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Home My WebLink About064763 - General - Contract - H-E-B, LPDate Received: 2�19/2026 Time Received: 4: 34 p. I'Tl . Record Number: PN25-00157 City Secretary Ivo.: 64763 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 H-E-B, LP, a Texas limited partnership ("Licensee"), acting by and through its duly authorized representative. RECITALS WHEREAS, Licensee is the owner of the real property located at 6900 AWG Way, Fort Worth, Texas 76140 ("Property"), being more particularly described as, Lot 2R3, Block 7, of Carter Industrial Park, an addition to the City of Fort Worth, Tarrant County, Texas, as recorded in Deed Records, by Instrument Number D224046931; and WHEREAS, the City owns a sewer easement (the "Public Property") adjacent to the Property, dedicated by plat, depicted on the final plat of the property (FP-22-009), which plat is recorded in the plat records of Tarrant County as Instrument D223035734; 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 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 a private ada ramp, steel fence and steel gate (the "Encroachment"). OFFICIAL RECORD Tier II Easement Encroachment Agreement Revised Page 1 of 12 CITY SECRETARY FT. WORTH, TX 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 ar 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 ar 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 actual 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 2 of 12 Revised +� 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 reasonably 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, and to restare the Public Property and access 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 ($1,012.50). � 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 Tier II Easement Encroachment Agreement Page 3 of 12 Revised sewerage, transmission of natural 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 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 promptly following notice to Licensee of such requirement. 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 Tier II Easement Encroachment Agreement Page 4 of 12 Revised 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 Public Property. 13. Licensee agrees to pay prior to delinquencies, 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 5 of 12 Revised 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. Prior to the end of the term of this Agreement, Licensee may submit a new encroachment application to the City. The City will not unreasonably withhold or delay approval of such application provided that the Encroachment follows the then current City codes and compliance. 20. 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. Tier II Easement Encroachment Agreement Page 6 of 12 Revised 21. This Agreement shall be binding upon the parties hereto and their successors and assigns. 22. This Agreement may be executed in multiple counterparts, each of which shall be considered an ariginal, but all of which shall constitute one instrument. [SIGNATURES APPEAR ON FOLLOWING PAGE] Tier II Easement Encroachment Agreement Page 7 of 12 Revised EXECUTED to be effective on the date signed by the City's Director of Development Services Department City: CITY OF FORT WORTH �aGton tfa��eGG By. Dalton Harrell (Feb 19, 2026 1338:08 CST) D. J. Harrell Director, Development Services Department Date: 02/19/2026 ATTEST: �/� ..�i�z'%m-� C po��n� pOHt�pO e�'�'° �9d0 p�a o-00 o�o o=d O�A*000 oo*�d �IIQ4 nEXAsati Approved As To Form and Legality Jannette Goodall, City Secretary i� C�,� Tayler R Canton 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. �� Kandice Merrick Development Services Manager C�]��Cy/,1�:7X�%]:7�7 �«] � i'�'i Xy:7 � ��1:�'1 FT. WORTH, TX Tier II Easement Encroachment Agreement Page 8 of 12 Revised Licensee: H-E-B, LP a Texas limited partnership . y �G By: j f Name: . Scott Title: Group Vice President of Real Estate and Shopping Center Development Date: February 5, 2026 STATE OF TEXAS COUNTY OF BEXAR �� BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas , on this day personally appeared Benjamin R. Scott, Group Vice President of Real Estate and Shopping Center Development, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that heexecuted the same for the purposes and consideration therein expressed, as the act and deed of H-E-B, LP, a Texas limited partnership (entity type), and in the capacity therein stated. GIVEN LTNDER MY HAND AND SEAL OF OFFICE this Sth day of February , 2026. � � �_— Notary Public in and for the State of Texas_ Y.�PAY �!/B^ �A SANCNEZ — _ Notary ID 51130807607 ";,��F� My Commissiun Expires = September 2, 2024 ��__,�,�� ,.��,�� Tier II Easement Encroachment Agreement Page 9 of 12 Revised r� � : i �.y v_�e� � �� :i�l II 1�''L�� ;� ��.�� ;� � : �� y x ��.y ��u w��r� 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 LJNDER MY HAND AND SEAL OF OFFICE this 19th day of February , 20 26 . li✓��ia'� �ltt� �� Notary Public in and for the State of Texas � Wendy BeardSlee �My Commisclon Expiras * t/2812029 Notary ID133237193 Tier II Easement Encroachment Agreement Page 10 of 12 Revised EXHIBIT A Depiction and description of the Encroachment Tier II Easement Encroachment Agreement Page 11 of 12 Revised ' � I ' � I � I I�;� � I � I PART OF �' I I LOT 2R, BLOCK 7 l_ I I CARTER INDUSTRIAL PARK (INST. NO. D213046190) , $•. �� I—� 40' SANITARY SEWER EASEMENT = � (INST.NO. D223035734) � � � � � �: PROPOSED DOCK RAMP o �. ENCROACHMENT J(' ' p Q AGREEMENT — � < (INST. NO. D223079720) � � F. � � � _ �_ � �``� � �� , �� \ \ m�llll i! � I�� : EXISTING PRIVATE STORM LINE �a �Q `�a <�� Ym PROJECT FORT WORTH, TEXAS Qzo SEPTEMBER 2025 �o� ROADRUNNER z � z NORTH � ENCROACHMENT #1 I � --� ENCROACHMENT #2 I ��a � � X X X �,.-,�— � PROPOSED PRIVATE FENCING � II � . X I I I �f � � � � � �V�i � T � �� p EXISTING 2" PRIVATE WATER LINE TO BE REMOVED AND REPLACED WITH 3" PRIVATE WATER LINE EXISTING PRIVATE WATER LINE GRAPHIC SCALE IN FEET Kimley>>>Horn 0 37. 5 75 150 801 Cherry Slreet, Unit 11 Suite 950 Fart Warth, TX 76102 817335-6511 Sta[e of Texas Regislration No. F-928 LEGAL DESCRIPTION ENCROACHMENT AREA BEING a 0.0070 acre (304 square foot) tract of land situated in the John Jennings Survey, Abstract No. 874, City of Fort Worth, Tarrant County, Texas; said tract being a portion of Lot 2R3, Block 7, Carter Industrial Park, an addition to the City of Fort Worth according to the plat recorded in Instrument Number D223035734, Official Public Records, Tarrant County, Texas; said tract being more particularly described as follows: COMMENCING at a 5/8-inch iron rod with cap stamped "KHA" found for corner in the common south line of said Lot 2R3 and the north line of Lot 2R2, Block 7, said Carter Industrial Park addition; THENCE North 62°51'02" East, along the said common line of Lots 2R2 & 2R3, a distance of 65.59 feet to a 5/8-inch iron rod with cap stamped "KHA" found for corner; THENCE North 89°28'58" East, continuing along said common line, a distance of 1.80 feet to a point for corner in the east line of a 40' sanitary sewer easement dedicated by said plat; THENCE North 00°31'02" West, departing said common line and along the said east line of the 40' sanitary sewer easement, a distance of 39.75 feet to the POINT OF BEGINNING; THENCE North 60°05'20" West, departing the said east line of the 40' sanitary sewer easement, a distance of 44.15 feet to a point for corner; THENCE South 89°28'58" West, a distance of 1.93 feet to a point for corner in the west line of the said 40' sanitary sewer easement; THENCE North 00°31'02" West, along the said west line of the 40' sanitary sewer easement, a distance of 10.54 feet to a point for corner; THENCE North 89°28'58" East, departing the said west line of the 40' sanitary sewer easement, a distance of 14.34 feet to a point for corner; THENCE South 00°31'02" East, a distance of 9.50 feet to a point for corner; THENCE South 89°28'58" West, a distance of 6.28 feet to a point for corner; THENCE South 60°05'20" East, a distance of 37.04 feet to a point for corner in the said east line of the 40' sanitary sewer easement; THENCE South 00°31'02" East, along the said east line of the 40' sanitary sewer easement, a distance of 4.64 feet to the POINT OF BEGINNING and containing 304 square feet or 0.0070 acres of land, more or less. NOTES Bearing system based on the Texas Coordinate System of 1983 (2011 adjustment), North Central Zone (4202). A survey plat of even survey date herewith accompanies this metes and bounds description. The undersigned, Registered Professional Land Surveyor, hereby certifies that the foregoing description accurately sets out the metes and bounds of the encroachment tract. � OF �P�G�ST! ENCROACHMENT AREA PART OF LOT 2R3, BLOCK 7, CARTER INDUSTRIAL PARK, JOHN JENNINGS SURVEY, ABSTRACT No. 874 MICHAEL CLEO BILLINGSLEY y: ��- �`o �;N CITY OF FORT WORTH, REGISTERED PROFESSIONAL •••••••••••••••••••••••••••••••••• TARRANT COUNTY, TEXAS LAND SURVEYOR NO. 6558 MICHAEL CLEO BILLINGSLEY 801 CHERRY STREET, �� Kimle >> Horn UNIT 11 SUITE 1300 ��po 6558 �P;� > FORT WORTH, TEXAS 76102 9/�%Q .F S S�� 801 Cherry Street, Unit 11, # 1300 Tel. No. (817) 335-6511 PH. 817-335-6511 S UFtv Fort Worth, Texas �s,o2 FIRM # 10194040 www.kimley-horn.com Scale Drawn bv Checked bv Date Proiect No. Sheet No. michael.billingsley@kimley-horn.com N�a �Rw mce 9/18/2025 os,szssoz , oFz WILLIS, REN 9/19/2025 921 AM K:\FTW SURVEY\069227449-HEB JUNCTION 2035\DWG\061323802-AWB-'�20JECT RO DRUNNER �JCROACHME TS.DWG � LEGEND P.O.B. = POINT OF BEGINNING P.O.C. = POINT OF COMMENCING IRFC = IRON ROD WITH CAP STAMPED"KHA"FOUND L4 M � J J L6 L2 � <) i <r 40' SANITARY SEWER EASEMENT � —0.0070 ACRES (INST. NO. D223035734) � 304 SQ. FT. LINE TABLE I I � P.O.B. �� NO. BEARING LENGTH i I M L1 N60°OS'20"W 44.15' � L2 S89°28'58"W 193' I cV NORTH � 10 20 GRAPHIC SCALE IN FEET � � �� LOT 2R3, BLOCK 7 L3 N00°31'02"W 10.54' I Io CARTER INDUSTRIAL PARK L4 r,as°za�sa��E 14.34' Iz (INST. NO. D223035734) L5 S00�31'02"E 9.50' I L6 sss°zs�se��w s.za� � N89°28'S8"E I / � 1.80' � L7 S60°05'20"E 37.04' / I L8 S00°31'02"E 4.64' � / / / � IRSC / / 6� �g / /// 51�2� � N62 LOT 2R2, BLOCK 7 � CARTER INDUSTRIAL PARK � �RSC � (INST. NO. D223035734) � I P.O.C. NOTES Bearing system based on the Texas Coordinate System of 1983 (2011 adjustment), North Central Zone (4202). A metes and bounds description of even survey date herewith accompanies this survey plat. The undersigned, Registered Professional Land Surveyor, hereby certifies that this survey plat accurately sets out the metes and bounds of the encroachment tract. ENCROACHMENT AREA PART OF LOT 2R3, BLOCK 7, CARTER INDUSTRIAL PARK, �' JOHN JENNINGS SURVEY, ,��..oF. .r P•'G� S T ER.� ABSTRACT No. 874 MICHAEL CLEO BILLINGSLEY y'�-�` � F� �;N CITY OF FORT WORTH, REGISTERED PROFESSIONAL •••••••••••••••••••••••••••••••••• TARRANT COUNTY, TEXAS LAND SURVEYOR NO. 6558 MICHAEL CLEO BILLINGSLEY 801 CHERRY STREET, �� Kimle >> Horn UNIT 11 SUITE 1300 ��po 6558 �P;� > FORT WORTH, TEXAS 76102 9/�%Q .F S S�� 801 Cherry Street, Unit 11, # 1300 Tel. No. (817) 335-6511 PH. 817-335-6511 S UFtv Fort Worth, Texas �s,o2 FIRM # 10194040 www.kimley-horn.com Scale Drawn bv Checked bv Date Proiect No. Sheet No. michael.billingsley@kimley-horn.com 1"=20' GRW mce 9/18/2025 os,szssoz zoFz WILLIS, REN 9/19/2025 921 AM K:\FTW SURVEY\069227449-HEB JUNCTION 2035\DWG\061323802-AWB-'�20JECT RO DRUNNER �JCROACHME TS.DWG � ENCROACHMENT #1 I I 40' SANITARY SEWER EASEMENT —�I (IN ST. NO.D223035734) I I I I I 3 a � U tt � 3 0 < a U O da �Q ��a g�� a�� I I I I I I I APPROX. I APPROX. � PROPOSED CONCRETE ADA RAMP � 2.3" 9 g�� i � EXISTING 8" PAVEMENT ° , I. v � a a � a�• e � , a . , " a; • � a � I I �� I SUBGRADE � I I, . . I I I APPROX. I 7.5' I 'I `/ I EXISTING 12" PUBLIC SEWER LINE I N.T.S. �Y� P ROJ ECT ROAD RU N N E R FORT WORTH, TEXAS SEPTEMBER 2025 ��a �o� ENCROACHMENT #2 I I � I I�— 40' SANITARY SEWER EASEMENT (INST.NO.D223035734) I I I � I �� \ � �- PROPOSED PRNATE FENCING � ' EXISTING LANDSCAPE AREA �� '� EXISTING 8" PAVEMENT I.�.�.�.�.�.�.�.�. .I �.,-.._ .�,� � � �`' �� a—m SUBGRADE . I I� ' i, I, I I I I IAPPROX. I 7.5' I I � I � EXISTING 12" PUBLIC SEWER LINE IN.T.S. I Kimley>>> Horn 801 Che�ry Street, Unit 11 Sui�e 950 Fort Worth, TX 76102 817-335-6511 Slate of Texas Regis[ralion No. F-928 EXHIBIT B Certificate of Insurance Tier II Easement Encroachment Agreement Page 12 of 12 Revised F�RT�OI�TH�� City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: H-E-B L.P. Subject of the Agreement: Tier II Easement Encroachment M&C Approved by the Council? * Yes ❑ No ❑✓ If so, the M&C must be attached to the cont�act. Is this an Amendment to an Existing contract? Yes ❑ No ❑✓ If so, provide the o�iginal contract number and the amendment numbe�^. Is the Contract "Permanent"? *Yes ❑ No 0 If unsu�e, see back page foN permanent cont�^act listing. Is this entire contract Confidentiial? *Yes ❑ No � Ifonly specific information is Confidential, please list what info�mation is Confidential and the page it is located. Certificate of Insurance Effective Date: Date Director signs Expiration Date: 30 years from execution If �different, fi�oin the approval date. If �applicable. Is a 1295 Form required? * Yes ❑ No ❑✓ *If so, please ensure it is attached to the approving M&C or attached to the contract. Project Number: Ifapplicable. *Did you include a Text field on the contract to add the City Secretary Contract (CSC) number? Yes ❑✓ No ❑ Contracts need to be routed for CSO processin� in the followin� order: 1. Katherine Cenicola (Approver) 2. Jannette S. Goodall (Signer) 3. Allison Tidwell (Form Filler) *Indicates the information is required and if the infor�nation is not provided, the contract will be returned to the departn�ent.