HomeMy WebLinkAboutContract 61799Date Received: AuguSt 7• 2024
Time Received: 12 p.m.-------
Record Number: PN24-00012
City Secretary No.: 61799------
PUBLIC PROPERTY EASEMENT ENCROACHMENT LICENSE AGREEMENT
TIER II
THIS AGREEMENT is made and entered into by and between THE CITY OF
FORT WORTH, a home mle 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 ONML Cottages at Deer Creek,
LLC, a(n) Texas limited liability company ("Licensee"), acting by and through its duly
authorized president.
RECITALS
WHEREAS, Licensee is the owner of the real property located at 1301 W.
Risinger Road, Fort Worth, Texas 76036 ("Property"), being more particularly described
as, being a tract of land situated in the J. Sise Survey, Abstract No. 1434, City of Fort
Worth, Tarrant County, Texas, as recorded in Deed Records, by Instmment Number
D221380048, in Tarrant County, Texas, and;
WHEREAS, the City owns a sanitary sewer easement (the "Public Property")
adjacent to the Property, recorded in the deed records of Tarrant County by instmment
number D209148667, and plat number FP-23-103 in the plat records of Tarrant County;
and
WHEREAS, Licensee desires to constmct, place, and maintain certain
improvements which will encroach in, on, above, 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 and
occupy 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 constmcting,
installing, and maintaining storm lines and wooden fence {the
Tier II Easement Encroachment Agreement Page 1 of 11
Revised 12/2022
"Encroachments"). Upon completion of the Encroachment, Licensee agrees to be
responsible for maintaining the Encroaclunent within the Public Property. Licensee shall
not expand or otherwise cause the Encroachment to further infringe in or on the Public
Property beyond what is specifically described in Exhibit "A."
2.
All constniction, installation, maintenance, and operation of the Encroachmeut
and the use or occupancy of the Public Property shall comply with and be performed in
strict compliance with this Agreement and with tl�e charter, ordinances, codes, aiid
policies of the City. Prior to the construction or installation of the Encroachment,
Licensee shall submit all plans and specifications to the Director of the Development
Services Department or duly authorized representative. Licensee shall not commence
constniction or installation of the Encroaclunent 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
relocatioii and installation of any existing or future utilities affected by such
Encroachinent and the use and occupancy of the Public Property, including the securing
the approval and consent of the appropriate utility companies and agencies of the State of
Texas and its political subdivisions. In the event that any installation, reinstallation,
relocation, or repair of any existing or future utility or iinproveinents owned by or
constructed by or on behalf of the public or at public expeiise is made more costly by
virtue of the constniction, maintenance, or existence of the Encroachment and use of
Public Property, Licensee shall 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 Development Services Department, or their
duly authorized representative.
4.
Licensee agrees that City inay enter and utilize the Public Property at any time for
any public purpose, including installing, repairing, replacing, or inaintaining
iinproveinents to its public facilities 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 the Encroachment resulting from the City's use of the Public Property;
however, the City shall make reasonable efforts to minimize such damage.
5.
Upon tennination of this Agreement, 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 the Director of Transportation and Public Works, the Director of
the Water Department, the Director of the Development Services Department or their
Tier II Easemeut Encroaclunent A�reement Page 2 of 11
Revised 12/2022
duly authorized representative. Any such reinoval of the Encroaclunent shall be in
accardance with then-existing City regulations and policies. It is understood and agreed
to by Licensee that if this Agreement tenninates and Licensee fails to remove the
Encroachment and restore the Public Property, Licensee hereby gives City permission to
remove the Encroaclunent and any supporting strucriires from the Public Property, to
restore the Public Property, and to assess a lien 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 constructioii, maintenance, inspection or
management of the Encroachment 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.
The term of this Agreement shall be for thirty (30) years, commencing on tlie
date this Agreement is executed by City. However, the City may terminate this
Agreement upon Licensee's noncoinpliance with any of the terms of this Agreeinent.
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
terrninate this Agreement. However, the City may, at its sole option, allow the Agreement
to remain iii effect so long as Licensee has taken reasonable ineasures to cure the
noncompliance or is continuing to diligently atternpt to remedy the noncoinpliance.
8.
It is further understood and agreed betweeil the parties hereto that the Public
Property to be used and encroached upon is held by City as tnistee for the public; that
City exercises such powers over the Public Property as have been delegated to it by the
Constitution of the State of Texas or by the Texas Legislariire; and that City cannot
contract away its duty and its legislative power to control the Public Property for the use
and benefit of the public. It is accordingly agreed that if the governing body of City may
at any tiine during the terin hereof detennine in its sole discretion to use or cause or
permit the Public Property to be used for any other public purpose, including but not
being limited to underground, surface, or overhead coinmunication, drainage, sanitary
sewerage, transinission of nariiral gas or electricity, or any other public purpose, whether
presently contemplated or not, that the parties agree to negotiate in good faith in order to
accominodate both the Encroachinent and the public ptupose.
Tier II Easement Encroaclunent Agreetnent Page 3 of 1 I
Revised 12/2022
9.
LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES
HEREBY INDEMNIFY, HOLD HARMLESS, AND DEFEND CITY, 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 WHATSOEVER HIND 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, ITS 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 Ea�hibit "A."
The amounts of such insurance shall be not less than
$1,000,000
with the understanding and agreeinent by Licensee that such insurance arnounts 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 ainended without at least thirty (30) days prior written notice to
the Building Official 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 II Easement Eucroachment A�reeuient Paae 4 of 11
Revised 12/2022
11.
Licensee agrees to deposit with the City when this Agreement is executed a
sufiicient sum of money to be used to pay necessary fees to record this Agreement in the
real property records of the county in which the Encroachment is located. After being
recorded, the original shall be returned to the City Secretary of the City of Fort Worth.
12.
Licensee agrees to comply fiilly with all applicable federal, state, and local laws,
statutes, ordinances, codes, and regulations in connection with the construction,
operation, and maintenance of the Encroachment and use of the Public Property.
13.
Licensee agrees to pay promptly when due all fees, taxes, or rentals provided for
by this Agreeinent or by any federal, state, or local statute, law, or regulation.
14.
Licensee covenants and agrees that it shall operate heretuider 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 right to control the details of its operations, and all persons performing same,
and shall be solely responsible for the acts and oinissions 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 subcontractors, and nothing herein shall be
construed as creating a partnership or joint enterprise between City and Licensee.
15.
Licensee agrees and acknowledges that this Agreemeut is solely for the purpose
of pennitting Licensee to construct, maintain, and locate the Encroaclunent over or within
the Public Property and is not a conveyance of airy right, title, or interest in or to 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 occupying such property.
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.
Tier II Easeuieut Encroaclunent Agreement Page 5 of 11
Revised 12/2022
17.
The parties agree that the duties and obligations contained in Section 5 shall
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 sixty (60) clays of such foreclosure or
assignment and assumes all of Licensee's rights and obligations hereimder. However, no
change of ownership due to foreclosure or assigrunent to any secured lender of Licensee
shall be effective as to City unless and until written notice of such foreclosure or
assigtunent is provided to City.
19.
Any cause of action for breach of this Agreement shall be brought in Tarrant
Counry, 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
[SIGNATURES APPEAR ON FOLLOWING PAGE]
Tier II Easement Encroaclunent A�reement P�je 6 of 11
Revised 12/2022
City:
CITY OF FORT WORTH
i?::k By: Dalton Harrellf>i.ug 6, 202415:10 CDT)
Licensee:
ONML Cottages at Deer Creek, LLC
a Texas limited liability company
By: ONML Manager, LLC
a Texas limited liability company
its manager
By: -T°"�c:L::__
D.J. Harrell, Director of the
Development Services Department
Name: Ty Robinson
Title: President
Date: Aug 6, 2024
ATTEST:
Jannette Goodall,
City Secretary
Date: Aug 6, 2024 Tier II Easement Encroaclunent Agreement Date: -7_,-,Zlf, -1.H
Approved As To Form and Legality
Jeremy Anato Mensah
Assistant City Attorney
Date: Aug 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 performance
and reporting requirements.
Dw�yne Hollars for
Dwayne Hc(lars for: (Aug 2, 202416:29 CDT)
Rebecca Owen
Development Services
Date: Aug 2, 2024 --------------Page 7 of l l Revised 12/2022
***THIS PAGE FOR CITY OF FORT WORTH OFFICE USE ONLY***
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 D.J. Harrell, known to me to be the person
whose name is subscribed to the foregoing instmment, 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 6th day of
August , 2024.
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 Notary I.D. 13323719-3
My Comm. Exp. July 28, 2025 Page 8 ofl l Revised 12/2022
STATE OF fiL�G S_
COUNTY OF �G( (f l��l'�
BEFORE ME, the undersigned authority, a Notary Public in and for the State of
T�1C4 , on this day personally appeared Ty Robinson, President known to me to be
the person whose name is subscribed to the foregoing instruinent, and acknowledged to
ine that he or she executed the same for the purposes and consideration therein expressed,
as the act and deed of ONML Cottages at Deer Creek, LLC, a Texas limited liability
company, and in the capacity therein stated.
GIVEN LTNDER MY HAND AND SEAL OF OFFICE this Z,y day of JHI�„
2024. d
l
Notary Public in and for t e
State of ��ct S
``"""'� JEFF KUNG
.
�`�Pt'Y"Ge�i
_2°;� �_Notary Public, State of Texas
%`��. 'Q� Comm. Expires 08-06•2024
':lF oF'i`��:
�i���������� Notary ID 1326Q8640
Tier II Easement Encrolchment A�reement
P�?e 9 of 11
Revised 12/2022
EXHIBIT A
Depiction and description of the Encroachment
Tier II Elseuient Encroachuient ADreeuient Page 10 of 11
Revised 12/2022
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Fort Worth Texas °�`°�.Te'a''S°°9
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f State a/Tezas Registralion No. F926
February 2024 ,.E.,.,.�w.w.;�..�..�m�,�..K.ro.TM.�r��
ENCROACHMENT #1 PRIVATE STORM DRAIN
0.002 - ACRE
BEING a tract of land situated in the John Sise Survey, Abstract No. 1434, City of Fort
Worth, Tarrant County, Texas and being a portion of Block H, Lot 26X of Deer Creek
Meadows, an addition to the city of Fort Worth, according to the plat filed of record in
Document No. D224030861 Official Public Records, Tarrant County, Texas (O.P.R.T.C.T.),
and being more particularly described as follows:
BEGINNING at a point in said Lot 26X, being South 81°16'10" West a distance of 277.57
feet and South 08°19'12" East a distance of 2.53 feet from a 1/2-inch iron rod found with
cap stamped "Goodwin & Marshall" for the northeast corner of said Lot 26X in the west line
of Union Pacific Railroad;
THENCE South OS°19'12" East, a distance of 10.00 feet to a point for corner;
THENCE South 81 °40'48" West, a distance of 10.00 feet to a point for corner;
THENCE North 08°19'12" West, a distance of 10.00 feet to a point for corner;
THENCE North 81 °40'48" East, a distance of 10.00 feet to the POINT OF BEGINNING and
containing 100 square feet or 0.002 acre of land.
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ENCROACHMENT #2 FENCE ENCROACHMENT
0.002 - ACRE
BEING a tract of land situated in the John Sise Survey, Abstract No. 1434, Tarrant
County, Texas and being a portion of that tract of land conveyed to ONML Cottages at
Deer Creek LLC., according to the document filed of record in Instrument No.
D221380048 Official Public Records, Tarrant County, Texas (O.P.R.T.C.T.), and being
more particularly described as follows:
BEGINNING at a point in said ONML tract, being South 81 °35'41" West a distance of 97.52
feet and North 00°12'04" West a distance of 41.70 feet from a 1/2-inch iron rod found with
cap stamped "Goodwin & Marshall" in the north line of Pere David Drive a 50 foot right-of-
way according to the plat filed of record in Document No. D224030861 O.P.R.T.C.T., at the
beginning of a 50' cul-de-sac in the intersection of Muntjac Drive, same being common with
the south line of said ONML tract;
THENCE South 89°47'S6" West, a distance of 10.00 feet to a point for corner;
THENCE North 00°12'04" West, a distance of 10.00 feet to a point for corner;
THENCE North 89°47'56" East, a distance of 10.00 feet to a point for corner;
THENCE South 00°12'04" East, a distance of 10.00 feet to the POINT OF BEGINNING and
containing 100 square feet or 0.002 acre of land.
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SEWER EASEMENT DRAINAGE
D209748667 EASEMENT
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Cottages at Deer Creek Meadows
C Q Fort Worth, Texas
ppF�Q� February2024
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��� THIS SHEET IS AN
��� 6�� Public Sewer Stub Encroachment - Plan View EXCERPT TAKEN FROM 1HE
CIVIL CONSTRUCTION Kimle
Cottages at Deer Creek Meadows PLANS FOR COTfAGES AT y�>>Horn
DEER CREEfC MEADOWS �x.ou,�,,,„a.
� � Fort Worth, Texas (CG22-00183) (SHEET s°��°�
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ELE ATION =
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ELEV TION =
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PRIVATE STORM LINE ENCROACHMENT
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� 720 THIS SHEET IS AN N M N
� EXCERPT TAKEN FROM THE �
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ELE�IATION =
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EXHIBIT B
Certificate of Insurance
Tier II Elsement Encroaclunent Agreement Page 11 of 11
Revised 12/2022
��R � CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIODIYYYY)
6/10/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES 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 THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer riQhts to the certificate hoider in lieu of such endorsement(s).
PRODUCER
Hotchkiss Insurance Agency, LLC
13430 Northwest Freeway
Suite 600
Houston TX 77040
NAME:y� Certificates Houston
ac No Ext • 800-899-9810 F
A DRIESS: ��S hiallc.com
INSURER 5 AFFORDING COVERAGE
iNsuReRn: Palomar S ecialt Insurance Com an
ONMLBEL-0t �NSURERB: T2X2S MUtUBI If1SUf8f1C2 CORI an
�NsuReR c� Associated Industries Insurance Co. Inc
713-956-0331
INSURED
ONM Living, LLC
1038 Texan Trail
Grapevine TX 76051
NAIC #
20338
22945
23140
COVERAGES CERTIFICATE NUMBER:673920266 REVISION NUMBEK:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TypE OF INSURANCE ADDL SUBR ppLICY NUMBER MMIDDlYYYY MMIDO/YYYY LIMRS
LTR
C X COMMERCIAL GENERAL LIABILITY AES124377000 6/10/2024 6/10/2025 Ep,CH OCCURRENCE S 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE a OCCUR PREMISES Ea occurrence S 100,000
MED EXP (Any one person) S ExCludOd
PERSONAL & ADV INJURY S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000
POLICY � jE � � LOC PRODUCTS - COMP/OP AGG 5 2,000,000
OTHER: S
AUTOMOBILELIABILITY COMBINED SINGLE LIMIT 5
Ea accident
ANYAUTO BODILY INJURY (Perperson) 5
OWNED SCHEDUIED BODILY INJURY (Per accident) 5
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTYDAMAGE S
AUTOS ONIY AUTOS ONLY Per accident
IS
C UMBRELLALIAB X OCCUR EXA124730000 6l10I2024 6/10I2025 EACHOCCURRENCE 55,000,000
X EXCESSLIAB CLAIMS-MADE AGGREGATE 55,000,000
DED X RETENTION S S
g WORKERSCOMPENSATION 0001280199 1/1/2024 1/1I2025 X
AND EMPLOYERS' LIABILITY STATUTE ER
ANYPROPRIETOR/PARTNEWEXECUTIVE Y� N�A E.L. EACH ACCIDENT S 1,000,000
OFFICER/MEMBEREXCLUDED7
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S 1,OOD,000
If yes, describe under
DESCRIP710N OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 1,000,000
A BuildersRisk BRCIS00110960002 6/1/2024 6/1/2025 PerLoc $2,000,000
Per Occ $10,000,000
DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES (ACORD 10t, AddiNonal Remarks Sehedule, may be attached ii mare space is required)
General Liability Named insured continued: ONML Construction Services LLC; ONML Cottages at Deer Creek LLC; ONML Villas at Eagle Ranch LLC;
ONML Villas at Deer Creek LLC; ONML Cottages at Anna Station, LLC; ONML Cottages at River Ridge, LLC; ONML Cottages at Chambers Grove LLC;
ONML Cottages at Lake Lavon LLC
The general liability policy inGudes a blanket additional insured endorsement (CG2010 07/04) when required by written contract.
The certificate holder is named as loss payee/mortgagee with regard to the Builders Risk policy and is subject the terms and conditions applicable to this policy.
See Attached...
CERTIFICATE HOLDER
Cy_l:[�i��tll�li�
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS.
Planning & Development - CFA Office
PN2400012 AUTHORIZED REPRESENTATIVE
200 Texas Street `
Fort Worth, TX 76102 '
�w j(�j�. l, v �
O 1988-2015 ACORD CORPORATION. Ail rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: ONMLBEI-01
LOC #:
AGENCY
Hotchkiss Insurance Agency, LLC
ADDITIONAL REMARKS SCHEDULE
NAMEDINSURED
ONM Living, LLC
1038 Texan Trail
Grapevine TX 76051
NAIC CODE
EFFECTIVE DATE:
Page 1 of 1
POLICY NUMBER
CARRIER
The ACORD name and logo are registered marks of ACORD
ACORD 101 (2008101) O 2008 ACORD CORPORATION. All rights reserved.