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Contract 51123
CITY SECRETARY CONTRACT NO. C 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,hereinafter referred to as the"City"and Greystar Development&Construction, L.P. Acting by and through its duly authorized agent, Philip Treacy Hereinafter referred to as"Grantee". WITNESSETH: For and in consideration of the payment by Grantee of charges set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Grantee permission to temporarily encroach upon, uses and occupy portion of the space under,on and/or above the streets,alleys,sidewalks or other public rights-of-way as follows: 3001 Crockett Street(University Side)Fort Worth,TX for the construction of Elan Crockett Row Apartments. 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. Ii 2. All use and occupancy of public street, alleys, sidewalks or other public rights-of-way under this agreement shall be in strict compliance with the Charter, Ordinances and Codes of the City and in accordance with the directions of the Building Official and the Director of Transportation and Public Works of City. --- f AEC �v OFFICIAL RECORD cr qUG,, CITY SECRETARY � o gFr 01,9 y FT.WORTH,TX Tgyy 1 CONSENT AC,REEMENTfor Temporary use of puhie ptopertyt.doc t `I I 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 and amounts prescribed by the Building Code of the City of Fort Worth for temporary use or occupancy of public property. The estimated total amount of said fee is: 259'x 10'=2,590 SF 2,590 SF x 0.03 x 131 =$10,178.70 5. Grantee, at no expense to City, shall make proper provision for the relocation and/or installation of any existing or future traffic control devises 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 and additional amount equal to such additional cost as determined by City. 6. The term of this agreement shall be for 131 days,from 08/06/18 to 12/14/18 , Provided, however, should the need for the encroachments granted hereunder at any time cease, Grantee agrees to immediately notify City of such condition; and, upon receipt of such notice by the Building Official of the City of Fort Worth,this agreement shall terminate. r 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 2 CONSFNT AGREEMENTfcr Temporary use of pudic propertyt.doc 'B". This agreement shall not be construed as the granting of a permanent easement, encroachment 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 Oficial for the protection of public health or safety,City may terminate and cancel this agreement. 9. Upon expiration or termination of this agreement for any reason whatsoever,Grantee shall,at no expense to City, restore the public rights-of-way and adjacent supporting structures to a condition 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 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 to 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 i 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 1 City shall not be responsible for trespass or any other damage or liability in connection with such j removal or restoration. Grantee shall reimburse City for the cost and expense of such removal and/or repairs immediately following billing for same by City. 3 CONSENT AGREEMENTIor Temporary use of puhlie propertyl.doe 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 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 the 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, shall 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 statue, law or regulation. 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 E 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 shalt be construed as creating a partnership or joint enterprise j between City and Grantee. I ! f 4 CONSENT AGREEMENTIor Temporary use of pubfie popertyl.doe 1 14. E GRANTEE COVENANTS 'AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMIFY, 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, CNCLUDING 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 CAUSE, IN WHOLE OR PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, 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, LICESNEES, 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 that the following: Property damage,per occurrence $100,000.00 Bodily injury,per person $250,000.00 Bodily injury or death,per occurrence $500,000.00 With the understanding of and agreement by Grantee that such insurance amounts shall be revised ! upward at City's option and that Grantee shall so revise such amount 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 I 5 � CONSENT AGREEMENTIor Temporary useof public propertjl dw. t( I . I iC i of the City of Fort Worth, A copy of such Certificate of Insurance is attached as Exhibit"A", k Grantee agrees to submit a similar Certificate of Insurance annually to City on the anniversary date of the execution of this agreement. Grantee, agrees, binds and obligates itself, it 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 Grantee's contractors. I 16. Grantee covenants and agrees that it will not assign all or any of its rights,privileges or duties i under this contract without 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. i 18. Should any action, whether real or asserted, at law or in equity, arise out of the terms and conditions of this agreement or out of the use and occupancy of City property as permitted 1 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' fees. �, 2018 I EXECUTED this j day of-At s4- GRANTOR: GRANTEE: CITY OF FORT WORTH Greystar Development&Construction, L.P. Bui(ding Officia U0 '02 Vice President Title " OFFICIAL RECORD 8 CITY?Are TARY CONSENT AGREEMENTrcrTemwjwy of public props FT.WORTH,TX I f , r M OVED TO FORM ND LEGALITY: f Assistant City Attorney Dates`_ City Secretary Date U: :O AS OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX 7 CONSENT AGREEMENTior Temporery use of pubic propertyt.doc Ii I€ I STATE OF TEXAS COUNTY OF TARRANT r F BEFORE ME,the undersigned authority,a Notary Public in and For the State of Texas, on this day personally appeared Philip Treace ,known to me to be the person whose name is subscribed to the foregoing instrument,and acknowledged to me l that he/she executed the same for the purposes and consideration therein expressed,as the act and deed of Greystar Development&Construction, L.P. and in the capacity therein stated !GIVEN UNDER MYHAND SEAL OF OFFICE this ( day Of A�s�} ,20 //;, Af ant Vice P sident Title Nota Public in and for The tate of Texas BRANDY MOSS z PP Notary PubJrc. State of Texas € ,u+•. y= Comm. Expires 11-26-2018 Notary ID 13003807-4 q�innf� I OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX E I i t STATE OF TEXAS COUNTY OF TARRANT BEFORE ME, the undersigned authority,a Notary Public in and ,Ft State of Te. on this day personally appeared ,known tome to be the person whose name is subscribed to thefoi6going instrument, and acknowledged to me that he/she executed the same fort u° o ies and considergtion therein expressed, as the act and deed of , and in the capacity therein stated. ,N UNDER MY NAND AND.SEAL OF OFFICE this l �day of _ 20 8 . Affiant /dire OF{c.�� f Title Notary .f Pablic in and or The State of Texas o,►rr Po R. G. NARE:Z Notary Pub110. ate of Texas Notary ID#12398238-8 CoromWon Etp.SEPT.13,2021 i 1 OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX Contractors Name: Point of Contact: Phone Number: Building Permit Number: Purpose for Closure: Begin Date: End Date: Type of Taper according to posted speed limit: Tapers @ 30 MPH,10ft Offset,150'minimum Tapers @ 35 MPH,l Oft Offset,aoVminimum coke. Tapers @ 40 MPH,l Oft Offset,a 65' No r fl rrow Eastern Lane Closure CROCKETT STREET ELAN CROCKETT ROW APARTMENTS Lu > CONSTRUCTION SITE 0 U) x I > z Z) { MORTON STREET i AC p ® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 8,21/2020 9i5i2017 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 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). PRODUCER Lockton Companies NAME:CT 8110 E.Union Avenue PHONE FAX Suite 700 E-MAILo Ex A C No Denver CO 80237 ADDRESS: (303)414-6000 INSURERS AFFORDING COVERAGE NAIC# INSURER A:HCC Specialty Insurance Company 11243 INSURED CRP West 7th University,L.P. INSURER B:*** SEE ATTACHMENT *** 1429355 a Delaware limited partenership INSURER C:Navigators Specialty Insurance Company 36056 750 Bering Drive,Suite 200 INSURER D: Houston,TX 77057 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 14932911 REVISION NUMBER: XXXXXXX 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 ADDL SUER POLICY EFF POLICY EX TYPE OF INSURANCE P LIMITS LTR IN D WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 21000,000 DAMAGITTO—RENTED A X N N S16PC3002500 6/21/2017 8/21/2020 CLAIMS-MADE 7 OCCUR PREM SES(Ea occurrren, $ 50 000 MED EXP(Any one person) s Excluded PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 41000,000 JPRO- POLICY 7 LOC PRODUCTS-COMP/OP AGG $ 4,000,000 I OTHER: $ AUTOMOBILE LIABILITY NOT APPLICABLE COMBINED SINGLE LIMIT $ Ea accident XXXXXXX ANY AUTO BODILY INJURY(Per person) $ XXXXX XXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ XXXXXXX $ XXXXXXX B UMBRELLA LIAB X OCCUR N N **SeeAttachtnent** 6/21/2017 8/21/2020 EACH OCCURRENCE $ 50,000.000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 50,000,000 DED RETENTION$ $ XXXXXXX i WORKERS COMPENSATION NOT APPLICABLE PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE — E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? F N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under XXXXXXX DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Contracts Pollution Liab. N N CH16ECPOBCPISNC 6/2I/2017 8/21/2020 Each Occ:$5,000,000 Aggregate:$35,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Elan Crockett Row Project located at 3001 Crockett Street,Fort Worth,TX 76107.CRP West 7th University,L.P.a Delaware limited partnership;Greystar Development& Construction,LP and all subcontractors arc included as Named Insured.If the liability politics arc cancelled by the issuing carrier for other than non-paymcnt,30-days notice will be provided to the certificate holder.10 days non-paymcnt.Completed Operations for 10 years or the applicable statute of repose.Terrorism included.Certificate Holder included as Additional Insured as required by written contract and per policy terms and provisions. CERTIFICATE HOLDER CANCELLATION See Attachment 14932911 The City of Fort Worth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Texas Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Worth TX 76102 AUTHORIZED REPRES AT VE L 170"/, 9 ef r ©1988- 01 44TOmaw All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AC�® DATE(MMIDD/YYYY) CERTIFICATE 4F LIABILITY INSURANCE 8/21/2020 9/5/2017 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 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). PRODUCER Lockton Companies CONTACT AME 8110 E.Union Avenue PHONE FAX No_ AIC No): Suite 700 E-MAIL Denver CO 80237 ADDRESS: (303)414-6000 INSURER(S)AFFORDING COVERAGE NAIC q INSURER A:HCC Specialty Insurance Company 11243 INSURED INSURER SEE ATTACHMENT *** 1429355 CRP West 7th University,L.P. — a Delaware limited partenership INSURER C:Navigators Specialty Insurance Company 36056 750 Bering Drive,Suite 200 INSURER D: Houston,TX 77057 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 14932911 REVISION NUMBER: XXXXXXX 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 SU Y EFF TYPE OF INSURANCE IH= D POLICY NUMBER MM/DD/YYYY MM LICY EXP LTR /DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 210002000 A X N N S16PC3002500 6/21/2017 8/21/2020 DAMAGE RENTED CLAIMS-MADE N-1 OCCUR PREMISES Ea occurrence $ 50 000 MED EXP(Any one person) $ Excluded PERSONAL&ADV INJURY $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 4,000,000 POLICY ]JE0 F LOC PRODUCTS-COMP/OP AGG s 4,000,000 OTHER: $ AUTOMOBILE LIABILITY NOT APPLICABLE CEa acOMBINED SINGLE LIMIT $ cident XXXXXXX ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED AUTOS ONLY SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX ONLY AUTOS ONLY Per accident $ XXXXXXX B UMBRELLALIABX OCCUR N N **See Attachment** 6/21/2017 8/21/2020 EACH OCCURRENCE s 50000000 X EXCESS tIAB CLAIMS-MADE AGGREGATE $ 50,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION NOT APPLICABLE PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX C Contracts Pollution Liab. N N CH16ECPOBCP18NC 6/21/20I7 8/21/2020 Each Occ:$5,000,000 Aggregate:$35,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Elan Crockett Row Project located at 3001 Crockett Street,Fort Worth,TX 76107.CRP West 7th University,LP.a Delaware limited partnership;Greystar Development& Construction,LP and all subcontractors are included as Named Insured.If the liability policies are cancelled by the issuing carrier for other than non-payment,30-days notice will be provided to the certificate holder.10 days non-payment.Completed Operations for 10 years or the applicable statute of repose.Terrorism included.Certificate Holder included as Additional Insured as required by written contract and per policy terms and provisions. CERTIFICATE HOLDER CANCELLATION See Attachment 14932911 The City of Fort Worth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Texas Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Worth TX 76102 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRES AT VE , J 0"/c Irl, 14x1 ©1988- 015 ACORD CORPO TION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD