1999-231 o rNANCE NO qq-,gZl
AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORKS
CONTRACT FOR THE CONSTRUCTION OF SIDEWALKS, PROVIDING FOR THE
EXPENDITURE OF FLrNDS THEREFOR, AND PROVIDING AN EFFECTIVE DATE (BID 2368
- BELL AVENUE, KINGS ROW AND DALLAS DRIVE SIDEWALKS, AWARDED TO FLOYD
SMITH CONCRETE, INC IN THE AMOUNT OF $162,029 65)
WHEREAS, the City has soh¢lted, received and tabulated competitive bids for the
construction ofpubhc works or improvements m 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 deacnbed 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 I That the following competitive bids for the construction ofpubhe works or
improvements, as dascnbed m the "Bid Invitations", "Bid Proposals" or plans and specifications on
file in the Office of the City's Purchasmg Agent filed according to the bid number assigned hereto,
are hereby accepted and approved as being the lowest responsible bids
BID
NIdMBER CONTRACTOR AMOUNT
2368 FLOYD SMITH CONCRETE, 1NC $162,029 65
SECTION II That 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 hereto accepted and approved, until such person shall comply with
all reqmrements 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 III That 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
w~th the bids accepted and approved herein, provided that such contracts are made in accordance
with the Notace to Bidders and Bid Proposals, and documents relating thereto specifying the terms,
conditions, plans and specifications, standards, quantities and specified sums contained there~n
SECTION IV That upon acceptance and approval of the above competitive bids and the
execution of contracts for the pubhc works and ~mpmvements as authorized herein, the C~ty Council
hereby authorizes the expenditure of funds m the manner and in the amount as spemfied in such
approved b~ds and authorized contracts executed pursuant thereto
SECTION V That this ordinance shall become effective immediately upon its passage and
approval
PASSED AND APPROVED thls the /;~/~ ~/~day of ~/g~Z~..1999
JAC~fLLER, MAYOR
ATTEST
JENNIFER WALTERS, CITY SECRETARY
APPROVED AS TO LEGAL FORM
HERBERT L PROUTY, CITY ATTORNEY
BID 2368 - CONTRACTUAL OR.I)
ATTACHMENT 1
TABULATION SHEET
B~d # 2368 DATE 6-3-99
BELL AVE KINGS ROW, DALLAS DR SIDEWALK
NoI DESdR!PTION VENDOR .... VENDOR VENDOR VENDOR VENDOR
SENECA
~, , I FLOYD DBR ED WILSON CREATIVE 4
':~' [ SMITH CONST
TOTAL $162,029.65 $165,381 50 $191,42525 $194,00200 $657,49814
1
CONTRACT AGREEMENT
STATE OF TEXAS §
COUNTY OF DENTON §
THIS AGREEMENT, made and entered into th~s 20 day of JULY A D., 1999, by and
between CITY OF DENTON of the County of DENTON and State of Texas, acting through
MICHAEL W. JEZ, City Manager, thereunto duly authorized so to do, hereinafter termed
"OWNER," and
FLOYD SMITH CONCRETE. INC
P.0, BOX 1781
DENTON, TEXAS 76202
of the C~ty of DENTON County of DENTON and State of TEXAS, hereinafter termed
"CONTRACTOR"
WiTNESSETH That for and m consideration of the payments and agreements
hereinafter mentioned, to be made and performed by OWNER, and under the condmons
expressed m the bonds attached hereto, CONTRACTOR hereby agrees w~th OWNER to
commence and complete performance of the work specified below
BID # 2368 - BELL AVENUE~ KINGS ROW, DALLAS DRIVE, SIDEWALKS
~n the amount of $162.029.65 and all extra work m connection therewith, under the terms
as stated in the General Conditions of the agreement, and at h~s (or their) own proper cost and
expense to furmsh all materials, supphes, machinery, eqmpment, tools, superintendence,
labor, insurance, and other accessories and serwces necessary to complete the work specified
above, ~n accordance w~th the conditions and prices stated m the Proposal attached hereto, and
m accordance with all the General Condlt~Ons of the Agreement, the Specml Conditions, the
Not~ce to B~dders (Advertisement for B~ds), Instructions to B~dders, and the Performance and
Payment Bonds, all attached hereto, and m
CA- 1
accordance wtth the plans, whtch tncludes all maps, plats, blueprints, and other drawings and
prmted or written explanatory matter thereof, and the Speclficattons therefore, as prepared by
ENGINI*.ERING DEPARTMENT
all of whtch are made a part hereof and collecttvely ewdence and constitute the entire contract
Independent Status
It ts mutually understood and agreed by and between C~ty and Contractor that
Contractor ts an independent contractor and shall not be deemed to be or considered an
employee of the Ctty of Denton, Texas, for the purposes of mcome tax, wtthholdmg, social
security taxes, vacatton or stck leave benefits, worker's compensatton, or any other Ctty
employee benefit C~ty shall not have supervtston and control of Contractor or any employee
of Contractor, and tt ~s expressly understood that Contractor shall perform the servtces
hereunder accordmg to the attached spectficattons at the general direction of the City Manager
of the Ctty of Denton, Texas, or his destgnee under th~s agreement
Indemmficat~on
Contractor shall and does hereby agree to mdenmdy and hold harmless the C~ty of
Denton from any and all damages, loss, or hablhty of any kind whatsoever, by reason of injury
to property or tfurd persons occastoned by any error, omission or negligent act of Contractor,
~ts officers, agents, employees, mvttees, and other persons for whom it ~s legally ltable, w~th
regard to the performance of thts Agreement, and Contractor w~ll, at its cost and expense,
defend and protect the Ctty of Denton against any and all such clatms and demands
Choice of Law and Venue
Thts agreement shall be governed by the law of the State of Texas and venue for its
construction and enforcement shall he m the courts of Denton County, Texas
The CONTRACTOR hereby agrees to commence work on or after the date establtshed
for the start of work as set forth m written notice to commence work and complete all work
w~thln the tune stated tn the Proposal, subject to such extensions of time as are prowded by the
General and Special Condtttons
The OWNER agrees to pay the CONTRACTOR m current funds the price or prices
shown tn the Proposal, which forms a part of thts contract, such payments to be subject to the
General and Special Condtttons of the Contract
CA - 2
IN WITNESS WHEREOF, the part~es of these presents have executed th~s agreement
in the year and day first above written
ATTEST /
(SEAL)
ATTEST:
I
CONT~CTOR
MAILING ADDRESS
PHONE NUMBER
FAX NUMBER
APPROVED AS TO F~ t ~ PmNTEB NAME
¢~g//~ (SEAL)
CITY ATTO~ I
CA - 3
PERFORMANCE BOND
STATE OF TEXAS §
COUNTY OF DENTON §
KNOW ALL MEN BY THESE PRESENTS That FLOYD SMITtt CONCRETE,
INC, whose address ~s P.O BOX 1781, DENTON, TX 76202, hereinafter called Prmmpal,
and ~N1~2~_t~,~c ~cJ~rv~ ~ t~ ~,9-,r~,~ ~ ~tq
a corporauon orgamzed arid ex,sUng under the laws of the State of TEXAS, and fully
authorized to transact busmess m the State of Texas, as Surety, are held and firmly bound unto
the C~ty of Denton, a mumc~pal corporauon orgamzed and ex,sUng under the laws of the State
of Texas, hereinafter called Owner, m the penal sum of ONE ItLrNDRED SIXTY TWO
TttOUSAND TWENTY NINE AND 651100 DOLLARS ($162,029 65) plus ten percent of
the stated penal sum as an addmonal sum of money representing addmonal court expenses,
attorneys' fees, and hqmdated damages arising out of or connected w~th the below Mentffied
Contract, ~n lawful money of the Umted States, to be prod ~n Denton County, Texas, for the
payment of wfuch sum well and truly to be made, we hereby b~nd ourselves, our he,rs,
executors, adm~mstrators, successors, and assigns, jointly and severally, firmly by these
presents Th~s Bond shall automaUcally be increased by the amount of any Change Order or
Supplemental Agreement wfueh mcreases the Contract price, but ~n no event shall a Change
Order or Supplemental Agreement wfuch reduces the Contract price decrease the penal sum of
this Bond.
THE OBLIGATION TO PAY SAME ~s conditioned as follows Whereas, the Principal
entered mto a certain Contract, ~dentffied by Ordinance Number 99-231, w~th the C~ty of
Denton, the Owner, dated the 20 day of July A.D 1999, a copy of whwh is hereto attached
and made a part hereof, for BID # 2368 - BELL AVENUE, KINGS ROW, DALLAS
DRIVE SIDEWALKS
NOW, THEREFORE, ff the Prmc~pal shall well, truly and faithfully perform and fulfill
all of the undertakings, covenants, terms, conditions and agreements of smd Contract ~n
accordance wxth the Plans, Specfficatlons and Contract Documents dunng the original term
thereof and any extension thereof which may be granted by the Owner, w~th or w~thout nouce
to the Surety, and during the hfe of any guaranty or warranty reqmred under th~s Contract, and
shall also well and truly perform and fulfill all the undertahngs, covenants, terms, conditions
and agreements of any and all duly authorized modfficatlons of smd Contract that may
hereafter be made, nouce of wMch modfficatmns to the Surety being hereby wmved, and, ~f the
Prmctpal,shall repair and/or replace all defects due to faulty materials and workmanship that
appear within a period of one (1) year from the date of final completion and final acceptance of
the Work by the Owner, and, ~f the Pnnmpal shall fully mdenmffy 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
~ncur m making good any default or defimency, then th~s obhgauon shall be void, otherwise, tt
shall rernam m full force and effect
PB - 1
PROVIDED FURTHER, that ff any legal action be filed upon this Bond, exclusive
venue shall he m Denton County, State of Texas
AND PROVIDED FURTHER, that the sa~d Surety, for value received, hereby
supulates and agrees that no change, extension of time, alteration or addtuon to the terms of
the Contract, or to the Work to be performed thereunder, or to the Plans, Specff~cauons,
Drawings, ere, accompanying the same, shall m anywise affect ~ts obhgauon on th~s Bond,
and it does hereby waive nonce of any such change, extension of time, alteration or addluon to
the terms of the Contract, or to the Work to be performed thereunder, or to the Plans,
Specifications, Drawings, etc
Tbas Bond Is given pursuant to the provisions of Chapter 2253 of the Texas
Government Code, as amended, and any other apphcable statutes of the State of Texas
The undersigned and designated agent ~s hereby designated by the Surety herein as the
Resident Agent m 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
ArUcle 7 19-1 of the Insurance Code, Vernon's Annotated C~v~l Statutes of the State of Texas
IN WITNESS WHEREOF, th~s instrument is executed in 4 cop~es, each one of which
shall be deemed an original, this the 20 day of JULY 1999
ATTEST PRINCIPAL
PRESiDEi~~' v~
ATTEST: SURETY
BY BY ~
ATTORN~Y~IN~FACT
The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service
of the process is
(NOTE Date of Performance Bond must be date of Contract If Resident Agent ts not a
corporaaon, gtve a person's name )
PB - 2
PAYMENT BOND
STATE OF TEXAS §
COUNTY OF DENTON §
KNOW ALL MEN BY THESE PRESENTS That FLOYD SMITH CONCRETE,
INC., whose address is P.O. BOX 1781, DENTON, TX 76202,hereinafter called Principal,
and/J. Nll/ce~g/~.P~r~' OF ,~r~e~c~ , a corporataon orgamzed and
exastmg under the laws of fhe State of TEXAS, and fully authorized to transact business m the
State of Texas, as Surety, are held and firmly bound unto the City of Denton, a mumcapal
corporanon orgamzed and exastmg under the laws of the State of Texas, hereinafter called
Owner, and unto all persons, farms, and corporaUons who may furmsh materials for, or
perform labor upon, the building or maprovements hereinafter referred to, in the penal sum of
ONE HUNDRED SIXTY TWO THOUSAND TWENTY NINE AND 65/100 DOLLARS
($162,019.65) m lawful money of the Umted States, to be paad an Denton, County, Texas, for
the payment of winch sum well and truly to be made, we hereby bind ourselves, our heirs,
executors, admlmstrators, successors, and assagns, jointly and severally, firmly by these
presents Tins Bond shall automatacally be increased by the amount of any Change Order or
Supplemental Agreement winch increases the Contract price, but in no event shall a Change
Order or Supplemental Agreement winch reduces the Contract price decrease the penal sum of
th~s Bond
THE OBLIGATION TO PAY SAME is conditioned as follows Whereas, the Principal
entered into a certain Contract, ldentafied by Ordinance Number 99-231, wath the Caty of
Denton, the Owner, dated the 20 day of JULY A.D. 1999, a copy of which is hereto attached
and made a part hereof, for BID # 2368 - BELL AVENUE, KINGS ROW, DALLAS
DRIVE SIDEWALKS.
NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties
and make prompt payment to all persons, firms, subcontractors, corporations and claunants
supplying labor and/or material in the prosecutaon of the Work provaded for In saad Contract
and any and all duly authorized mod~ficataons of said Contract that may hereafter be made,
notice of winch modffaCatlons to the Surety beang hereby expressly waaved, then this obhgauon
shall be vmd, otherwase it shall remain m full force and effect
PROVIDED FURTHER, that if any legal action be filed on this Bond, exclusave venue
shall lie m 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 addmon to the terms of
the Contract, or to the Work to be performed thereunder, or to the Plans, Specaflcanons,
Drawings, etc. aceompanymg the same, shall in anywise affect its obligation on this Bond,
and ~t does hereby waive nonce 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,
Speclflcatxons, Drawings, ere
PB - 3
Tills Bond is g~ven pursuant to the provisions of Chapter 2253 of the Texas
Governmant 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
Res~dem Agent m Denton County to whom any requisite notices may be dehvered and on
whom serwce of process may be had m matters arising out of such suretyship, as prowded by
Article 7 19-1 of the Insurance Code, Vernon's Annotated C~vll Statutes of the State of Texas
IN WITNESS WHEREOF, this instrument 1s executed in 4 cop~es, each one of which
shall be deemed an original, this the 20 day of JULY 1999.
ATTEST PRINCIPAL
ATTEST SURETY
BY
BY
ATTO~Y-IN-FX~T
The Reszdent Agent of the Surety m Denton County, Texas for delivery of notice and service
of the process ~s
STREETADD~SS ~D ~.~ ~a. ~,
(NOTE Date of Payment Bond must be date of Contract If Restdent Agent ts not a
corporatton, gtve a person's name )
2368 CONTRACT& BONDS & INSURANCE
PB - 4
07/28/99 09 ~0~ 02/02 NO 706
UNIVERSAL SURETY OF AMERICA
[s"L°'% --1
~ ~ Me. by These P~en~, 7hat U~ S~E~ OF ~ERICA, ~ co~orat~on duly ~d and
Ca~h~ Miller
~ts ~ a.d lawful At~rnoy(s) h~ Fact, w~h ~H powor a~d a~thonty hereby cmfferred in ~ name, place ~d stead to
execu~, acknowledge and dehwr bonds far
p~= FloTd Smith Concrete, Inc
~L $162,029 65
~d ~ bind ~. Company thereby as ~ and to ~e same ex~nt as ff such bonds we~e 8~ed by the ~esldon~ sesled ~th
· e co~omte ~al of ~e Compai~y sn~ du~ attested by i~ Sec~, he.by raine and ~nflrmm~ aB ~at ~e s~
Att~ey($) in Fact may do ~thm ~o above s~d hmtm~ons S~d appointment ~s made .nder and by authorl~ of ~.
fo]lo~n~ re.lUnCh adop~d By ~he Board of ~e~re of U~veraal Su~e~ of America at a meeting bom on ~e 11~ dsy of
J~F 1984
'Be It ~lwd, that the President, and any Vi~ President. ~e~ or any ~mtan~ Soc~ta~ shall be and ~a h~eby
rased ~ ~1 power end authority to appoint ~ one or m~a s~tab~ perone as At.rosy(s) m Fa~ to repreeo~ and
for and on ~h~fof the C~peny"
"~OL~D ~t th~ $~ature o~ a~ offi~r of ~e co~ora~n, and the seal of the co~oraUon may ~ a~ed or
pr~d by fa~stmflu ~ any ~we~ of at.may of~e ~oratlon, a~d thaL ~uch p~d fa~lo ~amre and ~al sha~ be
v~d and b~dmg upon tbs cor~ratio. '
In WI~ee ~n~o~ Um~real Su~ty of ~en~ ~s ~ed ~ p~n~ ~ ~ s~ed by lie P~a~en~
M~ ~d ~u ~m ~al ~ ha he~ a~ed t~s Snd day ~u~, ~D, 1998
Cou~ o~ ~
Ca ~ 2nd ~F of J~, m tbs ye~ of I~S, be~ m~ E~ ~a, a not~ pubh~ pe~o~y apps~
M~s~, per~"-ll~ kno~ ~ be ~e p~ who ~d ~a ~ m~en~ as ~s~dent. on ~half o~ ~
~o~a~oa ~e~m named and a~owMd~ed ~ me ~t the ~orsgoa e~u~d tt
I ~e uad~ 8eereta~ of Um~eal 8ure~ ~ America, hereb~ ce~t~ that ~he above and fore~omg ~s a fu~, ~uo
and ~ cop~ of ~o On~l Power of A~y ~suod by said Company, and do he.by ~bor ~lfy that the ea~d
Power clayey ~ ~ in
GI~N ~der my hand and the seal of sa~d compe~, st Houston, Texas, th~e 2 Sth day of J~ly
CITY OF DENTON
INSURANCE REQUIREMENTS FOR CONTRACTORS
Btdder's attentton ts directed to the tnsurance requtrements below It ts highly recommended
that bidders confer wtth thetr respecttve tnsurance carriers or brokers to determtne tn
advance of Btd submtsston the avatlabthty of insurance certtficates and endorsements as
prescribed and provtded heretn If an apparent low btdder fads to comply strictly with the
insurance requirements, that btdder may be dtsqualtfied from award of the contract Upon
bid award, all insurance requtrements shall become contractual obhgattons, whtch the
successful btdder shall have a duty to matntatn throughout the course of this contract
STANDARD PROVISIONS:
Wtthout hmttlng any of the other obhgattons or habthttes of the Contractor, the Contractor
shall provtde and matntatn unttl the contracted work has been completed and accepted by the
Ctty of Denton, Owner, the mtntmum tnsurance coverage as tndtcated heretnafler
As soon as practtcable after nottficatton of btd award, Contractor shall file wtth the
Purchastng Department satisfactory certtficates of tnsurance, contatntng the btd number and
tttle of the project Contractor may, upon wrttten request to the Purchastng Department, ask
for clartflcatton of any tnsurance requtrements at any trine, however, Contractors are strongly
advtsed to make such requests prtor to bid opemng, stnce the tnsurance requtrements may not
be modtfied or watved after btd opentng unless a wrttten exceptton has been submttted wtth the
bid Contractor shall not commence any work or dehver any material unttl he or she
recetves nottficatton that the contract has been accepted, approved, and stgned by the City of
Denton
All tnsurance pohctes proposed or obtatned tn sattsfactton of these requtrements shall comply
wtth the followtng general spectficattons, and shall be matntatned tn comphance wtth these
general spectficattons throughout the duratton of the Contract, or longer, tf so noted
· Each pohcy shall be ~ssued by a company authorized to do business m the State of
Texas wtth an A M Best Company rating of at least __A
· Any deductibles or self-insured retentions shall be declared tn the b~d proposal If
requested by the C~ty, the insurer shall reduce or ehmmate such deducttbles or
self-insured retentions wtth respect to the Ctty, tts
officials, agents, employees and volunteers, or, the contractor shall procure a bond
guaranteeing payment of losses and related mvest~gattons, claim admm~strat:on and
defense expenses
· L~abthty pohc~es shall be endorsed to prowde the following
Name as additional ~nsured the Ctty of Denton, tts Officials, Agents,
Employees and volunteers
That such ~nsurance ~s primary to any other ~nsurance available to the
adtht~onal insured with respect to clanns covered under the pohcy and that
th~s insurance apphes separately to each ~nsured agamst whom claun ~s made
or stat ~s brought The inclusion of more than one insured shall not operate
to mcrease the insurer's hmlt of habd~ty
· All pohc~es shall be endorsed to read
"SAID POLICY SHALL NOT BE CANCELLED, NONRENEWED OR
MATERIALLY CHANGE WITHOUT 30 DAYS ADVANCED WRITTEN
NOTICE BEING GIVEN TO THE OWNER (CITY) EXCEPT WHEN THE
POLICY IS BEING CANCELLED FOR NONPAYMENT OF PREMIUM IN
WHICH CASE 10 DAYS ADVANCE WRITTEN NOTICE IS REQUIRED"
· Should any of the reqmred msurance be prowded under a clmms-made form,
Contractor shall maintain such coverage continuously throughout the term of th~s
contract and, w~thout lapse, for a period of three years beyond the contract
expiration, such that occurrences arising during the contract term which g~ve rise
to claims made after expiration of the contract shall be covered
· Should any of the reqmred ~nsurance be prowded under a form of coverage that
includes a general annual aggregate lumt providing for claims investigation or legal
defense costs to be included m the general annual aggregate hm~t, the Contractor
shall either double the occurrence lwmts or obtain Owners and Contractors
Protective Llabthty Insurance
· Should any reqmmd insurance lapse dunng the contract term, requests for
payments originating after such lapse shall not be processed untd the City receives
satisfactory evidence of reinstated coverage as reqmmd by th~s contract, effective
as of the lapse date If msurance ~s not reinstated, City may, at ~ts sole option,
terminate th~s agreement effective on the date of the lapse
SPECIFIC ADDITIONAL INSURANCE REQUIREMENTS
~Ill insurance policies proposed or obtained in satisfaction of th~s Contract shall addit~onally
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
[XI A General Liability Insurance:
General Liability insurance wxth combmed smgle hmlts of not less than $1,000,000
shall be provided and ma[ntamed by the Contractor The pohcy shall be written on
an occurrence basis either in a smgle pohcy or ~n a comb~nanon of underlying and
umbrella or excess pohc~es
If the Commercial General L~abthty form (ISO Form CG 0001 current ed~tmn) ~s
used
· Coverage A shall include premises, operations, products, and completed
operations, independent contractors, contractual hablllty covering this
contract and broad form property damage coverage
· Coverage B shall include personal mjury
· 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 resultmg from explosion, collapse or underground (XCU)
exposures
· Broad form contractual liability (preferably by endorsement) covering this
contract, personal ln. lury hablhty and broad form property damage
liability
[X] Automobile Liabihty Insurance'
Contractor shall provide Commercial Automobile Liability Insurance with Combined
Single Limits (CSL) of not less than $1,000,000 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 pohcy endorsement for
· any auto, or
· all owned, hired and non-owned autos
IX] Workers Compensation Insurance
Contractor shall purchase and maintain Worker's Compensation insurance which, in
addition to meeting the m~mmum statutory requirements for issuance of such Insurance,
has Employer's Llabihty limits of at least $100,000 for each accident, $100,000 per
each employee, and a $500,000 policy hmlt 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 Llabihty Insurance
The Contractor shall obtain, pay for and maintain at all tunes during the prosecution of
the work under tins contract, an Owner's and Contractor's Protective Liability
insurance pohcy 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 Llablhty 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 Liabdlty Insurance
Professional liability insurance with limits not less than per claun with
respect to negligent acts, errors or omissions m connection with professional services is
required under this Agreement
[ ] Builders' Risk Insurance
Builders' Risk Insurance, on an All-Pask 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
[ ] Additional Insurance
Other insurance may be required on an individual basis for extra hazardous contracts
and specific service agreements If such additional insurance is rcqmred for a specific
contract, that requirement will be described m the "Specific CondRlons" of the contract
specifications
ATTACHMENT I
Ix] Worker's Compensat,on Coverage for Bu;Id,ng or Construction ProJects for
Governmental Ent~t~es
A. Deflmt~ons
Certificate of coverage ("cert~flcate")-A copy of a certificate of ~nsurance,
a certificate of authonty to self-~nsure ~ssued 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 ent~ty's employees prowd~ng serwces on a proJect, for the
duration of the project
Duration of the project - ~ncludes the t~me 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 prowd~ng serwces on the proJect ("subcontractor" ~n §406 096)
- includes all persons or ent~t~es performing all or part of the serwces the
contractor has undertaken to perform on the project, regardless of
whether that person contracted d~rectly w~th the contractor and
regardless of whether that person has employees Th~s includes, w~thout
limitation, Independent contractors, subcontractors, leasing companies,
motor carners, owner-operators, employees of any such entity, or
employees of any entity which furnmhes persons to provide serwces on
the project "Services" include, w~thout I~m~tat~on, prowdmg, hauling, or
del~venng equipment or materials, or providing labor, transportabon, or
other service related to a proJect "Serwces" does not ~nclude activities
unrelated to the project, such as food/beverage vendors, office supply
deliveries, and delivery of portable to~lets
B, The contractor shall prowde coverage, based on proper reporting of
classification codes and payroll amounts and flhng of any overage
agreements, which meets the statutory requirements of Texas Labor
Code, Section 401 011 (44) for all employees of the Contractor prowd~ng
serwces on the project, for the duration of the project
C The Contractor must prowde a certificate of coverage to the
governmental entity prior to being awarded the contract
D If the coverage per~od shown on the contractor's current cert~hcate of
coverage ends dunng the duratmn of the project, the contractor must,
prior to the end of the coverage penod, file a new cert~hcate of coverage
w~th the governmental entity showing that coverage has been extended
E The contractor shall obtain from each person providing serwces on a
project, and prowde to the governmental entity
(1) a certificate of coverage, prior to that person beginning work on the
project, so the governmental entity w~ll have on file cert~hcates of
coverage showing coverage for all persons prowd~ng serwces on the
project, and
(2) no later than seven days after receipt by the contractor, a new
certificate of coverage showing extension of coverage, ~f the
coverage period shown on the current cert~hcate of coverage ends
during the duration of the proJect
F The contractor shall retain all required cert~hcates of coverage for the
duration of the proJect and for one year thereafter
G. The contractor shall notify the governmental entity m writing by certified
mall or personal dehvery, w~thln 10 days after the contractor knew or
should have known, of any change that materially affects the prows~on
of coverage of any person prowdmg servmes on the proJect
H The contractor shall post on each project s~te a notme, m the text, form
and manner prescribed by the Texas Workers' Compensation
Commission, ~nform~ng all persons providing serwces on the project that
they are required to be covered, and stating how a person may verify
coverage and report lack of coverage
The contractor shall contractually require each person w~th whom ~t
contracts to provide serwces on a project, to
(1) provide coverage, based on proper reporting of classification codes
and payroll amounts and flhng of any coverage agreements, whmh
meets the statutory requirements of Texas Labor Code, Section
401 011(44) for all of ~ts employees prowdmg serwces on the
project, for the duration of the project,
(2) prowde to the contractor, prior to that person beginning work on
the project, a certificate of coverage showing that coverage ~s being
provided for all employees of the person prowdmg serwces on the
project, for the duration of the proJect,
(3) prowde the contractor, prior to the end of the coverage per~od, a
new certificate of coverage showing extension of coverage, ~f the
coverage period shown on the current certificate of coverage ends
during the duration of the project,
(4) obtain from each other person w~th whom ~t contracts, and prowde
to the contractor
(a) 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 per~od, ~f the coverage period
shown on the current certificate of coverage ends during the
duration of the project,
(5) retain all required certificates of coverage on file for the duration of
the project and for one year thereafter,
(6) not~fy the governmental entity ~n writing by certified ma~l or
personal dehvery, w~th~n 10 days after the person knew or should
have known, of any change that mater~ally affects the prows~on of
coverage of any person providing serwces on the project, and
(7) contractually require each person w~th whom ~t contracts, to
perform as required by paragraphs (1) - (7), w~th the certificates of
coverage to be provided to the person for whom they are prowd~ng
services
J By s~gmng th~s contract or prowd~ng or causing to be prowded a
certtflcate of coverage, the contractor ~s representing to the
governmental entity that all employees of the contractor who w~ll prowde
serwces on the project will be covered by workers' compensation
coverage for the duration of the project, that the coverage w~ll be based
on proper reporting of classification codes and payroll amounts, and that
all coverage agreements w~ll be filed w~th the appropriate insurance carrmr
or, ~n the case of a self-~nsured, w~th the commms~on's D~ws~on of Self-
Insurance Regulation Prowd~ng false or m~slead~ng ~nformat~on may
subject the contractor to adm~mstrat~ve penalties, criminal penalties, c~wl
penalties, or other c~wl actions
K The contractor's failure to comply w~th any of these provisions ~s a
breach of contract by the contractor which ent~tles the governmental
entity to declare the contract void ~f the contractor does not remedy the
breach w~th~n ten days after receipt of not~ce of breach from the
governmental entity
BID SUMMARY
One hundred sixty two thousand
TOTAL BID PRICE IN WORDS
twenty nlne and 65/100 dollars
In the event of the award of a contract to the undersigned, the
undersigned will furnish a performance bond and a payment bond for
the full amount of the contract, to secure proper compliance with
the terms and provisions of the contract, to insure and guarantee
the work until final completion and acceptance, and to guarantee
payment for all lawful claims for labor performed and ~aterials
furnished in the fulfillment of the contract.
It is understood that the work proposed to be done shall be
accepted, when fullM 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 correc=
and final.
Unit and lump-sum prices as shown for each item listed in this
proposal, shall control over extensions.
Floyd Smith Concrete Inc
BY ~ ~/~' 7~41~
1519 W~l£owwood Dr~ve
P 0 Box 1781
Street Address
Denton, TX 76202
City and State
Seal & Authorization
(If a Corporation) 940-565-0114
Telephone
B - 1
BID SUMMARY
PROJECT WORK DAYS BID
1 Bell Avenue Sxdewalk 15 $ 60 ~ ~.03.70
2 I~ngs Row S~dewalk 12 $ 39~918.05
3 Dallas Drive S~dewalk __28 $ 62,007.90
TOTAL $ ~.62,029.65
All ~tems accepted above will be awarded to one contractor Work days will be kept separately
for each ~tem hsted above The award of the bid shall be based on Items l, 2, and 3 above Total
work days will be the sum of all sections of the bid awarded
B-2
BELL AVENUE SIDEWALK BID TABULATION SHEET Work Days ~.~
Bid No
PO No
Item I : ' Description [ Quantity I Unit ! Umt Price I Total
21 [Contractors Warran~es and Understandings ]LS I $ 815.00 /LS I $ 815.00
Umt Price In Words Eight hundred fxfteen and 00/100 aollars
Umt Pnce In Words S~.x and 00/100 dollars
Umt Price In Words ~ixt:een ~n~ 20/100 dollars
Umt Price In Words Sxxteen and 20/100 dollars
1 oflhghtofWay $ 500.00 /LS $ 500.00
:Pnce In Words Five hundrc~l and dollars
3 Un~l~fiedExcavatton 151 $ 10,00 $ 1,510 00
Um~ Price In Words Ten and 00/100 dollars
7 $
UmI Price In Words T~ent¥ and 00/100 dollars
9 ]Sod [ 590 1~ 15 7.50 ~F[$ ~,~25.00
Um, Pnce In Words Seven and 50/100 dollars
107 Hydromulch [ 89 SY 15 6.50 /SY[$ 578.50
I
Umt Price In Words Szx and 50/100 dollars
12 Erosion Control 250.00 /LS
Um~ Pnc¢ In Words Two hundred fifty and 00/100 dol l~rs [
57 ]Asphalt Patch (2" - Type D) [ 1 ]Ton I$ 75.00 /To[$ 75.00
Umt Price In Words Seventy five and 00/100 dollars
4 5-A t A Concrete- Sidewalk Toe Wall 10 $ 365.00
UnlI ~c In Wo~ds r~ee h~ndred s~xty ~lve and 00/100 dollars I
8, I - [ I* 5®.oo ,sl, 5oo.oo
UmI Price In Words Five hundred and 00/100 dollars
2/8/99 P 3
BELL AVENUE SIDEWALK BID TABULATION SHEET Work Days.____.~.~
Bid No ~
PO No
83 Dnyeway6" 159 [ SY [$ 31.5o/sY15 5,008.50
Um~ Price In Words Thxrty one and 50/100 dollars
8 3A 4" Concrete S,dcwalk [ 876 SY $ 31'05/Sy $ 27,199.813
Um~ Pnce In Words Thxrt¥ one and 05/100 dollars
Um~ ?rice In Words Th~.rty and 00/100 dollars
Um~ Price In Words Three and 00/100 dollars
Umt~ Price In Words T~o hundr*d fxfty and 00/100 dollars
SP-31-A [Rem~forcmgSteel-SldewalkTocWall I 67 [ LB 15 .30/LBI$ 20.1
Um~ Price In Words ...... 30/100 dollars
Umt Price In Words NA
SP-39 1 $ 400. O0/F_~ $ 400.0
Umt Price In Words Four hundred and 00/100 dollars
SP-45 IM~scellaneous Sprinkler Sysmm ^djustment I S00.0(YLS $
Umt Price In Words F~.ve hundred and 00/100 dollars
$ $
$ $
thousand one hundred three& 70/100 dollars) 103.70
2/8/99 P 4
KINGS ROW SIDEWALK BID TABULATION SHEET Work
Bid No
PO No
1 21 ICo tractors Warrant]es and Understandings [LS [ $ 551.00/LS ] $ 551.00
Um!PnceIn Words Flve hundred f~fty one and 00/100 dollars
3-m IRemove Concrete Curb & Gutter I 80 LF $ 6.00/LF [ $ 480.0C
Umt Price In Words S~.x and 00/100 dollars
3-C Remove Concrete Steps I 1 EA I$ 25.00/EA $ 25.0C
Umt Price In Words Twenty f/ye and 00/100 dollars
31 PreparattonofRtghtofWay LS I$ 500.00/LS $ 500.0£
Umt Price In Words F~.ve hundred and 00/100 dollars
3 Un~lasmfiedExcavat~on 125 CY $ 10.00/CY $ 1,250.0£
Umt Pnce In Words Ten and 00/100 dollars
Umt Price In Words Twenty and 00/100 dollars
Umt Price In Words Seven and 50/100 dollars
Unit Price In Words S~.x and 50/100 dollars
3 12 Temporary Eromon Control LS $ 250.0fiLS $ 250.0(
Unit Price In Words Two hundred f~.fty and 00/100 dollars
81 Bamcades, Wamlng S,gns and Detours LS 15 500.00/LS I $ 500.0(
Umt Price In Words Fxve hundred and 00/100 dollars
g 3 Driveway 6" 45 $ 31.50/Sy $
Umt Price In Words lltxrty one and 50/100 dollars
g 3A Sidewalk 751 $ $ 23,318.55
Umt Price In Words Ihxrty one and 05/100 dollars
P5
KINGS ROW SIDEWALK BID TABULATION SHEET Work Days._~l~,..~
Bid No ~
PO No
SP-2 [Concrete Saw Cut 116 [ LF I$ 3.00/LF $ 348.09
Umt Price In Words Three and 00/100 dollars
SP-27 A~ustSerVlccLlnes 17 EA [$ 250.00/EA[$ 4,250.0
Umt Price In Words T~o hundred fifty and 00/100 dollars
SP-39 ~ect Signs 1 $ 400.00/EA $
Unit Pnce In Words Four hundred and 00/100 dollars l
SP-45 Miscellaneous Spnnkler System Adjustment LS ] $ 500.00LS $ 500.
Unit Price In Words Five hundred and 00/100 dollars
$ $
$ $
$ $
TOTAL(Thzrty nzne thousand nzne hundred e~ghteen & 05/100dollm's) $ 39,918.05
P6
DALLAS DRIVE SIDEWALK BID TABULATION SHEET Work Days~
Bid No ~
PO No
Item Description Quantity Unit Price Total
21 Contractors Warrantees and Understandings $ 837.G0/LS $ 837.00
Umt Price In Words E~.ght hundred thxrty seven and 00/100 dollars
1 3 Flex Base (6") 6 20.00/SY $ 120.0~
Unit Price In Words T~enty and 00/100 dollars
3-A IRemoveCon reteCurb&Gutter [ 150 [LF Is 6.00 FIs 000.00I
Umt Price In Words S~.x and 00/100 dollars
3-B [Remove Concrete Driveways I 25 SY $ 16.20/SyI $ 405.00I
Umt Price In Words Sxxteen and 20/100 dollars
3-F IRemov¢ Concrete Median 11 $ 178.20
Umt Price In Words Sxxteen and 20/100 dollars
,-G Remove Concrete - Other I 20 [SY Is 18.00/SY $ 360.O0
Umt Price In Words E~.ghteen and 00/100 dollars
31 I?r~arauon of Right of Way I ILS [$ 500.00/LS [$ 500.0C
Umt Price In Words Fzve hundred and 00/100 dollars
Untt Price In Words Seven and 50/100 dollars
lO7 IHy&ommch [ 641 SY [$ 3.00/s¥1s 1,923.0c
Umt Price In Words Three and O0/100 dollars
12 ILs I$ 250.00/LS [ $ 250.0G
Unit Price In Words Two hundred ftfty and 00/100 dollars
7 IAsphalt Patch (2"- Type D) I 43 $ 3,225.0°
Umt Price In Words Seventy fxve and 00/100 dollars
74 5-A ICla~s A Concrete-Sidewalk Retaining Wall I ~or 0 ICY I$ -0- /CY$ -0-
Un,t Price In Words NA
Untt Price In Words Seven hudnred f~-fty and 00/100 dollars
3 Concrete Driveway 6" 41 $ $
Unit Price In Words Thxrl one and 50/100 dollars
4/30/99 P 7
DALLAS DRIVE SIDEWALK BID TABULATION SHEET Work Days.__a%0~
Bid No
PO No
3A-1 14" Concrete Sidewalk 1164 I SY I $ 31.05/syI $36,16,2.20
Unit Price In Words Taxrty one and 05/100 dollars
Un!tPnce In Words Th,try one and 50/100 dollars
SP-2 Concrete Saw Cut I 364 $
Unit Pnce In Words Three and 00/100 dollars
SP-27 ]Adjust Service Lines I 1 , 250.00/EA 250.00
Umt Pmce In Words Two hundred f~fty and 00/100 dollars
SP-31-A Reinforcing Steel - Sidewalk Retmmng Wall I 260 $ .30/LB 78.00
Umt Price In Words .... 30/100 dollars
s.9 IPro ,
Unit Price In Words Four hundred and 00/100 dollars
SP-43 Asphalt Saw Cut I 1238 $ 1 50/LF $ 1,857 00
Umt Price In Words One and 50/100 dollars
;P-45 IMmcellaneous Sprinkler System AdjustmentI $ 500.00/LS $ 500.00
Unit Price In Wolds Fxve hundred and 00/100 dollars
3.3 I Un'las s · f ~ed Excavation I 79 ICY 1$ 10.00/LF I $ 790.00I
Unit Price In Words Ten and 00/100 dollars
3.7 ICotllP~cted Flll I 2 ]CY I$ 20.00 I$ 40.00
Unit Price zn Words Twenty and 00/100 dollars
$ $
TOTAL two thousand seven & 90/100 dollars) $62,007 90
4/30/99 P 8
PROOUCER (940) 382-9691 FAX (940)243-1050 I THIS CERTIFICATE IS ISSUED AII A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
~,mey & King Insurance I HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
830 South I- 3 SE, Suq l:e A ALTER THE COVERAGE AFFORDED BY THE POLICIES IIELOW
Denton, TX 76205-7829 COMPANIES AFFORDING COVERAGE
COMPANY S~ tuml ROMS
Arm Ext A
INSURED COMPANY Texas Work Comp Ins Fund
Floyd Smith Concrete, Inc
P o Box 1781
COMPANY
Denton TX 76201 c
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NNVlED ABOVE FOR THE POLICY PERIOD
INDICATED NOTVVITHSTANDINO 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 CONOITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
POLICY EFFECTIVE POLICY EXPIRATION
CO TYPE OF INSURANCE POLICY NUMBER LIMITS
LTR DATE {MMIDD/YY) DATE (MMr0D/YY)
GENERAL LIABILITY GENERAL AGGREGATE 2 I 000, OO0
X COMMERCIAL ~EHER ~L LIAEILITY PRODUCt'S COMP/OP AGG 2 i 000,000
A CLAIn~E X o~DuRCLP3044054 09/28/1998 O9/28/1999 PERSONAL&ADVlNJURY 1,O00,000
OWNER S & Cf3NTR~CTOR B PROT EACH OCCURRENCE 1,0001000
FIRE DAMAGe (Any one fire) 50 ~ 000
MED EXP (Any one pemon) S ! 000
AUTOMOBILE LIABILITY COMEINED SINGLE LIMIT $
ANY AUTO
ALL OWNED ~ LITOS BODILY INJURY $
SCHEDULED ~UTOS (Per
TSF0001082227 09/28/1998 O9/28/1999 ELM^CH^CD,DENT S 100,000
THE PROPRIETORt INCL EL DISEASE POLICY LIMIT $ 500,000
OFFICERS ARE EXCL ELDISEASE EAEMPLOYEe, $ 100!O00
DESCRIPTION OF OPE RATION S/LOCATION~EHICLE ~EE EDIAL ITEMS
:ITY OF DENTON, ITS OFF[C[ALS, A~ENTS, EHPLOYEES AND VOLUNTEERS ARE NANEO AS ADDITIONAL [NSURED
B3d 2368 - Bell Avenue, K~ngs Row, Dallas Dr3ve, S~dewalks
CERTIF~ATEHOLDER
Said policy shall not be ca~celled, renewed, or
ma:e~r~t-l~ changed without 30 days advance
w~!~ten no~ice being given to the O~er, except
~he~ ~he p~lfcy ~a Bein~c~.~c~lled for non-
pyment o~.p~mium,/in~hzch case lO days
CITY OF DENTON ~dvance w~itte.~n~no~i~,is required
9018 TEXAS STREET
DENTON, TX 76201 AUTHORI~DR RESEN VE
iA(~ORO 2S~ (1195) .,,,~ /' '~ / '~ ~CORD CORF~RATION 168m
/
JU]-2B-gg 10 37A ALLSTATE INS-HOLT AGCY g40 666 ~g42 P.01
UeRTIFICATE OF INSURANCE
L~ ALLSTATEINSURANCE COMPANY ~ ALLSTATEINDEMNITY COMPANY ~ ALLSTATETEXAS LLOYD'S
THIS CERTIFICATE IS I~UED AS A MA~ER O~ INFORMATION ONLY AND CONFER~ NO RIGHT~ UPON THE
CATE DOES NOT AMEND, EXTEND OR ALTER THE O~ERAGE AFFORDED BY THE POLICIES BELOW
CERTIFICATE HOLDER NAMEO INSURED
Name and Addre~ Pn~ho~ thl~ Cart Iflcal~ Is I~Gt;ed -- ~ ama and A~dress of Insur~ --
CZTY OF DENTON FLOYD ~]TH
PURCHASING DEPT P0 80X 1781
ATTN DEN[SE HARP00L DENTON TX 76231
[~(~40) 349-7302
This Is Io certify that policies of Insurance listed below have been lesued to the insured named above ~ubJeol to the expiration data Ind~cat~ below,
noIwtthstandlng any requirement, ler~ or condlUon of any Contract or other dooument with resp~ol lo which this cetllllcate may be Issued or may
peH~ln The Insurance afforded by the poIIoles deearlbed herein Is subJeoI to all the terms, exclusions, and condllio~s pi such policies
TYPE OF INSURANCE AND LIMIT8
Policy Effective Expiration
COMMERCIAL GENERAL [IABILI~ Numbm Date
Limit A~unt
GENERA~ AGGREGATE LIMIT (Olher t~.n Products -- Completed OperaUone)
PRODUCTS -- COMPLETED OPERATION8 AGGREGATE LIMIT~
PER~ONA~ AND ADVeRtiSING INJURY LIMIT ~
EACH ~CURR~N~E LIMIT
PHYSICAL DAMA~ LIMIT ~ $ ~ ANY ON~ LOSS
MEOICA~ EXPENSE ~IMIT $ AN~ ONE PERSON
WORKER~~ COMPEN~TION A Policy Effective Expiration
E~PLOVER~' LIA~IL~Y N~mber D~te ..... Date
.Co~ru~e. Llmltt
~RK;R$ COMPenSaTION ~TATUT~RY -- applle~ Only in,he ~ollow~ng ~late8 _
EMPLOYERS' BO0~LY INJURY ~Y ACCIDENT $ ~CH A~IDENT
LIABILITY BODILY INJURY BY DISEASE__ S EACH EMPLOYEE
BODILY I~JURY BY DISEAgE .$ ~LI~ LIMIT
AUTOMOBILE LIABILi~ Policy EffecUve ExplraUon
. Number 649559731 D.t. ~'11/99 ~te 06/11/00
~ANY AUTO ~ ~NEO AUTOS ~ HIREDAUTOS -- Combln~ 8t ~ Limit o~ Liability
BOOILY IN3URY & PROPERTY DA~A6E j $ 1, ()0~. OOO. I EACH AGCIDENT
~SPECIFIEO ~TOS ~ NON ~NEO AUTOS ~llt ~ Llmltl
UOWNEO P~IVATE ~S~ENOER AUTOS ! ,,~ ,,T'~ ~ '~ ff~% 4~ *, PER~ON
~WNEO AUTOS OTHEq THAN PRIVATE ~SSENGER S
UMBRELLA LIABILITY Policy ' E~ tlw Expiretlon
N~mbef Oat~ O~te
OTHER (Show ~lloy Eff~tlve ~ Expiration
type of Poll~y) Number Date
Numar ofd~ysnotl,e ~R ~ ~ ~[R ~ ~AY--~ 07/27/99
~hould any of thru above da~ribe~ ~emcm~ b~ oan6etied ~fore the expffatlon date, the Issuing oompany w)ll endaavo~ to mall wl~hmn the
AIIslale
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l~r~n~ K~¥ Output P~qe l
b/638S1 VJR2MO 96051/ A0405~45 0;/27/99
Display Devioe . , + ~ D~P21
User
I~)sured FLOYD SMITH Po] No , b495%9731
Phonel [ 817 ) ~65 - 0114 ~*ITEM L~TING*~ Aq~nt 08 O97821
Ins Line~ AUTO-COMM
8EL Y~AR MAK~/KOD~L VIN
1 1999 }~RD /EXPEDITION B 0365
2 1986 FORD /mtb0 FLATBED 3945
3 1981 f~RD /FLATBED 4181
4 [99! FORD /250 X~' 4446
5 1992 FORD '['RUON/F250 ~972
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