Loading...
HomeMy WebLinkAboutContract 49498 CITY OF FORT WORTH, TEXAS CITY SECRETARY /�� CONTRACT NO. `� �"//� � STANDARD AGREEMENT FOR PROFESSIONAL SERVICES This AGREEMENT is between the City of Fort Worth, a Texas home-rule municipality (the "CITY"), and Duane Rubeor, authorized to do business in Texas, an independent contractor ("Consultant"), for a PROJECT generally described as: Facility Data Collection and Assessment. The Agreement documents shall include the following: 1. This Standard Agreement for Professional Services, 2. Attachment "A" — Facility Data Collection and Condition Assessment Scope of Work, 3. Attachment "B" — Data Collection Proposal, 3. Attachment "C" —Verification of Signature Authority Form. Attachments A, B and C, which are attached hereto and incorporated herein, are made a part of this Agreement for all purposes. In the event of any conflict between the terms and conditions of Attachments A, B or C and the terms and conditions set forth in the body of this Agreement, the terms and conditions of this Agreement shall control. Article I Scope of Services (1) Consultant hereby agrees to perform as an independent contractor the services set forth in the Scope of Services attached hereto as Attachment "A". These services shall be performed in connection with Facility Data Collection and Assessment. (2) Additional services, if any, will be requested in writing by the City. City shall not pay for any work performed by Consultant or its subconsultants, subcontractors and/or suppliers that has not been ordered in writing. It is specifically agreed that Consultant shall not be compensated for any alleged additional work resulting from oral orders of any person. Article II Compensation Consultant shall be compensated in accordance with the Fee Schedule shown in Attachment "B". Payment shall be considered full compensation for all labor, materials, supplies, and equipment necessary to complete the services described in Attachment "B". However the total fee paid by the City shall not exceed a total of $49,000.00 unless the City and the Consultant mutually agree upon a fee amount for additional services and amend this Agreement accordingly. Q� 1234ss City of Fort Worth,Texas , Standard Agreement for Professional Services-Rubeor OFFICIAL RECORD � Revision Date:8/3//2017 Q Page 1 of8 CITY SECRETARY 8r RECEIVED o FT.WORTH, TBS r AUG 14 2M7 a d CITY OF FORT WORTH N -- 6' CffYSECRETARY ysD The Consultant shall provide monthly invoices to the City. Payment for services rendered shall be due within thirty (30) days of the uncontested performance of the particular services so ordered and receipt by City of Consultant's invoice for payment of same. Acceptance by Consultant of said payment shall operate as and shall release the City from all claims or liabilities under this Agreement for anything related to, done, or furnished in connection with the services for which payment is made, including any act or omission of the City in connection with such services. Article III Term Unless terminated pursuant to the terms herein, this Agreement shall be for a term of Twelve Months, beginning upon the date of its execution, or until the completion of the subject matter contemplated herein, whichever occurs first. Article IV Independent Contractor Consultant shall operate hereunder as an independent contractor, and not as an officer, agent, servant, or employee of the City. Consultant shall have exclusive control of and the exclusive right to control the details of its work to be performed hereunder and all persons performing same, and shall be solely responsible for the acts and omissions of its officers, agents, employees, contractors and subcontractors. The doctrine of respondent superior shall not apply as between City and Consultant, its officers, agents, employees, contractors, and subcontractors, and nothing herein shall be construed as creating a partnership or joint venture between City and Consultant. Article V Professional Competence and Indemnification (1) Work performed by Consultant shall comply in all aspects with all applicable local, state and federal laws and with all applicable rules and regulations promulgated by the local, state and national boards, bureaus and agencies. Approval by the City shall not constitute or be deemed to be a release of the responsibility and liability of Consultant or its officers, agents, employees, contractors and subcontractors for the accuracy and competency of its services performed hereunder. (2) In accordance with Texas Local Government Code Section 271.904, the Consultant shall indemnify, hold harmless, and defend the City against liability for any damage caused by or resulting from an act of negligence, intentional tort, intellectual property infringement, or failure to pay a subcontractor or supplier committed by the Consultant or Consultant's agent, consultant under contract, or another entity over which the Consultant's exercises control. City of Fort Worth,Texas Standard Agreement for Professional Services-Rubeor Revision Date:8/3//2017 Page 2 of 8 Article VI Insurance (1) Consultant shall not commence work under this Agreement until it has obtained all insurance required under this Article and the City has approved such insurance, nor shall Consultant allow any subcontractor to commence work on its subcontract until all similar insurance of the subcontractor has been so obtained and approval given by the City; provided, however, Consultant may elect to add any subconsultant as an additional insured under its liability policies. Commercial General Liability $1,000,000 each occurrence $2,000,000 aggregate Automobile Liability $1,000,000 each accident (or reasonably equivalent limits of coverage if written on a split limits basis). Coverage shall be on any vehicle used in the course of the Project. Worker's Compensation (required if Consultant has any employees) Coverage A: statutory limits Coverage B: $100,000 each accident $500,000 disease - policy limit $100,000 disease - each employee (2) Additional Insurance Requirements a. Except for employer's liability insurance coverage under Consultant's worker's compensation insurance policy, the City, its officers, employees and servants shall be endorsed as an additional insured on Consultant's insurance policies. b. Certificates of insurance shall be delivered to the Architectural Services, Attention: Brian R. Glass, 401 West 13th Street, Fort Worth, TX 76012, prior to commencement of work. c. Any failure on part of the City to request required insurance documentation shall not constitute a waiver of the insurance requirements specified herein. d. Each insurance policy shall be endorsed to provide the City a minimum thirty days notice of cancellation, non-renewal, and/or material change in policy terms or coverage. A ten days notice shall be acceptable in the event of non-payment of premium. e. Insurers must be authorized to do business in the State of Texas and have a current A.M. Best rating of A: VII or equivalent measure of financial strength and solvency. City of Fort Worth,Texas Standard Agreement for Professional Services-Rubeor Revision Date:8/3//2017 Page 3 of 8 f. Other than worker's compensation insurance, in lieu of traditional insurance, City may consider alternative coverage or risk treatment measures through insurance pools or risk retention groups. The City must approve in writing any alternative coverage. g. Workers' compensation insurance policy(s) covering employees employed on the Project shall be endorsed with a waiver of subrogation providing rights of recovery in favor of the City. h. City shall not be responsible for the direct payment of insurance premium costs for Consultant's insurance. i. Consultant's insurance policies shall each be endorsed to provide that such insurance is primary protection and any self-funded or commercial coverage maintained by City shall not be called upon to contribute to loss recovery. j. In the course of the Agreement, Consultant shall report, in a timely manner, to City's officially designated contract administrator any known loss occurrence which could give rise to a liability claim or lawsuit or which could result in a property loss. k. Consultant's liability shall not be limited to the specified amounts of insurance required herein. I. Upon the request of City, Consultant shall provide complete copies of all insurance policies required by these Agreement documents. Article VII Transfer or Assignment City and Consultant each bind themselves, and their lawful successors and assigns, to this Agreement. Consultant, its lawful successors and assigns, shall not assign, sublet or transfer any interest in this Agreement without prior written consent of the City. Article VIII Termination of Contract (1) City may terminate this Agreement for its convenience on 30 days' written notice. Either the City or the Consultant for cause may terminate this Agreement if either Party fails substantially to perform through no fault of the other and does not commence correction of such nonperformance with 5 days of written notice and diligently complete the correction thereafter City of Fort Worth,Texas Standard Agreement for Professional Services-Rubeor Revision Date:8/3//2017 Page 4 of 8 (2) If City chooses to terminate this Agreement under Article 8, upon receipt of notice of termination, Consultant shall discontinue services rendered up to the date of such termination and City shall compensate Consultant based upon calculations in Article II of this Agreement. (3) All reports, whether partial or complete, prepared under this Agreement, including any original drawings or documents, whether furnished by the City, its officers, agents, employees, consultants, or contractors, or prepared by Consultant, shall be or become the property of the City, and shall be furnished to the City prior to or at the time such services are completed, or upon termination or expiration of this Agreement. Article IX Right to Audit (1) 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 any directly pertinent books, documents, papers and records of Consultant involving transactions relating to this Agreement. Consultant agrees that the City shall have access during normal working hours to all necessary facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. City shall give Consultant reasonable advance notice of intended audits. (2) Consultant further agrees to include in all its subcontracts hereunder, a provision to the effect that the subcontracting consultant agrees that the City shall, until the expiration of three (3) years after final payment under the subcontract, have access to and the right to examine any directly pertinent books, documents, papers and records of such sub-consultant, involving transactions to the subcontract, and further, that City shall have access during normal working hours to all sub- consultant facilities, and shall be provided adequate and appropriate work space in order to conduct audits in compliance with the provisions of this article. City shall give Consultant and any sub-consultant reasonable advance notice of intended audit. (3) Consultant and sub-consultants agree to photocopy such documents as may be requested by the City. The City agrees to reimburse Consultant for the cost of copies at the rate published in the Texas Administrative Code in effect as of the time copying is performed. City of Fort Worth,Texas Standard Agreement for Professional Services-Rubeor Revision Date:8/3//2017 Page 5 of 8 Article X Minority Business and Small Business Enterprise (MBE)(SBE) Participation In accordance with the City's Business Diversity Enterprise Ordinance No. 20020-12-2011, as amended, the City has goals for the participation of minority business enterprises and/or small business enterprises in City contracts. Consultant acknowledges the MBE and SBE goals established for this Agreement and its accepted written commitment to MBE and SBE participation. Any misrepresentation of facts (other than a negligent misrepresentation) and/or the commission of fraud by the Consultant may result in the termination of this Agreement and debarment from participating in City contracts for a period of time of not less than three (3) years. Article XI Observe and Comply Consultant shall at all times observe and comply with all federal, state, and local laws and regulations and with all City ordinances and regulations which in any way affect this Agreement and the work hereunder, and shall observe and comply with all orders, laws ordinances and regulations which may exist or may be enacted later by governing bodies having jurisdiction or authority for such enactment. No plea of misunderstanding or ignorance thereof shall be considered. Consultant agrees to defend, indemnify and hold harmless City and all of its officers, agents and employees from and against all claims or liability arising out of the violation of any such order, law, ordinance, or regulation, whether it be by itself or its employees. Article XII Venue and Jurisdiction If any action, whether real or asserted, at law or in equity, arises on the basis of any provision 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. This Agreement shall be construed in accordance with the laws of the State of Texas. Article XIll Contract Construction The Parties acknowledge that each party and, if it so chooses, its counsel have reviewed and revised this Agreement and that the normal rule of construction to the effect that any ambiguities are to be resolved against the drafting party must not be employed in the City of Fort Worth,Texas Standard Agreement for Professional Services-Rubeor Revision Date:8/3//2017 Page 6 of 8 interpretation of this Agreement or any amendments or exhibits hereto. Article XIV Severability The provisions of this Agreement are severable, and if any word, phrase, clause, sentence, paragraph, section or other part of this Agreement or the application thereof to any person or circumstance shall ever be held by any court of competent jurisdiction to be invalid or unconstitutional for any reason, the remainder of this Agreement and the application of such word, phrase, clause, sentence, paragraph, section, or other part of this Agreement to other persons or circumstances shall not be affected thereby and this Agreement shall be construed as if such invalid or unconstitutional portion had never been contained therein. Article XV Notices Notices to be provided hereunder shall be sufficient if forwarded to the other Party by hand-delivery or via U.S. Postal Service certified mail return receipt requested, postage prepaid, to the address of the other Party shown below: City of Fort Worth: Attn: Brian R. Glass, AIA Architectural Services Manager 401 West 13th Street Fort Worth, Texas 76102 Consultant: Duane Rubeor Attn: Mr. Duane Rubeor 2 Red Oak Ct Mansfield, Texas 76063 Article XVI Headings The headings contained herein are for the convenience in reference and are not intended to define or limit the scope of any provision of this Agreement. City of Fort Worth,Texas Standard Agreement for Professional Services-Rubeor Revision Date:8/3//2017 Page 7 of 8 Article XVII Counterparts This Agreement may be executed in one or more counterparts and each counterpart shall, for all purposes, be deemed an original, but all such counterparts shall together constitute but one and the same instrument. Executed and effective this the 0—day o&A� , 2017. BY: BY: CITY OF FORT WORTH CONSULTANT Duane beor Jesus J. Chapa Duane Rubeor Assistant City Manager Date: �J ��p ' J 7 Date: APPR AL FZECOMMENDED: I / I By: Stev Cooke Director, Property Management APPROVED AS TO FORM AND LEGALITY M&C No.: NA By: G�� M&C Date: NA ohn B. Strong Assistant City A o`rney FORr m 1295 Certification: Not Required ATTEST: V r � a J a ei City S reit ry �XAS 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: &4-c •R "y Brian R. Glass,AIA Architectural Services Manager City of Fort worth,Texas OFFICIAL RECORD Standard Agreement for Professional Services-Rubeor Revision Date:8/3//2017 CITY SECRETARY Page 8 of 8 FT.WORTH,TX ATTACHMENT "A" Facility Data Collection and Condition Assessment Scope of Work 1) Using the resources of the PMD Facility Assessment Team, gather the data and assess the conditions of all City facilities as detailed in Exhibit A. For General Fund facilities, also gather the data and assess the conditions as detailed in Exhibit B (collectively, "Data Collection") 2) Complete assessment of 5 pilot facilities (Zipper Building, Southwest Regional Library, Southside Community Center, Police Central Division, Taylor Street Parking Garage) and have the data input into spreadsheets by August 23, 2017 3) Complete remaining facilities by December 24, 2017 4) Coordinate with PMD Facilities Maintenance Group and Facilities Planning Group to determine most effective and efficient means and methods for gathering data on general fund facilities 5) Provide transportation for yourself, with required commercial insurance 6) Determine the areas of expertise for team members, consult with Property Management Assistant Director for recommendation to assign categories of work and building assignments, team assignments, and develop a schedule for assessment completion to meet deadlines 7) Attend bi-weekly Enterprise Asset Management (EAM) meetings, currently scheduled for every other Tuesday afternoon from 2-3pm 8) Provide status update by phone or in person weekly to PMD Facilities Division Assistant Director 9) Coordinate visits to buildings with occupants, to include enterprise fund, internal service fund, and leased facilities such as the FW Zoo, Casa Manana, Community Arts Center, Rose Marine Theater, etc. 10) Complete spreadsheets as detailed in Exhibit A for all City-owned facilities (approximately 982 +/-), and complete additional spreadsheets as detailed in Exhibit B for all general fund facilities (approximately 350 +/-) 11) Perform quality control on Data Collected by team and on data entered into Excel spreadsheet 12) Continue to be involved in EAM implementation after Data Collection 13) Coordinate with PMD Facilities Architectural Services and Elements of Architecture as necessary to determine the most efficient method of completing Data Collection and assessment for Public Events facilities, Botanic Garden, and other facilities that have already had an independent assessment performed. The actual collection of data will be done by a combination of PMD Facilities Assessment Team, PMD Facilities Maintenance staff, PMD Facilities Planning staff, ITS GIS staff, sponsoring department staff, and other consultants. The exact amount of effort and time required is difficult to provide a precise estimate, and the work scope will be adjusted during the duration of this agreement. To properly compensate for the unknown effort required and unknown changes in scope, compensation will be based on the actual effort expended on an hourly basis with a not-to-exceed threshold and an allowance for reimbursable expenses ATTACHMENT "A" Facility Data Collection and Condition Assessment Scope of Work 1) Using the resources of the PMD Facility Assessment Team, gather the data and assess the conditions of all City facilities as detailed in Exhibit A. For General Fund facilities, also gather the data and assess the conditions as detailed in Exhibit B (collectively, "Data Collection") 2) Complete assessment of 5 pilot facilities (Zipper Building, Southwest Regional Library, Southside Community Center, Police Central Division, Taylor Street Parking Garage) and have the data input into spreadsheets by August 23, 2017 3) Complete remaining facilities by December 24, 2017 4) Coordinate with PMD Facilities Maintenance Group and Facilities Planning Group to determine most effective and efficient means and methods for gathering data on general fund facilities 5) Provide transportation for yourself, with required commercial insurance 6) Determine the areas of expertise for team members, consult with Property Management Assistant Director for recommendation to assign categories of work and building assignments, team assignments, and develop a schedule for assessment completion to meet deadlines 7) Attend bi-weekly Enterprise Asset Management (EAM) meetings, currently scheduled for every other Tuesday afternoon from 2-3pm 8) Provide status update by phone or in person weekly to PMD Facilities Division Assistant Director 9) Coordinate visits to buildings with occupants, to include enterprise fund, internal service fund, and leased facilities such as the FW Zoo, Casa Manana, Community Arts Center, Rose Marine Theater, etc. 10) Complete spreadsheets as detailed in Exhibit A for all City-owned facilities (approximately 982 +/-), and complete additional spreadsheets as detailed in Exhibit B for all general fund facilities (approximately 350 +/-) 11) Perform quality control on Data Collected by team and on data entered into Excel spreadsheet 12) Continue to be involved in EAM implementation after Data Collection 13) Coordinate with PMD Facilities Architectural Services and Elements of Architecture as necessary to determine the most efficient method of completing Data Collection and assessment for Public Events facilities, Botanic Garden, and other facilities that have already had an independent assessment performed. The actual collection of data will be done by a combination of PMD Facilities Assessment Team, PMD Facilities Maintenance staff, PMD Facilities Planning staff, ITS GIS staff, sponsoring department staff, and other consultants. The exact amount of effort and time required is difficult to provide a precise estimate, and the work scope will be adjusted during the duration of this agreement. To properly compensate for the unknown effort required and unknown changes in scope, compensation will be based on the actual effort expended on an hourly basis with a not-to-exceed threshold and an allowance for reimbursable expenses Exhibit "A" of ATTACHMENT "A" a, ) .p 5 C O ra L L L L O W a✓ � O O O L L L rUm ru _ Q� aJ w v) In v) v) v) v) o v) v) 1n v) cr� rr m v) v) v) V) [Q a1 aJ aJ (v a) a1 a) al al a) al 0 O Q Q) LL, a) 4- 4_ � 4— - � L� 4- �_ •L •L L L L L L L L •L � � L L L L L ai (1) W Q) (3) w w w (1) ai Q) (-i d. a- aJ (1) (1) I- I- i- I- f- I- F- I- F- H I- E E E a a Q a a a a a a Q a o o p a a a a Li- LL LL LL LL LL LL LL LL W-. LL 4- 4- 4= Ll LL LL Ll- +1 +1 vi vi vi vi vi vi vi vi bD r,D UD U UO to vi v) vi w tic ra v v v ac c r_ c a.) a) ) a) a) c c v v v c c a) a) a) � 4- CZ CZ Q Q C2 C2 C2 Q c C C C C Q. Q Q C Q C2 C2 O.. p Q Q C2 C2 Q C2 0- Q o _T tD rU to rU O- CL to rG tO C2 C2 C1 C2 u vt v) to vt v) Ln v) v) �- R a a a a v) (n (A CL a a v) v) v) un " O O O O O 0 O O DG 0 O O O O O 0 O O O O O O ® 2 2 2Q > Q s (n CL CL CL C1 C1 LL a a a LL CL 0- 01 CL LL a. LL a a a n- a. CL d 0- 0 0 o' a a N .w c m co O F — O � 03 O Q L QJ Q rU9 vl .L 's=. "- O C 0 1-• CL ro X Lc ai a� o Q N n _ N Cz z O Z3 (a O v) o o p m a� u) n c a p v W M U z v'i z I— -D O O � a� —_ >- _u •� a� v) Lu Q a) v m rNo � +- +- + +� O v) v) U tiD @ L m N Q CZ a1 a1 0 QI aJ N Q) U Q C 0 C O L -0 to C vOi vii N O O ) ) m4-1-1 v v n @ CL - 00 o > v D o ami ami 0)41 (13 u u D D CO LL Ln to Ln Ln U N Ln Q z U N 0 = > CO J O J J 3 0 0 0 0 a a a W LL LL L L L -C -C 41 41 i O o O L L L 0 O O 4— O E 4— 4— L ((pp f0 (O 0 1 L L v- Q1 Q1 al V V V L L L O O O •� V) 0 Ln V) V) 0 Vl V) V) V) V) V) m Q) v v aj w a) a) ai as (1) a) w 4— t= 4- 4= L L L •L L .L L L L L L L L. v ai a) (D a) w v v ai v (1) a) v > > > > > > > > > > > > > F- a a a a a a a a a a Q a a LL LL '- l.l_ LL LL LL LL LL 1.1.. LL LL LL LL Vl V) Of, V) V) V) V1 VI V) V) V) V) V) V) a_) c v _v cv Q_) Q 0- a a Q 0. Q n. n Q Q Q Q 0- v n Q Q Q 0z az 0_ Q Q Q Q Z5 - ; o V) Vl f1 V) (A V) VI 0 V) (A V) V) V) V) 0 l7 0 0 0 0 0 O 0 0 0 0 a a a LL aLL LL LL Q d aiLLa a a a �4i Q Q o n a a a a a nn c ca cc C: o i 2 iv a) O -0LntU) E v i.0 ° E :3U � ai V) EQ v ro co + c > p bLO UCL 0 0 N a) >- O U to L Z c o - = F U w u tip E f6 v c U L n o :} is ra c c 4 a -- c ro v - a v a) L o� �� Q o - o o - E o a E Q °n of u o v - a, > O o 0 0 v a, v ° _� p v v v v ao f U u O +, Q c `f- 4'- .L %. "O .� nJ •i- a In c ut 'O [� >- 1 a) > 0 0 o x x o o c p OQ v vc v v v U U `a lD m w O U � w w LL LL Z z LL �- rY v) ii ii U :kk Z Q a U (� S LL v LL s 0 M L 0 0 C� D C 0 N c tQn) bA V � L a l/7 U7 •� V) In In In Q) ai 4- �F-' ♦I-- L 1_ L L L L v > Q Q Q Q W Ll- LL LL LL LL LL Lf V vl yr vl vl Q) _) Q) Q) Q) _N Q C L 0- Q Q Q 7 7 7 3 n v N V) to n In d 1 d LL LL LL LL LL LL LL LL LL LL LL LL LL 0- (Ii a, Q cv U v -c- � +c C In Q) N (1) 0 i > _ > E — I— z v i 0 z 0 j bp °1 v nm —' L 0 0 o V1 LO In JO J J J 0 -5 ,z- --1 Z —' W QJ Q) Q) Q) bA bn bA w w w C_ �p Z In i- C C C C C i- '� +-� bA bA ami ria c�a Y Y Y Y Q L v a a CC Ln m m Q C (D v �- u C7 C7 C7 n n- n_ n_ n_ a 0 Q c pp c tw ,F ,u on u w Q) Q) Q) Q) Q) Q) U U Q) O C C ai u , c c � U U U U U U „l V) s - O O a� u v�B @ 4@ co ra a a E � -- E Q! W ra ca ra m co '- ro cb O LL LL In In In (n In In J J Z L J J U Electrical Information Exhibit"B"of ATTACHMENT"A" Address Information Asset Name Type of Oil Filter Meter Number Make Model Serial Comments Fuel Capacity of Generator Transfer Switch Type Transfer Switch Rating Transfer Switch Serial Battery Type Battery Date (if available) Oil Change Generator Hours Replacement Date Replacement Cost Temperature Reading Oil Pressure Reading Voltage Reading Amperage Reading Generator Physical Condition Rating Building Electrical System Rating Comments Backflows 1 Adderss Information # Backflow Preventers Asset Name Requested Work Comments Trigger Date Test Date Condition Rating Comments: Adderss Information #Backflow Preventers Asset Name Requested Work Comments Trigger Date Test Date Condition Rating Comments: Elevator Information Address Information Asset Name # Elevators Make Model Serial Number Comments Physical Condition Rating Comments: Address Information Asset Name #Elevators Make Model Serial Number Comments Physical Condition Rating Comments: HVAC Information Address Information Asset Name Area Served Filter Info (Size of Filter and how many of each Filter) Belt Info (Size of Belt and how many of each belt) #of Air Conditioning Systems Type of Primary A/C System Type of Primary Heating System Type Brand Model Number Serial Number Unit Voltage Phase (if available) Unit Amperage Condenser Info Additional Info Replacement Date Replacement Cost Physical Condition Rating Comments: HVAC Information Address Information Asset Name Area Served Filter Info (Size of Filter and how many of each Filter) Belt Info (Size of Belt and how many of each belt) #of Air Conditioning Systems Type of Primary A/C System Type of Primary Heating System Type Brand Model Number Serial Number Unit Voltage Phase (if available) Unit Amperage Condenser Info Additional Info Replacement Date Replacement Cost Physical Condition Rating Comments: Overhead Door 1 Address Information Asset Name Door# Overhead Door Brand Overhead Door Model Opening Width-Feet and Inches Opening Heights-Feet and Inches Door Panel Width-Feet and Inches Top Panel Height-Feet and Inches Middle Panel Height- Feet and Inches Bottom Panel Height-Feet and Inches Track and Roller Size Cable Diameter Spindle Size Number Torsion Tube Type Torsion Tube Length-Feet and Inches Spring Length- Inches Spring Width- Inches Spring Gauge Lift Type Operator Brand Remote Remarks Replacement Date Replacement Cost Physical Condition Rating Cable Length Feet Safety Device Comments: Plumbing Information Address Information Asset Name Model Serial Number Replacement Date Replacement Cost Physical Condition Rating Comments: Address Information Asset Name Model Serial Number Replacement Date Replacement Cost Physical Condition Rating Comments: Roofing Information Address Infromation Asset Name Age (Install Year) Sq. Feet Roof Material Type Roof Type Replacement Date Replacement Cost Physical Condition Rating Comments: Address Infromation Asset Name Age (Install Year) Sq. Feet Roof Material Type Roof Type Replacement Date Replacement Cost Physical Condition Rating Comments: ATTACHMENT"B" Glass, Brian R. From: Duane Rubeor <rubeorduane53@gmail.com> Sent: Thursday,July 27, 2017 11:15 AM To: Glass, Brian R. Subject: Data Collection Proposal Follow Up Flag: Follow up Flag Status: Flagged Brian: My proposal for the scope of work for the data collection project is as follows. Based on the scope of work discussed, I anticipate the project to take 800 hours to complete with the cost not to exceed$49,000.00. Please see breakdown of cost below. • 800 hours X$60.00 per hour=$48,000.00 • Reimbursables: $1000.00. If you have any questions or need additional information,please contact me. Thank you, Duane E. Rubeor Cell: 817-907-0972 E-mail: rubeorduane53@gmail.com 1 ATTACHMENT "C" VERIFICATION OF SIGNATURE AUTHORITY / lj� s For--,c TgF eAs Consultant hereby agrees to provide City with independent audit basic financial statements, but also the fair presentation of the financial statements of individual funds. Execution of this Signature Verification Form ("Form") hereby certifies that the following individuals and/or positions have the authority to legally bind Consultant and to execute any agreement, amendment or change order on behalf of Consultant. Such binding authority has been granted by proper order, resolution, ordinance or other authorization of Consultant. City is fully entitled to rely on the warranty and representation set forth in this Form in entering into any agreement or amendment with Consultant. Consultant will submit an updated Form within ten (10) business days if there are any changes to the signatory authority. City is entitled to rely on any current executed Form until it receives a revised Form that has been properly executed by Consultant. 1. Name: Signature 2. Name: Position: Signature 3. Name: Position: Signature Name: Signature of Presiden / CEO Other Title:L Date: Mo 0 ® DATE(MM/DD/YYYY) A ® CERTIFICATE OF LIABILITY INSURANCE D7,2s,2o17 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 NAME--CT Linda Robinson L Robinson Financial Services aHCDNNe M Fvc Noi:817-842-2329 2363 Hwy 287 N,Suite 215 ADpRIFss: Mansfield, TX 76063 PRODER CLIT MUCER ID#_' _ INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Atlantic Casual Insurance Co 42846 Duane Rubeor INSURER B.AmTrust Insurance Co _ 15954 2 Red Oak Ct INSURER C: Mansfield,TX 76063 INSURER 0; 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 TYPEOFINSURANCE ADDLSUBR POLICYNUMBER MMIDDY F MMIDDYIXP LIMITS LTR A GENERAL LIABILITY L076004874 08/07/2017 08107/2018 EACH OCCURRENCE S — DAMAGE RENTED X COMMERCIAL GENERAL LIABILITY I-- PREMISES Eacccurrence $ 1()n CLAIMS-MADE �OCCUR 1C MED EXP(Any one person) 5 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG S PRO- S X POLICY JECT LOC B AUTOMOBILE LIABILITY KPP1046782 08/07!2017 08/07/2018 COMBINED SINGLE LIMIT S 1,000,OOD (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS (Per accident) S NON-OWNEDAUTOS 5 _ 5 UMBRELLA LIAR HOCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE 1 F_ AGGREGATE 5 DEDUCTIBLE I I 5 RETENTION S 5 WORKERS COMPENSATION ( T RY LIMIT OER AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y/NE.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ if yes,describe under ! E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION The City of Fort Worth C/o Architectural Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE Attn: Brian R Glass POLICY PROVISIONS. 401 W 13thSt AU ORAD P SENTATIVE Fort Worth TX 76012 \ 1 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD CPPQuoteview Page 1 of 2 Back Quote: 2560990 Insured: Duane Rubeor Effective: 8/112017 to 811/2018 Firm AmTrust Insurance Company of Kansas,Inc Program: CPPCA-AICK Agent: Builders&Tradesmen's Insurance Services,Inc. Master Account: 18973954 Date First Rated: 7/20/2017 Daybook Product: Business Auto ITEM TWO SCHEDULE OF COVERAGES AND COVER Rating Date: 6!1/201612:00:00 AM COVERAGES SYMBOLS LIMIT THE MOST WE WILL PAY FOR ANY ONE ACC OR LOSS PREMIUM LIABILITY 7 1,000,000 $1,157.00 RENTAL VEHICLE peraecident PERSONAL INJURY PROTECTION (or equivalent No-fault Separately stated in each PIP endorsement minus Deductible coverage) ADDED PERSONAL INJURY PROT. (or equivalerd No-fault Separately stated in each Added PIP endorsement coverage) PROPERTY PROTECTION INS. Separately stated in P,P.I endorsement minus Deductible (Michigan only) AUTO MEDICAL PAYMENTS 7 $5000 $8.00 UNINSURED MOTORISTS 7 300,000 $110.00 UNDERINSURED MOTORISTS (When not included in Each Accident Uninsured Motorists Cov) Actual Cash Value or Cost of Repair,whichever is less,minus the Deductible PHYSICAL DAMAGE stated in the Schedule of Covered Autos for each covered auto,but no COMPP.EHENSIVE 7 Deductible applies to loss caused by lightning or Are,See ITEM FOUR for $169,00 hired or borrowed"autos". PHYSICAL DAMAGE Actual Cash Value or Cost of Repair,whichever is less,minus the$25 SPECIFIED CAUSES OF Deductible for each covered auto loss caused by Mischief or Vandalism. See LOSS ITEM FOUR for hired or borrowed"autos" PHYSICAL DAMAGE Actual Cash Value or Cost of Repair,whichever is less,minus the Deductible COLLISIOtJ 7 stated in the Schedule of Covered Autos for each covered auto.See ITEM $260.00 FOUR for hired or borrowed"autos". PHYSICAL DAMAGE TOWING AND LABOR Towing Limit for each disablement of a private Passenger"auto" Auto Expansion Coverage Auto Expansion Coverage: $250.00 TXATPAF $2,00 Premium for Endorsements $250.00 Estimated Annualized Premium$1,954.00 Total Premium $1,956.00 Total Auto Deviation State Total Auto Dev TX 0.927 ITEM THREE:SCHEDULE OF COVERED AUTOS YOU OWN Liab Ilttps://cpps-Nts.aintrtlstgroup.coin/ANACPPLIVE/CPPQuotetrieWV3.aspx?QuoteNtttti=256,.. 7/20/2017 CPPIQuOteview ~ ^ Page 2uf2 Unit Model Model Num Year Make VIN Class cost stated Suspend I I lieidl JTDed Code New Amt State Terr D ypel SCOLJC,0,m Coll JDdveCam Gn�. T.1al Auto �aPj ad JR."% 1 2009 DODGE 1D3HV13T19J5J2428 01199 34850 0 MNM&APLTax 11-11 — 1,." Tc w Insured Values 34850 i'l,uuu!I,UUO! No o 17()4 Auto Number State ISORating Date Company Rate Date —TX 0610112016 11/01/2016 Totals � .������ .�� ����. Policymemmmin: Prem ruMin Tax: Total� � vton000 Total Policy Cost: *tys000 Quote Installments --'-- -- Invoice Description Invoice Date 2 $197.40 3 $195.40 4 $195,40 10/31/2017 11/30/2017 Installment 5 of 9 12/31/20-17 195.40 InstaIlment6of9 1/31/2018 Installment 7 of9 $195.40 2128/2018 10 $195.40 4130,Q01 8 $195.40 Cost Bv Location Location# Address Location Total 2 Red Oak Ct Mansfield TX 76063 so Policy Level Coverages Automobile Taxes and Surcharge Pollcymtal $`.95uoo "This quote has been issued with the currently approved rates at the time it was Processed from our policy system. Your rates may be subject to Change Ifive have filed revised rates and rates are approved by the proper regulatory authority This quote maybe revised to reflect these new,approved Fates,upon the effective date of ourapprovai. Should JAou have any questions regarding this notice,Please contact your agent l�nx' --,_.-p',z....^..°**""p.^"."'Au"u/~zrLIvzxCrr\/uoIaV/on,V3.oup =256' 7/20/2017 � Glass, Brian R. From: Duane Rubeor <rubeorduane53@gmail.com> Sent: Thursday,July 27, 2017 10:38 AM To: Glass, Brian R. Subject: Request for Waiver of Workman's Compensation Requirement Follow Up Flag: Follow up Flag Status: Flagged Brian: Per our conversation, I am requesting a waiver for the workman's compensation requirement for doing business with the City of Fort Worth based on the following reason. As a sole proprietor, the work I will be performing for the City of Fort Worth will be completed solely by myself. I will have no employees working for the duration of the project. I appreciate your consideration for this request. Thank you, Duane E. Rubeor i