R2018-150 2018-08-27 RESOLUTION NO. R2018-150
A Resolution of the City Council of the City of Pearland, Texas, renewing a 5-
year agreement with the Texas Department of Transportation("TxDot")to host
the City's Annual Hometown Christmas Parade along portions of FM 518
beginning December 2018 and ending December 2022.
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PEARLAND, TEXAS:
Section 1. That certain 5-year agreement renewal with TxDot, a copy of which is
attached hereto as Exhibit"A", is hereby approved.
Section 2. The City Manager or his designee is hereby authorized to execute a contract
renewal with TxDot.
PASSED, APPROVED and ADOPTED this the 27th day of August, A.D., 2018.
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TOM REID
MAYOR
ATTEST:
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APPROVED AS TO FORM:
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DARRIN M. COKER
CITY ATTORNEY
Resoltuion No. R2018-150
® Exhibit"A" Form 1560-CS
Texas Department of Transportation (TxDOT) Professional Providerinsurance
03/13)
�'"" CERTIFICATE OF INSURANCE (Page 2of2
ori
(Previously Known As Form 1560-CSS)
This certificate of insurance is provided for Informational purposes only.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 referenced policies control over the terms of this certificate.
Prior to the beginning of work,the Contractor shall obtain the minimum insurance and endorsements specified. Only the TxDOT certificate of insurance form
is acceptable as proof of insurance for department contracts.Agents should complete the form providing all requested information then either fax or mail this
form directly to the address listed on page one of this form. Copies of endorsements listed below are not required as attachments to this certificate.
Insured: City of Pearland •
Street/Mailing Address: 3519 Liberty Dr
City: Pearland State: Texas Zip Code: 77581-5416
Phone Number: 281-652-1656 Vendor ID Number(11 digits):
Contractor/Client(if applicable):
Street/Mailing Address:
City: State: Zip Code:
Phone Number. Vendor ID Number(11 digits):
Workers'Compensation Insurance Coverage:
Endorsed with a Waiver of Subrogation in favor of TxDOT.
Carrier Name:Texas Municipal League Intergovernmental Risk Pool Carrier Phone Number. 800-537-6655
Address:1821 Rutherford Lane City: Austin State: TX Zip: 78754
Type of Insurance Policy Number Effective Date Expiration Date Limits of Liability
Workers'Compensation 6947 10/01/18 10/01/19 Not Less Than: Statutory-Texas
Commercial General Liability Insurance:
Carrier Name:Texas Municipal League Intergovernmental Risk Pool Carrier Phone Number: 800-537-6655
Address:1821 Rutherford Lane City: Austin State: TX Zip: 78754
Type of Insurance Policy Number Effective Date Expiration Date Limits of Liability
Commercial General 6947 10/01/18 10/01/19 Not Less Than:
Liability Insurance $500,000 each occurrence
• Bodily Injury
Property Damage $100,000 each occurrence
OR $100,000 for aggregate
Commercial General OR
Liability Insurance $600,000 combined single limit
Automobile Liability Insurance:
Carrier Name:Texas Municipal League Intergovernmental Risk Pool Carrier Phone Number. 800-537-6655
Address:1821 Rutherford Lane City: Austin State: TX Zip: 78754
Type of Insurance Policy Number Effective Date Expiration Date Limits of Liability
Business Automobile Policy 6947 10/01/18 10/01/19 Not Less Than:
Bodily Injury $250,000 each person
$500,000 each occurrence
Property Damage $100,000 each occurrence
Authorized Agent name, address and zip code:
Texas Municipal League Intergovernmental Risk Pool 1821 Rutherford Ln Austin,Texas 78754
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.
The Texas Department of Transportation maintains the information collected through this form. With few exceptions,you are entitled on request to be informed about
the information that we collect about you. Under sections 555.021 and 553.023 of the Texas Government Code,you also are entitled to receive and review the
information. Under section 559.004 of the Government Code,you are also entitled to have us correct information about you that is incorrect.
Area Code (512 ) 491-2300 :%dG* mac^ 07/18/18
Authorized Agent's Phone Number Original Signature of Authorized Agent Date
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Form 1560-CS
Texas Department of Transportation Professional Provider Insurance
,INSTRUCTIONS (Rev.°3'13'
Page 1 of 2
(Previously Known As Form 1560-CSS)
BEFORE YOU SUBMIT THIS FORM, MAKE SURE:
• You have the most current 1560-CS TxDOT form. Go to the following TxDOT Internet site:
• http•//www txdot gov/business/consultants/ins arance html then look for the Form 1560-CS.
• You have entered the 11-digit Vendor Identification Number,which includes your nine-digit FEIN (Federal Employer
Identification Number).
• You have entered each authorized agent's complete address,telephone number, policy expiration dates, sign and date.
• If more than one agent covers different types of insurance(one writes Workers'Compensation, but another writes
Auto), both have issued the certificate in its entirety.
• You have provided all requested information on the forms,which may be faxed but must be followed up with the
originally signed forms to the address listed below.
• The form is being submitted in connection with a professional services contract.
• For construction and maintenance contracts, go to the following TxDOT Internet site:
htt•://www.txdot.•ov/business/contractors/con rac .r-'nsurance.html then look for the Form 1560.
DO NOT COMPLETE THIS FORM UNLESS WORKERS'COMPENSATION IS ENDORSED WITH A WAIVER OF
SUBROGATION IN FAVOR OF TxDOT.
To avoid work suspension, an updated insurance form must reach the address listed below one business day
prior to the expiration date. List the contractor's legal company name, including the DBA(doing business as) name
as the insured. If a staff leasing service company is providing insurance, the staff leasing company name is shown
first as the named insured and then in parenthesis identify the contractor/client company (i.e. XYZ Staff 4 U,Inc.-staff
leasing service company (ABC Engineering, Inc.)). Show contact information (i.e. address, phone number, and etc.)
for the insured/staff leasing service company in the appropriate spaces. Show the contact information (i.e. address,
phone number, and etc.) for the contractor/client company in the appropriate° spaces. 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 or contracts on this form. Over-stamping or over-typing entries on the
certificate of insurance are not acceptable if they change the provisions of the certificate in any manner. Stamped,
typed, or printed signatures are not acceptable. 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. Binder
- numbers are not acceptable for policy numbers.
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:
If coverages are specified separately,they must be at least these amounts:
Bodily Injury $500,000 each occurrence
Property Damage $100,000 each occurrence
$100,000 for aggregate
MANUFACTURERS' or CONTRACTOR LIABILITY INSURANCE is not an acceptable substitute
for Comprehensive General Liability Insurance or Commercial General Liability Insurance.
BUSINESS AUTOMOBILE POLICY:
The coverage amount for a Business Automobile Policy may be shown as a minimum of$600,000 Combined Single
Limit by a typed orr printed entry and deletion of the specific amounts listed for Bodily Injury and Property Damage.
Personal Automobile Liability Insurance is not an acceptable substitute for a Business Automobile Policy. -
MAIL CERTIFICATES TO:
Texas Department of Transportation
Contract Services Office
125 E. 11th St.
Austin,TX 78701-2483
512-416-4620 (V) 512-416-4621 (F)