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HomeMy WebLinkAbout2004-016FILE REFERENCE FORM 2004-016 X Additional File Exists Additional File Contains Records Not Public, According to the Public Records Act Other FILES Date Initials Change Order No. 1 [Approved by PUB] 05/10/04 J R Change Order No. 2 — Ordinance 2004-371 12/07/04 J R ORDINANCE NO. &Ov-0/0 AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORKS CONTRACT FOR THE CONSTRUCTION OF HICKORY CREEK BASIN SANITARY SEWER REPLACEMENTS AND LINERS; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFORE; AND PROVIDING AN EFFECTIVE DATE (BID 3107-1-HCKORY CREEK BASIN SANITARY SEWER REPLACEMENTS AND LINERS AWARDED TO CIRCLE C CONSTRUCTION IN THE AMOUNT OF $1,995,275.50). 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 3107 Circle C Construction $1,995,275.50 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 CityCouncil 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 5. That this ordinance shall become effective immediately upon its passage and approval. PASSED AND APPROVED this the day of 2004. C d eEULbTCOLAYO ATTEST: JENNIFER WALTERS, CITY SECRETARY BY: Ju--�2' APPROVED AS TO LEGAL FORM: HER13ERT L. EROUTY, VfTY ATTORNEY BY: 3-0RD-Bid 3107 CONTRACT AGREEMENT STATE OF TEXAS § COUNTY OF DENTON § THIS AGREEMENT, made and entered into this 20th day of January A.D., 2004, 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 William J. Schultz, Inc., dba Ci le "C" Construction Fort Worth, Texas 76140 of the City of Eort Worth County of Tarrant and State of Texas , hereinafter termed "CONTRACTOR." WTTNESSETH: 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 3107 — Hickory Creek Basin Sanitary Sewer Replacements & Litters in the amount of $1.,856,545.50 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 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, nify indemand 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 he 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. A TEST: ATT APPROVED AS TO FORM: CA-3 City of Denton RED,00,01" FN VA rr fflm mu - (SEAL) William J. Schultz, Inc., dba Circle "C" Construction Company CONTRACTOR i P. 0. Box 4032 Trammell Fort Worth, TX,,.76140 MAILING ADDRESS 817/293-1863 PHONE NUMBER 817/293-1957 FAX NUMBER M TITLE William J. Schultz, President PRINTED NAME (SEAL) w Bond No. 6196733 PERFORMANCE BOND STATE OF TEXAS COUNTY OF DENTON William J. Schultz, Inc., dba ✓ KNOW ALL MEN BY THESE PRESENTS: That Circle "C" Construction Company whose address is 500 W rammell Street Fort Worth, TX 76140 herein called Principle, and Safew. Insurance Company of America corporation organized, and existing under the laws of the State of WAshington and fully 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 Owner, in the penal sum of One W1 1 i on, Ei ghtfijkndred Fifty -Six Thousand,Five Hundred Forty -Five and 50/100DOLLARS 1,856,545.50 plus 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 2_W4=016, with the City of Denton, the Owner, dated the 20th day of January . A.D. 2 004 ... a copy of which is hereto attached and made part hereof, for Bid 3107 — Hickory Creek Basin Sanitary Sewer Replacements & Liners. ' { 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 malting good any default or deficiency, then this obligation shall be void; otherwise, .it shall remain in, full force and effect. E 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 executy4 copies, each one of which shall be deemed an original, this the 209h day of Januarv. 2004. ✓ M-4 a.`" PRINCIPAL / William J. Schultz, Inc., dba ✓ Circle "C".Construction Company BY: PRESIDENT,, I lliam J. Schultz SURETY Safeco InsurAce Company of Ameri BY: A ORNEY -FACT Sheryl A. Klutts The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME; Pauline Lesch, Denton County Resident Agent STREET ADDRESS: 206 Elm Street, Suite 105, Lewisville, TX 75057 (NOTE: Date of Performance Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name.) Elm Bond No. 6196733 PAYMENT BOND STATE OF TEXAS COUNTY OF DENTON KNOW ALL MEN BY THESE PRESENTS William J. Schultz, Inc., dba ✓ That. Circle "C" Construction Company whose address is 500 W. Trammell Street Fort Worth . Tgaas 76140 hereinafter .called Principal, and Safeco Insurance Comoahv of America'_'.a corporation organized and existing under the laws of the State of Washington and fully 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 Owner, and unto all persons, firms, and corporations who may -furnish materials for, or perform labor upon, the building or improvements hereinafter referred to, in the penal sum of DOLLARS1,856,545.50a'm lawful money of the United States, to be paid in Denton, County, Texas, for the payment o f.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 2004 with the City of Denton the Owner, dated the 20th day of 7anuary A.D.. 2004✓, a copy of which is hereto attached and made a partereof,. for Bid 3107 - Hickory Creek Basin Sanitary Sewer Replacements and Liner 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 full 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, Vernon's Annotated Civil Statutes of the State of Texas. IN WITNESS WHEREOF, this instrument is executed }'n 4 copies, each one of which shall — —be deemed an original, this the 20th day of Uanuary 2004. ✓ ATTEST: I I• C� William J. Schultz, Inc.,dba Circle "C" Construction Company / BY: SECRETARY BY: PRESIDENT XSKKB%+ fitness as to Surety: BY: John A. Miller William J. Schultz SURETY Sheryl A. Klutts The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: Pauline Lesch, Denton County Resident Agent STREETADDRESS:206_Elm Street. Suite 105, Lewisville, TX 75057 (NOTE. Date of Payment Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name.) R SAFECO" State of Texas Surety Bond Claim Notice In accordance with Section 2253.021(f) of the Texas Government Code and Section 53.202(6) of the Texas Property Code, any notice of claim to the named surety under this bond(s) should be sent to: SAFECO Surety Adams Building 4634 154th PL NE Redmond, WA 98052 Mailing Address: SAFECO Surety PO Box 34526 Seattle, WA 98124 Phone: (425) 376-6535 Fax: (425) 376-6533 www.SAFECO.com EXHIBIT B IMPORTANT NOTICE TO SURETY BOND CUSTOMERS REGARDING THE TERRORISM RISK INSURANCE ACT OF 2002 As a surety bond customer of one of the SAFECO insurance companies (SAFECO Insurance Company of America, General Insurance Company of America, First National Insurance Company, American States Insurance Company or American Economy Insurance Company), it is our duty to notify you that the Terrorism Risk Insurance Act of 2002 extends to "surety insurance". This means that under certain circumstances, we may be eligible for reimbursement of certain surety bond losses by the United States government under a formula established by this Act. Under this formula, the United States government pays 90% of losses caused by certified acts of terrorism that exceed a statutorily established deductible to be paid by the insurance company providing the bond. The Act also establishes a $100 billion cap for the total of all losses to be paid by all insurers for certified acts of terrorism. Losses on some or all of your bonds may be subject to this cap. This notice does not modify any of the existing terms and condition so this bond, the underlying agreement guaranteed by this bond, any statutes governing the terms of this bond or any generally applicable rules of law. At this time there is no premium change resulting from this Act. S A F E C O" POWER SAFECO INSURANCE COMPANY OF AMERICA GENERAL INSURANCE COMPANY OF AMERICA 1131 OF ATTORNEY HOME OFFICE: SAFECO PLAZA SEATTLE, WASHINGTON 98185 No. 7498 KNOW ALL BY THESE PRESENTS: That SAFECO INSURANCE COMPANY OF AMERICA nd GENERAL INIRANCE COMPANY OF AMERICA, each a Washington corporation, does each hereby appoint y+f/ ++aaarrrarauurtarrtwtuarJOF9J A. MILLER; SHERYL A. KLIJTT JOHN A. MILLER, It; R.R. HARVEY; Fort Worth, Texasr+++r+t++++t+t++at+r+t++ta+aa+trtt++t+ its true and lawful attomey(s)-in-fad, with full authority to execute on its behalf fidelity and surety bonds or undertakings and other documents of a similar character issued in the course of its business, and to bind the respective company thereby. IN WITNESS WHEREOF, SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA have each executed and attested these presents this 21st day of April , 1999 R.A. PIERSON, SECRETARY W. RANDALL STODDARD, PRESIDENT CERTIFICATE Extract from the By -Laws of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA: "Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint Individuals as attomeys-in-fad or under other appropriate tides with authority to execute on behalf of the company fidelity and surety bonds and other documents of similar character Issued by the company in the course of its business... On any Instrument making or evidencing such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or undertaking of the company, the seal, or a facsimile thereof, may be Impressed or affixed or in any other manner reproduced; provided, however, that the seal shall not be necessary to the validity of any such instrument or undertaking." Extract from a Resolution of the Board of Directors of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970. "On any certificate executed by the Secretary or an assistantsecretary of the Company selling out, (i) The provisions of Article V, Section 13 of the By -Laws, and (II) A copy of the power-ofattomey appointment, executed pursuant thereto, and (III) Certifying that said powerofattomey appointment is in full force and effect, the signature of the certifying officer may be by facsimile, and the seal of the Company may be a facsimile thereof." I, R.A. Pierson, Secretary of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of these corporations, and of a Power of Attorney issued pursuant thereto, are We and correct, and that both the By -Laws, the Resolution and the Power of Attorney are still in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation this �a '" day of �QQ e CIO) cWnM SEAL SEAL T /� 1953 � [s2� �0!Cp(Wyypll��s RA. PIERSON, SECRETARY S-09741SAEF 7198 ® Registered trademark of SAFECO Corporation. 4/21199 POE 2 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 (CITI9 EXCEPT WHEN THE POLICY IS BEING CANCELLED FOR NONPAYMENT OF PREMIUM IN WHICH CASE 10 DAYS ADVANCE 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] A. General Liability Insurance: General Liability insurance with combined single limits of not less than $500,000 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 (XCQ exposures. Broad form contractual liability (preferably by endorsement) covering this contract, personal injury liability and broad form property damage liability. [X] 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 T exas Labor C ode and rule 2 8TAC 1 10.110 o f the T exas W orker's C ompensation 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' R isk Insurance, on an All -Risk form for 100% o f the completed v alue shall b e 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. (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 p aragraphs (1) -( 7), w ith t he c ertificates o f coverage t o b e p rovided t o t he 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 carrier 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. [ ] 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. ATTACHMENT 1 [X] Worker's Compensation Coverage for Building or Construction Projects for Governmental Entities A. Definitions: 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 t he c overage p eriod sh own o n t he c ontractor's c urrent c ertificate o f c overage 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: HICKORY CREEK BASIN SANITARY SEWER REPLACEMENTS AND LINERS Work Days /.S'O Bid No. 3107 P.O. No. BID TABULATION SHEET Item I Description I Quantity 1Unit Unit Price Total 1.21 Contractors Warranties and Understandings 1 LS 00 $ /oc5-000 / LS / 00 $ /ot.S000 Unit Price In words Y'n, i/e 'j/ u so n C/ �'- n O// O O 2.12-B 8' SDR-26 Sanitary Sewer Pipe1 5,207 1 LF $ 35 / LF is e / 77 038 �'+ Unit Price In Words / r' / Y 01" rf /70// 0 6 2.12-C 8' SDR-35 Sanl Sewer PI 8,071 LF $ c7 Z OO / LF $ / 9 i E 7 L // Unit Price In Words -AiPf TLJO �' n0//60 2.12-C 8' Class 51 Ductile Iron PIs� for Sani Sewer 1,739 LF $'19 O O / LF $ BS L/ J o0 Unit Price In Words rA/Or f /7//7g rF 170 /QQ WS31 B' HDPE DR-11,byopencut 44 LF 3 y oo / LF / y 1 //+� Unit Pdceln WOr& T h//' / YOL11, 401100 212-D 10' SDR-35 Sanitary Sewer Pipe1 541 LF $ 3rs p0/ LF $ /8935 eo /� Unit Price In Words noll0 a 212-E 10*Class 51 Ductile Iron Pipefor Sanita Sewer 100 LF $ S1 OO1 LF Unit Price Is Words t / r f D/7 a ^S �O// O 0 2.12-F 12' SDR-35 Sanitary Sewer Pipe 108 LF $ S O �LF 00 $ 84 02) Unit Price Ia Words 7Z—t ' tl e v� 1? Ol/O d 2.12- 15' BDR35 SanitarySewer Pip;30 LF O l $O _ OU LF $ zsso O Unit Price In Words / Ir v e n0// 0 0 3-13 Demolish and Remove Concrete Curb & Gutter 1,884 1 LF Is 2 O O 1 LF Is .776.8 00 Unit Price In Words Te✓ O 4 n d// o 0 3.1 Pre oration of Right of Way/ 1 LS OO Is l6000 / LS $ /,SOon U Unit Price In Words % -1 IF e /J h O U c5'SQ /7 C/ '/ n o 0 3.10.4 113roadcastSeeding 1 1,773 1 BY `r0 / BY $ ZG S 9 ,so Unit Price In Words O /r e. f 'rd�i o d 3.9 Block Sod 534 SY $ J OO / SY $ 2670 oa + e hd Unit Pricela Words T //uI- /,Od 3.12 Temporary Erosion Control 1 LS eo $ 9500 / 00 Unit Price In Words / n,& Y/ u and >�'�. .4 g 19 0IP 0/ �' nol o o 5.7-13 2'Asphalt Pavement 1 TN $ /20 00 TN Is /ZO �o 1 unit pricela words One %r H 0/r 7 wP r) t n0�/00 WS13, WS15 Concrete Manhole 4'I.D. 76 EA $ SO d�EA $/Z5-VD000 Unit Price In words One O n dall.,,e/ r/� ' L h0l/O 0 7.6 Contruct Concrete DropManhole 4//I.D. 5 EA $ISOO EA $ /Z SOO Oa Unit Price In Words w �ry G O 1,r�V [i/'CC.I L e.t Bartirades Waming Signs and Detours 1 1 LS1$14100001LS 0 o rl 1$11100D Unit Price In words 04 no / 1013IP2003 P-3. HICKORY CREEK BASIN SANITARY SEWER REPLACEMENTS AND LINERS Work Days Bid No. 3107 P.O. No. BID TABULATION SHEET Item Description Quantity I Unit I Total 82-A Construct Concrete Curb &Gutter 1 1,804 1 LF $ /,S 00/LF Is 27000 0 Unit Price In Words WS18 4' Sanitary Sewer Service Including Cleanout 172 1 EA Is 0,0 �/,$-'O / 04 Unit Price In Words r'Ou/ /i e..n0/iB O/ti n0/oe WS27 Remove Existing Manhole 82 EA S(000 oO/EA $,g%20000 / Unit Priceln Words r 'IX' /74en0//'ed f 00 WS26 AbandonExlstin Manhole 4 EA ��ll $ 700 0 EA $ /6000U Unit Price In Words OLr i' 4 u O//P O' SP-37 Ezcavatlon Protection 13,810 1 Li $ / 00 /LF $ /,?$00 00 Unit Price In Words O n e ,1- h 0//O 0 SP-39 Pro ed Si ns 6 EA $ SO 000/EA lEA $ ,70000 0 /^/'/ ti Unit Price In Words r' I/t h n C/ /P Q/ rf 'Ol/00 SP•43 As haft Saw Cut - 22,552 LF S Z `5 6 / LF s SG 390"' Unit Price In Words 71 Lv0 0'`r0//0 0 SP-2 Concrete S,, Cut 390 1 LF Fs 3 0 / LF Is 1170 00 Unit Price In Words f n 0�/0 0 . 3-A I Demolish and Remove Concrete Paving 97 1 BY Is /O O O / SY Is 97000 Unit Price In Words T A n 0 / 0 0 5.8 Reinforced Concrete Paving 78 BY Is i 0 0/ SY $ 3 v Z 0 00 ` / Unit Price In Words r inr T n0�/O O 3•C I Demolish/Reniove Concrete Sidewalk and Driveways 189 1 BY s Z O O ! BY Is 778 `5 Unit Price In Words p/ 0 f' n 0�/0 0 8.3 Construct Concrete Driveway 89 1 SY $ 1457 0 O / SY $ 1/001 00 1 Unit Price In Words / �" r/ (/t 8.3A Construct Concrete Sidewalk 69 1 SY s ,S 0 0/ BY Is /OS 00 + Unit PriceIo Words R•t— 7/// iie d// 0 d 7.6 Extre Depth for 4' Diameter Sanitary Soler Manhole 114 VF $ 9,5- GO / VF $ /083000 Unit Price In Words n/ n —0X r i vi 0// U 0 7.6 Extra Depth for 4' Diameetter Sanitary Sewer Drop Manhole 1 9 1 VF $ /SO O0/ VF I S /15 .000 Unit Price In Words 0/7 e l t. ii c✓i o t/ {• y(' �r 4 0//eb WS34 Manhole Lining for 4' Diameter/Manhole 609 VF — 00 / VF // Unit Price la Words 0 ne h e n o/il el �/ hT t/'!�1 4. 070�/OU 6.4 Sleeve Case Fx Water Llne-12' Steel Casing Pipe 1 160 1 LF $ /00 OG/ LF $ /6000 00 Unit Price In Words 0/16 .4 /70h,90 6.4 Sleeve Case Ex Water Una-20' Steel Casing Pipe 1 20 1 LF $ /,5­0 0 0/ LF $ 3 000 00 Unit Price la words one ILUnal.-ed 7C-1'jC1j1 It no//OC) in4 mnni HICKORY CREEK BASIN SANITARY SEWER REPLACEMENTS AND LINERS Work Days Bid No. 3107 P.O. No. BID TABULATION SHEET Item Description I Quantity I Unit I Unit Price I Total 16' Bore and Steel Encasement105 00 0 LF $ 25o, LF $ Z (. 2 S O Unit Price In Words 7 w o 16' RR Bore and Steel Encasement 60 LF $ 2 rs'O a/o LF $ /S_ 000oU � n� 1 Unit Price In Words T1utu 4un a'� O/ T''1' 7 /t n0//oo 16' Steel Encasement by Open Cut 40 LF $ 8s � � LF $ SV 00o0 / � Unit Price In Words e/ T >` 7 '// e 00" no/// 0 O 20' Bore and Steel Encasement I BO LF ZSO 0 0 LF $ ZOOO Unit Price In Words Two of n0//00 Relocate FH 1 EA $ 906 01EA $ 800 or) / Unit Price In Words g/ TL hu diP c/ f n0/00 Plans . Concrete Encasement of 8' SanB1 Sewer 120 LF $ L�r$ 00/ LF $ y2oo Unit Price In Words j T/ dat ,4 "O�/o O WS21 Cut and Plug E)dstIng Sanitary Sewer Line 14 EA $ /100 / EA $ oo0�0 Unit Price la Words one, O d 04 /'7 0X/ o O 6.8 Concrete Mrinhole 5' I.D. 2 1 EA $ ZZOO'/ EA $ VY00 Unit Price In Words -We 7o.4ouaon071., /tun dam!o/ It 70//og 7.6 Install Concrete Drop Manhole 5' I.D. 2 1 EA $ 9?$00 0 o EA $ 5-to 00 o O Unit Price In Words 0 I<X a&.fa o/rrs°� 0 6.6 Extra Depth for 5' Diameter SwItary Sewer Manhole 1 15 VF $ /S-O 0 0/ VF s Z 2 SO 00 Unit Price In Words On 6 h cr n wi' e 4#1 ye�-of n o//a 0 7.8 Extra Depth for 5' Diameter Sanitary Sewer Drop Manhole 1 19 1 VF $ /7,5001 VF Is 33 o 0 Unit Price In Words one ..4mna -e e�wd 1 no O WS34 Manhole Uning for 5' Diameter Manhole 1 58 1 VF I ZZ.9 00/VF I j3DS'0" Unit Price In Words W0 nol/oo SP-10 Rock Excwatlon 50 1 CY Is /O 0 O l CY $ 6-0 O p0 L Unit Price In Words TI n f' n 0�/ 00 SPECIAL Abandon Existin 6' SwIta Sewer 1.218 LF G Is O 0O / LF Is 7YY' Unit Priceln Words Lo/ iiT f /70//00 SPECIAL Abandon Existing 8' SanftaFy Sewer 1 1,863 1 LF $ O 00 / LF $ /fL.30 o0 Unit Price In Words .pn 4 n0l7OO WS35 Pips Ream 8' HDPE DR-11, or certa-lock C900 RJ PVC 658 1 LF $ 70 0 0 / LF $ $0 ZZOp0 Unit Price In Words WS31 Pipe Enlargement 6' to 88'/ 258 LF $ 3B Unit Price In Words Try%r i° Qi /1 n0//oo WS31 lPipe Enlargement 8' to 8' 1 421 1 LF $ O o 0 / LF $ /G84/0 oU Unit Price In Words -/- O / fr f 0//O O WS31 jPip, Enter ement 101, to 1D" . 793 IJ? s VJ— 00/ Ix Is 35,493 ° //++ Unit Price In Words b/ T T %V[ / n0 /o i nm Mm. IMA/�GY�GCIGJ LY•Yp uwuRu\tnu HICKORY CREEK BASIN SANITARY SEWER _._ ___ •—_ -- REPLACEMENTS AND LINERS Work Days Bid No. 3107 BID TABULATION cueer P.O. No. Itom Destrl doA on.min.I Unit I Usrt Priee Tyta1 W631 Ian EN emetS'to12• Sef L S'S2a°ILF ZB�Sie r.p1 Unit Prke In Woidt i t / / Twe,f, hO//o .. . Sapitam 30LWe Unit Pricela Wads �7' 3s LP S e01 P It / 1184 ./io , w232 LInellrsanl s T3s F Y9 aO LF s 3Goby °O // unit Price In Wm* 617 t �, �o wss2 Lne t In Sewer sea LF s 570 ° ° LF s Zo/dp eo Unit Pate Ice Wank W 2 L 01e'Seni MB LF S G y°° I LF s 3072 e J Unit Prks in Worts T Out 1 170 / O W332 LIM 27• Senhe Sewer SLIP U P' In ords O G Pt' n O//O O ..,•�••., S CIAL C nensm ?3 SY f %S 1 SY /7L S eu UdtWkaNWords GtiG f n F.'✓e f ne AL Rerwva Pyladn Clell ro arastln OO e0Y 300 eu / Unit prim in Words 2<4/It ECIAL ree W 1 s SOO °per 800 ee 11 tink Prim in Wo T / /7 ( O/r Cl Ir 0p/ SUBTOTAL SASE BID 11124=03 P-6. TOTAL P.05 HICKORY CREEK BASIN SANITARY SEWER REPLACEMENTS AND LINERS ALTERNATE NO. 1 MANHOLE REHAB SHEETS MH-1,2,3 & 4 BID TABULATION SHEET Work Days Bid No. 3107 P.O. No. Item Description Quantity I Unit I Unit Price I Total WS14 Replace Manhole Frame and Cover (Paved Area) 4 1 EA $ /s-00 00 / EA $ 4000 00 Unit Price In Words WS14 Replace Manhole Frame and Cover (Not Paved) 4 EA $ / Zo o c 0/ EA $ YOC760O Unit Price In Words WS34 Manhole Lining for 4' Diameter Manhole 1 480 1 VF $ Z5-0 % VF $ /ZOOOO Unit Price In Words 8.1 Barricades, Warning Signs and Detours 1 1 LS $ 5� 0600 / LS 0 $ 5,5-000 Unit Price In Words SP43 Asphalt Saw Cut 60 ix I $ 3�j oo/ LF $ Z/0O l Unit Price In Words SP-2 Concrete Saw Cut 20 LF $ 6 -," Unit Price In Words 3-C Demolish/Remove Concrete Sidewalk and Driveways 1 3 1 SY 00 Is Jam, / SY - Is /S00 Unit Price In Words 8.3A Construct Concrete Sidewalk 3 SY $ to s• 0 / SY a0 $ / 9S Unit Price In Words SUBTOTAL ALTERNATE NO. 1 B 73 O ° 0 P-7 HICKORY CREEK BASIN SANITARY SEWER REPLACEMENTS AND LINERS BID TABULATION SUMMARY SHEET ALTERNATE NO. 1 - BASE BID PLUS ALTERNATE 1 Work Days Bid No. 3107 P.O. No. /SSG S-`/S. S o /3 f3 730 Ocl /99SZ7S: S- 10/31/2003 P R Attachment AD1-1 BID SUMMARY TOTAL BASE BID PRICE IN WORDS one rni//ippon11 e d eia�f lTunodi �v S/X �housanc/ Fi✓e /l4nc/ ral Y01- U el" //arj an�I3dGlen�'r I ,. 1 TOTAL BASE BID PLUS ALTERNATE No. 1 PRICE IN WORDS one. ,n i //i o n nir2 <14".,W114✓ z2:r2e.f Yi'✓e Aot.,roncl 7iwoiia17sriea/ Alternate bid items: The additive alternate bid items may be added to the total base bid prior to award of a contract. Award of the contract will be based on items actually included in the Project. The decision to add the alternate items listed will be solely at the discretion of the City. The lowest responsive proposal for purposes of award shall be the conforming responsible Bidder offering the lowest aggregate amount for the base bid plus those additive alternate bid items providing the most features of the work as selected by the City. The City may or may not choose to incorporate any or all of the additive alternate items listed in the Proposal. 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. 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. Receipt is hereby acknowledged of the following addenda to the plans and specifications: Addendum No. 1 dated / 2 / - 03 Received GJgs Addendum No. 2 dated p y _ 03 Received /,,/,p f Addendum No. 3 dated Received —` Addendum No. 4 dated Received Addendum No. 5 dated Received UM6 TOTAL BASE BID PRICE IN 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. 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. Receipt is hereby acknowledged of the following addenda to the plans and specifications: Addendum No. 1 dated // Z I - 03 Received 4,10 f Addendum No. 2 dated l I - Z'/ - 03 Received A/ 4 J Addendum No. 3 dated Addendum No. 4 dated Addendum No. 5 dated Received Received Received W CONTRACTOR &),)11&m me dba Clec% C Cons�r4r-roh BY Piesi d.,, -F Soo LJ I,Ommg// Street Address fm. f 4,1o,1-4 72 7GJ VO City and State Seal & Authorization (If a Corporation) 817 - 2 93 - / 86 3 Telephone P-10 ACORDDATE CERTIFICATE OF LIABILITY INSURANCE (MWODfYY) 01/29/2004 PRODUCER Serial # THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOHN A. MILLER & ASSOCIATES, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. BOX 7214 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. FORT WORTH, TX 76111-0214 PHONE: (817) 834-7111 FAX: (817) 834-7115 INSURERS AFFORDING COVERAGE JIAIC# INSURED INSURERA: ST. PAUL FIRE & MARINE INS. CO. 24767 WILLIAM J. SCHULTZ, INC. DBA INSURER B:INSURER CIRCLE "C" CONSTRUCTION COMPANY, ET,�L C: P. O. BOX 40328 I/ry A INSURER D: FORT WORTH, TX 76140 INSURER E: COVERAGES 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 POLICES 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 LTR hoot NSR TYPE OF INSU E POLICY NUMBER POLICY EFFECTIVE DATE MM/DC POLICY EXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X DpM GE TO RENTED PRE ran a occu $ 300,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DEXP (Any oneperson) $ 10,000 A X $5,000 P.D. DED. KC09100112 / 08/12/03 08/12/04 X PERSONAL &ADV INJURY $ 1,000,000 X CONTRACTUAL, XCU GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 PE 7 F-ILOG POLICY Xji AUTOMOBILE X LIABILITY $ 1,000,0001 ANYAUTO/ EaacINED Cdeent'INGLELIMIT DILV INJURY A X ALL OWNED AUTOS SCHEDULED AUTOS KV09100082/ 08/12/03 08/12/04 (Per person) $ X HIRED AUTOS/ BODILY INJURY X $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per acnJdenl) $ GARAGE GARAGE LIABILITY AUTO ONLY -EA ACCIDENT' $ THAN EA ACC $ ANYAUTO $ AUTO ONLY: AGO EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ 8 DEDUCTIBLE a RETENTION $ $ WORKER'S COMPENSATION AND yyC gTp7U TH TORV LIMNS ER A EMPLOYERS'LIABILITY ANY ECUTIVE WVS9100115 08/12/03 08/12/04 EL EACH ACCIDENT $ 1,000,000 EL DISEASE -EA EMPLOYEE $ 1,000,000 OFFICER/MEMBEREXCLNERI If yes. describe under EL DISEASE -POLICY LIMIT $ 1,000,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONSILOCATIONS'VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS PROJECT: BID 3107 - HICKORY CREEK BASIN SANITARY SEWER REPLACEMENTS & LINERS THE CIT F DE IT'S OFFICIALS, AGENTS, EWLOYEES AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSUREDS ON A POL LIES (EXCEPT WORKER'S COMPENSATION) BALL LIABILITY POLICIES APPLY ON A PRIMARY BASIS IN RELATION TO TRE ADDITIONAL INSURED'S OWN POLICY, WHICH WILL BE NON-C A WAIVE OF SUBROGATION IN FAVOR OF THE ADDITIONAL INSUREDS IS INCLUDED ON THE WORKER OMP�ENSATION6POL . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OFDENTON/ DATE THEREOF, THE ISSUING INSURER WILL i�XYaiE MAIL 30 DA` Y>• TEN 901 B TEXAS STREET NOTICETOTHECERTIFI OLDERNAMEDT ELEFT DENTON, TEXAS 76201 X A�4 AUTHORIZED REPRES VE ACORD 25 (2001/08) CO D CORPORATION 1988 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 alter the coverage afforded by the policies listed thereon. ACORD 25 COPY NOTICE TO DESCRIBED PIERSONS OR ORGANIZATIONS OF MATERIAL CHANGE OR POLICY CANCELLATION ENDORSEI This endorsement changes: • your General Rules; or • any state -required endorsement that changes the Policy Changes or Cancellation rules in your General Rules. How Coverage Is Changed There are two changes explained below. 1. The following is added to the Policy Changes section. This change describes other persons or organizations we'll notify if a material change is made to your policy. Such change does not benefit any persons or organizations not described below. We'll mail or deliver written notice of a material change to your policy during its policy period to the described persons or organizations. The described persons or organizations and the number of days notice before the change will take affect are shown below. Material change means a reduction in the applicable: • coverage; or • limits of coverage. Described Persons Or Organizations (Name) The first named insured and all certificate holders requiring at least the number of days shown below. Number Of Days Notice TMBSI19ul (GENERAL LIABILITY POLICY) 2. The following is added to the Cancellation section. This change describes other persons or organizations we'll notify if your policy is canceled by you or us. Such change does not benefit any persons or organizations not described below. We'll also mail or deliver a notice of cancellation to the described persons or organizations. The described persons or organizations and the number of. days notice of cancellation before coverage, will end are shown below. No other change applies to the Cancellation rule. Other Terms All other terms of your policy remain the same. (Address) PO Box 40328 Ft. Worth, TX 76140 60 For material change or cancellation, other than nonpayment of premium 10 For nonpayment of premium Name of Insured Policy Number KC09100112 Effective Date 08/12/03 WILLIAM J. SCHULTZ, INC. Processing Date 08/25/03 13:10 001 D0084 Edi 10-00 Printed in U.S.A. Endorsement mSt.Paul Fire and Marine Insurance Co. 2000 All Rights Reserved Page 1 of 1 TE 02 02A (Ed.Effective 3/92) CANCELLATION PROVISION OR COVERAGE CHANGE ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below: Endorsement Effective Policy Number 08/12/03 KV09100082 Named Insured Countersigned by WILLIAM J. SCHULTZ, INC. (Authorized Representative) 60 * days before this policy is cancelled or materially changed to reduce or restrict coverage we will mail notice of the cancellation or change to: The first named insured and to all certificate holders requiring at least the number of days shown above. * except 10 days for non payment of premium. (Enter Name and Address) FORM TE 02 02A- CANCELLATION PROVISION OR COVERAGE CHANGE ENDORSEMENT Texas Standard Automobile Endorsement Revised March 18,1992 WC420601 (WORKER'S COMPENSATION POLICY; TEXAS NOTICE OF MATERIAL CHANGE This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 08/12/03 at 12:01 A.M. standard time, forms a part of (Date) Policy No. WVS9100115 Endorsement No. of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY NCCI Carrier Code 13706 (Name of Insurance Company) issued to: WILLIAM J. SCHULTZ, INC. Policy Expiration Date: 08/12/04 Premium (if any) $ Authorized Representative. This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. In the event of cancelation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of clays advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Sche- dule. Schedule 1. Number of days advance notice: 60 days except 10 days for non payment of premium 2. Notice will be mailed to: The first named insured and to all certificate holders requiring the number of days shown above.