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F'ORT wYirvRTH
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C' UL
J FOR
THE CONSTRUCTION OF
NorthsI de* 11 4 -Ineh Phase I
Part 1
City Project No. 0208
Be sy r c Tom, Higgins
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Mayor City Manager
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S. Frank Crum , P.E.
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' recor,, Water Department
Prepared for
1 �
The City of Fort Worth
Water Department
rtmergt
2014
LBrown&Gay Engineers,Inc.
500 West 7b Street,Suite 1 800
Fort Worth,TX 76142
Teel; 817.4387-613
Fa � 817-887-6135
�-Civil engineers&surveyors-
P°E Registration No.F-1
ENGINEERS, INC.
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RECEIVEDMAYO 5 2M
City of Fort Worth, Texas
n,n,n
Mayor and Counc"11 Co unmication
COUNCIL ACTION ' on 412,2120,14,
MIMMMUNNNOMMMMOMMIX"I
DATE: Tuesday, April 22,, '2014, REFERENCE NO.: C-261784
LOG NAME: 6ONS,1148PH:ll�P'1�-SJiL,OlUilS
SUBJECT.-I
Authorize Execution of a Contract,with S.,J. Louis Construction of Texas, Ltd, in the Amount, of
$8525,144.45 for Northside 11 48-Inch Water Main, Phase 1, Part 1 from Old Denton Road to Alta Vista
Road, Provide for Project Costs and Contingencies for a Project Total in the Amount of$8,925,459.45
(COUNCIL DISTRICT 7)
RECOMMENDATION:
It is recommended that the City Council authorize the execution of a contract with SJ Louis Construction
of Texas, Ltd, in the amount of$8,525,144.45 for Northside 11 48-inch Water Main, Phase 1, Part 1 from
Old Denton Road to Alta Vista Road, provide for project costs and contingencies for a project total in the
amount of$8,925,459.45.
DISCUSSION:
On March 5, 2013, (M:&C G-26144) the City Council authorized an! Engineering Ag�reelm�ein,t with Brown, &
Gay Engineers, Inc.,, I
for the preparation of plans, and specificationes, foir Northside II 4,8-�in�ch Water Main,
Phase 1. The proposed wate�r main will increase delivery and reliability to, the Northside 11 pressure plane.
To expedite construction, the project was divided into two parts:
• Part 1 —48-inch water main from Old Denton Road to Alta Vista Road
• Part 2—48-inch water main from Heritage Trace Parkway to Old Denton Road. (To be advertised in
Summer 2014)
Phase 1, Part 1, consists of the following-
• 48-inch water main beginning 100 feet west of the Alta Vista Road Timberland Boulevard
intersection westerly on Timberland Boulevard, then southerly on High School Drive, and on
Ridgeview Circle, then westerly on Keller Hicks Road to Old Denton Road.
• Replacement of small diameter water and sanitary sewer mains along Keller Hicks Road and
Ridgeview Circle.
This project was advertised for bids: on February 20) 2014 and February 271 2,011�4 in t,h�e� .F'olrt Worth Sitar-
i
Telex. 114, the following bids were received:
,gram. On March 20!,
Logname: 60NS1148PHIPI-SJLOUIS Page I of 2
Bildde Amount ITime Of C lotion
. Louis construction of Texas, Ltd $81152511144.45 2610 Calendar Days
'FNiorth Texas Contracting, Inc. 1202 1 3* 0
Jackson Construction, Ltd. 911414,036.50
R Construction, Inc F,$9,531,181.75
Mountain Cascade Holding Co. Inc.
llilam rJ. Schultz, Inc. d/bla circle $9,697,285.00
"C" construction company
...............M/WBE Office - S.J. Louis construction of Texas, Ltd., is in compliance with the City's BDE Ordinance by
committing to seven percent MBE participation and documentation good faith effort. S. J. Louis
Construction of Texas, LTD., identified several subcontracting and supplier opportunities. o ever, the
MBEs contacted in the areas identified did not submit the lowest bids. The city's goal on this project is 10
percent.
In addition to the contract amount, $138,000.00 (Water: X111151,1010,01.0101;1 Sewer: $ I3,010101.g1O) is required for
construction stakinglI project managlement, inspection and maternal testing and I26 , x.00 water:
$237,315.00, S,eweirs $12,51,000.,00) is, provided for contingencies.
The project is located in COUNCIL DISTRICT 7, Maspco 2213, 22F and 22J.
FISCAL CAL NFORMATION /CERTIFICATION
The Financial Management Services Director certifies that funds are available in the current capital
budgets, as appropriated, of the Water capital Projects Fund and the Sewer capital Projects Fund.
FUNS} CENTERS:
TO Fund/Account/Centers FROM I Fund Account Centers
265 54,1200 1602140208283 $7,9110,5106.80,
P251 5411 200 7021701201828131 �'6 114,637.651
cER TI F1;ICAT10NS0
S' �bmitted for CJtv Manaqer's Office Fernando costa 122
Or,l Inatln Department Head: S. Frank crumb (8207)
Additional Information Contact: Roberto C. Sauceda (2887)
ATTACHMENTS
1. 00NS1148P'H1 P1-SJLOUIS MAP. df (Public)
2. FAR,-0Q 6 C I P"##02082 P265. df (CFW Internal)
3. FAR-00007 C I P#02082 P27 . df (C FW Internal)
4. Fund verification P O5. df (CF "u'Internal
5. Fund varificactipn P2 115. d (CFW Internal
0. Niorthsidie 1,1481., c FW Internal)
Agreement
Purge I of 4
i
SECTION 00 52 43
2 AGREEMENT
3 THIS AGREEMIENT authorized
is made by and between the City of Forth
4 worth, a Texas home rule municipality, acting by and through its duly authorized City Manager,
cd S.J. Louis Construction of"'Texas, Ltd., authorized to do business in Texas, acting
6 by and through its duly authorized representative, ("Contractor").
City and Contractor, in consideration of the mutual covenants hereinafter set forth, ,agree as
8 follows;.
9 Article I WORK
10 Contractor shall complete all Work as specified or indicated in the Contract Documents for the
1 1 Project identified herein.
12 Article 2. RODE C "
13 The project for which the Work under the Contract Documents may he the whole or only a part is
14 g enerally described as follows:
15 Northside 11 48-Inch Water Main Phase f Part l
1 City Pro*ect No. 2 82
17 Article 3, CONTRACT TfW
18 3.1 Time is of the essence.
19 All time limits for Milestones, if any, and Final Acceptance as stated in the Contract
20 Documents are of the essence to this Contract.
21 3.2 Final Acceptance.
22 The Work will be complete for Final Acceptance within 250, days after the date when the
2
Contract Time commences to run as provided in ,Paragraph 2.03 of the General Conditions..
24 3.3 Liquidated damages
25 Contractor recognizes that time is of the essence of this Agreement and that City will
26 suffer financial loss if the Work is not completed within the times specified in Paragraph
27 3.2 above, plus any extension thereof allowed in accordance with Article 12 of the
�� 28 General Conditions. The Contractor also recognizes the delays, expense and difficulties
29 involved in proving in a legal proceeding„ the actual loss suffered by the City if the Work
30 is not completed on time.. Accordingly, instead of requiring any such proof", Contractor
l
31 agrees that as liquidated damages for delay (but not as a penalty), Contractor shall pay
32 City Six Hundred Fifty Dollars $ o. for each day that expires after the time
33 specified in Paragraph 3.2 for Final Acceptance until the City issues the Final Letter of
34 Acceptance.
iN
Ad
"rry'�OF FORT WORTH Northside It 48-Inch"dater Main,Phase I Part I
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS, City Project No,02082
Revised August 17,2012
I
005243-2
Agreement
Page 2 of 4
35 Article 4. CONTRACT PRICE
36 City agrees to pay Contractor for performance of the work in accordance with the Contract
7
Documents an amount i
n current funds of Ei-ght Million Five Hundred T"weri eve Thousand,
38, One Hundred Forty-four and 45/100 Dollars 144.4 ).
39 Article 51. CONTRACT DOCUMENTS
40 5.1 CONTENTS:
41 A. The Contract Documents which comprise the entire agreement between City and
Ad 42 Contractor concerning the word consist of the following:
43 1. This Agreement.
44 2. Attachments to this Agreement:
45 a. Bid Forte
46 1 Proposal Form
f,
47 2 vendor Compliance to Mate Law Non Resident Bidder
4 ) Prequalification Statement
49 4 State and Federal' documents (project specific
b Current Prevailing wage Rate Table
51 c. Insurance AC RD Fon-n s
52 d. Payment Bond
53 e. Performance Bond.
Milk 54 f. ,Maintenance Bond
55 g. Power of Attorney for the Bonds
56 h. Worker's Compensation Affidavit
57 i. MBE and/or SB,E Commitment form
58 3. General Conditions.
59 4. Supplementary Conditions.
60 5. Specifications specifically made a part of the Contract Documents by attachment
1 or not attached, as incorporated by reference and described in the Table of
62 Contents of the Project's Contract Documents.
3 6. Drawings.
64 7'. Addenda.
5 8. Documentation submitted by Contractor prior to Notice of Award.
66 9. The following which may be delivered or issued after the Effective Date of the
67 Agreement and, if issued, become an incorporated pant of the Contract Documents'.
8 a. Notice to, Proceed..
9 b Field Orders.
70 c. Charge Orders.
71 d. Letter of Flinal Acceptance,
72
_r
73
CITY OF FORT WORTH North de II 48-Inch water Main,Phase I Part I
S,TANDA-RD CONSTRUCTION SPECIFICATION DOCUMENTS Cite Project No,02082
Revised August 17,2012
i
0�" 00 52 4
Agreement
Page 3 of
74 Article h E IFIC "T`IO
75 6.1 Contractor covenants and agrees to indemnify, hold harmless and defend, at its own
76 expense, the city, its officers, servants and employees, from and against any and all
77 arising, out of or alleged to arise out of, the work and services to be performed
claims ,�
78 by the contractor, its officers, agents, employees, subcontractors, licenses or invitees
79 under this contract. This indemnification_provision is s ecificall intended too erate
and be effective even if it is alle ed or proven that all or some of the damages bein
1 son ht were caused in whole or in art an act ouission or ne li ence of the cl
■ r � at■on r ndem��r
t foThis ■ndemuty provision is intended to include, w,ithout li I I r
3 costs,expenses and legal fees incurred by the city in defending,against such claims and
84 causes of actions.
85
6 6.2 Contractor covenants and agrees to indemnify and hold harmless, at 'ts own expense,
87 the city,its officers,servants and employees,from and against any and all loss,damage
or destruction of property of the city,arising out of, or alleged to:arise out of,the work
and services to be performed by the contractor, its officers, agents, employees,
90 subcontractors, licensees or invitees under this contract. This indemnification
91 provision is specifically spec"fically intended to operate and be effective even if it is alle ed or
92 proven that all or some of the damages being sou ht were caused In whole or in art
93 b-y any act omission or ne li ence of the ci
94
95 ,article 7. MISCELLANEOUS
96 7.1 Terms.
i 97 Terms used in this Agreement ent which are defined in Article I of the General Conditions will
98 have the meanings indicated in the General Conditions.
99 7.2 Assignment of Contract.
100 This Agreement, including all, of the Contract Documents may not be assigned by the
to 1 Contractor without the advanced express written consent of the City.
102 7.3 Successors and Assigns.
+ `ity and Contractor each binds itself, its partners, successors,, ;assigns and legal
it 104 representatives to the other party hereto, in respect to all covenants, agreements and
105, obligations contained in the Contract Documents.
i
106 7.4 Severabi l ity.
107 Any provision or part of the Contract Documents held to be unconstitutional, void or
108 unenforceable by a court of competent *urisd fiction shall be deemed stricken, and all
109 remaining provisions shall continue to be valid and binding upon CITY and
110 CONTRACTOR.
111 7.5 Governing Law and venue.
112 This Agreement, including all of the Contract Documents is performable in the State of
113 Texas. Venue shall be, Tarrant County, Texas, or the United States District Court for the
I L 114 Northern District of Texas, Fort Worth Division.
l
CITY OF FORT WORTH North side If -Inch Water Main,Phase I Part I
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS, City Project No,02082
Revised August 17,2012
L
010, 2 43-4
Agreement
Page 4 of 4
1151 7.6 Other Provisions.
116 The Contractor agrees to pay at least minitnumn wage per hour, for all labor as the sane is
All 117 classified, promulgated and set out by the Cite a copy of which is attached hereto and
118 maide a part hereof the same as if it were copied verbatim herein.
119 7.7 Authority to Sign.
120 Contractor shall attach evidence of authority to sign Agreement, if other than duly
121 authorized signatory of the Contractor.
122
123 iN WITNESS WHEREOF,F, City and Contractor have executed this Agreement in multiple
124 counterparts.,
/Al'` 125
126 This Agreement is effective as of the last date signed by the Parties("Effective Date").
127
Contractor. Cite of Fort `worth
S.J. Louis Construction n""Taexas, Ltd.
Fernando Costa
By Assistant City Manager
(S ignature)
Date
UN��6 Les V• +
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Atte�s"t.
P'
(Printed Name) City .e ret
1 (Seal)
Title.
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Address: 520 South 6th Avenue
&C
Date: LY
City/State Zi Mansfield, Texas 76063 A roved asli Form and Legality,-.
Date Douglas,, lack
Assistant City,Attorney
128
129
130 APPROA AL RECOMMENDED:
131
132
133
MI 3"�" �iW1 riY V9CP!9IVli�''' S. Frank Crumb, L .........._.
I
3 D 1 RECTOR
1 5
136 Water Department
0,'443;s,gill i,
oR .
TX.
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CITY OF FORT WORTH North ,ide 1148-Inch Watery Main,Phase I Part I
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS ENTS Cit Project No.02082
Revised Auau t 17,2012
00 61 1 -I
PERFORMANCE BOND
Page I of
1 SECTION oo 61 13
PERFORMANCE ROAD Bond Igo. 9:0031257
3
THE STATE of TEXAS
§ KNOW ALL BY THESE PRESENTS:
COUNTY o F T A..N T"
7
That we, S.J. Louis Construction of Texas, Ltd., known wn as "Principal"cipal"herein and Liberty
9 Mutual Eire Insurance Company, a corp�ora.te surety(surettesl if more than one) duly authorized
10 to do business in the State of Texas, known as Surety" herein (whether one or more),are held
and firmly bound unto the City of Fort Worth, a municipal corporation created pursuant to the
12 laws of Texas, known as"City" herein, in the penal surn of, Eight NE11ion Five Hundred
13 Twenty Five Thouls2nd one Hundred Fo -fou,r and 5 .00 Dolla.rs 5,144.45 , lawful
1 oney of the United States, to be paid in port worth,Tarrant County, Texas for the payment of
15 which sung well and truly to be made,we hind ourselves, our heirs, executors', administrators,
16 successors and assigns,Jointly and severally, firmly by these presents,.
1,7 WHEREAS, the Principal has entered into a certain written contract with the City
1 awarded the day o " 20 ,which Contract is hereby referred to and
19 made a part hereof for all purp�oses as if fully set forth herein,to furnish all materials,equipment
labor and other accessorics defined by law, in the prosecution of the wort, including any Change
21 orders, as prodded for in said Contract designated as Northside 11 -Inch water Main, Phase 1,
Part 1, City Project No. 02082.
f.
23 NOW, THEREFORE,the condition of this obligation is such that if the said Principal
shall faithfully perfonn it obligations under the Contract and shall in all,respects duly and
25 faithfully per-form the Work, including Change orders, under the Contract, according to the plans,
26 specifications, and contract documents therein referred to, and as weld during any period of
27 extension of the Contract that may be granted on the part of the City, then this obligation shall be
l
8 and become null and void, otherwise to remain in fu l force and effect.
29 PROVIDED,FURTHER,,1RTHER,that if any legal action be filed on this Bond, venue shall lie in
't� 30 Tarrant County, Texas or the United :Mates District Court for the Northern District ofTexas, Fort
jf;
1 Worth Division.
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CITY O1~r'OR"T"
"4 r'ORTH Northsid 11 8-Inch Water I' 'ain,Phase I Part I
STA.ND,ARD CONSTRUCTION SPECIFICATION DOCUMENTS City Prajeci N .02082
��
Revised July I,2011
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l
00 bl 1
PERFORMANCE BOND
Page 2 of
1 This bond is madc and executed in compliance with the provisions of Chapter 2253 of the
2 Texas Govemment Code, as a ended, and all liabilities on d'iis bond shall be determined its
3 accordance with the provisions of said statue.
N IT ESE WHEREOF,the Principal and the Surety have SIGNED and SEALED
this instrument by duly authorized agents and officers on this the day of
1
r
6 kDL 20
7 PRINCIPAL:
8 S.J. Louis.Construction of Texas, Ltd.
II
12 Sign re
13 ATTEST.-
1
1 Les V. Whitman, General Manager
16 (Principal) Secretary Name arrrd Tittle
1
Address: 5201 South Wh Avenue
19 Mansfield, Texas 76063
Witness as to P I
23 SUR-ETY:
24 Liberty Mutual Flire, Insurance Cow
25
2
7 B Y:znv4_WiC
28 Signature
30 'Bruce N. Te ander, Attorne -i n-Fact
,3
Name and Title
Flame 0f f ce
33 Address; 2000 Westwood Drive, Wausau W11 54401
f
Su,rety Operations.-
f 3 450 Plymouth 'P Su i''fie 400
Plymouth Meeting, PA 9402-8284
7 Witness as,to Surety Telephone umber: 8001-862-6079
i
38
3
0
1 *Note: if signed by an officer of the Surety Company, there must be on file a certi°fted extract
J 2 from the by-laws showing that this person has authority to sign such obligation. If
43 Surety's physical address is different from its mailing address, both must be provided.
44 The date of the bond shall not be prior to the date the Contract is awarded.
i
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CITY OF FORT WORTH North side 11 48-Inch Water Main,Phase I Fart I
STANDARD,CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.02082
Revised July 1,2011
f
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N
9
LIMITED PARTNERSHIP IP` ACKNOWLEDGMENT
State of TEXAS
ss.
County of TAIL NT
On this day of 2014,before me personally appeared
Les V. iitman to me know who being by rye duly sworn,
that he/she is the General Manager ,, of the S.J. Louis Construction of Texas Ltd. the
Limited Partnership described in and which executed the foregoing lnstru.rnent, and that he/she signed his/her na.rie thereto by order of the
Board of Go° errors of said Limited Partnership.
LAll
s�
I/
ELIZA '7 ANN I7GR lrc County,-
V
'% Notary Public,Statan p�ley cor mission ex r,res 20.7(o"'. No's my commission Expires
v � mays 10, 2
is
State of MfNNESOTA
ss
County of HENNEPIN
i
On this day of ,2014, before me appeared Bruce N. Telander
to me personally known,
who being by me duly swom, did say that she is the Attorney-in-Fact of Libertv Mutual Fire Insu-rance
Company a corporation, that the seal affixed to the foregoing instrument is the corporate seal of said corporation and that said instrument
'ty der
was executed in behalf of said corporation by authority o its hoar of Directors;an that said Bruce N. Tela�n�.
acknowledged said instrument to be the free act and,deed of said corporation..
gb
p
MN f RACHEL THOMAS
„Yy Notary Public Ramsey County,
W
C TAB ( T My commission expires 01/31/15
( w_ o
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i f y Commission Expires Jan.31, 1
f�,
..........
THiIS POWER OF ATTORNEY IS NI T'VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
Thillis,Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except In the manner and to the
extent herein stated.
6171478
LIBERTY MUTUAL FIRE INSURANCE COMPANY
WAUSAU,WISCONSIN
POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS
That Liberty Mutual Fire Insurance Company(the mCompany"),a Wisconsin stock insurance company,through its Assistant Secretary,pursuant to and by
authority of the Board of Directors hereinafter set forth,does hereby name,constitute and appoint 13RIAN J.OESTREICH;BRUCE N.TELANDER;
JEROMET.OUIMET;JOHN E.TAUER;
CHRISTINE M.HANSEN;CRAIG REMICK;D.R.DOUGHERTY;DONALD R.OLSON;JACK CEDARLE,AF 11,
JOSHUA R.LOFTIS-KURT C.LUNDBLAD,LINDA K.FR,ENiCHl-MELINDA C.BLOD&ETT-NICOLE NELSON;PAMELA T CURRAN;R.W FRANiK;
RACHEL THOMAS;!§ANDRA M.DOZE,',AL)L b,F THE Cit-Y OF M11INNEAPOLIS,STATE O5F'fAINNESGTA..,...
each individually If there be more than one named,,Its true and lawful aftorney-in-fact,to make,exiecute,seal,acknowledge and deliver,for and on its belhalfas
surety and as its act and deed,any land a1l undertakings,, bonds, recognizances and other surety obligations,and the execution of such undertakings,bonds,
recognizances,and other surety obligations,in pursuance of these presents,shall be as binding upon the Company as if they had been duty signed by the silent and
att I r own proper pel sons.
ested by the secretary of Compan
the yin the i
That this power is made and executed pursuant to and by authority of the following Unanimous Consent and Vote of the Board of Directors dated June 28,2006
wherein,among other things,it was:
IN-
VOTED that the Secretary and each Assistant Secretary be, and each of them is, authorized to execute powers of attorney qualifying the attorney M
IL named in the given power of attorney to execute on behalf of the Company surety undertakings, bonds, recognizances and other surety V
Ch
obligations; and that the Secretary and each Assistant Secretary be, and each or any of them hereby is, authorized to attest to the execution U)
1% )
of any such power of attorney,and to affix thereto the corporate seal oft Co Company.
That the Resolution set forth above is a true copy thereof and is now in full force and effect.
IN WITNESS WHEREOF, this, Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of
IM'i Liberty Mutual Fire Insurance Company has,been affixed thereto in Plymouth Meeting,Pennsylvania this 17th _day of June 0
OI 20,13
LIBERTY MUTUAL FIRE INSURANCE COMPANY
44, >%UJ
> 0 C1
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B
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David M.Carey,Aais'tant Secretary
0
COMMONWEALTH OF PENNSYLVANIA ss
COUNTY OF MONTGOMERY
Lm
0 0
On this 17th day of June 2013 before me, a Notary Public,, personally came David M. Q to me known, and ILI
acknowledged that he is an Assistant Secretary of Liberty Mutual Fire Insurance Company; that he knows the, seal of said corporatilon; and that, he g
executed the above Power of Attorney and affixed the corporate seal of Liberty Mutual Fire Insurance Company thereto, with the authority and at the Z�
1W 2 if
direction of said'corporation. 4-0)
0
Ado'
IN TESTIMONY WHEREO�,oOl Paftiht�""pto, subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year 4:7 a-
F®RM,
first above written.
f 1"j,LN,
Al
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OF r� W
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A)71777 >%
erega Pastella, Notary Public
...... C4
"N "'r,P"A, A, 4,
I)f"( "11f'y ......
CERTIFICATE
E C4 M 'I" I
10
Q 1,the undersigned, an,As;4 �� of Liberty Mutual, Fire Insurance Company, do hereby certify that the original, power of attorney of which the E.
Z 00
foregoing is a full, true and corm copy, is in full force and effect on the date of this certificate; and 11 do further certify that the officer or official who
executed the said power ofattorney was one of the officers, or officials specially authorized by the Board of'Directors to appoint attiorney sin-fact as 0
provided in the Unanimous Consent and Vote of the B,oard of Directors,of Liberty Mutual Fire Insurance Company dated June:21,8,1 20016.
This certificate and',the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of th e Board I
of Directors of Liberty Mutual Fire Insurance Company evidenced by the Unanimous Consent and Vote of the Board of Directors dated June 28,2006
wherein it was
VOTED that the signatures of such officers and the seal of the Company may be affixed to any such power of attorney or to any certificate relating
thereto by facsimile,and any such power of attorney or certificate bearing such facsimile signature and facsimile seal shall be valid and binding
upon the Company when so affixed and in the future with respect to any surety undertakings, bonds, recognizances and other surety
obligations to which it is attached.
�ar
M
IN TESTIMONY WHEREOF I have hereunto subscribed my name and affixed the corporate seal of the said company, this day of
e
Gregory 'Davenport,,Asisis,tant Secretary
W.
f.'................. ...................................................
1 1 - I
Page I of
SECTION 00 61 14
PA YM ANT BOND Boyd No. 190031257
3
THE STATE of TEXAS §
5 § KNOW ALL BY TffESE PRESENTS:
6 COUNTY OF TAR. -ANT
1 7
That eve, SJ. Louis Coast ruction of Texas, I. t+dl., known as "Principal" herein and
9 Liberty Mutual Fire. Insurance Company, a corporate surety (sureties), duly authorized to do
10 business in the State of Texas, known as "Surety" herein (whether one or more), are held and
1%
1 1 firmly bound unto the City of Port Worth, a municipal corpora.tion created pursuant to the laws of
ttr
12 the State of Texas, Known as City"" herein, in the penal sunn of Eight Million Five Hundred
1 Twenty Five Thousand One f undyed. F -four and 45/100 .Dollars S 525 i.44.4,5 , law ful
the payment f
14 money of the United States, to be paid in ,Port worth, Tarrant County, Teas, for p y o�
15 which snrn well and truly be made, we bind ourselves, our heirs, executors, administrators,
successors and assigns,Jointly and severally, firmly by these presents:
t
17 NVHERE S, Principal has entered into a certain written Contract with City, awarded the
1 day of , 20 , which Contract is hereby referred to and
19 made a part hereof for all purposes as if Bully set forth herein, to famish all materials, equipment,
20 labor and other accessories as defined by law, in the prosecution of the Work as provided for in
21 said Contract and designated as Northside 1.1 -Inch "'mater Main, Phase 1, Part 1, City Project
22 No.: 02082
r
23 NOS'', THEREFORE, I-HE CONDITION OF MIS OBLIGATION is such than if
24 Principal shall pay all monies owing to any (and all) payment bond beneficiary as defined in
25 Chapter'2253 of the Texas Government Code, as amended in the prosecution of the Fork under
26 the Contract, then this obligation shall be and become null and void; otherwise to remain in full
27 force and effect.
28 This bond is made and executed in compliance with the provisions of Chapter 2253 of the
r
29 Texas Govemment Code, as amended, and all liabilities on this band shall be determined in
30 accordance with the provisions of said statute.
CITY of FORT wO,R ni Northside 11 48-Inch Water Main,Phase I Part I
STANDARD CONSTRUCTION RUCTION SPECIFICATION DOCUMENTS CIS Project No.02082
Revised July 1,2011
0,6 1 14 _2
PAYMENT BOND
rtE; �f21
IN WITNESS WFIFR_E F the Principal and SLrr*ety haxle cash SIGNED and SE LED thi s
l 2 instri.meni by dole authorized agents and cf cers ei this the � ° of
4
PRINCIPAL:
S.J. Louis Construction of Texas, Ltd..
ATTEST. By,
Signature
Les . Whitman General Manage
"R f—a
(Principal) Secretary philips j. Val. .. Name and Title
Address: 520 South 61h Avenue
Mansfield, Texas 76063
Vitness as to P ci
SURETY:
Liberty Mutual Lire Insurance Company
zllkv
ATTEST: BY.
Signature
See attached Power-of-Attorney Bruce N. Tel antler Attcrne -1 n-Fact
elt
(Surety) Secretary Warne and Title
Home Office*
mow. Address: 2000 Westwood Drive, Wausau, W1 54401
1
Surety per,ati ons:
Plymouth Sui t9 400
Witness as to Surety 800-862-6079
Telephone Kutner
5
6 Nate: If signed by an officer of the Surety, there must he on file a certified extract from the
7 bylaws showing that this person has auth ority to sign such obligation. If Surety's pliys cal
address is different from its nailing address, both must be provided.
91
10 The date of the bond sha.l l not e rror to the date the Con -act i s a�ardedi.
11 END OF SECTION
12
CITY OF FORT WORTH Northside 11 48-Inch Water Main,Phase I Part. II
STANDARD CONSTRUCTION SP11F'1CAT'ION DOCUMENTS City Project Rlu.02082
Revised July 1,2011
ii
pAR
All
f�
1
LIMITED PARTNERSHIP ACKNOWLEDGMENT
l
State o�f TEXAS
ss.
County of TA NT
in
On,this day of 20114, before me personally appeared
f
Les.V. Whitman to me known who being by me duly sworn,
that lie/she is the General Dana er of the S. `, Louis, Construction of Texas Ltd. the
United Partnership described in and which executed the foregoing instrument, and that he/she signed his/her name thereto by order of the
Board:of Governors of said Limited Partnership.
„
ISM � w
.''
� ► Notary Pub " Tarrant �ou� ,
Texan
Notary
gate of Texas
�. , y Commission Expires
My commission expires
IV,
troll 1100%111'
ACKNONMEDGMENT OF CORPORATE SURETY
U�
P
State of MTNNESOTA
r ss.
r
iliri County of HENNEPfN
1
On this day of ,2014, before me appeared Bruce N.Te[ander
y ;
to me personally 1uown, who being by me duly sworn, did say, that (s)he is the attorney- -Fact of Libeqy Mutual Fire Lnsurance
Companya corporation, that the seal affixed g " corporate corporation d that said instrument
to foregoing ���s eint �s the eo orate sea of say co o�`at
l was executed in behalf of said corporation by authoilty of its Board of Directors and that said Bruce N. Tela der
r acknowledged said instrument,to be the free act and deed of said corporation.
o0tio 111111111111111 111111101111111111111111111111
P
I'
If" X
RACHEL n � Notary Public Ramsey
PUBUC-MINNESOTA
AA
My commission expires 01/31/15,
f
X
i
............................................. ..................................... .......
THIS POWER OF ATTORNEY IIS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except,In the manner and to the
extent herein stated. 6171479
LIBERTY MUTUAL FIRE INSURANCE,COMPANY
WAUSAU,WISCONSIN
POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS
That Liberty Mutual Fire Insurance Company(the"Company"),a Wisconsin stock insurance company,through its Assistant Secretary,pursuant to and by
authority of the Board of Directors hereinafter set forth,does hereby name,constitute and ayoint BRIAN J.OESTREICH;BRUCE N.TELANDER;
j
CHRISTINE M.HANSEN;CRAIG REMICK;D.R.DOUGHER'TY-1 DONALD R.OLSON;JACK CEDARL AF 11;JEROME T.OUIMET;JOHN E.TAUER;
'TT
JOSHUA R.LOFTIS-KURT C.LUNDSLAD,LINDA K.FRENCH-MELINDA C.BLODGE -NII,C LE NELSON;PAMELA T.CUR RAN;R.W.,FRANK;
bANDRA M.DOZE,ALL 6F THE CITY OF MWRE'APOLIS,STATE OIFMINI ......I......................................
RACHEL THOMA§,
each individually if there be more than one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge and deliver,for and on its behalf as
surety and as its act,and dead, any and all underta kings, bonds, recognizances and other surety obligations and the execution of such undertakings,bonds,
recognizances and other surety obligations,in pursuance of these presents,,shall be as binding upon the Company as if they had:been duty signed by the president and
attested by the secretary of the Company in their own proper persons.
That this power is made and executed pursuant to and by authority of the following Unanimous Consent and Vote of the and of Directors dated June 28,2006
wherein,among other things,it was:
54
VOTED that the Secretary and each Assistant Secretary be, and each of them is, authorized to execute powers of attorney qualifying the attorney
named in the given power of attorney to execute on behalf of the Company surety undertakings, bonds, recognizances and other surety
obliglations; and that the Secretary and each Assistant Secretary be,and each or any of them!hereby is, authorized to attest to the execution
of any such power of attorney,,and to affix thereto the corporate seal of the Company.
wM"
A
i That the Resolution set forth above is a true copy thereof and is now in full force and effect.
xgg&
g
10
1/, IN WITNESS WHEREOF, this Power of Attorney, has been subscribed by an authorized officer or official of' the Company and the corporate seal of
1, LM
Liberty Mutual Fire Insurance!Company has been affixed thereto in Plymouth Meeting, Pennsylvania this 17th -day of June
0
2013`
LIBERTY MUTUAL FIRE,INSURANCE COMPANY
1111k,
LM
0 0.
By
ills
3
...... David M.Carey,,M@stant Secretary
0
COMMONWEALTH OF PENNSYLVANIA ss
COUNTY OF MONTGOMERY
LW
60 0 E
On this 17th day of June 2013 before me, a Notary Public, personally came Diavi� M. Carey, to me known, and 0.1
n, 0 -
jrfiftl/ 4"
rj��lgl,//,/ cu acknowledged that he is an Assistant Secretary of Liberty Mutual Fire: Insurance Company; that he knows the seal of said corporation; and that he .0 CD
E/Er LM
executed the above Power of Attorney and affixed' the corporate seal of Liberty Mutual Fire Insurance Company thereto with the authority and at the Coll
direction,of said corporation.
LM
co
IN TESTIMONY WHERE O,
1h 1#av*A�" to subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year 0
J,V?v.........
I r_
first above written,.
v,0 111-N '01i 0`)�` f1""11111P1114J',f'rl A
I" " I
a
AT;
.....�71 >
64
V,
By- 0
OF
-1 411
)�),�______ Public (4
.............. Terega Pastella,Notary
00
CERTIFICATE
147 4 ta"",
JI, El
jNop
0 1,the undersigned, an of Liberty Mutual Fire Insurance Company, do hereby certify that the original power of attorney of which the C,col
0 CD
foregoing is a full, true and cor"red copy, Is in full force and effect on the date of this certificate; and I do further ce rt that the officer or official who
ify L)v-
FW
executed the said power of attorney was one of the officers or officials specially authonzed by the Board of Directors to appoint attorneys-in-fact as o
provided in the Unanimous Consent and Vote of the Board of Directors of Liberty Mutual Fire Insurance Company dated June 28,2006. V-
This certificate and the above power of attorney may be signed,by facsimile or mechanically reproduced signatures under and by authority of the Board
of Directors of Liberty Mutual Fire Insurance Company evidenced,by the Unanimous Consent and Vote of the Board of Directors dated June 28, 2006
herein it was
VOTED that the signatures of such officers,and the seal of the Company may be affixed, to any such power of attorney or to any certificate relating
thereto by facsimile,and any such power of attorney or certificate bearing such facsimile signature and facsimile seal shall be valid and binding
upon the Company when so affixed and in the future with respect to any surety undertakings, bonds, recognizances, and other surety
ff
obligations to which it is attached.
INTEST F I co 7101 day of
ONY WHEREO eve hereunto subscribed my name and affixed the corporate seal of the said company, this
7
..................
OPP'&14111
4,...........
IR
ire gory W'.Davenport,Assistant Secretary
1/0,
Affia
.......... .......................................................................... ............
l
1
P!,
URI
f
Libe
1,
Mutual.)'
SURETY
Important Notice
TO, OBTAIN INFORMATION OR TO MAKE A C M:PLAINT.
You may write to Liberty Mutual surety at:
Liberty Mutual surety
J
Interchange Corporate Center
450 Plymouth Road, suite 400
Plymouth Meeti�ng, FAA 19482-8284
You may contact the Texas Department of Insurance to obtain information on
companies, coverages, rights or complaints at:
1-800-252-3439
You may w^rilte the Texas Department of Insurance:
P . Box 149104
Austin, Tx 78714-9104
Fax: (5 12) 475-1771
"web: httr)://www.tdi.state.tx.us,
E-�mail: ConsumerProtection tdiwstate.tx.us
Premium or, Claim Disputes,
Should you have a dispute concerning a premium, you should contact the agent first. If you
have a dispute concerning a Maim, your should contact the company first. If the dispute is not
resolved, you may contact the Texas Department ent of Insurance.
Attach, This Notice To Your Policy:
This notice is for information only and does not become a part or condition of the
F' attached document,
,MIC-3500 Page I of 2 Rev.7.1,017
�iDl-
,101iIV01i�i1 @VIiIU..
b er
/
Mutual.
j
NOTIFICACION IMPORTANTE
"ARA OBTE I R I FORMACION o R ALIZAR USIA QUE A.
f
Used puede escriir la notificacidn y dlriirla a Liberty Mutual surety en la siuiente
direccidn�:
r
Liberty Mutual surety
f Interchange Corporate, Center
450 Plymouth Road, suite 400
Plymouth Meeting PA 19462-8,284
Useed puede contactor al Departament,o de seguros die Texas para ohte er
f- in o ma io era de las co ar'i'as coderturas derechos o ue"a :
f r c n a c c � s
1-300 252-3439
Useed puede escrihir al Departamento de se urns de Texas a la siguiente direccidn,
P. 0. Box 149104
Austin, Tx 78714-9104
Fax: 51 475-1771
t e : http://www.td i.state.tx.us
E-mail Cons umerrotection tdi.state.t .us
is utas aceroa de prirrias o reelam os
En caso de que usted p,uiera elevar una disputa concerniente al terra de primas, poir favor
contacte en primer lugar a su agente. Si el to a de la disputa es relati o a urn reclamo, por
favor contacte a la cornpar l'a de se urns en primer termino. si usted considiera due la
disputa no es apropiadamente resuelta en estas instancias, entonces usted puede contactar
al Departa ento de seguros de Texas.
Adjunte esta n ti ieaci n a sul poli a:
Esta notificacidn es a Ios solos fines de su informacion y la misma no forma parte o
condiciona de manera alguna el docuIento adunto.
LIIC-35010, Page 2 of 2 Rev. 7.1,07
sim
0061 1 - 1
M.Am,rENANCE BOND
Rag. 1 of
SECTION 00 61 1
df M.r NTENANCE BOND Bond No. 190031 57
3
THE STATE of rrEXAS
,.. ow ALL BY TITESE PRESENTS:
6 COUNTY of TAR '"ANT
7
That Nve S.J. Louis Construction of Texas, Ltd'. known as"Principal"known , herei:n and Liberty.
Mutual Fire Insurance Company, a corporate surety(sureties, if more than one) duly
10 authorized to do business in the State of Texas, known as"Surety" herein whether one or snore),
I l are held and firmly bound unto the City of Fort Worth,a municipal corporation created pursuant
12 to the laws of the State of Texas, known as ` City" herein, in the sum of Eight Million Five
f
13 Hundred Twenty Five Thousand one Hundred F"o -four and 45/100 Dollars
. 144,45 y paid Tarrant County,
1I � ' � 1 .�� la. ful rnone of the United Mates to e a�.d in. Fort worth
�- 15 Texas, for payment of which s rn well and truly he!made unto the City and its successors,, we
16 hind ourselves, our heirs, execu tors, administrators, successors and assigns,Jointly and severally,
f" 17 firmly by these presents.
1S
1 WHEREAS, the Principal has entered into a certain written contract with the City awarded
t he day of 20 � whi ch Contract is hereby
by
referred to,and a made part hereof for all purposes as if fully set forth herein to fu ish all
22 materials, e quipin ent labor and other accessories as,defined by law, in the prosecution of the
23 Work, including any Work resulting from a duly authorized Change Order collectively herei,n,
24 the"Work) as provided for in said contract and designated as Northside 11 48-Inch Water Main,
25 Phase 1, Part 1, City Project No. 02082; and
26
27 WIfEREAS, Principal hinds itself to use such materials and to so construct the work in
29 accordance with the plans, specifications and Contract Documents that the Work is and will
29 remain lie from defects in materials or workmanship for and using the period or two years
aftcr the date of Final Acceptance of the Work by the City "N/Taintenance Pen*od" and
31
32 ""'HERE,AS, Principal hinds itself to repair or reconstruct the Work in whole or in part
r
33 upon receiving notice from the Cite of the need therefore at any time within the Maintenance
34 Period.
oil
CITY OF FORT WORTH N rib id 1 48-Inch Water Main,Phase 1 Part I
SO STANDARD C"O,NSTRUCT10 'sP C1FI TIo 'D,O,CU1' ENT'S City Project No.02082
Revised July 1,21011
j
0061 19
MA I?N T C NA r°N C E BOND
Page 2 nF.
t,
NOW THEREFORE, the condition of this obligation is such that if Principal shall
remedy,ajiy defective "Io'r , for hi.ch timely notice was provided by City, to a completion
satis,factory to the Cil),,, then this obligation shall become null and void otherw,ise to remain in
full force and effect.
6
IF
7 PRoV-LDED, HOWEVER, if Principal shall fail so to repair or reconstruct any timely
8 noticed defective Work, it is agreed that the City may cause any and all such defective Fork to
9 be repaired and/or reconstaicted with al I associated costs thereof being borne by the Principal and
10 the Surety under this Maintenance bond; and
12 PROBED FURTHER 1, that if any legal action be Filed on this Bondi venue shall lie in
1 Tarrant Count, Texas or the United States District Court for the Northem District ofT"e as, Port
14 Worth Division; and
1,
16 PROVIDED FURTHER, that this obligation shall be continuous in nature and
17 successive recoveries may be had hereon for successive breaches.
18
19
2
+`IT of FORT T WO TN i rtl� de 1148-Inch Water Main,Ph=I Pan 1
STANDARD� .ARD CONSTRUCTION SPECIFICATION ICATION DOCUMENTS ENTS City Project,No.02082
r
Revised July 1,2011
00619-
AIN'T`- ANCE BOND
Page 3 of,
IN WITNESS WTIEREOF, the Principal and the Surety have each SIGNED and SEALED, this
instrument by duly authorized agents and officers, on tl is tl-le� daffy r .._m
e 2 '_...
4
5 PTN'C IPA :
S.J. Louis Construction of Texas, Ltd.
7
8
Y
10 Si ore
I ATTEST:
13 Les V. Whitman, enerial Manager
l (Principal) Secretary Name and Title
1 flips J. aLl-a alil
16, Address: 520 'South 6hAvenue
17 Mansfield,'Texas,7606
18
Witness as to r iP6V ford
1 SURETY-
22 Liberty Mutual Fire Insurance C:gAqfanv..
24
25 BY.- �
26 S ign tore
27
Bruce N., Tel tinder, Attorney-in-Fact
ATTEST: Name and Title
30 Home Office*
31 See attached Power-of-Attorney Addres ZD t �e�tr cc d Dryve, au au, W 54401
r"
32 (Surety) Secretary Surety Operations:
45101 Plymouth Rd., Suite 400
Plymouth Meet ng, PA 19462-8284
5 W esis,as to Surety Telephone "umber- 8001-862-6079
i
7 6
37 *Note: If signed by an officer of the Surety Company, there must be on file a certified extract
38 from tine by--laws showing that this person has authority to sign such obili ation. If
9 Surety's physical address is different from its mailing address, bath must be provided.
The sate of the fond steals not e prior to tile date the Contract is awarded.
41
Ir
CITY OF FORT WORTH Nor r ide I}48-Inch Water Main,Phase I Part I
STA�I D July!CONSTRUCTION SPEC)FICATI N DOCUMENTS Project No,02082
Revised Ju} ,20,11
l
Iff l
LIMITED PARTNERSHIP ACKNOWLEDGMENT
(film
State of TEXAS
r ss.
County of TARRANT
On this day of ,2014,before me personally appeared
f%.
Les V. Whitman to me known who being by me duly sworn,
that he/she is the General Manager of the SA Louis Construction of Texu Ltd, the
Limited Partnership described in and which executed the foregoing instrument, and that he/she signed his/her name thereto by order of the
Board of Governors of'said Limited partnership.
(u yy mmw.muw'ww.i r M�
ETH ANN INGRAM Notary bl
. . ry bounty,
c�Moto of�
- My commission expires i.res 1 .7ay Commission Expire
May, 10, 2017
ACKNOWLEDGMENT OF CORPORATE SURETY
i
State of MfNNESOTA
ss.
County of HENNEPfN
Can this day of 20143 before me appeared Bruce N.Telandler
to me personally known, who being by me duly swore, did say that she is the Attorney-in-Fact in-Fact of Libe Mutual Fire Insurance
ConjpAny a corporation, that the seal affixed to the foregoing instrurnent is the corporate seal of said corporation and that said instrurnent
f was executed in behalf of said corporation by authority of its Board of Directors;and that said Bruce N.T"elander
J,
acknowledged said instrument to be the free act and deed of said corporation.
'1"
.amse County, MN
a
iota Public
dv w span p+c Jan. , My coni issi n expires, 01/' 1
Irr%%
rim
o.21 1 Liberty
u
SURETY
Important Notice
To OBTAIN INFORMATION OR TO MAKE A COMPLAINT.-
You may write to Liberty Mutual surety et:
Liberty Mutual Surety
Interchange Corporate center
450 Plymouth Road, Suite 400
Plymouth Fleeting,, PA 19462-82,84
You may contact the Texas Department of Insurance to obtain information on
L companies,, coverages, rights or complaints at-
1-800-251,2-3439
You may write the Texas Department of Insurance:
P. o. Box 14 104
Austin, TX 78714-9104
Fax: 12 475-1771
Web: h�ttiD://www.tdi.st,ate.tx.u,s
E-rnail: concur erProtectlon tdi.state.t .us
Premium or claim Disputes
Should you have a dispute concerning a premium, you should contact the agent first If you
have a dispute concerning a claim, you should contact the company first. If the dispute is not
resolved, you may contact the Texas Department of Insurance,,
Attach This Notice To Your Policy:
This notice is for information only and does not become a part or condition of the
attached document.
LMIC-3500 Page 1 of 2 R e v.7.1,017
1(2((
i
+I1Wi
Idi
p
Libe
14"OTI FICAC ION IMPORTAN�TE
PARA, OBTENER lN,FO MAcloN 0 R ALIZA R U!N UEJA:
U�sted puede escri,bir la notificacidn y dirigirla a Liberty Mutual Surety en la siguiente
d i recc i o n
1
Liberty Mutual Surety
Interchange corporate center
450 Plymouth Road, Suite 400
Plymouth Meeting, PA 19452-8284
Usted puede contactar al Departameln,tio de Se urns de Texas Para obtener
informacioln acerca de las co pahi'as, ce'derturas, derechos o uejas.
1-80 _252-3439
Listed puede escri it al Diepartamento de Se tiros de Texas a la si uiente direccidn:
P. 0. Sox 149104
Austin TX 787 14-9 104
Fax: 512 475-1771
Web: http,//www.tdi*l.,state.tx.us
E-mail: Con sumerF rotection ft tdi.state.tx.us
Di plul,tas ,acerca del pri ,as o reciamo
fi(«
En caso de que usted quiera elevar una displuta concerniente al tema de prisms, por favor
contacte en primer lu ar a su agente. Si el terna de la disputa es relativo a un reclamo, per
favor contacte a la cornpai"a de seguros en primer terming. Si usted considra due la
disputa no, es apropiadarnente resuelta en estas instancias, entonces usted puede contactar
al epartarnenito de Seguros die Teas..
Adjante esta oti icacion a su p6li au
Est a notificacidn es a los solos f'ines de su inforrnacidn y la misrna no forma paste o
condiciona de rnanera aluna el docurnento adjuntol.
��,; LMIc-3500 Page 2 of 2 Rear. 7.1,07
Client#: 5978 LOUICON11
ACORDT. OF INSURANCE DATE(I�II�uDD �LIABILITY
4021'"2014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON I THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THIS POLICIES
rto BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT":If the certificate holder,its an ADDITIONAL INSURED,the policy(ies),must he endorsed,If SUBROGATION IS"I 'AIVED,subjectto
the terms and Conditions of the policy,certain policies may require an endorsement.A,statement on this certificate dotes not confer rights to the
00 certificate holder in lieu,of such endorsement(s).
PRODUCER
CONTACT
T
NAME:
MN-COMMERCIAL LINES PHONE-""'612 349-2400 N 612 349'2490
�� Nom.. I ww....... .._.
COBB STREC -R DUNPHY Z1MMERMANN E�+MAIIL . ..u_ ww.... ._..a..�
150 S FIFTH ST"STE X800 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIL
MINNEAPOLIS,MN 55402
.. ... . INSURER A:�U' ICH AMERICAN INSURANCE COMPA
.......................... .�_ � ......................... . .... ............. .
_ __... � ...... .........
INSURED INSURER I ;XL SPECIALTY INSURANCE CO
SJ LOUIS CONSTRUCTION OF TEXAS LTD .. . ......
�._.� �., �� � �� ............
520 NTH AVE SOUTH
INSURER� ..._. �.
MANSFIELD,TX 75053 INSURER D
INSURER E N
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO, CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM I OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE 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..
INSR ADDL SUFI POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD�YYY I�IIIIIIIDDIYYYY� LIMITS
,. -.._... ��_.......�.� �,,,..,.�,w w............. _..... ,,...----------------
► GLO6478376 1110112013, 000 X00
7x+SEN'�EI��Ww,IL LIABILITY
�� 1101 EACH OCCURRENCE , .�.. n, .. ..,
% IF OMMERCIAIL GENERAL LIABILITY DAMAGE TO RENTED
I
PREMISES E �� $12000'.10010
.
CLAIMS-MADE Ex OCCUR MED EXP(Any one pemn) $5,000
X� CONTRACTUAL LIAR PER R PERS INA,L&ADV INJURY $1,000,000
x POLICY FORM AND XCU GENERAL AGGREGATE x2,000,0'0'0
GEN°"�L AGGREGATE LIMIT APPLIES'PER. .. .,m.., - ,,,,,,,, �_w
PRODUCTS-COMPIOP AGG ,�00,1000
F-1-- PRO- .., ....... .... ... ... ,..
POLICY Xi-JE�QT LOC $
A ILE LIAIBILI +" BAP6478317" 1 C a accAd n SING E LIMIT
ALITOMOI...,..._ '��1tI1�.� 1� 11��'�1 + 11 Ea�ccidenl) $1,000,0
ANY AUTO
BODILY INJURY(Per person)
ALL OWNED SCHEDULED BODILY INJURY(Per accident)
AUTOS , ._ AUTOS ___
NON-!I O WWNED PROPER [)A? if b
�s Per acrid nt
HIRED AUTOS AUTOS J
Ga .w..._
B UMBRELLA LIAR f,.... S 1_11 A 11/01/2013;11/01/ 0u1 C.
$
�C � OCCUR U 0005�0�4 � H OCCURRENCE, $102000
EXCESS LLAB CLAIMS-MADE AGGREGATE $1010001000
IEI a RETENTION 1 0 '
I/A A WC6 O 7l 1110112013 11/01/ 01 4 x
f N EIEWIP�O�YE COMPENSATION NY IO ST IML
vTl
ANY PROPRIETORIPARTNERIEXECUTIVE YIN STOP GAP LIABILITY E.L.EACH ACCIDENT $1,000,0010
(Mandatory In NNH)EXCLUDED? N NIA
A APPLIES IN,STATES E.IL, DISEASE-EA EMPLOYEE m
�.w...� � E $1 20001.000
II es,describe under
DESCRIPTION OF OPERATIONS below OF: ND,OH,WA,WY E.L.DISEASE POLICY LIMIT $11,'000,000
1
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORN 101,Additional Remarks Schedule,If more space is required)
SJIL.(PROJECT#tl d-, NORTHSIDE 11 48-INCH''IN"'ATER MAIN,PHASE 1 PANT"1,CITY PROJECT NIOl.,02002
ADDITIONAL INSURED ONLY IF REQUIRED BY WRITTEN CONTRACT WITH RESPECT T' 'GENERAL LIABILITY AND AUTOMOBILE.
LIABILITY APPLIES ON A PRIMARY BASIS: CITY OF FORT WORTH, INCLUDING THEIR:RESPECTIVE OFFICERS,DIRECTORS,
(See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
CI OF FORT'IVC RTH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TIME EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
1000 THR'OCKMORTON ST ACCORDANCE WITH THE POLICY PROVISIONS.
FORT WORTH(,TX 76102
AUTHORIZED REPRESENTATIVE.
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@'1988-20'10 ACGRD CORPORATION.Ail rights reserved,
ACORD 25(2010105) 11 of 2 The ACORD,niame and logo are registered marks of ACORD
591'7 7151M556 84 Ir JS
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OES�RPT �NS (Continued from Page 1
AGENTS AND EMPLOYEES(OWNER)
BROWN&GRAY ENGINEERS INC, GORROONUGNA AND ASSOCIATES INC, HVJ ASSOCIATES,V&A CONSULTING ENIGINEERS THE
RIGS GROUP,JQ ENGINEERS ONSU LTANT
IAIVER,OF SUBROGATION ONLY IF REQUIRED BY WRITTEN CONTRACT WITH RESPECT TO GENERAL LIABILITY,AUTOMOBILE
1„
J6 LIABILITY AND WORKERS'COMPENSATION APPLIES IN AL 10FAVOR OF.,CITY OF FORT WORTH
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SAGITTA 25.3(2010/05) 2 of 2