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HomeMy WebLinkAbout065110 - General - Contract - Wal-Mart Real Estate Business TrustDate Received: 4/27/2026 Time Received: 4:28 p.m. Record Number: PN25-00209 City Secretan, No.: 65110 PUBLIC PROPERTY EASEMENT ENCROACHMENT LICENSE AGREEMENT TIER !! 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 Wal-Mart Real Estate Business Trust, a Delaware business trust ("Licensee"). acting by and through its duly authorized represenative.. RECITALS WHEREAS, Licensee is the owner of the real property located at 3851 Airport Freeway, Fort Worth.. Texas 76111 ("Property"). being more particularly described as, Lot 1. Block 1. of an addition to the City of Fort Worth, Tarrant County, Texas, as recorded in Dced Records, by Instrument dumber D205180849: and WHEREAS, the City owns a 30 foot drainage easement (the "Public Property") adjacent to the Property, dedicated by plat. depicted on the final plat of the property (FS- 03-105).. which plat is recorded in the plat records of Tarrant County as Instrument D204107598: 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 follmNs: OFFICIAL RECORD AGREEMENT CITY SECRETARY FT. WORTH, TX t. 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 sewer line (the "Encroachment"). Upon completion of the Encroachment, Licensee agrees to be responsible for maintaining the Tier 11 Easement Encroachment agreement Pave I of 12 Standard 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 alter the execution of this Agreement. Rj 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. 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 Tier 11 l asenicnt Encroachment rlgreemcm Page 2 of 12 Standard 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 iirocurred 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). op The term of this Agreement shall be for thirty (30) years. commencing on the date this Agreement is executed by City. Ilmceer. 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 ",[thin thirty (30) days of notice from City. the City may terminate this Agreement. However,. the Cit} 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. is LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS, AND DEFEND CITY, ITS Tier 11 Easement Encroachment Agreement Page i of 12 Standard 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 $1,000,000 with the understanding and agreement that the City may require 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 Licensee's self -insured status is attached as Exhibit "C" 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 of this Agreement and until the Encroachment is removed and the Public Property is restored. 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 Tier II Easement Encroachment Agreement Page 4 of 12 Standard 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 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. 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 Easement Encroachment Agreement Page 5 of 12 Standard 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 or 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 dace 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. 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 original, but all of which shall constitute one instrument. Tier 11 Easement Encroachment Agreement Pa-c G of 12 Standard [SIGNATURES APPEAR ON FOLLOWING PAGE[ "Fier 11 Easement Encroachment Agreement Page 7 of 12 Standard EXECUTED to be el'iective on the date signed by the City's Director of Development Services Department city CITY OF FORT WORTH By: Dalton Harrell (Apr 27, 2026 15:20:06 EDT) 1 1)..1.I1arreII Director. Development Services Department 04/27/2026 Date: P`�`°"'�°° Approved As To form and Legality ATTEST- p a �,9do ��' eta .ao owe o=tla ��pp oodro a*p A .hL���xt QaQy aEXpS.00 Jannette Goodall. Tayler Canton City Secretary Assistant City Attorney Contract Compliance Manager: lay signino I acknowledge that I am the person responsible for the monitorin�(y and administration of this contract, including ensuring all performance and reporting requirements. jz�� Kandice Merrick Contract Compliance Manayder OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Tier 11 Easement Encroachment Agreement Page 8 of 12 Standard Licensee: WAL-MART REAL ESTATE BUSINESS TRUST a Delaware business , trust By: — Ti�,,`',' a Name: Drew Marshall Title: Director Date: 9 N I1l0 STATE OF }'{ § COUNTY OF § BEFORE ME, the undersigned authority, a Notary Public in and for the State of on this day personally appeared Drew Marshall, Senior Manager, known to me to be the person whose name is subscribed to the foregoing instrument, and acltttowledged to me that lie or she executed the same for the purposes and consideration therein expressed, as the act and deed of Wal-Mart Real Estate Business Trust, a Delaware business trust, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this '` day of , 2026. otary Public in and f`or the State of N17YLVWS- -Fier 11 Easement Encroachment Agreement Standard JOSEPH A PRITCHARD NOTARY PUBLIC BENTON COUNTY, ARKANSAS COMM. EXP. 07101f33 COMMISSION NO. 12724265 Page 9 of 12 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 the that he executed the same for the purposes and consideration therein expressed, as the act "Intl deed of the City of Fort Worth. and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL, OF OFFICE this 24TH day 01 April .20 Notary Public in and for the State of Texas Tier 11 Easement Encroachment Agreement Standard Au4ray Lee Wallace illacel my COMM18100" Expir-08 91/012028 _ Notary ID135062586 Page 10 of 1 EXHIBIT A Depiction and description of the Encroachment Tier 11 Easement Encroachment Agreement Page i I of 12 Standard it ANrA 0�4 L - �, -. e - -7. — A _4 HARPER Sr 6- I 4 7�771 TRACT 1 EASEMENT ENCROACHMENT DESCRIPTION - 0.0002 OF AN ACRE BEING a tract of land situated in the A. Mclemore Survey, Abstract No. 1056, City of Fort Worth, Tarrant County, Texas and being a part of Lot 1, Block 1 of Riverside Wal-Mart Addition, recorded in Cabinet A, Slide 9119, Plat Records, Tarrant County, Texas, (P.R.T.C.T.), being over and common to a drainage easement of said Riverside Wal-Mart Addition and being the same tract of land conveyed to Wal-Mart Real Estate Business Trust recorded in Document No. ❑205180849, Official Public Records, Tarrant County, Texas, (O.P.R.T.C.T.) and being more particularly describes as follows: BEGINNING at a point for corner in said Lot 1, from which a 5/8-inch iron rod found capped stamped "Dunaway" for an angle point of said Lot 1 and in the northwest right-of-way line of State Highway No. 121, a variable width public right-of-way, bears South 06014'39" East, 309.21 feet, also from which a broken TxDOT Monument for an angle point of said Lot 1 and in the northwest right-of-way of said State Highway No. 121, bears South 32°56'08" East, 319.55 feet; THENCE over said Lot 1 the following courses: THENCE South 89040'59" West, a distance of 36.62 feet to a point for corner; THENCE North 35'19'08" West, a distance of 0.30 feet to a point for corner; THENCE North 89°40'59" East, a distance of 36.62 feet to a point for corner; THENCE South 35019'08''' East, a distance of 0,30 feet to the POINT OF BEGINNING and containing 9 square feet or 0.0002 acres of land, more or less. 11 /1812025 MICHAEL J. SWAYNE -. .............................•... REGISTERED PROFEVMONAL MICHAEL J. SWAYNE Ik LAND SURVEYOR NO, 7143 7143 .,,. 400 OKLAHOMA DR.., SUITE 105 CELINA, TEXAS 75009 �'•-0�0 �Q `� �` ,`'•:..... ,U PH. 469-501-2200 i michael.swayne@kimley-horn.com rye TRACT 1 EASEMENT ENCROACHMENT EXHIBIT WAL-MART #5312 PORTION OF LOT 1, BLOCK 1 RIVERSIDE WAL-MART ADDITION OUT OF THE A. MCLEMORE SURVEY ABSTRACT NO. 1056 CITY OF FORT WORTH TARRANT COUNTY, TEXAS MA FORT WORTH, T% (EXP)0VVG5065563046.VVN1 5312 FORT OMQ AN3VgH3b'O83N3 ANUOSb9-HIHOM Aa03 ZM WM-99'4f9S5901DMCh{dX3) Xi'HiMOM A2f03 ZL£S VW-9VO£9SSMA3Adns-T3m N Y!d CO ZL SZOZI96ILL M914iJ. LY'3NkVMS y<x Q d W Z 0 w o'i W E/] o a0 0- U ¢ a) a'tr °� 1- z a�= � aa)aQ 2 TC14- CJp W (N w IL r3 t"" J > � fL' in -j CO LL Z IX a 6 c Off # CC 2 CIS 0 b m00r u c Ou un`Z �1� X 4 Q Q C[ 0z11wU0�— mri� W a W CC o CL LL a v� TocydL) o Q O li Co W rr 0 U) C7 to m m `k Qd V. Q r m J 1 YF-G+ w e F m� 0 C3 aaa~r-Qc�o� ;F J 0 Lij jq�' � CY W _L w o o L+ o f qf© d +rdQ� Li Wcid 0 m < 7 ir3 � in \ 0 0 Lu ai ,D_lu U ¢ W z z 0 1 Z 0 �.•' I ................... . .. VXI LZ !{ 4 /.......... I �C Z f f j# I I a Z) M / J W Q I � �III�I© I CD r1k tlr,T { I I z cs n I �Z m p I m n to t7 *mma p �� D m Cm z o 0 m z 3.86' s e m °z N Z n cnJ l � pr CA1 r 00 0mF�!: Q n y Z Immmy Om2 O j m m m ;o i A m m-- - L �Ln Q 10, IC I > "? 7 oc n 0 In �y zom x i u r C :a1 Z 1L1 Ltt�1 o�- I � f - � - -- Q X 1 � - m/ r 2 m 2 % z m % (Cm -141 ! r� X En z dD —A � � C m m Q En om G� > � Z n IS � { r ® CA rn zn zr" r D-0 rTs -v m EDQ m rn a -4 X Fn > 0In 7] m x~ x � w WALMART#D5312 ENCROACHMENT WALMART REAL Kim ESTATE BUSINESS 4l> Horn KIMLEV-HORN AND ASSOC IATES INC N N FORT WORTH, TX EXHIBIT A 10101 RrUNIONPLACE. suirE 4w SANANTONIO, TXT9216 a TRUST POONE 210-5419166FAX 216541.6699 II VAVW KIYLEY-H0RN COIN T&PE FIRM NO 929 � o ❑y EXHIBIT B Certificate of Insurance Fier II I:asenicnt hicroadmicnt Agreement Page 12 of 12 5tandill-d Walmart ** 1, Global Risk f f Management Effective Date: Continuous throughout the term of the below referenced agreement. RE: Request for proof of insurance / self-insurance pert he terms of a signed agreement To Whom It May Concern, W a I mart takes its obligations to its associates, customers, business partners, I and lords, and others very seriously. In order to best fulfill its responsibilities to its customers, associates, and shareholders, Walmart utilizes a comb ination of insurance, self -insured retentions, and self -insuran cefor a number of risks. With respect to claims arisingoutof third party liabiIitiesforaII forms of legal liability forbodilyinjuryand property damage, Walmart Inc., its affiliates and its subsidiaries (collectively "Walmart"), elects to self -insure the insurance requirements of its agreements where all owed byIawand by the terms of the agreement. With respect to claims arising from physical loss ordamageto structures, equipment and/orother tangible property for which Walmart assumes the responsibiIityfor the risk of loss, Walmartis self -funded. The existen ceofan insurance policy does not supersede WaImart's right to self -insure. Please allow this letter to serve as evidence of Walmart's election to self -insure. Walmart is prepared to meet its legal I iabilities in connection with its agreements. For evidence of the requisite net worth of Walmart, please visit htto://stock.waImart.com to view the current annual and quarterly reports. Si ncerely, WalmartGIobal Risk Management MEMORANDUM OF LIABILITY INSURANCE Current as of September 15, 2024 PRODUCER THIS MEMORANDUM I5 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 1OD36 OR ALTER THE COVERAGE DESCRIBED BELOW,, THIS MEMORANDUM MAY ONLY BE COPIED, PRINTED AND DISTRIBUTED WITHIN AN AUTHORIZED VI€WER 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 PRIOR WRITTEN CONSENT 15 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 THIS INFORMATION. INSURED COMPANIES AFFORDING COVERAGE NAIC ft Walmart Inc. Its Subsidiaries and Its Affiliates 702 Southwest M Street COMPANY A NATIONAL UNION FIRE INS, CO. OF PfTTSBURGH, PA - 19445 COMPANY B -- AJU INSURANCE COMPANY 19399 COMPANY C INDEMNITY INSURANCE COMPANY OF NORTH AMERICA 43575 Bentonville, AR 72716 COMPANY D 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 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, EYCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COMPANY LETTER TYPE OF INSURANCE POLICY NUMaER POLICY EFFECTIVE POLICY LIMITS _ DATE EXPIRATION LIMITS IN USD UNLESS OTHERWISE INDICATED DATE A GE E LLIABILITY _ 3609379 9,115,Q023 9115/2D25 H RREN E 10 ON "Ims it. MADE PERSONAL 8 ADV INJURY $1,OOO,OOO X COMMERCIAL GENERAL FIRE QAMAGE rAnyFire) )( GEN'L AGOG LIMIT APPLIES MED EXP fAny One P PER POLICE' PRODUCTS- COMP/OP AGGREGATE $3,000,GM GENERAL AGGRECjATE $3,000,000_ A B AUTOMOBILE LIABILITY 31357GS (ADS) 9/15/2024 9/15/2025 COMBINED SINGLE LIMIT $1,000,000 ANY AUTO 3135703 (MA) BODILY INJURY (Per Person) $ ALL OWNED AUTOS SCHEDULED AUTOS — BODILY INJURY (Per Accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE D EXC 5 1.1881LITY_ XEUG27892D36010 9il512024 9115N2025 _ _ % I UMBRELLA FORM AGGREGATE 55,000.00O OTHER. THAN UMBRELLA A B C WORKERS 'SEE BELOW 9115l2024 9115r2C25 WORKERS N MY N E EACH ACQQEta_ COMPENSATION/ EL DISEASE - POLICY QMrT EMPLOYERS LIABILITY EL DISEASE . EACH EMPLOYEE $1,000,000 ADDITIONAL INFORMATION GENERAL1ABILTYY: Cmerage+ncludes Professional Lrabi,tY including DrMist'S and OptlCians GENERAL LIABILITY POLICY 31509379 15 SUBJECT TO A SELF INSURED RETENTION OF USD $2,000,000 EACH OCCURRENCE vr,th respect to Commercial General Liab o, Policy 3609379 any Party with which the Named Insured has Contractually agreed to include as Additional Insured, such status is granted. Such Additional N SUred StatWS IS subject to"hrrks, trnns and conditions of the policy and Shall apply Only to the Extent Of and for no more Ulan The limits requited Within such contractual agrCCRient. EXCESS LIAR I LM!; ExCESS LIABILITY POLICY XEUG27892036 CIO 15 SUBJECT TO A SELF INSURED RETENTION OF USD $50,000,000 EACH OCCURRENCE WORKERS" COMPENSATION POLICIES: COMPANY A: CKCESS WORXERS COMPENSATION: 6583214 (FL) 6583215 (ALAZ,ME,NY,OH,OK,OR,WA) 6583216 (AR,GA;LA) COMPANY 6: 014111789(CO,CT,DC,L4,IN,KS,MI,NE,RI,$C,50,WV) 014111790(DE,HI,ID,MD,MN,MO,MS,MT,NM,NV,TN) 01411088 (AK^ND,N),PA,VA) 014111791 (WI) 014111787 (IL,KY,NC NH,UT,VT) COMPANY C: kVLR C7242a1NL1 (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, 2024 THIS MEMORANDUM 15 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 INSURERS OR WALMART, PRODUCER NAME, CONTACT PERSON AND ADDRESS - DIRECT COMPANY NAME AND ADDRESS NAJC No; D _ BROADSTREET INSURANCE COMPANY AND VARIOUS OTHER INSURERS EMAIL certregiiest@wal-mart.com NAMED INSURED AND ADDRE% _ Walmart Inc. Its Subsidaries and Its Affiliates 702 Southwest 8th Street Bentonville, AR 72716 - — POLICY NUMBER VARIOUS EFFECTIVE DATE 04/01/2025 DPIRAT10N DATE 04/01/2026 PROPERTY INFORMATION LOCATION/DESCUPrnON 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, SUBIECL 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 INFORMAnPERILS INSURED: ALL RisKS COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: f500,000,000 Y£S NO N/A RENTAL INCOME X N A.NKEi COVERAGE - FULL REPLACEMENT VALUE X TERRORISM COVERAGE X $200,000,000 IS DOMESTIC TERRORISM EXCLUDED? X _ LIMITED FUNGUS COVERAGE X FUNGUS EXCLUSION X REPLACEMENT COST X - - - - AGREED VALUE - X COINSURANCE X EQUIPMENT BREAKDCYWN - X LIMIT: INCLUDED ORDINANCE OR LAW -coverage for loss to undamaged portion of budding X _ LIMIT: $ INCLUDED -Drindition Costs X _ _ LIMIT: 50 D00 D -Increased Cost OfConstnicuon X LIMIT: $5G.000,01M EARTH MOVEMENT X LIMIT: 325 D00 600 FLOOD X LIMIT: 150 D 6vIND1HAIL X LIMIT: NCLUDED PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS _ MUTUAL WAIVER OF SUBROGATION ADDITIONAL INFORMATION Prope ft.: With respect to Property, any party with which the Named Insured has contractually agreed to irtclude as Additional Insured, Mortgagee, and/or Loss Payee, such status Is granted. Such status is subject to the limits, terms and conditions of the policy 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 policies, lim is and dates of coverage. Any modifications hereto are notauthorized. FORT WORTH. City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: Wal-Mart Real Estate Business Trust 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.