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HomeMy WebLinkAboutContract 51810 CITY SECRETARY CONTRACT NO. Appili Call L ITI A,(JREEvIEN_1_ page tcrl -11e colnlvmy presiders_ M—he c,)rnpariv vIc-1- president .Name of -r.t.-itCe shall be as W1 10C%Ur 1_1111'111ti1_WS the a COrPO-atiot'l. "'CONSLI" Y MiRLLMENTS S"I'ALL 13:2' 0 T AT',17 F D Ap p I iicivv s I A,,I H 'ut I I I� 1 iIIICC I ,!o p 1 01,a "'r,rt I Clk:a"C of Ills I ira I Ice a!I d I h r�C i3! copes of sketch the ar�2a(s) 'o bc [11'.'IL: b-, 1)c occUpk'd, arcUts) !,m­th alld w!dfll III �01o]e reel, 01cf, colnfC1 ad,!"-ess, iind Rulklim-, Pertilit Y, that applies to the W pjrl:lm, 111,2,crs ai%2 !mokcd, tppficajit firmshcs P.irkm,_, meter ritilliber to (Joidon A:dernnan ,�III Vranspon.itl(w PUhlIc V1 orks Dept. 3, Insurance Prop,-ry Daina­c, Per loccunrince S I 00W)il) BoJil-v hJury, per )cctx,,2nc,� 52 5 ).j If)L,) Bodily InjarY or Dcat'i per occurrence 4, FEE CALCU, LTION; RFCORDEL) WS SK1`.TC11 St 8,111 1-TED FOR p F R.N I TT A. Irthetil-n- docs not :"Xc--L!d thl-c,- 0) ddVS. the ['CC he Sl2.8f') Per day Ull to and v *nclud n., the third da , %�ith. a In ii:w I t - - I .- win oCS*1 2S.40 Ifinot-C than ; days. B It'the time exceeds t1hree (3) days, th; to PCi, day �\ill be $.015 per sq. It. of sldcwa 11( space and 5.03 per scl, ft, u CstrLc( spacC used, )TI In I 111 1 1111 oLS 1 2�.4`) $.'115 x Lcn�,tji x tViduh x Calendar Da. , Minimum StrCc t: S,(1_3 x I cn,;'ri - Width x ('alcnd,,.r 1),L,,\s S 128.-10 5. TRANSPOR'il ATION & 11U HIAC NN ORKS APPROVAL R-EQUil RED Appwvafl lit all crtsc contact G01-dol) frarisportallOT"I & ['1(1);Ic \,Vorks Dcpartmerit is located al 3111 W, 10'1' StrccL, grolilld You vv dl need their Si('natures on tel -tchc, C�j0 FC���o9';d:� q9y Ty -OFFI CIA L RECORD Ciri SECRETARY FT_ WORTH, ' TX CITY SECRETARY CONTRACT NO. CONSENT AGREEMENT FOR TEMPORARY USE OF PUBLIC PROPERTY STATE OF TEXAS COHNTY OFTARRANT THIS AGKFFIvIF.NI is made and entered into by and between the City of For 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 J t `dauchr onStruct;or,LLC Acting by and through its duly authorized agent, Michael Vauahn,President Hereinafter referred to as"Grantee". WITNESSETH: For and in consideration of the payment by Grantee of charges set out below and the true aril Faithtiil performance of the nwtual 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 Lite streets,alleys,sidewalks or other public rights-of-way as follows: 940 Clifton Street FortWorm_Texas 761.0.7_____ _. West side(southhound)of Clifton Street including sidewa k The location and description of said encroachment is more particularly described in Exhibit "R" attached hereto, incorporated herein and made a part hereof for all purposes. 2. All use and occupancy of T)uYic street, alleys, sidewaiks or other public rights-of-way under this agreement shall he in strict compliance with the Charter, Ordinances and Codes of the City and in accordance with the directions of the Bailding Official and the Director oFTransportation and Public Works of City. CONSENT.4GFFE-1AFM for Temparery uas it pubc pro ac OFMCDAIL RECORUs CITY SECRETA ` FT. WORTH, Ty 3. Upon expiration of this agreement and the privileges granted hereunder, there shall be no 1 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: Sidewalk:125'x5'=625SF x 0.015 x 28=$262.� Street:200'x12'=1, 0.03 x 28 days=$2,016 0 2� L- 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 28 days,from 1/16/2019 _to 2/13/2019 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. t 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 r I i 2 CONSENT AGREEMENTror Tamporary use of public propertyt.doc y€ f .T"_ This shall net bC constmed as to gracing of it peramimm easement. ::ncroachin nt n; liccn;c iron CQ4 puhlic*Tess,alleys, Nowalks,or niter riods-of-was; 8. Cityj through its duly _authorized representatives, shall haVC rhe Cud and unrestricted ri,ht to anter upon all pubiic rignts-int-evnay for the puivine of making inspeGti,ans to ,leternrire conirdiance with the term,, covenants and conditi.nn; herein. In the event that anv inspection ;hook reveal da breach of any terins, covenants or conditions herein. City sLalt give Grantae LJt1G::of such breaCh. SIMUld Siioh brua.ch not bC WIMLud by GCairtt:c: wahin twewt -Coot (24) hours of receipt of the notice, or within such Awrtm period of time as acenled Necessary by the 13ui'ding�Ot"ieial for the protectlm of puhiic haddi or safety, City may Len hum ,nit omwd this agmament. i;pon expiration or termination oP this agreement for any rearm whatsoever,Ci iAee shad: at CIO Cyense to Uy. restore the public rights-OF 1,vay and adjacent supporting structures to a condition mcmixible to the. Director of Ymnspnrtation and Puillic WeW or his duly wahoriVed renresentative and in accordance wn.i then existing(Tits specifieatu•n5, and (mine shaft rernmv all bar6cmie ,qui nwa suppils, manAN tw o(l er 'r" e, Rom saki IUWOU, GE11 te? Rohn covenants and arms that for a period of one (1) gear after dw ter inmiliou SAW Consent Agreement, Grantee vvifl repair all conditicris of daulaes to tl,e streets and sidewalks or other rights-of-way that have resulted from Grantee's use or occup lacy of rhe somas and sidewaHo or odwr rights-ot-way, as d: :ermined by rte`` Dimciror of %n9pOrtit`Wri am! hAhc h OrI_s or his de,iguee. Graritee agree., to begin such repairs vvithui thirty (301 days of r�:ccipt.of noikx froin ±he Orector ot` yrisportation quad Public WA, or his designee _111 repairs shat( he urfornwd in an expeditious and wolmarikke mariner and shall comply With ali applicable laves, Coutes, Ordinances and City specifications In the event thea Huls to comp" wish the covenants heroin conraiuod with respea to ywh rein w d or resunatfon, "tie City A nll ,We Clic right to r°move or dispose of:roy Bari icades, eTiipment, sgThcs. material; or other proper[,and repa.r any conditions vvivc:h in the opininn of Te Cky ax t masa" to bruq the publie Qiii-ol'way to Aw C:OmhUcin prencrOd lawn and CAy shrill inT he resoonsihle for tesla.,;or any ,Ser chimyc Cir hahility in w"nr ohm with such e.i,iovtl )i- rtstoratioll, (iriiotee s11.01 reWbnrOV ('its her TO cast MO expense of Yah removal ,(.;Alar repairs inuncdiawly 6ollovning IT% Ar snap by C&. I NWIMg hercin sWA w wonnawd as a "allor by ChY to zwhmc penal saawtiow prmwiled by be (We of be (Iry K Ma VAwth and rte i,--,vs Qn, of Tew %0ranivis nowirinvi, encroachment,UP011, 00 MQHC HOM of wwabhwhg Inkmion of this Ccwnf Ag2wwrlt. 10. It 1� till-dWl" 1-41dCrit-00d am agmd haw"n dw Parus hacro that City holds tllJJtvstloots' side-v�alks mW oCier 1111blic incht,Fcg the portions ol',uJi tvtt-1t;.sed mut encroached upon as denHhed herein, as sawo for to piblk That (Apt exarclsen such pnowns o.-iUI" the 'trects as 11LIVC bcon cicllcg ,utcd to it by dw Cendwthn of do Wats„ of Tzms or by 0,L: l;e-gi'-'h1flll-0; and the City Canixt OMMMU amy its dirty and its legislative POwta, to colltro !. the streets for the use and kner'it of the pulblic. It is ace dully agreed lot if joemkig hcd, City, to wit, its City Colulcii, ;hat! at my huric during the tenni her oC dacmure in its sole discretion to tise or cause w permit a) he used for any puNk pw puse me said enwowl"I podoll orrhe suven then this agr,:eaicnl shall be automatically urnwNd and w"Wavd, IL GrMwe agran to with all nllplicahlP federal, ,-aro all(i local law", ;T:ururcs) MiltanCeS, codes Or 1-egLljatiow, in :'ollueclioll with the and lilainlcnance 14wd w.,.r{ and me;' 12. Wnwe agrees hi pay pnmnprl;1 when dale all Res, mxm or rental, pnwkkd Or by W apnernew or by ally t"'cdcr'd -trntc o". !,--,'a! 1Iw or regulation. 13. 61-antee "Ind agrees that it Shall exercise all rights mad privileges granted hercuruh.nr as an indofloweiv amwantok and not as an oWeq agent savant cr ompklyce or City; tat Wariwe AM hime exclusive smund of and the exive AN to control the anvils of its operaticlis and aC!ivwws Ml Saul Mcilbal public ynopeny and Al puscars pet-Muing saris, and KaH he mAdy r"p"laillo Nor hi;, aca W owlish"s oC A officco, agen, s ,iVwwl clalphov", ':ontractor�� and irlvlrccs; that the (roclrinc ofrcspcmI.-,at :iq),.,n<)r ;hall not apply as bctwcrl Ciu,"- and (irltlutcc" t("' officc;-S' agents, servants, employees, ccjntram)r> and SUSCOCLMCM, and noMing lmr=V shall he combacd a GRANTEE COVENANTS AND AGREES TO Dol,:S HEYEav VNDF; IIFV, HOLD nARMLESS AND DEFEND CFVV� ITS OFFICERS, AGENTS, SFRVANTi AND EN1Pf.0,YEFS, FROM AND AGAIN STANY AND ALL CLAIM'-; OR MAI'S FOR PROPERTY MWAGE OR WS'S' AYI),OR PER-;ONAL INJIJRY, CNCLU MINC DITATTI, TO Al,L, PEI SONSI OF `.VIJAT30F'vT,-R KIND OR (J-1ARACTYR, NNHYIIWRFAL 01-1, ASSVRTFD, WiSING 01!T OF ()1? IN 1—{YNINECTION DWLCALY OR INDIRLCTL'S, THE NIAJ-N', - `E-'NANCI" OCCU)PAN'CV, US& EWTENCE OR LOCATION OF SAID tKES GRANTED HERELNDER WHETHER OR lNor IN OR PART, BY ALLEGED NEGLIGENCE OF OFFTCFRS :vUi-�NTS. SEPAWKS, EMWMACES, CONTRACTORS, STACI)NIRACTORV mcvNsvES OR 1NW11TVS CW (ITY! AND "RANTEF HEREBT ASSWES ALL 1JkWC!'IA AND kf]SPONSIBHA' f ' Of Cffy', ITS OFFMTRII AGENTM SERVAN'rS ADNI) li'JIMPLO)TES, FOR CILALNIS OR slut G12NTEE SHALL tAKENNINE ASSUME :V& UABUIFY AND RESPONSIBILITY AND SHALL fNDEAIN11FY CITI 1-'Oft ANY AND ALL I-NJI)RY ORL DAMAGE TO CITY PROPERTV, ARISINf-; nUT 01; OR IN CONNECTION 'A'ITTI AND ALL A(l'S OR OM IS'S 10711 Op fAZANTEF3 3' 'S OFFIlk' ERS. AGEINJS, SER VANT& EMPLOYEES, CONTRACTOR INVITEFS OR TRESPASSERS. 15. 10 tUrlih KV "Ah a ( ...,..F"W Of KMMU", MM&g Uay JIS "WEMC hokirr as proof that it has securc(! _ml paid 60t- a P(di(,, 01'00)hl.; !iahllit, illsw-aticc co",:rmgy all MOW risks related to the pimmmud un mi owymm; K ptAnk jwpaq is WAst m: !'he amol ill r� of a w h ims"mce ;h,lul h", lor le>s that the tollcp,,i a g d',WlJgc. )'A occ,Pt'znce S i Bowly QW, pu Fawn $25110000 Bodhl�j injury of dh:adl. Pei,0--1:-'al FCIRI:c �)00'000,0;) ki•h 6-£inloedla(St(,11 ihjlf hC CCS t�c'U q)`%,;wd :it op6on n"d rhar Wnwe 00 mi rzvke villi amonj Arimm1min, AdOwny, iwrivu 6) Wwam K Wt NqWmnan ninh iinw.me puhcy All provil, 7hat it cath it in -mudled rmnendoi mdulmouat Inwh., on, &w, pKWA6TQF1 04X"" We RWWWQ0WWl of the City of Fort Worth. A copy of such Certificate of Insurance is attached as Exhibit "A". 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. 16. Grantee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without prior written approval of City, and any attempted assignment without such prior written approval shall he 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 out of the terms and conditions of this agreement or out of the use and occupancy of City property as permitted hereunder, venue for said action shall be in Tarrant County,Texas. 19. Ir, any action brought by City for the enforcement of the obligations of Grantee,City shall he entitled to recover interest and reasonable attorneys' fccs. EXECUTED this__14_day of Jariany 2019 GRANTOR: GRANTEE: CITY OF FORT WORTS[ J.T.Vaughn Construction,LLC s_ Michael Vaughn Building Official S�r President Title CONSFNT AGPEEMENTfcr Temcerar/use of pu lic orapertyt&r OFFICIAL RECORD CITY SECRETARY FT. WORTH,TX 5, nLCity ttor N � r l Xwap U"F0IdAL RECORD CITY SECRETARY FT WORTH,TX S/'T171. OF 7'f:•,\`I- x'31.,FOR I-,'All"`, the ttaarlervi�tted rttrlhorily,a Nolary Public in «mid For tit -5tate of Test' un this(lay persortally appaitrerf known to me to be lite person whose name L5 subscrIhed to the�UYf',1;ifin,-, i[Istrianow, find if ckno,viedged ti)ine tltul heishe exec«led the same fir the purposes and const ler((tion therein expressed, as the(tet and:feed o ----------_—. , unit ill tlt.e capacity iheiehl staled. _ "t 7,,", l W)1','d ,t, ti;i:��l),3V1),Sra( 1 FOP'FI 'li;his dic�n - 1 oy 0 < J OW SHONTE JoNf.SNotary ID#131.72DFz1 k;lff ci MY Comrnis�Fxptres Xyl t/GI/`J, (24 A../ $ePte er 12. 2D1Z Title e !�'otary htrh The State i Texas 8 STATE OF TEXAS COUNTY OF TARRANT BEFORE LIE, the undersigned authority,a Notary Public in and For the State of Texas, on this day personally appeared Michael Vaughn ,known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the.came for the purposes rind consideration therein expressed,as the act and deed of J T.Vaucthn Construction.LLC_ and in the capacity therein stated. GIVF,N TINDER MY HAND AND SEAL OF OFFICE this, _ 14 (lily Of January yP MATT WILLETT Ge% n�Notary Public, State of Texas /� +Q� Comm. Expires 12-16-2020 Jf ant i�lF• S�•` o ° A c ,;,�r� Notary 10 13093499-8 Michael Vaughn,President Title :Votary Public in an The State of Texas 9 5' 12' Contractors Name: J.T.Vaughn Construction,LLC Point of Contact: Mark Allen Phone Number: 832A704232 125' Building Permit Number: UNTHSC Purpose for Closure: Extension of HSC campus thermal lines Parking Garage 200' Begin Date: 1/16/2019 Y End Date: 2/13/2019 Type of Taper according to posted speed limit: Tapers @ 30 MPH,I Oft Offset,150'minimum Tapers @ 35 ADH,1Oft Offset,9o5'TnjniMjjm Tapers @ 40 MPH,l Oft Offset,a 65' um Nock flrrow UNTHSC Sidewalk:125'x5'=625SF x 0.015 x 28 days=$262,5-0- Interdisciplinary Research &Education Building Street:200'x12'=1,500 SF x 0.03 x 28 days=$2,016 V Total= 22Z Camp Bowie Blvd I f fk 7 f DATE(MM/DO/YYYY) AC R" CERTIFICATE OF LIABILITY INSURANCE 1/15/2019 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). TACT PRODUCER ACIG Insurance Agency, Inc. NAAME : 2600 N. Central Expw . Suite 800 PHONE FAX Richardson,TX 7508 N 972-702-9004 'C.No): 972-687-0601 E-MAIL ADDRESS: accountmanagers@acip.com INSURERS AFFORDING COVERAGE NAIC Y www.acig.com INSURER A: American Contractors Ins.Co.RRG 12300 INSURED INSURER B: J.T. Vaughn Construction, LLC INSURERC: 10355 Westpark Drive Houston TX 77042 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 46569822 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 ADOL UBR POLICY NUMBER MM/POLICY EXP LTR /YYY MMIDD LIMITS A f COMMERCIAL GENERAL LIABILITY GL18A00049 6/1/2018 6/1/2019 EACH OCCURRENCE $10,000,000 AGL18B00049(GL Excess) 6/1/2018 6/1/2019 DAMAGE TO RE A CLAIMS-MADE ./ OCCUR GL18C00049(GL Excess) 6/1/2018 6/1/2019 PREMISES Ea occurrence $100000 MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY $10,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 POLICY E jE F] LOC PRODUCTS-COMP/OP AGG $10,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIABOCCUR EACHOCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION STATUTE OERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project Name: UNTHSC-IRB,Project Address: 3430 Camp Bowie Blvd.,Forth Worth,TX 76107,VCC Project No.2384-01 We have issued an industry-standard ACORD certificate of insurance for our customer.Texas state law(S.B.425)prohibits us from adding special wording to the certificate that would(1)alter,amend or extend coverage or terms&conditions provided by the insurance policy;or (2)provide false or misleading information concerning the insurance policy;or(3)refer to a legal or insurance requirement contained in a contract. here applicable endorsements are attached. CERTIFICATE HOLDER CANCELLATION 2384-01 City Of Fort Worth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cl Texas Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Worth TX 76102 AUTHORIZED REPRESENTATIVE _4 Michael J.O'Neill ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 91569822 '7AOGH19 18/19 GL I Pat J'Nea1 1/15/2014 10,55,95 AN_ (CST) I Page 1 of 9 This cert ificatc cancc Ls and auperscdcs ALL previously iss—d Ccrtificatcs. 933 ADDITIONAL INSURED - AUTOMATIC STATUS AS REQUIRED BY CONTRACT - BLANKET This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by written contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured(Section II)is amended to include as an insured any person or organization shown in the above SCHEDULE (called additional insured),but only with respect to liability for"bodily injury","property damage'or"personal and advertising injury" arising out of your premises or your operations for the additional insured,and only to the extent and for the minimum limits required in the written contract. B. The insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract,this insurance does not apply to"bodily injury"or"property damage"occurring after "your work"for the additional insured has been completed or after that portion of"your work"out of which the"bodily injury" or"property damage'arises has been put to its intended use by any person or organization,whichever occurs first. 2. Unless specifically required by written contract,this insurance does not apply to"bodily injury"or"property damage"arising out of the sole negligence,act or omission of the additional insured. 3. This insurance does not apply to"bodily injury","property damage"or"personal and advertising injury"for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to"bodily injury","property damage"or"personal and advertising injury"arising out of the rendering or failure to render any professional services by any insured or on any insured's behalf,including: a) The preparing,approving or failing to prepare or approve maps,shop drawings,opinions,reports,surveys,field orders,change orders,drawings or specifications;and b) Supervisory,inspection,architectural or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring,employment,training or monitoring of others by that insured,if the"occurrence"which caused the"bodily injury"or "property damage",or the offense which caused the"personal and advertising injury",involved the rendering of,or the failure to render,any professional architectural,engineering or surveying services. 5. This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically applies to that person or organization. 6. The insurance afforded herein only applies to the extent permitted by applicable state law,including statutes governing additional insured coverage in the construction industry. 7. The insurance afforded to the additional insured shall not exceed the minimum limits required in the written contract. C. In no event shall the insurance provided to the additional insured exceed the scope of coverage,including minimum limits,required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specked edition dates of the ISO CG2010 and/or C132037,then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A.and B.of this endorsement.In the event that CG2010 and/or CG2037 are required but no edition dates are specified,the 04/13 editions shall apply. D. This insurance is excess to any other insurance,whether primary,excess,contingent or on any other basis,available to the additional insured unless a written contract requires that this insurance be primary or primary and non-contributing. However,this insurance is always excess to other insurance,whether primary,excess,contingent or on any other basis,when the additional insured has been added to the other insurance as an additional insured. Nothing herein contained shall be held to vary,alter,waive or extend any of the terms,conditions,provisions,agreements or limitations of the mentioned Policy,other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective:Same as policy effective date unless otherwise indicated above. Policy Effective:6/11/2018 Policy No.: GL18A00049 Endorsement No.: Insured: J.T. Vaughn Construction, LLC Premium$ Insurance Company: American Contractors Insurance Co. RRG 4656982: I VAUGHN 1 18/19 GL I Pat O'Neal 1 1/15/2019 10:55:45 AM_ (CST) I Page 2 o This cortificatc canccla and Supersedes ALL previously issued Certificates. 336 NOTICE OF CANCELLATION, NONRENEWAL OR MATERIAL CHANGE - CERTIFICATE HOLDERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The certificate of insurance holders shown in the schedule below have requested that they receive written notice of cancellation, nonrenewal or material change with respect to this policy. If we decide to cancel, nonrenew or make a material change to this policy, we agree to mail or deliver sixty(60)days advance written notice to the certificate of insurance holders shown in the schedule below. However, if we are cancelling or nonrenewing due to nonpayment of premium,we will only provide the certificate of insurance holders shown in the schedule below with ten (10)days advance written notice. The notice of cancellation, nonrenewal or material change will be mailed to the addresses provided to us by the certificate of insurance issuer. Proof of mailing will be considered sufficient proof of our good faith attempt to provide notice of cancellation, nonrenewal or material change to the certificate of insurance holders shown in the schedule below. SCHEDULE All certificate of insurance holders where written notice of cancellation, nonrenewal or material change to this policy is required by written contract, permit or agreement with the Named Insured. Nothing herein contained shall be held to vary,alter,waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective:Same as policy effective date unless otherwise indicated above. Policy Effective:6/1/2018 Policy No.:GL1 BA00049 Endorsement No.: Insured: J.T. Vaughn Construction, LLC Premium$ Insurance Company: American Contractors Insurance Co RRG 4E569822 1 VAUGHN 118/19 GL I Pat :)'Neal 11/15/2014 10:55:45 AN_ (CST) I Page 3 of 4 This ccrtifi cat. cancels and superscdcs ALL previously issccd ccrtificatcs. 205 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person(s)or Organization(s): Any person or organization for whom you have agreed by written contract to furnish this waiver. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV—COMMERCIAL GENERAL LIABILITY CONDITIONS)is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the"products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Nothing herein contained shall be held to vary,alter,waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective:Same as policy effective date unless otherwise indicated above. Policy Effective Date:6/1/2018 Policy No.: GL18A00049 Endorsement No.: Insured: J.T. Vaughn Construction, LLC Premium$ Insurance Company: American Contractors Insurance Co RRG 4E569822VAUGHN 1 18/19 GL I eat G'Neal 11/15/2019 10:55:45 AN_ (CST) I page 4 of 4 This cert ificatc can cols and superscdcs ALL previously issccd certificates. A jam® DATE(MIUDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/15/2019 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 CONTACT MCGRIFF,SEIBELS&WILLIAMS OF TEXAS,INC. NAME: 818 Town&Country Blvd,Suite 500 PHONN Ext):713-877-8975 aC No):713-877-8974 Houston,TX 77024-4549 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC f INSURER A:Allmerica Financial Benefit Insurance Company 41840 INSURED INSURER B: J.T.Vaughn Construction,LLC 10355 Westpark Drive INSURER C: Houston,TX 77042-5312 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:9N5W7LP7 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 POLICY NUMBER MM/DD/YYYY MM/DD/YY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED— CLAIMS-MADE 7 OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO- JECT ❑LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY AWDA01628405 06/01/2018 06/01/2019 COMBINED SINGLE LIMIT Ea accident 1,000,000 IX ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS �( HIRED �( NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYY/N STATUTE ER 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 $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Project Name:UNTHSC-IRB Project Address:3430 Camp Bowie Blvd. Fort Worth,TX 76107 VCC Project No.:2384-01 In the event of cancellation by the insurance companies,the policies have been endorsed to provide(30)days Notice of Cancellation(except for non-payment)to the certificate holder shown below. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Worth AUTHORIZED REPRESENTATIVE 200 Texas Street 7/ Fort Worth,TX 76102 , Y_._. Page 1 of 1 ©1986-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Contract Compliance Manager: By si ' I acknowledge that I am the person responsible for t e m itoring and administration of this contract,including ens ' g 11 performance and reporting requirements. 01 (_0 Name of Em to ee/Si ature P Y >� ? () 1 1 A Titl / ❑ This form is N/A as No City Funds are associated with this Contract Printed Name Signature OFFMAL RECORD CITY SECRETARY FT. WORTH,TX