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HomeMy WebLinkAboutContract 44210CI^T,Y, SECRETARY CONTRACT 1i®. 0qZ1000 52 43 - 1 wmbabawgwww� Agreement Page 1 of 1 SECTION 00 52 43 2 AGREEMENT 3 4 THIS AGREEMENT is made by and between The City of Fort Worth, a Texas home rule 5 municipality acting by and through its duly authorized City Manager, ("City"), and William J. 6 Schultz, Inc. d/b/a Circle C Construction Company, a corporation authorized to do business in 7 Texas, acting by and through its duly authorized representative ("Contractor"). City and 8 Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: 9 Article 1. WORK 10 Contractor shall install ports and supply cleanout services for the 24-inch and 20-inch segments 11 of the City's Reclaimed Water Delivery System Distribution Main at the locations specified on 12 the attached location map incorporated herein (the "Work"), 13 Article 2. PROJECT 14 The Work is a part of the Village Creek Eastern Reclaimed Water Delivery System Distribution 15 Main - Installation of Cleaning Facilities (City Project No. 0213) (the "Project"). 16 The original project for which the Work under these Contract Documents may be the whole or a 17 part of is generally described as: 18 Village Creek Eastern_Reclaimed Water Delivery System Distribution Main (City Project No. 19 0213). 20 Article 3. CONTRACT TIME 21 3.1 Time is of the essence. 22 Contractor recognizes that tilne is of the essence, and it will deploy all the necessary equipinent 23 and man power to address the Work. The City expects the Contractor to have a sense of urgency 24 to complete the Work in a timely manner and all Work shall be completed no later than March 25 29, 2013, subject to the timely performance by others on this Project. 26 Article 4. CONTRACT PRICE 27 City agrees to pay Contractor for performance of the Work based on Contractor's bid an amount 28 in current funds not to exceed Eighty -Three Thousand Dollars ($83,000.00) 29 Article 5. CONTRACT DOCUMENTS 30 5.1 CONTENTS: 31 The Contract Documents which comprise the entire agreement between City and 32 Contractor concerning the Work consist of the following: 33 1. This Agreement. 34 2. Exhibits to this Agreement: 35 a. Proposal/Bid 36 b. Current Prevailing Wage Rate Table 37 c. Insurance Accord Form(s) 38 d. Performance Bond OFFICIAL RECORD 39 e. Maintenance Bond CITY SECRETARY 40 £ Power of Attorney for the Bonds FT. WORTNi TX 41 g. Workers Compensation Affidavit Village Creek Eastern Reclaimed Water Delivery System Distribution Main -Installation of Cleaning Facilities Circle C Conshuction Canpany 005243-2 Agreement Page 2 of 4 42 3. General Conditions incorporated by reference 43 4. The following which may be delivered or issued after the Effective Date of the 44 Agreement and, if issued, become an incorporated part of the Contract Documents: 45 a. Notice to Proceed. 46 b. Field Orders. 47 c. Change Orders. 48 d. Letter of Final Acceptance. 49 50 Article 6. INDEMNIFICATION 51 6.1 Contractor covenants and agrees to indemnify, hold harmless and defend, at its own 52 expense, the city, its officers, servants and employees, from and against any and all 53 claims arising out of, or alleged to arise out of, the work and services to be performed 54 by the contractor, its officers, agents, employees, subcontractors, licenses or invitees 55 under this contract. This indemnification provision is specifically intended to operate 56 and be effective even if it is alleged or proven that all or some of the damages being 57 sought were caused, in whole or in part, by any act, omission or negligence of the city. 58 This indemnity provision is intended to include, without limitation, indemnity for 59 costs, expenses and legal fees incurred by the city in defending against such claims and 60 causes of actions. 1 62 6.2 Contractor covenants and agrees to indemnify and hold harmless, at its own expense, 63 the city, its officers, servants and employees, from and against any and all loss, damage 64 or destruction of property of the city, arising out of, or alleged to arise out of, the work 65 and services to be performed by the contractor, its officers, agents, employees, 66 subcontractors, licensees or invitees under this contract. This indemnification 67 provision is specifically intended to operate and be effective even if it is alleged or 68 proven that all or some of the damages being sought were caused, in whole or in part, 69 by anv act, omission or negligence of the city. 70 71 Article 7. MISCELLANEOUS 72 7.1 Terms. 73 Terms used in this Agreement which are defined in Article 1 of the General Conditions will 74 have the meanings indicated in the General Conditions. 75 7.2 Assignment of Contract. 76 This Agreement, including all of the Contract Documents may not be assigned by the 77 Contractor without the advanced express written consent of the City. 78 7.3 Successors and Assigns. 79 City and Contractor each binds itself, its partners, successors, assigns and legal 80 representatives to the other party hereto, in respect to all covenants, agreements and 81 obligations contained in the Contract Documents, Village Creek Eastern Reclaimed Water Delivery System Distribution Main - Installation of Cleaning Facilities Circle C Construction Company 005243-3 Agreement Page 3 of 4 82 7.4 Severability. 83 Any provision or part of the Contract Documents held to be unconstitutional, void or 84 unenforceable by a court of competent jurisdiction shall be deemed stricken, and all 85 remaining provisions shall continue to be valid and binding upon CITY and 86 CONTRACTOR. 87 7.5 Governing Law and Venue. 88 This Agreement, including all of the Contract Documents is performable in the State of 89 Texas. Venue shall be Tarrant County, Texas, or the United States District Court for the 90 Northern District of Texas, Fort Worth Division. 91 7.6 Other Provisions. 92 The Contractor agrees to pay at least minimum wage per hour for all labor as the same is 93 classified, promulgated and set out by the City, a copy of which is attached hereto and 94 made a part hereof the same as if it were copied verbatim herein. 95 7.7 Authority to Sign. 96 Contractor shall attach evidence of authority to sign Agreement, if other than duly 97 authorized signatory of the Contractor. 98 99 SIGNATURE PAGE TO FOLLOW 100 Village Creek Eastern Reclaimed Water Delivery System Distribution Main -Installation of Cleaning Facilities Circle C Construction Company 005243-4 Agreement Page 4 of 4 101 IN WITNESS WHEREOF, City and Contractor have signed this Agreement in multiple 102 counterparts. At least one counterpart of each has been delivered to City and Contractor. 103 104 This Agreement will be effective on the last date subscribed by a signatory (which is the Effective 105 Date of the Agreement). 106 City of Fort Worth Contractor: William J. Schultz, Inc. dba Circle C Construction Company By: yfo 107 108 109 110 111 112 113 114 115 116 120 (Signature) Title: Vice -President Teresa S. Skelly (Printed Name) Address: P. 0. Box 40328 .Fort Worth, TX 76140 City/State/Zip: Date M&C IV Date Fernando Costa Assistant City Manager Date 2 2 / Assistant City Attorney APP .OV RECOMMENDED: S. Frank Crumb DIRECTOR, WATER DEPARTMENT 1000 Throckmorton, Fort Worth, TX-76102 OFFICIAL RECORD CITY SECRETARY r7s WORTH, TX Village Creek Eastern Reclaimed Water Delivery System Distribution Main -Installation of Cleaning Facilities Circle C Construction Company Cr x cv t-- - � . CfTY OF FORT WORTH RECLAIMED WATER SYSTEM PIGGING PROPOSAL JANUARY 23, 2413 � 1. Installation of 30-inch pig inlet, Greenbelt Road � $ � � 2. Installation of first 30-inch pigging outlet $ �_.tztJ 3.a. 30-inch pigging, first section, run 1 $ -1 f fh� � � 3.b. 30-inch pigging, first section, run 2 $ ���� 3.c. 30-inch pigging, first section, run 3 $ „�,�.� Subtotal Group 1 IUor �'�+ 7�2Xct S 4. InstaNation of second 30-inch pigging outlet, �'- � 5.a. 30-inch pigging, second section, run 1 $ 5.b. 30-inch pigging, second section, run 2 $ �-�- 30-inch pigging, second section, run 3 5.c. $ ,��-�3`.�. Subtotal Grou 2 Nor �i+ 1 � X o5 ...�..�.H�; -��--- 6, tnstallation of 24-inch pig inlet near Mosier Valley Road $ /� p oc�, G' � 7. Installation of 24-inch pig exit at FAA Road $ /�"c� ®p, ° o 8.a. 24-inch pigging, run 1 $ � �� o � � 8.b. 24-inch pigging, run 2 -- $ �r��D � U --- 8.c. 24-inch pigging, run 3 $ '/E) p , � ir7 G `r Subtotal Group 3 ��C1f1, � �i Ci r c ,� 9. Installation of 20-inch pig inlet at American Airlines Blvd. $ J,5"'c� t�c:�, �' � 10. Installation of 20-inch pig exit at DFW Airport pump station $ /� �� � , ° � 11.a. 20-inch pigging, run 1 ---i------_- $ ��,�� � � 11.b. 20-inch pigging, run 2 u $ ��� � �' 20-inch pigging, r�rn 3 $ .-... . ��, � O 4 91.c. � --- _ Subtota! Group 4 ey t.} � ' � � �i��. 1 f � r� � - � 12. --- -- Inetilaiian of 2tt-inch b ass in at ®FW er uault i Yp �p 9 � - $ _ - � � �—�-- �' �� , ► C r� (�z. t ._— � . TpTAL $ --� � � -- 1. F2e#erenc�a pigging plan dated January 14, 2U13, and sealer# plan set dated January i4, 2l}13. 2. Instaflation also lncludeci removing above ground piping and p#uggtng. 3. Addendum Nn. 1 —January 17, 2d13 [� (r' �� '� 4. Addendum No. 2 —January 23, 2t)13 rOTA � t0 �' � ► ar � � � •t s;:!iSseas47�r�AppQata;Locap,{tiherrsoittb'�YnrtvustTernoorary inremet i=itesit;taniani.iF9uiJ�G�!�-?f�i��itL� Preps�al.do�x �,ii� l r�ir'i � , �� t ohrrrrrrrrrrrrr Y72tS.o�89���8i3§�` 'r. PERFORMANCE BOND Bond No. TXC107206 THE STATE OF TEXAS § COUNTY OF TARRANT § KNOW ALL BY THESE PRESENTS: That we, (1) William J. Schultz, Inc. dba Circle C Construction Company, as Principal herein, and (2) Merchants Bonding Company (Mutual), a corporation organized under the laws of the State of (3) Iowa, and who is authorized to issue surety bonds in the State of Texas, Surety herein, are held and firmly bound unto the City of Fort Worth, a municipal corporation located in Tarrant and Denton Counties, Texas, Obligee herein, in the sum *Eighty_ Three Thousand and 00/100** Dollars ($*83,000.00*) for the payment of which sum we bind )urselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, Principal has entered into a certain written contract with the Obligee dated day of F, �,,,��!;-� 2013, a copy of which is attached hereto and made a part hereof for all purposes, for the construction o£ Contractor shall install ports and supply cleanout services for the 24-inch and 204nch segments of the City's Reclaimed Water Delivery System Distribution Main at the locations specified on the attached location map incorporated herein. NOW, THEREFORE, the condition of this obligation is such, if the said Principal shall faithfully perform the work in accordance with the plans, specifications, and contract documents and shall fully indemnify and hold harmless the Obligee from all costs and damages which Obligee may suffer by reason of Principal's default, and reimburse and repay Obligee for all outlay and expense that Obligee may incur in making good such default, then this obligation shall be void; otherwise, to remain in full force and effect. PROVIDED, HOWEVER, that this bond is executed pursuant to Chapter 2253 of the Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of such statute, to the same extent as if it were copied at length herein. 1N WITNESS WHEREOF, the duly authorized representatives of the Principal and the Surety have executed thi0 instrument. SIGNED and SEALED this ATTEST: (Principal) Secretary, Witness as to Principal ATTEST: Secretary g day of i I e �.��J�� 120139 Lankford William J. Schultz, Inc. dba Circle C Construction Company PRINCIPAL By: Teresa S. Skelly, mice -President Address Merchants SURETY By: 1►F�i� P. O. Box 40328 Fort Worth, TX 76140 Sheryl A. HIutts ,Attorney -in -Fact Address: 2100 Fleur Drive Des Moines, IA 50321-1158 Telephone Number: 1-800-678-8171 NOTE: (1) Correct name of Principal (Contractor). (2) Correct name of Surety. (3) State of incorporation of Surety Telephone number of surety must be stated. In addition, an original copy of Power of Attorney shall be attached to Bond by the Attorney -in -Fact. The date of bond shall not be prior to date of Contract. MERCHANPrs BONDING COMPANY POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations duly organized under the laws of the State of Iowa (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint, individually, John A Miller; John R Stockton; K R Harvey; Sheryl A Klutts of Fort Worth and State of TX their true and lawful Attorney -in -Fact, with full power and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any such instrument shall not exceed the amount of: TEN MILLION ($10,000,000.00) DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies, and all the acts of said Attorney -in -Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This Power -of -Attorney is made and executed pursuant to and by authority of the following By -Laws adopted by the Board of Directors of the Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 24, 2011, "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 1st day of January 2012 . �O pEt 9 .09. • : G �oA4 i tit y 1933 c; • •�Y• P 0 STATE OF IOWA COUNTY OF POLK ss. MERCHANTS BONDING COMPANY (MUTUAL) MERCHANTS NATIONAL BONDING, INC. By President On this 1st day of January 2012, before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year first above written. ;,� MARANDA GREENWALT � � � �, • Commission Number770312 My Commission Expires or October 28, 2014 Notary Public, Polk County, Iowa STATE OF IOWA COUNTY OF POLK ss. I, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this day of , 201304000, Vb ;O•oaPOq •.'O9' C4D: 2 -o- o y 1933 : c • oY• POA 0014 (11/11) Secretary MAINTENANCE BOND Bond No. TXC107206 THE STATE OF TEXAS § COUNTY OF TARRANT § KNOW ALL BY THESE PRESENTS: That William J. Schultz, Inc. dba Circle C Construction Company, ("Contractor"), as principal, and Merchants Bonding Company (Mutual), a corporation organized under the laws of the State of Iowa, ("Surety"), do hereby acknowledge themselves to be held and bound to pay unto the City of Fort Worth, a Municipal Corporation chartered by virtue of Constitution and laws of the State of Texas, ("City") in Tarrant County, Texas, the sum of *Eighty -Three Thousand and 00/100 Dollars ($*83,000.00*), lawful money of the United States, for payment of which sum well and truly be made into said City and its successors, said Contractor and Surety do hereby bind themselves, their heirs, executors, administrators, assigns and successors, jointly and severally. This obligation is conditioned, however, that: WHEREAS, said Contractor has this day entered into a written Contract with the City of Fort Worth, dated the of 2013 a copy of which is hereto attached and made a part hereof, for the performance of the following described public improvements: Contractor shall install ports and supply cleanout services for the 244nch and 20-inch segments of the City's Reclaimed Water Delivery System Distribution Main at the locations specified on the attached location map incorporated herein, the same being referred to herein and in said contract as the Work and being designated as Project Number(s): N/A and said contract, including all of the specifications, conditions, addenda, change orders and written instruments referred to therein as Contract Documents being incorporated herein and being made a part hereof, and, WHEREAS, in said Contract, Contractor binds itself to use such materials and to so construct the work that it will remain in good repair and condition for and during a period of two (2) years after the date of the final acceptance of the work by the City; and WHEREAS, said Contractor binds itself to maintain said work in good repair and condition for said term of two (2) years; and WHEREAS, said Contractor binds itself to repair or reconstruct the Work in whole or in part at any time within said period, if in the opinion of the Director of the City of Fort Worth Department of Water, it be necessary; and, WHEREAS, said Contractor binds itself, upon receiving notice of the need therefore to repair or reconstruct said Work as herein provided. NOW THEREFORE, if said Contractor shall keep and perform its said agreement to maintain, repair or reconstruct said Work in accordance with all the terms and conditions of said Contract, these presents shall be null and void, and have no force or effect. Otherwise, this Bond shall be and remain in full force and effect, and the City shall have and recover from Contractor and Surety damages in the premises as prescribed by said Contract. This obligation shall be a continuing one and successive recoveries may be had hereon for successive breaches until the full amount hereof is exhausted. 1N WITNESS WHEREOF, this instrument is executed in 4 counterparts, each of which shall be deemed an original, this day ATTEST: m (Principal) Secretary, Michele Witness as to Principal ATTEST: Secretary William J. Schultz, Inc. dba Circle C Construction Company PRINCIPAL By: Name: Teresa S. Skelly, Vie -President Address: P. O. Box 40328 Fort Worth. TX 76140 Merchants SURETY By: Name: Sheryl A. HIutts ,Attorney -in -Fact Address: 2100 Fleur Drive Des Moines, IA 50321-1158 Witness as to Surety, John A. filler Telephone Number: 1-800-678-8171 MERCHANT71 BONDING COMPANY,m POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations duly organized under the laws of the State of Iowa (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint, individually, John A Miller; John R Stockton; K R Harvey; Sheryl A Klutts of Fort Worth and State of TX their true and lawful Attorney -in -Fact, with full power and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any such instrument shall not exceed the amount of: TEN MILLION ($10,000,000.00) DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies, and all the acts of said Attorney -in -Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This Power -of -Attorney is made and executed pursuant to and by authority of the following By -Laws adopted by the Board of Directors of the Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 24, 2011. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 1st day of January 2012 . • �O�NG • �04j••. 00.ORPOq 'Oy• y 1933 c: • � 1r. A STATE OF IOWA COUNTY OF POLK ss. MERCHANTS BONDING COMPANY (MUTUAL) MERCHANTS NATIONAL BONDING, INC. President On this 1st day of January 2012 ,before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year first above written. {. MARANDA GREENWALT � ��,,�. �� :� Commission Number 770312 My Commission Expires °W October 28, 2014 Notary Public, Polk County, Iowa STATE OF IOWA COUNTY OF POLK ss. I, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this day of . 2013 G •�; s .y;Z rn: • •�� � gyp_ �?;V �1-••� -O- O ..,�• �i 2003 ;a' 1933 C: ' �• :.� •yam. • l• DOA 0014 (11/11) '•.,0��' ••y••'���F,a` .•�Y •.• Secretary IMPORTANT NOTICE To obtain information or make a complaint: You may contact your insurance agent at the telephone number provided by your insurance agent. You may cal! Merchants Banding Company's toll -free telephone number for information or to make a complaint at: 1-800.678-8171 You may con#act the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 14004524439 You may write the Texas bepartment of Insurance at: P. ©. Box 149104 Austin, TX 78714491 Q4 Fax: (512) 475A 771 Web: http://www.tdi.state.tx.us %mail: ConsumerProtection@tdi.state.tx.us PREMIUM AND CLAfM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. !f the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. SUP 0032 TX (7/07) " A� CERTIFICATE OF LIABILITY INSURANCE 2;22�2oi3YY) 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 K & S Insurance Agency 2255 Ridge Road, Ste. 333 P. 0. Box 277 Rockwall TX 75087 INSURED William J Schultz, Inc. dba Circle C Construction Company 500 W. Trammell Everman TX 76140 CERTIFICATE NUMBER: `"ry""'Debrah Cherr NAME: y PHONE (972) 771-4071 AIC No; (972)771-4695 aDDRESS: dcherry@kandsins . com INSURERS AFFORDING COVERAGE NAIC # INSURERA:United Fire & Casualty Company 13021 INSURERB:Great American Insurance Co. 16691 INsuRERc:Texas Mutual Insurance Co. INS URERD:Continental Casualtv Insurance 0443 INSURER E INSURER F 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY COM X MERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 5316434 8/12/2012 /12/2013 EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1001000 MED EXP (Any one person) $ 51000 PERSONAL & ADV INJURY $ 11000,000 G7152 6/11, CG7131 12/04 GENERAL AGGREGATE $ 2,0001000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 21000,000 POLICY X PRO LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1 000 000 A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 5316434 8/12/2012 /12/2013 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS Underinsured motorist $ 250,000 7109 1/06 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 51000,000 AGGREGATE $ 51000,000 B EXCESS LIAB CLAIMS -MADE TUU033288802 DED I X RETENTION$ 10100 $ /12/2012 8/12/2013 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEIMBOER PROPREXCLUDED? ECUTIVE (Mandatory in NH) N / A 0001193570 C420304A 1/00 /12/2012 /12/2013 X WC STATU- OTH- - E.L. EACH ACCIDENT $ 1 0OO OOO E.L. DISEASE - EA EMPLOYE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 000 D Contractor's Equipment 4032905705 /12/2012 /12/2013 Leased/Rented equip policy limit 500,000 Deductible: $1,000. Leased/rented equip per item 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) See above listing of additional insured and waiver of subrogation endorsement forms. Project: Relcaimed WaterDelivery System Distribution Main City of Fort Worth 1000 Throckmorton Street Fort Worth, TX 76102 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 IR Daiker-1/DEBBIE ����..•r�--_L� �---Y✓L-�—. ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSt125 ontnn.ri n+ The A('r)pn name and Innn am rnnictnrcrl mnr4c of Arr)Rll