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HomeMy WebLinkAboutContract 41152CONTRACT Na EASEMENT ENCROACHMENT LICENSE AGREEMENT THIS AGREEMENT is made and entered into by and between THE CITY OF FORT WORTH, a home rule municipal corporation of Tarrant County, Texas ("City"), acting by and through its duly authorized City Manager or duly designated Assistant City Manager ("City"), and The Dannon Company, Inc., a Delaware Corporation, hereinafter referred to as "Licensee", owner of the property located at 1300 West Peter Smith Street, Fort Worth, TX ("Property"). RECITALS WHEREAS, Licensee is the owner of certain real property described as Lot 2R- 1 R, Block 24 Jennings South Addition, an addition to the City of Fort Worth, Tarrant County, Texas as recorded in County Clerks Document No. D209116171 of the Plat records of Tarrant County ("Property"); and WHEREAS, the City has a 15 foot wide Storm Drain easement (the "Easement") in the property as shown on the map attached to this Agreement as Exhibit "A" and incorporated herein; and WHEREAS, Licensee desires to construct/place and maintain a building which will be used in connection with its manufacturing operations ( the "Encroachment") and which will encroach onto the City's Easement as shown on the attached survey and only to the extent shown thereon; and WHEREAS, to accommodate the needs of the Licensee, the City will allow the Encroachment under the terns and conditions as set forth in this Agreement. NOW, THEREFORE, the City and Licensee agree as follows: AGREEMENT 1. The City, in consideration of the payment by the Licensee of the fee set out below and covenants and agreements hereinafter contained, to be kept and perforrned by the Licensee, hereby grants permission to the Licensee to encroach upon and occupy a portion of the City's Easement as described in and at the location shown Exhibit A. Upon completion of the Encroachment, Licensee agrees to be responsible for maintaining any and all structures and buildings within and above the drainagereasementrLicetaseee 1 OFFICIAL RECORD CITY SECRETARY `, WORTH; T shall not expand or otherwise cause the Encroachment to further infringe in or on the City's Easement beyond what is specifically described in the exhibit(s) attached hereto. 2. All construction, maintenance and operation in connection with such Encroachment, use and occupancy shall comply and be performed in strict compliance with the Charter, Ordinance and Codes of the City and inaccordance with the directions of the Director of the Transportation and Public Works Department of City, or his duly authorized representative. Prior to the construction of the Encroachment, Licensee shall submit allplans and specifications to the Director or his duly authorized representative. Licensee shall not commence construction of the Encroachment until such approval shall be indicated in writing by the Director. However, such approval shall not relieve Licensee of responsibility and liability for concept, design and computation in the preparation of such plans and specifications. 3. Licensee agrees that City may enter and utilize the referenced areas at any time for the purpose of installing, repairing, replacing or maintaining improvements to its public facilities or utilities necessary for the health safety and welfare of the public for any other public purpose. City shall bear no responsibility or liability for any damage or disruption or other adverse consequences resulting from the Encroachment installed by Licensee, but City will make reasonable efforts to minimize such damage. 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 the Encroachment and use, Licensee shall pay to City an additional amount equal to such additional cost as reasonably determined by the Director of Transportation and Public Works of the City, or his duly authorized representative. 2 4. 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 Encroachment and uses provided for by this Agreement, Licensee agrees to pay to City at the time this Agreement is executed a fee in the sum of $575.00. 5. The term of this Agreement shall be for thirty years, commencing on the date this Agreement is executed by the City of Fort Worth and automatically renewed for an additional ten (10) year terms if all provisions of the preceding term have been fulfilled, payment of fee associated with a consent to encroach agreement that is in effect at that time and evidence that the City's insurance requirements are being met. 6 It is further understood and agreed upon between the parties hereto that the easements 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 easement 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 easement 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, that does not preclude the use of the Encroachment on the Property for a office building or activities related thereto, 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 the parties agree to negotiate in good faith in order to accommodate the Encroachment and the public purpose. 7. LICENSEE COVENANTS AND. AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS 3 OFFICERS, AGENTS, SERVANTS, EMPLOYEES AND ELECTED OFFICIALS 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, ARISING OUT OF OR IN CONNECTION WITH, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE OR LOCATION OF SAID ENCROACHMENTS AND USES GRANTED HEREUNDER, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, ELECTED OFFICIALS 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 THE ENCROACHMENTS AND ANY AND ALL ACTS OR OMISSIONS OF LICENSEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, OR INVITEES. S. While this Agreement is in effect, Licensee 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: $1,000,000 Commercial General Liability with the understanding of and agreement by Licensee that such insurance amounts shall be revised upward at City's option and that Licensee 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 4 written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is 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 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 Licensees' contractors. 9. 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 Encroachment on Easement 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. 10. 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 Encroachment and uses. 11. 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. 5 12. 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 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. 13. Licensee agrees and acknowledges that this Agreement is solely for the purpose of permitting Licensee to construct, maintain and locate the Encroachment over or within the described Easement and in not a conveyance of any right, title or interest in or to the Easement. 14. In any action brought by the City for the enforcement of the obligations of the Licensee, City shall be entitled to recover interest and reasonable attorney's fees. 15. The parties agree that the duties and obligation contained paragraphs 3 and 4 shall survive the termination of this Agreement. 16. Licensee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without the written approval of City, and any attempted assignment without such written approval should be void. 6 ATTEST: ALA.? ity Secretary 17. Any cause of action for breach of this Agreement shall be brought in Tarrant County, Texas. This Agreement shall be governed by the laws of the State of Texas. 18. This agreement shall be binding upon the parties hereto, their successors and assigns. EXECUTED this )2*'dayof u,20��. City City of Fort Worth BY 45.tl44 Fernando Costa, Asst. City Manag eics-"atetarg #4:). * f°104 140 a 0000 0000 0 000 Apt 0 Pt, k OU gii al aQ #10 ()SO oo0 o VA t00000 o°,ty Approved As To Form and Legality o*tX P5 9 Licensee: The Dannon Company, Inc NO Mi e R OU ; ____ _„— 'T _ ___.T_....vra .,,c. By: ttr Namer.Post Title: Plant Director Ain(Qtynd Assistant City Attorney OFFICIAL RECORD CITY SECRETARY Ft WORTH, TX 7 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 -- , known tometobe the person whose name is subscribed to the foregoing instrument, and acknowledgedto 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 20 day of Notary Public in and for the State of Texas 8 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 pp ersonall appeared ftrnanokoQ.5asAmk , known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the salve for the purposes and consideration therein expressed, as the act and deed of the Grantee, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this of n0\frCPSW ,20 .&•'} stetti .e,,,,,,t :c...- . HIABuwER.. . „a ,,, s. as s omm 3"„3 4 T r' ., t saN 2, .., , .., ... ,, s.z, iiiitti aa" day UACtsbt IY\ () Notary Public in and for the State of Texas 9 merle,,(*barteanted an mwmnadawnAlmon memdi Sbyarmplat rxa Clty otTaat Wan, bum mdivmu Impkimeang the mea®tmt sodmlkchm of water PIA _, kn.Nue,,"son Sd. j tnfthe�m Vt("thyme* la eff•t aatl t ndameflit( a,nmMM Martina] mde&' Irene One n isimf�ainwv.mde !some, eQ womte damn building omtdl le Owed. am the convection data nth =SSA watt .Wawaneamnewnn $.m o building lWl but lomat ter eeelotto la Sibdtka oath ea tnRtMm CPA atIm alter Ote army y flti bd4M➢:irable wart. mo Nut Ciy ofPortlWort1 deedh, mdmg xMn^mtmn;mad mrW.ntn daw'eqtmodadna,utnbnbadetorallwmkoaddmlwmaa:mt, amnteen MthMSidewalk Polk, Pe Yhy 136701 r.mn0116000017 UTILITYAny blkmlOty. Including me Ch.,. of Von Wm4+Lall bed S. 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PRTCT ts.eectr Lot 10 move ribt l it I IqI 1;1 NnNa i � JI ,_LT.abornwmcsamp I"N89°48'19"W 188.03' T Lllxgm S89°SI'17 West Petersmith Street IRV The Doman Cumpboy rite VoNmc 101441003O$ / DUCT 1.4 DR1WtNO SCALE: t•- .W Poltltm of Log A,BIock24 JmmnBW South Addition Volume 300-161.Page 13 PRIG' L6 aa Portion of 1 ition vet lea ARP4th �ys 13 to' tat ce0700/A.,T.:i its—. pi PRICE I Remainder or Lot 4. Block24 AS /toot Jov*ip South MMus IAnun.n>meaedpla0 nCsmoBan re I IYswbk WWm Right -au') Ltt Ik, Bloct43 Byde-)mningt Sobdbitlnn Cabinet A, Slide 3401 PRTCT Am DellaWiteO �n mB r,I 1 M.,4lia IS" "TWO* to Staring IDonna? Nhober Fu d1 164n' W av rmr, 136 L7 sair2ra2•w .Idlsv Lb .4r1 ':mbr W 1126IV grdnorW ...Mgr aaO& Ltsx1•WU mV3tl! LIT NORTH _i 14/00 SURYlVORScwnrlcAnON Ibud aid As �mowmet mdhuaa lmnmm ved ,..mopnrypleed uWermy pontoon( in from an maid ontia. wound tbe nll supervismea.,denteventlnpwneetaln nMnenwbaaotm°o,rofrmt Wattles. altiner Dt,Ock 212.12' u " m Let lR Block42 EIIP SWdlvieinn,PL Worth Cane A, Slide 1TT0 PRTCT IJ4• s0 �� FS - 009-029 B W Deus Subdivision Volume 26,01036K PRTCT 1 E W Beni Subd%Mon •olum, 26,130730 PRTCT )i W Betts Subdivision Volume 26,130030 PRTCT Lo14,elock01 EWBenn Subdhd)w Lou 3B.13lock2J Jennings South Addition Voiomevs63.enEe 200 IRTcr Mahn FORT WORTH CITY PLAN COMMISSION CPR' OPrORTVIOR'JB. TEXAS ThnWub. aldOely eaWItIvn Map Gmmnw4aof Pit Approval Qmya: 5/a4hACI RP This av 001e n vedalv.4u tc ,art ink no.tore TITMICE wit Ca Vro•veleeeltv+vvni Ivrarla.vi vtl Ike olnelopc M..a..nm+l..m.mwnvr_ s ,ro..wau r..0 ,oaw tI .a....mwou.rvnu... a,o,r.. wave d xa 0071/ b MTh,vipg�i�M�iu y many locidaitosnt*. Cos. +we. men to t,.m miry v. dart.y emu. i. TO AMP, �t 'ee ukn.bap.to pin. the $ once tat arse. urrnanic .term aaeuumurwe..sm,n avornment....ifirv. ea - aJ- a.nmrYaptHga.mnmthec,,w..,Kv.wor ..tic..&t. .n eaville tile out.wWt,<wm,ame, enJMabry k omit* ^er. Ilt• Inv Final Plat 10.808 Acres Lot 2R-1R, Block 24 JENNINGS SOUTH ADDITION Heinen 3Oplat of Lot 2R-1, Block 24, Jennings South Addition, Cabinet A. Slide 1086 & a portion of Lot A. Block 24. Jennings South Addition. Volume 388-84. Page 13 Plat Records, Tarrant County. Tams the remainder of Lot 4. Block 24, Jennings South Addition. an sin -recorded plat & a tract of land described by deed to The Hannon Company, Inc. as recorded i Volume t 1814, Pngc 305, Deed Records, Tarmm County, Texas ()VAX �n sit+►o�, at Med In Courtly Clerks Document No. Date u,ow.x: s lwn.;wam 1rwlitl.atamar....g smww, &merwsow nmer 6:4c17079:22.w rmmaIn:.t,amotwwRam rdwDole: 4'Z4ctdVJaa3AN G. Jennings Survey. Abstract No. 844 Fort Worth, Tarrant County, Tcxiis Febmary 2009 NOM REREAD CE SIRUOUTL PING MA CASING x SO uaR BILLING WORM OUCH COO. TC.NBOT G.61652 TC-62EA$ 462651 M.62LST H OCH EXIST. 111442510 TP-FDW. 26.43 Waa DmT. 1P.62IL71(+/-) 141101 OAA TP.621. -0+25 'I S6'R•tl156 SO -A S9.041I,1B n-6n.Bi SD -A SLAD+1L 1a-� �� IG1AL x HS 11.421 n.1r42ET1 It x./21.7s -- _:....: SD•B M 0419Ae rC AREA mw -.,, -ROHR 1_. 0+00 SO-4 SL26Q IGTFU 36 RS nNT25T i 1. / 50-D OO.W / tarMaOIW/ RN.62ILN M62D50' 6� I WO UZGT. j- cn /00 1 Concrete CAST. :Intl ( )i .1611.635. SO RN NwWW r— Multi—Story Concrete Block & Aluminum so-Asa.on actory Building �-C O22A3 11. .6 w FL x.621A3 OW SD-B M O22m u®G n-u2A8 {An a ra4Sb SO-C M 0+2721 41' IAEA CAM Aw-aem n.62506 x AOBf DNA RDOGP a 1 1P-62eAT(: ) ICI, Nal .>r.R'%ice.. SS LLya raD. i v 0/..0.uw 1+00 10 bail GRAPHIC OGLE y L E_L_E N_11_ ercrw"-. -12X/1121101L —JCL— PROPERTY IK LOT MC MOOR OG 7 ) e-n FOOtMwT MC. awes OTTM MCC Or PNMYW! f CAG41E ACOWA E' Ca9KIt MUCH MCC COMMAS —560-- 2 ,wmlwTgx6 to - 10P a Gall teV . VP 11 MOMS IP . 10P N MMOIT 1C . TM of CLAD G - oumi TT - TOP s LEI OY . OOTIW w LIL 01 . 1M el 4WaL R - HOP PC SO - /TOM DMA UM 1m - MOP Wn UK ffi . SMOA. II.WL R• WLL MC GENERAL NOTES 1. AU LINES. owes. CONStguclioe STALING ANC LAYOUT SHALL BE THE FIESPONSSU1Y OF THE CONTACTOR. 2. PRIOR TO BCGINNG CONSTRUCTION, CONTRACTOR SARI. WISPY ALL wMNSGHS IN THE FIELD MD REPORT ANY O15OCPCNDES TO INC ONNER$ AMC, S. ALL DNENSIONS ARE TO BACK OF CURB, COX Or PAVWEM, OR EKE OF CONCRETE BUILDING EDOTNG. UNLESS SHORN OTHERL6E A. CUTTING CUNT OVA IS Pem.MED FOR NF'OIAAXON ONLY. ALTHOUGH SHORN AS ACCURATELY AS POSSIBLE. THE CONTRACTOR 5 RESPONSIBLE FOR COOROMATNG CORN 12UGOPAL AND FTANOCC UTWIY CONPANCS AND LOCATING ALL UTILITIES N THE FIELD. CONSTR./GTION NOTES 1. ALL CONSTRUCOON SHALL DE DONE w CCORDANCE LM CURRENT CITY OE FORT WORTH STANDARD DETAILS AND CObTRUCTIN SPECIFCAIGNS 2. CONTRACTOR SHALL CONDUCE AND PAY FOR ALL UTILITY RORK TO BC OOC BY CITY FORCES AND/OR Hi/ACME UNTY CDIPANICS tern w .LINK cal ❑� Baird, Hampton & Brown, Inc. ❑ E c ne ing QE Surveying �1Pu. 11... -101 Y. LPN Ob 1 w Mays MTN �M11.,.Am• DENNEHY 04144344 ARCHIT RC TS .0 r WrrTI 1 LracCCL t.. O ISSUE $ REVISIONS >- Z 0 0 U Z 0 Z 4 0 W 2 1— FORT WORTH PLANT Z 0 J co W BATCHING FORT WORTH, TEXAS W. PETER SMITH O O 17 10. BATCHING GRADING PLAN JOB C-DPT-10 DATE 05/28/10 SHEET C3.0 Ex� l+-)sA CIER 11 i IT+ it CA 11 ]E OF 1T ,1A II 1ITV IN SL RANCIE DATE(MM/DD/YYYY) 06/28/2010 PRODUCER Aon Risk Services Northeast, Inc. Stamford CT Office 1600 Summer Street Stamford CT 06907-4907 USA PHONE-(866) 283-7122 FAX-(847) 953-5390 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC tt INSURED The Dannon Company, Inc. 100 Hillside Avenue 3rd Floor White Plains NY 10603 USA INSURER A: Zurich American Ins Co 16535 INSURER B: INSURER C: INSURER D. 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. LIMITS SHOWN ARE AS REQUESTED INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YYYYI DATE(MM/DD!YYYY) A ENERAL LIABILITYGL0298411909 01/01/2010 01/01/2011 EACH OCCURRENCE S22000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $2 , 000 , 000 PREMISES (Ea occurrence) CLAIMS MADE OCCUR MED EXP (Any one person) $10 060 , X Per Loc Agg - S2 000,000 PERSONAL & ADV INJURY S2,000,000 rGENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2 , 000 , 000 X POLICY E PRO- Ei LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) — 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 AUTO ONLY: AGG _ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE nOCCUR ri CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION WORKERS COMPENSATION AND WC STATU- TORY LIMITS IOTH- ER EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT ANY PROPRIETOR / PARTNER / EXECUTIVE i OFFICER/MEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) E.L. DISEASE -POLICY LIMIT If yes, describe under SPECIAL PROVISIONS below e OTHER t9 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS A Evidence of Insurance. 1 CERTIFICATE HOLDER City of Fort Worth Attn: Fernando Costa 1000 Throckmorton St. Fort Worth TX 76102 USA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Holder Identifier : Certificate No reir aa� ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. Alf rights reserved- The ACORD name and logo are registered marks of ACORD