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HomeMy WebLinkAboutContract 46957 CITY SECRTETARY . CONTRACWO RIGHT OF WAY ENCROACHMENT AGREEMENT (COMMERCIAL) THIS AGREEMENT is made and entered into by and between the City of Fort Worth, a municipal corporation of Tarrant County, Texas, acting herein by and through its duly authorized Planning and Development Department Director, hereinafter referred to as the "City", and COOK CHILDREN'S MEDICAL CENTER, acting herein by and through its duly authorized Vice President hereinafter referred to as "Licensee", Owner of the property located at 801 West 7th Avenue, Fort Worth, Texas 76104("Property"). AGREEMENT 1. For and in consideration of the payment by Licensee of the fee set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Licensee permission to construct/ install and/or allow to remain, Improvement(s) ("Improvement") that encroaches upon, uses and/or occupies portions of the space under, on and/or above the streets, alleys, sidewalks and other public rights-of- way, such Improvement(s) are described as follows: Request is being made to install and operate 23 street lights (max Height of 12W") and 28 irrigation heads along Seventh Ave. The location and description of said Improvement and the encroachment is more particularly described in Exhibit "A", attached hereto, incorporated herein and made a part hereof for all purposes. 2. All construction, maintenance and operation in connection with such Improvement, use and occupancy shall be performed in strict compliance with this Agreement and the Charter, Ordinances and Codes of the City and in accordance with the directions of the Director of Transportation and Public Works of City, or his duly ()IF F CI ., C9,' U[) 2014 ROW Encroachment Agreement-Commercial Page 1 of 1 1 authorized representative. All plans and specifications thereof shall be subject to the prior written approval of the Director of Transportation and Public Works, or his duly authorized representative, but such approval shall not relieve Licensee of responsibility and liability for concept, design and computation in preparation of such plans and specifications. 3. Upon completion of construction and installation of said Improvement and thereafter, there shall be no encroachments in, under, on or above the surface area of the streets, alleys, sidewalks and other public rights-of-way involved, except as described herein and shown on the hereinabove referred to Exhibit"A". 4. Licensee, at no expense to the City, shall make proper provisions for the relocation and installation of any existing or future utilities affected by such encroachment use and occupancy, including the securing of approval and consent from the utility companies and the appropriate agencies of the State and its political subdivisions. In the event that any installation, reinstallation, relocation or repair of any existing or future utility or improvements owned by, constructed by or on behalf of the public or at public expense is made more costly by virtue of the construction, maintenance or existence of such encroachment and use, Licensee shall pay to City an additional amount equal to such additional cost as determined by the Director of Transportation and Public Works of the City, or his duly authorized representative. 5. City may enter and utilize the referenced areas at any time for the purpose of installing or maintaining improvements necessary for the health, safety and welfare of the public or for any other public purpose. In this regard, Licensee understands and agrees that City shall bear no responsibility or liability for damage or disruption of improvements installed by Licensee or its successors, but City will make reasonable efforts to minimize such damage. 2014 ROW Encroachment Agreement-Commercial Page 2 of 11 6. In order to defray all costs of inspection and supervision which City has incurred or will incur as a result of the construction, maintenance, inspection or management of the encroachments and uses provided for by this Agreement, Licensee agrees to pay to City at the time this Agreement is requested an application fee in the sum of Three Hundred and Twenty-Five Dollars ($325.00). Upon execution of this Agreement and annually thereafter, Licensee agrees to pay a fee in the amount of$.56 per square/linear foot of the encroachment area. 7. The term of this Agreement shall be for thirty (30) years, commencing on the date this Agreement is executed by the City of Fort Worth. Provided however, this Agreement shall terminate upon the non-compliance of any of the terms of this Agreement by the Licensee. City shall notify Licensee of the non-compliance and if not cured within thirty days this Agreement shall be deemed terminated. 8. Upon termination of this Agreement, Licensee shall, at the option of City and at no expense to City, restore the public right-of-way and remove the Improvement encroaching into the public right-of-way, to a condition acceptable to the Director of Transportation and Public Works, or his duly authorized representative, and in accordance with then existing City specifications. It is understood and agreed to by Licensee that if this Agreement terminates and Licensee fails to remove the Improvement, Owner hereby gives City permission to remove the Improvement and any supporting structures and assess a lien on the Property for the costs expended by the City to remove such Improvement. 9. It is further understood and agreed upon between the parties hereto that the public rights-of-way, alleys, sidewalks ("public right-of-way") to be used and encroached upon 2014 ROW Encroachment Agreement-Commercial Page 3 of 11 as described herein, are held by City as trustee for the public; that City exercises such powers over the public right-of way as have been delegated to it by the Constitution of the State of Texas or by the Legislature; and that City cannot contract away its duty and its legislative power to control the public right-of-way for the use and benefit of the public. It is accordingly agreed that if the governing body of City may at any time during the term hereof determine in its sole discretion to use or cause or permit the right of way to be used for any other public purpose, including but not being limited to underground, surface of overhead communication, drainage, sanitary sewerage, transmission of natural or electricity, or any other public purpose, whether presently contemplated or not, that this Agreement shall automatically terminate. 10. Licensee agrees and acknowledges that this Agreement is solely for the purpose of permitting Licensee to construct, maintain and locate the Improvements over or within the described public right of way and is not a conveyance of any right, title or interest in or to the public right of way nor is it meant to convey any right to use or occupy property in which a third party may have an interest. Licensee agrees that it will obtain all necessary permission before occupying such property. 11. Licensee agrees to comply fully with all applicable federal, state and local laws, statutes, ordinances, codes or regulations in connection with the construction, operation and maintenance of said Improvement, encroachment and uses. 12. Licensee agrees to pay promptly when due all fees, taxes or rentals provided for by this Agreement or by any federal, state or local statute, law or regulation. 13. Licensee covenants and agrees that it shall operate hereunder as an independent contractor as to all rights and privileges granted hereunder and not as an officer, agent, 2014 ROW Encroachment Agreement-Commercial Page 4 of 11 servant or employee of City and Licensee shall have exclusive control of and the exclusive right to control the details of its operations, and all persons performing same, and shall be solely responsible for the acts and omissions of its officers, agents, servants, employees, contractors, subcontractors, licensees and invitees. The doctrine of respondeat superior shall not apply as between City and Licensee, its officers, agents, servants, employees, contractors and subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Licensee. 14. LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE OR LOCATION OF SAID IMPROVEMENT AND ENCROACHMENT AND USES GRANTED HEREUNDER, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES OR INVITEES OF THE CITY; AND LICENSEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH CLAIMS OR SUITS. LICENSEE SHALL LIKEWISE ASSUME ALL LIABILITY AND RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR ANY AND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT OF OR IN CONNECTION WITH ANY AND ALL ACTS OR OMISSIONS OF LICENSEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, INVITEES, OR TRESPASSERS. 2014 ROW Encroachment Agreement-Commercial Page 5 of 11 15. While this Agreement is in effect, Licensee agrees to furnish City with a Certificate of Insurance, naming City as certificate holder, as proof that it has secured and paid for a policy of public liability insurance covering all public risks related to the proposed use and occupancy of public property as located and described in Exhibit "A". The amounts of such insurance shall be not less than the following: $1,000,000 Commercial General Liability with the understanding of and agreement by Licensee that such insurance amounts shall be revised upward at City's option and that Licensee shall so revise such amounts immediately following notice to Licensee of such requirement. Such insurance policy shall provide that it cannot be canceled or amended without at least ten (10) days prior written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is attached as attached as Exhibit "B". Licensee agrees to submit a similar Certificate of Insurance annually to City on the anniversary date of the execution of this Agreement. Licensee agrees, binds and obligates itself, its successors and assigns, to maintain and keep in force such public liability insurance at all times during the term of this Agreement and until the removal of all encroachments and the cleaning and restoration of the city streets. All insurance coverage required herein shall include coverage of all Licensees' contractors. 16. Licensee agrees to deposit with the City when this Agreement is executed a sufficient sum of money to be used to pay necessary fees to record this Consent Agreement in its entirety in the deed records of Tarrant County, Texas. After being recorded, the original shall be returned to the City Secretary of the City of Fort Worth, Texas. 2014 ROW Encroachment Agreement-Commercial Page 6 of 11 17. In any action brought by the City for the enforcement of the obligations of Licensee, City shall be entitled to recover interest and reasonable attorney's fees. 18. Licensee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without the prior written approval of the Director of Planning and Development. Any attempted assignment without prior written approval will be void. 19. THE PARTIES AGREE THAT THE DUTIES AND OBLIGATION CONTAINED IN PARAGRAPH 8 SHALL SURVIVE THE TERMINATION OF THIS AGREEMENT. 20. This Agreement shall be binding upon the parties hereto, their successors and assigns. EXECUTED this day of , 20 / . 2014 ROW Encroachment Agreement-Commercial Page 7 of 11 City Licensee City of Fort Worth TYPE: COOK CHILDREN'S MEDICAL CENTER r By: By: k&,4 Randle Harwoo ,Director Name: Stanley E. Davis Planning and Development Title: Vice President ATTEST: Approved As To Form and Legality x City Secre'a y/, � Assistant Ci Attorney NO M&C REQUIRED OFFICIAL 1,MCOM 2014 ROW Encroachment Agreement-Commercial Page 8 of 11 2014 ROW Encroachment Agreement-Commercial Page 9 of 11 STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Randle Harwood, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of the City of Fort Worth, and in the capacity therein stated. IVEN ER Y AND SEAL OF OFFICE thi day of ° , 2 0 j{ / NAGM(A HACAI IMll6".SIR MF Nn0;t'rllXlf WthYb Nd..... mx<4 w,WhdJRU 111 iN 54f111 j � p f / �`��y + f I� 1 bl �If4� !{N l � �!!�k Y�(I'�mY a .i �o✓ f awryf D^ l IVf J I'd t r.rr"d� � �1 W` �a r"" �,,w � u. au fvWU�vu�uwg�;,�wfa, �uirwl�i,�wnain�arw!mm!w!^<? � �W+� Notary Public in and for the State of Texas FFICIAL RECORD CITY ', nQlRE"r1%11?K Y L FK WOIRTH� TX 2014 ROW Encroachment Agreement-Commercial Page 10 of 11 STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Stanley E. Davis, Vice President, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of Cook Children's Medical Center, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of OIONNIA ar au TEIJTSCH Notary Public � op *pa STATE OF TEXAS Notary Public in and for the MV Gomm,Exp.10-x2018 State of Texas OFFICIAL MORI) ur° 'iiECR AIRY 2014 ROW Encroachment Agreement-Commercial Page 11 of 11 PLOTTED BY:Brauer,Hunter ON:Tuesday,July 28,2015 AT:10:14 AM FILEPATH:G:\Production500\000700\B000759\Design\001\Drawings\Exhibits\15-0623 EA 7th Ave SL IRR LS Exhibits%IRR,SL EA.dwg 0 � -Ti zj D — x N r O ° �s Z ° _ rri Z! ° W A n W O0 - ANa I � E O o N v z m ! N w n c Z D -n r c s zap � ` z "3sp m 0 rn IJ�n,rEAn L. m X � � ZO i3 m _ - t, py � � ® y # o = m o # z n� --� -'70 � � 0 c 1p ° D m I m I mv n rn Y m I\ \ \ 0 0 s II T ::10 rri I z D p oD n D I O m oo Oo m O -0 m z m (�j O O m z A Z m m Z m III Z _ ° ° -1 V) w - C m D II Z w n z ? C) �_ ° j o z { � C z � � T N O uo I 7iH AVENUE rc� 3a� t z e x AI W Y v�D R e S �oa . t o A N I A Y I s MATCHLINE AREA 2(SEE SHEET IR1.02) F€ D I L. [ 3s = i> i J IL 9y 50 0.zo� p :UWmO Q g s a 39 z r 3 ro A mDX a , DO cmc=m w TO IS D > -°i w-aim N C TI Z 2 �� 4 ® Z P a > Z c� O �r00 oM3 0 Z 90m i r y r MAVENUE 3 s} N s L _._.__.__--_—__s__ !) z A �I= �g �Pa to A O 9 N ASm O A A < I C m I I MATCHLINE AREA 4(SEE SHEET IRI.04) L D� v�00 $ �mmcn a g3 a 7m X0 o:: a r x w z >r�� :fin 3g @. a 9D D AzA gg g4 ".D n Vr FORT WORTH Series SPECIFICATIONS Cast Iron Posts DESCRIPTION 18" sq. base The lighting post shall be all cast iron construction, massively tapered with a deep, 16-flute pattern on the shaft and a classic square base. The post shall be Antique Street Lamps' catalog number PI FWl8 XX finish. MATERIALS The post material shall be ASTM A48, Class 30 cast iron,formed true to the pattern with complete detail. All exposed hardware shall be tamper resistant stainless steel. Anchor bolts to be completely hot dip galvanized. Partially galva- nized bolts are not acceptable. DIMENSIONS The post shall be X'-XX"in height with an 18"square base. The post shall taper from a 7"diameter at the top of the base to a 4.5"dia- q 6„ meter at the post top. An integral 3"O.D. x 3"tenon shall be provid- ed at the top for luminaire mount- ing. The post top shall include a transitional donut between the fluted shaft and the tenon. INSTALLATION The post shall be provided with 7'-(Y, four 3/4"diameter, L-type anchor bolts, 55K psi,to be installed on a 15"diameter bolt circle. Two 6' 0 doors shall be provided in the base for anchorage and wir- ing access. A grounding screw shall be provided inside the base accessible from one door. For finish specifications and color options, see"Finish"section in catalog. ANTIQUE PIFW1815finish PIFw1813finish PIFw1812finish PIFW1810finish PIFW187finish PIFW186finish Street Lamps- 2011 W Rundberg Ln.•AutR TX 78758 Ph(800)410-8899•Fax(512)977-9622 FORT WORTH Series ORDERING INFORMATION Cast Iron Posts • 18" sq. base Choose the boldface catalog nomenclature that best suits your needs and write it on the appropriate line. Example: PI FW18 12 ANPP Options 3"O.D.x 3"High Tenon PI FW18 10 ANCM Post Series Hei ht Finish' PI FW18 6 ANPP Prime Painted ANBK Black 4.5'0 Post,Cost Iron 1U ANDB Dark Bronze FORT WORTH ANDG Dark Green 78"base 13 ANVG Verde Green 15 _us om o c RAL colors Paint finish to be PPG DTM#90-475 Options 8140 Z5 Receptacles C1 Y35 Banner Arms M42 Flagpole Holders Custom Logos Signage (see Signage&Accessories section in the catalog or con- Post Height tact Antique Street Lamps) rvorFs 1. For finish specifications and color options see Finish section in catalog or contact Antique Steet Lamps. ANCHORAGE GUIDE 13"Dia.Opening 5.5'x 4.5"H. Door Opening for Anchorage and J 70 Wiring Access r / (2 per post) { �� Door I 10.6" Openings O O 22" 15"Dia,Bolt Circle 3° C� 18 Sq qo D 3/4"0,55K psi,Hot Dip Galvanized L type Anchor Bolts(4 per Post) ANTIQUE Street Lamps-IT 2011 W Rundberg Ln.•AustirL TX 78758-Ph(800)410-8899-Fox(512)977-9622 bd dimensions are the alameter at the base DS4 WITH LUMINAIRE BASE CHOICE h 6 16:W .)91.`1. -11, *" ,6� S,F,'h 'h 41-h '9-bd '3.6'bd -4.5'bd '5-bd ',I,-5'bd I,bd '5'bd DS4 B DS4 X DS4 E DS4 D DS4 C DS4 P DS4 K DS4 M A I I ANNEAL 46 5" 4'2.5"h V4"I 5,h 44.5'h '4'bd *5'bd 5 4.5,b�13'h 42.6'h -4 G_bc, DS4 A DS4 R DS4 L DS4 W DS4 S DS4 N DS4 AU Twist&Lock photoelectric cell options available with lumincire bases S,N and AU only. FINIAL Cost aluminum TOOL-LESS BALLAST HOUSING CUTOFF REFLECTOR Anodized and segmented with porcelain socket PORCELAIN SOCKET Medium base REFRACTIVE GLOBE Clear acrylic BALLAST HOUSING With factory prewired H.I.D.ballast assembly GLOBESCREWS (4)114• stainless steel,socket set screws LUMINAIRE BASE Cast aluminum in a variety of styles BASE SCREWS (6)114'stainless steel,socket set screws LUMINAIRE BASE WITH REMOVING BALLAST ASSEMBLY for fastening to 3"O.D,post tenon BALLAST HOUSING 7 QUICK DISCONNECT PLUGS *13:-, Note:Lamp is not furnished with the furnihoirej • Sample catalog no: DS4 D 1505 MED ARF SR2 TB I PEB I ANBK DS4 E ARF sR4sc TB4 ANCM Series Wattage/Lamp Lens Material Distribution Voltage' Options NNW DS4 B' Metall-folide AM r Acrylic. SR2 IES Distrilbullon TBI 120volt HS' House sicie Snielo ANBK Block S4 X Refractive SF Single Fusing 70M MED 50M MED I SR3 IES Distribution TB2 208 volt ANDB Dark Bronze DF Double Fusing ANDG Dark Green Prrn FR4SC IES Distfibuti T83 240 volt PEBI Photoelectric cell button 120v DS4 C PEE12 Photoelectric cell button 2D3,240;277v ANPP PrimePalnw TB4 277 vat ,DS4 P amz)a PER Twist-Lock Pholocontrol Receptacle March DS4 K 347 347 volt PEI' NEMA Twist&Lock PE 120,208,240v =_T...seleel DS4 M H 480 480 volt PE3' NEMA Twist&Lock PE 347v RAL colors DS4 A igh Pre�uta Saduin PE4' NEMA Twist&Lock PE 480V DS4 R 35S MED I NOTES., PE73 NEMA Twist&Lock PE 277v SOS MED I Multi-top Bofllost(12a 208,240,277v),(120,277 DS4 L ,347v in Canado). DS4 W 70S MED wattages under 70S or 70M contact ASL tor voltage avoilob2ity. Paint finish to be PPG 12:HSo on is not avoibbLe with distribution option S75S or S174SC. 13 .r DS4 S3 I OOS MED ,Lock Photo Control a*available%vith N,S,and AU bases. DTM#90-475;B140;Z5;C1 Y35;M42 DS4 N' i 4.For ffrM and color opll:ns see Fnishsection ki cotcbq or contact ASL. DS4 AU' 150S MED 15.Consult factory for wattages for 8 Series Lumina re ease. CERTIFICATE OF LIABILITY INSURANCE DATE:1011114 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Strategic Risk Solutions(Cayman)Ltd NAME: 878 West Bay Road aC PHONE Ext: AIC,No), P.O.Box 1159 E-MAIL ADDRESS: Cayman KY1-1102 PRODUCER Grand Ca Y CUSTOMER t0#• Cayman Islands 1NSURER(S)AFFORDING COVERAGE NAIC# INSURED Cook Children's Health Care System INSURERA: Cook Children's Indemnity Company 801 Seventh Avenue INSURERB: Fort Worth,Texas 76104-2796 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iNSR ADDL SUBR I POLICY EFF POLICYEXP LTR TYPEOFINSURANCE INSR WVD POLICYNUMBER MMIDDIYYYY MMIDDIYYYY LIMITS GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Eaoccurrence $ 50,000 CLAIMS-MADE X I OCCUR MED EXP(Any One person) $ 0 A X CCICHPGL1415 10/1/2014 10/112015 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: r PRODUCTSICOMPIOPAGG $ 5,000,000 POLICY PROJECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Me accident ANY AUTO BODILY INJURY(Per $ ars _ ALL OWNED AUTOS BOD o n I LY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE(Per accident $ HIRED AUTOS $ NON-OWNED AUTOS $ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE S $ RETENTION S $ WORKERS COMPENSATION AND CSTATU- TH. EMPLOYERS'LIABILITY YIN DRY LIMITS _ ER ANY PROPRIETORIPARTNEPJEXECUTIVE E.L.EACH ACCIDENT OFFICER/MEMBEREXCLUDED? $ Mandat0 In NH) E.L.DISEASE-EA EMPLOYEE $- It yes,describe under E.L,DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It mom space Is required) Certificate Holder is an additional insured as required by written contract.Waiver of subrogation as required by written contract. This certificate does not amend,extend or after the coverage afforded by this policy. 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. 1000 Throckmorton AUTHORIZED REPRESENTATIVE Fort Worth,Texas 76102 ACORD 25(2010105) The ACORD name and logo are registered marks ofACORD ®1988.2009 ACORD CORPORATION.All rights reserved.