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Contract 48141-A1
� CITY SECRETARY, II CONTRACT NO. 1' RECEIVED a AUG 2 8 2017 FIRST AMENDMENT TO CITY SECRETARY CONTRACT NO._48141 CITY OF FORT WOR r ENCROACHMENT AGREEMENT CITY SECRETARY FIRST AMENDMENT TO CITY SECRETARY CONTRACT NO. _48141_, ROACHMENT 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 City Manager, its duly designated Assistant City Manager or Planning and Development Director, hereinafter referred to as the "City," and 1K S Main LLC, acting herein by and through its duly authorized representative, hereinafter referred to as"Licensee". RECITALS WHEREAS, the City of Fort Worth ("City") and Licensee made and entered into City Secretary Contract No. _48141_ on September 2, 2016 (the "Agreement") to authorize the use of right-of-way for the construction of aerial right of way and awning encroachment to be located in the public right-of-way; and WHEREAS,the parties wish to amend the Agreement to allow encroachment on the North sidewalk ramp landing; and WHEREAS, it is the mutual desire of City and Licensee to execute this Amendment to the Agreement to revise the exhibit in the Agreement to depict the revised encroachment area; NOW THEREFORE, City and Licensee, acting herein by and through their duly authorized representatives, enter into the following that amends the Agreement: 1. Exhibit A-1 is hereby attached hereto and incorporated herein to the Agreement, consisting of a revised description of the encroaching improvements. First Amendment to CSC No.48141 EFT.WRTNjTX RECO a 1 of 3 1K S Main LLC CROTARY 2. All other provisions of the Agreement which are not expressly amended herein shall remain in full force and effect EXECUTED on this the day 2017. CITY OF FORT W RTH: andle H od Director,Department of P11i g and Development Approved as to Form and Legality: Attested by: ,, ige M bane Mary J. Assistant City Attorney City Secre ary LICENSEE'S NAME: QF FRT 1K S Main; LLC By: TL * _ Printed Name: Dak Hatfield Title: Managing Member �XAS First Amendment to CSC No.48141 O"KI4 WORD 1 K S Main LLC CITY SECRETARY FT.WORTH,TX STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Randle Harwood, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of the CITY OF FORT WORTH, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this day o 52017. *�*Rv Pati J.C.WCA" j "otary PuW State of Tom comm. O&M-2019 Not y ublic, State of Texas a^�of Ndary ID 4710" STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Dak Hatfield, Managing Member , known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of 1K S Main, LLC and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this A day of , 2017. ......••rte SHARON I ARNOLD � _=o.'• ��s Notary Public, State of Texas A—Mai v: •`� Comm.Expires 04-13-2020 Notary Public, State of Texas �'o',1ZoF<�;c' Notary ID 4689064 fill,First Amendment to CSC No.48141 Page 3 of 3 1K S Main LLC O N b W o O U ° °a II -� ° ° a° CL I I i icli a° '-I- Q b ° l Q Ico N � U ° U • °° l � ^ M co Q w b I O CO M M ° = v— `^ i I I 3 ---- N3-- w-�-o --- v, j / v> �; L p � NVQ ° r-- b ° I � ° o � 0 I - O U) I wm vx I � CD M oF- Q wm WZ f o w Z Z w W O/ w 0 Q a O I LO 19t I v rn �1 ---- -------------------� p r N 1p Q = 0 NCO *k �p0) 15r, � �=CO� ULL CO Cb [f� �d / 7 p n- 3 � f LLAm p OR 1) p 1=04 O� • OCDY� ���•�Lo 3CO r- Cc� LL (Ml HAIM 319VW`dA) LL = A33 US NI` IN Hinos LL w co pnoAel poh-1 6mp•;iqlyxa;uewaaj6e;uawgoeooua\doiNsepuassawe\sjasn\:e:gledelid jassaw maipuy:Ag d69 Z4 LN4N8o NOW Wj-okl j Client#: 68318 18REDOAKRE DATE(MM/DD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 08/24/2017 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(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Wortham Insurance&Risk Mgmt. PHONE 8 FAX 1600 West Seventh Street [A/C, A Lo EXt: 17 336-3030 ,,/c No, 817-336-8257 Fort Worth,TX 76102-2505 ADDRESS: 817 336-3030 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Continental Insurance Company 35289 INSURED INSURER B;Continental Casualty Company 2044.3 1 KS Main,LLC National Fire Insurance Co of H 20478 CIO Red Oak Realty, LLC INSURER C: INSURER D 500 West 7th Street,Suite 1212 Unit 44 INSURER E: Fort worth,TX 76102 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 CONTRACTOR 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 INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY C5088174897 - 4/09/2017 04/09/2018 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occu TED $300 OOO MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 62,000,000 PRO- POLICY OJECT 7 LOC PRODUCTS-COMP/OP AGG 62,000,000 OTHER: I $ INED C AUTOMOBILE LIABILITY 05088174804 4/09/2017 04/09/201 Ea acct d.n1)SINGLE LIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS $ X HIRED AUTOS X AUTOS D POera cdenER tDAMAGE S B X UMBRELLA LIAB X OCCUR C5088174849 4/09/2017 04/09/2018 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED I X RETENTION$10000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CNA Paramount Additional Insured Mortgagee,Assignee or Receiver Endorsement No.CNA74969XX(1-15) REF: 1 KS Main, LLC-1001 S Main; 1007 S Main,Fort Worth,TX 76104 CERTIFICATE HOLDER CANCELLATION City of Fort worth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1000 Throckmorton ACCORDANCE WITH THE POLICY PROVISIONS. Fort Worth,TX 76102 AUTHORIZED REPRESENTATIVE .�"o�tie. V nth a'm P. ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S809134IM763444 18BKL 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. r e of Z-r-m ee Title