HomeMy WebLinkAbout065780 - General - Contract - All Saints Episcopal School of Fort WorthDate Received: 09/03/2026 Record Number: PN26-00106
Time Received:
9:32 a.m.
City Secretary No.: 65780
PUBLIC PROPERTY EASEMENT ENCROACHMENT LICENSE AGREEMENT
TIER II
THIS AGREEMENT is made and entered into by and between THE CITY OF
FORT WORTH, a home rule municipal corporation of Tarrant County, Texas ("City"),
acting by and through its duly authorized City Manager, Assistant City Manager, or
Director of the Development Services Department, and ALL SAINTS EPISCOPAL
SCHOOL OF FORT WORTH, a Texas nonprofit organization ("Licensee"), acting by
and through its duly authorized representative.
RECITALS
WHEREAS, Licensee is the owner of the real property located at 9700 Saints
Circle, Fort Worth, Texas 76108 ("Property"), being more particularly described as,
being a tract or parcel of land situated in the Hays Covington Survey, Abstract No. 256,
Tarrant County, Texas, as recorded in the Official Public Records, by Instrument Number
D196218941; and
WHEREAS, the City owns a public storm easement (the "Public Property")
adjacent to the Property, dedicated by plat, depicted on the final plat of the property (FS -
04 -169), which plat is recorded in the plat records of Tarrant County as Instrument
D204222703; 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:
OFFICIAL RECORD
AGREEMENT CITY SECRETARY
1. FT. WORTH, TX
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,
Revised July 2026 Page! of 11
Revised 12/2022
installing, and maintaining private electrical conduit (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 the reasonable
costs actually incurred by the City as a direct result of the encroachment, as determined
by the City based on its records and supporting documentation. Upon request, the City
shall provide reasonable documentation supporting such costs.
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.
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
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the Water Department, the Director of the Development Services Department or their
duly authorized representative. Any such removal of the Encroachment shall be in
accordance with then -existing City regulations and policies. It is understood and agreed
to by Licensee that if this Agreement terminates and Licensee fails to remove the
Encroachment and restore the Public Property, Licensee hereby gives City permission to
remove the Encroachment and any supporting structures from the Public Property, to
restore the Public Property, and to assess a lien on the Property for the costs expended by
the City in taking such actions.
6.
In order to defray all costs of inspection and supervision which the City has
incurred or will incur as a result of the construction, maintenance, inspection or
management of the Encroachment and use of Public Property as provided for by this
Agreement, Licensee agrees to pay to City at the time this Agreement is requested an
application fee in the sum of One Thousand Twelve Dollars and Fifty Cents
($1012.50).
7.
The term of this Agreement shall be for thirty (30) years, commencing on the
date this Agreement is executed by City. However, the City may terminate this
Agreement upon Licensee's noncompliance with any of the terms of this Agreement.
City shall notify Licensee in writing of any such noncompliance and if Licensee does not
cure the noncompliance within thirty (30) days of notice from City, the City may
terminate this Agreement. However, the City may, at its sole option, allow the Agreement
to remain in effect so long as Licensee has taken reasonable measures to cure the
noncompliance or is continuing to diligently attempt to remedy the noncompliance.
8.
It is further understood and agreed between the parties hereto that the Public
Property to be used and encroached upon is held by City as trustee for the public; that
City exercises such powers over the Public Property as have been delegated to it by the
Constitution of the State of Texas or by the Texas Legislature; and that City cannot
contract away its duty and its legislative power to control the Public Property for the use
and benefit of the public. It is accordingly agreed that if the governing body of City may
at any time during the term hereof determine in its sole discretion to use or cause or
permit the Public Property to be used for any other public purpose, including but not
being limited to underground, surface, or overhead communication, drainage, sanitary
sewerage, transmission of natural gas or electricity, or any other public purpose, whether
presently contemplated or not, that the parties agree to negotiate in good faith in order to
accommodate both the Encroachment and the public purpose.
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Revised 12/2022
9.
LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES
HEREBY INDEMNIFY, HOLD HARMLESS, AND DEFEND CITY, ITS
OFFICERS, AGENTS, SERVANTS, EMPLOYEES, AND ELECTED OFFICIALS
FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY
DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEATH, TO
ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER,
WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION
WITH, DIRECTLY OR INDIRECTLY, THE CONSTRUCTION,
MAINTENANCE, OCCUPANCY, USE, EXISTENCE, OR LOCATION OF THE
ENCROACHMENT AND USES GRANTED HEREUNDER, TO THE EXTENT
SUCH CLAIMS ARE SUITS ARE CAUSED BU THE NEGLIGENCE OR
WILLFUL MISCONDUCT OF LICENSEE, ITS OFFICERS, AGENTS,
SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS,
LICENSEES, OR INVITEES, LICENSEE SHALL LIKEWISE ASSUME ALL
LIABILITY AND RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR
ANY AND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT
OF OR IN CONNECTION WITH THE ENCROACHMENTS AND ANY AND
ALL ACTS OR OMISSIONS OF LICENSEE, ITS OFFICERS, AGENTS,
SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS,
LICENSEES, OR INVITEES.
10.
While this Agreement is in effect, Licensee agrees to furnish City with a
Certificate of Insurance naming City as certificate holder as proof that is has secured and
paid for a policy of public liability insurance covering all public risks related to the
proposed use and occupancy of public property as located and described in Exhibit "A."
The amounts of such insurance shall be not less than
$1,000,000
with the understanding and agreement by Licensee that such insurance amounts may be
revised upward at City's option and that Licensee shall so revise such amounts
immediately following notice to Licensee of such requirement. Such insurance policy
shall not be canceled or amended without at least thirty (30) days prior written notice to
the Building Official of the City. A copy of such Certificate of Insurance is attached as
Exhibit "B" and incorporated herein for all purposes. Licensee agrees, binds, and
obligates itself and its successors and assigns to maintain and keep in force such public
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.
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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.
If the City prevails 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.
Revised July 2026 Page 5 of I 1
Revised 12/2022
17.
The parties agree that the duties and obligations contained in Section 5 shall
survive the termination of this Agreement.
18.
Licensee covenants and agrees that it will not assign all or any of its rights,
privileges, or duties under this Agreement without the written approval of the City, and
any attempted assignment without such written approval shall be void. In the event
Licensee conveys the Property, Licensee may assign all of its rights and obligations under
this Agreement to the new owner of the Property, and Licensee shall be deemed released
from its duties and obligations hereunder upon City's approval in writing of such
assignment, which approval shall not be unreasonably conditioned or withheld.
Foreclosure by a secured lender of Licensee or assignment to a secured lender by
Licensee in the event of default or otherwise shall not require City approval provided that
said lender notifies City in writing within sixty (60) days of such foreclosure or
assignment and assumes all of Licensee's rights and obligations hereunder. However, no
change of ownership due to foreclosure or assignment to any secured lender of Licensee
shall be effective as to City unless and until written notice of such foreclosure or
assignment is provided to City.
19.
Prior to the end of the term of this Agreement, Licensee may submit a new
encroachment application to the City. The City will not unreasonably withhold or delay
approval of such application provided that the Encroachment follows the then current
City codes and compliance.
20.
Any cause of action for breach of this Agreement shall be brought in Tarrant
County, Texas, This Agreement shall be governed by the laws of the State of Texas.
21.
This Agreement shall be binding upon the parties hereto and their successors and
assigns.
This Agreement may be executed in multiple counterparts, each of which shall be
considered an original, but all of which shall constitute one instrument.
Revised July 2026 Page 6 of 11
Revised 12/2022
EXECUTED to be effective on the date signed by the City's Director of
Development Services Department
City:
CITY OF FORT WORTH
ZaGton 1-faneU
By: Dalton Harrell (Aug 31, 2026 10:42:39 CDT)
D. J. Harrell
Director, Development Services Department
Date: 08/31/2026
Q 000nn
g o! ART na
ATTEST:
moo =�
0°Q*
Jannette Goodall,
City Secretary
Approved As To Form and Legality
iif2.Ca rl
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.
Kandice Merrick
Contract Compliance Manager
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Revised July 2026 Page 7 of 11
Revised 12/2022
Licensee:
ALL SAINTS EPISCOPAL SCHOOL OF FORT WORTH
a Texas nonprofit corporation
By:
Name: Rachel Pearcy
Title: Chief Financial Officer
Date:
STATE OF ^T k,, §
COUNTY OF _ §
�-t BEFORE ME, the undersigned authority, a Notary Public in and for the State of
1C Gt S , on this day personally appeared
Lt( Title) 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
X11 �G���5� a huh— (�c
(entity type), and in the capacity
therein stated,
GIVEN UNDER MY HAND AND SEAL OF OFFICE this 1�-- _ day of
s , 2026.
V t�,.r rya MICHELLE C SHEPHERD
k'L& 1
Notary ID #6069096
Notary Public in and for the a My Commission Expires
'torte August 17, 2029
State of____________________
Revised July 2026 Page 8 of 11
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.
GNEN UNDER MY HAND AND SEAL OF OFFICE this 31st day of
August , 2026.
Notary Public in and for the State of Texas ,. 1 ATHLEEH BRADFORD
Notary Public
. STATE2
5 Notary ID, 12197195719 7
cP My Comm. ESF, Apr. 12, 2027
Revised July 2026 Page 9 of 11
Revised 12/2022
EXHIBIT A
Depiction and description of the Encroachment
Revised July 2026 Page 10 of 11
Revised 12/2022
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550 Bailey Avenue • Suite 400 • Fad Worth, Texas 76107
Tel: 817.335.1121
(TX REG. F-1114)
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EXHIBIT A -1a
STORM EASEMENT ENCROACHMENT
ALL SAINTS EPISCOPAL SCHOOL
FORT WORTH, TX
BEING a 0.0005 acre, 20 square feet tract of land situated in the Hays Covington Survey, Abstract Number 256, Tarrant
County, Texas, City of Fort Worth, being a portion of the tract of land described in the Special Warranty Deed with Vendor's
Lien to All Saints Episcopal School of Fort Worth recorded in Volume 12569, Page 23, Deed Records of Tarrant County, Texas,
a portion of Lot 1R, Block 1R, All Saints Episcopal School Addition, Document Number 204222703, Official Public Records of
Tarrant County, Texas, said 0.0005 acre tract of land being more particularly described as follows:
COMMENCING at a 5/8 inch iron rod found in the easterly right-of-way line of Longvue Avenue, a (120 foot wide right-of-way)
for the southwest corner of said Lot 1R and the beginning of a non -tangent curve to the right having a radius of 2,804.79 feet;
THENCE with the easterly right-of-way line of Longvue Avenue the following:
Northeasterly along said curve to the right through a central angle of 030 49' 38" an arc distance of 187.35 feet with a
chord bearing of North 020 25' 05" East and a chord distance of 187.32 feet to the end of said curve;
North 04° 20' 47" East a distance of 173.38 feet to a point;
THENCE departing the easterly right-of-way line of Longvue Avenue East a distance of 748.57 feet to a 5/8 inch iron rod with a
yellow cap stamped "Dunaway Assoc" set on the westerly line of a Public Drainage Easement dedicated in said Lot 1R, Block
1R, All Saints Episcopal School Addition for the POINT OF BEGINNING;
THENCE with the westerly line of said Public Drainage Easement North 449 53' 27" West a distance of 1.01 feet to a point;
THENCE departing the westerly line of said Public Drainage Easement North 389 03' 02" East a distance of 20.15 feet to a
point in the easterly line of said Public Drainage Easement;
THENCE with the easterly line of said Public Drainage Easement South 440 53' 27" East a distance of 1.01 feet to a 5/8 inch
iron rod with a yellow cap stamped "Dunaway Assoc" set for corner;
THENCE departing the easterly line of said Public Drainage Easement South 380 03' 02" West a distance of 20.15 feet to the
POINT OF BEGINNING;
CONTAINING a computed area of 0.0005 acres (20 square feet) of land.
8008722.001
A drawing of even date accompanies
this metes and bounds description.
JUNE 11, 2026
550 Bailey Avenue • Suite 400 • Fort Worth, Texas 76107
Tel: 817.335.1121
TEXAS REGISTERED SURVEYING FIRM NO, 10098100
GREGORY S. IFFLAND
®®O4351®
90 ®® ®®®o®�yo
06-15-2026
PAGE 1 OF 3
EXHIBIT
BEING 0.0005 ACRES OR
20 SQUARE FEET
OF
LOT 1R, BLOCK 1R
ALL SAINTS EPISCOPAL SCHOOL ADDITION
DOCUMENT NUMBER 204222703
SITUATED IN THE
HAYS COVINGTON SURVEY
ABSTRACT NO. 256
CITY OF FORT WORTH, TARRANT COUNTY, TEXAS
EXHIBIT 'A'
0 200'
SCALE FE
FEET
2
LU
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LULW
0¢
Q�oF=
LU
moo:
V a
W =
D
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N
FOUND 3/4' ( I
IRON ROD
(CONTROL
III
\ \
ALL SAINTS EPISCOPAL
MONUMENT) I
I
\ SCHOOL OF FORT WORTH I I
VOLUME 12569, PAGE 23
D.R.T.C.T.
A=4'13'32"
LOT 1R, BLOCK 1R
R=3879.72' L=286.13'
I I ALL SAINTS EPISCOPAL SCHOOL ADDITION
CH=N2' 14' 25"E 286.06'
DOCUMENT NUMBER 204222703
\\
j� \ O. P. R.T. C. T.
''
N04'20'47"E\ )
PUBLIC
2DRAINAGE
11
\ 0.0005 ACRES
238.70
EASEMENT
N3803'02"E 20 SQUARE FEET
\ �/
20' PUBLIC WATER
N
CAB NETA, PAGE 4305
P.R.T.C.T. \O.P.R.T.C.T.
DOCUMENT
NUMBERS44'53
204222703
20.15' , "
27 E
N44.5327W \ 1 01' / /
1.01, \
S38'03'02"W /
_N04'20'47"E
173.38'
A=3'49'38"
R=2804.79' L=187.35'
CH=N225' 05"E 187.32'
POINT OF
COMMENCING
5/8 IRON ROD FOUND
(CONTROL MONUMENT)
AST 748.57' /
POINT OF
BEGINNING - -�
SEE INSET A
PAGE 3
SAINTS CIRCLE \ ,
EMERGENCY ACCESS I
EASEMENT PUBLIC DRAINAGE
' - - -
DOCUMENT NUMBER I EASEMENT
204222703 CABINET A, SLIDE
o.P.R.T.C.T. I 4305
P.R.T,C.T.
BLOCK 1
LINDA VISTA ESTATES
VOLUME 388 C, PAGE 70
1
2
3
I 4
5
6
7 I
8
9
10 P.R.T.C.T.
16
17
®
111-I 12 13 14 115
= 5/8" IRON ROD WITH YELLOW CAP STAMPED "DUNAWAY ASSOC."
D.R.T.C.T. = DEED RECORDS, TARRANT COUNTY, TEXAS, P.R.T.C.T. =
O.P.R.T.C.T. = OFFICIAL PUBLIC RECORDS, TARRANT COUNTY, TEXAS
NOTES: The basis of bearings for this Easement is the State Plane
Zone 4202, North American Datum Of 1983.
B008722.001
A metes and bounds description of even
date accompanies this drawing .
JUNE 11, 2026
DUNAWA
550 Ba1ey Avenue • Suite 400 • Fort Worth, Texas 76107
Tel: 817.335.1121
TEXAS REGISTERED SURVEYING FIRM NO. 10098100
SET UNLESS OTHERWISE NOTED
PLAT RECORDS, TARRANT COUNTY, TEXAS
Coordinate System, Texas North Central
��® �STeRFI
GREGORY S. IFFLAND
<®®9p 4351
9'1'po®® yam
SU9
06-15-2026
PAGE 2 OF 3
EXHIBIT
BEING 0.0005 ACRES oR
20 SQUARE FEET
OF
LOT 1R, BLOCK 1R
ALL SAINTS EPISCOPAL SCHOOL ADDITION
DOCUMENT NUMBER 204222703
SITUATED IN THE
HAYS COVINGTON SURVEY
ABSTRACT NO. 256
CITY OF FORT WORTH, TARRANT COUNTY, TEXAS
EXHIBIT 'A'
INSET A
0 10'
SCALE FEET
1 "= 10'
\ \
\ 0.0005 ACRES
\ (20 SQUARE FEET)
\\
\
A�c,S'g6 \ \
N44.53'27"W \
1.01'
EAST 748.5
ALL SAINTS EPISCOPAL
SCHOOL OF FORT WORTH
VOLUME 12569, PAGE 23
D.R.T.C.T.
ALL SAINTS EPISCOPAL
SCHOOL OF FORT WORTH
VOLUME 12569, PAGE 23
D. R. T. C. T.
.S
s
�<v \
7 POINT OF \
BEGINNING
\ \
\ \
\ \
\ 20' PUBLIC \
\ DRAINAGE EASEMENT
\ DOCUMENT NUMBER
\ 204222703
O.P.R.T.C.T.
\
5/8" IRON ROD WITH YELLOW CAP STAMPED "DUNAWAY ASSOC."
D.R.T.C.T. = DEED RECORDS, TARRANT COUNTY, TEXAS, P.R.T.C.T. =
O.P.R.T.C.T. = OFFICIAL PUBLIC RECORDS, TARRANT COUNTY, TEXAS
NOTES: The basis of bearings for this Easement is the State Plane
Zone 4202, North American Datum Of 1983.
B008722.001
A metes and bounds description of even
date accompanies this drawing .
JUNE 11, 2026
550 Bailey Avenue • Suite 400 • Fort Worth, Texas 76107
Tel: 817.335.1121
TEXAS REGISTERED SURVEYING FIRM NO. 10098100
SET UNLESS OTHERWISE NOTED
PLAT RECORDS, TARRANT COUNTY, TEXAS
Coordinate System, Texas North Central
GREGORY S. IFFLAND
4351 P
900®® ®®®o®a yo
suR��
06-15-2026
PAGE 3 OF 3
EXHIBIT
BEING 0.0005 ACRES OR
20 SQUARE FEET
OF
LOT 1R, BLOCK 1R
ALL SAINTS EPISCOPAL SCHOOL ADDITION
DOCUMENT NUMBER 204222703
SITUATED IN THE
HAYS COVINGTON SURVEY
ABSTRACT NO. 256
CITY OF FORT WORTH, TARRANT COUNTY, TEXAS
795 CROSS SECTION A - A 795
z
0
1,iiuJ
550 Batley Avenue • Suite 400 • Fort Worth, Texas 76107
Tel: 817.335.1121
(1X l fG. F-1114)
EXHIBIT A®1b
STORM EASEMENT ENCROACHMENT
ALL SAINTS EPISCOPAL SCHOOL
FORT WORTH, TX
EXHIBIT B
Certificate of Insurance
Revised July 2026 Page I 1 of 11
Revised 12/2022
FORT WORTH®
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: All Saints Episcopal School of Fort Worth
Subject of the Agreement: Encroachment of City's public storm easement
M&C Approved by the Council? * Yes ❑ No II
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 back page 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 signature
If different from the approval date.
Expiration Date: 30 yrs after Director's signature
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. P N 26-00106
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes 0 No 0
Contracts need to be routed for CSO processing in the following order:
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.