLIFE 1 4.00 1.00 5.00 COST SAF DPS 1 2.00 0. SO 2.50 COST SUBC SUS TITLE C 3 75.01 0.00 75.01 COST TF TECHNOLOGY FUND 6 22.00 0,00 22.00 COST TFC TFC 3 7.50 0.00 7.50 COST TIMG TIME PAYMENT FEE 1 12.50 12.90 25.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 5 0.00 9.00 9.00 COST WRNT WARRANT FEE 1 50.00 0.00 50.00 FEES CSRV COLLECTION SERVICES FEE 1 115.50 0100 115.50 FEES CDC DRIVER SAFETY COURSE - 2013 1 9.90 0.00 9.90 FEES EFF ELECTRONIC FILING FEE 1 O.OD 10.00 30.00 FEES FILI FILING FEE 1 75.00 0.00 75.00 FEES IFEE INDIGENT FEE 3 0.90 17.10 10.00 FEES SFEE SERVICE FEE 2 150.00 0.00 150.00 FINE FINE FINE 4 582.70 0.00 $02.70 FINE WSF WATER SAFETY FINE 1 4.20 23.00 20.00 Money TOtPIS 9 1,191.74 371.76 1,563.50 Tha following totals raprenent - TYAnsfors Collected COST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 0.00 COST CHS COURTHOUSE SECURITY 0 0.00 0.00 0.00 COST DPSC DPS FAILURE TO APPEAR /OMNI FEES 0 0.00 0.00 0.00 COST IDF INDIGENT DEFENSE FUND 0 0.60 0.00 0.00 COST JCSF JUSTICE COURT SRCORITY FUND 0 0.00 0.00 0.00 COST JPAY JUDGE PAY RAISE FEE 0 0.00 0.00 0.00 COST JSF JUROR SERVICE FUND 0 0.00 0.00 0.00 COST LAF SHERIFF'S FEE 0 0.00 0.00 0.00 COST MVF MOVING VIOLATION FEE 0 0.00 0.00 0.00 COST PWAF TEXAS PARKS & WILDLIFE 0 0.00 0.00 0.00 COST CAP DPS 0 0.00 0.00 0.00 COST SUBC CUB TITLE C 0 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 0 0.00 0.00 0.00 COST TFC TFC 0 0.00 0.00 0.00 COST TIME TIME PAYMENT FEE 0 0.00 0.00 0100 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 0 0.00 0.00 0.00 COST WRNT WARRANT FEE 0 0.00 0.00 0.00 FEES CSRV COLLECTION SERVICES FEE 0 0.00 0.00 0.00 FEES DOC DRIVER SAFETY COURSE - 2013 0 0.00 0.00 0.00 FEES EFF ELECTRONIC FILING FEE 0 0.00 0.00 0.00 PEES FILI FILING PEE 0 0.00 0.00 0.00 FEES IFEG INDIGENT FEE 0 0.00 0.00 0.00 FEES SFEE SERVICE FEE 0 0.00 0.00 0100 FINE FINE FINE 0 0.00 0.00 0.00 FINE WSF WATER SAFETY FINE 0 0.00 0.00 0.00 Transfer Totoln 0 0.00 0.00 0.00 rho following totals roprouent - Jail Crcdit and Community Service :OST CCC CONSOLIDATED COURT COSTS 0 0.00 0.00 0.00 �OST CHS COURTHOUSE SECURITY 0 0.00 0.00 0.00 :OST DDSC DPS FAILURE TO APPEAR /OMNI FEES 0 0.00 0.00 0.00 ;OST IDF INDIGENT DEFENSE FUND 0 0.00 0.00 0.00 :OST JCSP JUSTICE COURT SECURITY FUND 0 0.00 0.00 0.00 90ST JPAY JUDGE PAY RAISE FEE 0 0.00 0.00 0.00 7OST JSF JUROR SERVICE FUND 0 0.00 0.00 0.00 `AST LAF SHERIFF'S FEE 0 0.00 0.00 0.00 t2-08-2016 PA4e 2 12-08-16;09:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 4/ 7 Money Diotrlbutien Report CALHOUN COUNTY JP5 NOVEMBER EDITED Type Cede Deeesiption Count Ratained Dieyu%Ped Money-Tetala COST MVP MOVING VIOLATION FEE 0 0.00 0.00 6.00 COST PWAF TEXAS PARK$ & WILDLIFE 0 0.00 0.00 0.00 COST SAF DPS 0 0100 0.00 0.00 COST SUBC SUB TITLE C 0 0.00 0.00 0.00 COST TF TECHNOLOGY FUND 0 0.00 0.00 0.00 COST TFC TFC 0 0.00 0.00 0.00 COST TIME TIME PAYMENT PEE 0 0.00 0.00 0.00 COST TPDF TRUANCY PREVENTION & DIVERSION FUND 0 0.00 0.00 0.00 COST WONT WARRANT FEE 0 - 0.00 0.00 0.00 FEES CSRV COLLECTION SERVICES FEE 0 1 0.00 0.00 0.00 FEES DDC DRIVER SAFETY COURSE - 2013 0 0.00 0.00 0.00 FEES EFF ELECTRONIC FILING FEE 0 0.00 0.00 0.00 FEES FILI FILING FEE 0 0.00 0.00 0.00 FEES TFEE INDIGENT FEE 0 0.00 0.00 0.00 FEES SFEE SERVICE FEE 0 0.00 0,00 0.00 FINE PINE FINE 0 0.00 0.00 0.00 FINE W$P WATER SAFETY FINE 0 9.00 0.00 0.00 Credit TOtalS The following totalo represent - Credit Card Paymentu COST CCC CONSOLIDATED COURT COSTS COST CHS COURTHOUSE SECURITY COST DPSC DPS FAILURE TO APPEAR /OMNI FEES COST IDF INDIGENT DEFENSE FOND COST JCSF JUSTICE COURT SECURITY FUND COST JPAY JUDGE PAY RAISE FEE COST JSF JUROR SERVICE FUND COST LAP SHERIFF'S FEE COST MVP MOVING VIOLATION FEE COST PWAF TEXAS PARKS & WILDLIPE COST SAF DPS COST SUBC SUB TITLN C COST TF TECHNOLOGY FUND COST TFC TFC COST TIME TIME PAYMENT FEE COST TPDF TRUANCY PREVENTION & DIVERSION POND COST WONT WARRANT FEE FEES CSRV COLLECTION SERVICES FEE FEES DDC DRIVER SAFETY COURSE - 2013 FEES EFF ELECTRONIC FILING FEE FEES FILL FILING PRE FEES IEEE INDIGENT FEE FEES SFEE SERVICE FEE FINE FINE FINE FINE WSF WATER SAFETY FINE Credit ToCala The following totalo repreoent - Combined Money and Credlto COST CCC CONSOLIDATED COURT COSTS COST CHS COURTHOUSE SECURITY COST DPSC DPS FAILURE TO APPEAR /OMNI FEES COST IDP INDIGENT DEFENSE FUND COST JCSF JUSTICE COURT SECURITY FUND COST JPAY JUDGE PAY RAISE FEE COST JSF JUROR SERVICE FOND COST LAP SHERIFF'$ FEE COST MVF MOVING VIOLATION FEE COST PWAF TEXAS PARKS & WILDLIFE COST SAY DPS COST SUBC SOS TITLE C COST TF TECHNOLOGY FUND COST TPC TFC COST TIME TIME PAYMENT FEE COST TPDF TRUANCY PREVENTXON & DIVERSION FUND COST WONT WARRANT PER FEES CSRV COLLECTION SERVICES FEE FEES DDC DRIVER SAFETY COURSE - 2013 0 0.00 0.00 0.00 2 0.00 72.00 80.00 2 6.00 0.06 6.00 0 0.00 0.00 GIGO 2 0.40 3160 4.00 2 2.00 0.00 2.00 2 1.20 10.8D 12.00 2 0.80 7.20 0.00 2 10.00 0100 10.00 2 0.02 0.18 0.20 0 0.00 0.00 0.00 0 0.00 0.00 0.00 2 60.00 0.00 60.00 2 0.00 0.00 8.00 2 6.G0 0.00 6.00 0 0.00 0.00 0.00 2 0.00 d.00 4,00 0 6.00 0.00 0.00 0 0.00 0.00 0.00 1 9.90 0.00 $,90 0 0.00 0.00 0.00 0 0.00 D.00 0.00 0 0.00 0.00 0.00 0 0.00 0.00 0.00 1 149.90 0.00 149.90 0 0.00 0.00 0.00 2 242.22 97.78 360.00 0 30.90 270.02 300,02 0 22.50 0.00 22.50 1 9.90 20.10 30.00 0 1.50 13.50 15.00 0 7.50 0.00 7.50 0 4.50 40.90 45.00 0 3.00 27.02 30,02 6 30,00 0.00 30.00 G 0.05 0.50 0.59 1 4.00 1.00 5.00 1 2,00 0.50 2.5o 5 135,01 0.00 135.01 0 30.00 0.00 30.00 5 13,50 0.00 13.50 1 12.50 12.50 25,00 7 0.00 13.00 13.00 1 50.00 0.00 50.00 1 115.50 0.00 115.50 2 19.00 0.00 19.B0 12-00-2016 Page 12-08-16;09:35AM;From;Calhoun County JP5 To:5534444 ;3619832461 # 5/ 7 Money Dintrlbution Report CALROON COONTY PP5 NOVEMBER EDTTED Typo Code Description Count RetAined Dinburaed Money-Tetalo FE5S OFF ELECTRONIC FILING FCE 3 0.00 lO.DO 30.00 PEES FILI FILING FEE 3 75.00 O.DO 75.00 FENS IFEE INDIGENT FEE 3 0.90 17.10 10.00 FENS $FEE SERVICE FOE 2 I50,00 0100 150,00 FINE FINE FINO 5 732.6D, 0.00 732.60 FINE WSF WATER SAFETY FINE 1 4,2D 23,00 28.00 Roport Totals 11 1,453.96 469.54 1,923.50 12-00-2015 Pago 12-08-16;09:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 6/ 7 Money DiotributioA RCPore CALHobH COM= ,785 Dfoy&tDE9, WMAD Date Payment Type Pines Court Coots Vees BOndo Restitution other Total 00-00-0000 Cash & Chocks Collected 0.00 0.00 0.00 O.OD 0.00 0.00 0.00 ,7ai1 Credits & Comm service 0.00 0.00 0.00 0.00 GIGO GIGO 0100 Credit Cards & Transfars 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total 09 all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09-01-1992 Cash & Checks Collected 0.00 0.00 0.00 GIGO 0.00 0.00 0.00 ,Tail Credits & Comm Sorvica GIGO 0.00 0.00 0.00 O.OD 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total or all Collections 0.00 0.00 0.00 GIGO 0.00 0.00 0.00 09-01-1993 Cash & Chocks Collected O.OD 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.06 O,Oo Total of all Collections 0.00 0.00 0.00 0.00 0.00 0100 0.00 09-01-A999 Cash & Checks Colloctod 0.00 0.00 0.00 O.DO 0.00 0.00 0.00 JAIL Credits & Comm Service 0.00 0.00 0.00 O.DO 0.00 0.00 0.00 Credit Cardd & Transfers 0.00 0100 0100 0.00 0.00 0.00 0.00 Total of all Collections 0.00 GIGO 0.00 0.00 0.00 GIGO 0.00 09-01-1997 Cash & Checks Collected 0.00 0.00 0.00 0.00 GIGO 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 040 Credit Cards & Transfer@ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Of all Collections 0.00 0.00 0.00 D.00 0.00 0.00 0.00 09-01-1999 Cash & Checks Colloctad 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Tran9forn D.00 0.00 0.00 0.00 0.00 0.00 0.00 Total of all Collections 0.00 0.00 0.00 0.00 0.00 0.00 0.00 09-01-2001 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total of all Collections 0.00 O.DD 0.00 0.00 0.00 0.00 0.00 09-01-2003 Cash & Checks Collected 0.00 0.00 0.00 0.00 0.00 O.DO 0.00 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total of all Collections 0.00 0.00 O.DO 0.00 0.00 0.00 0.00 01-01-2004 Cash & Checks Collected 610.70 554.40 390.40 0.00 0.00 0.00 1,S63.50 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Credit Cards & Transfers 149.90 200.20 9.90 0.00 0.00 0.00 360.00 Total of all Collections 760.60 754.60 400.30 0.00 0.00 0.00 1,923.50 TOTALS Cash & Chocks Collected 610.70 554.40 395.40 0.00 0.00 O.Do 1,563.50 Jail Credits & Comm Service 0.00 0.00 0.00 0.00 0.00 0.00 0,00 Credit Cards & Transfers 149.90 200.20 9.90 0.00 0.00 0.00 360.00 Total of all Collections 760.60 754.60 400.30 0.00 0.00 0.00 1,923.50 12-00-2016 Page 5 12-08-16;09:35AM;From:Calhoun County JP5 To:5534444 ;3619832461 # 7/ 7 money Distribution RopOrt CALHOUN COUNTY JP5 NOVEMBER 14DITED Deaari Lion count Collected Retained Diobur0ed State of Texaa Ouartorly Reporting Totals State Comptroller Cost and Feet Report Section I: Report for Offenses Committed 01.01.04 Forward l3 435.03 435.03 0.00 09-01-01 - 12-31-03 0 0.00 0.00 0.00 08-31-99 - 08-31-01 0 0.00 0.00 0.00 09-01.97 - 08-30-99 0 0.00 0.00 0.00 09.01-91 - 08.31-97 0 0.00 0.00 0.09 Dail Bond Fee 0 0.00 0.00 0.00 DNA Testing Fee - Conviotione 0 0.00 0.00 0.00 DNA Testing Fee - Comm Supvn 0 0.00 0.00 0.00 DNA Testing Fee - Juvenile 0 0.00 0.00 0.00 EMS Trauma Fund (EMS) 0 0.09 0.00 0.00 Juvenile Probation Diversion Fees 0 0.00 0.00 0.00 Jury Reimbursement Fee 8 30.02 1.00 27.02 Indigent Defense Fund 8 1$.00 1.50 13.50 Moving Violation Fees 6 0.55 0.05 0.50 state Traffic Pino 0 0.00 0.00 0.00 $action II: An Applicable Patton Officer Fees 2 1.50 0.00 1.50 Failure to Appear/Pay Veen 1 30.00 9.90 20.10 Judicial Fund - Count County Court 0 0.00 0.00 0.00 Judicial Fund - Statutory County Court 0 0.00 0.00 0.00 Motor Carrier Weight violations 0 0.00 0.00 0.00 Time Payment Fees 1 7.5.DO 12.50 12.50 Driving Record Fee 0 0.00 0.00 0.00 Judicial Support Fee 0 45.00 4.50 40-50 Truancy Prevention and Diversion Fund 0 0.00 0.00 0.00 Report Sub Total 47 588.10 472.48 115.62 State Comptroller Civil Fees Report CF: Elrth Certificate Fees 0 0.00 0.00 0.00 CF; Marriage License Fees 0 0.00 0.00 0.00 CF; Declaration of Informal Marriage 0 0.00 0.00 0.00 CF: NondisclOSUre Fees 0 0.00 0.00 0.00 CF! Juror Donations 0 0.00 0.00 0.00 CF; Justice Court Indig Filing Foes 3 10.00 0.90 17,10 CF•: stat prob Court Indig Filing Gees 0 0.00 0.00 0.00 CF; Stat Frob Court Judie Filing Fees 0 0.00 0.00 0.00 CF: $tat Cnty Court Indig Filing Fees 0 0.00 0.00 0.00 CF, Stat Cnty Court Judie Piling Face 0 0.00 0.00 0.00 CF: Cnst Cnty Court Indig Filing Fees 0 D.OD 0.00 0.00 CF, Cnst Cnty Court Judic Filing Fees 0 0.00 0.00 0.00 CF; Dist Court Divorce & Family Law 0 0.00 0.00 0.00 CF: Dist Court Other Divorce/Family Law 0 0.00 0.00 0.00 CF: Diet Court Indig Loga1 services 0 0.00 0.00 0.00 CF. Judicial Support Fee 0 0.00 0.00 0.00 Report Sub Total 3 18.00 0.90 17.10 Total Due For This Period 50 906.10 473.39 132.72 THE STATE OF TEXAS nefore me, the undorsigned authority, thin day County of Calhoun County personally AppearOd Nancy Fomykal, Juntiee of the Peace, Precinct No 5, Calhoun County, Texas, who being duly sworn, deposes and says that the above and foregoing%%port is true and correct. witness my hand this ,� flay oT�� A.���. Calhoun 0%CE CpG' Susan Riley From: Katherine Sutherland <kdsutherland@ag.tamu.edu> Sent: Monday, December 12, 2016 10:50 AM To: Donnie Montemayor; Barbara Moretich; vern.lyssy@calhouncotx.org; mike.pfeifer@calhouncotx.org; Roger.Galvan@calhouncotx.org; neiffritsch@calhouncotx.org; Kenneth Finster (kenny.finster@pct4.org); susan.riley@calhouncotx.org Cc: Eric C. Taylor; Tina Trevino; Rhonda Cummins Subject: Commissioner's Report and Travel for Calhoun County Attachments: Commissioners Report - Tina Trevino.pdf; November Commissioners report Eric Taylor.pdf; Comrpt_November_2016.pdf; Travel Report for November 2016.pdf Attached are the Calhoun County Commissioner's reports and travel for November 2016 Office i 552-9747 ADM 2.6 Reprint - 2.81 D-843 EXTENSION ACTIVITY REPORT TO COUNTY COMMISSIONERS COURT Miles traveled :217.20 Selected maior activities since last report -November 2016 November 7: Tina meets with her TEEA group where they planned for the upcoming Christmas Party on December 5. November 8: Tina attended the Calhoun County ISD District Education Improvement Advisory Panel (DEIA). Tina also held a food challenge practice where they have 4 Jr/Intermediate Teams and 2 Senior Teams. November 15: Tina along with 4 TEEA members attended the district TEEA meeting in Victoria. Tina also held a food challenge practice where they have 4 Jr/Intermediate Teams and 2 Senior Teams. November: 29: Tina also held a food challenge practice where they have 4 Jr/Intermediate Teams and 2 Senior Teams. c$ November 30: Tina attended the Wesley Ministry Meeting along with meeting with Signy the Wesley nurse to plan programs for the 2017 year. Direct Contacts: Phone:390 E-mail/Letters:485 Office:10 Site:15 W ebs ite/Newspaer:4700 Major events for next month —December 2016 Life Skill cooking class at Travis and CHS TEEA Meeting HST Coalition Travel(Personal Vehicle) In County Mileage: 61.7 Out of County Mileage:155.50 Tina Trevino f� V f� Calhoun Name County County Extension Agent -Family and Consumer Science November 2016 Title Date (Month -Year) Texas A&M Agril-ife Extension Services • College Station, Texas vN �o l o d b s +v Y O G EC J 0 O N m m +n o O O O o 0 0 0 O O O O _ t4 p aP o o ,p o p o rn o 0 00 o a v a ry MO. O�O <cnyto M N M Oi �t (`1 M r• � b vl h^ �•+ W Q W U O o E O 7 Cl d z w U O 94 a z O ti a U C4 0 W o 1 w a rx * c a S re > C4 U U W O s U > 'a w s> E b U a y > y F 00 > U U F v c U U V c a E3 m 'b4tn r m bIn p. p U U O O w 3 00 bq v L� W bA .�. .�., ro Q � .�., F�7 av-, ��-• .�+U.1 N a G! r•' 0 0 N 0 0 O O O O O CA N O O O O O p 0 0 0 N e'H `I N Q N IN t� OZY) H � V ADM 2.6 Reprint - 2.81 D-843 EXTENSION ACTIVITY REPORT TO COUNTY COMMISSIONERS COURT Miles traveled 716 Selected maior activities since last report- November 2016 Nov 1 — 4-H council distributed 67 coat donation boxes to Calhoun High School for a coat drive Nov 2-3 —Attended District 4-H Agents Association retreat in Corpus Christi Nov 5 — Took kids to Aggie fast Judging contest in College Station 5 kids competed. Nov 7 — Attended All Around 4-H meeting to Conduct Food Challenge presentation with Tina Trevino Nov 8 —Assisted Tina Trevino with Food Challenge Practice. Nov 9 — Held Major Livestock show sign up night. Nov 18-20 — Took kids to attend District 11 Cross roads, which is a career and college exploration event, 5 kids attended. Nov 28 — Held 4-H council meeting in which they baked cookies for Calhoun Sheriff's dept., Port Lavaca Police Dept., Point Comfort Police Dept., and Sea Drift Police Dept. Nov 28 — Held Parent and Adult Leader Association meeting in which we discussed possible fundraiser ideas. Nov 29 —Assisted Tina Trevino with Food Challenge Practice. Direct Contacts: Phone:72 E-mail/Letters:375 Off ice: 12 Site:7 Maior events for next month —Dec 2016 Dec 2-3: Coastal Bend Classic Dec 6: Extension Open House Dec 9-11: State District Council Retreat L__ I Eric Taylor Calhoun Name County County Extension Agent —4-H & Youth Development December 2016 Title Date (Month -Year) Texas AgriLife Extension Service • The Texas A&M University System • College Station, Texas ADM 2.6 Reprint - 2.81 D-843 EXTENSION ACTIVITY REPORT TO COUNTY COMMISSIONERS COURT Miles traveled: 534.8 Selected major activities since last re>l ort November 2-4: As a partner with the Victoria Children's Discovery Museum, I conducted the beach station during the Junior Marine Exploration Week held at Lighthouse Beach. Over the three-day event we reached 404 students and their teachers from elementary schools in Victoria and Port Lavaca. The event is designed for 4`h graders and includes other stations on the marsh habitat and blue crabs. November 3: Marine Advisory Committee meeting was held at the Green Iguana restaurant in Port Lavaca. Major agenda items including planning for the 2017 Cooking with Seafood program, adding another board member and an update from the Department of State Health Services on the current oyster season. November 10-12: I joined CEA Terrie Looney and Outreach Specialist Rhonda Patterson at the Conference for the Advancement of Science Teaching (CAST) held in San Antonio. We operated a vendor's booth in the exhibit hall and distributed marine science information to K-12 teachers. The organizers of the event expected 7,000 people to attend the conference. November 18: I led an earth science field trip with the OLG 61h grade class to Matagorda peninsula. Erosion, accretion, delta formation, marsh value, birdwatching, shell identification, marine debris, and dune formation were some of the topics during the trip. We also discussed the Gulf Intracoastal Waterway, the Colorado Locks and related marine/maritime careers. Most youth are unaware of the many job opportunities available upon the water. November 19: Fifteen students from the Victoria College Respiratory program volunteered to assist me with the monofilament recycling program. They spent 3 hours working and completed my backlog of gill nets. This will result in approximately 120 pounds of monofilament to return once the shipping boxes arrive. November 21-25: Thanksgiving vacation November 29: I was asked to serve on the Alcoa Community Advisory Board for the Point Comfort Operations and attended my first meeting. I anticipate I will be very involved in the educational effort when dredging starts on Causeway Cove. Direct Contacts by: Office: 10 E-mail/Letters:574 Site:173 Newsletters:1092 Phone:39 Volunteers:136 Major events for next month — December 2016 December 5-6: Texas Sea Grant meeting in College Station December 6: Annual Extension Open House December 8: Port Lavaca Christmas Parade. Rhonda Cummins Name CEA - CMR Title County November 2016 Date (Month -Year) Texas A&M AgriLife Extension • The Texas A&M University System • College Station, Texas Sea Grant Metrics • Number of Events: 1 Number of People at Events: 150 • Number of Presentations: 0 o Number of People at Presentations: • Number of K-12 Educational Activities: 2 o Number of Youth: 419 o Number of Educators: 37 • Number of Certificates Issued: 0 • Number of Volunteer Hours: 68.5 Note: this month hasl5 new people volunteering Consider and take necessary action to accept donations of 83 Burn Barrels from Marine Service with a value of $830.00 to Calhoun County Road and Bridge Precinct #2. (VL) Commissioner Lyssy made the motion to accept donations of 83 Burn Barrels from Marine Service, with a value of $830.00 to Calhoun County Road and Bridge Precinct #2. Commissioner Fritsch seconded the motion Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Vern Ly Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 December 1, 2016 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: a (361) 552-9656 Fax (361) 553-6664 Please place the following item on the Commissioners' Court Agenda for December,&, 2016 • Consider and take necessary to accept the donation to Calhoun County Road and Bridge, Pct. 2 from Marine Service. Sincere , Vern yC sy VL/Ij Freedom Boats USA, LLC 3535A US Hwy 87 Port Lavaca TX 77979 Phone W 361-5524975 forestc-freedomboatsusa.com ww Aecdomboatsusa.com Calhoun County Vem Lyssy a 12/5/2016 82 1 Consider and take necessary action on donation from Knipland LLC in the amount of $500 to the Calhoun County Historical Commission for the Edward F. Knipling Historical Marker. (MP) Commissioner Fritsch made the motion to accept donation from Knipland LLC in the amount of $500 to the Calhoun County Historical Commission for the Edward F. Knipling Historical Marker. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Susan Rile From: Rhonda Kokena <rhonda.kokena@calhouncoIx.org> 1 Sent: Tuesday, December 13, 2016 8:37 AM J/ To: Susan Riley Subject: AGENDA ITEM Please add to the next agenda: To Accept and Approve donation from Knipland LLC in the amount of $500 for the Edward F Knipling historical marker. RHONDA S. KOKENA cowwly Trea$4'we.r C,c+.1.{ owm C,m, +.v AvumzK. 11 202 S. Av,*v St, Sv,4v A POrtLav+xea,, Te"4, 77979 (361)553-4619 offecv (361)553-4614 fade, Consider and take necessary action to accept check in the amount of $2,973.75 for equipment that was sold at the auction and place in the Six Mile Community Volunteer Fire Department supplies -Miscellaneous (695-53992) account for 2017. (VL) Commissioner Lyssy made a motion to accept check in the amount of $2,973.75 for equipment that was sold at the auction and place in the Six Mile Community Volunteer Fire Department supplies - Miscellaneous (695-53992) account for 2017. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 December 12, 2016 Honorable Michael Pfeifer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Pfeifer: (361) 552-9656 Fax (361) 553-6664 Please place the following item on the Commissioners' Court Agenda for December 22, 2016 • Consider and take necessary to accept $2973.75 check for equipment that was sold at the auction and place in the Six Mile Community Volunteer Fire Department Supplies -Miscellaneous (695-53992) account for 2017. Sincerely Vern Lyssy VL/Ij Consignor Settlement Marvin D. Seitz & Associates CO #: 157 509 Ashland Creek Date: 12/5/2016 Victoria, TX 77901 Page: 1 Phone: 361-564-4646 Consignor Six Mile Volunteer Fire Department P.O.Box 209 Port Lavaca, TX 77979 Phone:361-550-9656 Auction: 2016 Port Lavaca Chamber of Commerce Consignment Auction Lot# Description Quantity Unit Prioe Ext.Price Expenses 420 18 HP Vanguard motor (locked up) 1.00 25.00 25.00 0.00 Bid Card # 47 421 18 Hp Pump & Motor (needs minor repairs) 1.00 100.00 100.00 0.00 Bid Card # 47 422 16' Trailer w/1000 gal water tank & Honda Motor 1.00 1,200.00 1,200.00 0.00 Motorized Equipment or Trailers Bid Card # 85 423 GMC 1 ton Truck unit 877 1.00 250.00 250.00 0.00 Motorized Vehicles Bid Card # 85 424 Chevy Utility Bed 1.00 60.00 60.00 0.00 Bid Card # 85 426 Aluminum Toolbox 1.00 25.00 25.00 0.00 Bid Card # 6 428 Chevy 1ton - Unit 701 1.00 1,500.00 1,500.00 0.00 Motorized Vehicles Bid Card # 2 429 GMC1ton Truck - Unit 523 1.00 350.00 350,00 0.00 Motorized Vehicles Bid Card # 2 430 Hose Reel w/Hose 1.00 5.00 5.00 0.00 Bid Card # 26 431 Hale Pump 1.00 10.00 10.00 0.00 Bid Card # 26 Consignor Settlement Marvin D. Seitz & Associates 509 Ashland Creek Victoria, TX 77901 Phone: 361-5644545 COMMISSION SETTINGS Calculate Commission By: Consignment Order Commission Structure Type: Sliding Scale up to $2,499.99 25% $2,500 - $9,999.99 200A Over $9,999.99 15% CO #: 157 Date: 12/5/2016 Page: 2 Total Quantity: 10.00 Total Invoice Sale Price: 3,525.00 Total Commission: ( 551.25) Total Due to Consignor: 2,973.75 Total Payments: 0.00 Balance: $2,973.75 Positive Balance, Monies Owed to Consignor Inventory Remaining For This Consignment Order Consider and take necessary action to declare certain items of County property as waste. These items were previously declared Surplus/Salvage and failed to sell at the Chamber Auction. (See List) (MP) Commissioner Fritsch made a motion to declare certain items of County property as waste. These items were previously declared Surplus/Salvage and failed to sell at the Chamber Auction. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. 10 desks 2 tables 3 tV's 6 printers 1 chair 2 pc's Untitled Page 1 Consider and take necessary action to declare certain items of property in the office of the District Clerk as Surplus/Salvage and remove from Inventory. (See List) (MP) Commissioner Fritsch made a motion to declare certain items of property in the office of the District Clerk as Surplus/Salvage and remove from Inventory. (See List) Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. From: Anna Kabela <anna.kabela@calhouncotx.org> Sent: Friday, December 16, 2016 9:56 AM To: susan.riley@ca[houncotx.org Subject: INVENTORY SURPLUS Attachments: INVENTORY.pdf Good morning Susan, Would you please be so kind as to place my attached Transfer, Surplus and Waste Declaration Request Forms on the next Commissioners' Court agenda so that the items can be removed from the District Clerk and District Court Inventory. This includes asking the Court to consider and take necessary action to transfer three file cabinets (asset #'s 450-0012, 450-0005, and 450-0014) from the Calhoun County District Clerk to the Calhoun County E911 District according to LGC 263.152. Thank you so much for your assistance in this matter. Anna Kabela Calhoun County District Clerk 211 South Ann Street Port Lavaca, Texas 77979 (361) 553-4630- Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: District clerk Requested By: Anna Kabela Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration small seen D1astic trasl can not needed electronic blue Plastic tub not needed 7 desktop file organizerg organizer not ne 1 large wooden desk not needed 1 wooden credenza not needed brown metal deskdivider 4 black file organizers not needed brown & black metal file organizer not needed 1 maroon fie organizer no nee ed i!reen tub not ngpded 3 computer monitor metal desktop stands not needed 1 umbrella not needed black telephone line cord not needed sure rotector not needed white exten ion cord not nggAgd gray telephone cord not needed Lo itech keyboard K350 not needed HP Keyboard K -0316 not needed 2 brown chairs not npAdpa clear Plastic desk organizer not needed plastic drawer organizer (2) not needed black metal desk divider not needed black metal basket not needed tall brown wooden cabinets not needed 1 wooden desk not needed 2 drawer metal file cabi et not needed Calhoun County, Texas SURPLUS/SALVAGE DECLARATION REQUEST FORM Department Name: District clerk Requested By: Anna Kabela Inventory Reason for Surplus/Salvage Number Description Serial No. Declaration 450-0108 lHewitt Packard Laser Jet 1160 CNLID26662 not needed 450-0108 Witt Packard Laser Jet 250 CNGXG37387not needed 450-0028 cabinet w/roller shelves not needed 450-0047 numbering machine Bates not needed 450-0006 metal desk not needed 450-0088 computer printer card not needed 4 metal desk not needed 427-0002 metal desk not needed 450-0093 -drawer metal file cabinet not needed 45 -00 2 4-drawer metal file cabinet not needed 450-0027 4-drawe-r.metalfile cabinets (2)not needed 450-0062 4-drawer metal file cabinets 2 not needed 0- -drawer metal file cabinet not needed -dra er eta file cabinet not needed Wireless Touch Keyboards (2) not neededLazite-eb 2 black Plastic crates not needed 7 pop-up note dispensers not needed Lighthous.(L-Picture not needed Hotel Lafayette picture not needed clipboard not needed tape dispenser 3 black high -back chairs not needed metal coat rack not needed 2 black metal book cases 4-drawer wooden desk dividers not needed BP Desk'et 6122 Printer not needed batter back-up sure protector not Deeded small paper shredder not nopdpd HP Photosmart C3135 printer not needed Consider and take necessary action on the matter of declaring certain items of County property as surplus/salvage. N/A From: Anna Kabela <anna.kabela@calhouncotx.org> Sent: Friday, December 16, 2016 9:56 AM To: susan.riley@calhouncotx.org Subject: INVENTORY SURPLUS Attachments: I N V ENTORY. pdf Good morning Susan, Would you please be so kind as to place my attached Transfer, Surplus and Waste Declaration Request Forms on the next Commissioners' Court agenda so that the items can be removed from the District Clerk and District Court Inventory. This includes asking the Court to consider and take necessary action to transfer three file cabinets (asset #'s 450-0012, 450-0005, and 450-0014) from the Calhoun County District Clerk to the Calhoun County E911 District according to LGC 263.152. Thank you so much for your assistance in this matter. Anna Kabela Calhoun County District Clerk 211 South Ann Street Port Lavaca, Texas 77979 (361) 553-4630 Calhoun County, Texas WASTE DECLARATION REQUEST FORM Department Name: DISTRICT CLERK Requested By: ANNA KAEELA Inventory Number Description Serial No. Reason for Waste Declaration fellows scanner P5-77C broken desktop fan broken shredder broken Consider and take necessary action on the matter of declaring certain items of County property in the office of the District Clerk as Waste and remove from inventory. (See List) (MP) Commissioner Lyssy made a motion to declare certain items of County property as Surplus/Salvage. Commissioner Fritsch seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. From: Anna Kabela <anna.kabela@calhouncotx.org> Sent: Friday, December 16, 2016 9:56 AM To: susan,riley@calhouncotx.org Subject: INVENTORY SURPLUS Attachments: I NVENTORY. pdf Good morning Susan, Would you please be so kind as to place my attached Transfer, Surplus and Waste Declaration Request Forms on the next Commissioners' Court agenda so that the items can be removed from the District Clerk and District Court Inventory. This includes asking the Court to consider and take necessary action to transfer three file cabinets (asset #'s 450-0012, 450-0005, and 450-0014) from the Calhoun County District Clerk to the Calhoun County E911 District according to LGC 263.152. Thank you so much for your assistance in this matter. Anna Kabela Calhoun County District Clerk 211 South Ann Street Port Lavaca, Texas 77979 (361)553-4630 Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Inventory Number Description Requested By: ANNA KASELA (DISTRICT CLERK) Serial No. Transfer From/To Department -0 -drawer metal file cabin t to Sheriff's Office 450-0003 4-drawer metal file cabin t to Sheriff's Office 450-0012 4-drawer metal file cabin t to 911 450-0005 4-drawer metal file cabin t to 911 450-0014 4-drawer metal file cabin t to 911 450-•0013 4-drawer metal file cabin(t to Precinct 3 450-0014 4-drawer metal file cabin(t to County Clerk's Office 450-0095 wooden counsel table to County Clerk's Office 450-0011 metal tewriter table to County Clerk's Office 450-0087 black chair on wheels to Elections Office 450-0079 L-shaped wooden desk to Precinct 2 black a ti rolling: carl to District Attorne 's Office wooden counsel table to County Clerk's Office wooden hutch to County Clerk's Office 2-tier red cart on wheels to County Clerk's Office 2-tier.red electric cart n wheels to County Clerk's Office square metal bulletin boaid to County Clerk's Office 2-drawer horizontal file dabinet to County Clerk's Office 2-tier plastic cart on wheels_____ to Elections Office wooden typewriter table to Elections Office 3 clip boards to Elections Office plastic desktop letterhol er to Elections Office wooden tabe w/folding less to Elections Office 2 plastic tables w fold ing legs to Elections Office 2-tier wooden cart on wheels to Elections Office 1 electric stapler to Elections Office 2-drawer metal file cabinet to Elections Office 9 U-shaped desks to Sheriff's Office Consider and take necessary action to authorize the transfer of three file cabinets (Asset #450-0012, 450-0005, and 450-0014) from the Calhoun County District Clerk to the Calhoun County E911 District according to LGC 263.152. (MP) Commissioner Fritsch made a motion to authorize the transfer of three file cabinets (Asset #450-0012, 450-0005, and 450-0014) from the Calhoun County District Clerk to the Calhoun County E911 District according to LGC 263.152. (MP) Commissioner Lyssy seconded that motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. From: Anna Kabela bee 1 , 2016@calhouncotx.org> Sent: Friday, December 16, 2016 9:56 AM To: susan.riley@calhouncotx.org Subject: INVENTORY SURPLUS Attachments: I NVENTORY. pdf Good morning Susan, Would you please be so kind as to place my attached Transfer, Surplus and Waste Declaration Request Forms on the next Commissioners' Court agenda so that the items can be removed from the District Clerk and District Court Inventory. This includes asking the Court to consider and take necessary action to transfer three file cabinets (asset #'s 450-0012, 450-0005, and 450-0014) from the Calhoun County District Clerk to the Calhoun County E911 District according to LGC 263.152. Thank you so much for your assistance in this matter. Anna Kabela Calhoun County District Clerk 211 South Ann Street Port Lavaca, Texas 77979 (361)553-4630 Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested By: ANNA KABELA (DISTRICT CLERK) Inventory Number Description Serial No. Transfer From/To Department 0- -drawer metal file cabin t to Sheriff's Office 450-0003 4-drawer metal file cabin t to Sheriff's Office 450-0012 4-drawer metal file cabin t to 911 450-0005 4-drawer metal file cabin t to 911 450-0014 4-drawer metal file cabin t to 911 450-0013 4-drawer metal file cabin(t to Precinct 3 450-0014 4-drawer metal file cabin t to County Clerk's Office 450-0095 wooden counsel table to County Clerk's Office 450-0011 metal typewriter table to County Clerk's Office 450-0087 black chair on wheels to Elections Office 490-0079 L-shaped oo en desk to Precinct 2 black a ti rolling ar to District Attorne 's Office wooden counsel table to County Clerk's Office wooden hutch to County Clerk's Office 2-tier red cart on wheels to County Clerk's Office 2-tier red electric cart n wheels to County Clerk's Office square metal bulletin boaid to County Clerk's Office 2-drawer horizontal file dabinet to County Clerk's Office 2-tier plastic cart on wheels to Elections Office wooden typewriter table to Elections Office 3 clip boards to Elections Office plastic desktop letterhol er to Elections Office wooden table w/folding legs to Elections Office. 2 Rlastic tables w/folding legs to Elections Office 2-tier wooden cart on wheels to Elections Office 1 electric stapler to Elections Office 2-drawer metal file cabinet to Elections Office 3 U-shaped desks to Sheriff's Office Calhoun County, Texas DEPARTMENTAL INVENTORY TRANSFER REQUEST FORM Requested By: ANNA KABBLA (DISTRICT COURT) Inventory Number Description Serial No. Transfer From/To Department 435-0028 Safe to IT Department Consider and take necessary action to authorize the transfer of various items of property from the Calhoun County District Clerk to other County Departments. (See Lists) (MP) Commissioner Fritsch made a motion to authorize the transfer of various items of property from the Calhoun County District Clerk to other County Departments. (See Lists) Commissioner Lyssy seconded that motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Consider and take necessary action on matter of transferring certain items of County property from one County department to another County department. (See List) N/A Approval of payroll. N/A Consider and take action on any necessary budget adjustments. Commissioner Fritsch made a motion to approve necessary budget adjustments. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. 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(MP) N/A Approval of bills. Commissioner Fritsch made a motion to approve Memorial Medical bills dated 12/22/2016. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Commissioner Fritsch made a motion to approve County bills dated 12/22/2016. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. Commissioner Fritsch made a motion to approve bills for Road & Bridge & 1 and for the Jail and Sheriff's Department. Commissioner Lyssy seconded the motion. Commissioners Galvan, Lyssy, Fritsch, Finster and Judge Pfeifer all voted in favor. December 8th, 2016 2016 APPROVAL MST - 2016 BUDGET COMMISSIONERS COURT MEETING OF 12/08/16 Commissioner Roger Galvan Road & Bridge #1 4C SERVICES LIMESTONE SOUTH TEXAS CORRUGATED PIPE CONCRETE PIPE MELSTAN CULVERT PIPE ADAPCO 30 GAL PERMANONE ADAPCO 30 GAL DRUM PERMANONE Commissioner Neil Fritsch; Road & Bridge #3 Sheriff George Aeman Jail, & Sheriffs Department $ 10,486.25 $ 2,400.00 $ 508.50 $ 704.40 $ 1,694.40 Subtotal: $ 15,793.55 Subtotal: $ STUNTRONICS LLC(PRE APPROVED 12/08) STUN PACK WITH BATTERY $ 1,015.00 SOUTHERN SOFTWARE(PRE APPROVED 12/08) ANNUAL RENEWAL $ 12,748.00 SOUTHERN SOFTWARE(PRE APPROVED 12/08) RENEWAL SUPPORT FEE $ 5,880.00 CODEX CORP(PRE APPROVED 12/08/16) MOBIL DEVICE WITH BATTERY $ 10,615.00 VICTORIA PROFESSIONAL PRISONER MEDICAL BILL $ 1,702.00 FIRESTONE OF PORT LAVACA OIL CHANGE $ 945.64 HEB CREDIT RECEIVABLES MISC GROCERIES $ 696.77 BEN E KEITH FOODS GROCERIES FOR INMATES $ 4,213.18 AMERICAN TIRE DISTRIBUTORS TIRES $ 1,414.44 Subtotal: $ 39,230.03 Total Vendor Disbursements: $ 55,023.58 December 22, 2016 2016 APPROVAL LIST - 2016 BUDGET COMMISSIONERS COURT MEETING OF 12/22/16 BALANCE BROUGHT FORWARD FROM APPROVAL LIST REPORT PAGE 36 FICA MEDICARE FWH AFLAC COMBINED INSURANCE C/O PEOPLES UNITED BANK NATIONWIDE RETIREMENT SOLUTIONS OFFICE OF THE ATTORNEY GENERAL - CHILD SUPPORT PRINCIPAL FINANCIAL GROUP RELIANCE STANDARD LIFE TEXAS ASSOCIATION OF COUNTIES HEBP MED/DENTAL/AD&D PREM FOR CO EMS TEXAS COUNTY & DISTRICT RETIREMENT SYSTEM TMPA 'FRUSIMARK UNITED WAY OF CALHOUN COUNTY WILLIAM E. HEITKAMP, TRUSTEE AT&T AT&T MOBILITY CABLE ONE CALVIN ANDERLE JP2:JUSTICE OF THE PEACE SEMINAR CARDMEMBER SERVICE - SHERIFF/JAIL CARDMEMBER SERVICE -COUNTY CENTERPOINT ENERGY CHALLENGE OFFICE PRODUCTS DA: OFFICE FURNITURE & ROLLING CART CHEM-DRY OF VICTORIA JP5:CARPET CLEANING CITY OF POINT COMFORT CITY OF PORT LAVACA CITY OF SEADRIFT CONSTELLATION NEW ENERGY CPL RETAIL ENERGY FRONTIER COMMUNICATIONS G&W GBRA JACKSON ELECTRIC COOP, INC. LA WARD TELEPHONE EXC. INC. MCI COMM SERVICE NEOFUNDS BY NEOPOST PLAS-MAC INC PORT LAVACA WAVE REPUBLIC SERVICES#847 SPRINT SUPERIOR TROPHIES TEXAS WAVENET WIRELESS TISD, INC VERIZON WIRELESS VICTORIA ELECTRIC CO-OP VOYAGER WCID#1 37 $6,167,245.01 P/R $ 50,987.81 P/R $ 11,665.70 P/R $ 47,063.27 P/R $ 4,301.65 P/R $ 2,214.52 P/R $ 2,725.48 P/R $ 1,401.24 P/R $ 2,101.55 P/R $ 3,641.86 P/R $ 603,708.69 P/R $ 132,195.18 P/R $ 252.00 P/R $ 3,327.98 P/R $ 10.00 P/R $ 348.91 A/P $ 51.86 A/P $ 496.15 A/P $ 2,057.72 A/P $ 565.21 A/P $ 459.20 A/P $ 7,226.70 A/P $ 2,559.51 A/P $ 4,852.96 A/P $ 107.50 A/P $ 118.57 A/P $ 5,654.09 A/P $ 188.20 AN $ 4,118.04 A/P $ 69.00 A/P $ 3,868.33 CAP PROJ: EMS SUBSTATION A/P $ 5,505.00 A/P $ 213.16 AN $ 402.01 A/P $ 324.86 A/P $ 30.54 CO CLERKTOSTAGE A/P $ 1,003.00 RI34:2000 GAL POLY TANK A/P $ 18,215.08 COMM CRT: SEMI ANNUAL YEARLY BIDS A/P $ 401.40 A/P $ 3,792.19 A/P $ 36.19 EXT SERV: AWARDS FOR OPEN HOUSE A/P $ 636.00 A/P $ 144.98 A/P $ 719.91 A/P $ 165.01 A/P $ 2,285.36 A/P $ 20,639.45 AT $ 8.84 TOTAL VENDOR DISBURSEMENTS: $ 7,120,106.87 CALHOUN COUNTY INDIGENT HEALTH CARE A/P $ 50,141.12 CALHOUN COUNTY OPERATING ACCOUNT A/P $ 664.68 TOTAL TRANSFERS BETWEEN FUNDS: $ 50,805.80 TOTAL AMOUNT FOR APPROVAL: $ 7,170,912.67 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ----- December 22, 2016 PAYABLES AND PAYROLL 11/1/2016 McKesson Drugs 3,198.71 11/1/2016 Payroll 259,000.60 11/1/2016 Payroll by Check 68.46 11/2/2016 Patient Refunds 422.00 11/2/2016 Weekly Payables 231,666.45 11/3/2016 Payroll Liabilities 352.38 11/3/2016 Payroll Liabilities 94,287.41 11/3/2016 Payroll by Check 966.21 11/7/2016 McKesson Drugs 1,927.81 11/9/2016 Weekly Payables 226,669.27 11/9/2016 Returned Check 45.00 11/14/2016 McKesson Drugs 2,500.62 11/15/2016 TDCRS 118,296,88 11/17/2016 Patient Refunds 2,003.19 11/17/2016 Weekly Payables 840,722.67 11/17/2016 Payroll by Check 1,079.84 11/17/2016 Payroll Liabilities 95,981.82 11/17/2016 Payroll 263,159.26 11/17/2016 Payroll by Check 1,079.84 11/18/2016 Payroll Liabilities 221.93 11/21/2016 Weekly Payables 190,478.96 11/21/2016 McKesson Drugs 2,590.06 11/23/2016 Credit Card Invoice 3,292.60 11123/2016 Credit Card Invoice 1,612.49 11/28/2016 McKesson Drugs 1,731.45 11/30/2016 Monthly Electronic Transfers for Payroll Expenses(not inci above) 497,58 11/30/2016 Monthly Electronic Transfers for Operating Expenses 6,137.25 Total Payables and Payroll $ 2,349,990.74 INTER -GOVERNMENT TRANSFERS Inter -Government Transfers for November 2016 218,451.27 218,451.27 IGT DSRIP Audit Cost - - Total Inter -Government Transfers $ 218,461.27 INTRA-ACCOUNT TRANSFERS 11/22/2016 from Memorial Medical Center to Private Waiver Clearing Acct 52,618.21 Total Intra-Account Transfers $ 62,618.21 SUBTOTALMEMORIAL MEDICAL CENTER DISBURSEMENTS $ 2,621,060.22ir INDIGENT HEALTHCARE FUND EXPENSES $ 60,141.12; NURSING HOME UPL EXPENSES FOR November 2016 $ 3,398,226.29' IGT November 2016sMPAP NH Program 9 $ MMC Construction $ GRAND TOTAL DISBURSEMENTS APPROVED December 22, 2016 $ 6,069,427.63 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR---- December 22, 2016 INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES Adu Sports Medicine Clinic William J. Crowley D.O. Richard Arroyo -Diaz HEB Pharmacy (Medimpact) MMC Professional Fees MMCenter (in -patient $.00 i Out -patient $37,064.16 r ER $3,501.09) Memorial Medical Clinic Port Lavaca Clinic Radiology Unlimited PA Regional Employee Assistance Victoria Anesthesiology Assoc Victoria Eye Center Victoria Heart & Vascular Center SUBTOTAL Memorial Medical Center (Indigent Healthcare Payroll and Expenses) Co -pays adjustments for November 2016 312.25 671.80 257.26 674.90 47.85 40,565.25 4,630.21 1,030.58 631.96 253.95 265.96 200.87 44.28 49,687.12 1,074.00 Subtotal 50,661.12 (520.00) MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ----- December 22, 2016 PAYABLES AND PAYROLL 11/1/2016 McKesson Drugs 3,198.71 11/l/2016 Payroll 259,000.60 11/112016 Payroll by Check 68.45 11/2/2016 Patient Refunds 422.00 11/2/2016 Weekly Payables 231,666.45 11/3/2016 Payroll Liabilities 352.38 11/3/2016 Payroll Liabilities 94,287.41 11/3/2016 Payroll by Check 966.21 11f7/2016 McKesson Drugs 1,927.81 11/9/2016 Weekly Payables 226,669.27 11/912016 Returned Check 45.00 11/14/2016 McKesson Drugs 2,500.62 11115/2016 TDCRS 118,296.88 11/17/2016 Patient Refunds 2,003.19 11/17/2016 Weekly Payables 840,722.67 11/17/2016 Payroll by Check 1,079.54 11/17/2016 Payroll Liabilities 95,981.82 11/17/2016 Payroll 263,159.26 11/17/2016 Payroll by Check 1,079.84 11/18/2016 Payroll Liabilities 221.93 11/21/2016 Weekly Payables 190,478.96 11/21/2016 McKesson Drugs 2,590.06 11/23/2016 Credit Card Invoice 3,292.60 11/23/2016 Credit Card Invoice 1,612.49 1112812016 McKesson Drugs 1,731.45 1113012016 Monthly Electronic Transfers for Payroll Expenses(not inel above) 497.58 11/30/2016 Monthly Electronic Transfers for Operating Expenses 6,137.25 Total Payables and Payroll $ 2,349,990.74 INTER -GOVERNMENT TRANSFERS Inter -Government Transfers for November 2016 218,451.27 218,451,27 IGT DSRIP Audit Cost - - Total Inter -Government Transfers $ 218,451.27 INTRA-ACCOUNT TRANSFERS 11/22/2016 from Memorial Medical Center to Private Waiver Clearing Acct 52,618.21 Total Infra -Account Transfers $ 62,618.21 SUBTOTAL M) MORIAL',MEDICGRNTER DIS$URSEMENTS; AL $ 2;@21,060i22 INDIGEN, ,HEALTHCARE FUND EXPENSES ,t $ 50,14172 NURSING H08hE-UPL EXPENSES FOR Novem4er2016 $398,2262,8 IGT NoVetnber 2016 MPAP NH Prpgratn ` $ , MMC.Construction; . 00W TOTAL DISBURSEMENTS Q PP.RQVEq:pecemtier 22;:�01,6 =; $ 6 669 42i_s3 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---- December 22 2016 INDIGENT HEALTHCARE FUND: INDIGENT EXPENSES Adu Sports Medicine Clinic William J. Crowley D.O. Richard Arroyo -Diaz HEB Pharmacy (Medimpact) MMC Professional Fees MMCenter (in -patient $.00 / Out -patient $37,064.16 / ER $3,501.09) Memorial Medical Clinic Port Lavaca Clinic Radiology Unlimited PA Regional Employee Assistance Victoria Anesthesiology Assoc Victoria Eye Center Victoria Heart & Vascular Center SUBTOTAL Memorial Medical Center (indigent Healthcare Payroll and Expenses) Co -pays adjustments for November 2016 Reimbursement from Medicaid 312.25 671.80 257.26 674.90 47.85 40,565.25 4,630.21 1,030.58 631.96 253.95 265.96 200.87 44.28 49,687.12 1,074.00 Subtotal 50,661.12 (620.00) V a l� N N N O W h V VI ry b N lV P Q E W ae W uz W^�C) H Hwu¢ i Hw�a wUWuW a W xHa C7 W�W �za�� �HC7 WNaU NW a�8 ¢�wo ua wmom wocu � n wowo] HW W WEo w wo b N N G O E U o rn o o O O O O O O O Q z i-� , G \O b M M ✓1 O b W r b a F w z 0 0 N O x w z U U ° W ° H oq v a v !J y� Vl V1 V1 V1 b �D b b �O b b ro p. 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Q papw., papW., pw{Wy µ�µ� O µ2W7 >a' Cal q a raiiW vai W vi W U W W a k7 w'z C4�d > rn a m� q rn E z z z E F F F P z Pz W W Gl w W W W 0 A Ll 0 0 0 0 A aai O O O O O O O O O O A z 'z z z z z z zZ 2 z 'z z z z A Fv O O o q a q n Q w w q aOa Q x P7 O Q � Pa UFO V U� � V C 3 ra z T T ° rn ° 0 G N N oW z� z 0 0 v v > FAO O b o 0 a � o 0 0 O U O U U Q U 6 Cza7 C7 ai W U V H x x al V U U rn o � 0 F z F w q q q o z ra zz z° z q Consider and take necessary action on single source, emergency and public welfare purchases and bills. N/A Public discussion of County matters. Commissioner Fritsch thanked the Court for their support during his tenure. Meeting Adjourned at 10.40 a.m.