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Contract 48355-A1
r CITY SECRETARY CONTRACT N0. FIRST AMENDMENT TO CITY SECRETARY CONTRACT NO.48355 ENCROACHMENT AGREEMENT This FIRST AMENDMENT TO CITY SECRETARY CONTRACT NO. 48355, ENCROACHMENT 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 Fort Worth Independent School District, 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. 48355 on November 9, 2016 (the "Agreement") to authorize the use of right-of-way for the construction of two (2)private chilled water lines and one (1)private electrical primary line to be located in the public right-of-way;and WHEREAS, the parties wish to amend the Agreement to remove the previously shown chilled water lines(2)and incorporate an additional private electric service line; 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 items; 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 and Exhibit B are hereby attached hereto and incorporated herein to the Agreement,consisting of a revised description of the encroaching improvements. p,�J► 3 q S 1 RF w First Amendment to CSC No.48355 Page 1 o J. Fort Worth Independent School District EOFFICIALCORD TARlr �' 0'O TX 9 CP rys�c9�� sb07 1 Wd 2. All other provisions of the Agreement which are not expressly amended herein shall remain in full force and effect EXECUTED on this the /4'2-day of CITY OF FOR WORTH: andle Ha#ood Director, ITepartment of Planning and Development Approved as to Form and Legality: Attested by: ) Rat ge Me K Mary J er 0� U Assistant City Attorney City Secretary ;2 Fort Wo r a School District: j(ps By: NO M&C RBQU�RED Printed Name: K nt P. Scribner Title: Superintendent of Schools E01FIF1100ALRDR!��3t First Amendment to CSC No.48355 Page 2 of 3 Fort Worth Independent School District 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 l 3 day of 6,e,46,,,?—L%20`7. Notary Public, State of Texas aY•e , IRMA SAEN2 = Notary Public, State of Texas =;. 7* . STATE OF TEXAS § ,,;.,_...+� con,n, Expiresol-2a-zo2o § NotoryID 2724984 COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Kent P. Scribner,Superintendent of Schools, 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 FORT WORTH INDEPENDENT SCHOOL DISTRICT, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of , 2011 4NAAKAR'EREZ Notary Public, Aate of Tedas My COMMISSION EXPIRES JANUARY 31,202 lOTARY ID: 130988289 First Amendment to CSC No.48355 Page 3 of 3 Fort Worth Independent School District LfU G=J / G / — PROP. PUBLIC M WATER LINE / CROSSING EXISTING PUBLIC GAS LINE CROSSING �2W PROP. PRIVATE ELECTRIC \ PRIMARY LINE (2) \'o I— E G E N C� 0 15 30 60 ENCR® AREA (375SF) GRAPHIC SCALE IN FEET 6100 WESTERN PLACE, SUITE toot VPA/STEM ACADEMY Pacheco Koch FORT WORTHTX 7610RIGHT—OF—WAY ENCROACHMENT AGREEMENT 817.a12.7155 LOT 1R, BLOCK 11R & TX REG. ENGINEERING FIRM F-469 TX REG. SURVEYING FIRM LS-10008001 LOT 1R, BLOCK 15 CHAMBERS ADDITITION LOCATED IN THE CITY OF FORT WORTH, TEXAS ✓ir.a%v BY CHECKED BY SCALE DATE j0MOSES NUMBER MOSES A. JACKSON SURVEY, ABSTRACT NO. 862, TSR JCM 1"=30' 07/14/16 3719-15.222 TARRANT COUNTY, TEXAS CVrG FILE: 3719-15.222U7IL.D'Jr`G XREF FILE: 3719-15.222_WATER.D1 "B" PROFOLE l/ M8 590 590 585 585 1581 PROP. GRADE 580 EX. 3" GAS 575 F APPROXI ATE 575 EX. GRADE PROP. 12- L�; 0 0 PUBLIC 570 M M CROSSING 570 565565 El ECTRIC PRIM CONDUIT 2 560 560 0+00 1+00 1+50 0 30 60 120 GRAPHIC SCALE IN FEET 0 6100 WESTERN PLACE, SUITE 1001 VPA/STEM ACADEMY Pacheco Koch FORT WORTH, TX 76107 817.412.7155 RIGHT-OF-WAY ENCROACHMENT AGREEMENT TX REG. ENGINEERING FIRM F-469 LOT 1R, BLOCK 11R & TX REG. SURVEYING FIRM LS-10008001 LOT 1R, BLOCK 15 CHAMBERS ADDITITION LOCATED IN THE CITY OF FORT WORTH, TEXAS .,4AWN BY I CHECKED BY SCALE DATE JOB NUMBER MOSES A. JACKSON SURVEY, ABSTRACT NO. 862, TSR JCM 1"=60' 07/26/2017 3719-15.222 TARRANT COUNTY, TEXAS DWG FILE: 3719-15.222UTIL.DWG XREF FILE: 3719-15.222_WATER.D1 ACO 0 DATE(MWDD/YYYY) �.. CERTIFICATE OF LIABILITY INSURANCE F7/7/2017 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 have ADDITIONAL INSURED provisions or 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). CT PRODUCER NAMP Carolyn Howard Higginbotham Insurance Agency, Inc. PHONE g17-347-7090 FAX 817-347-6981 500 W. 13th Street E-MAIL Fort Worth TX 76102 .choward@higginbotham.net INSURERS AFFORDING COVERAGE NAIC# INSURERA:Texas Political Subdivisions 99999 INSURED FO RTW79 INSURER B Fort Worth ISD INSURER C Attn: Risk Management Dept INSURER D 100 N. University Drive, Suite SW 170 Fort Worth Tx 76107 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1710979455 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 POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MWDD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY Y F0632 7/1/2017 7/1/2018 EACH OCCURRENCE $3,000,000 DAMAGE TO CLAIMS-MADE FX OCCUR PREMISES E RENTED occu encs $100,000 MED EXP(Any one person) $Excluded PERSONAL&ADV INJURY $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY 0 PRO- JECT LOC PRODUCTS-COM P/OPAGG $3,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y F0632 7/1/2017 7/1/2018 COMBINGLE LIMIT INED $1,000,000 X ANY AUTO BODILY INJURY(Per person) s OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMA X AUTOS ONLY X AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION 1PER OTH- AND EMPLOYERS'LIABILITY Y/N15TATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N I A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE s If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Right-of-Way Encroachment 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 200 Texas Street ACCORDANCE WITH THE POLICY PROVISIONS. Fort Worth TX 76102 AUTHORIZED REPRESENTATIVE JJ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 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. Janie S. Morales Development Manager