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Contract 47668
12 AM �D }�ECEIVEI� City Secretary Contract No. ApR-82016 FORP' WORTHO PROFESSIONAL SERVICES AGREEMENT This PROFESSIONAL SERVICES AGREEMENT ("Agreement") is made and entered into by and between the CITY OF FORT WORTH (the "City" or "Client"), a home- rule municipal corporation situated in portions of Tarrant, Denton, Johnson and Wise Counties, Texas, acting by and through its duly authorized Assistant City Manager, and Mike Pietsch, P.E. Consulting Services, Inc. ("Consultant"), a S Corporation in the State of Texas, and acting by and through Mike Pietsch, P.E. City and Consultant are each individually referred to herein as a "party" and collectively referred to as the "parties." The term "Consultant" shall include the Consultant, its officers, agents, employees, representatives, contractors or subcontractors. The term "City" shall include its officers, employees, agents, and representatives. 1. Scope of Services. Consultant hereby agrees, with good faith and due diligence, to provide the City with professional consulting services for specific description of services. Specifically, Consultant will perform all duties outlined and described in the Statement of Work, which is attached hereto as Proposal to Provide ISO Survey Consulting Services and incorporated herein for all purposes, and further referred to herein as the "Services." Consultant shall perform the Services in accordance with standards in the industry for the same or similar services. In addition, Consultant shall perform the Services in accordance with all applicable federal, state, and local laws, rules, and regulations. If there is any conflict between this Agreement and Exhibit Letter, the terms and conditions of this Agreement shall control. 2. Term. This Agreement shall commence upon March 1, 2016 ("Effective Date") and shall expire no later than J u n e 3 0 , 2 0 16("Expiration Date"), unless terminated earlier in accordance with the provisions of this Agreement or otherwise extended by the parties. This Agreement may be renewed for an additional three months at the City's option. 3. Compensation. The City shall pay Consultant an amount not to exceed $78,00y0.001iin ace rdance with the provisions of this Agreement. Consultant shall not p oFFICI OFFICIAL REGio� ervices for Mike Pietsch,P.E.Consulting Services,Inc CITY SECRETARY Professional Services Agreement—General Page I of FT.WORTH,TX 10 ev. 12,12015 City Secretary Contract No. the City not specified by this Agreement unless the City requests and approves in writing the additional costs for such services. The City shall not be liable for any additional expenses of Consultant not specified by this Agreement unless the City first approves such expenses in writing. City agrees to pay all invoices of Consultant within thirty (30) days of receipt of such invoice. Consultant may charge interest on late payments not to exceed one percent (1%). 4. Termination. 4.1. Convenience. Either the City or Consultant may terminate this Agreement at any time and for any reason by providing the other party with 30 days written notice of termination. 4.2 Breach. If either party commits a material breach of this Agreement, the non-breaching Party must give written notice to the breaching party that describes the breach in reasonable detail. The breaching party must cure the breach ten (10) calendar days after receipt of notice from the non-breaching party, or other time frame as agreed to by the parties. If the breaching party fails to cure the breach within the stated period of time, the non-breaching party may, in its sole discretion, and without prejudice to any other right under this Agreement, law, or equity, immediately terminate this Agreement by giving written notice to the breaching party. 4.3 Fiscal Funding Out. In the event no funds or insufficient funds are appropriated by the City in any fiscal period for any payments due hereunder, the City will notify Consultant of such occurrence and this Agreement shall terminate on the last day of the fiscal period for which appropriations were received without penalty or expense to the City of any kind whatsoever, except as to the portions of the payments herein agreed upon for which funds have been appropriated. 4.4 Duties and Obligations of the Parties. In the event that this Agreement is terminated prior to the Expiration Date, the City shall pay Consultant for services actually rendered up to the effective date of termination and Consultant shall continue to provide the City with services requested by the City and in accordance with this Agreement up to the effective date of termination. Upon termination of this Agreement for any reason, Consultant shall provide the City with copies of all completed or partially completed documents prepared under this Agreement. In the event Consultant has received access to City information or data as a requirement to perform services hereunder, Consultant shall return all City provided data to the City in a machine readable format or other format deemed acceptable to the City and certify that all City data has been removed from Consultant's computers and other electronic devices. 5. Disclosure of Conflicts and Confidential Information. 5.1 Disclosure of Conflicts. Consultant hereby warrants to the City that Consultant has made full disclosure in writing of any existing or potential conflicts of interest related to Consultant's services under this Agreement. In the event that any conflicts of interest arise after the Effective Date of this Agreement, Consultant hereby agrees immediately to make full disclosure to the City in writing. Mike Pietsch,P.E.Consulting Services,Inc Professional Services Agreement—General Page 2 of 10 Rev. 12/2015 City Secretary Contract No. 5.2 Confidential Information. The City acknowledges that Consultant may use products, materials, or methodologies proprietary to Consultant. The City agrees that Consultant's provision of services under this Agreement shall not be grounds for the City to have or obtain any rights in such proprietary products, materials, or methodologies unless the parties have executed a separate written agreement with respect thereto. Consultant, for itself and its officers, agents and employees, agrees that it shall treat all information provided to it by the City ("City Information") as confidential and shall not disclose any such information to a third party without the prior written approval of the City. 5.3 Unauthorized Access. Consultant shall store and maintain City Information in a secure manner and shall not allow unauthorized users to access, modify, delete or otherwise corrupt City Information in any way. Consultant shall notify the City immediately if the security or integrity of any City information has been compromised or is believed to have been compromised, in which event, Consultant shall, in good faith, use all commercially reasonable efforts to cooperate with the City in identifying what information has been accessed by unauthorized means and shall fully cooperate with the City to protect such information from further unauthorized disclosure. 6. Right to Audit. Consultant 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 at reasonable times any directly pertinent books, documents, papers and records of the Consultant involving transactions relating to this Agreement at no additional cost to the City. Consultant agrees that the City shall have access during normal working hours to all necessary Consultant facilities and shall be provided adequate and appropriate work space in order to conduct audits in compliance with the provisions of this section. The City shall give Consultant not less than 10 days written notice of any intended audits. 7. Independent Contractor. It is expressly understood and agreed that Consultant shall operate as an independent contractor as to all rights and privileges granted herein, and not as agent, representative or employee of the City. Subject to and in accordance with the conditions and provisions of this Mike Pietsch,P.E.Consulting Services,Inc Professional Services Agreement—General Page 3 of 10 Rev. 12/2015 City Secretary Contract No. Agreement, Consultant shall have the exclusive right to control the details of its operations and activities and be solely responsible for the acts and omissions of its officers, agents, servants, employees, contractors and subcontractors. Consultant acknowledges that the doctrine of respondeat superior shall not apply as between the City, its officers, agents, servants and employees, and Consultant, its officers, agents, employees, servants, contractors and subcontractors. Consultant further agrees that nothing herein shall be construed as the creation of a partnership or joint enterprise between City and Consultant. It is further understood that the City shall in no way be considered a Co-employer or a Joint employer of Consultant or any officers, agents, servants, employees or subcontractors of Consultant. Neither Consultant, nor any officers, agents, servants, employees or subcontractors of Consultant shall be entitled to any employment benefits from the City. Consultant shall be responsible and liable for any and all payment and reporting of taxes on behalf of itself, and any of its officers, agents, servants, employees or subcontractors. 8. Liability and Indemnification. CONSULTANT SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND ALL PROPERTY LOSS, PROPERTY DAMAGE ANDIOR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER, WHETHER REAL OR ASSERTED, TO THE EXTENT CAUSED BY THE NEGLIGENT ACT(S) OR OMISSION(S), MALFEASANCE OR INTENTIONAL MISCONDUCT OF CONSULTANT, ITS OFFICERS,AGENTS, SERVANTS OR EMPLOYEES. CONSULTANT COVENANTS AND AGREES TO, AND DOES HEREBY, INDEMNIFY, HOLD HARMLESS AND DEFEND THE CITY, ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR LAWSUITS FOR EITHER PROPERTY DAMAGE OR LOSS (INCLUDING ALLEGED DAMAGE OR LOSS TO CONSULTANT'S BUSINESS AND ANY RESULTING LOST PROFITS) ANDIOR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THIS AGREEMENT, TO THE EXTENT CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OR MALFEASANCE OF CONSULTANT, ITS OFFICERS, AGENTS, SERVANTS OR EMPLOYEES. 9. Assignment and Subcontracting. Consultant shall not assign or subcontract any of its duties, obligations or rights under this Agreement without the prior written consent of the City. If the City grants consent to an assignment, the assignee shall execute a written agreement with the City and the Consultant under which the assignee agrees to be bound by the duties and obligations of Consultant under this Agreement. The Consultant and Assignee shall be jointly liable for all obligations under this Agreement prior to the assignment. If the City grants consent to a subcontract. the subcontractor shall execute a written agreement with the Consultant referencing this Agreement under which Mike Pietsch,P.E.Consulting Services,Inc Professional Services Agreement—General Page 4 of 10 Rev. 1''/2015 City Secretary Contract No. the subcontractor shall agree to be bound by the duties and obligations of the Consultant under this Agreement as such duties and obligations may apply. The Consultant shall provide the City with a fully executed copy of any such subcontract. 10. Insurance. 10.1 The Consultant shall carry the following insurance coverage with a company that is licensed to do business in Texas or otherwise approved by the City: 1. Commercial General Liability with a combined limit of not less than $1,000,000 per occurrence. 2. Automobile Liability Insurance with a combined limit of not less that $1,000,000 per occurrence. 3. Professional Liability (Errors & Omissions) in the amount of $1,000,000 per claim and $1,000,000 aggregate limit. 4. Statutory Workers' Compensation and Employers' Liability Insurance requirements per the amount required by statute. 5. Any other insurance as required by City. 1.2 General Insurance Requirements: 1. All applicable policies shall name the City as an additional insured thereon, as its interests may appear. The term City shall include its employees, officers, officials, agents, and volunteers in respect to the contracted services. 2. The workers' compensation policy shall include a Waiver of Subrogation (Right of Recovery) in favor of the City of Fort Worth. 3. A minimum of Thirty (30) days notice of cancellation or reduction in limits of coverage shall be provided to the City. Ten (10) days notice shall be acceptable in the event of non-payment of premium. Notice shall be sent to the Risk Manager, City of Fort Worth, 1000 Throckmorton, Fort Worth, Texas 76102, with copies to the City Attorney at the same address. 4. The insurers for all policies must be licensed and/or approved to do business in the State of Texas. 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, written approval of Risk Management is required. 5. Any failure on the part of the City to request required insurance documentation shall not constitute a waiver of the insurance requirement. 6. Certificates of Insurance evidencing that the Consultant has obtained all required insurance shall be delivered to the City prior to Consultant proceeding with any work pursuant to this Agreement. 11. Compliance with Laws, Ordinances, Rules and Regulations. Consultant agrees to comply with all applicable federal, state and local laws, ordinances, rules and regulations. If the City notifies Consultant of any violation of such laws, ordinances, rules or regulations, Consultant shall immediately desist from and correct the violation. Mike Pietsch,P.E.Consulting Services,Inc Professional Services Agreement—General Page 5 of 10 Rev. 12/2015 City Secretary Contract No. 12. Non-Discrimination Covenant. Consultant, for itself, its personal representatives, assigns, subcontractors and successors in interest, as part of the consideration herein, agrees that in the performance of Consultant's duties and obligations hereunder, it shall not discriminate in the treatment or employment of any individual or group of individuals on any basis prohibited by law. If any claim arises from an alleged violation of this non-discrimination covenant by Consultant, its personal representatives, assigns, subcontractors or successors in interest, Consultant agrees to assume such liability and to indemnify and defend the City and hold the City harmless from such claim. 13. Notices. Notices required pursuant to the provisions of this Agreement shall be conclusively determined to have been delivered when (1) hand-delivered to the other party, its agents, employees, servants or representatives, (2) delivered by facsimile with electronic confirmation of the transmission, or (3) received by the other party by United States Mail, registered, return receipt requested, addressed as follows: TO THE CITY: City of Fort Worth With Copy to the City Attorney Attn: Rudy Jackson 1000 Throckmorton 505 W. Felix Fort Worth, TX 76102 Fort Worth TX 76115 TO CONSULTANT: Name: Mike Pietsch, P.E. Consulting Services, Inc. Attn: Mike Pietsch 3101 S. Country Club Rd. Garland, TX 75043-1311 214.728.6507 Cell 972.840.6665 Fax michaelpietsch@tx.rr.com 14. Solicitation of Employ Neither the City nor Consultant shall, during the term of this Agreement and additionally for a period of one year after its termination, solicit for employment or employ, whether as employee or independent contractor, any person who is or has been employed by the other during the term of this Agreement, without the prior written consent of the person's employer. This provision shall not apply to an employee who responds to a general solicitation or advertisement of employment by either party. Mike Pietsch,P.E.Consulting Services,Inc Professional Services Agreement—General Page 6 of 10 Rev. 12/2015 City Secretary Contract No. 15. Governmental Powers. It is understood and agreed that by execution of this Agreement, the City does not waive or surrender any of its governmental powers. 16. No Waiver. The failure of the City or Consultant to insist upon the performance of any term or provision of this Agreement or to exercise any right granted herein shall not constitute a waiver of the City's or Consultant's respective right to insist upon appropriate performance or to assert any such right on any future occasion. 17. Governing Law and Venue. 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, is brought on the basis 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. 18. Severability. If any provision of this Agreement is held to be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired. 19. Force Majeure. The City and Consultant shall exercise their best efforts to meet their respective duties and obligations as set forth in this Agreement, but shall not be held liable for any delay or omission in performance due to force majeure or other causes beyond their reasonable control (force majeure), including, but not limited to, compliance with any government law, ordinance or regulation, acts of God, acts of the public enemy, fires, strikes, lockouts, natural disasters, wars, riots, material or labor restrictions by any governmental authority, transportation problems and/or any other similar causes. 20. Headings Not Controlling. Headings and titles used in this Agreement are for reference purposes only and shall not be deemed a part of this Agreement. 21. Review of Counsel. The parties acknowledge that each party and its counsel have reviewed this Agreement and that the normal rules of construction to the effect that any ambiguities are to be resolved Mike Pietsch,P.E.Consulting Services,Inc Professional Services Agreement—General Page 7 of 10 Rev. 12/2015 City Secretary Contract No. against the drafting party shall not be employed in the interpretation of this Agreement or exhibits hereto. 22. Amendments. No amendment of this Agreement shall be binding upon a party hereto unless such amendment is set forth in a written instrument, and duly executed by an authorized representative of each party. 23. Entirety of Agreement. This Agreement, including any exhibits attached hereto and any documents incorporated herein by reference, contains the entire understanding and agreement between the City and Consultant, their assigns and successors in interest, 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. 24. Signature Authority. The person signing this Agreement, and any amendment hereto, hereby warrants that he/she has the legal authority to execute this Agreement on behalf of the respective party, and that such binding authority has been granted by proper order, resolution, ordinance or other authorization of the entity. Each party is fully entitled to rely on these warranties and representations in entering into this Agreement or any amendment hereto. 25. Counterparts. This Agreement may be executed in in one or more counterparts and each counterpart shall, for all purposes, be deemed an original, but all such counterparts shall together constitute one and the same. An executed Agreement, modification, amendment, or separate signature page shall constitute a duplicate if it is transmitted through electronic means, such as fax or e-mail, and reflects the signing of the document by any party. Duplicates are valid and binding even if an original paper document bearing each party's original signature is not delivered. 26. Third Party Beneficiaries. The provisions and conditions of this Agreement are solely for the benefit of the City and Consultant, and their lawful successors or assigns, and are not intended to create any rights, contractual or otherwise, to any other person or entity. 27. Surviva . Section 4.4 (Duties and Obligations of Parties), Section 5 (Confidentiality), Section 6 (Right to Audit), and Section 8 (Liability and Indemnification) shall survive termination of this Mike PietschP.E.Consulting Services,Inc Professional Services Agreement—General Page 8 of 10 Rev. 12/2015 City Secretary Contract No. Agreement. Executed in multiples this theAay of 20Ae. AGREED: AGREED: CITY OF FORT WORTH: NUKE PIETSCH,P.E By: y By: Va4t4 i_ 0041 wfVh Mike Pietsch Assistant City Manager T_®R President Date: tMl* te: Z/ ATTE T: $�� TES By: By: Q' Sharon Pietsch City Secretary Vice President/Treasurer APPR VED AS TO FORM AND LEGALITY: By: 041 16 A�er�� �t,u,K •C`tu`z-V+�t,,� Senior Assistant City Attorney CONTRACT AUTHORIZATION: M&C: k-_1-7(. _ Date Approved: e3a Form 1295 Certification No. ?,d OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX Mike Pietsch,P.E.Comdting Services,Inc Professional Services Agreement—General Page 9 of 10 Rev. 12/2015 City Secretary Contract No. EXHIBIT A LEGAL NAME OF ENTITY Professional Services Agreement—General Page 2 of 10 Rev.12/2015 Mike Pietsch, P.E. Consulting Services, Inc. 3101 S. Country Club Rd. V Garland, TX 75043-1311 Assisting Communities 972.271.3292 Phone With Their ISO Rating 214.728.6507 Cell 972.840.6665 Fax michaelpietsch@tx.rr.com July 13, 2015 Mr. Rudy Jackson, Fire Chief Fort Worth Fire Department 1000 Throckmorton St. Fort Worth, TX 76102 Dear Chief Jackson: Attached is a proposal for Mike Pietsch, P.E. Consulting Services, Inc. to perform their consulting services in conjunction with the City of Fort Worth's ISO rating. The services outlined below would be required to: Assist with the ISO Survey by Completing the ISO Pre-Survey Packet and then Transferring the Information to the ISO Field Representative. The ISO pre-survey packet requires an extensive amount of support data to document the answers the City of Fort Worth must provide via this packet. It will save the City Officials serving the City of Fort Worth a considerable amount of time if I am utilized to assist in filling out this packet. I should be assisting the ISO Field Representative during the entire survey. Since I trained many ISO Field Representatives and served as a technical reviewer over my 28+ years with ISO, I know exactly what is required. This will eliminate any confusion between the City of Fort Worth and the ISO Field Representative. The information transfer will proceed effortlessly if I am involved. My involvement will save the City Officials serving the City of Fort Worth countless staff-hours and allow them to concentrate on their normal daily activities. Also consider that since the 1970's I am have either been the ISO Field Representative or the consultant during each survey of Fort Worth by ISO. I know your community from the standpoint of developing an ISO rating. The total of time and costs reflect actual consultant fee expenses. If you have any questions or need other information, please let me know. Sincerely yours, W. Michael Pietsch, P.E. Civil Engineer WMP/spp PROPOSAL TO PROVIDE CONSULTING SERVICES TO THE CITY OF FORT WORTH ASSIST WITH ISO SURVEY BY MIKE PIETSCH, P.E. CONSULTING SERVICES, INC. OF GARLAND, TEXAS July 13, 2015 Proposal-City of Fort Worth Assist with ISO Survey Mike Pietsch,P.E. Consulting Services, Inc. 07/13/15 Page 2 The following is a proposed estimate of the time and costs that would be associated with a consulting project with Mike Pietsch, P.E. Consulting Services, Inc, for the City of Fort Worth. The consulting team will consist of Mike Pietsch, P.E. SCOPE OF CONSULTING SERVICES Complete the ISO pre-survey packet then document and present the answers to the questions presented in ISO's pre-survey packet. The ISO survey will cover the areas described below. • Evaluate and Correct ISO's Needed Fire Flow Report: • Texas Exception • Attendance at Fireman's Training School • Compressed Air Foam • Volunteer Certification • Fire Department: • Apparatus Inventories • Pump Tests • Staffing • Training • Operational Considerations • Fire Station Locations • Locating apparatus to maximize the grading • Distribution of companies • Fire Service Communications • Methods of alarm receipt • Number and training of dispatchers • Monitoring for Integrity • Emergency Power • Methods of dispatch • Water Department. • Supply Facilities • Hydrant Distribution • Hydrant Inspection • Flow Testing — perform and/or analyze flow tests Proposal—City of Fort Worth Assist with ISO Survey Mike Pietsch, P.E. Consulting Services, Inc. 07/13/15 Page 3 • Community Risk Reduction: • Fire Marshal — Inspections and Investigations • Codes • Staffing • Certifications • Training • Public Fire Education • Staffing • Certifications • Training Proposal-City of Fort Worth Assist with ISO Survey Mike Pietsch,RE. Consulting Services, Inc. 07/13/15 Page 4 TIME AND COST REQUIREMENTS • Assimilating data for Pre-survey Information $ 21,000 • Completing the Information in Home Office $40,000 • Transferring Information to ISO $ 14,500 • Expenses (Hotel, Meals, Transportation) $ 2,500 Total $ 78,000 The total cost to The City of Fort Worth will not exceed$78,000 to assist with the ISO re-evaluation for the City of Fort Worth. This proposal includes just 2 site visits. Additional site visits to discuss the results of the ISO survey are outside the scope of this proposal. PAYMENT AGREEMENT: The City of Fort Worth agrees to pay Mike Pietsch, P.E. Consulting Services, Inc. the sum of$78,000 upon the conclusion of the ISO survey. Submitted by." W. Michael Pietsch, P.E. Civil Engineer Mike Pietsch, P.E. Consulting Services, Inc. 3101 S. Country Club Rd. Gartand, TX 75043-1311 Phone.- 972-271-3292(Office) 214-728-6507(Cell) Fax.- 972-840-6665 Email• michaelp/etsch rr Df rr,com Proposal-City of Fort Worth Assist with ISO Survey Mike Pietsch,P.E.Consulting Services, inc. 07/13/15 Page 5 ACoORV CERTIFICATE O F LIABILITY INSURANCE DATE(MM/DDIYYYY) 2i8i2o16 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 CONAME:NTACT Sherrel Breazeale Consolidated Insurance Partners PHONE 214-691-5721 X-205 aC yo:214 691-6961 12201 Merit Drive, Ste 220 a DREs :sbreazeale@cipoftexas.com INSURER(S)AFFORDING COVERAGE NAIC# Dallas TX 75251 INSURERA:Hartford Lloyd's Insurance Co. 38253 INSURED INSURERB:Continental Casualty Company 186 Mike Pietsch INSURERC: P.E. Consulting Services, Inc. INSURER D: 3101 S. Country Club Road INSURER E. _ Garland TX 75043-1311 INSURER F: COVERAGES CERTIFICATE NUMBER:2016-2017 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 LTR TYPE OF INSURANCE AD SUB POLICY NUMBER MM/DDY EFF POLICY EXP LIMITS GENERAL LIABILITY 46 SBM UA4708 SC 1/27/2016 1/27/2017 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO REN D PREMISES Ea occurrence $ 300,000 A 7 CLAIMS-MADE Fx-]OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X I POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUBODILY INJURY(Per accident) $ TOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- I I OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? F-] NIA (Mandatory in NH) E.L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Architect/Engineers 596421053 - $5000 Ded 1/14/2016 1/27/2019 Each Claim � $1r 000 000 Professional Liability lairs Made/Retro 1/14/03 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION Cynthia.tyree@ fortworthtex 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. Attn: Cynthia A. Tyree Bob Bolen Public Safety Comple AUTHORIZED REPRESENTATIVE 505 W. Felix Fort Worth, TX 76115 David Oxford/SHEREL ACORD 25 i201 0105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9nimri)m Tha A(`r1Rr1 nama anti Innn arn panic#aearl marIrc of,&nnPn CERTIFICATE OF INTERESTED PARTIES C--a`7(o4 -;L- FORM 1295 loll Complete Nos.1-4 and 6 if there are Interested parties. OFFICE USE ONLY Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING I Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number of business. 2016-9961 Mike Pielsch P.E.,Consulting Services Inc. Garland,TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 0210612016 being filed. City of Fort Worth Date Acknowledged: 3—xt-- (e 3 Provide the Identification number used by the governmental entity or state agency to track or Identify the contract,and provide a description of the goods or services to be provided under the contract. 9 Assist with the ISO rate survey. All required ISO information will be developed and transferred to ISO. 4 Nature of interest(check applicable) Name of Interested Party City,State,Country(place of business) Controlling Intermediary Pietsch,Sharon Garland,TX United States X Pietsch,Mike Garland,TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct. MICHELLE L.LEWIS SIRIANNI Notary Public,State of Texas s: my Commission Expires February 24, 2019 Signature of authorized agent of contracting business entity hnm\\ AFFIX NOTARY STAMP/SEAL ABOVE r�1 Sworn to and subscribed before me,by the said 0 �i ice Pthis the In day of QbyLQ 1- 20_1\Q_,to certify which,witness my hand and seal of office. Cl.x JL k 0 M;Uy-L1 e C. +'i See Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.a.us Version V1.0.34944 M&C Review Page I of 2 official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA ��H COUNCIL ACTION: Approved on 3/22/2016 DATE: 3/22/2016 REFERENCE ,t*C-27642 LOG 36CONSULTANTAGREEMENTFORISO NO.: NAME: CODE: C TYPE: CONSENT PUBLIC NO HEARING: SUBJECT: Authorize Execution of a Professional Services Agreement with Mike Pietsch, P.E. Consulting Services, Inc., in the Amount of$78,000.00 for Consulting Services in Preparation of the City's 2016 Insurance Service Organization Rating Evaluation (ALL COUNCIL DISTRICTS) RECOMMENDATION: It is recommended that the City Council authorize execution of a Professional Services Agreement with Mike Pietsch, P.E. Consulting Services, Inc., in the amount of$78,000.00 for consulting services in preparation of the City's 2016 Insurance Services Organization Rating evaluation. DISCUSSION: The Insurance Services Organization (ISO) is an independent statistical rating and advisory organization that serves the property/casualty insurance industry. ISO collects information on a community's public fire protection and analyzes the data using the Fire Suppression Rating Schedule (FSRS). ISO then assigns a Public Protection Classification (PPC)from 1 to 10. A Class 1 represents exemplary public protection and Class 10 indicates less than minimum recognized protection. In 2006, the Fort Worth Fire Department contracted Mike Pietsch, P.E. Consulting Services, Inc., to provide consulting services in preparation for the City's ISO rating evaluation. The rating improved from a 3 to 2 classification. The evaluation of a community's public fire protection is performed by ISO every 10 years. The City's last evaluation was completed in 2006. The Fire Department will use this Agreement to contract with Mike Pietsch, P.E. Consulting Services, Inc., to assist the City of Fort Worth Fire Department in preparation for the 2016 ISO evaluation. The consultant will document answers to the questions presented in the ISO pre-survey packet and supporting data prior to an ISO field survey. The consultant will also represent the City during the ISO field survey, which is expected to be completed by June 30, 2016. M/WBE Office: A waiver of the goal for MBE/SBE subcontracting requirements was requested by the Department and approved by the M/WBE Office, in accordance with the BDE Ordinance, because the purchaser of goods or services from source(s)where subcontracting or supplier opportunities are negligible. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies upon approval of the above recommendation that funds are available in the current operating budget, as appropriated of the General Fund. http://apps.cfwnet.org/council_packet/mc review.asp?ID=22071&councildate=3/22/2016 4/12/2016 M&C Review Page 2 of 2 TO Fund Department Account Project Program Activity Budget Reference# Amount ID ID Year Chartfield 2) FROM Fund Department Account Project Program Activity Budget Reference# Amount ID ID Year Chartfield 2) 10100 0368050 1 5330201 1 1 $78,000.00 Submitted for City Manager's Office by: Valerie Washington (6199) Originating Department Head: Rudy Jackson (6801) Additional Information Contact: Scott Hanlan (6803) ATTACHMENTS Pietsch HB 1295.pdf http://apps.cfwnet.org/council_packet/mc_review.asp?ID=22071&councildate=3/22/2016 4/12/2016