WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND
Appears in 3 contracts
Samples: Engineering Services Contract, Engineering Services Contract, Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . ___ day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND
Appears in 3 contracts
Samples: Engineering Services Contract, Engineering Services Contract, Engineering Services Contract
WITNESS. ENGINEERCONTRACTOR, AS PRINCIPAL: Firm Name By: Signature Signature Type Name and Title SURETY: AGENT FOR SURETY: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoNAIC Number: Signature BY: AGENCY ADDRESS: SURETY ADDRESS PHONE NO. ATTESTLicensed Florida Insurance Agent? Yes No License Number: STATE OF ) COUNTY OF ) SS CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority) Before me, a Notary Public in duly commissioned, qualified and for the State of Texasacting personally, on this day personally appeared , known appeared: to me well known, who being by me first duly sworn upon oath says that he is Attorney-in-Fact for as Xxxxxx, and that he has been authorized by said Surety to be the person and officer whose name is subscribed to execute the foregoing instrument, Payment Bond on behalf of the Principal (Contractor) named therein favor of the owner. Subscribed and acknowledged sworn to before me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day Notary Public (Print, Type or Stamp Commissioned Name of Notary Public) Personally Known or Produced Identification (Type) In accordance with Part C, Section 19 and Part F Article 8 of the Contract, if applicable, list the Lead Surety. LEAD SURETY AGENT FOR XXXXXX Signature BY: AGENCY ADDRESS: SURETY ADDRESS: PHONE (THIS FORM MUST BE UTILIZED IN ALL FINAL PAY APPLICATIONS) F I N A L R E L E A S E O F L I E N KNOW ALL MEN BY THESE PRESENTS, that for and in consideration of the sum of monies, set out in the accompanying Estimate Statement No. , final, which quantity, the receipt of which is hereby acknowledged, is accepted as full and complete compensation for all work done, materials furnished and damages or claims arising under Orange County Contract No. Y22-117-R2, entitled: UNDERDRAINS INSTALLATION AND REPAIRS By: Contractor (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE METhe foregoing instrument was acknowledged before this day of 20 , by . Personally Known OR Produced Identification Type of identification Produced CHANGE ORDER REQUEST PURCHASE ORDER / DELIVERY ORDER / CONTRACT *Vendor Code: *Vendor Name: . *Date: *Change Order Request No.: *Document No.: Contract No. *Department: *Contact/Phone No.: ACCOUNTING LINE CHANGE ONLY: Accounting Line From: Accounting Line To: COMMODITY LINE NUMBER ADD: Amount: Amount: Comm. Line No.: _ Commodity Code: _ Quantity: _ Unit of Measure: Unit Cost: _ _ Description: MA Line No. _ Accounting Line: _ _ Amount: _ COMMODITY LINE NUMBER INCREASE / DECREASE / DELETE: Comm. Line No. _ Increase Qty By: _ Decrease Qty By: _ _ Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: _ _ _ _ Delete: _ (check only if you want to delete this line number). CANCELLATION: _ Please cancel Purchase Order / Delivery Order Original sent to vendor: Yes _No *JUSTIFICATION (Required for all transactions): _ Enter Retainage for line number(s) in the amount of _ % *Original PO/DO/Contract Award/Encumbrance circle one Contract Amount Encumbered/De-Encumbered Amount $ . $ . *Net Dollars for Previous Change Orders (Addition/Subtraction) circle one $ . $ . *Net Dollars for This Change Order (Addition/Subtraction) circle one $ . $ . *Total Dollars $ . $ . By signing this agreement, the undersigned authorityContractor hereby releases the County, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrumentits agents, and acknowledged to me that he executed same employees from any and all liabilities under this contract for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein statedfurther equitable adjustments and/or claims associated with this change order. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY*Vendor/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project NoContractor Authorization: Date: LEGEND*Departmental Approval: Date: E-13 *Purchasing & Contracts Approval: Date: For Purchasing Use Only Track Change Order: Yes No Change Award Amount to: $ Add the following text to the PO/DO: _ CHANGE ORDER REQUEST CONTINUATION SHEET Document No.: _ _ PURCHASE ORDER / DELIVERY ORDER / CONTRACT ACCOUNTING LINE CHANGE ONLY: Accounting Line From: Accounting Line To: Accounting Line Add: Accounting Line From: Accounting Line To: Accounting Line Add: COMMODITY LINE NUMBER ADD: Amount: Amount: Amount: Amount: Amount: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: COMMODITY LINE NUMBER INCREASE / DECREASE / DELETE: Amount: Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: Delete: (check only if you want to delete this line number). Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: Delete: (check only if you want to delete this line number). Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Delete (check only if you want to delete this line number). Decrease Unit Cost By: Accounting Line: *Departmental Approval: Date: _ Purchasing & Contracts Approval: Date: 53-25 (7/04) DRUG-FREE WORKPLACE FORM The undersigned vendor, in accordance with Florida Statute 287.087 hereby certifies that does: Name of Business
Appears in 2 contracts
Samples: ftp.orangecountyfl.net, ftp.orangecountyfl.net
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification Nomy hand and seal in the County and Commonwealth aforesaid this day of , 20 . ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for (SEAL) My Commission Expires: ACKNOWLEDGEMENT IF AN INDIVIDUAL (To be executed with the State Agreement) Commonwealth of Texas, Pennsylvania ) ) SS: or ) EIN: County of Allegheny ) I HEREBY CERTIFY that on this day date before me, an officer duly authorized in the Commonwealth and County named above to take acknowledgements, personally appeared , known to me to be the person in and officer whose name is subscribed to who executed the foregoing instrument, and acknowledged to before me that he he/she executed same for and as the act same. SWORN TO AND SUBSCRIBED before me this day of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of Notary Public (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, ACKNOWLEDGEMENT IF A PARTNERSHIP (To be executed with the undersigned authority, a Notary Public in and for the State Agreement) Commonwealth of Texas, Pennsylvania ) ) EIN: County of Allegheny ) I HEREBY CERTIFY that on this day date before me, an officer duly authorized in the Commonwealth and County named above to take acknowledgements, personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person in and officer whose name is subscribed to who executed the foregoing instrumentinstrument as a partner of , and a partnership. He/She acknowledged to me before that he he/she executed the same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and said partnership for the uses and purposes and consideration therein expressed and in the capacity therein statedmentioned. GIVEN UNDER MY HAND SWORN TO AND SEAL OF OFFICE on SUBSCRIBED before me this the day of , 20 . day of Notary Public (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND EXHIBIT A STATEMENT OF WORK To be determined by individual Service Authorization EXHIBIT B RATE SCHEDULE To be determined by individual Service Authorization Audited Indirect Rate: Profit Rate Not-to-Exceed 10%. Consultant shall be reimbursed only for employees working directly on Services for the Authority project. Profit Rate on Subconsultants Not-to-Exceed 5%. EXHIBIT C INVOICE FORMAT Service Authorization Number Invoice Number Company Name Invoice Period Address Date of Invoice LABOR CLASS & TITLE EMPLOYEE NAME SALARY RATE HOURS AMOUNT <<raw rate$/HR>> <<salary x hours>> <<salary x hours>> <<salary x hours>> <<salary x hours>> <<salary x hours>> Subtotal Labor Overhead Multiplier Subtotal Labor + overhead Profit Mulitplier (10%) <<overhead multiplier >> 10% a. total the column above b. ( = line a. x multiplier rate) c. ( = line a + line b) d. ( = line c x .10) Profit on Subs (5%) Total Prime Contractor labor and profit 5% e. ( .05 x line g) f. ( = c + d + e) SUBCONTRACTORS NAME '$ subcontractor cost NAME '$ subcontractor cost NAME '$ subcontractor cost TOTAL SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy g. Total the column above OTHER DIRECT COSTS Identify Costs by Company Identify Costs by Company <<no multiplier>> <<no multiplier>> amount amount h. total of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDODCs TOTAL INVOICE i. = line f + line g + line h BUDGE <<amount of Service Authorization This invoice Previously earned Earned to date Remaining on Contract x. x. X. m. = line k + line L n. = line j - line m
Appears in 1 contract
Samples: Agreement for Professional Services
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. (NAME) (SEAL) (NAME) (SEAL) ATTEST: CITY OF ARLINGTONXXXX ARUNDEL COUNTY, TEXASMARYLAND By: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed (NAME) COUNTY EXECUTIVE Approved as to form and legal sufficiency. Office of Law Date I HEREBY CERTIFY that I am an attorney admitted to practice before the Court of Appeals of Maryland and that the within instrument was prepared by me or Typed Name Director under my supervision. Office of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE Law Date STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MEMARYLAND, , TO WIT: I HEREBY CERTIFY that on this day of , in the year Nineteen Hundred and Ninety-Seven, before me, the undersigned authoritysubscriber, a Notary Public of the State of Maryland, in and for County, personally appeared Xxxxxxxx X. Xxxxxxxxx, party to the within Deed of Easement and Agreement, and she acknowledged the same to be her act. AS WITNESS my Hand and Notary Seal. NOTARY PUBLIC NOTARY SEAL MY COMMISSION EXPIRES: STATE OF MARYLAND, TO WIT: I HEREBY CERTIFY that on this day of , in the year Nineteen Hundred and Ninety-Seven, before me, the subscriber, a Notary Public of the State of Maryland, in and for County, personally appeared Xxxxxxx X. Xxxxxxxxx, party to the within Deed of Easement and Agreement, and he acknowledged the same to be his act. AS WITNESS my Hand and Notary Seal. NOTARY PUBLIC NOTARY SEAL MY COMMISSION EXPIRES: STATE OF MARYLAND, TO WIT: I HEREBY CERTIFY that on this day of , in the year Nineteen Hundred and Ninety-Seven, before me, the subscriber, a Notary Public of the State of Maryland, in and for the County aforesaid, personally appeared Xxxxxx X. Xxxxxxx for Xxxxxx X. Xxxxx, County Executive of Xxxx Xxxxxxx County, Maryland, a body corporate of the State of TexasMaryland, on this day personally appeared party to the within Deed of Easement and Agreement, known to me and he acknowledged the same to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, said body corporate. AS WITNESS my Hand and as thereof, and for the purposes and consideration therein expressed and in the capacity therein statedNotary Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDNOTARY PUBLIC
Appears in 1 contract
Samples: www.aacounty.org
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxxx Xxxxxx - President Xxxxxxxxx, Xxxxxxx and Associates, Inc. Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxx, RLA, ASLA who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxxxxxx, Xxxxxxx and Associates, Inc., a corporation of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 2018, __ day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2018. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYFOR MINORITY AND/WOMEN OR WOMAN OWNED BUSINESS ENTERPRISE ENTERPRISES (MWBETo be completed only if applicable) REPORT Please complete Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, include along with a copy of certification(s) your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with executed contracts Project Name: Project No: Date: LEGENDthis response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoAviation Performance Solutions, LLC. ATTEST: BY Xxxx Xxxxxxxx Vice President, Finance & Corporate Strategy CITY OF ARLINGTON, TEXASTEXAS BY Xxxxxx X. Xxxxxxx Deputy City Manager ATTEST: Xxxx Xxxxxx, Xxxxxx City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: BY THE STATE OF TEXAS § § LESSEE’S COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXX XXXXXXXX, known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of AVIATION PERFORMANCE SOLUTIONS, a corporation of County, Texas, LLC and as Principal thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the of , 20 201_. day of (SEAL) Notary Public in In and for the For The State of Texas My Commission Expires: Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § § CITY OF ARLINGTON, TEXAS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx XXXXXX X. XxxxxxxxXXXXXXX, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of Arlingtonthe State of Texas, Tarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities Deputy City Manager thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the of , 20 201_. day of (SEAL) Notary Public in In and for the For The State of Texas My Commission Expires: Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDEXHIBIT “A”
Appears in 1 contract
Samples: Lease Agreement
WITNESS. ENGINEER: Xxxxxx Xxxx and Xxxxxxx, Inc. BY: Printed or Typed Name Printed or Typed Title Tax Identification No. Xxxxx Xxxxxxx, P.E. Principal ATTEST: CITY OF ARLINGTON, TEXAS: BY: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Xxxxxx, P.E. Interim Director of Water Utilities Printed or Typed Title Public Works and Transportation APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: Xxxxx X. Xxxx, P.E. BY: Director of Water Utilities THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx Xxxxxxx, P.E. , who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment City Acknowledgement BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxxxx, P.E. , known to me to be the a person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Interim Director of Water Utilities Public Works and Transportation thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDTHE STATE OF TEXAS § COUNTY OF TARRANT § City Acknowledgement
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: Xxxx BY Xxxxx Xxxxx Deputy City Manager Xxxxxx Xxxxxx, Acting City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXX XXXXXXX, known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of TERRACON CONSULTANTS, a corporation of County, TexasINC., and as PRINCIPAL thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2010. Notary Public in and for the The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § CITY OF ARLINGTON, TEXAS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXXXXX XXXXX, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of ArlingtonTarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities DEPUTY CITY MANAGER thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2010. Notary Public in and for the The State of Texas My Commission Expires Notary's Printed Name My Commission ExpiresAttachment A Terracon Scope of Work Task 1: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDCommunity Involvement
Appears in 1 contract
Samples: arlingtontx.granicus.com
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS BY Xxxx Xxxxxx Director of Finance ATTEST: Xxxx Xxxxxx, Xxxxxx City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, Xxxxx Xxxxx City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of Bank, a corporation of County, Texasnational banking association, and as title thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2021. Notary Public in In and for the For The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of ArlingtonTarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities Deputy City Manager thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2021. Notary Public in In and for the For The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDTHE STATE OF TEXAS § Acknowledgment COUNTY OF TARRANT
Appears in 1 contract
WITNESS. ENGINEER: BY: Xxxxxx Xxxxxx, P.E. Printed or Typed Name Vice President / Principal Printed or Typed Title 00-0000000 Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND.
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxx X. Xxxxxxx TransSystems Corporation dba TransSystems Corporation Consultants Tax Identification NoXx. ATTEST: 00-0000000 CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , Xxxx X. Xxxxxxx who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of TransSystems Corporation dba TranSystems Corporation Consultants, a corporation of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 2017, __ day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2017. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYFOR MINORITY AND/WOMEN OR WOMAN OWNED BUSINESS ENTERPRISE ENTERPRISES (MWBETo be completed only if applicable) REPORT Please complete Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, include along with a copy of certification(s) your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with executed contracts Project Name: Project No: Date: LEGENDthis response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEERXXXX XXXXXXX 000 Xxxxxx Xxxxx Xx., Xxx Xxxxxxxxx, Xxxxx 00000 Phone: BY(000)000-0000 Web: Printed or Typed Name Printed or Typed Title xxx.xxxxxxxxxxx.xxx Email:xxxxxxxx@xxxx.xx.xxx Tax Identification No. ATTESTI.D. # 1-75-1631731-4 Date: PURCHASER: CITY OF ARLINGTON, TEXASTEXAS ATTEST: Xxxx XxxxxxBY: XXXX XXXXXXXXX Deputy City Manager XXXXX XXXXXX, Acting City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: THE STATE OF TEXAS § § ARTIST ACKNOWLEDGMENT COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXX XXXXXXX, known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of XXXX XXXXXXX, SCULPTOR, and as Owner thereof, and for the purposes and consideration therein expressed and in the capacity therein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 2010. day of [Seal] Notary Public in and for The State of Texas Notary's Printed Name THE STATE OF TEXAS § § CITY OF ARLINGTON, TEXAS § ACKNOWLEDGMENT COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXX XXXXXXXXX, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of THE CITY OF ARLINGTON, TEXAS, a municipal corporation of in Tarrant County, Texas, and as DEPUTY CITY MANAGER thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 2010. day of (SEAL) [Seal] Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the The State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND
Appears in 1 contract
Samples: arlingtontx.granicus.com
WITNESS. ENGINEERmy hand and official seal at the County and State aforesaid, this 28 day of May, 1998. (signature) (SEAL) Notary Public DEVELOPER JOINDER The undersigned, constituting the Developer pursuant to the Master Declaration of Covenants, Restrictions and Easements for Admiral's Cove, by its signature below, hereby joins in the execution of this Amendment #2 to Master Declaration of Covenants, Restrictions and Easements for Admiral's Cove attached hereto, as of the 28 day of May, 1998. ADMIRAL'S COVE ASSOCIATES, LTD. a Florida Ltd. Partnership By: BYB.L.W. ENTERPRISES General Partner By: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTESTAdmiral's Cove Inc. General Partner By: CITY OF ARLINGTON, TEXAS(signature) President Attest: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE (signature) Asst Secty STATE OF TEXAS § FLORIDA COUNTY OF TARRANT § Engineer Acknowledgment PALM BEACH BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxxxx Xxxxxxx and Xxxxxx Xxxxxxx, known to me well known to be the person persons described in and officer whose name is subscribed to who execute the foregoing instrumentinstrument as President and Secretary, respectively, of ADMIRAL'S COVE, INC., a Florida corporation, the said ADMIRAL'S COVE, INC. being the General Partner of BLW ENTERPRISES, LTD., a Florida Limited Partnership, and they severally acknowledged to before me that he they executed same for and such instrument as as the free act and deed of said Corporation, a corporation as the Limited Partner of Countythe General Partner of said Limited Partnership. WITNESS my hand and official seal at the County and State aforesaid, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 28 day of May, 1989. (signature) (SEAL) Notary Public CLASS B MEMBER JOINDER The undersigned constituting the Class B Member of Admiral's Cove Master Property Owners Association, Inc. by its signature below hereby joins in the execution of this Amendment #2 to Master Declaration of Covenants, Restrictions, and Easements for Admiral's Cove as attached hereto as of the 28 day of May, 1998. THE CLUB AT ADMIRALS COVE, INC. BY: (signature) Attest: (signature) STATE OF FLORIDA COUNTY OF PALM BEACH Before me, the undersigned authority, personally appeared Xxxxxxxx Xxxxxxx and Xxxxxx Xxxxxxx, to me well known to be the persons described in and who executed the foregoing instrument as President and Secretary, respectively, of THE CLUB AT ADMIRAL'S COVE, INC., a Florida corporation, and they severally acknowledged before me that they executed such instrument as such officers of said Corporation, and that the seal was affixed to said instrument and it is the true corporate seal of the Corporation, and that it was affixed to said instrument by due and regular corporate authority, and that said instrument is the free act and deed of said Corporation. WITNESS my hand and official seal at the County and State aforesaid, this 28 day of May, 1998. (signature) (SEAL) Notary Public CLASS C MEMBER JOINDER The undersigned constituting the Class "C" Member of Admiral's Cove Master Property Owners Association, Inc. by its signature below hereby joins in the execution of this Amendment #2 to Master Declaration of Covenants, Restrictions, and Easements for Admiral's Cove as attached hereto as of the State 28 day of Texas Notary's Printed Name My Commission ExpiresMay, 1998. ADMIRALS COVE ASSOCIATES, LTD a Florida Limited Partnership. BY: THE BLW ENTERPRISES, LTD Limited Partnership BY: ADMIRALS COVE, INC. General Partner By: (signature) President Attest: (signature) Assistant Secretary STATE OF TEXAS § FLORIDA COUNTY OF TARRANT § Municipal Acknowledgment PALM BEACH BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxxxxxx Xxxxxxx and Xxxxxx Xxxxxxx, known to me well known to be the person persons described in and officer whose name is subscribed to who execute the foregoing instrumentinstrument as President and Secretary, respectively, of ADMIRAL'S COVE, INC., a Florida corporation, the said ADMIRAL'S COVE, INC. being the General Partner of BLW ENTERPRISES, LTD., a Florida Limited Partnership, which is a General Partner of ADMIRALS COVE ASSOCIATES, LTD., a Florida Limited Partnership, and they severally acknowledged to before me that he they executed same for and such instrument as the free act and deed of said Corporation, as the Limited Partner of the City General Partner of Arlingtonsaid Limited Partnership. WITNESS my hand and official seal at the County and State aforesaid, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 28 day of May, 1989. (signature) (SEAL) Notary Public in and for THIRD AMENDMENT TO THE MASTER DECLARATION OF COVENANTS, RESTRICTIONS AND EASEMENTS FOR THE ADMIRAL'S COVE MASTER PROPERTY ASSOCIATION, INC. This Third Amendment made as of the State 24th day of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE June, 2004, by the ADMIRAL'S COVE MASTER PROPERTY OWNERS ASSOCIATION, INC., a Florida corporation not-for-profit (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDhereinafter referred to as "Property Owners Association").
Appears in 1 contract
Samples: acmpoa.com
WITNESS. ENGINEERSURVEYOR: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Surveyor Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: 2019 Surveying Services Project No: XXXX00000 Date: LEGENDMay 21, 2019 LEGEND * Answer with “YES” or “NO” AI Native American (AI) NW Native American, Women-Owned (NW) AS Asian (AS) AW Asian, Women-Owned (AW) XX Xxxxx (BL) BW Black, Women-Owned (BW) HI Hispanic (HI) HW Hispanic, Women-Owned (HW) WO Women-Owned (WO) Other PRIME CONTRACTOR/CONSULTANT *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount Xxxxxxx & Associates, Inc. No No N/A 60,000 LIST ALL SUBS: Name of Company & Address Description of Primary Work Type (For prequalification verification purposes) *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount X/X X/X X/X X/X X/X X/X ATTACHMENT “A” PROJECT DESCRIPTION & SUPPLEMENTARY SCOPE OF SERVICES 2019 SURVEYING SERVICES City of Arlington Project Xx. XXXX00000
Appears in 1 contract
Samples: Professional Services Contract
WITNESS. ENGINEER: BY: Printed H. S. FORD T. M. HAUER J. R. FLAD Vice-President. T. P. STREET Secretary. HARRY B. KELLEHER [SEAL) Notary Public. My Commission expires at death or Typed Name Printed or Typed Title Tax Identification Noon removal from Office. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE 103 STATE OF TEXAS § COUNTY LOUISIANA PARISH OF TARRANT § Engineer Acknowledgment BEFORE MEORLEANS BE IT KNOWN, That on this 3rd day of December, 1951, before me the undersigned authorityundersigned, a Notary Public in and for the said Parish and State of Texasduly qualified and commissioned as such, on this day personally appeared F. P. Doyle, the Vice-President, and F. Pinoges the Assistant Cashier of The National Bank of Commerce in New Orleans, a national banking association, duly organized and existing under the laws of the United States of America, Trustee under the foregoing instrument, to me personally known and known to me to be such officers, respectively, of said Bank, and personally known to me to be the person identical persons whose names are subscribed and officer whose name is subscribed affixed to the foregoing instrumentinstrument as such officers respectively, and acknowledged to me that he executed same for and as who subscribed the act name of , a corporation of County, Texasthe said Bank thereto, and as thereof, and for the purposes and consideration therein expressed in my presence and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this presence of the undersigned witnesses, 20 . day of (SEAL) Notary Public in lawful age and domicile, severally acknowledged that the same is their respective, free and voluntary act and deed as such officers and the free and voluntary act and deed of said Bank for the State uses and purposes therein expressed; and the said persons being each by me duly and severally sworn as individuals did depose and say that they are such officers, respectively, of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, said Bank; that they know the undersigned authority, a Notary Public in and for seal of said Bank; that the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed seal affixed to the foregoing instrumentinstrument was and is such corporate seal; that said seal was so affixed and said instrument was so signed on behalf of said Bank by the order and authority of the Board of Directors of said Bank; and that they signed their names thereto as such officers, respectively, of said Bank by like authority. In Testimony Whereof, the said Appearers have hereunto signed their names on the day and date first hereinabove written, in the presence of H. S. Ford and J. R. Flad, witnesses of lawful age and domicile, and acknowledged to me that he executed same for and as the act of the City of Arlingtonme, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) said Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDPublic.
Appears in 1 contract
Samples: Supplemental Indenture (Central Louisiana Electric Co Inc)
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § MARYLAND, COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, TO WIT: I HEREBY CERTIFY that on this day of , 2013, before me, the undersigned authorityofficer, personally appeared _ , of , who acknowledged the foregoing instrument to be his act and deed in such capacity, and that he is authorized to make this acknowledgment. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: (SIGNATURES CONTINUED ON THE NEXT PAGE) WITNESS: BOARD OF COUNTY COMMISSIONERS OF XXXXXXXXX COUNTY, MARYLAND By:_ Xxxxxxxx Xxxxx, Director Department of Housing and Community Development REVIEWED BY: Office of the County Attorney STAE OF MARYLAND, COUNTY OF FREDERICK, TO WIT: I HEREBY CERTIFY that on this day of _ , 2013, before me, the subscriber, a Notary Public for the State and County aforesaid, personally appeared Xxxxxxxx Xxxxx, Director, Housing and Community Development, Xxxxxxxxx County, Maryland, and did certify that as such officer, she did execute this instrument for the purposes stated herein, and did certify, under penalties of perjury, that she is authorized to execute this instrument on behalf of the Board of County Commissioners of Xxxxxxxxx County, Maryland. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: CONSENT OF LENDER [If not applicable, write N/A or No Lien] (Lender),holder of the indebtedness secured by the deed of trust [or mortgage] against the property herein described, recorded in Liber at folio , hereby consents to the terms and conditions of the foregoing Payment in Lieu Agreement, and does hereby further agree that the terms contained herein shall survive any sale under its deed of trust [mortgage], as evidenced by the signature of the undersigned trustee [or officer of corporation] under the above described deed of trust. By: [Lender’s name], Trustee STATE OF MARYLAND, CITY/COUNTY OF , TO WIT: I HEREBY CERTIFY that on this day of , 2013, before me, the subscriber, a Notary Public in and for the State of Texasand County aforesaid, on this day personally appeared , known to me Trustee, who acknowledged her/himself to be the person Trustee, and officer whose name is subscribed that she/he being authorized so to do, executed the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and instrument for the purposes therein contained, by signing his/her name. IN WITNESS WHEREOF, I set my hand and consideration therein expressed and in the capacity therein statedNotarial Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDNOTARY PUBLIC
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Xxxxxx Park Utility Relocation Project Project No: Date: LEGENDMarch 2020 LEGEND * Answer with “YES” or “NO” AI Native American (AI) NW Native American, Women-Owned (NW) AS Asian (AS) AW Asian, Women-Owned (AW) XX Xxxxx (BL) BW Black, Women-Owned (BW) HI Hispanic (HI) HW Hispanic, Women-Owned (HW) WO Women-Owned (WO) Other PRIME CONTRACTOR/CONSULTANT *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount Stantec Consulting Services Yes No LIST ALL SUBS: Name of Company & Address Description of Primary Work Type (For prequalification verification purposes) *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount Xxxxxxx & Associates Surveying No Yes AI $29,390 D&S Engineering Geotech No Yes WO $7,500 INTRODUCTION Stantec Consulting Services Inc. (Stantec) is pleased to provide the following proposed scope of work and not-to-exceed fee estimate for the Detailed Design of Xxxxxx Park Sanitary Sewer Main Replacement between X. Xxxxx Road and Timberbrook Court, and water and sewer along S. Pleasant Circle Rd (See Attachment “B”). Based on preliminary-y site visits and the preliminary engineering report (PER) prepared by Stantec the City of Arlington (City) has decided to move forward with channel stabilization and gravity sewer line improvements within the limits shown in Figure 1.
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEERmy hand and official seal, this the day of , 2000. Notary Public My Commission Expires: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE [NOTARIAL SEAL] STATE OF TEXAS § NORTH CAROLINA COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MEI, the undersigned authority, a Notary Public in and for the above State of Texasand Counties, on hereby certify that personally came before me this day personally appeared , known to me to be and acknowledged that he is Executive Director of the person and officer whose name is subscribed to the foregoing instrumentNorth Carolina Wildlife Resources Commission, and acknowledged to me that he executed same for by authority duly given and as the act of , a corporation said Agency of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name North Carolina, the foregoing and annexed instrument was signed in its name by , its , sealed with its corporate seal and attested by as its . WITNESS my hand and official seal, this the day of , 2000. Notary Public My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME[NOTARIAL SEAL] ASSISTANT SECRETARY CERTIFICATE I, the undersigned authority, Assistant Secretary of Duke Power, a Notary Public Division of Duke Energy Corporation, do hereby certify that the following is a true and correct excerpt of a Resolution adopted September 22, 1997, by the Management Committee of the Board of Directors of Duke Energy Corporation, and that said quoted Resolution has not been rescinded or amended: FURTHER RESOLVED, That Xxxxxx Xxxxx the Senior Vice-President of the Power Generation Division, be and hereby is authorized, to execute any contract, lease, deed or other instrument relating to real property without further action or approval by the Board of Directors of this Committee when deemed by said Senior Vice-President to be necessary or desirable in the operation of the Company’s business, subject, however, to a monetary limit of $1,500,000.00 consideration or value in any single transaction, and to execute such documents in any such transaction which is approved by a resolution of this Committee. FURTHER RESOLVED, That the Secretary or any Assistant Secretary be and hereby is authorized to attest and affix the Corporate seal to any contracts, leases, deeds or other instruments executed under authority of this resolution and may execute any certificate that may be required to certify the incumbency and authority of the officer or manager executing such documents. I further certify that on , 2000, Xxxxxx Xxxxx was the Senior Vice-President, Power Generation Division, and by reason of holding said position and pursuant to the above quoted Management Committee’s Resolution, had full authority to represent and act on behalf of Duke Energy Corporation with respect to the execution of an Agreement between Duke Power, a Division of Duke Energy Corporation and the North Carolina Wildlife Resources Commission for lands located in the State Counties of TexasAlexander, Burke, Caldwell, Catawba, Forsyth, Xxxxxx, Iredell, Lincoln, XxXxxxxx, Mecklenburg and Xxxxxx, North Carolina and to execute on behalf of Duke Xxxxx, a Division of Duke Energy Corporation all documents and instruments relating in any way thereto. WITNESS my hand and official seal of said Company this day personally appeared Xxxxx X. Xxxxxxxxof , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2000.
Appears in 1 contract
Samples: Public Access Area Agreement
WITNESS. ENGINEERCONTRACTOR, AS PRINCIPAL: Firm Name By: Signature Signature Type Name and Title SURETY: AGENT FOR SURETY: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoNAIC Number: Signature BY: AGENCY ADDRESS: SURETY ADDRESS PHONE NO. ATTESTLicensed Florida Insurance Agent? Yes No License Number: STATE OF ) COUNTY OF ) SS CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority) Before me, a Notary Public in duly commissioned, qualified and for the State of Texasacting personally, on this day personally appeared , known appeared: to me well known, who being by me first duly sworn upon oath says that he is Attorney-in-Fact for as Xxxxxx, and that he has been authorized by said Surety to be the person and officer whose name is subscribed to execute the foregoing instrument, Payment Bond on behalf of the Principal (Contractor) named therein favor of the owner. Subscribed and acknowledged sworn to before me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day Notary Public (Print, Type or Stamp Commissioned Name of Notary Public) Personally Known or Produced Identification (Type) In accordance with Part C, Section 19 and Part F Article 8 of the Contract, if applicable, list the Lead Surety. LEAD SURETY AGENT FOR XXXXXX Signature BY: AGENCY ADDRESS: SURETY ADDRESS: PHONE (THIS FORM MUST BE UTILIZED IN ALL FINAL PAY APPLICATIONS) F I N A L R E L E A S E O F L I E N KNOW ALL MEN BY THESE PRESENTS, that for and in consideration of the sum of monies, set out in the accompanying Estimate Statement No. , final, which quantity, the receipt of which is hereby acknowledged, is accepted as full and complete compensation for all work done, materials furnished and damages or claims arising under Orange County Contract No. Y18-151-R2, entitled: UNDERDRAINS INSTALLATION AND REPAIRS By: Contractor (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE METhe foregoing instrument was acknowledged before this day of 20 , by . Personally Known OR Produced Identification Type of identification Produced CHANGE ORDER REQUEST PURCHASE ORDER / DELIVERY ORDER / CONTRACT *Vendor Code: *Vendor Name: . *Date: *Change Order Request No.: *Document No.: Contract No. *Department: *Contact/Phone No.: ACCOUNTING LINE CHANGE ONLY: Accounting Line From: Accounting Line To: COMMODITY LINE NUMBER ADD: Amount: Amount: Comm. Line No.: _ Commodity Code: _ Quantity: _ Unit of Measure: Unit Cost: _ _ Description: MA Line No. _ Accounting Line: _ _ Amount: _ COMMODITY LINE NUMBER INCREASE / DECREASE / DELETE: Comm. Line No. _ Increase Qty By: _ Decrease Qty By: _ _ Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: _ _ _ _ Delete: _ (check only if you want to delete this line number). CANCELLATION: _ Please cancel Purchase Order / Delivery Order Original sent to vendor: Yes _No *JUSTIFICATION (Required for all transactions): _ Enter Retainage for line number(s) in the amount of _ % *Original PO/DO/Contract Award/Encumbrance circle one Contract Amount Encumbered/De-Encumbered Amount $ . $ . *Net Dollars for Previous Change Orders (Addition/Subtraction) circle one $ . $ . *Net Dollars for This Change Order (Addition/Subtraction) circle one $ . $ . *Total Dollars $ . $ . By signing this agreement, the undersigned authorityContractor hereby releases the County, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrumentits agents, and acknowledged to me that he executed same employees from any and all liabilities under this contract for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein statedfurther equitable adjustments and/or claims associated with this change order. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY*Vendor/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project NoContractor Authorization: Date: LEGEND*Departmental Approval: Date: E-13 *Purchasing & Contracts Approval: Date: For Purchasing Use Only Track Change Order: Yes No Change Award Amount to: $ Add the following text to the PO/DO: CHANGE ORDER REQUEST CONTINUATION SHEET Document No.: _ _ PURCHASE ORDER / DELIVERY ORDER / CONTRACT ACCOUNTING LINE CHANGE ONLY: Accounting Line From: Accounting Line To: Accounting Line Add: Accounting Line From: Accounting Line To: Accounting Line Add: COMMODITY LINE NUMBER ADD: Amount: Amount: Amount: Amount: Amount: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: COMMODITY LINE NUMBER INCREASE / DECREASE / DELETE: Amount: Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: Delete: (check only if you want to delete this line number). Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: Delete: (check only if you want to delete this line number). Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Delete (check only if you want to delete this line number). Decrease Unit Cost By: Accounting Line: *Departmental Approval: Date: _ Purchasing & Contracts Approval: Date: 53-25 (7/04) DRUG-FREE WORKPLACE FORM The undersigned vendor, in accordance with Florida Statute 287.087 hereby certifies that does: Name of Business
Appears in 1 contract
Samples: www.bidnet.com
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: JK WTP West High Service Pump Station Pump Addition Project No: WUTR19020 Date: LEGEND
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: Xxxx Xxxxxx, BY XXXXX XXXXX Deputy City Manager XXXXXX XXXXXX Acting City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 201 . Notary Public in and for the The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § CITY OF ARLINGTON, TEXAS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of ArlingtonTarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities DEPUTY CITY MANAGER thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 201 . Notary Public in and for the The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDAttachment A
Appears in 1 contract
Samples: arlingtontx.granicus.com
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: Xxxx Xxxxxx, BY XXX XXXXXXX Interim Deputy City Manager XXXX X. XXXXXX City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title THE STATE OF TEXAS § APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: THE STATE OF TEXAS § BY COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in and for the The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § CITY OF ARLINGTON, TEXAS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, XXX PARAGON known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of ArlingtonTarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities INTERMIN DEPUTY CITY MANAGER thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in and for the The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDAttachment A
Appears in 1 contract
Samples: arlingtontx.granicus.com
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Xxxxxx Xxxxxx Director of Business Development, Landscape Architecture Tax Identification NoXx. ATTEST: 00-0000000 CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxx Xxxxxx, Interim Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT DALLAS § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxxxxx, a corporation of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . _ day of (SEAL) , 2022. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxx Xxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . _ day of (SEAL) , 2022. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this formEXHIBIT A SCOPE OF SERVICES River Legacy Park Trail Replacement Phase II January 19, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2022
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoConsultant Halff Associates, Inc. Xxxxx Xxxxxxxx, PLA TaxIdentificationNo. 00-0000000 ATTEST: CITY OF ARLINGTON, TEXASTEXAS By: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxx Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title Director, Parks and Recreation APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BYBy: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx Xxxxxxxx, XXX, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed same for and as the act and deed of Halff Associates, Inc. a corporation of Dallas County, Texas, and as Director thereof, and for the purposes and consideration therein expressed and, in the capacity, therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this the day of , 2020. Notary Public, State of Texas My Commission Expires Notary's Printed Name THE STATE OF TEXAS § THE COUNTY OF TARRANT § City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, a municipal corporation of Tarrant County, Texas, and as the Parks and Recreation Director thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2020.
Appears in 1 contract
WITNESS. ENGINEER: ELDER ENGINEERING, INC. BY: Printed or Typed Name Printed or Typed Title Tax Identification No. Xxx Xxxxx, P.E. President ATTEST: CITY OF ARLINGTON, TEXAS: BY: Xxxx Xxxxxx, City Secretary Xxxxx Xxxxxx, P.E. Interim Director of Public Works and Transportation BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Xxxx, P.E. Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxx Xxxxx, P.E, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment City Acknowledgement BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxxxx, P.E. , known to me to be the a person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Interim Director of Water Utilities Public Works and Transportation thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDTHE STATE OF TEXAS § COUNTY OF TARRANT § City Acknowledgement
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEERROCHESTER DRUG CO-OPERATIVE, INC., a New York cooperative corporation By: BYName: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTESTTitle: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § ) COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME) ss.: On this ___ day of _______________, 2020, before me, the undersigned authorityundersigned, a Notary Public in and for the State of Texassaid State, on this day personally appeared ___________________________, personally known to me or proved to me on the basis of satisfactory evidence to be the person and officer individual whose name is subscribed to the foregoing instrument, within instrument and acknowledged to me that he executed the same for and as the act of , a corporation of County, Texasin his capacity, and as thereofthat by his signature on the instrument, and for the purposes and consideration therein expressed and in individual, or the capacity therein statedperson upon behalf of which the individual acted, executed the instrument. GIVEN UNDER MY HAND AND SEAL Notary Public GRANTEE: WITNESS: IEC ELECTRONICS CORP. a Delaware Corporation By: Name: Xxxxxx X. Xxxxxxx Title: Chief Financial Officer STATE OF OFFICE on ) COUNTY OF ) ss.: On this the , 20 . ___ day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME_______________, 2020, before me, the undersigned authorityundersigned, a Notary Public in and for the State of Texassaid State, on this day personally appeared Xxxxx Xxxxxx X. XxxxxxxxXxxxxxx, personally known to me or proved to me on the basis of satisfactory evidence to be the person and officer individual whose name is subscribed to the foregoing instrument, within instrument and acknowledged to me that he executed the same for in his capacity, and as that by his signature on the act instrument, the individual, or the person upon behalf of which the City of Arlingtonindividual acted, Texasexecuted the instrument. Notary Public EXHIBIT “C” FORM OF XXXX OF SALE XXXX OF SALE ROCHESTER DRUG CO-OPERATIVE, INC., a Texas municipal corporation, and as cooperate corporation organized under the Director Laws of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME New York whose address is 00 Xxx Xxxx Xxxxx, Xxxxxxxxx, Xxx Xxxx 00000 (“Seller”), for and in consideration of the sum of TEN DOLLARS, to it paid by IEC ELECTRONICS CORP., a corporation organized and existing under the Laws of the State of Delaware whose address is 000 Xxxxxx Xxxxxx, Xxxxxx, Xxx Xxxx 00000 (“Purchaser”), the receipt whereof is hereby acknowledged, has granted, bargained, sold, transferred and delivered, and by these presents does grant, bargain, sell, transfer and deliver unto Purchaser, all fixtures, Equipment and other personal property located on, and/or used by Seller in connection with its use and operation of, the Real Property, as such term is defined in that certain Purchase and Sale Agreement (the “Purchase Agreement”) dated as of __________ ___, 2020 by and between Seller and Purchaser (collectively, the “Transferred Property”). Except as expressly provided in the Purchase Agreement, this Xxxx of Sale and Seller’ conveyance of the Transferred Property is made without representation or warranty of any kind whatsover. TO HAVE AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDTO HOLD the same unto Purchaser forever.
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of _ , a corporation of _ County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: 2018 Water Main Condition Assessment Project No: WUWS18008 Date: LEGEND
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEERPrint name of witness AUBURN TRACE, LTD., a Florida Limited Witness Partnership By: Auburn Trace Joint Venture, its General Print name of witness Partner Witness By: Auburn Management, Inc., a Florida Corporation, its Managing Partner BY: Print name of witness Xxxxxx Xxxxxxx, President and Chief Executive Officer THE SCHOOL BOARD OF PALM BEACH Witness COUNTY, FLORIDA By: Print name of witness Xxxxxx X. Xxxxx, Chairman Date: ATTEST: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title REVIEWED AND APPROVED AS TO FORMXxxxxx X. Xxxxxxx, Ph.D. Superintendent LEGAL FORM Board Approval Date: XXXXX XXXXX, City School Board Attorney BYDate: THE STATE OF TEXAS § FLORIDA COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MEPALM BEACH The foregoing instrument was acknowledged before me this day of 2006, the undersigned authorityby Auburn Trace, Ltd., a Notary Public in Florida Limited Partnership, by Auburn Trace Joint Venture, its General Partner, by Xxxxxx Xxxxxxx, President and for the State Chief Executive Officer of TexasAuburn Management, on this day Inc., a Florida Corporation, its Managing Partner, who (please check one) is (are) personally appeared , known to me to be the person OR has (have) produced as identification and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein statedhe/she/they (please check one) did take an oath x did not take an oath. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE Notary Public STATE OF TEXAS § FLORIDA COUNTY OF TARRANT § Municipal Acknowledgment BEFORE MEPALM BEACH The foregoing instrument was acknowledged before me this day of , 2006 by and Xxxxxx X. Xxxxx, the undersigned authorityChairman of The School Board of Palm Beach County, a Notary Public in and for the State of TexasFlorida, on this day who (please check one) are personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person OR have produced as identification and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein statedhe/she/they (please check one) did take an oath x did not take an oath. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYNotary Public STATE OF FLORIDA COUNTY OF PALM BEACH The foregoing instrument was acknowledged before me this day of , 2006 by Xxxxxx X. Xxxxxxx, the Superintendent of The School Board of Palm Beach County, Florida, who (please check one) are personally known to me OR have produced as identification and he/WOMEN BUSINESS ENTERPRISE she/they (MWBEplease check one) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDdid take an oath x did not take an oath.
Appears in 1 contract
Samples: Easement Agreement
WITNESS. ENGINEERBy: BYPrint Name, Title GRANTOR: Printed or Typed Name Printed or Typed [name] By Print Name, Title Tax Identification NoDate WITNESS: By: Print Name, Title GRANTEE: NEW JERSEY AMERICAN WATER COMPANY, INC. ATTEST: CITY OF ARLINGTONBy Print Name, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE Date Acknowledgment for Individual STATE OF TEXAS § NEW JERSEY : COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME: On this day of , 20_, before me, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known who acknowledged under oath to me to be the person my satisfaction that he/she personally signed this Deed and officer whose name is subscribed to the foregoing instrumentthat he/she signed, sealed and acknowledged to me that he executed same for delivered this Deed as his/her voluntary act and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stateddeed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE Acknowledgment for Corporation STATE OF TEXAS § NEW JERSEY : COUNTY OF TARRANT § Municipal : On this day of , 20_, before me personally came to me known, who, being by me duly sworn, did depose and say that he/she is the of , the corporation described in and which executed the foregoing instrument; that he/she knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation, and that he/she signed his/her name thereto by like order. Notary Public My Commission Expires: Acknowledgment BEFORE MEfor Partnership STATE OF NEW JERSEY : COUNTY OF : On this day of , 20_, before me, the undersigned authority, personally appeared , a partner of , a New Jersey Partnership, who acknowledged under oath to my satisfaction that he/she personally signed this Deed and that he/she signed, sealed and delivered this Deed as his/her voluntary act and deed. Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYAcknowledgement for New Jersey-American Water Company, Inc. STATE OF NEW JERSEY COUNTY OF CAMDEN On this day of , 20 , before me, the undersigned authority, personally appeared , who, being by me duly sworn, did depose and say that he is the of New Jersey-American Water Company, Inc., the corporation described in and which executed the foregoing instrument; that he/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this formshe knows the seal of the said corporation; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said corporation, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDthat he/she signed his/her name thereto by like order. Notary Public My Commission Expires:
Appears in 1 contract
Samples: dnnh3qht4.blob.core.windows.net
WITNESS. ENGINEERmy hand and official seal the day and year in the certificate first above written. (Seal) NOTARY PUBLIC FOR ALASKA My Commission Expires: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE ACKNOWLEDGMENT LIMITED LIABILITY COMPANY STATE OF TEXAS § COUNTY ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) I, , a Notary Public, in and for the State of , hereby certify that , whose name as manager/member of , LLC., is signed to the foregoing instrument and who is known to me, acknowledged before me on this day that, being informed of the contents of the instrument, he or she, as such officer and with full authority, executed the same voluntarily for and as the act of said limited liability company. WITNESS my hand and official seal the day and year in this certificate above written. (Seal) NOTARY PUBLIC FOR ALASKA My Commission Expires: CORPORATE CERTIFICATE I, , certify that I am the Secretary of the Corporation named as Contractor in the foregoing instrument; that , who signed said instrument on behalf of the Contractor, was then of said Corporation; that said instrument was duly signed for and on behalf of said Corporation by authority of its governing body and is within the scope of its corporate powers. Signature CORPORATE ACKNOWLEDGMENT STATE OF TARRANT § Engineer Acknowledgment BEFORE MEALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this day of , 2022, before me, the undersigned authorityundersigned, a Notary Public in and for the State of Texas, on this day xxxx commissioned and sworn, personally appeared , (Name) and (Name) known to me to be the person President and officer whose name is subscribed to Secretary of , the corporation which executed the above and foregoing instrument, and who on oath stated they were duly authorized to execute said instrument and acknowledged to me that he executed they signed the same for freely and as the act voluntarily on behalf of , a said corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDmentioned.
Appears in 1 contract
Samples: Kodiak Island Borough Agreement
WITNESS. ENGINEERCONTRACTOR, AS PRINCIPAL: Firm Name By: Signature Signature Type Name and Title SURETY: AGENT FOR SURETY: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoNAIC Number: Signature BY: AGENCY ADDRESS: SURETY ADDRESS PHONE NO. ATTESTLicensed Florida Insurance Agent? Yes No License Number: STATE OF ) COUNTY OF ) SS CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority) Before me, a Notary Public in duly commissioned, qualified and for the State of Texasacting personally, on this day personally appeared , known appeared: to me well known, who being by me first duly sworn upon oath says that he is Attorney-in-Fact for as Xxxxxx, and that he has been authorized by said Surety to be the person and officer whose name is subscribed to execute the foregoing instrument, Payment Bond on behalf of the Principal (Contractor) named therein favor of the owner. Subscribed and acknowledged sworn to before me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day Notary Public (Print, Type or Stamp Commissioned Name of Notary Public) Personally Known or Produced Identification (Type) In accordance with Part C, Section 19 and Part F Article 8 of the Contract, if applicable, list the Lead Surety. LEAD SURETY AGENT FOR XXXXXX Signature BY: AGENCY ADDRESS: SURETY ADDRESS: PHONE (THIS FORM MUST BE UTILIZED IN ALL FINAL PAY APPLICATIONS) F I N A L R E L E A S E O F L I E N KNOW ALL MEN BY THESE PRESENTS, that for and in consideration of the sum of monies, set out in the accompanying Estimate Statement No. , final, which quantity, the receipt of which is hereby acknowledged, is accepted as full and complete compensation for all work done, materials furnished and damages or claims arising under Orange County Contract No. Y18-198-R2, entitled: OPERATION, MAINTENANCE & MONITORING OF THE LANDFILL GAS, LEACHATE AND STORMWATER MANAGEMENT SYSTEMS AT THE ORANGE COUNTY LANDFILL By: Contractor (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE METhe foregoing instrument was acknowledged before this day of 20 , by . Personally Known OR Produced Identification Type of identification Produced CHANGE ORDER REQUEST PURCHASE ORDER / DELIVERY ORDER / CONTRACT *Vendor Code: *Vendor Name: . *Date: *Change Order Request No.: *Document No.: Contract No. *Department: *Contact/Phone No.: ACCOUNTING LINE CHANGE ONLY: Accounting Line From: Accounting Line To: COMMODITY LINE NUMBER ADD: Amount: Amount: Comm. Line No.: _ Commodity Code: _ Quantity: _ Unit of Measure: Unit Cost: _ _ Description: MA Line No. _ Accounting Line: _ _ Amount: _ COMMODITY LINE NUMBER INCREASE / DECREASE / DELETE: Comm. Line No. _ Increase Qty By: _ Decrease Qty By: _ _ Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: _ _ _ _ Delete: _ (check only if you want to delete this line number). CANCELLATION: _ Please cancel Purchase Order / Delivery Order Original sent to vendor: Yes _No *JUSTIFICATION (Required for all transactions): _ Enter Retainage for line number(s) in the amount of _ % *Original PO/DO/Contract Award/Encumbrance circle one Contract Amount Encumbered/De-Encumbered Amount $ . $ . *Net Dollars for Previous Change Orders (Addition/Subtraction) circle one $ . $ . *Net Dollars for This Change Order (Addition/Subtraction) circle one $ . $ . *Total Dollars $ . $ . By signing this agreement, the undersigned authorityContractor hereby releases the County, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrumentits agents, and acknowledged to me that he executed same employees from any and all liabilities under this contract for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein statedfurther equitable adjustments and/or claims associated with this change order. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY*Vendor/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project NoContractor Authorization: Date: LEGEND*Departmental Approval: Date: E-13 *Purchasing & Contracts Approval: Date: For Purchasing Use Only Track Change Order: Yes No Change Award Amount to: $ Add the following text to the PO/DO: CHANGE ORDER REQUEST CONTINUATION SHEET Document No.: _ _ PURCHASE ORDER / DELIVERY ORDER / CONTRACT ACCOUNTING LINE CHANGE ONLY: Accounting Line From: Accounting Line To: Accounting Line Add: Accounting Line From: Accounting Line To: Accounting Line Add: COMMODITY LINE NUMBER ADD: Amount: Amount: Amount: Amount: Amount: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: Amount: Comm. Line No.: Commodity Code: Quantity: Unit of Measure: Unit Cost: Description: MA Line No. Accounting Line: COMMODITY LINE NUMBER INCREASE / DECREASE / DELETE: Amount: Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: Delete: (check only if you want to delete this line number). Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Decrease Unit Cost By: Accounting Line: Delete: (check only if you want to delete this line number). Comm. Line No. Increase Qty By: Decrease Qty By: Increase Unit Cost By: Delete (check only if you want to delete this line number). Decrease Unit Cost By: Accounting Line: *Departmental Approval: Date: _ Purchasing & Contracts Approval: Date: 53-25 (7/04) DRUG-FREE WORKPLACE FORM The undersigned vendor, in accordance with Florida Statute 287.087 hereby certifies that does: Name of Business
Appears in 1 contract
Samples: www.bidnet.com
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Consultant Xxxxxxxx, Xxxxx & Xxxxxx dba Schrickel, Xxxxxxx/PSC Xxxxxx Xxxxxx, RLA, ASLA- Sector Director Tax Identification No. 000000000 ATTEST: CITY OF ARLINGTON, TEXASTEXAS By: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Xxxxxxx Director of Water Utilities Printed or Typed Title Parks and Recreation APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BYBy: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxx, RLA, XXXX, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed same for and as the act and deed of Xxxxxxxx, Xxxxx & Xxxxxx dba Schrickel, Xxxxxxx/PSC (formerly Xxxxxxxxx, Xxxxxxx and Associates, Inc.) a corporation of Tarrant County, Texas, and as President xxxxxxx, and for the purposes and consideration therein expressed and, in the capacity, therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this the _ day of , 2022. Notary Public, State of Texas My Commission Expires Notary's Printed Name THE STATE OF TEXAS § THE COUNTY OF TARRANT § City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx Xxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, a municipal corporation of Tarrant County, Texas, and as the Parks and Recreation Director thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2022. My Commission Expires Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission ExpiresEXHIBIT A April 27, 2022 Xxxxxx Xxxxxxxxx, PLA, ASLA, CPSI Park Project Manager Arlington Parks and Recreation Department 000 Xxxx Xxxx Xx Arlington, TX 76013 RE: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, River Legacy Trail Realignment Contract Modification #6 – Sanitary Sewer Replacement Xxxxxx: Please consider this as a cost proposal for revising the undersigned authority, a Notary Public in plans per the attached Scope of Services and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act Fee Schedule. A summary of the City of Arlingtonfees is shown on below: TASK DESCRIPTION FEE TOTAL XXXXXXXXX – XXXXX, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL XXXXXXX: ADDITIONAL SURVEY FOR SEWER DESIGN $ 11,000 BOUNDARY SURVEY & PREPARE EASEMENTS FOR NEW SEWER LINE $ 10,500 AS-BUILT SURVEY OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission ExpiresTRAIL $ 3,500 XXXXXXXX | XXXXXXXXX XXXXXXX: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDPLAN REVISIONS / ADDITIONS $ 64,805 REIMBURSIBLES $ 1,000 DESIGN CONTINGENCIES $ 10,000 IES:
Appears in 1 contract
WITNESS. ENGINEER: BY: Xxxxx X. Xxxxxx Printed or Typed Name Vice-President Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx Xxxxxx, Acting City Secretary BY: Xxxxx Xxxxxx X. Xxxxxxxx Xxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx Xxxxxx X. XxxxxxxxXxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: 2017 Large Diameter Sanitary Sewer Replacement Project No: City of Arlington Project Xx. XXXX00000 Date: LEGEND
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxx XxxxxxX. Xxxxxxxxx, Director of Libraries City of Arlington, Library Department XXXX X. XXXXXX City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: BY THE STATE OF TEXAS § § CONSULTANT’S COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared ., known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of , a corporation of County, Texas, and as Principal thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2013. Notary Public in In and for the For The State of Texas My Commission Expires: Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § § CITY OF ARLINGTON, TEXAS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx XXXX X. XxxxxxxxXXXXXXXXX, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of Arlingtonthe State of Texas, Tarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities Libraries thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2013. Notary Public in In and for the For The State of Texas My Commission Expires: Notary's Printed Name My Commission ExpiresExhibit “A” XXX XXXX-00-000 Xxxxx of Work and Billing Schedule REQUEST FOR QUALIFICATIONS ANNOUNCEMENT RFQ LIBR-13-002 Dated: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE 01/07/2013 The City of Arlington (MWBE“City”) REPORT Please is seeking a response to this Request for Qualifications (RFQ) from organizations or individuals interested in providing professional services needed to complete this form, include copy a library planning study to fulfill the requirements of certification(s) an FY 2013 Institute of Museum and return with executed contracts Project Name: Project No: Date: LEGENDLibrary Services National Leadership Grant. The grant project involves an assessment of our community’s capacity to promote early learning and school readiness as well as recommend and offer guidance to either build the capacity of existing organizations to provide services or develop a new early education coalition to lead the effort.
Appears in 1 contract
Samples: arlingtontx.granicus.com
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoConsultant Xxxxxxxx, Xxxxx & Xxxxxx dba Xxxxxxxxx, Xxxxxxx/PSC Xxxxxx Xxxxxx, RLA, ASLA- Sector Director TaxIdentificationNo. 751156936 ATTEST: CITY OF ARLINGTON, TEXASTEXAS By: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxx Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title Director, Parks and Recreation APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BYBy: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxx, RLA, ASLA, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed same for and as the act and deed of Xxxxxxxx, Xxxxx & Xxxxxx dba Xxxxxxxxx, Xxxxxxx/PSC (formerly Xxxxxxxxx, Xxxxxxx and Associates, Inc.) a corporation of Tarrant County, Texas, and as President thereof, and for the purposes and consideration therein expressed and, in the capacity, therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this the _ day of , 2019. Notary Public, State of Texas My Commission Expires Notary's Printed Name THE STATE OF TEXAS § THE COUNTY OF TARRANT § City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, a municipal corporation of Tarrant County, Texas, and as the Parks and Recreation Director thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2019. My Commission Expires Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission Expires: THE STATE EXHIBIT A SCOPE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE MESERVICES JANUARY 2, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2019 REVISIONS TO BE MADE:
Appears in 1 contract
WITNESS. ENGINEERmy hand and official seal in the County and State last aforesaid this _ day of . (Seal) Notary Public (Print Name of Notary Above) Commission No.: BYMy Commission expires: Printed or Typed Name Printed or Typed Title Tax Identification NoWitnesses: Signature Name: Date: Signature Name: Date: TENANT: XXXXXX.XXX SERVICES, INC. ATTESTa Delaware corporation By: CITY OF ARLINGTON, TEXASName: Xxxx Xxxxxx, City Secretary BYTitle: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORMDate signed: XXXXX XXXXX, City Attorney BYWitnesses: THE Signature Name: Date: Signature Name: Date: STATE OF TEXAS § ) ) ss. COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME) On this day of , the undersigned authority20 , before me, a Notary Public in and for the State of Texas, on this day personally appeared , known to me known to be the person respectively, of , the corporation that executed the within and officer whose name is subscribed to the foregoing instrument, and acknowledged said instrument to me that he executed same be the free and voluntary act and deed of said corporation, for the uses and as the act of , a corporation of County, Texaspurposes therein mentioned, and as thereof, on oath stated that he/she/they is/are authorized to execute said instrument and for that the purposes and consideration therein expressed and in seal affixed is the capacity therein statedcorporate seal of said corporation. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name Residing at: My Commission Expirescommission expires: THE STATE OF TEXAS § ) ) ss. COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME) On this day of , the undersigned authority20 , before me, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me known to be the person , respectively, of , the corporation that executed the within and officer whose name is subscribed to the foregoing instrument, and acknowledged said instrument to me that he executed same for be the free and as the voluntary act and deed of the City of Arlington, Texas, a Texas municipal said corporation, for the uses and as the Director of Water Utilities thereofpurposes therein mentioned, and for on oath stated that he/she/they is/are authorized to execute said instrument and that the purposes and consideration therein expressed and in seal affixed is the capacity therein statedcorporate seal of said corporation. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name Residing at: My Commission Expirescommission expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE ADDENDUM 1 GROUND RENT There shall be no Capitalized Rent in the event the Term exceeds thirty (MWBE30) REPORT Please complete this formyears. As set forth in the table above, include copy the Ground Rent increases 7.5% (the “Ground Rent Escalation”) every five years, with the first increase in Ground Rent occurring five (5) years from the Commencement Date, and subsequent increases will occur every five (5) years thereafter. If the Commencement Date does not occur on the first day of certification(sa calendar month, then the Ground Rent Escalation will occur on the first day of the first full calendar month following the date that is five (5) and return with executed contracts Project Name: Project No: years from the Commencement Date: LEGEND. ADDENDUM 2 EXTENSION OPTIONS
Appears in 1 contract
Samples: Ground Lease Agreement
WITNESS. ENGINEERGRANTOR: BYMILLBROOK FIELDS LLC By: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST_ (SEAL) Name: CITY OF ARLINGTON, TEXASTitle: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § MARYLAND, COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, TO WIT: I HEREBY CERTIFY, that on this day of , 2018, before me, the undersigned authoritySubscriber, a Notary Public in and for the State of Texasand County aforesaid, on this day personally appeared , who acknowledged himself/herself to be the of Millbrook Fields LLC, a Maryland limited liability company, known to me (or satisfactorily proven) to be the person and officer whose name is subscribed to the foregoing within instrument, and acknowledged to me that he he/she executed the same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes therein contained as a duly authorized of such limited liability company by signing the name of such limited liability company by himself/herself as . AS WITNESS MY hand and consideration therein expressed and in the capacity therein statedNotarial Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE BILL NO. 18-032 BILL NO. 18-032 I HEREBY CERTIFY that the foregoing Deed of Easement was prepared on behalf of and at the request of Harford County, Maryland by or under the supervision of a member of the Bar of the Court of Appeals of Maryland. Xxxx X. Xxxxxx XXXX NO. 18-032 EXHIBIT A TO DEED OF TEXAS § COUNTY EASEMENT Description of Land PERMITTED ENCUMBRANCES ASSIGNMENT OF TARRANT § Municipal Acknowledgment BEFORE MEINSTALLMENT PURCHASE AGREEMENT BETWEEN MILLBROOK FIELDS LLC AND HARFORD COUNTY, MARYLAND DATED FOR VALUE RECEIVED, (the undersigned authority“Registered Owner”), a Notary Public subject to the approval of Harford County, Maryland, hereby sell[s], assign[s] and transfer[s] unto without recourse, [all] of the Registered Owner’s right, title and interest in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrumentInstallment Purchase Agreement referenced above; and the Registered Owner’s hereby irrevocably directs the Registrar (as defined in such Agreement) to transfer ownership of such Agreement on the books kept for registration thereof. The Registered Owner hereby represents, warrants and acknowledged certifies that there have been no amendments to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein statedsuch Agreement [except ]. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND:
Appears in 1 contract
Samples: Installment Purchase Agreement
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxx Xxxxxx Vice President Xxxxxx and Xxxxxxx, Inc. Tax Identification NoXx. ATTEST: 00-0000000 CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxx Xxxxxx, Interim Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , Xxxxx Xxxxxx who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxxx and Xxxxxxx, Inc., a corporation of Tarrant County, Texas, and as _ thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 2022, __ day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxx Xxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2022. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYFOR MINORITY AND/WOMEN OR WOMAN OWNED BUSINESS ENTERPRISE ENTERPRISES (MWBETo be completed only if applicable) REPORT Please complete Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, include along with a copy of certification(s) your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with executed contracts Project Name: Project No: Date: LEGENDthis response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS BY Xxxx Xxxxxxxxx City Manager ATTEST: Xxxx Xxxxxx, XXXX X. XXXXXX City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, BY XXX XXXXXX City Attorney BY: THE STATE OF TEXAS § UTA Acknowledgment COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) _ Notary Public in and for the The State of Texas _ My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § CITY OF ARLINGTON, TEXAS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxx Xxxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of ArlingtonTarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities CITY MANAGER thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) _ Notary Public in and for the The State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND_
Appears in 1 contract
Samples: Interlocal Agreement
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification Nomy hand and seal in the County and Commonwealth aforesaid this day of , 20 . ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for (SEAL) My Commission Expires: ACKNOWLEDGEMENT IF AN INDIVIDUAL (To be executed with the State Agreement) Commonwealth of Texas, Pennsylvania ) ) SS: or ) EIN: County of Allegheny ) I HEREBY CERTIFY that on this day date before me, an officer duly authorized in the Commonwealth and County named above to take acknowledgements, personally appeared , known to me to be the person in and officer whose name is subscribed to who executed the foregoing instrument, and acknowledged to before me that he he/she executed same for and as the act same. SWORN TO AND SUBSCRIBED before me this day of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of Notary Public (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, ACKNOWLEDGEMENT IF A PARTNERSHIP (To be executed with the undersigned authority, a Notary Public in and for the State Agreement) Commonwealth of Texas, Pennsylvania ) ) EIN: County of Allegheny ) I HEREBY CERTIFY that on this day date before me, an officer duly authorized in the Commonwealth and County named above to take acknowledgements, personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person in and officer whose name is subscribed to who executed the foregoing instrumentinstrument as a partner of , and a partnership. He/She acknowledged to me before that he he/she executed the same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and said partnership for the uses and purposes and consideration therein expressed and in the capacity therein statedmentioned. GIVEN UNDER MY HAND SWORN TO AND SEAL OF OFFICE on SUBSCRIBED before me this the day of , 20 . day of Notary Public (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND EXHIBIT A STATEMENT OF WORK To be determined by individual Service Authorization EXHIBIT B RATE SCHEDULE To be determined by individual Service Authorization Audited Indirect Rate: Profit Rate Not-to-Exceed 10%. Consultant shall be reimbursed only for employees working directly on Services for the Authority project. Profit Rate on Subconsultants Not-to-Exceed 5%. EXHIBIT C INVOICE FORMAT Service Authorization Number Invoice Number Company Name Invoice Period Address Date of Invoice LABOR CLASS & TITLE EMPLOYEE NAME SALARY RATE HOURS AMOUNT <<raw rate$/HR>> <<salary x hours>> <<salary x hours>> <<salary x hours>> <<salary x hours>> <<salary x hours>> Subtotal Labor Overhead Multiplier Subtotal Labor + overhead Profit Mulitplier (10%) <<overhead multiplier >> 10% a. total the column above b. ( = line a. x multiplier rate) c. ( = line a + line b) d. ( = line c x .10) Profit on Subs (5%) Total Prime Contractor labor and profit 5% e. ( .05 x line g) f. ( = c + d + e) SUBCONTRACTORS NAME '$ subcontractor cost NAME '$ subcontractor cost NAME '$ subcontractor cost TOTAL SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy g. Total the column above OTHER DIRECT COSTS Identify Costs by Company Identify Costs by Company <<no multiplier>> <<no multiplier>> amount amount h. total of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDODCs TOTAL INVOICE i. = line f + line g + line h BUDGE <<amount of Service Authorization This invoice Previously earned Xxxxxx to date Remaining on Contract j. k. L. m. = line k + line L n. = line j - line m
Appears in 1 contract
Samples: Agreement for Professional Services
WITNESS. ENGINEERSURVEYOR: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Surveyor Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND
Appears in 1 contract
Samples: Surveying Services Contract
WITNESS. ENGINEER[MANASSAS BORROWER], a By: BYName: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTESTTitle: CITY OF ARLINGTONASSOCIATION, TEXASAS TRUSTEE By Name: Xxxx Xxxxxx, City Secretary BYTitle: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § ) SS COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on ) On this day of , 2019, I do hereby certify that , personally appeared known to me to be of [MANASSAS BORROWER], personally known to me to be the same person and officer whose name is subscribed to the foregoing instrument, appeared before me this day in person and acknowledged that as such such person signed and delivered the said instrument as of said entity, pursuant to me that he executed same for and as the act of authority, a corporation of Countygiven by [MANASSAS BORROWER], Texas, and as thereof, and for the uses and purposes and consideration therein expressed and in the capacity therein statedset forth. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of Notary Public (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § ) SS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on ) On this day of , 2019, I do hereby certify that , personally appeared Xxxxx X. Xxxxxxxxknown to me to be of WILMINGTON TRUST, NATIONAL ASSOCATION, personally known to me to be the same person and officer whose name is subscribed to the foregoing instrument, appeared before me this day in person and acknowledged that as such such person signed and delivered the said instrument as of said entity, pursuant to me that he executed same for and as the act of the City of Arlingtonauthority, Texasgiven by WILMINGTON TRUST, a Texas municipal corporationNATIONAL ASSOCATION, and as the Director of Water Utilities thereof, and for the uses and purposes and consideration therein expressed and in the capacity therein statedset forth. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of Notary Public (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy EXHIBIT A LEGAL DESCRIPTION [INSERT LEGAL DESCRIPTION] The undersigned hereby acknowledges the receipt of certification(s) the Deed of Trust and return with executed contracts Project Note referred to in the forgoing Ground Lessor Estoppel Certificate and Agreement. CITY OF MANASSAS By: Name: Project No: Date: LEGEND:
Appears in 1 contract
Samples: Estoppel Certificate and Agreement
WITNESS. ENGINEERSigned, sealed and delivered in the presence of: BYOWNERS: Printed PRINT NAME AND ADDRESS Witness Signature Print Name Witness Signature Print Name STATE OF COUNTY OF Owner Signature 2nd Owner Signature (if applicable) I HEREBY CERTIFY that before me personally appeared by means of physical presence or Typed Name Printed online notarization, , as an individual who is/are [ ] personally known to me or Typed Title Tax Identification No[ ] has/have produced as identification or of a Corporation organized under the Laws of the State of , to me known to be the person(s) who signed the foregoing instrument as such officer(s), and each of whom acknowledge the execution thereof to be their free act and deed as such officer(s) for the uses and purposes therein mentioned, and they affixed thereto the official seal of said corporation, and the said instrument is the act and deed of said corporation, such execution having been authorized by the governing board thereof. ATTESTWITNESS my hand and official seal in the County and State last above written, this day of 20 . Notary Seal Notary Public WITNESS: CITY ----- BELOW SECTION TO BE COMPLETED BY TOWN OFFICIALS: ----- TOWN OF ARLINGTONJUPITER Signed, TEXASsealed and delivered in the presence of: Xxxx Xxxxxx, City Secretary BYWitness Signature By: Xxxxx X. Xxxxxxxx Printed or Typed Name Xxxxx, Director of Water Utilities Printed or Typed Title APPROVED AS TO FORMAttest: XXXXX XXXXXPrint Name Witness Signature Print Name Approved as to Form and Legal Sufficiency by Xxxxxx X. Xxxxx, City Town Attorney BY: THE STATE OF TEXAS § FLORIDA COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State PALM BEACH The foregoing instrument was acknowledged before me by means of Texas, on ☐ physical presence or ☐ online notarization this day of , 20 , by , Director, Town of Jupiter Utilities, who is personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDwho did not take an oath.
Appears in 1 contract
Samples: Indemnity Agreement
WITNESS. ENGINEERour hands and seals this day of , 2020. Grantor: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTESTDC ROCHELLE, LLC Grantee: CITY OF ARLINGTONXXXXXXXX, TEXASMunicipal Corporation By: Name: Xxxx Xxxxxx, Xxxxxxxxxxx Title: City Secretary BYManager Attest: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORMName: XXXXX XXXXX, Xxx Xxxxxx Title: City Attorney BY: THE Clerk STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME) ) SS ) I, the undersigned authorityundersigned, a Notary Public Public, in and for the County and State of Texasaforesaid, on this day DO HEREBY CERTIFY that as personally appeared , known to me to be the same person and officer whose name is subscribed to the foregoing instrument, appeared before me this day in person and acknowledged to me that he executed same signed and delivered said instrument on behalf of said as free and voluntary act, for the uses and as the act purposes therein set forth. Given under my hand and seal this: day of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated2020. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE NOTARY PUBLIC STATE OF TEXAS § ILLINOIS ) ) SS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, XXXX ) I the undersigned authorityundersigned, a Notary Public in and for said County, in the State of Texasaforesaid, on this day DO HEREBY CERTIFY that XXXX XXXXXXXXXXX, personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person City Manager of the City of Xxxxxxxx, a municipal corporation and officer XXX XXXXXX, personally known to me to be the City Clerk of the City of Xxxxxxxx, and personally known to me to be the same persons whose name is names are subscribed to the foregoing instrument, appeared before me this day in person and severally acknowledged that as such City Manager and City Clerk of said corporation they caused their signatures to me that he executed same for be affixed thereto, and as caused the act corporate seal of said corporation to be affixed thereto, pursuant to the authority given by the Council of the City of Arlington, Texas, a Texas municipal corporationXxxxxxxx as their free and voluntary act, and as the Director free and voluntary act and deed of Water Utilities thereofsaid corporation, and for the uses and purposes therein set forth. Given under my hand and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . seal this: day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2020.
Appears in 1 contract
Samples: By And
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxx Xxxxxx – Vice President Xxxxxx and Xxxxxxx, Inc. Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxx Xxxxxx, Interim Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx Xxxxxx, P.E. Principal / Vice President who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxxx and Xxxxxxx, Inc., a corporation of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 2022, day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxx Xxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2022.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § RHODE ISLAND COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MEIn said County of and State on the ________ day of December, the undersigned authority1996, a Notary Public in and for the State of Texas, on this day before me personally appeared ________, to me known to and known by me to be the person and officer whose name is subscribed to persons executing the foregoing instrument, and they acknowledged said instrument, by them executed, to me be their free act and deed. --------------------------------- Notary Public (In accordance with Section 34-11 of the Rhode Island General Laws, 1956, as amended) EXHIBIT D TEMPORARY CANTILEVER CRANE EASEMENT KNOW ALL MEN BY THESE PRESENTS, that he executed same the RHODE ISLAND ECONOMIC DEVELOPMENT CORPORATION, a Rhode Island public corporation, for and as in consideration of the act sum of One Dollar ($1.00) and other good and valuable consideration paid by ELECTRIC BOAT CORPORATION, a Delaware corporation with an address of County75 Exxxxxx Xxxxx Xxxx, TexasXxxxxx, XX 00000-0009, the receipt and as thereofsufficiency of which is hereby acknowledged, does hereby grant unto said Grantee, its successors and assigns, a non-exclusive easement in, on and over the parcel of real estate set forth and more particularly described on Schedule A attached hereto and made a part hereof, for a term of ten (10) years commencing on January 1, 1997 and terminating December 31, 2006 for the purposes purpose of ingress and consideration therein expressed egress to and in from a cantilever crane providing access to waters of the capacity therein statedNarragansett Bay, with all riparian rights attendant thereto. GIVEN UNDER MY HAND AND SEAL OF OFFICE The Grantee, its successors and assigns, shall have the right to enter upon the parcel of real estate described on this the , 20 . day of (SEAL) Notary Public in Schedule A attached hereto with men and equipment for the State purpose of Texas Notary's Printed Name My Commission Expiresingress and egress by it to said cantilever crane. The Grantee, for itself, its successors and assigns, by accepting and recording this easement, acknowledges and agrees that: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE MEIt accepts the rights to the parcel of real estate described on Schedule A in its present condition; it shall, thereafter, at its expense, install, repair, maintain and operate said easement area and cantilever crane; upon any occasion of disturbance by any of the undersigned authorityGrantee, a Notary Public in its successor and assigns, of the land area within the parcel described above, said Grantee, its successors and assigns, shall restore that land area as nearly as possible to its former condition prior to such disturbance (or as mutually agreed upon by said Granxxx xxx Grantor), said restoration to be without delay; and the maintenance of said easement area shall be the responsibility and at the sole risk of said Grantee, its successors and assigns. The Grantor, its successors and assigns, reserves the right to utilize the parcel of real estate described above for any purpose whatsoever; provided, however, that such use does not interfere with the easement herein granted. TO HAVE AND TO HOLD the same with all rights, privileges and appurtenances thereof or "hereunto pertaining and to the use of said Granxxx, xxs successors and assigns, for the State term of Texasten years as set forth herein, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes special purpose of being used and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDimproved as said Cantilever Crane Easement.
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . ___ day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Xxxxxx-Xxxxx Water Treatment Plant Filter and Backwash Improvements Project No: :XXXX00000 Date: LEGEND06-28-2022 LEGEND * Answer with “YES” or “NO” AI Native American (AI) NW Native American, Women-Owned (NW) AS Asian (AS) AW Asian, Women-Owned (AW) XX Xxxxx (BL) BW Black, Women-Owned (BW) HI Hispanic (HI) HW Hispanic, Women-Owned (HW) WO Women-Owned (WO) Other PRIME CONTRACTOR/CONSULTANT *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount HDR Engineering, Inc. No No LIST ALL SUBS: Name of Company & Address Description of Primary Work Type (For prequalification verification purposes) *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount Gupta and Associates, Inc. Electrical Engineering Yes AS $38,939 JQ Infrastructure, LLC Structural Engineering Yes AI $52,566 Signature Automation, LLC Instrumentation and Control Engineering Yes HI $57,773 KWH Engineering, LLC HVAC, Plumbing, and fire protection engineering Yes AS $23,606 Attachment A - Scope of Work City of Arlington Water Utilities Xxxxxx-Xxxxx Water Treatment Plant Filter and Backwash Improvements Project No. XXXX00000
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEERWILBOW-RAGLAND 202 DEVELOPMENT CORPORATION, a Texas corporation By: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: Xxxx Xxxxxxxxxx, President CITY OF ARLINGTON, TEXASTEXAS ATTEST: By: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title Deputy City Manager APPROVED AS TO FORM: XXXXX XXXXXBy: Xxx Xxxxxx, City Attorney BY: THE STATE OF TEXAS § WILBOW-XXXXXXX 202 DEVELOPMENT CORPORATION COUNTY OF TARRANT DALLAS § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXX XXXXXXXXXX, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of WILBOW-XXXXXXX 202 DEVELOPMENT CORPORATION, a duly authorized corporation of County, the state of Texas, and as PRESIDENT thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2012. Notary Public in In and for For the State of Texas My Commission Expires Notary's ’s Printed Name My Commission Expires: THE STATE OF TEXAS XXXXX XX XXXXX § COUNTY XXXX XX XXXXXXXXX, XXXXX XXXXXX OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of the City of ArlingtonCITY OF ARLINGTON, TexasTEXAS, a Texas municipal corporation, and as the Director of Water Utilities DEPUTY CITY MANAGER thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2012. Notary Public in In and for For the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDTexas
Appears in 1 contract
Samples: Developer Participation Agreement
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. BY XXXXXXXXX XXXXX Director CITY OF ARLINGTON ATTEST: CITY OF ARLINGTONBY XXXXX X. XXXXXXX, TEXAS: Xxxx XxxxxxFAICP Deputy City Manager XXXX XXXXXX, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Grantee Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXXXXXXX XXXXX, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of ARLINGTON HISTORICAL SOCIETY, an agency of Tarrant County, Texas, and as Executive Director thereof, and for the purposes and consideration therein expressed and in the capacity therein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE this the day of , 2017. Notary Public In and For The State of Texas My Commission Expires Notary's Printed Name THE STATE OF TEXAS § COUNTY OF TARRANT § City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXXX X. XXXXXXX, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the CITY OF ARLINGTON, TEXAS, a municipal corporation of the State of Texas, Tarrant County, Texas, and as the Deputy City Manager thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2017. Notary Public in and for the [Seal] The State of Texas Notary's Printed Name My Commission ExpiresEXHIBIT A SCOPE OF SERVICES Organization: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDArlington Historical Society
Appears in 1 contract
WITNESS. ENGINEER: XXXXXX X. XXXXX ASSOCIATES, INC. BY: Printed or Typed Name Printed or Typed Title Tax Identification No. Xxxxxx X. Xxxxxx, P.E., LEED AP Principal ATTEST: CITY OF ARLINGTON, TEXAS: BY: Xxxx Xxxxxx, City Secretary Xxxxx Xxxxxx, P.E. Director of Public Works and Transportation BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Xxxx, P.E. Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment City Acknowledgement BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. XxxxxxxxXxxxxx, P.E. , known to me to be the a person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities Public Works and Transportation thereof, and for the purposes and consideration therein expressed and in the capacity therein statedexpressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of , 20 . day of (SEAL) Notary Public in In and for the For The State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDTHE STATE OF TEXAS § COUNTY OF TARRANT § City Acknowledgement
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxxx Xxxxxx; R.L.A., A.S.L.A - President Xxxxxxxxx, Xxxxxxx and Assoc., Inc. Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxx, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxxxxxx, Xxxxxxx and Associates, Inc., a corporation _ of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2018, Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2018. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission ExpiresFOR MINORITY AND/OR WOMAN OWNED BUSINESS ENTERPRISES (To be completed only if applicable) Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, along with a copy of your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with this response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification. COMPANY NAME: PRIME AND SUBS & REPRESENTATIVE: ADDRESS: _ CITY, STATE, ZIP: EMAIL: _ TELEPHONE NO.: FAX NO.: _ INDICATE ALL THAT APPLY Minority Owned Business Enterprise Woman Owned Business Enterprise MINORITY STATUS: Has this firm been certified as a minority, women or disadvantaged business enterprise by any governmental agency? Yes No if yes, please specify government agency: Date of certification: The above information is for information only. The City of Arlington encourages minority business participation; however no preferences shall be given. MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please DATA GATHERING FORM (CONSULTANT SERVICES CONTRACT) The City of Arlington is gathering data on MWBE businesses. In order to be identified as a certified Minority/Woman Business Enterprise (MWBE) in the City of Arlington, please complete this form, include copy of certification(s) your Certification and return with executed contracts Project Nameyour RFQ documents. Please note that this data is for information only. Name of Consultant: Project NoIs Consultant MWBE? If yes, please check all that applies: Date: LEGENDYES NO Native American (AI) Native American, Women-Owned (NW) Asian (AS) Asian, Women-Owned (AW) Black (BL) Black, Women-Owned (BW) Hispanic (HI) Hispanic, Women-Owned (HW) Women-Owned (WO) MWBE Certifications accepted by the City of Arlington. The City will review other MWBE Certification. North Central Texas Regional Certification Agency (NCTRCA) State of Texas, historically Underutilized Business (HUB) Dallas/Fort Worth Minority Supplier Development Council (DFW MSDC) Women’s Business Council – Southwest (WBC-SW) Texas Department of Transportation (TxDOT) South Central Texas Regional Certification Agency (SCTRCA)
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEERmy hand and official seal, this the day of , 2000. Notary Public My Commission Expires: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE [NOTARIAL SEAL] STATE OF TEXAS § NORTH CAROLINA COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MEI, the undersigned authority, a Notary Public in and for the above State of Texasand Counties, on hereby certify that personally came before me this day personally appeared , known to me to be and acknowledged that he is Executive Director of the person and officer whose name is subscribed to the foregoing instrumentNorth Carolina Wildlife Resources Commission, and acknowledged to me that he executed same for by authority duly given and as the act of , a corporation said Agency of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name North Carolina, the foregoing and annexed instrument was signed in its name by , its , sealed with its corporate seal and attested by as its . WITNESS my hand and official seal, this the day of , 2000. Notary Public My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME[NOTARIAL SEAL] ASSISTANT SECRETARY CERTIFICATE I, the undersigned authority, Assistant Secretary of Duke Power, a Notary Public Division of Duke Energy Corporation, do hereby certify that the following is a true and correct excerpt of a Resolution adopted September 22, 1997, by the Management Committee of the Board of Directors of Duke Energy Corporation, and that said quoted Resolution has not been rescinded or amended: FURTHER RESOLVED, That Xxxxxx Xxxxx the Senior Vice-President of the Power Generation Division, be and hereby is authorized, to execute any contract, lease, deed or other instrument relating to real property without further action or approval by the Board of Directors of this Committee when deemed by said Senior Vice-President to be necessary or desirable in the operation of the Company’s business, subject, however, to a monetary limit of $1,500,000.00 consideration or value in any single transaction, and to execute such documents in any such transaction which is approved by a resolution of this Committee. FURTHER RESOLVED, That the Secretary or any Assistant Secretary be and hereby is authorized to attest and affix the Corporate seal to any contracts, leases, deeds or other instruments executed under authority of this resolution and may execute any certificate that may be required to certify the incumbency and authority of the officer or manager executing such documents. I further certify that on , 2000, Xxxxxx Xxxxx was the Senior Vice-President, Power Generation Division, and by reason of holding said position and pursuant to the above quoted Management Committee’s Resolution, had full authority to represent and act on behalf of Duke Energy Corporation with respect to the execution of an Agreement between Duke Power, a Division of Duke Energy Corporation and the North Carolina Wildlife Resources Commission for lands located in the State Counties of TexasAlexander, Burke, Caldwell, Catawba, Forsyth, Gaston, Iredell, Lincoln, McDowell, Mecklenburg and Xxxxxx, North Carolina and to execute on behalf of Duke Power, a Division of Duke Energy Corporation all documents and instruments relating in any way thereto. WITNESS my hand and official seal of said Company this day personally appeared Xxxxx X. Xxxxxxxxof , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2000.
Appears in 1 contract
Samples: Public Access Area Agreement
WITNESS. ENGINEERFMR LLC, a Delaware limited liability company By: BYName: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTESTTitle: CITY OF ARLINGTONTENANT: WITNESS: SILVER BRIDGE ADVISORS, TEXASLLC, a Delaware limited liability company By: Xxxx XxxxxxName: Title: LANDLORD: WITNESS: 000 XXXXX XXXXXX, City Secretary BYLLC, a Delaware limited liability company By: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORMPembroke Real Estate, Inc., its manager By: XXXXX XXXXX, City Attorney BYName: THE STATE OF TEXAS § Title: XXXXXXXXXXXX XX XXXXXXXXXXXXX ) ) ss COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MESUFFOLK ) On this day of , 2010, before me, the undersigned authoritynotary public, a Notary Public in and for the State of Texas, on this day personally appeared , known proved to me through satisfactory evidence of identification which was to be the person and officer whose name is subscribed to signed on the foregoing instrument, preceding or attached document and acknowledged to me that he executed same he/she signed it voluntarily for and its stated purpose as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein statedFMR LLC. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE COMMONWEALTH OF TEXAS § MASSACHUSETTS ) ) ss COUNTY OF TARRANT § Municipal Acknowledgment BEFORE MESUFFOLK ) On this day of , 2010, before me, the undersigned authoritynotary public, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known proved to me through satisfactory evidence of identification which was to be the person and officer whose name is subscribed to signed on the foregoing instrument, preceding or attached document and acknowledged to me that he executed same he/she signed it voluntarily for and its stated purpose as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein statedFMR LLC. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS COMMONWEALTH OF MASSACHUSETTS ) ) ss COUNTY OF SUFFOLK ) On this day of , 2010, before me, the undersigned notary public, personally appeared , proved to me through satisfactory evidence of identification which was to be the person whose name is signed on the preceding or attached document and acknowledged to me that he/she signed it voluntarily for its stated purpose as of FMR LLC. Notary Public My Commission Expires: EXHIBIT A Legal Description (to be attached) EXHIBIT I SCHEDULE OF CONSTRUCTION DOCUMENTS - TENANT’S WORK September 21, 2010 Construction Documents for 000 Xxxxx Xxxxxx 0xx Xxxxx Dated: September 1, 2010 Silver Bridge: Architectural: A001 Drafting Conventions and Symbols, Genera Notes and List of Drawings D106 Demolition Plan A106 Construction Plan A206 Reflected Ceiling Plan A306 Elec/Tel/Data Plan A406 Furniture/Equipment Plan A506 Finish Plan A600 Elevations A601 Elevations A800 Door and Frame Schedule, Door and Frame Types, Partition Types A801 Door and Frame Details A900 Interior Details A901 Interior Details Plumbing: P0.00 Detail, Legend, Schedules and General Notes P2.00 Sixth Floor Plan P7.00 Specifications Fire Protection: FP0.00 Details, Legend and Specifications FP2.00 Fire Protection Plan, Sixth Floor HVAC: H0.00 Legend, Symbols and Abbreviations H2.00 Sixth Floor H6.00 Control Diagrams H7.00 Details Sheet No. 1 H7.01 Details Sheet No. 2 H8.00 Schedules H9.00 Specifications and Notes Electrical: E0.00 Legend, Notes and Abbreviations E2.00 Lighting Plan Sixth Floor E3.00 Power Plan Sixth Floor E4.00 Fire Alarm Plan Sixth Floor E8.00 Detail Sheet No. 1 E8.01 Detail Sheet No. 2 E9.00 Schedules and Power Riser Diagram E10.00 Specifications and Demolition Notes Xxxxxxxx #0 Xxxxxxxxx 0, 0000 XXX-00 Relocated Door, Conference Room 611 SKA-02 Finish Schedule Revisions EXHIBIT J SCHEDULE OF CONSTRUCTION DOCUMENTS – STAIRWAY/COMMON AREA WORK Elevator Lobby /Common Corridors and Stair Removal Drawings Dated: September 1, 2010 Architectural: IA-001 Legends, Abbreviations & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this formKey Plan Floor 6 ID-106 Demolition Plan Floor 6 ID-107 Demolition Plan Floors 7, include copy of certification(s) 8 & 9 Stairwell ID-206 Demolition Reflected Ceiling Plan Floor 6 ID-207 Demolition RCP Floors 7, 8 & 9 Stairwell IA-106 Partition & Power Signal Plan Floor 6 IA-107 New Partition & Finish Plans Floors 7, 8 & 9 Stairwell IA-181 Door Types, Door & HDWR Sched., Glazing Dtls IA-182 Door and return with executed contracts Project NameHardware Schedule IA-206 Reflected Ceiling Plan Floor 6 IA-207 New Reflected Ceiling Plan Floors 7, 8 & 9 Stairwell IA-406 Finish Plan Floor 6 IA-731 Elevations and Details Floor 6 Elev. Lobby IA-732 Interior Details Floor 6 Structural: Project NoS-100 Slab Infill Part Plans & Details Fire Protection: DateFP-001 Fire Protection Legend, Notes, Detail and Specifications FP-206 Fire Protection 6th Floor Sprinkler Part Plan Mechanical: LEGENDH0.01 HVAC Specifications H0.02 HVAC Schedules Details H1.01 HVAC Demolition Plan HI.02 HVAC New Work Plan Electrical: E-001 Electrical Legend and Schedules E-002 Electrical Specifications E-106 Electrical Lobby Demolition Plan E-206 Electrical Lobby Lighting & Power Plan E-306 Electrical Lobby Fire Alarm Plan Addendum #1 Additional Scope Dated September 14, 2010 E-789 Electrical Stairway Demo. And New Work Plans FP-789 Fire Protection 7th – 9th Floor Sprinkler Part Plans
Appears in 1 contract
Samples: Sublease (Tokai Pharmaceuticals Inc)
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxx Xxxxxxx – Vice President Xxxxxx Engineering Group, Inc. Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , Xxxxx Xxxxxxx who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxxx Engineering Group, Inc., a corporation of Dallas County, Texas, and as _ thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 2018, __ day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2018. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYFOR MINORITY AND/WOMEN OR WOMAN OWNED BUSINESS ENTERPRISE ENTERPRISES (MWBETo be completed only if applicable) REPORT Please complete Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, include along with a copy of certification(s) your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with executed contracts Project Name: Project No: Date: LEGENDthis response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxxx Xxxxxx - President Xxxxxxxxx, Xxxxxxx and Associates Inc. Tax Identification No. ATTEST: 75- 1319504 CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxx, RLA, ASLA who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxxxxxx, Xxxxxxx and Associates, Inc., a corporation of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 2017, day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 2017. day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYFOR MINORITY AND/WOMEN OR WOMAN OWNED BUSINESS ENTERPRISE ENTERPRISES (MWBETo be completed only if applicable) REPORT Please complete Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, include along with a copy of certification(s) your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with executed contracts Project Name: Project No: Date: LEGENDthis response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Xxxxxxx Xxxxxx Printed or Typed Name Vice President Printed or Typed Title 00-0000000 Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDcontracts
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § MARYLAND, COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the undersigned authorityofficer, personally appeared _ , of , who acknowledged the foregoing instrument to be his act and deed in such capacity, and that he is authorized to make this acknowledgment. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: (SIGNATURES CONTINUED ON THE NEXT PAGE) WITNESS: BOARD OF COUNTY COMMISSIONERS OF XXXXXXXXX COUNTY, MARYLAND By:_ Xxxxxxxx Xxxxx, Director Department of Housing and Community Development REVIEWED BY: Office of the County Attorney STAE OF MARYLAND, COUNTY OF XXXXXXXXX, TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the subscriber, a Notary Public for the State and County aforesaid, personally appeared Xxxxxxxx Xxxxx, Director, Housing and Community Development, Xxxxxxxxx County, Maryland, and did certify that as such officer, she did execute this instrument for the purposes stated herein, and did certify, under penalties of perjury, that she is authorized to execute this instrument on behalf of the Board of County Commissioners of Xxxxxxxxx County, Maryland. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: CONSENT OF LENDER [If not applicable, write N/A or No Lien] (Lender),holder of the indebtedness secured by the deed of trust [or mortgage] against the property herein described, recorded in Liber at folio , hereby consents to the terms and conditions of the foregoing Payment in Lieu Agreement, and does hereby further agree that the terms contained herein shall survive any sale under its deed of trust [mortgage], as evidenced by the signature of the undersigned trustee [or officer of corporation] under the above described deed of trust. By: [Lender’s name], Trustee STATE OF MARYLAND, CITY/COUNTY OF , TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the subscriber, a Notary Public in and for the State of Texasand County aforesaid, on this day personally appeared , known to me Trustee, who acknowledged her/himself to be the person Trustee, and officer whose name is subscribed that she/he being authorized so to do, executed the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and instrument for the purposes therein contained, by signing his/her name. IN WITNESS WHEREOF, I set my hand and consideration therein expressed and in the capacity therein statedNotarial Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name NOTARY PUBLIC My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND:
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoAviation Performance Solutions, LLC. ATTEST: BY Xxxx Xxxxxxxx Vice President, Finance & Corporate Strategy CITY OF ARLINGTON, TEXASTEXAS BY Xxxxxx X. Xxxxxxx Deputy City Manager ATTEST: Xxxx Xxxxxx, Xxxxxx City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: BY THE STATE OF TEXAS § § LESSEE’S COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXXX XXXXXXXX., known to me (or proved to me on the oath of or through (description of identity card or other document)) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of AVIATION PERFORMANCE SOLUTIONS, a corporation of County, Texas, LLC and as Principal thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the of , 20 201_. day of (SEAL) Notary Public in In and for the For The State of Texas My Commission Expires: Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § § CITY OF ARLINGTON, TEXAS COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx XXXXXX X. XxxxxxxxXXXXXXX, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of Arlingtonthe State of Texas, Tarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities Deputy City Manager thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the of , 20 201_. day of (SEAL) Notary Public in In and for the For The State of Texas My Commission Expires: Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDEXHIBIT “A”
Appears in 1 contract
Samples: Lease Agreement
WITNESS. ENGINEERDEPARTMENT OF BUSINESS AND ECONOMIC DEVELOPMENT /s/ XXXXXXXXX X. XXXXX By: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY/s/ XXXXX X. XXXXXXXX Name: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORMTitle: XXXXX XXXXX, City Attorney BY: THE Secretary STATE OF TEXAS § MARYLAND, COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MEBALTIMORE, TO WIT: I HEREBY CERTIFY that on this 4th day of April, 2008, before me, a Notary Public of the undersigned authorityState of Maryland, in and for the State and City/County aforesaid, personally appeared Xxxxx X. Xxxxxxxx, who acknowledged himself to be the Secretary of Business and Economic Development of the State of Maryland, a principal department of the State of Maryland, known or satisfactorily proven to me to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the foregoing Agreement on behalf of the DEPARTMENT OF BUSINESS AND ECONOMIC DEVELOPMENT for the purposes therein contained as the duly authorized Secretary of Business and Economic Development of the State of Maryland. AS WITNESS my hand and Notarial Seal. /s/ XXXXX X. XXXXXXXXX Notary Public My Commission expires: 03/14/2012 WITNESS: AMERICAN WOODMARK CORPORATION /s/ XXXXXXX X. XXXXX By: /s/ XXXXXXXX XXXX (SEAL) Name: Xxxxxxx X. Xxxxx Name: Xxxxxxxx Xxxx Title: VP and CFO STATE OF VIRGINIA, CITY/COUNTY OF WINCHESTER, TO WIT: I HEREBY CERTIFY that on this 26th day of March, 2008, before me, a Notary Public in and for the State of TexasVirginia, on this day personally appeared Xxxxxxxx Xxxx, who acknowledged himself/herself to be the VP & CFO of American Woodmark Corporation, known or satisfactorily proven to me to be the person and officer whose name is subscribed to the foregoing within instrument, and acknowledged to me that she/he executed same for and as the act foregoing Amendment on behalf of AMERICAN WOODMARK CORPORATION, a corporation of County, Texas, and as thereof, and for the purposes therein contained as its duly authorized agent. AS WITNESS my hand and consideration therein expressed and in the capacity therein statedNotarial Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on /s/ XXXXXX XXXXXX Notary Public My Commission expires: 12/31/2008 FIRST AMENDMENT TO GRANT AGREEMENT THIS FIRST AMENDMENT TO GRANT AGREEMENT (this the , 20 . “Amendment”) is entered into as of this 4th day of (SEAL) Notary Public in and for April, 2008, effective as of December 30, 2007, between the COUNTY COMMISSIONERS OF ALLEGANY COUNTY, a political subdivision of the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE MEMaryland (the “County”), the undersigned authorityand AMERICAN WOODMARK CORPORATION, a Notary Public in and for Virginia corporation (the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND“Recipient”).
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § MARYLAND, COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the undersigned authorityofficer, personally appeared _ , of , who acknowledged the foregoing instrument to be his act and deed in such capacity, and that he is authorized to make this acknowledgment. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: (SIGNATURES CONTINUED ON THE NEXT PAGE) WITNESS: BOARD OF COUNTY COMMISSIONERS OF XXXXXXXXX COUNTY, MARYLAND By:_ Xxxxxxxx Xxxxx, Director Department of Housing and Community Development REVIEWED BY: Office of the County Attorney STAE OF MARYLAND, COUNTY OF FREDERICK, TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the subscriber, a Notary Public for the State and County aforesaid, personally appeared Xxxxxxxx Xxxxx, Director, Housing and Community Development, Xxxxxxxxx County, Maryland, and did certify that as such officer, she did execute this instrument for the purposes stated herein, and did certify, under penalties of perjury, that she is authorized to execute this instrument on behalf of the Board of County Commissioners of Xxxxxxxxx County, Maryland. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: CONSENT OF LENDER [If not applicable, write N/A or No Lien] (Lender),holder of the indebtedness secured by the deed of trust [or mortgage] against the property herein described, recorded in Liber at folio , hereby consents to the terms and conditions of the foregoing Payment in Lieu Agreement, and does hereby further agree that the terms contained herein shall survive any sale under its deed of trust [mortgage], as evidenced by the signature of the undersigned trustee [or officer of corporation] under the above described deed of trust. By: [Lender’s name], Trustee STATE OF MARYLAND, CITY/COUNTY OF , TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the subscriber, a Notary Public in and for the State of Texasand County aforesaid, on this day personally appeared , known to me Trustee, who acknowledged her/himself to be the person Trustee, and officer whose name is subscribed that she/he being authorized so to do, executed the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and instrument for the purposes therein contained, by signing his/her name. IN WITNESS WHEREOF, I set my hand and consideration therein expressed and in the capacity therein statedNotarial Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name NOTARY PUBLIC My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND:
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxxxx X. May - Director Teague, Nall, & Xxxxxxx, Inc. Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxxx X. May, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Teague, Nall, & Xxxxxxx, Inc., a corporation of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2015, Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 2015. day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission ExpiresFOR MINORITY AND/OR WOMAN OWNED BUSINESS ENTERPRISES (To be completed only if applicable) Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, along with a copy of your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with this response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification. COMPANY NAME: PRIME AND SUBS & REPRESENTATIVE: ADDRESS: _ CITY, STATE, ZIP: EMAIL: _ TELEPHONE NO.: FAX NO.: _ INDICATE ALL THAT APPLY Minority Owned Business Enterprise Woman Owned Business Enterprise MINORITY STATUS: Has this firm been certified as a minority, women or disadvantaged business enterprise by any governmental agency? Yes No if yes, please specify government agency: Date of certification: The above information is for information only. The City of Arlington encourages minority business participation; however no preferences shall be given. MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please DATA GATHERING FORM (CONSULTANT SERVICES CONTRACT) The City of Arlington is gathering data on MWBE businesses. In order to be identified as a certified Minority/Woman Business Enterprise (MWBE) in the City of Arlington, please complete this form, include copy of certification(s) your Certification and return with executed contracts Project Nameyour RFQ documents. Please note that this data is for information only. Name of Consultant: Project NoIs Consultant MWBE? If yes, please check all that applies: DateYES NO Native American (AI) Native American, Women-Owned (NW) Asian (AS) Asian, Women-Owned (AW) Black (BL) Black, Women-Owned (BW) Hispanic (HI) Hispanic, Women-Owned (HW) Women-Owned (WO) MWBE Certifications accepted by the City of Arlington. The City will review other MWBE Certification. North Central Texas Regional Certification Agency (NCTRCA) State of Texas, historically Underutilized Business (HUB) Dallas/Fort Worth Minority Supplier Development Council (DFW MSDC) Women’s Business Council – Southwest (WBC-SW) Texas Department of Transportation (TxDOT) South Central Texas Regional Certification Agency (SCTRCA) Others (please specify) - EXHIBIT “A” AUTHORIZATION FOR PROFESSIONAL SERVICES PROJECT NAME: LEGENDXxxxxx Xxxx Recreation Center Parking Lot TNP PROJECT NUMBER: ARL-xxxx CLIENT: City of Arlington P.O. Xxx 00000 XX 00-0000 000 X. Xxxx Xxxxxx Xxxxxxxxx, XX 00000 The City of Arlington (the CLIENT) hereby requests and authorizes Xxxxxx Xxxx and Xxxxxxx, Inc., (the CONSULTANT) to perform the following services: Article I xxx.xxxxxx.xxx engineers surveyors landscape architects SCOPE: Provide professional design and survey services in developing site improvements for the Xxxxxx Xxxx Recreation Center Parking Lot. A detailed scope of services for the project is included as Attachment 'A' and is made a part hereto. The site location is included as Attachment ‘C’ and is made a part hereto. Article II COMPENSATION to be on a basis of the following:
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxx Xxxxxxxx, PLA Director of Landscape Architecture Halff Associates, Inc. Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx Xxxxxxxx, PLA who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Halff Associates, Inc., a corporation of Dallas County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . 2019, __ day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2019. Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYFOR MINORITY AND/WOMEN OR WOMAN OWNED BUSINESS ENTERPRISE ENTERPRISES (MWBETo be completed only if applicable) REPORT Please complete Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, include along with a copy of certification(s) your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with executed contracts Project Name: Project No: Date: LEGENDthis response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § MARYLAND, COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the undersigned authorityofficer, personally appeared _ , of , who acknowledged the foregoing instrument to be his act and deed in such capacity, and that he is authorized to make this acknowledgment. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: (SIGNATURES CONTINUED ON THE NEXT PAGE) WITNESS: BOARD OF COUNTY COMMISSIONERS OF XXXXXXXXX COUNTY, MARYLAND By:_ Xxxxxxxx Xxxxx, Director Department of Housing and Community Development REVIEWED BY: Office of the County Attorney STAE OF MARYLAND, COUNTY OF FREDERICK, TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the subscriber, a Notary Public for the State and County aforesaid, personally appeared Xxxxxxxx Xxxxx, Director, Housing and Community Development, Xxxxxxxxx County, Maryland, and did certify that as such officer, she did execute this instrument for the purposes stated herein, and did certify, under penalties of perjury, that she is authorized to execute this instrument on behalf of the Board of County Commissioners of Xxxxxxxxx County, Maryland. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: CONSENT OF LENDER [If not applicable, write N/A or No Lien] (Lender),holder of the indebtedness secured by the deed of trust [or mortgage] against the property herein described, recorded in Liber at folio , hereby consents to the terms and conditions of the foregoing Payment in Lieu Agreement, and does hereby further agree that the terms contained herein shall survive any sale under its deed of trust [mortgage], as evidenced by the signature of the undersigned trustee [or officer of corporation] under the above described deed of trust. By: [Lender’s name], Trustee STATE OF MARYLAND, CITY/COUNTY OF , TO WIT: I HEREBY CERTIFY that on this day of , 2014, before me, the subscriber, a Notary Public in and for the State of Texasand County aforesaid, on this day personally appeared , known to me Trustee, who acknowledged her/himself to be the person Trustee, and officer whose name is subscribed that she/he being authorized so to do, executed the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and instrument for the purposes therein contained, by signing his/her name. IN WITNESS WHEREOF, I set my hand and consideration therein expressed and in the capacity therein statedNotarial Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name NOTARY PUBLIC My Commission Expires: THE STATE 0000-0000-0000, v. 1 Xxxxxxxxx County Board of County Commissioners Winchester Hall, 00 Xxxx Xxxxxx Xxxxxx, Xxxxxxxxx, XX 00000 ADEQUATE PUBLIC FACILITIES LETTER OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE MEUNDERSTANDING Xxxxxx Planned Unit Development Preliminary Plat # S1169 AP #14572 The following Letter of Understanding (“XXX”) between the Board of County Commissioners of Xxxxxxxxx County (“BOCC”), and Xxxxx Realty Capital, LLC (the “Developer”) its successors and assigns, sets forth the conditions and terms which the BOCC deems the minimum necessary improvements dealing with roads, schools, water and sewer service that must be in place for the property described below (the “Property”) to be developed in compliance with the Adequate Public Facilities Ordinance (“APFO”), which is codified as Chapter 1-20 of the County Code. Concurrent with the processing of this XXX for the Xxxxxx PUD, the undersigned authority, Developer is seeking approval by the BOCC of a Notary Public in Development Rights and Responsibilities Agreement (“DRRA”) under Chapter 1-25 of the County Code. The Developer hereby agrees and understands that compliance with the terms and conditions of this XXX is required for the State development of Texasthe Xxxxxx PUD to proceed. While this XXX is subject to approval by the BOCC through the process of, on this day personally appeared Xxxxx X. Xxxxxxxxand concurrent with, known to me the DRRA, it is expressly agreed that the XXX is a document which is separate and apart from the DRRA and that the XXX may be amended, by written amendment to be approved by the person Xxxxxxxxx County Planning Commission (“Planning Commission”), with no requirement to amend the DRRA. The Property is comprised of several parcels totaling +/- 23.61 acres of land zoned PUD, Planned Unit Development, located on the east and officer whose name west sides of Terra Firma Road, between I-70 and Old National Pike (MD 144). The Property will be developed with a maximum of 43 residential dwelling units (100% single family detached houses) (the “Xxxxxx PUD” or the “Project”). This XXX is subscribed express evidence that APFO approval has been granted for the Xxxxxx PUD, subject to the foregoing instrumentterms of the XXX, and acknowledged to me that he executed same this APFO approval will be effective for and as a period of three (3) years from the act date of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDBOCC APFO approval.
Appears in 1 contract
WITNESS. ENGINEER: PINNACLE ENTERTAINMENT, INC., A DELAWARE CORPORATION BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ITS: DATE: ATTEST: CITY OF ARLINGTONXXXXXXXX: XXXXXXXX DEVELOPMENT CORPORATION, TEXAS: Xxxx Xxxxxx, City Secretary A CALIFORNIA CORPORATION ASSISTANT SECRETARY (CORPORATE SEAL) BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director ITS: DATE: By its signature below, Xxxxxxxx’x assignees Wal-Mart and Sam’s Real Estate Business Trust agree, for the benefit of Water Utilities Printed or Typed Title APPROVED AS TO FORMSeller to the provisions of paragraphs 2 and 19 of the Second Amendment, and otherwise approve of the form of the Second Amendment. WAL-MART REAL ESTATE BUSINESS TRUST, a Delaware statutory trust By: XXXXX XXXXXIts: SAM’S REAL ESTATE BUSINESS TRUST, City Attorney BYa Delaware statutory trust By: THE Its: STATE OF TEXAS § ) ) COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME) On , 2004 before me, the undersigned authorityundersigned, a Notary Public in and for the State of Texassaid County and State, on this day personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the person and officer person(s) whose name is name(s) is/are subscribed to the foregoing instrument, within instrument and acknowledged to me that he he/she/they executed the same for and as the act of , a corporation of County, Texasin his/her/their authorized capacity(ies), and as thereofthat by his/her/their signature(s) on the instrument the person(s), or entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and for the purposes and consideration therein expressed and in the capacity therein statedofficial seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § ) ) COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME) On , 2004 before me, the undersigned authorityundersigned, a Notary Public in and for the State of Texassaid County and State, on this day personally appeared Xxxxx X. Xxxxxxxx, personally known to me or proved to me on the basis of satisfactory evidence to be the person and officer person(s) whose name is name(s) is/are subscribed to the foregoing instrument, within instrument and acknowledged to me that he he/she/they executed the same for in his/her/their authorized capacity(ies), and as that by his/her/their signature(s) on the act instrument the person(s), or entity upon behalf of which the City of Arlingtonperson(s) acted, Texasexecuted the instrument. WITNESS my hand and official seal. Notary Public STATE OF ) ) COUNTY OF ) On , 2004 before me, the undersigned, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for said County and State, personally appeared , personally known to me or proved to me on the State basis of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITYsatisfactory evidence to be the person(s) whose name(s) is/WOMEN BUSINESS ENTERPRISE (MWBEare subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) REPORT Please complete this formon the instrument the person(s), include copy or entity upon behalf of certification(swhich the person(s) acted, executed the instrument. WITNESS my hand and return official seal. Notary Public STATE OF ) ) COUNTY OF ) On , 2004 before me, the undersigned, a Notary Public in and for said County and State, personally appeared , personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/her signature(s) on the instrument the person(s), or entity upon behalf of which the person(s) acted, executed the instrument. WITNESS my hand and official seal. Notary Public EXHIBIT “A” LEGAL DESCRIPTION EXHIBIT “A” Parcels A and B as shown on map of Parcel Map 25640, in the City of Inglewood, filed in Book 289 Pages 53 to 61 Inclusive of Maps, in the office of the County Recorder of said county. Excepting and Reserving unto, Tidewater Associated Oil Company, its successors and assigns, in dead recorded February 25,1947, In Book 24243 Page 423, Official Records, all minerals, including but not limited to hydrocarbon carbonaceous substances, together with executed contracts Project Name: Project the right to mine, extract, recover and remove the same; provided, however, and grantor so covenants, that grantor, its successors and assigns, except by permission of grantee, Its successors or assigns, will never enter upon the surface of said land for the purpose of mining, extracting, removing or recovering said minerals, it being expressly covenanted and agreed, however, that grantor, its successors and assigns, shall have the right to mine, extract, recover and remove said minerals by means of directional or subsurface drilling or any other recovery method, whether similar or dissimilar so long as the surface of said lands is not occupied or used, or its support materially impaired. Also from that portion of said land lying Easterly of the following described line; beginning at a point In the Northerly line of the Southeast Quarter of said Section 34, distant thereon South 89° 59’ 12” East 1322.40 feet from the Northwest corner of said Southeast Quarter of said Section. Said point of beginning being the Northwest corner of the East half of said Southeast Quarter of said Section; thence along the Westerly line of said East half of said Southeast Quarter of said Section, South 0° 2’ 22” East 2590.40 feet to the Northerly fine of Century Boulevard, 100 feet wide. Also reserving unto Manchester Avenue Company, a California Corporation, by deed recorded August 31, 1956 in Book 52179 Page 412, Official Records, an undivided 28/200 of one percent of all minerals, oil, gas and other hydrocarbon substances or the proceeds therefrom in and under or that may be produced or saved from that portion of said land lying Northerly of a line parallel with and 1320 feet measured Southerly at right angles from the Northerly line of said Section 34. Also Except all subsurface oil, gas, casinghead gas and other hydrocarbon and other gaseous substances located on said property, as granted to Hollywood Park Operating Company, a Delaware Corporation, in a deed recorded May 18, 1982, as Instrument No. 82-511580, Official Records. Also reserving unto Xxxxx Xxxxxxx, F.T H_nton and Xxxx X. Xxx Xxxxx constituting the Board of Trustees of the Endowment Care Fund of Inglewood Park Cemetery Association., in deed recorded March 18, 1964 in Book D238 page 795, Official Records, all minerals, oil, gas and other hydrocarbon substances lying in or below a depth of 500 feet and without, right of surface entry on that portion of said land lying Northerly of a line parallel with and 1320 feet Southerly measured at right angles from the Northerly line of said Section 34. Also except from said portion thereof interest of Inglewood Golf Course, a partnership, in all oil, and gas royalties and payments derived form the existing oil and gas lease on said land, or any part thereof, which are presently of record in the office of the County Recorder of said County, as excepted and reserved by Inglewood Golf Course, a partnership, In deed recorded November 21, 1962, as Instrument No. 1996, in Book D 1829 Page 887, Official Records. Also except from a portion of said land, all minerals, oil, gas and other hydrocarbon substances lying in or under said land below a depth of _00 feet but without right of surface entry, as reserved by Xxxxx Xxxxxxx F.T. Xxxxxx and Xxxx X. Xxx Xxxxx, being the successor in the Office of Xxxxx X. Xxxxxxxxx and their successors in Office as Board of Trustees of the Endowment Care Fund of Inglewood Park Cemetery Association, in deed recorded March 18, 1964, as Instrument No. 1220, in Book D2398 Page 795, Official Records. Also Except from all said land oil, mineral, gas, hydrocarbon and other similar rights lying below the depth of 500 feet from the surface of said and without any right of entry to surface or to that portion of the subsurface less than 500 feet in depth, as quitclaimed to Hollywood Park Hotel Corporation, by a quitclaim deed recorded August 12, 1977, as Instrument No. 77-888762. A Certificate of Correction was recorded June 28, 2000 as Instrument No. 00-0993688, Official Records Assessor’s Parcel No: Date: LEGEND0000-000-000/026/027
Appears in 1 contract
WITNESS. ENGINEER: BY: Xxxxx X. Xxxxxx Printed or Typed Name Vice-President Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Lakehill Court Sanitary Sewer Main Relocation Project No: WUWS18017 Date: LEGENDDecember 14, 2018 LEGEND * Answer with “YES” or “NO” AI Native American (AI) NW Native American, Women-Owned (NW) AS Asian (AS) AW Asian, Women-Owned (AW) XX Xxxxx (BL) BW Black, Women-Owned (BW) HI Hispanic (HI) HW Hispanic, Women-Owned (HW) WO Women-Owned (WO) Other PRIME CONTRACTOR/CONSULTANT *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount HDR Engineering, Inc. No No 91% LIST ALL SUBS: Name of Company & Address Description of Primary Work Type (For prequalification verification purposes) *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount Xxxxxxx and Associates, Inc. Survey and Easement Documents No Yes AI 6% Terracon Geotechnical Investigation No No 3% Attachment “A” – Scope of Services Lakehill Court Sanitary Sewer Main Relocation City of Arlington Project Xx. XXXX00000
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § MARYLAND, COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, TO WIT: I HEREBY CERTIFY that on this day of , 2013, before me, the undersigned authorityofficer, personally appeared _ , of , who acknowledged the foregoing instrument to be his act and deed in such capacity, and that he is authorized to make this acknowledgment. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: (SIGNATURES CONTINUED ON THE NEXT PAGE) WITNESS: BOARD OF COUNTY COMMISSIONERS OF XXXXXXXXX COUNTY, MARYLAND By:_ Xxxxxxxx Xxxxx, Director Department of Housing and Community Development REVIEWED BY: Office of the County Attorney STAE OF MARYLAND, COUNTY OF XXXXXXXXX, TO WIT: I HEREBY CERTIFY that on this day of , 2013, before me, the subscriber, a Notary Public for the State and County aforesaid, personally appeared Xxxxxxxx Xxxxx, Director, Housing and Community Development, Xxxxxxxxx County, Maryland, and did certify that as such officer, she did execute this instrument for the purposes stated herein, and did certify, under penalties of perjury, that she is authorized to execute this instrument on behalf of the Board of County Commissioners of Xxxxxxxxx County, Maryland. WITNESS my hand and Notarial Seal. NOTARY PUBLIC My Commission Expires: CONSENT OF LENDER [If not applicable, write N/A or No Lien] (Lender),holder of the indebtedness secured by the deed of trust [or mortgage] against the property herein described, recorded in Liber at folio , hereby consents to the terms and conditions of the foregoing Payment in Lieu Agreement, and does hereby further agree that the terms contained herein shall survive any sale under its deed of trust [mortgage], as evidenced by the signature of the undersigned trustee [or officer of corporation] under the above described deed of trust. By: [Lender’s name], Trustee STATE OF MARYLAND, CITY/COUNTY OF , TO WIT: I HEREBY CERTIFY that on this day of , 2013, before me, the subscriber, a Notary Public in and for the State of Texasand County aforesaid, on this day personally appeared , known to me Trustee, who acknowledged her/himself to be the person Trustee, and officer whose name is subscribed that she/he being authorized so to do, executed the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and instrument for the purposes therein contained, by signing his/her name. IN WITNESS WHEREOF, I set my hand and consideration therein expressed and in the capacity therein statedNotarial Seal. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name NOTARY PUBLIC My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND:
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared , known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of , a corporation of County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: 2022 Water and Sanitary Sewer Improvements (UTA) Project No: WUWS22011 Date: LEGEND06-28-2022 LEGEND * Answer with “YES” or “NO” AI Native American (AI) NW Native American, Women-Owned (NW) AS Asian (AS) AW Asian, Women-Owned (AW) XX Xxxxx (BL) BW Black, Women-Owned (BW) HI Hispanic (HI) HW Hispanic, Women-Owned (HW) WO Women-Owned (WO) Other PRIME CONTRACTOR/CONSULTANT *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount Xxxxxx Xxxx and Xxxxxxx, Inc. No No N/A N/A LIST ALL SUBS: Name of Company & Address Description of Primary Work Type (For prequalification verification purposes) *Arlington Firm (Yes/No) *MWBE (Yes/No) TYPE (Use abbreviation in Legend) Anticipated Amount Xx Xxxxxxx-Xxxxx, Xxxxxxx & Associates, Inc. Survey Services Yes Yes WO $88,340 Solaray Engineering, Inc. Subsurface Utility Engineering (SUE) Services No Yes HI $137,480 ATTACHMENT ‘A’ SCOPE OF SERVICES, SCHEDULE, AND COMPENSATION DESIGN AND CONSTRUCTION SERVICES FOR 2022 WATER & SANITARY SEWER IMPROVEMENTS (UTA) CITY OF ARLINGTON PROJECT DESCRIPTION: The scope set forth herein defines the work to be performed by the CONSULTANT in completing the project. Both the CITY and CONSULTANT have attempted to clearly define the work to be performed and address the needs of the Project. WORK TO BE PERFORMED Consultant shall provide survey, SUE, design, bidding, and construction administration services for the Project. The Project includes approximately 11,525 LF of 8” water line improvements, 11,615 LF of 8” sanitary sewer improvements, and 2.20 miles of pavement reclamation along the 9 streets specified below: Street Water LF Water Size Sewer LF Sewer Size Paving Reclamation (Full Width) Xxxxx Dr (Xxxxx to Xxxxxx) 2,770 8” 2,770 8” ✓ Xxxx Xxxxxxx Xx (Xxxxxx to Pecan) 1,740 8” 1,740 8” ✓ Xxxxxxx Ave 450 8” 450 8” ✓ Xxxxx Ave 500 8” 500 8” ✓ Grand Ave (Xxxxxx to Pecan) 1,700 8” 1,700 8” ✓ College St (Grand to Park Row) 475 8” 505 8” ✓ West St (Xxxxxxxx to Park Row) 2,120 8” 2,150 8” ✓ Oak St (Xxxx Xxxxxxx to Park Row) 1,430 8” 1,460 8” ✓ Bessel Ave (West to Pecan) 340 8” 340 8” ✓ TOTAL 11,525 11,615 2.20 Miles The following tasks have been identified for inclusion in this scope of services: Task 1. Conceptual Design Task 2. Preliminary Design Task 3. Final Design Task 4. Bid Phase Services Task 5. Construction Administration Task 6. Survey Services Task 7. Subsurface Utility Engineering COMPENSATION: Compensation to be on a basis of the following:
Appears in 1 contract
Samples: Engineering Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx XxxxxxTEXAS BY XXXXXX X. XXXX Deputy City Manager ATTEST XXXX X. XXXXXX, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXXX XXXXXX, City Attorney BY: BY THE STATE OF TEXAS § § TRISTEM, LTD COUNTY OF TARRANT McLENNAN § Engineer Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared XXX XXXXXX, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of TRISTEM, LTD, a corporation of McLennan County, Texas, and as SENIOR PARTNER thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2011. Notary Public in In and for the For The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § § CITY Acknowledgment COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx XXXXXX X. XxxxxxxxXXXX, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City CITY OF ARLINGTON, TEXAS, a municipal corporation of Arlingtonthe State of Texas, Tarrant County, Texas, a Texas municipal corporation, and as the Director of Water Utilities Deputy City Manager thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2011. Notary Public in In and for the For The State of Texas My Commission Expires Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE ATTACHMENT “A” SCOPE OF SERVICES TRISTEM, LTD will perform all tasks necessary to complete a comprehensive evaluation of the CITY’s electric, natural gas, and telephone accounts to determine the accuracy of utility xxxxxxxx, including a review of amounts paid for the CITY's past utility bills for the past twenty-four (MWBE24) REPORT Please complete this formmonths or longer, if appropriate. This will include copy of certification(s) bills paid for electric (metered accounts, as well as any unmetered accounts for security lighting, street lights, and return with executed contracts Project Name: Project No: Date: LEGENDtraffic signals), gas, and telephone accounts to verify their accuracy.
Appears in 1 contract
Samples: arlingtontx.granicus.com
WITNESS. ENGINEERTHE VILLAS AT BRIDGEVEILLE HOMEOWNERS ASSOCIATION, INC. By: BY: Printed or Typed Name Printed or Typed Title Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXAS: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXX, City Attorney BY: THE (SEAL) (Name) (Title) STATE OF TEXAS § COUNTY OF TARRANT § Engineer Acknowledgment BEFORE MEto wit: I HEREBY CERTIFY that on the day of , 2022, before me, the undersigned authoritysubscriber, a Notary Public in and for the State of Texasjurisdiction aforesaid, on this day personally appeared , who acknowledged himself to be the of The Villas at Bridgeville Homeowners’ Association, Inc., known to me (or satisfactorily proven) to be the person and officer whose name is subscribed to the foregoing within instrument, and acknowledged to me that he executed the same for and the purpose therein contained as the act duly authorized of , a corporation of County, Texas, said Association. WITNESS my hand and as thereof, notarial seal the year and for the purposes and consideration therein expressed and in the capacity therein statedday first above written. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's NOTARY PUBLIC Printed Name My Commission Expires: THE STATE HERITAGE SHORES VILLAS, LLC, a Delaware limited liability company By: Brookfield Washington, L.L.C., a Delaware limited liability company its Managing Partner By: (SEAL) Printed Name: Title: COMMONWEALTH OF TEXAS § VIRGINIA : : SS. COUNTY OF TARRANT § Municipal Acknowledgment BEFORE MEFAIRFAX : BE IT REMEMBERED, that on this day of , 2022, personally came before me, the undersigned authoritySubscriber, a Notary Public in and for the State Commonwealth and County aforesaid, , of TexasBrookfield Washington, on this day personally appeared Xxxxx X. XxxxxxxxL.L.C., known to me to be a Delaware limited liability company, as Managing Partner of HERITAGE SHORE VILLAS, LLC, a Delaware limited liability company; that the person signature of the said is in his/her own proper handwriting; and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of signing, sealing, acknowledging and delivering said Agreement was duly authorized by the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein statedsaid limited liability company. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this under my Hand and Seal of Office the , 20 day and year aforesaid. day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGENDPublic
Appears in 1 contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Signature Xxxxxxxxx Xxxxx; X.X. Xxxxx Engineering, Inc. Tax Identification No. ATTEST: CITY OF ARLINGTON, TEXASTEXAS ATTEST: BY Xxxxxx Xxxxxxxx, Director Parks & Recreation Department Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BY: BY THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxxxxx Xxxxx, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he he/she executed same for and as the act and deed of Xxxxx Engineering, Inc., a corporation of Tarrant County, Texas, and as thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) , 2015, Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, Texas, a Texas municipal corporationcorporation of Tarrant County, Texas, and as the Director of Water Utilities the Parks & Recreation Department thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 2015. day of (SEAL) Notary Public in and for the Public, State of Texas My Commission Expires Notary's Printed Name My Commission ExpiresFOR MINORITY AND/OR WOMAN OWNED BUSINESS ENTERPRISES (To be completed only if applicable) Minority and/or Woman Owned Business Enterprises are encouraged to participate in Arlington’s procurement process. In order to be identified as a Qualified Minority and/or Woman Owned Business Enterprise in the City of Arlington, this form, along with a copy of your certification, must be returned to the RFQ Contact in the City of Arlington Community Development and Planning Department. You should return these documents with this response, or if you have already submitted this form and a copy of your certification to the Purchasing Division, it is not necessary to re-send certification. COMPANY NAME: PRIME AND SUBS & REPRESENTATIVE: ADDRESS: _ CITY, STATE, ZIP: EMAIL: _ TELEPHONE NO.: FAX NO.: _ INDICATE ALL THAT APPLY Minority Owned Business Enterprise Woman Owned Business Enterprise MINORITY STATUS: Has this firm been certified as a minority, women or disadvantaged business enterprise by any governmental agency? Yes No if yes, please specify government agency: Date of certification: The above information is for information only. The City of Arlington encourages minority business participation; however no preferences shall be given. MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please DATA GATHERING FORM (CONSULTANT SERVICES CONTRACT) The City of Arlington is gathering data on MWBE businesses. In order to be identified as a certified Minority/Woman Business Enterprise (MWBE) in the City of Arlington, please complete this form, include copy of certification(s) your Certification and return with executed contracts your RFQ documents. Please note that this data is for information only. Name of Consultant: Is Consultant MWBE? If yes, please check all that applies: YES NO Native American (AI) Native American, Women-Owned (NW) Asian (AS) Asian, Women-Owned (AW) Black (BL) Black, Women-Owned (BW) Hispanic (HI) Hispanic, Women-Owned (HW) Women-Owned (WO) MWBE Certifications accepted by the City of Arlington. The City will review other MWBE Certification. North Central Texas Regional Certification Agency (NCTRCA) State of Texas, historically Underutilized Business (HUB) Dallas/Fort Worth Minority Supplier Development Council (DFW MSDC) Women’s Business Council – Southwest (WBC-SW) Texas Department of Transportation (TxDOT) South Central Texas Regional Certification Agency (SCTRCA) Others (please specify) - XXXXX ENGINEERING, INC. XXXXXXXXX X. XXXXX, P.E. R. XXX XXXXX, P.E. September 15, 2015 Mr. Jadey Xxxxx Xxxxx Project NameManager City of Arlington Parks and Recreation Department 000 Xxxx Xxxx Xxxxxx Xxxxxxxxx, Xxxxx 00000 Re: Project Electrical Assessment of Xxxxxxx Xxxxx Xxxx xx Xxxxxxxxx, Xxxxx Dear Jadey: We appreciate the opportunity to submit this proposal to provide electrical engineering services for the referenced project. Our proposed fee and scope of services are as follows: XXXXXX MILL PARK Item No. of Manhours Manhour Rate Amount Site Investigation 12 $ 100.00 $ 1,200.00 Evaluation/Assessment 8 $ 100.00 $ 800.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 12 $ 100.00 $ 1,200.00 Opinion of Cost 16 $ 100.00 $ 1,600.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 5,280.00 XXXXXX XXXXXXXXX SPORTS COMPLEX Item No. of Manhours Manhour Rate Amount Site Investigation 16 $ 100.00 $ 1,600.00 Evaluation/Assessment 16 $ 100.00 $ 1,600.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 12 $ 100.00 $ 1,200.00 Opinion of Cost 16 $ 100.00 $ 1,600.00 Report 8 $ 70.00 $ 560.00 Total Fee $ 6,760.00 0000 X. X-00, Xxxxx 000 Phone 000-000-0000 Xxxxxxxxx, XX 00000 xxx.xxxxxxxxxxxxxxxx.xxx Fax 000-000-0000 Xx. Xxxxx Xxxxx September 15, 2015 XXXXXXXXXXX PARK Item No. of Manhours Manhour Rate Amount Site Investigation 8 $ 100.00 $ 800.00 Evaluation/Assessment 8 $ 100.00 $ 800.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 8 $ 100.00 $ 800.00 Opinion of Cost 8 $ 100.00 $ 800.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 3,680.00 XXXXX XXXXXX POOL Item No. of Manhours Manhour Rate Amount Site Investigation 4 $ 100.00 $ 400.00 Evaluation/Assessment 4 $ 100.00 $ 400.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 4 $ 100.00 $ 400.00 Opinion of Cost 4 $ 100.00 $ 400.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 2,080.00 XXXXXXX PARK Item No. of Manhours Manhour Rate Amount Site Investigation 8 $ 100.00 $ 800.00 Evaluation/Assessment 4 $ 100.00 $ 400.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 4 $ 100.00 $ 400.00 Opinion of Cost 4 $ 100.00 $ 400.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 2,480.00 Xx. Xxxxx Xxxxx September 15, 2015 MEADOWBROOK PARK Item No. of Manhours Manhour Rate Amount Site Investigation 8 $ 100.00 $ 800.00 Evaluation/Assessment 8 $ 100.00 $ 800.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 8 $ 100.00 $ 800.00 Opinion of Cost 6 $ 100.00 $ 600.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 3,480.00 XXXXXX XXXXXXX PARK Item No. of Manhours Manhour Rate Amount Site Investigation 4 $ 100.00 $ 400.00 Evaluation/Assessment 4 $ 100.00 $ 400.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 4 $ 100.00 $ 400.00 Opinion of Cost 4 $ 100.00 $ 400.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 2,080.00 PARKWAY CENTRAL PARK Item No. of Manhours Manhour Rate Amount Site Investigation 4 $100 $ 400.00 Evaluation/Assessment 4 $ 100.00 $ 400.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 4 $ 100.00 $ 400.00 Opinion of Cost 4 $ 100.00 $ 400.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 2,080.00 Xx. Xxxxx Xxxxx September 15, 2015 RIVER LEGACY PARK Item No. of Manhours Manhour Rate Amount Site Investigation 12 $ 100.00 $ 1,200.00 Evaluation/Assessment 8 $ 100.00 $ 800.00 Meetings with City Staff 2 $ 100.00 $ 200.00 Recommendations 8 $ 100.00 $ 800.00 Opinion of Cost 8 $ 100.00 $ 800.00 Report 4 $ 70.00 $ 280.00 Total Fee $ 4,080.00 SUMMARY Xxxxxx Mill Park $ 5,280.00 Xxxxxx Xxxxxxxxx Sports Complex $ 6,760.00 Xxxxxxxxxxx Park $ 3,680.00 Xxxxx Xxxxxx Pool $ 2,080.00 Xxxxxxx Park $ 2,480.00 Meadowbrook Park $ 3,480.00 Xxxxxx Xxxxxxx Park $ 2,080.00 Parkway Central Park $ 2,080.00 River Legacy Park $ 4,080.00 GRAND TOTAL $ 32,000.00 Proposed fee does not include: Date Preparation of construction documents required to implement proposed scope of work Exploratory excavation to determine location or condition of underground utilities Removal of electrical equipment covers necessary to investigate condition of wiring, bus, etc. (City staff or an electrical contractor hired by the City will de-energize switchgear and provide required access) Please call if you have any questions or if you need additional information. Sincerely, XXXXX ENGINEERING, INC. h EAY/sr ACCEPTED: LEGENDXxxxxxxx X. Xxxxx, P.E.
Appears in 1 contract
Samples: Consultant Services Contract
WITNESS. ENGINEER: BY: Printed or Typed Name Printed or Typed Title Tax Identification NoConsultant Xxxxxxxx, Xxxxx & Xxxxxx dba Xxxxxxxxx, Xxxxxxx/PSC Xxxxxx Xxxxxx, RLA, ASLA- Sector Director TaxIdentificationNo. 751156936 ATTEST: CITY OF ARLINGTON, TEXASTEXAS By: Xxxx Xxxxxx, City Secretary BY: Xxxxx X. Xxxxxx Xxxxxxxx Printed or Typed Name Director of Water Utilities Printed or Typed Title Director, Parks and Recreation APPROVED AS TO FORM: XXXXX XXXXXXxxxx Xxxxx, City Attorney BYBy: THE STATE OF TEXAS § COUNTY OF TARRANT § Engineer Consultant Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxx, RLA, ASLA, who is known to me or who was proved to me on the oath of (name of person identifying the acknowledging person) or who was proved to me through (description of identity card or other document issued by the federal or state government containing the picture and signature of the acknowledging containing the picture and signature of the acknowledging person) to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed same for and as the act and deed of Xxxxxxxx, Xxxxx & Xxxxxx dba Xxxxxxxxx, Xxxxxxx/PSC (formerly Xxxxxxxxx, Xxxxxxx and Associates, Inc.) a corporation of Tarrant County, Texas, and as President thereof, and for the purposes and consideration therein expressed and, in the capacity, therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this the day of , 2020. Notary Public, State of Texas My Commission Expires Notary's Printed Name THE STATE OF TEXAS § THE COUNTY OF TARRANT § City Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxxx Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act and deed of the City of Arlington, a municipal corporation of Tarrant County, Texas, and as the Parks and Recreation Director thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: THE STATE OF TEXAS § COUNTY OF TARRANT § Municipal Acknowledgment BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Xxxxx X. Xxxxxxxx, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed same for and as the act of the City of Arlington, Texas, a Texas municipal corporation, and as the Director of Water Utilities thereof, and for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the , 20 . day of (SEAL) Notary Public in and for the State of Texas Notary's Printed Name My Commission Expires: PRIME AND SUBS & MINORITY/WOMEN BUSINESS ENTERPRISE (MWBE) REPORT Please complete this form, include copy of certification(s) and return with executed contracts Project Name: Project No: Date: LEGEND2020.
Appears in 1 contract