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HomeMy WebLinkAboutContract 60690Date Received: 1/3/24 Time Received: 4:15PM Record Number: PND-00173 City Secretary No.: 6_0_6_90 ___ _ PUBLIC PROPERTY EASEMENT ENCROACHMENT LICENSE AGREEMENT TIER fl THIS AGREEMENT is made and entered into by and between THE CITY OF FORT WORTH, a home rule municipal corporation of Tarrant County, Texas ('"City"), acting by and through its duly authorized City Manager, Assistant City Manager, or Director of the Development Services Department, and. Southside City Church of Fort Worth, a(n) a Texas non-profit corporation ("Licensee")� acting by and through its duly authorized signatory. RECITALS WHEREAS, Licensee is the owner of the. real property located at 2606 Hemphill Street;. Fort Worth, Texas 76110 ("Property''), being more particular described as, Lot 6 and 7, Block 2, Lot 6R, Block 2, Blanchard Addition, as recorded in Deed Records, by Instrument Number D219161498., in.Tarrant County, T� and; WHEREAS, the City owns a sewer easement (the "Public Propertyt') adjacent to the Property, in. the plat records of Tarrant County as plat number FS-23-035; and WHEREAS, Licensee desires to construct, place, and maintain certain improvements which will encroach in, on, abov(\, or below the Public Property; and WHEREAS, to accommodate the needs of the Licensee, the City will allow the encroachment under the terms and conditions as .set forth in this Agreement. NOW, THEREFORE, the City and Licensee agree as follows: AGREEMENT 1. The City, in consideration .of the payment by Licensee of the fee set out below and covenants and agreements hereinafter contained to be kept and performed by Licensee, hereby grants permission to Licensee to encroach in, on, above, or below andoccupy a portion of the City's Public Property as described in and at the location shown on Exhibit "A," but only to the extent shown thereon, for the purpose of constructing, installing, and maintaining a private water line (the "Encroachment''). Upon completion of the Encroachment, Licensee agrees to be responsible for maintaining the Encroachment within the Public Property. Licensee shall not expand or otherwise cause Tier UEasement Encroachment Agreement Pt1go I of 12 Revised 12/2022 the Encroachment to further infringe in or on the Public Property beyond what is specifically described in Eghibit "A." 2. All construction, installation, naai.ntenance, and operation of the Encroachment axzd tbe use or occupancy of the Public Property shall comply with and be performed in strict compliance with this Agreement and with the charter, ordinances, codes, and policies of the City. Prior to the cot►struction or installation of the Encroachment, Licensee shall submit all plans and spec�cations to tbe Director of the Development Services Departn�ent or duly authorized representative. Licensee shall not commence constructian or installation of the Encroachment nor make any use of the Public Property until after the execution of this Agreement. 3. Licensee, at no expense to the City, shall make proper provisions for the relocation and installation of any existing or future utilities affected by such Encroachment ar�d the use and occupancy of the Public Property, zucluding the securing the approval and consent of the appropriate utility compan.ies and agencies of the State of Texas and its political subdivisions. In the event that any installation, reinstallatioq relocation, or repair of any existing or future utility or improvements owned by or constructed by or on behalf of the public or at public expense is made more costly by viriue of the constz-uction, maintenance, or existence of the Encroachment and use of Public k'roperty, Licensee s�all pay to City an additional amount equal to such additional cost as determined by the Director of Transportation and Public Works, the Director of the Water Department, the Director of the Developrnent Services Department, or their duly authorized representative. 4. Licensee agrees that City may enter and utilize the Public Property at any time for any public purpose, including anstalling, repairing, replacing, ar mai�,taiuning improvements to its public fac�lities or utilities necessary for the health, safety, and welfare of the public. The City shall have no responsibility or liability for any damages related to t�ae Encroachment resulting from the City's use of the Public Property; however, the City slaa�l make reasonable efforts to minimize such damage. 5. Upon termination of this Agreezx�ent, Licensee shall, at the option of and at no expense to the City, remove the Encroachment and restore the Public Property to a condition acceptable to tl�e Director of Transportation and Public Works, the Director of the Water Department, the Director o� the Development Services Department or their Tier ii Easement Encroachment Agreement Page 2 of 12 Revised 12/2022 duly authorized representative. Any such removal of the Encroachment shall be in accordance witl� then-ex�sting City regulations and palicies. It is understooa and agreed to by Licensee that if this Agreement terminates and Licensee fails to retnove the Encroaclunent and restore the Public Property, Licensee hereby gives City permission to remove the Encroachment and auy supporting structures from the Public Propezty, to restore the Public Property, and to assess a laen on the Property for the costs expended by the City in taking such actions. 6. In order to defray all costs of inspection and supervision which the City has incurred or will incur as a result of the constx-uction, maintenance, inspection or management of the Eneroachxnent and use of Public Property as provided for by this Agreement, Licensee agrees to pay to City at the time this Agreement is requested an application fee in the sum of Nine Hundred Dollars ($900.00). 7. Tl�e terrn of this Agreement shall be for thirty (30) years, commencing on the date this Agreernent is executed by City. However, the City may terminate this Agreement upon Licensee's noncompliance with any of the tem�s of this Agreerr�ent. City shall notify Licensee in writing of any such noncompliance and if Licensee does not cure the noncompliance within thirty (30) days of notice from City, the City may tei-minate this Agreement. However, the City may, at its sole option, allow the Agreement to remain in effect so long as Lice�see has talcen reasonable measures to cure the noncompliance or is continuing to diligently attempt to remedy the noncompliance. 8. It is further understood and agreed between the parties hereto that the Public Property to be used and encroached upon is held by City as trustee for the public; that City exercises such powers over the Public Property as laave been delegated to it by the Constitution of the State of Texas or by the Texas Legislature; and that City cannot cantract away its duty and its legislative power to control the Public Property for the use and benefit of the public. It is accordin.gly agreed that if the governing body of City may at any time during the term. hereof detez�ine i�o its sole discretion to use or caus� or permit the Publie Property to be used for any ather publitc putpose, including but not being limited to underground, surface, or overhead communication, drainage, sanitary sewerage, transmission of natural gas or electrzcity, or any other pubiic purpose, whether presently contemplated or nat, that the parties agree to negotiate in good faith in order to accommodate both the Encroachment and the pubLic purpose. Tier II Easement Encroachment Agreement I'age 3 of 12 Revised l2l2022 9. LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEIVINIFY, HOLD HARMLESS, AND DEFEND CIT'Y, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, AND ELECTED OFFICIALS FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHA,TSOEVER KIND OR CHARACTER, WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH, DIRECTLY OR INDIRECTLY, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE, OR LOCATION OF THE ENCROACHMENT AND USES GRANTED HEREUNDER, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY THE ALLEGED NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, ELECTED OFFICIALS, OR INVITEES OF THE CITY; AND LICENSEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH CLAIMS OR SUITS. LICENSEE SHALL LIKEWISE ASSUME ALL LIABILITY AND RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR ANY AND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT OF OR IN CONNECTION WITH THE ENCROACHMENTS AND ANY AND ALL ACTS OR OMISSIONS OF LICENSEE, TTS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, OR INVITEES. 10. While this Agreement is in effect, Licensee agrees to furnish City with a Certificate of Insurance naming City as certificate holder as proof that is has secured and paid for a policy of public liability insurance covering all public risks related to the proposed use and occupancy of public property as located and described in Eghibit "A." The amounts of such insurance shall be not less than $1,000,000 with the understanding and agreement by Licensee that such insurance amounts may be revised upward at City's option and that Licensee shall so revise such amounts immediately following notice to Licensee of such requirement. Such insurance policy shall not be canceled or amended without at least thirty (30) days prior written notice to the Building O�cial of the City. A copy of such Certificate of Insurance is attached as Exhibit "B" and incorporated herein for all purposes. Licensee agrees, binds, and obligates itself and its successors and assigns to maintain and keep in force such public liability insurance at all times during the term of this Agreement and until the removal of the Encroachment and restoration of the Public Property. All insurance coverage required herein shall include coverage of all Licensee's contractors and subcontractors. Tier I1 Eascment Encroachment Ageement Page 4 of 12 Rcviscd 12/2022 l �. Licensee agrees to deposit with the City when this Agreennent is executed a sufficient sum of money to be used to pay necessary fees to record this Agreement in the real property records of ihe county in which tke Encroachment is located. After being recorded, the original shall be returned to the City Secretary of the City of Fort Worth. 12. Licensee agxees to comply fully with all applicable federal, state, and local laws, statutes, ordinances, codes, and regulations in cnnnection with the construction, operation, and maintenance of the Encroachment aud use of the Public Property. 13. Licensee agrees to pay promptly when due all fees, t�es, or rentals provided for by this Ag�reemezzt or by any federal, state, or local statute, law, or regulation. 14. Licensee covenants and agrees that it shall operate hereunder as an independent contractor as to all rights and privileges granted hereunder and not as an officer, agent, servant, or employee of Ciiy, and Lxcensee shall have exclusive control of and the exclusive right to control the details of its operations, and all persons performing same, and shall be solely responsible foz the acts and o�.issiozis of its ofFicers, agents, servants, eznployees, contractors, subcontractors, licensees, and invitees. The doctrine oi respondeat superior shall not apply as between City and Licensee, its officers, agents, servants, employees, cantractors, and subcontractors, and nothing herein shall be construed as creating a partnership or joint enterprise between City and Licensee. 15. Licensee agreas and acknowledges that this Agreement is solely for the purpose of permitting Licensee to construct, maintain, and locate the Eneroachment over or within the Public Property and is not a conveyance of any right, title, or interest in or Co the Public Property, nor is it meant to convey any right to use or occupy property in which a third-party may have an interest. Licensee agrees that it will obtain all necessary permissions before occupyin� such property. Ticr fI �asement Cncroacliment Agreement Page 5 of 12 Revised l2/2022 16. In any action brought by the City for the enforcement of the obligations of the Licensee, City shall be entitled to recover interest and reasonable attorneys' fees. 17. The parties agree that the duties and obligations contained in Section 5 sball survive the termination of this Agreement. 18. Licensee covenants and agrees that it will not assign all or any of its rights, privileges, or duties under this Agreement without the written approval of the City, and any attempted assignment without such written approval shall be void. In the event Licensee conveys the Property, Licensee may assign all of its rights and obligations under this Agreement to the new owner of the Property, and Licensee shall be deemed released from its duties and obligations hereunder upon City's approval in writing of such assignment, which approval shall not be unreasonably conditioned or withheld. Foreclosure by a secured lender of Licensee or assignment to a secured lender by Licensee in the event of default or otherwise shall not require City approval provided that said lender notifies City in writing within sigty (60) days of such foreclosure or assignment and assumes all of Licensee's rights and obligations hereunder. However, no change of ownership due to foreclosure or assignment to any secured lender of Licensee shall be effective as to City unless and until written notice of such foreclosure or assignment is provided to City. 19. Any cause of action for breach of this Agreement shall be brought in Tarrant County, Texas. This Agreement shall be governed by the laws of the State of Texas. 20. This Agreement shall be binding upon the parties hereto and their successors and assigns. 21. This Agreement may be executed in multiple counterparts, each of which shall be considered an original, but all of which shall constitute one instrument Tier II Easement �ncroachment Agreement Page 6 of 12 Rcviscd 12/2022 = - x�<��„�.,. . [SIGNATURES APPEAR ON FOLLOWING PAGE] Tier II Easement Encroachment Agreement Page 7 of 12 Revised 12/2022 City: CITY OF FORT WORTH • �' ..:::::>�By: OJ Harrell (Jan 3, 2024 08:33 CST) Licensee: Southside City Church of Fort Worth a Texas non-profit corporation D.J. Harrell, Director of the Development Services Department Name: Darrel Auvenshine Title: Authorized Signatory Date: Jan 3, 2024 ATTEST: Jannette Goodall, City Secretary Date: Jan 3, 2024 Tier II Easement Encroachment Agreement Date: \ } / 3:-o / 2-o ;)--� • I Approved As To Form and Legality Jeremy Anato Mensah Assistant City Attorney Date: Jan 2, 2024 Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all perfo rmance and reporting requirements. J2Wffj/W ttottats on behalf of Dwayne Ho 7rs on behalf of. (Jan 2, 2024 09:22 CST) Rebecca Owen Development Services Date: Jan 2, 2024 Page 8 of 12 Revised 12/2022 '''*"'THIS PAGE FOR CITY OF FORT WORTH OFFICE USE O�LY''dd, STATE OF TEXAS § COUNTY OFT ARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared D.J. Harrell, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he executed the same for the purposes and consideration therein expressed, as the act and deed of the City of Fort Worth, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 3rd day of _Ja_n_u_a_ry ___ , 20�. Wendy L. Beardslee Digitally signed by Wendy L. Beardslee Date: 2024.01 .03 1 4:52:41 -06'00' Notary Public in and for the State of Texas After recording return to: Development Services Department Development Coordination Office 200 Texas Street Fort Worth, Texas 76102 Tier II Easement Encroachment Agreement WENDY L BEARDSLEE Notary Public STATE OF TEXAS Nota ry I.D. 13323719-3 My Comm. Exp. July 28, 2025 Page 9 of 12 Revised 12/2022 STATE OF TEXAS § COUNTY OF TARRANT § BEFORE M�, the undersigned authority, a Notary Public in and for the State of E �, on this day personally appeared Darrel Auvenshine, Authorized Signatory (Title) known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he or she executed the same for the purposes and consideration therein expressed, as the act and deed of Southside City Church of Fort Worth, a Texas non-profit corporation (entity type), and in the capacity therein stated. GIVEN iJNDER MY HAND AND SEAL OF OFFICE this Zv� aay of DrcF�i�Ea� 20 23 . � Notary Public in and for the State of%S ;�:���'st�;.,; DAVIDAVOORHEES =•:'�:*= My Notary ID # 131399903 �'�:•;� �'' � Expires January 5, 2026 Tier II Easement Encroachmcnt Ageement Page 10 of 12 Revised 12/2022 �, � . ... . _ ._ �T:� _ � . .� .. .I��Y's �;iy � f.....-. - . '" �. . . . . . � ' n . � . u � EI�IT A . Depiction and description o� the Encroachment . - .. ' � � � . . � .L :r � , r _ : y • -r,._ . } . ' .. � .),' . , _ ..:�_S -'� ,� * '�:/ _N � . i /, ' , � f ' Tier II Easement Encroachment Agreement Page 11 of 12 Revised 12/2022 N.T.S. OWNED/DEVELOPED BY: SOUTHSIDE CITY CHURCH 2606 HEMPHIL� STREET FORT WORTH, TEXAS 76110 DARREL AWENSHINE EMAIL: DAUVENSHINE@AOL.COM PREPARED BY: MJ THpMAS ENGINEERIPIG 4700 BRYANT IRVIN CT, STE: 204 FORT WORTH, TEXAS 76107 PH: (817) 732-9839 F/�X: (817)732-9841 REGISTRATION NO. F-9435 CONTACT: MICHAEL THOMAS, P.E. MAPSCO NO. 76V COUNCIL DISTRICT NUMBER: 1 � � ,�.ur � P .�' • .... T • �� � � .*. !* : ' 'I �°V�I + �F.<r. �NSEo.•ti ` 1�1����\� �! I1/21i23 LOCATION MAP FOR 2606 HEMPHIL STREET (LOT 6R-1, BLOCK 2) BLANCHARD ADDITION CITY OF FORT WORTH, TEXAS EXHIBIT "A" LEGAL DESCRIPTIQN ENCROACHMEiVT AGREEMENT BEING a 10 foot wide strip of land situated in Lot 6R-1, Block 2, Blanchard Addition, to the City of Fort Worth, Tarrant County, Texas, according to the plat recorded in County Clerk's File No. D223096599, of the Official Public Records of Tarrant County, Texas. Said 10 foot wide strip of land being more particu{arky described by metes and bounds, as follows: S�GINNING at a point lying in the West line of an existing 12 foot wide sanitary sewer easement, recorded in Volume 6512, Page 801, of the Deed Records of Tarrant County, Texas, and said POINT OF BEGINNING a]so lying N 00° 21' 13" W 29.21 feet, from a'/2' iron rod marked "Brittain & Crawford" set at the Northeast corner of Lot 5RB, Block 1, of Garret's Second Addition, to the City of Fort Worth, Tarrant County, Texas, according to the plat recorded in County Clerk's File No. D203185040, of the Official Public Recorcfs of Tarrant County, Texas, and an ELL corner of aforesaid Lot 6R-1, Block 2, Blanchard Addition; TH�NCE N 00° 21' 13" W 10.00 feet, continuing along the West line of said existing 12 foot wide sanitary sewer easement, to a point; THENCE EAST at 12.00 feet crossing the East line of said existing 12 foot wide sanitary sewer easement and the West line of an exis#ing 3 foot wide sanitary sewer easement, recorded in County Clerk's File No. D203014925, of the Official Public Records of Tarrant County, 7exas, and con#inuing in alf 15.00 feet, to a point lying in the East line of said existing 3 foot wide sanitary sewer easement; THENCE S 00� 21' 13" E 10.00 feet, along the East iine of said existing 3 foot wide sanitary sewer easement, to a point; THENCE WEST again severing said existing 3 foot wide sanitary sewer easement and the existing 12 foot wide sanitary sewer easement, to the POINT OF BEGINNING containing 0.003 acre (150 square feet) of land. //,`P:�� � 5; eqFa ��\ �c,; �' � J,j .............. .......:... ��CHRIS L_ BLEVINS ..Y...•. .....y.. ' q 5792 �;,' ��q �°FF s s � o ;:�0�� \�a •�L.. ...... ; �l 1l/ � 1 /21 /2023 G:12023\EAS�MENTS�T3lanchard Addition, Lot 6R-1, Dlk 2- Bncroachment Agrccment - 0.003 Acre.doc �' I�.■ _- � � . � � M � .�l _ • � 15' SANITARY SEWER EASEMENT C.C.#D1891 . =., .,..,...., ' a � —— --�---�—— 12' SANITARY $�WER EASEMENT I I 12' S�IJT6�H�'t�E�R D.R.T.C.7. I I ------------------I � � �'� ��r� T 1�E���EASEMENT � I I SEWER EA�S �.T. � � II 1 L311 . . - ;,. �. � � • U ` I � � •••� ■•� �, • � O i�' r�►�► • . . . . � ••,�,, / `� 1 : e __ o . �' � '��`� ' � � • • � M: • � � �� � - � � � `-� � �1 � i � • �-- " '_a•,�� ��� • - . "� � i► � '� � : •�� ��� •�.. •",'� `•�la�� � •�� • ' L Y L � �, . � � � . � � 1 � 1 � 1 � � � TTA� TEL (��j,';��—��11 �,9�xd� �'���,������A� P. �11 L���bq Up'vy-9r�w(A�d.co m �S+ br�ttbk}-k(�nlord.corn 39C�M���o�y so,9oo0 Fr-fY2Q'�al�/I/jajpsk-_/3nG�Id, LLC I'1CCK�YH�yti � bsdfv�d � � --� i V �, �I �' I u � I� � � �'' �I � � � � f'-' e � r I� � �? � � P � 8�ly N � � � � � � � � i .�.� . � i��. . ��� ' � '�I A1` � � r� � � • �� :• .•�• 'r��,:+` .�� '" ''i� . -� ����i •rr • . 1/� � � � ' � rii�r � . � . . . � �'� � Course Bearzng Distance L1 N 00°21'13" W 29.21' L2 N 00°21'13° W 10.00' L3 EAST 15.60' �4 s oo°27�ia° � io.ao� L5 WEST 15.00' NOVEMBER 21, 2023 EXHIBIT MAP OF �an��c���.o�R�EL�FN D BLOCK 2 BL��'�C�D��DDITION CITY OI���F�WbR�hQ�4f�ANT COUNT�'��I�E'_�X�D ADDITION CI�1'Y OF FORT WORTH� TARRANT COUNTY� TEXAS SCALE 1"=20' SOUTHSIDE CITY CHURCH\SOUTHSIDE CITY CHURCH-ENGROACHMENT-EXHIBIT. OWNED/DEVELOPED BY: SOUTHSIDE CIN CHURCH 2606 HEMPHILL STREET FOF2T WORTH, TEXAS 76110 DARF2EL AUVEIVSHINE �MAIL: DAUVENSHINE@AOLCOA PREPARED BY: MJ THOMAS ENGINEERING 4700 BRYANT IRVIN C7, STE: 20�1 FORT WORTH, TEXAS 761 Q7 PH: (817) 732-9839 FAX: (817)732-9841 REGISTRATION NO. F-9435 C�NTACT: MICHAEL 7MOMAS, P.E. r--� I L__� �EGEND EXISTING SEWER LINE PROPOSED WATER LINE PRQPOSED ENCRQACHA�ENT EXH�BIT C1- �� SANITARY SEWER LINE /� FOR ►� �� � SCALE 1" = 20' � FEET — � o is so 1/21/zoz3 2606 HEINPHiL STREET (LOT 6R-1, BLOCK 2y BLANCHARD ADDITION CITY OF FORT WORTH, TEXAS i ---�------' — - --- � � i ------ h— --- -- . — --r---- ----' - i I 700 _ 700 --- — — -- - _- - -- - ----- , --- -- ' � ,--- - - - — -=� ----- -- - - _ � - - - � � --�- - � _ _ - - _ ____ _ ---- � I --'__ -�-_-- _-- - - � _ - - -- - - ----. _� i � --- i , �, -- � _ - --_ _ �„ _ _ � � PIPE�I E929Y -- -- -- - ---- - - --- � _ _._ -- - '� - - --- _ _ . __ I 690 690 Q - -- - - - ---_ � ' I �-�----- - �__ _. -------- ---� — - -�p�� __ � � � �-----.---- --_-��- -- ��__--�.._.-� -- T_-�_� �� I- -- - � --I--___ -I--- — - -- ---�--_- ; � I �� ��._.__:__ _ _____ __�� -__ , , , � : _ _ ____�__--� ---- - _- - - , ----__ __ . _ 680 � - 680 0+ 00 D+ 15 OWNED/DEVELOPED BY: SOUTHSIDE C17Y CHURCH 2606 HEMPHILL STREET FQRT WpRTH, TEXAS 76110 DARR�L AUVENSHWE EMAIL: DAUVENSHINE a�OL.GOM PREPARED 8Y: MJ THOMAS ENGINEERIiVG 4700 BRYANT IRVIN CT, STE: 204 FORT Wp3�TH, TEXAS 76107 PFf: (817) 732-9839 FAX: (817)732-98�4i REGISTRATION NO. F-9435 CONTACT: MfCHAEL THOMAS, P.E. + .� r .�-� : �f'� r+ r ; � MICHAEL A, � 93640 *� * �� xx/zx/Zoz3 PROFILE SCALE HORIZONTAL SCALE: 1 "=20' VERTICAL SCALE: 1" =4' EXHIBITc2- PROFILE �OR 2606 HEMPHIL STREET (LOT 6R-1, g�OCK 2� BLANCHARD ADDITION CfTY OF FOR7 WORTH, TEXAS -', i- �:?�.� ,r'•. . . ..s^.a.d}.�w.. s i . . , . � .. . , '� .�. . . ,.- . . � �♦b'�`'�.�r • . ._ ,. ,. E��TT B Certificate of Insurance � - . . �--- . . _ _ -- - - - T� , _ _ • �-_. . . . . . � i �., � ; -� - �-� ,_ _ _ ., :-_. . . , ., _ - - . , , _ _- . ; - . -. . .; s:,x ..." _ y . ` "��:�� �. . . �_ . . _. .__ . , ,. e , . . , � . , . -� r=� , - _ . ., �- _ - _ ; , . ; - -. .. .�� � . _. . . , � ' } � . � . .. . _. _. Tier II Easement Encroa.chment Agreement Page 12 of 12 , Revised 12/2022 �►c'a � CERTIFICATE OF LIABILITY INSURANCE �nre �MMr�ormv� '12I1312023 THIS CERTIFlCATE IS ISSUED AS A MATTER OF 1NFORMATION ONLY AND CONFERS NO RIGHTS UPON TH� CERTIFICATE HOLDER. TFflS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, IXTENd OR ALTER 7HE CpVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICA7'E OF INSURANCE i�OES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. Ii41PORTANT: If the certifi�ate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provlsions or be endorsed. If SUBROGATION 15 WAIVED, subject to the terms and condltfons ot the poilcy, certafn pollcles may require an endorsement. A statement on this certtficate does noE confer r[qhts to the certificate holder In Eleu of such endorsemenf(s). rRooucEa Ross Insurance Agency 213 Old Hewitt Road Waco TX 76712 INSURED gpUTHSIflE CITY CHURCH OF FORT WOR7H 2794 NW 20TH STREET FORT WORTH TX 76'S06 INSUREA A !+ INSUREit B : INSURER C : INSUREFi D : INSURE3i E : ,TY INSURANCE CO NdIG N COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS �S TO CERTIFY THAT TNE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLiCY PERIOD INDICATED. NOTWITHSTANDING ANY RE�UIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TWIS CERTiFICATE MAY BE 1SSUED OR MAY PERTAIN, THE INSURANCE ,4FFORDED BY THE POLICIES �ESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS, EXGLUSIONS AND CONDITIQNS OF SUCH POLICIES. �IMITS SHOWN MAY HAVE BEEN REDUCED BY PA1D CLAiMS. INSR 7ypE OF INSl1RANCE �OL B POL]CY EFF POLICY E7(P U1MR5 LTR POLICY NUM6ER MMID� MMlI]U /4 �/ COMMERCIALGENERALIJABILITY �/ 1CPKP20{1910180 1/15/2023 1I15l2624 �CHOCCURRENCE s14Q0000 ✓ cv�,in�s-r.+noe � occuR °�ais�s �oca,�e� s100000 MEO EJ� (Any one persa�) E S��Q PERSOP7AL&ADVINJURY S�QODOOO GEMLAGGREGATEL�MITAPPLIESPER GENERALAG6REGATE S2QOOOOO POLICY � jE a ❑ LOC PRODUCTS - COMPlOP AGG s2U4D000 OTHER: s AUTOMOBILELL4BILITY COMBINED SfNGLE LIMIT s Ea acadent � ANY AUTO BODILY INJURY (Per person) S OWNED SCHEDULED BODILY INJURY (Per accident) ; AUTOS ONLY — AUTOS HIRED NON-OWNED PROPERTYDAMAGE s AUTOS ONLV AUTOS ONLY Per acdtlenl S U�NBRELLA WB OCCUR EACH OGGURRENCE 5 �G�� � CLAIMS-MAD� AGGREGATE S DED RETEN1lON S s WORKERS COMPENSA"f10N PER OiH- AHDEMPLOYERS't1ABILITY y�N STATUT@ ER ANYPkOPRIETOFt/PARTNER/D�CUTIVE ❑ NIA � E.LFACHACCIDENT S OFFICERlMEMBER IXCLUDED7 (Hland�tory la NHj EL DISEASE - EA EMPLOYEE S N yes, tlesdibe under DESCRIPIION OF pPERA710N5 below EL DiSEASE - POLICY LIMfT S �� DESGR1PT10N OF OPERATONS I LOCATiONS I VEHICLES (ACORD 107, Addi8onal Ramarks Schedula, may be attached H mom apace Is �equ'nad) roject name-Sauthside City Ch�rch Tiny Homes Village Froject #PN23-00'i73 CERTIFICATE HOLDEi2 :ITY OF FORT W�i2TH !00 TEXAS STREET �ORT WORTH TX 76102 �N23-001i3 ACORD 25 (2016103) GAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFQRE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH TH� Pp41CY PROVYSIOkS. AUTtiORIZED REPRESEHTATIVE OB WEATHERLY �O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD natne and logo are registered marks oi ACORD ProCuud oalnp Form� Bo�s Web softwero. www.Forms6aaa.com; y Impreeslve Publishlnfl 600-206-1877