HomeMy WebLinkAbout065233 - General - Contract - Rejeania DickeyDate Received: 5/21/2026 Record Number: PN26-00054
Time Received:
4:55 p.m. City Secretary No.: 65233
PtiBLIC 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 Rejeania Dickey, a(n)
("Licensee").
RECITALS
WHEREAS, Licensee is the owner of the real property located at 7117 Tamarack
Road, Fort Worth, Texas 76116 ("Property"), being more particularly described as Lot
3, Block 1, Stoney Creek Addition, an addition to the City of Fort Worth, Tarrant County,
Texas, as recorded in the Official Public Records, by Instrument Number D219287675;
Tarrant County, Texas, anal
WHEREAS, the City owns a water line easement (the "Public Property")
adjacent to the Property, dedicated by plat, depicted on the final plat of the property (F-
78-68), which plat is recorded in the plat records of Tarrant County as Instrument
Number Volume 388-124, Page 26, Plat Records, Tarrant County, Texas, 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
Tier II Easement Encroachment Agreement Page i of 11
Revised 12/2022
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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 retaining wall (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.
U,
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.
Tier II Easement Encroachment Agreement
Page 2oflt
Revised 12/2022
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).
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 11
Revised 12/2022
0
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 Homeowner's property as located and described in
Exhibit "A." The amounts of such insurance shall be not less than
$688,000
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
liability insurance at all times during the term of this Agreement and until the removal of
the Encroachment and restoration of the Public Property. All insurance coverage
required herein shall include coverage of all Licensee's contractors and subcontractors.
Tier 11 Easement Encroachment Agreement
Page 4 of 11
Revised 12/2022
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.
17.
Tier II Easement Encroachment Agreement Page 5 of I I
Revised 12/2022
The parties agree that the duties and obligations contained in Section 5 shah
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.
21.
assigns. This Agreement shall be binding upon the parties hereto and their successors and
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 Page 6 of] I
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
�aGton tta��2GG
By: Dalton Harrell (May 20, 2026 13:30:08 CDT)
D. J. Harrell
Director, Development Services Department
Date: 05/20/2026
.'. FORT�IIII
aa,°
ATTEST: v~s 9�°a
rg °o w:
% ..da�� aIIIInn�ooSga
o
Jannette Goodall,
City Secretary
Approved As To Form and Legality
Tayler 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,
jKandk
Contract Compliance Manager
Tier 11 Easement Encroachment Agreement
Page 7 of I 1
Revised 12/2022
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Licensee:
Rajeania Dickey
By: 41
A�?6�
Nam .
Date: .5
STATE OF V _ §
COUNTY OF §
BEFORE ME, the undersigned authority, a Notary Public in and for the State
of �rr�� on this day personally appeared
known to me to be the person whose name is
subsc bed to the foregoin 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 a (entity
type), and in the capacity therein stated.
7;I UNDER MY HAND AND SEAL OF OFFICE this 1 1 -.. day of
, ?026.
E
MARSEY F1.ATr
Nomy Pubk Stm afThw
GavePAP=11WI 24n and for the WtwyW1302'
State
Tier 11 Easement Encroachment Agreement Page 8 of 1 1
Revised 12/2022
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 loth day of
May , 2026.
Notary Public in and for the State of Texas
KATN LEEKF"' RD
Notary Pu6lw
STATE OF TED(AS
Nabry I.D, 12197197
Comm. Ex ADr. 12, 299
Tier 11 Easement Encroachment Agreement
Page 9 of 1 1
Revised 12/2022
EXHIBIT A
Depiction and Description of the
Encroachment
Tier 11 Easement Encroachment Agreement Page 10 of I 1
Revised 12/2022
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JSB ENGINEER (F-20338)
19285 Horseshoe Dr., Nevada Texas 75173 (2141843-6223
email: isbenaineertyatmail com
General Structural Design
7117 Tamarack Rd.
Fort Worth, Texas 76116
May 5, 2026
Client:
Darren Elmore
Extreme Construction
(817) 966-6799
extremelandscapeconstructionna hotmail cone
J. S. Barton, P. E.
(214)843-6223
1L F•naineer (214) 843-6223
Re: 7117 Tamarack Rd. —Fort Worth, 'I'exas
It is proposed to construct a retaining wall to replace an existing timber retaining wall on
the subject property in the approximate Iocation shown. The new retaining wall will be
constructed of stone and a high strength mortar (type "S"). The wall height will be
variable from 1' to 9'. The length of the wall will be 261'. The new wall will be in the
same location, length and height as the existing walls.
The footing should be 8" thick and the width will be variable as a function of the height.
Use 2 #3 horizontal rebar in the footing as shown. The wall should be flush with the
front and rear of the footing. The face of the wall should have a 12:1 slope. The top of
the wall should be 12" wide.
Concrete should be a minimum of S sacks per cubic yard mix, 3000 psi v 28 days and
reinforcing steel 60 ksi.
Construct a drain pocket on the rear near the bottom of the wail as shown. The drain
pocket should be approximately 12" in diameter at each weep hole. The drain pocket
should be filled with a uniform sized rock wrapped with geotextile filter fabric. Use 2"
weep holes extending through the wall at maximum 10' centers.
The 2021 IRC was referenced for this design.
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1 Eneineer (214_) 843-6223
Re: 7117 Tamarack Rd. — Fort Worth, Texas
IW i'!`
iron Add
} Itrpca}
Lot 31. Block 21
Ridglee Country Club
Estates
V. 389-62, P, 24
P
� Mrater Main
w 1tN V
r
rS..Wfi.
razor w mew rd ve r
Ub 4 1 q Lot 3. Block i
Storrey Creek Addition
:''etas gaaa t ar:t cyi if eir; V. 386-124, P. 26
i �r �lsrttnr•�''c'Pa I- _l�l � ���j � '•..,_,,.
N"tairmigVt� L ! I
0.033 Acre
1452 Sq. Ft. y
ncroachment Area « . CIOs wide
i��r rd. i{t'kupr
CtA.S, wrnxxr
YQ Ia" Imn Arad 'c
Ub
( Lot 4, Bkrck t
TON
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May5,2026
-3-
JSB En_eineer (214) 843-6223
Re: 7117 Tamarack Rd. — Fort Worth, Texas
]8"—I-]2"—) Grad,
]21 Slope
Stone W all
a
0
Stone R
D
Max.9
t] ] 3 30
( 1
Scale � inches
00
weep Hole
V
Drain
Pocket
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May 5.MG
HHpht
Width
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2'
16"
3'
is,
4
30"
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9
30,
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JSB Eneineer, (214) 843-6223
Re: 7117 Tamarack Rd. — Fort Worth, Texas
AGREEMENTS:
This report is based on the visual information available and the items discussed in the
body of the report. The opinions expressed are based on professional judgement and are
consistent with standard engineering practices. Further investigation may be necessary if
any noticeable changes occur. If any additional information becomes available, these
opinions may need to be modified or supplemented.
This report also gives engineering advice with regard to the best and most economical
method to stabilize and maintain the property. This advice assumes normally expected
subsurface conditions and conventional construction methods. The contractor is
responsible for compliance with Federal, State and local codes.
No warranty is expressed or implied as to the performance of this retaining wall. JSB
Engineer report does not warrant or predict the future performance of the structure. The
limit of liability for this review is the fee paid for this report.
The information provided in this report is intended for the private use of the client. If you
have any questions or comments regarding this report or if further assistance is desired,
please call.
J. S. Barton, P. E
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-5-
Encroachment Description
Page 1 of 2
Project ID - 260280•RT
Field Date - April 13. 2026
*See Page 2 of 2 for Exhibit
BEING a 0.033 acre,1452 square foot tract of land: being a portion of Lot 3. Block I. Stoney Creek Addition, as recorded
in Volume 388.124, Page 26. Plat Records, Tarrant County. Texas (P.R.T.C.T.): being a portion of that certain tract
conveyed to Dickey in D219287675, Real Property Records. Tarrant County. Texas a portio . of and certain
further
described by metes and bounds as follows:
The following Bearings, Distances. and/or Areas derived From GNSS observations performed by Texas Surveying &
Engineering, Inc. and reflect N.A.D. 1983, Texas State Plane Coordinate System. North central Zone 4202 (Grid - US
Survey Feet).
BEGINNING at a found 578" capped Iron rod. at the northwest corner of said Lot 3. same being at the common corner of
Lots 31 and B. Block 21. Rldglea Country Club Estates, as recorded In Volume 388-62. Page 29, P.R.T.C.T. and Tract B-2,
Ridqlea Country Club Estates. as recorded In Volume 368-42, Page 31. P.R.T,C.T., for the westerly northwest and
beginning corner of this tract:
THENCE N 29"13'14" E. 9.66 feet. with the common fine of said Lots 3 and 31, to a point. for the northerly northwest
corner of this tract. WHENCE a found 112" iron rod, at the common northerly corner of said Lots 3 and 31. bears
N 291314" E. 66.97 feet:
THENCE 5 67-47.17" E. 21.92 feet, severing said Lot 3, to a point. for the northeast corner of this tract
THENCE S 01°5757" E. 51.26 feet, over and across said Lot 3. to a point, in the south Ilne of said Lot 3 and in the north
line of Lot 4. of said Block 1. Stoney Creek Addition, for the southeast corner of this tract. WHENCE a set 112" capped iron
rod with plastic cap stamped "TEXAS SURVEYING INC". at a common corner of said Lots 3 and 4 bears N 77°49'03" E.
121.30 feet:
THENCE S 77°49'03" W. 25.40 feet, to a set f/2" iron rod with plastic cap stamped "TEXAS SURVEYING INC". at the
common westerly corner of said Lots 3 and 4. and In the east line of said Tract B-2. for the southwest corner of this
tract:
THENCE N 01°57'57" W, 56.48 feet. with the common line of said Lot 3 and Tract B-2. to the POINT OF BEGINNING, and
containing 0.033 acres. more or less.
Encroachment Description Certified Correct:
fjj ; O :. cP
--
Zachar , avory, Registered Professlonal L ury c or No. 5966 P. SAY
Te Sury yang & Engineering, Inc. • Weat rfo Branch `....................... ,
S I . W ut St. •Weatherford, TX 7608 ' q 5966
eat ordatxsurveying.com - 817.594-0400 9 O,e 0?�'
?.�....Ess�,.:• y
SUR��
TEXAS
SURVEYING 8c
ENGINEERING
WEATNERFORO • MINERAL WELLS - ALERO INC.
5URYEYBIG FIRM No. 10100009 -ENGINEERING FIRM No. F475116
Page 2 of 2
Line 8eat17
Distance
L1 N 29 19.66'
L2 S 67`421.92'L3 S 7)°4925.40'
Encroachment Exhibit
Project ID • 260280•RI
Field Date - April 13.2026
*See Page 1 of 2 for Description
Lot 31, Block 21
Ridglea Country Club
Estates
V. 388.62. P. 29
Fd. sr8"
Capped
iron Rod
\ Nor°5425„
\
P.O.B.
Fa 314^ \
Iron Rod
v
\
♦� �
5a9°2403"W 100.00 00'
Sped
C-PPed
Lot B. Block 21
Iron Rod
Ridqlea Country Club
Z
o
Estates
o
V. 388.62, P. 29
4
0.033 Acre
1452 Sq. Ft.
Encroachment Area
Tract 8-2
Ridqlea Country Club
Estates
V. 388.42, P. 31
I
C.I.R.S. Whence
I'd. 112d Irod Rod
brs N 77°49'03" E 0.65'
Ftl. 112"
Iron Rod
Notes A
1) Bearings. Distances. and/or Areas derived from
ONSS observations and reflect N.A.D. 1983. Texas
State Plane Coordnate System, North Central Zone
420z (Grid - us Survey Feet)
2) AN corners are Points. unless otherwise rated
Stoney Creek Addition
V. 388.124. P. 26
r�
CJRS. Whence
I'd. 1/2" Iron Rod
brs N 51°5447" E 1.00'
Lot 4. Block 1
Stoney Creek Addition
V. 388-124, P. 26
TEXAS
SURVEYING&
ENGINEERING
WEATHERFORD • MINERAL WELLS • ALEOO INC.
SURVEYING FIRM Na. 10300000 • ENGINEEGING FIRM NO, F-17586
'givz C�'
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EXHIBIT B
Certificate of Insurance
Tier lI Easement Encroachment Agreement Page 11 of 1 l
Revised 12/2022
United Services Automobile Association
USAA®
CHANGES TO USAA
HOMEOWNERS INSURANCE
POLICY SUMMARY
We're writing to provide the following summary of the updated homeowners policy information:
Effective Date of Change:
December 13, 202512:01 a.m. standard time
Policy Expiration Date:
December 13, 202612:01 a.m. standard time
Policy Location:
7117 TAMARACK RD,
Policy Number:
FORT WORTH, TX 76116
Named Insured:
USAA 008715107 91A
RAJEANIA A DICKEY
Additional Insured:
CITY OF FORT WORTH CONTRACT
Additional Insured Type:
CITY/MUNICIPALITY
Description of Coverages
Dwelling Coverage:
$688,000
Home Protector:
Included
Other Structures:
$68,800
Personal Belongings:
$344,000
Personal Liability:
$500,000
Medical Payments:
$5,000
Deductibles)
All Other Perils:
$2,000
Wind and Hail:
1.00% ($6,880)
Revised Annual Premium:
$8,103.51
Mortgagee Clause:
WELLS FARGO BANK, N.A. #936
ITS SUCCESSORS AND/OR ASSIGNS
PO BOX 1005i5
Loan Number:
FLORENCE, SC 29502-0515
0600612394
Your Home Protector coverage, if included, provides an additional 25% of dwelling coverage. Policy terms, conditions and
exclusions apply.
Notification to Additional Interest Upon Cancellation
If this policy is canceled or not renewed, the mortgagee or lender will be properly notified at least 10 days before the date
cancellation or nonrenewal takes effect.
Manage Your Account Online
You can log on to usaa.com any time to view or change your policy.
1. Scroll down to the "Insurance" tab.
2. Select the "I want to" dropdown.
3. Select "Review Home Characteristics" to view or update.
How to Contact Us
If you have questions about the new policy, please call us at one of the following numbers:
, Phone: 210-531-USAA (8722), our mobile shortcut #8722 or 800-531-8722
504479-0824
Page 1 of 2
Thank you,
United Services Automobile Association
504479-0824
Page 2 of 2
FORT WORTH.
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: Rejeania Dickey
Subject of the Agreement: Retaining wall encroaching the City's water line
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.
Effective Date: Date of Director's signing
If different from the approval date.
Expiration Date: 30 yrs fr Director's signing
If applicable.
Is a 1295 Form required? * Yes ❑ No 21
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If applicable. PN26-00054
*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 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.