Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Contract 51986
CITY SECETARY tid CO TRACT NO. 5 19 9 % tion% DESIGN PROCUREMENT AGREEMENT FOR PUBLIC WATER LINE RELOCATION This DESIGN PROCUREMENT AGREEMENT("Agreement"),is entered into by and between the City of Fort Worth,Texas, a home-rule municipal corporation situated in Tarrant,Denton, Johnson, Wise, and Parker Counties, Texas ("City"), acting by and through its duly authorized Assistant City Attorney, and Riverbend Investments, LTD, a Texas limited partnership ("Developer") acting by and through its duly authorized representative. City and Developer are referred to herein individually as a Party and collectively as the Parties. Recitals WHEREAS, Developer intends to construct a project in the City known as Trinity Lakes that will require the relocation of the City's water line; and WHEREAS, the Texas Department of Transportation ("TxDOT") is making interstate improvements that require the relocation of the City's water line; and WHEREAS,the City is required to relocate the water line in a timely manner or be subject to delay claims from TxDOT; and WHEREAS,the relocation of the water line("Project")is further described in Exhibit"A"; and WHEREAS, Developer has agreed to construct the water line pursuant to a Community Facilities Agreement; and WHEREAS, City has agreed to participate in the cost of the design of the water line relocation; WHEREAS, City and Developer desire to enter into this Design Procurement Agreement in order to accomplish the goals of the Parties; and WHEREAS, Developer has determined that Icon Consulting Engineers, Inc. ("Design Consultant") should provide the design of the Project based on demonstrated competence and qualifications to perform the Design Consultant services for a fair and reasonable price; and WHEREAS, City staff have reviewed the scope, fee and schedule for the design of the Project and find them to be fair and reasonable; and WHEREAS, City has agreed to pay Developer$41,900.00 for the design of the water line relocation ("City's Share") which Developer shall remit to the Design Consultant; and OFFICIAL RECORD Design Procurement Agreement for Public Water Line Relocation Page 1 of 13 Riverbend Investments,LTD CITY SECRETARY FT. WORTH,1rX WHEREAS, Developer shall not earn a fee based upon the City's Share of the design cost; NOW, THEREFORE, for and in consideration of the above recitals and the mutual covenants and agreements herein contained,the City and Developer agree as follows: SECTION 1 GENERAL REQUIREMENTS 1.1 The Project will generally consist of the design of certain public infrastructure in the form of a public water line relocation as further described on Exhibit A. 1.2 Developer will retain Icon Consulting Engineers, Inc. as the Design Consultant for the Project pursuant to a written agreement approved by the City, attached hereto as Exhibit B (the"Design Agreement"). 1.3 The Design Consultant shall provide a set of engineering drawings, renderings, contract specifications, estimates, and other documents necessary to permit and construct the Project, and shall attend project meetings, perform procurement and construction phase services to include shop drawing reviews,respond to RFIs,and prepare record drawings of the Project ("Construction Documents"). The Design Consultant shall maintain separate accounting of the costs of the various tasks outlined within the Design Agreement. The City shall pay to Developer the City's Share of the costs for the Construction Documents in the amount of$41,900.00. City's total liability to Developer pursuant to this Agreement shall not exceed $41,900.00. Developer shall pay all other cost of Design Consultant for the Construction Documents. Upon completion of the Construction Documents, as evidenced by submittal of the record drawings to the City by the Design Consultant, Developer shall submit to the City a copy of all invoices of Design Consultant and proof that Developer has paid Design Consultant in full for the Construction Documents. City shall pay $41,900.00 to Developer within 30 days after receiving the invoices and proof that Design Consultant has been paid in full. 1.4 City shall have the ultimate right to approve or disapprove the Construction Documents after consultation with Developer. 1.5 Developer shall ensure that Developer's agreement with the Design Consultant includes provisions requiring Design Consultant's services for preparation of water line easement documents necessary for the Project. 1.6 Developer shall be responsible for obtaining and paying all costs of obtaining all easements, TxDOT permits, and railroad permits necessary for the Project. 1.7 Developer shall be responsible for paying all costs associated with IPRC reviews and CFA documents. Design Procurement Agreement for Public Water Line Relocation Page 2 of 13 Riverbend Investments,LTD SECTION 2 TERMINATION, OWNERSHIP OF PLANS,APPROPRIATION AND FISCAL FUNDING OUT 2.1 Termination. This Agreement may be terminated without cause by either party upon delivery of three business days'written notice to the other party of such intent to terminate; provided, however, both parties shall be liable for their share of obligations incurred pursuant to the Design Agreement before such termination. 2.2 Ownership of Plans. City shall own the plans and other documents and work product Design Consultant creates for the Project. In the event this Agreement is terminated, City shall have the right to enter into an agreement with Design Consultant to complete Design Consultant's services for the Project. Developer shall include the City's ownership right in the plans and the City's right to enter into an agreement with Design Consultant to complete the design in Developer's agreement with the Design Consultant. 2.3 Fiscal Funding Out. Notwithstanding anything to the contrary, if, for any reason, at any time during the term of the Agreement,the Fort Worth City Council fails to approve funds sufficient for the City to fulfill its obligations under this Agreement,the City may terminate the portion of the Agreement regarding such obligations to be effective on the later of. (i) delivery by the City to Developer of written notice of the City's intention to terminate or (ii)the last date for which funding has been approved by the Fort Worth City Council for the purposes set forth in this Agreement. SECTION 3 FORCE MAJEURE 3.1 If either Party is unable, either in whole or part, to fulfill its obligations under this Agreement due to acts of God; strikes, lockouts, or other industrial disturbances; acts of public enemies; wars; blockades; insurrections; riots; epidemics; public health crises; earthquakes; fires; floods; restraints or prohibitions by any court, board, department, commission, or agency of the United States or of any state;declaration of a state of disaster or of emergency by the federal,state, county, or City government in accordance with applicable law; issuance of a Level Orange or Level Red Alert by the United States Department of Homeland Security;any arrests and restraints; civil disturbances; or explosions; or some other reason beyond the Party's reasonable control (collectively, "Force Majeure Event"), the obligations so affected by such Force Majeure Event will be suspended only during the continuance of such event. SECTION 4 LIABILITY AND INDEMNIFICATION 4.1 DEVELOPER SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND ALL PROPERTY LOSS, PROPERTY DAMAGE AND/OR PERSONAL INJURY, INCLUDINGDEATH, TOANYANDALL PERSONS,OFANYKIND OR CHARACTER, WHETHER REAL OR ASSERTED, TO THE EXTENT CAUSED BY THE NEGLIGENT ACT(S) OR OMISSION(S), MALFEASANCE OR INTENTIONAL MISCONDUCT OF Design Procurement Agreement for Public Water Line Relocation Page 3 of 13 Riverbend Investments,LTD DEVELOPER, ITS OFFICERS, AGENTS, SERVANTS OR EMPLOYEES IN CONNECTION WITH PERFORMANCE OF THIS AGREEMENT. 4.2 DEVELOPER AGREES TO DEFEND, INDEMNIFY, AND HOLD THE CITY, ITS OFFICERS, AGENTS, SERVANTS, AND EMPLOYEES HARMLESS AGAINST ANY AND ALL CLAIMS,LAWSUITS,ACTIONS, COSTS,AND EXPENSES OFANY KIND, INCLUDING, BUT NOT LIMITED TO, THOSE FOR PROPERTYDAMAGE OR LOSS (INCLUDING ALLEGED DAMAGE OR LOSS TO OWNER'S BUSINESS AND ANY RESULTING LOST PROFITS)AND/OR PERSONAL INJURY(INCLUDING DEATII) THAT MAY RELATE TO, ARISE OUT OF, OR BE OCCASIONED BY (I) DEVELOPER'S BREACH OF ANY OF THE TERMS OR PROVISIONS OF THIS AGREEMENT OR (II) ANY NEGLIGENT ACT OR OMISSION OR INTENTIONAL MISCONDUCT OF DEVELOPER, ITS OFFICERS, AGENTS, ASSOCL4TES, EMPLOYEES, CONTRACTORS(OTHER THAN THE CITY), OR SUBCONTRACTORS RELATED TO THE PERFORMANCE OF THIS AGREEMENT;EXCEPT THAT THE INDEMNITY PROVIDED FOR IN THIS SECTION SHALL NOT APPLY TO ANY LABILITY RESULTING FROM THE SOLE NEGLIGENCE OF THE CITY OR ITS OFFICERS,AGENTS, EMPLOYEES, OR SEPARATE CONTRACTORS,AND IN THE EVENT OF JOINT AND CONCURRENT NEGLIGENCE OF BOTH DEVELOPER AND CITY, RESPONSIBILITY, IF ANY, SHALL BE APPORTIONED COMPARATIVELYINACCORDANCE WITHTHELAWS OFTHESTATE OFTEXAS. NOTHING HEREIN SHALL BE CONSTRUED AS A WAIVER OF THE CITY'S GOVERNMENTAL IMMUNITY AS FURTHER PROVIDED BY THE LAWS OF TEXAS. 4.3 Developer's agreement with the Design Consultant shall include a release and indemnity in favor of City in substantially the following form: "DESIGN CONSULTANT SHALL INDEMNIFY, HOLD HARMLESS AND DEFEND THE CITY OF FORT WORTH AGAINST LIABILITY FOR ANY DAMAGE CAUSED BY OR RESULTING FROM AN ACT OF NEGLIGENCE, INTENTIONAL TORT, INTELLECTUAL PROPERTY INFRINGEMENT, OR FAILURE TO PAY A SUBCONTRACTOR OR SUPPLIER COMMITTED BY THE DESIGN CONSULTANT OR DESIGN CONSULTANT'S AGENT, CONSULTANT UNDER CONTRACT, OR ANOTHER ENTITY OVER WHICH THE DESIGN CONSULTANT EXERCISES CONTROL." SECTION 5 INSURANCE 5.1 Developer shall maintain the insurance requirements set forth in Exhibit C, which is attached hereto and incorporated herein for all purposes. 5.2 Developer shall require in its contract with Design Consultant that City is listed as an additional insured on Design Consultant's insurance policy. Design Procurement Agreement for Public Water Line Relocation Page 4 of 13 Riverbend Investments,LTD SECTION 6 NONDISCRIMINATION 6.1 Developer shall not engage in any unlawful discrimination based on race, creed, color, national origin, sex, age, religion, disability, marital status, citizenship status, sexual orientation or any other prohibited criteria in performing the services under this Agreement. SECTION 7 VENUE AND CHOICE OF LAW 7.1 Developer and City agree that this Agreement shall be construed in accordance with the laws of the State of Texas. If any action,whether real or asserted,at law or in equity,arises on the basis of any provision of this Agreement, venue for such action shall lie in state courts located in Tarrant County,Texas or the United States District Court for the Northern District of Texas—Fort Worth Division. SECTION 8 THIRD-PARTY RIGHTS AND ASSIGNMENTS 8.1 The provisions and conditions of this Agreement are solely for the benefit of the City and Developer, and any lawful assign or successor of Developer,and are not intended to create any rights, contractual or otherwise,to any other person or entity. 8.2 Developer agrees that it will not subcontract or assign all or any part of its rights,privileges or duties hereunder without the prior written consent of the City, and any attempted subcontract or assignment of same without such prior consent of the City shall be void. SECTION 9 BINDING COVENANTS 9.1 Subject to the limitations contained herein,the covenants,conditions and agreements made and entered into by the parties hereunder are declared to be for the benefit of and binding on their respective successors,representatives and permitted assigns, if any. SECTION 10 INDEPENDENT CONTRACTOR 10.1 Developer shall perform all work and services hereunder as an independent contractor, and not as an officer, agent, servant or employee of the City. Developer shall have exclusive control of, and the exclusive right to control the details of the work performed hereunder, and all persons performing same,and shall be solely responsible for the acts and omissions of its officers, agents, employees and subconsultants (or subcontractors). Nothing herein shall be construed as creating a partnership or joint venture between the City and Developer, its officers, agents, employees and subconsultants (or subcontractors), and doctrine of respondent superior has no application as between the City and Developer Design Procurement Agreement for Public Water Line Relocation Page 5 of 13 Riverbend Investments,LTD SECTION 11 AMENDMENTS, CAPTIONS,AND INTERPRETATION 11.1 Except as otherwise provided in this Agreement, the terms and provisions of this Agreement may not be modified or amended except upon the written consent of both the City and Developer. 11.2 Captions and headings used in this Agreement are for reference purposes only and shall not be deemed a part of this Agreement. 11.3 In the event of any dispute over the meaning or application of any provision of this Agreement, this Agreement shall be interpreted fairly and reasonably, and neither more strongly for or against any party, regardless of the actual drafter of this Agreement. SECTION 12 GOVERNMENTAL POWERS AND IMMUNITIES 12.1 It is understood that by execution of this Agreement, the City does not waive or surrender any of its governmental powers or immunities. SECTION 13 AUTHORIZATION AND COUNTERPARTS 13.1 By executing this Agreement on behalf of Developer,the person signing below affirms that he or she is authorized to execute this Agreement and that all representations made herein with regard to the signer's identity, address, and legal status are true and correct. 13.2 This Agreement may be executed in several counterparts,each of which will be deemed an original, but all of which together will constitute one and the same instrument. SECTION 14 SEVERABILITY AND NO WAIVER 14.1 It is agreed that in the event any covenant, condition or provision herein contained is held to be invalid by any court of competent jurisdiction, the invalidity of such covenant, condition or provision shall in no way affect any other covenant, condition or provision, and does not materially prejudice either Developer or City in connection with the rights and obligations contained in the valid covenants, conditions or provisions of this Agreement. 14.2 The failure of either party to insist upon the performance of any term or provision of this Agreement or to exercise any right granted hereunder shall not constitute a waiver of that party's right to insist upon appropriate performance or to assert any such right on any future occasion. Design Procurement Agreement for Public Water Line Relocation Page 6 of 13 Riverbend Investments,LTD SECTION 15 COMPLIANCE WITH LAWS 15.1 This Agreement is subject to all applicable federal, state and local laws, ordinances, rules and regulations, including, but not limited to, all provisions of the City's Charter and ordinances, as amended. 15.2 If City notifies Developer or any of its officers, agents, employees, contractors, subcontractors,licensees,volunteers,or invitees of any violation of such laws,ordinances, rules or regulations, Developer shall immediately desist from and correct the violation. SECTION 16 NOTICES 16.1 Notices to be provided hereunder shall be sufficient if forwarded to the other party by hand- delivery or via U.S. Postal Service certified mail, postage prepaid,to the address of the other party shown below: To the Citv: To Developer: Fort Worth Water Department Riverbend Investments,LTD Attn: Chris Harder Attn: Kenneth Newell 200 Texas Street 2550 S. Precinct Line Rd. Fort Worth, Texas 76102 Fort Worth,Texas 76118 with copies to: City Attorney's Office City of Fort Worth 200 Texas Street Fort Worth, Texas 76102 and City Manager's Office City of Fort Worth 200 Texas Street Fort Worth, Texas 76102 SECTION 17 HEADINGS 17.1 The headings contained herein are for the convenience in reference and are not intended to define or limit the scope of any provision of this Agreement. SECTION 18 Design Procurement Agreement for Public Water Line Relocation Page 7 of 13 Riverbend Investments,LTD RIGHT TO AUDIT 18.1 Developer agrees that the City shall, until the expiration of three (3) years after final payment under this Agreement, have access to and the right to examine any directly pertinent books, documents, papers and records of Developer involving transactions relating to this Agreement. Developer agrees that the City shall have access during normal working hours to all necessary Developer facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. The City shall give Developer reasonable advance notice of intended audits. 18.2 Developer shall include in its contract with the Design Consultant a right until the expiration of three (3) years after final payment under this Agreement, to have access to and the right to examine any directly pertinent books, documents, papers and records of Design Consultant involving transactions relating to this Agreement and the agreement between Developer and Design Consultant. Design Consultant must agree that the City shall have access during normal working hours to all necessary Design Consultant facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. The City shall give Design Consultant reasonable advance notice of intended audits. SECTION 19 PROHIBITION ON BOYCOTTING ISRAEL 19.1 Developer acknowledges that in accordance with Chapter 2270 of the Texas Government Code, the City is prohibited from entering into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and(2)will not boycott Israel during the term of the contract. The terms "boycott Israel" and "company" shall have the meanings ascribed to those terms in Section 808.001 of the Texas Government Code. By signing this contract, Developer certifies that Developer's signature provides written verification to the City that Developer: (1) does not boycott Israel; and(2) will not boycott Israel during the term of the contract. SECTION 20 SOLE AGREEMENT 20.1 This Agreement, including any exhibits attached hereto and any documents incorporated herein, contains the entire understanding and agreement between the City and Developer, and any lawful assign and successor of Developer,as to the matters contained herein. Any prior or contemporaneous oral or written agreement is hereby declared null and void to the extent in conflict with any provision of this Agreement. (Remainder of Page Intentionally Left Blank) Design Procurement Agreement for Public Water Line Relocation Page 8 of 13 Riverbend Investments,LTD IN WITNESS THEREOF,the parties have made and executed this Agreement in multiple originals to be effective on the date signed by the Assistant City Manager, in Fort Worth,Tarrant County, Texas. CITY OF FORT WORTH: DEVELOPER: Riverbend Investments, LTD, a Texas limited partnership By: RBE Investment Corp., it's general partner 9 Jesus J. Chapa 'Name:Wermeth ewell Title: President Assistant City Manager Date: 2/-1 — 17 Date:_ IS -1,q Recommended by: (� A(,, L Christopher Harder Water Department Director APPROVED AS TO FORM AND LEGALITY: Richard A. McCracken Assistant City Attorney !4, rk r v ATTEST: - - Contract Compliance Manager •, -,&By signing I acknowledge that I am the , (,person responsible for the monitoring and City Secretary administration of this contract, including ensuring all performance and reporting requirements Date /l`�c L No M&C Required. Form 1295:N/A Name: Chris Harder Title: Water Director Design Procurement Agreement for Public Water Line Relocation Page 9 of 3 FFICIAL RECORD Riverbend Investments,LTD CITY SECRETARY FT. WORTH, TX EXHIBIT A ' �` '` Fi0S70MG u• fOWMlENT AND M94C O SFM L PROPOSW TmhffrT Jew `. `� ON OF rMr NOT 70 Jr 97WM WPM O MSS MED AN N-CMS7MX7XW®T DAERS d, ` AJ'AMDONM M 36' WATERLINE SHEET C1.7 � 36' WATERLINE SHEET C1.3 r------------------ --------- _---r----------------'c -- ----------- &W VAR i W GTK SER i `. ti 1 � now SiJFS m 1 ` I NEWuk w-ww f PROPOW.76"Wx7JE OM ♦` 1 \} PRESPAE CLAW PSO PFE AVw- POESSW CAW 2M +V' i TRINITY HYD i }�PROPOSED.M'p PASS LW CLASS L._.....,.-------_____ �.---_Sw__.� ---�.-- _1------------------------ ----d 2W APE M r6RLME BT ORERS I r=Qr Junurr AtLorwnaMs \\ OWNER: RIVPRBEND /NYE5711ENT, LTD. ` WAMMM MSTAUA79W J'T OPER RiAN \\\ OPEN CUT tJflOMMA7N EMSMG STOW GtAlTTPMAt AM7XNC5 UNgFbSTOW sl?lDRAW tMS Design Procurement Agreement for Public Water Line Relocation Page 10 of 13 Riverbend Investments,LTD EXHIBIT B (AGREEMENT BETWEEN DEVELOPER AND ENGINEER) Design Procurement Agreement for Public Water Line Relocation Page 11 of 13 Riverbend Investments,LTD ■ iconConsulting Engineers, Inc. Civil Engineers - Designers - Planners May 01,2018 Mr. Kenneth Newell P.O.Box 185101 Fort Worth,Texas 76181 Re: Proposal for Professional Engineering and Surveying Services for proposed 36"water transmission main to provide water supply through the Trinity Lakes mixed use development area, located in Fort Worth,Texas. Dear Mr, Newell: Icon Consulting Engineers, Inc. appreciates the opportunity to submit this proposal to Riverbend Investment, LTD for professional engineering and surveying services for the proposed removal of an existing water transmission main that currently bisects the existing Trinity Lakes property, and related design necessary for the realignment of a new public 36" water transmission main along Trinity Boulevard that will provide service to your Trinity Lakes development. 1t is our understanding that a current City of Fort Worth/TxDOT project proposes a 36" water transmission main extending under Interstate 820 along the southern side of the existing off ramp of Trinity Boulevard. This project will entail extending this 36" water transmission main a distance of approximately 700 feet easterly along the existing Trinity Boulevard off ramp and then following the existing alignment of Trinity Boulevard for approximately another 1,500 feet to reconnect to the existing 33" transmission main. Proposed public water improvements are shown on attached Exhibit "A". With this proposal, we are proposing to provide the following specific scope of services: BASIC SCOPE OF SERVICES 1) Water Transmission Main Plans Icon will prepare Water Transmission Main Plans, including detailed design, drafting and specifications, for each of the following improvements in accordance with City of Fort Worth requirements. Icon will then provide all technical support necessary to facilitate acceptance of these plans by the City of Fort Worth. The plans will include the following: A. Water Plans: Plans will be prepared for the removal of an existing 33" water transmission main and the realignment of'a new 36"water transmission main along the Trinity Boulevard right-of-way. The new 36" line will extend from the Interstate 820 and Trinity Boulevard off ramp termination point of the City of Fort Worth/TxDOT water relocation project and precede easterly along and adjacent to the off ramp to the Trinity Boulevard right-of-way for a distance of approximately 700 feet. The transmission main will then continue easterly within the Trinity Boulevard right-of-way for approximately 1,500 feet to reconnect to the existing 33" transmission main. Included will be water line facilities and crossings (within the existing right-of-way for Trinity Boulevard) for future development phase connections. Vermillion Office Park - 2840 W.Southlake Blvd.,Suite 110 - Southlake,Tx 76092 Plione: (817)552-6210 Fax: (8 17)778-4845 Mr. Kenneth Newell May 01,2018 Page 2 B. Water Profiles: Water line profiles will be provided for the proposed 36" water transmission main and laterals. C. Traffic Control and Phasing Plans: Traffic control and phasing plans along with necessary details will be prepared for the construction of the proposed water line along Trinity Boulevard. D. Erosion & Sediment Control Plan: The plan will be prepared in compliance with the Texas Pollutant Discharge Elimination System (TPDES) program administered by the Texas Commission on Environmental Quality (TCEQ). The plan will include erosion and sediment control measures for use during construction of the project. E. Construction details. After reviewing the plans with the Client and City of Fort Worth staff, Icon will prepare the necessary applications and submit the Water Plans to the City of Fort Worth. We have included attending all required design coordination meetings with City staff for the purpose of obtaining plan approval. 2) Storm Water Pollution Prevention Plan The Storm Water Pollution Prevention Plan (SWPPP) manual will be prepared in accordance with the Texas Pollutant Discharge Elimination System (TPDES) General Permit for Storm Water Discharges from Construction Activities. This program is administered by the Texas Commission on Environmental Quality(TCEQ). The SWPPP manual will be prepared to cover the entire project. It is assumed that there will be a single General Contractor with overall responsibility for the day-to-day operations. That General Contractor will be responsible for implementing the SWPPP and for conducting the periodic inspections as required by the regulations. 3) Project Meetings During the surveying, planning, and design phases, Icon will attend project meetings with the Client, City of Fort Worth staff and/or other project design team members. We have budgeted 20 man-hours for meetings. 4) Construction Phase Services Construction administration services will be performed for the following: A. Prepare bid proposal forms for the 36" public water transmission main improvements. It is anticipated that all improvements will be bid as one bid package. B. Prepare bid proposal documents and submit to the Client/City of Fort Worth for distribution to contractors for bidding purposes. Mr.Kenneth Newell May 01,2018 Page 3 C. Prepare and issue addenda as appropriate to clarify, correct or change the bidding documents. D. Attend the pre-bid meeting for public water transmission main improvements. E. Respond to contractor questions during the bidding process. F. Once the construction bids have been submitted, assist the Client/City of Fort Worth in preparing a bid tabulation and in contractor selection. G. Provide assistance to the Client/City of Fort Worth in the preparation of construction contracts for execution by the Client and the successful contractor. H. Attend the pre-construction conference. I. Review request for information (RFI), shop drawings, material submittals, test reports, and change orders related to the work. J. Attend a once-a-month construction progress meeting. K. When the construction has been completed, perform a final review (in conjunction with City of Fort Worth staff) of the public water transmission main improvements and related work, and provide the contractors with a punch list for each phase. L. Once the punch list is completed, perform a final review of completed improvements in union with City of Fort Worth staff to verify all punch list items have been completed. 5) Record Drawings Upon completion of construction, Icon will prepare one (1) set of mylar record drawings, three (3) full size bond drawing sets, and electronic files in CAD and PDF formats for the City of Fort Worth based on marked-up plans to be provided by each of the contractors. COMPENSATION Icon Consulting Engineers, Inc. proposes to provide the Basic Scope of Services as described above on a joint lump sum/hourly fee basis as follows: 1) Water Transmission Main Plans - Icon will perform the services as described for a lump sum fee of$62,500. 2) Storm Water Pollution Prevention Plan—Icon will perform the services as described for a lump sum fee of$3,500. 3) Project Meetings - Icon will perform the services as described on an hourly fee basis at our standard hourly rates with an estimated fee of$3,800. Mr. Kenneth Newell May 01,2018 Page 4 4) Construction Phase Services — Icon will perform the services as described on an hourly fee basis at our standard hourly rates with an estimated fee of$12,000. 5) Record Drawings - Icon will perform the services as described for a lump sum fee of $2,000. Please note that the above fees are based on a smooth project implementation and have assumed no major changes to the scope of services. Fees shown for the hourly basis elements are for budgeting purposes only and invoices will reflect the actual time incurred. Should work outside the above scope of services be required, a separate proposal will be submitted to the Client for approval prior to our beginning the additional services. REIMBURSABLE EXPENSES Reimbursable expenses consisting of in-house reproduction charges and auto travel will be billed as a direct expense at our attached established rates. Reimbursable expenses consisting of courier services and outside reproduction charges will be billed as a direct expense at cost plus fifteen (15%) percent. Plan submittal and review fees, permit, filing and other agency fees, if paid by Icon, will be billed as a direct expense at cost plus ten (10%)percent. SPECIAL SERVICES We have made our best effort to prepare a thorough and complete proposal to successfully complete this project. However, there may be additional or special services that we are not currently aware of that are required or that the Client/City of Fort Worth may desire that we provide. These services may add time and cost to the ultimate schedule and budget for the project. Should such a situation occur, a separate proposal will be submitted to Riverbend Investment, LTD for approval prior to our beginning these services. The following is a partial list of services not considered to be a part of the Basic Scope of Services outlined in this proposal, but are services that can be provided if requested: • Geotechnical and environmental studies. • Design of improvements not specifically included in this proposal. • Assistance in the acquisition of property or off-site easements. • Hydraulic modeling of existing water system. • Redesign of the 36"water main after the layout has been approved by the client. • Revisions required due to amendments/changes in regulatory criteria (i.e., zoning and subdivision ordinances, design criteria, results of legislation, court decisions, etc.) adopted after the date of the proposal, which becomes effective retroactive prior to the date of the proposal. Mr.Kenneth Newell May 01,2018 Page 5 We at Icon Consulting Engineers, Inc. appreciate the opportunity to provide you with this proposal for professional engineering and surveying services for this project, and are very excited regarding the possibility of working with you. Once again, thank you for this opportunity. Please do not hesitate to call if you have any questions or if we may provide additional information. Sincerely, Icon Consulting Engineers,Inc. David C. Gregory,P.E. Vice President RN ProposalU8-05-01 Trinity Boulevard Water Main.doc con ons 1 1ftwm Dn��SPlarmeers The following five items listed below shall be incorporated into the Scope of Services of the letter proposal from Icon Consulting Engineers,Inc.to Mr.Kenneth Newell,dated May 1,2018,and incorporated into a design procurement agreement between the City of Fort Worth and Riverbend Investments,LTD. (1) Ownership of Plans. The City of Fort Worth shall own the plans and other documents and work product Icon creates for the Project. In the event Developer's Design Procurement Agreement with the City is terminated,City shall have the right to enter into an agreement with Icon for Icon to complete the Plans for the City. (2) ICON SHALL INDEMNIFY, HOLD HARMLESS AND DEFEND THE CITY OF FORT WORTH AGAINST LIABILITY FOR ANY DAMAGE CAUSED BY OR RESULTING FROM AN ACT OF NEGLIGENCE, INTENTIONAL TORT, INTELLECTUAL PROPERTY INFRINGEMENT, OR FAILURE TO PAY A SUBCONTRACTOR OR SUPPLIER COMMITTED BY THE ICON OR ICON'S AGENT, CONSULTANT UNDER CONTRACT, OR ANOTHER ENTITY OVER WHICH THE ICON EXERCISES CONTROL." (3) Icon shall list the City as an additional insured on Icon's insurance policy. (4) Icon agrees that the City shall, until the expiration of three(3)years after final payment under this Agreement, have access to and the right to examine any directly pertinent books, documents, papers and records of Icon involving transactions relating to this Agreement. Icon agrees that the City shall have access during normal working hours to all necessary Icon facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. The City shall give Icon reasonable advance notice of intended audits. (5) Icon shall prepare water line easement documents necessary for the Project. Developer Engin Riverbend Investments,LTD,a Icon Consulting Engineers,Inc. Texas Limited Partnership By: RBE Investment Corp, Its general er Name: Kenneth Newell ame: Davi C r ,P.E. Title:President Title: Vice P id 2840 W Southlake Boulevard,Suite 110 - Southlake,Tx 76092 Phone: (817)552-6210 - Fax: (817)552-3126 ENFN—F-9007 0 F ALCOR CERTIFICATE OF LIABILITY INSURANCE DATE(MM DD/YYYY) 02/15/2019 THIS CERTIFICATE IS ISSUED ASA 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 Carolyn Lease NAME: Cavnar Insurance Agency HONEExt: (817)337-7844 AXX No: (817)719-9231 PO Box 93297 E-MAIL Carolyn@cavnarinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC p Southlake TX 76092 INSURERA: Valley Forge Insurance Company 20508 INSURED INSURER B: The Continental Insurance Company 35289 Icon Consulting Engineers,INC INSURERC: Arch Insurance Co 2840 W SOUTHLAKE BLVD STE 110 INSURER D: INSURER E: SOUTHLAKE TX 76092 INSURER F: COVERAGES CERTIFICATE NUMBER: CL18121302635 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICYNUMBER MMIDD/YYYY MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE 1 OCCUR PREMISES Ea occurrence $DAMAGE TO RENTE 300,000 MED EXP(Any one person) $ 10'000 A 6021738417 12/21/2018 12/21/2019 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 4,000,000 X POLICY 0 PRO- F 4,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: EPLI $ 10,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 6021738417 12/21/2018 12/21/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY YIN 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A 6021738403 12/21/2018 12/21/2019 E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ h Professional Liability EacClaim 2,000,000 C PAAEP0012003 12/16)2018 12/16/2019 Aggregate 2,000,000 Deductible 10,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The General Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. The General Liability policy includes a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contact between the named insured and the certificate holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS. 200 Texas Street AUTHORIZED REPRESENTATIVE Fort Worth TX 76102 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD EXHIBIT C 1.01 Dutytquire and Maintain. Developer shall ensure that a policy or policies of insurance are procured and maintained at all times, in full force and effect,to provide coverage of the types and amounts specified herein, naming the City as an additional insured as set forth herein, and covering all public risks related to this Agreement. The insurance required hereunder may be met by a combination of self-insurance and primary and excess policies. 1.02 Types and Amounts of Coverage Required a. Commercial General Liability: (1) $1,000,000.00 per occurrence, $2,000,000.00 aggregate, including coverage for the following: (i)Premises Liability; (ii)independent contractors; (iii) products/completed operations; (iv) personal injury; (v) contractual liability; (vi) explosion, collapse, and underground property damage b. Property Damage Liability: (1) $1,000,000.00 per occurrence C. Umbrella Policy (1) $4,000,000.00 f. Worker's Compensation: (1) As required by law g. Employer's Liability: (1) $1,000,000.00 per accident 1.03 Revisions to Required Coverage. At the reasonable recommendation of the City's Risk Manager,the City may at any time revise insurance coverage requirements and limits required by this Agreement. Company agrees that within ten (10) days of receipt of written notice from the City, all such revisions requested by the City will be implemented. The policy or policies of insurance shall be endorsed to provide that no material changes in coverage, including, but not limited to, cancellation, termination, non-renewal, or amendment, shall be made without thirty (3 0)days'prior written notice to the City. 1.04 Underwriters and Certificates. The insurers for all policies must be licensed and 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 Risk Management. If the rating is below that required, prior written approval of the City's Risk Management Division is required. Design Procurement Agreement for Public Water Line Relocation Page 12 of 13 Riverbend Investments,LTD Within ten(10)business days following execution of this License,Developer shall ensure that City is furnished with certificates of insurance signed by the respective companies as proof that the types and amounts of insurance coverage required herein have been obtained. In addition, Developer shall, on demand,provide the City with evidence that it has maintained such coverage in full force and effect. 1.05 Deductibles. Deductible or self-insured retention limits on any line of coverage required herein shall not exceed $25,000.00 in the annual aggregate unless the limit per occurrence or per line of coverage, or aggregate is otherwise approved by the City. 1.06 No Limitation of Liability. The insurance requirements set forth in this section and any recovery by the City of any sum by reason of any insurance policy required under this License shall in no way be construed or affected to limit or in any way affect Company's liability to the City or other persons as provided by this Agreement or law. 1.07 Umbrella or Excess Liability. If insurance policies are not written for specified coverage limits,an Umbrella or Excess Liability insurance for any differences is required. Excess Liability shall follow form of the primary coverage. 1.08 Additional Insured. The City, its officers, employees and volunteers shall be named as an Additional Insured on the Commercial General Liability policies. 1.09 Waiver of Subrogation. The insurance shall include a waiver of rights of recovery (subrogation)in favor of the City of Fort Worth. 1.10 Copies of Policies and Endorsements. City shall be entitled, upon request and without expense, to receive copies of policies and endorsements thereto and may make any reasonable requests for deletion or revision or modifications of particular policy terms,conditions,limitations, or exclusions in order to comply with the requirements of this Agreement except where policy provisions are established by law or regulations binding upon either of party or the underwriter on any such policies. 1.11 Certificate of Insurance. Developer shall submit to the City a certificate of insurance evidencing all required insurance coverage and any applicable endorsements. Design Procurement Agreement for Public Water Line Relocation Page 13 of 13 Riverbend Investments,LTD TE A�C40RV® CERTIFICATE OF LIABILITY INSURANCE DA2i6/zo'9"' 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(les)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 NAME: Gwendolyn BlvinS ITO P S C Inc PHONE (972)252-9999 -FAX, N0; (9771751-9367 2311 Texas Drive Ste 100 E-MAIL ADDRESS: en.bivinsQinsteaml.com INSURERS AFFORDING COVERAGE NAIC Irving TX 75062 INSURER A:Travelers Lloyds Ins Company INSURED INSURERB:The Phoenix Insurance Company 25623 RBE Investment Corp INSURER C:SCOttsdale INSURER D: P 0 BOX 185219 INSURERE: Sort Worth TX 76181 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1811210388 6 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 TYPEOFINSURANCE ADDL SUER POLICPOLICYNUMBER MM/DDYEFF POLICY EXP MM/DD/YYYY LIMITS LTR COMMERCIAL GENERALUABIIJTY EACH OCCURRENCE S 1,000,000 A CLAIMS-MADE a OCCUR PREMISES Ea occurrence) S AMAGETORENTED 300,000 660-464H3403 11/16/2018 11/16/2019 MED EXP(Any one person) S 5,000 PERSONAL 4,ADV INJURY S 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY❑PRO- JECT 7 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 Ea acddeM B ANYAUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BA OL755407 11/16/2018 11/16/2019 BODILY INJURY(Per act:Merd) S X OS AUTOS HIREDAUTOS X NON-OWNED PROPERTY DAMAGE S AUTOS Per accident) Uninsured motorist combined single S 1,000,000 X UMSRELLALIAB HOCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS UAB CLAIMS-MAD E AGGREGATE $ 5,000,000 DED I X I RETENTION$ 0 CUP-7J913814 11/16/2018 11/16/2019 S WORKERS COMPENSATION PERATUTF THI ER - AND EMPLOYERS'LIABILrTY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑N/A E.L.EACH ACCIDENT 5 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 11 yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Occupational Accident TNS0000757 1/1/2019 1/1/2020 Per Oc/Agg Medlin NO limit with Employers Liability Employers WbPeramployse $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,AddlUonal Remarks Schedule,may be attached If mon apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF FORT WORTH THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 1000 THROCKKORTON ACCORDANCE WITH THE POLICY PROVISIONS. FORT WORTH, TX 76102 AUTHORIZED REPRESENTATIVE W Vacek Jr/DWEST ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS026(201401) ACORD® CERTIFICATE OF LIABILITY INSURANCE °"21/2o'i9' THIS CERTIFICATE IS ISSUED ASA 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(les)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). CONTCT: Gwendolyn H1Yln9 PRODUCER NAME ITO P 6 C Inc NE No.Fxtl. (972)252-9999 F PHONo:197212s2-9363 2311 Texas Drive Ste 100 E-MAIL gwen-bivins@insteaml.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 Irving TX 75062 INSURERA:Colony Ins Company INSURED INSURER B: Riverbend Investment LTD INSURER C: P 0 Box 185104 INSURER D: INSURER E: Ft Worth TX 76181 INSURER F: COVERAGES CERTIFICATE NUMBER:CL192103937 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 CONTRACTOR 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. INSRTYPE OF INSURANCE A 9 BR POLICY NUMBER MMIIOD EFF MM)LDICY EXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 AMAGE TO RENTED A CLAIMS-MADE a OCCUR PREMISES Ea occurrence) S 100,000 103GL000895002 3/12/2018 3/12/2019 MED EXP(Any one person) 5 5,000 PERSONAL d ADV INJURY S 1,000,000 GENLAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 2,000,000 X POLICY 0 PRO- 7 LOC PRODUCTS-COMP/OPAGG S 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S Ea accident) ANYAUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE S HIREDAUTOS P AUTOS Per accident S X UMBRELLA LIAR I X OCCUR EACH OCCURRENCE $ 4,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 4,000,000 DED I X I RETENTION$ 10,000 X3171902-00 3/12/2018 3/12/2019 $ WORKERS COMPENSATION PFA MITE OTH- AND EMPLOYERS'LIABILITY Y I N ER ANY PROPRIETORIPARTNER/EXECUTIVE ❑N/A E.L.EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,dascribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S B Occupational Accident THS0000757 03/15/2019 03/15/2019 EmployersLleblrly(per employee) $2,000,D00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) 30 Day cancellation attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF FORT WORTH THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 1000 THROCKMORTON ACCORDANCE WITH THE POLICY PROVISIONS. FORT WORTH, TX 76102 AUTHORIZED REPRESENTATIVE William Vacek Jr/WJV ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS026(201401)