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HomeMy WebLinkAbout2005-029ORDINANCE NO. ,MP "D,2,% AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORKS CONTRACT FOR THE CONSTRUCTION OF SIDEWALKS FOR THE CITY OF DENTON; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFORE; AND PROVIDING AN EFFECTIVE DATE (BID 3272-PRAIRIE, CRAWFORD, PAISLEY SIDEWALKS AWARDED TO FLOYD SMITH CONCRETE, INC. IN THE AMOUNT OF $162,145.18). WHEREAS, the City has solicited, received and tabulated competitive bids for the construction of public works or improvements in accordance with the procedures of STATE law and City ordinances; and WHEREAS, the City Manager or a designated employee has received and recommended that the herein described bids are the lowest responsible bids for the construction of the public works or improvements described in the bid invitation, bid proposals and plans and specifications therein; NOW, THEREFORE, THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS: SECTION 1. That the following competitive bids for the construction of public works or improvements, as described in the "Bid Invitations", 'Bid Proposals" or plans and specifications on file in the Office of the City's Purchasing Agent filed according to the bid number assigned hereto, are hereby accepted and approved as being the lowest responsible bids: BID NUMBER CONTRACTOR AMOUNT 3272 Floyd Smith Concrete, Inc. $162,145.18 SECTION 2. That the acceptance and approval of the above competitive bids shall not constitute a contract between the City and the person submitting the bid for construction of such public works or improvements herein accepted and approved, until such person shall comply with all requirements specified in the Notice to Bidders including the timely execution of a written contract and furnishing of performance and payment bonds, and insurance certificate after notification of the award of the bid. SECTION 3. That the City Manager is hereby authorized to execute all necessary written contracts for the performance of the construction of the public works or improvements in accordance with the bids accepted and approved herein, provided that such contracts are made in accordance with the Notice to Bidders and Bid Proposals, and documents relating thereto specifying the terms, conditions, plans and specifications, standards, quantities and specified sums contained therein. SECTION 4. That upon acceptance and approval of the above competitive bids and the execution of contracts for the public works and improvements as authorized herein, the City Council hereby authorizes the expenditure of funds in the manner and in the amount as specified in such approved bids and authorized contracts executed pursuant thereto. SECTION S. That this ordinance shall become effective immediately upon its passage and approval. PASSED AND APPROVED this the I day of aQAa:d�12005. 3 Q EULIl BROCK, MAYOR ATTEST: JENNIFER WALTERS, CITY SECRETARY BY: APPROVED AS TO LqGAL FORM: HERBERT L. PRWT , CITY ATTORNEY BY: 3-ORD-Bid vrferm-�, • CONTRACT AGREEMENT STATE OF TEXAS § COUNTY OF DENTON § THIS AGREEMENT, made and entered into this 18th day of January A.D., 2005, by and between City of Denton of the County of Denton and State of Texas, acting through Michael A. Conduff thereunto duly authorized so to do, hereinafter termed "OWNER," and Floyd Smith Concrete, Inc. Denton, TX 76202 of the City of Denton , County of Denton and State of Texas hereinafter termed "CONTRACTOR." WITNESSETH: That for and in consideration of the payments and agreements hereinafter mentioned, to be made and performed by OWNER, and under the conditions expressed in the bonds attached hereto, CONTRACTOR hereby agrees with OWNER to commence and complete performance of the work specified below: Bid #3272 — Prairie Crawford and Paisley Street Sidewalks in the amount of $162,145.18 and all extra work in connection therewith, under the terms as stated in the General Conditions of the agreement; and at his (or their) own proper cost and expense to furnish all materials, supplies, machinery, equipment, tools, superintendence, labor, insurance, and other accessories and services necessary to complete the work specified above, in accordance with the conditions and prices stated in the Proposal and the Performance and Payment Bonds, attached hereto, and in accordance with all the General Conditions of the Agreement, the Special Conditions, the Notice to Bidders (Advertisement for Bids), and Instructions to Bidders, as referenced herein and on file in the office of the Purchasing Agent, and in accordance with the plans, which includes all maps, plats, blueprints, and other drawings and printed or written explanatory matter thereof, and the Specifications therefore, as prepared by: City of Denton Eneineering Department all of which are referenced herein and made a part hereof and collectively evidence and constitute the entire contract. CA-1 Independent Status It is mutually understood and agreed by and between City and Contractor that Contractor is an independent contractor and shall not be deemed to be or considered an employee of the City of Denton, Texas, for the purposes of income tax, withholding, social security taxes, vacation or sick leave benefits, worker's compensation, or any other City employee benefit. City shall not have supervision and control of Contractor or any employee of Contractor, and it is expressly understood that Contractor shall perform the services hereunder according to the attached specifications at the general direction of the City Manager of the City of Denton, Texas, or his designee under this agreement. Indemnification Contractor covenants and agrees to and does hereby indemnify, hold harmless and defend, at its own expense, Owner, its officers, servants and employees, from and against any and all claims or suits for property loss or damage and/or personal injury, including death, to any and all persons, of whatsoever kind or character, whether real or asserted, arising out of the Work and services to be performed hereunder by Contractor, its officers, agents, employees, subcontractors, licensees or invitees, whether or not caused, in whole or in part, by the alleged negligence of the officers, servants, employees, of the Owner. Contractor likewise covenants and agrees to, and does hereby, indemnify and hold harmless Owner during the performance of any of the terms and conditions of this Contract, whether arising out of in whole or in part, any and all alleged acts or omissions of officers, servants, or employees of Owner. The provisions of this paragraph are solely for the benefit of the parties hereto and not intended to create or grant any rights, contractual or otherwise, to any other person or entity. Choice of Law and Venue This agreement shall be governed by the law of the State of Texas and venue for its construction and enforcement shall lie in the courts of Denton County, Texas. The CONTRACTOR hereby agrees to commence work on or after the date established for the start of work as set forth in written notice to commence work and complete all work within the time stated in the Proposal, subject to such extensions of time as are provided by the General and Special Conditions. The OWNER agrees to pay the CONTRACTOR in current funds the price or prices shown in the Proposal, which forms a part of this contract, such payments to be subject to the General and Special Conditions of the Contract. CA-2 IN WITNESS WHEREOF, the parties of these presents have executed this agreement in the year and day first above written. ATTEST: ATTEST: C�A� &V:: / rn�i fc e _ f-_ APPROVED -TO F CITY ATTORNE CA-3 w2zlzol �% (SEAL) F51 o d Lan t-I-k l,o-Aaraje TA e--, CONTRACTOR ;P.o. Boxa��l MAILING ADDRESS PHONE NUMBER "811.0 U'V Jill r ..V (SEAL) POWER OF ATTORNEY xx,1I Know All Men by These Presents: (Irrevocable) _ ""�_ No. SP- That this Power of Attorney is not valid or in effect unless allached to the bond which it authorizes executed, but may be detached by thapproving officer if desired. That Western Surety Cora any, a corporation, does hereby make, constitute and appoint the following THREE 1 3 1 authorized individuals: LATHY MILLER „ JAMES EDWARD KING" JEFFREY PARKS K114G;; `l., .t in the City of DENTON State of TEXAS , with limited authority, its true and lawful Attorney(s) in fact with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, the following described bond: BID PERFORMANCE, AND/OR PAYMENT BOND IN ADDITION THE RELATED TRANSACTIONS SUCH AS CONSENTS OF SURETY, RIDERS, AND LETTERS OF INTENT MAINTENANCE AND WARRANTY BONDS PROVIDING THE BOND PENALTY DOES NbT EXCEED FIVE MILLION AND NO/106 DOLLARS (**5 0130 000.00).✓ ********************************************************************** The acknowledgment and execution of such bond by the said Attorney in Fact shall be as binding upon this Company as if such bond had been executed and acknowledged by the regularly elected officers of this Company. All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of DECEMBER 31 2007 but until such time shall be irrevocable and in full force and effect. WESTERNiBUR)ETY,'Cp_MPANY�PGrther certifies that the following is a we and exact copy of Section 7 of the By -Laws of Western Surety Company, duly adopted and now in forcen°fo3viLtis"S tien 7'aAg bonds, policies, undertakings, Powers of Attorney, or other obligations of the co shall be executed in the co am, name of the Company by Ilse Presiden i,'SecPetery��eny Assistant Secretary, Treasureq or any Vice President, or by such other officers as the Board of Directors may authorirx. The President, any Vice Presde'n ',:Secretazy; any�Assistaot'Secretary, or the Treasurer may appoint Attomey. in Fact or Agents who shall have authority to issue bonds, policies, or undertakings m the name"df`theCompzn`y:HT^he_coipotule seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attomey or other obligattons of the corporation. The stgtta�lrte�F.any such officer. eddyN corpomta seal may be printed by facsimile." ® pn3L'c penal amount of the b,andtiierein described may be increased if there is attached to this Power, written authority so authorivng in the form of an endorsement, letter or I$teeam stened by the Senior Undb[vnidng Officer, Underwriting Officer, President, Vice President, Assistant Vice President, Treasurer, Secretary or Assistant Secretary of Westem b,,P ITNESS WIa3REOF Westem Surety Company has caused these presents to be executed by its Senior Vice President with its corporate seal affixed Ws 1st day of,. �f°'` �jjp � 2002 WESTE N SURETY COMPANY -�a���MaBaa+nrDao o ""a� STATE OF SOUTH DAKOTA as. BY COUNTY OF MINNEHAHA I Senior Vice Pr dent Dn. this Ist day of April in the year 2002 , before me, a Notary Public. persu,.aHy appeared Paul T. Bmnat who being by me duly swum, acknowledged that he signed the above Power of Attorney as the aforesaid officer of WESTERN SURETY COMPANY -and - acknowledged said instrument to be the voluntary act and deed of said corporation. / i D. KRELL • /}Lc�Tf//� - /IddiC,/, ///, _ L morARY PUBLIC(R— SOUTH DAKCTA Notary Public, South Dakota My Commission Expires November 30, 2005 1, the undersigned officer of Westem Surety Company, a stock corporation of the State of South Dakota, do hereby crnify that the attached Power of Attorney is in full fume and effect and is irrevocable', and furthermore, that Section 7 of the By -Laws of the company as set forth in th Power of Attom ,.is now in force. l!����y.,-_,, In testimony whereof, I have hereunto set my hand and the seal of Western Surety Company this .- 11( � day of Qii,l1r WESTE SURETY UOMPANY *IMORTANT: This date must be filled in before it is attached 1' to thPe bond and it must be the same date as the bond. By / �r Form 749-4-2002 Senior Vice Pre ent NOTICE: This border must be BLUE. It it is not BLUE, this is not a caddied copy. 77 PERFORMANCE BOND STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That Flovd Smith Concrete. Inc. whose ad ess is PO Box 1781 Denton T 6202 hereinafter called Principal, and ,lyy\C n a corporation organized and existing under the laws of the State o I PiCGI` , and flilly authorized to transact business in the State of Texas, as Surety, are held and firmly bound unto the City of Denton, a municipal corporation organized and existing under the laws of the State of Texas, hereinafter called wrier, in the penal sum of One h ed six two thousand one hundred fort five and 18/100 ✓/ DOLLARS (J1UJ45.l8)161us ten percent of the stated penal sum as an additional sum of money representing additional court expenses, attorneys' fees, and liquidated damages arising out of or connected with the below identified Contract, in lawful money of the United States, to be paid in Denton County, Texas, for the payment of which sum well and truly to be made, we hereby bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. This Bond shall automatically be increased by the amount of any Change Order or Supplemental Agreement, which increases the Contract price, but in no event shall a Change Order or Supplemental Agreement, which reduces the Contract price, decrease the penal sum of this Bond. THE OBLIGATION TO PAY SAME is conditioned as follows: Whereas, the Principal entered into a certain Contract, identified by Ordinance Number 200� with the City of Denton, the Owner, dated the 18th day of January A.D. 2005, copy of which is hereto attached and made a part hejebf, for Bid #3272 — Prairie. Crawford, and Paisley Street Sidewalks NOW, THEREFORE, if the Principal shall well, truly and faithfully perform and fulfill all of the undertakings, covenants, terms, conditions and agreements of said Contract in accordance with the Plans, Specifications and Contract Documents during the original term thereof and any extension thereof which may be granted by the Owner, with or without notice to the Surety, and during the life of any guaranty or warranty required under this Contract, and shall also well and truly perform and fulfill all the undertakings, covenants, terms, conditions and agreements of any and all duly authorized modifications of said Contract that may hereafter be made, notice of which modifications to the Surety being hereby waived; and, if the Principal shall repair and/or replace all defects due to faulty materials and workmanship that appear within a period of one (1) year from the date of final completion and final acceptance of the Work by the Owner; and, if the Principal shall fully indemnify and save harmless the Owner from all costs and damages which Owner may suffer by reason of failure to so perform herein and shall fully reimburse and repay Owner all outlay and expense which the Owner may incur in making good any default or deficiency, then this obligation shall be void; otherwise, it shall remain in full force and effect. PROVIDED. FURTHER, that if any legal action be filed upon this Bond, exclusive venue shall he in Denton County, State of Texas. AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc., accompanying the same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc. This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government Code, as amended, and any other applicable statutes of the State of Texas. The undersigned and designated agent is hereby designated by the Surety herein as the Resident Agent in Denton County to whom any requisite notices may be delivered and on whom service of process may be had in matters arising out of such suretyship, as provided by Article 7.19- 1 of the Insurance Code, Vernon's Annotated Civil Statutes of the State of Texas. IN WITNESS WHEREOF, this instrument is executed in 4 copes, each one of which shall be deemed an original, this the N4day o , cl-LD51/ . ATTEST: SECRETARY Floi.d BY: PRESIDPRTV/ ATTEST: SURETY R � BY: I, BY: a SE•kl(Y�) ATTORNEY- -FACT The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: �i�lMM0 , --� STREET ADDRESS: (NOTE: Date of Performance Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name.) HIM PAYMENT BOND STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That , whose address is PC hereinafter called Principal, and Va corporation organized and existing under the laws of the State of , and fully authorized to transact business in the State of Texas, as Surety, are held and finely bound unto the City of Denton, a municipal corporation organized and existing under the laws of the State of Texas, hereinafter called Owner, and unto all persons, firms, and corporations who may fiunish materials for, or perform labor upon, the building or improvements hereinafter referred to, in a penal sum of One hundre�slxty two thousand one hundred fortv five and 18/100 DOLLARS ($162.145.18� ifi lawful money of the United States, to be paid in Denton, County, Texas, for the payment of which sum well and truly to be made, we hereby bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. This Bond shall automatically be increased by the amount of any Change Order or Supplemental Agreement which increases the Contract price, but in no event shall a Change Order or Supplemental Agreement which reduces the Contract price decrease the penal sum of this Bond. THE OBLIGATION TO PAY SAME is conditioned as follows: Whereas, the Principal entered into a certain Contract, identified by Ordinance Number 200�5 29 , with the City of Denton, the Owner, dated the 18th day of January A.D. 2005%/a copy of which is hereto attached and made a part hereof, for Bid #3272 — Prairie. Crawford. and Paisley Street Sidewalks NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties and make prompt payment to all persons, firms, subcontractors, corporations and claimants supplying labor and/or material in the prosecution of the Work provided for in said Contract and any and all duly authorized modifications of said Contract that may hereafter be made, notice of which modifications to the Surety being hereby expressly waived, then this obligation shall be void; otherwise it shall remain in fall force and effect. PROVIDED FURTHER, that if any legal action be filed on this Bond, exclusive venue shall lie in Denton County, Texas. AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc., accompanying the same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc. This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government Code, as amended, and any other applicable statutes of the State of Texas. The undersigned and designated agent is hereby designated by the Surety herein as the Resident Agent in Denton County to whom any requisite notices may be delivered and on whom service of process may be had in matters arising out of such surety, as provided by Article 7.19-1 of the Insurance Code, V emon's Annotated Civil Statutes of the State of Texas. IN WITNESS WHEREOF, this instrument is executed in 4 codes, each one of which shall be deemed an original, this theday o�>/ ATTEST: SECRETARY ATTEST: P I ou/A S-/-g i 4-G,, 0 Liio BY: ( "1664 i- PRES NT / SURETY i The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: S � � : � 1 � ,1�• III (NOTE: Date of Payment Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name) CITY OF DENTON INSURANCE REQUIREMENTS FOR CONTRACTORS Bidder's attention is directed to the insurance requirements below. It is highly recommended that bidders confer with their respective insurance carriers or brokers to determine in advance of Bid submission the availability of insurance certificates and endorsements as prescribed and provided herein. If an apparent low bidder fails to comply strictly with the insurance requirements, that bidder may be disqualified from award of the contract. Upon bid award, all insurance requirements shall become contractual obligations, which the successful bidder shall have a duty to maintain throughout the course of this contract. STANDARD PROVISIONS: Without limiting any of the other obligations or liabilities of the Contractor, the Contractor shall provide and maintain until the contracted work has been completed and accepted by the City of Denton, Owner, the minimum insurance coverage as indicated hereinafter. As soon as practicable after notification of bid award, Contractor shall file with the Purchasing Department satisfactory certificates of insurance, containing the bid number and title of the project. Contractor may, upon written request to the Purchasing Department, ask for clarification of any insurance requirements at any time; however, Contractors are strongly advised to make such requests prior to bid opening, since the insurance requirements may not be modified or waived after bid opening unless a written exception has been submitted with the bid. Contractor shall not commence any work or deliver any material until he or she receives notification that the contract has been accepted, approved, and signed by the City of Denton. All insurance policies proposed or obtained in satisfaction of these requirements shall comply with the following general specifications, and shall be maintained in compliance with these general specifications throughout the duration of the Contract, or longer, if so noted: Each policy shall be issued by a company authorized to do business in the State of Texas with an A.M. Best Company rating of at least A. Any deductibles or self -insured retentions shall be declared in the bid proposal. If requested by the City, the insurer shall reduce or eliminate such deductibles or self -insured retentions with respect to the City, its officials, agents, employees and volunteers; or, the contractor shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. • Liability policies shall be endorsed to provide the following: •• Name as additional insured the City of Denton, its Officials, Agents, Employees and volunteers. •• That such insurance is primary to any other insurance available to the additional insured with respect to claims covered under the policy and that this insurance applies separately to each insured against whom claim is made or suit is brought. The inclusion of more than one insured shall not operate to increase the insurer's limit of liability. • All policies shall be endorsed to read: SAID POLICY SHALL NOT BE CANCELLED, NONRENEWED OR MATERIALLY CHANGE WITHOUT 30 DAYS ADVANCED WRITTEN NOTICE BEING GIVEN TO THE OWNER (CITY) EXCEPT WHEN THE POLICY IS BEING CANCELLED FOR NONPAYMENT OF PREMIUM IN WHICH CASE 10 DAYSADVANCE WRITTENNOTICE IS REQUIRED". • Should any of the required insurance be provided under a claims -made form, Contractor shall maintain such coverage continuously throughout the term of this contract and, without lapse, for a period of three years beyond the contract expiration, such that occurrences arising during the contract term which give rise to claims made after expiration of the contract shall be covered. • Should any of the required insurance be provided under a form of coverage that includes a general annual aggregate limit providing for claims investigation or legal defense costs to be included in the general annual aggregate limit, the Contractor shall either double the occurrence limits or obtain Owners and Contractors Protective Liability Insurance. • Should any required insurance lapse during the contract term, requests for payments originating after such lapse shall not be processed until the City receives satisfactory evidence of reinstated coverage as required by this contract, effective as of the lapse date. If insurance is not reinstated, City may, at its sole option, terminate this agreement effective on the date of the lapse. SPECIFIC ADDITIONAL INSURANCE REQUIREMENTS: All insurance policies proposed or obtained in satisfaction of this Contract shall additionally comply with the following marked specifications, and shall be maintained in compliance with these additional specifications throughout the duration of the Contract, or longer, if so noted: [x] IN A. General Liability Insurance: General Liability insurance with combined single limits of not less than 50$ 0,000 shall be provided and maintained by the Contractor. The policy shall be written on an occurrence basis either in a single policy or in a combination of underlying and umbrella or excess policies. If the Commercial General Liability form (ISO Form CG 0001 current edition) is used: • Coverage A shall include premises, operations, products, and completed operations, independent contractors, contractual liability covering this contract and broad form property damage coverage. Coverage B shall include personal injury. Coverage C, medical payments, is not required. If the Comprehensive General Liability form (ISO Form GL 0002 Current Edition and ISO Form GL 0404) is used, it shall include at least: Bodily injury and Property Damage Liability for premises, operations, products and completed operations, independent contractors and property damage resulting from explosion, collapse or underground (XCLI) exposures. Broad form contractual liability (preferably by endorsement) covering this contract, personal injury liability and broad form property damage liability. Automobile Liability Insurance: Contractor shall provide Commercial Automobile Liability insurance with Combined Single Limits (CSL) of not less than $300,000 either in a single policy or in a combination of basic and umbrella or excess policies. The policy will include bodily injury and property damage liability arising out of the operation, maintenance and use of all automobiles and mobile equipment used in conjunction with this contract. Satisfaction of the above requirement shall be in the form of a policy endorsement for: any auto, or all owned, hired and non -owned autos. [X] Workers Compensation Insurance Contractor shall purchase and maintain Worker's Compensation insurance which, in addition to meeting the minimum statutory requirements for issuance of such insurance, has Employer's Liability limits of at least $100,000 for each accident, $100,000 per each employee, and a $500,000 policy limit for occupational disease. The City need not be named as an "Additional Insured" but the insurer shall agree to waive all rights of subrogation against the City, its officials, agents, employees and volunteers for any work performed for the City by the Named Insured. For building or construction projects, the Contractor shall comply with the provisions of Attachment 1 in accordance with §406.096 of the Texas Labor Code and rule 28TAC 110.110 of the Texas Worker's Compensation Commission (TWCC). [ ] Owner's and Contractor's Protective Liability Insurance The Contractor shall obtain, pay for and maintain at all times during the prosecution of the work under this contract, an Owner's and Contractor's Protective Liability insurance policy naming the City as insured for property damage and bodily injury which may arise in the prosecution of the work or Contractor's operations under this contract. Coverage shall be on an"occurrence" basis, and the policy shall be issued by the same insurance company that carries the Contractor's liability insurance. Policy limits will be at least combined bodily injury and property damage per occurrence with a aggregate. [ ] Fire Damage Legal Liability Insurance Coverage is required if Broad form General Liability is not provided or is unavailable to the contractor or if a contractor leases or rents a portion of a City building. Limits of not less than each occurrence are required. [ ] Professional Liability Insurance Professional liability insurance with limits not less than per claim with respect to negligent acts, errors or omissions in connection with professional services is required under this Agreement. [ ] Builders' Risk Insurance Builders' Risk Insurance, on an All -Risk form for 100% of the completed value shall be provided. Such policy shall include as "Named Insured" the City of Denton and all subcontractors as their interests may appear. [ ] Commercial Crime Provides coverage for the theft or disappearance of cash or checks, robbery inside/outside the premises, burglary of the premises, and employee fidelity. The employee fidelity portion of this coverage should be written on a "blanket" basis to cover all employees, including new hires. This type insurance should be required if the contractor has access to City funds. Limits of not less than each occurrence are required. [ ] Additional Insurance Other insurance may be required on an individual basis for extra hazardous contracts and specific service agreements. If such additional insurance is required for a specific contract, that requirement will be described in the "Specific Conditions" of the contract specifications. [X] Worker's Compensation Coverage for Building or Construction Projects for Governmental Entities A. Defmitions: Certificate of coverage ("certificate") -A copy of a certificate of insurance, a certificate of authority to self -insure issued by the commission, or a coverage agreement (TWCC- 81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation insurance coverage for the person's or entity's employees providing services on a project, for the duration of the project. Duration of the project - includes the time from the beginning of the work on the project until the contractor's/person's work on the project has been completed and accepted by the governmental entity. Persons providing services on the project ("subcontractor" in §406.096) - includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project, regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees. This includes, without limitation, independent contractors, subcontractors, leasing companies, motor carriers, owner -operators, employees of any such entity, or employees of any entity which furnishes persons to provide services on the project. "Services" include, without limitation, providing, hauling, or delivering equipment or materials, or providing labor, transportation, or other service related to a project. "Services" does not include activities unrelated to the project, such as food/beverage vendors, office supply deliveries, and delivery of portable toilets. B. The contractor shall provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any overage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all employees of the Contractor providing services on the project, for the duration of the project. C. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. D. If the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project, the contractor must, prior to the end of the coverage period, file a new certificate of coverage with the governmental entity showing that coverage has been extended. E. The contractor shall obtain from each person providing services on a project, and provide to the governmental entity: (1) a certificate of coverage, prior to that person beginning work on the project, so the governmental entity, will have on file certificates of coverage showing coverage for all persons providing services on the project; and (2) no later than seven days after receipt by the contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project. F. The contractor shall retain all required certificates of coverage for the duration of the project and for one year thereafter. G. The contractor shall notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the contractor knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project. H. The contractor shall post on each project site a notice, in the text, form and manner prescribed by the Texas Workers' Compensation Commission, informing all persons providing services on the project that they are required to be covered, and stating how a person may verify coverage and report lack of coverage. I. The contractor shall contractually require each person with whom it contracts to provide services on a project, to: (1) provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all of its employees providing services on the project, for the duration of the project; (2) provide to the contractor, prior to that person beginning work on the project, a certificate of coverage showing that coverage is being provided for all employees of the person providing services on the project, for the duration of the project; (3) provide the contractor, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (4) obtain from each other person with whom it contracts, and provide to the contractor: (a) a certificate of coverage, prior to the other person beginning work on the project; and (b) a new certificate of coverage showing extension of coverage, prior to the end of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (5) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (6) notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and (7) contractually require each person with whom it contracts, to perform as required by paragraphs (1) - (7), with the certificates of coverage to be provided to the person for whom they are providing services. J. By signing this contract or providing or causing to be provided a certificate of coverage, the contractor is representing to the governmental entity that all employees of the contractor who will provide services on the project will be covered by workers' compensation coverage for the duration of the project, that the coverage will be based on proper reporting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carver or, in the case of a self - insured, with the commission's Division of Self -Insurance Regulation. Providing false or misleading information may subject the contractor to administrative penalties, criminal penalties, civil penalties, or other civil actions. K. The contractor's failure to comply with any of these provisions is a breach of contract by the contractor which entitles the governmental entity to declare the contract void if the contractor does not remedy the breach within ten days after receipt of notice of breach from the governmental entity. ' 1J15u.IU'LVV4 VY:11 Y4V 04Y IJV4 ul" vc DtAx'ViN ruAln^0114b $04tl! e.uV4/Vun BID #3272 ADDENDUM #1 Addendum #1 to be returned with Bid Proposal The attached pages are changes to the bid specifications. NO OTHER CHANGES AT THIS TIME. This form shall be signed and returned with your bid Name: f0 Signature: I t Company: Flo" 5in A Title: _ re-51 i41e4-f Date: J6u. 1V'ZUV4 VY:1L Y4U 04Y IBVL 41'1L ur LGM'1VIN euAVn. 114b V040! Y.VVWuV0 Project Name: Prairie, Crawford and Paisley Street Sidewalks Work Days 00 BM No. 3272 ATTACHMENT 1-AD7: BID TABULATION SHEET P.O. No. Xtem Deaeri tion I Quantity juaftl Unit Price Total 1.21 Contractors Warranties and Understandings 1 LS $ T LS $ -3, 3 9,5 Unit Price In Words 11 ✓die oag�va #regehf vO/Bvdo I 3-8 joutter Remove and Disposo of Concrete Curb & 1 250 LF IS / LF Is SD Unit Price In words Seri 4td o%oo d o //2 r5 3-C Remove Concrete Sidewalks and Driveways 450 SY $ 010,12 / SY Isq,m b Unit Price In Words-rwPatf o �00 dv// rs 3.1jj; o� oration of Righi of Wa t LS $ $9O J LS $ / DO ' Unit Price In Words - e aid/ q",L DO/oa dollaf " 3.3 Unclassified Bxcavation 335 CY IS o/ CY $ 69 Unit Price In Words EPeen °%a d01/4/5 3.7 lCompacted. Fill / Emabnkment 170 CY s c1j 'r CX $ asU Unit Price it Words TGFC/1 d o Ila f s 3.9 Block Sod 1 775 1 SY S -"'/ SY Unit Price In Words b �,6/00 610 lla r5 3.12 Tem orary Erostm Control 1 I LS IS 0 O�TLS $ lO Unit Price In Words 2n "d B911Op d ® ar'S 5.7-A, Plans sphalt Pavement Construction In Paisley Street Per Detail 120 SY o0 S t SY is 1,100M Unit Price In Words 4` oo r0 o 1/dr5 5.7-B Asphalt Pavement Patch Material C) 32 a TN IS T14 IS 5 Unit Prioe In Words 1 r80 el r$ 8.l Barricades, Warning Signs and Detours I I LS 06 S LS eo- S ,q Unit PricelnWotds g6L 1v2 r %� �%ioo dP /4i'S 8.2-A Concrete Curb and Gutter 220 LF s Sop / LF $ 33�V / Unit Price lnWords /-1 eri � `//oo doll4r.5 t1.2-A, Plans Concrete Curb At Edge Of Sidewalk 85 LF $ / LF ow $ /% Unit Price In Words e Ltd- w/r00 do11ag sP-100, Plans Cow. Retaining Wall At Edge Of Sidewalk 550 SF q s gee / SF $ Unit Price In Words Ff + 4hd, 4%o0 4r5 P.3 1JnU.1u'ZUU4 UY:IZ You e4Y IJUZ OITY OF ➢ENTON PURCHASING #6487 P.0061006 Project Name: Prairie, Crawford and Paisley Street Sidewalks Work Days 60 Bid No. 3272 ATTACHMENT I-AD7: BID TABULATION SHEET P.O. No. Item IDescription uantlty junitl Unit Price I Total 8.3 brivewa 6" 650 SY S 3t °O/ SY 3,25 �tYI Unit Rice In Words oemgig 8.3A-7 4" Concrete Sidewalk - Standard I Ss0 SY s 30' °p I SY I S Unit Price In Words r o//0o 'd 3.3A-3 4" Concrete Sidewalk - Curb Return Ramp Type I M EA S OO.s -7 EA S O pS °O UnitHce In Words °Oioo 8.3A-3 4" Concrete Sidewalk - Curb Return Ramp T e II 2 . EA co IS 0FA is 4SY0 4'I. Unit Price InWOrda o4&oamnelAggh LtAA r se V& cto dvllqj,3 8.3A-3 4" Concrete Sidewalk - Curb Return Ramp Type TH I 1 010 I EA IS 042149 rEA $ 4.2'J0 Unit Price In Words Two 4 na.,5,4*0o A r< A4 red Se ve d- b%ivo Ball arS O SP-2 ConcreteSawcut 450 LF S °lILF $ IffA9 // Unit Price In Words LL r 4`d 09400 ,• ° t 14tf $ F SP-27 Service AdjuAments 28 BA S 4q.2 747EA S /3 ff Unit Price In WordsFour h i ik a//+zv0 Nio0 d vilai"S SP-39 Project Signs 1 2 EA S SEA S /D // Unit MCC In Words l✓ e, ug'Ot ft � '90/i°O dollgfts SP-43 jAsphalt Saw Cut 1 1000 1 LF S �f LF S / 50 Unit Price In Words lone /'DO d. NCTCOO 8.15 Grouted Stone Kip to 20 5Y S O SY S / ©� Unit Price In Words g•vl 4�4 00/ma dolurs 8A3 Remove, Relocate and Reconstruct xWing 8' High Chain Link Fence Using Existing Fence Materials 602 LF IS 5,Og / LFIs 92 Unit Price In Words Three- `kW �/DO 4,9 / Q TOTALbehuAdf rd y l agagid B n G SIIO ItFS toffy- F1✓e `W 1, Avo do//4/-5 P-4 uff lulu 4 TOTAL BASE BID PRICE IN WORDS OAe h tt4dred S 1 4JL64 -1W v �Gt ousa ore ccnc�ye� fu -f v� ��/o® Ja1141-5 In the event of the award of a contract to the undersigned, the undersigned will furnish a performance bond and a payment bond for the full amount of the contract, to secure proper compliance with the terms and provisions of the contract, to insure and guarantee the work until final completion and acceptance, and to guarantee payment for all lawful claims for labor performed and materials furnished in the fulfillment of the contract. ► It is understood that the work proposed to be done shall be accepted, when fully completed and finished in accordance with the plans and specifications, to the satisfaction of the Engineer. 1 The undersigned certifies that the bid prices contained in this proposal have been carefully checked and are submitted as correct and final. Unit and lump sum prices as shown for each item listed in this proposal, shall control over extensions. The undersigned agrees this bid becomes the property of the City of Denton after the official opening. The undersigned affirms that they are duly authorized to execute this contract. Vendor hereby assigns to purchaser any and all claims for overcharges associated with this contract which arise under the antitrust laws of the United States, 15 USCA Section 1 et seq., and which arise under the antitrust laws of the State of Texas, Tex. Bus. & Com. Code, Section 15.01, et seq. law Receipt is hereby acknowledged of the following addenda to the plans and specifications: Addendum No. 1 dated . i 9-&T- O c/ Received /�VLI O,O c/ Addendum No. 2 dated Received Addendum No. 3 dated Addendum No. 4 dated Addendum No. 5 dated CONTPACTOR BY Received Received Received /sr/9 lfJlllOcyu�ood Street Address b"` rx , Ty - City and State Seal & Authorization (If a Corporation) 9 (fO - S - O // Telephone NMI VENDOR COMPLIANCE TO STATE LAW The 1985 Session of the Texas Legislature passed House Bill 620 relative to the award of contracts to non-resident. bidders. This law provides that, in order to be awarded a contract as low bidder, non-resident bidders (out-of-state contractors whose corporate offices or principal place of business are outside of the State of Texas) bid projects for construction, improvements, supplies or services in Texas at an amount lower tban. the lowest Texas resident, bidder by the same amount that a Texas resident bidder would be required to underbid a non-resident bidder in order to obtain a comparable contract in the state in which the non-resident's principal place of business is located. The appropriate blanks in Section A below must be filled out by all out-of-state or non-resident bidders in order for your bid to meet specifications. The failure of out-of-state or non-resident contractors to do so will automatically disqualify that bidder. Resident bidders must check the blank in Section B: A. Non-resident bidders in (give state), our principal place of business, are required to be percent lower than resident bidders by state law. A copy of the statute is attached. Non-resident bidders in (give state), our principal place of business, are not required to underbid resident bidders. B. Our principal place of business or corporate offices are in the State of Texas: 1/ Fl ig ,d ern 44 Cap&Y-ele zn, COMPANY BY %" P oi1C/ cT-19 Street Address City and State THIS FORM MUST BE RETURNED WITH YOUR BID. P-7 CONTRACTOR COMPLIANCE TO TEXAS SALES TAX CODE Comply with all requirements of the Texas Sales Tax Code. The Contractor hereby certifies that the Contract Amount is divided as follows: Materials incorporated into the Project (resold to the Owner as defined in Tax Code) All other charges and costs Total The total must equal the total amount of the Contract. CONTRACTOR: M p.o. 6ox17el l Sl `l ,tilt rl oayuma� Street Address City and State $ 12, a V, ro $_ I & 0& rg5, /9 THIS FORM SHALL BE EXECUTED AT THE TEWE OF EXECUTION OF THE CONTRACT AND SHALL BE MADE A PART OF THE CONTRACT. W U.S. DEPARTMENT OF HOUSING AD URBAN DEVELOPMENT COMMUNITY DEVELOPMENT -BLOCK GRANT PROGRAM CONTRACTOR'S CERTIFICATION CONCERNING LABOR STANDARDS AND PREVAILING WAGE REQUIREMENTS TO (Appropriate Recipieno: COMMUNITY DEVELOPMENT DIVISON I DATE % a — /6 _ D y c/o BARBARA ROSS PROJECT NUMBER B-03-MC-48-0036 PROJECT NAME Prairie, Crawford & Paisley St Sidewalks t. The undersigned, having executed a contract with THE CITY OF DENTON for the construction of the above -identified project, acknowledges that: (a) The Labor Standards provisions are included in the aforesaid contract: (b) Correction of any infractions of the aforesaid conditions, including infractions by any of his/her subcontractors and any lower tier contractors is his/her responsibility: 2. He/She certifies that: (a) Neither he/she nor any firm, partnership or association in which he/she has substantial interest is designated as an ineligible contractor by the Comptroller General of the United States pursuant to Section 5.6 (b) of the Regulations of the Secretary of Labor, PartS(29 CFR, Pans) or pursuant to Section 3(a) of the Davis -Bacon Act, as amended (40 U.S.C. 276a-2(a)). (b) No part of the aforementioned contract has been or will be subcontracted to any subcontractor if such sub- contractor or any firm, corporation, partnership or association in which such subcontractor has a substantial interest is designated as an ineligible contractor pursuant to any of the aforementioned regulatory or statutory provisions. 3. He/She agrees to obtain and forward to the aforementioned recipient within ten days after the execution of any subcontract, including those executed by his subcontractors and any lower tier subcontracts, a Subcontractor's Certification Concerning Labor Standards and Prevailing Wage Requirements executed by the subcontractors. 4. He/She certifies that: (a) The legal name and the business address of the undersigned are: Fl p ,4.5/w 'ry e&n& teTnf_. FED ID OR SS# ?S—a69-YI a� y AV, 1°1Xl,70 -RACE FJC'-xLG- 1, '�t 1/bo20a Information is optional. In the absence of a response, staff will determine race based on available information. IN The undersigned is: (CkeckOne) f(8'(A CORPORATION ORGANIZED IN THE STATE OF (2) A PARTNERSHIP (4) OTHER ORGANIZATIONS (Deccr,he) Ic) The name, title and address of the owner, partners or officers of the undersigned are: NAME I TITLE ADDRESS &/br Vrvlle, F1aud!5mi4A emu-t- '741 &5-tde'd :S, FIN u Q Sm rly Crmc(e �e 1,T� 'nnt or T pe Name of Contractor Se Efe� a f �/8 Ville, Eu/z°ss, l`x�/doo CD-4 U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT CERTIFICATION OF CONTRACTOR/SUBCONTRACTOR REGARDING EQUAL EMPLOYMENT OPPORTUNITY This certification is required pursuant to Executive Order 11246 (30 F. R. 1231-25). The implementing rules and regulations provide that any bidder or prospective contractor, or any of their proposed subcontractors, shall state as an initial part of the bid or negotiations of the contract whether it has participated in any previous contract or subcontract subject to the equal opportunity employment clause: and, s so, whether it has filed all compliance reports due under applicable instructions. Where the certification indicates that the bidder has not filed a compliance report due under applicable instructions, such bidder shall be required to submit a compliance report within seven calendar days after bid o submitted. peeing. No contract shall be awarded unless such report is Floyd 51n,. rn� 1" 0. '6X I7e/ Aewfaln t 7k- '76aa� Bidder has participated in a previous contract or subcontract subject to the Equal Opportunity Clause. Yes ❑ No r�11 2. Compliance reports were required to be filed in connection with such contract or subcontract. fVT�Yes ❑ No �1 3. Bidder has filed all compliance reports due under applicable instructions, including SF-100. JVt+ &Yes ❑ No 4. Have you ever been or are you being considered for sanction due to violation of Executive Order 11246, as amended? 0 Yes 1ztiNo NAME AND TITLE OF SIGNER (Please type) 1a- i6-o4{ DA J CD-6 A COPY OF THIS FORM MUST BE SIGNED BY EACH PROPOSED CONTRACTOR AND SUBCONTRACTOR. CERTIFICATION OF PROPOSED CONTRACTOR/SUBCONTRACTOR REGARDING SECTION 3 AND SEGREGATED FACILITIES Name of Prime Contractor or Subcontractor Prairie, Crawford and Paisley Street Sidewalks Project Name B-01-MC-48-0036 Project Number The undersigned hereby certifies that: A) Section 3 provisions are included in the Contract B) As contractor/subcontractor I agree to recruit new employees from the project neighborhood. New hires will be tracked and information submitted to the City of Denton for verification. Q NOTE: SECTION 3 COMPLIANCE INFORMATION MUST BE SUBMITTED TO THE COMMUNITYDEVELOPMENT OFFICE, 101 SOUTHLOCUSTSTREET, SUITE 500. A BREAKDOWN OF SUBCONTRACTORS MUST BE INCLUDED. D) No segregated facilities will be maintained. NAME AND TITLE OF SIGNER (PRINT OR TYPE) da�17-t /a-16-aZ-/ Date Cy►�:3 4 . ACORDn CERTIFICATE OF LIABILITY INSURANCE oiiz%z ' PRODUCER (940)382-9691 FAX (940)243-1050 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION Ramey & King Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR no North I-35 E - Denton, TX 76205 S' 2; Dana Hilliard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1 S RE AFFORDING COVERAGE NAIC # INSURED Floyd Smith Concrete, Inc P.O. Box 1781 Denton, TX 76202-1781 � R, ( 5 INSURERA Trinity Universal 19887 INSURERS: Texas Mutual Ins. Co. TXMUT INSURER C: INSURER D: INSURER E: rntroonr_ec 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR DD' 7ypE OF INSURA POLICY NUMBER PO EFFECTIVE 9/28/2QQ4 POLICY EXPIRATION LIMITS GENERALLIABILITY GLA1040046030 09/28/2005 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGETO RENTED $ 200,000 CLAIMS MADE a OCCUR MED EXP (Any one person) $ 5,000 A PERSONAL B ADV INJURY $ 1,000.000 GENERAL AGGREGATE 1 2,000.00Q GENL AGGREGATE UMIT APPLIES PER: PRODUCTS -COMPIOP AGO $ 2,000,000 POLICY j�T LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea amident) ALL OWNED AUTOS BODILY INJURY E SCHEDULED AUTOS rs (Par demean) HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Par accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO $ AUTOONLV: AGO E%CESSrUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ E $ DEDUCTIBLE g RETENTION $ WORKERS COMPENSATION AND TSF0001082227 9/28/2004 09/28/200 vv>; srATu- oTH B EMPLOYERS LIABILITY ANY PROPRIETORIPARTNEIVEXECUTIVE E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE -EA EMPLOYE $ 500,000 OFFICER(MEMBER EXCLUDED? It yea, dosalbe under SPECIAL PROVISIONS brow E.L. DISEASE -POUCY LIMIT $ 100,000 OTHER c- DEWjIIPTIONOFOPERTI9NS1L0GATI0 81V HICLES I EXCL SI NS ADDED BY ENDORS5EEMENTI1 PEC L VISIONS rolect; Prairie, Craw or , and Paisley Street STpewal�Cs aid policy shall not be cancelled, nonrenewed or materially changed without 30 days advanced written otice being given to the owner (city) except when the policy is bein ncelled for non payment of remium in which case 10 days adcanced written notice is required. ertificate holder is listed as an Additional Insured with respects to General Liability coverage City of Denton✓/ 901 B Texas Street Denton, TX 76201 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. arnanosnnni RttD FAX: nn rnron rneononnnM �oa� IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon. ACORD 25 (2001108) Mar 07 05 04:26p Holt Agency -Allstate Ins 940 566 5942 p.l D IISt te- You're in good hands. ALLSTATE COUNTY MUTUAL INSURANCE COMPANY CUSTOMER SERVICE REQUEST Home Office Irving, Texas COMMERCIAL AUTO POLICY Calendar Date 03/07/2005 Policy Number: 048637347 11/23 TEXAS BUSINESS NAME FLOYD SMITH BUSN ADDRESS : PO BOX 1781 CITY : DENTON ST: TX ZIP: 76202 HOME PHONE ( ) BUSINESS PHONE : ( 940 ) 565 - 0114 CHANGE POLICY INTEREST Dir o e: 0 Name: CITY OF DENTON BID 3272 Address: 901 B TEXAS STREET City: DENTON State: TX Zip: 76201 tnN D - ----------------------------------------------------------------------------- THIS ENDORSEMENT HAS AFFECTED THE FOLLOWING POLICY FORMS: Forms Added: TE2001A 0392 ADDITIONAL INSUREDS THIS REQUEST IS SUBJECT TO POLICY TERMS AND IS EFFECTIVE ONLY IF THE POLICY NOTED IS CURRENTLY IN FORCE EFFECTIVE 04:25 PM 03/07/2005 Notice: it is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits. POLIO'YHOLDER's ignature O igna NO: 097821 LOC: F47 940-566-2234 s ure Agent's Phone# m28531 Page 1 of 01 Feld 03 05 O5:O6p Holt Rgeno,4-811state Ins 940 5613 5942 p.2 WAII-State. Noun In good hands. \ CERTIFICATE OF INSURANCE \(� ALLSTATE INSURANCE CO ALLSTATE INDEMNITY CO _ALLSTATE LLOYD'S THIS CERTIFICATE IS ISSUED AS .A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS .............---...-,cnnencn nv mun nnnrlFS RrI nW. CERTIFICATE HOLDER NAMED INSURED Name and Address of Party to hom thisCenificau is Issued Name and Address of Insuree City ofDenton Ann: Purchasing Dept Floyd Smith Concrete Inc 901-S Texas Street P O Box 1781 Denton, TX 76201 Denton TX 76202 Bid N 3272 This is to Certify that policies of insurance listed below have been issued to the insured named above subject to the expiration date indicated below, notwithstanding any requirement, term condition of any contract or other document with respect to which this certificate my be issued or may pertain. The insurance afforded by the policies decribed heroin is subject to all the icons, exclusions, and conditions of TYPE OF icier INSURANCE AND LIMITS Each Occurrence Limit $ Physical Damage Limit Limits states: EMPLUYEK'3 .......... _..___-__ FE LIABILITY BODILY INJURY BY DISEASE $ POLICYMP�OY FACHE BODILY INJURY BY DISEASE $ IT AUTOh•IOBILELIABILITY Policy Effective Expiration Number 048637347 Date 11/23/04 Date 11/23/05 Coverage Basis Limits ANY AUTO _X_OWNED AUTO HIRED AUTOS SPECIFIEDAUTOS _X_NON-OWNED AUTO Combined Single Limit of Liability $1,000,000.00!/ _OWNED PRIVATE PASSENGER AUTOS _OWNED AUTOS OTHER THAN PRIVATE PASSENGER BODILY INJURY & PROPERTY DAMAGE EACH ACCIDENT Split Liability limits Bodily Injury Property Damage Each $ $ S S S $ Date Date EACH OCCURRENCE GENERAL AFFREGATE PRODUCTS-COMPLETED nPUP eT1nNR AC7f.REGAiE OTHER (Show Policy Enechve caPu�uo11 Number Date Date Auto Listing Attached /� � !` G/ J+ A 02/03/05 Number of days notice3� re`,hhr. Date R2853-1 `FEB=21-2005 00:03 FROM:FLOYD SMITH CONCRETE 940-565-0114 TO:3497302 P.2 (WAIIStift. ,�.W� Ww . CERTIFICATE OF INSURANCE kLLSTATE COUNTY MUTUAL INSURANCE COMPANY 10ME OFFICE - IRVING, TEXAS 75063 tereby certifies that the following insurance is in force; POLICYHOLDER POLICY NUMBER FLOYD SMITH 048637347 BAP 1 DBA FLOYD SMITH CONCRETE F PO BOX 1781 DENTON, TX 76202-1781 fhe person or organization designated below is described in the policy as: CITY OF DENTON BID 3272 901 B TEXAS STREET DENTON, TX 76201 overages designated are afforded as stated below: AS THEIR INTEREST MAY APPEAR To the person or organization stated above: This policy, as respects the interest of the loss payee, additional interested named herein, may be cancelled by the Company during the policy period bl. written notice at Its last address known to the Company. Proof of such mailing is deemed sufficient proof of such notice. This Certificate of Insurance neither affirmatively nor negatively amends, extent referred to above. BU1380-1 EFFECTIVE DATE OF CERTIFICATE 02/04/05 Y PERIOD TO 11/23/05 A.M. STANDARD TIME LIENHOLDER (Loss Payable Clause) ADDITIONAL INTERESTED PARTY ADDITIONAL INSURED CERTIFICATE HOLDER arty, additional insured or certificate holder giving such person or organization 10 days or alters the coverage afforded by the policy PAGE 1 OF 1 BU1142