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HomeMy WebLinkAboutContract 45083-A1 (2)RECEIVED DEC 19 2013 CITY SECRETARY 1 CONTRACT P10. ASSIGNMENT AND AMENDMENT OF ENCROACHMENT AGREEMENT City Secretary Contract No. 45083 I .. •..•gal THIS ASSIGNMENT OF ENCROACHMENT AGREEMENT ("Assignment") is made and entered into as of this day of ile ep vn b# v2013, by and between the CITY OF FORT WORTH, a Texas home -rule municipal corporation ("City"), Medical Plus Supplies, Inc., a Texas corporation ("Assignor"), and Texas Health Resources, a Texas non-profit corporation ("Assignee"). (Sometimes City, Assignor and Assignee are referred to individually as a "Party" and collectively as the "Parties"). WITNESSETH: WHEREAS, the City entered into an Encroachment Agreement, City Secretary Contract No. 45083 (the "Encroachment Agreement") with Assignor, the owner of certain real property more particularly described in the attached Legal Description (the "Property") located adjacent to or near the City's right-of-way on which the encroachments are located. The encroachments are more particularly described in the Encroachment Agreement and are sometimes called therein and herein the "Improvements"; WHEREAS, the Encroachment Agreement, filed on November 8, 2013 and recorded as Instrument No. D213290373 in the Real Property Records of Tarrant County, Texas, is attached hereto as Exhibit "A" and incorporated herein by reference as if set forth in full; WHEREAS, the description of the Improvements in the body of the Encroachment Agreement inadvertently did not include certain of the encroachments as shown on the survey plat of the Property; WHEREAS, Assignor has sold the Property to Assignee on December 1, 2013 as evidenced by a deed recorded as Instrument No. D2/_ Rg! o / &(rin the Real Property Records of Tarrant County, Texas; and WHEREAS, the Parties wish to amend the Encroachment Agreement to clarify the description of the Improvements and Assignor desires to assign the Encroachment Agreement to Assignee. AGREEMENT: NOW, THEREFORE, for and in consideration of the above and foregoing premises and the mutual covenants, t erins and conditions herein con tained, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties hereby agree as follows: 1. The description of the Improvements in paragraph 1 of the Encroachment Agreement is amended to read as follows: CSC No. 45083 Consent to Assignment Right of Way Encroachment Agreement Medical Plus Supplies, Inc. P11' GF /W2 (ccJz'ei QFFIGIALaRECORD QLLtYlSgQJ1ETARY PT. WORTH, TX "Building canopy, steps, concrete wall, portion of parking space and driveway over the westerly line of the Property into the 65 0 foot Public Right -of Way of 6th Avenue" 2. Exhibit "A" attached to the Encroachment Agreement is hereby deleted and replaced with the attached Exhibit "A" Revised 11/2013. 3. Assignor hereby assigns, transfers and conveys all rights and interests and delegates it duties and obligations under the Encroachment Agreement to Assignee. 4. Assignee hereby accepts the Assignment granted herein, and assumes all of Assignor's rights, duties and obligations arising under the Encroachment Agreement. 5. Assignor has full right, power and authority to enter into this Assignment, to make the representations set forth herein, and to carry out Assignor's obligations hereunder. Assignee has the full right, power and authority to enter into this Assignment, to make the representations set foith herein, and to carry out Assignee s obligations hereunder. 6. The effective date of this Assignment shall be the date of its execution by the City (the "Effective Date"). All rights , duties and obligations under the Encroachment Agreement arising, accruing or relating to the period before the Effective Date are allocated to Assignor and all rights, duties and obligations arising, accruing or relating to the period thereafter shall be allocated to Assignee. 7. Except as otherwise expressly set forth in this Assignment, Assignor will be discharged from any and all further obligations under the Encroachment Agreement as of the Effective Date. 8. Assignor represents warrants and covenants with City and Assignee that as of the Effective Date, Assignor is not in default of any of its obligations contained in the Encroachment Agreement. 9. City hereby consents to this Assignment upon the terms and conditions set forth herein. Unless and until City has executed this Assignment, it is of no effect. The consent granted herein should not be construed as consent to any further assignment The failure or delay of City in seeking to enfoi ce any provision of the Encroachment Agreement or this Assignment shall not be deemed a waiver of rights or remedies that City may have or a waiver of any subsequent breach of the terms and provisions therein or herein contained. 10. Any notice given by any Party to another Party must be in writing and shall be effective upon receipt when (i) sent by U.S. mail with property postage, certified mail return receipt requested or by a nationally recognized overnight delivery service, and (ii) addressed to the other Party at the address set out below or at such other address as the receiving Par5ty designates by proper notice to the sending Party. CSC No. 45083 Consent to Assignment Right of Way Encroachment Agreement Medical Plus Supplies Inc. Page 2 of 6 Rev 11/2013 City Planning and Development Department 1000 Throcicmorton Street Fort Worth TX 76102 Attention: Director Assignor Medical Supplies Plus, Inc. 13529 South Post Oak Road Houston TX 77045 Attention President Assignee Texas Health Resources 612 E Lamar Boulevard Arlington TX 76011 Attention: Vice Piesident, Real Estate Operations 11. Except as herein otherwise provided, this Assignment will be binding upon and inure to the benefit of the Parties and their respective successors and assigns. 12. Assignee shall cause this Assignment to be filed of record at Assignee's expense in the Real Property Records for Tarrant County, Texas. 13. The Certificate of Insurance for the Assignor attached as Exhibit "B" to the Encroachment Agreement is hereby deleted and replaced with the attached Certificate of Insurance from the Assignee as Exhibit "B" Revised 11/2013. 14. All terms and conditions. of the Encroachment Agreement not amended herein remain unaffected and in full force and effect, are binding on the Parties and are hereby ratified by the Parties Capitalized terms not defined herein shall have meanings assigned to them in the Encroachment Agreement. 15. This Assignment may be executed in multiple counterparts, each of which shall be deemed an original, and all of which, when taken together, shall constitute one and the same document which may be evidenced by one counterpart. [SIGNATURES APPEAR ON FOLLOWING PAGES] CSC No. 45083 Consent to Assignment Right of Way Encroachment Agreement Medical Plus Supplies Inc. Page 3 of 6 Rev 11/2013 ASSIGNOR: MEDICAL PLUS SUPPLIES, INC., a Texas corporation By: 7ta a Name: Esteban Rodriguez Title: president STATE OF TEXAS COUNTY OF e as the President of Medical before me by Esteban Rodriguez, This instrument was acknowledged ASSIGNEE: TEXAS HEALTH RESOURCES, a Texas nonceprofit corporation By: Name: Jon M. Sullivan Title. Vice :President, Real Estate Operations s car oration, on behalf of said corporation, Supplies plus, Inc., a Texa p [NOTARIAL SEAL] /" �,es,zifa ,....a Notary Public, State of Texas ANA E. RODRIGUEZ Notary Public, State of Texas My Commission Expires August 28, 2016 STATE OF TEXAS § XAS § Co T'Y' OF TARRANT § Operations of Texas Health Resources, a Texas Estate '�,� as the Vice President Real s marled ed before me by Jon Sullyoration. This instrument was ackno g non-profit corporation, on behalf of said carp Qp p Notary Public, State of Texas [NOTARIAL SEAL] CSC No, 45083 Consent to Assignment Right of Way Encroachment Agreement Medical Plus Supplies, Inc. Page 4of6 Rev 11/2013 ASSIGNOR: MEDICAL PLUS SUPPLIES, INC., a Texas corporation By: Name: Esteban Rodriguez Title: President STA'I'E OF TEXAS COUNTY OF ASSIGNEE: TEXAS ` EA TH RESOURCES, a Texas non-oth corporation By: Name: Jon M. van Title: Vice Pres nt, Real Estate Operations This instrument was acknowledged before me by Esteban Rodriguez, as the President of Medical Supplies Plus, Inc., a Texas corporation, on behalf of said corporation. Notary Public, State of Texas [NOTARIAL SEAL] STATE OF TEXAS COUNTY OF TARRANT This instrument was acknowledged before me by Jon Sullivan, as the Vice President Real Estate Operations of Texas Health Resources, a Texas non-profit corporation, on behalf of said corporation. Notary Public, Stateof Tex s { [NOTA_JAL SEAL] • -WI'"MI "Or CSC No. 45083 Consent to Assignment Right of Way Encroachment Agreement Medical Plus Supplies, Inc, Page 4 of 6 Rev 11/2013 APPROVED AS TO FORM AND LEGALITY: 04_24 ate Assistant City Attorney ATTEST: City Secre(aj [No M&C Required] STATE OF TEXAS COUNTY OF TARRANT CITY OF FORT WORTH .Ran1 dle Harwood, D recto Planning and Deveopment Date: itte)- /9.` 13 car This instrument was acknowledged before me on lairtsitst, as the Director of the Planning and Developme t Department of the Ci Texas municipal corporation on behalf of the City of Fort s rth. [NOTARIAL SE p v P 9i ? a• ••. _ • i �•• • ns °i7••• ••• }� T• `� CASSANDRA F. FOREMAN Notary Public, State of Texo=. My Commission Expires April 26, 2017 CSC No. 45083 Consent to Assignment Right of Way Encroachment Agreement Medical Plus Supplies, Inc. otary Public, State of • epartment DMA' of Fort Worth, a OFFICIAL RECORD , MI TX SECRETARY WORTH, IX ; nige--5- Rev 11/2013 LEGAL DESCRIPTION OF THE PROPERTY Lots 97 98, 99 and 100 of J A LEE'S SUBDIVISION OF BLOCK 8 OF FIELD -WELCH ADDITION, an Addition to the City of Fort Worth, Tan ant County, Texas, according to the Plat thereof recorded in Volume 256, Page 484 of the Deed Records of Tarrant County, Texas. CSC No. 45083 Consent to Assignment Right of Way Encroachment Agreement Medical Plus Supplies Inc. Page 6 of 6 Rev 11/2013 14.8' 1 SANITARY SEWER MANHOLE NO PARKING SIGN 65.0' PUBLIC RIGHT--OF-WAY Parking Space Concrete Wall 0 N el W -a Z E-- cn W w .•- > Lid > CCo te . 1-- 8 w r CC Q Steps k n. ci 03 in OQ _ i"" F--- W Stucco Canopy WATER ..Al METER NO PARKING o SIGN CONCRETE SIDEWALK CONCRETE OO°C)8'42"E z 1 1 1 1 I 1 1 Io I� Ij to 1 1 1 1 I 1 1 1 1 /2" IRON ROD SET MARKED "BRITTAIN Se CRAWFORD" r 1 I c3 IUr 0 to 1 8 1 0 0 eei M COVERED 12.7' 1 1 1 to liwa. 4.9 FACE OF BUILDING • 0.2' EAST OF PROPERTY LINE EXIT ONLY ., SIGN A 1 r7 CONC a el OF ONE ST( 911 ammo* im•Sa imam" es CONCRETE "X" CUT IN ONCRETE (SET) CERTIFICATE OF INSURANCE * 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 INSURED: Texas Health Resources (THR), including all affiliated non-profit facilities 612 East Lamar Blvd, Suite 1100 Arlington, TX 76011 P: 682-236-6451 F: 682-236-7208 INURERS AFFORDING COVERAGE: Company A: Texas Health Resources Self Insured Trust 501(c)(3) COVERAGES: This is to certify 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 all terms, exclusions and conditions of such policies, limits shown may have been reduced by paid claims. COVG TYPE OF POLICY# TRUST TRUST LIMITS LTR INSURANCE INCEPTION EXPRIRATION DATE DATE A QGeneral Liability THR SIT 10/1/1985 Continuous or Each Occurrence $1,000,000 (Trust) until cancelled by General Aggregate $3,000,000 insured A 0 Professional THR SIT 10/1/1985 Continuous or Each Occurrence Liability (Trust) until cancelled by General Aggregate insured Description of Operations/Location/Special Provisions: Texas Health Resources, all non-profit facilities Certificate Holder: City of Fort Worth Department of Development, Attention: David Schroeder, Planner 1000 Throckmorton St Fort Worth, TX 76102 Should any of the above described policies be cancelled, reduced or lapse; notice will be delivered to the certificate holder within 30 days. Certificate Holder is named as additional insured, but only as required by written contract and is limited to policy terms, conditions, exclusions, and limitations. AUTHORIZED SIGNATURE , Di ectorjlsuraice Se '1- ces, THR DATE: December 2, 2013 *EXHIBIT "B" Revised 11/2013 Page 1 of 15 L_ CITY SECRETARY CONTRACT RIGHT OF WAY ENCROACHMENT AGREEMENT (COMMERCIAL) THIS AGREEMENT 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 City Manager or its duly authorized Assistant City Manager or Planning and Development Department Director, hereinafter referred to as the' City", and Medical Plus Supplies, Inc., acting herein by and through its duly authorized Esteban V. Rodriguez, presiden4 hereinafter referred to as "Licensee", Owner of the property located at 911 6th Avenue, Fort Worth, TX 76104 ("Property"). AGREEMENT 1. For and in consideration of the payment by Licensee of the fee set out below and the true and faithful performance of the mutual covenants herein contained, City hereby grants to Licensee 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, sidewalks and other public rights -of - way, such Improvement(s) are described as follows: Installation of a canopy that will encroach the ROW • 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 2012 ROW Encroachment Agreement -Commercial Page 1 of 10 RECEIVED NOV 0 8 2013 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 1 Of 15 Page 2 of 15 • • authorized representative. All plans and specifications thereof shall be subject to the prior written approval of the Director of Transportation and Pubhc Works, or his duly authorized representative, but such approval shall not relieve Licensee of responsibility and liability for concept, design and computation in preparation of such plans and specifications. 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 heremabove referred to Exhibit "A". 4. Licensee, 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, Licensee 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, Licensee understands and agrees that City shall bear no responsibility or liability for damage or disruption of improvements installed by Licensee or its successors, but City will make reasonable efforts to minimize such damage. 2012 ROW Encroachment Agreement -Commercial Page 2 of 10 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 2 Of 15 Page 3 of 15 • • 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, 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. 7. 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. 8. Upon termination of this Agreement, Licensee 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 Licensee that if this Agreement terminates and Licensee 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. 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 2012 ROW Encroachment Agreement -Commercial Page 3 of 10 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 3 Of 15 Page 4 of 15 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 during the term hereof determine in its sole discretion to use or cause or permit the nght 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. Licensee agrees and acknowledges that this Agreement is solely for the purpose of permitting Licensee to construct, maintain and locate the Improvements over or within the described public right of way and is not a conveyance of any right, title or interest in or to the public right of way 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. 11. 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 Improvement, encroachment and uses. 12. 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. 13. 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, 2012 ROW Encroachment Agreement -Commercial Page 4 of 10 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 4 Of 15 Page 5 of 15 • • 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. 14. LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS 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 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 ANY AND ALL ACTS OR OMISSIONS OF LICENSEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, INVITEES, OR TRESPASSERS. 2012 ROW Encroachment Agreement -Commercial Page 5 of 10 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 5 Of 15 Page 6 of 15 • • 15. 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: S1,000,000 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 Licensee 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. 16. 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 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. 2012 ROW Encroachment Agreement -Commercial Page 6 of 10 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 6 Of 15 Page 7 of 15 • 17. In any action brought by the City for the enforcement of the obligations of Licensee, City shall be entitled to recover interest and reasonable attorney's fees. 18. Licensee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without the prior written approval of' the City Manager or designee. Any attempted assignment without prior written approval will be void. 19. THE PARTIES AGREE THAT THE DUTIES AND OBLIGATION CONTAINED IN PARAGRAPH 8 SHALL SURVIVE THE TERMINATION OF THIS AGREEMENT. 20. This Agreement shall be binding upon the parties hereto, their successors and assigns. EXECUTED thisSOAN u day of Cnl ri.3Qjn , 2013. 2012 ROW Encroachment Agreement -Commercial Page 7 of 10 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 7 Of 15 • Page 8 of 15 City City of Fort Worth By: Randle Harwoo Director Planning and Development ATTEST: Aft 6ity Secretary NO M&C REQUIRED • Licensee Medical Plus Supplies, Inc. By: ksoate Esteban V. Rodriquez President Approved As To Form and Legality Assistant City Attorney MM SACS/TRC• TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 8 Of 15 r • Page 9 of 15 • 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 R AND AND SEAL OF OFFICE this day of CASSANDRA F. FOREMAN Notary Public, State of Texas My Commission Expires April 26, 2017 otary Public in and for the State of Texas 2012 ROW Encroachment Agreement -Commercial Page 9 of 10 *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 9 Of 15 r— Page 10of15 1/4 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 ESTEBAN V. RODRIGUEZ, 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 MEDICAL PLUS SUPPLIES, INC., and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this / day of (Cara , 20 ANA E. 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MON •`W • � a • • • • , ▪ W •• • N •••• 1111 • • • Y • •f• 3� • • • • • • • a .• • • tD 144 • 00'08'42" E AREA COVERED h ;t• 6.6' tr 6.45' • 33.19' r 0 t0 1, PARKING SPACE • • • N •• ••' PARKING SPACES • •. • •.. • • 1.5' ' moo, • •• � • •i • • �• .. . • ,• •• ••• A f e r 1•cgvE•Reo' AREA• -• Jr r - 29.3' g Owl GUTTER 46 • • • • • • WALL • • St 2 HANDICAP • • • c W vj 00� 0 -< 46.96' PIPE RAIL • FENCE u 1 PARKING SPACE ASPHALT i rI 1i CONCRETE I/ •`�I' l • • •. • • • •• • • •• • • • •. 1 • • • i /.I /i O •N C//.R E 't' EL) • A • • •• ••• • r 0 -.1 0 0 8 • "4 J Cley - • *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 12 Of 15 • • Page 13 of 15 EXHIBIT `Al A • • • • • • ••• 24 • • ' I{• c • • • • •• • •: • • ' • • '1• 3.05h▪ im ' • ...• ir • 4 • • •• ••`• • '•' ••• • •• • • • • • • •• • •• .• • '2.3' :• • • •• M. • • * • • •• .• • • • • . •11 • • • t • 0 • • Z ••' v, • • 622 • • •. • • .m• • • •.�• • • • gym• 1• • • • • • . • • •• • • • • •' • • r • 40 N1 T 65' R/W ) 2.5' CURB de GUTTER • = 1 • •• • • • s - • ..• • it • • • • woldimwmximlor • • N ' z y �. . .' CbNCRETE, WALL r i. 7 11i gm"' �eare' .. --.'.• w . 11 I I+ fII I 1III II 2 HAN DICAP ' ., • • • . • O co A A 6.6' ot 6.45' ASPHALT CANOPY/ • 33.19' • 61'-0" 1.5' A 16 • * ' • • ralnKov1J at. • . • • .• • • •• ••• •• •••• .• 1 •..• • • ti •.•• . r • . •CQVERED AREA ► • 29.3' ✓ r O O --A C Cv, ca 0 n O (p 00 n 0 cn 1, PARKING SPACE • • '• lb a CEO N C R ET E •: 46.95' P PE RAIL FENCE • anuantl 4Z9 1I6 1 PARKING SPACE ASPHALT SPACES 0 • • • • .• 403) • 64 • • • ♦ • . ••11; o'N CR E fi El ' .1 O 0 • *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 13 Of 15 Page 14of15 EXHIBIT 'B' ACOROe CERTIFICATE OF LIABILITY INSURANCE I DATE(MMIDDJYYYY) 10/3/2013 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 Cushman Insurance Agency, Inc. P.O, Box 1069 Herndon INSURED MEDICAL PLUS SUPPLIES INC P.O. BOX 84110 PEARLAND VA 20172 CONTACT Cole Cushman PPHONtE Fyn. (703) 471-4335 FAX ,,,,I, (703)471-0938 AAODRE$4: ccushman@ cushmaninsurance . com INSURER(S) AFFORDING COVERAGE INSURERA Massachusetts Bav Insurance INSURER B: INSURER C : INSURER D INSURER E : TX 77584 INSURER F: Co. NAIC 0 COVERAGES CERTIFICATE NUMBER:CL1322607924 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 I TYPE OF INSURANCE SR Aye SWVQ POLICY NUMBER IMM/DC{ VYYYI IM�WL POLICY GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY A X CLAIMS -MADE X OCCUR Professional Liability GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY 1-1 ,Pi R:° I^1 LOC AUTOMOBILE UABIUTY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS UMBRELLA UAB EXCESS UAB DED I j RETENTONE WORKERS •COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERJEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below OCCUR CLAIMS -MADE YIN NIA 2DR9464379 02/23/2013 02/23/2014 LIMITS EACH OCCURRENCE S DAMAGE IUHtN TED MISES (Ea ommence)_ $ MED EXP (Any one person) $ PERSONAL & ADV INJURY S GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG I S Is El COMBINED SINGLE LIMIT I S Ea accident) BODILY INJURY (Per person) S BODILY INJURY (Per accident) PROPERTY DAMAGE (Par accident) EACH OCCURRENCE AGGREGATE WC STATU-ITC FR I I OTH- iCRY LIM E.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT I S DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more specs Is required) Certificate holder is listed as an additional insured when required by written contract. CERTIFICATE HOLDER The City of Fort Worth Department of Development Attn: David Schroeder, Planner 1000 Throckmorton St Fort Worth, TX 76102 ACORD 25 (2010/05) INS025(9fl1fl m CANCELLATION 2,000,000 100,000 5,000 2,000,000 4,000,000 4,000,000 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 L Cushman/SYEDA .ww..tre..see rr ,�'.+» Set ©1988-2010 ACORD CORPORATION, All rights reserved. Tha arnon name and Innn are ranintararl markt of arnun *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 14 Of 15 Page 15 of 15 By: MARY LOUISE GARCIA COUNTY CLERK CITY OF FORT WORTH 1000 THROCKMORTON ST FT WORTH, TX 76102 Submitter: CITY OF FORT WORTH/DEVELOPMENT & PLANNING 100 West Weatherford Fort Worth, TX 76196-0401 PHONE (817) 884-1195 DO NOT DESTROY WARNING - THIS IS PART OF THE OFFICIAL RECORD. Filed For Registration: 11/8/2013 2401 PM Instrument #: D213290373 A 15 PGS $68.00 D213290373 ANY PROVISION WHICH RESTRICTS THE SALE, RENTAL OR USE OF THE DESCRIBED REAL PROPERTY BECAUSE OF COLOR OR RACE IS INVALID AND UNENFORCEABLE UNDER FEDERAL. LAW. *ACS/TRC* TARRANT Doc: 000290373 Date: 11/08/2013 Vol: 0000000 Page: 00000 Page: 15 Of 15