HomeMy WebLinkAboutContract 62729Tier II Easement Encroachment Agreement Page 1 of 11
Revised 12/2022
Date Received: ________________ Record Number: PN24-00183
Time Received: ________________City Secretary No.: _____________
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 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 Harmon Retail Centre, LLC, a
Texas limited liability company ("Licensee”), acting by and through its duly authorized
representative.
RECITALS
WHEREAS, Licensee is the owner of the real property located at 9555 Harmon
Road, Fort Worth, Texas 76131 (“Property”), being more particularly described as, Lot
4, Block 1, of Harmon-Heritage Addition, an addition to the City of Fort Worth, Tarrant
County, Texas, as recorded in Deed Records, by Instrument Number D222290066, in
Tarrant County, Texas; and
WHEREAS, the City owns a water facility easement (the “Public Property”)
adjacent to the property, dedicated to the City in an easement filed in the Tarrant County
Deed Records as Instrument Number D210177410, as depicted on the final plat of the
property (FP-24-059), which plat is recorded in the plat records of Tarrant County as
Instrument Number D224222199; and
WHEREAS, Licensee desires to construct, 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
Tier II Easement Encroachment Agreement Page 2 of 11
Revised 12/2022
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 constructing,
installing, and maintaining two retaining walls (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
the Encroachment to further infringe in or on the Public Property beyond what is
specifically described in Exhibit “A.”
2.
All construction, installation, maintenance, and operation of the Encroachment
and the 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 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
construction 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 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 improvements owned by or
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 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 may enter and utilize the Public Property at any time for
any public purpose, including installing, repairing, replacing, or maintaining
improvements 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.
Tier II Easement Encroachment Agreement Page 3 of 11
Revised 12/2022
5.
Upon termination 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
duly authorized representative. Any such removal of the Encroachment shall be in
accordance with then-existing City regulations and policies. It is understood and agreed
to by Licensee that if this Agreement terminates and Licensee fails to remove the
Encroachment and restore the Public Property, Licensee hereby gives City permission to
remove the Encroachment and any supporting structures 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 construction, 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 One Thousand Twelve Dollars and Fifty Cents
($1012.50).
7.
The term of this Agreement shall be for thirty (30) years, commencing on the
date this Agreement is executed by City. However, the City may terminate this
Agreement upon Licensee’s noncompliance with any of the terms of this Agreement.
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
terminate this Agreement. However, the City may, at its sole option, allow the Agreement
to remain in effect so long as Licensee has taken 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 have been delegated to it by the
Constitution of the State of Texas or by the Texas Legislature; 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 time during the term hereof determine 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 communication, drainage, sanitary
sewerage, transmission of natural gas or electricity, or any other public purpose, whether
Tier II Easement Encroachment Agreement Page 4 of 11
Revised 12/2022
presently contemplated or not, that the parties agree to negotiate in good faith in order to
accommodate both the Encroachment and the public purpose.
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 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, 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 Exhibit “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 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
Tier II Easement Encroachment Agreement Page 5 of 11
Revised 12/2022
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.
11.
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 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 fully 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 Agreement 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 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 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 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 Agreement is solely for the purpose
of permitting Licensee to construct, maintain, and locate the Encroachment over or within
the Public Property and is not a conveyance of any 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.
Tier II Easement Encroachment Agreement Page 6 of 11
Revised 12/2022
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 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) 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
[SIGNATURES APPEAR ON FOLLOWING PAGE]
Tier II Easement Encroachment Agreement Page 7 of 11
Revised 12/2022
EXECUTED to be effective on the date signed by the City’s Director of
Development Services Department
City:
CITY OF FORT WORTH
By: ___________________________
D. J. Harrell
Director, Development Services Department
Date: ___________________________
ATTEST:Approved As To Form and Legality
______________________ _______________________________
Jannette Goodall, Hye Won Kim
City Secretary Assistant City Attorney
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.
__________________________________________
Rebecca Owen
Development Services Manager
Licensee:
Harrnon Retail Centre, LI,C
a Texas limited liability corr�pany
by: Harmo� Retail Manager, LLC
a Texas lim�ted liability company
its man r
By:
Name: Rian ire
Title: Manager
Datc: 1 � Z�-I ��ZS
THE STATE OF �. �(,
COUNTY OF �
BEFQI2� ME, the undersigr�ed authai-ity, a Notary Puhlic in and for the State of
TEXA,S, on this day persona[ly appeared Rian Maguire known tn �t�e to be the same person
whose na�ne is subscribed to the fore�oing instrument, a�d acknowledged to me that the same
was the act of Harman Retail Manager, LLC, the manager of, Harmon Retail Centre, LLC and
that f�e/she executed tf�e s�ne as the act aFsaid en#ities for the purpnses a�id consideration therein
expressed and in the capacity therein stated.
GIVEN UND�R MY HAND AND SEAL OF �FFICE tl�is =�_ da of
y
zo�.
Noiary Pu ic in an for the State of Texas
`..�9',siY av ., A B BY B OY D
,z.� � �Notary Public, Stete of Texas
�`���•+�, Comm. Expiras 01-fl5-2028
',��oF�```'' Nptary Ip 134702874
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Tier II Easement Eneroacha�ent Agreement Page $ oF 1 I
Revised 12/2022
Tier II Easement Encroachment Agreement Page 9 of 11
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 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_____day of
_____________, 2025.
__________________________________
Notary Public in and for the State of Texas
After recording return to:
Development Services Department
Development Coordination Office
100 Fort Worth Trail
Fort Worth, Texas 76102
Tier II Easement Encroachment Agreement Page 10 of 11
Revised 12/2022
EXHIBIT A
Depiction and description of the Encroachment
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HARRIS
KOCHER
SMITH
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Denver, Colorado 80203
P:303.623.6300 F:303.623.6311
CHC DEVELOPMENT
CHC HARMON
VICINITY MAP
SCALE: 1" = 500'
PROJECT #: 220451
SHEET NUMBER
1
1 OF 1
LEGEND OF ABBREVIATIONS
• D.R.T.C.T. DEED RECORDS, TARRANT COUNTY, TEXAS
• P.R.T.C.T. PLAT RECORDS, TARRANT COUNTY, TEXAS
• O.P.R.T.C.T. OFFICIAL PUBLIC RECORDS, TARRANT COUNTY, TEXAS
• DOC.# DOCUMENT NUMBER
• C.M. CONTROLLING MONUMENT
• SQ. FT. SQUARE FEET
• ROW RIGHT OF WAY
• CRS CAPPED REBAR SET
NOTE:
Bearings are based on the State Plane Coordinate System,
Texas North Central Zone (4202) North American Datum
of 1983 (NAD '83), with a combined scale factor of 1.00012
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DOC. #D2222290066
O.P.R.T.C.T.
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10.00' �
0.003 ACRES
150 SQ. FT.
' CALLED 0.434 ACRES
CITY OF FORT WORTH
RIGHT-OF-WAY EASEMENT
DOC.#D219157073
O.P.R.T.C.T.
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Phone: 817-864-1957
info@bcsdfw.com
TBPLS Firm #10194474
Page 1 of 2
DRAWN BY: SMW DATE: OCTOBER 7. 2024 JOB NO.: 2022.012.037
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150 SQUARE FEET
TRACT OUT OF
JOSIAH WALKER SURVEY
ABSTRACT #1600
CITY OF FORT WORTH
TARRANT COUNTY, TEXAS
P: \Survey\012 — Harris Kocher Smith\2022\037 — 9555 Harmon Rood\Drawings
EXHIBIT " "
PROPERTY DESCRIPTION
150 SQUARE FEET
TRACT OUT OF
JOSIAH WALKER SURVEY
ABSTRACT #1600
CITY OF FORT WORTH
TARRANT COUNTY, TEXAS
BEING a tract of land out of the Josiah Walker Survey, Abstract Number 1600, City of Fort Worth, Tarrant County,
Texas, being a portion of that tract described by deed to Harmon Retail Centre, LLC, as recorded under pocument
Number D2222290066, Official Public Records, Tarrant County, Texas, (O.P.R.T.C.T.), the subject property being
more particularly described by metes and abounds as follows (bearings are based State Plane Coordinate System,
Texas North Central Zone (4202), North American Datum of 1983 (NAD'83):
BEGINNING at a point on the east line of said Harmon tract, from which a 1/2 inch rebar with cap stamped "TEXAS
SURVEYING" found for the northwest corner of a right-of-way easement described by deed to the City of Fort Worth,
as recorded under pocument Number D219157073, O.P.R.T.C.T., bears North 00 degrees 18 minutes 11 seconds
West, a distance of 383.11 feet;
THENCE South 00 degrees 18 minutes 11 seconds East, with the east line of said Harmon tract, a distance of 10.00
feet, from which an "X" cut found for the southwest corner of said City of Fort Worth tract, bears South 00 degrees
18 minutes 11 seconds East, a distance of 92.43 feet;
THENCE through the interior of said Harmon tract, the following calls:
1. South 89 degrees 32 minutes 09 seconds West, a distance of 15.00 feet;
2. North 00 degrees 18 minutes 11 seconds West, a distance of 10.00 feet;
3. North 89 degrees 32 minutes 09 seconds East, a distance of 15.00 feet, returning to the POINT OF BEGINNING
and enclosing 0.003 acres (150 square feet) of land, more or less.
SURVEYOR'S CERTIFICATE
This is to certify that I, John H. Barton III, a Registered Professional Land Surveyor of the State of Texas, have prepared this map from an actual
survey on the ground, and that this map correctly represents that survey made by me or under my direction and supervision.
Date of Plat/Map: October 7, 2024 _
John arton III, RPLS# 6737
Page 2 of 2
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LEGEND OF ABBREVIATIONS
• D.R.T.C.T. DEED RECORDS, TARRANT COUNTY, TEXAS
• P.R.T.C.T. PLAT RECORDS, TARRANT COUNTY, TEXAS
• O.P.R.T.C.T. OFFICIAL PUBLIC RECORDS, TARRANT COUNTY, TEXAS
• DOC.# DOCUMENT NUMBER
• C.M. CONTROLLING MONUMENT
• SQ. FT. SQUARE FEET
• ROW RIGHT OF WAY
• CRS CAPPED REBAR SET
NOTE:
Bearings are based on the State Plane Coordinate System,
Texas North Central Zone (4202) North American Datum
of 1983 (NAD '83), with a combined scale factor of 1.00012
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HARMON RETAILCENTRE, LLC
DOC. #D2222290066
SCALE: 1" = 30' O.P.R.T.C.T.
BCS
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sur�uEsr�n�
3601 NE Loop 820, Suite 108
Fort Worth, TX 76137
Phone: 817-864-1957
info@bcsdfw.com
TBPLS Firm #10194474
Page 1 of 2
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CALLED 0.434 ACRES
CITY OF FORT WORTH
RIGHT-OF-WAY EASEMENT
DOC.#D219157073
O.P.R.T.C.T.
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150 SQ. FT.
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DRAWN BY: SMW DATE: OCTOBER 7. 2024 JOB NO.: 2022.012.037
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EXHIBIT " "
150 SQUARE FEET
TRACT OUT OF
JOSIAH WALKER SURVEY
ABSTRACT #1600
CITY OF FORT WORTH
TARRANT COUNTY, TEXAS
P: \Survey\012 — Harris Kocher Smith\2022\037 — 9555 Harmon Rood\Drawings
EXHIBIT " "
150 SQUARE FEET
TRACT OUT OF
JOSIAH WALKER SURVEY
ABSTRACT #1600
CITY OF FORT WORTH
TARRANT COUNTY, TEXAS
PROPERTY DESCRIPTION
BEING a tract of land out of the Josiah Walker Survey, Abstract Number 1600, City of Fort Worth, Tarrant County,
Texas, being a portion of that tract described by deed to Harmon Retail Centre, LLC, as recorded under pocument
Number D2222290066, Official Public Records, Tarrant County, Texas, (O.P.R.T.C.T.), the subject property being
more particularly described by metes and abounds as follows (bearings are based State Plane Coordinate System,
Texas North Central Zone (4202), North American Datum of 1983 (NAD'83):
BEGINNING at a point on the east line of said Harmon tract, from which a 1/2 inch rebar with cap stamped "TEXAS
SURVEYING" found for the northwest corner of a right-of-way easement described by deed to the City of Fort Worth,
as recorded under pocument Number D219157073, O.P.R.T.C.T., bears North 00 degrees 18 minutes 11 seconds
West, a distance of North 00 degrees 18 minutes 11 seconds West, a distance of 455.21 feet;
THENCE South 00 degrees 18 minutes 11 seconds East, with the east line of said Harmon tract, a distance of 10.00
feet, from which an "X" cut found for the southwest corner of said City of Fort Worth tract, bears South 00 degrees
18 minutes 11 seconds East, a distance of 20.34 feet;
THENCE through the interior of said Harmon tract, the following calls:
1. North 89 degrees 07 minutes 11 seconds West, a distance of 15.00 feet;
2. North 00 degrees 18 minutes 11 seconds West, a distance of 10.00 feet;
3. South 89 degrees 07 minutes 11 seconds East, a distance of 15.00 feet, returning to the POINT OF BEGINNING
enclosing 0.003 acres (150 square feet) or land, more or less.
SURVEYOR'S CERTIFICATE
This is to certify that I, John H. Barton III, a Registered Professional Land Surveyor of the State of Texas, have prepared this map from an actual
survey on the ground, and that this map correctly represents that survey made by me or under my direction and supervision.
Date of Plat/Map: October 3, 2024 _
Jo . Barton III, RPLS# 6737
Page 2 of 2
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OHN HOMER BARTON II
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Tier II Easement Encroachment Agreement Page 11 of 11
Revised 12/2022
EXHIBIT B
Certificate of Insurance
Client#: 166237 HARM024
DATE (MMIDDIYYYY)
ACORDrM CERTIFICATE OF LIABILITY INSURANCE 1/24/2025
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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT poller pownload
NAME:
InsureZone.com of Texas, IIIC. PHONE g66 243-5934 FAx
A/C, No, Ext : AIC, No :
dba AgentSecure.com E-MAIL
ADDRESS:
550 Bailey Ave., Ste 150
INSURER(S) AFFORDING COVERAGE NAIC #
Fort Worth, TX 76107 Vacant Ex ress
INSURER A : P
INSURED
Harmon Retail Centre
9555 harmon road
FORT WORTH, TX 76177
COVERAGES
CERTIFICATE NUMBER:
INSURER B :
INSURER C :
INSURER D :
INSURER E :
REVISION NUMBER:
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 ADDLSUBR POLICY EFF POLICY EXP LIMITS
LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A X COMMERCIAL GENERAL LIABILITY Y VEP0359234 1/23/2025 01/23/202 EACH OCCURRENCE $� ��Q�����
CLAIMS-MADE �X OCCUR PREMISES Ea oNcur° nce $ 50,000
MED EXP (Any one person) $ rJ,���
PERSONAL & ADV INJURY $ Excluded
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ��OOO�OOO
PRO-
POLICY JECT LOC PRODUCTS - COMP/OP AGG $ Excluded
OTH ER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident $
ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY Y� N TATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? ❑ N / A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Permit #PN24-00183
Certificate Holder is included as additional insured as required by written contract.
City of Fort Worth
100 Fort Worth Trail
Fort Worth, TX 76102
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
��..��
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S153549/M153545 SLC