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2013-081ORDINANCE NO. 2013-081 AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORKS CONTRACT FOR THE CLEARING OF SANITARY SEWER EASEMENTS AND 1NSTALLATION OF GATES AT MULTIPLE LOCATIONS AS SPECIFIED 1N BID 5171- SANITARY SEWER EASEMENT CLE�IRING AND GATE INSTALLATION; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR; AND PROVIDING AN EFFECTIVE DATE (BID 5171-AWARDED TO THE LOWEST RESPONSIBLE BIDDER MEETING SPECIFICATION, DCI CONTRACTING, INC.1N THE NOT TO EXCEED AMOLINT OF $318,860.00). 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 HERESY 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 5171 CONTRACTOR DCI Contracting, Inc. AMOUNT $318,860 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 award of the bid. SECTION 3. The Ciry Manager is hereby authorized to execute all necessary written contracts for the performance of the construction of the public works or improvements in accordance with the bids accepted and approved herein, provided that such contracts are made in accordance with the Notice to Bidders and Bid Proposals, and documents relating thereto specifying the terms, conditions, plans and specifications, standards, quantities and specified sums contained therein. SECTION 4. The City Council of the City of Denton, Texas hereby expressly delegates the authority to take any actions that may be required or pernutted to be performed by the City of Denton under Bid 5171 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 works and improvements as authorized herein, the City Council hereby authorizes the expenditure of funds in the manner and in the amount as specified in such approved bids and authorized contracts executed pursuant thereto. SECTION 6. This ordinance shall become effective immediately upon its passage and approval. PASSED AND APPROVED this the �/l� day of l l , 2013. MARK A. BURROUGHS, MAYOR ATTEST: JENNIFER WALTERS, CITY SECRETARY BY: APPROVED AS TO LEGAL FORM: ANITA BURGESS, CITY ATTORNEY „ BY: �' . a-o�-a� �i CONTRACT AGREEMENT STATE OF TEXAS § COUNTY OF DENTON § THIS ,4GREEMENT, made and entered into this 2nd day of April A.D., 2013, by and between City of Denton of the County of Denton and State of Texas, acting tluough Gearge C. Campbell thereunto duly authorized so to do, hereinaft�x termed "OWNER," and DCI Contractin� Inc 2045 E Hwv 380 Suite 100 Decatur TX 76234 of the City of Decatur, County of Wise 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 coinmence and complete performance of the work specified below: Bid 5171-Sanitary Sewer Easement Clearin� and Gate Installation in the amount of $318,860 and all extra worlc in connection therewith, under the terrns 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 (Bonds will be for the amount of the Gate Installation Oi�ly-$100,000), and in accardance 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: CitY En ing eerin� staft all of which are referenced herein ai7d 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 ar sicic 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 peiform 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. Indemnificatioe� 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 ofticers, servants, employees, of the Owner. Contractor likewise covenants and agrees to, and does hereby, indemnify and hold harnlless 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 agreernent shall be governed by the law of the State of Texas and venue for its construction and enforceinent shall lie in the coui-ts of Denton County, Texas. The CONTRACTOR hereby agrees to coinmence worlc on or af�er the date established for the start of work as set forth in written notice to commence worlc 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 conhact, 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 malce copies of the boolcs, records and computations pertaining to this agreeinent. The CONTRACTOR shall retain such boolcs, 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 fii7dings 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, witl�in 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 witlun a 50 mile radius of the City of Denton. The cost of the audit will be boi7ze by the OWNER unless the audit reveals an overpayil�ent of 1% or greater. If an overpayment of 1% or greater occurs, the reasonable cost of the audit, including any travel costs, nlust 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 tei-mination thereof. Each of the terms "books", "records", "docLUnents" 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 fuial printed docuinent. CA-3 IN WITNESS WHEREOF, the parties of these presents have executed this agreement in the year and day first above written. ATTEST: � r � �- � _ ATTEST: �� �hriS'�iYle M. UIJd�LL APPROVED AS TO FORM: � BY: ri 'i `A-� � ITA BURGESS; C " ATTORNEY � CA-4 City of Denton O WNER BY: ��✓ . � (SEAL) " �� "/ (�tir��'Y Y�j. �iv� . CONTRACTOR � � � '/ ♦ // ��� � � � J ♦ ♦ , , � ��� ' �� � • : � �/� � d /Yi • � ■ ' � � � . �� : i�.!r/� �i�,� � , - -� , � , . � • �'•ir�._ f�� �_ ..� � . . Bond No. 105873181 PEI2FO12MANC�+ BONI) STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That DCI Contractin�, Inc.� whose address is 2045 E Hwy 380 Suite 100 Deca -ir, TX 76234 hereinafter called Principal, and TravelefSAmeruaaty and Surety compan � a corporation organized and existing under the laws of the State of Connecticut , 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 eYisting under the laws of the State� Texas, hereinafter lled Owner, in the penal sum of One Hundred Thousand and 0/100 �OLLARS ($100,U0 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 otitrselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firn11y by these presents. This Bond shall automatically be increased by the amount of any Change Order ar Supplemental Agreement, which increases the Contract price, but in no event shall a Change Order or Supplemental Agreement, wliich 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 Nuinber 013-081, with the City of Denton, the Owner, dated the 2-nd- da-y--of-Apr-il-A_D.-2O1-3,- or Bid #5171-Sanitarv Sewer Easement Clearin and Gate Installation. (Performance Bond covers G e Installation n y as specified in Contract Agreement dated 4/2/2013)� NOW, THEREFORE, if the Principal shall well, truly and faithfi�lly perform and fulfill all of the undertakings, covenants, ternls, conditions and agreements of said Contract in accordance with the Pla.ris, Specifications and Contract Documents during the original term thereof and any extension thereof which may be granted by the Orvner, with or without notice to the Surety, and during the life of any guaranty or warranty required Lmder this Contract, and shall also well and truly perform and fulfill all the undei�takings, 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 worlunauship 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 Owiier 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. �; PRQVIDED FURTHER, that if any l�gal action be filed upan this Bond, exclusive venue shall lie in Denton County, State of Texas. AND PR4VIDED FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteratian or addition to the terms o£ tlie Cont�act, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc., accompanying tk�e same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration ox 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 givez� pursuant to the �rovisions of Chapter 2253 of t�xe Texas Government Code, as anr�ended, and any othex applicable statutes of the State of Texas. The u�dersigned and designated age�nt is hereby designated by the Surety herein as the Resident Agent in Denton County to whom any requisxte 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 copies each or�e of which shall be deemed an originai, tilis the 16th day of April _, 2013 �. ATTEST: PR�VCIPAL DCI Contr ' g, Inc v BY: VICE PRES DEN avid M. Proctor B' SIDENT Michae�H. Davis ✓ ATTES : ( BY: �� �� Ma ia J. ' ler SURETY Travelers Ca lt ret Company of America BY: v..� ATTORN Y-IN-�ACT . Robert G. Chapman The Resident Agent of the Su�rety in Denton County, Texas fox delivery of notice and service of the process is: NAME: Carmen Mims STREET ADDRESS: 1301 E. Collins Blvd Suite 111 Richardson, TX 75081 (NOTE: Date of Performance Bond r�ust be dafe of Contract. If Resident Agent is not a corporation, give a perso�t's name.) PB-2 � t3 �� Bond N0. 10587318i PAYMEIVT B>OND STATE O�' TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That DCI Contractin ,g Inc•',✓ whose address is 2045 E Hwy 380 Suite 100, TX 76234 hereinafter called Principal, and Travelo.�SAmericaty and su�-ty company a corporation organized and existing �nder the laws of the State of , and fiilly 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 improvemen hereinafter refened to, in the penal sum of One Hundred Thousand and 0/100DOLLARS�l00,00�n 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 Num�b�e 2013-081, with the City of Denton, the Owner, dated the 2nd day of April �.D. 2013�tor Bid #5171-Sanitary Sewer Easement Clearin� and Gate Installation- (Payment Bond covers/Gate Installation Only as specified in Contract Agreement dated 4/2/2013)l� NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties and make prompt payment to all persons, firms, subcontractors, coiporations and claimants supplying labor and/or material in the prosecution of the Worlc 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 tiled 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 Warlc 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 Worlc to be performed thereunder, or to the Plans, Specifications, Drawings, etc. .� This Bond is gxven pwrsuaz�t to the prov�isiox�s o� Chapter 2253 of the Texas Government Code, as amended, and any o#her appiicable statutes of the State of Texas. The undezsigned and designat�d agent is hereby designated by the Surety herein as the Resident Agent in Denton County io wham any requisite not'rces ma.y be delkvered and on whom service of process may be had in matters arising out of such s�.Erety, as provided by Axticle 7.I9-1 of the Insurance Code, Vernon's Annotated Civil Statutes of the State of Texas. �T WYTNESS WI�EREOF, #his instrument is executed 'm £our co 'es, each one of wlnxck� sha11 be deerned an original, this the �6tn day of April , 2013 . . �/� / !: I.I��v�. % I, /'7 � • • 1 �i. . • • ATTEST• � BY: Marc a J. M er PR�IVC�PAL DCI Contractin , Inc. � BY: � �' Michael H. Davis SURETY Travelers Cas lt & e Com an of America BY: A �R -IN-FACT Robert G. Chapman The Resident Agent of the Surety in Denton County, Texas for delivery of natice and service af the pracess is: NAME: Carmen Mims STREET ADDRESS: 1301 E. Collins Blvd, Suite 111, Richardson, TX 75081 (NOTE: Date of Payment Bond must be date of Cont�^act. corporation, give a pewsan's natne.) . � ,� If Resident Agent is not a V��� A� �l WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER ,�, POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. 'IYavelers Casualty and Surety Company of America � St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney-In Fact No. 223296 Certificate No. o � � � � � � "' � KNOW ALL MEN BY THESE PRESENTS: That 3t. Paul Fire and Marine Insurance Company, St. Paul Guazdian Insurance Company and St. Paul Mercury Insurance Company aze corporations duly organized under the laws of the State of Minnesota, that Fannington Casualry Company, Travelers Casualry and Surety Company, and Travelers Casualry and Surety Company of America are corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Cloyd W. Barnes, David G. Chapman, Robert G. Chapman!�Marcia J. Miller, and Nathan G. Chapman of the City of Lansing , State of Michigan , their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITN�S$ WHEREOF, the Comp�e�s�have caused this instrument to be signed and their corporate seals to be hereto affixed, tlus J Uly day of , Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company 18th St. Paul Mercury Insurance Company 'IYavelers Casualty and Surety Company 'IYavelers Casualty and Surety Company oFAmerica United States Fidelity and Guaranly Company �,�,,.�p��'����W,. G�6U,�� �Ti yF\RE� _'Yi \*N INSG ....++ 1NSUR'"v P�.lY ANO ��WB TY O?� y�poq�t�'�, °''b 4r , � M'f,p @p; '......, y �.`�a; ...........9.� s u � s� .y,�/tN'a',. f7r� 4�pFy 'H'0 ~ IYBZ� O ���PORATED � �jCORPWRA>F��S 3W.`ppPORATf.�t�4 9� @ ' �W �7 � �' c� : ! i a : —'— . � = W HARTFORD. � {HA�iF6� � e ���� �°qy�c�S,a 19%%� 1951 � ��^` �+;SEAL,:o3 5�'+.58AL;3� � CONN. o t caun. � �, 1896 � a� � � l� s� c° L'•• aQ` � °' � ..,� y +! �t ' �� �f � a.........� I d.•.... < e . h1Yl AtN y � F d � ��NCE yY`SNAp� '1 .,5...�. rN °b1 ti� v� �ry State of Connecticut City of Hartford ss. By: Georg Thompson, enior ice President 18th July 2011 On this the day of , before me personally appeazed George W. Thompson, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guazanty Insurance Company, Fidelity and Guazanty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and 5urety Company, Travelers Casualty and Surety Company of America, and United States Fideliry and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. G•T� ���t� �����Q�' In Witness Whereof, I hereunto set my hand and official seal. ��%i � W w" �� �Vn"^^""' �� My Commission expires the 30th day of June, 2016. � p�L�p # / Marie C. Tetreault, Notary Public ,Syv �,`fi V 58440-6-11 Printed in U.S.A. � WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER !N� WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attomey is granted under and by the authority of the following resolutions adopted by the Boazds of Directors of Farnungton Casualty Company, Fidelity and Guazanty Insurance Company, Fideliry and Guaranry Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surery Company, Travelers Casualry and Surery Company of America, and United States Fidelity and Guazanty Company, which resolutions aze now in full force and effect, reading as follows: RESOLVED, that the Chairtnan, tlte President, any Vice Chairman, any Executive V�ice President, any Senior Vice President, any V'ice President, any 5econd Vice President, the Treasurer, any Assistant TYeasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authoriry as lus or her certificate of authoriry may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, con�acts of indemniry, and othec writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Boazd of D'uectors at any tune may remove any such appointee and revoke the power given him ar her; and it is FURTHER RESOLVED, that the Cha'vxnan, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authoriry to one or more officers or employees of this Company, provided that eaclt such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOL�TED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or condiROnal undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chauman, any Executive Vice President, any Senior Vice President or any �ice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Execudve Vice President, any Senior Vi ce President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be aff'ixed by facsimile to any Power of Attorney or to any certif'icate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertaldngs and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsunile signature or facsunile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary, of Farnvngton Casualty Company, Fidelity and Guazanty Insurance Company, Fidelity and Guazanty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guazdian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surery Company, Travelers Casualty and 3urety Company of America, and United States Fideliry and Guazanty Company do hereby certify that the above and foregoing is a hve and correct copy of the Power of Attomey executed by said Companies, which is_ in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 16 th day of Ap r il 2013 ri✓'' � Kevin E. Hughes, Assistant Sec tary G�SU p�}1TiI�(� F10.Ew6� ��S � �,..+��q'r. Jp�t� ANp �� � YA�� 2 �.� �R a���+ ' ,y' �Q�.�......:��r �u�a•..�.......;a,�"�., 9 `9L9 � 'r*' O 6 �i�� e Y � APOfl f- ['� ; �u'poRPOFAT ict^ � y� � �� � � � �' b" � �° PoRAIED �1�� �� �'s �f f � O ya'. a xc�waqnp � 19 8 2 O � 9]% �' i r s f E o: a HAFiTFORD, � ��� � �- 1896 -� ����a � � 1951 � � �'rySEALlo�:' '-�`:.SEi'A.L%3€ d CONN. p 7y¢+�,�CONM� /jY. N � d�y � F�j � � �Men N�E`O `�ls : AN�ff , d!S'.....�.••*�adD Ld� n��D; �� y.0�+i' � A�� ���..n+" ��xm�wnm To verify the authenticity of this Power of Attorney, call 1-800-421-3880 or contact us at www.travelersbond.com. Please refer to t e Attomey-In-Fact number, the above-named individuals and the details of the bond to which the power is attached. � CIT�( OF DEtVTON INSUR�►NCE REQUIREIldIENTS FO&� CONTRACTORS Bidder's attention is directed to tlie insura�zce reqicirenze�zts below. It i� /iiglaly recorrcn�ended tliat bi�lrlers confer witlt tlaeir respective irzsa�wance ccz�riers or brokers to determine in advr�nce of Bi�l submissio�z tlte avaalability of' insur�cnce certificates r�nd endors�me►its as prescrrberl a�zd provi�led lzerein. If crn rcpparent low bic�der fr�ils to comply strictly witlz t/ae iresurrrnce requirements, tltc�t bidder nury be disc�a�alified fronz award of the co�Ztract. Uposi bi�l award, all insacrance reqalirements sJaal/ become con.tractual obli;atio�z�, whiclt tlie saiccessficl bidder slaalllzave a duty to mni�ztain t/trouglaout tdte course of tltis corttract. • STANDARD PIgOVISIONS: Without lzmiting a�zy of the otlzei� obligationa� or liabilities of the Contrcrcto�°, the Contracto�° shall provide and maintain irntil the contracted �-i�or�k has been completed and accepted by the City of Denton, Orvner, the minimu»2 insurance covercrge as indicated he�^einafte��. As soon as p�°acticable ccfter notiftcation of bid cn-t�ar�c�, Contracto�° shall file mith the Purchasing Department sc�tisfc�ctory cer�tzficates of insu�°crnce, col�taining the bicl nurnber and title of the p�oject. Contractoi^ mcry, zr�on rvi°itten r•eqarest to the Pu��chccsing Department, ask foN clarifrcation of c�ny insu��crnce �°equirements ut crny time; horvever, C'ontractors are strongly advised to make szrch r•eyzcesls prior� to bid openirrg, since the irr,surance requirements may not be modified or tinaived afler bid opening zcnless a written exception ha� been submitted witlz the bid. Contractor s1tall no1 canzr�T.e��ce �rny work ar rle/iver ttny material d�ntil he or she receives notificatioiZ tltat the cantract ]tcss been rd�eceptecl, �pproved, and �i,ned by tlae City ofDenton. All insia��i�nce policies ��•oposed o�° obtaihed in scrti.sfactio�� of these �°equi� erraents shall comply with the follo�-ving generccl S�ecificaCions, crl�cl shcrll be mcci��tc�ined in compliance with ihese general specifications th�°oi�ghotrl the dLn°atzon vf 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. Bes# Company rating of at least A- VII or better. • Any deductibles or selt=insured retentions shall be declared in the bid proposal. If requested by the City, the insurzr 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 admiiustration and defense expenses. • Liability policies shall be endorsed to provide the following: • Name as additional insured the City of Dentan, its Officials, Agents, Einployees aild volunteers. CI-9 • That such insurance is priinaiy to any other insurance available to the additional insured with respect to claims covered under the policy and that this _ insurance applies sepa�ately to each insured against whom claim is nzade or suit is brought. The inclusion of more than one iusured shall not operate to increase the insLU�er's limit of liability. • Ca�ce/lntion: �he City �•eyuires 30 day wriften notice slzould ahy of tlze policies desc�•eGed on tJze ce�•tifrcate be ca�zcelled or nzaterin/ly clianged before the �rpiratioiz date. • Should any of the required insurance be provicled undei� a claims-made form, Contractor shall maintain such coverage continuous�y 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 terin which give rise to claims made after expiration of the contract shall be covered. • 5hould any of t11e required insurance be provided Lu�der � form of coverage that includes a general amlual aggregate limit providing for claims investigation or legal deiense 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 teim, requests far 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 tlus agreement effective on the date of the lapse. CI - 10 SPECIFIC ADDITI�NAL INS�JRANC� R�QUIREMENTS: All insurance policies proposed or obtai�ze�i i�a 5atisfnction of this Contract shr�ll ndditionally comply with the folloiving marked specificr�tions, and shnll be m�intained in compliance with these arfrlitional specifictctions tlarouglaoact tlae dacrc�tio�z of tlie C'o�ztract, o� longer, if so noterl: [X] A. General Liability Instnrance: General Liability insurance with comUined 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 eiiher in a single policy or in a combination of underlying and umbrella or eYCess policies. If the Coininercial General Liability fornl(ISO Form CG 0001 cui7ent 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 t•equired. If the Comprehensive General Liability foi7n (ISO Form GL 0002 Current Edition a�id ISO Form GL 0404) is used, it shall include at least: Bodily injury and Properiy Damage Liability for premises, operations, products and completed operations, independent contractors and property damage resulting froin explosion, collapse or undergrotmd (XCU) exposures. Broad form contractual liability (preferably by endorsement) covering this contract, personal injury liability and broa.d forn� property damage liability. [X] Automobile g,iability Imsur�a��ceo Contractor shall provide Commercial Automobile Liability insurance with Combined Single Limits (CSL) of not less than �50�➢,000.00 either in a single policy or in a combination of basic and umbrella or excess policies. The policy will in�clude 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 ov�med, hired and non-o�vned autos. CI - 11 [X] Workers' Compensation Insurance Contractar shall purchase and maintain Worlcer's Compensation insurance which, in addition to nleeting the minimum statutory requirements for issuance of such insurance, has Employer's Liability limits of at least $100,U00 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 Attaclunent 1 in accordance with §406.096 of the Texas Labor Code and rule 28TAC 110.110 of the Texas Worlcer's Compensation Commission (TWCC). [] Owner's a�c� Contr�cto�-'s Proa�c�av� Liability Insuranc�e The Contractor shall obtain, pay for and maintain at all times during the prosecution of the work under this contract, an Qwner's �ind Contractor's Protective Liability insurance policy naming the City as instued for property damage and bodily injury wluch may arise in the prosecution of the worlc 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 witli a aggregate. [ ] Professional Liabili�y Inswra�ce Professional liability insurance with limits not less than per claim with respect to negligent acts, errors or omissions in comiection with professional services is required under this Ae eeinent. [ ] Builders' I�isk Ins.ur�nce Builders' Risk Insurance, on �n All-F.islc farm for 100% of the completed value shall be provided. SLich policy shall iuclude as "Named Insured" the City of Denton and all subcontractors as their interests may appPar. CI - 12 [ ] Cornmercial Crime Provides cover�ge for the theft or disappearance of cash or checics, robbery inside/outside the premises, burglary of the premises, aiid employee fidelity. The employee fidelity portion of this coverage should be written oii a"blanlcet" basis to cover all employees, including new hires. This type insurance should be required if the contractor l�as access to City funds. Limits of not less than each occurrence are required. [ ] Additional Insura�ce Other insurance may be required ou an individual basis for extra hazardous contracts and specific service agreements. If such additional insurance is required for a specific contract, that requirement �vill be described in the "Specific Conditions" of the contract specifications. CI - 13 AT�'AC�-IMEN'I' 1 [X] Workers' Compensati�o�► Coverage for Building oe� Comstructian Projects for Govern►nental Entities A. Deiinitions: Certificate of coverage ("certificate")-A copy of a cei�tificate of insurance, a certificate of authority to self-insure issued by tr�e conlinission, or a coverage agreement (TWCC- 81, TWCC-82, TWCC-83, or TWCG34), showing statutory workers' compensation insurance coverage for the persoi�'s or entity's employees providing services on a project, for t17e� durati�n 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 worlc on the project has been completed and accepted by the governll�ental 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 perfonn on the project, regardless of whether that person contracted directly with the contractor and regardless of ��hether that person has employees. This includes, without limitation, independent contrar,tors, 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 liinitation, 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 a# a.ny 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 contra�ct. D. If the coverage period shown on the contractor's current certificate of coverage ends during the duration flf the project, the contractar must, prior to the end of the coverage period, file a new ce:tificate 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 begirn�ing worlc on the project, so the govermnental entity will have on tile certificates of coverage showing coverage far 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 i�etain all required certificates of coverage for the duration �f the project and for one year thereafter. G. The contractor shall notity the governmental entity in wrrting by certified mail or personal delivery, within 10 days after the contractor lcnew or should have known, of any chailge that 7uaterially affects the provision of coverage of any person providing services on the project. H. The coi�tractor shall post on each project site a notice, in the text, form and manner prescribed by the Texas Workers' Compensation Coinmission, ulfoiming all persons providing services on the project that they are required to be covered, and stating how a person n�ay verify coverage and report l�ck of coverage. I. The contractor shall contractually require eacl� person with whom it contracts to provide services an a proj ect, tr�: 1) provide coverage, Uased on proper reporting of classification codes and payroll amounts and filing of any coverage agreeinents, which meets the statutory requirements of TeYas Labor Code, Section 401.011(44) for all of its employees providing services on #he project, for the duration of the project; 2) provide to the co�tractor, pri��r to th�f person beginning work on the project, a certificate of coverage sho��ving that coverage is being provided for all employees of the person proviciin� services on the project, for the dui•ation of the project; 3) provicie the contractor, prior to the end of the coverage period, a iiew certificate of coverage sho�ving e;�ctension of coverage, if the coverage period shown on the current certificate of coverage eizcls during the duration of the project; 4) obtain fi•om each other person with whom it contracts, and provide to the contractor: a) certificate of coverage, prior to the other person beginning worlc on the project; and b) a new certi6cate of coverage showing extezzsion of coverage, prior to the end of the coverage period, if the coverage period shown on the current certificate of coverage ends diiring the duration of the project; CI - 15 5) retain all required certificates of coverage on file for t11e duration of the project and for one pear thereaftei; 6) notify the goverrunental entity in writing by certified mail or personal delivery, within 10 days after the person ltnew or shoulci have Icnown, of any change that materially affects the provision of coverage of �ny person providing services on the project; and 7) contractually rec�uire eac11 person with whom it conh•acts, to perforin as required by paragra�hs (1) -(7), with the certificates of coverage to Ue 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 contractoi� is representing to the governmental entity that all employees of the contractor vrho �vill provide services on the project will be covered by workers' compensation coverage for the duratian of the project, that the coverage will be based on proper reporting of classification cocles and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carrier or, in tne case of a self- insured, �vith t��e convnissiorl's Division of Self-Insurauce 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 wliicl� entitles the governmental entity to declare the contract void if the contractor do�s not remeciy the breach withiu ten days after receipt of notice of breach from the govermneiltal entity. CI - 16 NFLICT OF INTEREST C�U�STI�h9NAIRE For vendor or other person dounel business with local governmental ent This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session FORM CIQ OFFICE USE ONLY This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a I 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. Name of person who has a biasiness re9ationshi� with local governm4ntal entity. � Check this box if you are filing an updat� to a previously faled questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7'h business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3 Name of local government officer v�ith whom filer has an em�l�yrroent 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-al, Lor,al Government Code. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer namecl in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? 0 Yes � No B. Is the filer of the questionnaire receiying or likely to r�ceive taxable income, other than investment income, from or at the direction of the local government officer named in this seciion 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? 0 Yes 0 No D. Describe each affiliation or business relationship. Signature of person doing business with the governmental entity CIQ - 1 Date Adopted 06/29l2007 SID #5171 PROPOSAL TO THE CITY OF DENTON, TEXAS FOR THE CONSTRLTCTIQN OF SAlyITARY SEWER EASEMENT CLEARING AND GATE INSTALLLATION II' DENTON, TEXAS The undersigned, as bidder, declares that the only persoil or parties interested in this proposal as principals are those named herein, that tlus proposal is made without collusion with any other person, firm, or corporation; that he has carefully examined the form of contract, Not�ce to Bidders, specifications and the plans therein refen•ed to, and has carefully examuied the locations, conditions, and classes of rnaterials .of the proposed work and a�ees that he wi11 provide all the necessary labor, inachinery, tools, apparatus, and other items incidental to construction, and wiil do all the work and fumish all the materials called for in the contract and specifications in the manner prescribed herein and according to the requirements of the City as therein set forth. It is understood that the following quantities of woxk to be done at uriit prices are approxunate only, and are intended principally to serve as a guide in evaluating bids. It is a�eed that the quantities of work to be done at unit prieas and material to be fiunished may be ulcreased or dimiuished 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 tlle specifications. The oontractor shall provide the numeric unit price and the unit price in words for each quantity. Unit price in words governs Qver the nurneric price given. It is further ab eed that change orders may be negotiated between the contractor and Gity #o cover additional wark ordered by the Ciiy, but not shown on the plans or required by the specifications, in accordance with the General Pravisions. Similarly, change orders may be negotiated to cover deletion of work so ordered. P-1 Project Name Calendar Days 365 - -- . _ __ _ __ ___ Sanitary Sewer Easement Clearing and Gate lnstalfation Bid Na 5171 _ _ - : P.O. No. _ _ BID TABULATION SHEET �tem Description Quantity Unit ; Unit Pcice ` Total 103.3 - Surety Bands 1 L3 $�i�0oo / LS $�gi Ooa . Unit Price In Words sG1G1�'i -�a �Se�aA flo �cA.lsS • � SS10-A 16' Easement Clearing 79;000 LF $'2 •�.d '/ LF �'►l3 $e� Unit Price In Words 1 r10- Da��l.Q.S TaS'c*'1t`! �-i'c•�`aS SS10-B 26' Easement Clearing 10,900 LF $���� / LF $�1,e4 0 Unit Price In Words '�iR.,�� -Deu..ea.S Con-ti - �Se�s� 5 SS11 Gate Installation 100 EA $ �� o o� 1 EA $ �o o,n e o : 1� 1 � • TOTAL BASE BID PRIGE IN WORDS: '�TN'�ZEE - HuaD[ti� �tr� �'t��SD.,•� D �1(s�i - Kv�+DRC� Skz N Da �•.d�. S 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. In tlie event of the award of a contract to the undersigned, the undersigned wi11 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 uritil final completion and acceptance, and to guarantee payment for all lawful clauns for labor performed and materials fiirnished in the fiilfillmerit of the contract. It is tuzderstood 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 undersi�ed certifies that the bid prices contained in this proposal have been carefully checked and are submitted as co�sect 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 tha official opening. The undersigned affirms that they are duly authorized to execute this contract. Vendor hereby assigns to purchaser any and all clairns for overchasges associated with this contract which arise under the antitrus# laws of the United States, 15 USCA Section 1 et seq., aild which arise under the antitrust laws of the State af Texas, Tex. Bus. & Com. Code, Section 15.01, et se . �! Receipt is hereby acknowledged of �t}le follovaing addenda to the plans and specifications: Addendum No. 1 dated ,� -�5 -! 3 Received ,� Addendtun No. 2 dated Received Addendum. No. 3 dated Received Addendum No. 4 dated Received Addendum No. 5 dated : Received �C � Cor�k( a_c_�; +na T vtC. . CONTR.ACTOR BY C� rE� 51�e.�r c�n .�f • t�. �ay5 �. �su 38A, S�-L�e �oo Street Address 7e.ca��r E T K 1 �.o � 3� City and State Seal & Authorization (If a Corporation) ���- �a� � o�aa Telephone P-5 VENDOR COMPLIANCE TO STATE LAW The 1985 Session of the Texas Legislature passed House Bill 620 relative to the awa.rd 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 pi?ncipal place of business are outside of the State of Texas) bid projects for construction, improvements, supplies or services in Texas at an ausoiult lower than the lowest Texas resident bidder by the sa.ine amoluzt#hat a Tex�s resident bidder would be required to underbid a non-resident bidder in arder to obtain a comparable contract in the state in which the non-resident's principal place of business is located, The appropriate blanks iu 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 disquali�y that Uidder. 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 thati resident bidders by state la�v. 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, Ot�r principal place of business or corparate offices are in the State of Texas: � �:1����]�l:ii ,�i Ci Can�ro_Ck, Yl�t , �'r1c. COMPANY BY J`J C-��eq S�e.+r,n,�a-n , V � r�• ,�0�15 E. klwti � , 5.��-Fe �oo Street Address cQ� F-rx `t�a�� City and State THIS F�RM MUST BE RETURNED WITH YQUR BID. . � CONTRACTOR COMPLIANCE TO TEXAS SALES TAX CODE Comply with all requirements of the Texas Sales Tax Code. The Contractor hereby certifies that the Contract Amount is divided as follows: Materials incorporated into the Project (resold to the Owner as defined in Tax Code) A11 other charges a.nd costs Total The total must eqLial the total amount of the Contract. CONTRACTOR: g qo �oo 0 $ ZZ8,aG� � 3i 8 , �6a �Ca �n��ar�na . T'r'LC. COMPANY BY - � rea� �hP�c rv�D-x� k V � �. �0�15 E. �k�su 3go, �u:►ke loo Street Address �����, Tx � � a�� City and State THIS F�RM SI3ALL BE E�+ CUTED AT THE TIME QF EXECUT�ON OF TFIE CONTRACT AND SHALL BE MADE A PART OF THE CONTRACT. P-7 CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law 6y H.B. 1491, 80th Leg., Regular Session. This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a person who has a business relafionship as defined by Section 176,001(1-a) with a Iocal governmental entiry and the person meets requirements under Section 176.006{a). By law th[s questiannaire must be filed with the records administrator of th� local govemmental entity notlaterthan the 7fh business day afterfhe date the person becomes aware offacts that r�quire the statement to be filed. See Section 176.006, Local Government Code. A person commits an offense if the person knowingly violates Section 176.D06, Local Government Code. An offense underthis section is a Class C misdemeanor. Name of person w4o has a business relationship with local governmental entity. C-� Y�q S1ne� rr��►-n � v��. ❑ Check this box ifyou are filing an update to a previously filed questionnaire. FORM CIQ OFFICE U5E ONLY Date Received (The law requires that you file an updated complefed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originafly filed questionnaire becomes incomplete or inaccurate.) IVame of locai government officerwlth whom filer has employment or business relafionship. I� O�f1.� Narne of Offcer This seciion (item 3 including subparts A, B, C& D) must 6e completed for each o�cer with whom the filer has an employment or other business relationship as defined by Section �76,001(1-a), Local Govemment 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? � Yes n No L�J B. Is the filer of the questionnaire recei�ing or likely to receive taxable income, other than investment income, from or at the direction of the local government o�cef named in this section AND the taicable income is not received from the local governmental entity? � Yes � No C. Is the filer of this questionnaire employed 6y a corporation or other business entfty with respect to which the local govemment officer serves as an officer or director, or holds an ownership of 10 percent or more? � Yes � No D. Describe each employment or business relationshtp with the iocal government officer named in this section. 1� o�n.� Signature of pe doing 6usiness with the govemmental entity �-�8-�� Date Adapted �S/29/2007 � �� OP ID: MK ,a��sro ���-�BFICA�E OF LdA�3�LI�Y �NSUt�6�CE DATE(MMID�lYYYY) 04123/20'i 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPOfV 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 aR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 6e 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 nat confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 517-321-4600 NAME:CT Marci Kohler David Chapman Agency, Inc. Fax: 517-321-9443 PHONE 517-321-4600 F'4X 517-321-9443 5700 W. Mt. Hop e Highway ,vc No Ext: AIC No : Lansing, MI 48�J17- E�MA�� mkohlern davidcha mana enc com ', David Chapman ADORESS: 1,:, P 9 Y• PRODUCER ri icrnn�oo in �e. DAVCO-'I I INSURED uci contracting� �IIC:.fi 2045 E. US Hwy 380, #100 Decatur, TX 76234 i '���� �.\ � INSURER(S) AFFORDING COVERAGE iNSUReRn:Great Midwest Insurance Com iNSUReR s: The Accident Fund Co INSURER C : INSURER D : INSURER E : NAIC # 10166 COVERAGES CERTIFICATE NUMBER: 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. ILTR TYPE OF INSURANCE DDL aR pOLICY NUMBER MMIDI DY� MM �D� LIMITS GENERALLIABILITY 'EACHOCCURRENCE $ 'I�OOO�OO � A X COMMERCIALGENERALLIABILITYf X/ PP00025560-01� 12I16/2012 12/16l2013 pREMISES Eaoccurtence S 300,40 CLAIMS-MADE a OCCUR� MED EXP (Any one persanJ S 5,00 X X,C,U included `� PERSONAL 8 ADV INJURY S �,���,QO X Contractual liab � GENERALAGGREGATE S Z,U�0,00 � GEN'LA�GREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ 2,000�00 POLICY X PR� LOC $ AUTOMOBILE LIABILITY`� )( �ONIBINED SINGLE LIMIT a � OOO,OO � A x ANY AUTO� CA00025465-01 � 12/16/2012 12/16/2013 �Ea accident) � BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accidentJ $ SCHEDULED AUTOS PROPERTY DAMAGE $ i� HIREDAUTOS (Peraccident) X NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ S�OOO�OO E%CESS LIAB CLAIMS-MADE AGGREGATE $ S�OOO�OO A X CX00000235-01 12/16/2012 12/16/2013 DEDUCTIBLE 3 X RETENTION $ 'IO,OOO § WORKERS COMPENSATION ✓ X T RY L MITS ��ER ANq EMPLOYERS' LIABILITY Y� N / B ANYPROPRIETORIPARTNERIEXECUTIVE WCV0321618 'I'II'I6/2O'I2 11/1612013 E.L.EACHACCIDENT $ 'I�OOO,OO � OFFICER/MEMBER EXCLUDED7 � N � / (Mandatory in NH) ALL STATES, INCL TEXAS� E.L. DISEASE-EA EMPLOYE $ 'I,OOO,OO / If yes, describe under , DESCRIPTIONOFOPER4TIONSbelaw E.L.DISEASE-POLICYLIMIT $ �,OOO,OO DESCRIPTION OF OPERATION5/ LOCATIONS 1 VEHICLES �Attach ACORD 101, Additional Remarks Schedule, if more space is required) Ref: Sanitary Sewer Easement Clearing and Gate Installation, Denton Texax ✓ Cit of Denton, its Officials Aqents{ Employees and Volunteers are named as a3di iona insureds on Genera� Liability and Umbrella per CG2033r30-Day / otlT`ice o Cf ancellation is provided for General Liability, Auto Liability, Umhrella and Workers Comp. Such insurances available to all additional C City of Denton `� 215 E McKinney Street Denton, TX 76201 ACORD 25 (2009/09) CITYDEN CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCOR�ANCE WITH THE POLICY PROVISIONS. AUTHORIZE� REPRESENTATIVE / ��� �n--"-z'°� �' ��Q`'�,-n"-"�' O 1988-2009 ACORD CORPORATION. All rights reserved. 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