1996-094 ORDINANCE NO q(,o"O q t,p
AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A CONTRACT FOR
THE PURCHASE OF MATERIALS, EQUIPMENT, SUPPLIES OR SERVICES, PROVIDING
FOR THE EXPENDITURE OF FUNDS THEREFOR, AND PROVIDING FOR AN EFFECTIVE
DATE
WHEREAS, the C~ty has sohc~ted, received and tabulated competitive bids for the purchase
of necessary materials, eqmpment, supphes or services in accordance with the procedures of STATE
law and City ordinances, and
WHEREAS, the C~ty Manager or a designated employee has rewewed and recommended
that the here~n described Nds are the lowest responsible bids for the materials, eqmpment, supphes
or services as shown in the "B~d Proposals" submitted therefore, and
WHEREAS, the C~ty Council has prowded ~n the City Budget for the appropriation of funds
to be used for the purchase of the materials, equipment, supplies or services approved and accepted
here~n, NOW, THEREFORE,
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS
SECTION I That the numbered ~tems m the following numbered bids for materials,
eqmpment, supphes, or servmes, shown ~n the "B~d Proposals" attached hereto, are hereby accepted
and approved as being the lowest responsible Nds for such items
BID ITEM
NUMBER NO_ Yt25[DDR AMOUNT
1868 ALL PREMIER EQUIPMENT SERVICES EXHIBIT "A"
1882 ALL WEFF INDUSTRIES $48,141 00
SECTION 11 That by the acceptance and approval of the above numbered items of the
submitted bids, the City accepts the offer of the persons submitting the bids for such ttems and
agrees to purchase the materials, equipment, supplies or services m accordance with the terms,
specfficat~ons, standards, quantmes and for the specified sums contained in the Bid Invitations, B~d
Proposals, and related documents
SECTION III That should the City and persons submitting approved and accepted ~tems and
of the submitted Nds w~sh to enter into a formal written agreement as a result of the acceptance,
approval, and awarding of the Nds, the C~ty Manager or his designated representative is hereby
authorized to execute the written contract whmh shall be attached hereto, provided that the written
contract is m accordance w~th the terms, conditions, specfficat~ons, standards, quantmes and
specified stuns contmned in the B~d Proposal and related documents here~n approved and accepted
SECTION IV That by the acceptance and approval of the above numbered ~tems of the
submitted b~ds, the Cxty Counml hereby authorizes the expendxture of funds therefor m the amount
and xn accordance w~th the approved b~ds or pursuant to a written contract made pursuant thereto as
authorized herexn
SECTION Y That thxs ordxnance shall become effective ~mmedmtely upon xts passage and
approval
PASSED AND APPROVED thxs/~day of ~ , 1996
ATTEST BOB~
JENNIFER WALTERS, CITY SECRETARY
APPROVED AS TO LEGAL FORM
HERBERT L PROUTY, CITY ATTORNEY
SUPPLY ORD
BID # 1868
BID NAME HEAVY EQUIP MECHANIC PREMIEREQUIP
OPEN DATE FEB 8, 1996 SVC
DE~*C~O-~ ~ VENDOR EXHIBIT "A"
HOURLY RATE BASED
UPON 40 HRS PER WEEK $38 00
2 HOURLY RATE FOR OVER
40 HOURS PER WEEK $38 00
DATE APRIL 16, 1996
C_.IIYXSOIJ~ C I/REPOllI
TO Mayor and Members of the City Cotmcfl
FROM Pack Svehla, Acting City Manager
SUBJECT BID # 1868 - ItEAVY EQUIPMENT MECItANICAL SERVICES
RE, CI)MMENi)ATION. We recommend this bid be awarded to the lowest responsible bidder,
Premier Equipment Services, at the hourly rate of
$38 00 per hour regular time
$38 00 per hour overtime
SIIMMARY: This bid is for a qualified technician with all associated equipment to preform
preventative maintenance and repmrs to the Solid Waste fleet at the landfill on an as needed basis The
bid requires a service truck with hydraulic cranes, tools, jacks, power wrenches, etc The City of
Denton furnishes parts and hmlted shop supplies only This is the second year ofth~s program and
it has proven to be very cost effective and satisfactory
With current work load and staffthe City of Denton Fleet Services Department is unable to dedicate
the required time and personnel to the landfill equipment maintenance program
The successful bidder will work under the direction of the Fleet Services Superintendent
The Fleet Services Department and Sohd Waste Landfill personnel have made several attempts to meet
w~th the L E David bidder to review the equipment and job requirements Each time the L E David
bidder has been non responsive
BAGKGROIJ~ Tabulation Sheet
PROGRAMS; DEPARTMENT~ OR GROUPS AFFECIED, Solid Waste Landfill Operations
and Fleet Services DIvision
F/SC~ The funds to pay for the services of Premier Equipment will be taken from Fleet
Services Sublet Labor Account #730-025-0580-8710
.~ve~wlly submitted
Acting City Manager
Name Tom D- Shaw, C P M
Title Purchasing Agent
726 AGENDA
DATE APRIL 16, 1996
CITY COIJNCIL REPORT
TO Mayor and Members of the City Council
FROM Rack Svehla, Acting City Manager
SUBJECT BID #1882 - 16 FT DIESEL RIDING MOWER
RECOMMENDATION. We recommend this bid be awarded to the lowest responsible bidder,
Weft Industries, m the amount of $48,141 00
SUMMARY: This bid is for the purchase of a 16' diesel powered riding mower The unit m a
motor pool replacement for a similar unit purchased in 1986 which is no longer economical to
maintain The replacement was approved during the 1995-96 budget process
This mower will be utilized by the Parks Department to malntmn park areas, medians, right of way
The old unit will be sold at pubhc auction
~ Tabulation Sheet
PROGRAMS: DEPARTMENTS OR GROUPS AFFECTED. Parks Department Grounds
Maintenance and Fleet Services Division
FISCAL IMPACT. This amt will be funded from an internal motor pool lease account #720-025-
0584-9104 and repaid by the department over a 60 month time period
Rick Svehla
Acting City Manager
Name Tom D Shaw, C P M
Title Purchasing Agent
725 AGENDA
BID # 1882
BID NAME 16 FT DIESEL RIDING GOLDTIt~VAITE'S WEFF
MOWER OF INDUSTRIES
OPEN DATE APRIL 2, 1996 TEXAS
Dt~SCRtP~}~ON '~NDOR VENDOR VENDOR VENDOR VENDOR
16 FT DIESEL RIDING MOWER
CAB, AC, AIR RIDE SEAT $52,380 00 $48,141 00
12 MOS
WARRANTY IN MONTHS OR 24 MOS UNLIMITED
OPERATIONS HOURS lS00 HRS HRS
DELIVERY IN DAY AFTER
_ RECEIPT OF ORDER 15-30 DAYS 45 DAYS _
HOWARD
MFG TORO PRICE
30580 TURF
MODEL GROUNDSMASTER HYDRO 180 ~ _
PROPOSED CONTRACT
AGREEMENT FOR MAINTENANCE SERVICES
Thas Agreement as made thas 16 day of April , 19 96
between the CITY OF DENTON, Texas, a munlcapal corporataon, of
Denton, Denton County, Texas (Caty) and Premier EquIpment Services,
whose address as 508 Austin St , Keller, TX 76248 (Contrac-
tor)
I. DUTIES
The parties to this Agreement stipulate and agree that City
shall employ, engage, and hmre Contractor an the pos~taon of Heavy
Equapment Mechanmc to perform the followmng duties
Provade routine preventatmve mazntenance service for all
heavy equmpment as determaned by Cmty
Provmde for emergency repaar for all heavy equmpment as
determaned by City
Contractor further agrees that mn the event of a break down
of equipment, Contractor w~ll, to the extent possable
absent events not controllable by the Contractor, make any
and all necessary repamrs to allow work to commence on the
next workang day
Coordinate all parts requmrements through the Caty of Denton
Fleet Services Department
Perform "parts pickup" servmces if required by Caty
II. CONSIDERATION
In consideration of such servIces, C~ty agrees to pay Contrac-
tor compensation in the amount not to exceed Eighty Thousand
Dollars ($80,000 09 at a rate of Thirty ~lght Dollars ($ 38 00,. )
per hour for the term of th~s Agreement Payment by C~ty for these
services properly performed will be made upon receipt and approval
of lnvomces submitted by Contractor every two weeks in accordance
with Cmty's standard processmng procedures
III. TERM
The term of this Agreement shall be for a period of one
year , beginning on May 1 , 19 96 , and
terminating on April 30 , 19 97
IV. TERMINATION
This Agreement may be termmnated by either party at any time
upon the giving of thirty (30) days written notice of termination
to the other party In the event of termination of this Agreement
in any manner, payments previously paid plus payments for services
properly performed to the date of termination shall be deemed to be
in full satisfaction of all claims against City under this
Agreement
V. I19DEPEI~-DENT CONTRACTOR
It is agreed and understood that any work requested by the
partmes hereto shall be performed under the terms of this Agreement
and that all parties hereto are considered independent contractors
Each party ms Interested only in the results obtained hereunder,
and has the general right of inspection and supervlsmon in order to
secure the satisfactory completion of such work Neither party
shall have control over the other party wmth respect to its hours
or tmmes, and under no cmrcumstances shall emther party hereto be
deemed an employee of the other or act as an agent of the other
VI. DUE DILIGENCE
Contractor warrants that he shall perform the oblmgatmons wmth
due diligence in a safe, competent, workmanlike manner and in
complmance wmth any and all applmcable statutes, rules, and
regulatmons of the Cmty of Denton and State and Federal law
PAGE 2
VII. INSURANCE
A Contractor shall maintain continuously in effect at all
times during the term of this agreement or any extension thereof,
at Contractor's expense, the following insurance coverage
Comprehensive General LiabilIty Insurance covering
the Contractor, its personnel and its operations,
for bodily injury and property damage in the
minimum amount of $1,000,000, combined single
l~m~ts on a per occurrence basis
B All policies shall be issued by a company authorized to do
business in the State of Texas, be approved by the City of Denton,
copies of which shall be provided to C~ty The policies shall name
the City as an additional named insured and shall provide for a
minimum of thirty (30) days written notice to the City prior to the
effectIve date of any cancellation or lapse of such polices
VIII EQUIPMENT
Contractor shall furnish a service truck with auto crane and
shall provide parts, fuel, and oil for th~s equipment Contractor
further agrees to furnish all basic hand tools, including any and
all tools necessary to make repairs and to service all types of
l~ght and heavy equipment
Contractor shall furnish all metal cutting and welding equip-
ment and all motor fuel and oil for operation of this equipment
City shall furnish all specialty tools required and designed by
the manufacturer to perform a specific service or repair needed to
a given piece of equipment
PAGE 3
IX. INDEMNITY
Contractor agrees to indemnify, hold harmless, and defend the
city, its officers, agents, and employees from and against any and
all claims or suits for ln3urles, damages, loss, or liability of
whatever kind or character, arising out of Contractor's error,
negligent act, or omission in connection with Contractor's perfor-
mance of the services described in this Agreement In addition,
Contractor shall hold harmless the City, its officers and employees
from any and all expenses, including attorneys' fees and court
costs which may be incurred by the City in litigation or otherwise
resisting any claim or liability which might be imposed on the City
as the result of the Contractor's activities In the event the
City is determined by a court of law to be ]olntly negligent for
such damage or injury, City shall indemnify Contractor on a pro-
portlonate basis in accordance with the final judgment determining
such joint liability
X. MISCELLANEOUS
This Agreement shall be construed under and in accordance with
the laws of the State of Texas, and all obligations of the parties
created hereunder are performable in Denton, Denton County, Texas
Ail notices provided to be given under this Agreement shall be
given by certified mall, registered mall, or hand-delivered,
addressed to the proper party, at the following address
The City of Denton Contractor
ATTN Jack Jarvls
215 E McKlnney
Denton, Texas 76201
PAGE 4
XI. MODIFICATION
It lS further agreed that no waiver or modification of this
Agreement or any covenant, condItion, or limitation contained
herein shall be valid unless in writing and duly executed by the
party to be charged therewith
EXECUTED this .~ day of
CITY OF DENTON, TEXAS
~~MANAGER
ATTEST
JENNIFER WALTERS, CITY SECRETARY
MICHAEL A BUCEK, ACTING CITY ATTORNEY
Premier Equipment Services
E \WPDOCS\K\MAINTENANCE K
PAGE 5
'PREMIER
EQUIPMENT SERVICE, INC.
ATTACHED IS COPIES OF THE INSURANCE POLICIES ON TRUCKS CURRENTLY
IN USE
308 AUSTIN STREET * KELLER, TEXAS 76248 ' (817) 431-6641 * MOBILE (817) 992-5297
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
17~,Ol PRESTON ROAD
DALLAS¢ TX 753Z9 *RENEWAL CERTIFICATE
FORM OF SUOINESS [] C~RPORATION [] PARTNERSHIP [] INBIVIBUAL [] OTHER POLICY NUMBER 299 ~ ? 52 -- A 16- ~ 3
. mTEM~ NAMEO INSURED ANO MAILIN6 A~O~ESS POLICY PER[OD FROM JAN-16-g6 TO JUL-lb-g
~o ~'717~ C att201AM Standa~dT,meattheaddressofthena~msur~asstat~
~ PREMIER E~UIPM~N~ SERVICE INC
50B AUSTIN 5T
K~LLER TX ZbZ~B-Z~4b
-- Ih.hlh,,,I,hh,lh,h,,hh,hl,h,hlh,~h,,h,h.,lll
PREMIUM SHOWN IS PAYABLE $ ~ ~ ~ ~ ~ 0 0 AT INCEP
1 ~4 CHEVROLET C70 PICKUP 16~J 7D19~EVl~O92g 3318300 0
ITEM TWO SCHEDULE OF COVERAGES AND COVERED AUTOS
COVERAGF SYMBOL COVERED AUTO NUMBER PREMIUM COVERAGE NAME LIMIT AUTO COVERAGE SYMBOL
AB LIABILITY-(SYNBOL 7)
$244.00 BODILY INJURY LIABILITY
LIMIT-COVERAGE AB - EACH PERSON, EACH ACCIDENT
25,000 50,000
$101.00 PROPERTY DAMAGE LIABILITY
LIMIT-COVERAGE A8 - EACH ACCIDENT
25.000
P2 $28°00 PERSONAL %NJURY PROTECT%ON(SEE ENDORSEMENT)
LIMIT-COVERAGE P2 - EACH PERSON 5.000
D $59.00 $100 DEDUCTIBLE COMPREHEN~IVE-(SYHBOL ?)
G $55.00 $S00 DEDUCTIBLE COLLISION (SYMBOL ?)
U UNINSURED/UNDERINSURED MOTORISTS(SEE ENDORSEMENT)
$34.00 LIMIT-COVERAGE U-BODILY iNJURY
EACH PERSON~ EACH ACCIDENT
25.000 50.000
$7.00 LIMIT-COVERAGE U-PROPERTY DAMAGE($250 DEDUCTIBLE)
EACH ACCIDENT
25,000
$528.00 ESTIMATED TOTAL PREMIUM FOR POLICY PERIOD JAN-16-96 TO JUL-16'V6
EXCEPTIONS AND ENDORSEMENTS ATTACHED TO THIS POLICY.
PREMIUM FOR ENDORSEMENTS(SHOWN ABOVE WHEN APPLICAdLE)
FINANCED-ANY LOSS UNDER PHYSICAL DAMAGE COVERAGE IS PAYABLE AS INTEREST MAY
APPEAR TO THE INSURED AND NATIONS BANK, PO BOX 740125, ATLANTA GA
30~74-0125.
IL 00 21 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT BROAD FORM.
TE 00 39B AMENDATORY ENDORSEMENT: CHANGE CONDITIONS AND DEFINITIONS.
TE O0 40 AMENDATORY ENDO~bEMENT-TEXAS~ CHANGE CANCELLATION OR NONRENEWAL
CONDITIONS.
ITEM 2-SYMBOL ? SPECIFICALLY DESCRIBED AUTOS.
TE O~ 01C PERSONAL INJURY PROTECTION ENDORSEMENT-TEXAS (COVERAGE P).
TE 04 06B MEXICO COVERAGE-LIMITED.
TE 04 09C UNINSURED/UNDERINSURED MOTORISTS INSURANCE (COVERAGE U).
TE 20 35A LOSS PAYABLE CLAUSE-MODIFIED.
TE 99 60A SUPPLEMENTARY DEATH BENEFIT.
CAR 1-TE2015A-MOBILE EQUIPMENT.
CAR 1-TE2045A-EXCLUSION OF EQUIPMENT.
THIS iS YOUB OEC~RATIONB PAGE COUNTERSIGNED 12-13-95
PLEASE A~ACH TO YOUR A~O POLICY BOOKL[T BY JOHN ANDERSON 7178-0
YOUR POLICY CONSISTS OF THIS PAGE. ANY ENDORSEUENTS AND THE ~LICY BOOKLET FORU 9 & 43 U. 2 N T PLEASE KEEP TOGETHER
155 4972
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
1i'301 PRESTON ROAD
DALLAS, TX 7531'9 *RENEWAL CERTIFICATE
FORM OF BU$1NES$ F~CORPORATION ~'~PARTNERSHiP~-'~INDIVIDUAL [-"~OTHER POLICY NUMBER DO0 7363-B07-43
,, ITEM1 NAMED INSURED AND MAILING ADDRESS POLICY PERIOD FROM FEB-O?-96 TO AUG-O?-9
,o 43-7178 C at1201AM Standard Time at the addmss of the named msured as stated her
' PREMIER EQUIPMENT SERVICE INC
308 AUSTIN ST STATE FARN PAYMENT
KELLER TX 1'6248-22/.6 PLAN NUMBER 0330633008
-- Ih,,hlh,,,hhhdh,h,,hh,hhh,hlhdh.h,h.,lll
'-- PREMIUM SHOWN IS PAYABLE $ $'~)47. O0 AT INCEP
,~u ~.Ol' P,~Y I , ,~ ~ · , ~ ~.~. THIS PAGE
~,~.r ~,~.~ E ~ I.-~ l ~-, ,~ ~ ~ ~ ,~-~ _ ~ F AMOUNT
ITEM THREE SCHEDULE OF COVERED AUTOS YOU OWN
SERIAL NUMBER (S) CLASS TERRITO
COVERED AUTO YEAR TRADE NAME MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER (VIN]
1 85 CHEVROLET $10 PICKUP 1GCBS 14ESF2218009 3A 0 0
ITEM TWO SCHEDULE OF COVERAGES AND COVERED AUTOS ~ V ,~,IDF" FOR
COVERAGF SYMBOL COVERED AUTO NUMBER PREMIUM COVERAGE NAME LIMIT AUTO COVERAGE SYMBOL h~ L. I . ,, -C, HA, IATION
AB LZABZLZTY-(SYMBOL 7)
$167.00 BODILY INJURY LIABILITY
LIMIT-COVERAGE AB - EACH PERSON. EACH ACCIDENT
25,000 50,000
$80.00 PROPERTY DAMAGE LIABILITY
LIMIT-COVERAGE AB - EACH ACCIDENT
25,000
$247.00 ESTIMATED TOTAL PREMIUM FOR POLICY PERIOD FEB-07-96 TO AUG-O?-96
EXCEPTIONS AND ENDORSEMENTS ATTACHED TO THIS POLICY.
PREMIUM FOR ENDORSEMENTS(SHO~N ABOVE ~HEN APPLICABLE)
IL O0 21 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT BROAD FORM.
TE O0 39B AMENDATORY ENDORSEMENT CHANGE CONDITIONS AND DEFINITIONS.
TE O0 40 AMENDATORY ENDORSEMENT-TEXAS CHANGE CANCELLATION OR NONRENE~AL
CONDITIONS.
ITEM 2-SYMBOL 7 SPECIFICALLY DESCRIBED AUTOS.
TE 04 06B MEXICO COVERAGE-LIMITED,
TE O~ 09D UNINSURED/UNDERINSURED MOTORISTS INSURANCE (COVERAGE U),.
THIS IS YOUR DECLARATIONS PAGE COUNTERSIGNED 01-04-96
PLEASE A~ACH ~0 YOUR AUTO POLICY BOOKLLT BY JOHN ANDERSON ? 178-0~
YOUR POLICY CONSISTS OF THiS PAGE ANY ENDORSEMENTS AND THE POLICY BOOKLET FORM 9843 P · 3 N T PLEASE KEEP TOGETHER
155-4972
PREMIER
EQUIPMENT SERVICE, INC.
Attached is a copy of the 1,000,000 O0 General Liability Insurance
Policy currently lneffect
308 AUSTIN STREET * KELLER, TEXAS 76248 ' (817) 431-6641 ' MOBILE (817) 992-5297
COMMERCIAL LIABILITY
~. , - ......... DECLARATIONS ~~'~
SCOTTSDALE INSURANCE COMPANY®
8877 North Galney Center Drive, Scottsdale, Arizona 85258
CLS217605 1-800~t23-7675 (outside Arizona)
Beo~wa~ of Numb.r A STOCK COMPANY Policy Number
CLS286521
Item I Named Insured and Malting Address
JAY JOHNSON
308 AUSTIN STREET
KELLER TX 76248
Agent Name and Address
BURNS & WILCOX LTD
1250 E COPELAND RD, #900
ARLINGTON TX 76011 Agent No 42-0020
Item 2 Pohcy Period From 10/03/95 To 10/03/96
12 01 A M Standard Time at the address of the Named Insured as stated herein
Item 3 Retroactive Date None
Item 4 Business Description HEAVY MACHINE REPAIR
Item 5 In return for the payment of the premium, end subject to all the torino of thio palloy, wa agree with you to provide
the insurance es stated In this policy
Thio policy oonoloto of the following coverage parte for which a premium ID Indicated Where no premium ID ohown, there le
no coverage Thio premium may be eubJeet to adjustment
Coverago Pert(s) Form No and Edition Dote Premium
Commercial General Liability Coverage Part CLS-SD~I (2-92) $1495 00
Profe_~!qnal Liability Coverage Part NOT COVERED $
~rowd~r~ th~ ~ov~-.-~ and thts ineufe~ i~ n~ a mef~ d the $
)reperty and canualty insurance gueramY ~, ,-.~_--~_~ $
A~le 1 14-2. requlms PaYmerit o! 4 85% tax an ~ I~'-'~m ' Total I$ 1,49500
POLICY FEE 115 00
STATE TAX 78 O9
STAMPING FEE 1 61
Item 6 Forms and endorsements applicable to all Coverage Parts CLS-SD-1 (02-92)
SHOW NUMBERS
Countersigned 10-12-95 DC/TH By DOI~CN;ISON
DATE AUTHORIZED REPRESENTATIVE
THIS COMMERCIAL LI/~ILII¥ DECLARATIONS AND THE SUPPLEMENTAL DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS
COVERAGE FORM(S) AND ENDORSEMENTS COMPLETE THE ABOVE NUMBERED POLICY
CLS D 1 110-92) ORIGINAL
JL SCOTTSDALE INSURANCE COMPANY ®
COMMERCIAL GENERAL LIABILITY COVERAC E PART
SUPPLEMENTAL DECLARATIONS
These Supplemental Deolaratlone form a part of polioy number el R~A6521
LIMITS OF INSURANCE
General Aggrogata Umlt (other than Produote/Completed Operations) $ 1.000.OD0
Produots/Completed Operations Aggregate Umlt $ 1,000.00o
Personal and Advertising Injury Umlt $ 1.000.000
Eac;h Ocourrsnce I. lmit $ 1.000,000
Rte Damage Umit $ 50.000 anyone tim
Idedicel Expense Umit $ EXCLUDED any one person
BUSINESS DESCRIPTION AND LOCATION OF PREMISES
Form of business
[] Individual [] Joint Venture [] Partnership [] Organization (other than Partnership or Joint Venture)
Business dasorlptlon HEAVY MACHINE REPAIR
Looaflon of all premises you own. rent or occupy SAME
PREMIUM
Rate Advance Premium
Classification Code No *Premium Basra PR/Co All Other Pr/Co All Other
IqACHINERY OR EQUIPNENT-INDUSTRIAL 97222 P)$1,900 16 402 30 477 S 523 $ 9~
-INSTALLATION, SERVICING OR REPAIR
FORMS AND ENDOR~EMENTB (other than applicable forms and endorsements shown elsewhere In the polloy)
Forms and endorsemanffi spply~ngtothieCoversge Part and made part ofthis pohcysttime of~ssue
CL$-JZ(02-95), CG0001(10 93), C$2101(11-85), CG2116(11-85), CG2141(11 85), CG2146(01-87), CG2147(10-93), 1L0017(11-85),
GL$-B~g(O~-9~), UTS-88g TX(09-94)~ UTS 1~8g(10-94), UTS 137g(0~ 93), UTS-182g(02-94), UTS 230g TX(09 94)
*(e) Nee, (o) Total cost, (m) Admi~lon, (p) Payroll, (e) Om~s 8ales. (u) Unite. (o) Other
THIS SUPPLEMENTAL DECLARATIONS AND THE COMMERCIAL LIABILITY DECLARATIONS, TOGETHER WITH THE COMMON POLICY
CONDITIONS COVERAGE FORM(S) AND ENDORSEMENTS COMPLETE THE ABOVE NUMBERED POLICY
CLS-SD-1 (2 92) ORIGINAL
J ENDORSEMENT
SCOTTSDALE INSURANCE COMPANY® NO.
AT[ACHED TO AND ENDORSEMENT EFFECTIVE
FORMING A PART OF (STANDARD TIME) INSURED AGENCY AND CODE
POLICY NUMBER MO DAY YR 12 Ot NOON
CLS286521 X
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
OPTIONAL PROVISIONS ENDORSEMENT
In consideration of the premium charged, it is agreed that the following special provisions (ind~cated by an "X") apply to
this policy
SCHEDULE
[] Bodily Injury, Property Damage, Personal Injury and Advertising Injury Liability Deductible Endorsement
Bodily injury Uability $ 500 00 per claimant
Property Damage Liability $ 500 00 per claimant
Personal Injury Uabthty $ 500 00 per claimant
Advertising injury Uabihty $ 500 00 per claimant
[] Service of Suit Clause
Service of Process will be made upon BURNS & WILCOX LTD
1250 EAST COPELAND ROAD #900~ ARLINGTON, TEXAS 76011
[] Minimum and Advance Premium Endorsement
Minimum Premium $ 1,495 00
[] Minimum Earned Premium
Minimum Earned Premium 25 % of the original premium
BODILY INJURY, PROPERTY DAMAGE, PERSONAL INJURY AND ADVERTISING INJURY
LIABILITY DEDUCTIBLE ENDORSEMENT
APPLICATION OF ENDORSEMENT (Enter below any hmitatlon on of such deductible ',~gregats" hmits for such coverages shall
the apphcat~on of thts endorsement If no hm~tat~on is entered, the not be reduced by the application of such deductible amount
deductibles apply to damages for all "bodily Injury," "property
damage, "personal Injury' "and "advertising injury," however 2 The deductible amounts Include all legal and loss adjustment
caused ) expenses
3 The deductible amounts stated in the Schedule apply under
the Bodily Injury Liability, Property Damage liability, Personal
Inlury babihty and Advertising injury bab~llty Coverages,
I Our obhgat*on under the Bodily Injury Uabdlty Property respectively, to all damages because of "bodily injury" or
Damage Uablhty, Personal Injury bab~hty and Advertising Injury personal Injury" sustained by one person, or to all dam ages
Uablhty Coverages to pay damages on your behalf applies only because of "property damage" sustained by one person, any
to the amount of damages in excess of any deductible organization, or association or any individual member of any
amounts ¢=tAtm-I In the ~hl;ldllle al)ova as appllcableto organization or assoclatton as the result of any one
such coverages, and the limits of insurance applicable to "each "occurrence"
occurrence' for such coverages wilt be reduced by the amount
UTS-128g (1094) Page 1 of 2
APR-26-1996 ~9 46 FARMERS INS 817 581 1941 P ~1
· 4-23-9~
I ~ODUCBR THIB GERTIFIOA~ 18 18RUED AB A MA~Efl OF INFORMATION ONLY AND CONFER8
EXTEND OR AL~R THE COVERAge AFFORDED BY THE POLI~IE8 BELOW
MARK CARL TNSUERNC~ AGENCY
6851 NE ~OOP 820 ST~, 226 cOMPANIES AFFORDING COVE~GE
SC~TSDAL~ ~SU~B~ COMPANY
JAY JOHNSON
308 AUSTIN STREET ~,~,~ O
KELLE~, TEXAS 76248
~LUSION9 AND GoNDmoN8 OF SUCH POLICiBa UM~S 8HO~ ~Y HAVE BBEN REDUCED BY PAID C~IMB
C~IM8 ~OZ O~UR PERSONAL & ADVERTIa~a I~URY S [ 000
~H O0~Ue~Z~0E t [ 000
(~ITY OF DENTON IS NAMED ADDITIONAL INSURED
WITH 30 DAYS CANCELLATION NOTICE
CT T¥ OF DEN't'ON MAIL 6'30 DAYB WRIt'TEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE
901 TEXAS ST.
DENTON ~, TX · 76201 LE'~' BUT FAILURE TO MAIL SUCH NOTICB SHALL IMPOSE NO 05LIGATION OR
LIABILITY OF ANY KIND uPON THE COMPANY, ITB AQENTE OR REPRESENTATIVES
~uTAL P 0!
H~R-25-1996 1~ 50 FARMERS INS 817 58i 1941 P~i
OBurns & Wilcox Ltd.
UN[~Rt*~ff~ M~l~Im~ AND ~$
INSURANCE BINDER
THIS BINDER ~ A TEM~RARY INSUR~CE ~NTRA~, 6UBJE~ TO ~E COND~ION8 SHOWN B~OW
pRODUCER,
I~URED JAY ~HN~N MARK ~ CARL
~51 NE L~P ~0 ~E 226
3~ Au~N ~TREET N RICHLAND HIL, TX 78180
K~LE~ TX 7~
L~A~ON OF
E~E~I~ FROM. 1~5 TO 10~, ~TH DAY~ AT 12 01 AM ~ANDARD TIME AT LOCATION OF RISK
INSURER[S)=
SCO~SDALE INSURANCE COMPANY
4 FORM OF COVERAGE: coMMERCIALGENUAB OCCURRENCE
5. UMIT~OEDUC'rlBLES'
L3ORDITK)HS:
91GLNED AppLIC,~'IlON,
INGLUDIS8 ~0 ADdiTIONAL. tHI~UREDS ADVISE I~s WE HEEOANY