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HomeMy WebLinkAbout065106 - General - Contract - Wal-Mart Stores TexasDate Received: 4/27/2026 Time Received: 4:25 p.m. Record Number: PN26-00020 Cite Secretary No.: 65106 PUBLIC PROPERTY EASENIENT ENCROACHMENT LICENSE AGREEMENT ru:x ii THIS AGREEMENT is made and entered into by and between THE CITY OF FORT WORTH. a home rule I11t1111Cipal corporation Of I arrant COl1IAt '. Texas ("City"). acting by and through its duly authorized City Manager. Assistant City Manager. or Director of' the Development Services Department. and %Val -Mart Stores Texas. a Delaware limited liability company ("Licensee"). acting by and through its duly authorized representative. RECITALS WIIEREAS. Licensee is the owner of'the real property located at 2401 Avondale I laslet Road. Dort Worth. Texas 76052 ("Property"). being more particularly described as. Lot I. Block 1. of Vista Crossroads Addition an addition to the City of Dort Worth. Tarrant County. Texas. as recorded in Deed Records. by Instrument NUIllber D2122875 16: and WIIEREAS. the City owns a sanitary sewer easement (tile "Public Property") adjacent to the Property. dedicated by plat. depicted on the final plat ol'thc property (FS- 008-088). which plat is recorded in the plat records of* Tarrant County as 111sU•ument D2122875 16: and WIIEREAS, Licensee desires to construct. place. and maintain certain improvements which will encroach in. Oil. above. or below the Public Property: and WHEREAS. to accommodate the needs Ot the lAce see. tile City will allow till' encroachlllCllt LIMICl'tile terms and conditions as set lorth In this Aorcclllcnt. NOW, TFIEREFORE. the City and Licensee agree as follows: AGREEMENT The City. in consideration of the payment by Licensee of the Ice set out below and covenants and ayoreements hereinafter contained to be kept and performed by Licensee. hereby grants permission to Licensee to encroach in. oil. 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 1)U1-l)0Se Of COIIStRiCtlllg. illstallin.g. and maintaining all electrical conduit (the "Encroachment"). Tier II Easement Encroachment Agreement OFFICIAL RECORD Page I of 12 Standard CITY SECRETARY Revised 12/2022 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 or on the Public Property beyond what is specifically described in Exhibit "A." �M 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 Nvith 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. RI Licensee, at no expense to the Cite. 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 0I'tl1�e State of Texas and its political subdivisions. Ill the event that any installation. reinstallation, relocation. or repair of any existing or future utility or improvements owned by or constructeLI 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. 5. Upon termin.ition 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 11 Easement Encroachment Agreement Page 2 of 12 Standard Revised 12/2022 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 it' this Agreement terminates and Licensee fails to remove the Encroachment and restore the Public Property. Licensee hereby gives City permission to remove tilt 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 suns of One Thousand Twelve Dollars and Fifty Cents (S 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 presently contemplated or not, that the parties agree to negotiate in good faith in order to accommodate both the Encroachment and the public purpose. Tier 11 Easement Encroachment Agreement Page 3 of 12 Standard Revised 12/2077 9. LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREIN 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 written documentation evidencing that Licensee is self -insured and maintains financial responsibility sufficient to cover all public liability risks related to the proposed use and occupancy of public property as located and described in Exhibit "A." The limits of such self-insurance shall be not less than $I,000,000 with the understanding and agreement that the City may rewire higher limits of indemnification at its option. and Licensee shall adjust accordingly upon receiving written notice of such requirement. Such self=insurance shall not be canceled or amended without at least thirty (30) days prior written notice to the Building Official of the City or ten (10) days prior written notice in the case of nonpayment to the Building Official of the City. Documentation of Licensees self-inSUred Status is attached as Exhibit "B" and incorporated herein for all purposes. Licensee agrees, binds. and obligates itself and its successors and assigns to maintain such self-insurance and Financial responsibility throughout the term or this Agreement and until the Encroachment is removed and the Public Property is restored. Tier II Easement Encroachment Agreement Page 3 of 12 Standard Revised 12l20221 In addition. Licensee shall require all contractors and subcontractors performing any work within the Encroachment to maintain, at their own expense, policies of public liability insurance covering all public risks arising from their operations. Such insurance shall name the City, Licensee.. and Licensee`s officers, agents. employees, successors, and assigns as members of the indemnified ,group. The limits of insurance required of contractors and subcontractors shall be not less than $1,000,000 or such higher limits as the City may require at its option. Licensee agrees, binds, and obligates itself and its successors and assigns to ensure that all contractors and subcontractors maintain such insurance coverage for the duratiOn of their work within the Encroachment and until the Encroachment is removed and the Public Property is restored. 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 ''North. 12. Licensee agrees to comply fully with all applicable federal, state, and local laws. statutes, ordinances, codes, and regulations in connection N%ith the construction, operation, and maintenance of the Encroachment and use of the I'Llblic Property. 0. Licensee agrees to pray 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 ofiicer. 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 perforating 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'permittin4- Licensee to construct, maintain, and locate the Encroachment over or ► ithin the Public Property and is not a conveyance of any right. title. or interest in or to the Tier 11 Easement Encroachnicilt Agreement Page 5 of 12 Standard Revised 12/2022 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. 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 Cit%. 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 ].ender 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 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 Lill reasonably 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. 21. Tier 11 Easement Encroachment Agreement 1'age G of 12 Standard Revised 12/2022 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 original, but all of which shall constitute 011C instrument. [SIGNATURES APPEAR ON FOLLOWING PAGE] Tier It Easement Encroachment Agreement Page 7 of 12 Standard Revised 12/2022 EXECUTED to be el'fcctive on the date signed by the City's Director of Development Services Department City: CITY OF FORT WORTH ft��� By: Dalton Harrell (Apr 24, 2026 14:03:04 CDT) D. J. Harrell Director, Development Services Department Date: 04/24/2026 p' -co Mit'll ATTEST': pas °s9=a Approved As To Form and Legality p°o*'�o aExA5a4p Jannette Goodall, Tayler Canton 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. ja�� Kandice Merrick Contract Compliance Manager OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Tier 11 Easement Encroachment Agreentetit 11rt-'e 9 ol, 1 Standard Re%i-ed 12 2022 Licensee:. Wal-Mart Stores Texas. a Delaware limited liability company y� By: -- N Name: Drew Marshall Title: Director, Real Estate Date: April 17. 2026 STATE OF ARKANSAS COUNTY OF BENTON BEFORE ME. the undersigned authority, a Notary Public in and for the State of Arkansas, on this day personally appeared Drew Marshall, Director of Real Estate known to me to be the person whose name is subscribed to the foregoing instrument. and acknowledged to me that he or she executed the same for the purposes and consideration therein expressed. as the act and deed of Wal-Mart Stores Texas, a Delaware limited liability company. and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 17th day of April. 2026. F A. FISHER RY PUBLIC N ry Public in and for the UNIY, ARKANSASState ofArkansas Q{R 11126/34 ON NO. 12402095 Tier 11 Easement Encroachment Agreement page 9 of 12 Standard 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 lie ereeutccl the same for the purposes and consideration therein expressed, as the act and deed of the City of Fart Werth, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 24th ,day of April , 2026 Notary Public in and for the State orTexas Tier 11 Easement Encroachment agreement Standard EC drey lea 1 apace COInMIS,Ion ExpiFes 911012028 tt3f ID1350B2596 Page 10 of 12 Revised 12/2022 EXHIBIT A Depiction and Description of the Encroachment Tier 11 Easement Encroachment Agreement Page I I of 12 Standard Revised 12/2022 ENCROACHMENTEASEMENT DESCRIPTION 0.008 ACRE BEING a tract of land situated in the B.R. Lacy Survey, Abstract No. 990, City of Fort Worth, Tarrant County, Texas and being a portion of Lot 1, Block 1 Vista Crossroads Addition, an addition to the City of Fort Worth, according to the Plat filed of record in Instrument No. ❑212287516 Plat Records, Tarrant County, Texas (P.R.T.C.T.), being a portion of that tract of land described in that certain deed to Wal-Mart Stores Texas LLC, recorded in D207365138 Official Public Records, Tarrant County, Texas (O.P.R.T.C.T.), and being more particularly described as follows: COMMENCING at a point for corner in said Lot 1, Block 1, being at a northwest corner, same being the terminus line transitioning from 15-feet to a 30-feet wide, of a Sanitary Sewer Easement recorded in said Vista Crossroads Addition, and being from which the northwest corner of said Lot 1, Block 1 bears South 63'19'24"'West, a distance of 309.05 feet; THENCE over and across said Lot 1, Block 1 and with the north line of said sanitary sewer easement, the following courses: North 6402126" East, a distance of 50.64 feet to a point for the BEGINNING of the herein described tract; North 64°21'26" East, a distance of 18.67 feet to a point for corner, from which an angle point in the north line of said sanitary sewer easement bears North 64°21'26" East, a distance of 105.53 feet; THENCE continuing over and across said Lot 1, Block 1, the following courses: South 39°29'32" East, a distance of 3.00 feet to a point for corner; South 51 `18'38" West, a distance of 2.57 feet to a point for corner; South 47'32'1.5" East, a distance of 28.56 feet to a point for corner in the south line of said sanitary sewer easement, being from which the southeast corner of said Lot 1, Block 1 bears South 60°24'06" West, a distance of 1,081.18 feet; THENCE South 64°21'26" West, with said south line, a distance of 10.78 feet to a point for corner, form which the transitioning from 30-feet to 15-feet wide terminus corner of said sanitary sewer easement, bears South 64°21'26" West, a distance of 67.39 feet; THENCE continuing over and across said Lot 1, Block 1, the following courses. - North 47°32'15" West, a distance of 26.10 feet to a point for corner; South 51 °18'38" West, a distance of 5.52 feet to a point for corner; North 38°48'05" West, a distance of 7.22 feet to the POINT OF BEGINNING and containing 366 square feet or 0.008 acres of land. MICHAEL J. SWAYNE `j REGISTERED PROFE SIONAL ••1CF LAND SURVEYOR NO. 7143 ... 400 NORTH OKLAHOMA DRIVE " SUITE 105 CELINA, TEXAS 75009 PH. 469-501-2200 michael,swayne@kimley-horn.com XLEY. GREG 2/2Q026 11 25 G.h9 K 10EL. SURVEYU5633634B4. WA 5754 - 02/04/2026 ENCROACHMENT EASEMENT OF B.. R. LACY SURVEY, '� •• ABSTRACT NO. 990 r ,.•'r T � •.• •©' CITY OF FORT WORTH '.....'.'.,........',.:' _ TARRANT COUNTY, TEXAS 'AM. 5764 FORT NIURTW TXS20�25EV) LEGEND A = CENTRAL ANGLE P.0.13. = POINT OF BEGINNING IRFC = IRON ROD W/CAP FOUND PFC = POINT FOR CORNER NWC = NORTH WEST CORNER SEC = SOUTH EAST CORNER P.R.T.C.T. = PLAT RECORDS OF TARRANT COUNTY, TEXAS O.P.R.T.C.T. = OFFICIAL PUBLIC RECORDS, TARRANT COUNTY, TEXAS J \ \ WATER EASEMENT ' / INST. NO. 0212207516 1 \ = J P.R.T.C.T. 1 l 1 PFC P+O B NORTHWEST CORNER LOT 1. SLOCK i L2 VISTA CROSSROADS ADD. L3 REARS S63"1924-W,, 309 05 J y+ 1 POC ' JL0 / SOUTHEASTCORNERSSOC" J 5©6 + L7 ! --LOT 1, BLOCK 1 VISTA CROSSROADS ADD 1 BEARS 560'24'06"W, 1.081 18' i L5 1 0.008 ACRE J'r J J 366 SQ. FT. J 1 J SANITARY SEWSR EASEMENT J INST NO 0212287516 / P R T C T LINE TABLE NO. BEARING LENGTH L1 N64°21'26"E 18.67' L2 S39`29'32"'E 3,00' L3 S51°18'38"W 2,57' L4 S47°32'15"E 28.56' L5 S64°21'26"W 10.78' L6 N47732'15'W 26,10' L7 S51 `18'38"W 5.52' L8 N38"48'05" VV 7.22' LOT 1, BLOCK i VISTA CROSSROADS ADDITION INST. NO. D212287546 P.R.T.C.T. WAL-MART STORES TEXAS LLC INST. NO. 0207365138 O.P.R,T.C.T. R V E 'y , 0. gS7 ABS-TRNC N 0 20 40 NORTH GRAPHIC SCALE IN FEET NOTES Bearing system is based on the Texas Coordinate System, North Central Zone (4202), North American Datum of 1983 (NAD 83), coordinates and distances are grid, U-S. Survey Feet EMERGENCY ACCESS & FIRE LANE EASEMENT INST. NO. D212287516 P.R.T.C.T. ENCROACHMENT EASEMENT B.R. LACY SURVEY, ABSTRACT NO. 990 CITY OF FORT WORTH TARRANT COUNTY, TEXAS ;.__Y. GREG 202026 11 25:41 K. ICEL SURVEY*53363494 W M 5764 - FORT 4AOR'TH TX FORT WORTH, TX(2025EV) - BNDRY I0 0 CD z if) �> 0 En m 1 ? X m0 9 cn x X 0 <rn"o CI? r + cncncn� z cn y nrn 0 G7om� mz �� +x mA > O �rnZ C Z X ^I� rnwm0 c m w 00 r- .n m z: x m0 co cn Z .r. 111 V z a� �N�� a n< en Z M m-1 m m n M- 2 mF) z{ > rz r Pip o xy�v too , � � rm m w m m omm 1 -Z zm Pm pm f3.S7 1r� -41 ry 1 z y X m?ur XZ G7 w mirl r� u> / m % m m z w VAdMMlt* _ ommyoHom �i uRtbat kriY STQTE NO 5 , 1)t tatty EXHIBIT B Certificate of Insurance Tier 11 Easement Encroachment Agreement Page 12 of 12 Standard Revised 1212422 Walmart i'� Global Risk % Management Effective Date: Continuous throughout the term of the below referenced agreement. RE: Request for proof of insurance / self-insurance pert he terms ofa signed agreement To Whom It May Concern, WaImart takes its obligations to its associates, customers, business partners, landlords, and others veryseriously. In order to best ful fill i ts responsibilities to its customers, associates, a nd shareholders, Walmart uti lizes a combi nation of insurance, self -insured retentions, and self-insurance for a number of risks. With respect to claims arisingoutof third party liabilities for all forms of legal liability for bodily infury and propertydamage, Walmart Inc.,its affiliates a nd i ts s ubsidiaries (collectively "Walmart"), el ects to self-insu re the i nsurance requirements of its agreements where aHowed by Iawand bytheterms of theagreement. With respectto claims arising from physical loss ordamage to structures, equipment and/or other tangible property for which Walmart assumes the res ponsibility for the risk of Ioss, Walmart is self -funded. The existence of an insurance policy does not s upersedeWalmart's right to self -insure.. Pleaseallowthis letter to serve as evidence of Walmart's electionto self -insure. Wa I mart is prepared to meet i is I egai I iabilities in connection with its agreements. For evi Bence of the requisite net worth of Walmart, pleasevi sit htto://stock.walm_a_rt.com to vi ew the current annual and quarterly reports. Sincerely, Walmart Global Risk Management MEMORANDUM OF LIABILITY INSURANCE Current as of September 15, 2025 PRODUCER THIS MEMORANDUM IS ISSUED AS A MATTER OF INFORMATION ONLY TO AUTHORIZED VIEWERS FOR MARSH USA INC THEIR INTERNAL USE ONLY AND CONFERS NO RIGHTS UPON ANY VIEWER OF THIS MEMORANDUM 1166 Avenue of the Americas OTHER THAN THOSE PROVIDED FOR IN THE POLICY. THIS MEMORANDUM DOES NOT AMEND, EXTEND New York, NY 10036 OR ALTER THE COVERAGE O€SCRIBED BELOW. THIS MEMORANDUM MAY ONLY BE COPIED, PRINTED AND DISTRIBUTED WITHIN AN AUTHORIZED VIEWER AND MAY ONLY BE USED AND VIEWED BY AN AUTHORIZED VIEWER FOR ITS INTERNAL USE. ANY OTHER USE, DUPLICATION OR DISTM13UTION OF THIS MEMORANDUM WITHOUT PRIOR. WRITTEN CONSENT IS PROHIBITED. THE INFORMATION CONTAINED HEREIN IS AS OF THE DATE REFERRED TO ABOVE. NEITHER THE INSURED NOR THE PRODUCER SHALL HAVE ANY OBLIGATION TO INFORM AN AUTHORIZED VIEWER OF ANY CHANGES TO THISINFORMATIO11. INSURED COMPANIES AFFORDING COVERAGE NAIL TIP Walmart Inc. Its Subsklearies and Its Afhlkates I Customer Drive COMPANY A NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA -- 19445 COMPANY B AIU INSURANCE COMPANY 19399 COMPANY C INDEMNITY INSURANCE COMPANY OF NORTH AMERICA 43575 _ Bentonville, AR 72716 COMPANY 0 ACE PROPERTY AND CASUALTY INSURANCE COMPANY 20699 COMPANY E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIOft OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MEMORANDUM 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. COMPANY LETTER TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY LIMITS LJ MrrS IN USD UNLESS OTHERWISE INDICATED DATE EXPIRATION DATE A GENERAL LIABILITY 3609379 9/15/2025 9/15/2026 EACH OCCURRENCE $1,000,000 X occUR PERSONAL & ADV INJURY $1,000,000 MADE dX[MINIS X COMMEKUL GENERAL FIRE DAMAGE (Any One Fire 1 000 0D0 MED EXR (Any One Person n a GEWL AGG LIMIT APPLIES PRODUCTS- COMP OP AGGREGATE _ $3,000,000 PER POLICY _ GENERAL AGGREGATE $3,000000 A B AUTOMOBILE LIABILITY 3135705 (ADS) 9/15/2025 9/15/2026 COMBINED SINGLE LIMIT $1,000,0GO X ANY AUTO 3135703 (MA) BODILY INJURY (Per Person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY IIOU'RY (Per Accident) - — $ _ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE — -- _ 0 EXCESS LIABILITY XEUG27892036 011 V1512025 911512026 EACH OCCURRENCE 15.00Q,000 JL JUMEIRELLA FORM AGGREGATE 55,000,040 ___ OTHER TIM4 UMEIRELIA FORM ABC WORXERS SEE BELOW 9115/2025 DM512026 WORKERS COMPENSATION LIMITS STATUTORY EL EACH ACCIDE14T 1.000 000 COMPENSATION/ IEL DISEASE - POLICY LIMI7 $1,000,000 EMPLOYERS LIABILITY EL DISEASE - EACH EMPLOYEE S1,00G,000 ADDITIONAL INFORMATION GENERAL LIABILITY. Coverage Includes Professional Liabildy including DruggrsVs and OpDuan's GENERAL LIABILITY POLICY 3609179 IS SUBJECT TO A SELF INSURED RETENTION OF USD 42,000,000 EACH OCCURRENCE With respect to Commercial General Lladllty, Policy 3609379 arty Party with which the Named Insured has contractually agreed to Include as Add,Wnal Insured, such status Is granted. Such Ado,Uonal Insured status is sulljmt to the IIrn ts, terms and corlcl,WS W the pdIcy and shall apply only to fhe extent of and for no mom than the limits required within such contractual agreement LIQL15 LIABILITY: EXCESS LIABILITY POLICY XEUG27892036 Oil IS SUBJECT TO A SELF INSURED RETENTION OF USD $SO,OD0,000 EACH OCCURRENCE WORKER'S' COMPENSATION POLICIES: COMPANY A: EXCESS WDRXERS'COMPENSATION: 6583214 (FL) 658321E (AL,A2,ME,NY,OH,OK,OR,WA) 6583216 (AR,GA,LA) COMPANY B: 014111789 (CO.CT,DC,Gt,IN,tci.M1,NF,R1,$C,3D,V?V) 014111790 (DE,HI,ID,MD,MN,MO,MS,MT,fiM,NV,T1t) 01411I788 (AK,MA,ND.NI,PA,VA) 014111791 (WI) 014111787 CIL,.KY,NC,NH,UT',VT) COMPANY C: wtRC7279987A (CA) The Memorandum of insurance serves solely to list insurance Policies, limits and dates of coverage. Any modifications hereto are not authorized. MEMORANDUM OF PROPERTY INSURANCE Current as of April 1, 2025 THIS MEMORANDUM IS ISSUED AS A MATTER OF INFORMATION ONLY TO THOSE WITH WHOM WALMART HAS A WRITTEN AGREEMENT REQUIRING WALMART TO FURNISH EVIDENCE OF INSURANCE ("AUTHORIZED VIEWERS)") FOR THEIR INTERNAL USE ONLY AND CONFERS NO RIGHTS UPON ANY AUTHORIZED VIEWER OTHER THAN THOSE PROVIDED FOR IN THE POLICY. THIS MEMORANDUM DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE DESCRIBED BELOW. THIS MEMORANDUM MAY ONLY BE COPIED, PRINTED AND DISTRIBUTED WITHIN AN AUTHORIZED VIEWER'S OWN ORGANIZATION AND MAY ONLY BE USED AND VIEWED BY AN AUTHORIZED VIEWER FOR ITS INTERNAL USE. ANY OTHER USE, DUPLICATION OR DISTRIBUTION OF THIS MEMORANDUM WITHOUT WALMART'S PRIOR WRITTEN CONSENT IS PROHIBITED. THIS MEMORANDUM DOES NOT CONSTITUTE A CONTRACT BETWEEN AUTHORIZED VIEWER AND THE ISSUING INSURER(S) OR WALMART. PRODUCER NAME, CONTACT PERSON AND ADDRESS DIRECT COMPANY NAME AND ADDRESS NAfc NO: 0 BROADSTREET INSURANCE COMPANY AND VARIOUS OTHER INSURERS _ EMAIL certrequest@wal-mart.com NAMED INSURED AND ADDRESS AV/almart Inc. Its Subsldaries and Its Affiliates 1 Customer Drive Bentonville, AR 72716 POLICY NUMBER VARIOUS EFFECTIVE DATE 04/01/2025 EXPIRATION DATE 04/01/2026 PROPERTY INFORMATION - ,_OCATIMfDESCRIPTPON - ALL LOCATIONS WITHIN THE UNITED STATES OF AMERICA OWNED BY WAL-MART STORES, INC., OR ANY OF ITS SUBSIDIARIES OR AFFILIATES, AND TO THE EXTENT REQUIRED BY SIGNED AGREEMENT, ANY PROPERTY FOR WHICH WALMART INC., OR ANY OF ITS SUBSIDIARIES OR AFFILIATES HAS AGREED IN WRITING TO FURNISH INSURANCE COVERAGE OF THE TYPE PROVIDED BY THE POLICIES OF INSURANCE REFERENCED HEREIN, SUBJECT TO ALL THE TERMS, CONDITIONS AND LIMITS SET FORTH IN SUCH POLICIES. -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 MEMORANDUM 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, COVERAGE INFORMATION PERILSINSURW: ALL RISKS COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: 1500,000,DOo YES NO N/A RENTAL INCOME X _ BLANKET COVERAGE - FULL REPLACEMENT VALUE X TERRORISM COVERAGE % Z00 ODO 000 -._ IS DOMESTIC TERRORISM EXCLUDED7 X - LIMITED FUNGUSCOVERA_ X - - _GE FUNGUS EXCLUSION X REPLACENIENT COST X -- AGREED VALUE X COINSURANCE X -- _ EQUIPMENT BREAKDOWN X LIMIT: INCLUDED ORDINANCE OR LAW -Coverage for loss to undamaged portion or budding X _ LIMIT: JINCLUDED -DemdiUon Costs X LIMIT: $50,0001000 -increased Cost of ConstrLxuon X LIMIT: $50,000,000 EARTH MOVEMENT X LIMIT: 5325.000,000 FLOOD X LIMIT:' IS0000000 WINO!'HAIL X LIMIT: SINCLUDED PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO Loss -- — - MUTUAL WAIVER. OF SUBROGATION ADDITIONAL INFORMATION Property: With respect to Property, any party with which the Named Insured has contractually agreed to include as Additional Insured, Mortgagee, and/or Loss Payee, such status is granted. Such status is subject to the limits, terms and conditions of the polity and shall apply only to the extent of and for no more than the limits required within such contractual agreement. The Memorandum of Insurance serves solely to list insurance policles, limits and dates of coverage. Any modifications hereto are not authorized. FORT WORTH. City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: Wal-Mart Stores Texas Subject of the Agreement: Tier II Easement Encroachment M&C Approved by the Council? * Yes ❑ No M If so, the M&C must be attached to the contract. Is this an Amendment to an Existing contract? Yes ❑ No 0 If so, provide the original contract number and the amendment number. Is the Contract "Permanent"? *Yes ❑ No 0 If unsure, see backpage for permanent contract listing. Is this entire contract Confidential? *Yes ❑ No 0 If only specific information is Confidential, please list what information is Confidential and the page it is located. Certificate of Insurance Effective Date: Date Director signs If different from the approval date. Expiration Date: 30 years from execution If applicable. Is a 1295 Form required? * Yes ❑ No ED *If so, please ensure it is attached to the approving M&C or attached to the contract. Project Number: If applicable. *Did you include a Text field on the contract to add the City Secretary Contract (CSC) number? Yes 0 No ❑ Contracts need to be routed for CSO processing in the followingorder: rder: 1. Katherine Cenicola (Approver) 2. Jannette S. Goodall (Signer) 3. Allison Tidwell (Form Filler) *Indicates the information is required and if the information is not provided, the contract will be returned to the department.