Administrative Policy 4-2 Purchasing Policy

Policy 4-2 PURCHASING & PAYMENT PROCEDURES

 

PLEASE CLICK HERE FOR A FULL PDF VERSION OF THIS POLICY.

 

DISTRIBUTION: All Departments

EFFECTIVE DATE: November 3, 2017 SUBJECT: Purchasing Policy

PURPOSE: The purpose of the purchasing policy is to ensure that competitive bidding and fair

purchasing practices are utilized by all City departments, agencies or entities that utilize the services of

the City of Lawton Financial Services Division, which will maximize their ability to successfully provide

quality service to the citizens of Lawton. This policy shall be the primary source for purchasing

procedures.

BACKGROUND: The City of Lawton Purchasing Policy was established in January 2003. On

September I, 2006 the policy was updated by the City Manager and those changes remained in effect

until May 22, 2014. On April 22, 2014 the Lawton City Council adopted Ordinance No. 14-1 I, which

increased the contract amounts that required formal competitive bidding in Lawton City Code. The

effective date of Ordinance No. 14-11 is May 22, 2014. This purchasing policy was updated on May 22,

2014 to correspond with the increased amounts authorized by City Code

PROCEDURES:

1. General

a. This policy shall be followed by all City departments, agencies or entities that utilize the services of the

City" of Lawton Financial Services Division, make purchases for the City of Lawton, or utilize City of

Lawton funding.

b. The Financial Services Division Supervisor is charged with monitoring compliance with this policy,

with keeping department directors and division supervisors informed on problem areas and with

providing necessary training to City employees on proper purchasing procedures.

c. All supervisory personnel are charged with ensuring that all purchases made by their entities are in

accordance with this policy. They are further charged with working with the Financial Services Division

Supervisor in resolving problems and requesting training for their personnel where needed.

d. This policy does not apply to the selection of contractors for the CDBG Homeowner Rehabilitation

Program, and HOME Homeowner Programs. Procedures for selecting contractors for the Homeowner

Rehabilitation Program are covered in Administrative Policy 7-1.

2. Capital Outlay Expenditures. In addition to this policy, Administrative Policy 13-1 must be

followed for Capital Outlay expenditures.

3. Exemptions. §10-1-I 13C of the City Code exempts architectural engineering, legal and other

professional services from competitive bid procedures. Using this guidance, professionals in the arts will

also be exempted. §10-1-113D of the City Code exempts utility service from the competitive bid

procedures. Purchases for fuels, computer equipment, auto parts, road oils, and PVC pipe are

accomplished by spot bidding (§10-1-101C, E and F, City Code). These items may be purchased to a

limit of $50,000.00, with the exception of PVC Pipe which has a limit of $75,000.00. 57 O.S. §549.1D

allows purchases from the Department of Corrections without competitive bids.

4. Encumbrances. Departments/divisions shall encumber funds as necessary to obtain a purchase

order in advance. Encumbrances are also used to set aside monies for known obligations. Encumbrances

are processed using the guidelines established by this policy. Any requirement for quotes must be adhered

to prior to processing an encumbrance.

5. Sole Source. There are times when an item is only available from a single source. Sole source

requests are approved when the goods/services can be obtained from only one known vendor. The

following applies to sole source purchases:

I. Sole source requests must be submitted and approved before the obligation of funds. Sole source

requests must be made using the format enclosed as Figure 1. All information required in the

draft memorandum must be provided.

2. Before approval of a sole source request, actions will be taken by the Financial Services Division

to find other sources for the goods/services.

3. For repeated purchases from the same vendor, such as library book purchases, an encumbrance

may be submitted to cover subsequent purchases. Requisitions submitted after receiving approval

must reflect the approval number and date in the Remarks section of the requisition.

4. No City funds are to be obligated before the approval of the Sole Source request.

6. Computers. Purchases of computers, computer related equipment, and software must be

reviewed and approved by the Information Technology (IT) Supervisor. The requisition must be initialed

by the IT Supervisor prior to being submitted to the Financial Services Division.

7. Communications Equipment. Purchases of radio, pager, telephone equipment or services, and

any other communications equipment must be coordinated and approved by the Electronic Maintenance

Division or IT Supervisor. This action must be taken in accordance with Administrative Policy 14-I,

dated June 14, 2001.

8. Department/Division Director Approvals. All documents submitted for processing must be

approved by department/division directors. This includes purchase requisitions, new specifications,

requests for bids/proposals (gold sheets), and department/division recommendations pertaining to formal

bids and proposals.

9. Local Vendor Preference. In accordance with §10-1-102, 10-1-108, and 10-1-116 of the City

Code, as amended by Ordinance 99-14, the City may give preference to local vendors who have

submitted bids within five percent (5%) of the lowest responsive bidder who is not a local vendor. This

preference shall not apply to public construction contracts. "'Local vendor" means any person or business

whose primary place of business is located and operating within the corporate limits of the City who

submits responsive bids for the purchase of goods and materials in response to the City' s solicitation for

bids.

10. State Contract. Items on the state contract may be purchased without obtaining bids, subject to funds

being available, in accordance with city code 10-l-113E.

11. Public improvement construction contracts under $ 50,000.00 may be awarded to the lowest

responsible bidder after receipt of written quotes obtained by Financial Services. Bidders must complete

and sign the invitations to bid and contract form as shown in Appendix E. Vendors will be notified at the

time of solicitation if mandatory' pre-quote conferences are scheduled.

12. Specific purchasing topics are addressed in the following appendices:

a. Appendix A - Purchasing Limits

b. Appendix t3 - Approval Requirements for Purchases

c. Appendix C -

d. Appendix D -

e. Appendix E -

f. Appendix F -

g. Appendix G -

h. Appendix H -

i. Appendix I -

Specifications - Purchases Costing $10,000.00 or more

Formal Bid Processing

Invitations to Bid and Contract

Contract Change Order Procedures

Special Authorizations

Budget Transfer

Extension of Contracts

REFERENCES: Chapter 10, Lawton City Code and Administrative Policies 7-1, 13-1, and 14-1.

RESCISSION: This policy rescinds Administrative Policy 4-2 dated May 22, 2014.

RESPONSIBLE DEPARTMENT: Finance (Financial Services)

..... 11

Jerry Ihle},..• - • -- "

City Manager

Novemebr 3, 2017

Attachments :

Appendix A-I

Figure 1 - Example of Sole Source Request

Figure 2 - Form FN 528 (Gold Sheet)

Figure 3 - Form 36-002 Contract Change Order

Figure 4 - Affidavit for Payment

Appendix A

Purchasing Limits

1. Maximum Purchase Limits.

a) The total limit a department/division may spend on one order, ticket or item without competitive

quotes is $ 4,499.99 .+

b) A minimum of three (3) oral or written quotes are required to be obtained by the

department/division on any one item or total order/invoice that costs between $ 4,500.00 and $11,999.99.

Dividing a single day's purchase from one (1) vendor into separate tickets will not exempt the purchase

from requiring oral quotes. Splitting a purchase to avoid the competitive bidding requirements is a

violation of City Code and State law. Quotes must be documented on the requisition or attached as a

separate document. A valid quote must include price, quantity, contact name, and telephone number. If

quotes have been received from an online source, quotes must include price, quantity, website and phone

number. Quotes received will be evaluated according to what is in the best interest of the City without

bias. The Financial Services Division reserves the right to confirm all vendor quotes and may request

additional quotes from known vendors if it be in the best interest of the City.

c) Purchases that cost between $ 12,000.00 and $50,000.00 must be forwarded to Financial Services

for three (3) written quotes. When submitting invoices to Financial Services for payment, all quotes must

accompany the invoice(s).

d) Any purchase over $50,000.00 requires formal bidding and a contract.

2. Purchasing limits pertain to items not covered by a City requirements contract. Items covered by

contract may be purchased above these limits.

3. Costs associated with things such as shipping, insurance, delivery and warranty shall be included

in computing the total cost of the purchase. If circumstances surrounding a solicitation will not allow the

same to be computed, an exception may be granted by Finance Director.

4. A non-collusion affidavit shall be required with any formal bid over $50,000.00. If items are on

contract, an affidavit must be on file in Financial Services. It is the responsibility of the

department/division to obtain this affidavit when needed.

5. For invoices exceeding $25,000, the department/division must obtain from the vendor the

affidavit for payment (Figure 4) and attach it to the invoice prior to sending it to Financial Services for

processing.

6. When obtaining oral quotes, one "no-bid" may be accepted if the phone number and point of

contact are recorded. No requisition may be processed with two "no-bids". If the department/division is

unable to obtain necessary oral quotes, they may forward the solicitation to Financial Services for

assistance. The vendor's name, address or website, item type, item price, quantity, and vendor's phone

number must be recorded for the oral quote to be complete. The Request for Quotes template located on

the P drive may also be utilized and sent to vendors.

7. Multiple purchases of the same item are considered a single item purchase. For example: one (1)

item costs $4,499.99 and may be purchased at will. Two (2) of this same item cost $8,999.98 and will

require three (3) oral quotes. Three (3) of the items cost $13,499.97 and require Financial Services to

obtain three (3) written quotes.

PURCHASING LIMIT GUIDELINES

Maximum Purchase Limits

Purchasing Department/Division Financial

Amount Services Remarks

$0 - $4,499.99 X No Quote Needed

$4,500 - $11,999.99 X Minimum of three (3) oral quotes

$12,000 Minimum of three (3) Written - $50,000 X

quotes

$50,000 or more X Requires Formal Bidding

Approval

Level

Routine

Acquisitions

Below

$12,000

hpI

$12,000 -

$50,000

Appendix B

woval Requirements for Purchases

$50,001

and over

Special

Payments

Computer

Related

Communications

Equipment

Motive

Equipment

Division XX XX XX XX 1 XX XX XX

Supervisor

Department XX XX XX XX 1 XX XX XX

Director

Financial XX XX XX XX 1 XX XX XX

Services

Finance XX XX XX 1

Director

City XX XX 2

Manager

Special XX 3 XX 4 XX 5

Approval

Note:

1.

2.

,

4.

5.

Special payments (1) include damage claims, education reimbursements, petty cash

reimbursements, employee reimbursements, dues and membership payments, professional

services payments and travel.

Special payments (2) include petty, cash reimbursements and travel expenses paid to department

directors.

Purchases of computer and computer related equipment must be approved by the IT Supervisor.

This includes any hardware or software purchases. Computer supplies (e.g., paper, cartridges,

etc.) do not fall in this category.

Purchases of communications equipment (radios, telephone systems, pagers, etc.) must be

coordinated and approved by the Electronic Maintenance Division or IT Supervisor.

All purchases relating to motor vehicles and related equipment must be submitted through the

Equipment Maintenance Superintendent for approval prior to purchase. This will ensure all

motive equipment is entered into the maintenance program, unit numbers are assigned and issued,

and maintenance history for future repairs and replacement. All motor vehicles and equipment

must be turned in for disposal through the Equipment Maintenance Division in order to ensure

maintenance records are retired as needed and to salvage recoverable parts. Motor vehicle refers

to any vehicle that has a gas, diesel, propane or compressed natural gas engine that is not

permanently fixed to a facility or facility process. Contact the Equipment Maintenance

Superintendent if uncertain as to whether a particular item qualifies as a motor vehicle or related

equipment.

Appendix C

Specifications Committee - Purchases Costing $10,000.00 or More

1. GENERAL:

A. The Specifications Committee will review all specifications of goods and services whose cost is

estimated to be $10,000.00 or greater, and have no existing approved specifications. Departments/

divisions must coordinate with Financial Services when specifications will be presented to the

Specifications Committee as it typically only meets one ( 1 ) time per month at the discretion of Financial

Services Supervisor. A department!division representative must attend the Specifications Committee

meeting in order to present the item. The assigned Buyer within Financial Services should also attend the

meeting as necessary.

B. The Specifications Committee will be composed of the City Manger or designee, City Attorney or

designee, Equipment Maintenance Superintendent, Finance Director or designee, and the Parks and

Grounds Superintendent.

C. Contracts and services administered by the City Engineer's office will not be required to have

review/approval by the Specifications Committee.

II. RESPONSIBILITIES:

A. Financial Services Division

1. The Financial Services Supervisor, or designated representative, shall:

a) Attend all meetings to provide information and act in the capacity of advisor.

b) Have the authority to make recommendations and provide alternate specifications for

consideration.

c) Schedule meetings as necessaw and prepare agenda.

d) Assist Departments/Divisions in the preparation of specifications.

e) Maintain a file of all approved specifications.

B. The Office of the City Attorney shall:

1. Attend all meetings in the capacity' of legal advisor and voting member of the Committee.

2. Review specifications to assure that all legal requirements are met and make recommendations

for changes at the Specification Committee Meeting.

C. Department/Division Responsibility:

1. Develop specifications for purchase/services that exceed $10,000.00.

2. Specifications shall not be restrictive and should allow for competitive bidding.

3. Prior to going to the Specification Committee for consideration, specifications for computers and

computer related equipment must be approved by the Information Technology (IT) Supervisor:

specifications for radios, telephone equipment or services must be approved by the IT Supervisor;

specifications for motor vehicles and related equipment must be approved by the Equipment

Maintenance Superintendent.

4. Special requirements, such as insurance needs, delivery times, or maintenance contracts should be

addressed in the specifications.

5. Submit the specifications to the Financial Services Division. Ensure that all necessary documents

are submitted with the specifications.

6. Attend Specifications Committee meeting to explain specifications.

Appendix D

Formal Bid Processing

°

2.

Formal bids are required for purchases of $ 50,000.0 l or more.

The following documents are required to be submitted by the requesting department/division:

A. Request for Bids/Proposal, Form FN 528 (Gold Sheet) (Figure 2).

B. If the specifications have been previously approved, the department/division must review

and certify that the specifications are current. If specifications have not been approved,

they must be submitted to the Financial Services Division for review/approval prior to the

Financial Services Division advertising for bids. See Appendix C.

1

bids.

All of the above documents must be submitted prior to the Financial Services Division soliciting

4. All documents pertaining to a formal bid request (Gold Sheet, Requisition and Division

Recommendation for Award) must be signed by the department/division director.

5. All contracts that are included as part of a bid package must be the standard form contract that has

been approved by the Legal Department. If deviations are required, the contract must be reviewed by the

Legal Department prior to being included as part of the bid package.

Appendix E

MAIL SEALED PROPOSALS TO:

City Clerk

City of Lawton

212 SW 9th Street

Lawton, OK 73501

Date Proposal Typed:

City of Lawton

REQUEST FOR PROPOSALS

DIRECT INQUIRIES TO:

Date(s) Advertised: No Proposals Received After:

2:00 P.M.

Proposal Number and Title: Proposal valid until:

Requirements-type Proposal: [--lyes [] no

Vendor Name and Point of Contact: Reason for No Proposal:

Mailing Address:

City: State: 29 p:

Area Code and Phone Number:

Delivery:

FAX Area Code and Phone Number:

Federal Employer Identification Number or Social Security Number

THIS PROPOSAL INVALID IF NOT SIGNED AND NOTARIZED

AFFIDAVIT:

STATE OF COUNTY OF , of lawful age, being first duly sworn, on oath says that:

1. Affiant is the duly authorized agent of the bidder/vendor and/or contractor submitting the competitive bid and executing the contract which is attached to this

statement, and that as such agent Affiant has the authority to bind the bidder/vendor, whether an individual, partnership, or corporation, for the purpose of

negotiating and entering into said agreement, and for certifying the facts pertaining to the essence of collusion among bidders and between bidders and City

officials or employees, as well as facts pertaining to the giving or offering of things of value to government personnel in return for special consideration in the letting

of any contract pursuant to the bid to which this statement is attached; 2. Affiant is fully aware of the facts and circumstances surrounding the making of the bid

and/or the procurement of the contract to which this statement is attached and has been personally and directly involved in the proceedings leading to the

submission of such bids; 3. Neither the bidder/vendor nor anyone subject to the bidder/vendor's d•ection or control has been a party: a. to any collusion among

bidders in restraint of freedom of competition by agreement to bid at a fixed price or to refrain from bidding, b. to any collusion with any municipal official or

employee as to quantity, quality or price in the prospective contract, or as to any other terms of such prospective contract, c in any discussions between bidders

and any municipal official concerning exchange of money or other thing of value for special consideration in the letting of a contract, nor d. to paying, giving or

donating or agreeing to pay, give or donate to any officer or employee of the City of Lawton, any money or other thing of value, either directly or indirectly, in

procuring the contract to which his statement is attached. 4. Affiant further agrees to be held personally liable in the event thatvAffiant has misrepresented the

scope or extend of Affiant's authority to bind the bidder herein, and to indemnify and hold harmless the City of Lawton its departments, boards, commissions,

agencies, institutions, and all employees of the aforementioned from all damages based upon such misrepresentation, including but not limited to all costs and

attorney fees incurred, in addition to any other remedies available by law.

Firm:

Address:

(City, State, Tip)

Pho ne:

SIGNATURE OF AUTHORIZED AGENT

PRINT/TYPE Name EFFI TLE

Subscribed & sworn before me this day of

Notary Public

My Commission expires:

2O

Appendix F

Contract Change Order Procedures

I° Requests for contract change orders will be processed on Contract Change Order form, Form 36-002,

(Figure 3).

II. Contract change orders will be processed using the following procedures:

a. When there is a change of conditions that requires modifications to a current contract, the

responsible department/division will coordinate the change. The responsible department/division

will obtain a letter from the vendor outlining the changes and the costs associated with each

change. The department/division director will submit a memorandum, with vendor's letter

attached, and recommendation regarding the proposed changes to the Financial Services Division.

B. The Financial Services Division will review the request and send it to the City Attorney's office

for review. Upon completion of the legal review, the Financial Services Division will prepare a

Contract Change Order, Form 36-002, and forward it to the originating department/division for

signature.

C. The responsible department/division will forward the form to the vendor for completion. Upon

return from the vendor, the completed form will be forwarded to the Financial Services Division

for further processing.

D. The Financial Services Division will prepare the agenda item for City Council approval.

g. After approval, the Financial Services Division will provide copies of the approved Form 36-002

to the vendor and responsible department/division. If disapproved, the Financial Services

Division will notify the originating department/division.

III. Approval authority. The City Council is the ONLY approving authority for contract change orders.

1. Emergency Purchase Orders

Appendix G

Special Authorizations

A. Emergency situations occur which require purchasing goods or services immediately.

B. During normal duty hours. Before obtaining the goods/services, the department/division director or his

representative must call the Financial Services Division for an Emergency Purchase Order number. An

Emergency Purchase Order will be issued only after it is determined that the goods/services cannot be

obtained utilizing the routine procedures.

C. After normal duty hours. If an emergency occurs after normal duty hours, the department/division

director or his representative should have the work done. On the first business day after the emergency,

contact the Financial Services Division to obtain an Emergency Purchase Order number. The department

director must include a memorandum with the requisition explaining the circumstances that necessitated

the work being done on an emergency basis.

D. The Emergency Purchase Order is to cover the existing emergency. Any other work that needs to be

done must be processed in accordance with this policy.

E. Emergency Purchase Orders will not be issued for work expected to exceed $ 50.000.00 . These

emergencies must be approved by the City Council prior to the work being done.

F. The following information must be provided when requesting an Emergency Purchase Order number:

1. Nature of emergency

2. Efforts taken to resolve using routine procedures

3. Length of time problem existed

4. Estimated cost of goods/services

5. Vendor to be used to provide service

G. The Emergency Purchase Order number must be listed on the purchase requisition.

2. Authorization Numbers

A. Certain repairs are provided from a rotating vendors list. The Financial Services Division maintains a

list of approved vendors for the following services:

1) Alternator/Starter Repairs

2) Appliance Repairs

3) Electrical Work

4) Plumbing Services

5) Heat/Air Conditioning Repairs (for work not covered by contract)

6) Overhead Door Repairs

7) Upholstery

B. Before obtaining these services, the department/division must obtain an authorization number from the

Financial Services Division.

C. Authorization numbers are issued only for repair of current equipment.

D. After the repairs have been completed, the department/division must inform the Financial Services

Division of the costs incurred.

E. The authorization number must be listed on the requisition.

Appendix H

Budget Transfers

Transfers of funds within budgeted accounts may be made using controlled Internal Transfer forms

obtained from Financial Services. The following procedures must be followed to transfer appropriated

budgeted amounts:

A. All transfers must be signed by the department/division director and the Financial Services Director.

B. The City, Manager will sign:

1) Any transfers out of the personnel services (100 series) accounts.

2) All transfers within the capital outlay (300 series) accounts for the purchase of items not

previously budgeted.

3) Any transfer over $10,000.00.

4) Transfers between statutory accounts, such as 100 series to 200 series, etc.

C. Transfers from one department to another department will be made pursuant to the current year Budget

Resolution.

D. Transmittal letters are not required to accompany a transfer form. However, in the reason for transfer

section, a brief description must explain the need for the funds going to the transfer-in account and the

reason funds are not required in the transfer-out account.

Appendix I

Extension of Contracts

Requirement contracts are bid for one (1) year, with the possibility of renewal for two (2) further years.

The following procedures shall be followed to extend an existing contract.

A. Approximately ninety (90) days before expiration date, the Financial Services Division will notify the

department/division director(s) of the expiration date and request their recommendation in writing on

whether to renew the contract. All recommendations must be signed or initialed by the

department/division director or assistant director.

l. If the department/division reply is affirmative, Financial Services will notify the vendor in writing

and request that the contract be extended. If the vendor agrees, a contract renewal form is signed and

returned by the vendor. If the vendor declines, Financial Services will advise the department/division

and get direction on how to proceed with the bid process.

2. If the department/division reply is negative, specific reasons for dissatisfaction with the contract must

be outlined in the department/division's reply. It is the responsibility, of the department/division to

notify' Financial Services on whether to proceed with any new bid solicitations.

3. For all contracts that are going out for the bid solicitation, instructions are provided in Appendix C,

Specifications, and Appendix D, Formal Bid Processing.

B. For contracts that are being extended, Financial Services will prepare an agenda item and contract

extension request for review by the City Attorney's office and ultimately submit it to the City Council. If

the extension is approved by City Council, the contract extension form is signed and copies are sent to the

department/division and to the vendor.

ATTACHMENTS - Appendix A-I, Figure 1

Sole Source Request

(to be submitted on Department letterhead)

MEMORANDUM

TO: Financial Services Division

THRU:

FROM:

SUBJECT:Sole Source Request

DATE:

Request that be accepted as a sole source provider for the

goods/services on the enclosed requisition. The goods/services requested are very specialized or a type of

acquired expertise is needed.

These goods/services will be used for the following:

A copy of the specifications for the goods/services is provided with this request.

To the best of my knowledge, is the only vendor that can provide these

goods/services. The goods/services must be obtained from this vendor for the following reasons:

The following is a brief description of all efforts which were made to determine if the goods/services are

available from our sources:

I understand that no city funds may be obligated for the goods/services until a determination is made on

this request. This department has not committed to purchasing these goods/services.

ATTACHMENTS - Appendix A-I, Figure 2

Form FN 528 (Gold Sheet)

REQUEST FOR BIDS

(FOR PURCHASES OF $ 50,000.01 AND OVER )

REQUEST FOR PROPOSALS

TO: Financial Services DATE:

FROM: (DEPARTMENT)

(DIVISION)

1. ITEM DESCRIPTION :

(POINT OF CONTACT)

2. BUDGETED :

Yes Amount Budgeted

No Estimated Amount

3. TYPE OF CONTRACT :

One-time Purchase ( Attach copy of the requisition)

Requirements Contract

4. PREVIOUSLY APPROVED SPECIFICATIONS:

Yes Specifications Number & Date Approved:

No Attach a copy of detailed specification for item in correct format.

Account

Attach Copy of Approved Transfer Request

Number

5. KNOWN SOURCES OF SUPPLY : (Include all sources which have bid on similar items within the

preceding three (3) years.)

FIRM.: ADDRESS.

6. COMMENTS:

Division Supervisor Department Director

ATTACHMENTS - Appendix A-I, Figure 3

Form 36-002 Contract Change Order pg. 1

CITY OF LAWTON, OKLAHOMA

Finance Department, Financial Services

Contract Change Order

DATE:

TO:

The City of Lawton

awarded contract.

Contract #:

Contract Name:

Change Order No.

and the above named vendor agree to the following changes in the previously

JUSTIFICATION FOR CHANGE

1. Specific items changed:

2. Necessity for change:

3. Is proposed change an alternate bid?

(Please Circle Yes or No)

YES NO

4. Will this change affect expiration or amount of insurance

coverage? (Please Circle Yes or No) YES NO

Change in contract price due to this Change Order:

Total decrease

Total increase

Difference between columns

$

$$

Net change in contract price (Please Check One)

INCREASE DECREASE NO CHANGE

The sum of is hereby (Please Circle One) ADDED to DEDUCTED from the total

contract price, and the total adjusted contract price, for this vendor, to date thereby is

(Please Check One) INCREASED DECREASED NO CHANGE

FM 36-002 (July 96)

ATTACHMENTS - Appendix A-I, Figure 3

Form 36-002 Contract Change Order pg. 2

CONTRACT CHANGE ORDER (CONT)

The time provided for completion in

One) UNCHANGED, INCREASED, DECREASED by

all provisions of the contract will apply hereto.

Department approval:

the contract is (Please Check

calendar days. This document and

Date:

Typed/Printed Name

Purchasing Division Review: Date:

, Financial Services Supervisor

Typed/Printed Name

AFFIDAVIT:

STATE OF COUNTY OF

says that:

.(name of affiant), of lawful age, being first duly sworn, on oath

1. Affiant is the duly authorized agent of the vendor awarded this contract and executing the above change

order, and that as such agent Affiant has the authority to bind the vendor, whether an individual,

partnership, or corporation, for the purpose of negotiating, altering and entering into said agreement, and for

certifying the facts pertaining to the existence of collusion among vendors and City officials or employees, as

well as facts pertaining to the giving or offering of things of value to government personnel in return for

special consideration in the letting or modifying of any contract entered to which this statement is attached; 2.

Affiant is fully aware of the facts and circumstances surrounding the making of the agreement and/or the

procurement of the contract to which this statement is attached and has been personally and directly involved

in the proceedings leading to the entry into such agreement; 3. Neither the vendor nor anyone subject to the

vendor' s direction or control has been a party: a. to any collusion among vendors in restraint of freedom of

competition by agreement to bid at a fixed price or to refrain from modifying this agreement; b. to any

collusion which any municipal official or employee as to quantity, quality or price in the contract, or as to any

other terms of such contract; c. in any discussions between vendors and any municipal official concerning

exchange of money or other thing of value for special consideration in the letting or modification of a

contract; nor d. to paying, giving or donating or agreeing to pay, give or donate to any officer or employee of

the City of Lawton, any money or other thing of value, either directly or indirectly, in procuring the contract

modification which his statement is attached. 4. Affiant further agrees to be held personally liable in the event

that Affiant has misrepresented the scope or extend of Affiant' s authority to bind the vendor herein, and to

indemni• and hold harmless the City of Lawton, its departments, boards, commissions, agencies, institutions,

and all employees of the aforementioned from all damages based upon such misrepresentation, including but

not limited to all costs and attorney fees incurred, in addition to any other remedies available by law.

Firm: SIGNATURE OF AUTHORIZED AGENT

Address:

PRINT/TYPE NAME/TITLE

(City, State, Zip) Subscribed & sworn before me this

,20

Phone:

Notary Public

My Commission Expires:

day of

CITY APPROVAL

ATTACHMENTS - Appendix A-I, Figure 3

Form 36-002 Contract Change Order pg. 3

The City of Lawton, Oklahoma,

a Municipal Corporation

ATTEST:

MAYOR

City Clerk

LEGAL REVIEW

APPROVED as to form and legality on behalf of the City of Lawton on the

,20

day of

CITY ATTORNEY

ENCUMBERING OFFICER REVIEW

I hereby certify, that the amount of this encumbrance has been entered against the designated

appropriation accounts and that this encumbrance is within the authorized available balance of said

appropriation.

Dated this day of ., 20

Encumbering Officer

ATTACHMENTS - Appendix A-I, Figure 4

Affidavit for Payment

AFFIDAVIT FOR CONTRACTS AND PAYMENTS $25,000 OR MORE

State of Oklahoma

County of

The undersigned (architect, contractor, supplier or engineer), of lawful age, being first duly sworn, on

oath says that this invoice or claim is true and correct. Affiant further states that the (work, services or

materials) as shown by this invoice or claim have been (completed or supplied) in accordance with the

plans, specifications, orders or requests furnished the affiant. Affiant further states that (s)he has made no

payment directly or indirectly to any elected official, officer or employee of the State of Oklahoma, any

count5r or local subdivision of the state, of money or any other thing of value to obtain payment of the

invoice or procure the contract or purchase order pursuant to which an invoice is required.

Business Name of Contractor, Architect,

Supplier or Engineer

BY:

Subscribed and sworn to before me this

Nota•' Public

(Seal)

My Commission Expires

day of ,20

Note: 62 Okla.St .Ann.:§ 310.9(B), Any county, municipality or school district executing a contract with

any architect, contractor, supplier or engineer for construction work, services or materials which are

needed on a continual basis from such architect, contractor, supplier or engineer under the terms of such

contract, or executing more than one contract during the fiscal year with such architect, contractor,

supplier or engineer, may require that the architect, contractor, supplier or engineer complete a signed

affidavit as provided for in subsection A of this section which shall apply to all work, services or

materials completed or supplied under the terms of the contract or contracts.