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Contract 41533-A2
CITY SECRET CONTRACT W.). SECOND AMENDMENT TO CITY SECRETARY CONTRACT NO.41533 ENCROACHMENT AGREEMENT This SECOND AMENDMENT TO CITY SECRETARY CONTRACT NO. 41533, ENCROACHMENT AGREEMENT is made and entered into by and between the CITY OF FORT WORTH, a municipal corporation of Tarrant County, Texas, acting herein by and through its duly authorized City Manager or duly designated Assistant City Manager, hereinafter referred to as the "City," and Lake Country Property Owners Association, acting herein by and through its duly authorized representative, hereinafter referred to as "Licensee". RECITALS WHEREAS, the City of Fort Worth ("City") and Licensee made and entered into City Secretary Contract No. 41533 on March 7, 2011, Texas (the "Agreement") to authorize the use of right-of-way for the construction of a stonewall, fountain feature, filter/pump equipment, watering system, electrical system and other improvements to be located in the public right-of-way; and WHEREAS, the Agreement was amended on May 24, 2011 in City Secretary Contract No. 41533-A1 filed as Instrument No to revise the location of the encroachments and to provide a notification clause; and WHEREAS, the parties wish to amend the Agreement to include an additional 11 feet of encroachment; and WHEREAS, it advisable to execute this Amendment to the Agreement to revise the exhibit in the Agreement to depict the additional encroachment area; 0 C-4 NOW THEREFORE, City and Licensee, acting herein by and through their duly Q authorized representatives, enter into the following that amends the Agreement: 0 U-1 U-1 1• OFFICIAL kI:CORD L-) CITY SECRETARY Second Amendment to CSC No.41533 Page 1 of 3 Lake Country Property Owners Association FT.WORTH,TX w Exhibit A is hereby replaced with Exhibit A-1 attached hereto and incorporated herein to the Agreement, consisting of a revised description of the encroaching improvements. 2. All other provisions of the Agreement which are not expressly amended herein shall remain in full force and effect EXECUTED on this the jkday of 01AY ' 2015. CITY OF FOR WORTH: NO M&C REQUIRED Candle Ha4id Director, Deyrtment of Planning and Development Approved as to Form and Legality: �Q ° Attested by: 0 V 0M ° Paige M ane °� ary J. K r Assistant City AttorneyX�S° City Secretary LAKE COUNTRY PROPERTY OWNERS ASSOCIATION: By: f'> -- xW/, Printed Name: Brian Munk Title: President OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX Second Amendment to CSC No.41533 Page 2 of 3 Lake Country Property Owners Association STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Randle Harwood, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of the CITY OF FORT WORTH, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of 015. CASSANDRA F. FOREMAN t Notary public,state at Texas Comtnission Expires Atli 26, 2017 aj otary Public, State of Texas STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Brian Munk, President, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of President of Lake Country Property Owners Association, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this ,� day of U , 2015. ..........A...........A.,.,.......... ao~PPY P�� LAURA ANN SMITH C�� , 1 My Commission Expires OF November 14,2018 Notary Public, State of Texas Second Amendment to CSC No.41533 Page 3 of 3 Lake Country Property Owners Association Boat Club Rd. w - ------ ------------------------- -------- s OC I. c 79 LM AWN a df W � a a: O � cn ' ` o t N 1 N Z --1� W W ' cti Qo .° � 41 W Q N#� t O oL �CG 8 BOLS x UES c 0Y ° � a CW W L. .c a Q > Z E .. ® DATE(MM/DDIYYYY) AC OR[� CERTIFICATE OF LIABILITY INSURANCE 03/31/2015 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 terms 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: Trent Sharp Trent Sharp FAX ac Nn o Ext): 469-221-7933 (A1C,No): 3939 Belt Line Road#650 ADDRESS: trent.sharp@phly.com INSURER(S)AFFORDING COVERAGE NAIC# Addison TX 75001 INSURER A: PHILADELPHIA INDEMNITY INSURANCE CO. 18058 INSURED INSURER B; Lake Country Property Owners Association INSURER C: 8051 Boat Club Road#121 INSURER D: INSURER E: Fort Worth TX 76179-3181 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 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. AUULLTR INSR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 100,000 CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ 5,000 C00001 (12/07) X PHPK1034336 07/15/2014 07/15/2015 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO $ )ECT LOC AUTOMOBILE LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNEDFHUHLHIYUAMAUE $ HIREDAUTOS AUTOS (Per accident) b UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WA U- TH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ OFFICEWMEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,K more space is required) REAL ESTATE DEVELOPMENT PROPERTY SITUATED AT INTERSECTION AT BOAT CLUB RD AND LAKE COUNTRY DRIVE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Worth THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Planning and Development Department ACCORDANCE WITH THE POLICY PROVISIONS. 1000 Throckmorton AUTHORIZED REPRESENTATIVE Fort Worth TX 76102 As per signature on file with the company. ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD