HomeMy WebLinkAboutContract 35818C�TY SECi�E o�p��(��Q�
C(�fVTRACI' PVO. C�
CONSEN"I' ACrREEMENT
I'OR
T`EMI'ORARY TJSE OI' PUBLIC PRUPERTY
STATE OF TEXAS
COiJT�JTY OF TARRANT
T_HI5 A,G:[ZEEMTNT is made and entered into by and bettiveen the C'ity of Fart Wortlr, a
❑iutaiciptil co���oraf[on oFTarrRqt Cow�ty, TexAs, actin�; het•ein by and through its duly xttthorized
Building qPfici�tl, liereinafler reE'ers•ed to as ll�e "City" aixc� �+�' �,=°�.�- _ -'� _ .. . -,> �
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Actin�x Uy and Bhi•ough ifs dtrl� �uthorized zgettt, �, r�- y:- :_ _. _, = , �
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T-Terein�fter re%reed to as "Gr�nfee".
WITNESS�T][if:
For flnd iii consideratioii of the plyment by Grttnt�e of cha��ges sel out belaw ar�d tl�e trite and �
failhfiul performunce of the mutull covenants herein contained CiC l�ere� �
> y y g�•ants t� Grarrtea �
permission to iempor�ri(y encroach upon, irses and o�cupy portion oP the spnoe iutder, o�i nnd/or
�bove the stl-eets, �ill�ys, sidewalks or other public ri�hrs-of wa�� �s follows ��� �1 ' '
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. . ., . - � - , = � ' , . , !-} , � ,.- � . � , . : ; ,�� � . �. - - � ' . �1:. . ,� _
i ne iocauon and desoripti�n of said enornach�nent is rnore pai�ticulert� clescribecl in EYh�bit "�" 7� f`-
f . , ; ,,.:
attached hei•eto, incorporated herein and nnado a pn��t Nereof foi° all pur�oses.
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Al) i�se and oecupanc� of pitblic stre,ot, alleys, sidcwntks o►• otfter pnbtic riglits-oi=wly tinc(ec f
this agreement shnll he in strict compliflnce with the Ch�i�ter, Ordinances and G�des of the City {
a�id tc� accordance wiYlt the ctirections nfthe Building (}fficiat and tite Diroclor oPTransportation j
and Pirblic '1�Vd►•ks of City, �
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CONS�NI' il(;REEMEN7(or Tem{wrery us� nt pubtic prnperlyt doc �
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3.
U��on expiration �f this a�reeine;nt �nd the privileges granCed hP.1'eundar, there shali be no
enet�oaci►rnont by (7j�anfee in, itnder, on or �.6ove the su�•face of tlie public ri�hfs-of �vay involr�ed.
��.
Grantee Agrees to pzy iu advnnc� �n encroacliment fee foc tiae temporary privilege af
�I1C1'ORGI711'�g il�]011 a poa•tion of the �iiblic rights�•nf •vva�� as desaribed in �xhibit "B". Said #'ee is
�r�icttlated in the manner anci amounts presccibed by the $uiltlin� Codo of tl��e City ofi Port �JVorth
fo�• turr�poc�u•y use or occiipancy oFpubiic property. Tha estunated total amoi�u[ of said fee is:
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5.
Gr�nfee, at uo expenss fo Ciey, shall make pr•oper �rovisio�� for the relocation and�or
itlsiaflltion of any existing or fiuture tr�affic control devises or otllf,r im�r�veinents aff'ected !�y
such �ncroachnaenf� USG 1t1C{ UQCLIp1tl4}�, includin� tl�e securing of ap�i�oval and consont fi•om the
appz•opi•iale a�c�ncies of tlic Stat�; �tnd its poiitical subclivista«s. In tt�e evet�t tliut a«y install�tian,
��einstallation, relocetion ar re��air of atiy existing oi• fi�tw�e tr�rf�'ic coiitrol device oi• improveinent
OWn�({ pP constrncted by or on behalf of tlte �i►blic or at pubtic expense is mnde more costly by
virtue of i:he eYisr�nce ��f suct� encroaclamaut and use, Grantee sftail p�y t�o City flnd additionnl
�moi�nt equa( io sucl� additiat�a! cost �s dete���ninecl by City.
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T�ie term of this a�ree�nent shall be for :, ��' d�t fron� � 7' ��l
,� Y�' —=�- C'�- to _ F` �-,;.
Provicled, liowever, sl�ouicl the need for the encroachments �;i�anked he.i• unde�• at an t�� ease
Y,
Cii�airtee agrees to irnmediateiy notify City of suclt conciition; and, upon ��ecei�t of sucli notice by
thP Buildin�; �F�oitil oC the City of Fort i�Vordi, t(iis agreenteaC sl�all fiermiiinte.
7.
it is expre;ssiy understood und agreed tl�at this Coa�se�zC Agreetneut is #br A tempvt'1ry
enernachri�ent in, tntder, over and upon the public property as located and described in E�hibit
2 CONSF.Ni'AGHFEldEN7/nrl'empoiaryuaeofpu611opropeAyt.doc
"B". This agreement shall not be consri•ued as the granting of a permanent easement,
enc��oachmaut or license ����on City's public streets, al(eys, sidewalks, or other cights-of w�y,
8.
City, throtagh its duly aiithorized i•epresentatives, slinll have the ft�Il and unrest►•icted right io
entei• upon al! public i•ights-of-way for the purpose of making inspections to detertnine
campliance with the terms, covenants and cnnditians herein. In the event that a►iy inspection
should reveal a bi•each of any tet�ms, covenants or conditions herein, City shall gi�ve Grantee
no�ice of such breach. Shaalct such breach not be corrected by Grttntee �vithin tweaty-four (24)
hours of receipt of the notice, or within such slaoi�ter period of time as deemed necessary by the
Buildi�ig Official %r the p�•oteceion af poblic health or saFety, Ciiy �nay terminate and cancel this
agreemant.
9.
Upon expiration or termination of this agreement for any reason �vhafsoever, Grantee sha(!, at
no e:cpeuse to City, restorre the public rights-af-�vay and adjacent supporking structures to a
condition acceptable Yo the Directa• nf Transpoi�tation flnd Public Worlcs oe his dirly authorized
cepresanfnti�ve �nci in accordc�nce with ihen existi�ig City specifications, and Graniee shall t•emove
ttll barricades, ec}uipment, supplies, materials or other property fi•om s�id location. Grantee
fiu-ther covenai�ts and agi�ees that for a pej•iod oF one (1) year after the tecminatxon of this Consent
Agreeinent, Grantee wi11 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 tbe st�•eets and sidewultcs or
other righrs�af-way, as datet7nined by the Direcior of Transportation and �'itblic Works or his
designee. Grantee agress to begin such repairs witfiin thirty (30) d�ys oF receipt of notice fi•o1n
the Director of T�•��nspo��tation and Public Works or l�is designee. All repairs shall be performed
in an expeditious ancE wortcm�nlike manner and shal( corrtply with all A�plicable laws, codes,
ordinances and City speciiications.
Cn tl�o avent that Grantee fai(s to comply r��ith the covenants laerein canfaineci with respect to
suoh removal or restoration, the City shall have the riglit to reir�ove or dispose of any barricades,
eqitipment, supplies, tnaterials oe other �n•operty and repair any conditions wf�icli in the opinion of
the City are necessa�y to bring the public rights-of-way ta the condition prescribed herein, an�l
City shall not be responsihle for trespass or any nther damage or liability ir� connection with such
removal or restoration. Grantee shall reim6urse City for the cost and e.tpense of such removal
anc�/or repairs immediately following billing for same by City.
3
CONS[fJT AGREEIAENTfor Tempornry use a1 pubic propc�ty7.dac
NoChing hexein sl�all be construed tts a waaver by City fo en%rce penal sanctions presceibed
by the Code of the City c�f Fort Worth and the I�ws of the Stata nf Texas Por Grantea's continued
encroachtnent upon the public rights-of-way fo[lowing terminztion of this Consent Agi�eetnent.
10.
It is furtller understood and agreed hetween the parties hereto that City holds tiie city strests,
afleys, sidewatks and other pt�blic rights-of way, including the portians oP s��ch stt�eets used and
encraached upon as described herein, as trustee for the public; ttiat City execcises such powers
ovei� tlie st�•eets as liave baen delegated to it by the Constitution of tlie State of Texas or by the
Legislature; and the City cannot conh�act away ifs daty and its legislative power to contcoi the
streeYs for the use anti benefit of the publia lt is accordingly agreed that if the govecning body of
City, eo wit, its City Cotmcii, sliall at any time during the term Ileeeof deterrnine in its sole
discretion to use or cnuse or permit to be used for any public pwpose the said enccoached portion
ofthe streets, then this agreemenC shall 6e automaticaily cancelecl and terminated.
11.
Gr�ntee agrees to comply fi�lly with aU applicable federal, state and local laws, siatutes,
ordin�nces, codes or regu[atidns in connection with the consh•uction, operation and maintenance
uf suid encr�achments and uses.
12.
Grantee �grees to pay promptly �vhen duo all fees, taxes or rentals p►�ovided frn• hy this
agreement or by any federal, state or local stahie, law or reg��lation.
13.
Grintee cavena�its and agrees thut it shnit e,cei•cise all rigl�ts and pri�vileges granted hereundei•
as an independent contractor, and not ss an offcer, agent, setvant o►• ernplo�ee o� City; ihat
Gra�rtee shall have exe(usiva conh•ol of nnd fhe exclusiva right to contcol the details of its
operalions and activities on said described public propeE•ty and al! persons performing same, aud
shall be sole(y �•esponsibio for tlte acts and omissions of its officers, agents, servants, ettxployees,
contractors, stibcontractors, licensees and invitees; that the doctrine af respoudeat superia• shall �
uot apply as between City and Grantee, its officecs, agents, servants, employees, contractors and
snbcontr�tciors, and nothina herein sha(1 be coustr�►ed as creating a partnership or joint enterprise !'
betvveen City and G�•antee. !
4
CONSEN7AGREEMENTfo� Temparery ucaaf puNic properiyt.doc
14.
GRANTEE COVENAN3'S AND AGItEES Ti) INDENINII+Y, AND DOES HERLBY
INDEMIFY, HOLD HARMLESS AND DEFEND C7TY, I'['S l}FFICERS, AG�NTS,
SERVA.Nx'S AND EMPLOYEES, FROM AND AGAPIST A.NY AND ALL CLAnVIS OR
SUITS FOR PROP�RTY DAMAGE OR LOSS AND/OR P�RSOIVAT. IlVJURY,
CNCLUDING DEATH, TO ANY AND ALL PERSONS, OF WAATSOEV�R KIND OR
CHARACTER, WHE�IER RL"AL OR ASSERTED, ARTSING OYJ'T OF 4R IlV
CONN�CTIQN WITH, DIlZECTLY OR TIYDIIi�CTLY, TH� MAIIVTENANCE,
OCCUPANCY, USE, EXiSTENCE OR LOCATrO1V� OT SAID �1V'CY20ACHMENT AND
US�S GRANTED HEREUND�R, WH�THER OR NOT CAUSE, IlV Wi�Qi,� OR PART,
�3Y AY,L�GED 1VEGLIGENC� �r O�+yC�RS, AG�NTS, S�RVANTS, EMPT,OXC�S,
CONTRACTORS, SUBCONTRACTORS, r,xCEIV"SEES UR INVIT�ES OF CITY; AND
GRANT�E I3EREBY ASSU'VIES ALL L�ABILITY AND RESPONSII3ILITY OI' CXTY,
iTS OFFIG`�RS, AG�NTS, S�RVANT� AND EMPLOY�ES, rOR SUCH CLAIMS 4R
S[r1'�"�e G�NT�I; SH�L]L I�I�Wd�E AS�Ut,hE at,a, i.ra�zro.��rv anra�
t2�SPONSYI3II,ITY AND SNALL INDEMNIF'Y CITY FOR AlVY AND AY,L IN,TU12Y QR
DEIMAGE TO CITY 1'ROP�RTX, ARISI1vG OUT OF QR IlV CONN�CTYON WITH
AMY AND Ai,L ACTS QR OMISSIONS OF GItANTEE, i'�S OT+'�'ICiRS, AGEIVTS,
S�RVAN�'S, �MPLUY��S, CON7'RACTO�S, SUBCONTl2ACTORS, LIC�SN�ES,
YN'VITE�S OR TT27CS]PASSERS.
A5.
GrAntee �rees to fi�e•nish City with n Certi�cnte of Insurnnce, naming City us certi�cate
holder, as praof that it has see�n•ed �ind paid for u policy of pu6lic lia�ilily insurance covering a[I
public risks rolated to the prapased use and occupancy of pubtic property as IocaYed and
descriGed in �xhibit "B", The amounts of such insurance shall be not less that the following:
Property damnge, peroccurrenpe $100,000.04
6odily injury, per person $25Q,b00.00
Bodity injury or death, per occuil•ence �500,000.00
With tl�e �tndorstanding af and agreement by Grantee thai suci� insurance arnounts sl►�ll bc ��evised
upward at City's option and that Grantee shall so revise such amount immediately following
i�otice to Grantee of such requirement. Such insurance policy shall provide that it cannot be
canceled o�• ameiided without at least tliirty (30) days' prior written notice to the Sailding Of�cial
5
CONSEMT AGREE�AENT(or 7empaary uso of pvhtic propndyt.dnc
o�' tlie C;it+,l vf' f act t�lG++�i4�- ��y �� �`�z�h C.�r%i#�c��; sf Insur�a�; is attar.�icd as �?��tsRt�yi "A'�,
t:Ytnrzte� �rp,,rEes t�s :�ui�rrsi5 a siY�,i��z, c;�►rti�xc��ate vfi l�t�«ra}rtx� ���naxa4t�{ i� Ci�€.y� �:�n t��� �.ra�i��e�:s�F�r
daT.cs cyt'itic ��.ecz�Eioa� a�`t#►is e�g�c�+er.at��tt.
ii:��n#�e, ;��r�:�:�., �3ii16�5 illi[� <7�51�l�7i�4S iffi8�l; i� sus;(:�;SS�T6 E1Ctfi liS:;l�,§'4:.'r fG d?lilFf1��81/k iSYiCI �5��}� 1!k
Eare� s»cFi patk�lie� liAbi��kf itasur�rw� a�t a!1 �itnsa c�uri�ig 2�ie �rn �f t�r.5 �gre�tr�vnk aetel �aais! �'�,�«^
t-e�a��nv�f c,i' :ti4 c��:a�«actarratsr�ry a�Ad xl�� alr;:xnixa� a��d r�stor�4�.n 4f ti►� cery :�tc�:�t��, /�.�1 in:S�iF•a�Ac�
i;uc��r��a n:��Elir-e.c� hPs�c:arn �f��l! a�r,iudu cavKr:�E�e tsi nt� C�runte�'s csn�tceu:tsyr;<.
la`e.
Cirt�nte.� c:c:�v�n�x.rtr� �a���i ��a�b ���t it �v�it uzu assigu :al1 ar �rey v� s� �i;�#cts, g+��iwi4�,� �r �+�r�
ut�der ti�i� c+�tttt"�sct +viihcei7t �t��49r' w�'i�i�n aiFrt�z�rt��2 c�f'�;'ii�y �ir� ��n�� ��prt�t4xi szs��aiP�s�sior�t vrif�a�r:t
�uch �+ri�rr +.vrirtes� flx��t�nv�s1 stixii �.� �vi�id.
I'!.
7'ieis .,�rc:�,:���e�t st�r�il pi�:, E19i[d�itl� ti[3tlil Pi3� )►A7I'kl.t`fi {1C�i'�kt.?� i�fE�6i' SU��.���H'3 8YHf1 2S3ip,YtS.
� �.
'af�c�uld t��vv c�cti+�r�, �vha;i�n� a��i �sr� us:,�xt�, a,t law cv�� iur �quity+, �aris� ar�t c�f'tk+e E�:ra�:: �nd
c�ortd.i4i��iss �Y ti�is R�e�YSlE;ll� 4at �Uk` [)� i:It+.� u�a e�iyt�. t+tx:��xanc>gs c�' i'si�� trrt�}�et`ty 2ag ��c;r'�rrta�:d
taer�tirz��F•, vr,.ltt�� f'i�i'seicai 3�Yiort �:f�ail b� pr 'i`�s�ran4 %otir�6y, `�'�;,as.
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[n au�y �c;tidan �r�u�t�� ��� �::ity� ftht' �iao e�ra�'ix+.x�ut��r�� of iE�3 ol�ti��cs�s ��4' d.irastt�ee, City shati t�
c�ttitded tii r�:ccr4�t;�• irot�t�s± �nd r�r�e�c►raa�h�ir attc�r��c�,�' f�s.
��? }� :�t-:i3'T'�:i� t(ti;� ,l �.�day c��'
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GUFIG'E){1' A�fi"��LlFAillisr 7rrn:Or�� uve r�l V�lfi: (tnfl%efiY'.dt a
A OV rD T P Rl ANi] LFL'rALiTY:
_ �
Assistant City Attorney �
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City Secreta�•y
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Date
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D�te
CON9ENi AOREEMENTtor Temporary u�e of public propartyl.dac
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C`O�IIN�'�' O�' 7'�I��.N�'
I3,��OnE,IV�E, ifie undersig�terC rarttho�dty, a IVotnf' ,PIiIjIdC l 1!di [I
For� tl�c Stat� of .Texrrs, on tlais �X�y personrrll.y «Pz�eare�l.���GClL�����
�_____ .��_ ,IC�id1Ul,Z iU iNN. 1!i G6 li1E �ILi'SOi7 FUFIOSL'
ratc�te i�s sitbscNiberl tv tlte foj�egoi»g instrattnent, tt�trl �elt�towPetlgecl tn r�ze
t6a�rt 1'aelsfze execreteri �/ae s�l»te fnr tke pr y�ose.s rentl cnrasulet•ri�inn tJtet�eirt
ex�yesser�, �es tYae ncP �farl �lee�l' of �/�� 5���i°`T 9
��n�r ��t ��Z� �far�«���y ��Q�•e�n s�aterl.
-#a,
c��r� v�r�.�n ��.��x.��rn � n SEAL �F DFFICE this• � rl�Ey
of , 20��
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TILL SLCItG' Of TG'J1;Cd5'
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�=o��P��� SUSANA R. KELLUM
:*s�;*, NOTARYPUBLICSTATEOFTEMAS
la,. +,l�J COMMISSIOM E%PIREE:
`�.��':'� OCTOBER 15, 2008
ST�(TE OF TEX'AS
CUUNTY OF TAR,�?ANT
B�'FOREME, the rrn�lewsignerl nuthority, a Notat^y PubCrc in and
F� �ijae St of exrrs,, on thrs dtcy personally «ppeared
U�� � ,known to me to be the J�e�sor� tt�6iose
ria»te is suGscrib�rt to the foregoing irtsdrument, an�l ncknowlerlgenl to me
thrxt !ae/she executed Plae snnre for prir �os¢s anrl cr�nsi l�ratln t therein
expressed, �rs t/te rrct nnrl deed of ,
a�1rC ir: the car�aclty thet�ein st�cterl.
VF.IV UNDER MYHAND�I�VD S�AL OF UFF.ICE this ��1�rlay
of � .�, 20 Q 1.
r
Affitcstt �
� � �I� r
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Title
�Votrrry PuGCic �n nrarl for
Tl: . _ _ "-�e���-=� �--= _��
,� ,,,�,��,,,, --_ -
`` w���' f2. G. NAR[:Z
! ; ia�'• � • � °;''--
_ _ Notary Public, State of Texas
- �• : - My Commission Expires
�''�''�aF�E'�°� September 10, 2009
'�"„��„��"
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i �nd i c,o�re.
�io�� 'R'ifmW
i�EMPORARY C�CU�ANCY �F�'ugl.lC PRu
. 3 I�I�1Y5
MORE THAN 3 DAYS
SIDEVI/AtK FEE- '"� � S6�F�. X� U�s9C 7�
SYREET FEE- S6�fT. X X
�, -�-���.
.�--� �� r�.. f�% �>
l_�/�YS
DAYS
.3; �3 l:
_ < ' _- .. r� � _�f- .� . � � ..
�i � �-�"\ zlf
Contractozs Name• ��.'-� � �l'�' 1 � �%u
1'oint of Contach � � .� - /f � �` z�/� �
Phone Number: ; t-; p; 5 3-� 3
Huilding Peanit Ntm�.ber: �' .�s O�- i� S� F�
�UI�6S8 fOi G'IOSUIC: %—�^'- / <'- !'_ i� � ; ,:' teL�C�:2, c_.
Begin Date: � �` '%'.�.._�/f-' � -.� End Aate_���
Type of'�'aper accordiag to posted speed limit:
Tapers Q 30 MPH 10ft OfFset 30fi minimum
'�apers ad 35 Mi�H lOft U#'fset 35ft minimum
Tapers (c� 40 MPH lOft Of.fset 40ft ininiruum
�'�2 � ��� a�
_ ��
3 �/�/ � ��
APPLIC�k�� (1�{,l�°["�LL FOR AND
REC�IVEPII�T�P�(��OtV AFTER ALL
APPR(7p(��.�}'�� g.��1�;Rg OR OBSTRUC
ARE II� ��,��;� ---
ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
4/27/2007
PRO�UCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
Wm. Rigg co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
777 main street, suite c-50 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Fort worth 'rx 76102 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(817) 820-8100 (817) 870-0310
INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERA: TYaveleXs Lloyda Insurance Co
KHR Groug, Ltd.
INSURERB: Travelers Indemnity Co of CT
KHK Construction, LLC
1201 E. 2nd Street INSURERC: Hartford Undezwriters Ins Co
Fort Worth TX 76102 INSURERD:
� _____ INSURERE:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POIICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONOITION 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
�R D�' POLICY EFFECTIVE POLrC� EXPIRATION
d$A TYPE OF INSURANCE POLICY NUMBER nnrc iuumnrw, . ,. i uurc
GENERAL LIABILITY EACH OCCURRENCE $
A X COMMERCIALGENERALLIABILITY I66075508741-TCT-07 4/30/2007 4/30/2008 DAMAGETO RENTED
PREMISES Ea occurence 3
CLAIMS MADE �X OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERALAGGREGATE $
GEN'LAGGREjG�ATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $
POLICY � I .�j R� � LOC
AUTOMOBILE LIABILITY
H X ANY AUTO
AlL OWNED AUTOS
SCIiEDULED AUTOS
X HIREDAUTOS
X NON-OWNE6 AUTOS
GARAGE LIABILITY
� ANY AUTO
BA-186D9336-07-SEL � 4/30/2007 � 4/30/2008
:SS/UMBRELIA LIABILITY
OCCUR � C�AIMS MADE ISMCUP1049Y162-TCT07 4/30/2007 4/30/2008
DEDUCTIBLE
C WORKERSCpMPENSATIONAND 46 WE NW6487 11/1/2006 11/1/2007
EMPLOYERS' LIAB�LITY
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED9
If yes, describe undar
SPECIAL PROVISIONS below
OTHER
A Cpmmercial Property/ I66075508741-TCT-07 4/30/2007 4/30/2008
Inland Marine
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS AODED BV ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE FiOLDE
TO WFIOM IT MAY CONCERN
ACORD 25 (2001/08)
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Perperson)
80DILY INJURY
(Per accident)
PROPERTY DAMAGE
$
$
$
(Per accident) $
AUTO ONLY - EA ACCIDENT $
OTHERTHAN EAACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
100,000
5,000
1,000,000
2,000,000
2,000,000
1,000,000
2,000,000
2.000.000
E.L. EACH ACC�DENT $ 1� 000 � 000
E.L. DISEASE - EA EMPLOYE $ 1, 000, 000
E.L. DISEASE - POLICY LIMIT $ 1, 000, 000
Business Personal Property
Limit: $150,000
Leased or Rented Equipment
Limit: $21,500
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEILED BEFORE THE EXPIRATION
UATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEPT, BUT FAILURE Tp 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ��
� �
OO ACORD CORPORATION 1988
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