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HomeMy WebLinkAboutContract 45470 (2)CITY SECREr CONTRACT N0. L-I5(110 EASEMENT ENCROACHMENT LICENSE AGREEMENT Connnercial. 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 its duly designated Assistant City Manager ("City") or Planning and Development Director, and W I COOK FOUNDATION INC hereinafter referred to as "Licensee", owner of the property located at 6210 John Ryan Drive, Fort Worth, Texas 76132 ("Property"). RECITALS WHEREAS, Licensee is the owner of certain real property described as Lot 11, Block C of the River Hills Addition, an addition to the City of Fort Worth, Tarrant County, Texas as recorded Cabinet B, Slide 1727 of the Real Property records of Tarrant County ("Property"); and WHEREAS, the City has a 10' utility 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 non -illuminated monument sign which will be used to advertise and direct traffic to the facility (the "Encroachment") and which will encroach onto the City's Easement as shown on the attached site plan, Exhibit "B", 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 on Exhibits A and B for the purpose of constructing and maintaining the non -illuminated monument sign (the "Encroachment"). Upon completion of the Encroachment, L' 2012 Easement Encroachment Agreement -Commercial REcrtvrp MAR 2 8 2014 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 Encroachment, 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 Encroachment, Licensee shall submit all plans and specifications to the applicable 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 2012 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 Two Hundred and Seventy Five Dollars ($275.00). Upon execution of this Agreement and annually thereafter, Licensee agrees to pay a fee in the amount of $.56 per square/linear foot of the encroachment area. 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 2012 Easement Encroachment Agreement -Commercial Page 3 of 9 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 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 2012 Easement Encroachment Agreement -Commercial Page 4 of 9 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 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. L icensee 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. L icensee 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. L icensee 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. 2012 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. 2012 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, 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 tcg day of 01/40•CC)/‘- City City of Fort Worth By: Director Planning and Development ATTEST: City Secretary 2012 Easement Encro Licensee: W I Cook Foundation, Inc. 20 1 By: George Montague Vice President of Real Estate Approved As To Form and Legality Assistant City Attorney OFFICIAL FtApRD i crrf SECRETAIR ruvoaThv TX STATE OF TEXAS COUNTY OF TARRANT BEFORE ME, the undersigned au ity, a ►j oj;� P 'l'c in and for t state of Texas, on this day personally appeared 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. GIVE UNDER MY HAND AND SEAL OF OFFICE this / , 20 i . lat APIRT: .1* * 4,- • 1.A CASSANDRA F. FOREMAN Notary Public. State of Texas My Commission Expires April 26, 2017 1 2012 Easement Encroachment Agreement -Commercial day of otary Public in and for the State of Texas CWOMO ECORD V. &U X1 ij ;1 is P ge.8e9-a 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 George Montague, Vice President of Real Estate, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed the same for the purposes and consideration therein expressed, as the act and deed of W I Cook Foundation, Inc., and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 3/ -•urt- day of dauwr,, 20 AL( , et**********oaaetaafrsriliaaepaattgia,aiva►aeraaata *. :P� of Cara Martz Notary Public STATE OF TEXAS My Comm. Exp.03-27-2016 Notary Public in and for the� State of Texas 2012 Easement Encroachment Agreement -Commercial Page 9 of 9 DEDICATION OF PLAT STATE OF TEXAS J COUNTY OF TARRANT J Fs- 97 -199 A1�2 D/lfot4iz Q-' 7a 7 WHEREAS, Cook Children's Medical Center, being the owner of the following described property to wit: BEING a 4.02 acre tract of land situated in the John F. Heath Survey, Abstract No. 641, and being a portion of Lot 1, Block C, River Hills, Phase 1 as recorded in Volume 338-195, Page 8, Plat Records, Tarrant County, Texas, said 4.02 acre tract of land being more particularly described by metes and bounds as follows: BEGINNING at o 5/8" iron pin found at the southeast corner of Lot 6, Block C, River Hills, Phase 1, an addition to the City of Fort Worth according to the plat recorded in Cabinet A, Slide 1853, said Plat Records; THENCE South, a distance of 430.39 feet to a 5/8" iron pin found in the north line of John Ryan Drive (a 68' wide public right-of-way) as recorded In Volume 388-195, Page 8, said Plot Records, said point being the beginning of a non -tangent curve to the left whose radius is 738.00 feet and whose long chord bears South 53' 21' 49" West; 199.39 feet; THENCE along said north line and curve to the left through a central angle of 15' 31' 38" an arc distance of 200.00 feet to a 5/8" iron pin set; THENCE North 44' 24' 00" West, leaving said north line, a distance of 499.06 feet to a 5/8" iron pin set; THENCE North 08' 43' 19" West, a distance of 34.89 feet to a 5/8" in pin set; THENCE North 81' 16' 41 " East, a distance of 125.00 feet to a 5/8" iron pin found; THENCE North 70' 54' 48" East, a distance of 153. pin set; THENCE North, a distance of 107.46 feet to a 5/8 south line of said Lot 6; THENCE South 85' 45' 00" Ea Fong said outh line, feet to the POINT OF BEGh coot ining acres of land more or • DUNAWAY ASSOCIATES, Inc. ffiicnos - rEu-mas - SURVEYORS' real Maf Sao Creek sole !aa rblt Iamb n: PasaS35-7407 tanc e fe /8" iron the thrf;56 46.56 A fl2 --antror/632 NOW THEREFORE KNOW ALL MEN BY THESE PRESENTS THAT: Cook Chl7dren's Medical Center, being the owner of the above described property, does hereby adopt this plat designating the above described property as: Lot 11, Block C RIVER HILLS ADDITION an addition to the City of Fort Worth, Tarrant County, T the owner does hereby dedicate to the public use fore easements shown hereon provided that all utilities the conditions stated herein. WITNESS UNDER MY HAND, THIS THE STA hildrens Medical Center it 998 cknowledged before me on this the I - day of Russell K. Tolman, President of Cook Children's Medical alf of said corporation) diIvrtr(G_Jc titLt..— NOTARY PUBLIC, STATE OF TEXAS .'rt :tLA ( C::AHAM ?Ubto • DUNAWAY ASSOCIATES; Inc. .®v®ems - PLANOIRS - SURVEYORS 1502 arise cbra Stith 200 rot Meth. ICII77-05L7 lies(m»a-xss Building lines will be per the City of Fort Worth Zoning Ordinances. Typical Vehicular Sight Easement at intersection of streets aro 20 feet by 20 feet. Basis of bearings is the cut line of Lot I, Block C, River Rills Phase 1, as ahown on the plat recorded in Volume 358-195, Page B. Plat Records, Tarrant County, Texas. 5/8" iron, set (or all lot corners. points of curvature and points of tangency. NOTE: AU. STREET CREAM THAN AS' IN ROM SHALL REWIRE S➢LW.W210 DC CMHIRUCrm AT 112 TUC ME PROPOift a Otf1Oora M ACCORDANCE WTI STANOMO NOR : }Mt M FOR MA AWo HAVE BUILD PACT FIX A PI TO MOW /Jq 17/11X11. LR.9a MY OMmH OR CNCr It CASON amnc 114 e 89 MD EO,A m MD FROM AND UPON SND EASOAREM DD 1M W W N01NUCfON. CR RUCIIW. AU. ORIPA. PATROLLING. NNTMIMa AND A .0 10 OI MMOMNO AU. al PART Cr ITS 117,12 Sfl1D . LL ATCM14A BC IMAGE ALL OC IN MTgR Nis MA:tWA M or roM M. SHALL Ntu' wo A • PMT OF ANY 7S. m mlmwmNs *eTIM Ct41S1RurnaN. ITfsMT➢CIIK SYSTEMS M ANY OF PfPp]1: AND ANY POLO UTYIY. 111. STALL HAVE Mt NWT Al All REMA/NOER LOT 1, BLOCK C RIVER HILLS, PHASE; VOL 388-195 PG. 8 5/9' IPS N08 43'19 "W 34.89' 125,00 5/8' IPS COOK CHILDREN'S MEDICAL CENTER VOL13048 PG.0149 D.R. T.C. r. NOTE: 15'X15' UTILITY EASEMENT Z_ LOT 6, BLOCK C RIVER HILLS. PHASE; CABINET A, SLIDE 1853 5/9' IPF j0t 5/B' IPF Ir NO WZXCIO P RMNY SAIL DE scum FOR MY LOT IN On PUT OMR =CMSON R MAX FOR Mt CPI- SITUCnON OF MC WATER. Snell. STOW DRAIN STA= I1001 A0 PANIC MPROYDACNIS AND APPROVAL IS WTMNED MOM M OTY OF r00 1121111 ,H Mee. / SVA AC SEMTO! TAWALEEAEASEMENT E PUBLIC OPEN SPACE RESTRICTION (TYPICAL AT ALL INTERSECTIONS) 110 'THEIR. Olinf, OR RAM OC ANY T VE ERCMOINC z•' M HOOC AS0't la: OF COD 110.110112. OUT NOT UNITED RI oNWNDR MOM. MLA SONS THOS. SHRUM CARS, IRUW. CR. MAY moans OC PLAtm OR RFWVSTWOTED IN TIC FOWL OPEN SPACE CAZWFNIS Al SNOT. W MR PLAT. TICK Caw SPAM CA'SSOf , WLL MINN 01 (MOT UNTL VACATED ➢Y ORDINANCE ADOPTED Cy M OTY CWNCL OF FORT WRAP MO 112 ITCPG1Y REPLA11LE OAKMONT BOULEVARD (120' RIGHT-OF-WAY) �� i'�- CND ' ; , r / i / i L07 10, BLOCK C i r S 85f5'OO e "f .. / / EXDINO.. 246.56 - I 5/8' IPF POB 5/8' IPS n"5%I Th EX. VOL10'ESMT. —► VOL. 388-193, PC. B LOT 11 BLOCK C EX, JO'X60' DRN VOL. 388-195, EX. 10'X10' UBL E. 388-195, PC. 1 RIVER HILLS, PHASCI CABINET 6, SUDE 1664 LOT 9R, BLOCK C RIVER HILLS, PHASEI CABINET 9, SLIDE 1164 EX. 15' DRNC & U77L. ESMT LOT 8, BLOCK C RIVER HILLS PHASES CAB/NET A. SUDE 681 LOT 7. :LOCK VER Hl. PH NET SUO 31'38" =738.00' T=100.62' L=200.00' L.C.=55321'49"W 199.39' CERTIF1CATION: Jul 087103� r/Ipry oP mow( 3 STARE or 'CGAS 1 WmW coon that Ihl ➢M.lNMnt nl duly 'late Ant. rattle Chia &ta S lateen by me lume ut TenanRECORDt CIn O ourIN, TOO=DSalimpd d phereon ei 41- "18 /S-147 Lair' xi-, cuUa1VCtEM TARRANT CIWLTCTRUS IJ rWY MNUJIRIITY LEASH H'Hn.r. gE:'PICFS THE S*E RENTAL OP U3E Of THE DESCReEDRB 'Rt gp4Y r,ECAUff OF COLOP ORR4CE IS Ig4LO ANL HttILH .5CEAaE TINDER FEM&LAN I, the undersigned, hereby certify that this map le an accurate representation of on actual eurvsy made on the ground under my direct auperviaian in the month of Aprl, 1998. James E. DoOtte Regtatrred Profanslonal Land Surveyor Tama Registration No. 4673 CITY OF FORT WORTH, TEXAS 01Y PLAN COMMISSION W S TAT Is VALO ONLY r RECORDED WI NN SM (e) MAIMS AFTER DATE or APPROVAL Fs-9/1-/ L%0 -ga lSApp- 98 Data Hbgeo YN J/JAES E. OROTIE 467251 3 ':K • Ss/ SORM 100' \lici\RITTY-torAl DUNAWAY ASSOC$A7ES, INC. 1501 MERR/MAC CIRCLE /700 FT. WORTH, TEXAS 76107 (817) 335-1121 OWNFR/DEVELOPER' COOK CHILDREN'S MEDICAL CENTER 810 77H AVENUE FORT WORTH, TEXAS 76104 (817) 885-4000 0 I MY — SCALE 1' 100• 7m' A Final Plat Of Lot 11, Block C FEET 100' RIVER HILLS ADDITION Being a replat of a portion of Lot 1, Block C, River Bills, Phase 1, as recorded in Volume 388-195, Page 8, Plat Records, Tarrant County, Texas, situated in the John F. Heath Survey, Abstract No. 641 in the City of Fort Worth, Tarrant County, Texas THIS PLAT FILED IN CABINET a, SLIDE NO. / ..77 DATE: _ _ 7'-8" 5" 311 3" 5'-011 EQ. EQ- CookChildren's Southwest Center s Cook Children's Pediatricians/Services Carol Brennan, M.D. 101 Alice Phillips, M.D. 101' • Rebecca E. Olvera, M.D. Marcus O7 eta, M.D. • Joyce ti, M.D. • Behavioral Health Orthopedic Surgery and Pediatric Surgery 107 • Southwest Radiology 105 • Fort Worth Pediatric Dentistry • Bruce H. Weiner, D.D.S. 100 Janell I. Plocheck, D.D.S. 100 Nathan G. West, D.M.D. 100 • LabCorp _ 110 • Brett L. Cochrum, M.D. 109A • John Young, M.D. 109 104 104 104 106 Mallktn111Scale: 3/4" =1'-0" Signage Innovations Environmental Signage Solutions 8181 Jetstar Drive Irving, TX 75063 www.asisignage.com Project Location Sign Type Qty. Fabricated aluminum cabinet with surface applied vinyl graphics, direct buried in concrete pier. Removeable inserts attached to cabinet with countersunk screws through face. Concrete mow strip Cook Children's Southwest Center Ft. Worth, TX Monolith (double-faced) 1 List of names revised. List of names revised. Revisions Side View AK 11/25/13 AK 11/18/13 By Date DALL-16863 Item: 1 Material Description: Fabricated aluminum cabinet, with removeable inserts. Graphics to be surface applied, double -laced graphics. Image colors: Logo = 3M Scotchcal 230-167 Blue 3M Scotchcal 230-15G Vivid Green Copy = 3M Scotchcal 220-10 White Font: Universe 67 Bold Condensed Badtground Colors: Top = SC-901 White Bottom = SC-122997 Cook's Interstate Blue Mounting: Direct Burial in Concrete Pier. i-8„ .IBIHX� Project Manager: Mike Richardson Client: Cook Children's Med Center File fr Location: •2013 PROJECTS •Southwest Center •2 - SHOP DRAWINGS •"SW Center 92x60 Ext Cabinet.ai" Notes Thle drawing le the property of ASI SIgnog. Innovations. This drawing le submitted under a confidential relationship for a specified purpose and the recipient, by accepting fills document, 1.311171113 custody and agrees Thal this document will not be copied or reproduced In whole or In part, nor Ito canlenls revealed In any manner or to any pecan except to meet the purpose for which II was delivered without express written permission }TOMAS! Signage Innovations. Date 10/01/13 Scale As Noted Drawn By AK Sheet 1 of 2 Dwg. No. DALL-16443-00.1 7'-8" v 2" 3" NI Signage Innovations 5'-0" 6" ;H t JT J t 4'-10" 10" a --r Environmental Signage Solutions 8181 Jetstar Drive Irving, TX 75063 www.asisignage.com 1"x1"x1/8" aluminum tubing 1/4"th steel plate bolted to aluminum structure. 3" schedule 40 Project Cook Children's Southwest Center Location Ft. Worth, TX Sign Type Monolith (double-faced) Qty. 1 2"x1"x1/8" aluminum tubing Concrete mow strip Concrete pier Revisions 6" H ll 10" By Date GALL-16863 Item:1 Material Desaiptiom Fabricated aluminum cabinet well removeable inserts. Graphics to be surface applied, double-faced graphics Image Colors: logo = 3M Scotchal 230-167 Blue 3M Scotchal 230-156 Vivid Green Copy = 3M Smtdial 210-10 White Font universe 67 Bold Condensed Background Colors: Top _ 5C-901 White Bottom = SC-122997 Cook's Interstate Blue Mounting: Direct Burial in Concrete Pier Project Manager: Mike Richardson Client: took children's Med Center File & Location: •2013 PROJECTS •Southwest Center •2 - SHOP DRAWINGS -"SW Center 92x60 Ext Cabinet-ai" Notes This drawing lithe properly olAg/ Sign..Innova"ans.mis drawing Is submitted under a conndenlw relationship for e specified purport and the recipient, by accepting this document, assumes custody ad agrees That th i document Mil not be copied or reproduced in whole coin pen, nor Its contents weeded in any manner or10 any person ',mantra meet the purpose for which It was delivered without express written permission from ASI Signage lnnedlons. Date 10/01/13 Scale 3/4" =1'-0" Drawn By AK Sheet 2 of 2 Dwg. No. DALL-16443-00.1.1 Rol CERTIFICATE OF LIABILITY INSURANCE ( DATE:1/30/14 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 Strategic Risk Solutions Governors Square 2nd FI., Bldg. 3 23 Lime Tree Bay Avenue P.O. Box 1159 KY1-1102 Grand Cayman , Cayman Islands INSURED Cook Children's Health Care System 801 Seventh Avenue Fort Worth Texas 76104 - 2796 CONTACT NAME: PHONE I FAX INC. No, Ext): I (AIC, No): E-MAIL ADDRESS: PRODUCER CUSTOMER ID #: INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: INSURER(5) AFFORDING COVERAGE Cook Children's Indemnity Company 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, 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 ADDL SUBR POLICYEFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYY) LIMITS GENERAL LIABILITY A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X I OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: J POLICY I I PROJECT I I LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS EXCESS LIAB DEDUCTIBLE $ RETENTION $ OCCUR CLAIMS -MADE WORKERS COMPENSA1 ION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN I X CCICGL201314 10/1/2013 10/1/2014 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: In connection with various Encroachment Agreements between the City of Fort Worth and Cook Children's. This certificate does not amend, extend or alter the coverage afforded by this policy. CERTIFICATE HOLDER City of Fort Worth 1000 Throckmorton Fort Worth, Texas 76102 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS/COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE tiVC ITORY LIMITS E.L. EACH ACCIDENT �OTH- JER $ 1,000,000 $ 50,000 $ 0 E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ 1,000,000 5,000,000 5,000,000 CANCELLATION 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 ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ©1988.2009 ACORD CORPORATION. All rights reserved.