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2010-078FILE REFERENCE FORM 2010-078 X Additional File Exists Additional File Contains Records Not Public, According to the Public Records Act Other FILE(S) Date Initials Chan ge Order No. 1 - Ordinance No. 2010-140 06/15/10 ) R Chan ge Order No. 2 (Purchasing) 06/04/10 ) R Chan ge Order No. 3 (Purchasing) 06/09/10 R Chan ge Order No. 4 (Purchasing) 07/20/10 R Chan ge Order No. 5 (Purchasing) 07/20/10 R Chan ge Order No. 6 (Purchasing) 07/23/10 )R- Chan ge Order No. 7 - Ordinance No. 2010-290 11/02/10 ) R ORDINANCE NO. ~ ~-O7~ AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC ~UORKS CONTRACT FOR THE CONSTRUCTION OF THE DOWNTOWN DENTON TRANSIT CENTER TO BE LOCATED AT 604E. HICKORY STREET, DENTON, TEXAS.; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR; AND PROVIDING AN EFFECTIVE DATE BID 4444-AWARDED TO THE LOWEST RESPONSIBLE BIDDER MEETING SPECIFICATION,CORBET GROUP, INC. IN THE AMOUNT OF $1,736,000}, WHEREAS, the City has solicited, received and tabulated competitive bids for the construction of public worl{s 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 oz' 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 Bled according to the bid number assigned hereto, are hereby accepted and approved as being the lowest responsible bids; BID NUMBER CONTRACTOR AMOUNT 4444 Corbet Graup, Inc, $1,736,000 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 City Manager is hereby authorized to execute all necessary written contracts for the performance of the construction of the public works or improvements in accordance with the bids accepted and approved herein, provided that such contracts are made in accordance with the Notice to Bidders and Bid Proposals, and documents relating thereto specifying the terms, conditions, plans and specifications, standards, quantities and specified sums contained therein, SECTION 4. 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 5, This ordinance shall become effective lm.mediately upon its passage and approval, . PAS SED AND APPROVED this the ~ da of ~ y , oID, A, U 0 S, MAYOR ATTEST: JENNIFER 'FALTERS, CITY SECRETARY APPROVED AS TO LEGAL FORM: ANITA BURGESS, CITY ATTORNEY BY: CONTRACT AGREEMENT STATE OF TEXAS § COUNTY OF DENTON § THIS AGREEMENT, made and entered into this 2nd day of March A.D. 2010, 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 Corbet Group Inc 2213 Butler St. Dallas TX 75235 of the City of Dallas, County of Dallas 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 4444- Downtown DentonTransit Center in the amount of $1,736,000 and all extra work in connection therewith, under the terms as stated in the General Conditions of the agreement; and. at his (or their) own proper cost and expense to 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: Jacobs Engineering all of which are referenced herein and made a part hereof -and collectively evidence and constitute the entire contract. CA-1 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. ATTEST: City of Denton OWNE If BY L 1 Q ~ (SEAL) - ATTEST: - r S CONTRAC R T CIO T)lAr'JCA ])iC+llAeA ri!)Ossd, MAILING ADDRESS PHONE NUMBER FAX NUMBER BY: ITLE APPROVED AS TO FORM: PRINTED NAME (SEAL). / TA BURGESS, CIT ATTORNEY CA-4 Gi: _ CC y~ 1 PERFORMANCE BOND STATE OF TEXAS 5 COUNTY OF DENTON KNOW ALL MEN BY THESE PRESENTS: That Corbet Group. Inc. whose address is 2213 Butler St. Dallas, TX 75235 hereinafter called Principal, and a corporation organized and existing under the laws of the State of , and fully authorized to transact business in the State of Texas, as Surety, are held and firmly bound unto the City of Denton, a municipal corporation organized and existing under the.laws -of the State of Texas, hereinafter called Owner, in the penal sum of One Million Seven Hundred -Thirty Six Thousand and 0/100 DOLLARS ($1,736,000) 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 sure of this Bond. THE OBLIGATION TO PAY SAME is conditioned as follows: Whereas, the Principal entered into a certain Contract, identified by Ordinance Number 2010-078 with the City of Denton, the Owner, dated the 2nd day of March A.D. 2010, for Bid #4444 Downtown Denton Transit Center. NOW, THEREFORE, if the Principal shall well, truly and faithfully perform and fulfill all of the undertakings, covenants, tenns, 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 copies, each one of which shall be deemed an original, this the day of , ATTEST: PRINCIPAL BY: SECRETARY BY: PRESIDENT ATTEST: SURETY BY: BY: ATTORNEY-IN-FACT The Resident Agent of the Surety.in Denton County, Texas for delivery of notice and service of the process is: NAME: STREET ADDRESS: (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 STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That Corbet Group, Inc, whose address is 2213 Butler St. Dallas, TX 75235 hereinafter called Principal, and a corporation organized and existing under the laws of the State of , and frilly authorized to transact business in the State of Texas, as Surety, are held and firmly bound unto the City of Denton, a municipal corporation organized and existing under the laws of the State of Texas, hereinafter called Owner, and unto all persons, firms, and corporations who may furnish materials for, or perform labor upon, the building or improvements hereinafter referred to, in the penal sum of One Million Seven Hundred Thirty Six Thousand and 0/100 DOLLARS ($1;736,000) 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 2010-078 with the City of Denton, the Owner, dated the 2"d day of March A.D: 2010, for Bid #4444 Downtown Denton Transit Center. 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 terrns 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 day of , ATTEST: PRINCIPAL BY: SECRETARY BY: PRESIDENT ATTEST: SURETY BY: BY: ATTORNEY-IN-FACT The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: STREET ADDRESS: (NOTE: Date of Payment Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name.) PB-4 CITY OF DENTON INSURANCE REQUIREMENTS FOR CONTRACTORS Bidder's attention is directed to the insurance requirements below. It is highly recommended that bidders confer with their respective insurance carriers or brokers to determine in advance of Bid submission the availability of insurance certificates and endorsements as prescribed and provided herein. If an apparent low bidder fails to comply strictly with the insurance requirements, that bidder may be disqualified from award of the contract. Upon bid award, all insurance requirements shall become contractual obligations, which the successful bidder shall have a duty to maintain throughout the course of this contract. STANDARD PROVISIONS: Without limiting any of the other obligations or liabilities of the Contractor, the Contractor shall provide and maintain until the contracted work has been completed and accepted by the City of Denton, Owner, the minimum insurance coverage as indicated hereinafter. As soon as practicable after notification of bid award, Contractor shall file with the Purchasing Department satisfactory certificates of insurance, containing the bid number and title of the project. Contractor may, upon written request to the Purchasing Department, ask for clarification of any insurance requirements at any time; however, Contractors are strongly advised to make such requests prior to bid opening, since the insurance requirements may not be modified or waived after bid opening unless a written exception has been submitted with the bid. Contractor shall not commence any work or deliver any material until he or she receives notification that the contract has been accepted, approved, and signed by the City of Denton. All insurance policies proposed or obtained in satisfaction of these requirements shall comply with the following general specifications, and shall be maintained in compliance with these general specifications throughout the duration of the Contract, or longer, if so noted- • Each policy shall be issued by a company authorized to do business in the State of Texas with an A.M. Best Company rating of at least A. • Any deductibles or self-insured retentions shall be declared in the bid proposal. If requested by the City, the insurer shall reduce or eliminate such deductibles or self-insured retentions with respect to the City, its officials, agents, employees and volunteers; or, the contractor shall -procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses. • Liability policies shall be endorsed to provide the following: • Name as additional insured the City of Denton, its Officials, Agents, Employees and volunteers. 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. • Cdncellation: The City requires 30 day written notice should any of the policies described on the certificate he 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 (XU) 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 property damage and bodily injury which may arise in the prosecution of the work or Contractor's operations under this contract. Coverage shall be on an "occurrence" basis, and the policy shall be issued by the same insurance company that carries.the Contractor's liability insurance. Policy limits will be at least combined bodily injury and property damage per occurrence with a aggregate. [ ] Fire Damage Legal Liability Insurance Coverage is required if Broad form General Liability is not provided or is unavailable to the contractor or if a contractor leases or rents a portion of a City building. Limits of not. less than each occurrence are required. [ ] Professional Liability Insurance Professional liability insurance with limits not less than per claim with respect to negligent acts, errors or omissions in connection with professional services is required under this Agreement. [ ] Builders' Risk Insurance Builders' 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. Cl - 13 ATTACHMENT 1 [X] Worker's Compensation Coverage for Building or Construction Projects for Governmental Entities A. Definitions: Certificate of coverage ("certificate ")-A copy of a certificate of insurance, a certificate of authority to self-insure issued by the commission, or a coverage agreement (TWCC- 81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation insurance coverage for the person's or entity's employees providing services on a project, for the duration of the project. Duration of the project - includes the time from the beginning of the work on the project until the contractor's/person's work on the project has been completed and accepted by the governmental entity. Persons providing services on the project ("subcontractor" in §406.096) - includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project, regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees. This includes, without limitation, independent contractors, subcontractors, leasing companies, motor carriers, owner-operators, employees of any such entity, or employees of any entity which furnishes persons to provide services on the project. "Services" include, without limitation, providing, hauling, or delivering equipment or materials, or providing labor, transportation, or other service related to a project. "Services" does not include activities unrelated to the project, such as food/beverage vendors, office supply deliveries, and delivery of portable toilets. B. The contractor shall provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any overage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all employees of the Contractor providing services on the project, for the duration of the project. C. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. D. If 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: Cl - 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. 1. 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 proj ect; 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. CI - 16 . . OR1,G]NAL COR[3'(=T COMMERCIAL BUILDERS Tom Shaw, Purchasing Agent City of Denton Purchasing Department 901-B Texas Street Denton, Texas 76209 940-349-7100 www.dentonpurchasing.com BID NOw 4444 DOWNTOWN.DENTON TRANSIT CENTER BIDS DUE: February 92010 2:00 PIVI Bid Submitted By: Corbet Groua, Inc PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 Bid No. 4444 PROPOSAL TO THE CITY OF DENTON, TEXAS FOR THE CONSTRUCTION OF DOWNTOWN DENTON TRANSIT CENTER 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 manner 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 that 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 lump sum prices may be increased to cover additional work ordered by the City, but not shown on the plans or required by the specifications, in accordance with the provisions to the General Conditions. Similarly,' they may be decreased to cover deletion of work so ordered It is understood and agreed that the work is to be completed in full within the number of workdays shown on the bid tabulation sheet. PAGE P - 1 OF BID #4444 t . 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.. 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 faihire 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: f • PAGE P - 2 OF BID #4444 BIDS Y TOTAL PRICE IN WORDS. A //,6- rd THE P"atc- " WMP%X"oN '>ATv- Wk0- No I.ATk nf*tAJ -W"WfjVf- IS, In the event of the award of .a contract to the undersigned, the undersigned will furnish a ANZO 10. performance bond and a payment bond for the full amount of the contract, td 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. 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 she.., and which arise under the antitrust laws of the State of Texas, Tex. Bus. & Com. Code, Section 15.01, et sea. When City of Denton terms and conditions conflict with Federal regulations, Federal regulations, terms and conditions shall prevail. PAGE P - 3 OF BID #4444 t Receipt is hereby acknowledged of the following addenda to the plans and specifications: Addendum No. I dated •2~ • 0 Received • 2"1 ' Addendum No. 2 dated -1.,3.10 Received z ' 3 • 10 Addendum No. 3 dated 2.8 • l o Received Z • g • (D Addendum No. 4 dated . Received Addendum No. S dated Received C.o "up I oc. R M CO O BY ~IZ44M Street Address l) RLLM. TA - -7523T City and State Seal & Authorization 21 y •q o S- O S (If a Corporation.) Telephone PAGE P - 4 OF BID #4444 1 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: O i-1.! G Ge-clipy IMC COMP BY 13pq" . nub 22t 3 Sonlee Street Address Tx -7523 S City and State THIS FORM MUST BE RETURNED WITH YOUR BID. PAGE P - 5 OF BID #4444 y: . . . BID #4444 ADDENDUM # 1 0. 'u + - • - . :s s 1 Addendurn #_1 to be returned'with ~Bid-Proposal - - . . - - _ _ 1 5 . y~ - The following are clarifcations to the bid specifications: - . t,y ` ] - ~see~attacted sheets . . . * ~ t _ - ~s F f 1 y Y - ' $ - - - i "i' _ _ +"3t , z rirT Y,. y _ , _ .w _ . Vd ~ r X f z zSy _ . x 1NOOTHER CHANGES AT ~fHIS TIME— _ rya L%~'`*' t '.""a ct { n1 y _ - c - _ (v - - N~, - - ' k - 11- t > e r~~; , . _ f k =This fig' m~shall he signed and returned with your bid. - Y .y....i} j /Ayr' v. 1 „~krl-4_ ~.r. Y r v :Name - - , T-~- _ s i t §:4 - r tip •1 r; 3`,.A _ - `~;t - Sign=atuTe F F - { - - - _ - - .A, _ ~ . - - '1~v ~ V ~ ~ , - - - . : . - -1 4$ -i E. _ . w s - - _l,2 _ Q - 1^ - .r Comp ny , %,CA "It t C-, A e e~v _ ~ `P p~+;~,`_°~p n~ ` Title: ' - 14 , t t ..d;± "'rte .F e".DQte: _ - - Y rR fj S _ F x rte.. - } r ° :,f< ' r tT ' - t I 2 - - _ - - - . . - .i fi e _ _ < - i L 1-f e .r - .r.1 _ 2 7 _ t ' ` ~ t - ` . . L. r = ` sh' : ` t a ; • . / / - -4 . _ I I - _t ~1. ~ ~ . . - a 'ter 8 ,s- .c ~ iC- . f - _ - , , W~. i t'4 If 3 y h , ~ S Y Sri _ 2 _ - t _ { ,...y_r~ t Mfr x+ " z 7. r 4 , ' a t I t - - - Y • s+x - t} -CA, - t t, A - f 1 SAFETY RECORD. QUESTIONNAIRE (Must Be Submitted With Bid Submittal) The City of Denton desires to avail itself of the benefits of Section 252.0435 -of the Local Government Code, and consider the safety records of potential contractors prior to awarding bids on City contracts. Pursuant to Section 252.0435 of the Local Government Code, the City of Denton has adopted the following written definition and criteria for accurately determining the safety record of a bidder prior to awarding bids on City contracts. ' The definition and criteria for determining the safety record of a bidder for this consideration shall be: The City of Denton shall consider the safety record of the bidders in determining the responsibility thereof The City may consider any incidence involving worker safety or safety of the citizens of the City of Denton, be it related or.cauused by environmental, mechanical, operational, supervision or any other cause or factor. Specifically, the City may consider, among other things: a. Complaints to, or final orders entered by, the Occupational Safety and Health Review Commission (OSHRC), against the bidder for violations of OSHA regulations within the past three (3) years. b. Citations (as defined below) from an Environmental Protection Agency (as defined below) for violations within the past five (5) years. Environmental Protection Agencies include,. but are not necessarily limited to, the U.S. Army Corps of Engineers (USACOE), the U.S. Fish and Wildlife Service (USFWS), the Environmental Protection Agency (EPA), the Texas Commission on Environmental Quality (TCEQ), the Texas Natural Resource Conservation Commission (TNRCC) (predecessor to the TCEQ),. the Texas Department of Health (TDH), the Texas Parks and Wildlife Department (TPWD), the Structural Pest Control Board (SPCB), agencies of local governments responsible for enforcing environmental protection or worker safety related laws or regulations, and similar regulatory agencies of other states of the United States. Citations include notices of violation, notices of enforcement, suspension/revocations of state or federal licenses or registrations,. fines assessed, pending criminal complaints, indictments, or convictions, administrative orders, draft orders, final orders, and judicial final judgments. C. Convictions of a criminal offense within the past ten (10) years, which resulted in bodily harm or death. d Any other safety related matter deemed by the City Council to be material in determining the responsibility of the bidder and his or her ability to perform the services or goods required by the bid documents in a safe environment, both for the. workers and other employees of bidder and the citizens of the City of Denton. PAGE SQ - 1 OF BID #4444 In order to obtain proper information from bidders so that City of Denton may consider the safety records of potential contractors prior to awarding bids on City contracts, City of Denton requires that bidders answer the following three (3) questions and submit them with their bids: QUESTION ONE Has the bidder, or the firm, corporation, partnership, or institution represented by the bidder, or anyone acting for such firm, corporation, partnership or institution, received citations for violations of OSHA within the past three (3) years? NO y YES If the bidder has indicated YES for question number one above, the bidder must provide to City of Denton, with its bid submission, the following information with respect to each such citation: Date of offense, location of establishment inspected, category of offense, final disposition of offense, if any, and penalty assessed. QUESTION TWO Has the bidder, or the firm, corporation, partnership, or institution represented by the bidder, or anyone acting for such firm, corporation, partnership or institution, received citations -for violations of environmental protection laws or regulations, of any kind or ' type, within the past five years? Citations include notice of violation, notice of enforcement, suspensionhevocations of state or federal licenses, or registrations, fines assessed, pending criminal complaints, indictments, or convictions, 'kninistrative orders, draft orders, final orders, and judicial final judgments. YES NO v If the bidder has indicated YES for question number two above, the bidder must provide to City of Denton, with its bid submission, the following information with respect to each such conviction: Date of offense or occurrence, location where offense occurred, type of offense, final disposition of offense, if any, and penalty assessed. QUESTION THREE Has the bidder, or the firm, corporation, partnership, or institution represented by bidder, or anyone acting for such firm, corporation, partnership, or institution, ever been convicted, within the past ten (10) years, of a criminal offense which resulted in serious bodily injury or death? NO V/ YES If the bidder has indicated YES for question number three above, the bidder must provide to City of Denton, with its bid submission, the following information with respect to each such conviction: Date of offense, location where offense occurred, type of offense, final disposition of offense, if any, and penalty assessed. PAGE SQ - 2 OF BID #4444 ACKNOWLEDGEMENT THE STATE OF TEXAS COUN'T'Y OF DENTON I certify that I have made no willful misrepresentations in this Questionnaire nor have I withheld information in my statements and answers to questions. I am aware that the information given by me in this questionnaire will- be investigated, with my full permission, and that any misrepresentations.or omissions may cause my bid to be rejected. i e Title PAGE SQ - 3 OF BID #4444 NFLICT 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 Recelved person who has a business relationship as defined by Section 176.001(1-a) with a local govemmental entity and the person meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local govemment entity 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 knowingly violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. Name of person who has a business relationship with local governmental entity. CoQ T Gtouic)j Itic. Tgq Gjanw E-q 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 7"' 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. KI _ 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? 1 F Yes 0 No l~ P, 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 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. NJA 4 21 q ID gna ure of g business with "9 emmentai entity Date Adopted 009912007 PAGE CIQ - 1 OF BID#4444 i THE AMERICAN INSTITUTE OF ARCHITECTS A1A Document A310 Bid Bond KNOW ALL MEN BY THESE PRESENTS, that we Corbet Group (Here insert full name and address or legal title of Contractor) P.O. Box 35528 - 2213 Butler Street, Dallas, Texas 75235 as Principal, hereinafter called the Principal, and The Guarantee Company of North America USA (Here insert full name and address or legal title of Surety) 25800 North Western Highway -Suite 720, Southfield, Michigan 48075 a corporation duly organized under the laws of the State of Michigan as Surety, hereinafter called the Surety, are held and firmly bound unto City of Denton (Here insert full name and address or legal title of Owner) 901-B Texas St., Denton, TX 76209 as Obligee, hereinafter called the Obligee, in the sum of Five percent of the greatest amount bid Dollars ($5% G.A.B.), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, The Principal has submitted a bid for (Here insert full name, address and description of project) Downtown Denton Transit Center t NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. Signed and sealed this 9th day of February, 2010 Corbet Group (Principal) (Sea,' . I (Witness) The Guarantee Company of North America USA (Witness) (T tle a4. Cox, A orney-In-Fact AIA DOCUMENT A310. BID BOND. AIA 0. FEBRUARY 1970 ED. THE AMERICAN 1 INSTITUTE OF ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D.C. 20006 WARNING: Unlicensed photocopying violates U.S. copyright laws and is subject to legal prosecution IMPORTANT NOTICE TO OBTAIN INFORMATION OR TO MAKE A COMPLAINT You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-252-3439 You may write the Texas Department of Insurance: P.O. Box 149104 Austin, Texas 78714-9104 FAX No. (512) 475-1771 j PREMIUM OR CLAIM DISPUTES Should you have a dispute concerning your prcmium or about a claim, you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of the attached document. THE GUARANTEE COMPANY OF NORTH AMERICA USA Southfield, Michigan POWER OF ATTORNEY KNOW ALL BY THESE PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA USA, a corporation organized and existing under the laws of the State of Michigan, having its principal office in Southfield, Michigan, does hereby constitute and appoint William D. Baldwin, Michael B. Hill, Brady K. Cox, Brock Baldwin, Brent Baldwin, Jennifer J. Clark Baldwin Insurance & Bonding Agency, Inc. its true and lawful attomey(syin-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise. The execution of such instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANY OF NORTH AMERICA USA as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at the principal office. The Power of Attorney is executed and may be certified so, and may be revoked, pursuant to and by authority of Article IX, Section 9.03 of the By-Laws adopted by the Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a.meeting held on the 31s` day of December, 2003. The President, or any Vice President, acting with any Secretary or Assistant Secretary, shall have power and authority: 1. To appoint Attomey(s)-in-fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto, bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof; and 2. To revoke, at any time, any such Attomey-in-fact and revoke the authority given, except as provided below 3. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted at a meeting duly called and held on the 31 st day of December 2003, of which the following is a true excerpt: RESOLVED that the signature of any authorized officer and the seal of the Company may be. affixed by facsimile to any Power of Attorney or certification 1 thereof authorizing the execution and delivery of any bond, undertaking, contracts of indemnity and other writings obligatory in the nature thereof, and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF, THE GUARANTEE COMPANY OF NORTH AMERICA USA has caused this instrument to be signed and its corporate seal to be affixed by its authorized officer, this 1st day ni/1TFF of June, 2009. THE GUARANTEE COMPANY OF NORTH AMERICA USA 4 STATE OF MICHIGAN Stephen Dullard, Vice President Randall Musselman, Secretary County of Oakland On this 1 st day of June, 2009 before me came the individuals who executed the preceding instrument, to me personally known, and being by me duly sworn, said that each is the herein described and authorized officer of The Guarantee Company of North America USA; that the seal affixed to said instrument is the Corporate Seal of said Company; that the Corporate Seal and each signature were duly affixed by order of the Board of Directors of said Company. Cynthia A. Takai IN WITNESS WHEREOF, I have hereunto set my hand at The Guarantee Notary Public, State of Michigan Company of North America USA offices the day and year above written. County of Oakland My Commission Expires February 27, 2012 ' Acting in Oakland County I, Randall Musselman, Secretary of THE GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby certify hhat the above and foregoing is a true and correct copy of a Power of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMERICA USA, which is still in full force and effect. IN WITNESS WHEREOF, I have thereunto set my hand and attached the seal of said Company this 9th -day of February 2010 Ca~TPC Randall Musselman Secretary AIA L *A1A Document A305'- 1986 Contractor's Qualification Statement The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading. SUBMITTED TO: The City of Denton ADDITIONS AND DELETIONS: The author of this document has ADDRESS: 901-B Texas Street, Denton, TX 76209 added information needed for its completion. The author may also I SUBMITTED BY: Corbet Group, Inc. have revised the text of the original AIA standard form. An Additions and Deletions Report that notes added I NAME: Bryan Garvey information as well as revisions to the standard form text is available from ADDRESS: 2213 Butler Street, Dallas, TX 75235 the author and should be reviewed. A vertical line in the left margin of this PRINCIPAL OFFICE: 2213 Butler Street, Dallas, TX 75235 document indicates where the author has added necessary information I ( X ] Corporation and where the author has added to or deleted from the original AIA text. [ ] Partnership This document has important legal [ ] Individual consequences. Consultation with an [ ] Joint Venture attorney is encouraged with respect to its completion or modification. [ ] Other This form is approved and recommended by the American NAME OF PROJECT: (if applicable) Downtown Denton Transit Center Institute of Architects (AIA) and The Associated General Contractors of TYPE OF WORK: ale separate form for each Classification of Work) America (AGC) for use in evaluating the qualifications of contractors. No I [ X ] General Construction endorsement of the submitting party or verification of the information is [ ] HVAC made by AIA or AGC. [ ] Electrical [ ] Plumbing [ ] Other: (Specify) § 1. ORGANIZATION . § 1.1 How many years has your organization been in business as a Contractor? 7 § 1.2 How many years has your organization been in business under its present business I name? 2 § 1.2.1 Under what other or former names has your organization operated? I JJK Inc., Corbet Group LLC - Both companies merged last year § 1.3 If your organization is a corporation, answer the following: § 1.3.1 Date of incorporation: 1982 § 1.3.2 State of incorporation: Texas § 1.3.3 President's name: Bryan Garvey AIA Document A305TM -1986. Copyright ©1964, 1969, 1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING: This AIA° Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this A10 ° Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 09:53:18 on 02/09/2010 under Order No. 13961495631 which expires on 09/08/2010, and is not for resale. User Notes: (962160717) § 1.3.4 Vice-president's name(s) I Devin Parsons § 1.3.5 Secretary's name: Devin Parsons § 1.3.6 Treasurer's name: Bryan Garvey § 1.4 If your organization is a partnership, answer the following: § 1.4.1 Date of organization: § 1.4.2 Type of partnership (if applicable): § 1.4.3 Name(s) of general partner(s) § 1.5 If your organization is individually owned, answer the following: § 1.5.1 Date of organization: § 1.5.2 Name of owner: § 1.6 If the form of your organization is other than those listed above, describe it and name the principals: § 2. LICENSING § 2.1 List jurisdictions and trade categories in which your organization is legally qualified to do business, and indicate registration or license numbers, if applicable. § 2.2 List jurisdictions in which your organization's partnership or trade name is filed. State of Texas § 3. EXPERIENCE § 3.1 List the categories of work that your organization normally performs with its own forces. Management § 3.2 Claims and Suits. (If the answer to any of the questions below is yes, please attach details.) § 3.2.1 Has your organization ever failed to complete any work awarded to it? No § 3.2.2 Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your organization or its officers? I No § 3.2.3 Has your organization filed any law suits or requested arbitration with regard to construction contracts within the last five years? No § 3.3 Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If the answer is yes, please attach details.) r AIA Document A305TM -1986. Copyright ©1964, 1969, 1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING: This AIA° Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AJO Document, or any 2 portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 09:53:18 on 02/09/2010 under Order No. 13961495631 which expires on 09/08/2010, and is not for resale. User Notes: (962160717) No t § 3.4 On a separate sheet, list major construction projects your organization has in progress, giving the name of project, owner, architect, contract amount, percent complete and scheduled completion date. Please see attached § 3.4.1 State total worth of work in progress and under contract: I $1,827,056.00 § 3.5 On a separate sheet, list the major projects your organization has completed in the past five years, giving the name of project, owner, architect, contract amount, date of completion and percentage of the cost of the work performed with your own forces. Please see attached § 3.5.1 State average annual amount of construction work performed during the past five years: I Eight Million Annually § 3.6 On a separate sheet, list the construction experience and present commitments of the key individuals of your organization. Please see attached § 4. REFERENCES § 4.1 Trade References: _ Please see attached § 4.2 Bank References: Park Cities Bank -Nancy Cordona -4300 Lovers Ln., Dallas, TX 75225 - 214-239-7700 § 4.3 Surety: § 4.3.1 Name of bonding company: Guarantee Company of North America § 4.3.2 Name and address of agent: I Baldwin - Cox Agency Brady Cox 1201 Kas Drive Ste. B, Richardson, TX 75081 § 5. FINANCING § 5.1 Financial Statement. § 5.1.1 Attach a financial statement, preferably audited, including your organization's latest balance sheet and income statement showing the following items: Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials inventory and prepaid expenses); Net Fixed Assets; Other Assets; AIA Document A305T" - 1986. Copyright ©1964, 1969, 1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING: This AIA® Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAO Document, or any 3 portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 09:53:18 on 02/09/2010 under Order No.1396149563_1 which expires on 09/08/2010, and is not for resale. User Notes: (962160717) Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes); Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings). § 5.1.2 Name and address of firm preparing attached financial statement, and date thereof: I Berry and Associates, PA, 2 Office Park Drive, Suite 102, Little Rock AR 72211- 05/31/2009 § 5.1.3 Is the attached financial statement for the identical organization named on page one? Yes § 5.1.4 If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent-subsidiary). § 5.2 Will the organization whose financial statement is attached act as guarantor of the contract for construction? Yes § 6. SIGNATURE § 6.1 Dated at this 9`h day of February 2010 Name of Organization: Corbet Group, Inc. By: Bryan Garvey - Title: President § 6.2 I M Bianca Dichiara being duly sworn deposes and says that the information provided herein is true and sufficiently complete so as not to be misleading. Subscribed and sworn before me this 9`h day of February 2010 Notary Public: • `'~~~~rr"'' 61ANCA M. DICHIARA J~,~~~r rued.,. My Commission Expires: ,p .3p . + Notary Public, State of Texas My Commission Expires ;~'oi't; October 30, 2011 4rrpµ, i AIA Document A305TM -1986. Copyright ©1964, 1969, 1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING: This AIA® Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA® Document, or any 4 portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 09:53:18 on 02/09/2010 under Order No.1396149563_1 which expires on 09/08/2010, and is not for resale. User'Notes: (962160717) Certification of Document's Authenticity AIA® Document D401 rm - 2003 I, Bryan Garvey, hereby certify, to the best of my knowledge, information and belief, that I created the attached final document simultaneously with its associated Additions'and Deletions Report and this certification at 09:53:18 on 02/09/2010 under Order No. 1396149563_1 from AIA Contract Documents software and that in preparing the attached final document I made no changes to the original text of AIA® Document A305T111 - 1986 - Contractor's Qualification Statement, as published by the AIA in its software, other than those additions and deletions shown in the associated Additions and Deletions Report. Signe ~D iels (Title) . ~ .1a (Dated) AIA Document D401 Tm - 2003. Copyright ©1992 and 2003 by The American Institute of Architects. All rights reserved. WARNING: This Ale Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may 1 result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 09:53:18 on 02/09/2010 under Order No.1396149563_1 which expires on 09/08/2010, and is not for resale. User Notes: (962160717) 3.4 Major Construction Projects in Progress - Acton Municipal Utility District $1,827,057.00 Owner: Acton Municipal Utility District 2001 Fall Creek Hwy Granbury, TX 76049 Richard English 817-326-4720 phone 817-326-5920 fax Architect: Quorum Architects, Inc 707 W Vickery Blvd, Ste 101 Fort Worth, TX 76104 David Duman 817-738-8095 phone 817-738-9524 fax 3.5 Major Construction Projects in Past Five Years - Parker County Hospital District $909,211.00 Owner: City of Weatherford 1121 Pecan Weatherford, TX 76086 Randall Young 817-599-1225 phone 817-599-1241 Architect: TMA Architects 814 Pennsylvania Ave, Ste 100 Fort Worth, TX 76104 Tom Malone 817-737-0404 phone 817-737-0401 fax - Las Colinas - Buildings RDFP2/P5 $1,471,446.00 Owner: RDF 141 West 114 Irving TX P2/P5 505 Pecan St, Ste 101 Fort Worth, TX 7102 Roger Franz 817- 632-4576 phone 817-529-3205 fax Architect: FJLC & Associates 4055 International Plaza, Ste 510 Fort Worth, TX 76109 John Franz 817-737-9922 phone 817-737-9536 fax - Wichita Falls Softball Complex $1,586,608.00 . Owner: City of Wichita Falls PO Box 1431 Wichita Falls, TX 76307 1300 7th Street Wichita Falls, TX 76307 Architect: Staley Baker Monson 4309 Old Jacksboro Hwy, Ste D-5 Wichita Falls, TX 76302 Monty Monson 940-692-1004 phone 940-696-2243 fax - Carrier Warehouse Facility $2,421,976.00 Owner: Lottem Development 3131 McKinney Ave, Ste 710 Dallas, TX 75204 Architect: FJLC 4055 International Plaza, Ste 510 Fort Worth, TX 76109 John Franz 817-737-9922 phone 817-737-9536 fax - Bremond ISD Classroom Addition $394, 047.00 Owner: Bremond Independent School District 601 West Collins Bremond, TX 76629 Hugh Ellis 254-746-7145 phone 254-746-7726 fax Architect: BLGY Architects 2204 Forbes Dr, Ste 101 Austin, TX 78754 Robert Floan 512-977-0390 - phone 512-977-0845 fax - USPS Melear Station $237,143.00 Owner: Arlington Melear MPO Station PO Box 667180 Dallas, TX 75266 Architect: FJLC & Associates 4055 International Plaza, Ste 510 Fort Worth, TX 76109 Bill Franz 817-737-9922 phone 817-737-9536 fax - Shell Buildings: Harker Heights, TX $445,000.00 Claremore, OK $410,000.00 Spring, TX $632,574.00 Victoria, TX $431,965.00 Owner: N3 Development 505 Pecan St, Ste 101 Fort Worth TX, 76102 Roger Franz 817-529-3201 phone 817-529-3205 fax Architect: FJLC & Associates 4055. International Plaza, Ste 510 Fort Worth, TX 76109 John Franz 817-737-9922 phone 817-737-9536 fax 3.6 Construction Experience Randy Parsons, Vice President of Construction: 20+ years experience Bryan Garvey, Principal: 12+ years experience t, Devin Parsons, Vice President: 11+ years experience Reggie Parsons, Consultant Director of Project Management: 36+ years experience 4.1 Trade References: - Anchor Electric, 1102 Columbia Dr, Mansfield, TX 76063 John Ross, 817-467-1177, 817-467-1177 fax - Diverse Construction Concepts, 109 Briarwood Dr, Mansfield, TX 76060 Dave Jones, 817-563-0138, 817-563-0138 fax - Intex Plumbing, 11981 Classical Ln, Forney, TX 75126 Seth McKee, 972-288-8041 X 109, 972-288-7206 fax - Pride Drywall, 2625 Verde Ct, Burleson, TX 76028 Wade Day, 817-558-0418, 817-558- 3259 fax - Star Excavation, PO Box 171, Cleburne, TX 76033 Ivan Hambright, 817-373-2963, 817-373-2457 4.2 Bank References: Park Cities Bank, 4300 Lovers Ln, Dallas, TX 75225, Account 0032001188 Nancy Cardona, 214-239-7700, 214-320-450fax1 APPENDIX B-GENERAL CONDITIONS AND FEDERAL REQUIREMENTS CITY OF DENTON DOWNTOWN DENTON TRANSIT CENTER SOLICITATION PACKET FORMS, ATTACHMENTs, ACKNOWLEDGMENTS AND CERTIFICATIONS 1. DBE Compliance Documents and Certification 2. Debarment and Suspension 3. Conflict Interest 4. Restrictions on Lobbying 5. Buy America [27] APPENDIX B-GENERAL CONDITIONS AND FEDERAL REQUIREMENTS f DBE DOCUMENTATION Bidders are required to document sufficient DBE participation to meet the established goal or, alternatively, document adequate good faith efforts to do so, as provided for in 49 CFR 26.53. The successful Bidder shall furnish the following documentation at the time of its bid: (i) The names and addresses of DBE firms that will participate in this contract; (ii) A description of the work each DBE will perform; (iii) The dollar amount of the participation of each DBE firm participating; (iv) Written documentation of the bidder/offeror's commitment to use a DBE subcontractor whose participation it submits to meet the contract goal; (v) Written confirmation from the DBE that it is participating in the contract as provided in the prime contractor's commitment; and (vi) If the contract goal is not met, evidence of good faith efforts to do so. Date, signature and title of authorized official to be included in documentation. 11 WITH B + ®R PRr®P®SAI~ D®C . JNTAT'- ON S1' BE S + D ~cu trtK I IfIC:A I t OF LIALSILI I Y INSUKANtrt OP-ID AW 9 CORBETG 10/06/0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BALDWIN-COX AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11201 Kas Drive, Suite B ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Richardson TX 75081 Phone: 972-644-2688 Fax: 972-644-8035 INSURERS AFFORDING COVERAGE NAIC0 It -D INSURER k Mt. Hawley Insurance Co. INSURER B: Texas Mutual Insurance Co 22945 Corbet Group Inc. INSURER C: Travelers 10647 PO Box 35528 INSURER D: Dallas TX 75235 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tN5K PJAYE4 POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/D DATE JMMIDDNYYY) OMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY MGLO 152 98 3 09/12/09 09/12/10 PREMISES (Ea occurencs) s 5 0 , 00 0 CLAIMS MADE FXI OCCUR MED EXP (Any one person) $5,000 X BLKT AI PERSONAL a ADV INJURY $1,000,000 X BIM WOS GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 PRO- POLICY rx-71 JT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT C X ANY AUTO BA-1147P158 10/07/09 10/07/10 (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY s SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per acadent) s X Blkt Al PROPERTY DAMAGE s X Blkt WOS (Per academy GARAGE LIABILITY AUTO ONLY - EA ACCIDENT s ANY AUTO OTHER THAN EA ACC s AUTO ONLY: AGG s EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE s5,000,000 A X OCCUR FICLAIMS MADE 10/07/09 09/12/10 AGGREGATE $5,000,000 s DEDUCTIBLE S RETENTION s s WORKERS COMPENSATION X TORY LIMITS X ER AND EMPLOYERS LIABILITY Y I N B ANY PROPRIETOR/PARTNER/EXECUTIVEM 0001031348 20090912 002 09/12/09 09/12/10 E.L. EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? (Mandator), In NH) BLKT WOS E.L. DISEASE - EA EMPLOYE s 1 , 000 , 000 H desonbe tinder E.L. DISEASE -POLICY LIMIT S 1 000 , 000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE t ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CORBCT COMMERCIAL BUILDERS DBE Compliance Documents and Certification (i) Name and address of DBE firm: Perez Concrete, Inc 5502 Gregg Street, Dallas, Texas 75235 (ii) A description of work: Concrete Construction (iii) $ of participating DBE firm (iv) We, Corbet Group, Inc commit to using the above named DBE subcontractor whose participation submits to meet the contract goal. (v) Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment (vi) Contract goal met Date: F ary 9, 20 By: Name: Bryan rvek'~ Title: President Company: Corbet Group, Inc Name: e~ Company: Per Concrete, Inc Title: '(de r PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 CORBET COMMERCIAL BUILDERS DBE Compliance Documents and Certification. SOLICITATION DOCUMENTATION (i) Name and address of DBE firm: Combination Plus Brokerage 1856 1-35 North, Carrollton, Texas 75006 (ii) A description of work: Landscape and Irrigation $ of participating DBE firm - NOTAPPLICABLE (iv) We, Corbet Group, Inc have solicited to the above named DBE subcontractor. (v) Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment - NOT APPLICABLE (vi) Contract goal not met; evidence of good faith efforts to do so - DIRECT CONTACT Date: F ry 9 0 By: Name: Bryan a e Title:. President PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 CO RBET COMMERCIAL BUILDERS DBE Compliance Documents and Certification SOLICITATION DOCUMENTATION (i) Name and address of DBE firm: T&B Demolition, LLC PO Box 177529, Irving, Texas 75017 (ii) A description of work: Demolition Construction $ of participating DBE firm - NOTAPPLICABLE (iv) We, Corbet Group, Inc have solicited to the above named DBE subcontractor. (v) Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment - NOT APPLICABLE (vi) Contract goal not met; evidence of good faith efforts to do so - DIRECT CONTACT Date: F ry 9, By: Name: Bry rv Title: President PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 CORBE=-lF COMMERCIAL BUILDERS DBE Compliance Documents and Certification SOLICITATION DOCUMENTATION (i) Name and address of DBE firm: Blake Construction PO Box 47, Argyle, Texas 76226 (ii) A description of work: Miscellaneous Steel $ of participating DBE firm - NOTAPPLICABLE (iv) We, Corbet Group, Inc have solicited to the above named DBE subcontractor. ~v Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment - NOT APPLICABLE (vi) Contract goal not met; evidence of good faith efforts to do so - DIRECT CONTACT Date: F ry 9, By: Name: cyan r y Title: President PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 CORBCT COMMERCIAL BUILDERS DBE Compliance Documents and Certification SOLICITATION DOCUMENTATION (i) Name and address of DBE firm: SPD Resources, LP PO Box 364, Hurst, Texas 76053 (ii) A description of work: Paint and Drywall $ - of participating DBE firm - NOTAPPLICABLE (iv) We, Corbet Group, Inc have solicited to the above named DBE subcontractor. (v) Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment - NOT APPLICABLE (vi) Contract goal not met; evidence of good faith efforts to do so - DIRECT CONTACT Date: F If ry 9, By: Name: r y Title: President PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 CORBE-1F COMMERCIAL BUILDERS DBE Compliance Documents and Certification SOLICITATION DOCUMENTATION (i) Name and address of DBE firm: JP Painting, Inc 9326 S Polk Street, Dallas, Texas 75232 (ii) A description of work: Drywall and Paint $ of participating DBE firm - NOTAPPLICABLE (iv) We, Corbet Group, Inc have solicited to the above named DBE subcontractor. (v) Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment - NOT APPLICABLE (vi) Contract goal not met; evidence of good faith efforts to do so - DIRECT CONTACT Date: r ry 9, By: Name: Brya Title: President s PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 C ORBET COMMERCIAL BUILDERS DBE Compliance Documents and Certification SOLICITATION DOCUMENTATION (i) Name and address of DBE firm: Curtis Mechanical Contractors, Inc 1610 Osprey, Desoto, Texas 7S11S (ii) A description of work: Mechanical Construction $ of participating DBE firm - NOTAPPLICABLE (iv) We, Corbet Group, Inc have solicited to the above named DBE subcontractor. (v) Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment - NOT APPLICABLE (vi) Contract goal not met; evidence of good faith efforts to do so - DIRECT CONTACT Date: ary 9, By: Name: B e Title: President PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 CORE3(=-T COMMERCIAL BUILDERS DBE Compliance Documents and Certification SOLICITATION DOCUMENTATION (i) Name and address of DBE firm: W&R Technology 2220 Lamesa Street, Dallas, Texas 75215 (ii) A description of work: Telecommunications Cabling $ of participating DBE firm - NOTAPPLICABLE (iv) We, Corbet Group, Inc have solicited to the above named DBE subcontractor. (v) Written confirmation from the DBE subcontractor that is participating in the contract as provided in the prime contractor's commitment - NOT APPLICABLE (vi) Contract goal not met; evidence of good faith efforts to do so - DIRECT CONTACT Date: F a ry 9, By: Name: rya arve Title: President r" PO Box 35528 Dallas, Texas 75235 Office 214-905-0585 Fax 214-905-0589 APPENDIX B-GENERAL CONDITIONS AND FEDERAL REQUIREMENTS CERTIFICATION OF CONTRACTOR REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS The potential contractor for DENTON contract (hereinafter "PRIMARY PARTICIPANT" - print name), CQ Q 6E r G gPQQ. JJ~X, certifies to the best of its knowledge and belief, that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; 2. Have not within a three year period preceding this proposal been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (2) of this certification; and 4. Have not within a three year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. (If the primary participant is unable to certify to any of the statements in this certification, the participant shall attach an explanation to this certification) THE PRIMARY PARTICIPANT CERTIFIES OR AFFIRMS THE TRUTHFULNESS AND ACCURACY OF THE CONTENTS OF THE STATEMENTS SUBMITTED ON OR WITH THIS CERTIFICATION AND UNDERSTANDS THAT THE PROVISIONS ON 31 U.S.C. SECTIONS 3801 ET SE O. ARE APPLICABLE THERETO. Date Signed Ignature a 1 e of utho ' e Official Primary participant is required to secure from every subcontractor this same certification and must submit such to DENTONprior to such subcontractor's commencing work under this contract. Contractor may make as many copies of this schedule as needed for certification by all subcontractors. (If the subcontractor is unable to certify to any of the statements above in this certification, the subcontractor shall attach an explanation to this certification) THE UNDERSIGNED SUBCONTRACTORS FOR THE T, CERTIFY OR AFFIRM AS TO ITSELF AND ITS PRINCIPALS THE TRUTHFULNESS AND ACCURACY OF THE CONTENTS OF THE STATEMENTS SET OUT ABOVE AND SUBMITTED ON OR WITH THIS CERTIFICATION AND UNDERSTAND THAT THE PROVISIONS OF 31 U.S.C. SECTIONS 3801 ET SEO. ARE APPLICABLE TO THIS CERTIFICATION. Signature Title Name of Firm (printed) Signature Title Name of Firm (printed) ST BE S'UB ; B.' ®R PROPOSAL t= [29] APPENDIX B-GENERAL CONDITIONS AND FEDERAL REQUIREMENTS CONFLICT OF INTEREST ACKNOWLEDGMENT AND CERTIFICATION 1. Policy In order to promote fairness and impartiality in DENTON's procurement process, involvement in any decision making role in the solicitation, or in the awarding or administration of a resulting contract by any Related Person who might receive some Benefit is prohibited. "Related Person" is defined as any employee, officer, Executive Committee member, or agent of DENTON. "Benefit" is defined as any direct or indirect pecuniary, financial, or other tangible advantage, gain, promotion, or interest growing out of or related in any manner to the solicitation or to a contract or subcontract growing out of the solicitation. Such involvement of any Related Person is also prohibited when a person bearing certain relationship to the Related Person ("Other Related Person") may receive a Benefit. Such "Other Related Person" is defined as any member of a Related Person's immediate family (a spouse, child, parent, brother or sister), a partner of any Related Person, or any person or organization which employs or is about to employ a Related Person or Other Related Person. If a Related Person or Other Related Person will or may so Benefit, a prohibited conflict of interest may exist. 2. Disclosures. Your obligation, as a prospective contractor under this solicitation, is to disclose fully all information you have or may acquire which has to do with any such Benefit which may come to any Related Person or Other Related Person. In considering the possibility of the existence of such benefit, you also need to consider each person and firm you believe may be involved as a joint venturer, or subcontractor, or other similar role in carrying out and performing a contract with DENTON pursuant to the solicitation. In other words, if you are aware of any business, financial, or other interest, or actual or potential employment relationship between any Related Person or any Other Related Person, on the one hand, and yourself or any other person or firm you believe may be involved in carrying out the contract to be awarded pursuant to this solicitation, on the other hand, you have an affirmative obligation to fully disclose that information to DENTON. You are encouraged to contact the Director of Contract Administration and Procurement or DENTON's General Council prior to the deadline for submitting your Response (defined as a bid, proposal or other response to this solicitation), make such disclosure, and request a ruling as to whether any prohibited conflict of interest does in fact exist. In order for your Response to be considered RESPONSIVE to this solicitation, it is mandatory that you complete and execute the Acknowledgment and Certification below, and include with your Response, written disclosure of all information relative to any potential conflict of interest which may be known to you, and which you have not disclosed to DENTON in writing prior to the submission of your Response. ACKNOWLEDGMENT AND CERTIFICATION (Potential Contractor) - The undersigned potential contractor of DENTON hereby acknowledges receipt and understanding of the Conflict of Interest provisions set out above; and hereby certifies that, except as heretofore or herewith fully disclosed in writing, to the best of potential contractor's knowledge and belief, no such conflict exists, or is likely to exist in the future pertaining to this procurement should the contract be awarded to potential contractor; and potential contractor further hereby promises to promptly notify TON in writing if such knowledge or belief changes in the future. By: ZV a re d i o uthorized lei f Potential Con ctor CoR-~ Gl6up Itic Name of Potential Contractor, (print) ACKNOWLEDGMENT AND CERTIFICATION (Recommended Subcontractor) The undersigned recommended subcontractor of DENTON hereby acknowledges receipt and understanding of the Conflict of Interest provisions set out above; and hereby certifies that, except as heretofore or herewith fully disclosed in writing, to the best of recommended subcontractor's knowledge and belief, no such conflict exists, or is likely to exist in the future pertaining to this procurement should the contract be awarded to recommended subcontractor, and recommended subcontractor further hereby promises to promptly notify DENTON in writing if such knowledge or belief changes in the future. By: Signature and Title of Authorized Official of Recommended Subcontractor Name of Recommended Subcontractor Note: Bidder shall make copies of the Conflict of Interest document and Acknowledgment and Certification form and provide same to each subcontractor bidder recommends for the contract. Bidder is required to secure an acknowledgment and certification from each subcontractor bidder recommends and submit such certification to DENTON prior to a subcontractor beginning any work under this contract. MUST BE S- ? NIITTE'D WITH BID OR PROP®SAI, [30] APPENDIX B-GENERAL CONDITIONS AND FEDERAL REQUIREMENTS CERTIFICATION OF COMPLIANCE WITH RESTRICTIONS ON LOBBYING I, ~y A GkU E V , hereby certify on behalf of ` (Printed Name and Title of Contractor Official) CCAET G eou P, 11 1 that (Printed Name of Contractor) (1) It will not use federal funds to support lobbying. (2) No federal funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member- of Congress in connection with the awarding of any Federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (3) If any funds other than Federal funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this Federal contract, grant loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. i (4) All subcontractors and subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance is placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S.C. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Executed this q_day of r W A P~7 , 20 10 . By: (Signature o u orized OfficQED (Title of Authorized Official) Note: Bidder shall make copies of this blank page and obtain certification from all subcontractors that bidder is recommending, and submit such certirications to DENTON prior to such subcontractors beginning any work under this contract. QMUST BE SUBNII~T'TED WITH BID OR PR®POSAI, [311 APPENDIX B-GENERAL CONDITIONS AND FEDERAL REQUIREMENTS BUY AMERICA CERTIFICATION Section 165 (a) of the Surface Transportation Act of 1982 permits FTA participation in this contract only if iron, steel and/or manufactured products used in the contract are produced in the United States. If the contract is for the procurement of buses, vans or other "rolling stock" as defined in 49 C.F.R. Part 661, the cost of components produced in the United States must exceed 60% of the cost of all components, and final assembly must take place in the United States. Complete one of the two certifications below if this contract is for the procurement of such rolling stock, or if steel and manufactured products are otherwise used in this contract: 1. The bidder hereby certifies that it will comply with the requirements of Section 165 (a) (or the requirements of Section 165 (b)3 if this contract is for the procurement of "rolling stock") of the Surface Transportation Assistance Act of 1982 and the regulations in 49 C.F. " 661. 2 0 Si ature Date v CpaFT- RAy~. Inc Name of Bidder (printed) Company Name Title OR 2. The bidder hereby certifies that it cannot comply with the requirements of Section 165(a) (or with the requirements of Section 165(b)3 if this contract is for the procurement of "rolling stock") of the Surface Transportation Act of 1982, but it may qualify an exception to the requirement pursuant to Section 165(b) of the Surface Transportation Assistance Act and regulations in 49 C.F.R. 661.7. (Fully explain and document facts on which bidder relies for its belief that it qualifies for exception). Signature Date Name of Bidder (printed) Company Name Title IF APPlLICABI~E, Mi1TST BE S MITTE'D WITH BID OR PROP®SAI, [32] Bond No. 75065875 f _ PERFORMANCE BOND STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That Corbet Group. InO"whose address is 2213 Butler- St. Dallas TX, 75235 hereinafter called Principal, and The Guarantee Company of North America USA , a corporation organized and existing under the laws of the State of Michigan , 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 ne Million Seven Hundred Thirty Six Thousand and 0/100~DOLLARS ( 1 736 00 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 tnily 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 N~ber 2010-078 with S City of Denton, the Owner, dated t e 2nd day of March A.D. 2010,~'for Bid #4444 wntown Denton Transit Center 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 perfonn 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 Bond No. 75065875 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 copies ach one of which- shall be deemed an original, this the 2nd day of March 2010 ATTEST- PRINCIPAL BY: s ATTEST: SURETY ` a The G tee Co any of Nort America I K, o~ BY: Candice Pierson, Witness BY 9Pti , O - N- C1A 1 ~r l ~ rady K.'Cox Y -j`The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: William D. Baldwin STREET ADDRESS: 1201 Kas Dr., Suite B, Richardson, TX 75081 (NOTE: Date of Performance Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name) PB - 2 Bond No. 75065875 PAYMENT BOND STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That Corbet Group, Inc,W'Ohose address is 2213 Butler St. Dallas TX 7,5235 hereinafter called Principal, and The Guarantee Company of North America USA , a corporation organized and existing under the laws of the State of Michigan , 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 ferred to, in the penal 4ZLI m of One Million Seven Hundred Thirty Six Thousand and 0/10QZOLLARS ($1,736,000 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 2010-078 with the City of Denton, the Own✓ ated the 2"d day of March A.D. 2010 r Bid #4444 Downtown Denton Transit Center. 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 tenns of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc. PB-3 Bond No. 75065875 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 copiers, each one of which shall be deemed an original, this the 2nd day of March , 2010 ATTEST. P CIPAL C BY: t D N ATTEST: SURETY eMt; T antee Co an of rth Amet ca USA'-, ` B Y: w4 e- Candice Pierson, Witness BY: r Qom! fJ a t `•P/ioi R/i.F f The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: William D. Baldwin STREET ADDRESS: 1201 Kas Dr., Suite B, Richardson, TX 75081 (NOTE: Date of Payment Bond must be date of Contract. If Resident Agent is not a corporation, give a person's name) PB-4 r 5 IMPORTANT NOTICE TO OBTAIN INFORMATION OR TO MAKE A COMPLAINT You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-252-3439 You may write the Texas Department of Insurance: P.O. Box 149104 Austin, Texas 78714-9104 FAX No. (512) 475.1771 PREMIUM OR CLAIM DISPUTES Should you have a dispute concerning your premium or about a claim, you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY This notice is for information only and does not become a part or condition of the attached document. ' E THE GUARANTEE COMPANY OFAO:RTH. AM:ERt A USA. Southfield, Michigan POWER OF ATTORNEY KNOW ALL BY THESE.PRESENTS: That THE GUARANTEE COMPANY OF NORTH AMERICA.USA0 corporation.organized and existing under the laws of the State of Michigan, having its principal office inSouthfield, Michigan, does hereby constitute and appoint William D.. ,Brrld>'vr.:jr; Michael B. Hill;.Brudy K: Coxvbrock :Baldwin, :Brenf.Buld in; JenniferI Clark ..8a1dWi4,1nsurunce & :Bo iding-A4 eficy, : h.c, its true and Lawful attorney(s)-in=fact to .execute, seat arid deliver for and on its behalf as surety, any and' all bonds- and undertakings, contracts of indemnity. and other writings:obligatory in:the nature :thereof, which are or maybe allowed, required or permitted by law, statute; rule; regulation; contract or otherwise. The execution-of`such,instrument(s) in pursuance of these presents, shall be as binding upon THE GUARANTEE COMPANYOF NORTH AMERICA USA as fully-.and amply, to all intents -andpurposes, as if the same had been duly _execufed.and acknowledged by its regularly elected officers at 'the principal office.. The Power. of Attorney is executed and may be certified so; and may be revoked, pursuant to and by authority of Article IX, Section 9:03 of the By.-Laws adopted by the. Board of Directors of THE GUARANTEE COMPANY OF NORTH AMERICA USA at a meeting held.on the 315'day of December, 2003. The President, or any Vice President, acting with any-Secretary or Assistant Secretary, shall have power and authority: 1- To appoint Attorney(s)-in-fact,, and to authorize them to execute on'behalf of. th6.C6m0ahy,-6hd attach the Seal-of the Company'he'r eto,.bonds and undertakings.;:contracts;of indernnity~and other'writings obligatory in the nature thereof-, and 2.. To-revoke, at any time, any such Attorney=in-fact and revoke the authority given,-except as.provided below 3. An connection with obligations in.fayor:of the Kentucky Department of Highways only, it_is:agreed: that the power and authority hereby given to the Attorney=in-Fact.cannot be-modified'or revoked unless. prior written personal notice. of such intent has been given'to the Commissioner - Dep. artment.of Highways :of the Commonwealth of Kentucky. at:least thirty (30) days prior to the modification. or:revocation.. Further, this Power. of Attorney is:signed and'sealed by facsimile pursuant to resolution of the Board of Directors of the Company adopted-at:a meeting duly called and held•onthe 3151 day of December2003, of-which the following is.a true.excerpt: RESOLVED..thatthe signature of fany-authorized officer and the seal of the Company may be affize:d by. facsimile to any Power of Attorney or certification thereof authorizing .the execution :and :delivery of any bond, undertaking,. contracts of indemnity and other writings obligatory in-the. nature thereof,. and such-signature and seal when so used shall have. the same force and effect as though manually affixed. IN :WITNESS WHEREOF., THE GUARANTEE COMPANY OF :NORTH* AMERICA USA has caused this instrument to be signed and its corporate- seal -tobe-affixed by its-authorized officer, *this 1.st day vJP`~►.TF°oA~. of June, 2009. THE GUARANTEE.COMPANY OF NORTH AMERICA'USA .n . Jai f►!AMC. 'STATE OF MICHIGAN Stephen Dullard,. Vice President Randa l Musselman, Secretary County qf Oakland On this 1st day of•June, 2009. before me came the individuals who executed the preceding instrument, to me .personally known, and being by me duly sworn, said that each is the herein described and authorized :officer of The Guarantee Company of North America USA; that the, seal affixed 'to'said instrument:.is_ the Corporate Seal of said. Company; that-. the Corporate Seal and. each. signature were. duly affixed `by order of the. Board of Directors of said' Company. Cynthia A. Takai IN WITNESS'WHEREOF,.I have hereunto set my hand at, The Guarantee Notary Public,. State of Michigan Company of North America USA.offices-the day and •year,above written. 1 County of Oakland My Commission Expires February 27, 2012 Acting in Oakland County . I, Randall`Musselman, Secretary of THE .GUARANTEE COMPANY OF NORTH AMERICA USA, do hereby°Leiifytthat the above.and`fo going is a true. and correct copy:ofa Power- of Attorney executed by THE GUARANTEE COMPANY OF NORTH AMER16A-b"-SA,~Wiiich is still in full rce and effect. IN WITI}IESS WHEREOF', I have thereunto set. myhand and attached the seal of' said Company this 2ndf~oaY-.of Ma"TC-kt> 2010 P~j.T1T AC'C` Randall Musselmans-Secretar,7 yORnfAMCR~4P. :t-y~~,,J~" "A. -moo ~r~ 1 ~~ffifffJ•- JEF& CERTIFICATE OF LIABILITY INSURANCE OP ID AW DATE (MM/DD/YYYY) CORBETG 03/16/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BALDWIN-COX AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1201 Kas Drive, Suite B ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Richardson TX 75081 Phone:972-644-2688 Fax:972-644-8035 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Mt. Hawley Insurance Co. / ~J INSURERB: Texas Mutual Insurance Co 22945 Corbet Group Inc 2Z'~~~Q INSURER C: Travelers 10647 PO BOX 35538 4• INSURER D: Dallas TX 75235 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURAN DATE (MM/DD/YYYY DATE MM/DD/YYYY LIMITS GENERAL LIABILITY L,10-0' EA6 / OCCURRENCE $ -1 , 000 , 000 A X COMMERCIAL GENERAL LIABILITY M L0152 983 09/12/09 09/12/10 PREMISES (Ea occurence) $ 5 0 , 0 0 O CLAIMS MADE X OCCU MED EXP (Any one person) $ 5 , 0 0 0 X BLKT AI PERSONAL a ADV INJURY $ 1, 0.0 0 , 000 X BLKT WOS GENERAL AGGREGATE $ 2, 000, 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY MBINED SINGLE LIMIT $ 1 000 000 C X ANY AUTO -00000" BA-114 7 P 15 8 10/07/09 10/07/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) X Blkt AI /10 PROPERTY DAMAGE $ X Blkt WOS (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $5,000,000 A X OCCUR F-1 CLAIMS MADE 10/07/09 09/12/10 AGGREGATE s5,000,000 $ DEDUCTIBLE $ RETENTION $ I $ WORKERS COMPENSATION WC 8 - H- AND EMPLOYERS' LIABILITY TORY LIMITS X ER YIN IX B ANY PROPRIETOR/PARTNER/EXECUTIVE~ Q001031348 2009091.2 002 09/12/09 0 9/ 12 / 10 E.L. EACH ACCIDENT $ 1 , 000 , 0 0 O OFFICER/MEMBER EXCLUDED? (Mandatory in NH) BLKT WOS E.L. DISEASE - EA EMPLOYEE $ 1, 000, 000,-- If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 , 0 0 0 , 0 0 0 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Cit of Denton, its Officials, Agents, Employees and volunteers are lised as a ditional insured on a primary and non contributory basisr/Waiver of ro favor of City of Dent its Officials, Agents, Employees and o unteers h respect to the General Liability and Workers' Compensation policies CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TFJE EXPIRATION DENTO-2 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 ✓/DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Denton IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Attn : David Salmon REPRESENTATIVES. 221 N. Elm St AUTHORIZED REPRESENTATIVE Denton TX 76201 n , c ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. 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