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HomeMy WebLinkAboutContract 44761 C43TY SECRETARY ' RIGHT O WAY ENCROACHMENT T G EEMENT THIS AGREEMENT El' T is made and entered into by and between the City of Fort Werth, a municipal corporation of Tarrant County, Texas, acting herein by and through its duly authorized City Manager or its duly authorized Assistant City Manager er or Planning and Development Department Director, hereinafter referred to as the "City", and The . 'eil P at Burnett Park Condom'n'urn Association, Inc., , acting herein y and through its duly authorized The Neil F at Burnett Park Condomini um Association, Inc., Board of Directors Treasurer hereinafter referred to as "Licensee", Owner of the property located at 411 W 7th Street, Fart Worth, Texas, 76102 ("Property"'). AGREEMENT 1. For and in consideration of the payment by Licensee of the fee set out below and the true and faithful perfon-nance of the mutual covenants :herein contained, City hereby ,grants to Licensee permission to construct/ install and/or allow to remain, Im rovernent s) ("Improvement") that encroaches upon, uses and/or occupies portions of the space under, on and/or above the streets, alleys, sidewalks and other public rights-of- way, such Improvement(s)) are described as follows: Install'new building canopy The location and description of said Improvement and the encroachment is more particularly described in Exhibit "'A", attached hereto, incorporated herein and made a part hereof for all purposes. 2. All construction, maintenance and operation in connection with such Improvement, use and occupancy shall be performed in strict compliance Faith. this Agreement and -the Charter, Ordinances and Codes of the City and in accorda. h the RE RECEIE 0 AUG 3 0 2013 OFFICIAL RECORD C;Ilry SECRETARY 201 ROW Encroachment Agreement-Canunereial 1 f 10 directions of the Director of Transportation and Public Works of City', or his duly authorized representative. All plans and specifica,tions thereof shall be subject to the prior written approval of the Director of Transportation and Public, Works, or his duly authorized representative, but such approval shall not relieve Licensee of responsibility and liability for concept, design and computation in preparation of such plans and s * peci f ications., 3, Upon completion of construction and installation of said Improvement and thereafter, there sha,ll be no encroachments in, under, on or above the surface area of the streets, alleys, sidewalks and other public rights-of-way involved, except as described herein and shown on the hereinabove referred to Exhibit "A"". 4. 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 use and occupancy, including the securing of approval and consent from the utility companies and the approp:nate agencies of the State and its political subdivisions. In the event that any installation, reinstallation, relocation or repair of any existing or future utility or improvements owned by, constructed by or on behalf of`the public or at public expense is made more costly by virtue of the construction, maintenance or existence of such encroachment and use,, Licensee shall pay to City an additional amount equal to such additional cost as determined by the Director of Transportation and Public Works of the City, or his duly authorized representative. 5. City may enter and utilize the referenced areas at any time for the purpose of installing or maintaining improvernents, necessary for the health, safety and welfare of the public or for any other public purpose. In this regard, Licensee understands, and agrees that City shall bear no responsibility or liability for damage or disruption of 2 012 ROW Encroachment Agreement-Conunercial Page 2 of 10 i,mprovernents installed by Licensee or its successors, but City will make reasonable efforts, to minimize such damage. 6, A In order to defray all costs of inspection and supervision which City has incurreu or will incur as a result of the construction, maintenance, inspection or, management of the encroachments and uses 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 Two Hundred and Seventy Five Dollars ($275.00). Upon execution of this Agreement and annually 'thereafter, Licensee agrees to pay a fee in the amount of$.56 per square/linear foot of the encroachment area. 7# T'he term of this Agreement shall be for thirty years, commencing on the date this Agreement is executed by the City of Fort Worth. Provided however, this Agreement shall terminate upon the non-compliance of any of the terms of this Agreement by the Licensee., City shall notify Licensee of the non-compliance and if i I not cured within thirty days this Agreement shall be deemed terminated. 8. Upon termination of this Agreement, Licensee shall, at the option of City and at no expense to City, restore the public rig,ht-of-way and remove the Improvement encroaching into the public n*ght-of-way, to a condition acceptable to the Director of Transportation and Public Works, or his duly authorized representative, and in accordance with then existing City splecificatio�ns. It is 'understood and agreed to by Licensee that if this Agreement terminates and Licensee falls to remove the Improvement, Owner hereby gives City permission to remove the Improvement and any supporting structures, and assess, a lien on the Property for the costs expended by the City to remove such Improvement. 9. 20�12 ROW Encroachment Agreement-Co nunercial Page 3 of 10 It is further understood and agreed upon between the parties hereto that the public rights-of-way, alleys, sidewalks (44public n'ght-of-way") to be used and encroached upon as described herein, are held by City as trustee for the public; that City exercises such powers over the public right-of way as have been delegated to it by the Constitution of the State of Texas or by the Legislature; and that City cannot contract away its duty and its legislative power to control the public right-of-way for the use and benefit of the public. It is accordingly agreed that if the governing,body of City may at any time during the to hereof determine in its sole discretion to use or cause or permit the right of way to be used for any other public purpose, including but not being limited to underground, surface of overhead communi cation, drainage, sanitary sewerage, transmission, of natural or electricity, or any other public purpose, whether presently contemplated or not, that this Agreement shall, automatically terminate., 10. Licensee agrees and acknowledges, that this Agreement is solely for the purpose of pen-nitting Licensee to construct, rnaintain and locate the Improvements over or within the described public right of way and is not a, conveyance of any right, title or interest in or to the public night of way nor is it n'ieant 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 permission before occupying such property. 11, Licensee agrees to comply fully with all applicable federal, state and local laws, statutes, ordinances, codes or regulations in connection with the construction, operation and maintenance of said Improvement, encroachment and uses. 12. Licensee agrees to pay promptly when due all fees, taxes or rentals provided for by this Agreement or by any federal, state or local statute, law or regulation. IS. 2 012 ROW Encroachment Agreement-Conu-nercial Page 4 of 10 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 City and Licensee shall have exclusive control of and the exclusive rift to control the details, of its operations, and all persons perfon-ning, same, and shall be solely responsible for the acts and omissions of its officers, agents, servants, employees, contractors, subcontractors, licensees and invitees. The doctrine of respondeat superior shall not apply as between City and Licensee, its officers, agents, servants,,, employees, contractors and S-Libcontractors,, and nothing berein shall be construed as creating a partnership or joint enterprise between City and Licensee. 14, LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS.) SERVANTS AND EMPLOYEES,, FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEAT'H, TO ANY AND ALL PERSONS, OF WHATSOEVER 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 SAID IMPROVEMENT AND ENCROACHMENT AND USES GRANTED HEREUNDER, THE OR NOT CAUSED, IN WHOLE OR IN PART, BY ALLEGED NEGLIGENCE, OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES 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 ANYAND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT OF OR IN CONNECTION WITH ANY AND ALL ACTS OR OMISSIONS OF LICENSEE,, ITS OFFICERS, AGENTS,, SERVANTS, EMPLOYEES, 20,12 RO,W Encroachment Agreement-Commercial Page 5 of 10 e_1 t.,ONTRACTORS, SUBCONTRACTORS, LICENSEES, INVITEES, OR TRESPASSERS,, 15, While this Agreement is in effect, Licensee agrees to furnish City with a Certificate of'lnsurance, nwning City as certificate holder, as proof that it 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 Exhibit "A". The amounts of such insurance shall be not less than the following: $1 1 .000,0010 Commerdal General U*Ubiit. with the understanding, of and agreement by Licensee that such insurance amounts, shall 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 provide that it cannot be canceled or amended without at least ten (1 0) days prior written notice to the Building Official of the City of Fort Worth. A copy of such Certificate of Insurance is attached as attached as Exhibit "B"'. Licensee agrees to submit a similar Certificate of Insurance annually to City on the anniversary date of the execution of this Agreernent. Licensee agrees, binds and obligates itself, its, successors and assigns, to maintain and keep in force such public liability insurance at all times during the to of this Agreement and until the removal of all encroachments and the cleaning and restoration of the city streets. All insurance coverage required herein shall include coverage of all Licensees' contractors 16. Licensee agrees, to deposit with the City when this Agreement is executed a sufficient sum of money to be used to pay necessary fees to record this Consent Agreernent in its entirety in the deed records of Tarrant County, Texas. After being 2 012 ROW Encrolacbment Agreement-Commercial Page 6 of 10 recorded, the original shall b�e returned to the City Secretary of the City of Fort Worth, Texas. 17, In any action brought by the City for the enforcement of the obligations of Licensee, City shall be entitled to recover interest and reasonable attorney's fees. 180, Licensee covenants and agrees that it will not assign all or any of its rights, n'p *Ieges out 1 1 vi les. under this contract without the pri'or written approval of the City. Manager or designee. Any attempted assignment without prior written approval will be 'd vol . 19. THE PARTIES AGREE THAT THE DUTIES AND OBLIGATION CONTAINED IN PARAGRAPH 8 SHALL SURVIVE THE TERMINATION OF' THIS AGREEMENT. 2010 This Agreement shall be binding upon the parties hereto., their successors and assigns. EXECUTED this day of 2o 11 17- 2 012 ROW Encroachment Agreement-Cominercial m I� Q i o; b � r1 y�,�ti"-f�i"", ,• I w STATE OF TEXAS COUNTY OF 1 ARRAN 'Dt� BEFORE E, the undersige authority, a Notary Public M and for the State of Texas, on this day personally appeared , known to me to he the person whose name is subscribed to the foregoing, instrument, and acknowledged to me that he/she 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. GIVE DER ' HAND AND SEAL OF OFFICE: thi day of 2 b - Ily RA R FOREMAN 11c,State of,Texa"J, MY Commission it p April 2691 o Notary Public in and for the State of Texas 2012 ROW Encroachment Agreement-Commercial Page 9 of'�10 STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Karen Annstrong, Board of Directors Treasurer , known to me to be the person whose name Is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of The Nell P at Burnett Park Condominium Association', Inc., and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this day,of '12013 DOUGLAS S GUESS Notary Public STATE OF TEXAS 1P my Comm.Exp.07-21-15 Not blic in and for the Sta -of Texas 2 012 ROW Encroachment Agreement-Commercial Page 1 0 of 10 XJCNI NIDIStAld 31VO ON Lj ............. . .................... ................................ �Du,i 'siiadX3 UO�jOnJ;SLJ00a� ............................. j �j LC) ACMILL 11 ISN00 NVMM TW"IVIWW ...........", ............ .............. --------- ................... tllllJabDUr)A UVID00S5V JMMOS S) U0DpUV d I!DN L............ —----- Adouoo Oupj!nq uos)apuV d HON :1070c4d ...........................—— -------------------------------- '17 77 --A U 0 -0 Ln cu 14--0 W Lj a_ < 4 D < U LJ U J NN H m LJ z CL G- 7 LL I it cln 00 .............. ............. rx CL z C3 ................. LJ ............I ------ -P a > > CL >e, 1114, I z . ....... m,,,,.......• mm.. u.,..w,._.-.-,._,,. yam,„ Y < u [LA- < LJ =Lji cxj I,. 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CL 0 n- t LJ 01 CY W CL m Cl ry The Neil P. at Bumett Park, a Condom n un PROPERTY DESCRIPTION BEING all of lot 5, Block 6 and a portion of' Lot 4,, Block 3 of the Hirsh field Addition to the City of Fort Worth, Tarrant County, Texas,, some being all of that certain l tract of' land conveyed to TCDFW 411 West Seventh L.P., as recorded in Volume 14482, Page 288, Deed records, Terrant County, Texas, -and bein' g further described as follows: BEGINNING of a tack in a plug found of tho intersection of tho southeasterly line of' West Seventh street (601' Right—of—way) with the 6 east line of Lamlor Street (601"1 Right—of—fty)), MENCE forth 59'18'46" East, along the soufheosterty Ii of said West Seventh Street, for al distance of 124.43 feet to a' tack i in a plug found' for comer; THENCE South 00*41"46" East,, departing said southeasterly line, for a distance of 164.51 feet to a crolw, foot cut In concrete found for comer, THENCE West, for a distance of 9.00 feet; THENCE South, for a distance of 10.13 feet to ja pk nail found for comer; 7'HENCE West, for a distance of 100.00 feet to ai Pik nail found for comer -on the aforementioned east line i of Lamar Street; I THENCE North, for a distance of 1111.13 feet to the POINT' -OF REGINNINQ end containing 15,381 square feet or 0.353 ocres of land, more or less. Pibm & Pamers, LLC 344.5 Highland Road' — Suite 2015 Dallas, Texcis 75228 DATE 3121120M ph:(214) 3281-3500 fox:(214) J28-3512 Fie Na 04088 Page RJ erg aliametrasurvivyUr-COM 0 A The Neil R at Bumett Park, a Condominium SI TE &U" Mon tole rnh bra"man .000 owe* 59 traffic,lot of' Beginning to(* bra**man M Wiater voolt ED004�4DI Area of building over property - 2.6 line is subject to Consent Wact Mh Agreement In Volume 10169, Page 1'0!14 and Volume 10797., Page 1202. Lot 51 Block 6 Ga. 0 0 Hvshfield Addkion 0.0 a"D L ' 4111 W Seventh Street %n 10 Story BfIck Building 131 9148 S . Ft. cn: WM str"t W9n 15,381 square feet ii 0353 acres v ov-) 2.1 0.90 x 6.9' Building Encroachment crow toot 0. of Line low % 4%, ot 4, Block 3 101 0 Romp, *"*�Udq ton, WEST 01*1 Wt (nd &VIn 0 4 0 pk, (nd WEST rm 9.00 a W foot 91W MhO Buildinlq Along Property dine '\\�'OUTH DA�W .3/21/2W6 Lot 4R, Block 3 10,13" Re No, 040M Page R4 Hl'rshfield Addition -0 DATE(MMiYYY) CERTIFICATE OF LIABILITY I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONILY AIND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD R. THII CERTIFICATE: D'O'ES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE 'COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN `rHE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER., IMPORTANT: it the certificate holder Is an ADDITIONAL INSURED,the pollc r ios must be ertdomed. If SUBROGATION IS WAIVED,subject to the terms and conditions at the policy,certain policies may require an endorsement. A statement on this certMcate does not confer rights to the certificate holder In lieu of such n domement(s). PRODUCER CONTACT AIA1 sociations Insura nce Agency, Inc. PHONE 1866)3841-6579 FAX (214)7 1-239 5401 N Central Expressway 0 a M5M ia onsi nasur ceaar`ge,n .co= Suite 2,0,0 INSURER(S)i AFFORDING COVERAGE NAIL 0 Dallas T.X 75205 94SUMREMIRA.Ph .ladael ia Indemnij;y 18058 INSURED mu R B col 1a3 C azua lCS! n 1127 The Ne 1 P at Burnett Park Condominium s,oc SU RC c/o, Somerset Association Management, Inc. INSURER D: 5401 N. Central Expwy. , Suite 360! INSURER E ,Dallas TX 75205 IN'SURER F: COVERAGES CERTIFICAkTE NUMBER,:13-14 REVISION N' !MBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A OV FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ING ANY REQUIREMENT, TERM OR CONDITION CAMP ANY CONTRACT OR MOTHER DOCUMENT KITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS CAP SUCH POU,CIEIS.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, MeM SR rYPF INSURANCE P L Y EFF I U'CY EXP LIWTS POLICY'N MBIER MJIII+/D M GENERAL IAI MLITY EACH OCCURRENCE $ 10000,000 X COMMERCIAL GENERAL LIABILITY M� M $ 1001000 RENTED CLAIMS-MADE OCCUR PHPKGL112013 MED EXP( one ,any 5,1000 PERSONAL AL 9 ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2f0000000 GEhrL AGGREGATE LIM�fiMT°APPLIES PER PRODUCTS M�.'?MP/ A $ 2,000,000 F iLILY PRO,- L C AUTOMOBILE BILI LIABILITY Ea COMBIR95 ac � LMW LI I 1 0Q0 CC0 AUTO BODILY INJURY(Per p!r4on) ALL OWNED SCHEDULED, �KPKGL112013 4/1/2013 4/1/2014 130Uird II4JURY(Per ) AUTOS AUT0S X NON-OWNED PROPERTYl AMMAA HIRED AUTOS AUTOS, X UMBRELLA LIAB X +r,CCUR EACH OCCURRENCE 5,C'C+�, IN A EXCEEXCESS LIAB� CLAIMS-MAI E AGGREGATE 5 0 00011006 10100 201333 ,/1/2013 4/1/2014 I E M I X, RETENTION M BTATL- [9711-WORKERS I 'E "r N AND E11 PLOYERS"LIABILITY ANY PROP IETOFVP"ABTNEPJE' ECM.�TWE YIN E L.EACH ACCIDENT OFFICERIMEMBER EXCLUDED? � N I A JMM&o,dxtaaryr in NH) E L N�tS��E-EA EMw�E"L2YE II n under D RI'PTION OF OPERATIONS;below E.L.DISEASE-POLICY LIM'�+IIT S B DIRECTORS OFFICERS 7385,401-131 13' /1,/ '01.3 /1/2024 LIMIT $1,00,01000 DEDUCTIBLE $2,5OO DESCRIPTI!M N OF OPERATIONS I LOCATIONS/VkHIC:tES (ArMachw ACO RD 101,Additional MRomer1k Schedule,If Mom space le mou lmdI EXHIBIT' CERTIFICATE HOLIER CANCELLATION TION SHOULD ANY CP THE ABOVE DESCRIEIEI)POLICIES BE CANCELLED, FORE. THE EXPIRATION DATIE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of Fort Worth Department of Development AUTHORIZED REPRESENTATIVE David Schroeder Planner 1000 Th,rockmorton Street Fort Worth, TX 76102 Dana Hadge A C R 2 'I ' @ 1988-2010 AC ORD CORPORATION.N TIO . ,All rights reserved. IN IA02'A ami mm ire, T'ho A t"rnon nihma onH Innn ara raniciforarr mArks of As r!'"pri ACC?Ra DATE(MMID D M) 1�40� CERTIFICATE, OF PROPERTY INSURANCE THIIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONS ONLY AND CONIFERS NO, RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE ,AFFORDED BY THE PC I IC:IIES E'IELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN:SUR,EI S, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. It this certificate Is being prepared for a party who has are Insurable lr Interest In,the property,do not use this form. :Use ACORD 27 or ACORD 28, PRODUCER, N CONTACT, Ia�►; � . n Insurance a Inc. (866)384-8579 ' . 5401 N Central Expressway MAII, ADDRESS.-em j�o@ass<>ciations.Lnsuranceagency.com Suite 200 PRODOCER Dal la as 75205 0013 B INSURER AFFORDI O COVERAGE NA1C 0 INSURED INSURER A'Columbia Casualty Com_n 112 ... The Nail P Burnett Park Condominium Assoc Inc, � - INw18'URER c/o Somerset Association Management, Inc. INSURER C 5401 N. Central Xxpwy. , Suite 360, INSURER D Dallas TX 75205 INSURER IE INSURER F' COVERAGES CERTIFICATE TE hltJ'lll'I E 13-14 REVISION DUMBER: LOCATION OF PREMISES J'IDESCMP"ION OF PROPERTY (Attach ACORD 101,Addl bona l Remarks,Sch dodo,If mwe space Is rem: THIS IS TO CERTIFY'T-AT THE PCrICNES OF INSURANCE CE LISTED BELOW HAVE BEE N ISSUED TO THE INSURED DIED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR, MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO,ALL THE TERMS, EXCLUSIONS AND CONDMONS"OF SUCH ..........POLIC�IE. S,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE CF IN' JRANCE POLICY wU ER POLICY EFFEC71VE PIOUCY EXPIRAMON COVERED PROPERTY ...�___..L.�AM'r LTR DATE( WDD ) PATE N YY .m PROPERTY BUILDING CAUSES OF LOSS DEDUCTIBLES PERSONAL PROPERTY BASIC BUILDING BUSINESS INCOME BROAD CONTENT EXTRA EXPENSE s SPECIAL RENTAL VALUE $ EARTHQUAKE � i BLANKET BUILDING $ WIND BLANKET PER PROP FLOOD ......_ BLANKET BLDG PP INLAND MARINE F P L.I Y CAUSES OF LOS NAMED PERILS POLICY NUMBER A CN1.IME '738540-13 4/1/2013, 4/1/2014 X FideityfEmptoyoe Thet .Std 00 TYPE OF POLICY X Dedu cbble $ I JAQC Cnl BOILER,&MACHINERY J EQUIPMENT BREAKDOWN N ... TOTAL 41 OF UNITS 5 m . m SP E tAL CONDM,ON°S l OTHER COVERAGES (Attach ACORD 101,Addltlonatl N'er auar 6 Schedule,If more tip a+ It re,ulmd') CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 'THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS. Department of p I t AU'Th@WED REPREBENTATN E tt David Schroeder,, Planner 1000 Throckmorton Street Fort Worth, TX 76102 Rana DdEM '-- ACO ND 24(2009 09) 0 19,95-2009 ACORD CORPORATION. All bights reserved. INS024(2 ) The ACORD name and logo are registered marks of ACORD