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2001-125
ORDINANCE NO 1` AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORKS CONTRACT FOR THE CONSTRUCTION FOR RE -ROOFING OF CITY HALL WEST, PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFORE, AND PROVIDING FOR AN EFFECTIVE DATE (BID 2637 — RE -ROOFING OF CITY HALL WEST, AWARDED TO C D MCKAMIE COMPANY, IN THE AMOUNT OF $120,000) 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 I 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 2637 C D McKamie Company $120,000 SECTION II 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 III 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 IV 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 V That this ordinance shall become effective immediately upon its passage and approval PASSED AND APPROVED this the Amday of llwCiIL , 2001 &"-� li),.bck EULINE BROCK, MAYOR ATTEST JENNIFER WALTERS, CITY SECRETARY BYGJA'lh A L Llfl� APPROVED AS TO LEGAL FORM BERBERT L PWUTY, Cp%Y ATTORNEY Y2637 — Re-Rookg of C y Hal est CONTRACTUAL ORDINANCE ATTACHMENT TABULATION SHEET BID 2637 Date 3/6/01 REROOFING CITY HALL WEST No DESCRIPTION VENDOR VENDOR VENDOR 117.li, Iil 11 JOHNSON C D MCKAMIE II'I 4i ii 111,1101111' ;; ,,; ;,�'� ROOFING CBS ROOFING COMPANY 1il, lil4'illlry ,ll Prince le Place of Business WACO, TX DENTON, TX JUSTIN, TX TOTAL BASE BID $140,810 $168,000 $120,000 1 Acknowledge Addendum Yes Yes Yes CONTRACT AGREEMENT STATE OF TEXAS § COUNTY OF DENTON § THIS AGREEMENT, made and entered into this --22—day of -March--A D , 2001, by and between City of Denton of the County of Denton and State of Texas, acting through Hnward Martin thereunto duly authorized so to do, hereinafter termed "OWNER," and of the City of Justin , County of Denton and State of Texas hereinafter termed "CONTRACTOR " WITNESSETH That for and in consideration of the payments and agreements hereinafter imentioned, 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 in the amount of �120,000 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 I 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,I 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, CA-1 and the Specifications therefore, as prepared by all of which are referenced her and made a part hereof and collectively evidence and constitute the entire contract 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 shall and does hereby agree to indemnify and hold harmless the City of Denton from any and all damages, loss, or liability of any kind whatsoever, by reason of injury to property or third persons occasioned by any error, omission or negligent act of Contractor, its officers, agents, employees, mvitees, and other persons for whom it is legally liable, with regard to the performance of this Agreement, and Contractor will, at its cost and expense, defend and protect the City of Denton against any and all such claims and demands 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 tune 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 AT TE T ATTEST CA-3 10 • (SEAL) MAILING ADDRESS PHONE NUMBER • • • FAX NUMBER �L PRINTED NAME (SEAL) 08.14 AM THE MCKAMIE COMPANY 9404792419 P.06 BOND# TEX0010818 PERI'ORMANCE BOND STA rE OF TEXAS COUNTY OF DENTON KNOW ALI. MEN BY THESE PRESENTS That.c.n MrKnmtn dot address i9 10z9�jJJJ�;i jay R,�Ad in�tin TX 767d7 976 —whose still ACCEPTANCE INSURANCE COMPANY hereinafter called I linwpal, exisiiitg under the laws of the Steto of a corporation Organized and and fulltransact business Inthe State of Texas, as Surety, arc held and firmly bound unto the City ofauthorizedtDenton, a municipal corporation org,tmzed and existing under the laws of the State of Texas, hereinafter called Owner, in the pena sum of _One_fiundrrd Tan� ($-LZQJM0_) Plus ton e �'�y Thnnaand a DOLLARS penal of Money reprt scnting adulainai Court expe expenses thestated attorneys' fees, ad liquidatedUM as an ddamages aitional rising 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, exoeutors, 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, THL OBLIG4T10N TO PAY SAME is conditioned as follows, Whereas, the Pnnl ipal entered olio a cm tam Contract, Identified by Ordinance Number 2001 125, with the City Of Denton, the Owner, dated die 2_ day of .mam)L A D hereto attached and made a part hereof, for Ada 2r;v� _ R unnnnvr ,a copy of which is -•-�.,,,,Y ir�ii wr�r NOW, THLREFORE, If the Principal shall well, truly and faithfully perform and Uriill all of the undertdkmgs, covenants, terms, conditions And agreements of said Contract in accordanel. 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 ,o the Surety, and during the life of any guaranty or warranty required under this Contract, and shull Rise 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 wanv, f the als and workmanshipandthat W, andt Principal shall repair and/or replace all defects due to faulty materi appear within a period of oite (1) year from the date of final compledA and final acceptonce of the Work by the Owner, and, if the Principal shall fully indemnity and save harmless the Owner froin all costs and damages which Owner may suffer by reason of failure to so perform h_rein and shall frilly retmbirse and repay Owner all outlay and expense which the Owner may Incur in making good any d,fault or deficiency, then this obligation shah be void, otherwise, it "'all runain m lull force and effect PB•1 APR-11-01 08115 AM THE MCKAMIE COMPANY 9404792419 P 07 BOND# TEX0010818 PROVIDED FURTHER, that if any legal action be filed upon this Bond, exclusive venue shall tic in Denton County, State of Texas AND PROVIDER 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, Specincauons, 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 terns of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc This Bond is glen pursuant to the provisions of Chapter 2253 of the Texas Gmernmont Code, as amended, and any other annlicable statutes of the Stair of Tova. The undersigned and designated agent is hereby designated by the Surety herein as the Resident Agent in Dentot County to whom any requisite notices may be delivered and on whom service of process ruy 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 WH 3REOF, this instrument is executed in 4_ copies, each one of which shall be deemed an original, this the _ 27 day of MArch , 2ooi ATTEST ATTEST r PRINCIPAL SURETY ACCEPTANCE INSURANCE COMPANY BY ATTORN 9Y-IN-FA i TOM YOUNG RANT the Resident Agent of the Surety in%R" County, Texas for delivery of notice and service of the process is NAME TEXAS CONTRACTORS SURETY STREET ADDRESS 3817 ALAMO AVE, FORT WORTH, TEXAS 76107 (NOTE pate of Perfor e-nee Bond must be date of Contract If Resident Agent is not a rorporation, give a parson', name ) PB-2 APR-11-01 08 15 AM THE MCKAMIE COMPANY 9404792419 P e8 PAYMENT BOND STATE OF TEXAS COUNTY OF DENTON BOND#' TEX0010818 KNOW ALI. MEN BY THESE PRESENTS That -C.D. Mt Kmnir CaWp W , whose address is Principal, and ACCEPTANCE Cptgp , hereinafter called existing under the laws of the State 'of NEBRAS ' a corporation organizcd and and fal and follauthonzcd tobusiness in the State of Texas, as Sunny, arc held and firmly bound unto he City of De ton,ta municipal corporation organized anc' existing under the haws of the State of Texas, hereinafter called Owner, and unto all per;ons, firms, and corporations who may furnish materials fur, or perform labor upon, the balding or improvements hereinafter referred to, in the penal stun or One Hi ndrnd 9'v....,., 1I)M and end aria) DOLLARS ($120,000) in lawful money of the United Suites, to be paid n Denton, County, Texas, for the payment of which sutn 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 Khali automatically increased by the amount of any Change Order or Supplemental Agreement whit h increasbe es the Contract price, but it: no event shall a Change Order or Supplemental Agreement %es the reduces the Contract price decrease the penal sum of this Bond TIIE OBLIGATION TO PAY SAME is conditioned as follows Whereas, the - Prmcipol entered into a certain Contract, identified by Ordinance Number 20(t117-5, with the City of Denton, the Owner, dated the -23— day of Marrh A D 1001 , a copy of which is hereto attached and made a part hereof, for Hid 2b47 _ A:1i0afing �f �,ty „ .,,. NOW, THEREFOPE, if the Principal shall well, truly and faithfully perfarni its duties and make prompt payment to all persons, firms, subcontracwrs, corporations and its duties 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 whit h 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 W3rk to be performed thereunder, or to the Plans, Specifications, Drawings, etc , accompanying the some, shall in anywise affect its obligation on this Bond, and it does hereby waive nc tics of any such change, extension of time, alteration or addition to the tenns of he Contract, or to the Work to be performed thereunder, or to the Plans, Spec.ifteatIons, Drawings, eic PB-3 rrn-11-01 08.16 AM THE MCKAMIE COMPANY 9404792419 P,09 BOND#' TEX0010818 This Bond is given pursuant to the provisions of Chapter ' 2253 of the Texas Government Code, as amended, and any other applicable statute of the State of Texas The undersigned aid designated agent is hereby designated by the Surety herein as the Resident Agent in Denton County to whom any requisite notices may be deliveredand on __ whom service of process may be had in matters arising out of such suretyship, as provided by _ Article 7 19.1 of die Insurance Code, Vornon's Annotated Civil Statutes of the State of Texas 1N WITNESS WIIEREOF, this instrument Is executed In _ 4 copies, each one of which shall be deemed an -iriginal, Ibis the -2L- day of March , _= ATTES9 t AT7 EST PRINCIPAL �� ���•Cz PRESIDENT SURETY -- - - ArrFPT1UW-2LC.U�-Lr.O1jPANY TOM BY - YOUNG The Resident Agent of the Surety in &Nbounty, Texas for delivery of notice and service of the process is NAMF TEXAS CONTRACTORS SURETY STREET ADDRESS _ 3817 ALAMO AVE , FORT WORTH, TEXAS 76107 (NO7E Dare of Payment Bond must be date of Contract If Resident Agent is not a corporation, give a person It name ) P6-4 POWER OF ATTORNEY ACCEPTANCE INSURANCE COMPANY REDLAND INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS That ACCEPTANCE INSURANCE COMPANY AND REDLAND INSURANCE COMPANY (Collectively referred to as "Company"), having its executive Offices in County of Douglas, State of Nebraska, has made, constituted and appointed, and does by these presents make, constitute and appoint Fred Thetford Tom Young its true and lawful Attomey(s)-in-Fact, with full power and authority hereby conferred in its name, place and stead, to execute, seal, acknowledge and deliver any and all bonds, undertakings, recogmzances or other written obligations in the nature thereof in any amount up to $3,000,000 for any single obligation and to bind the Corporation thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate seal of the Corporation and duly attested by its Secretary, hereby ratifying and confirming all that the said Attomey(s)-in-Fact may do in the premises This power of attorney is signed and sealed under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 1 Sth day of October, 1993, and said Resolution has not been amended or repealed "RESOLVED, that the Chairman of the Board, the President, an Executive Vice President or a Vice President be, and that each of them is, authorized to execute Powers of Attorney qualifying the Attorneys) -in -Fact named in the given Power of Attorney to execute in behalf of the Company, bonds, undertakings and other instruments of similar nature, and said officers may rename any such Attomey(s)-in Fact or agent and revoke any Power of Attorney previously granted to such person FURTHER RESOLVED, that the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with respect to any bond, undertaking or instruments of similar nature to which it is attached " INYLWI ESS WHEREO , the Com ny has causgd these presents to be signed by its Vice -President and its corporate seal to be hereunto affixed this 7 day of ?mD crosuRA,yr ,PsuRANcr ACCEPTANCE INSURANCE COMPANY REDLAND INSURANCE COMPANY 1409O:Arf ti pa `00.P0=AlA,'� SEAL 00 SEAL o oNA NEBPrS +1iE Rl0ff`+ 14 by John R Svoboda, Vice President STATE OF NEBRASKA ) COUNTY OF DOUGLAS )" On this 22nd day of April, 1999, before me personally came John R Svoboda to me known who being by me duly sworn, did depose and say that he is a Vice President of ACCEPTANCE INSURANCE COMPANY and REDLAND INSURANCE COMPANY, the Corporations described in and which executed the above instrument, that he knows the seals of said Corporations, that the seals affixed to the said instrument are such corporate seals, that they were so affixed by order of the Board of Directors of said Corporations and that he signed his name thereto by like order IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and y herein rst ove written GENERAL NOTARY State of Nebraska CAROL A ERN Carol A Em, Notary Public My Comm Up Match? 2010 CERTIFICATE STATE OF NEBRASKA ) COUNTY OF DOUGLAS )" I, the undersigned, Secretary of ACCEPTANCE INSURANCE COMPANY and REDLAND INSURANCE COMPANY, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the POWER OF ATTORNEY executed by said Companies which is in full force and has not been revoked, and furthermore that the Resolution of the Board of Dire to et forth in the Power of Attorney is now in force Signed and sealed at the County of Douglas Dated the day of mQ.Ya `E NSURAHCEo ' OWSURANCF0O q* fuv `OPPORI )E it ;o! OOIPORAIA, +1 SEAL= soL SEAL oar Peter A Knolla, Secretary t wM4 NEWS'y +046LU0 I IF YOU HAVE ANY QUESTIONS CONCERNING THE AUTHENTICITY OF THIS DOCUMENT, YOU ARE URGED TO CONTACT OUR POWER OF ATTORNEY CUSTODIAN AT 401-344-8800 WHOSE OFFICE IS LOCATED AT 222 SOUTH 1 Sth STREET, SUITE 600 N , OMAHA, NE 68102 CITY OF DENTON INSURANCE REQUIREMENTS FOR CONTRACTORS Bidder's attention is directed to the insurance requirements below It is highly recommended that-b 4der"oafer-wit&4hea-mpechve-tnsurance-camers-or-brokers-ta-dMrmine-iff 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—po ici—I' - es shal a —endorsed reatL "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 DAYS ADVANCE WRITTEN NOTICE 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 linuts of not less than �1,000nnn 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 Inability 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 prenuses, operations, products and completed operations, independent contractors and property damage resulting from explosion, collapse or underground (XCU) 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 500000 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 ansmg 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 anse in the prosecution of the work or Contractor's operations under this contract _Coverage shaffbe 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 [ ] 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 401011(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 theproject, 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 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 401011(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 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 comrrussion'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 Bid 263- Re Roof City Hall (West) - CONTRACT, Bonds & INS 3 2001 Bid/Solicitation No 2637 Bid # 2637 PAGE 1 OF 6 PROPOSAL REROOFING AT CITY HALL WEST CITY OF DENTON, TX NAME OF BIDDER ---DATE -- MA A -- - - / - -- -- - MS CHRISTY SKIRCHAK PURCHASING CITY OF DENTON 901-B TEXAS STREET DENTON, TX 76201 Dear Ms Skirchak The undersigned, in compliance with your advertisement for Bids for Reroofing on certain areas of the following building CITY HALL WEST have examined the Drawings and Specifications, together with the related documents and all conditions surrounding the work, and having visited the sites of the proposed work, hereby, proposes to furnish all work in every detail In accordance with the Contract Documents within the time set forth herein and at the prices stated below These prices shall cover all expenses incurred in performing the work under the Contract Documents, of which the Proposal is a part Attached herewith, find (Cashier's Check) (Certified Check) (Bid Bond) in the amount of five percent (5%) of the bid I (or we) acknowledge receipt of the following addenda ADDENDA #1 � g / (Initial) ADDENDA #2 (Initial) ADDENDA #3 (Initial) Bid # 2637 Bid/Solicitation No 2637 PROPOSAL REROOFING AT CITY HALL WEST CITY OF DENTON, TX PAGE 4OF6 CONTRACT DOCUMENTS Having examined the Proposal, General Instructions, Materials, Execution, Drawings, and Contract for (Bid # 6'471 and-Cond4tions forr-Reroofing-work-,and-- having examined the premises and circumstances affecting the work, the undersigned offer OFFER 1 To furnish all labor, material, tools, equipment, transportation, bonds, all applicable taxes, incidentals, and other facilities, and to perform all work for the said reroofing for the following area ,BASE BID - CITY H L WEST 1 MATERIALS I�+t LABOR a TOTAL D� UNIT PRICE PROPOSAL �L.'74 1 + O J d 1 Remove and replace damaged decking $Ilzi-per square foot 2 Remove and replace deteriorated nailers $v2#93 per linear foot d' 3 Install four inch (4") roof drain $ Oi each 4 Install ffpr inch (4") cast iron drain line complete with all connections, elbows, etc $L per linear foot 0 0 0, 5 Additional cost over and above the contract amount for weekend or overtime requested by the Owner $°" additional cost per man per hour Vy Bid # 2637 Bid/Solicitation No 2637 1 PAGE 5 OF 6 PROPOSAL REROOFING AT CITY HALL WEST CITY OF DENTON, TX QUALIFICATIONS 2 Contractor shall fill in below material manufacturer's company name of __materials being bid on _ Coal -Tar Elastomeric Membrane (CTEM) Self -Adhered CTEM Tile a Base Sheet Base Sheet Felt Bitumen r EXAMINATION OF SITE 3 By signing the Proposal Form, contractor acknowledges he or an authorized representative has examined the roofs and is aware of all field conditions (rooftop equipment, penetrations, roof drains, etc ), which may affect the work TAXES 4 A Tax Exempt Number will be provided after award of protect Tax shall not be included in your bid Upon receipt of notice of acceptance of this bid, within thirty (30) days of the date of this proposal, I (or we) agree to execute the formal contract within ten (10) days thereafter, and to deliver an Insurance Certificate, a SURETY BOND in the amount of ONE HUNDRED PERCENT (100%) of the contract price for the faithful performance of the contract, and a ONE HUNDRED PERCENT (100%) STATUTORY PAYMENT BOND The undersigned agrees to complete all work shown on the drawings and in the specifications within the time limits set forth below subject to additional days that may be added due to inclement weather and/or other justified and reasonable extensions or time as may be approved by the Owner Contractors that are awarded contracts shall be prepared at pre -construction to sit down with the City of Denton Representatives and present a plan that will illustrate how progression of work is to take place to insure completion of all work within specified time limits The contractor shall be required to (a) Commence work under this contract within 10 days after the Contractor receives the Notice to Proceed (b) Prosecute the work diligently, and (c ) Complete the work ready for use not later than one hundred sixty days (160) calendar days or contractor will be subject to liquidated damages as set forth below Bid # 2637 Bid/Solicitation No 2637 PAGE 6 OF 6 PROPOSAL REROOFING AT CITY HALL WEST CITY OF DENTON, TX It is contemplated that all work will be performed during normal hours of operation for this facility Work performed by the Contractor outside such normal workmo hours shall be -approved -in ---- writ g by line City o enfon or through its designated representative If the facility is not in operation due to weather or a legal Holiday, then work by the contractor shall not be performed at the facility unless approved, in writing, by the City of Denton and/or its representative If Sunday work is approved, in writing, by the City of Denton or its representatives, time will be charged on the same basis as weekdays NORMAL HOURS OF OPERATION TO BE DETERMINED AT PRE -CONSTRUCTION If delay in completing the work arises from unforeseen causes beyond the control and without the fault or negligence of the Contractor, the Contractor's right to proceed shall not be terminated nor the Contractor charged with damages Examples (but not limited to), Acts of God or of the public enemy, fires, floods, epidemics, quarantine restrictions, freight embargoes, unusually and severe wieather, etc In the case of unusually severe weather, the Contractor must provide to the Purchasing Agent and/or his/her representative proof that weather is unusually severe This is accomplished by obtaining United States weather statistics for past periods The amount of time extension will be for the number of days above and beyond the means during the performance period The undersigned agrees that the Owner may retain the sum of FIVE HUNDRED DOLLARS ($500 00) from the amount to be paid to the undersigned for each calendar day that the work contemplated remains incomplete beyond the time set forth This amount is agreed upon as the proper measure of liquidated damages which the Owner will sustain per day by failure of the undersigned to complete the work at the stipulated time, and is not to be construed in any sense as a penalty Payment will be made to the contractor within thirty (30) days after receipt of written acceptance of protect completion from the Owner's representative, contractor's invoice, and all written warranties from both contractor and manufacturer I (or we) agree to promptly furnish a correct and current financial statement of condition with list of owned equipment and experience record of completed protects for examination by the City of Denton and architect, if same is required SEAL (If by Corporation) RESPECTFULLY SUBMITTED BY i�f 11G (Name) (Address) Bid # 2637 Bid/Solicitation No 2637 PROPOSAL REROOFING AT CITY HALL WEST CITY OF DENTON, TX Indicate if () Partnership () Corporation If a partnership, list names and addresses of partners ( Sole Owner If corporation, indicate stAte in which corporation was organized and is existing Principal Stockholders (Name and Address) PAGE 7OF6 Bid # 2637 Bid/Solicitation No 2637 PAGE 2 OF 6 PROPOSAL REROOFING AT CITY HALL WEST CITY OF DENTON, TX --NOTME-TO BIDDERS - -- - - - -- BID #2637 Sealed proposals addressed to the City of Denton, Purchasing Department, 901-B Texas Street, Denton, TX 76201 will be received at the office of the Purchasing Agent prior 2 00 P M , Tuesday, March 6, 2001, then publicly opened for PURCHASING, the construction services as follows per bid instruction and specifications A Mandatory Pre -bid conference on Tuesday, February 20, 2001 at 10 00 a m in the Purchasing Department Conference Room located at 901-B Texas Street Any questions and/or request for addendum must be submitted In writing to the office of the Purchasing Agent, Attn Christy Skirchak, 901-B Texas Street, Denton, TX 76209, no later than February 26, 2001 BID #2637 - REROOFING OF CITY HALL WEST The bids will be publicly opened and read, bids received later than the specified time and date will be returned to the bidder unopened The bids will then be officially reviewed and awarded by the City Council as soon thereafter as possible All bid proposals, as well as Payment and Performance Bonds, must be made on the printed document forms included in the specifications The submitted bid shall not be altered, withdrawn, or resubmitted within sixty (60) days from and after the date of the bid opening Performance and Payment Bond Documents submitted with the contract must be on the forms provided In the bid packets Qualified prospective bidders may obtain copies of the bid invitation with information to bidders, bid proposals, plans and/or specifications at the Office of the Purchasing Agent, located at 901-B Texas Street, Denton, Texas, at the Service Center Complex, upon deposit of fifty $50 00) dollars per set Deposit will be refunded provided the documents are returned to the City of Denton's Purchasing Office within ten, 10 days after the bids are opened Each bid must be accompanied by a cashier's check, certified check or acceptable bid bond payable without recourse to the City of Denton, Texas in the amount not less than five (5%) of the bid submitted as a guarantee that the bidder will enter into a contract and execute any required bonds, and insurance certificate, within ten (10) days after the notification of the award of the contract to the bidder No officer or employee of the City of Denton shall have a financial interest, direct or indirect, in any contract with the City of Denton Bid # 2637 Bid/Solicitation No 2637 PAGE 3 OF 6 PROPOSAL REROOFING AT CITY HALL WEST CITY OF DENTON, TX Minority anT nfi small-.business_vgnd©rs-er4onkacters, are-eneeafaged-to bid onn-any-and-all City of — Denton, Texas projects The City of Denton, Texas reserves the right to reject any and al bids and to waive defects in bids CITY OFiDENTON, TEXAS (940) 349-7100 Tom D Shaw, CPM or Christy A, Skirchak Capital Protect Administrator This advertisement to run February 6, 2001 and February 13, 2001 8.32AM HOWARDHILLINSURANCE NO 450 P 2/7 Howard Hill Insurance 901 W.6eventh St, Suite 100 Fort Worth, TX 76102-3512 INSURED Charles D, McKamie DBA C.D. McKamie Company RT 1 Box 100 COMPANY Aa COMPANY e COM`PANY ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS BY THE POLICIES DESCRIBED HEREIN IS SUBJECT To ALL THE TERMS, LTR CO I TYPE OF INSURANCE PORGY NUMBER POLICYBPPECTRRI (MMMO(M POWCYEXPIRAT(ON DATE (MYIDDNV) UNITS GBNBRALLIABIUTY OOMMEROIALOENERAL LIABILITY CLAIMS MAONOOCCUR OWNERS ACONTW=RSPROT QNNNRALAOGRNQATE S PRODUCTS DOMPIDPAGG B PEMNALSADV INJURY S EACHCOCURRENCE S FIRS DAMAGE VM one flraj S MOD EXP WnY one S A AUTOMONU6 X UABIUTY ANYAUTO ALL OWNED AUTOB SCHEDULED AUTOS HIRED AUTO$ NONOWNEOAUTCB BAOS0646078 06/15/00 06/15/01 COMEINNOSINQU:UMIT B 1100010010 ILY INJURY eI Pawn) X IN (p�ile�lgenqURY S X PROPERTY DAMAGII $ ANY AUTO _ UMBRELLA FORM OTHER THANuMNRBLLa, n WORNBRBCOMPENBAMMANO BMPLOYERB' UABILITY NOL D uaty or uenton, its otticials, P ents, Employees & 6dlunteers are Additional Insured on Auto L for Bid-2637 Roofing at City Half. Pol has been endorsed with TE0202A-Said policy shall not be nonrenewed or materially changed without 30 days advanced written notice being given to the ow, BHOULO ANY OF THE ABOVE DESORIDED POLICIES N OANOBLL20 BEFORE THE EXPIRATION PATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAN City of Denton 3 0_ BAYS WWTTNN Rena TO THE CERTIFICATE HOLDER NAMED To THE LEFT, 901-B Texas Street BUT FAILURE To MAR. SOON NOTICE SHALL IMPOSE NO ODUMAT10N OR LIABSITY Denton, TX 76201 OF ANY MND undhl vun nnumw ,x A.EUM 04- RU25 2001 8If 40P32A-mumndRNe wHOWAuujiRDHILLINSURANCE c�tr�ri�rrPi, : IPA t�I r Ar poouceti HOWARD HILL,WALKER & COATS INS 901 W TfH STREET, N100 FORT WORTH, TX 7610E 817-338-2929 41.111150 CHARLES 0, MCKAMIE & RERECCA MCKAMIE C,D, MCKAMIE CnMFANY ; ZIRCON ENTERPRISES ne yn_�o� 6 EA.'nW—eE JUSTIN, TX 76247 IS TO CERTIFY 1TiAT THE POLICIES OI- m YYPE OP iMDunANec POL70YNE DeA M D 1 9RAL UABILITY X ' O MMOMOA64INKM Air A WlMaMe r1cew. CLS03 T950 OW,w NER'S A CONTRACTM 4 PROT NO 450 P 3/7 T-666 F 001/002 F-807 Yr rI I 4 - 2, - 2001 UEO AS A MATTER OF INK RMATION RIGHTS UPON THE CERTIF CATM COMPANY LVE BEEN ISSUW TO THE INSURED NAM9 AMOVB FOR THE POL ICY PERIOD 1 OFANY CONTRACT OR OTHER DOCUMENTWITH AESPBCT TO dVHICH THIS 60 BY THE I101-I0I1CS OVSCRIBED hCMVIN IS SU& ECTTO ALL T11111 TgRMS, 8 E UO PA p C .MS sr sprownwe I POLPeY EYMPATION 08/18/2001 ANY AUTO �01\\CBt"B t;UYp ' • . a ALI. OwNIM AuTOs kV T® B50o 1' ®CriEOULOD Gros oOT�'aatleva VOdby dn`CO Bolt % TO�,•sojef VIREO AUTOS VO4A &�� 9 1 ° N , I; 01 iM� ,f`1'YYSb{P 1tS UI tSC%'ri we IMOGI:. G `.NSA a.1 y •'ire i\Lae N0"*N6OAUT09 1t%suo ;I PIyYffiSEA1\SE t,,,nCR_EE'S' w'EIiTL� U.Y e S oar se + GPM lt1 Qi yoGy 1 6 d& i� "r T siy=/�Y�1 tR0 {i 59Ni tBOh Aoe UABfLm inn %9%4 :\.5 4M&{ G12z Ott ANY AUTO {pT 6 cyRCe C �e�tat AAA -�—»- I �quMdaDAy B RReRee L14016TY 4MDpELI.FORM CUBW43300 08/18/2000 OB/18/2001 e PD !!kHm NG COMMND►TDN AND NOTICE OF CANCELLA'j1011 :6RTIFIO1 Z. k- Q CITY OF DENTON 901 -B TEXAS STREET DENTON, TX 75201, 119Q�(P rl/II P AMC DAY q, Jt, ,'I FINS & WILCOX L MMITE IOO ATII1 :1000, 000. S 20009,000. Y C 2 _O DO.O do, iffiftailS 1A00,000- 100,o0D. • _ S.aoB. s1N0Ls LIMIT $ DAMAGE .,un ., I I, � r Ir EEFORE In NDEAVOR To MAIL LMCD TD YNE LEFT, UOATION DR LIAEIUTY 111INTATIV18 04-2a1'R�25 200� ernuNrnJRNS �HO���JAI RDHILLINSURANCE T-boo 45i0002/CIfIY 4h769T THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 02 0511 65 TEXAS CHANGES — AMENDMENT OF CANCELLATION PROVISIONS OR COVERAGE CHANGE This endorsement modifies Insurance Provided undertne following; COMMERCIAL GENERAL LIABILITY COVERAGE PART LIOUOR LIABILITY OOVERAGE PART OWNERS AND' CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAnE PART .---i afwymrLr I MIU UFEfiATIONS LIABILITY COVERAI3E PART RAILROAD PROTEOTIVE LIABILITY COVERACSE PART In the evens of cancellation or material change that reduces or restncls the insurance afforded by this Coverage Per, we Agree to mail Prior written notloe of cancellation or material change to SCHEDULE 1, Name CITY OF DENTION 2 Address 901-3 TEXAS STRISET DZN7`ON, TX 76201 3 Number of days advance nollos: 30 4 EXCEPT t0 4X Qj0 FOR NON-PAYMENT OF PREMIUM cc 02 0911 a9 Capyripg6 Insurance Serricas Office, leo., 1094 Pape 1 or 1 Sm/lp RPR 25 2001 8_33RM30Ue0WRRDHILLINSURRNCEy DW.,, CERTIFICATS OF LIABILI •RDDUCIVI 1 Waste= Integrity Tasuraase OW p. O Sox 150037 7706 Wyett Dr. 9_mt.-=tb, = 7ehlle INSURED C.D. KdXamtLa 00 , 'inn Rt. 1, Box 100 auetia, TX 78747 _7vMgP M9uRANSE RAL LWILRT O UNCIALdINOR AILITY CLAIMSNpOE eGCUR L 04491tT9 UMIT APAWBp PSR. 134 FNO 4501aPR P 5/71 07.51 INSURANCE INSURERS AFFORDING COVERAGE AN�- Iry�__------- iP C .MOFILA LIAFIIITY �WMAa" SINw.v url�� 1 ANY AUTO ALLewNCu^W7Q9 BOOM e:NUPY 1 SCHEOULEO AUTOS NIRCO AUT09 PCD0INJURY / m...wb.0 NON-OWNEMAUTOR — — — pROPERTY OAMA09 / t OUTY CLAIMAfOACqIPLE ONMPENBATe1N AND NCESOl57371 UAWTV 07110/20e0107/1-0/3001 OTHERTHAN AUTOON61 OanBaATe _ ._ _ +eeeep,O +ennnec dapapau mateni93. Ca N3edaiani'av000m*ntr CIE work;rs favor of city of Dentoy. policy also hap Blanket waiver of D TCA C AT O SHOULD ANY OF "it APOVF NP9OReeD POUCI9E EE OANOELLDO 11I THE SORINATIOR DATE THBREOP. THE DOWNS INSURER EESA ENDEAVOR TO MAR. 34--. DAYS WNITTER city of neaten 901 8 � 4'exas 9sreae NCTICA TO TND ADNrIHAAT6 NetOal HARWO 70 THE LSFii EUT PNWPH L1 TO OD EO 9HA IMPe9p No gELpSATIDry ORS ILRY DE ANY ONE UPON Dls%lrs aDNItTs 01 DAnten. TX 76201 APR 25 2001 8 33AM,305eWARDHILLINSURANCEY 134 Fu� otiORPR w �7d1 07 51 WC5XPV we NAME OCBAMMS L1 SMCnMIRUR ED A BEMEN'T ID PRODUCCEER 52S54200 y ENDORSEMENT DOCUMENT MCRXM - 2 iS CHANGED TO READ] BoLIOY I9 ItSAW9Y RNa0RAID TO ADD ENAORSEMENT NWSER WC4206OZ - TERAS NOTICE OF MATERXAL CRA"N MoopSEMENT 10•DAY NOTICE] OF CANCELLATION IN SAVOR OF CITY OF DENTON 501-F TZXAS STPANT DEMON, TX 76201 (TEXT WILL HE PRINTED ON DOCUMENT AB ENTHAMD) O Tip .9US ENO 4s 6e$AO1 APR 25 2001 B 33A�3W5ZH0WRRDHILLINSURANCEy 134 FN 450RPRP?"7J1 07t51 TEXAS WORKEIIS' COMP10"ATTON AND RMPLOVR&.4' I.IAnri ITV MANVAL WC 42 96 of Original PrinNng FJJecr(vaJonarary 1, 1994 TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT —TW0-e v e y c po wy because a7 s is shown i'n rt®m 3-A-airwe Information Page, In the avant of cancellation or other material/change of the policy, we will moo advance nonce to the person or orgaimili n named In the Schedule, The number of days advance notice is shown in the Schedule This andortement shall not operau directly or indirectly to boriefit anyone not named in the Schedule Schedule I Number of days advance notice; 2 Notice will be mailed to - Note use this' endorsoment if Texas is shown to Rom 3,A, of the Tuforteation Pare and the Insurer agrees to give to a third party advance notice of cancellation or other material change