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HomeMy WebLinkAboutContract 47019 (2)k� SA, CONTRACT NO. EASEMENT _ENCROACHMENT LICENSE AGREEMENT Co»mzei'cial THIS AGREEMENT is made and entered into by and between TFIE CITY OF FORT WORTH, a home rule municipal corporation of Tarrant County, Texas ("City"), acting by and through its duly authorized Planning and Development Director, and Spelunker Properties 1'?, LLC, a Texas limited liability company, hereinafter referred to as "Licensee", owner of the property located at 9509 N. Beach St. Ft. Worth, Texas 76244 ("Property"). RECITALS WHEREAS, Licensee is the owner of certain real property described as (Sage Medical Plaza), an addition to the City of Fort Worth, Tarrant County, Texas as recorded in County Clerks Document No. D215145788 or Volume and Page No. of the Real Property records of Tarrant County ("Property"); and WHEREAS, the City has a 35 foot wide slope 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 183.83 L.F. of retaining wall, 16 parking stalls, and 85 L.F. sidewalk which will be utilized by Lot 4, Bik 1 (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 terms 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 performed 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 for the purpose of constructing 183.83 L.F. of retaining n'all, 16 parking stalls, and 85 L.F. sidewalk (the "Encroachment"). Upon completion of the Encroachment, Licensee agrees 2014 Easement Encroachment Agreement -Commercial OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX i Page 1 of 9 to be responsible for maintaining any and all structures and buildings within and above the Easement. Licensee 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 Encroaclunent, use and occupancy shall comply and be performed in strict compliance with the Charter, Ordinance and Codes of the City and in accordance with the directions of the Director of the Transportation and Public Works Department or the Director of the Water Department of City, or his duly authorized representative. Prior to the construction of the Encroaclunent, Licensee shall submit all plans and specifications to the applicable Director or his duly authorized representative. Licensee shall not commence construction of the Encroaclunent 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 fixture 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 2014 Easement Encroachment Agreement -Commercial Page 2 of 9 Works or the Director of the Water Department of the City, or his duly authorized representative. 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 encroachments and uses provided for by this Agreement, Licensee agrees to pay to City at the time this Agreement is requested an application fee in the sum of Three Hundred and Twenty Five Dollars ($325.00). 5. The term of this Agreement shall be for thirty (30) years, commencing on the date this Agreement is executed by the City of Fort Worth. Provided however, this Agreement shall terminate upon the non-compliance of any of the terms of this Agreement by the Licensee. City shall notify Licensee of the non-compliance and if not cured within thirty days this Agreement shall be deemed terminated. 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. 2014 Easement Encroachment Agreement -Commercial Page 3 of 9 7. LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS 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. 8. 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 written notice to the Building Official of the City of Fort Worth. A copy of such 2014 Easement Encroachment Agreement -Commercial Page 4 of 9 Certificate of Insurance is attached as attached as Exhibit "B". Licensee agrees to submit a similar Certificate of Insurance annually to City on the anniversary date of the execution of this Agreement. Licensee agrees, binds and obligates itself, its successors and assigns, to maintain and keep in force such 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. 2014 Easement Encroachment Agreement -Commercial Page 5 of 9 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 is not a conveyance of any right, title or interest in or to the Easement nor is it meant to convey any right to use or occupy property in which a third party may have an interest. Licensee agrees that it will obtain all necessary permission before occupying such property. 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. 2014 Easement Encroachment Agreement -Commercial Page 6 of 9 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 Planning and Development Director, and any attempted assignment without such written approval Should be void. 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 sm day of ct City City of Fort Wtrth By: (4m - v Randle I.. arwood, Director Planning and Development ATTEST: lir a City Secretary 1 ( • berm- , 20 /5 Licensee: Spelunkers Properties VI, LLC By: - f*R-Name: Aktr Title: pi -tics Approved As To Form and Legality 10 %Act is Assistant City Attorney 2014 Easement Encroachment Agreement -Commercial 'PRIMAL RECORD Page 7 of 9 �,l f ';-ttirj 1 i =i1-Fi Li „-0:; �yf31T; ' J. 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 one 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 North, and in the capacity therein stated. G VEN UNDER MY i-A D AND SEAL OF OFFICE this day of is in and for the State of Texas OFFICIAL RECORD CITY SECRETARY ET. WORTH, TX 2014 Easement Encroachment Agreement -Commercial Page 8 of 9 STATE OF TEXAS COUNTY OF TARRANT t§ 5 BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, o11 this day personally appeared Timothy E. Ritter, AID., President, 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 Spelunker Properties VI, LLC, a Texas limited lir�bility company, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 2 day of SeecterALlie , 20 . WESLEY JOHNSTON MY COMMISSION EXPIRES March 2412018 Notary Public m and for the State of Texas sFFIe)DAL RECORD CITY SECRETARY 7T. WORTH, TX 2014 Easement Encroachment Agreement -Commercial Page 9 of 9 LOT 4 4' SIDEALK ENCROACHMENT AREA 16 PROPOSED PARKING STALLS '35' SLOPE EASEMENT 115.7 9' .e ea5.99° oe 2�T. ENCROACHMENT AREA 183.83 L F OF PROPOSED RETAINING WALL 35 SLO CITY OF INST . NO . D 1 C .JOT EASEMENT WORTH—: 12271300 .C.T 25' 7.1 • 11 11 ENCROACHMENT AREA 85 L . F . 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F9el G97 43 FG CSG,91 FG G57 94 Ft G97 00 FG GDG.45 FG G99 90 FG 07 40 TC PROPOSED PUBLK SANITARY CCWCR 697 37 FG G97 A7 TC G00.00 KG 00.50 FG an Dr coin wart. INii N. t: z LOT Or4r<' TO.^ a? TC G9G 20 FG] 9 G9G SO FG CO7 L4 FG C913 00 FG SEE SIDEWALK DET4IL� THIS SHEET PROPOSED PRIVATE STORM DRAIN COG .07 FG G47A2 PG GDG,7I FG C9G GO FG 696 G9 G9G.G7 FC C97 b7 FC G00.07 TC G97 70 TC GOG CO FC PTKOSED PRIVATE G•cG FG C97. 33 ICI ▪ 7 ICI :SIDEWALK DETAIL GIG FG Gs5 PG OF 00 FG 70/00 to Ft - FG 702 FG 01 nO FC caa.ob FG GO .54 TC G07.00 PG RETAINING WALL BY OTHERS OZ 07 I Lb co 101 70G.03 TW 7013.73 TW (CAUTION. °VOTING 12' WATER LINE iNN CAUTION It ExtriONC. uTLITts ARC INDICATED ON TIC MAIM RCOPONSIDILITY or MC CONTRACTOR TO VOW,' TIC PROMPTLY Of ALL COMICT5 Of '11•C WORK WITH gi REVISIONS 0010444004 CONSTRUCTION NOTES 0 NOT I-Ctis CONOTROCTON No. ouRINIK u. i HORIZONTALS: VERTICAL CONTROL -.▪ 7 Orr Mira xxXX WI NO N/A DIN Oi re- xxx CITY OF FORT WoRTI I. TEXAS .ntm:srioRIATION AND PUltile WORKS kCi CAPITAL PROJECTS DIVISION -a- WIER S. ASSOCIATES. ENC. SAGE MEDICAL PLAZA GRADING PLAN IL or 34 SAGE NIED.CAL 'LAZA DESIGN, SPECIFICATIONS, AND GENERAL NOTES GootochnIcal Information: THu (WWINMwal Cosign Is Mod angoW& nlallolanalat taken Erma' Tetracen Protect no. 93145113. no dadsbn nnallvertoa*laln a arasxadtg&Xxnn'W report !and the chokeolrotalnlrya a#daobnb mHodyna paler and dr dent, eared upon carym'ttbeadeN:RWN beamed Platut naegabla ask, Sol typo. rrra'NrvJ wan DaatnaV/. a:ncturaf Scams, etc. MansoneandtdIAefits Ask altar aaNemant aMrorMavinru aetoctaarowe d e wet otnrsnkla walk nndtnenlooyaxh tnTh as et Mk wtanlrytnmdnbn. A afobat*Matem mats* Lem owns Vow has aeon pmfam,MOy Tomuon Conti/tub Design la In compliancy with IBC aoctton 1610 Motor/al Strongtha and Properties: OecWut COvitent FNN Pteasve: 70totite atom wows: Ow. a SW near maw TYps (TN +lcoo Fat) Existing UtDINoz Lacr'n0 en oohing IAttnwnoM+la t. ImpoI oaInds stMat lotTht prole& TM eadador*EwNat 1-00Wfptnt harts ee0191J1p1tame+MM+to vat IRA IYJfnn INW Say nR.s. Cmlatt N, Glynaail the leu4wi(e)weag.J.Vg unle.MmNneatdtanamdwfi1 wn/cacanaMt Na Tor so•rol",^1. br Wt venS,Her, Silo Conditlont: Tht ntanig vat Omit bated o1 sits tandma a t lwaMG by dw d.et NW xmI Ant INN atpec ma tn.-Nun b.m main by Uft mglntatg Noy It any: ache s er nev.Uonh btcuf within I.ant Inn the lW ply Ohm.NMo watl,Noldy this Cnynwttor rncemnmGUant. Tomporary S1Cpoa: Temporary clops by ca W scar oagevofppa. as taqulred la aMny. T.mpomy ceps In MI or nnWntM shall be t&a&Wtsd p&cbb Ctynea ii apeatalens Drain: On Mainly wow IL Han or Ins, We4'aemm&N CAD: pnfomlad pope may be emlaot. but Lie paondal oma mast s41 br wmppd %kb NErari 9 N 9aosynUafe (&egwpprd Nor (or a•) Ihru face darn pp Poland Flit An an behind gtoncele Mleramin lobe MINX Je fis Ch of ogsnitt and NANININNnnbdNt- taopa,bd In tat TOCa a.Wedlghal os tomiNmm 90Ja &a pacer al (./-) Xo4 of pcxtM n aatatn Conant COIINSCUOflhtit b/ omen. No ma 40ai dWnNan p- mlbwxndmnnm Up 4ama ]mallet lack tot tidmaUna Conhoi Joiner. Ccn:InO.on/ lomponlwe ION are rerOMMeited ot2 of (maxi Maintenance and Manaaomant Lotter: Accompanyby Orally .Senn RNtNwoNla MNntmencs9M Mwla'amaW Ian& Is pod of move yam ono :sectC Was. cooiatl Ow *MG <a copy or ma en&rc ngo00 Inspection Roqulremonta and Recommendations: Theca MspLctIons wut be performed by of tor ben &anon at ba deign Cryroot. I. pmcoaWucam MN InspactM to delellnint it any eeeopllonal caldtione ens' Inn cou'd seed lea onaML.s wall deagt IntplCban le mLStW Win aubbato. (Nwslev (been worn nno nmbnaonm mom). Oee+y. W OCp emconnl. ,1Ds dram plpu IRA ttva oMaceda tog. 3. Inapocpol:otroika the gtmyMlcltLION deln (nJudrg proud Munn ate), A Irdpnctlen lonM9w Mal grWna te *Mt/4h Nora m1ttp. NI wells With helams equal tea pool& cup. Mug Int mu have nn klapt'Im pno doad cadet :upon/bk., W mit o/pnoof am) mind maei NRMItaMrNoly rtgwrrnwixt GRAVITY STONE RETAINING WALL NO SCALE REAR Or WALL MAY .SLOPE TO CAP (1 P.' MIN) OR DE VORTICAL DRAINAGE SWALE BEHIND WALL SLOPE MOH GRADE TO SWALC AT TOP OF WALL. SLOPE SWALE TO DRAIN WATER (ROM DCHrNO WALL NOTIFY THIS ENGINEER ir CRAM SLOPE 13 GREATER THAN 4: I. SEED ALL SLOPE^.. 4:1 OR LCa5. ItGTALL CORTEX (OR EQUAL) SLOPE PROTECTION ON storm GREATER TITAN 4:I . I r THICK LAYER or ON --ATE CLAY ORSIMIIAR TO COVER rum DRAIN. THIS CLAY LAYER 1S TO EXTEND A MINIMUM Or 8'-0 BEHIND THE RETAINING WAD.. WRAP expose° RUBBLE STONES WITH MIRAPN 140 N GCOSYNTHETIC (OR EQUAL) - LAP AT Tor AND BOTTOM A5 SHOWN. ir ALTERNATE CCOSYNOIETIC 15 TO BE USED. A COPY or TNC TECHNICAL DATA SHEET FOR THE ALTERNATE GCOSYNLHETIC MUST BE PROVIDED TO OUR PIP&, FOR REVIEW. CONTINUOUS -r DIAMETER N 12 ACTS PERFORATED are - TO BE INSTALLED AT. OR SLIGHTLY ABOVE. PENAL GRADE. IF PARALLEL OR,THRU PACE DRAINAGE CANNOT DC ACHIEVED, NOTIY THIS ENGINEER RUBBLE STONE AREA BELOW PVC CRAIN art TO DC SURrACED WITH MORTM TO FORM SMOOTH BASE FOR rvc DRAIN PIPE EXPOSED PACE IF USED. OPTIONAL I X 4 REDWOOD JOINT MAY REMAIN OR ee REMOVED rt,M,IL POLY RUNNING CONDNUDUS ALTER MORTAR SCR) fi} (THRU RUBBLE STONE AND tACC STONE) 114j1 - OR ATTACHED TO REAR OF REDWOOD P) (AT PACE STONC)AND CONTINUO TO REAR Or WALL STONE CONTROL / EXPANSION JOINT NO SCALE VARIES (1r MIN.) t w G' TtOCX (TYPICAL) PACE STONE VENEER. RUBBLE STONE WITH T1TC'5' MOWN. POROUS DRAIN AMA (RUBBLE STONE WITHOUT MORTAR - G` MINIMUM 1MOTH AT. BASE. G' MINIMUM WIDTH AT Tor) neVIZKNI: me I N Oar I OftCaIVnou 1 M1 lv.•> 1M1NLLOYW11URal.p1ta.IMY1Y 4' DIAMETER PVC DRAM PIPE AT 72' O.C. MAX. OR 2' DIAMETER I VC ORAN PIPE AT 48' 0 C MAX SLOPE TO DRAIN. EXTEND DRAIN PIPE THROUGH GiOSYNTHLTIC INTO GRAVEL DRAIN. IF WATER 15 DRAINED now OR OVER WALL CONSTRUCT A CONCRETE SPL A. n BLOCK 3' WOE X 4' LONG X G` THICK (SPLASH OLWCr MAY BE CONSTRUCTED Or GRAVEL. CONCRETE OR DTONC AND MORTAR). store CRADE AT CASE rog DRAINAGE AWAY rzoM WALL - MAX. SLOPE 4:1 - NOTIFY THIS ENGINEER Ir EROSION CONTROL 15 REQUIRED OR IF SLOPE IS GREATER THAN 4:1 DRAIN SLOPE TO Be CONCAVE ( 2 MIL PVC POND UNCZ Dr -OW _arvi:Al CLOCK WALL DIMENSIONS TABLE I HCIGNTADOVC cRADE WIDTH OF DACE OEPTIi BELOW CRADC` DEPTH SLOPED TOE' TOTAL HOOKY OF WALL— A 0 c 00 2'-0' 4f-0* 5'-01 G-O' '-6. 2'-0. 2'-C" 3•-3` .'.=9• '-0' 1'-O• ) '-O' 1'-O' 11-G• C` 0'-8• •-1 Os I •CP ) 3• 'A ' 1LS't O'-GI G. 2'-0" 3'-C 411-6` Ss- 0' ' MINIMUM DEPM. UNLESS WCK 15 ENCOUNTCP.ED. UPON ENCOUNTERING ROCK - NOTIFY THIS ENGINEER EMBEDMENT DEPTH TO BE INCRF.ASWD l'.0 ALONG PLOODPW N DUe TO POTENTIAL SCOUR. ENGINEER II5PECTION or WAIL MAYBE RCOUNRCD DY toot MUNiCU'MJW, Ronr y AN() SCHEDULE IN5PECTIan :NTH ENGINEER IluOR TO COMMEIICItIC CONSTRUCTION, 7•-0' 8.-9' " TOtAI HEIGHT OP WALL INCLUDING HEIGHT ABOVE GRADE AND DEPTH OClO'N GRADE. SCE GRADING PLANS BY IMCR /SSOCIATLS• INC. ( PROJECT n 14 120 DATED 08-05.15) I'OR WAIL HEIGHTS' T LOCATIONS. RETAINING WALL NTS Du _ _ ta t•S DAL U z z 0 0 cc 1- z 0 tJ N cc 2 0- W U Li 0 UJ F uarc LDQ Gi cc cci— cc J_v J00 Su� I NORTH BEACH STREET D015-0212A turn rt1 A R© CERTIFICATE OF LIABILITY INSURANCE 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 pollcy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to the terme anti conditions of the policy, certain policies may rectulro an endorsement. A statement on thls certificate does not confer rights to lho certificate holder In lieu of such endorsement(s). ir PRODUCER CNAME` MADELEY & COMPANY t,Q N tAx Kam I (NG, Not 4144 N, CENTRAL EXPRESSWAY ADDRESS: SUITE 410 DALLAS TX 75204 INSURED SPELUNKER PROPERTIES VI, LLC 701 BETHEL SCHOOL ROAD DATE (MMID D/YYYY) 08/24/2015 INSURERIS)AFFORDING COVERAGE INSURERA: MOUNT VERNON FIRE INSURANCE COMPANY INSURER B : INSURER C : INSURER D: INSURER E: COPPELL TX 75019 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR aV VLDVan ruuur trt• Puu y'r eM' LIMITS LTR INSD WVD POLICY (MM/DDIYYVY) (MMIDD/YVYY) _ _ IV EACH OCCURRENCE S 1,0001000 upnwucIli ncrrtcu 100,000 PREMISES (Ea occurrence) $ MED EXP (Arty one person) $ 5,000 A TBD 08/25/2015 08/25/2010 PERSONAL BADV INJURY $ 1,000,000 NAIL # TYPE OP INSURANCE _ COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE Q OCCUR �GEN'LAGGREGATE LIMITAPPLIES PER: { POLICY jE LOC 11 OTHER: AUTOMOBILE LIABILITY 1-1 ANY AUTO ALL OWNED AUTOS HIRED AUTOS UlADRELLALIAB 1 EXCESS LIAR SCHEDULED AUTOS NON -OWNED AUTOS OCCUR CLAIMSMADE DED I J RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPR ETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS belay It/A GENERAL AGGREGATE $ 2,000,000 PRODUCTS -CO/AP/OPAGG $ INCLUDED 1:U.11biNcU OIUULt uMl t (Ea accklenl) BODILY INJURY (Per person) EOOILY INJURY (Per accident) PHU:4Ni Y uAMAtit (Per accident) EACH OCCURRENCE AGGREGATE { STATUTE I d ERH EL EACHACCIOENT $ E,L DISEASE • EAEMPLOYETJ $ E.L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (..CORD 101,AddMonal Remarks Schedule, may beet -bathed It more apace Is roqu rod) TEMPORARY LOCATION ADDRESS: 9495 N BEACH STREET KELLER, TX 76244 CERTIFICATE HOLDER CANCELLATION CITY OF FORT WORTH 1000 THROCKMORTON STREET FORT WORTH TX 70102 ACORD 25 (2014/01) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES DE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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