HomeMy WebLinkAboutContract 48456 OW SECI ETARY L "
CUNTI'CACi'w.
Temporary Street Encroachments
Permit: PC16-00018 Application Date: 12/07/2016
Status: Issued Expiration Date: 04/02/2017
Permit Technician: Linda Pedroza Date Issued: 12/07/2016
Address:
Legal Description:
Mapsco: undefined Insp District: undefined Zoning: undefined
Description of Work: STREET RENTAL OF SIDEWALK AND LANE SPACE ON THROCKMORTON STREET
BETWEEN ATT BUILDING AND 9TH STREET; SAME ON HOUSTON STREET
Proj/Business Name: MUCKLEROY& FALLS
Applicant: CLINT MOYES, MUCKLEROY& FALLS,
Property Owner:
Contractor: ,
Occ Class Const Type Square Feet Occ Load Use Description
Temporary Encroachment 67959 $33,979.50
Total Fee $33,979.50
Balance $0.00
1 hereby affirm that the information contained herein is true and correct to the best of my knowledge, and agree to
conform to all regulations of the City of Fort Worth as described in the Fort Worth Municipal Code. I understand that
failure to comply with these provisions may result in the revocation of this permit.
In accordance with the State of Texas Underground Facility Damage Prevention and Safety Act(Utilities Code
Chapter 251), 1 hereby affirm that before performing any excavation 16"or deeper using mechanical equipment, I
have or will have contacted 1-800-545-6005 for proper identification and location of underground utilities in the area.
Signed: Date:
Sexually Oriented Business(Initials) Yes No
Under the Penalty of Law and Pursuant to Senate Bill 509 of the 77th Legislature of the State of Texas, I hereby
certify that an asbestos survey has, when applicable, been done in accordance with the Texas Asbestos Health
Protection Act(see Texas Occupations Code Section 1954.259)and the National Emission Standards for Hazardous
Air Pollutants for the area(s)being renovated and/or demolished. I understand that substantial penalties may result
from failure to conduct a proper asbestos survey.
All driveway access or street cuts require a separate permit and inspection from the Transportation and Public Works
Department(817-392-6526).
Signed: Date:
TO SCHEDULE INSPECTIONS CALL (817)392-6370
(If Permit is 3rd Party Inspections, contact your designated 3rd Party company to schedule inspection)
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CONSENT AGREEMENT
FOR I
TEMPORARY USE OF PUBLIC PROPERTY
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STATE OF TEXAS 4
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COUNTY OF TARRANT
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THIS AGREEMENT is made and entered into by and between the City of Fort Worth, a
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municipal corporation of Tarrant County, Texas, acting herein by and through its duly authorized E
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Building Official,hereinafter referred to as the"City"and HM+!Av' iLT"t>i
Mra «t —¢may e �A e__�5, � �'�x A� �r.... �-T�n �.�•r� svt,;'
Acting by and through its duly authorized agent,
Hereinafter referred to as"Grantee".
WITNESSETH:
For and in consideration of the payment by Grantee of charges set out below and the true and 4
faithful performance of the mutual covenants herein contained, City hereby grants to Grantee
permission to temporarily encroach upon, uses and occupy portion of the space under, on and/or
above the streets,alleys,sidewalks or other public rights-of-way as follows: 3
���•"� � •1'�ll... tsc3 `TH1L:�cac.rr�c,,�rpt ��~�•r- �'i�-�g—S- i
•f���'`��►�C�ti._tom,,_ 4 ��"` _�>����, a �- o� l-)y.sasS'u� ���E�`f'
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. I`
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All use and occupancy of public street, alleys, sidewalks or other public rights-of-way under I '
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this agreement shall be in strict compliance with the Charter, Ordinances and Codes of the City
and in accordance with the directions of the Building Official and the Director of Transportation {
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and Public Works of City.
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CONSENT AGREEMENTfor Temporary use of public propegyi.doe
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Upon expiration of this agreement and the privileges granted hereunder, there shall be no
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encroachment by Grantee in,under,on or above the surface of the public rights-of-way involved.4.
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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
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calculated in the manner and amounts prescribed by the Building Code of the City of Fort Worth
for temporary use or occupancy of public property. The estimated total amount of said fee is:
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Grantee, at no expense to City, shall make proper provision for the relocation and/or t
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installation of any existing or future traffic control devises or other improvements affected by €
such encroachment, use and occupancy, including the securing of approval and consent from the
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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 i
virtue of the existence of such encroachment and use, Grantee shall pay to City and additional
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amount equal to such additional cost as determined by City. 4
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The term of this agreement shall be for 1'S 0 days,from
Provided, however, should the need for the encroachments granted hereunder at any time cease,
Grantee agrees to immediately notify City of such condition; and, upon receipt of such notice by l i
the Building Official of the City of Fort Worth,this agreement shall terminate.
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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 j
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CONSENT AGREEME NTior Temporary use of public propertyf.doc
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"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.
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City, through its duly authorized representatives, shall have the full and unrestricted right to t
enter upon all public rights-of-way for the purpose of making inspections to determine
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 Grantee
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
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Building Official for the protection of public health or safety,City may terminate and cancel this
agreement.
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Upon expiration or termination of this agreement for any reason whatsoever,Grantee shalt, at
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no expense to City, restore the public rights-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 f
all barricades, equipment, supplies, materials or other property from said location. Grantee
further 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 to the streets and sidewalks or other
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rights-of-way that have resulted from Grantee's use or occupancy of the streets and sidewalks or
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other rights-of-way, as determined by the Director of Transportation and Public Works or his
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designee. Grantee agrees to begin such repairs within thirty (3 0) days of receipt of notice from
the Director of Transportation and Public Works or his designee. All repairs shall be performed t
in an expeditious and workmanlike manner and shall comply with all applicable laws, codes,
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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 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 j
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.
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CONSENT AGREEMENTfor Temporary us of public propedyl.doc S� 1
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Nothing herein shall be construed as a waiver by City to enforce 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 upon the public rights-of-way following termination of this Consent Agreement.
10.
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
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encroached upon as described herein, as trustee for the public; that City exercises such powers
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over the streets as have been delegated to it by the Constitution of the State of Texas or by the
Legislature; and the City cannot contract 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, shall at any time during the term hereof determine in its sole I 1
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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. I
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Grantee agrees to comply fully with all applicable federal, state and local laws, statutes, I
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ordinances, codes or regulations in connection with the construction, operation and maintenance
of said encroachments and uses. !
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Grantee agrees to pay promptly when due all fees, taxes or rentals provided for by this
agreement or by any federal,state or local statue,law or regulation.
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Grantee covenants and agrees that it shall exercise all rights and privileges granted hereunder
ontractor, and not as an officer, a l
as an independent c agent, servant or employee of City; that g
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,
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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 j
subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise j
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between City and Grantee. !
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CONSENT AGREEMEMTfor Temporary use of public prop"I.doc
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GRANTEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY
INDEMIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS,
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SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR
SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY,
CNCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR
CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN
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CONNECTION WITH, DIRECTLY OR INDIRECTLY, THE MAINTENANCE, {{ i
OCCUPANCY,USE, EXISTENCE OR LOCATION OF SAID ENCROACHMENT AND
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USES GRANTED HEREUNDER,WIIETIiER OR NOT CAUSE,IN WHOLE OR PART, 1
BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, a
CONTRACTORS, SUBCONTRACTORS, LICENSEES OR INVITEES OF CITY; AND
GRANTEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY OF CITY,
ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES, FOR SUCH CLAIMS OR If
SUITS. GRANTEE SHALL LIKEWISE ASSUME ALL LIABILITY AND t
RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR ANY AND ALL INJURY OR
DAMAGE TO CITY PROPERTY, ARISING OUT OF OR IN CONNECTION WITH I
ANY AND ALL ACTS OR OMISSIONS OF GRANTEE, ITS OFFICERS, AGENTS, !
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SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICESNEES,
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INVITEES OR TRESPASSERS.
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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 that the following:
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Property damage,per occurrence $100,000.00
Bodily injury,per person $250,000.00
Bodily injury or death,per occurrence $500,000.00 i I
With the understanding of and agreement by Grantee that such insuranec amounts shall be revised
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upward at City's option and that Grantee shall so revise such amount immediately following t
notice to Grantee of such requirement. Such insurance policy shall provide that it cannot be
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canceled or amended without at least thirty(30) days' prior written notice to the Building Official
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CONSENT AGREEMENTfor Temporary use of public propertyl.Aoc {
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of the City of Fort Worth. A copy of such Certificate of Insurance is attached as Exhibit "A".
Grantee agrees to submit a similar Certificate of Insurance annually to City on the anniversary j
date of the execution of this agreement.
Grantee, agrees, binds and obligates itself, it 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 Grantee's contractors.
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Grantee covenants and agrees that it will not assign all or any of its rights,privileges or duties
under this contract without prior written approval of City, and any attempted assignment without 1
such prior written approval shall be void.
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This agreement shall be binding upon the parties hereto,their successors and assigns.
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Should any action, whether real or asserted, at law or in equity, arise out of the terms and }
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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.
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In any action brought by City for the enforcement of the obligations of Grantee, City shall be +
entitled to recover interest and reasonable attorneys'fees.
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EXECUTED this IS; day of VA0+k7M_3EL ,-2ftm• I
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GRANTOR: GRANTEE:
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CITY OF FORT WORTH ��✓l1 �r'y i }
Building Official —
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HM&MF,Ltd.,d/b/a MUCKLEROY&FALLS,a Texas
Limited Partnership by Muckleroy&Falls Construction
Co.,a Texas Corporation and General Partner `
6 CONSENT AGREEMENTfor Temporary use of public properto.doc [
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APPROVED TO FO D LEGALITY;
Assistant City Atto e Date
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OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
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CONSENT AGREEMENTfer Temporary use of public propertyf.dpc
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STATE OF TEXAS
COUNTY OF TARRANT '
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BEF®.ISE ME, the undersigned authority,a Notary Public in and
For e State of Texas on this clay personally appeared
,known to me to be the person whose
name s erlo io going instrument, and acknowledged to me
that he/she executed the same for the arposes and gsiderad n therein
expressed, as the act and deed of ^w }
and in the capacity therein stated.
(VQ
.N UNDER MY HAND AND SEAL OF OFFICE this _ day
of 20
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Affcant
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Title
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Notary ublic in and for
The State of Texas
1
�psiY PUgG R G NAREZ
Notary Public
* * State of Texas
pF���P� Comm,Exp 09-10-2017
Notary ID 123982388
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STATE OF TEXAS � I
COUNTY OF TARRANT }
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BEFORE DIE, the undersigned authority, a Notaq Public in and
For the Stc to of Texas, on (Itis clay personally appeared
f 7-A.) ,known to me to be the person whose
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name is subscribed to the foregoing instrument, and acknowledged to the
that he/she executed the same for the purposes and consideration therein �.
expressed, as the act and deed of E�4 Fat"e-5F:r�I 1% ?
and in the capacity therein stated.
IilEN UNDER MYMAlirD AIVD SEAL OF OFFICE this
t'Sr9+- day
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Affiant//
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HM&MF,Ltd.,d/b/a MUCKLEROY&FALLS,a Texas
Limited Partnership by Muckleroy&Falls Construction
Co.,a Texas Corporation and General Partner L l
Notary Public in and for { {
The State of Texas — I
BETH AIKIN t
Notary Public. State of Texas {
1\r My Commission Expires
May 28, 2018
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—� HM&MFLT-01 CWENDORF
'4�oRoF CERTIFICATE OF LIABILITY INSURANCE DATE
8/18/ 2016 MMIDDffYYY)
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).
ACT
PRODUCER License#4682 NAME:
Fort Worth,TX-Hub International Insurance ServicesPHONE (817)g20-8100 Fa//� No, (817)870-0310
421 West Third Street,Suite 800 AIC No Ext
Fort Worth,TX 76102 ADDRESS: •service@hubinternational.com
INSURER(S)AFFORDING COVERAGE NAIC li
INSURER A:AmeriSure Insurance Company 19488
INSURED INSURER B:Texas Mutual Insurance Company 22945
HM&MF Ltd.dba Muckleroy&Falls INSURER C:
5801 Edwards Ranch Road,Suite 100 INSURER D:
Fort Worth,TX 76109 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 ADD SUBR POLICY EFF POLICY EXP
TYPE OF INSURANCE
LTR INSD WVD POLICYNUMBER MM/DDIYYYY MMIDD/YYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE _x OCCUR CPP20316241001 08/28/2016 08/20/2017 PREMISES(Ea occurrence) $ 100,000
MED EXP(Anyone person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: '4 I $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
A X ANY AUTO CA20316231002 08/28/2016 08/2812017 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
NON OWNED ) ') PROPERTY DAMAGE $
HIRED AUTOS AUTOS _ Per accident
$
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00
A EXCESS LIAB CLAIMS-MADE CU20316221001 08/28/2016 08/28/2017 AGGREGATE $
DED I X IRETENTION$ 0 - Aggregate $ 5,000,000
WORKERS COMPENSATION
STATUTE ER
AND EMPLOYERS'LIABILITY
B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN NIA TSF-0001053883 08/28/2016 08/2812017 E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
A Equipment Floater IM20315251002 08/28/2016 08/28/2017 Rented/Leased Equipm 151,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
The General Liability and Automobile Liability policies include a blanket additional insured endorsement ).hat provides additional insured status to the
certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status subject to policy terms
and conditions.The General Liability,Automobile Liability and Workers Compensation policies include a blanket waiver of subrogation endorsement that
provides this feature only when there is a written contract between the named insured and the certificate molder that requires it subject to policy terms and
conditions. The General Liability policy contains a special endorsement with"Primary and Noncontributory"wording when required by written contract
subject to policy terms and conditions.The Umbrella Policy Follows Form.The policies include an endorsement providing that(30)day's notice of
cancellation(or coverage change)and a(10)day's notice of cancellation for non-payment of Premium will be furnished to the certificate holder.
SEE ATTACHED ACORD 101
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY-OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
The Cit of Fort Worth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Y ACCORDANCE WITH THE POLICY PROVISIONS.
Street Management Section
311 W.10th Street
Fort worth,TX 76102 AUTHORIZED REPRESENTATIVE
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
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Contractors Name:
Point of Contact:
Phone Number:
Building Permit Number:
Purpose for Closure: T `;
Begin Date: End Date:
Type of Taper according to posted speed limit:
Tapers @ 30 NTH,IOft Offset,150'minimum
Tapers @ 35 M2H.10fft Offset,a05'minimnm
Tapers @ 40 MPH,lOft Offset,9-65' ,
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Contractors Name:
Point of Contact:
Phone Number:
Building Permit Number:
Purpose for Closure:
Begin Date: End Date:
Type of Taper according to posted speed limit:
Tapers @ 30 MPH,IOft Offset,150`minimum
Tapers @ 35 MB13,10ft Offset,aoVminimum
coke. !:ZTapers @ 40 MPH,1Oft Offset,2,6S'minimura
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