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Contract 60585
FORTWORTH. CSC No. 60585 CONTRACT FOR THE CONSTRUCTION OF Arterial Roadway Improvements Keller Hicks Road Lauren Way to US 377 City Project No. 100146 Mattie Parker David Cooke Mayor City Manager Lauren Prieur Director, Transportation and Public Works Department Prepared for The City of Fort Worth 3 Transportation and Public Works Department July 2023 3AN MULTATECH ARC HITECT6• EN G IN EER9 TBPE REG #0351 MULTATECH Engineers, Inc 2821 West 7'h Street, Suite 400 Fort Worth, Texas OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX FORT WORTH,. City of Fort Worth Standard Construction Specification Documents Adopted September 2011 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Paget of 5 SECTION 00 00 00 TABLE OF CONTENTS Division 00 - General Conditions Last Revised 00 05 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 11 Bidders Prequalifications 08/13/2011 00 45 12 Prequalification Statement 09/30/2021 0045 13 Prequalification Application 08/13/2021 00 45 26 Contractor Compliance with Workers' Compensation Law 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 01 32 16 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 66 00 Product Storage and Handling Requirements 07/01/2011 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 Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised December 9, 2022 City Project No. 100146 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Page 2 of 5 Technical Specifications which have been modified by the Engineer specifically for this Project; hard copies are included in the Project's Contract Documents NONE Technical Specifications listed below are included for this Project by reference and can be viewed/downloaded from the City's website at: httv:Hfortworthtexas.2ov/tuw/contractors/ or httDs:Happs.fortworthtexas.Lyov/Proi ectResources/ Division 02 - Existing Conditions Last Revised 0241 13 Selective Site Demolition 03/11/2022 0241 14 Utility Removal/Abandonment 12/20/2012 0241 15 Paving Removal 02/02/2016 Division 03 - Concrete 03 30 00 Cast -In -Place Concrete 03/11/2022 0334 13 Controlled Low Strength Material (CLSM) 12/20/2012 03 34 16 Concrete Base Material for Trench Repair 12/20/2012 03 80 00 Modifications to Existing Concrete Structures 12/20/2012 Division 26 - Electrical 26 05 00 Common Work Results for Electrical 03/11/2022 2605 10 Demolition for Electrical Systems 12/20/2012 26 05 33 Raceways and Boxes for Electrical Systems 12/20/2012 26 05 43 Underground Ducts and Raceways for Electrical Systems 07/01/2011 260550 50 C unisati ' s Multi Duet Conduit 02�7�rzoizoiv Division 31- Earthwork 31 00 00 Site Clearing 03/22/2021 3123 16 Unclassified Excavation 01/28/2013 31 23 23 Borrow 01/28/2013 31 24 00 Embankments 01/28/2013 31 25 00 Erosion and Sediment Control 04/29/2021 , /'fez 313600 31 37 00 Gabiefis Riprap 2 12/20/2012 Division 32 - Exterior Improvements 3201 17 Permanent Asphalt Paving Repair 12/20/2012 3201 18 Temporary Asphalt Paving Repair 12/20/2012 32 01 29 Concrete Paving Repair 12/20/2012 32 1123 Flexible Base Courses 12/20/2012 32 1129 Lime Treated Base Courses 12/20/2012 32 1133 Cement Treated Base Courses 06/10/2022 32 1137 Liquid Treated Soil Stabilizer 08/21/2015 32 1216 Asphalt Paving 12/20/2012 32 1273 Asphalt Paving Crack Sealants 12/20/2012 32 13 13 Concrete Paving 06/10/2022 CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised December 9, 2022 City Project No. 100146 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Page 3 of 5 32 1320 Concrete Sidewalks, Driveways and Barrier Free Ramps 12/09/2022 32 1373 Concrete Paving Joint Sealants 12/20/2012 32 14 13rok Urit g , 2%=2 32 1613 Concrete Curb and Gutters and Valley Gutters 12/09/2022 32 1723 Pavement Markings 06/10/2022 32 1725 Curb Address Painting 11/04/2013 3231 13 Chain Fences and Gates 12/20/2012 32 31 26 3'�9 Wire Fences and Gates 12/20/2012 12i�12 32 32 13 Wood Fe es a -a Gates Cast -in -Place Concrete Retaining Walls 06/05/2018 3291 19 Topsoil Placement and Finishing of Roadway Right-of-ways 03/11/2022 329213 Sodding 05/13/2021 (11 3292 14 N.or. N.at •, rg 05�io�rr3a021 32 93 43 Trees and Shrubs 12/20/2012 Division 33 - Utilities 33 01 30 Sewer and Manhole Testing 09/07/2018 33 01 31 Closed Circuit Television (CCTV) Inspection — Sanitary Sewer 03/11/2022 33 01 32 Closed Circuit Television (CCTV) Inspection — Storm Drain 03/11/2022 3303 10 33 04 10 Bypass Pumping of Existing Sewer Systems TeipA Beading and Eleetfieal isel tie , Toss r,.,...esien 12/20/2012 , 2/�12 i 2 i�12 33 04 } 33 04 12 33 04 30 Gentfel Stat ens Magnesiti Anode r.,tt,edie Pfete tie Systeffl Temporary Water Services 12i�12 07/01/2011 33 04 40 Cleaning and Acceptance Testing of Water Mains 02/06/2013 33 04 50 Cleaning of Pipes 03/11/2022 3305 10 Utility Trench Excavation, Embedment, and Backfill 04/02/2021 3305 12 Water Line Lowering 12/20/2012 3305 13 Frame, Cover and Grade Rings 09/09/2022 3305 14 Adjusting Manholes, Inlets, Valve Boxes, and Other Structures to 03/11/2022 Grade 3305 16 Concrete Water Vaults 12/20/2012 3305 17 Concrete Collars 03/11/2022 33 05 20 Auger Boring 12/20/2012 �3-A3-21 r Tu�rr.-r�l ar- Pla4e , 2 i�lz 33 05 22 Steel Casing Pipe 12/20/2012 33-05-23 Hand Turewling ,� 33 05 24 Installation of Carrier Pipe in Casing or Tunnel Liner Plate 12/09/2022 33 05 26 Utility Markers/Locators 12/20/2012 33 05 30 Location of Existing Utilities 12/20/2012 33 1105 Bolts, Nuts, and Gaskets 12/20/2012 33 11 10 Ductile Iron Pipe 12/09/2022 33 11 11 Ductile Iron Fittings 09/20/2017 33 11 12 Polyvinyl Chloride (PVC) Pressure Pipe 09/09/2022 33 11 13 Concrete Pressure Pipe, Bar -Wrapped, Steel Cylinder Type 12/20/2012 33 11 14 Buried Steel Pipe and Fittings 12/20/2012 33 1210 Water Services 1-inch to 2-inch 02/14/2017 33 1211 Large Water Meters 12/20/2012 33 1220 Resilient Seated Gate Valve 05/06/2015 33 1221 AWW k Rubsbur Fea4ea a„ ter- ly Valves nn �7vTn3,9019 CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised December 9, 2022 City Project No. 100146 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Page 4 of 5 33 1225 Connection to Existing Water Mains 02/06/2013 33 1230 Combination Air Valve Assemblies for Potable Water Systems 12/20/2012 33 1240 Fire Hydrants 01/03/2014 33 1250 Wa4ar Eamr) e Stmiens i i�Q 33 3 1 12 3L 3i l? ram,,. -ea i f Place Pipe (CIPP4 F4-bz7glatG Raifif f:ee Pipe for- n ayity Sanitary So.,, i 2i�12 i2i�lz 3331 15 High Density Polyethylene (HDPE) Pipe for Sanitary Sewer 04/23/2019 33 31 20 Polyvinyl Chloride (PVC) Gravity Sanitary Sewer Pipe 09/09/2022 33 31 21 Polyvinyl Chloride (PVC) Closed Profile Gravity Sanitary Sewer 12/20/2012 Pipe 33-34�2 ca-aitafy Se.., r � Dr flip ��rrn g L`.,1..,-,.ome,..4 C'a-aitafy C'o...ef i2 20/-20i2 �� 33-3-1 23 33 31 50 Pipe Sanitary Sewer Service Connections and Service Line 12�7rc�-20a0Q 04/26/2013 33 31 70 Combination Air Valve for Sanitary Sewer Force Mains 12/20/2012 3339 10 Cast -in -Place Concrete Manholes 12/20/2012 33 39 20 Precast Concrete Manholes 12/20/2012 333930 Ftrglwo Manholes xx . n n r4 ,2/�tz i 33 39 400 33 39 60 rite. awe eoess Chamber- (W Liners for Sanitary Sewer Structures 2i�iz 04/29/2021 3341 10 Reinforced Concrete Storm Sewer Pipe/Culverts 07/01/2011 3341 11 High Density Polyethylene (HDPE) Pipe for Storm Drain 12/20/2012 3341 12 Reinforced Polyethylene (SRPE) Pipe 11/13/2015 3341 13 Polypropylene Pipe for Storm Drain 06/10/2022 /'�Iz 33-4600 33 46 01 drainage Slotted Storm Drains 12 07/01/2011 33 46 02 Trench Drains 07/01/2011 33 49 10 Cast -in -Place Manholes and Junction Boxes 12/20/2012 33 49 20 Curb and Drop Inlets 03/11/2022 33 49 40 Storm Drainage Headwalls and Wingwalls 07/01/2011 Division 34 - Transportation 3441 10 Traffic Signals 03/11/2022 3441 10.01 Attachment A — Controller Cabinet 12/18/2015 3441 10.02 Attachment B — Controller Specification 02/2012 3441 10.03 Attachment C — Software Specification 01/2012 3441 11 Temporary Traffic Signals 11/22/2013 3441 13 Removing Traffic Signals 03/11/2022 34 41 20 Roadway Illumination Assemblies 12/20/2012 34 41 20.01 Arterial LED Roadway Luminaires 06/15/2015 34 41 20.02 Freeway LED Roadway Luminaires 06/15/2015 34 41 20.03 Residential LED Roadway Luminaires 06/15/2015 34 41 30 Aluminum Signs 11/12/2013 34 41 50 Single -Mode Fiber Optic Cable 02/26/2016 3471 13 Traffic Control 03/22/2021 CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised December 9, 2022 City Project No. 100146 00 00 00 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Appendix Page 5 of 5 GC-4.02 Subsurface and Physical Conditions Fly-4.06 Lb af:deus Eiwir-, nfnerta Condition . 4 S4e GC-6.06.1) Minority and Women Owned Business Enterprise Compliance GC-6.07 Wage Rates GC-6.09 Permits and Utilities GG 6. 1 P0xJis0ViFArYati3x GR-01 60 00 Product Requirements END OF SECTION CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised December 9, 2022 City Project No. 100146 City of Fort Worth, Texas Mayor and Council Communication DATE: 10/17/23 M&C FILE NUMBER: M&C 23-0886 LOG NAME: 20KELLER HICKS ROAD CONSTRUCTION SUBJECT (CD 10) Authorize Execution of a Construction Contract with McMahon Contracting in the Amount of $7,204,624.65 for Keller Hicks Road from Lauren Way to US 377; Authorize Temporary Closure of the Keller Hicks Road - Union Pacific Railroad Crossing from August 5, 2024 to October 6, 2024 for Construction Activities; Authorize the Temporary Closure of Keller Hicks Road Between Lauren Way and Katy Road from February 5, 2024 to May 6, 2024 for Construction Activities; Adopt Appropriation Ordinances and Amend the Fiscal Years 2024-2028 Capital Improvement Program (2018 Bond Program) RECOMMENDATION: It is recommended that the City Council: 1. Authorize execution of a contract with McMahon Contracting, LP. in the amount of $7,204,624.65 for the construction of Keller Hicks Road from Lauren Way to US 377 project (City Project No. 100146); 2. Authorize the temporary closure of the Keller Hicks Road - Union Pacific Railroad Crossing between the intersections Keller Hicks Road and Katy Road and Keller Hicks Road and US 377 from August 5, 2024 to October 6, 2024 for construction activities; 3. Authorize the temporary closure of Keller Hicks Road crossing between Lauren Way and Katy Road from February 5, 2024 to May 6, 2024 for construction activities; 4. Adopt the attached appropriation ordinance adjusting estimated receipts and appropriations in the General Capital Projects Fund by increasing receipts and appropriations in the Keller Hicks Road from Lauren Way to US 377 project (City Project No. 100146) in the amount of $690,000.00 and decreasing appropriations in the Contract Street Maintenance Programmable project (City Project No. P00020) by the same amount; 5. Adopt the attached appropriation ordinance adjusting estimated receipts and appropriations in the General Capital Projects Fund by increasing receipts and appropriations in the Keller Hicks Road from Lauren Way to US 377 project (City Project No. 100146) in the amount of $760,000.00 and decreasing appropriations in the Sidewalk Improvements Programmable project (City Project No. P00127) by the same amount; 6. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the General Capital Projects Fund in the amount of $1,294,933.00 from available funds for the Keller Hicks Road from Lauren Way to US 377 project (City Project No. 100146); 7. Adopt the attached appropriation ordinance adjusting appropriations in the 2018 Bond Program Fund by increasing receipts and appropriations in the Keller Hicks Road from Lauren Way to US 377 project (City Project No. 100146) in the amount of $255,067.00 and decreasing appropriations in the Authorized, Not Appropriated project (City Project No. U34018) by the same amount; and 8. Amend the Fiscal Years 2024-2028 Capital Improvement Program. DISCUSSION: The purpose of this Mayor and Council Communication (M&C) is to authorize execution of a contract with McMahon Contracting in the amount of $7,204,624.65 for Keller Hicks Road from Lauren Way to US 377 and to authorize certain road closures for the construction work. The project will improve the existing two-lane asphalt road with a three lane concrete road including a center turn lane, ten foot sidewalks replace drainage, and illumination improvements. The project will improve the existing Keller Hicks Road and Katy Road intersection from stop sign controlled to a traffic signal with left turn lanes. The construction of Keller Hicks will require an existing culvert to be removed and replaced that will change the elevation of the road at the culvert crossing. The City of Fort Worth Transportation and Public Works Department requests the temporary closure of Keller Hicks at the proposed culvert. The closure at the culvert is necessary due to the safety concerns of the narrow roadway crossing and proposed vertical changes. All residences and businesses will have access to their properties during the closure. The construction of Keller Hicks at Katy Road is a joint project with City of Keller to improve the existing at -grade railroad crossing across the Union Pacific Railroad tracks between Katy Road and US 377 that includes a new sidewalk crossing. An Interlocal Agreement (ILA) with Keller was authorized in November, 2021 (M&C 21-0904) but due to subsequently projected price increases, Keller delayed city council consideration until value engineering could be completed. The ILA is now scheduled to be heard by Keller's city council on October 17, 2023 in substantially the same amount, but slightly lower, as was authorized by M&C 21-0904. The City of Fort Worth Transportation and Public Works Department requests the temporary closure of the Keller Hicks Road railroad crossing between the intersections of Katy Road and US 377. The closure of the railroad crossing is necessary due to the safety concerns of the narrow roadway crossing and proposed vertical changes. Alternate crossings are located at Timberland Boulevard and Golden Triangle Boulevard. The following table demonstrates the funding history and total budget for the project: Capital Fund Name Project Name Appropriations Budget Revised Fiscal Year Adjustment 2024 Budget 34018-2018 Bond Program Fund 100146-Keller Hicks Road 30108-Transportation Impact Fee 100146-Keller Cap Fund Hicks Road 30106-Intergovernmental 100146-Keller Contribution Fund Hicks Road 34017-TaxNote 2017 Fund 100146-Keller Hicks Road 39008 - Transportation Impact Fee 100146-Keller Legacy Fund Hicks Road 30100-General Capital Projects 100146-Keller Fund Hicks Road (Project Total $2,000,000.00 $255,067.00 $2,998,523.13 $0.00 $1,499,303.60 $0.00 $100,000.00 $0.00 $411,476.87 $0.00 $0.00 $2,744,933.00 $7,009,303.60 $3,000,000.00 $2,255,067.00 $2,998,523.13 $1,499,303.60 $100, 000.00 $411,476.87 $2,744,933.00 $10,009,303.60 The project was advertised for bid on July 6, 2023 and July 13, 2023 in the Fort Worth Star -Telegram. On August 10, 2023 the following bids were received: Bidders Amount McMahon Contracting $7,204,624.65 DDM Construction $7,294,858.00 �XIT Paving Construction $7,620,747.60 McClendon Construction $7,718,527.55 Reyes Group $10,630,420.20 Construction of Keller Hicks from Lauren Way to US 377 is anticipated to begin in Spring 2024. This project is included in the 2018 Bond Program. Available resources within the General Fund will be used to provide interim financing until debt is issued. Once debt associated with the project is sold, bond proceeds will reimburse the General Fund in accordance with the statement expressing official Intent to Reimburse that was adopted as part of the ordinance canvassing the bond election (Ordinance No. 23209-05-2018) and subsequent actions taken by the Mayor and Council. DVIN-BE:McMahon Contracting is in compliance with the City's Business Equity Ordinance by committing 14% MWBE participation on this project. The City's MWBE goal on this project is 13%. Funding for this project was not included in the FY2024-2028 Capital Improvement Program (CIP) because construction cost estimates were not complete at the time of CIP development. The action in this M&C will amend the FY2024-2028 Capital Improvement Program. The Project is located in COUNCIL DISTRICT 10. FISCAL INFORMATION / CERTIFICATION: The Director of Finance certifies that funds are currently available in the Contract Street Maintenance, Sidewalk Improvements and Unspecified All Funds projects within the General Capital Projects Fund and in the Authorized, Not Approved project within the 2018 Bond Program Fund and upon approval of the above recommendations and adoption of the attached appropriation ordinances, funds will be available in the General Capital Projects Fund and the 2018 Bond Program Fund for the Keller Hicks Rd. (377 to Katy) project to support the above recommendations and award of the contract. Prior to an expenditure being incurred, the Transportation and Public Works Department has the responsibility of verifying the availability of funds. Submitted for Citv Manager's Office bv: William Johnson 5806 Oriainatina Business Unit Head: Lauren Prieur 6035 Additional Information Contact: Monty Hall 8662 0005 15- 1 ADDENDA Page 1 of 3 1 SECTION 00 05 15 2 ADDENDUM NO. 1 3 4 Keller Hicks Road — Lauren Way to US 377 5 City Project No. 100146 6 7 Issue Date: July 21, 2023 8 Bid Receipt Date: August 10, 2023 9 10 This addendum forms part of the Contract Documents referenced above and modifies the 11 original Contract Documents. Acknowledge receipt of this Addendum by signing in the 12 space below and in the space provided in Section 00 4100 Bid Form. Attach this 13 Addendum inside the Contract Documents and note receipt of this Addendum in the Bid 14 Proposal and on the outside of your sealed bid envelope. 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 1) Summarized below are responses to questions asked during the pre -bid meeting as well as follow-up questions received via email: a) Q: Construction Phasing — Are we allowed to do one way, one lane of traffic? A: One Way, One Lane Traffic Control will be allowed. The contractor is required to submit a revised traffic control plan prior to construction. b) Q: Are the utilities cleared? A: Yes, they've been relocating over the last two years. c) Q: Please confirm the days match in the documents. A: The Number of Days is 550. The Workbook and Agreement Spec have been revised to reflect both. d) Q: Please confirm the culvert is sized correctly, there are 2-10'x6' RCBs upstream. A: Culvert is sized correctly, the design storm requires 2-8'x4' RCBs under the road. The upstream 10'x6' RCBs were installed to allow the housing project to begin early and allow f'or necessary storage to not make existing conditions worse. e) Q: Please confirm the bid items to use for the connection from the existing 8'x4' RCBs to the existing 10'x6' RCBs. A: Please follow the provided detail for the connection and use Item 78 Storm Drain Structure (Culvert A Upstream — Connection to Existing 10'x6' Detail) bid as LS. Headwall Removal outside of the detail will use item 31 A Remove Headwall/SET (Culvert A Upstream — Existing 10'x6' Outf'all) bid per LS. 0 Q: Please confirm if concrete barriers are needed and if the bid item is included. A: There is no anticipated need f'or concrete barriers due to existing grades. CITY OF FORT WORTH Keller Hicks Road — Lauren Way to US 377 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 100146 Revised December 20, 2017 000515-2 ADDENDA Page 2 of 3 1 g) Q: Typically bid items 86-87 Railroad items are lump sum pre -determined 2 price. 3 A: Bid Item 86 Railroad Coordination has been given a predetermined price of 4 $30,000. Bid Item 87 Railroad Flagman has been given a predetermined price of 5 $75,000. 6 h) Q: Will Keller Hicks be closed during construction activities that directly 7 affect the Railroad Crossing? 8 A: Yes, the portion of Keller Hicks east of the Katy Road intersection will be 9 closed to construct the crossing. 10 i) Q: Please confirm the bid items to be used for temp asphalt and base under the 11 temp asphalt. 12 A: Please use Bid Item: 43A 6" Type B Asphalt on 6" Flexbase for the temporary 13 asphalt during construction. 14 j) Q: Please confirm the bid items to be used for temp asphalt for storm/water 15 temp asphalt. 16 A: Please use existing Bid Items 70 and 96 and follow the detail on sheet 43. 17 k) Q: Please confirm the number of Type 2 inlets and the bid item. 18 A: Please use Item 5: 10' Type 2 Inlet at a quantity of 5. 19 1) Q: Please confirm the quantities for the Rip Rap and where it is used in the 20 plans. 21 A: Item 6: Concrete Riprap is being used on the side slopes of the outfall of 2- 22 8'x4' RCB culvert at a quantity of 1,250 SY. Item 7: 18" Stone Riprap is being 23 used at the end of the same channel at a quantity of 520 SY. 24 m) Q: There are no items for the SETs or Flexamat indicated on the sheet 50? 25 A: Bid Item 99A: 30" SET, 1 Pipe at a quantity of 2 EA. Bid Item 9913: Erosion 26 Control Mat - Flexamat have been added at a quantity of 90 SY. 27 n) Q: The plans call out a 3' x 3' grate inlet at station 1+80 sheet 51. The bid item 28 97 calls for a 2'x4 grate inlet. Please clarify. 29 A: Bid Item 97 has been revised to a 3'x3' Grate inlet. 30 o) Q: Please provide clarification regarding the payment for the downstream 31 headwall to accommodate the double 8'x4'box culvert-42" RCP and 4'x4'RCB 32 installation.? 33 A: The downstream headwall for the 2-8'x4' RCB culvert shown on sheet 27 and 34 detailed on sheet 38 will be bid item 15A bid as a LS. 35 p) Q: Please provide clarification regarding the plugging of the remaining 36 101X6' RCB? 37 A: The preferred construction method for plugging the remaining 10'x6' RCB 38 will be answered in a later addendum. 39 40 2) The Following Bid Items have been impacted: 41 42 a) Bid Item 5 changed the description to 3349.8001 10' type 2 Inlet at a quantity of 5 EA. 43 b) Bid Item 6: 3137.1010 Concrete Riprap has been changed to a quantity of 1,250 SY. 44 c) Bid Item 7: 3137.0102 18" Stone Riprap, Dry has been changed to a quantity of 520 SY. CITY OF FORT WORTH Keller Hicks Road — Lauren Way to US 377 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 100146 Revised December 20, 2017 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 000515-3 ADDENDA Page 3 of 3 d) Bid Item 15A: 3349.1000 Culvert A Downstream Headwall Type PW-1 has been added a quantity of 1 L.S. e) Bid Item 31A: 0241.4401 Remove Headwall/SET (Culvert A Upstream, Existing 10'x6' Outfall) has been added a quantity of 1 LS. f) Bid Item 43A: 9999.0003 6" Asphalt Type B on 6" Flexbase (Temporary) has been added at a quantity of 2,800 SY g) Bid Item 78: Storm Drain Structure has revised to Storm Drain Structure (Culvert A — Connection to Existing 10'x6' Detail) at a quantity of 1 LS h) Bid Item 86 Railroad Coordination has been revised to a predetermined LS amount of $30,000. i) Bid Item 87 Railroad Flagman has been revised to a predetermined LS amount of $75,000. j) Bid Item 97: 2'x4' Grate Inlet has been revised to 3349.9002 3'x3' Grate Inlet. k) Bid Item 99A: 3349.4107 30" SET, 1 Pipe has been added a quantity of 2 EA. 1) Bid Item 9913: 9999.0000 Erosion Control Mat — Flexamat has been added a quantity of 90 Sy. 3) The following modifications have been made to the Project Manual: a) Section 00 52 43 AGREEMENT, Article 4, Section 4.1 first sentence has been revised from 180 days to 550 Days. 4) The following modifications have been made to the Plan Set: a) There are not modifications issued to the plan set. RECEIPT ACKNOWLEDGED END OF SECTION TRANSPORTATION & PUBLIC WORKS DEPARTMENT Digitally signed by Mitchell Me, DN:C=US Rv. 20 Mitchell Ai to n CN=1Mi chelllAilonoM odhlexas gov, Dale: 23.07.21 15:01:39-05'00' Mitch Aiton, P.E., P.M.P. Project Manager CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 20, 2017 Keller Hicks Road — Lauren Way to US 377 City Project No. 100146 0005 15- 1 ADDENDA Page 1 of 3 1 SECTION 00 05 15 2 ADDENDUM NO.2 3 4 Keller Hicks Road — Lauren Way to US 377 5 City Project No. 100146 6 7 Issue Date: August 1, 2023 8 Bid Receipt Date: August 10, 2023 9 10 This addendum forms part of the Contract Documents referenced above and modifies the 11 original Contract Documents. Acknowledge receipt of this Addendum by signing in the 12 space below and in the space provided in Section 00 4100 Bid Form. Attach this 13 Addendum inside the Contract Documents and note receipt of this Addendum in the Bid 14 Proposal and on the outside of your sealed bid envelope. 15 16 1) Summarized below are responses to questions asked during the pre -bid meeting as 17 well as follow-up questions received via email: 18 a) Q: Please confirm how manhole steps in the Culvert Connection detail are to 19 be paid for. 20 A: Manhole steps will be subsidiary to item 78. 21 b) Q: Please confirm the temporary asphalt repair items compared to the details. 22 A: Bid Item 70 will be used for all storm drain (except boxes) per the detail on 23 sheet 43. Bid Item 70A will be used for waterline A and Fire Hydrant work per the 24 detail on sheet 20. Bid item 70B will be used for the box culvert work per detail on 25 sheet 44. Bid item 96 will be used for waterline B&C per the detail on sheet 21. 26 c) Q: Please confirm the method of abandoning the existing 10'x6' Culvert. 27 A: We will be filling the existing culvert and plugging the openings. Sheet 27 has 28 been revised with the additional detail on added sheet 34A. Bid items 78A-78BC 29 have been added in relation to abandoning the remaining 10'x6' RCB. 30 31 2) The Following Bid Items have been impacted: 32 33 a) Bid Item 1A: 3349.4104 21" SET, 1 pipe had been added at a quantity of 1 EA. 34 b) Bid Item 16: 3341.0205 24" RCP, Class III has been added at a quantity of 680 LF. 35 c) Bid Item 9A: 3305.0204 Imported Embedment/Backfill, Crushed Rock at a quantity of 96 36 Cy. 37 d) Bid Item 38A: 3231.0305 12' Gate, Steel has been added at a quantity of 1 EA. 38 e) Bid Item 67A: 3312.3003 8" Gate Valve has been added at a quantity of 2 EA. 39 f) Bid Item 6713: 3312.2004 1" Private Service has been added at a quantity of 1 EA. CITY OF FORT WORTH Keller Hicks Road — Lauren Way to US 377 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 100146 Revised December 20, 2017 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 000515-2 ADDENDA Page 2 of 3 g) Bid Item 67C: 0241.1118 4"-12" Pressure Plug has been added at a quantity of 1 EA. h) Bid Item 70 has been revised to 3201.0122 Temporary Asphalt Pavement —Trench Repair for storm drain (all sizes) at a quantity of 2300 LF. i) Bid Item 70A: 3201.0122 Temporary Asphalt Pavement — Trench Repair for waterline (12" and smaller) has been added at a quantity of 95 LF. j) Bid Item 706: 3201.0122 Temporary Asphalt Pavement —Trench Repair for storm sewer RCB has been added at a quantity of 180 LF. k) Bid Item 73: 3312.0117 Connection to Existing 4"-12" Water Main has changed to a quantity of 5 EA. 1) Bid Item 76: 3292.0400 Seeding Hydromulch has changed to a quantity of 6,853 SY. m) Bid Item 78A: 9999.0002 Concrete Culvert Plug has been added at a quantity of 3.7 CY. n) Bid Item 7813: 0241.3001 Storm Culvert Grouting has been added at a quantity of 265 CY. o) Bid Item 78C: 3292.0400 Borrow by Plan has been added at a quantity of 800 CY. p) Bid Item 91: 3311.0261 8" PVC Water Pipe has been changed to a quantity of 467 LF. q) Bid Item 92: 3312.3002 8" Gate Valve has been changed to a quantity of 4 EA. r) Bid Item 94: 3312.0001 Fire Hydrant has been changed to a quantity of 1 EA. s) Bid Item 94A 0241.1302 Remove and Salvage 6" Water Valve has been added at a quantity of 1 EA. t) Bid Item 94B 0241.1303 Remove and Salvage 8" Water Valve has been added at a quantity of 1 EA. u) Bid Item 94C 0241.1510 Salvage Fire Hydrant has been added at a quantity of 1 EA. v) Bid Item 94D 3305.0116 Concrete Encasement for Utility Pipes has been added at a quantity of 2 CY. w) Bid Item 95 3312.0117 Connection to Existing 4"-12" Water Main changed to a quantity of 5 EA. x) Bid Item 96 has been revised to 3201.0122 Temporary Asphalt Pavement —Trench Repair for waterlines 12" and smaller at a quantity of 267 LF. y) Bid Item 98A 9999.0000 Clean Existing 18" CMP and Grates has been added at a quantity of 1 LS. z) Bid Item 101: 0241.3013 Remove 30" Storm Line has changed to a quantity of 50 LF. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 20, 2017 Keller Hicks Road — Lauren Way to US 377 City Project No. 100146 1 2 3 4 5 6 7 s 9 10 11 12 13 14 15 16 000515-3 ADDENDA Page 3 of 3 3) The following modifications have been made to the Project Manual: a) There are no modifications issue to the project manual. 4) The following modifications have been made to the Plan Set: a) Please see attached revised sheet 27 and additional sheet 34A to reflect the abandonment of the existing 10'x6' Culvert. RECEIPT ACKNOWLEDGED END OF SECTION TRANSPORTATION & PUBLIC WORKS DEPARTMENT Dlgitaly slgrwE by IAtchell m- ON: C=US Mitchell Aiton " °11Z-° ° tamg° BI'M.: 2023 08.01 13 43:20-05110' Mitch Aiton, P.E., P.M.P. Project Manager CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 20, 2017 Keller Hicks Road — Lauren Way to US 377 City Project No. 100146 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 0005 15 - 1 ADDENDA Page 1 of 2 SECTION 00 0515 ADDENDUM NO.3 Keller Hicks Road — Lauren Way to US 377 City Project No. 100146 Issue Date: August 2, 2023 Bid Receipt Date: August 10, 2023 This addendum forms part of the Contract Documents referenced above and modifies the original Contract Documents. Acknowledge receipt of this Addendum by signing in the space below and in the space provided in Section 00 4100 Bid Form. Attach this Addendum inside the Contract Documents and note receipt of this Addendum in the Bid Proposal and on the outside of your sealed bid envelope. 1) Summarized below are responses to questions asked during the pre -bid meeting as well as follow-up questions received via email: a) Q: Do we need a prequalified illumination contractor? A: Yes, we will need a prequalified illumination contractor on the project. b) Q: Can you confirm the bid items to use for the pavement repair outside the paving limits on the Keller waterline. A: Bid Item 96 will be used for temporary pavement repair. Added Bid Item 96A will be used for permanent pavement repair, please see revised sheets 18 and 21. 2) The Following Bid Items have been impacted: a) Bid Item 96: 3201.0122 Temporary Asphalt Pavement -Trench Repair -Waterline (Keller Detail) has been revised to a quantity of 60 LF. b) Bid Item 96A: 9999.0000 Permanent Asphalt Pavement -Trench Repair -Waterline (Keller Detail) has been added at a quantity of 207 LF. 3) The following modifications have been made to the Project Manual: a) Illumination Prequalified Contractor has been added to section 00 45 12. 4) The following modifications have been made to the Plan Set: a) Please see revised Plan Sheets 18 and 21 to reflect the Keller Waterline Pavement Repair. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 20, 2017 Keller Hicks Road — Lauren Way to US 377 City Project No. 100146 1 END OF SECTION 3 RECEIPT ACKNOWLEDGED 4 5 6 g "ALJ�� -��Company: LNG raw 000515-2 ADDENDA Page 2 of 2 TRANSPORTATION & PUBLIC WORKS DEPARTMENT digitally s'g by Mi"' Anon Bv: Mitchell Aiton pn16:521-65W--9oV Mitch Aiton, P.E., P.M.P. Project Manager CITY OF FORT WORTH Keller Hicks Road — Lauren Way to US 377 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 100146 Revised December 20, 2017 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 0005 15- 1 ADDENDA Page I of 2 SECTION 00 05 15 ADDENDUM NO.4 Keller Hicks Road — Lauren Way to US 377 City Project No. 100146 Issue Date: August 4, 2023 Bid Receipt Date: August 10, 2023 This addendum forms part of the Contract Documents referenced above and modifies the original Contract Documents. Acknowledge receipt of this Addendum by signing in the space below and in the space provided in Section 00 4100 Bid Form. Attach this Addendum inside the Contract Documents and note receipt of this Addendum in the Bid Proposal and on the outside of your sealed bid envelope. 1) Summarized below are responses to questions asked during the pre -bid meeting as well as follow-up questions received via email: a) Q: Can confirm how the retaining walls and traffic rails is to be paid for? A: Retaining Wall will be paid for by items 37A and 115, please reference the detail on sheet 80. Traffic Rail will be paid for by items 37B and 115A. 2) The Following Bid Items have been impacted: a) Bid Item 37A: 9999.0000 Retaining Wall has been added at a quantity of 648 SF. b) Bid Item 3713: 9999.0000 TxDOT Traffic Rail —Type T552 has been added at a quantity of 155 LF. c) Bid Item 79: 3471.0003 Traffic Control is a quantity of 18 MO. d) Bid Item 86: Railroad Coordination is a quantity of 1 EA at predetermined price of $30,000. e) Bid Item 87: Railroad Flagman is a quantity of 1 EA at predetermined price of $75,000. f) Bid Item 115 has been revised to 9999.0000 Retaining Wall at a quantity of 1223 SF. g) Bid Item 115A: 9999.0000 TxDOT Traffic Rail —Type T552 has been added at a quantity of 207 LF. 34 3) The following modifications have been made to the Project Manual: 35 36 a) There are no modifications to the project manual. 37 CITY OF FORT WORTH Keller Hicks Road — Lauren Way to US 377 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 100146 Revised December 20, 2017 1 2 3 4 5 6 7 8 9 10 11 12 000515-2 ADDENDA Page 2 of 2 4) The following modifications have been made to the Plan Set: a) There are no modifications to the project manual. END OF SECTION RECEIPT ACKNOWLEDGED TRANSPORTATION & PUBLIC WORKS DEPARTMENT G= signedbyM ,.. ANa� Mitchell Aiton DN C=USE=mil ela on�fahorNlemsgov, BY: CN=Mi023 804 L.ja r 1 Dale:2023A804 76:2938-0500' ,A Mitch Aiton, P.E., P.M.P. Co vanv:r4. Z. P Project Manager CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 20, 2017 Keller Hicks Road — Lauren Way to US 377 City Project No. 100146 cMAH01V CONTRACTING 11/08/2023 City of Fort Worth Transportation and Public Works Department 200 Texas Street Ft Worth, TX 76102 Phone: 817-392-7233 Reference: Arterial Roadway Improvements Keller Hicks Road (From Lauren Way to US 377) Paving, Water, Drainage, Signal & Street Light Improvements, Fort Worth, Texas 76244 Dear City of Fort Worth Transportation and Public Works Department, Please advise, who signed the Addendums? The signature differs from Scott's signature on the remaining Bidding documents of the vendor's bid packet. Will Mee, Chief Estimator signed the Addendums on the bid package. Scott Cummings, President, signed the final bid documents. Will you provide a copy of the corporate resolution showing who the authorized signers are? McMahon Contracting LP is not a corporation. The full legal name under Tax ID 87-2876025 is McMahon Contracting and Construction LLC dba McMahon Contracting LP. The authorized signers for McMahon Contracting LP are listed below with titles. Scott Cummings, President Chris Young, COO Shelley McMahon, VP Internal Operations Will Mee, Chief Estimator Respectfully, (94w'11VW,4q - Shelley McMahon VP Internal Operations McMahon Contracting LP 0011 13 INVITATION TO BIDDERS Page 1 of 2 SECTION 00 1113 INVITATION TO BIDDERS RECEIPT OF BIDS Sealed bids for the construction of Arterial Roadway Improvements, Keller Hicks Road, From Lauren Way US 377 ("Project") will be received by the City of Fort Worth Purchasing Office until 1:30 P.M. CST, Thursday, August 10, 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: 4000 SY 8" Concrete Pavement 3500 SY 4" Asphalt Pavement 300 LF 18" RCP Stormdrain 565 LF 8" Waterline by Open Cut and Bore 64 LF 8" Sanitary Sewer PREQUALIFICATION Certain improvements included in this project must be performed by a contractor or designated subcontractor who is pre -qualified by the City at the time of bid opening. The procedures for qualification and pre -qualification are outlined in the Section 3 of 00 21 13 — INSTRUCTIONS TO BIDDERS. 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 http://www.fortworthtexas.gov/purchasing/ 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. EXPRESSION OF INTEREST 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 — In person CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised 7/19/2021 City Project No. 100146 0011 13 INVITATION TO BIDDERS Page 2 of 2 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 via a web conferencing application: DATE: July 18, 2023 TIME: 2:00 PM Web Conference 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. INQUIRIES All inquiries relative to this procurement should be addressed to the following: Attn: Mitch Aiton, City of Fort Worth Email: Mitchell.aiton (a,fortworthtexas.gov Phone: 682-715-9424 AND/OR Attn: Paul J. Padilla, Multatech Engineering, Inc. Email: ppadilla@multatech.com Phone: 817-289-2060 ADVERTISEMENT DATES July 6, 2023 July 13, 2023 END OF SECTION CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised 7/19/2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS SECTION 00 2113 INSTRUCTIONS TO BIDDERS 1. Defined Terms Page 1 of 10 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) 3.1. Bidders or their designated subcontractors are required to be prequalified for the work types requiring prequalification as per Sections 00 45 11 BIDDERS PREQUALIFICATIONS and 00 45 12 PREQUALIFICATION STATEMENT. Firms seeking pre -qualification, must submit the documentation identified in Section 00 45 11 on Section 00 45 13 PREQUALIFICATION APPLICATION at least seven (7) calendar days prior to Bid opening for review and, if qualified, acceptance. The subcontractors listed by a Bidder on 00 45 12 must be prequalified for the appropriate work types. Subcontractors must follow the same timelines as Bidders for obtaining prequalification review. Bidders or Subcontractors who are not prequalified at the time bids are opened and reviewed may cause the bid to be rejected. Prequalification requirement work types and documentation are available by accessing all required files through the City's website at: httDs://apps.fortworthtexas.2ov/Proi ectResources/ CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 2 of 10 3.1.1. Paving — Requirements document located at: httns://aDDS.fortworthtexas.2ov/Proi ectResources/ResourcesP/02%20- %20Construction%2ODocuments/Contractor%2OPreaualification/TPW%2OPavin2 %20Contractor%2OPreaualification%2OPro2ram/PREOUALIFICATION%20REO UIREMENTS%20FOR%20PAVING%2OCONTRACTORS.Ddf 3.1.2. Roadway and Pedestrian Lighting — Requirements document located at: httns://aDDs.fortworthtexas.2ov/Proi ectResources/ResourcesP/02%20- %20Construction%2ODocuments/Contractor%2OPrecivalification/TPW%2ORoadwa v%20and%2OPedestrian%2OLi2htin2%2OPre(ivalification%2OPro2ram/STREET% 20LIGHT%20PREOUAL%20REOMNTS.Ddf 3.1.3. Water and Sanitary Sewer — Requirements document located at: httr)s://aDDs.fortworthtexas.2ov/Proi ectResources/ResourcesP/02%20- %20Construction%2ODocuments/Contractor%2OPreaualification/Water%2Oand%2 OSanitarv%2OSewer%2OContractor%2OPrequalification%2OPro2ram/W S S%2wre qual%20requirements.pdf 3.2. Each Bidder, unless currently prequalified, must submit to City at least seven (7) calendar days prior to Bid opening, the documentation identified in Section 00 45 11, BIDDERS PREQUALIFICATIONS. 3.2.1. Submission of and/or questions related to prequalification should be addressed to the City contact as provided in Paragraph 6.1. 3.3. The City reserves the right to require any pre -qualified contractor who is the apparent low bidder for a project to submit such additional information as the City, in its sole discretion may require, including but not limited to manpower and equipment records, information about key personnel to be assigned to the project, and construction schedule to assist the City in evaluating and assessing the ability of the apparent low bidder to deliver a quality product and successfully complete projects for the amount bid within the stipulated time frame. Based upon the City's assessment of the submitted information, a recommendation regarding the award of a contract will be made to the City Council. Failure to submit the additional information, if requested, may be grounds for rejecting the apparent low bidder as non -responsive. Affected contractors will be notified in writing of a recommendation to the City Council. 3.4. In addition to prequalification, additional requirements for qualification may be required within various sections of the Contract Documents. 4. Examination of Bidding and Contract Documents, Other Related Data, and Site 4.1. Before submitting a Bid, each Bidder: CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 3 of 10 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. 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. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 4 of 10 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: 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. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 5 of 10 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. 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: Mitch Aiton, P.E., Department of Transportation and Public Works Email: mitchell.aiton@fortworthtexas.gov Phone: 817-392-2457 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 https://www.fortworthtexas.govldepartmentsTiinancel purchasing/hids/23-xxxx. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 6 of 10 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. 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 01 25 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: httys://codelibrary.amlegal.com/codes/ftworth/latest/ftworth tx/0-0-0-22593 CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 7 of 10 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. 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. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 8 of 10 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 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. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 9 of 10 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. 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 htti)s://www.ethics.state.tx.us/data/forms/1295/1295.i)df 17.8. Failure or refusal to comply with the requirements may result in rejection of Bid. 18. Signing of Agreement CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 100146 0021 13 INSTRUCTIONS TO BIDDERS Page 10 of 10 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 Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENT Lauren Way to US 377 Revised/Updated November 2, 2021 City Project No. 1001466 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. Form CIQ (Conflict of Interest Questionnaire) (state.tx.us) httr)s://www.ethics.state.tx.us/data/forms/conflict/CIS.r)df ❑ CIQ Form does not apply CIQ Form is on file with City Secretary ❑ CIQ Form is being provided to the City Secretary ❑ CIS Form does not apply ❑ CIS Form is on File with City Secretary ❑ CIS Form is being provided to the City Secretary BIDDER: Mm,L,d LON�I�G�t� I L •P By: Signature: Title: preoldeiv END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Arterial Roadway Improvements: Keller Hicks Revised February 24, 2020 City Project No. 100146 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: Arterial Roadway Improvements: Keller Hicks Road - Lauren Way to US 377 City Project No.: 100146 Units/Sections: Unit 1: City of Fort Worth Improvements Unit 2: City of Keller Improvements Unit 3: Traffic Signal at Keller Hicks and Katy Road 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 Arterial Roadway Improvements Keller Hicks Road Revised 9/30/2021 Lauren Way to US 377 City Project No. 100146 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. Water Distribution, Urban and Renewal, 12-inch diameter b. Asphalt Paving Construction/Reconstruction (LESS THAN 15,000 square yards) c. Concrete Paving Construction/Reconstruction (LESS THAN 15,000 square yards) d. - 4. Time of Completion 4.1. The Work will be complete for Final Acceptance within 550 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 AArterial Roadway Improvements Keller Hicks Revised 9/30/2021 Road Lauren Way to US 377 City Project No. 100146 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. 6.3. Total Bid 7. Bid Submittal This Bid is submitted on Respectfully submitted Bv: " (Signature) sue- 6'., 11111,, (Printe ame) Title: Pre-s 0&. Company:Ill"I&JAaG v 6-24]LI-v-6/N91 Address: 4 oath r V G BAN P� ire MO State of Incorporation: �C Email: SLO//L�/hGMah�Le7/t]GTr/'9 .CO/�'t Phone: GD'7 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised 9/30/2021 by the entity named below. Receipt is acknowledged of the Initial following Addenda: Addendum No. 1: Addendum No. 2: Addendum No. 3: Addendum No. 4: Corporate Seal: AArterial Roadway Improvements Keller Hicks Road Lauren Way to US 377 City Project No. 100146 OD 42 u INDPROM Al. Paw 143 SECTION 00 42 43 PROPOSALFORM UNIT PRICE BID Bidder's Application Proj"t Item Infurn atim I Bidders Proposal Bidlialteml fkunpuon $Pecir atlon I I Unit Of I Did Unit Price Did Value N. Section No. Memm Quantity (Unit 1: City of Fort Worth Improvements I I '3341.0201 21"RCP.ClasslII 1334110 LF 460 $114.991 $52895.401 I I A 3349.4104 21" SET. I Pipe 133 49 40 EA 1 $4.080.881 $4.060.881 I 1 B 3341.0205 24" RCP Class III 13341 10 LF 680 $168.81 1 $114.790.801 I 2 3341.0302 30" RCP. Class III 13341 10 LF 564 $201.881 $113.860.321 I 3 3341,0309 36" RCP. Class III 13341 10 LF 845 $228.571 $193.141.651 I 4 3341.0309 42" RCP. Class Ill 13341 10 LF 195 $294.111 $57.351.45� I 5 3349,8001 IV tvne 2 Inlet 133 49 20 EA 5 $17.541.581 $87.707.90 I 6 3137.0101 Concrete Riurao 1313700 SY 1.250 $207.791 $259.737.501 I 7 3137.0102 18" Stone Moran. Dry 1313700 SY 520 $189.801 $98.696.001 I 8 3341.1501 8x4 Box Culvert 13341 10 LF 354 $1.333.261 $471.974.041 1 9 3341.1103 4x4 Box Culvert 13341 10 LF 95 $1.055.521 $100274.401 I 9A 3 305.0204 Imported Embendment/Backfill. Crushed Rock 1330510 CY 96 $85.201 S8.179.201 1 10 3349.0001 4'Stoml Junction Box 1334910 EA 7 $13,040.341 $91282.381 I 11 3349.0002 5' Storm Junction Box 13349 10 EA 2 $14.827.601 $29,655.201 I 12 3305.0109 Trench Safetv 13305 10 LF 2.633 S1.491 $3.923.171 13 3301.0002 Post CCTV Inspection 13301 31 LF 2.633 $2.791 $7.346.071 I 14 3125.0101 SWPPP 131 25 00 LS 1 $16.608.111 $16.608.111 I 15 9999.0000 TxDOT PRI Head7vallRailing I LF 72 $210.071 $15.125.041 15A 3349.1000 Culvert A Downstream Headwall Tvpe PW-I 133 49 40 LS 1 $189.565.431 $189.565.431 I 16 3349.6001 10' Recessed Inlet 133 49 20 EA 12 $10.855.921 $130.271.041 17 3349.7001 4' Drop Inlet 133 49 20 EA 2 $13.900.871 $27.801.741 I 18 024 1. 1000 Remove Cone Pvmt 10241 15 SY 997 $20.271 $20.209.191 I 19 0241.1100 Remove Asphalt Pvmt 1024115 SY 6,848 $9.391 $64.302.721 I 20 9999.0001 Remove Gravel Drive 10241 13 SF 1.518 $1.571 $2.363.261 I 21 0241.0402 Remove Asphalt Drive 1024113 SF 3351 $3.911 $14.666.411 I 22 0241.0401 Remove Concrete Drive 1024113 SF 1.125 $14.801 $16.650.001 I 23 0241.0500 Remove Fence 10241 13 LF 398 $11.871 $4.724.261 1 24 0241.0100 Remove Sidewalk 10241 13 SF 23 $12.541 S288.421 I 25 0241.0700 Remove Mailbox 1024113 EA 1 $4,612.881 $4.612.881 1 26 3110.0102 6"-12" Tree Removal 1311000 EA 8 $1,286.791 $10.294.321 I 27 0241.3011 Remove 15" Storm Line 10241 14 LF 94 $23,671 $2.224.981 28 0241.3019 Remove 36" Storm Line 10241 14 LF 200 $31,941 $6.388.001 I 29 0241.3015 Remove 24" Storm Line 10241 14 LF 47 $28.341 $1,331.981 I 30 0241.3013 Remove 18" Storm Line 10241 14 LF 85 $25.681 $2.182.801 I 31 0241.3201 Reprove Storm Sewer Box 10241 14 LF 61 $40.741 $2.485.141 31 A 0241.4401 Remove Headwall/SET (Culvert A Upstream. Existing I Vx6' Outf till 10241 14 LS 1 $86,906.491 $86.906.491 I 32 3211.0400 Hvdrated Lime 132 11 29 TN 190 $350.271 $66.551.301 I 33 3211.0502 8" Lime Treatment 13211 29 SY 12.730 $5.111 $65.050.301 I 34 3213.0401 6" Concrete Drivewav 132 1320 SF 1855 $9.991 $38.511.451 I 35 3213.0301 4" Cone Sidewalk 132 1320 SF 14,060 $7.721 $108,543.201 1 36 3212.0304 4" Asphalt Pavement Tvpe D 132 12 16 SY 586 $48.741 $28.561.64 I 37 3213.0103 8"Cone Pvmt 132 13 13 SY %320 $91.251 $850,450.00 I 37A 9999.0000 Retaining Wall 132 13 13 SF 648 $147.671 $95.690.16 I 37B 9999.0000TxDOT Traffic Rail -TvoeT552 I LF 155 $158.201 $24.521.00 I 38 3231,0113 6' Chain Link. Steel w/Barbed Wire 13231 13 LF 556 $47.491 $26.404.44 I 38A 3231,0305 12' Gate. Steel 13231 26 EA 1 $2.968.431 $2.968.43 I 39 3213.0504 Barrier Free Ramp. Tvpe M-2 (538) 132 1320 EA 4 $2.849.691 $11,398.76 40 3213.0506 Barrier Free Ramp. Tvoe P-I (D5401 132 1320 EA 12 $2.849.691 $34A96.28 I 41 3213.0507 Barrier Free Ramo. Tvoe P-2 132 13 20 EA 8 $2.849.691 $22,797.52 I 42 3212.0302 2" Asphalt Pvmt Tvpe D 132 12 16 BY 2.069 $27.421 $56,731.98 I 43 3212.0503 6" Asphalt Base Type B 132 12 16 SY 2.198 $66.411 $145.969.18 1 43A 9999.00036" Asphalt Type B on 6" Flexbase (Temporary) 132 12 16 SY 2.800 $124.381 $348.264.00 I 44 9999.0000 Gravel Drive I SF 597 $8.831 $5,271.51 I 45 3441.3201 LED Lighting Fixture 1344120 EA 11 $771.791 $8.489.69 I 46 3441.3003 Rdwv Illum Assembly TY 18 w/33A Arms 13441 20 EA 11 $6.103.091 $67.133.99 1 47 3441.3302 Rd- Illum Foundation TY 3 1344120 EA 11 $2.612.221 $28.734.42 1 48 3441.4003 Furnish/Install Alum Sian Ground Mount City Std. 13441 30 EA 14 $753.981 $10.555.72 I 49 2605.0111 Fumish/Install Elec Sew Pedestal 126 05 00 EA 1 $10.567.611 $10.567.61 1 50 3441.1502 Ground Box Tvoe B. w/Apron 13441 10 EA 4 $1.543.581 $6A74.32 I 51 3217.0005 4" DOT Pvmt Marking HAS (W) 132 1723 LF 27 $3.561 $96.12 I 52 3217.0002 4" SLD Pvmt Marking HAS (Y) 132 1723 LF 2.514 $1.371 $3,444.18 I 53 3217.0201 8" SLD Pvnrnt Marking HAS (W) 132 1723 LF 474 $3.151 $1.493.10 I 54 3217.0202 8" SLD Pvnrnt Marking HAS Yl 132 1723 LF 7,265 $3.151 $22,884.75 I 55 3217.0501 24" SLD Pvmm Marking HAE (WI 1321723 LF 293, $49.871 $14.611.91 I 56 3217.1002 lane Legend Arrow (TxDOT Tv 11 132 1723 EA e $189.981 $1,139.88 I 57 3217.1003 Lane Legend DBL Arrow 132 1723 EA 3 $255.291 $765.87 i 58 3217.1004 Lane Legend Only (TxDOT Tv 1) 132 1723 EA 3 $189.981 $569.94 I 59 3217.2103 REFL Raised Marker TY II -A -A 1321723 EA 62 $7.721 $478.64 I 60 3441.4108 Remove/Salvaae Sign Panel and Post 13441 30 EA 13 $195.921 $2,546.96 1 61 3123.0101 Unclassified Excavation by Plan 131 23 16 CY 1.250 $51.321 $64.150.00 I 62 3311.0241 8" Water Pipe 133 11 10 LF 50 $111.371 $5,568.50 63 3311.0141 6" Water Pi 133 11 10 LF 70 $100.351 $7.024.50 I 64 331 1.0001 Ductile Iron \�ater Fittings w/ Restraint f6-inch through 12-inch pipe) 133 I l 11 TON 1 $15.741.661 $7.870.83 CITY OF FORT WOR111 STANDA IDCUMI(MMON SPI:CIFICAI ION IXXtVENTS .Mlill Roaloay Inprmmknn: R<pa Hiss RorJ. A64n1 4 R�ic29.3a/2021 Cu)traW Uo 42 43 am PROPOSAL Pal i 43 UNIT PRICE BID Iidlist Itcm No I 65 I 66 I 67 67A 67B I 67C 68 I 69 I 70 I 70A 70B I 71 I 72 73 74 75 I 76 i 77 I 78 78A 78B I 78C I 79 80 81 I 82 83 84 85 (Unit 2 - I 86 I 87 I 88 I 69 I 90 I 91 I 92 I 93 I 94 I 94A I 94B 94C I 94D I 95 96 96A I 97 I 98 98A 99 19A 99B 100 I lot 102 I 103 I 104 I 105 106 107 108 109 I 110 111 712 113 I 114 I 115 I 115A 116 I 117 I 118 SECTION 00 42 43 PROPOSALFORM Pmjnn Item Inf nnation Description 0241.1512 Salvage I" Water Meter 3312.2001 1" Water Service. Meter Reconnection 3312.2003 1" Water Service 3312.3003 8" Gate Valve 3312.2004 1" Private Service 0241.1118 4"-12" Pressure Plot, 0241.1302 Remove & Salvage 6" Water Valve 0241.1510 Salvaae Fire Hydrant 3201.0122 Temporary Asphalt Pavement - Trench Repair -Storm (all sizes) 3201,0122 Temuorrary Asphalt Pavement -Trench Repair -Waterline (12" & smaller) 3201.0122 Termorrary Asphalt Pavement -Trench Repair -Box Culvert 3305.0109 Trench Safety (Water) 3312.0001 Fire Hydrant 3312.0117 Connection to Existing 4"A 2" Water Main 3312.3002 6" Gate Valve 3292.0100 Block Sod Placement 3292.0400 Seeding Hvdmmulch 9999.0000 Tree Protection 3349.0006 Storm Drain Structure (Culvert A - Connection to Existing 10'x6' Detail) 9999.0002 Concrete Culvert Plug 0241.3001 Storm Culvert Grouting 3292.0400 Borrow by Plan 3471.0003 Tragic Control 9999.0003 Remove/Reevlace sA and Floodlights 344O 1.1409 NO 8 Inu lePe� ECo+T) 0171.0102 As -Built Survey (Storm) d 0171.0101 Construction Staking 9999.0000 Construction Allowance City of Keller Improvements Specification Section No 0241 14 33 12 10 33 12 10 33 1220 33 12 10 0441 14 0241 14 0241 14 3201 17 3201 17 3201 17 33 05 10 33 1240 33 1225 33 1220 3292 13 32 92 13 3349 10 03 30 00 0241 14 31 23 23 3471 13 26 05 33 3441 10 01 71 23 01 71 23 Unit of Measure EA EA EA EA EA EA EA EA LF LF LF LF EA EA EA SY SY EA LS CY CY CY MO EA LF LF LS LS EA Bidder's Application Bid Quantity 1 1 1 2 1 2 3 2.300 95 180 120 2 5 2 1.490 6,853 42 1 3.7 265 800 18 3 1.762 5,250 1 1 1 Bidders Proposal Unit Price Bid Valoe ' $3.368.94 $4.556.31 $3,368.94 $3.856.00 $4,556.31 $2.431.39 $867.67 $867.24 $107.08 $107.41 $107.08 $1.49 $7.929.21 $5,677.19 $2.748.43 $7.46 $2.14 $237.47 $93.231.58 $5,769.29 $264.76 $85.22 $6.611.89 $29 446.82 121.85 $2.61 $11.873.72 $59,368.59 $200,000.00 ul -Total Unit 1 $3,368.94 1 $4,556.311 $3.36&941 $7.712.001 $4.556.311 $2.431.391 $1.735.34) $2,601.721 $246.284.001 $10.203.951 $19.274.401 $178.801 $15.858.421 $28,385.951 $5.496.861 $111.115.401 $14.665.421 $9.973.74 $93,231.58 1 $21,346.37 1 $70.161.401 $68,176.00 $119,014.02 $88.340.46 $38,499.70 $13,702.50 $11.873.72 $5%368.59 $200,000.00 $5,685,582.88 0135.0101 Railroad Coordination 01 35 13 EA 1 $30,000.00 $30,000.00 0135.0102 Railroad Ft 01 01 3513 EA 1 $75,000.00 $75,000.00 3305.1102 16" Casing §y Other Than Open Cut 33 05 22 LF 110 $717.87 $78,965.70 3311.0251 8" DIP Water 3311 10 LF 110 $162.26 $17,848.60 3311.0161 6" PVC Water P�e 3311 12 LF A$213.26 $2,132.60 3311.0261 8" PVC Water Pipe 33 11 12 LF 467 $114.73 $53,578.91 3312.3003 8" Gate Valve 33 12 20 EA 4 $4,586.59 $18,346.36 3312.3002 6" Gate Valve 33 12 20 EA 1 $2,748.43 $2,748.43 3312.0001 Fire Hydrant 33 12 40 EA 1 $8,001.53 $8,001.53 0241.1302 Remove and Salvage 6" Water Valve 0241 14 EA 1 $866.38 $866.38 0241.1303 Remove and Salvage 8" Water Valve 0241 14 EA 1 $866.38 $866.38 0241.1610 Salvage Fire Hydrant 0241 14 EA 1 $666.36 $866.38 3305.0116 Concrete Encasement for Will Pipes 33 05 10 CY 2 $751.19 $1,502.38 3312.0117 Connection to Existing 4"-12' ater Main 33 12 25 EA 5 $2,261.03 $11.305.15 3201.0122 Temporrary Asphalt Pavement -Trench Repair -Waterline (Keller Detail) 3201 17 LF 60 $107.08 $6,424.80 9999.0000 Permanent Asphalt Pavement - Trench Repair -Waterline (Keller Detail) 3201 17 LF 207 $104.46 $21,623.22 3349.9002 TxT Grate Inlet 33 12 60 EA 1 $10,153.17 $10.163.17 3341.0103 18" RCP, Class 111 3341 10 LF 80 $109.56 $8,764.80 9999.000 Clean existing 18" CMP and Grates 3341 10 LS 1 $6,077.02 $6,077.02 3341.0302 30" RCP, Class III 3341 10 LF 88 $201.66 $17,763.68 3349.4107 30" SET, 1 Pie 33 49 40 EA 2 $6,284.26. $12,568.52 9999.0000 Erosion Control Mat-Flexamat 31 37 00 BY 96 $59.31 $5,343.30 0241.3013 Remove 18" Storm Line 0241 14 LF 86 $25.68 $2,182.80 0241.3017 Remove 30" Storm Line 0241 14 LF 50 $31.94 $1,597.00 3305.0109 Trench Safety 330510 LF log $1.49 $156.45 0241.1100 Remove Asphalt Pvmt 0241 15 BY 2154 $3.91 $8.422.14 0241.1000 Remove Conc Pvmt 0241 15 SY 96 $20.28 $1,946.88 0241.0402 Remove Asphalt Drive 0241 13 SF 866 $3.91 $3,362.60 3123.0103 Borrow by Plan 31 23 23 CY 1200 $85.21 $102,252.00 3211.0400 Hydrated Lime 3211 29 TN 11 $350.27 $5,954.59 3211.0502 8" Lime Treatment 32 11 29 BY 1,105 $5.12 $5,657.60 3213.0401 6" Concrete Driveway 32 13 20 SF 2846 $10.16 $28,915.36 3213.0301 4" Conc Sidewalk 32 1320 SF 636 $4.75 $2,992.50 3212.0302 2" Asphalt Pvmt Tiype D 32 12 16 SY 72 $27.42 $1,974.24 3212.0503 6" Asphalt Base Type B 32 12 16 SY 71 $66.41 $5,113.57 3213.0103 8" Conc Pvmt 32 13 13 BY 671 $112.83 $75,708.93 3231.0113 6' Chain Link, Steel w/Barbed Wire 3231 13 LF 234 $47.49 $11,112.66 99999.0Q0Q00 Wall 32 32 13 SF 1226 $145A5 $177,885.35 1�41.32010 TRje�taiiniingg zture Type T552 LF 203 $32,712.21 L�� Li��hl'ng Falfic 34 41 20 EA $778.709 52,315.37 3441.3003 RdyyAN' IIIum Assembly TY 18 w/33A Arms 34 41 20 EA 3 $6,103.09 $18,309.27 �441.3302 Rdwy Ilium Foundation TY 3 34 41 20 EA 3 $2,612.22 $7.836.66 cny of FORT N'ORlli STMD,Ml C'ONTMETC71M SPIXIFICATIOV DOCLNIEx*18 I4+isal9/3arr0rl ANrria112oad++aY Inynoaementr xell.r I{„{x Read ,WJmdw+� CM1y Pmj 1\o IUOIiG ea 42 43 DID PROI`OSAI. Nv3oft SECTION 00 42 43 PROPOSALFORM UNIT PRICE BID Bidder's Application Pr jest Item Infrnmation Bidders Proposal II32dlist ]tem Description Specification Unit of Bid Unit Price Bid Value No Section No. Measure Quantity 1 119 3441.4003 Fumish/Install Alum Sign Ground Mount City Sid. 34 41 30 EA 11 $753.98 $8,293.78 1 120 3441.1502 Ground Box Tye B, w/Amon 3441 10 FA 2. $1,543.59 $3,087.18 1 121 2605.0111 Fumish/instalf �l I. Sery Pedestal 26 05 00 EA 2 $10,567.61 $21,135.22 1 122 3441.4108 Remove/Salvage Sign Panel and Post 3441 30 EA 5, $195.92 $979.60 1 123 3471.0001 Traffic Control 3471 13 MO 1 $8,243.55 $8,243.55 124 3217.0005 4" DOT Pvmt Marking HAS �(% 32 17 23 LF 4 $3.56 $14.24 1 125 321T0501 24" SLD Pvmnt Me IT AM (N� 32 17 23 LF 290 $49.87 $14,462.30 1 126 3217.0201 8" SLD Pvmnl Madcing AS ( 32 17 23 LF 50 $3.15 $157.50 l 127 3217.0202 8" SLD Pvmnl MarkingQ HASP 32 17 23 LF 92 $3.15 $289.80 1 128 3217.1002 Lane Legend Arrow (YxDOT Ty 1) 32 17 23 EA (, $189.98 $189.98 1 129 3217.1003 Lane Legend DBL Arrow 32 17 23 FA ( $255.21!1 $255.29 130 3217.1004 Lane Legend Only (TxDOT Ty 0 32 17 23 EA f $189.96 $189.98 131 3217.1001 Lane Legend RR 32 17 23 EA 2 $2,077.90 $4.155.80 132 3292.0100 Block Sod Placement 32 92 13 SY 221 $7.46 $1,648.66 133 3292.0400 Seeding Hydromulch 32 92 13 SY 1077 $2.14 $2,304.78 134 9999,0000 Metal Beam Guard Fence (SGT-STL Post)- SGT (8) HB-03A - TxDOT TxDOT LF 85 $99.89 $8,490.65 135 2605.3015 2" CONDT PVC SCH 80 T) 26 05 33 LF 299 $21.86 $6,533.15 1 136 3441.1409 NO 8Insulated Elec Condr 3441 10 LF 903 $2.61 $2,356.83 1 137 0171.0102 As -Built Survey (Storm) 01 71 23 LS 1 $11,873.72 $11,873.72 1 138 0171.0101 Construction Stakine 0171 23 LS 1 $59,368.59 $59,368.59 Sub -Total Unit 2 - $1,041,186.09 Unit 3 - Traffic Signal at Keller Hicks and Katy Road 1 139 2605.3014 2" CONDT RM (Riser) 26 05 33 LF 16Q $53.43 $8,014.50 1 140 2605.3015 2" COt�DT PVC SCH 80 (� 26 05 33 LF 726 $21.85 $15,841.25 141 2605.3021 3" CO DT PVC SCH 40 ( 26 05 33 LF 386 $29.6 � $11.278.40 142 2605.3031 4" CONDT PVC SCH 40 (T� 26 05 33 LF 190 $44.53J $8,460.70 1 143 3441.1001 Fumish Install 3-Sect Signa Head Assembly 3441 10 EA 8 $1,804.8� $14,438.48 1 144 3441.1002 Fumish/Instali 4-Sect Signal Head Assembly 3441 10 EA 4 $2,291.63 $9,166.62 1 145 3441.1012 Furnish/Install Ped Signal Head Assmbly 3441 10 EA 4 $1, 181A $4.725.76 1 146 3441.1031 Furnish/Install Audible Pedestrian Pushbutton Station 3441 10 FA 4 $3,039.6 $12,158.68 1 147 3441.1205 Furnish/Install VIVDS Detection Device 3441 10 EA 4 $10,092.66J $40,370.64 1 148 3441.1209 Furnish/Install BBU System EXT Mounted 3441 10 EA 1 $11,826.2¢2 $11,826.22 149 3441.1215 Furnish/Install HyQrid Detection Device let 3441 10 EA 4 $11,428.4�! $45,713.80 150 344,.1220 Fumish/Inslall N(o 711 Preemption Detector 3441 10 FA 4. $2,956.56 $11.826.24 1 151 3441.1224 Furnish/install Preemption Cable 3441 10 LF 346 $2.79 $948.60 1 152 3441.1310 4/C 14 AWG Multi -Conductor Cable 3441 10 LF 290 $2.9 $861.30 1 153 3441.1311 5/C 14 AWG Multi -Conductor Cable 3441 10 LF 175. $3.27 $572.25 1 154 3441.1315 20/C 14 AWG Multi -Conductor Cable 3441 10 LF 386 $13.65 $5,265.25 1 155 3441.1408 NO 6 Insulated Elec Condr-Black 3441 10 LF 179 $3.5 J $612.50 1 156 3441.1408 NO 6 Insulated Elec Condr-White 3441 10 LF 176 $3.5 $612.50 1 157 3441.1413 NO 6 Bare Elec Condr SLD 3441 10 LF 175 $3.09 $540.75 1 158 3441,1414 NO 8 Bare Elec Condr 3441 10 LF 1250 $2.37 $2.962.50 1 159 3441.1415 NO 10 Bare Elec Condr-Black 3441 10 LF 670 $1.60 $1,072.00 1 160 3441.1415 NO 10 Bare Elec Condr-Green 3441 10 LF 670 $1.60 $1,072.00 1 161 3441.1415 NO 10 Bare Elec Condr-White 3441 10 LF 670 $1.60 $1,072.00 162 3441.1502 Furnish/Install Ground Box Type B, w/Apron 3441 10 FA 3 $1,543.5�JJ $4,630.74 163 3441.1503 Fumish/Install Ground Box Tyne D, w/A 3441 10 EA 6 $2,208.51� $13,251.06 1 164 3441.1603 ,ron Fumish/Install 1O' - 20' Ped Pole Assmbly 3441 10 FA 2 $2,463.80J $4.927.60 1 165 3441.1617 Install Signal Pole (Type 41, 43, 45) 3441 10 FA 4 $17,216.8 $68,867.66 166 3441.1623 Fumish/Insta11 Mast Arm 16' - 36' 3441 10 EA 4 $9.261.60 $37.046.00 167 3441.1701 TY 1 Signal Foundation 3441 10 FA 2 $2,042.28 $4,084.56 168 3441.1703 net TY 3 Si net Foundation 3441 10 EA 4 $6,874.88 $27,499.52 1 169 3441.1715 Signal Foundation - 352i & BBU 3541 10 FA 1 $8,192.86 $8,192-86 1 170 3441,1725 Fumish/install ATC Signal Controller 35 41 10 FA 1 $7,717.92 $7,717.92 171 3441.1741 Furnish/Install 352i Controller Cabinet Assembly 344110 FA 1 $76,348.00 $76,348.00 172 3441.1771 Fumish/Install 120-240 Volt Single Phase Metered Pedestal 3441 10 EA f $10,567.6f $10,567.61 173 3305.0103 E,3{oloj,� Utilities 33 05 30 $1 484.2� $1 484 21 1 174 9999.0000 �ry, CTION CIABLE ���LIg f5 NF LLS F 341 $3,835.20 Sub -Total Unit 3 - $477,855.68 Bid Summary Unit 1: City of Fort Worth Improvements $5,685,582.88 Unit 2 - City of Keller Improvements $1,041,186.09 Unit 3 - Traffic Signal at Keller Hicks and Katy Road $477,855.68 ' TOTAL BASE BID $7,204,624.65 I END OF SECTION CFIY OF FORT WORTH STANDMD CDNMRVt TIONSPECIFICATION DOCL o=Nis tt.,iu19/302021 Aum.l R,od„ay ImFvu,nm.as; A<11x H"As Rated-ASssndum 4 C,t31h 1M N. 10n146 SECTION 00 43 13 BID BOND KNOW ALL BY THESE PRESENTS: 00 43 13 BID BOND Page 1 of 2 That we, McMahon Contracting. LP , known as "Bidder" herein and Westfield 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 CPN 100146 Arterial Roadway Improvements Keller Hicks Road 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 IOth day of August , 2023. PRINCIPAL: McMahon Contracting, LP BY: Signa re ATTEST 5 Witness as to Principal Name and Title CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Arterial Roadway Improvements: Keller Hicks Road Revised 9/3012021 City Project No. 100146 0oult,4L", M� Wltn S a t0 Surety JessicaAlmaguer, ren[ServiceSpecialist Attach Power of Attorney (Surety) for Attorney -in -Fact Address: 3019 Roy Orr Blvd Grand Prairie, TX 75050 SURETY: Westfield Insurance Company BY: Sign�gro-�(AJU Jade Porter, Attorney -in -Fact Name and Title Address: 2255 Ridge Road, Suite 333 Rockwall. TX 75087 Telephone Number: (972) 772-7220 00 43 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 SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Arterial Roadway Improvements: Keller Hicks Road Revised 9/30/2021 City Project No. 100146 THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME POWER # AND ISSUED PRIOR TO 05125/22, FOR ANY PERSON OR PERSONS NAMED BELOW. General POWER NO. 4220012 14 Power Westfield Insurance Co. of Attorney Westfield National Insurance Co. CERTIFIED COPY Ohio Farmers Insurance Co. Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as "Companies,' duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these presents make, constitute and appoint TONY FIERRO, JOHNNY MOSS, JAY JORDAN, MISTIE BECK, JEREMY BARNETT, JADE PORTER, ROBERT G. KANUTH, JARRETT WILLSON, JACK NOTTINGHAM, BRADY WILSON, BRENNAN WILLIAMSON, JOINTLY OR SEVERALLY of ROCKWALL and State of TX its true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship in any penal limit. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-i n- Fact may do in the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: "Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney -in -Fact. may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary." "Be it Further Resolved, that the signature of any such designated person and the seat of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting held on February 8, 2000). In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto affixed this 25th day of MAY A.D., 2022 . ,,y1,\11141NI,, „l1\I I1111 r1r 1, , 11f/!/I Corporate p\agyR, A "- P��oN�(��•l, \�SUp�"', WESTFIELD INSURANCE COMPANY seals+Q ,.•• • •• •.,tip.''"' °t ' ,� WESTFIELD NATIONAL INSURANCE COMPANY Affixed •� a'- ,' o:' P? ' �^ OHIO FARMERS INSURANCE COMPANY '[c: S 9" -t� i i-41:3= co �i''•.ti .� frr � , j ; z E' p ' =s � 848 ,4'Ng11 m*\,,,{•`•\',;` %'Inil.l,u+11 "''`•` B ,! State of Ohio y: County of Medina ss.: Gary Wftumper, Nationarsurety Leader and Senior Executive On this 25th day of MAY A.D., 2022 , before me personally came Gary W. Stumper to me known, who, being by me duly sworn, did depose and say, that he resides in Medina, OH; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order. Notarial Seal Affixed MCP' �`��% 'St�`�'• State of Ohio r 411►,1io David A. Kotnik, Attorney at Law, Notary Public County of Medina ss.: y ��. My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code) TE O F O I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; and furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this loth day of August A.D., 2023 „M111111411lI1, \\{1lr rll„l, , Ir II i111/II/, r•'agus�,trr'' . '�inNALiN'•I \NSUq,�,'. TETr loot SEAL J tg : a . SEAL Im Q a s � x�A ,A_. A- l Secretary sFrank A. Carrino, Secretary BPOAC2 (combined) (03-22) IMPORTANT NOTICE STATE OF TEXAS COMPLAINT PROCEDURES 1. IMPORTANT NOTICE To obtain information or make a complaint: 2. You may contact your agent. 3. You may call Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company's toll -free telephone number for information or to make a complaint at: 1-800-243-0210 4. You may also write to Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company at: Attn: Bond Claims One Park Circle P O Box 5001 Westfield Center, OH 44251-5001 Fax #330-887-0840 5. You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 6. You may write to the Texas Department of Insurance, Consumer Protection Section (MC 111-1A): P.O. Box 149091 Austin, TX 78714-9091 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: ConsumerProtection(a.tdi.texas. aov 7. PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the agent, Westfield Insurance Company, Westfield National Insurance Company, or Ohio Farmers Insurance Company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. 8. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. BD5430 (06-15) AVISO IMPORTANTE Para obtener informacion o para someter una queja: Puede comunicarse con su (title) al (telephone number). Usted puede Ilamar al numero de telefono gratis de Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company's para informacion o para someter una queja al: 1-800-243-0210 Usted tambien puede escribir a Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company: Attn: Bond Claims One Park Circle P O Box 5001 Westfield Center, OH 44251-5001 Fax #330-887-0840 Puede comunicarse con el Departamento de Sequros de Texas para obtener informacion acerca de companies, coberturas, derechos o quejas al: 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas, Consumer Protection Section (MC 111-1A): P.O. Box 149091 Austin, TX 78714-9091 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: ConsurnerProtection(a)tdi.texas.gov DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiene una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente, Westfield Insurance Company, Westfield National Insurance Company, o Ohio Farmers Insurance Company primero. Si no se resuelve 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 adjunto. 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 , our principal place of business, are required to be percent lower than resident bidders by State Law. A copy of the statute is attached. Nonresident bidders in the State of our principal place of business, are not required to underbid resident bidders. B. The principal place of business of r company or our parent company or majority owner is in the State of Texas. BIDDER: Mc M64AI 6VLVA( P By: �co� l��M J'Al, S �—(mature) Title: Pry Date: 6/( 01Z�3 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Arterial Roadway Improvements: Keller Hicks Road Revised 9/30/2021 City Project No. 100146 0045 11 -1 BIDDERS PREQUALIFICATIONS Pagel of 3 1 SECTION00 4511 2 BIDDERS PREQUALIFICATIONS 4 1. Summary. A Bidder or their designated subcontractors are required to be prequalifled or 5 have applied for prequalification by the City for the work types requiring prequalification 6 prior to submitting bids. To be considered for award of contract the Bidder must submit 7 Section 00 45 12, PREQUALIFICATION STATEMENT for the work type(s) listed with 8 their Bid. Any contractor or subcontractor who is not prequalifled for the work type(s) listed 9 must submit Section 00 45 13, PREQUALIFICATION APPLICATION in accordance with 10 the requirements below. The information must be submitted seven (7) days prior to the 11 date of the opening of bids. Subcontractors must follow the same timelines as contractors 12 for obtaining prequalification review. Bidders or Subcontractors who are not prequalifled at 13 the time bids are opened and reviewed may cause the bid to be rejected. 14 15 16 The prequalification process will establish a bid limit based on a technical evaluation and 17 financial analysis of the contractor. For example, a contractor wishing to submit bids on 18 projects to be opened on the 7th of April must file the information by the 31 st day of March 19 in order to eligible to work on these projects. In order to facilitate the approval of a Bidder's 20 Prequalification Application, the following must accompany the submission. 21 a. A complete set of audited or reviewed financial statements. 22 (1) Classified Balance Sheet 23 (2) Income Statement 24 (3) Statement of Cash Flows 25 (4) Statement of Retained Earnings 26 (5) Notes to the Financial Statements, if any 27 b. A certified copy of the firm's organizational documents (Corporate Charter, Articles 28 of Incorporation, Articles of Organization, Certificate of Formation, LLC 29 Regulations, and Certificate of Limited Partnership Agreement). 30 c. A completed Bidder Prequalification Application. 31 (1) The firm's Texas Taxpayer Identification Number as issued by the Texas 32 Comptroller of Public Accounts. To obtain a Texas Taxpayer Identification 33 number visit the Texas Comptroller of Public Accounts online at the 34 following web address www.window.state.tx.us/taxDermit/ and fill out the 35 application to apply for your Texas tax ID. 36 (2) The firm's e-mail address and fax number. 37 (3) The firm's DUNS number as issued by Dun & Bradstreet. This number 38 is used by the City for required reporting on Federal Aid projects. The DUNS 39 number may be obtained at www.dnb.com. 40 d. Resumes reflecting the construction experience of the principles of the firm for firms 41 submitting their initial prequalification. These resumes should include the size and 42 scope of the work performed. 43 e. Other information as requested by the City. 44 45 2. Prequalification Requirements 46 a. Financial Statements. Financial statement submission must be provided in 47 accordance with the following: 48 (1) The City requires that the original Financial Statement or a certified copy 49 be submitted for consideration. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised August 13, 2021 City Project No. 100146 0045 11 -2 BIDDERS PREQUALIFICATIONS Page 2 of 3 1 (2) To be satisfactory, the financial statements must be audited or reviewed 2 by an independent, certified public accounting firm registered and in 3 good standing in any state. Current Texas statues also require that 4 accounting firms performing audits or reviews on business entities within 5 the State of Texas be properly licensed or registered with the Texas State 6 Board of Public Accountancy. 7 (3) The accounting firm should state in the audit report or review whether 8 the contractor is an individual, corporation, or limited liability company. 9 (4) Financial Statements must be presented in U.S. dollars at the current rate 10 of exchange of the Balance Sheet date. 11 (5) The City will not recognize any certified public accountant as 12 independent who is not, in fact, independent. 13 (6) The accountant's opinion on the financial statements of the contracting 14 company should state that the audit or review has been conducted in 15 accordance with auditing standards generally accepted in the United 16 States of America. This must be stated in the accounting firm's opinion. 17 It should: (1) express an unqualified opinion, or (2) express a qualified 18 opinion on the statements taken as a whole. 19 (7) The City reserves the right to require a new statement at any time. 20 (8) The financial statement must be prepared as of the last day of any month, 21 not more than one year old and must be on file with the City 16 months 22 thereafter, in accordance with Paragraph 1. 23 (9) The City will determine a contractor's bidding capacity for the purposes 24 of awarding contracts. Bidding capacity is determined by multiplying the 25 positive net working capital (working capital = current assets — current 26 liabilities) by a factor of 10. Only those statements reflecting a positive 27 net working capital position will be considered satisfactory for 28 prequalification purposes. 29 (10) In the case that a bidding date falls within the time a new financial 30 statement is being prepared, the previous statement shall be updated with 31 proper verification. 32 b. Bidder Prequalification Application. A Bidder Prequalification Application must be 33 submitted along with audited or reviewed financial statements by firms wishing to be 34 eligible to bid on all classes of construction and maintenance projects. Incomplete 35 Applications will be rejected. 36 (1) In those schedules where there is nothing to report, the notation of 37 "None" or "N/A" should be inserted. 38 (2) A minimum of five (5) references of related work must be provided. 39 (3) Submission of an equipment schedule which indicates equipment under 40 the control of the Contractor and which is related to the type of work for 41 which the Contactor is seeking prequalification. The schedule must 42 include the manufacturer, model and general common description of 43 each piece of equipment. Abbreviations or means of describing 44 equipment other than provided above will not be accepted. 45 46 3. Eligibility for Award of Contract 47 a. The City shall be the sole judge as to a contractor's prequalification. 48 b. The City may reject, suspend, or modify any prequalification for failure by the 49 contractor to demonstrate acceptable financial ability or performance. 50 c. The City will issue a letter as to the status of the prequalification approval. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised August 13, 2021 City Project No. 100146 0045 11 -3 BIDDERS PREQUALIFICATIONS Page 3 of 3 I d. If a contractor has a valid prequalification letter, the contractor will be eligible to 2 perform the prequalified work types until the expiration date stated in the letter. 3 8 END OF SECTION CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised August 13, 2021 City Project No. 100146 CO 45 12 PREQUALIFICATI )N STATFMENT 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 Type Water Distribution, Urban and Renewal, 12-inch diameter Asphalt Paving Construction/Reconstruction (LESS THAN 15,000 square yards) Concrete Paving Construction/Reconstruction (LESS THAN 15,000 square yards) Contractor/Subcontractor Company Name I Roadway and Pedestrian Lighting ! E Afflc_ Prequalification Expiration Date �f /30/Z`{ The undersigned hereby certifies that the contractors and/or subcontractors described in the table above are currently prequalified for the work types listed. BIDDER: ',' & �' C. �l'`QG f,/'� j I P J 1 0 zaq ,Dy 41-r 4 ('Sd 0 W75ND END OF SECTION By: jlPJ!! CA) (Signature) Title: 0 f&X U� Date: 9 / 'O/Z� CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Arterial Roadway Improvements: Keller Hicks Road -Addendum Revised 09/30/2021 City Project No. 1OD146 FoRTWOR�THw May 22, 2023 Ms Shelley McMahon MC Mahon Contracting LP 3019 ROY ORR BLVD Grand Praire, TX 75050 PREQUALIFICATION TO BID CITY OF FORT WORTH WATER DEPARTMENT PROJECTS Dear Ms. Mcmahon: Thank you for your submittal of information and data toward prequalification to perform our work. We are pleased to advise that your prequalification has been finalized. A bid limit $74,566,360.00 has been established for your organization based on the financial data submitted. Your firm is prequalified to perform the following work: -- Wastewater Mains (all sizes) for New Development, Rehabilitation, and Redevelopment using Open Cut construction methods -- Water Mains (all sizes) for New Development, Rehabilitation, and Redevelopment using Open Cut construction methods The prequalification and bid limit established above will remain current through 4/30/2024 This date was established to be sixteen (16) months from the date of the most recent financial statement received, unless rescinded for cause. Should you desire prequalification in the future beyond the aforementioned, submittal of updated financials, work experience, and equipment list will be necessary for this department to establish a new bid limit. Please be advised that the plans and documents for the work to be performed must be submitted to and approved by the City of Fort Worth Water Department. We appreciate your interest in our work and should you have some question in this or other matters within our purview, please do not hesitate to contact Mr. John Kasavich at (817)392-8480 or Norma Sauceda at (817)392- 6055. Yours very truly, MAIL TO: John Kasavich, P.E. Fort Worth Water Department Engineering & Regulatory Services To Chris Harder, P.E. 200 Texas Street Water Director Fort Worth, TX 76102 Fort Worth SJLA --- awvnenracar WATER DEPARTMENT �.' THE CITY OP FORT WORTH * 200 TEXAS STREET * FORT WORTH, TEXAS 76102 817-392-8240 * FAX 817-392-8195 1964 •1993.2011 L.r Prl+tled on recycled paper FORT WORTHa October 17, 2022 Peachtree Construction, Ltd. 5801 Park Vista Cir Keller, Texas 76244 Attn: J. Barry Clark RE: PREQUALIFICATION FOR PAVING PROJECTS City of Fort Worth Dear Mr. Clark The City of Fort Worth Department of Transportation and Public Works has reviewed the material that you submitted for prequalification renewal to perform street paving in the City of Fort Worth. This letter is to advise you that Peachtree Construction, Ltd has been deemed qualified to bid upon and perform the following type(s) of street paving improvements: ASPHALT PAVEMENT HEAVY MAINTENANCE- NO LIMIT ASPHALT PAVEMENT CONSTRUCTION/RECONSTRUCTION - NO LIMIT This prequalification is effective October 1, 2022 and your project bid limit is $103,959,910.00 based upon the submitted financial statement. It shall remain in place for two (2) years as long as you remain in good standing with the City of Fort Worth. Prior to the end of the two years, you will be required to submit an updated financial statement for prequalification renewal consideration in accordance with the City specifications. In the interim, if you have any questions or comments, please do not hesitate to contact me. Sincerely, Edgar J. Garcia Construction Manager Transportation & Public Works Dept. Cc: file FORTWORTH. McMahon Contracting L.P. 3019 Roy Orr Blvd. Grand Prairie, Texas 75050 Attn: Shelly McMahon RE: PREQUALIFICATION FOR PAVING PROJECTS City of Fort Worth Dear Ms. McMahon, The City of Fort Worth Department of Transportation and Public Works has reviewed the material that you submitted for prequalification renewal to perform street paving in the City of Fort Worth. This letter is to advise you that McMahon Contracting L.P. has been deemed qualified to bid upon and perform the following type(s) of street paving improvements: Concrete Paving Construction/Reconstruction (Unlimited SY) Asphalt Paving Construction/Reconstruction (Unlimited SY) This pre -qualification is effective June 30, 2023 and your project bid limit is $74,566,360.00 based upon the submitted financial statement. It shall remain in place for two (2) years as long as you remain in good standing with the City of Fort Worth. Prior to the end of the two years you will be required to submit an additional financial statement for pre -qualification renewal consideration in accordance with City specifications. In the interim, if you have any questions or comments please do not hesitate to contact me. Sin1 , cG- Edg Garci Construction Manager Capital Delivery Division TPW City of Fort Worth Edcar. Garcia Rwfortworthtexas.cov 682-329-7133 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 00 45 26 - 1 CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW Page 1 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. 100146. 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. CONTRACT/OR: By: ��oTT C�tIN Company' lease Print) ,3j4 Signature: ~� Address ,q&J & "r, 7-50N-6 City/State ip THE STATE OF TEXAS § COUNTY OFTARRANT § Title: Plle.!C;444� (Please Print) BFFOIWEfihe undersigned authority, on this day personally appeared ���� , known to me to be the person whose name is subscribed to the fore oing instrumept, and ackno ledged to me that he/she executed the same as the act and deed of � d a l t4Pfor the purposes and consideration therein expressed and in the capacity tIVIin stated. qqn�" HAND AND SEAL OF OFFICE this , C� day of , 203 \oYP/// YESENIAGONZALES A Notary Public, State of Texas Comm. Expires 02-12-2026 tary Public in and for t tate of Texas Notary ID 129582593 END OF SECTION CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 Arterial Roadway Improvements- Keller Hicks Road City Project No. 100146 00 45 40 - 1 Business Equity Goal Page 1 of 2 1 PART 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 13% 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 httl)s://aDl)s.fortworthtexas.2ov/ProjectResources/ResourcesP/60%20- 46 %20MWBE/Business%20Ecluity%20Utilization%20Form DVIN%202022%20220324.Ddf 47 - - 48 Letter of Intent CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised October 27, 2021 City Project No. 100146 004540-2 Business Equity Goal Page 2 of 2 1 httDs://anus.fortworthtexas.2ov/ProiectResources/ResourcesP/60%20- 2 %20MWBE/Letter%20of%20Intent DVIN%202021.1)df 3 4 Business Equity Good Faith Effort Form 5 httns://anus.fortworthtexas.2ov/ProiectResources/ResourcesP/60%20- 6 %20MWBE/Good%20Faith%20Effort%20Form DVIN%202022.1)df 7 8 Business Equity Prime Contractor Waiver Form 9 httl)s:Hanus.fortworthtexas.2ov/ProiectResources/ResourcesP/60%20- 10%20MWBE/MWBE%20Prime%20Contractor%20Waiver-220313.Ddf 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/Proi ectResources/ResourcesP/60%20- %20MWBE/MWBE%20Joint%20Venture 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 Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised October 27, 2021 City Project No. 100146 00 52 43 - 1 Agreement Page 1 of 6 SECTION 00 52 43 AGREEMENT THIS AGREEMENT, authorized on 10/17/2023 , 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 McMahan Contracting, L.P. , 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: Arterial Roadway Improvements- Keller Hicks Road City Proiect No. 100146 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 Seven Million Two Hundred and Four Thousand Six Hundred and Twenty Four and 65/100 Dollars ($7,204,624.65). 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 550 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 One Thousand Two Hundred Fifty And 00/100 Dollars ($1,250.00) 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 Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised 8/22/2022 City Project No. 100146 00 52 43 - 2 Agreement Page 2 of 6 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 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 damaLyes being sought were caused, in whole or in Dart, by anv act, omission or negligence of the citv. This indemnity provision is intended to include, without limitation, indemnity for costs, expenses and legal fees incurred by the city in defending against such claims and causes of actions. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised 8/22/2022 City Project No. 100146 00 52 43 - 3 Agreement Page 3 of 6 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 urovision 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. 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. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised 8/22/2022 City Project No. 100146 00 52 43 - 4 Agreement Page 4 of 6 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. 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 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised 8/22/2022 Arterial Roadway Improvements Keller Hicks Road Lauren Way to US 377 City Project No. 100146 00 52 43 - 5 Agreement Page 5 of 6 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 STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised 8/22/2022 Arterial Roadway Improvements Keller Hicks Road Lauren Way to US 377 City Project No. 100146 005243-6 Agreement Page 6 of 6 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: By: �CB�( Scott Cummings (Nov 28, 202 12:02 CST) Signature Scott Cummings (Printed Name) Scott Cummings Title President Address Grand Prairie, City/State/Zip Date Texas, 75050 Nov 28, 2023 City of Fort Worth By. William Johnson (D c 11, 202316:45 CST) William Johnson Assistant City Manager Dec 11, 2023 Date FORonTq4aa Attest: �T'"'- aa4p oEXA?o4o I`I Jannette Goodall, City Secretary (Seal) M&C: 23-0886 Date: 10/17/2023 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. 4 24airyv Mitch Aiton (Nov 28, 202312:11 CST) Mitch Aiton, PE Senior Professional Engineer Approved as to Form and Legality: lj� DBlack (Dec 11, 2023 16:44 CST) Douglas W. Black Sr. Assistant City Attorney APPROVAL RECOMMENDED: Lauren Prieur (Dec 11, 202310:00 CST) Lauren Prieur, Director, Transportation and Public Works OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX CITY OF FORT WORTH Ancrial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised 8/22/2022 City Project No. 100146 IMPORTANT NOTICE STATE OF TEXAS COMPLAINT PROCEDURES 1. IMPORTANT NOTICE To obtain information or make a complaint: 2. You may contact your agent. 3. You may call Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company's toll -free telephone number for information or to make a complaint at: 1-800-243-0210 4. You may also write to Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company at: Attn: Bond Claims One Park Circle P O Box 5001 Westfield Center, Oil 44251-5001 Fax #330-887-0840 5. You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 6. You may write to the Texas Department of Insurance, Consumer Protection Section (MC 111-1A): P.O. Box 149091 Austin, TX 78714-9091 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: Con sumerProtection &tdi.texas.aov 7. PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the agent, Westfield Insurance Company, Westfield National Insurance Company, or Ohio Farmers Insurance Company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. 8. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. BD5430 (06-15) AVISO IMPORTANTE Para obtener informacion o para someter una queja: Puede comunicarse con su (title) al (telephone number). Usted puede Ilamar al numero de telefono gratis de Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company's para information o para someter una queja al: 1-800-243-0210 Usted tambien puede escribir a Westfield Insurance Company, Westfield National Insurance Company, and/or Ohio Farmers Insurance Company: Attn: Bond Claims One Park Circle P O Box 5001 Westfield Center, OH 44251-5001 Fax #330-887-0840 Puede comunicarse con el Departamento de Sequros de Texas para obtener information acerca de companies, coberturas, derechos o quejas al: 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas, Consumer Protection Section (MC 111-1A): P.O. Box 149091 Austin, TX 78714-9091 Fax: (512) 490-1007 Web: www.tdi.texas.gov E-mail: Consume rProtection etd i.texas.ciov DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiene una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente, Westfield Insurance Company, Westfield National Insurance Company, o Ohio Farmers Insurance Company primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI). UNA ESTE "ISO A SU POLIZA: Este aviso es solo para proposito de information y no se convierte en parte o condition del documento adjunto. 1 2 3 4 5 6 7 SECTION 00 61 13 PERFORMANCE BOND 006113-1 PERFORMANCE BOND Page 1 of2 #355373N THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF TARRANT § That we, McMahon Contracting, LP known as 8 "Principal" herein and Westfield insurance Company , a corporate 9 surety(sureties, if more than one) duly authorized to do business in the State of Texas, known as 10 "Surety" herein (whether one or more), are held and firmly bound unto the City of Fort Worth, a 11 municipal corporation created pursuant to the laws of Texas, known as "City" herein, in the penal 12 SUM of, Seven Million Two Hundred Four Thousand Six Hundred Twenty Four and 651100 Dollars 13 ($ 7,204,624.65 ), lawful money of the United States, to be paid in Fort Worth, 14 Tarrant County, Texas for the payment of which sum well and truly to be made, we bind 15 ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, 16 firmly by these presents. 17 WHEREAS, the Principal has entered into a certain written contract with the City 18 awarded the 1 7th day of October 20 23 , which Contract is hereby referred to and 19 made a part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment 20 labor and other accessories defined by law, in the prosecution of the Work, including any Change 21 Orders, as provided for in said Contract designated as Arterial Roadway Improvements- Keller ZD 22 Hicks Road, City Project No. 100146. 23 NOW, THEREFORE, the condition of this obligation is such that if the said Principal 24 shall faithfully perform it obligations under the Contract and shall in all respects duly and 25 faithfully perform the Work, including Change Orders, under the Contract, according to the plans, 26 specifications, and contract documents therein referred to, and as well during any period of 27 extension of the Contract that may be granted on the part of the City, then this obligation shall be 28 and become null and void, otherwise to remain in full force and effect. 29 PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in 30 Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort 31 Worth Division. CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised July 1, 2011 City Project No. 100146 0061 13 -2 PERFORMANCE BOND Page oft This bond is made and executed in compliance with the provisions of Chapter 2253 of the 2 Texas Government Code, as amended, and all liabilities on this bond shall be determined in 3 accordance with the provisions of said statue. 4 IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED 5 this instrument by duly authorized agents and officers on this the 20th day of October 6 .20 23 7 8 9 10 12 13 ATTEST: 14 r 15 16 (principa) Se retary 17 18 19 20 21 'NICK] I CISCL 22 Witness Asto Principal 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 Wi ess as to Surety 38 Rhiannon Portillo, Client Service Specialist 39 40 PRINCIPAL: McMahon Contrdctinq, LP BY: Signature \N-W(.knM(If4s e&-ai4e4- Name and Titl Address_ 3019 Rov Orr Blvd. Grand Prairie, TX 75050 SURETY: Westfield InsiAan C ny f AI I BY: l I�� Signture Jade Porter, Attorney -in -Fact Name and Title Address: 2255 Ridae Road, Ste 333 Rockwall, TX 75087 Telephone Number: 972-772-7220 41 *Note: If signed by an officer of the Surety Company, there must be on file a certified extract 42 from the by-laws showing that this person has authority to sign such obligation. If 43 Surety's physical address is different from its mailing address, both must be provided_ 44 The date of the bond shall not be prior to the date the Contract is awarded. 45 CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised July 1, 2011 City Project No. 100146 0061 14-1 PAYMENT BOND Page] of2 1 SECTION 00 61 14 #355373N 2 PAYMENT BOND 3 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § 7 That we, McMahon Contracting, LP known as 8 "Principal" herein, and Westfield Insurance Company , a 9 corporate surety (sureties), duly authorized to do business in the State of Texas, known as 10 `Surety" herein (whether one or more), are held and firmly bound unto the City of Fort Worth, a ] 1 municipal corporation created pursuant to the laws of the State of Texas, known as "City' herein, 12 In the penal sum of Seven Million Two Hundred Four Thousand Six Hundred Twenty Four and 651100 Dollars 13 ($ 7,204,624.65 ), lawful money of the United States, to be paid in Fort Worth, 14 Tarrant County, Texas, for the payment of which sum well and truly be made, we bind ourselves, 15 our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these 16 presents: 17 WHEREAS, Principal has entered into a certain written Contract with City, awarded the 18 17th day of October , 20 23 , which Contract is hereby referred to and 19 made a part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment, 20 labor and other accessories as defined by law, in the prosecution of the Work as provided for in 21 said Contract and designated as Arterial Roadway Improvements- Keller Hicks Road, City 22 Project No. 100146. 23 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if 24 Principal shall pay all monies owing to any (and all) payment bond beneficiary (as defined in 25 Chapter 2253 of the Texas Government Code, as amended) in the prosecution of the Work under 26 the Contract, then this obligation shall be and become null and void; otherwise to remain in full 27 force and effect. 28 This bond is made and executed in compliance with the provisions of Chapter 2253 of the 29 Texas Government Code, as amended, and all liabilities on this bond shall be determined in 30 accordance with the provisions of said statute. 31 CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised July 1, 2011 City Pmject No. 100146 0061 14-2 PAYMENT BOND Page 2 of 2 1 IN WITNESS WHEREOF, the Principal and Surety have each SIGNED and SEALED 2 this instrument by duly authorized agents and officers on this the 20th day of 3 October .20 23 4 5 6 7 S 9 10 12 ATTEST: (Principal) ecretary. Witness as to Pr cipal ATTEST: NIA (Surety) Secretary �[ N f I� `4 f J l �l 7lil�l7 Wi Hess as to Surety Rhiannon Portillo, Client Service Specialist PRINCIPAL: McMahon Contracting, LP BY: Sig(nlnature _Nt Name and Title Address: miq Roy nrr gi„ d Grand Prairie, TX 75050 SURETY: Westfield suran ompany BY: Sip e Jade Porter, Attorney -in -Fact Name and Title Address: _W5 Ridoe Rnad. Ste 333 Rockwall, TX 75087 Telephone Number: 972-772-7220 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 mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. END OF SECTION CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised July I, 2011 City Project No. 100146 0061 19-1 MAINTENANCE BOND Page 1 of3 1 SECTION 00 61 19 #355373N 2 MAINTENANCE BOND 3 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § 7 That we McMahon Contracting, LP known as 8 "Principal" herein and Westfield Insurance Company , a corporate surety 9 (sureties, if more than one) duly authorized to do business in the State of Texas, known as 10 "Surety" herein (whether one or more), are held and firmly bound unto the City of Fort Worth, a 11 municipal corporation created pursuant to the laws of the State of Texas, known as "City" herein, 12 In the Slim Of Seven Million Two Hundred Four Thousand Six Hundred Twenty Four and 651100 Dollars 13 ($ 7,204,624,65 ), lawful money of the United States, to be paid in Fort Worth, 14 Tarrant County, Texas, for payment of which sum well and truly be made unto the City and its 15 successors, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly 16 and severally, firmly by these presents. 17 18 WHEREAS, the Principal has entered into a certain written contract with the City awarded 19 the 17th day of October . 20 23, which Contract is hereby 20 referred to and a made part hereof for all purposes as if fully set forth herein, to furnish all 21 materials, equipment labor and other accessories as defined by law, in the prosecution of the 22 Work, including any Work resulting from a duly authorized Change Order (collectively herein, 23 the "Work") as provided for in said contract and designated as Arterial Roadway Improvements- 24 Keller Hicks Road, City Project No. 100146; and 25 26 WHEREAS, Principal binds itself to use such materials and to so construct the Work in 27 accordance with the plans, specifications and Contract Documents that the Work is and will 28 remain free from defects in materials or workmanship for and during the period of two (2) years 29 after the date of Final Acceptance of the Work by the City ("Maintenance Period"); and 30 31 WHEREAS, Principal binds itself to repair or reconstruct the Work in whole or in part 32 upon receiving notice from the City of the need therefor at any time within the Maintenance 33 Period. 34 CITY OF FORT WORTH Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised July 1, 2011 City Project No. 100146 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Z 0061 19-2 MAINTENANCE BOND Page 2of3 NOW THEREFORE, the condition of this obligation is such that if Principal shall remedy any defective Work, for which timely notice was provided by City, to a completion satisfactory to the City, then this obligation shall become null and void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, if Principal shall fail so to repair or reconstruct any timely noticed defective Work, it is agreed that the City may cause any and all such defective Work to be repaired and/or reconstructed with all associated costs thereof being home 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 Iie in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division; and PROVIDED FURTHER, that this obligation shall be continuous in nature and successive recoveries may be had hereon for successive breaches. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised July 1, 2011 Arterial Roadway Improvements Keller Hicks Road Lauren Way to US 377 City Project No. 100146 0061 19-3 MAINTENANCE BOND Page 3 of 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 loth day of October 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 .2023 ATTEST: (Principal) S cretaryl- I Witness H to Pr' cipal ATTEST: NIA Sur ty) Secretary 4h d) mdo �4We Witness as to Surety Rhiannon Portillo, Client Service Specialist PRINCIPAL,: McMahon Contractinq, LP BY: Signature Name and Ti�L' Address: nri j Q Rny �rr g�„A Grand Prairie, TX 75050 SURETY: Westfield l ura arnDany I BY: L S� t re PZ1 Jade Porter, Attorney -in -Fact Name and Title Address: 2255 Rid Qa� Road, Ste 333 Rockwal�MA 75087 Telephone Number: 972-772-7220 *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 Arterial Roadway Improvements Keller Hicks Road STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Lauren Way to US 377 Revised July 1, 2011 City Project No. 100146 THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME POWER # AND ISSUED PRIOR TO 05125=, FOR ANY PERSON OR PERSONS NAMED BELOW. General POWER NO. 4220012 14 Power Westfield Insurance Co. of Attorney Westfield National Insurance Co. CERTIFIED COPY Ohio Farmers Insurance Co. Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as 'Companies," duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these presents make, constitute and appoint TONY FIERRO, JOHNNY MOSS, JAY JORDAN, MISTIE BECK, JEREMY BARNETT, JADE PORTER, ROBERT G. KANUTH, JARRETT WILLSON, JACK NOTTINGHAM, BRADY WILSON, BRENNAN WILLIAMSON, JOINTLY OR SEVERALLY of ROCKWALL and State of TX its true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of suretyship in any penal limit. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- LIMITATION. THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorneys) -in -Fact may do in the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: "Be It Resolved, that the President, any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney -in -Fact. may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney -in -Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary." "Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached" (Each adopted at a meeting held on February 8, 2000). In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto affixed this 25th day of MAY A.D., 2022 . Corporate r+' S R•f tiONAL i ' WESTFIELD INSURANCE COMPANY Seals Affixed fit,";+ �n s o_ ••Gp'? . -,4.CE;'+� WESTFIELD NATIONAL INSURANCE COMPANY �t,�tiJt)ff OHIO FARMERS INSURANCE COMPANY S• EA� _�3C1 SS* 184B V raft State of Ohio """ By - County .' County of Medina ss.: Gary Wftumper, National' urety Leader and Senior Executive On this 25th day of MAY A.D., 2022 , before me personally came Gary W. Stumper to me known, who, being by me duly sworn, did depose and say, that he resides in Medina, OH; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument: that he knows the seals of said Companies: that the seals affixed to said instrument are such corporate seals; that they were so affixed by order of the Boards of Directors of said Companies: and that he signed his name thereto by like order. Notarial �N„a...•.w,,,� Seal AI A L S•,; Affixed tP: 1�ffl �''S State of Ohio o David A. Kotnik, Attorney at Law, Notary Public County of Medina ss.: My Commission Does Not Expire (Sec. 147.0E Ohio Revised Code) I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect: and furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. !n Witres5 Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 20th day of Oefaber A•f'., 2023 . „ �d�,YA,tIC bf 0"',,......... ``,•• ��ONAL, i :vZ - ' riAS� '�► '-= SEAL :mE a 3c , - E .Secreary y. 1848 • ' .... " + . Frank A. Carrino, Secretary SPOAC2 (combined) (03.22) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Additional Insured - Owners, Lessees Or Contractors - Automatic Status For Other Parties When Required In Written Contract Or Agreement With You Section II - Who Is An Insured is amended to include as an additional in- sured any person or organization you have agreed in writing in a contract or agreement to add as an additional in- sured on this Coverage Part. Such per- son(s) or organization(s) is an additional insured only with respect to liability for: a. "Bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by the performance of your ongoing opera- tions by you or on your behalf, under that written contract or written agreement. Ongoing operations does not apply to "bodily injury" or "proper- ty damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the loca- tion of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage aris- es has been put to its intended use by any person or organiza- tion other than another contrac- tor or subcontractor engaged in performing operations for a prin- cipal as a part of the same pro- ject; and b. "Bodily injury" or "property damage" caused, in whole or in part, by "your work" performed under that written contract or written agreement and in cluded in the "products -completed operations hazard", but only if: (1) The Coverage Part to which this endorsement is attached pro- vides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard'; and (2) The written contract or written agreement requires you to pro- vide additional insured coverage included within the "products - completed operations hazard" for that person or organization. If the written contract or written agreement requires you to provide additional insured coverage included within the "products -completed oper- ations hazard" for a specified length of time for that person or organiza- tion, the "bodily injury" or "property damage" must occur prior to the ex- piration of that period of time in order for this insurance to apply. If the written contract or written agreement requires you to provide additional insured coverage for a person or organization per only ISO additional insured endorsement form number CG 20 10, without specifying an edition date, and without specifi- cally requiring additional insured coverage included within the "prod- ucts -completed operations hazard", this Paragraph b. does not apply to that person or organization. 2. If the written contract or written agree- ment described in Paragraph 1. above specifically requires you to provide addi- tional insured coverage to that person or organization: a. Arising out of your ongoing opera- tions or arising out of "your work"; or Includes copyrighted material of Insurance GA 472 09 18 Services Office, Inc., with its permission. Page 1 of 3 b. By way of an edition of an ISO addi- tional insured endorsement that in- cludes arising out of your ongoing operations or arising out of 'your work"; then the phrase caused, in whole or in part, by in Paragraph A.1.a. and/or Para- graph A.1.b. above, whichever applies, is replaced by the phrase arising out of. 3. With respect to the insurance afforded to the additional insureds described in Para- graph A.1., the following additional exclu- sion applies: This insurance does not apply to "bodily injury", "property damage" or "personal C and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or draw- ings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hir- ing, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodily injury" or "prop- erty damage", or the offense which caused the "personal and advertising inju- ry", involved the rendering of, or the fail- ure to render, any professional architec- tural, engineering or surveying services. 4. This Paragraph A. does not apply to addi- tional insureds described in Paragraph B. B. Additional Insured - State Or Governmental Agency Or Subdivision Or Political Subdi- vision - Automatic Status When Required In Written Permits Or Authorizations 1. Section II - Who Is An Insured is amended to include as an additional in- sured any state or governmental agency or subdivision or political subdivision you have agreed in writing in a contract, agreement, permit or authorization to add as an additional insured on this Coverage Part. Such state or governmental agency or subdivision or political subdivision is an additional insured only with respect to op- erations performed by you or on your be- half for which the state or governmental agency or subdivision or political subdivi- sion issued, in writing, a contract, agree- ment, permit or authorization. 2. With respect to the insurance afforded to the additional insureds described in Para- graph 113.1., the following additional exclu- sions apply: This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" aris- ing out of operations performed for the federal government, state or mu- nicipality; or b. "Bodily injury" or "property damage" included within the "products - completed operations hazard." The insurance afforded to additional insureds described in Paragraphs A. and B.: Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract, writ- ten agreement, written permit or written authorization to provide for such addition- al insured; and 3. Does not apply to any person, organiza- tion, state, governmental agency or sub- division or political subdivision specifically named as an additional insured for the same project in the schedule of an en- dorsement added to this Coverage Part. D. With respect to the insurance afforded to the additional insureds described in Paragraphs A. and B., the following is added to Section III - Limits Of Insurance: The most we will pay on behalf of the addi- tional insured is the amount of insurance: Required by the written contract, written agreement, written permit or written au- thorization described in Paragraphs A. and B.; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of Insurance shown in the Decla- rations. E. Section IV - Commercial General Liability Conditions is amended to add the following: Automatic Additional Insured Provision This insurance applies only if the "bodily inju- ry" or "property damage" occurs, or the "per- sonal and advertising injury" offense is com- mitted: 1. During the policy period; and Includes copyrighted material of Insurance GA 472 09 18 Services Office, Inc., with its permission. Page 2 of 3 2. Subsequent to your execution of the writ- ten contract or written agreement, or the issuance of a written permit or written au- thorization, described in Paragraphs A. and B. F. Except when G. below applies, the following is added to Section IV - Commercial General Liability Conditions, 5. Other Insurance, and supersedes any provision to the contrary: When Other Additional Insured Coverage Applies On An Excess Basis This insurance is primary to other insurance available to the additional insured described in Paragraphs A. and B. except: 1. As otherwise provided in Section IV - Commercial General Liability Condi- tions, S. Other Insurance, b. Excess In- surance; or 2. For any other valid and collectible insur- ance available to the additional insured as an additional insured by attachment of an endorsement to another insurance policy that is written on an excess basis. In such case, this insurance is also excess. H G. The following is added to Section IV - Com- mercial General Liability Conditions, 5. Other Insurance, and supersedes any provi- sion to the contrary: Primary Insurance When Required By Writ- ten Contract, Agreement, Permit Or Au- thorization Except when wrap-up insurance applies to the claim or "suit" on behalf of the additional in- sured, this insurance is primary to any other insurance available to the additional insured described in Paragraphs A. and B. provided that: The additional insured is a Named In- sured under such other insurance; and You have agreed in writing in a contract, agreement, permit or authorization de- scribed in Paragraph A. or B. that this in- surance would be primary to any other in- surance available to the additional in- sured. As used in this endorsement, wrap-up insur- ance means any insurance provided by a con- solidated (wrap-up) insurance program. Primary And Noncontributory Insurance When Required By Written Contract, Agreement, Permit Or Authorization Except when wrap-up insurance applies to the claim or "suit" on behalf of the additional in- sured, this insurance is primary to and will not seek contribution from any other insurance available to the additional insured described in Paragraphs A. and B. provided that: 1. The additional insured is a Named in- sured under such other insurance; and 2. You have agreed in writing in a contract, agreement, permit or authorization de- scribed in Paragraph A. or B. that this in- surance would be primary and would not seek contribution from any other insur- ance available to the additional insured. As used in this endorsement, wrap-up insur- ance means any insurance provided by a con- solidated (wrap-up) insurance program. Section IV - Commercial General Liability Conditions, 9. Transfer Of Rights Of Re- covery Against Others To Us is amended by the addition of the following: We waive any right of recovery we may have against any additional insured under this en- dorsement against whom you have agreed to waive such right of recovery in a written con- tract, written agreement, written permit or writ- ten authorization because of payments we make for injury or damage arising out of your ongoing operations or 'your work" done under a written contract, written agreement, written permit or written authorization. However, our rights may only be waived prior to the "occur- rence" giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights. Includes copyrighted material of Insurance GA 472 09 18 Services Office, Inc., with its permission. Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS - CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement - Table of Contents: Coverage: Begins on Paqe: 1. Employee Benefit Liability Coverage.......................................................................................3 2. Unintentional Failure to Disclose Hazards..............................................................................9 3. Damage to Premises Rented to You........................................................................................9 4. Supplementary Payments...................................................................................................... 10 5. Medical Payments................................................................................................................... 10 6. 180 Day Coverage for Newly Formed or Acquired organizations ..................................... 10 7. Waiver of Subrogation............................................................................................................ 11 8. Automatic Additional Insured - Specified Relationships: .................................................. 11 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Relating to Premises; and • Mortgagee, Assignee or Receiver 9. Property Damage to Borrowed Equipment.......................................................................... 14 10. Employees as Insureds - Specified Health Care Services and Good Samaritan Services................................................................................................................................... 15 11. Broadened Notice of Occurrence.......................................................................................... 15 12. Nonowned Aircraft.................................................................................................................. 15 13. Bodily Injury Redefined.......................................................................................................... 15 14. Expected or Intended Injury Redefined................................................................................ 15 15. Former Employees as Insureds............................................................................................ 15 16. Voluntary Property Damage Coverage and Care, Custody or Control Liability Coverage.................................................................................................................................. 16 17. Broadened Contractual Liability - Work Within 50' of Railroad Property .........................17 18. Alienated Premises................................................................................................................. 17 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail Bonds: $ 2,500 Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 1 of 17 b. Loss of Earnings: $ 500 S. Medical Payments Medical Expense Limit: $ 10,000 9. Property Damage to Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 16. Voluntary Property Damage Coverage (Coverage a.) And Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance Coverage a. $1,000 Each Occurrence $5,000 Aggregate Coverage b. $5,000 Each Occurrence unless otherwise stated $ Deductible Amount (Each Occurrence) Coverage a. $250 Coverage b. $250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other b. Care, Custody or $ Control TOTAL ANNUAL PREMIUM $ Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 2 of 17 C. Coverages this endorsement pro- vided you did not have 1. Employee Benefit Liability Coverage knowledge of a claim or a. The following is added to Section I - "suit" on or before the Coverages: "first effective date" of this endorsement. Employee Benefit Liability Cover- age You will be deemed to have knowledge of a (1) Insuring Agreement claim or "suit" when any "authorized representa- (a) We will pay those sums that tive";the insured becomes legally obligated to pay as damag- a) Reports all, or any es caused by any act, error part, of the act, er- or omission of the insured, ror or omission to or of any other person for us or any other in - whose acts the insured is surer; legally liable, to which this insurance applies. We will b) Receives a written have the right and duty to or verbal demand defend the insured against or claim for dam - any "suit" seeking those ages because of damages. However, we will the act, error or have no duty to defend omission. against any "suit" seeking (2) Exclusions damages to which this in- surance does not apply. We This insurance does not apply to: may, at our discretion, in- vestigate any report of an (a) Bodily Injury, Property act, error or omission and Damage or Personal and settle any claim or "suit" that Advertising Injury may result. But: "Bodily injury", "property 1) The amount we will pay damage" or "personal and for damages is limited advertising injury". as described in Section (b) Dishonest, Fraudulent, III - Limits of Insu- Criminal or Malicious Act ance; and Damages arising out of any 2) Our right and duty to g y intentional, dishonest, defend ends when we fraudulent, criminal or mali- have used up the appli- cious act, error or omission, cable limit of insurance committed by any insured, in the payment of judg- including the willful or reck- ments or settlements. less violation of any statute. No other obligation or liabil- (c) Failure to Perform aCon- ity to pay sums or perform tract acts or services is covered unless explicitly provided for Damages arising out of fail - under Supplementary ure of performance of con - Payments. tract by any insurer. (b) This insurance applies to (d) Insufficiency of Funds damages only if the act, er- ror or omission, is negligent- Damages arising out of an ly committed in the "admin- insufficiency of funds to istration" of your "employee meet any obligations under benefit program"; and any plan included in the "employee benefit program". 1) Occurs during the policy period; or 2) Occurred prior to the "first effective date" of Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 3 of 17 GA 233 TX 09 17 (e) Inadequacy of Perfor- Q) Employment -Related Prac- mance of Invest- tices ment/Advice Given With Respect to Participation Any liability arising out of any: Any claim based upon: (1) Refusal to employ; 1) Failure of any invest- ment to perform; (2) Termination of employ- ment; 2) Errors in providing in- formation on past per- (3) Coercion, demotion, formance of investment evaluation, reassign - vehicles; or ment, discipline, defa- mation, harassment, 3) Advice given to any humiliation, discrimina- person with respect to tion or other employ - that person's decision to ment - related practices, participate or not to par- acts or omissions; or ticipate in any plan in- cluded in the "employee tial liability (4) Consequential benefit program". as a or (1) (2) (3) above. (f) Workers' Compensation and Similar Laws This exclusion applies whether the insured may be Any claim arising out of your held liable as an employer failure to comply with the or in any other capacity and mandatory provisions of any to any obligation to share workers' compensation, un- damages with or repay employment compensation someone else who must pay insurance, social security or damages because of the in - disability benefits law or any jury. similar law. (3) Supplementary Payments (g) ERISA Section I - Coverages, Sup - Damages for which any in- plementary Payments - Cover- sured is liable because of li- ages A and B also apply to this ability imposed on a fiduci- Coverage. ary by the Employee Re- tirement Income Security b. Who Is An Insured Act of 1974, as now or As respects Employee Benefit Lia- hereafter amended, or by bility Coverage, Section II - Who is any similar federal, state or an Insured is replaced by the follow - local laws. ing: (h) Available Benefits (1) If you are designated in the Dec - Any claim for benefits to the larations as: extent that such benefits are (a) An individual, you and your available, with reasonable spouse are insureds, but on - effort and cooperation of the ly with respect to the con - insured, from the applicable duct of a business of which funds accrued or other col- you are the sole owner. lectible insurance. (b) A partnership or joint ven- (i) Taxes, Fines or Penalties ture, you are an insured. Taxes, fines or penalties, in- Your members, your part- cluding those imposed un- ners, and their spouses are der the Internal Revenue also insureds but only with Code or any similar state or respect to the conduct of local law. your business. (c) A limited liability company, you are an insured. Your Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 17 members are also insureds, the end of the policy period, but only with respect to the whichever is earlier; and conduct of your business. Your managers are in- (b) Does not apply to any act, sureds, but only with respect error or omission that was to their duties as your man- committed before you ac- agers. quired or formed the organi- zation. (d) An organization other than a partnership, joint venture or c. Limits of Insurance limited liability company, you As respects Employee Benefit Lia- are an insured. Your "execu- bility Coverage, Section III - Limits tive officers" and directors of Insurance is replaced by the fol- are insureds, but only with lowing: respect to their duties as your officers or directors. (1) The Limits of Insurance shown in Your stockholders are also Section B. Limits of Insurance, insureds, but only with re- 1. Employee Benefit Liability spect to their liability as Coverage and the rules below fix stockholders. the most we will pay regardless of the number of: (e) A trust, you are an insured. Your trustees are also in- (a) Insureds; sureds, but only with respect to their duties as trustees. (b) Claims made or "suits" brought; (2) Each of the following is also an insured: (c) Persons or organizations making claims or bringing (a) Each of your "employees" "suits"; who is or was authorized to administer your employee (d) Acts, errors or omissions; or benefit program"; (e) Benefits included in your (b) Any persons, organizations "employee benefit program". or "employees" having prop- (2) The Aggregate Limit shown in er temporary authorization Section B. Limits of Insurance, to administer your "employ- 1. Employee Benefit Liability ee benefit program if you Coverage of this endorsement is die, but only until your legal the most we will pay for all dam - representative is appointed; ages because of acts, errors or or omissions negligently committed (c) Your legal representative if in the "administration" of your you die, but only with re- "employee benefit program". spect to duties as such. That (3) Subject to the limit described in representative will have all (2) above, the Each Employee your g rights and duties under Limit shown in Section B. Limits this Coverage Part. of Insurance, 1. Employee (3) Any organization you newly ac- Benefit Liability Coverage of quire or form, other than a part- this endorsement is the most we nership, joint venture or limited will pay for all damages sus - liability company, and over which tained by any one "employee", you maintain ownership or major- including damages sustained by ity interest, will qualify as a such "employee's" dependents Named Insured if no other similar and beneficiaries, as a result of: insurance applies to that organi- (a) An act, error or omission; or zation. However, coverage under this provision: (b) A series of related acts, er- a) Is afforded only until the (a) rors or omissions, regard - less of the amount of time day after you acquire that lapses between such or form the organization or acts, errors or omissions; Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 5 of 17 negligently committed in the d. Additional Conditions "administration" of your "employ- ee benefit program". As respects Employee Benefit Lia- bility Coverage, Section IV - Com- However, the amount paid under mercial General Liability Condi- this endorsement shall not ex- tions is amended as follows: ceed, and will be subject to the limits and restrictions that apply (1) Item 2. Duties in the Event of to the payment of benefits in any Occurrence, Offense, Claim or plan included in the "employee Suit is replaced by the following: benefit program." 2. Duties in the Event of An (4) Deductible Amount Act, Error or Omission, or Claim or Suit (a) Our obligation to pay dam- ages on behalf of the in- a. You must see to it that sured applies only to the we are notified as soon amount of damages in ex- as practicable of an act, cess of the Deductible error or omission which Amount stated in the Decla- may result in a claim. rations as applicable to To the extent possible, Each Employee. The limits notice should include: of insurance shall not be re- (1) What the act, error duced by the amount of this or omission was deductible. and when it oc- (b) The Deductible Amount curred; and stated in the Declarations (2) The names and applies to all damages sus- addresses of any- tained by any one "employ- one who may suf- ee", including such "employ- fer damages as a ee's" dependents and bene- result of the act, ficiaries, because of all acts, error or omission. errors or omissions to which this insurance applies. b. If a claim is made or suit is brought against (c) The terms of this insurance, any insured, you must: including those with respect to: (1) Immediately record the specifics of the 1) Our right and duty to claim or "suit" and defend the insured the date received; against any "suits" and seeking those damag- es; and (2) Notify us as soon as practicable. 2) Your duties, and the du- ties of any other in- You must see to it that volved insured, in the we receive written no - event of an act, error or tice of the claim or "suit" omission, or claim; as soon as practicable. apply irrespective of the ap- c. You and any other in- plication of the Deductible volved insured must: Amount. (1) Immediately send (d) We may pay any part or all us copies of any of the Deductible Amount to demands, notices, effect settlement of any summonses or le - claim or "suit" and, upon no- gal papers re- tification of the action taken, ceived in connec- you shall promptly reim- tion with the claim burse us for such part of the or "suit"; Deductible Amount as we have paid. Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 6 of 17 (2) Authorize us to ob- contributes equal tain records and amounts until it has other information; paid its applicable limit of insurance or none of (3) Cooperate with us the loss remains, in the investigation whichever comes first. or settlement of the claim or defense If any of the other in - against the "suit"; surance does not permit and contribution by equal shares, we will contrib- ( 4) Assist us, upon our ute by limits. Under this request, in the en- method, each insurer's forcement of any share is based on the right against any ratio of its applicable person or organi- limit of insurance to the zation which may total applicable limits of be liable to the in- insurance of all insur- sured because of ers. an act, error or omission to which c. Excess Insurance this insurance may also apply. This insurance is ex- cess over any of the d. No insured will, except other insurance, wheth- at that insured's own er primary, excess, con - cost, voluntarily make a tingent or on any other payment, assume any basis that is insurance obligation, or incur any purchased by you to expense without our coverage damages for consent. acts, errors or omis- sions that occurred prior (2) Item 5. Other Insurance is re- to the 'first effective placed by the following: date". S. Other Insurance e. Additional Definitions If other valid and collectible As respects Employee Benefit Lia- insurance is available to the bility Coverage, Section V - Defini- insured for a loss we cover tions is amended as follows: under this Coverage Part, our obligations are limited as (1) The following definitions are follows: added: a. Primary Insurance 1. "Administration" means: This insurance is prima- a. Providing information to ry except when c. below "employees", including applies. If this insurance their dependents and is primary, our obliga- beneficiaries, with re- tions are not affected spect to eligibility for or unless any of the other scope of "employee insurance is also prima- benefit programs"; ry. Then, we will share with all that other insur- b. Interpreting the "em- ance by the method de- ployee benefit pro- scribed in b. below. grams"; b. Method of Sharing c. Handling records in connection with the If all of the other insur- "employee benefit pro- ance permits contribu- grams"; or tion by equal shares, we will follow this meth- d. Effecting, continuing or od also. Under this ap- terminating any "em- proach each insurer ployee's" participation in Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 7 of 17 GA 233 TX 09 17 any benefit included in c. Unemployment insur- the "employee benefit ance, social security program". benefits, workers' com- pensation and disability However, "administration" benefits; and does not include: d. Vacation plans, includ- a. Handling payroll deduc- ing buy and sell pro- tions; or grams; leave of ab- b. The failure to effect or sence programs, includ- maintain any insurance ing military, maternity, or adequate limits of family, and civil leave; coverage of insurance, tuition assistance plans; including but not limited transportation and to unemployment insur- health club subsidies. ance, social security 4. "First effective date" means benefits, workers' com- the date upon which cover- pensation and disability age was first effected in a benefits. series of uninterrupted re- 2. "Cafeteria plans" means newals of insurance cover - plans authorized by applica- age. ble law to allow "employees" (2) The following definitions are de - to elect to pay for certain leted in their entirety and re - benefits with pre-tax dollars. placed by the following: 3. "Employee benefit pro- 8, "Employee" means a person grams" means a program actively employed, formerly providing some of all of the employed, on leave of ab- following benefits to "em- sence or disabled, or retired. ployees", whether provided "Employee" includes a through a "cafeteria plan" or "leased worker". "Employee" otherwise: does not include a "tempo- a. Group life insurance; rary worker". group accident or health 21. "Suit" means a civil proceed - insurance; dental, vision ing in which money damag- and hearing plans; and es because of an act, error flexible spending ac- or omission to which this in - counts; provided that no surance applies are alleged. one other than an "em- "Suit" includes: ployee" may subscribe to such benefits and a. An arbitration proceed - such benefits are made ing in which such dam - generally available to ages are claimed and to those "employees" who which the insured must satisfy the plan's eligibil- submit or does submit ity requirements; with our consent; b. Profit sharing plans, b. Any other alternative employee savings dispute resolution pro - plans, employee stock ceeding in which such ownership plans, pen- damages are claimed sion plans and stock and to which the in - subscription plans, pro- sured submits with our vided that no one other consent; or than an "employee" may subscribe to such c. An appeal of a civil pro - benefits and such bene- ceeding. fits are made generally available to all "employ- ees" who are eligible under the plan for such benefits; Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 17 2. Unintentional Failure to Disclose Haz- 2) Rust or other cor- ards rosion, decay, de - hidden Section IV - Commercial General Liabil- or latent latent defect it Conditions, 7. Representations is y p n any quality in a amended by the addition of the following: property that caus- Based on our dependence upon your rep- es it to damage or resentations as to existing hazards, if un- destroy itself; intentionally you should fail to disclose all 3) Smog; such hazards at the inception date of your policy, we will not reject coverage under 4) Mechanical break - this Coverage Part based solely on such down, including failure. rupture or bursting caused by centrif- 3. Damage to Premises Rented to You ugal force; a. The last Paragraph of 2. Exclusions 5) Settling, cracking, under Section I - Coverage e A - Bod- shrinking or ex- ily Injury and Property Damage Li- pansion; ability is replaced by the following: 6) Nesting or Exclusions c. through q. do not apply char e discharge to "property damage" by fire, explo- or r a or release of waste sion, lightning,smoke or soot to products or secre- premises while rented to you or tem- tions, by insects, porarily occupied by you with permis- birds, rodents or sion of the owner, for which the other animals; or amount we will pay is limited to the Damage to Premises Rented to 7) Presence, growth, You Limit as described in Section III proliferation, - Limits of Insurance. spread or any ac- fungus, in- tivityb. b. The insurance provided under Sec- cui g mold or I - Coverage A - Bodily Injury g y 1 y mildew, mildew, and any and Property Damage Liability ap- mycotoxins, plies to "property damage" arising out spores, scents or of water damage to premises that are byproducts pro - both rented to and occupied by you. duced or released (1) As respects Water Damage Le- by fungi. gal Liability, as provided in Para- (b) "Property damage" caused graph 3.b. above: directly or indirectly by any The exclusions under Section I - of the following: Coverage A - Bodily Injury and (i) Earthquake, volcanic Property Damage Liability, 2. eruption, landslide or Exclusions, other than i. War any other earth move - and the Nuclear Energy Liabil- ment; ity Exclusion (Broad Form), are deleted and the following are (ii) Water that backs up or added: overflows or is other- wise discharged from a This insurance does not apply to: sewer, drain, sump, (a) 'Property damage": sump pump or related equipment; (i) Assumed in any con- tract or agreement; or (iii) Water under the ground surface pressing on, or (ii) Caused by or resulting flowing or seeping from any of the follow- through: ing: 1) Foundations, walls, 1) Wear and tear; floors or paved surfaces; Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 9 of 17 2) Basements, you with permission of whether paved or the owner; not; or b. In the case of damage 3) Doors, windows or by fire, explosion, light - other openings. ning, smoke or soot, while rented to you; or (c) "Property damage" caused by or resulting from water c. In the case of damage that leaks or flows from by water, while rented plumbing, heating, air condi- to and occupied by you. tioning, fire protection sys- tems, or other equipment, (2) The most we will pay is limited as caused by or resulting from described in Section B. Limits of freezing, unless: Insurance, 3. Damage to Prem- ises Rented to You of this en- (i) You did your best to dorsement. maintain heat in the building or structure; or 4. Supplementary Payments (ii) You drained the equip- Under Section I - Supplementary Pay- ment and shut off the ments - Coverages A and B: water supply if the heat a. Paragraph 2. is replaced by the fol- was not maintained. lowing: (d) "Property damage" to: (i) Plumbing, heating, air conditioning, fire protec- tion systems, or other equipment or applianc- es; or (ii) The interior of any building or structure, or to personal property in the building or structure, caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit of Insurance With respect to the insurance afford- ed in Paragraphs 3.a. and 3.b. above, the Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (1) Paragraph 6. of Section III - Limits of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A - Bodily Injury and Property Dam- age Liability for damages because of "property dam- age" to any one premises: a. While rented to you, or temporarily occupied by Up to the limit shown in Section B. Limits of Insurance, 4.a. Bail Bonds of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 4. is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Sec- tion B. Limits of Insurance, 4.b. Loss Of Earnings of this endorsement per day because of time off from work. S. Medical Payments The Medical Expense Limit of Any One Person as stated in the Declarations is amended to the limit shown in Section B. Limits of Insurance, S. Medical Pay- ments of this endorsement. 6. 180 Day Coverage for Newly Formed or Acquired Organizations Section II - Who is an Insured is amended as follows: Subparagraph a. of Paragraph 3. is re- placed by the following: Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 10 of 17 a. Insurance under this provision is af- ance, but only with respect forded only until the 180th day after to liability arising out of the you acquire or form the organization ownership, maintenance or or the end of the policy period, use of that part of the prem- whichever is earlier; ises leased to you, subject to the following additional 7. Waiver of Subrogation exclusions: Section IV - Commercial General Liabil- This insurance does not ap- ity Conditions, 9. Transfer of Rights of ply to: Recovery Against Others to us is amended by the addition of the following: (i) Any 'occurrence" which takes place after you We waive any right of recovery we may cease to be a tenant in have against any person or organization s that premises; against whom you have agreed to waive such right of recovery in a written contract (ii) Structural alterations, or agreement because of payments we new construction or make for injury or damage arising out of demolition operations your ongoing operations or 'your work" performed by or on be - done under a written contract or agree- half of such additional ment with that person or organization and insured. included in the "products -completed oper- ations hazard". However, our rights may (b) Lessor of Leased Equip - only be waived prior to the 'occurrence" ment giving rise to the injury or damage for Any person or organization which we make payment under this Cov- from whom you lease erage Part. The insured must do nothing equipment when you and after a loss to impair our rights. At our re- such or person(s) or aniza- p g quest, the insured will bring "suit" or trans- have agreed per Par - fer those rights to us and help us enforce agra) agraph 8.a.(1) of this en- those rights. dorsement to provide insur- 8. Automatic Additional Insured - Speci- ance. Such person(s) or or- fied Relationships ganization(s) are insureds only with respect to liability a. The following is added to Section II - for "bodily injury", "property Who is an Insured: damage" or "personal and advertising injury" caused, in (1) Any person(s) or organization(s) whole or in part, by your described in Paragraph 8.a.(2) of maintenance, operation or this endorsement (hereinafter re- use of equipment leased to ferred to as additional insured) you by such person(s) or or- whom you are required to add as ganization(s). Aperson s or an additional insured under this organizations status as an Coverage Part by reason of a additional insured under this written contract, written agree- endorsement ends when ment, written permit or written their contract or agreement authorization. with you for such leased (2) Only the following persons or or- equipment ends. However, ganizations are additional in- this insurance does not ap- sureds under this endorsement, ply to any 'occurrence" and insurance coverage provided which takes place after the to such additional insureds is lim- equipment lease expires. ited as provided herein: (c) Vendors (a) Managers or Lessors of Any person or organization Premises (referred to below as ven- The manager or lessor of a dor) with whom you have premises leased to you with agreed per Paragraph whom you have agreed per 8.a.(1) of this endorsement Paragraph 8.a.(1) of this en- to provide insurance, but en- dorsement to provide insur- ly with respect to "bodily in- jury" or "property damage" Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 11 of 17 arising out of "your products" or sale of the which are distributed or sold products; in the regular course of the vendor's business, subject 6) Demonstration, in- to the following additional stallation, servicing exclusions: or repair opera- tions, except such (i) The insurance afforded operations per - the vendor does not formed at the ven- apply to: dor's premises in connection with the 1) "Bodily injury" or sale of the product; "property damage" for which the ven- 7) Products which, af- dor is obligated to ter distribution or pay damages by sale by you, have reason of the as- been labeled or re- sumption of liability labeled or used as in a contract or a container, part or agreement. This ingredient of any exclusion does not other thing or sub - apply to liability for stance by or for the damages that the vendor; or vendor would have in the absence of 8) "Bodily injury" or the contract or "property damage" agreement; arising out of the sole negligence of 2) Any express war- the vendor for its ranty unauthorized own acts or omis- by you; sions or those of its employees or 3) Any physical or anyone else acting chemical change in on its behalf. How - the product made ever, this exclusion intentionally by the does not apply to: vendor; 4) Repackaging, ex- a) The excep- tions contained cept when un- in Paragraphs packed solely for (it 4) or 6) the purpose of in- f of this o spection, demon- dorsement; or stration, testing, or the substitution of b) Such inspec- parts under in- tions, adjust- structions from the ments, tests or manufacturer, and servicing as then repackaged in the vendor has the original con- agreed to tainer; make or nor- malty under - 5) Any failure to make takes to make such inspections, in the usual adjustments, tests course of or servicing as the business, in vendor has agreed connection to make or normal- with the distri- ly undertakes to or sale make in the usual of the prod - o f the course of busi- course ness, in connection with the distribution Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 12 of 17 (ii) This insurance does not (iii) The ownership, mainte- apply to any insured nance or use of any el - person or organization: evators covered by this 1) From whom you insurance. have acquired (e) Mortgagee, Assignee or such products, or Receiver any ingredient, part or container, enter- Any person or organization ing into, accompa- with whom you have agreed nying or containing per Paragraph 8.a.(1) of this such products; or endorsement to provide in- surance, but only with re- 2) When liability in- spect to their liability as cluded within the mortgagee, assignee, or re- "products- ceiver and arising out of the completed opera- ownership, maintenance, or tions hazard" has use of the premises by you. been excluded un- However, this insurance der this Coverage does not apply to structural Part with respect to alterations, new construction such products. and demolition operations performed by or for that per - (d) State or Governmental son or organization. Agency or Subdivision or Political Subdivision - (3) The insurance afforded to addi- Permits or Authorizations tional insureds described in Par - Relating to Premises agraph 8.a.(1) of this endorse - Any state or governmental ment: agency or subdivision or po- (a) Only applies to the extent litical subdivision with which permitted by law; and you have agreed per Para- graph 8.a.(1) of this en- (b) Will not be broader than that dorsement to provide inuur- which you are required by ance, subject to the follow- the written contract, written ing additional provision: agreement, written permit or written authorization to pro - This insurance applies only vide for such additional in - with respect to the following sured; and hazards for which the state or governmental agency or (c) Does not apply to any per - subdivision or political sub- son, organization, vendor, division has issued a permit state, governmental agency or authorization in connec- or subdivision or political tion with premises you own, subdivision, specifically rent or control and to which named as an additional in - this insurance applies: sured under any other provi- sion of, or endorsement (i) The existence, mainte- added to, this Coverage nance, repair, construc- Part, provided such other tion, erection or removal provision or endorsement of advertising signs, covers the injury or damage awnings, canopies, cel- for which this insurance ap- lar entrances, coal plies. holes, driveways, man- holes, marquees, hoist b. With respect to the insurance afford - away openings, side- ed to the additional insureds de - walk vaults, street ban- scribed in Paragraph 8.a.(1) of this ners or decorations and endorsement, the following is added similar exposures; or to Section III - Limits of Insurance: (ii) The construction, erec- The most we will pay on behalf of the tion or removal of eleva- additional insured is the amount of in - tors; or surance: Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 13 of 17 (1) Required by the written contract, 9. Property Damage to Borrowed Equip - written agreement, written permit ment or written authorization described in Paragraph 8.a.(1) of this en- a. The following is added to Exclusion dorsement; or 2.j. Damage to Property under Sec- tion I - Coverage A - Bodily Injury (2) Available under the applicable and Property Damage Liability: Limits of Insurance shown in the Declarations; Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip - whichever is less. ment loaned to you, provided they are not being used to perform operations This endorsement shall not increase at the time of loss. the applicable Limits of Insurance shown in the Declarations. b. With respect to the insurance provid- ed by this section of the endorse- c. Section IV - Commercial General ment, the following additional provi- Liability Conditions is amended to sions apply: pp y include the following: (1) The Limits of Insurance shown in Automatic Additional Insured Pro- the Declarations are replaced by vision the limits designated in Section This insurance applies only if the B. Limits of Insurance, 9. "bodily injury" or "property damage" Property Damage to Borrowed occurs, or the "personal and advertis- Equipment of this endorsement ing injury" offense is committed: with respect to coverage provid- ed by this endorsement. These (1) During the policy period; and limits are inclusive of and not in addition to the limits being re- (2) Subsequent to your execution of placed. The Limits of Insurance the written contract or written shown in Section B. Limits of agreement, or the issuance of a Insurance, 9. Property Damage written permit or written authori- to Borrowed Equipment of this zation, described in Paragraph endorsement fix the most we will 8.a.(1). pay in any one "occurrence" re- d. Section IV - Commercial General gardless of the number of: Liability Conditions is amended as (a) Insureds; follows: (b) Claims made or "suits" Condition S. Other Insurance is brought; or amended to include:Persons or (c) oroganging Primary and Noncontributory In- making claimsbringing surance "suits". This insurance is primary to and will (2) Deductible Clause not seek contribution from any other insurance available to an additional (a) Our obligation to pay dam - insured per Paragraph 8.a.(1) of this ages on your behalf applies endorsement provided that: only to the amount of dam- ages for each "occurrence" (1) The additional insured is a which are excess of the Named Insured under such other Deductible Amount stated in insurance; and Section B. Limits of Insur- (2) You have agreed in writing in a ance, 9. Property Damage contract, agreement, permit or to Borrowed Equipment of authorization described in 8.a.(2) this endorsement. The limits of this endorsement that this in- of insurance will not be re- surance would be primary and duced by the application of would not seek contribution from such deductible amount. any other insurance available to (b) Section IV - Commercial the additional insured. General Liability Condi- tions, 2. Duties in the Event of Occurrence, of - Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 14 of 17 fense, Claim or Suit, ap- plies to each claim or "suit" irrespective of the amount. (c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as has been paid by us. 10. Employees as Insureds - Specified Health Care Services and Good Samar- itan Services Paragraph 2.a.(1)(d) under Section II - Who is an Insured does not apply to: a. Your "employees" who provide pro- fessional health care services on your behalf as a duly licensed nurse, emergency medical technician or paramedic in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place; or b. Your "employees" or "volunteer work- ers", other than an employed or vol- unteer doctor, providing first aid or good samaritan services during their work hours for you will be deemed to be acting within the scope of their employment by you or performing du- ties related to the conduct of your business. 11. Broadened Notice of Occurrence Paragraph a. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit under Section IV - Commercial General Liability Conditions is replaced by the following: a. You must see to it that we are notified as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, no- tice should include: (1) How, when and where the "oc- currence" or offense took place; (2) The names and addresses of any injured persons and wit- nesses; and (3) The nature and location of any injury or damage arising out of the 'occurrence" or offense. This requirement applies only when the 'occurrence" or offense is known to an "authorized representative". 12. Nonowned Aircraft The following is added to Exclusion 2.g. Aircraft, Auto or Watercraft under Sec- tion I - Coverage A - Bodily Injury and Property Damage Liability: This exclusion does not apply to an air- craft you do not own, provided that: a. The pilot in command holds a current effective certificate, issued by a duly constituted authority of the United States of America or Canada, desig- nating that person as a commercial or airline transport pilot; b. The aircraft is rented with a trained, paid crew; and c. The aircraft does not transport per- sons or cargo for a charge. 13. Bodily Injury Redefined Section V - Definitions, 4. "Bodily injury" is replaced by the following: 4. "Bodily injury" means bodily harm or injury, sickness, disease, disability, humiliation, shock, fright, mental an- guish or mental injury, including care, loss of services or death resulting from any of these at any time. 14. Expected or Intended Injury Redefined The last sentence of Exclusion 2.a. Ex- pected or Intended Injury under Section I - Coverage A - Bodily Injury and Property Damage Liability is replaced by the following: This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect per- sons or property. 15. Former Employees as Insureds The following is added to Paragraph 2. under Section II - Who is an Insured: 2. Each of the following is also an in- sured: Any of your former "employees", di- rectors, managers, members, part- ners or "executive officers", including but not limited to retired, disabled or those on leave of absence, but only for acts within the scope of their em- ployment by you or for duties related to the conduct of your business. Includes copyrighted material of Insurance GA 233 TX 09 17 Services Office, Inc., with its permission. Page 15 of 17 16. Voluntary Property Damage Coverage a. Coverage D - Voluntary Property Damage Coverage Section I - Coverages is amended to include the following: (1) Insuring Agreement GA 233 TX 09 17 (a) We will pay the cost to re- pair or replace "property damage" to property of oth- ers arising out of operations incidental to your business when: 1) Damage is caused by you; or 2) Damage occurs while in your possession. At your written request, we will make this payment re- gardless of whether you are at fault for the "property damage". If you, at our request, re- place, or make any repairs to, damaged property of others, the amount we will pay under Voluntary Prop- erty Damage Coverage will be determined by your actu- al cost to replace or repair the damaged property, ex- cluding any profit or over- head. Any payment we make un- der Voluntary Property Damage Coverage shall not be interpreted as an admis- sion of liability by you or by us. It shall be your duty, not our duty, to defend any claim or "suit" to which this insurance applies. No other obligation or liabil- ity to pay sums or perform acts or services is covered. (b) This insurance applies to "property damage" only if: 1) The "property damage" takes place in the "cov- erage territory"; and (2) Exclusions This insurance does not apply to "property damage" that would be excluded by Coverage A - Bodi- ly Injury and Property Damage Liability, 2. Exclusions, except for j. Damage to Property, par- agraphs (3), (4), (5) and (6), k. Damage to Your Product, and I. Damage to Your Work. (3) Definitions For purposes of Voluntary Property Damage Coverage only, the following definitions un- der Section V - Definitions are replaced by the following: 16. "Occurrence" means an in- cident, including continuous or repeated exposure to substantially the same gen- eral harmful conditions that result in "property damage". 20. 'Property damage" means physical injury to tangible property. "Electronic data" is not tangible property, and "property damage" does not include disappearance, ab- straction or theft. b. Care, Custody or Control Liability Coverage For purposes of the coverage provid- ed by Care, Custody or Control Li- ability Coverage in this endorsement only: (1) Section I - Coverage A - Bodily Injury and Property Damage Liability, 2. Exclusions, j. Damage to Property, Subpara- graphs (3), (4) and (5) do not ap- ply to "property damage" to the property of others described therein. (2) It shall be your duty, not our duty, to defend any claim or "suit" to which this insurance applies. No other obligation or liability to pay sums or perform acts or ser- vices is covered. This Paragraph (2) supersedes any provision in the Coverage Part to the contrary. 2) The "property damage" occurs during the policy (3) "Property damage" for which period. Care, Custody or Control Lia- Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 16 of 17 C. bility Coverage provides cover- (3) The Voluntary Property Dam- age shall be deemed to be age Coverage, Aggregate Limit caused by an "occurrence" but of Insurance is the most we will shall not serve to limit or restrict pay for the sum of all damages the applicability of any exclusion under Voluntary Property for "property damage" under this Damage Coverage. This limit Coverage Part. applies separately to each "cov- Limits of Insurance and Deducti- erage term". bles (4) Deductible Clause For purposes of the coverage provid- (a) Our obligation to pay dam- ed by Voluntary Property Damage ages on your behalf applies Coverage and Care, Custody or only to the amount of dam - Control Liability Coverage, Section ages for each "occurrence" III - Limits of Insurance is amended which are in excess of the to include the following: Deductible Amount stated for the applicable coverage (1) The Limits of Insurance shown in in the Schedule. The limits the Declarations are replaced by of insurance will not be re - the limits designated in Section duced by the application of B. Limits of Insurance, 16. such Deductible Amount. Voluntary Property Damage Coverage and Care, Custody (b) Section IV - Commercial or Control Liability Coverage, General Liability Condi- in this endorsement. These limits tions, 2. Duties in the are inclusive of, and not in addi- Event of Occurrence, of- tion to, the limits being replaced. fense, Claim or Suit, ap- The Limits of Insurance shown in plies to each claim or "suit" the Schedule fix the most we will irrespective of the amount. pay regardless of the number of: (c) We may pay any part or all (a) Insureds; of the Deductible Amount to effect settlement of any (b) Claims made or "suits" claim or "suit and, upon no - brought; or tification of the action taken, (c) Persons or organizations you shall promptly reim- making claims or bringing burse us for such part of the "suits". Deductible Amount as has been paid by us. (2) (a) Subject to (3) below, the Voluntary Property Dam- 17. Broadened Contractual Liability -Work age Coverage, Each Occur- Within 50' of Railroad Property rence Limit Of Insurance is Section V - Definitions, 12. "Insured con - the most we will pay for the tract" is amended as follows: sum of damages under Vol- untary Property Damage a. Paragraph c. is replaced by the fol- Coverage; lowing: GA 233 TX 09 17 (b) The Care, Custody or Con- c. Any easement or license agree- trol Liability Coverage, ment; Each Occurrence Limit Of Insurance is the most we will b. Paragraph f.(1) is deleted in its entire - pay for the sum of damages ty. under Care, Custody or 18. Alienated Premises Control Liability Coverage; Exclusion 2 because of all "property damage" j. Damage to Property, Paragraph (2) under Section I - Cover - arising out of any one "occur- age A - Bodily Injury and Property rence". Damage Liability does not apply if the premises are "your work". Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 17 of 17 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this Coverage Part restrict SUPPLEMENTARY PAYMENTS - COV- this insurance. Read the entire Coverage Part ERAGES A AND B. carefully to determine rights, duties and what is and is not covered. b. This insurance applies to "bodily injury" and "property damage" only if: Throughout this Coverage Part the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organi- zation qualifying as a Named Insured under this Coverage Part. The words "we", "us" and 'our" refer to the Company providing this insurance. The word "insured" means any person or organiza- tion qualifying as such under SECTION II - WHO IS AN INSURED. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V - DEFINITIONS. SECTION I -COVERAGES COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as dam- ages because of "bodily injury" or "prop- erty damage" to which this insurance ap- plies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit' seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" and settle any claim or "suit' that may result. But: (1) The amount we will pay for damages is limited as described in SECTION III - LIMITS OF INSURANCE; and (2) Our right and duty to defend ends when we have used up the applica- ble limit of insurance in the payment of judgments or settlements under SECTION I - COVERAGES, COV- ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY; SECTION I - COVERAGES, COV- ERAGE B. PERSONAL AND AD- VERTISING INJURY LIABILITY; or medical expenses under SECTION - COVERAGES, COVERAGE C. MEDICAL PAYMENTS. (1) The "bodily injury" or "property dam- age" is caused by an 'occurrence" that takes place in the "coverage ter- ritory"; (2) The "bodily injury" or "property dam- age" occurs during the policy period; and (3) Prior to the "coverage term" in which "bodily injury" or "property damage" occurs, you did not know, per Para- graph 1.d. below, that the "bodily in- jury" or "property damage" had oc- curred or had begun to occur, in whole or in part. c. 'Bodily injury" or "property damage" wh i ch: (1) Occurs during the "coverage term"; and (2) Was not, prior to the 'coverage term", known by you, per Paragraph 1.d. below, to have occurred; includes any continuation, change or re- sumption of that "bodily injury" or "prop- erty damage" after the end of the "cover- age term" in which it first became known by you. d. You will be deemed to know that "bodily injury" or "property damage" has occurred at the earliest time when any "authorized representative": (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; (2) Receives a written or verbal demand or claim for damages because of the "bodily irury" or "property damage"; (3) First observes, or first observed, the "bodily injury" or "property damage' (4) Becomes aware, or become aware, by any means other than as de- scribed in (3) above, that "bodily in- jury" or "property damage" had oc- curred or had begun to occur; or No other obligation or liability to pay sums (5) Becomes aware, or become aware, or perform acts or services is covered of a condition from which 'bodily in - unless expressly provided for under jury" or "property damage" is sub- stantially certain to occur. Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Pagel of 22 e. Damages because of "bodily injury" in- clude damages claimed by any person or organization for care, loss of services or death resulting at any time from the "bod- ily injury". 2. Exclusions This insurance does not apply to: a. Expected or Intended Injury "Bodily injury" or "property damage" which results from the intentional or criminal acts of the insured or which is in fact expected or intended by the insured, even if the injury or damage is of a differ- ent degree or type than actually expected or intended. This exclusion does not ap- ply to "bodily injury" resulting from the use of reasonable force to protect persons or property. b. Contractual Liability This exclusion applies only if you are in the business of manufacturing, distribut- ing, selling, serving or furnishing alcoholic beverages. d. Workers' Compensation and Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured sus- tained in the "workplace"; (2) An "employee" of the insured arising out of the performance of duties re- lated to the conduct of the insured's business; or "Bodily injury" or "property damage" for (3) The spouse, child, parent, brother or which the insured is obligated to pay sister of that "employee" as a conse- damages by reason of the assumption of quence of Paragraphs (1) or (2) liability in a contract or agreement. This above. exclusion does not apply to liability for This exclusion applies: damages: (1) Whether the insured may be liable as 1 That the insured would have in the () an employer or in any other capacity; absence of the contract or agree- and ment; or (2) To any obligation to share damages 2 Assumed in a contract or agreement () g with or repay someone else who that is an "insured contract", provided must pay damages because of the the "bodily injury" or "property dam- age" occurs subsequent to the exe- cution of the contract or agreement. This exclusion does not apply to liability When a claim for such "bodily injury" assumed by the insured under an "in - or "property damage" is made, we sured contract". will defend that claim provided the insured has assumed the obligation f. Pollutant to defend such daim in the "insured 1 "Bodilyinjury" or "property damage" () p pert y g contract". Such defense payments arising out of the actual, alleged or will not reduce the limits of insur- threatened discharge, dispersal, ante. seepage, migration, release, escape c. Liquor Liability or emission of "pollutants": "Bodily injury" or "property damage" for (a) At or from any premises, site or which any insured may be held liable by location which is or was at any reason of: time owned or occupied by, or rented or loaned to, any insured. (1) Causing or contributing to the intoxi- However, Paragraph (a) does cation of any person; not apply to: (2) The furnishing of alcoholic beverages 1) "Bodily injury" to any person to a person under the legal drinking injured while on any prem- age or under the influence of alcohol; ises, site or location owned or or occupied by, or rented or loaned to, you provided: (3) Any statute, ordinance or regulation relating to the sale, gift, distribution a) The injury is caused by or use of alcoholic beverages. the inadequate ventila- tion of vapors; Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 2 of 22 b) The person injured is first exposed to such vapors during the policy period; and c) Within 30 days of such first exposure, the per- son injured is clinically diagnosed or treated by a physician for the medical condition caused by the expo- sure to such vapors. However, Paragraph c) does not apply if the "bodily injury" is caused by vapors produced by or originating from equipment that is used to heat, cool or dehu- midify the building, or equipment that is used to heat water for per- sonal use, by the build- ing's occupants or their guests. product of any manufactur- ing process; 2) "Bodily injury" or "property damage" for which you may be held liable, if you are a contractor, and the owner or lessee of such premises, site or location has been added to this Coverage Part as an additional insured with respect to your ongoing operations or "your work" performed for that additional insured at that premises, site or location and such premises, site or location is not and never was owned or occupied by, or rented or loaned to, any insured, other than that additional in- sured; or 3) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire"; This exception 1) shall ap- ply only to Named Insureds; (b) At or from any premises, site or we shall have no duty to de- location which is or was at any fend or pay damages for time used by or for any insured any person or organization or others for the handling, stor- that is not a Named Insured. age, disposal, processing or However, this paragraph treatment of waste; does not apply if the "bodily (c) Which are or were at any time injury" is caused by vapors transported, handled, stored, produced by or originating treated, disposed of, or proc- from equipment that is used essed as waste by or for: to heat, cool or dehumidify the building, or equipment 1) Any insured; or that is used to heat water for personal use, by the 2) Any person or organization building's occupants or their for whom you may be le - guests. gally responsible; For the purpose of the ex- (d) At or from any premises, site or ception granted in Para- location on which any insured or graph 1) only, vapors any contractors or subcontrac- means any gaseous or air- tors working directly or indirectly borne irritant or airborne on any insured's behalf are per - contaminant, including forming operations if the "pollut- smoke, fumes, vapor or ants" are brought on or to the soot, but excluding asbes- premises, site or location in con- tos, which is discharged, nection with such operations by dispersed, emitted, released such insured, contractor or sub - or escapes from materials, contractor. However, Paragraph machinery or equipment (d) does not apply to: used in the service or main- 1) "Bodily injury" or "property tenance of the premises. damage" arising out of the Vapors does not mean any discharge, dispersal, seep - gaseous or airborne irritants age, migration, release, es - or contaminants used in a cape or emission of fuels, manufacturing process or lubricants or other operating which is the product or by- fluids, or exhaust gases, which are needed to per - Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 3 of 22 form, or are the result of, (2) Any loss, cost or expense arising out the normal electrical, hy- of any: draulic or mechanical func- tions necessary for the op- (a) Request, demand, order or eration of "mobile equip- statutory or regulatory require- ment" or its parts, if such ment that any insured or others fuels, lubricants or other test for, monitor, clean up, re - operating fluids, or exhaust move, contain, treat, detoxify or gases, escape, seep or mi- neutralize, or in any way re - grate, or are discharged, spond to, or assess the effects dispersed, released or emit- of, "pollutants"; or ted from a vehicle part de- (b) Claim or suit by or on behalf of a signed to hold, store or re- governmental authority for dam- ceive them. This exception ages because of testing for, does not apply if the fuels, monitoring, cleaning up, remov- lubricants or other operating ing, containing, treating, detoxi- fluids, or exhaust gases, fying or neutralizing, or in any escape, seep or migrate, or way responding to, or assessing are discharged, dispersed, the effects of, "pollutants". released or emitted with the intent to cause "bodily in- However, Paragraphs (2)(a) and (b) jury" or "property damage" do not apply to liability for damages or with the knowledge that because of "property damage" that "bodily injury" or "property the insured would have in the ab- damage" is substantially sence of such request, demand, or - certain to occur, or if such der or statutory or regulatory re- fuels, lubricants or other quirement, or such claim or "suit" by operating fluids, or exhaust or on behalf of a governmental au - gases, are brought on or to thority. the premises, site or loca- tion with such intent to es- g• Aircraft, Auto or Watercraft cape, seep or migrate, or be "Bodily injury" or "property damage" aris- discharged, dispersed, re- ing out of the ownership, maintenance, leased or emitted as part of use or entrustment to others of any air - the operations being per- craft, "auto" or watercraft owned or oper- formed by such insured, ated by or rented or loaned to any in - contractor or subcontractor; sured. Use includes operation and "load- 2) "Bodily injury" or "property ing or unloading". damage" sustained within a This exclusion applies even if the claims building and caused by the against any insured allege negligence or release of gases, fumes or other wrongdoing in the supervision, hir- vapors from materials ing, employment, training or monitoring of brought into that building in others by that insured, if the "occurrence" connection with operations which caused the "bodily injury" or "prop - being performed by you or erty damage" involved the ownership, on your behalf by a contrac- maintenance, use or entrustment to oth- tor or subcontractor; or ers of any aircraft, "auto" or watercraft 3) "Bodily injury" or "property that is owned or operated by or rented or damage" arising out of heat, loaned to any insured. smoke or fumes from a This exclusion does not apply to: "hostile fire"; or (1) A watercraft while ashore on prem- e At or from an remises, site or () y p ises you own or rent; location on which any insured or any contractors or subcontrac- (2) A watercraft you do not own that is: tors working directly or indirectly on any insured's behalf are per- (a) Less than 51 feet long; and forming operations if the opera- (b) Not being used to carry persons tions are to test for, monitor, or property for a charge; clean up, remove, contain, treat, detoxify or neutralize, or in any (3) Parking an "auto" on, or on the ways way respond to, or assess the next to, premises you own or rent, effects of, "pollutants". provided the "auto" is not owned by Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 4 of 22 or rented or loaned to you or the in- (1) Property you own, rent or occupy, in- sured; in- cluding any costs or expenses in- curred by you, or any other person, 4 Liability assumed under an insured () y y � organization or entity, for repair, re - contract" for the ownership, mainte- placement, enhancement, restoration nance or use of aircraft or watercraft; or maintenance of such property for or any reason, including prevention of (5) "Bodily injury" or "property damage" injury to a person or damage to an - arising out of: other's property; (a) The operation of machinery or (2) Premises you sell, give away or equipment that is on, attached abandon, if the "property damage" to, or part of, a land vehicle that arises out of any part of those prem- would qualify under the definition ises; of "mobile equipment" if it were (3) Property loaned to you; not subject to a compulsory or financial responsibility law or (4) Personal property in the care, cus- other motor vehicle insurance tody or control of an insured; law in the state where it is li- censed or principally garaged; or (5) That particular part of real property on which you or any contractors or (b) The operation of any of the ma- subcontractors working directly or in- chinery or equipment listed in directly on your behalf are performing Paragraph f.(2) or f.(3) of the operations, if the "property damage" definition of "mobile equipment". arises out of those operations; or h. Mobile Equipment (6) That particular part of any property that must be restored, repaired or re - "Bodily injury" or "property damage" aris- placed because "your work" was fin- ing out of: correctly performed on it. (1) The transportation of "mobile equip- ment" by an "auto" owned or oper- ated by or rented or loaned to any in- sured; or (2) The use of "mobile equipment" in, or while in practice for, or while being prepared for, any prearranged rac- ing, speed, demolition, or stunting activity. i. War "Bodily injury" or "property damage", how- ever caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, in- cluding action in hindering or defend- ing against an actual or expected at- tack, by any government, sovereign or other authority using military per- sonnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. Damage to Property "Property damage" to: Paragraphs (1), (3) and (4) of this exclu- sion do not apply to "property damage" (other than damage by fire or explosion) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days, for which the amount we will pay is limited to the Damage To Premises Rented To You Limit as described in SECTION III - LIM- ITS OF INSURANCE. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this ex- clusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations haz- ard". k. Damage to Your Product "Property damage" to "your product" aris- ing out of it or any part of it. Damage to Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products -completed operations haz- ard". Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 5 of 22 This exclusion does not apply if the dam- (c) Other employment -related prac- aged work or the work out of which the tices, policies, acts or omissions damage arises was performed on your including but not limited to coer- behalf by a subcontractor. cion, criticism, demotion, evalua- m. Damage to Impaired Property yor Prop- tion, failure to promote, reas- signment, discipline, defamation, erty Not Physically Injured harassment, humiliation or dis- "Property damage" to "impaired property" crimination directed at that per - or property that has not been physically son; or injured, arising out of: (2) The spouse, child, parent, brother or (1) A defect, deficiency, inadequacy or sister of that person as a conse- dangerous condition in "your prod- quence of "bodily injury" to that per- uct" or "your work"; or son at whom any of the employment - related practices described in Para- (2) A delay or failure by you or anyone graphs (a), (b) or (c) above is di - acting on your behalf to perform a rected. contract or agreement in accordance with its terms. This exclusion applies: This exclusion does not apply to the loss (1) Whether the insured may be liable as of use of other property arising out of an employer or in any other capacity; sudden and accidental physical injury to and "your product" or "your work" after it has (2) To any obligation to share damages been put to its intended use. with or repay someone else who n. Recall of Products, Work or Impaired must pay damages because of the Property injury. Any liability or damages claimed for any r. Additional Insured Prior Knowledge loss, cost or expense incurred by you or An additional insured added by attach - others for the loss of use, withdrawal, re- ment of an endorsement to this Coverage call, inspection, repair, replacement, ad- Part that is seeking coverage for a claim justment, removal or disposal of: or "suit", if that additional insured knew, (1) 'Your product"; per the following paragraph, that "bodily injury" or "property damage" had occurred (2) "Your work"; or or had begun to occur, in whole or in part, prior to the "coverage term" in which such (3) "Impaired property"; "bodily injury" or "property damage" oc- if such product, work or property is with- curs or begins to occur. drawn or recalled from the market or from An additional insured added by attach - use by any person or organization be- ment of an endorsement to this Coverage cause of a known or suspected defect, Part will be deemed to have known that deficiency, inadequacy or dangerous con- "bodily injury" or "property damage" has dition in it. occurred or has begun to occur at the o. Personal and Advertising Injury earliest time when that additional insured, or any one of its owners, members, part - "Bodily injury" arising out of "personal and ners, managers, executive officers, "em- advertising injury". ployees" assigned to manage that addi- p. Asbestos tional insured's insurance program, or "employees" assigned to give or receive "Bodily injury" or "property damage" aris- notice of an "occurrence", "personal and ing out of, attributable to, or any way re- advertising injury" offense, claim or "suit": lated to asbestos in any form or transmit- (1) Reports all, or any part, of the "bodily ted in any manner. injury" or "property damage" to us or q. Employment -Related Practices any other insurer; "Bodily injury" to: (2) Receives a written or verbal demand or claim for damages because of the (1) A person arising out of any: "bodily injury" or "property damage"; (a) Refusal to employ that person; (3) First observes, or first observed, the (b) Termination of that person's em- "bodily injury" or "property damage"; ployment; or Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 6 of 22 (4) Becomes aware, or become aware, (1) The amount we will pay for damages by any means other than as de- is limited as described in SECTION scribed in (3) above, that "bodily in- III - LIMITS OF INSURANCE; and jury" or "property damage" had oc- curred or had begun to occur; or (2) Our right and duty to defend ends when we have used up the applica- (5) Becomes aware, or become aware, ble limit of insurance in the payment of a condition from which "bodily in- of judgments or settlements under jury" or "property damage" is sub- SECTION I - COVERAGES, COV- stantially certain to occur. ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY; s. Electronic Data SECTION I - COVERAGES, COV- Damages arising out of the loss of, loss of ERAGE B. PERSONAL AND AD - use of, damage to, corruption of, inability VERTISING INJURY LIABILITY; or to access, or inability to manipulate "elec- medical expenses under SECTION tronic data". - COVERAGES, COVERAGE C. MEDICAL PAYMENTS. t. Distribution of Material in Violation of Statutes No other obligation or liability to pay sums or perform acts or services is covered "Bodily injury" or "property damage" aris- unless expressly provided for under ing directly or indirectly out of any action SUPPLEMENTARY PAYMENTS - COV- or omission that violates or is alleged to ERAGES A AND B. violate: b. This insurance applies to "personal and a. The Telephone Consumer Protection advertising injury" only if: Act (TCPA), including any amendment of or addition to such law; or (1) The "personal and advertising injury" is caused by an offense arising out of b. The CAN-SPAM Act of 2003, includ- your business; and ing any amendment of or addition to such law; or (2) The "personal and advertising injury" offense was committed in the "cover- c. Any statute, ordinance or regulation, age territory" during the policy period; other than the TCPA or CAN-SPAM and Act of 2003, that prohibits or limits the sending, transmitting, communicating (3) Prior to the "coverage term" in which or distribution of material or informa- the "personal and advertising injury" tion. offense is committed, you did not know, per Paragraph 1.d. below, that Exclusions c. through q. do not apply to "prop- the offense had been committed or erty damage" by fire or explosion to premises had begun to be committed, in whole while rented to you or temporarily occupied by or in part. you with permission of the owner, for which the amount we will pay is limited to the Dam- c. "Personal and advertising injury" caused age to Premises Rented To You Limit as de- by an offense which: scribed in SECTION III - LIMITS OF INSUR- (1) Was committed during the "coverage ANCE. term"; and COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as dam- ages because of "personal and advertis- ing injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal and advertising injury" to which this insurance does not apply. We may, at our discre- tion, investigate any offense and settle any claim or "suit" that may result. But: (2) Was not, prior to the "coverage term", known by you, per Paragraph 1.d. below, to have been committed; includes any continuation, change or re- sumption of that offense after the end of the "coverage term" in which it first be- came known by you. d. You will be deemed to know that a "per- sonal and advertising injury" offense has been committed at the earliest time when any "authorized representative": (1) Reports all, or any part, of the "per- sonal and advertising injury" to us or any other insurer; Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 7 of 22 (2) Receives a written or verbal demand (1) That the insured would have in the or claim for damages because of the absence of the contract or agree - "personal and advertising injury"; ment; or (3) First observes, or first observed, the (2) Assumed in a contract or agreement offense that caused the "personal that is an "insured contract", provided and advertising injury"; the "personal and advertising injury" is caused by or arises out of an of- 4 Becomes aware, or become aware, () fense committed subsequent to the by any means, other than as de- execution of the contract or agree - scribed in (3) above, that the offense ment. When a claim for such "per - had been committed or had begun to sonal and advertising injury" is made, be committed; or we will defend that claim, provided (5) Becomes aware, or become aware, the insured has assumed the obliga- of a condition from which "personal tion to defend such claim in the "in - and advertising injury" is substantially sured contract". Such defense pay - certain to occur. ments will not reduce the limits of in- surance. 2. Exclusions f. Breach of Contract This insurance does not apply to: "Personal and advertising injury" arising a. Knowing Violation of Rights of An- out of a breach of contract, except an im- other plied contract to use another's advertising idea in your "advertisement". "Personal and advertising injury" caused by or at the direction of the insured with g. Quality or Performance of Goods - the knowledge that the act would violate Failure to Conform to Statements the rights of another and would inflict "personal and advertising injury". "Personal and advertising injury" arising out of the failure of goods, products or b. Material Published With Knowledge of services to conform with any statement of Falsity quality or performance made in your "ad- vertisement". "Personal and advertising injury" arising out of oral or written publication of mate- h. Wrong Description of Prices rial, if done by or at the direction of the in- sured with knowledge of its falsity. "Personal and advertising injury" arising out of the wrong description of the price c. Material Published Prior to Coverage of goods, products or services stated in Term your "advertisement". "Personal and advertising injury" arising i. Infringement of Copyright, Patent, out of oral or written publication of mate- Trademark or Trade Secret rial whose first publication took place be- fore the later of the following: "Personal and advertising injury" arising out of the infringement of copyright, pat- (1) The inception of this Coverage Part; ent, trademark, trade secret or other intel- or lectual property rights. (2) The "coverage term" in which insur- However, this exclusion does not apply to ance coverage is sought. infringement, in your "advertisement", of d. Criminal Acts copyright, trade dress or slogan. "Personal and advertising injury" arising j• Insureds in Media and Internet Type out of a criminal act committed by or at Businesses the direction of the insured. "Personal and advertising injury" commit- e. Contractual Liability ted by an insured whose business is: "Personal and advertising injury" for (1) Advertising, broadcasting, publishing which the insured is obligated to pay or telecasting; damages by reason of the assumption of (2) Designing or determining content of liability in a contract or agreement. This web -sites for others; or exclusion does not apply to liability for damages: (3) An Internet search, access, content or service provider. Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 8 of 22 However, this exclusion does not apply to n. Pollutant Paragraphs 17. a., b. and c. of "personal and advertising injury" under SECTION V "Personal and advertising injury" arising -DEFINITIONS. out of the actual, alleged or threatened discharge, dispersal, seepage, migration, For the purposes of this exclusion, the release, escape or emission of "pollut- placlng of frames, borders or links, or ad- ants" at any time. vertising, for you or others anywhere on the Internet is not, by itself, considered o. Pollutant -Related the business of advertising, broadcasting, Any loss, cost or expense arising out of publishing or telecasting. any: k. Electronic Chatrooms or Bulletin (1) Request, demand, order or statutory Boards or regulatory requirement that any "Personal and advertising injury" arising insured or others test for, monitor, out of an electronic chatroom or bulletin clean up, remove, contain, treat, de - board any insured hosts, owns, or over toxify or neutralize, or in any way re - which any insured exercises control. spond to, or assess the effects of, "pollutants"; or I. Unauthorized Use of Another's Name or Product (2) Claim or suit by or on behalf of a governmental authority for damages "Personal and advertising injury" arising because of testing for, monitoring, out of the unauthorized use of another's cleaning up, removing, containing, name or product in your e-mail address, treating, detoxifying or neutralizing, domain name or metatag, or any other or in any way responding to, or as - similar tactics to mislead another's poten- sessing the effects of, "pollutants". tial customers. p. Asbestos m. Employment Related Practices "Personal and advertising injury" arising "Personal and advertising injury" to: out of, attributable to, or any way related to asbestos in any form or transmitted in (1) A person arising out of any: any manner. (a) Refusal to employ that person; q, Additional Insured Prior Knowledge (b) Termination of that person's em- An additional insured added by attach- ployment; or ment of an endorsement to this Coverage (c) Other employment -related prac- Part that is seeking coverage for a claim tices, policies, acts or omissions or "suit", if that additional insured knew, including but not limited to coer- per the following paragraph, that a "per- cion, criticism, demotion, evalua- sonal and advertising injury" offense had tion, failure to promote, reas- been committed or had begun to be signment, discipline, defamation, committed, in whole or in part, prior to the harassment, humiliation or dis- "coverage term" in which such offense crimination directed at that per- was committed or began to be committed. son; or An additional insured added by attach- (2) The spouse, child, parent, brother or ment of an endorsement to this Coverage sister of that person as a conse- Part will be deemed to have known that a quence of "personal and advertising "personal and advertising injury" offense injury" to that person at whom any of has been committed or has begun to be the employment -related practices committed at the earliest time when that described in Paragraphs (a), (b) or additional insured, or any one of its own- (c) above is directed. ers, members, partners, managers, ex- ecutive officers, "employees" assigned to This exclusion applies: manage that additional insured's insur- ance program, or "employees" assigned (1) Whetherthe insured y be liable as to give or receive notice of an "occur - an employer or in any other capacity; rence", "personal and advertising injury" and offense, claim or "suit": (2) To any obligation to share damages (1) Reports all, or any part, of the "per - with or repay someone else who sonal and advertising injury" to us or must pay damages because of the any other insurer; injury. Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 9 of 22 (2) Receives a written or verbal demand or claim for damages because of the "personal and advertising injury"; (3) First observes, or first observed, the offense that caused the "personal and advertising injury"; (4) Becomes aware, or become aware, by any means other than as de- scribed in (3) above, that the "per- sonal and advertising injury" offense had been committed or had begun to be committed; or (5) Becomes aware, or become aware, of a condition from which "personal and advertising injury" is substantially certain to occur. r. War "Personal and advertising injury", how- ever caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, in- cluding action in hindering or defend- ing against an actual or expected at- tack, by any government, sovereign or other authority using military per- sonnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. s. Distribution of Material in Violation of Statutes "Personal and advertising injury" arising directly or indirectly out of any action or omission that violates or is alleged to vio- late: a. The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; or b. The CAN-SPAM Act of 2003, includ- ing any amendment of or addition to such law; or c. Any statute, ordinance or regulation, other than the TCPA or CAN-SPAM Act of 2003, that prohibits or limits the sending, transmitting, communicating or distribution of material or informa- tion. a. We will pay medical expenses as de- scribed below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (1) The accident takes place in the "cov- erage territory" and during the policy period; (2) The expenses are incurred and re- ported to us within three years of the date of the accident; and (3) The injured person submits to ex- amination, at our expense, by physi- cians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, x-ray and dental services, including pros- thetic devices; and (3) Necessary ambulance, hospital, pro- fessional nursing and funeral ser- vices. 2. Exclusions We will not pay expenses for "bodily irury": a. Any Insured To any insured, except "volunteer work- ers". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury on Normally Occupied Premises To a person injured on that part of prem- ises you own or rent that the person nor- mally occupies. d. Workers' Compensation and Similar Laws COVERAGE C. MEDICAL PAYMENTS To a person, whether or not an "em- ployee" of any insured, if benefits for the 1. Insuring Agreement "bodily injury" are payable or must be pro- vided under a workers' compensation or disability benefits law or a similar law. Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 10 of 22 e. Athletic Activities a. An individual, you and your spouse are insureds, but only with respect to the con - To any person injured while officiating, duct of a business of which you are the coaching, practicing for, instructing or sole owner. participating in any physical exercises or games, sports, or athletic contests or ex- b. A partnership or joint venture, you are an hibitions of an athletic or sports nature. insured. Your members, your partners, and their spouses are also insureds, but f. Products -Completed Operations Haz- only with respect to the conduct of your and business. Included within the "products -completed c. A limited liability company, p y, you are an in - operations hazard". sured. Your members are also insureds, g. Coverage A Exclusions but only with respect to the conduct of your business. Your managers are insur- Excluded under COVERAGE A. BODILY eds, but only with respect to their duties INJURY AND PROPERTY DAMAGE LI- as your managers. ABILITY. d. An organization other than a partnership, SUPPLEMENTARY PAYMENTS - COVERAGES joint venture or limited liability company, A AND B you are an insured. Your "executive offi- cers" and directors are insureds, but only We will pay, with respect to any claim we investi- with respect to their duties as your offi- gate or settle, or any "suit" against an insured we cers or directors. Your stockholders are defend: also insureds, but only with respect to 1. All expenses we incur. their liability as stockholders. 2. Up to $250 for cost of bail bonds required be- e. A trust, you are an insured. Your trustees cause of accidents or traffic law violations are also insureds, but only with respect to arising out of the use of any vehicle to which their duties as trustees. the Bodily Injury Liability Coverage applies. 2. Each of the following is also an insured: We do not have to furnish these bonds. a• Your "volunteer workers" only while per- 3. The cost of bonds to release attachments, but forming duties related to the conduct of only for bond amounts within the applicable your business, or your "employees", other limit of insurance. We do not have to furnish than either your 'executive officers" (if these bonds. you are an organization other than a 4. All reasonable expenses incurred by the in- partnership, joint venture or limited liability sured at our request to assist us in the investi- company) or your managers (if you are a gation or defense of the claim or "suit", includ- limited liability company), but only for acts ing actual loss of earnings up to $250 a day within the scope of their employment by because of time off from work. you or while performing duties related to the conduct of your business. However, 5. All costs taxed against the insured in the none of these "employees" or "volunteer "suit". workers" are insureds for: 6. Prejudgment interest awarded against the in- (1) "Bodily injury" or "personal and ad- sured on that part of the judgment we become vertising injury": obligated to pay and which falls within the ap- plicable limit of insurance. If we make an offer (a) To you, to your partners or to pay the applicable limit of insurance, we will members (if you are a partner - not pay any prejudgment interest based on ship or joint venture), to your that period of time after the offer. members (if you are a limited li- ability company), to a co- 7. All interest on the full amount of any judgment "employee" while in the course that accrues after entry of the judgment and of his or her employment or per - before we have paid, offered to pay, or depos- forming duties related to the ited in court the part of the judgment that is conduct of your business, or to within the applicable limit of insurance. your other "volunteer workers" while performing duties relatedto These payments will not reduce the limits of insur- the conduct of your business; ance. SECTION II -WHO IS AN INSURED (b) To the spouse, child, parent, brother or sister of that co- 1. If you are designated in the Declarations as: "employee" or 'volunteer Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 11 of 22 worker" as a consequence of c. COVERAGE B. PERSONAL AND AD - Paragraph (1)(a) above; VERTISING INJURY LIABILITY does not apply to "personal and advertising injury" (c) For which there is any obligation arising out of an offense committed be - to share damages with or repay fore you acquired or formed the organiza- someone else who must pay tion. damages because of the injury described in Paragraphs (1)(a) No person or organization is an insured with re - or (b) above; or spect to the conduct of any current or past partner- ship, joint venture or limited liability company that (d) Arising out of his or her provid- is not shown as a Named Insured in the Declara- ing or failing to provide profes- tions. sional health care services. SECTION III - LIMITS OF INSURANCE (2) "Property damage" to property: 1 • The Limits of Insurance shown in the Declara- (a) Owned, occupied or used by; or tions and the rules below fix the most we will (b) Rented to, in the care, custody pay regardless of the number of: or control of, or over which a. Insureds; physical control is being exer- cised for any purpose by, b. Claims made or "suits" brought; or you, any of your "employees", "volun- c. Persons or organizations making claims teer workers", any partner or member or bringing "suits". (if you are a partnership or joint ven- ture), or any member (if you are a 2. a. The General Aggregate Limit is the most limited liability company). we will pay for the sum of: b. Any person (other than your "employee" (1) Medical expenses under COVER - or "volunteer worker"), or any organiza- AGE C. MEDICAL PAYMENTS; tion while acting as your real estate man- (2) Damages under COVERAGE A. ager. BODILY INJURY AND PROPERTY c. Any person or organization having proper DAMAGE LIABILITY, except dam - temporary custody of your property if you ages because of "bodily injury" or die, but only: "property damage" included in the "products -completed operations haz- (1) With respect to liability arising out of and"; and the maintenance or use of that prop- erty; and (3) Damages under COVERAGE B. PERSONAL AND ADVERTISING (2) Until your legal representative has INJURY LIABILITY. been appointed. This General Aggregate Limit will not ap- d. Your legal representative if you die, but ply if either the Location General Aggre- only with respect to duties as such. That gate Limit of Insurance, Paragraph 2.b., representative will have all your rights or the Construction Project General Ag- and duties under this Coverage Part. gregate Limit of Insurance, Paragraph 2.c. applies. 3. Any organization you newly acquire or form, other than a partnership, joint venture or lim- b. A separate Location General Aggregate ited liability company, and over which you Limit of Insurance, equal to the amount of maintain ownership or majority interest, will the General Aggregate Limit shown in the qualify as a Named Insured if there is no other Declarations, shall apply to each location similar insurance available to that organiza- owned by, or rented or leased to you and tion. However: is the most we will pay for the sum of: a. Insurance under this provision is afforded (1) Damages under COVERAGE A. only until the 90th day after you acquire or BODILY INJURY AND PROPERTY form the organization or the end of the DAMAGE LIABILITY, except dam - policy period, whichever is earlier; ages because of "bodily injury" or "property damage" included in the b. COVERAGE A. BODILY INJURY AND "products -completed operations haz- PROPERTY DAMAGE LIABILITY does ard ,and not apply to "bodily injury" or "property damage" that occurred before you ac- (2) Medical expenses under COVER- quired or formed the organization; and AGE C. MEDICAL PAYMENTS, Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 12 of 22 which can be attributed to operations at only a single location owned by, or rented or leased to you. c. A separate Construction Project General Aggregate Limit of Insurance, equal to the amount of the General Aggregate Limit shown in the Declarations, shall apply to each construction project and is the most we will pay for the sum of: (1) Damages under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, except dam- ages because of "bodily injury" or "property damage" included in the "products -completed operations haz- ard"; and (2) Medical expenses under COVER- AGE C. MEDICAL PAYMENTS; which can be attributed only to ongoing operations and only at a single construc- tion project. d. Only for the purpose of determining which General Aggregate Limit of Insurance, 2.a., 2.b., or 2.c., applies: (1) Location means premises involving the same or connecting lots, or prem- ises, whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. (2) Construction project means a loca- tion you do not own, rent or lease where ongoing improvements, altera- tions, installation, demolition or main- tenance work is performed by you or on your behalf. All connected ongo- ing improvements, alterations, instal- lation, demolition or maintenance work performed by you or on your behalf at the same location for the same persons or organizations, no matter how often or under how many different contracts, will be deemed to be a single construction project. 3. The Products -Completed Operations Aggre- gate Limit is the most we will pay under COV- ERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY for damages be- cause of "bodily injury" and "property damage" included in the "products -completed opera- tions hazard". 4. Subject to 2.a. above, the Personal and Ad- vertising Injury Limit is the most we will pay under COVERAGE B. PERSONAL AND AD- VERTISING INJURY LIABILITY for the sum of all damages because of all "personal and advertising injury" sustained by any one per- son or organization. 5. Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LI- ABILITY; and b. Medical expenses under COVERAGE C. MEDICAL PAYMENTS; because of all "bodily injury" and "property damage" arising out of anyone "occurrence". 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY for dam- ages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire or explosion, while rented to you or temporarily occupied by you with permission of the owner. 7. Subject to 5. above, the Medical Expense Limit is the most we will pay under COVER- AGE C. MEDICAL PAYMENTS for all medical expenses because of "bodily injury" sustained by any one person. The Limits of Insurance of this Coverage Part ap- ply separately to each "coverage term". SECTION IV -COMMERCIAL GENERAL LIABIL- ITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties in the Event of Occurrence, Offense, Claim or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or a "personal and advertising injury" of- fense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occur- rence" or offense took place; (2) The names and addresses of any in- jured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occur- rence" or offense. b. If a daim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the daim or "suit' and the date re- ceived; and (2) Notify us as soon as practicable. Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 13 of 22 You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or le- gal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investiga- tion or settlement of the claim or de- fense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any ex- pense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to re- cover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable un- der the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal repre- sentative. 4. Liberalization If, within 60 days prior to the beginning of this Coverage Part or during the policy period, we make any changes to any forms or endorse- ments of this Coverage Part for which there is currently no separate premium charge, and that change provides more coverage than this Coverage Part, the change will automatically apply to this Coverage Part as of the latter of a. The date we implemented the change in your state; or b. The date this Coverage Part became ef- fective; and will be considered as included until the end of the current policy period. We will make no ad- ditional premium charge for this additional coverage during the interim. 5. Other Insurance If other valid and collectible insurance is avail- able to the insured for a loss we cover under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY or COV- ERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other in- surance by the method described in c. below. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Cover- age, Builder's Risk, Installation Risk or similar insurance for "your work"; (b) That is Fire or Explosion insur- ance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or tem- porarily occupied by you with permission of the owner; or (d) If the loss arises out of the main- tenance or use of aircraft, "autos" or watercraft to the ex- tent not subject to SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY, 2. Exclusions, g. Aircraft, Auto or Watercraft. (2) Any other primary insurance avail- able to the insured covering liability for damages arising out of the prem- ises or operations, or the products and completed operations, for which Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 14 of 22 C. the insured has been added as an to the total applicable limits of insurance additional insured by attachment of of all insurers. an endorsement. 6. Premium Audit (3) Any other insurance: a. We will compute all premiums for this (a) Whether primary, excess, con- Coverage Part in accordance with our tingent or on any other basis, rules and rates. except when such insurance is written specifically to be excess b. Premium shown in this Coverage Part as over this insurance; and advance premium is a deposit premium only. At the dose of each audit period we (b) That is a consolidated (wrap-up) will compute the earned premium for that insurance program which has period and send notice to the first Named been provided by the prime con- Insured. The due date for audit and retro- tractor/project manager or owner spective premiums is the date shown as of the consolidated project in the due date on the bill. If: which you are involved. (1) The earned premium is less than the When this insurance is excess, we will deposit premium, we will return the have no duty under COVERAGE A. excess to the first Named Insured; or BODILY INJURY AND PROPERTY DAMAGE LIABILITY or COVERAGE B. (2) The earned premium is greater than PERSONAL AND ADVERTISING IN- the deposit premium, the difference JURY LIABILITY to defend the insured will be due and payable to us by the against any "suit" if any other insurer has first Named Insured upon notice from a duty to defend the insured against that us. "suit". If no other insurer defends, we will c. The first Named Insured must keep re - undertake to do so, but we will be entitled cords of the information we need for Pre- to the insured's rights against all those mium computation, and send us copies at other insurers. such times as we may request. When this insurance is excess over other 7. Representations insurance, we will pay only our share of the amount of the loss, if any, that ex- By accepting this Coverage Part, you agree: ceeds the sum of: a. The statements in the Declarations are (1) The total amount that all such other accurate and complete; insurance would pay for the loss in the absence of this insurance; and b. Those statements are based upon repre- sentations you made to us; and (2) The total of all deductible and self - insured amounts under all that other c. We have issued this Coverage Part in re- insurance. liance upon your representations. We will share the remaining loss, if any, 8. Separation of Insureds with any other insurance that is not de- Except with respect to the Limits of Insurance, scribed in this Excess Insurance provision and any rights or duties specifically assigned and was not bought specifically to apply in this Coverage Part to the first Named In - in excess of the Limits of Insurance sured, this insurance applies: shown in the Declarations of this Cover- age Part. a. As if each Named Insured were the only Named Insured; and Method of Sharing b• Separately to each insured against whom If all of the other insurance permits con- claim is made or suit is brought. tribution by equal shares, we will follow this method also. Under this approach 9. Transfer of Rights of Recovery Against each insurer contributes equal amounts Others to Us until it has paid its applicable limit of insurance or none of the loss remains, If the insured has rights to recover all or part whichever comes first. of any payment we have made under this Coverage Part, those rights are transferred to If any of the other insurance does not us. The insured must do nothing after loss to permit contribution by equal shares, we impair them. At our request, the insured will will contribute by limits. Under this bring "suit" or transfer those rights to us and method, each insurer's share is based on help us enforce them. the ratio of its applicable limit of insurance Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 15 of 22 10. Two or More Coverage Forms or Policies Issued by Us If this Coverage Part and any other Coverage Form or Coverage Part forming a part of this policy apply to the same "occurrence" or "per- sonal and advertising injury" offense, the ag- gregate maximum Limit of Insurance under all the Coverage Forms or Coverage Parts shall not exceed the highest applicable Limit of In- surance under any one Coverage Form or Coverage Part. This condition does not apply to any Coverage Form or Coverage Part is- sued by us specifically to apply as excess in- surance over this Coverage Part. 11. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named In- sured shown in the Declarations written notice of the nonrenewal not less than 30 days be- fore the expiration date. If notice is mailed, proof of mailing will be suf- ficient proof of notice. SECTION V -DEFINITIONS "Advertisement" means a notice that is broad- cast, telecast or published to the general pub- lic or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. "Adver- tisement" includes a publicity article. For pur- poses of this definition: publicly traded organization, your stockholders are also "authorized representatives". (5) A trust, your trustees are "authorized representatives". b. Your "employees": (1) Assigned to manage your insurance program; or (2) Responsible for giving or receiving notice of an "occurrence", "personal and advertising injury" offense, claim or "suit"; are also "authorized representatives". 3. "Auto" means: a. A land motor vehicle, trailer or semitrailer designed for travel on public roads, in- cluding any attached machinery or equipment; or b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 4. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. a. Notices that are published include mate- rial placed on the Internet or on similar 5. "Coverage term" means the following individ- electronic means of communication; and ual increment, or if a multi -year policy period, increments, of time, which comprise the policy b. Regarding web -sites, only that part of a period of this Coverage Part: web -site that is about your goods, prod- ucts or services for the purposes of at- a. The year commencing on the Effective tracting customers or supporters is con- Date of this Coverage Part at 12:01 AM sidered an "advertisement". standard time at your mailing address shown in the Declarations, and if a multk 2. "Authorized representative" means: year policy period, each consecutive an- nual nual period thereafter, or portion thereof if . If you are designated in the Declarations any period is for a period of less than 12 as: months, constitute individual "coverage (1) An individual, you and your spouse terms". The last "coverage term" ends at are "authorized representatives". 12:00 AM standard time at your mailing address shown in the Declarations on the (2) A partnership or joint venture, your earlier of: members, your partners, and their spouses are "authorized representa- (1) The day the policy period shown in tives". the Declarations ends; or (3) A limited liability company, your (2) The day the policy to which this Cov- members and your managers are erage Part is attached is terminated "authorized representatives". or cancelled. (4) An organization other than a partner- b. However, if after the issuance of this Cov- ship, joint venture or limited liability erage Part, any "coverage term" is ex - company, your "executive officers" tended for an additional period of less and directors are "authorized repre- than 12 months, that additional period of sentatives". Provided you are not a Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 16 of 22 time will be deemed to be part of the last b. You have failed to fulfill the terms of a preceding "coverage term". contract or agreement; 6. "Coverage territory" means: if such property can be restored to use by: a. The United States of America (including a. The repair, replacement, adjustment or its territories and possessions), Puerto removal of "your product" or "your work"; Rico and Canada; or b. International waters or airspace, but only b. Your fulfilling the terms of the contract or if the injury or damage occurs in the agreement. course of travel or transportation between any places included in a. above; or 12. "Insured contract" means: c. All other parts of the world if the injury or a. A contract for a lease of premises. How - damage arises out of: ever, that portion of the contract for a lease of premises that indemnifies any (1) Goods or products made or sold by person or organization for "property dam - you in the territory described in a. age" by fire or explosion to premises above; while rented to you or temporarily occu- pied by you with permission of the owner () p is not an "insured contract"; home is in the territory described in a. above, but is away for a short time b. A sidetrack agreement; on your business; or c. Any easement or license agreement, ex- (3) "Personal and advertising injury" of- cept in connection with construction or fenses that take place through the demolition operations on or within 50 feet Internet or similar electronic means of a railroad; of communication, d. An obligation, as required by ordinance, provided the insured's responsibility to to indemnify a municipality, except in con - pay damages is determined in a "suit" on nection with work for a municipality; the merits, in the territory described in a. above or in a settlement to which we e. An elevator maintenance agreement; agree. f. That part of any other contract or agree- 7. "Electronic data" means information, facts or ment pertaining to your business (includ- programs stored as or on, created or used on, ing an indemnification of a municipality in or transmitted to or from computer software, connection with work performed for a including systems and applications software, municipality) under which you assume the hard or floppy disks, CD-ROMs, tapes, drives, tort liability of another party to pay for cells, data processing devices or any other "bodily injury", "property damage" or "per - media which are used with electronically con- sonal and advertising injury" to a third trolled equipment. person or organization. Tort liability means a liability that would be imposed 8. "Employee" includes a "leased worker". "Em- by law in the absence of any contract or ployee" does not include a "temporary agreement. worker". Paragraph f. does not include that part of 9. "Executive officer" means a person holding any contract or agreement: any of the officer positions created by your charter, constitution, by-laws or any other (1) That indemnifies a railroad for "bodily similar governing document. injury", "property damage" or "per- sonal and advertising injury" arising 10. "Hostile fire" means one which becomes un- out of construction or demolition op - controllable or breaks out from where it was erations, within 50 feet of any rail - intended to be. road property and affecting any rail- road bridge or trestle, tracks, road- 11. "Impaired property" means tangible property, beds, tunnel, underpass or crossing; other than 'your product" or "your work", that cannot be used or is less useful because: (2) That indemnifies an architect, engi- neer or surveyor for injury or damage a. It incorporates "your product" or "your arising out of: work" that is known or thought to be de- fective, deficient, inadequate or danger- (a) Preparing, approving, or failing ous; or to prepare or approve, maps, shop drawings, opinions, re- ports, surveys, field orders, Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 17 of 22 change orders or drawings and der Internet services, including those specifications; or listed in Paragraph (6), above. (b) Giving directions or instructions, 13. "Leased worker' means a person leased to or failing to give them, if that is you by a labor leasing firm under an agree - the primary cause of the injury or ment between you and the labor leasing firm, damage; to perform duties related to the conduct of your business. "Leased worker" includes su- (3) Under which the insured, if an archi- pervisors furnished to you by the labor leasing tect, engineer or surveyor, assumes firm. "Leased worker" does not include a liability for an injury or damage aris- �� 'temporary worker'. ing out of the insured's rendering or failure to render professional ser- 14. "Loading or unloading" means the handling of vices, including those listed in Para- property: graph (2) above and supervisory, in- spection, architectural or engineering a. After it is moved from the place where it is activities; accepted for movement into or onto an aircraft, watercraft or "auto"; (4) That indemnifies an advertising, pub- lic relations or media consulting firm b. While it is in or on an aircraft, watercraft for "personal and advertising injury" or "auto"; or arising out of the planning, execution c. While it is being moved from an aircraft, or failure to execute marketing com- watercraft or "auto" to the place where it munications programs. Marketing is finally delivered; communications programs include but are not limited to comprehensive but "loading or unloading" does not include the marketing campaigns; consumer, movement of property by means of a me - trade and corporate advertising for all chanical device, other than a hand truck, that media; media planning, buying, is not attached to the aircraft, watercraft or monitoring and analysis; direct mail; "auto". promotion; sales materials; design; presentations; point -of -sale materi- 15. "Mobile equipment" means any of the follow- als; market research; public relations ing types of land vehicles, including any st- and new product development; tached machinery or equipment: (5) Under which the insured, if an adver- a. Bulldozers, farm machinery, forklifts and tising, public relations or media con- other vehicles designed for use principally sulting firm, assumes liability for "per- off public roads; sonal and advertising injury" arising b. Vehicles maintained for use solely on or out of the insured's rendering or fail- next to premises you own or rent; ure to render professional services, including those services listed in c. Vehicles that travel on crawler treads; Paragraph (4), above; d. Vehicles, whether self-propelled or not, (6) That indemnifies a web -site designer maintained primarily to provide mobility to or content provider, or Internet permanently mounted: search, access, content or service provider for injury or damage arising (1) Power cranes, shovels, loaders, dig - out of the planning, execution or fail- gers or drills; or ure to execute Internet services. (2) Road construction or resurfacing Internet services include but are not equipment such as graders, scrapers limited to design, production, distribu- or rollers; tion, maintenance and administration of web -sites and web -banners; host- e. Vehicles not described in a., b., c. or d. ing web -sites; registering domain above that are not self-propelled and are names; registering with search en- maintained primarily to provide mobility to gines; marketing analysis; and pro- permanently attached equipment of the viding access to the Internet or other following types: similar networks; or (1) Air compressors, pumps and genera- (7) Under which the insured, if a web- tors, including spraying, welding, site designer or content provider, or building cleaning, geophysical explo- Internet search, access, content or ration, lighting and well servicing service provider, assumes liability for equipment; or injury or damage arising out of the insured's rendering or failure to ren- Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 18 of 22 (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not con- struction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and genera- tors, including spraying, welding, building cleaning, geophysical explo- ration, lighting and well servicing equipment. However, "mobile equipment" does not in- clude any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law in the state where it is licensed or principally garaged. Land vehicles subject to a compulsory or fi- nancial responsibility law or other motor vehi- cle insurance law are considered "autos". 16. "Occurrence" means an accident, including continuous or repeated exposure to substan- tially the same general harmful conditions. 17. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private oc- cupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or ser- vices; f. The use of another's advertising idea in your "advertisement"; or g. Infringing upon another's copyright, trade dress or slogan in your "advertisement". 18. "Pollutant" means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, petroleum, petroleum products and petroleum by-products, and waste. Waste in- cludes materials to be recycled, reconditioned or reclaimed. 19. "Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been com- pleted or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been com- pleted; or (b) When all of the work to be done at the job site has been com- pleted if your contract calls for work at more than one job site; or (c) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, mainte- nance, correction, repair or replace- ment, but which is otherwise com- plete, will be treated as completed. b. Does not include "bodily injury" or "prop- erty damage" arising out of: (1) The transportation of property, un- less the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equipment or abandoned or unused materials; or e. Oral or written publication, in any manner, of material that violates a person's right of (3) Products or operations for which the privacy; classification, listed in the Declara- tions or in a schedule, states that Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 19 of 22 products -completed operations are included. 20. "Property damage" means: a. Physical injury to tangible property, in- cluding all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physi- cal injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. 21. "Suit" means a civil proceeding in which money damages because of "bodily injury", "property damage" or "personal and advertis- ing injury" to which this insurance applies are alleged. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent; or c. An appeal of a civil proceeding. 22. 'Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 23. "Volunteer worker" means a person who is not your "employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 24. "Workplace" means that place and during such hours to which the "employee" sustaining "bodily injury" was assigned by you, or any other person or entity acting on your behalf, to work on the date of "occurrence". 25. "Your product": a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have ac- quired; and (2) Containers (other than vehicles), ma- terials, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fit- ness, quality, durability, performance or use of "your product"; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. 26. '"Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment fur- nished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fit- ness, quality, durability, performance or use of "your work"; and (2) The providing of or failure to provide warnings or instructions. Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 20 of 22 NUCLEAR ENERGY LIABILITY EXCLUSION (Broad Form) 1. The insurance does not apply: A. Under any Liability Coverage, to "bodily injury" or "property damage": (1) With respect to which an insured un- der this Coverage Part is also an in- sured under a nuclear energy liability policy issued by Nudear Energy Li- ability Insurance Association, Mutual Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada, or any of their successors, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or (2) Resulting from the "hazardous prop- erties" of "nuclear material" and with respect to which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the insured is, or had this Coverage Part not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, un- der any agreement entered into by the United States of America, or any agency thereof, with any person or organization. B. Under any Medical Payments coverage, to expenses incurred with respect to "bodily injury" resulting from the "hazard- ous properties" of "nuclear material" and arising out of the operation of a "nuclear facility" by any person or organization. C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from the "hazardous properties" of "nu- clear material", if (1) The "nuclear material" (a) is at any "nuclear facility" owned by, or oper- ated by or on behalf of, an insured, or (b) has been discharged or dis- persed therefrom; (2) The "nuclear material" is contained in "spent fuel" or "waste" at any time possessed, handled, used, proc- essed, stored, transported or dis- posed of, by or on behalf of an in- sured; or (3) The "bodily injury" or "property dam- age" arises out of the furnishing by an insured of services, materials, parts or equipment in connection with the planning, construction, mainte- nance, operation or use of any "nu- clear facility", but if such facility is lo- cated within the United States of America, its territories or posses- sions or Canada, this Exclusion (3) applies only to "property damage" to such "nuclear facility" and any prop- erty thereat. 2. As used in this exclusion: "Hazardous properties" includes radioactive, toxic or explosive properties. "Nuclear material" means "source material", "special nuclear material" or "by-product mate- rial". "Source material", "special nuclear material", and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. "Spent fuel" means any fuel element or fuel component, solid or liquid, which has been used or exposed to radiation in a "nuclear re- actor". "Waste" means any waste material (a) con- taining "by-product material" other than the tailings or wastes produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its "source material" content, and (b) resulting from the operation by any person or organization of any "nuclear facility" included under the first two paragraphs of the definition of "nuclear facil- ity-. "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, proc- essing or packaging "waste"; C. Any equipment or device used for the processing, fabricating or alloying of "spe- cial nuclear material" if at any time the to- tal amount of such material in the custody of the insured at the premises where such equipment or device is located consists of or contains more than 25 grams of pluto- nium or uranium 233 or any combination thereof, or more than 250 grams of ura- nium 235; Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 21 of 22 D. Any structure, basin, excavation, prem- ises or place prepared or used for the storage or disposal of "waste'; and includes the site on which any of the fore- going is located, all operations conducted on such site and all premises used for such op- erations. "Nuclear reactor' means any apparatus de- signed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable material. "Property damage" includes all forms of radio- active contamination of property. Includes copyrighted material of Insurance GA 101 TX 09 10 Services Office, Inc., with its permission. Page 22 of 22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus° BUSINESS AUTO XC+® (EXPANDED COVERAGE PLUS) ENDORSEMENT, WITH POLLUTION LIABILITY FOR COVERED AUTOS This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. Blanket Waiver of Subrogation SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury" or "property damage" arising out of the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", provid- ed the "bodily injury" or "property damage" oc- curs subsequent to the execution or the "in- sured contract". B. Noncontributory Insurance SECTION IV - BUSINESS AUTO CONDI- TIONS, B. General Conditions, 5. Other In- surance c. is replaced by the following: c. Regardless of the provisions of Par- agraph a. above, this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia- bility assumed under an "insured contract" that requires liability to be assumed on a primary nonoontributo- ry basis. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been: 1. Executed prior to the accident causing "bodily injury" or "property damage"; and 2. Is still in force at the time of the "accident" causing "bodily injury" or "property dam- age". D. Employee Hired Auto 1. Changes in Liability Coverage The following is added to the Section II - Liability Coverage, A. Coverage, 1. Who is an Insured: An "employee" of yours is an "insured" while operating 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. 2. Changes in General Conditions SECTION IV - BUSINESS AUTO CON- DITIONS, B. General Conditions, 5. Other Insurance is amended by replac- ing Paragraph 5.b. with the following: C. Additional Insured by Contract b. For Hired Auto Physical Damage Coverage the following are deemed SECTION II - LIABILITY COVERAGE, A. to be covered "autos" you own: Coverage, I. Who is an Insured is amended to include as an insured any person or organi- (1) Any covered "auto" you lease, zation with which you have agreed in a valid hire, rent or borrow; and written contract to provide insurance as is af- (2) Any covered "auto" hired or forded by this policy. rented by your "employee under a contract in that individual "em- Includes copyrighted material of ISO AA 292 01 16 Properties, Inc., with its permission. Page 1 of 5 ployee's" name, with your per- Custody, or Control does not mission, while performing duties apply. related to the conduct of your business. 2. Limit of Insurance However, any "auto" that is leased, a. The Per "Accident" Limit is $25,000. hired, rented or borrowed with a driv- The Per "Accident" Limit is the most er is not a covered "auto". we will pay for the total of all damag- es and "covered pollution cost or ex- E. Audio, Visual and Data Electronic Equip- pense" resulting from any one "acci- ment dent" covered by this endorsement. SECTION III - PHYSICAL DAMAGE COV- Subject to the limit for Pollution Lia- ERAGE, C. Limit of Insurance is amended bility Broadened Coverage, the most by adding the following: we will pay for all "bodily injury', "property damage" and "covered pol- 4. The most we will pay for all "loss" to lution cost or expense" combined, audio, visual or data electronic resulting from any one "accident", is equipment and any accessories used the Limit of Insurance for Liability with this equipment as a result of any Coverage shown in the Declarations. one "accident" is the lesser of: b• The Aggregate Limit is $25,000. The a. The actual cash value of the Aggregate Limit is the most we will damaged or stolen property as pay for the sum of all damages and of the time of the "accident"; "covered pollution cost or expense" b. The cost of repairing or replac- involving insurance provided by this ing the damaged or stolen prop- endorsement. The Aggregate Limit erty with other property of like applies separately to each consecu- kind and quality; or tive annual period and to any remain- ing period of less than 12 months, c. $2,500. starting with the beginning of the Pol- icy Period shown in the Declarations, Provided the equipment, at the time unless the Policy Period is extended of the "loss" is: after issuance for an additional peri- a. Permanently installed in or upon od of less than 12 months. In that the covered "auto" in a housing, case, the additional period will be opening or other location that is deemed part of the last preceding pe- not normally used by the "auto" riod for purposes of determining the manufacturer for the installation Aggregate Limit. of such equipment; 3. Property Damage Liability Deductible b. Removable from a permanently The "Property Damage" and "Covered installed housing unit as de- Pollution Cost or Expense" Liability Cov- scribed in Paragraph 2.a. above; erage Deductible is $500. The damages or that would otherwise be payable under c. An integral part of such equip- Section II - Liability Coverage for "prop- ment. erty damage" and "covered pollution cost or expense" caused by any one "acci- F. Pollution Liability Broadened Coverage for dent" will be reduced by the "Property Covered Autos Damage" and "Covered Pollution Cost or Expense" Liability Coverage Deductible 1. Coverage g prior to the application of the Limit of In- a. Section II - Liability Coverage is surance provision. changed as follows: 4. Our Right to Reimbursement (1) Paragraph a. of the "Pollutant" To settle any claim or "suit" we will pay all Exclusion (Section II - Liability or any part of any deductible shown in Coverage, B. Exclusions) ap- this endorsement. You must reimburse us plies only to liability assumed for the deductible or the part of any de - under a contract or agreement. ductible we paid. (2) With respect to the coverage af- forded by Paragraph a.(1) above, Exclusion B.6. Care, Includes copyrighted material of ISO AA 292 01 16 Properties, Inc., with its permission. Page 2 of 5 5. Definitions Section V - Definitions, D. "covered pol- lution cost or expense" is deleted in its entirety and replaced by the following: D. "Covered pollution cost or expense" means any cost or expense arising out of: 1. Any request, demand, order or statutory or regulatory require- ment that any "insured" or others test for, monitor, clean up, re- move, contain, treat, detoxify or neutralize, or in any way re- spond to, or assess the effects of "pollutants'; or 2. Any claim or "suit' by or on be- half of a governmental authority for damages because of testing for, monitoring, cleaning up, re- moving, containing, treating, de- toxifying or neutralizing, or in any way responding to or as- sessing the effects of "pollu- tants". "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release, escape or emission of "pollu- tants": a. Before the "pollutants" or any proper- ty in which the "pollutants" are con- tained are moved from the covered "auto" to the place where they are fi- nally delivered, disposed of or aban- doned by the "insured". b. After the "pollutants" or any property in which the "pollutants" are con- tained are moved from the covered "auto" to the place where they are fi- nally delivered, disposed of or aban- doned by the "insured". Paragraphs a. and b. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollu- tants" not in or upon a covered "au- to", if: caused directly by such upset, overturn or damage. G. Who is an Insured -Amended SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who is an Insured is amended by adding the following: The following are "insureds": 1. Any subsidiary which is a legally incorpo- rated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this cover- age form. However, the insurance afforded by this provision does not apply to any subsidiary that is an "insured" under any other au- tomobile liability policy, or would be an "insured" under such policy but for termi- nation of such policy or the exhaustion of such policy's limits of insurance. 2. Any organization that is newly acquired or formed by you and over which you main- tain majority ownership. The insurance provided by this provision: a. Is effective on the date of acquisition or formation, and is afforded for 180 days after such date; b. Does not apply to "bodily injury' or "property damage" resulting from an "accident" that occurred before you acquired or formed the organization; c. Does not apply to any newly acquired or formed organization that is a joint venture or partnership; and d. Does not apply to an insured under any other automobile liability policy, or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli- cy's limits of insurance. 3. Any of your "employees" while using a covered "auto" in your business or your personal affairs, provided you do not own, hire or borrow that "auto". H. Liability Coverage Extensions - Supple- mentary Payments - Higher Limits (1) The "pollutants" or any property SECTION II - LIABILITY COVERAGE, A. in which the "pollutants" are con- Coverage, 2. Coverage Extensions, a. Sup- tained are upset, overturned or plementary Payments is amended by: damaged as a result of the 1. Replacing the $2,000 Limit of Insurance maintenance or use of a covered for bail bonds with $4,000 in (2); and "auto"; and 2. Replacing the $250 Limit of Insurance for (2) The discharge, dispersal, seep- reasonable expenses with $500 in (4). age, migration, release, escape or emission of the "pollutants" is Includes copyrighted material of ISO AA 292 01 16 Properties, Inc., with its permission. Page 3 of 5 I. Amended Fellow Employee Exclusion SECTION II - LIABILITY COVERAGE, B. Ex- clusions, 5. Fellow Employee is modified as follows: Exclusion 5. Fellow Employee is deleted. J. Hired Auto - Physical Damage If hired "autos" are covered "autos" for Liability Coverage, then Comprehensive and Collision Physical Damage Coverages as provided un- der SECTION III - PHYSICAL DAMAGE COVERAGE of this Coverage Part are ex- tended to "autos" you hire, subject to the fol- lowing: 1. The most we will pay for "loss" to any hired "auto" is $50,000 or the actual cash value or cost to repair or replace, which- ever is the least, minus a deductible. 2. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, or $1,000, whichever is less. 3. Hired Auto - Physical Damage coverage is excess over any other collectible insur- ance. 4. Subject to the above limit, deductible, and excess provisions we will provide cover- age equal to the broadest coverage appli- cable to any covered "auto" you own un- der this policy. Coverage includes loss of use of that hired au- to, provided it results from an "accident" for which you are legally liable and as a result of which a monetary loss is sustained by the leasing or rental concern. The most we will pay for any one "accident" is $3,000. If a limit for Hired Auto - Physical Damage is shown in the Schedule, then that limit replac- es, and is not added to, the $50,000 limit indi- cated above. K. Rental Reimbursement SECTION III - PHYSICAL DAMAGE is amended by adding the following: We will pay for rental reimbursement ex- penses incurred by you for the rental of an "auto" because of a "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each cov- erage you have on a covered "auto". No deductible applies to this coverage. 2. We will pay only for those expenses in- curred during the policy period beginning 24 hours after the "loss" and ending, re- gardless of the policys expiration, with the lesser of the following number of days: a. The number of days reasonably re- quired to repair the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or b. 30 days. 3. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses in- curred; or b. $50 per day. 4. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 5. We will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for under SECTION III - PHYSICAL DAM- AGE COVERAGE, A. Coverage, 4. Coverage Extensions. L. Transportation Expense - Higher Limits SECTION III - PHYSICAL DAMAGE COV- ERAGE, A. Coverage, 4. Coverage Exten- sions is amended by replacing $20 per day with $50 per day, and $600 maximum with $1,500 maximum in Extension a. Transpor- tation Expenses. M. Airbag Coverage SECTION III - PHYSICAL DAMAGE COV- ERAGE, B. Exclusions, 3.a. is amended by adding the following: However, the mechanical and electrical breakdown portion of this exclusion does not apply to the accidental discharge of an airbag. This coverage for airbags is excess over any other collectible insurance or warranty. N. Loan or Lease Gap Coverage SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit of Insurance is deleted in its entirety and replaced by the following, but only for private passenger type "autos" with an original loan or lease, and only in the event of a "total loss" to such a private passenger type "auto": a. The most we will pay for "loss" in any one "accident" is the greater of: (1) The amount due under the terms of the lease or loan to which your covered private passenger type "auto" is subject, but will not include: Includes copyrighted material of ISO AA 292 01 16 Properties, Inc., with its permission. Page 4 of 5 (a) Overdue lease or loan pay- This condition applies only when the "acci- ments; dent" or "loss" is known to: (b) Financial penalties imposed 1. You, if you are an individual; under the lease due to high mileage, excessive use or 2• A partner, if you are a partnership; abnormal wear and tear; 3. An executive officer or insurance manag- (c) Security deposits not re- er, if you are a corporation; or funded by the lessor; 4. A member or manager, if you are a lim- (d) Costs for extended warran- ited liability company. ties, Credit Life Insurance, Q. Unintentional Failure to Disclose Hazards Health, Accident or Disabil- ity Insurance purchased SECTION IV - BUSINESS AUTO CONDI- with the loan or lease; and TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is (e) Carryover balances from amended by adding the following: previous loans or leases, or (2) Actual cash value of the stolen or damaged property. b. An adjustment for depreciation and physical condition will be made in de- termining actual cash value at the time of "loss". 2. SECTION V - DEFINITIONS is amended by adding the following, but only for the purposes of this Loan or Lease Gap Coverage: "Total loss" means a "loss" in which the cost of repairs plus the salvage value ex- ceeds the actual cash value. O. Glass Repair -Waiver of Deductible SECTION III - PHYSICAL DAMAGE COV- ERAGE, D. Deductible is amended by adding the following: No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced. P. Duties in the Event of an Accident, Claim, Suit or Loss - Amended SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss, a. is amended by adding the following: However, if you unintentionally fail to disclose any hazards existing on the effective date of this Coverage Form, we will not deny cover- age under this Coverage Form because of such failure. R. Mental Anguish Resulting from Bodily Inju- ry SECTION V - DEFINITIONS, C. "Bodily inju- ry" is deleted in its entirety and replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including men- tal anguish and death sustained by the same person that results from such bodily injury, sickness or disease. "Bodily injury" does not include mental anguish or death that does not result from bodily injury, sickness or disease. S. Coverage for Certain Operations in Con- nection with Railroads With respect to the use of a covered "auto" in operations for or affecting a railroad: 1. Section V - Definitions, H. "Insured con- tract", 1.c. is amended to read: c. An easement or license agreement; 2. Section V - Definitions, H. "Insured con- tract", 2.a. is deleted. Includes copyrighted material of ISO AA 292 01 16 Properties, Inc., with its permission. Page 5 of 5 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC NON-CONTRIBUTORY COVERAGE ENDORSEMENT -WHERE REQUIRED BY WRITTEN CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY COVERAGE PART SCHEDULE LIMITS OF INSURANCE: $ 5 000,000 Each Occurrence Limit $ 5 000,000 Aggregate Limit COMMERCIAL UMBRELLA LIABILITY COVERAGE FORM, US 101 and US 101 UM, is amended as follows: A. SECTION III - LIMITS OF INSURANCE is amended to add the following: 7. For the purposes of this endorsement on- ly, the Limits of Insurance stated in the Schedule of this endorsement and de- scribed below will apply on a "non- contributory basis" within the parameters set forth in SECTION III - LIMITS OF IN- SURANCE of the Coverage Part to which this endorsement is attached: We will not pay more on behalf of a "non- contributory additional insured" than the lesser of: a. The Limits of Insurance stated in the Schedule of this endorsement; or b. The limits of insurance required in a written contract on a "non- contributory basis" for such "non- contributory additional insured", but only to the extent the required limits of insurance are in excess of the "underlying insurance"; or c. The Limits of Insurance available af- ter the payment of "ultimate net loss" on any insured's behalf from any claim or "suit". This provision is included within and does not act to increase the Limits of Insurance stated in the Declarations. B. SECTION IV - CONDITIONS is amended as follows: 1. Condition 9. Other Insurance is amended to add the following: It is agreed that this condition does not apply to the "non-contributory additional insured's" own insurance program. This exception to the Other Insurance Condition shall only apply if the applicable "underlying insurance" applies on a "non- contributory basis" for such "non- contributory additional insured" and only to the extent of the specific limits of insur- ance required in a written contract or agreement on a "non-contributory basis" that is in excess of the "underlying insur- ance". 2. The following condition is added: 15. As a precedent to the receipt of in- surance coverage hereunder, the "non-contributory additional insured" must give written notice of such claim or "suit", including a demand for de- fense and indemnity, to any other in- surer who had coverage for the claim or "suit" under its policies. Such no- tice must demand the full coverage available and the "non-contributory additional insured" shall not waive or limit such other available coverage. This condition does not apply to the "non-contributory additional insured's" own insurance program. C. SECTION IV - DEFINITIONS is amended to add the following: 30. "Non-contributory additional insured" means any person or organization: a. Qualifying as an additional insured under SECTION II - WHO IS AN IN- SURED, Paragraph 3. of the Cover - Includes copyrighted material of ISO US 4096 11 16 Properties, Inc., with its permission. Page 1 of 2 age Part to which this endorsement is (2) The written contract or agree - attached; and ment requires a specific limit of b. Being granted additional insured sta- insurance on a "non-contributory basis" that is in excess of "un- tus on a "non-contributory basis" in derlying insurance". the "underlying insurance" as re- quired in a written contract between 31. "Non-contributory basis" means that the an additional insured and a Named limits of insurance of the Coverage Part to Insured provided: which this endorsement is attached apply (1) The written contract or agree- to insured loss on behalf of the "non- contributory additional insured" prior to ment is executed before the "oc- limits of insurance from other insurance in currence" resulting in "bodily in- which the "non-contributory additional in- jury", "personal and advertising sured" is a named insured. injury" or "property damage" for which coverage is being sought under this endorsement; and Includes copyrighted material of ISO US 4096 11 16 Properties, Inc., with its permission. Page 2 of 2 ....eXaSMutuar WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 04 B EMPLOYERS LIABILITY POLICY Insured copy TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (X)Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas operations 3. Premium: The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Included, see Information Page This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/5/23 at 12:01 a.m. standard time, forms a part of: Policy no. 0002068808 of Texas Mutual Insurance Company effective on 10/5/23 Issued to: MCMAHON CONTRACTING AND CONSTRUCTION LLC DBA: MCMAHON CONTRACTING This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 9/28/23 WC 42 03 04 B Policy No.:ER00P363 Effective Date: 10/05/2023 Endorsement No.: CA� ASPEN THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED SCHEDULE ENDORSEMENT (PRIMARY, NON-CONTRIBUTORY & WAIVER OF SUBROGATION) It is hereby agreed that the Policy is amended as follows: 1. It is hereby agreed that the following scheduled entities are included as additional insureds on this Policy pursuant to Section VI. DEFINITIONS, Paragraph A. Additional Insured, subparagraph 3. Schedule of additional insured(s) Blanket — as required by written contract 2. With respect to such additional insureds scheduled in paragraph 1. the following is added to Section V. CONDITIONS, Paragraph K. Other Insurance: This insurance is primary and the insurer will not seek contribution from any other insurance available to such additional insured(s). 3. With respect to such additional insureds scheduled in paragraph 1. the following is added to Section V. CONDITIONS, Paragraph Q. Subrogation: However, if the insured has waived rights of recovery against such additional insured(s) in a written agreement prior to discovery of a pollution incident giving rise to loss, crisis cost or a claim under this Policy, the insurer also waives any right of recovery it may have under this Policy against such additional insured(s). All other terms and conditions of this Policy remain unchanged. ASPENV607 0717 Page 1 of 1 2017 ©Aspen Insurance U.S. Services Inc. All rights reserved. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION OR NONRENEWAL BY US NOTIFICATION TO A DESIGNATED ENTITY This endorsement modifies insurance provided under the following: BUSINESSOWNERS PACKAGE POLICY CLAIMS -MADE EXCESS LIABILITY COVERAGE PART COMMERCIAL AUTO COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART DENTIST'S PACKAGE POLICY ELECTRONIC DATA LIABILITY COVERAGE PART EXCESS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART PRODUCT WITHDRAWAL COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART - CLAIMS -MADE RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY SCHEDULE Name and mailing address of person(s) or organization(s): 1. FOR WHOM YOU ARE REQUIRED IN A WRITTEN CONTRACT THAT WAS EXECUTED ON OR AFTER THE EARLIER OF THE FOLLWING DATES: A. THE EFFECTIVE DATE OF THIS POLICY, OR B. THE EFFECTIVE DATE OF THE ORIGINAL POLICY OF WHICH THIS POLICY IS A RENEWAL OR RPLACEMENT, AND 2. FOR WHOM YOU ARE REQUIRED IN THAT SAME WRITTEN CONTRACT AS REFERRED TO IN 1. ABOVE TO PROVIDE CANCELLATION NOTICE Number of days notice (other than nonpayment of premium): 30 A. If we cancel or nonrenew this policy for any statutorily permitted reason other than nonpayment of premium we will mail notice to the person or organization shown in the Schedule. We will mail such notice at least the number of days shown in the Schedule before the effective date of cancellation or nonrenewal. B. If we cancel this policy for nonpayment of premium, we will mail notice to the person or organization shown in the Schedule. We will mail such notice at least 10 days before the effective date of cancellation. C. If notice is iled, proof of mailing to the mailing address shown in the Schedule will be sufficient proof of notice. D. In no event will coverage extend beyond the actual expiration, termination or cancellation of the policy. IA 4087 09 17 P ---eXaSMutuar WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 06 01 EMPLOYERS LIABILITY POLICY Insured copy TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. In the event of cancellation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. 1. Number of days advance notice: 2. Notice will be mailed to: Schedule PER LIST ON FILE This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/5/23 at 12:01 a.m. standard time, forms a part of: Policy no. 0002068808 of Texas Mutual Insurance Company effective on 10/5/22 Issued to: MCMAHON CONTRACTING AND CONSTRUCTION LLC DBA: MCMAHON CONTRACTING This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC420601 --- L X 1 utua WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 06 01 EMPLOYERS LIABILITY POLICY TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. In the event of cancellation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. 1. Number of days advance notice: 2. Notice will be mailed to: Schedule 30 PER LIST ON FILE This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on at 12:01 a.m. standard time, forms a part of: Policy no. of Texas Mutual Insurance Company effective on 0002068808 Issued to: McMahon Contracting & Construction, LLC This is not a bill Authorized representative NCCI Carrier Code: 29939 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 3/1/18 WC420601 FORT WORTH Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Arterial Roadway Improvements, Keller Hicks Rd -Lauren Way to US377 M&C: 23-0886 CPN: 100146 CSO: 60585 Date: 12/06/23 To: Name 1. Donnette Murphy 2. Patricia Wadsack 3. Lauren Prieur 4. Priscilla Ramirez 5. Doug Black 6. William Johnson 7 Ronald Gonzales 8 Jannette Goodall 9 Allison Tidwell 10. TPW Contracts Department Initials Risk -Approver M ""' TPW-Approver 'LW I-W TPW-Signer Legal -Approver -P- Legal-Signer I.b ACM -Signer CSCO-Approver P CSCO-Signer SG CSCO-Form Filler ji- TPW DOC#: Date Out 12/06/23 12/11/23 12/11/23 12/11/23 12/11/23 12/11/23 12/11/23 12/11/23 12/12/23 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 Re wired: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File Link to General Conditions & Specs ❑ Attach Signature, Initial and Notary Tabs Return To: Please notify TPWContracts@a fortworthtexas.gov for pickup when complete. Call ext. 7233 or ext. 8363 with questions. Thank you! FORT WORTH Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Arterial Roadway Improvements Keller Hicks Rd, Lauren Way to US 377 M&C: CPN: 100146 CSO: Date: 11 /28/23 To: Name I Scott Cummings/McMahon Contr 2. Project Manager: Mitch Aiton 3. Michelle Hadley -McGhee 4. Shelley McMahon/McMahon Contracting, LF 5. 6. 7 8 9 10. Department Initials Vendor -Signer 1��15?1_1 TPW-Signer 44A- TPW-Review m3 DOC#: Date Out 11 /28/23 11 /28/23 Dec 4, 2023 11 /28/23 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(i�fortworthtexas.2ov for pickup when complete. Call ext. 7233 or ext. 8363 with questions. Thank you! Bond Verification GM&C From: Jessica Almaouer To: Hadlev-McGhee. Michelle Subject: RE: PLEASE REPLY - BOND VERIFICATION REQUEST [CPN #100146 - (Arterial Roadway Improvements Keller Hicks Rd, Lauren Way to US377)] Date: Wednesday, November 29, 2023 4:16:24 PM Attachments: imaae001.ono Importance: High 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. Yes bond #355373N for project Arterial Roadway Improvements Keller Hicks Road Lauren Way to US 377/ CPN 100146 in the amount of $7,204,624.65 is correct and in place. Please let me know if you have any further questions. Thank you! Jessica Almaguer I Sr Client Service Specialist, Commercial Risk Direct: 972-805-4661 1 Jessica.Almaguer@kandsins.com K&S Insurance, a Baldwin Risk Partner From: Hadley -McGhee, Michelle <Michelle.Had ley-McGhee@fortworthtexas.gov> Sent: Wednesday, November 29, 2023 2:42 PM To: Jessica Almaguer <Jessica.Almaguer@kandsins.com> Subject: PLEASE REPLY - BOND VERIFICATION REQUEST [CPN #100146 - (Arterial Roadway Improvements Keller Hicks Rd, Lauren Way to US377)] CAUTION: External Message. Beware any links or attachments 11/28/2023 Good afternoon Jessica. The City of Fort Worth is in receipt of the following referenced bond(s) — BOND #355373N, in the amount of $7,204,624.65 (Seven Million Two Hundred Four - Thousand Six Hundred Twenty -Four and 61/100 Dollars), from McMahon Contracting LP, for City Project #100146 (Arterial Roadway Improvements Keller Hicks Rd, Lauren Way to US377). 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(@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. .fookl,z fo rwazd 0,1�oo7vteciative, C/Yielcelle O#adleyeeflzee Contract Compliance Specialist City of Fort Worth Transportation & Public Works (TPW) 200 Texas Street, Fort Worth, TX 76102 Direct: 817-392-7233 Michelle.Hadley-McGhee4fortworthtexas.aov City of Fort Worth — Working together to build a strong community. F RT WORTH.