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HomeMy WebLinkAboutContract 29476 JAN-06-2004 TUE 03:32 PM T/PW T.E. STREET MGMT. FAX ,NO, 817 392 8941 P. 04 1 _ CITY SECRETARY CONTRACT NO. CONSENT AGREEMENT FOR TEMPORARY USE OF PUBLIC PROPERTY STATE OF TEXAS COUNTY`OF TARRANT' • 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 Building Official,herinafter referred to as the "City"' and acting by and through its duly autb zed � L'#jai zeq&ep ,hereina er referred to as "Grantee". ' WITNES. SETH: For and in consideration of the payment by Granter of the charges set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Grantee permission to temporarily encroach upon,uses and occupy portions of the space under, on and/or above the streets, alleys, sidewalks or other public rights-of--way as follows: -r41&-Mj r-Q=, 1.a r-COT SGT 1 0,_. tr- t,',A j tJ �_;s. Pj ; JAN-06-2004 TUE 03:32 PM T/PW T. E. STREET MGMT. FAX N0. 817 392 8941 P. 05 The location and description of said encroachment is more particularly described in Exhibit "B" attached hereto, incorporated herein and made a part hereof for all purposes. Z. All use and occupancy of public streets,,alleys, sidewalks or other public rights-of-way under this agreement shall be in strict compliance with the Charter, Ordinances and Codes of City and in accordance with the directions of the Building Official and the Director of Transportation and Public Works of City. 3. Upon expiration of this agreement and the privileges granted �-... hereunder, there shall be no encroachment by Grantee in,under, on or above the surface of the public rights-of-way involved. 4. Grantee agrees to pay in advance an encroachment fee for the temporary privilege of encroaching upon a portion of the public rights= of-way as described in Exhibit`B". Said fee is calculated in the manner i and amounts prescribed by the Building Code of the City of Fort Worth I � for temporary use or occupancy of public property. The estimated total 1 amount of said fee is JAN-06-2004 TUE 03;32 PM T/N T. E, STREET MGMT, FAX N0, 817 392 8941 P. Ob r—� 5. Grantee, at no expense to City, shall make proper provision for the relocation and/or installation of an y existin or future traffic control I "g devices or other improvements affected by such encroachment,use and occupancy, including the securing of approval and consent from 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 traffic control device or improvement owned or constructed by or on behalf of the public or at public expense is made more costly by virtue of the existence of such encroachment and use, Grantee shall pay to City an addidonal amount equal to such additional cost as determined by.City. 6. The term of this agreement shall be for days, from zco,-,to o2�-I 44 provided,however, should the need for the encroachments granted hereunder at any time cease, Grantee agrees to immediately It notify City of such condition; and,upon receipt of such notice by the Building'Cfficial of the City of Fort Worth,this agreement shall 'I terminate. • I � J JAN-06-2004 TUE 13:33 PM T/PW T. E. STREET MGMT, FAX N0, 817 392 8941 P. 07 .-, 7. It is expressly understood and agreed that this Consent Agreement is for a temporary encroachment in,under, over and upon the public property as located and described in Exhibit `B". This'agreement shall not be construed as the granting of a permanent easement, encroachment or license upon City's public streets, alleys, sidewalks or other rights-of- way. S. City, through its duly authorized representatives, shall have the full and unrestricted right to enter upon all public rights-of-way for the purpose of making inspections to detemaine compliance with the terms, covenants and conditions herein. In the event that any inspection should reveal a breach of any terms, covenants or conditions herein, City shall give Grraniee notice of such breach. Should such breach not be corrected by Grantee within twenty-four(24) hours of receipt of the notice, or within such shorter period of time as deemed necessary by the Building Official for the protection of public health or safety, City may terminate and cancel this agreement. 9. 1 Upon expiration or termination of this agreement for any reason whatsoever, Grantee shall, at no expense to City,restore the public i nights-of-way and adjacent supporting structures 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, and Grantee shall remove all barricades, equipment, Al supplies, materials or other property from said location. Grantee further JAN-06-2004 TUE 03:33 PM T/PW T. E. STREET MGMT, FAX N0, 817 392 8941 P. 08 covenants and agrees that for a period of one (1) year after the termination of this Consent Agreement, Grantee will repair all conditions or damages too the streets and sidewalks or other rights-of-way that have resulted from Grantee's use or occupancy of the streets and sidewalks or other rights-of-way, as determined by the Director of Transportation and Public Works or his designee. Grantee agrees to I begin such repairs within thirty(34) days of receipt of notice from the ]director of Transportation and Public Works or his designee. All repairs shall be performed in an expeditious and workmanlike manner and shall.comply with all applicable laws, codes, ordinances and City specifications. In the event that Grantee fails to comply with the covenants herein contained with respect to such removal or restoration, the City shall have the right to remove or dispose of any barricades, equipment, supplies, materials or other property Y and repair any conditions which in the opinion of the City are necessary to bring the public rights-of-way to the condition prescribed herein, and.City shall not be responsible for trespass or any other damage or liability in connection with such removal or restoration. Grantee shall reimburse City for the cost and expense of such removal and/or repairs immediately following billing for same by City. Nothing herein shall be construed as a waiver by Cityao enforce „v penal sanctions prescribed by the Code of the City of Fort Worth and the laws of the State of Texas for Grantee's continued encroachment `7a /3 JAN-08-2004 TUE 03-33 PM T/PW T. E. STREET MGMT, FAX N0. 817 392 8941 P. 09 upon the public rights-of-way following termination of this Consent Agreement. l0. It is further understood and agreed between the parties hereto that City holds the city streets, alleys, sidewalks and other public rights-of- way, including the portions of such streets used and encroached upon as described herein as trustee for the ublic; that City exercises such l P � tY . powers over the streets as have been delegated to it by the Constitution of the State of Texas or by the Legislature; and that City cannot contras# . away its duty and its legislative power to control the streets for the use and benefit of the public. It is accordingly agreed that if the governing body of City, to wit, its City Council, should at any time during the term 1 hereof determine in its sole discretion to use or cause or permit to be used for any public purpose the said encroached portion of the.streets, then this agreement shall-be automatically canceled and terminated. 11. Grantee 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 encroachments and uses. 12. Grantee agrees to pay promptly when due all fees,taxes or rentals '^ provided for by this agreement orby any federal, state or local statute, law or regulation. 13. S (9p r3 JAN-06-2004 TUE 03:34 PM T/PW T. E. STREET MGMT. FAX NO 817 392 8941 P lU Cxrantee covenants and agrees that it shall exercise all rights and privileges granted hereunder as m independent contractor, and not as an officer, agent servant or employee of City; that Grantee shall have exclusive control of and the exclusive right to control the details of its operations and activities on said described public property 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; that the doctrine of respondeat superior shall not apply as between City and Grantee, its officers, agents, servants, employees, contractors and subcontractors, and nothing herein shall be construed as creating a partnership or j oint enterprise between City and Grantee. � 14. Grantee 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 maintenance, occupancy,use, existence or location of said 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 City; ' and grantee hereby assumes all liability and responsibility of City, its f � oF�3 JAN-06-2004 TUE 03:34 PM T/PW T, E, STREET MGMT, FAX N0, 817 392 8941 P. 11 officers; agents, servants and employees, for such claims or suits. Grantee 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 Grantee, its officers, agents, servants, employees,contractors; subcontractors, licensees, invitees or trespassers. 15. Grantee 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 `B". The amounts of such insurance shall be not less than the following: Property damage,per occurrence $100,000 Bodily injury,per person $250,000 Bodily injury or death,per occurrence $500,000 With the understanding of and agreement by Grantee that such insurance amounts shall be revised upward at City's option and that Grantee shall so revise such amounts immediately following notice to grantee of such i requirement. Such insurance policy shall provide that it cannot be canceled or amended without at least thirty(30} days' prior written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is attached as Exhibit"N'. Grantee agrees to submit a similar Certificate of Insurance annually to City on the anniversary date of the q� �1-!l '0` '` :f'`1 execution of this agreement. f� Olt �3 JAN-06-2004 TUE 03:35 PM T/PW T, E. STREET MGMT. FAX N0. 817 392 8941 P. 12 Grantee 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 of Grantee's contractors. 16. Grantee 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 City, and any attempted assignment without such prior written approval shall be void. 1.7. This agreement shall be binding upon the parties hereto, their 4 successors and assigns. 18. Should any action, whether real or asserted, at law or in equity, arise out of the-terms and conditions of this agreement or out of the use and occupancy of City property as permitted hereunder, venue for said action shall be in Tarrant County, Texas. 19. In any action brought by City for the enforcement of the obligations of Grantee, City shall be entitled to recover interest and reasonable attorneys' . r fees. 1l or- �3 JAN-06-2004 TUE 03.35 PM T/PW T, E. STREET MGMT, FAX N0, 817 392 8941 P. 13 EXECUTED This 2 2_+ day of ��ot Z $26% GRANTOR: GRANTEE: Y OF FORT WORTH L CIT BY BY. BUMDINOOMCIAI. M,q�eK Li.Y�Na �sC. APPRO TO FORM AND LEGALITY: ICKC&I 47 _ TITLE C, TTO Y DATE: \\\\\,`�OP Y IRtk �/'// PUB•.S i� dry sEC;RETAR.Y DATE' -d �����ii,• 1214 2CC� contract Authorization Date J �U .::•va. 'ttq Y i 1 for= 3 STATE OF TEXAS CO UAITY OF TARRANT. BEFOREME,the undersigned authority; alVotaryPublic in and Frlie State of Texas, on this day personally appeared VLr^ . �es''��"'k ,known to me to be theperson whose name is subscribed to the foregoing instrument, and acknowledged to the that helslce e�ecrrted the sane for the rrrposes cr d cgrasiderat1 _1 tizereit� expressed, as the act and deed of 23 and in'the capacity thereii:stated. IVE1l7 UNDER PJq'HAAlD,1 D SEAL OF OFFICE this J day Of Affiant Notary P cblic in and for The State of Texas .P ANGELA W~ , rsTFZADA Notary Pubjic STATE OF TEXAS y � ' M'00m'EXP.08/21/2007 11 l ,lniCiL %��' � .o JAN-06-2UU4 'VUE U3:3h PM '1'/PW T E STREET MGMT FAX NO 817 392 8941 P. 14 STATE OF TEXAS COUNTY OF TA RANT BEFORE ME,the undersigned authority,a Notary Public in and For 4e.Siate of Texas, on this day personally appeared, -MQLJL - ,known to me to be the person whose name is subscribed to the foregoing instrument,and acknowledged to me that helshe executed the same for the purposes and consideration therein expressed, as the act and deed of , and in the capacity therein stated IVEN UNDER MY HA"AND SEAL OF OFFICE this day of Af slant T9�OF�s 'i XPIR,,E,,,rr��,,•: TUk 1 Notary Public In and r The State of Texas - u ` i A a Contractors Name: L f v3 e,_Y V Point of Contact:_ : IQ 114 M; Phone Number: g 14.Ct3}.4:,13 < Building Permit Number:-PBo3 - 12 2(eC _ Purpose for Closure:' 2A6i- b-UKPSOZ LACZIaj Begin Date:nt f I& % oA End Date:CG fIa2g�e -end coke. _ Type.ofTaper according to posted speed limit: Tapers @ 30 MPH I Oft Offset 30ft minimum Tapers @ 35 MPH loft Offset 35ft minimum Tapers @ 40 MPH I Oft Offset 40ft minimum LLr J YZ � (2 �XZYy-� : /�170sF t � 130 S� - I� H141�J sT 5 b. v Pa*t4y x 2 i 3osi- K !.0 Altos , TF 1f.r S DAYS DA1 S 0.11 LESS SIDSIA!ALK r`L-s- �._ _SQFT. x X . � STI; � 'FEE �(C.J�.� SQ)Fl: n�OS X r iD TOIAL APPUCAW MUST CALL FOR A R CEIVE AN !� P TIbN AFlrEI'� CURIA �� -� 7 APPROM E MS OR 4 TRUCTIONS IN PLACE,. �"� r o -r-r- Pb c C;. CITY ��r- UY R W 3RIM, YEN. ACORDn CERTIFICATE OF LIABILITY INSURANCE Page 1 of 3 1 01/07DATE /2004 PRODUCER 877_945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America, Inc. - Regional Cert Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE INSURED Linbeck Construction Corporation INSURER A: Zurich American Insurance Company 16535-003 P. O. Box 22500 INSURER B: Houston, TX 77227 INSURER C: INSURER D: INSURERE: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION TR TYPE OFINSURANCE POLICY NUMBER DAT MMIDD/YY DATE /YY LIMITS • GENERAL LIABILITY GL0209090505 12/20/2003 12/20/2004 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Anyone fire) $ 100,000 CLAIMSMADE OOCCUR MEDEXP(Anyone person) $ 10,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 PRO- POLICYFX I JEC LOC • AUTOMOBILE LIABILITY TEXAS TAP209090405 12/20/2003 12/20/2004 COMBINED SINGLE LIMIT $ 1,000,000 • X ANYAUTO O/S BAP209090305 12/20/2003 12/20/2004 (Enaocident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIREDAUTOS BODILY INJURY NON-OWNED AUTOS (Per aeoident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACHOCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ I U $ A WORKERS COMPENSATION AND WC209090205 12/20/2003 12/20/2004 X TORYL,MITS CER EMPLOYERS'LIABILITY THE PROPRIETOR/ E.L.EACH ACCIDENT $ 1.000,000 PARTNERS/EXECUTIVE E.L.DISEASE-EAEMPLOYEE $ 11000,000 INCLUDED E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City of Fort Worth, its Officers and Employees are Additional Insureds on the general liability and automobile liability policies, but only to the extend of the indemnity of the contract and further subject to the terms, exclusions and conditions of the policy. favor lWayier of subroaatipn in CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION=csDt to Days for Hon-Papa sat SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR The City of Fort Worth REPRESENTATIVES. 311 W. 10th Street A=EZESE Fort Worth, TX 76102 ACORD 25-S(7/97) Co11:890117 Tp1:226638 Cert:3916577 ©ACORD CORPORATION 1988 ACORDw CERTIFICATE OF LIABILITY INSURANCE Page 1 of 3 01/07DATE /2004 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America, Inc. - Regional Cert Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE INSURED Linbeck Construction Corporation INSURER A: ZUrich American Insurance Company 16535-003 P. 0. SOx 22500 INSURER B: Houston, TX 77227 INSURER C: INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICYEFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YV ATE M PIRATI LIMITS A GENERAL LIABILITY GL0209090505 12/20/2003 12/20/2004 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Anyone fire) $ 100,000 CLAIMS MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2.000.000 POLICY X JE� F7 LOC A AUTOMOBILE LIABILITY TEXAS TAP209090405 12/20/2003 12/20/2004 COMBINED SINGLE LIMIT • X ANYAUTO O/S BAP209090305 12/20/2003 12/20/2004 (Eaaccident) $ 1,0001000 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGELIABILITY AUTO ONLY-EAACCIDENT $ ANYAUTO OTHERTHAN EAACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR FI CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ • WORKERS COMPENSATION AND WC209090205 12/20/2003 12/20/2004 X TORY LIMITS OEA EMPLOYERS'LIABILITY THE PROPRIETOR/ E.L.EACH ACCIDENT $ 11000,000 PARTNERS/EXECUTIVE E.L.DISEASE-EA EMPLOYEE $ 11000,000 ARE: I N LUDED E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSA.00ATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The City of Fort Worth, its Officers and Employees are Additional Insureds on the general liability and automobile liability policies, but only to the extend of the indemnity of the contract and further subject to the terms, exclusions and conditions of the policy. W vi r of subrocatipn in favor the holder(s) on the general liability and CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION Except to Days !or Noa-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR The City of Fort Worth REPRESENTATIVES. 311 W. 10th Street UTI/\ jDRIZED REPFESE A Fort Worth, TX 76102 ��`/,ayu _ 7 i/°A�• s ACORD 25-S(7/97) Coll:890117 Tpl:226638 Cert:3916577 ®ACORD CORPORATION 1988 WI11IS CERTIFICATE OF LIABILITY INSURANCE page 2 of 3 01107DATE /2004 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America, Inc. - Regional cart Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE INSURED Linbeck Construction Corporation INSURERA: Zurich American Insurance Company 16535-003 P. 0. Box 22500 Houston, TX 77227 INSURERB: INSURER C: INSURERD INSURER E: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS automobile liability policies, but only to the extent of the indemnity of the contract and further subject to the terms, exclusions and conditions of the policy. Coll:890117 Tpl:226638 Cert:3916577 Page 3 of 3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S(7/97) Co11:890117 Tp1:226638 Cert:3916577 ROAD WORK END AHEAD ROAD WORK JL X O O O O O L Y Q P � W a o � ARROW BOARD IF SPEED LIMIT Pp L6 N IS 40 MPH OR GREATER m 0 0 0 0 O RIGHT N I I 00000 J LANE CLOSED 0 Z rn Q C L d X 0 /ROAD RK END I I m AHEAD U ROAD WORK O U ZX Q JL °o This plan is submitted for TCP. I certify this plan will be used for the following location(s): N 11 and that all channelizing devices will conform to "General Notes" as shown on the back. w a Signatur Date: pf 04-L&+, 0 CITY OF FORT woR TYPICAL TWO WAY STREET TRANSPORTATION ONE LANE CLOSURE AND Note: PUBLIC WORKS See reverse side for General Notes and Device Spocin PLAN "2 41P, � `'''''JU�'� I ity of Fort Worth Transportation and Public Works Street Use Permit Page 1 of 1 FORTWORTH CITY OF FORT WORTH TRANSPORTATION AND PUBLIC WORKS STREET USE PERMIT DATE 1`9/2004 PERMIT#48937 MAPSCO 77N D.O.E.#NA (if apps=cable) STREET BLOCK FROM TO I DATE Mon.-Fri.Time TIME TIME BEGIN END BEGIN END SAT. SUN. 1.S MAIN ST 1550-1700 FELIKS GWOZDZ PL E ALLEN AVE 11/1212004 3/13/2004 24 HRS 24 FIRS 24 HRS TYPE OF WORK TO BE PERFORMED:(CHECK ALL THAT APPLY) RESIDENTIAL ID COMMERCIAL(SITE PLAN# ) n FUND RAISER _ SIDEWALK APPROACHES OTHER 1,0 SPECIAL EVENTS HANDICAP RAMP 0 STORM DRAIN D UTILITY(TYPE ) ❑BLOCK PARTY LANE CLOSURE TO STORE DUMPSTER FOR WORK AT JPS HOSPITAL"OK PER ATTACHED TRAFFIC CONTROL PLAN""TAPER IS NOT TO INTERFERE WITH THE BUS STOP, THIS PERMIT IS GRANTED TO THE CONTRA CTORIAPPLICANT UNDER THE FOLLOWING CONDITIONS: • CONTRACTOR IS REQUIRED TO HAVE THIS PERMIT AND TRAFFIC CONTROL PLAN AT THE WORK SITE AT ALL TIMES. • THIS PERMIT IS ISSUED IN ACCORDANCE WITH AN APPROVED TRAFFIC CONTROL PLAN. • ALL WORK IS CONSTRUCTED IN ACCORDANCE WITH THE CITY OF FORT WORTH'S"STANDARD SPECIFICATIONS FOR STREETS AND STORM DRAIN CONSTRUCTION MANUAL" • ADEQUATE TRAFFIC CONTROL DEVICES ARE INSTALLED AND MAINTAINED AS SHOWN IN THE ATTACHED TRAFFIC CONTROL PLAN(TCP)SUCH AS SIGNS,STANDARD TYPE I BARRICADES SAFEGUARD THE PROPERTIES AND PUBLIC • CITY TRAFFIC ENGINEER AND/OR INSPECTORS MAY REQUIRE ADDITIONAL TRAFFIC CONTROL DEVICES • ALL DAMAGES TO PUBLIC OR PRIVATE PROPERTY,INCLUDING UNDERGROUND FACILITIES,AND FOR ALL PERSONAL INJURIES ON WORK PERFORMED UNDER THIS PERMIT WILL BE THE RESPONSIBILITY OF THE CONTRACTOR • A 24-HOUR DECISION-MAKING CONTACT REPRESENTATIVE AND PHONE NUMBER IN THE EVENT OF AN EMERGENCY SHALL BE PROVIDED • IT IS UNDERSTOOD THAT VIOLATIONS OF THIS PERMIT MAY RESULT IN THE REVOCATION OF THE CONTRACTOR'S LICENSE. LINBECK GORDON ALDERMAN CONTRACTORIAPPLICANT PERMIT ISSUER /• ��, ��Cl/��� EMERGENCY CONTACT NAME KEVIN 1MMING 24-HOUR 682-885-7481 MOBILE 817-937-7213 PGR# FAX#682-885-1498 PHONE TRANSPORTATION AND PUBLIC WORKS DEPARTMENT STREET MANAGEMENT SECTION 311 W 10th STREET FORT WORTH,TX 76102 (817)392-6594 FAX(817)392-8941 r, Iv �1� http:,//Ipwperniit.cfwnet.org/popupj)cmiit.asp'?permlt—ld=48937 01/09!2004 i ROAD WORK END AHEAD ROAD WdRK X O O O O 00000 I I w ARROW SOMD IF SPEED LIMIT rb+ ] N IS 40 MPH OR GREATER M a 0 0 o O I RIGHT �Poo LANE N CLOSED O f�1 Z O C C L L d x a ROAD WORK END I AHEAD 0 < > ROAD WORK C O 1X - 0 This plan is submitted for TCP. I certify this pl.on will be used for the following locotion(s): N IN d' r and that all chonnelizing devices will conform to "General Notes" as shown on the back. o Signotu __.- .': ===="`- Date: Dy d 4/0'4 CITY OF FORT WORTH TYPICAL TWO WAY STREET TRANSPORTATION ONE LANE CLOSURE AND Note: PUBLIC WORKS See reverse side for General Notes and Device S ocinq. PLAN "241R"' 2-aF 3 s "GENERAL NOTES" 1. All channelizing devices shall be in accordance with the current edition of the Texas Manual on Uniform Traffic Control Devices. 2. All Traffic Control Devices shall have working visible warning lights as required in accordance with the current edition of TMUTCD. 3, For Temporary Situations, when it is not feasible to remove and restore pavement markings, channelization must be made dominant by using a very close device spacing. This is especially important in locations of conflicting information, such as where traffic is directed over a double yellow centerline. In such locations, channelizing device spacing of 10 feet is required. 4. For Long Term Stationary_work, all conflicting pavement markings must be removed and centerline striping provided where two way traffic is in adjacent lanes. 5. Contractor shall provide sidewalk closure, crosswalk closure and/or walkway bypass wherever pedestrian movements are affected by construction activities. All sidewalks and crosswalks shall be accessible when contractor is not working unless otherwise approved by the City Traffic Engineer. 6. The use of trailer mounted ARROW DISPLAYS may be required on all lane closures. The contractor shall provide one (1) stand-by unit in good working condition at the job site, ready for use, if his operation requires 24-hour a day closure set-ups and if required. 7. City Traffic Engineer and/or Inspectors may require additional traffic control devices, TYPICAL TRANSITION LENGTHS AND SUGGESTED MAXIMUM SPACING OF DEVICES Minimum Desirable Taper Suggested Maximum Device Suggested Sign Len the L Feet SP acin S acin Feet Posted 10, 11' 12' On a Taper On a.Tangent Speed Formula* Lane Lane Lane (Feet) (Feet) X. Dimension MPH Offset Offset Offset 30 150 1 165 180 30 60-75 120 35__ L=60 fi 40 265 295 40 80-100 240 45 450 495 540 45 90-110 320 50 L DNS 500 550 600 50 100-125 400 'L=Taper length in feet W=Width of offset in feet S=Posted speed Note: Buffer Zone will be 25 feet(maximum). LEGEND ❑ v Channelizing devices Trailer mounted arrow display (—'-? Flagger 11 Barricade ___J