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Contract 47693-R2
10 11 qjs R CSC No. , TON CITY OF FORT WORTH �U�✓ ��`�� w CONTRACT RENEWAL NOTICE Cs�Q c, CITY SECRETARY 5/5/17 �o► ti CONTRACT N0. �� 11048$ Azimuth Group, Inc. 3419 Westminster Ave, Suite 215 Dallas,TX 75205 Re: NOTICE OF CONTRACT RENEWAL Professional Services Agreement Contract No. CSC No. 47693-R1 (the"Contract") Renewal Term No. 2: May 31, 2017 to May 30, 2018 The above referenced Contract will expire on May 31, 2017. Pursuant to the Contract, contract renewals are at the sole option of the City. This letter is to inform you that the City is exercising its right to renew CSC No. 47693-R1 for an additional one year period, which will begin immediately upon the expiration of the current term and will end on May 30, 2018. All other terms and conditions of CSC No. 47693-R1 remain unchanged. Please return this signed acknowledgement letter, along with a copy of your current insurance certificate, to the address set forth below, acknowledging receipt of the Notice of Contract Renewal. Please log onto BuySpeed Online at http//fortworthtexas.gov/purchasing to insure that your company information is correct and up-to-date. If you have any questions concerning this Contract Renewal Notice,please contact me at the telephone number listed below. Sincerely yours, Darian Gavin, Contract Compliance Specialist OFFICIAL RECORD FMS, Purchasing Division CITY SECRETARY 817-392-2057 - Direct FT.tlWORTH,TX 817-392-8440 - Fax 1 hereby acknowledge receipt of the Contract Renewal Notice for CSC No. 47693-R1 t`or a one year period ending on May 30, 2018. pp .� By: TCESjDc l Date: © �� Printed N me and Title/A ti i nature F FRT CITY OF FORT WORTH: E all_ Jesus J. Chapa,sAssistant City Manager a J. Kayser,City Secreta Date: M&C No. N/A CSC No. CONTRACT COMPLIANCE MANAGER: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. By: L/ ,y Name: ,LJX,�,4ZQ, /C7�U25C�� Title: s� �ryyce K ct�� AC�® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4/7/2017 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(les) 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 NAMELinda Hackler : ANBTX Insurance Services, Inc. PHONE (972)419-7500 AIC No: (972)419-7555 12400 Coit Road, Suite 1100 MAIL linda.hackler@anbtxinsurance.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC# Dallas TX 75251-2039 INSURERA:Hartford Lloyds (TexasOnl ) 38253 INSURED INSURERB:Hartford Ins. Co. of Midwest The Azimuth Group, Inc INSURER C: 3419 Westminster Ave INSURER D: Ste 215 INSURER E Dallas TX 75205-1387 INSURER F: COVERAGES CERTIFICATE NUMBER:17/18 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MWDD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE FxI OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ 46SBAIF7125 2/1/2017 2/1/2018 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident AX HIRED AUTOS ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 46SBAIF7125 2/1/2017 2/1/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ AUTOS NON-OWNED Per accident X X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION 10,000 46SHAIF7125 2/1/2017 2/1/2018 1 $ WORKERS COMPENSATIONx PER OTH- AND EMPLOYERS'LIABILITY Y 1 N STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED7 B NIA (Mandatory In NH) 46WBCIO7976 2/1/2017 2/1/2018 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The General Liability policy includes a blanket automatic additional insured endorsement (provision) that 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. The General Liability and Workers Compensation policies include a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Worth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1000 Throckmorton ACCORDANCE WITH THE POLICY PROVISIONS. Fort Worth, TX 76102 AUTHORIZED REPRESENTATIVE Von Breaux/HACKLE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025r7mami