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HomeMy WebLinkAboutContract 48606-CA1 CITY SECRETARY CONTRACT No.. If R(o f�-C A I _ ASSIGNMENT AND CONSENT OF ENCROACHMENT LICENSE AGREEMENT THIS ASSIGNMENT AND CONSENT OF ENCROACHMENT LICENSE AGREEMENT ("Assignment") is made and entered into by and between the CITY OF FORT WORTH, a Texas home-rule municipal corporation ("City"), (2) Dhruva Musunuru, an individual and Stacy M. Musunuru, an individual, (collectively "Assignors"), and (3) Ice & Williams LLC, a Texas limited liability company ("Assignee"). Sometimes herein City, Assignors, or Assignee may also be referred to individually as a "Party" or collectively as the "Parties." WITNESSETH: WHEREAS, the City entered into a Right-of-Way Encroachment Agreement, City Secretary Contract No. 48606 (the "Encroachment Agreement"), on the 23`d day of January, 2017, with Assignors, the then-owner of certain real property more particularly described in the Encroachment Agreement and the exhibits attached thereto, which is attached hereto as "Exhibit A"to this assignment and incorporated herein by reference for all purposes; WHEREAS,the Encroachment Agreement was recorded the 4th day of December, 2018, as Instrument No. D218265454 in the Real Property Records of Tarrant County, Texas; WHEREAS, Assignors desire to assign the Encroachment Agreement to Assignee. AGREEMENT: NOW, THEREFORE, for and in consideration of the above and foregoing premises and the mutual covenants, terms, and conditions herein contained, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties hereby agree as follows: 1. Assignors hereby assign, transfer, and convey all rights and interests and delegate their duties and obligations under the Encroachment Agreement to Assignee. 2. Assignee hereby accepts the Assignment granted herein, and assumes all of Assignors' rights, duties, and obligations arising under the Encroachment Agreement. 3. Assignors have full right, power, and authority to enter into this Assignment, to make the representations set forth herein, and to carry out Assignors' obligations hereunder. Assignee has the full right, power, and authority to enter into this Assignment, to make the representations set forth herein, and to carry out Assignee's obligations hereunder. 4. The effective date of this Assignment shall be the date of its execution by the City (the "Effective Date"). All rights, duties, and obligations under the Encroachment Agreement arising, accruing, or relating to the period before the Effective Date, excluding all accrued and ,R�CE -pnpaid costs or fees, are allocated to Assignors. All rights, duties, and obli ahons arising, MAS 2p�g OFFICIAL.RECORD CITY p�FORT\N�RTN CITY SECRETARY CATV stCRETtlihcroachment Assignment Agreement Pa ;l ®RTH,TX Rev 10/2018 accruing, or relating to the period thereafter, including all outstanding unpaid costs or fees accrued prior to the Effective Date, shall be allocated to Assignee. 5. Except as otherwise expressly set forth in this Assignment, Assignors will be discharged from any and all further obligations under the Encroachment Agreement as of the Effective Date. 6. Notwithstanding any unpaid costs or fees accrued prior to the Effective Date referenced above in Section 4, Assignors represent, warrant, and covenant with City and Assignee that, as of the Effective Date, Assignors are not aware of any default of any of their obligations contained in the Encroachment Agreement. 7. City hereby consents to this Assignment upon the terms and conditions set forth herein. Unless and until City has executed this Assignment, it is of no effect. The consent granted herein should not be construed as consent to any further assignments. The failure or delay of City in seeking to enforce any provision of the Encroachment Agreement or this Assignment shall not be deemed a waiver of rights or remedies that City may have or a waiver of any subsequent breach of the terms and provisions therein or herein contained. 8. Any notice given by any Party to another Party must be in writing and shall be effective upon receipt when (i) sent by U.S. mail with proper postage, certified mail return receipt requested, or by a nationally recognized overnight delivery service, and (ii) addressed to the other Party at the address set out below or at such other address as the receiving Party designates by proper notice to the sending Party. City Planning and Development Department 200 Texas Street Fort Worth TX 76102 Attention: Director Assignors 2450 Oak Hill Cir#2124 Fort Worth, TX 76109 Assignee PO Box 939 Fort Worth, TX 76101 9. Except as herein otherwise provided, this Assignment will be binding upon and inure to the benefit of the Parties and their respective successors and assigns. Encroachment Assignment Agreement Page 2 of 9 Rev 10/2018 10. Assignee shall cause this Assignment to be filed of record at Assignee's expense in the Real Property Records for Tarrant County, Texas. 11. The Certificate of Insurance for the Assignors attached as Exhibit "B" to the Encroachment Agreement is hereby deleted and replaced with the attached Certificate of Insurance from the Assignee as "Exhibit B Revised 11/15/18." 12. All terms and conditions of the Encroachment Agreement not amended herein remain unaffected and in full force and effect, are binding on the Parties, and are hereby ratified by the Parties. Capitalized terms not defined herein shall have meanings assigned to them in the Encroachment Agreement. 13. This Assignment may be executed in multiple counterparts, each of which shall be deemed an original, and all of which, when taken together, shall constitute one and the same document which may be evidenced by one counterpart. [SIGNATURES APPEAR ON FOLLOWING PAGES] Encroachment Assignment Agreement Pale 3 of 9 Rev 10/2018 ASSIGNOR: Dhruva Musunuru and Stacy M. Musunuru By: C"" Name: Dhruva Musunuru By: P.4 ' / Name: Stacy A Musunuru STATE OF TEXAS § COUNTY OF TARRANT § This instrument was acknowledged before me on the 4th day of December, 2018 by Dhruva Musunuru, in his individual capacity. Notary Public, tate of Texas [NOTARIAL SEAL] Ell CARRiE MCGO V E R N ary Public,Stste of Texasmm, Expires 04-19-2021Notary 1D 126325118 STATE OF TEXAS § COUNTY OF TARRANT § This instrument was acknowledged before me on the 4' day of December, 2018 by Stacy M. Musunuru,in his individual capacity. Notary Public, State of Texas [NOTARIAL SEAL] CARRIE MCGOVERN . aPR`.P00% ;Notary Public, State of Texas ;N 'Q= Comm. Expires 04-19-2021 Notary ID 126325118 Pon OFFICIAL RECORD CITY SECRETARY Encroachment Assignment Agreement rpjWQ%TH, TX ASSIGNEE: Ice& Williams LLC a Texas limited liability company Name: Jamey I Title: Managing Member STATE OF TEXAS § COUNTY OF TARRANT § This instrument was acknowledged before me by k m-tA ice , as the 01 n�'l of��p�r �)��jigrlg,���a Texas limited liability company,on behalf of said company. r Notary P li ,re xas [NOTARIAL SEAL] PRESTON SEAN PATRY •,4. Notary Public, State of Texas Comm. Expires 03-11-2020 Notary ID 128854051 OFFICIAL RECORD CITY SECRETARY FT. WORTH,TX Encroachment Assignment Agreement e 5 of 9 Rev 10/2018 APPROVED AS TO FORM AND CITY OF FORT ORTH LEGALITY: 0 andle Hod, irect r Trey Qu &t � aIIt City AttornCy .� planning and Development D partment d ATTE T: �• ��_y Date: ty ecre TAF y. [No M&C Required] F' STATE OF TEXAS § COUNTY OF TARRANT § This instrument was acknowledged before me on Z4 , 201/Q by Randle Harwood, as the Director of the Planning and Development Department of the City of Fort Worth, a Texas municipal corporation on behalf of the City of Fort Wo h. Notary Publi , tate of TexA [NOTARIAL SEAL] JENNIFER LOUISE EZERNACK Notary Public,State of Texas r=\1,cPE Comm. Expires 03-01-2020 i''&� Notary ID 130561630 OFFICIAL RECORD I CITY SECRETARYll FT. WORTH,TX Encroachment Assignment Agreement Pae 6 of 9 Rev 10/2018 Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract,including ensuring all performance and reporting requirements. 4,2",- )j) ,,. e of Employee Title "EXHIBIT A" PRIOR AGREEMENT WITH ATTACHED EXHIBITS Encroachment Assignment Agreement Page 8 of 9 Rev 10/2018 Crry SECRETARY CONTRACT No RIGHT OF WAY ENCROACHMENT AGREEMENT (RESIDENTIAL) 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 Director of Planning and Development Department, hereinafter referred to as the "City", and Dhruva Musunuru and Stacy Al Musunuru hereinafter referred to as "Licensee", owner(s) of the property located at 1626 S. Adams Street, Fort Worth, Texas 76104 ("Property"). AGREEMENT 1. For and in consideration of the payment by Licensee of the fee set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Licensee permission to construct/ install and/or allow to remain, Improvement(s) ("Improvement") that encroaches upon, uses and/or occupies portions of the space under, on and/or above the streets, alleys, sidewalks and other public rights-of- way, such Improvement(s) are described as follows: Wood deck The location and description of said Improvement and the encroachment is more particularly described in Exhibit "A", attached hereto, incorporated herein and made a part hereof for all purposes. 2. All construction, maintenance and operation in connection with such Improvement, use and occupancy shall be performed in strict compliance with this Agreement and the Charter, Ordinances and Codes of the City and in accordance with the directions of the Director of Transportation and Public Works of City, or his duly authorized representative. All plans and specifications thereof shall be subject to the 2014 ROW Encroachment Agreement—Residential Page 1 of 11 prior written approval of the Director of Transportation and Public Works, or his duly authorized representative, but such approval shall not relieve Licensee of responsibility and liability for concept, design and computation in preparation of such plans and specifications. 3. Upon completion of construction and installation of said Improvement and thereafter, there shall be no encroachments in, under, on or above the surface area of the streets, alleys, sidewalks and other public rights-of-way involved, except as described herein and shown on the hereinabove referred to Exhibit "A". 4. Licensee, at no expense to the City, shall make proper provisions for the relocation and installation of any existing or future utilities affected by such encroachment use and occupancy, including the securing of approval and consent from the utility companies and 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 utility or improvements owned by, constructed by or on behalf of the public or at public expense is made more costly by virtue of the construction, maintenance or existence of such encroachment and use, Licensee shall pay to City an additional amount equal to such additional cost as determined by the Director of Transportation and Public Works of the City, or his duly authorized representative. 5. City may enter and utilize the referenced areas at any time for the purpose of installing or maintaining improvements necessary for the health, safety and welfare of the public or for any other public purpose. In this regard, Licensee understands and agrees that City shall bear no responsibility or liability for damage or disruption of improvements installed by Licensee or its successors, but City will make reasonable efforts to minimize such damage. 2014 ROW Encroachment Agreement—Residential Page 2 of 11 6. In order to defray all costs of inspection and supervision which City has incurred or will incur as a result of the construction, maintenance, inspection or management of the encroachments and uses provided for by this Agreement, Licensee agrees to pay to City at the time this Agreement is requested an application fee in the sum of Three Hundred Twenty-Five Dollars ($325.00). Upon execution of this Agreement and annually thereafter, Licensee agrees to pay a fee in the amount of$.56 per square/linear foot of the encroachment area. 7. The term of this Agreement shall be for thirty(30) years, commencing on the date this Agreement is executed by the City of Fort Worth. Provided however, this Agreement shall terminate upon the non-compliance of any of the terms of this Agreement by the Licensee. City shall notify Licensee of the non-compliance and if not cured within thirty days this Agreement shall be deemed terminated. 8. Upon termination of this Agreement, Licensee shall, at the option of City and at no expense to City, restore the public right-of-way and remove the Improvement encroaching into the public right-of-way, 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. It is understood and agreed to by Licensee that if this Agreement terminates and Licensee fails to remove the Improvement, Licensee hereby gives City permission to remove the Improvement and any supporting structures and assess a lien on the Property for the costs expended by the City to remove such Improvement. 9. It is further understood and agreed upon between the parties hereto that the public rights-of-way, alleys, sidewalks ("public right-of-way") to be used and encroached upon as described herein, are held by City as trustee for the public; that City exercises such 2014 ROW Encroachment Agreement—Residential Page 3 of 11 powers over the public right-of way 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 public right-of-way for the use and benefit of the public. It is accordingly agreed that if the governing body of City may at any time during the term hereof determine in its sole discretion to use or cause or permit the right of way to be used for any other public purpose, including but not being limited to underground, surface of overhead communication, drainage, sanitary sewerage, transmission of natural or electricity, or any other public purpose, whether presently contemplated or not, that this Agreement shall automatically terminate. 10. Licensee agrees and acknowledges that this Agreement is solely for the purpose of permitting Licensee to construct, maintain and locate the Improvements over or within the described public right of way and is not a conveyance of any right, title or interest in or to the public right of way nor is it meant to convey any right to use or occupy property in which a third party may have an interest. Licensee agrees that it will obtain all necessary permission before occupying such property. 11. Licensee 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 Improvement, encroachment and uses. 12. Licensee 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. 13. Licensee covenants and agrees that it shall operate hereunder as an independent contractor as to all rights and privileges granted hereunder and not as an officer, agent, servant or employee of City and Licensee shall have exclusive control of and the 2014 ROW Encroachment Agreement—Residential Page 4 of 11 exclusive right to control the details of its operations, 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. The doctrine of respondeat superior shall not apply as between City and Licensee, its officers, agents, servants, employees, contractors and subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Licensee. 14. LICENSEE 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 FIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE OR LOCATION OF SAID IMPROVEMENT AND ENCROACHMENT AND USES GRANTED HEREUNDER, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES OR INVITEES OF THE CITY; AND LICENSEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH CLAIMS OR SUITS. LICENSEE 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 LICENSEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, INVITEES, OR TRESPASSERS. 2014 ROW Encroachment A-reement—Residential Pa(ye 5 of 11 15. While this Agreement is in effect, Licensee agrees to furnish City with a Certificate of Insurance, as proof that it has secured and paid for a homeowner's policy related to the proposed use and occupancy of public property as located and described in Exhibit"A". The amounts of such insurance shall be not less than the following: $300,000.00 with the understanding of and agreement by the Licensee that such amounts shall be revised upward at the City's option and that the Licensee shall so revise such amounts immediately after receiving notice to Licensee of such requirement. Such insurance policy shall provide that it cannot be cancelled or amended without at least ten (10) days written notice to the Director of the Planning and Development Department or designee of the City of Fort Worth. A copy of such Certificate of Insurance is attached as attached as Exhibit "B". Licensee agrees to submit a similar Certificate of Insurance annually to City on the anniversary date of the execution of this Agreement. Licensee agrees, binds and obligates itself, its successors and assigns, to maintain and keep in force such homeowner's 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 or alleyways. 16. Licensee agrees to deposit with the City when this Agreement is executed a sufficient sum of money to be used to pay necessary fees to record this Consent Agreement in its entirety in the deed records of Tarrant County, Texas. After being recorded, the original shall be returned to the City Secretary of the City of Fort Worth, Texas 2014 ROW Encroachment Agreement—Residential Pa-e 6 of 11 17. In any action brought by the City for the enforcement of the obligations of Licensee, City shall be entitled to recover interest and reasonable attorney's fees. 18. Licensee 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 the Planning and Development Director. Any attempted assignment without prior written approval will be void. 19. THE PARTIES AGREE THAT THE DUTIES AND OBLIGATION CONTAINED IN PARAGRAPH 8 SHALL SURVIVE THE TERMINATION OF THIS AGREEMENT. 20. This Agreement shall be binding upon the parties hereto, their successors and assigns. EXECUTED this,,' day of / t) 2014 ROW Encroachment Agreement—Residential Page 7 of 11 City Licensee City of Fort Worth Dhruva Musunuru and Stacy M. Musunuru �j--, By:_ By: Rand e Harwood Name: Dhruva Musunuru Director i Planning and Development Name: Stacy M. Musunuru ATTEST: Approved As To Form and Legality City Secfet� y Assistant City Attorney �0�- F0 , ...... 2014 ROW Encroachment Agreement—Residential Page 8 of ll STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Randle Harwood, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of the City of Fort Worth, and in the capacity therein stated. GIVEN UNDER MY AND AND SEAL OF OFFICE thi day of 1 , 20 —7 7� _ J -�ri!C, jfG'c of 7�XCS Notary Public in and for the State of Texas 2014 ROW Encroachment Agreement—Residential Page 9 of 11 STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Dhruva Musunuru, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of Dhruva Musunuru, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 10th day of November , 2016 LAURA D. i41TC '2 — �_'``" Notary Public, Stag of Texas .' My commission F:t Notary Public in and for the 1 ; 7 Aut n2 20]7 -1 State of Texas 2014 ROW Encroachment Agreement—Residential Page 10 of 11 STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Stacy M. Musunuru, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of Stacy M. Musunuru, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 10th day of November , 2016 LAURA D. MITCHELL Notary PUbhc, State of Texas nl / My Cornmissian Expires a.ugust e2, 2617Notary Public in and for the State of Texas 2014 ROW EncroachmentAureement—Residential Page 11 of 11 EXHIBIT "A'° ENCROACHMENT AGREEMENT - CLS JOB No. 16-0038 Coombs .and Surveying, Inc. LOT 3R,BLOCK 3 P.O.Box 11370 Fort Worth,Texas 76110 GEORGE B. BONDIES SUBDIVISION (817)920-7600 (817)920-7617 FAX addition to the City of Fort Worth, T.B.P.L.S.FIRM No. 101110880 Tarrant County,Texas WEST IMA®D O X AVENUE according to the Plat recorded in — — — — Cabinet B, Slide 1983 Plat Records,Tarrant County, Texas. OF .TF �P�•v1 S T FR.•-I' x ;•Q�' � FO:flip I — — — — H RONALD W. COOMBS ...:-o'••• 5294....v..... � 9�°Ff 1�a�•� I I LOT 2,BLOCK 3 GEORGE B.BONDIES SUBDIVISION I 5 0' VOL.204-A,PG.85 +; P.R.T.C.T. cG 25' 25' ( T N 89011120"£ 100.00' ��o 1- I — — — — C.M. la W � I DECK ENCROACHMENT INTO IW DECK ENCROACHMENT INTO ALLEY R.O.W. = 132 S.F. o SAN, SEWER. ES'MT. = 149 S.F. 0 0 LOT 9 I . 0 13 EXISTING HOUSE I O I JERSEY HILL ADDMONLA VOL.63,PG.57 3.3 1-i- O a O P.R.T.C.T. LOT 3R,BLOCK 3 1-� 0 Ix w ( GEORGE B.BONDIES SUBDIVISION a CAB.B,SL.1983 ` ay ( P.R.T.C.T. 10 LOT 10 Lo OI I_-4' SANITARY SEWER ES'MT. ff! I C.M. N I S 89011'20" 100.00 4\0 �° I LOT 5,BLOCK 3 O GEORGE B.BONDIES SUBDIVISION VOL.204-A,PG.85 P.R.T.C.T. I ¢ I I I SCALE: 1 " = 30' Exhibit DATE(MM1DD)YYYY( A DS CERTIFICATE OF LIABILITY INSURANCE 1Oi1712016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Karen Ealres NAME: SOr � faiY7ii737 Eloy Leal State Farm Agent PHONE 817.656-9696 I= No): 817-656-2065 tea 5621 Bunker Blvd �@w E-MAIL karen.c.earies_ip statefarm.com:eloyL leal.b3u357statefarm.com `�y,: ADORE53: Watauga,TX 76148 INSURERS AFFORDING COVERAGE NAIC# INSURER A: State Farm Lloyds 43419 INSURED W `Y INSURER B: Dhruva&Stacy Musunuru INSURER C: 1626 S Adams St INSURER 0: Fort Worth,TX 76104-4409 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADD L SUBR! I POLICYEFF7 POLICY EXP LTR TYPE OF INSURANCE I POLICY NUMBER MMMDIYYYY I?MM/OOffYYYI LIMITS COMMERCIAL GENERAL LIABILITY L i EACH OCCURRENCE s 300,000 I DA WU I'b�2 NTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person s Homeowners Policy X I 58-CM-X995-7 10711412016 f 07/14/2017 PERSONAL&AOV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: I I GENERAL AGGREGATE O- rV71 POLICY i IE LOC PRODUCTS-COMPrOP AGG $ OTHER. Per Occurrence I ) S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO i OBOD(LVINJURY(Per persan) $ VIBODILY INJURY(Per accident) S AUTOSfIED SCHEDULED ONLY AUTOS _ HIRED NON-O NJEO i PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY 'Per accident i $ UMBRELLA LIAR -OCCUR EACH OCCURRENCE s EXCESSLIAB CLAIMS-MADE I AGGREGATE $ DED RETENTIONS I ! s j WORKERS COMPENSATION PER OTH- I AND EMPLOYERS'LIABILITY YIN STATUTE E ANY PROPRIETORIPARTNEWEXECUTIVE E.L.EACH ACCIDENT i$ OFFICE,RIMEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE s If yes,describe under DESCRIPTION OF OPERAT!ONS below E.L.DISEASE-POLICY LIMrT s i DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Certificate Halder Included as Additional Insured. Additional Insured shall be notified 10 days prior to cancellation of policy. Written notice in compliance with policy provisions or as required by law. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE:ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Fart Worth ACCORDANCE WITH THE POLICY PROVISIONS. Department of Development AUTHORIZE EPR SENTATIVE..-'% Attn:David Schroeder,Planner ff 4 1000 Throckmorton St, Fort Worth,TX 76102 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD IC014b6 132649.12 C3-16-20-x.6 Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. N/A —NO CITY FUNDING INVOLVED Date: Julie Wester,66 Development Manager MARY LOUISE GARCIA " ? COUNTY CLERK 100 West Weatherford Fort Worth, TX 76196-0401 PHONE (817) 884-1195 CITY OF FORT WORTH 200 TEXAS ST FT WORTH, TX 76102 Submitter: CITY OF FORT WORTH CFA OFFICE DO NOT DESTROY WARNING - THIS IS PART OF THE OFFICIAL RECORD. Filed For Registration: 1214f2018 10:21 AM Instrument#: D218265454 A 14 PGS $64.00 By: u D218265454 ANY PROVISION WHICH RESTRICTS THE SALE, RENTAL OR USE OF THE DESCRIBED REAL PROPERTY BECAUSE OF COLOR OR RACE IS INVALID AND UNENFORCEABLE UNDER FEDERAL LAW. "EXHIBIT B" REVISED 11/15/18 CERTIFICATE OF INSURANCE Encroachment Assignment Agreement Page 9 of 9 Rev 10/2018 Exhibit B Revised 11/15/18 DATE(MM/DD/YriY) A�ccwa CERTIFICATE OF LIABILITY INSURANCE 1/14/2019 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 NAME: Jennifer Hutton Higginbotham Insurance Agency, Inc. PHONE FAX 500 W. 13TH ,817-347-7053 A/c No):817-882-9284 Fort Worth TX 76102 nDORess: 'huffon@higginbotham.net INSURERS AFFORDING COVERAGE NAIC# INSURER A:Western World Insurance Company 13196 INSURED ICE%M INSURER B Ice&Williams, LLC 1700 6th Ave INSURER C Fort Worth TX 76110 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:654069000 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 ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD1YYYY MM/DD//YYYY LIMITS A X COMMERCIALGENERALLIABILITY NPP8522906 11/15/2018 11/15/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $100,000 X 250 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑ PRO JECT ❑LOC PRODUCTS-COMP/OPAGG $INCLUDED X OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE 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 LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STAT LITETE ER 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 I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 1626 S Adams St Fort Worth,TX 76104 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Worth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Planning&Development—CFA Office ACCORDANCE WITH THE POLICY PROVISIONS. PN 19-00018 200 Texas Street AUTHORIZED REPRESENTATIVE Fort Worth,Texas 76102 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD