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Home My WebLink AboutContract 59558FORTWORTH. PROJECT MANUAL CSC No. 59558 FOR THE CONSTRUCTION OF 2023 BRIDGE REHABILITATION CONTRACT 1 City Project No. 104687 Mattie Parker Mayor David Cooke City Manager Lauren Prior Director, Transportation and Public Works Department Prepared for The City of Fort Worth TRANSPORTATION AND PUBLIC WO 2023 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX FORT WORTH(.:) *40ir , "' City of Fort Worth Standard Construction Specification Documents Adopted September 2011 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Pagel of 3 SECTION 00 00 00 TABLE OF CONTENTS Division 00 - General Conditions Last Revised 0005 10 Mayor and Council Communication 07/01/2011 0005 15 Addenda 07/01/2011 0011 13 Invitation to Bidders 07/19/2021 0021 13 Instructions to Bidders 11/02/2021 0035 13 Conflict of Interest Statement 02/24/2020 00 41 00 Bid Form 09/30/2021 00 42 43 Proposal Form Unit Price 01/20/2012 0043 13 Bid Bond 09/11/2017 00 43 37 Vendor Compliance to State Law Nonresident Bidder 06/27/2011 0045 12 Prequalification Statement U-egtt,l;f;e tie Arri;,.atien 09/30/2021 0045 13 00 45 26 Contractor Compliance with Workers' Compensation Law 08/1z 07/01/2011 00 45 40 Business Equity Goal 10/27/2021 00 52 43 Agreement 11/23/2021 0061 13 Performance Bond 07/01/2011 0061 14 Payment Bond 07/01/2011 0061 19 Maintenance Bond 07/01/2011 00 61 25 Certificate of Insurance 07/01/2011 00 72 00 General Conditions 08/23/2021 00 73 00 Supplementary Conditions 03/09/2020 Division 01- General Requirements Last Revised 01 1100 Summary of Work 12/20/2012 01 25 00 Substitution Procedures 07/01/2011 01 31 19 Preconstruction Meeting 08/17/2012 01 31 20 Project Meetings 07/01/2011 013216 Construction Schedule 08/13/2021 01 32 33 Preconstruction Video 07/01/2011 01 33 00 Submittals 12/20/2012 0135 13 Special Project Procedures 03/11/2022 01 45 23 Testing and Inspection Services 03/09/2020 01 50 00 Temporary Facilities and Controls 07/01/2011 01 5526 Street Use Permit and Modifications to Traffic Control 03/22/2021 01 57 13 Storm Water Pollution Prevention Plan 07/01/2011 0158 13 Temporary Project Signage 07/01/2011 01 60 00 Product Requirements 03/09/2020 01 70 00 Mobilization and Remobilization 11/22/2016 01 71 23 Construction Staking and Survey 02/14/2018 01 74 23 Cleaning 07/01/2011 01 77 19 Closeout Requirements 03/22/2021 01 78 23 Operation and Maintenance Data 12/20/2012 01 78 39 Project Record Documents 07/01/2011 CITY OF FORT WORTH 2O23 BRIDGE REAHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 104687 Revised December 9, 2022 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Page 2 of 3 Technical Specifications which have been modified by the Engineer specifically for this Project; hard copies are included in the Project's Contract Documents Division 34 - Transportation 3471 13 1 Traffic Control 1 3/22/2021 TxDOT Standard Specifications for Construction and Maintenance of Highways, Streets and Bridges 2014 adopted by the Texas Department of Transportation are included for this Project by reference and can viewed/downloaded from TxDOT's website address below: httDS://ftD.txdot. eov/nubltxdot-infolcmd/cserve/specsl2014/standard/sDecbook-2014.Ddf Item 104 Removing Concrete Item 110 Excavation Item 132 Embankment Item 347 Thin Overlay Mixture Item 354 Planning and Texturing Pavement Item 360 Concrete Pavement Item 400 Excavation and Backfill for Structures Item 420 Concrete Substructures Item 422 Concrete Superstructures Item 429 Concrete Structure Repair Item 438 Cleaning and Sealing Joints Item 450 Railing Item 540 Metal Beam Guard Fence Item 542 Removing Meta Beal Guard Fence Item 544 Guardrail End Treatments Item 752 Tree and Brush Removal Item 780 Concrete Crack Repair Item 788 Concrete Beam Repair Item 3002 Spray Applied Underseal Membrane Appendix GC-6.06.1) Minority and Women Owned Business Enterprise Compliance GC-6.07 Wage Rates GN-1.00 General Notes SD-1.00 Standard Construction Details END OF SECTION CITY OF FORT WORTH 2O23 BRIDGE REAHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 104687 Revised December 9, 2022 City of Fort Worth, Texas Mayor and Council Communication DATE: 05/23/23 M&C FILE NUMBER: M&C 23-0431 LOG NAME: 2023 BRIDGE REHABILITATION CONTRACT 1 SUBJECT (CD 2, CD 3, CD 4, CD 5, CD 6, CD 8 and CD 9 / Future CD 2, CD 3, CD 4, CD 5, CD 8 and CD 9) Authorize Execution of a Contract with Gibson & Associates, Inc., in the Amount of $942,626.10 for 2023 Bridge Rehabilitation at Seventeen Locations RECOMMENDATION: It is recommended that the City Council authorize execution of a contract with Gibson & Associates, Inc., in the amount of $942,626.10 for the 2023 Bridge Rehabilitation Contract 1 project (City Project No. 104687) at seventeen locations. DISCUSSION: The purpose of the Mayor and Council Communication (M&C) is to authorize the execution of a contract with Gibson & Associates, Inc., in the amount of $942,626.10 for 2023 Bridge Rehabilitation Contract 1 project at multiple locations. The contract provides for the repair and rehabilitation of seventeen bridges listed below: Bridge Over Map Current Future District District Anderson Boulevard 1 Tributary of West 66T 5 5 Fork Trinity River 'Tributary of West Anderson Boulevard 2 Fork Trinity River 66T 5 5 Berry Street Sycamore Creek 77Z 8 8 East Rosedale Street Sycamore Creek 77M 8 8 Ederville Road Cottonwood 67W 5 5 Creek Henderson Street Railroad 62Y 9 9 North Beach Street NB Big Fossil Creek 50A 4 4 North Beach Street SB Big Fossil Creek 50A 4 4 North Beach Street NB & SB Tributary of Big 50A 4 4 Fossil Creek 'Trinity Bypass North Main Street Channel 62V 2 2 Overton Park Drive East Tributary of Clear 89G 3 3 Fork Trinity River 'Tributary of South Wildcat Way Village Creek 119L 6 8 Western Center Boulevard Big Fossil Creek 35Y 4 4 EB Western Center Boulevard Big Fossil Creek 35Y 4 4 WB Western Center Boulevard Tributary of Big 35Z 4 4 EB Fossil Creek Western Center Boulevard Tributary of Big 35Z 4 4 WB Fossil Creek White Settlement Road Railroad 62Y 9 9 Major bridge repair and rehabilitation includes vertical and overhead concrete structural repair; concrete beam repair; metal toe rail installation; bridge approach slab replacement; expansion joint replacement; metal beam guard fence repair, and guardrail end treatment replacement. Construction is expected to start in summer 2023 and be completed by winter 2023. Upon completion of the project, there will be no anticipated impact on the general fund operating budget. The project was advertised for bid on February 23, 2023 and March 2, 2023 in the Fort Worth Star - Telegram. On March 30, 2023, the following bids were received: Bidders I Amount (Time of Completion (Gibson & Associates, Inc. $942,626.10 210 Calendar Days ICapko Concrete Structures, LLCM $1,155,184.00 MWBE OFFICE: Gibson & Associates, Inc. is in compliance with the City's Business Equity Ordinance by committing to 17% Minority/Women- owned Business Enterprises (MWBE) participation on this project. The City's Minority/Women-owned Business Enterprises (MWBE) goal on this project is 16%. Funding is budgeted in the TPW Dept Highway & Streets Department's General Capital Projects Fund for the purpose of funding the 2023 Bridge Rehab contract 1 project, as appropriated. This project is located in COUNCIL DISTRICTS 2, 3, 4, 5, 6 and 9/ FUTURE COUNCIL DISTRICTS 2, 3, 4, 5, 8 and 9. FISCAL INFORMATION / CERTIFICATION: The Director of Finance certifies that funds are available in the current capital budget, as previously appropriated, in the General Capital Projects Fund for the 2023 Bridge Rehab contract 1 project to support the approval of the above recommendation and execution of the contract. Prior to any expenditure being incurred, the Transportation and Public Works Department has the responsibility to validate the availability of funds. Submitted for Citv Manaaer's Office bv: William Johnson 5806 Oriainatina Business Unit Head: Lauren Prieur 6035 Additional Information Contact: Monty Hall 8662 ADDENDUM NO. 1 2023 BRIDGE REHABILITATION CONTRACT 1 CITY PROJECT NO.: 104687 Addendum No. 1 Issued: March 22, 2023 Revised Bid Date: March 30, 2023 The Specification, Contract Documents and Drawings for the above project are revised and amended as follows: 1. BID DATE: The bid will be received by the City of Fort Worth Purchasing Office until 1:30 P.M. CST, Thursday, March 30, 2023. 2. SECTION 00 00 00 TABLE OF CONTENTS: Page 2 of Table of Contents shall replace with attached revised page. 3. SECTION 00 42 43 PROPOSAL FORM: The proposal form shall replace with attached revised proposal form. 4. BRIDGE PLAN SHEET: Plan Sheet no. 3, 4, 5, 9 and 17 shall replace with attached revised plan sheets. Please acknowledge receipt of this addendum by completing the requested information at the following locations: 1. In the space provide on the signature page of the Proposal Form 2. Indicate in upper case letters on the outside of your sealed bid envelope: "RECEIVED & ACKNOWLEDGED ADDENDUM NO. 1" 3. Execute acknowledgement below and submit signed copy with your proposal at the time of bid submittal Failure to acknowledge receipt of the Addendum No. I could cause the subject bidder to be considered "NONRESPONSIVE", resulting in disqualification. Receipt Acknowledged: Lauren Prieur, P.E. Director Transportation and Public Works Dept. //;; By: ?//,/ Company: bS6r)2/A J 0 ( I afej J rI(. By: 74nrguZ lAwr Tariqul Islam Project Manager ADDENDUM NO. 1 2023 BRIDGE REHABILITATION CONTRACT 1 CITY PROJECT NO.: 104687 Addendum No. 1 Issued: March 22, 2023 Revised Bid Date: March 30, 2023 The Specification, Contract Documents and Drawings for the above project are revised and amended as follows: 1. BID DATE: The bid will be received by the City of Fort Worth Purchasing Office until 1:30 P.M. CST, Thursday, March 30, 2023. 2. SECTION 00 00 00 TABLE OF CONTENTS: Page 2 of Table of Contents shall replace with attached revised page. 3. SECTION 00 42 43 PROPOSAL FORM: The proposal form shall replace with attached revised proposal form. 4. BRIDGE PLAN SHEET: Plan Sheet no. 3, 4, 5, 9 and 17 shall replace with attached revised plan sheets. Please acknowledge receipt of this addendum by completing the requested information at the following locations: 1. In the space provide on the signature page of the Proposal Form 2. Indicate in upper case letters on the outside of your sealed bid envelope: "RECEIVED & ACKNOWLEDGED ADDENDUM NO. 1" 3. Execute acknowledgement below and submit signed copy with your proposal at the time of bid submittal Failure to acknowledge receipt of the Addendum No. 1 could cause the subject bidder to be considered "NONRESPONSIVE", resulting in disqualification. Receipt Acknowledged: LI-A Company: Lauren Prieur, P.E. Director Transportation and Public Works Dept. By: 74w4rd 9a. 4m Tariqul Islam Project Manager 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Page 2 of 3 Technical Specifications which have been modified by the Engineer specifically for this Project; hard copies are included in the Project's Contract Documents Division 34 - Transportation 3471 13 1 Traffic Control 1 3/22/2021 TxDOT Standard Specifications for Construction and Maintenance of Highways, Streets and Bridges 2014 adopted by the Texas Department of Transportation are included for this Project by reference and can viewed/downloaded from TxDOT's website address below: httD s://ftD.txdot. cov/nub/txdot-info/cmdlcserve/specsl2014/standard/snecbook-2014.ndf Item 104 Removing Concrete Item 110 Excavation Item 132 Embankment Item 360 Concrete Pavement Item 400 Excavation and Backfill for Structures Item 420 Concrete Substructures Item 422 Concrete Superstructures Item 429 Concrete Structure Repair Item 438 Cleaning and Sealing Joints Item 439 Bridge Deck Overlays Item 450 Railing Item 540 Metal Beam Guard Fence Item 542 Removing Meta Beal Guard Fence Item 544 Guardrail End Treatments Item 752 Tree and Brush Removal Item 780 Concrete Crack Repair Item 788 Concrete Beam Repair Appendix GC-6.06.1) Minority and Women Owned Business Enterprise Compliance GC-6.07 Wage Rates GN-1.00 General Notes SD-1.00 Standard Construction Details END OF SECTION CITY OF FORT WORTH 2O23 BRIDGE REAHABILTTATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 104687 Revised December 9, 2022 00 42 43 BID PROPOSAL Page 1 of 1 UNIT PRICE BID SECTION 00 42 43 PROPOSALFORM Project Item Information Bidder's Application Bidlist Specification Section Unit of Bid Description Item No. No. Measure Quantity 1 REMOBILIZATION 01 70 00 EA 1 2 REMOVING CONC (PAV) 104-6001 SY 160.0 3 REMOVING CONC (APPR SLAB) 104-6027 SY 80.0 4 EXCAVATION (ROADWAY) 110-6001 CY 37.0 5 EMBANKMENT (FINAL)(ORD COMP)(TY B) 132-6003 CY 20.0 6 CONC PVMT (CONT REINF - CRCP) (7) 360-6001 SY 160.0 7 CEM STABIL BKFL 400-6005 CY 37.0 8 CL C CONC (MISC) 420-6074 CY 1.4 9 APPROACH SLAB 422-6015 CY 29.0 10 CONC STR REPAIR (VERTICAL & OVERHEAD) 429-6007 SF 289.4 11 CONC STR REPAIR (STANDARD) 429-6009 SF 73.0 12 CLEANING AND SEALING EXISTING JOINTS 438-6001 LF 492.0 13 MULTI -LAYER POLYMER OVERLAY 439-6013 SY 14.4 14 RAIL (TOERAIL) 450 -- LF 7,381.0 15 MTL W-BEAM GD FEN (TIM POST) 540-6001 LF 674.5 16 TERMINAL ANCHOR SECTION 540-6005 EA 5.0 17 MTL BEAM GD FEN TRANS (TL2) 540-6007 EA 26.0 18 DOWNSTREAM ANCHOR TERMINAL SECTION 540-6016 EA 11.0 19 REMOVE METAL BEAM GUARD FENCE 542-6001 LF 1,468.0 20 GUARDRAIL END TREATMENT (INSTALL) 544-6001 EA 8.0 21 TREE REMOVAL (4" - 12" DIA) 752-6005 EA 1.0 22 CONC CRCK REPR (DISCRETE) (ROUT AND SEAL) 780-6004 LF 20.0 23 CONCRETE BEAM REPAIR (CFRP) 788-6002 EA 3.0 24 9999.0096 PAVING CONSTRUCTION ALLOWANCE LS 1.0 END OF SECTION Bidder's Proposal Unit Price Bid Value $500.00 $500.00 $50,000.00 $50,000.00 Total Bid $50,500.00 CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised 9/30/2021 2023 BRIDGE REHABILITATION CONTRACT 1 City Project No. 104687 ESTIMATED QUANTITIES BID REM NUMBER 104 104 110 132 1 6001 6027 6001 6003 1 BID ITEM DESCRIPTION REMOVING CONIC REMOVING CONC EXCAVATION EMBANKMENT (PAV) (APPR SLAB) (ROADWAY) CO.NA)LO D I BRIDGE NO. I FEATURE CARRIED FEATURE CROSSED LOCATION SY SY CY CY I I I 1 ANDERSON BLVD TRIBUTARY OF WEST FORK TRINITY RIVER 0.2 MILES EAST OF IH 820 I I I 2 ANDERSON BLVD TRIBUTARY WEST FORKTRINITY RIVER 0.2 OF IH I I � ..'I... ..... B RY .............. �O/F SYCAMORE 6REIX ........ �MIILESS`N\O`RTH y300 ...... 1.1 MILES EPSF dF, �H SSW ............. .. 3 .................. ....... I ) U., 4 EAST ROSEDALE ST SYCAMORE CREEK 0.1 MILES EAST OF US 287 , I I I 5 EDERVILLE RD COTTONWOOD CREEK 2.3 MILES EAST OF IH 820 I I I 6 N BEACH ST NB BIG FOSSIL CREEK 1.0 MILES NORTH OF IN 820 I I I 7 N BEACH ST SB BIG FOSSIL CREEK 1.0 MILES NORTH OF IN 820 I I I I 8 BEACH NNB/ & SB MILIN 8i200 I I {, l `ST ..N. 1 1 , O�RTON PARK D� i , 1 ' 1 y �T}RIIB�U7TARY`OF�'/BIG`FOSSIL ICRREtEK�, h TRlBUTARY 8F CLEAR F6RK AINRY RIVER "1.1 )IES`'NOOR\T,HH `OFF , 1 1 0.2 �ILES EAST 6F S HIJLEN ST , 1 , 1 { , , , 1 , , 1 , 1 1 1 1 1 1 1 ` , 1 1 I 'I' 10 S WILDCAT WAY TRIBUTARY OF VILLAGE CREEK 0.9 MILES EAST OF IH 35W I I 11 WESTERN CENTER BLVD EB BIG FOSSIL CREEK 0.1 MILES EAST OF IH 35W I I I 12 WESTERN CENTER BLVD WB BIG FOSSIL CREEK 0.1 MILES EAST OF IH 35W 160.0 I 80.0 37 20 I I 13 WESTERN CENTER BLVD EB TRIBUTARY OF BIG FOSSIL CREEK 0.8 MILES EAST OF IH 35W I I I I 14 WESTERN CENTER BLVD WB TRIBUTARY OF BIG FOSSIL CREEK 0.8 MILES EAST OF IH 35W I I I I 15 HENDERSON ST FORT WORTH WESTERN RAILROAD 0.7 MILES SOUTHEAST OF W NORTHSIDE DR I I I 16 NORTH MAIN ST TRINITY BYPASS CHANNEL 0.4 MILES SOUTHEAST OF E NORTHSIDE DR I I � 17 WHITE SETTLEMENT RD FORT WORTH WESTERN RAILROAD 0.8 MILES EAST OF UNIVERSITY DR I I TOTAL 160.0 80.0 37 20 10 ADDENDUM NO. 1 KD 3/23 RC IFXNG NEGIGIENEN ENGINEERING FINK F-1141 C.: FORT WORTH CRY OF FORTWO BRIDGE REPAIRS ESTIMATED QUANTITIES a...... W6 TE%AS I rmvw w woccr m. r SEEM 1 OF 3 a,e.a. *ca mwn I awl Nu 3 pw/Active Projects/FTWH1700201.00/FTWH170020101/800 Plans and Drowings/8.30 Cut Sheets/83.07 Bridge/Package 7/FTWH1700201_EO07_01.dgn ESTIMATED QUANTITIES (CONTINUED) .......... BID ITEM NUMBER 360 400 420 422 429 429 438 439 = 6001 6005 6074 6015 6007 6009 6001 6013 CO R &aT" CONC STIR REPAIR CL(MISC) ONC - M BID ITEM DESCRIPTION (CONTCONCREINIF — CEM CROP) (77 STABIL BKFL APPROACH SLAB �STR OVERHEAD) (STANDARD) SC NNIINE),,AND JOINTSSTI POLYMER OVERLAY - - Q I BRIDGE NO. FEATURE CARRIED SY CY CY CY SF SF LF - " SY - I 1 ANDERSON BLVD 8.8 I 2 ANDERSON BLVD 0.3 1454 - - _ Al .. .. .. I 0.3 3.4 4.0 5 EDERVILLE RD S j' 6 I N BEACH ST NB 7.6 = I 7 N BEACH ST SB 8.0 9.0 " I BEACH ST NB&SB 1 I...B.. I 9 r...N .. OVERTON PARK DR E .............................................. 0.3 30.4 ................. ........ 11.1 10 S WILDCAT WAY 0.2 0.6 - 11 WESTERN CENTER BLVD EB 12.4� _ 12 WESTERN CENTER BLVD WE 160.0 37 29 I 13 WESTERN CENTER BLVD EB 32.2 - I I 14 WESTERN CENTER BLVD WE 40.6 390 - I I 15 HENDERSON ST - I 16 NORTH MAIN ST _ i I 17 WHITE SETTLEMENT RD I TOTAL 160.0 37 1.4 29 289.4 73.0 492 14.4 (!)INCLUDES A 100% INCREASE FROM FIELD OBSERVED QUANTMES. E a gyp,/Active Projects/FTWH1700201.00/FTWH170020101/800 Plans and Drawings/8.30 Cut Sheets/83.07 Bridge/Package 7/FTWH1700201—EO07-02.dgn A ADDENDUM NO. 1 KD 3/23 IFXNG RFGISIERFR ENGINFFIRM F-11411111 moll".::� FORT WORTH CRY OF FORTWO BRIDGE REPAIRS ESTIMATED QUANTITIES TEAS I rmvw w wocc, m. I.AD am SHEET 2 OF 3 a,e.a. rw mwn awl Nu 4 ESTIMATED QUANTITIES (CONTINUED) BID REM NUMBER 450540 540 540 540 542 544 752 780 7BB __ 6001 6005 6007 6016 6001 6001 6005 6004 6002 BID REM DESCRIPTION RAIL (TOERNL) MTL DOWNSTREAM (TIM POSE GO TERMINAL MILT BLS ANCHOR TERMINAL REMOVE METAL BEAM GUARD GUARDRAIL END TREATMENT CONIC CRCK REPR BEAM REMOVAL (DISCRF (ROUT CREPAIR�(CFRP) FEP! SECTONANCHOR �GD�)FEN SECTION FENCE (INSTALL) (44.� 12- AND S�EAI.) I BRIDGE NO. I FEATURE CARRIED LF LF EA EA EA LF EA EA LF EA I 1 ANDERSON BLVD I 2 ANDERSON BLVD I 3 BERRY Sf I 4 EAST ROSEDALE ST 5 EDERVILLE RD 3 6 I N BEACH ST NB 112.5 1 4 2 255.0 1 I 7 N BEACH ST SS 312.0 3 1 402.0 1 10 I 8 N BEACH ST NB & SS 50.0 3 1 120.0 1 9 R �VERf�� PAR �� .yy, .. 77..... ... .... ..... ......... ..... ........ ..... ..... ..... ... ........ ..... .. 1 .. ..... ..... ........ ..... 1 10 S WILDCAT WAY 11 WESTERN CENTER BLVD EB 62.5 2 4 2 170.0 10 12 WESTERN CENTER BLVD WB 37.5 2 4 1 153.0 1 13 WESTERN CENTER BLVD EB 50.0 4 2 184.0 2 14 WESTERN CENTER BLVD WB 50.0 4 2 184.0 2 I 15 HENDERSON ST 2880 I 16 NORTH MAIN ST 1648 WHITE SETTLEMENT RD 2653 �17 TOTAL 7381 674.5 5 26 11 1468.0 8 1 20 3 E a gyp,/Active Projects/FTWH1700201.00/FTWH170020101/800 Plans and D—iags/8.30 Cut Sheets/83.07 Bridge/Package 7/FTWH1700201_E007_03.dga 10 ADDENDUM NO. 1 KID 3/23 IFX,IS RFGISIERFR ENRINF-1141 FIRM F1111 FORT WORTH CRY OF FORTWO BRIDGE REPAIRS ESTIMATED QUANTITIES TEAS I rmw. w woccr m. SHEET 3 OF 3 a,e.a. rw mwn 1 awl Nu 5 CLEAN A(ND LSFEIAL EXIST JOINT REPAIR DETAILSSFE REPAIR EXIST CONCRETE , SEE OVERHANG Cy T TDETAILS b't Al EXIST DRNEWAY� REPAIR 5'x8' AREA OF EXISTING ED OVERLAY (p3q.M3pGS1� SEE OVERIAY REPAIR HCTES \ / / EXIST SIDEWALK /�' FACEO EXIST `,,,0001' FACE OF r I' : EXIST CURB BEGIN BRIDGE / / ABUTMENT NO. BENT NO. 2 BENT N0. 3 BENT N0. 4 �� 1 / / —. —. —. —. _ " BERRY Sf FACE OF EXIST CURB j• FACE OF EXIST 1 ;�(I BRIDGE RNL 1 1' EXIST SIDEWALK EXIST EDGE OF (EXIST FENCE LINE ---------- * -- "-- ----------------------- ---------------------------------------GAS- ------------------------ --------------- EXIST OVERHEAD UTILITY ----------.EXIST OVERHEAD BgRIDGEUGHDNG_______________________________ ______________________________________________________ EXIST OVERHEAD ___ ________________ (lYP) REPAIR EXIST CONCRETE UTILITY POLE (TYP) OVERHANG 0.1 —SEE IXISf UNDERGROUND GAS LANE OVERHANG EPAIR ETAILS PLAN (NOT TO SCALE) NBI NO.: 02-220-0—ZB28-80-002 CONCRETE OVERHANG REPAIR NOTES: GENERAL NOTES: 1. REMOVE ANY DAMAGED OR LOOSE CONCRETE. 1. CONTRACTOR TO COORDINATE WITH CITY ON LANE CLOSURE. TRAFFIC CONTROL IS SUBSIDARY TO SE OF r 3/22/2023 2. SAW —CUT THE PERIMETER OF REPAIR APPROXIMATELY REPAIR COST. •�P.•^""""'F+y % 70 4, INCHES BUT DO NOT CUT EXISTING REINFORCING SfTEELL. ADJUST DEPTH AS NECESSARY TO AVOID DAMAGING REINFORCEMENT. 2. AS —BUILT PUNS NOT AVAILABLE FOR THIS BRIDGE. CONTRACTOR TO VERIFY REPAIR AREAS AND .......................7 THOMAS G. ASHCRAFT SAW —CUT LINE (TV) ^ \ 3. USE ONLY HAND TOOL OR POWER—DRNEN CHIPPING TOOLS (15-1-13 HAMMER MAXIMUM) TO REMOVE CONCRETE. DIMENSIONS IN THE FIELD PRIOR TO ORDERING MATERIALS.1411 3. EXISTING BRIDGE INFORMATION ACQUIRED FROM •••:••••••••' •••••••••••••:-- �10' 4. IF MORE THAN % THE PERIMETER OF ANY MILD REINFORCEMENT SITE VISIT CONDUCTED ON NOVEMBER 18TH, 2022. AL IS EXPOSED OR IF THE EXPOSED BAR EXHIBITS SIGNIFICANT SPAIl AREA (7YP) _TO CORROSION, REMOVE THE CONCRETE FROM AROUND THE OVERLAY REPAIR NOTES: —_ � _—� ENTIRE BAR. PROVIDE 4i INCH CLEARANCE OR 1.5 TIMES THE , 1r��•!/T^✓ -- LARGEST SIZED AGGREGATE IN THE REPAIR MATERIAL, WHICHEVER IS GREATER, BETWEEN THE STEEL AND SURROUNDING CONCRETE. 1 REPAIR DAMAGED PORTION OF EXISTING OVERLAY IN , •If/�``� ACCORDANCE WITH TXDOT STANDARD SPECIFICATION 5. USE ABRASIVE BLASTING OR OTHER APPROVED TECHNIQUE ITEM 439, BRIDGE DECK OVERLAYS. Q ADDENDUM NO. 1 KD 3/23 --- n \ TO REMOVE RUST FROM EXPOSED STEEL SURFACES. _ 2. THE EDGES OF THE EXISTING OVERLAY SHOULD BE ' \ 8. CLEAN AND EXTEND EXISTING REINFORCEMENT INTO NEW SQUARED OFF 70 ACCEPT THE JOINT WTH THE NEW ' OVERLAY. PAYMENT FOR EQUIPMENT, LABOR, AND ALL' N0 CONSTRUCTION. ANY REINFORCEMENT THAT IS DAMAGED AND DETERMINED BY THE ENGINEER TO BE IN NEED OF INCIDENTALS TO REMOVE THE EXISTING OVERLAY I REPLACEMENT WILL BE DONE AT THE CONTRACTOR'S EXPENSE. - FOR PURPOSE OF PLACEMENT OF THE NEW OVERLAY IS SUBSOTY TO TXDOT STANDARD SPECIFICATION IFXRS RFGISIERFR & EN6INFFRIR4 FIRM 1 7. EXISTING STEEL POST AND BASE PLATE TO BE REUSED. IF ANY DAMAGE TO THOSE ELEMENTS OCCURS DURING REMOVAL ITEM 439, BRIDGE DECK OVERLAYS. , Enu OF CONCRETE, CONTRACTOR TO REPAIR DAMAGE PER 0 FORT ORTH. DIRECTION OF THE ENGINEER AT THE CONTRACTOR'S EXPENSE. 8. FOLLOW THE TXDOT 'CONCRETE REPAIR MANUAL', CHAPTER 3, SECTION 3— MAJOR SPALL REPAIR AND CONCRETE REPLACEMENT CITY OF FORT WO BRIDGE REPAIRS AFOR CONCRETE SURFACE PPLICATION, FORMS, PTION, REPAIR MATERIAL MIXING, ANDCURING. BRIDGE REPAIR DETAILS OVERHANG REPAIR DETAILS 9. USE TXDOT CLASS 'C' CONCRETE (V-3,800 PSI) FOR THE REPAIR. BERRY STREET O MOB PAIL,POST NO. 10 FROMWESTWEST « 10. REPAIR OF CONCRETE DECK OVERHANG TO BE PAID FOR UNDER OVER SYCAMORE CREEK POST NO. 11 FROM W« e—O 4'-0' S OUTH RAIL CLASS C CONC (MISC). THIS PAYMENT INCLUDES ALL LABOR, EQUIPMENT, AND MA WS i0 REMOVE AND DISPOSE THE `m' """ I i0E""` "'° "'°"" X0-V— W6 POSE NO. 19 FROM WEST « 3'-3' OF EXISTING DECK OVERHANG CONCRETE JRn�o css TEXAS mw .o- am SHEET 1 OF 2 cn.ra Iuo _ 9 pw/Active Projects/FTWH 1700201.00/ FTWH 170020101/ 800 Plans and Drowings/8.30 Cut Sheets/ 83.07 Bridge/Package 7/Berry St over Sycamore Creek/FWTH1700201—BerryStOverSyocomoreCreek—BLO1 dgn REPAIR SPALL ON EXIST �d CONCRETE SIDEWALK (30 S SEE CONCRETE REPAIR DEfLS gc REPAIR SPAIl ON EXIST REPAIR DAMAGED PORTION OF �EXIST ABOVE \ \ \ a CONCRETE WINGWALL(8.2 S IXISf CONCRETE OVERHANG GROUND GAS c AND REMOVE SMALL TREE [[1 - REPa SIR ON EXIST CONCRETE ABUTMENT £ SEE CONCRETE REPAIR DETA115 R(,2 CY TOTAL) -SEE (A LINE DNE RR ALES R:ONCRETE RERAR DETAILS CAP (0.6 SFl AND ON WINGWALL (4.1 SF) -SEE cCONS ETE REAP\ DETAILS REPAIR EXIST CONCRETE DECK OVERHANG �0.1 -SEE CONCRETE DECK OVERHANG EPaR DEraLs y Ic 1 \`• r', 1, EXIST SIDEWALK, EXIST EDGE OF BFACE 0 RIDGE RAILI ,:� '• ',`•,'• REPAIR 5'x20' AREA OF DOSIING END BRIDGE DAMAGED OVERLAY (11.1 SY) - BENT NO. 2 \ BENT No. 3 , \ ABUTMENT NO. 4 SEE OVERLAY REPAIR NOTES _ l fit-, — . . BEGIN BRIDGE '•,. _ ABUTMENT N0. 1 �q OVERTON PARK DR E EXIST EDGE OF ` PAVEMENT ,'.,�': ,,'.,\'•, FACE OF EXIST l c EXIST SIDEWALK REPAIR SPALL ON EXIST BRIDGE RAIL • �1 CONCRETE COLUMN (1 SF)- .; ' �,� ,, �•�1 cL ,ONCRErE REPAIR DE LS REPAIR SPALL O�J EXSI CONCRETE ABUTMENT CAP 1.3 S - SEE CONCRETE REP DET LS NBI NO.: 02-220-0-ZO82-50-001 PLAN (NorrSCALE) SE of r 3/22/2023 ` GENERAL NOTES: i 1. CONTRACTOR TO COORDINATE WITH CITY ON LANE TNOMAS G. ASHCRAFi CLOSURE. TRAFFIC CONTROL IS SUBSIDARY TO REPAIR REPAIR COST. 1411 2. AS -BUILT PLANS NOT AVAILABLE FOR THIS BRIDGE STEM CONTRACTOR TO VERIFY REPAIR AREAS AND ............. N.. AL.AAA Na'c DIMENSIONS IN THE FIELD PRIOR TO ORDERING Ir,'•//T�` mma` DIMENSIONS ¢ 3. EXISTING BRIDGE INFORMATION ACQUIRED FROM al �l� SITE VISIT CONDUCTED FEBRUARY LOTH, 2022. n a'a . . .. .. . .. .. . .. .. . .. .. / AlADDENDUM N0. 1 KID 3/23 aaa OVERLAY REPAIR NOTES: 1. REPAIR DAMAGED PORTION OF EXISTING OVERLAY IN c ACCORDANCE WITH TKDCT STANDARD SPECIFICATION - 1EMSREGI5IEREN E REM 439, BRIDGE DECK OVERLAYS. & ENGINEERING FIRM 2. THE EDGES OF THE EXISTING OVERLAY SHOULD BE - FtTu SQUARED OFF TO ACCEPT THE JOINT WITH THE NEW � OVER PAYMENT FOR EQUIPMENT LABOR, AND ALL - .. FOWORTHo INCIDENTALS TO REMOVE THE EXISTING OVERLAY FOR PURPOSE OF PLACEMENT OF THE NEW OVERLAY a IS SUBSIDIARY TO TKDOT STANDARD SPECIFICATION ffEM 439, BRIDGE DECK OVERLAYS. _ CITY OF FORT WO BRIDGE REPAIRS BRIDGE REPAIR DETAILS OVERTON PARK DR E OVER TRIBUTARY OF CLEAR FORK TRINTiY RIVER wu. TG W6 TE%ASI rmvx m.rmsxo. w< CBR �"w� am r SHEET 1 OF 3 cn,wx Nno raven awl �o- 17 pw/Active Projects/FTWH 1700201.00/ FTWH 170020101/800 Plans and Drowings/8.30 Cut Sheets/83.07 Bridge/Pockage 7/Overton Pork Or E over Trib Clear Fork Trinity/FWTH1700201-0vertonParkD(FOverTCFT-BL01.dgn CITY OF FORT WORTH Transportation and Public Works 2023 Bridge Rehabilitation Contract 1 City Project No. 104687 ADDENDUM NO. 1 - END OF SECTION - 2023 Bridge Rehabilitation Contract 1 City Project No. 104687 ADDENDUM NO. 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 42 43 44 45 46 47 48 49 0011 13 INVITATION TO BIDDERS Page 1 of 2 SECTION 00 1113 INVITATION TO BIDDERS RECEIPT OF BIDS Sealed bids for the construction of 2023 BRIDGE REHABILITATION CONTRACT 1, City project No. 104687 will be received by the City of Fort Worth Purchasing Office until 1:30 P.M. CST, Thursday, March 23, 2023 as further described below: City of Fort Worth Purchasing Division 200 Texas Street Fort Worth, Texas 76102 Bids will be accepted by: US Mail, Courier, FedEx or hand delivery at the address above; Bids will be opened publicly and read aloud at 2:00 PM CST in the City Council Chambers. GENERAL DESCRIPTION OF WORK The major work will consist of the (approximate) following: 160 SY CONC PVMT (CONT REINF - CRCP) (7) 289 SF CONC STR REPAIR (VERTICAL & OVERHEAD) 492 LF CLEANING AND SEALING EXISTING JOINTS 7,381 LF RAIL (TOERAIL) 674 LF MTL W-BEAM GD FEN (TIM POST) 3 EA CONCRETE BEAM REPAIR (CFRP) DOCUMENT EXAMINATION AND PROCUREMENTS The Bidding and Contract Documents may be examined or obtained on-line by visiting the City of Fort Worth's Purchasing Division website at httt)://www.fortworthtexas.,2ov/Durchasin�_ / and clicking on the link to the advertised project folders on the City's electronic document management and collaboration system site. The Contract Documents may be downloaded, viewed, and printed by interested contractors and/or suppliers. Copies of the Bidding and Contract Documents may be purchased at Street Services, City of Fort Worth, TPW, 5001 James Ave, Fort Worth, TX 76115. The cost of Bidding and Contract Documents is: $30.00 EXPRESSION OF INTERSEST To ensure potential bidders are kept up to date of any new information pertinent to this project, all interested parties are requested to email Expressions of Interest in this procurement to the City Project Manager and the Design Engineer. The email should include the company's name, contact person and that individual's email address and phone number. All Addenda will be distributed directly to those who have expressed an interest in the procurement and will also be posted in the City of Fort Worth's purchasing website at http://fortworthtexas.gov/purchasing/ PREBID CONFERENCE — Web Conference A prebid conference will be held as discussed in Section 00 21 13 - INSTRUCTIONS TO BIDDERS at the following date, and time: CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Revised 7/19/2021 2023 BRIDGE REHABILITATION CONTRAT 1 City Project No. 104687 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 0011 13 INVITATION TO BIDDERS Page 2 of 2 Via a web conferencing application: DATE: Wednesday, March 8, 2023 TIME: 10.00 A.M. A prebid field conference will be held to clarify Toerail installation at following location, date, and time: LOCATION: 2501 White Settlement Rd DATE: Friday, March 10, 2023 TIME: 10:00 A.M. Invitations with links to the web conferencing application will be distributed directly to those who have submitted an Expression of Interest. If a prebid conference is held, the presentation and any questions and answers provided at the prebid conference will be issued as an Addendum to the call for bids. If a prebid conference is not being held, prospective bidders can e-mail questions or comments in accordance with Section 6 of the Instructions to Bidders referenced above to the project manager(s) at the e-mail addresses listed below. Emailed questions will suffice as "questions in writing." If necessary, Addenda will be issued pursuant to the Instructions to Bidders. CITY'S RIGHT TO ACCEPT OR REJECT BIDS City reserves the right to waive irregularities and to accept or reject any or all bids. AWARD City will award a contract to the Bidder presenting the lowest price, qualifications and competencies considered. FUNDING Any Contract awarded under this INVITATION TO BIDDERS is expected to be funded from revenues generated from bonds, grants etc. and reserved by the City for the Project. INQUIRIES All inquiries relative to this procurement should be addressed to the following: Attn: Tariqul Islam, City of Fort Worth Email: tariaul.islamna,fortworthtexas.izov ADVERTISEMENT DATES February 23, 2023 March 2, 2023 92 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Revised 7/19/2021 2023 BRIDGE REHABILITATION CONTRAT 1 City Project No. 104687 0021 13 INSTRUCTIONS TO BIDDERS SECTION 00 2113 INSTRUCTIONS TO BIDDERS 1. Defined Terms Pagel of 8 1.1. Capitalized terms used in these INSTRUCTIONS TO BIDDERS are defined in Section 00 72 00 - GENERAL CONDITIONS. 1.2. Certain additional terms used in these INSTRUCTIONS TO BIDDERS have the meanings indicated below which are applicable to both the singular and plural thereof. 1.2.1. Bidder: Any person, firm, partnership, company, association, or corporation acting directly through a duly authorized representative, submitting a bid for performing the work contemplated under the Contract Documents. 1.2.2. Nonresident Bidder: Any person, firm, partnership, company, association, or corporation acting directly through a duly authorized representative, submitting a bid for performing the work contemplated under the Contract Documents whose principal place of business is not in the State of Texas. 1.2.3. Successful Bidder: The lowest responsible and responsive Bidder to whom City (on the basis of City's evaluation as hereinafter provided) makes an award. 2. Copies of Bidding Documents 2.1. Neither City nor Engineer shall assume any responsibility for errors or misinterpretations resulting from the Bidders use of incomplete sets of Bidding Documents. 2.2. City and Engineer in making copies of Bidding Documents available do so only for the purpose of obtaining Bids for the Work and do not authorize or confer a license or grant for any other use. 3. Prequalification of Bidders (Prime Contractors and Subcontractors) OMITTED 4. Examination of Bidding and Contract Documents, Other Related Data, and Site 4.1. Before submitting a Bid, each Bidder: 4.1.1. Shall examine and carefully study the Contract Documents and other related data identified in the Bidding Documents (including "technical data" referred to in Paragraph 4.2. below). No information given by City or any representative of the City other than that contained in the Contract Documents and officially promulgated addenda thereto, shall be binding upon the City. 4.1.2. Should visit the site to become familiar with and satisfy Bidder as to the general, local and site conditions that may affect cost, progress, performance or furnishing of the Work. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 0021 13 INSTRUCTIONS TO BIDDERS Page 2 of 8 4.1.3. Shall consider federal, state and local Laws and Regulations that may affect cost, progress, performance or furnishing of the Work. 4.1.4. OMITTED 4.1.5. Shall study all: (i) reports of explorations and tests of subsurface conditions at or contiguous to the Site and all drawings of physical conditions relating to existing surface or subsurface structures at the Site (except Underground Facilities) that have been identified in the Contract Documents as containing reliable "technical data" and (ii) reports and drawings of Hazardous Environmental Conditions, if any, at the Site that have been identified in the Contract Documents as containing reliable "technical data." 4.1.6. Is advised that the Contract Documents on file with the City shall constitute all of the information which the City will furnish. All additional information and data which the City will supply after promulgation of the formal Contract Documents shall be issued in the form of written addenda and shall become part of the Contract Documents just as though such addenda were actually written into the original Contract Documents. No information given by the City other than that contained in the Contract Documents and officially promulgated addenda thereto, shall be binding upon the City. 4.1.7. Should perform independent research, investigations, tests, borings, and such other means as may be necessary to gain a complete knowledge of the conditions which will be encountered during the construction of the project. For projects with restricted access, upon request, City may provide each Bidder access to the site to conduct such examinations, investigations, explorations, tests and studies as each Bidder deems necessary for submission of a Bid. Bidder must fill all holes and clean up and restore the site to its former conditions upon completion of such explorations, investigations, tests and studies. 4.1.8. Shall determine the difficulties of the Work and all attending circumstances affecting the cost of doing the Work, time required for its completion, and obtain all information required to make a proposal. Bidders shall rely exclusively and solely upon their own estimates, investigation, research, tests, explorations, and other data which are necessary for full and complete information upon which the proposal is to be based. It is understood that the submission of a proposal or bid is prima -facie evidence that the Bidder has made the investigations, examinations and tests herein required. 4.1.9. Shall promptly notify City of all conflicts, errors, ambiguities or discrepancies in or between the Contract Documents and such other related documents. The Contractor shall not take advantage of any gross error or omission in the Contract Documents, and the City shall be permitted to make such corrections or interpretations as may be deemed necessary for fulfillment of the intent of the Contract Documents. 4.2. Reference is made to Section 00 73 00 — Supplementary Conditions for identification of: CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 0021 13 INSTRUCTIONS TO BIDDERS Page 3 of 8 4.2.1. those reports of explorations and tests of subsurface conditions at or contiguous to the site which have been utilized by City in preparation of the Contract Documents. The logs of Soil Borings, if any, on the plans are for general information only. Neither the City nor the Engineer guarantee that the data shown is representative of conditions which actually exist. 4.2.2. those drawings of physical conditions in or relating to existing surface and subsurface structures (except Underground Facilities) which are at or contiguous to the site that have been utilized by City in preparation of the Contract Documents. 4.2.3. copies of such reports and drawings will be made available by City to any Bidder on request. Those reports and drawings may not be part of the Contract Documents, but the "technical data" contained therein upon which Bidder is entitled to rely as provided in Paragraph 4.02. of the General Conditions has been identified and established in Paragraph SC 4.02 of the Supplementary Conditions. Bidder is responsible for any interpretation or conclusion drawn from any "technical data" or any other data, interpretations, opinions or information. 4.2.4. Standard insurance requirements, coverages and limits. 4.3. The submission of a Bid will constitute an incontrovertible representation by Bidder: (i) that Bidder has complied with every requirement of this Paragraph 4, (ii) that without exception the Bid is premised upon performing and furnishing the Work required by the Contract Documents and applying the specific means, methods, techniques, sequences or procedures of construction (if any) that may be shown or indicated or expressly required by the Contract Documents, (iii) that Bidder has given City written notice of all conflicts, errors, ambiguities and discrepancies in the Contract Documents and the written resolutions thereof by City are acceptable to Bidder, and when said conflicts, etc., have not been resolved through the interpretations by City as described in Paragraph 6., and (iv) that the Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performing and furnishing the Work. 4.4. The provisions of this Paragraph 4, inclusive, do not apply to Asbestos, Polychlorinated biphenyls (PCBs), Petroleum, Hazardous Waste or Radioactive Material covered by Paragraph 4.06. of the General Conditions, unless specifically identified in the Contract Documents. 5. Availability of Lands for Work, Etc. 5.1. The lands upon which the Work is to be performed, rights -of -way and easements for access thereto and other lands designated for use by Contractor in performing the Work are identified in the Contract Documents. All additional lands and access thereto required for temporary construction facilities, construction equipment or storage of materials and equipment to be incorporated in the Work are to be obtained and paid for by Contractor. Easements for permanent structures or permanent changes in existing facilities are to be obtained and paid for by City unless otherwise provided in the Contract Documents. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 0021 13 INSTRUCTIONS TO BIDDERS Page 4 of 8 5.2.Outstanding right-of-way, easements, and/or permits to be acquired by the City are listed in Paragraph SC 4.01 of the Supplementary Conditions. In the event the necessary right- of-way, easements, and/or permits are not obtained, the City reserves the right to cancel the award of contract at any time before the Bidder begins any construction work on the project. 5.3. The Bidder shall be prepared to commence construction without all executed right-of- way, easements, and/or permits, and shall submit a schedule to the City of how construction will proceed in the other areas of the project that do not require permits and/or easements. 6. Interpretations and Addenda 6.1. All questions about the meaning or intent of the Bidding Documents are to be directed to City in writing on or before 2 p.m., the Monday prior to the Bid opening. Questions received after this day may not be responded to. Interpretations or clarifications considered necessary by City in response to such questions will be issued by Addenda delivered to all parties recorded by City as having received the Bidding Documents. Only questions answered by formal written Addenda will be binding. Oral and other interpretations or clarifications will be without legal effect. Address questions to: City of Fort Worth 200 Texas Street Fort Worth, TX 76102 Attn: Tariqul Islam, Transportation and Public Works Email: tariqul.islam@fortworthtexas.gov Phone: 817-392-2486 6.2. Addenda may also be issued to modify the Bidding Documents as deemed advisable by City. 6.3. Addenda or clarifications may be posted via the City's electronic document management and collaboration system at hfr)s:Hdocs.b360.autodesk.com/shares/eO95d696-3f9e- 4115-be9a-bf3f931333b8 6.4. A prebid conference may be held at the time and place indicated in the Advertisement or INVITATION TO BIDDERS. Representatives of City will be present to discuss the Project. Bidders are encouraged to attend and participate in the conference. City will transmit to all prospective Bidders of record such Addenda as City considers necessary in response to questions arising at the conference. Oral statements may not be relied upon and will not be binding or legally effective. 7. Bid Security 7.1. Each Bid must be accompanied by a Bid Bond made payable to City in an amount of five (5) percent of Bidder's maximum Bid price, on the form attached or equivalent, issued by a surety meeting the requirements of Paragraph 5.01 of the General Conditions. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 0021 13 INSTRUCTIONS TO BIDDERS Page 5 of 8 7.2. The Bid Bonds provided by a Bidder will be retained until the conditions of the Notice of Award have been satisfied. If the Successful Bidder fails to execute and return the Contract Documents within 14 days after the Notice of Award conveying same, City may consider Bidder to be in default, rescind the Notice of Award and act on the Bid Bond. Such action shall be City's exclusive remedy in the event Bidder is deemed to have defaulted. 8. Contract Times The number of days within which, or the dates by which, Milestones are to be achieved in accordance with the General Requirements and the Work is to be completed and ready for Final Acceptance is set forth in the Agreement or incorporated therein by reference to the attached Bid Form. 9. Liquidated Damages Provisions for liquidated damages are set forth in the Agreement. 10. Substitute and "Or -Equal" Items The Contract, if awarded, will be on the basis of materials and equipment described in the Bidding Documents without consideration of possible substitute or "or -equal" items. Whenever it is indicated or specified in the Bidding Documents that a "substitute" or "or - equal" item of material or equipment may be furnished or used by Contractor if acceptable to City, application for such acceptance will not be considered by City until after the Effective Date of the Agreement. The procedure for submission of any such application by Contractor and consideration by City is set forth in Paragraphs 6.05A., 6.05B. and 6.05C. of the General Conditions and is supplemented in Section 0125 00 of the General Requirements. 11. Subcontractors, Suppliers and Others 11.1. In accordance with the City's Business Equity Ordinance No.25165-10-2021 the City has goals for the participation of minority business and/or women business enterprises in City contracts $100,000 or greater. See Section 00 45 40 for the M/WBE Project Goals and additional requirements. Failure to comply shall render the Bidder as non -responsive. Business Equity Ordinance No.25165-10-2021, as amended (replacing Ordinance No. 24534-11-2020), codified at: https://codelibrary.amlegal.com/codes/ftworth/latest/ftworth tx/0-0-0-22593 11.2. No Contractor shall be required to employ any Subcontractor, Supplier, other person or organization against whom Contractor or City has reasonable objection. 12. Bid Form 12.1. The Bid Form is included with the Bidding Documents; additional copies may be obtained from the City. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 0021 13 INSTRUCTIONS TO BIDDERS Page 6 of 8 12.2. All blanks on the Bid Form must be completed and the Bid Form signed in ink. Erasures or alterations shall be initialed in ink by the person signing the Bid Form. A Bid price shall be indicated for each Bid item, alternative, and unit price item listed therein. In the case of optional alternatives, the words "No Bid," "No Change," or "Not Applicable" may be entered. Bidder shall state the prices for which the Bidder proposes to do the work contemplated or furnish materials required. All entries shall be legible. 12.3. Bids by corporations shall be executed in the corporate name by the president or a vice-president or other corporate officer accompanied by evidence of authority to sign. The corporate seal shall be affixed. The corporate address and state of incorporation shall be shown below the signature. 12.4. Bids by partnerships shall be executed in the partnership name and signed by a partner, whose title must appear under the signature accompanied by evidence of authority to sign. The official address of the partnership shall be shown below the signature. 12.5. Bids by limited liability companies shall be executed in the name of the firm by a member and accompanied by evidence of authority to sign. The state of formation of the firm and the official address of the firm shall be shown. 12.6. Bids by individuals shall show the Bidder's name and official address. 12.7. Bids by joint ventures shall be executed by each joint venture in the manner indicated on the Bid Form. The official address of the joint venture shall be shown. 12.8. All names shall be typed or printed in ink below the signature. 12.9. The Bid shall contain an acknowledgement of receipt of all Addenda, the numbers of which shall be filled in on the Bid Form. 12.10. Postal and e-mail addresses and telephone number for communications regarding the Bid shall be shown. 12.11. Evidence of authority to conduct business as a Nonresident Bidder in the state of Texas shall be provided in accordance with Section 00 43 37 — Vendor Compliance to State Law Non Resident Bidder. 13. Submission of Bids Bids shall be submitted on the prescribed Bid Form, provided with the Bidding Documents, at the time and place indicated in the Advertisement or INVITATION TO BIDDERS, addressed to Purchasing Manager of the City, and shall be enclosed in an opaque sealed envelope, marked with the City Project Number, Project title, the name and address of Bidder, and accompanied by the Bid security and other required documents. If the Bid is sent through the mail or other delivery system, the sealed envelope shall be enclosed in a separate envelope with the notation "BID ENCLOSED" on the face of it. 14. Withdrawal of Bids CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 0021 13 INSTRUCTIONS TO BIDDERS Page 7 of 8 14.1. Bids addressed to the Purchasing Manager and filed with the Purchasing Office may be withdrawn prior to the time set for bid opening. A request for withdrawal must be made in writing and delivered to the Purchasing Office to receive a time stamp prior to the opening of Bids. A timely withdrawn bid will be returned to the Bidder or, if the request is within one hour of bid opening, will not be read aloud and will thereafter be returned unopened. 14.2. In the event any Bid for which a withdrawal request has been timely filed has been inadvertently opened, said Bid and any record thereof will subsequently be marked "Withdrawn" and will be given no further consideration for the award of contract. 15. Opening of Bids Bids will be opened and read aloud publicly. An abstract of the amounts of the base Bids and major alternates (if any) will be made available to Bidders after the opening of Bids. 16. Bids to Remain Subject to Acceptance All Bids will remain subject to acceptance for a minimum of 90 days or the time period specified for Notice of Award and execution and delivery of a complete Agreement by Successful Bidder. City may, at City's sole discretion, release any Bid and nullify the Bid security prior to that date. 17. Evaluation of Bids and Award of Contract 17.1. City reserves the right to reject any or all Bids, including without limitation the rights to reject any or all nonconforming, nonresponsive, unbalanced or conditional Bids and to reject the Bid of any Bidder if City believes that it would not be in the best interest of the Project to make an award to that Bidder. City reserves the right to waive informalities not involving price, contract time or changes in the Work and award a contract to such Bidder. Discrepancies between the multiplication of units of Work and unit prices will be resolved in favor of the unit prices. Discrepancies between the indicated sum of any column of figures and the correct sum thereof will be resolved in favor of the correct sum. Discrepancies between words and figures will be resolved in favor of the words. 17.1.1. Any or all bids will be rejected if City has reason to believe that collusion exists among the Bidders, Bidder is an interested party to any litigation against City, City or Bidder may have a claim against the other or be engaged in litigation, Bidder is in arrears on any existing contract or has defaulted on a previous contract, Bidder has performed a prior contract in an unsatisfactory manner, or Bidder has uncompleted work which in the judgment of the City will prevent or hinder the prompt completion of additional work if awarded. 17.2. In addition to Bidder's relevant prequalification requirements, City may consider the qualifications and experience of Subcontractors, Suppliers, and other persons and organizations proposed for those portions of the Work where the identity of such Subcontractors, Suppliers, and other persons and organizations must be submitted as provided in the Contract Documents or upon the request of the City. City also may consider the operating costs, maintenance requirements, performance data and guarantees of major items of materials and equipment proposed for incorporation in the Work when such data is required to be submitted prior to the Notice of Award. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 0021 13 INSTRUCTIONS TO BIDDERS Page 8 of 8 17.3. City may conduct such investigations as City deems necessary to assist in the evaluation of any Bid and to establish the responsibility, qualifications, and financial ability of Bidders, proposed Subcontractors, Suppliers and other persons and organizations to perform and furnish the Work in accordance with the Contract Documents to City's satisfaction within the prescribed time. 17.4. Contractor shall perform with his own organization, work of a value not less than 35% of the value embraced on the Contract, unless otherwise approved by the City. 17.5. If the Contract is to be awarded, it will be awarded to lowest responsible and responsive Bidder whose evaluation by City indicates that the award will be in the best interests of the City. 17.6. Pursuant to Texas Government Code Chapter 2252.001, the City will not award contract to a Nonresident Bidder unless the Nonresident Bidder's bid is lower than the lowest bid submitted by a responsible Texas Bidder by the same amount that a Texas resident bidder would be required to underbid a Nonresident Bidder to obtain a comparable contract in the state in which the nonresident's principal place of business is located. 17.7. A contract is not awarded until formal City Council authorization. If the Contract is to be awarded, City will award the Contract within 90 days after the day of the Bid opening unless extended in writing. No other act of City or others will constitute acceptance of a Bid. Upon the contract award, a Notice of Award will be issued by the City. 17.7.1. The contractor is required to fill out and sign the Certificate of Interested Parties Form 1295 and the form must be submitted to the Project Manager before the contract will be presented to the City Council. The form can be obtained at httvs://www.ethics.state.tx.us/data/forms/1295/1295.vdf 17.8. Failure or refusal to comply with the requirements may result in rejection of Bid. 18. Signing of Agreement 18.1. When City issues a Notice of Award to the Successful Bidder, it will be accompanied by the required number of unsigned counterparts of the Project Manual. Within 14 days thereafter, Contractor shall sign and deliver the required number of counterparts of the Project Manual to City with the required Bonds, Certificates of Insurance, and all other required documentation. 18.2. City shall thereafter deliver one fully signed counterpart to Contractor. END OF SECTION CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENT City Project No. 104687 Revised/Updated November 2, 2021 00 35 13 CONFLICT OF INTEREST STATEMENT Page 1 of 1 SECTION 00 35 13 CONFLICT OF INTEREST STATEMENT Each bidder, offeror or respondent to a City of Fort Worth procurement is required to complete a Conflict of Interest Questionnaire or certify that one is current and on file with the City Secretary's Office pursuant to state law. If a member of the Fort Worth City Council, any one or more of the City Manager or Assistant City Managers, or an agent of the City who exercise discretion in the planning, recommending, selecting or contracting with a bidder, offeror or respondent is affiliated with your company, then a Local Government Officer Conflicts Disclosure Statement (CIS) may be required. You are urged to consult with counsel regarding the applicability of these forms and Local Government Code Chapter 176 to your company. The referenced forms may be downloaded from the links provided below. httr)://www.ethics.state.tx.us/forms/CIQ.r)df httiD://www.ethics.state.tx.us/forms/CIS.iDdf ❑ CIQ Form does not apply 0 CIQ Form is on file with City Secretary ❑ CIQ Form is being provided to the City Secretary M CIS Form does not apply ❑ CIS Form is on File with City Secretary ❑ CIS Form is being provided to the City Secretary BIDDER: Gibson & Associates, Inc. 11210 Ryliecrest Drive Balch Springs, TX 75180 END OF SECTION By: Alan C. Meador Signature: Title: Vice President CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised February 24, 2020 2023 BRIDGE REHABILITATION CONTRACT 1 City Project No. 104687 0041 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: 2023 BRIDGE REHABILITATION CONTRACT 1 City Project No.: 104687 Units/Sections: BRIDGE 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, will 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 2023 BRIDGE REHABILITATION CONTRACT 1 Revised 9/30/2021 City Project No. 104687 0041 00 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. Prequalification The Bidder acknowledges that the following work types must be performed only by prequalified contractors and subcontractors: a. Not Applicable b. C. d. e. f. 9• h. 4. Time of Completion 4.1. The Work will be complete for Final Acceptance within 210 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. Prequalification Statement, Section 00 45 12 g. Conflict of Interest Affidavit, Section 00 35 13 *If necessary, CIQ or CIS forms are to be provided directly to City Secretary h. Any additional documents that may be required by Section 12 of the Instructions to Bidders CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 2023 BRIDGE REHABILITATION CONTRACT 1 Revised 9/30/2021 City Project No. 104687 0041 00 BID FORM Page 3 of 3 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 proposal and then totaling all of the extended amounts. Total Bid $942,626.10 7. Bid Submittal This Bid is submitted on March 30, 2023 by the entity named below. Respectfully submitted, (Receipt is acknowledged of the Initial �� ✓� following Addenda: By: i; / �> Addendum No. 1: V _ (Signature) (Addendum No. 2: JAddendum No. 3: NIA Alan C. Meador JAddendum No. 4: (Printed Name) Title: Vice President Company: Gibson & Associates, Inc. Corporate Seal: Address: 11210 Ryliecrest Dr. Balch Springs, Texas 75180 State of Incorporation: Texas Email: trevm a aibsonassoc.net Phone: 972-557-1199 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 2023 BRIDGE REHABILITATION CONTRACT 1 Revised 9/30/2021 City Project No. 104687 00 42 43 BID PROPOSAL Page I of I SECTION 00 42 43 PROPOSALFORM UNIT PRICE BID Bidder's Application Protect Item Information Bidder's Proposal Bidlist Description Specification Section Unit of Bid Unit Price Bid Value Item No No Measure Quantity I REMOBILIZATION 017000 EA 1 $50000 $500,001 2 REMOVING CONC (PAV) 104-6001 SY 160.0 $125.00 $20,000.001 3 REMOVING CONC (APPR SLAB) 104-6027 SY 80.0 $125.00 $10,000.00l 4 EXCAVATION (ROADWAY) 110-6001 CY 37.0 $250.00 $9,250,001 5 EMBANKMENT (FINAL)(ORD CONIP)(TY B) 132-6003 CY 20.0 $345.00 $6,900.001 6 CONC PVMT (CONT REINF - CRCP) (7") 360-6001 SY 160.0 $287 50 $46,000.001 7 CEM STABIL BKFL 400-6005 CY 37.0 $345 00 $12,765.00� 8 CL C CONC (MISC) 420-6074 CY 1.4 $25,000.00 $35,000.00 9 APPROACH SLAB 422-6015 CY 290 $1,900.00 $55,100.00 10 CONC STR REPAIR (VERTICAL R OVERHEAD) 429-6007 SF 289.4 $190 00 $54,986 001 I CONC STR REPAIR (STANDARD) 429-6009 SF 73.0 $190.00 $13,870.001 12 CLEANING AND SEALING EXISTING JOINTS 438-6001 LF 492.0 $40.00 $19,680.001 13 MULTI -LAYER POLYNIER OVERLAY 439-6013 SY 14A $435.00 $6,264.00) 14 RAIL(TOERAIL) 450-- LF 7,38L0 $43.85 $323,656.85I 15 MTL W-BEAM GD FEN (TIM POST) 540-6001 LF 674.5 $2Z50 $18,548,751 16 TERMINAL ANCHOR SECTION 540-6005 EA 5.0 $687 50 $3,437.501 17 MTL BEAM GD FEN TRANS (TL2) 540-6007 EA 26.0 $1,045 00 $27,170.001 18 DOWNSTREAM ANCHOR TERMINAL SECTION 540-6016 EA 11.0 $1,210.00 $13,310.001 19 REMOVE METAL BEAM GUARD FENCE 542-6001 LF 1,468.0 $11.00 $16,148.001 20 GUARDRAIL END TREATMENT (INSTALL) 544-6001 EA 80 $3,080.00 $24,640.001 21 TREE REMOVAL (4" - 12" D1A) 752-6005 EA 1.0 $1,000.00 $1,000.001 22 CONIC CRCK REPR (DISCRETE) (ROUT AND SEAL) 780-6004 LF 200 $50 00 $1,000.001 23 CONCRETE BEAM REPAIR (CFRP) 788-6002 EA 3.0 $57,80000 $173,400.001 24 9999.0096 PAVING CONSTRUCTION ALLOWANCE LS 1.0 $50,000.00 $50,000.001 Total Bid $942,626.101 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 2023 BRIDGE REHABILITATION CONTRACT I Revised 9/30/2021 City Project No 104687 SECTION 00 43 13 BID BOND KNOW ALL BY THESE PRESENTS: 00 43 13 BID BOND Page 1 of 2 That we. Gibson & Associates, Inc. , known as "Bidder" herein and Federal Insurance Company 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 2023 BRIDGE REHABILITATION CONTRACT 1 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 13th day of March . 2021 ATTEST: Witness as to Principal CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised 913012021 PRINCIPAL: Gibson & Associates, Inc. BY: Ovk',eZ Signature rl�r� C.Mtm�for-jlir�l��fialQn� Name and Title 2023 BRIDGE R.EHABILITAI'ION' CONTRACT 1 City Project No. 104687 pit7lis as to Surety Attach Power of Attorney (Surety) for Attorney -in -Fact Address: 11210 Ryliecrest Dr. Balch Sprini?s, TX .75180-0579 SURETY: Federal Insurance Company Signature Robbi Morales, Attorney -in -fact Name and Title Address: 5005 LBJ Freeway, Suite 1500 Dallas. TX 75244 Telephone Number: 214/989-0000 0043 13 BID BOND Page 2 of 2 *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 SI-VTI0N CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS 2023 BRIDGE REHABILITATION CONTRACT I Revised 9/30/2021 City Project No. 104687 C:H"ERE3' Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Westchester Fire Insurance Company I ACE American Insurance Company Know All by These Presents, that FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, WESTCHESTERFIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY corporations of the Commonwealth of Pennsylvania, do each hereby constitute and appoint Don E. Cornell, Sophinie Hunter, Tina McEwan, Robbi Morales, Mikaela Peppers, Tonle Petranek, Ricardo J. Reyna, Joshua Saunders and Kelly A. Westbrook of Dallas, Texas; Steven Dwain Brockinton of Little Rock, Arkansas ------------------------------------------------------ each as their true and lawful Attorney -in -Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY have each executed and attested these presents and affixed their corporate seals on this 4th day of February, 2022. lkivm \L Chlortx. Assistant Secretary STATE OF NEW JERSEY County of Hunterdon 7 v"L ac,., Stephen 11.1 kiney. Vice President •ro...� • •lrw- On this 4th day of February, 2022 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros and Stephen M. Haney, to me known to be Assistant Secretary and Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY, the companies which executed the foregoing Power Of Attorney, and the said Dawn M. Chloros and Stephen M. Haney, being by me duly sworn, severally and each for herself and himself did depose and say that they are Assistant Secretary and Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and know the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that their signatures as such officers were duly affixed and subscribed by like authority. Notarial Seal KATHERINE J. ADELAAR NOl'AAY NOTARY PUBLIC OF NEW JERSEY�Iary `•' No.2316686 COMM)8810n Expires July 16, 20245 Public <�JERg� CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016; WESTCHESTER FIRE INSURANCE COMPANY on December 11, 2006; and ACE AMERICAN INSURANCE COMPANY on March 20, 2009: "RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, recognizances, contracts and other written commitments of the Company entered into in the ordinary course ofbusiness (each a "Written Commitmene'): (1) Each of the Chairman, the President and the Vice Presidents of the Company Is hereby authorized to execute any Written Commitment for and on behalfofthe Company, under the sea) of the Company or otherwise. (2) Each duly appointed attorney -in -Fact of the Company is hereby authorized to execute any Written Commitment for and on behalfofthe Company, under the seal of the Company or otherwise, to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such attorney -in -fact. (3) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to appoint in writing any person the attorney -in - fact of the Company with full power and authority to execute, for and on behalfofthe Company, under the seal ofthe Company or otherwise, such Written Commitments ofthe Company as may be specified in such written appointment, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to delegate in writing to any other officer of the Company the authority to execute, for and on behalf of the Company, under the Company's seal or otherwise, such Written Commitments of the Company as are specified in such written delegation, which specification may be by general type or class of Written Commitments or by specification ofoneormore particular Written Commitments. (5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, may be affixed by facsimile on such Written Commitment or written appointment or delegation. FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of officers, employees and other persons to act for and on behalf of the Company, and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested." 1, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY (the "Companies") do hereby certify that (i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect, (it) the foregoing Power of Attorney is trite, correct and in full force and effect. Given under my hand and seals of said Companies at Whitehouse Station, NJ, this March 13, 2023 .o r •..w •. Davin \I. Chloros. AssistanI Sccrctar§` IN THE EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT: Telephone (908) 903- 3493 Fax (908) 903- 3656 e-mail: surety@chubb.com Combined: FED-VIG-PI-WFIC-AAIC (rev. 11-19) To obtain information or make a complaint: You may call Chubb's toll -free telephone number for information or to make a complaint at You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-252-3439 You may write the Texas Department of Insurance P.O. Box 149104 Austin, TX 78714-9104 FAX # (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us 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. Para obtener informacion o para someter una queja: Usted puede llamar al numeeo de telefono gratis de Chubb's para informacion o para someter una quej a al Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companfas, coberturas, derechos o quejas al 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas P.O. Box 149104 Austin, TX 78714-9104 FAX # (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us Si dene una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente primero. Si no se resueve la disputa, puede entonces comunicarse con el departamento (TDI). Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adjunto. Form 99-10-0299 (Rev. 1-08) 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 iState Here or Blank`;, our principal place of business, are required to be % Here I percent lower than resident bidders by State Law. A copy of the statute is attached. Nonresident bidders in the State of iState Here or Blank', , 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. 0 BIDDER: Gibson & Associates, Inc. 11210 Ryliecrest Dr. Balch Springs, Texas 75180 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised 9/30/2021 By: Alan C. Meador (Signature) Title: Vice President Date: % %(.� 2023 BRIDGE REHABILITATION CONTRACT 1 City Project No. 104687 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 00 45 12 - 1 PREQUALIFICATION STATEMENT Page 1 of 1 SECTION 00 45 12 PREQUALIFICATION STATEMENT Each Bidder for a City procurement is required to complete the information below by identifying the prequalified contractors and/or subcontractors whom they intend to utilize for the major work type(s) listed. Major Work Prequalification Contractor/Subcontractor Company Name Type Expiration Date Not Applicable The undersigned hereby certifies that the contractors and/or subcontractors described in the table above are currently prequalified for the work types listed. BIDDER: Gibson & Associates, Inc. Company 11210 Rvliecrest Dr. Address Balch Springs, Texas 75180 City/State/Zip By: Alan C. Meador (Please Print) Signature: Title: Vice President (Please Print) Date: March 30, 2023 END OF SECTION CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTSCity Project No. 104687 Revised September 30, 2021 2 3 4 5 6 7 8 9 10 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 00 45 26 - 1 CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW Page I of I SECTION 00 45 26 CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW Pursuant to Texas Labor Code Section 406.096(a), as amended, Contractor certifies that it provides worker's compensation insurance coverage for all of its employees employed on City Project No. 104687 Contractor further certifies that, pursuant to Texas Labor Code, Section 406.096(b), as amended, it will provide to City its subcontractor's certificates of compliance with worker's compensation coverage. CONTRACTOR: Gibson & Associates, Inc. Company 11210 Ryliecrest Dr. Address Balch Springs, TX 75180 City/State/Zip THE STATE OF TEXAS § COUNTY OFTARRANT § By: Alan C. Meador (Please Print) Signature: Title: Vice President (Please Print) BEFORE ME, the undersigned authority, on this day personally appeared Alan C. Meador , known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same as the act and deed of Vice President for the purposes and consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 29th day of March 2023 L Notary Public in and for the State of Texas END OF SECTION PAM N DAVIS Notary Public, State of Texas Comm. Expires 03 30-2026 L Notdry ID 283117-2 CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 2023 BRIDGE REHABILITATION CONTRACT I City Project No. 104687 00 45 40 - 1 Business Equity Goal Page 1 of 2 1 SECTION 00 45 40 2 Business Equity Goal 3 APPLICATION OF POLICY 4 If the total dollar value of the contract is $100,000 or more, then a Business Equity goal is applicable. 5 A Business Equity Firm refers to certified Minority-, and/or Women-, owned Business Enterprises 6 (M/WBEs). 7 8 POLICY STATEMENT 9 It is the policy of the City of Fort Worth to ensure the full and equitable participation of Business Equity 10 Firms when applicable, in the procurement of all goods and services. All requirements and regulations 11 stated in the City's Business Equity Ordinance No.25165-10-2021, (replacing Ordinance No. 24534-11- 12 2020 (codified at: httDs://codelibrarv.amle2al.com/codes/ftworth/latest/ftworth tx/0-0-0-22593) apply to 13 this bid. 14 15 BUSINESS EOUITY PROJECT GOAL 16 The City's Business Equity goal on this project is 16% of the total bid value of the contract (Base bid 17 applies to Parks and Community Services). 18 19 METHODS TO COMPLY WITH THE GOAL 20 On City contracts where a Business Equity Goal is applied, offerors are required to comply with the City's 21 Business Equity Ordinance by meeting or exceeding the above stated goal or otherwise comply with the 22 ordinance through one of the following methods: 1. Commercially useful services performed by a 23 Business Equity prime contractor, 2. Business Equity subcontracting participation, 3. Combination 24 of Business Equity prime services and Business Equity subcontracting participation, 4. Business 25 Equity Joint Venture/Mentor-Protege participation, 5. Good Faith Effort documentation, or 6. 26 Prime contractor Waiver documentation. 27 28 SUBMITTAL OF REOUIRED DOCUMENTATION 29 Applicable documents (listed below) must be received by the Purchasing Division, OR the offeror shall 30 EMAIL the Business Equity documentation to the assigned City of Fort Worth Project Manager or 31 Department Designee. Documents are to be received no later than 2:00 p.m., on the third City 32 business day after the bid opening date, exclusive of the bid opening date. 33 34 The Offeror must submit one or more of the following documents: 35 1. Utilization Form and Letter(s) of Intent, if the goal is met or exceeded; 36 2. Good Faith Effort Form and Utilization Form, including supporting documentation, if 37 participation is less than stated goal, or no Business Equity participation is accomplished; 38 3. Prime Contractor Waiver Form, including supporting documentation, if the Offeror will perform 39 all subcontracting/supplier opportunities; or 40 4. Joint Venture/Mentor-Protege Form, if goal is met or exceeded with a Joint Venture or Mentor- 41 Protege participation. 42 43 These forms can be found at: 44 Business Equity Utilization Form and Letter of Intent 45 httDs://anus.fortworthtexas.2ov/Pro_iectResources/ResourcesP/60 - MW E/Business Equity Utilization 46 Form DVIN 2022 220324.Ddf 47 48 Letter of Intent CITY OF FORT WORTH 2O23 BRIDGE REAHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 104687 Revised October 27, 2021 004540-2 Business Equity Goal Page 2 of 2 1 httDs://anus.fortworthtexas.e_ov/Pro_iectResources/ResourcesP/60 - MWBE/Letter of Intent DVIN 2 2021.Ddf 4 Business Equity Good Faith Effort Form 5 httns://aDDs.fortworthtexas.2ov/ProiectResources/ResourcesP/60 - MWBE/Good Faith Effort 6 Form DVIN 2022.Ddf 7 8 Business Equity Prime Contractor Waiver Form 9 httns://aDDs.fortworthtexas.2ov/ProiectResources/ResourcesP/60 - MWBE/MWBE Prime Contractor 10 Waiver-220313.ndf 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Business Equity Joint Venture Form httr)s://aDDs.fortworthtexas.2ov/ProiectResources/ResourcesP/60 - MWBE/MWBE Joint Venture 220225.Ddf FAILURE TO ACHIEVE THE GOAL OR OTHERWISE COMPLY WITH THE ORDINANCE WILL RESULT IN THE BIDDER/OFFEROR BEING DECLARED NON -RESPONSIVE AND THE BID REJECTED. FAILURE TO SUBMIT THE REOUIRED BUSINESS EOUTY DOCUMENTATION OR OTHERWISE COMPLY WITH THE ORDINANCE WILL RESULT IN THE BID BEING DECLARED NON- RESPONSIVE, THE BID REJECTED AND MAY SUBJECT THE BIDDER/OFFEROR TO SANCTIONS AS DESCRIBED IN SEC. 20-373 OF THE ORDINANCE. For Questions, Please Contact The Business Equity Division of the Department of Diversity and Inclusion at (817) 392-2674. END OF SECTION CITY OF FORT WORTH 2O23 BRIDGE REAHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 104687 Revised October 27, 2021 00 52 43 - 1 Agreement Page 1 of 7 SECTION 00 52 43 AGREEMENT THIS AGREEMENT, authorized on Mav 23, 2023, 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 Gibson & Associates, Inc., authorized to do business in Texas, acting by and through its duly authorized representative, ("Contractor"). City and Contractor may jointly be referred to as Parties. City and Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: Article 1. WORK Contractor shall complete all Work as specified or indicated in the Contract Documents for the Project identified herein. Article 2. PROJECT The project for which the Work under the Contract Documents may be the whole or only a part is generally described as follows: 2023 BRIDGE REHABILITATION CONTRACT 1 CITY PROJECT NUMBER 104687 Article 3. CONTRACT PRICE City agrees to pay Contractor for performance of the Work in accordance with the Contract Documents an amount, in current funds, of NINE HUNDRED FORTY-TWO THOUSAND, SIX HUNDRED TWENTY-SIX AND 10/100 DOLLARS ($942,626.10). Contract price may be adjusted by change orders duly authorized by the Parties. Article 4. CONTRACT TIME 4.1 Final Acceptance. The Work shall be complete for Final Acceptance within 210 days after the date when the Contract Time commences to run, as provided in Paragraph 2.02 of the General Conditions, plus any extension thereof allowed in accordance with Article 12 of the General Conditions. 4.2 Liquidated Damages Contractor recognizes that time is of the essence for completion of Milestones, if any, and to achieve Final Acceptance of the Work and City and the public will suffer from loss of use 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), Contractor shall pay City Six Hundred Fifty AND 00/100 Dollars ($650.00) for each day that expires after the time specified in Paragraph 4.1 for Final Acceptance until the City issues the Final Letter of Acceptance. OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 104687 Revised 8/22/2022 00 52 43 - 2 Agreement Page 2 of 7 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: a. Bid Form 1) Proposal Form 2) Vendor Compliance to State Law Non -Resident Bidder 3) Prequalification Statement 4) State and Federal documents (project specific) b. Current Prevailing Wage Rate Table c. Insurance ACORD Form(s) d. Payment Bond e. Performance Bond f. Maintenance Bond g. Power of Attorney for the Bonds h. Worker's Compensation Affidavit i. MBE and/or SBE Utilization Form 3. General Conditions. 4. Supplementary Conditions. 5. Specifications specifically made a part of the Contract Documents by attachment or, if not attached, as incorporated by reference and described in the Table of Contents of the Project's Contract Documents. 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 CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 104687 Revised 8/22/2022 00 52 43 - 3 Agreement Page 3 of 7 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 specifically intended to operate and be effective even if it is alleged or proven that all or some of the damages being sought were caused, in whole or in part, by anv act, omission or negligence of the city. 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. 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 indemnification provision is specifically intended to operate and be effective even if it is alleged or proven that all or some of the damages being sought were caused, in whole or in part, by anv act. omission or negligence of the citv. Article 7. MISCELLANEOUS 7.1 Terms. Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. 7.2 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. 7.3 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. 7.4 Severability/Non-Waiver of Claims. 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. The failure of City or Contractor to insist upon the performance of any term or provision of this Agreement or to exercise any right granted herein shall not constitute a waiver of City's or Contractor's respective right to insist upon appropriate performance or to assert any such right on any future occasion. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 104687 Revised 8/22/2022 00 52 43 - 4 Agreement Page 4 of 7 7.5 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. 7.6 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 Non -appropriation of Funds. In the event no funds or insufficient funds are appropriated by City in any fiscal period for any payments due hereunder, City will notify Vendor of such occurrence and this Agreement shall terminate on the last day of the fiscal period for which appropriations were received without penalty or expense to City of any kind whatsoever, except as to the portions of the payments herein agreed upon for which funds have been appropriated. 7.8 Prohibition On Contracts With Companies Boycotting Israel. Contractor, unless a sole proprietor, acknowledges that in accordance with Chapter 2271 of the Texas Government Code, if Contractor has 10 or more full time -employees and the contract value is $100,000 or more, the City 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. The terms "boycott Israel" and "company" shall have the meanings ascribed to those terms in Section 808.001 of the Texas Government Code. By signing this contract, Contractor certifies that Contractor's signature provides written verification to the City that if Chapter 2271, Texas Government Code applies, Contractor: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. 7.9 Prohibition on Boycotting Energy Companies. Contractor acknowledges that in accordance with Chapter 2274 of the Texas Government Code -(as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2), the City is prohibited from entering into a contract for goods or services that has a value of $100,000 or more, which will be paid wholly or partly from public funds of the City, with a company (with 10 or more full-time employees) unless the contract contains a written verification from the company that it: (1) does not boycott energy companies; and (2) will not boycott energy companies during the term of the contract. The terms "boycott energy company" and "company" have the meaning ascribed to those terms by Chapter 2274 of the Texas Government Code (as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2). To the extent that Chapter 2274 of the Government Code is applicable to this Agreement, by signing this Agreement, Contractor certifies that Contractor's signature provides written verification to the City that Contractor: (1) does not boycott energy companies; and (2) will not boycott energy companies during the term of this Agreement. 7.10 Prohibition on Discrimination Against Firearm and Ammunition Industries. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 104687 Revised 8/22/2022 00 52 43 - 5 Agreement Page 5 of 7 Contractor acknowledges that except as otherwise provided by Chapter 2274 of the Texas Government Code (as added by Acts 2021, 87th Leg., R.S., S.B. 19, § 1), the City is prohibited from entering into a contract for goods or services that has a value of $100,000 or more which will be paid wholly or partly from public funds of the City, with a company (with 10 or more full-time employees) unless the contract contains a written verification from the company that it: (1) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will not discriminate during the term of the contract against a firearm entity or firearm trade association. The terms "discriminate," "firearm entity" and "firearm trade association" have the meaning ascribed to those terms by Chapter 2274 of the Texas Government Code (as added by Acts 2021, 87th Leg., R.S., S.B. 19, § 1). To the extent that Chapter 2274 of the Government Code is applicable to this Agreement, by signing this Agreement, Contractor certifies that Contractor's signature provides written verification to the City that Contractor: (1) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will not discriminate against a firearm entity or firearm trade association during the term of this Agreement. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 104687 Revised 8/22/2022 00 52 43 - 6 Agreement Page 6 of 7 7.11 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 performed by any Contractor employee who is not legally eligible to perform such services. 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 LICENSEES. City, upon written notice to Contractor, shall have the right to immediately terminate this Agreement for violations of this provision by Contractor. 7.12 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. 7.13 No Cause of Action Against Engineer. Contractor, its subcontractors 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 by 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 construction contractor or other entity or their employees in connection with their work or any health or safety precautions. CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 104687 Revised 8/22/2022 005243-7 Agreement Page 7 of 7 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: Texas Materials Group, dba Texas Bit. By: .CYGC�IZ � �/i�62 Alan C. Meador (May 23, 202314:00 CDT) Signature Alan C. Meador (Printed Name) Vice President Title 11210 Ryliecrest Dr Address Balch Springs, Texas 75180 City/State/Zip May 23, 2023 Date City of Fort Worth William Johnson (Ju 7, 2023 17:34 CDT) William M Johnson Assistant City Manager Jun 7, 2023 Date ten, n pgo!FONT �OAdd Attest: ` ;�o =; loan nEXvA°gao Jannette Goodall, City Secretary (Seal) M&C: 23-0431 Date:5-23-2023 Form 1295 No.: 2023-1008012 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. r Tariqul Islam (May 24, 2023 10:50 CDT) Tariqul Islam Project Manager Approved as to Form and Legality: l DBlack (Jun 7, 202310:22 CDT) Douglas W. Black Sr. Assistant City Attorney APPROVAL RECOMMENDED: _� . Lauren Prieur (Jun 5, 202316:21 CDT) Lauren Prieur, Director Transportation & Public Works Department CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CITY PROJECT NO. 104687 Revised 8/22/2022 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Bond No. K41680593 0061 13 - 1 PERFORMANCE BOND Page i oft 1 SECTION 00 6113 2 PERFORMANCE BOND 3 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § 7 That we, Gibson & Associates. Inc. known as "Principal" herein and 8 Federal Insurance Company , a corporate surety(sureties, if more than 9 one) duly authorized to do business in the State of Texas, known as "Surety" herein (whether one 10 or more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created 11 pursuant to the laws of Texas, known as "City" herein, in the penal sum of, NINE HUNDRED 12 FORTY-TWO THOUSAND, SIX HUNDRED TWENTY-SIX AND 10/100 DOLLARS 13 ($942.626,10). lawful money of the United States, to be paid in Fort Worth, Tarrant County, 14 Texas for the payment of which sum well and truly to be made, we bind ourselves, our heirs, 15 executors, administrators, successors and assigns, jointly and severally, firmly by these presents. 16 WHEREAS, the Principal has entered into a certain written contract with the City 17 awarded the 23rd day of May, 2023, which Contract is hereby referred to and made a part hereof 18 for all purposes as if fully set forth herein, to furnish all materials, equipment labor and other 19 accessories defined by law, in the prosecution of the Work, including any Change Orders, as 20 provided for in said Contract designated as 2023 BRIDGE REHABILITATION CONTRACT 1, 21 City Project No.104687. 22 NOW, THEREFORE, the condition of this obligation is such that if the said Principal 23 shall faithfully perform it obligations under the Contract and shall in all respects duly and 24 faithfully perform the Work, including Change Orders, under the Contract, according to the plans, 25 specifications, and contract documents therein referred to, and as well during any period of 26 extension of the Contract that may be granted on the part of the City, then this obligation shall be 27 and become null and void, otherwise to remain in full force and effect. 28 PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in 29 Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort 30 Worth Division. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July I, 2011 2023 BRIDGE REHABILITATION CONTRACT I CITY PROJECT NO. 104687 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 42 43 44 0061 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 statue. IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED this instrument by duly authorized agents and officers on this the 23rd day of May , 20 23 . ATTES'�1 I (Principal) SecretA Witness as to Principal 000, /G�itness as % Surety PRINCIPAL: Gibson;Sgignatur Associates. Inc. BY: Name andTitle Address: 11210 Ryliecrest Dr. Balch Springs, Texas 75180 SURETY: Federal Insurance Comt)anv BY: Signature Robbi Morales, Attorney -in -fact Name and Title Address: 5005 LBJ Freeway, Suite 1500 Dallas, TX 75244 Telephone Number: 214/989-0000 *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 2023 BRIDGE REHABILITATION CONTRACT I CITY PROJECT NO. 104657 Bond No. K41680593 0061 14 - 1 PAYMENT BOND Page 1 of 2 1 SECTION 00 6114 2 PAYMENT BOND 3 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § 7 That we, Gibson & Associates. Inc., known as "Principal" herein, and 8 Federal Insurance Corn Danv I a corporate surety 9 (sureties), duly authorized to do business in the State of Texas, known as "Surety" herein 10 (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal 11 corporation created pursuant to the laws of the State of Texas, known as "City" herein, in the 12 penal sum of NINE HUNDRED FORTY-TWO THOUSAND. SIX HUNDRED TWENTY-SIX 13 AND 10/100 DOLLARS ($942.626.10). lawful money of the United States, to be paid in Fort 14 Worth, Tarrant County, Texas, for the payment of which sum well and truly be made, we bind 15 ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, 16 firmly by these presents: 17 WHEREAS, Principal has entered into a certain written Contract with City, awarded the 18 23rd day of May, 2023, which Contract is hereby referred to and made a part hereof for all 19 purposes as if fully set forth herein, to furnish all materials, equipment, labor and other 20 accessories as defined by law, in the prosecution of the Work as provided for in said Contract and 21 designated as 2023 BRIDGE REHABILITATION CONTRACT 1, City Project No.104687. 22 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if 23 Principal shall pay all monies owing to any (and all) payment bond beneficiary (as defined in 24 Chapter 2253 of the Texas Government Code, as amended) in the prosecution of the Work under 25 the Contract, then this obligation shall be and become 111.111 and void; otherwise to remain in full 26 force and effect. 27 This bond is made and executed in compliance with the provisions of Chapter 2253 of the 28 Texas Government Code, as amended, and all liabilities on this bond shall be determined in 29 accordance with the provisions of said statute. 30 CITY Ol' PORT WORTH 2023 13RIDUE REHAMLITATION CONTRACT 1 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 CiTY PROJECT NO. 104687 0061 14-2 PAYMENTBOND Page 2 of 2 I IN WITNESS WHEREOF, the Principal and Surety have each SIGNED and SEALED 2 this instrument by duly authorized agents and officers on this the 23rd day of 3 May 20 23 . 4 5 6 7 8 9 10 12 PRINCIPAL: Gibson & Associates, Inc. ATTEST: BY: d Signature �(/C610 TPgS-eclea t (Principal) Secretary Name and Title Address: 11210 Ryliecrest Dr Balch Springs, Texas 75180 Witness as to Principal SURETY: Federal Insurance Company ATTEST: BY: Signature Robbi Morales, Attorney -in -fact (Surety) Secretary Name and Title Address: 5005 LBi Freeway, Suite 1500 Dallas. TX 75244 fitness as to Surety Telephone Number: 214/989-0000 Note: If signed by an officer of the Surety, there must be on file a certified extract from the bylaws showing that this person has authority to sign such obligation. If Surety's physical address is different from its (nailing 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 Revised July I, 2011 2023 BRIDGE REHABILITATION CONTRACT I CITY PROJECT NO. 104687 Bond No. K41680593 0061 19- 1 MAINTENANCE: BOND Page I ol'3 1 SECTION 00 61 19 2 MAINTENANCE BOND 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § 7 8 That we Gibson & Associates, Inc. known as "Principal" herein and 9 Federal Insurance Company , a corporate surety (sureties, if more than 10 one) duly authorized to do business in the State of Texas, known as "Surety" herein (whether one 11 or more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created 12 pursuant to the laws of the State of Texas, known as "City" herein, in the sum of NINE 13 HUNDRED FORTY-TWO THOUSAND, SIX HUNDRED TWENTY-SIX AND 10/100 14 DOLLARS ($942.626.10), lawful money of the United States, to be paid in Fort Worth, Tarrant 15 County, Texas, for payment of which sum well and truly be made unto the City and its 16 successors, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly 17 and severally, firmly by these presents. 18 19 WHEREAS, the Principal has entered into a certain written contract with the City awarded the 20 23'a day of May, 2023, which Contract is hereby referred to and a made part hereof for all 21 purposes as if fully set forth herein, to furnish all materials, equipment labor and other accessories 22 as defined by law, in the prosecution of the Work, including any Work resulting from a duly 23 authorized Change Order (collectively herein, the "Work') as provided for in said contract and 24 designated as 2023 BRIDGE REHABILITATION CONTRACT 1, City Project No.]04687; and 25 WHEREAS,, Principal binds itself to use such materials and to so construct the Work in 26 accordance with the plans, specifications and Contract Documents that the Work is and will 27 remain free from defects in materials or workmanship for and during the period of two (2) years 28 after the date of Final Acceptance of the Work by the City ("Maintenance Period"); and 29 30 WHEREAS, Principal binds itself to repair or reconstruct the Work in whole or in part 31 upon receiving notice from the City of the need therefor at any time within the Maintenance 32 Period. 33 CITY OF FORT WORTH 2O23 BRIDGE REHABILITATION CONTRACT I STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 CITY PROJECT NO. 104687 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 0061 19-2 MAINTENANCE BOND Page 2 of 3 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 a]I 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 PORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July I, 2011 2023 BRIDGE REHABILITATION CONTRACT I CITY PROJECT NO. 104687 0061 19-3 MAINTENANCE BOND Page 3 ol'3 IN WITNESS WHEREOF, the Principal and the Surety have each SIGNED and SEALED this 2 instrument by duly authorized agents and officers on this the 23rd day of May 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 , 20 23 . ATTE T: (Principal) Secrets y Witness as to Principal ATTEST: (Surety Secretary /itessas to Surety PRINCIPAL: Gibson & Associates, Inc. Signature 44G — e' �ce Name and Title Address: 11210 Ryliecrest Dr Balch Springs, Texas 75180 SURETY: Federal Insurance COmDanv Signature Robbi Morales, Attorney -in -fact Name and Title Address: 5005 LBT Freewav, Suite 1500 Dallas. TX 75244 Telephone Number: 214/989-0000 *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 2023 BRIDGE REHABILITATION CONTRACT I CITY PROJECT N0. 104687 C H U B S Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Westchester Fire Insurance Company I ACE American Insurance Company Know All by These Presents, that FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY corporations ofthe Commonwealth of Pennsylvania, do each hereby constitute and appoint Don E. Cornell, Sophinie Hunter, Tina McEwan, Robb! Morales, Mikaela Peppers, Tonie Petranek, Ricardo J. Reyna, Joshua Saunders and Kelly A. Westbrook of Dallas, Texas; Steven Dwain Brockinton of Little Rock, Arkansas ----------------------------------- ----------------- each as their true and lawful Attorney-in-Factto execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than hail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY have each executed and attested these presents and affixed their corporate seals on this 4th day of February, 2022. Rival\1.t:hlrlrtr:.:1�.i•ulntticrl'ct;ny STATE OF NEW JERSEY County of Hunterdon Sleplicn NJ. I lancy. Vice PresidellI On this 4uh day of February, 2022 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros and Stephen M. Haney, tome known to be Assistant Secretary and Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros and Stephen M. Haney, being by me duly sworn, severally and each for herself and himself did depose and say that they are Assistant Secretary and Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and know the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that their signatures as such officers were duly affixed and subscribed by like authority. Notarial Seal COD KATHERINE J. ADELAAR NOTARY PUBLIC OF NEW JERSEYNo. 237e686 COMMIS61on Expires July 16. 2024 Nurm' Puhllc CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016; WESTCHESTER FIRE INSURANCE COMPANY on December 11, 2006; and ACE AMERICAN INSURANCE COMPANY on March 20, 2009: "RESOLVED, that the following authorizations relate to the execution, for and on behalf ofthe Company, of bonds, undertakings, recognizances, contracts and other written commitments of the Company entered Into in the ordinary course of business (each a "Written Commitment"): (1) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized to execute any Written Commitment for and an behalf of the Company, under the seal ofthe Company or otherwise, (2) Each duly appointed attorney -in -fact ofthe Companyis hereby authorized to execute any Written Commitmentfor and an behalfofthe Company, under the seal ofthe Company or otherwise, to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such attorney -in -fact. (3) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to appoint in writing any person the attorney -in - fact of the Company with full power and authority to execute, for and on behalfofthe Company, under the seal ofthe Company or otherwise, such Written Commitments ofthe Company as may be specified in such written appointment, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and an behalf of the Company, to delegate in writing to any other officer of the Company the authority to execute, for and on behalf of the Company, under the Company's seal or otherwise, such Written Commitments ofthe Company as are specified in such written delegation, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments, (5) The signature ofany officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, may be affixed by facsimile on such Written Commitment or written appointment or delegation. FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statement ofthe powers and authority of officers, employees and other persons to act for and on behalf of the Company, and such Resolution shall not limiter otherwise affect the exercise of any such power or authority otherwise validly granted or vested." 1, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY (the "Companies") do hereby certify that (i) the foregoing Resolutions adopted by the Board of Directors ofthe Companies are true, correct and in full force and effect, (ii) the foregoing Power of Attorney is true, correct and in full force and effect. Given under my hand and seals of said Companies at Whitehouse Station, NJ, this May 23 2023 µc A id1/L.Cb `e 1� 0 lrtv;n \I. Chlon s. Assistant Sccrcviry IN THE EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT US AT: Telephone (9081 903- 3493 Fax (908) 903- 3656 e-mail: suretyCalchubb.com Combined: FED-VIG-PI-WFIC-AAIC (rev. 11-19) Policyholder Information Notice IMPORTANT NOTICE To obtain information or make a complaint You may call Chubb's toll -free telephone number for information or to make a complaint at RVAIURT-Iff01;I►]-VI You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-252-3439 You may write the Texas Department of Insurance P.O. Box 149104 Austin, TX 78714-9104 FAX # (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us 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. AVISO IMPORTANTE Para obtener informacion o para someter una quej a: Usted puede llamar at numeeo de telefono gratis de Chubb's para informacion o para someter una queja at 1-800-36-CHUBB Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companfas, coberturas, derechos o quejas at 1-800-252-3439 Puede escribir at Departamento de Seguros de Texas P.O. Box 149104 Austin, TX 78714-9104 FAX # (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: Cons umerProtection@tdi. state. tx.us DISPUTES SOBRE PRIMAS O RECLAMOS: Si tiene una disputa concerniente a su pima o a un reclamo, debe comunicarse con el agente primero. Si no se resueve la disputa, puede entonces comunicarse con el departamento (TDI). UNA ESTE AVISO A SU POLIZA: Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adj unto. Form 99-10-0299 (Rev. 1-08) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT - FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number GL21147970201 Policy Expiration Date 06/30/2023 Named Insured GIBSON & ASSOCIATES INC Agency Number 0765330 Hate 06/27/2022 Agency BOWEN MICLETTE & BRITT LLC Policy Effective Date 06/30/2022 Account Number 20072791 Issuing Company AMERISURE INSURANCE COMPANY 1. a. SECTION II -WHO IS AN INSURED is amended to add as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business. b. The written contract or written agreement must: (1) Require additional insured status for a time period during the term of this policy; and (2) Be executed prior to the "bodily injury", "property damage", or "personal and advertising injury" leading to a claim under this policy. c. If, however: (1) "Your work" began under a letter of intent or work order; and (2) The letter of intent or work order led to a written contract or written agreement within 30 days of beginning such work; and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specified in this endorsement. 2_ The insurance provided under this endorsement is limited as follows: a. That person or organization is an additional insured only with respect to liability caused, in whole or in part, by: (1) Premises you: (a) Own; (b) Rent; (c) Lease; or (d) Occupy; (2) Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to "bodily injury" or "property damage" occurring after: (a) All work to be performed by you or on your behalf for the additional insured(s) at the site of the covered operations is complete, including related materials, parts or equipment (other than service, maintenance or repairs); or (b) That portion of "your work" out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working for a principal as a part of the same project. Includes copyrighted material of Insurance Services Office, Inc. CG 70 85 10 15 Pages 1 of 3 (3) Completed operations coverage, but only if: (a) The written contract or written agreement requires completed operations coverage or "your work" coverage; and (b) This coverage part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". However, the insurance afforded to such additional insured only applies to the extent permitted by law. b. If the written contract or written agreement: (1) Requires "arising out of" language; or (2) Requires you to provide additional insured coverage to that person or organization by the use of either or both of the following: (a) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 10 01 ; or (b) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 10 01; then the phrase "caused, in whole or in part, by" in paragraph 2.a. above is replaced by "arising out of". c. If the written contract or written agreement requires you to provide additional insured coverage to that person or organization by the use of: (1) Additional Insured —Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13; or (2) Additional Insured —Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 07 04 or CG 20 37 04 13; or (3) Both those endorsements with either of those edition dates; or (4) Either or both of the following: (a) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 without an edition date specified; or (b) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 without an edition date specified; then paragraph 2.a. above applies. d. Premises, as respects paragraph 2.a.(1) above, include common or public areas about such premises if so required in the written contractor written agreement. e. Additional insured status provided under paragraphs 2.a.(1)(b) or 2.a.(1)(c) above does not extend beyond the end of a premises lease or rental agreement. f. The limits of insurance that apply to the additional insured are the least of those specified in the: (1) Written contract; (2) Written agreement; or (3) Declarations of this policy. The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. g. The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of, or failure to render, any professional services, including but not limited to: (1) The preparing, approving, or failing to prepare or approve: (a) Maps; (b) Drawings; (c) Opinions; Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 3 CG 70 85 10 15 (d) Reports; (e) Surveys; (f) Change orders; (g) Design specifications; and (2) Supervisory, inspection, or engineering services. h. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4.Other Insurance is deleted and replaced with the following: 4. Other Insurance. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether: a. Primary; b. Excess; c. Contingent; or d. On any other basis; but if the written contractor written agreement requires primary and non-contributory coverage, this insurance will be primary and non-contributory relative to other insurance available to the additional insured which covers that person or organization as a Named Insured, and we will not share with that other insurance. i_ If the written contract or written agreement as outlined above requires additional insured status by use of CG 20 10 11 85, then the coverage provided under this CG 70 85 endorsement does not apply except for paragraph 2.h. Other Insurance. Additional insured status is limited to that provided by CG 20 10 11 85 shown below and paragraph 2.h. Other Insurance shown above. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Blanket where required by written contract or written agreement that the terms of CG 20 10 11 85 apply. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. CG 2010 11 85 Copyright, Insurance Services Office, Inc., 1984 j. The insurance provided by this endorsement does not apply to any premises or work for which the person or organization is specifically listed as an additional insured on another endorsement attached to this policy. Includes copyrighted material of Insurance Services Office, Inc. CG 70 85 10 15 Pages 3 of 3 Policy #GL21147970201 Effective Dates: 06/3012022-06/30/2023 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION REQUIRED BY WRITTEN CONTRACT OR CERTIFICATE OF INSURANCE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV —Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ Policy #CA21146960201 Effective Dates: 06130/2022-06130/2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS ADVANTAGE COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The premium for this endorsement is $ 1. BROAD FORM INSURED SECTION it - LIABILITY COVERAGE, A.1. Who Is An Insured is amended bythe addition of the following: d. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or a majority interest, will qualify as a Named Insured. However, (1) Coverage under this provision is afforded only until the end of the policy period; (2) Coverage does not apply to "accidents" or "loss" that occurred before you acquired or formed the organization; and (3) Coverage does not apply to an organization that is an "insured" under any other policy or would bean "insured" but for its termination or the exhausting of its limit of insurance. e. Any "employee" of yours using: (1) A covered "auto" you do not own, hire or borrow, or a covered "auto" not owned by the "employee" or a member of his or her household, while performing duties related to the conduct of your business or your personal affairs; or (2) An "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. However, your "employee" does not qualify as an insured under this paragraph (2) while using a covered "auto" rented from you or from any member of the "employee's" household. Your members, if you are a limited liability company, while using a covered "auto" you do not own, hire or borrow and while performing duties related to the conduct of your business or your personal affairs. g. Any person or organization with whom you agree in a written contract, written agreement or permit, to provide insurance such as is afforded under this policy, but only with respect to your covered "autos". This provision does not apply: (1) Unless the written contract or agreement is executed or the permit is issued prior to the "bodily injury" or "property damage"; (2) To any person or organization included as an insured by an endorsement or in the Declarations; or (3) To any lessor of "autos" unless: (a) The lease agreement requires you to provide direct primary insurance for the lessor; (b) The "auto" is leased without a driver; and Includes copyrighted material of Insurance Services Office, Inc. CA 71 18 1109 Pagel of 5 (c) The lease had not expired. Leased "autos" covered under this provision will be considered covered "autos" you own and not covered "autos" you hire. h. Any legally incorporated organization or subsidiary in which you own more than 50% of the voting stock on the effective date of this endorsement. This provision does not apply to "bodily injury" or "property damage" for which an "insured" is also an insured under any other automobile policy or would be an insured under such a policy, but for its termination or the exhaustion of its limits of insurance, unless such policy was written to apply specifically in excess of this policy. 2. COVERAGE EXTENSIONS- SUPPLEMENTARY PAYMENTS Under Section II - LIABILITY COVERAGE, A2.a. Supplementary Payments, paragraphs (2) and (4) are deleted and replaced as follows: (2) Up to $2,500 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. 3. AMENDED FELLOW EMPLOYEE EXCLUSION Under SECTION II - LIABILITY COVERAGE, B. EXCLUSIONS, paragraph 5. Fellow Employee is deleted and replaced by the following: 5. Fellow Employee "Bodily injury" to: a. Any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business. However, this exclusion does not apply to your "employees" that are officers, managers, supervisors or above. Coverage is excess over any other collectible insurance. b. The spouse, child, parent, brother or sister of that fellow "employee" as a consequence of paragraph a. above. 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE AND LOSS OF USE EXPENSE A. Under SECTION III -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, the following is added: If any of your owned covered "autos" are covered for Physical Damage, we will provide Physical Damage coverage to "autos" that you or your "employees" hire or borrow, under your name or the "employee's" name, for the purpose of doing your work. We will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the Declarations, Item Three, Schedule of Covered Autos You Own, or on any endorsements amending this schedule. B. Under SECTION III -PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions. paragraph b. Loss Of Use Expenses is deleted and replaced with the following: b. Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision, only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 5 CA 71 18 1109 (2) Specified Causes of Loss, only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3) Collision, only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will payfor any expenses for loss of use is $30 per day, to a maximum of $2,000, C. Under SECTION IV— BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, paragraph b. is replaced by the following: b. For Hired Auto Physical Damage, the following are deemed to be covered "autos" you own: 1. Any covered "auto" you lease, hire, rent or borrow; and 2. Any covered "auto" hired or rented by your "employees" under a contract in that individual "employee's" name, with your permission, while performing 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", nor is any "auto" you hire from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 5. LOAN OR LEASE GAP COVERAGE Under SECTION III — PHYSICAL DAMAGE COVERAGE, A. COVERAGE, the following is added: If a covered "auto" is owned or leased and if we provide Physical Damage Coverage on it, we will pay, in the event of a covered total "loss", any unpaid amount due on the lease or loan for a covered "auto", less: (a) The amount paid under the Physical Damage Section of the policy; and: (b) Any: (1) Overdue lease or loan payments including penalties, interest or other charges resulting from overdue 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) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; (4) Security deposits not refunded by a lessor; and (5) Carry-over balances from previous loans or leases. [-�;i4►Kill 1111111041lyiI *1111*-14Ti14►III I Under SECTION III - PHYSICAL DAMAGE COVERAGE, AA. Coverage Extensions, paragraph a. Transportation Expenses is deleted and replaced by the following: a. Transportation Expenses (1) We will pay up to $75 per day to a maximum of $2,000 for transportation expense incurred by you because of covered "loss". We will pay only for those covered "autos" for which you carry Collision Coverage or either Comprehensive Coverage or Specified Causes of Loss Coverage. We will pay for transportation expenses incurred during the period beginning 24 hours after the covered "loss" and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". This coverage is in addition to the otherwise applicable coverage you have on a covered "auto". No deductibles apply to this coverage. Includes copyrighted material of Insurance Services Office, Inc. CA 71 18 1109 Page 3 of 5 (2) This coverage does not apply while there is a spare or reserve "auto" available to you for your operation. 7. AIRBAG COVERAGE Under SECTION III - PHYSICAL DAMAGE, B. EXCLUSIONS, paragraph 3. is deleted and replaced by the following: 3. We will not pay for "loss" caused by or resulting from any of the following unless caused by other "loss" that is covered by this insurance: (1) Wear and tear, freezing, mechanical or electrical breakdown. However, this exclusion does not include the discharge of an airbag. (2) Blowouts, punctures or other road damage to tires. 8. GLASS REPAIR —WAIVER OF DEDUCTIBLE Section III — PHYSICAL DAMAGE COVERAGE, D. Deductible is amended to add the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 9. COLLISION COVERAGE —WAIVER OF DEDUCTIBLE Under Section III - PHYSICAL DAMAGE COVERAGE, D. Deductible is amended to add the following: When there is a loss to your covered "auto" insured for Collision Coverage, no deductible will apply if the loss was caused by a collision with another "auto" insured by us. 10. KNOWLEDGE OF ACCIDENT Under SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss, paragraph a. is deleted and replaced by the following: a. You must see to it that we are notified as soon as practicable of an "accident", claim, "suit" or "loss". Knowledge of an "accident", claim, "suit" or "loss" by your "employees" shall not, in itself, constitute knowledge to you unless one of your partners, executive officers, directors, managers, or members (if you area limited liability company) has knowledge of the "accident", claim, "suit" or "loss". Notice should include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. 11. TRANSFER OF RIGHTS (BLANKET WAIVER OF SUBROGATION) Under SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions paragraph 5. Transfer Of Rights Of Recovery Against Others To Us is deleted and replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. However, if the "insured" has waived rights to recover through a written contract, or if your work was commenced under a letter of intent or work order, subject to a subsequent reduction in writing with customers whose customary contracts require a waiver, we waive any right of recovery we may have under this Coverage Form. Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 5 CA 71 18 1109 12. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Under SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, paragraph 2. Concealment, Misrepresentation Or Fraud is amended by the addition of the following: We will not deny coverage under this Coverage Form if you unintentionally fail to disclose all hazards existing as of the inception date of this policy. You must report to us any knowledge of an error or omission in your representations as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. riic�:��l�h`L�i�I�]�J :1�[r1. 7�1:[ ] :><ts_11►[�ld:Ir�ti[�I�fyl�[wI�]iIN*Wlb]iln►1Y.i;l:l'�1l When required by written contract or written agreement, the definition of "insured contract" is amended as follows. The exception contained in paragraph H.3. relating to construction or demolition operations on or within 50 feet of a railroad: and Paragraph H.a. are deleted with respect to the use of a covered "auto" in operations for, or affecting, a railroad. Includes copyrighted material of Insurance Services Office, Inc. CA 71 18 1109 Page 5 of 5 Policy #CA21146960201 Effective Dates: 06130/2022-06/30/2023 COMMERCIAL AUTO CA 7165 0911 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY NON-CONTRIBUTORY COVERAGE WHEN REQUIRED BY INSURED CONTRACT OR CERTIFICATE This endorsement modifies insurance provided underthe BUSINESS AUTO COVERAGE FORM The provisions of the Coverage Form apply unless changed by this endorsement. This endorsement identifies person(s) or organization(s) who are "insured" under the Who Is An Insured Provision of the Coverage Form. This endorsement changes the policy on the inception date of the policy, unless another date is shown below. Endorsement Effective: 06/30/2022 Countersigned By: Named Insured: GIBSON & ASSOCIATES INC (Authorized Representative) (No entry may appear above. If so, information to complete this endorsement is in the Declarations.) 1. Section II — Liability Coverage, A. Coverage, 1. Who Is An Insured Is amended to add: Any person or organization with whom you have an "insured contract"which requires: i. that person or organization to be added as an "insured" underthis policy or on a certificate of insurance; and ii. this policy to be primary and non-contributoryto any like insurance available to the person or organization. Each such person or organization is an "insured" for Liability Coverage. They are an "insured" only if that person or organization is an "insured" under in SECTION II of the Coverage Form. The contract between the Named Insured and the person or organization is an "insured contract". 2. Section IV — Business Auto Conditions, B. General Conditions, 5. Other Insurance, paragraph d. is deleted and replaced by the following for the purpose of this endorsement only: d. When coverage provided under this Coverage Form is also provided under another Coverage Form or policy, we will provide coverage on a primary, non-contributory basis. Includes copyrighted material of Insurance Services Office, Inc. with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B (Ed. 6-14) 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: The premium charge for this endorsement shall be 0.020 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: $9,599 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 06/30/2022 Policy No. WC211479802 Endorsement No.0 insured Gibson & Associates, Inc. Premium $ Insurance Company Amerisure Insurance Company Countersigned by WC 42 03 04 B (Ed. 6-14) © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. GREAT AMERICAN INSURANCE CO Policy #TUE429571607 410660 Effective Dates: 06/30/2022-06/30/2023 TAU 9500 (Ed, 11 97) EXCESS LIABILITY POLICY There are provisions in this policy that restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Words and phrases in quotation marks have special meaning and can be found in the Definitions Section or the specific policy provision where they appear. In consideration of the payment of the premium and in reliance upon the statements in the Declarations we agree with you to provide coverage as follows: INSURING AGREEMENTS I. COVERAGE We will pay on behalf of the Insured "loss" in excess of the Underlying Limits of Insurance shown in Item 5. of the Declarations, but only up to an amount not exceeding the Company's Limits of Insurance as shown in Item 4. of the Declarations. Except for the terms, conditions, definitions and exclusions of this policy, the coverage provided by this policy will follow the First Underlying Insurance Policy, as shown in Item 5. of the Declarations. The inclusion or addition hereunder of more than one Insured shall not operate to increase the Company's Limits of Insurance beyond that set forth in Item 4. of the Declarations. We will be furnished a complete copy of the First Underlying Insurance Policy described in Item 5. of the Declarations. It. LIMITS OF INSURANCE A. The Limits of Insurance shown in the Dec- larations and the rules below describe the most we will pay regardless of the num- ber of: 1. Insureds; 2. claims made or suits brought; or 3. Persons or organizations making claims or bringing suits. B. The Limits of Insurance of this policy will apply as follows: 1. This policy applies only in excess of the Underlying Limits of Insurance shown in Item 5. of the Declarations. 2. The aggregate limit shown in Item 4. of the Declarations is the most we will pay for all "loss" that is subject to an aggregate limit provided by the First Underlying Insurance Policy. The ag- gregate limit applies separately and in the same manner as the aggregate lim- its provided by the First Underlying In- surance Policy. 3. Subject to 13.2., the occurrence limit stated in Item 4. of the Declarations is the most we will pay for all "loss" arising out of any one occurrence to which this policy applies. 4. Subject to Paragraphs B.2. and B.3. above, if the underlying Limits of In- surance stated in Item 5. of the Dec- larations are reduced or exhausted solely by payment of "loss," such in- surance provided by this policy will apply in excess of the reduced Under- lying Limits or, if all Underlying Limits are exhausted, will apply as underlying insurance subject to the same terms, conditions, definitions and exclusions of the First Underlying Insurance Poli- cy, except for the terms, conditions, definitions and exclusions of this poli- cy. 5. The Limits of Insurance of this policy apply separately to each consecutive annual period and to any remaining pe- TAU 9500 (Ed. 11197) XS (Page 1 of 5) GREAT AMERICAN INSURANCE CO 410660 riod of less than 12 months, starting 2. exposure to testing for, monitoring of, with the beginning of the policy period cleaning up, removing, containing or shown in the Declarations, unless the treating of asbestos, asbestos pro - policy period is extended after issu- ducts, asbestos -containing materials ante for an additional period of less or products, asbestos fibers or as - than 12 months. In that case, the addi- bestos dust; or tional period will be deemed part of the last preceding period for purposes 3. any obligation to investigate, settle or of determining the Limits of Insurance. defend, or indemnify any person against any claim or suit arising out of, Ili. DEFENSE or related in any way, either directly or indirectly, to asbestos, asbestos pro - A. We will not be required to assume charge ducts, asbestos -containing materials of the investigation of any claim or de- or products, asbestos fibers or as- fense of any suit against you. bestos dust. B. Any "loss": B. We will have the right, but not the duty, to be associated with you or your underlying 1. with respect to which any Insured un- insurer or both in the investigation of any der this policy is also an Insured under claim or defense of any suit which in our a nuclear energy liability policy issued opinion may create liability on us for "loss" by Nuclear Energy Liability Insurance under this policy. If we exercise such Association, Mutual Atomic, Energy Li - right, we will do so at our own expense. ability Underwriters, Nuclear Insurance Association of Canada or any of their C. If all Underlying Limits of Insurance stated successors, or would be an Insured in Item 5. of the Declarations are ex- under any such policy but for its ter- hausted solely by payment of "loss," we mination upon exhaustion of its Limit shall have the right but not the duty to of Insurance; or investigate and settle any claim or assume the defense of any suit which in our opin- 2. resulting from the "hazardous prop - ion may give rise to a "loss" under this erties" of "nuclear material" and with policy. Such investigation or defense shall respect to which: be at our own expense. We may, how- ever, withdraw from the defense of such a. a person or organization is re - suit and tender the continued defense to quired to maintain financial pro - you if our applicable Limits of Insurance tection pursuant to the Atomic stated in Item 4. of the Declarations are Energy Act of 1954, or any law exhausted by payment of "loss." amendatory thereof, or IV. EXCLUSIONS b. any Insured is, or had this policy not been issued would be, entitled This policy does not apply to: to indemnity from the United States of America, or any agency "loss," thereof, under any agreement en- A. Any including, but not limited to tered into by the United States of settlements, judgments, costs, charges, America, or any agency thereof, expenses, costs of investigations, or the with any person or organization. fees of attorneys, experts, or consultants arising out of or related in any way, either Any injury or "nuclear property damage" directly or indirectly, to: resulting from the "hazardous properties" of "nuclear material", if: 1. asbestos, asbestos products, asbes- tos -containing materials or products, 1. the "nuclear material" asbestos fibers or asbestos dust, in- cluding, but not limited to, manufac- a. is at any "nuclear facility" owned ture, mining, use, sale, installation, re- by, or operated by or on behalf moval, or distribution activities; of, any Insured; or TAU 9500 (Ed. 11197) XS (Page 2 of 5) GREAT AMERICAN INSURANCE GO 410660 b. has been discharged or dispersed or uranium 233 or any combina- therefrom; tion thereof, or more than 250 grams of uranium 235; 2. the "nuclear material" is contained in "spent fuel" or "nuclear waste" at any time possessed, handled, used, pro- cessed, stored, transported or dis- posed of by or on behalf of any In- sured; or 3. the injury or "nuclear property dam- age" arises out of the furnishing by any Insured of services, materials, parts or equipment in connection with the planning, construction, mainten- ance, operation or use of any "nuclear facility," but if such facility is located within the United States of America, its territories or possessions or Canada, this Exclusion B.3. applies only to "nu- clear property damage" to such "nu- clear facility" and any property therein. As used in this exclusion: 1. "Hazardous properties" include radio- active, toxic or explosive properties. 2. "Nuclear facility" means: a. any "nuclear reactor"; b. any equipment or device designed or used for: (1) separating the isotopes of uranium or plutonium, (2) processing or utilizing "spent fuel," or (3) handling, processing or packaging "nuclear waste"; c. any equipment or device used for the processing, fabricating or al- loying of "special nuclear material" if at any time the total amount of such material in the custody of the insured at the premises where such equipment or device is lo- cated consists of or contains more than 25 grams of plutonium d. any structure, basin, excavation, premises or place prepared or used for the storage or disposal of "nuclear waste," and includes the site on which any of the foregoing is located, all oper- ations conducted on such site and all premises used for such oper- ations; 3. "Nuclear material" means "source ma- terial," "special nuclear material" or "by-product material." 4. "Nuclear property damage" includes all forms of radioactive contamination of property. 5. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain re- action or to contain a critical mass of fissionable material. 6. "Nuclear Waste" means any "nuclear waste" material: a. containing "by-product material" other than the tailings of "nuclear wastes" produced by the extrac- tion or concentration of uranium or thorium from any ore pro- cessed primarily for its "source material" content, and b. resulting from the operation by any person or organization of any "nuclear facility" included within the definition of "nuclear facility" under Paragraph C.2.a. or C.2.b. 7. "Source material," "special nuclear ma- terial," and "by-product" material have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. 8. "Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a "nuclear reactor." TAU 9500 (Ed. 11 /97) XS (Page 3 of 5) GREAT AMERICAN INSURANCE CO 410660 V. DEFINITIONS 3. The policy period will end on the day and hour stated in the cancellation no - "Loss" means those sums which you are le- tice. gally obligated to pay as damages, after mak- ing proper deductions for all recoveries and 4. If we cancel, final premium will be cal - salvage. culated pro rata based on the time this VI. CONDITIONS policy was in force. A. Appeals In the event you or any underlying insurer elects not to appeal a judgment in excess of the amount of the Underlying Insurance, we may elect to appeal at our expense. If we do so elect, we will be liable for the costs and additional interest accruing dur- ing this appeal, In no event will this provi- sion increase our liability beyond the ap- plicable Limits of Insurance described in Section II. of this policy. B. Bankruptcy or Insolvency The bankruptcy, insolvency or inability to pay of any Insured will not relieve us from our obligation to pay "loss" covered by this policy. In the event of bankruptcy, insolvency or refusal or inability to pay, of any under- lying insurer, the insurance afforded by this policy will not replace such underlying insurance, but will apply as if the under- lying insurance was fully available and col- lectible. C. Cancellation 1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancellation is to take effect. 2. We may cancel this policy. If we can- cel because of nonpayment of pre- mium, we must mail or deliver to you not less than ten (10) days advance written notice stating when the can- cellation is to take effect. If we cancel for any other reason, we must mail or deliver to you not less than thirty (30) days advance written notice stating when the cancellation is to take effect. Mailing that notice to you at your mail- ing address shown in Item 1. of the Declarations will be sufficient to prove notice. 5. If you cancel, final premium will be more than pro rata; it will be based on the time this policy was in force and increased by our short rate cancella- tion table and procedure. 6. Premium adjustment may be made at the time of cancellation or as soon as practicable thereafter but the cancella- tion will be effective even if we have not made or offered any refund due you. Our check or our representative's check, mailed or delivered, will be sufficient tender of any refund due you. 7. The first Named Insured in Item 1. of the Declarations will act on behalf of all other Insureds with respect to the giving and receiving of notice of can- cellation and the receipt of any refund that may become payable under this policy. 8. Any of these provisions that conflict with a law that controls the cancella- tion of the insurance in this policy is changed by this statement to comply with the law. D. Maintenance of Underlying Insurance During the period of this policy, you agree: 1. To keep the policies listed in the Schedule of Underlying Insurance in full force and effect; 2. That the Limits of Insurance of the policies listed in the Schedule of Un- derlying Insurance will be maintained except for any reduction or exhaus- tion of aggregate limits by payment of claims or suits for "loss" covered by Underlying Insurance. TAU 9500 (Ed. 11197) XS (Page 4 of 5) GREAT AMERICAN INSURANCE CO M1 11I19121f If you fail to comply with these require- 4. The Insureds will not, except at their ments, we will only be liable to the same own cost, voluntarily make a payment, extent that we would have been had you assume any obligation, or incur any fully complied with these requirements. expense, other than for first aid, with- out our consent. E. Notice of Occurrence 1. You must see to it that we are notified as soon as practicable of an occur- rence which may result in a "loss" covered under this policy. To the ex- tent possible, notice will include: a. how, when and where the occur- rence took place; b. the names and addresses of any injured persons and witnesses; c. the nature and location of any in- jury or damage arising out of the occurrence. 2. If a claim or suit against any Insured is reasonably likely to involve this policy you must notify us in writing as soon as practicable. 3. You and any other involved Insured must: a. immediately send us copies of any demands, notices, summonses or legal papers received in con- nection with the claim or suit; b. authorize us to obtain records and other information; c. cooperate with us in the inves- tigation, settlement or defense of the claim or suit; and d. assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the Insured be- cause of injury or damage to which this insurance may also ap- ply. F. Other Insurance If other insurance applies to a "loss" that is also covered by this policy, this policy will apply excess of the other insurance. Nothing herein will be construed to make this policy subject to the terms, conditions and limitations of such other insurance. However, this provision will not apply if the other insurance is specifically written to be excess of this policy. Other insurance includes any type of self- insurance or other mechanism by which an Insured arranges for funding of legal liabilities. G. Terms Conformed to Statute The terms of this Policy which are in con- flict with the statutes of the state where this Policy is issued are amended to con- form to such statutes. If we are prevented by law or statute from paying on behalf of the Insured, then we will, where permitted by law or statute, indemnify the Insured. H. When "Loss" is Payable Coverage under this policy will not apply unless and until the Insured or the In- sured's underlying insurance has paid or is obligated to pay the full amount of the Underlying Limits of Insurance stated in Item 5. of the Declarations. When the amount of "loss" has finally been determined, we will promptly pay on be- half of the Insured the amount of "loss" covered under the terms of this policy. TAU 9500 (Ed. 11197j XS (Page 5 of 5) GREAT AMERICAN INSURANCE CO Policy #TUE429571607 410660 Effective Dates: 06/30/2022-06/3012023 TAU 9999 (Ed. 11/97) GENERAL ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US IT IS AGREED THAT SECTION VI - CONDITIONS IS AMENDED TO INCLUDE THE FOLLOWING: M. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US IF ANY INSURED HAS RIGHTS TO RECOVER ALL OR PART OF ANY PAYMENT WE HAVE MADE UNDER THIS POLICY, THOSE RIGHTS ARE TRANSFERRED TO US. THE INSURED MUST DO NOTHING AFTER LOSS TO IMPAIR THOSE RIGHTS AND MUST HELP US ENFORCE THEM. ANY RECOVERIES WILL BE APPLIED AS FOLLOWS: 1, ANY INTERESTS, INCLUDING THE INSURED, THAT HAVE PAID AN AMOUNT IN EXCESS OF OUR PAYMENT UNDER THIS POLICY WILL BE REIMBURSED FIRST; 2. WE THEN WILL BE REIMBURSED TO THE AMOUNT WE HAVE PAID; AND 3. LASTLY, ANY INTERESTS, INCLUDING THE INSURED, OVER WHICH OUR INSURANCE IS EXCESS, ARE ENTITLED TO CLAIM THE RESIDUE. EXPENSES INCURRED IN THE EXERCISE OF RIGHTS OF RECOVERY WILL BE APPORTIONED BETWEEN THE INTERESTS, INCLUDING THOSE OF THE INSURED, IN THE RATIO OF THEIR RESPECTIVE RECOVERIES AS FINALLY SETTLED. IN CONSIDERATION FOR THE PREMIUM PAID FOR THIS ENDORSEMENT, THIS POLICY WAIVES ANY RIGHT OF RECOVERY WE MAY HAVE AGAINST THE PERSON OR ORGANIZATION SHOWN BELOW BECAUSE OF PAYMENTS WE MAKE CAUSED BY ANY LIABILITY TO WHICH THIS POLICY APPLIES PROVIDED THAT THE INSURED WAIVED SUCH RIGHT AS PART OF A WRITTEN CONTRACT PRIOR TO A LOSS, AND THEN ONLY TO THE EXTENT THAT SUCH INSURANCE IS PROVIDED BY A POLICY LISTED IN THE SCHEDULE OF UNDERLYING INSURANCE, AND FOR NO BROADER COVERAGE THAN IS PROVIDED BY SUCH POLICY. THIS WAIVER ONLY APPLIES TO A PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO PROVIDE A WAIVER FOR RIGHTS OF RECOVERY AGAINST SUCH PERSON OR ORGANIZATION, SUBJECT TO THE CONDITIONS SET FORTH IN THIS ENDORSEMENT. THIS ENDORSEMENT DOES NOT CHANGE ANY OTHER PROVISION OF THE POLICY. TAU 9999 (Ed. 11197) PRO (Page 1 0f 1 ) GREAT AMERICAN INSURANCE CO Policy #TUE429571607 410660 Effective Dates:06/30/2022-06/3012023 TAU 9999 (Ed. 11/97) GENERAL ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF CONDITIONS -OTHER INSURANCE ------------- PARAGRAPH F. OTHER INSURANCE UNDER SECTION VI - CONDITIONS IS HEREBY DELETED F. IF OTHER INSURANCE APPLIES TO A "LOSS" THAT IS ALSO COVERED BY THIS POLICY, THIS POLICY WILL APPLY EXCESS OF THE OTHER INSURANCE, EXCEPT AS PROVIDED BY A POLICY LISTED IN THE SCHEDULE OF UNDERLYING INSURANCE AND FOR NO BROADER COVERAGE THAN IS PROVIDED BY SUCH POLICY, AND SOLELY WITH RESPECT TO A WRITTEN CONTRACT ENTERED INTO BY THE INSURED PRIOR TO ANY "LOSS" FOR WHICH THE INSURED IS LEGALLY LIABLE, AND WHICH REQUIRES THAT THIS INSURANCE APPLY PRIOR TO ANY OTHER INSURANCE AVAILABLE TO AN ADDITIONAL INSURED IN EXCESS OF THE UNDERLYING COVERAGE BUT ONLY FOR THE PERSON OR ORGANIZATION THAT IS SHOWN IN SCHEDULE A BELOW. NOTHING HEREIN WILL BE CONSTRUED TO MAKE THIS POLICY SUBJECT TO THE TERMS, CONDITIONS AND LIMITATIONS OF SUCH OTHER INSURANCE. IN ADDITION, THIS PROVISION WILL NOT APPLY IF THE OTHER INSURANCE IS SPECIFICALLY WRITTEN BE EXCESS OF THIS POLICY. SCHEDULE A 1. ANY PERSON OR ORGANIZATION FOR WHOM OR FOR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO PROVIDE INSURANCE ON A PRIMARY AND NON-CONTRIBUTORY BASIS, SUBJECT TO THE TERMS AND CONDITIONS OF THIS POLICY. OTHER INSURANCE INCLUDES ANY TYPE OF SELF-INSURANCE OR OTHER MECHANISM BY WHICH AN INSURED ARRANGES FOR FUNDING OF LEGAL LIABILITIES. THIS ENDORSEMENT DOES NOT CHANGE ANY OTHER PROVISION OF THE POLICY. TAU 9999 (Ed. 11/97) PRO (Page 1 0f 1 ) Policy #GL21147970201 Effective Dates: 06/3012022-06130/2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATI ON, NONRENEWAL OR MATERIAL CHANGE -THIRD PARTY This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL UMBRELLA LIABILITY COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM TRUCKERS COVERAGE FORM Subject to the cancellation provisions of the Coverage Form to which this endorsement is attached, we will not: 1. Cancel; 2. Nonrenew; or, 3. Materially change (reduce or restrict) this Coverage Form, except for nonpayment of premium, until we provide at least 6C days written notice of such cancellation, nonrenewal or material change. Written notice will be to the person or organization named in the Schedule. Such notice will be by certified mail with return receipt requested. This notification of cancellation, nonrenewal or material change to the person or organization named in the Schedule is intended as a courtesy only. Our failure to provide such notification will not: 1. Extend any Coverage Form cancellation date; 2. Negate the cancellation as to any insured or any certificate holder; 3. Provide any additional insurance that would not have been provided in the absence of this endorsement; or 4. Impose liability of any kind upon us. This endorsement does not entitle the person or organization named in the Schedule to any benefits, rights or protection under this Coverage Form. SCHEDULE Name Of Person Or Organization Mailing Address Any person or organization holding a certificate of insurance issued The address shown for that person or organization in for you, provided the certificate: that certificate of insurance 1. Refers to this policy; 2. States that notice of: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; will be provided to that person or organization; 3. Is in effect at the time of the: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; and 4. Is on file at your agent or broker's office for this policy IL 70 66 0714 Policy #CA21146960201 Effective Dates: 06/30/2022-06/30/2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATI ON, NONRENEWAL OR MATERIAL CHANGE -THIRD PARTY This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL UMBRELLA LIABILITY COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM TRUCKERS COVERAGE FORM Subject to the cancellation provisions of the Coverage Form to which this endorsement is attached, we will not: 1. Cancel; 2. Nonrenew; or, 3. Materially change (reduce or restrict) this Coverage Form, except for nonpayment of premium, until we provide at least 30 days written notice of such cancellation, nonrenewal or material change. Written notice will be to the person or organization named in the Schedule. Such notice will be by certified mail with return receipt requested. This notification of cancellation, nonrenewal or material change to the person or organization named in the Schedule is intended as a courtesy only. Our failure to provide such notification will not: 1. Extend any Coverage Form cancellation date; 2. Negate the cancellation as to any insured or any certificate holder; 3. Provide any additional insurance that would not have been provided in the absence of this endorsement; or 4. Impose liability of any kind upon us. This endorsement does not entitle the person or organization named in the Schedule to any benefits, rights or protection under this Coverage Form. SCHEDULE Name Of Person Or Organization Mailing Address Any person or organization holding a certificate of insurance issued The address shown for that person or organization in for you, provided the certificate: that certificate of insurance 1. Refers to this policy; 2. States that notice of: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; will be provided to that person or organization; 3. Is in effect at the time of the: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; and 4. Is on file at your agent or broker's office for this policy IL 70 66 0714 Policy #wC211479802 Effective Dates: 06/3012022-06/3012023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US Number of Days Notice 60 For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation is increased to the number of days shown in the Schedule above. If this policy is cancelled by us we will send the Named Insured and any party listed in the following schedule notice of cancellation based on the number of days notice shown above. SCHEDULE Name of Person or Organization The Name of Person or Organization is any person or organization holding a certificate of insurance issued for you, provided the certificate: 1 . Refers to this policy; 2. States that notice of: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; will be provided to that person or organization; 3. Is in effect at the time of the: a. Cancellation; b. Nonrenewal; or c. Material change reducing or restricting coverage; and 4. Is on file at your agent or broker's office for this policy. Mailing Address The Mailing Address is the address shown for that person or organization in that certificate of insurance. IL70450507 GREAT AMERICAN INSURANCE CO Policy #TUE429571607 410660 Effective Dates: 06/30/2022-06/30/2023 TAU 9999 (Ed. 11197) GENERAL ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION - ADDITIONAL PROVISIONS (EXCEPTION FOR SCHEDULED ADDITIONAL INSURED) NOTWITHSTANDING THE CANCELLATION PROVISIONS OF THIS POLICY, WE HEREBY AGREE TO ENDEAVOR TO PROVIDE 30 DAYS WRITTEN NOTICE OF CANCELLATION TO THE PERSON OR ORGANIZATION, WHO IS AN ADDITIONAL INSURED UNDER THIS POLICY AND SPECIFICALLY NAMED IN SCHEDULE A BELOW FOR ANY CANCELLATION, EXCEPT CANCELLATION FOR NON-PAYMENT OF PREMIUM. IF WE CANCEL FOR NON- PAYMENT OF PREMIUM, WE WILL GIVE NO LESS THAN (10) DAYS ADVANCED WRITTEN NOTICE TO THE NAMED INSURED. IT IS FURTHER AGREED AND UNDERSTOOD THAT THIS NOTIFICATION IS MERELY PROVIDED AS A COURTESY SERVICE TO THE FIRST NAMED INSURED SHOWN IN ITEM 1. OF THE DECLARATIONS PAGE AND DOES NOT INFLUENCE OR AMEND THE RIGHTS, DUTIES, OR OBLIGATIONS OF THE COMPANY OR THE NAMED INSURED UNDER THIS POLICY IN ANY WAY. FAILURE TO PROVIDE SUCH NOTIFICATION AS INDICATED ABOVE WILL NOT BE INTERPRETED TO EXTEND THE POLICY CANCELLATION DATE OR NEGATE THE CANCELLATION OF THIS POLICY. SCHEDULE A NAME OF PERSON OR ORGANIZATION MAILING ADDRESS ANY PERSON OR ORGANIZATION, WHO QUALIFIES AS AN ADDITIONAL INSURED UNDER THIS POLICY AND HAS REQUIRED VIA WRITTEN CONTRACT FOR THE NAMED INSURED TO PROVIDE NOTICE OF CANCELLATION FOR REASONS OTHER THAN NON-PAYMENT OF PREMIUM, BUT ONLY IF AN ACCURATE LIST OF SUCH PERSONS OR ORGANIZATIONS WITH CORRECT MAILING ADDRESSES AND CONTACT NAMES HAVE BEEN PROVIDED TO US UPON THE LATTER DATE OF EITHER: (1) WITHIN 10 DAYS OF THE INCEPTION DATE OF THIS POLICY; OR (2) WITHIN 10 DAYS OF ISSUING THIS ENDORSEMENT. THIS ENDORSEMENT DOES NOT CHANGE ANY OTHER PROVISION OF THE POLICY. TAU 9999 (Ed. 11197) PRO (Page 1 of 1 FORT WORTH. Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE:2023 Bridae Rehabilitation. Contract 1 M&C: 23-0431 CPN: 104687 CSO: 59558 DOC#: Date: 06/01 /23 To: Name Department Initials Date Out 1 Donnette Murphy Risk -Approver °�' 06/05/23 2. Michael Owen TPW-Approver 06/05/23 3. Lauren Prieur TPW-Signers 06/05/23 4. Priscilla Ramirez Legal -Approver R 06/06/23 5. Doug Black Legal -Signer � 06/07/23 6. William Johnson ACM -Signer 06/07/23 7 Ronald Gonzales CSCO-Approver )6/08/23 8 Jannette Goodall CSCO-Signer 06/08/23 9 Allison Tidwell CSCO-Form Filler 06/08/23 10. TPW Contracts TPW CC: Program Manager, Sr. CPO, TPW BSPAP Recon Team, TPW Records Room, TPW Contracts DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: [-]YES ®No RUSH: [—]YES ®No SAME DAY: DYES ❑No NEXT DAY: ❑YES ❑No ROUTING TO CSO: ®YES ❑No Action Re wired: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File Link to the General Conditions & Specs ❑ Attach Signature, Initial and Notary Tabs Return To: Please notify TPWContracts@a fortworthtezas.gov for pickup when complete. Call ext. 7233 or ext. 8363 with questions. Thank you! FORTWORTH. Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: 2023 Bridae Rehabilitation Contract 1 M&C: CPN: Date: 05/16/23 To: Name 1. Gibson & Associates 2. Proj Mgr: Tariqul Islam 3. Michelle Hadley -McGhee 4. 5. 6. 7 8 9 10. 104687 CSO: Department Initials Vendor -Signer TPW-Signer T/ TPW-Review 11 DOC#: Date Out 05/23/23 05/24/23 05/26/23 CC: Program Manager, Sr. CPO, TPW BSPAP Recon Team, TPW Records Room, TPW Contracts DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: []YES ®No RUSH: []YES ®No SAME DAY: ❑YES ❑No NEXT DAY: ❑YES ❑No ROUTING TO CSO: ®YES ❑No Action Required: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return To: Please notify TPWContracts(afortworthtexas.2ov for pickup when complete. Call ext. 7233 or ext. 8363 with questions. Thank you! aBond Verification From: Robbi Morales To: Hadlev-McGhee. Michelle Subject: RE: PLEASE REPLY - BOND VERIFICATION REQUEST [CPN #104687 - 2023 Bridge Rehabilitation, Contract 1] Date: Friday, May 26, 2023 12:23:11 PM Attachments: imaae001.Dno CAUTION: This email originated from outside of the City of Fort Worth email system. Do not click any links or open attachments unless you recognize the sender and know the content is safe. I can confirm that we issued bond no. K41680593 for Gibson & Associates, Inc. to the City of Fort Worth in the amount of $942,626.10 for the 2023 Bridge Rehabilitation Contract 1, City Project No. 104687 and this is a valid bond. Robb! Morales Client Specialist III/Surety California License No. OE98189 robbi.morales1(a)aon.com 214/989-2411 Fax 214/989-2580 www.aon.com Aon Surety US Construction & Insfrastructure 5005 LBJ Freeway, Suite 1500 Dallas, TX 75244 Mailing Address: MSC 17849 / P. O Box 803507 / Dallas, TX 75380 In California: Aon Risk Services Southwest, Inc. 0559715 This email message, including any ottochment(s), is intended only for the named recipient(s) and may contain confidential, proprietary or legally privileged information. Unauthorized individuals or entities are not permitted access to this information. Any dissemination, distribution, disclosure, or copying of this information is unauthorized and strictly prohibited. If you have received this message in error, please advise the sender by reply email, and delete this message and any attachments. From: Hadley -McGhee, Michelle <Michelle.Hadley-McGhee@fortworthtexas.gov> Sent: Friday, May 26, 2023 12:16 PM To: Robbi Morales <robbi.moralesl@aon.com> Subject: PLEASE REPLY - BOND VERIFICATION REQUEST [CPN #104687 - 2023 Bridge Rehabilitation, Contract 1] ALERT: This message originated outside of Aon's network. BE CAUTIOUS before clicking any link or attachment. 05/26/2023 Good morning Ms Robbi. Thank you for returning my phone message this morning. The City of Fort Worth is in receipt of the following referenced bond(s) — BOND #K41680593, in the amount of $942,626.10 (Nine Hundred Forty -Two Thousand, Six Hundred Twenty -Six and 10/100 Dollars), from Gibson & Associates, Inc., for City Project #104687 - 2023 Bridge Rehabilitation, Contract 1). Please provide confirmation that both the bond(s) and dollar amount(s) are valid. Your prompt attention to this matter is greatly appreciated! If there are additional questions or concerns, please do not hesitate to contact me at, michelle. had lev-mcahee(a)fortworthtexas.aov, or by phone, 817-392-7233. Should this request have reached you in error, or needs to be directed elsewhere, please be so kind to provide the name of the contact, with both an email address & phone number of the person or department being referenced. It is appreciated. ,foo/tin� fozwazd 00�oiozeciative, C&&Aehle 0gadlejr01cJFAee Contract Compliance Specialist City of Fort Worth Transportation & Public Works (TPW) 200 Texas Street, Fort Worth, TX 76102 Direct: 817-392-7233 Michelle.Hadlev-McGhee(&fortworthtexas.aov City of Fort Worth — Working together to build a strong community. FDAT WURTH.