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Contract 46075
CITY SECRjETgN' FORTWORTH C114TRACT N0. ✓ PROJECT MANUAL FOR THE CONSTRUCTION OF Water and Sanitary Sewer Replacement Contract 2009 WSM-L City Project No.01478 Water Project No. P253-608170147883 Sewer Project No. P258-708170147883 DOE No. 6754 Betsy Price David Cooke Mayor City Manager S. Frank Crumb, P.E. Director, Water Department r �EAAS � Prepared for The City of Fort Worth Water Department July 2014 -s O�� It:• P. '� �5:cv� 7 -15-10H Prepared by: tn teague nail & perkins 1100 MACON STREET COF"FICIAL RF-CORD FORT WORTH,TEXAS 76102 �CR� �(817) 336-5773 - TNP No. FTW 10255 4 �3C TBPE REG#F-230 RECEIVED OCT 2 9 M&C Review Page 1 of 3 Official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA F°witTWOR TH COUNCIL ACTION: Approved on 10/14/2014-Ordinance Nos. 21504-10-2014& 21505-10-2014 DATE: 10/1412014 REFERENCE NO.: C-27043 LOG NAME: 6009WSML- MEBURNS CODE: C TYPE: CONSENT HEARING: NO SUBJECT: Authorize Execution of a Contract with M.E. Burns Construction, Inc., in the Amount of $1,841,146.00 for Water and Sanitary Sewer Replacement Contract 2009, WSM-L on Dublin Drive, Conlin Drive, De Cory Road, Sarah Jane Lane, Alcannon Street, Ray Alvin Drive, Rodeo Street and Trueland Drive, Provide for Project Costs and Contingencies for a Project Total in the Amount of$1,956,746.00 and Adopt Appropriation Ordinances (COUNCIL DISTRICT 8) " RECOMMENDATION: It is recommended that the City Council: 1. Authorize the transfer of$1,956,746.00 from the Water and Sewer Operating Fund in the amount of$1,057,641.00 to the Water Capital Projects Fund and in the amount of $899,105.00 to the Sewer Capital Projects Fund; 2. Adopt the attached appropriation ordinances increasing estimated receipts and appropriations in the Water Capital Projects Fund in the amount of$1,057,641.00 and the Sewer Capital Projects Fund in the amount of$899,105.00 from available funds; and 3. Authorize the City Manager to execute a contract with M.E. Burns Construction, Inc., in the amount of $1,841,146.00 for Water and Sanitary Sewer Replacement Contract 2009, WSM-L. DISCUSSION: On April 5, 2011, (M&C C-24821) the City Council authorized an Engineering Agreement with Teague Nall and Perkins, Inc., to prepare plans and specifications for Water and Sanitary Sewer Replacement Contract 2009, WSM-L. This Mayor and Council Communication is to authorize a construction contract for the replacement of the deteriorated water and/or sanitary sewer mains as indicated on the following streets: y Street From To Scope of Work Dublin Drive Hensley Drive 11corner Drive Water/Sewer Conlin Drive Limerick Drive Dublin Drive Water/Sewer De Cory Limerick Drive Oak Grove Water/Sewer Road Road Sarah Jane Eastline Road 1,630 feet, east then south 485 feet Rodeo Street Water/Sewer Lane Alcannon Trueland Drive Wichita Water Street Street http://apps.cfwnet.org/council_packet/mc review.asp?ID=20305&councildate=10/14/2014 10/21/2014 M&C Review Page 2 of 3 Dave Alvin Rodeo Street I Sane rah Jane Sewer Rodeo Street Wichita Street Ray Alvin Sewer Drive Trueland Rodeo Street 400 feet Sewer Drive 11 north The project was advertised for bid on July 17, 2014 and July 24, 2014 in the Fort Worth Star- Telegram. On August 14, 2014 the following bids were received: BIDDER I AMOUNT TIME OF COMPLETION M.E. Burns Construction, Inc. $1,841,146.00 250 Calendar Days Woody Contractors, Inc. $1,980,717.50 CD Builders, Inc. $2,004,948.02 Jackson Construction, Ltd. $2,555,302.00 Muniz Construction, Inc. $2,578,715.00 Ark Construction Services, LLC $2,580,343.00 In addition to the contract cost, $59,600.00 (water: $34,800.00; sewer: $24,800.00) is required for construction staking, inspection and material testing and $56,000.00 (water: $30,000.00; sewer: $26,000.00) is provided for project contingencies. M/WBE Office- M.E. Burns Construction, Inc., is in compliance with the City's BDE Ordinance by committing to nine percent MBE participation on this project. The City's MBE goal on this project is nine percent. Additionally, M.E. Burns Construction, Inc., is a certified M/WBE firm. The project is located in COUNCIL DISTRICT 8, Mapsco 91 U, 91Y and 92A, 92B, 92E and 92F. FISCAL INFORMATION/CERTIFICATION: The Financial Management Services Director certifies that upon approval of the above recommendations, and adoption of the attached appropriation ordinances, funds will be available in - the current capital budgets as appropriated, of the Water Capital Projects Fund and the Sewer Capital Projects Fund. w TO Fund/Account/Centers FROM Fund/Account/Centers 1&2) 1) PE45 538040 0609020 $1.057,641.00 P253 476045 6081701478ZZ $1,057,641.00 1) PE45 538040 0709020 $899,105.00 1&2) $899.105.00 P258 476045 7081701478ZZ $992,841.00 P253 541200 608170147883 2 P253 531200 608170147852 3 000.00 P258 541200 708170147883 $848,305.00 2 6 000.00 P253 531350 608170147852 2 $6,000.00 P253 511010 608170147880 2 200.00 P253 531350 608170147880 2 $1,022,841.00 P253 541200 608170147883 2 $6,000.00 P253 531200 608170147884 2 $3,000-00 P253 531350 608170147884 http://apps.cfwnet.org/council_packet/mc review.asp?ID=20305&councildate=10/14/2014 10/21/2014 M&C Review Page 3 of 3 a. 2) $10.000.00 P253 531350 608170147885 P253 531350 608170147892 200.00 P253 511010 608170147893 200.00 P253 531350 608170147894 200.00 P258 531350 708170147852 4 000.00 P258 511010 708170147880 4 000.00 P258 531350 708170147880 200.00 2) $874.305.00 P258 541200 708170147883 y 4 P258 531200 708170147884 000.00 " P258 531350 708170147884 2 000.00 P258 531350 708170147885 8 000.00 P258 531350 708170147892 200.00 P258 511010 708170147893 200.00 P258 531350 708170147894 200.00 P258 531200 708170147852 2 000.00 Submitted for City Manager's Office by: Fernando Costa (6122) Originating Department Head: Andrew Cronberg (5020) Additional Information Contact: Susan Schwinger(6529) ATTACHMENTS 6009WSML-MEBurns Map (1).pdf - 6009WSML-MEBurns Map (2).pdf 6009WSML-MEBurns Map (3).pdf 6009WSML-MEBURNS P253 AO.docx 6009WSML-MEBURNS P258 AO.docx http://apps.cfwnet.org/council_packet/mc review.asp?ID=20305&councildate=10/14/2014 10/21/2014 ADDENDUM NO. 'I FOR WATER AND SANITARY SEWER REPLACEMENT CONTRACT 2009 WSM-L Water Project No. P253-608170147883 Sewer Project No. P258-708170147883 City Contract No. 01478 D.O.E. No. 6754 Addendum No. 1 Issue Date: August 13, 2014 Bid Receipt Date: August 14, 2014 This addendum forms part of the contract documents referenced above and modifies the '0 original Contract Documents. Acknowledge receipt of this addendum by signing and attaching it to the .Contract Documents (inside cover). Note receipt of the Addendum in the Bid Form and on the outer envelope of your bid. PLEASE MAKE NOTE OF THE FOLLOWING REWSIONS; CLARIFICATION: 1. General: Any sewer service that crosses an existing or proposed water.lime shall be 4" 8DR-26 PVC with 22 linear feet of cement stabilized sand embedment centered over the water line crossing and will be paid for under Bid Item #8 - 'Special - 4 Sewer Service SDR-26 wl CSS" in Unit 2 of the Bid Proposal, Section 00 42 43. Any sewer service not crossing an existing_or proposed water fine shall be paid.for under Bid Item#7—"3331.3101 4"Seaver Service" in Unit 2 and will not require cement stabilized sand embedment. 2. General,All permanent asphalt pavement repair shall be 5'width. Bid Item#37 in Unit 1 of the Bid Proposal, Section 00 42 43 has been revised to °3201.0112.5' Wide Asphalt Pvmt Repair, Residential," 3. Plan Sheet#8—at STA 1+00 of proposed water line `C', a 12"x8" cut-in tee with 12" solid sleeves and $" gate valve shall be installed. Crossing Detail #7 incorrectly shows a 12"x8"tapping sleeve and valve. 4. Section 00 42 43.- Bid Proposal Unit 1, Bid Item#20—"3305.0003 8"Water Line Lowering"—the bid amount of 2 per each is a contingency quantity for locations where a new 1.2-inch or smaller water line is installed and crosses an existing 1 ADDENDUM NO. 1 underground conflict which requires the water line.to be lowered greater than two feet below the standard depth and has not been detailed in the Drawing. See City Specification 33 05 12.Actual quantity will vary based on conditions encountered in the field during construction:. Any low.erings shown in the crossings details In the plans shall be paid for by the linear foot of pipe and tonnage of fitting. SPECIFICATION AND CONTRACT DOCUMENTS: 5. Section 00 11 13 - Invitation to Bidders: Replace the Invitation to Bidders in its entirety w.ith th_e attached revised Invitation to Bidders. 6. Section 00 41 00—Bid Form: Replace the Bid Form in its entirety with the attached revised Bid Form. 7. Section 00 42 43;-Proposal Form: Replace the Proposal Form in its entirety with the attached revised Proposal Form.. 8. Section 00 45 12 Prequalification Statement: Replace the Prequalification Statement in its entirety with the attached revised Prequalification .Statement. 9. Section.00 45 13—Bidders Prequalification ADpfication: Replace the Bidders Prequalification Application in its entirety with the attached revised Bidders Prequalification Application. 10. Section 00 52 43—Agreement: Under Article 3. Contract Time, Item 3.2 Final Acceptance shall now read "The Work will be complete for Final Acceptance within 250 days after the date when the Contract Time commences to run as provided in Paragraph 2.03 of the. General Conditions. CONSTRUCTION PLANS: 11. Plan sheets 2. 3, 18; 19. 45; and 46: The construction sequencing notes have been revised as follows: "Proposed construction on Dublin and Conlin shall be performed before or concurrent to all other lines, see sheets 45 and 46 for recommended construction sequencing." 12. Plan sheets 10 11 30 31 and 32: These sheets have been removed from the plans and are not a part of this project. Plans were correct and did not contain these sheets on the City's Buzzsaw site, but hard copies available for purchase 2 ADDENDUM NO. 1 Incorrectly contained these plan sheets. Quantities for these sheets were not included in the Bid Proposal. 13. Plan Sheets 42 and 43: Manholes at STA 9+68 and STA 19+59 shall be constructed as:standard manholes with hydraulic slides,not as drop manholes. 14. ec 'pt Ac owledaed: Water Department By: � Title: � f. By. To, 169 Tony Sholola, PE Engineering Manager Water Department r+ i i i 3 ADDENDUM NO. 1 005243-1 Agreement Page 1 of 4 SECTION 00 52 43 AGREEMENT THIS AGREEMENT, authorized on (!C( (4 , 2014 is made by and between the City of Fort Worth, a Texas home rule municipality, acting by and through its duly authorized City Manager, ("City"), and M.E.Burns Construction,Inc., authorized to do business in Texas, acting by and through its duly authorized representative,("Contractor"). City and Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: Article 1.WORK Contractor shall complete all Work as specified or indicated in the Contract Documents for the Project identified herein. Article 2.PROJECT The project for which the Work under the Contract Documents may be the whole or only a part is generally described as follows: Water and Sanitary Sewer Replacement Contract 2009 WSM-L City Project No. 01478 Article 3. CONTRACT TEVIE 3.1 Time is of the essence. All time limits for Milestones, if any, and Final Acceptance as stated in the Contract a Documents are of the essence to this Contract. 3.2 Final Acceptance. The Work will be complete for Final Acceptance within 250 days (Addendum No.l) after the date when the Contract Time commences to run as provided in Paragraph 2.03 of the General Conditions. + 3.3 Liquidated damages Contractor recognizes that time is of the essence of this Agreement and that City will .� suffer financial loss if the Work is not completed within the times specified in Paragraph 3.2 above, plus any extension thereof allowed in accordance with Article 12 of the General Conditions. The Contractor also recognizes the delays, expense and difficulties involved in proving in a legal proceeding the actual loss suffered by the City if the Work is not completed on time. Accordingly, instead of requiring any such proof, Contractor agrees that as liquidated damages for delay (but not as a penalty), Contractor shall pay City Six Hundred-Fifty Dollars(1650) for each day that expires after the time specified in Paragraph 3.2 for Final Acceptance until the City issues the Final Letter of Acceptance. - CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised December 20,2012 005243-2 Agreement Page 2 of 4 Article 4.CONTRACT PRICE City agrees to pay Contractor for performance of the Work in accordance with the Contract Documents an amount in current funds of One Million,Eieht Hundred Forty One Thousand, One Hundred Forty Six Dollars and No Cents ($1,841,146.00), Article 5. CONTRACT DOCUMENTS 5.1 CONTENTS: A. The Contract Documents which comprise the entire agreement between City and ' Contractor concerning the Work consist of the following: 1. This Agreement. ,W 2. Attachments to this Agreement: a. Bid Form 1) Proposal Form 2) Vendor Compliance to State Law Non-Resident Bidder 3) Prequalification Statement 4) State and Federal documents(project speck) b. Current Prevailing Wage Rate Table ** c. Insurance ACORD Form(s) d. Payment Bond e. Performance Bond f. Maintenance Bond g. Power of Attorney for the Bonds h. Worker's Compensation Affidavit i. MWBE Commitment Form 3. General Conditions. 4. Supplementary Conditions. 5. Specifications specifically made a part of the Contract Documents by attachment or, if not attached, as incorporated by reference and described in the Table of Contents of the Project's Contract Documents. 6. Drawings. 7. Addenda. 8. Documentation submitted by Contractor prior to Notice of Award. 9. The following which may be delivered or issued after the Effective Date of the Agreement and, if issued,become an incorporated part of the Contract Documents: a. Notice to Proceed. b. Field Orders. c. Change Orders. d. Letter of Final Acceptance. CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised December 20,2012 005243- A_ru i i lt-P, Page 3 of 4 Article 6.INDEMNIFICATION 1.2 Contractor covenants and agrees to indemnify, hold harmless and defend, at its own expense, the city, its officers, servants and employees, from and against any and all claims arising out of, or alleged to arise out of,the work and services to be performed by the contractor, its officers, agents, employees, subcontractors, licenses or invitees under this contract. This indemnification provision is specifically intended to operate and be effective even if it is alleged or proven that all or some of the damages being sought were caused,in whole or in part, by any act, omission or negligence of the city. This indemnity provision is intended to include, without limitation, indemnity for costs,expenses and legal fees incurred by the city in defending against such claims and causes of actions. 6.2 Contractor covenants and agrees to indemnify and hold harmless, at its own expense, 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, subcontractors, licensees or invitees under this contract. This indemnification provision is specifically intended to operate and be effective even if it is alleged or proven that all or some of the damages being sought were caused, in whole or in part, by any act,omission or negligence of the city. Article 7.MISCELLANEOUS 7.1 Terms. Terms used in this Agreement which are defined in Article 1 of the General Conditions will have the meanings indicated in the General Conditions. 7.2 Assignment of Contract. This Agreement, including all of the Contract Documents may not be assigned by the Contractor without the advanced express written consent of the City. 7.3 Successors and Assigns. City and Contractor each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, in respect to all covenants, agreements and obligations contained in the Contract Documents. 7.4 Severability. Any provision or part of the Contract Documents held to be unconstitutional, void or unenforceable by a court of competent jurisdiction shall be deemed stricken, and all remaining provisions shall continue to be valid and binding upon CITY and CONTRACTOR. 7.5 Governing Law and Venue. This Agreement, including all of the Contract Documents is performable in the State of Texas. Venue shall be Tarrant County, Texas, or the United States District Court for the Northern District of Texas,Fort Worth Division. CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised December 20,2012 005243-4 Agreement Page 4 of 4 7.6 Other Provisions. The Contractor agrees to pay at least minimum wage per hour for all labor as the same is classified, promulgated and set out by the City, a copy of which is attached hereto and made a part hereof the same as if it were copied verbatim herein. 7.7 Authority to Sign. Contractor shall attach evidence of authority to sign Agreement, if other than duly authorized signatory of the Contractor. IN WITNESS WHEREOF, City and Contractor have executed this Agreement in multiple counterparts. ++ This Agreement is effective as of the last date signed by the Parties("Effective Date"). City of Fort Worth Con ctor: —' u,.✓h � 1L By.� �� Fernando Costa / By: Assistant City Manager (L 7E ature) M&C G 2-4-D Ll 3 .s��Ga. U-✓ti'` Date (p (Printed Name) Attest: Title: �{C� a J y r, City creta G �y o�� Ad ess: (Seal) 8 ° Ci tate/Zip: 9 A proved to Form and y a � ," S Doug W. Black Assistant City Attorney APPROVAL RECOMMENDED: ® �cCO� Andrew T. Cronberg, P.E., � C $����� Interim DIRECTOR, Water Department �4v 1000 Throckmorton Street FT WORM TX Fort Worth, TX 76102 qP CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised December 20,2012 0061 13-1 PERFORMANCE BOND Page 1 oft SECTION 00 6113 Bond 44398273 ,.. PERFORMANCE BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF TARRANT § That we,M.E.Burns Construction,Inc.,known as"Principal"herein and SureTec Insurance Company , a corporate surety(sureties, if more than one)duly authorized 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 LM pursuant to the laws of Texas,known as"City"herein,in the penal sum of,One Million.Eight Hundred Forty One Thousand. One Hundred Forty-Six Dollars and No Cents PW ($1841,146.00),lawful money of the United States,to be paid in Fort Worth,Tarrant County, Texas for the payment of which sum well and truly to be made,we bind ourselves, our heirs, ,P executors,administrators,successors and assigns,jointly and severally,firmly by these presents. WHEREAS,the Principal has entered into a certain written contract with the City P0 awarded the N day of OCI'0 20 LL(,which Contract is hereby referred to and made a part hereof for all purposes as if fully set forth herein,to furnish all materials,equipment labor and other accessories defined by law,in the prosecution of the Work, including any Change Orders,as provided for in said Contract designated as Water and Sanitary Sewer Replacement Contract 2009 WSM-.L,City Project No.01478 NOW,THEREFORE, the condition of this obligation is such that if the said Principal shall faithfully perform it obligations under the Contract and shall in all respects duly and faithfully pet-form the Work,including Change Orders,under the Contract, according to the plans, specifications, and contract documents therein referred to,and as well during any period of extension of the Contract that may be granted on the part of the City,then this obligation shall be and become null and void,otherwise to remain in full force and effect. PROVIDED FURTHER,that if any legal action be filed on this Bond,venue shall lie in Tarrant County,Texas or the United States District Court for the Northern District of Texas, Fort Worth Division. CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised November 9,2011 PIM I 1 006113-2 PERFORMANCE BOND Page 2 of 2 This bond is made and executed in compliance with the provisions of Chapter 2253 of the Texas Government Code,as amended,and all liabilities on this bond shall be determined in accordance with the provisions of said statue. 11v WITNESS WHEREOF,the Principal and the Surety have SIGNED and SEALED this instrument by duly authorized agents and officers on this the 14 day of 0 096Z_ z0 A. PRINCIPAL: M.E.Burns C�onctructiQn, Inc rp BY: Signature rf ATTEST: (Principal)Secretary Name acid T itku Address: P.O.Box 786 ur eson,TX 76097 PW Witness as to Principal SURETKInsulce Sur Com a t BY: _ ignature Tracy L Gingras ,F Name and Title Address: 500 West 13th Street Fort Worth,TX 76102 Witness as to Surety Telephone Number: 800-728-2374 *Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. w CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised November 9,2011 POA#, 4221178 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"),-a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make,constitute and appoint Tracy L. Gingras,Gary B.McElroy its true and lawful Attomey-in-fact, with full power and authority hereby conferred in its name,place and stead,to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment shall continue in force until 12/31/2015 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute,acknowledge and deliver,any and all bonds,recognizances,contracts,agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attomey-in-Fact shall be binding upon the Company as if signed by the President and scaled and effected by dic Corporate Secretary. Be it Resolved that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20`6 of April, 1999.) In Witness Whereof,, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President,and its corporate seal to be hereto affixed this 21 st day of March,A.D.2013. T SvRANC� SURETEC INSURANCE COMPANY .X ..q wc ; By. w w i>; John krdox Jr. resident State of Texas ss: County of Harris ........... ••. On this 21st day of March,AD.2013 before me personally came John Knox Jr.,to me known,who,being by me duly sworn,did depose and say,that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument;that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the Board of Directors of said Company;and that he signed his name thereto by like order. JACQUELYN MALDONADO Notary Public �J State of Texas My Comm.Exp.511812017 Jacq elyn Maldonado,Notary Public My commission expires May 18,2017 1,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 14 day of 6Cf001 f— 20 A.D. ..r Bre t Beaty,Assistant ecretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call(713)812-0800 any business day between 8:00 am and 5:00 pm CST. i SureTec Insurance Company THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION Statutory Complaint Notice To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint at: 1-866-732-0099 You may also write to the Surety at: SureTec Insurance Company 5000 Plaza on the Lake, Suite 290 Austin, TX 78746 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252-3439. You may write the Texas Department of Insurance at PO Box 149104 Austin, TX 78714-9104 Fax#: 512-475-1771 PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. -� Important Notice Regarding Terrorism Risk Insurance Act of 2002 In accordance with the Terrorism Risk Insurance Act of 2002 (the"Act"), this disclosure notice is provided for surety bonds on which one or more of the following companies is the issuing surety: SureTec Insurance Company, U. S. Specialty Insurance Company, and any other company that is added to SureTec Insurance Company for which LW surety business is underwritten by SureTec Insurance Company ("Issuing Sureties"). The premium attributable to any bond coverage for"acts of terrorism"as defined in Section 102(1) of the Act is Zero Dollars ($0.00). The United States will reimburse the Issuing Sureties for ninety percent(90%) of any covered losses from terrorist acts certified under the Act exceeding the applicable surety deductible. The actual coverage provided by your bond for acts of terrorism, as is true for all coverages, is limited by the terms, conditions, exclusions, penalties, limits, other provisions of your bond and the underlying contract, any endorsements to the bond and generally applicable rules of law, This Important Notice Regarding Terrorism Insurance Risk Act of 2002 is for informational purposes only and does not create coverage nor become a part or condition of the attached document. Exclusion of Liability for Mold, Mycotoxins, and Fungi The Bond to which this Rider is attached does not provide coverage for, and the surety thereon shall not be liable for, molds, living or dead fungi, bacteria, allergins, histamines, spores, hyphae, or mycotoxins, or their related products or parts, nor the remediation thereof, nor the consequences of their occurrence, existence, or appearance. Rev 11.11.03 I 0061 14-1 PAYMENT BOND Page 1 of 2 SECTION 00 6114 Bond#4398273 PAYMENT BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF TARRANT § i That we, M.E. Burns Construction, Inc., known as "Principal" herein, and SureTec Insurance Company I a corporate surety (sureties), duly authorized 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 laws of the State of Texas, known as "City" herein, in the penal sum of One NE11ion, Eight Hundred Forty One TliuuSanu. vv^uT Hundred Forty Six Dollars and No Cents ($1,841.146.00), lawful money of the United States, to be paid in Fort Worth, Tarrant County, Texas, for the payment of which sum well and truly be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents: WHEREAS,Principal has entered into a certain written Contract with City, awarded the 1H day of DG-[O&E& , 201LL, which Contract is hereby referred to and made a part hereof for all purposes as if fully set forth herein, to famish all materials, equipment, labor and other accessories as defined by law, in the prosecution of the Work as provided for in said Contract and designated as Water and Sanitary Sewer Replacement Contract 2009 WSM-L, City Project No. 01478 NOW, THEREFORE, THE CONDITION OF THIS OBLIGAMN is such that if Principal shall pay all monies owing to any (and all) payment bond beneficiary (as defined in Chapter 2253 of the Texas Government Code, as amended)in the prosecution of the Work under the Contract, then this obligation shall be and become null and void; otherwise to remain in full force and effect. This bond is made and executed in compliance with the provisions of Chapter 2253 of the Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said statute. CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised November 9,2011 0061 14-2 PAYMENT BOND Page 2of2 IN WITNESS WHEREOF,the Principal and Surety have each SIGNED and SEALED this instrument by duly authorized agents and officers an this the l day of Da TO t3fi�- , 20j _. PRINCIPAL: 1� M.E.Burns Construction,Inc. ATTEST: BY. S I Signature �= (Principal) Secretary Name and Title Address: P.O.Box 786 Burleson,TX 76097 tf Witness as to Principal SURETY: SureTec Ingrr-a-rlce Com an ATTEST: BY: Signa re n/a Tracy L Gingras,Attorney-in-Fact (Surety) Secretary Name and Title Address: 500 West 13th Street ]AOL L/y Fort Worth,TX 76102 Witness as to Surety . Telephone Number: 800-728-2374 Note: If signed by an officer of the Surety, there must be on file a certified extract from the bylaws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address,both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. END OF SECTION CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01478 Revised November 9,2011 PoA#: 4221178 SureTec Insurance Company p Y LIMITED POWER OF ATTORNEY Know All Alen by These Presents, That SURETEC INSURANCE COMPANY (the "Company"),-a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents IN make,constitute and appoint Tracy L.Gingras,Gary B.McElroy its true and lawful Attorney-in-fact, with full power and authority hereby conferred in its name, place and stead,to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars($5,000,000.00) �. and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President,sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment shall continue in force until 1213112015 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute,acknowledge and deliver,any and all bonds,recognizances,contracts,agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and crTeutcd by the Curpurate Secretary. Be it Resolved that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20`t"of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 21 st day of March,A.D.2013. u"aMw SURETEC INSURANCE COMPANY y\3RANC N' � ��r.......,.,.Fc By. w w J n John dox Jr:,r resident a. fState of Texas ss: ' County of Harris �''1...... On this 21st day of March,A.D.2013 before me personally came John Knox Jr.,to me known,who,being by me duly sworn,did depose and say,that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above i~ instrument;that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the iBoard of Directors of said Company;and that he signed his name thereto by like order. po mm LDONADO A PRr blic xas 5/18/2017 Jacquelyn Maldonado,Notary Public My commission expires May 19,2017 On I,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney,executed by said Company, which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set out in the Power of Attorney are in full force and effect. WE Given under my hand and the seal of said Company at Houston, Texas this 1_day of G'(V 1 i U 2014 , A.D. FP M.Bre t Beaty,Assistant ecretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call(713)812-0800 any business day between 8:00 am and 5:00 pm CST. SureTec Insurance Company THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION Statutory Complaint Notice To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint at: 1-866-732-0099 You may also write to the Surety at: SureTec Insurance Company 5000 Plaza on the Lake, Suite 290 Austin, TX 78746 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252-3439. You may write the Texas Department of Insurance at PO Box 149104 Austin, TX 78714-9104 Fax#: 512-475-1771 PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Important Notice Regarding Terrorism Risk Insurance Act of 2002 In accordance with the Terrorism Risk Insurance Act of 2002 (the"Act"), this disclosure notice is provided for surety bonds on which one or more of the following companies is the issuing surety: SureTec Insurance Company, U. S. Specialty Insurance Company, and any other company that is added to SureTec Insurance Company for which .. surety business is underwritten by SureTec Insurance Company("Issuing Sureties"). The premium attributable to any bond coverage for"acts of terrorism"as defined in Section 102(1) of the Act is Zero Dollars ($0.00). The United States will reimburse the Issuing Sureties for ninety percent(90%) of any covered losses from terrorist acts certified under the Act exceeding the applicable surety deductible. The actual coverage provided by your bond for acts of terrorism, as is true for all coverages, is limited by the terms, conditions, exclusions, penalties, limits, other provisions of your bond and the underlying contract, any endorsements to the bond and generally applicable rules of law. This Important Notice Regarding Terrorism Insurance Risk Act of 2002 is for informational purposes only and does not create coverage nor become a part or condition of the attached document. Exclusion of Liability for Mold, Mycotoxins, and Fungi The Bond to which this Rider is attached does not provide coverage for, and the surety thereon shall not be liable for, molds, living or dead fungi, bacteria, allergins, histamines, spores, hyphae, or mycotoxins, or their related products or parts, nor the remediation thereof, nor the consequences of their occurrence, existence, or appearance. Rev 11.11.03 006119-1 N AINTFNANCE BOND Page 1 of 3 SECTION 00 6119 MAINTENANCE BOND Bond#4398273 THE STATE OF TEXAS § w § KNOW ALL BY THESE PRESENTS: COUNTY OF TARRANT § That we,M.E.Burns Construction,Inc.,known as"Principal"herein and SureTec Insurance Company , a corporate surety(sureties,if more than one) duly authorized 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 laws of the State of Texas,known as"City"herein,in the sum of One Million, Eiaht Hundred Forty One Thousand,One Hundred Forty Six Dollars and No Cents ln�fi� Tarrant C'niwnty (�i.b41,146.UUj,Iawlul IIiurl�y v Ul+ uiiltcu .��aaca, w uv pfiiu iu,.v.. ..•: w+ Texas,for payment of which sum well and truly be made unto the City and its successors,we bind ourselves,our heirs, executors,administrators,successors and assigns,jointly and severally, firmly by these presents. WHEREAS,the Principal has entered into a certain written contract with the City awarded the 14 day of OC-10BEIZ ,20j-$which Contract is hereby referred to and a made part hereof for all purposes as if fully set forth herein,to ft rnish all materials,equipment labor and other accessories as defined by law, in the prosecution of the Work, including any Work resulting from a duly authorized Change Order(collectively herein,the"Work's as provided for in said contract and designated as Water and Sanitary Sewer Replacement Contract 2009 WSM-L,City Project No.01478; and r NVBZREAS, Principal binds itself to use such materials and to so construct the Work in accordance with the plans,specifications and Contract Documents that the Work is and will remain free from defects in materials or workmanship for and during the period of two (2)years '! after the date of Final Acceptance of the Work by the City ("Maintenance Period");and WHEREAS,Principal binds itself to repair or reconstruct the Work in whole or in part upon receiving notice from the City of the need therefor at any time within the Maintenance Period. CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No.01476 Revised November 9,2011 s 006119-2 MAINTENANCE BOND Page 2 of 3 NOW THEREFORE, the condition of this obligation is such that if Principal shall remedy any defective Work,for which timely notice was provided by City, to a completion satisfactory to the City,then this obligation shall become null and void; otherwise to remain in PE full force and effect. PROVIDED,HOWEVER, if Principal shall fail so to repair or reconstruct any timely noticed defective Work,it is agreed that the City may cause any and ail such defective Work to be repaired and/or reconstructed with all associated costs thereof being borne by the Principal and the Surety under this Maintenance bond; and PROVIDED FURTHER,that if any legal action be filed on this Bond,venue shall lie in T 1__TT •. oa..a,,,, ,,a .+1,0 1_�n'*�°vi.� Tlic±rift OfTPvac 1✓nrt i P0 Tarrant County, 1CXf1S'Ui t1 he Un ed ata�ca L iau:vt C u L.Lva u e o , Worth Division; and PM PROVIDED FURTHER,that this obligation shall be continuous in nature and successive recoveries may be bad hereon for successive breaches. r CITY OF FORT WORTH water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Proj act No.01478 Revised November 9,2011 0061 19-3 MAINTENANCE BOND Page 3 of 3 IN WITNESS WHERE OF,the Principal and the Surety have each SIGNED and SEALED this instrument by duly authorized agents and officers on this the L-day of OGZO U'fL ,20_L_�_. PRINCIPAL: M. Burns Construction Inc. BY: ASigna e ATTEST l4iS (Principal)Secretary Name and Title Address: P.O.Box 786 Burleson,TX 76007 so Witness as to Principal SURETY: o► SureTe nsur nce Company In # B gnature Tracy L.Gingras,Attomey-in-Fact �. ATTEST: Name and Title n/a Address: 500 West 13th Street (Surety)Secretary Fort Worth,TX 76102 CA Uik -AI Witness as to Surety Telephone Number: 800-728-2374 r *Note: If signed by an officer of the Surety Company,there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address,both must be provided. rThe date of the bond shall not be prior to the date the Contract is awarded. r CITY OF FORT WORTH Water and Sanitary Sewer Replacement Contract 2009 WSM-L STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City ProjcctNo.01478 11� Revised November 9,2011 C PoA m 4221178 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"),-a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents PM make,constitute and appoint Tracy L.Gingras,Gary B.McElroy its true and lawful Attorney-in-fact,with full power and authority hereby conferred in its name,place and stead,to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include,waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment shall continue in force until 12/31/2015 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: fir Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute, acknowledge and deliver,any and all bonds,recognizances,contracts,agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by tue Curpurate Secretary. Be it Resolved that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 2e of April, 1999.) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President,and its corporate seal to be hereto affixed this 21st day of March,A.D.2013. SURETEC INSURANCE COMPANY By: John 4dox Jr. resident State of Texas ss: County of Harris b •�`' ` •�Wi1Mm*M� On this 21st day of March,AD.2013 before me personally came John Knox Jr.,tome known,who,being by me duly sworn,did depose and say,that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument;thIt he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the Board of Directors of said Company;and that he signed his name thereto by like order. JACQUELYN MAIDONADO Notary Public State of Texas �'•*�Fh`' My Comm.Exp.511812017 Jacq 6lyn Maldonado,Notary Public My commission expires May 18,2017 I,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and convect copy of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this fy day of OGZ°�. 1� A.D. Bre t Beaty,Assistant ecretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call(713)812-0800 any business day between 8:00 am and 5:00 pm CST. SureTec Insurance Company THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION Statutory Complaint Notice To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint at: 1-866-732-0099 You may also write to the Surety at: SureTec Insurance Company 5000 Plaza on the Lake, Suite 290 Austin, TX 78746 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252-3439. You may write the Texas Department of Insurance at PO Box 149104 Austin, TX 78714-9104 Fax#: 512-475-1771 PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Important Notice Regarding Terrorism Risk Insurance Act of 2002 ** In accordance with the Terrorism Risk Insurance Act of 2002 (the"Act"), this disclosure notice is provided for surety bonds on which one or more of the following companies is the issuing surety: SureTec Insurance Company, U. S. Specialty Insurance Company, and any other company that is added to SureTec Insurance Company for which surety business is underwritten by SureTec Insurance Company ("Issuing Sureties"). The premium attributable to any bond coverage for"acts of terrorism"as defined in Section 102(1) of the Act is Zero Dollars ($0.00). The United States will reimburse the Issuing Sureties for ninety percent(90%) of any covered losses from terrorist acts certified under the Act exceeding the applicable surety deductible. The actual coverage provided by your bond for acts of terrorism, as is true for all coverages, is limited by the terms, conditions, exclusions, penalties, limits, other provisions of your bond and the underlying contract, any endorsements to the bond and generally applicable rules of law. This Important Notice Regarding Terrorism Insurance Risk Act of 2002 is for informational purposes only and does not create coverage nor become a part or condition of the attached document. Exclusion of Liability for Mold, Mycotoxins, and Fungi The Bond to which this Rider is attached does not provide coverage for, and the surety thereon shall not be liable for, molds, living or dead fungi, bacteria, allergins, histamines, spores, hyphae, or mycotoxins, or their related products or parts, nor the remediation thereof, nor the consequences of their occurrence, existence, or appearance. Rev 11.11.03 AC®® DATE(MMIDD/YYYY) V CERTIFICATE OF LIABILITY INSURANCE l 10/23/2014 +� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 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 is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the tears and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CT Amanda Villanueva _ Higginbotham Insurance Agency, Inc. NNE, 800-728-2374 FAX 817-347-6981 500 W. 13th Street E-MAIL Fort Worth TX 76102 .avillanueva @higginbotham.net _INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Service Lloyds Insurance Company 43389 ' INSURED INSURER B:United Fire Lloyds 43559 M. E. Burns Construction INSURERC: R and D Bums Brothers, Inc. P.O. Box 783 INSURER D Burleson TX 76097 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1949383167 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 OR CONDITION OF ANY CONTRACT OR 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYW MMIDD B X COMMERCIAL GENERAL LIABILITY 85315567 101112014 10/1/2015 EACH OCCURRENCE $1,000,000 AMAGE TO RENTED CLAIMS-MADE Ex-]OCCUR PREM SES Ea occurrence) $100,000 X Ded:$1.000 MED EXP(Any one person $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT F�LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 85315567 01112014 1011/2015 COMBINED SINGLE DVrF- S Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ AU-8rED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X HIRE0.0.DSSAUTOS x NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ B X UMBRELLA LIAB X OCCUR 85315567 1011/2014 10/1/2015 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X I RETENTION$$10,000 $ A WORKERS COMPENSATION SRZB2287313 1011/2014 101112015 7 X STATUTE OERH AND EMPLOYERS'LIABILITY YIN NIA E.L.EACH ACCIDENT $1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$1,000,000 If Yes,describe under # DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) The General Liability and Automobile Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status and General Liability,Automobile Liability and Workers'Compensation policy includes a blanket waiver of subrogation endorsement to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. The General Liability policy contains a special endorsement with"Primary and Noncontributory"wording. See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS. 1000 Throckmorton Street Ft.Worth TX 76102-0000 AUTHORIZED REPRESENTATIVE // @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: _ LOC#: '4� ADDITIONAL REMARKS SCHEDULE Page I of AGENCY NAMEDINSURED Higginbotham Insurance Agency, Inc. M.E. Burns Construction POLICY NUMBER R and D Bums Brothers, Inc. P.O.Box 783 .4 Burleson TX 76097 CARRIER NAIC CODE EFFECTIVE DATE; ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Umbrella is follow form. Water and Sanitary Sewer Replacement Contract 2009 WSM-L,City project No.01478 Certificate holder is insured as noted above and complete to include:City of Fort Worth,Teague Nall and Perkins and ANA Consultants including their respective officers,directors,agents and employees. RIM w w ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD