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2013-058
ORDINANCE NO. 2013-058 AN ORDINANCE ACCEPTING PROPOSALS AND AWARDING A PUBLIC WORKS CONTRACT FOR THE REPLACEMENT OF TWO 10-INCH SEWER CROSSINGS AS PART OF THE US HWY 380 WIDENING PROJECT; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR; AND PROVIDING AN EFFECTNE DATE (BID 5131-AWARDED TO WILSON CONTRACTOR SERVICES, LLC IN THE AMOUNT OF $202,509.40). 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. 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 CONTR.ACTOR AMOUNT 5131 Wilson Contractor Services, LLC $202,509.40 SECTION 2. 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 awaxd of the bid. SECTION 3. The City Manager is hereby authorized to execute a11 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. The City Council of the City of Denton, Texas hereby expressly delegates the authority to take any actions that may be required or permitted to be performed by the City of Denton under Bid 5131 to the City Manager of the City of Denton, Texas, or his designee. SECTION 5. Upon acceptance and approval of the above competitive bids and the execution of contracts for the public worlcs and improvements as authorized herein, the City Council hereby authorizes the expenditure of funds in the manner and in the amount as speciiied in such approved bids and authorized contracts executed pursuant thereto. SECTION 6. This ordinance shall become effective immediately upon its passage and approval. PASSED AND APPROVED this the �� day of �f �� , 2013. ATTEST: JENNIFER WALTERS, CITY SECRETARY BY: l� APPROVED AS TO LEGAL FORM: ANITA BURGESS, CITY ATTORNEY �_ ,_�°�� BY: � , c� s-o = �a si3i .. ' CONTRACT AGREEMENT STATE OF TEXAS § COUNTY OF DENTON § THIS AGREEMENT, made and entered into this 5th day of March A.D., 2013, by and between City of Denton of the County of Denton and State of Texas, acting. through George C. Campbell thereunto duly authorized so to do, hereinafter termed "OWNER," and Wilson Contractor Services LLC 107 Bell Ave. Suite 3 Denton, TX 76201 of the City of Denton, County of Denton and State of Texas , hereinafter termed "CONTRACTOR." WITNESSETH: That for and in consideration of the payments and agreements hereinafter mentioned, to be made and performed by OWNER, and under the conditions expressed in the bonds attached hereto, CONTRACTOR hereby agrees with OWNER to commence and complete performance of the work specified below: Bid 5131-US 380 Urban Utility Relocation Phase II in the amount of $202,509.40 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 all local, state and federal laws; and plans, which includes all maps, plats, blueprints, and other drawings and printed or written explanatory matter thereof, and the Specifications therefore, as prepared by: all of which are referenced herein and made a part hereof and collectively evidence and constitute the entire contract. CA-1 Independent Status It is mutually understood and agreed by and between City and Contractor that Contractor is an independent contractor and shall not be deemed to be or considered an employee of the City of Denton, Texas, for the purposes of income tax, withholding, social security taxes, vacation or sick leave benefits, worker's compensation, or any other City employee benefit. City shall not have supervision and control of Contractor or any employee of Contractor, and it is expressly understood that Contractor shall perform the services hereunder according to the attached specifications at the general direction of the City Manager of the City of Denton, Texas, or his designee under this agreement. Indemnification Contractor covenants and agrees to and does hereby indemnify, hold harmless and defend, at its own expense, Owner, its officers, servants and employees, from and against any and all claims or suits for property loss or damage and/or personal injury, including death, to any and all persons, of whatsoever kind or character, whether real or asserted, arising out of the Work and services to be performed hereunder by Contractor, its officers, agents, employees, subcontractors, licensees or invitees, whether or not caused, in whole or in part, by the alleged negligence of the officers, servants, employees, of the Owner. Contractor likewise covenants and agrees to, and does hereby, indemnify and hold harmless Owner during the performance of any of the terms and conditions of this Contract, whether arising out of in whole or in part, any and all alleged acts or omissions of officers, servants, or employees of Owner. The provisions of this paragraph are solely for the benefit of the parties hereto and not intended to create or grant any rights, contractual or otherwise, to any other person or entity. Choice of Law and Venue This agreement shall be governed by the law of the State of Texas and venue for its construction and enforcement shall lie in the courts of Denton County, Texas. The CONTRACTOR hereby agrees to commence work on or after the date established for the start of work as set forth in written notice to commence work and complete all work within the time stated in the Proposal, subject to such extensions of time as are provided by the General and Special Conditions. The OWNER agrees to pay the CONTRACTOR in current funds the price or prices shown in the Proposal, which forms a part of this contract, such payments to be subject to the General and Special Conditions of the Contract. CA-2 Right to Audit The OWNER shall have the right to audit and make copies of the books, records and computations pertaining to this agreement. The CONTRACTOR shall retain such books, records, documents and other evidence pertaining to this agreement during the contract period and five years thereafter, except if an audit is in progress or audit findings are yet unresolved, in which case records shall be kept until all audit tasks are completed and resolved. These books, records, documents and other evidence shall be available, within 10 business days of written request. Further, the CONTRACTOR shall also require all Subcontractors, material suppliers, and other payees to retain all books, records, documents and other evidence pertaining to this agreement, and to allow the OWNER similar access to those documents. All books and records will be made available within a 50 mile radius of the City of Denton. The cost of the audit will be borne by the OWNER unless the audit reveals an overpayment of 1% or greater. If an overpayment of 1% or greater occurs, the reasonable cost of the audit, 'including any travel costs, must be borne by the CONTRACTOR which must be payable within five business days of receipt of an invoice. Failure to comply with the provisions of this section shall be a material breach of this contract and shall constitute, in the OWNER'S sole discretion, grounds for termination thereof. Each of the terms "books", "records", "documents" and "other evidence", as used above, shall be construed to include drafts and electronic files, even if such drafts or electronic files are subsequently used to generate or prepare a final printed document. CA-3 IN WITNESS WHEREOF, the parties of these presents have executed this agreement in the year and day first above written. A TEST. City of Denton T OWNE BY: (SEAL) ATTEST: W, l se.J C~sT'~.oc~o~ ~y ..E s L ~C - CONTRACTOR MAILING ADDRESS 91Y0 o1113 PHONE NUMBER 94(0 k9o ii -Is FAX NUMBER BY: 03, AUTHORIZED SIGNATURE WeAc~o,,, t_SA sori -ces wcs APPROVED AS TO FORM: PRINTED NAME, TITLE (SEAL) BY: ANITA BURGESS, CITY ATTORNEY CA-4 PERFORMANCE BOND STATE OF TEXAS § Bond No. 4390343 COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That Wilson Contractor Services, LLC✓ whose address is 107 Bell Avenue Suite 3 Denton TX 76201 hereinafter called Principal, and SureTec Insurance Companyv" a corporation organized and existing under the laws of the State of Texas 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 Two Hundred Two Thousand Five Hundred Nine and 401100 DOLLARS✓($202,5o9- 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 2013-058, with the City of Denton, the Owner, dated the~th day of March A.D. 2013vfor Bid #5131-US 380 Urban Utility Relocation Phase 2 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 two (2) years from the date of final completion and final acceptance of the Work by the Owner; and, if the Principal shall fully indemnify and save harmless the Owner from all costs and damages which Owner may suffer by reason of failure to so perform herein and shall fully reimburse and repay Owner all outlay and expense which the Owner may incur in making good any default or deficiency, then this obligation shall be void; otherwise, it shall remain in full force and effect. PB - 1 PROVIDED FURTHER, that if any legal action be filed upon this Bond, exclusive venue shall lie in Denton County, State of Texas. AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc., accompanying the same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc. This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government Code, as amended, and any other applicable statutes of the State of Texas. The undersigned and designated agent is hereby designated by the Surety herein as the Resident Agent in Denton County to whom any requisite notices may be delivered and on whom service of process may be had in matters arising out of such suretyship, as provided by Article 7.19-1 of the Insurance Code, Vernon's Annotated Civil Statutes of the State of Texas. IN WITNESS WHEREOF, this instrument is executed in four copse, each one of which shall be deemed an original, this the. 5tt, day of March 2013 ATTEST: PRINCIPAL Wilson Contractor Services, LL•C BY: L S CRETARY BY: _ PRESIDENT .ATTEST: SURETY SureTec Insurance Company BY: C , Pat Pinchback, Witness $y; ATTORNE -IN-FAC / Lisa Borhaug The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: Lisa Borhaug STREET ADDRESS: 321 Stately Oak Lane, Lake Dallas, Texas 75065 (NOTE: Date of Performance Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name.) PB-2 PAYMENT BOND Bond No. 4390343 STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That Wilson Contractor Services LLC✓ whose address is 107 Bell Ave Suite 3 Denton TX 76201 hereinafter called Principal, and SureTec Insurance company , a corporation organized and existing under the laws of the State of TBxas , 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 surn of Two Hundred Two Thousand Five Hundred Nine and 40/100 Dollar202,509.40_ rn 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 x,013-058, with the City of Denton, the Owner, dated the 5th day of March A.D. 2013, or Bid 5131-US 380 Urban Relocation Phase 2 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. PB-3 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 in four copies, each one of which shall be deemed an original, this the 5th day of March 2013 ATTEST: PRINCIPAL Wilson Contractor Services, LLC__^ BY: da/ - SECRETARY BY: PRESIDENT ATTEST: SURETY BY: SureTec Insurance Company A& Pat Pinchback, Witness BY; 4VM:N_A~~ ATTO -IN-FAC / Lisa Borhaug The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: - Lisa Borhaug_ STREET ADDRESS: 321 Stately Oak Lane, Lake Dallas, Texas 75065 (NOTE.- Date of Payment Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name.) PB-4 i SureTec Insurance Company THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION Statutory Complaint Notice To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint at: 1-866-732-0099. You may also write to the Surety at: SureTec Insurance Company 9737 Great Hills Trail, Suite 320 Austin, Tx 78759 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252-3439. You may write the Texas Department of Insurance at: PO Box 149104 Austin, TX 78714-9104 Fax#: 512-475-1771 Web: http://www.tdi.state.tx.us Email: ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Terrorism Risks Exclusion The Bond to which this Rider is attached does not provide coverage for, and the surety shall not be liable for, losses caused by acts of terrorism, riot, civil insurrection, or acts of war. Exclusion of Liability for Mold, Mycotoxins, Fungi & Environmental Hazards The Bond to which this Rider is attached does not provide coverage for, and the surety thereon shall not be liable for, molds, living or dead fungi, bacteria, allergens, histamines, spores, hyphae, or mycotoxins, or their related products or parts, nor for any environmental hazards, bio-hazards, hazardous materials, environmental spills, contamination, or cleanup, nor the remediation thereof, nor the consequences to persons, property, or the performance of the bonded obligations, of the occurrence, existence, or appearance thereof. i POA a: 4221029 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPAN the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint ~ Clem F. Lesch, Steven W. Lewis, Allen Sparks, Eric Lesch, Lisa Borhaug, Roger Bales its true and lawful Attorney-in-fact, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: / Five Million and 00/100 Dollars ($5,000,000.00)v and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment shall continue in force. until - 12/31/2014 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20°i of April, 1999) In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affixed this 3rd day of September, A.D. 2010. u ,.w SURETEC INS E C PANY SVRp'N~'F m~, K By. w n= John o Jr., resident State of Texas ss: County of Harris On this 3rd day of September, A.D. 2010 before me personally came John Knox Jr„ to me known, who, being by me duly sworn, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument; that he knows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order of the Board of Directors of said Company; and that he signed his name thereto by like order, "oly'ua'" JACQUELYN MALDONADO Notary Public, State of Texas acq ely~ aldoi ado, Notary Public My Commission Expires May 18, 2013 y Comm Sion ex s May 18, 2013 I, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this 5th y of March 2013 , A.D. M. Brent Beaty, Assistant Secretary Any instrument issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call (713) 912-0800 any business day between 8:00 am and 5:00 pm CST. 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- VII or better. • 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. CI-9 • 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. • Cancellation: The City requires 30 day written notice should any of the policies described on the certificate be cancelled or materially changed before the expiration date. • 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. CI - 10 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 $1,000,000.00 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 (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 $500,000.00 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. CI - 11 [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 properly 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. [ ] 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. Cl - 12 [ ] Commercial Crime Provides coverage for the theft or disappearance of cash or checks, robbery inside/outside the premises, burglary of the premises, and employee fidelity. The employee fidelity portion of this coverage should be written on a "blanket" basis to cover all employees, including new hires. This type insurance should be required if the contractor has access to City funds. Limits of not less than each occurrence are required. [ ] Additional Insurance Other insurance may be required on an individual basis for extra hazardous contracts and specific service agreements. If such additional insurance is required for a specific contract, that requirement will be described in the "Specific Conditions" of the contract specifications. CI - 13 ATTACHMENT 1 [X] Workers' 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 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: CI - 14 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. L 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) 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; CI- 15 5) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; 6) notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and 7) contractually require each person with whom it contracts, to perform as required by paragraphs (1) - (7), with the certificates of coverage to be provided to the person for whom they are providing services. J. By signing this contract or providing or causing to be provided a certificate of coverage, the contractor is representing to the governmental entity that all employees of the contractor who will provide services on the project will be covered by workers' compensation coverage for the duration of the project, that the coverage will be based on proper reporting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance 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. Cl - 16 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. OFFICE USE ONLY This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a Date Received person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 1 Name of person who has a business relationship with local governmental entity. 2 ❑ Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3 Name of local government officer with whom filer has an employment or business relationship. Name of Officer This section, (item 3 including subparts A, B, C & D), must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? 0 Yes O No B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? 0 Yes 0 No C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? . E-1 Yes 0 No D. Describe each affiliation or business relationship. 4 Signature of person doing business with the governmental entity Date Adopted 06129/2007 r~rn i BID #5131 PROPOSAL TO THE CITY OF DENTON, TEXAS FOR THE CONSTRUCTION OF US 380,URBAN UTILITY RELOCATION PHASE 2 IN DENTON, TEXAS The undersigned, as bidder, declares that the only person or parties interested in this.. proposal. as principals are those named herein,- that this proposal is made without.collusion with any other person, firm, or corporation; that he has carefully examined the form of contract, Notice to'Bidders, . specifications and the plans therein referred to, and has carefully examined the locations; conditions, and classes of materials of the proposed work and agrees that he will provide..all the necessary labor, machinery, tools, apparatus, and other items incidental to construction, and will do all' the work and furnish all the materials called for in the contract and specifications in the mariner prescribed herein and according to the requirements of the City as therein set forth. It is understood that the following quantities of work to be done at unit prices are approximate only, and are intended principally to serve as a guide in evaluating bids. It is agreed thax the quantities of work to be done at unit-prices and material to be furnished may be. increased or diminished as may be considered necessary; in the.opinion of the City, to complete the work fully as planned and contemplated, and that all quantities of work whether increased or decreased are to be performed at-the unit prices set forth below .except as provided: for in the specifications. The contractor shall provide the numeric unit price .and the unit price in words for each quantity. Unit price in words governs over the numeric price given. It is further. agreed that change :orders may be negotiated between the contractor and City to cover additional work ordered by the City, but not shown on the plans or required by the specifications, in accordance with the Generat Provisions.. Similarly, change orders may be negotiated to :cover deletion of work so ordered. It is understood and agreed that the work is to be completed in full within the time specified in the General Provisions. Accompanying this proposal is a certified or cashier's check or Bid Bond, payable to the Owner, in the amount of five percent of the total bid. P-1 It is understood that the bid security accompanying this proposal. shall be returned to the bidder, unless in case. of the acceptance of the proposal, the bidder. shall fail to execute a contract and file a performance bond and a payment bond within fifteen days after its acceptance, in which case 'the_ bid security shall become the property of the Owner, and shall be considered as a payment for' damages due to delay and other inconveniences suffered by the Owner on account of such failure of the bidder. Owner reserves the right to reject any and all bids, Owner may investigate the-prior performance of bidder on other contracts, either public or private, in evaluating bid proposals. . Should bidder alter, change, or qualify any specification of the bid, Owner may automatically disqualify bidder. The undersigned hereby proposes and agrees to perform-all work 'of whatever nature, required,. in strict accordance with the plans and specifications; for the following sum or prices, to wit: P-2 Project Name Calendar Days 60 US 380 Urban Utility Relocation Phase 2 Bid No. P.O. No. BID TABULATION SHEET Item Description Quantity Unit Unit Price Total 103.3 Surety Bonds 1 LS J$ / L5 $ Unit Price In Words 107.9.3 Excavation Protection 578 LF $ / LF J$ Unit Price In Words 201 Temporary Erosion Control 578 LF $ / LF J$ Unit Price In Words 202.6 Seeding Turf Grass 1,100 SY $ / SY $ i Unit Price In Words 203.3 General Site Preparation 1 LS J$ / LS $ Unit Price In Words 502.1-A 15' 1. D. Concrete Manhole (0-6 ft deep) 9 EA $ / EA $ Unit Price In Words 502.1-C 15' I.D. Drop Concrete Manhole (0-6 ft deep) 1 EA J$ / 'EA $ Unit Price In Words 502.1-D Additional MH Depth ( > 6 ft deep) 50 VF J$ / VF $ Unit Price In Words 502.1.2 Manhole Adjustment 3 FEATs / EA $ Unit Price In Words 502.12.4 Core Into Existing Manhole 1 EA $ / EA $ Unit Price In Words 503.3-A 120" Steel Casing by Borerrunnel 119 LF $ / LF $ Unit Price In Words 503.3-A 118" Steel Casing by Borerrunnel 169 LF $ / LF $ Unit Price In Words 507-A 112" Sanitary Sewer 375 LF J$ / LF $ Unit Price In Words 507-B 10" Sanitary Sewer 203 LF $ / LF $ Unit Price In Words i Addendum 2 - Page 2 Project Name Calendar Days 60 US 380 Urban Utility Relocation Phase 2 Bid No. P.O. No. BID TABULATION SHEET Item Description Quantity Unit Unit Price Total 8,01 Barricades, Warning Signs and Detours 1 LS J$ / LS $ Unit Price In Words SS01 JCut and Plug Existing Sanitary Sewer 6 EA J$ / EA $ Unit Price In Words SS02 JAbandon Existing Manhole 5 EA $ / EA J$ Unit Price In Words i SS03 Remove Existing Manhole 2 EA $ / EA T$ I Unit Price In Words TOTAL BASE BID: i i Addendum 2 - Page 3 BID SUMMARY TOTAL BASE BID PRICE IN WORDS: l The award of the contract will be based on. the Total Base Bid. The lowest responsive proposal for purposes of award shall be the conforming responsible bidder offering the.lowest cost for the base. bid. hi 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. The. undersigned agrees this bid Becomes the property of the City of Denton, after the` official opening. The undersigned affirms that they are duly authorized to execute this contract. Vendor hereby assigns to purchaser any and all claims for overcharges associated with this . contract which arise under the antitrust laws of the United States, 15 USCA Section 1 et sea., and which arise under the antitrust laws of the State of Texas, Tex. Bus. & . Com:. Code, Section .1.5.01, "s P-5 Receipt is -hereby acknowledged of the .following addenda to the plans and specifications: Addendum No. 1 dated Received Addendum No. 2 dated Received' Addendum No. 3 dated Received 'Addendum No. 4 dated Received . Addendum No. 5 dated. Received CONTRACTOR L BY 66-1 Street Address TV City and State Seal & Authorization (If a Corporation) 2V3 //7 Telephone P-6 VENDOR COMPLIANCE TO STATE LAW The 1985 Session of the Texas Legislature passed House Bill 620, relative to the award of contracts to non-resident bidders. This law provides that, in order to be awarded a contract as low. bidder, non-resident bidders (out-of-state contractors whose corporate offices or principal place of business are outside of the State of Texas) bid projects for. construction, improvements, supplies or services. in Texas at an amount lower than the lowest Texas resident bidder by the same amount that a Texas resident.bidder would be required to underbid a non-resident bidder in order to obtain a comparable contract in the state in which the non-resident's principal place of business is located. The appropriate blanks in Section A below must be filled out by all out-of-state or non-resident bidders in order for your bid to meet specifications. The failure of out=of--state or:non-resident contractors to do so will. automatically disqualify that bidder. Resident bidders must check the blank in Section B. A.. Non-resident bidders in (give state), our principal place of..business,. are required to be percent lower than resident bidders by state law. A copy of the statute is attached. Non-resident bidders in (give state), our principal place of business, are not required to underbid resident bidders. B. Our principal place of business or corporate offices are in the State of Texas: BIDDER: CONVANY Street Address 7y c~ City and State THIS FORM MUST BE RETURNED WITH YOUR BID. P-7 CONTRACTOR. COMPLIANCE TO TEXAS SALES TAX CODE Comply with all requirements of the Texas Sales Tax Code. The Contractor hereby certifies that the Contract Amount is divided as follows: Materials. incorporated into the Project $ CZ90 (resold to the Owner as defined in Tax Code) All other charges and costs rL ~'G Total { 57~~.r~U The total,must equal the total amount of the Contract. CONTRACTOR: COMPANY BY fi l (JVI ~s u s~ Z0 Z . f'&r l 14611" Street Address City and State THIS FORM SHALL BE EXECUTED AT THE TIME OF EXECUTION OF THE. CONTRACT AND SHALL BE MADE A PART OF THE CONTRACT. P-8 I i CITY I OF DENTON Purchasing Department 901-B Texas St. Denton, TX 76209 (940) 349-7100 www.dentonpurchasing.com ADDENDUM #1 January 10, 2013 B-id #5131 For US 380 Urban Relocation Phase 2 BIDS DUE: January 17, 2013 2:00 P.M. Bid submitted by: Company Name BID #5131 ADDENDUM #1 Addendum #1 to be returned with Bid Proposal Please see the following three pages for changes to the bid specifications: NO OTHER CHANGES AT THIS TIME. This form shall be signed and returned with your bid. Name: L~ h o0.1 Signature: (/y Cz /x), Company: (A). C.k 4Z < l Title: Date: / 3 i ADDENDUM NO.1 TO PLANS, SPECIFICATIONS AND CONTRACT DOCUMENTS FOR CITY OF DENTON, TEXAS US 384 URBAN UTILITY RELOCATION PHASE 2 BID NO. 5131 TO: PROSPECTIVE BIDDERS AND PLAN HOLDERS The Plans, Specifications and Contract Documents shall be modified as required by the following items: Item 1-1 PLANS: Replacement: Sheet 12 Sheet 12 of the construction plans (sealed 10/11/12) is hereby replaced in its entirety by Sheet 12A (sealed 1/9/13). Item 1-2 PLANS: Replacement: Sheet 13 Sheet 13 of the construction plans (sealed 10/11/12) is hereby replaced in its entirety by Sheet 13A (sealed 1/9/13). All items in conflict with this addendum are hereby deleted. THIS ADDENDUM IS MADE PART OF THE PLANS, SPECIFICATIONS AND CONTRACT DOCUMENTS AND SHALL BE ACKNOWLEDGED ON THE PROPOSAL. e City of Denton, Texas JAMES E: WILDER ...............ti...~ Jim Wilder, P.E. ,a 1 83438 CiA5 Addendum 1- Page 1 O N m Y O N W JIM I tlS`7~~ tay OR 1! @g Ltd 0 ~ae~~ ' 1( ` ~i~F ~ ~R~m'°~g<6 ~ m (x3~#z v M a v 1 €~y ~ €L'1 LI I b d/1 16'[8 rv Ill ~Y..,. a - - ti V Be'IB _ S I €1 1; a d/1 cm- n ZI I : y v sz•le N 9b 9 < 2 - bka ~ d/1 91T6 _ 31 l _ Y s w Z N _ i I I 1 " I~~ 1 ` =='S-7777 -_!._-R _ _ ~1A1 .c . b b yl re'I6e o ti w ~ I e Ada J 1 }a i 1 E(%27 1 'eLR .Cl V V hB'6LR OU (X3) 31 l .L1 V ~1 LBY6 gnu B'B°+BY VR'9L9 rT, w pro U O q n m g I H ~ ~~F~ 3 0 o m rv m m m° N m ~ O ~ gR r.,T , 1ff~f N N o W 41 a o / n 01 z II i 5~ = Y ~ Y~Y i °9rew lnB .zl v v Q ~ %g` 5 f1 S (x9) sL'e M .tI v r e 5 I p~ c 1 1 ° 0p u B/1 cshs 0.d ~ / ~ K I5 V 09reYA r , G~~i ~ q * Q€ L9K LlV €o FM1~( ~ N ei ce' s nsil A ~7 ~ I.'sL+c Yu i Ret~ p a b V61'9YB o lb F }~~5wi] d<~<°5° ~Z G ~l 8,: ~ E r6'sW 3 100 .LIV ~ Z r F U W : r6'nA -M .Z/ V 0/1 61YS M Wggi » ~¢ot: I I rv 8 I~oF~d~~C("~ ¢ aoa _ H I rh'9re v vee'ne o 5 5 8 ~ILLLLKK r ro Wa 'mg I f i ° ~ i7~ Y ~ L •nv ,LI v ~ ~ o I A3 ~i ~g iae4 3.5 ~Nmri J 6 I~ ZB#1 Yl6 0/! 00559 4 R h _ 1.__ x ~h6 J 6 II ~ sB5r9 6 1110 .LIV V EL U c9reha -xl ,zI v w c - a ~ , ~ ( i['9YB -NI ,LIV p ~ ~ n 9 B 1 15 0/11Y'fs9 A , I,C BACSf1-]..llSVi ' ~A I 1 _ 9/i W'ei° 2 ~I I151 I} ~1 At P - pp I I' I ~ a 1 } tt N V tlCnB 5 gyp...,. ~6 ~ 6 ) ~;I I• 1l lyll d ~ ~1 y - -__~i_-__--.__._--_~____ T 7 I 2 f9 1 0/1 9B'fS9 I ' xµ~n ~ - y, B 'BO ° 1S V 00'9Y° a ~ I ~ ~ N$~~ amg ~ Y m m ~ z m z I j < LL ~ W w W W N m , m CC Z Y 3 f- ~ w o xF a o N ~ ~ ~ ° n n n w o v d a g ~ ' a a I~ I I~ 11 z~' M 8 G~°S$m ! I ~ d I i S° e ~ I I i°n z Y I gl 1 K - - 'I I I I; , W N O O I ~ I I i j I j F N Z N d Q W O Ile. 0 ~a I' U ~~~5 I I I I ~ ~ O~ 8° j I I ~a ~ M m 's I ~ I a ~I 1~ I ~ F rn ~I I - - 00 sR ~ ~ I j 5 I J lp x$85 I 5I F, of E"I $R w { I ~0 ~I° I~ I r ~ O O O O iE a-0 'I I I I{® oA - I I ~ I I I Iq p a o S~ Y II, j I I a" le °ii I I ~ ~ I I .I 3 E l i I ~I I ~ g I she `~p~i~9 g! I I I y'~ y L~ q~ 4 a 8 z I I ~ I I €~gy ~ U W w '~s ~R' w 6w I I it ~ r ~a~ ~ ; I ~ I ~p - m m m I I F I ' ,l ~ O Z Y W A to w O p ~ I I w o c=ilia a CITY OF DENTON Purchasing Department 901-B Texas St. Denton, TX 76209 (940) 349-7100 www.dentonpurchasing.com ADDENDUM #2 January 14, 2013 Bid #5131 For .US 380 Urban Relocation Phase 2 BIDS DUE: January 17, 2013 2:00 P.M. Bid submitted by: Company Name BID #5131 ADDENDUM #2 Addendum #2 to be returned with Bid Proposal Please see the following three pages for changes to the bid specifications and bid tabulation sheets: NO OTHER CHANGES AT THIS TIME. This form shall be signed and returned with your bid. Name: Signature: l,1 Company: LA) ~ Title: f r-c e,, d f `f Date: /Z/ 7/~0/3 i ADDENDUM NO.2 TO PLANS, SPECIFICATIONS AND CONTRACT DOCUMENTS FOR CITY OF DENTON, TEXAS US 380 URBAN UTILITY RELOCATION PHASE 2 BID NO. 5131 TO: PROSPECTIVE BIDDERS AND PLAN HOLDERS The Plans, Specifications and Contract Documents shall be modified as required by the following items: Item 2-1 SPECIFICATIONS: SPECIAL CONTRACT REQUIREMENTS AND BID ITEM DEFINITIONS: Modification: Page SC-2 and Bid Tabulation Sheet. Item 107.19.3 Excavation Protection: This item is to be paid for separately on a per linear foot of excavation trench excavated. The cost for excavation protection shall not be considered a subsidiary cost of pipe or manhole installation. A new bid tabulation sheet is attached below to replace the existing bid tabulation sheet. All items in conflict with this addendum are hereby deleted. i THIS ADDENDUM IS MADE PART OF THE PLANS, SPECIFICATIONS AND CONTRACT DOCUMENTS AND SHALL BE ACKNOWLEDGED ON THE PROPOSAL. City of Denton, Texas Jim Wilder, P.E.~¢~ ~~~•rH. rrq nu uu.•.•.••.. JAMES E. WILDER 9rr rr.rd... ` 834380 . /jq /13 Addendum 2 - Page 1 Project Name Calendar Days 60 US 380 Urban Utility Relocation Phase 2 Bid No. P.O. No. BID TABULATION SHEET Item Description Quantity Unit Unit Price Total 103.3 JSurety Bonds 1 LS J$ ~'c~c / LS $ Unit Price In Words 107.9.3 JExcavation Protection 578 LF J$ / LF Is 7-32L-- Unit Price In Words ! l ~~i G c~ Q 201 Temporary Erosion Control 578 LF J$ / LF Unit Price In Words 202.6 Seeding Turf Grass 1,100 SY $ l-S f~ I SY $ Unit Price In Words ojl 203.3 General Site Preparation 1 LS J$LS 1 i Unit Price In Words 502.1-A 15'I.D. Concrete Manhole (0-6 ft deep) 9 EA $ EA Unit Price In Words 411 502.1-C 151 I.D. Drop Concrete Manhole (0-6 ft deep) 1 EA J$ /41/0- - / EA $ Unit Price In Words t~e s 502.1-D Additional MH Depth ( > 6 ft deep) n /t 50 VF $ ~SV / VF Unit Price In Words • f'( 1•; 502.1.2 Manhole Adjustment 3 EA $ EA $ / oG~ t Unit Price In Words x 6i~~n~ r/ -ire c ~ O-,~ r 502.12.4 JCore Into Existing Manhole ) 1 /EA $ EA $ Unit Price In Words 503.3-A 20" Steel Casing by Bore/Tunnel 119 LF $ PS)_/3! S / LF $L0 fag 1 Unit Price In Words GUp l~/,~/ 'f ' ~ ~ • is 503.3-A 118" Steel Casing by Borerrunnel 169 LF J$ LF Unit Price In Words 507-A 112" Sanitary Sewer / 375 n LF $ LF $ J g3S Unit Price In Words/tea _ /Gw 507-B 10" Sanitary Sewer 203 LF $ LF J$ /S / 7 uf~ Unit Price In Words 1 Addendum 2 - Page 2 Project Name Calendar Days 60 US 380 Urban Utility Relocation Phase 2 Bid No. P.O. No. BID TABULATION SHEET Item Description Quantity Unit Unit Price Total 801 Barricades, Warning Signs and Detours 1 LS $ Do. "^l LS Is Unit Price In Words ~~vc 2 SS01 Cut and Plug Existing Sanitary Sewer 6 EA $~_Gr I EA Unit Price In Words SS02 JAbandon Existing Manhole /5 EA J$ EA r~%✓ 7~, ,~G://mss Unit Price In Words SS03 Remove Existing Manhole 2 EA / EA F~, Unit Price In Words TOTAL BASE BID: j Lnn/• `/0 Addendum 2 - Page 3 1 ® FDATE (MMIDD/YYYY) A4C°R° CERTIFICATE OF LIABILITY INSURANCE 3119!2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER TA T NAME: Allen Independent Insurance Group RHONE AIC No:= IC. No. Exti:972-231-8277 3010 LBJ Freeway Ste. 920 E-MAIL Dallas TX 75234-7004 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A :TeXaS Mutual Insurance CO. INSURED / WILSO-2 INSURER B: Wilson Contractor Services LLC INSURER C:St. Paul Fire Marine Ins CO. 107 Bell Avenue, Suite 3 INSURER D : Denton TX 76201-0000 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 1150303487 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDLISUBR IL SR TYPE OF INS NCE POLICY EFF POLICY EXP LIMITS INSR WVD POLICY NUMBER MMIDDIYYYV MM/DDIYYYY B GENERAL LIABILITY Y 5316518 /15/2012 /15/2013 EACH OCCURRENCE $1,000,000 X -DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 CLAIMS-MADE 15F] OCCUR MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $2,000,000 RO- LOC $ POLICY X P JFQT B AUTOMOBILE LIABILITY Y Y 85316518 /15/2012 !1512013 INN _D SINGLE LIMIT Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS NAUTOS ON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ C X UMBRELLA LIAB X OCCUR Y Y QK09102631 /15/2012 /15/2013 EACH OCCURRENCE $9,000,000 B 85316518 /15/2012 /15/2013 EXCESS LIAR CLAIMS-MADE AGGREGATE $9,000,000 DIED X RETENTION $10,0 $ A WORKERS COMPENSATION Y SF0001108679 /15/2012 /15/2013 X I S1 WC STATU- OE H- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L. EACH ACCIDENT $1,000,000 OFFICERWEMBER EXCLUDED? I N/A (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Equipment Floater Y Y 5316518 /1512012 /15/2013 Limit $1,154,488 Deductible $1,000 Except Leased/Rented $350,000 Installation $2,500 Installation $135,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) The checked ADDL INSR and SUBR WVD boxes refer to the following specific endorsements, copies attached:' General Liability - Additional Insured-Owners, Lessees or Contractors-Automatic Status When Required in Construction Agreement with you Form #CG2033 07/04; Additional Insured-Owners, Lessees or Contractors-Completed Operations Form #CG2037 07/04; Primary Additional Insured Amendato Endorsement Form #CG7096 11/03; Texas Ultra Liability Plus Endorsement Form #CG7152 06111 (Blanket Waiver of Subrogation). See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Dento ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Department 901-B Texas St AUTHORIZED REPRESENTATIVE / Denton TX 76209 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: WILSO-2 LOC AIC Ro ADDITIONAL REMARKS SCHEDULE Pagel of 1 AGENCY NAMED INSURED Independent Insurance Group Wilson Contractor Services LLC 107 Bell Avenue, Suite 3 POLICY NUMBER Denton TX 76201-0000 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Automobile Liability - Business Auto Ultra Endorsement Form #CA7109 01/06 (Additional Insured Status by Contract, Agreement or Permit & Waiver of Subrogation Required by Contract). Workers Compensaiton - Texas Waiver of Our Right to Recover From Others Endorsement Form #WC420304A 01/00. RE: Project - US 380 Urban Relocation Phase 2 - Bid #5131 I I II I i ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I I II INDEPENDENT INSURANCE j " GROUP Effective January 1, 2012, the issuance of certificates of insurance will fall under the terms of a new law passed by the Texas state legislature in 2011. The details are still emerging and there are still a lot of unanswered questions but based on information released by the Texas Department of Insurance this is how all insurance agencies across Texas will be handling certificates of insurance as of the first of the year. The new law requires all Texas agents to issue certificates only on forms approved by the Texas Department of Insurance. As of this date the Accord form 25 2010/05 version and seven TXDOT forms have been approved for use. If an insurance agent issues a liability certificate or completes an insurance questionnaire other than the Accord form 25, edition May, 2010 or other approved forms they will be subject to a fine of up to $1,000 per violation and the possible loss of their insurance license. In addition, as it pertains to insurance coverage, it will be against the law to add any verbiage to the certificate of insurance that is not a word for word reproduction of language that is found in the insurance policy of the insured listed on the certificate. For this reason we will now attach copies of the endorsements to the certificates so that certificate holders can review them to see if the policy language meets their specific requirements. We will be allowed to put a job description or reference number on the certificate if requested. This law applies to any certificate of insurance issued in the state of Texas regardless of the location of the person requesting the certificate. This means if an out-of-state certificate is requested we must still follow the guidelines established by this new law. We expect many owners and contractors will be surprised to learn that their in-house form and/or questionnaire can no longer be completed until they are filed and approved by the state of Texas. At some point in the future the state of Texas will establish a website that will list all approved certificate forms. As of December 27, 2011 this site has not been released to the public. As of the first of the year we have no choice but to issue all certificates of insurance using forms approved by the state of Texas. We will attach a notice to all of our certificates advising the certificate holder of the new law and the limitations we face in issuing certificates of insurance. It is possible that a certificate holder may contact you regarding this new law. If that is the case we suggest that you refer them to our office so we can answer any questions and direct them on steps they can take if they wish to file their form and have it approved in Texas. If you have any questions concerning this law please contact our office. Dallas Office Ennis Office 3010 LBJ Freeway, Suite 920 1307 E. Ennis Ave. Dallas, TX 75234 Ennis, TX 75119 972.231.82.77 • 972.231.8291 972.878.6221 9 972.878.6255 Fax Toll Free 888.258.1938 j i Independent TInsurance Agents of Texas To Whom It May Concern: Re: SIB 425 - Certificates of Insurance There is a new law effective Jan. 1, 2012 that affects certificates of insurance. SB 425 requires that all certificate of insurance forms, including electronic evidence of insurance, be approved by the Texas Department of Insurance before the form can be used to certify insurance after Jan. 1, 2012. Already approved is the ACORD 25 form (2010105), which is widely used in business as a standard certificate. Company-specific forms will have to be approved by TDI, or a company can agree to accept the ACORD 25 form as evidence of casualty insurance. Special certificate forms can be filed for approval at: P&C Intake Unit Texas Department of Insurance 333 Guadalupe Austin, TX 78701 After Jan. 1, 2012 it will be illegal for an agent or insurance company to issue evidence of insurance on a certificate form that has not been approved by TDI. It is also illegal for anyone to require an agent or insurance company to use a certificate form that has not been approved. The law provides some guidance on the construction and limitations of certificates, as follows: • A certificate is not a policy of insurance and does not amend, extend, or alter the coverage afforded by the referenced insurance policy. • A certificate shall not confer to a certificate holder new or additional rights beyond what the referenced policy or any executed endorsement provides. • A certificate may not contain a reference to a legal or insurance requirement contained in a contract other than the underlying contract of insurance or endorsement to the insurance policy. • A person may have a legal right to notice of cancellation, nonrenewal or material change or any similar notice only if (1) the person is named within the policy or an endorsement to the policy, and (2) the policy or endorsement, or a state law or rule, requires notice to be provided. Furthermore, the law provides this warning to certificate holders: "A certificate of insurance that is executed, issued, or required and that is in violation of this chapter is void and has no effect." If you have any questions about the new law, please contact the Texas Department of Insurance at 800.252.3439. You can view more information about the filing rules on the TDI website at hfp:/&vww.tdi.texas.gov/ruiesfnformall 216.html. You can read the text of SB 425 at hfp:/&vvvw.ca pitol.state.b(.us/tlodoes/82R/billtext/pdf/SB00425F.pdf. P.O. Box 684487, Austin, Texas 78768 • 1115 SanJacinto, Suite 100, Austin, Texas 78701 • 800.880.7428 • 512.476.6281 • 512.469.9512 Fax • Irfo@llat.org • www.liat.org I Policy ##85316518 Effective 09/15/2012-2013 COMMERCIAL GENERAL LIABILITY Wilson Contractor Services, LLC CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or organization have agreed in writing in a contract or This insurance does not apply to: agreement that such person or organization be added as an additional insured on your policy. Such 1. "Bodily injury", "property damage" or "personal person or organization is an additional insured only and advertising injury" arising out of the with respect to liability for "bodily injury", "property rendering of, or the failure to render, any damage" or "personal and advertising injury" professional architectural, engineering or caused, in whole or in part, by: surveying services, including: 1. Your acts or omissions; or a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports, surveys, field orders, behalf; change orders or drawings and specifications; or in the performance of your ongoing operations for the additional insured. b. Supervisory, inspection, architectural or engineering activities. A person's or organization's status as an additional insured under this endorsement ends when your 2. "Bodily injury" or "property damage" occurring operations for that additional insured are completed. after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 II I I POLICY NUMBER: 85316518 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ izations : Location And Description Of Completed Operations i i Blanket as required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11 - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". CG 20 37 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 Policy #85316518 Effective 9/15/2012-2013 Wilson Contractor Services, LLC CG 70 96 11 03 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY ADDITIONAL INSURED AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Blanket as required by written contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. WHO IS AN INSURED (Section II) is amended to b. Excess Insurance include as an insured the person or organization This insurance is excess over: shown in the Schedule, but only with respect to your liability, which may be imputed to that person or (1) Any of the other insurance, whether organization directly arising out of your ongoing primary, excess, contingent or on any operations or premises owned by or rented to you. other basis: A person's or organization's status as an additional (a) That is Fire, Extended Coverage, insured under this endorsement ends when your Builder's Risk, Installation Risk or operations for that insured are completed or your similar coverage for "your work"; occupancy of the premises terminates. B. With respect to insurance provided to the person or (b) That is Fire insurance for premises organization shown in the Schedule of this rented to you or temporarily Endorsement, Condition 4. Other Insurance is occupied by you with permission of replaced by the following: the owner; (c) That is insurance purchased by you 4. Other Insurance to cover your liability as a tenant for If other valid and collectible insurance is "property damage" to premises available for a loss we cover under Coverages rented to you or temporarily A and B of this Coverage Part, our obligations occupied by you with permission of are limited as follows: the owner; or (d) If the loss arises out of the a. Primary Insurance maintenance or use of aircraft, This insurance is primary and we will not "autos" or watercraft to the extent seek contribution from other insurance not subject to Exclusion g. of available to the person or organization Section I - Coverage A - Bodily shown in the Schedule of this endorsement Injury And Property Damage except when b. below applies. Liability. CG 70 96 11 03 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 CG 70 96 11 03 When this insurance is excess, we will have We will share the remaining loss, if any, no duty under Coverages A or B to defend with any other insurance that is not the insured against any "suit" if any other described in this Excess Insurance insurer has a duty to defend the insured provision and was not bought specifically to against that "suit". If no other insurer apply in excess of the Limits of Insurance defends, we will undertake to do so, but we shown in the Declarations of this Coverage will be entitled to the insured's rights against Part. all those other insurers. c. Method Of Sharing When this insurance is excess over other If all of the other insurance permits insurance, we will pay only our share of the contribution by equal shares, we will follow amount of the loss, if any, that exceeds the this method also. Under this approach each sum of: insurer contributes equal amounts until it has paid its applicable limit of insurance or (1) The total amount that all such other none of the loss remains, whichever comes insurance would pay for the loss in the first. absence of this insurance; and If any of the other insurance does not permit (2) The total of all deductible and contribution by equal shares, we will self-insured amounts under all that other contribute by limits. Under this method, insurance. each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. i I CG 70 96 11 03 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 Policy #85316518 Effective 9/15/2012-2013 Wilson Contractor Services, LLC CG 71 52 06 11 TEXAS - ULTRA LIABILITY PLUS ENDORSEMENT COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. * Coverage for non-owned watercraft is extended to 51 feet in length * Voluntary Property Damage Coverage $5,000 Occurrence with a $10,000 Aggregate * Care, Custody and Control Property Damage Coverage $25,000 Occurrence with a $100,000 Aggregate - $500 Deductible * Product Recall Expenses $25,000 Each Recall Limit with a $50,000 Aggregate - $1,000 Deductible * Water Damage Legal Liability - $25,000 * Increase in Supplementary Payments: Bail Bonds to $1,000 and Loss of Earnings to $500 * For newly formed or acquired organizations - extend the reporting requirement to 180 days * Automatic Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction Agreement With You * Automatic Additional Insured - Vendors * Automatic Additional Insured - Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With You * Automatic Additional Insured - Managers or Lessor of Premises * Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured * Additional Insured - Employee Injury to Another Employee * Primary Additional Insured * Expanded Fire Legal Liability to include Explosion, Lightning and Sprinkler Leakage * Automatically included - Aggregate Limits of Insurance (per location) * Automatically included - Aggregate Limits of Insurance (per project) * Knowledge of occurrence - Knowledge of an "occurrence", "claim" or suit' by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee * Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancelation or non-renewal. * Liberalization Condition * Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 Ibs GVW * Blanket Waiver of Subrogation * Property Damage -Borrowed Equipment * Property Damage Liability - Elevators * Bodily Injury Redefined * Extended Property Damage * Damage to Media Legal Liability - $50,000 REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 15 FOR CHANGES AFFECTING YOUR INSURANCE PROTECTION CG 71 52 06 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 15 III CG 71 52 06 11 Conditions 10., 11. and 12. are added: 10. Blanket-Waiver Of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing operations performed by you or on your behalf, done under a contract with that person or organization, "your work", or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed. 11. If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision. 12. Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. The following conditions are added in regard to Coverage R - Product Recall Expense In event of a "product recall", you must 1. See to it that we are notified as soon as practicable of a "product recall". To the extent possible, notice should include how, when and where the "product recall" took place and estimated "product recall expense". 2. Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance. 3. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed. 4. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn statement of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. 5. Cooperate with us in the investigation or settlement of any claim. 6. Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies. SECTION V - DEFINITIONS At Item 12. Mobile Equipment the wording at f.(1) is deleted and replaced by the following: f.(1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; except for such vehicles that have a gross vehicle weight less than 1000 Ibs which are not designed for highway use. CG 71 52 06 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 14 of 15 i CA 71 09 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ULTRA ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COVERAGE INDEX Descriptio n Page TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE 1 BROAD FORM INSURED 1 EMPLOYEES AS INSUREDS 2 ADDITIONAL INSURED STATUS BY CONTRACT, AGREEMENT OR PERMIT 2 AMENDED FELLOW EMPLOYEE EXCLUSION 2 TOWING AND LABOR 2 PHYSICAL DAMAGE ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 3 EXTRA EXPENSE - THEFT 3 RENTAL REIMBURSEMENT AND ADDITIONAL TRANSPORTATION EXPENSE 3 PERSONAL EFFECTS COVERAGE 4 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 4 AIRBAG ACCIDENTAL DISCHARGE 4 AUTO LOAN/LEASE TOTAL LOSS PROTECTION ENDORSEMENT 4 GLASS REPAIR - DEDUCTIBLE AMENDMENT 5 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 5 WAIVER OF SUBROGATION REQUIRED BY CONTRACT 5 UNINTENTIONAL FAILURE TO DISCLOSE 5 HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE 5 EXTENDED CANCELLATION CONDITION 6 I The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in (Bold Italics) are likewise for information only and by themselves shall be deemed to grant no coverage. A. TEMPORARY SUBSTITUTE AUTO PHYSICAL B. BROADENED LIABILITY COVERAGES DAMAGE SECTION 11 - LIABILITY COVERAGE in Paragraph A. SECTION I - COVERED AUTOS, paragraph C. Certain Coverage at 1. Who Is An Insured is amended to Trailers, Mobile Equipment and Temporary include the following: Substitute Autos is amended by adding the following at the end of the existing language: (Broad Form Insured) If Physical Damage Coverage is provided under this d. Any legally incorporated subsidiary in which you Coverage form for an "auto" you own, the Physical own more than 50% of the voting stock on the Damage coverages provided for that owned "auto" are effective date of the Coverage Form. However, the extended to any "auto" you do not own while used with Named Insured does not include any subsidiary that the permission of its owner as a temporary substitute for is an "insured" under any other automobile policy or the covered "auto" you own that is out of service would be an "insured" under such a policy but because of its breakdown, repair, servicing, "loss", or for its termination or the exhaustion of its Limit destruction. of Insurance. CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 6 I I CA 71 09 01 06 e. Any organization that is acquired or formed by you, C. AMENDED FELLOW EMPLOYEE EXCLUSION during the term of this policy and over which you maintain majority ownership. However, the Named Only with respect to your "employees" who occupy Insured does not include any newly formed or positions which are supervisory in nature, SECTION II. acquired organization: LIABILITY B. Exclusion 5. Fellow Employee is (1) That is a joint venture or partnership, replaced by: (2) That is an "insured" under any other policy, 5. Fellow Employee (3) That has exhausted its Limit of Insurance under "Bodily Injury": any other policy, or (a) To you, or your partners or members (if you are a partnership or joint venture), or to your (4) 180 days or more after its acquisition or members (if you are a limited liability formation by you, unless you have given us company); notice of the acquisition or formation. Coverage does not apply to "bodily injury" or (b) To your "executive officers" and directors (if „ property damage" that results from an accident that you are an organization other than a partnership, joint venture, or limited liability occurred before you formed or acquired the company) but only with respect to organization. performance of their duties as your officers or directors; (Employee as insureds) (c) For which there is an obligation to share f. Any employee of yours while acting in the course of damages with or repay someone else who your business or your personal affairs while using a must pay damages because of the injury covered "auto" you do not own, hire or borrow. described in paragraph a and b above; or (Additional Insured Status by Contract, Agreement (d) Arising out of his or her providing or failing or Permit) to provide professional health care services. g. Any person or organization whom you are required For purposes of this endorsement, a position is deemed to add as an additional insured on this policy under to be supervisory in nature if that person performs a written contract or agreement; but the written principle work which is substantially different from that contract or agreement must be: of his or her subordinates and has authority to hire, (1) Currently in effect or becoming effective during transfer, direct, discipline or discharge. the term of this policy; and D. BROADENED PHYSICAL DAMAGE COVERAGES (2) Executed prior to the "bodily injury" or "property damage". SECTION III - PHYSICAL DAMAGE COVERAGE The additional insured status will apply only with respect Coverage is amended as follows: to your liability for "bodily injury" or "property damage" (TOWING AND LABOR) which may be imputed to that person(s) or 2. Towing and Labor organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the We will pay towing and labor costs incurred, up to the location(s) designated, if any. limits shown below, each time a covered "auto" Coverage provided by this endorsement will not exceed classified and rated as a private passenger type, "light the limits of liability required by the written contract or truck" or "medium truck" is disabled: written agreement even if the limits of liability stated in (a) For private passenger type vehicles or "light the policy exceed those limits. This endorsement shall trucks" we will pay up to $75 per not increase the limits stated in Section II. C. Limits of disablement. "Light trucks" have a gross Insurance. vehicle weight (GVW) of 10,000 pounds or For any covered "auto" you own this Coverage Form less. provides primary coverage. CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 6 I III CA 71 09 01 06 a. The amount paid under the Physical Damage (4) Your members, managers or insurance Coverage Section of the policy; and manager, if you are a limited liability b. Any: company; or (1) Overdue lease / loan payments at the time (5) Your officials, trustees, board members or of the "loss"; insurance manager, if you are a not-for-profit organization. (2) Financial penalties imposed under a lease G. WAIVER OF SUBROGATION REQUIRED BY for excessive use, abnormal wear and tear or high mileage; CONTRACT (3) Security deposits not returned by the lessor; Under SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer (4) Costs for extended warranties, Credit Life of Rights of Recovery Against Others to Us Insurance, Health, Accident or Disability the following language is added: Insurance purchased with the loan or lease; However, we waive any rights of recovery we may and have against the person or organization with whom (5) Carry-over balances from previous loans or you have agreed in writing in a contract, agreement leases. or permit, to provide insurance such as is afforded under the policy to which this endorsement is (GLASS REPAIR - DEDUCTIBLE AMENDMENT) attached. This provision does not apply unless the written contract or written agreement has been Under D., Deductible is amended by adding the executed, or permit has been issued, prior to the following: "bodily injury" or "property damage." Any deductible shown in the Declarations as H. UNINTENTIONAL FAILURE TO DISCLOSE applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired, Under SECTION IV - BUSINESS AUTO rather than replaced. CONDITIONS, Subsection B. General Conditions, F. AMENDED DUTIES IN THE EVENT OF the following is added to 2. Concealment, ACCIDENT, CLAIM, SUIT OR LOSS Misrepresentation Or Fraud : Your unintentional error in disclosing, or failing to Under SECTION IV - BUSINESS AUTO CONDITIONS, disclose, any material fact existing at the effective Subsection A., Loss Conditions , the following is date of this Coverage Form, or during the policy added to paragraph 2. Duties In The Event of period in connection with any additional hazards, will Accident, Suit or Loss: not prejudice your rights under this Coverage Form. d. Knowledge of any "accident," "claim," "suit" or 1. HIRED, LEASED, RENTED OR BORROWED "loss" will be deemed knowledge by you when AUTO PHYSICAL DAMAGE notice of such "accident," "claim," "suit" or "loss" Under SECTION IV - BUSINESS AUTO CONDITIONS has been received by: B. General Conditions 5. Other Insurance (1) You, if you are an individual; Paragraph 5.b, is replaced by the following: (2) Any partner or insurance manager if you are b. (1) For "Comprehensive" and "Collision" Auto a partnership; Physical Damage provided by this endorsement, the following are deemed to be covered "autos" (3) An executive officer or insurance manager, you own: if you are a corporation; (a) Any Covered "auto" you lease, hire, rent or borrow; and I CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 6 I WORKERS' COMPENSATION AND EMPLOYERS Texasmutwr LIABILITY INSURANCE POLICY Instu~nceCatnpatty WC 42 03 04 A TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization ( X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. ~I 2. Operations: ALL TEXAS OPERATIONS 3. Premium The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium INCLUDED, SEE INFORMATION PAGE. This endorsement changes the policy to which It Is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on at 12:01 A.M. standard time, forms a part of Policy No. TSF-0001108679 20120915 of the Texas Mutual Insurance Company Issued to WILSON CONTRACTOR SERVICES LLC Endorsement No. DBA; WILSON CONSTRUCTION .~Cv~ /i! Premium $ rC_ !y Authorized Representative WC420304A (ED. 1-01-2000) INSURED'S COPY OUSER 9-12-2012 i ~I~