HomeMy WebLinkAboutContract 45616 MY
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FORTWORTH
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C0NTrtAj(:Y,0n/ 'j1, Co.
„a ca", PROJECT MANUAL
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CLIEW DEWR i IIV�VIe FOR
THE CONSTRUCTION F
WESTERN C"EN"TER BLVD.AT NORTH RIVERSIDE DR.
AND
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FARM TO MARKET 1187 AT I EMPHILL STREET
INTERSECTION IMPROVEMENTS
C"i `r0je�cNo.02182
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Betsy Price Toms Higgins
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Mayer Interim City Manager
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Douglas W.Wrersi ,P.E.
Director,Transportation and Public Works Department
Prepared for
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The City of Fort Wort
Transportation on and Plubilic Work
Infrastructure Resign and Construction Group
2013
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1 Half Associates,Inc.
4000 Fossil Creek Boulevard
Fw Fort"""worth,Texas 76137
Firm Registration Now F'-312 nL
TrnnS stems Corporation Consultants
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t 500 W.7th Street,Suite 11010
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Fort Werth,'Teas 76102 r BENJAMIN l�� E
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M&C Review Page 1 of
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FORTWOR-TH
CITY COUNCIL AGENDA
COUNCIL ACTION: Approved on 4/16/2014
�NO
GATE: 4/15/2014 REFERENCE NO.:**C-28788 LOG NAME: 20N RIVERSIDE AT
WESTERN CENTER
PUBLIC
CODE. C TY'P'E. CONSENT I�IEARING. N
SUBJECT: Authorize Execution of a Construction Contract with Durable Specialties, Inc.,in the
Amount of$748,000.00 for Installation of New Traffic Signals, Paving Improvements,
Median Modifications,Sidewalks and ADA Ramps at Two Intersections, North Riverside
Drive at Western Center Boulevard and FMI 11187 at Hemphill Street and Provide for
j Contingencies for a.Project Total in the Amount of$914,185.00
Project Costs and Contin enc�e
(COUNCIL DISTRICTS 4 and )
,' RECOMMENDATION:
N
It is recommended that the City Council authorize the execution of a construction contract with
Durable Specialties, Inc., in the amount of$748,000.00 for installation of new traffic signals, paving
improvements,median modifications,sidewalks and ADA ramps at two intersections, Forth Riverside
Drive at Western Center Boulevard and FM 1187 at Hemphill Street and provide for project costs and
contingencies for a project total in the amount of$914,185.00.
DISCUSSION:
These projects were evaluated using the Intersection Improvements Criteria developed in 2004 to
select locations where improvements are needed(City Project No.02182).The criteria are based on
traffic congestion,vehicular delays, accident history and pedestrian access.These improvements
include instaillling new traffic signal hardware with new ADA ramps and median modifications on Forth
Riverside Drive at Western Center Boulevard and FM 1187 at Hemphill Street.
POP
Funding for this project is included in the 2007 Critical Capital Plrojects Fund and the Street
Improvements 2008 Fund. The contract was advertised for bid in the Fort Worth Star-Telearam on
December 5,2018 and December 12, 2018.The following bid was received on January 18,2014:
BIDDER A►MOUNT
Durable Specialties, Inc. $748,000.00
The bid received was within the City's estimate of probable costs. Staff considers this amount to be
fair and treasonable for the scope of work to be performed.
MfWBE Office-Durable Specialties, Inc.,is in compliance with the City's BDE Ordinance by
committ ing to 10 percent MBE participation on this project. The City's MBE goal for this project is
nine percent. Construction will'begin,dune 5,2014.
This project is located l in COUNCIL DISTRICTS 4 and 8, Mapsco 262Z and 466J.
FISCAL INFORMA►TION'XERTIFICA►TION:
The Financial Management Services Director certifies-that are available in the current capital fund„as
appropriated,in the 2007 Critical)Capital Projects Fund and the Street Improvements 2008 Fund.
TO Fund/Account/Centers, FROM Fund/Account/Centers,
POP
h 'ap s.c wune�t.or council. packet/mc_revi ewu.a.sp?ID=1. . . 4/15/2014
M&C Review Page 2 of 2
0204 541200 2043902182813 $503,000.00
0295 541200 2047102,182813 $245,000.00
..........
Submitted for City Manager's Office by: Fernando s,ta(6122)
in tun NA
Department Head* Douglas W.Wiersig(7801)
Additional Information Contact: Lissette Acevedo(272,2)
ATTACHMENTS
1187 at Hem pLh� ll mappdf
http://apps.,cfwn,et.,org/c,ounci,l,_packet/mc,—review.asp?ID=1. . . 4/15/ 14
J
j
CITY OF FORT."WORTH
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT
T
ADDENDUM NO.I
WESTERN CENTER` ER BL''VD.AT"NORTH R.VERSIDE DR.
N�
AND
FARM TO MARKET KET 1 1.87 AT HE,1' PHILL,STREET
INTERSECTION IMPROVEMENTS
D.O.E.2134
CITE'`PROJEC T NO.02182
ADDENDUM RELEASE IRATE: January 3,2114
BID RECEIVED DATE: January 16,20x4
The Plans, Specifications and Contract Documents for the above referenced project are hereby
revised and amended as follows:
1. SECTION' 00 1.1 13 1NVITATION TO BIDDERS Page l of 2: Bid Date is
revised froni Tliursday,January 9,2'014 to ThursdaV,January ar 16,2014.
y„ 2. Clarification: The paving improvements for"''western Center .blvd. and North Riverside
Dr. shall be constructed in two phases. 'rile Western Center Blvd. median noses shall be
constructed in one phase. The islands and North Riverside Dr. median noses shall be
constructed in a second phase.
3. Replace entire proposal section with the version enclosed herein. (Revised excel
spreadsheet has been pasted to BLIZZsaw
a. Removed the following bid item from Unit I:
i. Bid Item 64 Irrigation Adjustments
b. Revised the quantity of the following bid items in Unit I:
i.. Bid Item 27—Valve Box Adjustment: Quantity increased from 2 EA to 4
EA
ii.. Bid Item 38—Furnish/Install Radar Detector Bach Plate 4: quantity reduced
frorn 4 TA to 1 EA
c. Revised the quantity of the following bid items in Unit 11:
r_
i. Bid Item 33 — Furnish/Install Advance Radar Detector: Quantity reduced
from 6 EA to 2 EA Bid Item#revised to did Item 34
ii. Bid Item 34—Furnisl 'Install Radar Cable: Quantity reduced from 3480 LF
to 2365 LF r.turd Item#revised ed to.did Item 3
iii. .Bid Item 3 Furnish/Install Radar Detector Bach Plate 4: Quantity reduced
from 6 EA to 2 EA Bid Item#revised to Bid Item 3
U} iv. Bid Item 36—Furnish/Install Radar Detector Bach Plate 6: Quantity reduced.
fi
i
WESTERN "ELATE L D.AT NORTH R-1VE1 SIDE DR.
I11„
AND
FARM TO ARKET 1187 AT HE:MPHILL S"rRErLT
INTERSECTION IMPROVEMENTS
ADDENDUM Nth. 1.
frorn 6 EA to 0 EA-Bid Item#rev.red to Bid Item 37
d. Added the following bid items to Unit :
i. 'New laid item 64—Utility Adjustment Allowance--$5,000.00
ii. laid Item 65—Construction Allowance-$1000.00
e. added the following laid items to Unit 11:
i. Bid Item 10—Excavation(roadway)—106 CY
All subsequent id Items were renumbered accordingly
a ii. Bid Item 68—Construction Allowance-$101000.00
4. replace Section 00 21 1 "Instructions to Bidders'with the attached document.
5. Replace Section 00 45 11 "Bidders Prequalifications"with the attached document.
6. Add the attached TxDOT Special Provision 002---017 to the contract documents..
7. Replace Section 01 11 00 "Summary of Work", paragraph 1.4. .2. with the following
paragraph,
"The Contractor shall locate, verify working, condition and protect all existing sprinkler
systems lines and heads(if'any). remove,adjust and reinstall in good condition equal to or
better than existing condition; replace, if in dared conflict, with the same or letter,quality
material and appurtenances. Payment shall be made per the Utility Adjustment Allowance
bid item.19
8. Removed the.following specification under Division 99--Special Technical Specifications:
99N9�9�.0010 ITLI�yI-IRRIGATION I'4.�►, ADJUSTMENTS
.. Added the fallowing specifications under Division 9' Special Technical Specifications:.
9999.00 10 III1►IT 1"' --
UTILITY ADJUST ENT ALLOW A.N C E
Items bid as Utility Adjustment Allowance shall consist of utility adjustments(:fix. irrigation
adjustments) or other non-subsidiary items requested for construction by the City of fort
Worth and at the direction of the Project Engineer. `I"'he payment to the Contractor shall be
the actual cost of the work plus ten percent(10%)to cover the cost of bond and overhead
incurred by the Contractor in handling,the wort.
999' .0015 BID ITEM--CONSTRUCTION ALLOWANCE
Items bid as Construction Allowance shall consist of miscellaneo us construction or other
non-subsidiary items requested for construction by the City of Fort Worth and at the
direction of the Project Engineer. The payment to the Contractor shall be the actual cost of
the work plus ten percent (10�%) to cover the cost of bond and overhead incurred by the
Contractor in handling the wort.
Addendum Flo. 1
WESTERN CENTER BLVD.AT NORTH RIVERSIDE DR.
AND
FARM TO MARKET 1187 Arl'HEIMUIIPHILL STREET
Il' TER ECTI N IMPROVEMENTS
ADDENDUM NO. I
10. Replace the following Sheets with these attached to this addendum:
a. Sheet A4
h. Sleet A7
e. Sheet A8
d. Sheet B2
e. Sheet B4
1 Sheet,1
g.. Sheet B6
h.. Sheet B9
i. Sheet B 1
j. Sheet B 11
11.Remove the following TxDOT Standard from the plans:
a. TxDOT FW District Standard CP-TEP-03
12.Add the attached City of Fort Worth Standards to the Farm to Market 1187 and 1.lemphill
Street portion of the plans:
a. Traffic Signal.Pole Details( 4 41 1 -D60 )
J h. Traffic Signal Miscellaneous us Details( 4 41 1 -D 7)
13.Add the attached Tx T Standards to the plans:
a. CRC (1)-1 (2 Sheets)
h. BC Standards(12 Sheets)
c. v'Z(BT )-1 (2 Sheets)
,. d. T P(2-4)-12(1 Sheet)
%, Adde, d u No. 1
WESTERUN CENTER BLVD.AT NORTHRIVERSIDE,DR.
AND
FARM TO MARKET 1187 AT HEMPHILL STREET
INTERSECTION IMPROVEMENTS
ADDENDUM NO. I
Please acknowledge receipt of the AddendLIM in the following locations:
(1) In the space provided below
(2) In the amended Proposal
(3) Indicate in Lipper case letters Oil the Outside of the sealed bid,envelope:
"RECEIVED&ACKNOWLEDGED ADDENDUM NO. 11)
ply Failure to acknowledge the receipt of Addendum No. I could cause the subject bidder to be
considered "NON-RES PONS WE", resulting in disqualification- A signed copy of this
addendum shall be placed into the proposal at the time of bid submittal.
RECE'l PT ACKNOWLEDGED:
By: V A
Title:
Addendum o. 1
J;
005243-1
Agreement
Pagel of5
1 SECTION 00 52 43
2 AGREEMENT
3
4 AGREEMENT THIS AGREEMENT,is made by and between
5 The City of Forth"worth,a home rule municipal corporation in the State of Texas,acting by and
6 through its City Manager,hereinafter called City,and Durable Specialties,Inc.,a corporation.
7 (legal description,e.g.corporation,LP,L LQ,authorized to do business in Texas,acting by and
8 through its duly authorized representative,hereinafter called Contractor.City and Contractor,in
9 consideration of the mutual covenants hereinafter set forth,agree as follows:
a
10 Article 1.WORK
11 Contractor shall complete all Work as specified or indicated in the Contract Documents for the
12 Project identified herein.
13 Article 2.PROJECT
14 The project for which the Work Linder the Contract Documents may be the whole or only a part is
15 generally described as follows:
1.6 Installation of New Traffic Signals,Paying,Ian rovements Median Modifications
17 Sidewalks and ABA Ramps at Two Intersections North Riverside Drive at Western Center
1 18 Boulevard and FM 11 7 at Hemphill Street
19 CITY PROJECT NCB.till 2
20 Article 3.CONTRACT TIME
U
1 3.1 Time is of the essence.
22 All time limits for Milestones,if any,and Final Acceptance as stated in the Contract
23 documents are of the essence to this Contract.
4 3.2 Final Acceptance.
25 The Work will be complete for Final Acceptance within 180,calendar days after the date
26 when the Contract Time commences to run as provided in Paragraph 2.03 of the General
27 Conditions.
JJII
28 3.3 Liquidated damages
29 Contractor recognizes that time is of the essence of this A greement and that City will
30 suffer financial lass if the Work is not completed within the times specified in paragraph
31 3.2 above,plus any extension thereof allowed in accordance with Article 12 of the
32 General Conditions.The Contractor also recognizes the delays,expense and difficulties
�; 33 involved in proving in a legal preceding-the actual loss suffered by the City if the Work is
34 not completed on time.Accordingly,instead of requiring any such proof,Contractor
35 agrees that as liquidated damages for delay(but not as a penalty),Contractor shall pay
36 City Two.Hundred Fifty Dollars($250.00)for each day that expires after the time
7 specified in Paragraph 3.2 for Final Acceptance until the City issues the Final.Letter of
38 .Acceptance..
FOR
If,,.
CITY OF FORT WORTH Western Center Blvd at North Riverside Dr
STANDA.RD CONSTRUCTION SPECIFICATION DOCUMENTS Farm to Market 1187 at Hemphill St
R vised ug-ust 17,2012 02182
00 5,2 43-2
Agreement
Page 2 of 5
39 Article 4.CONTRACT'PRICE
40 City agrees to pay Contractor for performance of the Work in accordance with the Contract
41 Documents an amount in,current funds of Seven Hundred Forty-eight Tho�usand and
42 no/100.........................................................................Dollars($748,000.00),
43 Article 5.CONTRACT DOCUMENTS
44 51.1 CONTENTS:
45 A. The Contract Documents which comprise the entire agreement between City and
46 Contractor concerning the Work consist of the following:
I PP 47 1. This,Agreement.
48 2. Exhibits to this Agreement:
49 a. Bid Forrn
50 1) Proposal Form
51 2) Prequalificatioln Statement
52 3) State and Federal documents
53 bi. Current.Prevailing Wage Rate Table
017
n( )
54 c. Insurance Accord Foin s
55 d. Payment Bond
56 e. PerfonTiance Bond
57 f. Power of Attorney for the Bonds
518 g. Worker's Cornpensation Affidavit
519 h. MWBE Commitment Form
60 3. General Conditions.,
61 4. Supplementary Conditions.
62 5. Specifications as included in the Project Manual.
63 6. Drawings.
64 T, Addenda.
"10
65 8. Documentation submitted by Contractor prior to Notice of Award.
66 9. The following which may be delivered or issued after the Effective Date of the
67 Agreement and,if issued,become an incorporated part of the Contract Documents:
68 a. Notice to Proceed.
69 b. Field Orders.
70 c. Change Orders.
71 d. Letter of Final Acceptance.
pt,
72
73
"M
CITY OF FORT WORTH Western Center Blvd at North Riverside Dr
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Karr to Vfarket 1'187 at Hemphill St
RevisedAugmt 17,2012 02182
l
52 43 3
Agreement
Page 3 of
74 ,article 6. NINI FI A I N
75 6.1 Contractor covenants and agrees to indemnify,hold harmless and defend,at its own
76 expense,the city,its officers,servants and employees,from and against any and all
77 claims arising out of,or alleged to arise out of,the work and services to be performed
78 by the contractor,its officers,agents,employees,subcontractors,licenses or invitees
79 under this contract.This indemnification provision is s ecificall intended too erate
80 and be effective even if it is alleged or proven that all or some of the damages es bein
81 sought were caused in whole or in art by any act omission or ne li ence of the ci
without M i indemnity 8 This indemnity provision is intended to include, thout limitation, ndemnity for
83 costs,expenses and legal fees incurred by the city in defending against such claims and
84 causes of actions.
85
86 6.2 Contractor covenants and agrees to indemnify and hold harmless,at its oven expense,
87 the city,its officers,servants and employees,from and against any and all loss,damage
88 or destruction of property of the city,arising out of,or alleged to arise out of,the work
89 and services to be performed by the contractor,its officers,agents,employees,
90 subcontractors,licensees or invitees under,this contract. This indemnification
91 provision is specifically intended tooperate and be effective even if it is alle ed or
92 proven that all or some of the damages being sought were caused in whole or in part
9�3 by any act omission or ne li ence of the cit
94
95 Article 7.,MISCELLANEOUS
96 7.1 Teams.
97 Terms used in this Agreement which are defined in Article 1 of the General eneral Conditions will
98 have the meanings indicated in the General Conditions,
99 7.2 Assignment of Contract..
100 This Agreement,including all of the Contract Documents may not be assigned by the
101 Contractor without the advanced express written consent of the City.
102 7,3 Successors and Assigns.
103 City and Contractor each binds itself,its partners,successors,assigns and legal
104 representatives to the other panty hereto,in respect to all covenants,agreements and
105 obligations contained in the Contract Documents.
U,.,
106 7.4 Severability.
1.07 Any prevision or pat of the Contract Documents held to be unconstitutional,void or
POP 108 unenforceable by a court of competent jurisdiction shall be deemed stricken,and all
109 remaining provisions shall continue to be valid and binding upon CITY and
110 CONTRACTOR..
111 7.5 governing Law and Venue.
112 This Agreement,including all of the Contract Documents is performable in the Mate of
113 Texas.Venue shall be Tarrant County,Texas,or the?united States District Court for the
114 Northern District of Texas,Fort'worth Division.
r�
CITY OF FORT WORTH PVester n(.7enter Blvd at North Riverside Dr
STANDARD CONSTRUC-HON SPECIFICATION DOCUMENTS Farr to Market 118'7 at Hemphill St
NO Revised August 17,2012 0 182
005243-4
Agreement
VPW Page of 5
115 7.6 Other Provisions.
116 the Contractor agrees to pair at least minimum wage per hour for all labor as the same is
117 classified,promulgated and set out by the City,a copy of which is attached hereto and
118 made a part hereof'the same as if it were copied verbatim herein.
119 7.7 authority to Sign.
120 Contractor shall attach evidence of authority to sign Agreement,if other than duly
121 authorized signatory of the Contractor.
122
123 SIGNATURE PAGE'iT' FOLLOW
124
1�
CITY OF FOR.°..C"WORTH Western "enter Blvd at,North Riverside Dr
STANDARD CONSTRUCTION N SPECIFICATION DOCUMEN'rs Farm to Market 11'87 at Hemp dl,"t
Revised August 17,2012 O2182
005243-5
Agreement
Page 5 of
125 IN WITNESS WHEREOF,CAF, ter and Contractor have signed this Agreement in multiple
16
counterparts. At least one counterpart each has been delivered to City"and Contractor.
127
128 This Agreement will be effective on Aprit,15,201.4 (which is the Effective Date of the
129 Agreement).
s; 130
ry
City of Fort Wort;
Contractor:
Fernando .costa
Assistant City Manager
V (Signature)
ZG OU
M C
c� V Date
sprint �ame)
Title: Attest: � .
�4._City Secretary
Address: �� h� 0�
(Sea]) ,,
"i "StateZ '. r s Form and Leg i ,--�`0
DOLIg t .Black
Assistant City Attorney
131.
132
133 APR": AL RECOMMENDED:
(ENDED:
134
135
1.37 �►+rilas W.Wi ig,P.E.
138 DIRECTOR,
139 Transportation ortation Publie Works Department
140
®�u�was�!�ui�mmWW�muuiwumumoom�mmdvromm�m�u�uuu i000uomumuummi�wi�� m��''"'�
OFFICIAL R
iem
stern Center Blvd at North Riverside Dr CITY `FORT vC RTI W
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form to Market 87 at Hemphill t
it�
I"M Revised August 17,2012 02182
p((/;;�iNAMamio�oFb'JMIN���rtfrtfMW4uAm rev. ' �uo��INNNMNrcrtm�ImRmumubudf�rtlliiiiR
ii
JJy 006113_I.
PERFORMANCE BOND
Page I of
u Bond 3375803
SECTION 00 6113
PERFORMANCE BOND
THE STATE OF TEXAS §
KNOW ALL BY THESE PRESENTS:
us, COUNTY OF TARRANT
That we,Durable Specialties.Inc.,known as"Principal"herein and Great American
Insurance Company of New York ,a corporate surety(,sureties,if more than
one)duly authorized to do business in-the State of Texas,known as"Surety"herein(whether one
or more),are held and firmly bound unto the City of Fort Worth,a municipal corporation created
U
pursuant to the laws ofTexas,known as"City"'herein,in the petal sure of,Seven Hundred
Fo -eight Thousand and no/100........................ Dollars($748,000.00),lawful money of
i
the United States,to be paid in Fort Forth,Tarrant County,Texas for the payi ncnt of which sum
well and truly to be made,we bind ourselves,our heirs,executors,administrators,successors and
"P, jointly and severally,firmly by these presents.
RPM W'HER.:LAS,the Principal has entered into a certain°written contract with the City
1 awarded the 1 day of ril,
2014 which Contract is hereby referred to and made a part hereof
for all purposes as if fully set forth herein,to famish all materials,equipment labor and other
u„
accessories defined by law,in the prosecution of the Work,including any Change Orders,as
provided for in said Contract designated as Installation offew Tr Signals,Paving
Impro vem nts,Median Modifications,Side-K;alks and ADA Ramps at Two Intersections,North
Riverside Drive at Western Center Boulevard and FM 1187 at Hemphill 'treet
City,project : 02182
NOW,THEREFORE,the condition of this obligation is such that if the said Principal
shall faithfully perform it obligations under the Contract and shall in all respects duly and
faithfully perform the Work,including Change Orders,under the Contract,according to the plans,
specifications,and contract documents therein referred to,and as well during any period of
extension of the Contract that may be granted on the part of the City,then this obligation shall be
and become null and void,otherwise to remain in Rill force and effect.
CITY of FORT WORTH Western Center Blvd at North Riverside,fir.
STANDARD CONSTRUCTION SPECIFICATION DO(-UNLENTS .Farris to Market 1187 at H mphill St.
:.vised August 17,2012, 02182
uyw
rl
0061 1,3 2
PERFORMANCE BOND
Page 2 of 3
PROVIDED ITURTBER,that if any legal action be fled on this Bond,venue shall lie in
Tarrant Count,Teas or the united Mates district Court for the Northern D strict of Texas,Fort
Worth:division.
This bond is made and executed in compliance with the provisions of Chapter 2253 of the
Texas Government Code,as amended,and all liabilities on this bond shall be determined in
accordance with the provisions of said statue.
I WITNESS S E F,the Principal and-the Surety have SIGNED and SEALED
o
this instrument by duly authorized agents and officers on this the 15th day of 20 4.
PRINCIPAL:
Durable Specialties, Inc.
BY: P
Signature
ATTEST:
ten,
C..mm.µ„
1„.. � �9�F � '"I�Imi.uM' ”'ry a'iiµ ��.*i � d IuwsKK " ," '4y„, ,° �. "M�•qb�. °„"
(Principal)Secretary Name adj isle _
Address: PO Sox 535969
man ra1r1e TX 75053
Witness as to Principal
Great r can lnsura , any
of r1
0ek
BY:
Kgnatnre
Jack M Crowley, Attorney in Fact
- awe and Title
Address: 15305 North Dallas Parkway
#1100 _..
. Addison, TX 75001
Witness as tea'Sur M �� Telephone Number: 972-385-9800
1
CI"T"E''OF FORT WORTH Westeni Comer Blvd at North Riverside Dr.
' TIT OCU TS Form Mar t 11 7 at Hemphill t.STANDARD CONSTRUCTION PEC1F1C
Revised.August 17,21 12 (➢2182
J
l'.
0061 13.3
1 M111 PERFORMANCE BOND
Page 3 of 3
*Note: If Signed by an officer of the Surety Company,there must be on file a certified extract
from the by-laws shoving that this person has authority to sign such obligation. If
Surety's physical address is different from its mailing address,both must be provided.
The date of the bored shall not be prior to the date the ContTact is awarded.
Vp
u,.,,
wy
C1 oP OR IORT'B
Western Center Blvd at North.riverside Dr.
STANDARD CONSTR? CTIO PECLFICATIO DOCUMENTS Fartn to Marls t 1187 at Hemphill St.
Revised August 17,2012 02182
u
GREAT AMERICAN I' 'SRAM E COMPANY OF NEW YORK
New York
Administrative Office:301 E 4TH STREET . CINCINNATI,OHIO 452.02 513-369-500�O • FAX 513-723-2740
The number of persons authorized by
this power of attorney is not more than FOUR No.0 `9950
POWER OF ATTORNEY
r
KNOW ALL MEN BY THESE PRESENTS:That the GREAT AMERICAN INSURANCE COMPANY OF NEW YORK,a corporation
organized and existing ender and by virtue of the laws of the State of New York,does hereby nominate,constitute and appoint the
person or persons named below its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of
the said Company,as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature
thereof;provided that the liability of the said Company on any such bond,undertaking or contract of suretyship executed under this
authority shall not exceed the limit stated below.
Dame Address Limit of Power
JACK M.CROWLEY PATRICIA A.SMITH ALL OF ALL
s-rE 'EN R.FOSTER MARIE PER Y"M'w?IAN ADDISON, $75,000,0W00
TEXAS
M This Power of Attorney revokes all previous powers issued on behalf of the attorney(s)-in-,fact named above.
IN WITNESS WHEREOF,the CLEAT AMERICAN INSURANCE ANCE COMPANY OF NE'IP11 YORK has caused these presents to be signed
and attested by its appropriate officers and its corporate seal hereunto affixed this 29TH' clay of NOVEMBER , 2012'
Attest GREAT AMERICAN INSURANCE COMPANY OF NEW YORK
IN RM SEAL 991
Assistcant,S"ec°rcttary Daisrrarrar Senicar Vice President
DAVID C.KITCHIN(877-377-24015)
STATE OF OHIO,COUNTY OF HAMILTON-ss:
On this 29TH day of NOVEMBER , 2012 ,before me personally appeared DAVID C.I ITCHIN,to me known,
being duly sworn,deposes and'says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond
Division of Great American Insurance Company of New"York,the Company described in and which executed the above instrument
that he knows the;seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed
his name thereto by like authority..
KAREN L.GROSHEIM
NOTARY Y PUBLIC,'TATS OF OHIO
MY COMMISSION EMPIRES 2-20-96
This Power of Attorney is granted by authority of the following resolutions adopted by the Beard of Directors of great
American Insurance Company of New York by unanimous written consent dated May 14,2009.
RESOLVED That the Divisional President,the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisional
Assistant Vice Presidents,or any one of them,be and hereby is authorized,from time to time,to appoint one or more Attorneys-in-Fact
to execute on behalf of the Company,as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations
in the nature thereof,to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment
at any time.
RESOLVED FURTHER.-That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant
Secretary of the Company may be affixed by facsimile to any power of attorney orcertificate of either given for the execution of any bond,
undertaking,contract of suretyship,or other written obligation in the etagere thereof,such signature and seal when so used being hereby
adopted by the Company as the original signature of such officer and the original,seal of the Company,to be valid and binding upon the
Company with the same force and effect as though manually affixed.
CERTIFICATION
I,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company of New York,do hereby certify that
the foregoing Power of Attorney and the Resolutions of the Board of Directors of May 14,2009 have not been revoked and are
now in Ball force and effect.
Signed and sealed thin 15t ay of April 2014
CDR Arf
S
.„4.s;sr.stcarrt Secretary
511551(4811)
E
00 61 l4-1
T
P � T BaND
Page I o 2
Bond 3375803
SECTION O,O 61 14
OR, PAY-NEM'BOND
'THE STATE OR TEXAS
KNOW ALL BY THESE PRESENTS:
COUNTY OF T ARRANT:
That eve, Durable Specialties., Inc.. known as "Principal" herein, and
C t o L an_Tusurance Company., o f New York a corporate surety
(sureties), duly authorized to do business in the State of Texas, known as "Surety" herein
whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal.
J, corporation created pursuant to the laves of the State of Texas, known as "City" herein, in the
penal sum of Seven Hundred Forty-eiLyht Thousand and no/100.... Dollars ($748, O�00. 0),
lawful money of the United States, to be paid in Fort Worth., Tarrant County, Texas, for the
payment of which sum well and truly be made, we bind ourselves, our heirs, executors,
administrators,successors and assigns,jointly and severally,firmly by these presents:
WHEREAS,Principal has entered into a certain written Contract with City,awarded the
15th of ,2014,which.Contract is hereby referred to and made a part hereof for all purposes
as if fully set forth herein.,, to furnish all materials, equipment, labor and other accessories as
», defined by law,in the prosecution of the Work as provided for in said Contract and designated as
Installation of New Traffic,Signals,.,_Pavin Iii rovements bedlam Modifications,
Sidewalks and ADA.:Ramps at Two Intersections North Riverside Thrive at Western Center
Boulevard and FM 11 87 at Hem hill Street
+Cl]t P_,red ct#02182.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if
Principal shall pay all ironies owing to any (and all) payment bond beneficiary as defined in
Chapter 2253 of the Teas Government Cade,as amended)in the prosecution of the Wort under
the Contract"then this obligation shall be and become null and void, otherwise to remain in ill
force and effect..
„N CITY OF FORT WORTH Western Center vBlvd at North Riverside Dr
STANDARD C"ONSTR.UCTION SPECIFICATION DOCUMENTS S F rm to Market 1187 at Hemphill St
Revised August 1,7,2012 02182
I
00 61 14-L.
1„ PAYS 1T BC1
Page 2 of 2
This bond is made and executed in compliance with the provisions of Chapter 2253 of the
Texas Government Code, as amended, and. all liabilities on this bond shall be determined in
accordance with the provisions of said statute.
IN WITNESS WHEREOF,the Principal and Surety have each SIGNED and SEALED
this instrument by duly authorized agents and officers on this the 15' day of� r�l,2014..
l
PRINCIPAL:
Durable c, lties Inc.
ATTEST: B
Signature
0� 1/a
(Principal)Secretary Marne and Title I
Address.
PQ Box- 10 5 969
Irand _..
0
Witness as to Principal
Great American Inaurace m
ny of
New York ��
o
E BY: d111 Sign#e_
ZA� _... ac 1.e�y, ttorney in "act
(Surety Secretary Name and Title
Address: 15305 North Dallas Parkway
#1100
.,.�
Addison, T 7 �0 1
Witness as Surer w,,
800
Telephone umber'
'
Note- If signed by an officer e Surety, there roust be on file a certified extract from the
bylaws showing that this person has authority to, sign such.. obligation. If Surety's physical
address is different,from its mailing address,both must be provided,
The date of the bond shall not be prior to the date the Contract is awarded..
END OF SECTION
CITY OF FORT WORTH West em Center vBlvd at North Riverside Dr
'9
STANDARD ARD CONSTRUCTIO SPECIFICATION DCCUIvENT r Farm to Market 1187 at Hemphill st
Revised August 17,2012. 02182
F
GREAT AMERICAN INSURANCE COMPANY OF NEW YORK
New York.
Administrative Office:341 E 4TH STREET CINCINNATI,OHIO 45202, 513-369-5000 0 FAX 513-723-,2740
The number of persons authorized by
this paver of attorney is not more than FOUR No.0 19950
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:That the GREAT AMERICAN INSURANCE COMPANY OF NET YORK,a corporation
organized and existing under and by virtue of the laws of the,Mate of New York,does hereby nominate,constitute and appoint the
person or persons named below its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of
the said Company,as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature
thereof;provided that the liability of the said Company on any such band,undertaking or,contract of suretyship executed under this
authority shall not exceed the limit stated below.
Name Address Limit of Power
JACK M.CROWLEY PATRICIA A.SMITH ALL OF ALL
VI STEVEN R.FOSTER MARIE PERR'YI' AN A DISON, $75,000,00U0
TEXAS
m This Power of Attorney revokes all previous powers issued on behalf of the attorneys)-in-fact named above.
IN WITNESS WHEREOF,the GREAT AMERICAN INSURANCE COMPANY OF NEW YORK has caused these presents to be signed
and attested by its appropriate officers and its corporate seal hereunto affixed this 29TH day of NOVEMBER , 2012
Attest GREAT AMERICAN INSURANCE COMPANY OF NEW YORK
SEA *1
Assr.stom.5ecreiary Divisional.fie ntor Vice President
DAVID C�.KITC IN(877-377-2405)
STATE OF OHIa,COUNTY OF HAMILTON-ss:
On this 29TH day of NOVEMBER , 2012 ,before me personally appeared DAVID C.KITCHIN,to me known,
being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond'
Division of Great American Insurance Company of New York,the Company described!in and which executed the above instrument;
that he knows the seal;that it was so affixed by authority of his office tinder the By-Laws of said Company,and that he signed
his name thereto by like authority.
KAREN L.CR SHEIMI
NOTARY PUBLIC,STATE OF OHIO
, MY COMMISSION EXPIRES 02'-20-`I0
•w
This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great
American Insurance Company of New York by unanimous written consent dated May 14,2009.
RESOLVED: That the Divisional President,the several Divisional Senior Vice,Presidents,Divisional/ice presidents and Divisional
Assistant Vice Presidents,or any one of them,be and hereby is authorized,from time to time,to appoint one or more Attorneys-in-Face
to execute on behalf of the Company,as suret,any and all bonds,undertakings and contracts of suretyship,or other written obligations
in the nature thereof;to prescribe their respective duties and the respective limits of their authority and to revoke any such appointment
at any time.
i
RESOLVED FURTHER:That the Company,seal and the signature of any of the aforesaid officers and any Secretary or Assistant
Secretary of the Company may be affixed by facsimile to anypow+er of attorney or certificate of either given for the execution of any bond,
undertaking,contract of suretyship,or other written obligation in the nature thereof,such.signature and seal when so used being hereby
adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the
a
Company with the same force and effect as though manually affixed.
CERTIFICATION
1,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company of New York,do hereby certify that
the foregoing Power of Attorney and the Resolutions of the Board of Directors of May 14,2009 have not been revoked and are
)y now in full force and effect.
1t
Signed and sealed this5' Iay of Ail 2014
w
00,
�wr
EAR.
,9',ssr.slcrnt 7ecr-etar;y
11851(4111)
X0611'9-1
M.AJ TENANCE BOND
Page 1 of
Band 3375803
SECTION 00 61 1
MAINTENANCE BOND
THE STATE►T E Off`'TEXAS "
KNOW ALL BY THESE PRESENTS:
I„, COUNTY OF T . T
That we Durable Specialties,Inc.,known as"Principal"herein and Great American
In sur an.c e Company of New York ,a corporate surety(sureties,if'more than
one)duly authorized to do business in the State of Texas,known as"Surety"herein(whether one
or more),are held and firrnly bound unto the City?of Fort"worth,a.,municipal corporation created
pursuant to the laws of the State of Texas,known as"City"herein,in the sure of Seven Hundred
Fo -el t Thousand an no/100..............................Dollars($748,000.00),lawful money.
of the United.Mates,to be paid in:Fort Worth,Tarrant County,Texas,for payment of which sum
well and truly be made unto the City and its successors,we bind ourselves,our heirs,executors,
administrators,successors and assigns,jointly and severally,firmly by these presents.
WHEREAS,the Principal has entered into a certain written contract with the City awarded
�y
the 1 5th day ofd,2014,which Contract is hereby referred to and a made part hereof for all
purposes as if:ally set forth herein,to furnish all materials,equipment labor and other accessories
as defined by lave,in the prosecution of the Work,including any'Work resulting from a duly
authorized Change Order(collectively herein,the"Work")as provided for in said contract and
designated as Installation of New'Traffic Si rrals Paving lam rovements Median
Modifications Sidewalks and ADAM Ramps at Two Intersections North Riverside Drive at
Western Center Boulevard and FM 1187 at Hem hill Street,,City Pro'eet 021.82,and
WHEREAS,Principal binds itself to use such materials,anal:to so construct the`Fork in
accordance with the plans,specifications and Contract Documents that the Work is and will
remain.,free from defects in materials or workmanship for and durin.g the period of two(2)years
after the date of Final Acceptance of the Work by the City("Maintenance Period");and
y,. WHEIREA. ,Principal binds itself to repair or reconstruct the'Work in whole or in part
upon receiving notice from.the City of the need therefor at any time within the Maintenance
y Period.
CITY OF FORT WORTH Western Center Blvd at North,Riverside Dr
STANDARD MNSTRUCTION SPECIFICATION DOCUMENTS Farm to Market 118"at Hemphill St.
Revised August 17,2012: 02182
115;
0061 19.2
tt'
MAINTENANCE BOND
�r
Page 2,of
NOW'T'�REFORE,the condition of this obligation is such that if Principal shall
remedy any defective Work,for which timely notice was provided by City,to a completion
satisfactory to the city,then this obligation shall become null and void;otherwise to remain in
full.force and effect.
PROVIDED,HOWEVER, if Principal shall fail so to repair or reconstruct any timely
3
noticed defective Work ,,it is agreed that the City may cause any and all such defective Work to
be repaired and/or reconstructed with all associated costs thereof being borne by-the Principal and
the Surety under this:maintenance bond,and
PROVIDED FURTHER,that if any legal action be filed on this Bond,venue shall lie in
Tarrant county,Texas or the'Linited States:District court for the Northern ern District of Texas,Port
p Worth Division,and
PROVIDED ED THER,that this obligation shall be continuous in.nature and
successive recoveries may be had hereon for successive breaches.
P
CITY CAF FORT WORTH Western Center Blvd at North Riverside Dr
STANDARD CONSTRUCTION SPECIFJC ATION DOCT WE1"T a Farm to Market]]87 at Hemphill St.
Revised August 17,2012 0218
Y,
0061 19-3
1
MAINTENANCE BOND
Page 3 of 3
I WITNESS`BEREOF,the Principal and the Surety have each I D and SEALED this
instrument by duly authorized agents anal officers on this the 1 5th day 2014.
PRINCIPAL
Durable Specialties, Inc.
BY-
r n^ V rd,Pm
Signature
.ATTEST-
A.'o 6/m�"'
�w a
Principal Secretary Name and Ti
<,q Address: P+3 Box 535969'
Grand Prairie, TX 75053
Witness as to Principal
SURETY:
e a t Aercan... nuraa .Ybm-pany of
w ature
.. Jack M Crowley, Attorney in Tact
ATTEST: Name and Title
_ Address: 153 5 Nor,th Dallas Parkway
ur cretary #1100
. .w Addison TX 75001
'witness a Surety" Telephone lumber: 972-385-9800
*NOTE. s icer of the surety company,there must he on file a certified
extract fro m the by-laws showing that this person has authority to sign such obligation. If
y surety's physical address is different from its mailing address,both must be provided.The date of
the bond shall not be prior to the date the contract is awarded
Y
CITY OF FORT W TPI Western Center,Blvd at North Riverside Dr
STANDARD CONSTRUCTION SPEC01 A.TI N I OCUNE H'I'S Farm to Market 1187 at Hemphill 8t.
Revised August 17 2012 02182
f
1/
GREAT AMERI AN IN SU RANCE COMPANY OF NEW YORK
New York
IF Administrative Office:301 E 4TH STREET * CINCINNATI,OHIO 45202 w 513-369-5000 is FA)(513-723-2740
The number,of persons authorized by
this power of attorney is not more than FOUR No.0 199,50
POWER OF ATTORNEY
1101 011 KNOW ALL MEN BY THESE PRESENTS.That the GREAT AMERICAN INSURANCE COMPANY OF NEW YORK,a corporation
organized)and existing under and by virtue of the laws of the State of New York,does hereby nominate,constitute and appoint the
person or persons named below its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of
the said Company,as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature
thereof;provided that the liability of the said Company on any such bond,undertaking or contract of suretyship executed under this
`� authority shall not exceedi the llimit stated bellow.
Name Address Limit of Power
,SACK M.CROWLEY PATRICIA A.SMITH ALL OF ALL
I;,, STEVEN R.POSTER MARIE PER'RYMAN ADDSON, 7 ,000,1 00w
TEXAS
l
This Power of Attorney revokes all previous powers issued on behalf of the attorneys)-in-fact named above.
IN WITNESS WHEREOF,the GREAT AMERICAN INSURANCE COMPANY OF NEW YORK has caused these presents to be signed
and attested by its appropriate officers and its corporate seal hereunto affixed this 29TH day of NOVEMBER , 2012
a
Attest GREAT AMERICAN INSURANCE COMPANY OF NEW YORK
GaPp�d'
.. SEAL
Assistant Secretaq Divisional:niorVice Presidew
DAVID G.K;ITCHI (877-377-2405)
STATE OF OHIO,COUNTY OF HAMILTON-ssn
On this 29TH day of NOVEMBER , 2012 ,before me personally appeared DAVID C.KITCHIIN,to me knovw n:,
being duly sworn,deposes and says that he resides in Cincinnati),Ohio,that he is a Divisional Senior Vice President of the Bond
Division of Great American Insurance Company of New"York,the Company described in and!which executed the above instrument;
that he knows the seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed
his name thereto by like authority.
KAREN L.GR SHEIM
NOTARY PLIBI.IG,STATE OF OHIO
MY COMMI88i014 EXPIRES 02-2D-1
This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great
American Insurance Company of New York by unanimous written consent dated May 14,2099.
R'E OLVEDi.That the Divisional President,the several.Divisional Senior Dice Presidents,Divisional Vice Presidents and Divisional
to a y n-�Fect
Assistant Vice Presidents,or any one of them,be and hereby is authorized,from time to time, appoint one or more�wttorne s-r
i to execrate on behalf of the Company,as surety,any and'ail bonds,undertakings and contracts of suretyship,or other written obligations
in the nature thereof,to prescribe their respective duties and the respective limits of'their authority,and to revoke any such appointment
at any tune.
11 P'ESOLVED FURTHER:That the Company,seal and the signature of any of the aforesaid officers and any Secretary or Assistant
Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either even for the execution of any bond,
undertaking,contract of suretyship,or other written obligation in the nature thereof,such signature and,seal when so used being hereby
adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the
Company with the same force and effect as though manually affixed.
CERTIFICATION
1,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company of New"York,do hereby certify that
the foregoing Power of Attorney and the Resolutions of the Board of Directors of May 14,2009 have not been revoked and'are
i now in full farce and effect.
Signed and sealed this 15 tbay of April 2014
otl?tllf I
SEALS
., Assistant.ect•ett
S11 851(4/1'1)
1
Great Insurance Company of New York
J
GRFATAnoucAN. Great American Alliance Insurance Company
INSURANCE GROUP Great Arnenican Insurance Company
al
E4$1PORTANT NOTICE-.
To obtain information or make a complaint:
You may contact the Texas Department of Lnsivan to obtain in-forinatioil on comparnes,
f'
coverages,rights or complaints at:
1-800-2-52-3439
You may write the Teas Departmei-it of insurance at:
P.O.Box 149104
Austin,TX 7 8 71 -9 1.04
A-X# -512-47-5..1771.
Your notice of claim against the attached bond may be ven to the survey company that issued
the bond by send.i,n.0 it by certified or rcgistered snail to the following address:
MaiLing Address. Crreat American Lns rance Company Claim
. .Box 2575
Cincinnati, Ohio 45201-2575
Physical Address: Great A mcncan Insurance, Company C Cairn.
8 Walnut Street.
7th Floor
inc=' a.ti, Ohio 45202-3
You may also contact the Groat American Insurance Company Claim office by telephone at:
Telephone umber-. 1-513-3369-5069
PREIMUM OR CLAD4 DISPUTES:
If you have a disputee concerning a premium,you should contact the agent first.If you have a
7 dispute concerning;a claim.,you should contact the company first.If the dispute is not resolved.,
your may contact the Teas Department of Insurance.
.TT XCH THIS NOTICE TO YOUR BOA
Tla_i.s notice is for information only and does not boco re a part or condition of the attached
document.
F. 667A (12102)
f
1
AC"Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYY`Y)
/2014
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 AFFORDEUI BY THE POLICIES
BELT W. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETVVEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLIER®
IMPORTANT: If the certificate holder is an,ADDITIONAL INSURED,the policy(lies)must be endorsed., If SUBROGATION IS WAIVED,subject to
the terms and conditions,of the policy,certain policies may require an endorsernent. A,statement on this certificate does not confer rights to the
certificate holder in Iieu of such endors,emient(s).
PRODUCER CONTACT Holly Gravenor
_NAME:
iFrank Side Insurance Agency Fort Worth, PHONE (817)737-4943 HA X (817)737-4947
(.Sficl Nol;
E",M AIL
SS:
Member: K & S Group Iagravenor@fsifw.com
ADQRE
IIL�R S�AFFORDING COVERAGE NAIC#
,2900 Marquita Drive qSURE
Fort Worth TX 76116-4016 INSURER A:Continental Casualty, Insurance 20443
INSURED IN SURER 13:CRC-Continental Casualty Ins. 20443
f
Durable Specialties, Inc. INSURER C�Hanoyer Insurance qo�!!pl 22292
12302', Paddock Way Drive INSURER D:
IF INSURER E:
Grand Prairie TX 75050 INSURER F
E
COVERAGES CERTIFICATE NUMBER:DST ALOBI 314 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD,
INDICATED, NOTWITH STAN DI,NG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRlBED HEREIN IS SUBJECT TO ALL'THE TERMS,
EXCLUSIONS AND CONDITIONS OF'SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
XP
INSR TYPE OF INSURANCE "A L POLICY NUMBER POLICY"ELF= POLICY E LIMITS
LTR GENERAL LIABILITY IN-5&WVQ _JM%DQ/)=yJ fMM)D tYYYY1 1,000,0100
EACH OCCURRENCE $
DAMAGE TO RErWffff_
X COMMERCIAL GENERAL LIABILITY PREM)aEaJEA ozumenWJ $ 300,0,00
A CLAIMS-MADE OCCUR 4032510,262GL 5/31/2013 5/31/2014 MED E (Any one p rson) S 5f000
x XCU PERSONAL&ADV INJURY $ 1,000,0100
X Contractual GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG 1$ 2,0010,000
POLICY PR O-
1E-JECI LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 000 000
Ea acciide,nt)
A ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED 4032510259AUTO 5/31/2013 5/31/2014 BODILY INJURY(Per accident)
AUTOS AUTOS
�;X NONLOWNED _F�_ROPERTY DAMAGE
HIRED AUTOS AUTOS (P r a�qdenU
:x
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGrREGATE
DED RETENTION$ $
A WORKERS COMPENSATION x
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1 000-t000
OFFiCERIME�MBER EXCLUDED? N NIA
(Mandatory In NH) 4032564659 5/31/2013 5/31/2014 1 DISEASE-EA EMPLOYEE S 1 000 1 000
If ns,describe under
D ES OF OPERATiONS belolw E L DISEASE-POLICY LiMiT $ ---I NCO 2-0-0
C j(Contractor ls Equipment IND9933202EQ 5/31/2013 5/31/2014 Leased/Rented Any One It ern 250f0001
Deductible 1,1000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORN, 101,Additional Remarks Schedule,If more space is required)
DST # 417 - Western Center Blvd at North Riverside Dr. and FM 1187 at Hemphill St, City Project, # 012182.
The general liability and auto policile's include blanket automatic additional insured endorsements that
provide additional insured status on a primary & non-contributory basis 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, auto & workers compensation policies include blanket automatic waiver of
subrogation endorsements that provide this feature only when there is a written contract betwelen the
named insured and the certificate holder that requires it --------------
CERTIFICATE HOLDER CANCELLATION
Nikki.Mc Leroy @FortWort;hTex SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAN BEFORE
THE EXPIRATION DAT'E THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Worth
Transportation and Public Works AUTHORIZED REPRESENTATIVE
NN Attn: Nikki McLe!roy
10001 Throckmorton Street
Fort Worth, TX 76102
Steven Siddons/HGRAVE
NN ACORD 25 2010105) Oc 19188-20110 ACORN CORPORATION.All rights reserved.
INS029;t9minnrii nii Tha,&ropni nnirmn nnirl Innin nro rar-tietararl rn:*rtca r%f Arr)pn