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25-R-037 Multiple Use Agreement TxDot-Automated License Plate RecognitionRESOLUTION NO. 25-R-037 A RESOLUTION BY THE CITY COUNCIL OF THE CITY OF SCHERTZ, TEXAS AUTHORIZING THE CITY MANAGER TO ENTER IN A MULTIPLE USE AGREEMENT WITH THE TEXAS DEPARTMENT OF TRANSPORTATION ALLOWING THE INSTALLATION AND OPERATION OF AUTOMATED LICENSE PLATE RECOGNITION CAMERAS IN TEXAS DEPARTMENT OF TRANSPORTAION RIGHT-OF-WAY; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, The City Council of the City of Schertz has determined the addition of Automatic License Plate Recognition (ALPR) Cameras will increase public safety and aid the Police Department in crime prevention efforts and strategies; the Police Department seeks to purchase ALPR parts and services from Flock Safety; and functions and services; and WHEREAS, the City Council desires to engage with the Texas Department of Transportation (TxDOT) and asks that Flock Safety be allowed to place ALPR Cameras in TxDOT right -of- way on behalf of the City of Schertz; and WHEREAS, the City Council finds it to be in the public interest to authorize the City Manager to sign Multiple -Use -Agreement with TxDOT. NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SCHERTZ, TEXAS THAT: Section 1. The City Council hereby authorizes the City Manager to enter into a Multiple - Use -Agreement with TxDOT for the installation and operation of ALPR Cameras in TxDOT right-of-way. Section 2. The recitals contained in the preamble hereof are hereby found to be true, and such recitals are hereby made a part of this Resolution for all purposes and are adopted as a part of the judgment and findings of the City Council. Section 3. All resolutions, or parts thereof, which are in conflict or inconsistent with any provision of this Resolution are hereby repealed to the extent of such conflict, and the provisions of this Resolution shall be and remain controlling as to the matters resolved herein. Section 4. This Resolution shall be construed and enforced in accordance with the laws of the State of Texas and the United States of America. Section 5. If any provision of this Resolution or the application thereof to any person or circumstance shall be held to be invalid, the remainder of this Resolution and the application of such provision to other persons and circumstances shall nevertheless be valid, and the City Council hereby declares that this Resolution would have been enacted without such invalid provision. Section 6. It is officially found, determined, and declared that the meeting at which this Resolution is adopted was open to the public and public notice of the time, place, and subject matter of the public business to be considered at such meeting, including this Resolution, was given, all as required by Chapter 551, Texas Government Code, as amended. Section 7. This Resolution shall be in force and effect from and after its final passage, and it is so resolved. I ';� PASSED AND ADOPTED, this J ATT T: City Secretary, S eila Edmondson day of , 2025. CITY OF SCHERTZ, TEYAS Gutierrez EXHIBIT A (Multiple Use Agreement with TxDOT, Installation of ALPR's) Form 2044 (Rev. 8121) Page 1 of 10 STATE OF TEXAS § COUNTY OF TRAVIS § MULTIPLE USE AGREEMENT 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 City of Schertz - Police Department hereinafter called City of Schertz party of the second part, is to become effective when fully executed by both parties. WITNESSETH WHEREAS, on the 1st day of April , 2025 , the governing body forthe City of Schertz entered into Resolution/Ordinance No. Resolution 25-R-037 hereinafter identified by reference, authorizing the City of Schertz 's participation in this agreement with the State; and WHEREAS, the City of Schertz has requested the State to permit the construction, maintenance and operation of public Automated License Plate Readers (ALPR) on the highway right of way, (ROADWAY See Attached CONTROL SECTION NO. N/A ). (General description of area including either the control number or GPS coordinates.) 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 City of Schertz will enter into ag reements with the State for the purpose of determining the respective responsibilities of the City of Schertz and the State with reference thereto, and conditioned that such uses are in the public interest and will not damage the highway facilities, impairsafety, 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. 8/21) Page 2 of 10 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 City of Schertz will prepare orprovideforthe construction plans forthe 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 afterpriorwritten approval of the State. Any sidewalks, curb ramps and other pedestrian elements to be constructed, either on site or off site, by the City of Schertz 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 City of Schertz and found not to comply with ADAorTAS shall be corrected at the entire expense of the- City of Schertz 2. INSPECTION Ingress and egressshall be allowed at all timestosuch facilityfor 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 greaterthan prescribed for 11/2 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. Forth 2044 (Rev. 8/21) Page 3 of 10 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 Timely maintenance, repair and operation of the facility shall be entirely the responsibility of the City of Schertz . Such responsibility shall not be transferred, assigned or conveyed to a third party without the advanced written approval of the State. These responsibilities expressly include the timely maintenance and repair of any portion of the facility necessary to comply with the Americans with Disabilities Act 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. If the State determines that City of Schertz has failed to comply with these responsibilities, it will perform the necessary work and charge City of Schertz the actual cost of the work. 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 City of Schertz shall maintain all books, documents, papers, accounting records and other evidence pertaining to fees collected and costs (hereinafter called the Records). The City of Schertz shall make the records available during the term of the Ag reement 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 B. Audit Report. If fees are collected by the City of Schertz for the use of the facility under this agreement, the City of Schertz will provide the State an annual audit report detailing the fees collected forthe use of the facility and the costs associated with constructing, maintaining, and operating the facility within the same period. If the report shows more fees collected than expenses for the construction, operation, or maintenance of the facility the City of Schertz must provide a multiple year plan detailing how the additional revenue will be used for construction, operation, or maintenance of the facility. Form 2044 (Rev. Ml) Paged of 10 C. 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 City of Schertz '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 party, all obligations herein to make improvements to said facility shall immediately cease and terminate and City of Schertz shall be responsible for the facility's timely removal at no cost to the State. If the State determines that City of Schertz has failed to timely remove the facility, it will perform the necessary work and charge City of Schertz the actual cost of the work. 8. MODIFICATIONITERMINATION OF AGREEMENT If in the sole judgment of the State it is found at any future time that traffic conditions have so changed thatthe existence oruse 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 City of Schertz shall provide written notification to the State that such facilitywill be discontinued for the purpose defined herein. The City of Schertz shall, within thirty (30) days from the date of said notification, clearthe 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 provisions of any existing agreements between the parties hereto. Form 2044 (Rev. 8/21) Page 5 of 10 12. INDEMNIFICATION THE City of Schertz WILL INDEMNIFY THE STATE AGAINST ANY AND ALL DAMAGES AND CLAIMS FOR DAMAGES, INCLUDING THOSE RESULTING FROM INJURY OR DEATH OF PERSONS OR FOR LOSS OF OR DAMAGE TO PROPERTY, ARISING OUT OF, INCIDENT TO OR IN ANY MANNER CONNECTED WITH THE CONSTRUCTION, OPERATION OR MAINTENANCE OF THE FACILITY, WHICH INDEMNIFICATION SHALL EXTEND TO AND INCLUDE ANY AND ALL COURT COSTS, ATTORNEY'S FEES AND EXPENSES RELATED TO OR CONNECTED WITH ANY CLAIMS OR SUITS FOR DAMAGES AND SHALL, IF REQUESTED IN WRITING BY THE STATE TO DO SO, ASSIST THE STATE, OR RELIEVE THE STATE FROM DEFENDING ANY SUCH SUITS BROUGHT AGAINST IT. THE INDEMNIFICATION OF THE STATE SHALL EXTEND FOR A PERIOD OF TWO (2) YEARS BEYOND THE DATE OF TERMINATION OF THIS AGREEMENT. DURING EACH YEAR WHILE THERE IS ANY LIABILITY BY REASON OF THE AGREEMENT CONTAINED IN THIS SUBSECTION OF THIS RESOLUTION, INCLUDING THE CALENDAR YEAR 2025 THE CITY OF SCHERTZ (CITY) SHALL COMPUTE AND ASCERTAIN THE RATE AND AMOUNT OF AD VALOREM TAX, BASED ON THE LATEST APPROVED TAX ROLLS OF SAID ENTITY, WITH FULL ALLOWANCES BEING MADE FOR TAX DELINQUENCIES AND COSTS OF TAX COLLECTION, WHICH WILL BE SUFFICIENT TO RAISE AND PRODUCE THE MONEY REQUIRED TO PAY ANY SUMS WHICH MAY BE OR BECOME DUE DURING ANY SUCH YEAR, IN NO INSTANCE TO BE LESS THAN TWO (2%) PER CENT OF SUCH OBLIGATION, TOGETHER WITH INTEREST THEREON, BECAUSE OF THE OBLIGATION HEREIN ASSUMED. SAID RATE AND AMOUNT OF AD VALOREM TAX IS HEREBY ORDERED TO BE LEVIED AND IS HEREBY LEVIED AGAINST ALL TAXABLE PROPERTY IN SAID ENTITY FOR EACH YEAR WHILE ANY LIABILITY EXISTS BY REASON OF THE OBLIGATION UNDERTAKEN BY THIS SUBSECTION OF THIS RESOLUTION, AND SAID AD VALOREM TAX SHALL BE ASSESSED AND COLLECTED EACH SUCH YEAR UNTIL ALL OF THE OBLIGATIONS HEREIN INCURRED SHALL HAVE BEEN DISCHARGED AND ALL LIABILITY HEREUNDER DISCHARGED. No party to this agreement intends to waive, relinquish, limit or condition its general g overn mental immunity from liability in any way. Each party agrees and acknowledges that it is not an agent, servant, oremployee of the other party and that under this provision each party is responsible only for its own acts and for those of its agents, servants, independent contractors or employees. Such responsibility includes, but is not Form 2044 (Rev. 8/21) Page $ of 10 limited to any claims or amounts arising or recovered and er the "Workers Compensation Law, ° the Texas Tort Claims Act, Chapter 101, Texas Civil Practice and Remedies Code; or any other applicable laws or regulations, all as time to time may be amended. Nothing in this ag reement shall be construed as creating any liability in favor of any third party against the State and the City of Schertz . Additionally, this agreement shall not ever be construed as relieving any third party from any liability againstthe State. Furthermore, the City of Schertz shall become fully subrogated to the State's rights of recovery and shall be entitled to maintain any action over and against any third party who maybe liable for damages. The State agrees to execute and deliver instruments and papers and to otherwise do that which is necessary to secure such rights. 13. INSURANCE The City of Schertz , shall provide necessary safeguards to protectthe public on State maintained highways including adequate insurance for payment of any damages which might result d uring the constriction, maintenance, repair and operation of the facility. City of Schertz shall include TxDOT as an additional insured by endorsement in City of Schertz is commercial general liability insurance policy. Prior to beginning work on the State's right of way, the City of Schertz 's construction contractor shall submit to the State a completed insurance form (TxDOT Form No. 1560) or appropriate certificate of self-insurance and shall maintain the required coverage during the construction of the facility. 14. USE OF RIGHT OF WAY It is understood that the State by execution of this agreement does not impair or relinq uish the State's right to use such land for highway purposes when it is required forthe construction or re -construction of the traffic facility forwhich it was acquired, nor shall use of the land under such agreement ever be construed as abandonment by the State of such land 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. 15. ADDITIONAL CONSENT REQUIRED The State asserts only that it has sufficient title for highway purposes. The City of Schertz shall be responsiblefor 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, ADAand public utilities. 16. 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 FederEd Regulations, § 710, shall be attached to and become a partof this agreement. Form 2044 (Rev. 8/21) Page 7 of 10 17.CIVIL RIGHTS ASSURANCES The. City of Schertz _, 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 land 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 City of Schertz 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, Nan -discrimination in Federally -Assisted programs of the Department of Transportation - Effectuation of Title VI of the Civil Rights Actof 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 land and the facilities thereon, and hold the same as if said ag reement had never been made or issued. 18. 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. 19. 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 thisagreement 20. AUDIT The State may conduct an audit or investigation of any aspect of this agreement. The City of Schertz 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 City of Schertz if that service is authorized by this agreement. Form 2044 (Rev. 8P21) Page 8 of 10 21. AUTHORITY OF STATE AUDITOR The state auditor may conduct an auditor investigation of any entity receiving funds from the state directly under the contractor indirectly through a subcontract under the contract. Acceptance of funds directly under the contractor indirectly through as ubcontract 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 subjectof an and it or investigation must provide the state auditorwith access to any information the state and itor considers relevantto the investigation or audit 22. NOTICES All notices required under this agreement shall be mailed or hand delivered to the following respective addresses: STATE (Mailing Address) Texas Department of Transportation Maintenance Division 125 East 11th Street Austin, Texas 78701-2483 23. TIMELY PAYMENT (Name of other party) (Mailing Address) City of Schertz Police Department 1400 Schertz Parkway Bldg. 6 Schertz, Texas 78154 When required by any provision of this agreement requires a paymentto be made to the State, the other party hereto shall within thirty (30) days from receipt of the State'swritten notification pay the State forthe full cost of repairing any damages to the highway facility which may resultfrom the other party's construction, maintenance, repairor operation of the facility. 24. 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: ExhibitA-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. 8/21) Page 9 of 10 IN WITNESS WHEREOF, the parties have hereunto affixed their signature, the on the 1st day of April 120 25 and the State on the day of _ 20 25 By; City of Schertz (Name of other party) Signature Steve Williams Printed Name City Manger Title Schertz Police Department Agency 210-619-1200 Contact Office and Telephone No STATE OF TEXAS Executed and approved for the Texas Transportation Commission forthe purpose and effect of activating and/or carrying out the orders, and established policies or work programs heretofore approved and authorized by the Texas Transportation Commission. 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V fw r-q'5 XgQa r' WH U .g3 erwimr -I r . + ��.+• . t...r . c• . -- .� Cr } _s t 7��9�_ 3��a�o�g3��s a 9� Yj$e $Js T-S4 ., 4 oil sill ^.v `n galas 2! m � IR T r = 38 9i fill g � jq alo t_ -•�r f i14' p s l A41 t $ - o�g'o z�a, ��o�a,�o�o ale�o,�el•a-g Si11ay�i �838�S.S e .I ' fi- i hwrremm nf.momrw.ioxm WME.DmWmAwoWmftA�MV vs m Z K D ODcm m =_myuo z Oz N zo0�'i z O Z wrc� f1 E� I Nall aka B Z x aqua• �C;^x-�� � �•�x a m 2F n r W tp `fa ` O � 1n 1Ai1 a .za . a$y• a�; �x; - V ' g ;35g3x 13 A s1NIH#Qlc3Djgl d � s � 334aSe33$g�g��?Pg�a95�a�6ya.� s e� o 4A alas$°9;-3�aji =fig N vea; � s H EXHIBIT D (Certificate of Insurance (TxDOT Form 1560) TM CERTIFICATE OF INSURANCE Form1560 (Rev. 07124) Previous editions of this form may not be used. Y Page 1 of 2 Agents should complete this form by providing all requested infomnation, than either email, fax, or mail this form as noted at the bottom of page two Copies of endorsements listed below are not required as attachments to this certificate. This certificate is Issued as a matter 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: Flock Group Inc DBA Flock Safety StreetlMailing Address: 1170 Howell Mill Rd NW CRy/StatgfZip: Atlanta, Georgia 30318 Phone Number: ( 866 ) 901 - 1781 WORKERS' COMPENSATION INSURANCE COVERAGE: Endorsed with a Waiver of Subrogation in favor of TxDOT. Carrier Name: Travelers Property Casualty Company of America Carrier Phone #: ( 4] 5 ) 732 - 1400 Address: 100 California St. I City, State, Zip: San Francisco, CA 94111 Type of Insurance Policy Number Effective Bate Expiration Date ILimits of Liability: Workers' Compensation UMT346569-24-13-G 08,23/2024 08/23/2025 Not Less Than: Statutory - Texas COMMERCIAL GENERAL LIABILITY INSURANCE: Carrier Name: Travelers Property Casualty Company of America Carrier Phone #: ( 415 ) 732 - 1400 Address: 100 California St. ity, Staff 2a : San Francisco, CA 94111 Type of Insurance: Policy Number. Effective Date: Expiration Data: Limits of Liability: Commercial General H-630-9W194831 TIL-24 08/23R024 08123t2025 Not Low Than: Liability Insurance $ 600,000 each occurrence BUSINESS AUTOMOBILE POLICY: Carrier Name: Travelers Property Casualty Company of America rri r Phone #: ( 415 ) 732- 1400 Address: 100 Califomia St City Stge, Zip: San Francisco, CA 94111 Type of Insurance: Policy Number: Effective Date: I Expiration Date: I Limits of Uabllity: Business Automobile Policy 810.6T343696-24-13-G 08232024 UMBRELLA POLICY (if applicable): Carrier Name: Travelers Property Casualty Company of America Address: 100 Califomia St. Type of Insurance: Policy Number: Effective Daw Umbrella Policy CUP-6T3869242443 08232024 0823/2025 Not Less Than: $ 600,000 combined single limit Carrier Phone #: ( 415 ) 732 - 1400 City, State, Zip: San Francisco, CA 94111 Expiration Date: Limits of Liability: 08232025 10=000 Should any of the above described policies be cancelled before the expiration date thereof, notice win 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. tf this farm Is sent by facsimile machine (fax), the sender adopts the document received by 7kDOT as a duplicate original and adopts the signature produced by the recehring fax machine as the senders origins! signature. Agency Name Address City, State, Zip Code Marsh Risk & Insurance Services Four Ebarcadero Center, Suite 1100 San Francisco, CA 94111 ( 415 ) 215 - 0717 10/082024 Authorized Agent's Phone Number Authorized Agent Original Signature Date 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 coiled about you. Under §§552.021 and 552.023 of the Texas Govemment 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 Form 1560 (Rev. D7124) Page 2 of 2 NOTES TO AGENTS: Agents must provide all requested information then either email, fax, or mail this form as noted below. Pre-printed limits are the minimum required; if higher limits are provided by the policy, enter the higher limit amount on an Acord Form. 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 contractor's 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 Texas Department of Insurance (TDI) approved forms are the only acceptable proof of insurance for department contracts. The preferred Certificate of Insurance (COI) is on a 1560 or Acord form. 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. 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 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. Completed forms may be submitted by any of the following methods: Email: CST Insurance@txdot.gov Fax: (512) 416-2536 Mail: Texas Department of Transportation CST — Contract Processing 125 E. 11th Street Austin, TX 78701-2483 EXHIBIT E (Attachment A — FHWA Additional Requirements) Form 2044 (Rev. 8121) Page 10 of 10 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, § 710A05. 1. Any sig nificant 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 real property interest shall receive prior approval by the Texas Department of Transportation subject to concurrence by the FHWA. 3. Real property interest 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 real property interest facility ceases to be used or is abandoned.