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PR 17457: MULTIPLE USE AGREEMENT WITH TX DEPARTMENT OF TRANSPORTATION FOR USE OF RIGHT-OF-WAYS FOR BUS SHELTERS
P. R. NO. 17457 12/21 /2012 rb /gt RESOLUTION NO. A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A MULTIPLE USE AGREEMENT WITH THE TEXAS DEPARTMENT OF TRANSPORTATION FOR THE USE OF THEIR RIGHT -OF -WAYS FOR BUS SHELTERS WHEREAS, per Resolution No. 12 -485, the City Council authorized a contract with Civil Concepts, Inc. for survey /design and oversight of the construction of concrete bus shelters for the City of Port Arthur Transit Department (PAT); and WHEREAS, the Port Arthur Transit has requested the State to permit the construction and maintenance and operation of a public Passenger Shelter Facility on the highway right -of -way on Texas State Highway 87, Texas State Highway 347 and Farm to Market Road 365; and WHEREAS, the State has indicated its willingness to approve the establishment of such facilities and other uses conditioned that PAT will enter into agreements with the State for the purpose of determining the respective responsibilities of the PAT and the State with reference thereto, and conditioned that such uses are in the public interest and will not damage the highway facilities, impair safety, impede maintenance or in any way restrict the operation of the highway facility, all as determined from engineering and traffic investigations conducted by the State; and WHEREAS, it is in the best interest of the citizens of Port Arthur to enter into a Multiple Use Agreement with the Texas Department of s.pr17457 1 Transportation, in substantially the same form as attached hereto as Exhibit NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PORT ARTHUR: Section 1. That the facts and opinions in the preamble are true and correct. Section 2. That the City Manager is herein authorized to enter into a Multiple Use Agreement with the Texas Department of Transportation, in substantially the same form as attached as hereto as Exhibit "A ", for the use of their right -of -ways to permit the construction, maintenance and operation of a public Passenger Shelter Facility as delineated in Exhibit "A ". Section 3. That a copy of the caption of this Resolution shall be spread upon the Minutes of the City Council. READ, ADOPTED, AND APPROVED, this day of January, 2013 AD, at a Regular Meeting of the City Council of the City of Port Arthur, Texas by the following vote: AYES: Mayor: Councilmembers: NOES: s.pr17457 2 Mayor ATTEST: City Secretary APPROVED AS TO FORM: —? 0 Ci At .rney f APPROVED FOR ADMINISTRATION: City Manager Ale 41rAW Director of T ansit s.pr17457 3 Texas anhosportztion Font 2044 (Rev. 0$/12) Pagel of 16 MULTIPLE USE AGREEMENT STATE OF TEXAS § COUNTY OF TRAVIS § THIS AGREEMENT made by the State of Texas by and between the Texas Department of Transportation, hereinafter referred to as "State ", party of the first part, and Port Arthur Transit , hereinafter called P.A.T., party of the second part, is to become effective when fully executed by both parties. WITNESSETH WHEREAS, on the day of , 20_, the governing body for the City of Port Arthur, entered into Resolution /Ordinance No. hereinafter identified by reference, authorizing the City's participation in this agreement with the State; and WHEREAS, the P.A.T. has requested the State to permit the construction, maintenance and operation of a public Passenger Shelter Facility on the highway right of way: Address Roadway Control Section Number 4930 Guifway Drive Texas State Highway 87 0306 -03 5138 Gulfway Drive Texas State Highway 87 0306 -03 1800 Jefferson Drive Texas State Highway 347 0667 -01 4800 Highway 365 Farm to Market Road 365 0932 -01 shown graphically by the preliminary conceptual site plan in Exhibit "A" and being more specifically described by metes and bounds of Exhibit "B ", which are attached and made a part hereof; and WHEREAS, the State has indicated its willingness to approve the establishment of such facilities and other uses conditioned that the P.A.T. will enter into agreements with the State for the purpose of determining the respective responsibilities of the P.A.T. and the State with reference thereto, and conditioned that such uses are in the public interest and will not damage the highway facilities, impair safety, impede maintenance or in any way restrict the operation of the highway facility, all as determined from engineering and traffic investigations conducted by the State. Form 2044 (Rev. 08/12) Page 2 of 9 AGREEMENT NOW, THEREFORE, in consideration of the premises and of the mutual covenants and agreements of the parties hereto to be by them respectively kept and performed as hereinafter set forth, it is agreed as follows: 1. DESIGN AND CONSTRUCTION Civil Concepts, Inc. will prepare or provide for the construction plans for the facility, and will provide for the construction work as required by said plans at no cost to the State. Said plans shall include the design of the access control, necessary horizontal and vertical clearances for highway structures, adequate landscape treatment, adequate detail to ensure compliance with applicable structural design standards, sufficient traffic control provisions, and general layout. They shall also delineate and define the construction responsibilities of both parties hereto. Completed plans will be submitted to State for review and approval and when approved shall be attached to the agreement and made a part thereof in all respects. Construction shall not commence until plans have been approved by the State. Any future revisions or additions shall be made after prior written approval of the State. Any sidewalks, curb ramps and other pedestrian elements to be constructed, either on site or off site, by the P.A.T. shall be in accordance with the requirements of Title II of the Americans With Disabilities Act (ADA) and with the Texas Accessibility Standards (TAS). Elements constructed by the P,A.T. and found not to comply with ADA or TAS shall be corrected at the entire expense of the P.A.T. 2. INSPECTION Ingress and egress shall be allowed at all times to such facility for Federal Highway Administration personnel and State Forces and equipment when highway maintenance operations are necessary, and for inspection purposes; and upon request, all parking or other activities for periods required for such operations will be prohibited. 3. PARKING REGULATIONS Parking regulations shall be established limiting parking to single unit motor vehicles of size and capacity no greater than prescribed for 1 -1/2 ton trucks, such vehicles to conform in size and use to governing laws. Parking shall be permitted only in marked spaces. Parking shall be prohibited when a security threat, as determined by TxDOT, exists. f orrn 2044 (Rev. 08/12) Page 3 of 9 4. PROHIBITION /SIGNS Regulations shall be established prohibiting the parking of vehicles transporting flammable or explosive loads and prohibiting use of the area in any manner for peddling, advertising or other purposes not in keeping with the objective of a public facility. The erection of signs other than those required for proper use of the area will be prohibited. All signs shall be approved by the State prior to the actual erection. 5. RESPONSIBILITIES Maintenance and operation of the facility shall be entirely the responsibility of the P.A.T. Such responsibility shall not be transferred, assigned or conveyed to a third party without the advanced written approval of the State. Further, such responsibility shall include picking up trash, mowing and otherwise keeping the facility in a clean and sanitary condition, and surveillance by police patrol to eliminate the possible creation of a nuisance or hazard to the public. Hazardous or unreasonably objectionable smoke, fumes, vapor or odors shall not be permitted to rise above the grade line of the highway, nor shall the facility subject the highway to hazardous or unreasonably objectionable dripping, droppings or discharge of any kind, including rain or snow. 6. FEES Any fees levied for use of the facilities in the area shall be nominal and no more than are sufficient to defray the cost of construction, maintenance and operations thereof, and shall be subject to State approval. A. Retention Period. The P.A.T. shall maintain all books, documents, papers, accounting records and other evidence pertaining to fees collected and costs (hereinafter called the Records). The P.A.T. shall make the records available during the term of the Agreement and for four years from the date the Agreement is terminated, until completion of all audits, or until pending litigation has been completely and fully resolved, whichever occurs last. 13. Availability. The State or any of its duly authorized representatives, the Federal Highway Administration, the United States Department of Transportation, Office of Inspector General, and the Comptroller General shall have access to the 's records that are directly pertinent to this Agreement for the purpose of making audits and examinations. 7. TERMINATION UPON NOTICE This provision is expressly made subject to the rights herein granted to both parties to terminate this agreement upon notice, and upon the exercise of any such right by either Form 2044 (Rev, 08/12) Page 4 of 9 party, all obligations herein to make improvements to said facility shall immediately cease and terminate. 8. MODIFICATION /TERMINATION OF AGREEMENT If in the sole judgment of the State it is found at any future time that traffic conditions have so changed that the existence or use of the facility is impeding maintenance, damaging the highway facility, impairing safety or that the facility is not being properly operated, that it constitutes a nuisance, is abandoned, or if for any other reason it is the State's judgment that such facility is not in the public interest, this agreement under which the facility was constructed may be: (1) modified if corrective measures acceptable to both parties can be applied to eliminate the objectionable features of the facility; or (2) terminated and the use of the area as proposed herein discontinued. 9. PROHIBITION OF STORAGE OF FLAMMABLE MATERIALS All structures located or constructed within the area covered by the agreement shall be fire resistant. The storage of flammable, explosive or hazardous materials is prohibited. Operations deemed to be a potential fire hazard shall be subject to regulation by the State. 10. RESTORATION OF AREA The P.A.T, shall provide written notification to the State that such facility will be discontinued for the purpose defined herein. The P.A.T. shall, within thirty (30) days from the date of said notification, clear the area of all facilities that were its construction responsibility under this agreement and restore the area to a condition satisfactory to the State. 11. PREVIOUS AGREEMENTS It is understood that this agreement in no way modifies or supersedes the terms and agreements between the provisions of any existing ag parties hereto. P 12. INDEMNIFICATION Each party acknowledges that it is not an agent, servant, or employee of the other party. Each party is responsible for its own acts and deeds and for those of its agents, servants, or employees. Neither party hereto intends to waive, relinquish, limit or condition its right to avoid any such liability When notified by the State to do so, the other party hereto shall within thirty (30) days from receipt of the State's written notification pay the State for the full cost of repairing any damages to the highway facility which may result from its construction, maintenance or operation of the facility, and shall promptly reimburse the State for costs of construction and /or repair work made necessary by reason of such damages. Form 2044 {Rev. 08/12) Page 5 or 9 Nothing in this agreement shall be construed as creating any liability in favor of any third party against the State and the P.A.T. Additionally, this agreement shall not ever be construed as relieving any third party from any liability against the State and the P.A.T. shall become fully subrogated to the State and shall be entitled to maintain any action over and against the third party which may be liable for having caused the P.A.T. to pay or disburse any sum of money hereunder. 13. HOLD HARMLESS The P.A.T. shall indemnify and save harmless the State and its officers and employees from all claims and liability due to its materials or activities of itself, its agents, or employees, performed under this agreement and that are caused by or result from error, omission, or negligent act of the party or of any person employed by the party. The P.A.T, shall also indemnify and save harmless the State from any and all expense, including but not limited to attorney fees that may be incurred by the State in litigation or otherwise resisting the claim or liabilities that may be imposed on the State as a result of such activities by the P.A.T., its agents, or employees authorized under this agreement. The P.A.T. further agrees to indemnify and save harmless the State from and against all claims, demands, and causes of action of every kind and character brought by any employee of the party against the State due to personal injuries and /or death to such employee resulting from any alleged negligent act by either commission or omission on the part of the P.A.T. The indemnification of the State shall extend for a period of three (3) years beyond the date of termination of this agreement. 14. INSURANCE The P.A.T., shall provide necessary safeguards to protect the public on State maintained highways including adequate insurance for payment of any damages which might result during the construction, maintenance and operation of the facility occupying such airspace or thereafter, and to save the State harmless from damages, to the extent of said insurance coverage and insofar as it can legally do so. Prior to beginning work on the State's right of way, the P.A.T.'s construction contractor shall submit to the State a completed insurance form (TxDOT Form No. 1560) and shall maintain the required coverage during the construction of the facility. 15. USE OF RIGHT OF WAY It is understood that the State by execution of this agreement does not impair or relinquish the State's right to use such land for highway purposes when it is required for the construction or re- construction of the traffic facility for which it was acquired, nor shall use of the land under such agreement ever be construed as abandonment by the State of such and Form 2044 (Rev. 08/12) Page 6 of 9 acquired for highway purposes, and the State does not purport to grant any interest in the land described herein but merely consents to such use to the extent its authority and title permits. 16. ADDITIONAL CONSENT REQUIRED The State asserts only that it has sufficient title for highway purposes. The P.A.T. shall be responsible for obtaining such additional consent, permits or agreement as may be necessary due to this agreement. This includes, but is not limited to, appropriate permits and clearances for environmental, ADA and public utilities. 17. FHWA ADDITIONAL REQUIREMENTS If the Facility is located on the Federal -Aid Highway System, "ATTACHMENT A ", which states additional requirements as set forth in the Federal Highway Administration's Title 23, Code of Federal Regulations, § 710, shall be attached to and become a part of this agreement. 18. CIVIL RIGHTS ASSURANCES The P.A.T„ for itself, its personal representatives, successors and interests and assigns, as part of the consideration hereof, does hereby covenant and agree as a covenant running with the land that: (1) no persons, on the grounds of race, color, sex, age, national origin, religion or disabling condition, shall be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination in the use of said facility; (2) that in the construction of any improvements on, over or under such and and the furnishing of services thereon, no person on the ground of race, color, sex, age, national origin, religion or disabling condition, shall be excluded from participation in, denied the benefits of, or otherwise be subjected to discrimination; (3) that the P.A.T. shall use the premises in compliance with all other requirements imposed by or pursuant to Title 49, Code of Federal Regulations, Department of Transportation, Subtitle A, Office of the Secretary, Part 21, Non- discrimination in Federally - Assisted programs of the Department of Transportation - Effectuation of Title VI of the Civil Rights Act of 1964, and as said Regulations may be amended. That if in the event of any breach of the above non - discrimination covenants, the State shall have the right to terminate the agreement and reenter and repossess said and and the facilities thereon, and hold the same as if said agreement had never been made or issued. 19. AMENDMENTS Any changes in the time frame, character or responsibilities of the parties hereto shall be enacted by a written amendment executed by both parties hereto. Form 2044 (Rev. 08/12) Page 7 of 9 20. LEGAL CONSTRUCTION In case one or more of the provisions contained in this agreement shall for any reason be held invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any provision hereof and this agreement shall be construed as if such invalid, illegal, or unenforceable provision had never been contained in this agreement. 21. AUDIT The State may conduct an audit or investigation of any aspect of this agreement. The P.A.T. must provide the State with access to any information the State considers relevant to the investigation or audit. The audit can include, but is not limited to, any contract for construction or maintenance of any facility or structure authorized by this agreement or any contract to provide a service to the F.A.T. if that service is authorized by this agreement. 22. AUTHORITY OF STATE AUDITOR The state auditor may conduct an audit or investigation of any entity receiving funds from the state directly under the contract or indirectly through a subcontract under the contract. Acceptance of funds directly under the contract or indirectly through a subcontract under this contract acts as acceptance of the authority of the state auditor, under the direction of the legislative audit committee, to conduct an audit or investigation in connection with those funds. An entity that is the subject of an audit or investigation must provide the state auditor with access to any information the state auditor considers relevant to the investigation or audit. 23. COMPLIANCE OF THE LAW The P.A.T. shall comply with all federal, state, and local law, statutes, ordinances, rules and regulations and with the orders and decrees of any courts or administrative bodies or tribunals in any manner affecting the performance of this agreement. 24. NOTICES All notices required under this agreement shall be mailed or hand delivered to the following respective addresses: STATE (Name of other party) (Mailing Address) (Mailing Address) Texas Department of Transportation Maintenance Division 125 East 11th Street Austin, Texas 78701 -2483 Form 2044 (Rev. 08/ 12) Page 8 of 9 25. WARRANTS The signatories to this agreement warrant that each has the authority to enter into this agreement on behalf of the party represented. • List of Attached Exhibits: Exhibit A - General Layout Exhibit B - Metes and Bounds Description Exhibit C - Approved Construction Plans Exhibit D - Certificate of Insurance (TxDOT Form 1560) Exhibit E - Attachment A (FHWA Additional Requirements) Form 2044 (Rev. 08/12) Page 9 of 9 IN WITNESS WHEREOF, the parties have hereunto affixed their signature, the on the day of — , 20, and the State on the day of , 20 STATE OF TEXAS Executed and approved for the Texas (Name of other party) Transportation Commission for the purpose and effect of activating and /or carrying out the orders, and established policies or work By: programs heretofore approved and authorized Signature by the Texas Transportation Commission. By: Printed Name Director, Maintenance Division Title Printed Name Agency Date APPROVAL RECOMMENDED: Contact Office and Telephone No. District Engineer Printed Name Date • Exhibit A General Layout I or r r r a � •` : 'mod * ,, - � J r , , .+ ?J, ' {) , LCIi �r �'„ / �' (;: . 1.` i : • " *, +j . . q . . •' -• • ...„.... ,.,,,, / A. „0-0.‘ - ,. .�, , .. ,, . , 4 N.: � , vio + ~is 'fi r' r' � • 4 d i k, f$Y= - • ., - - ' . , --.A t • 0 f4t 4, V1 i'`;' .... • I , At!" ....,i, e....y. .tif , 4 .::W . ....=:::it..4.. , . ..-,Aye.... - ,.- . . /f �* , fi . 4 t � —, 4 ,. , , it ‘ N N. - , 7 4 ,' .^",- .--. . c '' ...;....;•:,:,, i itit' , ; 2 ' to r� � 1 _ � •. t .' r � .,, - f � wY, t8�F5rrn tI�1 N. . A Rtl,f� �'_ -� v -. / \ ' s . + + 1 ,mss . .. i . i y -- / Y e ti; 1 s i ` „•s •+T L v � , • d �� !f ...:, • N,_„,k /a,:s1 . 3,.,0a , ,,„, ''. r. '. ' ' :17 41 -..• - ,;•• i # : „. '.44 ' S te 0 ',4". ' ' —47-7 '`'` Y.' " , .., - / -• '.:•,... A" ' . 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'.. ° L > , ' ,, ',- " . f .,�. - - - .4 / <' F es: ., - - • ��s� . , a <" r . ., , J �� ��. 3 i \ , Y ' a ♦ � . r, r � � .. 4 � � � ,, � ® > Z ' �.� ,,r) ro / .\ d . r : F e A .. k �r•> Imo' \� •• A P`s � ./: J Lam': , „.. , y i f vr,. r ` � - , �� R .� , J • • P � t � 4 q • ' � � d is,* 4* ,4 / , e ), . . ` I , /,-. / t , ,. y Exhibit B Metes and Bounds Description Exhibit B Not Applicable Exhibit C Approved Construction Plans - • LEGEND EXISTING CONDITIONS EN 0.C. On4X OF CURD[x E.C. EDGE O dKgLTL = y 8 •: ELEVATION .o HIGHWAY 83 oGOLF POP T1 v �I n ® 00'R.O.W. 7 : 1 GRATE NUT C. CLEAN 01)1 5 FIRE HYDRANT "11' M En LL ox q oq rvIEgSECIIOx V a n - 5OrvEFEPOLCE 9 O. Exov[ ^ � U ^ e L 6 ELEC]RC vE![q ^ " ^ G ^d E R p rz _ O G wMROL 9 6 �- -_ „ SOE QQ1I GABLE PEDESTAL •�j9 G �� ® PEDESTAL 00 . 42_,,.__,....._—.0,T=7.:----- __.... _.r —. ._ .. __. _ _. a te` _ �. ... %I / / //. ._� '7L 5 L q: iq SFORLhR = __,.........,, 4'-- w�lEN vN VE O �y0` • • � N w FO^ IPPOLIT ADDITION ad N VOL. 272 PC. 939 APR, 11, 1950 N' !co O ao� wl oo�a a Ofi a PROPOSED CONDITIONS Ea.wL..= :,:t...n. —. . HIGY.WAY 03 GU .�. .•m.k., '.wa..m IDO'R.O.W. ...W .4, ti x• R. A 1 13 Dq OwER,EGI. q Y K x..e. vw oU�. ^ 09- GOB-. GUTTER ^16 0 ^'t4 )] ) - � De caesmxmoT TT i. x SIGN a ALlt_ r...=■, NOITWAT • . t oiy � e C X56 SITE PLAN aq ■930 GULF WAY DRIVE P. in IPPOLITO ADDITION VOL. 272 PG. 939 APR. I1, 1950 rd 'RI WET 1 L 1 LEGEND ExISrING CONDITIONS PAVEMENT B.C. OACX Or CORD E ., CO, O OF CONCRENo T E HIGHWAY 100 8'7 R. ICULFP0RT) N 6 ,'„-.t. 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LOCATION < `re..� 2 ■ / V „ E - TREE (s • • fp / SITE PLAN tr, 5138 GULFWAY Fi OPIVE P O ps . , ‘ . .." 2 8 000. 153 O c.< j81.3.07.. .c 14,4' .r u.0 . . .c °g s$S L - LEGEND ExISTNG CONDITIONS • G • 7 .. TOP OF PAVEMENT D.. QII C.C. GROUND 2000248 K i N.C. J.C.O.R. ° ypp ° 10 RLa [M . tox y 'e:$ °- U' ok— SY • WARD P y -_�� 'f a __ U n n , Up ..,0 Li� T v f - ! '- : ° SERVICE Pae *D DESn Mov + t 0 w u[ciRK ER L.LS uEtER 1 1 0 M10 C f 'L WATER uEiE TR Ito. .. fo T _.ma _. —_ _ —. c.DLaRC O[st .0 ... _ _.._ ..__ . __. _._ _.. .♦. �.� REf7Z w �_ y PEDESTAL S - .. -- ( J . PIPELINE o TUMID. ,...........,.. oc © ELECTRIC TR.xsFDRUER MP' px cx weTER v.NVE .._. �. . -- _. _ —.. ....own, 1 BT,O`gDy3 Ooe _ o- � OLn D`'.. � �. ill • p } oR wT rz [ OR STATE H!CHWAY 347 1 (J DRIVE) u• < Z Oe o- N ~ m ~ O ao oo ° a :,, , tt d PROPOSED CONDITIONS .. r..rv. rw.A..a 2005042188 4.44 .... nT..T ...o. n..a.' Fi e ... x.. 1 0 9 .N s y a jj yD f f` y am MC len f ` S I ._ ... .P70.4 Pow. LOC AD. ff • t. x,01 Choy O _® ... r a..v Q ^ mn c b.5 B g SpMO LMT a_SGry 51oH .a. S�rvwxr 1,77 y H 0 �.�� , o - ii 0 .— 0 . 4, a _ 0 c a 417 PL.. 1 1800 JEFFERSON o— 5 OR Nr[RS[cTpv — STATE HIGHWAY 36J DRIVE (JEFFERSON DRIVE) 2: o- €o ry a ryy • SHEET • • • • • • • LEGEND - Z. gf%'tar"' EXISTING CONDITIONS —I E C. EDGE OF CONCRETE E.A. EDGE OF ASPHALT N.C. unnit, GROUND 111 T.B. TOP OE BANTI SG. SPOT ELETTATON 1 590, ,F....._ 0 '.4.' • WOO ESST00 ELVA,. . p • 4 TZTIL` ?A""'" -$- 1W,.01 0-AL,A1. FRL..V.12'.10i65 • GUARD POST "lb IT' :Eir g I 1 MY AIOTT <00 AREA LOTT O LICHT POLE .10 SERBICE LE _ ''' _ '''' NCT PO ...-----15 ES ' 41E 1 ;ISIPRII.LkSER • TT' • • s • vs w • ''' Wtir.4ELEEIER E, -- 7, •'-' Al . i ' L MANHOLE S 5 ' ' . _ . _ Y • . .. ° • •• s ' ' Is.7 . . 0 sw Y :It. s . •' ._' ---.. . 'W • • , . . -......-'. W.H . ' ' = -H7 .•:- . . ' 7, - — _= ' ' ' = --- '''- — . 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LA DON STANI)ARD SIQLS WHEELCHAIR RAMP AND Cl1RB & GUTTER GENERAL NO'ILS osxS@r I wttw 4. a �ss p . u.... � --lf ) . lw r ; ` :: e f. µ r..4..7"..72. . �t v 6 � r IL . . nx) ` � , „ oA� 1'' = — .?.. _ ...N n' ...,.) N r . % ..t r,« 5 ,, E �,a d%. as, .) . P sao wl s..,. '�' '' \ —�` mr _ .,. � ' i .. ..,., .. , en >....w r •4 V � nJZ ,mn• - . \ WI'I 0. CHAIIR RAMP S ECT ION s..0 � nu .a . ut,. wr.....,.r,+, a ;rc .. FRONT VIEW HANDICAP RAMP I ...n a t °i w ' . • . � .. `w r i �or N. tches 111, .1 e .ewwup, ,w. % 6 _ `.2".".2:2 wm� /q.jr, ,s m ewes'•• b mx. u.n:.:".. rr .e. F. dmZ .` I . t r As F O r !Y K rqe ...qt.., w' CURB SECTON B —B DRIVEWAY SECTION .„,o. 14 o e_ • 3 �.4-5.07i7.7: �—�t y am\ e.w •.,,e..t mR i......,.. «.� rm: w..a VI ,:ti '.;p / : t,.....,, SIDE .,a,:pq« '- (pia', view) ...,.a t. «.0 r ` :� _ ,... dM / 1- "' .a mot, F . 1 9 .. p..W ��.I�IFl - 1— a `l e'.w — �' R /r • CONCRETE • V ..,b. �. e.. m.. q ..e.., t . SIDEWALK SINGLE SIDEWALK AL t HANDICAP ENA T RT IVE WHEELCHAIR RAMPS WHEELCHAIR RAMP SIDEWALK R & STREET �D TAILS SIDEWALK SEC110N E —E DETAILS • st-, ,.,.. • L T • • "' ragTh,2..1,4,;._ Ic;01)c70)1 0 • • .ce .9t1 CCENTEREID C . 6 - ' 0 ' L6 L a 5I AR AN N T.M E .• *tmoa / CO .3 BARS 6EA .5 8r5i z? :%• 5 ""'s Athk • 51-01 Pt AN SECTION A-A SUS SHELTER FOUNDATION •7.4 DETML • m 1 • • - . Exhibit D Certificate of Insurance (TxDOT Form 1560) CERTIFICATE OF INSURANCE r1a1111 ),i(io .:;: '_-^�•:;' (Rev 07;121 f reviniis editions of this for,,, may not be used. ,ux,= Demi ot,l Page 1 of 2 ,r •., of T Agents should complete the form providing all requested information then either fax or mail this form directly to the address listed on page Iwo of this form. Copies of endorsements listed below are not required as attachments to this certificate. This certificate is issued as a 'latter of information only and confers no rights upon the certificate holder. This certificate does not confer any rights or obligations other than the rights and obligations conveyed by the policies referenced on this certificate. The terms of the policies referenced in this certificate control over the terms of the certificate_ Insured: Street /Mailing Address: City /State /Zip: Phone Number: ( WORKERS' COMPENSATION INSURANCE COVERAGE: Endorsed with a Waiver of Subrogation in favor of TxDOT. ___ Carrier Name: Carrier Phone #: (� Address: _ _ City, State, Zip: Type of Insurance Policy Number Effective Date Expiration Date — Limits of Liability: Workers' Compensation Not Loss Than: Statutory - Texas COMMERCIAL GENERAL LIABILITY INSURANCE: Carrier Name: Carrier Phone #: ( ) - Address: — City, State, Zip: Type of Insurance: Policy Number: Effective Date: Expiration Date: Limits of Liability: Commercial General Not Less Than: Liability Insurance $ 600,000 each occurrence BUSINESS AUTOMOBILE POLICY: Carrier Name: _ —_ — _ Carrier Phone #: ( Address: _ Cit , State, Zi•: Type of Insurance: Policy Number: Effective Date: Expiration Date: Limits of Liability: Business Automobile Poiicy Not Less Than: $ 600,000 combined single limit UMBRELLA POLICY (if applicable): Carrier Nam e: — _ Carrier Phone #: ( ) — - Address: City, State, Zip: — - ----- ._.. - -- Type of Insurance: Policy Number_ Effective Date: Expiration Date: Limits of Liability: —_ Umbrella Policy Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. THIS IS TO CERTIFY to the Texas Department of Transportation acting on behalf of the State of Texas that the insurance policies named are in full force and effect. If this form is sent by facsimile machine (fax), the sender adopts the document received by TxDOT as a duplicate original and adopts the signature produced by the receiving fax machine as the sender's original signature. Agency Name Address City, State, Zip Code ( Authorized Agent's Phone Number Authorized Agent Original Signature Date The Texas Departrnent of Transportation maintains the information collected through this form. With few exceptions, you are entitled on request to he informed about the information that we collect about you. Under § §552.021 and 552.02.3 of the Texas Government Code, you also are entitled to receive and review the information. Under §559.004 of the Government Code, you are also entitled to have us correct information about you that is incorrect. Fax completed form to: 512/416 -2536 Dorm 1560 62ov. 07112) )'nge.2of2 NOTES TO AGENTS: Agents must provide all requested information then either fax or mail this form directly to the address listed below. Pre - printed limits are the minimum required; if higher limits are provided by the policy, enter the higher limit amount and strike - through or cross -out the pre - printed limit. To avoid work suspension, an updated insurance form must reach the address listed below one business day prior to the expiration date. Insurance must be in force in order to perform any work. Binder numbers are not acceptable for policy numbers. The certificate of insurance, once on file with the department, is adequate for subsequent department contracts provided adequate coverage is still in effect. Do not refer to specific projects /contracts on this form. List the contractors legal company name, including the DBA (doing business as) name as the insured. If a staff leasing service is providing insurance to the contractor /client company, list the staff leasing service as the insured and show the contractor /client company in parenthesis. The TxDOT certificate of insurance form is the only acceptable proof of insurance for department contracts. List the contractor's legal company name, including the DBA (doing business as) name as the insured or list both the contractor and staff leasing service as insured when a staff leasing service is providing insurance. Over - stamping and /or over - typing entries on the certificate of insurance are not acceptable if such entries change the provisions of the certificate in any manner. This form may be reproduced. DO NOT COMPLETE THIS FORM UNLESS THE WORKERS' COMPENSATION POLICY IS ENDORSED WITH A WAIVER OF SUBROGATION IN FAVOR OF TXDOT. The SIGNATURE of the agent is required. CERTIFICATE OF INSURANCE REQUIREMENTS: WORKERS' COMPENSATION INSURANCE: The contractor is required to have Workers' Compensation Insurance if the contractor has any employees including relatives. • The word STATUTORY, under limits of liability, means that the insurer would pay benefits allowed under the Texas Workers' Compensation Law. GROUP HEALTH or ACCIDENT INSURANCE is not an acceptable substitute for Workers' Compensation. COMMERCIAL GENERAL LIABILITY INSURANCE: MANUFACTURERS' or CONTRACTOR LIABILITY INSURANCE is not an acceptable substitute for Comprehensive General Liability Insurance or Commercial General Liability Insurance. BUSINESS AUTOMOBILE POLICY: If coverages are specified separately, they must be at least these amounts: Bodily Injury $500,000 each occurrence $100,000 each occurrence Property Damage $100,000 for aggregate PRIVATE AUTOMOBILE LIABILITY INSURANCE is not an acceptable substitute for a Business Automobile Policy. MAIL ALL CERTIFICATES TO: Texas Department of Transportation CST — Contract Processing Unit (RA /200 -- 1st FI.) 125 E. 11th Street Austin, TX 78701 -2483 512/416 -2540 (Voice), 512/416 -2536 (Fax) Exhibit E Attachment A (FHWA Additional Requirements) VIII ATTACHMENT A Inasmuch as this project is on the Federal -Aid highway system, the following additional requirements as applicable with the Federal Highway Administration's Title 23, Code of Federal Regulations, § 710. 1. Any significant revision in the design or construction of the facility shall receive prior approval by the Texas Department of Transportation subject to concurrency by the FHWA. 2. Any change in the authorized use of airspace shall receive prior approval by the Texas Department of Transportation subject to concurrence by the FHWA. 3. The airspace shall not be transferred, assigned or conveyed to another party without prior Texas Department of Transportation approval subject to concurrence by the FHWA. 4. This agreement will be revocable in the event that the airspace facility ceases to be used or is abandoned. it