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Home My WebLink AboutContract 56038CSC No. 56038 � 000000-i STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Page lof2 TABLE OF CONTENTS Division 00 - General Conditions 00 05 10 Mayor and Council Communication 00 OS 15 Addenda 00 11 13 Invitation to Bidders 00 21 13 Insfructions to Bidders 00 35 13 Conflict of Interest Affidavit 00 4100 Bid Form 00 42 43 Proposal Form Unit Price 00 43 13 Bid Bond 00 43 37 Vendor Compliance to State Law Nonresident Bidder 00 45 26 Contractor Compliance with Workers' Compensation Law 00 45 40 Minority Business Enterprise Goal 00 52 43 Agreement 00 61 13 Performance Bond 00 61 14 Payment Bond 00 61 19 Maintenance Bond 00 6125 Certificate of Insurance 00 72 00 General Conditions 00 73 00 Supplementary Conditions Division Ol - General Requirements O1 11 00 Summary of Work O1 25 00 Substitution Procedures O1 31 19 Preconstruction Meeting O1 3120 Project Meetings Ol 32 16 Construction Progress Schedule O1 32 33 Preconstruction Video O1 33 00 Submittals 0145 23 Testing and Inspection Services O1 SO 00 Temporary Facilities and Controls O1 57 13 Storm Water Pollution Prevention Plan O1 58 13 Temporary Project Signage O1. 60 00 Product RequiremenYs 01 66 00 Product Storage and Handling Requirements O1 70 00 Mobilization and Remobilization 01 7123 Construction Staking and Survey O1 7123.1 Attachment A Survey Staking Standards O1 74 23 Cleaning O1 77 19 Closeout Requirements O1 78 23 Operation and Maintenance Data O1 78 39 Project Record Documents Division 02 - Ea�isting Conditions 02 41 13 Selective Site Demolition 02 41 15 Paving Removal Division 03 - Concrete 03 30 00 Cast-In-Place Concrete C� Z�7 � a Ci] :� y'.�[ �� :� STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Playground Replacen:e�tt a! Worlh Hil/s, Casino Beach, Hillside Park 102342, 102956,102337 Revised February 2, 2016 00 00 00 - a STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Page 2of2 Division 11- Equipment 11 68 13 Playground Equipment Division 1Z - Furnishings 12 69 15 Wood Fiber Playground Surfacing Division 31- Earthwork 31 10 00 - Site Clearing 31 23 16 Unclassified Excavation 3125 00 Erosion and Sediment Control Division 32 - Exterior Improvements 32 13 13 Concrete Paving 32 13 20 Concrete Sidewalks, Driveways and B'arrier Free Ramps 32 13 73 Concrete Paving Joint Sealants 32 33 00 Site Furnishings 32 91 19 Topsoil Placement and Finishing of Parkways 32 92 13 Hydro-Mulching, Seading, and Sodding Division 33 - Utilities 33 41 16 Sub-drainage Piping Appendix GC-6.06.D GC-6.07 GC-6.09 Minority and Women Owned Business Enterprise Compliance Wage Rates Permits and UtiIities END OF SECTION CTi'Y OF FORT WORTH STANDt1ItD CONSTRUCTION SPECiFICATION DOCUMENTS Playground Replacwne�rt a1 Worlh Hflls, Casino Beach, HilJsfde Park I02342, 102956,102337 Revised February 2, 2016 City of Fort Worth, Texas Mayor and Council Communication DATE: 06/22/21 M&C FILE NUMBER: M&C 21-0486 LOG NAME: 80PLAYGROUND REPLACEMENT WORTH HILLS, CASINO BEACH, HILLSIDE SUBJECT (CD 7, CD 8, and CD 9) Authorize Execution of a Contract with North Rock Construction, LLC, in the Amount of $726,680.28 for Replacement of Playgrounds at Worth Hills, Casino Beach, and Hillside Parks, Provide for Additional Project Cost and Contingencies in the Amount of $86,699.00 for a Total Construction Cost of $813,379.28, Adopt Attached Appropriation Ordinance and Amend the Fiscal Years 2021-2025 Capital Improvement Program RECOMMENDATION: It is recommended that the City Council: 1. Authorize execution of a contract with North Rock Construction, LLC, in the amount of $726,680.28 for Playground Replacement at Worth Hills (City Project No. 102342), Casino Beach (City Project No. 102456), and Hillside Parks (City Project No.102337); 2. Adopt the attached appropriation ordinance adjusting estimated receipts and appropriations in the General Capital Projects Fund by decreasing estimated receipts and appropriations in the PARD Maintenance & Replacement programmable project (City Project No. P00133) in the amount of $150,000.00 and increasing estimated receipts and appropriations in the Park Improvements programmable project (City Project No. P00059) by the same amount; and 3. Amend the Fiscal Years 2021-2025 Capital Improvement Program. DISCUSSION: The purpose of this Mayor and Council Communication (M&C) is to authorize the award and execution of a construction contract with North Rock Construction, LLC, in the amount of $726,680.28 for playground replacement at Worth Hills, Casino Beach and Hillside Parks. The Fiscal Year (FY) 2019 Capital Improvement Program (CIP) identified $250,000.00 in PAYG for the playground replacement at Worth Hills Park; $250,000.00 for Casino Beach Park; and $250,000 for Hillside Park. Total funding for these projects is $750,000.00. Base bid improvements include the following: Removing and disposing of existing playground equipment, concrete sidewalks, concrete mow strips, ADA ramps, sub-drainage systems, wood fibar safety surface materials. Installation of new playground equipment, concrete walks, concrete mow strips, ADA ramps, sub-drainage systems, topsoil placement, sod, wood fibar safety surface materials, park benches and lighting. Recommended Alternate Bid items include the following: Unit #4 Alternate Bids: Bid List Item No. 4-01 Worth Hills Park - electrical system including light pole and light fixture; Bid List Item No. 4-02 Worth Hills Park - concrete pad for relocated picnic table; and These projects were advertised for bids on April 1 and April 8, 2021 in the Fort Wo►th Star-Telegram. On April 29, 2021, the following bids were received and tabulated: In orderto fully fund this project, the Meadowbrook Golf Course Playground Replacement identified in the FY 2021-2025 CIP will be deferred and the $150,000.00 in PAYG funds will be reallocated to this project. The action in this M&C will amend the FY 2021- 2025 Capital Improvement Program. It is estimated that construction will begin in July 2021 and be completed by October 2021. Business Equity: North Rock Construction, LLC, is in compliance with the City's Business Equity Ordinance by committing 9% Business Equity participation on this project. The City's Business Equity goal on this project is 9%. FISCAL INFORMATION / CERTIFICATION: The Director of Finance certifies that funds are currently available in the PARD Maintenance & Replacement programmable project within the General Capital Projects Fund and upon approval of the above recommendations and adoption of the attached appropriation ordinance, funds will be available in the General Capital Projects Fund for the Park Improvements programmable project to fund the Worth Hills, Casino Beach, and Hillside Park projects to support the approval of the above recommendations and execution of the construction contract. Prior to an expenditure being incurred, the Park & Recreation Department has the responsibility of verifying the availability of funds. Submitted for City Manager's Office by: Valerie Washington 6192 Originating Business Unit Head: Richard Zavala 5704 Additional Information Contact: David Creek 5744 Bid List Item No. 4-03 Worth Hills Park - pet waste station. ADDENDUM #1 Worth Hills, Casino Beach, Hillside Playground Replacement April 22, 2021 TO ALL BIDDERS: Please attach ADDENDUM #1 to the specifications. This addendum is hereby made a part of the Contract Documents and is issued to modify explain or correct the original drawings and/or project manual. All of the revisions or clarifications to the Construction Drawings and Specifications can be found in BIM 360 in the folder titled Bid Documents Package in the sub-folder ADDENDUM 1. CONSTRUCTION DRAWINGS REFER TO SHEET 2, 3, 5, 8, 12, 13 PROJECT MANUAL REFER TO 00 41 00 Bid Proposal Workbook WRITTEN QUESTIONS SENT BY EMAIL 1. QUESTION: Attached is the specification for the light fixture the manufactures say is available. The one in the plans are no longer available, the supplier said they can match the light pole but the fixture is no longer available. We can price replacing the existing fixture to match the new since the old style is not available. Please let me know how you would like me to proceed. ANSWER: Use the light fixture specification provided by manufacture (see attached spec). 2. QUESTION: I noticed there were no pay items for relocating bench and table. Should we put costs in Item #3 remove items inside limits of demolition? ANSW ER: Yes QUESTION: Will this just be an item quantity overrun change order or can you increase the bid quantity? ANSW ER: Bid quantity has been increased. See revised 00 41 00 Bid Proposal Workbook 3. QUESTION: Referenced email: Please contact City of Fort Worth for their approved contractor list. They typically require this for any City work; especially street lighting. I have forwarded this email to you because I received some feedback from one of my electrical subs that I may need to resort to an "approved contractors list". Are you familiar with this, is the project requiring this for the minimal electrical scope on an alternate? Any assistance is greatly appreciated sir, thank you. ANSWER: A permit is required for the electrical work and any permit requirements will be the requirements for this work. END OF ADDENDUM #1 Bid Opening Date: April 29, 2021 Acknowledge the receipt of this Addendum on your Proposal. By. �az� ��c��, Patrick Vicknair, Project Manager Release Date: April 22, 2021 � HOLOPHANE° LEADER IN LIGHTING SOLUTIONS Catalog Number Notes Type ATIC ACRYLIC 4P 3MATIC ACRYLIC LECTOR PRISMATIC ACRYLIC REFRACTOR NINAIRE USING SCREWS � � ITTER FOR 3" 0 TENON Mazimumweight-371bs Maximum effective projected area - 2.19 sq. ft. AWDE3 AcrylicWashington Postlite Utility LED3 SPECIFICATIONS General Description The Acrylic Washingtan Postlite Utility LED3 is designed far ease of maintenance with the plug-in electrical module common ta each of the luminaires in Holophane's Utility Luminaire Series. The large acorn-shaped luminaire, while reminiscent of the 1920's, contains a powerful, stalk-mounted Chip-On-Board, LED platform with a precision optical system that maximizes post spacings while maintaining uniform illumination Mechanical Specifications The luminaire housing shall: • Be heavy grade A360 cast aluminum (aluminum with <7%<opper) • IP55 rated housing provides tool-less access with a spring-loatled latch • In<orporate a hidden hinge door allowing the door to swing open and remain open • Offer units with an EEI- NEMA twist lock photocantrol receptacle, the housing contains a tempered glass window to allow lightto reach the cell • Mounttoslip-fitterthatwillaccept3"highby2-7/8"to3-1/8"O.D.poletenon • Provide four uniquely designed stainless steel spring clips, enclosed in a clear polyvinyl chloride sleeve and adjusted by 1l4-20 hex-head bolts that se<urely cradle the prismatic acrylic refractor.The same'/+-20 bolts also support the decorative rib and banding aszembly The finish shall: • Utilize a polyester power coat paintto ensure maximum durabiliry • Meet5000-hoursaltspray • OfferTiger Drylacfinishes that are applied by a Tiger Drylac certifietl facility. Electrical S�ecifications The driver shall meet the following requirements: • Certified by UL or CSA far wet locations • A factory programmable electronic driverwith 0-10U dimming control leads • LEDs shall have a minimum of 70 CRI and available in 2700K, 3000K, 4000K, and 5000K CCT • TheelectricalsystemshallbedesignedtameetANSI/IEEEC62.41.2andshallofferalOkVlSkA surge protection, fail off, as standard with an upgradable 20kV/10kA surge protection, fail aff with indicator light, option • Lumen output can be customized priorto manufacturing by way of FPDxx Options • The electrical components are mounted on an aluminum plate that is removeable with minimum use of tools. A matching five <ondudor plug connectsto the receptacle in the luminaire housing to <omplete the wiring. For photoelectric aperation, the eledrical module is provided with an EEI-NEMA twist-lock photocell re<epta<le. a„ a„ . �" . �" . L r L LE� raEnwn Ontical Specifications The optical system is IP66 rated and consists of a pre<isely molded thermal resistant acrylic refractor and top reflectar mounted within the decorative acrylic optic. The top reflector redirects over 50°h of the upward light into the controlling refractor while allowing a soft up- light camponent to define the traditional acarn shape ofthe luminaire. The lower refractor uses precisely molded prisms to maximize the pole spacings while maintaining uniform illuminance. Two rehactors are available, designed for IES type III and V distributions. Lunar Optics shielding is available for asymmetric and symmetric distributions. Control O�tions The control options shall include, but not limited to, the following: • Field adjustable autputto adjust output ta luminaire - AO • Long life photocontrol, 20 years — PCLL, P34 and P48 with DTL • 3 and 7 pin re<eptacles internally in housing (PR3, PR7) or inside acrylic lens mounted (PR7E) • nLight Air rSBOR6 outdoor fixture-mounted motion and photo-sensor, features a dual radio to communicate wirelessly to other nLight Air devices for group response to motion, on/off control in response to daylight and by swit<h — RSBOR6 • Fixture embedded nlight Air network interface for individual fixture control and dimming -NLTAIR2. Certificatian and Standards • LuminaireshallbeULorCSAlisted. • Suitableforoperationinanambienttemperatureupta40°C/105°FperULorCSAcertification • LM79 compliant • DesignLights Consortium� (DLC) Premium qualified praduct and DLC qualified produd. Not all versions ofthis produd may be DLC Premium qualified or DLC qualified. Please checkwith the DLC Qualified Products List at www.designlights.ora/QPL to confirm which versions are qualified. Warranty — 5 Years Limited Complete warranty terms located at: wwwacuitybrands.com/support/warranty/terms-and-conditions Note: Actual performance may differ as a result of end-user environmentand appli<ation. All values are design or typi<al values, measured under laboratory <onditions at 25 °C. S�9cuiiyBrands. I Holophane � 3825 Columbus Rd, Granville, OH 43023 � Phone:866-HOLOPHANE ��vww.holophane.com AWDE3u 0 2020 Acuity Brands Lighting, Inc All rights reserved. Rev.10/06/20 Specifications su6jedto changewithoutnotice. Page 1 of7 AWDE3 AcrylicWashington Postlite Utility LED3 � HOLOPHANEB LFADER ]Y LICHiIYG SOLUIIONS ORDERING INFORMATION Example: AWDE3 P50 30K MVOLT MS AL3 BK MB ST TBK AO ,� � AWDE3 Acrylic Washington Postlite Utility P10 3,700 nominal lumens 27K 2700K (CT MVOLT Auto-Sensing 120-277V 50/60HZ MS Madern Style Swing LED3 p20 6,OOOnominallumens 30K 3000KCCT HVOLT Auto-Sensing347-480V50/60HZ OpenDesign P30 9,OOOnominallumens 40K 4000KCCT LS LeafStyleSwing P40 12,OOOnominallumens 50K SOOOK(CT OpenDesign P50 13,800 nominal lumens P60 16,100 nominal lumens P70 20,100nominallumens �� AL3 Acrylic,Typelll BK Black (Blank) NaTrim BL Ball TBK Black ALS Acrylic,TypeV BZ Bronze FBM FuIlCoverwithMedallionsandBand CL ClearAcrylic3" TBZ Branze AL3LU Acrylic,Typelll GH Graphite FNT FullCoveronly CR Cross TGL Gold LunarOptic GN Green MB MedallionsandBand EG Eagle TGH Graphite ALSLU Acrylic,Type V GR Grey RBM Ribs, Band and Medallions FL Flower TGN Green LunarOptic PP Prime Paint FRBM Full Cover, Ribs, Band and Medallians KC Knurled Cap TGR Grey WH White PN Pawn TPP Prime Paint CMC CustomMatchColorFinish ST Standard TWH White XX STD Finish,TBD RM Roman Cross TCMC Custam Match Color Finish RAL RALSpecified TRAL RAL(olor TRX STDFinish,TBD � � l, � � ii i �, CONTHOLSOPTIONS PREWIREDLEADOPTIONS OPTICOPTIONS AO FieldAdjustable0utput L1H i.5ftprewiredleads TB TucsonBlackCover DE ROAM 0-tOVolt Dimming Controls, includes NEMA twistlock L03 3ft prewired leads photocontrolreceptacle L70 10ftprewiredleads NEMALABELOPTIONS PR3 NEMAtwistlockphatocontrolreceptacle-3pin L20 20ftprewiredleads NL1X1 1"X1"ANSIWattageLabel PR7 NEMAtwistiockdimmingphotocontrolreceptacle-7pin L25 25ftprewiredleads NL2X2 2"X2"ANSIWattageLabel PR7E NEMAtwisdockdimmingphotocontrolceceptade-7Pin(UnderGlass) L30 30ftprewiredleads PCLL Long Life DTLTwistlock Photacontrol for Solid State, MVOLT OPTIC OPTIONS P34 Long Life DTLTwistlock Photacantrol for Solid State, 347V UA Unitized Assembly P48 LongLifeDTLTwistlockPhotacontrolforSolidState,480V SH Shorting Cap RSBOR6 nlight Motion Sensing Photocontrols NLTAIR2 nLightr102.0Antenna DHIVER ELECTHICALOPTIONS FPDxx FactoryProgrammedDriver 20KV Extremesurgeprotection20kV/IOkA,failoffwithinditatorlight DECORATIUE BAND OPTIONS ABMX Ribs and Band Kit, Field installed (Fieldinstalled. Forusewithunitswithaetfactoryinstalled ri6s and band and no finial. Insertfinial colnr forX) HOUSE-SIDE SHIELD OPTIONS GVDH5590 HouseSideShieldSolid90° GVDHSSI2 HouseSideShieldSolid120° GVDHSSI8 HouseSideShieldSolid180° GVDHSL90 HouseSideShieldforLunarOpticSalid90' GVDHSLI2 HouseSideShieldforLunarOpticSalid120° GVDHSLI8 HouseSideShieldforLunarOpticSalid180° S�4cuity8rands. I Holophane � 3825 Columbus Rd., Granville, OH 43023 � Phone:866-HOLOPHANE � svww.holophane.<om AWDE3u O 2020 Acuity Brantls Lighting, Inc All rights reserved. Rev.10/06/20 Specificaiions su6jectto change withoutnotice. Page 2 of 7 AWDE3 AcrylicWashington Postlite Utility LED3 � HOLOPHANEB t�n� � � �,��v� ��,g. s OPTIONS MATRIX I = Cambined Options Included N = Combination Not available Y = Valid Option Combination LUMEN AMBIENT TEMPERATURE (LAT) MULTIPLIERS Use the fadors to determine relative lumen output for average ambienttemperaturesfrom 0-40°C (32-104°F) DE = UL listed companents without GPS capability, external antenna is black and includes ROAM capable node only, ROAM service package sold separately via Acuity Controls PROJECTED LED LUMEN MAINTENANCE Data references the extrapolated performance projedions forthe platforms noted in 25°C ambient, based on 6,000 hours of LED testing (tested per IESNA LM-80-08 and projected per IESNATM-21-11►. To calculate LLF, use the lumen maintenance factor that corresponds to the desired number of operating hours below. For other lumen maintenance values, contact factory. S�1Gp%IyBCal1CI5. Holophane � 3825 Columbus Rd., Granville, OH 43023 � Phone:866-HOLOPHANE � www.holophane.com AWDE3u 0 2020 Aaity Brands Lighting, Inc All rights reserved. Rev.10/06/20 Specificationssubjectto changewithout notire. Page 3 of7 MATRIX KEY ROAM OPTION DETAILS The italitized data is extrapolated beyond the TM-21 standard. n�� AcrylicWashington Postlite Utility LED3 � HOLOPHANE° I FeDER IN ISGFTfIYG SOLUTfONS PERFORMANCE DATA S�1CU%�]/BI'811CI5. Holaphane � 3825 Colum6us Rd., Geanville, OH 43023 � Phone:866-HOLOPHANE � wviw.holophane.com AWDE3u 02020AcuityBrandsLighting,IncAllrightsreserved. Rev.10/06/20 Specificationssubjecttochangewithoutnotice. Page4of7 AWDE3 � AcrylicWashington Postlite Utility LED3 HOLOPHANEm LEFDER IV LIGHII VG SOI.UilUYS fPDXX DATA OPTIONS ,� ,, ,,, ��•� �� Al3 ALS AL3lU ALSLU Al3 ALS AI3LU ALSLU AL3 ALS AL3W ALSLU AL3 ALS Al3LU ALSLU S�andard 24 3,193 3,184 2,480 2,661 3,624 3,614 2,815 3,021 3,b92 3,681 2,867 3,077 3,759 3,748 2,920 3,133 fP095 23 3,043 3,039 2,363 2,536 3,454 3,444 2,fi83 2,819 3,518 3,508 2,132 2,932 3,582 3,572 2,783 2,986 FPD90 22 1,892 2,884 2,24b 2,410 3,283 3,273 2,550 2,736 3,344 J.334 2,597 2,787 3,405 3,395 1,645 2,819 ,� � � � � � � �.� � � I � AL3 ALS AL3W ALSLU M3 ALS Al3lU ALSLU AL3 ALS AL3LU ALSW AL3 ALS AL3LU ALS�U Standard 40 5,184 5,158 4,026 4,320 5,881 5,866 4,570 4,904 5,993 5,975 4,655 4,995 6,102 6,084 4,740 5,085 FPD95 37 4,941 4,926 3,837 4,118 5,608 5,591 4,356 4b74 5,712 5,695 4,437 4,761 5,816 5,799 4,518 4,847 FPD90 36 4,697 4,683 3,618 3,914 5,331 5,315 4,141 4,443 5,430 5,414 4,218 4,526 5,529 5,513 4,295 4,607 FPD85 33 4,452 4,438 3,457 3,710 SA53 5,038 3,925 4,211 5,147 5,131 3,998 4,290 5,240 5,2I5 4,071 4,361 FPD80 31 4,205 4,192 3,166 3,504 4,773 4,159 3,707 3,978 4,862 4,847 3,716 4,052 4,950 4,935 3$45 4,725 FPD75 29 3,958 3,945 3,073 3,298 4,492 4,478 3,489 3,744 4,575 4,561 3,SS4 3,813 4,658 4,645 3b19 3,882 FPD70 27 3,708 3,b97 2,880 3,090 4,209 4,196 3,269 3,509 4,287 4,274 3,330 3,573 4,365 4,352 3,391 3,638 ,� � i �� i � ��i ' i i � Ali ALS AL3W ALSLU AL3 ALS AL3LU AISIU AL3 ALS AL3W ALSLU Al3 ALS AL3LU ALSLU Standard 61 7,799 7,775 6,058 6,�99 8,SS2 8,826 6,876 7,371 9A1fi 8,989 7,003 7,514 9,180 9,153 7,131 7,651 FPD95 58 7,741 7,717 6,013 6,451 8,786 8,760 6,825 7,321 8,949 8,912 6,951 7,458 9,112 9,085 1,078 7,594 FPD90 55 7,367 7,345 5,123 6,139 8,362 8,338 6,496 6,969 8,517 8,492 6,616 7,098 8,672 8b47 6,736 7,228 FPD85 52 6,990 6,969 5,430 5$25 1,934 7,911 6,163 6,612 8,081 S,O51 6,271 6,735 8,228 8,704 6,392 6,858 FP080 49 6,610 6,590 5,135 5,508 7,503 7,481 5,828 6,252 7,642 7,619 5,935 6,369 7,781 1,758 6,044 6,485 FPD75 46 6,226 6,207 4,836 5,189 7,067 7,04G 5,490 5,889 7,198 l,l7fi 5,591 5,999 7,329 7,301 5,693 6,108 FPD70 43 5,839 5,921 4,536 4,966 6,628 6,609 5,148 5,523 6,751 6,730 5,243 5,626 6,873 6,853 5,339 5,729 ,� .:� �,i � �,�.i '•� � � AL3 ALS AL3LU ALSIU AL3 ALS ALiIU ALSLU AL3 ALS AL3LU ALSLU AL3 ALS AL3LU ALSLU Standard 79 10,396 10,365 8,075 8,664 11,801 11,765 9,iG6 9,835 1t,019 11,983 9,336 10,017 12,238 12,201 9,506 10,199 FPD95 76 10,239 10,209 7,953 8,533 11,623 11,S8B 9A28 9,687 11,838 11,802 9,195 9,8b6 12,OS3 11,011 9,363 10,045 FPD90 73 9,711 9,142 7,590 8,143 11,092 11,OS8 8,615 9,2M 11,197 11,263 8,715 9,415 71,502 11,4fi8 8,935 9,586 FPDBS 69 9,195 9,261 7,220 7,746 10,551 10,519 8,195 8,793 10,74b 10,714 8,341 8,956 10,94� 10,909 8,499 9,119 FPD80 65 8,810 8,784 6,843 7,343 10,001 9,971 7,768 8,335 10,186 10,155 7,912 8.489 10,311 10,340 8,056 8.643 ,� � � � � � � �.� � � I AL3 ALS Al3LU ALSW Al3 ALS Al3LU ALSLU AL3 ALS AL3LU ALSW AL3 ALS AL3W ALSLU Standard 97 11,956 11,920 9,286 9,964 13,571 13,530 10,541 11,310 13,8t1 13,781 10,73fi 11,519 74,OR 14,031 10,931 71,729 FPD95 93 11,932 11,896 9,267 9,944 13,544 13,503 10,520 11,287 13,794 13,753 10,714 11,496 74,045 14,�3 10,909 11,705 FPD90 SB 11,399 11,364 8,853 9,500 12,939 11,999 10,050 10,783 13,178 13,139 10,236 10,982 13,411 13,377 10,427 11,182 FPD85 83 10,854 10,822 8,430 9,046 12,321 12,183 9,570 10,268 12,548 11,511 9,747 10,458 12,776 12,738 9,924 10,648 �� '�1 � '�I •� '�� AL3 Al5 Al3 ALS AL3 ALS AL3 ALS Standard 120 13,927 13,886 15,809 15,162 16,102 16A54 16,395 16,346 fPD95 113 13,362 13,323 15,168 iS,123 ! 15,449 15,403 � 15,730 15,663 FPD90 107 12,783 12,745 14,510 14,467 14,779 14,735 15,048 15,003 FPD85 101 11,188 12,152 13$35 13,794 � 14,092 14p50 14,348 14,305 ,� �� i•i ' � i AL3 ALS Al3 ALS AL3 ALS AL3 ALS - Standard 156 17,423 17,371 _ 19,776 19,717 - 20,143 20,083 20,509 20,448 FPD95 148 16,778 16,728 � 19,043 18,987 19,397 19,339 _ 19,749 19,691 FPD90 140 16,106 16,058 18,�81 18,221 18,620 18,565 � 18,959 18,9@ _ FPD85 133 75,408 15,362 _ 17,489 11,436 17,813 17,760 _ 18,137 18,083 � FPD80 126 14,684 14,640 16,667 16,617 16,976 16,925 17,�84 11,233 S�cuilyBrands. I Holophane � 3825 Columhus Ad., Granville, OH 43023 � Phone: 966-HOLOPHANE � www.holophane.com AWDE3u 02020AcuiryBrandsLighting,IncAllrightsreserved. Rev.10/06/20 Specificationssubjecttochangewithoutnotice. Page5of7 AWDE3 AcrylicWashington Postlite Utility LED3 Mark Appropriate Box forTrim Option Housing �� llll[i�l�l�l� � A ..- co�er ❑ Ribs ❑ Finial ❑ � BALL (BL) ❑ � CLEAR (CL) ��e � �`�i' ■ -� � ❑ ❑ ❑ ❑ ❑ ❑R � � / 1 EAGLE FLOWER KNURLED (EG) (FL) (KL) ❑ � PAWN (PN) �❑ ❑ � CROSS (CR) S�4cuiiyBrands. I Holophane � 3825 Columhus Ad., Granville, OH 43023 � Phone:866-HOLOPHANE � svv�w.holophane.com 02020AcuityBrandsLighting,IncA�lrightsreserved. Rev.10/06/20 Specificationssubjedtochangewithoutnotire. ❑ � STANDARD (ST) � HOLOPHANE� { �e DER IY WGIITfYG SOLUi1Q\S _I ❑ ROMAN CRO55 (RM) AWDE3u Page 6 of 7 Top Black (TB) No Cover (Blank) Full Cover (FNT) Ribs, Band, and Top Black (TB & RBMX) Medallions, Band, and Full Cover (FEM) Ribs, Band, and Full Cover (FRBM) Medallions and Band (MB) Ribs and Band (RBM) AWDE3 AcrylicWashington Postlite Utility LED3 OPTIONAL COMPONENTS . . . AO Manual field adjustable output dimming device RSBOR6 Motion and photosensor (Black) communicates wirelessly to other nLightAlR devices �� 20KV Safeguard your investment from extreme voltage spikes with our new Extreme 20kV/10kA SPD NLTAIR2 Fixture embedded nLight AIR network interface provides individual fixture control and digital dimming capabilities DE Remote Asset Management Control Decorative Node includes NEMA twistlock photocontrol receptacle S�euity8rands. I Holophane � 3825 Columhus Rd., Granville, OH 43023 � Plione:966-HOLOPHANE � www.holophane.com 02020AcuityBrandsLighting,Inc.Allrightsreserved. Rev.10/Ob/20 Spetificationssubjedtochangewithoutnotice. � HOLOPHANEB �enoea �v ucxnuc sowna�s AWDE3u Page 7 of 7 00 35 13 BID FORM Page 1 of 1 SECTION 00 35 13 CONFLICT OF INTEREST STATEMENT Each bidder, offeror or respondent (hereinafter referred to as "You") to a City of Fort Worth procurement may be required to complete a Conflict of Interest Questionnaire (the attached CIQ Form) and/or a Local Government Officer Conflicts Disclosure Statement (the attached CIS Form) pursuant to state law. You are urged to consult with counsel regarding the applicability of these forms to your company. The referenced forms may be downloaded from the links provided below. http://www.ethics.state.tx.us/forms/CIQ.pdf http�//www.ethics.state.tx.us/forms/CIS.pdf � ❑ � � 0 I�I BIDDER: CIQ Form does not apply CIQ Form is on file with City Secretary CIQ Form is being provided to the City Secretary CIS Form does not apply CIS Form is on File with City Secretary CIS Form is being provided to the City Secretary North Rock Construction 525 S Loop 288 Suite 105 Denton, Tx 76205 By: Printed Name Here Signature: Title: president END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form Revised 20171109 00 41 00 Bid Proposal Workbook (2).xls 00 41 00 BID FORM Page 1 of 3 SECTION 00 41 00 BID FORM TO: The Purchasing Manager c/o: The Purchasing Division 200 Texas Street City of Fort Worth, Texas 76102 FOR: City Project No's Units/Sections: Playground Replacement at Worth Hills, Casino Beach, Hillside 102342, 102456, 102337 Unit 1-Worth Hills Park Unit 2-Casino Beach Park Unit 3-Hillside Park 1. Enter Into Agreement The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with City in the form included in the Bidding Documents to perform and furnish all Work as specified or indicated in the Contract Documents for the Bid Price and within the Contract Time indicated in this Bid and in accordance with the other terms and conditions of the Contract Documents. 2. BIDDER Acknowledgements and Certification 2.1. In submitting this Bid, Bidder accepts all of the terms and conditions of the INVITATION TO BIDDERS and INSTRUCTIONS TO BIDDERS, including without limitation those dealing with the disposition of Bid Bond. 2.2. Bidder is aware of all costs to provide the required insurance, wili do so pending contract award, and will provide a valid insurance certificate meeting all requirements within 14 days of notification of award. 2.3. Bidder certifies that this Bid is genuine and not made in the interest of or on behalf of any undisclosed individual or entity and is not submitted in conformity with any collusive agreement or rules of any group, association, organization, or corporation. 2.4. Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid. 2.5. Bidder has not solicited or induced any individual or entity to refrain from bidding. 2.6. Bidder has not engaged in corrupt, fraudulent, collusive, or coercive practices in competing for the Contract. For the purposes of this Paragraph: a. "corrupt practice" means the offering, giving, receiving, or soliciting of any thing of value likely to influence the action of a public official in the bidding process. b. "fraudulent practice" means an intentional misrepresentation of facts made (a) to influence the bidding process to the detriment of City (b) to establish Bid prices at artificial non-competitive levels, or (c) to deprive City of the benefits of free and open competition. c. "collusive practice" means a scheme or arrangement between two or more Bidders, with or without the knowledge of City, a purpose of which is to establish Bid prices at artificial, non-competitive levels. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form Revised 20150821 00 41 00 Bid Proposal Workbook (2).xls 0o a� ao BID FORM Page 2 of 3 d. "coercive practice" means harming or threatening to harm, directly or indirectly, persons or their property to influence their participation in the bidding process or affect the execution of the Contract. 3. Qualification The Bidder acknowledges that the following work types must be perFormed only by qualified contractors and subcontractors: a. Surveying b.Concrete Paving c.Playground Erection d.Electrical 4. Time of Completion 4.1. The Work will be complete for Final Acceptance within 120 days days after the date when the the Contract Time commences to run as provided in Paragraph 2.03 of the General Conditions. 4.2. Bidder accepts the provisions of the Agreement as to liquidated damages in the event of failure to complete the Work {and/or achievement of Milestones} within the times specified in the Agreement. 5. Attached to this Bid The following documents are attached to and made a part of this Bid: a. This Bid Form, Section 00 41 00 b. Required Bid Bond, Section 00 43 13 issued by a surety meeting the requirements of Paragraph 5.01 of the General Conditions. c. Proposal Form, Section 00 42 43 d. Vendor Compliance to State Law Non Resident Bidder, Section 00 43 37 e. MWBE Forms (optional at time of bid) f. Conflict of Interest Affidavit, Section 00 35 13 *If necessary, CIQ or CIS forms are to be provided directly to City Secretary g. Any additional documents that may be required by Section 12 of the Instructions to Bidders 6. Total Bid Amount 6.1. Bidder will complete the Work in accordance with the Contract Documents for the following bid amount. In the space provided below, please enter the total bid amount for this project. Only this figure will be read publicly by the City at the bid opening. 6.2. It is understood and agreed by the Bidder in signing this proposal that the total bid amount entered below is subject to verification and/or modification by multiplying the unit bid prices for each pay item by the respective estimated quantities shown in this proposai and then totaling all of the extended amounts. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form Revised 20150821 00 41 00 Bid Proposal Workbook (2).xls 0o a� o0 BID FORM Page 3 of 3 6.3. Evaluation of Alternate Bid Items <use this if applicable, otherwise delete> Total Base Bid <use this if applicable, otherwise delete Alternate Bid <use this if applicable, otherwise delete> Deductive Alternate<use this if applicable, otherwise Additive Alternate <use this if applicable, otherwise Total Bid 7. Bid Submittal This Bid is submitted on April 29, 2021 Respectfully submitted, re) (Printed Name) $0.00 $0.00 #REF! #REF! $0.00 by the entity named below. Receipt is acknowledged of the Initial following Addenda: Addendum No. 1: JFG Addendum No. 2: Addendum No. 3: Addendum No. 4: Title: President Company: North Rock Construction Address: 525 S Loop 288 Suite 105 Denton, Tx 76205 State of Incorporation: Texas Email: jgann@nrockconstruction.com Phone: 940-220-5500 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form Revised 20150821 Corporate Seal: �, � , i �; � �� , , �, , 00 41 00 Bid Proposal Workbook (2).xls !IU d2 Jt mo reorus a�. r:�e� � ��n SECTION 00 42 43 PROPOSALFORM Unit #1- WORTH HILLS PARK- BASE BID --- - _ 1-01 Install temporary project construction siqn __ 01 58 13 _ __. _ _ _ ___ __. 1-02 Inslall temporary tree proteclion 32 93 43 __ _ _ _ _--- ___ _ -- 1-03 Remove items inside limits of demolition 02 41 13 - — _ ___ -----___. _ __ __ _ __ - — 1-04 Remove trees selective site demolition 02 41 13 _ _. 1-04 Proposed concrete walk 32 13 13__ 1-05 Proposed sub-drainape system (pipe,fabric, gravel) 11 68 13 __ 1-06 Proposed topsoil and qradinp 32 91 19 _ _ - -- - 1-07 Proposed playground eguipment (2-5 structure)___ ,_ 11 68 13_ _ 1-08 _ Prop_ osed playground equipment _(2 bay swinqs) 11 68 13 __ 1-09 Proposed wood fibar safety surfacinq ___ _ 12 68 15 - — -- -------- _, - 1-10 Proposed sod in all disirubed areas 32 92 13 __ __ _ -- -- 1-11 Pro osed terraced stones Unit #2 - CASINO BEACH PARK- BASE BID Bid List Item Description Speci(cation No. . Section No. 2-01_ Install temporary_project construction sign __ __ 01 58 13_ _ 2-02 _ Install tempora_ry_ tree prolection __ _ 32 93 43 _ 2-03 Remove all items inside limits of demolition 02 41 13 -----_--- -- ..__------- ------- ------ - 2-04 Remove concrete walk 02 41 15 --- ------- --- ___ ----- - --- -- 2-05 Proposed concrete walk 32 13 13 . 2-06 Proposed concrete mowstrip 32 13 13 _ 2-07 Proposed,ADA ramp 32 13 13 _ 2-08 Proposed sub-drainaqe system 11 68 13 _ _.___ - -- 2 09 Proposed topsoil placement ___ ____ 32 91 19 _ __ _ _. ._ _ --- 2 10 Proposed Qlayqround equipmenl�Prototype #2) _ 11 68 13 __ - --- - 2 11 Proposed wood fibar safety_surfacing _.____ _,___ 12 68 15 __ 2-12 Proposed sod in all distrubed areas 32 92 13 _ 2 13 Proposed benches _ _ ____ __ _ _ __ _ _ _ _ _ 32 33,00 _ _ - - - - --- -. 2 14 _ ProposedADAparkinq , _, , __ _ ___ _ _ ___„_. 2-15 Proposed road base parkinq __ LS 1 $1,013.18 -- - - LS 1 $1,744.15 - ------ _ _LS_ _ _� $4,903.47 --- _ ----- LS 1 $3,170.45 SF 496 $63.30 -- -- - - - - ---- LS 1 $10,752.84 - -- - ---- LS 1 $6,333.60 _ LS 1 $33,249.14 _ ------- LS 1 _ $7,546.03 SF 2070 $2.78 ---- -- - — --- LS 1 $12193.23 Unit o( Bid Unit Price Measure Quantity LS LS SF SF LF SF _ LS __ 31 1C i Bid Value 1 $1,013.18 $1013.18 __ _ ------ 1 . _ $1 848.54 __._ $1 848_54 - 1 _ $4,995.29 _ $4,995.29 315 $4.31 $1,357.65 ----- _ - — - - - -- --- 675 $35 83 _ _ $24,185.25 - --- 291 $46.41_ __ $13,50_5,31 -_ _ 1 $4,172.59 _ $4,172.59 _ __ 1 _$11,374.89 _ $11,374.89 _ 1 _$�619 20_ $3 619.20 1 . �$128,909.12 , _�8 909.12 -'-- - 5500 ___$3.37 ___$184535.00 _ 1 _ $12,645 63 ___$12,645.63 - --- 2 $1,920.20 __ $3,840.40 1 $6,572.16 $6,572.16 _ _. _1_ , , $2,164 27 ___ $22164.27 CfIY ()P F'(1RT W(HtI7I ST. W U.-\RU Cc)NSTRUCI fON SPIiCI�IC:\TI()N UOCUMLNTti Fnnn Rcvisal2(112UI30 IX7 91 00 l3id I'rvp.�»I W irzAMn�k �� a, nio reoros:u. Pag. 2 nf i SECTION 00 42 43 PROPOSALFORM Unit #3 - HILLSIDE PARK BASE BID Bid Lisl Ilem Specification Unil of Description No. Seclion No. Measure - __ _ __ 3-01 Install temporary project construction siqn .__ 01 58 13 LS - - - -- - --- ----- 3-02 Install temporary tree protection 32 93 43 LS _ __- -__ 3-03 Remove all items inside limits of demoiition 02 41 13 LS - - ___----- ----. _ _ - -- - _ _. ___ _--- 3-04 Remove concrete waik 02 41 15 SF ___ -- -- - - __ - - - . -- 3-05 Proposed concrete walk 32 13 13 SF _ -- -__ 3-06 Proposed concrete mowstrip 32 13 13 ._ LF --- 3-07 Proposed ADA ramp 32 13 13 _ EA - - - -- _ 3-08 Proposed sub-drainape system 11 68 13 LS _ -- _ 3-09 Proposed_t_opsoilplacement _ _.__________ 329119___ LS _ ---- 3-10 Proposed playground equipment (Prototype #3) 11 68 13 LS - —_ __� _ _ - -- -- 3-11 _ Proposed wood fibar safety surfacing _ 12 68 15 __ SF _ 3-12 __ Proposed sod in all distrubed areas 32 92 13_ _ LS _ 3-13 Proposed benches 32 33 00_ EA _ Bid __ _., _ Unil Price 1 $1,013.1 1 $2,039.E 1 $4,536.1 _- -- ---- - 3577 $1.f _-- - --- 1385 $20.( - 298 $45.E -- - - - - -- 1 $4,172.� 1 $11�996_c ---1- $3,958_`, 6137I 1_ $12,_t 2 $2.2 Bid Value 11 172 cm� nr ruar wuaru SI'.-\ND:\ItU CU.ISIRUCll(1N tiPYCIPIC:\TI<)N IXX'UMIN �ti Fnnn Re�ix•d 2a12U12o W al OD UiJ Prop�s�l WurkM�k U(I J2 43 131U I'Hc)P()ti:\I. Pogc 1 ��f i SECTION 00 42 43 PROPOSALFORM Total Bid $751,770.09 END OF SECTION cnv o�� roK�r wok'ri� tiT.�NU.\RD Cl)N57RI7CT1()N tiPLCII7C.-\1I/1N IXK'11Mk:Nl'ti I�omi Rcvi»J 201 �U I?n O1141 f� Oid Pn.p��l WwkFuuk 00 43 13 BID BOND Page 1 of 2 SECTION 00 43 13 BID BOND KNOW ALL BY THESE PRESENTS: That we, North Rock Construction, LLC , known as "Bidder" herein and ��'` ' � ,��t,�UC�r�r�� r�i�ny , , „ g , �, € a corporate surety duly authorized to do business in the State of Texas, known as "Surety° herein, are held and firmly bound unto the City of Fort Worth, a municipal corporation created pursuant to the laws of Texas, known as "City" herein, in the penal sum of five percent (5%) of Bidder's maximum bid price, in lawful money of the United States, to be paid in Fort Worth, Tarrant County, Texas for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has submitted a bid or proposal to perform Work for the following project designated as Playground Replacement at Worth Hills, Casino Beach, Hillside Park 0 NOW, THEREFORE, the condition of this obligation is such that if the City shall award the Contract for the foregoing project to the Principal, and the Principal shall satisfy all requirements and conditions required for the execution of the Contract and shall enter into the Contract in writing with the City in accordance with the terms of such same, then this obligation shall be and become null and void. If, however, the Principal fails to execute such Contract in accordance with the terms of same or fails to satisfy all requirements and conditions required for the execution of the Contract, this bond shall become the property of the City, without recourse of the Principal and/or Surety, not to exceed the penalty hereof, and shall be used to compensate City for the difference between Principal's total bid amount and the next selected bidder's total bid amount. PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division. IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED this instrument by duly authorized agents and officers on this the 29th day of Aprii , 2021. PRINCIPAL: North Rock Con BY: �,i �tion, LLC ,�� i � � � � t �, ' �; .�- �i��C �0�,�-f" Name and Title CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form Revised 20171109 00 41 00 Bid Proposal Workbook (2).xls 00 43 13 BID BOND Page 2 of 2 Attach Power of Attorney (Surety) for Attorney-in-Fact Address: 525 S. Loop 288, Suite 105 nPnton TX 76205 SURETY: Atlantic Specialty Insurance BY: ' � - � � Brady K. Cox. Attorney-in-Fa�t� � ? �' ; ! , '� � , �, � Name and Title ` � � � Address: 605 Hi hway 169 Norfh, Suit� 800 Plymouth, MN 55441 ''�—' Telephone Number: 781-332-7000 "'Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by laws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form Revised 20171109 00 41 00 Bid Proposal Workbook (2).xls � intact INSURpNCE x KNOW ALL MEN BY THESE PRESENTS, that ATLANTIG SPECIALT'Y INSURANCE COMPANY, a New York cpiPoratipn with its principal office in Plymquth, Minnesota, does hereby cpnstitute and appoint: William Baldwin, Blaine Allen, Brent Baldwin, Brock Baldwin, Brady K. Cox, Russ Frenzel, Michael B. Hill, Chandler Nazzal, John A Aboumrad, each individually if there be more than one named, its true and lawful Attomey-in-Fact, to make, execute, seal and deliver, for and on its behalf as surety, any and all bonds, recognizances, contracts of indemnity, and all other wriungs obligatory in the namre thereof; provided that no bond or undertaking executed under this authority shall exceed in amount the sum of: unlimited and the execution of such bonds, recognizances, contracts of indemnity, and all other writings obligatory in the nature therepf in pursuance of these presents, shall be as binding upon said Company as if they had been fully signed by an authorized officer of the Company and sealed with the Company seal. This Power of Attorney is made and executed by authority of the following resolutipns adopted by the Board of Directors of ATLANTIC SPECIALT'I' INSURANCE COMPANY qn the twenty-fifth day of September, 2012: Resolved: That the President, any Senior Vice President or Vice-President (each an "Authorized Officer") may execute for and in behalf of the Company any and all bonds, recognizances, contracts of indemni[y, and all other writings obligatory in the nature thereof, and affix the seal of the Gompany thereto; and that the Authorized Officer may appoint and authorize an Attorney-in-Fact to execute on behalf of the Company any and all such instruments and to affix tk�e Company seal thereto; and that the Authorized Officer may at any time remove any such Attorney-in-Fact and revoke all power and authority given to any such Attorney-in- Fact. Resolved: That the Attorney-in-Fact may be given full power and authority to execute for and in the name and on behalf of the Company any and all bonds, recognizances, contracts of indemnity, and all other writings obligatory in the nature thereof, and any such instrument executed by any such Attorney-in-Fact shall be as binding upon the Company as if signed and sealed by an Authorized Officer and, further, the Attorney-in-Fact is hereby authorized to verify any affidavit required to be attached to bonds, recognizances, contracts of indemni[y, and all other writings obligatory in the nature thereof. This power of attorney is signed and sealed by facsimile under the authority of the following Resolution adopted by the Board of Directors of ATLANTIC SPEGIALTY INSURANCE COMPANY on the twenty-fifth day of September, 2012: Resolved: That the signature of an Authorized Officer, the signature of the Secretary or the Assistanc Secretary, and the Company seal may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing an Attorney-in-Fact for purposes only of executing and sealing any bpnd, undertaking, recognizance or other written obligation in the nature thereof, and any such signature and seal where so used, being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed. IN WITNESS WHEREOF, ATLANTIC SPECIALTY INSURANCE COMPANY has caused these presents to be signed by an Authorized Pfficer and the seal of the Company to be affiaced this twenty-seventh day of April, 2020. $TATE OF MINNESOTA HENNEPIN COLJN'1'Y . 'Y -o �PPOR,qr�9 n ; SEAL =�': � sa� � : �Y �!�,Y9P��.ba Paul J. Brehm, Senior Vice President On this twenty-seventh day of April, 2020, before me personally came Paul J. Brehm, Senior Vice President of ATLAN'TIC SPECIALTY INSURANGE COMPANY, to me personally known to be the individual and officer described in and who executed the preceding instrument, and he acknowledged the execution of the same, and being by me duly sworn, that he is the said officer of the Company aforesaid, and that the seal affixed.to the preceding instrument is the seal of said Company and that the said seal and the signature as such officer was duly affixed and subscribed to the said instrume�t by the authority and at the direction of the Company. ALiSON DWAN NASH•TROUT cpires 25 %sti�n �z�� /i� Notary Public I, the undersigned, Secretary of ATLANTIC SPECIALT'I' INSURANCE COMPANY, a New York Corporation, do hereby certify that the foregoing ppwer of attorney is in full force and has not been revoked, and the resolu[ions set forth above are now in force. Signed and sealed. Dated 29th day of ApPll 2�2� This Power of Attorney expires January 31, 2025 , I „' , , �I � � � � � �� t ,�,,' ,�� .� , �,, � , �� Kara Barrow, Secretary Please direc[ bond verificaaons to suren=r7intactinsurance.com IMPORTANT NOTICE To obtain infarmation or make a complaint: You may contact your agent. AVISO IMPORTANTE Para obtener informacion o para someter una queja: Puede communicarse con su agente. You may cail your Insurance Carrier's toll-free Usted puede Ilamar al numero de telefono gratis de su telephone number for information or to make compania de seguros para informacion o para someter a complaint at: una queja al: 1-800-321-2721 You may also write to your Insurance Carrier � Atlantic Specialty Insurance Company Paralegai 605 Highway 169 North, Suite 800 Plymouth, MN 55441 Email: surety@intactinsurance.com Phone:1-800-662-0156 1 �00,321-2721 Usted tambien puede escribir a su compania de seguros en: Atlantic Specialty Insurance Company Paralegal 605 Highway 169 North, Suite 800 Plymouth, MN 55441 Email: surety@intactinsurance.com Phone:1-800-662-0156 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints � 1-800-252-3439 You may write the Texas Department of I nsurance: P.O. Box 149104, Austin, TX 78714-9104 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: ConsumerProtectionCc�tdi.texas.qov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companias, coberturas, derechos o quejas al: 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas: P.O. Box 149104, Austin, TX 78714 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: ConsumerProtection(a�tdi.texas.qov DISPUTAS SOBRE PRIMAS ❑ RECLAMOS: Si tiene una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI). ATTACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA: Este aviso es solo This notice is for information only and does opara proposito de informacion y no se convierte en parte not become a part or condition of the attached condicion del documento adjunto. document. VCM PHN TX 001 10 13 00 43 37 VENDOR COMPLIANCE TO STATE LAW Page 1 of 1 SECTION 00 43 37 VENDOR COMPLIANCE TO STATE LAW NON RESIDENT BIDDER Texas Government Code Chapter 2252 was adopted for the award of contracts to nonresident bidders. This law provides that, in order to be awarded a contract as low bidder, nonresident bidders (out-of-state contractors whose corporate offices or principal place of business are outside the State of Texas) bid projects for construction, improvements, supplies or services in Texas at an amount lower than the lowest Texas resident bidder by the same amount that a Texas resident bidder would be required to underbid a nonresident bidder in order to obtain a comparable contract in the State which the nonresident's principal place of business is located. The appropriate blanks in Section A must be filled out by all nonresident bidders in order for your bid to meet specifications. The failure of nonresident bidders to do so will automatically disqualify that bidder. Resident bidders must check the box in Section B. A. Nonresident bidders in the State of State Here or Blank! , our principal place of business, are required to be % Here ' percent lower than resident bidders by State Law. A copy of the statute is attached. Nonresident bidders in the State of �,. �te Here or Blankf , our principal place of business, are not required to underbid resident bidders. B. The principal place of business of our company or our parent company or majority owner is in the State of Texas. � BIDDER: North Rock Construction 525 S Loop 288 Suite 105 Denton, Tx 76205 By: Printed Name Here Title Date: END OF SECTiON CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Form Revised 20110627 President April 28, 2021 00 41 00 Bid Proposal Workbook (2).xls 00 45 26 - I CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW Page 1 of 1 fl i� SECTION 00 45 26 CONTRACTOR COMPLtANCE WITH WORKER'S COMPENSATION LAW 3 Pursuant to Texas Labor Code Section 406.096(a), as amended, Contractor certifies that it 4 provides worker's compensation insurance coverage for all of its employees employed on City 5 Project No. 102031, 102032, 102033. Contractor further certifies that, pursuant to Texas Labor 6 Code, Section 406.096(b), as amended, it will provide to City its subcontractor's certificates of 7 compliance with worker's compensation coverage. 8 E l0 11 12 13 14 15 16 l7 18 19 20 21 22 23 24 CONTRACTOR: North Rock Construction Company 525 S Loop 288 Suite 105 Address Denton, Ci ty/State/Zip Tx 76205 THE STATE OF TEXAS COUNTY OFTARRANT 0 � gy; John F Gann II Signat�rre Title: (Please Print) 25 BEFORE ME, the undersigned authority, on this day personally appeared 26 ��, /� �� C�� , known to me to be the person whose name is 27 subs— cr�ib`e'd�to the foregoing instrument, and acknowledged to me that he/she executed the same as 28 the act and deed of Nb✓•f�G� Pio/�,�, �r yi r�,c c�i1bK , L�C for the purposes and 29 consideration therein expressed and in the capacity therei— n�d. 30 31 32 33 34 35 36 37 Ri:? 39 GIVEN UNDER MY HAND AND SEAL OF OFFICE this .�� , 20 Z ( Juan Pedro Najera Jr. My Commisslon Expires 03/04/2024 ID No. 130567983 CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS END OF SECTION 2 � y�' day of Pla,��ground Repluceme�V a1 6I'orlh Hi/Ls, Cusino Beuch, Hillside Park (Please Print) President 102342, 102156, l02337 Revised July l, 2011 005243-1 Agreement Page l of 5 SECTiON 00 52 43 AGREEMENT THiS AGREEMENT, authorized on June 22, 2021 is made by and between the City of Fort Worth, a Texas home rule municipality, acting by and through its duly authorized City Manager, ("City"), and North Rock Construction, LLC, authorized to do business in Texas, acting by and through its duly authoi•ized representative, ("Contractor"). City and Conh-actor, in consideration of the mut�ial covenants hereinafter set forth, agree as follows: Article 1. WORK Contractoi• shall cotnplete all Work as specified or indicated in the Contract Documents for the Project identified herein. Article 2. PROJECT Tl�e project for which the Work under the Contract Documents may be the whole or only a part is generally described as follows: Playground Replacement at Worth Hills, Casino Beach, Hillside. City Project No's. 102342, 102456, 102337. Article 3. CONTRACT PRICE City agrees to pay Contractor for perfonnance of the Work in accordance with the Contract Documents an amount, seven hundred twenty six thousand six hundred eighty dollars twenty eight cents in current funds, of Dollars ($ 726,680.28). Article 4. CONTRACT TIME 4.1 Final Acceptance. The Work will be complete for Final Acceptance within l20 days after the date when the Contract Time commences to run, as provided in Paragraph 2.03 of the General Conditions, plus any extension tl�ereof allowed in accordance with Article 12 of the General Conditions. 4.2 Liquidated Damages Contractor recognizes that time is of'tJae essence for completion of Milestones, if any, and to achieve Final Acceptance of the Work and City will suffer financial loss if the Work is not completed within the time(s) specified in Paragraph .4.1 above. The Contractor also recognizes the delays, expense and difficulties involved in proving in a legal proceeding, the actual loss suffered by the City if the Work is not completed on time. Accordingly, instead of requiring any such proof, Contractor agrees that as liquidated damages for delay (but not as a penalty), Contractar shall pay City Six Hundred Fifty Dollars ($650) for each day that expires after the time specified in Paragraph 4.l for Final Acceptance until the City issues the Final Letter of Acceptance. Article 5. CONTRACT DOCUMENTS 5.1 CONTENTS: A. The Contract Documents which comprise the entire agreement between City and Contractor concerning the Work consist of the following: 1. This Agreement. 2. Attachments to this Agreement: CiTY OF FORT WORTH Playground Replacement at Wordi hills, Casino Beach, Hillside STANDARD CONSTRUCT[ON SPECIFICATION DOCUMENTS 102342, 102456, 102337 Revised 09/06/2019 005243-2 Agreement Page 2 of 5 3 4. a. b. c. d. e. f. g� h. i. Bid Form 1) Proposal Form 2) Vendor Compliance to State Law Non-Resident Bidder 3) Prequalification Statement 4) State and Federal documents (�roject specific) Current Prevailing Wage Rate Table Insui•ance ACORD Form(s) Pay►nent Bond Perforinance Bond Maintenance Bond Power of Attorney for the Bonds Worker's Compensation Affidavit M/WBE and/or SBE Utilization Form General Conditions. Supplementary Conditions. 5. Specifications specifically made a part of the Contract Docmnents by attachment or, if not attached, as incorporated by reference and described in the Table of Contents of the Project's Contract Docuinents. 6. Drawings. 7. Addenda. 8. Documentation submitted by Contractor prior to Notice of Award. 9. The following which may be delivered or issued after the Effective Date of the Agreement and, if issued, become an incorporated part of the Contract Documents: a. Notice to Proceed. b. Field Orders. c. Change Orders. d. Letter of Final Acceptance. Article 6. INDEMNIFICATION 6.1 Contractor covenants and agrees to indemnify, hold harmless and defend, at its own expense, the city, its officers, servants and employees, from and against any and all claims arising out of, or alleged to arise out of, the work and services to be performed by the contractor, its officers, agents, employees, subcontractors, licenses or invitees under this contract. This indemnification provision is specificallv intended to operate and be effective even if it is alle�ed or proven that all or some of the dama�es bein� sou�ht were caused in whole or in part, bv anv act, omission or ne�ligence of the citv. This indemnity provision is intended to include, without limitation, indemnity for costs, expenses and legal fees incurred by the city in defending against such claims and causes of actions. CITY OF FORT WORTH Playground Replacemen[ at Worth hills, Casino Beach, Hillside STANDARD CONSTRUCTION SPECIFICATION DOCLTMENTS 102342, 102456, 102337 Revised 09/06/2019 005243-3 Agreement Page 3 of 5 6.2 Contractor covenants and agrees to indemnify and hold harmless, at its own expense, the city, its officers, servants and employees, from and against any and all loss, damage or destruction of property of the city, arising out of, or alleged to arise out of, the work and services to be performed by the contractor, its officers, agents, employees, subcontractors, licensees or invitees under this contract. This indemni�cation provision is specificallv intended to operate and be effective even if it is alleged or proven that all or some of the damaEes bein� sou�ht were caused, in whole or in part, bv anV act, omission or negli�ence of the citv. Article 7. MiSCELLANEOUS 7.1 Terms. 7.2 7.3 7.4 7.5 7.6 Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. Assignment of Contract. This Agreement, including all of the Contract Documents may not be assigned by the Contractor without the advanced express written consent of the City. Successors and Assigns. City and Contractor each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, in respect to all covenants, agreements and obligations contained in the Contract Documents. Severability. Any provision or part of the Contract Documents held to be unconstitutional, void or unenforceable by a court of competent jurisdiction shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon CITY and CONTRACTOR, Governing Law and Venue. This Agreement, including all of the Contract Documents is performable in the State of Texas. Venue shall be Tarrant County, Texas, or the United States District Court for the Northern District of Texas, Fort Worth Division. Authority to Sign. Contractor shall attach evidence of authority to sign Agreement if signed by someone other than the duly authorized signatory of the Contractor. 7.7 Prohibition On Contracts With Companies Boycotting Israel. Contractor acknowledges that in accordance with Chapter 2270 of the Texas Government Code, the Ciry is prohibited from entering into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott israel during the term of the contract. CITY OF FORT WORTH Playground Replacement at Worth hills, Casino Beacli, Hillside STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 102342, 102456, 102337 Revised 09/06/2019 0o sz a3 - a Agreement Page 4 of 5 7.8 7.9 The terms "boycott Israel" and "company" shall have the meanings ascribed to those terms in Section 808.00 ] of the Texas Government Code. By sigrring tl:is cor:tract, Contractor certifies that Co�:tractor's sig�iature provides writtei: verification to the City tliat Contractor: (1) does not boycott Israel; a�td (2) will »ot boycott 7srael duriirg tlze tei•»z of t/7e contract. Immigration Nationality Act. Contractor shall verify the identity and employment eligibility of its employees who perform work under this Agreement, including completing the Employment Eligibility Verification Form (I-9). Upon request by City, Contractor shall provide City with copies of all I-9 forms and supporting eligibility documentation for each employee who performs work under this Agreement. Contractor shall adhere to all Federal and State laws as well as establish appropriate procedures and controls so that no services will be perfonned by any Contractor employee who is not legally eligible to perfoi7n such seivices. CONTRACTOR SHALL INDEMNIFY CITY AND HOLD CiTY HARMLESS FROM ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO ViOLATIONS OF THIS PARAGRAPH BY CONTRACTOR, CONTRACTOR'S EMPLOYEES, SUBCONTRACTORS, AGENTS, OR LICENSEE5. City, upon written notice to Contractor, shall have the right to iinmediately terminate this Agreement for violations of this provision by Contractor. No Third-Party Beneficiaries. This Agreement gives no rights or benefits to anyone other than the City and the Contractor and there are no third-party beneficiaries. 7.10 No Cause of Action Against Engineer. Conh-actor, its subconh-actors and equipment and materials suppliers on the PROJECT or their sureties, shall maintain no direct action against the Engineer, its officers, employees, and subcontractors, for any claim arising out of, in connection with, or resulting from the engineering services performed. Only the City will be the beneficiary of any undertaking Uy the Engineer. The presence or duties of the Engineer's personnel at a construction site, whether as on-site representatives or otherwise, do not make the Engineer or its personnel in any way responsible for those duties that belong to the City and/or the City's construction contractors or other entities, and do not relieve the construction contractors or any other entity of their obligations, duties, and responsibilities, including, but not limited to, all construction methods, means, techniques, sequences, and procedures necessary for coordinating and completing all portions of the construction work in accordance with the Contract Documents and any health or safety precautions required by such construction work. The Engineer and its personnel have no authority to exercise any control over any consUuction contractor or other entity or theu employees in connection with their work or any health or safety precautions. SIGNATURE PAGE TO FOLLOW CITY OF FORT WORTH Playground Replacement at Worth hills, Casino Beach, Hillside STANDARD CONSTRUCTION SPECiFICATION DOCUMENTS 102342, 102456, 102337 Revised 09/06/2019 00 52 43 - 5 Agreement Page 5 of5 IN WITNESS WHEREOF, City and Contractor have each executed this Agreement to be effective as of the date subscribed by the City's designated Assistant City Manager ("Effective Date"). Contractor: A} or� (loc)l {ov,.5�-fio "' By: Signam � (Printed Name) � Pr-tsi'� fTitle S1-.s Sa""!d,, Loop 29� ,ft.,Jk /4� Address D-w111 "J , /.eX'.'. 2.1 ?6a � City/State/Zip Date'' CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised 09/06/2019 City of Fort Worth By: Valerie R. Washington Assistant City Manager Date Attest: Ronald Gonzalez Acting City Secretary ·(Seal) M&C: 21-0486 Date: 6/22/21 Form 1295 No.: 2021-751090 Contract Compliance Manager: By signing, I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Patrick Vicknair Project Manager Approved as to Form and Legality: Douglas W. Black Assistant City Attorney APPROVAL RECOMMENDED: Richard Zavala Director, Park & Recreation Department Playground Replacement at Worth hills, Casino Beach, Hillside 102342, 102456, 102337 Richard Zavala (Jul 14, 2021 19:13 CDT) Richard Zavala DBlack (Jul 16, 2021 14:28 CDT) Valerie Washington (Jul 16, 2021 16:21 CDT) Valerie Washington Jul 16, 2021 Ronald P. Gonzales (Jul 16, 2021 16:55 CDT) Ronald P. Gonzales , 00 61 14 - 1 PAYMENT BOND Page 1 of 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 THE STATE OF TEXAS COUNTY OF TARRANT SECTION 00 61 14 PAYMENT BOND § § § Bond No. 800024024 KNOW ALL BY THESE PRESENTS: That we, North Rock Construction, LLC , known as "Principal" herein, and Atlantic Specialty Insurance Company , a corporate surety (sureties), duly authorized to do business in the State of Texas, known as "Surety" herein (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created pursuant to the laws of the State of Texas, known as "City" herein, lri the penal SU1Tl Of Seven Hundred Twenty Six Thousand Six Hundred Eighty Dollars 28/100 Dollars ($ 726,680.28 ), lawful money of the United States, to be paid in Fort Worth, Tarrant County, Texas, for the payment of which sum well and truly be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents: 17 WHEREAS, Principal has entered into a certain written Contract with City, awarded the 18 22nd day of June , 20 21 , which Contract is hereby referred to and 19 20 21 22 23 24 25 26 27 28 29 30 31 made a part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment, labor and other accessories as defined by law, in the prosecution of the Work as provided for in said Contract and designated as Playground Replacement at Worth Hills, Casino Beach, Hillside Park 102342, 102456, 102337. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Principal shall pay all monies owing to any (and all) payment bond beneficiary (as defined in Chapter 2253 of the Texas Government Code, as amended) in the prosecution of the Work under the Contract, then this obligation shall be and become null and void; otherwise to remain in full force and effect. This bond is made and executed in compliance with the provisions of Chapter 2253 of the Texas Government Code, as amended, and all liabilities on this bond shall be determined in accardance with the provisions of said statute. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July l, 2011 Plnyg�rotrnd Replacement at G�'orth Hills, Casino ]3each, Hillside Park 102342, 102456, 102337 00 61 14 - 2 PAYMENT BOND Page 2 of 2 1 IN WITNESS WHEREOF, the Principal and Surety have each SIGNED and SEALED 2 this instrument by duly authorized agents and officers on this the 25th day of 3 � June , 20 21 PRINCIPAL: North Rock Construction, LLC Veronica Ramo� � Witness as to Surety 1 �' ,' z - � ' ' , ,;� '� . , , , . �i � , ) '' �" �� ' i, BY: � ,; ' Signa � � ,,, John F. Gann II, President Name and Title Address: 525 S. Loop 288 Suite 105 Denton, TX 76205 SURETY: Atlantic Specialty Insurance Company BY: Signature Blaine Allen, Attorney-in-Fact Name and Title Address: 605 Highway 169 North Suite 800 Plymouth, Minnesota 55441 Telephone Number: (952) 852-2431 A T•1'TCIT. ATTEST: ) Secretary �,�l�i� �.n`�� 5 6 7 8 9 10 11 12 Note: If signed by an officer of the Surety, there must be on file a certified e�ract from the bylaws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. END OF SECTION C1TY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 Playgro:ind Replacement at Warth I�ills, Casino Beach, Hrllside Park 102342, 102456, 102337 . 006113-1 PERFORMANCE BOND Page 1 of 2 1 2 3 4 5 6 SECTION 00 61 13 Bond No. 800024024 PERFORMANCE BOND THE STATE OF TEXAS COUNTY OF TARRANT § § KNOW ALL BY THESE PRESENTS: § 7 That we, North Rock Construction, LLC 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 known as "Principal" herein and Atlantic Specialty Insurance Company , a corporate surety(sureties, if more than one) duly authorized to do business in the State of Texas, known as "Surety" herein (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created pursuant to the laws of Texas, known as "City" herein, in the penal SUITl Of, Seven Hundred Twenty Six Thousand Six Hundred Eighty Dollars 28/100 Dollars ($ 726,680.28 ), lawful money of the United States, to be paid in Fort Worth, Tarrant County, Texas for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has entered into a certain written contract with the City awarded the 22�d day of June , 20 21, which Contract is hereby referred to and made a part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment labor and other accessories defined by law, in the prosecution of the Work, including any Change Orders, as provided for in said Contract designated as Arcadia Trails Park - Playground Replacements 102031, 102032, 102033. NOW, THEREFORE, the condition of this obligation is such that if the said Principal shall faithfully perform it obligations under the Contract and shall in all respects duly and faithfully perform the Work, including Change Orders, under the Contract, according to the plans, specifications, and contract documents therein referred to, and as well during any period of extension of the Contract that may be granted on the part of the City, then this obligation shall be and become null and void, otherwise to remain in full force and effect. PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 Yltryground Replacemen� at W'orth Hills, Casrno Beach, HilTside Park 102342, 102456, 102337 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18I 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 00 61 13 - 2 PERFORMANCE BOND Page 2 of 2 This bond is made and executed in compliance with the provisions of Chapter 2253 of the Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said staiue. IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED this instrument by duly authorized agents and o�cers on this the 25th day of June , 20 21 . PRINCIPAL: North Rock Construction , LLC Veronica Ram� , Witness as to Surety , BY: , ' , , Si r � John F. Gann II, President Name and Title Address: 525 S. Loop 288 Suite 105 Denton, TX 76205 � �, � �, � ; � , � , SURETY: ' � � � ' � ' Atlantic Specialty Insurance Company�� , , �,� ' ' , � " � , , j , BY: ' Signature Blaine Allen, Attorney-in-Fact Name and Title Address: 605 Highway 169 North Suite 800 Plymouth, Minnesota 55441 Telephone Number: (952) 852-2431 !„ ��/>, 11��,. *Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 Playground Replacement at YVor[h Nills, Casino ]3each, Hillside Park 102342, 102456, 102337 006119-1 � MAINTENANCE BOND Page 1 of 3 1 2 3 4 5 6 7 8 9 10 11 12 SECTION 00 61 19 MAINTENANCE BOND THE STATE OF TEXAS COUNTY OF TARRANT r, Bond No. 800024024 KNOW ALL BY THESE PRESENTS: That we North Rock Construction. LLC "Principal" herein and Atlantic Specialty Insurance Company , a corporate surety (sureties, if more than one) duly authorized to do business in the State of Texas, known as "Surety" herein (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created pursuant to the laws of the State of Texas, known as "City" herein, 13 lri tile SU1T1 Of Seven Hundred Twenty Six Thousand Six Hundred Eighty and 28/100 Dollars 14 ($ 726,680.28 ), lawful money of the United States, to be paid in Fort Worth, 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Tarrant County, Texas, for payment of which sum well and truly be made unto the City and its successors, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has entered into a certain written contract with the City awarded the 22nd day of June , 20 21 , which Contract is hereby referred to and a made part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment labor and other accessories as defined by law, in the prosecution of the Work, including any Work resulting from a duly authorized Change Order (collectively herein, the "Work") as provided for in said contract and designated as Playground Replacement at Worth Hills, Casino Beach, Hillside Park 102342, 102456, 102337 and WHEREAS, Principal binds itself to use such materials and to so construct the Work in accordance with the plans, specifications and Contract Documents that the Work is and will remain free from defects in materials or workmanship for and during the period of two (2) years after the date of Final Acceptance of the Work by the City ("Maintenance Period"); and CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 Pluyground Replacentent ut Wo�•th Hills, Casino Beach, Hillside Park 102342, 102456, 102337 00 61 19 - 2 MAINTENANCE BOND Page 2 of 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 WHEREAS, Principal binds itself to repair or reconstruct the Work in whole or in part upon receiving notice from the City of the need therefor at any time within the Maintenance Period. NOW THEREFORE, the condition of this obligation is such that if Principal shall remedy any defective Work, for which timely notice was provided by City, to a completion satisfactory to the City, then this obligation shall become null and void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, if Principal shall fail so to repair or reconstruct any timely noticed defective Work, it is agreed that the City may cause any and all such defective Work to be repaired and/or reconstructed with all associated costs thereof being borne by the Principal and the Surety under this Maintenance bond; and PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division; and PROVIDED FURTHER, that this obligation shall be continuous in nature and successive recoveries may be had hereon for successive breaches. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Playground Replacenzent u! I�I'orlh Hills, Casino Beach, Hi//srde Park 102342, 102456, 102337 Revised July 1, 2011 00 61 19 - 3 MAINTENANCE BOND Page 3 of 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 IN WITNESS WHEREOF, the Principal and the Surety have each SIGNED and SEALED this instrument by duly authorized agents and officers on this the 25th day of June � 20 21 PRINCIPAL: North Rock Construction, LLC ATTEST: (Surety) Secretary,//Li re.�/�/c�vrlc� ��. . Veronica Ramo Witness as to Surety BY: � � Si uie , � � John F. Gann II, President Name and Title Address: 525 S. Loop 288 Suite 105 Denton, TX 76205 , SURETY• � , � , ��, • �� , ,, 1�1 �� i � �� Signature % ; �; Atlantic Specialty Insurance Company-� ` , i BY: ' -i Blaine Allen, Attorney-in-Fact Name and Title Address: 605 Highway 169 North Suite 800 Plymouth, Minnesota 55441 Telephone Number: (952) 852-2431 �� , *Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Playground Replacenient a! {�Vo��th Hills, Casino Beach, Hil/srde Park 102342, 102456, 102337 Revised July 1, 2011 � intact INSURANCE �;4 t � � KNOW ALL MEN BY THESE PRESENTS, that AT"LANTIC SPECIALT'Y INSURANCE COMPANY, a New York corporation with its principal office in PlymoutU, Minnesota, does hereby constitute and appoint: William Baldwin, Blaine Allen, Brent Baldwin, Brock Baldwin, Brady K. Cox, Russ Frenzel, Michael B. Hill, Chandler Nazzal, John A Aboumrad, each individually if there be more than one named, its true and lawful Attomey-in-Fact, to make, execute, seal and deliver, for and on its behalf as surety, any and all bonds, recognizances, con�acts of indemnity, and all other writings obligatory in the nature thereof; provided that no bond or undertaking executed under this authority shall exceed in amount the sum of: unlimited and the execution of such bonds, recognizances, contracts of indemnity, and all other writings obligatory in the nature thereof in pursuance of these presents, shall be as binding upon said Company as if they had been fully signed by an authorized officer of the Company and sealed with the Company seal. This Power of Attorney is made and executed by authority of the following resolutions adopted by the Board of Directors of ATLANTIC SPECIALTY INSURANCE COMPANY on the twenty-fifth day of September, 2012: Resolved: That the President, any Senior Vice President or Vice-President (each an "Authorized Officer") may execute for and in behalf of the Company any and all bonds, recognizances, contracts of indemnity, and all other wriungs obligatory in the nature theteof, and affix the seal of the Company thereto; and that the Authorized Officer may appoint and authorize an Attomey-in-Fact to execute on behalf of the Company any and all such instruments and to affiac the Company seal thereto; and that the Authorized Officer may at any time remove any such Attorney-in-Fact and revoke all power and authority given to any such Attomey-in- Fact. Resolved: That the Attomey-in-Fact may be given full power and authoriry to execute for and in the name and on behalf of the Company any and all bonds, recognizances, contracts of indemniry, and all other writings obligatory i� the nature thereof, and any such instrument executed by any such Attorney-in-Fact shall be as binding upon the Company as if signed and sealed by an Authorized Officer and, further, the Attorney-in-Fact is hereby authorized to verify any affidavit required to be attached to bonds, recognizances, contracts of indemnity, and all other writings obligatory in the nature thereof. This power of attorney is signed and sealed by facsimile under the authoriry of the following Resolution adopted by the Board of Directors of ATLANTIC SPECIALTY INSURANCE COMPANY on the twenty-fifth day of Septembeg 2012: Resolved: That the signature of an Authorized Officer, the signature of the Secretary or the Assistant Secretary, and the Company seal may be affixed by facsimile to any power of attorney or to any certificate relating thereto appointing an Attorney-in-Fact for purposes only of execuflng and sealing any bond, undertaking, recognizance or other written obligation in the nature thereof, and any such signature and seal where so used, being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force a�d effect as though manually affiaced. IN WITNESS WHEREOF, ATLANTIC SPECIALTY INSURANCE COMPANY has caused these presents to be signed by an Authorized Officer and the seal of the Company to be affixed this twenty-seventh day of April, 2020. STATE OF MINNESOTA HENNEPIN COUNTY �¢�Ogqr�,9�=: SEAL %�": 1986 0 �' sy cW.YaPad!',3s'` Paul J. Brehm, Senior Vice President On this twenty-seventh day of April, 2020, before me personally came Paul J. Brehm, Senior Vice President of ATLANTIC SPECIALTY INSURANCE COMPANY, to me personally known to be the individual and officer described in and who executed the preceding instrument, and he acknowledged the execution of the same, and being by me duly sworn, that he is the said officer of the Company aforesaid, and that the seal affixed to the preceding instrument is the seal of said Company and that the said seal and the signature as such officer was duly affixed and subscribed to the said instrument by the authority and at the direction of the Company. pUSON DWAN NASN•TROUT !IOTARY PUBLIC • MiNNESOTA My Cammisslorr6xpires I, the undersigned, Secretary of ATLANTIC SPECIALTY INSURANCE COMPANY, a New York Corporation, do hereby certify that the foregoing power of attorney is in full force and has not been revoked, and the resoluuons set forth above are now in force. Si�ned and sealed. Dated 25th day of 7une 2021 This Power of Attorney expires January 31, 2025 ? ;s�,II��C ,�� Notary Public ��->'-.-"�' Kara Barrow, Secretary Please direct bond verificauons to suret}�(ri�intactitisuraiicecom �, ��, �' � � � � , IMPORTANT NOTICE To obtain information or make a complaint: You may contact your agent. AVISO IMPORTANTE Para obtener informacion o para someter una queja: Puede communicarse con su agente. You may call your Insurance Carrier's toll-free Usted puede Ilamar ai numero de telefono gratis de su telephone number for information or to make compania de seguros para informacion o para someter a complaint at: una queja al: 1-800-321-2721 You may also write to your Insurance Carrier � Atlantic Specialty Insurance Company Paralegal 605 Highway 169 North, Suite 800 Plymouth, MN 55441 Email: surety@intactinsurance.com Phone:1-800-662-0156 1�00�21-2721 Usted tambien puede escribir a su compania de seguros en: Atlantic Specialty Insurance Company Paralegal 605 Highway 169 North, Suite 800 Plymouth, MN 55441 Email: surety@intactinsurance.com Phone:1-800-662-0156 You may contact the Texas Department of Puede comunicarse con el Departamento de Seguros de Insurance to obtain information on Texas para obtener informacion acerca de companias, companies, coverages, rights or complaints coberturas, derechos o quejas al: � 1-800-252-3439 You may write the Texas Department of Insurance: 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas: P.O. Box 149104, Austin, TX 78714-9104 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: ConsumerProtection(c�tdi.texas.qov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If 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. P.O. Box 149104, Austin, TX 78714 Fax: (512) 490-1007 Web: wuvw.tdi.texas.gov E-mail: ConsumerProtection(a�tdi.texas.pov DISPUTAS SOBRE PRIMAS ❑ RECLAMOS: Si tiene una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI). UNA ESTE AVISO A SU POLIZA: Este aviso es solo opara proposito de informacion y no se convierte en parte condicion del documento adjunto. VCM PHN TX 001 1013 COMMERCIAL GENERAL LIABILITY CG 20 38 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR C�NTRACTORS - AUTOMATIC STATUS FOR OTH ER PARTIES WHEN REQUIRED IN WRITTEN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured: B. With respect to the additional insureds, exclusions apply: insurance afforded to these the following additional 1. Any person or organization for whom you are pertorming operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the pertormance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for the person or organization described in Paragraph 1. above are completed. This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 38 0413 O Insurance Services Office, Inc., 2012 Page 1 of 2 b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement applicable Limits of Declarations. shall not increase the Insurance shown in the Page 2 of 2 O Insurance Services Office, Inc., 2012 CG 20 38 04 13 POLICY NUMBER: 85322011 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLiCY. PLEASE READ IT CAREFULLY. ADDlTlONAL INSURED - OWNERS, LESSEES 4R CC)NTRACT�RS -- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABIUTY COV�ERAGE PART PRODUCTS/COMPl..ETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s l.ocation And Descri tion Of Com leted O erations ANY PERSON OR ORGANIZATION TO WHOM LOCATIONS D�SIGNATED AND YOU HAVE AGREED TO NAME AS ADDIT- DESCRIBED IN THE ABOVE IONAL INSURED BY WRFTTEH CONTRACT MENTIONED WRITTEN CONTRACT OR AGREEMENT IF THE CONTRACT OR OR AGREEMENT AGREEMENT IS EXECUTED PRIOR TO LOSS Information re uired to com lele this Schedule, if not shown above, will be shown in the Declarations. PREMIlTM l, 500 A. Section ll — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to tiability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the tocation designated and described in the Schedule of this endorsement pertormed for fhat additional insured and included in the "products -completed operafions hazarcf". However: 1. The insurance afforded to such addiiional insured only appties to the exteni permiited by law; and 2. If coverage provided to ihe addiiionaf insured is required by a contract or agreement, the insurance afforded to such additional insured wifl not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added io Section III — Limits Of insurance: !f coverage provided to the additional insured is required by a contract or agreement, the most we will pay on be halfi of the additional insured is the amount of insurance: 1. Required by the contract or agreement; flr 2. Avaifable under the appliceble Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 3i 0413 m fnsurance Services Office, Inc., 2012 Page 1 of 1 *26016570* Illllf IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII Policy Number: 85322011 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE C�NDITI4N This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILIT( COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following Condition and contrary: is added to the Other Insurance supersedes any provision to the (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG ZO 01 04 13 O fnsurance Services Office, Inc., 2012 Page 1 of 1 CG 72 80 07 17 LIMITED EXTENDED ULTRA LIABILITY PLUS ENDORSEMENT COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. * Extended Property Damage * Expanded Fire Legal Liability to include Explosion, Lightning and Sprinkler Leakage * Coverage for non-owned watercraft is extended to 51 feet in length * Property Damage - Borrowed Equipment * Property Damage Liability - Elevators * Coverage D- Voluntary Property Damage Coverage $5,000 Occurrence with a $10,000 Aggregate * Coverage E- Care, Custody and Control Property Damage Coverage $25,000 Occurrence with a$100,000 Aggregate -$500 Deductible * Coverage F- Electronic Data Liability Coverage -$50,000 * Coverage G- Product Recall Expense $25,000 Each Recall Limit with a$50,000 Aggregate -$1,000 Deductible " Coverage H- Water Damage Legal Liability -$25,000 * Coverage I- Designated Operations Covered by a Consolidated (Wrap-Up) Insurance Program - Limited Coverage * Increase in Supplementary Payments: Bail Bonds to $1,000 * Increase in Supplementary Payments: Loss of Earnings to $500 * For newly formed or acquired organizations - extend the reporting requirement to 180 days '` Broadened Named Insured * Automatic Additional Insured - Vendors * Automatic Additional Insured - Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With You * Automatic Additional Insured - Managers or Lessor of Premises * Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured '` Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations " Additional Insured - Consolidated Insurance Program (Wrap-Up) Off-Premises Operations Only - Owners, Lessees or Contractors Automatic Status When Required in Construction Agreement With You * Additional Insured - Employee Injury to Another Employee * Automatically included - Aggregate Limits of Insurance (per location) * Automatically included - Aggregate Limits of Insurance (per project) * Knowledge of occurrence - Knowledge of an "occurrence", "claim or suit" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee * Blanket Waiver of Subrogation * Liberalization Condition * Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. *"Insured ContracY' redefined for Limited Railroad Contractual Liability * Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 Ibs GVW * Bodily Injury Redefined REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 12 FOR CHANGES AFFECTING YOUR INSURANCE PROTECTION CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 12 CG 72 80 07 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED EXTENDED ULTRA LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION I - COVERAGES A. The following changes are made at COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Extended Property Damage At 2. Exclusions exclusion a. Expected or Intended Injury is replaced with the following: "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 2. Expanded Fire Legal Liability At 2. Exclusions the last paragraph is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of this owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE . 3. Non-Owned Watercraft At 2. Exclusions exclusion g. Aircraft, Auto Or Watercraft (2)(a) is deleted and replaced by the following: (a) Less than 51 feet long; 4. Property Damage — Borrowed Equipment At 2. Exclusions the following is added to paragraph (4) of exclusion j. Damage To Property: This exclusion does not apply to "property damage" to borrowed equipment while at a jobsite and while not being used to perForm operations. The most we wili pay for "property damage" to any one piece of borrowed equipment under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. 5. Property Damage Liability — Elevators At 2. Exclusions the following is added to paragraphs (3), (4) and (6) of exclusion j. Damage To Property : This exclusion does not apply to "property damage" resulting from the use of elevators. However, any insurance provided for such "property damage" is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. B. The following coverages are added: 1. COVERAGE D- VOLUNTARY PROPERTY DAMAGE COVERAGE "Property damage" to property of others caused by the insured: a. While in your possession; or b. Arising out of "your work". Coverage applies at the request of the insured, whether or not the insured is legally obligated to pay. For the purposes of this Voluntary Property Damage Coverage only: Exclusion j. Damage to Property is deleted and replaced by the following: CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 12 CG 72 80 07 17 j. Damage to Property "Property damage" to: (1) Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease, operate or use; (2) Property transported by or damage caused by any "automobile", "watercraft" or "aircraft" you own, hire or lease; (3) Property you own, rent, lease, borrow or use. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or ihe Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. 2. COVERAGE E- CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE 3. For the purpose of this Care, Custody and Control Property Damage Coverage only: a. Item (4) of Exclusion j. does not apply. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. COVERAGE F- ELECTRONIC DATA LIABILITY COVERAGE For the purposes of this Electronic Data Liability Coverage only: a. Exclusion p. of Coverage A— Bodily Injury And Property Damage Liability in Section I— Coverages is replaced by the following: 2. Exclusions This insurance does not apply to: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of "bodily injury". 4. b. "Property Damage" means: (1) Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or (2) Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or (3) Loss of, loss of use of, damage to, corruption of, inability to access or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. Alf such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this Electronic Data Liability Coverage ,"electronic data" is not tangible property. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE COVERAGE G- PRODUCT RECALL EXPENSE a. Insuring Agreement (1) We will pay 90% of "product recall expense" you incur as a result of a"product recall" you initiate during the coverage period. (2) We will only pay for "product recall expense" arising out of "your products" which have been physically relinquished to others. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 12 CG 72 80 07 17 b. Exclusions This insurance does not apply to "product recall expense" arising out of: (1) Any fact, circumstance or situation which existed at the inception date of the policy and which you were aware of, or could reasonably have foreseen that would have resulted in a"product recall". (2) Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the manufacture, design, processing, storage, or transportation of "your product". (3) The withdrawal of similar products or batches that are not defective, when a defect in another product or batch has been found. (4) Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or directors. (5) Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged. (6) "Bodily Injury" or "Property Damage". (7) Failure of "your producY' to accomplish its intended purpose, including any breach of warranty of fitness, quality, efficacy or efficiency, whether written or implied. (8) Loss of reputation, customer faith or approval, or any costs incurred to regain customer market, or any other consequential damages. (9) Legal fees or expenses. (10) Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of "your producY'. (11) "Product recall expense" arising from the "product recall" of any of "your products" for which coverage is excluded by endorsement. (12) Any "product recall" initiated due to the expiration of the designated shelf life of "your producY'. 5. COVERAGE H- WATER DAMAGE LEGAL LIABILITY The Insurance provided under Coverage H(Section I) applies to "property damage" arising out of water damage to premises that are both rented to and occupied by you. The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE 6. COVERAGE I— DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM The following exclusion is added to Paragraph 2. Exclusions of SECTION I— COVERAGES COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE LIABILITY : r. This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or operations included within the "products-completed operations hazard" for any "consolidated (Wrap-up) insurance program" which has been provided by the prime contractor / project manager or owner of the construction project in which you are involved. This exclusion applies whether or not a consolidated (Wrap-up) insurance program: a. Provides coverage identical to that provided by this Coverage Part; or b. Has limits adequate to cover all claims. This exclusion does not apply if a"consolidated (Wrap-up) insurance program" covering your operations has been cancelled, non-renewed or otherwise no longer applies for reasons other than exhaustion of all available limits, whether such limits are available on a primary, excess or on any other basis. You must advise us of such cancellation, nonrenewal or termination as soon as practicable. For purposes of this exclusion a"consolidated (wrap-up) insurance program" is a program providing insurance coverage to all parties for exposures involved with a particular (typically major) construction project. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 12 CG 72 80 07 17 C. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended: 1. To read SUPPLEMENTARY PAYMENTS 2. Bail Bonds Item 1.b. is amended as follows: b. Up to $1,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 3. Loss of Earnings Item 1.d. is amended as follows: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. 4. The following language is added to Item 1. However, we shall have none of the duties set forth above when this insurance applies only for Voluntary Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid the Limit of Liability or the Aggregate Limit for these coverages. SECTION II - WHO IS AN INSURED A. The following change is made: Extended Reporting Requirements Item 3.a. is deleted and replaced by the following : a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. B. The following provisions are added: 4. BROAD FORM NAMED INSURED Item 1.f. is added as follows: f. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period only if there is no other similar insurance available to that entity. However: (1) Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired more than 50 percent of the voting stock; and (2) Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired more than 50 percent of the voting stock. 5. Additional Insured - Vendors a. Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s) arising out of "your products" shown with the Schedule which are distributed or sold in the regular course of the vendor's business is an insured. However: (1) The insurance afforded to such vendor only applies to the extent permitted by law; and (2) If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. b. With respect to the insurance afforded to these vendors, the following additional exclusions apply: (1) This insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 12 CG 72 80 07 17 (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container. (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of products. (� Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product. (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: i. The exceptions contained in Sub-paragraphs d. or f.; or ii. Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 6. Additional Insured — Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You a. Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" directly arising out of the maintenance, operation or use of equipment leased to you, which may be imputed to such person or organization as the lessor of equipment. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 7. Additional Insured — Managers or Lessors of Premises a. Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: (1) Any "occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) shown in the Schedule. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 12 CG 72 80 07 17 8. Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured a. Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to liability for "bodily injury" or "property damage" or "personal and advertising injury" which may be imputed to that architect, engineer or surveyor arising out of: (1) Your acts or omissions; or (2) Your acts or omissions of those acting on your behalf; in the perFormance of your ongoing operations perFormed by you or on your behalf. But only if such architects, engineers or surveyors, while not engaged by you, are contractually required to be added as an additional insured to your policy. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services, including: (1) The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services. 9. Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations � Any state or governmental agency or subdivision or political subdivision is an insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. This insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations perFormed for the federal government, state or municipality; or (2) "Bodily injury" or "property damage" included within the "products-completed operations hazard". 10. Additional Insured Consolidated Insurance Program (Wrap-Up) Off-Premises Operations Only - Owners, Lessees or Contractors a. Any persons or organizations for whom you are performing operations, for which you have elected to seek coverage under a Consolidated Insurance Program, when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy is an insured. Such person or organization is an additional insured only with respect to your liability which may be imputed to that person or organization directly arising out of your ongoing operations perFormed for that person or organization at a premises other than any project or location that is designated as covered under a Consolidated Insurance Program. A person's or organization's status as an insured under this endorsement ends when your operations for that insured are completed. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 12 CG 72 80 07 17 b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies. This insurance does not apply to: "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection 11. Additional Insured - Employee Injury to Another Employee With respect to your "employees" who occupy positions which are supervisory in nature: Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED is amended to read: a. "Bodily injury" or "personal and advertising injury" (1) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); (2) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph (1)(a) above; or (3) Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3'.a. is deleted. For the purpose of this Item 11 only, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, direct, discipline or discharge. SECTION III - LIMITS OF INSURANCE A. The following Items are deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard"; and c. Damages under Coverage B; and d. Damages under Coverage H. 3. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard" and Coverage G. 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented to you or temporarily occupied by you with permission of the owner. B. The following are added: 8. Subject to Paragraph 5. of SECTION III — LIMITS OF INSURANCE $25,000 is the most we will pay under Coverage H for Water Damage Legal Liability. 9. Coverage G- Product Recall Expense Aggregate Limit $50,000 Each Product Recall Limit $25,000 a. The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you incur as a result of all "product recalls" you initiate during the endorsement period. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 12 CG 72 80 07 17 b. The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000 deductible, for "product recall expense" you incur for any one "product recall" you initiate during the endorsement period. We will only pay for the amount of Product Recall Expenses which are in excess of the deductible amount. The deductible applies separately to each Product Recall. The limits of insurance will not be reduced by the amount of this deductible. We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. 10. Aggregate Limits of Insurance (Per Location) The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 11. Aggregate Limits of Insurance (Per Project) The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. 12. With respects to the insurance afforded to additional insureds afforded coverage by items 5 through 11 of SECTION II — WHO IS AN INSURED above, the following is added: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; b. Available under the applicable Limits of Insurance shown in the Declarations; Whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 13. Subject to 5. of SECTION III — LIMITS OF INSURANCE , a$5,000 "occurrence" limit and a$10,000 "aggregate" limit is the most we will pay under Coverage A for damages because of "property damage" covered under Coverage D- Voluntary Property Damage Coverage . For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. 14. Subject to 5. of SECTION III — LIMITS OF INSURANCE , a$25,000 "occurrence" limit and a$100,000 "aggregate" limit is the most we will pay under Coverage E- Care, Custody and Control Coverage regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Deductible - Our obligation to pay damages on your behalf applies only to the amount of damages in excess of $500. This deductible applies to all damages because of "property damage" as the result of any one "occurrence" regardless of the number of persons or organizations who sustain damages because of that "occurrence". We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. As respects this coverage "Aggregate" is the maximum amount we will pay for all covered "occurrences" during one policy period. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 12 CG 72 80 07 17 For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted discretion in making payments under this coverage. 15. Subject to 5. of SECTION III — LIMITS OF INSURANCE , the most we will pay for "property damage" under Coverage F- Electronic Data Liability Coverage for loss of "electronic data" is $50,000 without regard to the number of "occurrences". SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS A. The following conditions are amended: 1. Knowledge of Occurrence a. Condition 2., Items a. and b. are deleted and replaced by the following: (1) Duties In The Event Of Occurrence, Offense, Claim Or Suit (a) You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. Knowledge of an "occurrence" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. To the extent possible, notice should include: i. How, when and where the "occurrence" took place; ii. The names and addresses of any injured persons and witnesses, and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. (b) If a claim is made or "suiY' is brought against any insured, you must: i. Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. Knowledge of a claim or "suiY' by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. 2. Where Broad Form Named Insured is added in SECTION II — WHO IS AN INSURED of this endorsement, Condition 4. Other Insurance 6. Excess Insurance (1).(a) is replaced by the following: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not withstanding any other language in any other policy. This provision does not appiy to a policy written to apply specifically in excess of this policy. B. The following are added: 10. Condition (5) of 2.c. (5) Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at your actual cost, excluding profit or overhead. 11. Blanket Waiver Of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing operations pe.rformed by you or on your behalf, done under a contract with that person or organization, "your work", or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily injury" or "property damage" occurs or the "personal and advertising injury" offense is committed. 12. Liberalization If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision. CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 10 of 12 CG 72 80 07 17 13. Unintentional Failure to Disclose All Hazards Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. 14. The following conditions are added in regard to Coverage G- Product Recall Expense 15. In event of a"product recall", you must a. See to it that we are notified as soon as practicable of a"product recall". To the extent possible, notice should include how, when and where the "product recall" took place and estimated "product recall expense". b. Take ail reasonable steps to minimize "product recall expense". This wiil not increase the limits of insurance. c. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed. d. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn statement of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. e. Cooperate with us in the investigation or settlement of any claim. f. Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies. Limited Railroad Contractual Liability The following conditions are applicable only to coverage afforded by reason of the redefining of an "insured contracY' in the DEFINITIONS section of this endorsement: a. Railroad Protective Liability coverage provided by ISO form CG 0035 with minimum limits of $2,000,000 per occurrence and a$6,000,000 general aggregate limit must be in place for the entire duration of any project. b. Any amendment to the Other Insurance condition of form CG 0035 alters the primacy of the coverage or which impairs our right to contribution will rescind any coverage afforded by the redefined "insured contracY' language. c. For the purposes of the Other Insurance condition of form CG 0035 you, the named insured, will be deemed to be the designated contractor. • SECTION V - DEFINITIONS A. At item 12. Mobile Equipment the wording at f.(1) is deleted and replaced by the following: f.(1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; except for such vehicles that have a gross vehicle weight less than 1,000 Ibs which are not designed for highway use. B. Item 3. "bodily injury" is deleted and replaced with the following: 3. "bodily injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. C. Item 9. "Insured Contract" c. is deleted and replaced with the following: c. Any easement or license agreement; CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 12 CG 72 80 07 17 D. Item 9. "Insured Contract" f.(1) is deleted E. The following definitions are added for this endorsement only: 23. "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tape drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 24. "Product recall" means a withdrawal or removal from the market of "your producY' based on the determination by you or any regulatory or governmental agency that: a. The use or consumption of "your producY' has caused or will cause actual or alleged "bodily injury" or "property damage"; and b. Such determination requires you to recover possession or control of "your product" from any distributor, purchaser or user, to repair or replace "your product", but only if "your producY' is unfit for use or consumption, or is hazardous as a result of: (1) An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or transportation of "your product'; or (2) Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product" by someone other than you. 25. "Product recall expense" means reasonable and necessary expenses for: a. Telephone, radio and television communication and printed advertisements, including stationery, envelopes and postage. b. Transporting recalled products from any purchaser, distributor or user, to locations designated by you. c. Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or independent contractors you hire. d. Transportation and accommodation expense incurred by your employees. e. Rental expense incurred for temporary locations used to store recalled products. f. Expense incurred to properly dispose of recalled products, including packaging that cannot be reused. g. Transportation expenses incurred to replace recalled products. h. Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to exceed your original cost of manufacturing, processing, acquisition and/or distribution. These expenses must be incurred as a result of a"product recall". CG 72 80 07 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12 of 12 COMMERCIAL AUTO CA 71 09 01 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ULTRA ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMON POLICY CONDITIONS COVERAGEINDEX DESCRIPTION PAGE Temporary Substitute Auto Physical Damage 2 Broad Form Insured 2 Employee as Insureds 2 Additional Insured Status by Contract, Agreement or Permii 2 Bail Bond Coverage 3 Loss of Earnings Coverage 3 Amended Fellow Employee Coverage 3 Towing and Labor 3 Physical Damage Additional Transportation Expense Coverage 3 Extra Expense - Theft 3 Rental Reimbursement and Additional Transportation Expense 4 Personal Effects Coverage 4 Personal Prope�ty of Others 4 Locksmith Coverage 4 Vehicle Wrap Coverage 5 Airbag Accidental Discharge 5 Audio, Visual and Data Electronic Equipment Coverage 5 Auto Loan/Lease Total Loss Protection 5 Glass Repair — Deductible Amendment 5 Amended Duties in the Event of Accident, Claim, Suit or Loss 6 Waiver of Subrogation Required by Contract 6 Unintentional Failure to Disclose 6 Hired, Leased, Rented or Borrowed Auto Physical Damage 6 Mental Anguish 7 E�ended Cancellation Condition 7 The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in (Bold Italics) are likewise for information only and by themselves shall be deemed to grant no coverage. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 * 15018460 * I IIIIII IIIII IIIIIIIIII IIIII IIIIIIIIII IIIII IIII IIII (Temporary Substitute Auto Physica� Damage) A. TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE SECTION I— COVERED AUTOS, paragraph C. Certain Trailers, Mobils Equipment and Temporary Substitute Autos is amended by adding the following at the end of the existing language: If Physical Damage Coverage is provided under this Coverage form for an "auto" you own, the Physical Damage coverages provided for that owned "auto" are extended to any "auto" you do not own while used with the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss", or destruction B. BROADENED LtABlLITY COVERAGES SECTION II — LIABILITY COVERAGE in Paragraph A. Coverage at 1. Who Is An Insured is amended to include the following: (Broad Form Insured) d. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy bui for its termination or the exhaustion of its Limit of Insurance. e. Any organization that is acquired or formed by you, during the term of this policy and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired ' organization: (1) That is a joint venture or partnership, (2) That is an "insured" under any other policy, (3? That has exhausted iis Limits of Insurance under any other policy, or (4) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation Coverage does not apply to "bodily injury" or "property damage" that results from an accident that occurred before you formed or acquired the organization. (Employee as InsuredsJ f. Any employee of yours while acting in the course of your business or your personal affairs while using a covered "auto" you do not own, hire or borrow. (Additional lnsured Status by Contract, Agreemenf or Permit) g. Any person or organization whom you are required to add as an additional insured on this policy under a written contract or agreement; but the written contract or agreement must be: (1) Currently in effect or becoming effective during the term of this policy; and (2) Executed prior to the "bodily injury" or "property damage." The additional insured status will apply only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the location(s) designated, if any. Coverage provided by this endorsement will not exceed the limits of liability required by the written contract or written agreement even if the limits of liability stated in the policy exceed those limits. This endorsement shall not increase the limits stated in Section II. C. Limits of Insurance. For any covered "auto" you own this Coverage Form provides primary coverage. Page 2 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 C. BROADENED SUPPLEMENTARY PAYMENTS SECTION II. LIABILITY A. Coverage 2. Coverage Extensions a. Supplementary Payments (2) and (4) are replaced by the following: (Bail Bond Coverage) (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to fumish these bonds. (Loss of Earnings Coverage) (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earning up to $500 a day because of time off from work. (Amended Fel/ow Employee Exclusion) D. AMENDED FELLOW EMPLOYEE EXCLUSION Only with respect to your "employees" who occupy positions which are supervisory in nature, SECTION 11. LIABILITY B. Exclusion 5. Fellow Employee is replaced by: 5. Fellow Employee "Bodily Injury": a. To you, or your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); b. To your "executive officers" and directors (if you are an organization other than a partnership, joint venture, or limited liability company) but only with respect to performance of their duties as your officers or directors; c. For which there is an obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph a and b above; or d. Arising out of his or her providing or failing to provide professional health care services. For purposes of this endorsemeni, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, transfer, direct, discipline or discharge. E. BROADENED PHYSICAL DAMAGE COVERAGES SECTION 111— PHYSICAL DAMAGE COVERAGE A. Coverage is amended as follows: (Towing and Labor) 2. Towing is deleted and replaced with the following: 2. Towing and Labor We will pay towing and labor costs incurred, up to the limiis shown below, each time a covered "auio" is disabled: a. For privaie passenger type vehicles we will pay up to $100 per disablement. b. For all other covered "auto's" we will pay up to $500 per disablement However, the labor must be performed at the place of disablement. (Physical Damage Additional Transportafion Expense Coverage) 4. Coverage Extensions a. Transportation Expenses is amended to provide the following limits: We will pay up to $60 per day to a maximum of $1,800. All other terms and provisions of this section remain applicable. The following language is added to 4. Coverage Extensions: (Extra Expense — Theft) c. Theft Recovery Expense If you have purchased Comprehensive Coverage on an "auto" that is stolen, we will pay the expense of returning that stolen auto to you. The limit for this coverage extension is $5,000. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with iis permission. Page 3 of 7 *16018470* IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII (Rental Reimbursement and Additional Transportation Expense) d. Rental Reimbursement We will provide Rental Reimbursement and Additional Expense coverage oniy for those Physical Damage coverages for which a premium is shown in the Declarations or schedule pages. Coverage applies only to a covered "auto". (1) We will pay for auto rental expense and the expense incurred by you because of "loss" to remove and ° transfer your materials and equipment from a covered "auto" to a covered "auto." Payment applies in addition to the otherwise applicable coverage you have on a covered "auto." No deductible applies to this coverage. (2) We will pay only for expenses incurred during the policy period and beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto." If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you, or (b) 30 days. (3) Our payment is iimited to the lesser of the following amounts: (a) Necessary and actual expenses incurred; or (b) $75 per day. (c) This coverage does not apply while there are spare or reserve "autos" available to you for your operations. (d) If "loss" results from the total theft of a covered "auto" of the privaie passenger or light truck type, we will pay under this coverage only that amount of your rental reimbursement expense which is not already provided for under the SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses. (Personal Effects Coverage) e. Personal Effects If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is siolen, we will pay, without application of a deductible, up to $500 for Personal Effects stolen with the "auto". The insurance provided under this provision is excess over any other collectible insurance. For this coverage extension, Personal Effects means tangible property that is worn or carried by an "insured". (Personal Property of Ofhers) f. Personal Property of Others We will pay up to $500 for loss to personal property of others in or on your covered "auto." This coverage applies only in the event of "loss" to your covered "auto" caused by fire, lightning, explosion, theft, mischief or vandalism, the covered "auto's" collision with another object, or the covered "auto's" overtum. No deductibles apply to this coverage. (Locksmith Coverage) g. Locksmith Coverage We will pay up to $250 per occurrence for necessary locksmith services for keys locked inside a covered private passenger "auto". The deduciible is waived for these services. Page 4 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 (Vehicle Wrap Coverage) h. Vehicle Wrap Coverage If you have Comprehensive or Collision coverage on an "auto" that is a total loss, in addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of iotal loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. (Airbag Accidental Discharge) F. SECTION III — PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended at 3. to include the following language: If you have purchased Comprehensive or Collision Coverage under this policy, this exclusion does not apply to mechanical breakdown relating to the accidental discharge of an air bag. This coverage applies only to a covered auto you own and is excess of any other collectible insurance or warranty. No deductible applies to this coverage. G. BROADENED LIMITS OF INSURANCE (Audio, Visual and Data Electronic Equipment Coverage) SECTION III — PHYSICAL DAMAGE COVERAGE — C. Limit of Insurance at 1.b. is amended to provide ihe following limits: b. Limits of $1,000 per "loss" is increased to $5,000 per "loss". All other terms and provisions of this section remain applicable. (Auto Loan/Lease Total Loss Protection) SECTION III — PHYSICAL DAMAGE COVERAGE — C. Limit of Insurance is amended by adding the following language: 4. In the event of a total "loss" to a covered "auto" shown in the Schedule pages, subject at the time of the "loss" to a loan or lease, we will pay any unpaid amount due including up to a maximum of $500 for early termination fees or penalties on the lease or loan for a covered"auto" less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease / loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit l.ife Insurance, Health, Accident or Disabifity Insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. (G/ass Repair— Deductible Amendment) H. GLASS REPAIR — DEDUCTIBLE SECTION III — PHYSICAL DAMAGE COVERAGE — D. Deductible is amended by adding the following: Any deductible shown in the Declarations as applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired> rather than replaced. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 *17018480* IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII��IIIIAI (Amended Dufies in fhe Event of Accident, Claim, Suit or Loss) I. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, the following is added to paragraph 2. Duties In The Event of Accident, Suit or Loss: d. Knowledge of any "accidenf', "claim", "suiY' or "loss" will be deemed knowledge by you when noiice of such "accident", "claim", "suit" or "loss" has been received by: (1) You, if you are an individual; (2) Any partner or insurance manager if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; (4) Your members, managers or insurance manager, if you are a limiied liability company; or �5) Your officials, trustees, board members or insurance manager, if you are a not-for-profit organization. (Waiver of Subroga#ion by Contract) J. WAIVER OF SUBROGATION REQUIRED BY CONTRACT Under SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer of Rights of Recovery Against Others to Us the following language is added: However, we waive any rights of recovery we may have against the person or organization with whom you have agreed in writing in a cantract, agreement or permit, to provide insurance such as is afforded under the policy to which this endorsement is attached. This provision does not apply unless the written contract or written agreement has been executed, or permit has been issued, prior to the "bodily injury" or "property damage." (Unintentional Failure to Disc/ose) K. UNINTENTIONAL FAILURE TO DISCLOSE Under SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, the following is added to 2. Concealment, Misrepresentation Or Fraud: Your uninientional error in disclosing, or failing to disclose any material fact existing at the effective date of this Coverage Form, or during the policy period in connection with any additional hazards, will noi prejudice your rights under this Coverage Form. (Hired, Leased, Rented or Borrowed Auto Physical Damage) L. HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE Under SECTION tV — BUSINESS AUTO CONDITIONS B. General Conditions 5. Other Insurance Paragraph 5.b. is replaced by the following: b. (1) For "Comprehensive" and "Collision" Auto Physical Damage coverage provided by this endorsement, the following are deemed to be covered "autos" you own: (a) Any Covered "auto" you lease, hire, rent or borrow; and (b) Any Covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while pertorming duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" (2) Limit of Insurance For This Section The most we will pay for any one "loss" is the lesser of the following: (a) $75,000 per accident, or (b) actual cash value at the time of loss, or (c) cost of repair. Page 6 of 7 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 71 09 01 17 Minus a$500 deductible. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. No deductible applies to "loss" caused by fire or lightning. (3) This Hired Auto Physical Damage coverage is excess over any other collectible insurance. (4) Definitions For This Section (a) Comprehensive Coverage: from any cause except the covered "auto's" collision with another object or the covered "auto's" overturn. We will pay glass breakage, "loss" caused by hitting a bird or animal and, "loss" caused by falling objects or missiles. (b) Collision Coverage: caused by the covered "auto's" collision with another object or by the covered "auto's" overturn. (Mental Anguish) M. MENTAL ANGUISH Under SECTION V— DEFINITIONS, C, is replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including mental anguish or death resulting from bodily injury, sickness, or disease. (Extended Cancellation Condition) N. EXTENDED CANCELLATION CONDITION Under CANCELLATION, of the COMMON POLICY CONDITIONS form, item 2.b. is replaced by the following: b. 60 days before the effective date of cancellation if we cancel for any other reason. CA 71 09 01 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 *18018490* IIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII CA 73 34 09 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY - 4THER [NSURANCE CONDITION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following language replaces SECTION IV BUSINESS AUTO CONDITIONS Part B. General Conditions 5. Other Insurance c.; c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Covered Autos Liability Coverage is primary for any liability assumed under an "insured contract". This coverage will also be non-contributory if it is required by the terms of the "insured contract". CA 73 34 09 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 � utua WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC420304B Agent copy TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (X)Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations 3. Premium: All Texas operations The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Included, see Information Page This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 3/11/21 at 12:01 a.m. standard time, forms a part of: Policy no. 0001302851 of Texas Mutual Insurance Company effective on 3/11/21 Issued to: NORTH ROCK CONSTRUCTION LLC This is not a bill NCCI Carrier Code: 29939 r�l�,� Authorized representative 3/9121 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com �(800) 859-5995 � Fax (800) 359-0650 WC 42 03 04 B