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Contract 44036 (2)
LA Nil Nos 2349 Fe 2 anar VACiletAitt ?kijoc I a° it Lee WORK REQUEST ST AND RELEASE OF ¥ __ WJl (XIV HOLD RARML S k `3D JINIE} N1IF1CATIo 4-SIGMEMENT FOR WORK WITS A orniT EASEMENT, NT, C UMOFFu AY OR PARKWAY WHEREAS, 'i'he City of Fort Worth, ("City") desires to have removed from certain property located at S. Handley Dr from E. Lancaster to Union Pacific Railroad tracks ("Property"), the railroad tracks located in or under the existing right-ofpway, as described, below, ("Work"), and W1LEREAS, City bias agreed to engage a contractor, Shannon Heath d/b/a Railroad Construction, duly authorized to perform work within the City's easements, rights -of way, parkways or other public spaces, to perform the Work ("Contractor"); and WHEREAS, the Work is described as follows: Removal of existing railroad tracks, crossties, other track material, and all associated debris located within the rightnof-way on a portion of E Handley Drive as shown on Exhibit "A" attached hereto and incorporated herein, resurfacing of the street with asphalt, and approval of the project by a Street Services Inspector; and WHEREAS, the City has been granted the might to remove and convey said railroad tracks. NOW, THEREFORE, City and Contractor agree as follows: 1. Contractor shall follow all appropriate City specifications and guidelines for performance of the Work, 2. Contractor shall be currently licensed by the City's Transportation and Public Works Department, which includes providing insurance guaranteeing the faithful performance and durability of the Work as described in the license application. 3, Contractor agrees to indemnify and hold harmless the City, its officers, agents, contractors and employees and any person or entity connected with or in privity with them from any and all costs, charges, claims demands, losses, damages, causes of action, suits and liabilities of any kind, including the expenses of litigation, court costs and attorney' s fees, for injuries to, or the death or illness of, any person and for damage to any property arising out of or in connection with the Work including installation of materials or equipment, removal and disposal of debris or damage to the premises, regardless of whether such injuries, illness, death or damages are reasonably foreseeable or reasonably within the contemplation of the parties to this agreement. The terms of this document apply even if such injuries, illness, death or damage are proximately caused by the negligence or other fault of the City of Fort Worth, its officers, agents, contractors and employees. 4. Contractor agrees that its sole compensation from City for said Work shall be the right to own and possess the removed rail road tracks; provided however, that Contractor shall remove said tracks from the work site within ten days of the Work's completion. 5. City agrees to maintain the street upon expiration of the Street and Storm Drain Bond, OFF1CMI. RECORD CITY SECRETARY FT. WORTH, TX 0'1-1 O-1 3 P01 :52 I N 3A11 294) CONTRACTOR: Shannon Heath d/b/a Railroad Construction ckR/444.n /).1) 17/C‘i7LX Contractor's Printed Name S.--Aaht)(v\ eML Contractor's Signature /&// 7�/• Ge.gL Sf Contractor's Mailing Addss (Street) • • 1 • 1 •• ei • .. • • _ 1 l ♦ . . 1 1 _ 1 . 1 . • • r i • `. 1. Dentston b777 750,2, 1 (City, State, Zip Code of owner) M&C: N/A Date: / `ag' ^43 CI1TYO w in WORTH: Thamida.A Fernando Costa Assistant City Manager Recommended By; (v Douglas Wi Wiersig Director, Transportation/Public arks Approved as to Form and Legality: Douglas W. Black Assistant City Attorney Al TEST: Mary Kayser City Secretary • --- OFFICIAL RECORD CITY SECRETARY F'C WORTh, TX 15 30 Feet t:xhAbt "A" Remove old track and crossties, haul off all debris, and repair street crossing with asphalt. N 60 01/kJh/2313 13: 24 DAVID COLEMAN INS AG PAGE Ei11 01 Acorrc,� C " TIFIC T y F LI ILITY 1,. 1,J C 4 DATE(MMmO/YYYY) �.� I 01/08/2013 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the pollcy(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 David Coleman Insurance Agency ACT NAM,±: Cindy Lalsure 1300 W Audie Murphy Pkwy Ste 6 PHONE .w 972-782-6330 I to c, No): 972-782-7734 EMAIL dcoleman f ADDREss• I� armersaigent-corT1 INSURER(S) AFFORDING COVERAGE INSURER At Scottsdale Insurance Company INSURED Farmersvllle, TX 7544-2 972 2;04 Billy & Robert Shannon Heath 1011 W Gandy St Denison, TX 75020 INSURER B INSURER GI INSURER D' INSURER E : INSURER F NAIL # 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. NOTWTHSTANDING 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' -- IADDL'SUBR P6LICY EFF POLICY l;XP LTR I, TYPE or INSURANCE INS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE fl OCCUR ' GE 4'L AGGREGATE LIMIT APPLIES PER: POLICY L I PR0 JrCT LOG AUTOMOBILE LIABILITY ANY AUTO AUTOSALL NED AUYOSULED NON -OWNED AUTOS HIRED AUTOS UMBRELLA LIAR _.•-I EXCESS LIAR I I DED I I RETENT ON $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER(MEMBER EXCLUDED? (Mandatory in NH) (ryes describe under DESCRIPTION OF OPERATIONS below OCCUR CLAIM$ MADE Y/N wvg POLICY NUMBER fMM/DD/YYYY1 IMM/DDMYYY% L11 I L_I 1 IJ NIA n r~ E] CPS1674500 11/15/2012 11 /16/2013 DESCRIPTION OF OPERATIONS / Lc/CATIONS / VEHICLES (Attach ACORD RIM, Additional Remarks Schadula, If more spa co is regplred) Debris Removal -Construction Site CERTIFICATE HOLDER City of Fort Worth 1000 Throckmorton St Fort Worth TX 75020 ACORD 25 (2010/06) CANCELLATION EACH OCCURRENCE DAMAGE TO RENTED P$FSAISES (Ea occurrence) MED EXP (Any one person) PERSONAL 3 ADV INJURY GENERAL AGGREGATE LIMITS $ 1,000,000 $ 100,000 $ 5,000 $ 1,000,000 $ 1,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 $ COM(INEO SINGLE UMIt (Es accident) BODILY INJURY (Perpvrson) BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE (Per Eceidarit ) EACH OCCURRENCE AGGREGATE s ! $ WC STATU- r OTH-f TORY Lj11ZS t Eft E.L. EACH ACCIDENT E.L. DISEASE • EA EMPLOYEEI $ E.L DISEASE - POLICY LIMIT ) $ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR)7PD REPRESENTATIV © E 88.2'b10 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered ma s of ACORD Produced using Forms Boars Web software. www.FormsBoss,com; © Impressive Publiebinsa e00-208.1977 Nguyen, Tai From: Black, Doug Sent: Tuesday, January 08, 2013 2.57 PM To: Nguyen, Tai Cc: Nevans, Catherine Subject: RE UPRR & Handley Drive abandon track removal agreement Importance: High Tale It looks good. Bring it and if I'm not here, leave the copies for or with Cathy Nevans. 1'll take care of getting it to Fernando and to CSO and back to you. I'm heading to council meeting momentarily. db Douglas W. Black Assistant City Attorney City of Fort %Vorth woo Throckillorton Fort Worth, TX 761.02 817 .392. 615 tel. 17.392.8359 fax Doug. Blackufortworthtexas.gOV (please note the new email address as of Oct. 1, 2011) From: Nguyen, Tai Sent: Tuesday, January 08, 2013 2:22 PM To: Black, Doug Subject: RE: UPRR & Handley Drive abandon track removal agreement Doug, Attached is the final agreement package. Please review and let me know as soon as you ok. I then bring 3 copies to your office for signature routing. Question: is it ok with fax copies, the originals will come later, I need to get approve quick to be in time for 1.-10-2013 work window at the IocationThanks Tai From: Black, Doug Sent: Monday, January 07, 2013 10:01 AM To: Nguyen, Tai Cc: Behmanesh, George Subject: RE: UPRR & Handley Drive abandon track removal agreement Importance: High Tai. Here are my revisions — and a clean copy for signatures. My only other question is the insurance. Billy sold to his son Shannon around April last year. The insurance is still in Billy's name. We'II need either a revised insurance certificate, a statement from the insurance company that it's still valid for Shannon, or a copy of the bill of sale showing what Shannon acquired from Billy - and hopefully including the insurance.