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HomeMy WebLinkAboutContract 30762 CITY SECRETARY ' STATE OF TEXAS § CONTRACT NO. 20�G�L § KNOW ALL PERSONS BY THESE PRESENT COUNTY OF TARRANT § RIGHT-OF-WAY USE AGREEMENT TO INSTALL A WELL FOR ENVIRONMENTAL MONITORING This Agreement is entered into by and between the City of Fort Worth, a home-rule municipal corporation situated in Tarrant and Denton Counties, Texas, hereinafter called "City", acting herein through Libby Watson, it's duly authorized Assistant City Manager, and Drake Realty Group, Inc., hereinafter referred to as "User", pursuant to the requirements of Chapter 12.5, Division 4, of the City Code of the City of Fort Worth. NOW THEREFORE, it is agreed as follows: 1. GRANT OF USE A. City agrees to permit User to install and maintain a monitoring well on a City right-of- way, as shown on the map attached hereto as Exhibit "A" which is incorporated into and made a part of this Agreement as if set forth fully herein, for the express purposes of conducting environmental sampling: One (1) monitoring well, designated as "PMW-8", to be located within the City Right-of-Way behind the curb adjacent to the west side of North Main Street at 501 North Main Street. Legal Description: North Fort Worth, Block 9, Lots 1, 2, 3, 4, 45, 46, 47 and 48, Fort Worth, Tarrant County, Texas. B. Users shall submit to the City's Traffic Engineer a Traffic Control Plan for written approval prior to the commencement of any work under this Agreement and shall provide a copy of such approved Traffic Control Plan to the Environmental Manager. C. User shall have no property rights to any City property or right-of-way in which the well is installed and environmental sampling is conducted, and access to the property shall be nonexclusive at the City's discretion. 2. REGULATION OF CONSTRUCTION A. User shall conduct environmental sampling in accordance with federal, state and local laws and regulations. Right of Way Use Agreement for Environmental Monitoring , e J. 1g Drake Realty Group, Inc. ,? - l V _1 B. The construction of the well shall comply with the scope and details of construction of the well that is included in User's Informal Request for Sub-surface Environmental Sampling, dated March 18, 2004 and User's Formal Request for Temporary Access to Install Monitor Well, dated June 7, 2004 and which are hereby attached as Exhibits "B" and "C", both of which are incorporated into this Agreement by reference. The top of the manhole box for the well shall be completed to be at, or slightly above ground level and will be encased in an 8-inch diameter, water-tight steel manhole box along with a minimum 24-inch by 24-inch concrete slab that is sloped back to ground level, in order to protect it and not interfere with everyday use of the land around it. C. User shall ensure that the person who performs the drilling and installation of the monitoring well in conjunction with the environmental sampling, or other party with appropriate oversight of the drilling project, is properly licensed and bonded in accordance with V.T.C.A. Texas Water Code, Chapter 32, to perform work on City's property or public right-of-way. Verification of such licensure shall be made available upon demand by the City. D. User agrees that it shall require any Contractor that performs any aspect of the construction, operation, or maintenance of the Monitoring Well to possess all federal, state, and local licenses to perform all work contracted for, prior to initiation of such work. E. User agrees to use the equipment that it has listed in Exhibits "B" and "C", in the construction, operation, and maintenance of the well. F. User has indicated in Exhibit C that it will utilize the services of Stratacore, Inc., which is a state-licensed environmental drilling firm, to install the monitoring well. If User determines that it will be necessary to contract with another company, User agrees to obtain written acceptance by the City prior to initiation of any drilling or installation. G. User shall maintain and operate the monitoring well. In the event that User determines the need to contract the maintenance and operation of the well with a third party, User shall notify the City of same in writing prior to doing so, and shall obtain written acceptance by the City of such a contract. H. User shall install, maintain, and monitor the well: a. In accordance with the City of Fort Worth's Standard Specification for Street and Storm Drain Construction, which is hereby incorporated into and made a part of this Agreement as if fully set forth herein; b. So that there is minimal disturbance to traffic and to the pe e of the surrounding neighborhoods; ~- Rightof Way Use Agreement for Environmental Monitoring Page of 12 Drake Realty G roa P. Inc. I — _ generated as a result of said monitoring wells, and any other information submitted to the Texas Commission on Environmental Quality, upon request of the City or otherwise, shall be provided to the City at the same time that such information is submitted to Texas Commission on Environmental Quality. B. If environmental monitoring confirms contamination of soil or groundwater within the City's right-of-way or other property, User shall notify the City's Department of Environmental Management of same in writing within ten (10) days after receiving confirmation of contamination. User shall cooperate with the City in mitigating the contamination as necessary. User agrees that in the event contamination is attributable to and resulting from User's activities, such remediation shall be undertaken at User's sole cost and expense in accordance with the procedures and standards set forth by the Texas Commission on Environmental Quality and/or the United States Environmental Protection Agency. 5. RESTORATION OF RIGHT-OF-WAY AND OF CITY PROPERTY A. User shall repair, clean up, and restore all rights-of-way and other City property disturbed during the installation, maintenance, and sampling of wells, and shall warrant the repairs and restoration of such rights-of-way and other property for a period of two (2) years from the date of completion of same. Such repairs, clean up, and restoration shall return the rights-of-way and other disturbed property to substantially the same condition they were in before User's operations began. The determination that the rights-of-way, other City property, and their surfaces have been returned to substantially the same condition shall be made by the City's Director of Transportation and Public Works, or his designee. B. City shall have the right at any time to order and require User to remove or abate any spill, discharge, well equipment, or other facility that is dangerous to life or property. In the event User fails or refuses to comply with the City's order, or if an emergency exists which precludes the City from giving notice to User prior to responding, City shall have the right to remove or abate same at the expense of User, all without compensation or liability for damages to User. C. Within five (5) days of the expiration or earlier termination of this Agreement, User shall remove the well and restore the City's right-of-way and other property in accordance with part A of this paragraph. User's plan to remove the well and restore property is subject to the City's approval, and shall be submitted to City prior to the removal. D. If, within fifteen (15) days' written notice from the City, User fails to remove the well and restore property as required, City may cause the well to be removed and the rights- of-way and any other affected property to be restored without notice to User. User shall pay City for all costs incurred by City in said removal and restoration. i Right of Way Use Agreement for Environmental Monitoring Pa 4 of 1� Drake Realty Group,Inc. it 6. RELOCATION OF MONITORING WELLS A. User, at its sole cost and expense, and upon the City's request (without claim for reimbursement or damages against the City), shall relocate any and all wells so identified by this Agreement, where necessary due to street construction or reconstruction by or on behalf of the City, or due to the construction or relocation of City utility lines, including, but not limited to, water, sanitary sewer, storm drains, street lights and traffic signal conduits, or due to any other work by or on behalf of the City or general public in or under the City rights-of-way. B. If City requires User to relocate its wells pursuant to Part A of this paragraph, User shall relocate or remove its wells upon receiving a written directive from City to do so, within seven (7) days of receipt of said notice, unless otherwise stated in the directive. In the event User fails to comply with the directive, the City shall have the right to relocate or remove or cause the relocation or removal of the wells, and User shall reimburse City for all its costs. C. City reserves the right to permit to be laid and repaired, sewer, gas, water, and other pipelines, cable, conduits, and other similar facilities in, along, over, or under any rights-of-way and other City property occupied by User pursuant to this Agreement. City further reserves the right to require User to remove or relocate its wells to enable use of the rights-of-way or other property by City's franchisees, licensees, and invitees. City, its officers, and employees, shall not be liable to User for any damages, loss or expenses arising out of the performance of such work or the relocation or removal of User's wells; however, nothing herein shall relieve any other person or corporation from liability for damage to User's wells, equipment, and other facilities. 7. TERM The term of this Agreement shall be on the date of its execution by both parties and shall terminate no later than November 30, 2004. In the event contamination is confirmed by Texas Commission on Environmental Quality, and the City through use of the well within term of this Agreement then the term of the Agreement may become a period of five (5) years from the date of its execution, upon written request for amendment made by User to the City and the City's written approval. The amendment request shall state that additional environmental sampling will be necessary, and shall include all pertinent data relevant to, and justifying, extension of this Agreement. Right of Way Use Agreement for Environmental Monitoring agg$ie12 Drake Realty Group, Inc- - a - 8. INDEMNIFICATION A. Definitions. In this paragraph, the following works and phrases shall be defined as follows: 1. Environmental Damages shall mean all claims, judgments, damages, losses, penalties, fines, liabilities (including strict liability), encumbrances, liens costs, and expenses of investigation and defense of any claim, whether or not such claim is ultimately defeated, and of any good faith settlement of judgment, of whatever kind or nature, contingent or otherwise, matured or unmatured, foreseeable or unforeseeable, including without limitation reasonable attorney's fees and disbursements and consultant's fees, any of which are incurred as a result of the existence of a violation of environmental requirements pertaining to the wells, and including without limitation: a. Damages for personal injury and death, or injury to property or natural resources; b. Fees incurred for the services of attorneys, consultants, contractors, experts, laboratories and investigation or remediation of the monitoring wells or any violation of environmental requirements including, but not limited to, the preparation of any feasibility studies or reports of the performance of any cleanup, remediation, removal, response, abatement, containment, closure, restoration or monitoring work _required by any federal state or local_governmental agency or political subdivision, or otherwise expended in connection with the existence of such monitoring wells or violations or environmental requirements, and including without limitation any attorney's fees, costs and expenses incurred in enforcing this contract or collecting any sums due hereunder; and c. Liability to any third person or governmental agency to indemnify such person or agency for costs expended in connection with the items referenced in subparagraph (b) herein. 2. Environmental requirements shall mean all applicable present and future statutes, regulations, rules, plans, authorizations, concessions, franchises, and similar items, of all governmental agencies, departments, commissions, boards, bureaus, or instrumentalities of the United States, states, and political subdivisions thereof and all applicable judicial, administrative, and regulatory decrees, judgments, and orders relating to the protection of human health or the environment, including without limitation: Right of Way Use Agreement for Environmental Monitoring PagEtiVf`12,, Drake Realty Group, Inc. a. All requirements, including, but not limited to, those pertaining to reporting, licensing, emissions, discharges, releases, or threatened releases of hazardous materials, pollutants, contaminants or hazardous or toxic substances, materials, or wastes whether solid, liquid, or gaseous in nature, into the air, surfacewater, groundwater, stormwater, or land, or relating to the manufacture, processing, distribution, use, treatment, storage, disposal, transport, or handling of pollutants, contaminants, or hazardous or toxic substances, materials, or wastes, whether solid, liquid, or gaseous in nature; and b. All requirements pertaining to the protection of the health and safety of employees or the public. B. General Indemnification. USER DOES HEREBY RELEASE, INDEMNIFY, REIMBURSE, DEFEND, AND HOLD HARMLESS THE CITY, ITS OFFICERS, AGENTS, AND EMPLOYEES, FROM AND AGAINST ANY AND ALL LIABILITY, CLAIMS, SUITS, DEMANDS, OR CAUSES OF ACTIONS WHICH MAY ARISE DUE TO ANY LOSS OR DAMAGE TO PERSONAL PROPERTY, OR PERSONAL INJURY, AND/OR DEATH, OCCURRING AS A CONSEQUENCE OF THE USER'S OPERATIONS UNDER THIS AGREEMENT, WHEN SUCH INJURIES, DEATH, OR DAMAGES ARE CAUSED BY THE SOLE NEGLIGENCE OF USER, ITS OFFICERS, AGENTS, EMPLOYEES, OR CONTRACTORS, OR THE JOINT NEGLIGENCE OF USER, ITS OFFICERS, AGENTS, EMPLOYEES, OR CONTRACTORS AND ANY OTHER PERSON OR ENTITY. C. Environmental Indemnification. USER DOES HEREBY RELEASE, INDEMNIFY, DEFEND, REIMBURSE, AND HOLD HARMLESS THE CITY, ITS OFFICERS, AGENTS, AND EMPLOYEES, AGAINST ANY AND ALL ENVIRONMENTAL DAMAGES AND THE VIOLATION OF ANY AND ALL ENVIRONMENTAL REQUIREMENTS RESULTING FROM USER'S OPERATIONS UNDER THIS AGREEMENT WHEN SUCH ENVIRONMENTAL DAMAGES OR VIOLATION OF ENVIRONMENTAL REQUIREMENTS ARE CAUSED BY THE ACT OR OMISSION OF USER, ITS OFFICERS, AGENTS, EMPLOYEES, OR CONTRACTORS, OR THE JOINT ACT OR OMISSION OF USER, ITS OFFICERS, AGENTS, EMPLOYEES, OR CONTRACTORS AND ANY OTHER PERSON OR ENTITY. D. The obligations of the User under this paragraph shall include, but not be limited to, the burden and expense of defending all claims, suits and administrative proceedings (with counsel reasonably approved by the City), even if such claims, suits or proceedings are groundless, false, or fraudulent, and conducting all negotiations of any description, and paying and discharging, when and as the same become due, any and all judgments, penalties or other sums due against such indemnified persons. Right of Way Use Agreement for Environmental Monitoring Page 7 of 12 Drake Realty Group,Inc. E. Upon learning of a claim, lawsuit, or other liability which User is required hereunder to indemnify, City shall provide user with reasonable timely notice of same. F. The obligations of the user under this paragraph shall survive the expiration or termination of this Agreement and the discharge of all other obligations owed by the parties to each other hereunder. 9. INSURANCE A. During the term of this Agreement, User shall maintain the following insurance coverage and the respective policies thereof shall cover all risks related to the use and occupancy of the right-of-way and other City property and all other risks associated with this use Agreement: 1. Commercial General Liability Insurance: $1,000,000.00 per occurrence combined single limit for bodily injury and property damage. $2,000,000.00 aggregate. 2. Environmental Impairment Liability/Pollution Liability: $1,000,000.00 minimum per occurrence 3. Automobile Liability Insurance: a. $1,000,000.00 each accident b. Coverage shall be on "any auto", including leased, hired, owned, non-owned and borrowed vehicles. B. User shall require its contractors to maintain the following insurance coverage: 1. Commercial General Liability Insurance: $1,000,000.00 per occurrence combined single limit for bodily injury and property damage 2. Automobile Liability Insurance: a. $1,000,000.00 each accident; or $250,000 Property Damage and $500,000 Bodily Injury per person per occurrence. Right of Way Use Agreement for Environmental Monitoring Page 8 of 12 Drake Realty Group, Inc. b. Coverage shall be on "any auto", including leased, hired, owned, non-owned and borrowed vehicles. 3. Workers' Compensation Insurance a. Statutory limits for Workers' Compensation; and b. Employer's Liability: $100,000.00 each accident/occurrence; $100,000.00; and disease-each employee; $500,000.00 disease-policy limit. C. All policies shall contain the following endorsements: 1. City shall be named as an additional insured on all policies in respect to the monitoring wells, environmental sampling, and the operations under this Agreement; 2. City shall be notified not less than thirty (30) days prior to the cancellation, or non-renewal of, or material changes to, said policies; and 3. All policies shall be endorsed with waivers of subrogation in favor of the City. D. The insurers for all policies must be approved to do business in the State of Texas and be currently rated in terms of financial strength and solvency to the satisfaction of the Risk Manager. E. The insurers for all policies must be licensed/approved to do business in the State of Texas. Except for workers' compensation, all insurers must have a minimum rating of A: VII in the current A.M. Best Key Rating Guide or have reasonably equivalent financial strength and solvency to the satisfaction of the Risk Manager. F. Programs of self-insurance in lieu of commercial insurance policies shall be assessed, and as appropriate, approved by the Risk Manager; and, as applicable, pre-approved by the Texas Department of Insurance. All such approvals must be completed and/or received by City prior to execution of this Agreement. G. The deductibles or self insured retention (SIR) affecting the insurance coverage required shall be acceptable to the Risk Manager, and in lieu of traditional insurance, alternative coverage maintained through insurance pools or risk relations groups must be also approved. Right o W Use A reement or Environmental Monitoring a MLt 8 f ay 8 f 8 ���Drake Realty Group, Inc. H. User shall provide City with certificates of insurance documenting User's and User's contractor's coverage as outlined above prior to commencing any operations under this Agreement. Certificates shall be submitted to the Director of Environmental Management. I. Any failure on the part of the City to request documentation of insurance required herein shall not be construed as a waiver of the requirement for same. J. The City may revise insurance requirements specified herein, at its sole discretion, to protect its interest, giving ample prior notice to User. 10. CONSIDERATION In consideration for the use herein granted, User agrees to pay City a fee in the amount of $250.00 (two hundred, fifty dollars, and no cents), which is due and payable upon User's acceptance of this Agreement. Such fees shall be used by the City to offset the cost of regulating and monitoring the use agreement activities specified herein. 11. NOTICE Any notice or communication required in the administration of this Agreement shall be sent as follows: If to City: If to User: Mr. Brian Boerner, Director Dept. of Environmental Mgt. Mohammed Kamal , PE City of Fort Worth Koos & Associates , Inc. 10410 Markison Road 1000 Throckmorton St. Dallas , Texas 75238 Fort Worth, TX 76102-6311 Phone : ( 214 ) 341-5377 12. TERMINATION A. In the event User defaults in the performance of any of its obligations under this Agreement or misrepresents to the City a material fact, the City shall have a right to terminate this Agreement upon giving the User written notice describing the breach or omission in reasonable detail. The User shall have a ten (10) day period commencing upon the date of notice of default in which to effect a cure. If the User fails to effect a cure within the aforesaid ten (10) day period, the City may terminate this Agreement by written notice to User. Right of Way Use Agreement far Environmental Monitoring Fa Dra'reRealty Group, Inc. a� �,;qU B. Upon termination, the User shall be released from all contractual obligations to the City, except that all of User's duties, obligations, and liabilities set forth in Paragraphs 4, 5, and 8 shall remain in effect as indicated herein. The requirements imposed under Paragraph 4, "REPORTING REQUIREMENTS AND MITIGATION OF CONTAMINATION", shall survive for a period of two (2) years after the termination of the Agreement, or until such time that any contamination which may have occurred has been mitigated to the satisfaction of the City, and the Texas Commission on Environmental Quality, whichever period is longer. The requirements imposed under Paragraph 5, "RESTORATION OF RIGHT-OF-WAY AND OF CITY PROPERTY", shall survive for two (2) years after the termination of this Agreement, or until such time that the property affected is restored to its original condition and such restoration fully complies with Paragraph 5 of this Agreement, whichever period is longer. The duties, obligations, and liabilities set forth in Paragraph 8, "INDEMNIFICATION", shall survive the expiration or termination of this Agreement. 13. GOVEP.NING LAWS It is mutually agreed and understood that this Agreement is made and entered into by the City and User with reference to the existing Charter and Ordinances of City and the laws of the State of Texas, and of the United States, which govern all matters affecting this Agreement, and User agrees to comply fully with all the provisions of same. 14. ENTIRETY This Agreement constitutes the entire agreement by the parties hereunder, and any prior or contemporaneous oral or written agreements shall be void. This Agreement may be amended or changed only by the written agreement of both parties. 15. SEVERABILITY In case any one or more of the provisions contained in the Agreement shall for any reason be held to be invalid, illegal, or unenforceable in any respect, such invalidity, illegality, or unenforceability shall not affect any other provision of this Agreement, and this Agreement shall be construed as if such invalid, illegal, or unenforceable provisions had never been contained herein. 16. VENUE Venue of any suit or cause of action under this contract shall lie in Tarrant County, Texas. Right of Way Use Agreement for Environmental Monitoring PFIj- �i2r =. Drake Realty Group, Inc. tj c _ C 17. AUTHORIZATION The undersigned officer and/or agents of the parties hereto are properly authorized officials and have the necessary authority to execute this Agreement on behalf of the parties hereto, and each party hereby certifies to the other that any necessary resolutions extending such authority have been duly passed and are now in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Agreement in triplicate originals in Tarrant County, Texas. DRAKE REALTY GROUP, INC. CITY OF FORT WORTH BY: Libby WWon TITLE: Pu����cQa,1�' Assistant City Manager Date Signed: — —Q 7 Date Signed: /04t, Xy CORPORATE SEAL: APPROVED AS TO FORM Assistant rity Attorney WITNESS: ATTEST- 1 anlLeL__', (Signature) 4 Marty endrix, City Secretary Print Name: No M&C required CRPo9.ol.o4vl Right of Way Use Agreement for Environmental Monitoring i Pgge 2-of 12 Drake Really Group, Inc. Exhibit A. I I I I - I I I � I w w C Co j z m Z MW-6 MW-5 O Co O N I O U Z j MW-4 O PMw-8 : F ; I I Former USTs location ,I I -----j O MW-3 MW-2 O MW-1 0 24" Sewer Line ( MW-70 LEGEND O Existing Monitoring Well ■ Proposed Monitoring Wells SITE DRAWING with Vicinity DATE SCALE Former Texas Rail Joint-Facility H o -- - 500 North Main Street 06/08/04 Fort Worth, Texas LPST ID # 113594, Facility ID # NA Koos & Associates, fnC. : q llqlqxa KOOS & ASSOCIATES. INC. ENGINEERING G EN.'!{ ilr'r�:r1i_N7AL f�ON�t..11_TA7VT5 March 18, 2004 Via Fax: (817)392-6359 Mr. Chris Breitling Environmental Management The City of Fort Worth 1000 Throckmorton Street Fort Worth, Texas 76102 Re: Access to the City Right-of-Way in order to install a monitoring well in relation to the gasoline release at the former Texas Rail Joint property located at 500 N. Main Street, Fort Worth, Texas; LPST ID 113594& Facility ID#None Dear Mr. Breitling: As we discussed over telephone this afternoon, we are required to install a -iici on':ng well in the City Right-of-Way of Main Street near the intersection of 4`h Street in order to define the groundwater contamination resulted from a release of gasoline at the above referenced site. I he installation of this well was requested by the Texas Commission on Environmental Quality (TCEQ) recently in a Corrective Action Response Form (CARF) dated January 4, 2004. Subsequently, following TGEQ Instructions, Koos &Associates, Inc, (KAI) submitted a proposal to install a monitoring well on January 22, 2004. The TCEQ approved this well crn March 4, 2004 by a CARF. Due to presence of the abandoned Brewery building, the well will have to be installed in the City Right-0f-Way on grass between the sidewalk and the street curve. KAI requests access to the City Right of Way so that the aforementioned activities can be completed in a timely manner. For your convenience, a site drawing is attached to show the approximate location of the proposed monitoring well. The proposed well will be 25 feet deep and constructed with a 2-inch diameter PVC pipe and screen. The surface will be completed with a flush mount inside a 2' by 2' Concrete pad. It appears that it will be necessary to close one lanc of Itu, suultl h(RJIId Main Street. Lane closure will be done by following appropriate traffic control plan which will be developed by following Texas Manual of Traffic Control Devices. KAI sincerely appreciates your cooperation in this matter. Should you .nave any questions, please feel free to contact us at(214)341-5377. Sincerely, Koos& Associates,Inc. Mohammed S. Kamal, PE Project Manager Enclosre Site Drawing TCEQ CARF dated January 15, 2004 TCEQ CARF dated March 4, 2004 l I _ 10d10 MAFIKISON V704,0 OALLAS. TEXAS -7123E3-1G130 • f21a1 349.5377 FAX t21 Ali 3-:1 ?-, './,VVw�h;C)QSINC,GCJM ZO 39vd S31VI00SSV QNC S00>i ObSLZbEbZZ 8Z=91 bOOZ/81/EO 20"Water Line` 24" Storm Sewer Line , I I I 11 I I i II I I W Ij W I i I• � UJI W I I Q !1 N I I II • � I I jW ! U Z I MW-5 i l O PMW-7 I I C) ■ j ' f i O f Ii Q MWS Former UST9 facstlon I I PMW-9 I (ii"•ii` � � I 1 � r1111pMW-3 MO z i I MW-1 O ! i I I PMW-8 24- Sewer Line ■ f 4"Wafer Lino LEGEND O Existing Monitoring Well ■ Proposed Monitoring Wells SITE DRAWING H ; DATE SCALE Former Texas Rail Joint Facility 0 500 North Main Street 03/18/04 Fort Worth, Texas LPST ID # 113594, Facility ID # NA Koos & Associates, Inc. Z0 39bd 53iVIDOSSd CNV SOOM 0G5LZbEb16 86=91 t,006/8Z/E0 Exhibit C: KOOS & ASSOCIATES, INC. ENGINEERING ENVIRONMENTAL CONSULTANTS June 7, 2004 Mr. Chris Breitling Environmental Management The City of Fort Worth 1000 Throckmorton Street Fort Worth, Texas 76102 Re: Formal request to gain access to the City right-of-way in order to install a monitoring well in relation to the gasoline release at the former Texas Rail Joint property located at 500 N. Main Street, Fort Worth, Texas; LPST ID 113594 & Facility ID # None. Dear Mr. Breitling: We have received your approval of our informal request to install a monitoring well at the above referenced site. As you requested, please consider this as our formal request to gain access to the City right-of-way. The following provides the requested information: Documentation showing efforts to locate wells other than� on city property: The TCEQ requested that the monitoring well must be placed in a location which is directly west of the former Underground Storage Tanks (USTs) location. The property located Westside of the site across Main Street was completely occupied by the existing building. Therefore, we believe the only logical place to install a monitoring well would be the right-of-way in close proximity to the former brewery building. The well will be installed in grass area between sidewalk and the curb of Main Street. A map showing all previous well and/or sampling locations. including those on the subject rp operty: A map which shows the locations of all existing and proposed monitoring wells is attached. Documented contacts with the surrounding utilities: Only Digtess was notified on March 24, 2003 and will be updated prior to begin drilling activities. A copy of the fax that confirms the Digtess notification is attached. According to the confirmation fax, Digtess notified the following utility companies: TXU-FUEL-STS, LONE STAR XCHG, ONCOR-E/TXU-G-S, TXU COMM, ONCOR-FTW No other utility company was notified. Detailed information about the proposed Well Installation: A map showing the location of the proposed monitoring well is attached. The well will be located on grass between sidewalk and the street curb on the west side of Main Street. The proposed well will be located directly to the west across Main Street from the former USTs on the subject property. The well will be a 2-inch diameter 25-foot deep well constructed with schedule 40 PVC pipe. A truck mounted drilling rig will be used to install the monitoring well. The surface will be completed with a flush mount surrounded by concrete pad. It will be necessary to close one south bound lane of Main Street during drilling. Traffic control dleJices will be provided by Dallas Lite & Barricade. The drilling activities will be provided by Strartcore, Inc. and the sampling, operation and maintenance of the monitoring well will be conducted by Koos & Associates, Inc.. The contact information for the drilling company and Koos &Associates, Inc. is as follows: Drilling Company: Stratacore, Inc. Contact: Brad Eskue Phone: (817) 675-5090 Address: 5524 Midway Road, Suite 3; Ft. Worth, Texas 76117 10410 MARKISON ROA❑ • OALLAS, TEXAS 75236-1650 • (214] C41-5377 • PAX(21a) 341-7540 • WWW.K00SINC.00M Environmental Consultant: Koos &Associates, Inc. Project Manager: Mohammed S. Kamal, PE Phone: (214)341-5377 (office); (214)769-2138 (mobile) Address: 10410 Markison Road, Dallas, Texas We expect that the well will be in use for at least 18 months. Once the site closure is obtained from the TCEQ, the monitoring well will be plugged and abandoned following the TCEQ and Texas Water Well Drillers Board regulation. All monitoring wells at the site will be sampled quarterly. It will not be necessary to close any lane during sampling of the proposed monitoring well. Detailed Information of the proposed samplina: A total of three soil samples will be collected from the monitoring well boring. Samples will be collected at 0-2.5', 5-15' and total depth of the boring. We expect to complete the drilling within four hour period. Drilling will be started at 9:30 AM and will be completed by 12:30 PM. One south bound lane of Main Street will be closed drilling. Lane closure will not be necessary during development, purging and sampling of the monitoring well. All sampling activities will be conducted by Koos & Associates, Inc. personnel under the supervision of Mohammed S. Kamal. The contact number has been provided previously. Responsible party contact information: Name: Drake Realty Group, Inc. Address: 5524 Midway Road, Suite 3, Fort Worth, Texas Contact: Chris Johnson Title: President Phone: (817)989-7466 Koos & Associates, Inc. sincerely appreciates your cooperation in this matter. Should you have any questions, please feel free to contact us at (214)341-5377. Sincerely, Koos & Associates, Inc. Mohammed S. Kamal, PE Project Manager Enclosre Site Drawing Digtess Confirmation Fax Areal Photo Site Vicinity Map 20" Water Line--. in I• 24" Storm Sewer Line l I� I I II I I i II i ' • II I I w j I i Ij � W ! Ijcl) W I I iI a cn ' , 11 mIjw m - I Mw-r) Mp 6 ` I I W m I p N O 0 I 0 Z j MW-4 PMW-8 II Former USTs location I ! I ' I O MW-3 MW-2 I I MW-1 I I I O ! I ; II • I 24" Sewer Line I MW-7 O ; 4" Water Line LEGEND p Existing Monitoring Well ■ Proposed Monitoring Wells SITE DRAWING H DATE SCALE Former Texas Rail Joint Facility 0 50' 500 North Main Street 06/08/04 Fort Worth, Texas LPST ID # 113594, Facility ID # NA Koos & Associates, Inc. To X;tX (34441 SPIE .L �.: g � 5 G. G. SEQUENCE NUMBER 0526 CDC = XXX Texas Excavation Safety System * ROUTINE MESSAGES Sent to Offices ) as follows DTXU-FUEL-STS °ONCOR- E/TXU-G-S OSM&P-F o TXU COMM ONCOR - FTW * LONE STAR XCHG Locate Request No. 0040785006 Prepared By KRISTEN CROUSE On 18-MAR-04 At 1955 MapRef : Grid: 324530097200A Footprint : D02 Location: County: TARRANT Town : FORT WORTH Address : 50000 N MAIN ST Beginning Work Date 03/24/04 Time of Day: 08 : 00 am Duration: 01 DAY Fax-A-Locate Date at Excavation Type SEISMIC Nature of Work DRILLING Blasting ? NO 48 Hr Notice ? YES White Line ? NO Digging Deeper Than 16 Inches ? YES Person Calling : MOHAMMED KAMAL Company Name KOOS & ASSOCIATES , INC . Work by KOOS & ASSOCIATES, INC . For DRAKE REALTY Person to Contact : MOHAMMED KAMAL Phone No. ( 214 ) 341-5377 / ( 214 ) 765-2138 ( Hours: 08 : 00 am/08 : 00 am ) Fax No. ( 214 ) 341-7540 Email : MKAMAL@KOOSINC. COM Remarks : MARK ALL UNDERGROUND FACILITIES AS NECESSARY Near Intersection: 4TH ST WORK DATE: 03-24-2004 08 : 00 AM EXPLOSIVES: N WHITE PAINT : N 16 INCH : Y MAPSCO: GRIDS : PLEASE LOCATE THE CITY RIGHT OF WAY OF SOUTH B OUND MAIN STREET BETWEEN FORMER BREWERY BUILDING AND THE CURVE OF MAIN STREET . 143684. XML MKAMAL@KOOSINC. COM Map Cross Reference : MAPSCO 62, V FaxBack Requested ? YES Lone Star Xref : 040785006 to 912143417540 at 18 : 34: 06 on FRI , 03/ 19/04 for XXX #0526 � \ § CL \ } G � z § \ U > d = o \ \ & \ U CL U7 / 0 < a cla } - � ca /} : L.L 2 / § / \ } CD / \ § / E ( U u u 75 \ a A 9 < \ 2 2 _ \ \ o ± - \ , \ - , � .� \_ I',.a-, � �C* 0c, 0" !cr L:r -.") - , p'•' Lac_ r;-_ SEG'JEN;,F NJMBEF; 0116 CCC - TCO texas cxcavatic.r. SaFety Sys' a,n I-G0T _NC * MESSAGES Sent tc O'' fi�e (si 59 foi _vwyi-s em 'XU-FUEL-STS ONCOR--E/'Xu-C-S St,"P- F TXU CCW CNCDR - FTW LONE STAR X7H5 Lc•catE Request Nc. 048785ZOE '45� z• f�'rupared 8y KRISTEN CRCrJSE MaaR�f Grid: 3245300972028 Factprint: 002 Loc.atior: County: T;�,RRAN- Town: 7OR7 WORTH 14 Addraea: 500 N M?LN ST rieglnninS Work Jate 03/2410-'1 Ti;-:a of Dny: OP:00 am Our-wt-_r: 01 CAi Fax-A--Locato Date Excavation Type SEISMIC Nature cf 'WcrK DRILLING Bla,tinc ? NO 48 Hr- Notice ? YES ,Jhite Line ? NO Digging DEe;j,--.- Than 1.6 inches ? YES Ferrcn Calling MOHIWEO KAYAL Compa:I'y Name K^uS & ASSr�rTa FC :,y.C, Boric ey KDOS 13 ASSOCIATES, :.UC. ro - DRAKE REALTY ?Creon lc Contac- . MOHAW:vEr'l K;NAL Phone No. t 2714 i3-41 --5377 / ! �_< )163-2132 ( Hc;(-jr-s- 08: 0(; ar.`/O8: 00 am i rr2x No. 1 2_4 )341-75.40 Fm2 is MKAMAL@K00S?NC. C3M 2ema-ks MARK PLL UNCEFGROUNO =Ae'_ , r1_S RS NECESSARY Near :ntersecticn: /-T!^ ST ,vuR{ DATE: G.3- 24-200a 08:00 AM EXP—,CSiVES: N WHTT= PAINT : N 16 INCH r' Mt)PSC0: GRIO`r: ~'LEASE ! OC4TE IHE CITY R-'GHT OF WAY 0 SOUTH S : JN3 MAIN STREET BETWEEN FDRMER. BR W_tiY 3L17LDING ANO THE CURVE OF MAIN TRF�T . 143'b64. XNfl 40MAL@K00SINC. CCN1 At ? Cro:s Rer4are-icc : MAPSCO 52, V i =a36ack RequasteJ 7 YES Lorne St a' Xre 14C78SOOS to 9i9-4678S7559 at 22: 56: 1 :1 on rHJ. 03%18/0-4 `cr TiD #0' 16 f V� 03/1812UCI T"U 23:01 f:S:RS 'No 6831; q..ol: 1i?;J;3�_ 7t T hi i,_.`t=, =ti Page 1 of 1 r St III 00 eo s s. w� wa y ti� 46 �. , i i i i i i i i F.. i W W i a: Uca i m i z Z MW-5 MW-6 0 O O a N O , U i Zi MW-4 O PMW-8 ; I-----j i Former USTs location i 0MW-3 MW-2 O MW-1 I' O MW-70 — — — .......................................................... r_rr LEGEND O Existing Monitoring Well ■ Proposed Monitoring Wells SITE DRAWING with Vicinity H DATE SCALE Former Texas Rail Joint Facility , 500 North Main Street 06/08/04 Fort Worth, Texas LPST ID # 113594, Facility ID # NA Koos & Associates, Inc. A � CERTIFICATE OF LIABILITY INSURANCE "9,2;104Y' PRIDOUnER THIS CERTIFICATE IS ISSUED AS A MA17ER OF INFORIVIAT10N Wm, Rigg Co, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MEND OR Ft. Main St, Suite 2-5 ALT99 THEN OVER FICATE DOES AFFORbrtD 9Y THMPOLICf S BELOW. Ft. Worth. TX 78102-5333 917-820-6100 INSURERS AFFORDING COVERAGE tN9URE6 INSURER A: EVGItt6t lnd�'Pnnily 1136 campany IN'Pinnacle Sciences, Inc, - -- -- -_. - � Q`' •-• - yunell o: _Uniti.n Strata Core, Inc drake Realty AgUReRc_ Texas Mutyal Insurance Co 6624 Midway Rd., Ste. 3 - Fort Worth TX 76117 INsuPLR e,_ _ ,. I Jt`SURER F' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW mAVE BEEN 16SJ,:1 To THE INSVFIED NAMED ABOVE FOR THE POLICY PEAI01) INAICATED,NOTWITMSTANDING ANY RIQUIREMENT, TEAM OR CONDITION OF ANY CONTR;,(-f DR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 16BUED OR MAY PERTAIN,THE INSURANCE AFFORDED by THE POLICIE;. 1)i SCRIBED HEREIN 16 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN AIDU'a BY PAID CLAIMS. A R . _ _ .. -... i'rrf&Cf"e ' v "-.PBO-P 1NBURANCE —_P_OUCv N—UMB4F_ KE IMMIARtyfr ioLIMiT-3 OENEAL LIABILITY 4COOD3682041 3/18t04 3118/05 EACH OCCLQnffYCE_ 1—_:903000 _ X�COMAIE9CIAL GL, LIABflliti l LIRE DAMAGE JAnY ono Ill e, 5 �- SOgOG CLAlMG 1dADG L X ,OCCUR f INCLUDES 61-ANKH i MEO EXP(Any one pp�naff S I POLLUADDL.INSUREDS & L.PERSONAL&AW INJUWY TtQN a 100000 __ X - I A I —._ 11(• PAOF.WIA VVAIVERS OF SUB t GENERALAGfiREGATE- 3 MPiOP AGG 2C 000❑ 3 O�N'L AQGRE:IAT I?R IT APPROnLJCTS IPLiF6 PER: � .-- I �_.. .,_CU.. .... ._.+.._.. POLIcr I 1(hoc li 9 AUTOMOBILE LIABILITY 7850972 31 8104 3!18105 CoN,aweo B N5LE LJW1 s I tE�accdci�tl 1CUCCLC _I ANY AUTO --. ALL OWNED AUT Z;4 !l I I DOOILY IWURY 1 [Pei W(.onl I X j SCHEOULCO AUTOS I X HIRED AUT06 ' l 8001LT INJII111 I � !Per acc.t19n11 i PROPERTY DWV AGE S IPte 6wCiL�?nl! AOONLY GAR1AOt•LLAPWTY 1VTton[_CIflEN" S I ANY AUTO I OTMER YHAN EA AC ► I AUTO ONLY. AGO 9 TXCESti L ABil1TY F_ACN OCCUHPENCE I__I OCCUR I l CLABdB ro�GOE A06REGATL •._. _.1 9 .._.. I q I RETENTION 3 _ IWC 8YA1U. OYw tr ,wo■XFJIe coMP6MCAnoN uAlb 7SF i 1 wBd600 f 3/14!04 311 a;'QS I.X;TOgv_LIk1lTs; _I_ER..� . ...__ _ - ERIPLOYERS'UABIUTY , [E.L.EACH ACCIDENT _ 9 1 QOOOTj I•E.L.016gASt:E_A EMPLOYEE1 9 1003700_ I E.L.OISEA35 PCLfCv LIMIT 8 10n00 ❑ f OTHEN DEBCRIPT40N OF OPERATIONS/LOCATIONSIYEHICLESIDCCLU010Nk ADDI'0 BY ?iDO 113EM£NT/6Pl1:4AL PROV;3IOW DpAkE REALTY, INC. IS nN ADOITtONAL NS JRED UNDER THIS POLICY. THE CERTIFICATE HOLDER IS ALSO AN A)') T;0NAL INSURED UNI)EFr THIS POLICY FAX 817.392-6359/817-989-7467 CERTIFICATE NOLDEFi X `AD0111DNAL INSURED; INBLR 3 l'TTER: CANCELLATION $MOULD ANT III TME ABOVE t7ESCR1RtiD P041�fE5 9C GAW=>I,W IKP9AE THE L901AAY1oM CITY OF FOIST WORTH:ATTN: DATE TH[AEOP,THE ISSU'"INSUPER Yr111 MDEAVON TO MAIL 10 DAYS wwnEN 44" BUT T. O 70 C.BRIETLIlVG;ENVIf�ON, N1GMT.DEP1' NOTICE� NOTHe DeLgATIIJNI OR LIAHIUTY Of ANT KIND EUrON THE n+cu EA ITS AOkNTB OR 1000 'CHROCKMORTON ST REPRESQMTATIVEB. FT. WORTH, TX 76102 AVY1040RIz6D"R q�lY ACORO 26-5{7197} 95 I,�ACOAD CORPORATION 1881 CZL-4 Z040'd VN '00 Doll V-HH10169611.96.01 09;B 70. 2 d3S 0\ O ACORD. CERTIFICATE OF LIABILITY INSURANCE DArE912 104YI PRODUCER THIS CERTIFICATE IS ISSUED AS A MAttER OF INFORMATION Wm. Rigg Co. ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE 777 Main St. Suite C-50 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR R. Worth. TX 76102-5333 ALTER THE COVERAGE AFFORDED NY THE POLICIES BELOW. __ ... 817-820-8100 i INSURERS AFFORDING COVERAGE T�- INSURED INSURER A. - Evarest indemnity Ins CmMa, _ Pinnacle Sciences, Inc. -------- --- ... � -"- Strata Core, Inc;Drake Realty I IlLsuaell e:- _Unitrin 7f -- IWAMER C: Texas Mutuel Insmance CO 5524 Midway Fid_, Ste. 3 II --- - --- -•_ Fort Worth TX 76117 INSURER D. _-- -- —- -^- _—_- INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED t0 THE:INSURED NAMED ABOVE FOR THE POLICY PERIOb INDICATED,NOTWITHSTANDING ANY REOUIRI_MENT, TERM OR CONOrrION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED Op MAY PERTAIN,tHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE;TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN9N? empf LTRTYRE Of fNBUNANCE-� -— ?OUCY MIM9ER ro40Y iet'PINIM,M-na" !!NITS -- A WNERAL UAMLITY 400003882041 3/10104 1 3118/05 ',EACH DCCIIIItIENCE _ :!_ 1000000 X COMMERCIAL GENERAL LIABILITY i I FIRE DAMAGE IAM.Iie1 :6 54000 r - ]CLAIMS MADE L x l OCCUR INCLUDES BLANKET I MED EXP Wvj ons ImmCORI is _ 5000 X POLLUTION ADDL.INSUREDS& PERSONAL&ADV INJURY '; f IoOGoQo, ff X PROP_LIAB. —_ WAIVERS OF SUB, I GENERAL AGGREGATE- i _-Y 2000000-, G' 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS CUMPR7P AGG f a00000D x. POU'_' ►. - r_. LDC I I_.-_- - ------- -- -"--.- - 9 'AUTONOBILE LABILITY 7850972 1 3118104 3/1 BIDS I COMBINECI EryGLE UFAT fEa a¢idclnl I 1000010 ANY AUTO ALL OWNED AUTOS j I BODILY INJURY I f X'SCHEDULED AUTOS i i I�� 1_ ---•_' ._... --- X_ HIRED AUTOS I BODILY BWBJRY I (Per aaeid"41X NON•OWNED AUTOS PROPERTY DAMAGE ; 7 1 We aeeidenU GARAGE LIABILITY I j AUTO ONLY EA AC_CIDENr f ---- ANY AUTO ( I OTHER THAN Ea ACC I -- I AUTO ONLY: G EICCESB LIAe1UTY I ;EACH OCCURRENCE _- -�OCCUR .j CLAtUSMADE I `AGGREGATE RETENTION f I WC STA1'U- IOTM- C WO...A.DOMP6NiATtONAND TSF1 128A620 3114/04 3/14/OS _X j TDAV LIMITS j _I_ER.i --- EMPLOYENS'LIABILITY � E.L EACH OCCIDENT ! .,••_ 10 I j E.L.DISEASE•EA EMKQ_YEE -- I 9 E.L.DISEASE-POLICY LIMIT II )000000 OTWN I I I I DESCRIPtION OF OPERA110N5lLOCATIONSIVE4NICLEEIEXCLUS10NS ADDED BY ENDONSEMENTISPECIAL PROVISIONS DRAKE REALTY,INC.IS AN ADDITIONAL INSURED UNDER T1415 POLICY. THE CERTIFICATE HOLDER IS ALSO AN ADDITIONAL INSURED UNDER THIS POLICY PAX:B17-392-63591B17-989-7467 CERTIFICATE HOLDER X ,ADDITIONAL INSURED:INSURER LETTER: CANCELLATION Y r� y-I� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES de CANCEL.®btMM TME t"nanoN CITY OF FORT WORTH:A i N: DATE THEREOF.THE ISSUING INSURER mLL ENDEAVOR TO MAILt0 DAYS WRITTEN O,BRIETLING;ENVIRON. MGMT.DEPT NOTICE TO THE GERTIFICATE HOLDER NAMED TO 1HE LEFT,BUT FIVIAXW TO 00 30 aHALI 1000 THROCKMORTON ST. IMPOSE NO OBLIGAT1011 OR UABIUTY OF ANY RIND UPON THE MBUNfi.ITS AGENTS OR RM FT. WORTH, TX 76102 UTH-U ENTATIVE6. ATNONIYED WPWPMWVIV L ACORD 26-517/97! 2-95 4 ACORb COIgPORATI 198 VU-3 ZOM'd 6£Z-1 '00 0018 'HM-H06J 69£926£1186-01 0041 V0, 2 d3S AGQRD. CERTIFICATE OF LIABILITY INSURANCE eare9/21/04 ' PRODUCER THIS CERTIFICATE IS ISSUED AS A FATTER OF INFORMATION Wm. Rigg Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 777 Main St, Suite C-50 HOLDER. THIS CERTIFICATE DOES NOT AMENb, EXTEND OR Ft. Worth. TX 70102-5333 ALTER THE COVZRAGE APPORbED BY THE POLICIr3 NFLOw- 817-820-8100 INSURERS AFFORDING COVERAGE EY9URED --- INSURER A: _Everest Indemnity Ins CoMpanY-_ 1` Pinnacle Sciences, Inc. j._._ --.—__ �, _ INSURER B: Unitrin- Strata Core, Inc;Drake Realty — ��2� Midway FiCI„ Ste, 3 7 RERC: Texas Mutual Insutonge Co a- --- ------.., -- Fort Worth TX 76117 11 INSURER D:--- 'INSURER E: COVERAGES 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 OESCRIBEb HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ _ -- -. SLTIk TIR TYPE OF INSURANCE POLICY NR1IM TPOLIar EFPECTwE POLICY EXPIRATION UMIT3 A MCRAL UABIUTV 400003882041 3/18/04 3118/05 EACH DCCURR_EN_CE_ I• idoe000 )(1COMMERCIAL GENERAL LIABILITY FIRE DAMAGE Wn - onelM�I if --_ 50000 CLAIMS MADE I X I OCCUR INCLUDES BLANKET I MED ExP IA^r o'+o Pv.w.d L, soon _ X POLLUTION __ ADDL.INSUREDS& PERSGNAL s Atw INJURY ! 1000oo0 XO�.LIl4g _— WAIVERS OF SUB. + rGENERALAGGA%A_TE 111 - _2000000 GEN'L AGGREGATE LIMIT APPLIES PER: r PRODUCTS-LCMP1pP AGG t - _2000000 X I POLICY --�oko LOC -- -- - - -1 JECT 8 AUTOMOBILE LIAMUTV 7850972 3/18/04 3118ro5 COMBINED SINGLE LIMIT I f >POOP)o ANY AUTO ICA d--WOW._.--'--- ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS 1 I trw pf'ovo X HIRED AUTOS I I ?BODILY INJURY f X NON-OWNED AUTOS i ; IPO acadenq I F— i PA(1PERTr DAMAGE f f (Pet aeridetnll IOARAOELIAOIUTY i ! AUTO_ONLY-E+ACCICENT S_ ANY AUTO I OTHER THAN EA ACC Lf _ AUTO ONLY: AGG S EXCESS UABRdtY I I EACH OCCURRENCE I,f_..._..—_. .--.... . �_. OCCUR I l CLAIMS MADE IAGGREGATE, i RETENTION f I Is C W43 WERE CaMPlIIpAT1ON AND TSP11204620 3/14/04 3/14106 X 1 TOMY unci r'3., EMPLOYERS'LIABILITY I ..-- i E.L EACH p•CCIDFNT C.L.DISEASEF•A EMPLOYEE'• _ 100OPQ0-- E.L.DISEASE POLICY LIMIT S i000000 OTHER 1 1 I DMMPTION OF OPFAAT1nWAJDCATIONSNEHICLMUCWSIONS ADDED BY MOR5ERIENtfSPEC1AL PROVISIONS STRATA CORE, INC.IS AN ADDITIONAL INSURED UNDER THE GENEFTAL LIABILITY POLICY. THE CERTIFICATE HOLDER IS ALSO AN ADDITIONAL INSURED_ FAX:817-392433159/817-989-7467 CERTIFICATE HOLDER X I ADDITIONAL INstimm; INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCWBEb POLICIES BF CANCELLED oLCOM THE EXPIRATION CITY OF FT. WORTH; ATTN: DATE 11iEREOF, THE ISSUING INSURER MALL ENDEAVOR TO MAIL 10 DAYS WRITTEN C.BRIETLING; LNVIRON.MGMT.DEPT NOTICE TO THE CER TIFlCAtE HOLDEN NAMED TO THE LEFT.BUT FAILURE TO DO 50 SHALL 1000 THROCKMORTON ST. IMPOSE NO OBUGAnON OR UAMUTV OF ANY RIND UPON THE INSURER.ITS AGENTS OR FT. WORTH, TX 76102 KPIUMEYTAT(VIS AUt140MZM R �rn ,n1 M ACORD 26.5 171071 2.66 a ACORD CORPORATION 1988 UH ZOAO'd 1£Z-1 '00 0018 'HM-H08l 65£926£1196-01 95:£1, VO, LZ d3S ��_ C'�R� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDYY) r" 10/21/2003 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOHN L.WORTHAM 8 SON,L.L.P. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.BOX 1388 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR HOUSTON,TEXAS 77251-1388 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE ,LURED INSURERA: Hartford Lloyds Insurance Company KOOS&ASSOCIATES, INC. 10410 MARKISON ROAD INSURER B: DALLAS,TX 75238 INSURER C: INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE I POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER Y1 F" LIMITS A GENERAL LIABILITY 61SBAKT5725 10/26/2003 10/26/2004 EACH OCCURRENCE S 1,000.000 ✓ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(An one ire) I S 300.000 CLAIMS MADE I✓ OCCUR MED EXP(Anyone person) S 10.000 PERSONAL 3 ADV INJURY S 1,00'0.0C'- GENERAL AGGREGATE IS 2.00C,00� GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP!OP AGG I S 2.000001 POLICY PROjECT F1 LOC A AUTOMOBILE LIABILITY 61SBAKT5725 10/26/2003 10!26/200 COMBINED SINGLE LIMIT S 1,00c,c0c ANY AUTO (Ea aec,dent) ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per parson) ✓ HIRED AUTOS BODILY INJURY S ✓ NON-OWNED AUTOS (Per accident PROPERTY DAMAGE S (Per accident) GARAGELIABILITY AUTO ONLY-EA ACCIDENT I S ANY AUTOEA ACC S OTHER 7HAN AUTO ONLY: AGG S EXCESS LIABILITY EACH OCCURRENCE I S OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION SWC : S ATR WORKERS COMPENSATION AND OR I!MIT IOF H- S EMPLOYERS'LIABILITY E.L.EACH ACCIDENT I S E.L.DISEASE-EA EMPLOYEE S E.L.DISEASE-POLICY LIMIT I S OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHIC LE SIEXC LU S IONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS ,ERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOAl- LEFT, t LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILI Y, ANY KIND UPON THE ISSUER,ITS AGENTS OR REPRESENTATIVES. O` AUTHORIZED REPRESENTATIVE Q JOHN L. JIVOR TH.-Of& SON, L.L.P. (CORD 25S(7/97) ©ACORD CORPORATI IMPORTANT If the certificate holder is an ADDITIONAL IN5UHED, the pollcylies) must be endorsed. A Ctato n+pnt on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it aff rmatively or negatively emend, extend or altar the coverage afforded by the policies lis,.ed thereon. AGUND Z"(1197) VU-3 ZO/ZO'd 6£Z-1 '00 0018 'HM-H083 65£9Z6£1186-01 00:V1 00, 2 d3S 10/05/2004 14:15 2143417540 KOOS AND ASSOCIATES PAGE 02 WORKERS' COMPENSATION AND Texmmutual- EMPLOYERS LIABILITY INSURANCE POLICY Insurat>rt:Ciampany 221 W Gth Street, SuitF 300 Austin,Texas 78701.3403 INFORMATION PAGE ITEM KOOS $ ASSOCIATES INC. .. . — __._.._._,__.._.._,. _ _-_• —.—___---i 10410 MARKISON RD DALLAS, TX 75238-1650 POLICY NUMBER INSURED NAMEAND SBP-0001114205 20040308 ADDRESS Federal Tax ID 75-2291794 OTHER WORKPLACE:NOT=MOWN ABOVEBureau Number stm dttuehed scheoule of operation. Branch 00000 PRODUCER TEXAS MUTUAL INSURANCE COMPANY Renewal of 0001114205 221 W 6TH ST STE 300 Entity CORPORATION AUSTIN, TX 78701 -340 Interim Adjustment 00002 Group ITEM The Policy Period is 1rom� 3-08-2004 To: 3-08-2005 12:01 A.M.standard time at the insured's mailing address ITEM 9 A. Workers'Cumprosation insurance: Part One of the policy applies to the Workers' Compensation Law of the states listed herr' TEXAS B. Employers Liability Insurance: Part Two or the policy applies to work in each state listed in item 3A. Thr+limits of ntlr l iahility under Part Two are: Bodily Injury by Accident f 500 ,000 Each Accident Bodily Injury by Disease $ 500 ,000 Each Employee Bodily Injury by Disease $ 500,000 Policy Limit C. Other States Insurance: Part three of the policy applleS to the states, it any.Ilsted here: NOT APPLICABLE D. This policy includes these endorsements and schedules: Sen Schedule of Endorsements attached ITEM 4 The prcmlum for thi pollr•y will be determined by our manuals of Rules,classifications,Rates and Rating Plans. All information required below Is subject to verification and change by audit. ro7ALf.::TY.1°TT TA'4.f+.fi';Piit M11,M 1 ,783 .00 WA I VEn riF SOAROC.AT I ON . . . . . . . . . . . . . . . .00 I INCREASED LIMITS . . . . . . . . . . . . . . . . . . . . . 18.00 TOTAL PREMIUM SUBJECT TO MODIFICATIONS . . . . . . . . . . 1 ,801 .00 PREMIUM MODIFIED TO REFLECT PREM INCENTIVE OF ( 85 ) 270,00- PREMIUM MODIFIED TO REFLECT SCHEDULE RATING OF ( .90 ) . 153,00- DEDUCTIBLE PREMIUM . . . . . . . . . . . . . . . . . .00 ADM/FELA OR USLBIH MINIMUM . . . . . . . . . . . . . .00 PREMIUM DISCOUNT , IF APPLICABLE ( ) . . . . . , .00 EXPENSE CONSTANT CHARGE . . . . . . . . . . . . . . . . . 150.00 .00 TOTAL 1 .520.00 MINIMUM PRFMIUM 248.00 l DENcsi'PakMr.:r.; 1 ,528.00 `! PAL—" Countersigned by _— Issue Date: 3-15-2004 The Texas Mutual Insurance Company is required by law to provide its policyholders with certain accident prevention services as required by Texas Labor Code Section 411.066 at no additional charge. If you would like more information call 1-800$59-5995 or (512) 322-3800 . If you have any questions about this requirement, call the Division of Workers' Health and Safety, Workers' Compensation Commission at 1-800452-9595. iA650066i (Ep.oi.4