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HomeMy WebLinkAboutContract 34302 CITY SECRETARY CONTRACT NO. CONSENT AGREEMENT FOR SIGNS 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 City Manager or duly designated Assistant City Manager, hereinafte'rI referred to as the "City", and Rrk Rea-� Em4e- KeV4 acting herein by and through its duly authorized Gfjxero,� -PGt{4Kerr hereiinafter referred to as "Grantee", Owner of the property located at r0 � � Ao,%f\Ak ("Property") on behalf of kwj4m referred to as "Business", located at fir+ (4r-I, -rK `T(o if o . WITNESSETH: 1. For and in consideration of the payment by Grantee of the fee set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Grantee permission to install a sign and any supporting structure (both hereinafter referred to as "Sign") that encroaches TY !��� upon, uses and/or occupies portions of the space under, on and/or above the streets, alleys, sidewalks and other public rights-of-way as follows: 0 sttn asOX'W01-� A The location and description of said Sign 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 encroachment, 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 prior written approval of the Director of Transportation and Public Works, or his duly authorized representative, but such approval shall not relieve Grantee of responsibility and liability for concept, design and computation in preparation of such plans and specifications. U 3. Upon completion of construction and installation of said Sign 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. Grantee, 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, Grantee 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, Grantee understands and agrees that City shall bear no responsibility or liability for :ljL ,�q damage or disruption of improvements installed by Grantee or its successors, but City will make reasonable efforts to minimize such damage. 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, Grantee agrees to pay to City at the time this Agreement is executed a fee in the sum of 7. a. Subject to section 7(b) and Section 9, the term of this Agreement shall be for thirty years, commencing on the date this Agreement is executed by the City of Fort Worth. b. This Agreement shall automatically terminate days from the date `Business ceases to operate at oz 0� Hale �L tt�V`+L -9 yio. If this Business ceases to operate, Grantee acknowledges and agrees to comply with Section 8. 8. Upon termination of this Agreement, Grantee shall, at the option of City and at no expense to City, restore the public right-of-way and remove the Sign 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 4 by Grantee that if this Agreement terminates because the Business ceases to operate and Grantee fails to remove the Sign, Owner hereby gives City permission to remove the Sign and any supporting structures and assess a lien on the Property for the costs expended by the City to remove such Sign. 9. It is further understood and agreed upon between the parties hereto that the City streets, alleys, sidewalks and other public rights-of-way, including the portions of such streets, alleys, sidewalks and other public rights-of-way to be used and encroached upon as described herein, are held by City as trustee for the public-, that City exercises such powers over the streets as have been delegated to it by the Constitution of the State of Texas or by the Legislature-, and that City cannot contract away its duty and its legislative power to control the streets for the use and benefit of the public. It is accordingly agreed that if the governing body of City should at any time during the term hereof determine in its sole discretion to use or cause or permit the said portions of the streets, alleys, sidewalks and other rights-of-way to be used for any other public purpose, including but not being limited to underground, surface or overhead communication, drainage, sanitary sewerage, transmission of natural gas or electricity, or any other public purpose, whether presently contemplated or not, then this Agreement shall be automatically canceled or terminated. 10. Grantee understands and agrees that the granting of any encroachment hereunder is not meant to convey to Grantee any right to use or occupy property rJL lisv�51.� in which a third party may have an interest, and Grantee agrees that it will obtain all necessary permission before occupying such property. 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 Sign, encroachment and uses. 12. Grantee agrees to pay promptly when due all fees, taxes or rentals provided for by this Agreement or by any federal, state or local statute, law or regulation. 13. Grantee 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 Grantee shall have exclusive control of and the 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 Grantee, its officers, agents, servants, employees, contractors and subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Grantee. n 14. GRANTEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE OR LOCATION OF SAID SIGN 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 GRANTEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH CLAIMS OR SUITS. GRANTEE SHALL LIKEWISE ASSUME ALL LIABILITY AND RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR ANY AND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT OF OR IN CONNECTION WITH ANY AND ALL ACTS OR OMISSIONS OF GRANTEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, INVITEES, OR TRESPASSERS. 15. While this Agreement is in effect, 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 "A". The amounts of such insurance shall be not less than the following: Property damage, per occurrence $100,000 Bodily injury, per person $250,000 Bodily injury or death, per occurrence $500,000 with the understanding of and agreement by Grantee that such insurance amounts shall be revised upward at City's option and that Grantee shall so revise such amounts immediately following notice to Grantee of such requirement. Such insurance policy shall provide that it cannot be canceled or amended without at least ten (10) days prior written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is attached as attached as Exhibit "B". 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, its successors and assigns, to maintain and keep in force such public liability insurance at all times during the term of this Agreement and until the removal of all encroachments and the cleaning and restoration of the city streets. All insurance coverage required herein shall include coverage of all Grantee's contractors. ' l 1A.� 8 °`' 16. Grantee 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 17. In any action brought by the City for the enforcement of the obligations of Grantee, City shall be entitled to recover interest and reasonable attorney's fees. 18. Grantee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without the prior written approval of the City Manager or designee. 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. 9 EXECUTED thisJL�)day of , 20Q�-). LAP CITY OF FORT WORTH, GRANTOR Vied 65k(e RANTEE By� By. Bob Riley, Development Director. FrQh � Cjtr *za✓ ATTEST: APPROVED AS O FO AND LEGALITY Aj k� City ' ecretary /-4-55'r5l-� Ci y Attorney 10 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 Bob Riley 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 HAND AND SEAL OF OFFICE this I day of Q1Y�YN , 20�. Notary Pulic in and for the State of Texas WY°�, ANGELq MADA Notary q STATE()F TEXAS QMF Uh'C"". Exp.08/21/2007 v ate!;. 1�5'I7v`L p�'U 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 Frah q &,- 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 ` angd� consideration therein expressed, as the act and deed of and in the capacity therein stated. Q� GIVEN UNDER MY {AND AND SEAL OF OFFICE this U — day of 20 0 . t th �pGONDAVIDNEEDKAM *Se Public in and for the n *= MY COMMISSION EXPIRES �,,,be 1,2W7 Texas 12 STATF FARJN Agent A. 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'f NEW ELECTR CH TCH T �' _ _.:".:-..'+",'-_;,'-:;�• �..;.Y'.Fti:3F= '.1 4-HIGH METER BASE -. ate• G '•''N, IF POb LE F ?a �1I08enue 1.210 Squxe Pe � t ;;r r `56BP.E YP \` /' -�<E •ir-r-r----Ay FF = 18tb Av00-O" ' 2 TREE PLANTERS' r I r if AT DECK L VEL STONE T NING WALL la'-8 1/a• i r:�-2�^,?.,.:r,c,r�.�.-;:,.,��.-;}, .,. ��� GUARDRAIL W/ TOP It BOTTOM RAIL TO MATCH D _ RAMP RAILING - TYPICAL o `}wiz 99.911 -TOP OF nu 1110 8t6 Avenue 1,460 Squara Feet _ L.••-- ' - OF STAIR FF = 100'-0` SPA < NEW CO. STAIR W/ Y P VIDE 'EW LA IN TAB STAN D HAND 96,L68- BOTTOM KE ING W THE A RAILS - EXTE 2' AT _L STAIR LANDING ?�C"" ,.=�� _`•: CONCRETE RETAINING WALL AT J , TO E NO 7H - AL BOTTOM t I- T P I ? t INSIDE NEXT TO RAMP AND UP } 1" MAX RISE II" TREAD/ i-. TO SIDE OF STAIR r OF11-BOTTOM �II .1 / 3 S:P IrS RZ'o' . o - - F'-•"_,; VAN ACCESSIBLE HANDICAP f ,•l -' PARKING SIGN TO TAS STANDARD i1 T•.1 1112 8tb Avenue - 1,315 Sqwre Feet �`-•/i `�, \ 1� -r'''-''''1' RAMP SURFACE FF 100'-01 .'•- 3 - /pay/.{y //\))/ _,•. 1:12.5 SLOPE RAMP W/ TAB STANDARD 1-1/2" WELDED I {� PIPE HANDRAIL AT 34" CAL ' GRADE REFER DTL. STONE RETAINING WALL ` : I {1~ IYP�it L C 2t I /\ 99.615- TOP OF 1114 8th Avenue m 1485 Square Feet i RAMP FF = 100'-0° AREA IS' IN FRONT OF I J S- 99919 - TYPICAL GRADE ON rS'c i'_.. .7�Ys' AREADUMPSTPRi, I -THICKEN - -a- •-- OUTSIDE OF DOOR RILLS - - SLAB TO 8' W174 45 t• CONC. CURB - REINFORCING -12.CC TAPER TO 0' AS Gam;•, (.,�.� y SHOWN- TYPICAL 3V HIGH - V CONCRETE -� FILLED PIPE BOLLARD W/ 8' BOARD FENCE WELDED CAP-PAINTED DUMPbTER ENCLOSURE �� -p r �!•'--^•-� W/ 5' HIGH -V CONCRETE 6 FILLED PIPE BOLLARDS .� WELDED DOME CAP - O EXISTING CONCRETE DRIVE TO REMAIN PAINTFENCE t BOLLARDS TIE NEW CONCRETE PARKING INTO W 0 0 DRIVE WITH a3 DOWELS °IL' OC TIE NEW CON.. CURB INTO EXIST. CURB 0.7 PARKING NOTES: 1. 1100 BTH. AVENUE ---------------------------NO EXISTING PARKING 9. MAXIMUM SLOPE OR SIDESLOPE ON HANDICAP CHANGE TO LOWER INTENSITY USE PARKING SPACE OR ACCE55 ASILE - 1:50 NO PARKING REQUIREMENT 10. MAXIMUM SLOPE ON ACCESSIBLESID ROUTE NOT 2, I102 4 fip4 8TH. AVENUE --------------------- NO EXISTING PARKING GREATER THAN 1:12 OR SIDE SLOPE NOT I NO PARKING REQUIREMENT GREATER THAN 1:50 8TH. AVENUE --------------------------- NO EXiTSTING PARKING CHANGE CP USE - L;84 Sr' e.14 PARKING SPACES REQUIRED I-I/2° DIA STEEL PIPE W/ WELDED JOINTS - GRIND 1. 1108 t 1110 8TH, AVENUE----------------------- NO EXISTING PARKING 1'-0• SMOOTH - PRIME PAINTED CHANGE TO LOWER INTENSITY USE BEER/4EDpAAT PIPILS MAY ---- NO PARKING REQUIRED V S. 1112 t 1114 etH, AVENUE------------------- NO EXISTING PARKING JE PLANDING - MA NO PARKING REQUIREMENT 4 �_ '�r' "PER FOO' 6. PARKING REnwI12Rn--------------------- - SEAL W%RSPKRAYED TO URETHANE / S'�. K I "' �+ "`a`1, �� ­� �yt ==^y=j Jy•�• 1 R C z j; TYPICAL ALL BRICK WALLS I --,J �.• ` ii tl'' D 'ACE �(� :-�'- -:_.,-�:,•,.__::--j-=L==.-.;,;:::-ram-,� � e\/ ; ;.:.fir;_;;,;�=:,._�;. �� I• 3 �y , , .r.: sC�.r i=_r<_:�.r;''C���J�:.{;� i:� ; I a i Avenue = 1249 Square Feet IIL � I _}, �1 � � MT1 I'r'f��-�- lr'I tT'%} C�+' � {7:L:F���L.L':�1a�1ti�=_i •-rr���r-_1 'i J,._-•1 (•"`jam j y r� �_ > �_; R-^- 'OR TOILET / I-HOUR FIRE WALL- I-LAYER OF TYPE 'X' NSTRUCTION GYP BD- EACH SIDE - TO ROOF DECK iEPER A-L CAL INSULATION ID COMMON ALL INTERIOR ACE y� TYPICAL STOREFRONT: Avenue — 1,448 Square Feet NOEWRIGINA WOODL STORCONSTEFRONTRUCTION TAND O HATCH t,-•"Y' .,7-T•-:I'(._ T DETAILING- REUSE TRANSOMS �} •' L'1 -?,'- �T,-"••I-•. L�� WHERE POSSI6LE- PROVIDE I_I'-.L- NEW THERMOPAYNE -LOW-E + t_1 -[F.:r{.;•:i?-'-L' ij'i:�L.I.` la+ue:aru-uor GLAZING - USE AZ@K' FOR ALL I i"` ' it-'�)• i- j:-L+ +'i SILL 1 EXTERIOR CONDITIONS MT` F'rT � ]-:'''r -LI — ` REBUILD BRICK AS NECESSARY r�f� j' '(, ''"Ci'(,',_ I TO MATCH ELEVATION zi NEW FULL LIGHT O DOOR W/ AYN t THERMOPE LW TEMPERED GLAZING IN WOOD FRAME — PROVIDE HEAD 1 JAMB WEATHERSTRIP AND ADA STYLE 2-HOUR FIRE WALL - 1-LAYERS OF TYPE 'X' THRESHOLD WITH WEATHERSTRIP GYP BD-EACH SIDE - TO ROOF DECK i 1 I 1 • OR S/1'CONCRETE PLASTER ( j( I PROVIDE FULL ACOUSTICAL INSULATION _ j - ----tt-- M .1 ` ` 0 ., X kCE �� I! ..]I~ w w Avenue = 1,293 Square Feet i cuJ 73'-3" s t*�T-i- �.r�-ii{Fi:•I i3�'�.t���{-��1:�� W � � {_1F 1 2R TOILET 1 ISTRUCTION FOR AS I-HOUR FIRE WALL - I-LAYER Of TYPE'X` Q = I GYP BD- EACH SIDE - TO ROOF DECK ] NMI op" --_—�- * —_-- 1 co 3 COMMONTION ALL INTERIOR URE BREAK FINISH NOTES APPLIES TO ALL 4 SPACES •'i (HERS PLOOR - LEVEL W/ HIGH STRENGTH SELF �CE -LEVELING FIB I it GYPSUM OR TROWELED ER CONCRETE - STAIN AND SEAL AS DIRECTED BY OWNER I A v e n v'e - 1,-110 Square F e E't. WALLS - BRICK CLEAN a Se 6L r� NOTetED o w r I�AYlllel 1 YA.. 1 nw+ tot 9/15/2006 Times 1s23 PM Tot 8179214954 0 8179214954 Page: 003-004 Client#: 55474 JAMES100 ACORDM CERTIFICATE OF LIABILITY INSURANCE 09/15/�aYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 817-347-7069 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Higginbotham 8 Assoc., Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 99 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 908 Fort Worth,TX 76101 / INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER II' HANOVER INSURANCE CO. 22292 Park Hill Real Estate Partners, L.P. INSURER a James D Finley and Charlotte Finley INSURER C: 2501 Parkview Dr,Suite 418 INSURER D. Ft.Worth,TX 76102 INSURER E COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR AD D' TYPE OF INSURANCE POLICY NUMBER POLIO LI Y EFFECTIVE POLICY EXPIRATION LIMITS TR NSR A GENERAL LIABILITY BINDER303707 06/22/06 06/22/07 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $200 Q00 CLAIMS MADE a OCCUR MED EXP(Any one person) $1 O 000 PERSONAL d ADV INJURY $1 OOO OQO GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO Me occident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Penton) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per ac adent) $ PROPERTY DAMAGE $ (Per aW dent) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESSIUMBRELLA LIABILITY BINDER307829 06122/06 06122/07 EACH OCCURRENCE $10 000 000 X OCCUR CLAIMS MADE AGGREGATE $1O O0O 000 $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STORY,ATU• OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POL[CY L[MIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is included as an Additional Insured on the General Liability where required by written contract but only in accordance with policy terms,conditions and exclusions and only with respect to liability arising out of operations of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Worth DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL IQ_ DAYS WRITTEN 1000 Throckmorton NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Fort Worth,TX 76102 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATN ACORD 25(2001/08)1 of 2 #M179325 �14 A ( 0 ACORD CORPORATION 1988 E74clo% - e 4 1 CERTIFICATE OF INSURANCE .t....... This certifies that ❑ STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois ❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois ,,,.��.,, � ❑ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough,Ontario ❑ STATE FARM FLORIDA INSURANCE COMPANY,Winter Haven, Florida ® STATE FARM LLOYDS, Dallas,Texas insures the following policyholder for the coverages indicated below: Policyholder Jason Needham, State Farm Agent Address of policyholder PO sox 11070 Fort Worth, TX 76110 Location of operations 1708 8 Avenue Fort Worth, TX 76110 Description of operations Insurance The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms,exclusions,and conditions of those policies.The limits of liability shown may have been reduced by any paid claims. POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date ; Expiratio Date (at beginning of polic y period) 93-TK-0024-7 L Comprehensive 10-20-2005 10-20-2006 BODILY INJURY AND 93-TK-0024-7 L Business Liability 10-20-2005 10-20-2006 PROPERTY DAMAGE - ---- ---------------------- ----------- ------------ --------- -- ---- '- - - -- -- -- This insurance includes: ❑ Products-Completed Operations ❑ Contractual Liability Each Occurrence $ 1,000,000 ® Personal Injury ❑Advertising Injury General Aggregate $2,000,000 ❑ Products—Completed $2,000,000 ❑ Operations Aggregate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Date Expiration Date (Combined Single Limit) 58-TX-2043-0 F ® Umbrella 10-10-2005 10-10-2006 Each Occurrence $2,000,000 ❑ Other Aggregate $ 4,000,000 POLICY PERIOD Part I-Workers Compensation - Statutory Effective Date Expiration Date Workers' Compensation Part II-Employers Liability and Employers Liability Each Accident $ Disease-Each Employee $ Disease-Policy Limit $ POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date Expiration Date (at beginning of policy period) THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS,EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Name and Address of Certificate Holder If any of the described policies are canceled before City of Fort Worth their expiration date, State Farm will try to mail a 1000 Throckmorton written notice to the certificate holder 30 days before Fort Worth, Tx 76102 cancellation. If however,we fail to mail such notice, 0 obligaW be imposed on State entatives. S n ture of Authorized Representative A t 9/19/2006 Title Date Jason Needham Agent Name Telephone Number 817-921-4111 Agent's Code Stamp Agent Code 43-7858 AFO Code F063 558-994 a.5 Rev.11-08-2004 Printed in U.S.A. 2 r�� . CITY SECRETARY NO. CONSENT AGREEMENT FOR SIGNS 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 City Manager or duly designated Assistant City Manager, hereinafter ``referred to as the "City", and "'Ry-k � �� RQ�,� Emz�-e, K e-r-,4 �-.'P. acting herein by and through its dully authorized GeAero,� -Pm4Ker hefreiinafter referred to as "Grantee", Owner of the properrt�y( ,located at 1—tb 0 �� Ay- Aoan("Property") on behalf of k644w\ *z- T�yyn hereinafter referred to as "Business", located at I�bg p e rk (4r-4, T Iwo . WITNESSETH: 1. For and in consideration of the payment by Grantee of the fee set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Grantee permission to install a sign and any supporting structure (both hereinafter referred to as "Sign") that encroaches 1 upon, uses and/or occupies portions of the space under, on and/or above the streets, alleys, sidewalks and other public rights-of-way as follows: N // �1 s � o x The location and description of said Sign 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 encroachment, 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 prior written approval of the Director of Transportation and Public Works, or his duly authorized representative, but such approval shall not relieve Grantee of responsibility and liability for concept, design and computation in preparation of such plans and specifications. 2 3. Upon completion of construction and installation of said Sign 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. Grantee, 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, Grantee 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, Grantee understands and agrees that City shall bear no responsibility or liability for damage or disruption of improvements installed by Grantee or its successors, but City will make reasonable efforts to minimize such damage. 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, Grantee agrees to pay to City at the time this Agreement is executed a fee in the �)2f00 sum of 7. a. Subject to section 7(b) and Section 9, the term of this Agreement shall be for thirty years, commencing on the date this Agreement is executed by the City of Fort Worth. b. This Agreement shall automatically terminate 30 days from the date Business ceases to operate at nog 8i� ke fL "V ' . If this Business ceases to operate, Grantee acknowledges and agrees to comply with Section 8. 8. Upon termination of this Agreement, Grantee shall, at the option of City and at no expense to City, restore the public right-of-way and remove the Sign 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 4 by Grantee that if this Agreement terminates because the Business ceases to operate and Grantee fails to remove the Sign, Owner hereby gives City permission to remove the Sign and any supporting structures and assess a lien on the Property for the costs expended by the City to remove such Sign. 9. It is further understood and agreed upon between the parties hereto that the City streets, alleys, sidewalks and other public rights-of-way, including the portions of such streets, alleys, sidewalks and other public rights-of-way to be used and encroached upon as described herein, are held by City as trustee for the public; that City exercises such powers over the streets as have been delegated to it by the Constitution of the State of Texas or by the Legislature; and that City cannot contract away its duty and its legislative power to control the streets for the use and benefit of the public. It is accordingly agreed that if the governing body of City should at any time during the term hereof determine in its sole discretion to use or cause or permit the said portions of the streets, alleys, sidewalks and other rights-of-way to be used for any other public purpose, including but not being limited to underground, surface or overhead communication, drainage, sanitary sewerage, transmission of natural gas or electricity, or any other public purpose, whether presently contemplated or not, then this Agreement shall be automatically canceled or terminated. 10. Grantee understands and agrees that the granting of any encroachment hereunder is not meant to convey to Grantee any right to use or occupy property 5 in which a third party may have an interest, and Grantee agrees that it will obtain all necessary permission before occupying such property. 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 Sign, encroachment and uses. 12. Grantee agrees to pay promptly when due all fees, taxes or rentals provided for by this Agreement or by any federal, state or local statute, law or regulation. 13. Grantee 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 Grantee shall have exclusive control of and the 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 Grantee, its officers, agents, servants, employees, contractors and subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Grantee. 6 14. GRANTEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS, SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE OR LOCATION OF SAID SIGN 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 GRANTEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH CLAIMS OR SUITS. GRANTEE SHALL LIKEWISE ASSUME ALL LIABILITY AND RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR ANY AND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT OF OR IN CONNECTION WITH ANY AND ALL ACTS OR OMISSIONS OF GRANTEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, INVITEES, OR TRESPASSERS. 15. While this Agreement is in effect, 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 "A". The amounts of such insurance shall be not less than the following: Property damage, per occurrence $100,000 Bodily injury, per person $250,000 Bodily injury or death, per occurrence $500,000 with the understanding of and agreement by Grantee that such insurance amounts shall be revised upward at City's option and that Grantee shall so revise such amounts immediately following notice to Grantee of such requirement. Such insurance policy shall provide that it cannot be canceled or amended without at least ten (10) days prior written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is attached as attached as Exhibit "B". 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, its successors and assigns, to maintain and keep in force such public liability insurance at all times during the term of this Agreement and until the removal of all encroachments and the cleaning and restoration of the city streets. All insurance coverage required herein shall include coverage of all Grantee's contractors. 8 16. Grantee 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 17. In any action brought by the City for the enforcement of the obligations of Grantee, City shall be entitled to recover interest and reasonable attorney's fees. 18. Grantee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without the prior written approval of the City Manager or designee. 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. 9 EXECUTED this 1(%��ay oif—n , 20QU. CITY OF FORT WORTH, GRANTOR ReG►I Fis ` GRANTEE By j By: Bob Riley, Development Director. an w r ATTEST: APPR AS TO FORM AND LEGALITY A3341 City Secretary - �S� ity Attorney NO M&C REQUIRED io 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 Bob Riley 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 HAND AND SEAL OF OFFICE this�,day of 20 . Notary Pu is in and for the State of Texas ypt:^r ANGELA ESTRADA Notwr pwft * STATE OF TEXAS MI CaaR.W.0812112007 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 Fy-Ah 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 ` IW' 91R V-eAIo 6 ?W+K . L-T., and in the capacity therein stated. 5 IV N UNDER MY HAND AND SEAL OF OFFICE this day of 20 . JASOtdDAVIDNEEDHAM Nqky Public in and for the MY COMMISSION EXPIRES StaW of Texas December 1,2ov 12 L aabv a VL a SIAIF FARMim Agent A. Agent RNSURANCE. 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S IF F03 LE Yp �Vww 1,210 Sqw, P rr O�h 2 TREE PLANTERS AT DECK L I L STONE T NING WALL 10 -- BOTTOM RAIL TO MATCH RAMP RAILI TYPICAL o 49.411 - TOP Or 1110 sth 6v~ 1.460 Square Feet OF STAIR FF - 100'-0 mume SPA NEW CO STAIR W1 P VIDE LA 5 IN TAS STAN D HAND 9LA&S- BOTTOM ING W STAIR LANDING NE_4% KEE T RAILS - EXT 2' AT TO E NO HONCRETE RETAINING WALL AT Al:AL BOTTOM 4 1- 4AT F, INSIDE NEXT TO RAMP AND UP V MAX RISMRMII' TREAD/ TO SIDE OF STAIR 94.11- BOTTOM OF RAMP 3 SP ES %Z& VAN ACCESSIBLE 14AWDIQAP Zr PARKING SIGN TO TAG STANDARD NON-SLIP CONC. 1. 14 Avomw 131S Squre feet.112 0 RAMP SURPACE P -0. W2.5 SLOPE RAMP W/ TAS STANDARD H/2' WELDED APER Pipe; HANDRAIL AT 34* CAL GRADE-- Mr-r-sk DTL. STONE RETAINING WALL ............... A- CL9 99-815-TOP OF 1111 Oth Avenm IAGS Square rest RAMP AREA 15'IN FRONT or I 0 99'119 TYPICAL GRADE ON-- DUMPSTER -THICKEN OJTSIDE OF DOOR SILLS SLAB TO 0*WITH 29 TAPER TO 0' AS CONC. CURB - REINFORCING 0 rJ*OC SHOWN-TYPICAL I v CONCRETE 8' BOARD FENCE FILLED HIGH-PIPE BOLLARD W/ DUMPSTER ENCLOSURE WRLDED CAP- PAINTED W1 S' HIGH-4'CONCRETE . FILLED PIPE BOLLARDS WELDED DOME CAP- 0 EXISTING CONCRETE DRIVE TO REMAIN TIP PAINTPENCS i BOLLARDS 0 0 .NEW CONCRETE PARKING INTO TIE NEW COW-' CURB DRIVE WITH 93 DOWELS 0 W OC 0 10`5 1/4' 0 INTO EXIST.CUM 0 '0 0 0 Law L 6v7 PARKING NOTES. 1. 1100 8TH. AVENUE- ---------------------------NO EXISTING PARKING 9. MAXIMUM SLOPE OR SIDESLOPE ON HANDICAP CHANGE TO LOWER INTENSITY USE PARKING SPACE OR ACCESS ASILF - 1:50 NO PARKING REQUIREMENT 10. MAXIMUM SLOPE ON ACCESSIBLE ROUTE NOT 2.1102 ( 1104 8TH. AVENUE ---------------------NO EXISTING PARKING GREATER THAN 1:12 OR SIDE SLOPE NOT NO PARKING REQUIREMENT GREATER THAN 1:50 3.J104 STH. AVENUE --------------------------- NO EXITSTING PARKING CHANGE OF USE - 1484 SF 414 PARKING 5PACF-5 REQUIRED 1-1/2v OIA STEEL PIPE W1 WELDED JOINTS GRIND 9.1108 t 1110 STH, AVENUE-----------------------NO EXISTING PARKING SMOOTH - PRIME PAINTED INTERMEDIATE RAILS MAY CHANGE TO LOWER INTENSITY USE a_, '1/4' DIA.PIPE NO PARKING REQUIRED S. 1112 It 1114 OtH. AVENUE-------------------------NO NO EXISTING PARKING NO PARKING REQUIREMENT PER POO L. PARKING REQUIRIP-)------------------ - ------ O REM SEAL WT. /SPRAYED URALL ETHANE , �• ` TYPICAL ALL BRICK WALL6 'ACE Avenue = 1,249 Square Feet �� `(' y t V MT I 1-�rJ�-- '"L 4.,1.� __!-Li y�,-i{`7.;7-^i.I 'a IC F� �..! --i7 mitt w w.. �•ljl..li.t �k..�.1«i..d.1.TJ.} :OR TOILET 1 I-HOUR FIRE WALL-1-LAYER OF TYPE 'X' NSTRUCTION GYP BD-EACH SIDE - TO ROOF DECKIEPER CAL INSULATION 1 1 - I1 ID COMMON ALL INTERIOR ACE ��.••...,�...�; � + TYPICAL STOREFRONT: Avenue — 1,448 Square Fee. NEW WOOD STOREFRONT TO MATCH _ •---------• 1 ORIGINAL CONSTRUCTION AND Irr�-* - ,7 y:: DETAILING- REUSE TRANSOMS "I' f>�[�`;,J - --ti-� ��mrsEe -v-�o�� WHERE POSSIBLE- PROVIDE I L... r{ NEW THERMOPAYNE - LOW-E 1 a I {T'}� ••#' [�`'(.�7 Issas;rls-soot GLAZING-USE AZEK' FOR ALL t U�`'ltl SILL / EXTERIOR CONDITIONS MT! f _ w ` REBUILD BRICK AS NECESSARY I F' 't.'=LET`- ll_: ` g W TO MATCH ELEVATION I W��_;. =1::_..1.5--, 1' NEW FULL LIGHT HM DOOR W/ � TNERM I LOW-9 TEMPERED GNWO } GLAZM IN WOOD FRAME � — PROVIDE HEAD t JAMB f�r'_�� WEATHERSTRIP AND ADA STYLE 55 THRESHOLD WITH WEATHERSTRIP F71 GYP BD PREACHL WOE-TO it OFFDE.CK 'X' t I I ! • OR OVI%4'CONCRETE PLASTER PRDE PULL ACOUSTICAL INSULATION I Bill III -- �_ 00 I d J, to a 4 ACE �` I` _JG w [ --...-- 00 Avenue = 1,29 Square Feet �. - s_ F s_ T.}_ r•:;_`- • w MTi ST.a ITS_{,I;j..i.i2-+%"�'�:•: r"�� 1 +� 1 i i----I --I I t-•-- > F- I _ I 1 ! DR TOILET 1 '? 1• �' IL ISTRUCTION ! �_ v Q EFSR A4 1� 1-HOUR FIRE WALL - 1-LAYER OF TYPE'X' I•�'I J�V �4 1 GYP BD-EACH SIDE - TO ROOF DECK J 7 CD 3 COMMONTION ,ALL IVER10R ,URlIr BREAw FINISH NOTES - APPLIES TO ALL 4 SPACES FLOOR - LEVEL W/HIGH STRENGTH 6ELF-LEVELING GYPSUM OR TROWELED FIBER CONCRETE - �LCF STAIN AND SEAL AS DIRECTED BY OWNER Avenue L — L-110 Square r-e e t_ WALLS - BRICK - GLEAN Is bllAL tcv�OeIR r]QYIIIAI 1 — LEA 1/1AT ter 9/15/2006 Timer 1r23 PM To: 8179214954 M 8179214954 Pager 003-004 C I ient#:55474 JAM ES'100 DATE(MM/DDIYYYY) Awrox . CERTIFICATE OF LIABILITY INSURANCE 09/15/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 817-347-7069 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Higginbotham 8r Assoc., Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 99 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 908 Fort Worth,TX 76101 ® INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: HANOVER INSURANCE CO. 22292 Park Hill Real Estate Partners, L.P. INSURER B: James D Finley and Charlotte Finley INSURER C: 2501 Parkview Dr,Suite 418 INSURER D Ft.Worth,TX 76102 INSURER E.- COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR ADWN TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSRDATE A GENERAL LIABILITY BINDER303707 06/22/06 06/22/07 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $.100 000 CLAIMS MADE 5XI OCCUR MED EXP(Any one person) $10 000 PERSONAL d ADV INJURY $1 000 000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG $2 00O 000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea ecciderd) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY.EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTOONLY: AGG $ A EXCESSAIMBRELLA LIABILITY BINDER307829 06/22/06 06/22/07 EACH OCCURRENCE $10 000 000 X OCCUR CLAIMS MADE AGGREGATE $10 000 000 $ DEDUCTIBLE $ RETENTION $ $ TH- WORKERS COMPENSATION AND WC I IMIT FR EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT Is OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is included as an Additional Insured on the General Liability where required by written contract but only in accordance with policy terms,conditions and exclusions and only with respect to liability arising out of operations of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Worth DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 1000 Throckmorton NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SMALL Fort Worth,TX T6102 IMPOSENO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIV _. ACORD 25(2001108)1 of 2 #M179325 %%, A ( 0 ACOR'D CORPORATION 1988 G,K r I614 it CERTIFICATE OF INSURANCE .T....... This certifies that ❑ STATE FARM FIRE AND CASUALTY COMPANY,Bloomington, Illinois ❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois ,,,.....�i ❑ STATE FARM FIRE AND CASUALTY COMPANY,Scarborough,Ontario ❑ STATE FARM FLORIDA INSURANCE COMPANY,Winter Haven, Florida ® STATE FARM LLOYDS, Dallas,Texas insures the following policyholder for the coverages indicated below: Policyholder Jason Needham, State Farm Agent Address of policyholder PO Box 11070 Fort Worth, TX 76110 Location of operations 1708 8 Avenue Fort Worth, TX 76110 Description of operations Insurance The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is subject to all the terms,exclusions,and conditions of those policies.The limits of liability shown may have been reduced by any paid claims. POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date ; Expiration Data (at beginning of policy period) 93-TK-0024-7 L Comprehensive 10-20-2005 10-20-2006 BODILY INJURY AND 93-TK-0024-7 L Business Liability 10-20-2005 10-20-2006 PROPERTY DAMAGE --------- ------------------- --------------------------- ------------------------------------- This insurance includes: ❑ Products-Completed Operations ❑ Contractual Liability Each Occurrence $1,000,000 ® Personal Injury ❑Advertising Injury General Aggregate $2,000,000 ❑ Products—Completed $2,000,000 ❑ Operations Aggregate POLICY PERIOD BODILY INJURY AND PROPERTY DAMAGE EXCESS LIABILITY Effective Date Expiration Data (Combined Single Limit) 58-TX-2043-0 F ® Umbrella 10-10-2005 10-10-2006 Each Occurrence $2,000,000 ❑Other Aggregate $4,000,000 POLICY PERIOD Part I-Workers Compensation - Statutory Effective Date Expiration Date Workers' Compensation Part II-Employers Liability and Employers Liability Each Accident $ Disease-Each Employee $ Disease-Policy Limit $ POLICY PERIOD LIMITS OF LIABILITY POLICY NUMBER TYPE OF INSURANCE Effective Date ; Expiration Date (at beginning of policy period) THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS,EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. Name and Address of Certificate Holder If any of the described policies are canceled before City of Fort Worth their expiration date, State Farm will try to mail a 1000 Throckmorton written notice to the certificate holder 30 days before Fort Worth, TX 76102 cancellation. If however,we fail to mail such notice, %M&F imposed on State tatives. S n ture of Authorized Representative A t 9/19/2006 Title Date Jason Needham Agent Name Telephone Number 817-921-4111 Agent's Code Stamp Agent Code 43-7858 AFO Code F063 556-994 a.5 Rev.11-M2004 Printed in U.SA. 2 0 Request Letter for Jason Needham State Farm Agency t �d Page 1 of 1 Miller, James F. From: Jason Needham [Jason.needham.nv00@statefarm.com] Sent: Monday, October 02, 2006 6:20 PM To: Miller, James F. Subject: Request Letter for Jason Needham State Farm Agency October 2, 2006 Department of Development City of Fort Worth Attn: James F. Miller 1000 Throckmorton St Fort Worth, TX 76102 Re: Letter of Request for Encroachment Agreement Jason Needham State Farm Agency Dear Jim: I am writing to respectfully request an encroachment agreement for an exterior sign at my business. The City of Fort Worth specifies no signage may hang over city property lines without prior approval. The property line begins within 32 inches of my office front door. My proposed sign will extend approximately 6 1/2 feet from the building face, which will be approximately four feet beyond the property line. Please see the submitted encroachment agreement and attached plans for details. The reasons for my request are: 1) My business newly opened August 1, 2006 and the sign will provide visibility; 2) The sign is part of new renovations to the building; and, 3) The sign is exactly the type stipulated by the Fort Worth South Economic Development Committee, which is revitalizing the area around my office. I trust this request for encroachment will be acceptable. Please direct any questions you may to the address or phone listed below. Thank you for your time. Jason Needham, CLU, ChFC �, r C k•k'-a L- Q / 1708 8th Avenue PO Box 11070 Fort Worth, TX 76110 Ph: (817) 921-4111 • kb" Jimmie Wauford Business Development N IG S Phone:817-847-0571 ext 109 Toll Free:800-486-7695 ext 109 Fax:817-847-0579 2633 Blue Mound Rd.W. Mobile:817-401-5425 Ft.Worth,Tx.76052 Email:jwauford@signrush.com www.willowcreeksigns.com 10/25/2006 �*;aa�taaaf Nsaa�l� CITY OF FT WORTH `•�� ,� ,�.•`j 1000 THROCKMORTON "■�, *;�x•a FT WORTH TX 76102 Submitter: CITY OF FT WORTH/J CRAIG EATON SUZANNE HENDERSON TARRANT COUNTY CLERK TARRANT COUNTY COURTHOUSE 100 WEST WEATHERFORD FORT WORTH, TX 76196-0401 DO NOT DESTROY WARNING - THIS IS PART OF THE OFFICIAL RECORD. fled For Registration: 12/08/2006 02:28 PM Instrument#: D206386269 OPR 21 PGS $92.00 l IIIIIII IIII IIIII IIItI IIIII IIIII IIII!IIIII IIIII IIIII IIII IIII D206386269 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.