HARRIS COUNTY BID COVER SHEET

Document Sample
HARRIS COUNTY BID COVER SHEET Powered By Docstoc
					         HARRIS COUNTY                                                                 Job No. 06/0186
                BID COVER SHEET                                             Date Due:      June 12, 2006
                                                                                DUE NO LATER THAN 2:00 P.M.
                                                                               LOCAL TIME IN HOUSTON, TEXAS
                                                                            Bids received later than the date and time
                                                                            above will not be considered.


   BID FOR: Term Contract for HVAC Repair Parts for Harris County (For one year beginning
   approximately September 1, 2006)
                                                    OFFERORS NOTE!!

  Carefully read all instructions, requirements and                     Please return bid in an appropriately sized envelope or
  specifications.  Fill out all forms properly and                      box. PACKAGE MUST SHOW THE JOB NUMBER,
  completely. Submit your bid with all appropriate                      DESCRIPTION AND BE MARKED "SEALED BID".
  supplements and/or samples.

                                               RETURN BID TO:
                                     HARRIS COUNTY PURCHASING AGENT
                                       1001 PRESTON AVENUE, SUITE 670
                                            HOUSTON, TEXAS 77002

For additional information, contact:      Jamie Kovar at (713) 755-6457

You must sign below in INK; failure to sign WILL disqualify the offer. All prices must be typewritten or written
in ink.
                                          Total Amount of Bid: $

Company Name:

Company Address:

City, State, Zip Code:

Taxpayer Identification Number (T.I.N.):

Telephone No. :                             FAX No.:                         e-mail:

Print Name:

Signature:
___________________________________________________________________________________

[Your signature attests to your offer to provide the goods and/or services in this bid according to the published provisions of this
Job. When an award letter is issued, it becomes a part of this contract. Contract is not valid until Purchase Order is issued.]

ACCEPTED BY:_____________________________________________                                        Date:_____________________
           HARRIS COUNTY JUDGE ROBERT ECKELS
JLK/vcj
Revised 12/04




                                                                                                                         Page 1 of 20
                                                        TABLE OF CONTENTS
Items checked below represent components which comprise this bid/proposal package. If the item IS NOT checked, it is NOT
APPLICABLE to this bid/proposal. Offerors are asked to review the package to be sure that all applicable parts are included. If any
portion of the package is missing, notify the Purchasing Department immediately.

It is the Offeror's responsibility to be thoroughly familiar with all Requirements and Specifications. Be sure you understand the following
before you return your bid packet.
__X__ 1.            Cover Sheet
                    Your company name, address, the total amount of the bid/proposal, and your signature (IN INK) should appear on this
                    page.

__X__ 2.          Table of Contents
                  This page is the Table of Contents.

__X__ 3.          General Requirements
                  You should be familiar with all of the General Requirements.

__X__ 4.          Special Requirements/Instructions
                  This section provides information you must know in order to make an offer properly.

__X__ 5.          Specifications
                  This section contains the detailed description of the product/service sought by the County.

__X__ 6.          Pricing/Delivery Information
                  This form is used to solicit exact pricing of goods/services and delivery costs.

__X__ 7.          Attachments
                  __X__ a.          Residence Certification/Tax Form
                                    Be sure to complete this form and return with packet.

                  _____    b.       Bid Guaranty & Performance Bond Information & Requirements
                                    This form applies only to certain bids/proposals. All public work contracts over $25,000 require a
                                    Payment Bond and over $100,000 must also have a Performance Bond, in a form approved by the
                                    County. Please read carefully and fill out completely.

                  _____    c.       Bid Check Return Authorization Form
                                    This form applies only to certain bids/proposals. Please read carefully and fill out completely.

                  _____    d.       Vehicle Delivery Instructions
                                    Included only when purchasing vehicles.

                  _____    e.       Minimum Insurance Requirements
                                    Included when applicable (does not supersede "Hold Harmless" section of General Requirements).

                  _____    f.       Worker’s Compensation Insurance Coverage Rule 110.110
                                    This requirement is applicable for a building or construction contract.

                  _____    g.       Financial Statement
                                    When this information is required, you must use this form.

                  _____    h.       Reference Sheet
                                    When this information is required, you must use this sheet.

                  _____    i.       HIPAA Requirements

                  ______ j.         Other
                                    From time to time other attachments may be included.


                                                                                                                               Page 2 of 20
Revised 03/04




                Page 3 of 20
                                      GENERAL REQUIREMENTS FOR BIDS

READ THIS ENTIRE DOCUMENT CAREFULLY. FOLLOW ALL INSTRUCTIONS. YOU ARE
RESPONSIBLE FOR FULFILLING ALL REQUIREMENTS AND SPECIFICATIONS. BE SURE YOU
UNDERSTAND THEM.

General Requirements apply to all advertised bids; however, these may be superseded, whole or in part, by the SPECIAL
REQUIREMENTS/INSTRUCTIONS OR OTHER DATA CONTAINED HEREIN. Review the Table of Contents. Be
sure your bid package is complete.

ACCESS TO RECORDS
In special circumstances, vendor may be required to allow duly authorized representatives of Harris County, the Harris
County Hospital District or the state and federal government access to contracts, books, documents, and records
necessary to verify the nature and extent of the cost of services provided by vendor.

ADDENDA
When specifications are revised, the Harris County Purchasing Department will issue an addendum addressing the nature
of the change. Offerors must sign and include it in the returned bid package.

ASSIGNMENT
The successful offeror may not assign, sell or otherwise transfer this contract without written permission of Harris County
Commissioners Court.

AWARD
Harris County reserves the right to award this contract on the basis of LOWEST AND BEST OFFER in accordance with
the laws of the State of Texas, to waive any formality or irregularity, to make awards to more than one offeror, to reject
any or all bids. In the event the lowest dollar offeror meeting specifications is not awarded a contract, the offeror may
appear before the Commissioners Court, Hospital District Board of Managers, Community Supervision & Corrections
Department Board, the Juvenile Board or other applicable governing body and present evidence concerning his
responsibility after officially notifying the Office of the Purchasing Agent of his intent to appear.

BID FORM COMPLETION
Fill out and return to the Harris County Purchasing Department ONE (1) complete bid form in an appropriately sized
envelope or box. PACKAGE MUST SHOW THE JOB NUMBER, DESCRIPTION AND BE MARKED
“SEALED BID.” An authorized representative of the offeror should sign the Bid Cover Sheet. The contract will be
binding only when signed by Harris County, funds are certified by the County Auditor and or the Hospital District, as
applicable, and a Purchase Order issued.

BID RETURNS
Offerors must return all completed bids to the Harris County Purchasing Department reception desk at 1001 Preston
Avenue, Suite 670, Houston, Texas before 2:00 P.M. LOCAL TIME IN HOUSTON, TEXAS on the date specified.
Late bids will not be accepted.

BONDS
If this bid requires submission of bid guarantee and performance bond, there will be a separate page explaining those
requirements. Bids submitted without the required bid bond or cashier's checks are not acceptable.



Revised 09/05




                                                                                                               Page 4 of 20
CERTIFICATION REGARDING DEBARMENT, SUSPENSION INELIGIBILITY, AND VOLUNTARY
EXCLUSION
The Contractor certifies by execution of this Contract that it is not ineligible for participation in federal or state
assistance programs under Executive Order 12549, "Debarment and Suspension." The Contractor further agrees to
include this certification in all contracts between itself and any subcontractors in connection with the services performed
under this Contract. Contractor also certifies that contractor will notify Harris County in writing immediately if
contractor is not in compliance with Executive Order 12549 during the term of this contract. Contractor agrees to refund
Harris County for any payments made to the contractor while ineligible.

COLOR SELECTION
Determination of colors of materials is a right reserved by the using department unless otherwise specified in the bid.
Unspecified colors shall be quoted as standard colors, NOT colors which require up charges or special handling.
Unspecified fabrics or vinyls should be construed as medium grade. If offeror fails to get color/material approvals prior
to delivery of merchandise, the using department may refuse to accept the items and demand correct shipment without
penalty, subject to other legal remedies.

CONTRACT OBLIGATION
Harris County Commissioners Court must award the contract and the County Judge or other person authorized by the
Harris County Commissioners Court must sign the contract before it becomes binding on Harris County or the offerors.
Department heads are NOT authorized to sign agreements for Harris County. Binding agreements shall remain in effect
until all products and/or services covered by this purchase have been satisfactorily delivered and accepted.

CONTRACT RENEWALS
Renewals may be made ONLY by written agreement between Harris County and the offeror. Any price escalations are
limited to those stated by the offeror in the original bid.

DIGITAL FORMAT
If offeror obtained the bid specifications in digital format in order to prepare a response, the bid must be submitted in
hard copy according to the instructions contained in this bid package. If, in its bid response, offeror makes any changes
whatsoever to the County's published bid specifications, the County's bid specifications as published shall control.
Furthermore, if an alteration of any kind to the County's published bid specifications is only discovered after the contract
is executed and is or is not being performed, the contract is subject to immediate cancellation.

DISQUALIFICATION OF OFFEROR
Upon signing this bid document, an offeror offering to sell supplies, materials, services, or equipment to Harris County
certifies that the offeror has not violated the antitrust laws of this state codified in Texas Business and Commerce Code
§15.01, et seq., as amended, or the federal antitrust laws, and has not communicated directly or indirectly the bid made
to any competitor or any other person engaged in such line of business. Any or all bids may be rejected if the County
believes that collusion exists among the offerors. Bids in which the prices are obviously unbalanced may be rejected. If
multiple bids are submitted by an offeror and after the bids are opened, one of the bids is withdrawn, the result will be
that all of the bids submitted by that offeror will be withdrawn; however, nothing herein prohibits a vendor from
submitting multiple bids for different products or services.

E-MAIL ADDRESSES CONSENT
Vendor affirmatively consents to the disclosure of its e-mail addresses that are provided to Harris County, the Harris
County Flood Control District, the Harris County Hospital District including its HMO, the Harris County Appraisal
District, or any agency of Harris County. This consent is intended to comply with the requirements of the Texas Public
Information Act, Tex. Gov’t Code Ann. §522.137, as amended, and shall survive termination of this agreement. This
consent shall apply to e-mail addresses provided by Vendor, its employees, officers, and agents acting on Vendor’s
behalf and shall apply to any e-mail address provided in any form for any reason whether related to this bid/proposal or
otherwise.
Revised 09/05




                                                                                                                Page 5 of 20
EVALUATION
Evaluation shall be used as a determinant as to which bid items or services are the most efficient and/or most economical
for the County. It shall be based on all factors which have a bearing on price and performance of the items in the user
environment. All bids are subject to tabulation by the Harris County Purchasing Department and recommendation to the
appropriate governing body. Compliance with all bid requirements, delivery and needs of the using department are
considerations in evaluating bids. Pricing is NOT the only criteria for making a recommendation. The Harris County
Purchasing Department reserves the right to contact any offeror, at any time, to clarify, verify or request information with
regard to any bid.

FISCAL FUNDING
A multi-year lease or lease/purchase arrangement (if requested by the Special Requirements/Instructions), or any contract
continuing as a result of an extension option, must include fiscal funding out. If, for any reason, funds are not
appropriated to continue the lease or contract, said lease or contract shall become null and void on the last day of the
current appropriation of funds. After expiration of the lease, leased equipment shall be removed by the offeror from the
using department without penalty of any kind or form to Harris County. All charges and physical activity related to
delivery, installation, removal and redelivery shall be the responsibility of the offeror.

GOVERNING FORMS
In the event of any conflict between the terms and provisions of these requirements and the specifications, the
specifications shall govern. In the event of any conflict of interpretation of any part of this overall document, Harris
County's interpretation shall govern.

GOVERNING LAW
This bid solicitation is governed by the competitive bidding requirements of the County Purchasing Act, Texas Local
Government Code, §262.021 et seq., as amended. Offerors shall comply with all applicable federal, state and local laws
and regulations. Offeror is further advised that these requirements shall be fully governed by the laws of the State of
Texas and that Harris County may request and rely on advice, decisions and opinions of the Attorney General of Texas
and the County Attorney concerning any portion of these requirements.

GRANT FUNDING
Any contract entered into by the County that is to be paid from grant funds shall be limited to payment from the grant
funding and the vendor/provider understands that the County has not set aside any County funds for the payment of
obligations under a grant contract. If grant funding should become unavailable at any time for the continuation of
services paid for by the grant, and further funding cannot be obtained for the contract, then the sole recourse of the
provider shall be to terminate any further services under the contract and the contract shall be null and void .

HIPAA COMPLIANCE
Offeror agrees to comply with the Standards for Privacy of Individually Identifiable Health Information of the Health
Insurance Portability and Accountability Act of 1996, PL 104-191, 45 CFR Parts 160-164, as amended, and the Texas
Medical Records Privacy Act, Texas Health and Safety Code Chapter 181, as amended, collectively referred to as
"HIPAA", to the extent that the Offeror uses, discloses or has access to protected health information as defined by
HIPAA. Offeror may be required to enter a Business Associate Agreement pursuant to HIPAA.

HOLD HARMLESS AGREEMENT
Contractor, the successful offeror, shall indemnify and hold Harris County harmless from all claims for personal injury,
death and/or property damage resulting directly or indirectly from contractor's performance. Contractor shall procure
and maintain, with respect to the subject matter of this bid, appropriate insurance coverage including, as a minimum,
public liability and property damage with adequate limits to cover contractor's liability as may arise directly or indirectly
from work performed under terms of this bid. Certification of such coverage must be provided to the County upon
request.

Revised 09/05




                                                                                                                 Page 6 of 20
INSPECTIONS & TESTING
Harris County reserves the right to inspect any item(s) or service location for compliance with specifications and
requirements and needs of the using department. If an offeror cannot furnish a sample of a bid item, where applicable,
for review, or fails to satisfactorily show an ability to perform, the County can reject the bid as inadequate.

INVOICES AND PAYMENTS
Offerors shall submit an original invoice on each purchase order or purchase release after each delivery, indicating the
purchase order number. Invoices must be itemized. Any invoice, which cannot be verified by the contract price and/or is
otherwise incorrect, will be returned to the offeror for correction. Under term contracts, when multiple deliveries and/or
services are required, the offeror may invoice following each delivery and the County will pay on invoice. Contracts
providing for a monthly charge will be billed and paid on a monthly basis only. Prior to any and all payments made for
goods and/or services provided under this contract, the offeror should provide his Taxpayer Identification Number or
social security number as applicable. This information must be on file with the Harris County Auditor’s office. Failure
to provide this information may result in a delay in payment and/or back-up withholding as required by the Internal
Revenue Service.

MAINTENANCE
Maintenance required for equipment bid should be available in Harris County by a manufacturer-authorized maintenance
facility. Costs for this service shall be shown on the Pricing/Delivery Information form. If Harris County opts to include
maintenance, it shall be so stated in the purchase order and said cost will be included. Service will commence only upon
expiration of applicable warranties and should be priced accordingly.

MATERIAL SAFETY DATA SHEETS
Under the "Hazardous Communication Act", commonly known as the "Texas Right To Know Act", an offeror must
provide to the County with each delivery, material safety data sheets which are applicable to hazardous substances
defined in the Act. Failure of the offeror to furnish this documentation will be cause to reject any bid applying thereto.

NAME BRANDS
Specifications may reference name brands and model numbers. It is not the intent of Harris County to restrict these bids
in such cases, but to establish a desired quality level of merchandise or to meet a pre-established standard due to like
existing items. Offerors may offer items of equal stature and the burden of proof of such stature rests with offerors.
Harris County shall act as sole judge in determining equality and acceptability of products offered.

NEW MILLENIUM COMPLIANCE
All products and/or services furnished as part of this contract must be compliant for the present year and forward. This
applies to all computers including hardware and software as well as all other commodities with date sensitive embedded
chips.

POTENTIAL CONFLICTS OF INTEREST
An outside consultant or contractor is prohibited from submitting a bid for services on a Harris County project of which
the consultant or contractor was a designer or other previous contributor, or was an affiliate, subsidiary, joint venturer or
was in any other manner associated by ownership to any party that was a designer or other previous contributor. If such a
consultant or contractor submits a prohibited bid, that bid shall be disqualified on the basis of conflict of interest, no
matter when the conflict is discovered by Harris County. Potential bidders are advised that they may have disclosure
requirements pursuant to Texas Local Government Code, Chapter 176. This law requires persons desiring to do business
with the County to disclose any gifts valued in excess of $250 given to any County Official or the County Official’s
family member, or employment of any County Official or the County Official’s family member during the preceding
twelve (12) month period. The disclosure questionnaire must be filed with the Harris County Clerk. Refer to Texas
Local Government Code, Chapter 176 for the details of this law.



Revised 09/05




                                                                                                                 Page 7 of 20
PRICING
Prices for all goods and/or services shall be firm for the duration of this contract and shall be stated on the
Pricing/Delivery Information form. Prices shall be all inclusive: No price changes, additions, or subsequent
qualifications will be honored during the course of the contract. All prices must be written in ink or typewritten.
Pricing on all transportation, freight, drayage and other charges are to be prepaid by the contractor and included in the
bid prices. If there are any additional charges of any kind, other than those mentioned above, specified or unspecified,
offeror MUST indicate the items required and attendant costs or forfeit the right to payment for such items. Where unit
pricing and extended pricing differ, unit pricing prevails.

PURCHASE ORDER AND DELIVERY
The successful offeror shall not deliver products or provide services without a Harris County Purchase Order, signed by
an authorized agent of the Harris County Purchasing Department. The fastest, most reasonable delivery time shall be
indicated by the offeror in the proper place on the Pricing/Delivery Information form. Any special information
concerning delivery should also be included, on a separate sheet, if necessary. All items shall be shipped F.O.B.
INSIDE DELIVERY unless otherwise stated in the specifications. This shall be understood to include bringing
merchandise to the appropriate room or place designated by the using department. Every tender or delivery of goods
must fully comply with all provisions of these requirements and the specifications including time, delivery and quality.
Nonconformance shall constitute a breach which must be rectified prior to expiration of the time for performance.
Failure to rectify within the performance period will be considered cause to reject future deliveries and cancellation of
the contract by Harris County without prejudice to other remedies provided by law. Where delivery times are critical,
Harris County reserves the right to award accordingly.

RECYCLED MATERIALS
Harris County encourages the use of products made of recycled materials and shall give preference in purchasing to
products made of recycled materials if the products meet applicable specifications as to quantity and quality. Harris
County will be the sole judge in determining product preference application.

SEVERABILITY
If any section, subsection, paragraph, sentence, clause, phrase or word of these requirements or the specifications shall be
held invalid, such holding shall not affect the remaining portions of these requirements and the specifications and it is
hereby declared that such remaining portions would have been included in these requirements and the specifications as
though the invalid portion had been omitted.

SILENCE OF SPECIFICATIONS
The apparent silence of specifications as to any detail, or the apparent omission from it of a detailed description
concerning any point, shall be regarded as meaning that only the best commercial practice is to prevail and that only
material and workmanship of the finest quality are to be used. All interpretations of specifications shall be made on the
basis of this statement. The items furnished under this contract shall be new, unused of the latest product in production
to commercial trade and shall be of the highest quality as to materials used and workmanship. Manufacturer furnishing
these items shall be experienced in design and construction of such items and shall be an established supplier of the item
bid.

SUPPLEMENTAL MATERIALS
Offerors are responsible for including all pertinent product data in the returned bid package. Literature, brochures, data
sheets, specification information, completed forms requested as part of the bid package and any other facts which may
affect the evaluation and subsequent contract award should be included. Materials such as legal documents and
contractual agreements, which the offeror wishes to include as a condition of the bid, must also be in the returned bid
package. Failure to include all necessary and proper supplemental materials may be cause to reject the entire bid.



Revised 09/05




                                                                                                                Page 8 of 20
TAXES
Harris County is exempt from all federal excise, state and local taxes unless otherwise stated in this document. Harris
County claims exemption from all sales and/or use taxes under Texas Tax Code §151.309, as amended. Texas Limited
Sales Tax Exemption Certificates will be furnished upon written request to the Harris County Purchasing Agent.

TERM CONTRACTS
If the contract is intended to cover a specific time period, the term will be given in the specifications under SCOPE.

TERMINATION
Harris County reserves the right to terminate the contract for default if offeror breaches any of the terms therein,
including warranties of offeror or if the offeror becomes insolvent or commits acts of bankruptcy. Such right of
termination is in addition to and not in lieu of any other remedies which Harris County may have in law or equity.
Default may be construed as, but not limited to, failure to deliver the proper goods and/or services within the proper
amount of time, and/or to properly perform any and all services required to Harris County's satisfaction and/or to meet all
other obligations and requirements. Harris County may terminate the contract without cause upon thirty (30) days
written notice.

TITLE TRANSFER
Title and Risk of Loss of goods shall not pass to Harris County until Harris County actually receives and takes possession
of the goods at the point or points of delivery. Receiving times may vary with the using department. Generally,
deliveries may be made between 8:30 a.m. and 4:00 p.m., Monday through Friday. Offerors are advised to consult the
using department for instructions. The place of delivery shall be shown under the "Special Requirements/Instructions"
section of this bid package and/or on the Purchase Order as a "Deliver To:" address.

WAIVER OF SUBROGATION
Offeror and offeror's insurance carrier waive any and all rights whatsoever with regard to subrogation against Harris
County as an indirect party to any suit arising out of personal or property damages resulting from offeror's performance
under this agreement.

WARRANTIES
Offerors shall furnish all data pertinent to warranties or guarantees which may apply to items in the bid. Offerors may
not limit or exclude any implied warranties. Offeror warrants that product sold to the County shall conform to the
standards established by the U.S. Department of Labor under the Occupational Safety and Health Act of 1970. In the
event product does not conform to OSHA Standards, where applicable, Harris County may return the product for
correction or replacement at the offeror's expense. If offeror fails to make the appropriate correction within a reasonable
time, Harris County may correct at the offeror's expense.


                                              VENDORS OWING TAXES
Pursuant to TX Local Government Code 262.0276, Harris County Commissioners Court has adopted a policy which
requires that vendors’ taxes be current as of the date bids/proposals are due. Bidders with delinquent taxes on the due
date will not be eligible for award. Whether or not a vendor’s taxes are delinquent will be determined by an independent
review of the Tax Office records. Vendors who believe a delinquency is reflected in error must contact the Tax Office to
correct any errors or discrepancies prior to submitting their bid in order to ensure that their bid will be considered . Tax
records are available online at the Tax Office website—www.hctax.net. Prior to submitting a bid, vendors are
encouraged to visit the Tax Office website, set up a portfolio of their accounts and make their own initial determi nation
of the status of their tax accounts. Furthermore, if, during the performance of this contract, a vendor’s taxes become
delinquent, Harris County reserves the right to provide notice to the Auditor or Treasurer pursuant to Texas Local
Government Code §154.045. This policy is effective for all bids due on or after May 1, 2004.



Revised 09/05




                                                                                                                Page 9 of 20
                               SPECIAL REQUIREMENTS/INSTRUCTIONS

The following requirements and instructions supersede General Requirements where applicable.

1.     Application
       Should this contract apply to other governmental entities, references to “Harris County” and the “Harris
       County Commissioners Court” may apply to one or more of the following:
       --“Harris County Flood Control District” governed by “Harris County Commissioners Court”
       --“Harris County Hospital District” governed by its “Board of Managers”
       --“Harris County Community Supervision and Corrections Department” governed by its
       Standing Committee for Probation Matters”
       --“Greater Harris County 9-1-1 Emergency Network” governed by its “Board of Managers”

2.     Bid Requirements
       Each bidder should submit as a bid this entire ITB, completed where necessary, for example, the ITB cover
       sheet, the Price Sheets, Residence Certification, etc. Use the envelope provided with the ITB, or a
       comparable one, clearly indicating on the outside the Job Number, Job Description, and marked "SEALED
       BID". Harris County shall not be responsible for any effort or cost expended in the preparation of a
       response to this ITB. All protests should be coordinated through the Purchasing Office prior to award
       recommendation to Commissioners Court.

3.     Delivery
       If delivery is required, all items must be packaged so as to be protected from damage during shipping and
       handling. Any item(s) damaged in shipping must be replaced in kind, or repaired, by the contractor, at the
       discretion of, and at no additional charge to, Harris County.

4.     Payment
       Harris County will pay original invoices that clearly itemize the goods and/or services provided as to
       quantity, part number, description, price, applicable discount (if any), labor charges showing time
       differential, if applicable and if previously agreed to, and delivery, installation, and set-up costs, if
       applicable and if previously agreed to. Only charges as stated on the Price/Delivery Information Sheet(s)
       submitted as a part of the bid will be considered.

       Invoices must indicate Harris County or Harris County Hospital District, as applicable, the address to which
       the product(s) and/or service(s) were delivered, and the applicable purchase order number. Invoices will be
       matched to delivery tickets prior to payment, therefore, all delivery tickets should have an accurate
       description of the product(s) and/or service(s).

5.     Usage Reports
       Harris County reserves the right to request, and receive at no additional cost, up to two (2) times during the
       contract period, a usage report detailing the products and/or services furnished to date under a contract
       resulting from this ITB. The reports must be furnished no later than five (5) working days after written
       request and itemize all purchases to date by Harris County department, description of each item purchased,
       including manufacturer, quantity of each item purchased, per unit and extended price of each item
       purchased, and total amount and price of all items purchased.
       Revised 12/98




                                                                                                        Page 10 of 20
                                               SPECIFICATIONS

                          Term Contract for HVAC Repair Parts for Harris County

SCOPE
The intention of this Harris County Invitation To Bid (ITB) is to solicit bids for a term contract to furnish and
deliver repair and/or replacement parts and related items for heating, ventilation, and air conditioning (HVAC)
equipment for Harris County for one year beginning approximately September 1, 2006, in the quantities estimated
herein, to various locations throughout Harris County.

For information regarding the bid process, please contact Jaime Kovar, Office of the Purchasing Agent, at (713)
755-6457, or, for technical information concerning the products described in this ITB, contact Greg Medlin,
Facilities and Property Management, at (713) 755-6847.

DESCRIPTION
The contractor shall furnish, and deliver as required, if required, repair and/or replacement parts and related items
for heating, ventilation, and air conditioning (HVAC) systems, as detailed in Pricing/Delivery Information Sheets of
this ITB. Manufacturers and model numbers are referenced in order to be instructive as to type, class, etc.
acceptable to Harris County. However, any products of equal or greater quality will be considered.

Maintenance of the HVAC systems in approximately one hundred twenty (120) Harris County owned buildings
throughout Harris County is the primary use for the products to be furnished under this contract. This is a materials
supply contract only. Harris County personnel will perform all repairs.

RELATED ITEMS
Bidder may offer for sale additional items related to the scope of goods and/or services described above and/or listed
in the Pricing/Delivery Information Section of this ITB by identifying other items and/or brands not identified by
Harris County in this ITB. No item priced to Harris County over $500.00 each may be considered as a
related item, and therefore may not be purchased under this contract. Though the “related items” offered
may be considered during the award recommendation, and/or may be made a part of a subsequent contract, if any,
with Harris County, the affect of the related items cannot be extended and totaled in determining the lowest bidder
since an estimated usage is unknown. Purchases by Harris County of related items should not exceed 20% of
the total annual purchases under the contract.

CONTRACTOR QUALIFICATIONS
Contractor must be an established, full line, stocking supplier of heating, ventilation and air conditioning (HVAC)
equipment and related items, and maintain, at a minimum, normal working hours of 7:30 to 5:00, Monday through
Friday, except for official Harris County holidays. Contractor must also have walk-in/will call pick up service
during normal working hours.

To insure an uninterrupted source of repair parts, the County reserves the right to award multiple contracts. Each
item may be awarded to a "Primary" and a "Secondary" contractor with the intention of initially requesting from the
“Primary” contractor and only from the “Secondary” contractor as necessary due to time constraints, availability,
etc.




                                                                                                         Page 11 of 20
                                                             PRICING/DELIVERY INFORMATION

I. Pricing: Bidder must complete open boxes to right of double vertical lines. Quantities are estimated, Harris County may require more or less. In
   case of discrepancy between unit and extended pricing, unit pricing governs. Harris County reserves the right to award by item, group, overall, or
   otherwise, as best serves the county’s interest. Quantities listed below will be used to determine the low bidder.


                                                                                    Bidder:
Item                             Description                             UM Qty      Manufacturer      Part No.          $/UM             Ext $
  1     MC tank acet exchange                                            ea   100
  2     R tank oxygen exchange                                           ea   100
  3     RR-N40 nitrogen exchange                                         ea   75
  4     FEH1056S 1/2 HP 460V, A.O. Smith                                 ea    5
  5     slime-out bottle of 100, Aquasolve Chemical                      ea   40
  6     TKR-1001 Pneu, Barber-Colman                                     ea   60
  7     WA484-Boo wall mounted 230/3, Bard                               ea    4
  8     WA372-Boo wall mounted 230volt e phase A/C unit, Bard            ea    2
  9     EHWAo5-Bo9 9KW heat strip, Bard                                  ea    4
  10    HV-NFI 102210, Bell & Gossett                                    ea    2
  11    HB-BNFI 1022 13, Bell & Gossett                                  ea    2
  12    BJT025L6C 230/3 condenser, Bohn                                  ea    2
  13    H2DA124DBEL 460 volt 3 phase compressor, Bristol                 ea    2
  14    H20R583ABCA 230-1 967445 A/C compressor, Bristol                 ea    2
  15    H21C343ABCA 230-1 967475 A.C compressor, Bristol                 ea    2
  16    101 assb gas/elec controller for damper, California Economizer   ea    2
  17    4178-08 Calgon Foambrite, 10 gal                                 ea   30
  18    VEDK12M2 roof ventilator, Cams                                   ea    2
  19    998-0661-51, Copeland valve                                      ea    6
  20    ZR57K3PFV(KC) 230-1 967595 A/C compressor, Copeland              ea    3
  21    4DC3A2200-TSK-800, Copelametic                                   ea    2
  22    4RK2-250A-TSK-800, Copelametic                                   ea    5
  23    CR41KQ-TF5-980WB, Copelaweld                                     ea    2
  24    ZR47K3-TF5-935 Copelaweld                                        ea    2
Item                             Description                             UM Qty     Manufacturer       Part No.          $/UM             Ext $
                                                                                                                                         Page 12 of 20
 25    3" FSK tape to seal duct work, 0821, Fasson                          ea   100
 26    2650-760 smoke detector, Firex                                       ea   10
       90svw-7 1.5 115 230 1 chilled water vertical air handler and coil,
 27    1st Co                                                               ea    2
 28    6143 30A 3P 24V, Fumas                                               ea   25
 29    1402P-3" wide aluminum face UL rated tape, Hardcast                  ea   35
 30    RM1 20" round diffuser, Hart & Cooley                                ea    9
 31    24"x24" perforated A/C supply grill, Hart & Cooley                   ea   130
 32    24"x24" Renps S/R T-bar lay in, Hart & Cooley                        ea   95
 33    24x24 HVS diffuserwith 6-12" duct connection, Hart & Cooley          ea   28
 34    659T1 20x20 T-bar FG W/R6, Hart & Cooley                             ea   16
 35    Brazing rods w/ 15% silver 1# 61035, Harris                          ea   25
 36    78 air vent 401485, Hoffman                                          ea   15
 37    791 air vent 101482, Hoffman                                         ea   11
 38    VGF31EM25 2 1/2" flange valve, Honeywell                             ea    3
 39    MP953C1083 VLV Oper, Honeywell                                       ea    7
 40    ML6984A1006 actuator, Honeywell                                      ea   11
 41    VA701DC-D001 actuator, Honeywell                                     ea    2
 42    TP970A2004 Da Stat, Honeywell                                        ea    9
 43    V3361E3005 3" flanged connection water valve, Honeywell              ea    2
 44    8" shaft, 17/16" diameter for blower wheel, Houston bearing          ea    2
       Oil-hardware set rubber insert, A/C compressors oil reservoir,
 45    Houston Bearing                                                      ea    2
 46    AC2020 electronic control, ICM Controls                              ea   16
 47    712-202-G1 D-Tel electronic freon leak detector, Inficon             ea    5
 48    9701i programmable thermostat, Invensys                              ea   13
 49    9715i programmable thermostat, Invensys                              ea    8
 50    2.3x48x75 FSK duct insulation, Johns Mannville                       ea   20
 51    11/2x48x100 J/M FSK75 wrap, Johns Mannville                          ea    5
 52    V11HAA-100 EP SWT, Johnson Control                                   ea    4
 53    MP823E001A, Johnson Control                                          ea    4
 54    T-4002-201 RM STA, Johnson Control                                   ea   25
Item                            Description                                 UM Qty     Manufacturer   Part No.   $/UM   Ext $

                                                                                                                        Page 13 of 20
 55    T-5800-3 rcvr ctr, Johnson Control                      ea    2
 56    DX-9100-8454, Johnson Control                           ea    2
 57    VG7241ST 2" shilled water valve, Johnson Control        ea   71
 58    70356014 blower wheel assembly, Lau                     ea    2
 59    1-ABS 115V pump, Little Giant                           ea    9
 60    VCL-45ULS 115 volt condensate pump, Little Giant        ea    5
 61    FS4-3 Flo Swit 114400, McDonnel                         ea    5
 62    FS8-W flow switch, McDonnel                             ea   25
 63    Flat ESS 1"x10' 24 gauge (ARL) sheet metal, M&M Manf.   ea   665
 64    14"x5' sheet metal duct pipe, M&M Manf.                 ea   160
 65    8" sheet metal collar 507D w/ damper duct, M&M Manf.    ea   95
 66    H855 3HP dual voltage motor 208-230/460V, Magnetek      ea    2
 67    E300 7.5HP ODP S213T, Magnetek                          ea    2
 68    E356 7.5HP TEFC 213T, Magnetek                          ea    2
 69    E260 3HP TEFC 182T, Magnetek                            ea    4
 70    E226 3HP ODP S182T, Magnetek                            ea    5
 71    E227 5HP ODP S184T, Manetek                             ea    4
 72    #5, 5lb. Bad air sponge, Mateson                        ea   50
 73    AH2D101A4 gas valve, Neuco                              ea    2
 74    UDAP75 gas heater w/ powered vent, Reznor               ea    2
 75    97782 spark igniter for gas furnace, Reznor             ea    4
 76    41215 manifold set, Ritchie                             ea   15
 77    900-002 Calibtn kit, Robertshaw                         ea   10
 78    7/8 x 1" pipe insulation, Rubatex                       ea   1000
 79    T19-301 thermostat, Siebe                               ea   10
 80    MA-418 actuator 120V, Siebe                             ea    2
 81    175 air flow training video, Simuair                    ea    2
 82    KT-83-VCP100 element kit, Sporlan                       ea   20
 83    RC-4864-HH replaceable core drier, Sporlan              ea   20
 84    DP42V14 electrical contactor 40A 2P 24V, Square D       ea   35
 85    AGC5561EXG 460/3 A/C compressor, Tecumseh               ea    2
 86    6" x 25" R6 insulation flex duct, Tele-Flow             ea   300
Item                            Description                    UM Qty      Manufacturer   Part No.   $/UM   Ext $
                                                                                                            Page 14 of 20
 87    7"x 25' R6 insulation flex duct, Tele-Flow             ea   1000
 88    8"x 25' R6 insulation flex duct, Tele-Flow             ea   2500
 89    9" x 25" R6 insulation flex duct, Tele-Flow            ea   300
 90    10"x 25' R6 insulation flex duct, Tele-Flow            ea   500
 91    12" x 25" R6 insulation flex duct, Tele-Flow           ea   300
 92    20" x 25" R6 insulation flex duct, Tele-Flow           ea   100
 93    16511401 actuator, Vicon Controls                      ea    2
 94    16502101 Aux electronic switch, Vicon Controls         ea    2
 95    1F86-244 non programmable thermostat, White Rodgers    ea   30
 96    6" collars with dampers                                ea   100
 97    8" collars with dampers                                ea   100
 98    9" collars with dampers                                ea   100
 99    10" colllars with dampers                              ea   100
100    12" collars with dampers                               ea   100
101    Harris silver 15% 1#                                   ea   100
102    50/50 1# bar                                           ea   100
103    50# reclaim fee                                        ea   100
104    2" UL181-FX black duct tape                            ea   50
105    DVU35 digital thermometer                              ea   40
106    Grills 24 X 24 HVS DIFFUSER, 6-12                      ea   105
107    Uv Light HVAC-PHI-357-GA-110VOLT                       ea    6
108    Uv Light HVAC-PHI 357HO-26 14" GUARDIAN                ea    5
109    Refrigerant Recovery 50# RECLAIM EXCHANGE FEE          ea   50
110    Uv Light HVAC-PHI 212-16 GUARDIAN AIR                  ea   10
111    Cond. Unit BHT015H2BF BOHN 230/1CONDENSER              ea    1
112    Coil HX-7.5V MAGICAIRE *D8* R                          ea    2
113    Grills 24 X 24 PD PERF FACE ONLY                       ea   150
114    Cond. Unit BHT020H2CF BOHN 230/3CONDENSER              ea    1
115    2" Flanges Bell & Gossett SERIES 90 90-34S 2" FLANGE   ea    2
116    2" Flanges SERIES 90 90-34S 2" FLANGE                  ea    2
117    WM2277HW L.G. INDUSTRIAL                               ea    1
118    Air Dryer QPNC 35 REF AIR DRYER                        ea    1
Item                              Description                 UM Qty      Manufacturer   Part No.   $/UM   Ext $
                                                                                                           Page 15 of 20
119    10 Hp Motor                                           ea   1
120    Controler                                             ea   5
121    H10045 3/4 277v Ecm Motor                             ea   2
122    Fan Motor E357 MAGNETEK 10HP TEFC 215T                ea   5
123    Compressor ZR57K3PFV(KC) 230/1 (967595)               ea   2
124    Air Dryer HPR-25 HANKINSON AIR DRYER                  ea   1
125    4JTS Metal 4JTS-32"-36"X4'                            ea   50
126    Flow Switch FS8-W MCDONNEL FLO SWCH 120601            ea   10
127    Air Vent 78 HOFFMAN AIR VENT 401485                   ea   5
128    Curb Adpt. 50DP016 TO DH180 CURB ADPT.                ea   1
129    Relay RA890F1288 HONEYWELL *D5* FG                    ea   1
130    Grills 24 X 24 RENPS S/R T-BAR LAY IN                 ea   50
131    WYM2004B 230/3 24V                                    ea   1
132    Duct Heater 15KW DUCT HEATER 480/3 2ST-24V            ea   5
133    T Stat TKR-1001 BARBER-COLMAN PNEU                    ea   10
134    Air Dwyer HPR5-10 HANKINSON AIR DRYER                 ea   1
135    T Stat 9715i INVENSYS PROGRAMMABLE                    ea   5
136    Thermocouple W Polit 195-0001 CONTROL PRODUCTS RECI   ea   1
137    5 Hp Motor M3308 5HP 215 230/460/3 MOTOR              ea   1
138    Compressor ZR61K3PFV 230/1 COM (967472)               ea   1
139    Duct Heater CBK20, 480V. QUOTE #C254075-5             ea   1
140    B&G Pump 100-NFI BELL&GOSSETT 106189                  ea   2
141    T Stat 1F86-344 WHITE RODGERS NON PRG                 ea   15
142    Blower Assembly 026-25381-700 BLW ASSEM               ea   2
143    Ele. Pressure Switch V11HAA-100 JOHNSON CTRL EP SWT   ea   10
144    Compressor ZR57K3-PFV-930 COPELAWELD                  ea   1
145    Comb. Analyzer 24-8200 BACHARACH FYRITE PRO           ea   1
146    Reversing Relay R-3030-1 REVERSING RELAY              ea   5
147    Compressor AVA5546EXG TECUMSEH 460/3                  ea   1
148    Duct Liner 1 X 47.5 X 100 RC LINER                    ea   2
149    Heat Exchanger 36390016701 YORK HEAT EXCHGR           ea   1
Item                         Description                     UM Qty    Manufacturer   Part No.   $/UM   Ext $
150    WYM2004B 230/3                                        ea   1

                                                                                                        Page 16 of 20
151    Arl FLAT ESS 1" X 10' 24GA (ARL)                   ea   1000
152    B&G Pump HV-NFI BELL&GOSSETT 102210                ea    1
153    Digital Thermoete DVU35 WEISS DIGITAL THERMOMETE   ea   10
154    Module S8610U1003 HONEYWELL MODULE                 ea    5
155    Uv Light HVAC-PHI 212HO-16 GUARDIAN AIR            ea    1
156    Vac. Pump 93560 RITCHIE SUPERVAC 6CFM              ea    1
157    100' Duct Sealant 1402P-3 HARDCAST U.L. ALUM       ea   20
158    Actuator ML6984A1006 HONEYWELL ACTUATOR            ea    3
159    B&G Pump PL-30B BELL&GOSSETT PUMP *D4*             ea    1
160    Pressure Cont. P70AA-118C JOHNSON CTRL PRESS       ea    5
161    Duct Pipe Fittings Duct Pipe & Fttgs 507-36        ea    5
162    Duct Heater 2TP04542425 YORK 24KW 208/230          ea    1
163    Actuator M573-8111 BARBER-COLMAN                   ea    4
164    Duct Board 1-1/2X48X120 EI800 J/M DUC R6           ea   400
165    Mod.Air Damper MARD-10 MODULATING AIR DAMPER       ea    2
166    Flex Duct 8"X25'UPC036/F216 SJ625 R6               ea   400
167    TSTAT 9701i INVENSYS PROGRAMMABLE                  ea    3
168    Actuator VC6934ZZ11 ACTU.                          ea    4
169    Da. Phe. Stat TP970A2004 HONEYWELL DA STAT         ea    5
170    3 Phase Monitor ICM450C ICM 3PHASE MONITOR         ea    3
171    Photohelic Guage A3002-RMR PHOTOHELIC GAUGE        ea    1
172    TSTAT 9720i INVENSYS PROGRAMMABLE                  ea    2
173    Isolators NDC YELLOW ISOLATOR                      ea   20
174    B&G Pump Motor 111061 BELL&GOSSETT 1/6 MOTOR       ea    1
175    Micro Water Filter 4612-W3 CALGON MICRO #4         ea   10
176    Acr Tubbing 7/8 COPPER TUBE ACR                    ea   200
177    Duct Tape AC57 2" UL181-FX BLACK(557)              ea   50
178    Return Ir Grills 672 10X8 RETURN AIR GRILL         ea   75
179    3 HP Fan Motor FC3106 A.O.SMITH 1HP 3PH F MTR      ea    1
180    Sensor SEN951 SENSOR                               ea    1
181    R410a Txv Valve 1TV0905 AFFINITY TXV R410A         ea    3
Item                           Description                UM Qty      Manufacturer   Part No.   $/UM   Ext $
182    B&G Pump PL-36 BELL&GOSSETT PUMP 1BL001            ea    1

                                                                                                       Page 17 of 20
183    1" Asco Valve 8210G4 ASCO 1" VALVE                   ea    1
184    Air Vent 79 HOFFMAN AIR VENT 401488                  ea    3
185    Pully 2TB160 PULLEY                                  ea    1
186    5# Bad Air Sponge #5 5 LB MATESON BAD AIR SPONGE     ea   10
187    Sheet Metal 1/8X60 SHEETS 30E060060                  ea    1
188    TSTATS Guards TG512A1009 HONEYWELL STAT GRD          ea   15
189    Controler RKS-1001 INVENSYS CONTROLLER               ea    1
190    Jard Transformor 7541C JARD 75VA 120/208/240/        ea   10
191    Ele. Heat Strip 2HK16501506W WARREN HT STRIP         ea    2
192    Fan Motor 9F10135A FAN MOTOR                         ea    1
193    8" Duct Collars 5400                                 ea   50
194    3 HP ODP Motor M3211T MOTOR                          ea    1
195    Dyer Cores RC-4864-HH SPORLAN CORE                   ea   15
196    Pillow Block Bearing VPS-319 1 3/16 PILLOW BLOCK     ea    2
197    Ad-1 Auto Drain AD-1 AUTO DRAIN                      ea    1
198    Cond. Coil                                           ea    1
199    B&G Dual Unit Pres. 8 BELL&GOSSETT 2/UNIT B 110199   ea    3
200    MCP1040-5211 ACT                                     ea    2
201    18 AWG 8 Cond Wire THERMOWIRE W/JKT                  ea   1000
202    Min. Refr. Oil 4310-07 CALGON 150 ZEROL              ea   10
203    Dir. Acting Stat T-4002-201 JOHNSON CTRL RM STA      ea    5
204    Pressure Switch P658B1012 HONEYWELL P-E SWITCH       ea    5
205    Blower Motor 9F30204A BLOWER MOTOR                   ea    1
206    Johnson Temp Cntl. A72CE-1 TEMPERATUE CNTL 120V      ea    1
207    Honeywell Actuator ML7420A3055 HONEYWELL             ea    1
208    Duct Tape AC50 2" BLACK DUCT TAPE                    ea   30
209    Honeywell Actuator VC6934 ACTUATOR                   ea    2
210    Flex Duct 12"X25'UPC036/F216 SJ625 R6                ea   150
211    Flex Duct 6"X25'UPC036/F216 SJ625 R6                 ea   300
212    TSTAT TH5110D1022 HONEYWELL FOCUS                    ea    5
213    Flex Duct 7"X25'UPC036/F216 SJ625 R6                 ea   250
Item                          Description                   UM Qty      Manufacturer   Part No.   $/UM   Ext $
214    Gasket Roll 000808001 8'GASKET                       ea   10

                                                                                                         Page 18 of 20
215   Dryer C-163-S SPORLAN CATCH-ALL                       ea   20
216   Steel Swifel Casters                                  ea   5
217   Refr. Flush Calgon 4300-10 CALGON RX11 DISPLAY        ea   1
218   2 Hp Blower Motor 02419623716 YORK BL 2 HP MTR        ea   1
219   5 Hp Motor E227M MAGNETEK 5HP ODP S184T               ea   1
220   Aquastat L4008E1156 HONEYWELL AQUASTAT                ea   2
221   3" Fasson Fsk Tape 0821 3"                            ea   25
222   York Txv Valve 1TV0703 YORK TXV 48/60                 ea   3
223   TSTATS Guards TG511A1000 HONEYWELL STAT GRD           ea   10
224   Honeywell Actuator VCZZ6100 CART.FOR ACT.             ea   10
225   Txv Valves SVE-8CP100 SPOR 5/8X7/8 ODF                ea   3
226   Diff. Pressure Switch 2374-410 R/S DIFF PRSSR SWTCH   ea   5
227   Non Prog. TSTATS 1F78-144 WHITE RODGERS NON PRG       ea   5
228   1.5 Hp Motor H536 A.O.SMITH 1-1/2HP 1725              ea   1
229   York Ing. Ctrl. 02529012004 YORK IGN CTRL G775        ea   2
230   Da. TSTAT Kit TP970A2145 HONEYWELL DA STA KT          ea   2
                             Grand Total                              $




                                                                          Page 19 of 20
II.    Related Items: Identify a specific document and pricing reference, for example, ABC, Inc. 10/1/06 Fall
       Catalog list price column, or XYZ Co. 1/1/06 Jobber Price Sheet wholesale price column, etc., and a
       multiplier thereto, for example, 75% to indicate a 25% discount, or 110% to indicate a 10% premium. The
       purchases by Harris County of these related items should not exceed 20% of the total annual purchases under
       the contract. No item priced to Harris County over $500/each may be considered as a related item,
       and therefore may not be purchased under this contract.

      1. Document and pricing reference: ____________________________________________
         _________________________________________ Multiplier: ____________________

      2. Document and pricing reference: ____________________________________________
         _________________________________________ Multiplier: ____________________


III. Pick up/delivery: It is anticipated that the following locations will require the product and/or service
     described in this ITB. However, other locations may also have needs. Bidder should indicate the approximate
     mileage from the most likely point of available product/service to each of the following locations as if traveled
     over major thoroughfares that result in the safest, yet fastest, available direct route.


                Location(s)                                       Mileage

                1.      Facilities & Property Management
                        49 San Jacinto, Houston, TX            __________ miles


IV. Payment Discount: Indicate the payment discount(s) available depending on the when invoices are paid. For
    example, 1/30 means a 1% discount if paid within 30 days, 2/15 means a 2% discount if paid within 15 days,
    etc.



V.     Renewal: Harris County may request to renew the original contract as amended from time to time, at the
       same terms, conditions, and pricing. Each renewal will be in one (1) year increments, not to exceed four (4)
       years.




                                                                                                         Page 20 of 20
                                                                                                               Attachment a
                                                                                                           Job No. 06/0186

                                RESIDENCE CERTIFICATION/TAX FORM
Pursuant to Texas Government Code §2252.001 et seq., as amended, Harris County requests Residence
Certification. §2252.001 et seq. of the Government Code provides some restrictions on the awarding of
governmental contracts; pertinent provisions of §2252.001 are stated below:

          (3)      "Nonresident bidder" refers to a person who is not a resident.

          (4)      "Resident bidder" refers to a person whose principal place of business is in this state, including a
                   contractor whose ultimate parent company or majority owner has its principal place of business
                   in this state.

          I certify that                             is a Resident Bidder of Texas as defined in
                    [Company Name]
          Government Code §2252.001.

          I certify that                             is a Nonresident Bidder as defined in
                       [Company Name]
          Government Code §2252.001 and our principal place of business is                            .
                                                                              [City and State]

Taxpayer Identification Number (T. I. N.):

Company Name submitting Bid/Proposal:

Mailing Address:

If you are an individual, list the names and addresses of any partnership of which you are a general partner:



PROPERTY: List all taxable property owned by you or above partnerships in Harris County.

Harris County Tax Acct. No.*                  Property address or location**




* This is the property account identification number assigned by the Harris County Appraisal District.
** For real property, specify the property address or legal description. For business personal property, specify the
   address where the property is located. For example, office equipment will normally be at your office, but inventory
   may be stored at a warehouse or other location.

Do you carry Health Insurance on your employees? ___Yes ___No

If yes, what is the percentage of employees insured? _____%
Revised 08/05




                                                                                                                  Page 21 of 20