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Contract 43156-U
STATE OF TEXAS COUNTY OF TARRANT NCROACHMI_NT AGRI rMI,N T CITY SECRETARY� CONTRACT bO. THIS AGR{FEMI-NT 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 Planning and Development Department Director, Leo E. Wanta & Assoc. Inc. hereinafter referred to as the "City", and acting herein by and through its duly authorized VICE PRESIDENT, WILLIAM LOTT, hereinafter referred to as "Grantee", Owner of the property located at 801 W. Magnolia Ave. 76104«Property"). WITNESSETH: 1. OFFICIAL RECORD; CITY SECRETARY FtWORTUTX 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 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, 04-30-12 P12:43 IN sidewalks and other public rights -of -way, such Improvement(s) are described as follows' (See attached plans and Description of Work) Double sided ADA ramp, structural column, and overhead stainless steel canopy all encroach upon the public right of way on the north side of the building along Magnolia Avenue. 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 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 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. 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 3 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 TWO HUNDRED SEVENTY FIVE Dollars ($ 275.00 7. The term of this Agreement shall be for thirty years, commencing on the date this Agreement is executed by the City of Fort Worth. 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 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 Grantee that if this Agreement terminates and Grantee fails to remove the Improvement, Owner 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. 4 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 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 dunng 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. 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 in which a third party may have an interest, and Grantee agrees that it will obtain all necessary permission before occupying such property. 5 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 Improvement, 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. 14. GRANTEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS 6 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 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 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: $1,000,000 Commercial General Liability 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. 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. 8 EXECUTED this City City of Fort Worth By: Ran —de Harwood Director.-s-z-a,ti. Title: Planning and Develo me o� •Ce ' aQ0000 ell day of ATTEST: ity Secret�r�y ea0 si i AOa lel oO V 00:0 Nc, .�r. 0 o ?EX%-s*ssistant City Attorney ,2012 Grantee (Business Name) Leo E Wanta & Assoc. Inc. By: (4 Name: WILLIAM LOTT Vice President oved As To Form And Legality 10 • OFFICIAL RECORD CITY SECRETARY Ft WORTH, TX 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 HAND AND SEAL OF OFFICE this 0 day of r IRMA SAENZ Notary Public STATE OF TEXAS My Comm. Exp. Jan. 28, 2016 Notary Public in and for the State of Texas -' 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 William Lott, VP 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 Vice Presidential Approval stated. and in the capacity therein GIVEN UNDER MY HAND AND SEAL OF OFFICE this 16th day of March ,2012 12 72 Notary j'Pu.lic in and for the State of Texas O�� c. RayWalter Boothe o My Commission Expires ,r'V:� 10/05/2015 r 1 1• t : • I 1 • . • • Ft a74' w Jogs ants tmr • ' 1 -: R ->� W. MAGNOLIA AVENUE =SCatc CUM SM., .. • • • t 1. I PAYFR�(OIL :•.• 3 tin 'w. h .: . 4,. ..J 1 ''(. I• „'• A. I ;.e NIA .0 •7. 4r. 1N. ° r,'�.! :r 4 *I u .ra.,, 1 r r21 •i. 1 LOT 3 BLOCKJI MARTIN SINGLE STORY RESTAURANT i TYPEDI-Bs SPRINKLED LOAD BEARING MASONRY W/ BRICK VENEER & STEEL ROOF JOLSTS 4,286 Sq.Ft. A/C 4,486 Sq.Ft. A.U.R. OCCUPANY: RESTAURANT OCCUPANCY:'A-T OCCUPANTS: 220 FF = 652.91' 14'N.....� INDIC%\TFT:EXTENT 1P-m2sr \ Enlarged Site Plan - Brewed Site Extent q 5't4' 101-8" 161-0- 3/16' t. 1'-0- i'• w Z, to IIp ..°} IZ .•I I LJ ram , t. naa J 1 1 lort'-ss�2o' i 1 1 o • I FF '652.91' I I ,.1111.11, 1p-487.3Y • i•' :0 710.110E . ff l 6c-2 ..w. •^I LOT4 BLOCK B L MARTIN & MOODIE 1 i p 1 —l_--. Il-1 -4 TON-w.2o' 1 rr- • Itataletatedi 1P-4Q7.71 CC 1N6 51201 MUIR OW • • • FF 652.91' I 7P-sS2sr rF T7 .7t: rt .042.37' tutu INDICATES OF SITE W 1P-dSt rr _.- .TP-6(1163' • .? 1P451.72‘__._ • • c f1}: . • l.�''�'' � : J. .. • r--r.. ,......• � I4 I,. • 9 w a-a-iau ...sir......— - II* r.NI, YYpmr nark lue• ala Modern Village • • • 11. a W • • • 11 • 2-24-12 2011.14 stascT A101 f 22 es • PLAN NOTES BY SYMBOL I—p i - Sm aumi. ni soucasm oraQa 2 •--.oa MQ MOO.MAMC NMISC 0. SAM INK MC =IC PUMPS MAN 11001 1,001. SIX AM la AM. WPM 0 ramie 1Q u r N RAa coax or. t1: sac wore. ra Amt sa Pala swum' ■ HAa cram: rat IRapa Ao1001 nun M CNN ra mars RO+w1ons r+IM.M- eUuT-U Tom moo m arraR p , a �e nraD HOMO r ❑r ra oMor:llm.pplR OMCC RAM Ullbo AT M. loam Stoll VIM C01100 Oar AIM & Sru.1M Q OM AM Tito[ omit ME M MI we STAros COMINVOTUCIOROP 0 OMB r 1 mac MC= ar&. 0,21 cm MU MI-U Doom 91t2* PLAN LEGEND L. NO NOT SILO MLL 1/ sawn= SIIEL MORO .I NO/ WOO MI WILL �01 NM 1000 STUD M I. 11/ SDIIC M1I G ammaimimmi A! MLO MIX NRM ® NOI �-is VOW 1NLI'711.roots . MU. �ii FOR �DtS t OT!!WM' AOOT TOR PUS IHD1 Mo[ TO Old 0 ROOF Old 0 Floor Plan or 410• rrta• 1z14 1/4• - 1'4' 0 GENERAL ROOF NOTES 1. DOSTTIIC ROOF COMPOSITION & EAVE FLASHING SNALI. REMAIN UNDISTURBED. 2. PRE -FUSSED METJII. CUTTERS SH,M.L RUN ALONG TIE EAST & WEST LINES Of THE EAUIE. AS INDICATED ON IRIS PLAN. 3. ALL DOWNSPOUTS SHALL BE FASTENED TO THE WALL WITH PRE -FINISHED META. STRAPS. MATCH CUTTERS. 4, OOW NSPOUTS SHALL SHED WATER ON TO A PRE -MANUFACTURED CONCRETE SASH BLACK OR OTHER IMPS WOUS SURFACE. 5. PRE -MANUFACTURED ROOF TOP WAU( PADS. FINAL SPACING & LAYOUT ID BE OETERMINEO BASED UPON EQUIPMENT SERVICE LO JION REQUIREMENTS. 6. REFER TO MECHANICAL AND PLUMBING PLANS FOR l OCA1LOIiS OF ADOTRONA . ROOF PENETRATIONS. 7. EXPOSED VENT STACKS TO BE FIELD PANTED TO MATCH ROOF COLOR. & METAL GUTTERS. F ASHINGS, COUNTER FLASHNGS. CORNER & OPENING TRIM AND DOENN SPOUTS TO BE PRE -FINISHED STEEL, AS SELECTED BY OWNER 9. PROME STEEL FRMJED DOD WITH Jrrb '-GUARODECC RANDS. SINGLE STORY RESTAURANT TYPE TQ-B. SPRINKLED LOAD BEARING MASONRY W/ BRICK VENEER & STEEL ROOF JOLSTS 4.286 Sq.Ft. A/C 4486 SOFT. A.UR OCCUPANT: RESTAURANT OCCUPANCY: "A-T OCCUPANTS: 220 .NOM 0 vtI ( 1 ill#111 y— • 1 is \LIp lSifFEL • " 1.11,1 1.!tl;., f.11.1 „ 1 SEE A/CURI Cal T 2 Roof Plan D•t0' Trio• 164-o- 1/e. • 1.-0. Tr--tiK• 1210/111322211 tr; i11iy 11111�1� hIiI i r4r Gan 1141 11 .., 'I 4 tram / 4' ;; 1 !•11 f'. 1. 7n a . I le NM Pt • IN Ha I 1111•• 11:1{.i1•I•', I I lb .11 To•-Tdi• u La'. 3 MOM --1 13'-1di1• 14. it .. V • • c-"lr L Cal 1 rIE TS I] ago n[nAaa a. . , jrzrr: ...........No 1- 1 J r7Ei COMO 1.4//40v TM 2-24-12 ..s 2011.14 PISMO A201 6 71 T/ MONOLITI N. 118'-8— S CANOPY . 108'_8• APPROXIMATE LOCATION OF PROPERTY LINE 11'-5- EXTENSION OF CANOPY FROM TILT WALL FACE PAVER BOCK SEE A101� 1�FWLSF; 4 ffO F100R Y low —Oa 1 m 6' PRE-F885H o GLOSS ' RACK SiEd C x. HORIZONTAL 118 REU*000 SCREEN SINNED (p1FSTNUr TORE) T/Exit-n Ic PMIT FADE Of COST. STUCCO CANOPY MATTE TRACK I. EAT CHANNELS 0 24.00, PRE -FIN 841CK OR PONDER 81ACR I SIEII.5IWPORES FOR EW GINOPY, PER S NS LUGIVRAL EMCEED • - ARE-FWISSED 'OALVAWME' METAL SOFYIT. SEE A202 EAVE RASPING &- ROOF COMPOSITION TO .ROUJN-UEDMIREED. 1- L {�Ilt!ittIi�li��ii'�I��i��:itlli1 1:j tl11 1 iiittrtt?ttrt(tttlltitti. SM. WM - PER STRUCYL ENOR STEEL HANORAI. SEEA21 0 - S¢ ICI *\\\\\\\\\\ \\\\I-\ ._.. CONCRETE SEE A204, RDIF PER smut EMIR •. Wall Section thru Covered Porch & Loggia 010' 1'ti' 218 8 410' 3/4' = 112+3 CONCRETE TAM ISIINC WHcREIE FOUNDATION 0 QPEES 2-24-2012 m —der:s -'ism s t-W. —__ Foal �WPvew elw %VISION RW9 TM 2-24-12 2011.14 DRonar DRAIN DATE A701 a a 2 co • • 18 22 of m0 _-v..._.- Modern Village BREWED 801 Magoon. Ave. Fort Worth. Texee 4 eat rag mi ER t Boothe Architect,. be. PlenNaz & Dzcien Va. lao tal pEgA C.11210 it an is ars net Ileac 4B-r RA OUT SIDE FACE OF BUILDING 1 Enlarged Floor Plan did rid rid did 2 Detail - Ramp did I'ir rid did tre SJMNfss Slat NRa1AE ; mass SIR wawa u l 11 i I i,• 1 1 ' I. WI wI. COO SIC I� mR 9 AS WSSOU snll MOOT REFER 10 A101 FOR GIACINO 3 Detail - Ramp did rir 1'id or vr.rd Past FVL Fur. AB2,Br t STAIISSpEkl NAIII 4UPE 0Ul41 F I 11 S1AM16S6HAM M t-jI {11. t-0C. 1'd rPLAN NOTES BY SYMBOL pp tam aum, to most wet { ©teeaQ PM MAN Mg K® moo not al e U VMS WWI MOORS 212 IAWIT. W O 0 1101a10/ OR W Wa[W®( 0.14 UMW Ilytlta4I O—TWOS SINS OMOQ 101'®au illy 0 me Imam mown mann ITZW WI irm¢:10 n/W WI20 ea mm irmt Qd—*SIY Ara Me SI*W APS ❑i 1M WYL two *OW Marta A W0AW 0 ❑ IMQtlN110 OWWi A OTIOWW WWW 011IQW/OI� n Tom OWL nee >t[yl m'a01 �PLANLEGEND „root 'vetM 4 WA11Aa Wm. ts=It x(11 STD OIL NEN NON OW MU ♦/ IdIo 9mle Ia ar.Im — MICR flll YII6I TmolOom011ot NOT 1111.10.111 WOW SWOT 114111 9I OICW '1@ I. . /IL=as n1 toss! WSW' -RAIDf01 IOW MO RI[ TO uNiWOr WO omI- r 4 NOT USED 5 Detail - Landing or rit' rid rid did 1'i4 rid rid Wr • 1'd yf . r-0• cos watt wee 2-24-12 2011.14 A204 ACORDCERTIFICATE OF LIABILITY INSURANCE I DATE (NN/DD/YI'W) 03/14/2012 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 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 M J KILPATRICK INS AGENCY INC 2410 MONTGOMERY ST FORT WORTH INSURED BREWED INC 801 W SHAW STE 107 TX 76107 FORT WORTH TX 76110 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. ILTR TYPE OF INSURANCE AUULSUBRJ _ - - - POLICY EFF POLICY EXP INSR WVD POLICY NUMBER INMIDD/YYYYI IMMIDDNYYYI LIMITS GENERAL LIABILITY x CONTACT NAME: AJCC,No. Extl: I FAX No%: ADDIL RESS: I NAICA A OCCUR CLAIMS -MADE COMMERCIAL GENERALUABILITY CLAIMS -MADE OCCUR GGEEN LAGGREG�ATE LIMIT APPLIES PER: IC PDDCY 1 1 .Pica I IEi LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS UMBRELLA UAB EXCESS UAB DED t I RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETORIPA.RTNER/EXECUTNE N 1 A OFFICER/MEMBER EXCLUDED? f ' Mandatory in NH) ryes, describe under DESCRIPTION OF OPERATIONS below SCHEDULED AUTOS NON -OWNED AUTOS Y CPS-1558043 INSURER(S) AFFORDING COVERAGE INSURERA: SCOTTSDALE INSURANCE CO INSURER 8: INSURER C: INSURER D INSURER E: INSURER F: EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES /Ea .occurrence) $ MEO EXP (My one person). 03/14/2012 03/14/2013 PERSONAL &toy INJURY GENERAL AGGREGATE PRODUCTS-COMP/OP AGG COMBINED SINGLE LIMIT (Ea occident) BODILY INJURY (Per person) BODILY INJURY (Per actident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE $ AGGREGATE S $ INC &TATU-TA FR I IO k E.L. EACH ACCIDENT $ E.L. DISEASE -EAEMPLOYEE 3 E.L DISEASE POUCY LIMIT $ DESCRIPTION OF OPERATIONS !LOCATIONS !VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CITY OF FORT WORTH 1000 THROCKMORTON FORT WORTH TX 76102 CANCELLATION 41297 1,000,000 100,000 5,000 1,000,000 2,000,000 Exduded SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD