Loading...
2008-094 FILE REFERENCE FORM 2008-094 X Additional File Exists Additional File Contains Records Not Public, According to the Public Records Act Other FILE(S) Date Initials JR Change Order Number One – Ordinance No. 2009-021 01/13/09 ORDINANCE NO. ~O AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORKS CONTRACT FOR THE CONSTRUCTION OF THE ROSELAWN DRIVE 24-INCH WATER LINE; PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR; AND PROVIDING AN EFFECTNE DATE (BID 3971-ROSELAWN 24-INCH WATER LINE AWARDED TO THE LOWEST RESPONSIBLE BIDDER MEETING SPECIFICATION, FOX CONTRACTORS INC., IN THE AMOUNT OF $1,104,582.64). WHEREAS, the City has solicited, received and tabulated competitive bids for the construction of public works or improvements in accordance with the procedures of State law and City ordinances; and WHEREAS, the City Manager or a designated employee has received and recommended that the herein described bids are the lowest responsible bids for the construction of the public works or improvements described in the bid invitation, bid proposals and plans and specifications therein; NOW, THEREFORE, THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS: SECTION 1. The following competitive bids for the construction of public works, or improvements, as described in the "Bid Invitations", "Bid Proposals" or plans and specifications on file in the Office of the City's Purchasing Agent filed according to the bid number assigned hereto, are hereby accepted and approved as being the lowest responsible bids: BID NUMBER CONTRACTOR AMOUNT 3971 Fox Contractors Inc. $1,104,582.64 SECTION 2. The acceptance and approval ofthe above competitive bids shall not constitute a contract between the City and the person submitting the bid for constmction 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 famishing 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 ofthe construction ofthe 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 ofthe 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 immediately upon its passage and approval. PASSED AND APPROVED this the U/ ~ day of ,2008. C PE . McNE[LL, MAYOR ATTEST: JENNIFER WALTERS, CITY SECRETARY BY: ~ ,L~/U(,(AJ APPROVED AS TO LEGAL FORM: EDWIN M. SNYDER~Y A3TOR BY: 3-ORD-bid 3971 6 CONTRACT AGREEMENT STATE OF TEXAS § COUNTY OF DENTON § THIS AGREEMENT, made and entered into this 6th day of May A.D., 2008, 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, hereinafrer termed "OWNER," and Fox Contractors Inc. Midlothian, TX 76065 of the City of Midlothian, County of Ellis and State of Texas ,hereinafter termed "CONTRACTOR." WITNESSETH: That for and in consideration of the payments and agreements hereinafrer 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 3971 Roselawn Drive 24 Inch Water Line in the amount of $1.104,582.64 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: Kimley-Horn and Associates all of which are referenced herein and made a part hereof and collectively evidence and constitute the entire contract. CA-1 Independent Status It is mutually understood and agreed by and between City and Contractor that Contractor is an independent contractor and shall not be deemed to be or considered an employee of the City of Denton, Texas, for the purposes of income tax, withholding, social security taxes, vacation or sick leave benefits, worker's compensation, or any other City employee benefit. City shall not have supervision and control of Contractor or any employee of Contractor, and it is expressly understood that Contractor shall perform the services hereunder according to the attached specifications at the general direction of the City Manager of the City of Denton, Texas, or his designee under this agreement. Indemnification Contractor covenants and agrees to and does hereby indemnify, hold harmless and defend, a[ 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 Phis 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 yeazs thereafter, except if an audit is in progress or audit findings aze 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 ] 0 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: Grp 2ff~~~r ~.~.~~r~ GAL ~' ~~ZZ`~y~ City of Denton OWNER BY: ~~t ~ ~ ~. ~.~ rnGL/ZG7.G/,~iZi (SEAL) ATT//EST: /} ,, ~ ,~ ', • ~ 1~ti I ~.GC2C'Zl~~l ~,~i,~_,~l'tC/lZ~ CONT C R FoX ~~ fry ~s ~r~rc ,~.r 9sl A2i~lo~!l1~a.~I , TX 3~o~S MAILING ADDRESS APPROVED AS TO FORM: ,~ ATTORNE CA-4 /9 ~z) X23 - (~~~o PHONE NUMBER I `7 ~z) ~Z3-lat~D9- FAX NUMBER TITLE PR "~ED~PQAME (SEAL) PERFORMANCE BOND STATE OF TEXAS § COUNTY OF DENTON § KNOW ALL MEN BY THESE PRESENTS: That Fox Contractors Inc. whose address is PO Box 951 Midlothian, TX 76065 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 One Hundred Four Thousand Five Hundred Eighty Two and 64/100 DOLLARS ($1,104,582.64) plus ten percent of the stated penal sum as an additional sum of money representing additional court expenses, attorneys' fees, and liquidated damages arising out of or connected with the below identified Contract, in lawful money of the United States, to be paid in Denton County, Texas, for the payment of which sum well and truly to be made, we hereby bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. This Bond shall automatically be increased by the amount of any Change Order or Supplemental Agreement, which increases the Contract price, but in no event shall a Change Order or Supplemental Agreement, which reduces the Contract price, decrease the penal sum of this Bond. THE OBLIGATION TO PAY SAME is conditioned as follows: Whereas, the Principal entered into a certain Contract, identified by Ordinance Number 2008-094, with the City of Denton, the Owner, dated the 6th day of May A.D. 2008, a copy of which is hereto attached and made a part hereof, for Bid 3971 Roselawn Drive 24 Inch Water Line. 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 guazanty 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 hereafrer 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) yeazs 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 FUR'T'HER, 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 Govemment 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: BY: SECRETARY ATTEST: BY: PRINCIPAL BY: PRESIDENT SURETY 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. IjResident 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 Fox Contractors Inc., whose address is PO Box 951 Midlothian, TX 76065, 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, and unto all persons, firms, and corporations who may furnish materials for, or perfornt labor upon, the building or improvements hereinafter referred to, in the penal sum of One Million One Hundred Four Thousand Five Hundred Eighty Two and 64/100DOLLARS ($1,104,582.64) 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 fo-lows: Whereas, the Principal entered into a certain Contract, identified by Ordinance Number 2008- 094, with the City of Denton, the Owner, dated the 6th day of May A.D. 2008, a copy of which is hereto attached and made a part hereof, for Bid 3971 Roselawn 24 Inch Water Line. NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties and make prompt payment to all persons,, firms, subcontractors, corporations and claimants supplying labor and/or material in the prosecution of the Work provided for in said Contract and any and all duly authorized modifications of said Contract that may hereafter be made, notice of which modifications to the Surety being hereby expressly waived, then this obligation shall be void; otherwise it shall remain in full force and effect. PROVIDED FURTHER, that if any legal action be filed on this Bond, exclusive venue shall lie in Denton County, Texas. AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the, Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc., accompanying the same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc. PB-3 This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government Code, as amended, and any other applicable statutes of the State of Texas. The undersigned and designated agent is hereby designated by the Surety herein as the Resident Agent in Denton County to whom any requisite notices may be delivered and on whom service of process may be had in matters arising out of such surety, as provided by Article 7.19-1 of the Insurance Code, Vemon'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: BY: SECRETARY ATTEST: BY: PRINCIPAL BY: PRESIDENT SURETY 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. !f 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. ]t 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. 7j an apparent low bidder fails to comply strictly with the insurance requirements, that bidder may be disqualified from award ojthe 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 notifcation of bid award, Contractor shall frle 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 6e 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 adnunistration 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. C[-9 • That such insurance is primary to any other insurance available to the additional insured with respect to claims covered under the policy and that this insurance applies separately to each insured against whom claim is made or suit is brought. The inclusion of more than one insured shall not operate to increase the insurer's limit of liability. • Cancellation: The City requires 30 day written notice should any of the policies described on the certificate be cancelled or materially changed before the expiration date. • Should any of the required insurance be provided under aclaims-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: A[l 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,OOO,OOO.OOshall be provided and maintained by the Contractor. The policy shall be written on an occurrence basis either in a single policy or in a combination of underlying and umbrella or excess policies. If the Commercial General Liability form (ISO Form CG 0001 current edition) is used: • Coverage A shall include premises, operations, products, and completed operations, independent contractors, contractual liability covering this contract and broad form property damage coverage. Coverage B shall include personal injury. Coverage C, medical payments, is not required. If the Comprehensive General Liability form (ISO Form GL 0002 Current Edition and ISO Form GL 0404) is used, it shall include at least: Bodily injury and Property Damage Liability for premises, operations, products and completed operations, independent contractors and property damage resulting from explosion, collapse or underground (XCU) exposures. Broad form contractual liability (preferably by endorsement) covering this contract, personal injury liability and broad form property damage liability. [X] Automobile Liability Insurance: Contractor shall provide Commercial Automobile Liability insurance with Combined Single Limits (CSL) of not less than $500,000.00 either in a single policy or in a combination of basic and umbrella or excess policies. The policy will include bodily injury and property damage liability arising out of the operation, maintenance and use of all automobiles and mobile equipment used in conjunction with this contract. Satisfaction of the above requirement shall be in the form of a policy endorsement for: any auto, or all owned, hired and non-owned autos. CI-I1 [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 [ ] Fire Damage Legal Liability Insurance aggregate. 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. CI - 12 [ ] Commercial Crime Provides coverage for the theft or disappearance of cash or checks, robbery inside/outside the premises, burglary of the premises, and employee fidelity. The employee fidelity portion of this coverage should be written on a "blanket" basis to cover all employees, including new hires. This type insurance should be required if the contractor has access to City funds. Limits of not less than each occurrence are required. [ ] .Additional Insurance Other insurance may be required on an individual basis for extra hazardous contracts and specific service agreements. If such additional insurance is required for a specific contract, that requirement will be described in the "Specific Conditions" of the contract specifications. CI - 13 ATTACHMENT 1 ]X] 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 ("subcontractoi'in §406.096) -includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project, regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees. This includes, without limitation, independent contractors, subcontractors, leasing companies, motor carriers, owner-operators, employees of any such entity, or employees of any entity which furnishes persons to provide services on the project. "Services" include, without limitation, providing, hauling, or delivering equipment or materials, or providing labor, transportation, or other service related to a project. "Services" does not include activities unrelated to the project, such as food beverage vendors, office supply deliveries, and delivery of portable toilets. B. The contractor shall provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any overage agreements,. which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all employees of the Contractor providing services on the project, for the duration of the project. C. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. D. If the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project, the contractor must, prior to the end of the coverage period, file a new certificate of coverage with the governmental entity showing that coverage has been extended. E. The contractor shall obtain from each person providing services on a project, and provide to the governmental entity: CI-14 1) a certificate of coverage, prior to that person beginning work on the project, so the govemmental 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. I. 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) anew 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 thereafrer; 6) notify the governmental entity in writing by certified mail or personal delivery, within ] 0 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and 7) contractually require each person with whom it contracts, to perform as required by paragraphs (1) - (7), with the certificates of coverage to be provided to the person For whom they are providing services. J. By signing this contract or providing or causing to be provided a certificate of coverage, the contractor is representing to the governmental entity that all employees of the contractor who will provide services on the project will be covered by workers' compensation coverage for the duration of the project, that the coverage will be based on proper reporting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self- insured, with the commission's Division of Self-Insurance Regulation. Providing false or misleading information may subject the contractor to administrative penalties, criminal penalties, civil penalties, or other civil actions. K. The contractor's failure to comply with any of these provisions is a breach of contract by the contractor which entitles the governmental entity to declaze the contract void if the contractor does not remedy the breach within ten days afrer receipt of notice of breach from the governmental entity. 1 CI - 16 ONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other erson doin business with local overnmental entit 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 Receivers person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 1 Name of person who has a business relationship with local governmental entity. 2 Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you fle 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. 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 CIO as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? 0 Y ~ N o es 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? 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 N Y es o D. Describe each affliction or business relationship. 4 Signature of person doing business with the governmental entity Date naov~aa orvzerzoo~ CIQ - 1 ~-vx Con~~~~~~-vrs Project Name: Roselawn Drive 24-Inch Water Line - ' Working Days 120 Bia No. 3s71 BID TABULATION SHEET P.O. No. kem Spec. Name of Pay Item with Fst Unk Bitl Amount No. kem Unk Pnee In Worts pua Unk Price Bid t TXDOT hem Mob1Ra5Qn ~ 1 LS - 500 ~ dollars and Ol} ( DQ'~ cents par anti U , $ g (~ 000 . D U 2 Item 506 24' W a te r L i na by e n C u t Op 7,110 LF ~ ~ ~ ~ / ~ ~ ~ ~ p / ~ „(,t~y4-+• y~r .• ~ dollars and O / I cams Per une ~., q 3 /"'7L~ $ Z S 3 Item 506 20" Water Line by Open C - 114 LF doYars and cents per unit (~ ~1,~ $ 10 ~ L4-/ E 4 Item 506 6" Water Line by Open Cut 450 LF 7J dollars and cants per unk /ryy $ 7~• ~~ 7 $ ~Z 6 Item 509 36" Sl~el Casing by Bore vriN 24" Cartier Pipe 166 LF - tlollarsantl U ~ cents per unk lj,~,//-- //~~~~ $ UlUlOiW ~j $ z QX .' Q 6 Items Concrete Encasemem 130 LF 504.52.13 dollars end 5047.2.1 cems per anti '1~ E `YJ , UQ (~ ~l $ Q ~ r 1 V 7 ttem 502.62 24" Gate Valve wkh B g EA ers antl Q cents rank (~~ ~,1 3Id.J(.YJ. $ q~,5on. no 8 Item 502.62 20" Gate Valve with Box 1,ytwc{YL ~Q],(~ 1 EA dollars end ' ~2~_ ~~ ~~ ~ ~Q cents per unh 0 /~/' $ 3 0 J ( 9 Item 502.6.2 12" Gate Valve wkh Bon ~ Ql 3 EA dollars and cents per unit $ ~~p j , l1lJ /y _ /~ E µ Q % y7 , QL~ 10 Item 502.62 6" Gale VeNe v4018ox iq EA dollars and ' cents per and ((~~ EALO.OO Q~~~ 3 °/L.t.'U• ~Q ; 11 Item 502.6.3 CombinatioP Air R easeNacuum Relief Valve wah Vauh 3 EA ~- dollars and cents Per unit $~. L E 5 ~~ , UU 12 Item 502.11.2 6' Blowok Vale p EA dollars and , cents per unk `,/, $. ~ , OV // /~ nnq ~l g (p (Ql'L', UU 13 ~ Item 502.3 Fire Hydrant ~~ 7 YW~4' 10 EA dollars and ~/.~ ~~~~//~~ L ~ cents per unit S 0, ~U Q .,t+ , ( E '^r"/ 14 Item 506.6 Re ove Plug 8 C ann e d t o Existing 20" Water Una 2 FA n ~ n // t~"~"~['r. dollars antl cents per unh ~~//~~ 'l $S~W~ 00 '-1 3 ~ ~ UDO~ t!j~ t5 Item 107.19.3 Trench Safety ~ 7,674 LF A dollars and cent it / 0 Zx ' °l ~J.~~ s per un E • 7 / 3 V a~ ~p ~y !!~ i1 Project Name: Roselawn Drive 24-Inch Water Line - working Days 120 BItl No. 3971 BID TABULATION SHEET P.O. No. Item No. Spac. kem Name of Pay Item v+Mh Unk Price In Words Fst Dua Unk Unk Bid Pdce Amount ~ Bid ig ttem 502.8 C athodic Protection 1 LS _ ars and ~- am ~,(} cents ar unit / t~ N~ S~?7 ~U.~.~U y ] E /i7 i7 Item 301.5.7 Gravel D{iveway Repair (fle>masa) 66 SV tlollars and ' cents er unk S 3•~J $ J/ +•~D i8 ttem 305.2.4 Concrete Drivaw R pair i6 SV dollars end _ Yp1 nn/n~ cents par unk E +U~ $ ~ZV+W 7g Item 202.6 Hydromukh 7,286 LF dollars antl _ 77/~~ ~ cents r unk S ~ r / /N~+~ $ I 2g Item 803.3 Dry iprap 439 SY dollars and ~ ~" n^ C rants par unk S • UQ S 1 U V t: 27 Item 201 SWPPP.pntl Erosion Control during Lon ction ~ 1 LS tar nd ~ n q cants per unk ,A~ S AJU • ~ r E I ~•1U ' ~`+ 22 Item 801.5 Temporary 3-Strand Barbwira Fenw 7.058 LF dollars end ~] ~ ~/ ~ y ~ ~ cents per unk ~ E /']J j E ~` J" '.10 27 Item 801.5 Tem rary Ga n¢ d Steel Tube Gate 8 ~` dollars and - ' ~1 cents rank ~1 S Q //~~ _ S ~. tY(JV• Qd 7R Item 801.5 Pe neM 8-Sirend Barbwire Fenw 4,165 LF dollars and cents er unk S .Q~ $ ~'~ ~~ O~ 25 Item 801.5 Permanent GaNan¢ed Steel Tube Gate 4 F11 ' dollars antl - ants par unk S Q+ ~ 0~ $ ~' ~© 28 TXDOT Item Barricades, Signs and TraRC Handling 1 LS 502 tlollars antl / ` D cenlsperuntt ~ E 7000• ~,Do~'o0 $ 27 Item 107.20 Project Sign 2 ~' dollars end r e ,l q cents per uni t y $ ° ~• oV / ~^ `~ ~ ) $ `. `a `"~' • 28 Item 103.1 Contraftors Warranties and Understandings !U+-C-rl 1 LS dollars an tl ((~~/~/yy ` ] Q cents per un k S ~g%'/ / • ~ ( / $ ~ 0 -/ ~• (] ~ Base Bid TOTAL BID For All Items s ~ 10~-j~Z.~~ BID SUMMARY TOTAL BASE BID PRICE IN WORDS ~- flu LLL'G~ i ~ .. ,. In the event of the award of a contract to the undersigned,-the undersigned will famish a performance bond and a payment bond for. the full amount of the contract, to secure proper compliance with the terms and provisions of the contract, to insure and guarantee the work until final completion and acceptance, and to guazantee 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 cazefully checked and aze submitted as correct and final. Unit and lump sum prices as shown for each item listed in this proposal, shal] control over extensions.•I~gxege. The undersigned agrees this bid becomes the property of the City of Denton after the official opening. The undersigned affirms that they aze duly authorized to execute this contract. Vendor hereby assigns to purchaser any and all claims for overcharges associated with this contract which arise under the antitrust laws of the United States, 15 USCA Section 1 et sea., and which arise under the antitrust laws of the State of Texas, Tex. Bus. & Com. Code, Section 15.01, et se . P-5 Receipt is hereby acknowledged of the following addenda to the plans and specifications: Addendum No. 1 dated Received 3 Il D Addendum No. 2 dated S ~ Received Addendum No. 3 dated Received Addendum No. 4 dated Received Addendum No. 5 dated ~~ k~ 1 x ~(Q0~2h City and State Seal & Authorizatio \\ ~~//~~,,,, (If a Corporation) a w l ~Z~ -~ 7 U -~ Telephone P-6 Street Address Bond # TXIFSUO 414918 PERFORMANCE BOND STATE OF TEXAS COUNTY OF DENTON KNOW ALL MEN BY THESE PRESENTS: That Fox Contractors Inc.~se address is PO Box 95l Midlothian. TX 76065 hereinafter called Principal, and International Fidelity Insurance Company t/ a corporation organized and existing under the laws of the State of New Jersey ,and fully authorized to Vansact business in the State of Texas, as Surety, aze held and firmly bound unto the City of Denton, a municipal corporation organized and existing under the laws of the Statc of Texas, hereinafter called Owner, in the penal sum of One Million One Hundred Pour Thousand Five Hundred Eiehtv Two and 64!100 v DOLLARS ($1,104,582.644-plus ten percent of the stated penal sum as an additional sum of money representing additional court expenses, attorneys' fees, and liquidated damages azising out of nr connected with the below identified ('.nntract, in lawful money of the T (nited States, to he paid in llenton County, Texas, for the payment of which sum well and truly to be made, we hereby bind owselves, ow 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 ConVact 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 cntcred into a certain Contract, identified by Orduiancc N ~r'2008-094 with the City of Denton, the Owner, dated the 6th day of Mav A.D. 2008, a copy of which is hereto attached and made a part hereof, for Bid 3971 Roselav•m Drive 241nch Water Line.' 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 [hereof and any extension thereof which may be granted by the Owner, with or without notice to the Surety, and during the life of any guazanty or warranty required under this Contract, and shall also well and tmly 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 Swety 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) yeazs from the date of final completion and fmal 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 £ailwe to so perform herein and shall fully reimbwse 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 an 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 tmdersigned 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, Vemon'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 6th day of May , 2008 / ATTEST: BY: ~eEt,,, ~i SE TARY ATTEST: BY: Oh~u-Ga- KSC .,~OLL s714 PRINCIPAL Fox Contractgrs, Inc. ,- BY: ~ A,A. F za',v~ SIDENT~f(Of /j~CGtLlJ1~ SURETY International Fidelity Insurance Cofnp BY: ATTORNEY-I -FAT ~ - .. The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: Debi Moon /STAR Insurance Agency STRF,ET ADDRESS: 4805 South Colony Blvd: The Colony TX 75056 (NOTE: Date ojPerfnrmance Bond mast be date njContract. IjResident Agent is not a corporation, give a person's nome.J PB-2 Co\''~ 0 PAYMENT BOND STATE OF TEXAS COUNTY OF DENTON KNOW ALL MEN BY THESE PRESENTS' That Fox Contractors Inc.,~ose address is PO Box 951 Midlothian, TX 7tiU(i5, hereinafter called Principal, and International Fidelity Insurance Company , a corporation organized and existing under the laws of the State of New Jersey ,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 famish materials for, or perform labor upon, the building or improvements hereinafter referred to, in the penal sum ofd One Million One Hundred Four Thousand Fivc Hundred Eighty Two and 64/100DOLLARS ($1,104,582.64j~n lawful money of the lJnited 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 2008- 094, with the City of Denton, the Owner, dated the 6th day of May A.D. 2008 a copy of which is hereto attached and made a part hereof; for Bid 3971 Roselawn 24 Inch Water Line. 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, [hen this obligation shall be void; otherwise it shall remain in full force and effect. PROVIDED FURTHER, that if any legal action he filed on this Bond, exclusive venue shall lie in Denton County, Texas. AND PROVIDED FUR"I'HER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition [o the terms of the Contract, or to the Work to be performed thereunder, or to the Flans, Specifications, Drawings, etc., accompanying the same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract, or to the Work to be performed thereunder, or to the Plans, Specifications, Drawings. etc. PB-3 This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government Code, as amended, and any other applicable statutes of the State of Texas. The undersigned and designated agent is hereby designated by the Surety hcrcin 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, Vemon'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 6th day of May ,2008/ ATTEST: BY: ,~~- SE ' "1'ARY A1~TEST: BY: i~~-~ ~ . ~t ~~-c~ PRINCIPAL Fox Contra tors, Inc. ,, I// /_ riY; c ~~ RESIDENT ~ehn~C6t!/~ct.t SlJRr:'1'Y International Fidelity InsurancetCo~y BY: ~ (?/t nl~~iQA~-. A'1"l'ORNEY- -FAC`f ~ - The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the process is: NAME: Debi Moon /STAR Insurance Apency STREF..T ADDRESS: 4805 South Colony Blvd: The Colony, Tx 75056 (NOTE: Date of Payment Bond must be date of Contract. !f Resident Agent is not a corporation, give aperso»'s name.) rn-a ~`0~ ~ 5P tt rr~ 3 ~ +~° T, 4 r ` 'vNLWARK NEW 1FRSE] 071025207 r` ~~ ~f* + .'~`••~~, ~ :TZ ~ ~'a1., ~'~' r ~~++,, \ K C :~ . h i " ~ NW .. ~ Yom. r ~. KNOW "ALL MEN DY TllN SE PRESEN I S Thar.INTERNATIONAI PIUELITY INSURANCE COMPANY, a corporation organized and existing - - ~ -- i x• Vlzws of the State of New~lerseyM and having ns pnnmpal office m [he;Gty of Newark, New fersey„does hereby Consnlute and'appmnt N ry b ~. r -, ~. ..- ,:.t __. `,MICHAEL,D HEND KSON ;GARY ~~!• R+HCATLCY PAT Y MOORE MONICA CAMPOS BRYAN K MOORE C![ANA K "W[LL'ISRK D",FRESHLR `; ;~ ~" ` „; ~, ,, w x ~ 3 5" 3 ~~~ 1.,r r stir t& s v - ~+ ~ v y' ;;;:- ~ S_ ' ~ its true and lawful attorney(s) in fact [o execute seal and deliver (or and-on rts behal@as surety, anyland all bondsand undertakings, contracts of mdertuuty;and ~ '' other wnungs obhgarory m thenamre thereof, +whmh are or may,~be allowed, reyuued or peimrtte by law, stature, mle, regulation, contractor otherw[se; and '. the-execnnon bf such mswinent(s) m_. pursuance'o( these presents `shall be astimdmg upon [tesmd INTERNATIONAL P'IDELITY,+INSURANCE~ :; COMPANY, as fully $nd~amply, m all intents and purposes as if the~sarne had been duly executed and acknoivledgetl by ~tsrregularly-elected officers at tts -...principal office.;: • t ,. _ -. ... - - .-. x "This Power oEAttorney is executed, and may be reJbkeU pursuanr~id and by audiorf[y o(Arnele`°3 Section 3, o(the By-Lawa~adop[ed 6y die Board of ~Direc[ors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting called and held on the 7th day of Febmary 1974 - ~. The President or any Vine President, Executive Vice-President, Secretary' or Assutant~Secm[ary, shall have power and authority ~ r .. _. (1) To appoint Attorneys-in-(ac[, and to autho(iie them to executebdbehalf o(tlieCompany, and attach the Seal of the Company there[o7 bonds and% . undertakings, contracts of indemnity andother writings obhgatory~m the nature thereoCan4 (2)TO remove, at any time, any such attorney-in-(act and revoketheauthoriry given Further, this Power of Attorney is signed and sealed by facsimile pursuant to resolution of the Board of Directors of saidCompany adopted a[ a meeting - duly called and held on the 29th day of Apnl. 1982 of which the following is a tine excerpt ' Now therefore the signatures of such officers and the seal of die Company may be affixed many suchpower of attorney or any certificate relating thereto by facsimile, and xny inch power of attorney orcertificate bearingsuch facsimile signatures of Yacsimile seal shall be validandbind mg upon the Company and any such power so executed and certified by (acsiniile signatures and facsimile seal shall he valid and .binding upon the Company in the (unite withrespec[ to any bond or undertaking m which it is attached. ~~ IMPORTANT NOTICE TO OBTAIN INFORMATION OR MAID A COMPLAINT: You may call International Fidelity Insurance Company's toll-free telephone number for information or to make a complaint at: 800-333-4167 You may also write to International Fidelity Insurance Company at: Attn: Claims Department One Newark Center, 20'" Flnnr Newark, NJ 07102 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 800-252-3439 You may write the Texas Department of Insurance at: P.O. Boa 149104 Austin, TX 78714-9104 Fna:(512)475-1771 Web: htto:/lwww.tdistate.tx.us E-mail: ConsumerPro[ectionntdistate.ts.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact your Agent or International Fidelity Insurance Company first If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR BOND. This notice is for information only and does not become a part or a condition of the attached document and is given to comply with Teaas legal and regulatory requirements. ACORD CERTIFICATE OF LIABILITY INSURANCE DnrE(MnvoonvvY) n 5 16 2008 PRODUCER phone: 817-299-3800 Fax: 817-299-3890 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION IBTX Risk Services Hurst ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8701 Bedford Euless Rd. , #450 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Hurst TX 76053 ALTER THE COVERAGE AFFORDED BV THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAICp INSURED wsuRERA:COnt inental Insurance Com an 5289 Fox Contractors, Inc. PO Box 951 I` ~ INSURER e:Val le For e Insurance Com an 0508 Midlothian TX 76065-0951 \3~ ~ wsuRERCSt Paul Fire & Marine Ins Co 4767 S ~ INSURER D' 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 HE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TEAMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSfl LT OD' POLICY NUMBEfl POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY 2093016549 S~1Q~2 QQ8 S~lO~2OO9 EACH OCCURRENCE $1 QQQ QQQ X COMMERCIAL GENERAL LIABILITY A A PREMISES Ea occurence 5300 QQQ CLAIMS MADE ~ OCCU MED E%P (Any one person) $ 1Q QQQ PERSONALBADV INJURY gl OOO OOO GENERAL AGGREGATE 32 OOO QQQ , GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG $2 OOO OOO POLICY X PRO LOG Lt Pollution 100 QQQ $ AU TOMOBILE LIABIL 02093016552 5/10/2008 5/10/2009 X ANYAUTO COMBINED SINGLE LIMIT IEa accitlenq 51, 000, OOO ALL OW NED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) '/~ HIRED AUTOS BODILY INJURY 5 NON-OWNED AUTOS (Per accitlenl) PROPERTY OAMgGE $ (PerauiOenQ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT g ANV AUTO OTHER THAN EA ACC g AUTOONLY: AGG $ C EXCESSNMBPELLA LIABILITY QK-09101279 5~1Q~2 QQB 5~10~2009 EACH OCCURRENCE $5 QQQ~QQQ $ OCCUR ~ GLAIMS MADE AGGREGATE g s QQQ QQQ $ DEDUCTIBLE X RETENTION S1Q Q Q 5 $ WORKERS COMPENSATION AND ' WC2093016563 5/10/2008 5/10/200 X r"cv iMlr- oTH- EMPLOYEflS LIABILITY ~ ANV PROPRIETOFLPARTNERIEXECUTIVE EL EACH ACCIDENT $ 1 QQQ QQQ OFFICEWMEMBER EXCLUDED? It yes tlescribe antler E.L. DISEASE-EA EMPLOYEE $ 1 QQQ, QQQ r , SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT 51 QQQ QOO OTHER DESCRIPTION OFOPEflATIONS/LOCATIONS /VEHICLES/ E%CLUSION$ ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS la 1 Insured is included on the General Liability and Auto policies per policy form as required by ritten contract. an et of Subro ation is included on the General Liability, Auto and Workers' Comp as equired by written contract. *10 Day Notice of ancel la[ion applies £or non-payment of premium" E: Roselawn Drive 24-inch Water Line, Denton, TX 75209; HID No. 3971/ ity of Denton, its Officials, Agents, Employees and Volunteers and Kimley-Horn and Associates, Inc. are included as dditional IpsUred on the General Liability and Automobile policies per policy form. The General Liability and ontinued./. City of Denton 901-B Texas Street Denton TX 75209 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO hIAIL 30'a.BA'fS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, EUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ACO R D 25 IMPORTANT It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). Ii SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Automobile insurance is primary, and any other valid and collectable insurance for the Additional Insured shall be excess. waiver of Subrogation is included in favor of City of Denton, its Officials, Agents, Employees and Volunteers on the Workers' Compensation policy. Umbrella policy follows form.