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Home My WebLink AboutContract 49197-A1 �co DECEIVED CITY SECRETARY Cr Cn OCT 1 12017 Q FIRST AMENDMENT CONTRACT NO.. V` 1 '4 N TO CITY SECRETARY CONTRACT NO. 49197 -'fTY OF FORT VVORTk It. ENCROACHMENT AGREEMENT ry MYSECRETAR! Qj T ' ST AMENDMENT TO CITY SECRETARY CONTRACT NO. 491979yt1 140 ENCROACHMENT AGREEMENT is made and entered into by and between the CITY OF FORT WORTH, a municipal corporation of Tarrant County, Texas, acting herein by and through its duly authorized City Manager, its duly designated Assistant City Manager or Planning and Development Director, hereinafter referred to as the "City," and Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P., a Texas Limited Partnership, acting herein by and through its duly authorized representative, hereinafter referred to as "Licensee". RECITALS WHEREAS, the City of Fort Worth ("City") and Licensee made and entered into City Secretary Contract No. 49197 on June 16, 2017 (the "Agreement") to authorize the use of right- of-way for the construction of a skybridge to be located in the public right-of-way (the "ROW"); and WHEREAS, the parties wish to amend the Agreement to accommodate the relocation of a private storm drain to the ROW to make room for a pier for the sky bridge and WHEREAS, it is the mutual desire of City and Licensee to execute this Amendment to the Agreement to add an exhibit to depict the additional encroachment area; NOW THEREFORE, City and Licensee, acting herein by and through their duly authorized representatives, enter into the following that amends the Agreement: 1. Exhibit A-1 is hereby attached hereto and incorporated herein to the Agreement, consisting of a description of the additional encroaching improvements. OFFICIAL RECORD 4835-3852-3728.2 CITY SECRETARY First Amendment to CSC No. 49197 FTp1i RTH TX Columbia Plaza Medical Center of Forth Worth Subsidiary,L.P. 2. All other provisions of the Agreement which are not expressly amended herein shall remain in full force and effect EXECUTED on this the A—day of OQ,6 b1tr ' 2017. CITY OF FORT ORTH: andle Harwo • Director, Department of Planning and Development Approved as to Form and Legality: At ed by: FONT Paiye—MebdDe Mary J. Kayser 3 Assistant City Attorney City Secretary * ' �p5 Columbia Plaza Medical Center NO M&C RECQUIRJCD of Fort Worth Subsidiary, L.P.: By: Colu is North Texas Sub i�diiary GP, LLC, its general partner By: Prinked ame: Nicholas L. Paul Title: Vice President FOFFICIALRECORD ETARY 4835-3852-3728.2 IH, TX First Amendment to CSC No. 49197 2 of 3 Columbia Plaza Medical Center of Forth Worth Subsidiary,L.P. Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contact, including ensuring all performance and reporting requirements. .. A ame of Employee Janie S. Morales Department Manager OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME,. the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Randle Harwood, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of the CITY OF FORT WORTH, and in the capacity therein stated. '1 GIVEN GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of IS ' 2017. n; JENNIFER LOUISE EZERNACK T_Notary Public, State of Texas Comm. Expires 03-01-20204�- ublic tate of T as ' I ` Notary ID 130561630 STATE OF TENNESSEE § COUNTY OF DAVIDSON § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Tennessee, on this day personally appeared Nicolas L. Paul, Vice President, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed the same for the purposes and consideration therein expressed, as the act and deed of Columbia North Texas Subsidiary GP, LLC, the general partner of Columbia Plaza Medical Center of Fort Worth Subsidiary, L.P., Texas limited partnership, on behalf of the limited partnership and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF FICE this ail day of 2017. '�INESSEE No Public, Sta e o .1(1Yle� C� i NOTARY PUBUG A. 40�SON1001#1.C�v . *Commission Expires!.`,".G. ^ ' OFFICIAL RECORD CITY SECRETARY FT.WORTH,Ti 4835-3852-3728.2 First Amendment to CSC No.49197 Page 3 of 3 Columbia Plaza Medical Center of Forth Worth Subsidiary,L.P. Z8ZL£-ZS8£-S£8b I 1 --- YAI AVENUES ' 11}■i qy CT 5€g4 a� g � ��E ii'_86iiEtAE6i�'eapp E�iaEa=� � i t i 8#�#i s P �p c F,,; � 3�3I _F G E �f�i FtI Hill, o 77sa' a �A 3c f ;�ica .Ci 9CFR iA • 3 f a •a 3 va 14 I I PLAZA MEDICALCENTER. Kimley))Horn EME RGENCY DEPARTMENT _1.E v 1191HX3 PREPARED FOR of HCA -�— �.R+....�,�..... o� _ CITY OF FORTNORTH,TE7f/15 Page 1 of 1 Health Care Indemnity, Inc. I C M 1100 Charlotte Avenue,Suite 800 Certificate Of Insurance v Nashville,TN_37203 � Phone:615!34451.93- ---- - _ _ ___Date:. .._ 05/02/2017--- ---- _ Fax:855-775=0393"— _;- .__ -, - -- - Email:Corps{nsuranee@HCAHealthcare.com COi#: 48059-2017 Thisis& certify to;__ _ -City of ForLWorth _ _ Name cif Certrficate H�Ider)_- ----=X260 Texas St_Te�--� 1 - - `-- Fort Worth, - TX-76102 that the described insurance coverages as provided by the- indicated policy has been issued to: Named Insured.- HCA HOLDINGS,_INC.:AND SUBSIDIARY ORGANIZATIONS Address: EXISTING NOW.OR HEREAFTER CREATED OR ACQUIRED ti j ONE PARK PLAZA NASHVILLE]TN737202-0550 The Policy identified below by a policy number is in force on the date of Certificate issuance. Insurance is afforded only with respect to those coverages for which" a specific limit of liability has been entered and is subject to all the termsofthe Policy having reference thereto. This Certificate of Insurance neither affirmatively nor negatively amends,extends or alters the coverage afforded under any policy identified herein. POLICY NO. POLICY PERIOD I - - ---' � - - - - Effective:1/1/2017 HCI-EX-1 0117-01 - Expiration:1/112018 i I - 1 - - l TYPE OF INSURANCE LIMITS OF LIABILITY Comprehensive General Liability- -- - Occurrence Form $1;000,000 Each and Every Occurrence = ` _ Bodily-Injury _ _._ -- • Property Damage -- - -$1-000,000 Aggregate -•-Products arid-Completed Operations • Personal and Advertising Injury Health Care Professional Liability $0 Each and Every Occurrence --: ---- �� Occurrence Form - __-- $0 Aggregate -- SPECIAL.:CONDITIONS/OTHER-COVEP.AGES---------"------ _The Named Insured Includes:--Columbia P1az3'fAed1ca1Center of f=ort Worth Subsidiary, LP d/b/a Medical City _:- Forth Worth COID: 34318 --- :ancellation: Should any of the above described policies be canceled before the expiration date thereof,the issuing company will endeavor to mail ninety days written iotice to the above named certificate holder,but failure to mail such notice shall impose no obligation or liability of any kind upon the company. Authorized Spature