BRANDON TIDWELL
DOUG LANE
10820 N. Tidwell Rd., Bon Aqua, TN 37025
2059 Lake Dr., Centerville, TN 37033
PIPPA TAYLOR
6585 Oak Hill Rd., Lyles, TN 37098
COUNTY SCHOOLS
DR. CHRISTY MAYS
450 Hwy 50, Centerville, TN 37033
TIM HOBBS
9220 Old Bon Aqua Rd., Bon Aqua, TN 37025
JANE HERRON
PO Box 13, Nunnelly, TN 37137
DR. TABITHA CUDE
4141 Lewis Rd., Centerville, TN 37033
*
*
1807
Marcy Tidwell
Director of Schools
115 MURPHREE AVENUE
CENTERVILLE, TN 37033
REGULAR BOARD MEETING
Monday, June 1, 2026 6:30 PM
Central Office - Room 203
I. Call To Order
II. Public Comment
Citizens that would like an opportunity to speak to the Board of Education during public
comment should sign up on the sheet provided at the meeting location. Anyone desiring to
speak on any subject may speak for 3 minutes without prior school board notification. The
sign-up sheet will be available from 5:30 p.m. - 6:30 p.m.
III. Moment of Silence
IV. Pledge of Allegiance
V. Agenda for June 1, 2026
VI. Regular Meeting Minutes for May 4, 2026
VII. Special Called Session Meeting Minutes for May 7, 2026
VIII. Special Called Session Meeting Minutes for May 21, 2026
IX. Special Recognition
A. Employee of the Year
B. Friend of Education
X. Consent Agenda Items
A. Board Chair's Report
1. Chair's Countersigned Warrants
B. Personnel Report
C. Financial Report
D. Attendance Report
E. Family Resource Centers End of Year Reports
XI. Items Requiring Board Action
A. EHHS Football Overnight Camp - On Campus
B. Approve Change Order - EHHS CTE Building
C. Approve RJ Young SMP/Maintenance Agreement
D. Approve Bids for Maintenance Department
1. Flooring
2. Fire Alarm Monitoring/Service Repair and Equipment Replacement
3. Epoxy Floor Coating
4. Annual Paving and Patching
5. Annual Sealing and Striping
6. Concrete Pouring at Schools
7. Gym Floor Services
8. HVAC Replacement, Repair and Annual Services
9. Painting at Schools
E. Proposed School Board Meeting Dates for 2026-2027
F. Annual Agenda for 2026-2027
G. Approve CIS Job Shares for 2026-2027
H. Resolution to Grant Authority to Designate Reserves
I. Grant Executive Committee Authority to Close Out Fiscal Year
J. 2026-2027 Differentiated Pay Plan
K. TSSE Membership Dues
L. OPEB Resolution 26-03
M. Board Policies Review - 3.200--3.212
N. Budget Amendments
O. Budgets for 2026-2027
P. Capitol Projects 2026-2027
XII. Student Recognition for Dane Gilbert
XIII. Announcements
A. Regular Board Meeting for July 6, 2026 (pending approval of 26-27 Board Meeting
Dates)
B. Discuss Dates for Board Retreat/Training Regarding Strategic Plan
XIV. Closing Comments
A. Legislative Representative
B. Board Chair, Board Members and Director of Schools
XV. Adjourn
Doug Lane
HOMELAND COUNTY SCHOOLS
Dr. Christy Mays
2059 Lake Drive, Centerville, TN 37033
450 Hwy. 50, Centerville, TN 37033
Pippa Taylor
Brandon Tidwell
6585 Oak Hill Rd,, Lyles, TN 37098
10820 N. Tidwell Rd., Bon Aqua, TN 37025
1807
Tim Hobbs
Jane Herron
9220 Old Bon Aqua Rd., Bon Aqua, TN 37025
PO Box 13, Nunnelly, TN 37137
Marcy Tidwell
Dr. Tabitha Cude
Director of Schools
4141 Lewis Rd., Centerville, TN 37033
115 MURPHREE AVENUE
CENTERVILLE, TN 37033
The Hickman County Board of Education will meet in regular session on Monday, June 1, 2026 at
6:30 p.m. in Room 203 of the Central Office complex.
I.
Call to Order
II.
Public Comment
Citizens that would like an opportunity to speak to the Board of Education during public
comment should sign up on the sheet provided at the meeting location. Anyone desiring to
speak on any subject may speak for 3 minutes without prior school board notification. The
sign-up sheet will be available from 5:30 p.m. - 6:30 p.m.
III.
Moment of Silence
IV.
Pledge of Allegiance
V.
Agenda for June 1, 2026
VI.
Regular Meeting Minutes for May 4, 2026
VII.
Special Called Session Meeting Minutes for May 7, 2026
VIII. Special Called Session Meeting Minutes for May 21, 2026
IX. Special Recognitions
A. Employee of the Year-Pippa Taylor
B. Friend of Education-Director of Schools
X. Consent Agenda Items
A. Board Chair's Report
1. Chair's Countersigned Warrants
B. Personnel Report
C. Financial Report
D. Attendance Report
E. Family Resource Centers End of Year Reports
XI. Items Requiring Board Action
A. EHHS Football Overnight Camp - On Campus-Coach and Players
B. Approve Change Order for EHHS CTE Building-Derek Newsom
C. Approve RJ Young SMP/Maintenance Agreement-Derek Newsom
D. Approve Bids for Maintenance Department-Tanya Williams
1. Flooring
2. Fire Alarm Monitoring/Service Repair and Equipment Replacement
3. Epoxy Floor Coating
4. Annual Paving and Patching
5. Annual Sealing and Striping
6. Concrete Pouring at Schools
7. Gym Floor Services
8. HVAC Replacement, Repair and Annual Services
9. Painting at Schools
E. Proposed School Board Meeting Dates for 2026-2027-Director of Schools
F. Annual Agenda for 2026-2027-Director of Schools
G. Approve CIS Job Shares for 2026-2027-Director of Schools
H. Resolution to Grant Authority to Designate Reserves-Director of Schools
I. Grant Executive Committee Authority to Close Out Fiscal Year-Director of Schools
J. 2026-2027 Differentiated Pay Plan-Director of Schools
K. TSSE Membership Dues-Director of Schools
L. OPEB Resolution 26-03-Business Officer
M. Board Policies Review-3.200-3.212-Misty Shelton
N. Budget Amendments-Business Officer
O. Budgets for 2026-2027
P. Capitol Projects 2026-2027
XII. Student Recognition for Dane Gilbert-Christy Mays
XIII. Announcements
A. Regular Board Meeting for July 6, 2026 (pending approval of 26-27 Board Meeting Dates)
B. Discuss Dates for Board Retreat/Training Regarding Strategic Plan
XIV. Closing Comments
A. Legislative Representative-Christy Mays
B. Board Chair, Board Members and Director of Schools
XV. Adjourn
HICKMAN COUNTY BOARD OF EDUCATION
REGULAR BOARD MEETING---May 4, 2026
The Hickman county Board of Education met on May 4, 2026, at 6:30 PM in
Hickman County High School Library.
Present: Tabitha Cude, Jane Herron, Tim Hobbs, Doug Lane, Christy Mays, Pippa
Taylor, Brandon Tidwell.
I. Call To Order
II. Public Comment
Citizens that would like an opportunity to speak to the Board of Education
during public comment should sign up on the sheet provided at the meeting
location. Anyone desiring to speak on any subject may speak for 3 minutes
without prior school board notification. The sign-up sheet will be available
from 5:30 p.m. - 6:30 p.m.
III. Moment of Silence
IV. Pledge of Allegiance
V. Agenda for May 4, 2026
Motion to approve the Agenda for May 4, 2026.
Motion made by Doug Lane.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
VI. Regular Meeting Minutes for April 13, 2026
Motion to approve the Regular Meeting Minutes for April 13, 2026.
Motion made by Jane Herron.
Motion seconded by Tabitha Cude.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
VII. Special Called Session Minutes for April 29, 2026
Motion to approve Special Called Session Minutes for April 29, 2026.
Motion made by Tabitha Cude.
HICKMAN COUNTY BOARD OF EDUCATION
REGULAR BOARD MEETING---May 4, 2026
Motion seconded by Brandon Tidwell.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
VIII. Special Recognition
A. Employee of the Month
B. Student Board Representative Recognitions
C. Recognition of Students Scoring 29 or Above on the ACT
D. Building Teachers of the Year
1. EHES Teacher of the Year
2. EHIS Teacher of the Year
3. EHMS Teacher of the Year
4. EHHS Teacher of the Year
5. CES Teacher of the Year
6. CIS Teacher of the Year
7. HCMS Teacher of the Year
8. HCHS Teacher of the Year
E. Novice School Teachers of the Year
1. EHES Novice School Teacher of the Year
2. CES Novice School Teacher of the Year
3. EHHS Novice School Teacher of the Year
4. CIS Novice School Teacher of the Year
5. HCHS Novice School Teacher of the Year
F. Novice District Level Teachers of the Year
1. Grades Pre-K - 4
2. Grades 9-12
G. District Teachers of the Year
1. Grades Pre-K - 4
2. Grades 5-8
3. Grades 9-12
HICKMAN COUNTY BOARD OF EDUCATION
REGULAR BOARD MEETING- May 4, 2026
H. Leaders of the Year
1. Principal of the Year
2. Supervisor of the Year
IX. Consent Agenda Items
Motion to approve Consent Agenda Items.
Motion made by Doug Lane.
Motion seconded by Tabitha Cude.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
A. Board Chair's Report
1. Chair's Countersigned Warrants
B. Personnel Report
C. Financial Report
D. Attendance Report
X. Items Requiring Board Action
A. Trip Request
1. HCHS JROTC
Motion to approve HCHS JROTC cadet leadership challenge.
Motion made by Tabitha Cude.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
2. HCMS Boys' Basketball
Motion to approve HCMS Boys' Basketball camp.
Motion made by Christy Mays.
Motion seconded by Jane Herron.
Motion Result: Passed
HICKMAN COUNTY BOARD OF EDUCATION
REGULAR BOARD MEETING---May 4, 2026
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
3. HCHS Girls' Basketball
Motion to approve HCHS Girls' Basketball overnight trips.
Motion made by Tabitha Cude.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
B. Textbook Adoption
Motion to approve Textbook Adoption for schedule E (Computer Science, Health
and Wellness, CTE blanket adoption) ELA 3 year gap adoption. K-2, Wonders -
Sounds First - Amplify CKLA Skills Workbook. 3-5, Wit and Wisdom. 6-8, 9-12
My Perspectives.
Motion made by Jane Herron.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
C. Budget Amendments
Motion to approve Budget Amendments 33, 34 & 35.
Motion made by Doug Lane.
Motion seconded by Brandon Tidwell.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
HICKMAN COUNTY BOARD OF EDUCATION
REGULAR BOARD MEETING---May 4, 2026
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
D. OPEB
Motion to approve Option 2 for OPEB.
Motion made by Doug Lane.
Motion seconded by Jane Herron.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
E. Budget for FY27 (141, 143)
Motion to approve the agenda by Cude then Mays then 2 amendments Motion to
amend the Budget for FY 27 (141, 143) from 13 cents to 8 cents with a
separate presentation for the capitol outlay projects
with a separate presentation for the capitol outlay projects.
Motion made by Tabitha Cude.
Motion seconded by Christy Mays.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
Motion to amend the Budget for FY 27 (141) from 13 cents to 8 cents.
Motion made by Jane Herron.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
HICKMAN COUNTY BOARD OF EDUCATION
REGULAR BOARD MEETING---May 4, 2026
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
with a separate presentation for the capitol outlay projects.
Motion made by Jane Herron.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
Motion to approve budget 143.
Motion made by Doug Lane.
Motion seconded by Tabitha Cude.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
F. Board Policies
1. Revised Board Policies 1.804, 2.400, 5.114, 5.1151, 5.200, 5.201,
5.202, 5.302, 5.400, 5.403, 5.606, New 5.608, 5.800, 6.411 (2nd Reading)
Motion to approve revised board policies 1.804, 2.400, 5.114, 5.1151,
5.200, 5.201, 5.202, 5.302, 5.400, 5.403, 5.606, New 5.608, 5.800, 6.411
(2nd Reading).
Motion made by Doug Lane.
Motion seconded by Christy Mays.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
2. Board Policies Review 2.800--2.900
HICKMAN COUNTY BOARD OF EDUCATION
REGULAR BOARD MEETING May 4, 2026
Motion to approve Board Policies Review 2.800--2.900.
Motion made by Jane Herron.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
XI. Announcements
A. Regular Board Meeting for June 1, 2026
B. Director's Evaluation and Board Self-Evaluation
C. School Budget Presentation to County Legislative Body - May 7, 2026 5:30
p.m.
D. TSBA Fall District Meeting - September 17, 2026 - Lawrence County
(E.O. Coffman Middle School)
XII. Closing Comments
A. Legislative Representative
B. Board Chair, Board Members, Student Representatives and Interim Director
of Schools
XIII. Adjourn
Motion to adjourn.
Motion made by Tabitha Cude.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Yea
Jane Herron:
Yea
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 7, Nay: 0
HICKMAN COUNTY BOARD OF EDUCATION
SPECIAL CALLED BOARD MEETING---May 7, 2026
The Hickman county Board of Education met on May 7, 2026, at 7:00 PM in
Central Office - Room 203.
Present: Jane Herron, Tim Hobbs, Pippa Taylor, Brandon Tidwell, Absent:
Tabitha Cude, Doug Lane, Christy Mays.
I. Call To Order
II. Moment of Silence
III. Pledge of Allegiance
IV. Agenda for May 7, 2026
Motion to approve the Agenda for May 7, 2026.
Motion made by Jane Herron.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Absent
Doug Lane:
Absent
Christy Mays:
Absent
Jane Herron:
Yea
Tim Hobbs:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 4, Nay: 0, Absent: 3
V. Items Requiring Board Action
A. FY27 Budget
Amend the motion according to the expenditure increase and decrease.
Motion made by Jane Herron.
Motion seconded by Brandon Tidwell.
Motion Result: Passed
Tabitha Cude:
Absent
Doug Lane:
Absent
Christy Mays:
Absent
Jane Herron:
Yea
Tim Hobbs:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 4, Nay: 0, Absent: 3
Amend the motion according to the expenditure increase and decrease.
Motion made by Jane Herron.
Motion Result: Passed
Tabitha Cude:
Absent
Doug Lane:
Absent
Christy Mays:
Absent
HICKMAN COUNTY BOARD OF EDUCATION
SPECIAL CALLED BOARD MEETING---May 7, 2026
Jane Herron:
Yea
Tim Hobbs:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 4, Nay: 0, Absent: 3
VI. Adjourn
Motion to adjourn.
Motion made by Jane Herron.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Absent
Doug Lane:
Absent
Christy Mays:
Absent
Jane Herron:
Yea
Tim Hobbs:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 4, Nay: 0, Absent: 3
HICKMAN COUNTY BOARD OF EDUCATION
SPECIAL CALLED BOARD MEETING---May 21, 2026
The Hickman county Board of Education met on May 21, 2026, at 6:30 PM in
Central Office - Room 203.
Present: Tim Hobbs, Doug Lane, Christy Mays, Pippa Taylor, Brandon Tidwell,
Absent: Tabitha Cude, Jane Herron.
I. Call To Order
II. Moment of Silence
III. Pledge of Allegiance
IV. Agenda for May 21, 2026
Motion to approve the May 21, 2026.
Motion made by Doug Lane.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Absent
Jane Herron:
Absent
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 5, Nay: 0, Absent: 2
V. Items Requiring Board Action
A. FY27 Budget
Motion to accept FY27 Budget at 2 cents with $405,000 capital outlay.
Motion made by Doug Lane.
Motion Result: Unseconded
Motion to increase to 4 cents with $405,000 capital outlay.
Motion made by Tim Hobbs.
Motion seconded by Brandon Tidwell.
Motion Result: Passed
Tabitha Cude:
Absent
Jane Herron:
Absent
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 5, Nay: 0, Absent: 2
Motion to move the sales tax estimate to 3.1 million for FY27.
Motion made by Brandon Tidwell.
Motion seconded by Tim Hobbs.
Motion Result: Passed
Tabitha Cude:
Absent
HICKMAN COUNTY BOARD OF EDUCATION
SPECIAL CALLED BOARD MEETING---May 21, 2026
Jane Herron:
Absent
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 5, Nay: 0, Absent: 2
VI. Adjourn
Motion to adjourn.
Motion made by Doug Lane.
Motion seconded by Pippa Taylor.
Motion Result: Passed
Tabitha Cude:
Absent
Jane Herron:
Absent
Tim Hobbs:
Yea
Doug Lane:
Yea
Christy Mays:
Yea
Pippa Taylor:
Yea
Brandon Tidwell:
Yea
Yea: 5, Nay: 0, Absent: 2
Date/Time: 4/30/2026 11:29 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004689
A Dirty Job
665
04/30/2026
141- -11140
$7,000.00
41004690
Amazon
727
04/30/2026
141- -11140
$61.89
41004691
EAI Education
7657
04/30/2026
141- -11140
$380.98
41004692
Everon FKA ADT Commercial
7196
04/30/2026
141- -11140
$1,900.92
41004693
Josh Houstion & associates, Inc.
7413
04/30/2026
141- -11140
$75.75
41004694
Kelley Designs
9287
04/30/2026
141- -11140
$170.00
41004695
Owen's Oil Co., Inc.
4257
04/30/2026
141- -11140
$879.20
41004696
Scholastic, Inc.
4871
04/30/2026
141- -11140
$5,608.00
41004697
Southern Rock Restaurant, LLC
7603
04/30/2026
141- -11140
$197.29
41004698
Teacher Created Resources
10
04/30/2026
141- -11140
$182.79
41004699
Teacher Direct
5359
04/30/2026
141- -11140
$117.31
41004700
The Dreaded Lawncare
7933
04/30/2026
141- -11140
$8,600.00
41004701
Town Of Centerville
5315
04/30/2026
141- -11140
$733.39
41004702
TreviPay-Walmart
8999
04/30/2026
141- -11140
$279.43
141 Total:
$26,186.95
Bank Total:
$26,186.95
Bank Payment Count:
14
Date/Time: 4/30/2026 10:29 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date Cash Account
Amount
42001153
Quill, LLC
4574
04/30/2026
142-101-11140
$614.92
142-101 Total:
$614.92
42001152
Amazon
727
04/30/2026
142-201-11140
$1,673.86
142-201 Total:
$1,673.86
Bank Total:
$2,288.78
Bank Payment Count:
2
Date/Time:
5/4/2026 11:35 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004703
Bennett & DeCamp PLLC
8071
05/04/2026
141- -11140
$1,058.00
41004704
Bon Aqua Lyles Utility Distric
851
05/04/2026
141- -11140
$5,681.23
41004705
Wilson, Brett
8602
05/04/2026
141- -11140
$718.86
41004706
Lambert, Christopher
8802
05/04/2026
141- -11140
$2,396.20
41004707
County Of Hickman Misc Acct
1633
05/04/2026
141- -11140
$58,222.29
41004708
Edupoint Educational Systems,
9294
05/04/2026
141- -11140
$9,401.46
LLC
41004709
Estes, Kimberly
8197
05/04/2026
141- -11140
$958.48
41004710
Floyd, Mason
8798
05/04/2026
141- -11140
$1,437.72
41004711
Fundraiser Blankets
9254
05/04/2026
141- -11140
$6,875.00
41004712
Gilliam, Robin M.
7647
05/04/2026
141- -11140
$6,709.36
41004713
Gordon, Annie Martin
9189
05/04/2026
141- -11140
$1,677.34
41004714
Gordon, Wendell
2484
05/04/2026
141- -11140
$6,230.12
41004715
Hinson, Aric D.
7648
05/04/2026
141- -11140
$1,677.34
41004716
McManus, Christy
8120
05/04/2026
141- -11140
$370.77
41004717
Owen's Oil Co., Inc.
4257
05/04/2026
141- -11140
$27,457.04
41004718
Paczkowski, Hannah
9295
05/04/2026
141- -11140
$2,191.24
41004719
Ragan, Ray
4749
05/04/2026
141- -11140
$3,354.68
41004720
Barnhill, Samantha
8601
05/04/2026
141- -11140
$1,198.10
41004721
Smith, Kelvin Jefferson II
5270
05/04/2026
141- -11140
$1,677.34
41004722
Southern Rock Restaurant, LLC
7603
05/04/2026
141- -11140
$132.39
41004723
SSC Service Solutions
4832
05/04/2026
141- -11140
$61,838.58
Compass Group USA, Inc.
41004724
Tennessee School Board Assoc.
61
05/04/2026
141- -11140
$75.00
41004725
Tennessee School Resource
8571
05/04/2026
141- -11140
$250.00
Officer Assoc.
41004726
Overby, Tia
8632
05/04/2026
141- -11140
$718.86
41004727
Town Of Centerville
5315
05/04/2026
141- -11140
$1,900.56
41004728
United States Treasury
5817
05/04/2026
141- -11140
$363.03
41004729
Whitaker, Wesley
7554
05/04/2026
141- -11140
$220.40
141 Total:
$204,791.39
Bank Total:
$204,791.39
Bank Payment Count:
27
Date/Time:
5/4/2026 11:39 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date Cash Account
Amount
42001155
Mayberry, Kimberly D.
4108
05/04/2026
142-010-11140
$117.45
142-010 Total:
$117.45
42001154
County Of Hickman Misc Acct
1633
05/04/2026
142-901-11140
$390.19
142-901 Total:
$390.19
Bank Total:
$507.64
Bank Payment Count:
2
Date/Time: 5/6/2026 10:45 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004730
Collins, Cailey
1503
05/06/2026
141- -11140
$3,354.68
41004731
Campbell, Rebecca L.
9298
05/06/2026
141- -11140
$1,437.72
41004732
County Of Hickman Misc Acct
1633
05/06/2026
141- -11140
$204,557.84
41004733
Smith, Crissy
9308
05/06/2026
141- -11140
$1,437.72
41004734
Hickman County Trustee
2937
05/06/2026
141- -11140
$5,903.57
41004735
Fink, Andrew J.
9310
05/06/2026
141- -11140
$2,396.20
41004736
Moss, Jason
9299
05/06/2026
141- -11140
$1,437.72
41004737
Gribbins, Tatum
9029
05/06/2026
141- -11140
$1,677.34
141 Total:
$222,202.79
Bank Total:
$222,202.79
Bank Payment Count:
8
Date/Time:
5/6/2026 10:49 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
42001156
County Of Hickman Misc Acct
1633
05/06/2026
142-010-11140
$399.81
142-010 Total:
$399.81
42001156
County Of Hickman Misc Acct
1633
05/06/2026
142-101-11140
$2,443.30
142-101 Total:
$2,443.30
42001156
County Of Hickman Misc Acct
1633
05/06/2026
142-170-11140
$367.36
142-170 Total:
$367.36
42001156
County Of Hickman Misc Acct
1633
05/06/2026
142-201-11140
$303.60
142-201 Total:
$303.60
42001156
County Of Hickman Misc Acct
1633
05/06/2026
142-601-11140
$118.51
142-601 Total:
$118.51
42001156
County Of Hickman Misc Acct
1633
05/06/2026
142-901-11140
$1,033.33
142-901 Total:
$1,033.33
Bank Total:
$4,665.91
Bank Payment Count:
1
Date/Time:
5/6/2026 10:53 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Cafeteria
143
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
43000783
County Of Hickman Misc Acct
1633
05/06/2026
143- -11140
$10,552.56
43000784
Town Of Centerville
5315
05/06/2026
143- -11140
$134.87
143 Total:
$10,687.43
Bank Total:
$10,687.43
Bank Payment Count:
2
Date/Time: 5/7/2026 10:50 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004738
Becker's School Supplies
951
05/07/2026
141- -11140
$164.96
41004739
Brewer Chemicals & Equip, LLC
861
05/07/2026
141- -11140
$420.00
41004740
Brewer, Robert G.
7665
05/07/2026
141- -11140
$150.80
41004741
Buchanan, Amanda
920
05/07/2026
141- -11140
$110.50
41004742
Carson Dellosa Publishing LLC
1327
05/07/2026
141- -11140
$194.65
41004743
Cross, Emily
1744
05/07/2026
141- -11140
$220.40
41004744
Dex Imaging & Mailing
1912
05/07/2026
141- -11140
$651.97
41004745
ESGI, LLC
2261
05/07/2026
141- -11140
$1,040.00
41004746
Suits Me Fine Farm
6330
05/07/2026
141- -11140
$2,200.00
41004747
Green, Ben
2652
05/07/2026
141- -11140
$1,437.72
41004748
Hand 2 Mind, Inc.
2108
05/07/2026
141- -11140
$46.98
41004749
Meriwether Lewis Electric Coop.
3694
05/07/2026
141- -11140
$43,852.76
41004750
ODP Business Solutions, LLC
4261
05/07/2026
141- -11140
$350.09
41004751
Oriental Trading Co., Inc.
6258
05/07/2026
141- -11140
$709.79
41004752
Quill, LLC
4574
05/07/2026
141- -11140
$226.15
41004753
Really Good Stuff, LLC
4606
05/07/2026
141- -11140
$215.00
41004754
Tanner, Katelyn
6315
05/07/2026
141- -11140
$34.80
41004755
Teacher Direct
5359
05/07/2026
141- -11140
$121.74
141 Total:
$52,148.31
Bank Total:
$52,148.31
Bank Payment Count:
18
Date/Time:
5/7/2026 10:56 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
42001157
Amazon
727
05/07/2026
142-101-11140
$5,091.42
42001159
Mcc Nashville
1836
05/07/2026
142-101-11140
$1,469.00
142-101 Total:
$6,560.42
42001158
Turpin, Jennifer
5444
05/07/2026
142-801-11140
$743.55
142-801 Total:
$743.55
Bank Total:
$7,303.97
Bank Payment Count:
3
Date/Time:
5/7/2026 11:19 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Cafeteria
143
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
43000785
Gordon Food Service, Inc.
2488
05/07/2026
143- -11140
$92,611.85
43000786
Murfreesboro Pure Milk Co, Inc.
7552
05/07/2026
143- -11140
$2,661.60
43000787
Optimus Pest Solutions
47
05/07/2026
143- -11140
$240.00
43000788
Pepsi Cola
6726
05/07/2026
143- -11140
$2,594.00
43000789
Prairie Farms Dairy
18
05/07/2026
143- -11140
$18,585.36
43000790
Prince Hardware, LLC
4321
05/07/2026
143- -11140
$440.75
43000791
Quill Corporation
4573
05/07/2026
143- -11140
$992.93
43000792
Volco
5841
05/07/2026
143- -11140
$597.10
143 Total:
$118,723.59
Bank Total:
$118,723.59
Bank Payment Count:
8
Date/Time: 5/11/2026 11:31 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 2
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004756
Ace Hardware
635
05/11/2026
141- -11140
$511.01
41004757
Amazon
727
05/11/2026
141- -11140
$139.98
41004758
AT & T
7542
05/11/2026
141- -11140
$219.61
41004759
Buchanan, Shannon
1164
05/11/2026
141- -11140
$110.50
41004760
Carson Dellosa Publishing LLC
1327
05/11/2026
141- -11140
$17.94
41004761
Central States Bus Sales, Inc.
1326
05/11/2026
141- -11140
$2,664.09
41004762
CNB Computers USA, Inc.
6586
05/11/2026
141- -11140
$349.00
41004763
Constructive Playthings
1303
05/11/2026
141- -11140
$108.71
41004764
County Of Hickman Misc Acct
1633
05/11/2026
141- -11140
$7,611.91
41004765
Dean Oil Co., Inc.
1985
05/11/2026
141- -11140
$4,846.98
41004766
Don Kennedy Roofing Co., Inc.
6673
05/11/2026
141- -11140
$715.00
41004767
Duley, L.C.S.W., Joe
1814
05/11/2026
141- -11140
$1,625.00
41004768
Dunlap, Marcus
8955
05/11/2026
141- -11140
$173.57
41004769
Freeman Lumber & Supply
2325
05/11/2026
141- -11140
$1,573.96
41004770
Gross, Debbie
2675
05/11/2026
141- -11140
$97.88
41004771
Hibbs, Polly
3038
05/11/2026
141- -11140
$46.40
41004772
Jenkins, Michelle Carol
7423
05/11/2026
141- -11140
$98.60
41004773
Karco Parts
3364
05/11/2026
141- -11140
$171.58
41004774
Kelsan, Inc.
3379
05/11/2026
141- -11140
$2,996.38
41004775
Lakeshore Learning
3463
05/11/2026
141- -11140
$1,376.21
41004776
Lumber Yard, The
3652
05/11/2026
141- -11140
$2,059.87
41004777
Main Street Emporium
7541
05/11/2026
141- -11140
$493.70
41004778
Mid-South Bus Center, Inc
3706
05/11/2026
141- -11140
$823.12
41004779
Monica Ogles PT
7756
05/11/2026
141- -11140
$4,328.50
41004780
O'Reilly Auto Parts
4265
05/11/2026
141- -11140
$919.77
41004781
Oriental Trading Co., Inc.
6258
05/11/2026
141- -11140
$399.61
41004782
Owen's Oil Co., Inc.
4257
05/11/2026
141- -11140
$2,224.32
41004783
Plumbmaster, Inc.
4379
05/11/2026
141- -11140
$63.45
41004784
Prince Hardware, LLC
4321
05/11/2026
141- -11140
$2,893.73
41004785
Quill Corporation
4573
05/11/2026
141- -11140
$33.30
41004786
Quill, LLC
4574
05/11/2026
141- -11140
$2,754.72
41004787
Republic Service, LLC #840
4739
05/11/2026
141- -11140
$203.67
41004788
Reynolds Electrical Contractors,
4621
05/11/2026
141- -11140
$2,590.00
Llc
41004789
Rietveld, Stephanie
993
05/11/2026
141- -11140
$1,750.00
41004790
Scholastic, Inc.
4871
05/11/2026
141- -11140
$276.76
41004791
Soliant Health, LLC
8569
05/11/2026
141- -11140
$2,091.75
41004792
SSC Service Solutions
4832
05/11/2026
141- -11140
$61,838.58
Compass Group USA, Inc.
41004793
State Of Tn Dept Of Labor
4824
05/11/2026
141- -11140
$110.00
41004794
State Systems, LLC
5242
05/11/2026
141- -11140
$3,444.46
41004795
The King's Daughter's School
7928
05/11/2026
141- -11140
$5,250.00
41004796
Unifirst Corp.
5758
05/11/2026
141- -11140
$754.68
141 Total:
$120,758.30
Bank Total:
$120,758.30
Date/Time: 5/11/2026 11:31 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 2 of 2
Bank Payment Count:
41
Date/Time: 5/11/2026 11:36 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date Cash Account
Amount
42001160
Cathey, Vince
9230
05/11/2026
142-101-11140
$435.00
142-101 Total:
$435.00
Bank Total:
$435.00
Bank Payment Count:
1
Date/Time: 5/14/2026 10:06 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004797
Benefits, Inc.
1195
05/14/2026
141- -11140
$2,161.32
41004798
Duley, L.C.S.W., Joe
1814
05/14/2026
141- -11140
$1,007.50
41004799
Everon FKA ADT Commercial
7196
05/14/2026
141- -11140
$396.00
41004800
Fellowship Construction
2295
05/14/2026
141- -11140
$137,470.13
41004801
First Farmers & Merchants Bank
8074
05/14/2026
141- -11140
$137,470.13
41004802
Harvill, Nancy
2758
05/14/2026
141- -11140
$4,715.90
41004803
Hickman Co Trustee
2722
05/14/2026
141- -11140
$256,303.79
41004804
Interpreters Unlimited, Inc.
6501
05/14/2026
141- -11140
$191.25
41004805
Jenkins, Michelle Carol
7423
05/14/2026
141- -11140
$98.60
41004806
Josh Houstion & associates, Inc.
7413
05/14/2026
141- -11140
$32.00
41004807
Lakeshore Learning
3463
05/14/2026
141- -11140
$619.84
41004808
Matrix Mechanical Solutions,
7974
05/14/2026
141- -11140
$13,393.45
LLC
41004809
Roman A/V, LLC.
7045
05/14/2026
141- -11140
$500.00
41004810
Scholastic, Inc
5880
05/14/2026
141- -11140
$830.28
41004811
School Specialty
1433
05/14/2026
141- -11140
$161.13
41004812
Sergeant Laboratories, Inc.
7631
05/14/2026
141- -11140
$17,637.69
41004813
Soliant Health, LLC
8569
05/14/2026
141- -11140
$2,091.75
41004814
Stellar Therapy Services, LLC
8260
05/14/2026
141- -11140
$8,330.00
41004815
Tennessee Bureau Of
5491
05/14/2026
141- -11140
$200.00
Investigation
41004816
Town Of Centerville
5315
05/14/2026
141- -11140
$12,607.04
41004817
Zayo Education
2141
05/14/2026
141- -11140
$2,075.55
141 Total:
$598,293.35
Bank Total:
$598,293.35
Bank Payment Count:
21
Date/Time: 5/14/2026 10:15 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
42001166
Hickman Co Trustee
2722
05/14/2026
142-010-11140
$150.20
42001168
Main Street Media
8777
05/14/2026
142-010-11140
$40.00
142-010 Total:
$190.20
42001161
Amazon
727
05/14/2026
142-101-11140
$5,942.82
42001165
Grassroots Workshops
9251
05/14/2026
142-101-11140
$1,327.50
42001166
Hickman Co Trustee
2722
05/14/2026
142-101-11140
$1,231.05
42001167
Josh Houstion & associates, Inc.
7413
05/14/2026
142-101-11140
$90.00
142-101 Total:
$8,591.37
42001166
Hickman Co Trustee
2722
05/14/2026
142-170-11140
$82.70
142-170 Total:
$82.70
42001166
Hickman Co Trustee
2722
05/14/2026
142-201-11140
$150.20
142-201 Total:
$150.20
42001162
East Hickman High School
2110
05/14/2026
142-801-11140
$1,345.50
42001163
East Hickman High School
2113
05/14/2026
142-801-11140
$3,561.72
42001164
East Hickman High School
2244
05/14/2026
142-801-11140
$1,900.50
42001166
Hickman Co Trustee
2722
05/14/2026
142-801-11140
$82.70
142-801 Total:
$6,890.42
42001166
Hickman Co Trustee
2722
05/14/2026
142-901-11140
$2,568.64
142-901 Total:
$2,568.64
42001166
Hickman Co Trustee
2722
05/14/2026
142-911-11140
$82.70
142-911 Total:
$82.70
Bank Total:
$18,556.23
Bank Payment Count:
8
Date/Time: 5/14/2026 10:19 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Cafeteria
143
Payment Number Vendor Name
Vendor ID
Payment Date Cash Account
Amount
43000793
Boehms, Charlotte
1209
05/14/2026 143- -11140
$505.10
143 Total:
$505.10
Bank Total:
$505.10
Bank Payment Count:
1
Date/Time: 5/18/2026 10:41 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004818
Anderson, Belinda
8051
05/18/2026
141- -11140
$386.28
41004819
AT&T
7542
05/18/2026
141- -11140
$65.48
41004820
B & E Electronics, Inc.
856
05/18/2026
141- -11140
$4,444.00
41004821
Crown Awards
7569
05/18/2026
141- -11140
$525.99
41004822
Dickson Electric System
1806
05/18/2026
141- -11140
$33,150.62
41004823
Dickson Medical Associates
2022
05/18/2026
141- -11140
$125.00
41004824
Ferrellgas
7446
05/18/2026
141- -11140
$1,819.56
41004825
Pace Analytical National
2230
05/18/2026
141- -11140
$378.00
41004826
Porter, Savannah
8555
05/18/2026
141- -11140
$240.00
41004827
Rj Young Company
4691
05/18/2026
141- -11140
$4,191.49
41004828
SSC Service Solutions
4832
05/18/2026
141- -11140
$7,250.00
Compass Group USA, Inc.
41004829
Virco, Inc.
5830
05/18/2026
141- -11140
$999.60
41004830
Walmart
5868
05/18/2026
141- -11140
$198.67
141 Total:
$53,774.69
Bank Total:
$53,774.69
Bank Payment Count:
13
Date/Time: 5/18/2026 10:53 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
42001170
Rj Young Company
4691
05/18/2026
142-010-11140
$254.12
142-010 Total:
$254.12
42001170
Rj Young Company
4691
05/18/2026
142-101-11140
$189.48
42001171
Cathey, Vince
9230
05/18/2026
142-101-11140
$282.75
142-101 Total:
$472.23
42001169
Amazon
727
05/18/2026
142-811-11140
$2,291.48
142-811 Total:
$2,291.48
42001170
Rj Young Company
4691
05/18/2026
142-901-11140
$200.06
142-901 Total:
$200.06
Bank Total:
$3,217.89
Bank Payment Count:
3
Date/Time: 5/18/2026 10:59 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Cafeteria
143
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
43000794
American Fidelity Assurance Co
636
05/18/2026
143- -11140
$1,358.99
43000795
Ameritas Life Insurance Corp.
7442
05/18/2026
143- -11140
$81.42
43000796
Beam Insurance Administrators
7435
05/18/2026
143- -11140
$428.41
LLC
43000797
Cracker Barrel
6218
05/18/2026
143- -11140
$487.96
43000798
Hickman Co Trustee
2722
05/18/2026
143- -11140
$1,790.02
43000799
Hickman County Trustee
2937
05/18/2026
143- -11140
$18,882.67
43000800
Rj Young Company
4691
05/18/2026
143- -11140
$336.83
43000801
Tennessee Farmers Life
5297
05/18/2026
143- -11140
$25.00
Insurance
143 Total:
$23,391.30
Bank Total:
$23,391.30
Bank Payment Count:
8
Date/Time: 5/19/2026 11:23 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date Cash Account
Amount
41004831
First Farmers & Merchants Bank
8074
05/19/2026
141- -11140
$7,235.27
41004832
Visa
8268
05/19/2026 141- -11140
$901.70
141 Total:
$8,136.97
Bank Total:
$8,136.97
Bank Payment Count:
2
Date/Time: 5/19/2026 11:26 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number Vendor Name
Vendor ID
Payment Date Cash Account
Amount
42001172 Visa
8268
05/19/2026 142-801-11140
$900.00
142-801 Total:
$900.00
Bank Total:
$900.00
Bank Payment Count:
1
Date/Time:
5/21/2026 1:06 PM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004833
Hickman Co Trustee
2722
05/21/2026
141- -11140
$1,050.00
41004834
Hickman County Trustee
2937
05/21/2026
141- -11140
$433,637.72
41004835
Metropolitan Life
3677
05/21/2026
141- -11140
$120.00
41004836
Tennessee Child Support
1312
05/21/2026
141- -11140
$791.00
Receipting Unit
41004837
Tennessee Farmers Life
5297
05/21/2026
141- -11140
$925.00
Insurance
141 Total:
$436,523.72
Bank Total:
$436,523.72
Bank Payment Count:
5
Date/Time: 5/21/2026 1:16 PM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
42001173
Hickman County Trustee
2937
05/21/2026
142-010-11140
$3,253.77
142-010 Total:
$3,253.77
42001173
Hickman County Trustee
2937
05/21/2026
142-101-11140
$10,983.39
142-101 Total:
$10,983.39
42001173
Hickman County Trustee
2937
05/21/2026
142-170-11140
$1,537.70
142-170 Total:
$1,537.70
42001173
Hickman County Trustee
2937
05/21/2026
142-201-11140
$1,627.47
142-201 Total:
$1,627.47
42001173
Hickman County Trustee
2937
05/21/2026
142-401-11140
$1,321.90
142-401 Total:
$1,321.90
42001173
Hickman County Trustee
2937
05/21/2026
142-601-11140
$1,447.01
142-601 Total:
$1,447.01
42001173
Hickman County Trustee
2937
05/21/2026
142-801-11140
$278.38
142-801 Total:
$278.38
42001173
Hickman County Trustee
2937
05/21/2026
142-901-11140
$11,846.49
42001174
Tennessee Farmers Life
5297
05/21/2026
142-901-11140
$30.00
Insurance
142-901 Total:
$11,876.49
42001173
Hickman County Trustee
2937
05/21/2026
142-911-11140
$255.94
142-911 Total:
$255.94
Bank Total:
$32,582.05
Bank Payment Count:
2
Date/Time: 5/22/2026 9:43 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
42001176
Ricketts, Aubrey
9248
05/22/2026
142-101-11140
$250.00
42001178
Campbell, Lauren
9247
05/22/2026
142-101-11140
$250.00
142-101 Total:
$500.00
42001175
Amazon
727
05/22/2026
142-811-11140
$2,678.94
142-811 Total:
$2,678.94
42001177
Gilliam, Dewanna Adaire
7760
05/22/2026
142-901-11140
$377.00
42001179
Wilson, Anita
7954
05/22/2026
142-901-11140
$1,152.00
142-901 Total:
$1,529.00
Bank Total:
$4,707.94
Bank Payment Count:
5
Date/Time:
5/22/2026 9:37 AM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004838
Allegra Print & Imaging
650
05/22/2026
141- -11140
$36.11
41004839
Amazon
727
05/22/2026
141- -11140
$2,986.70
41004840
AT & T
7542
05/22/2026
141- -11140
$362.50
41004841
Brewer, Robert G.
7665
05/22/2026
141- -11140
$150.80
41004842
Cashier's Office
1736
05/22/2026
141- -11140
$3,080.00
41004843
CNB Computers USA, Inc.
6586
05/22/2026
141- -11140
$99,450.00
41004844
Gallaher & Associates, Inc.
7285
05/22/2026
141- -11140
$4,065.00
41004845
Gross, Debbie
2675
05/22/2026
141- -11140
$59.09
41004846
Hickman Co Solid Waste Man.
2746
05/22/2026
141- -11140
$87.60
41004847
Hickman County High School
40
05/22/2026
141- -11140
$3,970.00
41004848
Kelsan, Inc.
3379
05/22/2026
141- -11140
$2,980.70
41004849
McCaleb, Rachel
7746
05/22/2026
141- -11140
$54.38
41004850
Burkheart, Michelle
9242
05/22/2026
141- -11140
$130.50
41004851
Oriental Trading Co., Inc.
6258
05/22/2026
141- -11140
$715.37
41004852
Osborne, Angie M.
4291
05/22/2026
141- -11140
$134.85
41004853
Pace Analytical National
2230
05/22/2026
141- -11140
$378.00
41004854
Quill
4576
05/22/2026
141- -11140
$84.94
41004855
Quill, LLC
4574
05/22/2026
141- -11140
$70.19
41004856
Republic Service, LLC #840
4739
05/22/2026
141- -11140
$4,439.12
41004857
School Specialty
1433
05/22/2026
141- -11140
$76.83
41004858
SSC Service Solutions
4832
05/22/2026
141- -11140
$19,200.00
Compass Group USA, Inc.
41004859
Herrera, Tammy
8538
05/22/2026
141- -11140
$75.40
41004860
Tanner, Katelyn
6315
05/22/2026
141- -11140
$49.30
41004861
Thermatec
5348
05/22/2026
141- -11140
$13,597.00
41004862
TreviPay-Walmart
8999
05/22/2026
141- -11140
$647.42
41004863
WNKX Hickman Digital Media,
3446
05/22/2026
141- -11140
$400.00
INC.
141 Total:
$157,281.80
Bank Total:
$157,281.80
Bank Payment Count:
26
Date/Time: 5/26/2026 12:06 PM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
General Purpose
141
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
41004864
Amazon
727
05/26/2026
141- -11140
$39.88
41004865
BELFOR Property Restoration,
8920
05/26/2026
141- -11140
$29,489.19
Inc.
41004866
County Of Hickman Misc Acct
1633
05/26/2026
141- -11140
$63,253.11
41004867
Carl, Delta
8469
05/26/2026
141- -11140
$155.00
41004868
Dunlap, Marcus
8955
05/26/2026
141- -11140
$96.57
41004869
EAI Education
7657
05/26/2026
141- -11140
$885.00
41004870
Hatton, Lynn
5923
05/26/2026
141- -11140
$84.50
41004871
Hibbs, Polly
3038
05/26/2026
141- -11140
$40.60
41004872
Hickman Co Trustee
2722
05/26/2026
141- -11140
$1,374.10
41004873
Jenkins, Michelle Carol
7423
05/26/2026
141- -11140
$75.40
41004874
Gordon, Joseph
9325
05/26/2026
141- -11140
$1,437.72
41004875
Lakeshore Learning
3463
05/26/2026
141- -11140
$1,733.74
41004876
Matrix Mechanical Solutions,
7974
05/26/2026
141- -11140
$6,189.45
LLC
41004877
Hanes, Michael
8284
05/26/2026
141- -11140
$390.50
41004878
Monica Ogles PT
7756
05/26/2026
141- -11140
$3,244.70
41004879
Optimus Pest Solutions
47
05/26/2026
141- -11140
$750.00
41004880
Shelton, Misty L.
375
05/26/2026
141- -11140
$92.80
41004881
Soliant Health, LLC
8569
05/26/2026
141- -11140
$3,974.33
41004882
Tennessee Book Company
5286
05/26/2026
141- -11140
$1,982.00
41004883
The Brook Center Therapy
8659
05/26/2026
141- -11140
$4,896.66
Solutions, LLC
41004884
Water Authority Of Dickson Co.
5874
05/26/2026
141- -11140
$2,298.00
141 Total:
$122,483.25
Bank Total:
$122,483.25
Bank Payment Count:
21
Date/Time: 5/26/2026 12:10 PM
Hickman County Finance
User:
Misty Weems
Payment Register By Account Control
Page 1 of 1
Bank Name
Bank Number
Federal
142
Payment Number
Vendor Name
Vendor ID
Payment Date
Cash Account
Amount
42001180
American Paper & Twine
797
05/26/2026
142-010-11140
$578.20
Company
42001182
Thomasson, Julia
192
05/26/2026
142-010-11140
$704.70
42001183
Mayberry, Kimberly D.
4108
05/26/2026
142-010-11140
$175.45
142-010 Total:
$1,458.35
42001184
TEK Industries, LLC
9239
05/26/2026
142-101-11140
$360.25
142-101 Total:
$360.25
42001181
County Of Hickman Misc Acct
1633
05/26/2026
142-401-11140
$20.00
142-401 Total:
$20.00
42001181
County Of Hickman Misc Acct
1633
05/26/2026
142-601-11140
$50.00
142-601 Total:
$50.00
42001181
County Of Hickman Misc Acct
1633
05/26/2026
142-901-11140
$390.19
142-901 Total:
$390.19
Bank Total:
$2,278.79
Bank Payment Count:
5
Doug Lane
2059 Lake Drive, Centerville, TN 37033
HOMELAND COUNTY SCHOOLS
Christy Mays
450 Hwy. 50, Centerville, TN 37033
Pippa Taylor
Brandon Tidwell
6585 Oak Hill Rd, Lyles, TN 37098
10820 N. Tidwell Rd., Bon Aqua, TN 37025
1807
TIM HOBBS
Jane Herron
9220 Old Bon Aqua Rd , Bon Aqua, TN 37025
PO Box 13, Nunnelly, TN 37137
Dr. Belinda Anderson
Tabitha Cude
Interim Director of Schools
4141 Lewis Rd., Centerville, TN 37033
115 MURPHREE AVENUE
CENTERVILLE, TN 37033
Memorandum
To:
Board Members
From:
Dr. Belinda Anderson
Date:
4/27/2026
Re:
May Personnel Report
Leave of Absence
Professional
Support Staff
Hiring
Professional
Support Staff
Resignation
Professional
Support Staff
Shelby Frizzell
EHIS Assistant
Jason Swaw
Bus Driver
Retirement
Professional
Support Staff
Transfers
Professional
Support Staff
Appointment
Professional
William (Billy) Sawyer
EHHS Head Football Coach
Support Staff
Harper Shelton
HCMS Girls' Golf Coach
Open Positions
www.hickmank12.org
Click On Employment Opportunities
*Denotes a relationship under board policy 1.108. Applicants are qualified for the positions
Template Name: LGC Summary
Hickman County Finance
User:
Michael Elkins
Created by:
LGC
Summary Financial Statement
Date/Time:
6/1/2026 10:18 AM
May 2026
Page 1 of 4
141
General Purpose School
Year-To-Date
Month-To-Date
Estimate
Account
Description
Budget Estimate
Actual
% of Budget
Avg/Mth
Actual
% of Avg
Revenues
40110
Current Property Tax
2,773,333.00
(2,861,438.85)
103.18%
231,111.08
0.00
0.00%
40120
Trustee's Collections - Prior Year
75,000.00
(64,181.33)
85.58%
6,250.00
0.00
0.00%
40125
Trustee's Collections - Bankruptcy
500.00
(49.96)
9.99%
41.67
0.00
0.00%
40130
Cir Clk/Clk & Master Collections-Pr Yr
40,000.00
(19,484.33)
48.71%
3,333.33
0.00
0.00%
40140
Interest And Penalty
15,000.00
(11,129.29)
74.20%
1,250.00
0.00
0.00%
40161
Payments In Lieu Of Taxes - T. V.A.
3,500.00
(2,085.91)
59.60%
291.67
0.00
0.00%
40162
Payments In Lieu Of Taxes-Local
6,000.00
(6,000.00)
100.00%
500.00
0.00
0.00%
40210
Local Option Sales Tax
2,975,000.00
(2,693,024.81)
90.52%
247,916.67
0.00
0.00%
40270
Business Tax
45,000.00
(16,680.75)
37.07%
3,750.00
0.00
0.00%
41110
Marriage Licenses
1,300.00
(1,054.50)
81.12%
108.33
0.00
0.00%
43570
Receipts From Individual Schools
30,000.00
(10,758.33)
35.86%
2,500.00
0.00
0.00%
43582
Community Service Fees - Adults
200.00
(11.57)
5.79%
16.67
0.00
0.00%
44120
Lease/Rentals/PPP
7,500.00
(1,685.00)
22.47%
625.00
0.00
0.00%
44170
Miscellaneous Refunds
30,000.00
(41,219.12)
137.40%
2,500.00
0.00
0.00%
44530
Sale Of Equipment
15,000.00
0.00
0.00%
1,250.00
0.00
0.00%
44560
Damages Recovered From Individuals
3,000.00
(360.00)
12.00%
250.00
0.00
0.00%
44570
Contributions & Gifts
20,000.00
(27,025.00)
135.13%
1,666.67
0.00
0.00%
44990
Other Local Revenues
30,000.00
0.00
0.00%
2,500.00
0.00
0.00%
46175
On-Behalf Contributions For OPEB
40,000.00
0.00
0.00%
3,333.33
0.00
0.00%
46510
Tennessee Investment in Student
25,081,234.00
(22,832,049.35)
91.03%
2,090,102.83
0.00
0.00%
46515
Early Childhood Education
445,000.00
(237,677.33)
53.41%
37,083.33
0.00
0.00%
46520
School Food Service
22,000.00
(16,839.13)
76.54%
1,833.33
0.00
0.00%
46550
Driver Education
10,000.00
(6,585.61)
65.86%
833.33
0.00
0.00%
46590
Other State Education Funds
818,936.60
(578,936.60)
70.69%
68,244.72
0.00
0.00%
46610
Career Ladder Program
37,500.00
(29,615.89)
78.98%
3,125.00
0.00
0.00%
46790
Other Vocational
1,660,665.59
(125,401.04)
7.55%
138,388.80
0.00
0.00%
46851
State Revenue Sharing -T.V.A.
220,000.00
(148,638.93)
67.56%
18,333.33
0.00
0.00%
46980
Other State Grants
59,525.19
0.00
0.00%
4,960.43
0.00
0.00%
46990
Other State Revenues
100,000.00
(216,790.55)
216.79%
8,333.33
0.00
0.00%
47143
Special Education - Grants To States
16,574.12
0.00
0.00%
1,381.18
0.00
0.00%
47640
Rotc Reimbursement
65,000.00
(48,287.26)
74.29%
5,416.67
0.00
0.00%
48990
Other
4,000.00
(36,856.17)
921.40%
333.33
0.00
0.00%
49700
Insurance Recovery
64,055.14
(70,594.97)
110.21%
5,337.93
0.00
0.00%
49800
Transfers In
10,000.00
0.00
0.00%
833.33
0.00
0.00%
Total
Revenues
34,724,823.64
(30,104,461.58)
86.69%
2,893,735.30
0.00
0.00%
Expenditures
71100
Regular Instruction Program
(17,320,800.60)
15,695,817.84
90.62%
(1,443,400.05)
1,605,836.81
111.25%
Template Name: LGC Summary
Hickman County Finance
User:
Michael Elkins
Created by:
LGC
Summary Financial Statement
Date/Time:
6/1/2026 10:18 AM
May 2026
Page 2 of 4
141
General Purpose School
Year-To-Date
Month-To-Date
Estimate
Account
Description
Budget Estimate
Actual
% of Budget
Avg/Mth
Actual
% of Avg
71150
Alternative Instruction Program
(317,021.00)
184,218.80
58.11%
(26,418.42)
19,186.59
72.63%
71200
Special Education Program
(3,752,982.12)
2,693,441.78
71.77%
(312,748.51)
274,646.65
87.82%
71300
Career and Technical Education
(2,033,598.73)
955,100.29
46.97%
(169,466.56)
105,312.45
62.14%
72110
Attendance
(225,221.00)
137,954.41
61.25%
(18,768.42)
13,270.51
70.71%
72120
Health Services
(970,868.99)
673,985.79
69.42%
(80,905.75)
62,120.14
76.78%
72130
Other Student Support
(1,249,822.00)
927,407.79
74.20%
(104,151.83)
92,259.21
88.58%
72210
Regular Instruction Program
(1,709,956.00)
1,137,004.85
66.49%
(142,496.33)
120,702.65
84.71%
72220
Special Education Program
(550,492.00)
408,124.42
74.14%
(45,874.33)
45,909.31
100.08%
72230
Career and Technical Education
(221,945.22)
138,943.58
62.60%
(18,495.44)
12,294.15
66.47%
72250
Technology
(559,224.00)
434,540.35
77.70%
(46,602.00)
15,759.50
33.82%
72290
Other Programs
(35,000.00)
30,497.82
87.14%
(2,916.67)
0.00
0.00%
72310
Board Of Education
(697,742.00)
578,625.26
82.93%
(58,145.17)
13,252.85
22.79%
72320
Director Of Schools
(338,617.00)
206,904.53
61.10%
(28,218.08)
16,019.45
56.77%
72410
Office Of The Principal
(2,116,218.00)
1,471,361.45
69.53%
(176,351.50)
144,304.39
81.83%
72510
Fiscal Services
(50,000.00)
0.00
0.00%
(4,166.67)
0.00
0.00%
72610
Operation Of Plant
(2,704,798.00)
2,448,926.17
90.54%
(225,399.83)
256,291.77
113.71%
72620
Maintenance Of Plant
(1,441,028.19)
1,076,641.46
74.71%
(120,085.68)
70,438.61
58.66%
72710
Transportation
(2,006,898.00)
1,463,709.21
72.93%
(167,241.50)
85,387.43
51.06%
72810
Central And Other
(318,544.00)
123,333.86
38.72%
(26,545.33)
7,019.72
26.44%
73100
Food Service
(46,696.00)
4,600.00
9.85%
(3,891.33)
4,600.00
118.21%
73300
Community Services
(114,189.00)
72,351.14
63.36%
(9,515.75)
7,149.13
75.13%
73400
Early Childhood Education
(535,338.00)
376,922.00
70.41%
(44,611.50)
28,666.28
64.26%
76100
Regular Capital Outlay
(1,687,947.78)
936,206.95
55.46%
(140,662.32)
144,705.40
102.87%
Total
Expenditures
(41,004,947.63)
32,176,619.75
78.47%
(3,417,078.97)
3,145,133.00
92.04%
Total
141
General Purpose School
(6,280,123.99)
2,072,158.17
33.00%
(523,343.67)
3,145,133.00
600.97%
Template Name: LGC Summary
Hickman County Finance
User:
Michael Elkins
Created by:
LGC
Summary Financial Statement
Date/Time:
6/1/2026 10:18 AM
May 2026
Page 3 of 4
142
School Federal Projects
Year-To-Date
Month-To-Date
Estimate
Account
Description
Budget Estimate
Actual
% of Budget
Avg/Mth
Actual
% of Avg
Revenues
44170
Miscellaneous Refunds
0.00
0.00
0.00%
0.00
0.00
0.00%
47131
Vocational Educ - Basic Grants To
123,906.21
(49,692.50)
40.10%
10,325.52
0.00
0.00%
47141
Title 1 Grants To Local Educ Agencies
1,305,599.16
(778,342.93)
59.62%
108,799.93
0.00
0.00%
47143
Special Education - Grants To States
1,085,813.68
(721,237.64)
66.42%
90,484.47
0.00
0.00%
47145
Special Education Preschool Grants
53,018.44
(13,686.47)
25.81%
4,418.20
0.00
0.00%
47146
English Language Acquisition Grants
0.00
(86,207.30)
0.00%
0.00
0.00
0.00%
47148
Rural Education
84,010.08
(39,584.43)
47.12%
7,000.84
0.00
0.00%
47189
Eisenhower Prof Development State
238,659.59
(65,701.47)
27.53%
19,888.30
0.00
0.00%
47309
COVID-19 Grant D
74,500.00
(31,025.00)
41.64%
6,208.33
0.00
0.00%
47401
American Rescue Plan Act Grant #1
0.00
0.00
0.00%
0.00
0.00
0.00%
47590
Other Federal Through State
136,548.80
0.00
0.00%
11,379.07
0.00
0.00%
Total
Revenues
3,102,055.96
(1,785,477.74)
57.56%
258,504.66
0.00
0.00%
Expenditures
71100
Regular Instruction Program
(876,386.21)
662,418.20
75.59%
(73,032.18)
49,601.14
67.92%
71200
Special Education Program
(814,441.23)
615,221.70
75.54%
(67,870.10)
50,183.81
73.94%
71300
Career and Technical Education
(108,348.36)
105,547.63
97.42%
(9,029.03)
39,597.18
438.55%
72130
Other Student Support
(30,202.96)
23,315.92
77.20%
(2,516.91)
6,537.72
259.75%
72210
Regular Instruction Program
(935,379.28)
614,645.81
65.71%
(77,948.27)
44,910.43
57.62%
72220
Special Education Program
(306,890.89)
243,494.92
79.34%
(25,574.24)
20,479.85
80.08%
72230
Career and Technical Education
(4,907.03)
1,389.08
28.31%
(408.92)
743.55
181.83%
72710
Transportation
(25,500.00)
14,238.35
55.84%
(2,125.00)
2,246.75
105.73%
Total
Expenditures
(3,102,055.96)
2,280,271.61
73.51%
(258,504.66)
214,300.43
82.90%
Total
142
School Federal Projects
0.00
494,793.87
100.00%
0.00
214,300.43
0.00%
Template Name: LGC Summary
Hickman County Finance
User:
Michael Elkins
Created by:
LGC
Summary Financial Statement
Date/Time:
6/1/2026 10:18 AM
May 2026
Page 4 of 4
143
Central Cafeteria
Year-To-Date
Month-To-Date
Estimate
Account
Description
Budget Estimate
Actual
% of Budget
Avg/Mth
Actual
% of Avg
Revenues
43521
Lunch Payments - Children
0.00
(779.65)
0.00%
0.00
0.00
0.00%
43522
Lunch Payments - Adults
22,000.00
(19,183.99)
87.20%
1,833.33
0.00
0.00%
43523
Income From Breakfast
2,500.00
(2,551.38)
102.06%
208.33
0.00
0.00%
43525
A La Carte Sales
265,000.00
(180,360.30)
68.06%
22,083.33
0.00
0.00%
43570
Receipts From Individual Schools
0.00
0.00
0.00%
0.00
0.00
0.00%
44110
Investment Income
1,000.00
(122.42)
12.24%
83.33
0.00
0.00%
44170
Miscellaneous Refunds
0.00
0.00
0.00%
0.00
0.00
0.00%
47111
USDA School Lunch Program
1,800,000.00
(1,429,095.50)
79.39%
150,000.00
0.00
0.00%
47113
Breakfast
750,000.00
(549,799.30)
73.31%
62,500.00
0.00
0.00%
47114
USDA Other
0.00
(7,126.56)
0.00%
0.00
0.00
0.00%
Total
Revenues
2,840,500.00
(2,189,019.10)
77.06%
236,708.33
0.00
0.00%
Expenditures
73100
Food Service
(2,957,934.00)
2,550,040.90
86.21%
(246,494.50)
178,840.76
72.55%
Total
Expenditures
(2,957,934.00)
2,550,040.90
86.21%
(246,494.50)
178,840.76
72.55%
Total
143
Central Cafeteria
(117,434.00)
361,021.80
307.43%
(9,786.17)
178,840.76
1,827.
lssrtn07.p 71-4
Hickman County School District
05/27/26
Page:1
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
Centerville Elementary School
School No.
005
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
46
39
85
90
84.3331
90.0666
01
69
48
117
130
121.2664
130.0000
02
50
44
94
103
95.1997
103.5999
03
.0000
.0000
04
.0000
.0000
05
.0000
.0000
06
.0000
.0000
07
.0000
.0000
08
.0000
.0000
09
.0000
.0000
10
.0000
.0000
11
.0000
.0000
12
.0000
.0000
K-12
165
131
296
323
300.7993
323.6666
GRAND TOTAL
165
131
296
323
300.7993
323.6666
lssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 2
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
Centerville Intermediate
School No.
007
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
.0000
.0000
02
.0000
.0000
03
51
54
105
114
107.1331
114.0000
04
39
52
91
103
95.0664
103.0000
05
56
48
104
112
104.0664
112.0000
06
.0000
.0000
07
.0000
.0000
08
.0000
.0000
09
.0000
.0000
10
.0000
.0000
11
.0000
.0000
12
.0000
.0000
K-12
146
154
300
329
306.2659
329.0000
GRAND TOTAL
146
154
300
329
306.2659
329.0000
1ssrtn07 P 71-4
Hickman County School District
05/27/26
Page: 3
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
East Hickman Elementary School
School No.
015
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
56
55
111
116
110.1998
116.0000
01
48
45
93
107
99.9331
107.0000
02
47
47
94
102
95.0664
101.0000
03
.0000
.0000
04
.0000
.0000
05
.0000
.0000
06
.0000
.0000
07
.0000
.0000
08
.0000
.0000
09
.0000
.0000
10
.0000
.0000
11
.0000
.0000
12
.0000
.0000
K-12
151
147
298
325
305.1993
324.0000
GRAND TOTAL
151
147
298
325
305.1993
324.0000
1ssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 4
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
East Hickman Intermediate
School No.
016
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
.0000
.0000
02
.0000
.0000
03
41
43
84
92
86.9998
92.0000
04
53
48
101
116
108.9997
116.0000
05
59
55
114
126
118.1330
126.2666
06
.0000
.0000
07
.0000
.0000
08
.0000
.0000
09
.0000
.0000
10
.0000
.0000
11
.0000
.0000
12
.0000
.0000
K-12
153
146
299
334
314.1327
334.2666
GRAND TOTAL
153
146
299
334
314.1327
334.2666
1ssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 5
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
East Hickman Middle School
School No.
017
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
.0000
.0000
02
.0000
.0000
03
.0000
.0000
04
.0000
.0000
05
.0000
.0000
06
61
55
116
134
125.0663
133.8666
07
40
48
88
97
90.6664
97.6666
08
59
44
103
111
99.1997
111.0000
09
.0000
.0000
10
.0000
.0000
11
.0000
.0000
12
.0000
.0000
K-12
160
147
307
342
314.9325
342.5333
GRAND TOTAL
160
147
307
342
314.9325
342.5333
1ssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 6
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
East Hickman High School
School No.
018
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
.0000
.0000
02
.0000
.0000
03
.0000
.0000
04
.0000
.0000
05
.0000
.0000
06
.0000
.0000
07
.0000
.0000
08
.0000
.0000
09
54
48
102
110
99.7330
110.0000
10
50
42
92
96
86.6664
96.0000
11
47
39
86
94
82.7997
94.1999
12
49
29
78
81
72.1997
81.0000
K-12
200
158
358
381
341.3990
381.1999
GRAND TOTAL
200
158
358
381
341.3990
381.1999
1ssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 7
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
Hickman County Learning Academ
School No.
019
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
.0000
.0000
02
.0000
.0000
03
.0000
.0000
04
.0000
.0000
05
.0000
.0000
06
2
1.6666
2.0000
07
3
3.0000
3.0000
08
1
1
2
6
5.8000
6.0000
09
1
1
5
4.2666
5.0000
10
2
2
5
4.7999
5.0000
11
1
2
3
6
6.0000
6.0000
12
4
4
9
9.0000
9.0000
K-12
5
7
12
36
34.5333
36.0000
GRAND TOTAL
5
7
12
36
34.5333
36.0000
1ssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 8
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
Hickman County Middle School
School No.
020
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
.0000
.0000
02
.0000
.0000
03
.0000
.0000
04
.0000
.0000
05
.0000
.0000
06
52
44
96
110
105.3998
110.0000
07
56
49
105
110
104.2664
109.0000
08
56
51
107
126
121.5998
126.0000
09
.0000
.0000
10
.0000
.0000
11
.0000
.0000
12
.0000
.0000
K-12
164
144
308
346
331.2661
345.0000
GRAND TOTAL
164
144
308
346
331.2661
345.0000
1ssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 9
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
Hickman County High School
School No.
030
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
.0000
.0000
02
.0000
.0000
03
.0000
.0000
04
.0000
.0000
05
.0000
.0000
06
.0000
.0000
07
.0000
.0000
08
.0000
.0000
09
65
26
91
98
87.1330
98.3333
10
36
42
78
91
79.8664
91.0000
11
49
35
84
91
79.9997
91.0000
12
57
49
106
109
96.9996
109.0000
K-12
207
152
359
389
343.9989
389.3333
GRAND TOTAL
207
152
359
389
343.9989
389.3333
1ssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 10
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No.
410
Date
05/27/26
Month of School
School Name:
HC SPED SERVICE SCHOOL
School No.
999
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
.0000
.0000
01
1
1
1
.0000
.0000
02
.0000
.0000
03
2
2
I
2
.0000
.0000
04
2
2
2
.0000
.0000
05
1
1
2
2
.0000
.0000
06
.0000
.0000
07
.0000
.0000
08
1
1
1
.0000
.0000
09
.0000
.0000
10
.0000
.0000
11
.0000
.0000
12
.0000
.0000
K-12
5
3
8
8
.0000
.0000
GRAND TOTAL
5
3
8
8
.0000
.0000
lssrtn07.p 71-4
Hickman County School District
05/27/26
Page: 11
05.26.02.00.06
Director's Monthly Membership Attendance Report
12:59 PM
School District: Hickman County
District No. 410
Date
05/27/26
Month of School
School Name:
District Summary
School No.
No. of Days In Session: 15
Prepared By:
Phone:
Begin Date: 05/01/26 End Date: 05/22/26
Grade
Net Enrollment to Date
End of Month
Average Daily
Average Daily
Membership
Attendance
Membership
Male
Female
Total
K
102
94
196
206
194.5329
206.0666
01
117
94
211
238
221.1995
237.0000
02
97
91
188
205
190.2662
204.5999
03
94
97
191
208
194.1329
206.0000
04
94
100
194
221
204.0662
219.0000
05
116
104
220
240
222.1994
238.2666
06
113
99
212
246
232.1328
245.8666
07
96
97
193
210
197.9329
209.6666
08
116
97
213
244
226.5995
243.0000
09
120
74
194
213
191.1327
213.3333
10
88
84
172
192
171.3328
192.0000
11
97
76
173
191
168.7994
191.1999
12
106
82
188
199
178.1994
199.0000
K-12
1,356
1,189
2,545
2,813
2592.5272
2804.9999
GRAND TOTAL
1,356
1,189
2,545
2,813
2592.5272
2804.9999
End of report
Centerville Family Resource Center
Goals for 2025-2026
End of Year Report
Community Partnerships
GOAL: FRC will observe a 2% increase in
community donations, either monetary, or by
goods and services, as compared to the
2024-2025 data.
ACTION STEP 1: CFRC will identify community partners
and volunteers to meet service needs by; reaching out
to local churches, businesses, and individuals. These
partnerships will be crucial to obtaining the hygiene
and food items needed to service the students in K -12.
ACTION STEP 2: CFRC will meet with community
partners and volunteers to share the current goals and
needs of the K-12 student body and determine how
these needs can be met. This can be done by
requesting specific item donations per month to meet
student needs such as deo, shampoo, soap, wash
clothes, etc. (Food & Christmas)
ACTION STEP 3: By May 2026 and throughout the year
leading up to this date, CFRC will promote the need for
services and donation via social media, emails, and
community events and involvement.
CFRC worked on meeting new community
partners. CFRC had new monetary, Friday Friends
food, hygiene items, and Christmas gift donations
from the Turkey Trot, Holiday Market at GSW,
individuals, civic organizations, churches, and
Second Harvest Food Bank. There were 104 new
sponsors for Operation Santa Claus. 49 were
sponsors from last year.
Chronically Out of School
GOAL: CFRC will help to decrease Chronically
Out of School number at Centerville Elementary
School by 10% from previous year's total.
ACTION STEP 1:
By August 5, 2025, CFRC will
meet with the DBA and Accountability Supervisor
to identify at-risk students.
ACTION STEP 2: CFRC will meet the students on
the first day of school. CFRC will do Monday
morning check-ins and send encouraging mail at
least 5 times during the year.
ACTION STEP 3:
By May 2026, CFRC will track
students' attendance by a spreadsheet and
compile data.
At-risk students were identified in August. CFRC
sent out letters and the first reward was handed
out in October for the first grading period. This
was repeated at every grading period. Chronic
Absenteeism dropped from 43% last year to 21%
this year.
Family Sustainability
GOAL: CFRC will address needs and support
parents of Centerville students. CFRC will observe
a 4% outreach support total for the school year.
ACTION STEP 1:
CFRC will contact parents and
identify reasons/needs of the family with students
in need.
ACTION STEP 2:
CFRC will support parents to
help them get students to school and other
activities.
ACTION STEP 3: CFRC will reward parents for
continuing to get involved with their students and
schools.
Parents were contacted by letter of their student
being identified as chronically out of school for
2024-25 school year. Information was given to
them about how to help their child. Prizes were
handed out.
CFRC is a member of the Tier III Truancy Board.
The board met with parents and students. CFRC
has informed them of services offered. 25
students and parents were seen by the director of
CFRC.
Family Support
GOAL: By May 2026, CFRC will provide food,
Christmas, and/or basic needs support to at least
20% of the economically disadvantaged students
at the 4 Centerville schools.
ACTION STEP 1:
August 2025, CFRC will meet
with faculty and staff at CES, CIS, HCMS, and
HCHS to inform them of all services offered and
how to refer students.
ACTION STEP 2:
September 2025, CFRC will
send home Operation Santa Claus forms for
families that need help or want to help.
ACTION STEP 3:
CFRC will hand out Christmas
in December. Friday Friends will be handed out
weekly starting in August.
The director contacted all the schools and
informed them of the ways to refer students to
CFRC.
Operation Santa Claus forms were sent to
students in Pk-12 grades. On December 13th, 333
children from 134 families were helped. That is a
student increase of 39.33%. Pick up date was
December 13, 2025. The number of direct services
was 1,332.
Friday Friends helped 93 students from 44
families for the 2025-2026 school year. That was a
decrease from last year of 146. The number of
direct services was 1,513.
Literacy
GOAL: By April 2026, CFRC will engage Pre-K
children ages 3-5 in reading readiness skills and
see a 5% growth in skills by using an assessment
tool.
ACTION STEP 1:
By September 2025, evaluate
Pre-K children that attend classes by a placement
test.
ACTION STEP 2:
CFRC will hold classes weekly
from September thru April that offer reading, site
words, and educational materials for the parents
to use at home to increase reading readiness in
their child.
ACTION STEP 3:
By April 2026, re-evaluate
children by using the same means as in the Fall to
measure growth.
Toddlers and Preschoolers came a total of 23
weeks from September to April. 26 students came
for a total of 273 times. A parent stayed with their
child for the class. They also received a binder
with worksheets to use at home.
Pre-K students ages 3-5 were evaluated and 90%
knew all shapes, numbers, and letters. This was a
30% increase from mid-year.
East Hickman Family Resource (EFRC)
May 20, 2026
Backpack and school supplies
71 Students received backpacks/school supplies
19 of those 71 received clothes/shoes of some sort
3 of those 71 received all their back-to-school needs (Shoes, clothes, backpacks, school
supplies, hygiene products, anything they needed)
Roughly 100 drawstring backpacks with supplies went to Shady Grove Community
Center
Sidewalk Chalk Event
On Monday August 4th, I hosted the Second Annual Sidewalk Chalk event. This event is
where volunteers come together and draw pictures on the walkways leading into East
Elementary and East Intermediate school. This is something so simple, but the students
love it.
If you want to volunteer for next year, please let me know.
Please keep in mind, several Elementary students can not read so pictures are better at
the Elementary School and we do both pictures and words at East Intermediate.
Classroom Sponsors
19 teachers/classrooms at EHES
17 teachers/classrooms at EHIS
I hosted a sponsor meet and greet so that sponsors could come in and meet the teachers
and students for the first time and introduce themselves. This took place at both school.
17 sponsors at EHES attended
15 sponsors at EHIS attended
If you want to sponsor a class or know anyone/business interested, please pass along my
information to them
Free Haircuts
18 free haircuts went to students this school year
Several students received more than one this school year.
18 students at $20 = $360
This will be something I continue next school year, if you know a stylist willing to donate a
free haircut, please pass along my contact information to them.
I do have money already set aside for back to school haircuts for the 2026-2027
school year.
I am working on a certificate for next year where I will send a certificate home with
students when I can not contact the parents.
Volunteer Readers
Local volunteers came in at least once a month to read to classrooms at EHES
The volunteers read a book, and they might bring snacks, a goodie bag, or a coloring
sheet that goes along with the book. Something so small makes a huge difference to the
kids.
This year I had school staff members, student's parents, high school kids, business
owners, class sponsors, the Sheriff's Department, and community leaders.
If you want to volunteer for next year, please let me know. I am already working on next
years calendar
Snack Attack
Snacks were a huge deal this year
The teachers were truly thankful for the snacks this year.
Average cost for 1 student to be provided snacks for 160 days of school is $60 for that 1
student
If a teacher has 5 students who need a snack, that's $300 that teacher has to spend to
provide a snack, some days it might be more than 5 kids so that number might go up.
61 students at $60 for the year = $3,660
roughly 11,000 snacks went into the schools this year through EFRC
I do give snacks to other schools also.
Roughly $335.00 when to other schools
By August 1, I plan to have enough snacks on hand that I can give all EHES teachers back-
to-school snacks to start the year with. If you would like to donate snacks, just please be
mindful of the expiration date.
Friday Friends
90 students received F.F. weekly
6 of those 90 received 2 bags a week
All students received 2 bags the week before school breaks, normally on Wednesday and
Friday (Fall Break, Thanksgiving, Christmas, Spring Break)
On average a bag cost $11.50
3 breakfast options, 3 to 4 food options, 4 to 5 snacks, at least 1 juice, 1 white and 1
chocolate milk
Sometimes I put in candy or special treats for them (Halloween, Christmas,
Valentines, Easter)
96 bags at $11.50 =$1,104 a week
Bags went home 37 times this school year
$1,104 per week at 37 weeks is $40,848
Poptart, Oatmeal, Cereal Bowl= $1.90 (Breakfast)
Ramen Noodles, Chef Boyardee, Soup, Mac & Cheese Bowl =$3.85 (lunch/dinner)
Cheez-its, Fruit Snacks, Popcorn, Crackers, Chips =$2.79 (Snacks)
Juice, White Milk, Chocolate Milk =$3.05 (drinks)
All of that on average is $11.50
F.F. will continue Firday Friends throughout the summer also. (summer camp, I meet
people or deliver to families who need it)
Hygiene Bags
Hygiene bags go along with Friday Friends bag. At least twice a year I try to send a
hygiene bag home with Friday Friend students. I normally do this in October and then
again later in the year around February.
These bags are different for each school
EHES receives a toothbrush with toothpaste. EHES students receive it more often
(4 times) because of sickness and all the germs that they love to share
EHIS students receive a toothbrushes with toothpaste and floss for 3rd and 4th
grade, 5th grade students receives a toothbrush with toothpaste, floss plus
deoderant.
EHMS and EHHS receives a toothbrush, toothpaste, deoderant, bodywash, bar
soap, bath sponge (loofah), mini shampoo, lotion, just whatever 1 have available on
hand is what I make work.
Average cost for EHES per hygiene bag is $2.00
Average cost for EHIS per hygiene bag is $4.50
Average cost for EHMS and EHHS per hygiene bag is $11.00
Roughly $720.00
Food Pantry
57 Students received food from the food pantry at some point this school year
57 students with an average family size of 4 people= 228 people
228 people X $13.00=$2,964
Some of those students received it multiple times
I think higher pantry numbers were due to snap benefit issues, the ice storm, rising
grocery prices, and rising gas prices will probably effect it soon.
Truck or Treat
EFRC participates in the trunk or treat at EHES every year
roughly 700 kids came through this past Halloween
Holiday Dinner Boxes
Thanksgiving Dinners (donated by-Second Harvest, Local Churches, Businesses, and
Individuals)
45 families received Thanksgiving Dinner boxes (Some families needed 2 boxes for
larger families so 51 total boxes went out)
161 people were affected by these meals (rough estimate)
Estimated $50 per box
51 boxes at $50= $2,550
The number of Thanksgiving boxes went down this year because I lost some support
from United Way and I received a smaller number of donated boxes from Second
Harvest (75 boxes were given out last year)
Christmas Dinners
35 families received Christmas Dinner boxes (some families needed 2 boxes so 40
total boxes went out)
117 people were affected by these meals (rough estimate)
Estimated $50 per box
40 boxes at $50=$2,000
Blessing Box in front of EHES
I have my blessing box out in front of EHES. I check it regularly and stock it with
whatever I have extra.
Publix Partnership
I
partnered with someone from the Publix Distribution Center to deliver bread and
bakery items to families in need.
I received 8 loads so far.
I am working on trying to continue this throughout the summer but the person I work
with is retiring and it is a hassle for me to drive to Nashville to pick it up weekly.
Coat Drive (Clearview Church)
Roughly 60 families came through that day
Roughly 150 items went out that day (coats, hoodies, sweaters, sweatshirts, gloves, and
hats)
We also handed out socks and shoes (I do not have that number)
We are planning it again in November so if you have used but nice items, please consider
donating them to me
Operation Santa
128 families
289 children
17 children went to Shop with a Cop
School Closet
Every East school has a school closet with clothes, hygiene products, shoes, school
supplies, and snacks for students who need them. I work with the schools to help keep
these closets supplied.
They normally call me when they have a need for items
Be A Better Buddy Program
I work with students at EHES who are at risk of disciplinary referrals to the Principle due
to behavior issues.
I also work with students who just need some positivity or compassion in their life
This is a check in and check out system.
I served 4 students on the behavior side this year. All 4 made great improvements and
by the end of February all disciplinary referrals had stopped for these students. They
finished the year strong and with better behavior. 1 will check in with them next year
and continue to help them if needed.
I also have lunch on Fridays with students who have good behavior.
YEARLY FOOD DRIVE AT EHES
This year was my 3rd year hosting the EFRC Food Drive at EHES. I host this food drive yearly
during the month of March. During this time students bring in food to donate to my program.
This is a competition between classrooms. The top 3 classrooms get a reward from me. This
year first place received a pizza party while watching a movie in my room. The second place
class recieved extra recess with freeze pops. The third place class received extra recess. I take
the class during that time so the teachers get an extra break that day as well. It is a win win for
everyone involved. My program gets food donated for snacks, Friday Friends, and the food
pantry. The students get bragging rights and an extra reward. Plus the teachers get an extra
little break. I plan to continue this again next year.
ONE GEN AWAY
I partner with this non-profit organization to help bring food into Hickman Co.
We hosted 10 giveaways in 2025, serving between 200-300 families each time
We have hosted 4 giveaways so far in 2026, we have 5 more left for 2026
The 5 giveaways we have left will be at EHHS on the second Saturday of June, August,
September, November, and December.
I also partnered with One Gen and held a special food handout on Nov. 24th 2025 at EHHS
from 5 p.m. to 7 p.m. We handed out 200 pantry boxes with bread and bakery items to
families in need. (This was during the time that SNAP benefits were cut)
I also held another special food handout on February 3rd at EHES from 3:30-5:30 where
we served 35 families with multiple boxes of food and bakery items. We also delivered a
truck of food to Hidden Valley Lakes for families there that could not get out. (This was
during the ice storm)
Hidden Valley Project (my project)
I spent a good bit of time in the Hidden Valley area during the summer of 2025. I decided I
wanted to help the children there and the families. I know some people choose to live that
life, but the children are raised there. Some of the kindest people that live there were born
and raised there and can not afford to leave. I know a lot of people judge others without
getting to know them, I am very grateful I did not do that to the people in Hidden Valley. They
are so appreciative and kind to me and my team of volunteers.
On September 24th from 1 p.m. to 5 p.m. my volunteers and I spent the afternoon at the
Hidden Valley Office
One Gen met me there with a truck load of food, bakery items, and drinks
164 boxes of shelf stable food
164 cases of Snapple drinks
164 boxes of bread/bakery items
We handed out
30 Backpacks with supplies
Over 100 pairs of shoes
Roughly 120 toothbrush/toothpaste sets
Diapers and wipes
Laundry Soap
Blankets and pillows
Toys
Hygiene products
80 bottles of shampoo
80 bottles of conditioner
80 deodorants (40 men's, 40 women's)
60 bottles of lotion
50 bottles of body wash
50 bars of soap
50 bottles of body spray, perfume, or cologne
Tons of clothes
25 boxes full of clothes in all sizes
Upcoming Plans for EFRC Summer of 2026
ONE GEN AWAY FOOD DISTRIBUTIONS AT EHHS
June 13
August 8
September 12
November 14
December 12
Volunteers are always needed. 1 can give out community service hours for school, TN
Promise, or court ordered community service hours. I have a form or they are welcome to
bring their own form. Volunteers arrive at 7:30 and we are done about 10:30.
I will meet with One Gen in October 2026 to set our schedule for 2027. My goal is to have the
food handouts at least 6 times in 2027.
SUMMER FEEDING WITH TN KIDS NUTRITION
I will be on the road every Tuesday starting May 26th and ending July 28th handing out
food boxes to children in Hickman Co. (1 have attached a flyer)
Signs went up in the community on 5/11/26 at all the stops so the community can be
aware it is coming.
Last summer we handed out 8,732 boxes of food in 10 weeks
8,732 X 7 breakfast= 61,124 breakfast meals
8 732 X 7 lunches=61,124 lunch meals
122,248 meals were handed out total to kids in Hickman Co.
Touch A Truck at EHHS on Saturday July 11 4 p.m.-7 p.m.
I will be handing out backpacks with school supplies at this event
I will also be handing out toothbrushes and toothpaste kits for kids
I am currently working on hygiene products to have on hand for those who might be in
need of them. I do not have it worked out yet but I am hoping to get it done.
Shady Grove Project (my next project)
Just like the Hidden Valley Project, but I changed locations. I want to help different areas in
Hickman County each year. I plan to help the Shady Grove Community with back to school
needs for the 2026-2027 school year. I have recently delivered 8 boxes of school supplies and
3 boxes of clothes to Shady Grove Community Center. The community center is where the
items will be stored until it is time for the handout. The plan is to host a community day in
mid July where families will come to the Shady Grove Community Center and pick out what
they need. If you have any used items in good condition, please consider donating them to
me for this project.
Christmas in July
I am currently working on a Christmas in July Toy Drive. I do not have all the details worked
out just yet but I am currently working on it. I am planning on this being a community event.
Page Properties, First Farmers Bank, and Apex bank have all agreed to be a drop location
where people can donate toys for the toy drive. I will make flyers to hang throughout the
community and I will also use social media to help spread the word. This is a first time event
and I might not have many toys donated but I wanted to try something new to help restock
the Operation Santa toy closet.
I am planning to work this into the Touch A Truck event
Breakfast with Santa
In the past I gave out stuffed animals to children who attended Breakfast with Santa here
at EHES. This coming up year, I would like to give each child a coloring book with a pack of
crayons.
Any other ideas on items to give out that would be affordable
I need about 150
East Hickman Family Resource on Facebook
These are the prices I use to
figure the cost ofd F.F. bag.
Friday Friends Food Bag Items (These are the most used items but not all of the items 1 use)
Breakfast Items
Cereal Bars (Lucky Charms, Cinnimon Toast Crunch Fruit Loops)
$0.45 per bar
Pop-tarts
$0.45 per pack
Cereal Cups
$1.00 per cup
Nature Valley (crunch bar, oatmeal squares)
$0.70 per bar
Little Bite Muffins
$0.80 per pack
Instant Oatmeal
$0.45 per 2 packs
Lunch/Dinner
Ramen Noodles
$0.30 per pack
Chief Boyardee
$1.25 per can
Hormel Compleat Dinner
$2.50 per dinner
Vienna Sausage
$0.90 per can
Mac and Cheese bowls
$1.00 per bowl
Rice A Roni Cups
$1.50 per bowl
Mashed Potato Cups
$1.00 per bowl
Extra
Granola Bars/Fruit Grain Bars
$0.20 per bag
Fruit Snacks
$0.55 per 2 packs
Beef Jerky
$0.75 per 2 mini sticks
Microwave Popcorn
$0.50 per pack
Individual Chips/Cheez-it (small bags)
$0.60 per bag
Rice Crispy treats
$0.32 per treat
Individual Small bags of Cookies
$0.52 per bag
Peanut Butter/Cheese Crackers
$0.55 per pack
Juice Box/Capri Sun
$0.35 per juice
Shelf Stable Milk/chocolate milk
$1.35 per milk
Prices I use to
Hyglene Bags (twice a year for most students)
figure the prices of
hygiene bags.
Toothbrush
$1.00
Toothpaste
$1.00
Floss
$1.00
Mini Deoderant
$1.50
Mini Shampoo
$2.00
Mini Bodywash
$2.00
Bar Soap
$1.50
Bath Sponge/loofah
$1.00
HIGHAM COUNTY SCHOOLS
1507
Hickman County Schools Board Agenda Item Request
Date:
5/22/26
Name of School:
East Hickman Hish School
Item Request:
Football Camp on Campus
Explanation:
Inthe past we have held Footlan u Camp over Right, on campus
For the last 2years we have had to do Crup offsite. This
leads to Caup being More expensive for our program Also, fudge
Site that include all the amerities Reeded (field Fadax for lis, weight, AV)
is Virtually impossible. Iam requesty permission todo Camp
On Camps @ EHHS , So that we Cver lesson the Expenses of Camp at
ensure we had all the ammenizes readed ba a Sucesful Camp
Attachments (if necessary and appropriate):
Signature of Person requesting to be placed on the agenda:
Billy Saure Billy Sawyere
Signature of Building Principal:
AIA®
Document G701® - 2017
Change Order
PROJECT: (Name and address)
CONTRACT INFORMATION:
CHANGE ORDER INFORMATION:
East Hickman High School
Contract For: Contruction
Change Order Number: 004
Agricultural/Vocational Building
7700 TN-7
Date: 10-24-2025
Date: 05-06-2026
Lyles, TN
OWNER: (Name and address)
ARCHITECT: (Name and address)
CONTRACTOR: (Name and address)
Hickman County Schools
Lyle Cook Martin Architects
Fellowship Construction
114 North Central Avenue, Suite 203
310 Franklin Street
2668 Spencer Mill Road
Centerville, TN 37033
Clarksville, TN 37040
Bon Aqua, TN 37025
THE CONTRACT IS CHANGED AS FOLLOWS:
(Insert a detailed description of the change and, if applicable, attach or reference specific exhibits. Also include agreed upon
adjustments attributable to executed Construction Change Directives.)
An additional 1 day has been added to the substantial completion date for December 2025 due to weather delays.
An additional 6 days have been added to the substantial completion date for January 2026 due to weather delays.
An additional 7 days have been added to the substantial completion date for February 2026 due to weather delays.
An additional 2 days have been added to the substantial completion date for March 2026 due to weather delays.
An additional 5 days have been added to the substantial completion date for April 2026 due to weather delays.
An additional 18 days have been added to the substantial completion date for Below-Grade utilities 8" Fire Line
An additional 30 days have been added to the substantial completion date for Below-Grade utilities - Reroute Gas Line (wait for
Board Approval)
An additional 27 days have been added to the substantial completion date for Finish Floor Elevation modifications to footing details.
See attached itemization.
The original Contract Sum was
$
580,000.00
The net change by previously authorized Change Orders
$
22,901.76
The Contract Sum prior to this Change Order was
$
602,901.76
The Contract Sum will be unchanged by this Change Order in the amount of
$
0.00
The new Contract Sum including this Change Order will be
$
602,901.76
The Contract Time will be increased by Ninety-Six (96) days.
The new date of Substantial Completion will be 08-20-2026
NOTE: This Change Order does not include adjustments to the Contract Sum or Guaranteed Maximum Price, or the Contract Time,
that have been authorized by Construction Change Directive until the cost and time have been agreed upon by both the Owner and
Contractor, in which case a Change Order is executed to supersede the Construction Change Directive.
NOT VALID UNTIL SIGNED BY THE ARCHITECT, CONTRACTOR AND OWNER.
BrodA.Martin
ARCHITECT (Signature)
CONTRACTOR
June (Signature) Clu
OWNER (Signature)
Bradley A. Martin, III
Jin Irwin Pres.
(Printed name, title, and
(Printed name and title)
(Printed name and title)
license number if required)
May 7, 2026
5/8/2026
Date
Date
Date
AIA Document G701 - 2017. Copyright © 1979, 1987, 2000, 2001 and 2017. All rights reserved "The American Institute of Architects," "American Institute of
Architects,' "AIA," the AIA Logo, and "AIA Contract Documents" are trademarks of The American Institute of Architects. This document was produced at 14:27:08
1
CDT on 05/07/2026 under Subscription No. .20250156901 which expires on 08/30/2026, is not for resale, is licensed for one-time use only, and may only be used
in accordance with the AIA Contract Documents Terms of Service. To report copyright violations, e-mail docinfo@aiacontracts.com
User Notes:
(69aee075d218c3ad6312ada2)
01 26 25 - WEATHER DELAY REPORT
Month and Year
SBC Project Number and Project Name:
Reported Below:
East Hickman Vocational Building
December 2025
Weather condition
Work scheduled on critical path for this day
Date
causing delay
that was delayed.
1
Rain Day- 0.12
Underground Utilities/ grading site
2
Rain Day- 0.55
Underground Utilities/ grading site
3
Dry out day
Underground Utilities/ grading site
4
Rain Day- 0.34
Underground Utilities/ grading site
5
Dry out day
Underground Utilities/ grading site
6
Dry out day
Underground Utilities/ grading site
7
8
9
10
11
Dry out day
Underground Utilities/ grading site
12
Dry out day
Underground Utilities/ grading site
13
14
15
16
17
18
Rain Day- 1.05
Underground Utilities/ grading site
19
Dry out day
Underground Utilities/ grading site
20
Dry out day
Underground Utilities/ grading site
21
Dry out day
Underground Utilities/ grading site
22
23
24
25
26
27
28
29
Rain day 0.18
Underground Utilities/ grading site
30
Dry out day
Underground Utilities/ grading site
31
Total number of days this month with delay due to weather 12 days
Baseline number from Section 01 26 20 11 days
Total - Baseline = claimable days 1 days
END OF SECTION
TN Higher Education - Standard Document - May 2018
Page 1 of 1
Climatological Data for DICKSON, TN - December 2025
Temperature
Date
HDD
CDD
Maximum
Precipitation
New Snow
Minimum
Average
Departure
Snow Depth
2025-12-01
41
23
320
-11 5
33
0
0.12
00
0
2025-12-02
35
26
30.5
-127
34
n
0.55
00
0
2025-12-03
40
25
32.5
-10.5
a
0
000
00
0
2025-12-04
35
29
320
-108
33
0
0.34
00
0
2025-12-05
32
31
315
JIJ
33
0
0.00
00
D
2025-12-06
44
30
370
-53
28
0
0.00
00
0
2025-12-07
42
27
145
-76
30
0
0.00
00
0
2025-12-08
44
28
360
-5.9
19
0
0.00
00
0
2025-12-09
4b.
21
345
-72
30
0
0.00
00
0
2025-12-10
53
37
450
35
20
0
0.00
0.0
0
2025-12-11
42
22
320
-9.3
33
a
0.00
00
0
2025-12-12
55
34
44 5
34
20
0
0.00
00
0
2025-12-13
51
31
410
01
24
0
0.00
00
0
2025-12-14
38
12
250
-15.7
40
0
0.00
0.0
0
2025-12-15
3%
9
23.5
-170
41
0
0.00
0.0
0
2025-12-16
51
21
360
-44
29
0
0.00
00
0
2025-12-17
60
35
47.5
73
17
0
0.00
00
0
2025-12-18
59
a
53.5
13 5
11
0
L05
0.0
0
2025-12-19
49
28
38.5
43
26
0
0 02
0.0
0
2025-12-20
62
25
43.5
38
21
V
0.00
0.0
0
2025-12-21
55
42
4#5
90
16
0
000
00
0
2025-12-22
56
32
440
47
21
0
000
00
0
2025-12-23
65
55
600
208
5
0
0.00
0.0
0
2025-12-24
74
58
660
27.0
0
I
0.00
00
0
2025-12-25
67
57
620
231
3
0
0.00
00
0
2025-12-26
65
61
63.0
243
2
0
0.00
00
0
2025-12-27
"
54
600
214
5
0
0.00
0.0
0
2025-12-28
71
64
67 5
24.0
0
3
0.00
00
0
2025-12-29
69
26
47.)
9.2
17
0
018
00
0
2025-12-30
35
25
29.0
-92
36
0
0.00
00
0
2025-12-31
49
21
350
-31
30
0
0.00
00
0
Sum
1591
1035
-
.
699
I
2.26
00
.
Average
51.3
33.4
42.4
19
"
.
.
#
00
Normal
504
306
40.5
.
no
0
5.13
06
a
Observations for each day cover the 24 hours ending
at the time given below (Local Standard Time).
Mux Temperature 8pm
Min Temperature 8pm
Precipitation 8pm
Snowfall unknown
Snow Depth 8pm
01 26 25 - WEATHER DELAY REPORT
Month and Year
SBC Project Number and Project Name:
Reported Below:
East Hickman Vocational Building
January 2026
Weather condition
Work scheduled on critical path for this day
Date
causing delay
that was delayed.
1
2
3
4
5
6
7
8
9
Rain Day- 0.09
Underground Utilities/ grading site
10
Rain Day- 0.26
Underground Utilities/ grading site
11
Dry out day
Underground Utilities/ grading site
12
Dry out day
Underground Utilities/ grading site
13
14
Rain Day- 0.11
Underground Utilities/ grading site
15
Dry out day
Underground Utilities/ grading site
16
Rain Day- 0.12
Underground Utilities/ grading site
17
Dry out day
Underground Utilities/ grading site
18
19
20
21
Rain day 0.27
Underground Utilities/ grading site
22
Dry out day
Underground Utilities/ grading site
23
24
Snow day- 2.00
Underground Utilities/ grading site
25
Snow day 1.30
Underground Utilities/ grading site
26
ice/ dry out day
Underground Utilities/ grading site
27
ice/ dry out day
Underground Utilities/ grading site
28
ice/ dry out day
Underground Utilities/ grading site
29
ice/ dry out day
Underground Utilities/ grading site
30
ice/ dry out day
Underground Utilities/ grading site
31
ice/ dry out day
Underground Utilities/ grading site
Total number of days this month with delay due to weather 18 days
Baseline number from Section 01 26 20 12 days
Total - Baseline = claimable days 6 days
END OF SECTION
TN Higher Education - Standard Document - May 2018
Page 1 of 1
Climatological Data for DICKSON, TN - January 2026
Temperature
Date
HDD
CDD
Maximum
Minimum
Precipitation
Average
Departure
2026-01-01
61
26
43.5
55
21
0
0.00
2026-01-02
54
33
43.5
56
21
0
0.06
2026-01-03
47
33
400
22
25
0
0.05
2026-01-04
49
25
370
-07
18
0
0.00
2026-01-05
63
28
45 5
79
19
0
0.00
2026-01-06
65
48
56.5
190
8
0
0.00
2026-01-07
67
37
520
146
13
0
0.00
2026-01-08
69
37
530
156
12
0
0.00
2026-01-09
72
00
660
287
45
1
0.00
2020-01-10
60
42
53.0
117
14
0
026
2026-01-11
12
7.
15 5
-1.7
29
0
0.00
2026-01-12
49
20
14.5
-2.7
30
0
000
2026-01-13
62
28
45.0
78
20
0
0.00
2024-01-14
52
30
10
6
24
a
0.11
2026-01-15
32
20
2000
-111
10
a
0.00
2026-01-16
50
in
40
-31
31
)
012
2026-01-17
41
R
115
16
31
0
0.00
2026-01-18
32
14
230
-14.2
42
0
0.00
2026-01-19
37
16
265
-107
38
0
0.00
2026-01-20
39
10
245
-127
40
0
000
2026-01-21
12
24
310
-43
2
0
027
2026-01-22
4%
10
140
no
27
0
0.00
2026-01-23
35
19
27.0
-104
38
0
0.00
2020-01-24
19
4
165
210
48
0
2.00
31
13
220
-150
HB
0
130
2026-01-26
31
7
190
417
IA
@
0.00
2026-01-27
29
5
The
-20
48
a
0.00
2026-01-28
31
11
210
-169
+1
0
0.00
2026-01-29
:
14
25 5
-125
39
0
0.00
2026-01-30
29
17
210
-15.2
42
0
0.00
2026-01-31
"
12
165
-21 S
48
11
000
Sum
1394
746
.
B
440
I
426
Average
45.0
241
345
-30
.
.
.
Normal
475
27 5
37.5
.
853
0
433
Observations for each day cover the 24 hours ending
at the time given below (Local Standard Time).
Max Temperature 8pm
Min Temperature 8pm
Precipitation 8pm
01 26 25 - WEATHER DELAY REPORT
Month and Year
SBC Project Number and Project Name:
Reported Below:
East Hickman Vocational Building
February 2026
Weather condition
Work scheduled on critical path for this day
Date
causing delay
that was delayed.
1
2
3
Rain Day- 0.38
Underground Utilities/ grading site
4
Dry out day
Underground Utilities/ grading site
5
Dry out day
Underground Utilities/ grading site
6
7
8
9
10
11
Rain Day- 0.46
Underground Utilities/ grading site
12
Dry out day
Underground Utilities/ grading site
13
Dry out day
Underground Utilities/ grading site
14
Rain Day- 0.08
Underground Utilities/ grading site
15
Rain Day- 1.67
Underground Utilities/ grading site
16
Dry out day
Underground Utilities/ grading site
17
Dry out day
Underground Utilities/ grading site
18
Dry out day
19
20
Rain day 0.31
Underground Utilities/ grading site
21
Dry out day
Underground Utilities/ grading site
22
Dry out day
Underground Utilities/ grading site
23
24
25
Rain day 0.15
Underground Utilities/ grading site
26
Rain day 0.30
Underground Utilities/ grading site
27
Dry out day
Underground Utilities/ grading site
28
Dry out day
Underground Utilities/ grading site
29
30
31
Total number of days this month with delay due to weather 18 days
Baseline number from Section 01 26 20 11 days
Total - Baseline = claimable days 7 days
END OF SECTION
TN Higher Education - Standard Document - May 2018
Page 1 of 1
Climatological Data for DICKSON, TN - February 2026
Temperature
Date
HDD
CDD
Maximum
Precipitation
Minimum
Average
Departure
2026-02-01
30
17
23.5
-150
41
0
0.00
2026-02-02
46
22
34.0
-4.6
31
0
0.00
2026-02-03
46
26
36.0
-2.8
29
0
0.38
2026-02-04
40
26
33.0
-60
32
0
0.00
2026-02-05
30
18
24.0
-15.2
41
0
0.00
2026-02-06
56
22
39.0
-04
26
0
0.00
2026-02-07
42
26
34.0
-5.6
31
0
0.00
2026-02-08
51
24
37.5
-23
27
0
0.00
2026-02-09
68
28
48.0
8.0
17
0
0.00
2026-02-10
73
34
53.5
133
11
0
0.00
2026-02-11
62
41
51.5
11.1
13
0
0.46
2026-02-12
53
31
42.0
14
23
0
0.00
2026-02-13
61
30
45.5
46
19
0
0.00
2026-02-14
59
30
44.5
34
20
0
0.08
2026-02-15
49
45
47.0
57
18
0
1.67
2026-02-16
66
34
50.0
84
15
0
0.00
2026-02-17
60
36
48.0
62
17
0
0.00
2026-02-18
61
56
58.5
164
6
0
0.00
2026-02-19
72
55
63.5
212
1
0
0.00
2026-02-20
70
48
59.0
164
6
0
036
2026-02-21
54
37
45.5
27
19
0
0.00
2026-02-22
37
27
32.0
-11.1
33
0
0.00
2026-02-23
30
18
24.0
-19.4
41
0
0.00
2026-02-24
50
15
32.5
-11.1
32
0
0.00
2026-02-25
60
44
52.0
8.1
13
0
0.15
2026-02-26
57
46
51.5
7.3
13
0
0.30
2026-02-27
67
34
50.5
6.1
14
()
0.00
2026-02-28
75
33
54.0
9.3
11
0
0.00
Sum
1525
903
-
-
600
0
3.40
Average
54.5
32.3
43.4
20
-
-
-
Normal
52.3
30.4
41.4
-
663
1
4.90
Observations for each day cover the 24 hours ending
at the time given below (Local Standard Time).
Max Temperature : 8pm
Min Temperature : 8pm
Precipitation : 8pm
Climatological Data for DICKSON, TN - March 2026
Temperature
Date
HDD
CDD
Maximum
Precipitation
Minimum
Average
Departure
2026-03-01
65
42
53.5
8.5
11
0
0.00
2026-03-02
61
43
52.0
6.7
13
0
0.03
2026-03-03
70
53
61.5
15.9
3
0
0.00
2026-03-04
76
59
67.5
217
0
3
0.00
2026-03-05
73
58
65.5
194
0
1
0.00
2026-03-06
81
51
66.0
19.6
0
1
0.00
2026-03-07
75
56
65.5
188
0
1
0.50
2026-03-08
65
53
59.0
120
6
0
0.00
2026-03-09
72
43
57.5
10.2
7
0
0.02
2026-03-10
78
60
69.0
214
0
4
0.03
2026-03-11
73
52
62.5
14.6
2
0
0.56
2026-03-12
54
40
47,0
-11
18
0
0.08
2026-03-13
67
33
50.0
16
15
0
0.00
2026-03-14
77
40
58.5
9.8
6
0
0.00
2026-03-15
77
58
67.5
18.5
0
3
0.00
2026-03-16
72
32
52.0
2.7
13
0
0.95
2026-03-17
39
21
30.0
-196
35
0
0.00
2026-03-18
62
32
47.0
-2.9
18
0
0.00
2026-03-19
74
36
55.0
4.7
10
0
0.00
2026-03-20
80
43
61.5
10.9
3
0
0.00
2026-03-21
86
58
72.0
21.1
0
7
0.00
2026-03-22
87
63
75.0
23.8
0
10
0.00
2026-03-23
79
42
60.5
9.0
4
0
0.00
2026-03-24
69
41
55.0
32
10
0
0.00
2026-03-25
75
49
62.0
9,9
3
0
0.00
2026-03-26
83
59
71.0
18.6
0
6
0.00
2026-03-27
77
43
60.0
7.3
5
0
0.00
2026-03-28
60
35
47.5
-56
17
0
0.00
2026-03-29
72
35
53.5
0.1
11
0
0.00
2026-03-30
75
57
66.0
12.3
0
1
0,00
2026-03-31
78
63
70.5
16.5
0
6
0.00
Sum
2232
1450
-
-
210
43
2.17
Average
72.0
46.8
59.4
10.0
-
-
-
Normal
61.1
37.7
49.4
-
489
6
5.44
Observations for each day cover the 24 hours ending
at the time given below (Local Standard Time).
Max Temperature : 8pm
Min Temperature : 8pm
Precipitation : 8pm
01 26 25 - WEATHER DELAY REPORT
Month and Year
SBC Project Number and Project Name:
Reported Below:
East Hickman Vocational Building
March 2026
Weather condition
Work scheduled on critical path for this day
Date
causing delay
that was delayed.
1
2
3
4
5
6
7
Rain Day- 0.50
Underground Utilities/ grading site
8
Dry out day
Underground Utilities/ grading site
9
10
11
Rain Day- 0.56
Underground Utilities/ grading site
12
Rain Day- 0.08
Underground Utilities/ grading site
13
Dry out day
Underground Utilities/ grading site
14
Dry out day
Underground Utilities/ grading site
15
16
Rain day 0.95
Underground Utilities/ grading site
17
Dry out day
Underground Utilities/ grading site
18
Dry out day
Underground Utilities/ grading site
19
Dry out day
Underground Utilities/ grading site
20
21
22
23
24
25
26
27
28
29
30
31
Total number of days this month with delay due to weather 10 days
Baseline number from Section 01 26 20 8 days
Total - Baseline = claimable days 2 days
END OF SECTION
TN Higher Education - Standard Document - May 2018
Page 1 of 1
01 26 25 - WEATHER DELAY REPORT
Month and Year
SBC Project Number and Project Name:
Reported Below:
East Hickman VOC Building
April 2026
Weather condition
Work scheduled on critical path for this day
Date
causing delay
that was delayed.
1
2
3
Rain Day- 0.13
final grade/sidwalks
4
Rain Day- 0.57
final grade/sidwalks
5
Rain Day- 0.20
final grade/sidwalks
6
Dry out day
final grade/sidwalks
7
Dry out day
final grade/sidwalks
8
9
10
11
12
13
14
15
16
Rain Day- 0.24
final grade/sidwalks
17
Rain Day- 0.24
final grade/sidwalks
18
Dry out day
final grade/sidwalks
19
Dry out day
final grade/sidwalks
20
21
22
23
24
25
26
27
28
Rain Day- 2.18
final grade/sidwalks
29
Dry out day - 0.55
final grade/sidwalks
30
Dry out day
final grade/sidwalks
31
Total number of days this month with delay due to weather 12 days
Baseline number from Section 01 26 20 7days
Total - Baseline = claimable days 5 days
END OF SECTION
TN Higher Education - Standard Document - May 2018
Page 1 of 1
Climatological Data for DICKSON, TN - April 2026
Temperature
Date
HDD
CDD
Maximum
Minimum
Precipitation
Average
Departure
2026-04-01
81
62
71.5
17.2
0
7
0.00
2026-04-02
80
66
73.0
18.4
0
8
0.00
2026-04-03
84
64
74.0
19.1
0
9
0,13
2026-04-04
77
61
69.0
13.7
0
4
0.57
2026-04-05
62
44
53.0
-2.6
12
0
0.20
2026-04-06
68
37
52.5
-3.4
12
0
0.00
2026-04-07
66
43
54.5
-1.7
10
0
0.00
2026-04-08
77
42
59.5
3.0
5
0
0.00
2026-04-09
76
54
65.0
82
0
0
0.00
2026-04-10
78
47
62.5
5.4
2
0
0.00
2026-04-11
79
52
65.5
8.1
0
I
0.00
2026-04-12
82
51
66.5
8.8
0
2
0.00
2026-04-13
76
63
69.5
11.5
0
5
0.04
2026-04-14
82
61
71.5
13.3
0
7
0.00
2026-04-15
84
59
71.5
13.0
0
7
0.00
2026-04-16
80
58
69.0
102
0
4
0.24
2026-04-17
82
55
68.5
94
0
4
0.24
2026-04-18
70
45
57.5
-1.9
7
0
0.08
2026-04-19
64
39
51.5
-8.1
13
0
0.00
2026-04-20
72
39
55.5
-4.4
9
0
0.00
2026-04-21
78
42
60.0
-0.2
5
0
0,00
2026-04-22
79
45
62.0
16
3
0
0.00
2026-04-23
80
49
64.5
3.8
0
0
0.00
2026-04-24
77
55
66.0
51
0
1
0.03
2026-04-25
78
60
69.0
7.8
0
4
0,00
2026-04-26
82
53
67.5
6.1
0
3
0.00
2026-04-27
81
56
68.5
6.8
0
4
0.00
2026-04-28
79
59
69.0
7.1
0
4
2.18
2026-04-29
67
61
64.0
19
I
0
0.55
2026-04-30
63
48
55.5
-6.9
9
0
0.00
Sum
2284
1570
-
-
88
74
4.26
Average
761
52.3
64.2
5.6
-
-
-
Normal
70.9
46.2
58.6
.
223
29
4.93
Observations for each day cover the 24 hours ending
at the time given below (Local Standard Time).
Observation times may have changed during this period.
Max Temperature : 8pm, 7pm
Min Temperature : 8pm, 7pm
Precipitation : 8pm, 7pm
FC
FELLOWSHIP
P.O. Box 310
CONSTRUCTION
Bon Aqua, TN 37025
Phone: (615) 412-4446
Fax: (615) 412-4454
March 12, 2025
Lyle-Cook Martin Architects
310 Franklin St Clarksville TN, 37040
Re:
East Hickman Vocational Building
To whom it may concern:
Fellowship Construction is requesting an 18 calendar days contract extension for the existing 8 inch fire line underneath the
proposed building foundation. Construction was halted when bloodhound found the fire line on November 20th and a change order
was given after a board meeting on December 3rd. It then took 5 days to excavate and encase 2 portions of the fire line in concrete.
This halted the progress of construction because the existing fire line would be in the way of the concrete foundation.
Fellowship Construction is requesting 30 day contract extension for moving the existing gas line from the foundation of the proposed
building. The bi-weekly meeting was held on December 17th and we could not get an approved change order until the board meeting
on January 12th it then took 3 days to move the gas line. This halted the progress of construction because the existing gas line
would be in the way of the concrete foundation.
Thank you,
Mike Irwin
Project Manager
Enclosure:
- Job delays
LYLE.COOK.MARTIN
ARCHITECTS
East Hickman High School
Project No 1402.1
Agricultural/Vocational Education Building
Job Progress
Meeting Minutes
17 Dec 25
Attending:
Jennifer Turpin-HCS
Cayla Moultin-HCS
Toby Warren-HCS
Mike Irwin-Fellowship Construction
Jamie Irwin-Fellowship Construction
Jeff Corlew- LCMA
Work in Progress
Topsoil stripped, building layout, and currently forming for reinforcement over the existing fire line with
concrete placement planned for today.
Items discussed
1. Informed Jennifer that 2-1"conduits provided from our new building to the existing building for
fire alarm, fiber, intercom, etc. Discussed having school
tech people at a future progress meeting with the contractor's electricians.
2. Reviewed existing utility lines encountered under the building pad.
a. Storm line from the existing greenhouse. Decision was made to cap the line after it exists
the greenhouse and place a cover over the existing floor drain in the storage area of the
greenhouse.
b. Existing gas line serving the existing greenhouse crossing the building pad will be
redirected around the front of the building and be reconnected after the line exits our
building footprint.
C. Existing site lighting conduit also encountered under the Northeast corner of the building
pad and must be rerouted to the light pole located 2 feet from the building corner.
Contractor to provide the owner with pricing for the items above and a change order
will be drafted for approval at the next school board meeting January 12, 2026.
FC
FELLOWSHIP
P.O. Box 310
CONSTRUCTION
Bon Aqua, TN 37025
Phone: (615) 412-4446
Fax: (615) 412-4454
April 28, 2026
Lyle-Cook Martin Architects
310 Franklin St Clarksville TN, 37040
Re:
East Hickman Vocational Building
To whom it may concern:
Fellowship Construction is requesting an 27 calendar day contract extension for the discrepancy on the finish floor
elevation. I sent an email on March 10th and we discussed it in the meeting on March 31st and the concrete sub-contractor started
the additional spread footing on April 6th.
Thank you,
Mike Irwin
Project Manager
Enclosure:
- Job delays
Order #: JVLW00
RJYoung
Tax Exempt (Attach Exemption Certificate)
P.O. Box 280358 Nashville, TN 37228
Phone: (615)255-8551 Toll Free: (800)347-1955
Date:05/15/2026
SMP/Maintenance Agreement
Bill To:
HICKMAN COUNTY SCHOOL SYSTEM
115 MURPHREE AVE
CENTERVILLE, TN 37033-1430
Account #: R-551084
Qty.
Manufacturer
Model
Product Number
Equipment Number
Serial Number
Unit Price
Amount
1
See Attached Equipment List
1) The equipment specified above will be provided at the following rates:
Commencement Date
Term
Monthly Payment
Billing Frequency
Overage Billing Frequency
---
$ 2,500.00
Monthly
Unlimited
Type
Monthly Min
Overage Rate
Agreement Includes
Equipment Types
BW Supplies
Upgrade
Color Supplies
Existing Equipment
Parts/Labor
Remarks
This is an Unlimited SMP agreement for contract(s) #HNUR00 & #HO7000 and will be reviewed/revised annually. No meters required. No overages
billed.
The minimum monthly payment of $5,509.74 includes both lease and SMP. Please see attached spreadsheet for equipment list.
Signature:
Sales Rep:
Date:
Print Name:
Sales Mgr:
Date:
Title:
Date:
Additional terms and conditions on page 2
Page of 2
Initials:
2. The title to any and all products listed on the Sales Order remain with RJ Young Company (RJY) until full payment is received from you. Invoices are payable upon receipt unless prior written approval is received
from the RJY corporate offices.
3. Without prior written approval of RJY you may not assign any of your rights or obligations under this Agreement or allow a lien or encumbrance of any kind to be placed upon any products for which you have not
received title free and clear.
4. If payment is not paid when due, you will pay us a late charge of up to 15% of the amount of the payment or $15.00 whichever is greater (or such lesser rate as is maximum rale allowed under applicable law). You
also agree to pay $35.00 for each returned check. Restrictive endorsements or additional terms on checks you send to us will not reduce your obligations to US.
5. If payment is not paid when due, we will have the right to take ONE OR MORE of the following actions, in addition to any and all other remedies that may be available to us under the law: (a) cancel this agreement
without prior notice or warning to you; (b) file a law suit against you to collect all past due amounts, plus all our reasonable legal costs, including but not limited to reasonable attorneys' fees, reasonable overhead for
employee time spent on preparing for suit or attempting to collect payments and mitigate our damages; (c) repossess the Equipment or apply to a court for an order allowing repossession for any Equipment for which
you have not received title free and clear.
6. This Agreement, and other terms and conditions that you have acknowledged receipt of by signing this Sales Order, constitute the entire Agreement.
7. As a convenience to you and to further expedite this transaction for you, you agree that a photocopy, electronic image or facsimile of this Agreement which includes a photocopy, electronic image or facsimile of the
signatures of both parties shall be as valid, authentic and legally binding as the original version for all purposes and shall be admissible in court as final and conclusive evidence of this transaction and of the
execution of this document.
SMP AND/OR MAINTENANCE AGREEMENT
The following terms and conditions are in addition to the General Terms and Conditions above.
8. Service includes both labor and material for adjustments, repairs and replacement of parts as necessitated by normal equipment usage. Also included are regularly scheduled preventive maintenance and
emergency service subject to provisions. The charge is based on the original geographic installation location of the machine and RJY must be notified whenever the geographical location of the equipment is
changed. If the equipment has been moved to a new RJY service zone, a new agreement must be reached. For efficient and electronic meter reading, RJY utilizes specialized software that reports current meter
readings on all print devices connected to your Network. Customer agrees that meters may be accessed and reported in this manner. Should the number of scans exceed the total of all prints and copies, we reserve
the right to invoice these excess scans at $.0025 per scan. This agreement does not cover overhauls on the machine,
9. Service calls will be made during normal business hours at the specified installation address. (Business hours are 8:00 a.m. to 5:00 p.m., Monday to Friday). Travel and labor time on calls made other than during
normal business hours will be charged to Customer at established overtime rates.
10. Meter cards or fax forms will be provided to the Customer for monthly or quarterly billings. If forms are not received by the required date, an estimated meter will be used for billing purposes.
11. Customer agrees to make available a Meter Contact for training purposes in the use of the equipment and agrees to notify RJY of any change in the Meler Contact assignment.
12. Service will not be provided on equipment upon which there has been used unauthorized parts or supplies or that has been modified or used by unauthorized personnel lo repair or change said equipment.
Master or drums will not be replaced under this agreement when damage is caused by operator abuse or error, An initial master or drum charge may be required on older equipment,
13. This agreement shall be effective on the date of delivery of equipment if new equipment, otherwise on the commencement date listed on the contract and shall continue for a period of 12 months from the date
and will automatically renew for consecutive 12 month periods unless written cancellation notice is given by either party 30 days prior to the end of the then current term. In the event of cancellation of this agreement
for any reason, unused supplies shall be the property of RJY, although Customer may purchase the supplies at the then prevailing retail rates. Customer agrees to pay the periodic charges and upon failure to do so
RJY may (1) terminate the agreement, (2) refuse to service the equipment or furnish supplies, (3) recover damages as a result thereof.
14. At the end of each contract anniversary date, the rate charge can increase without written notice to allow for cost increases.
15. This agreement is not refundable or transferrable to a third party. If the equipment is traded in on new equipment, any unused portion of the contract period charge shall be prorated and credited lo the Customer.
16. This agreement may not be assigned by Customer without the written consent of RJY. This instrument contains the entire agreement between the parties and cannot be altered or amended except by an
instrument in writing signed by the parties hereto. Any agreement containing variations from the printed terms set forth herein must be accepted and counter-signed by an officer of RJY at its offices in Nashville,
Tennessee.
17. Sales or use tax shall be added where applicable.
Page 2 of 2
The Hickman County Finance Office is accepting sealed bids from licensed and qualified
contractors for the removal and installation of flooring at three schools.
The project will consist of two (2) bid items:
Bid Item 1: Luxury Vinyl Plank (LVP) Flooring
Bid Item 2: Carpet
Bidders may submit proposals for one or both bid items. Bid documents and specifications are
available online at: www.hickmank12.org/request-for-proposa
Sealed bids must be submitted by mail or hand delivered to the Hickman County Finance Office,
114 North Central Avenue, Suite 203, Centerville, TN 37033. All bids must be clearly marked on
the outside of the envelope "School Flooring" and received no later than 10:00 a.m. on May
13, 2026, at which time they will be publicly opened at the above address. There will be a pre-
bid meeting on May 5, 2026 at 9:00 A.M. for viewing spaces.
The Hickman County Board of Education reserves the right to accept or reject any and all bids,
in whole or in part, and to waive any informalities or technicalities deemed to be in the best
interest of the Board.
Present Penny Rochelle
Muty wearn
3 3 bids recd
Mallard Having
Offerparch
BJB Construction Company
au attached bids
School Flooring Bid Tabulation
Item 1 LVT
EHES
EHIS
EHMS
LVT
Furniture Removal
Total
LVT
Furniture Removal
Total
LVT
Furniture Removal
Total
Mallard Flooring
$15,930.22
$2,150.00
$18,080.22
$3,610.68
$900.00
$4,510.68
$5,259.32
$1,200.00
Offerporch
$6,459.32
$9,648.34
$1,324.99
$10,973.33
$2,076.70
$265.00
$2,341.70
$2,670.04
$265.00
BJB Construction
$2,935.04
$22,504.00
$2,450.00
$24,954.00
$5,016.00
$500.00
$5,516.00
$6,206.00
$675.00
$6,881.00
Item
2
EHES Carpet
Furniture Removal
Total
Mallard Flooring
$9,478.40
$2,150.00
$11,628.40
9800
Offerporch
$5,253.34
$706.66
$5,960.00
2100
BJB Construction
$11,948.00
$1,300.00
$13,248.00
2700
2925
Recommending Mallard Flooring at a total of $34,278.62 without furniture removal and $40,678.62 with furniture removal.
While Offerporch is the lowest bid, we have not worked with this company before.
Also we do not feel confident that all components were included in bid.
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, nor
C. in any discussions between bidders and any municipal official concerning exchange of money or
other things of value for special consideration in the letting of a contract.
3. no officer or employee of HCS either directly or indirectly, owns any interest in the bidder's business.
NON-BOYCOTT OF ISRAEL
Concerning the Non-Boycott of Israel Act (TCA 12-4-1 et seq.), by submission of this bid/quote/proposal, each
supplier and each person signing on behalf of any supplier certifies, and in the case of a joint
bid/quote/proposal, each party thereto certifies as to its own organization, under penalty of perjury, that to the
best of its knowledge and belief that each supplier is not boycotting Israel pursuant to § 12-4-1 and will not
during the term of any award. Note: Applicable only to contracts of $250,000 or more and to suppliers with 10
or more employees.
BACKGROUND CHECKS
In accordance with TCA § 49-5-413, all contractor representatives must supply a fingerprint sample and submit
to a criminal history records check conducted by the Tennessee Bureau of Investigation (TBI) and the Federal
Bureau of Investigation (FBI) before entering school property when students are present.
The undersigned hereby acknowledges receipt of these affidavits and certifies that the submittal in response to
this solicitation is in full compliance with the listed requirements. Failure to properly acknowledge issues
concerning the above is grounds for bid rejection and may subject the signer to penalties as directed by the
appropriate laws.
SIGNATURE OF AUTHORIZED AGENT Cynchea Chick
Subscribed and sworn to before me this
7
of
2026
Signature of Notary Public
Cammy 06/29/2027 day May
My Commission Expires
COMMOR B. STATE OF NEWBERRY
TENNESSEE
NOTARY
DICK
PUBLIC
COUNTY
BID ITEM 1 SUMMARY (total price)
Totals should include all materials, components and labor needed to complete
EHES ~2,450 sq ft Wood Look $ 15,930.22 Furniture removal/replacement $ 2,150.00
total 18,080.22
Stone Look $
68
EHIS ~525 sq ft
Wood Look $3,610.xx
Furniture removal/replacement $ 900.00
total 4,510,68
Stone Look $
EHMS ~675 sq ft
Wood Look $
Furniture removal/replacement $ 1,200.00
Stone Look $5,259.72
total: 6,459.32
BID ITEM 2 SUMMARY (total price)
Totals should include all materials, components and labor needed to complete
EHES ~1,300 sq ft $ 9,478.40
Furniture removal/replacement
$2,150.00
11,628,40
Cynthia chick
STATE OF TENNESSEE
COUNTY OF Dickson
SUBSCRIBED AND SWORN TO BEFORE, ME
COMOR B DICKSON TENNESSEE NOTARY STATE PUBLIC OF COUNTY
THIS THE 7 DAY OF May 2026
NOTARY PUBLIC
MY COMMISSION EXPIRES: 06/29/2027
*Affidavit Acknowledgement and Conflict of Interest must be completed and returned in sealed bid*
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of interest provisions.
TCA 5-21-121 provides:
(a)
The director, purchasing agent, members of the committee, members of the county legislative body or
other officials, employees, or members of the board of education or highway commission shall not be
financially interested or have any personal beneficial interest, either directly or indirectly in the purchase of
any supplies, materials, equipment or contractual services for the county.
(b)
No firm, corporation, partnership, association or individual furnishing any such supplies, materials,
equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any
assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or
association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other
things of value whatsoever, or any promise, obligation or contract for future reward or compensation.
Date: 5-7-26
Name: Cynthra Chick
Please describe below any relationships, transactions, positions you hold (volunteer or otherwise), or
circumstances that you believe could contribute to a conflict of interest:
Y
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or committees you (and/or
your spouse) sit on, the name of your employer and any businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my knowledge.
Date: 5-7-26
Signature: Cynthia Chick
MALLARD FLOORING
711 Highway 70 E
Dickson, TN 37055 US
service@mallardflooring.com
www.MallardFlooring.com
NOR are FLOORING
-
Estimate
ADDRESS
ESTIMATE
3079
DATE
03/24/2026
Bill Lynch
Hickman County School System
115 Murphree Avenue
Centerville, TN 37033
DATE
ACTIVITY
DESCRIPTION
QTY
RATE
AMOUNT
Sales
3 Offices 670 SqFt (not a plank wood
19
108.78
2,066.82
look Tuscan Sandstone $2.59)
Sales
Transitions
2
75.00
150.00
Sales
Install LVP
670
2.75
1,842.50
300.00
Sales
Carpet take up
75
4.00
Sales
Taylor Dynamics
2
160.00
320.00
East Middle
Sales
Cove Base
3
120.00
360.00
Sales
Furniture remove and relace
1,200.00
1,200.00
Labor
Dump fee
1
100.00
100.00
Freight Charge
1
120.00
120.00
SUBTOTAL
6,459.32
The signed estimate approval and 75% down confirms the above customer
selection. The remaining balance and any additional unforeseen customer
approved work is due upon completion.
TAX
0.00
TOTAL
$6,459.32
Accepted By
Accepted Date
Page 1 of 1
MALLARD FLOORING
711 Highway 70 E
Dickson, TN 37055 US
service@mallardflooring.com
www.MallardFlooring.com
FLOORING
Estimate
ADDRESS
ESTIMATE
3078
DATE
03/23/2026
Bill Lynch
Hickman County School System
115 Murphree Avenue
Centerville, TN 37033
DATE
ACTIVITY
DESCRIPTION
QTY
RATE
AMOUNT
Hickman Intermediate
Sales
LVP Mohawk Bentwood 522SqFt
522
2.19
1,143.18
Sales
Taylor Dynamics
1
160.00
160.00
Sales
Flexco Transitions
4
75.00
300.00
Labor
LVP Install
522
2.75
1,435.50
Labor
Dump Fee
1
150.00
150.00
Labor
Carpet removal
58
4.00
232.00
Freight Charge
freight
1
120.00
120.00
Labor
Furniture remove and replace
1
900.00
900.00
Sales
Case of cove base glue
1
70.00
70.00
SUBTOTAL
4,510.68
The signed estimate approval and 75% down confirms the above customer
selection. The remaining balance and any additional unforeseen customer
approved work is due upon completion.
TAX
0.00
$4,510.68
TOTAL
Accepted By
Accepted Date
Page 1 of 1
MALLARD FLOORING
711 Highway 70 E
Dickson, TN 37055 US
service@mallardflooring.com
www.MallardFlooring.com
FLOORING
Estimate
ADDRESS
ESTIMATE
3077
DATE
03/23/2026
Bill Lynch
Hickman County School System
115 Murphree Avenue
Centerville, TN 37033
DATE
CTIVITY
DESCRIPTION
QTY
RATE
AMOUNT
East Hickman Elementary
Office 1,2nd room,3rd room. Hallway,
Office ,Closet, Office 5 Assistant
Principal, Speech Room. Conference
Room and library
Sales
LVP 2438.1 Mohawk Bentwood 2.5
2,738
2.19
5,996.22
Glue Down
Sales
Carpet Removal SqYd (will lay over
271
4.50
1,219.50
VCT so we do not disturb it)
Sales
LVP Install
2,738
2.75
7,529.50
Sales
Library Carpet removal By SqYd
144
4.00
576.00
Sales
Library Carpet install By SqFt
1,296
2.75
3,564.00
Sales
Flexco transition
7
75.00
525.00
Sales
Library Carpet Tile Tectonic Nylon
22
187.20
4,118.40
Engineered Floors SQFt
Sales
Flexco 2000 Wall Base
4
120.00
480.00
Sales
Library Carpet Glue Taylor Dynamics
5
160.00
800.00
Sales
Dump Trailer will rent a 15ton
400.00
400.00
Labor
furniture removes and replaces
1
4,300.00
4,300.00
Freight Charge
1
200.00
200.00
The signed estimate approval and 75% down confirms the above customer
SUBTOTAL
29,708.62
selection. The remaining balance and any additional unforeseen customer
approved work is due upon completion.
TAX
0.00
TOTAL
$29,708.62
Page 1 of 2
MEMPHIS AND SHELBY COUNTY
0
Shelby County Clerk
BUSINESS TAX LICENSE
WANDA HALBERT
RECEIPT NUMBER
251010115
150 Washington Avenue
Memphis, Tennessee 38103-1800
LICENSE NUMBER
220002398
THIS LICENSE EXPIRES
05/15/2026
CLASSIFICATION
3
OWNER(S)
OFFERPORCH HOMES LLC
OFFERPORCH
BUSINESS LOCATION ADDRESS
676 CLINTON PL
676 CLINTON PL
MEMPHIS, TN 38126
MEMPHIS, TN 38126
MUST DISPLAY IN A CONSPICUOUS
PLACE
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
01/29/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
PHONE
FAX
Next First Insurance Agency, Inc.
(A/C, No. ExI):
(855) 222-5919
(A/C, No):
PO Box 60787
E-MAIL
Palo Alto, CA 94306
ADDRESS:
support@nextinsurance.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Next Insurance US Company
16285
INSURED
INSURER B :
OfferPorch Homes LLC
INSURER C :
254 Court Ave Ste 310
Memphis, TN 38103
INSURER D :
INSURER E:
INSURER F :
COVERAGES
CERTIFICATE NUMBER: 942197985
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
TYPE OF INSURANCE
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000.00
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$100,000.00
MED EXP (Any one person)
$10,000.00
A
NXTWH9LFKH-02-GL
01/29/2026
01/29/2027
PERSONAL & ADV INJURY
$1,000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$1,000,000.00
PRO-
POLICY
LOC
PRODUCTS- COMP/OP AGG
$1,000,000.00
JECT
$
OTHER:
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY
$
(Ea accident)
ANY AUTO
BODILY INJURY (Per person)
$
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$
AUTOS ONLY
AUTOS ONLY
(Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
$
DED
RETENTION $
PER
OTH-
WORKERS COMPENSATION
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
OFFICER/MEMBEREXCLUDED?
N/A
(Mandatory in NH)
E.L. DISEASE- EA EMPLOYEE
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Proof of Insurance.
CERTIFICATE HOLDER
CANCELLATION
OfferPorch Homes LLC
LIVE CERTIFICATE
254 Court Ave Ste 310
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Memphis, TN 38103
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ann Ryan
Click or scan to view
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
OF
THE
SEAL
STATE
Bureau of Workers' Compensation
OF
Exemption Registry
GREAT THE AGRICULTURE COMMERCE )
State of Tennessee
220 French Landing Drive Suite 1-B
1796
Nashville TN, 37243-1002
CURTDELL GILES Jr.
254 Court Ave., Suite 310, Curtdell Giles Jr.
7/16/2025
Memphis TN 38103
Initial Workers' Compensation Exemption Registration Acknowledgment
Please review the filing information below and notify our office immediately of any discrepancies.
Reg. Control #:
2025000014351
Date Filed: 7/16/2025
Effective Date: 7/16/2025
Application Name:
CURTDELL GILES Jr.
Expiration Date: 7/16/2027
Filing Type:
Initial Workers' Compensation Exemption
Status:
Active
Physical Addr:
254 Court Ave., Suite 310, Curtdell Giles Jr., Memphis TN 38103
Business Name:
OfferPorch Homes LLC
Business Control #:
001133856
Existing State License: Yes
77366
Business County:
Not Required
County License #:
220002398
Expiration Date:
5/15/2025
Business City:
Not Required
City License #:
220002398
Expiration Date:
5/15/2025
Document Receipt
FIS - Online Payment Portal -
$50.00
FIS - Online Payment Portal - 08144C
$50.00
Congratulations on your filing. To maintain your exemption, the business entity associated with this registration must remain active
and in good standing, which includes timely filing of annual reports. In addition, you must file a renewal application within 60 days
of the expiration date noted above to maintain the exemption.
THE
STATE OF TENNESSEE
AGRICULTURE
GREAT
F)
Claudia Byers
220 French Landing Drive Suite 1-B
Nashville TN, 37243-1002
Workers' Compensation Exemption Registration
CURTDELL GILES Jr.
Effective: 7/16/2025
Expires: 7/16/2027
Claudia Byers
Registration Control #
2025000014351
Bureau of Workers' Compensation
Validate at https://www.tn.gov/workforce/injuries-at-
Exemption Registry
work/employers/employers/wc-exemption-registry.litml
Tennessee Bureau of Workers' Compensation * 220 French Landing Drive Suite 1-B Nashville, TN 37243
Tel: (615) 532-1319 * ttps:/www.ta.gov/workforce/injuries-at-work/employers/employers/wc-exemption-regisiry.him
INVITATION TO BID
School Flooring Project
The Hickman County Finance Office is accepting sealed bids from licensed and qualified contractors for the
removal and installation of flooring at three schools.
The project will consist of two (2) bid items:
Bid Item 1: Luxury Vinyl Plank (LVP) Flooring
Bid Item 2: Carpet
Bidders may submit proposals for one or both bid items. Bid documents and specifications are available online
at: www.hickmank12.org/request-for-proposal
Sealed bids must be submitted by mail or hand delivered to the Hickman County Finance Office, 114 North
Central Avenue, Suite 203, Centerville, TN 37033. All bids must be clearly marked on the outside of the
envelope "School Flooring" and received no later than 10:00 a.m. on May 13, 2026, at which time they will
be publicly opened at the above address. There will be a pre-bid meeting on May 5, 2026 at 9:00 A.M. starting
at East Hickman Elementary School for viewing spaces.
The Hickman County Board of Education reserves the right to accept or reject any and all bids, in whole or in
part, and to waive any informalities or technicalities deemed to be in the best interest of the Board.
Flooring Removal and Replacement Specifications
Include product detail sheet with bid documents (Manufacturer, product name, item #, etc)
Bid Item 1 - Remove carpet and install LVP flooring
LVP
Glue down
Minimum thickness: 2.5mm
Minimum wear layer: 20 mil or 0.5 mm
Style: Would like pricing for wood look and stone look
Color: To be determined by school principal based on available options
*There will be a line for furniture removal and replacement pricing if your company provides this service
East Hickman Elementary School - Front office area, speech, conference room, ~2,450 sq ft
East Hickman Intermediate School - Front office area, ~525 sq ft
East Hickman Middle School - Front office area, ~675 sq ft
Bid Item 2 - Remove carpet and install carpet tiles
Carpet Tiles
Glue down
Commercial grade
24" X 24" tile
Color: To be determined by school principal based on available options
*There will be a line for furniture removal and replacement pricing if your company provides this service
East Hickman Elementary School - Library -1,300 sq ft
BID ITEM 1 SUMMARY (total price)
Totals should include all materials, components and labor needed to complete
EHES ~2,450 sq ft Wood Look $ 9,648.34
Furniture removal/replacement $ 1,324.99
Stone Look $ 9,648.34
EHIS ~525 sq ft
Wood Look $ 2,076.70
Furniture removal/replacement $ 265.00
Stone Look $ 2,076.70
EHMS ~675 sq ft Wood Look $ 2,670.04
Furniture removal/replacement $ 265.00
Stone Look $ 2,670.04
BID ITEM 2 SUMMARY (total price)
Totals should include all materials, components and labor needed to complete
EHES ~1,300 sq ft $ 5,253.34
Furniture removal/replacement
$ 706.66
*Affidavit Acknowledgement and Conflict of Interest must be completed and returned in sealed bid*
AFFIDAVIT ACKNOWLEDGEMENT
AMERICANS WITH DISABILITIES ACT
Bidder shall take the necessary actions to ensure its facilities and employment practices are in compliance with
the applicable requirements of the Americans with Disabilities Act. Any costs of such compliance will be the
sole responsibility of the bidder.
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 BACKGROUND CHECKS
Bidder shall comply with Public Chapter 587 of 2007, as codified in Tennessee Code Annotated Section 49-5-
413, which requires any person, corporation or entity who enters into or renews a contract with a local board of
education, to provide a criminal history records check conducted by the Tennessee Bureau of Investigation
and the Federal Bureau of Investigation for each employee prior to permitting the employee to have contact
with students or enter school grounds when students are present.
DRUG FREE WORKPLACE REQUIREMENTS
Private employers with five or more employees desiring to contract for construction services attest that they
have a drug free workplace program in effect in accordance with Tennessee Code Annotated Section 50-9-
112.
COMPLIANCE AGREEMENT WITH PUBLIC CHAPTER 587 of 2007
Contractor shall comply with Public Chapter 587 of 2007, as codified in Tennessee Code Annotated Section
49- 5-413, which requires all contractors to facilitate a criminal history records check conducted by the
Tennessee Bureau of Investigation and the Federal Bureau of Investigation for each employee prior to
permitting the employee to have contact with students or enter school grounds..
IRAN DIVESTMENT ACT
Under the Iran Divestment Act, T.C.A. §§ 12-12-101--12-12-113, political subdivisions in Tennessee are
prohibited from entering into any procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer is required under T.C.A. § 12-12-106 to
create a list of persons who engage in investment activities in Iran. Any person who is on the list is ineligible to
contract with any political subdivision of this state, and any such contract is declared void ab initio under $ 12-
12-110.
On or after July 1, 2016, every bid or proposal submitted to a political subdivision where competitive bidding is
required must contain the following statement, submitted by the bidder under penalties of perjury:
"By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in
the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury,
that to the best of its knowledge and belief that each bidder is not on the list created pursuant to $ 12-
12-106."
COLLUSION AMONG BIDDERS
The bidder submitting the competitive bid which is attached to this statement, for the purpose of certifying the
facts pertaining to the existence of collusion among bidders and between bidders and municipal 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.
1. Bidder is fully aware of the facts and circumstances surrounding the making of the bid to which this
statement is attached and has been personally and directly involved in the proceedings leading to the
submission of such bid; and
2. neither the bidder nor anyone subject to the bidder's direction 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, nor
C. in any discussions between bidders and any municipal official concerning exchange of money or
other things of value for special consideration in the letting of a contract.
3. no officer or employee of HCS either directly or indirectly, owns any interest in the bidder's business.
NON-BOYCOTT OF ISRAEL
Concerning the Non-Boycott of Israel Act (TCA 12-4-1 et seq.), by submission of this bid/quote/proposal, each
supplier and each person signing on behalf of any supplier certifies, and in the case of a joint
bid/quote/proposal, each party thereto certifies as to its own organization, under penalty of perjury, that to the
best of its knowledge and belief that each supplier is not boycotting Israel pursuant to § 12-4-1 and will not
during the term of any award. Note: Applicable only to contracts of $250,000 or more and to suppliers with 10
or more employees.
BACKGROUND CHECKS
In accordance with TCA § 49-5-413, all contractor representatives must supply a fingerprint sample and submit
to a criminal history records check conducted by the Tennessee Bureau of Investigation (TBI) and the Federal
Bureau of Investigation (FBI) before entering school property when students are present.
The undersigned hereby acknowledges receipt of these affidavits and certifies that the submittal in response to
this solicitation is in full compliance with the listed requirements. Failure to properly acknowledge issues
concerning the above is grounds for bid rejection and may subject the signer to penalties as directed by the
SIGNATURE appropriate laws. OF AUTHORIZED AGENT
Subscribed and sworn to before me this
11th
day of
May
, 2026
.
Signature of Notary Public But and
My Commission Expires
BRUCE
JOHNSON
7/27/2017
STATE
OF
TENNESSEE
NOTARY
PUBLIC
SHELBY
COUNTY
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of interest provisions.
TCA 5-21-121 provides:
(a)
The director, purchasing agent, members of the committee, members of the county legislative body or
other officials, employees, or members of the board of education or highway commission shall not be
financially interested or have any personal beneficial interest, either directly or indirectly, in the purchase of
any supplies, materials, equipment or contractual services for the county.
(b)
No firm, corporation, partnership, association or individual furnishing any such supplies, materials,
equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any
assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or
association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other
things of value whatsoever, or any promise, obligation or contract for future reward or compensation.
Date:
5/11/2026
Name:
Curtdell Giles Jr.
Please describe below any relationships, transactions, positions you hold (volunteer or otherwise), or
circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or committees you (and/or
your spouse) sit on, the name of your employer and any businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the bést of my knowledge.
Date:
5/11/2026
Signature:
5/11/26, 2:13 PM
Pro Solutions IV, Grey Mist, Resilient / Vinyl I Mohawk Flooring
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UltimateFlex Loose Lay
I
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***** 4.7 (70) Write a review
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Designed with added thickness for extra comfort underfoot and allows for easy plank replacement to
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Color: Grey Mist
WHERE TO BUY
ADD SAMPLE TO CART
SEE THIS IN MY ROOM
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Pro Solutions IV, Grey Mist, Resilient / Vinyl | Mohawk Flooring
ABOUT THIS PRODUCT
DESCRIPTION
Flexible vinyl plank flooring that's 100% waterproof, easy to clean, simple to repair, and built with
added thickness for enhanced comfort and a premium wear layer for top-tier protection.
FEATURES
FASHT
to
CLEAN
EasyClean® technology helps repel dirt and grime, while the enhanced wear
layer adds extra protection against everyday scuffs, scratches, and wear.
PHANEED
COMFORT
Designed with added thickness for extra comfort underfoot and allows for easy
plank replacement to extend the life of your floor.
FET
FRIENDLY
Warranty protection against pet stains for added peace of mind.
WEAR
SECURITY
Premium Wear Resistance: Up to a 20 mil wear layer for upgraded protection
against everyday wear and tear.
WATERPRODE
PROOF
100% waterproof floors perfect for any room in the home.
TECHNOLOGIES
EASYCLEAN+
X
Repels dirt and grime for simple cleanup
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Learn More
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Pro Solutions IV, Grey Mist, Resilient / Vinyl I Mohawk Flooring
PRODUCT SPECS & RESOURCES
PRODUCT SPECS
COLLECTION
Style Name
Pro Solutions IV
Product Line
UltimateFlex Loose Lay
Product Type
Resilient Vinyl
Color Name
Grey Mist
PRODUCT DETAILS
Look
Wood
Construction
Flex Vinyl
Edge Treatment
Micro Bevel
Floorscore Certified
TRUE
INSTALLATION
Grade
On, Above or Below Grade
Sub-Floor
Wood/Concrete
Underlayment
Not attached
X
Installation Method
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MEASUREMENT
Plank Thickness
5 mm
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Pro Solutions IV, Grey Mist, Resilient / Vinyl I Mohawk Flooring
Wear Layer
20 mil
Width In Inches
7.25"
Length
48"
Sq. Ft. Per Carton
24.2
Veneer Thickness
N/A
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Whitmore Terrace LL, Percy, Resilient / Vinyl | Mohawk Flooring
IN
MOHAWK
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X
VIEWALL
à
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MEDIA
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Whitmore Terrace LL, Percy, Resilient / Vinyl I Mohawk Flooring
UltimateFlex Loose Lay
Whitmore Terrace LL
4.9 (15) Write a review
100% waterproof floors perfect for any room in the home.
EasyClean® technology repeis dirt and grime, while a premium wear layer delivers top-tier protection against everyday wear and tear.
Designed with added thickness for extra comfort underfoot and allows for easy plank replacement to extend the life of your floor.
Learn More View Specs & Resources
Color: Percy
WHERE TO BUY
ADD SAMPLE TO CART
SEE THIS IN MY ROOM
ABOUT THIS PRODUCT
DESCRIPTION
Create a beautifully cohesive look with coordinating wood and tile designs from the Whitmore Terrace collection. The carefully selected colors in a trending
palette allow you to mix or match for easy styling, and a variety of flooring constructions provide options for any performance need.
FEATURES
EasyClean® technology helps repel dirt and grime, while the enhanced wear layer adds extra protection against everyday scuffs,
scratches, and wear.
Designed with added thickness for extra comfort underfoot and allows for easy plank replacement to extend the life of your floor.
Warranty protection against pet stains for added peace of mind.
THAN
Premium Wear Resistance: Up to a 20 mil wear layer for upgraded protection against everyday wear and tear.
x
100% waterproof floors perfect for any room in the home.
Hi! I'm Aiden, your A.I. flooring expert. How can I help?
TECHNOLOGIES
htts://ww.mhawkfloring.com/shop/Resient/detalSR01/Whitmore_Terae_L/906/Rercy7productlinesilineFietobse-Lay&sfsfalse&s=tun
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Whitmore Terrace LL, Percy, Resilient / Vinyl I Mohawk Flooring
EASYCLEAN
Repels dirt and grime for simple cleanup and stain protection.
Learn More
PRODUCT SPECS & RESOURCES
PRODUCT SPECS
COLLECTION
Style Name
Whitmore Terrace LL
Product Line
UltimateFlex Loose Lay
Product Type
Resilient Vinyl
Color Name
Percy
PRODUCT DETAILS
Look
Stone
Construction
Loose Lay
Species
Marble
Texture
All Over
Floorscore Certified
TRUE
INSTALLATION
Grade
On, Above or Below Grade
Sub-Floor
Wood/Concrete
Underlayment
Not Attached
Installation Method
Glue Down
MEASUREMENT
Plank Thickness
5.0 mm
Wear Layer
20 mil
Width In Inches
12'
X
Length
24"
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Sq. Ft. Per Carton
24
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Style Number
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Construction
Tufted
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Surface Appearance
Textured Patterned Loop
Textured Patterned Loop
Gauge
1/12" (47.00 rows per 10cm)
1/12" (47.00 rows per 10cm)
Tufted Weight
16
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Density
6,063
6,697
Dye Method
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Fiber Type
Envirostrand™ SD PET
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Soil Release Technology
Mohawk Protection Plus Soil
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Primary Backing
Non Woven Synthetic
Non Woven Synthetic
Secondary Backing
UltraSet Matrix
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Indoor Air Quality
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Green Label Plus Certified # 100055
Size
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24" X 24" (.6096 m X .6096 m)
Sqyd per Carton
10.66 sqyd/ctn
10.66 sqyd/ctn
Installation Method
Brick Ashlar / Quarter Turn
Brick Ashlar / Quarter Turn
Flammability
ASTM E 648 Class 1 (Glue Down)
ASTM E 648 Class 1 (Glue Down)
Smoke Density
ASTM E 662 Less than 450
ASTM E 662 Less than 450
Static Propensity
AATCC-134 Under 3.5 KV
AATCC-134 Under 3.5 KV
Country of Origin
USA
USA
Warranties
10-Year Limited Wear Warranty
10-Year Limited Wear Warranty
10-Year Limited Static Protection
10-Year Limited Static Protection
10-Year Limited Edge Ravel, Zippering, Delamination,
10-Year Limited Edge Ravel, Zippering, Delamination,
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Rev 0658_Aug/2019
W-9
Request for Taxpayer
Give form to the
Form
Identification Number and Certification
requester. Do not
(Rev. March 2024)
send to the IRS.
Department of the Treasury
Go to www.irs.gov/FormW9 for Instructions and the latest information.
Internal Revenue Service
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded
entity's name on line 2)
BJB Construction Company Inc
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
Individual/sole proprietor
C corporation
S
Trust/estate
See Specific Instructions on page 3.
Partnership
LLC. Enter the tax classification (C = C corporation, = S corporation, P = Partnership)
Exempt payee code (if any)
Print or type.
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
code (if any)
Other (see instructions)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
outside the United States.)
this box if you have any foreign partners, owners, or beneficiaries. See instructions
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
1373 Holly Tree Gap Rd
6 City, state, and ZIP code
Brentwood, TN. 37027
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For Individuals, this is generally your social security number (SSN). However, for a
-
-
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entitles, it is your employer identification number (EIN). If you do not have a number, see How to get a
or
TIN, later.
Employer Identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
04 - 3777109
Part Il Certification
Under penalties of perjury, 1 certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Signature of
Here
U.S. person
Debbie Benbow
Date 3/13/2026
General Instructions
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
noted.
to another flow-through entity in which it has an ownership interest. This
change is intended to provide a flow-through entity with information
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
after they were published, go to www.irs.gov/FormW9.
requirements. For example, a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
An individual or entity (Form W-9 requester) who is required to file an
should check the "LLC" box and enter its appropriate tax classification.
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)
State DL Connessee
14123171
BOARD FOR LICENSI NG CONTRACTORS
CONTRACTOR
BJB CONSTRUCTION COMPANY INC
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 61519
SEALTH THE STATE
LIC STATUS: ACTIVE
EXPIRATION DATE: September 30, 2026
$473,240.00; BC
AGRICULTURE 7796* 7
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
02/12/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
CONTACT NAME: LISA WILSON
INSURANCE GROUP OF AMERICA LLC
PHONE:
FAX: (615)905-1698
SMALL BUSINESS
6640 CAROTHERS PKWY STE 160
E-MAIL ADDRESS: llsa.wilson@iga.biz
FRANKLIN, TN 37067
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A
Central Mutual
20230
INSURED
INSURER B
All America
20222
BJB CONSTRUCTION COMPANY INC
INSURER C
1373 HOLLY TREE GAP RD
BRENTWOOD, TN 37027
INSURER D
INSURER E
INSURER F
CERTIFICATE NUMBER
7018655
REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDLISUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
Y
Y
9606838
8/8/2025
8/8/2026
EACH OCCURRENCE
$
1,000,000
DAMAGE TO RENTED PREMISES
$
300,000
COMMERCIAL GENERAL LIABILITY
(Ea occurrence)
CLAIMS-MADE
OCCUR
MED EXP (Any one person)
$
5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PERSONAL & ADV INJURY
$
1,000,000
POLICY
PRO-
LOC
GENERAL AGGREGATE
$
2,000,000
JECT
PRODUCTS- COMP/OP AGG
$
2,000,000
B
AUTOMOBILE LIABILITY
Y
Y
9606837
8/8/2025
8/8/2026
COMBINED SINGLE LIMIT (Ea
$
1,000,000
accident)
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS
AUTOS
PROPERTY DAMAGE (Per
$
HIRED AUTOS
NON-OWNED
accident)
AUTOS
A
UMBRELLA LIABILITY
Y
Y
9606839
8/8/2025
8/8/2026
EACH OCCURRENCE
$
5,000,000
UMBRELLA
AGGREGATE
$
5,000,000
OCCUR
LIAB
EXCESS LIAB
CLAIMS-MADE
DED
RETENTION $
A
WORKERS COMPENSATION AND
9606841
8/8/2025
8/8/2026
WC STATUTORY LIMITS
OTHER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
1,000,000
ANY PROPRIETOR/PARTNERS/EXEC
Y
UTIVE OFFICE/MEMBER EXCLUDED?
EL DISEASE - EA EMPLOYEE
$
1,000,000
(Mandatory in NH)
E.L DISEASE- POLICY LIMIT
$
1,000,000
if yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES
Certificate Holders are additional insured por the attached endorsements.
Subject to all of the terms, conditions, exclusions and definitions of the above referenced policies as issued by the carrier(s).
Excluded proprielors, partners, executive officers, and members:
DEBBIE BENBOW
BRUCE BENBOW
CERTIFICATE HOLDER
CANCELLATION
BJB CONSTRUCTION COMPANY INC.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
1373 HOLLY TREE GAP RD
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
BRENTWOOD, TN 37027
THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
LISA WILSON
BEYOND JUST BUILDERS
NUMBERS
BJB
CONSTRUCTION COMPANY INC
BJB
1373 Holly Tree Gap Rd, Brentwood, TN. 37027
CONSTRUCTION
CONSTRUCTION
COMPANY
COMPANY
References:
1) Brent Stidham
Senior Maintenance Engineer
(Managing govt buildings in Brentwood TN)
City Of Brentwood
brent.stidham@brentwoodtn.gov
(615)533-5032
15+ Years as a customer
2) Ryan Edwards
Continuous Improvement Coordinator
Advanced Composites
Ryan.edwards@advcmp.com
(615)630-1843
15+ Years as a customer
3) Yvonne Parker
Sr. Specialist, Consumer Care National Facilities
T-Mobile
Yvonne.parker@t-mobile.com
(931)980-8867
8 Years as a customer
4) Wesley King
Service Manager
The Mathews Company
wking@themathewscompany.com
(615)394-8451
15+ Years as a customer
Office 615-457-3304
www.BJBConstruction.com
INVITATION TO BID
School Flooring Project
The Hickman County Finance Office is accepting sealed bids from licensed and qualified contractors for the
removal and installation of flooring at three schools.
The project will consist of two (2) bid items:
Bid Item 1: Luxury Vinyl Plank (LVP) Flooring
Bid Item 2: Carpet
Bidders may submit proposals for one or both bid items. Bid documents and specifications are available online
at: www.hickmank12.org/request-for-proposal
Sealed bids must be submitted by mail or hand delivered to the Hickman County Finance Office, 114 North
Central Avenue, Suite 203, Centerville, TN 37033. All bids must be clearly marked on the outside of the
envelope "School Flooring" and received no later than 10:00 a.m. on May 13, 2026, at which time they will
be publicly opened at the above address. There will be a pre-bid meeting on May 5, 2026 at 9:00 A.M. starting
at East Hickman Elementary School for viewing spaces.
The Hickman County Board of Education reserves the right to accept or reject any and all bids, in whole or in
part, and to waive any informalities or technicalities deemed to be in the best interest of the Board.
Flooring Removal and Replacement Specifications
Include product detail sheet with bid documents (Manufacturer, product name, item #, etc)
Bid Item 1 - Remove carpet and install LVP flooring
LVP
Glue down
Minimum thickness: 2.5mm
Minimum wear layer: 20 mil or 0.5 mm
Style: Would like pricing for wood look and stone look
Color: To be determined by school principal based on available options
*There will be a line for furniture removal and replacement pricing if your company provides this service
East Hickman Elementary School - Front office area, speech, conference room, ~2,450 sq ft
East Hickman Intermediate School - Front office area, ~525 sq ft
East Hickman Middle School - Front office area, ~675 sq ft
Bid Item 2 - Remove carpet and install carpet tiles
Carpet Tiles
Glue down
Commercial grade
24" X 24" tile
Color: To be determined by school principal based on available options
*There will be a line for furniture removal and replacement pricing if your company provides this service
East Hickman Elementary School - Library ~1,300 sq ft
BID ITEM 1 SUMMARY (total price)
Totals should include all materials, components and labor needed to complete
EHES ~2,450 sq ft Wood Look $ 22,504.00
Furniture removal/replacement $2450.00
Stone Look $ 22,504.00
EHIS ~525 sq ft
Wood Look $5,016.00
Furniture removal/replacement $500.00
Stone Look $5,016.00
EHMS ~675 sq ft
Wood Look $ 6,206.00
Furniture removal/replacement $675.00
Stone Look $6,206.00
*Note: LVP material allowance of $3.00/sf for both options.
BID ITEM 2 SUMMARY (total price)
Totals should include all materials, - components and labor needed to complete
EHES -1,300 sq ft $11,948.00
Furniture removal/replacement
$ 1,300.00
*Notes:
- Minor Prep included
- Demo can be added for additional cost
- Work to be done durring normal hours
*Affidavit Acknowledgement and Conflict of Interest must be completed and returned in sealed bid*
AFFIDAVIT ACKNOWLEDGEMENT
AMERICANS WITH DISABILITIES ACT
Bidder shall take the necessary actions to ensure its facilities and employment practices are in compliance with
the applicable requirements of the Americans with Disabilities Act. Any costs of such compliance will be the
sole responsibility of the bidder.
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 BACKGROUND CHECKS
Bidder shall comply with Public Chapter 587 of 2007, as codified in Tennessee Code Annotated Section 49-5-
413, which requires any person, corporation or entity who enters into or renews a contract with a local board of
education, to provide a criminal history records check conducted by the Tennessee Bureau of Investigation
and the Federal Bureau of Investigation for each employee prior to permitting the employee to have contact
with students or enter school grounds when students are present.
DRUG FREE WORKPLACE REQUIREMENTS
Private employers with five or more employees desiring to contract for construction services attest that they
have a drug free workplace program in effect in accordance with Tennessee Code Annotated Section 50-9-
112.
COMPLIANCE AGREEMENT WITH PUBLIC CHAPTER 587 of 2007
Contractor shall comply with Public Chapter 587 of 2007, as codified in Tennessee Code Annotated Section
49- 5-413, which requires all contractors to facilitate a criminal history records check conducted by the
Tennessee Bureau of Investigation and the Federal Bureau of Investigation for each employee prior to
permitting the employee to have contact with students or enter school grounds..
IRAN DIVESTMENT ACT
Under the Iran Divestment Act, T.C.A. §§ 12-12-101--12-12-113, political subdivisions in Tennessee are
prohibited from entering into any procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer is required under T.C.A. § 12-12-106 to
create a list of persons who engage in investment activities in Iran. Any person who is on the list is ineligible to
contract with any political subdivision of this state, and any such contract is declared void ab initio under $ 12-
12-110.
On or after July 1, 2016, every bid or proposal submitted to a political subdivision where competitive bidding is
required must contain the following statement, submitted by the bidder under penalties of perjury:
"By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in
the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury,
that to the best of its knowledge and belief that each bidder is not on the list created pursuant to $ 12-
12-106."
COLLUSION AMONG BIDDERS
The bidder submitting the competitive bid which is attached to this statement, for the purpose of certifying the
facts pertaining to the existence of collusion among bidders and between bidders and municipal 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.
1. Bidder is fully aware of the facts and circumstances surrounding the making of the bid to which this
statement is attached and has been personally and directly involved in the proceedings leading to the
submission of such bid; and
2. neither the bidder nor anyone subject to the bidder's direction 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, nor
C. in any discussions between bidders and any municipal official concerning exchange of money or
other things of value for special consideration in the letting of a contract.
3. no officer or employee of HCS either directly or indirectly, owns any interest in the bidder's business.
NON-BOYCOTT OF ISRAEL
Concerning the Non-Boycott of Israel Act (TCA 12-4-1 et seq.), by submission of this bid/quote/proposal, each
supplier and each person signing on behalf of any supplier certifies, and in the case of a joint
bid/quote/proposal, each party thereto certifies as to its own organization, under penalty of perjury, that to the
best of its knowledge and belief that each supplier is not boycotting Israel pursuant to § 12-4-1 and will not
during the term of any award. Note: Applicable only to contracts of $250,000 or more and to suppliers with 10
or more employees.
BACKGROUND CHECKS
In accordance with TCA § 49-5-413, all contractor representatives must supply a fingerprint sample and submit
to a criminal history records check conducted by the Tennessee Bureau of Investigation (TBI) and the Federal
Bureau of Investigation (FBI) before entering school property when students are present.
The undersigned hereby acknowledges receipt of these affidavits and certifies that the submittal in response to
this solicitation is in full compliance with the listed requirements. Failure to properly acknowledge issues
concerning the above is grounds for bid rejection and may subject the signer to penalties as directed by the
appropriate laws.
SIGNATURE OF AUTHORIZED AGENT Nathaniel Benbow
Subscribed and sworn to before me this
day of May
, 2026
-
Signature of Notary Public Notary to be submitted after notice of award if neeeded.
My Commission Expires
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of interest provisions.
TCA 5-21-121 provides:
(a)
The director, purchasing agent, members of the committee, members of the county legislative body or
other officials, employees, or members of the board of education or highway commission shall not be
financially interested or have any personal beneficial interest, either directly or indirectly , in the purchase of
any supplies, materials, equipment or contractual services for the county.
(b)
No firm, corporation, partnership, association or individual furnishing any such supplies, materials,
equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any
assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or
association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other
things of value whatsoever, or any promise, obligation or contract for future reward or compensation.
Date: 5/6/2026
Name: Nathaniel Benbow
Please describe below any relationships, transactions, positions you hold (volunteer or otherwise), or
circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or committees you (and/or
your spouse) sit on, the name of your employer and any businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my knowledge.
Date: 5/6/2026
Signature: Nathaniel Benbow
The Hickman County Finance Office will be accepting bids for a "Fire Alarm
Monitoring/Service Repair and Equipment Replacement."
This bid is for a multi-year contract covering fire alarm monitoring/service repair, and
equipment replacement for Hickman County Schools.
This bid will be system wide for all schools. The bid will be for a period of 3 years with a
mutual two-year extension option. This bid will be good for the period of July 1, 2026 - June
30, 2029.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Business license
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with
all local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114
North Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside
of the envelope "Fire Alarm Monitoring/Service Repair and Equipment Replacement".
Bids will be opened on May 26, 2026, at 10:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all
bids or parts of the bids and to waive any informalities that would prevent the acceptance
of a better bid.
Complete the bid on B (specs) and submit your bid on those forms.
Specifications can be found at https://ww.hickmank12.org/requestforproposal. Or by
calling 391-729-3391 Ext 3.
Present Penny Rochelle
3) bids rec'd
Minty cems
Dlease see attached
BA
APR 3 O 2026
The Hickman County Finance Office will be accepting bids for a "Fire Alarm
Monitoring/Service Repair and Equipment Replacement."
This bid is for a multi-year contract covering fire alarm monitoring/service repair, and
equipment replacement for Hickman County Schools.
This bid will be system wide for all schools. The bid will be for a period of 3 years with a
mutual two-year extension option. This bid will be good for the period of July 1, 2026 - June
30, 2029.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Business license
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with
all local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114
North Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside
of the envelope "Fire Alarm Monitoring/Service Repair and Equipment Replacement".
Bids will be opened on May 26, 2026, at 10:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all
bids or parts of the bids and to waive any informalities that would prevent the acceptance
of a better bid.
Complete the bid on B (specs) and submit your bid on those forms.
Specifications can be found at https://ww.hickmank12.org/requestforproposal. Or by
calling 391-729-3391 Ext 3.
NOTE: Please use this sheet to enter your bid figures and attach any necessary
documents to the back of the bid sheet.
SCOPE
This bid is for the 2026/2027, 2027/2028, 2028/2029 school years with a mutual two-year
extension option provided no increase in charges or costs during the 5 years bid period with
an annual renewal contract letter of intent.
SPECIFICATIONS
Multi-Year Contract Requirements
This bid is for a multi-year contract covering fire alarm monitoring, service repair, and
equipment replacement for Hickman County Schools.
All pricing submitted must remain firm for the entire five-year contract period. If, at any
point during the contract term, the awarded vendor increases pricing for any reason, the
contract shall be considered null and void, and the entire project will be rebid.
1 I Page
Annual Fire Alarm Monitoring by School
Fire Alarm Monitoring Services
This bid covers the annual cost of monthly fire alarm monitoring for all eight (8) Hickman
County School buildings. The facilities included in this service are:
EHES- East Hickman Elementary School
EHIS - East Hickman Intermediate School
EHMS- East Hickman Middle School
EHHS- East Hickman High School
CES- Centerville Elementary School
CIS - Centerville Intermediate School
HCMS - Hickman County Middle School
HCHS - Hickman County High School
The awarded vendor shall provide continuous fire alarm monitoring services for each
building and shall invoice the district annually for the full year of monthly monitoring
services. All monitoring must meet applicable Fire Marshal requirements and comply with
all state and local fire safety regulations.
Annual Cost of Monthly Fire Alarm Monitoring $ $ 4800
2 I Page
ANNUAL ALARM TESTING and CERTIFICATION SERVICING
of ALARM EQUIPMENT and COMPONENTS
At all eight schools, to be scheduled and finished by July 15th of each calendar year. This is
to include a written check-off report in accordance with NFPA, to be provided for each
school location's front office binder. A written hard copy of the report and service ticket
should be left with each school's front office and hard copies sent to the Maintenance
Director's office.
Annual Fire Alarm Testing and Certification Service of Alarm
Equipment and Components $ 10,000
3 I Page
Installation of Communication Converter System for Fire
Alarm Panel (One-time charge, applicable if upgrade is selected)
Installation
Furnish and install a UL-listed communicator and all required accessories, wiring,
power supplies, antennas, and mounting hardware.
All equipment shall be fully compatible with the existing fire alarm control panel
and associated system components.
Installation shall be performed in accordance with the manufacturer's instructions
and industry best practices.
Programming and Testing
Program the communicator and associated fire alarm monitoring equipment to
ensure proper operation and supervision.
Verify successful transmission of all required alarm, supervisory, and trouble
signals to the Monitoring Station.
Conduct complete functional testing and provide confirmation that the monitoring
system is operating correctly and reliably.
Compliance
All work shall comply with all applicable local, state, and national codes,
including but not limited to:
NFPA 72- National Fire Alarm and Signaling Code
UL 864- Standard for Control Units and Accessories for Fire Alarm
Systems
Equipment shall be listed and approved for fire alarm service and monitoring
applications.
Documentation
Provide test results, programming documentation, and verification of Monitoring
Station communication upon completion.
Coordinate all required inspections, testing, and acceptance documentation with
the Authority Having Jurisdiction (AHJ) as applicable.
4 I Page
Installation Labor Per Site
EHES
$ 100
EHIS
$ 100
EHMS
$ 100
EHHS
$ 100
CES
$ 100
CIS
$ 100
HCMS
$ 100
HCHS
$ 100
Total Installation Cost $ 800 800
Equipment Cost Per Site
EHES
$ $ 200
EHIS
$ 200
$
EHMS
$ 200
EHHS
$ 200
CES
$ 200
CIS
$ 200
HCMS
$ 200
$
HCHS
$ 200
$
Total Equipment Cost $ $ 1600
5 I Page
COST of SERVICING REPAIR and/or REPLACEMENT of
EQUIPMENT
Service call trip charge is limited to one trip charge per trip to the same zip code. Multi trip
charges will only be permitted if moving to a second zip code but not to a second location
in the same zip code.
Our zip codes for the 8 locations are Centerville Buildings 37033: CES, CIS, HCMS, HCHS
and Lyles Buildings 37098: EHES, EHIS, EHMS, EHHS.
Service Call Trip Charge $ 80
$ 100 extinguister or kitchen hard
Hourly rate per tech $ $ 1,200 fire Alarm
(normal rate)
150 Ex or hood
/
Hourly rate per tech $ $ - 300 fire Alarm
(over-time rate)
All parts exceeding $1,000.00 in cost must accompany the vendors' actual cost invoices
incurred and attached with to billing invoices to ensure mark-ups are accurate and correct.
Invoices without tickets will not be paid.
Parts plus percentage of mark-up
30
%
6 I Page
Annual Fire Extinguisher Inspections and Servicing
This contract will allow for the bidding of the fire extinguishers to be checked off by
location in each building and shall provide inspection, serviced by recharge, and/or
replaced if beyond container life cycle and shall be annually retagged as prescribed in the
Fire Marshals codes. Buildings are to be serviced 100% and accurately count all locations
not missing any extinguishers.
The service will be for all 11 locations in the school district to include all eight school
buildings, HCHS B Building, Central Office Building, and Bus Garage. A hard copy of the
checked-off inspections report by location shall be left with each location's front office
and a hard copy to be sent to the Maintenance Director's office upon completion. At the
bus garage there are spare extinguishers upstairs that are to be inspected, serviced,
tagged and recharged and/or replaced as needed. There are extinguishers downstairs in
the garage area for bus/vehicles that are annually serviced, tagged and recharged and/or
replaced as needed.
Location mapping and check-off sheets shall be the responsibility of the bidding vendor
and not charged to HCBOE.
NOTE: This agreement contract will require that the vendor return during the calendar year
at no charge and tag & service any extinguishers that are missed at no cost to the owner, in
the event they were not tagged during the inspections and found by the Maintenance
and/or the Fire Marshall.
Annual inspection fee per extinguisher one time re-tag by
location $ 6.00
New extinguisher replacement cost per size $
Fire extinguisher recharge cost per size $
5 lb -75 - 101b - k-class $ 210
- 70 - k class $ 180
7 I Page
Fire Suppression Hoods: Bi-Annual Fire Suppression
Hoods
Kitchen Hood Suppression System Service Requirements
The Hickman County Schools facilities are equipped with kitchen areas that include one or
more fire-suppression hoods. The awarded vendor shall provide comprehensive annual
servicing of all hood suppression systems in accordance with applicable codes and
manufacturer specifications.
As part of the annual service, the vendor is required to:
1. Inspect, test, and properly service all hood suppression systems located within
each school facility.
2. Install new fusible links on every suppression hood as required on an annual
basis.
3. Provide cleanup services in the event that a system discharges during inspection
or testing. This includes the full cleanup and removal of any dry chemical agent
discharged onto kitchen equipment or surrounding surfaces.
All work must be performed by certified technicians and documented through detailed
service reports provided to the district upon completion.
Inspection Tagging and Compliance Requirements
1. Inspection Tagging
Upon completion of each inspection, the awarded vendor shall affix the appropriate
inspection tag or sticker to every hood suppression system. The tag must clearly
display the date of inspection and any other information required by applicable fire
codes.
2. Inspection Scheduling and Compliance
All inspections must be performed within the timeframes prescribed by the Fire
Marshal and all relevant fire safety codes. Inspections shall be completed on or up
to two (2) days prior to the required due date.
Under no circumstances may any inspection occur after the required due
date.
The awarded vendor is fully responsible for tracking and managing all
required inspection intervals across all school kitchens.
3. Documentation and Reporting Requirements
On the same day each inspection is completed, the vendor shall:
8 I Page
Provide a copy of the inspection report directly to the kitchen manager
before leaving the site, and
Deliver a hard copy of the full inspection report to the Maintenance
Director's office.
All documentation must be complete, accurate, and compliant with all reporting
standards established by the district and governing authorities.
BiAnnual Manual Pull Station Tagging
In addition to the annual hood suppression inspections and tagging requirements
described above, the awarded vendor shall install a new biannual inspection tag on the
manual suppression pull device located at each hood system. This tag must clearly
indicate the inspection date and comply with all applicable fire safety and Fire Marshal
code requirements. The vendor is responsible for ensuring all biannual tags remain
current and are replaced on schedule.
Suppression inspections are to be at the following kitchen locations:
CES $
220
CIS $
220
HCMS $ 220 $
HCHS $ $ 220
EHES $ 220
EHIS $ 220 220
EHMS $ 220
EHHS $
440
2 systems
EHHS/VOCATIONAL CULINARY ARTS KITCHEN $
220
Total amount for two (2) Bi-Annual Suppression Hood Inspections per year:
$ 2,800
10 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal
laws regarding "workers on school properties." The Hickman County Board
of Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature:
7 Mal
Print:
Tony MAllini
-
Title:
Senior Account MANAger
-
Date:
5/20/26
-
11 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This
provision shall not apply to contracts with a total value of less than two hundred fifty
thousand dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or
persons or entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion,
or other unreasonable basis, and is not based on a valid business reason. Tenn.
Code § 12-4-119
Signature:
7 Mal
Print:
Tony Mallini
-
Date:
5-20-26
12 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name:
State Systems, INC Tony Mallin,
Bidder Signature:
7 Mul
5/20/26
Date:
12 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/20/26
Name: TONY MAlliN.
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/20/26
7Ml
Signature:
13 I Page
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
8/1/2026
3/20/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER Lockton Companies, LLC
NAME:
DBA Lockton Insurance Brokers, LLC in CA
PHONE
FAX
(A/C. No. Ext):
(A/C, No):
CA license #0F15767
E-MAIL
ADDRESS:
3280 Peachtree Rd. NE, Ste. 1000
INSURER(S) AFFORDING COVERAGE
NAIC #
Atlanta GA 30305
INSURER A: Hudson Excess Insurance Company
14484
(404) 460-3600
INSURED
INSURER B : The Travelers Indemnity Company
25658
State Systems LLC
1551530
1861 Vanderhorn Dr
INSURER C : The Charter Oak Fire Insurance Company
25615
Memphis TN 38134
INSURER D : Travelers Property Casualty Company of America
25674
INSURER E : Westchester Surplus Lines Insurance Co
10172
INSURER F :
COVERAGES
CERTIFICATE NUMBER: 23179830
REVISION NUMBER: XXXXXXX
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN is SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
A
N
N
ALM10130-00
2/7/2026
8/1/2026
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$ 500,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 5,000,000
POLICY
PRO-
LOC
PRODUCTS-COMP/OP AGG
$ 2,000,000
JECT
$
OTHER:
COMBINED SINGLE LIMIT
B
AUTOMOBILE LIABILITY
N
N
DT-810-A8126919-IND-26
2/7/2026
2/7/2027
(Ea accident)
$ 1,000,000
ANY AUTO
BODILY INJURY (Per person)
$ XXXXXXX
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$ XXXXXXX
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$ XXXXXXX
AUTOS ONLY
AUTOS ONLY
(Per accident)
$ XXXXXXX
A
UMBRELLA LIAB
OCCUR
N
N
ALMU10056-00
2/7/2026
8/1/2026
EACH OCCURRENCE
$ 5,000,000
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$ 5,000,000
DED
RETENTION $ 10,000
$ XXXXXXX
PER
OTH-
WORKERS COMPENSATION
N
C
2/7/2026
2/7/2027
AND EMPLOYERS' LIABILITY
UB-A8090273-26-26-G
STATUTE
ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 1,000,000
OFFICER/MEMBER-EXCLUDED?
N
N/A
(Mandatory In NH)
E.L. DISEASE- EA EMPLOYEE
$ 1,000,000
If yes, describe under
E.L. DISEASE- POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS below
A
Prof/Poll
N
N
ALM10130-00
2/7/2026
8/1/2026
Limits: Included/$1M
D
Leased/Rented Equip
QT-630-A8150089-TIL-26
2/7/2026
2/7/2027
Limits: $250K
E
Fress
G4878947A 001
2/7/2026
8/1/2026
Fac Occ $5M ! A.gg $5M
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
23179830
ACCORDANCE WITH THE POLICY PROVISIONS.
State Systems Inc.
1861 Vanderhorn Drive
AUTHORIZED REPRESENTATIVE
Memphis TN 38134
Khigler
© 1988-2013 ACORD CORPORATION. All rights reserve
STATE OF TENNESSEE
DEPARTMENT OF
COMMERCE AND INSURANCE
STATE SYSTEMS, LLC
ID NUMBER: 2508
LIC STATUS ACTIVE
EXPIRATION DATE: July 31, 2026
ALARM SYSTEMS CONTRACTORS BOARD
ALARM CONTRACTING COMPANY
THIS is TO CERTIFY THAT ALL REQUIREMENTS
OF THE STATE OF TENNESSEE HAVE BEEN MET
11398
ATTN:ROBERT MCBRIDE
STATE SYSTEMS, LLC
1861 VANDERHORN DR
MEMPHIS, TN 38134
14012338
State of Cennessee
ALARM SYSTEMS CONTRACTORS BOARD
ALARM CONTRACTING COMPANY
STATE SYSTEMS, LLC
ROBERT GRAHAM MCBRIDE
This is to certify that all requirements of the State of Tennessee have been met.
OF THE STATEOF OF
ID NUMBER: 2508
LIC STATUS: ACTIVE
EXPIRATION DATE: July 31, 2026
FLORIDA AGRICULTURE 7796 J
FIRE
CCTV
BURGL IR
VOID
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
VOID
VOID
MA
STATE OF TENNESSEE
DEPARTMENT OF
COMMERCE AND INSURANCE
STATE SYSTEMS, INC.
434137
ID NUMBER: 40841
LIC STATUS: ACTIVE
EXPIRATION DATE: November 30, 2027
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
THIS IS TO CERTIFY THAT ALL REQUIREMENTS
OF THE STATE OF TENNESSEE HAVE BEEN MET
STATE SYSTEMS, INC.
1861 VANDERHORN DRIVE
MEMPHIS, TN 38134
434137
State of Tennessee
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
STATE SYSTEMS, INC.
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 40841
EXPIRATION DATE: November 30, 2027
STATE GREAT THE AGRICULTURE OMMERC XVI F
THE STATES
LIC STATUS: ACTIVE
UNLIMITED; CE-D; CE-F; CE-G; CMC; MU-A
7796
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
AMERICAN
FIRE PROTECTION
®
GROUP, INC.
Attn: Hickman Co. Finance
RFP Response For:
"Fire Alarm Monitoring/Service
Repairs and Equipment
Replacement"
114 N Central Ave, Ste 203
Centerville, TN 37033
May 22, 2026
American Fire Protection Group, Inc. Strong Values, Exceptional Results
The Hickman County Finance Office will be accepting bids for a "Fire Alarm
Monitoring/Service Repair and Equipment Replacement."
This bid is for a multi-year contract covering fire alarm monitoring/service repair, and
equipment replacement for Hickman County Schools.
This bid will be system wide for all schools. The bid will be for a period of 3 years with a
mutual two-year extension option. This bid will be good for the period of July 1, 2026 - June
30, 2029.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Business license
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with
all local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114
North Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside
of the envelope "Fire Alarm Monitoring/Service Repair and Equipment Replacement".
Bids will be opened on May 26, 2026, at 10:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all
bids or parts of the bids and to waive any informalities that would prevent the acceptance
of a better bid.
Complete the bid on B (specs) and submit your bid on those forms.
Specifications can be found at https://ww.hickmank12.org/requestforproposal. Or by
calling 391-729-3391 Ext 3.
Annual Fire Alarm Monitoring by School
Fire Alarm Monitoring Services
This bid covers the annual cost of monthly fire alarm monitoring for all eight (8) Hickman
County School buildings. The facilities included in this service are:
EHES- East Hickman Elementary School
EHIS - East Hickman Intermediate School
EHMS - East Hickman Middle School
EHHS- East Hickman High School
CES- Centerville Elementary School
CIS - Centerville Intermediate School
HCMS - Hickman County Middle School
HCHS - Hickman County High School
The awarded vendor shall provide continuous fire alarm monitoring services for each
building and shall invoice the district annually for the full year of monthly monitoring
services. All monitoring must meet applicable Fire Marshal requirements and comply with
all state and local fire safety regulations.
Annual Cost of Monthly Fire Alarm Monitoring $
4,320.00
(all 8 sites combined, per year)
21
Installation of Communication Converter System for Fire
Alarm Panel (One-time charge, applicable if upgrade is selected)
Installation
Furnish and install a UL-listed communicator and all required accessories, wiring,
power supplies, antennas, and mounting hardware.
All equipment shall be fully compatible with the existing fire alarm control panel
and associated system components.
Installation shall be performed in accordance with the manufacturer's instructions
and industry best practices.
Programming and Testing
Program the communicator and associated fire alarm monitoring equipment to
ensure proper operation and supervision.
Verify successful transmission of all required alarm, supervisory, and trouble
signals to the Monitoring Station.
Conduct complete functional testing and provide confirmation that the monitoring
system is operating correctly and reliably.
Compliance
All work shall comply with all applicable local, state, and national codes,
including but not limited to:
NFPA 72 - National Fire Alarm and Signaling Code
UL 864 - Standard for Control Units and Accessories for Fire Alarm
Systems
Equipment shall be listed and approved for fire alarm service and monitoring
applications.
Documentation
Provide test results, programming documentation, and verification of Monitoring
Station communication upon completion.
Coordinate all required inspections, testing, and acceptance documentation with
the Authority Having Jurisdiction (AHJ) as applicable.
4 I Page
COST of SERVICING REPAIR and/or REPLACEMENT of
EQUIPMENT
Service call trip charge is limited to one trip charge per trip to the same zip code. Multi trip
charges will only be permitted if moving to a second zip code but not to a second location
in the same zip code.
Our zip codes for the 8 locations are Centerville Buildings 37033: CES, CIS, HCMS, HCHS
and Lyles Buildings 37098: EHES, EHIS, EHMS, EHHS.
Service Call Trip Charge $
100.00
Hourly rate per tech $
140.00
(normal rate)
Hourly rate per tech $
210.00
(over-time rate)
All parts exceeding $1,000.00 in cost must accompany the vendors' actual cost invoices
incurred and attached with to billing invoices to ensure mark-ups are accurate and correct.
Invoices without tickets will not be paid.
Parts plus percentage of mark-up
50
%
6|Page
Fire Suppression Hoods: Bi-Annual Fire Suppression
Hoods
Kitchen Hood Suppression System Service Requirements
The Hickman County Schools facilities are equipped with kitchen areas that include one or
more fire-suppression hoods. The awarded vendor shall provide comprehensive annual
servicing of all hood suppression systems in accordance with applicable codes and
manufacturer specifications.
As part of the annual service, the vendor is required to:
1. Inspect, test, and properly service all hood suppression systems located within
each school facility.
2. Install new fusible links on every suppression hood as required on an annual
basis.
3. Provide cleanup services in the event that a system discharges during inspection
or testing. This includes the full cleanup and removal of any dry chemical agent
discharged onto kitchen equipment or surrounding surfaces.
All work must be performed by certified technicians and documented through detailed
service reports provided to the district upon completion.
Inspection Tagging and Compliance Requirements
1. Inspection Tagging
Upon completion of each inspection, the awarded vendor shall affix the appropriate
inspection tag or sticker to every hood suppression system. The tag must clearly
display the date of inspection and any other information required by applicable fire
codes.
2. Inspection Scheduling and Compliance
All inspections must be performed within the timeframes prescribed by the Fire
Marshal and all relevant fire safety codes. Inspections shall be completed on or up
to two (2) days prior to the required due date.
Under no circumstances may any inspection occur after the required due
date.
The awarded vendor is fully responsible for tracking and managing all
required inspection intervals across all school kitchens.
3. Documentation and Reporting Requirements
On the same day each inspection is completed, the vendor shall:
8 Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Junifer mcmula
Print: Jennifer McMullin
Title: Special Hazards, Alarm & Detection Sales
Date: 5/22/2026
10 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/librar/0
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23. pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Jennifer McMullin, American Fire Protection Group
Bidder Signature:
Jennifer mcmall
Date:
5/22/2026
12
AMERICAN
Fire Extinguisher Inspection List
FIRE PROTECTION
GROUP, INC.
Location Code:
Contact:
Company: American Fire Protection Group
Contact Address:
Address: 155 North Conalco Drive
Jackson, TN 38301
Phone:
Company Phone: 731-424-0310
Email:
Inspector: Cody Holland
2055 TN Portable Fire Ext
Property Evaluated:
Date of Work:
Frequency: Annual
Description: Fire Extinguishers
Work Order:
Deficio cy Sundary
Status: Open
Fire extinguisher deficiency for Tag # 8, Serial Number: K-88321
Model: Ansu
AA
Size: 10#, Type: ABC.
6yr due
Status: Open
Fire extinguisher deficiency for Tag # 14, Serial Number: E-83203600, Model: Sentry AA10S, Size: 10#, Type: ABC.
6yr due
Status: Open
Fire extinguisher deficiency for Tag # 16, Serial Number: E-72508148, Model: Sentry AA10S, Size: 10#, Type: ABC.
6yr due
Service Summary
American Fire Protection Group, 155 North Conalco Drive, Jackson, TN, 38301 Phone: 731-424-0310
Page 1 of 4
AMERICAN
American Fire Protection Group
155 North Conalco Drive
FIRE PROTECTION
Jackson, TN 38301
GROUP, INC.
Phone: 731-424-0310
Fire Extinguisher Inspection List
Account Information
Facility Name:
Property Type:
Location Code:
Service Address:
Owner:
Owner's Phone:
Owner's Address:
Zone: 1
Zone: 1
Tag
Serial Number
Model
Size
Type
Location
La
Servi
ext Service
Frequency
Inspection
Comments
1
C-99119847
SimplexGrinnell
10#
ABC
Right dock entrance,
yı 024
Hydro 2030
Annual
Pass
(2017) AA10s
breakroom
2
C9911988
SimplexGrinnell
10#
ABC
Pole #1 in from
f
6)20.
Hydro 2030
Annual
Pass
(2017) AA10s
breaknom
3
I51719087
Badger (2025)
10#
ABC
2nd pole
throms
New 2025
6 yr 2031
Annual
Pass
ADV-10MP-1
4
C-99119899
SimplexGrinnell
10#
ABC
Bac wan behind
6 yr 2024
Hydro 2030
Annual
Pass
(2017) AA10s
poy dercoat.
5
H22617059
Badger (2023)
10#
ABC
3rd pole down in front of
New 2023
6 yr 2029
Annual
Pass
ADV-10
office
6
C-99119836
SimplexGrinnell
10#
ABC
2nd door by loading
6 yr 2024
Hydro 2030
Annual
Pass
(2017) AA10S
dock
7
H22617054
Badger (2023)
10#
ABC
Inside office
New 2023
6 yr 2029
Annual
Pass
ADV-10
8
K-883213
Ansul (2011)
10#
ABC
Loading area
New 2018
6 yr 2024
Annual
Fail
6yr due
AA105
9
C-99119841
SimplexGrinnell
10#
ABC
Middle pole in loading
6 yr 2024
Hydro 2030
Annual
Pass
(2017) AA10S
area
10
C-99119853
SimplexGrinnell
10#
ABC
Exit door by dock
6 yr 2024
Hydro 2030
Annual
Pass
(2017) AA10S
11
E-83203601
Sentry (2018)
10#
ABC
Pole 7 in front of dock
6 yr 2024
Hydro 2030
Annual
Pass
AA10S
12
H-09109074
Sentry (2022)
10#
ABC
Pole by welding area,
6 yr 2024
Hydro 2030
Annual
Pass
AA10S
beside rack
13
C-99119898
SimplexGrinnell
10#
ABC
Back wall welding area
6 yr 2024
Hydro 2030
Annual
Pass
(2017) AA10S
#1
© FormLink Systems, Inc., Fire Extinguisher 2.1
Page 3 of 4
AMERICAN
Fire Alarm Inspection and Testing Report
FIRE PROTECTION
GROUP, INC.
Location Code:
Contact:
Company: American Fire Protection Group
Address: 155 North Conalco Drive
Contact Address:
Jackson, TN 38301
Company Phone: 731-424-0310
Phone:
Inspector: Cody Holland
Email:
50454 TN Fire Alarm
Date of Work: 12/4/2025
Frequency: Annual
Tag: Green
Property Evaluated:
Description: Fire Alarm and Devices (Fire Alarm
Inspection)
Work Order:
mple ficiency Summary
There are ne rep tted deficiencies for this submission
General Comments
These items are outside the regular scope of the required inspection and are not the result of an engineering review. This information is not intended to be all-
inclusive but rather a list of items discovered as a by-product of the required inspection.
There are no general comments for this submission
American Fire Protection Group, 155 North Conalco Drive, Jackson, TN, 38301 Phone: 731-424-0310
Page 1 of 7
American Fire Protection Group
AMERICAN
155 North Conalco Drive
FIRE PROTECTION
Jackson, TN 38301
GROUP. INC.
Phone: 731-424-0310
Power Supplies
Control Unit
Manufacturer:
Model Number:
Location:
Disconnecting Location:
Notifier
Fcps-24s8
Nurse station 2
Mech room
Battery 1
Load Test
Voltage:
Amps:
Mfr Year:
VDC:
Ah:
Charger
Result of Battery 1 & 2
12
7
2023
Battery 1
13.54
5.39
Voltage:
14.74
Battery 2
Load Test
Voltage:
Amps:
Mfr Year:
VDC:
Ah:
Charger
Battery 2
Voltage:
Pass
Fail
Replaced
12
7
2023
13.92
4.60
13.74
5. Testing Results
5.1 Control Unit and Related Equipment
Description
Visual Inspection
Functional Test
Results
Control unit
Yes
No
Yes
No
Pass
Fail
N/A
Lamps / LEDs / LCDs
Yes
No
Yes
No
Pass
Fail
N/A
Fuses
Yes
No
Yes
No
Pass
Fail
N/A
Trouble signals
Yes
No
Yes
No
Pass
Fail
N/A
Disconnect switches
Yes
No
Yes
No
Pass
Fail
N/A
Ground-fault monitoring
Yes
No
Yes
No
Pass
Fail
N/A
Supervision
Yes
No
Y
Pass
Fail
N/A
Annunciators
Yes
No
Ye.
No
Pass
Fail
N/A
Remote power panels
Yes
No
No
Pass
Fail
N/A
Other
Yes
No
Y
No
Pass
Fail
N/A
5.2 Secondary Power
Description
Visual Inspection
Functional Test
Results
Battery condition
Yes
No
Yes
No
Pass
Fail
N/A
Load voltage
Yes
No
Yes
No
Pass
Fail
N/A
Discharge test
Yes
No
Yes
No
Pass
Fail
N/A
Charger test
Yes
No
Yes
No
Pass
Fail
N/A
Remote panel batteries
Yes
No
Yes
No
Pass
Fail
N/A
5.3 Notification Appliances
Include Notification Appliances Table on this Report?
Yes
No
Notification Appliances
Appliance Type
# Installed
# Tested
Test Results
Bell(s)
0
0
Pass
Fail
N/A
Horn(s)
0
0
Pass
Fail
N/A
Horn/Strobe(s)
17
17
Pass
Fail
N/A
Mini Horn(s)
0
0
Pass
Fail
N/A
Speaker(s)
0
0
Pass
Fail
N/A
Speaker/Strobe(s)
0
0
Pass
Fail
N/A
Strobe(s)
0
0
Pass
Fail
N/A
5.4 Interface Equipment
Complete supplementary interface component test form for all interface components.
Circuit Interface / Signaling Line Circuit Interface / Fire Alarm Control Interface
American Fire Protection Group, 155 North Conalco Drive, Jackson, TN, 38301 Phone: 731-424-0310
Page 3 of 7
American Fire Protection Group
AMERICAN
155 North Conalco Drive
FIRE PROTECTION
Jackson, TN 38301
GROUP, INC.
Phone: 731-424-0310
Zone: 1
Asset
Address
Location
Notes
Frequenc
Last
Test
Comments
Type
y
Tested
Results
TS
Backflow bottom
Annual
12/4/2025
Pass
TS
Backflow top
Annual
12/4/2025
Pass
TS
Riser room
Annual
12/4/2025
Pass
WF
Riser room
Annual
12/4/2025
Pass
WF
Wet riser
Annual
12/4/2025
Pass
Zone: Main
Zone: Main
Asset
Address
Location
Notes
Frequenc
Last
Test
Comments
Type
y
Tested
Results
DH
00269159
At rm 108
Annual
12/4/2025
Pass
DH
00269148
At rm 118
Annual
12/4/2025
Pass
DH
00269149
At rm 118
Annual
12/4/2025
Pass
DH
00269168
At mm 203
Annual
12/4/2025
Pass
DH
00269169
At rm 203
Annual
12/4/2025
Pass
SD
00269175
At rm 207
Annu
12/4/2025
Pass
DH
00269085
At rm 309
Ann al
/4/2025
Pass
DH
00269086
At rm 309
nu
/4/2025
Pass
SD
00269096
At m 326
12/4/2025
Pass
DH
00269097
At mm 401
nual
12/4/2025
Pass
DH
00269099
At rm 401
nual
12/4/2025
Pass
SD
00269101
At rm 409
Annual
12/4/2025
Pass
DH
00269107
At rm 410
Annual
12/4/2025
Pass
DH
00269108
At rm 410
Annual
12/4/2025
Pass
PS
00269105
At mm 410
Annual
12/4/2025
Pass
DH
00269178
At room 209
Annual
12/4/2025
Pass
DH
00269179
At room 209
Annual
12/4/2025
Pass
DH
00269087
At room 309
Annual
12/4/2025
Pass
DH
00269088
At room 309
Annual
12/4/2025
Pass
SD
00269076
By room 219
Annual
12/4/2025
Pass
SD
00269077
By room 223
Annual
12/4/2025
Pass
DD
00269121
Dining area ceiling
Annual
12/4/2025
Pass
DD
00269122
Dining area ceiling
Annual
12/4/2025
Pass
SD
00269186
Dining rm
Annual
12/4/2025
Pass
SD
00269188
Dining rm
Annual
12/4/2025
Pass
DD
00269126
Dining room
Annual
12/4/2025
Pass
DD
00269127
Dining room
Annual
12/4/2025
Pass
PS
00269189
Dining room exit
Annual
12/4/2025
Pass
HD
00269190
Dining room storage
Annual
12/4/2025
Pass
PS
00269161
Front door
Annual
12/4/2025
Pass
HD
00269187
In dining room
Annual
12/4/2025
Pass
SD
00269136
In laundry
Annual
12/4/2025
Pass
HD
00269135
In laundry room
Annual
12/4/2025
Pass
DD
In the hall outside of
00269144
activities, supply
Annual
12/4/2025
Pass
room
HD
00269131
In the kitchen
Annual
12/4/2025
Pass
HD
00269132
In the kitchen
Annual
12/4/2025
Pass
HD
00269134
In the kitchen
Annual
12/4/2025
Pass
SD
00269075
Nurses station 2
Annual
12/4/2025
Pass
American Fire Protection Group, 155 North Conalco Drive, Jackson, TN, 38301 Phone: 731-424-0310
Page 5 of 7
American Fire Protection Group
AMERICAN
155 North Conalco Drive
FIRE PROTECTION
Jackson, TN 38301
GROUP, INC.
Phone: 731-424-0310
Zone: Main
Asset
Address
Location
Notes
Frequenc
Last
Test
Comments
Type
y
Tested
Results
SD
00269146
SD 35
Annual
12/4/2025
Pass
SD
00269142
SD 37
Annual
12/4/2025
Pass
SD
00269139
SD 39
Annual
12/4/2025
Pass
SD
00269119
SD 41
Annual
12/4/2025
Pass
SD
00269130
SD 43
Annual
12/4/2025
Pass
SD
00269125
SD 44
Annual
12/4/2025
Pass
SD
00269129
SD 46
Annual
12/4/2025
Pass
PS
00269112
Serinity rm
Annual
12/4/2025
Pass
SD
00269120
Vending machine
Annual
12/4/2025
Pass
6. Notifications That Testing Is Complete
Contact
Time
Monitoring organization:
AFPG
10:00
Building management:
Maintenance
10:00
7. System Restored To Normal Operation
Date:
12/4/2025
Time:
10:00
8. Observations
These items are outside the regular scope of the required inspection nd an not result of an engineering review. This information is not intended
to be all-inclusive but rather a list of items discovered as a by-prom of the quir inspection.
Please see the summary section at the top of the form for the co ments.
9. Inspector Information:
Test Verification:
Inspected By
Cody Holland
Inspector Signature
C'Jall
Inspector License:
50454 TN Fire Alarm
Date of Work
12/4/2025
Inspection Notes
Owner's Section
Is the Owner or a representative available?
Yes
No owner available onsite
American Fire Protection Group, 155 North Conalco Drive, Jackson, TN, 38301 Phone: 731-424-0310
Page 7 of 7
AMERICAN
Suppression Hood Inspection and Testing Report
FIRE PROTECTION
®
GROUP, INC.
Location Code:
Contact:
Company: American Fire Protection Group
Contact Address:
Address: 155 North Conalco Drive
Jackson, TN 38301
Phone:
Company Phone: 731-424-0310
Email:
Inspector: Brian Johnson
1960 Port/Fixed Ext.
Date of Work: 9/16/2025
Frequency: Annual
Property Evaluated:
Tag: Green
Description: Hood (Hood Inspection)
Work Order:
Deficie cy m nary
There are no repo ed den encies for this submission
Ge
al Comments
These items are outside the regular scope of the spec in and are not the result of an engineering review. This information is not intended to be all-
inclusive but rather a list of items discovered as a by-product of he required inspection.
There are no general comments for this submission
American Fire Protection Group, 155 North Conalco Drive, Jackson, TN, 38301 Phone: 731-424-0310
Page 1 of 3
American Fire Protection Group
AMERICAN
155 North Conalco Drive
FIRE PROTECTION
Jackson, TN 38301
GROUP, INC.
Phone: 731-424-0310
Title
Maintenance
Date
9/16/2025
Inspected By
Brian Johnson
Inspector Signature
L4/
Inspector License:
1960 Port/Fixed Ext.
Date of Work
9/16/2025
Observations
These items are outside the regular scope of the required inspection
and are not the result of an engineering review. This information is not
intended to be all-inclusive but rather a list of items discovered as a
by-product of the required inspection.
Sample
American Fire Protection Group, 155 North Conalco Drive, Jackson, TN, 38301 Phone: 731-424-0310
Page 3 of 3
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association to
whom any contract may be awarded, by rebate, gift or other otherwise, any money
or other things of value whatsoever, or any promise, obligation or contract for future
reward or compensation.
Date: 5/26/26
Name: RICHARD EVERETT MANAGER, ACTIVE ENERGY SERVICESCE
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any businesses
you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/26/26
Signature: Rhnu
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101- 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/0
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: ACTIVE ENERGY SERVICES, LLC
Bidder Signature: Rhurd
Date:
5/26/26
12 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature:
Print:
RICHARD EVERETT
Date:
5/26/26
Phone/Email:
11 I Page
POST IN A
City of Clarksville
License Number
CONSPICUOUS
Business License and Gross Receipt Tax
106334
PLACE
THIS LICENSE EXPIRES ON 05/15/2027
Business Name: ACTIVE ENERGY SERVICES LLC
Business ID:
0510329
Location:
RICHARD EVERETT
State ID:
0104267492
4705 CHAPEL HILL RD
SOUTHSIDE, TN 37171
BUSINESS TAX
SEAL OF TENNESSSE THE THE CITY OF DEPARTMENT
RICHARD EVERETT
4705 CHAPEL HILL RD
DEC.1785
SOUTHSIDE, TN 37171
THE LICENSE PERIOD IS JANUARY 1ST TO
DECEMBER 31ST (CALENDAR YEAR). YOUR RENEWAL
IS DUE BY APRIL 15TH AND MUST BE SUBMITTED NO
LATER THAN APRIL 15TH TO AVOID PENALTY AND
INTEREST. ALL RETURNS MUST BE FILED
ELECTRONICALLY WITH THE STATE OF TENNESSEE
Classification: CLASS 4
DEPARTMENT OF REVENUE
Date Issued: 04/15/2026
THIS LICENSE DOES NOT PERMIT OPERATION UNLESS
PROPERLY ZONED, AND/OR IN COMPLIANCE WITH ALL
OTHER APPLICABLE LAWS/RULES. ALSO, AS REQUIRED
BY TENN. CODE ANN. § 39-17-1801 ET SEQ, BUSINESSES
MUST COMPLY WITH ALL PROVISIONS OF THE
Christen Wilcox
TENNESSEE NON-SMOKERS PROTECTION ACT.
By
Chief Financial Officer
This License is NOT Transferable
License Copy
POST IN A
City of Clarksville
License Number
CONSPICUOUS
Business License and Gross Receipt Tax
106334
PLACE
THIS LICENSE EXPIRES ON 05/15/2027
Business Name: ACTIVE ENERGY SERVICES LLC
Business ID:
0510329
Location:
RICHARD EVERETT
State ID:
0104267492
4705 CHAPEL HILL RD
SOUTHSIDE, TN 37171
BUSINESS TAX
RICHARD EVERETT
4705 CHAPEL HILL RD
SOUTHSIDE, TN 37171
CITY OF CLARKSVILLE
THE
OF
AGRICULTURE
COMMERCE
Classification: CLASS 4
SEAL
TENNESSEE
Date Issued: 04/15/2026
DEC.1785
By
Christen Wilcox
Chief Financial Officer
7796'
STATE OF TENNESSEE
DEPARTMENT OF REVENUE
Resale Authorization
January 14, 2026
Letter ID:
L1963260352
ACTIVE ENERGY SERVICES, LLC
Account ID:
1000032556-SLC
4705 CHAPEL HILL RD
Account Type:
Sales and Use Tax
SOUTHSIDE TN 37171-9104
The above named taxpayer has been granted authority in accordance with Tenn. Code Ann. §
67-6-102 and Tenn. Comp. R. & Regs. 1320-05-01-62 and 1320-05-01-68 to make purchases
intended for subsequent resale without payment of sales or use tax. Any merchandise or other
taxable item purchased without the payment of tax upon this resale certificate that is used or
consumed in any manner by the taxpayer, or is given away, must be reported and the tax paid
directly to the Tennessee Department of Revenue.
It is a misdemeanor to misuse the certificate of resale for the purpose of obtaining taxable property
or services without the payment of the sales or use tax when it is due and such wrongful use is
grounds for the Commissioner to revoke the taxpayer's Certificate of Registration.
The taxpayer must furnish its supplier(s) at the time of purchase with a copy of the enclosed
certificate with the lower portion properly completed. The original certificate should be retained for
copy purposes. The supplier must maintain a file copy as evidence of the sales tax exemption.
Later purchases do not require the submission of additional copies. The taxpayer must notify the
seller in writing if the certificate is no longer valid.
David Senegano
David Gerregano
Commissioner of Revenue
Taxpayer Services Division
500 Deaderick Street
Nashville, TN 37242
Tel 615-253-0600
www.tn.gov/revenue
aL0025
THE
STATE
STATE OF TENNESSEE
AGRICULTURE
DEPARTMENT OF REVENUE
1796
Letter ID:
L1963260352
ACTIVE ENERGY SERVICES, LLC
Effective Date:
January 14, 2026
4705 CHAPEL HILL RD
Account ID:
1000032556-SLC
SOUTHSIDE TN 37171-9104
Account Type:
Sales and Use Tax
Location ID:
0104267492
Location Address:
ACTIVE ENERGY SERVICES, LLC
1300 COLLEGE ST
CLARKSVILLE TN 37040-3326
Sales and Use Tax Certificate of Resale
The above named taxpayer has been granted authority in accordance with Tenn. Code Arin. §
67-6-102 and Tenn. Comp. R. & Regs. 1320-05-01-62 and 1320-05-01-68 to make purchases
intended for subsequent resale without payment of sales or use tax. Any merchandise or other
taxable item purchased without the payment of tax upon this resale certificate that is used or
consumed in any manner by the taxpayer, or is given away, must be reported and the tax paid
directly to the Tennessee Department of Revenue.
The supplier must maintain a file copy as evidence of the sales tax exemption. Later purchases do
not require the submission of additional copies.
Seller's Name
Seller's Address (City & State)
I, RICHARD EVERETT
, as an authorized representative of the
taxpayer, certify that the products or services purchased are intended for subsequent resale by the
purchaser for the following reason.
(X) resale of the tangible personal property, taxable service, taxable amusement, or taxable digital
product
( ) rental or leasing of the tangible personal property
( ) a component part of a manufactured, assembled, processed or refined finished product that is
for resale
Under penalty of perjury, I affirm this to be a true and correct statement.
RICHARD EVERETT
Alum
1/14/26
Print Name of Authorized Representative
Signature of Authorized Representative
Date
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
03/23/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
Commercial Service
PHONE
Carlson Insurance Group
(A/C. No. Ext):
(615) 200-7464
(A/C, FAX No): (888) 667-1469
E-MAIL
166 Belinda Pkwy Suite 100
ADDRESS:
service@carlsoninsgrp.com
INSURER(S) AFFORDING COVERAGE
NAIC #
Mount Juliet
TN 37122
INSURER A: ERIE INSURANCE EXCHANGE
26271
INSURED
INSURER B : ERIE INSURANCE P&C COMPANY
26830
Active Energy Services LLC
INSURER C:
4705 Chapel Hill Road
INSURER D :
INSURER E:
Southside
TN 37171
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$ 2,000,000
MED EXP (Any one person)
$ 5,000
A
Q61-0223467
09/10/2025
09/10/2026
PERSONAL & ADV INJURY
2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
4,000,000
POLICY
PRO-
JECT
LOC
PRODUCTS- COMP/OP AGG
$ 4,000,000
$
OTHER:
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY
(Ea accident)
$ 1,000,000
ANY AUTO
BODILY INJURY (Per person)
$
A
OWNED
SCHEDULED
Q09-1040070
09/10/2025
09/10/2026
BODILY INJURY (Per accident)
$
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$
AUTOS ONLY
AUTOS ONLY
(Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ 5,000,000
A
EXCESS LIAB
CLAIMS-MADE
Q33-1070407
09/10/2025
09/10/2026
AGGREGATE
$
DED
RETENTION $
$
WORKERS COMPENSATION
PER
OTH-
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 1,000,000
B
OFFICER/MEMBER EXCLUDED?
N
N/A
Q93-1000935
09/10/2025
09/10/2026
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
$300,000
RENTED/LEASED EQUIPMENT
A
Q61-0223467
09/10/2025
09/10/2026
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
State of Tennessee - CPO Risk Manager
312 Rosa L Parks Ave
AUTHORIZED REPRESENTATIVE
3rd Floor Central Procurement Office
Nashville
TN 37243
cari crawford
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
POST IN A
City of Clarksville
License Number
CONSPICUOUS
Business License and Gross Receipt Tax
106334
PLACE
THIS LICENSE EXPIRES ON 05/15/2027
Business Name: ACTIVE ENERGY SERVICES LLC
Business ID:
0510329
Location:
RICHARD EVERETT
State ID:
0104267492
4705 CHAPEL HILL RD
SOUTHSIDE, TN 37171
THEY OF CLARKSVILLE
THE
BUSINESS TAX
OF
RICHARD EVERETT
SEAL
TENNESSEE
4705 CHAPEL HILL RD
SOUTHSIDE, TN 37171
DEC.1785
THE LICENSE PERIOD IS JANUARY 1ST TO
DECEMBER 31ST (CALENDAR YEAR). YOUR RENEWAL
IS DUE BY APRIL 15TH AND MUST BE SUBMITTED NO
LATER THAN APRIL 15TH TO AVOID PENALTY AND
INTEREST. ALL RETURNS MUST BE FILED
Classification: CLASS 4
ELECTRONICALLY WITH THE STATE OF TENNESSEE
DEPARTMENT OF REVENUE
Date Issued: 04/15/2026
THIS LICENSE DOES NOT PERMIT OPERATION UNLESS
PROPERLY ZONED, AND/OR IN COMPLIANCE WITH ALL
OTHER APPLICABLE LAWS/RULES. ALSO, AS REQUIRED
BY TENN. CODE ANN. § 39-17-1801 ET SEQ, BUSINESSES
MUST COMPLY WITH ALL PROVISIONS OF THE
By
Christen Wilcox
TENNESSEE NON-SMOKERS PROTECTION ACT.
Chief Financial Officer
This License is NOT Transferable
License Copy
POST IN A
City of Clarksville
License Number
CONSPICUOUS
Business License and Gross Receipt Tax
106334
PLACE
THIS LICENSE EXPIRES ON 05/15/2027
Business Name: ACTIVE ENERGY SERVICES LLC
Business ID:
0510329
Location:
RICHARD EVERETT
State ID:
0104267492
4705 CHAPEL HILL RD
SOUTHSIDE, TN 37171
BUSINESS TAX
RICHARD EVERETT
4705 CHAPEL HILL RD
SOUTHSIDE, TN 37171
CITY OF CLARKSVILLE
THE
OF
AGRICULTURE
COMMERCE
Classification: CLASS 4
SEAL
TENNESSEE
Date Issued: 04/15/2026
DEC.1785
By
Christen Wilcox
Chief Financial Officer
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature:
Print: RICHARD EVERETT
Title: MANAGER
Date: 5/26/26
10 I Page
The Hickman County Finance Office will be accepting bids for a "Fire Alarm
Monitoring/Service Repair and Equipment Replacement."
This bid is for a multi-year contract covering fire alarm monitoring/service repair, and
equipment replacement for Hickman County Schools.
This bid will be system wide for all schools. The bid will be for a period of 3 years with a
mutual two-year extension option. This bid will be good for the period of July 1, 2026 - June
30, 2029.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Business license
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with
all local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114
North Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside
of the envelope "Fire Alarm Monitoring/Service Repair and Equipment Replacement".
Bids will be opened on May 26, 2026, at 10:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all
bids or parts of the bids and to waive any informalities that would prevent the acceptance
of a better bid.
Complete the bid on B (specs) and submit your bid on those forms.
Specifications can be found at https://ww.hickmank12.org/requestforproposal. Or by
calling 391-729-3391 Ext 3.
NOTE:
Please use this sheet to enter your bid figures and attach any necessary
documents to the back of the bid sheet.
SCOPE
This bid is for the 2026/2027, 2027/2028, 2028/2029 school years with a mutual two-year
extension option provided no increase in charges or costs during the 5 years bid period with
an annual renewal contract letter of intent.
SPECIFICATIONS
Multi-Year Contract Requirements
This bid is for a multi-year contract covering fire alarm monitoring, service repair, and
equipment replacement for Hickman County Schools.
All pricing submitted must remain firm for the entire five-year contract period. If, at any
point during the contract term, the awarded vendor increases pricing for any reason, the
contract shall be considered null and void, and the entire project will be rebid.
1| Page
Annual Fire Alarm Monitoring by School
Fire Alarm Monitoring Services
This bid covers the annual cost of monthly fire alarm monitoring for all eight (8) Hickman
County School buildings. The facilities included in this service are:
EHES- East Hickman Elementary School
EHIS - East Hickman Intermediate School
EHMS - East Hickman Middle School
EHHS- East Hickman High School
CES- Centerville Elementary School
CIS - Centerville Intermediate School
HCMS- Hickman County Middle School
HCHS- Hickman County High School
The awarded vendor shall provide continuous fire alarm monitoring services for each
building and shall invoice the district annually for the full year of monthly monitoring
services. All monitoring must meet applicable Fire Marshal requirements and comply with
all state and local fire safety regulations.
Annual Cost of Monthly Fire Alarm Monitoring $ 4,320 00
2 I Page
ANNUAL ALARM TESTING and CERTIFICATION SERVICING
of ALARM EQUIPMENT and COMPONENTS
At all eight schools, to be scheduled and finished by July 15th of each calendar year. This is
to include a written check-off report in accordance with NFPA, to be provided for each
school location's front office binder. A written hard copy of the report and service ticket
should be left with each school's front office and hard copies sent to the Maintenance
Director's office.
Annual Fire Alarm Testing and Certification Service of Alarm
Equipment and Components $ 16,000.00
3 I Page
Installation of Communication Converter System for Fire
Alarm Panel (One-time charge, applicable if upgrade is selected)
Installation
Furnish and install a UL-listed communicator and all required accessories, wiring,
power supplies, antennas, and mounting hardware.
All equipment shall be fully compatible with the existing fire alarm control panel
and associated system components.
Installation shall be performed in accordance with the manufacturer's instructions
and industry best practices.
Programming and Testing
Program the communicator and associated fire alarm monitoring equipment to
ensure proper operation and supervision.
Verify successful transmission of all required alarm, supervisory, and trouble
signals to the Monitoring Station.
Conduct complete functional testing and provide confirmation that the monitoring
system is operating correctly and reliably.
Compliance
All work shall comply with all applicable local, state, and national codes,
including but not limited to:
NFPA 72 - National Fire Alarm and Signaling Code
UL 864- Standard for Control Units and Accessories for Fire Alarm
Systems
Equipment shall be listed and approved for fire alarm service and monitoring
applications.
Documentation
Provide test results, programming documentation, and verification of Monitoring
Station communication upon completion.
Coordinate all required inspections, testing, and acceptance documentation with
the Authority Having Jurisdiction (AHJ) as applicable.
4 I Page
Installation Labor Per Site
EHES
$ 1,000.00
EHIS
$ 1,000
EHMS
$ 1,000
EHHS
$ 1,000
CES
$ 1,000
CIS
$ 1,000
HCMS
$ 1,000
HCHS
$ 1,000
Total Installation Cost $ 8,000
Equipment Cost Per Site
EHES
$ 450
EHIS
$ 45000
EHMS
$ 45000
EHHS
$ 45000
CES
$ 45000
CIS
$ 450000
HCMS
$ 45000
HCHS
$ 450
Total Equipment Cost $ 3,600
51 Page
COST of SERVICING REPAIR and/or REPLACEMENT of
EQUIPMENT
Service call trip charge is limited to one trip charge per trip to the same zip code. Multi trip
charges will only be permitted if moving to a second zip code but not to a second location
in the same zip code.
Our zip codes for the 8 locations are Centerville Buildings 37033: CES, CIS, HCMS, HCHS
and Lyles Buildings 37098: EHES, EHIS, EHMS, EHHS.
Service Call Trip Charge $ 12500
Hourly rate per tech $ 100
(normal rate)
Hourly rate per tech $ 14000
(over-time rate)
All parts exceeding $1,000.00 in cost must accompany the vendors' actual cost invoices
incurred and attached with to billing invoices to ensure mark-ups are accurate and correct.
Invoices without tickets will not be paid.
Parts plus percentage of mark-up 15%
%
6 I Page
Annual Fire Extinguisher Inspections and Servicing
This contract will allow for the bidding of the fire extinguishers to be checked off by
location in each building and shall provide inspection, serviced by recharge, and/or
replaced if beyond container life cycle and shall be annually retagged as prescribed in the
Fire Marshals codes. Buildings are to be serviced 100% and accurately count all locations
not missing any extinguishers.
The service will be for all 11 locations in the school district to include all eight school
buildings, HCHS B Building, Central Office Building, and Bus Garage. A hard copy of the
checked-off inspections report by location shall be left with each location's front office
and a hard copy to be sent to the Maintenance Director's office upon completion. At the
bus garage there are spare extinguishers upstairs that are to be inspected, serviced,
tagged and recharged and/or replaced as needed. There are extinguishers downstairs in
the garage area for bus/vehicles that are annually serviced, tagged and recharged and/or
replaced as needed.
Location mapping and check-off sheets shall be the responsibility of the bidding vendor
and not charged to HCBOE.
NOTE: This agreement contract will require that the vendor return during the calendar year
at no charge and tag & service any extinguishers that are missed at no cost to the owner, in
the event they were not tagged during the inspections and found by the Maintenance
and/or the Fire Marshall.
Annual inspection fee per extinguisher one time re-tag by
location $ 16 00
New extinguisher replacement cost per size $ 15500
Fire extinguisher recharge cost per size $ 60 00
7 I Page
Fire Suppression Hoods: Bi-Annual Fire Suppression
Hoods
Kitchen Hood Suppression System Service Requirements
The Hickman County Schools facilities are equipped with kitchen areas that include one or
more fire-suppression hoods. The awarded vendor shall provide comprehensive annual
servicing of all hood suppression systems in accordance with applicable codes and
manufacturer specifications.
As part of the annual service, the vendor is required to:
1. Inspect, test, and properly service all hood suppression systems located within
each school facility.
2. Install new fusible links on every suppression hood as required on an annual
basis.
3. Provide cleanup services in the event that a system discharges during inspection
or testing. This includes the full cleanup and removal of any dry chemical agent
discharged onto kitchen equipment or surrounding surfaces.
All work must be performed by certified technicians and documented through detailed
service reports provided to the district upon completion.
Inspection Tagging and Compliance Requirements
1. Inspection Tagging
Upon completion of each inspection, the awarded vendor shall affix the appropriate
inspection tag or sticker to every hood suppression system. The tag must clearly
display the date of inspection and any other information required by applicable fire
codes.
2. Inspection Scheduling and Compliance
All inspections must be performed within the timeframes prescribed by the Fire
Marshal and all relevant fire safety codes. Inspections shall be completed on or up
to two (2) days prior to the required due date.
Under no circumstances may any inspection occur after the required due
date.
The awarded vendor is fully responsible for tracking and managing all
required inspection intervals across all school kitchens.
3. Documentation and Reporting Requirements
On the same day each inspection is completed, the vendor shall:
8 I Page
Provide a copy of the inspection report directly to the kitchen manager
before leaving the site, and
Deliver a hard copy of the full inspection report to the Maintenance
Director's office.
All documentation must be complete, accurate, and compliant with all reporting
standards established by the district and governing authorities.
Bi-Annual Manual Pull Station Tagging
In addition to the annual hood suppression inspections and tagging requirements
described above, the awarded vendor shall install a new bi-annual inspection tag on the
manual suppression pull device located at each hood system. This tag must clearly
indicate the inspection date and comply with all applicable fire safety and Fire Marshal
code requirements. The vendor is responsible for ensuring all bi-annual tags remain
current and are replaced on schedule.
Suppression inspections are to be at the following kitchen locations:
CES 240°/UISIT 480
CIS 480°C
HCMS 48000
HCHS $ 240 ²/UISIT 480
EHES 480°C
EHIS $ 240 48000
EHMS 480
EHHS 480°C
EHHS/VOCATIONAL CULINARY ARTS KITCHEN 600°/NIST 1200
Total amount for two (2) Bi-Annual Suppression Hood Inspections per year:
$ 5,04000
91 Page
The Hickman County Finance Office will be accepting bids for a "Epoxy Floor Coating." This bid
will be system wide for all schools. This bid will be from June 1, 2026 - May 31, 2027.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
Background Acknowledgement Form
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Per TCA 49-5-406, all bidders' employees working on school properties must comply with all
local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114 North
Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside of the
envelope "Epoxy Floor Coating."
Bids will be opened on May 13, 2026, at 11:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all bids or
parts of the bids and to waive any informalities that would prevent the acceptance of a better
bid.
Complete the bid on B (specs) and submit your bid on those forms.
Specifications can be found at https://ww.hickmank12.org/requestforproposal. Or by calling
391-729-3391 Ext 3.
Present Penny Rochille
2 Bids Ree'd
Must weems
Garage Floor Coating of Nashville LLC
BJB Construction Company Inc.
BA
APR 22 2026
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
4/27/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
David Michael Wiatr
PHONE
BNA Insurance Group LLC
(A/C, No, Ext):
(615) 431-1262
(A/C, FAX No): (615) 468-4712
E-MAIL
9045 Carothers Pkwy
ADDRESS:
frontdesk@bnainsurancegroup.com
Ste 301
INSURER(S) AFFORDING COVERAGE
-NAIC #
Franklin
TN 37067
INSURER A: WILSON MUT INS CO
19950
INSURED
INSURER B : HANOVER AMER INS CO
36064
GARAGE FLOOR COATING OF NASHVILLE LLC
INSURER C :
2913 CHERRYBARK CT
INSURER D:
INSURER E:
HERMITAGE
TN 37076
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDLISUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
1,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$
100,000
MED EXP (Any one person)
$
5,000
A
5000274758
07/18/2025
07/18/2026
PERSONAL & ADV INJURY
$
1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
2,000,000
PRO-
POLICY
JECT
LOC
PRODUCTS - COMP/OP AGG
$
2,000,000
$
OTHER:
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY
$
(Ea accident)
1,000,000
ANY AUTO
BODILY INJURY (Per person)
$
OWNED
SCHEDULED
A
AUTOS ONLY
5000274758
07/18/2025
07/18/2026
BODILY INJURY (Per accident)
$
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$
AUTOS ONLY
AUTOS ONLY
(Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED
RETENTION $
$
WORKERS COMPENSATION
PER
OTH-
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
EL EACH ACCIDENT
$
1,000,000
B
OFFICER/MEMBER EXCLUDED?
N
N/A
WZ5H689899
07/18/2025
07/18/2026
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Hickman County Schools
ACCORDANCE WITH THE POLICY PROVISIONS.
Hickman County Finance Office
AUTHORIZED REPRESENTATIVE
114 North Central Avenue, Suite 203
David Michael Wish
Centerville TN 37033
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
The
Hanover
Insurance Group-
WORKERS COMPENSATION AND EMPLOYER'S LIABILITY INSURANCE POLICY
31
EXTENSION OF INFORMATION PAGE
RENEWAL OF W25-H689899-03
CARRIER CODE NO. 30937
Policy Number
Policy Period
Coverage is Provided in the
Agency Code
From
To
WZ5-H689899-04
07/18/2025
07/18/2026
THE HANOVER AMERICAN INSURANCE COMPANY
1802610
ITEM 1. Named Insured and Address
Agent
Telephone: 615-431-1262
GARAGE FLOOR COATING OF NASHVI
BNA INSURANCE GROUP, LLC
2913 CHERRYBARK CT
9045 CAROTHERS PKWY #301
HERMITAGE, TN 37076
FRANKLIN, TN 37067
Federal ID No.
POLICY
**ADDITIONAL LOCATIONS **
SCHEDULE
PAGE 2
PAGE 1
LOCATION
ADDRESS
NUMBER
001
2913 CHERRYBARK CT
HERMITAGE, TN
37076
Form 331-0226 (9-03)
WC000001B
Date Issued: 05/14/2025
ORIGINAL/INSURED
Payment Type: ELECTRONIC EXCHANGE
WCDEC1
NASHVILLE AND DAVIDSON COUNTY BUSINESS
Davidson County Clerk's Office
TAX LICENSE
700 Second Avenue South, Suite 101
P.O. Box 196333
BUSINESS NUMBER
214695
Nashville, Tennessee 37219-6333
RECEIPT NUMBER
1054019
615-862-6254
GOVERNMEN
THIS LICENSE EXPIRES
05/15/2027
OWNER(S)/OFFICER(S)
PHRUCE DAVIES
*
KURT MILLER
AO
COLLETTO
BUSINESS LOCATION ADDRESS
GARAGE FLOOR COATING OF NASHVILLE
2913 CHERRYBARK CT
GARAGE FLOOR COATING OF NASHVILLITYLE ESEVIALE
3241 THOROUGHBRED DR
HERMITAGE, TN 37076
DAVIDSON
HERMITAGE, TN 37076
AND
MUST DISPLAY IN A CONSPICUOUS PLACE
Contact Metro Codes to verify this location is properly
zoned.
BUSINESS NUMBER
214695
RECEIPT NUMBER
1054019
CLASSIFICATION
3
TAX PERIOD
FROM
01/01/2025
TO
12/31/2025
THIS LICENSE EXPIRES 05/15/2027
ISSUE DATE
04/17/2026
Brenda Wynn
BRENDA WYNN, COUNTY CLERK
A ROBERSON
DEPUTY CLERK
NASHVILLE AND DAVIDSON COUNTY BUSINESS
Davidson County Clerk's Office
TAX LICENSE
700 Second Avenue South, Suite 101
P.O. Box 196333
BUSINESS NUMBER
214695
Nashville, Tennessee 37219-6333
RECEIPT NUMBER
0902519
615-862-6254
SECURITY
THIS LICENSE EXPIRES
05/15/2026
OWNER(S)/OFFICER(S)
BRUCE DAVIES
KURT MILLER
BUSINESS LOCATION ADDRESS
GARAGE FLOOR COATING OF NASHVILLE, LLC
GARAGE FLOOR COATING OF NASHVILLE
2913 CHERRYBARK CT
SERVICE
3241 THOROUGHBRED DR
HERMITAGE, TN 37076
DAVIDSON
HERMITAGE, TN 37076
AND
MUST DISPLAY IN A CONSPICUOUS PLACE
Contact Metro Codes to verify this location is properly
zoned.
BUSINESS NUMBER
214695
CITY
COUNTY
RECEIPT NUMBER
0902519
TOTAL GROSS SALES
CLASSIFICATION
3
LESS DEDUCTIONS
BUSINESS TAX DUE
TAX PERIOD
(LESS CREDITS)
FROM
STARTED
MINIMUM TAX
TO
07/24/2019
PENALTY
INTEREST
NEW LICENSE FEE
15.00
THIS LICENSE EXPIRES 05/15/2026
TOTAL TAX DUE
15.00
ISSUE DATE
09/18/2025
ORIGINAL ISSUE DATE
07/24/2019
ORIGINAL ISSUE USER
RMEYER
COMBINED TOTAL
15.00
Brenda Wynn
BRENDA WYNN, COUNTY CLERK
TL DANDRIDGE
DEPUTY CLERK
STANDARD BUSINESS TAX LICENSE
TOTAL DUE
$15.00
USER
RMEYER
CHECK
$30.00
STATION
WK208
CHECK NO.
103
DRAWER
267
CHANGE
$15.00
SITE
1
WORK DATE
07/24/2019
Specifications Part B
Epoxy Floor Coating
Scope:
Prep floors so there is no debris before application.
Apply 2 coats of two-component high solids, moisture-mitigating,
industrial epoxy floor coating.
The epoxy coating should be low odor and zero VOC.
Add full-chip media of customer's choosing from the supplier's
selection.
Apply 2 coats of a two-component polyaspartic-polyurea clear coat
providing a high gloss finish to a 5.0 mils dry film thickness per coat.
All labor and materials to complete this work shall be included in the
bid.
BID
All bid amounts should be quoted per square foot.
1. Bid per square foot of less than 1,000 square foot.
$5.75
2. Bid per square foot of 1,000 - 3,000 square feet.
$5.25
3. Bid per square foot greater than 3,000 square feet.
$5.00
Submitted By:
Name of Organization
Garage Floor Coating of Nashville, LLC
Submitted by (Name)
Bruce Davies
Title
Managing Member
Address
2913 Cherrybark Ct.
Hermitage, TN 37076
Telephone
(615) 878-4320
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Burce Dawir
Print: BRUCE DAVIES
Title: Managing Member
Date: April 27, 2026
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: April27,2026 Name: BRUCE Davie Garage Floor Coating of Nastiville, LLC
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: April 27
Signature: Buse Davis
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Garage Floor Coating of Nastiville, LLC (Brice DAVIES)
Bidder Signature; Draver Davis
Date: April 27, 2026
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
$ 12-4-119
Signature: Surce Davie
Print: BEUCE Davies
Date: April 27,
Phone/Email: 615-878-4320 garagefloorcoating. frasting agmail. cor
W-9
Request for Taxpayer
Form
Give form to the
(Rev. March 2024)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
Go to www.irs.gov/FormW9 for instructions and the latest information.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1. and enter the business/disregarded
entity's name on line 2.)
BJB Construction Company Inc
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
See Specific Instructions on page 3.
Individual/sole proprietor
C corporation
S corporation
Partnership
Trust/estate
LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
Exempt payee code (if any)
Print or type.
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
Other (see instructions)
code (if any)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
outside the United States.)
this box if you have any foreign partners, owners, or beneficiaries. See instructions
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
1373 Holly Tree Gap Rd
6 City, state, and ZIP code
Brentwood, TN. 37027
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
-
-
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
or
TIN, later.
Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
04 - 3777109
Part
II
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me): and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Signature of
Here
U.S. person
Debbie Benbow
Date 3/13/2026
General Instructions
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
noted.
to another flow-through entity in which it has an ownership interest. This
Future developments. For the latest information about developments
change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions, such as legislation enacted
regarding the status of its indirect foreign partners, owners, or
after they were published, go to www.irs.gov/FormW9.
beneficiaries, so that it can satisfy any applicable reporting
requirements. For example, a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC" box and enter its appropriate tax classification.
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)
State of Tennessee
14123171
BOARD FOR LICENSING ONTRACTORS
CONTRACTOR
BJB CONSTRUCTION COMPANY INC.
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 61519
SEALTH OF THE STATEOF STATE OF
LIC STATUS: ACTIVE
IDV
EXPIRATION DATE: September 30, 2026
GOILEA AGRICULTURE 7
$473,240.00; BC MO IN-1313 *7796*
VIVIC
DEPARTMENT OF
COMMERCE AND INSURANCE
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
02/12/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT NAME: LISA WILSON
INSURANCE GROUP OF AMERICA LLC
SMALL BUSINESS
PHONE:
FAX: (615)905-1698
6640 CAROTHERS PKWY STE 160
E-MAIL ADDRESS: lisa.wilson@iga.biz
FRANKLIN, TN 37067
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A
Central Mutual
20230
INSURED
INSURER B
All America
20222
BJB CONSTRUCTION COMPANY INC
1373 HOLLY TREE GAP RD
INSURER C
BRENTWOOD, TN 37027
INSURER D
INSURER E
INSURER F
CERTIFICATE NUMBER
7018655
REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
Y
Y
9606838
8/8/2025
8/8/2026
EACH OCCURRENCE
$
1,000,000
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED PREMISES
$
300,000
(Ea occurrence)
CLAIMS-MADE
OCCUR
MED EXP (Any one person)
$
5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PERSONAL & ADV INJURY
$
1,000,000
POLICY
PRO-
LOC
GENERAL AGGREGATE
$
2,000,000
JECT
PRODUCTS- COMP/OP AGG
$
2,000,000
B
AUTOMOBILE LIABILITY
Y
Y
9606837
8/8/2025
8/8/2026
COMBINED SINGLE LIMIT (Ea
$
1,000,000
accident)
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS
AUTOS
PROPERTY DAMAGE (Per
$
HIRED AUTOS
NON-OWNED
accident)
AUTOS
A
UMBRELLA LIABILITY
Y
Y
9606839
8/8/2025
8/8/2026
EACH OCCURRENCE
$
5,000,000
UMBRELLA
OCCUR
AGGREGATE
$
5,000,000
LIAB
EXCESS LIAB
CLAIMS-MADE
DED
RETENTION $
A
WORKERS COMPENSATION AND
9606841
8/8/2025
8/8/2026
WC STATUTORY LIMITS
OTHER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
1,000,000
ANY PROPRIETOR/PARTNERS/EXEC-
Y
UTIVE OFFICE/MEMBER EXCLUDED?
E.L. DISEASE- EA EMPLOYEE
$
1,000,000
(Mandatory in NH)
E.L DISEASE- POLICY LIMIT
$
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES
Certificate Holders are additional insured per the attached endorsements.
Subject to all of the terms, conditions, exclusions and definitions of the above referenced policies as issued by the carrier(s).
Excluded proprietors, partners, executive officers, and members:
DEBBIE BENBOW
BRUCE BENBOW
CERTIFICATE HOLDER
CANCELLATION
BJB CONSTRUCTION COMPANY INC.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
1373 HOLLY TREE GAP RD
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
BRENTWOOD, TN 37027
THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
LISA WILSON
NATURE
BEYOND JUST BUILDERS
BJB
CONSTRUCTION COMPANY INC
BJB
1373 Holly Tree Gap Rd, Brentwood, TN. 37027
CONSTRUCTION
CONSTRUCTION
COMPANY
COMPANY
References:
1) Brent Stidham
Senior Maintenance Engineer
(Managing govt buildings in Brentwood TN)
City Of Brentwood
brent.stidham@brentwoodtn.gov
(615)533-5032
15+ Years as a customer
2) Ryan Edwards
Continuous Improvement Coordinator
Advanced Composites
Ryan.edwards@advcmp.com
(615)630-1843
15+ Years as a customer
3) Yvonne Parker
Sr. Specialist, Consumer Care National Facilities
T-Mobile
Yvonne.parker@t-mobile.com
(931)980-8867
8 Years as a customer
4) Wesley King
Service Manager
The Mathews Company
wking@themathewscompany.com
(615)394-8451
15+ Years as a customer
Office 615-457-3304
www.BJBConstruction.com
Specifications Part B
Epoxy Floor Coating
Scope:
Prep floors so there is no debris before application.
Apply 2 coats of two-component high solids, moisture-mitigating,
industrial epoxy floor coating.
The epoxy coating should be low odor and zero VOC.
Add full-chip media of customer's choosing from the supplier's
selection.
Apply 2 coats of a two-component polyaspartic-polyurea clear coat
providing a high gloss finish to a 5.0 mils dry film thickness per coat.
All labor and materials to complete this work shall be included in the
bid.
BID
All bid amounts should be quoted per square foot.
1. Bid per square foot of less than 1,000 square foot.
$20.34
2. Bid per square foot of 1,000 - 3,000 square feet.
$15.82
3. Bid per square foot greater than 3,000 square feet.
$13.56
Submitted By:
Name of Organization
BJB Construction Company Inc.
Submitted by (Name)
Nathaniel Benbow
Title
Estimator/ Principal Officer
Address
1373 Holly Tree Gap Rd, Brentwood, TN. 37027
Telephone
615-394-1411
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Title: Estimator/ Principal Officer
Date: 5/11/2026
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/11/2026
Name: Nathaniel Benbow
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/11/2026
Signature: Nathaniel Benbow
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23. pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Nathaniel Benbow
BJB Construction Company Inc.
Bidder Signature: Nathaniel Benbow
Date: 5/11/2026
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Date: 5/11/2026
ї
The Hickman County Finance Office will be accepting sealed bids for "Annual
Paving and Patching".
Bid prices must be good for July 1, 2026 - June 30, 2027.
All bidders are required to submit a conflict-of-interest disclosure form that
can be obtained at https://www.hickmank12.org/requestforproposal.
Specifications may be found at
https://www.hickmank12.org/requestforproposal, or by contacting the
building maintenance office at 931-729-3391 ext 3.
Bidders must meet TCA 49-5-406 and all other state, federal and local
guidelines and laws regarding working on school properties.
Bidders are required to attach:
TN Paving contractor's license
1-million-dollar liability insurance
workers compensation insurance
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
Background Acknowledgement Form
Sealed bids must be mailed, or hand delivered to the Hickman County
Finance Office, 114 North Central Ave, Suite 203, Centerville, TN 37033 and
clearly marked "Annual Paving, Patching, and Striping Bid" on the outside of
the mailing envelope.
Bids will be opened on May 12, 2026, at 10:30 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept and
reject any and all bids or parts of bids, and to waive any informalities that may
prevent the acceptance of a better bid.
2 Bids Rec'd
Present Piny Rochelle
Nickell Contracting LLC
CardiClar
sessions Daving Company
see attached bids
PAVING
Bid Specifications: Bid form (use this form to bid please).
Scope:
All paving costs include cleaning, milling, key joints, and tie ins, removal of
any vegetation, cleaning of loose sand and millings and the application of the
required tack coats per the standard DOT specifications and laying of topcoat
as per each of the line items below. Any low drains, utility covers, riser are to
be included, unless the paving grade is milled down near the level surface of
the finished and final topping. There are not to be any trip hazards and water
is not to pond on the surface and be subject to freezing ice hazards. Must be
smooth and graded level to travel with properly pitched draining.
GENERAL ANNUAL PAVING BID:
OVERLAY:
Price per square yard for 2-inch overlay rolled to 1.5-inch thickness
$ 25.30
per square yard.
BINDER /PAVING:
Repaving to include 2-inch of CW grade to (220# per square yard) with binder
and additional 1.5-inch finished rolled (165# per square yard) topcoat.
$ 190.82
per square yard.
MILLING:
Sawing/Demo or Milling existing pavement by the square yard removed down
to 4-inches, to include sawing and hauling off/disposal of the excess debris.
$ 99.91
per square yard.
PATCH PAVING:
To saw cut, remove all loose broken materials, including the removal of any
wet earth, ensuring solid dry compaction layer is exposed, adding back a
minimum of 4-inches of pug and rock material rolled with 2-inches of CW
binder, and 1.5-inches of topcoat rolled to smooth level seams to grade.
$ 289.05
per square yard.
GENERAL GRADING/DITCHING/DRAINS/CURTAIN DRAINS:
General Earth removal "during a paving work", such as undercutting, drainpipe
or curtain drains installation, ditching for removal of excess clay dirt.
$ 320.12
per square yard.
Page | 1
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Atan Nikell
Print: R. Paul Nickell
Title: President
Date: 5/12/2026
Page I 2
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/7/2026 Name: R Paul Nickell
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/7/2026 Signature:
Page I 3
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/o
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: R Pal Nickell - Nichell Contracting, LLC.
Bidder Signature:
Date:
5/7/2026
Page I 4
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature:
Print: R Pal Nickell
Date: 5/7/2026
Phone/Email: 331-454-6484 Tadllh@duickell.com
Page I 5
Page I 6
NICKCON-01
KSTEWART
ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
5/11/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
Athens Insurance
PHONE
FAX
(A/C, No, Ext):
(423) 745-3062
(A/C, No):
(423) 745-8888
110 W. Washington Avenue
E-MAIL
Athens, TN 37303
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Cincinnati Specialty
13037
INSURED
INSURER B : Business First Insurance Co
11697
Nickell Contracting LLC
INSURER C :
785 Armstrong Lane
INSURER D :
Columbia, TN 38401
INSURER E:
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
LIMITS
(MM/DD/YYYY)
A
1,000,000
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
CSU0236120
7/24/2025
7/24/2026
100,000
PREMISES (Ea occurrence)
$
1,000
MED EXP (Any one person)
$
1,000,000
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
2,000,000
PRO-
2,000,000
POLICY
PRODUCTS - COMP/OP AGG
$
JECT
LOC
OTHER:
$
COMBINED SINGLE LIMIT
A
AUTOMOBILE LIABILITY
(Ea accident)
S
1,000,000
ANY AUTO
CSU0236120
7/24/2025
7/24/2026
BODILY INJURY (Per person)
$
OWNED
SCHEDULED
AUTOS ONLY
AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
HIRED
NON-OWNED
(Per accident)
$
AUTOS ONLY
AUTOS ONLY
S
A
UMBRELLA LIAB
2,000,000
OCCUR
EACH OCCURRENCE
$
CSU0261601
7/24/2025
7/24/2026
S
2,000,000
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
DED
RETENTION $
S
PER
OTH-
B
WORKERS COMPENSATION
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
521-24987
7/24/2025
7/24/2026
1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
S
OFFICER/MEMBER EXCLUDED?
Y
N/A
1,000,000
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
S
If yes, describe under
1,000,000
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Hickman County
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
all Carter
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
State of Tennessee
416827
14057318
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
NICKELL CONTRACTING, LLC
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 81702
LIC STATUS: ACTIVE
SEALOR SEAL OF THE XVI STATEOF STATE
EXPIRATION DATE: August 31. 2026
UNLIMITED; BC-B; BC-C
GREAT THE AGRIC OMMERO LITURE SECURITY
7796
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
The Hickman County Finance Office will be accepting sealed bids for "Annual
Paving and Patching".
Bid prices must be good for July 1, 2026 - June 30, 2027.
All bidders are required to submit a conflict-of-interest disclosure form that
can be obtained at https://www.hickmank12.org/requestforproposal.
Specifications may be found at
https://www.hickmank12.org/requestforproposal, or by contacting the
building maintenance office at 931-729-3391 ext 3.
Bidders must meet TCA 49-5-406 and all other state, federal and local
guidelines and laws regarding working on school properties.
Bidders are required to attach:
TN Paving contractor's license
1-million-dollar liability insurance
workers compensation insurance
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
Background Acknowledgement Form
Sealed bids must be mailed, or hand delivered to the Hickman County
Finance Office, 114 North Central Ave, Suite 203, Centerville, TN 37033 and
clearly marked "Annual Paving, Patching, and Striping Bid" on the outside of
the mailing envelope.
Bids will be opened on May 12, 2026, at 10:30 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept and
reject any and all bids or parts of bids, and to waive any informalities that may
prevent the acceptance of a better bid.
PAVING
Bid Specifications: Bid form (use this form to bid please).
Scope:
All paving costs include cleaning, milling, key joints, and tie ins, removal of
any vegetation, cleaning of loose sand and millings and the application of the
required tack coats per the standard DOT specifications and laying of topcoat
as per each of the line items below. Any low drains, utility covers, riser are to
be included, unless the paving grade is milled down near the level surface of
the finished and final topping. There are not to be any trip hazards and water
is not to pond on the surface and be subject to freezing ice hazards. Must be
smooth and graded level to travel with properly pitched draining.
GENERAL ANNUAL PAVING BID:
OVERLAY:
Price per square yard for 2-inch overlay rolled to 1.5-inch thickness
$ 2100
per square yard.
BINDER/PAVING:
Repaving to include 2-inch of CW grade to (220# per square yard) with binder
and additional 1.5-inch finished rolled (165# per square yard) topcoat.
$ 5450
per square yard.
MILLING:
Sawing/Demo or Milling existing pavement by the square yard removed down
to 4-inches, to include sawing and hauling off/disposal of the excess debris.
$
1850
per square yard.
PATCH PAVING:
To saw cut, remove all loose broken materials, including the removal of any
wet earth, ensuring solid dry compaction layer is exposed, adding back a
Page I 1
by Robert Hutcheson
segsions Paving Company
President
minimum of 4-inches of pug and rock material rolled with 2-inches of CW
binder, and 1.5-inches of topcoat rolled to smooth level seams to grade.
$
23500
per square yard.
GENERAL GRADING/DITCHING/DRAINS/CURTAIN DRAINS:
RNH
General Earth removal "during a paving work", such as undercutting, drainpipe
or curtain drains installation, ditching for removal of excess clay dirt.
$
21500
per square yard.
NOTE: any necessary drainpipo, curtain chain installations
or similar work to be negotiated, Pricing is only
for undercatting DD removal OF KNH excess material to
be replaced with stone.
Sessions Paving Company
ay Robert 1. Hutcheson
President
Page I 2
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Sessions Paving Company
Signature:
Print: Robert N. Hutcheson
Title: President
Date: 5/12/2026
Page I 3
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA 85-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/12/2026 Name: Sessions PavingCorpany
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Page I 4
Date: 5/12/2026 Signature:
President
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Sessions Paving Company
Bidder Signature: Robert A. Hutcheson President
Page I 5
Date:
5/12/2026
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
12-4-119
Sessions Paving Company
Signature: Robert 1. Hutheror
Print:
Robert N.Hutcheson President
Date:
5/12/2026
Phone/Email: (615)356-0600 rnhutahesen@severspoingco
Page I 6
Page I 7
CONTRACTOR DRUG-FREE WORKPLACE AFFIDAVIT
STATE OF TENNESSEE
COUNTY OF DAVIDSON
1. Now comes the Affiant, who being duly sworn, deposes and says:
2. He/she is the principal officer for
SESSIONS PAVING COMPANY
(Name and Address of Bidding Entity
P.O. Box 90266 (6535 Robertson Avenue)
Nashville, TN 37209
3. That the bidding entity has submitted a bid to
Hickman County, TN
(Owner)
for the construction of
Annual Paving and Patching
(Name of Project)
=
4. That the bidding entity employs no less than five (5) employees.
5. That the Affiant certifies that the bidding entity has in effect, at the time of submission of its bid to
perform the construction referred to above, a drug-free workplace program that complies with
§ 50-9-113, Tennessee Code Annotated.
6. That this affidavit is made on personal knowledge.
Further Affiant saith not.
AFFIANT
President
STATE OF TENNESSEE
COUNTY OF DAVIDSON
Before me personally appeared
Robert N. Hutcheson
, with whom I am personally
acquainted (or proved to me on the basis of satisfactory evidence), and who acknowledges that such
person executed the foregoing affidavit for the purposes therein contained.
Witness my hand and seal at office this
12th
day of May
, 2026.
Notary Public
Jean m Starkey
JEAN M. STATE STARKEY
OF
My commission expires January 22, 2029
TENNESSEE
COUNTY OF DAVIDSON
NOTARY
PUBLIC
STATE OF TENNESSEE
DEPARTMENT OF
COMMERCE AND INSURANCE
SESSIONS PAVING COMPANY
435324
ID NUMBER: 6962
LIC STATUS: ACTIVE
EXPIRATION DATE: January 31, 2028
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
TIIIS IS TO CERTIFY THAT ALL REQUIREMENTS
OF THE STATE OF TENNESSEE HAVE BEEN MET
SESSIONS PAVING COMPANY
P.O. BOX 90266
NASHVILLE, TN 37209-0266
-135324
State of Tennessee
15065470
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
SESSIONS PAVING COMPANY
This is 10 certify that all requirements of the State of Tennessee have been mel.
ID NUMBER: 6962
DEPARTMENT THE XVI STATE OF
LIC STATUS: ACTIVE
EXPIRATION DATE: January 31. 2028
UNLIMITED; BC; CE-A; CE-B; HC-D; HRA; MU
NAME AGRICULTURE 1796 9
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
Client#: 614030
22SESSIPAV
DATE (MM/DD/YYYY)
ACORD™
CERTIFICATE OF LIABILITY INSURANCE
03/24/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
Wendy Nowlin
McGriff, a MMA LLC Company
PHONE
FAX
(A/C, No, Ext):
615 346-0323
(A/C, No):
8777677417
3322 West End Ave., Suite 300
E-MAIL
ADDRESS:
wmnowlin@mcgriff.com
Nashville, TN 37203
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Charter Oak Fire Insurance Company
25615
INSURED
INSURER B : Travelers Property Casualty Co of Amer
25674
Sessions Paving Company
INSURER C : MidSouth Insurance Company
12839
6535 Robertson Avenue
INSURER D : Travelers Indemnity Co of America
25666
P.O. Box 90266
INSURER E :
Nashville, TN 37209
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
(MM/DD/YYYY)
LIMITS
POLICY NUMBER
(MM/DD/YYYY)
A
COMMERCIAL GENERAL LIABILITY
DTCO7890P35ACOF
04/01/2026
04/01/2027
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$300,000
PD Ded:500
MED EXP (Any one person)
$5,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
PRO-
POLICY
JECT
LOC
PRODUCTS- COMP/OP AGG
$2,000,000
$
OTHER:
COMBINED SINGLE LIMIT
D
AUTOMOBILE LIABILITY
8108M9623792626G
04/01/2026
04/01/2027
(Ee accident)
$1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$
AUTOS ONLY
AUTOS ONLY
(Per accident)
$
B
UMBRELLA LIAB
OCCUR
CUP2J5568542626
04/01/2026
04/01/2027
EACH OCCURRENCE
$5,000,000
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$5,000,000
DED
RETENTION $10000
$
WORKERS COMPENSATION
PER
OTH-
C
WC052562026
01/01/2026
01/01/2027
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$1,000,000
OFFICER/MEMBER EXCLUDED?
N
N/A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Proof of Coverage
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Sessions Paving Company
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
6535 Robertson Avenue
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 90266
Nashville, TN 37209-0000
AUTHORIZED REPRESENTATIVE
Mason H Pope
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
1 of 1 The ACORD name and logo are registered marks of ACORD
#S39421219/M39421081
WMN
The Hickman County Finance Office will be accepting sealed bids for "Annual
Sealing and Striping".
Bid prices must be good for July 1, 2026 - June 30, 2027.
All bidders are required to submit a conflict-of-interest disclosure form that
can be obtained at https://www.hickmank12.org/requestforproposal.
Specifications may be found at
https/www.hickmank12.org/requestforproposal, or by contacting the
building maintenance office at 931-729-3391 ext 3.
Bidders must meet TCA 49-5-406 and all other state, federal and local
guidelines and laws regarding working on school properties.
Bidders are required to attach:
TN business license
1-million-dollar liability insurance
workers compensation insurance
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
Background Acknowledgement Form
Sealed bids must be mailed, or hand delivered to the Hickman County
Finance Office, 114 North Central Ave, Suite 203, Centerville, TN 37033 and
clearly marked "Annual Paving, Patching, and Striping Bid" on the outside of
the mailing envelope.
Bids will be opened on May 12, 2026, at 11:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept and
reject any and all bids or parts of bids, and to waive any informalities that may
prevent the acceptance of a better bid.
Present Penny Rochulle
3 bids rec'd
BJB Construction Company
Sessions Paving Company
American Stripes, LLC
see attached
Bid specifications: Bid form (use this form format to bid please).
Scope:
Seal coating, crack filling, and re-striping of parking lot.
This includes:
Preparation prior to sealcoating the entire area will be swept and
cleaned of all debris with commercial blowers.
Oil spots will be cleaned and primed as necessary.
Adjust any drainage basins/manhole covers prior to asphalt patch
installation
Striping - Re-stripe the parking lots to approved color and lay-out
including all lines, handicap stencils, hashes, crosswalks, curbing and
other noted
Contractor will dispose of all refuse and debris collected during
preparation operations.
ANNUAL PARKING LOT MAINTENANCE:
Crack sealing:
Cost to remove all vegetation from cracks, scrape, shovel, blow out, sweep,
clean pavement of all granular dirt build-up including drains. Add HOT
SLURRY filling of all cracks, level with a mopped finish.
$.85
per linear foot.
SEALING:
Cost to remove any vegetation, clean pavement and simply spray TWO
COATS of parking lot sealer.
$.23
per square foot.
STRIPING by SCHOOL:
*Note - HCBOE reserves the right to divide/award the striping portion of this
bid to bidders that only do striping, in the event we receive a better bid.
Striping bid requires that the parking lot is blown clean of all loose granular
debris and removed from the paved area, curbs, and drains prior to painting
stripes. All striping is to conform to meeting the most recent and latest ADA
accessibility laws and regulations. All paint to get double coated.
Locations for Striping Pricing:
Centerville Elementary School, 104 Mary Field Avenue, Centerville TN 37033
(includes street turn lane, front parking lot, side bus lane, and the rear back
parking area.)
$7,345.00
Double Paint
$19,631.00
Sealing Lot
Centerville Intermediate School, 110 Mary Field Avenue, Centerville TN 37033
(includes turn in from the city street, the front parking lot, main drive, and side
turn-around, exiting back to ending at the edge of the city street.)
$3,955.00
Double Paint
$ 12,123.00
Sealing Lot
Hickman County Middle School, 1639 Bulldog Blvd, Centerville TN 37033
(Vineyard Field Drive, and to include the main front of the building, the side
gym, and the donut parking lot at the rear to the school.)
$7,910.00
Double Paint
$20,954.00
Sealing Lot
Hickman County High School, 1645 Bulldog Blvd., Centerville TN 37033
(to include the 360 circle drive around the building, all parking areas front,
side and back, the upper soccer field spaces, and the all parking at the rear
administrative building. All markings, arrows and road highway center lanes
to be properly yellow laned marked, all spaces to be white striped.)
$ 31,428.00
Double Paint
$ 67,578.00
Sealing Lot
East Hickman Elementary School, 5191 Hwy 100, Lyles TN 37098
(to include the road markings around all three main driveways entering all
three schools, road letters identifying the four-letter school names, i.e., EHES,
EHIS, EHMS, then the front of the EHES parking lot lanes, all arrows, yellow
dividing traffic lanes markings, road letters, and stop bars per the principal
preference, as well as the fire lanes.)
$ 10,170.00
Double Paint
$ 17,661.00
Sealing Lot
East Hickman Intermediate School, 5198 East Eagle Drive. Lyles TN 37098
(to include front and rear donut lot area of the school building and roads,
enter and exit arrows, crosswalks, parking spaces, and fire lane.)
$ 3,051.00
Double Paint
$ 18,657.00
Sealing Lot
East Hickman Middle School, 9414 East Eagle Drive, Lyles Tn 37098
(to include all road front, entire gym side, and rear lot parking areas, arrows
and markings to enter and exit.)
$ 9,040.00
Double Paint
$ 21,812.00
Sealing Lot
East Hickman High School, 7700 Hwy 7, Lyles TN 37098
(to include all markings surrounding the entire campus, which includes road
traffic markings, front, rear and side parking lots as well as outlying athletic
parking lots, tennis softball and baseball fields, two divided lanes adding 15
mph every 300ft starting at the entrance and down the road circling around
the school. All stop bars painted, arrows and directional markings ending at
the gates. Main Hwy 7 entrance to refresh the stop bars and divider lanes.)
$36,160.00
Double Paint
$ 102,348.00
Sealing Lot
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Title: Estimator/ Principal Officer
Date: 5/6/2026
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/6/2026
Name: Nathaniel Benbow
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/6/2026
Signature: Nathaniel Benbow
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/o
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Nathaniel Benbow
BJB Construction Company Inc.
Bidder Signature: Nathaniel Benbow
Date: 5/6/2026
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Date: 5/6/2026
I
BEYOND JUST BUILDERS
BJB
CONSTRUCTION COMPANY INC
BJB
1373 Holly Tree Gap Rd, Brentwood, TN. 37027
CONSTRUCTION
CONSTRUCTION
COMPANY
COMPANY
References:
1) Brent Stidham
Senior Maintenance Engineer
(Managing govt buildings in Brentwood TN)
City Of Brentwood
brent.stidham@brentwoodtn.gov
(615)533-5032
15+ Years as a customer
2) Ryan Edwards
Continuous Improvement Coordinator
Advanced Composites
Ryan.edwards@advcmp.com
(615)630-1843
15+ Years as a customer
3) Yvonne Parker
Sr. Specialist, Consumer Care National Facilities
T-Mobile
Yvonne.parker@t-mobile.com
(931)980-8867
8 Years as a customer
4) Wesley King
Service Manager
The Mathews Company
wking@themathewscompany.com
(615)394-8451
15+ Years as a customer
Office 615-457-3304
www.BJBConstruction.com
W-9
Request for Taxpayer
Give form to the
Form
(Rev. March 2024)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
Go to www.irs.gov/FormW9 for instructions and the latest information.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded
entity's name on line 2.)
BJB Construction Company Inc
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
Individual/sole proprietor
C corporation
S corporation
Trust/estate
See Specific Instructions on page 3.
Partnership
LLC. Enter the tax classification (C = c corporation, S = S corporation, P = Partnership)
Exempt payee code (if any)
Print or type.
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
code (if any)
Other (see instructions)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
outside the United States.)
this box if you have any foreign partners, owners, or beneficiaries. See instructions
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
1373 Holly Tree Gap Rd
6 City, state, and ZIP code
Brentwood, TN. 37027
7 List account number(s) here (optional)
Part
I Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For Individuals, this is generally your social security number (SSN). However, for a
-
-
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
or
TIN, later.
Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
04 - 3777109
Part
II
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Signature of
Here
U.S. person
Debbie Benbow
Date 3/13/2026
General Instructions
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
noted.
to another flow-through entity in which it has an ownership interest. This
Future developments. For the latest information about developments
change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions, such as legislation enacted
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
after they were published, go to www.irs.gov/FormW9.
requirements. For example, a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC" box and enter its appropriate tax classification.
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)
1944
State of Connessee
14123171
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
BJB CONSTRUCTION COMPANY INC.
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 61519
OF THE XVI STATEO
LIC STATUS: ACTIVE
EXPIRATION DATE: September 30, 2026
GREAT SEAL THE AGRICULTURE 125 CHIME 7
$473,240.00; BC
7796
IN-1313
VC
DEPARTMENT OF
COMMERCE AND INSURANCE
DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
02/12/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT NAME: LISA WILSON
INSURANCE GROUP OF AMERICA LLC
PHONE:
FAX: (615)905-1698
SMALL BUSINESS
6640 CAROTHERS PKWY STE 160
E-MAIL ADDRESS: llsa.wilson@iga.biz
FRANKLIN, TN 37067
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A
Central Mutual
20230
INSURED
INSURER B
All America
20222
BJB CONSTRUCTION COMPANY INC
INSURER C
1373 HOLLY TREE GAP RD
BRENTWOOD, TN 37027
INSURER D
INSURER E
INSURER F
CERTIFICATE NUMBER
7018655
REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDLSUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
Y
Y
9606838
8/8/2025
8/8/2026
EACH OCCURRENCE
$
1,000,000
DAMAGE TO RENTED PREMISES
$
300,000
COMMERCIAL GENERAL LIABILITY
(Ea occurrence)
CLAIMS-MADE
OCCUR
MED EXP (Any one person)
$
5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PERSONAL & ADV INJURY
$
1,000,000
POLICY
PRO-
LOC
GENERAL AGGREGATE
$
2,000,000
JECT
PRODUCTS- COMP/OP AGG
$
2,000,000
B
AUTOMOBILE LIABILITY
Y
Y
9606837
8/8/2025
8/8/2026
COMBINED SINGLE LIMIT (Ea
$
1,000,000
accident)
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS
AUTOS
PROPERTY DAMAGE (Per
$
HIRED AUTOS
NON-OWNED
accident)
AUTOS
A
UMBRELLA LIABILITY
Y
Y
9606839
8/8/2025
8/8/2026
EACH OCCURRENCE
$
5,000,000
AGGREGATE
$
5,000,000
UMBRELLA
OCCUR
LIAB
EXCESS LIAB
CLAIMS-MADE
DED
RETENTION $
A
WORKERS COMPENSATION AND
9606841
8/8/2025
8/8/2026
WC STATUTORY LIMITS
OTHER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
1,000,000
ANY PROPRIETOR/PARTNERS/EXEC-
Y
UTIVE OFFICE/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$
1,000,000
(Mandatory in NH)
E.L. DISEASE- POLICY LIMIT
$
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES
Certificate Holders are additional insured per the attached endorsements.
Subject to all of the terms, conditions, exclusions and definitions of the above referenced policies as issued by the carrier(s).
Excluded proprietors, partners, executive officers, and members:
DEBBIE BENBOW
BRUCE BENBOW
CERTIFICATE HOLDER
CANCELLATION
BJB CONSTRUCTION COMPANY INC.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
1373 HOLLY TREE GAP RD
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
BRENTWOOD, TN 37027
THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
LISA WILSON
The Hickman County Finance Office will be accepting sealed bids for "Annual
Sealing and Striping".
Bid prices must be good for July 1, 2026 - June 30, 2027.
All bidders are required to submit a conflict-of-interest disclosure form that
can be obtained at https://www.hickmank12.org/requestforproposal
Specifications may be found at
https://www.hickmank12.org/requestforproposal, or by contacting the
building maintenance office at 931-729-3391 ext 3.
Bidders must meet TCA 49-5-406 and all other state, federal and local
guidelines and laws regarding working on school properties.
Bidders are required to attach:
TN business license
1-million-dollar liability insurance
workers compensation insurance
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
Background Acknowledgement Form
Sealed bids must be mailed, or hand delivered to the Hickman County
Finance Office, 114 North Central Ave, Suite 203, Centerville, TN 37033 and
clearly marked "Annual Paving, Patching, and Striping Bid" on the outside of
the mailing envelope.
Bids will be opened on May 12, 2026, at 11:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept and
reject any and all bids or parts of bids, and to waive any informalities that may
prevent the acceptance of a better bid.
Bid specifications: Bid form (use this form format to bid please).
Scope:
Seal coating, crack filling, and re-striping of parking lot.
This includes:
Preparation prior to sealcoating the entire area will be swept and
cleaned of all debris with commercial blowers.
Oil spots will be cleaned and primed as necessary.
Adjust any drainage basins/manhole covers prior to asphalt patch
installation
Striping - Re-stripe the parking lots to approved color and lay-out
including all lines, handicap stencils, hashes, crosswalks, curbing and
other noted
Contractor will dispose of all refuse and debris collected during
preparation operations.
ANNUAL PARKING LOT MAINTENANCE:
Crack sealing:
Cost to remove all vegetation from cracks, scrape, shovel, blow out, sweep,
clean pavement of all granular dirt build-up including drains. Add HOT
SLURRY filling of all cracks, level with a mopped finish.
$ 1.50
per linear foot.
SEALING:
Cost to remove any vegetation, clean pavement and simply spray TWO
COATS of parking lot sealer.
$ 0.24
per square foot.
Sessions Paving Company
leg Robert A Hutchern
President
STRIPING by SCHOOL:
*Note - - HCBOE reserves the right to divide/award the striping portion of this
bid to bidders that only do striping, in the event we receive a better bid.
Striping bid requires that the parking lot is blown clean of all loose granular
debris and removed from the paved area, curbs, and drains prior to painting
stripes. All striping is to conform to meeting the most recent and latest ADA
accessibility laws and regulations. All paint to get double coated.
Locations for Striping Pricing:
Centerville Elementary School, 104 Mary Field Avenue, Centerville TN 37033
(includes street turn lane, front parking lot, side bus lane, and the rear back
parking area.)
$ 6,000.00
Double Paint
$ 18,000.00
Sealing Lot
Centerville Intermediate School, 110 Mary Field Avenue, Centerville TN 37033
(includes turn in from the city street, the front parking lot, main drive, and side
turn-around, exiting back to ending at the edge of the city street.)
$ 4,000.00
Double Paint
$ 12,000.00
Sealing Lot
Hickman County Middle School, 1639 Bulldog Blvd, Centerville TN 37033
(Vineyard Field Drive, and to include the main front of the building, the side
gym, and the donut parking lot at the rear to the school.)
$ 6,750.00
Double Paint
$ 20,950.00
Sealing Lot
Sessions Paving Company
ley Robert A. Antiteson
President
Hickman County High School, 1645 Bulldog Blvd., Centerville TN 37033
(to include the 360 circle drive around the building, all parking areas front,
side and back, the upper soccer field spaces, and the all parking at the rear
administrative building. All markings, arrows and road highway center lanes
to be properly yellow laned marked, all spaces to be white striped.)
$ 18,000.00
Double Paint
$ 54,000.00
Sealing Lot
East Hickman Elementary School, 5191 Hwy 100, Lyles TN 37098
(to include the road markings around all three main driveways entering all
three schools, road letters identifying the four-letter school names, i.e., EHES,
EHIS, EHMS, then the front of the EHES parking lot lanes, all arrows, yellow
dividing traffic lanes markings, road letters, and stop bars per the principal
preference, as well as the fire lanes.)
$ 15,000.00
Double Paint
$ 42,000.00
Sealing Lot
East Hickman Intermediate School, 5198 East Eagle Drive. Lyles TN 37098
(to include front and rear donut lot area of the school building and roads,
enter and exit arrows, crosswalks, parking spaces, and fire lane.)
$ 3,250.00
Double Paint
$ 9,250.00
Sealing Lot
East Hickman Middle School, 9414 East Eagle Drive, Lyles Tn 37098
(to include all road front, entire gym side, and rear lot parking areas, arrows
and markings to enter and exit.)
$ 12,000.00
Double Paint
$ 32,500.00
Sealing Lot
Sessions Paving Company
leg Robert n. Hutcheson
President
East Hickman High School, 7700 Hwy 7, Lyles TN 37098
(to include all markings surrounding the entire campus, which includes road
traffic markings, front, rear and side parking lots as well as outlying athletic
parking lots, tennis softball and baseball fields, two divided lanes adding 15
mph every 300ft starting at the entrance and down the road circling around
the school. All stop bars painted, arrows and directional markings ending at
the gates. Main Hwy 7 entrance to refresh the stop bars and divider lanes.)
$ 30,000.00
Double Paint
$ 90,000.00
Sealing Lot
Sessions Paving company
leg Robert 1. Hattheson
President
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Sessions Paving Company
Signature: Robert 1. Hutcheson
Print:
Robert N. Hutcheson
Title:
President
Date:
5/12/2026
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/12/2026
Name: Sessions Paving Company
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/12/2026 Signature: Robert 1. Hutcheson
President
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/0
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name:
Sessions Paving Company
Bidder Signature:
Robert 1. Hutcheson President
Date:
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israet to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
$ 12-4-119
Sessions Paving Company
Signature:
Robert 1. Hntcheson
Print:
Robert N. Hutcheson President
Date:
5/12/2026
Phone/Email: (615)356-0600 rnhntcheson@sessionspaving.com
CONTRACTOR DRUG-FREE WORKPLACE AFFIDAVIT
STATE OF TENNESSEE
COUNTY OF DAVIDSON
1. Now comes the Affiant, who being duly sworn, deposes and says:
2: He/she is the principal officer for
SESSIONS PAVING COMPANY
(Name and Address of Bidding Entity
P.O. Box 90266 (6535 Robertson Avenue)
Nashville, TN 37209
3. That the bidding entity has submitted a bid to Hickman (Owner) County, TN
for the construction of
Annual Sealing and 5 triping
(Name of Project)
4.
That the bidding entity employs no less than five (5) employees.
5.
That the Affiant certifies that the bidding entity has in effect, at the time of submission of its bid to
perform the construction referred to above, a drug-free workplace program that complies with
§ 50-9-113, Tennessee Code Annotated.
6.
That this affidavit is made on personal knowledge.
Further Affiant saith not.
Robert A. Antcheson
AFFIANT
President
STATE OF TENNESSEE
COUNTY OF DAVIDSON
Before me personally appeared
Robert N. Hutcheson
, with whom I am personally
acquainted (or proved to me on the basis of satisfactory evidence), and who acknowledges that such
person executed the foregoing affidavit for the purposes therein contained.
Witness my hand and seal at office this
, 2026
JEAN
M.
12th day of May
Jean M. Starkey
STATE STARKEY
Notary(Public
My commission expires January 22, 2029
COUNTY
OF
STATE OF TENNESSEE
DEPARTMENT OF
COMMERCE AND INSURANCE
SESSIONS PA VING COMPANY
435324
ID NUMBER: 6962
LIC STATUS: ACTIVE
EXPIRATION DATE: January 31. 2028
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
THIS IS TO CERTIFY THAT ALL REQUIREMENTS
OF THE STATE OF TENNESSEE HAVE BEEN MET
SESSIONS PAVING COMPANY
P.O. BOX 90266
NASHVILLE, TN 37209-0266
State of Tennessee
15065470
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
SESSIONS PAVING COMPANY
This is 10 certify that all requirements of the State of Tennessee have been met.
THE
ID NUMBER: 6962
LIC STATUS: ACTIVE
STATE AGRICULTURE
EXPIRATION DATE: January 31. 2028
UNLIMITED; BC; CE-A; CE-B; HC-D; HRA; MU
7786
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
Client#: 614030
22SESSIPAV
DATE (MM/DD/YYYY)
ACORD™
CERTIFICATE OF LIABILITY INSURANCE
03/24/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT
NAME:
Wendy Nowlin
McGriff, a MMA LLC Company
PHONE
FAX
(A/C, No, Ext):
615 346-0323
(A/C, No):
8777677417
3322 West End Ave., Suite 300
E-MAIL
ADDRESS:
wmnowlin@mcgriff.com
Nashville, TN 37203
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Charter Oak Fire Insurance Company
25615
INSURED
INSURER B: Travelers Property Casualty Co of Amer
25674
Sessions Paving Company
INSURER C: MidSouth Insurance Company
12839
6535 Robertson Avenue
INSURER D: Travelers Indemnity Co of America
25666
P. O. Box 90266
INSURER E:
Nashville, TN 37209
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
COMMERCIAL GENERAL LIABILITY
DTCO7890P35ACOF
04/01/2026
04/01/2027
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$300,000
PD Ded:500
MED EXP (Any one person)
$5,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
PRO-
POLICY
JECT
LOC
PRODUCTS- COMP/OP AGG
$2,000,000
OTHER:
$
COMBINED SINGLE LIMIT
D
AUTOMOBILE LIABILITY
8108M9623792626G
04/01/2026
04/01/2027
(Ee accident)
$1,000,000
ANY AUTO
BODILY INJURY (Per person)
$
OWNED
SCHEDULED
AUTOS ONLY
BODILY INJURY (Per accident)
$
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$
AUTOS ONLY
AUTOS ONLY
(Per accident)
$
B
UMBRELLA LIAB
OCCUR
CUP2J5568542626
04/01/2026
04/01/2027
EACH OCCURRENCE
$5,000,000
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$5,000,000
DED
RETENTION $10000
$
WORKERS COMPENSATION
PER
OTH-
C
WC052562026
01/01/2026
01/01/2027
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
EL EACH ACCIDENT
$1,000,000
OFFICER/MEMBER EXCLUDED?
N
N/A
(Mandatory in NH)
E.L. DISEASE- EA EMPLOYEE
$1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Proof of Coverage
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Sessions Paving Company
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
6535 Robertson Avenue
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 90266
Nashville, TN 37209-0000
AUTHORIZED REPRESENTATIVE
Mason H Pope
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
1 of 1 The ACORD name and logo are registered marks of ACORD
#S39421219/M39421081
WMN
The Hickman County Finance Office will be accepting sealed bids for "Annual
Sealing and Striping".
Bid prices must be good for July 1, 2026 - June 30, 2027.
All bidders are required to submit a conflict-of-interest disclosure form that
can be obtained at https://www.hickmank12.org/requestforproposal.
Specifications may be found at
https://www.hickmank12.org/requestforproposal, or by contacting the
building maintenance office at 931-729-3391 ext 3.
Bidders must meet TCA 49-5-406 and all other state, federal and local
guidelines and laws regarding working on school properties.
Bidders are required to attach:
TN business license
1-million-dollar liability insurance
workers compensation insurance
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
Background Acknowledgement Form
Sealed bids must be mailed, or hand delivered to the Hickman County
Finance Office, 114 North Central Ave, Suite 203, Centerville, TN 37033 and
clearly marked "Annual Paving, Patching, and Striping Bid" on the outside of
the mailing envelope.
Bids will be opened on May 12, 2026, at 11:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept and
reject any and all bids or parts of bids, and to waive any informalities that may
prevent the acceptance of a better bid.
Bid specifications: Bid form (use this form format to bid please).
Scope:
Seal coating, crack filling, and re-striping of parking lot.
This includes:
Preparation prior to sealcoating the entire area will be swept and
cleaned of all debris with commercial blowers.
Oil spots will be cleaned and primed as necessary.
Adjust any drainage basins/manhole covers prior to asphalt patch
installation
Striping - Re-stripe the parking lots to approved color and lay-out
including all lines, handicap stencils, hashes, crosswalks, curbing and
other noted
Contractor will dispose of all refuse and debris collected during
preparation operations.
ANNUAL PARKING LOT MAINTENANCE:
Crack sealing:
Cost to remove all vegetation from cracks, scrape, shovel, blow out, sweep,
clean pavement of all granular dirt build-up including drains. Add HOT
SLURRY filling of all cracks, level with a mopped finish.
$
1.00
per linear foot.
SEALING:
Cost to remove any vegetation, clean pavement and simply spray TWO
COATS of parking lot sealer.
$
.18
per square foot.
1 I Page
STRIPING by SCHOOL:
*Note - HCBOE reserves the right to divide/award the striping portion of this
bid to bidders that only do striping, in the event we receive a better bid.
Striping bid requires that the parking lot is blown clean of all loose granular
debris and removed from the paved area, curbs, and drains prior to painting
stripes. All striping is to conform to meeting the most recent and latest ADA
accessibility laws and regulations. All paint to get double coated.
Locations for Striping Pricing:
Centerville Elementary School, 104 Mary Field Avenue, Centerville TN 37033
(includes street turn lane, front parking lot, side bus lane, and the rear back
parking area.)
$ 2,916.00 Double Paint
$ $ 16,830.00 Sealing Lot
Centerville Intermediate School, 110 Mary Field Avenue, Centerville TN 37033
(includes turn in from the city street, the front parking lot, main drive, and side
turn-around, exiting back to ending at the edge of the city street.)
$ 1,626.00
Double Paint
$ 11,842.00
Sealing
Lot
Hickman County Middle School, 1639 Bulldog Blvd, Centerville TN 37033
(Vineyard Field Drive, and to include the main front of the building, the side
gym, and the donut parking lot at the rear to the school.)
$ 2,806.00 Double Paint
$ 18,017.00 Sealing Lot
Hickman County High School, 1645 Bulldog Blvd., Centerville TN 37033
(to include the 360 circle drive around the building, all parking areas front,
side and back, the upper soccer field spaces, and the all parking at the rear
2 I Page
administrative building. All markings, arrows and road highway center lanes
to be properly yellow laned marked, all spaces to be white striped.)
$ 15,067.00 Double Paint
$ 61,242.00 Sealing Lot
East Hickman Elementary School, 5191 Hwy 100, Lyles TN 37098
(to include the road markings around all three main driveways entering all
three schools, road letters identifying the four-letter school names, i.e., EHES,
EHIS, EHMS, then the front of the EHES parking lot lanes, all arrows, yellow
dividing traffic lanes markings, road letters, and stop bars per the principal
preference, as well as the fire lanes.)
$ 4,848.00
Double Paint
$ 13,362.00 Sealing Lot
East Hickman Intermediate School, 5198 East Eagle Drive. Lyles TN 37098
(to include front and rear donut lot area of the school building and roads,
enter and exit arrows, crosswalks, parking spaces, and fire lane.)
$ 2,016.00 Double Paint
$ 8,656.00 Sealing Lot
East Hickman Middle School, 9414 East Eagle Drive, Lyles Tn 37098
(to include all road front, entire gym side, and rear lot parking areas, arrows
and markings to enter and exit.)
$ 3,145.00 Double Paint
$ 21, 597.00 Sealing Lot
East Hickman High School, 7700 Hwy 7, Lyles TN 37098
(to include all markings surrounding the entire campus, which includes road
traffic markings, front, rear and side parking lots as well as outlying athletic
parking lots, tennis softball and baseball fields, two divided lanes adding 15
3 I Page
mph every 300ft starting at the entrance and down the road circling around
the school. All stop bars painted, arrows and directional markings ending at
the gates. Main Hwy 7 entrance to refresh the stop bars and divider lanes.)
$ 20,750.00 Double Paint
$ 81,810.00 Sealing Lot
4 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: allen Herringt
Print: Allan Herrington
Title: Projet Manager
Date: 5-11-26
5 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5-11-26 Name: Allan Herrington
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
1 have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5-11-26 Signature: allen Heringt
6 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/librar/0
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: American Stripers, LLC
Bidder Signature: allen Humingt
Date: 5-11-26
71 Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
$ 12-4-119
Signature: allm Humptr
Print: Allan Herrington
Date: 5-11-26
Phone/Email: (931) 381-6292 Americanstripers@yahoo.co
8 I Page
State of Tennessee
429408
14875265
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
AMERICAN STRIPERS, LLC
This is le certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 59722
LICSTATUS: ACTIVE
CANADA THE REVIEW
EXPIRATION DATE: July 31. 2027
$1,962,980.00; HRA-B.2
THE AGRICULTURE V
1796
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
Client#: 2337473
22AMERISTR
DATE (MM/DD/YYYY)
ACORD™
CERTIFICATE OF LIABILITY INSURANCE
09/08/2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
April Garrett
FAX
PHONE
McGriff, a MMA LLC Company
(A/C, No, Ext):
615 279-8477
(A/C, No):
8777677417
3322 West End Ave., Suite 300
E-MAIL
ADDRESS:
April.Garrett@mcgriff.com
INSURER(S) AFFORDING COVERAGE
NAIC #
Nashville, TN 37203
615 292-9000
INSURER A: Monroe Guaranty Insurance Company
32506
INSURED
INSURER B: FCCI Insurance Company
10178
American Stripers, LLC
INSURER C:
2407 Park Plus Drive
INSURER D:
Columbia, TN 38401-4510
INSURER E :
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
LIMITS
(MM/DD/YYYY)
A
COMMERCIAL GENERAL LIABILITY
CPP10009518701
09/09/2025
09/09/2026
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTED
CLAIMS-MADE
PREMISES (Ea occurrence)
$100,000
OCCUR
PD Ded:1,000
MED EXP (Any one person)
$5,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
PRO-
PRODUCTS - COMP/OP AGG
$2,000,000
POLICY
JECT
LOC
$
OTHER:
A
AUTOMOBILE LIABILITY
CA10009518801
09/09/2026
COMBINED SINGLE LIMIT
09/09/2025
(Ea accident)
$1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$
AUTOS ONLY
(Per accident)
AUTOS ONLY
$
B
UMBRELLA LIAB
OCCUR
UMB10009519001
09/09/2025
09/09/2026
EACH OCCURRENCE
$5,000,000
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$5,000,000
$
DED
RETENTION $10000
PER
OTH-
B
WORKERS COMPENSATION
WC010009518901
09/09/2025
09/09/2026
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$1,000,000
OFFICER/MEMBER EXCLUDED?
N
N/A
E.L. DISEASE- EA EMPLOYEE
$1,000,000
(Mandatory in NH)
If yes, describe under
E.L. DISEASE- POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space la required)
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
American Stripers, LLC
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
2407 Park Plus Dr.
ACCORDANCE WITH THE POLICY PROVISIONS.
Columbia, TN 38401
AUTHORIZED REPRESENTATIVE
Reynond M. Dum
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
1 of 1 The ACORD name and logo are registered marks of ACORD
JLCH
#S38214758/M38214746
The Hickman County Finance Office is accepting bids for "Concrete Pouring at Schools"
2025-2026.
Bid prices must be good for July 1, 2026 - June 30, 2027.
Specifications can be found at https://www.hickmank12.org/requestorproposalor
by calling 931-729-3391 Ext 3.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://www.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with all local,
state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114 North
Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside of the
envelope "Concrete Pouring at School."
Bids will be opened on May 12,2026 at 10:00 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all bids or
parts of bids and to waive any informalities that would prevent the acceptance of a
better Present bid. Penny Rockle
1 Bid Reed
Mists New
BJB Construction Company
bid attached
BEYOND JUST BUILDERS
REPONDJUST BUTLDERS BE
BJB
CONSTRUCTION COMPANY INC
BJB
1373 Holly Tree Gap Rd, Brentwood, TN. 37027
CONSTRUCTION
CONSTRUCTION
COMPANY
COMPANY
References:
1) Brent Stidham
Senior Maintenance Engineer
(Managing govt buildings in Brentwood TN)
City Of Brentwood
brent.stidham@brentwoodtn.gov
(615)533-5032
15+ Years as a customer
2) Ryan Edwards
Continuous Improvement Coordinator
Advanced Composites
Ryan.edwards@advcmp.com
(615)630-1843
15+ Years as a customer
3) Yvonne Parker
Sr. Specialist, Consumer Care National Facilities
T-Mobile
Yvonne.parker@t-mobile.com
(931)980-8867
8 Years as a customer
4) Wesley King
Service Manager
The Mathews Company
wking@themathewscompany.com
(615)394-8451
15+ Years as a customer
Office 615-457-3304
www.BJBConstruction.com
Specifications part B
BID FORM
(fill in below and attach to bid documents
SPECS: Concrete Pouring at Schools
SCOPE: This bid is a one-year bid price for flatwork forming, pouring, and finishing. All materials
and labor are to be included in the per-square-foot bid. The bid may specify a surcharge for delivery
in addition to the cost per square or linear foot if it is less than a full truckload of concrete.
All bidders must comply with TCA 49-5-406 regarding the prohibition on working with prior felons or
sex offenders on school properties. All workers must be randomly drug tested yearly, and bidders
must submit a letter affidavit stating that they are in compliance with this requirement and meet all
federal, state, and local laws.
Bidders must maintain and attach the following:
Contractor license for concrete work
1-million-dollar liability insurance certificate
Workers compensation insurance certificate
TN business license or TN contractor license for concrete work
The square foot rate is to include the following:
Excavation of dirt of not less than 8 inches, with 4 inches compacted 3/4 stone rock or pug
mix.
Formed and finished to level surfaces to not cause a trip or mower hazards.
All surrounding disturbed areas, rocks, and debris must be cleaned up. Areas are to be
finished with seed and straw.
Concrete finishing is to be smooth-troweled or broom-finished as specified for the specific
job.
Flatwork is to have wire and expansion joints sawed in. Rebar is used when needed.
All concrete is to 4500 psi unless otherwise specified.
Bid this work on the form and attach paper documents to the bid.
1. Flat work by square foot:
$10.45/sf
2. Rebar if needed:
$ +5.65sf
3. Surcharge for pours less than a truck load:
$ +9.89/sf
Ditch paving is to be excavated, formed and leveled to grade as to not cause trip hazards
and or mower damage. All disturbed areas are to be cleaned up free of rocks and finished
graded. Areas are to be seeded, and straw covered upon completion of work. All concrete
is to be 4500 psi unless specified otherwise.
Ditch paving by linear foot:
1. 3 ft. width
$ 67.80
2. 4 ft. width
$ 79.10
3. 6 ft. width
$ 101.70
Curbing repair/pouring: 18-inch width by 12-inch height.
$56.50
linear foot price
1 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101- - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/o
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23. pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Nathaniel Benbow
Bidder Signature: Nathaniel Benbow
Date: 5/6/2026
2 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/6/2026
Name: Nathaniel Benbow
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/6/2026
Signature: Nathaniel Benbow
3 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Title: Estimator/ Principal Officer
Date: 5/6/2026
4 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Date: 5/6/2026
ï
5 I Page
W-9
Request for Taxpayer
Give form to the
Form
(Rev. March 2024)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
Go to www.irs.gov/FormW9 for instructions and the latest information.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1. and enter the business/disregarded
entity's name on line 2.)
BJB Construction Company Inc
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
See Specific Instructions on page 3.
Individual/sole proprietor
C corporation
S corporation
Partnership
Trust/estate
LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
Exempt payee code (if any)
Print or type.
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
code (if any)
Other (see instructions)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
outside the United States.)
this box if you have any foreign partners, owners, or beneficiaries. See Instructions
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
1373 Holly Tree Gap Rd
6 City, state, and ZIP code
Brentwood, TN. 37027
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
-
-
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
or
TIN, later.
Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
04 - 3777109
Part
11
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Signature of
Here
U.S. person
Debbie Benbow
Date 3/13/2026
General Instructions
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
noted.
to another flow-through entity in which it has an ownership interest. This
Future developments. For the latest information about developments
change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions, such as legislation enacted
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
after they were published, go to www.irs.gov/FormW9.
requirements. For example, a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC" box and enter its appropriate tax classification.
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)
the
41904
State of Tennessee
14123171
BOARD FORLICENSING CONTRACTORS
CONTRACTOR
BJB CONSTRUCTION COMPANY INC.
This is to certify that all requirements of the State of Tennessee have been met,
ID NUMBER: 61519
STATE THE OF
LIC STATUS: ACTIVE
IDV
EXPIRATION DATE: September 30, 2026
$473,240.00; BC
GOREAT AGRICULTURE 7796*
IN-1313
VC
DEPARTMENT OF
COMMERCE AND INSURANCE
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
02/12/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT NAME: LISA WILSON
INSURANCE GROUP OF AMERICA LLC
SMALL BUSINESS
PHONE:
FAX: (615)905-1698
6640 CAROTHERS PKWY STE 160
E-MAIL ADDRESS: lisa.wilson@iga.biz
FRANKLIN, TN 37067
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A
Central Mutual
20230
INSURED
INSURER B
All America
20222
BJB CONSTRUCTION COMPANY INC
1373 HOLLY TREE GAP RD
INSURER C
BRENTWOOD, TN 37027
INSURER D
INSURER E
INSURER F
CERTIFICATE NUMBER
7018655
REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
Y
Y
9606838
8/8/2025
8/8/2026
EACH OCCURRENCE
$
1,000,000
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED PREMISES
$
300,000
(Ea occurrence)
CLAIMS-MADE
OCCUR
MED EXP (Any one person)
$
5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PERSONAL & ADV INJURY
$
1,000,000
POLICY
PRO-
LOC
GENERAL AGGREGATE
$
2,000,000
JECT
PRODUCTS- COMP/OP AGG
$
2,000,000
B
AUTOMOBILE LIABILITY
Y
Y
9606837
8/8/2025
8/8/2026
COMBINED SINGLE LIMIT (Ea
$
1,000,000
accident)
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS
AUTOS
PROPERTY DAMAGE (Per
$
HIRED AUTOS
NON-OWNED
accident)
AUTOS
A
UMBRELLA LIABILITY
Y
Y
9606839
8/8/2025
8/8/2026
EACH OCCURRENCE
$
5,000,000
UMBRELLA
OCCUR
AGGREGATE
$
5,000,000
LIAB
EXCESS LIAB
CLAIMS-MADE
DED
RETENTION $
A
WORKERS COMPENSATION AND
9606841
8/8/2025
8/8/2026
WC STATUTORY LIMITS
OTHER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
1,000,000
ANY PROPRIETOR/PARTNERS/EXEC-
Y
UTIVE OFFICE/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$
1,000,000
(Mandatory in NH)
E.L. DISEASE- POLICY LIMIT
$
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES
Certificate Holders are additional insured per the attached endorsements.
Subject to all of the terms, conditions, exclusions and definitions of the above referenced policies as issued by the carrier(s).
Excluded proprietors, partners, executive officers, and members:
DEBBIE BENBOW
BRUCE BENBOW
CERTIFICATE HOLDER
CANCELLATION
BJB CONSTRUCTION COMPANY INC.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
1373 HOLLY TREE GAP RD
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
BRENTWOOD, TN 37027
THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
LISA WILSON
The Hickman County Finance Office will be accepting bids for a "Multi-Year Gym Floor
Services Contract." This bid will be system wide for all schools. The bid will be for a period
of 3 years with a mutual two-year extension option. This bid will be good for the period of
July 1, 2026 - June 30, 2029.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Business license
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with
all local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114
North Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside
of the envelope "Multi-Year Gym Floor Services Contract."
Bids will be opened on May 11, 2026, at 10:30 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all
bids or parts of the bids and to waive any informalities that would prevent the acceptance
of a better bid.
Complete the bid on B (specs) and submit your bid on those forms.
Specifications can be found at https://ww.hickmank12.org/requestforpoposal. Or by
calling 391-729-3391 Ext 3.
Present Renny Rochelle
3 Bids Rec'd
Scout Sport Floors
NicdeWinght
BJB Construction Company Inc.
BAM Flooring, Inc.
Please Use This Sheet and Fill Out the Annual Screen/Sealing Cost by School as Follows:
SCREENING
Centerville Elementary School
(4140 sq ft)
$ 3,577.42
Centerville Intermediate School
(3588 sq ft)
$ 3,200
Hickman County Middle School
(7800 sq ft)
$ 5,309.21
Hickman County High School
(11998 sq ft)
$6,840.30
East Hickman Elementary School
(6000 sq ft)
$ 3,847.23
East Hickman Intermediate School
(3588 sq ft)
$ 3,200
East Hickman Middle School
(8262 sq ft)
$ 5,393.62
East Hickman High School
(14160 sq ft)
$ 8,266.19
FULL SAND
Centerville Elementary School
(4140 sq ft)
$ 16,112
Centerville Intermediate School
(3588 sq ft)
$ 16,227
Hickman County Middle School
(7800 sq ft)
$ 24,347
Hickman County High School
(11998 sq ft)
$ 30,653
East Hickman Elementary School
(6000 sq ft)
$ 17,942
East Hickman Intermediate School
(3588 sq ft)
$ 15,721
East Hickman Middle School
(8262 sq ft)
$ 25,660
East Hickman High School
(14160 sq ft)
$ 36,515
1 I Page
STAGE RE-SANDING SEALING or REPAINTING
Stage re-sanding sealing or repainting as requested by the Maintenance Director if needed.
Stages by the square footage:
Sand and 2 coats of sealer finish by the square foot
$ 5.50
Sand and 2 coats of rolled on oil base paint
$ 5.50 $
NOTE: All screening, sealing, or sanding bid pricing must remain the same during the
contract 3-to-5-year period and may not be increased.
2 I Page
The Hickman County Finance Office will be accepting bids for a "Multi-Year Gym Floor
Services Contract." This bid will be system wide for all schools. The bid will be for a period
of 3 years with a mutual two-year extension option. This bid will be good for the period of
July 1, 2026 - June 30, 2029.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Business license
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with
all local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114
North Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside
of the envelope "Multi-Year Gym Floor Services Contract."
Bids will be opened on May 11, 2026, at 10:30 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all
bids or parts of the bids and to waive any informalities that would prevent the acceptance
of a better bid.
Complete the bid on B (specs) and submit your bid on those forms.
Specifications can be found at https://ww.hickmank12.org/requestforproposal Or by
calling 391-729-3391 Ext 3.
SCREENING AND SEALING and or FULL GYM SANDING BID SHEET
SCOPE OF WORK
The process shall include:
Proper cleaning of the floors, followed by screening and a thorough second cleaning prior
to finishing.
Application of an approved oil-modified, water-based finish.
Application of a coat of sealer as part of the finishing process.
Removal of all tables, equipment, and other items to ensure no furniture legs or fixtures
are affected during preparation or finishing.
The final finish must:
Be free of streaking, runs, excessive pooling, debris, or any damage to adjacent finishes
such as floor tiles.
Have no visible blend lines at the bleachers.
Show no streaks, dry areas, or marks indicating inadequate finish.
Present a high-gloss, glass-like appearance without imperfections.
Additional Requirements:
All bidders are responsible for verifying their own measurements of square footage.
FINISH REQUIREMENTS FLOOR SCREENING
All floors are to be screened, cleaned, and finished with two coats of MFMA-approved,
two-component water-based high-gloss urethane gym finish (Bona or Basic Coatings).
2317 2nd Avenue South
SCOUT
Birmingham, AL 35233
info@scoutfloors.com
SPORT FLOORS
205.307.5629
Terms and Conditions/Clarifications:
1. All Full Gym Sanding Pricing is based on current floor designs as of May 8, 2026. Gamelines and
Logos are as listed below.
East Hickman High School Paint the Following Game Lines and Logos:
1) Main Basketball Game Lines
2) Main Volleyball Game Lines
3) Cross Court Basketball Lines - (2 EA)
4) Cross Court Volleyball Lines - (2 EA)
5) Border - 4.5' Baseline / 3' Sideline
6) Baseline Letters - 4' Tall "East Hickman"
7) Center Logo - 14' X 10' "EH"
8) TSSAA Logos - 4' x 4' - (2 EA)
9) Eagle Logos - 4' X 6' - (2 EA)
East Hickman Middle School Paint the Following Game Lines and Logos:
1) Main Basketball Game Lines
2) Main Volleyball Game Lines
3) Border - 3'
4) Baseline Letters - 2.5'
5) 3/4 Court Logos - 8' x 4' "EH"- (2 EA)
East Hickman Elementary School Paint the Following Game Lines:
1) Main Basketball Game Lines
2) Border - 6"
3) Row Lines - (7 EA)
4) Baseball Bases - (1 EA)
East Hickman Intermediate School Paint the Following Game Lines:
1) Main Basketball Game Lines
2) Main Volleyball Game Lines
3) Baseball Bases - (1 EA)
4) Line Numbers on Outside of Court
Hickman County High School Paint the Following Game Lines and Logos:
1) Main Basketball Game Lines
SCOUTFLOORS.COM
2317 2nd Avenue South
SCOUT
Birmingham, AL 35233
info@scoutfloors.com
SPORT FLOORS
205.307.5629
2) Main Volleyball Game Lines
3) Cross Court Basketball Lines - (2 EA)
4) Border - 1'
5) Baseline Letters - 4'
6) Center Logo - 16' X 16' "HC"
7) Stained 3PT Arcs - (2 EA)
8) Painted Lanes - (2 EA)
Hickman County Middle School Paint the Following Game Lines and Logos:
1) Main Basketball Game Lines
2) Main Volleyball Game Lines
3) Border - 3'
4) Baseline Letters - 2.5'
5) Center Court Logo - 8'x 8' Bulldog Head
Centerville Intermediate School Paint the Following Game Lines and Logos:
1) Main Basketball Game Lines
2) Main Volleyball Game Lines
3) Baseball Bases - (1 EA)
4) Line Numbers on Outside of Court
5) Center Logo - 4' x 4' Paw with 1' Tall Letters
Centerville Elementary School - Iron Bound Court Paint the Following Game Lines:
1) Main Basketball Game Lines
2) Main Volleyball Game Lines
3) Baseball Bases - (1 EA)
4) Dashed White Lines - (2 EA)
SCOUTFLOORS.COM
2317 2nd Avenue South
SCOUT
Birmingham, AL 35233
info@scoutfloors.com
SPORT FLOORS
205.307.5629
General Terms:
1. Work to be performed at mutually agreeable schedule
2. Owner shall provide 208V 3 phase power within 25' of gymnasium and have electrician / maintenance
available to connect and disconnect sanding equipment to breaker panel upon commencement and
completion of the work; Scout shall provide all equipment and leads necessary for panel connection
3. Owner shall have floor cleared of all items, bleachers retracted, and all tape pulled from floor prior to
arrival
4. Scout cannot guarantee that there is sufficient amount of wear layer remaining to be sanded without
exposing staples and is not responsible should sanding not be
5. Design services are excluded; Owner shall provide artwork vector files for all logos and graphics
6. Owner shall provide use of dumpsters
7. A minimum of one week prior to commencement of work, during, and at all times after completion of
work, the HVAC system should be complete, operational, and conditioning air to be within
specifications of 65-85 degrees Fahrenheit with relative humidity between 35-50%
8. Excludes moving, adjustments to, or any other work associated with bleachers, goals, or other athletic
equipment
9. Scout shall not be responsible for the protection of completed work; Owner shall prevent access to
staff / students upon completion or otherwise protect floors to allow for other trade work
10. Performance and Payment bonds excluded
11. Sales tax is excluded; Owner shall provide sales tax exemption certificates
12. All logos priced with natural breeks between colors. Breaks can
be removed for an additional cost.
SCOUTFLOORS.COM
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israet as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature: Will It
Print: WillFor
Date: 5/4/2026
Phone/Email: (423) 602-3396 wfor@scovtfloors.com
4 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101- - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Will Fox
Bidder Signature: will TX
Date: 05/04/2026
5 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Will Jot
Print: Will Fox
Title: Project Coordinator
Date: 5/4/2026
3 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
Interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or Indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 05/04/2026 Name: will Fox
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 05/04/2026 Signature: will Feb
6 I Page
Please Use This Sheet and Fill Out the Annual Screen/Sealing Cost by School as Follows:
SCREENING
Centerville Elementary School
(4140 sq ft)
$ 4,968.00
Centerville Intermediate School
(3588 sq ft)
$ 4,306.00
Hickman County Middle School
(7800 sq ft)
$ 9,360.00
Hickman County High School
(11998 sq ft)
$ 14,398.00
East Hickman Elementary School
(6000 sq ft)
$7,200.00
East Hickman Intermediate School
(3588 sq ft)
$4,306.00
East Hickman Middle School
(8262 sq ft)
$9,915.00
East Hickman High School
(14160 sq ft)
$ 16,992.00
FULL SAND
Centerville Elementary School
(4140 sq ft)
$17,336.00
Centerville Intermediate School
(3588 sq ft)
$ 15,025.00
Hickman County Middle School
(7800 sq ft)
$32,663.00
Hickman County High School
(11998 sq ft)
$50,242.00
East Hickman Elementary School
(6000 sq ft)
$25,125.00
East Hickman Intermediate School
(3588 sq ft)
$15,025.00
East Hickman Middle School
(8262 sq ft)
$34,598.00
East Hickman High School
(14160 sq ft)
$59,295.00
1 I Page
STAGE RE-SANDING SEALING or REPAINTING
Stage re-sanding sealing or repainting as requested by the Maintenance Director if needed.
Stages by the square footage:
Sand and 2 coats of sealer finish by the square foot
$4/sf
Sand and 2 coats of rolled on oil base paint
$4/sf
NOTE: All screening, sealing, or sanding bid pricing must remain the same during the
contract 3-to-5-year period and may not be increased.
2 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Title: Estimator/ Principal Officer
Date: 5/6/2026
3 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. in compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Date: 5/6/2026
Phone/Email: 615-394-1411
Nathan@bjbconstruction.com
4 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101- - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Nathaniel Benbow
BJB Construction Company Inc.
Bidder Signature: Nathaniel Benbow
Date: 5/6/2026
5 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/6/2026
Name: Nathaniel Benbow
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/6/2026
Signature: Nathaniel Benbow
6 I Page
W-9
Request for Taxpayer
Give form to the
Form
Identification Number and Certification
requester. Do not
(Rev. March 2024)
send to the IRS.
Department of the Treasury
Go to www.irs.gov/FormW9 for instructions and the latest information.
Internal Revenue Service
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1. and enter the business/disregarded
entity's name on line 2.)
BJB Construction Company Inc
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
Individual/sole proprietor
C corporation
S corporation
Trust/estate
See Specific Instructions on page 3.
Partnership
LLC. Enter the tax classification (C = C corporation, S = S corporation, P= Partnership)
Exempt payee code (if any)
Print or type.
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
code (if any)
Other (see instructions)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
outside the United States.)
this box if you have any foreign partners, owners, or beneficiaries. See instructions
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
1373 Holly Tree Gap Rd
6 City, state, and ZIP code
Brentwood, TN. 37027
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For Individuals, this is generally your social security number (SSN). However, for a
I
-
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
or
TIN, later.
Employer Identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
04 - 3777109
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Signature of
Here
U.S. person
Debbie Benbow
Date 3/13/2026
New line 3b has been added to this form. A flow-through entity is
General Instructions
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
noted.
to another flow-through entity in which it has an ownership interest. This
change is intended to provide a flow-through entity with information
Future developments. For the latest information about developments
related to Form W-9 and its Instructions, such as legislation enacted
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
after they were published, go to www.irs.gov/FormW9.
requirements. For example, a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
An individual or entity (Form W-9 requester) who is required to file an
should check the "LLC" box and enter its appropriate tax classification.
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)
State of Cennessee
14123171
BOARD FOR LICENSING CONTRAC TORS
CONTRACTOR
BJB CONSTRUCTION COMPANY INC.
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 61519
SEALTH OF THE STATE
LIC STATUS: ACTIVE
EXPIRATION DATE: September 30, 2026
$473,240.00; BC
UNITED THE TIMER 7796* J
GREAT AGRICULTURE OF
IN-1313
VIC
DEPARTMENT OF
COMMERCE AND INSURANCE
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
02/12/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT NAME: LISA WILSON
INSURANCE GROUP OF AMERICA LLC
PHONE:
SMALL BUSINESS
FAX: (615)905-1698
6640 CAROTHERS PKWY STE 160
E-MAIL ADDRESS: lisa.wilson@iga.biz
FRANKLIN, TN 37067
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A
Central Mutual
20230
INSURED
INSURER B
All America
20222
BJB CONSTRUCTION COMPANY INC
INSURER C
1373 HOLLY TREE GAP RD
BRENTWOOD, TN 37027
INSURER D
INSURER E
INSURER F
CERTIFICATE NUMBER
7018655
REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
Y
Y
9606838
8/8/2025
8/8/2026
EACH OCCURRENCE
$
1,000,000
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED PREMISES
$
300,000
(Ea occurrence)
CLAIMS-MADE
OCCUR
MED EXP (Any one person)
$
5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PERSONAL & ADV INJURY
$
1,000,000
POLICY
PRO-
LOC
GENERAL AGGREGATE
$
2,000,000
JECT
PRODUCTS- COMP/OP AGG
$
2,000,000
B
AUTOMOBILE LIABILITY
Y
Y
9606837
8/8/2025
8/8/2026
COMBINED SINGLE LIMIT (Ea
$
1,000,000
accident)
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS
AUTOS
PROPERTY DAMAGE (Per
$
HIRED AUTOS
NON-OWNED
accident)
AUTOS
A
UMBRELLA LIABILITY
Y
Y
9606839
8/8/2025
8/8/2026
EACH OCCURRENCE
$
5,000,000
UMBRELLA
OCCUR
AGGREGATE
$
5,000,000
LIAB
EXCESS LIAB
CLAIMS-MADE
DED
RETENTION $
A
WORKERS COMPENSATION AND
9606841
8/8/2025
8/8/2026
WC STATUTORY LIMITS
OTHER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
1,000,000
ANY PROPRIETOR/PARTNERS/EXEC
Y
UTIVE OFFICE/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$
1,000,000
(Mandatory in NH)
E.L. DISEASE- POLICY LIMIT
$
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES
Certificate Holders are additional insured per the attached endorsements.
Subject to all of the terms, conditions, exclusions and definitions of the above referenced policies as issued by the carrier(s).
Excluded proprietors, partners, executive officers, and members:
DEBBIE BENBOW
BRUCE BENBOW
CERTIFICATE HOLDER
CANCELLATION
BJB CONSTRUCTION COMPANY INC.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
1373 HOLLY TREE GAP RD
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
BRENTWOOD, TN 37027
THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
LISA WILSON
BENANDRST
SECURITY
BEYOND JUST BUILDERS
REVONDJUST BUILDITS
BJB
CONSTRUCTION COMPANY INC
BJB
1373 Holly Tree Gap Rd, Brentwood, TN. 37027
CONSTRUCTION
CONSTRUCTION
COMPANY
COMPANY
References:
1) Brent Stidham
Senior Maintenance Engineer
(Managing govt buildings in Brentwood TN)
City Of Brentwood
brent.stidham@brentwoodtn.gov
(615)533-5032
15+ Years as a customer
2) Ryan Edwards
Continuous Improvement Coordinator
Advanced Composites
Ryan.edwards@advcmp.com
(615)630-1843
15+ Years as a customer
3) Yvonne Parker
Sr. Specialist, Consumer Care National Facilities
T-Mobile
Yvonne.parker@t-mobile.com
(931)980-8867
8 Years as a customer
4) Wesley King
Service Manager
The Mathews Company
wking@themathewscompany.com
(615)394-8451
15+ Years as a customer
Office 615-457-3304
www.BJBConstruction.com
SCREENING AND SEALING and or FULL GYM SANDING BID SHEET
SCOPE OF WORK
The process shall include:
Proper cleaning of the floors, followed by screening and a thorough second cleaning prior
to finishing.
Application of an approved oil-modified, water-based finish.
Application of a coat of sealer as part of the finishing process.
Removal of all tables, equipment, and other items to ensure no furniture legs or fixtures
are affected during preparation or finishing.
The final finish must:
Be free of streaking, runs, excessive pooling, debris, or any damage to adjacent finishes
such as floor tiles.
Have no visible blend lines at the bleachers.
Show no streaks, dry areas, or marks indicating inadequate finish.
Present a high-gloss, glass-like appearance without imperfections.
Additional Requirements:
All bidders are responsible for verifying their own measurements of square footage.
FINISH REQUIREMENTS FLOOR SCREENING
All floors are to be screened, cleaned, and finished with two coats of MFMA-approved,
two-component water-based high-gloss urethane gym finish (Bona or Basic Coatings).
BAM FLOORING, INC,
Please Use This Sheet and Fill Out the Annual Screen/Sealing Cost by School as Follows:
SCREENING
Centerville Elementary School
(4140 sq ft)
$ 2,060.00
Centerville Intermediate School
(3588 sq ft)
$ 1,765.00
Hickman County Middle School
(7800 sq ft)
$ 3,820.00
Hickman County High School
(11998 sq ft)
$ 5,880.00
East Hickman Elementary School
(6000 sq ft)
$ 2,940.00
East Hickman Intermediate School
(3588 sq ft)
$ 1,765.00
East Hickman Middle School
(8262 sq ft)
$ 4,060.00
East Hickman High School
(14160 sq ft)
$ 7,300.00
FULL SAND
Centerville Elementary School
(4140 sq ft)
$ 10,200.00
Centerville Intermediate School
(3588 sq ft)
$ 9,000.00
Hickman County Middle School
(7800 sq ft)
$ 15,450.00
Hickman County High School
(11998 sq ft)
$ 22,800.00
East Hickman Elementary School
(6000 sq ft)
$ 10,520.00
East Hickman Intermediate School
(3588 sq ft)
$ 9,000.00
East Hickman Middle School
(8262 sq ft)
$ 16,325.00
East Hickman High School
(14160 sq ft)
$ 27,000,00
x
THE FULL SAND PRICING ABOVE INCLUDES THE COMPLETE SANDING
TO BARE WOOD, 2 COATS OF SEAL, / SET OF PAINTEDMAIN
BASKETBALL + VOLLEYBALL GAME LINES ($1,800) AND FINISHING
WITH 3 COATS OF WATER BASE OR 2 COATS OF OIL
MODIFIED FINISH. A PRICE LIST FOR ALL OTHER
PAINTING IS INCLUDED WITH THIS BID.
STAGE RE-SANDING SEALING or REPAINTING
Stage re-sanding sealing or repainting as requested by the Maintenance Director if needed.
Stages by the square footage:
Sand and 2 coats of sealer finish by the square foot
$ 3,00 $
Sand and 2 coats of rolled on oil base paint
$ 3.00
NOTE: All screening, sealing, or sanding bid pricing must remain the same during the
contract 3-to-5-year period and may not be increased.
2 I Page
BAM
FLOORING
GAME COURT PAINTED LINES, AREAS, LOGOS, LETTERING & STAINING
BASKETBALL GAME LINES
$ 1,000 PER COURT
VOLLEYBALL GAME LINES
$ 800 PER COURT
BADMITTON GAME LINES
$ 800 PER COURT
PICKLEBALL GAME LINES
$ 800 PER COURT
FOUR SQUARE GAME LINES
$ 250 PER COURT
PAINTED BORDER 1'X1'
$ 700
PAINTED BORDER 2' X 2'
$ 850
PAINTED BORDER 3' X 3'
$ 1,000
PAINTED BORDER 4' X 4'
$ 1,250
PAINTED BORDER 5'X5'
$ 1,500
PAINTED LANES
$ 1,000
PAINTED 3-POINT AREAS
$ 1,500
PAINTED CENTER CIRCLE
$ 500
PAINTED LOGO(SMALL, 1-COLOR)
$ 500
PAINTED LOGO(SMALL, 2-COLOR)
$ 850
PAINTED LOGO(SMALL, MULTI-COLOR)
$ 1,200+
PAINTED LOGO(MED, 1-COLOR)
$ 750
PAINTED LOGO(MED, 2-COLOR)
$ 1,100
PAINTED LOGO(MED, MULTI-COLOR)
$ 1,500+
PAINTED LOGO(LARGE, 1-COLOR)
$ 1,000
PAINTED LOGO(LARGE, 2-COLOR)
$ 1,750
PAINTED LOGO(LARGE, MULTI-COLOR)
$ 2,500+
LETTERING(SMALL, 1-COLOR)
$ 40 PER LETTER
LETTERING(SMALL, 2-COLOR)
$ 55 PER LETTER
LETTERING(SMALL, MULTI-COLOR)
$ 75+ PER LETTER
LETTERING(MED, 1-COLOR)
$ 50 PER LETTER
LETTERING(MED, 2-COLOR)
$ 65 PER LETTER
LETTERING(MED, MULTI-COLOR)
$ 90+ PER LETTER
LETTERING(LARGE, 1-COLOR)
$ 60 PER LETTER
LETTERING(LARGE, 2-COLOR)
$ 75 PER LETTER
LETTERING(LARGE, MULTI-COLOR)
$ 100+ PER LETTER
STAINED/TINTED LANES
$ 2,500
STAINED/TINTED 3-POINT AREAS
$ 3,500
STAINED/TINTED BORDER
$ 2,500-$5,000 DEPENDING ON SIZE
STAINED/TINTED FULL COURT
$ 5,000-$7,000
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/10/26 Name:
BRUCE F.MARTIN
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
1 have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date:
5/10/26
Signature:
6 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23. pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name:
BRUCE F.MARTIN
Bidder Signature:
BmF.Wart.
Date:
5/10/26
5 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature:
Bm
Print:
BRUCE F.MARTIN
5/10/26
Date:
Phone/Email:
4 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature:
Bm 7. Mart
Print:
BRUCE F. MARTIN
Title:
PRESIDENT
Date:
5/10/26
3 I Page
BAM
FLOOBING
May 11, 2026
Tanya Williams
Hickman Co Schools
Centerville, TN
Dear Tanya,
Hickman County Schools currently has copies on file of the business licenses and insurance requirements
for BAM Flooring, Inc. If BAM Flooring, Inc. is awarded this contract and new copies of the following are
requested, they will certainly be provided at any time.
TN Business License
Liability Insurance Certificate
Workers Compensation Insurance
Business License
Thank you for the opportunity to be of service. Please let me know if you have any questions or need
any additional information at this time.
Thanks,
Bruce Martin
BAM Flooring, Inc.
1647 Colonial Shores Dr.
Hixson, TN 37343
(423) 661-4579
The Hickman County Finance Office will be accepting bids for a 3 year with a
mutual two-year extension option. "HVAC Replacement, Repair and Annual
Services Contract" - July 1, 2026 - June 30, 2029.
Bidders must be Tennessee-licensed mechanical contractors and must
provide proof of $1,000,000 liability insurance and workers' compensation
insurance. Insurance certificates must be attached to the bid.
All bidders must comply with TCA 49-5-406 as well as all applicable local,
state, and federal regulations governing work performed on school property.
All bidders must attach:
TN business license
1-million-dollar business insurance
Workers compensation insurance certificates to the bid
Background Acknowledgement Form
Iran Divestment Act Certification
Non-Boycott of Israel Certification
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Specifications and Part B specs can be found online at:
https://www.hickmank12.org/requestforproposal
Sealed bids must be mailed or hand delivered to the Hickman County Finance
Office, 114 North Central Avenue, Suite 203, Centerville, TN 37033 and clearly
marked on the outside of the envelope "HVAC Replacement, Repair and
Annual Services Contract". Bids will be opened on May 11, 2026, at 10:00
a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject
any and all bids or parts of the bids and to waive any informalities that would
prevent the acceptance of a better bid.
Present Pensy Rochelle
4 Bids
Minty w eeral
Lee Company
NHS Mechanical
Matrix Mechanical Solutions
S.M. Lawrence
Please All attached
HVAC SERVICES BID FORM
Vendor Name: NHS MECHANICAL
Contact Name: Chris Miller
Phone: 615-708-0394
Email: cmiller@nhsmechanical.com
Date: 5/6/2026
1. Fire Damper Cleaning
Service every four (4) years per NFPA 80
Per Damper Charge:
$75.00
per damper
2. Annual Summer HVAC Services
Locations (10):
EHES, EHIS, EHMS, EHHS, CES, CIS, HCMS, HCHS, ANNEX BUILDING,
HCBOE
Scope of Work:
Coils, filters, belts, unit inspection, and unit run test
Annual Service Charge:
$ 47,892.00
3. HVAC Services - Labor Rates
Onsite standard rate for repairs and installation
Monday-Friday I 8:00 AM - 5:00 PM
Certified HVAC Technician (onsite):
$ 125.00
per hour
Helper/Laborer (onsite):
$ 105.00
per hour
Trip Charge:
$ 50.00
per day, per zip code
4. Refrigerant Charges
If bidder provides refrigerant; weighted in at installation
R22:
$ 169.00
per lb
R410A:
$ 65
per lb
R454B:
$80.00
per lb
Other (specify): Varies based on refrigerant cost
$ N/A
per lb
5. Flat Recovery Charges
Recovery/vacuum charge when required
Per Call / Per Unit:
$75.00
6. Parts and Materials Markup
Applies if bidder furnishes parts (fans, motors, compressors, control boards,
etc.)
Cost plus 35
% markup
Note: Parts invoice must be attached to every billing for transparency.
7. Miscellaneous Truck Parts
Includes items such as wire nuts, tape, fittings, conduit, etc.
Per Trip Charge:
$15.35
Bid Certification
I certify that the above pricing is accurate and valid for the bid period and
complies with all specifications.
Authorized Signature: SBL
Printed Name: Terry Burch
Title: Project Operations Manager
Date: 5/6/2024
Part B Specs:
3 year contract period : July 1, 2026 - June 30, 2029 with a mutual two-year
extension option.
Scope:
Repairs of existing equipment
In the event a unit requires repairs beyond normal minor same-day service
and standard repair parts, a quote must be submitted by email to the
Maintenance Director's office before any major components-such as
compressors-are ordered. A purchase order approval must be issued prior
to proceeding with or placing a hold on repairs for the unit.
Annual Summer Servicing
Annual summer servicing is to be completed in May - June, and not later
that July 15th.
The billing for the annual summer service will be pre-invoiced in May
each year.
Summer Service to include:
(Approximately 125 PTACS, 440 other HVAC units such as mini split, air handler, split
system, etc.)
Clean all condenser coils.
Evaporator coils to be inspected and cleaned as required.
Use the filters provided by HCBOE maintenance department.
Replace the belts as needed. Notify the HCBOE maintenance
department so they can provide the necessary belts for replacement.
Minor repairs such as low refrigerant, contactors, relays, or
thermostats are to be completed at the time of summer service as
needed.
Service and adjust tension bearings.
Boiler maintenance in the fall.
Tankless heaters to be serviced and flushed.
Report needed repairs to the HCBOE maintenance department prior
to moving to the next school SO that repairs may be approved while
the bidder technician is on site.
Please provide the HCBOE Maintenance Department with a list of all
findings, organized by the school.
East Hickman Elementary School
East Hickman Intermediate School
East Hickman Middle School
East Hickman High School
Centerville Elementary School
Centerville Intermediate School
Hickman County Middle School
Hickman County High School
Annex Building
Hickman County Board of Education
Fan motors checked, cleaned and unit to be run tested for proper
pressures and optimum performance.
Ensure that all units are fully functional for the upcoming school year
by July 25th of each year.
Installations
Any existing unit that is deemed condemned and no longer cost-effective to
repair by the Maintenance Director will be replaced with a newly installed
unit. In the event that a repair estimate exceeds the reasonable cost VS the
cost of a new unit, the Maintenance Director will purchase the equipment and
the bidder will provide a quote based on the hourly bid rate, truck parts,
transitions needed, and etc.
Fire Dampers
Fire dampers are to be cleaned and inspected 1 year after installation and
every 4 years after that.
Fusible links must be replaced every 4 years per NFPA 80 standards.
Damaged or corroded links must be replaced immediately.
Locate and clean all accessible duct fire dampers and or fresh air fire
dampers.
The bidder shall provide the maintenance director's office with a detailed
record per building of the inspection date, inspector's name and any required
repairs.
Response Time for Classroom Service Calls
All service calls related to classroom conditions shall receive a reasonably
prompt response, with same-day service expected whenever possible and no
later than the next business morning at a minimum. If the Contractor is
unable to meet this response timeframe, the Client reserves the right to
engage a secondary service contractor to address the issue as necessary,
without penalty.
Security
All bidders must check in at the front office upon arrival for every service trip to
any school building. A state-issued driver's license is required and will be
scanned into the background system. After check-in, you will be issued a visitor
pass sticker and may be escorted by Maintenance personnel to the required access
location if needed.
This procedure is mandatory. Even if the work being performed is outside, all
contractors must first report to the front office immediately upon entering school
grounds.
Note
Hickman County Schools reserves the right to have any unit installed
internally by district personnel or externally by other providers if it is
determined to be more cost-effective and the Maintenance Director deems
such action necessary.
Additionally, the Hickman County Board of Education may receive state or federal
grant funding that requires mechanical replacement projects to be bid under
separate guidelines. In such cases, this contract will not apply. Bidders may
choose to submit a separate bid for those projects if they wish to do so.
The Hickman County Board of Education reserves the right to establish and
enforce the following conditions.
Where it is determined to be cost-effective for the maintenance budget, Hickman
County Schools may provide the contractor with necessary materials and
supplies, including filters, units, or repair parts needed to complete the work. The
contractor's primary responsibility under this contract is to provide certified labor
technicians for diagnostics, repairs, services, and, when required, installations or
equipment startups.
Hickman County Schools reserves the right to install, repair, or replace units at
its discretion. Contractors will be informed at the time of service if the district
elects to proceed with alternative arrangements. The district reserves the right to
perform services internally or utilize other providers when deemed necessary.
Term, Fiscal Year, and Termination
This Agreement is for a term of three (3) consecutive fiscal years and shall
operate on a fiscal year basis.
Either party may terminate this Agreement for convenience by providing
written notice of termination to the other party at least sixty (60) calendar
days prior to the end of the applicable fiscal year. Any termination will
become effective only at the close of that fiscal year.
Upon delivery of a timely notice of termination, the Agreement shall expire
without further obligation at the end of the fiscal year, unless the parties agree
in writing to terminate it sooner or to submit any unresolved disputes to
arbitration. Arbitration shall not be required if both parties agree in written
format.
All notices of termination shall be in writing and delivered in accordance with
the notice provisions of this Agreement.
Trip Charge
Service call trip charge is limited to one trip charge per trip to the same zip
code. Multi trip charges will only be permitted if moving to a second zip code
but not to a second location in the same zip code.
Our zip codes for the 8 locations are Centerville Buildings 37033: CES, CIS,
HCMS, HCHS and Lyles Buildings 37098: EHES, EHIS, EHMS, EHHS.
Assignment, Sale, or Transfer of Contractor
In the event the Contractor sells, transfers, assigns, or otherwise conveys all
or substantially all of its business or assets, or if a successor contractor
seeks to assume this Agreement, the Contractor shall provide written notice
to the Hickman County Board of Education prior to such sale, transfer, or
assumption.
This Agreement shall not be assigned or assumed by any successor entity
without the prior written consent of the Hickman County Board of Education,
which consent may be withheld at the Board's sole discretion. The Board
expressly reserves the right, upon notice of such sale or proposed
assumption, to terminate this Agreement without penalty and to rebid the
services covered herein.
Any attempted assignment or assumption of this Agreement without
compliance with this provision shall be deemed a material breach of the
Agreement.
Subcontractors
The use of subcontractors that have not received prior written approval is
strictly prohibited. This Agreement is awarded solely to the bidder identified at
the time of bid award, and no portion of the work may be subcontracted
without the advance written approval of the Maintenance Director.
All proposed subcontractors must be submitted for review and approval prior
to performing any work under this Agreement. Approval of any subcontractor
shall be at the sole discretion of the Maintenance Director. The Contractor
shall remain fully responsible for the performance, acts, and omissions of any
approved subcontractor.
Any use of an unapproved subcontractor shall constitute a material breach of
this Agreement and may result in termination.
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: SBh
Print:
Terry Burch
Title: Project Operations Manager
Date: 5/6/2026
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
12-4-119
Signature: TBL
Print:
Terry Burch
Date: 5/6/2020
Phone/Email: thurch@nhs Medanical.com
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23. pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Terry Burch
Bidder Signature: Bh
Date: 5/6/2026
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation
Date: 5/6/2C Name: TBL
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/6/26 Signature: TBL
NASHVILLE AND DAVIDSON COUNTY BUSINESS
Davidson County Clerk's Office
TAX LICENSE
700 Second Avenue South, Suite 101
P.O. Box 196333
BUSINESS NUMBER
258395
Nashville, Tennessee 37219-6333
RECEIPT NUMBER
1047213
615-862-6254
THIS LICENSE EXPIRES
05/15/2027
OWNER(S)/OFFICER(S)
NATIONAL HVAC SERVICE
ROBERT LEHMAN
BUSINESS LOCATION ADDRESS
NATIONAL H.V.A.C. SERVICE, L.P.
NHS MECHANICAL
624 GRASSMERE PARK STE 8
149 PARK SOUTH COURT
NASHVILLE, TN 37211
NASHVILLE, TN 37210
MUST DISPLAY IN A CONSPICUOUS PLACE
Contact Metro Codes to verify this location is properly
zoned.
BUSINESS NUMBER
258395
CITY
COUNTY
RECEIPT NUMBER
1047213
TOTAL GROSS SALES
CLASSIFICATION
4
LESS DEDUCTIONS
BUSINESS TAX DUE
TAX PERIOD
(LESS CREDITS)
FROM
STARTED
MINIMUM TAX
TO
01/01/2026
PENALTY
INTEREST
NEW LICENSE FEE
15.00
15.00
THIS LICENSE EXPIRES 05/15/2027
TOTAL TAX DUE
15.00
15.00
ISSUE DATE
02/20/2026
COMBINED TOTAL
30.00
Brenda Wynn
BRENDA WYNN, COUNTY CLERK
J WALDEN
DEPUTY CLERK
STANDARD BUSINESS TAX LICENSE
TOTAL DUE
$30.60
USER
JWALDEN
CREDIT CARD
$30.60
STATION
WK205
AUTH NO.
096198
DRAWER
266
$0.00
SITE
I
CHANGE
WORK DATE
02/20/2026
PRINTED BY
JWALDEN
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
4/1/2027
4/8/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER Lockton Companies, LLC
NAME:
DBA Lockton Insurance Brokers, LLC in CA
PHONE
FAX
(A/C, No. Ext):
(A/C, No):
CA license #0F15767
E-MAIL
ADDRESS:
444 W. 47th St., Ste. 900
INSURER(S) AFFORDING COVERAGE
NAIC #
Kansas City MO 64112-1906
(816) 960-9000 kcasu@lockton.com
INSURER A: Greenwich Insurance Company
22322
INSURED
NATIONAL HVAC SERVICE DBA NHS MECHANICAL
INSURER B: XL Insurance America, Inc.
24554
1304803
149 PARK SOUTH COURT
INSURER C : Allied World National Assurance Company
10690
NASHVILLE TN 37210
INSURER D :
INSURER E:
INSURER F :
COVERAGES
CERTIFICATE NUMBER: 22494572
REVISION NUMBER: XXXXXXX
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
COMMERCIAL GENERAL LIABILITY
N
N
RGD300147507
4/1/2026
4/1/2027
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$ 1,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
POLICY
PRO-
JECT
LOC
PRODUCTS- COMP/OP AGG
$ 4,000,000
$
OTHER:
COMBINED SINGLE LIMIT
A
AUTOMOBILE LIABILITY
N
N
RAD943796407
4/1/2026
4/1/2027
(Ea accident)
$ 5,000,000
ANY AUTO
BODILY INJURY (Per person)
$ XXXXXXX
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$ XXXXXXX
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
AUTOS ONLY
(Per accident)
$ XXXXXXX
AUTOS ONLY
XXXXXXX
C
UMBRELLA LIAB
OCCUR
N
N
0313-7473
4/1/2026
4/1/2027
EACH OCCURRENCE
$ 5,000,000
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$ 5,000,000
DED
RETENTION $0
$ XXXXXXX
WORKERS COMPENSATION
PER
OTH-
B
N
AND EMPLOYERS' LIABILITY
RWD300147607.
4/1/2026
4/1/2027
STATUTE
ER
B
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
STOP GAP: ND, OH, WA, WY
E.L. EACH ACCIDENT
$ 1,000,000
OFFICER/MEMBER EXCLUDED?
N
N/A
(Mandatory in NH)
EL DISEASE- EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
EL DISEASE- POLICY LIMIT
$ 1,000.000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: METROPOLITAN BOARD OF PUBLIC EDUCATION, 2601 BRANSFORD AVENUE, NASHVILLE, TN 37204.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
22494572
ACCORDANCE WITH THE POLICY PROVISIONS.
PURCHASING AGENT,
METROPOLITAN BOARD OF PUBLIC EDUCATION,
AUTHORIZED REPRESENTATIVE
2601 BRANSFORD AVENUE
NASHVILLE TN 37204
Josh M Amella
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
COUNTY SCHOOLS
*
1807
HVAC Services
Attn: Hickman County Finance Office
114 North Central Avenue STE 203
Centerville, TN 37033
HVAC Replacement, Repair and
Annual Services Contract
Bid date: Monday, May 11, 2026 @ 10:00 am
Submitted by:
LEE
LLEE
Hickman County Schools
HVAC Replacement, Repair and
Annual Services Contract
Monday, May 11, 2026 @ 10:00am
TABLE OF CONTENTS
Bid Form
Tennessee Contractor License
Background Check Acknowledgement
Form
State of Tennessee Non-Boycott of
Israel Certification
Iran Divestment Act Certification
Hickman County Government Conflict
of Interest Disclosure Form
Evidence of Insurance COI
Lee Company Overview
Lee Company Service Offerings
facilities solutions . home services . leecompany.com
HVAC SERVICES BID FORM
Vendor Name: Lee Company
Contact Name: John Sloan
Phone: 256-338-8411
Email: John.Sloan@LeeCompany.com
Date: 5/6/2026
1. Fire Damper Cleaning
Service every four (4) years per NFPA 80
Per Damper Charge:
$ 150.00
per damper
2. Annual Summer HVAC Services
Locations (10):
EHES, EHIS, EHMS, EHHS, CES, CIS, HCMS, HCHS, ANNEX BUILDING,
HCBOE
Scope of Work:
Coils, filters, belts, unit inspection, and unit run test
Annual Service Charge:
$69,705.00
3. HVAC Services - Labor Rates
Onsite standard rate for repairs and installation
Monday-Friday I 8:00 AM - 5:00 PM
Certified HVAC Technician (onsite):
$ 136.00
per hour
Helper/Laborer (onsite):
$ 136.00
per hour
Trip Charge:
$ 75.00
per day, per zip code
4. Refrigerant Charges
If bidder provides refrigerant; weighted in at installation
R22:
$ 75.00
per lb
R410A:
$ 25.00
per lb
R454B:
$ 40.00
per lb
Other (specify):
$
per lb
5. Flat Recovery Charges
Recovery/vacuum charge when required
Per Call / Per Unit:
$ 150.00
6. Parts and Materials Markup
Applies if bidder furnishes parts (fans, motors, compressors, control boards,
etc.)
Cost plus 30
% markup
Note: Parts invoice must be attached to every billing for transparency.
7. Miscellaneous Truck Parts
Includes items such as wire nuts, tape, fittings, conduit, etc.
Per Trip Charge:
$ 20.00
Bid Certification
I certify that the above pricing is accurate and valid for the bid period and
complies with all specifications.
Authorized Signature:
Printed Name: David B. Sims
Title: Director of operations
Date: 5/6/26
STATE OF TENNESSEE
DEPARTMENT OF
COMMERCE AND INSURANCE
5
LEE COMPANY
430959
ID NUMBER: 9255
LIC STATUS: ACTIVE
EXPIRATION DATE: October 31, 2027
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
THIS IS TO CERTIFY THAT ALL REQUIREMENTS
OF THE STATE OF TENNESSEE HAVE BEEN MET
LEE COMPANY
4057 RURAL PLAINS CIR
FRANKLIN, TN 37064
430959
State of Tennessee
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
LEE COMPANY
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 9255
THE STATE OF
LIC STATUS: ACTIVE
EXPIRATION DATE: October 31, 2027
UNLIMITED; BC; CE; CMC; MU; S-Medical Gas
SCHEAT AGRICULTURE J
7796
IN-1313
DEPARTMENT OF
COMMERCE AND INSURANCE
BOARD FOR LICENSING CONTRACTORS
AREAS OF CERTIFICATION/MONEY LIMITS
UNLIMITED; BC; CE; CMC; MU; S-Medical Gas
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature:
Print: David Sims
Title: Director of Operations
Date: 5/5/2026
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
§ 12-4-119
Signature: John
Print: David Sims
Date: 5/5/2026
Phone/Email: bsims@leecompany.com
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library//
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Lee Company
Bidder Signature:
Date: 5/5/2026
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/5/2026
Name: David Sims
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/5/2026
Signature:
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
3/1/2027
2/20/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER Lockton Companies, LLC
NAME:
DBA Lockton Insurance Brokers, LLC in CA
PHONE
FAX
(A/C, No. Ext):
(A/C, No):
CA license #0F15767
E-MAIL
ADDRESS:
500 W. Monroe, Ste. 3400
INSURER(S) AFFORDING COVERAGE
NAIC #
Chicago IL 60661
INSURER A: Zurich American Insurance Company
16535
(312) 669-6900 midwestcertificates@lockton.com
INSURED
Lee Company
INSURER B : Starr Indemnity & Liability Company
38318
1501491
15050 State Highway 20
INSURER C : Travelers Property Casualty Company of America
25674
Madison, AL 35756
INSURER D :
INSURER E:
INSURER F :
COVERAGES
CERTIFICATE NUMBER: 21117387
REVISION NUMBER: XXXXXXX
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
A
N
N
GLO 3537803-03
3/1/2026
3/1/2027
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$ 1,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
PRO-
POLICY
LOC
PRODUCTS - COMP/OP AGG
$ 4,000,000
JECT
$
OTHER:
COMBINED SINGLE LIMIT
A
AUTOMOBILE LIABILITY
N
N
BAP 3537804-03
3/1/2026
3/1/2027
(Ea accident)
$ 5,000,000
ANY AUTO
BODILY INJURY (Per person)
$ XXXXXXX
OWNED
SCHEDULED
BODILY INJURY (Per accident)
XXXXXXX
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$ XXXXXXX
AUTOS ONLY
AUTOS ONLY
(Per accident)
$ XXXXXXX
C
UMBRELLA LIAB
OCCUR
N
N
CUP-C5438925
3/1/2026
3/1/2027
EACH OCCURRENCE
$ 10,000,000
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$ 10,000,000
DED
RETENTION $
XXXXXXX
PER
OTH-
WORKERS COMPENSATION
N
ER
A
WC 3537802-03
3/1/2026
3/1/2027
STATUTE
AND EMPLOYERS' LIABILITY
Y N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 1,000.000
OFFICER/MEMBER EXCLUDED?
N
N/A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below.
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
B
Excess Liability
N
N
1000588841261
3/1/2026
3/1/2027
$15,000,000 per Occurrence/Aggregate
C
Inland Marine
QT-630-5T394871-TIL-26
3/1/2026
3/1/2027
See Attachment
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER
CANCELLATION See Attachment
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
21117387
ACCORDANCE WITH THE POLICY PROVISIONS.
Evidence of Insurance
AUTHORIZED REPRESENTATIVE
JIGGI
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
Attachment Code: D607064 Master ID: 1501491, Certificate ID: 21117387
Lee Company
Installation / Builders Risk
INSURER: Travelers Property Casualty Company of America
POLICY NUMBER: QT-630-5T394871-TIL-26
TERM: 3/1/2026 - 3/1/2027
Contractors Equipment - As per schedule on file with carrier
Coverage
Limit of Insurance
Deductible
Leased/Rented Equipment - Per Item
$250,000
$5,000
Installation / Builders Risk
$1,000,000
$10,000
Cargo - - Per Conveyance
$100,000
$5,000
LEE
Form of Business
S-Corporation
Date of Incorporation - April 5, 1965
Number of Years in Business
82 years (Since 1944)
60 years under current name (formerly Lee Refrigeration)
Number of Employees
1,700+ Employees: 400 Office Employees, 1,200+ Field Employees
Company Officers
Richard Perko, P.E. CEO
Rob Ivy
Chief Financial Officer
Robert Lunny
Chief Operating Officer
Office Locations
Corporate Office - Franklin, TN
Chattanooga, TN
Madison, AL
Murfreesboro, TN
Clarksville, TN
Knoxville, TN
Bowling Green, KY
Cookeville, TN
Financial Information
Last 5 Years of Revenue
Year
Revenue
2025
$ 454 Million
2024
$ 415 Million
2023
$ 370 Million
2022
$ 340 Million
2021
$ 304 Million
Bonding Company
Liberty Mutual
HUB International (formerly The Crichton Group)
3011 Armory Drive, Suite 250
Nashville, TN 37204 I (615) 383-9761
facilities solutions home services . leecompany.com
LEE
Bonding Limit
$125,000,000 aggregate
$60,000,000 single project
Banking
Pinnacle Financial Partners
Mr. Todd Carter
211 Commerce Street, Suite 300
Nashville, TN 37201
(615) 690-4064
Todd.carter@pnfp.com
Insurance
Travelers Insurance
One Tower Square
Hartford, CT 06183
Bodily Injury/Property Damage:
$ 1,000,000 each occurrence
Completed Operations:
$ 2,000,000
General Aggregate:
$ 2,000,000 per project
Umbrella:
$15,000,000
Professional Liability:
$ 1,000,000
facilities solutions home services leecompany.com
LEE
Facilities Solutions
COMPANY
Facility Services
HVAC Maintenance Programs
Electrical Services
Coil cleaning
Arc-flash ratings/NFPA 70E
Filter and belt replacement
Data logging/Test and balance
Technical inspection of equipment
EV-electrical vehicle charging
Explosion proof
Generator installation and maintenance
Plumbing Maintenance Programs
Industrial
Certification of backflow devices
Infrared testing
Inspections of plumbing fixtures and equipment
Lighting retrofits
Maintenance on water heaters/boilers
Load testing
Motor controls
Outdoor lighting/Pole lighting
HVAC Services
Service upgrades
Air compressors
Solar
Air handling units
Surge protection
Boilers
Transformer/Utility
Chillers
Troubleshooting
Cooling towers
Cooling/Heating problems
Technical Services
Driers
Air/Water test and balance
Equipment replacement
Annual code compliance services
Exhaust fans
Building automation systems
Heat wheels
Building commissioning, recommissioning and
Humidification/Dehumidification problems
retrocommissioning
Make-up air units
Building forensics
Noise Issues
Compressed air audits
Pumps
Energy retrofits, including VFD's
Refrigeration and refrigerant recovery
Energy star rating
Test labs
Fire damper inspections
VAV systems
Hot water energy management systems
HVAC and lighting control
Plumbing Services
Indoor air quality (IAQ)
Backflow devices
Life safety/Fire code compliance
Camera drain inspections
Med gas inspections
Drain jetting
Steam trap retrofits
Drain maintenance
Faucets
Hose bibbs/Wall faucets
Pumps
Sewer issues
Urinals
Water closets
Water heaters
Water leaks/drain/sewer problems
leecompany.com
LEE
Facilities Solutions
COMPANY
Manufacturing
Construction / Special Projects
Our shop provides custom manufactured products
Design and construction of mechanical and plumbing
and assemblies that help reduce downtime for
systems, our core business for decades, has helped us become
systems and processes for clients such as:
the "Premier Mechanical Services" provider in our markets.
Electrical contractors
General contractors
Our services include:
Government agencies
BIM/3D modeling
Healthcare facilities
Building automation controls
Industrial facilities
Design/Build services with in-house professional
Laboratories
engineers and designers
Duct and pipe insulation
Specialty contractors
Equipment installation
Utilities
Equipment startup and commissioning
Wastewater contractors
Field supervision
Geothermal systems
LEED AP's
Our products include:
Medical gases
Access ladders
Pipe fitting
Air filtrations systems
Plumbing
Booths for welding, grinding, and other work
Pre-construction service/estimating
Complete pre-fabricated mechanical
Pre-fabrication/logistics
and plumbing piping systems
Project management
Custom enclosures for ATM's/electrical/
Project scheduling
fire protection/plumbing/conditioned. spaces/indoor
Sheet metal
and outdoor applications/etc.
Shop/Coordination drawings
Custom equipment modifications
Site work
Emergency pipe replacement spools
Test and balance
Guard shacks
Variable refrigerant flow systems (VRF/VRV)
Honed/Drilled materials
Water treatment
Humidification
Welding
HVAC control systems
Industrial pipe spools
Pipe fabrication
Rooftop unit curb adaptors
Security bar, frame and grate systems
Service and operating platforms for all
types of equipment
Sheet metal fabrication
Skid-mounted equipment (MPE, industrial process, etc.)
Specialty climate-controlled enclosures
Specialty firearms lockers and safes
Steel fabrication
leecompany.com
2
fm
Facilities Solutions
A Service of
LEE
Facility Management & Maintenance
An integrated service providing clients with access to an experienced and skilled team dedicated to support
your business and facility's day to day operations, repair and maintenance needs.
HVAC
Managed Projects
Equipment installation and replacement
Site and parking lots
Equipment repair and service
Roofs
Inspections and diagnostics
Flooring
Planned maintenance (filters, belts, cleaning)
Painting
Minor interior refresh and reconfigurations
Building exterior, windows, siding
Industrial floor coatings
Plumbing
Inspections and diagnostics
Fixture repair and replacement
Services
Water heaters
Exterior high pressure wash
Fencing
Floor care (carpet, tile, wood)
Electrical
Janitorial
Circuit modifications
Landscaping
Exit signs
Lawn care
Exterior lighting
Parking lot
Inspections and maintenance
Pest control
Lamp and ballast repair and replacement
Window cleaning
Lighting maintenance
Receptacles, breakers and panels
General Maintenance
24/7 emergency service
Carpentry
Carpet/Tile
Ceiling
Concrete
Doors and windows
Drywall
Painting
Roofing
Site utilities/Grading
leecompany.com
HVAC SERVICES BID FORM
Vendor Name:
S.M. Lawrence
Contact Name: Rex Ruddle
Phone: 615-248-2813
Email: Service@SmLawrence.com
Date: 5-8-2024
1. Fire Damper Cleaning
Service every four (4) years per NFPA 80
Per Damper Charge:
$ 40.00
per damper
2. Annual Summer HVAC Services
Locations (10):
EHES, EHIS, EHMS, EHHS, CES, CIS, HCMS, HCHS, ANNEX BUILDING,
HCBOE
Scope of Work:
Coils, filters, belts, unit inspection, and unit run test
Annual Service Charge:
$ 38,800.00
3. HVAC Services - Labor Rates
Onsite standard rate for repairs and installation
Monday-Friday I 8:00 AM - 5:00 PM
Certified HVAC Technician (onsite):
$ 120.00
per hour
Helper/Laborer (onsite):
$ 95.00
per hour
Trip Charge:
$ 50.00
per day, per zip code
4. Refrigerant Charges
If bidder provides refrigerant; weighted in at installation
R22:
$ 100.00
per lb
R410A:
$ 50.00
per lb
R454B:
$ 90.00
per lb
Other (specify):
$
per lb
5. Flat Recovery Charges
Recovery/vacuum charge when required
Per Call / Per Unit:
$ 55.00
6. Parts and Materials Markup
Applies if bidder furnishes parts (fans, motors, compressors, control boards,
etc.)
Cost plus 35 % markup
Note: Parts invoice must be attached to every billing for transparency.
7. Miscellaneous Truck Parts
Includes items such as wire nuts, tape, fittings, conduit, etc.
Per Trip Charge:
$ 20.00
Bid Certification
I certify that the above pricing is accurate and valid for the bid period and
complies with all specifications.
Authorized Signature: Van High
Printed Name: Van Right
Title: V.P. of Operations
Date: 5/8/2026
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Van High
Print:
Van Kight
Title:
V.P. of Operations
Date:
5/8/2026
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
$ 12-4-119
Signature: Van Kept
Print:
Van Kight
Date: 5/8/2026
Phone/Email: 615 - 846 0060 VKight@SmLawrence.com
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: S.M. Lawrence - Van Kight
Bidder Signature:
Van tep
Date:
5/8/2026
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
or other things of value whatsoever, or any promise, obligation or contract for
Date: future money 5/8/2016 reward or Name: compensation. Vankisht Van A
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/8/2026 Signature: Van !
HVAC SERVICES BID FORM
Vendor Name: Matrix Mechanical Solutions, LLC
Contact Name: Daniel D. Enbarbs
Phone: 615-879-6420
Email: danie1@matio mechanicalstutions.com
Date: 5-1-26
1. Fire Damper Cleaning
Service every four (4) years per NFPA 80
Per Damper Charge:
$ 110
per damper
2. Annual Summer HVAC Services
Locations (10):
EHES, EHIS, EHMS, EHHS, CES, CIS, HCMS, HCHS, ANNEX BUILDING,
HCBOE
Scope of Work:
Coils, filters, belts, unit inspection, and unit run test
Annual Service Charge:
$60,000.00
3. HVAC Services - Labor Rates
Onsite standard rate for repairs and installation
Monday-Friday I 8:00 AM - 5:00 PM
Certified HVAC Technician (onsite):
$ 110
per hour
7 I Page
Helper/Laborer (onsite):
$ 90
per hour
Trip Charge:
$ 110
per day, per zip code
4. Refrigerant Charges
If bidder provides refrigerant; weighted in at installation
R22:
$ 150
per lb
R410A:
$ 75
per lb
R454B:
$ 75
per lb
Other (specify):
$ 75
per lb
5. Flat Recovery Charges
Recovery/vacuum charge when required
Per Call / Per Unit:
$
150
6. Parts and Materials Markup
Applies if bidder furnishes parts (fans, motors, compressors, control boards,
etc.)
Cost plus 20
% markup
Note: Parts invoice must be attached to every billing for transparency.
8 I Page
7. Miscellaneous Truck Parts
Includes items such as wire nuts, tape, fittings, conduit, etc.
Per Trip Charge:
$ 50 $
Bid Certification
I certify that the above pricing is accurate and valid for the bid period and
complies with all specifications.
Authorized Signature: DIOSS
Printed Name: DanielD. Eubanks
Title: CEO
Date: 5-1-26
9 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Oloc
Print: Daniel D. Eubanks
Title: CEO
Date: 5-1-26
10 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
$ 12-4-119
Signature: 0.005
Print: Daniel D. Eubanks
Date: 5-1-26
Phone/Email:
11 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/o
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Matrix Mechanical Solutions, LLC
Bidder Signature: Dallas
Date: 5-1-26
12 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5-1-26
Name: Matrix Mechanical Solutions, LLC
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5-1-26
Signature: Oldr
13 I Page
MATRMEC-02
KFEREBEE
ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
4/28/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
Morrison & Fuson Insurance Agency, Inc.
PHONE
FAX
(A/C, No, Ext):
(615) 446-8087
(A/C, No):
(615) 446-4617
104 Church Street
E-MAIL
Dickson, TN 37055
mfins@fusonins.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Erie Insurance Company
26263
INSURED
INSURER B: Erie Ins Exch
26271
Matrix Mechanical Solutions, LLC
INSURER C : Accident Fund Ins Co Of Amer
10166
Kim Stiles
9743 Old Hillsboro Rd
INSURER D:
Bon Aqua, TN 37025
INSURER E:
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
COMMERCIAL GENERAL LIABILITY
1,000,000
EACH OCCURRENCE
$
2/6/2027
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
X
Q61-0362950
2/6/2026
1,000,000
PREMISES (Ea occurrence)
$
MED EXP (Any one person)
$
5,000
1,000,000
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
2,000,000
PRO-
2,000,000
POLICY
JECT
LOC
PRODUCTS COMP/OP AGG
$
OTHER:
$
B
COMBINED SINGLE LIMIT
1,000,000
AUTOMOBILE LIABILITY
(Ea accident)
$
ANY AUTO
Q02-0640069
2/6/2026
2/6/2027
BODILY INJURY (Per person)
$
OWNED
SCHEDULED
AUTOS ONLY
AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
HIRED
NON-OWNED
AUTOS ONLY
(Per accident)
$
AUTOS ONLY
$
B
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
7,000,000
EXCESS LIAB
CLAIMS-MADE
Q26-0670423
2/6/2026
2/6/2027
AGGREGATE
$
7,000,000
DED
RETENTION $
0
$
C
WORKERS COMPENSATION
PER
OTH-
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
100133554
11/15/2025
11/15/2026
1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
OFFICER/MEMBER EXCLUDED?
N
N/A
1,000,000
(Mandatory in NH)
E.L. DISEASE- EA EMPLOYEE
$
If yes, describe under
1,000,000
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
A
Equipment Floater
Q61-0362950
2/6/2026
2/6/2027
Floater
1,215,000
A
Rented/Leased Equip
Q61-0362950
2/6/2026
2/6/2027
R/L Limit
75,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Hickman County Schools is identified as Additional Insured with respect to General Liability per written contract.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Hickman County Schools
ACCORDANCE WITH THE POLICY PROVISIONS.
115 Murphree Avenue
Centerville, TN 37033
AUTHORIZED REPRESENTATIVE
the
ACORD 25 (2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
THE
STATE
J
STATE OF TENNESSEE
DEPARTMENT OF REVENUE
Business Tax Filing Status Certificate
April 5, 2026
Letter ID:
L1409359296
DANIEL EUBANKS
Account ID:
1001782120-BUS
MATRIX MECHANICAL SOLUTIONS, LLC
9743 OLD HILLSBORO RD
Account Type:
Business Tax
BON AQUA TN 37025-1542
Dear MATRIX MECHANICAL SOLUTIONS, LLC:
This certificate confirms the business tax filing status of Retailer for the above-named taxpayer. The
certificate is valid beginning April 15, 2026 and expiring on April 15, 2027 for the following location:
Location ID:
1001683765
Location Address:
MATRIX MECHANICAL SOLUTIONS, LLC
9743 OLD HILLSBORO RD
BON AQUA TN 37025-1542
According to Tenn. Code Ann. § 67-4-720, a vendor that receives a certificate from a
customer shall not owe additional tax, nor be refunded tax, based on a retroactive change
in the customer's filing status as a wholesaler or retailer during the certificate's effective
period.
The taxpayer may furnish its supplier(s) with a COPY of the enclosed certificate upon vendor(s)
request. Vendors may rely on the certificate for transactions occurring during the certificate's
effective period for the purpose of determining their business liability. The original certificate
should be retained for the taxpayer's records. The vendor must maintain a file copy as evidence
of their business tax filings.
Tennessee Department of Revenue
Business Tax Filing Status Certificate
Location Address:
Effective Period Begin: April 15, 2026
MATRIX MECHANICAL SOLUTIONS, LLC
Effective Period End: April 15, 2027
9743 OLD HILLSBORO RD
Filing Status:
Retailer
BON AQUA TN 37025-1542
Location ID:
1001683765
Hickman County
Business Tax Standard License
April 8, 2026
Letter ID:
L1993956800
MATRIX MECHANICAL SOLUTIONS, LLC
9743 OLD HILLSBORO RD
Expiration Date:
15-May-2027
BON AQUA TN 37025-1542
Return Due By:
15-Apr-2027
The business tax license printed below certifies the receipt and approval of your business tax
license application or the renewal of a license for your existing business. The license is valid until
the expiration date noted above. Your license number is 1001344093 and your classification is 4.
The certificate must be displayed publicly at the location for which it is issued.
All business tax returns are required to be filed and the payment remitted electronically. Your
return is due on April 15, 2027. Please visit www.tn.gov/revenue for additional information.
Note: This license does not permit operation unless properly zoned and/or in compliance
with all other applicable state, county, or city laws, rules and regulations. Also, as required
by Tenn. Code Ann. § 39-17-1801 et seq., businesses must comply with all provisions of the
Tennessee Non-Smoker Protection Act.
DETACH LICENSE BELOW AND DISPLAY IN PUBLIC AREA
Hickman County
Business Tax Standard License
This certificate must be publicly displayed.
OF
THE
MATRIX MECHANICAL SOLUTIONS, LLC
Date Issued:
08-Apr-2026
9743 OLD HILLSBORO RD
Classification:
4
BON AQUA TN 37025-1542
RE
Letter ID:
L1993956800
License Number:
1001344093
Expiration Date:
15-May-2027
W-9
Request for Taxpayer
Give form to the
Form
(Rev. March 2024)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
Go to www.irs.gov/FormW9 for instructions and the latest information.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1. and enter the business/disregarded
entity's name on line 2.)
Matrix Mechanical Solutions, LLC
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
See Specific Instructions on page 3.
Individual/sole proprietor
C corporation
S corporation
Partnership
Trusl/estate
LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
Exempt payee code (if any)
Print or type.
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
code (if any)
Other (see instructions)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
outside the United States.)
this box if you have any foreign partners, owners, or beneficiaries. See instructions
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
9743 Old Hillsboro Road
6 City, state, and ZIP code
Bon Aqua, TN 37025
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
-
I
resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
or
TIN, later.
Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
85 - 3995388
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) i have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citlzen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, OLERS you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Signature of
Here
Date 02/18/2026
U.S. person
New line 3b has been added to this form. A flow-through entity is
General Instructions
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
noted.
to another flow-through entity in which it has an ownership interest. This
change is intended to provide a flow-through entity with information
Future developments. For the latest Information about developments
related to Form W-9 and its instructions, such as legislation enacted
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
after they were published, go to www.irs.gov/FormW9.
requirements. For example, a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
An individual or entity (Form W-9 requester) who is required to file an
should check the "LLC" box and enter its appropriate tax classification.
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)
The Hickman County Finance Office is accepting bids for "Painting at
Schools" 2025-2026.
Bid prices must be good for July 1, 2026 - June 30, 20267.
Specifications can be found at
https://ww.hickmank12.org/requestforproposal. Or by calling 391-729-
3391 Ext 3.
All bidders must attach:
A conflict-of-interest disclosure form can be obtained at
https://ww.hickmank12.org/requestforproposal.
Iran Divestment Act Certification
Non-Boycott of Israel Certification
TN business license
A 1-million-dollar liability insurance certificate
Workers compensation insurance
Background Acknowledgement Form
Per TCA 49-5-406, all bidders' employees working on school properties must comply with
all local, state, and federal laws.
Sealed bids must be mailed or hand-delivered to the Hickman County Finance Office, 114
North Central Avenue, Suite 203, Centerville, TN 37033, and clearly marked on the outside
of the envelope "Painting at Schools."
Bids will be opened on May 12, 2026, at 10:30 a.m. in the Finance Office.
The Hickman County Board of Education reserves the right to accept or reject any and all
bids or parts of bids and to waive any informalities that would prevent the acceptance of a
better bid.
Present Penny Rochille
3 buts rec'd
BJB Construction Company
Nicle Wright
Art's House Painting
offer Porch
see attached bids
BEYOND JUST BUILDERS
SECURITY
BJB
CONSTRUCTION COMPANY INC
BJB
1373 Holly Tree Gap Rd, Brentwood, TN. 37027
CONSTRUCTION
CONSTRUCTION
COMPANY
COMPANY
References:
1) Brent Stidham
Senior Maintenance Engineer
(Managing govt buildings in Brentwood TN)
City Of Brentwood
brent.stidham@brentwoodtn.gov
(615)533-5032
15+ Years as a customer
2) Ryan Edwards
Continuous Improvement Coordinator
Advanced Composites
Ryan.edwards@advcmp.com
(615)630-1843
15+ Years as a customer
3) Yvonne Parker
Sr. Specialist, Consumer Care National Facilities
T-Mobile
Yvonne.parker@t-mobile.com
(931)980-8867
8 Years as a customer
4) Wesley King
Service Manager
The Mathews Company
wking@themathewscompany.com
(615)394-8451
15+ Years as a customer
Office 615-457-3304
www.BJBConstruction.com
Specifications Part B
Painting at Schools
Scope:
Proper prep, sand, and glaze any peeling paint to avoid it being visible to the final
finish.
Ensure proper manufacturer-prepped surface for good adhesion.
Avoid peeling or chipping paint.
Application is to be brushed or rolled on for a smooth, clean finish.
All specs apply to interior and exterior projects.
Painting specs will be applied to latex, urethane, or epoxy finishes, where the
manufacturer requirement is to include primer and paint applications.
Metal doors and frames (both sides) 4x7
$ 288.00
Frames only (per opening) 4x7
$ 96.00
Dumpster doors (both sides with poles trim)
$ 1104.00
Miscellaneous Trim (priced per linear foot)
$ 2.5/If
CMU walls: Exterior scrape, scuff, prime, and paint
$4
SF
CMU walls: Interior scrape, scuff, prime, and paint
$ 3
SF
Handrails: To include top, mid, and bottom rails. Prep/paint
$ 28
linear ft
Single Rails: To include one railing continuous, and brackets, posts $ 21
linear ft
Picketed fencing or hand railing continuous, brackets, posts
$ 3.5
linear foot
EFIS/CORNICE: Both metal/Cladding Board Stucco (paint)
$ 3
square foot
Cost plus for materials
20%
markup %/equipment/lift rental and paint.
Minimum per job to mobilize $ 2000.00
ALTERNATE 2
Straight-out the pricing of painters by the hour to sand, prep, and paint anything requested
by the schools and furnish materials listed by the painters prior to the job start.
Painters by the hour $ 80
Materials plus markup %
20%
for any items limited to rollers, brushes, paint,
primer, etc.
NOTE: This bid does not allow add-on charges for standard "tools of trade" such as
trucks, drop cloths, and ladders, which are considered part of the standard tools of
the trade that most businesses already possess.
1 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101- - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/c
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name: Nathaniel Benbow
Bidder Signature: Nathaniel Benbow
Date: 5/6/2026
2 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 5/6/2026
Name: Nathaniel Benbow
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/6/2026
Signature: Nathaniel Benbow
3 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
$12-4-119
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Date: 5/6/2026
Phone/Email: 615-394-1411
Nathan@bjbconstruction.com
4 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Nathaniel Benbow
Print: Nathaniel Benbow
Title: Estimator/ Principal Officer
Date: 5/6/2026
5 I Page
W-9
Request for Taxpayer
Give form to the
Form
(Rev. March 2024)
Identification Number and Certification
requester. Do not
Department of the Treasury
send to the IRS.
Internal Revenue Service
Go to www.irs.gov/FormW9 for instructions and the latest information.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded
entity's name on line 2.)
BJB Construction Company Inc
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
only one of the following seven boxes.
certain entities, not individuals;
see instructions on page 3):
Individual/sole proprietor
C corporation
S corporation
Trust/estate
See Specific Instructions on page 3.
Partnership
LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership)
Exempt payee code (if any)
Print or type.
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
code (if any)
Other (see instructions)
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
outside the United States.)
this box if you have any foreign partners, owners, or beneficiaries. See Instructions
5 Address (number, street, and apt. or suite no.). See instructions.
Requester's name and address (optional)
1373 Holly Tree Gap Rd
6 City, state, and ZIP code
Brentwood, TN. 37027
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Social security number
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For Individuals, this is generally your social security number (SSN). However, for a
-
-
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
or
TIN, later.
Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
04 - 3777109
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Signature of
Here
U.S. person
Debbie Benbow
Date 3/13/2026
General Instructions
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise
foreign partners, owners, or beneficiaries when it provides the Form W-9
noted.
to another flow-through entity in which it has an ownership interest. This
Future developments. For the latest information about developments
change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions, such as legislation enacted
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
after they were published, go to www.irs.gov/FormW9.
requirements. For example, a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
Purpose of Form
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC" box and enter its appropriate tax classification.
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X
Form W-9 (Rev. 3-2024)
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
02/12/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT NAME: LISA WILSON
INSURANCE GROUP OF AMERICA LLC
PHONE:
FAX: (615)905-1698
SMALL BUSINESS
6640 CAROTHERS PKWY STE 160
E-MAIL ADDRESS: lisa.wilson@iga.biz
FRANKLIN, TN 37067
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A
Central Mutual
20230
INSURED
INSURER B
All America
20222
BJB CONSTRUCTION COMPANY INC
INSURER C
1373 HOLLY TREE GAP RD
BRENTWOOD, TN 37027
INSURER D
INSURER E
INSURER F
CERTIFICATE NUMBER
7018655
REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF
SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
Y
Y
9606838
8/8/2025
8/8/2026
EACH OCCURRENCE
$
1,000,000
DAMAGE TO RENTED PREMISES
$
300,000
COMMERCIAL GENERAL LIABILITY
(Ea occurrence)
CLAIMS-MADE
OCCUR
MED EXP (Any one person)
$
5,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PERSONAL & ADV INJURY
$
1,000,000
POLICY
PRO-
LOC
GENERAL AGGREGATE
$
2,000,000
JECT
PRODUCTS- COMP/OP AGG
$
2,000,000
B
AUTOMOBILE LIABILITY
Y
Y
9606837
8/8/2025
8/8/2026
COMBINED SINGLE LIMIT (Ea
$
1,000,000
accident)
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS
AUTOS
PROPERTY DAMAGE (Per
$
HIRED AUTOS
NON-OWNED
accident)
AUTOS
A
UMBRELLA LIABILITY
Y
Y
9606839
8/8/2025
8/8/2026
EACH OCCURRENCE
$
5,000,000
UMBRELLA
OCCUR
AGGREGATE
$
5,000,000
LIAB
EXCESS LIAB
CLAIMS-MADE
DED
RETENTION $
A
WORKERS COMPENSATION AND
9606841
8/8/2025
8/8/2026
WC STATUTORY LIMITS
OTHER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
1,000,000
ANY PROPRIETOR/PARTNERS/EXEC
Y
UTIVE OFFICE/MEMBER EXCLUDED?
E.L. DISEASE- EA EMPLOYEE
$
1,000,000
(Mandatory in NH)
E.L. DISEASE- POLICY LIMIT
$
1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES
Certificate Holders are additional insured per the attached endorsements.
Subject to all of the terms, conditions, exclusions and definitions of the above referenced policies as issued by the carrier(s).
Excluded proprietors, partners, executive officers, and members:
DEBBIE BENBOW
BRUCE BENBOW
CERTIFICATE HOLDER
CANCELLATION
BJB CONSTRUCTION COMPANY INC.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
1373 HOLLY TREE GAP RD
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH
BRENTWOOD, TN 37027
THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
LISA WILSON
State of Cennessee
14123171
BOARD FOR LICENSING CONTRACTORS
CONTRACTOR
BJB CONSTRUCTION COMPANY INC.
This is to certify that all requirements of the State of Tennessee have been met.
ID NUMBER: 61519
SEAL-OF THE XVI STATEOF STATE OF
LIC STATUS: ACTIVE
EXPIRATION DATE September 30, 2026
$473,240.00; BC
GREAT AGRICULTURE CHIMERC 7796 7
IN-1313
VIVIC
DEPARTMENT OF
COMMERCE AND INSURANCE
VOID
THE
Town of Centerville Business Tax
Minimal Activity Business License
ART'S HOUSE PAINTING
Date Issued: 05-05-2026
ART'S HOUSE PAINTING
Business Tax Classification: 3
2810 COUNTRY CLUB DR
Tax Period:
to
CENTERVILLE TN
Next Tax Due: 09-15-2027
37033-3916
Expiration: 10-15-2027
License Type: New/Renewal
License Number: 6685
Local Tax Account #: 1000110
Effective January 1, 2014, counties and cities will issue a minimal activity business license to any person with
annual sales of more than $3,000 but less than $100,000 per year within a jurisdiction.
The minimal activity license will be issued upon receipt of an application and payment of a $15 fee. The applicant
must attest that the applicant is engaged in business within the county or incorporated municipality and has sales of
less than $100,000 per year within the jurisdiction. No person with sales of more than $3,000 but less than
$100,000 per year can engage in business in the jurisdiction without first obtaining the minimal activity license.
If a person has more than one location in the jurisdiction, a separate minimal activity license and $15 fee is
required for each location. Any person obtaining a minimal activity license must display the license in the person's
place of business. Persons with $3,000 or less in annual sales in any incorporated municipality or county may, but
are not required to, have a minimal activity license.
Each minimal activity license will expire thirty days after the end of what would be the taxpayer's filing period if
the person were filing a business tax return. Each year, a new minimal activity license must be obtained for each
of the person's locations if the person will meet the qualifying gross receipts criteria; another $15 license fee must
be paid for each new minimal activity license.
In any year in which a person's gross receipts in the jurisdiction are $100,000 or more, the person will be required
to file a regular business tax return for the tax year.
DETACH LICENSE BELOW AND DISPLAY IN PUBLIC AREA
Town of Centerville Business Tax
Minimal Activity Business License
This certificate must be publicly displayed
ART'S HOUSE PAINTING
THE
Date Issued: 05-05-2026
STATE
Business Tax Classification: 3
2810 COUNTRY CLUB DR
Tax Period:
to
Next Tax Due: 09-15-2027
CENTERVILLE TN
Expiration: 10-15-2027
37033-3916
License Type: New/Renewal
7796
License Number: 6685
Local Tax Account #: 1000110
Docusign Envelope ID: D9D6CF21-AFB1-4BA0-94BE-5DA4CFC995BC
Memorandum of Commercial
FARMERS
Insurance
INSURANCE
Insured: TIDWELL, ARTHUR ARTS HOUSE PAINTING
Effective Date: 05-04-2026
Company: MID-CENTURY INSURANCE COMPANY
Policy Number: 607236057
Agent Number: 662739L
Rates quoted reflect the rates in effect as of the date of this application and are subject to revision. The company
reserves the right to accept, reject or modify this application after investigation, review of the application and review
of all other underwriting information. The undersigned represents and warrants that he/she has applied for the
insurance coverage(s) as set forth above, pursuant to an application entered into the insurer's computer records,
and hereby confirms that he/she supplied information so entered and warrants and represents that all such
information is true and correct.
We may use your credit history to run an "insurance score" for the purpose of underwriting or rating your policy. An
insurance score is a number or rating derived from an algorithm, computer application, model or other process that
is based wholly or in part on credit information. We use an insurance score to predict an individual applicant's or
customer's future insurance loss exposure.
Applicable only to states with the privacy act: I have received a copy of the investigation practices and protection of
your privacy form, which advises me of my rights concerning the investigative practices of the member companies
and exchanges of the Farmers Insurance Group of Companies.
The property limits are only estimated values based upon the information provided to us by you and third parties.
You are responsible for determining the appropriate Building and/or Business Personal Property coverage limits.
Please also note that this estimate does not replace or supersede any term or condition of your policy and does not
replace any required current professional appraisals or use of other estimating methods.
FRAUD WARNING STATEMENTS
All States (other than AL, AR, AZ, CO, DC, FL, LA, MD, ME, NJ, NM, OH, OR, PA, RI, TN, VA, WA and WV)- Any person
who knowingly and with intent to defraud any insurance company or other person files an application for insurance
containing any materially false information or conceals, for the purpose of misleading, information concerning any
fact material thereto commits a fraudulent insurance act, which is a crime and subjects that person to criminal and
civil penalties.
AL, AR, AZ, DC, LA, MD, NM, RI and WV- Any person who knowingly (or willfully in MD) presents a false or
fraudulent claim for payment of a loss or benefits or who knowingly (or willfully in MD) presents false information in
an application for insurance is guilty of a crime and may be subject to fines or confinement in prison.
California - For your protection, California law requires the following to appear on this form: Any person who
knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the
payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.
Colorado- It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance
company for the purpose of defrauding or attempting to defraud the company. Penalties may include
imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance
company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or
claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a
settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within
the department of regulatory agencies.
Florida and Oklahoma- WARNING: Any person who knowingly and with intent to injure, defraud, or deceive any
insurer files a statement of claim or an application containing any false, incomplete, or misleading information is
guilty of a felony (In FL, a person is guilty of a felony of the third degree).
ME, TN, VA, WA It is a crime to knowingly provide false, incomplete, or misleading information to an insurance
company for the purpose of defrauding the company. Penalties include imprisonment, fines, and denial of
insurance benefits.
New Jersey - Any person who includes any false or misleading information on an application for an insurance policy
is subject to criminal and civil penalties.
Ohio - Any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits
an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
31-1275ED6 08-22
Page 1 of 3
Docusign Envelope ID: D2824F72-1FAF-8326-831C-5B3B55DA99FB
CNA
Coverage:
Workers' Compensation
Account Name:
Arts House Painting
Underwritten
TRANSPORTATION
by:
INSURANCE COMPANY (20494)
Policy Period:
05/01/2026 05/01/2027
WORKERS' COMPENSATION
FEIN
415156683
Employers' Liability Limits
Limit
Bodlly Injury by Accident (Per Accident)
$500,000
Bodily Injury by Disease (Policy Limit)
$500,000
Bodlly Injury by Disease (Each Employee)
$500,000
Rating Information
Rating Period 05/01/2026 05/01/2027
Location
State
Class
Class Description
Payroll
Rate
Est.Annual
Code
Premium
Premium
Basis
1
TN
5474
Camouflage Work-Palnting-& Drivers
$10,000
3.803
$380.00
Class Total for Location #1
$380.00
Class Total for TN
$380.00
9807
Employers Liability Increased Limits
.0110
$4.00
9848
Employers Liability Increased Limits -
#######
$96.00
Balance To Minimum Premium
0930
Waiver Of Subrogation
.0000
$0.00
Modified Premium
$480.00
9887
Schedule Modification Adjustment
.7500
($120.00)
Credit
Total Estimated Standard Premium
$360.00
0990
Required To Balance To Min Premium
.0000
$501.00
0900
Expense Constant
.0000
$160.00
9740
Terrorism Premium
0130
$1.00
9741
Catastrophe (O/T Cert Acts Of Terror)
0250
$3.00
Total Estimated Premium
$1,025.00
Total Estimated Cost
$1,025.00
Total Workers' Compensation Premium:
$1,025.00
Page:2
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision shall
not apply to contracts with a total value of less than two hundred fifty thousand dollars
($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial relations
with Israel, or companies doing business in or with Israel or authorized by, licensed by, or
organized under the laws of the State of Israel to do business, or persons or entities doing
business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code § 12-
4-119
Signature: arthur didwell
Print: Arthur Tiowell
Date: 5/5/26
Phone/Email: adtidwelL54@GMAiL.Com
4 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when on
school premises. The contractor may be asked to provide proof of background
check.
Signature: authur Ridwell
Print:
Arthur Towell
Title: Sole-proprietor - PAINTER
Date: 5/5/26
5 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education or
highway commission shall not be financially interested or have any personal beneficial
interest, either directly or indirectly, in the purchase of any supplies, materials,
equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall the
director or purchasing agent or any assistant or employee accept or receive directly or
indirectly from any person, firm, corporation, partnership or association to whom any
contract may be awarded, by rebate, gift or other otherwise, any money or other things
of value whatsoever, or any promise, obligation or contract for future reward or
Date: compensation. 5/5/26 Name: althur Lidwed
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or committees
you (and/or your spouse) sit on, the name of your employer and any businesses you or your
spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 5/5/26 Signature: Vidwell
3 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101- - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in investment
activities in Iran. The state's chief procurement officer, as required by T.C.A. 12-
12-106, has created a list of persons who engage in investment activities in Iran.
Any person who is on the list is ineligible to contract with any political subdivision
of the State of Tennessee, and any such contract will be considered void under
T.C.A. 12-12-110. The list is published on the Tennessee Department of General
Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/ibary/cpo
-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of any
bidder certifies, and in the case of a joint bid each party thereto certifies as to its
own organization, under penalty of perjury, that to the best of its knowledge and
belief that each bidder is not on the list created pursuant to T.C.A 12-12-106.
Bidder Name: ARthuR Tiowell
Bidder Signature: acttors
Date: 5/5/26
2 I Page
Arts
Specifications Part B
Painting at Schools
Scope:
Proper prep, sand, and glaze any peeling paint to avoid it being visible to the final finish.
Ensure proper manufacturer-prepped surface for good adhesion.
Avoid peeling or chipping paint.
Application is to be brushed or rolled on for a smooth, clean finish.
All specs apply to interior and exterior projects.
Painting specs will be applied to latex, urethane, or epoxy finishes, where the
manufacturer requirement is to include primer and paint applications.
Metal doors and frames (both sides) 4x7
$ 250
Frames only (per opening) 4x7
$ 75
Dumpster doors (both sides with poles trim)
$ 250
Miscellaneous Trim (priced per linear foot)
$ 2.50
CMU walls: Exterior scrape, scuff, prime, and paint
$ 2.75
SF
CMU walls: Interior scrape, scuff, prime, and paint
$ 1.75
SF
Handrails: To include top, mid, and bottom rails. Prep/paint
$ 6
linear ft
Single Rails: To include one railing continuous, and brackets, posts $ 4
linear ft
Picketed fencing or hand railing continuous, brackets, posts$ $ 8
linear foot
EFIS/CORNICE: Both metal/Cladding Board Stucco (paint) $ 2.50
square foot
Cost plus for materials
25
markup %/equipment/lift rental and paint.
Minimum per job to mobilize $ 200
ALTERNATE 2
Straight-out the pricing of painters by the hour to sand, prep, and paint anything requested by
the schools and furnish materials listed by the painters prior to the job start.
Painters by the hour $ 30 per PAINTERS
Materials plus markup % 25
for any items limited to rollers, brushes, paint, primer,
etc.
NOTE: This bid does not allow add-on charges for standard "tools of trade" such as trucks,
drop cloths, and ladders, which are considered part of the standard tools of the trade that
most businesses already possess.
1 I Page
CASEY DORTON, HICKMAN COUNTY CLERK
LICENSE
0414309
MINIMAL ACTIVITY BUSINESS TAX LICENSE
Total Due: 15.00
Cash: 20.00 Check: Check No.: Change: 5.00
KARLIE wk03 Drawer: 3 Site: 1
Work Date: 05/05/2026
DETACH THIS PORTION FOR CONFIDENTIAL FILE
CASEY DORTON
HICKMAN COUNTY CLERK
LICENSE
114 N. CENTRAL AVE, SUITE 202
CENTERVILLE, TN 37033
0414309
MINIMAL ACTIVITY BUSINESS TAX LICENSE
Mailing
Location
5331 ART'S HOUSE PAINTING
ART'S HOUSE PAINTING
2810
2810 COUNTRY CLUB DR
COUNTRY CLUB DR
CENTERVILLE, TN 37033
CENTERVILLE, TN 37033
TONYA TIDWELL
LOCAL ACCOUNT NUMBER
5331
ISSUE DATE
05/05/26
TAX PERIOD
STARTED - 05/05/2026
STATE ACCOUNT NUMBER
1001946589
TRANSACTION NUMBER
EXPIRATION DATE
5/15/2027
CLASS
03
SALES TAX NUMBER
Drawer:3 Site:1
-- POST AT LOCATION OF BUSINESS - --
IF BUSINESS CLOSES, MOVES, OR CHANGES OWNERS, NOTIFY THIS OFFICE
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
05/06/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY
AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and
conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT
NAME: Daryl Foster
Daryl Foster(662739L)
PHONE
FAX
1585 Mallory Ln Ste 207
(A/C, NO, EXT): 615-373-9919
(A/C, NO): 615-750-5076
E-MAIL
ADDRESS: ffoster@farmersagent.com
Brentwood
TN 37027-3035
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Truck Insurance Exchange
21709
INSURED
INSURER B: Farmers Insurance Exchange
21652
ARTHUR TIDWELL
INSURER C: Mid Century Insurance Company
21687
dba: ART'S HOUSE PAINTING
INSURER D: CNA/National Fire Insurance Company
20478
2810 COUNTRY CLUB DR
INSURER E:
CENTERVILLE
TN 37033
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY
REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE
POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDTL
SUBR
POLICY EFF
POLICY EXP
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
LTR
INSD
WVD
(MM/DD/YYYY)
(MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
$
PREMISES (Ea Occurrence)
100,000
MED EXP (Any one person)
$
5,000
C
607236057
05/04/2026
05/04/2027
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY
PROJECT
LOC
PRODUCTS- COMP/OP AGG
$ 2,000,000
OTHER:
$
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY
$
(Ea accident)
ANY AUTO
BODILY INJURY (Per person)
$
OWNED AUTOS
SCHEDULED
BODILY INJURY (Per accident)
$
ONLY
AUTOS
HIRED AUTOS
NON-OWNED
PROPERTY DAMAGE
$
ONLY
AUTOS ONLY
(Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED
RETENTION $
$
WORKERS COMPENSATION
PER
OTHER
$
AND EMPLOYERS' LIABILITY
STATUTE
ANY PROPRIETOR/PARTNER/
Y/N
E.L. EACH ACCIDENT
$ 500,000
EXECUTIVE OFFICER/MEMBER
N/A
8035891913
05/04/2026
05/04/2026
D
Y
E.L. DISEASE- EA EMPLOYEE
to
500,000
EXCLUDED? (Mandatory in NH)
If yes, describe under DESCRIPTION OF
E.L. DISEASE- POLICY LIMIT
$
500,000
OPERATIONS below
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
2810 COUNTRY CLUB DR, CENTERVILLE, TN 37033
CERTIFICATE HOLDER
CANCELLATION
Arthur Tidwell
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
dba: Art's House Painting
DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
2810 Country Club Dr
AUTHORIZED REPRESENTATIVE
Centerville, TN 37033
7 Dayl Forter
ACORD 25 (2016/03)
©1988-2015 ACORD CORPORATION. All Rights Reserved
31-1769 11-15
The ACORD name and logo are registered marks of ACORD
MEMPHIS AND SHELBY COUNTY
o
C
Shelby County Clerk
BUSINESS TAX LICENSE
WANDA HALBERT
RECEIPT NUMBER
251010115
150 Washington Avenue
Memphis, Tennessee 38103-1800
LICENSE NUMBER
220002398
THIS LICENSE EXPIRES
05/15/2026
CLASSIFICATION
3
OWNER(S)
OFFERPORCH HOMES LLC
OFFERPORCH
BUSINESS LOCATION ADDRESS
676 CLINTON PL
676 CLINTON PL
MEMPHIS, TN 38126
MEMPHIS, TN 38126
MUST DISPLAY IN A CONSPICUOUS
PLACE
ACORD®
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
01/29/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
CONTACT
PRODUCER
NAME:
Next First Insurance Agency, Inc.
PHONE
FAX
(A/C, No. Ext):
(855) 222-5919
(A/C, No):
PO Box 60787
E-MAIL
Palo Alto, CA 94306
ADDRESS:
support@nextinsurance.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Next Insurance US Company
16285
INSURED
INSURER B :
OfferPorch Homes LLC
INSURER C:
254 Court Ave Ste 310
Memphis, TN 38103
INSURER D:
INSURER E:
INSURER F :
COVERAGES
CERTIFICATE NUMBER: 942197985
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
(MM/DD/YYYY)
(MM/DD/YYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000.00
DAMAGE TO RENTED
CLAIMS-MADE
OCCUR
PREMISES (Ea occurrence)
$100,000.00
MED EXP (Any one person)
$10,000.00
A
NXTWH9LFKH-02-GL
01/29/2026
01/29/2027
PERSONAL & ADV INJURY
$ 1,000,000.00
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$1,000,000.00
PRO-
POLICY
LOC
PRODUCTS - COMP/OP AGG
$1,000,000.00
JECT
$
OTHER:
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY
$
(Ea accident)
ANY AUTO
BODILY INJURY (Per person)
$
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY
AUTOS
HIRED
NON-OWNED
PROPERTY DAMAGE
$
AUTOS ONLY
AUTOS ONLY
(Per accident)
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED
RETENTION $
$
PER
OTH-
WORKERS COMPENSATION
STATUTE
ER
AND EMPLOYERS' LIABILITY
Y/N
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
OFFICER/MEMBEREXCLUDED?
N/A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Proof of Insurance.
CERTIFICATE HOLDER
CANCELLATION
OfferPorch Homes LLC
LIVE CERTIFICATE
254 Court Ave Ste 310
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Memphis, TN 38103
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ann Ryan
Click or scan to view
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
OF
THE
SEAL
STATEOF
STATE
Bureau of Workers' Compensation
OF
Exemption Registry
GREAT THE AGRICULTURE COMMERCE )
State of Tennessee
220 French Landing Drive Suite 1-B
1796
Nashville TN, 37243-1002
CURTDELL GILES Jr.
254 Court Ave., Suite 310, Curtdell Giles Jr.
Memphis TN 38103
7/16/2025
Initial Workers' Compensation Exemption Registration Acknowledgment
Please review the filing information below and notify our office immediately of any discrepancies.
Reg. Control #:
2025000014351
Date Filed: 7/16/2025
Effective Date: 7/16/2025
Application Name:
CURTDELL GILES Jr.
Expiration Date: 7/16/2027
Filing Type:
Initial Workers' Compensation Exemption
Status:
Active
Physical Addr:
254 Court Ave., Suite 310, Curtdell Giles Jr., Memphis TN 38103
Business Name:
OfferPorch Homes LLC
Business Control #:
001133856
Existing State License: Yes
77366
Business County:
Not Required
County License #:
220002398
Expiration Date:
5/15/2025
Business City:
Not Required
City License #:
220002398
Expiration Date:
5/15/2025
Document Receipt
FIS - Online Payment Portal -
$50.00
FIS - Online Payment Portal - 08144C
$50.00
Congratulations on your filing. To maintain your exemption, the business entity associated with this registration must remain active
and in good standing, which includes timely filing of annual reports. In addition, you must file a renewal application within 60 days
of the expiration date noted above to maintain the exemption.
THE
SEAL
STATE OF TENNESSEE
GREAT
AGRICULTURE
F)
Claudia Byers
220 French Landing Drive Suite 1-B
*7796*
Nashville TN, 37243-1002
Workers' Compensation Exemption Registration
CURTDELL GILES Jr.
Effective: 7/16/2025
Expires: 7/16/2027
Claudia Byers
Registration Control #
2025000014351
Bureau of Workers' Compensation
Validate at https://www.tn.gov/workforce/injuries-at-
Exemption Registry
work/employers/employers/we-exemption-registry.html
Tennessee Bureau of Workers' Compensation * 220 French Landing Drive Suite 1-B Nashville, TN 37243
Tel: (615) 532-1319 * ttps://www.tn.gov/workforce/injuries-at-work/employers/employers/wo-exemption-registry.hml
OfferDorch
Specifications Part B
Painting at Schools
Scope:
Proper prep, sand, and glaze any peeling paint to avoid it being visible to the final
finish.
Ensure proper manufacturer-prepped surface for good adhesion.
Avoid peeling or chipping paint.
Application is to be brushed or rolled on for a smooth, clean finish.
All specs apply to interior and exterior projects.
Painting specs will be applied to latex, urethane, or epoxy finishes, where the
manufacturer requirement is to include primer and paint applications.
Metal doors and frames (both sides) 4x7
$ 96.37
Frames only (per opening) 4x7
$ 73,50
Dumpster doors (both sides with poles trim)
$ 289.11
Miscellaneous Trim (priced per linear foot)
$ 2.04
CMU walls: Exterior scrape, scuff, prime, and paint
$ .62
SF
CMU walls: Interior scrape, scuff, prime, and paint
$ .62
SF
Handrails: To include top, mid, and bottom rails. Prep/paint
$ 6.13
linear ft
Single Rails: To include one railing continuous, and brackets, posts $ 2.04
linear ft
Picketed fencing or hand railing continuous, brackets, posts
$ 4.08
linear foot
EFIS/CORNICE: Both metal/Cladding Board Stucco (paint)
$ .62
square foot
Cost plus for materials .25
markup %/equipment/lift rental and paint.
Minimum per job to mobilize $ 390.00
ALTERNATE 2
Straight-out the pricing of painters by the hour to sand, prep, and paint anything requested
by the schools and furnish materials listed by the painters prior to the job start.
Painters by the hour $ 61.25
Materials plus markup %
.25
for any items limited to rollers, brushes, paint,
primer, etc.
NOTE: This bid does not allow add-on charges for standard "tools of trade" such as
trucks, drop cloths, and ladders, which are considered part of the standard tools of
the trade that most businesses already possess.
1 I Page
Hickman County Government
Conflict of Interest Disclosure Form
The County Financial Management System of 1981 contains the most stringent conflict of
interest provisions. TCA $5-21-121 provides:
(a) The director, purchasing agent, members of the committee, members of the county
legislative body or other officials, employees, or members of the board of education
or highway commission shall not be financially interested or have any personal
beneficial interest, either directly or indirectly, in the purchase of any supplies,
materials, equipment or contractual services for the county.
(b) No firm, corporation, partnership, association or individual furnishing any such
supplies, materials, equipment or contractual services, shall give or offer, nor shall
the director or purchasing agent or any assistant or employee accept or receive
directly or indirectly from any person, firm, corporation, partnership or association
to whom any contract may be awarded, by rebate, gift or other otherwise, any
money or other things of value whatsoever, or any promise, obligation or contract for
future reward or compensation.
Date: 05/11/2026 Name:
Curtdell Giles Jr.
Please describe below any relationships, transactions, positions you hold (volunteer or
otherwise), or circumstances that you believe could contribute to a conflict of interest:
I have no conflict of interest to report.
I have the following conflict of interest to report (please specify any boards or
committees you (and/or your spouse) sit on, the name of your employer and any
businesses you or your spouse may own.
I hereby certify that the information set forth above is true and complete to the best of my
knowledge.
Date: 05/11/2026 Signature:
3 I Page
IRAN DIVESTMENT ACT CERTIFICATION
I understand that under the Iran Divestment Act, T.C.A. 12-12-101 - 12-12-113,
political subdivisions in Tennessee are prohibited from entering into any
procurement or contract over $1,000 with a person who engages in
investment activities in Iran. The state's chief procurement officer, as required
by T.C.A. 12-12-106, has created a list of persons who engage in investment
activities in Iran. Any person who is on the list is ineligible to contract with any
political subdivision of the State of Tennessee, and any such contract will be
considered void under T.C.A. 12-12-110. The list is published on the
Tennessee Department of General Services' website at:
https://www.tn.gov/content/dam/tn/generalservices/documents/cpo/library/0
po-library/public-information-
library/List of persons pursuant to Tenn. Code Ann. 12-12-
106 Iran Divestment Act updated with NY06-07-23.pdf
CERTIFICATION
By submission of this bid, each bidder and each person signing on behalf of
any bidder certifies, and in the case of a joint bid each party thereto certifies
as to its own organization, under penalty of perjury, that to the best of its
knowledge and belief that each bidder is not on the list created pursuant to
T.C.A 12-12-106.
Bidder Name:
Curtdell Giles Jr.
Bidder Signature:
Date:
05/11/2026
2 I Page
State of Tennessee
Non-Boycott of Israel Certification
The Bidder certifies that it is not currently engaged in and will not for the duration of the
contract engage in a boycott of Israel as defined by Tenn. Code § 12-4-119. This provision
shall not apply to contracts with a total value of less than two hundred fifty thousand
dollars ($250,000) or to contractors with less than ten (10) employees.
According to the law, a boycott of Israel means engaging in refusals to deal, terminating
business activities, or other commercial actions that are intended to limit commercial
relations with Israel, or companies doing business in or with Israel or authorized by,
licensed by, or organized under the laws of the State of Israel to do business, or persons or
entities doing business in Israel, when such actions are taken:
1. In compliance with, or adherence to, calls for a boycott of Israel, or
2. In a manner that discriminates on the basis of nationality, national origin, religion, or
other unreasonable basis, and is not based on a valid business reason. Tenn. Code
$ 12-4-119
Signature:
Print:
Curtdell Giles Jr.
Date:
05/11/2026
Phone/Email:
901-472-4006 / curtdellgiles@offerporch.com
4 I Page
Background Check Acknowledgement Form
Contractor is required to meet al TCA 49-5-406, local, state, and federal laws
regarding "workers on school properties." The Hickman County Board of
Education further requires that no prior felons, drug offenders, or sexual
registered offenders work on any school properties.
Contractors will be required to wear contractor provided identification when
on school premises. The contractor may be asked to provide proof of
background check.
Signature: Carldell A
Print:
Curtdell Giles Jr.
Title:
Owner
Date:
05/11/2026
5 I Page
Proposed
School Board Meeting Dates
2026-2027
July 6, 2026
August 3, 2026
September 14, 2026
October 19, 2026
November 2, 2026
December 7, 2026
January 11, 2027
February 1, 2027
March 1, 2027
April 12, 2027
May 3, 2027 - @ HCHS Library - Awards
June 7, 2027
Hickman County Board of Education
Annual Agenda 2026-2027
July 2026
Board Meeting
Board Policy Review
Approval of School Fees
Student Discipline Hearing Authority
Designation
Bullying and Harassment Report to Board
Strategic Plan and Goals
Personnel Decisions and Placement 26-27
August 2026
Board Meeting
Board Policy Review
September 2026
Board Meeting
Board Policy Review
Election of Officers of the Board
October 2026
Board Meeting
Board Policy Review
Compliance Report
Textbook Certification
Approval of School Calendar
November 2026
Board Meeting
Board Policy Review
Approval of Supplement Splitting
December 2026
Board Meeting
Board Policy Review
January 2027
Board Meeting
Board Policy Review
Set Date(s) for Board Retreat
February 2027
Board Meeting
Board Policy Review
FY28 Budget Discussion
FY28 Budget Calendar
March 2027
Board Meeting
Board Policy Review
FY28 Budget Discussion
Set Attendance Zones
April 2027
Board Meeting
Board Policy Review
FY28 Budget Discussion
Textbook Adoption Approval
May 2027
Board Meeting
Board Policy Review
FY28 Budget (141, 142, 143)
Recognize Teachers of the Year
Authorize Superintendent to Submit Grants,
Applications, Reports, Amendments, and
Addenda
June 2027
Board Meeting
Board Policy Review
Personnel Decisions and Placement 27-28
Annual Agenda
Grant Executive Committee authority to close
Adopt Board Meeting Schedule 2027-2028
out fiscal year
Recognize Employee of the Year and Friend
Annual Budget FY28 (if needed)
of Education
Teacher Tenure
May 27,2026
To Mrs. Marcy Tidwell and Hickman Co. Board Members,
I am requesting that you consider Dusty Covington and Tammy Potts for a job share position for
the 2026-2027 school year at Centerville Intermediate School. Mrs. Covington and Mrs. Potts
were each granted a 100 day contract previously at CIS.
Mrs. Covington is currently and has served as the Academic Facilitator for CIS for six years and
served our school system for the last 17 years in teacher capacities.
Mrs. Potts retired December 2022 after working in Hickman and Rutherford County Schools.
Mrs. Potts returned to her hometown and began working to fulfill the RTI needs at CIS. Mrs.
Potts stepped up and took an active role while Mrs. Covington was out for a necessary medical
leave. She shared the Academic Facilitator role this current year.
They have a reputation of high quality instructional strategies, effective communication with
parents, students, and staff, and proven data showing these strengths. They will be a great
asset to CIS for the upcoming school year.
Thank you for your time and consideration.
Sincerely,
Rose Korte Stites
May 27, 2026
To whom it may concern:
We are requesting a job share position for the 2026-2027 school year. The purpose of
requesting a job share position is to continue to provide intervention for our students and
provide teacher support at CIS. This job share opportunity will allow us to fulfill our family
obligations at home (grandchildren and elderly parents) and continue to provide our knowledge
of teaching to students and faculty. We currently work successfully together in this position.
We understand that according to Board Policy 5.1051:Job Sharing Guidelines, that this position
is based on yearly approval by the board.
We appreciate your consideration in approving our 2026-2027 school year job share. Please
find attached information detailing job duties and responsibilities for the next school year.
Sincerely,
Dusty Covington
Tammy Potts
JammyB Patts
2026-2027 Job Share Plan:
Mrs. Covington will work Monday and Wednesday.
Mrs. Potts will work Tuesday and Thursday.
Fridays will be alternated.
If approved, teachers will provide a detailed calendar for the 2026-2027 school year.
Both teachers will attend inservice for the first full week, during the school year,
professional development as necessary, and other required school activities.
One teacher will fill in for the other teacher should the need arise as much as possible
(rather than getting a substitute).
Teachers will communicate effectively through notes, emails, or any necessary means to
ensure that student and teacher needs are met.
Duties:
Both teachers will work together to oversee RTI placement, schedules, fidelity checks,
and implementation.
Both will have a focus centered on helping teachers and students close the early
learning gaps. Modeling when necessary.
Both will have a curriculum/planning/data approach with teachers. Modeling when
necessary.
Both teachers will provide RTI instruction as needed.
Both teachers will be available for testing purposes.
Both teachers will assist administrators as needs arise.
Positives To Consider:
Both teachers requesting job shares have had Level 5 effectiveness in the past.
Teachers have almost 40+ years of combined experience working with students in
grades Pre-K-5.
Teachers successfully worked together as a team previously.
Mrs. Potts is a retired teacher and through job share opportunities, she is able to
continue to help students and teachers and not exceed her 120 days. This allows her to
maintain her retirement status.
In the event of unforeseen circumstances, the role does not suffer. For example, when
Mrs. Covington was forced to take a medical leave in the past, Mrs. Potts was able to
fulfill her duties.
The school system saves money due to teachers not receiving benefits.
In studies done in the United States, all administrators surveyed agreed that job sharing
had not diminished the quality of education (Garman, 1988). Similarly, seventy-five
percent of parents in another study felt that the quality of their children's education had
either improved or stayed the same in job sharing classrooms.
It is educationally valuable for students to be exposed to different styles and energies.
They benefit from the variety and enjoy the enthusiasm of two different educators.
Centerville Intermediate School
110 Mary Field Avenue
Centerville, TN 37033
Phone 931-729-2748
Fax 931-729-5497
Principal, Rose Korte Stites
Assistant Principal, Tarrah Lawson
May 27, 2026
To Mrs. Marcy Tidwell and Hickman County Board Members,
I am requesting that you consider Ashley Rochelle and Meredith Qualls for a job share
position for the 2026-2027 school year at Centerville Intermediate School. The request
for this position has been granted previously for these teachers at Centerville
Elementary School. Mrs. Rochelle and Mrs. Qualls have a reputation of strong
classroom management, high-quality instructional strategies, and effective
communication with parents, students, and staff. They would be an asset to Centerville
Intermediate.
Thank you for your time and consideration.
Sincerely,
May 27, 2026
To whom it may concern:
We are requesting a job share position for the 2026-2027 school year. The purpose
of requesting a job share position is to be able to better care for our young families
while continuing to serve as educators. We held a job share position for
2016-2017, 2017-2018, 2018-2019, 2019-2020, 2020-2021, 2021-2022,
2022-2023, 2023-2024, 2024-2025 and 2025-2026 school years, but we understand
that according to Board Policy 5.1051: Job Sharing Guidelines, that this position is
based on year to year approval by the board. The following attachment includes
our plan and other important information regarding job sharing.
Thanks for your consideration on this matter.
Sincerely,
Ashley Rochelle
Ashley Rochelle
Meredith Qualls
The Job-Share Plan for 2026-2027
-Ashley will work every Monday and Wednesday.
-Meredith will work every Tuesday and Thursday.
-Ashley and Meredith will alternate each Friday.
-Both teachers will be responsible for teaching assigned subject areas on their designated
day.
-Both teachers will be present for Inservice.
-One teacher will fill in for the other teacher should the need arise as much as possible.
-Teachers will keep a communication log. The log will be used daily to keep each other
informed and record pertinent information such as attendance, student behavior, notes
from parents, and school news.
-If approved, teachers will provide a detailed calendar for the 2026-2027 school year.
Positives to Consider
-Both teachers requesting to job share have had a Level 5 in overall effectiveness in the
past.
-Teachers have taught together for over 8 years and have very similar classroom
management and teaching styles.
-Teachers successfully job shared for the 2016-2017, 2017-2018, and 2018-2019,
2019-2020, 2020-2021, 2021-2022, 2022-2023, 2023-2024, 2024-2025 and 2025-2026
school years.
-Students benefit from a variety of teaching styles and two fresh, energized educators.
-Quality of teaching may be improved due to a "two heads are better than one" problem
solving approach.
-School system saves money due to teachers not receiving benefits.
-Job sharing is a practice in many surrounding counties, in grades that include even as
young as kindergarten. Our school system has had a successful job sharing experiences
in the past.
-By being exposed to the styles of two teachers, children learn to work with different
people and personalities. The ability to work with others is a valuable lifelong skill that
all people need throughout their time in school and later in the workforce.
-Children who have behavior problems get a fresh start every day. Negative feelings are
less likely to carry over to the next morning.
-In studies done in the United States, all administrators surveyed agreed that job sharing
had not diminished the quality of education (Garman, 1988). Similarly, seventy-five
percent of parents in another study felt that the quality of their children's education had
either improved or stayed the same in job sharing classrooms.
-Consider this analogy: Children have two parents. They love both of them for different
reasons and are comfortable with them. The two parents are different from each other
and will react differently to similar situations. Children can understand this. When
children have two teachers, it is not unlike having two parents. The two teachers are
individuals who are appreciated for different reasons. Their expectations are alike; their
personalities are different. It is not difficult for a child to accept the two people and to
learn from each of them.
-It is educationally valuable for students to be exposed to different styles and energies.
They benefit from the variety and enjoy the enthusiasm of two different educators.
Parent Survey
-An anonymous parent input survey was sent home in February 2017 in regard to the
2016-1017 job share experience Parents were asked to rate the job-share experience
based on seven categories: overall communication, teacher accessibility, academic
growth, meeting students' individual needs, classroom environment, overall student
happiness, and discipline. This survey was based on a scale of 1 to 4 (1 being low, 4
being high). Out of the surveys returned, every one of the 7 categories had an average of
4.
Parent Quotes from the survey:
"It's been a great year!"
"It has been great. There has been wonderful support from both teachers, and we greatly
appreciate it."
"This year was the first year with a co-teacher classroom. I thought it was great. My
daughter really enjoyed the co-teacher experience."
"I really believe that having co-teachers is great."
"This experience has been really good. The students seem very happy as do the
teachers."
Other Quotes Concerning Job-Sharing
"The year I job shared was the best year ever. It can be great for kids if it is the right
team. In Sumner County at my school right now there are two job shares. One is
extremely dynamic in Kindergarten, and the other is a 5th grade team." - Tressa Sanders
(Former employee and job share position holder of Hickman County Schools)
"When my daughter was in kindergarten at Gower Elementary in Nashville she had
teachers that job shared. One teacher worked Mon, Tues and every other Wed and the
other worked Thurs, Fri and every other Wed. If one of them needed a day off for
personal reasons or sick kids the other took her spot so they never needed a sub! This
was a great experience for us. Our daughter loved both teachers and the different qualities
they brought. The kids got so many different ways of learning between the two of
them!"- Sarah Price (Parent of a child in a job share classroom)
Resolution 26-02
Assignment Authority
GASB 54
BE IT RESOLVED by the Board of Education of Hickman County, Tennessee,
assembled in regular session this 1st day of June, 2026, that the Director of Schools
shall have the authority to establish the amounts of funds that will be ASSIGNED for
specific purposes for the fiscal year ended June 30, 2026.
Upon approval, this resolution will be place in the minutes of the Board of Education.
The resolution must be passed each fiscal year.
Action:
Aye
Nay
Absent
Adopted:
Attest:
Closing out 2025-2026 Financial Books
The Executive Committee, with guidance from our State Financial Consultant, Business
Officer, Finance Office Director and Assistant Director, will close out the financial books,
including budget amendments. All members will be provided with a report at the next
board meeting.
Motion will be needed to grant the Executive Committee such authority.
Hickman County Schools
Proposed Differentiated Pay Plan
FY 2026-2027
Hard to Staff (School, Subject, or Placement)
Description
The district will offer a signing bonus for hard to fill positions. For the 2026-2027 school year. The
offering and amounts of signing bonus will be at the discretion of the Director of Schools.
Eligibility Criteria
The district may offer a signing bonus for hard to fill positions. For the 2026-2027 school year, signing
bonuses may be offered in the following areas: K-12 Special Education and special education
comprehensive classes, Secondary Math, Secondary Science, K-12 School Counselors, K-12 Principals,
and Secondary Foreign Language teachers. The signing bonus is for newly hired employees. The
offering and amounts of signing bonus will be at the discretion of the Director of Schools but not to
exceed $4,000 per individual
Compensation Type and Size
Compensation Type: Bonus
Bonus Type: Signing/Recruitment
Compensation Amount: The compensation will be given as a bonus. It will be paid as follows: one half on
or about 31 December 2026 and one half on or about May 31, 2026. Amounts are negotiable from
$1,000 to $4,000.
Estimated Cost $36,000
Instructional Roles or Responsibilities
Description
After School Tutors
Number of Unique Roles: 8
Eligibility Criteria
Level of Overall Effectiveness
Certified in Content/Grade Area
Compensation Type and Size
Mentors: Hourly $37.50 per hour
Estimated Cost $20,400
Performance
Description
The District will award a performance bonus for all teachers who receive an overall effectiveness score of
a 4 or 5 from the 2025-2026 school year based on the LOE scores calculated in TNCompass.
Eligibility Criteria Eligible Teachers: Teacher
Eligibility Criteria: Level of overall effectiveness (LOE)
The District will award a performance bonus for all teachers who receive an overall effectiveness score of
a 4 or 5 from the 2025-2026 school year based on the LOE scores calculated in TNCompass.
Compensation will be given as a bonus on or about 1 December
Compensation Type and Size
Compensation Type: Bonus
Bonus Type: Performance - LOE
Compensation Amount:
The District will award a performance bonus for all teachers who receive an overall effectiveness score of
a 4 or 5 from the 2025-2026 school year based on the LOE scores calculated in TNCompass.
Compensation may be given as a bonus on or about 1 December 2026 with $200,000.00 being divided
per share for the number of teachers qualifying; (level 4 teachers will receive 1 share of the allocation
with a maximum amount of $1,000.00: level 5 teachers will receive 2 shares of the allocation with a
maximum amount of $2,000.00). Reach 185.
Estimated Cost $200,000
Education
The District will continue to pay for education training in five lanes: Bachelors, Masters, Masters +30/45,
Ed.S and Doctorate. (See attached salary schedule.)
Other
High School & Middle School Bookkeepers (4) X $5,000
Estimated Cost: $20,000
Tennessee School Systems for Equity
Wayne Qualls, Executive Director Emeritus
Marlon Davis, Executive Director
2026 - 2027 Membership Dues Invoice
Hichmen Co.
Board of Education
Dues Structure
ADM Used is 6th Month of Current FY AS Reported To TDOE By LEA
$1.50 Per Student Up To First 1500 ADM
$0.75 Per Student Up To Next 3000 ADM
Calculation Capped At 4500 ADM
2832
6th Month FY 2025-2026 ADM
I. $1.50
1500
= $ 2,250.00
ADM Up To First 1500 Students
II. $0.75
1332
= $
999.00
ADM Up To Next 3000 Students
(Capped at 4500 ADM by TSSE Board)
III. Total Amount of Dues for 2026-2027 (I+II) = $ 3,249.00
Please Remit To: TSSE
2880 Dodd Hollow Road
Centerville, TN 37033
Resolution No. 26-03
Guidelines to Govern the Hickman County Board of Education's GASB 45 Trust
WHEREAS, A contract with the Hickman County Education Association (HCEA) established a
medical insurance premium payments for retired teachers; and
WHEREAS, The Hickman County Board of Education entered into an agreement with the
Tennessee School Boards Association's GASB 45 Trust ("the Trust" or "Trust") to fund such a
program; and
WHEREAS, The contract with the HCEA expired on June 30, 2014; and
WHEREAS, The Hickman County Board of Education adopted Resolution 16-01 in order to
establish new rules and regulations to govern participation and expenditures relative to the Trust
and its recipients; and
WHEREAS, The Hickman County Board of Education adopted Resolution 19-02 in order to
establish new rules and regulations to govern participation and expenditures relative to the Trust
and its recipients; and
WHEREAS, The Hickman County Board of Education now desires to establish new rules and
regulations to govern participation and expenditures relative to the Trust and its recipients from
henceforth;
NOW, THEREFORE, BE IT RESOLVED by the Board of Education in Hickman County,
Tennessee, assembled in regular session this 1st day of June 2026 that:
Section 1: The Trust is applicable (i.e., open to participation) to full time employees according to
the guidelines set forth herein, who meet the following criteria:
A. Licensed employees who were hired on or before June 30, 2015, or;
B. Licensed employees who were employed by the Hickman County School System during
the time the Trust has been in effect from its inception through June 30, 2015, and who
left the Hickman County School System and then became re-employed by the Hickman
County School System on or after July 1, 2015, or;
C. All other support staff, employed on or before June 30, 2015 and employed as of May
22, 2026.
Section 2: To be eligible to participate in receiving funds from the Trust, an employee must
meet all of the requirements of this Resolution, must meet State of Tennessee requirements to
enroll in the State of Tennessee retiree plan, and must complete state and local forms at the
time of filing for retirement, which must be no later than the date of the last payroll payment for
the school year in which the employee is retiring.
Section 3: For those not eligible for Medicare at the time of retirement, the Board will contribute
the following from the time of retirement until the retiree becomes eligible for Medicare or for a
maximum of six (6) years, whichever comes first. However, if a retiring teacher has provided 35
or more years of continuous service in the Hickman County School System, premiums will be
paid for a maximum of ten (10) years or until retiree becomes eligible for Medicare, whichever
comes first, according to the following schedule:
A.
30 or more years of service in Hickman County Schools
1.
55% of a single policy premium
2.
30% of a family policy premium
B.
20-29 years of service in Hickman County Schools
1.
45% of a single family policy premium
2.
25% of a family policy premium
C.
10-19 years of service in Hickman County Schools
1.
35% of a single policy premium
2.
15% of a family policy premium
D.
Support Staff benefit amount will be equal to the dollar amount provided for licensed
staff.
Section 4: Retirees who meet the following conditions shall be eligible for reimbursement for
Medicare supplement insurance in accordance with the schedule set below:
A. Must meet State of Tennessee requirements to enroll in the State of Tennessee plan for
Medicare supplement insurance:
B. Are eligible for Medicare at the time of retirement; or
C. Become eligible for Medicare after participating in Section 3, above;
D. Medicare supplement payments shall be paid as a reimbursement, one time per year, in
the month of December, according to the following rate schedule:
(i) Licensed Retirees with 30 or more years of service in the Hickman County
Schools shall receive a local contribution, which when combined with the State of
Tennessee contribution, shall equal 100% of premium cost.
(a) Support Staff benefit amount will be equal to the local contribution
dollar amount provided for licensed staff.
(ii) Retirees with 20-29 years of service in the Hickman County Schools shall
receive a local contribution, which shall equal 35% of premium cost.
(iii) Retirees with 10-19 years of service in the Hickman County Schools shall
receive a local contribution, which shall equal 25% of premium cost.
(iv) Support Staff benefit amount will be equal to the dollar amount provided for
licensed staff.
Section 5: Upon exhaustion of funds in the Trust, membership in the Trust is abolished. If
sufficient funds are not available to make a complete payment during any fiscal year to eligible
retirees participating in the Trust, the remaining Trust funds are to be prorated and each
participant will receive an equal share, with the exception if there is an odd amount, the last
eligible participant, arranged alphabetically, will receive an odd amount to zero the Trust account
out.
Section 6: The Board hereby ratifies and approves all Medicare supplement payments which
have been made to any retirees since the expiration of the Agreement between the Board of
Education and the Hickman County Education Association, subject to approval by the State of
Tennessee and applicable rules and regulations.
Adopted, this 1st day of June 2026.
Action:
Aye
Nay
Pass
Absent
Aye:
Absent:
Adopted:
Attest:
COUNTY SCHOOLS
1807
Misty Shelton
VPK Supervisor/Licensure Coordinator/Board Policies
Hickman County Schools
115 Murphree Avenue
Centerville, Tennessee 37033
To: School Board Members
From: Misty Shelton
Date: June 2026
Up for Review:
3.200 Buildings and Grounds Management
3.201 Safety
3.202 Emergency Preparedness Plan
3.203 Crisis Management
3.204 Risk Management and Threat Assessment Team
3.205 Security
3.206 Community Use of Facilities
3.208 Facilities Planning
3.211 New Project Planning
3.212 District Water Testing
Thank you for your careful consideration of these policies.
931-729-3391 ext. 2226
misty.shelton@hickmank12.org
fax 931-729-3834
The Hickman County School System does not discriminate in its educational programs, activities, or employment practices on the basis of race, sex, national
origin, religion, creed, age, marital status, or disability as required by Title VI of the Civil Rights Acts of 1964, Title IX of the Educational Amendments of 1972, and
Section 504 of the Rehabilitation Act of 1973. All necessary accommodations are made for equitable participation by constituents without regard to race, gender,
disability, economic status, or special needs as required by Section 427 of the General Education Provision Act & P.L. 107-110-NO CHILD LEFT BEHIND.
Hickman County Board of Education
Descriptor Term:
Descriptor Code:
Issued Date:
3.200
03/07/22
Building and Grounds Management
Rescinds:
Issued:
3.200
12/02/19
1
All school properties shall be maintained in good physical condition: safe, clean, sanitary, and as
2
comfortable and convenient as the facilities will permit or the use requires.
3
The director of schools will develop and implement a continuing program of maintenance of all
4
district-owned buildings and grounds which shall provide for the following:
5
1. Adequate custodial programs for all schools;
6
7
2. Improvement and maintenance of school buildings and grounds;
8
9
3. Repairs, including repairs of equipment, and painting; and
10
11
4. Determination of obsolete equipment.
12
The following are responsibilities of building principals:
13
1. To oversee the operation of the school plant and require that personnel assigned to the building
14
keep it in a clean, healthful, and pleasant condition;
15
16
2. To make continuing checks for hazardous conditions, including safety and operation of
17
equipment, and prevention of hazardous situations caused by carelessness; and
18
19
3. To request, on a timely basis, appropriate maintenance and repairs through appropriate channels.
Version Date: March 8, 2022
Hickman County Board of Education
Descriptor Code:
Issued Date:
Descriptor Term:
3.201
03/07/22
Safety
Rescinds:
Issued:
3.201
12/02/19
1
Within board policy, the principal shall develop procedures for keeping school facilities safe and free
2
from hazards. 1
3
All staff members shall report current and potential hazards to their immediate supervisors.
4
Each principal is responsible for seeing that the practice of safety is a part of the instructional program
5
of the school and that it is appropriately geared to students at different grade levels.
6
The program shall include:¹
7
1. Fire prevention
8
2. Accident prevention
9
3. Warning systems
10
4. Emergency drills (Fire, severe weather, earthquake, and bomb threat)
11
5. Emergency closings
12
6. Traffic safety
13
7. Traffic and parking controls
14
8. Safety inspections
15
9. First aid
16
10. A disaster preparedness plan for a nuclear or other major emergency.
17
Only students assigned to the school, the staff of the school, parents of students, and other persons with
18
lawful and valid business on the school premises shall enter onto the grounds or into the buildings of
19
the schools during the hours of student instruction. All staff members shall report all persons
20
appearing to be improperly on school premises to the principal.²
21
The principal shall secure assistance from law enforcement officials when he deems it necessary in
22
order to maintain order or security during the school day or during extracurricular activities at school.
23
In addition, the director of schools or designee shall provide the local law enforcement agency with all
24
safety and security plans. 3
Version Date: March 8, 2022
Safety
3.201
Legal References
Cross References
1.
TCA 49-6-805(7)
Visitors to the School 1.501
2.
TCA 49-6-2008(a), (b)
Emergency Preparedness Plan 3.202
3.
TCA 49-6-804(c); TCA 49-6-805
Care of School Property 6.311
Page 2 of 2
Hickman County Board of Education
Descriptor Term:
Descriptor Code:
Issued Date:
3.202
07/07/25
Emergency Preparedness Plan
Rescinds:
Issued:
3.202
08/04/24
1
The director of schools shall be responsible for developing, maintaining and acquiring Board approval
2
of the district Emergency Preparedness Plan, which shall include procedures for bomb threats, civil
3
disturbances, armed intruders, earthquakes, fires, tornadoes or other severe weather, and medical
4
emergencies.
5
The principal of each school shall develop and implement emergency preparedness drills which shall
6
be approved by the director of schools. When appropriate, such drills shall be held in conjunction with
7
emergency response agencies. These procedures shall be in written form and distributed to all staff,
8
students and parents.
9
FIRE AND SAFETY DRILLS
10
The principal shall ensure that one fire drill requiring full evacuation is given every thirty (30) school
11
days, with no more than two (2) fire drills occurring during the first thirty (30) full days of the school
12
year. Additionally, he/she shall ensure that four (4) fire safety educational announcements are
13
conducted throughout the year.²
14
The principal shall ensure that three (3) additional safety drills are given during the school year. 3 These
15
drills may cover inclement weather, earthquakes, armed intruders, or other emergency drills that do not
16
require full evacuation. A record of all fire or safety drills, including the time and date, shall be kept in
17
each school's office.³
18
The principal/designee shall regularly check the quantity, locations, and conditions of fire
19
extinguishers and shall give all school personnel instructions on how to properly use fire extinguishers.
20
The district shall work with local law enforcement and the local fire department to develop a procedure
21
for identifying the cause of fire alarm activation. This procedure must be in place by January 1, 2025
22
and shall be reviewed and updated annually thereafter.⁴
23
ANNUAL DRILLS⁵
24
The principal shall ensure that the school safety team conducts each of the following type of drills
25
annually:
26
1. An armed intruder drill in coordination with local law enforcement;
27
28
2. An incident command drill; and
29
30
3. An emergency safety bus drill.
Version Date: July 11, 2025
Emergency Preparedness Plan
3.202
1
ARMED INTRUDER DRILLS
2
The director of schools or his/her designee shall ensure that each school safety team conducts at least
3
one (1) armed intruder drill annually in coordination with local law enforcement.⁴
4
AED DRILLS⁶
5
All schools shall conduct a CPR and AED drill to ensure students are aware of the steps that must be
6
taken in the event of a medical emergency. The principal shall be responsible for ensuring the drill
7
occurs.
8
The Director of Schools shall develop the necessary administrative procedures on AED and CPR
9
training, planning, notification, and maintenance to comply with state law.
10
The principal shall regularly check the quantity, locations, and conditions of fire extinguishers and
11
shall give all school personnel instructions on how to properly use fire extinguishers.
12
MEDICAL EMERGENCIES/PANDEMIC FLU⁷
13
In the event of medical emergencies, such as a pandemic flu outbreak, school officials shall cooperate
14
and consult with the local and state health departments and other local emergency or healthcare
15
providers in protecting students and the community from further infection. The director of schools
16
shall develop procedures for health emergencies in accordance with state law and regulations.
17
REMOTE LEARNING DRILLS⁸
18
At least once each school year, a remote learning drill shall be conducted. The drill shall accurately
19
reflect how students will transition to remote learning in the event of a disruption to school operations.
20
Students shall not be asked or required to transition to remote learning at any time during the drill.
Legal References
Cross References
1. TRR/MS 0520-01-02-.30(2); TCA 49-6-804; TCA
Emergency Closings 1.8011
49-6-805(8)
Safety 3.201
2. TCA 68-102-137(b); Public Acts of 2025. Chapter
Community Use of School Facilities 3.206
No. 315
3. TCA 68-102-137(f)
4. TCA 49-6-807(e)
5. TCA 49-6-807
6. TCA 49-2-122; TCA 49-6-1208
7. TCA 49-6-3004(a), (e); TCA 49-5-404
8.
TCA 49-2-139
Page 2 of 2
Hickman County Board of Education
Descriptor Term:
Descriptor Code:
Issued Date:
3.203
03/07/22
Crisis Management
Rescinds:
Issued:
3.203
12/02/19
1
The principal shall develop a Crisis Management plan for use in times of crisis, including suicides, shootings, and
2
death of a student, parent or faculty member. Within the development of such plan, the principal shall appoint a
3
Crisis Team which shall deal with specific situations, make decisions, and disseminate information in the event
4
of a crisis. Members of the Team shall consist of the principal, guidance counselor, and at least two other staff
5
members designated by the principal.
6
The principal of each building shall be responsible for the development of emergency procedures which shall be
7
distributed to building employees, parents, and members of the Crisis Team. Training for all school employees
8
in the crisis management procedures shall be conducted annually during in-service sessions prior to the beginning
9
of school.
10
In the event of a crisis, the principal shall notify the Crisis Team members and the director of schools. If he
11
determines it to be necessary, the principal shall contact the appropriate emergency services (police, fire,
12
ambulance, etc.).
13
All media attention shall be directed to the director of schools' office.
Cross References
News Releases, News Conferences, and Interviews 1.503
Version Date: March 8, 2022
Hickman County Board of Education
Descriptor Code:
Issued Date:
Descriptor Term:
3.204
07/07/25
Risk Management and Threat
Rescinds:
Issued:
Assessment Team
3.204
04/08/24
1
It shall be the responsibility of the director of schools to develop an appropriate safety program for the
2
school system. The Board shall provide sufficient staff and budget for its implementation.
3
The Board shall designate a professional staff person who shall be responsible for the promotion and
4
development of a prevention and safety education program for students and personnel employed by the
5
school system. This person shall be given authority and title commensurate with the task and shall
6
answer directly to the director of schools. The general areas of responsibilities include, but are not
7
limited to, in-service training, development of accident prevention procedures, accident record keeping
8
and facility inspection.
9
General¹
10
A threat assessment team shall be created within the school district to develop intervention-based
11
approaches to prevent violence, manage reports of potential threats, and create a system that fosters a
12
safe, supportive, and effective school environment. The Director of Schools shall appoint the members
13
of the threat assessment team.
14
The Director of Schools shall develop administrative procedures regarding the training and operations
15
of the team to comply with state law and State Board of Education rules and regulations.
16
TEAM MEETINGS
17
All threat assessment team meetings shall be closed to the public.²
18
RECORDKEEPING
19
The team shall document all behaviors and incidents deemed to pose a risk to school safety or that
20
resulted in intervention and shall provide the information to the Director of Schools.
21
A report of the activities of the threat assessment team will be compiled and shared with the Board
22
before each regular meeting.
23
Documents produced or obtained regarding these assessment activities will not be open for public
24
inspection.
25
REPORTING⁴
26
The Director of Schools shall develop a process for providing parent(s)/guardian(s) information on
27
credible threats of violence or significantly disruptive behavior directed toward or occurring on the
Version Date: July 11, 2025
Risk Management and Threat Assessment Team
3.204
1
grounds of the school their student attends. Such reports shall include incidents that are reported to a
2
state or local law enforcement agency. These reports must be made within forty-eight (48) hours of the
3
district's report to law enforcement.
4
At least once per quarter, the Director of Schools shall provide the Board with a report listing the total
5
number of incidents reported to state and local law enforcement agency requiring notice to
6
parent(s)/guardian(s) for the respective quarter as well as total for the year to date.
Legal References
Cross References
1. TCA 49-6-2701
School District Records 1.407
2. TCA 49-6-2701(f)
Safety 3.201
3.
TCA 49-6-2702
Security 3.205
4.
Public Acts of 2025. Chapter No. 215
Student Records 6.600
Page 2 of 2
Hickman County Board of Education
Descriptor Code:
Issued Date:
Descriptor Term:
3.205
08/05/24
Security
Rescinds:
Issued:
3.205
04/08/24
1
The director of schools shall establish procedures as required to adequately protect school property which
2
shall include, but not be limited to:¹
3
1. Closing and securing teacher work areas when being left unattended or at the end of the day;
4
5
2. Denying students permission to use the classrooms, laboratories, gymnasiums or other school
6
facilities or equipment without appropriate faculty supervision;
7
8
3. Controlling the issuance of building keys and master keys;
9
10
4. Developing programs which contribute to the proper care and use of school facilities and
11
equipment; and
12
13
5. Equipment purchased with federal funds shall be managed as directed by federal and state law. 2
14
The principal shall call law enforcement officials in cases involving illegal entry, theft or vandalism.
15
The principal shall notify the director of schools within 48 hours after each case of vandalism, theft,
16
building damage and illegal entry.
17
The director of schools, or his/her representative, is authorized to sign a criminal complaint and to
18
press charges against perpetrators of vandalism against school property.
19
All exterior doors leading into a school building shall be locked at all times and access to school
20
buildings is limited to the school's primary entrance during the school day as well as when students are
21
present outside of regular school hours.³
22
The principal shall immediately call law enforcement officials and the Director of Schools in cases
23
involving illegal entry, assault and battery resulting in serious personal injury or involving the use of a
24
weapon, building damage, theft, vandalism endangering life health, or safety, or valid threats of mass
25
violence.⁴ The Director of Schools/designee is authorized to sign a criminal complaint and press
26
charges. The Director of Schools shall report all signing of such complaints to the Board.
27
AFTER SCHOOL HOURS
28
If, outside of regular school hours, there is a need to unlock the doors during a school activity, a school
29
district employee shall be stationed by the door to ensure access is limited to authorized persons.³
30
SCHOOL POLICING¹
Version Date: August 12, 2024
Security
3.205
1
The Board may enter into a memorandum of understanding with a chief of a law enforcement agency
2
to provide school policing. Any memorandum of understanding shall address, at a minimum, the
3
following issues:
4
1. Any School Resource Officer (SRO) assigned under a memorandum must be in compliance
5
with all laws, regulations and rules of the Peace Officer Standards and Training Commission at
6
the time of assignment and remain compliant throughout the tenure of his or her assignment;
7
8
2. As a condition of assignment, any SRO must participate in forty (40) hours of basic training in
9
school policing within twelve (12) months of assignment Every year thereafter the SRO shall
10
participate in a minimum of sixteen (16) hours of training specific to school policing. All
11
training programs shall be approved by the Peace Officers Standards and Training
12
Commission.⁵
13
14
3. Any SRO assigned under the memorandum remains an employee of the law enforcement
15
agency, subject to that agency's direction, control, supervision and discipline, though the Board
16
may agree to indemnify and reimburse the law enforcement agency for any part or all of the
17
increased costs incurred by the law enforcement agency as a result of the assignment of the
18
SROs.
19
20
4. No officer shall be assigned to a school, or continue in such an assignment, without the consent
21
of the Director.
22
23
5. In the event that more than one SRO is assigned to a school system, the law enforcement
24
agency shall designate one of the SROs as the senior SRO, or such other, appropriate title. The
25
duties of the senior SRO, however designated, shall include, but not be limited to, the
26
following:
27
a. To represent and carry out the policies of the law enforcement agency assigning the
28
SROs.
29
b. To supervise the SROs in the performance of their duties;
30
c. To consult with the Director regarding the best use of the available resources for school
31
policing; and
32
d. To resolve disputes between the SROs and students or faculty members.
33
34
6. The memorandum may be effective for any length of time, including continuing until
35
terminated by the parties, and may contain any reasonable notice requirement for the
36
termination of the memorandum. However, the memorandum shall contain a provision
37
allowing the Director to suspend the active participation of the SROs in the event that the
38
Director certifies that the health, safety or wellbeing of the students or faculty members require
39
the immediate suspension.
40
CYBERSECURITY
41
The Director of Schools/designee shall develop an administrative procedure regarding the district's
42
cybersecurity plan to identify cybersecurity risks, implement mitigation planning, and protect
43
cyberinfrastructure against cyberattacks and other cybersecurity threats and incidents.
Page 2 of 3
Security
3.205
Legal References
Cross References
1.
TCA 49-6-805(3)
Visitors to the Schools 1.501
2.
2 CFR $ 200.313
Inventories 2.702
3.
TCA 49-6-817
Care of School Property 6.311
4.
Public Acts of 2024, Chapter No. 882
5.
TCA 49-6-4217
6.
TCA 49-6-805(9)
Page 3 of 3
Hickman County Board of Education
Descriptor Code:
Issued Date:
Descriptor Term:
3.206
03/07/22
Community Use of School Facilities
Rescinds:
Issued:
3.206
12/02/19
1
When not in use for school purposes, school buildings and grounds or portions thereof may be used for
2
public, governmental, charitable, civic, recreational, cultural, and other purposes as approved by the
3
Board.
I
4
1. Requests for the use of school facilities shall be made at the office of the principal prior to the
5
date of use;
6
7
2. Student clubs and activities, parent-teacher associations, and other organizations affiliated with
8
the schools shall be permitted use of school facilities without charge;
9
10
3. School facilities may not be used for private profit, except that unused facilities may be leased
11
for private day-care centers which provide educational and child care services to the
12
community;²
13
14
4. All activities must be under adult supervision and approved by the building principal. In all
15
cases, an assigned school employee will be present. The group using the facilities will be
16
responsible for any damage to the building or equipment;
17
18
5. Groups receiving permission for building use are restricted to the dates and hours approved and
19
to the building area and facilities specified, unless requested changes are approved by the
20
principal;
21
22
6. Groups receiving permission for building use are responsible for the observance of all fire and
23
safety regulations at all times;
24
25
7. The use of alcoholic beverages, drugs or tobacco, profane language, or gambling in any form is
26
not permitted in school buildings;
27
28
8. The Board will cooperate with recognized agencies, such as the Red Cross, National Guard and
29
Civil Defense, and will make suitable facilities available without charge during community
30
emergencies;
31
32
9. When school kitchens are used, at least one member of the cafeteria staff must be present to
33
supervise the use of the equipment;
34
35
10. The Board will approve and periodically review a fee schedule for the use of school facilities
36
by community or civic organizations and other non-profit, recreational, religious, political or
37
philosophical groups; and
Version Date: March 8, 2022
Community Use of School Facilities
3.206
1
11. School facilities may be used by the director's employees or invited service providers to
2
provide student enrichment services and/or community education services, provided the
3
following requirements are met:
4
a. a written detailed description of the service must be provided to the principal of the
5
school where the service is to be provided;
6
b. the principal must approve the offering of the service along with its date, time and
7
location;
8
c. the director of schools must approve the principal's recommendation, set the fees to be
9
charged and the payment to be made to the service provider, and inform the Board of
10
approved services;
11
d. no products, marketing, sales, offers, trades, and such related activities may be
12
involved;
13
e. the principal has total oversight authority over the service and service provider once it is
14
approved; and
15
f. all laws, rules and regulations, and applicable policy will be observed.
Legal References
Cross References
1. TCA 49-50-201; TCA 49-2-203(b)(4); TCA 49-2-
Board-Community Relations 1.500
405
Tobacco-Free Schools 1.803
2. TCA 49-2-203(b)(4)(B)
Emergency Preparedness Plan 3.202
Tutoring for Pay 5.608
Care of School Property 6.311
Page 2 of 2
Hickman County Board of Education
Descriptor Code:
Issued Date:
Descriptor Term:
3.208
03/07/22
Facilities Planning
Rescinds:
Issued:
3.208
12/02/19
1
The director of schools shall present an annual assessment of facility needs to the Board in October. The
2
needs assessment shall include a review of each school site. Each principal shall prepare the assessment
3
for his/her school with input from staff, parents and community leaders.
4
The individual school needs assessment shall include the following information:
5
1. building, site and utility deficiencies
6
2. maintenance issues
7
3. number of classrooms with class sizes
8
4. population and enrollment projections
9
5. community needs
10
6. other information as directed
11
The system-wide needs assessment shall include the following information:
12
1. individual school assessments
13
2. system-wide population growth projections
14
3. industrial and business forecasts
15
4. other information as deemed necessary
16
ASBESTOS¹
17
The director of schools shall maintain an Asbestos Management Plan for all buildings leased, owned, or
18
otherwise used as school buildings and maintain and update the plan to keep it current with ongoing
19
operations and maintenance, periodic surveillance, inspection, re-inspection, and response action
20
activities.
21
The director of schools shall:
22
A. annually publish a notification on the Asbestos Management Plan availability and the status of
23
asbestos activities;
24
25
B. educate and train maintenance and custodial staff about asbestos and how to deal with it, in
26
accordance with state and federal statutes;
27
28
C. notify short-term or temporary workers on the locations of the building materials containing
29
asbestos;
30
31
D. post warning labels in routine maintenance areas where asbestos was previously identified or
32
assumed;
Version Date: March 8, 2022
Facilities Planning
3.208
1
E. follow set plans and procedures designed to minimize the disturbance of building materials
2
containing asbestos; and
3
4
F. survey the condition of these materials every six (6) months to assure that they remain in good
5
condition.
6
The director of schools shall designate an Asbestos Hazard Emergency Response Act (AHERA)
7
Manager as the designated Asbestos Program Coordinator. All inquiries regarding the asbestos plan and
8
asbestos-related issues should be directed to the AHERA Manager.
Legal References
1. 40 CFR §§ 763.91-93;
15 USCA §§ 2641-2656
Page 2 of 2
Hickman County Board of Education
Descriptor Term:
Descriptor Code:
Issued Date:
3.211
04/08/24
New Project Planning
Rescinds:
Issued:
3.211
03/07/22
1
SELECTION OF ARCHITECT
2
The Board shall approve a registered architect for new projects of construction, expansion, and/or
3
maintenance as required by law. The Board shall execute a contract with such architect for each project.
4
SELECTION OF ENGINEER¹
5
Following the execution of a contract for architectural services, the architect or architectural firm shall
6
select a registered engineer for each project.
7
SITE SELECTION
8
The Board shall have sole discretion with choosing sites for construction. 2 When determining where to
9
begin new projects, the Board shall consider the current and future populations of the area, transportation
10
routes, and accessibility to utilities.
11
BUILDING ACCESSIBILITY
12
The construction, remodeling, renovation, expansion, or modification of a school building shall comply
13
with state and federal requirements regarding building accessibility.
Legal References
1. TCA 62-2-107; TRR/MS 0520-01-04-.01(2)
2. TCA 49-2-203(a)(3); Rutherford County Board of
Education v. Rutherford County Commission, 2000
Tenn. App. LEXIS 703
3.
28 CFR § 36.201; TRR/MS 0520-01-04-.01(1)
Version Date: April 15, 2024
Hickman County Board of Education
Descriptor Term:
Descriptor Code:
Issued Date:
3.212
03/07/22
District Water Testing
Rescinds:
Issued:
3.212
12/02/19
1
General
2
All district facilities built before January 1, 1998 shall be tested for lead in drinking water every two
3
(2) years.¹
4
The Director of Schools shall develop appropriate administrative procedures to facilitate this testing
5
and address any necessary corrective action.
6
RESPONSE TO TESTING RESULTS¹
7
If test results show that lead levels exceed fifteen parts per billion (15 ppb) but are below twenty parts
8
per billion (20 ppb), that school shall conduct lead level tests on an annual basis. This shall continue
9
until tests show that the lead levels are under fifteen parts per billion (15 ppb).
10
If test results show that lead levels equal or exceed twenty parts per billion (20 ppb), the school shall
11
immediately remove the drinking water source from service. The drinking water source shall not be
12
available for use until retesting confirms the water lead level does not exceed twenty parts per billion
13
(20 ppb). If corrective action is taken, retesting shall occur within ninety (90) days.
14
The Director of Schools/designee shall notify the appropriate authorities within twenty-four (24) hours
15
of a test result showing that lead levels equal or exceed twenty parts per billion (20 ppb).
16
Parent(s)/guardian(s) shall be notified within five (5) business days of such test result.
Legal References
1.
TCA 49-2-133
Version Date: March 8, 2022
Hickman County Board of Education
Budget Amendment - 36
Fund 141 - General Purpose
June 1, 2026
Account
Description
Debit
Credit
Justification
71200 312 -
Contracts w/Private Agcy
$ 36,407.92
71200 399
Other Contracted Svc
$ 10,502.44
71200 429
Inst Supplies
6,659.50
71200 499
Other Supplies
1,432.97
To cover contracted expense to
71200 725
SPED Equipment
3,303.11
meet SPED Student services in
72220 131
Medical Empolyees
6,624.00
excess of the original budgeted
72220 312
Contracts w/Private Agcy
7,000.00
amount
72220 355
Travel
1,171.73
72220 399
Other Contracted Svc
1,424.50
72220 524
Inservice
1,138.67
71100 128
Homebound Teachers
4,000.00
To cover cost in excess of
71100 198
Substitutes
17,000.00
budgeted amounts for
71100 117
Career Ladder Program
11,500.00
Homebound Teachers and
71100 163
Educational Asst
9,500.00
Substiture Teachers
TOTALS
58,832.42 $ 58,832.42
Approved:
Attest:
Board Chair
Marcy Tidwell
Hickman County Board of Education
Budget Amendment - 37
Fund 141 - General Purpose
June 1, 2026
Account
Description
Debit
Credit
Justification
72310 - 513 -
Worker's Comp Ins
$22,000.00
To cover consulting contract
72310 399 -
Other Contracted Svc
22,000.00
approved by the board
71100 722 -
Reg Instr Equipment
$ 26,844.00
To use funds for purchase of
71100 - 449 -
Text Books
26,844.00
Text Books
72210 432
Library Books/Media
1,000.00
To cover excess expenditures
72210 - 399 ⑉
Other Contracted Svc
1,000.00
from original budget
TOTALS
$ 49,844.00 $ 49,844.00
Approved:
Attest:
Board Chair
Marcy Tidwell
Hickman County Board of Education
Budget Amendment - 38
Fund 141 - General Purpose
June 2, 2025
Account
Description
Debit
Credit
Justification
46790
Other CTE Revenue
27,088.67
TCAT Revenue
71300 599 -
Other Charges
27,088.67
46590
Summer Learning Camp
362,755.34
71100 - 116 - SLC
Teachers
159,000.00
71100 - 163 - SLC
Educational Asst
26,400.00
71100 - 201 - SLC
Social Security
11,494.80
71100 - 204 - SLC
State Retirement
17,501.76
71100 - 212 - SLC
Employer Medicare
2,688.30
71100 - 429 - SLC
Inst Supplies
1,550.00
71100 - 499 - SLC
Other Supplies
16,275.00
71100 - 599 - SLC
Other Charges
2,200.00
71200 - 399 - SLC
Other Contracted Svc
4,016.16
72120 - 131 - SLC
Medical Personnel
9,600.00
72120 - 201 - SLC
Social Security
595.20
72120 - 204 - SLC
State Retirement
864.00
72120 - 212 - SLC
Employer Medicare
139.20
72210 - 105 - SLC
Supervisor
23,450.00
Summer Learning Camp
72210 - 201 - SLC
Social Security
1,453.90
72210 - 204 - SLC
State Retirement
2,110.50
72210 - 212 - SLC
Employer Medicare
340.03
72710 - 146 - SLC
Bus Drivers
28,000.00
72710 - 189 - SLC
Other Salaries & Wages
1,575.00
72710 - 201 - SLC
Social Security
1,934.40
72710 - 204 - SLC
State Retirement
2,808.00
72710 - 212 - SLC
Employer Medicare
452.40
72710 - 412 - SLC
Diesel Fuel
18,254.00
73100 - 165 - SLC
Cafeteria Personnel
21,219.20
73100 - 201 - SLC
Social Security
1,315.59
73100 - 204 - SLC
State Retirement
2,565.40
73100 - 212 ⑉ SLC
Employer Medicare
307.68
73100 - 422 - SLC
Food Supplies
4,644.82
TOTALS
$ 389,844.01 $ 389,844.01
Approved:
Attest:
Board Chair
Marcy Tidwell
Hickman County, Tennessee
General Purpose School Fund 141
Statement of Proposed Operations
For the Fiscal Year Ending June 30, 2027
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
ESTIMATED REVENUES
Net Penny
Rate
Property Tax
40000 Local Taxes
83,969
0.3381
2,838,975 Current
40100 County Property Taxes
83,969
0.0200
167,937
Increase
40110 Current Property Taxes
3,168,716
2,773,333
2,773,333
3,006,912
233,579
83,969
0.3581
3,006,912 Total
40120 Trustee's Collection - Prior Year
67,993
75,000
75,000
75,000
0
40125 Trustee's Collection - Bankruptcy
103
500
500
500
0
40130 Circuit/Clerk & Master Collections - Prior Years
29,377
40,000
40,000
25,000
(15,000)
40140 Interest and Penalty
13,586
15,000
15,000
15,000
0
40161 Payments in Lieu of Taxes - TVA
2,890
3,500
3,500
2,500
(1,000)
40162 Payments in Lieu of Taxes - Local Utilities
6,000
6,000
6,000
6,000
0
40200 County Local Option Taxes
40210 Local Option Sales Tax
3,293,354
2,975,000
2,975,000
3,100,000
125,000
40270 Business Tax
45,181
45,000
45,000
45,000
0
40300 Statutory Local Taxes
40320 Bank Excise Tax
0
0
0
0
0
40350 Interstate Telecommunication Tax
0
0
0
0
0
Total Local Taxes
6,627,200
5,933,333
5,933,333
6,275,912
342,579
41000 Licenses and Permits
41100 Licenses
41110 Marriage Licenses
1,320
1,300
1,300
1,300
0
Total Licenses and Permits
1,320
1,300
1,300
1,300
0
43000 Charges for Current Services
43500 Education Charges
43517 Tuition Other
0
0
0
0
0
43570 Receipts from Individual Schools
12,502
30,000
30,000
25,000
(5,000)
43582 Community Service Fees Adults
126
200
200
200
0
Total Charges for Current Services
12,628
30,200
30,200
25,200
(5,000)
44000 Other Local Revenues
44100 Recurring Items
44110 Investment Income
339,950
0
0
0
0
44120 Lease/Rentals
2,230
7,500
7,500
7,500
0
44170 Miscellaneous Refunds
23,821
30,000
30,000
40,000
10,000
44500 Nonrecurring Items
Page 1
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
44530 Sale of Equipment
15,379
15,000
15,000
15,000
0
44560 Damages Recovered from Individuals
20,316
3,000
3,000
3,000
0
44570 Contributions and Gifts
66,834
20,000
20,000
20,000
0
44990 Other Local Revenues
0
30,000
30,000
0
(30,000)
Total Other Local Revenues
468,530
105,500
105,500
85,500
(20,000)
Total Local Revenue
7,109,678
6,070,333
6,070,333
6,387,912
317,579
46000 State of Tennessee
46175 On-Behalf Contributions for OPEB
69,895
40,000
40,000
50,000
10,000
46500 State Education Funds
46510 Tennessee Investment in Student Achievemer
24,453,717
25,081,234
25,081,234
25,367,661
286,427
46513 TISA-On-behalf Payments
50,082
0
0
17,332
46515 Early Childhood Education
456,119
445,000
445,000
425,000
(20,000)
46520 School Food Service
16,684
22,000
22,000
22,000
0
46550 Driver Education
8,199
10,000
10,000
10,000
0
46590 Other State Education Funds
292,095
240,000
818,937
240,000
0
46591 Coordinated School Health
0
0
0
0
0
46594 Family Resource Centers
0
0
0
0
0
46610 Career Ladder Program
36,983
37,500
37,500
27,360
(10,140)
46790 Other Vocational
160,426
759,000
1,543,702
0
(759,000)
46800 Other State Revenues
46851
State Revenue Sharing - TVA
204,756
220,000
220,000
220,000
0
46980 Other State Grants
67,684
0
0
0
0
46981 Safe Schools
0
0
0
0
0
46990 Other State Revenues
370,158
100,000
100,000
200,000
100,000
Total State of Tennessee
26,186,798
26,954,734
28,318,372
26,579,353
(375,381)
47000 Federal Government
47100 Federal Through State
47143 Special Education-Grants to States
31,639
0
0
0
0
47401 American Rescue Plan Act Grant #1
0
0
0
0
0
47590 Other Federal Through State
49,858
0
0
0
0
47600 Direct Federal Revenue
47640 ROTC Reimbursement
88,422
65,000
65,000
75,000
10,000
47990 Other Direct Federal Revenue
0
0
0
0
0
Total Federal Government
169,919
65,000
65,000
75,000
10,000
48000 Other Governments and Citizens Groups
48130 Contributions
532,794
0
0
0
0
48990 Other
49,921
0
4,000
110,000
110,000
Total Other Governments and Citizens Groups
582,715
0
4,000
110,000
110,000
Page 2
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
Total Estimated Revenues
34,049,110
33,090,067
34,457,705
33,152,265
62,198
49000 OTHER SOURCES (NON-REVENUE)
49700 Insurance Recovery
212,961
0
0
0
0
49800 Transfers In
137,817
10,000
10,000
0
(10,000)
Total Other Sources
350,778
10,000
10,000
0
(10,000)
Total Estimated Revenues & Other Sources
34,399,888
33,100,067
34,467,705
33,152,265
52,198
ESTIMATED EXPENDITURES
71000 Instruction
71100 Regular Instruction Program
116 Teachers
10,131,640
10,722,365
10,722,365
10,841,539
119,174
117 Career Ladder Program
33,000
35,000
35,000
24,000
(11,000)
128 Homebound Teachers
2,569
6,000
6,000
8,000
2,000
140 Salary Supplements
438,836
440,000
440,000
457,600
17,600
163 Educational Assistants
475,025
497,075
497,075
475,000
(22,075)
188 Bonus Payments
0
0
504,000
0
0
189 Other Salaries and Wages
390,041
410,000
410,000
410,000
0
198 Non-Certified Substitute Teachers
171,150
210,000
210,000
210,000
0
201 Social Security
837,646
922,514
961,070
920,384
(2,130)
204 State Retirement
741,859
918,910
955,291
898,784
(20,126)
207 Medical Insurance
1,598,253
2,090,000
2,090,000
1,751,063
(338,937)
212 Employer Medicare
2,759
0
0
0
0
215 On-behalf Payments to OPEB
26,391
0
0
0
0
336 Maint and Repair Service - Equipment
7,347
10,000
10,000
15,000
5,000
399 Other Contracted Services
9,557
107,000
117,000
65,000
(42,000)
429 Instructional Supplies and Materials
129,205
115,000
115,000
135,000
20,000
449 Textbooks
211,456
150,000
150,000
325,400
175,400
471 Software
0
0
0
0
0
499 Other Supplies and Materials
23,984
8,000
3,000
3,000
(5,000)
595 TISA-On-behalf Payments
40,177
0
0
0
0
599 Other Charges
1,650
0
0
0
0
722 Regular Instructional Equipment
41,067
150,000
145,000
125,000
(25,000)
730 Vocational Instruction Equipment
0
0
0
0
0
Total Instructional Program
15,313,612
16,791,864
17,370,801
16,664,770
(127,094)
71150 Alternative Instruction Program
116 Teachers
169,786
213,289
213,289
205,000
(8,289)
163 Educational Assistants
24,054
26,000
26,000
27,000
1,000
201 Social Security
13,924
18,306
18,306
17,748
(558)
Page 3
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
204 State Retirement
13,864
17,438
17,438
15,475
(1,963)
207 Medical Insurance
19,971
37,988
37,988
23,002
(14,986)
355 Travel
1,390
2,000
2,000
1,500
(500)
429 Instructional Supplies and Materials
1,045
1,000
1,000
1,000
0
499 Other Supplies and Materials
1,317
1,000
1,000
1,000
0
Total Alternative Schools
245,351
317,021
317,021
291,725
(25,296)
71200 Special Education Program
116 Teachers
1,872,137
2,021,836
1,936,836
2,025,430
3,594
124 Psychological Personnel
0
0
0
0
0
128 Homebound Teachers
3,319
7,500
7,500
7,500
0
163 Educational Assistants
477,636
528,820
528,820
521,820
(7,000)
171 Speech Pathologist
225,115
255,769
183,769
180,000
(75,769)
201 Social Security
188,915
210,266
198,256
199,637
(10,629)
204 State Retirement
215,032
217,170
205,786
219,032
1,862
207 Medical Insurance
406,600
414,442
414,442
382,181
(32,261)
212 Employer Medicare
0
0
0
0
0
312 Contracts with Private Agencies
122,711
105,000
105,000
200,000
95,000
399 Other Contracted Services
64,314
75,000
75,000
95,000
20,000
429 Instructional Supplies and Materials
1,003
7,000
7,000
5,000
(2,000)
499 Other Supplies and Materials
1,545
5,000
5,000
5,000
0
595 TISA-On-behalf Payments
9,905
0
0
0
0
725 Special Education Equipment
0
5,000
5,000
5,000
0
Total Special Educational Program
3,588,232
3,852,803
3,672,408
3,845,600
(7,203)
71300 Career and Technical Education Program
116 Teachers
896,864
932,216
932,216
925,000
(7,216)
140 Supplements
604
6,000
6,000
6,000
0
189 Other Salaries and Wages
150
5,000
5,000
5,000
0
198 Non-Certified Substitute Teachers
18,000
21,600
21,600
21,600
0
201 Social Security
68,150
73,809
73,809
73,256
(553)
204 State Retirement
62,790
73,785
73,785
64,201
(9,584)
207 Medical Insurance
104,665
127,562
127,562
161,027
33,465
307 Communications
0
0
0
0
0
336 Maintenance and Repair Services-Equipment
3,921
0
0
0
0
355 Travel
6,944
9,000
9,000
9,000
0
399 Other Contracted Services
0
0
0
0
0
429 Instructional Supplies and Materials
3,405
10,000
10,000
5,000
(5,000)
449 Text Books
5,324
7,000
7,000
7,000
0
471 Software
0
0
141,050
0
0
499 Other Supplies and Materials
11,776
20,000
20,000
10,000
(10,000)
599 Other Charges
82,520
3,500
3,500
3,500
0
730 Vocational Instruction Equipment
102,920
15,000
476,113
10,000
(5,000)
790 Other Equipment
3,466
10,000
10,000
10,000
0
Page 4
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
Total Vocational Education Program
1,371,499
1,314,472
1,916,635
1,310,584
(3,888)
Total Instruction
20,518,694
22,276,160
23,276,864
22,112,679
(163,481)
72000 Support Services
72110 Attendance
105 Supervisor/Director
62,394
96,000
96,000
101,712
5,712
189 Other Salaries & Wages
55,437
57,932
57,932
59,000
1,068
201 Social Security
8,668
11,776
11,776
12,294
518
204 State Retirement
11,492
15,639
15,639
14,347
(1,292)
207 Medical Insurance
15,800
19,374
19,374
9,900
(9,474)
355 Travel
308
1,500
1,500
1,500
0
399 Other Contracted Services
15,852
20,000
20,000
5,500
(14,500)
499 Other Supplies and Materials
800
1,500
1,500
1,000
(500)
524 In Service/Staff Development
500
1,500
1,500
0
(1,500)
719 Office Equipment
0
0
0
0
0
Total Attendance
171,251
225,221
225,221
205,253
(19,968)
72120 Health Services
105 Supervisor/Director
74,104
78,000
78,000
78,000
0
130 Social Workers
88,171
102,800
102,800
109,289
6,489
131 Medical Personnel
382,670
397,459
397,459
410,000
12,541
189 Other Salaries & Wages
56,443
59,100
109,100
64,000
4,900
201 Social security
44,449
48,758
52,583
50,589
1,831
204 State Retirement
53,324
58,551
63,051
58,780
229
207 Medical Insurance
65,201
60,206
60,206
74,942
14,736
212 Employer Medicare
139
0
0
0
0
355 Travel
2,419
2,000
2,000
2,000
0
399 Other Contracted Services
22,095
35,000
35,000
35,000
0
413 Drugs and Medical Supplies
4,988
5,500
5,500
5,500
0
499 Other Supplies and Materials
2,676
3,000
3,000
3,000
0
524 Inservice
2,864
3,000
3,000
3,000
0
599 Other Charges
17,953
4,000
55,170
4,000
0
735 Health Equipment
4,635
4,000
4,000
4,000
0
Total Health Service
822,131
861,374
970,869
902,100
40,726
72130 Other Student Support
123 Guidance Personnel
656,370
719,709
719,709
800,000
80,291
189 Other Salaries and Wages
186,774
193,500
193,500
200,000
6,500
201 Social Security
62,040
67,861
67,861
76,500
8,639
204 State Retirement
59,980
71,231
71,231
73,183
1,952
207 Medical Insurance
99,169
88,521
88,521
126,777
38,256
Page 5
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
322 Evaluating and Testing
3,133
16,000
16,000
73,000
57,000
344 Payments to Schools - Other
64,000
64,000
64,000
56,000
(8,000)
355 Travel
7,862
8,000
8,000
8,000
0
399 Other Contracted Services
0
10,000
10,000
49,000
39,000
499 Other Supplies and Materials
338
4,000
4,000
3,000
(1,000)
524 Inservice
150
2,000
2,000
2,000
0
599 Other Charges
129
5,000
5,000
4,000
(1,000)
701 Administration Equipment
6,000
0
0
0
0
Total Other Student Support
1,145,945
1,249,822
1,249,822
1,471,460
221,638
72210 Regular Instruction Program
105 Supervisor/Director
119,485
125,000
125,000
125,785
785
129 Librarians
479,084
500,235
500,235
492,000
(8,235)
161 Secretary(s)
231,649
227,599
227,599
230,000
2,401
162 Clerical Personnel
263,138
318,482
318,482
320,000
1,518
189 Other Salaries and Wages
83,696
91,921
91,921
95,000
3,079
201 Social Security
85,938
93,638
93,638
93,446
(192)
204 State Retirement
106,994
109,735
109,735
108,026
(1,709)
207 Medical Insurance
180,509
207,846
207,846
187,247
(20,599)
212 Employer Medicare
331
0
0
0
0
336 Maint and Repair Services - Equipment
4,051
4,000
4,000
4,000
0
355 Travel
2,511
2,500
2,500
2,500
0
399 Other Contracted Services
16,283
16,000
16,000
5,000
(11,000)
432 Library Books and Media
6,672
8,000
8,000
8,000
0
499 Other Supplies and Materials
353
3,000
3,000
3,000
0
524 In-Service/Staff Development
1,006
2,000
2,000
2,000
0
599 Other Charges
0
0
0
0
0
701 Administration Equipment
0
0
0
0
0
722 Regular Instruction Equipment
0
0
0
0
0
790 Other Equipment
0
0
0
0
0
Total Regular Instruction Program
1,581,700
1,709,956
1,709,956
1,676,004
(33,952)
72220 Special Education Program
105 Supervisor/Director
92,046
93,500
93,500
97,200
3,700
124 Psychological Personnel
79,109
83,000
168,000
169,000
86,000
131 Medical Personnel
65,335
69,000
141,000
147,000
78,000
189 Other Salaries and Wages
5,000
5,000
5,000
5,000
0
196 In-Service Training
415
2,000
2,000
2,000
0
201 Social Security
17,682
19,317
31,328
32,145
12,828
204 State Retirement
19,238
19,679
31,064
34,572
14,893
207 Medical Insurance
7,900
9,101
9,101
38,898
29,797
312 Contracts with Private Agencies
1,202
7,000
7,000
0
(7,000)
336 Maint and Repair Services - Equipment
5,295
5,000
5,000
6,500
1,500
355 Travel
6,277
7,500
7,500
7,500
0
Page 6
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
399 Other Contracted Services
58,523
60,000
60,000
60,000
0
524 In-Service Training
1,530
4,000
4,000
4,000
0
Total Special Education Program
359,552
384,097
564,492
603,815
219,718
72230 Career and Technical Education Program
105 Supervisor/Director
89,315
95,500
95,500
98,000
2,500
189 Other Salaries and Wages
40,131
42,000
84,297
43,000
1,000
201 Social Security
9,564
10,519
13,755
10,787
268
204 State Retirement
10,436
10,584
15,698
12,002
1,418
207 Medical Insurance
4,567
2,696
4,696
18,016
15,320
336 Maint and Repair Services - Equipment
2,698
3,000
3,000
3,000
0
355 Travel
0
2,000
2,000
3,000
1,000
399 Other Contracted Services
142
3,000
3,000
0
(3,000)
499 Other Supplies and Materials
6,056
0
0
2,000
2,000
524 In-Service Training
0
0
0
0
0
790 Other Equipment
8,230
0
0
0
0
Total Vocational Education Program
171,139
169,299
221,945
189,805
20,506
72250 Technology
105 Supervisor
74,104
78,000
78,000
78,000
0
189 Other Salaries and Wages
50,808
74,899
74,899
78,000
3,101
201 Social Security
8,732
11,697
11,697
11,934
237
204 State Retirement
12,328
15,527
15,527
15,373
(154)
207 Medical Insurance
8,244
9,101
9,101
24,669
15,568
336 Maint and Repair Services - Equipment
1,555
6,000
6,000
6,000
0
350 Internet Connectivity
92,786
105,000
105,000
75,000
(30,000)
355 Travel
0
2,000
1,000
1,000
(1,000)
399 Other Contracted Services
77,641
195,000
195,000
152,050
(42,950)
499 Other Supplies and Materials
1,477
2,000
2,000
2,000
0
599 Other Charges
0
0
1,000
1,000
1,000
722 Regular Instruction Equipment
99,735
60,000
60,000
70,000
10,000
Total Technology
427,410
559,224
559,224
515,026
(44,198)
72290 Other Programs
215 On-Behalf Payments for OPEB
69,895
35,000
35,000
70,000
35,000
Total Other Programs
69,895
35,000
35,000
70,000
35,000
72310 Board of Education
191 Board and Committee Members Fees
16,800
16,800
16,800
16,800
0
196 In-Service Training
4,323
7,000
7,000
7,000
0
201 Social Security
1,123
2,142
2,142
1,821
(321)
204 Medical Insurance
14,510
15,800
15,800
7,900
(7,900)
Page 7
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
305 Audit Services
35,000
35,000
35,000
35,000
0
320 Dues and Memberships
11,229
26,000
26,000
26,000
0
331 Legal Services
6,386
25,000
25,000
25,000
0
355 Travel
1,837
4,000
4,000
4,000
0
399 Other Contracted Services
3,500
8,000
8,000
11,000
3,000
506 Liability Insurance
145,968
160,000
160,000
175,000
15,000
510 Trustees Commission
135,500
150,000
150,000
150,000
0
513 Workers Compensation Insurance
196,642
240,000
240,000
230,000
(10,000)
534 Refund to Applicant for Criminal Investigation
0
1,000
1,000
1,000
0
599 Other Charges
2,378
7,000
7,000
7,000
0
Total Board of Education
575,196
697,742
697,742
697,521
(221)
72320 Director of Schools
101 County Official/Administrative Officer
125,000
130,000
130,000
130,000
0
161 Secretary(s)
114,112
122,644
122,644
125,000
2,356
201 Social Security
18,211
19,328
19,328
19,508
180
204 State Retirement
24,772
26,516
26,516
24,145
(2,371)
207 Medical Insurance
13,834
15,729
15,729
33,146
17,417
307 Communication
416
1,000
1,000
0
(1,000)
336 Maint and Repair Services - Equipment
10,763
14,000
14,000
14,000
0
348 Postal Charges
0
1,000
1,000
1,000
0
355 Travel
1,311
1,400
1,400
5,000
3,600
399 Other Contracted Service
0
3,000
3,000
5,000
2,000
435 Office Supplies
1,047
1,500
1,500
1,500
0
499 Other Supplies and Materials
1,153
2,500
2,500
2,500
0
599 Other Charges
0
0
0
0
0
Total Office of the Superintendent
310,619
338,617
338,617
360,799
22,182
72410 Office of the Principal
104 Principals
719,596
808,000
808,000
815,000
7,000
139 Assistant Principals
588,481
658,000
658,000
635,000
(23,000)
189 Other Salaries and Wages
101,050
104,000
104,000
109,200
5,200
201 Social Security
104,991
116,105
116,105
115,381
(724)
204 State Retirement
102,596
121,912
121,912
115,475
(6,437)
207 Medical Insurance
136,438
178,201
178,201
121,902
(56,299)
348 Postal Charges
0
1,000
1,000
1,000
0
355 Travel
0
3,000
3,000
3,000
0
399 Other Contracted Services
129,545
126,000
126,000
126,000
0
Total Office of the Principal
1,882,697
2,116,218
2,116,218
2,041,958
(74,260)
72510 Fiscal Services
399 Other Contracted Services
47,303
50,000
50,000
50,000
0
Page 8
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
Total Fiscal Services
47,303
50,000
50,000
50,000
0
72610 Operation of Plant
307 Communication
50,311
40,000
40,000
50,000
10,000
399 Other Contracted Services
769,490
837,298
837,298
837,298
0
410 Custodial Supplies
37,621
38,500
38,500
40,000
1,500
415 Electricity
962,544
990,000
990,000
1,100,000
110,000
434 Natural Gas
88,276
150,000
150,000
150,000
0
454 Water and Sewer
314,473
345,000
345,000
345,000
0
499 Other Supplies and Materials
262
3,500
3,500
3,500
0
501 Boiler Insurance
8,822
10,500
10,500
10,500
0
502 Building and Contents Insurance
250,000
275,000
275,000
290,000
15,000
790 Other Equipment
10,613
15,000
15,000
15,000
0
Total Operation of Plant
2,492,412
2,704,798
2,704,798
2,841,298
136,500
72620 Maintenance of Plant
105 Supervisor/Director
74,104
78,000
78,000
78,000
0
161 Secretary(s)
22,534
23,549
23,549
24,500
951
189 Other Salaries and Wages
187,312
242,650
242,650
250,000
7,350
201 Social Security
23,098
26,332
26,332
26,966
634
204 State Retirement
35,824
41,580
41,580
47,129
5,549
207 Medical Insurance
45,984
53,892
53,892
57,126
3,234
335 Maint & Repair Services - Building
244,813
250,000
335,000
250,000
0
336 Maint & Repair Services - Equipment
203,605
275,000
275,000
275,000
0
355 Travel
0
1,500
1,500
0
(1,500)
399 Other Contracted Services
168,662
245,000
245,000
200,000
(45,000)
418 Equipment and Machinery Parts
4,428
8,000
8,000
10,000
2,000
499 Other Supplies and Materials
0
1,000
1,000
0
(1,000)
790 Other Equipment
61,684
50,000
50,000
97,000
47,000
Total Maintenance of Plant
1,072,048
1,296,503
1,381,503
1,315,721
19,218
72710 Transportation
105 Supervisor/Director
74,104
78,000
78,000
78,000
0
142 Mechanic(s)
84,826
100,000
100,000
105,000
5,000
146 Bus Drivers
821,578
912,575
882,575
900,000
(12,575)
161 Secretary(s)
22,534
23,549
23,549
24,500
951
189 Other Salaries and Wages
175
0
30,000
30,000
30,000
201 Social Security
75,546
82,231
82,231
85,145
2,914
204 State Retirement
118,522
129,587
129,587
148,809
19,222
207 Medical Insurance
119,011
126,956
126,956
134,573
7,617
212 Employer Medicare
380
0
0
0
0
299 Other Fringe Benefits
18,910
20,000
20,000
20,000
0
335 Maintenance and Repair Services - Building
3,012
4,000
4,000
4,000
0
Page 9
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
338 Maintenance and Repair Services - Vehicles
35,896
35,000
35,000
30,000
(5,000)
355 Travel
0
2,000
2,000
2,000
0
399 Other Contracted Services
35,164
50,000
50,000
50,000
0
412 Diesel Fuel
93,465
150,000
150,000
165,000
15,000
418 Equipment and Machinery Parts
412
2,000
2,000
2,000
0
424 Garage Supplies
862
3,000
3,000
3,000
0
425 Gasoline
23,549
35,000
35,000
45,000
10,000
433 Lubricants
7,131
8,000
8,000
8,000
0
442 Propane
45,064
60,000
60,000
60,000
0
450 Tires and Tubes
13,964
15,000
15,000
15,000
0
453 Vehicles Parts
68,875
90,000
90,000
90,000
0
511 Vehicle and Equipment Insurance
65,000
75,000
75,000
80,000
5,000
599 Other Charges
468
5,000
5,000
5,000
0
718 Motor Vehicles
23,075
0
0
0
0
729 Transportation Equipment
160,896
0
0
170,000
170,000
Total Transportation
1,912,419
2,006,898
2,006,898
2,255,027
248,129
72810 Central and Other
201 Social Security
0
383
383
0
(383)
210 Unemployment Compensation
0
20,000
20,000
10,000
(10,000)
299 Other Fringe Benefits
0
5,000
5,000
5,000
0
316 Contributions
45,880
50,000
50,000
50,000
0
399 Other Contracted Services
46,675
50,000
50,000
50,000
0
499 Other Supplies and Materials
19,273
15,000
15,000
7,500
(7,500)
599 Other Charges
47,551
174,161
178,161
0
(174,161)
Total Central and Other
159,379
314,544
318,544
122,500
(192,044)
Total Support Services
13,201,096
14,719,313
15,150,849
15,318,287
598,974
73000 Operation of Non-Instructional Services
73100 Food Service
105 Supervisor/Director
37,052
39,000
39,000
39,000
0
165 Cafeteria Personnel
0
0
0
0
0
201 Social Security
2,756
2,984
2,984
2,984
0
204 State Retirement
4,391
4,712
4,712
5,214
502
422 Food Supplies
4,233
0
0
0
0
Total Food Service
48,432
46,696
46,696
47,198
502
73300 Community Services
189 Other Salaries and Wages
73,886
76,987
76,987
79,000
2,013
201 Social security
5,462
5,891
5,891
6,044
153
204 State Retirement
8,755
9,301
9,301
10,381
1,080
Page 10
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
207 Medical Insurance
15,800
17,010
17,010
16,748
(262)
499 Other Supplies and Materials
4,999
5,000
5,000
5,000
0
719 Office Equipment
0
0
0
0
0
Total Community Services
108,902
114,189
114,189
117,173
2,984
73400 Early Childhood Education
105 Supervisor/Director
45,862
48,000
48,000
49,000
1,000
116 Teachers
192,341
232,395
232,395
235,000
2,605
163 Educational Assistants
88,149
92,000
92,000
95,000
3,000
189 Other Salaries and Wages
11,495
12,000
12,000
13,000
1,000
198 Non-Certified Substitute Teachers
5,000
5,000
5,000
5,000
0
201 Social Security
22,892
29,789
29,789
30,371
582
204 Retirement
27,323
33,479
33,479
33,240
(239)
207 Medical Insurance
33,500
35,175
35,175
68,359
33,184
355 Travel
351
500
500
500
0
399 Other Contracted Services
0
0
0
0
0
429 Instructional Supplies and Materials
10,488
15,000
15,000
15,000
0
449 Textbooks-Bound
0
0
0
0
0
499 Other Supplies and Materials
15,903
15,000
15,000
15,000
0
524 Inservice
589
2,000
2,000
2,000
0
790 Other Equipment
26,532
15,000
15,000
15,000
0
Total Early Childhood Education
480,425
535,338
535,338
576,470
41,132
Total Operation of Non-Instructional Services
637,759
696,223
696,223
740,841
44,618
76000 Capital Outlay
76100 Regular Capital Outlay
304 Architects
7,550
0
87,613
0
0
350 Internet Connectivity
412,794
0
0
0
399 Other Contracted Services
0
0
0
0
0
706 Building Construction
0
759,000
614,279
0
(759,000)
707 Building Improvements
0
585,000
772,000
0
(585,000)
790 Other Equipment
0
100,000
40,000
0
(100,000)
799 Other Capital Outlay
490,696
135,000
110,000
0
(135,000)
Total Regular Capital Outlay
911,040
1,579,000
1,623,893
0
(1,579,000)
Total Estimated Expenditures
35,268,589
39,270,696
40,747,829
38,171,807
(1,098,889)
99000 ESTIMATED OTHER USES
99100 Transfers Out
590 Transfers to Other Funds
0
0
0
0
0
Page 11
Original
Amended
CY
PY
Actual
Estimate
Estimate
Estimate
Difference
MOE Total
MOE Total
Account No.
Description
2024-2025
2025-2026
2025-2026
2026-2027
2026-2027
6,504,712
6,162,133
342,579
5.56%
Total Estimated Other Uses
0
0
0
0
0
Total Estimated Expenditures and Other Uses
35,268,589
39,270,696
40,747,829
38,171,807
(1,098,889)
Excess of Estimated Revenues Over
(Under) Estimated Expenditures
(868,701)
(6,170,629)
(6,280,124)
(5,019,542)
1,151,087
Estimated Beginning Fund Balances July 1
13,325,415
12,456,714
12,456,714
10,333,055
(2,123,659)
Fund Balance Audit Adjustment
Estimated Ending Fund Balances June 30
12,456,714
6,286,085
6,176,590
5,313,513
(972,572)
Page 12
2026-2027 Capital Projects Request
Baseball Field Drains - EHMS
$20,000
Playground Fence - EHMS
$10,000
Tennis Court Repair/Resurface - EHHS, HCHS
$200,000
Roof - EHIS
$175,000
Total $405,000
Tennessee Internal School Uniform Accounting Policy Manual
Applicable Laws and Exhibits - Appendix A
Exhibit 1
PROPOSED FUNDRAISING ACTIVITIES
Fund/account name VIOLEYBALL
Proposed fundraising activities: VELLEYBALL Calendar donations
Purposed Uses of funds raised
t-shirts, team apparel
Expected student involvement (school-wide or specific school organization)
each volleyball player raise $200
Method by which school will receive profit cash
Requested by Christie Carter
Name/Title
Date May 5, , 2024
Approved by Jina A Principal L Jugji
Date 5-5-26
Approved by Belinda
Date 5-7-26
Director of Schools*
* The Director of Schools must approve all fundraising activities that involve the participation
of the general student population in the marketing process of the fundraising effort.
A-2
Tennessee Internal School Uniform Accounting Policy Manual
Applicable Laws and Exhibits - Appendix A
Exhibit 1
PROPOSED FUNDRAISING ACTIVITIES
Fund/account name HCMS Cheer
Proposed fundraising activities: Mini Cheer Clinic
Purposed Uses of funds raised To pay for new equipment
or apparel used by the cheer leaders.
Expected student involvement (school-wide or specific school organization)
members of HCMS Cheer team and any
upcoming K-5th graders.
Method by which school will receive profit Cash or check
Requested by Madelyn Owens/Coach Date 5/7/26
Name/Title
Approved by Jina Principal
Date 5/7/26
Approved by Belinds audor
MAY 08 2026
Date
Director of Schools*
*The Director of Schools must approve all fundraising activities that involve the participation
of the general student population in the marketing process of the fundraising effort.
A-2
Tennessee Internal School Uniform Accounting Policy Manual
Applicable Laws and Exhibits - Appendix A
Exhibit 1
PROPOSED FUNDRAISING ACTIVITIES
Fund/account name HCMS Cheer
Proposed fundraising activities: Peach Sales
Purposed Uses of funds raised
To pay for new
(Run out banner for football, signs for cheerleaders cheer leaders
equipment used by cheerleaders.
to hold.)
Expected student involvement (school-wide or specific school organization)
members of the HCMS Cheer team.
Method by which school will receive profit cash or Check
Requested by Madelyn Owens/Coac cheer Date 5/7/26
Name/Title
Approved by Tina L. Principal Thepier
Date 5/7/26
Approved by Belinde Ada
Date
MAY 0 8 2026
Director of Schools*
*The Director of Schools must approve all fundraising activities that involve the participation
of the general student population in the marketing process of the fundraising effort.
A-2
Tennessee Internal School Uniform Accounting Policy Manual
Applicable Laws and Exhibits - Appendix A
Exhibit 1
PROPOSED FUNDRAISING ACTIVITIES
Fund/account name HCMS cheer
Proposed fundraising activities: Butter Braid Pastry
Fundraiser.
Purposed members Uses of funds of raised the HCMS Cheer team will
sell these pasteries tohelp cover the
costs of their uniform order.
Expected student involvement (school-wide or specific school organization)
12 team members
Method by which school will receive profit Cash or check to
HCMS Cheer
Requested by madelyn Owens/Coach
Date 5/8/26
Name/Title
Approved by Jina S. Principal Hugper
Date 5/11/26
Approved by Belinda audissin
MAY 1 1 2026
Date
Director of Schools*
* The Director of Schools must approve all fundraising activities that involve the participation
of the general student population in the marketing process of the fundraising effort.
A-2
Fundraiser Agreement
This agreement is entered into between Music City Fundraising (hereinafter referred to as "the Company") and Hickman
Co MS Cheer (hereinafter referred to as "The Group"). on 5/11/2026.
General terms & conditions of the agreement are as follows:
This fundraiser will begin on Monday May 11, 2026
The terms of this contract run from the date of the agreement signature until delivery on 6/4/2026.
The Group will sell Butter Braid pastries (one pastry = one unit) for $18 each
Wholesale cost of each unit will be: $11.75 plus applicable sales tax.
Profit from each unit will be:
$6.25 for total sales of under 300 units
$7.00 for total sales of 300 or more units
For sales of 300 or more units, the Company will apply a discount on the invoice to adjust the profit amount.
For deliveries within 50 miles of Franklin, TN. sales under 150 units may incur a delivery fee of $50.
For deliveries further than 50 miles from Franklin. TN, sales under 200 units may incur a $100 delivery fee.
The delivery fee may be lowered or waived by The Company at their discretion.
The Company will deliver all products & provide an invoice that includes any applicable sales tax collected on the
wholesale price of the pastries.
The Company will remit all collected sales tax to the Tennessee Department of Revenue on behalf of The Group.
All sales tax collected online will be remitted to the Tennessee Department of Revenue by the online processor.
The amount collected online for any online sales will be deducted from the amount due on the invoice.
The Group will pay the wholesale cost of the total units sold (and any applicable sales tax) and will keep the
remainder of the collected monies as profit.
If the total amount collected online exceeds the amount due on the invoice, The Company will bring The Group's
profit check to delivery.
By signing below, the Representative of The Company and the Representative of The Group agree to the terms of this
document.
Knubuly Jummer
President; Music City Fundraising
5/11/2026
Tax Id# 27-0648747
MUSIC CITY
FUNDRAISING
Madelyn Avers School or Group Representative, Title Cheer Coach
Ina S.Hugi Principal
5/11/26
School or Group
Date
Belinda anderson
MAY 1 1 2026
Tennessee Internal School Uniform Accounting Policy Manual
Applicable Laws and Exhibits-Appendix A
Exhibit 1
PROPOSED FUNDRAISING ACTIVITIES
Fund/account name Sunshine Comittee
Proposed fundraising activities: sell snack cart
Purposed Uses of funds raised
to build staff morale and Glebrate
Staff
Expected student involvement (school-wide or specific school organization)
school-wide
Method by which school will receive profit cash
Requested by Hannah Redden /PE Teacher
Date April 28,2026
Name/Title
Approved by KathyDich Principal
Date 4-28-26
Approved by BelidAM
APR 2 9 2026
Date
Director of Schools
The Director of Schools must approve all fundraising activities that involve the participation
of the general student population in the marketing process of the fundraising effort.
A-4
PROPOSED FUNDRAISING ACTIVITIES
Fund/Account Name: SOftBAll\ BASeBALL
Proposed Fundraising Activities: RAg BAll touchment
Proposed Uses of Funds Raised: SoftBAll \ BASEBALL - FielD RASES,
Equipment PRnetices Supplies, FielD upgrades
Expected Student Involvement (school-wide or specific school organization):
SOFTBALL | BAseBAll plAyeRs
Method by which school will receive profit: ENTRANCE Fee's concessiones
ANDREW Fink - BASCBAL
Requested by (Name/Title): Chris LAMBERT - SOPTBA" Date: 5-7-24
Approved by (Principal):
Date: 5-7-26
Approved by
(Director of Schools):
Belinda Ander Date:
MAY 0 8 2026
PROPOSED FUNDRAISING ACTIVITIES
Fund/Account Name: Volleyball
Proposed Fundraising Activities: Fill my volleyball
Proposed Uses of Funds Raised: Volleyball team equipment, necessities, and anything needed for the team.
Expected Student Involvement (school-wide or specific school organization):
Volleyball team
Method by which school will receive profit:
Check & Cash
Requested by (Name/Title):
Heather Nihoff
Date: 5/12/26
Approved by (Principal):
Date: 5-13-26
Approved by
(Director of Schools):
Belinda auden
MAY 132026 13
Date:
PROPOSED FUNDRAISING ACTIVITIES
Fund/Account Name: Volleyball
Proposed Fundraising Activities: Business sponsors
Proposed Uses of Funds Raised: Volleyball team equipment, necessities, and anything needed for the team.
Expected Student Involvement (school-wide or specific school organization):
Volleyball team
Method by which school will receive profit:
Check & Cash
Requested by (Name/Title):
Heather Nihoff
Date: 5/12/26
Approved by (Principal):
Date: 5-13-26
Approved by
(Director of Schools):
Belinderade
Date:
MAY 1 3 2026
PROPOSED FUNDRAISING ACTIVITIES
Fund/Account Name: Volleyball
Proposed Fundraising Activities: Car wash / bake sale June 6
Proposed Uses of Funds Raised: Volleyball team equipment, necessities, and anything needed for the team.
Expected Student Involvement (school-wide or specific school organization):
Volleyball team
Method by which school will receive profit:
Check & Cash
Requested by (Name/Title):
Heather Nihoff
Date: 5/12/26
Approved by (Principal):
Jana Wills
Date: 5-13-26
Approved by
MAY 1 3 2026
(Director of Schools):
Date:
PROPOSED FUNDRAISING ACTIVITIES
Fund/Account Name: School Fundraising
Proposed Fundraising Activities: Concessions at Field Day
Proposed Uses of Funds Raised: Gym Equipment
Expected Student Involvement (school-wide or specific school organization):
School-wide
Method by which school will receive profit: Cash/Check
Requested by (Name/Title): Preston Hall
Date: 4/27/26
Approved by (Principal):
Ojana Willis
Date: 4-27-26
Approved by
(Director of Schools):
Balinde Adle
Date:
APR 2 7 2026
PROPOSED FUNDRAISING ACTIVITIES
Fund/Account Name: School Fundraising
Proposed Fundraising Activities: School-wide Basketball Tournament and Concessions
Proposed Uses of Funds Raised: Gym Equipment
Expected Student Involvement (school-wide or specific school organization):
School-wide
Method by which school will receive profit: Cash/Check
Requested by (Name/Title): Preston Hall
Date: 4/27/26
Approved by (Principal):
Gana Wills
Date: 4-27-26
Approved by
(Director of Schools):
BelindaAde
Date:
APR 2 7 2026
HOMELAND COUNT SCHOOLS
CHRISTY MAYS
DOUG LANE
450 Hwy 50, Centerville, TN 37033
2059 Lake Drive, Centerville, TN 37033
SHERRI BAKER
RONALD GAMMONS
9037 E 40 Rd., Bon Aqua, TN 37025
6419 Rice Ln., Lyles, TN 37098
1807
JANE HERRON
TIM HOBBS
PO Box 13, Nunnelly, TN 37137
9220 Old Bon Aqua Rd., Bon Aqua, TN 37025
John Mullins
TABITHA CUDE
Superintendent of Schools
4141 Lewis Rd., Centerville, TN 37033
115 MURPHREE AVENUE
CENTERVILLE, TN 37033
School Support Organization
Request For Fundraising Activities
Organization HCHS Cheer (with HCMS Cheer)
Proposed Fundraising Activity Selling Peaches
Date(s)
Approval - June 20
Location(s)
Pickup at HCMS
Jillian O'Neal
Requested By
President/Chair of Organization
Date
Recommended By Roby Principal Emerson
5-13-26
Date
Approved Belinia Ader
MAY 2 6 2026
Director of Schools or Designee
Date
Not Approved
Director of Schools or Designee
Date
** A signed copy will be mailed to the organization and forwarded to the school**
SCHOOL SUPPORT ORGANIZATIONS
PROPOSED FUNDRAISING ACTIVITIES
(Pursuant to Section 49-2-804. TCA.
To be submitted prior to scheduling any fundraising activity.)
AND TCA SECTION 49-2-601 ET SEQ., OUR
IN COMPLIANCE WITH SCHOOL BOARD POLICY
SCHOOL SUPPORT ORGANIZATION SUBMITS THIS PROPOSED FUNDRAISING ACTIVITY FOR THE DIRECTOR'S
APPROVAL WE REALIZE THAT THE DIRECTOR SHALL CONSIDER, AT A MINUMUM, THE FOLLOWING WHTN
APPROVING OR DENYING A REQUEST BY A SCHOOL SUPPORT ORGANIZATION TO ENGAGE IN A
FUNDRAISING ACTIVITY:
1) Whether the fundraising activity, as scheduled, conflicts with the fundraising activity of the
school district or an individual school within the district, and
2) Whether the fundraising activity is consistent with the goals and mission of the school and/or the
school district.
The undersigned submits that this fundraising activity Is consistent with the goals and mission of the school
and/or the school district, as well as the organization mission, goals, and objectives.
ORGANIZATION: Back ofthe net Bulldogs
DATE OF PROPOSED FUNDRAISING: June 19thg 20th
PROPOSED FUNDRAISING ACTIVITY: seccer camp and alumni
game
PROPOSED USES OF THE FUNDS RAISED: Camera subscription
for bulledgs soccer team
OTHER COMMENTS/CONSIDERATIONS RELATED TO THE FUNDRAISER.
Regismoth Jan Brop Signature/Title
DATE: 5-8-26
REQUESTED BY
DATE: 5-18-26
REVIEWED BY:
APPROVED BY: Belinda Anderson School Principal/Designee
MAY 1 8 2026
DATE:
Director of Schools/Designee
Internal School Funds Manual
Applicable Laws and Exhibits - Appendix A
Exhibit 1
FUNDRAISER AUTHORIZATION FORM
School Hickman County High School
Fund/club/class account Volleyball - 601
Expected timeframe of fundraiser August 7 2026
Proposed fundraising activities Alumni Game
Method of fundraising (e.g., in-person, crowdfunding, etc.) In-person
Proposed uses of funds raised* Team Camp
Expected student involvement (school-wide or specific school organization)
Community
Method by which school will receive profit Cash / check
Requested by Kacher Hudgins / Head Coach
Date 5/4/26
Name/Title
Approved by Roby Principal Emerson
Date 5-4-26
Approved by BadidsAd
MAY 1 9 2026
Date
Director of Schools**
* Any change in proposed uses of funds raised must be approved by the Director of
Schools
** The Director of Schools must approve all fundraising activities that involve the
participation of the general student population in the marketing process of the
fundraising effort.
A-3
Internal School Funds Manual
Applicable Laws and Exhibits - Appendix A
Exhibit 1
FUNDRAISER AUTHORIZATION FORM
School Hickman County High School
Fund/club/class account Volleyball 601
Expected timeframe of fundraiser July 2026
Proposed fundraising activities Jr. Volleydawgs Clinics
Method of fundraising (e.g., in-person, crowdfunding, etc.) In-parson
Proposed uses of funds raised* Team Camp
Expected student involvement (school-wide or specific school organization)
Community
Method by which school will receive profit Cash / check
Requested by Rachel Hudgins / Head Coach
Date 5/4/26
Name/Title
Approved by Proby Principal Emason
Date 5-4-26
Approved by Belinda anderan
MAY 0 8 2026
Date
Director of Schools**
* Any change in proposed uses of funds raised must be approved by the Director of
Schools
** The Director of Schools must approve all fundraising activities that involve the
participation of the general student population in the marketing process of the
fundraising effort.
A-3
PROPOSED FUNDRAISING ACTIVITIES
STATE
East Hickman High School
REFICE
7700 Hwy 7, Lyles, TN 37098
Phone 931-670-1366 Fax 931-670-1039
Fund/Account Name EHHS Baseball
Account Number 608
Proposed fundraising activities: Community members pay for a three day camp led
primarily by EHHS Baseball Student-athletes.
Purposed Uses of funds raised: Facility upgrodes, new jerseys, and future expenses For
the 2026-2027 year.
Expected Student involvement (school-wide or specific school organization): EHHS Baseball players Coach/
interact with Campers through Small groups.
Method by which school will receive profit: Cash/Check
Requested by: Colton Huntt /Teacher; Coach
5/6/26
Name/Title
Date
Acknowledge by:
a
5/4/24
Date
Approved
by: Genter Bookkeeper Principal
5/6/20
Date
Belinde Doll
MAY 1 8 2026
Approved by:
Director of Schools*
Date
* The Director of Schools must approve all fundraising activities that involve the participation
of the general student population in the marketing process of the fundraising effort.
revised 4/2022

## Table 1

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 2

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 3

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 4

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 5

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 6

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 7

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 8

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 9

| Tim Hobbs: | Yea |
| --- | --- |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: Yea: 7, Nay: 0 | Yea |

## Table 10

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 11

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 12

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |

## Table 13

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 14

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 15

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
|  |  |

## Table 16

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 17

| Tabitha Cude: | Yea |
| --- | --- |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: Yea: 7, Nay: 0 | Yea |

## Table 18

| Tabitha Cude: | Absent |
| --- | --- |
| Doug Lane: | Absent |
| Christy Mays: | Absent |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
| Yea: 4, Nay: 0, Absent: | 3 |

## Table 19

| Tabitha Cude: | Absent |
| --- | --- |
| Doug Lane: | Absent |
| Christy Mays: | Absent |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
|  |  |

## Table 20

| Tabitha Cude: | Absent |
| --- | --- |
| Doug Lane: | Absent |
| Christy Mays: | Absent |

## Table 21

| Jane Herron: | Yea |
| --- | --- |
| Tim Hobbs: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
| Yea: 4, Nay: 0, Absent: | 3 |

## Table 22

| Tabitha Cude: | Absent |
| --- | --- |
| Doug Lane: | Absent |
| Christy Mays: | Absent |
| Jane Herron: | Yea |
| Tim Hobbs: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
| Yea: 4, Nay: 0, Absent: | 3 |

## Table 23

| Tabitha Cude: | Absent |
| --- | --- |
| Jane Herron: | Absent |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
| Yea: 5, Nay: 0, Absent: | 2 |

## Table 24

| Tabitha Cude: | Absent |
| --- | --- |
| Jane Herron: | Absent |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |

## Table 25

| Jane Herron: | Absent |
| --- | --- |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
| Yea: 5, Nay: 0, Absent: | 2 |

## Table 26

| Tabitha Cude: | Absent |
| --- | --- |
| Jane Herron: | Absent |
| Tim Hobbs: | Yea |
| Doug Lane: | Yea |
| Christy Mays: | Yea |
| Pippa Taylor: | Yea |
| Brandon Tidwell: | Yea |
| Yea: 5, Nay: 0, Absent: | 2 |

## Table 27

| Bank Name | Bank Number |
| --- | --- |
| General Purpose | 141 |

## Table 28

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004689 | A Dirty Job | 665 | 04/30/2026 | 141- -11140 | $7,000.00 |
| 41004690 | Amazon | 727 | 04/30/2026 | 141- -11140 | $61.89 |
| 41004691 | EAI Education | 7657 | 04/30/2026 | 141- -11140 | $380.98 |
| 41004692 | Everon FKA ADT Commercial | 7196 | 04/30/2026 | 141- -11140 | $1,900.92 |
| 41004693 | Josh Houstion & associates, Inc. | 7413 | 04/30/2026 | 141- -11140 | $75.75 |
| 41004694 | Kelley Designs | 9287 | 04/30/2026 | 141- -11140 | $170.00 |
| 41004695 | Owen's Oil Co., Inc. | 4257 | 04/30/2026 | 141- -11140 | $879.20 |
| 41004696 | Scholastic, Inc. | 4871 | 04/30/2026 | 141- -11140 | $5,608.00 |
| 41004697 | Southern Rock Restaurant, LLC | 7603 | 04/30/2026 | 141- -11140 | $197.29 |
| 41004698 | Teacher Created Resources | 10 | 04/30/2026 | 141- -11140 | $182.79 |
| 41004699 | Teacher Direct | 5359 | 04/30/2026 | 141- -11140 | $117.31 |
| 41004700 | The Dreaded Lawncare | 7933 | 04/30/2026 | 141- -11140 | $8,600.00 |
| 41004701 | Town Of Centerville | 5315 | 04/30/2026 | 141- -11140 | $733.39 |
| 41004702 | TreviPay-Walmart | 8999 | 04/30/2026 | 141- -11140 | $279.43 |
|  |  |  |  | 141 Total: | $26,186.95 |
|  |  |  |  | Bank Total: | $26,186.95 |
|  |  |  |  | Bank Payment Count: | 14 |

## Table 29

| Bank Name | Bank Number |
| --- | --- |
| Federal | 142 |

## Table 30

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001153 | Quill, LLC | 4574 | 04/30/2026 | 142-101-11140 |  | $614.92 |
|  |  |  |  |  | 142-101 Total: | $614.92 |
| 42001152 | Amazon | 727 | 04/30/2026 | 142-201-11140 |  | $1,673.86 |
|  |  |  |  |  | 142-201 Total: | $1,673.86 |
|  |  |  |  |  | Bank Total: | $2,288.78 |
|  |  |  |  | Bank | Payment Count: | 2 |

## Table 31

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 41004703 | Bennett & DeCamp PLLC | 8071 | 05/04/2026 | 141- -11140 |  | $1,058.00 |
| 41004704 | Bon Aqua Lyles Utility Distric | 851 | 05/04/2026 | 141- -11140 |  | $5,681.23 |
| 41004705 | Wilson, Brett | 8602 | 05/04/2026 | 141- -11140 |  | $718.86 |
| 41004706 | Lambert, Christopher | 8802 | 05/04/2026 | 141- -11140 |  | $2,396.20 |
| 41004707 | County Of Hickman Misc Acct | 1633 | 05/04/2026 | 141- -11140 |  | $58,222.29 |
| 41004708 | Edupoint Educational Systems, LLC | 9294 | 05/04/2026 | 141- -11140 |  | $9,401.46 |
| 41004709 | Estes, Kimberly | 8197 | 05/04/2026 | 141- -11140 |  | $958.48 |
| 41004710 | Floyd, Mason | 8798 | 05/04/2026 | 141- -11140 |  | $1,437.72 |
| 41004711 | Fundraiser Blankets | 9254 | 05/04/2026 | 141- -11140 |  | $6,875.00 |
| 41004712 | Gilliam, Robin M. | 7647 | 05/04/2026 | 141- -11140 |  | $6,709.36 |
| 41004713 | Gordon, Annie Martin | 9189 | 05/04/2026 | 141- -11140 |  | $1,677.34 |
| 41004714 | Gordon, Wendell | 2484 | 05/04/2026 | 141- -11140 |  | $6,230.12 |
| 41004715 | Hinson, Aric D. | 7648 | 05/04/2026 | 141- -11140 |  | $1,677.34 |
| 41004716 | McManus, Christy | 8120 | 05/04/2026 | 141- -11140 |  | $370.77 |
| 41004717 | Owen's Oil Co., Inc. | 4257 | 05/04/2026 | 141- -11140 |  | $27,457.04 |
| 41004718 | Paczkowski, Hannah | 9295 | 05/04/2026 | 141- -11140 |  | $2,191.24 |
| 41004719 | Ragan, Ray | 4749 | 05/04/2026 | 141- -11140 |  | $3,354.68 |
| 41004720 | Barnhill, Samantha | 8601 | 05/04/2026 | 141- -11140 |  | $1,198.10 |
| 41004721 | Smith, Kelvin Jefferson II | 5270 | 05/04/2026 | 141- -11140 |  | $1,677.34 |
| 41004722 | Southern Rock Restaurant, LLC | 7603 | 05/04/2026 | 141- -11140 |  | $132.39 |
| 41004723 | SSC Service Solutions Compass Group USA, Inc. | 4832 | 05/04/2026 | 141- -11140 |  | $61,838.58 |
| 41004724 | Tennessee School Board Assoc. | 61 | 05/04/2026 | 141- -11140 |  | $75.00 |
| 41004725 | Tennessee School Resource Officer Assoc. | 8571 | 05/04/2026 | 141- -11140 |  | $250.00 |
| 41004726 | Overby, Tia | 8632 | 05/04/2026 | 141- -11140 |  | $718.86 |
| 41004727 | Town Of Centerville | 5315 | 05/04/2026 | 141- -11140 |  | $1,900.56 |
| 41004728 | United States Treasury | 5817 | 05/04/2026 | 141- -11140 |  | $363.03 |
| 41004729 | Whitaker, Wesley | 7554 | 05/04/2026 | 141- -11140 |  | $220.40 |
|  |  |  |  | 141 | Total: | $204,791.39 |
|  |  |  |  | Bank | Total: | $204,791.39 |
|  |  |  |  | Bank Payment | Count: | 27 |

## Table 32

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001155 | Mayberry, Kimberly D. | 4108 | 05/04/2026 | 142-010-11140 |  | $117.45 |
|  |  |  |  |  | 142-010 Total: | $117.45 |
| 42001154 | County Of Hickman Misc Acct | 1633 | 05/04/2026 | 142-901-11140 |  | $390.19 |
|  |  |  |  |  | 142-901 Total: | $390.19 |
|  |  |  |  |  | Bank Total: | $507.64 |
|  |  |  |  | Bank | Payment Count: | 2 |

## Table 33

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004730 | Collins, Cailey | 1503 | 05/06/2026 | 141- -11140 | $3,354.68 |
| 41004731 | Campbell, Rebecca L. | 9298 | 05/06/2026 | 141- -11140 | $1,437.72 |
| 41004732 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 141- -11140 | $204,557.84 |
| 41004733 | Smith, Crissy | 9308 | 05/06/2026 | 141- -11140 | $1,437.72 |
| 41004734 | Hickman County Trustee | 2937 | 05/06/2026 | 141- -11140 | $5,903.57 |
| 41004735 | Fink, Andrew J. | 9310 | 05/06/2026 | 141- -11140 | $2,396.20 |
| 41004736 | Moss, Jason | 9299 | 05/06/2026 | 141- -11140 | $1,437.72 |
| 41004737 | Gribbins, Tatum | 9029 | 05/06/2026 | 141- -11140 | $1,677.34 |
|  |  |  |  | 141 Total: | $222,202.79 |
|  |  |  |  | Bank Total: | $222,202.79 |
|  |  |  |  | Bank Payment Count: | 8 |

## Table 34

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001156 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 142-010-11140 |  | $399.81 |
|  |  |  |  |  | 142-010 Total: | $399.81 |
| 42001156 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 142-101-11140 |  | $2,443.30 |
|  |  |  |  |  | 142-101 Total: | $2,443.30 |
| 42001156 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 142-170-11140 |  | $367.36 |
|  |  |  |  |  | 142-170 Total: | $367.36 |
| 42001156 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 142-201-11140 |  | $303.60 |
|  |  |  |  |  | 142-201 Total: | $303.60 |
| 42001156 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 142-601-11140 |  | $118.51 |
|  |  |  |  |  | 142-601 Total: | $118.51 |
| 42001156 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 142-901-11140 |  | $1,033.33 |
|  |  |  |  |  | 142-901 Total: | $1,033.33 |
|  |  |  |  |  | Bank Total: | $4,665.91 |
|  |  |  |  | Bank | Payment Count: | 1 |

## Table 35

| Bank Name | Bank Number |
| --- | --- |
| Cafeteria | 143 |

## Table 36

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 43000783 | County Of Hickman Misc Acct | 1633 | 05/06/2026 | 143- -11140 | $10,552.56 |
| 43000784 | Town Of Centerville | 5315 | 05/06/2026 | 143- -11140 | $134.87 |
|  |  |  |  | 143 Total: | $10,687.43 |
|  |  |  |  | Bank Total: | $10,687.43 |
|  |  |  |  | Bank Payment Count: | 2 |

## Table 37

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004738 | Becker's School Supplies | 951 | 05/07/2026 | 141- -11140 | $164.96 |
| 41004739 | Brewer Chemicals & Equip, LLC | 861 | 05/07/2026 | 141- -11140 | $420.00 |
| 41004740 | Brewer, Robert G. | 7665 | 05/07/2026 | 141- -11140 | $150.80 |
| 41004741 | Buchanan, Amanda | 920 | 05/07/2026 | 141- -11140 | $110.50 |
| 41004742 | Carson Dellosa Publishing LLC | 1327 | 05/07/2026 | 141- -11140 | $194.65 |
| 41004743 | Cross, Emily | 1744 | 05/07/2026 | 141- -11140 | $220.40 |
| 41004744 | Dex Imaging & Mailing | 1912 | 05/07/2026 | 141- -11140 | $651.97 |
| 41004745 | ESGI, LLC | 2261 | 05/07/2026 | 141- -11140 | $1,040.00 |
| 41004746 | Suits Me Fine Farm | 6330 | 05/07/2026 | 141- -11140 | $2,200.00 |
| 41004747 | Green, Ben | 2652 | 05/07/2026 | 141- -11140 | $1,437.72 |
| 41004748 | Hand 2 Mind, Inc. | 2108 | 05/07/2026 | 141- -11140 | $46.98 |
| 41004749 | Meriwether Lewis Electric Coop. | 3694 | 05/07/2026 | 141- -11140 | $43,852.76 |
| 41004750 | ODP Business Solutions, LLC | 4261 | 05/07/2026 | 141- -11140 | $350.09 |
| 41004751 | Oriental Trading Co., Inc. | 6258 | 05/07/2026 | 141- -11140 | $709.79 |
| 41004752 | Quill, LLC | 4574 | 05/07/2026 | 141- -11140 | $226.15 |
| 41004753 | Really Good Stuff, LLC | 4606 | 05/07/2026 | 141- -11140 | $215.00 |
| 41004754 | Tanner, Katelyn | 6315 | 05/07/2026 | 141- -11140 | $34.80 |
| 41004755 | Teacher Direct | 5359 | 05/07/2026 | 141- -11140 | $121.74 |
|  |  |  |  | 141 Total: | $52,148.31 |
|  |  |  |  | Bank Total: | $52,148.31 |
|  |  |  |  | Bank Payment Count: | 18 |

## Table 38

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001157 | Amazon | 727 | 05/07/2026 | 142-101-11140 |  | $5,091.42 |
| 42001159 | Mcc Nashville | 1836 | 05/07/2026 | 142-101-11140 |  | $1,469.00 |
|  |  |  |  |  | 142-101 Total: | $6,560.42 |
| 42001158 | Turpin, Jennifer | 5444 | 05/07/2026 | 142-801-11140 |  | $743.55 |
|  |  |  |  |  | 142-801 Total: | $743.55 |
|  |  |  |  |  | Bank Total: | $7,303.97 |
|  |  |  |  | Bank | Payment Count: | 3 |

## Table 39

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 43000785 | Gordon Food Service, Inc. | 2488 | 05/07/2026 | 143- -11140 | $92,611.85 |
| 43000786 | Murfreesboro Pure Milk Co, Inc. | 7552 | 05/07/2026 | 143- -11140 | $2,661.60 |
| 43000787 | Optimus Pest Solutions | 47 | 05/07/2026 | 143- -11140 | $240.00 |
| 43000788 | Pepsi Cola | 6726 | 05/07/2026 | 143- -11140 | $2,594.00 |
| 43000789 | Prairie Farms Dairy | 18 | 05/07/2026 | 143- -11140 | $18,585.36 |
| 43000790 | Prince Hardware, LLC | 4321 | 05/07/2026 | 143- -11140 | $440.75 |
| 43000791 | Quill Corporation | 4573 | 05/07/2026 | 143- -11140 | $992.93 |
| 43000792 | Volco | 5841 | 05/07/2026 | 143- -11140 | $597.10 |
|  |  |  |  | 143 Total: | $118,723.59 |
|  |  |  |  | Bank Total: | $118,723.59 |
|  |  |  |  | Bank Payment Count: | 8 |

## Table 40

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004756 | Ace Hardware | 635 | 05/11/2026 | 141- -11140 | $511.01 |
| 41004757 | Amazon | 727 | 05/11/2026 | 141- -11140 | $139.98 |
| 41004758 | AT & T | 7542 | 05/11/2026 | 141- -11140 | $219.61 |
| 41004759 | Buchanan, Shannon | 1164 | 05/11/2026 | 141- -11140 | $110.50 |
| 41004760 | Carson Dellosa Publishing LLC | 1327 | 05/11/2026 | 141- -11140 | $17.94 |
| 41004761 | Central States Bus Sales, Inc. | 1326 | 05/11/2026 | 141- -11140 | $2,664.09 |
| 41004762 | CNB Computers USA, Inc. | 6586 | 05/11/2026 | 141- -11140 | $349.00 |
| 41004763 | Constructive Playthings | 1303 | 05/11/2026 | 141- -11140 | $108.71 |
| 41004764 | County Of Hickman Misc Acct | 1633 | 05/11/2026 | 141- -11140 | $7,611.91 |
| 41004765 | Dean Oil Co., Inc. | 1985 | 05/11/2026 | 141- -11140 | $4,846.98 |
| 41004766 | Don Kennedy Roofing Co., Inc. | 6673 | 05/11/2026 | 141- -11140 | $715.00 |
| 41004767 | Duley, L.C.S.W., Joe | 1814 | 05/11/2026 | 141- -11140 | $1,625.00 |
| 41004768 | Dunlap, Marcus | 8955 | 05/11/2026 | 141- -11140 | $173.57 |
| 41004769 | Freeman Lumber & Supply | 2325 | 05/11/2026 | 141- -11140 | $1,573.96 |
| 41004770 | Gross, Debbie | 2675 | 05/11/2026 | 141- -11140 | $97.88 |
| 41004771 | Hibbs, Polly | 3038 | 05/11/2026 | 141- -11140 | $46.40 |
| 41004772 | Jenkins, Michelle Carol | 7423 | 05/11/2026 | 141- -11140 | $98.60 |
| 41004773 | Karco Parts | 3364 | 05/11/2026 | 141- -11140 | $171.58 |
| 41004774 | Kelsan, Inc. | 3379 | 05/11/2026 | 141- -11140 | $2,996.38 |
| 41004775 | Lakeshore Learning | 3463 | 05/11/2026 | 141- -11140 | $1,376.21 |
| 41004776 | Lumber Yard, The | 3652 | 05/11/2026 | 141- -11140 | $2,059.87 |
| 41004777 | Main Street Emporium | 7541 | 05/11/2026 | 141- -11140 | $493.70 |
| 41004778 | Mid-South Bus Center, Inc | 3706 | 05/11/2026 | 141- -11140 | $823.12 |
| 41004779 | Monica Ogles PT | 7756 | 05/11/2026 | 141- -11140 | $4,328.50 |
| 41004780 | O'Reilly Auto Parts | 4265 | 05/11/2026 | 141- -11140 | $919.77 |
| 41004781 | Oriental Trading Co., Inc. | 6258 | 05/11/2026 | 141- -11140 | $399.61 |
| 41004782 | Owen's Oil Co., Inc. | 4257 | 05/11/2026 | 141- -11140 | $2,224.32 |
| 41004783 | Plumbmaster, Inc. | 4379 | 05/11/2026 | 141- -11140 | $63.45 |
| 41004784 | Prince Hardware, LLC | 4321 | 05/11/2026 | 141- -11140 | $2,893.73 |
| 41004785 | Quill Corporation | 4573 | 05/11/2026 | 141- -11140 | $33.30 |
| 41004786 | Quill, LLC | 4574 | 05/11/2026 | 141- -11140 | $2,754.72 |
| 41004787 | Republic Service, LLC #840 | 4739 | 05/11/2026 | 141- -11140 | $203.67 |
| 41004788 | Reynolds Electrical Contractors, Llc | 4621 | 05/11/2026 | 141- -11140 | $2,590.00 |
| 41004789 | Rietveld, Stephanie | 993 | 05/11/2026 | 141- -11140 | $1,750.00 |
| 41004790 | Scholastic, Inc. | 4871 | 05/11/2026 | 141- -11140 | $276.76 |
| 41004791 | Soliant Health, LLC | 8569 | 05/11/2026 | 141- -11140 | $2,091.75 |
| 41004792 | SSC Service Solutions Compass Group USA, Inc. | 4832 | 05/11/2026 | 141- -11140 | $61,838.58 |
| 41004793 | State Of Tn Dept Of Labor | 4824 | 05/11/2026 | 141- -11140 | $110.00 |
| 41004794 | State Systems, LLC | 5242 | 05/11/2026 | 141- -11140 | $3,444.46 |
| 41004795 | The King's Daughter's School | 7928 | 05/11/2026 | 141- -11140 | $5,250.00 |
| 41004796 | Unifirst Corp. | 5758 | 05/11/2026 | 141- -11140 | $754.68 |
|  |  |  |  |  | 141 Total: $120,758.30 |
|  |  |  |  |  | Bank Total: $120,758.30 |

## Table 41

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001160 | Cathey, Vince | 9230 | 05/11/2026 | 142-101-11140 |  | $435.00 |
|  |  |  |  |  | 142-101 Total: | $435.00 |
|  |  |  |  |  | Bank Total: | $435.00 |
|  |  |  |  | Bank | Payment Count: | 1 |

## Table 42

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004797 | Benefits, Inc. | 1195 | 05/14/2026 | 141- -11140 | $2,161.32 |
| 41004798 | Duley, L.C.S.W., Joe | 1814 | 05/14/2026 | 141- -11140 | $1,007.50 |
| 41004799 | Everon FKA ADT Commercial | 7196 | 05/14/2026 | 141- -11140 | $396.00 |
| 41004800 | Fellowship Construction | 2295 | 05/14/2026 | 141- -11140 | $137,470.13 |
| 41004801 | First Farmers & Merchants Bank | 8074 | 05/14/2026 | 141- -11140 | $137,470.13 |
| 41004802 | Harvill, Nancy | 2758 | 05/14/2026 | 141- -11140 | $4,715.90 |
| 41004803 | Hickman Co Trustee | 2722 | 05/14/2026 | 141- -11140 | $256,303.79 |
| 41004804 | Interpreters Unlimited, Inc. | 6501 | 05/14/2026 | 141- -11140 | $191.25 |
| 41004805 | Jenkins, Michelle Carol | 7423 | 05/14/2026 | 141- -11140 | $98.60 |
| 41004806 | Josh Houstion & associates, Inc. | 7413 | 05/14/2026 | 141- -11140 | $32.00 |
| 41004807 | Lakeshore Learning | 3463 | 05/14/2026 | 141- -11140 | $619.84 |
| 41004808 | Matrix Mechanical Solutions, LLC | 7974 | 05/14/2026 | 141- -11140 | $13,393.45 |
| 41004809 | Roman A/V, LLC. | 7045 | 05/14/2026 | 141- -11140 | $500.00 |
| 41004810 | Scholastic, Inc | 5880 | 05/14/2026 | 141- -11140 | $830.28 |
| 41004811 | School Specialty | 1433 | 05/14/2026 | 141- -11140 | $161.13 |
| 41004812 | Sergeant Laboratories, Inc. | 7631 | 05/14/2026 | 141- -11140 | $17,637.69 |
| 41004813 | Soliant Health, LLC | 8569 | 05/14/2026 | 141- -11140 | $2,091.75 |
| 41004814 | Stellar Therapy Services, LLC | 8260 | 05/14/2026 | 141- -11140 | $8,330.00 |
| 41004815 | Tennessee Bureau Of Investigation | 5491 | 05/14/2026 | 141- -11140 | $200.00 |
| 41004816 | Town Of Centerville | 5315 | 05/14/2026 | 141- -11140 | $12,607.04 |
| 41004817 | Zayo Education | 2141 | 05/14/2026 | 141- -11140 | $2,075.55 |
|  |  |  |  | 141 Total: | $598,293.35 |
|  |  |  |  | Bank Total: | $598,293.35 |
|  |  |  |  | Bank Payment Count: | 21 |

## Table 43

| Federal | 142 |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- |
| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| 42001166 | Hickman Co Trustee | 2722 | 05/14/2026 | 142-010-11140 |  | $150.20 |
| 42001168 | Main Street Media | 8777 | 05/14/2026 | 142-010-11140 |  | $40.00 |
|  |  |  |  |  | 142-010 Total: | $190.20 |
| 42001161 | Amazon | 727 | 05/14/2026 | 142-101-11140 |  | $5,942.82 |
| 42001165 | Grassroots Workshops | 9251 | 05/14/2026 | 142-101-11140 |  | $1,327.50 |
| 42001166 | Hickman Co Trustee | 2722 | 05/14/2026 | 142-101-11140 |  | $1,231.05 |
| 42001167 | Josh Houstion & associates, Inc. | 7413 | 05/14/2026 | 142-101-11140 |  | $90.00 |
|  |  |  |  |  | 142-101 Total: | $8,591.37 |
| 42001166 | Hickman Co Trustee | 2722 | 05/14/2026 | 142-170-11140 |  | $82.70 |
|  |  |  |  |  | 142-170 Total: | $82.70 |
| 42001166 | Hickman Co Trustee | 2722 | 05/14/2026 | 142-201-11140 |  | $150.20 |
|  |  |  |  |  | 142-201 Total: | $150.20 |
| 42001162 | East Hickman High School | 2110 | 05/14/2026 | 142-801-11140 |  | $1,345.50 |
| 42001163 | East Hickman High School | 2113 | 05/14/2026 | 142-801-11140 |  | $3,561.72 |
| 42001164 | East Hickman High School | 2244 | 05/14/2026 | 142-801-11140 |  | $1,900.50 |
| 42001166 | Hickman Co Trustee | 2722 | 05/14/2026 | 142-801-11140 |  | $82.70 |
|  |  |  |  |  | 142-801 Total: | $6,890.42 |
| 42001166 | Hickman Co Trustee | 2722 | 05/14/2026 | 142-901-11140 |  | $2,568.64 |
|  |  |  |  |  | 142-901 Total: | $2,568.64 |
| 42001166 | Hickman Co Trustee | 2722 | 05/14/2026 | 142-911-11140 |  | $82.70 |
|  |  |  |  |  | 142-911 Total: | $82.70 |
|  |  |  |  |  | Bank Total: | $18,556.23 |
|  |  |  |  | Bank | Payment Count: | 8 |

## Table 44

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 43000793 | Boehms, Charlotte | 1209 | 05/14/2026 | 143- -11140 | $505.10 |
|  |  |  |  | 143 Total: | $505.10 |
|  |  |  |  | Bank Total: | $505.10 |
|  |  |  |  | Bank Payment Count: | 1 |

## Table 45

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004818 | Anderson, Belinda | 8051 | 05/18/2026 | 141- -11140 | $386.28 |
| 41004819 | AT&T | 7542 | 05/18/2026 | 141- -11140 | $65.48 |
| 41004820 | B & E Electronics, Inc. | 856 | 05/18/2026 | 141- -11140 | $4,444.00 |
| 41004821 | Crown Awards | 7569 | 05/18/2026 | 141- -11140 | $525.99 |
| 41004822 | Dickson Electric System | 1806 | 05/18/2026 | 141- -11140 | $33,150.62 |
| 41004823 | Dickson Medical Associates | 2022 | 05/18/2026 | 141- -11140 | $125.00 |
| 41004824 | Ferrellgas | 7446 | 05/18/2026 | 141- -11140 | $1,819.56 |
| 41004825 | Pace Analytical National | 2230 | 05/18/2026 | 141- -11140 | $378.00 |
| 41004826 | Porter, Savannah | 8555 | 05/18/2026 | 141- -11140 | $240.00 |
| 41004827 | Rj Young Company | 4691 | 05/18/2026 | 141- -11140 | $4,191.49 |
| 41004828 | SSC Service Solutions Compass Group USA, Inc. | 4832 | 05/18/2026 | 141- -11140 | $7,250.00 |
| 41004829 | Virco, Inc. | 5830 | 05/18/2026 | 141- -11140 | $999.60 |
| 41004830 | Walmart | 5868 | 05/18/2026 | 141- -11140 | $198.67 |
|  |  |  |  | 141 Total: | $53,774.69 |
|  |  |  |  | Bank Total: | $53,774.69 |
|  |  |  |  | Bank Payment Count: | 13 |

## Table 46

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001170 | Rj Young Company | 4691 | 05/18/2026 | 142-010-11140 |  | $254.12 |
|  |  |  |  |  | 142-010 Total: | $254.12 |
| 42001170 | Rj Young Company | 4691 | 05/18/2026 | 142-101-11140 |  | $189.48 |
| 42001171 | Cathey, Vince | 9230 | 05/18/2026 | 142-101-11140 |  | $282.75 |
|  |  |  |  |  | 142-101 Total: | $472.23 |
| 42001169 | Amazon | 727 | 05/18/2026 | 142-811-11140 |  | $2,291.48 |
|  |  |  |  |  | 142-811 Total: | $2,291.48 |
| 42001170 | Rj Young Company | 4691 | 05/18/2026 | 142-901-11140 |  | $200.06 |
|  |  |  |  |  | 142-901 Total: | $200.06 |
|  |  |  |  |  | Bank Total: | $3,217.89 |
|  |  |  |  | Bank | Payment Count: | 3 |

## Table 47

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 43000794 | American Fidelity Assurance Co | 636 | 05/18/2026 | 143- -11140 | $1,358.99 |
| 43000795 | Ameritas Life Insurance Corp. | 7442 | 05/18/2026 | 143- -11140 | $81.42 |
| 43000796 | Beam Insurance Administrators LLC | 7435 | 05/18/2026 | 143- -11140 | $428.41 |
| 43000797 | Cracker Barrel | 6218 | 05/18/2026 | 143- -11140 | $487.96 |
| 43000798 | Hickman Co Trustee | 2722 | 05/18/2026 | 143- -11140 | $1,790.02 |
| 43000799 | Hickman County Trustee | 2937 | 05/18/2026 | 143- -11140 | $18,882.67 |
| 43000800 | Rj Young Company | 4691 | 05/18/2026 | 143- -11140 | $336.83 |
| 43000801 | Tennessee Farmers Life Insurance | 5297 | 05/18/2026 | 143- -11140 | $25.00 |
|  |  |  |  | 143 Total: | $23,391.30 |
|  |  |  |  | Bank Total: | $23,391.30 |
|  |  |  |  | Bank Payment Count: | 8 |

## Table 48

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004831 | First Farmers & Merchants Bank | 8074 | 05/19/2026 | 141- -11140 | $7,235.27 |
| 41004832 | Visa | 8268 | 05/19/2026 | 141- -11140 | $901.70 |
|  |  |  |  | 141 Total: | $8,136.97 |
|  |  |  |  | Bank Total: | $8,136.97 |
|  |  |  |  | Bank Payment Count: | 2 |

## Table 49

| Federal | 142 |  |  |  |  |
| --- | --- | --- | --- | --- | --- |
| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| 42001172 | Visa | 8268 | 05/19/2026 | 142-801-11140 | $900.00 |
|  |  |  |  | 142-801 Total: | $900.00 |
|  |  |  |  | Bank Total: | $900.00 |
|  |  |  |  | Bank Payment Count: | 1 |

## Table 50

| Bank Name | Bank Number |
| --- | --- |
| General Purpose | 141 |

## Table 51

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004833 | Hickman Co Trustee | 2722 | 05/21/2026 | 141- -11140 | $1,050.00 |
| 41004834 | Hickman County Trustee | 2937 | 05/21/2026 | 141- -11140 | $433,637.72 |
| 41004835 | Metropolitan Life | 3677 | 05/21/2026 | 141- -11140 | $120.00 |
| 41004836 | Tennessee Child Support Receipting Unit | 1312 | 05/21/2026 | 141- -11140 | $791.00 |
| 41004837 | Tennessee Farmers Life Insurance | 5297 | 05/21/2026 | 141- -11140 | $925.00 |
|  |  |  |  | 141 Total: | $436,523.72 |
|  |  |  |  | Bank Total: | $436,523.72 |
|  |  |  |  | Bank Payment Count: | 5 |

## Table 52

| Bank Name | Bank Number |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- |
| Federal | 142 |  |  |  |  |  |
| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-010-11140 |  | $3,253.77 |
|  |  |  |  |  | 142-010 Total: | $3,253.77 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-101-11140 |  | $10,983.39 |
|  |  |  |  |  | 142-101 Total: | $10,983.39 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-170-11140 |  | $1,537.70 |
|  |  |  |  |  | 142-170 Total: | $1,537.70 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-201-11140 |  | $1,627.47 |
|  |  |  |  |  | 142-201 Total: | $1,627.47 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-401-11140 |  | $1,321.90 |
|  |  |  |  |  | 142-401 Total: | $1,321.90 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-601-11140 |  | $1,447.01 |
|  |  |  |  |  | 142-601 Total: | $1,447.01 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-801-11140 |  | $278.38 |
|  |  |  |  |  | 142-801 Total: | $278.38 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-901-11140 |  | $11,846.49 |
| 42001174 | Tennessee Farmers Life Insurance | 5297 | 05/21/2026 | 142-901-11140 |  | $30.00 |
|  |  |  |  |  | 142-901 Total: | $11,876.49 |
| 42001173 | Hickman County Trustee | 2937 | 05/21/2026 | 142-911-11140 |  | $255.94 |
|  |  |  |  |  | 142-911 Total: | $255.94 |
|  |  |  |  |  | Bank Total: | $32,582.05 |
|  |  |  |  | Bank | Payment Count: | 2 |

## Table 53

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001176 | Ricketts, Aubrey | 9248 | 05/22/2026 | 142-101-11140 |  | $250.00 |
| 42001178 | Campbell, Lauren | 9247 | 05/22/2026 | 142-101-11140 |  | $250.00 |
|  |  |  |  |  | 142-101 Total: | $500.00 |
| 42001175 | Amazon | 727 | 05/22/2026 | 142-811-11140 |  | $2,678.94 |
|  |  |  |  |  | 142-811 Total: | $2,678.94 |
| 42001177 | Gilliam, Dewanna Adaire | 7760 | 05/22/2026 | 142-901-11140 |  | $377.00 |
| 42001179 | Wilson, Anita | 7954 | 05/22/2026 | 142-901-11140 |  | $1,152.00 |
|  |  |  |  |  | 142-901 Total: | $1,529.00 |
|  |  |  |  |  | Bank Total: | $4,707.94 |
|  |  |  |  | Bank | Payment Count: | 5 |

## Table 54

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004838 | Allegra Print & Imaging | 650 | 05/22/2026 | 141- -11140 | $36.11 |
| 41004839 | Amazon | 727 | 05/22/2026 | 141- -11140 | $2,986.70 |
| 41004840 | AT & T | 7542 | 05/22/2026 | 141- -11140 | $362.50 |
| 41004841 | Brewer, Robert G. | 7665 | 05/22/2026 | 141- -11140 | $150.80 |
| 41004842 | Cashier's Office | 1736 | 05/22/2026 | 141- -11140 | $3,080.00 |
| 41004843 | CNB Computers USA, Inc. | 6586 | 05/22/2026 | 141- -11140 | $99,450.00 |
| 41004844 | Gallaher & Associates, Inc. | 7285 | 05/22/2026 | 141- -11140 | $4,065.00 |
| 41004845 | Gross, Debbie | 2675 | 05/22/2026 | 141- -11140 | $59.09 |
| 41004846 | Hickman Co Solid Waste Man. | 2746 | 05/22/2026 | 141- -11140 | $87.60 |
| 41004847 | Hickman County High School | 40 | 05/22/2026 | 141- -11140 | $3,970.00 |
| 41004848 | Kelsan, Inc. | 3379 | 05/22/2026 | 141- -11140 | $2,980.70 |
| 41004849 | McCaleb, Rachel | 7746 | 05/22/2026 | 141- -11140 | $54.38 |
| 41004850 | Burkheart, Michelle | 9242 | 05/22/2026 | 141- -11140 | $130.50 |
| 41004851 | Oriental Trading Co., Inc. | 6258 | 05/22/2026 | 141- -11140 | $715.37 |
| 41004852 | Osborne, Angie M. | 4291 | 05/22/2026 | 141- -11140 | $134.85 |
| 41004853 | Pace Analytical National | 2230 | 05/22/2026 | 141- -11140 | $378.00 |
| 41004854 | Quill | 4576 | 05/22/2026 | 141- -11140 | $84.94 |
| 41004855 | Quill, LLC | 4574 | 05/22/2026 | 141- -11140 | $70.19 |
| 41004856 | Republic Service, LLC #840 | 4739 | 05/22/2026 | 141- -11140 | $4,439.12 |
| 41004857 | School Specialty | 1433 | 05/22/2026 | 141- -11140 | $76.83 |
| 41004858 | SSC Service Solutions Compass Group USA, Inc. | 4832 | 05/22/2026 | 141- -11140 | $19,200.00 |
| 41004859 | Herrera, Tammy | 8538 | 05/22/2026 | 141- -11140 | $75.40 |
| 41004860 | Tanner, Katelyn | 6315 | 05/22/2026 | 141- -11140 | $49.30 |
| 41004861 | Thermatec | 5348 | 05/22/2026 | 141- -11140 | $13,597.00 |
| 41004862 | TreviPay-Walmart | 8999 | 05/22/2026 | 141- -11140 | $647.42 |
| 41004863 | WNKX Hickman Digital Media, INC. | 3446 | 05/22/2026 | 141- -11140 | $400.00 |
|  |  |  |  | 141 Total: | $157,281.80 |
|  |  |  |  | Bank Total: | $157,281.80 |
|  |  |  |  | Bank Payment Count: | 26 |

## Table 55

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account | Amount |
| --- | --- | --- | --- | --- | --- |
| 41004864 | Amazon | 727 | 05/26/2026 | 141- -11140 | $39.88 |
| 41004865 | BELFOR Property Restoration, Inc. | 8920 | 05/26/2026 | 141- -11140 | $29,489.19 |
| 41004866 | County Of Hickman Misc Acct | 1633 | 05/26/2026 | 141- -11140 | $63,253.11 |
| 41004867 | Carl, Delta | 8469 | 05/26/2026 | 141- -11140 | $155.00 |
| 41004868 | Dunlap, Marcus | 8955 | 05/26/2026 | 141- -11140 | $96.57 |
| 41004869 | EAI Education | 7657 | 05/26/2026 | 141- -11140 | $885.00 |
| 41004870 | Hatton, Lynn | 5923 | 05/26/2026 | 141- -11140 | $84.50 |
| 41004871 | Hibbs, Polly | 3038 | 05/26/2026 | 141- -11140 | $40.60 |
| 41004872 | Hickman Co Trustee | 2722 | 05/26/2026 | 141- -11140 | $1,374.10 |
| 41004873 | Jenkins, Michelle Carol | 7423 | 05/26/2026 | 141- -11140 | $75.40 |
| 41004874 | Gordon, Joseph | 9325 | 05/26/2026 | 141- -11140 | $1,437.72 |
| 41004875 | Lakeshore Learning | 3463 | 05/26/2026 | 141- -11140 | $1,733.74 |
| 41004876 | Matrix Mechanical Solutions, LLC | 7974 | 05/26/2026 | 141- -11140 | $6,189.45 |
| 41004877 | Hanes, Michael | 8284 | 05/26/2026 | 141- -11140 | $390.50 |
| 41004878 | Monica Ogles PT | 7756 | 05/26/2026 | 141- -11140 | $3,244.70 |
| 41004879 | Optimus Pest Solutions | 47 | 05/26/2026 | 141- -11140 | $750.00 |
| 41004880 | Shelton, Misty L. | 375 | 05/26/2026 | 141- -11140 | $92.80 |
| 41004881 | Soliant Health, LLC | 8569 | 05/26/2026 | 141- -11140 | $3,974.33 |
| 41004882 | Tennessee Book Company | 5286 | 05/26/2026 | 141- -11140 | $1,982.00 |
| 41004883 | The Brook Center Therapy Solutions, LLC | 8659 | 05/26/2026 | 141- -11140 | $4,896.66 |
| 41004884 | Water Authority Of Dickson Co. | 5874 | 05/26/2026 | 141- -11140 | $2,298.00 |
|  |  |  |  | 141 Total: | $122,483.25 |
|  |  |  |  | Bank Total: | $122,483.25 |
|  |  |  |  | Bank Payment Count: | 21 |

## Table 56

| Payment Number | Vendor Name | Vendor ID | Payment Date | Cash Account |  | Amount |
| --- | --- | --- | --- | --- | --- | --- |
| 42001180 | American Paper & Twine Company | 797 | 05/26/2026 | 142-010-11140 |  | $578.20 |
| 42001182 | Thomasson, Julia | 192 | 05/26/2026 | 142-010-11140 |  | $704.70 |
| 42001183 | Mayberry, Kimberly D. | 4108 | 05/26/2026 | 142-010-11140 |  | $175.45 |
|  |  |  |  |  | 142-010 Total: | $1,458.35 |
| 42001184 | TEK Industries, LLC | 9239 | 05/26/2026 | 142-101-11140 |  | $360.25 |
|  |  |  |  |  | 142-101 Total: | $360.25 |
| 42001181 | County Of Hickman Misc Acct | 1633 | 05/26/2026 | 142-401-11140 |  | $20.00 |
|  |  |  |  |  | 142-401 Total: | $20.00 |
| 42001181 | County Of Hickman Misc Acct | 1633 | 05/26/2026 | 142-601-11140 |  | $50.00 |
|  |  |  |  |  | 142-601 Total: | $50.00 |
| 42001181 | County Of Hickman Misc Acct | 1633 | 05/26/2026 | 142-901-11140 |  | $390.19 |
|  |  |  |  |  | 142-901 Total: | $390.19 |
|  |  |  |  |  | Bank Total: | $2,278.79 |
|  |  |  |  | Bank | Payment Count: | 5 |

## Table 57

| To: | Board Members |
| --- | --- |
| From: | Dr. Belinda Anderson |
| Date: | 4/27/2026 |
| Re: | May Personnel Report |

## Table 58

| Retirement |  |
| --- | --- |
| Professional |  |
| Support Staff |  |
| Transfers |  |
| Professional |  |
| Support Staff |  |
| Appointment |  |
| Professional William (Billy) Sawyer | EHHS Head Football Coach |
| Support Staff Harper Shelton | HCMS Girls' Golf Coach |

## Table 59

| 141 General | Purpose School |  | Year-To-Date |  |  | Month-To-Date |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Account | Description | Budget Estimate | Actual | % of Budget | Estimate Avg/Mth | Actual | % of Avg |
| Revenues |  |  |  |  |  |  |  |
| 40110 | Current Property Tax | 2,773,333.00 | (2,861,438.85) | 103.18% | 231,111.08 | 0.00 | 0.00% |
| 40120 | Trustee's Collections - Prior Year | 75,000.00 | (64,181.33) | 85.58% | 6,250.00 | 0.00 | 0.00% |
| 40125 | Trustee's Collections - Bankruptcy | 500.00 | (49.96) | 9.99% | 41.67 | 0.00 | 0.00% |
| 40130 | Cir Clk/Clk & Master Collections-Pr Yr | 40,000.00 | (19,484.33) | 48.71% | 3,333.33 | 0.00 | 0.00% |
| 40140 | Interest And Penalty | 15,000.00 | (11,129.29) | 74.20% | 1,250.00 | 0.00 | 0.00% |
| 40161 | Payments In Lieu Of Taxes - T. V.A. | 3,500.00 | (2,085.91) | 59.60% | 291.67 | 0.00 | 0.00% |
| 40162 | Payments In Lieu Of Taxes-Local | 6,000.00 | (6,000.00) | 100.00% | 500.00 | 0.00 | 0.00% |
| 40210 | Local Option Sales Tax | 2,975,000.00 | (2,693,024.81) | 90.52% | 247,916.67 | 0.00 | 0.00% |
| 40270 | Business Tax | 45,000.00 | (16,680.75) | 37.07% | 3,750.00 | 0.00 | 0.00% |
| 41110 | Marriage Licenses | 1,300.00 | (1,054.50) | 81.12% | 108.33 | 0.00 | 0.00% |
| 43570 | Receipts From Individual Schools | 30,000.00 | (10,758.33) | 35.86% | 2,500.00 | 0.00 | 0.00% |
| 43582 | Community Service Fees - Adults | 200.00 | (11.57) | 5.79% | 16.67 | 0.00 | 0.00% |
| 44120 | Lease/Rentals/PPP | 7,500.00 | (1,685.00) | 22.47% | 625.00 | 0.00 | 0.00% |
| 44170 | Miscellaneous Refunds | 30,000.00 | (41,219.12) | 137.40% | 2,500.00 | 0.00 | 0.00% |
| 44530 | Sale Of Equipment | 15,000.00 | 0.00 | 0.00% | 1,250.00 | 0.00 | 0.00% |
| 44560 | Damages Recovered From Individuals | 3,000.00 | (360.00) | 12.00% | 250.00 | 0.00 | 0.00% |
| 44570 | Contributions & Gifts | 20,000.00 | (27,025.00) | 135.13% | 1,666.67 | 0.00 | 0.00% |
| 44990 | Other Local Revenues | 30,000.00 | 0.00 | 0.00% | 2,500.00 | 0.00 | 0.00% |
| 46175 | On-Behalf Contributions For OPEB | 40,000.00 | 0.00 | 0.00% | 3,333.33 | 0.00 | 0.00% |
| 46510 | Tennessee Investment in Student | 25,081,234.00 | (22,832,049.35) | 91.03% | 2,090,102.83 | 0.00 | 0.00% |
| 46515 | Early Childhood Education | 445,000.00 | (237,677.33) | 53.41% | 37,083.33 | 0.00 | 0.00% |
| 46520 | School Food Service | 22,000.00 | (16,839.13) | 76.54% | 1,833.33 | 0.00 | 0.00% |
| 46550 | Driver Education | 10,000.00 | (6,585.61) | 65.86% | 833.33 | 0.00 | 0.00% |
| 46590 | Other State Education Funds | 818,936.60 | (578,936.60) | 70.69% | 68,244.72 | 0.00 | 0.00% |
| 46610 | Career Ladder Program | 37,500.00 | (29,615.89) | 78.98% | 3,125.00 | 0.00 | 0.00% |
| 46790 | Other Vocational | 1,660,665.59 | (125,401.04) | 7.55% | 138,388.80 | 0.00 | 0.00% |
| 46851 | State Revenue Sharing -T.V.A. | 220,000.00 | (148,638.93) | 67.56% | 18,333.33 | 0.00 | 0.00% |
| 46980 | Other State Grants | 59,525.19 | 0.00 | 0.00% | 4,960.43 | 0.00 | 0.00% |
| 46990 | Other State Revenues | 100,000.00 | (216,790.55) | 216.79% | 8,333.33 | 0.00 | 0.00% |
| 47143 | Special Education - Grants To States | 16,574.12 | 0.00 | 0.00% | 1,381.18 | 0.00 | 0.00% |
| 47640 | Rotc Reimbursement | 65,000.00 | (48,287.26) | 74.29% | 5,416.67 | 0.00 | 0.00% |
| 48990 | Other | 4,000.00 | (36,856.17) | 921.40% | 333.33 | 0.00 | 0.00% |
| 49700 | Insurance Recovery | 64,055.14 | (70,594.97) | 110.21% | 5,337.93 | 0.00 | 0.00% |
| 49800 | Transfers In | 10,000.00 | 0.00 | 0.00% | 833.33 | 0.00 | 0.00% |
|  | Total Revenues | 34,724,823.64 | (30,104,461.58) | 86.69% | 2,893,735.30 | 0.00 | 0.00% |
| Expenditures |  |  |  |  |  |  |  |
| 71100 | Regular Instruction Program | (17,320,800.60) | 15,695,817.84 | 90.62% | (1,443,400.05) | 1,605,836.81 | 111.25% |

## Table 60

| 141 General | Purpose School |  | Year-To-Date |  |  | Month-To-Date |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Account | Description | Budget Estimate | Actual | % of Budget | Estimate Avg/Mth | Actual | % of Avg |
| 71150 | Alternative Instruction Program | (317,021.00) | 184,218.80 | 58.11% | (26,418.42) | 19,186.59 | 72.63% |
| 71200 | Special Education Program | (3,752,982.12) | 2,693,441.78 | 71.77% | (312,748.51) | 274,646.65 | 87.82% |
| 71300 | Career and Technical Education | (2,033,598.73) | 955,100.29 | 46.97% | (169,466.56) | 105,312.45 | 62.14% |
| 72110 | Attendance | (225,221.00) | 137,954.41 | 61.25% | (18,768.42) | 13,270.51 | 70.71% |
| 72120 | Health Services | (970,868.99) | 673,985.79 | 69.42% | (80,905.75) | 62,120.14 | 76.78% |
| 72130 | Other Student Support | (1,249,822.00) | 927,407.79 | 74.20% | (104,151.83) | 92,259.21 | 88.58% |
| 72210 | Regular Instruction Program | (1,709,956.00) | 1,137,004.85 | 66.49% | (142,496.33) | 120,702.65 | 84.71% |
| 72220 | Special Education Program | (550,492.00) | 408,124.42 | 74.14% | (45,874.33) | 45,909.31 | 100.08% |
| 72230 | Career and Technical Education | (221,945.22) | 138,943.58 | 62.60% | (18,495.44) | 12,294.15 | 66.47% |
| 72250 | Technology | (559,224.00) | 434,540.35 | 77.70% | (46,602.00) | 15,759.50 | 33.82% |
| 72290 | Other Programs | (35,000.00) | 30,497.82 | 87.14% | (2,916.67) | 0.00 | 0.00% |
| 72310 | Board Of Education | (697,742.00) | 578,625.26 | 82.93% | (58,145.17) | 13,252.85 | 22.79% |
| 72320 | Director Of Schools | (338,617.00) | 206,904.53 | 61.10% | (28,218.08) | 16,019.45 | 56.77% |
| 72410 | Office Of The Principal | (2,116,218.00) | 1,471,361.45 | 69.53% | (176,351.50) | 144,304.39 | 81.83% |
| 72510 | Fiscal Services | (50,000.00) | 0.00 | 0.00% | (4,166.67) | 0.00 | 0.00% |
| 72610 | Operation Of Plant | (2,704,798.00) | 2,448,926.17 | 90.54% | (225,399.83) | 256,291.77 | 113.71% |
| 72620 | Maintenance Of Plant | (1,441,028.19) | 1,076,641.46 | 74.71% | (120,085.68) | 70,438.61 | 58.66% |
| 72710 | Transportation | (2,006,898.00) | 1,463,709.21 | 72.93% | (167,241.50) | 85,387.43 | 51.06% |
| 72810 | Central And Other | (318,544.00) | 123,333.86 | 38.72% | (26,545.33) | 7,019.72 | 26.44% |
| 73100 | Food Service | (46,696.00) | 4,600.00 | 9.85% | (3,891.33) | 4,600.00 | 118.21% |
| 73300 | Community Services | (114,189.00) | 72,351.14 | 63.36% | (9,515.75) | 7,149.13 | 75.13% |
| 73400 | Early Childhood Education | (535,338.00) | 376,922.00 | 70.41% | (44,611.50) | 28,666.28 | 64.26% |
| 76100 | Regular Capital Outlay | (1,687,947.78) | 936,206.95 | 55.46% | (140,662.32) | 144,705.40 | 102.87% |
|  | Total Expenditures | (41,004,947.63) | 32,176,619.75 | 78.47% | (3,417,078.97) | 3,145,133.00 | 92.04% |
| Total 141 | General Purpose School | (6,280,123.99) | 2,072,158.17 | 33.00% | (523,343.67) | 3,145,133.00 | 600.97% |

## Table 61

| 142 School | Federal Projects |  | Year-To-Date |  |  | Month-To-Date |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Account | Description | Budget Estimate | Actual | % of Budget | Estimate Avg/Mth | Actual | % of Avg |
| Revenues |  |  |  |  |  |  |  |
| 44170 | Miscellaneous Refunds | 0.00 | 0.00 | 0.00% | 0.00 | 0.00 | 0.00% |
| 47131 | Vocational Educ - Basic Grants To | 123,906.21 | (49,692.50) | 40.10% | 10,325.52 | 0.00 | 0.00% |
| 47141 | Title 1 Grants To Local Educ Agencies | 1,305,599.16 | (778,342.93) | 59.62% | 108,799.93 | 0.00 | 0.00% |
| 47143 | Special Education - Grants To States | 1,085,813.68 | (721,237.64) | 66.42% | 90,484.47 | 0.00 | 0.00% |
| 47145 | Special Education Preschool Grants | 53,018.44 | (13,686.47) | 25.81% | 4,418.20 | 0.00 | 0.00% |
| 47146 | English Language Acquisition Grants | 0.00 | (86,207.30) | 0.00% | 0.00 | 0.00 | 0.00% |
| 47148 | Rural Education | 84,010.08 | (39,584.43) | 47.12% | 7,000.84 | 0.00 | 0.00% |
| 47189 | Eisenhower Prof Development State | 238,659.59 | (65,701.47) | 27.53% | 19,888.30 | 0.00 | 0.00% |
| 47309 | COVID-19 Grant D | 74,500.00 | (31,025.00) | 41.64% | 6,208.33 | 0.00 | 0.00% |
| 47401 | American Rescue Plan Act Grant #1 | 0.00 | 0.00 | 0.00% | 0.00 | 0.00 | 0.00% |
| 47590 | Other Federal Through State | 136,548.80 | 0.00 | 0.00% | 11,379.07 | 0.00 | 0.00% |
|  | Total Revenues | 3,102,055.96 | (1,785,477.74) | 57.56% | 258,504.66 | 0.00 | 0.00% |
| Expenditures |  |  |  |  |  |  |  |
| 71100 | Regular Instruction Program | (876,386.21) | 662,418.20 | 75.59% | (73,032.18) | 49,601.14 | 67.92% |
| 71200 | Special Education Program | (814,441.23) | 615,221.70 | 75.54% | (67,870.10) | 50,183.81 | 73.94% |
| 71300 | Career and Technical Education | (108,348.36) | 105,547.63 | 97.42% | (9,029.03) | 39,597.18 | 438.55% |
| 72130 | Other Student Support | (30,202.96) | 23,315.92 | 77.20% | (2,516.91) | 6,537.72 | 259.75% |
| 72210 | Regular Instruction Program | (935,379.28) | 614,645.81 | 65.71% | (77,948.27) | 44,910.43 | 57.62% |
| 72220 | Special Education Program | (306,890.89) | 243,494.92 | 79.34% | (25,574.24) | 20,479.85 | 80.08% |
| 72230 | Career and Technical Education | (4,907.03) | 1,389.08 | 28.31% | (408.92) | 743.55 | 181.83% |
| 72710 | Transportation | (25,500.00) | 14,238.35 | 55.84% | (2,125.00) | 2,246.75 | 105.73% |
|  | Total Expenditures | (3,102,055.96) | 2,280,271.61 | 73.51% | (258,504.66) | 214,300.43 | 82.90% |
| Total 142 | School Federal Projects | 0.00 | 494,793.87 | 100.00% | 0.00 | 214,300.43 | 0.00% |

## Table 62

| 143 Central | Cafeteria |  | Year-To-Date |  |  | Month-To-Date |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Account | Description | Budget Estimate | Actual | % of Budget | Estimate Avg/Mth | Actual | % of Avg |
| Revenues |  |  |  |  |  |  |  |
| 43521 | Lunch Payments - Children | 0.00 | (779.65) | 0.00% | 0.00 | 0.00 | 0.00% |
| 43522 | Lunch Payments - Adults | 22,000.00 | (19,183.99) | 87.20% | 1,833.33 | 0.00 | 0.00% |
| 43523 | Income From Breakfast | 2,500.00 | (2,551.38) | 102.06% | 208.33 | 0.00 | 0.00% |
| 43525 | A La Carte Sales | 265,000.00 | (180,360.30) | 68.06% | 22,083.33 | 0.00 | 0.00% |
| 43570 | Receipts From Individual Schools | 0.00 | 0.00 | 0.00% | 0.00 | 0.00 | 0.00% |
| 44110 | Investment Income | 1,000.00 | (122.42) | 12.24% | 83.33 | 0.00 | 0.00% |
| 44170 | Miscellaneous Refunds | 0.00 | 0.00 | 0.00% | 0.00 | 0.00 | 0.00% |
| 47111 | USDA School Lunch Program | 1,800,000.00 | (1,429,095.50) | 79.39% | 150,000.00 | 0.00 | 0.00% |
| 47113 | Breakfast | 750,000.00 | (549,799.30) | 73.31% | 62,500.00 | 0.00 | 0.00% |
| 47114 | USDA Other | 0.00 | (7,126.56) | 0.00% | 0.00 | 0.00 | 0.00% |
|  | Total Revenues | 2,840,500.00 | (2,189,019.10) | 77.06% | 236,708.33 | 0.00 | 0.00% |
| Expenditures |  |  |  |  |  |  |  |
| 73100 | Food Service | (2,957,934.00) | 2,550,040.90 | 86.21% | (246,494.50) | 178,840.76 | 72.55% |
|  | Total Expenditures | (2,957,934.00) | 2,550,040.90 | 86.21% | (246,494.50) | 178,840.76 | 72.55% |
| Total 143 | Central Cafeteria | (117,434.00) | 361,021.80 | 307.43% | (9,786.17) | 178,840.76 | 1,827. |

## Table 63

| Grade |  | Net Male |  | Enrollment to Female | Date Total |  | End of Month Membership |  | Average Daily Attendance |  | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  | 46 |  | 39 | 85 |  | 90 |  | 84.3331 |  | 90.0666 |
| 01 |  | 69 |  | 48 | 117 |  | 130 |  | 121.2664 |  | 130.0000 |
| 02 |  | 50 |  | 44 | 94 |  | 103 |  | 95.1997 |  | 103.5999 |
| 03 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 04 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 05 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 06 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 07 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 08 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 09 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 10 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 11 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 12 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| K-12 |  | 165 |  | 131 | 296 |  | 323 |  | 300.7993 |  | 323.6666 |
| GRAND TOTAL |  | 165 |  | 131 | 296 |  | 323 |  | 300.7993 |  | 323.6666 |

## Table 64

| Grade |  | Net Male |  | Enrollment to Female | Date Total |  | End of Month Membership |  | Average Daily Attendance | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 01 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 02 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 03 |  | 51 |  | 54 | 105 |  | 114 |  | 107.1331 | 114.0000 |
| 04 |  | 39 |  | 52 | 91 |  | 103 |  | 95.0664 | 103.0000 |
| 05 |  | 56 |  | 48 | 104 |  | 112 |  | 104.0664 | 112.0000 |
| 06 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 07 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 08 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 09 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 10 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 11 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 12 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| K-12 |  | 146 |  | 154 | 300 |  | 329 |  | 306.2659 | 329.0000 |
| GRAND TOTAL |  | 146 |  | 154 | 300 |  | 329 |  | 306.2659 | 329.0000 |

## Table 65

| Grade |  | Net |  | Enrollment to | Date |  | End of Month Membership |  | Average Daily Attendance | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
|  |  | Male |  | Female | Total |  |  |  |  |  |
| K |  | 56 |  | 55 | 111 |  | 116 |  | 110.1998 | 116.0000 |
| 01 |  | 48 |  | 45 | 93 |  | 107 |  | 99.9331 | 107.0000 |
| 02 |  | 47 |  | 47 | 94 |  | 102 |  | 95.0664 | 101.0000 |
| 03 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 04 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 05 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 06 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 07 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 08 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 09 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 10 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 11 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 12 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| K-12 |  | 151 |  | 147 | 298 |  | 325 |  | 305.1993 | 324.0000 |
| GRAND TOTAL |  | 151 |  | 147 | 298 |  | 325 |  | 305.1993 | 324.0000 |

## Table 66

| Grade |  | Net Male |  | Enrollment to Female | Date Total |  | End of Month Membership |  | Average Daily Attendance |  | Average Daily Membership |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 01 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 02 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 03 |  | 41 |  | 43 | 84 |  | 92 |  | 86.9998 |  | 92.0000 |  |
| 04 |  | 53 |  | 48 | 101 |  | 116 |  | 108.9997 |  | 116.0000 |  |
| 05 |  | 59 |  | 55 | 114 |  | 126 |  | 118.1330 |  | 126.2666 |  |
| 06 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 07 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 08 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 09 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 10 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 11 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| 12 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |  |
| K-12 |  | 153 |  | 146 | 299 |  | 334 |  | 314.1327 |  | 334.2666 |  |
| GRAND TOTAL |  | 153 |  | 146 | 299 |  | 334 |  | 314.1327 |  | 334.2666 |  |

## Table 67

| Grade |  | Net Male | Enrollment to Female | Date Total | End of Month Membership |  | Average Daily Attendance |  | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  | .0000 |  | .0000 |
| 01 |  |  |  |  |  |  | .0000 |  | .0000 |
| 02 |  |  |  |  |  |  | .0000 |  | .0000 |
| 03 |  |  |  |  |  |  | .0000 |  | .0000 |
| 04 |  |  |  |  |  |  | .0000 |  | .0000 |
| 05 |  |  |  |  |  |  | .0000 |  | .0000 |
| 06 |  | 61 | 55 | 116 | 134 |  | 125.0663 |  | 133.8666 |
| 07 |  | 40 | 48 | 88 | 97 |  | 90.6664 |  | 97.6666 |
| 08 |  | 59 | 44 | 103 | 111 |  | 99.1997 |  | 111.0000 |
| 09 |  |  |  |  |  |  | .0000 |  | .0000 |
| 10 |  |  |  |  |  |  | .0000 |  | .0000 |
| 11 |  |  |  |  |  |  | .0000 |  | .0000 |
| 12 |  |  |  |  |  |  | .0000 |  | .0000 |
| K-12 |  | 160 | 147 | 307 | 342 |  | 314.9325 |  | 342.5333 |
| GRAND TOTAL |  | 160 | 147 | 307 | 342 |  | 314.9325 |  | 342.5333 |

## Table 68

| Grade |  | Net Male | Enrollment to Female | Date Total |  | End of Month Membership |  | Average Daily Attendance | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  |  | .0000 | .0000 |
| 01 |  |  |  |  |  |  |  | .0000 | .0000 |
| 02 |  |  |  |  |  |  |  | .0000 | .0000 |
| 03 |  |  |  |  |  |  |  | .0000 | .0000 |
| 04 |  |  |  |  |  |  |  | .0000 | .0000 |
| 05 |  |  |  |  |  |  |  | .0000 | .0000 |
| 06 |  |  |  |  |  |  |  | .0000 | .0000 |
| 07 |  |  |  |  |  |  |  | .0000 | .0000 |
| 08 |  |  |  |  |  |  |  | .0000 | .0000 |
| 09 |  | 54 | 48 | 102 |  | 110 |  | 99.7330 | 110.0000 |
| 10 |  | 50 | 42 | 92 |  | 96 |  | 86.6664 | 96.0000 |
| 11 |  | 47 | 39 | 86 |  | 94 |  | 82.7997 | 94.1999 |
| 12 |  | 49 | 29 | 78 |  | 81 |  | 72.1997 | 81.0000 |
| K-12 |  | 200 | 158 | 358 |  | 381 |  | 341.3990 | 381.1999 |
| GRAND TOTAL |  | 200 | 158 | 358 |  | 381 |  | 341.3990 | 381.1999 |

## Table 69

| Grade |  | Net Male |  | Enrollment to Female | Date Total |  | End of Month Membership |  | Average Daily Attendance |  | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 01 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 02 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 03 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 04 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 05 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 06 |  |  |  |  |  |  | 2 |  | 1.6666 |  | 2.0000 |
| 07 |  |  |  |  |  |  | 3 |  | 3.0000 |  | 3.0000 |
| 08 |  | 1 |  | 1 | 2 |  | 6 |  | 5.8000 |  | 6.0000 |
| 09 |  | 1 |  |  | 1 |  | 5 |  | 4.2666 |  | 5.0000 |
| 10 |  | 2 |  |  | 2 |  | 5 |  | 4.7999 |  | 5.0000 |
| 11 |  | 1 |  | 2 | 3 |  | 6 |  | 6.0000 |  | 6.0000 |
| 12 |  |  |  | 4 | 4 |  | 9 |  | 9.0000 |  | 9.0000 |
| K-12 |  | 5 |  | 7 | 12 |  | 36 |  | 34.5333 |  | 36.0000 |
| GRAND TOTAL |  | 5 |  | 7 | 12 |  | 36 |  | 34.5333 |  | 36.0000 |

## Table 70

| Grade |  | Net Male |  | Enrollment to Female | Date Total |  | End of Month Membership |  | Average Daily Attendance | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 01 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 02 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 03 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 04 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 05 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 06 |  | 52 |  | 44 | 96 |  | 110 |  | 105.3998 | 110.0000 |
| 07 |  | 56 |  | 49 | 105 |  | 110 |  | 104.2664 | 109.0000 |
| 08 |  | 56 |  | 51 | 107 |  | 126 |  | 121.5998 | 126.0000 |
| 09 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 10 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 11 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| 12 |  |  |  |  |  |  |  |  | .0000 | .0000 |
| K-12 |  | 164 |  | 144 | 308 |  | 346 |  | 331.2661 | 345.0000 |
| GRAND TOTAL |  | 164 |  | 144 | 308 |  | 346 |  | 331.2661 | 345.0000 |

## Table 71

| Grade |  | Net Male |  | Enrollment to Female | Date Total | End of Month Membership |  | Average Daily Attendance |  | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 01 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 02 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 03 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 04 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 05 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 06 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 07 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 08 |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 09 |  | 65 |  | 26 | 91 | 98 |  | 87.1330 |  | 98.3333 |
| 10 |  | 36 |  | 42 | 78 | 91 |  | 79.8664 |  | 91.0000 |
| 11 |  | 49 |  | 35 | 84 | 91 |  | 79.9997 |  | 91.0000 |
| 12 |  | 57 |  | 49 | 106 | 109 |  | 96.9996 |  | 109.0000 |
| K-12 |  | 207 |  | 152 | 359 | 389 |  | 343.9989 |  | 389.3333 |
| GRAND TOTAL |  | 207 |  | 152 | 359 | 389 |  | 343.9989 |  | 389.3333 |

## Table 72

| Grade |  | Net Male |  | Enrollment to Female | Date Total |  | End of Month Membership |  | Average Daily Attendance |  | Average Daily Membership |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| K |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 01 |  |  |  | 1 | 1 |  | 1 |  | .0000 |  | .0000 |
| 02 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 03 |  | 2 |  |  | 2 | I | 2 |  | .0000 |  | .0000 |
| 04 |  | 2 |  |  | 2 |  | 2 |  | .0000 |  | .0000 |
| 05 |  | 1 |  | 1 | 2 |  | 2 |  | .0000 |  | .0000 |
| 06 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 07 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 08 |  |  |  | 1 | 1 |  | 1 |  | .0000 |  | .0000 |
| 09 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 10 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 11 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| 12 |  |  |  |  |  |  |  |  | .0000 |  | .0000 |
| K-12 |  | 5 |  | 3 | 8 |  | 8 |  | .0000 |  | .0000 |
| GRAND TOTAL |  | 5 |  | 3 | 8 |  | 8 |  | .0000 |  | .0000 |

## Table 73

| Grade |  | Net |  | Enrollment to | Date |  | End of Month |  | Average Daily |  | Average Daily |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
|  |  |  |  |  |  |  | Membership |  | Attendance |  | Membership |
|  |  | Male |  | Female | Total |  |  |  |  |  |  |
| K |  | 102 |  | 94 | 196 |  | 206 |  | 194.5329 |  | 206.0666 |
| 01 |  | 117 |  | 94 | 211 |  | 238 |  | 221.1995 |  | 237.0000 |
| 02 |  | 97 |  | 91 | 188 |  | 205 |  | 190.2662 |  | 204.5999 |
| 03 |  | 94 |  | 97 | 191 |  | 208 |  | 194.1329 |  | 206.0000 |
| 04 |  | 94 |  | 100 | 194 |  | 221 |  | 204.0662 |  | 219.0000 |
| 05 |  | 116 |  | 104 | 220 |  | 240 |  | 222.1994 |  | 238.2666 |
| 06 |  | 113 |  | 99 | 212 |  | 246 |  | 232.1328 |  | 245.8666 |
| 07 |  | 96 |  | 97 | 193 |  | 210 |  | 197.9329 |  | 209.6666 |
| 08 |  | 116 |  | 97 | 213 |  | 244 |  | 226.5995 |  | 243.0000 |
| 09 |  | 120 |  | 74 | 194 |  | 213 |  | 191.1327 |  | 213.3333 |
| 10 |  | 88 |  | 84 | 172 |  | 192 |  | 171.3328 |  | 192.0000 |
| 11 |  | 97 |  | 76 | 173 |  | 191 |  | 168.7994 |  | 191.1999 |
| 12 |  | 106 |  | 82 | 188 |  | 199 |  | 178.1994 |  | 199.0000 |
| K-12 |  | 1,356 |  | 1,189 | 2,545 |  | 2,813 |  | 2592.5272 |  | 2804.9999 |
| GRAND TOTAL |  | 1,356 |  | 1,189 | 2,545 |  | 2,813 |  | 2592.5272 |  | 2804.9999 |

## Table 74

| Breakfast Items |  |
| --- | --- |
| Cereal Bars (Lucky Charms, Cinnimon Toast Crunch Fruit Loops) | $0.45 per bar |
| Pop-tarts | $0.45 per pack |
| Cereal Cups | $1.00 per cup |
| Nature Valley (crunch bar, oatmeal squares) | $0.70 per bar |
| Little Bite Muffins | $0.80 per pack |
| Instant Oatmeal | $0.45 per 2 packs |
| Lunch/Dinner |  |
| Ramen Noodles | $0.30 per pack |
| Chief Boyardee | $1.25 per can |
| Hormel Compleat Dinner | $2.50 per dinner |
| Vienna Sausage | $0.90 per can |
| Mac and Cheese bowls | $1.00 per bowl |
| Rice A Roni Cups | $1.50 per bowl |
| Mashed Potato Cups | $1.00 per bowl |
| Extra |  |
| Granola Bars/Fruit Grain Bars | $0.20 per bag |
| Fruit Snacks | $0.55 per 2 packs |
| Beef Jerky | $0.75 per 2 mini sticks |
| Microwave Popcorn | $0.50 per pack |
| Individual Chips/Cheez-it (small bags) | $0.60 per bag |
| Rice Crispy treats | $0.32 per treat |
| Individual Small bags of Cookies | $0.52 per bag |
| Peanut Butter/Cheese Crackers | $0.55 per pack |
| Juice Box/Capri Sun | $0.35 per juice |
| Shelf Stable Milk/chocolate milk | $1.35 per milk |

## Table 75

| Toothbrush | $1.00 |
| --- | --- |
| Toothpaste | $1.00 |
| Floss | $1.00 |
| Mini Deoderant | $1.50 |
| Mini Shampoo | $2.00 |
| Mini Bodywash | $2.00 |
| Bar Soap | $1.50 |
| Bath Sponge/loofah | $1.00 |

## Table 76

| Date: | 5/22/26 |
| --- | --- |
| Name of School: | East Hickman Hish School |
| Item Request: | Football Camp on Campus |
| Explanation: |  |

## Table 77

| PROJECT: (Name and address) | CONTRACT INFORMATION: | CHANGE ORDER INFORMATION: |
| --- | --- | --- |
| East Hickman High School Agricultural/Vocational Building 7700 TN-7 Lyles, TN | Contract For: Contruction Date: 10-24-2025 | Change Order Number: 004 Date: 05-06-2026 |
| OWNER: (Name and address) Hickman County Schools 114 North Central Avenue, Suite 203 Centerville, TN 37033 | ARCHITECT: (Name and address) Lyle Cook Martin Architects 310 Franklin Street Clarksville, TN 37040 | CONTRACTOR: (Name and address) Fellowship Construction 2668 Spencer Mill Road Bon Aqua, TN 37025 |

## Table 78

| The original Contract Sum was | $ 580,000.00 |
| --- | --- |
| The net change by previously authorized Change Orders | $ 22,901.76 |
| The Contract Sum prior to this Change Order was | $ 602,901.76 |
| The Contract Sum will be unchanged by this Change Order in the amount of | $ 0.00 |
| The new Contract Sum including this Change Order will be | $ 602,901.76 |

## Table 79

| BrodA.Martin | Clu |  |
| --- | --- | --- |
| ARCHITECT (Signature) | CONTRACTOR June (Signature) | OWNER (Signature) |
| Bradley A. Martin, III | Jin Irwin Pres. |  |
| (Printed name, title, and license number if required) | (Printed name and title) | (Printed name and title) |
| May 7, 2026 | 5/8/2026 |  |
| Date | Date | Date |

## Table 80

| SBC Project Number and Project Name: | Month and Year Reported Below: |
| --- | --- |
| East Hickman Vocational Building | December 2025 |

## Table 81

| Date | Weather condition causing delay | Work scheduled on critical path for this day that was delayed. |
| --- | --- | --- |
| 1 | Rain Day- 0.12 | Underground Utilities/ grading site |
| 2 | Rain Day- 0.55 | Underground Utilities/ grading site |
| 3 | Dry out day | Underground Utilities/ grading site |
| 4 | Rain Day- 0.34 | Underground Utilities/ grading site |
| 5 | Dry out day | Underground Utilities/ grading site |
| 6 | Dry out day | Underground Utilities/ grading site |
| 7 |  |  |
| 8 |  |  |
| 9 |  |  |
| 10 |  |  |
| 11 | Dry out day | Underground Utilities/ grading site |
| 12 | Dry out day | Underground Utilities/ grading site |
| 13 |  |  |
| 14 |  |  |
| 15 |  |  |
| 16 |  |  |
| 17 |  |  |
| 18 | Rain Day- 1.05 | Underground Utilities/ grading site |
| 19 | Dry out day | Underground Utilities/ grading site |
| 20 | Dry out day | Underground Utilities/ grading site |
| 21 | Dry out day | Underground Utilities/ grading site |
| 22 |  |  |
| 23 |  |  |
| 24 |  |  |
| 25 |  |  |
| 26 |  |  |
| 27 |  |  |
| 28 |  |  |
| 29 | Rain day 0.18 | Underground Utilities/ grading site |
| 30 | Dry out day | Underground Utilities/ grading site |
| 31 |  |  |
|  | Total number of days this | month with delay due to weather 12 days |
|  | Baseline number from Section | 01 26 20 11 days |
|  | Total - Baseline = claimable | days 1 days |

## Table 82

|  |  |  | Climatological | Data for DICKSON, | TN | - December | 2025 |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Date |  | Temperature |  |  |  |  |  |  |  |
|  | Maximum | Minimum | Average | Departure | HDD | CDD | Precipitation | New Snow | Snow Depth |
| 2025-12-01 | 41 | 23 | 320 | -11 5 | 33 | 0 | 0.12 | 00 | 0 |
| 2025-12-02 | 35 | 26 | 30.5 | -127 | 34 | n | 0.55 | 00 | 0 |
| 2025-12-03 | 40 | 25 | 32.5 | -10.5 | a | 0 | 000 | 00 | 0 |
| 2025-12-04 | 35 | 29 | 320 | -108 | 33 | 0 | 0.34 | 00 | 0 |
| 2025-12-05 | 32 | 31 | 315 | JIJ | 33 | 0 | 0.00 | 00 | D |
| 2025-12-06 | 44 | 30 | 370 | -53 | 28 | 0 | 0.00 | 00 | 0 |
| 2025-12-07 | 42 | 27 | 145 | -76 | 30 | 0 | 0.00 | 00 | 0 |
| 2025-12-08 | 44 | 28 | 360 | -5.9 | 19 | 0 | 0.00 | 00 | 0 |
| 2025-12-09 | 4b. | 21 | 345 | -72 | 30 | 0 | 0.00 | 00 | 0 |
| 2025-12-10 | 53 | 37 | 450 | 35 | 20 | 0 | 0.00 | 0.0 | 0 |
| 2025-12-11 | 42 | 22 | 320 | -9.3 | 33 | a | 0.00 | 00 | 0 |
| 2025-12-12 | 55 | 34 | 44 5 | 34 | 20 | 0 | 0.00 | 00 | 0 |
| 2025-12-13 | 51 | 31 | 410 | 01 | 24 | 0 | 0.00 | 00 | 0 |
| 2025-12-14 | 38 | 12 | 250 | -15.7 | 40 | 0 | 0.00 | 0.0 | 0 |
| 2025-12-15 | 3% | 9 | 23.5 | -170 | 41 | 0 | 0.00 | 0.0 | 0 |
| 2025-12-16 | 51 | 21 | 360 | -44 | 29 | 0 | 0.00 | 00 | 0 |
| 2025-12-17 | 60 | 35 | 47.5 | 73 | 17 | 0 | 0.00 | 00 | 0 |
| 2025-12-18 | 59 | a | 53.5 | 13 5 | 11 | 0 | L05 | 0.0 | 0 |
| 2025-12-19 | 49 | 28 | 38.5 | 43 | 26 | 0 | 0 02 | 0.0 | 0 |
| 2025-12-20 | 62 | 25 | 43.5 | 38 | 21 | V | 0.00 | 0.0 | 0 |
| 2025-12-21 | 55 | 42 | 4#5 | 90 | 16 | 0 | 000 | 00 | 0 |
| 2025-12-22 | 56 | 32 | 440 | 47 | 21 | 0 | 000 | 00 | 0 |
| 2025-12-23 | 65 | 55 | 600 | 208 | 5 | 0 | 0.00 | 0.0 | 0 |
| 2025-12-24 | 74 | 58 | 660 | 27.0 | 0 | I | 0.00 | 00 | 0 |
| 2025-12-25 | 67 | 57 | 620 | 231 | 3 | 0 | 0.00 | 00 | 0 |
| 2025-12-26 | 65 | 61 | 63.0 | 243 | 2 | 0 | 0.00 | 00 | 0 |
| 2025-12-27 | " | 54 | 600 | 214 | 5 | 0 | 0.00 | 0.0 | 0 |
| 2025-12-28 | 71 | 64 | 67 5 | 24.0 | 0 | 3 | 0.00 | 00 | 0 |
| 2025-12-29 | 69 | 26 | 47.) | 9.2 | 17 | 0 | 018 | 00 | 0 |
| 2025-12-30 | 35 | 25 | 29.0 | -92 | 36 | 0 | 0.00 | 00 | 0 |
| 2025-12-31 | 49 | 21 | 350 | -31 | 30 | 0 | 0.00 | 00 | 0 |
| Sum | 1591 | 1035 | - | . | 699 | I | 2.26 | 00 | . |
| Average | 51.3 | 33.4 | 42.4 | 19 | " | . | . | # | 00 |
| Normal | 504 | 306 | 40.5 | . | no | 0 | 5.13 | 06 | a |

## Table 83

| SBC Project Number and Project Name: | Month and Year Reported Below: |
| --- | --- |
| East Hickman Vocational Building | January 2026 |

## Table 84

| Date | Weather condition causing delay | Work scheduled on critical path for this day that was delayed. |
| --- | --- | --- |
| 1 |  |  |
| 2 |  |  |
| 3 |  |  |
| 4 |  |  |
| 5 |  |  |
| 6 |  |  |
| 7 |  |  |
| 8 |  |  |
| 9 | Rain Day- 0.09 | Underground Utilities/ grading site |
| 10 | Rain Day- 0.26 | Underground Utilities/ grading site |
| 11 | Dry out day | Underground Utilities/ grading site |
| 12 | Dry out day | Underground Utilities/ grading site |
| 13 |  |  |
| 14 | Rain Day- 0.11 | Underground Utilities/ grading site |
| 15 | Dry out day | Underground Utilities/ grading site |
| 16 | Rain Day- 0.12 | Underground Utilities/ grading site |
| 17 | Dry out day | Underground Utilities/ grading site |
| 18 |  |  |
| 19 |  |  |
| 20 |  |  |
| 21 | Rain day 0.27 | Underground Utilities/ grading site |
| 22 | Dry out day | Underground Utilities/ grading site |
| 23 |  |  |
| 24 | Snow day- 2.00 | Underground Utilities/ grading site |
| 25 | Snow day 1.30 | Underground Utilities/ grading site |
| 26 | ice/ dry out day | Underground Utilities/ grading site |
| 27 | ice/ dry out day | Underground Utilities/ grading site |
| 28 | ice/ dry out day | Underground Utilities/ grading site |
| 29 | ice/ dry out day | Underground Utilities/ grading site |
| 30 | ice/ dry out day | Underground Utilities/ grading site |
| 31 | ice/ dry out day | Underground Utilities/ grading site |
|  | Total number of days this | month with delay due to weather 18 days |
|  | Baseline number from Section | 01 26 20 12 days |
|  | Total - Baseline = claimable | days 6 days |

## Table 85

|  |  | Climatological | Data for DICKSON, | TN - January 2026 |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Date |  | Temperature |  |  |  |  |  |
|  | Maximum | Minimum | Average | Departure | HDD | CDD | Precipitation |
| 2026-01-01 | 61 | 26 | 43.5 | 55 | 21 | 0 | 0.00 |
| 2026-01-02 | 54 | 33 | 43.5 | 56 | 21 | 0 | 0.06 |
| 2026-01-03 | 47 | 33 | 400 | 22 | 25 | 0 | 0.05 |
| 2026-01-04 | 49 | 25 | 370 | -07 | 18 | 0 | 0.00 |
| 2026-01-05 | 63 | 28 | 45 5 | 79 | 19 | 0 | 0.00 |
| 2026-01-06 | 65 | 48 | 56.5 | 190 | 8 | 0 | 0.00 |
| 2026-01-07 | 67 | 37 | 520 | 146 | 13 | 0 | 0.00 |
| 2026-01-08 | 69 | 37 | 530 | 156 | 12 | 0 | 0.00 |
| 2026-01-09 | 72 | 00 | 660 | 287 | 45 | 1 | 0.00 |
| 2020-01-10 | 60 | 42 | 53.0 | 117 | 14 | 0 | 026 |
| 2026-01-11 | 12 | 7. | 15 5 | -1.7 | 29 | 0 | 0.00 |
| 2026-01-12 | 49 | 20 | 14.5 | -2.7 | 30 | 0 | 000 |
| 2026-01-13 | 62 | 28 | 45.0 | 78 | 20 | 0 | 0.00 |
| 2024-01-14 | 52 | 30 | 10 | 6 | 24 | a | 0.11 |
| 2026-01-15 | 32 | 20 | 2000 | -111 | 10 | a | 0.00 |
| 2026-01-16 | 50 | in | 40 | -31 | 31 | ) | 012 |
| 2026-01-17 | 41 | R | 115 | 16 | 31 | 0 | 0.00 |
| 2026-01-18 | 32 | 14 | 230 | -14.2 | 42 | 0 | 0.00 |
| 2026-01-19 | 37 | 16 | 265 | -107 | 38 | 0 | 0.00 |
| 2026-01-20 | 39 | 10 | 245 | -127 | 40 | 0 | 000 |
| 2026-01-21 | 12 | 24 | 310 | -43 | 2 | 0 | 027 |
| 2026-01-22 | 4% | 10 | 140 | no | 27 | 0 | 0.00 |
| 2026-01-23 | 35 | 19 | 27.0 | -104 | 38 | 0 | 0.00 |
| 2020-01-24 | 19 | 4 | 165 | 210 | 48 | 0 | 2.00 |
|  | 31 | 13 | 220 | -150 | HB | 0 | 130 |
| 2026-01-26 | 31 | 7 | 190 | 417 | IA | @ | 0.00 |
| 2026-01-27 | 29 | 5 | The | -20 | 48 | a | 0.00 |
| 2026-01-28 | 31 | 11 | 210 | -169 | +1 | 0 | 0.00 |
| 2026-01-29 | : | 14 | 25 5 | -125 | 39 | 0 | 0.00 |
| 2026-01-30 | 29 | 17 | 210 | -15.2 | 42 | 0 | 0.00 |
| 2026-01-31 | " | 12 | 165 | -21 S | 48 | 11 | 000 |
| Sum | 1394 | 746 | . | B | 440 | I | 426 |
| Average | 45.0 | 241 | 345 | -30 | . | . | . |
| Normal | 475 | 27 5 | 37.5 | . | 853 | 0 | 433 |

## Table 86

| SBC Project Number and Project Name: | Month and Year Reported Below: |
| --- | --- |
| East Hickman Vocational Building | February 2026 |

## Table 87

| Date | Weather condition causing delay | Work scheduled on critical path for this day that was delayed. |
| --- | --- | --- |
| 1 |  |  |
| 2 |  |  |
| 3 | Rain Day- 0.38 | Underground Utilities/ grading site |
| 4 | Dry out day | Underground Utilities/ grading site |
| 5 | Dry out day | Underground Utilities/ grading site |
| 6 |  |  |
| 7 |  |  |
| 8 |  |  |
| 9 |  |  |
| 10 |  |  |
| 11 | Rain Day- 0.46 | Underground Utilities/ grading site |
| 12 | Dry out day | Underground Utilities/ grading site |
| 13 | Dry out day | Underground Utilities/ grading site |
| 14 | Rain Day- 0.08 | Underground Utilities/ grading site |
| 15 | Rain Day- 1.67 | Underground Utilities/ grading site |
| 16 | Dry out day | Underground Utilities/ grading site |
| 17 | Dry out day | Underground Utilities/ grading site |
| 18 | Dry out day |  |
| 19 |  |  |
| 20 | Rain day 0.31 | Underground Utilities/ grading site |
| 21 | Dry out day | Underground Utilities/ grading site |
| 22 | Dry out day | Underground Utilities/ grading site |
| 23 |  |  |
| 24 |  |  |
| 25 | Rain day 0.15 | Underground Utilities/ grading site |
| 26 | Rain day 0.30 | Underground Utilities/ grading site |
| 27 | Dry out day | Underground Utilities/ grading site |
| 28 | Dry out day | Underground Utilities/ grading site |
| 29 |  |  |
| 30 |  |  |
| 31 |  |  |
|  | Total number of days this | month with delay due to weather 18 days |
|  | Baseline number from Section | 01 26 20 11 days |
|  | Total - Baseline = claimable | days 7 days |

## Table 88

|  |  | Climatological | Data for DICKSON, | TN - February 2026 |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Date |  | Temperature |  |  |  |  |  |
|  | Maximum | Minimum | Average | Departure | HDD | CDD | Precipitation |
| 2026-02-01 | 30 | 17 | 23.5 | -150 | 41 | 0 | 0.00 |
| 2026-02-02 | 46 | 22 | 34.0 | -4.6 | 31 | 0 | 0.00 |
| 2026-02-03 | 46 | 26 | 36.0 | -2.8 | 29 | 0 | 0.38 |
| 2026-02-04 | 40 | 26 | 33.0 | -60 | 32 | 0 | 0.00 |
| 2026-02-05 | 30 | 18 | 24.0 | -15.2 | 41 | 0 | 0.00 |
| 2026-02-06 | 56 | 22 | 39.0 | -04 | 26 | 0 | 0.00 |
| 2026-02-07 | 42 | 26 | 34.0 | -5.6 | 31 | 0 | 0.00 |
| 2026-02-08 | 51 | 24 | 37.5 | -23 | 27 | 0 | 0.00 |
| 2026-02-09 | 68 | 28 | 48.0 | 8.0 | 17 | 0 | 0.00 |
| 2026-02-10 | 73 | 34 | 53.5 | 133 | 11 | 0 | 0.00 |
| 2026-02-11 | 62 | 41 | 51.5 | 11.1 | 13 | 0 | 0.46 |
| 2026-02-12 | 53 | 31 | 42.0 | 14 | 23 | 0 | 0.00 |
| 2026-02-13 | 61 | 30 | 45.5 | 46 | 19 | 0 | 0.00 |
| 2026-02-14 | 59 | 30 | 44.5 | 34 | 20 | 0 | 0.08 |
| 2026-02-15 | 49 | 45 | 47.0 | 57 | 18 | 0 | 1.67 |
| 2026-02-16 | 66 | 34 | 50.0 | 84 | 15 | 0 | 0.00 |
| 2026-02-17 | 60 | 36 | 48.0 | 62 | 17 | 0 | 0.00 |
| 2026-02-18 | 61 | 56 | 58.5 | 164 | 6 | 0 | 0.00 |
| 2026-02-19 | 72 | 55 | 63.5 | 212 | 1 | 0 | 0.00 |
| 2026-02-20 | 70 | 48 | 59.0 | 164 | 6 | 0 | 036 |
| 2026-02-21 | 54 | 37 | 45.5 | 27 | 19 | 0 | 0.00 |
| 2026-02-22 | 37 | 27 | 32.0 | -11.1 | 33 | 0 | 0.00 |
| 2026-02-23 | 30 | 18 | 24.0 | -19.4 | 41 | 0 | 0.00 |
| 2026-02-24 | 50 | 15 | 32.5 | -11.1 | 32 | 0 | 0.00 |
| 2026-02-25 | 60 | 44 | 52.0 | 8.1 | 13 | 0 | 0.15 |
| 2026-02-26 | 57 | 46 | 51.5 | 7.3 | 13 | 0 | 0.30 |
| 2026-02-27 | 67 | 34 | 50.5 | 6.1 | 14 | () | 0.00 |
| 2026-02-28 | 75 | 33 | 54.0 | 9.3 | 11 | 0 | 0.00 |
| Sum | 1525 | 903 | - | - | 600 | 0 | 3.40 |
| Average | 54.5 | 32.3 | 43.4 | 20 | - | - | - |
| Normal | 52.3 | 30.4 | 41.4 | - | 663 | 1 | 4.90 |

## Table 89

|  |  | Climatological | Data for DICKSON, | TN - March 2026 |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Date |  | Temperature |  |  |  |  |  |
|  | Maximum | Minimum | Average | Departure | HDD | CDD | Precipitation |
| 2026-03-01 | 65 | 42 | 53.5 | 8.5 | 11 | 0 | 0.00 |
| 2026-03-02 | 61 | 43 | 52.0 | 6.7 | 13 | 0 | 0.03 |
| 2026-03-03 | 70 | 53 | 61.5 | 15.9 | 3 | 0 | 0.00 |
| 2026-03-04 | 76 | 59 | 67.5 | 217 | 0 | 3 | 0.00 |
| 2026-03-05 | 73 | 58 | 65.5 | 194 | 0 | 1 | 0.00 |
| 2026-03-06 | 81 | 51 | 66.0 | 19.6 | 0 | 1 | 0.00 |
| 2026-03-07 | 75 | 56 | 65.5 | 188 | 0 | 1 | 0.50 |
| 2026-03-08 | 65 | 53 | 59.0 | 120 | 6 | 0 | 0.00 |
| 2026-03-09 | 72 | 43 | 57.5 | 10.2 | 7 | 0 | 0.02 |
| 2026-03-10 | 78 | 60 | 69.0 | 214 | 0 | 4 | 0.03 |
| 2026-03-11 | 73 | 52 | 62.5 | 14.6 | 2 | 0 | 0.56 |
| 2026-03-12 | 54 | 40 | 47,0 | -11 | 18 | 0 | 0.08 |
| 2026-03-13 | 67 | 33 | 50.0 | 16 | 15 | 0 | 0.00 |
| 2026-03-14 | 77 | 40 | 58.5 | 9.8 | 6 | 0 | 0.00 |
| 2026-03-15 | 77 | 58 | 67.5 | 18.5 | 0 | 3 | 0.00 |
| 2026-03-16 | 72 | 32 | 52.0 | 2.7 | 13 | 0 | 0.95 |
| 2026-03-17 | 39 | 21 | 30.0 | -196 | 35 | 0 | 0.00 |
| 2026-03-18 | 62 | 32 | 47.0 | -2.9 | 18 | 0 | 0.00 |
| 2026-03-19 | 74 | 36 | 55.0 | 4.7 | 10 | 0 | 0.00 |
| 2026-03-20 | 80 | 43 | 61.5 | 10.9 | 3 | 0 | 0.00 |
| 2026-03-21 | 86 | 58 | 72.0 | 21.1 | 0 | 7 | 0.00 |
| 2026-03-22 | 87 | 63 | 75.0 | 23.8 | 0 | 10 | 0.00 |
| 2026-03-23 | 79 | 42 | 60.5 | 9.0 | 4 | 0 | 0.00 |
| 2026-03-24 | 69 | 41 | 55.0 | 32 | 10 | 0 | 0.00 |
| 2026-03-25 | 75 | 49 | 62.0 | 9,9 | 3 | 0 | 0.00 |
| 2026-03-26 | 83 | 59 | 71.0 | 18.6 | 0 | 6 | 0.00 |
| 2026-03-27 | 77 | 43 | 60.0 | 7.3 | 5 | 0 | 0.00 |
| 2026-03-28 | 60 | 35 | 47.5 | -56 | 17 | 0 | 0.00 |
| 2026-03-29 | 72 | 35 | 53.5 | 0.1 | 11 | 0 | 0.00 |
| 2026-03-30 | 75 | 57 | 66.0 | 12.3 | 0 | 1 | 0,00 |
| 2026-03-31 | 78 | 63 | 70.5 | 16.5 | 0 | 6 | 0.00 |
| Sum | 2232 | 1450 | - | - | 210 | 43 | 2.17 |
| Average | 72.0 | 46.8 | 59.4 | 10.0 | - | - | - |
| Normal | 61.1 | 37.7 | 49.4 | - | 489 | 6 | 5.44 |

## Table 90

| SBC Project Number and Project Name: | Month and Year Reported Below: |
| --- | --- |
| East Hickman Vocational Building | March 2026 |

## Table 91

| Date | Weather condition causing delay | Work scheduled on critical path for this day that was delayed. |
| --- | --- | --- |
| 1 |  |  |
| 2 |  |  |
| 3 |  |  |
| 4 |  |  |
| 5 |  |  |
| 6 |  |  |
| 7 | Rain Day- 0.50 | Underground Utilities/ grading site |
| 8 | Dry out day | Underground Utilities/ grading site |
| 9 |  |  |
| 10 |  |  |
| 11 | Rain Day- 0.56 | Underground Utilities/ grading site |
| 12 | Rain Day- 0.08 | Underground Utilities/ grading site |
| 13 | Dry out day | Underground Utilities/ grading site |
| 14 | Dry out day | Underground Utilities/ grading site |
| 15 |  |  |
| 16 | Rain day 0.95 | Underground Utilities/ grading site |
| 17 | Dry out day | Underground Utilities/ grading site |
| 18 | Dry out day | Underground Utilities/ grading site |
| 19 | Dry out day | Underground Utilities/ grading site |
| 20 |  |  |
| 21 |  |  |
| 22 |  |  |
| 23 |  |  |
| 24 |  |  |
| 25 |  |  |
| 26 |  |  |
| 27 |  |  |
| 28 |  |  |
| 29 |  |  |
| 30 |  |  |
| 31 |  |  |
|  | Total number of days this | month with delay due to weather 10 days |
|  | Baseline number from Section | 01 26 20 8 days |
|  | Total - Baseline = claimable | days 2 days |

## Table 92

| SBC Project Number and Project Name: | Month and Year Reported Below: |
| --- | --- |
| East Hickman VOC Building | April 2026 |

## Table 93

| Date | Weather condition causing delay | Work scheduled on critical path for this day that was delayed. |
| --- | --- | --- |
| 1 |  |  |
| 2 |  |  |
| 3 | Rain Day- 0.13 | final grade/sidwalks |
| 4 | Rain Day- 0.57 | final grade/sidwalks |
| 5 | Rain Day- 0.20 | final grade/sidwalks |
| 6 | Dry out day | final grade/sidwalks |
| 7 | Dry out day | final grade/sidwalks |
| 8 |  |  |
| 9 |  |  |
| 10 |  |  |
| 11 |  |  |
| 12 |  |  |
| 13 |  |  |
| 14 |  |  |
| 15 |  |  |
| 16 | Rain Day- 0.24 | final grade/sidwalks |
| 17 | Rain Day- 0.24 | final grade/sidwalks |
| 18 | Dry out day | final grade/sidwalks |
| 19 | Dry out day | final grade/sidwalks |
| 20 |  |  |
| 21 |  |  |
| 22 |  |  |
| 23 |  |  |
| 24 |  |  |
| 25 |  |  |
| 26 |  |  |
| 27 |  |  |
| 28 | Rain Day- 2.18 | final grade/sidwalks |
| 29 | Dry out day - 0.55 | final grade/sidwalks |
| 30 | Dry out day | final grade/sidwalks |
| 31 |  |  |
|  | Total number of days this | month with delay due to weather 12 days |
|  | Baseline number from Section | 01 26 20 7days |
|  | Total - Baseline = claimable | days 5 days |

## Table 94

|  |  | Climatological | Data for DICKSON, | TN - April 2026 |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Date |  | Temperature |  |  |  |  |  |
|  | Maximum | Minimum | Average | Departure | HDD | CDD | Precipitation |
| 2026-04-01 | 81 | 62 | 71.5 | 17.2 | 0 | 7 | 0.00 |
| 2026-04-02 | 80 | 66 | 73.0 | 18.4 | 0 | 8 | 0.00 |
| 2026-04-03 | 84 | 64 | 74.0 | 19.1 | 0 | 9 | 0,13 |
| 2026-04-04 | 77 | 61 | 69.0 | 13.7 | 0 | 4 | 0.57 |
| 2026-04-05 | 62 | 44 | 53.0 | -2.6 | 12 | 0 | 0.20 |
| 2026-04-06 | 68 | 37 | 52.5 | -3.4 | 12 | 0 | 0.00 |
| 2026-04-07 | 66 | 43 | 54.5 | -1.7 | 10 | 0 | 0.00 |
| 2026-04-08 | 77 | 42 | 59.5 | 3.0 | 5 | 0 | 0.00 |
| 2026-04-09 | 76 | 54 | 65.0 | 82 | 0 | 0 | 0.00 |
| 2026-04-10 | 78 | 47 | 62.5 | 5.4 | 2 | 0 | 0.00 |
| 2026-04-11 | 79 | 52 | 65.5 | 8.1 | 0 | I | 0.00 |
| 2026-04-12 | 82 | 51 | 66.5 | 8.8 | 0 | 2 | 0.00 |
| 2026-04-13 | 76 | 63 | 69.5 | 11.5 | 0 | 5 | 0.04 |
| 2026-04-14 | 82 | 61 | 71.5 | 13.3 | 0 | 7 | 0.00 |
| 2026-04-15 | 84 | 59 | 71.5 | 13.0 | 0 | 7 | 0.00 |
| 2026-04-16 | 80 | 58 | 69.0 | 102 | 0 | 4 | 0.24 |
| 2026-04-17 | 82 | 55 | 68.5 | 94 | 0 | 4 | 0.24 |
| 2026-04-18 | 70 | 45 | 57.5 | -1.9 | 7 | 0 | 0.08 |
| 2026-04-19 | 64 | 39 | 51.5 | -8.1 | 13 | 0 | 0.00 |
| 2026-04-20 | 72 | 39 | 55.5 | -4.4 | 9 | 0 | 0.00 |
| 2026-04-21 | 78 | 42 | 60.0 | -0.2 | 5 | 0 | 0,00 |
| 2026-04-22 | 79 | 45 | 62.0 | 16 | 3 | 0 | 0.00 |
| 2026-04-23 | 80 | 49 | 64.5 | 3.8 | 0 | 0 | 0.00 |
| 2026-04-24 | 77 | 55 | 66.0 | 51 | 0 | 1 | 0.03 |
| 2026-04-25 | 78 | 60 | 69.0 | 7.8 | 0 | 4 | 0,00 |
| 2026-04-26 | 82 | 53 | 67.5 | 6.1 | 0 | 3 | 0.00 |
| 2026-04-27 | 81 | 56 | 68.5 | 6.8 | 0 | 4 | 0.00 |
| 2026-04-28 | 79 | 59 | 69.0 | 7.1 | 0 | 4 | 2.18 |
| 2026-04-29 | 67 | 61 | 64.0 | 19 | I | 0 | 0.55 |
| 2026-04-30 | 63 | 48 | 55.5 | -6.9 | 9 | 0 | 0.00 |
| Sum | 2284 | 1570 | - | - | 88 | 74 | 4.26 |
| Average | 761 | 52.3 | 64.2 | 5.6 | - | - | - |
| Normal | 70.9 | 46.2 | 58.6 | . | 223 | 29 | 4.93 |

## Table 95

| Bon | Aqua, TN 37025 |
| --- | --- |
| Phone: | (615) 412-4446 |
| Fax: | (615) 412-4454 |

## Table 96

| Qty. | Manufacturer | Model | Product Number | Equipment Number | Serial Number | Unit Price | Amount |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1 |  | See Attached Equipment List |  |  |  |  |  |

## Table 97

| Commencement Date | Term | Monthly Payment | Billing Frequency | Overage Billing Frequency |
| --- | --- | --- | --- | --- |
|  | --- | $ 2,500.00 | Monthly | Unlimited |

## Table 98

|  |  | EHES |  |  | EHIS |  |  | EHMS |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
|  | LVT | Furniture Removal | Total | LVT | Furniture Removal | Total | LVT | Furniture Removal | Total |
| Mallard Flooring | $15,930.22 | $2,150.00 | $18,080.22 | $3,610.68 | $900.00 | $4,510.68 | $5,259.32 | $1,200.00 | $6,459.32 |
| Offerporch | $9,648.34 | $1,324.99 | $10,973.33 | $2,076.70 | $265.00 | $2,341.70 | $2,670.04 | $265.00 | $2,935.04 |
| BJB Construction | $22,504.00 | $2,450.00 | $24,954.00 | $5,016.00 | $500.00 | $5,516.00 | $6,206.00 | $675.00 | $6,881.00 |

## Table 99

|  |  | Furniture Removal | Total |
| --- | --- | --- | --- |
| Mallard Flooring | $9,478.40 | $2,150.00 | $11,628.40 |
| Offerporch | $5,253.34 | $706.66 | $5,960.00 |
| BJB Construction | $11,948.00 | $1,300.00 | $13,248.00 |

## Table 100

| SIGNATURE OF AUTHORIZED AGENT | Cynchea Chick |
| --- | --- |
| Subscribed and sworn to before me this | 7 of 2026 day May |
| Signature of Notary Public | Cammy |
| My Commission Expires | 06/29/2027 |
| COMMOR B. STATE OF NEWBERRY TENNESSEE NOTARY DICK PUBLIC COUNTY |  |

## Table 101

| Furniture removal/replacement | $ 2,150.00 |
| --- | --- |
| Furniture removal/replacement | $ 900.00 |
| Furniture removal/replacement | $ 1,200.00 |

## Table 102

| EHES ~2,450 sq ft | Wood Look | $ 15,930.22 |
| --- | --- | --- |
|  | total | 18,080.22 |
|  | Stone Look | $ |
| EHIS ~525 sq ft | Wood Look total Stone Look | 68 $3,610.xx 4,510,68 $ |
| EHMS ~675 sq ft | Wood Look | $ |
|  | Stone Look total: | $5,259.72 6,459.32 |

## Table 103

| DATE ACTIVITY | DESCRIPTION | QTY | RATE | AMOUNT |
| --- | --- | --- | --- | --- |
| Sales | 3 Offices 670 SqFt (not a plank wood look Tuscan Sandstone $2.59) | 19 | 108.78 | 2,066.82 |
| Sales | Transitions | 2 | 75.00 | 150.00 |
| Sales | Install LVP | 670 | 2.75 | 1,842.50 |
| Sales | Carpet take up | 75 | 4.00 | 300.00 |
| Sales | Taylor Dynamics | 2 | 160.00 | 320.00 |
|  | East Middle |  |  |  |
| Sales | Cove Base | 3 | 120.00 | 360.00 |
| Sales | Furniture remove and relace |  | 1,200.00 | 1,200.00 |
| Labor | Dump fee | 1 | 100.00 | 100.00 |
| Freight Charge |  | 1 | 120.00 | 120.00 |
| The signed estimate approval and 75% down confirms the | above customer SUBTOTAL |  |  | 6,459.32 |
| selection. The remaining balance and any additional approved work is due upon completion. | unforeseen customer TAX |  |  | 0.00 |
|  | TOTAL |  |  | $6,459.32 |

## Table 104

| DATE | ACTIVITY | DESCRIPTION | QTY | RATE | AMOUNT |
| --- | --- | --- | --- | --- | --- |
|  |  | Hickman Intermediate |  |  |  |
|  | Sales | LVP Mohawk Bentwood 522SqFt | 522 | 2.19 | 1,143.18 |
|  | Sales | Taylor Dynamics | 1 | 160.00 | 160.00 |
|  | Sales | Flexco Transitions | 4 | 75.00 | 300.00 |
|  | Labor | LVP Install | 522 | 2.75 | 1,435.50 |
|  | Labor | Dump Fee | 1 | 150.00 | 150.00 |
|  | Labor | Carpet removal | 58 | 4.00 | 232.00 |
|  | Freight Charge | freight | 1 | 120.00 | 120.00 |
|  | Labor | Furniture remove and replace | 1 | 900.00 | 900.00 |
|  | Sales | Case of cove base glue | 1 | 70.00 | 70.00 |
| The signed estimate | approval and 75% down confirms the | above customer SUBTOTAL |  |  | 4,510.68 |
| selection. The approved work is | remaining balance and any additional due upon completion. | unforeseen customer TAX |  |  | 0.00 |
|  |  | TOTAL |  |  | $4,510.68 |

## Table 105

| DATE | CTIVITY | DESCRIPTION | QTY | RATE | AMOUNT |
| --- | --- | --- | --- | --- | --- |
|  |  | East Hickman Elementary |  |  |  |
|  |  | Office 1,2nd room,3rd room. Hallway, Office ,Closet, Office 5 Assistant Principal, Speech Room. Conference Room and library |  |  |  |
|  | Sales | LVP 2438.1 Mohawk Bentwood 2.5 Glue Down | 2,738 | 2.19 | 5,996.22 |
|  | Sales | Carpet Removal SqYd (will lay over VCT so we do not disturb it) | 271 | 4.50 | 1,219.50 |
|  | Sales | LVP Install | 2,738 | 2.75 | 7,529.50 |
|  | Sales | Library Carpet removal By SqYd | 144 | 4.00 | 576.00 |
|  | Sales | Library Carpet install By SqFt | 1,296 | 2.75 | 3,564.00 |
|  | Sales | Flexco transition | 7 | 75.00 | 525.00 |
|  | Sales | Library Carpet Tile Tectonic Nylon Engineered Floors SQFt | 22 | 187.20 | 4,118.40 |
|  | Sales | Flexco 2000 Wall Base | 4 | 120.00 | 480.00 |
|  | Sales | Library Carpet Glue Taylor Dynamics | 5 | 160.00 | 800.00 |
|  | Sales | Dump Trailer will rent a 15ton |  | 400.00 | 400.00 |
|  | Labor | furniture removes and replaces | 1 | 4,300.00 | 4,300.00 |
|  | Freight Charge |  | 1 | 200.00 | 200.00 |

## Table 106

| SUBTOTAL | 29,708.62 |
| --- | --- |
| TAX | 0.00 |
| TOTAL | $29,708.62 |

## Table 107

| RECEIPT NUMBER | 251010115 |
| --- | --- |
| LICENSE NUMBER | 220002398 |
| THIS LICENSE EXPIRES | 05/15/2026 |
| CLASSIFICATION | 3 |

## Table 108

| CONTACT NAME: |  |
| --- | --- |
| PHONE (A/C, No. ExI): (855) 222-5919 | FAX (A/C, No): |
| E-MAIL ADDRESS: support@nextinsurance.com |  |

## Table 109

|  |  |  |
| --- | --- | --- |
|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| INSURER A : | Next Insurance US Company | 16285 |
| INSURER B : |  |  |
| INSURER C : |  |  |
| INSURER D : |  |  |
| INSURER E: |  |  |
| INSURER F : |  |  |

## Table 110

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $1,000,000.00 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $100,000.00 |
| MED EXP (Any one person) | $10,000.00 |
| PERSONAL & ADV INJURY | $1,000,000.00 |
| GENERAL AGGREGATE | $1,000,000.00 |
| PRODUCTS- COMP/OP AGG | $1,000,000.00 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $ |
| AGGREGATE | $ |
|  | $ |
| PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $ |
| E.L. DISEASE- EA EMPLOYEE | $ |
| E.L. DISEASE - POLICY LIMIT | $ |
|  |  |

## Table 111

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | NXTWH9LFKH-02-GL | 01/29/2026 | 01/29/2027 |
|  | AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  |  |  |  |
|  | UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ |  |  |  |  |  |
|  | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  |  |  |  |
|  |  |  |  |  |  |  |

## Table 112

| Reg. Control #: | 2025000014351 Date Filed: 7/16/2025 |
| --- | --- |
| Application Name: | CURTDELL GILES Jr. |
| Filing Type: | Initial Workers' Compensation Exemption |
| Status: | Active |
| Physical Addr: | 254 Court Ave., Suite 310, Curtdell Giles Jr., |
| Business Name: | OfferPorch Homes LLC |
| Business Control #: | 001133856 |
| Existing State License: | Yes 77366 |
| Business County: | Not Required |
| County License #: | 220002398 |
| Business City: | Not Required |
| City License #: | 220002398 |

## Table 113

| Effective Date: | 7/16/2025 |
| --- | --- |
| Expiration Date: | 7/16/2027 |

## Table 114

| Expiration Date: | 5/15/2025 |
| --- | --- |
| Expiration Date: | 5/15/2025 |

## Table 115

| FIS - Online Payment Portal - | $50.00 |
| --- | --- |
| FIS - Online Payment Portal - 08144C | $50.00 |

## Table 116

| Effective: | 7/16/2025 | Expires: 7/16/2027 |
| --- | --- | --- |
| Registration | Control # | 2025000014351 |

## Table 117

| Bid Item 1: | Luxury Vinyl Plank (LVP) Flooring |
| --- | --- |
| Bid Item 2: | Carpet |

## Table 118

| EHES ~2,450 sq ft | Wood Look | $ 9,648.34 | Furniture removal/replacement | $ 1,324.99 |
| --- | --- | --- | --- | --- |
|  | Stone Look | $ 9,648.34 |  |  |
| EHIS ~525 sq ft | Wood Look | $ 2,076.70 | Furniture removal/replacement | $ 265.00 |
|  | Stone Look | $ 2,076.70 |  |  |
| EHMS ~675 sq ft | Wood Look | $ 2,670.04 | Furniture removal/replacement | $ 265.00 |
|  | Stone Look | $ 2,670.04 |  |  |

## Table 119

| SIGNATURE OF AUTHORIZED | AGENT |  |  |  |
| --- | --- | --- | --- | --- |
| Subscribed and sworn to | before me this | 11th day of | May | , 2026 . |
| Signature of Notary Public My Commission Expires | But | 7/27/2017 | and |  |
| BRUCE STATE OF TENNESSEE NOTARY PUBLIC SHELBY | JOHNSON COUNTY |  |  |  |

## Table 120

|  |  |
| --- | --- |
|  | Hi! I'm Aiden, your A.I. flooring expert. How can I help? |
|  |  |

## Table 121

| COLLECTION |  |
| --- | --- |
| Style Name | Pro Solutions IV |
| Product Line | UltimateFlex Loose Lay |
| Product Type | Resilient Vinyl |
| Color Name PRODUCT DETAILS | Grey Mist |
| Look | Wood |
| Construction | Flex Vinyl |
| Edge Treatment | Micro Bevel |
| Floorscore Certified INSTALLATION | TRUE |
| Grade | On, Above or Below Grade |
| Sub-Floor | Wood/Concrete |
| Underlayment | Not attached |
| Installation Method MEASUREMENT | Hi! I'm Aiden, your A.I. flooring expert. How can I help? |
| Plank Thickness | 5 mm |

## Table 122

| Wear Layer | 20 mil |
| --- | --- |
| Width In Inches | 7.25" |
| Length | 48" |
| Sq. Ft. Per Carton | 24.2 |
| Veneer Thickness | N/A |

## Table 123

| FEATURES |  |
| --- | --- |
|  | EasyClean® technology helps repel dirt and grime, while the enhanced wear layer adds extra protection against everyday scuffs, scratches, and wear. |
|  | Designed with added thickness for extra comfort underfoot and allows for easy plank replacement to extend the life of your floor. |
|  | Warranty protection against pet stains for added peace of mind. |
| THAN | Premium Wear Resistance: Up to a 20 mil wear layer for upgraded protection against everyday wear and tear. |
|  | 100% waterproof floors perfect for any room in the home. Hi! I'm Aiden, your A.I. flooring expert. How can I help? |
| TECHNOLOGIES |  |

## Table 124

|  | PRODUCT SPECS |
| --- | --- |
| COLLECTION |  |
| Style Name | Whitmore Terrace LL |
| Product Line | UltimateFlex Loose Lay |
| Product Type | Resilient Vinyl |
| Color Name | Percy |
| PRODUCT DETAILS |  |
| Look | Stone |
| Construction | Loose Lay |
| Species | Marble |
| Texture | All Over |
| Floorscore Certified | TRUE |
| INSTALLATION |  |
| Grade | On, Above or Below Grade |
| Sub-Floor | Wood/Concrete |
| Underlayment | Not Attached |
| Installation Method | Glue Down |
| MEASUREMENT |  |
| Plank Thickness | 5.0 mm |
| Wear Layer | 20 mil |
| Width In Inches | 12' |
| Length | 24" Hi! I'm Alden, your A.I. flooring expert. How can I help? |
| Sq. Ft. Per Carton | 24 |

## Table 125

|  | DAILY WIRE | STREAMING ONLINE |
| --- | --- | --- |
| Style Number | QA194 | QA195 |
| Construction | Tufted | Tufted |
| Surface Appearance | Textured Patterned Loop | Textured Patterned Loop |
| Gauge | 1/12" (47.00 rows per 10cm) | 1/12" (47.00 rows per 10cm) |
| Tufted Weight | 16 | 16 |
| Density | 6,063 | 6,697 |
| Dye Method | 100% Solution Dyed | 100% Solution Dyed |
| Fiber Type | Envirostrand™ SD PET | Envirostrand™ SD PET |
| Soil Release Technology | Mohawk Protection Plus Soil | Mohawk Protection Plus Soil |
| Primary Backing | Non Woven Synthetic | Non Woven Synthetic |
| Secondary Backing | UltraSet Matrix | UltraSet® Matrix |
| Indoor Air Quality | Green Label Plus Certified # 100055 | Green Label Plus Certified # 100055 |
| Size | 24" X 24" (.6096 m X .6096 m) | 24" X 24" (.6096 m X .6096 m) |
| Sqyd per Carton | 10.66 sqyd/ctn | 10.66 sqyd/ctn |
| Installation Method | Brick Ashlar / Quarter Turn | Brick Ashlar / Quarter Turn |
| Flammability | ASTM E 648 Class 1 (Glue Down) | ASTM E 648 Class 1 (Glue Down) |
| Smoke Density | ASTM E 662 Less than 450 | ASTM E 662 Less than 450 |
| Static Propensity | AATCC-134 Under 3.5 KV | AATCC-134 Under 3.5 KV |
| Country of Origin | USA | USA |
| Warranties | 10-Year Limited Wear Warranty | 10-Year Limited Wear Warranty |
|  | 10-Year Limited Static Protection | 10-Year Limited Static Protection |
|  | 10-Year Limited Edge Ravel, Zippering, Delamination, and Dimensional Stability Warranty | 10-Year Limited Edge Ravel, Zippering, Delamination, and Dimensional Stability Warranty |
|  | 10-Year Limited Stain Resistance Warranty | 10-Year Limited Stain Resistance Warranty |
|  | 10-Year Limited Colorfastness to Light Warranty | 10-Year Limited Colorfastness to Light Warranty |
|  | 10-Year Limited Colorfastness to Atmospheric Contaminants | 10-Year Limited Colorfastness to Atmospheric Contaminants |

## Table 126

| page | [X] 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor C corporation S Partnership Trust/estate | 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): |
| --- | --- | --- |
|  | LLC. Enter the tax classification (C = C corporation, = S corporation, P = Partnership) | Exempt payee code (if any) |
|  | Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner. Other (see instructions) | Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) |
|  | 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions | (Applies to accounts maintained outside the United States.) |

## Table 127

|  | 5 Address (number, street, and apt. or suite no.). See instructions. | Requester's name and address (optional) |
| --- | --- | --- |
|  | 1373 Holly Tree Gap Rd |  |
|  | 6 City, state, and ZIP code Brentwood, TN. 37027 |  |
|  | 7 List account number(s) here (optional) |  |

## Table 128

|  | Social security number |
| --- | --- |
| Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entitles, it is your employer identification number (EIN). If you do not have a number, see How to get a | - - or |
| TIN, later. | Employer Identification number |
| Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. | 04 - 3777109 |

## Table 129

| Sign Here | Signature of U.S. person Debbie Benbow |  | Date | 3/13/2026 |
| --- | --- | --- | --- | --- |

## Table 130

| CONTACT NAME: | LISA WILSON |
| --- | --- |
| PHONE: | FAX: (615)905-1698 |
| E-MAIL ADDRESS: | llsa.wilson@iga.biz |

## Table 131

| INSURER(S) AFFORDING | COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A | Central Mutual | 20230 |
| INSURER B | All America | 20222 |
| INSURER C |  |  |
| INSURER D |  |  |
| INSURER E |  |  |
| INSURER F |  |  |

## Table 132

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 300,000 |
| MED EXP (Any one person) | $ 5,000 |
| PERSONAL & ADV INJURY | $ 1,000,000 |
| GENERAL AGGREGATE | $ 2,000,000 |
| PRODUCTS- COMP/OP AGG | $ 2,000,000 |
| COMBINED SINGLE LIMIT (Ea accident) | $ 1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  |  |
| EACH OCCURRENCE | $ 5,000,000 |
| AGGREGATE | $ 5,000,000 |
|  |  |
| [X] WC STATUTORY LIMITS | OTHER |
| E.L. EACH ACCIDENT | $ 1,000,000 |
| EL DISEASE - EA EMPLOYEE | $ 1,000,000 |
| E.L DISEASE- POLICY LIMIT | $ 1,000,000 |
|  |  |

## Table 133

| INSR LTR | TYPE OF INSURANCE | INSR | ADDLISUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT | Y | Y | 9606838 | 8/8/2025 | 8/8/2026 |
| B | [X] AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS | Y | Y | 9606837 | 8/8/2025 | 8/8/2026 |
| A | [X] [X] UMBRELLA LIABILITY UMBRELLA OCCUR LIAB EXCESS LIAB CLAIMS-MADE DED RETENTION $ | Y | Y | 9606839 | 8/8/2025 | 8/8/2026 |
| A | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERS/EXEC Y UTIVE OFFICE/MEMBER EXCLUDED? (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below |  |  | 9606841 | 8/8/2025 | 8/8/2026 |

## Table 134

| 1) | Brent Stidham Senior Maintenance Engineer (Managing govt buildings in Brentwood TN) City Of Brentwood brent.stidham@brentwoodtn.gov (615)533-5032 15+ Years as a customer |
| --- | --- |
| 2) | Ryan Edwards Continuous Improvement Coordinator Advanced Composites Ryan.edwards@advcmp.com (615)630-1843 15+ Years as a customer |
| 3) | Yvonne Parker Sr. Specialist, Consumer Care National Facilities T-Mobile Yvonne.parker@t-mobile.com (931)980-8867 8 Years as a customer |
| 4) | Wesley King Service Manager The Mathews Company wking@themathewscompany.com |
|  | (615)394-8451 15+ Years as a customer |

## Table 135

| EHES ~2,450 sq ft | Wood Look | $ 22,504.00 | Furniture removal/replacement | $2450.00 |
| --- | --- | --- | --- | --- |
|  | Stone Look | $ 22,504.00 |  |  |
| EHIS ~525 sq ft | Wood Look | $5,016.00 | Furniture removal/replacement | $500.00 |
|  | Stone Look | $5,016.00 |  |  |
| EHMS ~675 sq ft | Wood Look Stone Look | $ 6,206.00 $6,206.00 | Furniture removal/replacement | $675.00 |

## Table 136

| SIGNATURE OF AUTHORIZED | AGENT | Nathaniel Benbow |
| --- | --- | --- |
| Subscribed and sworn to | before me this | day of May , 2026 - |
| Signature of Notary Public | Notary to be | submitted after notice of award if neeeded. |
| My Commission Expires |  |  |

## Table 137

| EHES | $ 100 |
| --- | --- |
| EHIS | $ 100 |
| EHMS | $ 100 |
| EHHS | $ 100 |
| CES | $ 100 |
| CIS | $ 100 |
| HCMS | $ 100 |
| HCHS | $ 100 |

## Table 138

| EHES | $ $ 200 |
| --- | --- |
| EHIS | $ 200 $ |
| EHMS | $ 200 |
| EHHS | $ 200 |
| CES | $ 200 |
| CIS | $ 200 |
| HCMS | $ 200 $ |
| HCHS | $ 200 $ |

## Table 139

| CES $ | 220 |
| --- | --- |
| CIS $ | 220 |
| HCMS | $ 220 $ |
| HCHS | $ $ 220 |
| EHES | $ 220 |
| EHIS | $ 220 220 |
| EHMS | $ 220 |
| EHHS | $ 440 2 systems |

## Table 140

| Print: | Tony Mallini |
| --- | --- |
| - Date: | 5-20-26 |

## Table 141

| Bidder Name: | State Systems, INC Tony Mallin, |
| --- | --- |
| Bidder Signature: | 7 Mul |
| Date: | 5/20/26 |

## Table 142

| CONTACT NAME: |  |  |
| --- | --- | --- |
| PHONE (A/C. No. Ext): |  | FAX (A/C, No): |
| E-MAIL ADDRESS: |  |  |

## Table 143

|  |  |  |
| --- | --- | --- |
|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| INSURER A: | Hudson Excess Insurance Company | 14484 |
| INSURER B : | The Travelers Indemnity Company | 25658 |
| INSURER C : | The Charter Oak Fire Insurance Company | 25615 |
| INSURER D : | Travelers Property Casualty Company of America | 25674 |
| INSURER E : | Westchester Surplus Lines Insurance Co | 10172 |
| INSURER F : |  |  |

## Table 144

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 500,000 |
| MED EXP (Any one person) | $ 10,000 |
| PERSONAL & ADV INJURY | $ 1,000,000 |
| GENERAL AGGREGATE | $ 5,000,000 |
| PRODUCTS-COMP/OP AGG | $ 2,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ 1,000,000 |
| BODILY INJURY (Per person) | $ XXXXXXX |
| BODILY INJURY (Per accident) | $ XXXXXXX |
| PROPERTY DAMAGE (Per accident) | $ XXXXXXX |
|  | $ XXXXXXX |
| EACH OCCURRENCE | $ 5,000,000 |
| AGGREGATE | $ 5,000,000 |
|  | $ XXXXXXX |
| [X] PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $ 1,000,000 |
| E.L. DISEASE- EA EMPLOYEE | $ 1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $ 1,000,000 |
| Limits: Included/$1M Limits: $250K Fac Occ $5M ! A.gg $5M |  |

## Table 145

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: | N | N | ALM10130-00 | 2/7/2026 | 8/1/2026 |
| B | [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY | N | N | DT-810-A8126919-IND-26 | 2/7/2026 | 2/7/2027 |
| A | [X] [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ 10,000 | N | N | ALMU10056-00 | 2/7/2026 | 8/1/2026 |
| C | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER-EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A | N | UB-A8090273-26-26-G | 2/7/2026 | 2/7/2027 |
| A D E | Prof/Poll Leased/Rented Equip Fress | N | N | ALM10130-00 QT-630-A8150089-TIL-26 G4878947A 001 | 2/7/2026 2/7/2026 2/7/2026 | 8/1/2026 2/7/2027 8/1/2026 |

## Table 146

| Service Call Trip Charge | $ 100.00 |  |
| --- | --- | --- |
| Hourly rate per tech $ | 140.00 | (normal rate) |
| Hourly rate per tech $ | 210.00 | (over-time rate) |

## Table 147

| Print: | Jennifer McMullin |
| --- | --- |
| Title: | Special Hazards, Alarm & Detection Sales |
| Date: | 5/22/2026 |

## Table 148

| Company: | American Fire Protection Group |
| --- | --- |
| Address: | 155 North Conalco Drive Jackson, TN 38301 |
| Company Phone: | 731-424-0310 |
| Inspector: | Cody Holland 2055 TN Portable Fire Ext |
| Date of Work: |  |
| Frequency: | Annual |

## Table 149

| Description: | Fire Extinguishers |
| --- | --- |
| Work Order: |  |

## Table 150

| Zone: 1 |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Tag | Serial Number | Model | Size | Type | Location | La Servi | ext Service | Frequency | Inspection | Comments |
| 1 | C-99119847 | SimplexGrinnell (2017) AA10s | 10# | ABC | Right dock entrance, breakroom | yı 024 | Hydro 2030 | Annual | Pass |  |
| 2 | C9911988 | SimplexGrinnell (2017) AA10s | 10# | ABC | Pole #1 in from f breaknom | 6)20. | Hydro 2030 | Annual | Pass |  |
| 3 | I51719087 | Badger (2025) ADV-10MP-1 | 10# | ABC | 2nd pole throms | New 2025 | 6 yr 2031 | Annual | Pass |  |
| 4 | C-99119899 | SimplexGrinnell (2017) AA10s | 10# | ABC | Bac wan behind poy dercoat. | 6 yr 2024 | Hydro 2030 | Annual | Pass |  |
| 5 | H22617059 | Badger (2023) ADV-10 | 10# | ABC | 3rd pole down in front of office | New 2023 | 6 yr 2029 | Annual | Pass |  |
| 6 | C-99119836 | SimplexGrinnell (2017) AA10S | 10# | ABC | 2nd door by loading dock | 6 yr 2024 | Hydro 2030 | Annual | Pass |  |
| 7 | H22617054 | Badger (2023) ADV-10 | 10# | ABC | Inside office | New 2023 | 6 yr 2029 | Annual | Pass |  |
| 8 | K-883213 | Ansul (2011) AA105 | 10# | ABC | Loading area | New 2018 | 6 yr 2024 | Annual | Fail | 6yr due |
| 9 | C-99119841 | SimplexGrinnell (2017) AA10S | 10# | ABC | Middle pole in loading area | 6 yr 2024 | Hydro 2030 | Annual | Pass |  |
| 10 | C-99119853 | SimplexGrinnell (2017) AA10S | 10# | ABC | Exit door by dock | 6 yr 2024 | Hydro 2030 | Annual | Pass |  |
| 11 | E-83203601 | Sentry (2018) AA10S | 10# | ABC | Pole 7 in front of dock | 6 yr 2024 | Hydro 2030 | Annual | Pass |  |
| 12 | H-09109074 | Sentry (2022) AA10S | 10# | ABC | Pole by welding area, beside rack | 6 yr 2024 | Hydro 2030 | Annual | Pass |  |
| 13 | C-99119898 | SimplexGrinnell (2017) AA10S | 10# | ABC | Back wall welding area #1 | 6 yr 2024 | Hydro 2030 | Annual | Pass |  |

## Table 151

| Company: | American Fire Protection Group |
| --- | --- |
| Address: | 155 North Conalco Drive Jackson, TN 38301 |
| Company Phone: | 731-424-0310 |
| Inspector: | Cody Holland 50454 TN Fire Alarm |
| Date of Work: | 12/4/2025 |
| Frequency: | Annual |
| Tag: | Green |

## Table 152

|  |  |  |  | Power | Supplies |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Control Unit | Manufacturer: Notifier |  | Model Number: Fcps-24s8 |  | Location: Nurse station | 2 |  | Disconnecting Location: Mech room |
| Battery 1 | Voltage: 12 | Amps: 7 | Mfr Year: 2023 | Load Test Battery 1 | VDC: 13.54 | Ah: 5.39 | Charger Voltage: 14.74 | Result of Battery 1 & 2 |
| Battery 2 | Voltage: 12 | Amps: 7 | Mfr Year: 2023 | Load Test Battery 2 | VDC: 13.92 | Ah: 4.60 | Charger Voltage: 13.74 | [X] Pass Fail Replaced |

## Table 153

| Description | Visual Inspection | Functional Test | Results |
| --- | --- | --- | --- |
| Control unit | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Lamps / LEDs / LCDs | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Fuses | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Trouble signals | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Disconnect switches | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Ground-fault monitoring | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Supervision | [X] Yes No | [X] Y | [X] Pass Fail N/A |
| Annunciators | [X] Yes No | [X] Ye. No | [X] Pass Fail N/A |
| Remote power panels | [X] Yes No | No | [X] Pass Fail N/A |
| Other | Yes No | Y No | Pass Fail N/A |

## Table 154

| Description | Visual Inspection | Functional Test | Results |
| --- | --- | --- | --- |
| Battery condition | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Load voltage | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Discharge test | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Charger test | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |
| Remote panel batteries | [X] Yes No | [X] Yes No | [X] Pass Fail N/A |

## Table 155

| Appliance Type | # Installed | # Tested | Test Results |
| --- | --- | --- | --- |
| Bell(s) | 0 | 0 | [X] Pass Fail N/A |
| Horn(s) | 0 | 0 | [X] Pass Fail N/A |
| Horn/Strobe(s) | 17 | 17 | [X] Pass Fail N/A |
| Mini Horn(s) | 0 | 0 | [X] Pass Fail N/A |
| Speaker(s) | 0 | 0 | [X] Pass Fail N/A |
| Speaker/Strobe(s) | 0 | 0 | [X] Pass Fail N/A |
| Strobe(s) | 0 | 0 | [X] Pass Fail N/A |

## Table 156

| Zone: 1 |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Asset Type | Address | Location | Notes | Frequenc y | Last Tested | Test Results | Comments |
| TS |  | Backflow bottom |  | Annual | 12/4/2025 | Pass |  |
| TS |  | Backflow top |  | Annual | 12/4/2025 | Pass |  |
| TS |  | Riser room |  | Annual | 12/4/2025 | Pass |  |
| WF |  | Riser room |  | Annual | 12/4/2025 | Pass |  |
| WF |  | Wet riser |  | Annual | 12/4/2025 | Pass |  |

## Table 157

| Zone: Main |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Asset Type | Address | Location | Notes | Frequenc y | Last Tested | Test Results | Comments |
| DH | 00269159 | At rm 108 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269148 | At rm 118 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269149 | At rm 118 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269168 | At mm 203 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269169 | At rm 203 |  | Annual | 12/4/2025 | Pass |  |
| SD | 00269175 | At rm 207 |  | Annu | 12/4/2025 | Pass |  |
| DH | 00269085 | At rm 309 |  | Ann al | /4/2025 | Pass |  |
| DH | 00269086 | At rm 309 |  | nu | /4/2025 | Pass |  |
| SD | 00269096 | At m 326 |  |  | 12/4/2025 | Pass |  |
| DH | 00269097 | At mm 401 |  | nual | 12/4/2025 | Pass |  |
| DH | 00269099 | At rm 401 |  | nual | 12/4/2025 | Pass |  |
| SD | 00269101 | At rm 409 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269107 | At rm 410 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269108 | At rm 410 |  | Annual | 12/4/2025 | Pass |  |
| PS | 00269105 | At mm 410 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269178 | At room 209 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269179 | At room 209 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269087 | At room 309 |  | Annual | 12/4/2025 | Pass |  |
| DH | 00269088 | At room 309 |  | Annual | 12/4/2025 | Pass |  |
| SD | 00269076 | By room 219 |  | Annual | 12/4/2025 | Pass |  |
| SD | 00269077 | By room 223 |  | Annual | 12/4/2025 | Pass |  |
| DD | 00269121 | Dining area ceiling |  | Annual | 12/4/2025 | Pass |  |
| DD | 00269122 | Dining area ceiling |  | Annual | 12/4/2025 | Pass |  |
| SD | 00269186 | Dining rm |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269188 | Dining rm |  | Annual | 12/4/2025 | Pass |  |
| DD | 00269126 | Dining room |  | Annual | 12/4/2025 | Pass |  |
| DD | 00269127 | Dining room |  | Annual | 12/4/2025 | Pass |  |
| PS | 00269189 | Dining room exit |  | Annual | 12/4/2025 | Pass |  |
| [X] HD | 00269190 | Dining room storage |  | Annual | 12/4/2025 | Pass |  |
| PS | 00269161 | Front door |  | Annual | 12/4/2025 | Pass |  |
| HD | 00269187 | In dining room |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269136 | In laundry |  | Annual | 12/4/2025 | Pass |  |
| [X] HD | 00269135 | In laundry room |  | Annual | 12/4/2025 | Pass |  |
| DD | 00269144 | In the hall outside of activities, supply room |  | Annual | 12/4/2025 | Pass |  |
| [X] HD | 00269131 | In the kitchen |  | Annual | 12/4/2025 | Pass |  |
| [X] HD | 00269132 | In the kitchen |  | Annual | 12/4/2025 | Pass |  |
| [X] HD | 00269134 | In the kitchen |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269075 | Nurses station 2 |  | Annual | 12/4/2025 | Pass |  |

## Table 158

| Zone: Main |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| Asset Type | Address | Location | Notes | Frequenc y | Last Tested | Test Results | Comments |
| [X] SD | 00269146 | SD 35 |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269142 | SD 37 |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269139 | SD 39 |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269119 | SD 41 |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269130 | SD 43 |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269125 | SD 44 |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269129 | SD 46 |  | Annual | 12/4/2025 | Pass |  |
| [X] PS | 00269112 | Serinity rm |  | Annual | 12/4/2025 | Pass |  |
| [X] SD | 00269120 | Vending machine |  | Annual | 12/4/2025 | Pass |  |

## Table 159

|  | Contact | Time |
| --- | --- | --- |
| Monitoring organization: | AFPG | 10:00 |
| Building management: | Maintenance | 10:00 |

## Table 160

| Date: | 12/4/2025 |
| --- | --- |
| Time: | 10:00 |

## Table 161

| Company: | American Fire Protection Group |
| --- | --- |
| Address: | 155 North Conalco Drive Jackson, TN 38301 |
| Company Phone: | 731-424-0310 |
| Inspector: | Brian Johnson 1960 Port/Fixed Ext. |
| Date of Work: | 9/16/2025 |
| Frequency: | Annual |
| Tag: | Green |

## Table 162

| Title | Maintenance |
| --- | --- |
| Date | 9/16/2025 |
| Inspected By | Brian Johnson |

## Table 163

| Inspector License: | 1960 Port/Fixed Ext. |
| --- | --- |
| Date of Work | 9/16/2025 |
| Observations |  |

## Table 164

| Signature: |  |
| --- | --- |
| Print: | RICHARD EVERETT |
| Date: | 5/26/26 |
| Phone/Email: |  |

## Table 165

| Business ID: | 0510329 |
| --- | --- |
| State ID: | 0104267492 |

## Table 166

| Business Name: | ACTIVE ENERGY SERVICES LLC |
| --- | --- |
| Location: | RICHARD EVERETT 4705 CHAPEL HILL RD SOUTHSIDE, TN 37171 |

## Table 167

| Classification: | CLASS 4 |
| --- | --- |
| Date Issued: | 04/15/2026 |

## Table 168

| Classification: | CLASS 4 |
| --- | --- |
| Date Issued: | 04/15/2026 |

## Table 169

| Letter ID: | L1963260352 |
| --- | --- |
| Account ID: | 1000032556-SLC |
| Account Type: | Sales and Use Tax |

## Table 170

| Letter ID: | L1963260352 |
| --- | --- |
| Effective Date: | January 14, 2026 |
| Account ID: | 1000032556-SLC |
| Account Type: | Sales and Use Tax |
| Location ID: | 0104267492 |
| Location Address: |  |

## Table 171

| CONTACT NAME: Commercial Service |  |
| --- | --- |
| PHONE (A/C. No. Ext): (615) 200-7464 | (A/C, FAX No): (888) 667-1469 |
| E-MAIL ADDRESS: service@carlsoninsgrp.com |  |

## Table 172

|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A: | ERIE INSURANCE EXCHANGE | 26271 |
| INSURER B : | ERIE INSURANCE P&C COMPANY | 26830 |
| INSURER C: |  |  |
| INSURER D : |  |  |
| INSURER E: |  |  |
| INSURER F : |  |  |

## Table 173

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 2,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 2,000,000 |
| MED EXP (Any one person) | $ 5,000 |
| PERSONAL & ADV INJURY | 2,000,000 |
| GENERAL AGGREGATE | 4,000,000 |
| PRODUCTS- COMP/OP AGG | $ 4,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ 1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $ 5,000,000 |
| AGGREGATE | $ |
|  | $ |
| [X] PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $ 1,000,000 |
| E.L. DISEASE - EA EMPLOYEE | $ 1,000,000 |
| E.L. DISEASE - POLICY LIMIT | $ 1,000,000 |
|  | $300,000 |

## Table 174

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | Q61-0223467 | 09/10/2025 | 09/10/2026 |
| A | [X] [X] [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  | Q09-1040070 | 09/10/2025 | 09/10/2026 |
| A | [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ |  |  | Q33-1070407 | 09/10/2025 | 09/10/2026 |
| B | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  | Q93-1000935 | 09/10/2025 | 09/10/2026 |
| A | RENTED/LEASED EQUIPMENT |  |  | Q61-0223467 | 09/10/2025 | 09/10/2026 |

## Table 175

| Business ID: | 0510329 |
| --- | --- |
| State ID: | 0104267492 |

## Table 176

| Classification: | CLASS 4 |
| --- | --- |
| Date Issued: | 04/15/2026 |

## Table 177

| Classification: | CLASS 4 |
| --- | --- |
| Date Issued: | 04/15/2026 |

## Table 178

| Print: | RICHARD EVERETT |
| --- | --- |
| Title: | MANAGER |
| Date: | 5/26/26 |

## Table 179

| EHES | $ 1,000.00 |
| --- | --- |
| EHIS | $ 1,000 |
| EHMS | $ 1,000 |
| EHHS | $ 1,000 |
| CES | $ 1,000 |
| CIS | $ 1,000 |
| HCMS | $ 1,000 |
| HCHS | $ 1,000 |

## Table 180

| EHES | $ 450 |
| --- | --- |
| EHIS | $ 45000 |
| EHMS | $ 45000 |
| EHHS | $ 45000 |
| CES | $ 45000 |
| CIS | $ 450000 |
| HCMS | $ 45000 |
| HCHS | $ 450 |

## Table 181

| Service Call Trip Charge | $ 12500 |  |
| --- | --- | --- |
| Hourly rate per tech $ | 100 | (normal rate) |
| Hourly rate per tech $ | 14000 | (over-time rate) |

## Table 182

| CES | 240°/UISIT 480 |
| --- | --- |
| CIS | 480°C |
| HCMS | 48000 |
| HCHS | $ 240 ²/UISIT 480 |
| EHES | 480°C |
| EHIS | $ 240 48000 |
| EHMS | 480 |
| EHHS | 480°C |

## Table 183

| CONTACT NAME: David Michael Wiatr |  |
| --- | --- |
| PHONE (A/C, No, Ext): (615) 431-1262 | (A/C, FAX No): (615) 468-4712 |
| E-MAIL ADDRESS: frontdesk@bnainsurancegroup.com |  |

## Table 184

|  | INSURER(S) AFFORDING COVERAGE | -NAIC # |
| --- | --- | --- |
| INSURER A: | WILSON MUT INS CO | 19950 |
| INSURER B : | HANOVER AMER INS CO | 36064 |
| INSURER C : |  |  |
| INSURER D: |  |  |
| INSURER E: |  |  |
| INSURER F: |  |  |

## Table 185

| INSR LTR | TYPE OF INSURANCE | INSD | ADDLISUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | 5000274758 | 07/18/2025 | 07/18/2026 |
| A | [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  | 5000274758 | 07/18/2025 | 07/18/2026 |
|  | UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ |  |  |  |  |  |
| B | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  | WZ5H689899 | 07/18/2025 | 07/18/2026 |
|  |  |  |  |  |  |  |

## Table 186

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 100,000 |
| MED EXP (Any one person) | $ 5,000 |
| PERSONAL & ADV INJURY | $ 1,000,000 |
| GENERAL AGGREGATE | $ 2,000,000 |
| PRODUCTS - COMP/OP AGG | $ 2,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ 1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $ |
| AGGREGATE | $ |
|  | $ |
| [X] PER OTH- STATUTE ER |  |
| EL EACH ACCIDENT | $ 1,000,000 |
| E.L. DISEASE - EA EMPLOYEE | $ 1,000,000 |
| E.L. DISEASE - POLICY LIMIT | $ 1,000,000 |
|  |  |

## Table 187

| Policy Number | Policy Period | Coverage is Provided in the | Agency Code |
| --- | --- | --- | --- |
|  | From To |  |  |
| WZ5-H689899-04 | 07/18/2025 07/18/2026 | THE HANOVER AMERICAN INSURANCE COMPANY | 1802610 |

## Table 188

| LOCATION NUMBER | ADDRESS |
| --- | --- |
| 001 | 2913 CHERRYBARK CT HERMITAGE, TN 37076 |

## Table 189

| BUSINESS NUMBER | 214695 |
| --- | --- |
| RECEIPT NUMBER | 1054019 |
| THIS LICENSE EXPIRES | 05/15/2027 |

## Table 190

| BUSINESS NUMBER | 214695 |
| --- | --- |
| RECEIPT NUMBER | 1054019 |
| CLASSIFICATION | 3 |

## Table 191

| FROM | 01/01/2025 |
| --- | --- |
| TO | 12/31/2025 |

## Table 192

| BUSINESS NUMBER | 214695 |
| --- | --- |
| RECEIPT NUMBER | 0902519 |
| THIS LICENSE EXPIRES | 05/15/2026 |

## Table 193

|  | CITY | COUNTY |
| --- | --- | --- |
| TOTAL GROSS SALES |  |  |
| LESS DEDUCTIONS |  |  |
| BUSINESS TAX DUE (LESS CREDITS) |  |  |
| MINIMUM TAX |  |  |
| PENALTY |  |  |
| INTEREST |  |  |
| NEW LICENSE FEE |  | 15.00 |
| TOTAL TAX DUE |  | 15.00 |

## Table 194

| BUSINESS NUMBER | 214695 |
| --- | --- |
| RECEIPT NUMBER | 0902519 |
| CLASSIFICATION | 3 |

## Table 195

| FROM | STARTED |
| --- | --- |
| TO | 07/24/2019 |

## Table 196

| ISSUE DATE | 09/18/2025 |
| --- | --- |
| ORIGINAL ISSUE DATE | 07/24/2019 |
| ORIGINAL ISSUE USER | RMEYER |

## Table 197

| USER | RMEYER |
| --- | --- |
| STATION | WK208 |
| DRAWER | 267 |
| SITE | 1 |
| WORK DATE | 07/24/2019 |

## Table 198

| TOTAL DUE | $15.00 |
| --- | --- |
| CHECK | $30.00 |
| CHECK NO. | 103 |
| CHANGE | $15.00 |

## Table 199

| Name of Organization | Garage Floor Coating of Nashville, LLC |
| --- | --- |
| Submitted by (Name) | Bruce Davies |
| Title | Managing Member |
| Address | 2913 Cherrybark Ct. |
|  | Hermitage, TN 37076 |
| Telephone | (615) 878-4320 |

## Table 200

| Print: | BRUCE DAVIES |
| --- | --- |
| Title: | Managing Member |
| Date: | April 27, 2026 |

## Table 201

| Bidder Name: | Garage Floor Coating of Nastiville, LLC (Brice DAVIES) |
| --- | --- |
| Bidder Signature; | Draver Davis |
| Date: April | 27, 2026 |

## Table 202

|  | [X] 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor C corporation S corporation Partnership Trust/estate | 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): |
| --- | --- | --- |
|  | LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) | Exempt payee code (if any) |
|  | Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner. Other (see instructions) | Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) |
|  | 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See instructions | (Applies to accounts maintained outside the United States.) |

## Table 203

|  |  |  |
| --- | --- | --- |
|  | 5 Address (number, street, and apt. or suite no.). See instructions. | Requester's name and address (optional) |
|  | 1373 Holly Tree Gap Rd |  |
|  | 6 City, state, and ZIP code |  |
|  | Brentwood, TN. 37027 |  |
|  | 7 List account number(s) here (optional) |  |

## Table 204

| the line 1 to avoid | Social security number |
| --- | --- |
| Enter your TIN in the appropriate box. The TIN provided must match name given on backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a | - - or |
| TIN, later. | Employer identification number |
| Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. | 04 - 3777109 |

## Table 205

| Sign Here | Signature of U.S. person Debbie Benbow | Date 3/13/2026 |
| --- | --- | --- |

## Table 206

| CONTACT NAME: | LISA WILSON |
| --- | --- |
| PHONE: | FAX: (615)905-1698 |
| E-MAIL ADDRESS: | lisa.wilson@iga.biz |

## Table 207

|  |  |  |
| --- | --- | --- |
| INSURER(S) AFFORDING | COVERAGE | NAIC # |
| INSURER A | Central Mutual | 20230 |
| INSURER B | All America | 20222 |
| INSURER C |  |  |
| INSURER D |  |  |
| INSURER E |  |  |
| INSURER F |  |  |

## Table 208

| LIMITS |  |  |
| --- | --- | --- |
| EACH OCCURRENCE | $ | 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ | 300,000 |
| MED EXP (Any one person) | $ | 5,000 |
| PERSONAL & ADV INJURY | $ | 1,000,000 |
| GENERAL AGGREGATE | $ | 2,000,000 |
| PRODUCTS- COMP/OP AGG | $ | 2,000,000 |
| COMBINED SINGLE LIMIT (Ea accident) | $ | 1,000,000 |
| BODILY INJURY (Per person) | $ |  |
| BODILY INJURY (Per accident) | $ |  |
| PROPERTY DAMAGE (Per accident) | $ |  |
|  |  |  |
| EACH OCCURRENCE | $ | 5,000,000 |
| AGGREGATE | $ | 5,000,000 |
|  |  |  |
| [X] WC STATUTORY LIMITS |  | OTHER |
| E.L. EACH ACCIDENT | $ | 1,000,000 |
| E.L. DISEASE- EA EMPLOYEE | $ | 1,000,000 |
| E.L DISEASE- POLICY LIMIT | $ | 1,000,000 |

## Table 209

| INSR LTR | TYPE OF INSURANCE | ADDL INSR | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT | Y | Y | 9606838 | 8/8/2025 | 8/8/2026 |
| B | [X] AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS | Y | Y | 9606837 | 8/8/2025 | 8/8/2026 |
| A | [X] [X] UMBRELLA LIABILITY UMBRELLA OCCUR LIAB EXCESS LIAB CLAIMS-MADE DED RETENTION $ | Y | Y | 9606839 | 8/8/2025 | 8/8/2026 |
| A | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERS/EXEC- Y UTIVE OFFICE/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below |  |  | 9606841 | 8/8/2025 | 8/8/2026 |

## Table 210

| 1) | Brent Stidham Senior Maintenance Engineer (Managing govt buildings in Brentwood TN) City Of Brentwood brent.stidham@brentwoodtn.gov (615)533-5032 15+ Years as a customer |
| --- | --- |
| 2) | Ryan Edwards Continuous Improvement Coordinator Advanced Composites Ryan.edwards@advcmp.com (615)630-1843 15+ Years as a customer |
| 3) | Yvonne Parker Sr. Specialist, Consumer Care National Facilities T-Mobile Yvonne.parker@t-mobile.com (931)980-8867 8 Years as a customer |
| 4) | Wesley King Service Manager The Mathews Company wking@themathewscompany.com (615)394-8451 15+ Years as a customer |

## Table 211

| Name of Organization | BJB Construction Company Inc. |
| --- | --- |
| Submitted by (Name) | Nathaniel Benbow |
| Title | Estimator/ Principal Officer |
| Address | 1373 Holly Tree Gap Rd, Brentwood, TN. 37027 |
|  |  |
|  |  |
| Telephone | 615-394-1411 |

## Table 212

| Print: | Nathaniel Benbow |
| --- | --- |
| Title: | Estimator/ Principal Officer |
| Date: | 5/11/2026 |

## Table 213

| (a) | The director, purchasing agent, members of the committee, members of the county legislative body or other officials, employees, or members of the board of education or highway commission shall not be financially interested or have any personal beneficial interest, either directly or indirectly, in the purchase of any supplies, materials, equipment or contractual services for the county. |
| --- | --- |
| (b) | No firm, corporation, partnership, association or individual furnishing any such supplies, materials, equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other things of value whatsoever, or any promise, obligation or contract for future reward or compensation. |

## Table 214

| Print: | Nathaniel Benbow |
| --- | --- |
| Date: | 5/11/2026 |

## Table 215

| Print: | R. Paul Nickell |
| --- | --- |
| Title: | President |
| Date: | 5/12/2026 |

## Table 216

| Signature: |  |  |
| --- | --- | --- |
| Print: | R | Pal Nickell |
| Date: |  | 5/7/2026 |
| Phone/Email: |  | 331-454-6484 Tadllh@duickell.com |

## Table 217

| CONTACT NAME: |  |
| --- | --- |
| PHONE (A/C, No, Ext): (423) 745-3062 | FAX (A/C, No): (423) 745-8888 |
| E-MAIL ADDRESS: |  |

## Table 218

|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A: | Cincinnati Specialty | 13037 |
| INSURER B : | Business First Insurance Co | 11697 |
| INSURER C : |  |  |
| INSURER D : |  |  |
| INSURER E: |  |  |
| INSURER F : |  |  |

## Table 219

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | 1,000,000 $ |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | 100,000 $ |
| MED EXP (Any one person) | 1,000 $ |
| PERSONAL & ADV INJURY | 1,000,000 $ |
| GENERAL AGGREGATE | $ 2,000,000 |
| PRODUCTS - COMP/OP AGG | 2,000,000 $ |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | S 1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | S |
| EACH OCCURRENCE | 2,000,000 $ |
| AGGREGATE | S 2,000,000 |
|  | S |
| [X] PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | 1,000,000 S |
| E.L. DISEASE - EA EMPLOYEE | 1,000,000 S |
| E.L. DISEASE - POLICY LIMIT | 1,000,000 $ |
|  |  |

## Table 220

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | CSU0236120 | 7/24/2025 | 7/24/2026 |
| A | [X] [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  | CSU0236120 | 7/24/2025 | 7/24/2026 |
| A | [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ |  |  | CSU0261601 | 7/24/2025 | 7/24/2026 |
| B | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  | 521-24987 | 7/24/2025 | 7/24/2026 |
|  |  |  |  |  |  |  |

## Table 221

| Print: | Robert N. Hutcheson |
| --- | --- |
| Title: | President |
| Date: | 5/12/2026 |

## Table 222

| Bidder Name: | Sessions Paving Company |
| --- | --- |
| Bidder Signature: | Robert A. Hutcheson President |
|  |  |

## Table 223

| Signature: | Sessions Paving Company Robert 1. Hutheror |
| --- | --- |
| Print: | Robert N.Hutcheson President |
| Date: | 5/12/2026 |
| Phone/Email: | (615)356-0600 rnhutahesen@severspoingco |

## Table 224

| 1. | Now comes the Affiant, who being duly sworn, deposes and says: |
| --- | --- |
| 2. | He/she is the principal officer for SESSIONS PAVING COMPANY |
|  | (Name and Address of Bidding Entity |
|  | P.O. Box 90266 (6535 Robertson Avenue) Nashville, TN 37209 |
| 3. | That the bidding entity has submitted a bid to Hickman County, TN (Owner) |
|  | for the construction of Annual Paving and Patching |
| = | (Name of Project) |
| 4. | That the bidding entity employs no less than five (5) employees. |
| 5. | That the Affiant certifies that the bidding entity has in effect, at the time of submission of its bid to perform the construction referred to above, a drug-free workplace program that complies with § 50-9-113, Tennessee Code Annotated. |
| 6. | That this affidavit is made on personal knowledge. |

## Table 225

| ID NUMBER: | 6962 |
| --- | --- |
| LIC STATUS: | ACTIVE |
| EXPIRATION | DATE: January 31. 2028 |
| UNLIMITED; | BC; CE-A; CE-B; HC-D; HRA; MU |

## Table 226

| CONTACT NAME: Wendy Nowlin |  |
| --- | --- |
| PHONE (A/C, No, Ext): 615 346-0323 | FAX (A/C, No): 8777677417 |
| E-MAIL ADDRESS: wmnowlin@mcgriff.com |  |

## Table 227

|  |  |  |
| --- | --- | --- |
|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| INSURER A: | Charter Oak Fire Insurance Company | 25615 |
| INSURER B : | Travelers Property Casualty Co of Amer | 25674 |
| INSURER C : | MidSouth Insurance Company | 12839 |
| INSURER D : | Travelers Indemnity Co of America | 25666 |
| INSURER E : |  |  |
| INSURER F: |  |  |

## Table 228

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $300,000 |
| MED EXP (Any one person) | $5,000 |
| PERSONAL & ADV INJURY | $1,000,000 |
| GENERAL AGGREGATE | $2,000,000 |
| PRODUCTS- COMP/OP AGG | $2,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ee accident) | $1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $5,000,000 |
| AGGREGATE | $5,000,000 |
|  | $ |
| [X] PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $1,000,000 |
| E.L. DISEASE - EA EMPLOYEE | $1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $1,000,000 |
|  |  |

## Table 229

| INSR LTR | TYPE OF INSURANCE | ADDL INSR | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR PD Ded:500 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | DTCO7890P35ACOF | 04/01/2026 | 04/01/2027 |
| D | [X] [X] [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  | 8108M9623792626G | 04/01/2026 | 04/01/2027 |
| B | [X] [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $10000 |  |  | CUP2J5568542626 | 04/01/2026 | 04/01/2027 |
| C | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  | WC052562026 | 01/01/2026 | 01/01/2027 |
|  |  |  |  |  |  |  |

## Table 230

| Print: | Nathaniel Benbow |
| --- | --- |
| Title: | Estimator/ Principal Officer |
| Date: | 5/6/2026 |

## Table 231

| Bidder Name: | Nathaniel Benbow | BJB Construction Company Inc. |
| --- | --- | --- |
| Bidder Signature: | Nathaniel | Benbow |

## Table 232

| Print: | Nathaniel Benbow |
| --- | --- |
| Date: | 5/6/2026 |

## Table 233

| 1) | Brent Stidham Senior Maintenance Engineer (Managing govt buildings in Brentwood TN) City Of Brentwood brent.stidham@brentwoodtn.gov (615)533-5032 15+ Years as a customer |
| --- | --- |
| 2) | Ryan Edwards Continuous Improvement Coordinator Advanced Composites Ryan.edwards@advcmp.com (615)630-1843 15+ Years as a customer |
| 3) | Yvonne Parker Sr. Specialist, Consumer Care National Facilities T-Mobile Yvonne.parker@t-mobile.com (931)980-8867 8 Years as a customer |
| 4) | Wesley King Service Manager The Mathews Company wking@themathewscompany.com |
|  | (615)394-8451 15+ Years as a customer |

## Table 234

|  |  |  |
| --- | --- | --- |
|  | 5 Address (number, street, and apt. or suite no.). See instructions. | Requester's name and address (optional) |
|  | 1373 Holly Tree Gap Rd |  |
|  | 6 City, state, and ZIP code |  |
|  | Brentwood, TN. 37027 |  |
|  | 7 List account number(s) here (optional) |  |
|  |  |  |

## Table 235

|  | Social security number |
| --- | --- |
| Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. | - - or Employer identification number |
| Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. | 04 - 3777109 |

## Table 236

| Sign Here | Signature of U.S. person Debbie Benbow | Date 3/13/2026 |
| --- | --- | --- |

## Table 237

| INSURER(S) AFFORDING | COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A | Central Mutual | 20230 |
| INSURER B | All America | 20222 |
| INSURER C |  |  |
| INSURER D |  |  |
| INSURER E |  |  |
| INSURER F |  |  |

## Table 238

| LIMITS |  |  |
| --- | --- | --- |
| EACH OCCURRENCE | $ | 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ | 300,000 |
| MED EXP (Any one person) | $ | 5,000 |
| PERSONAL & ADV INJURY | $ | 1,000,000 |
| GENERAL AGGREGATE | $ | 2,000,000 |
| PRODUCTS- COMP/OP AGG | $ | 2,000,000 |
| COMBINED SINGLE LIMIT (Ea accident) | $ | 1,000,000 |
| BODILY INJURY (Per person) | $ |  |
| BODILY INJURY (Per accident) | $ |  |
| PROPERTY DAMAGE (Per accident) | $ |  |
|  |  |  |
| EACH OCCURRENCE | $ | 5,000,000 |
| AGGREGATE | $ | 5,000,000 |
|  |  |  |
| [X] WC STATUTORY LIMITS |  | OTHER |
| E.L. EACH ACCIDENT | $ | 1,000,000 |
| E.L. DISEASE - EA EMPLOYEE | $ | 1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $ | 1,000,000 |
|  |  |  |

## Table 239

| INSR LTR | TYPE OF INSURANCE | INSR | ADDLSUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT | Y | Y | 9606838 | 8/8/2025 | 8/8/2026 |
| B | [X] AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS | Y | Y | 9606837 | 8/8/2025 | 8/8/2026 |
| A | [X] [X] UMBRELLA LIABILITY UMBRELLA OCCUR LIAB EXCESS LIAB CLAIMS-MADE DED RETENTION $ | Y | Y | 9606839 | 8/8/2025 | 8/8/2026 |
| A | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERS/EXEC- Y UTIVE OFFICE/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below |  |  | 9606841 | 8/8/2025 | 8/8/2026 |

## Table 240

| Signature: | Sessions Paving Company Robert 1. Hutcheson |
| --- | --- |
| Print: | Robert N. Hutcheson |
| Title: | President |
| Date: | 5/12/2026 |

## Table 241

| Bidder Name: | Sessions Paving Company |
| --- | --- |
| Bidder Signature: | Robert 1. Hutcheson President |

## Table 242

| Signature: | Robert 1. Hntcheson |
| --- | --- |
| Print: | Robert N. Hutcheson President |
| Date: | 5/12/2026 |
| Phone/Email: | (615)356-0600 rnhntcheson@sessionspaving.com |

## Table 243

| 1. | Now comes the Affiant, who being duly sworn, deposes and says: |
| --- | --- |
| 2: | He/she is the principal officer for SESSIONS PAVING COMPANY |
|  | (Name and Address of Bidding Entity |
|  | P.O. Box 90266 (6535 Robertson Avenue) Nashville, TN 37209 |
| 3. | That the bidding entity has submitted a bid to Hickman (Owner) County, TN |
|  | for the construction of Annual Sealing and 5 triping |
|  | (Name of Project) |
| 4. | That the bidding entity employs no less than five (5) employees. |
| 5. | That the Affiant certifies that the bidding entity has in effect, at the time of submission of its bid to perform the construction referred to above, a drug-free workplace program that complies with § 50-9-113, Tennessee Code Annotated. |
| 6. | That this affidavit is made on personal knowledge. |

## Table 244

|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A: | Charter Oak Fire Insurance Company | 25615 |
| INSURER B: | Travelers Property Casualty Co of Amer | 25674 |
| INSURER C: | MidSouth Insurance Company | 12839 |
| INSURER D: | Travelers Indemnity Co of America | 25666 |
| INSURER E: |  |  |
| INSURER F: |  |  |

## Table 245

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $300,000 |
| MED EXP (Any one person) | $5,000 |
| PERSONAL & ADV INJURY | $1,000,000 |
| GENERAL AGGREGATE | $2,000,000 |
| PRODUCTS- COMP/OP AGG | $2,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ee accident) | $1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $5,000,000 |
| AGGREGATE | $5,000,000 |
|  | $ |
| [X] PER OTH- STATUTE ER |  |
| EL EACH ACCIDENT | $1,000,000 |
| E.L. DISEASE- EA EMPLOYEE | $1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $1,000,000 |
|  |  |

## Table 246

| INSR LTR | TYPE OF INSURANCE | ADDL INSR | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR PD Ded:500 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | DTCO7890P35ACOF | 04/01/2026 | 04/01/2027 |
| D | [X] [X] [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  | 8108M9623792626G | 04/01/2026 | 04/01/2027 |
| B | [X] [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $10000 |  |  | CUP2J5568542626 | 04/01/2026 | 04/01/2027 |
| C | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  | WC052562026 | 01/01/2026 | 01/01/2027 |
|  |  |  |  |  |  |  |

## Table 247

| preference, as well as | the fire lanes.) |
| --- | --- |
| $ 4,848.00 | Double Paint |
| $ 13,362.00 | Sealing Lot |

## Table 248

| Print: | Allan Herrington |
| --- | --- |
| Title: | Projet Manager |
| Date: | 5-11-26 |

## Table 249

| ADDRESS: |  |  |
| --- | --- | --- |
|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| INSURER A: | Monroe Guaranty Insurance Company | 32506 |
| INSURER B: | FCCI Insurance Company | 10178 |
| INSURER C: |  |  |
| INSURER D: |  |  |
| INSURER E : |  |  |
| INSURER F: |  |  |

## Table 250

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $100,000 |
| MED EXP (Any one person) | $5,000 |
| PERSONAL & ADV INJURY | $1,000,000 |
| GENERAL AGGREGATE | $2,000,000 |
| PRODUCTS - COMP/OP AGG | $2,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $5,000,000 |
| AGGREGATE | $5,000,000 |
|  | $ |
| PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $1,000,000 |
| E.L. DISEASE- EA EMPLOYEE | $1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $1,000,000 |
|  |  |

## Table 251

| INSR LTR | TYPE OF INSURANCE | ADDL INSR | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR PD Ded:1,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | CPP10009518701 | 09/09/2025 | 09/09/2026 |
| A | [X] [X] [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  | CA10009518801 | 09/09/2025 | 09/09/2026 |
| B | [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $10000 |  |  | UMB10009519001 | 09/09/2025 | 09/09/2026 |
| B | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  | WC010009518901 | 09/09/2025 | 09/09/2026 |
|  |  |  |  |  |  |  |

## Table 252

| 1. Flat work by square foot: | $10.45/sf |
| --- | --- |
| 2. Rebar if needed: | $ +5.65sf |
| 3. Surcharge for pours less than a truck load: | $ +9.89/sf |

## Table 253

| 1. 3 ft. width | $ 67.80 |
| --- | --- |
| 2. 4 ft. width | $ 79.10 |
| 3. 6 ft. width | $ 101.70 |

## Table 254

| Bidder Name: | Nathaniel Benbow |
| --- | --- |
| Bidder Signature: | Nathaniel Benbow |
| Date: 5/6/2026 |  |

## Table 255

| (a) | The director, purchasing agent, members of the committee, members of the county legislative body or other officials, employees, or members of the board of education or highway commission shall not be financially interested or have any personal beneficial interest, either directly or indirectly, in the purchase of any supplies, materials, equipment or contractual services for the county. |
| --- | --- |
| (b) | No firm, corporation, partnership, association or individual furnishing any such supplies, materials, equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other things of value whatsoever, or any promise, obligation or contract for future reward or compensation. |

## Table 256

| Print: | Nathaniel Benbow |
| --- | --- |
| Title: | Estimator/ Principal Officer |
| Date: | 5/6/2026 |

## Table 257

| Print: | Nathaniel Benbow |
| --- | --- |
| Date: | 5/6/2026 |

## Table 258

|  |  |  |
| --- | --- | --- |
| page | [X] 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor C corporation S corporation Partnership Trust/estate | 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): |
|  | LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) | Exempt payee code (if any) |
|  | Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner. Other (see instructions) | Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) |
|  | 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See Instructions | (Applies to accounts maintained outside the United States.) |

## Table 259

|  | 5 Address (number, street, and apt. or suite no.). See instructions. | Requester's name and address (optional) |
| --- | --- | --- |
|  | 1373 Holly Tree Gap Rd |  |
|  | 6 City, state, and ZIP code Brentwood, TN. 37027 |  |
|  | 7 List account number(s) here (optional) |  |

## Table 260

|  | Social security number |
| --- | --- |
| Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. | - - or Employer identification number |
| Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. | 04 - 3777109 |

## Table 261

| Sign Here | Signature of U.S. person Debbie Benbow | Date 3/13/2026 |
| --- | --- | --- |

## Table 262

| CONTACT NAME: | LISA WILSON |
| --- | --- |
| PHONE: | FAX: (615)905-1698 |
| E-MAIL ADDRESS: | lisa.wilson@iga.biz |

## Table 263

| INSURER(S) AFFORDING | COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A | Central Mutual | 20230 |
| INSURER B | All America | 20222 |
| INSURER C |  |  |
| INSURER D |  |  |
| INSURER E |  |  |
| INSURER F |  |  |

## Table 264

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 300,000 |
| MED EXP (Any one person) | $ 5,000 |
| PERSONAL & ADV INJURY | $ 1,000,000 |
| GENERAL AGGREGATE | $ 2,000,000 |
| PRODUCTS- COMP/OP AGG | $ 2,000,000 |
| COMBINED SINGLE LIMIT (Ea accident) | $ 1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  |  |
| EACH OCCURRENCE | $ 5,000,000 |
| AGGREGATE | $ 5,000,000 |
|  |  |
| [X] WC STATUTORY LIMITS | OTHER |
| E.L. EACH ACCIDENT | $ 1,000,000 |
| E.L. DISEASE - EA EMPLOYEE | $ 1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $ 1,000,000 |
|  |  |

## Table 265

| INSR LTR | TYPE OF INSURANCE | ADDL INSR | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT | Y | Y | 9606838 | 8/8/2025 | 8/8/2026 |
| B | [X] AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS | Y | Y | 9606837 | 8/8/2025 | 8/8/2026 |
| A | [X] [X] UMBRELLA LIABILITY UMBRELLA OCCUR LIAB EXCESS LIAB CLAIMS-MADE DED RETENTION $ | Y | Y | 9606839 | 8/8/2025 | 8/8/2026 |
| A | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERS/EXEC- Y UTIVE OFFICE/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below |  |  | 9606841 | 8/8/2025 | 8/8/2026 |

## Table 266

| Centerville Elementary School | (4140 sq ft) | $ 3,577.42 |
| --- | --- | --- |
| Centerville Intermediate School | (3588 sq ft) | $ 3,200 |
| Hickman County Middle School | (7800 sq ft) | $ 5,309.21 |
| Hickman County High School | (11998 sq ft) | $6,840.30 |
| East Hickman Elementary School | (6000 sq ft) | $ 3,847.23 |
| East Hickman Intermediate School | (3588 sq ft) | $ 3,200 |
| East Hickman Middle School | (8262 sq ft) | $ 5,393.62 |
| East Hickman High School | (14160 sq ft) | $ 8,266.19 |

## Table 267

| Centerville Elementary School | (4140 sq ft) | $ 16,112 |
| --- | --- | --- |
| Centerville Intermediate School | (3588 sq ft) | $ 16,227 |
| Hickman County Middle School | (7800 sq ft) | $ 24,347 |
| Hickman County High School | (11998 sq ft) | $ 30,653 |
| East Hickman Elementary School | (6000 sq ft) | $ 17,942 |
| East Hickman Intermediate School | (3588 sq ft) | $ 15,721 |
| East Hickman Middle School | (8262 sq ft) | $ 25,660 |
| East Hickman High School | (14160 sq ft) | $ 36,515 |

## Table 268

| Sand and 2 coats of sealer finish by the square foot | $ 5.50 |
| --- | --- |
| Sand and 2 coats of rolled on oil base paint | $ 5.50 $ |

## Table 269

| Signature: |  | Will It |
| --- | --- | --- |
| Print: |  | WillFor |
| Date: |  | 5/4/2026 |
|  | Phone/Email: | (423) 602-3396 wfor@scovtfloors.com |

## Table 270

| Print: | Will Fox |
| --- | --- |
| Title: | Project Coordinator |
| Date: | 5/4/2026 |

## Table 271

| (a) | The director, purchasing agent, members of the committee, members of the county legislative body or other officials, employees, or members of the board of education or highway commission shall not be financially interested or have any personal beneficial interest, either directly or indirectly, in the purchase of any supplies, materials, equipment or contractual services for the county. |
| --- | --- |
| (b) | No firm, corporation, partnership, association or individual furnishing any such supplies, materials, equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any assistant or employee accept or receive directly or Indirectly from any person, firm, corporation, partnership or association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other things of value whatsoever, or any promise, obligation or contract for future reward or compensation. 05/04/2026 |

## Table 272

| Centerville Elementary School | (4140 sq ft) | $ 4,968.00 |
| --- | --- | --- |
| Centerville Intermediate School | (3588 sq ft) | $ 4,306.00 |
| Hickman County Middle School | (7800 sq ft) | $ 9,360.00 |
| Hickman County High School | (11998 sq ft) | $ 14,398.00 |
| East Hickman Elementary School | (6000 sq ft) | $7,200.00 |
| East Hickman Intermediate School | (3588 sq ft) | $4,306.00 |
| East Hickman Middle School | (8262 sq ft) | $9,915.00 |
| East Hickman High School | (14160 sq ft) | $ 16,992.00 |

## Table 273

| Centerville Elementary School | (4140 sq ft) | $17,336.00 |
| --- | --- | --- |
| Centerville Intermediate School | (3588 sq ft) | $ 15,025.00 |
| Hickman County Middle School | (7800 sq ft) | $32,663.00 |
| Hickman County High School | (11998 sq ft) | $50,242.00 |
| East Hickman Elementary School | (6000 sq ft) | $25,125.00 |
| East Hickman Intermediate School | (3588 sq ft) | $15,025.00 |
| East Hickman Middle School | (8262 sq ft) | $34,598.00 |
| East Hickman High School | (14160 sq ft) | $59,295.00 |

## Table 274

| Sand and 2 coats of sealer finish by the square foot | $4/sf |
| --- | --- |
| Sand and 2 coats of rolled on oil base paint | $4/sf |

## Table 275

| Print: | Nathaniel Benbow |
| --- | --- |
| Title: | Estimator/ Principal Officer |
| Date: | 5/6/2026 |

## Table 276

| (a) | The director, purchasing agent, members of the committee, members of the county legislative body or other officials, employees, or members of the board of education or highway commission shall not be financially interested or have any personal beneficial interest, either directly or indirectly, in the purchase of any supplies, materials, equipment or contractual services for the county. |
| --- | --- |
| (b) | No firm, corporation, partnership, association or individual furnishing any such supplies, materials, equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other things of value whatsoever, or any promise, obligation or contract for future reward or compensation. |
|  | Nathaniel Benbow |

## Table 277

| 5 Address (number, street, and apt. or suite no.). See instructions. | Requester's name and address (optional) |
| --- | --- |
| 1373 Holly Tree Gap Rd |  |
| 6 City, state, and ZIP code Brentwood, TN. 37027 |  |
| 7 List account number(s) here (optional) |  |

## Table 278

| Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. | Social security number I - or Employer Identification number 04 - 3777109 |
| --- | --- |

## Table 279

| Sign Here | Signature of U.S. person Debbie Benbow |  | Date | 3/13/2026 |
| --- | --- | --- | --- | --- |

## Table 280

| CONTACT NAME: | LISA WILSON |
| --- | --- |
| PHONE: | FAX: (615)905-1698 |
| E-MAIL ADDRESS: | lisa.wilson@iga.biz |

## Table 281

| INSURER(S) AFFORDING | COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A | Central Mutual | 20230 |
| INSURER B | All America | 20222 |
| INSURER C |  |  |
| INSURER D |  |  |
| INSURER E |  |  |
| INSURER F |  |  |

## Table 282

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 300,000 |
| MED EXP (Any one person) | $ 5,000 |
| PERSONAL & ADV INJURY | $ 1,000,000 |
| GENERAL AGGREGATE | $ 2,000,000 |
| PRODUCTS- COMP/OP AGG | $ 2,000,000 |
| COMBINED SINGLE LIMIT (Ea accident) | $ 1,000,000 |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  |  |
| EACH OCCURRENCE | $ 5,000,000 |
| AGGREGATE | $ 5,000,000 |
|  |  |
| [X] WC STATUTORY LIMITS | OTHER |
| E.L. EACH ACCIDENT | $ 1,000,000 |
| E.L. DISEASE - EA EMPLOYEE | $ 1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $ 1,000,000 |
|  |  |

## Table 283

| INSR LTR | TYPE OF INSURANCE | ADDL INSR | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT | Y | Y | 9606838 | 8/8/2025 | 8/8/2026 |
| B | [X] AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS | Y | Y | 9606837 | 8/8/2025 | 8/8/2026 |
| A | [X] [X] UMBRELLA LIABILITY UMBRELLA OCCUR LIAB EXCESS LIAB CLAIMS-MADE DED RETENTION $ | Y | Y | 9606839 | 8/8/2025 | 8/8/2026 |
| A | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERS/EXEC Y UTIVE OFFICE/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below |  |  | 9606841 | 8/8/2025 | 8/8/2026 |

## Table 284

| 1) | Brent Stidham Senior Maintenance Engineer (Managing govt buildings in Brentwood TN) City Of Brentwood brent.stidham@brentwoodtn.gov (615)533-5032 15+ Years as a customer |
| --- | --- |
| 2) | Ryan Edwards Continuous Improvement Coordinator Advanced Composites Ryan.edwards@advcmp.com (615)630-1843 15+ Years as a customer |
| 3) | Yvonne Parker Sr. Specialist, Consumer Care National Facilities T-Mobile Yvonne.parker@t-mobile.com (931)980-8867 8 Years as a customer |
| 4) | Wesley King Service Manager The Mathews Company wking@themathewscompany.com (615)394-8451 15+ Years as a customer |

## Table 285

| Centerville Elementary School | (4140 sq ft) | $ 2,060.00 |
| --- | --- | --- |
| Centerville Intermediate School | (3588 sq ft) | $ 1,765.00 |
| Hickman County Middle School | (7800 sq ft) | $ 3,820.00 |
| Hickman County High School | (11998 sq ft) | $ 5,880.00 |
| East Hickman Elementary School | (6000 sq ft) | $ 2,940.00 |
| East Hickman Intermediate School | (3588 sq ft) | $ 1,765.00 |
| East Hickman Middle School | (8262 sq ft) | $ 4,060.00 |
| East Hickman High School | (14160 sq ft) | $ 7,300.00 |

## Table 286

| Centerville Elementary School | (4140 sq ft) | $ 10,200.00 |
| --- | --- | --- |
| Centerville Intermediate School | (3588 sq ft) | $ 9,000.00 |
| Hickman County Middle School | (7800 sq ft) | $ 15,450.00 |
| Hickman County High School | (11998 sq ft) | $ 22,800.00 |
| East Hickman Elementary School | (6000 sq ft) | $ 10,520.00 |
| East Hickman Intermediate School | (3588 sq ft) | $ 9,000.00 |
| East Hickman Middle School | (8262 sq ft) | $ 16,325.00 |
| East Hickman High School | (14160 sq ft) | $ 27,000,00 |

## Table 287

| Sand and 2 coats of sealer finish by the square foot | $ 3,00 $ |
| --- | --- |
| Sand and 2 coats of rolled on oil base paint | $ 3.00 |

## Table 288

| BASKETBALL GAME LINES | $ 1,000 PER COURT |
| --- | --- |
| VOLLEYBALL GAME LINES | $ 800 PER COURT |
| BADMITTON GAME LINES | $ 800 PER COURT |
| PICKLEBALL GAME LINES | $ 800 PER COURT |
| FOUR SQUARE GAME LINES | $ 250 PER COURT |
| PAINTED BORDER 1'X1' | $ 700 |
| PAINTED BORDER 2' X 2' | $ 850 |
| PAINTED BORDER 3' X 3' | $ 1,000 |
| PAINTED BORDER 4' X 4' | $ 1,250 |
| PAINTED BORDER 5'X5' | $ 1,500 |
| PAINTED LANES | $ 1,000 |
| PAINTED 3-POINT AREAS | $ 1,500 |
| PAINTED CENTER CIRCLE | $ 500 |
| PAINTED LOGO(SMALL, 1-COLOR) | $ 500 |
| PAINTED LOGO(SMALL, 2-COLOR) | $ 850 |
| PAINTED LOGO(SMALL, MULTI-COLOR) | $ 1,200+ |
| PAINTED LOGO(MED, 1-COLOR) | $ 750 |
| PAINTED LOGO(MED, 2-COLOR) | $ 1,100 |
| PAINTED LOGO(MED, MULTI-COLOR) | $ 1,500+ |
| PAINTED LOGO(LARGE, 1-COLOR) | $ 1,000 |
| PAINTED LOGO(LARGE, 2-COLOR) | $ 1,750 |
| PAINTED LOGO(LARGE, MULTI-COLOR) | $ 2,500+ |
| LETTERING(SMALL, 1-COLOR) | $ 40 PER LETTER |
| LETTERING(SMALL, 2-COLOR) | $ 55 PER LETTER |
| LETTERING(SMALL, MULTI-COLOR) | $ 75+ PER LETTER |
| LETTERING(MED, 1-COLOR) | $ 50 PER LETTER |
| LETTERING(MED, 2-COLOR) | $ 65 PER LETTER |
| LETTERING(MED, MULTI-COLOR) | $ 90+ PER LETTER |
| LETTERING(LARGE, 1-COLOR) | $ 60 PER LETTER |
| LETTERING(LARGE, 2-COLOR) | $ 75 PER LETTER |
| LETTERING(LARGE, MULTI-COLOR) | $ 100+ PER LETTER |
| STAINED/TINTED LANES | $ 2,500 |
| STAINED/TINTED 3-POINT AREAS | $ 3,500 |
| STAINED/TINTED BORDER | $ 2,500-$5,000 DEPENDING ON SIZE |
| STAINED/TINTED FULL COURT | $ 5,000-$7,000 |

## Table 289

| (a) | The director, purchasing agent, members of the committee, members of the county legislative body or other officials, employees, or members of the board of education or highway commission shall not be financially interested or have any personal beneficial interest, either directly or indirectly, in the purchase of any supplies, materials, equipment or contractual services for the county. |
| --- | --- |
| (b) | No firm, corporation, partnership, association or individual furnishing any such supplies, materials, equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other things of value whatsoever, or any promise, obligation or contract for future reward or compensation. |

## Table 290

| Bidder Name: | BRUCE F.MARTIN |
| --- | --- |
| Bidder Signature: | BmF.Wart. |
| Date: | 5/10/26 |

## Table 291

| Signature: | Bm |
| --- | --- |
| Print: | BRUCE F.MARTIN |
| Date: | 5/10/26 |
| Phone/Email: |  |

## Table 292

| Signature: | Bm |
| --- | --- |
| Print: | BRUCE F. MARTIN |
| Title: | PRESIDENT |
| Date: | 5/10/26 |

## Table 293

| R22: |  |
| --- | --- |
| $ 169.00 | per lb |
| R410A: |  |
| $ 65 | per lb |
| R454B: |  |
| $80.00 | per lb |
| Other (specify): Varies | based on refrigerant cost |
| $ N/A | per lb |

## Table 294

| Signature: | SBh |
| --- | --- |
| Print: | Terry Burch |
| Title: | Project Operations Manager |
| Date: | 5/6/2026 |

## Table 295

| Signature: | TBL |
| --- | --- |
| Print: | Terry Burch |
| Date: | 5/6/2020 |
| Phone/Email: | thurch@nhs Medanical.com |

## Table 296

| Bidder Name: | Terry Burch |
| --- | --- |
| Bidder Signature: | Bh |
| Date: | 5/6/2026 |

## Table 297

| BUSINESS NUMBER | 258395 |
| --- | --- |
| RECEIPT NUMBER | 1047213 |
| THIS LICENSE EXPIRES | 05/15/2027 |

## Table 298

|  | CITY | COUNTY |
| --- | --- | --- |
| TOTAL GROSS SALES |  |  |
| LESS DEDUCTIONS |  |  |
| BUSINESS TAX DUE (LESS CREDITS) |  |  |
| MINIMUM TAX |  |  |
| PENALTY |  |  |
| INTEREST |  |  |
| NEW LICENSE FEE | 15.00 | 15.00 |
| TOTAL TAX DUE | 15.00 | 15.00 |

## Table 299

| BUSINESS NUMBER | 258395 |
| --- | --- |
| RECEIPT NUMBER | 1047213 |
| CLASSIFICATION | 4 |

## Table 300

| FROM | STARTED |
| --- | --- |
| TO | 01/01/2026 |

## Table 301

| USER | JWALDEN |
| --- | --- |
| STATION | WK205 |
| DRAWER | 266 |
| SITE | I |
| WORK DATE | 02/20/2026 |
| PRINTED BY | JWALDEN |

## Table 302

| TOTAL DUE | $30.60 |
| --- | --- |
| CREDIT CARD | $30.60 |
| AUTH NO. | 096198 |
| CHANGE | $0.00 |

## Table 303

| CONTACT NAME: |  |
| --- | --- |
| PHONE (A/C, No. Ext): | FAX (A/C, No): |
| E-MAIL ADDRESS: |  |

## Table 304

|  |  |  |
| --- | --- | --- |
|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| INSURER A: | Greenwich Insurance Company | 22322 |
| INSURER B: | XL Insurance America, Inc. | 24554 |
| INSURER C : | Allied World National Assurance Company | 10690 |
| INSURER D : |  |  |
| INSURER E: |  |  |
| INSURER F : |  |  |

## Table 305

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 2,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 1,000,000 |
| MED EXP (Any one person) | $ 10,000 |
| PERSONAL & ADV INJURY | $ 1,000,000 |
| GENERAL AGGREGATE | $ 4,000,000 |
| PRODUCTS- COMP/OP AGG | $ 4,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ 5,000,000 |
| BODILY INJURY (Per person) | $ XXXXXXX |
| BODILY INJURY (Per accident) | $ XXXXXXX |
| PROPERTY DAMAGE (Per accident) | $ XXXXXXX |
|  | XXXXXXX |
| EACH OCCURRENCE | $ 5,000,000 |
| AGGREGATE | $ 5,000,000 |
|  | $ XXXXXXX |
| [X] PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $ 1,000,000 |
| EL DISEASE- EA EMPLOYEE | $ 1,000,000 |
| EL DISEASE- POLICY LIMIT | $ 1,000.000 |
|  |  |

## Table 306

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: | N | N | RGD300147507 | 4/1/2026 | 4/1/2027 |
| A | [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY | N | N | RAD943796407 | 4/1/2026 | 4/1/2027 |
| C | [X] [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $0 | N | N | 0313-7473 | 4/1/2026 | 4/1/2027 |
| B B | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A | N | RWD300147607. STOP GAP: ND, OH, WA, WY | 4/1/2026 | 4/1/2027 |
|  |  |  |  |  |  |  |

## Table 307

| R22: |  |
| --- | --- |
| $ 75.00 | per lb |
| R410A: $ 25.00 | per lb |
| R454B: $ 40.00 | per lb |
| Other (specify): |  |
| $ | per lb |

## Table 308

| Print: | David Sims |
| --- | --- |
| Title: | Director of Operations |
| Date: | 5/5/2026 |

## Table 309

| Bidder Name: |  | Lee Company |
| --- | --- | --- |
| Bidder Signature: |  |  |
| Date: 5/5/2026 |  |  |

## Table 310

| CONTACT NAME: |  |
| --- | --- |
| PHONE (A/C, No. Ext): | FAX (A/C, No): |
| E-MAIL ADDRESS: |  |

## Table 311

|  |  |  |
| --- | --- | --- |
|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| INSURER A: | Zurich American Insurance Company | 16535 |
| INSURER B : | Starr Indemnity & Liability Company | 38318 |
| INSURER C : | Travelers Property Casualty Company of America | 25674 |
| INSURER D : |  |  |
| INSURER E: |  |  |
| INSURER F : |  |  |

## Table 312

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 2,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ 1,000,000 |
| MED EXP (Any one person) | $ 10,000 |
| PERSONAL & ADV INJURY | $ 2,000,000 |
| GENERAL AGGREGATE | $ 4,000,000 |
| PRODUCTS - COMP/OP AGG | $ 4,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ 5,000,000 |
| BODILY INJURY (Per person) | $ XXXXXXX |
| BODILY INJURY (Per accident) | XXXXXXX |
| PROPERTY DAMAGE (Per accident) | $ XXXXXXX |
|  | $ XXXXXXX |
| EACH OCCURRENCE | $ 10,000,000 |
| AGGREGATE | $ 10,000,000 |
|  | XXXXXXX |
| [X] PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $ 1,000.000 |
| E.L. DISEASE - EA EMPLOYEE | $ 1,000,000 |
| E.L. DISEASE - POLICY LIMIT | $ 1,000,000 |
| $15,000,000 per See Attachment | Occurrence/Aggregate |

## Table 313

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: | N | N | GLO 3537803-03 | 3/1/2026 | 3/1/2027 |
| A | [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY | N | N | BAP 3537804-03 | 3/1/2026 | 3/1/2027 |
| C | [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ | N | N | CUP-C5438925 | 3/1/2026 | 3/1/2027 |
| A | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below. | N/A | N | WC 3537802-03 | 3/1/2026 | 3/1/2027 |
| B C | Excess Liability Inland Marine | N | N | 1000588841261 QT-630-5T394871-TIL-26 | 3/1/2026 3/1/2026 | 3/1/2027 3/1/2027 |

## Table 314

| Coverage | Limit of Insurance | Deductible |
| --- | --- | --- |
| Leased/Rented Equipment - Per Item | $250,000 | $5,000 |
| Installation / Builders Risk | $1,000,000 | $10,000 |
| Cargo - - Per Conveyance | $100,000 | $5,000 |

## Table 315

| Year | Revenue |
| --- | --- |
| 2025 | $ 454 Million |
| 2024 | $ 415 Million |
| 2023 | $ 370 Million |
| 2022 | $ 340 Million |
| 2021 | $ 304 Million |

## Table 316

| Bonding Limit | $125,000,000 aggregate |
| --- | --- |
|  | $60,000,000 single project |
| Banking | Pinnacle Financial Partners Mr. Todd Carter 211 Commerce Street, Suite 300 Nashville, TN 37201 (615) 690-4064 |
|  | Todd.carter@pnfp.com |
| Insurance | Travelers Insurance One Tower Square Hartford, CT 06183 |

## Table 317

| Bodily Injury/Property Damage: | $ 1,000,000 each occurrence |
| --- | --- |
| Completed Operations: | $ 2,000,000 |
| General Aggregate: | $ 2,000,000 per project |
| Umbrella: | $15,000,000 |
| Professional Liability: | $ 1,000,000 |

## Table 318

|  | R22: |  |
| --- | --- | --- |
|  | $ 100.00 | per lb |
|  | R410A: |  |
|  | $ 50.00 | per lb |
|  | R454B: |  |
|  | $ 90.00 | per lb |
|  | Other (specify): |  |
|  | $ | per lb |

## Table 319

| Signature: | Van High |
| --- | --- |
| Print: | Van Kight |
| Title: | V.P. of Operations |
| Date: | 5/8/2026 |

## Table 320

| Signature: | Van Kept |
| --- | --- |
| Print: | Van Kight |
| Date: | 5/8/2026 |
| Phone/Email: | 615 - 846 0060 VKight@SmLawrence.com |

## Table 321

| Bidder Name: | S.M. Lawrence - Van Kight |
| --- | --- |
| Bidder Signature: | Van tep |
| Date: | 5/8/2026 |

## Table 322

|  | R22: |  |
| --- | --- | --- |
|  | $ 150 | per lb |
|  | R410A: $ 75 | per lb |
|  | R454B: $ 75 | per lb |
|  | Other (specify): |  |
|  | $ 75 | per lb |

## Table 323

| Signature: | Oloc |
| --- | --- |
| Print: | Daniel D. Eubanks |
| Title: | CEO |
| Date: | 5-1-26 |

## Table 324

| CONTACT NAME: |  |  |
| --- | --- | --- |
| PHONE (A/C, No, Ext): (615) 446-8087 | FAX (A/C, No): | (615) 446-4617 |
| E-MAIL mfins@fusonins.com ADDRESS: |  |  |

## Table 325

|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A: | Erie Insurance Company | 26263 |
| INSURER B: | Erie Ins Exch | 26271 |
| INSURER C : | Accident Fund Ins Co Of Amer | 10166 |
| INSURER D: |  |  |
| INSURER E: |  |  |
| INSURER F: |  |  |

## Table 326

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | 1,000,000 $ |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | 1,000,000 $ |
| MED EXP (Any one person) | $ 5,000 |
| PERSONAL & ADV INJURY | 1,000,000 $ |
| GENERAL AGGREGATE | $ 2,000,000 |
| PRODUCTS COMP/OP AGG | 2,000,000 $ |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | 1,000,000 $ |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $ 7,000,000 |
| AGGREGATE | $ 7,000,000 |
|  | $ |
| [X] PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | 1,000,000 $ |
| E.L. DISEASE- EA EMPLOYEE | 1,000,000 $ |
| E.L. DISEASE - POLICY LIMIT | 1,000,000 $ |
| Floater R/L Limit | 1,215,000 75,000 |

## Table 327

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: | [X] X |  | Q61-0362950 | 2/6/2026 | 2/6/2027 |
| B | [X] [X] [X] AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  | Q02-0640069 | 2/6/2026 | 2/6/2027 |
| B | [X] [X] [X] UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ 0 |  |  | Q26-0670423 | 2/6/2026 | 2/6/2027 |
| C | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | [X] N/A |  | 100133554 | 11/15/2025 | 11/15/2026 |
| A | Equipment Floater |  |  | Q61-0362950 | 2/6/2026 | 2/6/2027 |
| A | Rented/Leased Equip |  |  | Q61-0362950 | 2/6/2026 | 2/6/2027 |

## Table 328

| Letter ID: | L1409359296 |
| --- | --- |
| Account ID: | 1001782120-BUS |
| Account Type: | Business Tax |

## Table 329

| Location ID: | 1001683765 |
| --- | --- |
| Location Address: | MATRIX MECHANICAL SOLUTIONS, LLC 9743 OLD HILLSBORO RD BON AQUA TN 37025-1542 |

## Table 330

| Effective Period Begin: | April 15, 2026 |
| --- | --- |
| Effective Period End: | April 15, 2027 |
| Filing Status: | Retailer |
| Location ID: | 1001683765 |

## Table 331

| Letter ID: | L1993956800 |
| --- | --- |
| Expiration Date: | 15-May-2027 |
| Return Due By: | 15-Apr-2027 |

## Table 332

| Date Issued: | 08-Apr-2026 |
| --- | --- |
| Classification: | 4 |
| Letter ID: | L1993956800 |
| License Number: | 1001344093 |
| Expiration Date: | 15-May-2027 |

## Table 333

|  | 5 Address (number, street, and apt. or suite no.). See instructions. | Requester's name and address (optional) |
| --- | --- | --- |
|  | 9743 Old Hillsboro Road |  |
|  | 6 City, state, and ZIP code |  |
|  | Bon Aqua, TN 37025 |  |
|  | 7 List account number(s) here (optional) |  |
|  |  |  |

## Table 334

| Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a | Social security number - I or |
| --- | --- |
| TIN, later. | Employer identification number |
| Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. | 85 - 3995388 |

## Table 335

| 1) | Brent Stidham |
| --- | --- |
|  | Senior Maintenance Engineer (Managing govt buildings in Brentwood TN) |
|  | City Of Brentwood |
|  | brent.stidham@brentwoodtn.gov |
|  | (615)533-5032 15+ Years as a customer |
| 2) | Ryan Edwards Continuous Improvement Coordinator Advanced Composites Ryan.edwards@advcmp.com (615)630-1843 15+ Years as a customer |
| 3) | Yvonne Parker Sr. Specialist, Consumer Care National Facilities T-Mobile Yvonne.parker@t-mobile.com |
|  | (931)980-8867 8 Years as a customer |
| 4) | Wesley King Service Manager The Mathews Company wking@themathewscompany.com |
|  | (615)394-8451 15+ Years as a customer |

## Table 336

| Metal doors and frames (both sides) 4x7 | $ 288.00 |  |
| --- | --- | --- |
| Frames only (per opening) 4x7 | $ 96.00 |  |
| Dumpster doors (both sides with poles trim) | $ 1104.00 |  |
| Miscellaneous Trim (priced per linear foot) | $ 2.5/If |  |
| CMU walls: Exterior scrape, scuff, prime, and paint | $4 | SF |
| CMU walls: Interior scrape, scuff, prime, and paint | $ 3 | SF |
| Handrails: To include top, mid, and bottom rails. Prep/paint | $ 28 | linear ft |
| Single Rails: To include one railing continuous, and brackets, posts | $ 21 | linear ft |
| Picketed fencing or hand railing continuous, brackets, posts | $ 3.5 | linear foot |
| EFIS/CORNICE: Both metal/Cladding Board Stucco (paint) | $ 3 | square foot |

## Table 337

| Bidder Name: | Nathaniel Benbow |
| --- | --- |
| Bidder Signature: | Nathaniel Benbow |
| Date: 5/6/2026 |  |

## Table 338

| Print: | Nathaniel Benbow |
| --- | --- |
| Title: | Estimator/ Principal Officer |
| Date: | 5/6/2026 |

## Table 339

|  |  |  |
| --- | --- | --- |
|  | [X] 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor C corporation S corporation Partnership Trust/estate | 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): |
|  | LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) | Exempt payee code (if any) |
|  | Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate box for the tax classification of its owner. Other (see instructions) | Exemption from Foreign Account Tax Compliance Act (FATCA) reporting code (if any) |
|  | 3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification, and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check this box if you have any foreign partners, owners, or beneficiaries. See Instructions | (Applies to accounts maintained outside the United States.) |

## Table 340

|  | 5 Address (number, street, and apt. or suite no.). See instructions. | Requester's name and address (optional) |
| --- | --- | --- |
|  | 1373 Holly Tree Gap Rd |  |
|  | 6 City, state, and ZIP code Brentwood, TN. 37027 |  |
|  | 7 List account number(s) here (optional) |  |

## Table 341

| Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For Individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. | Social security number - - or Employer identification number |
| --- | --- |
| Note: If the account is in more than one name, see the instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. | 04 - 3777109 |

## Table 342

| Sign Here | Signature of U.S. person Debbie Benbow | Date | 3/13/2026 |
| --- | --- | --- | --- |

## Table 343

| CONTACT NAME: | LISA WILSON |
| --- | --- |
| PHONE: | FAX: (615)905-1698 |
| E-MAIL ADDRESS: | lisa.wilson@iga.biz |

## Table 344

| INSURER(S) AFFORDING | COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A | Central Mutual | 20230 |
| INSURER B | All America | 20222 |
| INSURER C |  |  |
| INSURER D |  |  |
| INSURER E |  |  |
| INSURER F |  |  |

## Table 345

| LIMITS |  |  |
| --- | --- | --- |
| EACH OCCURRENCE | $ | 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $ | 300,000 |
| MED EXP (Any one person) | $ | 5,000 |
| PERSONAL & ADV INJURY | $ | 1,000,000 |
| GENERAL AGGREGATE | $ | 2,000,000 |
| PRODUCTS- COMP/OP AGG | $ | 2,000,000 |
| COMBINED SINGLE LIMIT (Ea accident) | $ | 1,000,000 |
| BODILY INJURY (Per person) | $ |  |
| BODILY INJURY (Per accident) | $ |  |
| PROPERTY DAMAGE (Per accident) | $ |  |
|  |  |  |
| EACH OCCURRENCE | $ | 5,000,000 |
| AGGREGATE | $ | 5,000,000 |
|  |  |  |
| [X] WC STATUTORY LIMITS |  | OTHER |
| E.L. EACH ACCIDENT | $ | 1,000,000 |
| E.L. DISEASE- EA EMPLOYEE | $ | 1,000,000 |
| E.L. DISEASE- POLICY LIMIT | $ | 1,000,000 |
|  |  |  |

## Table 346

| INSR LTR | TYPE OF INSURANCE | ADDL INSR | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] [X] GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC JECT | Y | Y | 9606838 | 8/8/2025 | 8/8/2026 |
| B | [X] AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OWNED AUTOS | Y | Y | 9606837 | 8/8/2025 | 8/8/2026 |
| A | [X] [X] UMBRELLA LIABILITY UMBRELLA OCCUR LIAB EXCESS LIAB CLAIMS-MADE DED RETENTION $ | Y | Y | 9606839 | 8/8/2025 | 8/8/2026 |
| A | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERS/EXEC Y UTIVE OFFICE/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below |  |  | 9606841 | 8/8/2025 | 8/8/2026 |

## Table 347

| FEIN | 415156683 |
| --- | --- |
| Employers' Liability Limits | Limit |
| Bodlly Injury by Accident (Per Accident) | $500,000 |
| Bodily Injury by Disease (Policy Limit) | $500,000 |
| Bodlly Injury by Disease (Each Employee) | $500,000 |

## Table 348

| Location | State | Class Code | Class Description | Payroll Premium Basis | Rate | Est.Annual Premium |
| --- | --- | --- | --- | --- | --- | --- |
| 1 | TN | 5474 | Camouflage Work-Palnting-& Drivers | $10,000 | 3.803 | $380.00 |
| Class Total | for Location | #1 |  |  |  | $380.00 |
| Class Total | for TN |  |  |  |  | $380.00 |
|  |  | 9807 | Employers Liability Increased Limits |  | .0110 | $4.00 |
|  |  | 9848 | Employers Liability Increased Limits - Balance To Minimum Premium |  | ####### | $96.00 |
|  |  | 0930 | Waiver Of Subrogation |  | .0000 | $0.00 |
| Modified | Premium |  |  |  |  | $480.00 |
|  |  | 9887 | Schedule Modification Adjustment Credit |  | .7500 | ($120.00) |
| Total | Estimated | Standard | Premium |  |  | $360.00 |
|  |  | 0990 | Required To Balance To Min Premium |  | .0000 | $501.00 |
|  |  | 0900 | Expense Constant |  | .0000 | $160.00 |
|  |  | 9740 | Terrorism Premium |  | 0130 | $1.00 |
|  |  | 9741 | Catastrophe (O/T Cert Acts Of Terror) |  | 0250 | $3.00 |
| Total | Estimated | Premium |  |  |  | $1,025.00 |
| Total | Estimated Cost |  |  |  |  | $1,025.00 |
| Total Workers' |  | Compensation | Premium: |  |  | $1,025.00 |

## Table 349

| Signature: |  | arthur didwell |
| --- | --- | --- |
| Print: |  | Arthur Tiowell |
| Date: |  | 5/5/26 |
|  | Phone/Email: | adtidwelL54@GMAiL.Com |

## Table 350

| Print: | Arthur Towell |
| --- | --- |
| Title: | Sole-proprietor - PAINTER |
| Date: | 5/5/26 |

## Table 351

| Bidder Name: | ARthuR Tiowell |
| --- | --- |
| Bidder Signature: | acttors |

## Table 352

| Metal doors and frames (both sides) 4x7 | $ 250 |
| --- | --- |
| Frames only (per opening) 4x7 | $ 75 |
| Dumpster doors (both sides with poles trim) | $ 250 |
| Miscellaneous Trim (priced per linear foot) | $ 2.50 |
| CMU walls: Exterior scrape, scuff, prime, and paint | $ 2.75 SF |
| CMU walls: Interior scrape, scuff, prime, and paint | $ 1.75 SF |

## Table 353

| ISSUE DATE | 05/05/26 |
| --- | --- |
| TAX PERIOD | STARTED - 05/05/2026 |
| EXPIRATION DATE | 5/15/2027 |

## Table 354

| LOCAL ACCOUNT NUMBER | 5331 |
| --- | --- |
| STATE ACCOUNT NUMBER | 1001946589 |
| TRANSACTION NUMBER |  |
| CLASS | 03 |
| SALES TAX NUMBER |  |

## Table 355

| CONTACT NAME: | Daryl Foster |  |  |
| --- | --- | --- | --- |
| PHONE (A/C, NO, | EXT): 615-373-9919 | FAX (A/C, NO): | 615-750-5076 |
| E-MAIL ADDRESS: | ffoster@farmersagent.com |  |  |

## Table 356

| INSURER(S) AFFORDING COVERAGE | NAIC # |
| --- | --- |
| INSURER A: Truck Insurance Exchange | 21709 |
| INSURER B: Farmers Insurance Exchange | 21652 |
| INSURER C: Mid Century Insurance Company | 21687 |
| INSURER D: CNA/National Fire Insurance Company | 20478 |
| INSURER E: |  |
| INSURER F: |  |

## Table 357

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $ 1,000,000 |
| DAMAGE TO RENTED PREMISES (Ea Occurrence) | $ 100,000 |
| MED EXP (Any one person) | $ 5,000 |
| PERSONAL & ADV INJURY | $ 1,000,000 |
| GENERAL AGGREGATE | $ 2,000,000 |
| PRODUCTS- COMP/OP AGG | $ 2,000,000 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $ |
| AGGREGATE | $ |
|  | $ |
| PER OTHER STATUTE | $ |
| E.L. EACH ACCIDENT | $ 500,000 |
| E.L. DISEASE- EA EMPLOYEE | to 500,000 |
| E.L. DISEASE- POLICY LIMIT | $ 500,000 |
|  |  |

## Table 358

| INSR LTR | TYPE OF INSURANCE | ADDTL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| C | [X] [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC OTHER: |  |  | 607236057 | 05/04/2026 | 05/04/2027 |
|  | AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS SCHEDULED ONLY AUTOS HIRED AUTOS NON-OWNED ONLY AUTOS ONLY |  |  |  |  |  |
|  | UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ |  |  |  |  |  |
| D | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/ Y/N EXECUTIVE OFFICER/MEMBER Y EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  | 8035891913 | 05/04/2026 | 05/04/2026 |
|  |  |  |  |  |  |  |

## Table 359

| RECEIPT NUMBER | 251010115 |
| --- | --- |
| LICENSE NUMBER | 220002398 |
| THIS LICENSE EXPIRES | 05/15/2026 |
| CLASSIFICATION | 3 |

## Table 360

| CONTACT NAME: |  |
| --- | --- |
| PHONE (A/C, No. Ext): (855) 222-5919 | FAX (A/C, No): |
| E-MAIL ADDRESS: support@nextinsurance.com |  |

## Table 361

|  | INSURER(S) AFFORDING COVERAGE | NAIC # |
| --- | --- | --- |
| INSURER A : | Next Insurance US Company | 16285 |
| INSURER B : |  |  |
| INSURER C: |  |  |
| INSURER D: |  |  |
| INSURER E: |  |  |
| INSURER F : |  |  |

## Table 362

| LIMITS |  |
| --- | --- |
| EACH OCCURRENCE | $1,000,000.00 |
| DAMAGE TO RENTED PREMISES (Ea occurrence) | $100,000.00 |
| MED EXP (Any one person) | $10,000.00 |
| PERSONAL & ADV INJURY | $ 1,000,000.00 |
| GENERAL AGGREGATE | $1,000,000.00 |
| PRODUCTS - COMP/OP AGG | $1,000,000.00 |
|  | $ |
| COMBINED SINGLE LIMIT (Ea accident) | $ |
| BODILY INJURY (Per person) | $ |
| BODILY INJURY (Per accident) | $ |
| PROPERTY DAMAGE (Per accident) | $ |
|  | $ |
| EACH OCCURRENCE | $ |
| AGGREGATE | $ |
|  | $ |
| PER OTH- STATUTE ER |  |
| E.L. EACH ACCIDENT | $ |
| E.L. DISEASE - EA EMPLOYEE | $ |
| E.L. DISEASE- POLICY LIMIT | $ |
|  |  |

## Table 363

| INSR LTR | TYPE OF INSURANCE | ADDL INSD | SUBR WVD | POLICY NUMBER | POLICY EFF (MM/DD/YYYY) | POLICY EXP (MM/DD/YYYY) |
| --- | --- | --- | --- | --- | --- | --- |
| A | [X] [X] [X] COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC OTHER: |  |  | NXTWH9LFKH-02-GL | 01/29/2026 | 01/29/2027 |
|  | AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNED AUTOS ONLY AUTOS ONLY |  |  |  |  |  |
|  | UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS-MADE DED RETENTION $ |  |  |  |  |  |
|  | WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below | N/A |  |  |  |  |
|  |  |  |  |  |  |  |

## Table 364

| Reg. Control #: | 2025000014351 Date Filed: 7/16/2025 |
| --- | --- |
| Application Name: | CURTDELL GILES Jr. |
| Filing Type: | Initial Workers' Compensation Exemption |
| Status: | Active |
| Physical Addr: | 254 Court Ave., Suite 310, Curtdell Giles Jr., |
| Business Name: | OfferPorch Homes LLC |
| Business Control #: | 001133856 |
| Existing State License: | Yes 77366 |
| Business County: | Not Required |
| County License #: | 220002398 |
| Business City: | Not Required |
| City License #: | 220002398 |

## Table 365

| Effective Date: | 7/16/2025 |
| --- | --- |
| Expiration Date: | 7/16/2027 |

## Table 366

| Expiration Date: | 5/15/2025 |
| --- | --- |
| Expiration Date: | 5/15/2025 |

## Table 367

| FIS - Online Payment Portal - | $50.00 |
| --- | --- |
| FIS - Online Payment Portal - 08144C | $50.00 |

## Table 368

| Metal doors and frames (both sides) 4x7 | $ 96.37 |  |
| --- | --- | --- |
| Frames only (per opening) 4x7 | $ 73,50 |  |
| Dumpster doors (both sides with poles trim) | $ 289.11 |  |
| Miscellaneous Trim (priced per linear foot) | $ 2.04 |  |
| CMU walls: Exterior scrape, scuff, prime, and paint | $ .62 | SF |
| CMU walls: Interior scrape, scuff, prime, and paint | $ .62 | SF |
| Handrails: To include top, mid, and bottom rails. Prep/paint | $ 6.13 | linear ft |
| Single Rails: To include one railing continuous, and brackets, posts | $ 2.04 | linear ft |
| Picketed fencing or hand railing continuous, brackets, posts | $ 4.08 | linear foot |
| EFIS/CORNICE: Both metal/Cladding Board Stucco (paint) | $ .62 | square foot |

## Table 369

| (a) | The director, purchasing agent, members of the committee, members of the county legislative body or other officials, employees, or members of the board of education or highway commission shall not be financially interested or have any personal beneficial interest, either directly or indirectly, in the purchase of any supplies, materials, equipment or contractual services for the county. |
| --- | --- |
| (b) | No firm, corporation, partnership, association or individual furnishing any such supplies, materials, equipment or contractual services, shall give or offer, nor shall the director or purchasing agent or any assistant or employee accept or receive directly or indirectly from any person, firm, corporation, partnership or association to whom any contract may be awarded, by rebate, gift or other otherwise, any money or other things of value whatsoever, or any promise, obligation or contract for future reward or compensation. |

## Table 370

| Bidder Name: | Curtdell Giles Jr. |
| --- | --- |
| Bidder Signature: |  |
| Date: | 05/11/2026 |

## Table 371

| Print: | Curtdell Giles Jr. |
| --- | --- |
| Date: | 05/11/2026 |
| Phone/Email: | 901-472-4006 / curtdellgiles@offerporch.com |

## Table 372

| Print: | Curtdell Giles Jr. |
| --- | --- |
| Title: | Owner |
| Date: | 05/11/2026 |

## Table 373

| Board Meeting | Board Policy Review |
| --- | --- |
| Approval of School Fees | Student Discipline Hearing Authority Designation |
| Bullying and Harassment Report to Board | Strategic Plan and Goals |
| Personnel Decisions and Placement 26-27 |  |

## Table 374

| Board Meeting | Board Policy Review |
| --- | --- |
| Election of Officers of the Board |  |

## Table 375

| Board Meeting | Board Policy Review |
| --- | --- |
| Compliance Report | Textbook Certification |
| Approval of School Calendar |  |

## Table 376

| Board Meeting | Board Policy Review |
| --- | --- |
| Approval of Supplement Splitting |  |

## Table 377

| Board Meeting | Board Policy Review |
| --- | --- |
| Set Date(s) for Board Retreat |  |

## Table 378

| Board Meeting | Board Policy Review |
| --- | --- |
| FY28 Budget Discussion | FY28 Budget Calendar |

## Table 379

| Board Meeting | Board Policy Review |
| --- | --- |
| FY28 Budget Discussion | Set Attendance Zones |

## Table 380

| Board Meeting | Board Policy Review |
| --- | --- |
| FY28 Budget Discussion | Textbook Adoption Approval |

## Table 381

| Board Meeting | Board Policy Review |
| --- | --- |
| FY28 Budget (141, 142, 143) | Recognize Teachers of the Year |
| Authorize Superintendent to Submit Grants, Applications, Reports, Amendments, and Addenda |  |

## Table 382

| Board Meeting | Board Policy Review |
| --- | --- |
| Personnel Decisions and Placement 27-28 | Annual Agenda |
| Grant Executive Committee authority to close out fiscal year | Adopt Board Meeting Schedule 2027-2028 |
| Recognize Employee of the Year and Friend of Education | Annual Budget FY28 (if needed) |
| Teacher Tenure |  |

## Table 383

| [X] I. $1.50 | 1500 | = | $ 2,250.00 |
| --- | --- | --- | --- |
|  | ADM Up To First 1500 Students |  |  |
| [X] II. $0.75 | 1332 | = $ | 999.00 |
|  | ADM Up To Next 3000 Students (Capped at 4500 ADM by TSSE Board) |  |  |
| III. Total | Amount of Dues for 2026-2027 | (I+II) = | $ 3,249.00 |

## Table 384

| A. | 30 or more years of service in Hickman County Schools |
| --- | --- |
|  | 1. 55% of a single policy premium |
|  | 2. 30% of a family policy premium |
| B. | 20-29 years of service in Hickman County Schools |
|  | 1. 45% of a single family policy premium |
|  | 2. 25% of a family policy premium |
| C. | 10-19 years of service in Hickman County Schools |
|  | 1. 35% of a single policy premium |
|  | 2. 15% of a family policy premium |

## Table 385

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: Building and Grounds Management | Descriptor Code: 3.200 | Issued Date: 03/07/22 |
|  |  | Rescinds: 3.200 | Issued: 12/02/19 |

## Table 386

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: | Descriptor Code: 3.201 | Issued Date: 03/07/22 |
|  | Safety | Rescinds: 3.201 | Issued: 12/02/19 |

## Table 387

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: Emergency Preparedness Plan | Descriptor Code: 3.202 | Issued Date: 07/07/25 |
|  |  | Rescinds: 3.202 | Issued: 08/04/24 |

## Table 388

| 1 | ARMED INTRUDER DRILLS |
| --- | --- |
| 2 3 | The director of schools or his/her designee shall ensure that each school safety team conducts at least one (1) armed intruder drill annually in coordination with local law enforcement.⁴ |
| 4 | AED DRILLS⁶ |
| 5 6 7 | All schools shall conduct a CPR and AED drill to ensure students are aware of the steps that must be taken in the event of a medical emergency. The principal shall be responsible for ensuring the drill occurs. |
| 8 9 | The Director of Schools shall develop the necessary administrative procedures on AED and CPR training, planning, notification, and maintenance to comply with state law. |
| 10 11 | The principal shall regularly check the quantity, locations, and conditions of fire extinguishers and shall give all school personnel instructions on how to properly use fire extinguishers. |
| 12 | MEDICAL EMERGENCIES/PANDEMIC FLU⁷ |
| 13 14 15 16 | In the event of medical emergencies, such as a pandemic flu outbreak, school officials shall cooperate and consult with the local and state health departments and other local emergency or healthcare providers in protecting students and the community from further infection. The director of schools shall develop procedures for health emergencies in accordance with state law and regulations. |
| 17 | REMOTE LEARNING DRILLS⁸ |
| 18 19 20 | At least once each school year, a remote learning drill shall be conducted. The drill shall accurately reflect how students will transition to remote learning in the event of a disruption to school operations. Students shall not be asked or required to transition to remote learning at any time during the drill. |

## Table 389

| Legal | References | Cross References |
| --- | --- | --- |
| 1. | TRR/MS 0520-01-02-.30(2); TCA 49-6-804; TCA 49-6-805(8) | Emergency Closings 1.8011 Safety 3.201 |
| 2. | TCA 68-102-137(b); Public Acts of 2025. Chapter No. 315 | Community Use of School Facilities 3.206 |
| 3. | TCA 68-102-137(f) |  |
| 4. | TCA 49-6-807(e) |  |
| 5. | TCA 49-6-807 |  |
| 6. | TCA 49-2-122; TCA 49-6-1208 |  |
| 7. | TCA 49-6-3004(a), (e); TCA 49-5-404 |  |
| 8. | TCA 49-2-139 |  |

## Table 390

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: Crisis Management | Descriptor Code: 3.203 | Issued Date: 03/07/22 |
|  |  | Rescinds: 3.203 | Issued: 12/02/19 |

## Table 391

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: | Descriptor Code: 3.204 | Issued Date: 07/07/25 |
|  | Risk Management and Threat Assessment Team | Rescinds: 3.204 | Issued: 04/08/24 |

## Table 392

| Legal References | Cross References |
| --- | --- |
| 1. TCA 49-6-2701 | School District Records 1.407 |
| 2. TCA 49-6-2701(f) | Safety 3.201 |
| 3. TCA 49-6-2702 | Security 3.205 |
| 4. Public Acts of 2025. Chapter No. 215 | Student Records 6.600 |

## Table 393

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: Security | Descriptor Code: 3.205 | Issued Date: 08/05/24 |
|  |  | Rescinds: 3.205 | Issued: 04/08/24 |

## Table 394

| 4 | 1. Any School Resource Officer (SRO) assigned under a memorandum must be in compliance |
| --- | --- |
| 5 6 7 | with all laws, regulations and rules of the Peace Officer Standards and Training Commission at the time of assignment and remain compliant throughout the tenure of his or her assignment; |
| 8 9 10 11 12 13 | 2. As a condition of assignment, any SRO must participate in forty (40) hours of basic training in school policing within twelve (12) months of assignment Every year thereafter the SRO shall participate in a minimum of sixteen (16) hours of training specific to school policing. All training programs shall be approved by the Peace Officers Standards and Training Commission.⁵ |
| 14 15 16 17 18 19 | 3. Any SRO assigned under the memorandum remains an employee of the law enforcement agency, subject to that agency's direction, control, supervision and discipline, though the Board may agree to indemnify and reimburse the law enforcement agency for any part or all of the increased costs incurred by the law enforcement agency as a result of the assignment of the SROs. |
| 20 21 22 | 4. No officer shall be assigned to a school, or continue in such an assignment, without the consent of the Director. |
| 23 24 25 26 | 5. In the event that more than one SRO is assigned to a school system, the law enforcement agency shall designate one of the SROs as the senior SRO, or such other, appropriate title. The duties of the senior SRO, however designated, shall include, but not be limited to, the following: |
| 27 28 | a. To represent and carry out the policies of the law enforcement agency assigning the SROs. |
| 29 | b. To supervise the SROs in the performance of their duties; |
| 30 31 | c. To consult with the Director regarding the best use of the available resources for school policing; and |
| 32 | d. To resolve disputes between the SROs and students or faculty members. |
| 33 |  |
| 34 35 36 37 38 39 | 6. The memorandum may be effective for any length of time, including continuing until terminated by the parties, and may contain any reasonable notice requirement for the termination of the memorandum. However, the memorandum shall contain a provision allowing the Director to suspend the active participation of the SROs in the event that the Director certifies that the health, safety or wellbeing of the students or faculty members require the immediate suspension. |
| 40 | CYBERSECURITY |
| 41 42 43 | The Director of Schools/designee shall develop an administrative procedure regarding the district's cybersecurity plan to identify cybersecurity risks, implement mitigation planning, and protect cyberinfrastructure against cyberattacks and other cybersecurity threats and incidents. |

## Table 395

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: Community Use of School Facilities | Descriptor Code: 3.206 | Issued Date: 03/07/22 |
|  |  | Rescinds: 3.206 | Issued: 12/02/19 |

## Table 396

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: Facilities Planning | Descriptor Code: 3.208 | Issued Date: 03/07/22 |
|  |  | Rescinds: 3.208 | Issued: 12/02/19 |

## Table 397

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: New Project Planning | Descriptor Code: 3.211 | Issued Date: 04/08/24 |
|  |  | Rescinds: 3.211 | Issued: 03/07/22 |

## Table 398

|  | Hickman County Board of | Education |  |
| --- | --- | --- | --- |
|  | Descriptor Term: District Water | Descriptor Code: 3.212 | Issued Date: 03/07/22 |
|  | Testing | Rescinds: 3.212 | Issued: 12/02/19 |

## Table 399

| Account |  | Description |  | Debit | Credit |  | Justification |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 71200 312 - |  | Contracts w/Private Agcy |  |  | $ 36,407.92 |  |  |
| 71200 399 |  | Other Contracted Svc |  | $ 10,502.44 |  |  |  |
| 71200 429 |  | Inst Supplies |  | 6,659.50 |  |  |  |
| 71200 499 |  | Other Supplies |  | 1,432.97 |  |  | To cover contracted expense to |
| 71200 725 |  | SPED Equipment |  | 3,303.11 |  |  | meet SPED Student services in |
| 72220 131 |  | Medical Empolyees |  | 6,624.00 |  |  | excess of the original budgeted |
| 72220 312 |  | Contracts w/Private Agcy |  | 7,000.00 |  |  | amount |
| 72220 355 |  | Travel |  | 1,171.73 |  |  |  |
| 72220 399 |  | Other Contracted Svc |  |  | 1,424.50 |  |  |
| 72220 524 |  | Inservice |  | 1,138.67 |  |  |  |
| 71100 128 |  | Homebound Teachers |  |  | 4,000.00 |  | To cover cost in excess of |
| 71100 198 |  | Substitutes |  |  | 17,000.00 |  | budgeted amounts for |
| 71100 117 |  | Career Ladder Program |  | 11,500.00 |  |  | Homebound Teachers and |
| 71100 163 |  | Educational Asst |  | 9,500.00 |  |  | Substiture Teachers |
|  |  | TOTALS |  | 58,832.42 | $ 58,832.42 |  |  |
|  |  |  |  |  |  |  |  |

## Table 400

| Account |  | Description |  | Debit | Credit |  | Justification |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 72310 - 513 - 72310 399 - |  | Worker's Comp Ins Other Contracted Svc |  | $22,000.00 | 22,000.00 |  | To cover consulting contract approved by the board |
| 71100 722 - 71100 - 449 - |  | Reg Instr Equipment Text Books |  | $ 26,844.00 | 26,844.00 |  | To use funds for purchase of Text Books |
| 72210 432 72210 - 399 ⑉ |  | Library Books/Media Other Contracted Svc |  | 1,000.00 | 1,000.00 |  | To cover excess expenditures from original budget |
|  |  | TOTALS |  | $ 49,844.00 | $ 49,844.00 |  |  |

## Table 401

| Account |  | Description |  | Debit | Credit |  | Justification |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 46790 |  | Other CTE Revenue |  | 27,088.67 |  |  | TCAT Revenue |
| 71300 599 - |  | Other Charges |  |  | 27,088.67 |  |  |
| 46590 |  | Summer Learning Camp |  | 362,755.34 |  |  |  |
| 71100 - 116 - SLC |  | Teachers |  |  | 159,000.00 |  |  |
| 71100 - 163 - SLC |  | Educational Asst |  |  | 26,400.00 |  |  |
| 71100 - 201 - SLC |  | Social Security |  |  | 11,494.80 |  |  |
| 71100 - 204 - SLC |  | State Retirement |  |  | 17,501.76 |  |  |
| 71100 - 212 - SLC |  | Employer Medicare |  |  | 2,688.30 |  |  |
| 71100 - 429 - SLC |  | Inst Supplies |  |  | 1,550.00 |  |  |
| 71100 - 499 - SLC |  | Other Supplies |  |  | 16,275.00 |  |  |
| 71100 - 599 - SLC |  | Other Charges |  |  | 2,200.00 |  |  |
| 71200 - 399 - SLC |  | Other Contracted Svc |  |  | 4,016.16 |  |  |
| 72120 - 131 - SLC |  | Medical Personnel |  |  | 9,600.00 |  |  |
| 72120 - 201 - SLC |  | Social Security |  |  | 595.20 |  |  |
| 72120 - 204 - SLC |  | State Retirement |  |  | 864.00 |  |  |
| 72120 - 212 - SLC |  | Employer Medicare |  |  | 139.20 |  |  |
| 72210 - 105 - SLC |  | Supervisor |  |  | 23,450.00 |  | Summer Learning Camp |
| 72210 - 201 - SLC |  | Social Security |  |  | 1,453.90 |  |  |
| 72210 - 204 - SLC |  | State Retirement |  |  | 2,110.50 |  |  |
| 72210 - 212 - SLC |  | Employer Medicare |  |  | 340.03 |  |  |
| 72710 - 146 - SLC |  | Bus Drivers |  |  | 28,000.00 |  |  |
| 72710 - 189 - SLC |  | Other Salaries & Wages |  |  | 1,575.00 |  |  |
| 72710 - 201 - SLC |  | Social Security |  |  | 1,934.40 |  |  |
| 72710 - 204 - SLC |  | State Retirement |  |  | 2,808.00 |  |  |
| 72710 - 212 - SLC |  | Employer Medicare |  |  | 452.40 |  |  |
| 72710 - 412 - SLC |  | Diesel Fuel |  |  | 18,254.00 |  |  |
| 73100 - 165 - SLC |  | Cafeteria Personnel |  |  | 21,219.20 |  |  |
| 73100 - 201 - SLC |  | Social Security |  |  | 1,315.59 |  |  |
| 73100 - 204 - SLC |  | State Retirement |  |  | 2,565.40 |  |  |
| 73100 - 212 ⑉ SLC |  | Employer Medicare |  |  | 307.68 |  |  |
| 73100 - 422 - SLC |  | Food Supplies |  |  | 4,644.82 |  |  |
|  |  |  |  |  |  |  |  |
|  |  | TOTALS |  | $ 389,844.01 | $ 389,844.01 |  |  |

## Table 402

| Account No. | Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
|  | ESTIMATED REVENUES |  |  |  |  |  |  |  |  |
|  |  |  |  |  |  |  | Net Penny | Rate | Property |
| 40000 | Local Taxes |  |  |  |  |  | 83,969 | 0.3381 |  |
| 40100 | County Property Taxes |  |  |  |  |  | 83,969 | 0.0200 |  |
| 40110 | Current Property Taxes | 3,168,716 | 2,773,333 | 2,773,333 | 3,006,912 | 233,579 | 83,969 | 0.3581 |  |
| 40120 | Trustee's Collection - Prior Year | 67,993 | 75,000 | 75,000 | 75,000 | 0 |  |  |  |
| 40125 | Trustee's Collection - Bankruptcy | 103 | 500 | 500 | 500 | 0 |  |  |  |
| 40130 | Circuit/Clerk & Master Collections - Prior Years | 29,377 | 40,000 | 40,000 | 25,000 | (15,000) |  |  |  |
| 40140 | Interest and Penalty | 13,586 | 15,000 | 15,000 | 15,000 | 0 |  |  |  |
| 40161 | Payments in Lieu of Taxes - TVA | 2,890 | 3,500 | 3,500 | 2,500 | (1,000) |  |  |  |
| 40162 | Payments in Lieu of Taxes - Local Utilities | 6,000 | 6,000 | 6,000 | 6,000 | 0 |  |  |  |
| 40200 | County Local Option Taxes |  |  |  |  |  |  |  |  |
| 40210 | Local Option Sales Tax | 3,293,354 | 2,975,000 | 2,975,000 | 3,100,000 | 125,000 |  |  |  |
| 40270 | Business Tax | 45,181 | 45,000 | 45,000 | 45,000 | 0 |  |  |  |
| 40300 | Statutory Local Taxes |  |  |  |  |  |  |  |  |
| 40320 | Bank Excise Tax | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 40350 | Interstate Telecommunication Tax | 0 | 0 | 0 | 0 | 0 |  |  |  |
|  | Total Local Taxes | 6,627,200 | 5,933,333 | 5,933,333 | 6,275,912 | 342,579 |  |  |  |
| 41000 | Licenses and Permits |  |  |  |  |  |  |  |  |
| 41100 | Licenses |  |  |  |  |  |  |  |  |
| 41110 | Marriage Licenses | 1,320 | 1,300 | 1,300 | 1,300 | 0 |  |  |  |
|  | Total Licenses and Permits | 1,320 | 1,300 | 1,300 | 1,300 | 0 |  |  |  |
| 43000 | Charges for Current Services |  |  |  |  |  |  |  |  |
| 43500 | Education Charges |  |  |  |  |  |  |  |  |
| 43517 | Tuition Other | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 43570 | Receipts from Individual Schools | 12,502 | 30,000 | 30,000 | 25,000 | (5,000) |  |  |  |
| 43582 | Community Service Fees Adults | 126 | 200 | 200 | 200 | 0 |  |  |  |
|  | Total Charges for Current Services | 12,628 | 30,200 | 30,200 | 25,200 | (5,000) |  |  |  |
| 44000 | Other Local Revenues |  |  |  |  |  |  |  |  |
| 44100 | Recurring Items |  |  |  |  |  |  |  |  |
| 44110 | Investment Income | 339,950 | 0 | 0 | 0 | 0 |  |  |  |
| 44120 | Lease/Rentals | 2,230 | 7,500 | 7,500 | 7,500 | 0 |  |  |  |
| 44170 | Miscellaneous Refunds | 23,821 | 30,000 | 30,000 | 40,000 | 10,000 |  |  |  |
| 44500 | Nonrecurring Items |  |  |  |  |  |  |  |  |

## Table 403

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 44530 Sale of Equipment | 15,379 | 15,000 | 15,000 | 15,000 | 0 |  |  |  |
| 44560 Damages Recovered from Individuals | 20,316 | 3,000 | 3,000 | 3,000 | 0 |  |  |  |
| 44570 Contributions and Gifts | 66,834 | 20,000 | 20,000 | 20,000 | 0 |  |  |  |
| 44990 Other Local Revenues | 0 | 30,000 | 30,000 | 0 | (30,000) |  |  |  |
| Total Other Local Revenues | 468,530 | 105,500 | 105,500 | 85,500 | (20,000) |  |  |  |
| Total Local Revenue | 7,109,678 | 6,070,333 | 6,070,333 | 6,387,912 | 317,579 |  |  |  |
| 46000 State of Tennessee |  |  |  |  |  |  |  |  |
| 46175 On-Behalf Contributions for OPEB | 69,895 | 40,000 | 40,000 | 50,000 | 10,000 |  |  |  |
| 46500 State Education Funds |  |  |  |  |  |  |  |  |
| 46510 Tennessee Investment in Student Achievemer | 24,453,717 | 25,081,234 | 25,081,234 | 25,367,661 | 286,427 |  |  |  |
| 46513 TISA-On-behalf Payments | 50,082 | 0 | 0 | 17,332 |  |  |  |  |
| 46515 Early Childhood Education | 456,119 | 445,000 | 445,000 | 425,000 | (20,000) |  |  |  |
| 46520 School Food Service | 16,684 | 22,000 | 22,000 | 22,000 | 0 |  |  |  |
| 46550 Driver Education | 8,199 | 10,000 | 10,000 | 10,000 | 0 |  |  |  |
| 46590 Other State Education Funds | 292,095 | 240,000 | 818,937 | 240,000 | 0 |  |  |  |
| 46591 Coordinated School Health | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 46594 Family Resource Centers | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 46610 Career Ladder Program | 36,983 | 37,500 | 37,500 | 27,360 | (10,140) |  |  |  |
| 46790 Other Vocational | 160,426 | 759,000 | 1,543,702 | 0 | (759,000) |  |  |  |
| 46800 Other State Revenues |  |  |  |  |  |  |  |  |
| 46851 State Revenue Sharing - TVA | 204,756 | 220,000 | 220,000 | 220,000 | 0 |  |  |  |
| 46980 Other State Grants | 67,684 | 0 | 0 | 0 | 0 |  |  |  |
| 46981 Safe Schools | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 46990 Other State Revenues | 370,158 | 100,000 | 100,000 | 200,000 | 100,000 |  |  |  |
| Total State of Tennessee | 26,186,798 | 26,954,734 | 28,318,372 | 26,579,353 | (375,381) |  |  |  |
| 47000 Federal Government |  |  |  |  |  |  |  |  |
| 47100 Federal Through State |  |  |  |  |  |  |  |  |
| 47143 Special Education-Grants to States | 31,639 | 0 | 0 | 0 | 0 |  |  |  |
| 47401 American Rescue Plan Act Grant #1 | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 47590 Other Federal Through State | 49,858 | 0 | 0 | 0 | 0 |  |  |  |
| 47600 Direct Federal Revenue |  |  |  |  |  |  |  |  |
| 47640 ROTC Reimbursement | 88,422 | 65,000 | 65,000 | 75,000 | 10,000 |  |  |  |
| 47990 Other Direct Federal Revenue | 0 | 0 | 0 | 0 | 0 |  |  |  |
| Total Federal Government | 169,919 | 65,000 | 65,000 | 75,000 | 10,000 |  |  |  |
| 48000 Other Governments and Citizens Groups |  |  |  |  |  |  |  |  |
| 48130 Contributions | 532,794 | 0 | 0 | 0 | 0 |  |  |  |
| 48990 Other | 49,921 | 0 | 4,000 | 110,000 | 110,000 |  |  |  |
| Total Other Governments and Citizens Groups | 582,715 | 0 | 4,000 | 110,000 | 110,000 |  |  |  |

## Table 404

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 | 342,579 | 5.56% |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Total Estimated Revenues | 34,049,110 | 33,090,067 | 34,457,705 | 33,152,265 | 62,198 |  |  |  |  |
| 49000 OTHER SOURCES (NON-REVENUE) |  |  |  |  |  |  |  |  |  |
| 49700 Insurance Recovery | 212,961 | 0 | 0 | 0 | 0 |  |  |  |  |
| 49800 Transfers In | 137,817 | 10,000 | 10,000 | 0 | (10,000) |  |  |  |  |
| Total Other Sources | 350,778 | 10,000 | 10,000 | 0 | (10,000) |  |  |  |  |
| Total Estimated Revenues & Other Sources | 34,399,888 | 33,100,067 | 34,467,705 | 33,152,265 | 52,198 |  |  |  |  |
| ESTIMATED EXPENDITURES |  |  |  |  |  |  |  |  |  |
| 71000 Instruction |  |  |  |  |  |  |  |  |  |
| 71100 Regular Instruction Program |  |  |  |  |  |  |  |  |  |
| 116 Teachers | 10,131,640 | 10,722,365 | 10,722,365 | 10,841,539 | 119,174 |  |  |  |  |
| 117 Career Ladder Program | 33,000 | 35,000 | 35,000 | 24,000 | (11,000) |  |  |  |  |
| 128 Homebound Teachers | 2,569 | 6,000 | 6,000 | 8,000 | 2,000 |  |  |  |  |
| 140 Salary Supplements | 438,836 | 440,000 | 440,000 | 457,600 | 17,600 |  |  |  |  |
| 163 Educational Assistants | 475,025 | 497,075 | 497,075 | 475,000 | (22,075) |  |  |  |  |
| 188 Bonus Payments | 0 | 0 | 504,000 | 0 | 0 |  |  |  |  |
| 189 Other Salaries and Wages | 390,041 | 410,000 | 410,000 | 410,000 | 0 |  |  |  |  |
| 198 Non-Certified Substitute Teachers | 171,150 | 210,000 | 210,000 | 210,000 | 0 |  |  |  |  |
| 201 Social Security | 837,646 | 922,514 | 961,070 | 920,384 | (2,130) |  |  |  |  |
| 204 State Retirement | 741,859 | 918,910 | 955,291 | 898,784 | (20,126) |  |  |  |  |
| 207 Medical Insurance | 1,598,253 | 2,090,000 | 2,090,000 | 1,751,063 | (338,937) |  |  |  |  |
| 212 Employer Medicare | 2,759 | 0 | 0 | 0 | 0 |  |  |  |  |
| 215 On-behalf Payments to OPEB | 26,391 | 0 | 0 | 0 | 0 |  |  |  |  |
| 336 Maint and Repair Service - Equipment | 7,347 | 10,000 | 10,000 | 15,000 | 5,000 |  |  |  |  |
| 399 Other Contracted Services | 9,557 | 107,000 | 117,000 | 65,000 | (42,000) |  |  |  |  |
| 429 Instructional Supplies and Materials | 129,205 | 115,000 | 115,000 | 135,000 | 20,000 |  |  |  |  |
| 449 Textbooks | 211,456 | 150,000 | 150,000 | 325,400 | 175,400 |  |  |  |  |
| 471 Software | 0 | 0 | 0 | 0 | 0 |  |  |  |  |
| 499 Other Supplies and Materials | 23,984 | 8,000 | 3,000 | 3,000 | (5,000) |  |  |  |  |
| 595 TISA-On-behalf Payments | 40,177 | 0 | 0 | 0 | 0 |  |  |  |  |
| 599 Other Charges | 1,650 | 0 | 0 | 0 | 0 |  |  |  |  |
| 722 Regular Instructional Equipment | 41,067 | 150,000 | 145,000 | 125,000 | (25,000) |  |  |  |  |
| 730 Vocational Instruction Equipment | 0 | 0 | 0 | 0 | 0 |  |  |  |  |
| Total Instructional Program | 15,313,612 | 16,791,864 | 17,370,801 | 16,664,770 | (127,094) |  |  |  |  |
| 71150 Alternative Instruction Program |  |  |  |  |  |  |  |  |  |
| 116 Teachers | 169,786 | 213,289 | 213,289 | 205,000 | (8,289) |  |  |  |  |
| 163 Educational Assistants | 24,054 | 26,000 | 26,000 | 27,000 | 1,000 |  |  |  |  |
| 201 Social Security | 13,924 | 18,306 | 18,306 | 17,748 | (558) |  |  |  |  |

## Table 405

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 204 State Retirement | 13,864 | 17,438 | 17,438 | 15,475 | (1,963) |  |  |
| 207 Medical Insurance | 19,971 | 37,988 | 37,988 | 23,002 | (14,986) |  |  |
| 355 Travel | 1,390 | 2,000 | 2,000 | 1,500 | (500) |  |  |
| 429 Instructional Supplies and Materials | 1,045 | 1,000 | 1,000 | 1,000 | 0 |  |  |
| 499 Other Supplies and Materials | 1,317 | 1,000 | 1,000 | 1,000 | 0 |  |  |
| Total Alternative Schools | 245,351 | 317,021 | 317,021 | 291,725 | (25,296) |  |  |
| 71200 Special Education Program |  |  |  |  |  |  |  |
| 116 Teachers | 1,872,137 | 2,021,836 | 1,936,836 | 2,025,430 | 3,594 |  |  |
| 124 Psychological Personnel | 0 | 0 | 0 | 0 | 0 |  |  |
| 128 Homebound Teachers | 3,319 | 7,500 | 7,500 | 7,500 | 0 |  |  |
| 163 Educational Assistants | 477,636 | 528,820 | 528,820 | 521,820 | (7,000) |  |  |
| 171 Speech Pathologist | 225,115 | 255,769 | 183,769 | 180,000 | (75,769) |  |  |
| 201 Social Security | 188,915 | 210,266 | 198,256 | 199,637 | (10,629) |  |  |
| 204 State Retirement | 215,032 | 217,170 | 205,786 | 219,032 | 1,862 |  |  |
| 207 Medical Insurance | 406,600 | 414,442 | 414,442 | 382,181 | (32,261) |  |  |
| 212 Employer Medicare | 0 | 0 | 0 | 0 | 0 |  |  |
| 312 Contracts with Private Agencies | 122,711 | 105,000 | 105,000 | 200,000 | 95,000 |  |  |
| 399 Other Contracted Services | 64,314 | 75,000 | 75,000 | 95,000 | 20,000 |  |  |
| 429 Instructional Supplies and Materials | 1,003 | 7,000 | 7,000 | 5,000 | (2,000) |  |  |
| 499 Other Supplies and Materials | 1,545 | 5,000 | 5,000 | 5,000 | 0 |  |  |
| 595 TISA-On-behalf Payments | 9,905 | 0 | 0 | 0 | 0 |  |  |
| 725 Special Education Equipment | 0 | 5,000 | 5,000 | 5,000 | 0 |  |  |
| Total Special Educational Program | 3,588,232 | 3,852,803 | 3,672,408 | 3,845,600 | (7,203) |  |  |
| 71300 Career and Technical Education Program |  |  |  |  |  |  |  |
| 116 Teachers | 896,864 | 932,216 | 932,216 | 925,000 | (7,216) |  |  |
| 140 Supplements | 604 | 6,000 | 6,000 | 6,000 | 0 |  |  |
| 189 Other Salaries and Wages | 150 | 5,000 | 5,000 | 5,000 | 0 |  |  |
| 198 Non-Certified Substitute Teachers | 18,000 | 21,600 | 21,600 | 21,600 | 0 |  |  |
| 201 Social Security | 68,150 | 73,809 | 73,809 | 73,256 | (553) |  |  |
| 204 State Retirement | 62,790 | 73,785 | 73,785 | 64,201 | (9,584) |  |  |
| 207 Medical Insurance | 104,665 | 127,562 | 127,562 | 161,027 | 33,465 |  |  |
| 307 Communications | 0 | 0 | 0 | 0 | 0 |  |  |
| 336 Maintenance and Repair Services-Equipment | 3,921 | 0 | 0 | 0 | 0 |  |  |
| 355 Travel | 6,944 | 9,000 | 9,000 | 9,000 | 0 |  |  |
| 399 Other Contracted Services | 0 | 0 | 0 | 0 | 0 |  |  |
| 429 Instructional Supplies and Materials | 3,405 | 10,000 | 10,000 | 5,000 | (5,000) |  |  |
| 449 Text Books | 5,324 | 7,000 | 7,000 | 7,000 | 0 |  |  |
| 471 Software | 0 | 0 | 141,050 | 0 | 0 |  |  |
| 499 Other Supplies and Materials | 11,776 | 20,000 | 20,000 | 10,000 | (10,000) |  |  |
| 599 Other Charges | 82,520 | 3,500 | 3,500 | 3,500 | 0 |  |  |
| 730 Vocational Instruction Equipment | 102,920 | 15,000 | 476,113 | 10,000 | (5,000) |  |  |
| 790 Other Equipment | 3,466 | 10,000 | 10,000 | 10,000 | 0 |  |  |

## Table 406

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 | 342,579 | 5.56% |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Total Vocational Education Program | 1,371,499 | 1,314,472 | 1,916,635 | 1,310,584 | (3,888) |  |  |  |  |
| Total Instruction | 20,518,694 | 22,276,160 | 23,276,864 | 22,112,679 | (163,481) |  |  |  |  |
| 72000 Support Services |  |  |  |  |  |  |  |  |  |
| 72110 Attendance |  |  |  |  |  |  |  |  |  |
| 105 Supervisor/Director | 62,394 | 96,000 | 96,000 | 101,712 | 5,712 |  |  |  |  |
| 189 Other Salaries & Wages | 55,437 | 57,932 | 57,932 | 59,000 | 1,068 |  |  |  |  |
| 201 Social Security | 8,668 | 11,776 | 11,776 | 12,294 | 518 |  |  |  |  |
| 204 State Retirement | 11,492 | 15,639 | 15,639 | 14,347 | (1,292) |  |  |  |  |
| 207 Medical Insurance | 15,800 | 19,374 | 19,374 | 9,900 | (9,474) |  |  |  |  |
| 355 Travel | 308 | 1,500 | 1,500 | 1,500 | 0 |  |  |  |  |
| 399 Other Contracted Services | 15,852 | 20,000 | 20,000 | 5,500 | (14,500) |  |  |  |  |
| 499 Other Supplies and Materials | 800 | 1,500 | 1,500 | 1,000 | (500) |  |  |  |  |
| 524 In Service/Staff Development | 500 | 1,500 | 1,500 | 0 | (1,500) |  |  |  |  |
| 719 Office Equipment | 0 | 0 | 0 | 0 | 0 |  |  |  |  |
| Total Attendance | 171,251 | 225,221 | 225,221 | 205,253 | (19,968) |  |  |  |  |
| 72120 Health Services |  |  |  |  |  |  |  |  |  |
| 105 Supervisor/Director | 74,104 | 78,000 | 78,000 | 78,000 | 0 |  |  |  |  |
| 130 Social Workers | 88,171 | 102,800 | 102,800 | 109,289 | 6,489 |  |  |  |  |
| 131 Medical Personnel | 382,670 | 397,459 | 397,459 | 410,000 | 12,541 |  |  |  |  |
| 189 Other Salaries & Wages | 56,443 | 59,100 | 109,100 | 64,000 | 4,900 |  |  |  |  |
| 201 Social security | 44,449 | 48,758 | 52,583 | 50,589 | 1,831 |  |  |  |  |
| 204 State Retirement | 53,324 | 58,551 | 63,051 | 58,780 | 229 |  |  |  |  |
| 207 Medical Insurance | 65,201 | 60,206 | 60,206 | 74,942 | 14,736 |  |  |  |  |
| 212 Employer Medicare | 139 | 0 | 0 | 0 | 0 |  |  |  |  |
| 355 Travel | 2,419 | 2,000 | 2,000 | 2,000 | 0 |  |  |  |  |
| 399 Other Contracted Services | 22,095 | 35,000 | 35,000 | 35,000 | 0 |  |  |  |  |
| 413 Drugs and Medical Supplies | 4,988 | 5,500 | 5,500 | 5,500 | 0 |  |  |  |  |
| 499 Other Supplies and Materials | 2,676 | 3,000 | 3,000 | 3,000 | 0 |  |  |  |  |
| 524 Inservice | 2,864 | 3,000 | 3,000 | 3,000 | 0 |  |  |  |  |
| 599 Other Charges | 17,953 | 4,000 | 55,170 | 4,000 | 0 |  |  |  |  |
| 735 Health Equipment | 4,635 | 4,000 | 4,000 | 4,000 | 0 |  |  |  |  |
| Total Health Service | 822,131 | 861,374 | 970,869 | 902,100 | 40,726 |  |  |  |  |
| 72130 Other Student Support |  |  |  |  |  |  |  |  |  |
| 123 Guidance Personnel | 656,370 | 719,709 | 719,709 | 800,000 | 80,291 |  |  |  |  |
| 189 Other Salaries and Wages | 186,774 | 193,500 | 193,500 | 200,000 | 6,500 |  |  |  |  |
| 201 Social Security | 62,040 | 67,861 | 67,861 | 76,500 | 8,639 |  |  |  |  |
| 204 State Retirement | 59,980 | 71,231 | 71,231 | 73,183 | 1,952 |  |  |  |  |
| 207 Medical Insurance | 99,169 | 88,521 | 88,521 | 126,777 | 38,256 |  |  |  |  |

## Table 407

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 | 342,579 |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 322 Evaluating and Testing | 3,133 | 16,000 | 16,000 | 73,000 | 57,000 |  |  |  |
| 344 Payments to Schools - Other | 64,000 | 64,000 | 64,000 | 56,000 | (8,000) |  |  |  |
| 355 Travel | 7,862 | 8,000 | 8,000 | 8,000 | 0 |  |  |  |
| 399 Other Contracted Services | 0 | 10,000 | 10,000 | 49,000 | 39,000 |  |  |  |
| 499 Other Supplies and Materials | 338 | 4,000 | 4,000 | 3,000 | (1,000) |  |  |  |
| 524 Inservice | 150 | 2,000 | 2,000 | 2,000 | 0 |  |  |  |
| 599 Other Charges | 129 | 5,000 | 5,000 | 4,000 | (1,000) |  |  |  |
| 701 Administration Equipment | 6,000 | 0 | 0 | 0 | 0 |  |  |  |
| Total Other Student Support | 1,145,945 | 1,249,822 | 1,249,822 | 1,471,460 | 221,638 |  |  |  |
| 72210 Regular Instruction Program |  |  |  |  |  |  |  |  |
| 105 Supervisor/Director | 119,485 | 125,000 | 125,000 | 125,785 | 785 |  |  |  |
| 129 Librarians | 479,084 | 500,235 | 500,235 | 492,000 | (8,235) |  |  |  |
| 161 Secretary(s) | 231,649 | 227,599 | 227,599 | 230,000 | 2,401 |  |  |  |
| 162 Clerical Personnel | 263,138 | 318,482 | 318,482 | 320,000 | 1,518 |  |  |  |
| 189 Other Salaries and Wages | 83,696 | 91,921 | 91,921 | 95,000 | 3,079 |  |  |  |
| 201 Social Security | 85,938 | 93,638 | 93,638 | 93,446 | (192) |  |  |  |
| 204 State Retirement | 106,994 | 109,735 | 109,735 | 108,026 | (1,709) |  |  |  |
| 207 Medical Insurance | 180,509 | 207,846 | 207,846 | 187,247 | (20,599) |  |  |  |
| 212 Employer Medicare | 331 | 0 | 0 | 0 | 0 |  |  |  |
| 336 Maint and Repair Services - Equipment | 4,051 | 4,000 | 4,000 | 4,000 | 0 |  |  |  |
| 355 Travel | 2,511 | 2,500 | 2,500 | 2,500 | 0 |  |  |  |
| 399 Other Contracted Services | 16,283 | 16,000 | 16,000 | 5,000 | (11,000) |  |  |  |
| 432 Library Books and Media | 6,672 | 8,000 | 8,000 | 8,000 | 0 |  |  |  |
| 499 Other Supplies and Materials | 353 | 3,000 | 3,000 | 3,000 | 0 |  |  |  |
| 524 In-Service/Staff Development | 1,006 | 2,000 | 2,000 | 2,000 | 0 |  |  |  |
| 599 Other Charges | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 701 Administration Equipment | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 722 Regular Instruction Equipment | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 790 Other Equipment | 0 | 0 | 0 | 0 | 0 |  |  |  |
| Total Regular Instruction Program | 1,581,700 | 1,709,956 | 1,709,956 | 1,676,004 | (33,952) |  |  |  |
| 72220 Special Education Program |  |  |  |  |  |  |  |  |
| 105 Supervisor/Director | 92,046 | 93,500 | 93,500 | 97,200 | 3,700 |  |  |  |
| 124 Psychological Personnel | 79,109 | 83,000 | 168,000 | 169,000 | 86,000 |  |  |  |
| 131 Medical Personnel | 65,335 | 69,000 | 141,000 | 147,000 | 78,000 |  |  |  |
| 189 Other Salaries and Wages | 5,000 | 5,000 | 5,000 | 5,000 | 0 |  |  |  |
| 196 In-Service Training | 415 | 2,000 | 2,000 | 2,000 | 0 |  |  |  |
| 201 Social Security | 17,682 | 19,317 | 31,328 | 32,145 | 12,828 |  |  |  |
| 204 State Retirement | 19,238 | 19,679 | 31,064 | 34,572 | 14,893 |  |  |  |
| 207 Medical Insurance | 7,900 | 9,101 | 9,101 | 38,898 | 29,797 |  |  |  |
| 312 Contracts with Private Agencies | 1,202 | 7,000 | 7,000 | 0 | (7,000) |  |  |  |
| 336 Maint and Repair Services - Equipment | 5,295 | 5,000 | 5,000 | 6,500 | 1,500 |  |  |  |
| 355 Travel | 6,277 | 7,500 | 7,500 | 7,500 | 0 |  |  |  |

## Table 408

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 |
| --- | --- | --- | --- | --- | --- | --- |
| 399 Other Contracted Services | 58,523 | 60,000 | 60,000 | 60,000 | 0 |  |
| 524 In-Service Training | 1,530 | 4,000 | 4,000 | 4,000 | 0 |  |
| Total Special Education Program | 359,552 | 384,097 | 564,492 | 603,815 | 219,718 |  |
| 72230 Career and Technical Education Program |  |  |  |  |  |  |
| 105 Supervisor/Director | 89,315 | 95,500 | 95,500 | 98,000 | 2,500 |  |
| 189 Other Salaries and Wages | 40,131 | 42,000 | 84,297 | 43,000 | 1,000 |  |
| 201 Social Security | 9,564 | 10,519 | 13,755 | 10,787 | 268 |  |
| 204 State Retirement | 10,436 | 10,584 | 15,698 | 12,002 | 1,418 |  |
| 207 Medical Insurance | 4,567 | 2,696 | 4,696 | 18,016 | 15,320 |  |
| 336 Maint and Repair Services - Equipment | 2,698 | 3,000 | 3,000 | 3,000 | 0 |  |
| 355 Travel | 0 | 2,000 | 2,000 | 3,000 | 1,000 |  |
| 399 Other Contracted Services | 142 | 3,000 | 3,000 | 0 | (3,000) |  |
| 499 Other Supplies and Materials | 6,056 | 0 | 0 | 2,000 | 2,000 |  |
| 524 In-Service Training | 0 | 0 | 0 | 0 | 0 |  |
| 790 Other Equipment | 8,230 | 0 | 0 | 0 | 0 |  |
| Total Vocational Education Program | 171,139 | 169,299 | 221,945 | 189,805 | 20,506 |  |
| 72250 Technology |  |  |  |  |  |  |
| 105 Supervisor | 74,104 | 78,000 | 78,000 | 78,000 | 0 |  |
| 189 Other Salaries and Wages | 50,808 | 74,899 | 74,899 | 78,000 | 3,101 |  |
| 201 Social Security | 8,732 | 11,697 | 11,697 | 11,934 | 237 |  |
| 204 State Retirement | 12,328 | 15,527 | 15,527 | 15,373 | (154) |  |
| 207 Medical Insurance | 8,244 | 9,101 | 9,101 | 24,669 | 15,568 |  |
| 336 Maint and Repair Services - Equipment | 1,555 | 6,000 | 6,000 | 6,000 | 0 |  |
| 350 Internet Connectivity | 92,786 | 105,000 | 105,000 | 75,000 | (30,000) |  |
| 355 Travel | 0 | 2,000 | 1,000 | 1,000 | (1,000) |  |
| 399 Other Contracted Services | 77,641 | 195,000 | 195,000 | 152,050 | (42,950) |  |
| 499 Other Supplies and Materials | 1,477 | 2,000 | 2,000 | 2,000 | 0 |  |
| 599 Other Charges | 0 | 0 | 1,000 | 1,000 | 1,000 |  |
| 722 Regular Instruction Equipment | 99,735 | 60,000 | 60,000 | 70,000 | 10,000 |  |
| Total Technology | 427,410 | 559,224 | 559,224 | 515,026 | (44,198) |  |
| 72290 Other Programs |  |  |  |  |  |  |
| 215 On-Behalf Payments for OPEB | 69,895 | 35,000 | 35,000 | 70,000 | 35,000 |  |
| Total Other Programs | 69,895 | 35,000 | 35,000 | 70,000 | 35,000 |  |
| 72310 Board of Education |  |  |  |  |  |  |
| 191 Board and Committee Members Fees | 16,800 | 16,800 | 16,800 | 16,800 | 0 |  |
| 196 In-Service Training | 4,323 | 7,000 | 7,000 | 7,000 | 0 |  |
| 201 Social Security | 1,123 | 2,142 | 2,142 | 1,821 | (321) |  |
| 204 Medical Insurance | 14,510 | 15,800 | 15,800 | 7,900 | (7,900) |  |

## Table 409

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 | 342,579 | 5.56% |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 305 Audit Services | 35,000 | 35,000 | 35,000 | 35,000 | 0 |  |  |  |  |
| 320 Dues and Memberships | 11,229 | 26,000 | 26,000 | 26,000 | 0 |  |  |  |  |
| 331 Legal Services | 6,386 | 25,000 | 25,000 | 25,000 | 0 |  |  |  |  |
| 355 Travel | 1,837 | 4,000 | 4,000 | 4,000 | 0 |  |  |  |  |
| 399 Other Contracted Services | 3,500 | 8,000 | 8,000 | 11,000 | 3,000 |  |  |  |  |
| 506 Liability Insurance | 145,968 | 160,000 | 160,000 | 175,000 | 15,000 |  |  |  |  |
| 510 Trustees Commission | 135,500 | 150,000 | 150,000 | 150,000 | 0 |  |  |  |  |
| 513 Workers Compensation Insurance | 196,642 | 240,000 | 240,000 | 230,000 | (10,000) |  |  |  |  |
| 534 Refund to Applicant for Criminal Investigation | 0 | 1,000 | 1,000 | 1,000 | 0 |  |  |  |  |
| 599 Other Charges | 2,378 | 7,000 | 7,000 | 7,000 | 0 |  |  |  |  |
| Total Board of Education | 575,196 | 697,742 | 697,742 | 697,521 | (221) |  |  |  |  |
| 72320 Director of Schools |  |  |  |  |  |  |  |  |  |
| 101 County Official/Administrative Officer | 125,000 | 130,000 | 130,000 | 130,000 | 0 |  |  |  |  |
| 161 Secretary(s) | 114,112 | 122,644 | 122,644 | 125,000 | 2,356 |  |  |  |  |
| 201 Social Security | 18,211 | 19,328 | 19,328 | 19,508 | 180 |  |  |  |  |
| 204 State Retirement | 24,772 | 26,516 | 26,516 | 24,145 | (2,371) |  |  |  |  |
| 207 Medical Insurance | 13,834 | 15,729 | 15,729 | 33,146 | 17,417 |  |  |  |  |
| 307 Communication | 416 | 1,000 | 1,000 | 0 | (1,000) |  |  |  |  |
| 336 Maint and Repair Services - Equipment | 10,763 | 14,000 | 14,000 | 14,000 | 0 |  |  |  |  |
| 348 Postal Charges | 0 | 1,000 | 1,000 | 1,000 | 0 |  |  |  |  |
| 355 Travel | 1,311 | 1,400 | 1,400 | 5,000 | 3,600 |  |  |  |  |
| 399 Other Contracted Service | 0 | 3,000 | 3,000 | 5,000 | 2,000 |  |  |  |  |
| 435 Office Supplies | 1,047 | 1,500 | 1,500 | 1,500 | 0 |  |  |  |  |
| 499 Other Supplies and Materials | 1,153 | 2,500 | 2,500 | 2,500 | 0 |  |  |  |  |
| 599 Other Charges | 0 | 0 | 0 | 0 | 0 |  |  |  |  |
| Total Office of the Superintendent | 310,619 | 338,617 | 338,617 | 360,799 | 22,182 |  |  |  |  |
| 72410 Office of the Principal |  |  |  |  |  |  |  |  |  |
| 104 Principals | 719,596 | 808,000 | 808,000 | 815,000 | 7,000 |  |  |  |  |
| 139 Assistant Principals | 588,481 | 658,000 | 658,000 | 635,000 | (23,000) |  |  |  |  |
| 189 Other Salaries and Wages | 101,050 | 104,000 | 104,000 | 109,200 | 5,200 |  |  |  |  |
| 201 Social Security | 104,991 | 116,105 | 116,105 | 115,381 | (724) |  |  |  |  |
| 204 State Retirement | 102,596 | 121,912 | 121,912 | 115,475 | (6,437) |  |  |  |  |
| 207 Medical Insurance | 136,438 | 178,201 | 178,201 | 121,902 | (56,299) |  |  |  |  |
| 348 Postal Charges | 0 | 1,000 | 1,000 | 1,000 | 0 |  |  |  |  |
| 355 Travel | 0 | 3,000 | 3,000 | 3,000 | 0 |  |  |  |  |
| 399 Other Contracted Services | 129,545 | 126,000 | 126,000 | 126,000 | 0 |  |  |  |  |
| Total Office of the Principal | 1,882,697 | 2,116,218 | 2,116,218 | 2,041,958 | (74,260) |  |  |  |  |
| 72510 Fiscal Services |  |  |  |  |  |  |  |  |  |
| 399 Other Contracted Services | 47,303 | 50,000 | 50,000 | 50,000 | 0 |  |  |  |  |

## Table 410

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 |
| --- | --- | --- | --- | --- | --- | --- |
| Total Fiscal Services | 47,303 | 50,000 | 50,000 | 50,000 | 0 |  |
| 72610 Operation of Plant |  |  |  |  |  |  |
| 307 Communication | 50,311 | 40,000 | 40,000 | 50,000 | 10,000 |  |
| 399 Other Contracted Services | 769,490 | 837,298 | 837,298 | 837,298 | 0 |  |
| 410 Custodial Supplies | 37,621 | 38,500 | 38,500 | 40,000 | 1,500 |  |
| 415 Electricity | 962,544 | 990,000 | 990,000 | 1,100,000 | 110,000 |  |
| 434 Natural Gas | 88,276 | 150,000 | 150,000 | 150,000 | 0 |  |
| 454 Water and Sewer | 314,473 | 345,000 | 345,000 | 345,000 | 0 |  |
| 499 Other Supplies and Materials | 262 | 3,500 | 3,500 | 3,500 | 0 |  |
| 501 Boiler Insurance | 8,822 | 10,500 | 10,500 | 10,500 | 0 |  |
| 502 Building and Contents Insurance | 250,000 | 275,000 | 275,000 | 290,000 | 15,000 |  |
| 790 Other Equipment | 10,613 | 15,000 | 15,000 | 15,000 | 0 |  |
| Total Operation of Plant | 2,492,412 | 2,704,798 | 2,704,798 | 2,841,298 | 136,500 |  |
| 72620 Maintenance of Plant |  |  |  |  |  |  |
| 105 Supervisor/Director | 74,104 | 78,000 | 78,000 | 78,000 | 0 |  |
| 161 Secretary(s) | 22,534 | 23,549 | 23,549 | 24,500 | 951 |  |
| 189 Other Salaries and Wages | 187,312 | 242,650 | 242,650 | 250,000 | 7,350 |  |
| 201 Social Security | 23,098 | 26,332 | 26,332 | 26,966 | 634 |  |
| 204 State Retirement | 35,824 | 41,580 | 41,580 | 47,129 | 5,549 |  |
| 207 Medical Insurance | 45,984 | 53,892 | 53,892 | 57,126 | 3,234 |  |
| 335 Maint & Repair Services - Building | 244,813 | 250,000 | 335,000 | 250,000 | 0 |  |
| 336 Maint & Repair Services - Equipment | 203,605 | 275,000 | 275,000 | 275,000 | 0 |  |
| 355 Travel | 0 | 1,500 | 1,500 | 0 | (1,500) |  |
| 399 Other Contracted Services | 168,662 | 245,000 | 245,000 | 200,000 | (45,000) |  |
| 418 Equipment and Machinery Parts | 4,428 | 8,000 | 8,000 | 10,000 | 2,000 |  |
| 499 Other Supplies and Materials | 0 | 1,000 | 1,000 | 0 | (1,000) |  |
| 790 Other Equipment | 61,684 | 50,000 | 50,000 | 97,000 | 47,000 |  |
| Total Maintenance of Plant | 1,072,048 | 1,296,503 | 1,381,503 | 1,315,721 | 19,218 |  |
| 72710 Transportation |  |  |  |  |  |  |
| 105 Supervisor/Director | 74,104 | 78,000 | 78,000 | 78,000 | 0 |  |
| 142 Mechanic(s) | 84,826 | 100,000 | 100,000 | 105,000 | 5,000 |  |
| 146 Bus Drivers | 821,578 | 912,575 | 882,575 | 900,000 | (12,575) |  |
| 161 Secretary(s) | 22,534 | 23,549 | 23,549 | 24,500 | 951 |  |
| 189 Other Salaries and Wages | 175 | 0 | 30,000 | 30,000 | 30,000 |  |
| 201 Social Security | 75,546 | 82,231 | 82,231 | 85,145 | 2,914 |  |
| 204 State Retirement | 118,522 | 129,587 | 129,587 | 148,809 | 19,222 |  |
| 207 Medical Insurance | 119,011 | 126,956 | 126,956 | 134,573 | 7,617 |  |
| 212 Employer Medicare | 380 | 0 | 0 | 0 | 0 |  |
| 299 Other Fringe Benefits | 18,910 | 20,000 | 20,000 | 20,000 | 0 |  |
| 335 Maintenance and Repair Services - Building | 3,012 | 4,000 | 4,000 | 4,000 | 0 |  |

## Table 411

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 338 Maintenance and Repair Services - Vehicles | 35,896 | 35,000 | 35,000 | 30,000 | (5,000) |  |  |  |
| 355 Travel | 0 | 2,000 | 2,000 | 2,000 | 0 |  |  |  |
| 399 Other Contracted Services | 35,164 | 50,000 | 50,000 | 50,000 | 0 |  |  |  |
| 412 Diesel Fuel | 93,465 | 150,000 | 150,000 | 165,000 | 15,000 |  |  |  |
| 418 Equipment and Machinery Parts | 412 | 2,000 | 2,000 | 2,000 | 0 |  |  |  |
| 424 Garage Supplies | 862 | 3,000 | 3,000 | 3,000 | 0 |  |  |  |
| 425 Gasoline | 23,549 | 35,000 | 35,000 | 45,000 | 10,000 |  |  |  |
| 433 Lubricants | 7,131 | 8,000 | 8,000 | 8,000 | 0 |  |  |  |
| 442 Propane | 45,064 | 60,000 | 60,000 | 60,000 | 0 |  |  |  |
| 450 Tires and Tubes | 13,964 | 15,000 | 15,000 | 15,000 | 0 |  |  |  |
| 453 Vehicles Parts | 68,875 | 90,000 | 90,000 | 90,000 | 0 |  |  |  |
| 511 Vehicle and Equipment Insurance | 65,000 | 75,000 | 75,000 | 80,000 | 5,000 |  |  |  |
| 599 Other Charges | 468 | 5,000 | 5,000 | 5,000 | 0 |  |  |  |
| 718 Motor Vehicles | 23,075 | 0 | 0 | 0 | 0 |  |  |  |
| 729 Transportation Equipment | 160,896 | 0 | 0 | 170,000 | 170,000 |  |  |  |
| Total Transportation | 1,912,419 | 2,006,898 | 2,006,898 | 2,255,027 | 248,129 |  |  |  |
| 72810 Central and Other |  |  |  |  |  |  |  |  |
| 201 Social Security | 0 | 383 | 383 | 0 | (383) |  |  |  |
| 210 Unemployment Compensation | 0 | 20,000 | 20,000 | 10,000 | (10,000) |  |  |  |
| 299 Other Fringe Benefits | 0 | 5,000 | 5,000 | 5,000 | 0 |  |  |  |
| 316 Contributions | 45,880 | 50,000 | 50,000 | 50,000 | 0 |  |  |  |
| 399 Other Contracted Services | 46,675 | 50,000 | 50,000 | 50,000 | 0 |  |  |  |
| 499 Other Supplies and Materials | 19,273 | 15,000 | 15,000 | 7,500 | (7,500) |  |  |  |
| 599 Other Charges | 47,551 | 174,161 | 178,161 | 0 | (174,161) |  |  |  |
| Total Central and Other | 159,379 | 314,544 | 318,544 | 122,500 | (192,044) |  |  |  |
| Total Support Services | 13,201,096 | 14,719,313 | 15,150,849 | 15,318,287 | 598,974 |  |  |  |
| 73000 Operation of Non-Instructional Services |  |  |  |  |  |  |  |  |
| 73100 Food Service |  |  |  |  |  |  |  |  |
| 105 Supervisor/Director | 37,052 | 39,000 | 39,000 | 39,000 | 0 |  |  |  |
| 165 Cafeteria Personnel | 0 | 0 | 0 | 0 | 0 |  |  |  |
| 201 Social Security | 2,756 | 2,984 | 2,984 | 2,984 | 0 |  |  |  |
| 204 State Retirement | 4,391 | 4,712 | 4,712 | 5,214 | 502 |  |  |  |
| 422 Food Supplies | 4,233 | 0 | 0 | 0 | 0 |  |  |  |
| Total Food Service | 48,432 | 46,696 | 46,696 | 47,198 | 502 |  |  |  |
| 73300 Community Services |  |  |  |  |  |  |  |  |
| 189 Other Salaries and Wages | 73,886 | 76,987 | 76,987 | 79,000 | 2,013 |  |  |  |
| 201 Social security | 5,462 | 5,891 | 5,891 | 6,044 | 153 |  |  |  |
| 204 State Retirement | 8,755 | 9,301 | 9,301 | 10,381 | 1,080 |  |  |  |

## Table 412

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 |
| --- | --- | --- | --- | --- | --- |
| 207 Medical Insurance | 15,800 | 17,010 | 17,010 | 16,748 | (262) |
| 499 Other Supplies and Materials | 4,999 | 5,000 | 5,000 | 5,000 | 0 |
| 719 Office Equipment | 0 | 0 | 0 | 0 | 0 |
| Total Community Services | 108,902 | 114,189 | 114,189 | 117,173 | 2,984 |
| 73400 Early Childhood Education |  |  |  |  |  |
| 105 Supervisor/Director | 45,862 | 48,000 | 48,000 | 49,000 | 1,000 |
| 116 Teachers | 192,341 | 232,395 | 232,395 | 235,000 | 2,605 |
| 163 Educational Assistants | 88,149 | 92,000 | 92,000 | 95,000 | 3,000 |
| 189 Other Salaries and Wages | 11,495 | 12,000 | 12,000 | 13,000 | 1,000 |
| 198 Non-Certified Substitute Teachers | 5,000 | 5,000 | 5,000 | 5,000 | 0 |
| 201 Social Security | 22,892 | 29,789 | 29,789 | 30,371 | 582 |
| 204 Retirement | 27,323 | 33,479 | 33,479 | 33,240 | (239) |
| 207 Medical Insurance | 33,500 | 35,175 | 35,175 | 68,359 | 33,184 |
| 355 Travel | 351 | 500 | 500 | 500 | 0 |
| 399 Other Contracted Services | 0 | 0 | 0 | 0 | 0 |
| 429 Instructional Supplies and Materials | 10,488 | 15,000 | 15,000 | 15,000 | 0 |
| 449 Textbooks-Bound | 0 | 0 | 0 | 0 | 0 |
| 499 Other Supplies and Materials | 15,903 | 15,000 | 15,000 | 15,000 | 0 |
| 524 Inservice | 589 | 2,000 | 2,000 | 2,000 | 0 |
| 790 Other Equipment | 26,532 | 15,000 | 15,000 | 15,000 | 0 |
| Total Early Childhood Education | 480,425 | 535,338 | 535,338 | 576,470 | 41,132 |
| Total Operation of Non-Instructional Services | 637,759 | 696,223 | 696,223 | 740,841 | 44,618 |
| 76000 Capital Outlay |  |  |  |  |  |
| 76100 Regular Capital Outlay |  |  |  |  |  |
| 304 Architects | 7,550 | 0 | 87,613 | 0 | 0 |
| 350 Internet Connectivity | 412,794 | 0 | 0 | 0 |  |
| 399 Other Contracted Services | 0 | 0 | 0 | 0 | 0 |
| 706 Building Construction | 0 | 759,000 | 614,279 | 0 | (759,000) |
| 707 Building Improvements | 0 | 585,000 | 772,000 | 0 | (585,000) |
| 790 Other Equipment | 0 | 100,000 | 40,000 | 0 | (100,000) |
| 799 Other Capital Outlay | 490,696 | 135,000 | 110,000 | 0 | (135,000) |
| Total Regular Capital Outlay | 911,040 | 1,579,000 | 1,623,893 | 0 | (1,579,000) |
| Total Estimated Expenditures | 35,268,589 | 39,270,696 | 40,747,829 | 38,171,807 | (1,098,889) |
| 99000 ESTIMATED OTHER USES |  |  |  |  |  |
| 99100 Transfers Out |  |  |  |  |  |
| 590 Transfers to Other Funds | 0 | 0 | 0 | 0 | 0 |

## Table 413

| Account No. Description | Actual 2024-2025 | Original Estimate 2025-2026 | Amended Estimate 2025-2026 | Estimate 2026-2027 | Difference 2026-2027 | CY MOE Total 6,504,712 | PY MOE Total 6,162,133 | 342,579 |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Total Estimated Other Uses | 0 | 0 | 0 | 0 | 0 |  |  |  |
| Total Estimated Expenditures and Other Uses | 35,268,589 | 39,270,696 | 40,747,829 | 38,171,807 | (1,098,889) |  |  |  |
| Excess of Estimated Revenues Over (Under) Estimated Expenditures | (868,701) | (6,170,629) | (6,280,124) | (5,019,542) | 1,151,087 |  |  |  |
| Estimated Beginning Fund Balances July 1 | 13,325,415 | 12,456,714 | 12,456,714 | 10,333,055 | (2,123,659) |  |  |  |
| Fund Balance Audit Adjustment Estimated Ending Fund Balances June 30 | 12,456,714 | 6,286,085 | 6,176,590 | 5,313,513 | (972,572) |  |  |  |

## Table 414

| Baseball Field Drains - EHMS | $20,000 |
| --- | --- |
| Playground Fence - EHMS | $10,000 |
| Tennis Court Repair/Resurface - EHHS, HCHS | $200,000 |
| Roof - EHIS | $175,000 |
|  | Total $405,000 |

## Table 415

| Requested by | Christie Carter | Date | May 5, , 2024 |
| --- | --- | --- | --- |
|  | Name/Title |  |  |
| Approved by | Jina A L Jugji | Date | 5-5-26 |
|  | Principal |  |  |
| Approved by | Belinda | Date | 5-7-26 |
|  | Director of Schools* |  |  |

## Table 416

| Requested by Madelyn Owens/Coach Name/Title | Date | 5/7/26 |
| --- | --- | --- |
| Approved by Jina Principal | Date | 5/7/26 |
| Approved by Belinds audor | Date | MAY 08 2026 |
| Director of Schools* |  |  |

## Table 417

| Requested by madelyn Owens/Coach | Date | 5/8/26 |
| --- | --- | --- |
| Name/Title |  |  |
| Approved by Jina S. Hugper | Date | 5/11/26 |
| Principal |  |  |
| Approved by Belinda audissin | Date | MAY 1 1 2026 |
| Director of Schools* |  |  |

## Table 418

| Knubuly Jummer President; Music City Fundraising | 5/11/2026 |  |
| --- | --- | --- |
| Tax Id# 27-0648747 |  | MUSIC CITY FUNDRAISING |

## Table 419

| Madelyn Avers Cheer | Coach |
| --- | --- |
| School or Group Representative, Title |  |

## Table 420

| School or Group Ina S.Hugi Principal | 5/11/26 Date |
| --- | --- |

## Table 421

| Requested by Hannah Redden /PE Teacher Name/Title | Date April 28,2026 |
| --- | --- |
| Approved by KathyDich Principal | Date 4-28-26 |
| Approved by BelidAM | APR 2 9 2026 Date |
| Director of Schools |  |

## Table 422

|  | ANDREW |  |  |
| --- | --- | --- | --- |
| Requested by (Name/Title): | Chris LAMBERT - SOPTBA" | Date: | 5-7-24 |
| Approved by (Principal): |  | Date: | 5-7-26 |
| Approved by (Director of Schools): | Belinda Ander | Date: | MAY 0 8 2026 |

## Table 423

| Requested by (Name/Title): | Heather Nihoff | Date: | 5/12/26 |
| --- | --- | --- | --- |
| Approved by (Principal): |  | Date: | 5-13-26 |
| Approved by (Director of Schools): | Belinda auden | Date: | MAY 132026 13 |

## Table 424

| Requested by (Name/Title): | Heather Nihoff | Date: | 5/12/26 |
| --- | --- | --- | --- |
| Approved by (Principal): |  | Date: | 5-13-26 |
| Approved by (Director of Schools): | Belinderade | Date: | MAY 1 3 2026 |

## Table 425

| Requested by (Name/Title): | Heather Nihoff | Date: | 5/12/26 |
| --- | --- | --- | --- |
| Approved by (Principal): | Jana Wills | Date: | 5-13-26 |
| Approved by (Director of Schools): |  | Date: | MAY 1 3 2026 |

## Table 426

| Requested by (Name/Title): | Preston Hall | Date: | 4/27/26 |
| --- | --- | --- | --- |
| Approved by (Principal): | Ojana Willis | Date: | 4-27-26 |
| Approved by (Director of Schools): | Balinde Adle | Date: | APR 2 7 2026 |

## Table 427

| Requested by (Name/Title): | Preston Hall | Date: | 4/27/26 |
| --- | --- | --- | --- |
| Approved by (Principal): | Gana Wills | Date: | 4-27-26 |
| Approved by (Director of Schools): | BelindaAde | Date: | APR 2 7 2026 |

## Table 428

| REQUESTED BY | Jan Brop | DATE: | 5-8-26 |
| --- | --- | --- | --- |
|  | Signature/Title |  |  |
| REVIEWED BY: | Regismoth | DATE: | 5-18-26 |
|  | School Principal/Designee |  |  |
| APPROVED BY: | Belinda Anderson | DATE: | MAY 1 8 2026 |
|  | Director of Schools/Designee |  |  |

## Table 429

| Requested by | Kacher Hudgins / Head Coach | Date | 5/4/26 |
| --- | --- | --- | --- |
|  | Name/Title |  |  |
| Approved by | Roby Emerson | Date | 5-4-26 |
|  | Principal |  |  |
| Approved by | BadidsAd | Date | MAY 1 9 2026 |
|  | Director of Schools** |  |  |

## Table 430

| Requested by | Rachel Hudgins / Head Coach | Date | 5/4/26 |
| --- | --- | --- | --- |
|  | Name/Title |  |  |
| Approved by | Proby Emason | Date | 5-4-26 |
|  | Principal |  |  |
| Approved by | Belinda anderan | Date | MAY 0 8 2026 |
|  | Director of Schools** |  |  |

## Table 431

| Requested by: | Colton Huntt /Teacher; Coach | 5/6/26 |
| --- | --- | --- |
|  | Name/Title | Date |
| Acknowledge by: | a | 5/4/24 |
| Approved by: | Genter Bookkeeper | Date 5/6/20 |
|  | Principal | Date |
| Approved by: | Belinde Doll | MAY 1 8 2026 |
|  | Director of Schools* | Date |