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HomeMy WebLinkAboutContract 26850 CITY SECRETARY�`I CONTRACT No. b ,5 0_ CONSENT AGREEMENT FOR TEMPORARY USE OF PUBLIC PROPERTY STATE OF TEXAS COUNTY OF TARRANT THIS 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 Building Official, herinafter referred to as the "City"' and SYS, Iry acting by and through its duly authorized �'�' �'� iPo o f s S y 774.-7 s Z r/ , hereinafter referred to as "Grantee". WITNESSETH: 1. For and in consideration of the payment by Grantee of the charges set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Grantee of the space under, on and/or above the streets, alleys, sidewalks or other public rights-of-way as follows: Pr w .9 J/ S. Fir If 91a 5-0 S rH,4 T (U U U Ur�1���PJilh rd LD 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. 2. All use and occupancy of public streets, alleys, sidewalks or other public rights-of-way under this agreement shall be in strict compliance with the Charter, Ordinances and Codes of City and in accordance with the directions of the Building Official and the Director of Transportation and Public Works of City. 3. Upon expiration of this agreement and the privileges granted hereunder, there shall be no encroachment by Grantee in, under, on or above the surface of the public rights-of-way involved. 4. 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 calculated in the manner b`7 the Rnilrlinrr ('nrl(,, nfthr,. ('itv of1'Ort Worth lU1' l�1I1�01�U�� USt; UI' UCCU�dI1Uy Ul�)LlUill; �luj�l,ll)�. ilI� f:Jliilliit�:u t,v�uL .v amount of said fee is � G OC�f,� 11'EC00)D ��,0 U Or CrIS��W"J:�LS�US ll 2 5. Grantee, at no expense to City, shall make proper provision for the relocation and/or installation of any existing or future traffic control devices or other improvements affected by such encroachment, use and occupancy, including the securing of approval and consent from the 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 virtue of the existence of such encroachment and use, Grantee shall pay to City an additional amount equal to such additional cost as determined by City. 6. The term of this agreement shall be for days, from to G`�d''0/ provided, however, should the need for the encroachments . . ,.� 1 ,1� + .,n• i .. ^i- -,n� { 1•nni�P ^,nrn^ to 1m.n,�r rl;9folm notify City of such condition; anct, upon receipt of-such iiutice Dy Elie Building Official of the City of Fort Worth, this agreement shall terminate. 7. 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 `B". This agreement shall not be construed as the granting of a permanent easement, encroaclunent or license upon City's public streets, alleys, sidewalks or other rights-of- way. 8. City, through its duly authorized representatives, shall have the full and unrestricted right to 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 Building Official for the protection of public health or safety, City may terminate and cancel this agreement. Upon expiration or termination of this agreement for any re whatsoever, Grantee shall, at no expense to City, restore the publi � Q V�rNk�,^__3'16 EN rights-of-way and adjacent supporting structures to a condition ho `�U^'U= q 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 all barricades, equipment, supplies, materials or other property from said location. Grantee further 4 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 too the streets and sidewalks or other rights-of-way that have resulted from Grantee's use or occupancy of the streets and sidewalks or other rights-of-way, as determined by the Director of Transportation and Public Works or his designee. Grantee agrees to begin such repairs within thirty (30) days of receipt of notice from the Director of Transportation and Public Works or his designee. All repairs shall be performed in an expeditious and workmanlike manner and shall comply with all applicable laws, codes, 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 I '. i . -. .-ter .- f�l(`.' �1� 'n{lr-n n,• I1'll�ttZtl !'`('Yl,l��('.1��� \IIll�l x:11(`.�l rPm w`�l or restoration. Grantee shall reirnburse LILY for Lhe cost ariU cxpeiisc 01 such removal and/or repairs immediately following billing for same by City. 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- 5 lInC� 1a H TE. 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 encroached upon as described herein, as trustee for the public; that City exercises such powers over the streets as have been delegated to it by the Constitution of the State of Texas or by the Legislature; and that 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, should at any time during the term hereof determine in its sole 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. 11. Grantee agrees to comply fully with all applicable federal, state and local laws, statutes, ordinances, codes or regulations in connection with the construction, operation and maintenance of said encroachments and uses. 12. Grantee agrees to pay promptly when due all fees, taxes or rentals provided for by this agreement or by any federal, state or local statute, law or regulation. CMU"c��� GIIS[U7Gij1{WU 6 (M��I�M YYiY Y 13. Grantee covenants and agrees that it shall exercise all rights and privileges granted hereunder as an independent contractor, and not as an officer, agent, servant or employee of City; that 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, 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 subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Grantee. 14. Grantee covenants and agrees to indemnify, and does hereby indemnify, hold harmless and defend City, its officers, agents, servants and employees, from and against any and all claims or suits for property damage or loss and/or personal injury, including death, to any and all persons, of whatsoever kind or character, whether real or asserted, arising out of or in connection with, directly or indirectly, the maintenance, occupancy, use, existence or location of said encroachment and uses granted hereunder, whether or not caused, in whole or in part, by alleged negligence of officers, agents, servants, iCOID j-�,.� ��r�J employees, 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 suits. Grantee shall likewise assume all liability and responsibility and shall indemnify City for any and all injury or damage to City property, arising out of or in connection with any and all acts or omissions of Grantee, its officers, agents, servants, employees, contractors, subcontractors, licensees, invitees or trespassers. 15. 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 than the following: Property damage, per occurrence $100,000 Bodily injury, per person $250,000 Bodily injury or death, per occurrence $500,000 With the understanding of and agreement by Grantee that such insurance hF' r0Vj1.Pr1 »psA1�i-d alt. Cifv'� option and tb.gt Grantee shall so I revise such amounts immediately following notice to grantee of such requirement. Such insurance policy shall provide that it cannot be canceled or amended without at least thirty (30) days' prior written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is attached as Exhibit "A". Grantee agrees to submit a similar U r ��� EFAIIY 8 Certificate of Insurance annually to City on the anniversary date of the execution of this agreement. Grantee agrees, binds and obligates itself, its 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 of Grantee's contractors. 16. Grantee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without the prior written approval of City, and any attempted assignment without such prior written approval shall be void. 17. This agreement shall be binding upon the parties hereto, their successors and assigns. 18. Should any action, whether real or asserted, at law or in equity, arise viii Vl L�ll. Lei iiia i..iU �:L•,.�,'. �:'.. J �r.'.� .��t f1r o>>} of lli- 1,,P •nrl occupancy of City property as permitted hereunder, venue for said action shall be in Tarrant County, Texas. 19. In any action brought by City for the enforcement of the obligations of Grantee, City shall be entitled to recover interest and reasonable attorneys' _a fees. 9 EXECUTED This 13 day of ) 2000. GRANTOR: GRANTEE: CITY OF FOR WORTH BY: BUILDING OFFICIAL APPRO E, D TP FOW AND LEGALITY: TITLE ClATTEY DATE: a C Y SECRETARY DATE: HC -)ko mk gmwo-P-0 Contract Authorization Date CNN 11,113MRY 10 STATE OF TEXAS COUNTY OF TARRAIVT BEFORE ME, the undersigned authority, a ArotaryPublic in and Fie SA to qf-Te-vas, on this day personally appeared ,kjio;vn to me to be the persoii whose name is subscribed to !e foregoing instrument, and acknowledged to me that lie/she executed the same for the purposes and coni eration therein expressed, as the act and deed of L W 51 &ck 1A and in the capacity therein stated. of �G PEA' UNDER MY HAND AND SEAL OF OFFICE th is � day tr � 200�—. Affra��t M:NOTARY RENDA J.NUNN PUBLIC3'�farj, ATE OF TEXAS mission Expires 7-10-2001 Public t (IIIfor 11 �1,p9,Mn., rye➢ '+�/UO C 'V. STATE OF TEXAS COUNTY OF TARRANT BEFORE ME, the undersigned authority, a Notary Public in and For e State of Texas, on this day personally appeared ffa ,known to ine to be the person whose name is subscribed to the foregoing instrument, and acknowledged to ine that he/she executed the same for the pur o�ses �n�d c nsideration therein expressed, as the act and deed of �h�'YL` Iv,� .SyS+P��, and in the capacity therein stated GIVEN UNDER MY HAND AND SEAL OF OFFICE this L _ day Of 'YUin42 , 20-c�. Affiant D -P iro h Tide ' DENISE ROTEN Notary Public in and for The State of Texas Notary Public,State of Texas L/} i My Commission �Expires C/� 12 G?Ma QQY �N^ _MID Yl7(/U f m ANCHOR ROOFING SYSTEMS LTD. c-12 _ U 5 ie p r7r-�' . /�/,9 N UIS 60 G �J s2 QUOal a f,Vsz 1 it I Cl L D � LD 1 / ,j TEMPORA OC UP OF PUBLIC PRO MOPE TKA 4 3 D v rWAYS OR L�W -SIDEW FEE= v SQFT. XDAYS _ i SQFT. X I TOTAL = 7lC�� -enc c z_c 2809 North Houston •Fort Worth, Texas 76106-7138• Certified WBE/DBE• www.anchor-rfg.com (817) 625-4351 •Metro 429-3734 •Fax(817) 625-9709 END END ROAD WORK J �ROAD WORK I .Q .Q 0 0 0 (000 oI I o + 0 i o o I a � Y Q o W t f o I � 3a WW I Ja � 0 ! N 0 00 0 RIGHT LANE o V RIGHT LANE CLOSED o CLOSED AHEAD t t AHEAD S o� P13 of 0 ! I 0 o RIGHT LANE RIGHT LANE G0 CLOSED CLOSED 0 AHEAD AHEAD + p I 00 m -- z M cn X! E m ROAD -A- WORK Q WORK � I I Q c AHEAD i > X X Q ROAD WORK lJ' AHEAD CD J This plan is submitted for TCP. I certify this plan will be used for the followTAd,4C HPR,4 CD ii s f"?¢d s c7 4Q r"10' ti ,P- T y T11 G_,j1 W and that all channelizing devices will conform to "General Notes" as shown on the back. o Signature:Cry lFe Date: 6 CITY OF FORT WORTH TYPICAL ONE WAY STREET TRANSPORTATION TWO -LANE CLOSURE AND Note: PUBLIC WORKS —�ee�veme-s�o�e�lt.S and D�e,Spacing — PLAN "B" ANCHOR ROOFING SYSTEMS LTD. us 'e 0 17 �-t' AJ f� �W.19/,A/ S T/7,P e viC 44 eu -� �(v 0/2 -e .f'd S ,rc� i •� _ D p �7 I /Z y 3,�� 7- 4D 0 pv 1 Gti �� r1 fell nu r/��-/s.L C •jam• F :• 3 t '� I � Oyu ✓ �f L � D � I G CO��r'k� 'GijEY fa TE FANCY OF PUB C PRO 1 PERTY MORE MN DAr 3 6A OR 4 O.Od IDEW . I SQF. X HAYS SQFT. X X neyS „ 2809 North Houston •Fort Worth, Texas 76106-7138•Certified WBE/DBE•www.anchor-rfg.com (817) 625-4351 •Metro 429-3734 •Fax(817) 625-9709 ACORDw CERTIFICATE OF LIABILITY INSURANCE DATE( IM/DD/YY) 10/11/2000 j PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LUCIEN WRIGHT INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1200 West Freeway # 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Worth, Texas -76102 INSURERS AFFORDING COVERAGE INSURED Anchor Roofing Systems, Ltd. INSURERA: American Mfg. Mutual Ins . INSURERB: Lumbermens Mutual Cas . Ins . jl 2809 N Houston Street 1NSURERc National Union Fire Ins . FORT WORTH TX 76106 INSURER D: 1817/625-4351 FAX 625-7886 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTVVITHSTAN DING 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 ry POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i;NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS — � LTR DATE MM/DD/YY DATE MM/DD/YY j GENERAL LIABILITY EACH OCCURRENCE $1, 000, 0 0 0 11 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) s 5 0, 0 0 0 CLAIMS MADE Fx_]OCCUR MED EXP(Any one person) $5, 000 u A X CONTRACTUAL 5AC042141-03 08/09/00 08/09/01 PERSONAL BADV INJURY $1, 000, 000 X CG2503 GENERAL AGGREGATE s2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG s2, 0 0 0, O O O j POLICY X JEPROC Q LOC I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) s 1, 000, 0 0 0 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ I B X HIRED AUTOS F5D026796-03 08/09/00 08/09/01 BODILY INJURY $ j II X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) i GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S j I ANY AUTO OTHER THAN EAACC S_ AUTO ONLY: AGG S j EXCESS LIABILITY EACH OCCURRENCE s5, 060, 000 X OCCUR CLAIMS MADE AGGREGATE s5, 000, 000 3SX005622-02 08/09/00 08/09/01 s Ca S �I X RETENTION 5 1 0, 0 0 0 � — WC STATU- OTH- WORKERS COMPENSATION AND X TORY LIMITS ER Ii EMPLOYERS'LIABILITY 5 BH 0 4 3 217-0 2 08/09/00 08/09/01 E.L.EACH ACCIDENT 5 5 0 0, 0 0 0 j A E.L.DISEASE-EA EMPLOYEE 5 5 0 0, 0 0 0 E.L.DISEASE-POLICY LIMIT s 5 0 0 0 0 0 B OTHER IN MARINE 3AT642007-03 08/09/00 08/09/01 LEASED EQUIP $150, 000 �I INSTALLATION $650, 000 PER OCC $25, 000 STORAGE $25, 000 IN TRANSIT DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS I� PROJ:WORTHINGTON HOTEL REROOF, 200 MAIN ST, FT WORTH. CITY OF FORT WORTH & RANDY BURKETT INCLUDED AS ADDITIONAL INSURED ON GEN LIA, AUTO LIA & UMBRELLA. I ' CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION v J L i CII :.�','���Ippp` SHOULD ANY OF THE ABOVE DESCR.IE�D Pd�t}hClEj�rBj�' q�e�EL� EFOR THE EXPIRATION7 llU CITY OF FORT WORTH DATE THEREOF,THE ISSUING INSURL�WIiA6Li. J5AUii 9 '2171 DAYS WRITTEN ATTN: CYNTHIA ALEXANDER NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALLi 1000 THROCKMORTON IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR it FT WORTH TX 76012 REPRESENTATIVES. j AUTHORIZED REPRESENTATIVE FAX 817/871-8941 ACORD 25-S(7/97) ©ACORD CORPORATION 1y CITY OF FORT WORTH TRANSPORTATION AND PUBLIC WORKS STREET USE PERMIT DATE 6/15/2001 PERMIT# 12460 MAPSCO D.O.E.# NONE (if applicable) STREET BLOCIs FROM TO DATE TIME M-F TIME TIME SAT. 1.FOURTH STREET MAIN STREET COMMERCE STREET 6/18/2001 6/18/2001 9:00 AM 1:00 PM 2. 3. 4. 5. TYPE OF WORK TO BE PERFORMED: (check all that apply) ❑ RESIDENTIAL ❑ COMMERCIAL(SITE PLAN# ❑ CURB/GUTTER ❑ DRIVE APPROACHES ❑ SIDEWALK 0 OTHER ❑ HANDICAP RAMP ❑ STORM DRAIN ❑ UTILITI(TYPE CRANE SETUP WILL SET UP CRANE TO SET ROOFING MATERIAL ON WELLS FARGO BUILDING,TWO LANES. CONTRACTOR MUST BE FIMSHED BY 1 PM. THIS PERMIT IS GRANTED TO THE CONTRACTOR UNDER THE FOLLOWING CONDITIONS: 0 .ALL WORK IS CONSTRUCTED IN ACCORDANCE WITH THE CITY OF FORT WORTH'S"STANDARDS SPECIFICATIONS FIR STREETAND STORM DRAIN CONSTRUCTION MANUAL" 0 ADEQUATE TRAFFIC CONTROL DEVICES ARE INSTALLED AND MAINTAINED AS SHOWN IN THE ATTACHED TRAFFIC CONTROL PLAN(TCP)SUCH AS SIGNS,BARRICADES AND WARNING LIGHTS TO SAFEGUARD THE PROPERTIES AND Pi1BLIC 0 CITY TRAFFIC ENGINEER AND/OR INSPECTORS MAY REQUIRE ADDITIONAL TRAFFIC CONTROL DEVICES ALL DAMAGES TO PUBLIC OR PRIVATE PROPERTY,INCLUDING UNDERGROUND FACILITIES,AND FOR ALL PERSONAL • INJURIES ON WORK PERFORMED UNDER THIS PERMIT WILL BE THE RESPONSIBILITY OF THE CONTRACTOR A 24-HOUR DECISION-MAKING CONTACT REPRESENTATIVE AND PHONE NUMBER IN THE EVENT OF AN EMERGENCY SHALL BE PROVIDED ITIS UNDERSTOOD THAT I%OLATIONS OF THIS PERMIT MAY RESULT IN THE REVOCATION OF THE CONTRACTOR'S LICENSF ('UN7K4CT OR IS REQUIRED TO HAVE THIS PERMIT AND TRAFFIC CONTROL PLAN AT THE WORK SITE AT ALL TIMES. / THIS PERMIT IS ISSUED IN ACCORDANCE WITH AN APPROVED TRAFFIC CONTROL PIAN(TCP1 ANCHnR RnOFIN( CONTRACTOR r PERMIT ISSUER EMERGENCY CONTACT NAME Pn RMN]n 24-HOUR PHONE 817-625-4407 MOBILE 817-819-4407 PGR# CONTRACTOR IS REQUIRED TO HAVE THIS PERMIT AT THE WORK SITE AT ALL TIMES. THIS PERMIT IS ISSUED IN ACCORDANCE WITH AN APPROVED TRAFFIC CONTROL PLAN. INSPECTOR SIGNATURE FopTWopTH DATE OF FINAL END END ROAD WORK (ROAD WORK 0 O O 100 0 O O O o o 0 to o YQ n I oW o I 3a !I o I ISO I t LL Z �. O �O O O O O 'J O RIGHT LANE RIGHT LANE 4 I CLOSED CLOSED c AHEAD AHEAD 0 C14 I I I P i 0 i O - O RIGHT LANE CLOSED RIGHT LANE oo AHEAD CLOSED o — AHEAD I I I o O O x Eco ROAD WORK I I c AHEAD j 10 X X ROAD WORK t t t AHEAD .SL. This plan is submitted for TCP. I certify this plan will be used for the following location(s): 3 w e//s F.-Y"?p d 5-C7 i ti T s/ T�f G—V v/— Q�a and that all channelizing devices will conform to "General Notes" as shown on the back. !`__'_ 3 Signature: Date: (, — ! 3— v _ CITY OF FORT WORTH TYPICAL ONE WAY STREET I TRANSPORTATION TWO - LANE CLOSURE AND Note: -° PUBLIC WORKS see�e[se_suejor-aeneral N hand e.Spadng— PLAN SIB PoRTVVokTH C I Y OF FORT `NORTH �TWOkTH jam--- TEMPORARY STREET CLOSURE REQUEST FORM FORM Only those temporary street closings not interfering with necessary traffic circulation and police and fire emergency vehicle routes shall he permitted Agency Requesting Cinture Date Requested 7 ,4A-) )VO/Z iPoCPF/^. 9 1Y. o yTaAt.. Responsible Official Street Address Phone A5� �-P r s. AJ g FAN Reason for Closure e /7,4/1,j -e s -e 7— I 1 st Street to be closed From To f/77y S Tit 2�� ,g .v (9-0 -(2?- 2nd 2nd Street to be closed From To Beg Date and time of Closure End Date and time of Closure Closure time comments REQUIREMENTS • SUFFICIENT LEAD TIME MUST BE PROVIDED IN ORDER TO REVIEW AND APPROVE THE TRAFFIC CONTROL PLAN AND PROCESS PERMIT • AN APPROVED TRAFFIC CONTROL PLAN SHALL BE SUBMITTED PRIOR TO ISSUANCE OF A PERMIT • MUST PROVIDE A CERTIFICATE OF INSURANCE NAMING THE CITY OF FORT"WORTH AS AN ADDITIONAL INSURED (1,000,000 GENERAL LIABILITY) GDEC 00QD t r� TRANSPORTATION AND PUBLIC WORKS TRAFFIC ENGINEERING DIVISION / STREET MANAGEMENT 1000 THROCKMORTON FORT WORTK TX 76102 (817) 871-7894 FAX (817) 871-8941