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HomeMy WebLinkAboutResolution - 2021-R0303 - Contract 15949 with Blackstone Concrete Ventures, LLC 8.24.21Resolution No. 2021-R0303 Item No. 7.17 August 24, 2021 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock, Public Works Contract No. 15949 for concrete on Mac Davis Lane as per ITB 21-15949-JM, by and between the City of Lubbock and Blackstone Concrete Ventures, of Lubbock, Texas, and related documents. Said Contract is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council on August 24, 2021 t1- DANIEL M. POPE, MAYOR A ST: -TJA�) Reb cca Garza, City Secretary APPROVED AS TO CONTENT: ca cEachern, Assistant City Manager APPROVED AS TO FORM: f/A a 11� 7"144� --- Aelli Leisure, Assistant City Attorney ccdocs/RES.Contract 15949 -- Mac Davis Concrete 08.02.21 BID SUBMITTAL FORM BID CONTRACT DATE: 04�gt-/ PROJECT NUMBER: ITB 21-15949-JM, Concrete on Mac Davis Lane Bid of Bidder) (hereinafter called To the Honorable Mayor and City Council City of Lubbock, Texas (hereinafter called Owner) Ladies and Gentlemen: The Bidder, in compliance with your Invitation to Bid for the construction of the referenced project, having carefully examined the plans, specifications, instructions to bidders, notice to bidders and all other related contract documents and the site of the intended work, and being familiar with all of the conditions surrounding the construction of the intended project including the availability of materials and labor, hereby intends to furnish all labor, materials, and supplies; and to construct the project in accordance with the plans, specifications and contract documents, within the time set forth therein and at the price stated. The bidder binds himself on acceptance of his bid to execute a contract and any required bonds, according to the accompanying forms, for performing and completing the said work within the time stated and for the prices stated. Offeror hereby agrees to commence the work on the above project on a date to be specified in a written "Notice to Proceed" of the Owner and to substantially complete the project within 60 Days as stipulated in the specification and other contract documents. Offeror hereby further agrees to pay to Owner as liquidated damages in the sum of $1,204.28 for each consecutive calendar day after substantial completion set forth herein above for completion of this project, all as more fully set forth in the General Conditions of the Agreement. Bidder understands and agrees that this bid submittal shall be completed and submitted in accordance with instruction number 29 of the General Instructions to Bidders. Bidder understands that the Owner reserves the right to reject any or all bids and to waive any formality in the bidding. The Bidder agrees that this bid shall be good and may not be withdrawn for a period of 60 calendar days after the scheduled closing time for receiving bids. The undersigned Bidder hereby declares that he has visited the site of the work and has carefully examined the plans, specifications and contract documents pertaining to the work covered by this bid, and he further agrees to commence work on or before the date specified in the written notice to proceed, and to substantially complete the work on which he has bid; as provided in the contract documents. Bidders are required, whether or not a payment or performance bond is required, to submit a cashier's check or certified check issued by a bank satisfactory to the City of Lubbock, or a bid bond from a reliable surety company, payable without recourse to the order of the City of Lubbock in an amount not less than five percent (5%) of the total amount of the bid submitted as a guarantee that bidder will enter into a contract, obtain all required insurance policies, and execute all necessary bonds (if required) within 10 business days after notice of award of the contract to him. City of Lubbock Public Works ITB 21-15949-JM Concrete on Mac Davis Lane Blackstone Concrete Ventures, Lubbock TX Quantity UOM Extended Cost Item Description Class "C" Concrete (3600 PSI in 28 days) Reinforced (ref. section 8.07.12 for #0-1 specifications for reinforcement Information); 4500 SY $ 540,000 Including Labor, equipment, removal and disposal of Existing Materials, subgrade prep, saw cut joints, complete and in Place.) #0-8 Mobilization 1 EA 53,250 Total: $ 593,250 Enclosed with this bid is a Cashier's Check or Certified Check for Dollars ($ ) or a Bid Bond in the sum of _ Dollars ($ Apbp , which it is agreed shall be collected and retained -by the Owner as liquidated damages in the event the bid is accepted by the Owner and the undersigned fails to execute the necessary contract documents, insurance certificates, and the required bond (if any) with the Owner within 10 business days after the date of receipt of written notification of acceptance of said bid; otherwise, said check or bond shall be returned to the undersigned upon demand. Bidder understands and agrees that the contract to be executed by Bidder shall be bound and include all contract documents made available to him for his inspection in accordance with the Notice to Bidders. Pursuant to Texas Local Government Code 252.043(g), a competitive sealed bid that has been opened may not be changed for the purpose of correcting an error in the bid price. THEREFORE, ANY CORRECTIONS TO THE BID PRICE MUST BE MADE ON THE BID SUBMITTAL FORM PRIOR TO BID OPENING. (Seal if Bidder is a Corporation) ATTEST: Secretary Bidder acknowledges receipt of the following addenda: Addenda No. 1 Addenda No. _ Addenda No. _ Addenda No. Date 7/23/2021 Date Date Date Date:0�� f 6Auhorize Si ature (Printed or Typed Nard7e Company Address Cit County State Zip Code Telephone: Fax: FEDERAL TAX ID or SOCIAL SECURITY No. EMAIL: !7tWfi itM►iCi4ET�. GO+�. NMBE oman Black American Native American Firm: ispanic Asian Pacific Other pec� American American INSURANCE REQUIREMENTS 1, the undersigned Bidder certify that the insurance requirements contained in this bid document have been reviewed by me and my Insurance Agent/Broker. If I am awarded this contract by the City of Lubbock, I will be able to, within ten (10) business days after being notified of such award by the City of Lubbock, furnish a valid insurance certificate to the City meeting all of the requirements defined in this bid. If the time requirement specified above is not met, the City has the right to reject this proposal and award the contract to another contractor. If you have any questions concerning these requirements, please contact the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572. SUSPENSION AND DEBARMENT CERTIFICATION Federal Law (A-102 Common Rule and OMB Circular A-110) prohibits non -Federal entities from contracting with or making sub -awards under covered transactions to parties that are suspended or debarred or whose principals are suspended or debarred. Covered transactions include procurement contracts for goods or services equal to or in excess of $25,000 and all non -procurement transactions (e.g., sub -awards to sub - recipients). Contractors receiving individual awards of $25,000 or more and all sub -recipients must certify that their organization and its principals are not suspended or debarred by a Federal agency. Before an award of $25,000 or more can be made to your firm, you must certify that your organization and its principals are not suspended or debarred by a Federal agency. I, the undersigned agent for the firm named below, certify that neither this firm nor its principals are suspended or debarred by a Federal agency. TEXAS GOVERNMENT CODE SECTION 2252.152 The undersigned representative of the undersigned company or business, being an adult over the age of eighteen (18) years of age, pursuant to Texas Government Code, Chapter 2252, Section 2252.152, certify that the company named above is not listed on the website of the Comptroller of the State of Texas concerning the listing of companies that are identified under Section 806.051, Section 807.051 or Section 2253.153. 1 further certify that should the above -named company enter into a contract that is on said listing of companies on the website of the Comptroller of the State of Texas, which do business with Iran, Sudan or any Foreign Terrorist Organization, I will immediately notify the City of Lubbock Purchasing and Contract Department. TEXAS GOVERNMENT CODE SECTION 2271.002 Company hereby certifies the following: 1. Company does not boycott Israel; and 2. Company will not boycott Israel during the term of the contract. The following definitions apply to this state statute: (1) "Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business purposes; and (2) "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent company, or affiliate of those entities or business associations that exists to make a profit. This Certification is required from a Company if the Company has 10 or more full-time employees and the contract for goods or services (which includes contracts formed through purchase orders) has a value of $100,000 or more that is to be paid wholly or partly from public funds of the governmental entity. _Agreement Example Review This sample Agreement has been reviewed and (V jis acceptable ( ) is acceptable as noted Contractor Acknowledgement In compliance with this solicitation, the undersigned bidder, having examined the bid documents, instructions to bidders, documents associated with the invitation to bid, and being familiar with the conditions to be met has reviewed the above information regarding: • Insurance Requirements • Suspension and Debarment Certification • Texas Government Code Section 2252.152 • Texas Government Code Section 2271.002 An individual authorized to bind the company must sign the following section. Failure to execute this portion may result in bid rejection. By signing below, the terms stated have been reviewed and approved. Company Name: O&NA *Tvrl-r IDAIC,"M9 Vi -VlFs. LLB, Signed By: Print Name and Title: f f l& K ff l i T Date: CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2021-783840 Blackstone Concrete Ventures, LLC Lubbock, TX United States Date Filed: 07/28/2021 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. ITB 21-15949-JM Concrete on Mac Davis Lane (BT-56PV) 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Marquez, Hugo Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is J (-sl 1"f l l- ✓1 All -to My address is 1-��rJ�CIc l (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in C County, State of -,on the L day of J�-( - 7 20_j�_. (nnont) (year) Signature of authoriz d agent of contracting business entity eclarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.ceffd98a CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1 - 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2021-783840 Blackstone Concrete Ventures, LLC Lubbock, TX United States Date Filed: 07/28/2021 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Date Acknowledged: g Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. ITB 21-15949-JM Concrete on Mac Davis Lane (BT-56PV) 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Marquez, Hugo Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is and my date of birth is My address is (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of on the day of , 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.ceffd98a BOND CHECK BEST RATING LICENSED IN TEXAS DATE BY: CONTRACT AWARD DATE: August 24, 2021 CITY OF LUBBOCK SPECIFICATIONS FOR CONCRETE ON MAC DAVIS LANE RFP 21-15949-JM CONTRACT: 15949 PROJECT NUMBER: 92697.9240.30000 Plans & Specifications may be obtained from https://ci-lubbock-tx.bonfirehub.com/ City of Lubbock TEXAS CITY OF LUBBOCK Lubbock, Texas Page Intentionally Left Blank ADDENDUM Page Intentionally Left Blank ME� (itv of bubock iFM4 ADDENDUM I Clarifications & O&A's RFP 21-15949-JM Concrete on Mac Davis Lane DATE ISSUED: July 23, 2021 CLOSE DATE: July 29, 2021 at 3:00 p.m. The following items take precedence over specifications for the above named Request for Proposals (RFP). Where any item called for in the RFP documents is supplemented here, the original requirements, not affected by this addendum, shall remain in effect. Please review, incorporate, and acknowledge the information in this addendum on the signature page of the Proposal Submittal Form. Clarifications 1. Bid Description REVISION INFORMATION: DELETE: Concrete Paving, 8" Class "C" Concrete (3600 PSI in 28 days) Reinforced (ref. section 8.7.12 for specifications for reinforcement Information); Including Labor, equipment, removal and disposal of Existing Materials, subgrade prep, saw cut joints, complete and in Place.) REPLACE WITH:" Class "C" Concrete (3600 PSI in 28 days) Reinforced (ref. section 8.07.12 for specifications for reinforcement Information); Including Labor, equipment, removal and disposal of Existing Materials, subgrade prep, saw cut joints, complete and in Place.) 2. Q&A's Q. There are no plans in specifications. A. There are no plans for this project. Q. There is no section 8.7.12 as specified in ITB 21 under bid table. A. The bid form has been correct to reflect 8.07.12 Q. No reinforcement sizes are specified for 8" thick concrete. A. Use specifications for 7" concrete. Q. Will the contractor be responsible to transport the asphalt and where? A. Yes to the city land fill and the inspector will show you where to go. Q. Does the asphalt that is removed need to be milled? A. If possible but is not required. Q. Can two sack concrete be used? A. No only Class "C" Concrete. Q. Can a line item be provided for additional excavation and material replacement if subsurface material is not approved? A. If additional excavation is needed we will take it out to a depth of 7" as specified in the bid form. All requests for additional information or clarification must be submitted in writing and directed to: Jessie Montes, Buyer III City of Lubbock Purchasing and Contracts Management Office 1314 Avenue K, Floor 9 Lubbock, Texas 79401 Questions may be faxed to (806)775-2164 or Email to JMonteskmylubbock.us Questions are preferred to be posted on BidSync: www.bidsync.com THANK YOU, P"& 4gad CITY OF LUBBOCK Jessie Montes Buyer III City of Lubbock Purchasing and Contracts Management Office It is the intent and purpose of the City of Lubbock that this request permits competitive proposals. It shall be the offeror's responsibility to advise the Director of Purchasing and Contract Management if and language, requirements, etc., or any combinations thereof, inadvertently restricts or limits the requirements stated in this RFP to a single source. Such notification must be submitted in writing and must be received by the Director of Purchasing and Contract Management no later than five (5) business days prior to the close date. A review of such notifications will be made. 2 1. NOTICE TO BIDDERS 2. GENERAL INSTRUCTIONS TO BIDDERS 3. BID SUBMITTAL — (must be submitted by published due date & time) 3-1. BID SUBMITTAL FORM 3-2. CITY OF LUBBOCK REFERENCE FORM 3-3. CITY OF LUBBOCK INSURANCE REQUIREMENT AFFIDAVIT 3-4. SAFETY RECORD QUESTIONNAIRE 3-5. SUSPENSION AND DEBARMENT CERTIFICATION 3-6. PROHIBITION ON CONTRACTS WITH COMPANIES BOYCOTTING ISRAEL VERIFICATION 4. LIST OF SUB -CONTRACTORS 5. PAYMENT BOND 6. PERFORMANCE BOND 7. CERTIFICATE OF INSURANCE 8. CONTRACT 9. CONFLICT OF INTEREST QUESTIONNAIRE CHAPTER 176 10. CHAPTER 46. DISCLOSURE OF INTERESTED PARTIES 11. GENERAL CONDITIONS OF THE AGREEMENT 12. CITY OF LUBBOCK WAGE DETERMINATIONS 13. SPECIAL CONDITIONS (IF APPLICABLE) 14. SPECIFICATIONS 2 Page Intentionally Left Blank NOTICE TO BIDDERS Page Intentionally Left Blank City of Lubbock TEXAS ITB 21-15949-JM Concrete on Mac Davis Lane 1. NOTICE TO BIDDERS 1.1. Bidders may submit responses electronically by uploading required documents at the City of Lubbock's partner website, Bonfire. This Invitation to Bid is for your convenience in submitting a bid for the specified project. 1.2. Electronic bids will be opened in the office of the Director of Purchasing and Contract Management, Citizens Tower, 1314 Avenue K, Floor 9, Lubbock, Texas, 79401, and via teleconference as shown below at 3:00 PM on July 29, 2021, or as changed by the issuance of formal addenda to all planholders, to furnish all labor and materials and perform all work for the construction of the above referenced. 1.3. After the expiration of the time and date above first written, said sealed bids will be opened in the office of the Director of Purchasing and Contract Management and publicly read aloud. Bids will be opened via teleconference if date/time stamped on or before the deadline stated at the office listed above. The Zoom meeting information is as follows: Website: https://zoom.us/i/9759171012?pwd=bkFtRTNIcXV1SkhWdkZiMDk4MXh2dzO9 Meeting ID: 975 917 1012 Passcode: 1314 1.4. It is the sole responsibility of the bidder to ensure that his bid is actually received by the office of the Director of Purchasing and Contract Management for the City of Lubbock, before the expiration of the date above first written. Any bid received after the date and hour specified will be rejected and returned unopened to the bidder. 1.5. Bids are due at 3:00 PM on July 29, 2021, and the City of Lubbock Council members will consider the bids on September 28, 2021, at the Citizens Tower, 1314 Avenue K, Lubbock, Texas, or as soon thereafter as may be reasonably convenient, subject to the right to reject any or all bids and waive any formalities. The successful bidder will be required to furnish a performance bond in accordance with Chapter 2253, Government Code, in the amount of 100% of the total contract price in the event that said contract price exceeds $100,000 and the successful bidder will be required to furnish a payment bond in accordance with Chapter 2253, Government Code, in the amount of 100% of the total contract price in the event that said contract price exceeds $50,000. Said statutory bonds shall be issued by a company carrying a current Best Rating of "A" or better. THE BONDS MUST BE IN A FORM ACCEPTABLE TO THE CITY ATTORNEY. NO WORK ON THE CONTRACT SHOULD COMMENCE BEFORE THE BONDS ARE PROVIDED AND APPROVED. 1.6. Please allow time to upload required documentation. 24hrs in advance is recommended. 1.7. The estimated budget for this project is $600,000 1.8. Bidders are required, whether or not a payment or performance bond is required, to submit a cashier's or certified check issued by a bank satisfactory to the City of Lubbock, or a proposal bond from a reliable surety company, payable without recourse to the order of the City of Lubbock in an amount not less than 5% of the total amount of the proposal submitted as a guarantee that bidder will enter into a contract and execute all necessary bonds within ten (10) business days after notice of award of the contract to the bidder. FAILURE OF THE BIDDER TO INCLUDE BID SECURITY WITH THE BID SUBMITTAL SHALL CONSTITUTE A NONRESPONSIVE BID AND RESULT IN DISQUALIFICATION OF THE BID SUBMITTAL. 1.9. Copies of plans and specifications may be obtained at bidder's expense from the City of Lubbock Purchasing and Contract Management office. Plans and specifications can be viewed online and downloaded from https://ci-lbbock-tx.bonfirchub.com/portal/ at no cost. In the event of a large file size, please be patient when downloading or viewing. BUSINESSES WITHOUT INTERNET ACCESS may use computers available at most public libraries. 1.10. It shall be each bidder's sole responsibility to inspect the site of the work and to inform bidder regarding all local conditions under which the work is to be done. It shall be understood and agreed that all such factors have been thoroughly investigated and considered in the preparation of the bid submitted. 2. PRE -BID MEETING 2.1. For the purpose of familiarizing bidders with the requirements, answering questions, and issuing addenda as needed for the clarification of the Invitation to Bid (ITB) documents, a non -mandatory pre -bid meeting will be held July 22, 2021 at 10:00 a.m., via teleconference. The Zoom meeting information is as follows: Website: https:Hzoom.us/I/9759171012?pwd=bkFtRTNIcXVlSkhWdkZiMDk4MXh2dzO9 Meeting ID: 975 917 1012 Passcode: 1314 2.2. All persons attending the meeting will be asked to identify themselves and the prospective bidder they represent. 2.3. It is the bidder's responsibility to attend the pre -bid meeting though the meeting is not mandatory. The City will not be responsible for providing information discussed at the pre -bid meeting to bidders who do not attend the pre -bid meeting. 3. Attention of each bidder is particularly called to the schedule of general prevailing rate of per diem wages included in the contract documents on file in the office of the Purchasing and Contract Management Office of the City of Lubbock, which document is specifically referred to in this notice to bidders. Each bidders attention is further directed to Texas Government Code, Chapter 2258, Prevailing Wage Rates, and the requirements contained therein concerning the above wage scale and payment by the contractor of the prevailing rates of wages as heretofore established by owner in said wage scale. 4. The City of Lubbock hereby notifies all bidders that in regard to any contract entered into pursuant to this advertisement, minority and women business enterprises will be afforded equal opportunities to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, sex, disability, or national origin in consideration for an award. 5. The City of Lubbock does not discriminate against persons with disabilities. City of Lubbock pre -proposal meetings and proposal openings are available to all persons regardless of disability. If you require special assistance, please contact the Purchasing and Contract Management Office at (806) 775-2572 write to Post Office Box 2000, Lubbock, Texas 79457 at least 48 hours in advance of the meeting. CITY OF LUBBOCK, Marta Alvarez DIRECTOR OF PURCHASING & CONTRACT MANAGEMENT Page Intentionally Left Blank GENERAL INSTRUCTIONS TO BIDDERS Page Intentionally Left Blank GENERAL INSTRUCTIONS TO BIDDERS 1. BIDDER INQUIRIES AND CLARIFICATION OF REQUIREMENTS 1.1 It is the intent and purpose of the City of Lubbock that this request permit competitive bids. It shall be the bidder's responsibility to advise the Purchasing and Contract Management Office if any language, requirements, etc., or any combinations thereof, inadvertently restricts or limits the requirements stated in this ITB to a single source. Such notification must be submitted in writing and must be received by the City of Lubbock Purchasing and Contract Management Office no later than five (5) calendar days before the bid closing date. A review of such notifications will be made. 1.2 NO BIDDER SHALL REQUEST ANY INFORMATION VERBALLY. ALL REQUESTS FOR ADDITIONAL INFORMATION OR CLARIFICATION CONCERNING THIS INVITATION TO BID (ITB) MUST BE SUBMITTED IN WRITING NO LATER THAN FIVE (5) CALENDAR DAYS PRIOR TO THE BID CLOSING DATE AND ADDRESSED TO: Jessie Montes, Buyer III City of Lubbock Purchasing and Contract Management Office 1314 Avenue K, Floor 9 Lubbock, Texas 79401 Fax: 806-775-2164 Email: JMontes@mylubbock.us 2. TIME AND ORDER FOR COMPLETION 2.1 The construction covered by the contract documents shall be substantially completed within 60 Days from the date specified in the Notice to Proceed issued by the City of Lubbock to the successful bidder. 2.2 The Contractor will be permitted to prosecute the work in the order of his own choosing, provided, however, the City reserves the right to require the Contractor to submit a progress schedule of the work contemplated by the contract documents. In the event the City requires a progress schedule to be submitted, and it is determined by the City that the progress of the work is not in accordance with the progress schedule so submitted, the City may direct the Contractor to take such action as the City deems necessary to ensure completion of the project within the time specified. 2.3 Upon receipt of notice to proceed, and upon commencement of the work, the Contractor shall ensure daily prosecution of the work is conducted every business day until the work is completed, regardless if the work will be substantially or finally complete ahead of specified deadlines in the agreement, unless the City determines time off from said prosecution is necessary or reasonable and Contractor received said determination in writing from the City. Additionally, inclement weather shall be the only other reason consistent, daily prosecution of the work may not take place on those inclement weather days. 3. GUARANTEES 3.1 All equipment and materials incorporated in the project and all construction shall be guaranteed against defective materials and workmanship. Prior to final acceptance, the Contractor shall furnish to the Owner, a written general guarantee which shall provide that the Contractor shall remedy any defects in the work, and pay for any and all damages of any nature whatsoever resulting in such defects, when such defects appear within ONE year from date of final acceptance of the work as a result of defective materials or workmanship, at no cost to the Owner (City of Lubbock). 3.2 Notwithstanding any provisions contained in the contractual agreement, the Contractor represents and warrants fault -free performance and fault -free result in the processing date and date -related data (including, but not limited to calculating, comparing and sequencing) of all hardware, software and firmware products delivered and services provided under this Contract, individually or in combination, as the case may be from the effective date of this Contract. Also, the Contractor warrants calculations will be recognized and accommodated and will not, in any way, result in hardware, software or firmware failure. The City of Lubbock, at its sole option, may require the Contractor, at any time, to demonstrate the procedures it intends to follow in order to comply with all the obligations contained herein. 3.3 The obligations contained herein apply to products and services provided by the Contractor, its sub- contractor or any third party involved in the creation or development of the products and services to be delivered to the City of Lubbock under this Contract. Failure to comply with any of the obligations contained herein, may result in the City of Lubbock availing itself of any of its rights under the law and under this Contract including, but not limited to, its right pertaining to termination or default. 3.4 The warranties contained herein are separate and discrete from any other warranties specified in this Contract, and are not subject to any disclaimer of warranty, implied or expressed, or limitation to the Contractor's liability which may be specified in this Contract, its appendices, its schedules, its annexes or any document incorporated in this Contract by reference. 4. BID AWARD 4.1 The City of Lubbock reserves the right to reject any or all bids, reject any particular item on a bid, and to waive immaterial formalities and to accept the offer most advantageous to the City of Lubbock in its sole discretion. Unless otherwise specified herein, the City shall award the bid based on the total bid for Bid Items One (1) through Two (2) plus the sum of any Alternate Bids or Options the City may select. 4.2 All bids are evaluated for compliance with specifications before the bid price is considered. Response to specifications is primary in determining the best low bid. Failure to comply with the specifications may result in disqualification of the bid. 4.3 In case of tie bids, preference will be given to local bidders. Consistent and continued tie bidding may be cause for rejection of bids by the City of Lubbock and/or investigation by the Attorney General to determine possible Anti -Trust violations. 4.4 Before the City may award a bid to a nonresident bidder, the nonresident bidder's bid must be lower than lowest bid submitted by a responsible Texas bidder by the same margin or amount that a Texas bidder would be required to underbid the nonresident bidder in the nonresident bidders' home state. 4.5 Any contract made, or purchase order issued, as a result of this Invitation to Bid, shall be entered into the State of Texas and under the laws of the State of Texas. In connection with the performance of work, the Bidder agrees to comply with the Fair Labor Standard Act, Equal Opportunity Employment Act, and all other applicable Federal, State, and Local laws, regulations, and executive orders to the extent that the same may be applicable. 4.6 NO INDIVIDUAL OF ANY USING DEPARTMENT HAS THE AUTHORITY TO LEGALLY AND/OR FINANCIALLY COMMIT THE CITY TO ANY CONTRACT, AGREEMENT OR PURCHASE ORDER FOR GOODS OR SERVICES, UNLESS SPECIFICALLY SANCTIONED BY THE REQUIREMENTS OF THIS INVITATION TO BID. GENERAL INSTRUCTIONS TO BIDDERS (Continued) 5. ADDENDA & MODIFICATIONS 5.1 Any changes, additions, or clarifications to the ITB are made by ADDENDA information available over the Internet at https:Hci-lubbock-tx.bonfirehub.com/portal/. We strongly suggest that you check for any addenda a minimum of forty-eight hours in advance of the response deadline. BUSINESSES WITHOUT INTERNET ACCESS may use computers available at most public libraries. 5.2 Any bidder in doubt as to the true meaning of any part of the specifications or other documents may request an interpretation thereof from the Purchasing and Contract Management Office. At the request of the bidder, or in the event the Purchasing and Contract Management Office deems the interpretation to be substantive, the interpretation will be made by written addendum issued by the Purchasing and Contract Management Office. Such addenda issued by the Purchasing and Contract Management Office will be available over the Internet at hgps://ci-lubbock-tx.bonfirehub.com/portal/ and will become part of the bid package having the same binding effect as provisions of the original ITB. NO VERBAL EXPLANATIONS OR INTERPRETATIONS WILL BE BINDING. In order to have a request for interpretation considered, the request must be submitted in writing and must be received by the City of Lubbock Purchasing and Contract Management Office no later than five (5) calendar days before the bid closing date. 5.3 All addenda, amendments, and interpretations of this solicitation shall be in writing. The City of Lubbock shall not be legally bound by any amendment or interpretation that is not in writing. Only information supplied by the City of Lubbock Purchasing and Contract Management Office in writing or in this ITB should be used in preparing bid responses. All contacts that a bidder may have had before or after receipt of this ITB with any individuals, employees, or representatives of the City and any information that may have been read in any news media or seen or heard in any communication facility regarding this bid should be disregarded in preparing responses. 5.4 The City does not assume responsibility for the receipt of any addendum sent to bidders. 6. EXAMINATION OF DOCUMENTS AND REQUIREMENTS 6.1 Each bidder shall carefully examine all ITB documents and thoroughly familiarize itself with all requirements before submitting a bid to ensure that their bid meets the intent of these specifications. 6.2 Before submitting a bid, each bidder shall be responsible for making all investigations and examinations that are necessary to ascertain conditions and requirements affecting the requirements of this Invitation to Bid. Failure to make such investigations and examinations shall not relieve the bidder from obligation to comply, in every detail, with all provisions and requirements of the Invitation to Bid. 6.3 Notices of any discrepancies or omissions in these plans, specifications, or contract documents, shall be given to the Purchasing and Contract Management Office and a clarification obtained before the bids are received, and if no such notice is received by the Purchasing and Contract Management Office prior to the opening of bids, then it shall be deemed that the bidder fully understands the work to be included and has provided sufficient sums in its bid to complete the work in accordance with these plans and specifications. If bidder does not notify Purchasing and Contract Management Office before bidding of any discrepancies or omissions, then it shall be deemed for all purposes that the plans and specifications are sufficient and adequate for completion of the project. It is further agreed that any request for clarification must be submitted no later than five (5) calendar days prior to the bid closing date. 7. BID PREPARATION COSTS 7.1 Issuance of this ITB does not commit the City of Lubbock, in any way, to pay any costs incurred in the preparation and submission of a bid. 7.2 The issuance of this ITB does not obligate the City of Lubbock to enter into contract for any services or equipment. 7.3 All costs related to the preparation and submission of a bid shall be paid by the bidder. 8. TRADE SECRETS, CONFIDENTIAL INFORMATION AND THE TEXAS PUBLIC INFORMATION ACT 8.1 If you consider any portion of your bid to be privileged or confidential by statute or judicial decision, including trade secrets and commercial or financial information, clearly identify those portions. 8.2 The City of Lubbock will honor your notations of trade secrets and confidential information and decline to release such information initially, but please note that the final determination of whether a particular portion of your bid is in fact a trade secret or commercial or financial information that may be withheld from public inspection will be made by the Texas Attorney General or a court of competent jurisdiction. In the event a public information request is received for a portion of your bid that you have marked as being confidential information, you will be notified of such request and you will be required to justify your legal position in writing to the Texas Attorney General pursuant to Section 552.305 of the Government Code. In the event that it is determined by opinion or order of the Texas Attorney General or a court of competent jurisdiction that such information is in fact not privileged and confidential under Section 552.110 of the Government Code and Section 252.049 of the Local Government Code, then such information will be made available to the requester. 8.3 Marking your entire bid CONFIDENTIAL/PROPRIETARY is not in conformance with the Texas Open Records Act. 8.4 Pursuant to Section 552.234(c) of the Texas Government Code, submit your open records request using the link provided below. https:Hlubbocktx. og_vqa.us/WEBAPP/_rs/(S(quiyirflbtihahjnyce cs))/SLipportHome.aspx 8.5 For more information, please see the City of Lubbock Public Information Act website at: https://ci.lubbock.tx.us/pages/public-information-act 9. LICENSES, PERMITS, TAXES 9.1 The price or prices for the work shall include full compensation for all taxes, permits, etc. that the bidder is or may be required to pay. 10. UTILIZATION OF LOCAL BUSINESS RESOURCES 10.1 Prospective bidders are strongly encouraged to explore and implement methods for the utilization of local resources, and to outline in their bid submittal how they would utilize local resources. 11. CONFLICT OF INTEREST 11.1 The bidder shall not offer or accept gifts or anything of value nor enter into any business arrangement with any employee, official or agent of the City of Lubbock. 11.2 By signing and executing this bid, the bidder certifies and represents to the City the bidder has not offered, conferred or agreed to confer any pecuniary benefit or other thing of value for the receipt of special treatment, advantage, information, recipient's decision, opinion, recommendation, vote or any other exercise of discretion concerning this bid. 11.3 It is not necessary to fill out the CIQ Form unless you have a business relationship that might cause a conflict of interest with the City of Lubbock 11.4 Effective January 1, 2006, Chapter 176 of the Texas Local Government Code requires that any vendor or person considering doing business with a local government entity disclose in the Questionnaire, Form CIQ, the vendor or person's affiliation or business relationship that might cause a conflict of interest with a local government entity. By law, the questionnaire must be filed with the records administrator of the City of Lubbock not later than the Seventh business day after the date the person becomes aware of the facts that require the statement to be filed. The questionnaire can be found at: s://www.ethics.state.tx.us/forms/conflict/ For the City of Lubbock, these forms should be filed with the City Secretary's Office, P.O. Box 2000, Lubbock, Texas, 79457 See Section 176.006, Local Government Code: http://www.statutes.legis.state.tx.us/SOTWDocs/LG/htm/LG. 176.htm. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 12. CONTRACT DOCUMENTS 12.1 All work covered by the contract shall be done in accordance with contract documents described in the General Conditions. 12.2 All bidders shall be thoroughly familiar with all of the requirements set forth on the contract documents for the construction of this project and shall be responsible for the satisfactory completion of all work contemplated by said contract documents. 13. CERTIFICATE OF INTERESTED PARTIES 13.1 Effective January 1, 2016, Section 2252.908, as amended, of Chapter 2252 of the Texas Government Code requires certain business entities to submit an electronic disclosure form to the Texas Ethics Commission before entering into a contract with a local government entity when any of the following apply: 1) Contract requires an action or vote by the City Council (governing body); OR 2) Contract value is $1 Million or greater; OR 3) Contract is for services that would require a person to register as a lobbyist under Chapter 305 of the Government Code. This must be done before executing the contract. The disclosure form may be found at hops://www.ethics.state.tx.us/whatsnew/elf_ info_forml295.htm. You must log in and create an account the first time you fill out the form. Tutorial videos on how to log in for the first time and how to fill out the form can be found through the link above. After you electronically submit the disclosure form, a screen will come up confirming the submission and assigning a certificate number. Then, you must print the form, have an authorized agent complete the declaration and sign, and provide it to the City (scanned email copy is acceptable). 14. PLANS FOR USE BY BIDDERS 14.1 It is the intent of the City of Lubbock that all parties with an interest in submitting a bid on the project covered by the contract documents be given a reasonable opportunity to examine the documents and prepare a bid without charge or forfeiture of deposit. The contract documents may be examined without charge as noted in the Notice to Bidders. 15. PAYMENT 15.1 All payments due to Contractor shall be made in accordance with the provisions of the General Conditions of the contract documents. 16. AFFIDAVITS OF BILLS PAID 16.1 The City of Lubbock reserves the right, prior to final acceptance of this project to require the Contractor to execute an affidavit that all bills for labor, materials and incidentals incurred in the construction of the improvements contemplated by the contract documents have been paid in full and that there are no claims pending, of which the Contractor has been notified. 17. MATERIALS AND WORKMANSHIP 17.1 The intent of these contract documents is that only materials and workmanship of the best quality and grade will be furnished. The fact that the specifications may fail to be sufficiently complete in some detail will not relieve the Contractor of full responsibility for providing materials of high quality and for protecting them adequately until incorporated into the project. The presence or absence of a representative of the City on the site will not relieve the Contractor of full responsibility of complying with this provision. The specifications for materials and methods set forth in the contract documents provide minimum standards of quality, which the Owner believes necessary to procure a satisfactory project. 18. PLANS FOR THE CONTRACTOR 18.1 The contractor will, upon written request, be furnished up to five sets of plans and specifications and related contract documents for use during construction. Plans and specifications for use during construction will only be furnished directly to the Contractor. The Contractor shall then distribute copies of plans and specifications to suppliers, subcontractors or others, as required for proper prosecution of the work contemplated by the Contractor. 19. PROTECTION OF THE WORK 19.1 The Contractor shall be responsible for the care, preservation, conservation, and protection of all materials, supplies, machinery, equipment, tools, apparatus, accessories, facilities, and all means of construction, and any and all parts of the work whether the Contractor has been paid, partially paid, or not paid for such work, until the date the City issues its certificate of completion to Contractor. The City reserves the right, after the bids have been opened and before the contract has been awarded, to require of a bidder the following information: 19.1.1 The experience record of the bidder showing completed jobs of a similar nature to the one covered by the intended contract and all work in progress with bond amounts and percentage completed. 19.1.2 A sworn statement of the current financial condition of the bidder. 19.1.3 Equipment schedule. 20. TEXAS STATE SALES TAX 20.1 This contract is issued by an organization which qualifies for exemption provisions pursuant to provisions of Article 20.04 of the Texas Limited Sales, Excise and Use Tax Act. 20.2 The Contractor must obtain a limited sales, excise and use tax permit which shall enable him to buy the materials to be incorporated into the work without paying the tax at the time of purchase. 21. PROTECTION OF SUBSURFACE LINES AND STRUCTURES 21.1 It shall be the Contractor's responsibility to prosecute the work contemplated by the contract documents in such a way as to exercise due care to locate and prevent damage to all underground pipelines, utility lines, conduits or other underground structures which might or could be damaged by Contractor during the construction of the project contemplated by these contract documents. The City of Lubbock agrees that it will furnish Contractor the location of all such underground lines and utilities of which it has knowledge. However, such fact shall not relieve the Contractor of his responsibilities aforementioned. All such underground lines or structures cut or damaged by Contractor during the prosecution of the work contemplated by this contract shall be repaired immediately by Contractor to the satisfaction of the City of Lubbock, Texas, at Contractor's expense. 22. BARRICADES AND SAFETY MEASURES 22.1 The contractor shall, at his own expense, furnish and erect such barricades, fences, lights and danger signals, and shall take such other precautionary measures for the protection of persons, property and the work as may be necessary. The Contractor will be held responsible for all damage to the work due to failure of barricades, signs, and lights to protect it, and when damage is incurred, the damaged portion shall be immediately removed and replaced by Contractor at his own cost and expense. The Contractor's responsibility for maintenance of barricades, signs, and lights shall not cease until the date of issuance to Contractor of City's certificate of acceptance of the project. 23. EXPLOSIVES 23.1 The use of explosives will not be permitted unless written permission to do so is obtained by the Contractor from the City. In all cases where written permission is obtained for the use of explosives, the Contractor shall assume full responsibility for all damage, which may occur as a direct or indirect result of the blasting. In addition, in all cases where explosives are authorized to be used, the Contractor shall use utmost care so as not to endanger life or property and the Contractor shall further use only such methods as are currently utilized by persons, firms, or corporations engaged in similar type of construction activity. 23.2 Explosive materials shall not be stored or kept at the construction site by the Contractor. 23.3 In all cases where explosives are to be used during the construction of the project contemplated by this contract, it shall be the duty of the Contractor to notify each utility company having structures (above or below the ground) in proximity to the site of the work of Contractor's intention to use explosives, and such notice shall be given sufficiently in advance to enable the companies to take such steps as they may deem necessary to protect their property from injury. Such notice, however, shall not relieve the Contractor of responsibility for any damage resulting from his blasting operations. 24. CONTRACTOR'S REPRESENTATIVE 24.1 The successful bidder shall be required to have a responsible local representative available at all times while the work is in progress under this contract. The successful bidder shall be required to furnish the name, address and telephone number where such local representative may be reached during the time that the work contemplated by this contract is in progress. 25. INSURANCE 25.1 The Contractor shall not commence work under this contract until he has obtained all insurance as required in the General Conditions of the contract documents, from an underwriter authorized to do business in the State of Texas and satisfactory to the City. Proof of coverage shall be furnished to the City and written notice of cancellation or any material change will be provided ten (10) days in advance of cancellation or change. All policies shall contain an agreement on the part of the insurer waiving the right to subrogation. The Contractor shall procure and carry at his sole cost and expense through the life of this contract, insurance protection as hereinafter specified. Coverage in excess of that specified herein also shall be acceptable. Such insurance shall be carried with an insurance company authorized to transact business in the State of Texas and shall cover all operations in connection with this contract, whether performed by the Contractor or a subcontractor, or separate policies shall be provided covering the operation of each subcontractor. A certificate of insurance specifying each and all coverages shall be submitted before contract execution. 25.2 PROOF OF COVERAGE SHALL BE FURNISHED TO THE CITY OF LUBBOCK IN THE FORM OF A CERTIFICATE OF INSURANCE. THE INSURANCE CERTIFICATES FURNISHED SHALL NAME THE CITY OF LUBBOCK AS ADDITIONAL INSURED ON AUTO/GENERAL LIABILITY ON A PRIMARY AND NON-CONTRIBUTORY BASIS TO INCLUDE PRODUCTS OF COMPLETE OPERATIONS. PROVIDE A WAIVER OF SUBROGATION IN FAVOR OF THE CITY OF LUBBOCK. IT SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO PROVIDE TO THE OWNER ALL PROOF OF COVERAGE INSURANCE DOCUMENTS INCLUDING WORKERS COMPENSATION COVERAGE FOR EACH SUBCONTRACTOR. COPIES OF THE ENDORSEMENTS ARE REQUIRED. 26. LABOR AND WORKING HOURS 26.1 Attention of each bidder is particularly called to the schedule of general prevailing rate of per diem wages included in these contract documents. The wage rate that must be paid on this project shall not be less than specified in the schedule of general prevailing rates of per diem wages as above mentioned. The bidders' attention is further directed to the requirements of Texas Government Code, Chapter 2258, Prevailing Wage Rates providing for the payment of the wage schedules above mentioned and the bidder's obligations thereunder. The inclusion of the schedule of general prevailing rate of per diem wages in the contract documents does not release the Contractor from compliance with any wage law that may be applicable. Construction work under the contract requiring an inspector shall not be performed on weekends or holidays unless the following conditions exist: 26.1.1 The project being constructed is essential to the City of Lubbock's ability to provide the necessary service to its citizens. 26.1.2 Delays in construction are due to factors outside the control of the Contractor. The Contractor is approaching the penalty provisions of the contract and Contractor can show he has made a diligent effort to complete the contract within the allotted time. 26.1.3 Before construction work requiring an inspector is to be performed on Sunday or holidays, the Contractor must notify the Owner's Representative not less than three full working days prior to the weekend or holiday he desires to do work and obtain written permission from the Owner's Representative to do such work. The final decision on whether to allow construction work requiring an inspector on Sunday or holidays will be made by the Owner's Representative. 26.2In any event, if a condition should occur or arise at the site of this project or from the work being done under this contract which is hazardous or dangerous to property or life, the Contractor shall immediately commence work, regardless of the day of the week or the time of day, to correct or alleviate such condition so that it is no longer dangerous to property or life. 27. PAYMENT OF EMPLOYEES AND FILING OF PAYROLLS 27.1 The contractor and each of his subcontractors shall pay each of his employees engaged in work on the project under this contract in full (less mandatory legal deductions) in cash, or by check readily cashable without discount, not less often than once each week. The Contractor and each of his subcontractors shall keep a record showing the name and occupation of each worker employed by the Contractor or subcontractor in the construction of the public work and the actual per diem wages paid to each worker. This record shall be open at all reasonable hours to inspection by the officers and agents of the City. The Contractor must classify employees according to one of the classifications set forth in the schedule of general prevailing rate of per diem wages, which schedule is included in the contract documents. The Contractor shall forfeit as a penalty to the City of Lubbock on whose behalf this contract is made, sixty dollars ($60) for each laborer, workman, or mechanic employed for each calendar day, or portion thereof, such laborer, workman or mechanic is paid less than the wages assigned to his particular classification as set forth in the schedule of general prevailing rate of per diem wages included in these contract documents. 28. PROVISIONS CONCERNING ESCALATION CLAUSES 28.1 Bids submitted containing any conditions which provide for changes in the stated bid price due to increases or decreases in the cost of materials, labor or other items required for the project will be rejected and returned to the bidder without being considered. 29. PREPARATION FOR BID 29.1 The bidder shall submit his bid on forms furnished by the City, and all blank spaces in the form shall be correctly filled in, stating the price in numerals for which he intends to do the work contemplated or furnish the materials required. Such prices shall be written in ink, distinctly and legibly, or typewritten. In case of discrepancy between the unit price and the extended total for a bid item, the unit price will be taken. A bid that has been opened may not be changed for the purpose of correcting an error in the bid price. 29.2 If the bid is submitted by an individual, his name must be signed by him or his duly authorized agent. If a bid is submitted by a firm, association, or partnership, the name and address of each member must be given and the bid signed by a member of the firm, association or partnership, or person duly authorized. If the bid is submitted by a company or corporation, the company or corporate name and business address must be given, and the bid signed by an official or duly authorized agent. Powers of attorney authorizing agents or others to sign bids must be properly certified and must be in writing and submitted with the bid. 29.3 Pursuant to Texas Local Government Code 252.043(g), a competitive sealed bid that has been opened may not be changed for the purpose of correcting an error in the bid price. THEREFORE, ANY CORRECTIONS TO THE BID PRICE MUST BE MADE ON THE BID SUBMITTAL FORM PRIOR TO BID OPENING. 29.4 Bid submittals may be withdrawn and resubmitted at any time before the time set for opening of the bids, but no bid may be withdrawn or altered thereafter. 30. BOUND COPY OF CONTRACT DOCUMENTS 30.1 Bidder understands and agrees that the contract to be executed by bidder shall be bound and will include the following: (a) Notice to Bidders. (b) General Instructions to Bidders. (c) Bidder's Submittal. (d) Statutory Bonds (if required). (e) Contract Agreement. (f) General Conditions. (g) Special Conditions (if any). (h) Specifications. (i) Insurance Certificates for Contractor and all Sub -Contractors. (j) All other documents made available to bidder for his inspection in accordance with the Notice to Bidders. 29.2 If Plans and Specifications are too bulky or cumbersome to be physically bound, they are to be considered incorporated by reference into the aforementioned contract documents. 31. OUALIFICATIONS OF BIDDERS 31.1 The bidder may be required before the award of any contract to show to the complete satisfaction of the City of Lubbock that it has the necessary facilities, ability, and financial resources to provide the service specified therein in a satisfactory manner. The bidder may also be required to give a past history and references in order to satisfy the City of Lubbock about the bidder's qualifications. The City of Lubbock may make reasonable investigations deemed necessary and proper to determine the ability of the bidder to perform the work, and the bidder shall furnish to the City of Lubbock all information for this purpose that may be requested. The bidder's bid may be deemed not to meet specifications or the bid may be rejected if the evidence submitted by, or investigation of, the bidder fails to satisfy the City of Lubbock that the bidder is properly qualified to carry out the obligations of the contract and to complete the work described therein. Evaluation of the bidder's qualifications shall include: (a) The ability, capacity, skill, and financial resources to perform the work or provide the service required. (b) The ability of the bidder to perform the work or provide the service promptly or within the time specified, without delay or interference. (c) The character, integrity, reputation, judgment, experience, and efficiency of the bidder. (c) The quality of performance of previous contracts or services. (d) The safety record of the Contractor and proposed Sub -Contractors 31.2 Before contract award, the recommended contractor for this project may be required to show that he has experience with similar projects that require the Contractor to plan his work efforts and equipment needs with City of Lubbock specifications in mind. Demonstration of experience shall include a complete list of ALL similar municipal and similar non -municipal current and completed projects for the past three (3) years for review. This list shall include the names of supervisors and type of equipment used to perform work on these projects. In addition, the Contractor may be required to provide the name(s) of supervisor(s) that will be used to perform work on this project in compliance with City of Lubbock specifications herein. 32. PLANS FOR THE CONTRACTOR 32.1 The contractor will, upon written request, be furnished up to five sets of plans and specifications and related contract documents for use during construction. Plans and specifications for use during construction will only be furnished directly to the Contractor. The Contractor shall then distribute copies of plans and specifications to suppliers, subcontractors or others, as required for proper prosecution of the work contemplated by the Contractor. 33. ANTI -LOBBYING PROVISION 33.1 DURING THE PERIOD BETWEEN THE BID CLOSE DATE AND THE CONTRACT AWARD, BIDDERS, INCLUDING THEIR AGENTS AND REPRESENTATIVES, SHALL NOT DIRECTLY DISCUSS OR PROMOTE THEIR BID WITH ANY MEMBER OF THE LUBBOCK CITY COUNCIL OR CITY STAFF EXCEPT IN THE COURSE OF CITY -SPONSORED INQUIRIES, BRIEFINGS, INTERVIEWS, OR PRESENTATIONS, UNLESS REQUESTED BY THE CITY. 33.2 This provision is not meant to preclude bidders from discussing other matters with City Council members or City staff. This policy is intended to create a level playing field for all potential bidders, assure that contract decisions are made in public, and to protect the integrity of the bid process. Violation of this provision may result in rejection of the bidder's bid. 34. PREVAILING WAGE RATES 34.1 Bidders are required to comply with Texas Government Code, Chapter 2258, Prevailing Wage Rates, with respect to the payment of prevailing wage rates for the construction of a public work, including a building, highway, road, excavation, and repair work or other project development or improvement, paid for in whole or in part from public funds, without regard to whether the work is done under public supervision or direction. A worker is employed on a public work if the worker is employed by the contractor or any subcontractor in the execution of the contract for the project 34.2 A worker employed on a public work by or on behalf of the City of Lubbock shall be paid not less than the general prevailing rate of per diem wages for the work of a similar character in the locality in which the work is performed, and not less than the general prevailing rate of per diem wages for legal holiday and overtime work. 34.3 A contractor or subcontractor who violates Texas Government Code Section 2258.023 shall pay to the City of Lubbock sixty dollars ($60) for each worker employed for each calendar day or part of the day that the worker is paid less than the wage rates stipulated in the contract. 35. PROTEST 35.1 All protests regarding the ITB process must be submitted in writing to the City Director of Purchasing and Contract Management within 5 working days after the protesting party knows of the occurrence of the action which is protested relating to advertising of notices deadlines, proposal opening and all other related procedures under the Local Government Code, as well as any protest relating to alleged improprieties with the ITB process. This limitation does not include protests relating to staff recommendations as to award of contract. Protests relating to staff recommendations may be directed to the City Manager. All staff recommendations will be made available for public review prior to consideration by the City Council as allowed by law. 35.2 FAILURE TO PROTEST WITHIN THE TIME ALLOTTED SHALL CONSTITUTE A WAIVER OF ANY PROTEST. Page Intentionally Left Blank BID SUBMITTAL FORM Page Intentionally Left Blank BID SUBMITTAL FORM BID CONTRACT DATE: OTAS/1.n1 PROJECT NUMBER: ITB 21-159494M, Concrete on Mac Davis Lane Bid of Bidder) (hereinafter called To the Honorable Mayor and City Council City of Lubbock, Texas (hereinafter called Owner) Ladies and Gentlemen: The Bidder, in compliance with your Invitation to Bid for the construction of the referenced project, having carefully examined the plans, specifications, instructions to bidders, notice to bidders and all other related contract documents and the site of the intended work, and being familiar with all of the conditions surrounding the construction of the intended project including the availability of materials and labor, hereby intends to furnish all labor, materials, and supplies; and to construct the project in accordance with the plans, specifications and contract documents, within the time set forth therein and at the price stated. The bidder binds himself on acceptance of his bid to execute a contract and any required bonds, according to the accompanying forms, for performing and completing the said work within the time stated and for the prices stated. Offeror hereby agrees to commence the work on the above project on a date to be specified in a written "Notice to Proceed" of the Owner and to substantially complete the project within 60 Days as stipulated in the specification and other contract documents. Offeror hereby further agrees to pay to Owner as liquidated damages in the sum of $1,204.28 for each consecutive calendar day after substantial completion set forth herein above for completion of this project, all as more fully set forth in the General Conditions of the Agreement. Bidder understands and agrees that this bid submittal shall be completed and submitted in accordance with instruction number 29 of the General Instructions to Bidders. Bidder understands that the Owner reserves the right to reject any or all bids and to waive any formality in the bidding. The Bidder agrees that this bid shall be good and may not be withdrawn for a period of 60 calendar days after the scheduled closing time for receiving bids. The undersigned Bidder hereby declares that he has visited the site of the work and has carefully examined the plans, specifications and contract documents pertaining to the work covered by this bid, and he further agrees to commence work on or before the date specified in the written notice to proceed, and to substantially complete the work on which he has bid; as provided in the contract documents. Bidders are required, whether or not a payment or performance bond is required, to submit a cashier's check or certified check issued by a bank satisfactory to the City of Lubbock, or a bid bond from a reliable surety company, payable without recourse to the order of the City of Lubbock in an amount not less than five percent (5%) of the total amount of the bid submitted as a guarantee that bidder will enter into a contract, obtain all required insurance policies, and execute all necessary bonds (if required) within 10 business days after notice of award of the contract to him. City of Lubbock Public Works ITB 21-15949-JM Concrete on Mac Davis Lane Blackstone Concrete Ventures, Lubbock TX Item Description Class "C" Concrete (3600 PSI in 28 days) Reinforced (ref. section 8.07.12 for #0-1 specifications for reinforcement Information); Including Labor, equipment, removal and disposal of Existing Materials, subgrade prep, saw cut joints, complete and in Place.) #0-8 Mobilization Quantity UOM Extended Cost 4500 SY $ 1 EA 540,000 53,250 Total: $ 593,250 Enclosed with this bid is a Cashier's Check or Certified Check for Dollars ($ ) or a Bid Bond in the sum of Dollars ($49 , which it is agreed shall be collected and retaine by the Owner as liquidated damages in the event the bid is accepted by the Owner and the undersigned fails to execute the necessary contract documents, insurance certificates, and the required bond (if any) with the Owner within 10 business days after the date of receipt of written notification of acceptance of said bid; otherwise, said check or bond shall be returned to the undersigned upon demand. Bidder understands and agrees that the contract to be executed by Bidder shall be bound and include all contract documents made available to him for his inspection in accordance with the Notice to Bidders. Pursuant to Texas Local Government Code 252.043(g), a competitive sealed bid that has been opened may not be changed for the purpose of correcting an error in the bid price. THEREFORE, ANY CORRECTIONS TO THE BID PRICE MUST BE MADE ON THE BID SUBMITTAL FORM PRIOR TO BID OPENING. (Seal if Bidder is a Corporation) ATTEST: Secretary Bidder acknowledges receipt of the following addenda: Addenda No. 1 Addenda No. _ Addenda No. _ Addenda No. Date 7/23/2021 Date Date Date Dater Authorize Si ature .4 (Printed or Typed Na e , *4f- Company Iwo 4G* Address tyaocek , tits ��OGI� Ci�61t6 County State Zi Code Telephone: Fax: FEDERAL TAX ID or SOCIAL SECURITY No. EMAIL: 4*40, &*A004 46W'4aTC. CD4%, M/WBE Woman Black American ative American Firm: Hispanic scan Pacific Other peci y American American INSURANCE REQUIREMENTS I, the undersigned Bidder certify that the insurance requirements contained in this bid document have been reviewed by me and my Insurance Agent/Broker. If I am awarded this contract by the City of Lubbock, I will be able to, within ten (10) business days after being notified of such award by the City of Lubbock, furnish a valid insurance certificate to the City meeting all of the requirements defined in this bid. If the time requirement specified above is not met, the City has the right to reject this proposal and award the contract to another contractor. If you have any questions concerning these requirements, please contact the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572. SUSPENSION AND DEBARMENT CERTIFICATION Federal Law (A-102 Common Rule and OMB Circular A-i 10) prohibits non -Federal entities from contracting with or making sub -awards under covered transactions to parties that are suspended or debarred or whose principals are suspended or debarred. Covered transactions include procurement contracts for goods or services equal to or in excess of $25,000 and all non -procurement transactions (e.g., sub -awards to sub - recipients). Contractors receiving individual awards of $25,000 or more and all sub -recipients must certify that their organization and its principals are not suspended or debarred by a Federal agency. Before an award of $25,000 or more can be made to your firm, you must certify that your organization and its principals are not suspended or debarred by a Federal agency. I, the undersigned agent for the firm named below, certify that neither this firm nor its principals are suspended or debarred by a Federal agency. TEXAS GOVERNMENT CODE SECTION 2252.152 The undersigned representative of the undersigned company or business, being an adult over the age of eighteen (18) years of age, pursuant to Texas Government Code, Chapter 2252, Section 2252.152, certify that the company named above is not listed on the website of the Comptroller of the State of Texas concerning the listing of companies that are identified under Section 806.051, Section 807.051 or Section 2253.153. I further certify that should the above -named company enter into a contract that is on said listing of companies on the website of the Comptroller of the State of Texas, which do business with Iran, Sudan or any Foreign Terrorist Organization, I will immediately notify the City of Lubbock Purchasing and Contract Department. TEXAS GOVERNMENT CODE SECTION 2271.002 Company hereby certifies the following: 1. Company does not boycott Israel; and 2. Company will not boycott Israel during the term of the contract. The following definitions apply to this state statute: (1) 'Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business purposes; and (2) "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent company, or affiliate of those entities or business associations that exists to make a profit. This Certification is required from a Company if the Company has 10 or more full-time employees and the contract for goods or services (which includes contracts formed through purchase orders) has a value of $100,000 or more that is to be paid wholly or partly from public funds of the governmental entity. Agreement Example Review This sample Agreement has been reviewed and (V/ is acceptable ( ) is acceptable as noted Contractor Acknowledgement In compliance with this solicitation, the undersigned bidder, having examined the bid documents, instructions to bidders, documents associated with the invitation to bid, and being familiar with the conditions to be met has reviewed the above information regarding: • Insurance Requirements • Suspension and Debarment Certification • Texas Government Code Section 2252.152 • Texas Government Code Section 2271.002 An individual authorized to bind the company must sign the following section. Failure to execute this portion may result in bid rejection. By signing below, the terms stated have been reviewed and approved. Company Name: O(AaffOryr 6&MCA6T6 I�aJI L.LC� Signed By: Print Name and Title: #KK tr(V4 ff,' Date: Page Intentionally Left Blank BID BOND Page Intentionally Left Blank BID BOND KNOW ALL MEN BY THESE PRESENTS, that we Blackstone Concrete Ventures LLC 8418 Wayne Ave Lubbock TX 79424 as principal, hereinafter called the "Principal," and SURETEC INSURANCE COMPANY, 1330 Post Oak Boulevard, Suite 1100, Houston, Tx 77056, as surety, hereinafter called the "Surety," are held and firmly bound unto City of Lubbock 1314 Avenue K Floor 9 Lubbock TX 79401 as obligee, hereinafter called the "Obligee," in the sum of FIVE PERCENT (5%) OF THE AMOUNT BID Dollars ($ ) for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the principal has submitted a bid for Project ITB 21-159449-JM Concrete of Mac Davis Lane NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as specified in the bid, enter into a contract in writing or, in the event of the failure of the Principal to enter into such Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution of the final contract shall furnish evidence of financing in a manner and form acceptable to Principal and Surety that financing has been firmly committed to cover the entire cost of the project. SIGNED, sealed and dated this 29th day of Jul , 20 21. O H I G G I N B 0 T H A M Singe S.ourco, P.O. Box 1071 (NO) 723-0771 Wid'Aa Fads, TX 76307 FAX (940) 761-5280 Blackstone Concrete Ventures LLC (Principal) SureTec Insurance Company BY: Kay Blair , Attorney -in -Fact SureTec Bid Bond rev. 1.1.06 POA4 4221381 JOINT LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That SureTec Insurance Company, a Corporation duly organized and existing under the laws of the State of Texas and having its principal office in the County of Harris, Texas and Markel Insurance Company (the "Company'), a corporation duly organized and existing under the laws of the state of Illinois, and having its principal administrative office in Glen Allen, Virginia, does by these presents make, constitute and appoint: Shawn Blacklock, Kay Blair, Shane Smith, Donna Martinez Their true and lawful agent(s) and attorney(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on their own behalf, individually as a surety or jointly, as co -sureties, and as their act and deed any and all bonds and other undertaking in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shalt not exceed the sum of: Five Million and 00/100 Dollars ($5,000,000.00) This Power of Attorney is granted and is signed and seated under and by the authority of the following Resolutions adopted by the Board of Directors of SureTec Insurance Company and Markel Insurance Company: "RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice President, Secretary, Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the company, qualifying the attorney or attorneys named in the givers power of attorney, to execute in behalf of, and acknowledge as the act and deed of the SureTec Insurance Company and Markel Insurance Company, as the case may be, all bond undertakings and contracts of suretyship, and to affix the corporate seal thereto " IN WITNESS WHEREOF, Markel Insurance Company and SureTec Insurance Company have caused their official seal to be hereunto affixed and these presents to be signed by their duly authorized officers on the tst day of December , 2020 . SureTec Insurance Companynn,�,w,u \�SURAIyC.C' ,r•�dy G: r X ':t� w ' W 'n Michael C. Keirnig, President&�P`•., 1 �r Y� Q Commonwealth of Virginia County of Henrico SS: Markel In uragce Company SEAL • • 441NQ%`2 b: Rabin Russo, Senior Vice President On this tst day of December, 2020 A. D., before me, a Notary Public of the Commonwealth of Virginia, in and for the County of Henrico, duly commissioned and qualified, came THE ABOVE OFFICERS OF THE COMPANIES, to me personally known to be the individuals and officers described in, who executed the preceding instrument, and they acknowledged the execution of same, and being by me duly sworn, disposed and said that they are the officers of the said companies aforesaid, and that the seals affixed to the proceeding instrument are the Corporate Seals of said Companies, and the said Corporate Seals and their signatures as officers were duly affixed and subscribed to the said instrument by the authority and direction of the said companies, and that Resolutions adopted by the Board of Directors of said Companies referred to in the preceding instrument is now in force. ®`®a e ^ s A 4 i e J ssa f N TESTIMONY WHEREOF, I have hereunto set my hand, and affixed maeb Peaiaete C � �cf Henrico, the day and year first above written. - o MY C0Ndlvoc-SICN I BY: e Donna Donavant, Notary Public 70b3968 J ® My commission expires 1/31/2023 We, the undersigned Officers of SureTec Insurance Company and Marker S Yfi •y dq'A mot. Sre(f�V dslVterby certify that the original POWER OF ATTORNEY of which the foregoing is a full, true and correct copy is stilt in full farce and effect and IN WITNESS WHEREOF, we have hereunto set our hands, and affixed the Seals of said Companies, on thea'7 day of Surgec Insur ce C pang) °j By F s M. Br t Beaty, Assistant Secretai Markel Insurance Company By:, Richard R. Grinnan, Vice President arid -Secretary Any Instrument Issued in excess of the penalty stated above is totally void and without any validity. 4221381 For verification of the authority of this Power you may call (713)812-0800 on any business day between 8:30 AM and 5:00 PM CST. SureTec Insurance Company IMPORTANT NOTICE Statutory Complaint Notice/Filing of Claims To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint or file a claim at: 1-866-732-0099. You may also write to the Surety at: SureTec Insurance Company 9737 Great Hills Trail, Suite 320 Austin, TX 78759 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252- 3439. You may write the Texas Department of Insurance at: PO Box 149104 Austin, TX 78714-9104 Fax#: 512-490-1007 Web: http://www.tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIMS DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Texas Rider 8/2019 Page Intentionally Left Blank City of Lubbock, TX Purchasing and Contract Management Similar Projects and Reference Form Please list three references of current customers who can verify the quality of service your company provides. The City prefers customers of similar size and scope of work. Please do not use the City of Lubbock. REFERENCE ONE Company Name: TXDOT Brownfield Office Address: 800 W Webb, PO Box 1147, Brownfield, TX 79316 Contact Person and Title: Seve Sisneros, P.E. / Area Engineer Phone: (806) 637-4501 Similar Project: FM 3519 Garza Co 2767-02-004 Company Name: TXDOT Snyder Office Email: seve.sisneros@txdot.gov REFERENCE TWO Address: 111 N Kings Hwy Place, Snyder, TX 79549 Contact Person and Title: Stewart Chapman, P.E. / Area Engineer Phone: (323) 573-0143 Year 2020 Email: stewart.chapman@txdot.gov Similar Project: US 380, etc. Stonewall Co, etc. 6339-13-001 REFERENCE THREE Company Name: TXDOT Lubbock District Address: 135 E Slaton Hwy, Lubbock, TX 79404 Contact Person and Title: Anthony Self / Lubbock District Bridge Coordinator Phone: (806) 778-7729 Year 2020 Email: anthony.self@txdot.gov Similar Project: Year 2020 TXDOT Lubbock District Various Bridge Locations Garza Co 6352-84-001 Page Intentionally Left Blank Contractors Statement of Qualifications Individual contractors and joint ventures submitting a bid must complete the following evaluation information for the Project. Joint ventures shall be composed of not more than two firms and each firm must complete separate evaluations. Evaluation information must be submitted at time of bid submittal. Failure to submit the following Bidder Evaluation information may result in the OWNER considering the bid non -responsive and result in rejection of the bid by the OWNER. Bidders are to provide any additional information requested by the OWNER. In evaluating a firm's qualifications, the following major factors will be considered: A. FINANCIAL CAPABILITY: For this project, the CONTRACTOR'S financial capability to undertake the project will be determined by the CONTRACTOR'S ability to secure bonding satisfactory to the OWNER. B. EXPERIENCE: Do the organization and key personnel have appropriate technical experience on similar projects? C. SAFETY: Does the organization stress and support safety as an important function of the work process? D. QUALITY OF WORK: (1) Does the organization have a commitment to quality in every facet of their work - the process as well as the product? (2) Does the organization have a written quality philosophy and/or principles that exemplifies their work? If so, submit as Attachment "A". (3) Has this organization ever received an award or been recognized for doing "quality" work on a project? If so, give details under Attachment "A". E. CONFORMANCE TO CONTRACT DOCUMENTS: (1) Does the organization have a commitment and philosophy to construct projects as designed and as defined in the Contract Documents? The OWNER reserves the right to waive irregularities in determining the firm's qualifications and reserves the right to require the submission of additional information. The qualifications of a firm shall not deprive the OWNER of the right to accept a bid, which in its judgement is the lowest and best bid, to reject any and all bids, to waive irregularities in the bids, or to reject nonconforming, non- responsive, or conditional bids. In addition, the OWNER reserves the right to reject any bid where circumstances and developments have in the opinion of the OWNER changed the qualifications or responsibility of the firm. Material misstatements on the qualifications forms may be grounds for rejection of the firm's bid on this project. Any such misstatement, if discovered after award of the contract to such firm, may be grounds for immediate termination of the contract. Additionally, the firm will be liable to the OWNER for any additional costs or damages to the OWNER resulting from such misstatements, including costs and attorney's fees for collecting such costs and damages. Complete the following information for your organization: Contractor's General Information Organization Doing Business As Blackstone Concrete Ventures Business Address of Principle Office 10210 Quaker Ave Lubbock, TX 79424 Telephone Numbers Main Number (806) 891-1840 / (619) 240-4607 Fax Number Web Site Address Form of Business (Check One) A Corporation A Partnership An Individual Date of Incorporation State of Incorporation Chief Executive Officer's Name President's Name Vice President's Name(s) Secretary's Name Treasurer's Name If a Partnership Date of Organization 4/19/2019 State whether partnership is general or limited Limited Liability Corporation If an Individual Name A Business Address organizationIdentify all individuals not previously named which exert a significant amount of business control over the Robert Bleisch Josh Allen Jorge Burgos Mark Murray Hugo Marquez Indicators of Organization Average Number of Current Full Time Average Estimate of Revenue for the Employees 20 Current Year $4,000,000 Contractor's Organizational Experience Organization Doing Business As Blackstone Concrete Ventures Business Address of Regional Office 10210 Quaker Ave Lubbock, TX 79424 Name of Regional Office Manager David Winter Telephone Numbers Main Number (619) 240-4607 Fax Number Web Site Address 1, List of names that this organization currently, has or anticipates operating under over the history of the organization, including the names of related companies presently doing business: Names of Organization From Date To Date List of companies, firms or organizations that own any part of the organization. Name of companies, firms or organization Percent Ownership Construction Experience Years experience in projects similar to the proposed project: As a General Contractor 20+ 1 As a Joint Venture Partner Has this or a predecessor organization ever defaulted on a project or failed to complete any work awarded to it? No If yes provide full details in a separate attachment. See attachment No. Has this or a predecessor organization been released from a bid or proposal in the past ten years? No If yes provide full details in a separate attachment. See attachment No. Has this or a predecessor organization ever been disqualification as a bidder or proposer by any local, state, or federal agency within the last five ears? No If yes provide full details in a separate attachment. See attachment No. Is this organization or your proposed surety currently in any litigation or contemplating litigation? No If yes provide full details in a separate attachment. See attachment No. Has this or a predecessor organization ever refused to construct or refused to provide materials defined in the contract documents? No If yes provide full details in a separate attachment. See attachment No. Contractor's Proposed Key Personnel Organization Doing Business As Blackstone Concrete Ventures Proposed Project Organization Provide a brief description of the managerial structure of the organization and illustrate with an organizational cart. Include the title and names of key personnel. Include this chart at an attachment to this description. See attachment No. ATTACHMENT C Blackstone Concrete Ventures business operations comprises of Managing Partners Robert Bleisch, Jorge Burgos, and Hugo Marquez who are at the top command of the organization. Hugo Marquez is the managing partner in the field who oversees work, and is in charge of all of project managers. The Field Operations Office Team comprises of David Winter and Tyler Hebert who support all Project Managers with equipment rentals, materials, project and contract compliance, etc. The Project Managers are each responsible for their own projects and have to support them the project superintendent and other folks who work in the field. Provide a brief description of the managerial structure proposed for this project and illustrate with an organizational cart. Include the title and names of proposed key personnel and alternates. Include this chart at an attachment to this description. See attachment No. ATTACHMENT D Blackstone Concrete Ventures will use a simpler model with the Concrete Patching project for the City of Lubbock managerial structure as can be seen in attachment D. The project manager will dedicate 100% of their time working on their project, overseeing the project superintendent and workers. The Field Operations Office Team will be supporting all folks in the field with various needs. Attachment F shows how Blackstone ensures quality, compliance, safety, amongst other items in the work between the project manager, the Field Operations Office Team and the project owner. Experienceof • Provide information on the key personnel proposed for this project that will provide the following key functions. Provide information for candidates for each of these positions on the pages for each of these key personnel. Also provide biographical information for each primary and alternate candidate as an attachment. The biographical information must include the following as a minimum: technical experience, managerial experience, education and formal training, work history which describes project experience, including the roles and responsibilities for each assignment, and primary language. Additional information highlighting experience which makes them the best candidate for the assignment should also be included. see ATTACHMENT E Role Primary Candidate Alternate Candidate Project Manager Robert Herden Project Superintendent Arturo Montano Project Safety Officer Tyler Hebert Quality Control Manager Arturo Montano If key personnel are to fulfill more than one of the roles listed above, provide a written narrative describing how much time will be devoted to each function, their qualifications to fulfill each role and the percentage of their time that will be devoted to each role. If the individual is not to be devoted solely to this project, indicate how time it to be divided between this project and their other assignments. Managing Partners Robert Bleisch Jorge Burgos Josh Allen Mark Murray Project Manager Managin Partner Hugo Marquez Field Operations Tyler Hebert Project Superintendent Tyler Cofradia Safety, Quality, Laborers Project Compliance and Field Operations David Winter Project Superintendent Arturo Montano Safety, Quality, Laborers Project Manager/ Superintendent Robert Herden Safety, Quality, Laborers Blackstone Employees=Blackstone Employees=Blackstone Employees BLACKSTONE CONCRETE VENTURES CITY OF LUBBOCK - CONCRETE PATCHING _ia.�_L�1:1►�iL�I�y��a�1:T�1_1�It�I_i�[�]�l_1��1:/e\:i� BLACKSTONE CONCRETE VENTURES CITY OF LUBBOCK — CONCRETE PATCHING /_tiaf-AW:IuLAZIIm14WA24.*19I,111,11tap Project Manager/Safety Officer: Robert Herden Robert Herden recently started working with Blackstone Concrete Ventures. Robert has over 20+ years working in construction and 8+ years working in a managerial type role including being at TXDOT as a Project Manager/ Inspector. Robert was recently working with Allen Butler Construction before coming to us at Blackstone. Robert's experience range is vast working in different parts of the industry gaining technical and managerial experience along the way. In over the 20+ years Robert has been working in the field, Robert has worked on 30+ projects. Through Robert's experience as an inspector, his attention to quality of work makes him the perfect candidate to take on the Project Manager and Safety Officer roles in the Concrete Patching project. About 80% of Robert's time will be spent as the Project Manager for the Concrete Patching work, while the remaining 20% will be dedicated to ensuring Safety on site. Robert will be receiving office support when ordering materials, ensuring material compliance, as explained in a later organizational approach to completing project attachment. Robert's experience as an inspector helps ensure that Blackstone Concrete Ventures only produces high quality work. Robert is a native English speaker and has much various experience working with sidewalks, curb and gutters, valley gutters, etc. Work Robert has been involved with includes, but is not limited to working on the Marsha Sharp Freeway US 62/82 in Lubbock and Terry County, Woodrow Rd bridges, Milwaukee, City of Lubbock North University, Loop 289, and Slide Rd. Project Superintendent: Arturo Montano Arturo Montano has been working in construction for over 35+ and has worked on big and small projects throughout the state of Texas. This past summer, Arturo Montano worked with Blackstone to do the Concrete Patching work, projected to end early August 2021. In the summer of 2020, Oneway Concrete (subcontracted by Tizack): sidewalks, curb and gutters, valley gutters, etc. between 501h St and 34th St East of Indiana Ave and West of Elgin Ave. Even more recently, Arturo completed the 2020 Lubbock District Various Locations bridge preventative maintenance which included carbon fiber wrapping some concrete beams at the intersection of I-27 and Loop 289. He and his team were able to complete 92% of the working using only 57% of the time allotted by TXDOT. Currently Arturo is working now working on CR 20 in Swisher Co and is expected to finish the project by the end of February 2021. Arturo will be 100% dedicated working the City of Lubbock Concrete Patching project to ensure 100% compliance and satisfaction. Arturo speaks fluent English and has much experience with sidewalks, curb and gutters, valley gutters and all items listed in the project. Tyler Hebert Tyler Hebert has been working with Blackstone Concrete Ventures since its inception in October 2020 and has been working in construction for 3 years. Tyler has worked on various projects with Blackstone including most recently, the City of Lubbock Concrete Patching 2021 work this summer summer, Garza Co Lubbock District 2020 BPM, at various locations in Lubbock District, currently on CR 20 and FM 2301 in Swisher Co and CR Z bridge in Hale Co. Tyler has received formal training in all the basics including but not limited to SW3P, traffic control, quality control, safety, management. Tyler has also working in other areas around the state of Texas. Tyler is a native English speaker. BLACKSTONE CONCRETE VENTURES ATTACHMENT F - ORGANIZATIONAL APPROACH TO COMPLETING PROJECT The Blackstone Concrete Ventures Project Manager and Field Operations team work together closely to handle all contract administration to ensure the project proceeds with the utmost efficiency. Project Managers notify Field Operations Teams of the project needs and while the Field Operations Team fulfills various needs demonstrated below. These needs can be related to tools, equipment or supplies, contract compliance paperwork, subcontractor scheduling, etc. This frees up the Project Manager focus more energy on supervising work, ensuring quality and safety as well as help foster the ability to anticipate future issues to try and prevent them. Although the Field Operations Team works at reducing the paperwork, the Project Manager will always deal with on -site owner concerns directly, while always informing the Field Operations Team of needed actions to ensure we deliver quality, safety, and compliance to the owner. Proposed Project Managers Organization Doing Business As Primary Candidatc Name of Individual Blackstone Concrete Ventures Robert Herden Years of Experience as Project Manager 5+ Years of Experience with this organization 4 months, new hire Number of similar projects as Project Manager 6 Number of similar projects in other positions 15 Current Project Assignments See Below Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date Swisher Co FM 2301 0789-04-006 50% October 2021 Harrison Co Johnson St 0919-03-062 50% October 2021 Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Name Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Project Project Candidate role on Project Alternate Candidate Name of Individual Candidates role on Project Years of Experience as Project Manager Years of Experience with this organization Number of similar projects as Project Manager Number of similar projects in other positions Current Project Assignments Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date Reference Contact Name Information (listing names indicates approval to contacting the Name names individuals as a reference) Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Proj ect Project Candidate role on Proj ect Candidate role on Project Proposed Project Superintendent Organization Doing Business As Primary Candidatc Name of Individual Blacksone Concrete Ventures Arturo Montano Years of Experience as Project Superintendent 35+ Years of Experience with this organization 2 years 5 months (Since inception) Number of similar projects as Superintendent 20+ Number of similar projects in other positions 15+ Current Project Assignments TXDOT Lubbock Co BPM 6374-29-001 Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date TXDOT Lubbock Co 2021 BPM 6374-29-001 100% November 2021 Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Name Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Project Project Candidate role on Project Alternate Candidate Name of Individual Candidate role on Project Years of Experience as Project Superintendent Years of Experience with this organization Number of similar projects as Superintendent Number of similar projects in other positions Current Project Assignments Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date Reference Contact Name Information (listing names indicates approval to contacting the Name names individuals as a reference) Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Proj ect Project Candidate role on Proj ect Candidate role on Project Proposed Project Safety Officer Organization Doing Business As Primary Candidatc Name of Individual Blackstone Concrete Ventures Tyler Hebert Years of Experience as Project Safety Officer 3 Years of Experience with this organization 1 year Number of similar projects as Safety Officer 3 Number of similar projects in other positions 6 Current Project Assignments TXDOT Lubbock Co BPM 6374-29-001 Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date TXDOT Lubbock Co BPM 6374-29-001 100% November 2021 Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Name Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Project Project Candidate role on Project Alternate Candidate Name of Individual Candidate role on Project Years of Experience as Project Safety Officer Years of Experience with this organization Number of similar projects as Safety Officer Number of similar projects in other positions Current Project Assignments Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date Reference Contact Name Information (listing names indicates approval to contacting the Name names individuals as a reference Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Proj ect Project Candidate role on Proj ect Candidate role on Project Proposed Project Quality Control Manager Organization Doing Business As Primary Candidatc Name of Individual Blackstone Concrete Ventures Arturo Montano Years of Experience as Quality Control Manager 35+ Years of Experience with this organization 2 years, 9 months, since inception Number of similar projects as Quality Manager 20+ Number of similar projects in other positions 15+ Current Project Assignments Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date TXDOT Lubbock Co BPM 6374-29-001 100% November 2021 Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Name Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Project Project Candidate role on Project Alternate Candidate Name of Individual Candidate role on Project Years of Experience as Quality Control Manager Years of Experience with this organization Number of similar projects as Quality Manager Number of similar projects in other positions Current Project Assignments Name of Assignment Percent of Time Used for this Project Estimated Project Completion Date Reference Contact Name Information (listing names indicates approval to contacting the Name names individuals as a reference) Title/ Position Title/ Position Organization Organization Telephone Telephone E-mail E-mail Proj ect Project Candidate role on Proj ect Candidate role on Project Contractor's Project Experience and Resources Organization Doing Business As Blackstone Concrete Ventures Provide a list of major projects that are currently underway, or have been completed within the last ten years on Attachment A Provide a completed Project Information form (Attachment B) for projects that have been completed in the last five years which specifically illustrate the organizations capability to provide best value to the Owner for this project. Include a completed Project Information form (Attachment B) for projects which illustrate the experience of the proposed key personnel. Provide a description of your organizations approach to completing this project to provide best value for the Owner. Including a description of your approach in the following areas: 1. Contract administration 2. Management of subcontractor and suppliers 3. Time management 4. Cost control See ATTACHMENT F 5. Quality management 6. Project site safety 7. Managing changes to the project 8. Managing equipment 9. Meeting HUB / MWBE Participation Goal Equipment Provide a list of major equipment ro osed for use on this project. Attach Additional Information if necess Equipment Item Primary Use on Project Own B ill Y Lease Skid Steer Break concrete/asphalt, move debris, and dig X X 8 yard dump trucks Move debris and materials X Work trucks Transport workers and equipment X Box truck Transport tools and equipment X Trailers Move equipment and materials X Truss Screed/work bridge Division of Work between Organization and Subcontractor What work will the organization complete using its own resources? Blackstone Concrete Ventures will be doing 100% of the work listed in the bid items. What work does the organization propose to subcontract on this project? Blackstone Concrete Ventures plans to sub out the traffic control Contractor's Subcontractors and Vendors Organization Doing Business As Blackstone Concrete Ventures Project. • • Provide a list of subcontractors that will provide more than 10 percent of the work (based on contract amounts Name Work to be Provided Est. Percent of Contract HUB/MWBE Firm FC Traffic Control Provide necessary signs from traffic control as needed < 5% No Provide information on the proposed key personnel, project experience and a description of past relationship and work experience for each subcontractor listed above using the Project Information Forms. Equipment Vendors Provide a list of major equipment proposed for use on this project. Attach Additional Information if necessary Vendor Name Equipment / Material Provided Furnish Only Furnish and Install HUB/M WBE Firm WarrenCAT Equipment Rentals X West Materials Asphalt Materials as needed X PB Materials City Class C Concrete X Al Building Supply Rebar, curing compound, concrete chairs, etc. X CIVIC Construction Materials Expansion joint, joint sealant, wood, X United Rentals Equipment Rentals X Ingram Concrete City Class C Concrete X 10 City of Lubbock Attachment A Current Projects and Project Completed within the last 10 Years Project Owner TXDOT Plainview Office Project Name CR 20 Swisher 0908-17-016 General Description of Project: Proposed bridge class culvert structure consisting of the removal of existing structure Project Cost $552,000.00 Date Project Completed February 2021 Key Project Personnel Project Manager Project Superintendent Safety Officer Quality Control Manager Name Hugo Marquez Arturo Montano Jason Valdez Jose Marquez Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Title/ Position Organization Telephone E-mail Owner Heath Bozeman, P.E. CFM Area Engineer / Plainview TXDOT / Plainview Office (806) 293-5101 heath.bozeman@txdot.gov Designer Construction Manager Project Owner TXDOT Plainview Office Project Name CR Z Hale Co 0905-12-044 General Description of Project: Construction of bridge replacement Project Cost $436,230.00 Date Project Completed January2021 Key Project Personnel Project Manager Project Superintendent Safety Officer Quality Control Manager Name Hugo Marquez Jose Cofradia Jose Cofradia Hugo Marquez Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Title/ Position Organization Telephone E-mail Owner Heath Bozeman, P.E. CFM Area Engineer / Plainview TXDOT / Plainview Office (806) 293-5101 heath.bozeman@txdot.gov Designer Construction Manager Project Owner TXDOT Plainview Office Project Name FM 2301 Swisher Co 0789-04-006 General Description of Project: Bridge replacement consisting of grading, rework base, concrete paving, bridge signing, and striping Project Cost $1,543,187.50 Date Project Completed Apd12021 Key Project Personnel Project Manager Project Superintendent Safety Officer Quality Control Manager Name Hugo Marquez Jose Cofradia Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Title/ Position Organization Telephone E-mail Owner Heath Bozeman, P.E. CFM Area Engineer / Plainview TXDOT / Plainview Office (806) 293-5101 heath.bozeman@txdot.gov Designer Construction Manager 11 /23/2020 11:53 AM 31 p. 34 City of Lubbock Attachment A Current Projects and Project Completed within the last 10 Years Project Owner TXDOT Lubbock District Project Name TXDOT Lubbock District Various Bridge Locations Garza Co 6352-84-001 General Description of Project: 2020 Lubbock District bridge preventative maintenance at various locations in Lubbock District Project Cost $499,834.80 Date Project Completed January2021 Key Project Personnel Project Manager Project Superintendent Safety Officer Quality Control Manager Name Hugo Marquez Arturo Montano Arturo Montano Jose Marquez Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Title/ Position Organization Telephone E-mail Owner Anthony Self Lubbock District Bridge Coordinator TXDOT Lubbock District (806) 778-7729 anthony.self@txdot.gov Designer Construction Manager Project Owner TXDOT Snyder Office Project Name US 380, etc. Stonewall Co, etc. 6339-13-001 General Description of Project: Bridge repair consisting of deck, bent repair, and joint repair Project Cost $815,500.00 Date Project Completed 6/30/2020 Key Project Personnel Project Manager Project Superintendent Safety Officer Quality Control Manager Name Hugo Marquez Jose Cofradia Jose Cofradia Jose Marquez Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Title/ Position Organization Telephone E-mail Owner Stewart Chapman, RE Area Engineer / Snyder Office TXDOT / Snyder Office (325) 573-0143 stewart.chapman@txdot.gov Designer Construction Manager Project Owner TXDOT Brownfield Office Project Name FM 3519 Garza Cc 2767-02-004 General Description of Project: Bridge maintenance consisting of bridge structure repairs, concrete riprap, polymer overlay, one surse, MBGF upgrades, and striping Project Cost $1,617,520.30 Date Project Completed 6/9/2020 Key Project Personnel Project Manager Project Superintendent Safety Officer Quality Control Manager Name Hugo Marquez Arturo Montano Jose Cofradia Jose Marquez Reference Contact Information (listing names indicates approval to contacting the names individuals as a reference) Name Title/ Position Organization Telephone E-mail Owner Save Sisneros, RE Area Engineer / Brownfield Office TXDOT / Brownfield Office (806) 778-7729 seve.sisneros@txdot.gov Designer Construction Manager 11 /23/2020 11:53 AM 31 p. 34 City of Lubbock Protect Information Attachment B Project Owner TXDOT Plainview Office Project Name CR 20 Swisher 0908-17-016 General Description of Project Proposed bridge class culvert structure consisting of the removal of existing structure Budget History Schedule Performance Amount % of Bid Amount Date Days Bid $552,000.00 100% Notice to Proceed 10/712020 Change Orders Contract Substantial Completion Date at Notice to Proceed Owner Enhancements Contract Final Completion Date at Notice to Proceed Completed Unforeseen Conditions Change Order Authorized Substantial Completion Date 51 %of time used Design Issues $29,000.00 Change Order Authorized Final Completion Date Total Actual / Estimated Substantial Completion Date Final Cost $581,00.00 $552,000.00 ey Project Pers Actual / Estimated Final Project Manager Completion Date April 2021 80 122 (66%) Project Sup Safety Officer Quality Control Manager Name Hugo Marquez Arturo Montano Jason Valdez Jose Marquez Percentage of Time Devoted to the Project 20% 90% 100% 100% Proposed for this Project Hugo Marquez Arturo Montano Jason Valdez Jose Marquez Did Individual Start and Complete the Project? Is scheduled to Is scheduled to Is scheduled to Is scheduled to If not, who started or completed the project in their place. Reason for change. Reference Name Title/ Position Organization Telephone E-mail Owner Heath Bozeman, P.E. CFM Area Engineer / Plainview TXDOT / Plainview Office (806) 293-5101 heath.bozeman@txdot.gov Designer Construction Manager Surety Aksel Firat President/ Surety Agent The Surety Place (480) 543-1589 akself@suretyplace.com sues / Disputes Resolved or P solution b3llffbitration, Litigation or Dispute Review Boards Number of issues Total Amount involved in Number of issues Total Amount involved in 0 Resolved ° Resolved Issues ° Pending° Resolved Issues 31 11 /23/2020 11:53 AM p. 35 City of Lubbock Protect Information Attachment B Project Owner TXDOT Plainview Office Project Name CR Z Hale Co 0905-12-044 General Description of Project Construction of bridge replacement Budget History Schedule Performance Amount % of Bid Amount Date Days Bid $436,230.00 100% Notice to Proceed 8/20/2020 Change Orders Contract Substantial Completion Date at Notice to Proceed Owner Enhancements Contract Final Completion Date at Notice to Proceed 100% completed Unforeseen Conditions Change Order Authorized Substantial Completion Date 80 % of time used thus far Design Issues Change Order Authorized Final Completion Date Total $436,230.00 (100% expected) Actual / Estimated Substantial Completion Date Final Cost ey Project Pers Actual / Estimated Final Project Manager Completion Date January 2021 Project Sup Safety Officer Quality Control Manager Name Hugo Marquez Jose Cofradia Jose Cofradia Hugo Marquez Percentage of Time Devoted to the Project 20% 10% 10% 20% Proposed for this Project Hugo Marquez Jose Cofradia Jose Cofradia Hugo Marquez Did Individual Start and Complete the Project? Is scheduled to Is scheduled to Is scheduled to Is scheduled to If not, who started or completed the project in their place. Reason for change. Reference Name Title/ Position Organization Telephone E-mail Owner Heath Bozeman, P.E. CFM Area Engineer / Plainview TXDOT / Plainview Office (806) 293-5101 heath.bozeman@txdot.gov Designer Construction Manager Surety Aksel Firat President/ Surety Agent The Surety Place (480) 543-1589 akself@suretyplace.com sues / Disputes Resolved or Pendin olution b3liMitration, Litigation or Dispute Review Boards MW Number of issues 0 Total Amount involved in o Number of issues o Total Amount involved in o Resolved j Resolved Issues Pending Resolved Issues 31 11 /23/2020 11:53 AM p. 35 City of Lubbock Protect Information Attachment B Project Owner TXDOT Plainview Office Project Name FM 2301 Swisher Co 0789-04-006 (in progress) General Description of Project Bridge replacement consisting of grading, rework base, concrete paving, bridge signing, and striping Budget History Schedule Performance Amount % of Bid Amount Date Days Bid $1,543,187.50 100% Notice to Proceed 7/13/2020 Change Orders Contract Substantial Completion Date at Notice to Proceed Owner Enhancements Contract Final Completion Date at Notice to Proceed Scheduled to be completed Unforeseen Conditions Change Order Authorized Substantial Completion Date within alloted days Design Issues Change Order Authorized Final Completion Date Total $1,543,187.50 (100% expected) Actual / Estimated Substantial Completion Date Final Cost ey Project Pers Actual / Estimated Final Project Manager Completion Date October 2021 Project Sup Safety Officer Quality Control Manager Name Hugo Marquez Jose Cofradia Jose Cofradia Hugo Marquez Percentage of Time Devoted to the Project 20% 90% 90 20% Proposed for this Project Hugo Marquez Jose Cofradia Jose Cofradia Jose Cofradia Did Individual Start and Complete the Project? Is scheduled to Is scheduled to Is scheduled to Is scheduled to If not, who started or completed the project in their place. Reason for change. Reference Name Title/ Position Organization Telephone E-mail Owner Heath Bozeman, P.E. CFM Area Engineer / Plainview TXDOT / Plainview Office (806) 293-5101 heath.bozeman@txdot.gov Designer Construction Manager Surety Aksel Firat President/ Surety Agent The Surety Place (480) 543-1589 akself@suretyplace.com sues / Disputes Resolved or Pe olution b3llff6itration, Litigation or Dispute Review Boards Number of issues o Total Amount involved in o Number of issues o Total Amount involved in 0 Resolved Resolved Issues PendingResolved Issues 31 11 /23/2020 11:53 AM p. 35 City of Lubbock Protect Information Attachment B Project Owner TXDOT Lubbock District Project Name Various Bridge Locations Garza Co 6352-84-001 General Description of Project 2020 Lubbock District bridge preventative maintenance at various locations in Lubbock District Budget History Schedule Performance Amount % of Bid Amount Date Days Bid $517,184.80 100% Notice to Proceed 7/8/2020 Change Orders -$17,350.00 -3.4% Contract Substantial Completion Date at Notice to Proceed Owner Enhancements Contract Final Completion Date at Notice to Proceed 100%comleted Unforeseen Conditions Change Order Authorized Substantial Completion Date 57%of time used Design Issues Change Order Authorized Final Completion Date Total Actual / Estimated Substantial Completion Date Final Cost $499,834.80 96.6% ey Project Pers Actual / Estimated Final Project Manager Completion Date October2021 Project Sup Safety Officer Quality Control Manager Name Hugo Marquez Arturo Montano Arturo Montano Jose Marquez Percentage of Time Devoted to the Project 10% 10% 10% 10% Proposed for this Project Hugo Marquez Arturo Montano Arturo Montano Jose Marquez Did Individual Start and Complete the Project? Is scheduled to Is scheduled to Is scheduled to Is scheduled to If not, who started or completed the project in their place. Reason for change. Reference Name Title/ Position Organization Telephone E-mail Owner Anthony Self Lubbock District Bridge Coordinator TXDOT / Lubbock District (806) 778-7729 anthony.self@txdot.gov Designer Construction Manager Surety Aksel Firat President/ Surety Agent The Surety Place (480) 543-1589 akself@suretyplace.com idusues / Disputes Reso in olution b itration, Litigation or Dispute Review Boards Number of issues 0 Total Amount involved in 0 Number of issues o Total Amount involved in o Resolved Resolved Issues Pending Resolved Issues 31 11 /23/2020 11:53 AM p. 35 City of Lubbock Protect Information Attachment B Project Owner TXDOT Snyder Office Project Name US 380, etc. Stonewall Co, etc. 6339-13-001 General Description of Project Bridge repair consisting of deck, bent repair, and joint repair Budget History Schedule Performance Amount % of Bid Amount Date Days Bid $270,200.00 100% Notice to Proceed 2/12/2020 1 Change Orders $283,100.00 104.8% Contract Substantial Completion Date at Notice to Proceed Owner Enhancements $262,200.00 97% Contract Final Completion Date at Notice to Proceed Unforeseen Conditions Change Order Authorized Substantial Completion Date Design Issues Change Order Authorized Final Completion Date Total Actual / Estimated Substantial Completion Date Final Cost $815,500.00 201.8 r ey Project Pers Actual / Estimated Final Project Manager Completion Date 6/30/2020 33 of 33 days used Project Sup Safety Officer Quality Control Manager Name Hugo Marquez Jose Cofradia Jose Cofradia Jose Marquez Percentage of Time Devoted to the Project 100% 80% 20 100% Proposed for this Project Hugo Marquez Jose Cofradia Jose Cofradia Jose Marquez Did Individual Start and Complete the Project? Yes Yes Yes Yes If not, who started or completed the project in their place. Reason for change. Reference Name Title/ Position Organization Telephone E-mail Owner Stewart Chapman, RE Area Engineer / Snyder Office TXDOT / Snyder Office (323) 573-0143 stewart.chapman@txdot.gov Designer Construction Manager Surety Aksel Firat President/ Surety Agent The Surety Place (480) 543-1589 akself@suretyplace.com sues / Disputes Resolved or Pe olution b bitration, Litigation or Dispute Review Boards Number of issues Total Amount involved in Number of issues Total Amount involved in o Resolved 0 Resolved Issues Pending0 Resolved Issues 31 11 /23/2020 11:53 AM p. 35 City of Lubbock Protect Information Attachment B Project Owner TXDOT Brownfield Office Project Name FM 3519 Garza Cc 2767-02-004 General Description of Project Bridge maintenance consisting of bridge stucture repairs, concrete riprap, polymer overlay, one surse, MBGF upgrades and striping Budget History Schedule Performance Amount % of Bid Amount Date Days Bid $1,306,629.40 100 Notice to Proceed 10/21/2019 Change Orders $114,750.00 8.8% Contract Substantial Completion Date at Notice to Proceed Owner Enhancements $196,140.90 15% Contract Final Completion Date at Notice to Proceed Unforeseen Conditions Change Order Authorized Substantial Completion Date Design Issues Change Order Authorized Final Completion Date Total Actual / Estimated Substantial Completion Date Final Cost $1,617,520.30 123.8i ey Project Pers Actual / Estimated Final Project Manager Completion Date s/9/2o20 (fib f)122 days used Project Sup Safety Officer Quality Control Manager Name Hugo Marquez Arturo Montano Jose Cofradia Jose Marquez Percentage of Time Devoted to the Project 100i 100 100 100% Proposed for this Project Hugo Marquez Arturo Montano Jose Cofradia Jose Marquez Did Individual Start and Complete the Project? Yes Yes Yes Yes If not, who started or completed the project in their place. Reason for change. Reference Name Title/ Position Organization Telephone E-mail Owner Save Sisneros, RE Area Engineer / Brownfield Office TXDOT / Brownfield Office (806) 637-4501 seve.sisneros@txdot.gov Designer Construction Manager Surety Aksel Firat President/ Surety Agent The Surety Place (480) 543-1589 akself@suretyplace.com sues / Disputes Resolved or PendinglWolution b bitration, Litigation or Dispute Review Boards Number of issues Total Amount involved in Number of issues o Total Amount involved in o Resolved Resolved Issues Pending Resolved Issues 31 11 /23/2020 11:53 AM p. 35 City of Lubbock, TX Purchasing and Contract Management Safety Record Questionnaire The City of Lubbock City Council desires to avail itself of the benefits of Section 252.0435 of the Local Government Code, and consider the safety records of potential contractors prior to awarding proposals on City contracts. Pursuant to Section 252.0435 of the Local Government Code, City of Lubbock has adopted the following written definition and criteria for accurately determining the safety record of a proposer prior to awarding proposals on City contracts. The definition and criteria for determining the safety record of a proposer for this consideration shall be: The City of Lubbock shall consider the safety record of the offerors in determining the responsibility thereof. The City may consider any incidence involving worker safety or safety of the citizens of the City of Lubbock, be it related or caused by environmental, mechanical, operational, supervision or any other cause or factor. Specifically, the City may consider, among other things: a. Complaints to, or final orders entered by, the Occupational Safety and Health Review Commission (OSHRC), against the proposer for violations of OSHA regulations within the past three (3) years. b. Citations (as defined below) from an Environmental Protection Agency (as defined below) for violations within the past five (5) years. Environmental Protection Agencies include, but are not necessarily limited to, the U.S. Army Corps of Engineers (USACOE), the U.S. Fish and Wildlife Service (USFWS), the Environmental Protection Agency (EPA), the Texas Commission on Environmental Quality (TCEQ), the Texas Natural Resource Conservation Commission (TNRCC) (predecessor to the TCEQ), the Texas Department of State Health Services (DSHS), the Texas Parks and Wildlife Department (TPWD), the Structural Pest Control Board (SPCB), agencies of local governments responsible for enforcing environmental protection or worker safety related laws or regulations, and similar regulatory agencies of other states of the United States. Citations include notices of violation, notices of enforcement, suspension/revocations of state or federal licenses or registrations, fines assessed, pending criminal complaints, indictments, or convictions, administrative orders, draft orders, final orders, and judicial final judgments. C. Convictions of a criminal offense within the past ten (10) years, which resulted in bodily harm or death. d. Any other safety related matter deemed by the City Council to be material in determining the responsibility of the offeror and his or her ability to perform the services or goods required by the proposal documents in a safe environment, both for the workers and other employees of offeror and the citizens of the City of Lubbock. In order to obtain proper information from offerors so that City of Lubbock may consider the safety records of potential contractors prior to awarding proposals on City contracts, City of Lubbock requires that offerors answer the following four (4) questions and submit them with their proposals: QUESTION ONE Has the offeror, or the firm, corporation, partnership, or institution represented by the offeror, or anyone acting for such firm, corporation, partnership or institution, received citations for violations of OSHA within the past three (3) years? YES NO V If the offeror has indicated YES for question number one above, the offeror must provide to City of Lubbock, with its proposal submission, the following information with respect to each such citation: Date of offense, location of establishment inspected, category of offense, final disposition of offense, if any, and penalty assessed. QUESTION TWO Has the offeror, or the firm, corporation, partnership, or institution represented by the offeror, or anyone acting for such firm, corporation, partnership or institution, received citations for violations of environmental protection laws or regulations, of any kind or type, within the past five years? Citations include notice of violation, notice of enforcement, suspension/revocations of state or federal licenses, or registrations, fines assessed, pending criminal complaints, indictments, or convictions, administrative orders, draft orders, final orders, and judicial final judgments. YES NO-_ If the offeror has indicated YES for question number two above, the offeror must provide to City of Lubbock, with its proposal submission, the following information with respect to each such conviction: Date of offense or occurrence, location where offense occurred, type of offense, final disposition of offense, if any, and penalty assessed. QUESTION THREE Has the offeror, or the firm, corporation, partnership, or institution represented by offeror, or anyone acting for such firm, corporation, partnership, or institution, ever been convicted, within the past ten (10) years, of a criminal offense which resulted in serious bodily injury or death? YES NO V If the offeror has indicated YES for question number three above, the offeror must provide to City of Lubbock, with its proposal submission, the following information with respect to each such conviction: Date of offense, location where offense occurred, type of offense, final disposition of offense, in any, and penalty assessed. QUESTION FOUR Provide your company's Experience Modification Rate and supporting information: ACKNOWLEDGEMENT THE STATE OF TEXAS COUNTY OF LUBBOCK I certify that I have made no willful misrepresentations in this Questionnaire nor have I withheld information in my statements and answers to questions. I am aware that the information given by me in this questionnaire will be investigated, with my full permission, and that any misrepresentations or omissions may cause my proposal to be rejected. Signature f 1 l4t�i 'wM Title 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. PROPOSED LIST OF SUB -CONTRACTORS Company Name r C Location L0I6HI c k_ Minority Owned Services Provided Yes No ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Cl ❑ THIS FORM SHALL BE COMPLETED AND RETURNED ALONG WITH YOUR RESPONSE IF NO SUB -CONTRACTORS WILL BE USED PLEASE INDICATE SO SUBM/I'TTED BY: (PRINT NAME OF COMPANY) Page Intentionally Left Blank POST -CLOSING DOCUMENT REQUIREMENTS The below -listed document must be received in the Purchasing and Contract Management Office Not Later Than SEVEN BUSINESS DAYS after the close date when responses are due. FINAL LIST OF SUB -CONTRACTORS Page Intentionally Left Blank FINAL LIST OF SUB -CONTRACTORS Minority Owned Company Name Location Services Provided FC 4bbo�� Yes No ❑ 0 1. cCAC_CAfAm\setLlce 2. ❑ ❑ 3. ❑ ❑ 4. ❑ ❑ 5. ❑ ❑ 6. ❑ ❑ 7. ❑ ❑ 8. ❑ ❑ 9. ❑ ❑ 10. ❑ ❑ IL ❑ ❑ 12. ❑ ❑ 13. ❑ ❑ 14. ❑ ❑ 15. ❑ ❑ 16. ❑ ❑ SUBMITTED BY: Q�6w_ CCWTAC Vern Vc�) PRINT NA ME OF COMPANY) THIS FORM SHALL BE COMPLETED AND RETURNED NOT LATER THAN SEVEN BUSINESS DAYS AFTER THE CLOSE DATE WHEN PROPOSALS ARE DUE IF NO SUB -CONTRACTORS WILL BE USED PLEASE INDICATE SO RFP 21-15949-.1M -CONCRETE MAC DAVIS LANE Page Intentionally Left Blank PAYMENT BOND Page Intentionally Left Blank STATUTORY PAYMENT BOND PURSUANT TO SECTION 2253.021(a) OF THE TEXAS GOVERNMENT CODE (CONTRACTS MORE THAN $50,000) Bond No. 4449134 KNOW ALL MEN BY THESE PRESENTS, that Blackstone Concrete Ventures, LLC (hereinafter called the Principal(s), as Principal(s), and Suretec Insurance Company (hereinafter called the Surety(s), as Surety(s), are held and firmly bound unto the City of Lubbock (hereinafter called the Obligee), in the amount of Five Hundred Ninety -Three Thousand Two Hundred Fift Dollars and no cents ($593,250.00) lawful money of the United States for the payment whereof, the said Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has entered into a certain written contract with the Obligee, dated the 24tb day of Auzust, 2021, to RFP 21-15949-JM Concrete on Mac Davis Lane and said Principal under the law is required before commencing the work provided for in said contract to execute a bond in the amount of said contract which contract is hereby referred to and made a part hereof as fully and to the same extent as if copied at length herein. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal shall pay all claimants supplying labor and material to him or a subcontractor in the prosecution of the work provided for in said contract, then, this obligation shall be void; otherwise to remain in full force and effect; PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Section 2253.021(a) of the Texas Government Code, and all liabilities on this bond shall be determined in accordance with the provisions of said Article to the same extent as if it were copied at length herein. IN WITNESS WHEREOF, the said Principal (s) and Surety (s) have signed and sealed this instrument this 24th day of Au ust 2021. Suretec Insurance Company Surety Ua�Al �*By: W (Title) u Kay Blair, Attorney -in -Fact (Printed Name) Blackstone_ Concrete Ventures, LLC (Company Name) By: Mark Murray Managing Member (Title) Page Intentionally Left Blank The undersigned surety company represents that it is duly qualified to do business in Texas, and hereby designates Dawn Ta, low Higginbotham Insurance Agency, 9111 Milwaukee Ave Lubbock, TX 79424 an agent resident in Lubbock 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. H IGGI NBOTHAM Global Reach. Local Touch. Single Source, P.O. Box 1071 Wichita Falls. TX 76307 Approved as to Form City of Lubbock By: City Attorney (940) 723-0771 FAX (940) 761-5280 Suretec Insurance Company Surety *By: (Title) Kay B air, Attorney -in -Fact * Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If signed by an Attorney in Fact, we must have copy of power of attorney for our files. Page Intentionally Left Blank POA# 4221381 JOINT LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That SureTec Insurance Company, a Corporation duly organized and existing under the laws of the State of Texas and having its principal office in the County of Harris, Texas and Markel Insurance Company (the "Company"), a corporation duly organized and existing under the laws of the state of Illinois, and having its principal administrative office In Glen Allen, Virginia, does by these presents make, constitute and appoint: Shawn Blacktock, Kay Blair, Shane Smith, Donna Martinez Their true and lawful agent(%) and attorneys) -in -fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on their own behalf, individually as a surety or jointly, as co -sureties, and as their act and dead any and all bonds and other undertaking in suretyship provided, however, that the penal sum of any one such Instrument executed hereunder shall not exceed the sum of. - Five Million and 00/100 Dollars ($5,000,000.00) This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolutions adopted by the Board of Directors of SureTec Insurance Company and Markel Insurance Company: 'RESOLVED, That the President, Senior Vice President, vice President, Assistant Vice President, Secretary, Treasurer and each of them hereby is a-athorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the company, qualifying the attorney or attorneys named in the given power of attorney, to execute in behalf of, and acknowledge as the act and deed of the SureTec Insurance Company and Markel Insurance Company, as the case may be, all bond undertakings and contracts of suretyship, and to affix the corporate seat thereto." IN WITNESS WHEREOF, Markel Insurance Company and SureTec Insurance Company have caused their official seal to be hereunto affixed and these presents to be signed by their duly authorized officers on the ist day of oawmbai , 2020 . SureTec Insurance Company suRANCF PUG\CO ay: 9: g Michael C. Keimig, President �ifi `ti, l e t Commonwealth of Virginia County of Henrico SS, `s�$V iNr�i Markel Insur. ce Company `0 By: Rdbin Russo, Senior Vice President ��rrrrrij jnt+��•�• On this tei day of Dace nw. mac A. D., before me, a Notary Public of the Commonwealth of Virginia, In and for the County of Henrico, duly commissioned and qualified, came THE ABOVE OFFICERS OF THE COMPANIES, to me personally known to be the individuals and officers described in, who executed the preceding instrument, and they acknowledged the execution of same, and being by me duly sworn, disposed and said that they are the officers of the said companies aforesaid, and that the seals affixed to the proceeding instrument are the Corporate Seals of said Companies, and the said Corporate Seals and their signatures as officers were duly affixed and subscribed to the said Instrument by the authority and direction of the said companies, and that Resolutions adopted by the Board of Directors of said Companies referred to In the preceding instrument Is now in force. ••� �'�+i r r rrirrrr .•', P,D O' • r'•, IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed m,•b SaaF r tbg�ityAf Henrico, the day and year first above written. my COMMISSION By: L n WbIBF_R O ', _ = Donna Donavan[, Notary Public yA 7063968 �' . My commission expires 1/31/2023 We, the undersigned Officers of SureTec Insurance Company and Marke�'�siiy�C��iy t%�q$erby certify that the original POWER OF ATTORNEY of which the foregoing is a full, true and correct copy is still in full farce and effect and hasltgt;,lil � (fifoitd. �� I IN WITNESS WHEREOF, we have hereunto set our hands, and affixed the Seals of said Companies, on the day of S (> J. Su e08eatyAMssist.nt an Markel Insurance Company By/ By ff < M. Br Secreta Rirharri R rtinn.n vice 0.nel, —t �.. Any Instrument Issued in excess of the penalty stated above is totally void and without any validity. 42.21381 For verification of the authority of this Power you may call (713)812-0800 on any business day between 8:30 AM and 51)0 PM CST. SureTec Insurance Company THIS BOND RIDER CONTAINS IMPORTANT COVERAGE Statutory Complaint Notice/Filing of Claims INFORMATION To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint or file a claim at: 1-866-732-0099. You may also write to the Surety at: SureTec Insurance Company 9737 Great Hills Trail, Suite 320 Austin, Tx 78759 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252- 3439. You may write the Texas Department of Insurance at PO Box 149104 Austin, TX 78714-9104 Fax#:512-490-1007 Web: http://www.tdi.state.tx.us Email: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Texas Rider 06042014 PERFORMANCE BOND Page Intentionally Left Blank STATUTORY PERFORMANCE BOND PURSUANT TO SECTION 2253.021(a) OF THE TEXAS GOVERNMENT CODE (CONTRACTS MORE THAN $100,000) Bond No. 4449134 KNOW ALL MEN BY THESE PRESENTS, that Blackstone Concrete Ventures, LLC (hereinafter called the Principal(s), as Principal(s), and Suretec Insurance Company (hereinafter called the Surety(s), as Surety(s), are held and firmly bound unto the City of Lubbock (hereinafter called the Obligee), in the amount of Five Hundred Ninety -Three Thousand Two Hundred Fifty Dollars and no/cents ($593,250.00) lawful money of the United States for the payment whereof, the said Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has entered into a certain written contract with the Obligee, dated the 20, day of August, 2021, to RFP 21-15949-JM Concrete on Mac Davis Lane and said principal under the law is required before commencing the work provided for in said contract to execute a bond in the amount of said contract which contract is hereby referred to and made a part hereof as fully and to the same extent as if copied at length herein. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal shall faithfully perform the work in accordance with the plans, specifications and contract documents, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Section 2253.02l(a) of the Texas Government Code, and all liabilities on this bond shall be determined in accordance with the provisions of said article to the same extent as if it were copied at length herein. IN WITNESS WHEREOF, the said Principal (s) and Surety (s) have signed and sealed this instrument this 24th day of Au ust , 2021. Suretec insurance Comnan Surety * By: gaa� 'Met� (Title) Kay T31air, Attorney -in -Fact Blackstone Concrete Ventures, LLC (Company Name) By: Mark Murray . (Printed Name) Agnature Managing Member (Title) Page Intentionally Left Blank The undersigned surety company represents that it is duly qualified to do business in Texas, and hereby designates Dawn Taylor, -Higginbotham Insurance Agency, 9111 Milwaukee Ave Lubbock TX 79424 an agent resident in Lubbock 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. HIGGINBOTHAM global Reach. Local Touch_ Single Source PO. Box 1071 (940) 723.0771 Wiohila Fal.s, TX 7&07 FAX (940) 761-5280 Approved as to Form City of Lubbock By: City Attorney Suretec Insurance, Company Surety *By._g?f 4Wam_1 (Title) Kay Blair, Attorney -in -Fact * Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If signed by an Attorney in Fact, we must have copy of power of attorney for our files. Page Intentionally Left Blank ppA# 4221381 JOINT LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That SureTec Insurance Company, a Corporation duly organized and existing under the laws of the State of Texas and having Its principal office in the County of Harris, Texas and Markel Insurance Company (the 'Company), a corporation duly organized and existing under the laws of the state of Illinois, and having its principal administrative office in Glen Allen, Virginia, does by these presents make, constitute and appoint: Shawn Blacklock, Kay Blair, Shane Smith, Donna Martinez Their true and lawful agent(s) and attorney(s).in-fact, each in their separate capacity if more than one Is named above, to make, execute, seal and deliver for and on their own behalf, individually as a surety or jointly, as co -sureties, and as their act and deed any and all bonds and other undertaking In suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: Five Million and 00/100 Dollars ($5,000,000.00) This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolutions adopted by the Board of Directors of SureTec Insurance Company and Markel Insurance Company. "RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice President, Secretary, Treasurer and each of them hereby is authorized to execute powers of attorney. and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the company, qualifying the attorney or attorneys named in the given power of attorney, to execute In behalf of, and acknowledge as the act and deed of the SureTec Insurance Company and Markel Insurance Company, as the case may be, all bond undertakings and contracts of suretyship, and to affix the corporate seat thereto " IN WITNESS WHEREOF, Markel Insurance Company and SureTec Insurance Company have caused their official seal to be hereunto affixed and these presents to be signed by their duly authorized officers on the iai day of DKmmbw . wim . SureTec Insurance Company 4+ONCF By. 7 to Go Michael C. Keimig, President IN Commonwealth of Virginia County of Henrico SS: •`\\$ rry,��� Markel lnsu7ce Company SEA . By '�, •'.7 �� Rdbin Russo, Senior Vice President ///hlll*lilt55\\\` On this i■i day of Duwntw. 2a20 A. D.. before me, a Notary Public of the Commonwealth of Virginia, in and for the County of Henrico, duly commissioned and qualified, came THE ABOVE OFFICERS OF THE COMPANIES, to me personally known to be the individuals and officers described in, who executed the preceding instrument, and they acknowledged the execution of same, and being by me duly sworn, disposed and sold that they are the officers of the said companies aforesaid, and that the seals affixed to the proceeding instrument are the Corporate Seals of said Companies, and the said Corporate Seals and their signatures as officers were duly affixed and subscribed to the said Instrument by the authority and direction of the said companies, and that Resolutions adopted by the Board of Directors of said Ompaniesreferred tointhe preceding Instrument Isnow inforce, ••••�ssrtlrrrrrr p, OO/�,A,'•, IN TESTIMONY WHEREOF, i have hereunto set m hand, and affixed m CF�n a y rU ,SR pkg tya: Henrico, the day and year first above written. o Y ���•.�.k •, � MY n • COMMISSION gy.� C> NUMBER � Q • O Donna Donavant, Notary Public 7063968 \ w C� My commission expires 1/31/2023 We, the undersigned Officers of SureTec Insurance Company and Mark. -I Igsi , y kglgerby certify that the original POWER OF ATTORNEY of whrch the foregoing is a full, true and correct copy is stilt in full force and effect and hafiegtl iq (pokil IN WITNESS WHEREOF, we have hereunto set our hands, and affixed the Seals of said Companies, on the � 1 " day of , Su ec*Insurce pan), BM. Br tant Secreta Markel Insurance Company Richard R. Grinnan, Vice President an ary Any Instrument Issued in excess of the penalty stated above is totally void and without any validity. 4221381 For verification of the authority of this Power you may call (713)812-08W on any business day between 8:30 AM and 5:00 PM CST Page Intentionally Left Blank Cyo171IIw[OFNIWOalela tMere0 Page Intentionally Left Blank CERTIFICATE OF INSURANCE TO: CITY OF LUBBOCK DATE: P.O. BOX 2000, LUBBOCK, TX 79401 TYPE OF PROJECT: THIS IS TO CERTIFY THAT (Name and Address of Insured) is, at the date of this certificate, insured by this Company with respect to the business operations hereinafter described, for the typed of insurance and in accordance with the provisions f the standard policies used by this company, the further hereinafter described. Exceptions to standard policy noted hereon. TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EFFECTIVE LIMITS DATE DATE GENERAL LIABILITY ❑ Commercial General Liability General Aggregate $ ❑ Claims Made Products-Comp/Op AGG $ ❑ Occurrence Personal & Adv. Injury $ ❑ Owner's & Contractors Protective Each Occurrence $ ❑ Fire Damage (Any one Fire) $ Med Exp (Any one Person) $ AUTOMOTIVE LIABILITY ❑ Any Auto Combined Single Limit $ ❑ All Owned Autos Bodily Injury (Per Person) $ ❑ Scheduled Autos Bodily Injury (Per Accident) $ ❑ Hired Autos Property Damage $ ❑ Non -Owned Autos 11 GARAGE LIABILITY ❑ Any Auto Auto Only - Each Accident $ ❑ Other than Auto Only: Each Accident $ Aggregate $ ❑ BUILDER'S RISK ❑ 100% of the Total Contract Price $ ❑ INSTALLATIONFLOATER $ EXCESS LIABILITY ❑ Umbrella Form Each Occurrence $ Aggregate $ ❑ Other Than Umbrella Form $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY The Proprietor/ ❑ Included Statutory Limits Partners/Executive ❑ Excluded Each Accident $ Officers are: Disease Policy Limit $ Disease -Each Employee $ OTHER The above policies either in the body thereof or by appropriate endorsement provide that they may not be changed or canceled by the insurer in less than the legal time required after the insured has received written notice of such change or cancellation, or in case there is no legal requirement, in less than five days in advance of cancellation. FIVE COPIES OF THE CERTIFICATE OF INSURANCE MUST BE SENT TO THE CITY OF LUBBOCK (Name of Insurer) By: Title: The Insurance Certificates Furnished shall name the City of Lubbock as Additional Insured on Auto General Liability and provide a Waiver of Subrogation in favor of the City of Lubbock. THE ADDITIONAL INSURED ENDORSEMENT SHALL INCLUDE PRODUCTS AND COMPLETE OPERATIONS. INSURANCE INFORMATION CONTINUED CONTRACTORCHECKLIST A CONTRACTOR SHALL: (1) provide coverage for its employees providing services on a project, for the duration of the project based on proper reporting of classification codes and payroll amounts and filling of any coverage agreements; (2) provide a certificate of coverage showing workers' compensation coverage to the governmental entity prior to beginning work on the project; (3) provide the governmental entity, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project; (4) obtain from each person providing services on a project, and provide to the governmental entity: (A) a certificate of coverage, prior to that person beginning work on the project, so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project; and (B) no later than seven days after receipt by the contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (5) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (6) notify the governmental entity in writing by certified mail or personal delivery, within ten (10) days after the contractor knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; (7) post a notice on each project site informing all persons providing services on the project that they are required to be covered, and stating how a person may verify current coverage and report failure to provide coverage. This notice does not satisfy other posting requirements imposed by the Act or other commission rules. This notice must be printed in at least 19-point normal type, and shall be in both English and Spanish and any other language common to the worker population. The text for the notices shall be the following text provided by the commission on the sample notice, without any additional words or changes: PROOF OF COVERAGE SHALL BE FURNISHED TO THE CITY OF LUBBOCK IN THE FORM OF A CERTIFICATE OF INSURANCE. THE INSURANCE CERTIFICATES FURNISHED SHALL NAME THE CITY OF LUBBOCK AS ADDITIONAL INSURED ON AUTO/GENERAL LIABILITY ON A PRIMARY AND NON-CONTRIBUTORY BASIS TO INCLUDE PRODUCTS OF COMPLETE OPERATIONS. PROVIDE A WAIVER OF SUBROGATION IN FAVOR OF THE CITY OF LUBBOCK. IT SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO PROVIDE TO THE OWNER ALL PROOF OF COVERAGE INSURANCE DOCUMENTS INCLUDING WORKERS COMPENSATION COVERAGE FOR EACH SUBCONTRACTOR. COPIES OF THE ENDORSEMENTS ARE REQUIRED. REQUIRED WORKERS' COMPENSATION COVERAGE "The law requires that each person working on this site or providing services related to this construction project must be covered by workers' compensation insurance. This includes persons providing, hauling, or delivering equipment and materials, or providing labor or transportation or other service related to the project, regardless of the identity of their employer or status as an employee." "Call the Texas Workers' Compensation Commission at 512-305-7238 to receive information on the legal requirement for coverage, to verify whether your employer has provided the required coverage, or to report an employer's failure to provide coverage." and contractually require each person with whom it contracts to provide services on a project, to: (A) provide coverage based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements for all of its employees providing services on the project, for the duration of the project; (B) provide a certificate of coverage to the contractor prior to that person beginning work on the project; (C) provide the contractor, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (D) obtain from each other person with whom it contracts, and provide to the contractor: (i) a certificate of coverage, prior to the other person beginning work on the project; and (ii) prior to the end of the coverage period, a new certificate of coverage showing extension of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (E) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (F) notify the governmental entity in writing by certified mail or personal delivery, within (ten) 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and (G) contractually require each other person with whom it contracts, to perform as required by paragraphs (A) - (IT), with the certificate of coverage to be provided to the person for whom they are providing services. The Contractor shall not commence work under this contract until he has obtained all insurance as required in the General Conditions of the contract documents, from an underwriter authorized to do business in the State of Texas and satisfactory to the City. Proof of coverage shall be furnished to the City and written notice of cancellation or any material change will be provided ten (10) calendar days in advance of cancellation or change. All policies of insurance, required herein, including policies of insurance required to be provided by Contractor and its subcontractors, shall contain a waiver of any and all of the insurer's or payor's, in the event of self-insurance, rights to subrogation that any such insurer or payor, in the event of self-insurance, may acquire by virtue of payment of any loss under such insurance or self-insurance. All certificates of insurance submitted to the City in conformity with the provisions hereof shall establish such waiver. The Contractor shall procure and carry at its sole cost and expense through the life of this contract, insurance protection as hereinafter specified. Coverage in excess of that specified herein also shall be acceptable. Such insurance shall be carried with an insurance company authorized to transact business in the State of Texas and shall cover all operations in connection with this contract, whether performed by the Contractor or a subcontractor, or separate policies shall be provided covering the operation of each subcontractor. A certificate of insurance specifying each and all coverages shall be submitted prior to contract execution. REQUIRED WORKERS' COMPENSATION COVERAGE "The law requires that each person working on this site or providing services related to this construction project must be covered by workers' compensation insurance. This includes persons providing, hauling, or delivering equipment and materials, or providing labor or transportation or other service related to the project, regardless of the identity of their employer or status as an employee." "Call the Texas Workers' Compensation Commission at 512-305-7238 to receive information on the legal requirement for coverage, to verify whether your employer has provided the required coverage, or to report an employer's failure to provide coverage." and contractually require each person with whom it contracts to provide services on a project, to: (A) provide coverage based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements for all of its employees providing services on the project, for the duration of the project; (B) provide a certificate of coverage to the contractor prior to that person beginning work on the project; (C) provide the contractor, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (D) obtain from each other person with whom it contracts, and provide to the contractor: (i) a certificate of coverage, prior to the other person beginning work on the project; and (ii) prior to the end of the coverage period, a new certificate of coverage showing extension of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (E) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (F) notify the governmental entity in writing by certified mail or personal delivery, within (ten) 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and (G) contractually require each other person with whom it contracts, to perform as required by paragraphs (A) - (H), with the certificate of coverage to be provided to the person for whom they are providing services. Page Intentionally Left Blank ili. O CERTIFICATE OF LIABILITY INSURANCE � (MDIYYYY) 70�212712021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Christy Smith Legacy Insurance Group g Y P FAA PHONE 806 642-0200 AIC, No, Ext : � � (A/C, No): ADDRESS: christy(c(legacyinsurancel.com 10210 Quaker Ave INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Lubbock TX 79424 INSURED INSURER B: Progressive County Mutual Insurance Company Blackstone Concrete Ventures LLC INSURERC: INSURER D : 6827 6th St. INSURER E : Lubbock TX 79416 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO - PRO JECT❑ POLICY ❑ LOC OTHER: GENERAL AGGREGATE $ PRODUCTS- COMP/OP AGG $ $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS NON -OWNED AUTOS ONLY I► AUTOS ONLY X X 01187272-1 10/02/2020 10/02/2021 (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ XHIRED BODILY INJURY (Per accident) $ HRUHLKI Y JAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N l A PER- STATUTE I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) City of Lubbock is listed as Additional Insured on the Commercial Auto policy CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Lubbock ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 2000, Floor 9 AUTHORIZED REPRESENTATIVE Lubbock, TX 79457 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD h CE?MMERC14L Policy number: 011872721 llndennri en bv. Progressive Court/ thtual Insurance Co. insured: BLACKSTONE CONCRETE VENTURES LLC Idarch 8, 2021 Policy Period: 10/02/2020 — 10/02/2021 Mailing Address Progressive County k1!.tual Insurance Cc, t I r ors 0 Bard, Ng Cleue"Lr,d. N 44101 1-800-444-4487 For customer service, 24 hours a day, CITY OF LUBBOCK days a esk PO BOX 2000 FL9 LUBBECKTX 79457 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree ,with you that insurance provided by this endorsement will be primary for any povuer unit specifically described on the Declarations Page. Limit of Liability Bodily Injury each person/ each accident Property Damage each accident Combined Liability $1,000,000 each accident This endorsement applies to Policy Number: 01187272/ Issued to (Name of Insured) BLACKSTONE CONCRETE VENTURES LLC Effective date of endorsement: 01 iOS"2021 Parro 1 198 (01/04) rY1 cr Policy expiration date: '10j02j2021 LEGACY INS GROUP LLC PO BOX 848 CHILDRESS, TX 73521 Named insured BLACKSTONE CONCRETE VENTURES LLC 6827 6TH ST. LUBBOCK, TX 79416 Commercial Auto PROGREll/UE COMM£XOIAL Policy number: 01187272-1 Underwritten by: Progressive County Mutual Ins Co February 26, 2021 Policy Period: Oct 2, 2020 - Oct 2, 2021 Page 1 of 4 progressiveagent.com Online Service Make payments, check billing activity, print policy documents, or check the status of a claim. 1-580-477-4840 Insurance Coverage Summary LEGACY INS GROUP LLC Contact your agent for personalized service. This is your Declarations Page 1-800-444-4487 Your coverage has changed For customer service if your agent is unavailable or to report a claim. Your coverage began on October 2, 2020 at 12:01 a.m. This policy expires on October 2, 2021 at 12:01 a.m. This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto, unless the policy contract allows the stacking of limits. The policy contract is form 6912 (06/10). The contract is modified by forms 2852TX (02/07), 1652TX (05/07), 1890 (03/08), 1891 (03/08), 1198 (01/04), Z529TX (03/07), Z528TX (03/07), 8610 (05/09), 8610TX (06/17), Z313 (05/07), 4852TX (03/07), 4881TX (09/14) and Z228 (01/11). The named insured organization type is a corporation. Motor Vehicle Crime Prevention Authority Fee Your payment includes a $4.00 fee per vehicle each year. This fee helps fund: auto burglary, theft and fraud prevention; criminal justice efforts; and trauma care and emergency medical services for victims of accidents due to traffic offenses. By law, we send this fee to the Motor Vehicle Crime Prevention Authority (MVCPA). Policy changes effective February 25, 2021 Premium change: ...................... Changes: $1,936.00 ....................................................... Coverage has been changed on your policy. The changes shown above will not be effective prior to the time the changes were requested. continued Form 6489 TX (01/20) Outline of coverage Description ............................................................... Liability To Others Bodily Injury and Property Damage Liability ............................................................... Hired Auto Liability To Others Bodily Injury and Property Damage Liability ............................................................... Employer Non -Owned Auto Liability To Others Bodily Injury and Property Damage Liability ............................................................... Uninsured/Underinsured Motorist ............................................................... Uninsured Motorist Property Damage ............................................................... Personal Injury Protection ............................................................... Comprehensive See Auto Coverage Schedule ............................................................... Collision See Auto Coverage Schedule ............................................................... Roadside Assistance See Auto Coverage Schedule Subtotal policy premium ............................................................... Motor Vehicle Crime Prevention Authority Fee ............................................................... Fees ............................................................... Total 12 month policy premium and fees Number of Employees: (0-10) Cost of Hire: $5,000 or less (if any) Rated drivers ......................................................... 1. HUGO MARQUEZ ......................................................... 2. JOSE C JUAREZ ......................................................... 3. JASON VALDEZ ......................................................... 4. DAVID WINTER ......................................................... 5. TYLER HERBERT Auto coverage schedule 1 . 2012 Dodge Ram Truck 2500 VIN: 3C6UD5PL1CG331552 Liability Liability UM/UIM BI UM PD Premium .................................................. $3,287 $191 $93 Physical Damage Comp Deductible Comp Premium Collision Deductible Premium .................................................. $1,000 $515 $1,000 Other Coverages Roadside Limit Roadside Premium Premium .................................................. Selected $35 Policy number: 01187272-1 BLACKSTONE CONCRETE Page 2 of 4 Limits Deductible Premium ...................................................................................................... $18,774 $1,000,000 combined single limit ...................................................................................................... 115 $1,000,000 combined single limit 124 $1,000,000 combined single limit ...................................................................................................... $100,000 combined single limit ...................................................................................................... 1,032 Included in combined single limit $250 647 ...................................................................................................... $2,500 each person 404 ...................................................................................................... 2,573 Limit of liability less deductible ...................................................................................................... 8,758 Limit of liability less deductible ...................................................................................................... 35 Actual Cash Value (plus $2,000.00 Permanently Attached Equip) Garaging Zip Code: 79416 Radius: 50 PIP ......... $80 Collision Premium $1,138 $32,462 24 45 $32,531 Auto Total $5,339 Continued Form 6489 TX (01/20) Policy number: 01187272-1 BLACKSTONE CONCRETE Page 3 of 4 2. 2020 RAM Ram 3500 Actual Cash Value (plus $2,000.00 Permanently Attached Equip) VIN: 3C63RRMLXLG103185 Garaging Zip Code: 79416 Radius: 50 Liability Liability UM/UIM BI UM PD PIP Premium .................................................................................................................................................................. $3,727 $191 $99 $80 Physical Damage Comp Comp Deductible Premium Collision Deductible Collision Premium Auto Total Premium .................................................................................................................................................................. $1,000 $539 $1,000 $2,772 $7,408 3. 2009 Ford F750 Super Duty Stated Amount: *$39,950 (including Permanently Attached Equip) VIN: 3FRXF75CX9V109310 Garaging Zip Code: 79416 Radius: 50 Liability Liability UM/UIM BI UM PD PIP Premium .................................................................................................................................................................. $1,873 $153 $109 $60 Physical Damage Comp Comp Deductible Premium Collision Deductible Collision Premium Auto Total Premium .................................................................................................................................................................. $1,000 $288 $1,000 $1,040 $3,523 4. 2009 Ford F750 Super Duty Stated Amount: *$39,950 (including Permanently Attached Equip) VIN: 3FRXF75C99V109315 Garaging Zip Code: 79416 Radius: 50 Liability Liability UM/UIM BI UM PD PIP Premium .................................................................................................................................................. $1,873 $153 $109 $60 Physical Damage Comp Comp Deductible Premium Collision Deductible Collision Premium Auto Total Premium .................................................................................................................................................................. $1,000 $288 $1,000 $1,040 $3,523 5. 2004 Intl 440 Stated Amount: *$30,000 (including Permanently Attached Equip) VIN: 1 HTMKAAR04H650570 Garaging Zip Code: 79416 Radius: 50 Liability Liability UM/UIM BI UM PD PIP Premium .................................................................................................................................................. $4,994 $153 $144 $50 Physical Damage Comp Comp Deductible Premium Collision Deductible Collision Premium Auto Total Premium .................................................................................................................................................................. $1,000 $459 $1,000 $1,672 $7,472 6. 2013 RAM Ram 2500 Actual Cash Value (plus $2,000.00 Permanently Attached Equip) VIN: 3C6UR5JLODG545413 Garaging Zip Code: 79416 Radius: 50 Liability Liability UM/UIM BI UM PD PIP Premium ................................................................................................................................................... $3,020 $191 $93 $74 Physical Damage Comp Comp Deductible Premium Collision Deductible Collision Premium Auto Total Premium .................................................................................................................................................................. $1,000 $484 $1,000 $1,096 $4,958 Continued Form 6489 TX (01/20) Policy number: 01187272-1 BLACKSTONE CONCRETE Page4 of 4 *A vehicle's stated amount should indicate its current retail value, including any special or permanently attached equipment. In the event of a total loss, the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value, less deductible. Be sure to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy. Loss Payee information .................................................................................................................................................................... 1 . Loss Payee Auto 2 AMERICREDIT FINANCIA PO BOX 1510 COCKEYSVILLE, MD 21030 2020 RAM Ram 3500 (3C63RRMLXLG103185) .................................................................................................................................................................... 2 . Loss Payee Auto 3 CENTURY TRUCKS & VAN 1300 EAST MAIN ST. GRAND PRAIRIE, TX 75050 2009 Ford F750 Super Duty (3FRXF75CX9V109310) .................................................................................................................................................................... 3 . Loss Payee Auto 4 CENTURY TRUCKS & VAN 1300 EAST MAIN ST GRAND PRAIRIE, TX 75050 2009 Ford F750 Super Duty (3FRXF75C99V109315) Additional Insured information 1 . Additional Insured CITY OF LUBBOCK PO BOX 2000 FL9 LUBBOCK, TX 79457 Form 6489 TX (01/20) Waiver of Subrogationt This endorsement modifies insurance provided under the following: Commercial Auto Policy l',Jotor Truck Cargo Liability Coverage Endorsement the agree to waive any and all subrogation claims against the person or organization designated belovv. Name of Person or Organization: CITY OF LUBBOCK PO BOX 2000 FL9 LUBBECK TX 79457 This endorsement applies to policy number: 011872721 Issued to: BLACKSTONE CONCRETE VENTURES LLC 5827 OTH ST. LUBBOCK TX 79416 Endorsement effective: 03/08/2021 Expiration: 10/02/2021 All other ferns, limits and provisions of this policy remain unchanged. Form 9;i 110 lh (OE/1 71 H Cr Policy Number: CA000040928-01 CG20101219 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: CONINAERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(s) Any person or organization that is an owner, lessee or man- All locations at which the Named Insured is performing ager of real property or personal property on which you are ongoing operations. performing ongoing operations, or a contractor on whose behalf you are performing ongoing operations, but only if coverage as an additional insured is required by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the persons) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 13 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 2 of 2 13 Policy Number: CA000040928-01 CG20371219 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Or Organization(s) Completed Operations Any person or organization that is an owner, lessee or All locations except locations where "your work" is or was manager of real property or personal property for whom you related to a job or project involving single-family dwellings, work or have worked, or a contractor on whose behalf you multi -family dwellings (other than rental work or have worked, but only if coverage as an additional apartments in an apartment building: (a) originally insured extending to "bodily injury" or "property damage" constructed and at all times used for such purpose, or (b) included in the "products -completed operations hazard" is converted from a commercial building), condominiums, required by a written contract or written agreement that is an townhomes, townhouses, time-share units, fractional - "insured contract" and provided that the "bodily injury" or ownership units, cooperatives and/or any other structure or "property damage" first occurs subsequent to the execution space used or intended to be used as a residence. of the contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 13 3. Limits of Insurance a. The amount we will pay for damages is limited as described below with respect to damages covered under this en- dorsement: (1) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages because of "property damage", (2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of "prop- erty damage" arising out of any one "occurrence"; (3) Supplementary Payments will reduce the Each Occurrence and Aggregate Limits of Insurance shown in the Schedule; and (4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occur- rence Limit and the General Aggregate Limit shown in the Declarations. 4. Other Insurance This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you, either as a Named Insured or an Additional Insured, whether primary, excess, contingent or any other basis. PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 0104 13) The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contractor agreement that this insurance would be primary and would not seek con- tribution from any other insurance available to the additional insured. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Services Office Endorsement CG 24 04 05 09) SCHEDULE Name Of Person Or Organization: Any person or organization, but only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract; and (2) The injury or damage first occurs subsequent to the execution of the written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Condi- tions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the per- son or organization shown in the Schedule above. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 8 0 with its permission, 2009, 2012 & 2013. ADMIRAL INSURANCE COMPANY A Delaware Corporation 10101►►i ILVAI;I0o] F 10 4111E" 1014IWO THIS POLICY IS NOT OBTAINED PRIMARILY FOR PERSONAL, FAMILY OR HOUSEHOLD PURPOSES. THIS POLICY CONSISTS OF: Declarations; Common Policy Conditions; and One or more Coverage Parts. A Coverage Part Consists of: - One or more Coverage Forms; and - Applicable Forms and Endorsements. In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative. G !, W. Robert Berkley, Jr. President n Philip S. Welt Secretary Administrative Office: 7233 E. Butherus Drive, Scottsdale, AZ 85260 (480) 509-6627 Policy Issuing Office: 1000 Howard Blvd., Suite 300, P.O. Box 5430, Mount Laurel, NJ 08054 Telephone (856) 429-9200 Facsimile (856)429-8611 [JA 10 01 07 20] Have a complaint or need help? If you have a problem with a claim or your premium, call your insurance company or HMO first. If you can't work out the issue, the Texas Department of Insurance may be able to help. Even if you file a complaint with the Texas Department of Insurance, you should also file a complaint or appeal through your insurance company or HMO. If you don't, you may lose your right to appeal. Admiral Insurance Group To get information or file a complaint with your insurance company or HMO: Call: (480) 509-6627 Email: nic_regulatory@nautilus-ins.com Mail: 7233 E. Butherus Drive, Scottsdale, AZ 85260 The Texas Department of Insurance To get help with an insurance question or file a complaint with the state: Call: 1-800-252-3439 Online: www.tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: MC 111-1 A, P.O. Box 149091, Austin, TX 78714 iTiene una queja o necesita ayuda? Si tiene un problema con una reclamaci6n o con su prima de seguro, [lame primero a su compania de seguros o HMO. Si no puede resolver el problema, es posible que el Departamento de Seguros de Texas (Texas Department of Insurance, por su nombre en ingles) pueda ayudar. Aun si usted presenta una queja ante el Departamento de Seguros de Texas, tambien debe presentar una queja a traves del proceso de quejas o de apelaciones de su compania de Seguros o HMO. Si no to hate, podria perder su derecho para apelar. Admiral Insurance Group Para obtener informacion o para presentar una queja ante su compania de Seguros o HMO: Llame a: (480) 509-6627 Correo electr6nico: nic_regulatory@nautilus-ins.com Direcci6n postal: 7233 E. Butherus Drive, Scottsdale, AZ 85260 El Departamento de Seguros de Texas Para obtener ayuda con una pregunta relacionada con los seguros o para presentar una queja ante el estado: Llame: 1-800-252-3439 En linea: www.tdi.texas.gov Correo electr6nico: ConsumerProtection@tdi.texas.gov Direcci6n postal: MC 111-1A, P.O. Box 149091, Austin, TX 78714 Al 00 12 09 20 Policy Number: All 80 00 09 20 Effective Date: 02/19/2021 Ai1*iral INSURANCE GR0L;P I a 6orkloy Company Carrier: ADMIRAL INSURANCE COMPANY Named Insured: BLACKSTONE CONRETE VENTURES, LLC IMPORTANT — POLICYHOLDER NOTICES Form Intentionally Left Blank All 80 00 09 20 Page 1 of 1 0 ,Admiral INSURANCE GROUP a Berkley Company Carrier: Admiral Insurance Company Policy No.: CA000040928-01 Named Insured and Mailing Address BLACKSTONE CONRETE VENTURES, LLC 8418 WAYNE AVE. LUBBOCK, TX 79424 COMMON POLICY DECLARATIONS Renewal/Rewrite of: NEW POLICY PERIOD: From 02/19/2021 to 02/19/2022 At 12:01 A.M. Standard Time at the address of the Named Insured as stated herein THE NAMID INSURID IS: Other BUSINESS DESCRIPTION: Bridge overpass concrete repair for TX DOT AUDIT PERIOD: Annual IN RETURN FOR THE PAYMENT OF THE PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGES FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. Commercial General Liability Coverage $30,000.00 Products/Completed Operations Liability Coverage PREMIUM $30,000.00 POLICY FEE $750.00 PREMIUM: $30,000.00 STAMPING TAX $23.06 TERRORISM PREMIUM: SURPLUS LINES TAX $1,491.38 TOTAL: $32,264.44 TOTAL PREMIUM: $30,000.00 Forms) and Endorsements) made a part of this policy at inception: REFER TO SCHEDULE OF FORMS, At 00 18 03 98 This policy is not binding unless countersigned by Admiral Insurance Company or its authorized representative Countersigned On: 2/24/2021 At: Austin, TX By. horized Repr se ative THESE COMMON POLICY DECLARATIONS AND THE COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS (OR PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART DECLARATIONS), TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART(S), FORM(S) AND ENDORSEMENT(S), IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. DE20010820 Page 1 of 1 ,s ira NSU RANCE GROUP a Berkley Company CARRIER Admiral Insurance Company POLICY NUMBER CA000040928-01 LIMITS OF INSURANCE COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Each Occurrence Limit $ 1,000,000 General Aggregate Limit $ 2,000,000 (Other Than Products- Completed Operations) Products - Completed Operations Aggregate Limit $ 2,000,000 Personal and Advertising Injury Limit $ 1,000,000 Damage To Premises Rented To You Limit $ 300,000 Any One Premises Medical Expense Limit $ 5,000 Any One Person PREMIUM Classification Code Premium Basis Rate Per BRIDGE OR ELEVATED HIGHWAY 91266 $2,500,000 $12.00 $1,000 Sales CONSTRUCTION - CONCRETE Advance Premium $30,000.00 Total Advance Premium $30,000.00 Minimum Term Premium $30,000.00 THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. DE20020820 Page 1 of I SCHEDULE OF FORMS Named Insured: BLACKSTONE CONRETE VENTURES, LLC Policy No.: CA000040928-01 FORM NUMBER TITLE JAI0010720 COVER JACKET - ADMIRAL INSURANCE COMPANY AI00120920 TEXAS COMPLAINT NOTICE DE20010820 COMMON POLICY DECLARATIONS DE20020820 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS AI67040920 CLAIM REPORTING NOTICE ADDRESS INFORMATION AI00101011 GUARANTY FUND NONPARTICIPATION NOTICE AI00180398 SCHEDULE OF FORMS CG00010413 COMIv1ERCIAL GENERAL LIABILITY COVERAGE FORM CG20101219 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION CG20371219 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS CG21060514 EXCLUSION -ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY - WITH LIMITED BODILY INJURY EXCEPTION CG21320509 COMMUNICABLE DISEASE EXCLUSION CG21651204 TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING EQUIPMENT EXCEPTION CG21750115 EXCLUSION OF CERTIFIED ACTS OF TERRORISM AND EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES Al 00 18 03 98 Page 1 of 3 CG22340413 EXCLUSION - CONSTRUCTION MANAGEMENT ERRORS AND OMISSIONS CG22790413 EXCLUSION - CONTRACTORS - PROFESSIONAL LIABILITY CG24260413 AMENDMENT OF INSURED CONTRACT DEFINITION CG24500615 LIMITED COVERAGE FOR DESIGNATED UNMANNED AIRCRAFT IL00171198 COMMON POLICY CONDITIONS IL00210702 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT AD07400207 CROSS LIABILITY EXCLUSION AD08420216 BODILY INJURY REDEFINED AD08700507 EIFS & SPRAY - ON SIDING EXCLUSION AD66090295 MINIMUM PREMIUM AND MINIMUM RETAINED PREMIUM AMENDATORY ENDORSEMENT I:\lIr7�f�f!]�ll1�IIIa11�11�\a111�r�1�lYU.7�\�[��I R IKIR MI I[ilm011NtIIILIEEmuONNsk'"RIIMm0camINw=.\►\I AD69630519 DESIGNATED STATE EXCLUSION - NEW YORK AD69640519 DESIGNATED STATE EXCLUSION - COLORADO AD68881213 SPECIAL EXCLUSIONS JOINT FORM OCCURRENCE VERSION AD67081013 OCCUPATIONAL DISEASE EXCLUSION ABSOLUTE AD67180813 RESIDENTIAL CONSTRUCTION ACTIVITIES EXCLUSION (ABSOLUTE EXCEPT APARTMENTS) AD67190705 CONDOMINIUM CONVERSION EXCLUSION All 00 18 03 98 Page 2 of 3 AD67270406 INJURY TO TEMPORARY, VOLUNTEER OR CASUAL WORKER EXCLUSION AD67480511 INTELLECTUAL PROPERTY EXCLUSION (AMENDED DEFINITION OF PERSONAL AND ADVERTISING INJURY) AD67600415 PREMIUM BASIS DEFINITION -GROSS SALES AD69840420 CONTRACTOR INSURANCE AGREEMENT - DEDUCTIBLE PENALTY AI44020519 SERVICE OF SUIT Al 00 18 03 98 Page 3 of 3 Policy Number: CA000040928-01 Al 67 04 09 20 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CLAIM REPORTING NOTICE ADDRESS INFORMATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM It is agreed that the following is hereby added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS paragraph 2. Duties In The Event Of Occurrence, Offense, Clain Or Suit: C. You and any other involved insured must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. Notice must be given to: Admiral Insurance Group, a Berkley Company Attention: Claims Department, Mt. Laurel Corporate Park, 1000 Howard Blvd., Suite 300, P.O. Box 5430, Mount Laurel, NJ 08054 Or E-mail to: admc].aims!aJadmira:lins.com Al 67 04 09 20 Page 1 of I GUARANTY FUND NONPARTICIPATION NOTICE This insurance contract is with an insurer not licensed to transact insurance in this state and is issued and delivered as surplus line coverage under the Texas insurance statutes. The Texas Department of Insurance does not audit the finances or review the solvency of the surplus lines insurer providing this coverage, and the insurer is not a member of the property and casualty insurance guaranty association created under Chapter 462, Insurance Code. Chapter 225, Insurance Code, requires payment of a 4.85% percent tax on gross premium. Al 00 10 10 11 COMMERCIAL GENERAL LIABILITY CG 00 0104 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. The words "we", "us" and "our" refer to the company providing this insurance. The word "insured" means any person or organization qualifying as such under Section II — Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section V —Definitions. 64BE" Y[67►1QK61101IM-11"W COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury" or "property damage" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "bodily injury" or "property damage" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments — Coverages A and B. b. This insurance applies to "bodily injury" and "property damage" only if: (1) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; (2) The "bodily injury" or "property damage" occurs during the policy period; and (3) Prior to the policy period, no insured listed under Paragraph 1. of Section II — Who Is An Insured and no "employee" authorized by you to give or receive notice of an "occurrence" or claim, knew that the "bodily injury" or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. c. "Bodily injury" or "property damage" which occurs during the policy period and was not, prior to the policy period, known to have occurred by any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim, includes any continuation, change or resumption of that "bodily injury" or "property damage" after the end of the policy period. d. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section II — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim: (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property damage"; or (3) Becomes aware by any other means that "bodily injury" or "property damage" has occurred or has begun to occur. e. Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 1 of 16 2. Exclusions This insurance does not apply to: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" resulting from the use of reasonable force to protect persons or property. b. Contractual Liability "Bodily injury" or "property damage" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages: (1) That the insured would have in the absence of the contractor agreement; or (2) Assumed in a contract or agreement that is an "insured contract", provided the "bodily injury" or "property damage" occurs subsequent to the execution of the contractor agreement. Solely for the purposes of liability assumed in an "insured contract", reasonable attorneys' fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "bodily injury" or "property damage", provided: (a) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same "insured contract"; and (b) Such attorneys' fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. c. Liquor Liability "Bodily injury" or "property damage" for which any insured may be held liable by reason of: (1) Causing or contributing to the intoxication of any person; (2) The furnishing of alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or (3) Any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in: (a) The supervision, hiring, employment, training or monitoring of others by that insured; or (b) Providing or failing to provide transportation with respect to any person that may be under the influence of alcohol; if the "occurrence" which caused the "bodily injury" or "property damage", involved that which is described in Paragraph (1), (2) or (3) above. However, this exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. For the purposes of this exclusion, permitting a person to bring alcoholic beverages on your premises, for consumption on your premises, whether or not a fee is charged or a license is required for such activity, is not by itself considered the business of selling, serving or furnishing alcoholic beverages. d. Workers' Compensation And Similar Laws Any obligation of the insured under a workers' compensation, disability benefits or unemployment compensation law or any similar law. e. Employer's Liability "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Paragraph (1) above. This exclusion applies whether the insured may be liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the inj ury. This exclusion does not apply to liability assumed by the insured under an "insured contract". CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 2 of 16 L Pollution (d) At or from any premises, site or location on (1) "Bodily injury" or "property damage" arising which any insured or any contractors or out of the actual, alleged or threatened subcontractors working directly or indirectly discharge, dispersal, seepage, migration, release on any insured's behalf are performing or escape of "pollutants": operations if the "pollutants" are brought on or to the premises, site or location in (a) At or from any premises, site or location connection with such operations by such which is or was at any time owned or insured, contractor or subcontractor. occupied by, or rented or loaned to, any However, this subparagraph does not apply insured. However, this subparagraph does to: not apply to: (i) "Bodily injury" or "property damage" (i) "Bodily injury" if sustained within a arising out of the escape of fuels, building and caused by smoke, fumes, lubricants or other operating fluids vapor or soot produced by or originating which are needed to perform the normal from equipment that is used to heat, cool electrical, hydraulic or mechanical or dehumidify the building, or functions necessary for the operation of equipment that is used to heat water for "mobile equipment" or its parts, if such personal use, by the building's occupants fuels, lubricants or other operating fluids or their guests; escape from a vehicle part designed to (ii) "Bodily injury" or "property damage" for hold, store or receive them. This which you may be held liable, if you are exception does not apply if the "bodily a contractor and the owner or lessee of injury" or "property damage" arises out such premises, site or location has been of the intentional discharge, dispersal or added to your policy as an additional release of the fuels, lubricants or other insured with respect to your ongoing operating fluids, or if such fuels, operations performed for that additional lubricants or other operating fluids are insured at that premises, site or location brought on or to the premises, site or and such premises, site or location is not location with the intent that they be and never was owned or occupied by, or discharged, dispersed or released as part rented or loaned to, any insured, other of the operations being performed by than that additional insured; or such insured, contractor or (iii) "Bodily injury" or "property damage" subcontractor; arising out of heat, smoke or fumes from (ii) "Bodily injury" or "property damage" a "hostile fire"; sustained within a building and caused (b) At or from any premises, site or location by the release of gases, fumes or vapors which is or was at any time used by or for from materials brought into that building any insured or others for the handling, in connection with operations being storage, disposal, processing or treatment of performed by you or on your behalf by a waste; contractor or subcontractor; or (c) Which are or were at any time transported, (iii) "Bodily injury" or "property damage" handled, stored, treated, disposed of, or arising out of heat, smoke or fumes from processed as waste by or for: a "hostile fire". (i) Any insured; or (e) At or from any premises, site or location on which any insured or any contractors or (ii) Any person or organization for whom subcontractors working directly or indirectly you may be legally responsible; or on any insured's behalf are performing operations if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants". CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 3 of 16 (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (b) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". However, this paragraph does not apply to liability for damages because of "property damage" that the insured would have in the absence of such request, demand, order or statutory or regulatory requirement, or such claim or "suit" by or on behalf of a governmental authority. g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 26 feet long; and (b) Not being used to carry persons or property for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or (5) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or (2) The use of "mobile equipment" in, or while in practice for, or while being prepared for, any prearranged racing, speed, demolition, or stunting activity. i. War "Bodily injury" or "property damage", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. j. Damage To Property "Property damage" to: (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 4 of 16 (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products - completed operations hazard". k. Damage To Your Product "Property damage" to "your product" arising out of it or any part of it. 1. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. m. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. n. Recall Of Products, Work Or Impaired Property Damages claimed for any loss, cost or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: (1) "Your product"; (2) "Your work"; or (3) "Impaired property"; if such product, work, or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. o. Personal And Advertising Injury "Bodily injury" arising out of "personal and advertising injury". p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. However, this exclusion does not apply to liability for damages because of "bodily injury". As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD- ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. q. Recording And Distribution Of Material Or Information In Violation Of Law "Bodily injury" or "property damage" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN- SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transactions Act (FACIA); or CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 5 of 16 (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing, dissemination, disposal, collecting, recording, sending, transmitting, communicating or distribution of material or information. Exclusions c. through n. do not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III — Limits Of Insurance. COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY 1. Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "personal and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages for "personal and advertising injury" to which this insurance does not apply. We may, at our discretion, investigate any offense and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section III — Limits Of Insurance; and (2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverages A or B or medical expenses under Coverage C. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments — Coverages A and B. b. This insurance applies to "personal and advertising injury" caused by an offense arising out of your business but only if the offense was committed in the "coverage territory" during the policy period. 2. Exclusions This insurance does not apply to: a. Knowing Violation Of Rights Of Another "Personal and advertising injury" caused by or at the direction of the insured with the knowledge that the act would violate the rights of another and would inflict "personal and advertising injury". b. Material Published With Knowledge Of Falsity "Personal and advertising injury" arising out of oral or written publication, in any manner, of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral or written publication, in any manner, of material whose first publication took place before the beginning of the policy period. d. Criminal Acts "Personal and advertising injury" arising out of a criminal act committed by or at the direction of the insured. e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. f. Breach Of Contract "Personal and advertising injury" arising out of a breach of contract, except an implied contract to use another's advertising idea in your "advertisement". g. Quality Or Performance Of Goods — Failure To Conform To Statements "Personal and advertising injury" arising out of the failure of goods, products or services to conform with any statement of quality or performance made in your "advertisement". h. Wrong Description Of Prices "Personal and advertising injury" arising out of the wrong description of the price of goods, products or services stated in your "advertisement". CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 6 of 16 i. Infringement Of Copyright, Patent, Trademark Or Trade Secret "Personal and advertising injury" arising out of the infringement of copyright, patent, trademark, trade secret or other intellectual property rights. Under this exclusion, such other intellectual property rights do not include the use of another's advertising idea in your "advertisement". However, this exclusion does not apply to infringement, in your "advertisement", of copyright, trade dress or slogan. j. Insureds In Media And Internet Type Businesses "Personal and advertising injury" committed by an insured whose business is: (1) Advertising broadcasting publishing or telecasting; (2) Designing or determining content of web sites for others; or (3) An Internet search, access, content or service provider. However, this exclusion does not apply to Paragraphs 14.a., b. and c. of "personal and advertising injury" under the Definitions section. For the purposes of this exclusion, the placing of frames, borders or links, or advertising, for you or others anywhere on the Internet, is not by itself, considered the business of advertising, broadcasting, publishing or telecasting. k. Electronic Chatrooms Or Bulletin Boards "Personal and advertising injury" arising out of an electronic chatroom or bulletin board the insured hosts, owns, or over which the insured exercises control. 1. Unauthorized Use Of Another's Name Or Product "Personal and advertising injury" arising out of the unauthorized use of another's name or product in your e-mail address, domain name or metatag, or any other similar tactics to mislead another's potential customers. m. Pollution "Personal and advertising injury" arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants" at any time. n. Pollution -related Any loss, cost or expense arising out of any: (1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or (2) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing treating, detoxifying or neutralizing or in any way responding to, or assessing the effects of, "pollutants". o. War "Personal and advertising injury", however caused, arising directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. p. Recording And Distribution Of Material Or Information In Violation Of Law "Personal and advertising injury" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN- SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA)I and any amendment of or addition to such law, including the Fair and Accurate Credit Transactions Act (FACIA); or (4) Any federal, state or local statute, ordinance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the printing dissemination, disposal, collecting recording, sending, transmitting, communicating or distribution of material or information. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 7 of 16 COVERAGE C — MEDICAL PAYMENTS 1. Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (a) The accident takes place in the "coverage territory" and during the policy period; (b) The expenses are incurred and reported to us within one year of the date of the accident; and (c) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, X-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hospital, professional nursing and funeral services. 2. Exclusions We will not pay expenses for "bodily injury": a. Any Insured To any insured, except "volunteer workers". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises g. Coverage A Exclusions Excluded under Coverage A. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 1. We will pay, with respect to any claim we investigate or settle, or any "suit" against an insured we defend: a. All expenses we incur. b. Up to $250 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. c. The cost of bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $250 a day because of time off from work. e. All court costs taxed against the insured in the "suit". However, these payments do not include attorneys' fees or attorneys' expenses taxed against the insured. f. Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. g. All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. These payments will not reduce the limits of insurance. To a person injured on that part of premises you 2. If we defend an insured against a "suit" and an own or rent that the person normally occupies. indemnitee of the insured is also named as a party to the d. Workers' Compensation And Similar Laws "suit", we will defend that indemnitee if all of the following conditions are met: To a person, whether or not an "employee" of any a. The "suit" against the mdemnitee seeks damages for insured, if benefits for the bodily injury are payable or must be provided under a workers' which the insured has assumed the liability of the compensation or disability benefits law or a similar indemnitee in a contract or agreement that is an law. "insured contract"; e. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports, or athletic contests. L Products -Completed Operations Hazard Included within the "products -completed operations hazard". b. This insurance applies to such liability assumed by the insured; c. The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 8 of 16 d. The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee; e. The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and L The indemnitee: (1) Agrees in writing to: (a) Cooperate with us in the investigation, settlement or defense of the "suit"; (b) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the "suit"; (c) Notify any other insurer whose coverage is available to the indemnitee; and (d) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and (2) Provides us with written authorization to: (a) Obtain records and other information related to the "suit"; and (b) Conduct and control the defense of the indemnitee in such "suit". So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 2.b.(2) of Section I — Coverage A — Bodily Injury And Property Damage Liability, such payments will not be deemed to be damages for "bodily injury" and "property damage" and will not reduce the limits of insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when we have used up the applicable limit of insurance in the payment of judgments or settlements or the conditions set forth above, or the terms of the agreement described in Paragraph L above, are no longer met. SECTION II — WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co-" employee" or "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) or (b) above; or CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 9 of 16 (d) Arising out of his or her providing or failing to provide professional health care services. (2) "Property damage" to property: (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). b. Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part. a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing suits". 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" ; and c. Damages under Coverage B. 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". 4. Subject to Paragraph 2. above, the Personal And Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 5. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: 6. a. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III — LINIITS OF INSURANCE 1. The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Damages under Coverage A; and b. Medical expenses under Coverage C because of all "bodily injury" and "property damage" arising out of any one "occurrence". Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with perm ission of the owner. 7. Subject to Paragraph 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 10 of 16 SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. d. No insured will, except at that insureds own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. b. Excess Insurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (pi) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) That is Fire insurance for premises rented to you or temporarily occupied by you with permission of the owner; (iii) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I — Coverage A — Bodily Injury And Property Damage Liability. (b) Any other primary insurance available to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 11 of 16 (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. (4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding web sites, only that part of a web site that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. 2. "Auto" means: c. The first Named Insured must keep records of the a. A land motor vehicle, trailer or semitrailer designed information we need for premium computation, and for travel on public roads, including any attached send us copies at such times as we may request. machinery or equipment; or CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 12 of 16 b. Any other land vehicle that is subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. However, "auto" does not include "mobile equipment". 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. 4. "Coverage territory" means: a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in Paragraph a. above; or c. All other parts of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in Paragraph a. above; (2) The activities of a person whose home is in the territory described in Paragraph a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication; provided the insured's responsibility to pay damages is determined in a "suit" on the merits, in the territory described in Paragraph a. above or in a settlement we agree to. 5. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker". 6. "Executive officer" means a person holding any of the officer positions created by your charter, constitution, bylaws or any other similar governing document. 7. "Hostile fire" means one which becomes uncontrollable or breaks out from where it was intended to be. 8. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by the repair, replacement, adjustment or removal of "your product" or "your work" or your fulfilling the terms of the contract or agreement. 9. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except in connection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing; (2) That indemnities an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 13 of 16 10. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 11. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or " auto" ; b. While it is in or on an aircraft, watercraft or "auto"; or c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 12. "Mobile equipment" means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in Paragraph a., b., c. or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. However, "mobile equipment" does not include any land vehicles that are subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged. Land vehicles subject to a compulsory or financial responsibility law or other motor vehicle insurance law are considered "autos". 13. "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 14. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication, in any manner, of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral or written publication, in any manner, of material that violates a person's right of privacy; f. The use of another's advertising idea in your "advertisement"; or g. Infringing upon another's copyright, trade dress or slogan in your "advertisement". 15. "Pollutants" mean any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 14 of 16 16. "Products -completed operations hazard": a. Includes all "bodily injury" and "property damage" occurring away from premises you own or rent and arising out of "your product" or "your work" except: (1) Products that are still in your physical possession; or (2) Work that has not yet been completed or abandoned. However, "your work" will be deemed completed at the earliest of the following times: (a) When all of the work called for in your contract has been completed. (b) When all of the work to be done at the j ob site has been completed if your contract calls for work at more than one job site. As used in this definition, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 18. "Suit" means a civil proceeding in which damages because of "bodily injury", "property damage" or "personal and advertising injury" to which this insurance applies are alleged. "Suit" includes: (c) When that part of the work done at a job site has been put to its intended use by any 19 person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. b. Does not include "bodily injury" or "property damage" arising out of: (1) The transportation of property, unless the injury or damage arises out of a condition in or on a vehicle not owned or operated by you, and that condition was created by the "loading or unloading" of that vehicle by any insured; (2) The existence of tools, uninstalled equipment or abandoned or unused materials; or (3) Products or operations for which the classification, listed in the Declarations or in a policy Schedule, states that products -completed operations are subject to the General Aggregate Limit. 17. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, electronic data is not tangible property. a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. "Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 20. "Volunteer worker" means a person who is not your "employee", and who donates his or her work and acts at the direction of and within the scope of duties determined by you, and is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 21. "Your product": a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 15 of 16 22. "Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and (2) The providing of or failure to provide warnings or instructions. CG 00 0104 13 0 Insurance Services Office, Inc., 2012 Page 16 of 16 Policy Number: CA000040928-01 CG20101219 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: CONINAERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(s) Any person or organization that is an owner, lessee or man- All locations at which the Named Insured is performing ager of real property or personal property on which you are ongoing operations. performing ongoing operations, or a contractor on whose behalf you are performing ongoing operations, but only if coverage as an additional insured is required by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the persons) or organizations) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 13 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 2 of 2 13 Policy Number: CA000040928-01 CG20371219 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Or Organization(s) Completed Operations Any person or organization that is an owner, lessee or All locations except locations where "your work" is or was manager of real property or personal property for whom you related to a job or project involving single-family dwellings, work or have worked, or a contractor on whose behalf you multi -family dwellings (other than rental work or have worked, but only if coverage as an additional apartments in an apartment building: (a) originally insured extending to "bodily injury" or "property damage" constructed and at all times used for such purpose, or (b) included in the "products -completed operations hazard" is converted from a commercial building), condominiums, required by a written contract or written agreement that is an townhomes, townhouses, time-share units, fractional - "insured contract" and provided that the "bodily injury" or ownership units, cooperatives and/or any other structure or "property damage" first occurs subsequent to the execution space used or intended to be used as a residence. of the contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 13 Policy Number: CA000040928-01 CG 2106 05 14 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY - WITH LIMITED BODILY IN- JURY EXCEPTION This endorsement modifies insurance provided under the following: CON,4ERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion 2.p. of Section I —Coverage A— Bodily Injury And Property Damage Liability is replaced by the follow- ing: 2. Exclusions This insurance does not apply to: p. Access Or Disclosure Of Confidential Or Personal Information And Data -related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) The loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. However, unless Paragraph (1) above applies, this exclusion does not apply to damages because of "bodily in- jury As used in this exclusion, electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMs, tapes, drives, cells, data processing devices or any other media which are used with electroni- cally controlled equipment. B. The following is added to Paragraph 2. Exclusions of Section I —Coverage B — Personal And Advertising Injury Lia- bility: 2. Exclusions This insurance does not apply to: Access Or Disclosure Of Confidential Or Personal Information "Personal and advertising injury" arising out of any access to or disclosure of any persons or organization's confi- dential or personal information, including patents, trade secrets, processing methods, customer lists, financial infor- mation, credit card information, health information or any other type of nonpublic information. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic ex- penses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of any ac- cess to or disclosure of any person's or organization's confidential or personal information. CG 2106 05 14 © Insurance Services Office, Inc., 2013 Page 1 of 1 13 Policy Number: CA000040928-01 CG 2132 05 09 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMUNICABLE DISEASE EXCLUSION This endorsement modifies insurance provided under the following: CON,4ERCIAL GENERAL, LIABILITY COVERAGE PART A. The following exclusion is added to Paragraph 2. Exclusions of Section I —Coverage A —Bodily Injury And Property Damage Liability: 2. Exclusions This insurance does not apply to: Communicable Disease "Bodily injury" or "property damage" arising out of the actual or alleged transmission of a communicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the: a. Supervising, hiring, employing, training or monitoring of others that maybe infected with and spread a com- municable disease; b. Testing for a communicable disease; c. Failure to prevent the spread of the disease; or d. Failure to report the disease to authorities. B. The following exclusion is added to Paragraph 2. Exclusions of Section I —Coverage B — Personal And Advertising Injury Liability: 2. Exclusions This insurance does not apply to: Communicable Disease "Personal and advertising injury" arising out of the actual or alleged transmission of a communicable disease. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the: a. Supervising, hiring, employing, training or monitoring of others that maybe infected with and spread a com- municable disease; b. Testing for a communicable disease; c. Failure to prevent the spread of the disease; or d. Failure to report the disease to authorities. CG 2132 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 13 Policy Number: CA000040928-01 CG 2165 12 04 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TOTAL POLLUTION EXCLUSION WITH A BUILDING HEATING, COOLING AND DEHUMIDIFYING EQUIPMENT EXCEPTION AND A HOSTILE FIRE EXCEPTION This endorsement modifies insurance provided under the following: CON,4ERCIAL GENERAL, LIABILITY COVERAGE PART Exclusion L under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following: This insurance does not apply to: f. Pollution (1) "Bodily injury" or "property damage" which would not have occurred in whole or part but for the actual, alleged or threatened discharge, disper- sal, seepage, migration, release or escape of "pol- lutants" at any time. This exclusion does not apply to: (a) "Bodily injury" if sustained within a building which is or was at any time owned or occu- pied by, or rented or loaned to, any insured and caused by smoke, fumes, vapor or soot produced by or originating from equipment that is used to heat, cool or dehumidify the building, or equipment that is used to heat wa- ter for personal use, by the building's occu- pants or their guests; or (b) "Bodily injury" or "property damage" arising out of heat, smoke or fumes from a "hostile fire" unless that "hostile fire" occurred or originated: (i) At any premises, site or location which is or was at any time used by or for any in- sured or others for the handling, storage, disposal, processing or treatment of waste; or (ii) At any premises, site or location on which any insured or any contractors or subcon- tractors working directly or indirectly on any insureds behalf are performing oper- ations to test for, monitor, clean up, re- move, contain, treat, detoxify, neutralize or in any way respond to, or assess the ef- fects of, "pollutants". (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regula- tory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way re- spond to, or assess the effects of, "pollutants"; or (b) Claim or suit by or on behalf of a governmen- tal authority for damages because of testing for, monitoring, cleaning up, removing, con- taining, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of, "pollutants". CG 2165 12 04 0 ISO Properties, Inc., 2003 Page 1 of 1 Policy Number: CA000040928-01 CG 2175 0115 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION OF CERTIFIED ACTS OF TERRORISM AND EXCLUSION OF OTHER ACTS OF TERRORISM COMMITTED OUTSIDE THE UNITED STATES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY A. The following exclusion is added: This insurance does not apply to: TERRORISM "Any injury or damage" arising, directly or indirectly, out of a "certified act of terrorism", or out of an "other act of ter- rorism" that is committed outside of the United States (including its territories and possessions and Puerto Rico), but within the "coverage territory". However, with respect to an "other act of terrorism", this exclusion applies only when one or more of the following are attributed to such act: 1. The total of insured damage to all types of property exceeds $25,000,000 (valued in US dollars). In determining whether the $25,000,000 threshold is exceeded, we will include all insured damage sustained by property of all per- sons and entities affected by the terrorism and business interruption losses sustained by owners or occupants of the damaged property. For the purpose of this provision, insured damage means damage that is covered by any insur- ance plus damage that would be covered by any insurance but for the application of any terrorism exclusions; or 2. Fifty or more persons sustain death or serious physical injury. For the purposes of this provision, serious physical in- jury means: a. Physical injury that involves a substantial risk of death; or b. Protracted and obvious physical disfigurement; or c. Protracted loss of or impairment of the function of a bodily member or organ; or 3. The terrorism involves the use, release or escape of nuclear materials, or directly or indirectly results in nuclear reac- tion or radiation or radioactive contamination; or 4. The terrorism is carried out by means of the dispersal or application of pathogenic or poisonous biological or chemi- cal materials; or 5. Pathogenic or poisonous biological or chemical materials are released, and it appears that one purpose of the terror- ism was to release such materials. With respect to this exclusion, Paragraphs 1. and 2. describe the thresholds used to measure the magnitude of an incident of an "other act of terrorism" and the circumstances in which the threshold will apply for the purpose of determining whether this exclusion will apply to that incident. CG 2175 0115 C Insurance Services Office, Inc., 2015 Page 1 of 2 13 B. The following definitions are added: 1. For the purposes of this endorsement, "any injury or damage" means any injury or damage covered under any Cov- erage Part to which this endorsement is applicable, and includes but is not limited to "bodily injury", "property dam- age", "personal and advertising injury", "injury" or "environmental damage" as may be defined in any applicable Coverage Part. 2. "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in accordance with the provisions of the federal Terrorism Risk Insurance Act, to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a "certified act of terrorism" include the following: a. The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; b. The act resulted in damage: (1) Within the United States (including its territories and possessions and Puerto Rico); or (2) Outside of the United States in the case of: (a) An air carrier (as defined in Section 40102 of title 49, United States Code) or United States flag vessel (or a vessel based principally in the United States, on which United States income tax is paid and whose insurance coverage is subject to regulation in the United States), regardless of where the loss oc- curs; or (b) The premises of any United States mission; and c. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influ- ence the policy or affect the conduct of the United States Government by coercion. 3. "Other act of terrorism" means a violent act or an act that is dangerous to human life, property or infrastructure that is committed by an individual or individuals and that appears to be part of an effort to coerce a civilian population or to influence the policy or affect the conduct of any government by coercion, and the act is not a "certified act of ter- rorism". Multiple incidents of an "other act of terrorism" which occur within a seventy-two hour period and appear to be car- ried out in concert or to have a related purpose or common leadership shall be considered to be one incident. C. The terms and limitations of any terrorism exclusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. CG 2175 0115 0 Insurance Services Office, Inc., 2015 Page 2 of 2 0 Policy Number: CA000040928-01 CG 22 34 04 13 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - CONSTRUCTION MANAGEMENT ERRORS AND OMISSIONS This endorsement modifies insurance provided under the following: CONaIERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclu- sions of Section I — Coverage A — Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of. This exclusion applies even if the claims against any in- sured allege negligence or other wrongdoing in the supervi- sion, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodi- ly injury" or "property damage", or the offense which caused the "personal and advertising injury", involved that which is described in Paragraph 1. or 2. 1. The preparing, approving, or failure to prepare or ap- This exclusion does not apply to "bodily injury" or "proper - prove, maps, shop drawings, opinions, reports, surveys, ty damage" due to construction or demolition work done by field orders, change orders or drawings and specifica- you, your "employees" or your subcontractors. tions by any architect, engineer or surveyor performing services on a project on which you serve as construction manager; or 2. Inspection, supervision, quality control, architectural or engineering activities done by or for you on a project on which you serve as construction manager. CG 22 34 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000040928-01 CG 22 79 04 13 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - CONTRACTORS - PROFESSIONAL LIABILITY This endorsement modifies insurance provided under the following: CONaIERCIAL GENERAL LIABILITY COVERAGE PART The following exclusion is added to Paragraph 2. Exclu- sions of Section I — Coverage A — Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: 2. Subject to Paragraph 3. below, professional services include: 1. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services by you or on your behalf, but only with respect to either or both of the following operations: 3' a. Providing engineering, architectural or surveying services to others in your capacity as an engineer, architect or surveyor; and b. Providing, or hiring independent professionals to provide, engineering, architectural or surveying ser- vices in connection with construction work you per- form. This exclusion applies even if the claims against any in- sured allege negligence or other wrongdoing in the su- pervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", in- volved the rendering of or failure to render any profes- sional services by you or on your behalf with respect to the operations described above. a. Preparing, approving, or failing to prepare or ap- prove, maps, shop drawings, opinions, reports, sur- veys, field orders, change orders, or drawings and specifications; and b. Supervisory or inspection activities performed as part of any related architectural or engineering ac- tivities. Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction con- tractor. CG 22 79 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000040928-01 CG 24 26 04 13 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF INSURED CONTRACT DEFINITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The definition of "insured contract" in the Definitions section is replaced by the following: "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnities any person or organization for damage by fire to premises while rented to you or temporari- ly occupied by you with permission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement, except m con- nection with construction or demolition operations on or within 50 feet of a railroad; d. An obligation, as required by ordinance, to indemni- fy a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertain- ing to your business (including an indemnification of a municipality m connection with work per- formed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "prop- erty damage" is caused, in whole or in part, by you or by those acting on your behalf. However, such part of a contract or agreement shall only be consid- ered an "insured contract" to the extent your as- sumption of the tort liability is permitted by law. Tort liability means a liability that would be im- posed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any con- tract or agreement: (1) That indemnities a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations, within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, un- derpass or crossing; (2) That indemnifies an architect, engineer or sur- veyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, re- ports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (3) Under which the insured, if an architect, engi- neer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, includ- ing those listed in (2) above and supervisory, in- spection, architectural or engineering activities. CG 24 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 13 Policy Number: CA000040928-01 COMMERCIAL GENERAL LIABILITY CG 24 50 06 15 LIMITED COVERAGE FOR DESIGNATED UNMANNED AIRCRAFT This endorsement modifies insurance provided under the following: CONPOERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description Of Unmanned Aircraft 1. Any "unmanned aircraft" operated under a FAA Section 333 Exemption. 2. Any "unmanned aircraft" weighing less than 4.4 pounds and operated under FAA Part 107 Rules. 3. Any "unmanned aircraft" that: a. Weighs less than 4.4 pounds; and b. Is operated at least 5 nautical miles away from an airport or heliport having an operational control tower or published instrument flight procedure; and c. Is operated at least 5 nautical miles away from a military base or national park; and d. Is operated at an altitude below 400 feet; and e. Is manually flown within the unaided (other than corrective lenses) visual line of sight of the remote pilot in command or the person manipulating the flight controls of the "unmanned aircraft". 4. Any other "unmanned aircraft" endorsed to this policy. Description Of Operation(s) Or Project(s) Operations directly related to the Business Description shown in the Declarations. Limit Of Insurance Paragraph C. below does not apply. Unmanned Aircraft Liability Aggregate Limit: $ please refer to Section III — Limits of Insurance. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Exclusion 2.g. Aircraft, Auto Or Watercraft under Section I —Coverage A —Bodily Injury And Property Damage Liability is replaced by the following: 2. Exclusions This insurance does not apply to: g. Aircraft, Auto Or Watercraft (1) Unmanned Aircraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to oth- ers of any aircraft that is an "unmanned aircraft". Use includes operation and "loading or unloading". This Paragraph g.(1) applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or en- trustment to others of any aircraft that is an "unmanned aircraft". This Paragraph g.(1) does not apply to "unmanned aircraft" described in the Schedule, but only with re- spect to the operation(s) or project(s) described in the Schedule. CG 24 50 06 15 © Insurance Services Office, Inc., 2014 Page 1 of 3 13 (2) Aircraft (Other Than Unmanned Aircraft), Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to oth- ers of any aircraft (other than "unmanned aircraft"), "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This Paragraph g.(2) applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or en- trustment to others of any aircraft (other than "unmanned aircraft"), "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This Paragraph g.(2) does not apply to: (a) A watercraft while ashore on premises you own or rent; (b) A watercraft you do not own that is: (i) Less than 26 feet long, and (ii) Not being used to carry persons or property for a charge; (c) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto' is not owned by or rented or loaned to you or the insured; (d) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or (e) "Bodily injury" or "property damage" arising out of: (i) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or finan- cial responsibility law or other motor vehicle insurance law where it is licensed or principally gar- aged; or (ii) The operation of any of the machinery or equipment listed in Paragraph L(2) or L(3) of the defini- tion of "mobile equipment". B. The following exclusion is added to Paragraph 2. Exclusions of Coverage B— Personal And Advertising Injury Lia- bility: 2. Exclusions This insurance does not apply to: Unmanned Aircraft "Personal and advertising injury" arising out of the ownership, maintenance, use or entrustment to others of any air- craft that is an "unmanned aircraft". Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervi- sion, hiring, employment, training or monitoring of others by that insured, if the offense which caused the "personal and advertising injury" involved the ownership, maintenance, use or entrustment to others of any aircraft that is an "unmanned aircraft". This exclusion does not apply to: a. The use of another's advertising idea in your "advertisement"-, b. Infringing upon another's copyright, trade dress or slogan in your "advertisement'; or c. "Unmanned aircraft" described in the Schedule, but only with respect to the operation(s) or project(s) described in the Schedule. C. If an Unmanned Aircraft Liability Aggregate Limit is shown in the Schedule, the following provisions are added to Sec- tion III — Limits Of Insurance: 1. Subject to Paragraph 2. or 3. of Section III —Limits Of Insurance, whichever applies, the Unmanned Aircraft Lia- bility Aggregate Limit shown in the Schedule is the most we will pay for the sum of: a. Damages under Coverage A; b. Damages under Coverage B; and CG 24 50 06 15 0 Insurance Services Office, Inc., 2014 Page 2 of 3 c. Medical expenses under Coverage C; because of all "bodily injury", "property damage" and "personal and advertising injury" arising out of the owner- ship, maintenance, use or entrustment to others of any aircraft that is an "unmanned aircraft". 2. Paragraph 4., the Personal And Advertising Injury Limit, Paragraph 5., the Each Occurrence Limit, Paragraph 6., the Damage To Premises Rented To You Limit, and Paragraph 7., the Medical Expense Limit, of Section III — Limits Of Insurance continue to apply to "bodily injury", "property damage" and "personal and advertising injury", as applicable, arising out of the ownership, maintenance, use or entrustment to others of any aircraft that is an "un- manned aircraft" but only if, and to the extent that, a limit of insurance is available under the Unmanned Aircraft Liability Aggregate Limit. D. The following definition is added to the Definitions section: "Unmanned aircraft" means an aircraft that is not: 1. Designed; 2. Manufactured; or 3. Modified after manufacture; to be controlled directly by a person from within or on the aircraft. CG 24 50 06 15 0 Insurance Services Office, Inc., 2014 Page 3 of 3 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or deliv- ering to us advance written notice of cancella- tion. 2. We may cancel this policy by mailing or deliver- ing to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of premi- um; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and rec- ords as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; IL 00 17 11 98 b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes in- surance inspections, surveys, reports or rec- ommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representa- tive. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 Policy Number: CA000040928-01 IL 00 2107 02 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY ENDORSEMENT (BROAD FORM) This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply: A. Under any Liability Coverage, to "bodily injury" or "property damage": (1) With respect to which an "insured" under the policy is also an insured under a nuclear ener- gy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters, Nucle- ar Insurance Association of Canada or any of their successors, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or (2) Resulting from the "hazardous properties" of "nuclear material" and with respect to which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the "insured" is, or had this policy not been issued would be, enti- tled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any per- son or organization. B. Under any Medical Payments coverage, to expens- es incurred with respect to "bodily injury" result- ing from the "hazardous properties" of "nuclear material" and arising out of the operation of a "nu- clear facility" by any person or organization. C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazardous properties" of "nuclear material", if: (1) The "nuclear material" (a) is at any "nuclear facility" owned by, or operated by or on be- half of, an "insured" or (b) has been dis- charged or dispersed therefrom; (2) The "nuclear material" is contained in "spent fuel" or "waste" at any time possessed, han- dled, used, processed, stored, transported or disposed of, by or on behalf of an "insured"; or (3) The "bodily injury" or "property damage" arises out of the furnishing by an "insured" of services, materials, parts or equipment in con- nection with the planning, construction, maintenance, operation or use of any "nuclear facility", but if such facility is located within the United States of America, its territories or possessions or Canada, this exclusion (3) ap- plies only to "property damage" to such "nu- clear facility" and any property thereat. IL 00 2107 02 © ISO Properties, Inc., 2001 Page 1 of 2 13 2. As used in this endorsement: "Hazardous properties" includes radioactive, toxic or explosive properties. "Nuclear material" means "source material", "Special nuclear material" or "by-product material". "Source material", "special nuclear material", and "by- product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof. "Spent fuel" means any fuel element or fuel compo- nent, solid or liquid, which has been used or exposed to radiation in a "nuclear reactor". "Waste" means any waste material (a) containing "by- product material" other than the tailings or wastes pro- duced by the extraction or concentration of uranium or thorium from any ore processed primarily for its "source material" content, and (b) resulting from the operation by any person or organization of any "nucle- ar facility" included under the first two paragraphs of the definition of "nuclear facility". "Nuclear facility" means: (a) Any "nuclear reactor"; (b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plu- tonium, (2) processing or utilizing "spent fuel", or (3) handling, processing or packag- ing "waste"; (c) Any equipment or device used for the pro- cessing, fabricating or alloying of "special nu- clear material" if at any time the total amount of such material in the custody of the "in- sured" at the premises where such equipment or device is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin, excavation, premises or place prepared or used for the storage or dis- posal of "waste"-, and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations. "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissionable ma- terial. "Property damage" includes all forms of radioactive contamination of property. IL 00 2107 02 © ISO Properties, Inc., 2001 Page 2 of 2 13 Policy Number: CA000040928-01 AD 07 40 02 07 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARE- FULLY. CROSS LIABILITY EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART It is agreed this insurance does not apply to: (1) Any claim made or "suit" brought for dam- ages or liability of any kind by any Named Insured or any "employee", "volunteer worker", "temporary worker", "executive of- ficer", director, stockholder, partner or member of any Named Insured against any other Named Insured or any "employee", "volunteer worker", "temporary worker", "executive officer", director, stockholder, partner or member of any other Named In- sured because of "bodily injury", "property damage" or "personal and advertising inju- ry", or (2) Any claim made or "suit" brought for dam- ages by the spouse, child, parent, brother or sister of any "employee", "volunteer work- er", "temporary worker", "executive of- ficer", director, stockholder, partner or member of any Named Insured as a conse- quence of (1) above. It is further agreed the Company shall not have the obligation to indemnify, defend, adjust, investigate or pay any cost or expense of any kind for any claim made or "suit" brought which is excluded under the terms of this endorsement. AD 07 40 02 07 Page 1 of 1 Policy Number: CA000040928-01 AD 08 42 02 16 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BODILY INJURY REDEFINED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM (OCCURRENCE VERSION) COMMERCIAL GENERAL LIABILITY COVERAGE FORM (CLAIMS -MADE) PRODUCTS AND COMPLETED OPERATIONS LIABILITY COVERAGE FORM (OCCURRENCE VERSION) PRODUCTS AND COMPLETED OPERATIONS LIABILITY COVERAGE FORM (CLAIMS -MADE VERSION) LIQUOR LIABILITY COVERAGE (OCCURRENCE VERSION) LIQUOR LIABILITY COVERAGE (CLAIMS -MADE) OWNER'S AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM EXCESS LIABILITY COVERAGE FORM UMBRELLA LIABILITY COVERAGE FORM The definition of "bodily injury" in DEFINITIONS is amended as follows: "Bodily injury" means physical injury, physical sickness or physical disease sustained by any one person, including death resulting from any of these at any time. "Bodily injury" does not include shock or emotional, mental or psychological distress, injury, trauma or anguish, or other similar condition, unless such condition results solely and directly from that one person's prior physical injury, physical sickness or physical disease otherwise covered under this insurance. AD 08 42 02 16 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 0 with its permission, 2016. Policy Number: CA000040928-01 AD 08 70 05 07 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EIFS & SPRAY -ON SIDING EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART This insurance does not apply to liability, injury or damages b. an adhesive and/or mechanical fasteners used of any kind, to include but not limited to "bodily injury", to attach the insulation board to the substrate; "property damage" and "personal and advertising injury", and including costs or expenses, actually or allegedly arising c. a reinforced base coat; and out of, related to, caused by, contributed to by, or in any way connected with: d. a finish coat providing surface texture and color. A. EIFS (Exterior Insulation & Finish System) 1. The design, manufacture, sale, use, construction, fabrication, preparation, installation, application, maintenance or repair including remodeling, ser- vice, correction, or replacement of, an "exterior in- sulation and finish system" (commonly referred to as synthetic stucco or EIFS) or any part or portion thereof, or any substantially similar system or any part or portion thereof, including the application or use of conditioners, primers, accessories, flash- ings, coatings, caulkmgs or sealants in connection with such a system. 2. Any design, manufacture, construction, fabrica- tion, preparation, installation, application, mainte- nance, use, sale, service, repair, remodeling, cor- rection, replacement or service of any exterior component, fixture or feature of any structure if an "exterior insulation and finish system" is used on any part of that structure. For the purposes of this endorsement an "exterior insu- lation and finish system" means an exterior cladding or finish system used on any part of any structure and consisting of: a. a rigid or semi -rigid insulation board made of expanded polystyrene or other materials; and B. Spray -On Siding 1. The design, manufacture, sale, use, construction, fabrication, preparation, installation, application, maintenance or repair including remodeling, ser- vice, correction, or replacement of, "spray -on sid- ing", or any part or portion thereof, or any substan- tially similar siding or any part or portion thereof, including the application or use of conditioners, primers, accessories, flashings, coatings, caulkings or sealants in connection with such siding. 2. Any design, manufacture, construction, fabrica- tion, preparation, installation, application, mainte- nance, use, sale, service, repair, remodeling, cor- rection, replacement or service of any exterior component, fixture or feature of any structure if a "spray -on siding" is used on any part of that struc- ture. For the purposes of this endorsement "spray -on siding" means any spray -applied or brush -applied liquid or semi -liquid coating containing polyvinyl chloride resin or ceramic, and applied to any exterior part of any structure. AD 08 70 05 07 Page 1 of 1 13 Policy Number: CA000040928-01 AD 66 09 02 95 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MINIMUM PREMIUM AND MINIMUM RETAINED PREMIUM AMENDATORY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART 1. Condition 5. Premium Audit as shown in SECTION You shall maintain records of such information as is IV- CONDITIONS is deleted and replaced by the necessary for premium computation, and shall send following condition: copies of such records to us at the end of the policy 5. Premium Audit period and at such times during the policy period as we All premiums for this policy shall be computed in may direct. accordance with our rules, rates, rating plans, 2. It is further agreed that Section A. Cancellation, premiums and minimum premiums applicable to the paragraph 5. of the COMMON POLICY Insurance afforded herein. CONDITIONS IS amended to read as follows: Premium designated in this policy as Advance Premium is a Deposit Premium which shall be credited to the amount of the earned premium due at the end of the policy period. At the close of each period (or part thereof terminating with the end of policy period), designated in the DECLARATIONS as the audit period, the earned premium shall be computed for such period and, upon notice thereof to the first Named Insured, shall become due and payable. Should it become necessary to institute collection activities, including litigation, in order to collect the additional earned premium, then you shall be responsible for 100% of the expenses, fees and costs incurred by the Company in that regard plus any collectible interest. If the total computed earned premium for the policy period is less than the premium previously paid, then we shall receive and retain no less than the minimum premium(s) listed in the coverage part(s) attached hereto. 5. If the policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be the lesser of the pro rata of the actual earned premium or Minimum Premium. If the Named Insured cancels, the refund may be less than pro rata. However in no event shall we retain less than 25% of the Advance Premium shown in the DECLARATIONS. AD 66 09 02 95 Page 1 of 1 13 Policy Number: CA000040928-01 AD 66 11 0511 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE (APPLICABLE TO INDEMNITY AND EXPENSES) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM SCHEDULE Coverage Amount and Basis of Deductible PER CLAIM PER OCCURRENCE Bodily Injury Liability $ $ Property Damage Liability $ $ Bodily Injury Liability and/or Property Damage Liability Combine $ $ 5,000.00 Personal and Advertising Injury Liability $ $ 5,000.00 (If no entry appears above, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement. If no limitation is entered, the deductibles apply to damages for all "bodily injury", "property damage" and "personal and advertising injury", however caused. Damages includes any payments made under the Supplementary Payments provisions of this policy including, but not limited to, expenses we incur to investigate or settle a claim or to defend a "suit".): No limitations 1. Our obligation under the Bodily Injury Liability, Property Damage Liability, and Personal and Advertising Injury Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as applicable to such coverages. Damages includes any payments made under the Supplementary Payments provisions of this policy including, but not limited to, expenses we incur to investigate or settle a claim, or to defend a "suit". 2. The deductible applies to the coverage option and to the basis of the deductible indicated by the placement of the deductible amount in the Schedule above. The deductible amount stated in the Schedule above applies as follows: a. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a PER CLAIM basis, that deductible applies as follows: AD 66 11 0511 Page 1 of 2 0 (1) Under Bodily Injury Liability Coverage, to all damages sustained by any one person because of "bodily injury", (2) Under Personal and Advertising Injury Liability Coverage, to all damages sustained by any one person because of "personal and advertising injury"; (3) Under Property Damage Liability Coverage, to all damages sustained by any one person because of "property damage", or (4) Under Bodily Injury Liability and/or Property Damage Liability Coverage Combined, to all damages sustained by any one person because of: (a) `Bodily injury", (b) "Property damage"' or (c) "Bodily injury" and "property damage" combined as the result of any one "occurrence". If damages are claimed for care, loss of services or death resulting at anytime from "bodily injury", a separate deductible amount will be applied to each person making a claim for such damages. With respect to "property damage" and "personal and advertising injury", person includes an organization. b. PER OCCURRENCE BASIS. If the deductible amount indicated in the Schedule above is on a PER OCCURRENCE basis, that deductible amount applies as follows: (1) Under Bodily Injury Liability Coverage, to all damages because of "bodily injury"; (2) Under Personal and Advertising Injury Liability Coverage, to all damages sustained by any one person because of "personal and advertising injury"; (3) Under Property Damage Liability Coverage, to all damages because of "property damage", or (4) Under Bodily Injury Liability and/or Property Damage Liability Coverage Combined, to all damages because of: (a) `Bodily injury"' (b) "Property damage"' or (c) "Bodily injury" and "property damage" combined, as the result of any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that "occurrence". 3. The terms of this insurance, including those with respect to: a. Our right and duty to defend the insured against any "suits" seeking those damages; and b. Your duties in the event of an "occurrence", claim, or "suit"; apply irrespective of the application of the deductible amount. 4. We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 5. When used in this endorsement, damages include any payments made under the Supplementary Payments provisions of this policy including, but not limited to, expenses we incur to investigate or settle a claim or to defend a "suit". 6. If you do not promptly reimburse us for any deductible amount owed, then any cost incurred by us in collection of the deductible amount will be added and applied in addition to the applicable deductible amount without any limitation. These costs include, but are not limited to, collection agency fees, attorney's fees and interest. AD 66 11 0511 Page 2 of 2 0 Policy Number: CA000040928-01 AD68830413 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY LONG TERM EXPOSURE EXCLUSIONS - JOINT FORM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM RAILROAD PROTECTIVE LIABILITY COVERAGE FORM ASBESTOS EXCLUSION (ABSOLUTE) This insurance does not apply to liability, injury or damages of any kind, to include but not limited to "bodily injury", "prop- erty damage" or "personal and advertising injury" including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with actual, alleged or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the mining, manufacturing, distribution, sale, resale, rebranding, instal- lation, repair, removal, encapsulation, abatement, replacement or handling of, exposure to, testing for or failure to disclose the presence of asbestos, products containing asbestos, or products designed or used to protect from the inhalation, ingestion, contact with or other exposure to asbestos whether or not the asbestos is or was at any time airborne as a fume, dust, powder, fiber or particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatso- ever. It is further agreed that this insurance does not apply to any loss, cost or expense including but not limited to, payment for investigation or defense, fines, penalties, interest and other costs or expenses, arising out of or related to any: (1) Clean up or removal of asbestos or products and materials containing asbestos; (2) Such actions as may be necessary to monitor, assess and evaluate the release or threat of same, of asbestos or products and material containing asbestos; (3) Disposal of asbestos substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; (4) Compliance with any law or regulation regarding asbestos; (5) Existence, storage, handling or transportation of asbestos; (6) Any supervision, instructions, recommendations, warranties (express or implied), warnings or advice given or which should have been given. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. LEAD EXCLUSION (ABSOLUTE) This insurance does not apply to liability, injury or damages of any kind, to include but not limited to "bodily injury", "property damage" or "personal and advertising injury" including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with actual, alleged or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the mining, manufacturing, distribution, sale, resale, AD 68 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Page 1 of 3 0 its permission, 2012. rebranding, installation, repair, removal, encapsulation, abatement, replacement or handling of, exposure to, ingestion of or testing for or failure to disclose the presence of lead, products containing lead, or products designed or used to protect from the inhalation, ingestion, contact with or other exposure to lead, whether or not the lead is or was at any time airborne as a fume, dust, powder, fiber or particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever. It is further agreed that this insurance does not apply to any loss, cost or expense, including but not limited to payment for investigation or defense, fines, penalties, interest and other costs or expenses, arising out of or related to any: (1) Clean up or removal of lead or products and materials containing lead; (2) Such actions as may be necessary to monitor, assess and evaluate the release or threat of same, of lead or products and material containing lead; (3) Disposal of lead substances or the taking of such other action as may be necessary to temporarily or permanently prevent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; (4) Compliance with any law or regulation regarding lead; (5) Existence, storage, handling or transportation of lead; (6) Any supervision, instructions, recommendations, warranties (express or implied), warnings or advice given or which should have been given. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. MICROORGANISMS, BIOLOGICAL ORGANISMS OR ORGANIC CONTAMINANTS EXCLUSION (GENERAL LIABILITY BROAD FORM) This insurance does not apply to: (1) Liability, injury or damages of any kind, to include but not limited to "bodily injury", "property damage" or " personal and advertising injury", including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with actual, alleged or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the exposure to, presence of, formation of, existence of or actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of any microorganisms, biological organisms or organic con- taminants, including but not limited to mold, mildew, fungus, spores, yeast or other toxins, allergens, infectious agents, wet or dry rot or rust, or materials of any kind containing them at any time, regardless of the cause of growth, prolifera- tion or secretion; or (2) Any loss, cost or expense arising out of any: (a) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or many way respond to, or assess the effects of microorganisms, bio- logical organisms or organic contaminants, including but not limited to mold, mildew, fungus, spores, yeast, or other toxins, allergens, infectious agents, wet or dry rot or rust, or any materials containing them at any time, regardless of the cause of growth, proliferation or secretion. (b) Claim or "suit" by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of microorganisms, biological organisms or organic contaminants, including but not limited to mold, mildew, fungus, spores, yeast, or other toxins, allergens, infectious agents, wet or dry rot or rust, or any materials containing them at any time, regardless of the cause of growth, proliferation or secretion. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit" or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury", "property damage" or "personal injury and advertising injury" to which this endorsement applies. AD 68 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Page 2 of 3 0 its permission, 2012 SILICA EXCLUSION (ABSOLUTE) This insurance does not apply to liability, injury or damages of any kind, to include but not limited to "bodily injury", "prop- erty damage" or "personal and advertising injury" including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with actual, alleged, or threatened past, present or future claims arising in whole or in part, either directly or indirectly, out of the mining, manufacturing, distribution, sale, resale, rebranding, instal- lation, repair, removal, encapsulation, abatement, replacement or handling of, exposure to, ingestion of, testing for or failure to disclose the presence of, failure to warn or advise of silica, products containing silica, or products designed or used to protect from the inhalation, ingestion, contact with or any other exposure to silica, whether or not the silica is or was at any time airborne as a fume, dust, powder, fiber or particle, contained in a product, carried on clothing, inhaled, transmitted in any fashion or found in any form whatsoever. It is further agreed that this insurance does not apply to any loss, cost or expense including, but not limited to, payment for investigation or defense, fines, penalties, interest and other costs or expenses, arising out of or related to any: (1) Clean up or removal of silica or products and materials containing silica; (2) Such actions as may be necessary to monitor, assess and evaluate the release or threat of same, of silica or products and material containing silica; (3) Disposal of silica substances or the taking of such other action as may be necessary to temporarily or permanently pre- vent, minimize or mitigate damage to the public health or welfare or to the environment, which may otherwise result; (4) Compliance with any law or regulation regarding silica; (5) Existence, storage, handling or transportation of silica; (6) Any supervision, instructions, recommendations, warranties (express or implied), warnings or advice given or which should have been given. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. ELECTROMAGNETIC RADIATION EXCLUSION (ABSOLUTE) This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury", including costs or expenses, arising out of, related to, caused by, contributed to by, or in any way connected with the actual or alleged exposure to, presence of, formation of or existence of "electromagnetic radiation", 2. Any loss, claim, "suit", cost or expense arising out of any request, demand, order, statutory, regulatory or govern- mental requirement that any insured or others for whom any insured is legally liable, test for, comply with standards for, monitor, clean up, remove, contain, treat, detoxify, neutralize, abate, mitigate or in any way respond to or assess the effects of "electromagnetic radiation", 3. Any loss, claim, "suit", cost or expense, including but not limited to fines or penalties, arising out of any failure to comply with any statutory, regulatory or governmental standards concerning acceptable levels of "electromagnetic radiation"; 4. Any supervision, instructions, recommendations, warnings or advice given or which should have been given in con- nection with Paragraphs 1., 2. or 3. above; or 5. Any obligation to share damages with or repay anyone else who must pay damages in connection with Paragraphs 1., 2., 3. or 4. above. "Electromagnetic radiation" means any form of electrical and magnetic energy, or electric and magnetic field(s) within the electromagnetic spectrum, whether naturally occurring or artificially created, regardless of source, and includes, but is not limited to, radio frequency radiation. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. AD 68 83 04 13 Includes copyrighted material of Insurance Services Office, Inc., with Page 3 of 3 0 its permission, 2012 Policy Number: CA000040928-01 AD68930117 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCED COVERAGE (Commercial General Liability Coverage Form) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM L AMENDED EXCLUSIONS NON -OWNED WATERCRAFT COVERAGE - Up to 55 feet SECTION I — COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Exclu- sion g. Aircraft, Auto or Watercraft, Paragraph (2) is deleted in its entirety and replaced by the following: (2) A watercraft you do not own that is: (a) Less than 55 feet long; and (b) Not being used to carry persons or property for a charge; MEDICAL PAYMENTS — PRODUCTS -COMPLETED OPERATIONS HAZARD SECTION I — COVERAGES — COVERAGE C — MEDICAL PAYMENTS Exclusion f. Products -Completed Operations Hazard is deleted in its entirety. CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM EXCLUSION (LIMITED EXCEPTION FOR OPERATIONS AWAY FROM PROJECT LOCATION) The following exclusion is added to paragraph 2., Exclusions of COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY (Section I — Coverages): This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or opera- tions included within the "products -completed operations hazard" at any location for which a consolidated (wrap-up) insur- ance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not the consolidated (wrap-up) insurance program: (1) Provides coverage identical to that provided by this Coverage Form; (2) Has limits adequate to cover all claims; or (3) Remains in effect. However, if the consolidated (wrap-up) insurance program does not provide coverage for your operations that are performed away from the location of the construction project, this exclusion will not apply. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 8 0 with its permission, 2009, 2012 & 2013. IL AMENDED COVERAGES KNOWLEDGE OF OCCURRENCE The following paragraph is added to Section IV — Commercial General Liability Conditions Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: Notice of an "occurrence" which may result in a claim under this insurance shall be given as soon as practicable after knowledge of the "occurrence" has been reported to you, one of your "executive officers", or any "employee" authorized by you to give or receive notice of an "occurrence". UNINTENTIONAL ERRORS AND OMISSIONS The following paragraph is added to Section IV — Commercial General Liability Conditions Paragraph 6. Representations: However, the unintentional omission of, or unintentional error in, any information given or provided by you shall not preju- dice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our right of cancellation or non -renewal. III. ADDED COVERAGES PERSONAL PROPERTY OF OTHERS IN YOUR CARE, CUSTODY OR CONTROL — LIMITED COVERAGE SCHEDULE Sub -Limits of Insurance: $10,000 Each Occurrence (Included in the Each Occurrence Limit shown in the Declarations) $10,000 Aggregate (Included in the General Aggregate Limit shown in the Declarations) The Sub -Limits of Insurance shown above are included within and not in addition to the Each Occurrence Limit and the General Aggregate Limit shown in the Declarations. Supplementary Payments will reduce the Each Occurrence and Aggregate Sub -Limits of Insurance shown above. It is agreed COMMERCIAL GENERAL LIABILITY COVERAGE FORM - SECTION I — COVERAGE A Exclusion j. (4) is deleted, but only with respect to personal property of others in the care, custody or control of the Named Insured, subject to the following exclusions, conditions and limitations. 1. Exclusions This insurance does not apply to: a. "Property damage" arising out of operations performed on behalf of the Named Insured by others; b. "Property damage" arising out of an "occurrence" at premises owned, rented, leased, operated, occupied or used by you; c. "Property damage" to property while in transit; d. "Property damage" arising out of any error, omission or deficiency in the design, specifications, workmanship or materials of the personal property in the Named Insured's care, custody or control; e. "Property damage" arising out of delay, loss of market, loss of use, loss of profits, or any similar indirect or conse- quential loss of any kind; f. "Property damage" included within the "products -completed operations hazard", or g. Damages exceeding the actual cash value of the personal property in the care, custody or control of the Named In- sured at the time of the "occurrence." 2. Conditions Our right and duty to defend ends when we have used up the applicable sub -limit of insurance in the payment of judg- ments or settlements or Supplementary Payments under the insurance provided by this endorsement. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 8 0 with its permission, 2009, 2012 & 2013. 3. Limits of Insurance a. The amount we will pay for damages is limited as described below with respect to damages covered under this en- dorsement: (1) The Aggregate Limit shown in the Schedule is the most we will pay for the sum of all damages because of "property damage", (2) The Each Occurrence Limit shown above is the most we will pay for the sum of all damages because of "prop- erty damage" arising out of any one "occurrence"; (3) Supplementary Payments will reduce the Each Occurrence and Aggregate Limits of Insurance shown in the Schedule; and (4) All sums we pay for damages or Supplementary Payments under this endorsement will reduce the Each Occur- rence Limit and the General Aggregate Limit shown in the Declarations. 4. Other Insurance This insurance is excess over any other valid and collectible Property or Inland Marine insurance available to you, either as a Named Insured or an Additional Insured, whether primary, excess, contingent or any other basis. PRIMARY AND NONCONTRIBUTORY — OTHER INSURANCE CONDITION (Insurance Services Office Endorsement CG 20 0104 13) The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contractor agreement that this insurance would be primary and would not seek con- tribution from any other insurance available to the additional insured. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (Insurance Services Office Endorsement CG 24 04 05 09) SCHEDULE Name Of Person Or Organization: Any person or organization, but only if the following conditions are met: (1) You have expressly agreed to the waiver in a written contract; and (2) The injury or damage first occurs subsequent to the execution of the written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Condi- tions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the per- son or organization shown in the Schedule above. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 8 0 with its permission, 2009, 2012 & 2013. Scheduled Railroad: CONTRACTUAL LIABILITY — RAILROADS (Insurance Services Office Endorsement CG 24 17 10 01) SCHEDULE Designated Job Site: Any railroad, but only if the following conditions are met: Any job site covered by this insurance where you are per - a. You have expressly agreed to indemnify the railroad in forming operations for or affecting a Scheduled Railroad. a written contract entered into by you; and b. The injury or damage occurs subsequent to the execu- tion of the written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- ble to this endorsement.) With respect to operations performed for, or affecting, a Scheduled Railroad at a Designated Job Site, the definition of "in- sured contract" in the Definitions section is replaced by the following: 9. "Insured Contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with per- mission of the owner is not an "insured contract"; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a munici- pality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a munici- pality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liabil- ity that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or dam- age; (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT (WITH TOTAL AGGREGATE LIMIT FOR COVERAGES A, B AND C) SCHEDULE Designated Construction Projects: All construction projects covered by this insurance. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- ble to this endorsement.) AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 8 0 with its permission, 2009, 2012 & 2013. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction pro- ject, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. However, the most we will pay under the Designated Construction Project General Aggregate Limit for all Desig- nated Construction Projects combined is $5,000,000 . 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard", and for medical expenses under COVERAGE C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project. Such pay- ments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Des- ignated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVER- AGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (SECTION I), which can- not be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Desig- nated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to ap- ply as stipulated. IV. ADDITIONAL INSUREDS ADDITIONAL INSURED — LESSOR OF LEASED EQUIPMENT — AUTOMATIC STATUS WHEN REQUIRED IN LEASE AGREEMENT WITH YOU (Insurance Services Office Endorsement CG 20 34 04 13) A. Section II Who Is An Insured is amended to include as an additional insured any persons) or organizations) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agree- ment that such person(s) or organization(s) be added as an additional insured on your policy. Such persons) or organiza- tion(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such persons) or organization(s). However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted bylaw-, and AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 8 0 with its permission, 2009, 2012 & 2013. 2. Will not be broader than that which you are required by the contractor agreement to provide for such additional in- sured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agree- ment with you for such leased equipment ends. B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement you have entered into with the additional insured; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ADDITIONAL INSURED — MANAGERS OR LESSORS OF PREMISES (Insurance Services Office Endorsement CG 20 1104 13) SCHEDULE Designation Of Premises (Part Leased To You): All premises leased to you and covered by this insurance. Name Of Person(s) Or Organization(s) (Additional Insured): Any person or organization that is a manager or lessor of real property, but only if coverage as an additional insured is re- quired by a written contract or written agreement that is an "insured contract", and provided the "bodily injury" or "prop- erty damage" first occurs, or the "personal and advertising injury" offense is first committed, subsequent to the execution of the contract or agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II Who Is An Insured is amended to include as an additional insured the person(s) or organizations) shown in the Schedule, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or or- ganization(s) shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw-, and 2. If coverage provided to the additional insured is required by a contractor agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III —Limits Of Insurance: If coverage provided to the additional insured is required by a contractor agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shown m the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 8 0 with its permission, 2009, 2012 & 2013. ADDITIONAL INSURED — MORTGAGEE, ASSIGNEE OR RECEIVER (Insurance Services Office Endorsement CG 20 18 04 13) SCHEDULE I Name Of Person(s) Or Or2anization(s) I Designation Of Premises I Any person or organization that is a mortgagee, assignee or re- ceiver for a premises shown in this Schedule, but only if cov- erage as an additional insured is required by a written contract or written agreement that is an "insured contract", and pro- vided the "bodily injury" or "property damage" first occurs, or the "personal and advertising injury" offense is first commit- ted, subsequent to the execution of the contract or agreement. All premises covered by this insurance. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to their liability as mortgagee, assignee, or receiver and arising out of the owner- ship, maintenance, or use of the premises by you and shown in the Schedule. However: 1. The insurance afforded to such additional insured only applies to the extent permitted bylaw-, and 2. If coverage provided to the additional insured is required by a contractor agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III —Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization who is a sponsor of a trade show where you are operating a booth or displaying your product, but only: 1. For injury or damage occurring at the trade show; and 2. When you and such person or organization have agreed in writing in a contractor agreement executed prior to the beginning of the trade show that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; while attending the trade show sponsored by this additional insured. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 8 0 with its permission, 2009, 2012 & 2013. A person's or organization's status as an additional insured under this endorsement ends when your attendance at the trade show ends. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" and included in the "products -completed operations hazard". C. With respect to the insurance afforded to these additional insureds, the following is added to Section III —Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. ADDITIONAL INSURED — STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION — PERMITS OR AUTHORIZATIONS (INSURANCE SERVICES OFFICE ENDORSEMENT CG 20 12 04 13) SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or governmental agency or subdivision or political subdivision that has issued a permit or authorization for opera- tions performed by you or on your behalf. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II —Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted bylaw-, and b. If coverage provided to the additional insured is required by a contractor agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section III —Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. AD 68 93 0117 Includes copyrighted material of Insurance Services Office, Inc., Page 8 of 8 0 with its permission, 2009, 2012 & 2013. Policy Number: CA000040928-01 AD69630519 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED STATE EXCLUSION - NEW YORK This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM Schedule Job or Project: None Premises: None This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury", including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with: (1) Any operations or activities performed by or on behalf of any insured in the State of New York; or (2) Any premises, site or location owned leased, occupied, maintained or used by or on behalf of any insured in the State of New York. This exclusion does not apply to the Job or Project, or to the Premises, shown in the Schedule above. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. AD 69 63 05 19 Page 1 of 1 Policy Number: CA000040928-01 AD 69 64 05 19 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED STATE EXCLUSION - COLORADO This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM LIQUOR LIABILITY COVERAGE FORM Schedule Job or Project: None Premises: None This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury", including costs or expenses, actually or allegedly arising out of, related to, caused by, contributed to by, or in any way connected with: (1) Any operations or activities performed by or on behalf of any insured in the State of Colorado; or (2) Any premises, site or location owned, leased, occupied, maintained or used by or on behalf of any insured in the State of Colorado. This exclusion does not apply to the Job or Project, or to the Premises, shown in the Schedule above. We shall have no duty to investigate, defend or indemnify any insured against any loss, claim, "suit," demand, fine or other proceeding alleging injury or damages of any kind, to include but not limited to "bodily injury," "property damage," or "per- sonal and advertising injury" to which this endorsement applies. AD 69 64 05 19 Page 1 of 1 Policy Number: CA000040928-01 AD 68 88 12 13 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIAL EXCLUSIONS - JOINT FORM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM (OCCURRENCE VERSION) PRE-EXISTING DAMAGE EXCLUSION It is agreed under Section 1 Coverages, Coverage A Bodily Injury and Property Damage Liability, 1. Insuring Agree- ment, Paragraphs b (3), c and d are deleted in their entirety and the following exclusion is added to this policy: This insurance does not apply to: 1. Any damages arising out of or related to "bodily injury" or "property damage", whether such "bodily injury" or "property damage" is known or unknown, (a) which first occurred prior to the inception date of this policy (or the retroactive date of this policy, if any; whichever is earlier); or (b) which are, or are alleged to be, in the process of occurring as of the inception date of the policy (or the retroac- tive date of this policy, if any; whichever is earlier) even if the "bodily injury" or "property damage" continues during this policy period. 2. Any damages arising out of or related to "bodily injury" or "property damage", whether known or unknown, which are in the process of settlement, adjustment or "suit" as of the inception date of this policy (or the retroactive date of this policy, if any; whichever is earlier). We shall have no duty to defend any insured against any loss, claim, "suit", or other proceeding alleging damages arising out of or related to "bodily injury" or "property damage" to which this endorsement applies. EMPLOYMENT -RELATED PRACTICES EXCLUSION A. The following exclusion is added to Paragraph 2., Exclusions of Section I —Coverage A— Bodily Injury And Proper- ty Damage Liability: This insurance does not apply to: "Bodily injury" to: (1) A person arising out of any "wrongful employment act(s)", or (2) The spouse, child, parent, brother, sister or registered domestic partner of that person as a consequence of "bodi- ly injury" to that person at whom any of the "wrongful employment act(s)" described in Paragraph (1) above is directed. This exclusion applies: (1) Whether any insured may be liable as an employer or in any other capacity; (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury; and (3) Whether the "wrongful employment act(s)" occurs before employment, during employment or after employment of that person. AD 68 88 12 13 Page 1 of 2 13 B. The following exclusion is added to Paragraph 2., Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: This insurance does not apply to: "Personal and advertising injury" to: (1) A person arising out of any "wrongful employment act(s)"; or (2) The spouse, child, parent, brother, sister or registered domestic partner of that person as a consequence of "per- sonal and advertising injury" to that person at whom any of the "wrongful employment act(s)" described in Par- agraph (1) above is directed. This exclusion applies: (1) Whether any insured may be liable as an employer or in any other capacity; (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury; and (3) Whether the "wrongful employment act(s)" occurs before employment, during employment or after employment of that person. C. Additional Definitions: (1) "Wrongful employment act(s)" means any of the following actual, alleged or related acts committed by or on behalf of any insured arising out of a potential, actual or post employment relationship with any person: (a) Discrimination or harassment because of race, color, religion, age, sex, disability, pregnancy, national origin, sexual orientation, marital status, or any other basis prohibited by law which results in termination of the em- ployment relationship, or demotion, or failure or refusal to hire or promote, or failure to accommodate an "em- ployee" or potential "employee", or denial of an employment privilege, or the taking of any adverse or differen- tial employment action; or (b) Sexual harassment including unwelcome sexual advances, requests for sexual favors or other conduct of a sexual nature that is made a condition of employment, is used as a basis for employment decisions, or creates an intimi- dating, hostile or offensive work environment that interferes with work performance; or (c) Termination, constructive discharge, wrongful failure to hire, wrongful demotion, retaliation, misrepresentation, infliction of emotional distress, defamation, invasion of privacy, humiliation, wrongful evaluation, or breach of an implied contractor agreement relating to employment, whether arising out of any personnel manual, policy statement or oral representation; or (d) Physical assault or battery, or any other similar behavior that creates an intimidating, hostile, offensive or dan- gerous work environment; or (e) Training or failing to train any "employee" in accordance with any applicable federal, state or local law, regula- tion, ordinance, rule, guidance document or policy directive governing any act described in Paragraph C. (1) (a) through Paragraph C. (1) (d) above; or (f) Failure to comply with any applicable federal, state or local law, regulation, ordinance, rule, guidance document or policy directive related to the prevention of any act described in Paragraph C. (1) (a) through Paragraph C. (1) (d) above; or (g) malicious prosecution. AD 68 88 12 13 Page 2 of 2 13 Policy Number: CA000040928-01 AD 67 08 10 13 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OCCUPATIONAL DISEASE EXCLUSION (ABSOLUTE) This endorsement modifies insurance provided under the following: CONaIERCIAL GENERAL LIABILITY COVERAGE PART It is agreed there is no coverage afforded under this policy for any "bodily injury" to any individual resulting from any occu- pational or environmental disease arising out of any insured's operations, completed operations or products. AD 67 08 10 13 Page 1 of 1 13 Policy Number: CA000040928-01 AD67180813 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. RESIDENTIAL CONSTRUCTION ACTIVITIES EXCLUSION (ABSOLUTE EXCEPT APARTMENTS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM It is agreed this insurance does not apply to liability arising in whole or in part, either directly or indirectly, out of any past, present or future "residential construction activities" performed by or on behalf of any insured or others. For the purposes of this endorsement, "residential construction activities" means any work or operations related to any job or project involving the construction, repair, remodeling, renovation, maintenance, change or modification of single-family dwellings, multi -family dwellings (excepting only rental apartments in an apartment building: (a) originally constructed and at all times used for such purpose; or (b) converted from a commercial building such as a warehouse, factory, hotel or bank), condominiums, townhom es, townhouses, tune -share units, fractional -ownership units, cooperatives and/or any other structure or space used or intended to be used as a residence, whether full-time, part-time, live -work combination, vacation, or tempo- rary residence, and regardless of the actual use or occupancy of any such structure or space, whether or not: 1. The job or project also includes structures, space, areas and/or units designed, constructed, sold, leased, occupied or used for any commercial or other non-residential purpose; or 2. The present or future ownership of any such structure or space by any person or organization is fee simple, joint tenancy, tenancy -in -common, tenancy -in -the -entirety, tenancy -in -partnership, community property, deeded time-share, non -deeded time-share, fractional interest, shareholder interest and/or any other form of common or fractional interest ownership or management. It is further agreed that for any claim made or "suit" brought which is excluded under the terms of this endorsement, we will have no obligation to defend, adjust or investigate or pay any cost for investigation, defense, adjustment or attorney fees arising out of or related to such claims. AD 67 18 08 13 Page 1 of 1 13 Policy Number: CA000040928-01 AD 67 19 07 05 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONDOMINIUM CONVERSION EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is agreed this insurance does not apply to liability arising in whole or in part, either directly or indirectly, out of any past, present or future job or project performed by or on behalf of any insured or others involving the construction, repair, remodeling, renovation, maintenance, change or modification of any structure, if the structure is or has been converted, changed or modified at any time by or on behalf of any insured or others to condominiums, townhomes or townhouses. It is further agreed that for any claim or "suit' brought which is excluded under the terms of this endorsement, we will have no obligation to defend, adjust or investigate or pay any cost for investigation, defense, adjustment or attor- ney fees arising out of or related to such claim or "suit'. All other terms and conditions remain unchanged AD 67 19 07 05 Page 1 of 1 13 Policy Number: CA000040928-01 AD 67 27 04 06 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INJURY TO TEMPORARY, VOLUNTEER OR CASUAL WORKER EXCLUSION This endorsement modifies insurance provided under the following: CON,4ERCIAL GENERAL LIABILITY COVERAGE PART OWNERS' AND CONTRACTORS' PROTECTIVE LIABILITY COVERAGE PART This insurance does not apply to "bodily injury" or "per- worker" does not include a person who is furnished to any sonal and advertising injury" to any: insured by a labor union to substitute for a permanent "em- s. "Temporary worker"; ployee" on leave or to meet seasonal or short-term work- load conditions. 2. "Volunteer worker"; 3. "Casual worker"; or 4. The spouse, child, parent, brother, sister or registered domestic partner of that worker as a consequence of 1., 2. or 3. above. For the purposes of this endorsement only, "temporary worker" means: A person who is furnished to any insured to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions; however, "temporary For the purposes of this endorsement only, "casual worker" means: 1. A person, other than a person furnished to you by a labor union, who acts at the direction of and within the scope of duties determined by any insured, and is em- ployed by any insured for a short time and for a limited and temporary purpose; or 2. A person for whom any insured, or a labor leasing firm acting on behalf of any insured, does not withhold fed- eral income taxes and pay federal unemployment tax. AD 67 27 04 06 0 ISO Properties, Inc., 2000 Page 1 of 1 13 Policy Number: CA000040928-01 AD 67 48 05 11 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INTELLECTUAL PROPERTY EXCLUSION (AMENDED DEFINITION OF PERSONAL AND ADVERTISING INJURY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART I. SECTION I — COVERAGES — COVERAGE B PER- SONAL AND ADVERTISING INJURY LIABILITY Exclusion i. is deleted in its entirety and replaced by the following: i. "Personal and advertising injury" arising out of: (1) Any infringement, disparagement, dilution or diminution of or damage to: (a) Copyright, slogan or title; (b) Patent; (c) Trademark, service mark, service name, collective mark or certification mark, in- cluding without limitation any word, name, symbol, device or any combination thereof used to identify or distinguish the origin of a good, product or service; (d) Trade secret or practice; (e) Trade dress, including without limitation any shape, color, design or appearance used to distinguish the origin of a good, product or service; (f) Advertising ideas, concepts, campaigns, or style of doing business; or (g) Any other proprietary property rights or intellectual property rights recognized or implied by law. (2) Any false designation of the origin of a good, product or service. (3) Any deceptive, false, fraudulent, misleading, unfair, unlawful or untrue business act or practice. II. The definition of "personal and advertising injury" in the DEFINITIONS section of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM is de- leted in its entirety and replaced by the following: "Personal and advertising injury" means injury, includ- ing consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; c. The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person occupies, committed by or on behalf of its owner, landlord or lessor; d. Oral or written publication of material that slan- ders or libels a person or organization or dispar- ages a person's or organization's goods, products or services; or e. Oral or written publication of material that vio- lates a person's right of privacy. AD 67 48 05 11 Page 1 of 1 13 Policy Number: CA000040928-01 AD 67 60 04 15 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PREMIUM BASIS DEFINITION - GROSS SALES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART When used as a Premium Basis, the following definition applies. Gross Sales 1. Definition Gross Sales means the gross amount charged by the named insured, concessionaires of the named insured or by others trading under the insured's name for: a. All goods or products sold or distributed. b. Operations performed during the policy period. c. Rentals. d. Dues or fees. 2. Inclusions The following items shall not be deducted from gross sales: a. Foreign exchange discounts. b. Freight allowance to customers. c. Total sales of consigned goods and warehouse receipts. d. Trade or cash discounts. e. Bad debts. f. Repossession of items sold on installments (amount actually collected). 3. Exclusions The following items shall be deducted from gross sales: a. Sales or excise taxes which are collected and submitted to a governmental division. b. Credits for repossessed merchandise and products returned. Allowances for damaged and spoiled goods. c. Finance charges for items sold on installments. d. Freight charges on sales if freight is charged as a separate item on customer's invoice. e. Royalty income from patent rights or copyrights which are not product sales. f. Rental receipts for products liability coverage only. AD 67 60 04 15 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 0 with its permission, 2012. Policy Number: CA000040928-01 AD 69 84 04 20 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR INSURANCE AGREEMENT - DEDUCTIBLE PENALTY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Schedule Limits of Insurance General Aggregate Limit (Other than Products -Completed Operations) $ 2,000,000 Products -Completed Operations Aggregate Limit $ 1,000,000 Each Occurrence Limit $ 1,000,000 Personal And Advertising Injury Limit $ 1,000,000 Deductible $ 10,000 Per Claim The following Condition is added to SECTION IV — CONEVIERCIAL GENERAL LIABILITY CONDITIONS: I. You have agreed to obtain prior to any claim or "suit" covered by this insurance the following from every "contractor" performing work, operations or services for you or on your behalf: A. A Certificate of Insurance identifying you as an Additional Insured under each such "contractor's" Commercial General Liability Insurance, with Limits of Insurance equal to or greater than the Limits of Insurance shown in the Schedule above, with respect to any liability arising out of any work, operations or services performed by the "contractor". Further, such Certificates of Insurance shall specify that the "contractor's" insurance shall be primary to and shall not participate or contribute with the insurance afforded by this policy. B. A written contract wherein the "contractor" agrees to hold harmless, defend and indemnify you from and against all losses, costs, expenses, claims, "suits," ..bodily injury", property damage", "personal and advertising injury" or other damages to the fullest extent permitted by law, including with respect to your own negligence and excepting only your sole negligence, with respect to any liability arising out of or related to any work, operations or services performed or to be performed by the "contractor". Such written contracts shall further specify that the "contractor" shall name you as an Additional Insured under that "contractor's" Commercial General Liability insurance as set forth in Paragraph I. A. above prior to the commencement of any work, and the Limits of Insurance provided by such Commercial General Liability insurance shall be equal to or greater than the Limits of Insurance shown in the Schedule above. II. The coverage afforded to you under this insurance, including any duty to defend or indemnify you, shall be excess over and shall not contribute with any insurance, whether collectible or not, naming you as an Additional Insured under any "contractor's" insurance, regardless of whether the Other Insurance conditions of coverage, or any other policy language in the "contractor's" insurance renders it excess, contingent or contributory. III. You must retain Certificates of Insurance and written contracts that you obtain from each "contractor" and provide copies to us upon our written or oral request up to ten years after the Policy Period. We have the right but not the obligation to collect, inspect, monitor, maintain or approve Certificates of Insurance or Additional Insured Endorsements or contracts referenced in Section I. We do not warrant that any Certificate of Insurance, Additional Insured Endorsement, or contract complies with any law, regulation, code, standard or contractual AD 69 84 04 20 Page 1 of 2 obligation. This condition applies to us and to any rating, advisory, rate service, independent claim adjuster or similar organization performing services on our behalf. IV. Your failure to obtain the Certificates of Insurance and written contracts as described in Paragraph I. above will not invalidate the insurance provided by this policy or relieve us of our obligations to you under the terms of this policy; however, it will increase your Deductible to the amount shown in the Schedule. For any claim or "suit' involving one "contractor" performing work, operations or services for you or on your behalf, the Deductible shown in the Schedule will apply if; at the time any injury or damage arising directly or indirectly out of the work, operations or services of that "contractor" occurs, you have not obtained both the Certificate of Insurance and written contract from that "contractor". For any claim or "suit' involving more than one "contractor" performing work, operations or services for you or on your behalf, the Deductible shown in the Schedule will apply if, at the time any injury or damage arising directly or indirectly out of the work, operations or services of the "contractors" occurs, you have not obtained both the Certificate of Insurance and written contract from every "contractor". To any claim or "suit' subject to the higher Deductible, our obligation to pay damages on your behalf applies only to amounts in excess of the Deductible amount shown in the Schedule above for "bodily injury" or "property damage" caused by an "occurrence" arising out of your negligence. V. A. The Deductible amount shown in the Schedule above applies to all damages sustained by any one person because of: (1) "bodily injury"; (2) "property damage"; or (3)"bodily injury" and "property damage" combined; as the result of any one "occurrence". B. If damages are claimed for care, loss of services or death resulting at any time from "bodily injury", a separate deductible amount will be applied to each person making a claim for such damages. C. With respect to "property damage", person includes an organization. D. When used in Paragraph V. A. above, damages includes any payments made under the Supplementary Payments provisions of this policy including, but not limited to, expenses we incur to investigate or settle a claim or to defend a "suit". E. We may pay all or any part of the Deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the Deductible amount as has been paid by us. If you do not promptly reimburse us for any Deductible amount owed, then any cost incurred by us in collection of the Deductible amount will be added and applied in addition to the applicable Deductible amount without any limitation. These costs include, but are not limited to, collection agency fees, attorney's fees and interest. VI. For the purposes of this endorsement, the term "contractor" means any independent contractor, subcontractor, sub - subcontractor or service provider hired by you to perform work, operations or services for you or on your behalf. AD 69 84 04 20 Page 2 of 2 13 Policy Number: CA000040928-01 Al 44 02 05 19 Effective Date: 02/19/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY SERVICE OF SUIT Pursuant to any statute of any state, territory or district of the United States which makes provision therefore, the Company hereby designates the Superintendent, Commissioner or Director of Insurance or other Officer specified for that purpose in the Statute, or his/her successor or successors in office, as its true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by or on behalf of you or any beneficiary hereunder arising out of this contract of insurance, and hereby designates the below named as the person to whom the said Officer is authorized to mail such process or a true copy thereof. It is further agreed that service of process in such suit may be made upon Janet Shemanske, or her nominee of the Company at 7233 East Butherus Drive, Scottsdale, Arizona 85260, and that in any suit instituted against the Company upon this policy, it will abide by the final decision of such Court or of any Appellate Courtin the event of an appeal. Nothing herein shall constitute a selection or designation of forum, or a waiver of any of the Company's rights to select a forum or court, including any of the federal courts of the United States. This includes any right to commence an action in or remove or transfer an action to the United States District Court or any other court of competent jurisdiction, as permitted by law. Further, pursuant to any statute of any state, territory or district of the United States of America or province of Canada, which makes provision therefore, we hereby designate the Superintendent, Commissioner or Director of Insurance or other officer specified for that purpose in the statute, or his successor or successors in office, as our true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by you or on your behalf or any beneficiary hereunder arising out of this contract of insurance, and we hereby designate the above named as the person to whom the said officer is authorized to mail such process or a true copy thereof. Al 44 02 05 19 Page 1 of 1 13 Uss Tpextasmutual0 WORKERS' COMPENSATION INSURANCE PO Box 12058 Austin, TX 78711-2058 HIGGINBOTHAM INS AGENCY INC 1300 10TH ST WICHITA FALLS TX 76301-3227 CONFIDENTIALITY NOTICE: This communication may contain confidential, proprietary or privileged information and is intended only for the person to whom the communication is addressed. If you are not the intended recipient, please immediately notify Texas Mutual's information services center at (800) 859-5995 or information@texasmutual.com and destroy all copies of the communication as your use, disclosure, copying or storage of the communication is prohibited and may be a violation of state or federal law. R ROA 2021-02-25 Print Cover Page Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY GENERAL CHANGE ENDORSEMENT The policy to which this endorsement is attached is amended as shown below: The servicing agent is amended to: Agent #43074 HIGGINBOTHAM INS AGENCY INC Amended agency contact name to reflect: Debbie Anderson Note to agent: WC 99 03 01 Agent copy As servicing agent, you now have access through Texas Mutual Online (TMO) to all the policy's documents, including loss data, policy changes and billing information. Please contact our customer service team @1-800-859-5995 to set up your account. Premium is determined at Final Audit. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC Premium change: $0.00 This is not a bill NCCI Carrier Code: 29939 Endorsement no. Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 2/25/21 WC 99 03 01 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC OU 04 22 C EMPLOYERS LIABILITY POLICY Agent copy TERRORISM RISK INSURANCE PROGRAM This endorsement addresses the requirements of the Terrorism Risk Insurance Act of 2002 as amended and extended by the Terrorism Risk Insurance Program Reauthorization Act of 2019. It serves to notify you of certain limitations under the Act, and that your insurance carrier is charging premium for losses that may occur in the event of an Act of Terrorism. Your policy provides coverage for workers compensation losses caused by Acts of Terrorism, including workers compensation benefit obligations dictated by state law. Coverage for such losses is still subject to all terms, definitions, exclusions, and conditions in your policy, and any applicable federal and/or state laws, rules, or regulations. Definitions The definitions provided in this endorsement are based on and have the same meaning as the definitions in the Act.lf words or phrases not defined in this endorsement are defined in the Act, the definitions in the Act will apply. "Act" means the Terrorism Risk Insurance Act of 2002, which took effect on November 26, 2002, and any amendments thereto, including any amendments resulting from the Terrorism Risk Insurance Program Reauthorization Act of 2019. "Act of Terrorism" means any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security, and the Attorney General of the United States as meeting all of the following requirements: a. The act is an act of terrorism. b. The act is violent or dangerous to human life, property or infrastructure. c. The act resulted in damage within the United States, or outside of the United States in the case of the premises of United States missions or certain air carriers or vessels. d. The act has been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. "Insured Loss" means any loss resulting from an act of terrorism (and, except for Pennsylvania, including an act of war, in the case of workers compensation) that is covered by primary or excess property and casualty insurance issued by an insurer if the loss occurs in the United States or at the premises of United States missions or to certain air carriers or vessels. "Insurer Deductible" means, for the period beginning on January 1, 2021, and ending on December 31, 2027, an amount equal to 20% of our direct earned premiums, during the immediately preceding calendar year. Limitation of Liability The Act limits our liability to you under this policy. If aggregate Insured Losses exceed $100,000,000,000 in a calendar year and if we have met our Insurer Deductible, we are not liable for the payment of any portion of the amount of Insured Losses that exceeds $100,000,000,000; and for aggregate Insured Losses up to $100,000,000,000, we will pay only a pro rata share of such Insured Losses as determined by the Secretary of the Treasury. Policyholder Disclosure Notice 1 Insured Losses would be partially reimbursed by the United States Government. If the aggregate industry Insured Losses occurring in any calendar year exceed $200,000,000 the United States Government would pay 80% of our Insured Losses that exceed our Insurer Deductible. 2 Notwithstanding item 1 above, the United States Government will not make any payment under the Act for any portion of Insured Losses that exceed $100,000,000,000. PO Box 12058, Austin, TX 78711-2058 1 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 04 22 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 00 04 22 C Agent copy 3 The premium charge for the coverage your policy provides for Insured Losses is included in the amount shown in Item 4 of the Information Page or in the Schedule below. Schedule State Rate Premium TEXAS 0.00 $0.00 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC Premium change: $0.00 This is not a bill NCCI Carrier Code: 29939 Endorsement no. 1 Authorized representative PO Box 12058, Austin, TX 78711-2058 2 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 2/25/21 WC 00 04 22 C USs Tpextasmutual0 WORKERS' COMPENSATION INSURANCE PO Box 12058 Austin, TX 78711-2058 Important Insurance Documents Enclosed BRANTLEY & WRIGHT INSURANCE AGENCY 1630 MAIN ST VERNON TX 76384-4702 Please forward the Insured's copy to them immediately. CONFIDENTIALITY NOTICE: This communication may contain confidential, proprietary or privileged information and is intended only for the person to whom the communication is addressed. If you are not the intended recipient, please immediately notify Texas Mutual's information services center at (800) 859-5995 or information@texasmutual.com and destroy all copies of the communication as your use, disclosure, copying or storage of the communication is prohibited and may be a violation of state or federal law. Important Notice: Your Texas Mutual policy provides coverage for claims made by Texas employees for Texas benefits only. If you have employees that need workers' compensation coverage in other states, notify your agent immediately. 2020-10-02 Print Cover Page Tle'XasMutuai WORKERS' COMPENSATION INSURANCE 10/2/20 Notice to Policyholder/Agent: Safety Services Agent copy Pursuant to Texas Labor Code §411.066, Texas Mutual Insurance Company is required to notify its policyholders that accident prevention services are available from Texas Mutual Insurance Company at no additional charge. These services may include surveys, recommendations, training programs, consultations, analyses of accident causes, industrial hygiene, and industrial health services. Texas Mutual Insurance Company is also required to provide return -to -work coordination services as required by Texas Labor Code §413.021 and to notify you of the availability of the return -to -work reimbursement program for employers under Texas Labor Code §413.022. If you would like more information, contact Texas Mutual Insurance Company at 844-WORKSAFE (967-5723) and safety@texasmutual.com for accident prevention services or 844-WORKSAFE (967-5723) and safety@texasmutual.com for return -to -work coordination services. For information about these requirements call the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) at 1-800-687-7080 or for information about the return -to -work reimbursement program for employers call the TDI-DWC at (512) 804-5000. If Texas Mutual Insurance Company fails to respond to your request for accident prevention services or return -to - work coordination services, you may file a complaint with the TDI-DWC in writing at http://www.tdi.texas.gov or by mail to Texas Department of Insurance, Division of Workers' Compensation, MS-8, at 7551 Metro Center Drive, Austin, Texas 78744-1645. In addition to the services above, Texas Mutual offers thousands of free materials in our Safety Resource Center at texasmutual.com. The resource center is home to an extensive library of free DVDs, posters, handouts and online videos, many of which are available in Spanish. Texas Mutual regularly enhances the resource center to provide tools that meet your ever -changing needs. We understand, however, that you may need to speak with a professional about specific safety issues. With our safety services support center, help is just a phone call away. Simply dial 844-WORKSAFE (967-5723) between 8 a.m. and 5 p.m. CST. Our knowledgeable, responsive representatives are ready to: • Help you access streaming videos, interactive tools and other free safety resources at texasmutual.com • Identify your industry's top safety hazards and suggest best practices that address those hazards • Conduct virtual surveys of your workplace • Suggest specific safety programs that address your unique needs Thank you for choosing Texas Mutual Insurance Company as your workers' compensation carrier. We value your business and will work hard to continue earning it. 2200 Aldrich Street Austin, Texas 78723-3474 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (512) 224-3090 LPSERV Tle'XaSMutual WORKERS' COMPENSATION INSURANCE 10/2/20 BRANTLEY & WRIGHT INSURANCE AGENCY 1630 MAIN ST VERNON TX 76384-4702 Regarding Policy no. Blackstone Concrete Ventures LLC 0002038846 Agent Cover Letter Agent copy Policy period 10/4/20 to 10/4/21 Thank you for placing this account with Texas Mutual Insurance Company. For your records we are enclosing: • The policyholder's original copy of the policy. • Claims reporting information and forms. • Your agency copy of the policy. We offer many online services for agents and policyholders at texas mutual.com. Our website allows you to submit applications online, manage your accounts with us, view your clients' claim information, create customized loss reports, and stay up-to-date with Texas MutualO news and events. As the state's leading provider of workers' compensation insurance, we strive to set the standard in Texas for service, communication, and ease of doing business. If you have any questions, please email us at underwriting@texasmutual.com, or call us at (800) 859-5995. Sincerely, GABRIELA ESQUIVEL Underwriting Team PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 COVAGENT Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Figure: 28 TAC §1.601(a)(2)(C) Have a workers' compensation complaint or need help? Contact your insurance company if you have a question or problem about your premium or a claim: Texas Mutual Insurance Company • Call: Information Services at (512) 224-3800 • Toll -free: (800) 859-5995 • Email: information@texasmutual.com • Mail: Texas Mutual Insurance Company Attn: Information Services Center 2200 Aldrich St Austin, TX 78723-3474 For problems with your policy If your problem with the premium is not resolved, contact the National Council on Compensation Insurance, Dispute Resolution Services: • Mail: 901 Peninsula Corporate Circle Boca Raton, FL 33487-1362 • Fax: (561) 893-5043 • Email: regulatoryoperations@ncci.com • Phone: (800) 622-4123 If you believe there has been a violation of law related to your workers' compensation policy, file a complaint with the Texas Department of Insurance: • Call: (800) 252-3439 • Online: www.tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: MC 111-1A P.O. Box 149091 Austin, TX 78714-9091 For employees with claim issues If one of your employees has a problem with a claim, contact the Texas Department of Insurance, Division of Workers' Compensation, Compliance and Investigations: • Mail: MS-8 7551 Metro Center Drive, Suite 100 Austin, TX 78744 • Fax: (512) 490-1030 • Email: DWC-ComplianceReview@tdi.texas.gov • Phone: (800) 252-7031 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Figure: 28 TAC §1.601(a)(2)(C) 4Tiene una queja de compensacion para trabajadores o necesita ayuda? Comuniquese con su compahia de seguros si tiene una pregunta o problema relacionado con su prima de seguro o con una reclamacion: Texas Mutual Insurance Company • Llame a: Information Services al (512) 224-3800 Telefono gratuito: (800) 859-5995 Correo electr6nico: information@texasmutual.com Direcci6n postal: Texas Mutual Insurance Company Attn: Information Services Center 2200 Aldrich St Austin, TX 78723-3474 Para problemas con su poliza Si su problema con la prima de seguro no es resuelto, comuniquese con el Consejo Nacional de Seguros de Compensacion (National Council on Compensation Insurance, por su nombre en ingles), Servicios para la Resolucion de Disputas: • Correo postal: 901 Peninsula Corporate Circle Boca Raton, FL 33487-1362 • Fax: (561) 893-5043 • Correo electr6nico: regulatoryassurance@ncci.com • Telefono: (800) 622-4123 Si usted piensa que ha habido una violacion a la ley, la cual esta relacionada con su poliza de compensacion para trabajadores, presente una queja ante el Departamento de Seguros de Texas: • Llame al: (800) 252-3439 • En linea: www.tdi.texas.gov • Correo electr6nico: ConsumerProtection@tdi.texas.gov • Correo postal: MC 111-1A P.O. Box 149091 Austin, TX 78714-9091 Para empleados que tienen problemas con sus reclamaciones Si uno de sus empleados tiene un problema con una reclamaci6n, comuniquese con la Seccion de Cumplimiento e Investigaciones (Compliance and Investigations, por su nombre en ingles) del Departamento de Seguros de Texas, Division de Compensacion para Trabajadores (Texas Department of Insurance, Division of Workers' Compensation, por su nombre en ingles). • Correo postal: MS-8 7551 Metro Center Drive, Suite 100 Austin, TX 78744 Fax: (512) 490-1030 Correo electr6nico: DWC-ComplianceReview@tdi.texas.gov Telefono: (800) 252-7031 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy NCCI Carrier Code: 29939 Item 1 Insured name and address Producer 09503 Item 2 Item 3 Item 4 Information Page Agent copy Blackstone Concrete Ventures LLC Policy number 10210 QUAKER AVE LUBBOCK TX 79424-8394 0002038846 Other workplaces not shown above Federal tax ID Entity See Schedule of Operations attached. 834457906 LLC Interim adjustment Quarterly 33% - 3 Reports BRANTLEY & WRIGHT INSURANCE AGENCY Branch 1630 MAIN ST VERNON TX 76384-4702 Dallas Renewal of 0002038846 The policy period is from: 10/4/20 To: 10/4/21 12:01 a.m. standard time at the insured's mailing address A. Workers' Compensation Insurance: Part One of the policy applies to the Workers' Compensation Law of the states listed here: Texas B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A. The Limits of our Liability under Part Two are: Bodily Injury by Accident $1,000,000.00 Each Accident Bodily Injury by Disease $1,000,000.00 Policy Limit Bodily Injury by Disease $1,000,000.00 Each Employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: None D. This policy includes these endorsements and schedules: see Schedule of Endorsements attached. The premium for this policy will be determined by our manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Payroll Premium Total payroll and estimated manual premium $50,000.00 $7,995.00 Description Factor Amount Waiver of Subrogation 160.00 Increased Limits Factor 1,000,000/1,000,000/1,000,000 0.014 112.00 Increased Limits Balance to Minimum Premium ($150) 38.00 Schedule Modifier 0.980 (166.00) Healthcare Network Option 0.120 (977.00) Premium Discount 0.029 (208.00) Expense Constant 150.00 Total estimated annual premium $7,104.00 Minimum premium $250.00 /U"e Issue date: 10/2/20 Countersigned by Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission ©Copyright 2020 National Council of Compensation Insurance, Inc. All rights reserved. PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 01 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy Policy number Issue date Policy period 0002038846 10/2/20 10/4/20 to 10/4/21 Location Address 00001 Blackstone Concrete Ventures LLC 10210 QUAKER AVE LUBBOCK, TX 79424-8394 Extension of Information Page Item 1: Locations Agent copy Effective Expires 10/4/20 10/4/21 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 /4L/4-X(r�� Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 01 B-LOCS Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy Policy number Issue date Policy period 0002038846 10/2/20 10/4/20 to 10/4/21 Class codes for primary named insured State Location Code Classification 10/4/20 to 10/4/21 42 00001 5203 Concrete Construction -Bridges-& Drivers Estimated manual premium 0930 Blanket Waiver: All Texas operations 10/04/2020 - 10/04/2021 9812 Increased Limits Factor 1,000,000/1,000,000/1,000,000 9848 Increased Limits Balance to Minimum Premium ($150) 9887 Schedule Modifier 9874 Healthcare Network Option 0063 Premium Discount 0900 Expense Constant Total payroll and Texas total premium Schedule of Operations Item 4: Premium Calculation Agent copy Premium basis Rate per total estimated $100 of Estimated annual remuneration remuneration annual premium 50,000.00 15.990 7,995.00 $7,995.00 0.020 160.00 0.014 112.00 1.000 38.00 0.980 (166.00) 0.120 (977.00) 0.029 (208.00) 1.000 150.00 $50,000.00 $7,104.00 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 00 00 01 B-CALC Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy Policy number Issue date 0002038846 10/2/20 State Endorsement TM LRC 2008 TM MV 2011 TM PC 2003 WC000000C WC000001 B WC 00 04 06 WC000414A WC000422B WC420301 J WC420304B WC 42 03 08 WC420310 WC420407 WC420408A Policy period 10/4/20 to 10/4/21 Description Extension of Information Page Item 3: Endorsement Schedule Agent copy Limited Reimbursement for Texas Employees Injured in Other Jurisdictions Mutuals - Membership and Voting Notice Policy Conditions Endorsement Policy Conditions Form Policy Coverage Document (Declarations Page) Premium Discount Endorsement Notification of Change in Ownership Endorsement Terrorism Risk Insurance Act Coverage Endorsement Texas Amendatory Endorsement Blanket Texas Waiver of Our Right To Recover from Others Endorsement Partners, Officers and Others Exclusion Endorsement Sole Proprietors, Partners, Officers and Others Coverage Endorsement Texas- Audit Premium and Retrospective Premium Endorsement Network Discount Endorsement This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 00 00 01 B-ENDS Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 00 00 00 Ci Agent copy In return to the payment of the premium and subject to all terms of this policy, we agree with you as follows: GENERAL SECTION A. The Policy This policy includes at its effective date the Information Page and all endorsements and schedules listed there. It is a contract of insurance between you (the employer named in Item 1 of the Information Page) and us (the insurer named on the Information Page). The only agreements relating to this insurance are stated in this policy. The terms of this policy may not be changed or waived except by endorsement issued by us to be part of this policy. C. Workers Compensation Law Workers Compensation Law means the workers or workmen's compensation law and occupational disease law of each state or territory named in Item 3.A. of the Information Page. It includes any amendments to that law which are in effect during the policy period. It does not include any federal workers or workmen's compensation law, any federal occupational disease law or the provisions of any law that provide nonoccupational disability benefits. B. Who Is Insured D. State You are insured if you are an employer named in Item 1 of State means any state of the United States of America, and the Information Page. If that employer is a partnership, and if the District of Columbia. you are one of its partners, you are insured, but only in your capacity as an employer of the partnership's employees. E. Locations This policy covers all of your workplaces listed in Items 1 or 4 of the Information Page; and it covers all other workplaces in Item 3.A. states unless you have other insurance or are self -insured for such workplaces. PART ONE - WORKERS COMPENSATION INSURANCE A. How This Insurance Applies D. We Will Also Pay This workers compensation insurance applies to bodily injury We will also pay these costs, in addition to other amounts by accident or bodily injury by disease. Bodily injury includes payable under this insurance, as part of any claim, proceeding resulting death. or suit we defend: 1. Bodily injury by accident must occur during the policy period. 2. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's' last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. B. We Will Pay We will pay promptly when due the benefits required of you by the workers compensation law. C. We Will Defend We have the right and duty to defend at our expense any claim, proceeding or suit against you for benefits payable by this insurance. We have the right to investigate and settle these claims, proceedings or suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. 1. reasonable expenses incurred at our request, but not loss of earnings; 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amount payable under this insurance; 3. litigation costs taxed against you; 4. interest on a judgment as required by law until we offer the amount due under this insurance; and 5. expenses we incur. E. Otherinsurance We will not pay more than our share of benefits and costs covered by this insurance and other insurance or self- insurance. Subject to any limits of liability that may apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remaining insurance will be equal until the loss is paid. PO Box 12058, Austin, TX 78711-2058 1 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE F. Payments You Must Make You are responsible for any payments in excess of the benefits regularly provided by the workers compensation law including those required because: 1. of your serious and willful misconduct; 2. you knowingly employ an employee in violation of law; 3. you fail to comply with a health or safety law or regulation; or 4. you discharge, coerce or otherwise discriminate against any employee in violation of the workers compensation law. If we make any payments in excess of the benefits regularly provided by the workers compensation law on your behalf, you will reimburse us promptly. G. Recovery From Others We have your rights, and the rights of persons entitled to the benefits of this insurance, to recover our payments from anyone liable for the injury. You will do everything necessary to protect those rights for us and to help us enforce them. H. Statutory Provisions These statements apply where they are required by law. 1. As between an injured worker and us, we have notice of the injury when you have notice. 2. Your default or the bankruptcy or insolvency of you or your estate will not relieve us of our duties under this insurance after an injury occurs. 3. We are directly and primarily liable to any person entitled to the benefits payable by this insurance. Those persons may enforce our duties; so may an agency authorized by law. Enforcement may be against us or against you and us. 4. Jurisdiction over you is jurisdiction over us for purposes of the workers compensation law. We are bound by decisions against you under that law, subject to the provisions of this policy that are not in conflict with that law. 5. This insurance conforms to the parts of the workers compensation law that apply to: a. benefits payable by this insurance; b. special taxes, payments into security or other special funds, and assessments payable by us under that law. 6. Terms of this insurance that conflict with the workers compensation law are changed by this statement to conform to that law. Nothing in these paragraphs relieves you of your duties under this policy. PART TWO - EMPLOYERS LIABILITY INSURANCE A. How This Insurance Applies B. We Will Pay This employers liability insurance applies to bodily injury by We will pay all sums that you legally must pay as damages accident or bodily injury by disease. Bodily injury includes because of bodily injury to your employees, provided the bodily resulting death. injury is covered by this Employers Liability Insurance. 1. The bodily injury must arise out of and in the course of the injured employee's employment by you. 2. The employment must be necessary or incidental to your work in a state or territory listed in Item 3.A. of the Information Page. 3. Bodily injury by accident must occur during the policy period. 4. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. 5. If you are sued, the original suit and any related legal actions for damages for bodily injury by accident or by disease must be brought in the United States of America, its territories or possessions, or Canada. The damages we will pay, where recovery is permitted by law, include damages: 1. For which you are liable to a third party by reason of a claim or suit against you by that third party to recover the damages claimed against such third party as a result of injury to your employee; 2. For care and loss of services; and 3. For consequential bodily injury to a spouse, child, parent, brother or sister of the injured employee; provided that these damages are the direct consequence of bodily injury that arises out of and in the course of the injured employee's employment by you; and 4. Because of bodily injury to your employee that arises out of and in the course of employment, claimed against you in a capacity other than as employer. PO Box 12058, Austin, TX 78711-2058 2 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE C. Exclusions This insurance does not cover: 1. Liability assumed under a contract. This exclusion does not apply to a warranty that your work will be done in a workmanlike manner; 2. Punitive or exemplary damages because of bodily injury to an employee employed in violation of law; 3. Bodily injury to an employee while employed in violation of law with your actual knowledge or the actual knowledge of any of your executive officers; 4. Any obligation imposed by a workers compensation, occupational disease, unemployment compensation, or disability benefits law, or any similar law; 5. Bodily injury intentionally caused or aggravated by you; 6. Bodily injury occurring outside the United States of America, its territories or possessions, and Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America or Canada who is temporarily outside these countries; 7. Damages arising out of coercion, criticism, demotion, evaluation, reassignment discipline, defamation, harassment, humiliation, discrimination against or termination of any employee, or any personnel practices, policies, acts or omissions; 8. Bodily injury to any person in work subject to the Longshore and Harbor Workers' Compensation Act (33 U.S.C. Sections 901 et seq.), the Non -appropriated Fund Instrumentalities Act (5 U.S.C. Sections 8171 et seq.), the Outer Continental Shelf Lands Act (43 U.S.C. Sections 1331 et seq.), the Defense Base Act (42 U.S.C. Sections 1651 et seq.), the Federal Coal Mine Safety and Health Act (30 U.S.C. Sections 801 et seq. and 901 - 944), any other federal workers or workmen's compensation law or other federal occupational disease law, or any amendments to these laws; 9. Bodily injury to any person in work subject to the Federal Employers' Liability Act (45 U.S.C. Sections 51 et seq.), any other federal laws obligating an employer to pay damages to an employee due to bodily injury arising out of or in the course of employment, or any amendments to those laws; 10. Bodily injury to a master or member of the crew of any vessel, and does not cover punitive damages related to your duty or obligation to provide transportation, wages, maintenance, and cure under any applicable maritime law; 11. Fines or penalties imposed for violation of federal or state law; and 12. Damages payable under the Migrant and Seasonal Agricultural Worker Protection Act (29 U.S.C. Sections 1801 et seq.) and under any other federal law awarding damages for violation of those laws or regulations issued thereunder, and any amendments to those laws. D. We Will Defend We have the right and duty to defend, at our expense, any claim, proceeding or suit against you for damages payable by this insurance. We have the right to investigate and settle these claims, proceedings and suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. We have no duty to defend or continue defending after we have paid our applicable limit of liability under this insurance. E. We Will Also Pay We will also pay these costs, in addition to other amounts payable under this insurance, as part of any claim, proceeding, or suit we defend: 1. Reasonable expenses incurred at our request, but not loss of earnings; 2. Premiums for bonds to release attachments and for appeal bonds in bond amounts up to the limit of our liability under this insurance; 3. Litigation costs taxed against you; 4. Interest on a judgment as required by law until we offer the amount due under this insurance; and 5. Expenses we incur. F. Otherinsurance We will not pay more than our share of damages and costs covered by this insurance and other insurance or self- insurance. Subject to any limits of liability that apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remaining insurance and self-insurance will be equal until the loss is paid. G. Limits of Liability Our liability to pay for damages is limited. Our limits of liability are shown in Item 3.B. of the Information Page. They apply as explained below. 1. Bodily Injury by Accident. The limit shown for "bodily injury by accident -each accident" is the most we will pay for all damages covered by this insurance because of bodily injury to one or more employees in any one accident. A disease is not bodily injury by accident unless it results directly from bodily injury by accident. 2. Bodily Injury by Disease. The limit shown for "bodily injury by disease -policy limit" is the most we will pay for all damages covered by this insurance and arising out of bodily injury by disease, regardless of the number of employees who sustain bodily injury by disease. The limit shown for "bodily injury by disease -each employee" is the most we will pay for all damages because of bodily injury by disease to any one employee. Bodily injury by disease does not include disease that results directly from a bodily injury by accident. PO Box 12058, Austin, TX 78711-2058 3 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE 3. We will not pay any claims for damages after we have paid the applicable limit of our liability under this insurance. H. Recovery From Others We have your rights to recover our payment from anyone liable for an injury covered by this insurance. You will do everything necessary to protect those rights for us and to help us enforce them. I. Actions Against Us There will be no right of action against us under this insurance unless: 1. You have complied with all the terms of this policy; and 2. The amount you owe has been determined with our consent or by actual trial and final judgment. This insurance does not give anyone the right to add us as a defendant in an action against you to determine your liability. The bankruptcy or insolvency of you or your estate will not relieve us of our obligations under this Part. PART THREE - OTHER STATES INSURANCE A. How This Insurance Applies 4. If you have work on the effective date of this policy in 1. This other states insurance applies only if one or more any state not listed in Item 3.A of the Information Page, states are shown in Item 3.C. of the Information Page. coverage will not be afforded for that state unless we are 2. If you begin work in any one of those states after the notified within thirty days. effective date of this policy and are not insured or are not self -insured for such work, all provisions of the policy B. Notice will apply as though that state were listed in Item 3.A. of Tell us at once if you begin work in any state listed in Item the Information Page. 3.C. of the Information Page. 3. We will reimburse you for the benefits required by the workers compensation law of that state if we are not permitted to pay the benefits directly to persons entitled to them. PART FOUR - YOUR DUTIES IF INJURY OCCURS Tell us at once if injury occurs that may be covered by this 4. Cooperate with us and assist us, as we may request, policy. Your other duties are listed here. in the investigation, settlement or defense of any claim, 1. Provide for immediate medical and other services proceeding or suit. required by the workers compensation law. 5. Do nothing after an injury occurs that would interfere 2. Give us or our agent the names and addresses of the with our right to recover from others. injured persons and of witnesses, and other information 6. Do not voluntarily make payments, assume obligations we may need. or incur expenses, except at your own cost. 3. Promptly give us all notices, demands and legal papers related to the injury, claim, proceeding or suit. PART FIVE - PREMIUM A. Our Manuals C. Remuneration All premium for this policy will be determined by our manuals Premium for each work classification is determined by of rules, rates, rating plans and classifications. We may multiplying a rate times a premium basis. Remuneration is the change our manuals and apply the changes to this policy if most common premium basis. This premium basis includes authorized by law or a governmental agency regulating this payroll and all other remuneration paid or payable during the insurance. policy period for the services of: B. Classifications Item 4 of the Information Page shows the rate and premium basis for certain business or work classifications. These classifications were assigned based on an estimate of the exposures you would have during the policy period. If your actual exposures are not properly described by those classifications, we will assign proper classifications, rates and premium basis by endorsement to this policy. 1. all your officers and employees engaged in work covered by this policy; and 2. all other persons engaged in work that could make us liable under Part One (Workers Compensation Insurance) of this policy. If you do not have payroll records for these persons, the contract price for their services and materials may be used as the premium basis. This paragraph 2 will not apply if you give us proof that the employers of these persons lawfully secured their workers compensation obligations. PO Box 12058, Austin, TX 78711-2058 4 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE D. Premium Payments You will pay all premium when due. You will pay the premium even if part or all of a workers compensation law is not valid. E. Final Premium The premium shown on the Information Page, schedules, and endorsements is an estimate. The final premium will be determined after this policy ends by using the actual, not the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered by this policy. If the final premium is more than the premium you 'd t t th b I If i 't ' I ill 2. If you cancel, final premium will be more than pro rata; it will be based on the time this policy was in force, and increased by our short rate cancellation table and procedure. Final premium will not be less than the minimum premium. F. Records You will keep records of information needed to compute premium. You will provide us with copies of those records when we ask for them. V. o us, you mus pay us e a ance. is ess, we - G. Audit refund the balance to you. The final premium will not be less You will let us examine and audit all your records that relate than the highest minimum premium for the classifications to this policy. These records include ledgers, journals, covered by this policy. registers, vouchers, contracts, tax reports, payroll and disbursement records, and programs for storing and If this policy is cancelled, final premium will be determined in retrieving data. We may conduct the audits during regular the following way unless our manuals provide otherwise: business hours during the policy period and within three 1. If we cancel, final premium will be calculated pro years after the policy period ends. Information developed by rata based on the time this policy was in force. Final audit will be used to determine final premium. Insurance rate premium will not be less than the pro rata share of the service organizations have the same rights we have under minimum premium. this provision. PART SIX - CONDITIONS A. Inspection We have the right, but are not obliged to inspect your workplaces at any time. Our inspections are not safety inspections. They relate only to the insurability of the workplaces and the premiums to be charged. We may give you reports on the conditions we find. We may also recommend changes. While they may help reduce losses, we do not undertake to perform the duty of any person to provide for the health or safety of your employees or the public. We do not warrant that your workplaces are safe or healthful or that they comply with laws, regulations, codes or standards. Insurance rate service organizations have the same rights we have under this provision. D. Cancellation B. Long Term Policy If the policy period is longer than one year and sixteen days, all provisions of this policy will apply as though a new policy were issued on each annual anniversary that this policy is in E force. C. Transfer of Your Rights and Duties Your rights or duties under this policy may not be transferred without our written consent. If you die and we receive notice within thirty days after your death, we will cover your legal representative as insured. 1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancellation is to take effect. 2. We may cancel this policy. We must mail or deliver to you not less than ten days advance written notice stating when the cancellation is to take effect. Mailing that notice to you at your mailing address shown in Item 1 of the Information Page will be sufficient to prove notice. 3. The policy period will end on the day and hour stated in the cancellation notice. 4. Any of these provisions that conflicts with a law that controls the cancellation of the insurance in this policy is changed by this statement to comply with the law. Sole Representative The insured first named in Item 1 of the Information Page will act on behalf of all insured's to change this policy, receive return premium, and give or receive notice of cancellation. PO Box 12058, Austin, TX 78711-2058 5 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY TM LRC 2008 Agent copy LIMITED REIMBURSEMENT FOR TEXAS EMPLOYEES INJURED IN OTHER JURISDICTIONS IMPORTANT NOTICE! PLEASE READ THIS ENDORSEMENT CAREFULLY This policy does not provide "other states" insurance coverage. This endorsement provides reimbursement coverage to you for those Texas employees who are described in the Texas Labor Code §§406.071-.072. Therefore the coverage is for injuries to your Texas employees that occur in another state if (i) the injury would have been compensable had it occurred in Texas and (ii) the employee has significant contacts with Texas or the employment is principally located in Texas. An employee has significant contacts with Texas if the employee was hired or recruited in Texas, and (i) the employee was injured not later than one year after the date of hire; or (ii) has worked in Texas for at least ten working days during the twelve months preceding the date of injury. Employees hired or recruited by you outside Texas to work in another state are specifically excluded from the terms and provisions of this policy. If you conduct business in states other than Texas, you must comply with those state laws. You must promptly notify your agent before you begin work in any jurisdiction other than Texas. We are not authorized to provide workers' compensation insurance in any jurisdiction other than Texas. You are responsible for all of your legal obligations for your failure to comply with requirements of the workers' compensation laws of any jurisdiction other than Texas. Part Three Other States Insurance of the policy is deleted and replaced with the following: Limited Reimbursement Provision A. How this endorsement applies This endorsement will reimburse you after you have made payments for benefits for injuries to your Texas employees required of you in another jurisdiction. This reimbursement provision only applies to bodily injury by accident including death or bodily injury by disease including death incurred by your employee who qualifies for Texas workers' compensation benefits under Sec. 406.071 of the Texas Labor Code. 1. Bodily injury must arise out of and in the course of the injured employee's temporary employment by you in a state other than Texas. 2. Bodily injury by accident must occur during the policy period. 3. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last injurious exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. 4. The employee incurring bodily injury must be eligible for Texas workers' compensation benefits and must make a written election of workers' compensation benefits in the state in which the bodily injury occurred in lieu of Texas workers' compensation benefits. You must send us written notice of such election within 10 days of receiving notice yourself. Failure to provide such notice means any reimbursement will be made in accordance with the Texas Labor Code. PO Box 12058, Austin, TX 78711-2058 1 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 TM LRC 2008 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY B. Reimbursement TM LRC 2008 Agent copy 1. We will reimburse you for the amount you have paid as workers' compensation benefits for employees, as defined above, under the workers' compensation law of any state listed in the schedule. 2. We will deduct from the benefits so reimbursed any amounts we have paid as Texas benefits to the employee for the same injury for which the other jurisdiction's benefits are required. 3. Sections D through G of Part One of the policy will apply to reimbursement provided by this endorsement. Sections A, B, C and H of Part One of the policy will not apply to reimbursement provided by this endorsement. 4. We will reimburse you for reasonable attorney's fees you have paid to defend the injury claim in another jurisdiction. II. Exclusions, Limitations and Conditions The following conditions apply to the reimbursement afforded by this endorsement: 1. Nothing in this endorsement confers jurisdiction in another state or constitutes our doing business in another state. 2. Reimbursement will be made in Texas. 3. Travis County, Texas is the sole venue for any lawsuit involving reimbursement under this endorsement. 4. This endorsement provides reimbursement only in Texas and fully releases and indemnifies us and holds us harmless from any liability arising from your failure to obtain workers' compensation coverage in another jurisdiction. 5. The reimbursement provided by this endorsement excludes: a. bodily injury, including death, to an employee while employed in a jurisdiction where you have secured your obligation under the workers' compensation law by other insurance or by self-insurance; b. bodily injury, including death, to an employee while employed in a state where you affirmatively rejected the workers' compensation law; or c. fines or penalties arising out of your failure to comply with requirements of the workers' compensation law of any state. III. Premium The premium basis and rates for work by Texas employees in jurisdictions other than Texas are the same as if the work had been done in Texas. IV. Schedule Designated States: All states of the United States of America except North Dakota, Ohio, Washington and Wyoming. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC NCCI Carrier Code: 29939 This is not a bill Authorized representative 2of2 PO Box 12058, Austin, TX 78711-2058 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 TM LRC 2008 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND TM MV 2011 EMPLOYERS LIABILITY POLICY Agent copy MUTUALS - MEMBERSHIP AND VOTING NOTICE The insured is notified that by virtue of this policy, he is a member of Texas Mutual Insurance Company, and is entitled to vote either in person or by proxy at any and all meetings of said Company. The Annual Meetings are held in its Home Office, 2200 Aldrich Street Austin, Texas 78723-3474, on the fourth Tuesday of June in each year, at 1:00 o'clock p.m. each year unless the Board of Directors of Texas Mutual Insurance Company specifies otherwise. MUTUALS - PARTICIPATION CLAUSE WITHOUT CONTINGENT LIABILITY No Contingent Liability: This policy is non -assessable. The policyholder is a member of the company and shall participate, to the extent and upon the conditions fixed and determined by the Board of Directors in accordance with the provisions of law, in the distributions of dividends so fixed and determined. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 TM MV 2011 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND TM PC 2003 EMPLOYERS LIABILITY POLICY Agent copy The named insured ratifies and accepts the terms and conditions of the policy to which this endorsement is attached as well as the terms listed below. 1. Policies that are on an interim reporting basis may not be financed. Texas Mutual Insurance Company may cancel coverage if it determines that interim reports have been financed in violation of this prohibition. 2. The named insured certifies that the payroll established by classification codes in the application for coverage is a true and reasonable estimate for the period of coverage requested and will promptly report any material change in payroll exposures to Texas Mutual Insurance Company. Texas Mutual Insurance Company may adjust premium for the policy upon receipt of such information. 3. The named insured and its affiliates permit Texas Mutual Insurance Company access to all of their employment information and records filed with the Texas Workforce Commission, and hereby waive the confidentiality of such information and records. 4. All obligations of the named insured are performable in Travis County, Texas and said county will be the legal venue for any suit arising from this contract. Maintenance of an action in Travis County, Texas does not work an injustice to the named insured and is in the interest of the parties, and transfer of the action would work an injustice to the parties. Any suits must be filed in Travis County, Texas. 5. If the insured defaults on payment of any premiums due under any policy issued, then all premiums due and unpaid shall become due and payable at Texas Mutual Insurance Company's offices in Austin, Travis County, Texas. 6. All information supplied to Texas Mutual Insurance Company by the named insured or its agent in the application for insurance or otherwise is true and complete; nothing material regarding its operations has been omitted; and the named insured intended Texas Mutual Insurance Company to rely on such information in issuing this policy. The named insured assumed the duty of full disclosure of such information and that Texas Mutual Insurance Company has no duty to inquire further regarding such information. The named insured is not violating any provision of the Texas Workers' Compensation Act and is not subcontracting any work to a subcontractor with the intent to avoid liability as an employer. 7. The named insured will not cause any certificate of insurance to be issued for the purpose of satisfying the workers' compensation insurance requirements of any third party, including any governmental entity, unless the remuneration paid to the individual workers performing such work is disclosed to Texas Mutual Insurance Company and included in the premium calculation of the named insured. If the named insured causes a certificate of insurance to be issued for the purpose of allowing the employees of a person other than the named insured to perform work at any job site where workers' compensation is required, and such workers are not covered by workers' compensation insurance, such action by the named insured is a material breach of this insurance policy and constitutes fraud upon Texas Mutual Insurance Company. 8. The named insured has appointed the agent whose name appears on the application as its agent in fact and agrees that any representations made on its behalf by that agent are the representations of the named insured, unless there is an express written agreement between Texas Mutual Insurance Company and the agent that the agent acts on behalf of Texas Mutual Insurance Company. 9. Acceptance of this policy with all endorsements and tender of the deposit premium constitute the insured's agreement with all of the terms and conditions thereof, and the insured's acknowledgement of the obligation to pay all premiums due for the policy. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 TM PC 2003 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 00 04 06 EMPLOYERS LIABILITY POLICY Agent copy PREMIUM DISCOUNT ENDORSEMENT The premium for this policy and the policies, if any, listed in Item 3 of the Schedule may be eligible for a discount. This endorsement shows your estimated discount in Item 1 or 2 of the Schedule. The final calculation of premium discount will be determined by our manuals and your premium basis as determined by audit. Premium subject to retrospective rating is not subject to premium discount. Schedule Estimated Eligible Premium First Next Next Balance 1. State $5,000 $95,000 $400,000 TEXAS 0.00% 9.50% 11.90% 12.40% 2. Average percentage discount 2.90% 3. Other Policies: 4. If there are no entries in Items 1, 2, and 3 of the Schedule see the Premium Discount Endorsement attached to your policy number: This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 /V4-x(r�� Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 04 06 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 00 04 14 A EMPLOYERS LIABILITY POLICY Agent copy 90-DAY REPORTING REQUIREMENT —NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT You must report any change in ownership to us in writing within 90 days of the date of the change. Change in ownership includes sales, purchases, other transfers, mergers, consolidations, dissolutions, formations of a new entity, and other changes provided for in the applicable experience rating plan. Experience rating is mandatory for all eligible insureds. The experience rating modification factor, if any, applicable to this policy, may change if there is a change in your ownership or in that of one or more of the entities eligible to be combined with you for experience rating purposes. Failure to report any change in ownership, regardless of whether the change is reported within 90 days of such change, may result in revision of the experience rating modification factor used to determine your premium. This reporting requirement applies regardless of whether an experience rating modification is currently applicable to this policy. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 04 14 A Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC OU 04 22 B EMPLOYERS LIABILITY POLICY Agent copy TERRORISM RISK INSURANCE PROGRAM This endorsement addresses the requirements of the Terrorism Risk Insurance Act of 2002 as amended and extended by the Terrorism Risk Insurance Program Reauthorization Act of 2015. It serves to notify you of certain limitations under the Act, and that your insurance carrier is charging premium for losses that may occur in the event of an Act of Terrorism. Your policy provides coverage for workers compensation losses caused by Acts of Terrorism, including workers compensation benefit obligations dictated by state law. Coverage for such losses is still subject to all terms, definitions, exclusions, and conditions in your policy, and any applicable federal and/or state laws, rules, or regulations. Definitions The definitions provided in this endorsement are based on and have the same meaning as the definitions in the Act .If words or phrases not defined in this endorsement are defined in the Act, the definitions in the Act will apply. "Act" means the Terrorism Risk Insurance Act of 2002, which took effect on November 26, 2002, and any amendments thereto, including any amendments resulting from the Terrorism Risk Insurance Program Reauthorization Act of 2015. "Act of Terrorism" means any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security, and the Attorney General of the United States as meeting all of the following requirements: a. The act is an act of terrorism. b. The act is violent or dangerous to human life, property or infrastructure. c. The act resulted in damage within the United States, or outside of the United States in the case of the premises of United States missions or certain air carriers or vessels. d. The act has been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. "Insured Loss" means any loss resulting from an act of terrorism (and, except for Pennsylvania, including an act of war, in the case of workers compensation) that is covered by primary or excess property and casualty insurance issued by an insurer if the loss occurs in the United States or at the premises of United States missions or to certain air carriers or vessels. "Insurer Deductible" means, for the period beginning on January 1, 2015, and ending on December 31, 2020, an amount equal to 20% of our direct earned premiums, during the immediately preceding calendar year. Limitation of Liability The Act limits our liability to you under this policy. If aggregate Insured Losses exceed $100,000,000,000 in a calendar year and if we have met our Insurer Deductible, we are not liable for the payment of any portion of the amount of Insured Losses that exceeds $100,000,000,000; and for aggregate Insured Losses up to $100,000,000,000, we will pay only a pro rata share of such Insured Losses as determined by the Secretary of the Treasury. Policyholder Disclosure Notice 1 Insured Losses would be partially reimbursed by the United States Government. If the aggregate industry Insured Losses exceed: a. $100,000,000, with respect to such Insured Losses occurring in calendar year 2015, the United States Government would pay 85% of our Insured Losses that exceed our Insurer Deductible. b. $120,000,000, with respect to such Insured Losses occurring in calendar year 2016, the United States Government would pay 84% of our Insured Losses that exceed our Insurer Deductible. PO Box 12058, Austin, TX 78711-2058 1 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 04 22 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 00 04 22 B Agent copy c. $140,000,000, with respect to such Insured Losses occurring in calendar year 2017, the United States Government would pay 83% of our Insured Losses that exceed our Insurer Deductible. d. $160,000,000, with respect to such Insured Losses occurring in calendar year 2018, the United States Government would pay 82% of our Insured Losses that exceed our Insurer Deductible. e. $180,000,000, with respect to such Insured Losses occurring in calendar year 2019, the United States Government would pay 81 % of our Insured Losses that exceed our Insurer Deductible. f. $200,000,000, with respect to such Insured Losses occurring in calendar year 2020, the United States Government would pay 80% of our Insured Losses that exceed our Insurer Deductible. 2 Notwithstanding item 1 above, the United States Government will not make any payment under the Act for any portion of Insured Losses that exceed $100,000,000,000. 3 The premium charge for the coverage your policy provides for Insured Losses is included in the amount shown in Item 4 of the Information Page or in the Schedule below. Schedule State Rate Premium TEXAS 0.00 $0.00 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC NCCI Carrier Code: 29939 This is not a bill Authorized representative 2of2 PO Box 12058, Austin, TX 78711-2058 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 00 04 22 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 01 J EMPLOYERS LIABILITY POLICY Agent copy TEXAS AMENDATORY ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. GENERAL SECTION B. Who Is Insured is amended to read: You are insured if you are an employer named in Item 1 of the Information Page. If that employer is a partnership or joint venture, and if you are one of its partners or members, you are insured, but only in your capacity as an employer of the partnership's or joint venture's employees. D. State is amended to read: State means any state or territory of the United States of America, and the District of Columbia. PART ONE - WORKERS' COMPENSATION INSURANCE E. Other Insurance is amended by adding this sentence: This section only applies if you have other insurance or are self -insured for the same loss. F. Payments You Must Make This section is amended by deleting the words "workers' compensation" from number 4. H. Statutory Provisions This section is amended by deleting the words "after an injury occurs" from number 2. PART TWO - EMPLOYERS LIABILITY INSURANCE C. Exclusions Sections 2 and 3 are amended to add: This exclusion does not apply unless the violation of law caused or contributed to the bodily injury. Section 6 is amended to read: 6. Bodily injury occurring outside the United States of America, its territories or possessions, and Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America, Mexico or Canada who is temporarily outside these countries. D. We Will Defend This section is amended by deleting the last sentence. PART FOUR - YOUR DUTIES IF INJURY OCCURS Number 6 of this part is amended to read: 6. Texas law allows you to make weekly payments to an injured employee in certain instances. Unless authorized by law, do not voluntarily make payments, assume obligations or incur expenses, except at your own cost. PO Box 12058, Austin, TX 78711-2058 1 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY PART FIVE - PREMIUM A. Our Manuals are amended by adding the sentence: WC420301 J Agent copy In this part, "our manuals" means manuals approved or prescribed by the Texas Department of Insurance. C. Remuneration Number 2 is amended to read: 2. All other persons engaged in work that would make us liable under Part One (Workers' Compensation Insurance) of this policy. This paragraph 2 will not apply if you give us proof that the employers of these persons lawfully secured workers' compensation insurance. E. Final Premium Number 2 is amended to read: 2. If you cancel, final premium will be calculated pro rata based on the time this policy was in force. Final premium will not be less than the pro rata share of the minimum premium. PART SIX - CONDITIONS A. Inspection is amended by adding this sentence: Your failure to comply with the safety recommendations made as a result of an inspection may cause the policy to be canceled by us. C. Transfer of Your Rights and Duties is amended to read: Your rights and duties under this policy may not be transferred without our written consent. If you die, coverage will be provided for your surviving spouse or your legal representative. This applies only with respect to their acting in the capacity as an employer and only for the workplaces listed in Items 1 and 4 on the Information Page. D. Cancellation is amended to read: 1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancellation is to take effect. 2. We may cancel this policy. We may also decline to renew it. We must give you written notice of cancellation or nonrenewal. That notice will be sent certified mail or delivered to you in person. A copy of the written notice will be sent to the Texas Department of Insurance — Division of Workers' Compensation. 3. Notice of cancellation or nonrenewal must be sent to you not later than the 30th day before the date on which the cancellation or nonrenewal becomes effective, except that we may send the notice not later than the 10th day before the date on which the cancellation or nonrenewal becomes effective if we cancel or do not renew because of: a. Fraud in obtaining coverage; b. Misrepresentation of the amount of payroll for purposes of premium calculation; c. Failure to pay a premium when payment was due; d. An increase in the hazard for which you seek coverage that results from an action or omission and that would produce an increase in the rate, including an increase because of failure to comply with reasonable recommendations for loss control or to comply within a reasonable period with recommendations designed to reduce a hazard that is under your control; e. A determination by the Commissioner of Insurance that the continuation of the policy would place us in violation of the law, or would be hazardous to the interests of subscribers, creditors, or the general public. PO Box 12058, Austin, TX 78711-2058 2 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC420301 J Agent copy 4. If another insurance company notifies the Texas Department of Insurance - Division of Workers' Compensation that it is insuring you as an employer, such notice shall be a cancellation of this policy effective when the other policy starts. Add the following to the policy: PART SEVEN - OUR DUTY TO YOU FOR CLAIM NOTIFICATION A. Claims Notification We are required to notify you of any claim that is filed against your policy. Thereafter we must notify you of any proposal to settle a claim or, on receipt of a written request from you, of any administrative or judicial proceeding relating to the resolution of a claim, including a benefit review conference conducted by the Texas Department of Insurance —Division of Workers' Compensation. You may, in writing, elect to waive this notification requirement. We must, on the written request from you, provide you with a list of claims charged against your policy, payments made, and reserves established on each claim, and a statement explaining the effect of claims on your premium rates. We must furnish the requested information to you in writing no later than the 30th day after the date we receive your request. The information is considered to be provided on the date the information is received by the United States Postal Service or is personally delivered. COMPLAINT NOTICE: DISPUTE RESOLUTION SERVICES NCCI'S DISPUTE RESOLUTION PROCESS DOES NOT APPLY TO WORKERS COMPENSATION CLAIMS. For workers compensation claim disputes, see "CLAIM COMPLAINT" below. For issues related to a violation of law related to your policy, see "VIOLATIONS OF LAW" below. Important Note: The dispute resolution services provided through the Dispute Resolution Process (Process) of the National Council on Compensation Insurance (NCCI) are voluntary. The Process is not an administrative remedy that must be exhausted before you pursue relief in court. Using the Process does not prevent you or the carrier that issued the policy from pursuing any available legal remedies at any time. NCCI can assist in the resolution of a dispute regarding your policy that is related to any of the following matters: • The application or interpretation of rules contained in the various NCCI manuals (including, but not limited to, classification codes and experience rating modifications)Rating programs • Endorsements • Forms Contact the carrier that issued the policy and attempt to resolve the dispute directly. If you and the carrier cannot agree, then contact NCCI to ask for assistance. NCCI's Basic Manual addresses dispute resolution in Appendix G. You may obtain dispute resolution services only after you have made a reasonable attempt to first resolve the dispute directly with the carrier and after you have paid any undisputed premium due to the carrier. PO Box 12058, Austin, TX 78711-2058 3 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 01 J EMPLOYERS LIABILITY POLICY Agent copy Send your request for assistance by mail to NCCI, Dispute Resolution Services, 901 Peninsula Corporate Circle, Boca Raton, FL 33487-1362; or by fax to 561-893-5043; or by email to regulatoryoperations(a�ncci.com. THIS NOTICE OF THE DISPUTE RESOLUTION PROCESS IS FOR INFORMATION ONLY AND DOES NOT BECOME A PART, TERM, OR CONDITION OF THIS POLICY. VIOLATIONS OF LAW: If you believe there has been a violation of law related to your policy, file a complaint with the Texas Department of Insurance. Phone: 1-800-252-3439 Online: tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: MC 111-1A, PO Box 149091, Austin, TX 78714 CLAIM COMPLAINT: If there is a workers compensation claim complaint involving one of your employees, then contact the Texas Department of Insurance —Division of Workers' Compensation, Compliance and Investigations by mail to7551 Metro Center Drive, Suite 100, MS-8, Austin, TX 78744; or by fax to 512-490-1030; or by e-mail to DWC-ComplianceReview@tdi.texas.gov. THIS NOTICE IS FOR INFORMATION ONLY AND DOES NOT BECOME A PART, TERM, OR CONDITION OF THIS POLICY. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 4 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 04 B EMPLOYERS LIABILITY POLICY Agent copy TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas operations 3. Premium: The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Included, see Information Page This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 04 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 42 03 08 Agent copy TEXAS PARTNERS, OFFICERS AND OTHERS EXCLUSION ENDORSEMENT The policy does not cover bodily injury to any person described in the Schedule. The premium basis for the policy does not include the remuneration of such persons. You will reimburse us for any payment we must make because of bodily injury to such persons. Schedule Name, title Josh Allen, Vice -President Mark Murray, Treasurer Jorge Burgos, Managing Member Robert Bleisch, Managing Member This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 42 03 08 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 10 EMPLOYERS LIABILITY POLICY Agent copy TEXAS SOLE PROPRIETORS, PARTNERS, OFFICERS AND OTHERS COVERAGE ENDORSEMENT Pursuant to Section 406.097, Labor Code, sole proprietors, partner(s) or corporate executive officer(s) of the named insured are covered under this workers' compensation policy, unless specifically excluded from coverage through an endorsement to the policy. Such persons shall be named in the Schedule below and the premium basis for the policy shall include their remuneration. For employees excluded from workers compensation coverage by law, an election has been made by or on behalf of each person described in "Others" in the Schedule to be subject to the workers compensation law of the state named in the Schedule. Such persons shall be named in the Schedule below and the premium basis for the policy shall include their remuneration. Schedule Name, title Hugo Marquez, President State Texas This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC420310 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY TEXAS - AUDIT PREMIUM AND RETROSPECTIVE PREMIUM Section D of Part Five of the policy is replaced by the following provision: PART FIVE - PREMIUM D. Premium Payments WC 42 04 07 Agent copy You will pay all premium when due. You will pay the premium even if part or all of a workers' compensation law is not valid. The billing statement or invoice for audit additional premiums and/or retrospective additional premiums establishes the date that the premium is due. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 42 04 07 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 04 08 A EMPLOYERS LIABILITY POLICY Agent copy TEXAS HEALTH CARE NETWORK ENDORSEMENT This endorsement indicates that you have elected under this policy to provide workers' compensation health care services to your injured employees through a certified workers' compensation health care network that we have either established or contracted with, as provided in Chapter 1305 of the Texas Insurance Code and in Title 28, Chapter 10 of the Texas Administrative Code. We will provide you with information concerning the use of our certified workers' compensation health care network(s) in our service area(s) and your rights and responsibilities as a participant in our network program. This includes information describing the service area(s) applicable to you and your injured employees as required in NCCI's Basic Manual for Workers' Compensation and Employers' Liability Insurance. In accordance with Chapter 1305 Texas Insurance Code and Title 28, Chapter 10 of the Texas Administrative Code, we will also provide you with information that is required to be given to your employees, including an employee's notice of network requirements and an employee acknowledgement form. Your premium may have been reduced because you have agreed to participate in our certified workers' compensation health care network. The amount of the premium reduction is shown on the Information Page of this policy. The reduction is estimated at the policy inception and adjusted at final audit of the policy. The reduction may be pro -rated if you elect to participate in a certified workers' compensation health care network during the policy year or if you terminate your participation in our certified workers' compensation health care network before the policy expires. The premium reduction you received may be forfeited if we determine that you have failed to provide the notice of network requirements and employee acknowledgement form to your employees in accordance with Chapter 1305.005(d) and 1305.451 Texas Insurance Code and Title 28, Chapter 10 of the Texas Administrative Code. Minimum premium policies are not eligible for this premium reduction. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 04 08 A USs Tpextasmutual0 WORKERS' COMPENSATION INSURANCE PO Box 12058 Austin, TX 78711-2058 Important Insurance Documents Enclosed BLACKSTONE CONCRETE VENTURES LLC 10210 QUAKER AVE LUBBOCK TX 79424-8394 Please forward the Insured's copy to them immediately. CONFIDENTIALITY NOTICE: This communication may contain confidential, proprietary or privileged information and is intended only for the person to whom the communication is addressed. If you are not the intended recipient, please immediately notify Texas Mutual's information services center at (800) 859-5995 or information@texasmutual.com and destroy all copies of the communication as your use, disclosure, copying or storage of the communication is prohibited and may be a violation of state or federal law. Important Notice: Your Texas Mutual policy provides coverage for claims made by Texas employees for Texas benefits only. If you have employees that need workers' compensation coverage in other states, notify your agent immediately. 2020-10-02 Print Cover Page Tle'XaSMutual WORKERS' COMPENSATION INSURANCE 10/2/20 Regarding Policy no. Blackstone Concrete Ventures LLC 0002038846 Dear Policyholder, Information From Your Underwriter Policy period 10/4/20 to 10/4/21 Insured copy Thank you for placing your account with Texas Mutual Insurance Company. For your convenience, we are enclosing a copy of your workers' compensation policy along with two claim -reporting forms you may use if one of your employees has a work -related accident. You can also save time by reporting your injuries online at texasmutual.com. Our website also offers services that allow you to view your claim information, create your own customized loss reports, manage your workplace safety programs and stay up-to-date with Texas MutualO news and events. As the state's leading provider of workers' compensation insurance, we strive to set the standard in Texas for service, communication, and ease of doing business. If you have any questions, please email us at information@texasmutual.com or call us at (800) 859-5995. Sincerely, GABRIELA ESQUIVEL Underwriting Team PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 COVINSUR Tle'XaSMutual WORKERS' COMPENSATION INSURANCE 10/2/20 Regarding Policy no. Blackstone Concrete Ventures LLC 0002038846 Dear Policyholder, Welcome Letter Policy period 10/4/20 to 10/4/21 Insured copy Enclosed is our policyholder packet. Thank you for choosing Texas Mutual Insurance Company. We know you have a choice of workers' compensation carriers, and we are determined to continue to earn your business. As a policyholder - owned mutual company, Texas Mutual is singularly focused on serving you and your employees. We work hard to help you control your premium, fight workers' compensation fraud and prevent workplace accidents. If your employees get injured on the job, our professionals are committed to helping them get well and return as productive members of the workforce. Thank you again for your partnership. Please let us know if there is anything we can do to improve our service to you. Sincerely, &Le Richard Gergasko President & CEO PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Making the most of Texas Mutual services Thank you for choosing Texas Mutual Insurance Company. This brief guide will help you get the most value from your Texas Mutual coverage. Earn dividends Dividends reward loyal customers who share Texas Mutual's commitment to preventing workplace accidents. Visit texasmutual.com/OwnershipPays to learn more about dividends Understand your Your annual premium is an estimate based on your payroll, the type of work your employees premium perform, your loss history, your safety programs and other factors. At the end of your policy period, we will review your account to determine your actual payroll and/or any operational changes during the policy year. If necessary, we will adjust your premium accordingly. You may get money back, or you may be billed. Report injuries • Report injuries the same day they happen, if possible. The fastest way to report injuries is at texasmutual.com. If you cannot report online, you may report by phone at (800) 859-5995, or send a completed DWC-1 form (available on our website — texasmutual.com) by fax to (877) 404-7999 or by mail to Texas Mutual Insurance Company, P.O. Box 12029, Austin, Texas 78711-2029. • Give the employee a copy of the injury report and the "Employee's Rights and Responsibilities" brochure. The brochure can be located on the Texas Mutual Website or The Texas Department of Insurance Website. • Keep accurate records of the dates when you take any claim -related action, including when you file a Supplemental Report of Injury (DWC-6 form) or Employer's Wage Statement (DWC-3 form). You are required to give a copy of these forms to the employee at the time of completion. • You can complete the DWC-3 online by going to Texas Mutual Online (texasmutual.com) and clicking on the Employer Tab. This is the preferred method, but you can also complete the form manually and fax it to our office. • If you have a network policy, you are required to give the employee a copy of the "Notice of Network Requirements" within three days of new employee hire and at the time of injury. The employer must provide employees with a notice of network requirements, which can be located on our website, in English, Spanish, or any other language common to employees. Additional network requirements can be located on our website. Prevent workplace An investment in workplace safety is an investment in your employees and your bottom line. accidents By preventing accidents, you can reduce your workers' compensation costs and improve your productivity. Texas Mutual is your partner in safety. Whether you need help finding free safety resources on our website or advice on a specific safety issue, we are here to help. Simply call us toll -free at 844-WORKSAFE between 8 a.m. and 5 p.m. Central Standard Time (CST) to speak with a knowledgeable, responsive safety services support center representative. You also have access to a multimedia library of 2,000 free training materials in the safety resource center at texasmutual.com. PO Box 12058, Austin, TX 78711-2058 1 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Launch a return -to- When employees miss work due to on-the-job injuries, their employers must find a way to make work process up for lost production. Meanwhile, injured employees must contend with the depression and financial stress that often come with being away from work. Texas Mutual works with you to get your injured employees well and back on the job. Visit texasmutual.com/safety/rtwtools.shtm for more information and free tools. Fight fraud Workers' compensation fraud is bad for your business. Our investigators specialize in protecting your premium dollars from the trickle -down effects of fraud. Visit the Fighting Fraud section at texasmutual.com to learn how you can help us stop those who try to cheat the system. Save time with You can handle most of your workers' comp needs at texas mutual.com. Visit our website to Texas Mutual® report injuries, get free safety training materials, review claim detail reports, submit interim online payroll reports and report suspected fraud. Get Telephone Use our enhanced automated phone services at (800) 859-5995 between 6 a.m. assistance and 9 p.m. CST to: • Verify quote and policy status, including issue date and policy period • Check payment status, including amount and receipt date • Retrieve return payment information, including check number and issue date • Confirm deposit and/or premium amount due • Verify claim number and assigned workers' compensation specialist • Get address and fax information Representatives are available between 8 a.m. and 5:30 p.m. CST to help with: • Interim and final audit information • Information and enrollment for free policyholder workshops • Access to password -protected online services and password reset • Workers' comp health care network information • Any of your workers' comp needs Did someone get We hope you never experience a workplace accident, but if you do, you need to know some injured on the job? basic information about the claims process. Visit the Employers section at texasmutual.com, and click on Claims to learn what to do if an employee gets injured on the job. Register for our Texas Mutual's free, monthly email newsletter includes tips on workplace safety, return -to -work, email newsletter and other strategies for reducing your workers' comp costs and improving your productivity. To register, visit texasmutual.com/news/phenews.shtm. PO Box 12058, Austin, TX 78711-2058 2 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE 10/2/20 Regarding Policy no. Blackstone Concrete Ventures LLC 0002038846 Dear Policyholder: Privacy Notice Insured copy Policy period 10/4/20 to 10/4/21 The management and staff of Texas Mutual Insurance Company (formerly the Texas Workers' Compensation Insurance Fund) are committed to maintaining the confidentiality of your non-public, personal information. We do not disclose any non-public, personal information about our customers to anyone, except as permitted by law. We do not sell any information about our customers to mailing list companies or mass marketing organizations. What information? As your current workers' compensation insurance carrier, we may collect non-public, personal information directly from you or your agent. We use this information only to serve your insurance needs, conduct company business, and fulfill legal and regulatory requirements. For example, we collect information from you or your agent, such as: • your company name, address, and federal identification number; • your payroll, assets, and employee class codes; and • your loss runs (history of the number and severity of workplace injuries and illnesses). We may obtain information from your transactions and other dealings with us such as payment history and premium balance. Also, depending on the nature of your transaction with us, we may collect information from third parties, including injured workers, health care providers, other insurance companies, government agencies, information clearinghouses, courts, and other public records. Confidentiality and Security Measures We treat your information as strictly confidential, and we maintain physical, electronic and procedural safeguards to protect your personal information. The Texas Mutual® employees who have access to our customers' non-public, personal information are those who need it for business purposes. We also instruct our employees on the importance of maintaining the confidentiality of our customers' information. At Texas Mutual Insurance Company, we respect our current and former customers' privacy. We are proud of the strong relationships we have built over the years, and we value your business. Sincerely, IT Security Team PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 TMPNL Tle'XasMutuai WORKERS' COMPENSATION INSURANCE 10/2/20 Notice to Policyholder/Agent: Safety Services Insured copy Pursuant to Texas Labor Code §411.066, Texas Mutual Insurance Company is required to notify its policyholders that accident prevention services are available from Texas Mutual Insurance Company at no additional charge. These services may include surveys, recommendations, training programs, consultations, analyses of accident causes, industrial hygiene, and industrial health services. Texas Mutual Insurance Company is also required to provide return -to -work coordination services as required by Texas Labor Code §413.021 and to notify you of the availability of the return -to -work reimbursement program for employers under Texas Labor Code §413.022. If you would like more information, contact Texas Mutual Insurance Company at 844-WORKSAFE (967-5723) and safety@texasmutual.com for accident prevention services or 844-WORKSAFE (967-5723) and safety@texasmutual.com for return -to -work coordination services. For information about these requirements call the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) at 1-800-687-7080 or for information about the return -to -work reimbursement program for employers call the TDI-DWC at (512) 804-5000. If Texas Mutual Insurance Company fails to respond to your request for accident prevention services or return -to - work coordination services, you may file a complaint with the TDI-DWC in writing at http://www.tdi.texas.gov or by mail to Texas Department of Insurance, Division of Workers' Compensation, MS-8, at 7551 Metro Center Drive, Austin, Texas 78744-1645. In addition to the services above, Texas Mutual offers thousands of free materials in our Safety Resource Center at texasmutual.com. The resource center is home to an extensive library of free DVDs, posters, handouts and online videos, many of which are available in Spanish. Texas Mutual regularly enhances the resource center to provide tools that meet your ever -changing needs. We understand, however, that you may need to speak with a professional about specific safety issues. With our safety services support center, help is just a phone call away. Simply dial 844-WORKSAFE (967-5723) between 8 a.m. and 5 p.m. CST. Our knowledgeable, responsive representatives are ready to: • Help you access streaming videos, interactive tools and other free safety resources at texasmutual.com • Identify your industry's top safety hazards and suggest best practices that address those hazards • Conduct virtual surveys of your workplace • Suggest specific safety programs that address your unique needs Thank you for choosing Texas Mutual Insurance Company as your workers' compensation carrier. We value your business and will work hard to continue earning it. 2200 Aldrich Street Austin, Texas 78723-3474 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (512) 224-3090 LPSERV O RKWELL,TX Health care network inforniation 1 As of january 1, 2018 X 1° e ,Lsmutua WORKERS' COMPENSATION INSURANCE WORK SAFE, TEXAS' At Texas Mutual Insurance Company, we are committed to the safety of Texas workers. WorkWell, TX serves as an extension of that commitment, ensuring quality care for employees who are injured on the job. WorkWell, TX is a workers' compensation health care network certified by the state of Texas. By choosing the network option from Texas Mutual, you keep your costs low with a network discount and our focus on getting injured workers well and back on the job. Our providers have been chosen to treat your employees because of their proven record of success with work -related injuries and illnesses. A network that offers high -quality care, better results, and savings is a win -win for you and your employees. To help introduce your employees to WorkWell, TX, this packet offers information and resources, which they must read and sign. Start by reviewing the checklist below to discover what you and your workforce will need to know and do in case an injury occurs. Employer Checklist 1. Review this packet. 2. Post the Notice of Network Requirements in a common area where your employees will see it. 3. Distribute the Notice of Network Requirements to employees when you begin the program, within 3 days of hiring a new employee, and at the time of injury. Keep a record of how, when, where and to whom you delivered the Notice of Network Requirements. 4. Have all employees sign the Employee Acknowledgment form and keep it in the employee's personnel file. (An employee who refuses to sign remains subject to network requirements. Document a refusal to sign the acknowledgment in the employee's personnel file.) 5. When an injury occurs, report it immediately to Texas Mutual and if necessary, provide or arrange transportation for the injured employee to the network provider, or emergency facility if appropriate. 6. Work -related injuries must be treated by network -approved physicians. Review the online provider directory on texasmutual.com for a list of network providers. If you or an injured employee needs help locating a provider, you may call WorkWell, TX at (844) 867-2338. Thank you for choosing WorkWell, TX. If you have any questions, please contact us at (844) 867-2338 or visit texasmutual.com. Sincerely, WorkWell, TX Support Team (844) 867-2338 WORKWELLJX 71M WORKWELL,TX Notice of Network Requirements (Post in visible area for all employees) Your employer has chosen WorkWell, TX as its certified workers' compensation health care network in partnership with Texas Mutual Insurance Company, a workers' compensation insurance carrier. WorkWell, TX will manage the health care and treatment you may receive if you are injured on the job or diagnosed with an occupational illness while employed here. WorkWell, TX doctors are trained in treating work -related injuries and illnesses and getting people back to work and back to a productive life. The information in this packet will help you to seek care for your injury and describes what to do if you are injured while on the job. What to do if you are injured while on the job If you are injured at work, tell your employer right away. Your employer will help with any questions you may have about seeking treatment through WorkWell, TX. You may also contact Texas Mutual if you have any questions about your treatment. Our shared goal with your employer is to return you to work as soon as it is safe to do so. A list of network doctors in your service area is available on texasmutual.com or by downloading the WorkWell, TX mobile app. You may contact us at (844) 867-2338 or at the address below for assistance. WorkWell, TX 6210 East Highway 290 Austin, Texas 78723-1098 In case of an emergency If you are injured and it is an emergency, you should seek treatment at the nearest medical care facility immediately. This also applies if you are injured outside the service area. Emergency care does not require preapproval. Texas law defines `medical emergency" as a medical condition that comes up suddenly. After you receive emergency care, you may need ongoing care. Select a network doctor from the WorkWell, TX network. The doctor you choose will oversee the care for your injury. You must obtain referrals to see another health care provider or specialist from your treating doctor, except for emergency care. i I I I a 49MVION IMPAW jal Treatment prescribed by your doctor may need to be approved in advance. Your doctor needs to request approval from the network for a specific treatment before the treatment or service is provided. You may continue to need further care after completing the approved treatment. If you are hurt at work and it is not an emergency and you live in the network service area, you must choose a treating doctor from the WorkWell, TX network. This is required so that WorkWell, TX covers the costs for the care. If you belong to a health maintenance organization (HMO) at the time of your injury� you may choose your HMO primary care doctor as your treating doctor. You must have chosen the doctor as your primary care doctor before your injury. We will approve the choice of your HMO doctor if they agree to the terms of the network contract and to abide by applicable laws. For a list of network doctors available in your area, please visit texasmutual.com or download the WorkWell, TX mobile app. The WorkWell, TX provider directory is updated monthly. Doctors who speak Spanish or who are no longer taking new patients will be flagged with an icon on their record. If your treating doctor leaves the network, we will notify you in writing. You will have the right to choose another treating doctor from the network directory. If your doctor leaves the network and you have a life threatening or acute condition for which a disruption of care would be harmful to you, your doctor may request to continue your treatment for an extra 90 days. If you live outside of the service area, you may request a service area review by calling WorkWell,TX. You should provide proof to support your request. WorkWell, TX will inform you of its decision within seven days of receiving your request. If you disagree with WorkWell, TXs final decision, you have the right to file a complaint with the Texas Department of Insurance. Your complaint must include your name, address, phone number, a copy of WorkWell, TXs decision and any proof you sent to WorkWell, TX for review. A complaint form is available on tditexas.gov or you may ask for a form by writing to: Mail Code 103-6A Texas Department of Insurance PO Box 149104 Austin, Texas 78714-9104 When waiting for WorkWell, T-X to make a decision or for the Texas Department of Insurance to review your complaint, you are still expected to use the network for all health care. You may be required to pay for health care services received out of the network if it is decided you do live in t network's service area. I- Changing doctors If you are not satisfied with your first choice of a treating doctor, you can select a different treating doctor from the network directory. We will not deny your choice to see a different treating doctor. Before you can change treating doctors a second time, you must get permission from the network by calling (844) 867-2338. Referrals You do not have to get a referral if you have an emergency. All other health care and specialist referrals should be made through your treating doctor. All health care services that you request will be made available by the network on a timely basis, as required by your medical condition. This includes referrals. All health care services, including referrals, will be made available within 21 days after your request. Out -of -network approvals WorkWell, TX must approve all of your treating doctor or specialist's out -of -network referrals before you visit the provider. If you need to request approval, please call (844) 867-2338. Payment for health care Network doctors have agreed to seek payment from Texas Mutual for your treatment. They will not look to you for payment. If you receive treatment from a doctor who is not in the network without prior approval from WorkWell, TX, you may have to pay for the cost of that care. Medical costs for treatment by non -network health care providers may be covered only if one of the following situations occurs: • Emergency care is needed. You should go to the nearest hospital or emergency care facility. • You do not live within the service area of the network. • Your treating doctor or specialist refers you to an out -of -network provider or facility and WorkWell, TX approves the referral. • You have chosen your HMO primary care doctor. Your doctor must agree to abide by the network contract and applicable laws. Preauthorization, adverse determination and independent review A list of the procedures and services that need preauthorization is on texasmutual.com. The list in this packet is not intended to be all-inclusive; health care is an evolving science. Procedures and treatments requiring prior approval will also evolve. Treating providers should verify preauthorization requirements by referring to the updated list on texasmutual.com. If WorkWell, TX denies the request, you or the requesting doctor may ask for a review of that decision. If still dissatisfied, you, your provider or a person acting on your behalf may request an independent review. The preauthorization agent will provide any relevant medical records related to the injury to the independent review group. They may also provide any treatment guidelines used and a list of the doctors who provided care to you. We take your concerns seriously. If you are dissatisfied, you can file a complaint with WorkWell, TX. You may do this if you are not sated with any aspect of the network, including care you received. You must file your complaint within 90 days after the date of the event that is the basis for the complaint. If you have questions about the complaint process you can reach the Grievance Coordinator by phone at (844) 297-5723, by fax at (512) 224-8800, by email at wwtxcomplaints@texasmutual.com, or by mail at the address below. WorkWell, TX Attention: Grievance Coordinator PO Box 12029 Austin, Texas 78711-2029 Texas law does not permit WorkWell, TX to retaliate against you if you file a complaint against the network. We will not retaliate if you appeal the decision of the network. The law does not permit us to retaliate against your provider if they file a complaint against the network or appeal the decision of the network on your behalf. You have the right to file a complaint with the Texas Department of Insurance. The Texas Department of Insurance complaint form is available on the department's website at tdi.texas.gov or you may request a form by writing to: Managed Care Quality Assurance Office Mail Code 103-6A Texas Department of Insurance PO Box 149104 Austin, Texas 78714-9104 WorkWell,, TX Preauthorization List Hospital/ASC All non -emergency hospital or ASC (inpatient, outpatient, and observation) admissions including principle scheduled procedures and length of stay. Preauthorization request should include specific hardware, implantables, external delivery system, etc. to be utilized. Surgery/Procedures/Integral Devices All non -emergency surgeries represented by AMA CPT codes 10010-69990 and/or G codes which represent a surgical procedure performed in a setting or place of service other than the doctor's office [POS 11]. Preauthorization request should include specified hardware, implantables, external delivery system, etc. to be utilized. • All botox injections • All spinal injections (including but not limited to): >> Epidural steroid injections >> RFTC or cryotherapy/cryoablation >> Sacral iliac joint injection >> Facet injection >> Medical branch block • Trigger point injections (AMA CPT 20553) • Bone growth stimulators • Discograms • Implantable drug delivery system • Investigational or experimental procedures or devices as determined by ODG or listed as an AMA category III code. Stimulator devices (including, but not limited to): >> TENS units >> Interferential units >> Neuromuscular sbmulatc)rs >> Dual units >> Spinal cord stimulator >> Peripheral nerve stimulator >> Brain stimulator Physical Medicine • All chiropractic treatments • Manipulations under anesthesia (MUA) • All PT/OT (unless requestor or rendering provider/facility is participating through Align) • Biofeedback Diagnostics • All initial and repeat MRI and CT scans • Bone density scans • Surface electromyography (EMG) • Unless otherwise specified in this list, all repeat individual diagnostic studies (series) having a billed amount greater than $350. • Surface electromyography (EMG) Other • Durable medical equipment (DME), prosthetics and/or orthotics ' greater than $500.00 billed (purchase or accumulated rental or combination of rental/purchase) • Gym memberships • Texas Department of Insurance, Division of Workers' Compensation (DWC) Pharmacy Closed Formulary per 28 TAC §134, Subchapter F. Alternative Treatment • Acupuncture outside ODG • Acupressure • Yoga Rehab Programs • Work conditioning • Work hardening • Chronic pain management program • Medical rehabilitation • Brain and spinal cord rehabilitation • Chemical dependency programs • Weight loss programs Nursing Home • Skilled nursing facility, including skilled care within the same facility • Convalescent care • Residential care • Assisted living/group homes Psychological Testing and Psychotherapy • Subsequent evaluations • Subsequent tests or testing • Therapy • Biofeedback fj 25 SO 7 5 100 Kik--cl-, S) TI 5 IfK, INUC, WorkWell, TX Service Area County List A Comal Gray Kendall Newton Stephens Anderson Comanche Grayson Kenedy Nolan Sterling Andrews Concho Gregg Kent Nueces Stonewal Angelina Cooke Grimes Kerr Swisher Aransas Coryell Guadalupe Kimble O Archer Crane Kleberg Ochiltree T Armstrong Crosby H Oldham Tarrant Atascosa Hale L Orange Taylor Austin D Hall Lamar Terry Dallam Hamilton Lamb P Throckmorton B Dallas Hansford Lampasas Palo Pinto Titus Bailey Dawson Hardin Lavaca Panola Tom Green Bandera Deaf Smith Harris Lee Parker Travis Bastrop Delta Harrison Leon Parmer Trinity Baylor Denton Hartley Liberty Pecos Tyler Bee Dewitt Haskell Limestone Polk Bell Dickens Hays Lipscomb Potter U Bexar Donley Hemphill Live Oak Upshur Blanco Duval Henderson Llano R Upton Bosque Hidalgo Loving Rains Uvalde Bowie E Hill Lubbock Randall Brazoria Eastland Hockley Lynn Reagan v Brazos Ector Hood Real Van Zandt Briscoe ElPaso Hopkins M Red River Victoria Brooks Ellis Houston Madison Reeves Brown Erath Howard Marion Refugio W Burleson Hudspeth Martin Roberts Walker Burnet F Hunt Mason Robertson Waller Falls Hutchinson Matagorda Rockwall Ward C Fanin I McCulloch Runnels Washington Caldwell Camp Fayette McLennan Rusk Webb Calhoun Fisher Irion McMullen Wharton Callahan Floyd Medina S Wichita Cameron Fort Bend 3 Menard Sabine Wilbarger Cam p Franklin Jack Midland San Augustine Willacy Carson Freestone Jackson Milam San Jacinto Williamson Cass Frio Jasper p Mitchell San Patricio Wilson Castro Jefferson ue Monta g San Saba Winkler Chambers G Jim Hogg Montgomery Schleicher Wise Cherokee Gaines Jim Wells Moore Scurry Wood Clay Galveston Johnson Morris Shackelford Cochran Garza Jones Motley Shelby Y Coke Gillespie N Sherman Yoakum Coleman Glasscock K Smith Young Collin Goliad Karnes Nacogdoches Somervell Colorado Gonzales kaufman Navarro Starr -Om- WORKWELL,TX Employee Acknowledgment of Workers' Compensation Network I have received information that informs me how to get health care under my employer's workers' compensation insurance. If I am hurt on the job and live in a service area described in this packet, I understand that: 0 1 must choose a treating doctor from the list of doctors in the network. Or, I may ask my HMO primary care physician to agree to serve as my treating doctor. If I select my HMO primary care physician as my treating doctor, I will call Texas Mutual Insurance Company at (844) 867-2338 to notify them of my choice. 0 1 must go to my treating doctor for all health care for my injury. If I need a specialist, my treating doctor will refer me to a specialist. If I need emergency care, I may go anywhere. 0 Texas Mutual will pay the treating doctor and other network providers for the treatment for my compensable injury. 0 1 may have to pay the bill if I get health care from someone other than a network doctor without prior network approval. Knowingly making a false workers' compensation claim may lead to a criminal investigation that could result in criminal penalties such as fines and imprisonment. Signature Date Printed name I live at: Street address City State Zip code Name of employer: Name of network: WorkWell, TX To the employer: Each employee must sign this form when you begin the program or within 3 days of being hired, and at the time an injury occurs. Please indicate at which point this acknowledgement was completed. Ei Initiating the network program (companywide) Ei Initial employee notification (new hire) Ei Injury notification (Date of injury: Keep this completed form in the employee's personnel file. It could be requested by Texas Mutual. LB-1234-1708 -,)2017Texas Mutual Insurance. Company [ page 1 of 2 ] First Fill Simplifying the prescription process and helping workers take the first step toward getting wE " Texas Mutual's First Fill Program enables your employees to get prescribed medication quickly after an injury occurs, even if you haven't had the opportunity to file a claim. Injured workers can get a seven-day supply for each covered prescription with a maximum of $500 per prescription with just the First Fill form. Complete the First Fill form on the back of this sheet and advise your employee to present it at a participating Optum pharmacy. The form is valid for the first fill and cannot be used if the first prescription fill is being requested more than 10 days after the injury occurred. If additional forms are needed, visit the employer forms section at texas mutual.com. eXIPSMutual® WORKERS' COMPENSATION INSURANCE i' WORK SAFE, TEXAS' texasmutual.com I worksafetexas.com 0 1230 ! ....................III, KH-1478-1903-BW2. C12019 Texas Mutual Insurance Company OPTUM- Prescription First Fill Form exaSMutual® WORKERS' COMPENSATION INSURANCE [ page 2 of 2 ] Prescription First Fill Instructions 1. Participating Optum pharmacies include Walgreens, CVS, Walmart, Kroger, Target, Costco, Sam's Club, Brookshire, HEB and Tom Thumb. To locate other participating pharmacies, visit www.texasmutual.com/hcn or www.tmesys.com. 2. Complete the form and take to the pharmacy along with your prescription from the provider. 3. This form allows you to fill your initial prescription(s) with a maximum cost of $500 per covered prescription and a maximum seven day supply. 4. If you have questions, please call us at (866) 599-5426, available 24 hours a day, seven days a week. Bin #: 004261 PCN#: CAL Group Number: TXSMFF Member ID: Member Name: Employer Name: Date of Injury: Pharmacy Help Desk: (800) 964-2531 Date of injury + SSN combined as follows: YYMMDD123456789 Injured worker's first and last name PLEASE NOTE: This form is only valid within 10 days of the injury date. Once your claim has been reviewed, you will be sent a new card in the mail. If you do not receive a pharmacy card, please call us at (866) 599-5426. Issuance of this letter or dispensing of a prescription does not constitute acceptance of your claim. Optum I P.O. Box 152539 1 Tampa, FL 33684-2539 IMP14-1913-03 Send the specified copies to your Workers' Compensation Insurance Carrier and the injured employee. *Employers - Do not send this form to the Texas Department of Insurance, Division of Workers' Compensation, Unless the Division specifically requests a direct filling. CLAIM # CARRIER'S CLAIM # EMPLOYERS FIRST REPORT OF INJURY OR ILLNESS 1. Name (Last, First, M.I.) 2. Sex F ❑ M ❑ 3. Social Security Number 4. Home Phone 5. Date of Birth (m-d-y) 6. Does the Employee Speak English? If No, Specify Language YES[:] NO ❑ 7. Race White ❑ Black ❑ Asian ❑ 8. Ethnicity Hispanic ❑ Native American ❑ Other ❑ 9. Mailing Address Street or P.O. Box City State Zip Code County 10. Marital Status Married ❑ Widowed ❑ Se arated ❑ Single ❑ Divorced ❑ 11. Number of Dependent Children 12. Spouse's Name 13. Doctor's Name 14. Doctor's Mailing Address (Street or P.O.Box) City State Zip Code 15. Date of Injury (m-d-y) 16. Time of Injury 17. Date Lost Time Began (m-d-y) am ❑ pm ❑ - - 18. Nature of Injury* 19. Part of Body Injured or Exposed* 20. How and Why Injury/Illness Occurred* 21. Was employee ❑ 22. Worksite Location of Injury (stairs, dock, etc.)* doing his YES regularjob? NO ❑ 23. Address Where Injury or Exposure Occurred Name of business if incident occurred on a business site Street or P.O. Box County City State Zip Code 24. Cause of Injury(fall, tool, machine, etc.)* 25. List Witnesses 26. Return to work 27. Did employee 28. Supervisor's 29. Date Reported date/or expected die? Name (m-d-y) (m-d-y) YES ❑ NO ❑ 30. Date of Hire (m-d-y) 31. Was employee hired or recruited in Texas? 32. Length of Service in Current Position 33. Length of Service in Occupation - YES ❑ NO ❑ Months Years Months Years 34. Employee Payroll Classification Code 35. Occupation of Injured Worker 36. Rate of Pay at this Job 37. Full Work Week is: 38. Last Paycheck was: 39. Is employee an Owner, Partner, or Corporate Officer? $ Hourly $ Weekly _Hours _Days $ for _Hours or _Days vFc n Nn n 40. Name and Title of Person Completing Form 41. Name of Business 42. Business Mailing Address and Telephone Number 43. Business Location (If different from mailing address) Street or P.O. Box Telephone Number and Street City State Zip Code City State Zip Code 44. Federal Tax Identification Number 45. Primary North American Industry Classification System 46. Specific NAICS Code 47. Texas Comptroller Taxpayer No. Code:(6 digit) 1 (6 digit) 1 48. Workers' Compensation Insurance Company 49. Policy Number 50. Did you request accident prevention services in past 12 months? YES ❑ NO ❑ If yes, did you receive them? YES ❑ NO❑ 51. Signature and Title (READ INSTRUCTIONS ON INSTRUCTION SHEET BEFORE SIGNING) X Date �E F CLAIM # Carrier # SUPPLEMENTAL REPORT OF INJURY Part I EMPLOYER INFORMATION 1. Employer business name 2. Employer phone # 3. Employer mailing address 4. Insurance carrier name 5. Does the employer have return to work (RTW) opportunities available based on the injured worker's current capabilities? yes no If so, identify contact person and phone # 6. Has the insurance carrier provided RTW coordination services within the past 12 months? yes Date no 7. Has the employer requested RTW training from DWC or the insurance carrier? yes no 8. Has the insurance carrier provided accident prevention services in the past 12 months? yes O Date no 9. Has the employer requested accident prevention services from the insurance carrier? yes no Pali II KLASUN FUR FILING THIS KLPUKT (deadlines vary, see Instructions) 10. F—] a. The injured worker returned to work in either a full or limited capacity: File this report within 3 days. b. The injured worker is earning more or less than the pre -injury wage because of the injury: File within 10 days. c. The injured worker returned, then later had additional lost time or reduced wages as a result of the injury: File within 3 days. d. The injured worker resigned or was terminated from employment: File within 10 days. Part III INJURED WORKER INFORMATION 11. Injured worker name 12. SSN (last 4 digits) 13. DOI xxx-xx- 14. Injured worker mailing address and phone # 15. First day of lost time or reduced 16. First day of additional lost time wages for this injury (mm/dd/yyyy) or reduced wages (mm/dd/yyyy) 17, Has the injured worker experienced 8 days (cumulative) of lost time or reduced wages as a result of the injury? yes no If yes, the date of the 8`h day (mm/dd/yyyy) 18. Date of most recent RTW 19. Has the injured worker resigned, been terminated or died? yes 0 no 0 0 Full duty, full pay date of resignation date of termination date of death O Limited duty, full pay i 19a. Reason for resignation/termination O Limited duty, reduced pay 19b. Was the injured worker on limited duty when terminated? yes = no 0 20. Hours the injured worker was working during the pay period of 21. Weekly/hourly earnings for the pay period of to hours per week to : $ weekly or $ Indicated hours are: Indicated wages are: 0 Increase from pre -injury 0 Increase from pre -injury wage 0 Same as pre -injury 0 Same a pre -injury wage 0 Decrease from pre -injury 0 Decrease from pre -injury wage This Corm to be tiled with: The employer's insurance carrier and the injured worker in the timeframe as noted in Part/1. 22. To the best of my knowledge the information provided in this report is accurate and may be relied upon for evaluation of eligibility for benefits. Submitted by: = Employer F—] Injured Worker (If no longer working for the employer where injury occurred.) Signature and Title of person completing this form Date DWC FORM-6 (Rev. 10/05) Page 1 DIVISION OF WORKERS' COMPENSATION NOTICE TO EMPLOYEES CONCERNING ASSISTANCE AVAILABLE IN THE WORKERS' COMPENSATION SYSTEM FROM THE OFFICE OF INJURED EMPLOYEE COUNSEL Have you been injured on the job? As an injured employee in Texas, you have the right to free assistance from the Office of Injured Employee Counsel (OIEC). OIEC is the state agency that assists unrepresented injured employees with their claim in the workers' compensation system. You can contact OIEC by calling its toll -free telephone number: 1-866-393-6432. More information about OIEC and its Ombudsman Program is available at the agency's website (www.oiec.texas.gov). OMBUDSMAN PROGRAM WHAT IS AN OMBUDSMAN? An Ombudsman is an employee of OIEC who can assist you if you have a dispute with your employer's insurance carrier. An Ombudsman's assistance is free of charge. Each Ombudsman has a workers' compensation adjuster's license and has completed a comprehensive training program designed specifically to assist you with your dispute. An Ombudsman can help you identify and develop the disputed issues in your case and attempt to resolve them. If the issues cannot be resolved, the Ombudsman can help you request a dispute resolution proceeding at the Texas Department of Insurance, Division of Workers' Compensation. Once a proceeding is scheduled an Ombudsman can: • Help you prepare for the proceeding (Benefit Review Conference and/or Contested Case Hearing); • Attend the proceeding with you and communicate on your behalf; and • Assist you with an appeal or a response to an insurance carrier's appeal, if necessary. ----------------------------------------------------------------------------------------------------------------------------------------- CONNECT W @OIEC O' @OIECTexas 0 Tube @OIECtube oiec.texas.gov Figure 28 TAC §276.5(c) - April 2018 AVISO PARA LOS EMPLEADOS SOME LAASISTENCIA DISPONIBLE EN ELSISTEMA DE COMPENSACION PARATRABAJADORES POR PARTE DE LA OFICINA DE ASESORIA PUBLICA PARAEL EMPLEADO LESIONADO cSe ha lesionado en el trabajo? Como empleado lesionado en Texas, usted tiene derecho a recibir asistencia gratuity por parte de la Oficina de Asesoria Publica para el Empleado Lesionado (Office of Injured Employee Counsel —OIEC, por su nombre y siglas en ingles). OIEC es la agencia estatal que asiste a los empleados lesionados que no cuentan con representacion legal con su reclamacion en el sistema de compensacion para trabajadores. Usted puede comunicarse con OIEC Ilamando a su n6mero de telefono gratuito: 1-866-393-6432. Mas informacion sobre OIEC y sobre el Programa de Ombudsman se encuentra disponible en el sitio web de la agencia (www.oiec.texas.gov). 'ROGRAF IA DE OMBUDSMAN c QUE ES UN OMBUDSMAN? Un Ombudsman es un empleado de OIEC que le puede asistir si usted tiene una disputa con la aseguradora de su empleador. La asistencia por parte del Ombudsman es gratuity. Cada Ombudsman cuenta con una licencia de ajustador de compensacion pars trabajadores y ha completado un extenso programs de capacitacion, el cual ha sido disenado especificamente para asistirle a usted con su disputa. Un Ombudsman puede ayudarle a identificar y desarrollar los asuntos en disputa en su caso a intentar resolverlos. Si los asuntos no pueden ser resueltos, el Ombudsman puede ayudarle a solicitar un procedimiento de resolucion de disputas ante el Departamento de Seguros de Texas, Division de Compensacion para Trabajadores (Texas Department of Insurance, Division of Workers' Compensation, por su nombre en ingles). Una vez que el procedimiento ha sido programado, el Ombudsman puede: • Ayudarle a prepararse pars el procedimiento (Conferencia pars Revision de Beneficios [Benefit Review Conference, por su nombre en ingles] y/o Audiencia pars Disputar Beneficios [Contested Case Hearing, por su nombre en ingles]); • Asistir al procedimiento con usted y hablar en su nombre; y • Ayudarle con una apelacion o con una respuesta a la apelacion de una aseguradora, y si es necesario. --------------------------------------------------------------------------------------------------------------------------------------- 1ir CONECTESE W @OIEC 0 @OIECTexas Titulo 28 Codigo Administrativo de Texas NOTICE TO EMPLOYEES CONCERNING WORKERS' COMPENSATION IN TEXAS COVERAGE: Blackstone Concrete Ventures LLC has workers' compensation insurance coverage from Texas Mutual Insurance Company in the event of work -related injury or occupational disease. This coverage is effective from 10/4/20. Any injuries or occupational diseases which occur on or after that date will be handled by Texas Mutual Insurance Company. An employee or a person acting on the employee's behalf, must notify the employer of an injury or occupational disease not later than the 30th day after the date on which the injury occurs or the date the employee knew or should have known of an occupational disease, unless the Texas Department of Insurance, Division of Workers' Compensation (Division) determines that good cause existed for failure to provide timely notice. Your employer is required to provide you with coverage information, in writing, when you are hired or whenever the employer becomes, or ceases to be, covered by workers' compensation insurance. EMPLOYEE ASSISTANCE: The Division provides free information about how to file a workers' compensation claim. Division staff will answer any questions you may have about workers' compensation and process any requests for dispute resolution of a claim. You can obtain this assistance by contacting your local Division field office or by calling 1-800-252-7031. The Office of Injured Employee Counsel (OIEC) also provides free assistance to injured employees and will explain your rights and responsibilities under the Workers' Compensation Act. You can obtain OIEC's assistance by contacting an OIEC customer service representative in your local Division field office or by calling 1-866-EZE-OIEC (1-866-393-6432). SAFETY VIOLATIONS HOTLINE: The Division has a 24 hour toll -free telephone number for reporting unsafe conditions in the workplace that may violate occupational health and safety laws. Employers are prohibited by law from suspending, terminating, or discriminating against any employee because he or she in good faith reports an alleged occupational health or safety violation. Contact the Division at 1-800-452-9595. Notice 6 (01/13) TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION Rule 110.101(e)(1) COVERED EMPLOYER Texas Workers' Compensation Rule 110.101(e)(1) requires employers who are covered by workers' compensation through a commercial insurance company to advise their employees that they do have workers' compensation insurance coverage and to advise their employees of the Texas Department of Insurance, Division of Workers' Compensation's toll free number to obtain additional information about their workers' compensation rights. Notices in English, Spanish and any other language common to the employer's employee population must be posted and: 1 Prominently displayed in the employer's personnel office, if any; 2 Located about the workplace in such a way that each employee is likely to see the notice on a regular basis; 3 Printed with a title in at least 26 point bold type, subject in at least 18 point bold type, and text in at least 16 point normal type; and 4 Contain the exact words as prescribed in Rule 110.101(e)(1). The notice on the reverse side meets the above requirements. Failure to post or to provide notice as required in the rule is a violation of the Act and Division rules. The violator may be subject to administrative penalties. Do Not Post This Side AVISO A LOS EMPLEADOS SOBRE LA COMPENSACION PARA TRABAJADORES EN TEXAS COBERTURA: Blackstone Concrete Ventures LLC tiene cobertura de seguros de compensacion pars trabajadores con Texas Mutual Insurance Company para protegerle en caso de una lesion o enfermedad ocupacional relacionada con el trabajo. Esta cobertura esta vigente desde 10/4/20. Cualquier lesion o enfermedad ocupacional que ocurra en o despues de esta fecha sera manejada por Texas Mutual Insurance Company. Un empleado o una persona que actue en nombre del empleado, debe notificar al empleador sobre una lesion o una enfermedad ocupacional a no mas tardar de treinta (30) dias, a partir de la fecha en que ocurrio la lesion o en la fecha en la que el empleado se entero o deberia de haberse enterado de la enfermedad ocupacional, al menos que el Departamento de Seguros de Texas, Division de Compensacion para Trabajadores (Texas Department of Insurance, Division of Workers' Compensation — TDI-DWC, por su nombre y siglas en ingles) (Division) determine que existio una buena causa para que no se haya notificado al empleador dentro del tiempo senalado. Su empleador tiene la obligacion de proporcionarle a usted informacion por escrito sobre la cobertura cuando usted es contratado o cuando su empleador adquiere o deja de tener una cobertura de seguro de compensacion para trabajadores. ASISTENCIA AL EMPLEADO: La Division proporciona informacion gratuita sobre como presentar una reclamacion de compensacion para trabajadores. El personal de la Division contestara cualquier pregunta que usted pueda tener sobre la compensacion para trabajadores y procesara cualquier solicitud de resolucion de disputas relacionada con una reclamacion. Usted puede obtener este tipo de asistencia comunicandose con su oficina local de la Division o Ilamando al telefono 1-800-252-7031. La Oficina de Asesoria Publica para el Empleado Lesionado (Office of Injured Employee Counsel — OIEC, por su nombre y siglas en ingles tambien ofrece asistencia gratuita a los empleados lesionados y ellos le explicaran cuales son sus derechos y responsabilidades bajo la Ley de Compensacion para Trabajadores. Usted puede obtener la asistencia de OIEC comunicandose con un representante de servicio al cliente de OIEC en su oficina local de la Division o Ilamando al 1-866-EZE-OIEC (1-866-393-6432). LINEA DIRECTA PARA REPORTAR VIOLACIONES DE SEGURIDAD: La Division cuenta con una linea gratuita telefonica que esta en servicio las 24 horas del dia para reportar condiciones inseguras en el area de trabajo que podrian violar Ias leyes ocupacionales de salud y seguridad. La ley prohibe que los empleadores suspendan, despidan o discriminen en contra de cualquier empleado porque eI o ella de buena fe reporta una alegada violacion ocupacional de salud o seguridad. Comuniquese con la Division al telefono 1-800-452-9595. Notice 6 (01/13) TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION Rule 110.101(e)(1) EMPLEADOR CON COBERTURA El Reglamento 110.101 (e)(1) de Compensaci6n para Trabajadores de Texas requiere que los empleadores que cuentan con una cobertura de compensaci6n para trabajadores mediante una compania de seguros comercial notifiquen a sus empleados que ellos cuentan con una cobertura de seguro de compensaci6n para trabajadores a informen a sus empleados sobre el numero de la linea telef6nica gratuita del Departamento de Seguros de Texas, Divisi6n de Compensaci6n para Trabajadores para obtener informaci6n adicional sobre sus derechos de compensaci6n para trabajadores. Avisos en ingles, espanol y cualquier otro idioma comun para la poblaci6n de los trabajadores del empleador deben ser puestos a la vista y: 1 Mostrarse en un lugar prominente de la oficina de personal del empleador, si es que la hay; 2 Ubicar este aviso en el area de trabajo de tal manera que los empleados to vean regularmente; 3 El titulo debe ser impreso en tamano 26, en letra negrita de punto, el tema debe ser impreso en tamano 18, en letra negrita de punto, y el texto, por to menos en tamano 16 en letra negrita de punto normal; y 4 Contener las palabras exactas segun to senalado en el Reglamento 110.101 (e)(1). El aviso que se muestra al reverso de esta pagina cumple con los requisitos que se han senalado en la parte de arriba. El negarse a mostrar o proporcionar esta informaci6n, segun to requerido en el reglamento es una falta a la ley y a los reglamentos de la Divisi6n. El infractor podria estar sujeto a sanciones administrativas. Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Figure: 28 TAC §1.601(a)(2)(C) Have a workers' compensation complaint or need help? Contact your insurance company if you have a question or problem about your premium or a claim: Texas Mutual Insurance Company • Call: Information Services at (512) 224-3800 • Toll -free: (800) 859-5995 • Email: information@texasmutual.com • Mail: Texas Mutual Insurance Company Attn: Information Services Center 2200 Aldrich St Austin, TX 78723-3474 For problems with your policy If your problem with the premium is not resolved, contact the National Council on Compensation Insurance, Dispute Resolution Services: • Mail: 901 Peninsula Corporate Circle Boca Raton, FL 33487-1362 • Fax: (561) 893-5043 • Email: regulatoryoperations@ncci.com • Phone: (800) 622-4123 If you believe there has been a violation of law related to your workers' compensation policy, file a complaint with the Texas Department of Insurance: • Call: (800) 252-3439 • Online: www.tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: MC 111-1A P.O. Box 149091 Austin, TX 78714-9091 For employees with claim issues If one of your employees has a problem with a claim, contact the Texas Department of Insurance, Division of Workers' Compensation, Compliance and Investigations: • Mail: MS-8 7551 Metro Center Drive, Suite 100 Austin, TX 78744 • Fax: (512) 490-1030 • Email: DWC-ComplianceReview@tdi.texas.gov • Phone: (800) 252-7031 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Figure: 28 TAC §1.601(a)(2)(C) 4Tiene una queja de compensacion para trabajadores o necesita ayuda? Comuniquese con su compahia de seguros si tiene una pregunta o problema relacionado con su prima de seguro o con una reclamacion: Texas Mutual Insurance Company • Llame a: Information Services al (512) 224-3800 Telefono gratuito: (800) 859-5995 Correo electr6nico: information@texasmutual.com Direcci6n postal: Texas Mutual Insurance Company Attn: Information Services Center 2200 Aldrich St Austin, TX 78723-3474 Para problemas con su poliza Si su problema con la prima de seguro no es resuelto, comuniquese con el Consejo Nacional de Seguros de Compensacion (National Council on Compensation Insurance, por su nombre en ingles), Servicios para la Resolucion de Disputas: • Correo postal: 901 Peninsula Corporate Circle Boca Raton, FL 33487-1362 • Fax: (561) 893-5043 • Correo electr6nico: regulatoryassurance@ncci.com • Telefono: (800) 622-4123 Si usted piensa que ha habido una violacion a la ley, la cual esta relacionada con su poliza de compensacion para trabajadores, presente una queja ante el Departamento de Seguros de Texas: • Llame al: (800) 252-3439 • En linea: www.tdi.texas.gov • Correo electr6nico: ConsumerProtection@tdi.texas.gov • Correo postal: MC 111-1A P.O. Box 149091 Austin, TX 78714-9091 Para empleados que tienen problemas con sus reclamaciones Si uno de sus empleados tiene un problema con una reclamaci6n, comuniquese con la Seccion de Cumplimiento e Investigaciones (Compliance and Investigations, por su nombre en ingles) del Departamento de Seguros de Texas, Division de Compensacion para Trabajadores (Texas Department of Insurance, Division of Workers' Compensation, por su nombre en ingles). • Correo postal: MS-8 7551 Metro Center Drive, Suite 100 Austin, TX 78744 Fax: (512) 490-1030 Correo electr6nico: DWC-ComplianceReview@tdi.texas.gov Telefono: (800) 252-7031 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy NCCI Carrier Code: 29939 Item 1 Insured name and address Producer 09503 Item 2 Item 3 Item 4 Information Page Insured copy Blackstone Concrete Ventures LLC Policy number 10210 QUAKER AVE LUBBOCK TX 79424-8394 0002038846 Other workplaces not shown above Federal tax ID Entity See Schedule of Operations attached. 834457906 LLC Interim adjustment Quarterly 33% - 3 Reports BRANTLEY & WRIGHT INSURANCE AGENCY Branch 1630 MAIN ST VERNON TX 76384-4702 Dallas Renewal of 0002038846 The policy period is from: 10/4/20 To: 10/4/21 12:01 a.m. standard time at the insured's mailing address A. Workers' Compensation Insurance: Part One of the policy applies to the Workers' Compensation Law of the states listed here: Texas B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A. The Limits of our Liability under Part Two are: Bodily Injury by Accident $1,000,000.00 Each Accident Bodily Injury by Disease $1,000,000.00 Policy Limit Bodily Injury by Disease $1,000,000.00 Each Employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: None D. This policy includes these endorsements and schedules: see Schedule of Endorsements attached. The premium for this policy will be determined by our manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Payroll Premium Total payroll and estimated manual premium $50,000.00 $7,995.00 Description Factor Amount Waiver of Subrogation 160.00 Increased Limits Factor 1,000,000/1,000,000/1,000,000 0.014 112.00 Increased Limits Balance to Minimum Premium ($150) 38.00 Schedule Modifier 0.980 (166.00) Healthcare Network Option 0.120 (977.00) Premium Discount 0.029 (208.00) Expense Constant 150.00 Total estimated annual premium $7,104.00 Minimum premium $250.00 /U"e Issue date: 10/2/20 Countersigned by Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission ©Copyright 2020 National Council of Compensation Insurance, Inc. All rights reserved. PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 01 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy Policy number Issue date Policy period 0002038846 10/2/20 10/4/20 to 10/4/21 Location Address 00001 Blackstone Concrete Ventures LLC 10210 QUAKER AVE LUBBOCK, TX 79424-8394 Extension of Information Page Item 1: Locations Insured copy Effective Expires 10/4/20 10/4/21 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 /4L/4-X(r�� Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 01 B-LOCS Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy Policy number Issue date Policy period 0002038846 10/2/20 10/4/20 to 10/4/21 Class codes for primary named insured State Location Code Classification 10/4/20 to 10/4/21 42 00001 5203 Concrete Construction -Bridges-& Drivers Estimated manual premium 0930 Blanket Waiver: All Texas operations 10/04/2020 - 10/04/2021 9812 Increased Limits Factor 1,000,000/1,000,000/1,000,000 9848 Increased Limits Balance to Minimum Premium ($150) 9887 Schedule Modifier 9874 Healthcare Network Option 0063 Premium Discount 0900 Expense Constant Total payroll and Texas total premium Schedule of Operations Item 4: Premium Calculation Insured copy Premium basis Rate per total estimated $100 of Estimated annual remuneration remuneration annual premium 50,000.00 15.990 7,995.00 $7,995.00 0.020 160.00 0.014 112.00 1.000 38.00 0.980 (166.00) 0.120 (977.00) 0.029 (208.00) 1.000 150.00 $50,000.00 $7,104.00 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 00 00 01 B-CALC Tle'XaSMutual WORKERS' COMPENSATION INSURANCE Workers' Compensation and Employer's Liability Policy Policy number Issue date 0002038846 10/2/20 State Endorsement TM LRC 2008 TM MV 2011 TM PC 2003 WC000000C WC000001 B WC 00 04 06 WC000414A WC000422B WC420301 J WC420304B WC 42 03 08 WC420310 WC420407 WC420408A Policy period 10/4/20 to 10/4/21 Description Extension of Information Page Item 3: Endorsement Schedule Insured copy Limited Reimbursement for Texas Employees Injured in Other Jurisdictions Mutuals - Membership and Voting Notice Policy Conditions Endorsement Policy Conditions Form Policy Coverage Document (Declarations Page) Premium Discount Endorsement Notification of Change in Ownership Endorsement Terrorism Risk Insurance Act Coverage Endorsement Texas Amendatory Endorsement Blanket Texas Waiver of Our Right To Recover from Others Endorsement Partners, Officers and Others Exclusion Endorsement Sole Proprietors, Partners, Officers and Others Coverage Endorsement Texas- Audit Premium and Retrospective Premium Endorsement Network Discount Endorsement This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 00 00 01 B-ENDS Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 00 00 00 Ci Insured copy In return to the payment of the premium and subject to all terms of this policy, we agree with you as follows: GENERAL SECTION A. The Policy This policy includes at its effective date the Information Page and all endorsements and schedules listed there. It is a contract of insurance between you (the employer named in Item 1 of the Information Page) and us (the insurer named on the Information Page). The only agreements relating to this insurance are stated in this policy. The terms of this policy may not be changed or waived except by endorsement issued by us to be part of this policy. C. Workers Compensation Law Workers Compensation Law means the workers or workmen's compensation law and occupational disease law of each state or territory named in Item 3.A. of the Information Page. It includes any amendments to that law which are in effect during the policy period. It does not include any federal workers or workmen's compensation law, any federal occupational disease law or the provisions of any law that provide nonoccupational disability benefits. B. Who Is Insured D. State You are insured if you are an employer named in Item 1 of State means any state of the United States of America, and the Information Page. If that employer is a partnership, and if the District of Columbia. you are one of its partners, you are insured, but only in your capacity as an employer of the partnership's employees. E. Locations This policy covers all of your workplaces listed in Items 1 or 4 of the Information Page; and it covers all other workplaces in Item 3.A. states unless you have other insurance or are self -insured for such workplaces. PART ONE - WORKERS COMPENSATION INSURANCE A. How This Insurance Applies D. We Will Also Pay This workers compensation insurance applies to bodily injury We will also pay these costs, in addition to other amounts by accident or bodily injury by disease. Bodily injury includes payable under this insurance, as part of any claim, proceeding resulting death. or suit we defend: 1. Bodily injury by accident must occur during the policy period. 2. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's' last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. B. We Will Pay We will pay promptly when due the benefits required of you by the workers compensation law. C. We Will Defend We have the right and duty to defend at our expense any claim, proceeding or suit against you for benefits payable by this insurance. We have the right to investigate and settle these claims, proceedings or suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. 1. reasonable expenses incurred at our request, but not loss of earnings; 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amount payable under this insurance; 3. litigation costs taxed against you; 4. interest on a judgment as required by law until we offer the amount due under this insurance; and 5. expenses we incur. E. Otherinsurance We will not pay more than our share of benefits and costs covered by this insurance and other insurance or self- insurance. Subject to any limits of liability that may apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remaining insurance will be equal until the loss is paid. PO Box 12058, Austin, TX 78711-2058 1 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE F. Payments You Must Make You are responsible for any payments in excess of the benefits regularly provided by the workers compensation law including those required because: 1. of your serious and willful misconduct; 2. you knowingly employ an employee in violation of law; 3. you fail to comply with a health or safety law or regulation; or 4. you discharge, coerce or otherwise discriminate against any employee in violation of the workers compensation law. If we make any payments in excess of the benefits regularly provided by the workers compensation law on your behalf, you will reimburse us promptly. G. Recovery From Others We have your rights, and the rights of persons entitled to the benefits of this insurance, to recover our payments from anyone liable for the injury. You will do everything necessary to protect those rights for us and to help us enforce them. H. Statutory Provisions These statements apply where they are required by law. 1. As between an injured worker and us, we have notice of the injury when you have notice. 2. Your default or the bankruptcy or insolvency of you or your estate will not relieve us of our duties under this insurance after an injury occurs. 3. We are directly and primarily liable to any person entitled to the benefits payable by this insurance. Those persons may enforce our duties; so may an agency authorized by law. Enforcement may be against us or against you and us. 4. Jurisdiction over you is jurisdiction over us for purposes of the workers compensation law. We are bound by decisions against you under that law, subject to the provisions of this policy that are not in conflict with that law. 5. This insurance conforms to the parts of the workers compensation law that apply to: a. benefits payable by this insurance; b. special taxes, payments into security or other special funds, and assessments payable by us under that law. 6. Terms of this insurance that conflict with the workers compensation law are changed by this statement to conform to that law. Nothing in these paragraphs relieves you of your duties under this policy. PART TWO - EMPLOYERS LIABILITY INSURANCE A. How This Insurance Applies B. We Will Pay This employers liability insurance applies to bodily injury by We will pay all sums that you legally must pay as damages accident or bodily injury by disease. Bodily injury includes because of bodily injury to your employees, provided the bodily resulting death. injury is covered by this Employers Liability Insurance. 1. The bodily injury must arise out of and in the course of the injured employee's employment by you. 2. The employment must be necessary or incidental to your work in a state or territory listed in Item 3.A. of the Information Page. 3. Bodily injury by accident must occur during the policy period. 4. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. 5. If you are sued, the original suit and any related legal actions for damages for bodily injury by accident or by disease must be brought in the United States of America, its territories or possessions, or Canada. The damages we will pay, where recovery is permitted by law, include damages: 1. For which you are liable to a third party by reason of a claim or suit against you by that third party to recover the damages claimed against such third party as a result of injury to your employee; 2. For care and loss of services; and 3. For consequential bodily injury to a spouse, child, parent, brother or sister of the injured employee; provided that these damages are the direct consequence of bodily injury that arises out of and in the course of the injured employee's employment by you; and 4. Because of bodily injury to your employee that arises out of and in the course of employment, claimed against you in a capacity other than as employer. PO Box 12058, Austin, TX 78711-2058 2 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE C. Exclusions This insurance does not cover: 1. Liability assumed under a contract. This exclusion does not apply to a warranty that your work will be done in a workmanlike manner; 2. Punitive or exemplary damages because of bodily injury to an employee employed in violation of law; 3. Bodily injury to an employee while employed in violation of law with your actual knowledge or the actual knowledge of any of your executive officers; 4. Any obligation imposed by a workers compensation, occupational disease, unemployment compensation, or disability benefits law, or any similar law; 5. Bodily injury intentionally caused or aggravated by you; 6. Bodily injury occurring outside the United States of America, its territories or possessions, and Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America or Canada who is temporarily outside these countries; 7. Damages arising out of coercion, criticism, demotion, evaluation, reassignment discipline, defamation, harassment, humiliation, discrimination against or termination of any employee, or any personnel practices, policies, acts or omissions; 8. Bodily injury to any person in work subject to the Longshore and Harbor Workers' Compensation Act (33 U.S.C. Sections 901 et seq.), the Non -appropriated Fund Instrumentalities Act (5 U.S.C. Sections 8171 et seq.), the Outer Continental Shelf Lands Act (43 U.S.C. Sections 1331 et seq.), the Defense Base Act (42 U.S.C. Sections 1651 et seq.), the Federal Coal Mine Safety and Health Act (30 U.S.C. Sections 801 et seq. and 901 - 944), any other federal workers or workmen's compensation law or other federal occupational disease law, or any amendments to these laws; 9. Bodily injury to any person in work subject to the Federal Employers' Liability Act (45 U.S.C. Sections 51 et seq.), any other federal laws obligating an employer to pay damages to an employee due to bodily injury arising out of or in the course of employment, or any amendments to those laws; 10. Bodily injury to a master or member of the crew of any vessel, and does not cover punitive damages related to your duty or obligation to provide transportation, wages, maintenance, and cure under any applicable maritime law; 11. Fines or penalties imposed for violation of federal or state law; and 12. Damages payable under the Migrant and Seasonal Agricultural Worker Protection Act (29 U.S.C. Sections 1801 et seq.) and under any other federal law awarding damages for violation of those laws or regulations issued thereunder, and any amendments to those laws. D. We Will Defend We have the right and duty to defend, at our expense, any claim, proceeding or suit against you for damages payable by this insurance. We have the right to investigate and settle these claims, proceedings and suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. We have no duty to defend or continue defending after we have paid our applicable limit of liability under this insurance. E. We Will Also Pay We will also pay these costs, in addition to other amounts payable under this insurance, as part of any claim, proceeding, or suit we defend: 1. Reasonable expenses incurred at our request, but not loss of earnings; 2. Premiums for bonds to release attachments and for appeal bonds in bond amounts up to the limit of our liability under this insurance; 3. Litigation costs taxed against you; 4. Interest on a judgment as required by law until we offer the amount due under this insurance; and 5. Expenses we incur. F. Otherinsurance We will not pay more than our share of damages and costs covered by this insurance and other insurance or self- insurance. Subject to any limits of liability that apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remaining insurance and self-insurance will be equal until the loss is paid. G. Limits of Liability Our liability to pay for damages is limited. Our limits of liability are shown in Item 3.B. of the Information Page. They apply as explained below. 1. Bodily Injury by Accident. The limit shown for "bodily injury by accident -each accident" is the most we will pay for all damages covered by this insurance because of bodily injury to one or more employees in any one accident. A disease is not bodily injury by accident unless it results directly from bodily injury by accident. 2. Bodily Injury by Disease. The limit shown for "bodily injury by disease -policy limit" is the most we will pay for all damages covered by this insurance and arising out of bodily injury by disease, regardless of the number of employees who sustain bodily injury by disease. The limit shown for "bodily injury by disease -each employee" is the most we will pay for all damages because of bodily injury by disease to any one employee. Bodily injury by disease does not include disease that results directly from a bodily injury by accident. PO Box 12058, Austin, TX 78711-2058 3 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE 3. We will not pay any claims for damages after we have paid the applicable limit of our liability under this insurance. H. Recovery From Others We have your rights to recover our payment from anyone liable for an injury covered by this insurance. You will do everything necessary to protect those rights for us and to help us enforce them. I. Actions Against Us There will be no right of action against us under this insurance unless: 1. You have complied with all the terms of this policy; and 2. The amount you owe has been determined with our consent or by actual trial and final judgment. This insurance does not give anyone the right to add us as a defendant in an action against you to determine your liability. The bankruptcy or insolvency of you or your estate will not relieve us of our obligations under this Part. PART THREE - OTHER STATES INSURANCE A. How This Insurance Applies 4. If you have work on the effective date of this policy in 1. This other states insurance applies only if one or more any state not listed in Item 3.A of the Information Page, states are shown in Item 3.C. of the Information Page. coverage will not be afforded for that state unless we are 2. If you begin work in any one of those states after the notified within thirty days. effective date of this policy and are not insured or are not self -insured for such work, all provisions of the policy B. Notice will apply as though that state were listed in Item 3.A. of Tell us at once if you begin work in any state listed in Item the Information Page. 3.C. of the Information Page. 3. We will reimburse you for the benefits required by the workers compensation law of that state if we are not permitted to pay the benefits directly to persons entitled to them. PART FOUR - YOUR DUTIES IF INJURY OCCURS Tell us at once if injury occurs that may be covered by this 4. Cooperate with us and assist us, as we may request, policy. Your other duties are listed here. in the investigation, settlement or defense of any claim, 1. Provide for immediate medical and other services proceeding or suit. required by the workers compensation law. 5. Do nothing after an injury occurs that would interfere 2. Give us or our agent the names and addresses of the with our right to recover from others. injured persons and of witnesses, and other information 6. Do not voluntarily make payments, assume obligations we may need. or incur expenses, except at your own cost. 3. Promptly give us all notices, demands and legal papers related to the injury, claim, proceeding or suit. PART FIVE - PREMIUM A. Our Manuals C. Remuneration All premium for this policy will be determined by our manuals Premium for each work classification is determined by of rules, rates, rating plans and classifications. We may multiplying a rate times a premium basis. Remuneration is the change our manuals and apply the changes to this policy if most common premium basis. This premium basis includes authorized by law or a governmental agency regulating this payroll and all other remuneration paid or payable during the insurance. policy period for the services of: B. Classifications Item 4 of the Information Page shows the rate and premium basis for certain business or work classifications. These classifications were assigned based on an estimate of the exposures you would have during the policy period. If your actual exposures are not properly described by those classifications, we will assign proper classifications, rates and premium basis by endorsement to this policy. 1. all your officers and employees engaged in work covered by this policy; and 2. all other persons engaged in work that could make us liable under Part One (Workers Compensation Insurance) of this policy. If you do not have payroll records for these persons, the contract price for their services and materials may be used as the premium basis. This paragraph 2 will not apply if you give us proof that the employers of these persons lawfully secured their workers compensation obligations. PO Box 12058, Austin, TX 78711-2058 4 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE D. Premium Payments You will pay all premium when due. You will pay the premium even if part or all of a workers compensation law is not valid. E. Final Premium The premium shown on the Information Page, schedules, and endorsements is an estimate. The final premium will be determined after this policy ends by using the actual, not the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered by this policy. If the final premium is more than the premium you 'd t t th b I If i 't ' I ill 2. If you cancel, final premium will be more than pro rata; it will be based on the time this policy was in force, and increased by our short rate cancellation table and procedure. Final premium will not be less than the minimum premium. F. Records You will keep records of information needed to compute premium. You will provide us with copies of those records when we ask for them. V. o us, you mus pay us e a ance. is ess, we - G. Audit refund the balance to you. The final premium will not be less You will let us examine and audit all your records that relate than the highest minimum premium for the classifications to this policy. These records include ledgers, journals, covered by this policy. registers, vouchers, contracts, tax reports, payroll and disbursement records, and programs for storing and If this policy is cancelled, final premium will be determined in retrieving data. We may conduct the audits during regular the following way unless our manuals provide otherwise: business hours during the policy period and within three 1. If we cancel, final premium will be calculated pro years after the policy period ends. Information developed by rata based on the time this policy was in force. Final audit will be used to determine final premium. Insurance rate premium will not be less than the pro rata share of the service organizations have the same rights we have under minimum premium. this provision. PART SIX - CONDITIONS A. Inspection We have the right, but are not obliged to inspect your workplaces at any time. Our inspections are not safety inspections. They relate only to the insurability of the workplaces and the premiums to be charged. We may give you reports on the conditions we find. We may also recommend changes. While they may help reduce losses, we do not undertake to perform the duty of any person to provide for the health or safety of your employees or the public. We do not warrant that your workplaces are safe or healthful or that they comply with laws, regulations, codes or standards. Insurance rate service organizations have the same rights we have under this provision. D. Cancellation B. Long Term Policy If the policy period is longer than one year and sixteen days, all provisions of this policy will apply as though a new policy were issued on each annual anniversary that this policy is in E force. C. Transfer of Your Rights and Duties Your rights or duties under this policy may not be transferred without our written consent. If you die and we receive notice within thirty days after your death, we will cover your legal representative as insured. 1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancellation is to take effect. 2. We may cancel this policy. We must mail or deliver to you not less than ten days advance written notice stating when the cancellation is to take effect. Mailing that notice to you at your mailing address shown in Item 1 of the Information Page will be sufficient to prove notice. 3. The policy period will end on the day and hour stated in the cancellation notice. 4. Any of these provisions that conflicts with a law that controls the cancellation of the insurance in this policy is changed by this statement to comply with the law. Sole Representative The insured first named in Item 1 of the Information Page will act on behalf of all insured's to change this policy, receive return premium, and give or receive notice of cancellation. PO Box 12058, Austin, TX 78711-2058 5 of 5 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 00 00 C Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY TM LRC 2008 Insured copy LIMITED REIMBURSEMENT FOR TEXAS EMPLOYEES INJURED IN OTHER JURISDICTIONS IMPORTANT NOTICE! PLEASE READ THIS ENDORSEMENT CAREFULLY This policy does not provide "other states" insurance coverage. This endorsement provides reimbursement coverage to you for those Texas employees who are described in the Texas Labor Code §§406.071-.072. Therefore the coverage is for injuries to your Texas employees that occur in another state if (i) the injury would have been compensable had it occurred in Texas and (ii) the employee has significant contacts with Texas or the employment is principally located in Texas. An employee has significant contacts with Texas if the employee was hired or recruited in Texas, and (i) the employee was injured not later than one year after the date of hire; or (ii) has worked in Texas for at least ten working days during the twelve months preceding the date of injury. Employees hired or recruited by you outside Texas to work in another state are specifically excluded from the terms and provisions of this policy. If you conduct business in states other than Texas, you must comply with those state laws. You must promptly notify your agent before you begin work in any jurisdiction other than Texas. We are not authorized to provide workers' compensation insurance in any jurisdiction other than Texas. You are responsible for all of your legal obligations for your failure to comply with requirements of the workers' compensation laws of any jurisdiction other than Texas. Part Three Other States Insurance of the policy is deleted and replaced with the following: Limited Reimbursement Provision A. How this endorsement applies This endorsement will reimburse you after you have made payments for benefits for injuries to your Texas employees required of you in another jurisdiction. This reimbursement provision only applies to bodily injury by accident including death or bodily injury by disease including death incurred by your employee who qualifies for Texas workers' compensation benefits under Sec. 406.071 of the Texas Labor Code. 1. Bodily injury must arise out of and in the course of the injured employee's temporary employment by you in a state other than Texas. 2. Bodily injury by accident must occur during the policy period. 3. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last injurious exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. 4. The employee incurring bodily injury must be eligible for Texas workers' compensation benefits and must make a written election of workers' compensation benefits in the state in which the bodily injury occurred in lieu of Texas workers' compensation benefits. You must send us written notice of such election within 10 days of receiving notice yourself. Failure to provide such notice means any reimbursement will be made in accordance with the Texas Labor Code. PO Box 12058, Austin, TX 78711-2058 1 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 TM LRC 2008 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY B. Reimbursement TM LRC 2008 Insured copy 1. We will reimburse you for the amount you have paid as workers' compensation benefits for employees, as defined above, under the workers' compensation law of any state listed in the schedule. 2. We will deduct from the benefits so reimbursed any amounts we have paid as Texas benefits to the employee for the same injury for which the other jurisdiction's benefits are required. 3. Sections D through G of Part One of the policy will apply to reimbursement provided by this endorsement. Sections A, B, C and H of Part One of the policy will not apply to reimbursement provided by this endorsement. 4. We will reimburse you for reasonable attorney's fees you have paid to defend the injury claim in another jurisdiction. II. Exclusions, Limitations and Conditions The following conditions apply to the reimbursement afforded by this endorsement: 1. Nothing in this endorsement confers jurisdiction in another state or constitutes our doing business in another state. 2. Reimbursement will be made in Texas. 3. Travis County, Texas is the sole venue for any lawsuit involving reimbursement under this endorsement. 4. This endorsement provides reimbursement only in Texas and fully releases and indemnifies us and holds us harmless from any liability arising from your failure to obtain workers' compensation coverage in another jurisdiction. 5. The reimbursement provided by this endorsement excludes: a. bodily injury, including death, to an employee while employed in a jurisdiction where you have secured your obligation under the workers' compensation law by other insurance or by self-insurance; b. bodily injury, including death, to an employee while employed in a state where you affirmatively rejected the workers' compensation law; or c. fines or penalties arising out of your failure to comply with requirements of the workers' compensation law of any state. III. Premium The premium basis and rates for work by Texas employees in jurisdictions other than Texas are the same as if the work had been done in Texas. IV. Schedule Designated States: All states of the United States of America except North Dakota, Ohio, Washington and Wyoming. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC NCCI Carrier Code: 29939 This is not a bill Authorized representative 2of2 PO Box 12058, Austin, TX 78711-2058 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 TM LRC 2008 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND TM MV 2011 EMPLOYERS LIABILITY POLICY Insured copy MUTUALS - MEMBERSHIP AND VOTING NOTICE The insured is notified that by virtue of this policy, he is a member of Texas Mutual Insurance Company, and is entitled to vote either in person or by proxy at any and all meetings of said Company. The Annual Meetings are held in its Home Office, 2200 Aldrich Street Austin, Texas 78723-3474, on the fourth Tuesday of June in each year, at 1:00 o'clock p.m. each year unless the Board of Directors of Texas Mutual Insurance Company specifies otherwise. MUTUALS - PARTICIPATION CLAUSE WITHOUT CONTINGENT LIABILITY No Contingent Liability: This policy is non -assessable. The policyholder is a member of the company and shall participate, to the extent and upon the conditions fixed and determined by the Board of Directors in accordance with the provisions of law, in the distributions of dividends so fixed and determined. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 TM MV 2011 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND TM PC 2003 EMPLOYERS LIABILITY POLICY Insured copy The named insured ratifies and accepts the terms and conditions of the policy to which this endorsement is attached as well as the terms listed below. 1. Policies that are on an interim reporting basis may not be financed. Texas Mutual Insurance Company may cancel coverage if it determines that interim reports have been financed in violation of this prohibition. 2. The named insured certifies that the payroll established by classification codes in the application for coverage is a true and reasonable estimate for the period of coverage requested and will promptly report any material change in payroll exposures to Texas Mutual Insurance Company. Texas Mutual Insurance Company may adjust premium for the policy upon receipt of such information. 3. The named insured and its affiliates permit Texas Mutual Insurance Company access to all of their employment information and records filed with the Texas Workforce Commission, and hereby waive the confidentiality of such information and records. 4. All obligations of the named insured are performable in Travis County, Texas and said county will be the legal venue for any suit arising from this contract. Maintenance of an action in Travis County, Texas does not work an injustice to the named insured and is in the interest of the parties, and transfer of the action would work an injustice to the parties. Any suits must be filed in Travis County, Texas. 5. If the insured defaults on payment of any premiums due under any policy issued, then all premiums due and unpaid shall become due and payable at Texas Mutual Insurance Company's offices in Austin, Travis County, Texas. 6. All information supplied to Texas Mutual Insurance Company by the named insured or its agent in the application for insurance or otherwise is true and complete; nothing material regarding its operations has been omitted; and the named insured intended Texas Mutual Insurance Company to rely on such information in issuing this policy. The named insured assumed the duty of full disclosure of such information and that Texas Mutual Insurance Company has no duty to inquire further regarding such information. The named insured is not violating any provision of the Texas Workers' Compensation Act and is not subcontracting any work to a subcontractor with the intent to avoid liability as an employer. 7. The named insured will not cause any certificate of insurance to be issued for the purpose of satisfying the workers' compensation insurance requirements of any third party, including any governmental entity, unless the remuneration paid to the individual workers performing such work is disclosed to Texas Mutual Insurance Company and included in the premium calculation of the named insured. If the named insured causes a certificate of insurance to be issued for the purpose of allowing the employees of a person other than the named insured to perform work at any job site where workers' compensation is required, and such workers are not covered by workers' compensation insurance, such action by the named insured is a material breach of this insurance policy and constitutes fraud upon Texas Mutual Insurance Company. 8. The named insured has appointed the agent whose name appears on the application as its agent in fact and agrees that any representations made on its behalf by that agent are the representations of the named insured, unless there is an express written agreement between Texas Mutual Insurance Company and the agent that the agent acts on behalf of Texas Mutual Insurance Company. 9. Acceptance of this policy with all endorsements and tender of the deposit premium constitute the insured's agreement with all of the terms and conditions thereof, and the insured's acknowledgement of the obligation to pay all premiums due for the policy. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 TM PC 2003 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 00 04 06 EMPLOYERS LIABILITY POLICY Insured copy PREMIUM DISCOUNT ENDORSEMENT The premium for this policy and the policies, if any, listed in Item 3 of the Schedule may be eligible for a discount. This endorsement shows your estimated discount in Item 1 or 2 of the Schedule. The final calculation of premium discount will be determined by our manuals and your premium basis as determined by audit. Premium subject to retrospective rating is not subject to premium discount. Schedule Estimated Eligible Premium First Next Next Balance 1. State $5,000 $95,000 $400,000 TEXAS 0.00% 9.50% 11.90% 12.40% 2. Average percentage discount 2.90% 3. Other Policies: 4. If there are no entries in Items 1, 2, and 3 of the Schedule see the Premium Discount Endorsement attached to your policy number: This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 /V4-x(r�� Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 04 06 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 00 04 14 A EMPLOYERS LIABILITY POLICY Insured copy 90-DAY REPORTING REQUIREMENT —NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT You must report any change in ownership to us in writing within 90 days of the date of the change. Change in ownership includes sales, purchases, other transfers, mergers, consolidations, dissolutions, formations of a new entity, and other changes provided for in the applicable experience rating plan. Experience rating is mandatory for all eligible insureds. The experience rating modification factor, if any, applicable to this policy, may change if there is a change in your ownership or in that of one or more of the entities eligible to be combined with you for experience rating purposes. Failure to report any change in ownership, regardless of whether the change is reported within 90 days of such change, may result in revision of the experience rating modification factor used to determine your premium. This reporting requirement applies regardless of whether an experience rating modification is currently applicable to this policy. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 04 14 A Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC OU 04 22 B EMPLOYERS LIABILITY POLICY Insured copy TERRORISM RISK INSURANCE PROGRAM This endorsement addresses the requirements of the Terrorism Risk Insurance Act of 2002 as amended and extended by the Terrorism Risk Insurance Program Reauthorization Act of 2015. It serves to notify you of certain limitations under the Act, and that your insurance carrier is charging premium for losses that may occur in the event of an Act of Terrorism. Your policy provides coverage for workers compensation losses caused by Acts of Terrorism, including workers compensation benefit obligations dictated by state law. Coverage for such losses is still subject to all terms, definitions, exclusions, and conditions in your policy, and any applicable federal and/or state laws, rules, or regulations. Definitions The definitions provided in this endorsement are based on and have the same meaning as the definitions in the Act .If words or phrases not defined in this endorsement are defined in the Act, the definitions in the Act will apply. "Act" means the Terrorism Risk Insurance Act of 2002, which took effect on November 26, 2002, and any amendments thereto, including any amendments resulting from the Terrorism Risk Insurance Program Reauthorization Act of 2015. "Act of Terrorism" means any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security, and the Attorney General of the United States as meeting all of the following requirements: a. The act is an act of terrorism. b. The act is violent or dangerous to human life, property or infrastructure. c. The act resulted in damage within the United States, or outside of the United States in the case of the premises of United States missions or certain air carriers or vessels. d. The act has been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. "Insured Loss" means any loss resulting from an act of terrorism (and, except for Pennsylvania, including an act of war, in the case of workers compensation) that is covered by primary or excess property and casualty insurance issued by an insurer if the loss occurs in the United States or at the premises of United States missions or to certain air carriers or vessels. "Insurer Deductible" means, for the period beginning on January 1, 2015, and ending on December 31, 2020, an amount equal to 20% of our direct earned premiums, during the immediately preceding calendar year. Limitation of Liability The Act limits our liability to you under this policy. If aggregate Insured Losses exceed $100,000,000,000 in a calendar year and if we have met our Insurer Deductible, we are not liable for the payment of any portion of the amount of Insured Losses that exceeds $100,000,000,000; and for aggregate Insured Losses up to $100,000,000,000, we will pay only a pro rata share of such Insured Losses as determined by the Secretary of the Treasury. Policyholder Disclosure Notice 1 Insured Losses would be partially reimbursed by the United States Government. If the aggregate industry Insured Losses exceed: a. $100,000,000, with respect to such Insured Losses occurring in calendar year 2015, the United States Government would pay 85% of our Insured Losses that exceed our Insurer Deductible. b. $120,000,000, with respect to such Insured Losses occurring in calendar year 2016, the United States Government would pay 84% of our Insured Losses that exceed our Insurer Deductible. PO Box 12058, Austin, TX 78711-2058 1 of 2 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 00 04 22 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 00 04 22 B Insured copy c. $140,000,000, with respect to such Insured Losses occurring in calendar year 2017, the United States Government would pay 83% of our Insured Losses that exceed our Insurer Deductible. d. $160,000,000, with respect to such Insured Losses occurring in calendar year 2018, the United States Government would pay 82% of our Insured Losses that exceed our Insurer Deductible. e. $180,000,000, with respect to such Insured Losses occurring in calendar year 2019, the United States Government would pay 81 % of our Insured Losses that exceed our Insurer Deductible. f. $200,000,000, with respect to such Insured Losses occurring in calendar year 2020, the United States Government would pay 80% of our Insured Losses that exceed our Insurer Deductible. 2 Notwithstanding item 1 above, the United States Government will not make any payment under the Act for any portion of Insured Losses that exceed $100,000,000,000. 3 The premium charge for the coverage your policy provides for Insured Losses is included in the amount shown in Item 4 of the Information Page or in the Schedule below. Schedule State Rate Premium TEXAS 0.00 $0.00 This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC NCCI Carrier Code: 29939 This is not a bill Authorized representative 2of2 PO Box 12058, Austin, TX 78711-2058 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 00 04 22 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 01 J EMPLOYERS LIABILITY POLICY Insured copy TEXAS AMENDATORY ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. GENERAL SECTION B. Who Is Insured is amended to read: You are insured if you are an employer named in Item 1 of the Information Page. If that employer is a partnership or joint venture, and if you are one of its partners or members, you are insured, but only in your capacity as an employer of the partnership's or joint venture's employees. D. State is amended to read: State means any state or territory of the United States of America, and the District of Columbia. PART ONE - WORKERS' COMPENSATION INSURANCE E. Other Insurance is amended by adding this sentence: This section only applies if you have other insurance or are self -insured for the same loss. F. Payments You Must Make This section is amended by deleting the words "workers' compensation" from number 4. H. Statutory Provisions This section is amended by deleting the words "after an injury occurs" from number 2. PART TWO - EMPLOYERS LIABILITY INSURANCE C. Exclusions Sections 2 and 3 are amended to add: This exclusion does not apply unless the violation of law caused or contributed to the bodily injury. Section 6 is amended to read: 6. Bodily injury occurring outside the United States of America, its territories or possessions, and Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America, Mexico or Canada who is temporarily outside these countries. D. We Will Defend This section is amended by deleting the last sentence. PART FOUR - YOUR DUTIES IF INJURY OCCURS Number 6 of this part is amended to read: 6. Texas law allows you to make weekly payments to an injured employee in certain instances. Unless authorized by law, do not voluntarily make payments, assume obligations or incur expenses, except at your own cost. PO Box 12058, Austin, TX 78711-2058 1 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY PART FIVE - PREMIUM A. Our Manuals are amended by adding the sentence: WC420301 J Insured copy In this part, "our manuals" means manuals approved or prescribed by the Texas Department of Insurance. C. Remuneration Number 2 is amended to read: 2. All other persons engaged in work that would make us liable under Part One (Workers' Compensation Insurance) of this policy. This paragraph 2 will not apply if you give us proof that the employers of these persons lawfully secured workers' compensation insurance. E. Final Premium Number 2 is amended to read: 2. If you cancel, final premium will be calculated pro rata based on the time this policy was in force. Final premium will not be less than the pro rata share of the minimum premium. PART SIX - CONDITIONS A. Inspection is amended by adding this sentence: Your failure to comply with the safety recommendations made as a result of an inspection may cause the policy to be canceled by us. C. Transfer of Your Rights and Duties is amended to read: Your rights and duties under this policy may not be transferred without our written consent. If you die, coverage will be provided for your surviving spouse or your legal representative. This applies only with respect to their acting in the capacity as an employer and only for the workplaces listed in Items 1 and 4 on the Information Page. D. Cancellation is amended to read: 1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancellation is to take effect. 2. We may cancel this policy. We may also decline to renew it. We must give you written notice of cancellation or nonrenewal. That notice will be sent certified mail or delivered to you in person. A copy of the written notice will be sent to the Texas Department of Insurance — Division of Workers' Compensation. 3. Notice of cancellation or nonrenewal must be sent to you not later than the 30th day before the date on which the cancellation or nonrenewal becomes effective, except that we may send the notice not later than the 10th day before the date on which the cancellation or nonrenewal becomes effective if we cancel or do not renew because of: a. Fraud in obtaining coverage; b. Misrepresentation of the amount of payroll for purposes of premium calculation; c. Failure to pay a premium when payment was due; d. An increase in the hazard for which you seek coverage that results from an action or omission and that would produce an increase in the rate, including an increase because of failure to comply with reasonable recommendations for loss control or to comply within a reasonable period with recommendations designed to reduce a hazard that is under your control; e. A determination by the Commissioner of Insurance that the continuation of the policy would place us in violation of the law, or would be hazardous to the interests of subscribers, creditors, or the general public. PO Box 12058, Austin, TX 78711-2058 2 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC420301 J Insured copy 4. If another insurance company notifies the Texas Department of Insurance - Division of Workers' Compensation that it is insuring you as an employer, such notice shall be a cancellation of this policy effective when the other policy starts. Add the following to the policy: PART SEVEN - OUR DUTY TO YOU FOR CLAIM NOTIFICATION A. Claims Notification We are required to notify you of any claim that is filed against your policy. Thereafter we must notify you of any proposal to settle a claim or, on receipt of a written request from you, of any administrative or judicial proceeding relating to the resolution of a claim, including a benefit review conference conducted by the Texas Department of Insurance —Division of Workers' Compensation. You may, in writing, elect to waive this notification requirement. We must, on the written request from you, provide you with a list of claims charged against your policy, payments made, and reserves established on each claim, and a statement explaining the effect of claims on your premium rates. We must furnish the requested information to you in writing no later than the 30th day after the date we receive your request. The information is considered to be provided on the date the information is received by the United States Postal Service or is personally delivered. COMPLAINT NOTICE: DISPUTE RESOLUTION SERVICES NCCI'S DISPUTE RESOLUTION PROCESS DOES NOT APPLY TO WORKERS COMPENSATION CLAIMS. For workers compensation claim disputes, see "CLAIM COMPLAINT" below. For issues related to a violation of law related to your policy, see "VIOLATIONS OF LAW" below. Important Note: The dispute resolution services provided through the Dispute Resolution Process (Process) of the National Council on Compensation Insurance (NCCI) are voluntary. The Process is not an administrative remedy that must be exhausted before you pursue relief in court. Using the Process does not prevent you or the carrier that issued the policy from pursuing any available legal remedies at any time. NCCI can assist in the resolution of a dispute regarding your policy that is related to any of the following matters: • The application or interpretation of rules contained in the various NCCI manuals (including, but not limited to, classification codes and experience rating modifications)Rating programs • Endorsements • Forms Contact the carrier that issued the policy and attempt to resolve the dispute directly. If you and the carrier cannot agree, then contact NCCI to ask for assistance. NCCI's Basic Manual addresses dispute resolution in Appendix G. You may obtain dispute resolution services only after you have made a reasonable attempt to first resolve the dispute directly with the carrier and after you have paid any undisputed premium due to the carrier. PO Box 12058, Austin, TX 78711-2058 3 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 01 J EMPLOYERS LIABILITY POLICY Insured copy Send your request for assistance by mail to NCCI, Dispute Resolution Services, 901 Peninsula Corporate Circle, Boca Raton, FL 33487-1362; or by fax to 561-893-5043; or by email to regulatoryoperations(a�ncci.com. THIS NOTICE OF THE DISPUTE RESOLUTION PROCESS IS FOR INFORMATION ONLY AND DOES NOT BECOME A PART, TERM, OR CONDITION OF THIS POLICY. VIOLATIONS OF LAW: If you believe there has been a violation of law related to your policy, file a complaint with the Texas Department of Insurance. Phone: 1-800-252-3439 Online: tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: MC 111-1A, PO Box 149091, Austin, TX 78714 CLAIM COMPLAINT: If there is a workers compensation claim complaint involving one of your employees, then contact the Texas Department of Insurance —Division of Workers' Compensation, Compliance and Investigations by mail to7551 Metro Center Drive, Suite 100, MS-8, Austin, TX 78744; or by fax to 512-490-1030; or by e-mail to DWC-ComplianceReview@tdi.texas.gov. THIS NOTICE IS FOR INFORMATION ONLY AND DOES NOT BECOME A PART, TERM, OR CONDITION OF THIS POLICY. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 4 of 4 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 01 J Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 04 B EMPLOYERS LIABILITY POLICY Insured copy TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas operations 3. Premium: The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Included, see Information Page This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 04 B Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY WC 42 03 08 Insured copy TEXAS PARTNERS, OFFICERS AND OTHERS EXCLUSION ENDORSEMENT The policy does not cover bodily injury to any person described in the Schedule. The premium basis for the policy does not include the remuneration of such persons. You will reimburse us for any payment we must make because of bodily injury to such persons. Schedule Name, title Josh Allen, Vice -President Mark Murray, Treasurer Jorge Burgos, Managing Member Robert Bleisch, Managing Member This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 42 03 08 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 10 EMPLOYERS LIABILITY POLICY Insured copy TEXAS SOLE PROPRIETORS, PARTNERS, OFFICERS AND OTHERS COVERAGE ENDORSEMENT Pursuant to Section 406.097, Labor Code, sole proprietors, partner(s) or corporate executive officer(s) of the named insured are covered under this workers' compensation policy, unless specifically excluded from coverage through an endorsement to the policy. Such persons shall be named in the Schedule below and the premium basis for the policy shall include their remuneration. For employees excluded from workers compensation coverage by law, an election has been made by or on behalf of each person described in "Others" in the Schedule to be subject to the workers compensation law of the state named in the Schedule. Such persons shall be named in the Schedule below and the premium basis for the policy shall include their remuneration. Schedule Name, title Hugo Marquez, President State Texas This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC420310 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND EMPLOYERS LIABILITY POLICY TEXAS - AUDIT PREMIUM AND RETROSPECTIVE PREMIUM Section D of Part Five of the policy is replaced by the following provision: PART FIVE - PREMIUM D. Premium Payments WC 42 04 07 Insured copy You will pay all premium when due. You will pay the premium even if part or all of a workers' compensation law is not valid. The billing statement or invoice for audit additional premiums and/or retrospective additional premiums establishes the date that the premium is due. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 10/2/20 WC 42 04 07 Tle'XaSMutual WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 04 08 A EMPLOYERS LIABILITY POLICY Insured copy TEXAS HEALTH CARE NETWORK ENDORSEMENT This endorsement indicates that you have elected under this policy to provide workers' compensation health care services to your injured employees through a certified workers' compensation health care network that we have either established or contracted with, as provided in Chapter 1305 of the Texas Insurance Code and in Title 28, Chapter 10 of the Texas Administrative Code. We will provide you with information concerning the use of our certified workers' compensation health care network(s) in our service area(s) and your rights and responsibilities as a participant in our network program. This includes information describing the service area(s) applicable to you and your injured employees as required in NCCI's Basic Manual for Workers' Compensation and Employers' Liability Insurance. In accordance with Chapter 1305 Texas Insurance Code and Title 28, Chapter 10 of the Texas Administrative Code, we will also provide you with information that is required to be given to your employees, including an employee's notice of network requirements and an employee acknowledgement form. Your premium may have been reduced because you have agreed to participate in our certified workers' compensation health care network. The amount of the premium reduction is shown on the Information Page of this policy. The reduction is estimated at the policy inception and adjusted at final audit of the policy. The reduction may be pro -rated if you elect to participate in a certified workers' compensation health care network during the policy year or if you terminate your participation in our certified workers' compensation health care network before the policy expires. The premium reduction you received may be forfeited if we determine that you have failed to provide the notice of network requirements and employee acknowledgement form to your employees in accordance with Chapter 1305.005(d) and 1305.451 Texas Insurance Code and Title 28, Chapter 10 of the Texas Administrative Code. Minimum premium policies are not eligible for this premium reduction. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 10/4/20 at 12:01 a.m. standard time, forms a part of: Policy no. 0002038846 of Texas Mutual Insurance Company effective on 10/4/20 Issued to: Blackstone Concrete Ventures LLC This is not a bill NCCI Carrier Code: 29939 Authorized representative 10/2/20 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 04 08 A CONTRACT Page Intentionally Left Blank Contract 15949 STATE OF TEXAS COUNTY OF LUBBOCK THIS AGREEMENT, made and entered into this 24h day of August 2021 by and between the City of Lubbock, County of Lubbock, State of Texas, acting by and through the Mayor, City of Lubbock, thereunto authorized to do so, hereinafter referred to as OWNER, and Blackstone Concrete Ventures, LLC of the City of Lubboc County of Lubbock and the State of Texas hereinafter termed CONTRACTOR. WITNESSETH: That for and in consideration of the payments and agreements hereinafter mentioned, to be made and performed by the OWNER and under the conditions expressed in the bond bearing even date herewith (if any) the CONTRACTOR hereby agrees with OWNER to commence and complete the construction of certain improvements described as follows: RFP 21-15949-JM Concrete on Mac Davis Lane and all extra work in connection therewith, under the terms as stated in the contract documents and at his (or their) own proper cost and expense to furnish all materials, supplies, machinery, equipment, tools, superintendence, labor, insurance and other accessories and services necessary to complete the said construction in accordance with the contract documents as defined in the General Condition of Agreement. Blackstone Concrete Ventures, proposal dated Jul 29, 2021, is incorporated into and made a part of this agreement. The CONTRACTOR hereby agrees to commence work within ten days after the date written notice to do so shall have been given to him and to substantially complete same within the time specified in the contract documents. The OWNER agrees to pay the CONTRACTOR in current funds for the performance of the contract in accordance with the proposal submitted therefore, subject to additions and deductions, as provided in the contract documents and to make payment on account thereof as provided therein. IN WITNESS WHEREOF, the parties to these presents have executed this agreement in Lubbock, Lubbock County, Texas in the year and day first above written. CONTRACTOR: Blackstone Concrete Ventures, LLC COMPLETE ADDRESS: Blackstone Concrete Ventures, LLC 10210 Quaker Avenue Lubbock, Texas 79424 ATTES j--- V'(')6sk I tv\ CITY OF LUBB C , TEXAS (OWNER): By: Daniel M. Pope, ilayor ATTEST: s -A,*' Re ec a Garza, City Secret APPRO D AS TO ON T: blic Works Representative Name (Printed) D to APP O D AS TO FORM: K W*eisure, Assistant City Attorney Page Intentionally Left Blank NON -COLLUSION AFFIDAVIT STATE OF TEXAS LUBBOCK COUNTY p-K- / f 11e47 being first duly sworn, on his/her oath, says that the bid above submitted is a ge uine and not a sham or collusive bid, or made in the interest or on behalf of any person not therein named; and s/he further says that the said respondent has not directly induced or solicited any firm on the above work or supplies to put in a sham , or any other person or corporation to refrain from a statement of qualifications; and that said firm has not in any manner sought by collusion to secure to self an advantage over any other firm or firms. V�c&0»,F C�,cge. V£Tvnazs [. FirmIf Name 449&_4�41 Signature td'� Title Subscribed and sworn to before me this/U day of 2021 Notary Public My Commission Expires: [ 0(` 1 "11 (__011� >�Y °�sCHRISTY SMITH `nNotary ID #130937218 /� My Commission Expires "' December 19, 2024 NOTE: THIS FORM MUST BE COMPLETED AND INCLUDED IN WITH THE SUBMISSION Page Intentionally Left Blank I" NO D) A.1 ffircelel 13 11 Mept@] a ImeIW.T" DIDIuIoleo I Page Intentionally Left Blank GENERAL CONDITIONS OF THE AGREEMENT 1. OWNER Whenever the word Owner, or First Party, are used in this contract, it shall be understood as referring to the City of Lubbock, Texas. 2. CONTRACTOR Whenever the word Contractor, or Second Party, is used, it shall be understood to mean the person, persons, co -partnership or corporation, to wit Blackstone Concrete Ventures, LLC who has agreed to perform the work embraced in this contract, or their legal representative. 3. OWNER'S REPRESENTATIVE As referred in General Conditions Cont'd 4. CONTRACT DOCUMENTS The contract's documents shall consist of the Notice to Offerors, General Instructions to Offerors, Proposal, Signed Agreement, Statutory Bonds (if required), General Conditions of the Agreement, Special Conditions of the Agreement (if any), Specifications, Plans, Insurance Certificates, and all other documents made available to Offeror for inspection in accordance with the Notice to Offerors. The above described materials are sometimes referred to herein as the "contract" or "contract documents". 5. INTERPRETATION OF PHRASES Whenever the words "Directed," "Permitted," "Designated," "Required," "Considered Necessary," "Prescribed," or words of like import are used, it shall be understood that the direction, requirement, permission, order, designation or prescription of the Owner's Representative is intended; and similarly, the words "Approved," "Acceptable," "Satisfactory," or words of like import shall mean approved by or acceptable or satisfactory to the Owner's Representative. 6. SUBCONTRACTOR The term Subcontractor, as employed herein, includes only those having a direct contract with the Contractor for performance of work on the project contemplated by these contract documents. Owner shall have no responsibility to any Subcontractor employed by Contractor for performance of work on the project contemplated by these contract documents, but said Subcontractors will look exclusively to Contractor for any payments due Subcontractor. The City reserves the right to approve or disapprove the selection of any subcontractor(s). 7. WRITTEN NOTICE Written notice shall be deemed to have been duly served if delivered in person to the individual or to a member of the firm or to an officer of the corporation for whom it is intended, or if delivered at or sent certified mail to the last business address known to the party who gives the notice. 8. CONTRACTOR'S RESPONSIBILITIES Unless otherwise stipulated, the Contractor shall provide and pay for all materials, supplies, machinery, equipment, tools, superintendence, labor, insurance, and all water, light, power, fuel, transportation and all other facilities necessary for the execution and completion of the work covered by the contract documents. Unless otherwise specified, all materials shall be new and both workmanship and materials shall be of a good quality. The Contractor shall, if required, furnish satisfactory evidence as to the kind and quality of materials. Materials or work described in words which so applied have well known, technical or trade meaning shall be held to refer such recognized standards. All work shall be done and all materials furnished in strict conformity with the contract documents. 9. SUBSTANTIALLY COMPLETED The term "Substantially Completed" is meant that the structure or project contemplated by the contract documents has been made suitable for use or occupancy or the facility is in a condition to serve its intended purpose, but still may require minor miscellaneous work and adjustment. 10. LAYOUT Except as specifically provided herein, the Contractor shall be responsible for laying out all work and shall accomplish this work in a manner acceptable to the Owner's Representative. The Owner's Representative will check the Contractor's layout of all major structures and any other layout work done by the Contractor at Contractor's request, but this check does not relieve the Contractor of the responsibility of correctly locating all work in accordance with the Plans and Specifications. 11. KEEPING OF PLANS AND SPECIFICATIONS ACCESSIBLE The Contractor shall be furnished ten copies of all Plans and Specifications without expense to Contractor and Contractor shall keep one copy of same consistently accessible on the job site. 12. RIGHT OF ENTRY The Owner's Representative may make periodic visits to the site to observe the progress or quality of the executed work and to determine, in general, if the work is proceeding in accordance with the contract documents. Owner's Representative will not be required to make exhaustive or continuous onsite inspections to check the quality or quantity of the work, nor will Owner's Representative be responsible for the construction means, methods, techniques, sequences or procedures, or the safety precautions incident thereto. Notwithstanding the Owner's Representative's rights of entry hereunder, the Owner's Representative will not be responsible for the Contractor's failure to perform the work in accordance with the Contract Documents. 13. LINES AND GRADES The Contractor is responsible for construction layout based on the control provided in the construction documents. All lines and grades shall be furnished whenever Owner's Representative (as distinguished from Resident Project Representative(s)) deems said lines and grades are necessary for the commencement of the work contemplated by these contract documents or the completion of the work contemplated by these contract documents. Whenever necessary, Contractor shall suspend its work in order to permit Owner's Representative to comply with this requirement, but such suspension will be as brief as practical and Contractor shall be allowed no extra compensation therefore. The Contractor shall give the Owner's Representative ample notice of the time and place where lines and grades will be needed. All stakes, marks, etc., shall be carefully preserved by the Contractor, and in case of careless destruction or removal by Contractor, its Subcontractors, or its employees, such stakes, marks, etc., shall be replaced by the Owner's Representative at Contractor's expense. 14. OWNER'S REPRESENTATIVE'S AUTHORITY AND DUTY Unless otherwise specified, it is mutually agreed between the parties to this Agreement that the Owner's Representative (as distinguished from Resident Project Representative(s))has the authority to review all work included herein. The Owner's Representative has the authority to stop the work whenever such stoppage may be necessary to ensure the proper execution of the contract. The Owner's Representative shall, in all cases, determine the amounts and quantities of the several kinds of work which are to be paid for under the contract documents, and shall determine all questions in relation to said work and the construction thereof, and shall, in all cases, decide every question which may arise relative to the execution of this contract on the part of said Contractor. The decision of the Owner's Representative shall be conclusive in the absence of written objection to same delivered to Owner's Representative within fifteen (15) calendar days of any decision or direction by Owner's Representative. In the absence of timely written objection by Contractor, as provided herein, any and all objection or objections shall be deemed waived. 15. SUPERINTENDENCE AND INSPECTION It is agreed by the Contractor that the Owner's Representative shall be and is hereby authorized to appoint from time to time such subordinate engineers, supervisors, or inspectors, as distinguished from Resident Project Representative, as the said Owner's Representative may deem proper to inspect the materials furnished and the work done under this Agreement, and to see that said material is furnished and said work is done in accordance with the specifications therefore. The Contractor shall furnish all reasonable aid and assistance required by the subordinate engineers, supervisors or inspectors for the proper inspection and examination of the work. The Contractor shall regard and obey the directions and instructions of any subordinate engineers, supervisors or inspectors so appointed, when such directions and instructions are consistent with the obligations of this Agreement and accompanying plans and specifications provided, however, should the Contractor object to any orders by any subordinate engineer, supervisor or inspector, the Contractor may within fifteen (15) calendar days make written appeal to the Owner's Representative for its decision. In the absence of timely written objection by Contractor, as provided herein, any and all objection or objections shall be deemed waived. 16. CONTRACTOR'S DUTY AND SUPERINTENDENCE The Contractor shall give personal attention to the faithful prosecution and completion of this contract and shall keep on the work, during its progress, a competent superintendent and any necessary assistants, all satisfactory to Owner's Representative. The superintendent shall represent the Contractor in its absence and all directions given to superintendent shall be binding as if given to the Contractor. It is expressly agreed that adequate supervision by competent and reasonable representatives of the Contractor is essential to the proper performance of the work and lack of such supervision shall be grounds for suspending operations of the Contractor. The work, from its commencement to completion, shall be under the exclusive charge and control of the Contractor and all risk in connection therewith shall be borne by the Contractor. The Owner or Owner's Representatives shall not be responsible for the acts or omissions of the Contractor, or any subcontractors, or any of Contractor's agents or employees, or any other persons performing any of the work. 17. CONTRACTOR'S UNDERSTANDING It is understood and agreed that the Contractor has, by careful examination, satisfied itself as to the nature and location of the work, the confirmation of the ground, the character, quality and quantity of materials to be encountered, the character of equipment and facilities needed preliminary to and during the prosecution of the work, and the general and local conditions, and all other matters which in any way affect the work under the contract documents. No oral agreement or conversation with any officer, agent, or employee of the Owner, or Owner's Representative either before or after the execution of this contract, shall affect or modify any of the terms or obligations herein contained. Subject to the rights of Owner as set forth in Paragraph 23 hereof, all modifications and/or amendments to the contract documents, shall be in writing, and executed by Owner's Representative and Contractor. Unless otherwise specified herein, all loss, expense or damage to Contractor arising out of the nature of the work to be done, or from the action of the elements, or from any unforeseen circumstance and the prosecution of the work, shall be sustained and borne by the Contractor at its own cost and expense. 18. CHARACTER OF WORKERS The Contractor agrees to employ only orderly and competent workers, skillful in the performance in the type of work required under this contract, to do the work; and agrees that whenever the Owner's Representative shall inform Contractor in writing that any person or persons on the work, are, in Owner's Representative's sole opinion, incompetent, unfaithful, disorderly, or otherwise unacceptable to Owner or Owner's Representative, such person or persons shall be discharged from the work and shall not again be employed on the work without the Owner's Representative's written consent. 19. CONSTRUCTION PLANT The Contractor shall provide all labor, tools, equipment, machinery and materials necessary in the prosecution and completion of this contract where it is not otherwise specifically provided that Owner shall furnish same, and it is also understood that Owner shall not be held responsible for the care, preservation, conservation, or protection of any materials, tools, equipment or machinery or any part of the work until it is finally completed and accepted. The building of structures for the housing of workers or equipment will be permitted only at such places as the Owner's Representative shall consent or direct, and the sanitary conditions of the grounds in or about such structure shall at all times be maintained in a manner satisfactory to the Owner's Representative. 20. SANITATION Necessary sanitary conveniences for the use of laborers on the work site, properly secluded from public observation, shall be constructed and maintained by the Contractor in such manner and at such points as shall be approved by the Owner's Representative and their use shall be strictly enforced. 21. OBSERVATION AND TESTING The Contractor is responsible for construction quality control testing, cost, and reporting of the type and extent required by the contract documents. The Owner or Owner's Representative shall have the right at all times to observe and test the work. Contractor shall make necessary arrangements and provide proper facilities and access for such observation and testing at any location wherever such work is in preparation or progress. Contractor shall ascertain the scope of any observation that may be contemplated by Owner or Owner's Representative and shall give ample notice as to the time each part of the work will be ready for such observation. Owner or Owner's Representative may reject any such work found to be defective or not in accordance with the contract documents, regardless of the stage of its completion or the time or place of discovery of such errors and regardless of whether Owner's Representative has previously accepted the work. If any such work should be covered without approval or consent of the Owner, it must, if requested by Owner or Owner's Representative, be uncovered for examination at Contractor's expense. In the event that any part of the work is being fabricated or manufactured at a location where it is not convenient for Owner or Owner's Representative to make observations of such work or require testing of said work, then in such event Owner or Owner's Representative may require Contractor to furnish Owner or Owner's Representative certificates of inspection, testing or approval made by persons competent to perform such tasks at the location where that part of the work is being manufactured or fabricated. All such tests will be in accordance with the methods prescribed by the American Society for Testing and Materials or such other applicable organization as may be required by law or the contract documents. If any such work which is required to be inspected, tested, or approved is covered up without written approval or consent of the Owner or Owner's Representative, it must, if requested by the Owner or Owner's Representative, be uncovered for observation and testing at the Contractor's expense. The cost of all such inspections, tests and approvals shall be borne by the Contractor unless otherwise provided herein. Any work which fails to meet the requirements of any such tests, inspections or approvals, and any work which meets the requirements of any such tests or approvals but does not meet the requirements of the contract documents shall be considered defective, and shall be corrected at the Contractor's expense. Neither observations by the Owner or Owner's Representative, nor inspections, tests, or approvals made by Owner, Owner's Representative, or other persons authorized under the contract documents to make such inspections, tests, or approvals shall relieve the Contractor from its obligation to perform the work in accordance with the requirements of the contract documents. 22. DEFECTS AND THEIR REMEDIES It is expressly agreed that if the work or any part thereof, or any material brought on the site of the work for use in the work or selected for the same, shall be deemed by the Owner or Owner's Representative as unsuitable or not in conformity with plans, specifications and/or contract documents, the Contractor shall, after receipt of written notice thereof from the Owner's Representative, forthwith remove such material and rebuild or otherwise remedy such work so that it shall be in full accordance with the contract documents. It is further agreed that any remedial action contemplated as hereinabove set forth shall be at Contractor's expense. 23. CHANGES AND ALTERATIONS The Contractor further agrees that the Owner may make such changes and alterations as the Owner may see fit, in the line, grade, form dimensions, plans or materials for the work herein contemplated, or any part thereof, either before or after the beginning of the construction, without affecting the validity of this contract and the accompanying bond. If such changes or alterations diminish the quantity of the work to be done, they shall not constitute the basis for a claim for damages, or anticipated profits on the work that may be dispensed with. If they increase the amount of work, and the increased work can fairly be classified under the specifications, such increase shall be paid according to the quantity actually done and at the unit price established for such work under this contract; otherwise such additional work shall be paid for as provided under Extra Work. In case the Owner shall make such changes or alterations as shall make useless any work already done or material already furnished or used in said work, then the Owner shall recompense the Contractor for any material or labor so used, and for actual expenses incurred in preparation for the work as originally planned. 24. EXTRA WORK The term "extra work" as used in this contract shall be understood to mean and include all work that may be required by the Owner or Owner's Representative to be done by the Contractor to accomplish any change, alteration or addition to the work as shown on the plans and specifications or contract documents and not covered by Contractor's proposal, except as provided under Changes and Alterations in Paragraph 23. It is agreed that the Contractor shall perform all extra work under the observation of the Owner's Representative when presented with a written work order signed by the Owner's Representative; subject, however, to the right of the Contractor to require written confirmation of such extra work order by the Owner. It is also agreed that the compensation to be paid to the Contractor for performing said extra work shall be determined by the following methods: Method (A) - By agreed unit prices; or Method (B) - By agreed lump sum; or Method (C) - If neither Method (A) or Method (B) be agreed upon before the extra work is commenced, then the Contractor shall be paid the lesser of the following: (1) actual field cost of the extra work, plus fifteen (15%) percent to the firm actually performing the work, and additional higher -tier markups limited to 5% to cover additional overhead and insurance costs; or (2) the amount that would have been charged by a reasonable and prudent Contractor as a reasonable and necessary cost for performance of the extra work, as estimated by the Engineer and approved by the Owner.. In the event said extra work be performed and paid for under Method (C)(1), then the provisions of this paragraph shall apply and the "actual field cost" is hereby defined to include the cost of all workers, such as foremen, timekeepers, mechanics and laborers, materials, supplies, teams, trucks, rentals on machinery and equipment, for the time actually employed or used on such extra work, plus actual transportation charges necessarily incurred, together with all expenses incurred directly on account of such extra work, including Social Security, Old Age Benefits, Maintenance Bonds, Public Liability and Property Damage and Workers' Compensation and all other insurances as may be required by law or ordinances or directed by the Owner or Owner's Representative, or by them agreed to. Owner's Representative may direct the form in which accounts of the actual field cost shall be kept and records of these accounts shall be made available to the Owner's Representative. The Owner's Representative may also specify in writing, before the work commences, the method of doing the work and the type and kind of machinery and equipment to be used; otherwise, these matters shall be determined by the Contractor. Unless otherwise agreed upon, the prices for the use of machinery and equipment shall be determined by using 100%, unless otherwise specified, of the latest Schedule of Equipment and Ownership Expenses adopted by the Associated General Contractors of America. Where practical, the terms and prices for the use of machinery and equipment shall be incorporated in the written extra work order. The fifteen percent (15%) of the actual field cost to be paid to Contractor shall cover and compensate Contractor for its profit, overhead, general superintendence and field office expense, and all other elements of cost and expense not embraced within the actual field cost as herein defined, save that where the Contractor's Camp or Field Office must be maintained primarily on account of such Extra Work, then the cost to maintain and operate the same shall be included in the "actual field cost." No claim for extra work of any kind will be allowed unless ordered in writing by Owner's Representative. In case any orders or instructions appear to the Contractor to involve extra work for which Contractor should receive compensation or an adjustment in the construction time, Contractor shall prior to commencement of such extra work, make written request to the Owner's Representative for a written order authorizing such extra work. Should a difference of opinion arise as to what does or does not constitute extra work or as to the payment therefore, and the Owner's Representative insists upon its performance, the Contractor shall proceed with the work after making written request for written order and shall keep adequate and accurate account of the actual field cost thereof, as provided under Method (C) (1). If Contractor does not notify Owner's Representative before the commencement of any extra work, any claim for payment due to alleged extra work shall be deemed waived. 25. DISCREPANCIES AND OMISSIONS It is further agreed that it is the intent of the contract documents that all work described in the proposal, the specifications, plans and other contract documents, is to be done for the prices quoted by the Contractor and that such price shall include all appurtenances necessary to complete the work in accordance with the intent of these contract documents as interpreted by Owner's Representative. Notices of any discrepancies or omissions in these plans, specifications, or contract documents, shall be given to the Owners' Representative and a clarification obtained before the proposals are received, and if no such notice is received by the Owner's Representative prior to the opening of proposals, then it shall be deemed that the Contractor fully understands the work to be included and has provided sufficient sums in its proposal to complete the work in accordance with these plans and specifications. If Contractor does not notify Owner's Representative before offering of any discrepancies or omissions, then it shall be deemed for all purposes that the plans and specifications are sufficient and adequate for completion of the project. It is further agreed that any request for clarification must be submitted no later than five (5) calendar days prior to the opening of proposals. In the absence of a requested clarification for a conflict in the documents prior to proposals being reviewed, it will be assumed that the Contractor proposes the higher cost alternative on conflicts identified after proposals are reviewed. 26. RIGHT OF OWNER TO MODIFY METHODS AND EQUIPMENT If at any time the methods or equipment used by the Contractor are found to be inadequate to secure the quality of work with the rate of progress required under this contract, the Owner or Owner's Representative may order the Contractor in writing to increase their safety or improve their character and efficiency and the Contractor shall comply with such order. If, at any time, the working force of the Contractor is inadequate for securing the progress herein specified, the Contractor shall, if so ordered in writing, increase its force or equipment, or both, to such an extent as to give reasonable assurance of compliance with the schedule of progress. 27. PROTECTION AGAINST ACCIDENT TO EMPLOYEES AND THE PUBLIC AND GENERAL The Contractor shall take out and procure a policy or policies of Workers' Compensation Insurance with an insurance company licensed to transact business in the State of Texas, which policy shall comply with the Workers' Compensation laws of the State of Texas. The Contractor shall at all times exercise reasonable precaution for the safety of employees and others on or near the work and shall comply with all applicable provisions of federal, state and municipal laws and building and construction codes. All machinery and equipment and other physical hazards shall be guarded in accordance with the "Manual of Accident Prevention in Construction" of Associated General Contractors of America, except where incompatible with federal, state or municipal laws or regulations. The Contractor, its sureties and insurance carriers shall defend, indemnify and hold harmless the Owner and Engineer and all of its officers, agents and employees against any all losses, costs, damages, expenses, liabilities, claims and/or causes of action, whether known or unknown, fixed, actual, accrued or contingent, liquidated or unliquidated, including, but not limited to, attorneys' fees and expenses, in connection with, incident to, related to, or arising out of, the Contractor's or any subcontractor's, agent's or employee's, in any manner whatsoever, omission, execution and/or supervision of this contract, and the project which is the subject matter of this contract. The safety precautions taken shall be the sole responsibility of the Contractor, in its sole discretion as an Independent Contractor; inclusion of this paragraph in the Agreement, as well as any notice which may be given by the Owners or the Owner's Representative concerning omissions under this paragraph as the work progresses, are intended as reminders to the Contractor of its duty and shall not be construed as any assumption of duty to supervise safety precautions by either the Contractor or any of its subcontractors. 28. CONTRACTOR'S INSURANCE As referred in General Conditions Cont'd 29. DISABLED EMPLOYEES Contractors having more than fifteen (15) employees agree to comply with the Americans with Disabilities Act of 1990, and agree not to discriminate against a qualified individual with a disability because of the disability of such individual in regard to job application procedures, the hiring, advancement, or discharge of employees, employee compensation, job training, and other terms, conditions, and privileges of employment. 30. PROTECTION AGAINST CLAIMS OF SUBCONTRACTORS, LABORERS, MATERIALMEN, AND FURNISHERS OF MACHINERY. EOUIPMENT AND SUPPLIES Without limiting, in any way, manner or form, the indemnity provided by Contractor in paragraph 27 hereof, the Contractor agrees that it will indemnify and save the Owner and Engineer and all of its officers, agents and employees, harmless against any and all claims, liabilities, losses, damages, expenses and causes of action arising out of, in any way, manner or form, the demands of subcontractors, laborers, workmen, mechanics, material men and furnishers of machinery and parts thereof, equipment, power tools, and supplies, incurred in the performance of this contract and the project which is the subject matter of this contract. When Owner so desires, the Contractor shall furnish satisfactory evidence that all obligations of the nature hereinabove designated have been paid, discharged or waived. 31. PROTECTION AGAINST ROYALTIES OR PATENT INVENTION The Contractor shall pay all royalties and license fees, and shall provide for the use of any design, device, material or process covered by letters patent or copyright by suitable legal agreement with the Patentee or owner thereof. Without limiting, in any way, manner or form, the indemnity provided by Contractor in paragraph 27 hereof, the Contractor shall defend all suits or claims for infringement of any patent or copyrights and shall indemnify and save the Owner and Engineer, and all of its officers, agents and employees harmless from any loss on account thereof, except that Owner shall defend all such suits and claims and shall be responsible for all such loss when a particular design, device, material or process or the product of a particular manufacturer or manufacturers is specified or required in these contract documents by Owner; provided, however, if choice of alternate design, device, material or process is allowed to the Contractor, then Contractor shall indemnify and save Owner, and all of its officers, agents and employees harmless from any loss on account thereof. Notwithstanding anything herein to the contrary, if the material or process specified or required by Owner and/or this contract is an infringement, the Contractor shall be responsible for such loss unless it gives written notice of such infringement to the Owner's Representative prior to offering. 32. LAWS AND ORDINANCES The Contractor shall at all times observe and comply with all federal, state and local laws, ordinances and regulations, which in any manner affect the contract or the work, and without limiting, in any way, manner or form, the indemnity provided by Contractor in paragraph 27 hereof, Contractor shall indemnify and save harmless the Owner and Engineer and all of its officers, agents, and employees against any claims arising from the violation of any such laws, ordinances, and regulations, whether by the Contractor, its employees, or subcontractors. If the Contractor observes that the plans and specifications are at variance therewith, he shall notify the Owner's Representative in writing prior to proposing and any necessary changes shall be adjusted as provided in the contract for changes in the work. In the absence of timely written notification to Owner's Representative of such variance or variances within said time, any objection and/or assertion that the plans and specifications are at variance with any federal, state or local laws, ordinances or regulations shall be deemed waived. If the Contractor, its employees or subcontractors perform any work contrary to such laws, ordinances, rules and regulations, and without such notice to the Owner's Representative, Contractor shall bear all costs arising there from. The Owner is a municipal corporation of the State of Texas and the law from which it derives its powers, insofar as the same regulates the objects for which, or the manner in which, or the conditions under which the Owner may enter into contracts, shall be controlling, and shall be considered as part of this contract to the same effect as though embodied herein. 33. SUBCONTRACTING The Contractor agrees that it will retain personal control and will give its personal attention to the fulfillment of this contract. The Contractor further agrees that subletting of any portion or feature of the work, or materials required in the performance of this contract, shall not relieve the Contractor from its full obligations to the Owner, as provided by the contract documents. 34. TIME FOR SUBSTANTIAL COMPLETION AND LIQUIDATED DAMAGES Please see attached. 35. TIME AND ORDER OF COMPLETION It is the meaning and intent of this contract, unless otherwise herein specifically provided, that the Contractor shall be allowed to prosecute its work in such order of precedence, and in such manner as shall be most conductive to economy of construction. The Contractor shall ensure daily prosecution of the work is conducted every business day until completed, regardless if the work will be substantially or finally complete ahead of specified deadlines in the agreement, unless the City determines time off from said prosecution is necessary or reasonable and Contractor received said determination in writing from the City. Further, when the Owner is having other work done, either by contract or by its own force, the Owner's Representative (as distinguished from the Resident Project Representative) may direct the time and manner of constructing work done under this contract so that conflicts will be avoided and the construction of the various works being done for the Owner shall be harmonized. Additionally, inclement weather shall be the only other reason consistent, daily prosecution of the work may not take place on those inclement weather days. The Contractor shall submit, at such times as may reasonably be requested by the Owner's Representative, schedules which shall show the order in which the Contractor intends to carry on the work, with dates at which the Contractor will start the several parts of the work and estimated dates of completion of the several parts. 36. TIME OF PERFORMANCE The Contractor agrees that it has submitted its proposal in full recognition of the time required for the completion of this project, taking into consideration the average climatic range and industrial conditions prevailing in this locality, and has considered the liquidated damage provisions of paragraph 34 hereinabove set forth and expressly agrees that it shall not be entitled to, nor will it request, an extension of time on this contract, except when its work has been delayed by an act or neglect of the Owner, Owner's Representative, employees of the Owner or other contractors employed by the Owner, or by changes ordered in the work, or by strike, walkouts, acts of God or the public enemy, fire or flood. Any request for extension shall be in writing with the written request for same setting forth all justifications, in detail, for the request, and submitted to Owner's Representative within twenty (20) calendar days of the occurrence of the event causing said delay. A failure by Owner's Representative to affirmatively grant the extension no later than within twenty (20) calendar days of written submission by Contractor shall be deemed a denial, and final. Further, in the absence of timely written notification of such delay and request for extension, as provided herein, any request for extension by Contractor shall be deemed waived. 37. HINDRANCE AND DELAYS In executing the contract, the Contractor agrees that in undertaking to complete the work within the time herein fixed, Contractor has taken into consideration and made allowances for all hindrances and delays incident to such work, whether growing out of delays due to unusual and unanticipated circumstances, difficulties or delays in securing material or workers, or any other cause or occurrence. No charge shall be made by the Contractor for hindrance or delays from any cause during the progress of any part of the work embraced in this contract except where the work is stopped by order of the Owner or Owner's Representative for the Owner's convenience, in which event, such expense as in the sole judgment of the Owner's Representative that is caused by such stoppage shall be paid by Owner to Contractor. 38. OUANTITIES AND MEASUREMENTS No extra or customary measurements of any kind will be allowed, but the actual measured or computed length, area, solid contents, number and weight only shall be considered, unless otherwise specifically provided. In the event this contract is let on a unit price basis, then Owner and Contractor agree that this contract, including the specifications, plans and other contract documents are intended to show clearly all work to be done and material to be furnished hereunder. Where the estimated quantities are shown, and only when same are expressly stated to be estimates, for the various classes of work to be done and material to be furnished under this contract, they are approximate and are to be used only as a basis for estimating the probable cost of the work and for comparing their proposals offered for the work. In the event the amount of work to be done and materials to be furnished are expressly stated to be estimated, and only when same are expressly stated to be estimated, it is understood and agreed that the actual amount of work to be done and the materials to be furnished under this contract may differ somewhat from these estimates, and that where the basis for payment under this contract is the unit price method, payment shall be for the actual amount of work done and materials furnished on the project, provided that the over run or under run of estimated quantities32 note exceed 15% of the estimated quantity. 39. PROTECTION OF ADJOINING PROPERTY The Contractor shall take proper means to protect the adjacent or adjoining property or properties in any way encountered, which may be injured or seriously affected by any process of construction to be undertaken under this agreement, from any damage or injury by reason of said process of construction; and Contractor shall be liable for any and all claims for such damage on account of his failure to fully protect all adjacent property. Without limiting, in any way, manner and form, the indemnity provided by Contractor in paragraph 27 hereof, the Contractor agrees to indemnify, save and hold harmless the Owner and Engineer, and any of its officers, agents and employees, against any and all claims or damages due to any injury to any adjacent or adjoining property, related to, arising from or growing out of the performance of this contract. 40. PRICE FOR WORK In consideration of the furnishing of all necessary labor, equipment and material and the completion of all work by the Contractor, and on the delivery of all materials embraced in this contract in full conformity with the specifications and stipulations herein contained, the Owner agrees to pay the Contractor the price set forth in the proposal attached hereto, which has been made a part of this contract, and the Contractor hereby agrees to receive such price in full for furnishing all materials and all labor required for the aforesaid work, also, for all expenses incurred by Contractor and for well and truly performing the same and the whole thereof in the manner and according to this agreement, the attached specifications, plans, contract documents and requirements of Owner's Representative. 41. PAYMENTS No payments made or certificates given shall be considered as conclusive evidence of the performance of the contract, either wholly or in part, nor shall any certificate or payment be considered as acceptance of defective work. Contractor shall at any time requested during the progress of the work furnish the Owner or Owner's Representative with a verifying certificate showing the Contractor's total outstanding indebtedness in connection with the work. Before final payment is made, Contractor shall satisfy Owner, by affidavit or otherwise, that there are no outstanding liens against Owner's premises by reason of any work under the contract. Acceptance by Contractor of final payment of the contract price shall constitute a waiver of all claims against Owner, Owner's agents and employees, which have not theretofore been timely filed as provided in this contract. 42. PARTIAL PAYMENTS On or before the tenth day of each month, the Contractor shall submit to Owner's Representative an application for partial payment. Owner's Representative shall review said application for partial payment if submitted, and the progress of the work made by the Contractor and if found to be in order, shall prepare a certificate for partial payment showing as completely as practical the total value of the work done by the Contractor up to and including the last day of the preceding month. The determination of the partial payment by the Owner's Representative shall be in accordance with Paragraph 14 hereof. The Owner shall then pay the Contractor on or before the fifteenth day of the current month the total amount of the Owner's Representative's Certificate of Partial Payment, less 5% of the amount thereof, which 5% shall be retained until final payment, and further, less all previous payments and all further sums that may be retained by Owner under the terms of the contract documents. Payment for materials on hand and delivered to the project site will be limited to 100 percent less the 5 percent standard retainage until actually incorporated into the project. Any partial payment made hereunder shall not constitute a waiver by the Owner of any and all other rights to enforce the express terms of the contract documents, and all remedies provided therein, as to any and all work performed, to be performed and/or materials delivered hereunder, including, but limited to, work to which said partial payment is attributable. 43. SUBSTANTIAL COMPLETION Contractor shall give Owner's Representative written notice of substantial completion. Within thirty- one (31) working days after the Contractor has given the Owner's Representative written notice that the work has been substantially completed, the Owner's Representative and/or the Owner shall inspect the work and within said time, if the work be found to be substantially completed in accordance with the contract documents, the Owner's Representative shall issue to the Owner and Contractor a certificate of substantial completion. Notwithstanding the issuance of a certificate of substantial completion, Contractor shall proceed with diligence to finally complete the work within the time provided in this contract. 44. FINAL COMPLETION AND PAYMENT The Contractor shall give written notice to Owner's Representative of final completion. Upon written notice of final completion, the Owner's Representative shall proceed to make final measurement to determine whether final completion has occurred. If the Owner's Representative determines final completion has occurred, Owner's Representative shall so certify to the Owner. Upon certification by Owner's Representative of final completion, Owner shall pay to the Contractor on or before the 31 st working day after the date of certification of final completion, the balance due Contractor under the terms of this agreement. Neither the certification of final completion nor the final payment, nor any provisions in the contract documents shall relieve the Contractor of the obligation for fulfillment of any warranty which may be required in the contract documents and/or any warranty or warranties implied by law or otherwise. 45. CORRECTION OF WORK As referred in General Conditions Cont'd 46. PAYMENT WITHHELD The Owner or Owner's Representative may, on account of subsequently discovered evidence, withhold or nullify the whole or part of any certification to such extent as may be necessary to protect itself from loss on account of: (a) Defective work not remedied and/or work not performed, (b) Claims filed or reasonable evidence indicating possible filing of claims, (c) Damage to another contractor, (d) Notification to owner of failure to make payments to Subcontractors or Suppliers, (e) Failure to submit up-to-date record documents as required, (f) Failure to submit monthly progress schedule updates or revised scheduled as requested by Owner, (g) Failure to provide Project photographs required by Specifications. When the above grounds are removed, or the Contractor provides a surety bond satisfactory to the Owner, in the amount withheld, payment shall be made for amounts withheld because of them. 47. CLAIM OR DISPUTE It is further agreed by both parties hereto that all questions of dispute or adjustment presented by the Contractor shall be in writing and filed with the Owner's Representative within fifteen (15) calendar days after the Owner's Representative has given any direction, order or instruction to which the Contractor desires to take exception. Timely written notice of dispute as provided in this contract of any decision by Owner's Representative or Owner shall be a condition precedent to the bringing and/or assertion of any action or claim by Contractor of any right under this Contract. If the matters set forth in the notice of dispute are not granted or otherwise responded to by Owner's Representative within fifteen (15) calendar days of receipt of notice of dispute by Owner's Representative, said objections shall be deemed denied. Any decision by the Owner's Representative, or deemed denial by the Owner's Representative, shall be final and conclusive in the absence of fraud. It is further agreed that the acceptance by the Contractor of the final payment shall be a bar to any and all claims of the Contractor, and constitute a waiver of the right to assert any claim against Owner, Owner's agents and employees and Owner's Representative, by Contractor. 48. NON-COMPLIANCE AND/OR ABANDONMENT BY CONTRACTOR In case the Contractor should (1) abandon and fail or refuse to resume work within fifteen (15) calendar days after written notification from the Owner or the Owner's Representative, or (2) if the Contractor fails to comply with the written orders of the Owner's Representative, when such orders are consistent with this contract, then the Surety on the bond shall be notified in writing and directed to complete the work and a copy of said notice shall be delivered to the Contractor. In the event a bond is not required by law, or otherwise obtained by the Contractor, no further notice of such non-compliance to Contractor shall be required. After receiving said notice of abandonment or non-compliance , the Contractor shall not remove from the work any machinery, equipment, tools, materials or supplies then on the job, but the same, together with any materials and equipment under the contract for work, may be held for use on the work by the Owner or the Surety of the Contractor, or another contractor, in completion of the work; and the Contractor shall not receive any rental or credit therefore (except when used in connection with Extra Work, where credit shall be allowed as provided for under paragraph 24 of this contract); it being understood that the use of such equipment and materials will ultimately reduce the cost to complete the work and be reflected in the final settlement. In the event the Contractor, or Surety, whichever is applicable, should fail to commence compliance with the notice hereinbefore provided within ten (10) calendar days after service of such notice, and/or shall fail to proceed with diligence to complete the project as contemplated and in compliance with all terms and provisions of the contract documents, then the Owner may exercise any and all remedies available to it pursuant to law, contract, equity or otherwise, including, but not limited to, providing for completion of the work in either of the following elective manners: (a) The Owner may employ such force of persons and use of machinery, equipment, tools, materials and supplies as said Owner may deem necessary to complete the work and charge the expense of such labor, machinery, equipment, tools, materials and supplies to said Contractor, and the expense so charged shall be deducted and paid by the Owner out of such moneys as may be due, or that may thereafter at any time become due to the Contractor under and by virtue of this Agreement. In case such expense is less than the sum which would have been payable under this contract, if the same had been completed by the Contractor, then said Contractor shall receive the difference. In case such expense is greater than the sum which would have been payable under this contract, if the same had been completed by said Contractor, then the Contractor and/or its Surety shall pay the amount of such excess to the Owner; or (b) The Owner, under sealed proposals, after notice published as required by law, at least twice in a newspaper having a general circulation in the County of location of the work, may let the contract for the completion of the work under substantially the same terms and conditions which are provided in this contract. In case of any increase in cost to the Owner under the new contract as compared to what would have been the cost under this contract, such increase shall be charged to the Contractor and the Surety shall be and remain bound therefore. Should the cost to complete any such new contract prove to be less than that which would have been the cost to complete the work under this contract, the Contractor or his Surety shall be credited therewith. In the event the Owner's Representative elects to complete the work, as described above, when the work shall have been finally completed, the Contractor and his Surety shall be so notified and certification of completion as provided in paragraph 44 hereinabove set forth, shall be issued. A complete itemized statement of the contract accounts, certified to by Owner's Representative as being correct shall then be prepared and delivered to Contractor and his Surety, if applicable, whereon the Contractor or his Surety, or the Owner as the case may be, shall pay the balance due as reflected by said statement within 30 days after the date of certification of completion. In the event the statement of accounts shows that the cost to complete the work is less than that which would have been the cost to the Owner had the work been completed by the Contractor under the terms of this contract, or when the Contractor and/or his Surety, if applicable, shall pay the balance shown to be due by them to the Owner, then all machinery, equipment, tools, materials or supplies left on the site of the work shall be turned over to the Contractor and/or his Surety, if applicable. Should the cost to complete the work exceed the contract price, and the Contractor and/or his Surety, if applicable, fail to pay the amount due the Owner within the time designated hereinabove, and there remains any machinery, equipment, tools, materials or supplies on the site of the work, notice thereof, together with an itemized list of such equipment and materials shall be mailed to the Contractor and his Surety, if applicable, at the respective addresses designated in this contract; provided, however, that actual written notice given in any manner will satisfy this condition. After mailing, or other giving of such notice, such property shall be held at the risk of the Contractor and his Surety, if applicable, subject only to the duty of the Owner to exercise ordinary care to protect such property. After fifteen (15) calendar days from the date of said notice the Owner may sell such machinery, equipment, tools, materials or supplies and apply the net sum derived from such sale to the credit of the Contractor and his Surety, if applicable. Such sale may be made at either public or private sale, with or without notice, as the Owner may elect. The Owner shall release any machinery, equipment, tools, materials, or supplies that remain on the jobsite and belong to persons other than the Contractor or his Surety, if applicable, to their proper owners. The remedies provided to Owner by law, equity, contract, or otherwise, shall be cumulative, to the extent permitted by law. It is expressly agreed and understood that the exercise by Owner of the remedies provided in this paragraph shall not constitute an election of remedies on the part of Owner, and Owner, irrespective of its exercise of remedies hereunder, shall be entitled to exercise concurrently or otherwise, any and all other remedies available to it, by law, equity, contract or otherwise, including but not limited to, liquidated damages, as provided in paragraph 34, hereinabove set forth. 49. LIM ITAT IO N ON CON TRAC TOR 'S R EMEDY The remedies of Contractor hereunder shall be limited to, and Owner shall be liable only for, work actually performed by Contractor and/or its subcontractors as set forth in the contract documents, and Owner shall not be liable for any consequential, punitive or indirect loss or damage that Contractor may suffer in connection with the project which is the subject matter of this contract. 50. BONDS The Contractor is required to furnish a performance bond in accordance with Chapter 2253, Government Code, in the amount of 100% of the total contract price in the event that said contract price exceeds $100,000 and the Contractor is required to furnish a payment bond in accordance with Chapter 2253, Government Code, in the amount of 100% of the total contract price in the event that said contract price exceeds $50,000. All bonds shall be submitted on forms supplied by the Owner, and executed by a Surety Company listed on the State Treasury's "Approved" list and authorized to do business in the State of Texas. It is further agreed that this contract shall not be in effect until such bonds are so furnished. 51. SPECIAL CONDITIONS In the event special conditions are contained herein as part of the contract documents and said special conditions conflict with any of the general conditions contained in this contract, then in such event the special conditions shall control. 52. LOSS OR EXPENSE DUE TO UNUSUAL OR UNANTICIPATED CIRCUMSTANCES Unless otherwise specified herein, all loss, expense or damage to the Contractor arising out of the nature of the work to be done, or from the action of the elements, or from any unforeseen circumstance or from unusual obstructions or difficulties, naturally occurring, man made or otherwise, which may be encountered in the prosecution of the work, shall be sustained and borne by the Contractor at his own cost and expense. 53. INDEPENDENT CONTRACTOR Contractor is, and shall remain, an independent contractor with full, complete and exclusive power and authority to direct, supervise, and control its own employees and to determine the method of the performance of the work covered hereby. The fact that the Owner or Owner's Representative shall have the right to observe Contractor's work during Contractor's performance and to carry out the other prerogatives which are expressly reserved to and vested in the Owner or Owner's Representative hereunder, is not intended to and shall not at any time change or effect the status of the Contractor as an independent contractor with respect to either the Owner or Owner's Representative or to the Contractor's own employees or to any other person, firm, or corporation. 54. CLEANING UP The Contractor shall at all times keep the premises free from accumulation of debris caused by the work, and at the completion of the work Contractor shall remove all such debris and also its tools, scaffolding, and surplus materials and shall leave the work room clean or its equivalent. The work shall be left in good order and condition. In case of dispute Owner may remove the debris and charge the cost to the Contractor. 55. HAZARDOUS SUBSTANCES AND ASBESTOS Hazardous Substances (herein so called), as defined in the Comprehensive Environmental Response, Compensation, and Liability Act (42 U.S.C.S. §9601(14)) and the regulations promulgated thereunder, as same may be amended from time to time, hydrocarbons or other petroleum products or byproducts and/or asbestos, in any form, shall not (i) be utilized, in any way, manner or form, in the construction of, or incorporation into, the Project; or (ii) be brought upon, placed, or located, by any party, on the Project site, or any other property of the City, without the written consent of the Owner's Representative. If Contractor believes that the utilization of a Hazardous Substance, hydrocarbons or other petroleum products or byproducts and/or asbestos is necessary in the construction of the Project, or that it is necessary to place and/or otherwise locate upon the site of the Project or other property of the City, a Hazardous Substance, hydrocarbons or other petroleum products or byproducts and/or asbestos, Contractor shall notify the Owner's Representative, and request consent therefrom, at least twenty (20) days prior to such action. Owner's Representative may grant or deny the request of Contractor and provide whatever requirements such consent, if granted, is conditioned upon, in its sole and absolute discretion. If the request of Contractor is not granted, or otherwise not responded to, by Owner's Representative within five (5) days of the receipt of said request, said request shall be deemed to be denied. In the event Owner's Representative shall consent to the request of Contractor, Contractor shall be responsible for ensuring that all personnel involved in the Project are (i) trained for the level of expertise required for proper performance of the actions contemplated by this Contract and, in particular, in all aspects of handling, storage, disposal and exposure of Hazardous Substances, hydrocarbons or other petroleum products or byproducts and/or asbestos; and (ii) are provided and utilize all protective equipment, including without limitation, personal protective gear, necessary to provide protection from exposure to Hazardous Substances, hydrocarbons or other petroleum products or byproducts and/or asbestos. 56. NONAPPROPRIATION All funds for payment by the City under this contract are subject to the availability of an annual appropriation for this purpose by the City. In the event of non -appropriation of funds by the City Council of the City of Lubbock for the goods or services provided under the contract, the City will terminate the contract, without termination charge or other liability, on the last day of the then -current fiscal year or when the appropriation made for the then -current year for the goods or services covered by this contract is spent, whichever event occurs first. If at any time funds are not appropriated for the continuance of this contract, cancellation shall be accepted by the Seller on thirty (30) days prior written notice, but failure to give such notice shall be of no effect and the City shall not be obligated under this contract beyond the date of termination. 57. THE CITY RIGHT TO AUDIT At any time during the term of this Contract and for a period of four (4) years thereafter the City or a duly authorized audit representative of the City, or the State of Texas, at its expense and at reasonable times, reserves the right to audit Contractor's records and books relevant to all services provided under this Contract. In the event such an audit by the City reveals any errors/overpayments by the City, Contractor shall refund the City the full amount of such overpayments within thirty (30) days of such audit findings, or the City, at its option, reserves the right to deduct such amounts owing the City from any payments due Contractor. 58. NON -ARBITRATION The City reserves the right to exercise any right or remedy available to it by law, contract, equity, or otherwise, including without limitation, the right to seek any and all forms of relief in a court of competent jurisdiction. Further, the City shall not be subject to any arbitration process prior to exercising its unrestricted right to seek judicial remedy. The remedies set forth herein are cumulative and not exclusive, and may be exercised concurrently. To the extent of any conflict between this provision and another provision in, or related to, this document, this provision shall control. 59. CONTRACTOR ACKNOWLEDGES Contractor acknowledges by supplying any Goods or Services that the Contractor has read, fully understands, and will be in full compliance with all terms and conditions and the descriptive material contained herein and any additional associated documents and Amendments. The City disclaims any terms and conditions provided by the Contractor unless agreed upon in writing by the parties. In the event of conflict between these terms and conditions and any terms and conditions provided by the Contractor, the terms and conditions provided herein shall prevail. The terms and conditions provided herein are the final terms agreed upon by the parties, and any prior conflicting terms shall be of no force or effect. 60. LABOR CODE CHAPTER 214 Sec. 214.008. MISCLASSIFICATION OF CERTAIN WORKERS; PENALTY. (a) A person who contracts with a governmental entity to provide a service as defined by Section 2155.001, Government Code, shall properly classify, as an employee or independent contractor in accordance with Chapter 201, any individual the person directly retains and compensates for services performed in connection with the contract. (b) In this subsection, "subcontractor" means a person directly retained and compensated by a person who contracts with a governmental entity to provide a service as defined by Section 2155.001, Government Code. A subcontractor shall properly classify, as an employee or independent contractor in accordance with Chapter 201, any individual the subcontractor directly retains and compensates for services performed in connection with the contract for which the subcontractor is retained. (c) A person who fails to properly classify an individual as required by Subsection (a) or (b) shall pay to the commission a penalty equal to $200 for each individual that the person has not properly classified. (d) The commission may not take action to collect a penalty under this section from a person after the third anniversary of the date on which the violation occurred. 61. CERTIFICATE OF INTERESTED PARTIES House Bill 1295, adopted by the 84th Legislature, created §2252.908, Texas Government Code. Section 2252.908 requires a business entity entering into certain contracts with a governmental entity or state agency to file with the governmental entity or state agency a disclosure of interested parties at the time the business entity submits the signed contract to the governmental entity or state agency. Section 2252.908 requires the disclosure form to be signed by the authorized agent of the contracting business entity, acknowledging that the disclosure is made under oath and under penalty of perjury. Section 2252.908 applies only to a contract that requires an action or vote by the governing body of the governmental entity or state agency before the contract may be signed or has a value of at least $1 million. Instructions for completing Form 1295 are available at: https:Hci.lubbock.tx.us/departments/purchasing/vendor-information 62. TEXAS GOVERNMENT CODE SECTION 2252.152 Vendors/Contractors/Providers must be in compliance with the provisions of §2252.152 and §2252.153 of the Texas Government Code, which states in part, contracts with companies engaged in business with Iran, Sudan, or Foreign Terrorist Organizations are prohibited. A governmental entity may not enter into a contract with any company listed on the Comptroller of the State of Texas website identified under Section 806.051 or Section 2253.253, which do business with Iran, Sudan or any Foreign Terrorist Organization. By submitting a signed response to this request, contractor verified to Lubbock County that it is not on any such list. 63. TEXAS GOVERNMENT CODE SECTION 2271.002 The Contractor warrants that it complies with Chapter 2271.002 of the Texas Government Code by verifying that: 1. Company does not boycott Israel; and 2. Company will not boycott Israel during the term of the contract. Pursuant to Section 2271.002, Texas Government Code: (1) 'Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business purposes; and (2) "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent company, or affiliate of those entities or business associations that exists to make a profit. 64. CONTRACTOR ACKNOWLEDGES Contractor Acknowledges by supplying any Goods or Services that the Contractor has read, fully understands, and will be in full compliance with all terms and conditions and the descriptive material contained herein and any additional associated documents and Amendments. The City disclaims any terms and conditions provided by the Contractor unless agreed upon in writing by the parties. In the event of conflict between these terms and conditions and any terms and conditions provided by the Contractor, the terms and conditions provided herein shall prevail. The terms and conditions provided herein are the final terms agreed upon by the parties, and any prior conflicting terms shall be of no force or effect. 65. TEXAS PUBLIC INFORMATION ACT The requirements of Subchapter J, Chapter 552, Government Code, may apply to this contract and the contractor or vendor agrees that the contract can be terminated if the contractor or vendor knowingly or intentionally fails to comply with a requirement of that subchapter. To the extent Subchapter J, Chapter 552, Government Code applies to this agreement, Contractor agrees to: (1) preserve all contracting information related to the contact as provided by the records retention requirements applicable to the governmental body for the duration of the contract; (2) promptly provide to the governmental body any contracting information related to the contract that is in the custody or possession of the entity on request of the governmental body; and (3) on completion of the contract, either: (A) provide at no cost to the governmental body all contracting information related to the contract that is in the custody or possession of the entity; or (B) preserve the contracting information related to the contract as provided by the records retention requirements applicable to the governmental body. 66. CONFIDENTIALITY The Contractor shall retain all information received from or concerning the City and the City's business in strictest confidence and shall not reveal such information to third parties without prior written consent of the City, unless otherwise required by law. 67. INDEMNITY The Contractor shall indemnify and save harmless the city of Lubbock and its elected officials, officers, agents, and employees from all suits, actions, losses, damages, claims, or liability of any kind, character, type, or description, including without limiting the generality of the foregoing, all expenses of litigation, court costs, and attorney's fees, for injury or death to any person, or injury to any property, received or sustained by any person or persons or property, to the extent arising out of, related to or occasioned by, the negligent acts of the Contractor, its agents, employees, and/or subcontractors, related to the performance, operations or omissions under this agreement and/or the use or occupation of city owned property. The indemnity obligation provided herein shall survive the expiration or termination of this agreement. GENERAL CONDITIONS OF THE AGREEMENT (Items 3, 28, 34, and 45) 3. OWNER'S REPRESENTATIVE Whenever the word Owner's Representative or representative is used in this contract, it shall be understood as referring to, City of Lubbock, or its representative Mike Gilliland, Director of Public Utilities, so designated who will inspect constructions; or to such other representatives, supervisors, architects, engineers, or inspectors as may be authorized by said Owner to act in any particular under this agreement. Engineers, supervisors or inspectors will act for the Owner under the direction of Owner's Representative, but shall not directly supervise the Contractor or persons acting on behalf of the Contractor. 28. CONTRACTOR'S INSURANCE The Contractor shall not commence work under this contract until he has obtained all insurance as required in the General Conditions of the contract documents, from an underwriter authorized to do business in the State of Texas and satisfactory to the City. Proof of coverage shall be furnished to the City and written notice of cancellation or any material change will be provided ten (10) calendar days in advance of cancellation or change. All policies of insurance, required herein, including policies of insurance required to be provided by Contractor and its subcontractors, shall contain a waiver of any and all of the insurer's or payor's, in the event of self-insurance, rights to subrogation that any such insurer or payor, in the event of self-insurance, may acquire by virtue of payment of any loss under such insurance or self-insurance. All certificates of insurance submitted to the City in conformity with the provisions hereof shall establish such waiver. The Contractor shall procure and carry at its sole cost and expense through the life of this contract, insurance protection as hereinafter specified. Coverage in excess of that specified herein also shall be acceptable. Such insurance shall be carried with an insurance company authorized to transact business in the State of Texas and shall cover all operations in connection with this contract, whether performed by the Contractor or a subcontractor, or separate policies shall be provided covering the operation of each subcontractor. A certificate of insurance specifying each and all coverages shall be submitted prior to contract execution. PROOF OF COVERAGE SHALL BE FURNISHED TO THE CITY OF LUBBOCK IN THE FORM OF A CERTIFICATE OF INSURANCE. THE INSURANCE CERTIFICATES FURNISHED SHALL NAME THE CITY OF LUBBOCK AS ADDITIONAL INSURED ON AUTO/GENERAL LIABILITY ON A PRIMARY AND NON-CONTRIBUTORY BASIS TO INCLUDE PRODUCTS OF COMPLETE OPERATIONS. PROVIDE A WAIVER OF SUBROGATION IN FAVOR OF THE CITY OF LUBBOCK. IT SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO PROVIDE TO THE OWNER ALL PROOF OF COVERAGE INSURANCE DOCUMENTS INCLUDING WORKERS COMPENSATION COVERAGE FOR EACH SUBCONTRACTOR. COPIES OF THE ENDORSEMENTS ARE REQUIRED. A. Commercial General Liability Insurance (Primary Additional Insured and Waiver of Subrogation required) The contractor shall have Comprehensive General Liability Insurance with limits of $1,000,000 Combined Single Limit in the aggregate and $1,000,000 per occurrence to include: Products of Complete Operation Endorsements Products & Completed Operations AGG Contractual Liability Personal Injury & Advertising Injury Med Exp (Any one Person) w/Heavy Equipment Occurrence XCU B. Owner's and Contractor's Protective Liability Insurance — NOT REQUIRED C. Comprehensive Automobile Liability Insurance (Waiver of Subrogation Required) The Contractor shall have Comprehensive Automobile Liability Insurance with limits of not less than; Bodily Injury/Property Damage, $1,000,000 Combined Single Limit per occurrence, to include all owned and non -owned cars including: Employers Non - ownership Liability Hired and Non -owned Vehicles. D. Builder's Risk Insurance/Installation Floater Insurance — NOT REQUIRED E. Umbrella Liability Insurance (Primary Additional Insured and Waiver of Subrogation required) The Contractor shall have Umbrella Liability Insurance in the amount of $4,000,000 on all contracts with coverage to correspond with Comprehensive General Liability and Comprehensive Automobile Liability coverage's. F. Worker's Compensation and Employers Liability Insurance (Waiver of Subrogation required) Worker's Compensation Insurance covering all employees whether employed by the Contractor or any Subcontractor on the job with Employers Liability of at least $1,000,000 1. Definitions: Certificate of coverage ("certificate") - A copy of a certificate of insurance, a certificate of authority to self -insure issued by the commission, or a coverage agreement (TWCC-81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation insurance coverage for the person's or entity's employees providing services on a project, for the duration of the project. Duration of the project - includes the time from the beginning of the work on the project until the Contractor's/person's work on the project has been completed and accepted by the governmental entity. Persons providing services on the project ("subcontractor" in Section 406.096, Texas Labor Code) - includes all persons or entities performing all or part of the services the Contractor has undertaken to perform on the project, regardless of whether that person contracted directly with the Contractor and regardless of whether that person has employees. This includes, without limitation, independent contractors, subcontractors, leasing companies, motor carriers, owner -operators, employees of any such entity, or employees of any entity which furnishes persons to provide services on the project. "Services" include, without limitation, providing, hauling, or delivering equipment or materials, or providing labor, transportation, or other service related to a project. "Services" does not include activities unrelated to the project, such as food/beverage vendors, office supply deliveries, and delivery of portable toilets. 2. The Contractor shall provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all employees of the contractor providing services on the project, for the duration of the project. 3. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. 4. If the coverage period shown on the Contractor's current certificate of coverage ends during the duration of the project, the Contractor must, prior to the end of the coverage period, file a new certificate of coverage with the governmental entity showing that coverage has been extended. 5. The Contractor shall obtain from each person providing services on the project, and provide to the governmental entity: (a) a certificate of coverage, prior to that person beginning work on the project, so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project; and (b) no later than seven days after receipt by the Contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project. 6 The Contractor shall retain all required certificates of coverage for the duration of the project and for one year thereafter. 7. The Contractor shall notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the Contractor knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project. 8. The Contractor shall post on each project site a notice, in the text, form and manner prescribed by the Texas Workers' Compensation Commission, informing all persons providing services on the project that they are required to be covered, and stating how a person may verify coverage and report lack of coverage. 9. The Contractor shall contractually require each person with whom it contracts to provide services on the project, to: (a) provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44) for all of its employees providing services on the project, for the duration of the project; (b) provide to the Contractor, prior to that person beginning work on the project, a certificate of coverage showing that coverage is being provided for all employees of the person providing services on the project, for the duration of the project; (c) provide the Contractor, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (d) obtain from each other person with whom it contracts, and provide to the Contractor: (1) a certificate of coverage, prior to the other person beginning work on the project; and (2) a new certificate of coverage showing extension of coverage, prior to the end of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (e) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (f) notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and (g) contractually require each person with whom it contracts to perform as required by paragraphs (a) - (g), with the certificates of coverage to be provided to the person for whom they are providing services. 10. By signing this contract or providing or causing to be provided a certificate of coverage, the Contractor is representing to the governmental entity that all employees of the Contractor who will provide services on the project will be covered by worker's compensation coverage for the duration of the project, that the coverage will be based on proper reporting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self -insured, with the commission's Division of Self -Insurance Regulation. Providing false or misleading information may subject the Contractor to administrative penalties, criminal penalties, civil penalties, or other civil actions. 11. The Contractor's failure to comply with any of these provisions is a breach of contract by the Contractor which entitles the governmental entity to declare the contract void if the Contractor does not remedy the breach within ten days after receipt of notice of breach from the governmental entity. G. Proof of Coverage Before work on this contract is commenced, each Contractor and subcontractor shall submit to the Owner for approval five Certificates of Insurance covering each insurance policy carried and offered as evidence of compliance with the above insurance requirements, signed by an authorized representative of the insurance company setting forth: (1) The name and address of the insured. (2) The location of the operations to which the insurance applies. (3) The name of the policy and type or types of insurance in force thereunder on the date borne by such certificate. (4) The expiration date of the policy and the limit or limits of liability thereunder on the date borne by such certificate. (5) A provision that the policy may be canceled only by mailing written notice to the named insured at the address shown in the proposal specifications. (6) A provision that written notice shall be given to the City ten days prior to any change in or cancellation of the policies shown on the certificate. (7) The certificate or certificates shall be on the form (or identical copies thereof) contained in the job specifications. No substitute of nor amendment thereto will be acceptable. (8) If policy limits are paid, new policy must be secured for new coverage to complete project. (9) A Contractor shall: (a) provide coverage for its employees providing services on a project, for the duration of the project based on proper reporting of classification codes and payroll amounts and filling of any coverage agreements; (b) provide a certificate of coverage showing workers' compensation coverage to the governmental entity prior to beginning work on the project; (c) provide the governmental entity, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the Contractor's current certificate of coverage ends during the duration of the project; (d) obtain from each person providing services on a project, and provide to the governmental entity: (i) a certificate of coverage, prior to that person beginning work on the project, so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project; and (ii) no later than seven days after receipt by the Contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (e) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (f) notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the Contractor knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; (g) post a notice on each project site informing all persons providing services on the project that they are required to be covered, and stating how a person may verify current coverage and report failure to provide coverage. This notice does not satisfy other posting requirements imposed by the Texas Worker's Compensation Act or other commission rules. This notice must be printed with a title in at least 30-point bold type and text in at least 19-point normal type, and shall be in both English and Spanish and any other language common to the worker population. The text for the notices shall be the following text provided by the commission on the sample notice, without any additional words or changes: REQUIRED WORKERS' COMPENSATION COVERAGE "The law requires that each person working on this site or providing services related to this construction project must be covered by workers' compensation insurance. This includes persons providing, hauling, or delivering equipment or materials, or providing labor or transportation or other service related to the project, regardless of the identity of their employer or status as an employee. " "Call the Texas Workers' Compensation Commission at 800-372-7713 or 512-804-4000 (www. tdi. state. tx. us) to receive information of the legal requirements for coverage, to verify whether your employer has provided the required coverage, or to report an employer's failure to provide coverage; " and (h) contractually require each person with whom it contracts to provide services on a project, to: (i) provide coverage based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements for all of its employees providing services on the project, for the duration of the project; (ii) provide a certificate of coverage to the Contractor prior to that person beginning work on the project; (iii) include in all contracts to provide services on the project the following language: "By signing this contract or providing or causing to be provided a certificate of coverage, the person signing this contract is representing to the governmental entity that all employees of the person signing this contract who will provide services on the project will be covered by workers' compensation coverage for the duration of the project, that the coverage will be based on proper reprinting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self -insured, with the commission's Division of Self -Insurance Regulation. Providing false or misleading information may subject the Contractor to administrative penalties, criminal penalties, civil penalties, or other civil actions."; (iv) provide the Contractor, prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (v) obtain from each other person with whom it contracts, and provide to the Contractor: (1) a certificate of coverage, prior to the other person beginning work on the project; and (2) prior to the end of the coverage period, a new certificate of coverage showing extension of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (vi) retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (vii) notify the governmental entity in writing by certified mail or personal delivery, within 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project; and (viii) contractually require each other person with whom it contracts, to perform as required by paragraphs (i)-(viii), with the certificate of coverage to be provided to the person for whom they are providing services. 34. TIME FOR SUBSTANTIAL COMPLETION AND LIQUIDATED DAMAGES It is hereby understood and mutually agreed by and between the Contractor and the Owner, that the date of beginning and time for completion as specified in the Notice to Proceed and contract documents, respectively, of work to be done hereunder are essential conditions of this contract; and it is further mutually understood and agreed that the work embraced in this contract shall be commenced as provided in the contract documents. If the Contractor should neglect, fail, or refuse to substantially complete the work within the time herein specified, then the Contractor does hereby agree as part of the consideration for the awarding of this contract, the Owner may withhold permanently from Contractor's total compensation, the sum of $1,204.28 PER CONSECUTIVE CALENDAR DAY, not as a penalty, but as liquidated damages for the breach of the contract as herein set forth for each and every working day that the Contractor shall be in default after the time stipulated for substantially completing the work. If the Contractor should neglect, fail, or refuse to finally complete the work within the time herein specified, then the Contractor does hereby agree as part of the consideration for the awarding of this contract, the Owner may withhold permanently from Contractor's total compensation, the sum of $1,204.28 CONSECUTIVE CALENDAR DAY, not as a penalty, but as liquidated damages for the breach of the contract as herein set forth for each and every working day that the Contractor shall be in default after the time stipulated for substantially completing the work. It is expressly understood and agreed, by and between Contractor and the Owner, that the time for the substantial completion of the work described herein is reasonable time for the completion of the same, taking into consideration the average climatic range and conditions and usual industrial conditions prevailing in this locality. The amount is fixed and agreed upon by and between the Contractor and the Owner because the actual damages the Owner would sustain in such event would be difficult and/or impossible to estimate, however, the amount agreed upon herein is a reasonable forecast of the amount necessary to render just compensation to Owner, and is expressly agreed to be not disproportionate to actual damages as measured at time of breach. IT IS FURTHER AGREED AND UNDERSTOOD BETWEEN THE CONTRACTOR AND OWNER THAT TIME IS OF THE ESSENCE OF THIS CONTRACT. 45. CORRECTION OF WORK Contractor shall promptly remove from Owner's premises all materials condemned by the Owner's Representative on account of failure to conform to the contract documents, whether actually incorporated in the work or not, and Contractor shall at its own expense promptly replace such condemned materials with other materials conforming to the requirements of the contract documents. Contractor shall also bear the expense of restoring all work of other contractors damaged by any such removal or replacement. If Contractor does not remove and replace any such condemned work within a reasonable time but not to exceed 30 days after a written notice by the Owner or the Owner's Representative, Owner may remove and replace it at Contractor's expense. The Contractor shall pay all claims, cost, losses, and damages (including but not limited to all fees and charges of the engineers, architects, attorneys, and other professionals and all court or arbitration or other dispute resolution cost) arising out of or relating to such correction or removal. Neither the final payment, nor certification of final completion or substantial completion, nor any provision in the contract documents shall relieve the Contractor of responsibility for faulty materials or workmanship, and Contractor shall remedy any defects due thereto and pay for any damage to other work resulting therefrom, which shall appear within a period of two years from the date of certification of final completion by Owner's Representative. DAVIS BACON WAGE DETERMINATIONS Page Intentionally Left Blank General Decision Number: TX20210280 07/02/2021 Superseded General Decision Number: TX20200280 State: Texas Construction Type: Building Counties: Crosby and Lubbock Counties in Texas. BUILDING CONSTRUCTION PROJECTS (does not include single family homes or apartments up to and including 4 stories). Note: Under Executive Order (EO) 13658, an hourly minimum wage of $10.95 for calendar year 2021 applies to all contracts subject to the Davis -Bacon Act for which the contract Is awarded (and any solicitation was issued) on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.95 per hour (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in calendar year 2021. If this contract is covered by the EO and a classification considered necessary for performance of work on the contract does not appear on this wage determination, the contractor must pay workers in that classification at least the wage rate determined through the conformance process set forth in 29 CFR 5.5(a)(1)(11) (or the EO minimum wage rate, if it is higher than the conformed wage rate). The EO minimum wage rate will be adjusted annually. Please note that this EO applies to the above -mentioned types of contracts entered into by the federal government that are subject to the Davis -Bacon Act itself, but it does not apply to contracts subject only to the Davis -Bacon Related Acts, including those set forth at 29 CFR 5.1(a)(2)-(60). Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Modification Number Publication Date 0 01/01/2021 1 07/02/2021 BOIL0074-003 01/01/2017 Rates Fringes BOILERMAKER ...................... $ 28.00 22.35 CARP0665-00105/01/2017 Rates Fringes CARPENTER ........................ $ 22.25 7.31 ELECO602-008 03/01/2020 Rates Fringes ELECTRICIAN .................... ..$ 23.12 3%+10.75 ENG10178-005 06/01/2020 Rates Fringes POWER EQUIPMENT OPERATOR (1) Tower Crane ............. $ 32.85 13.10 (2) Cranes with Pile Driving or Caisson Attachment and Hydraulic Crane 60 tons and above...$ 28.75 10.60 (3) Hydraulic cranes 59 Tons and under ............. .$ 32.35 13.10 IRON 0084-01106/01/2020 Rates Fringes IRONWORKER, ORNAMENTAL ... $ 25.26 7.13 * IRON0263-003 06/01/2020 Rates Fringes IRONWORKER, STRUCTURAL ........... $ 25.14 7.43 PLUM 0404-00109/01/20 20 Rates Fringes PLUMBER .......................... $ 26.05 8.81 ---- ----------------------------------------------------------- SH EE0049-00104/01/2019 Rates Fringes SHEET METAL WORKER (HVAC Duct Installation Only) .............. .$ 21.73 14.94 ---------------------------------------------------------------- SUTX2014-060 07/21/2014 Rates Fringes BRICKLAYER ....................... $ 20.04 0.00 CEMENT MASON/CONCRETE FINISHER...$19.60 0.00 INSULATOR - MECHANICAL (Duct, Pipe & Mechanical System Insulation) .............. $19.77 7.13 IRONWORKER, REINFORCING ... $12.27 0.00 LABORER: Common or General.$12.35 0.00 LABORER: Mason Tender - Brick ... $11.36 0.00 LABORER: Mason Tender - Cement/Concrete ..................$10.58 0.00 LABORER: Pipelayer..............$12.49 2.13 LABORER: Roof Tearoff .......... .$11.28 0.00 OPERATOR: Backhoe/Excavator/Trackhoe .$14.25 0.00 OPERATOR: Bobcat/Skid Steer/Skid Loader ............... $13.93 0.00 OPERATOR: Bulldozer.............$18.29 1.31 OPERATOR: Drill ................ .$16.22 0.34 OPERATOR: Forklift ............ ..$14.83 0.00 OPERATOR: Grader/Blade .......... $13.37 0.00 OPERATOR: Loader................$13.55 0.94 OPERATOR: Mechanic..............$17.52 3.33 OPERATOR: Paver (Asphalt, Aggregate, and Concrete) ......... $ 16.03 0.00 OPERATOR: Roller................$12.70 0.00 PAINTER (Brush, Roller, and Spray) ......................... $14.27 0.00 ROOFER .......................... .$ 13.75 0.00 SHEET METALWORKER, Excludes HVAC Duct Installation.......... $ 21.13 6.53 TILE FINISHER ................. $11.22 0.00 TILE SETTER ...................... $14.00 2.01 TRUCK DRIVER: Dump Truck ...... $12.39 1.18 TRUCK DRIVER: Flatbed Truck ... $19.65 8.57 TRUCK DRIVER: Semi -Trailer Truck .......................... $12.50 0.00 TRUCK DRIVER: Water Truck ---------------------------------------------------------------- ....... $ 12.00 4.11 WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. "General Decision Number: TX20210002 01/01/2021 Superseded General Decision Number: TX20200002 State: Texas Construction Types: Heavy and Highway Counties: Armstrong, Carson, Crosby, Ector, Irion, Lubbock, Midland, Potter, Randall, Taylor and Tom Green Counties in Texas. HEAVY & HIGHWAY CONSTRUCTION PROJECTS Note: Under Executive Order (EO) 13658, an hourly minimum wage of $10.95 for calendar year 2021 applies to all contracts subject to the Davis -Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.95 per hour (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in calendar year 2021. If this contract is covered by the EO and a classification considered necessary for performance of work on the contract does not appear on this wage determination, the contractor must pay workers in that classification at least the wage rate determined through the conformance process set forth in 29 CFR 5.5(a)(1)(ii) (or the EO minimum wage rate, if it is higher than the conformed wage rate). The EO minimum wage rate will be adjusted annually. Please note that this EO applies to the above -mentioned types of contracts entered into by the federal government that are subject to the Davis - Bacon Act itself, but it does not apply to contracts subject only to the Davis -Bacon Related Acts, including those set forth at 29 CFR 5.1(a)(2)-(60). Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Modification Number Publication Date 0 01/01/2021 * SUTX2011-002 08/02/2011 Rates Fringes CEMENT MASON/CONCRETE FINISHER (Paving & Structures) ... $13.SS ELECTRICIAN ...................... $ 20.96 FORM BUILDER/FORM SETTER Paving & Curb .............. .$12.36 Structures ................. .$13.52 LABORER Asphalt Raker ........... ....$12.28 Flagger................... .$ 9.30 Laborer, Common...... $10.30 Laborer, Utility ........... $ 11.80 Work Zone Barricade Servicer.................... $10.30 POWER EQUIPMENT OPERATOR: Asphalt Distributer...... ...$14.87 Asphalt Paving Machine ...... $13.40 Broom and Sweeper ........... $ 11.21 Crane, Lattice Boom 80 Tons or Less ............... .$16.82 Crawler Tractor Operator .... $13.96 Excavator, 50,000 Ibs or less ........................ $13.46 Front End Loader Operator, Over 3 CY................... $12.77 Front End Loader, 3CY or less ....................... $12.28 Loader/Backhoe............ $14.18 Mechanic ................... $ 20.14 Milling Machine ............ .$15.54 Motor Grader, Rough ........ $16.15 Motor Grader, Fine.......... $17.49 Pavement Marking Machine .... $16.42 Reclaimer/Pulverizer....... $12.85 Roller, Asphalt ............. $10.95 Roller, Other ............. $10.36 Scraper ..................... $10.61 Spreader Box ............... $12.60 Servicer ......................... $13.98 Steel Worker (Reinforcing). $13.50 TRUCK DRIVER Lowboy -Float ............... $14.46 Single Axle ................. $ 12.74 Single or Tandem Axle Dump..$11.33 Tandem Axle Tractor with Semi ........................$12.49 --------------------------------------------------------------- WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. Page Intentionally Left Blank SPECIAL CONDITIONS Page Intentionally Left Blank SPECIAL CONDITIONS 1. TIME AND ORDER FOR COMPLETION The patching process covered by the contract documents shall be fully completed within 60 Six consecutive calendar days from the date specified in the Notice to Proceed issued by the City of Lubbock to the successful bidder. A. The Asphalt patching, with locations and materials as designated by the City's representative, may begin as soon as the Contractor receives the Notice to Proceed, and proceed until all designated locations are completed. B. The repairs shall be completed in 60 consecutive calendar days. The Contractor shall pay to the owner $1,204.28 per day for each calendar day after that until completion as liquidated damages. No credit will be given for bad weather days or other delays. In the event it is determined by the City that the progress of the work is not satisfactory, the City may direct the Contractor to take such action as the City deems necessary to insure completion of the project within the time specified. 2. CHANGES IN THE WORK The Street Department may make changes in the scope of the work required to be performed by the Contractor under the Contract or making additions thereto, or by omitting work there from, without involving the Contract, and without relieving or releasing the Contractor from any of his obligations under the contract or any guarantee given by him pursuant to the Contract provisions, and without affecting the validity of the guaranty bonds, and without relieving or releasing the surety or sureties of said bonds. All such work shall be executed under the terms of the original Contract unless it is expressly provided otherwise Except for the purpose of affording protection against any emergency endangering health, life, limb or property, the Contractor shall make no change in the materials used or in the specified manner of constructing and/or installing the improvements or supply additional labor, services or materials beyond that actually required for the execution of the contract, unless in pursuance of a written order from the local Public Agency authorizing the Contractor to proceed with the change. No claim for an adjustment of the contract price will be valid unless so ordered. If applicable unit prices are contained in the agreement (established as a result of either a unit price bid or a Supplement Schedule of Unit Prices) the Street Department may order the Contractor to proceed with desired changes in the work, the value of such changes to be determined by the measured quantities involved and the applicable unit prices specified in the contract; provided that in case of a unit price contract the net value of all changes does not increase or decrease the original total amount shown in the Agreement by more than twenty-five (25%) percent. 3. SUPERINTENDENCE The Contractor's Superintendent and/or his assistants will not be allowed to serve two functions simultaneously, such operating machinery and acting as Superintendent at the same time. The Contractor's Superintendent must be free of individual responsibilities to enable him to give the entire project his constant attention to facilitate the progress thereof. The Contractor's Superintendent will be responsible for establishing grade control on concrete removal and replacement. 4. PROSECUTION OF WORK The Contractor will, before starting any work on any street, erect barricades and signs, or provide sufficient flagmen, as approved by the Street Superintendent, to give notice to vehicular traffic. During the construction the Contractor will close thru traffic, as approved by the Street Superintendent. At no time during the period of construction shall driveways and/or alleys be left impassable between the night time hours of 6 P.M. to 6 A.M., except during the construction of the curb and gutter for which the driveways and/or alleys shall remain closed not more than 4 days including 72 hours for curing. The Contractor will, during the progress of the work, erect and maintain for twenty-four hours a day such barricades and warnings, as approved by the Street Superintendent, necessary to give notice to vehicular and pedestrian traffic of any and all obstructions and insofar as possible keep the streets and/or alleys on which work is being done in a passable condition. During the time the concrete is curing in the alleys and until it can be opened to traffic, the Contractor shall maintain warning signs on barricades with lights at each end of the block until the alley can be opened to traffic. The flagmen will be required to wear vests and use the type of flag as shown on flagging detail sheet in specifications All equipment working on the streets will at all times have at least two (2) red, orange or fluorescent red -orange flags at least 16" x 16" in size. These flags shall be mounted high enough on the equipment so that they will be visible to all traffic meeting or passing the equipment. Before work is started on any street it will be the responsibility of the Contractor to notify each property owner that has a car or cars parked in their driveways or garages so that each owner might have the opportunity to move their cars. The Contractor shall schedule his work on major thoroughfares and collectors at least 5 days in advance, in order that businesses may have time to adjust their plans. On all thoroughfares and collectors, the Contractor and the City's Representatives will work with each of the businesses, hospitals, schools, etc., so that only part of the driveways into their parking lots will be closed. At no time will any parking lot be completely closed, without prior approval from the Owner's Representative, unless the work is being accomplished at night and the businesses are closed. The Contractor shall be responsible for notifying affected businesses of the proposed work and the projected schedule for completion of this work. Immediately after each re -construction the Contractor shall clean, remove any paving materials from gutters, rubbish and temporary structures from the street, restore in an acceptable manner all property, both public and private which has been damaged during the prosecution of the work, and leave the site of the work in a neat and presentable condition throughout. The cost of the "cleanup" shall be included as part of the cost of the various items of the work involved, and no direct compensation will be made for this work. The Contractor should familiarize himself with the Texas Manual on UNIFORM TRAFFIC CONTROL DEVICES for Streets and Highways. Part VI. 5. BARRICADES AND DANGER, WARNING AND DETOUR SIGNS AND TRAFFIC HANDLING The Contractor shall have the sole responsibility for providing, installing, moving, replacing, maintaining, cleaning and removing upon completion of work, all barricades, warning signs, barriers, cones, lights, signals and other such type devices for handling traffic control as indicated in the plans or as directed by the Street Superintendent. All barricades, warning signs, barriers, cones, lights, signals and other such type devices shall conform to details shown on the plans and as indicated in the Texas Manual on Uniform Traffic Control Devices. The Contractor may provide special signs not covered by plans to protect the traveling public against special conditions or hazards, provided however, that such signs are first approved by the Street Superintendent. Upon completion of the work, all barricades, warning signs, barriers, cones, lights, signals and other such type devices and evident thereof shall be removed by the Contractor. 6. MAINTENANCE OF DETOURS The Contractor shall do such work as may be necessary to maintain detours and facilities for safe public travel in accordance with the Traffic Control Plan and these specifications. There shall be maintained in passable condition, such temporary roads and structures as may be necessary to accommodate public travel. Temporary approaches and crossings of intersecting highways shall be provided and maintained in a safe and passable condition by the Contractor at his entire expense. 7. PUBLIC SAFETY AND CONVENIENCE Ingress and egress to private property shall be provided as specified in the plans or as directed by the Street Superintendent. The Contractor shall plan and execute his operations in a manner that will cause the minimum interference with traffic. The Contractor shall secure the Street Superintendent's approval of his proposed plan of operation, sequence of work, and methods of providing for the safe passage of traffic before it is placed into operation. If at any time during construction the approved plan does not accomplish the intended purpose, due to weather or other conditions affecting the safe handling of traffic, the Contractor shall immediately make necessary changes therein to correct the unsatisfactory conditions. At night or otherwise, all equipment not in use shall be stored in such a manner and at such locations as not to interfere with the safe passage of traffic. The Contractor shall provide and maintain flaggers at such points and for such periods of time as may be required to provide for the safety and convenience of public travel and Contractor's personnel, and as directed by the Street Superintendent. Flaggers shall be English speaking, courteous, well informed, physically and mentally able to effectually perform their duties in safeguarding and directing traffic and protecting the work, and shall be neatly attired and groomed at all times when on duty. When directing traffic, flaggers shall use standard attire, flags and signals and follow the flagging procedures set forth in the Texas Manual on Uniform Traffic Control Devices for Streets and Highways. 8. REMOVING OBSTRUCTIONS The Contractor shall familiarize himself with the existing obstructions including sidewalks, trees, poles, etc., prior to building. It shall be the Contractor's responsibility to remove these obstructions at the direction of the Street Superintendent, except that the utility companies will move their equipment at no cost to the Contractor. The Contractor will receive no compensation for delay caused by the Utility Companies in relocating or removing their equipment. 9. TEST OF MATERIALS The City of Lubbock Pavement Management laboratory test results shall be the sole consideration for approval of materials, mix designs, adequacy of procedures, etc. The results of such testing shall be evaluated and final approval given by the Street Superintendent. A. CONCRETE MATERIALS Before Concrete materials can be used on any street, a current mix design (not older than 30 days) with test reports will be submitted to the Street Superintendent for approval. During the construction period, concrete tests that fail will require the location to be cored at the contractor's expense. If the concrete cores fail, the concrete work will be removed and replaced at no additional cost to the City of Lubbock. B. HOT MIX The Contractor, or supplier of such materials, shall submit a mix design to the City Pavement Management office, at least thirty (30) days prior to the reconstruction, a mix design it shall include, but not limited to crushed face counts, Flakiness Index tests, and magnesium sulfate(soundness) tests. The Gradation requirements shall be necessary to meet the gradation requirements of Item 6.3 (HMAC Mix Design Requirements). The crushed face count, Flakiness Index, and Magnesium Sulfate requirements shall meet those established in City of Lubbock Standard Paving Specifications, Item number 6.4. 10. SUBCONTRACTOR The Contractor shall not award any work to any subcontractor without prior written approval of the Owner, which approval will not be given until the Contractor submits to the Owner a written statement concerning the proposed award to the subcontractor, which statement shall contain such information as the Owner may require. The Contractor shall be as fully responsible to the Owner for the acts and omissions of his subcontractors, and of persons either directly or indirectly employed by them, as he is for the acts and omissions of persons directly employed by him. The Contractor shall cause appropriate provisions to be inserted in all subcontracts relative to the work to bind subcontractors to the Contractor by the terms of the General Conditions and other contract documents insofar as applicable to the work of subcontractors and to give the Contractor the same power as regard terminating any subcontract that the Owner may exercise over the Contractor under any provision of the contract documents. Nothing contained in this contract shall create any contractual relation between any subcontractor and the Owner and said subcontractor will look exclusively to contractor for any payments due subcontractor. 11. UNDERGROUND UTILITIES The Contractor's attention is directed to the fact that pipelines and other underground installations as may be shown on the plans have been taken from the best available information. There may be other pipelines or installations. The Contractor shall hold harmless the City from any and all suits or claims resulting from damage by his operations to any pipeline or underground installation. It is the Contractor's responsibility, during the period of street construction, to insure that all utility cuts in the limits of street construction have been properly backfilled, compacted, and the top 6" inches backfilled with 2-sack flowable fill. It is not the intent to require the Contractor to provide for the utility cut repair but for the individual utility company making the cut to provide their own repairs. In the case of a City underground installation, the Contractor may be required, at the Street Superintendent's option, to repair the cut with 2-sack flowable fill at the unit price bid. 12. PARTIAL PAYMENT On or before the tenth day of each month, the Contractor shall submit to Owner's Representative an application for partial payment. Owner's Representative shall review said application for partial payment and the progress of the work made by the Contractor and if found to be in order shall prepare a certificate for partial payment showing as completely as practical the total value of the work done by the Contractor up to and including the last day of the preceding month. 13. CORRECTION OF WORK AFTER FINAL PAYMENT Neither the final payment nor certificate nor any provision in this contract shall relieve the Contractor of responsibility for faulty materials or workmanship, and he shall remedy and defects due thereto and pay for any damage to other work resulting there from, which shall appear within a period of one (2) years from date of final acceptance of the project. The Owner or the Owner's Representative shall give notice of observed defects with reasonable promptness. 14. LABOR The Contractor must abide by the Wage and Hour Laws of the State of Texas, or the U.S. Department of Labor, and must not pay less than the rate legally prescribed or as set forth herein, whichever is higher. Payment for time worked over forty -hours per week shall be made at one and one-half (1-1/2) times the above prevailing rates. Payment for time worked on legal holidays shall be paid at one and one-half (1-1/2) times the regular governing per diem wage rates. Any laborer, workman or mechanic required or permitted to work in excess of eight (8) hours per calendar day, under the emergency exceptions to House Bill No. 115 of the 44th Legislature invoked by HCR No. 201 of the 47th Legislature shall be paid on the basis of eight (8) hours constituting a day's work. 15. EQUIPMENT All equipment shall be keep in good working conditions no leaks. Any equipment that shows signs of leaks shall be fixed immediately, and shall not be used until such leaks are fixed. The Milling Machine shall be capable of complete pavement removal at a full depth of no less than 10 '/2" in a single pass. The milling machine shall be capable of maintain grade control at full depth plus or minus 1". The Milling machine shall be a self-propelled milling machine. It shall have self -loading devices to promote continuous milling operation. 16. WORKING HOURS DEFINED During this contract the contractor shall make every effort to complete the work ahead of schedule. The working day shall consist of but, is not limited to the following hours 8 AM to 5 PM Monday thru Friday. Working on Saturday shall subject to the approval of the Street Superintendent of his representative. At any time during the contract the street superintendent or his representative may adjust the working hours if adequate progress is not being made. 17. WORK SCHEDULE The work schedule shall follow a predetermined route that will be laid out by the street superintendent or his representative at the preconstruction meeting. At any time the street superintendent or his representative shall have the capability to adjust the predetermined route. The contractor or his representative may summit in writing no less than 10 working days to the street superintendent or his representative a request to change the predetermined route. This request will be subject to approval by the street superintendent or his representative. 4 SPECIFICATIONS Page Intentionally Left Blank City of Lubbock Engineering Minimum Design Standards and Specifications LubCity of bock Tf%Af Department of Engineering City of Lubbock, Texas May 1, 2020 This document contains general standards and specifications for design work on public infrastructure. At all times these regulations are subject to the direct supervision and judgment of the City Engineer who may make modifications in their implementation as may be necessary on a case -by -case basis, acting in the best interest of the public. Approval of plans shall constitute general conformance with the City of Lubbock Minimum Design Standards and Specifications Approval of plans shall not relieve the Engineer of Record or the Developer from the responsibility to comply with local, State, or Federal requirements, and/or any errors or omissions in plans and specifications 00 City of ibbock E X A S May 4, 2020 Subject: City of Lubbock Public Works Engineering Minimum Design Standards & Specifications To whom it may concern: This letter is to advise of the release of the 2020 annual update to the City of Lubbock Public Works Engineering Minimum Design Standards and Specifications. Over the past two years the City of Lubbock Engineering staff has been working with vendors, manufacturers, engineering firms and the development community to update and improve the 2018 edition. The Public Works Engineering Department will be reviewing plans and making comments according to these standards for any proposed infrastructure beginning May 11, 2020. Therefore, any plans received by this department dated on or after May 11, 2020 will be reviewed under these newly adopted design and construction standards. This manual is available in digital format on the City of Lubbock website. Please feel free to contact me if you have any questions Sincerely, za"'ILd "n I LaQ-� Michael G. Keenum, P.E. Division Director of Engineering / City Engineer City of Lubbock 1625 136 Street Lubbock, Texas 79401 (806) 775-2393 C:\USERS\158869W'PDATA\LOCAL\MICROSOFI\WINDOWS\INETCACHE\CONTENT.OUIZOOKWVIQYOAF\STD SPECS ADOPTION LETTERDOCX 0 City of ibbock TEXAS June l 1, 2020 Subject: City of Lubbock Engineering Minimum Design Standards & Specifications To whom it may concern: This letter is to advise of the release of an amendment to the 2020 City of Lubbock Engineering Minimum Design Standards and Specifications. This amendment adds American AVK fire hydrants to the Approved Materials List. This change is effective immediately. This manual is available in digital format on the City of Lubbock website. Please feel free to contact me if you have any questions Sincerely, Michael G. Keenum, P.E. Division Director of Engineering / City Engineer City of Lubbock 1314 Avenue K Lubbock, Texas 79401 (806) 775-2347 C: USEM127498 APPDATA LOCAL MCROSOF nWINDOWS JNETCACHECONfEM'.OUTLOOKOSO2SJ3DMSTD SPECS AMENDMENT L=P DOCX No Text 2020 Design Standards and Specifications Table of Contents SECTION1......................................................................................................................................... 1 MINIMUM DESIGN STANDARDS FOR WATER DISTRIBUTION..........................................................1 1.01 General...................................................................................................................................1 1.02 Design Flow.............................................................................................................................1 1.03 Design Pressure....................................................................................................................... 2 1.04 Hydraulic Design...................................................................................................................... 2 1.05 Typical Layout..........................................................................................................................2 1.06 Bedding and Cover...................................................................................................................3 1.07 Relation to Sanitary Sewer Mains and Appurtenances..................................................................3 1.08 Pipe Size and Spacing...............................................................................................................6 1.09 Pipe Materials.......................................................................................................................... 6 1.10 Methods of Connection............................................................................................................. 6 1.11 Flanged Outlets........................................................................................................................7 1.12 Valve Spacing.......................................................................................................................... 7 1.13 Fire Protection Requirements....................................................................................................7 1.14 Easements...............................................................................................................................8 1.15 Soil Analysis.............................................................................................................................9 1.16 Pipe Restraints and Reaction Blocking........................................................................................9 1.17 Tunneling, Jacking and Boring...................................................................................................9 1.18 Dead-end Mains..................................................................................................................... 10 1.19 Abandonment of Water Mains................................................................................................. 10 SECTION2.......................................................................................................................................11 CHECK LIST FOR WATER DISTRIBUTION CONSTRUCTION PLANS ................................................. 11 2.01 Plan Submittal Requirements................................................................................................... 11 2.02 Plan Details........................................................................................................................... 13 SECTION3.......................................................................................................................................17 MINIMUM DESIGN STANDARDS FOR SANITARY SEWERS.............................................................. 17 3.01 General.................................................................................................................................17 3.02 Design Flow........................................................................................................................... 17 3.03 Hydraulic Design.................................................................................................................... 18 3.04 Design Details........................................................................................................................ 18 3.05 Typical Layout........................................................................................................................ 19 3.06 Bedding and Cover................................................................................................................. 20 3.07 Relation to Water Mains.......................................................................................................... 20 3.08 Abandonment of Sewer Mains and Manholes............................................................................ 22 3.09 Easements.............................................................................................................................22 3.10 Soil Analysis........................................................................................................................... 22 3.11 Tunneling, Jacking and Boring................................................................................................. 23 3.12 Lift Station............................................................................................................................. 23 SECTION4....................................................................................................................................... 25 CHECK LIST FOR SANITARY SEWER CONSTRUCTION PLANS......................................................... 25 4.01 Plan Submittal Requirements................................................................................................... 25 4.02 Plan Details........................................................................................................................... 27 SECTION5....................................................................................................................................... 29 STANDARD SPECIFICATIONS FOR WATER MAIN CONSTRUCTION ................................................ 29 5.01 General.................................................................................................................................29 5.02 Plan Requirements................................................................................................................. 29 5.03 Plan Approval......................................................................................................................... 29 5.04 Inspection............................................................................................................................. 29 5.05 Specifications.........................................................................................................................29 5.06 Materials of Construction........................................................................................................ 29 5.07 Methods of Construction......................................................................................................... 38 5.08 Pneumatic Testing for Tapping Sleeves.................................................................................... 45 5.09 Hydrostatic Pressure Testing................................................................................................... 45 5.10 Sterilization and Bacteriological Testing.................................................................................... 46 2020 Design Standards and Specifications Table of Contents 5.11 Restoration and Clean Up........................................................................................................ 47 5.12 Warranty and Acceptance....................................................................................................... 48 SECTION6.......................................................................................................................................49 STANDARD SPECIFICATIONS FOR SANITARY SEWER MAIN CONSTRUCTION ............................... 49 6.01 General.................................................................................................................................49 6.02 Plan Requirements................................................................................................................. 49 6.03 Plan Approval......................................................................................................................... 49 6.04 Inspection............................................................................................................................. 49 6.05 Specifications.........................................................................................................................49 6.06 Materials of Construction........................................................................................................ 50 6.07 Methods of Construction......................................................................................................... 54 6.08 Inspection, Testing, Approval and Acceptance of Gravity Flow Sanitary Sewer Pipe and Manholes. 63 6.09 Lift Station............................................................................................................................. 69 6.10 Restoration and Clean Up........................................................................................................ 70 6.11 Warranty and Acceptance....................................................................................................... 71 SECTION7....................................................................................................................................... 73 APPROVED MATERIALS AND MANUFACTURERS LIST..................................................................... 73 7.01 Introduction........................................................................................................................... 73 7.02 Product Submittal Procedures.................................................................................................. 73 7.03 Evaluation Process................................................................................................................. 74 7.04 Approval Process.................................................................................................................... 74 7.05 Water System........................................................................................................................ 76 7.06 Sanitary Sewer System........................................................................................................... 83 7.07 Water and Sanitary Sewer Systems.......................................................................................... 88 SECTION8.......................................................................................................................................91 Standard Specifications for streets and drainage construction...................................................... 91 8.01 General.................................................................................................................................91 8.02 Design Standards................................................................................................................... 92 8.03 Testing and Inspection........................................................................................................... 93 8.04 Notification of Property Owners............................................................................................... 93 8.05 Protection of Utilities and Irrigation Systems............................................................................. 93 8.06 Water for Construction............................................................................................................ 94 8.07 Concrete............................................................................................................................... 95 8.08 Subgrade and Base.............................................................................................................. 103 8.09 Hot Mix Asphalt Concrete Surface(HMAC).............................................................................. 109 8.10 Micro-Surfacing....................................................................................................................116 8.11 Storm Sewer........................................................................................................................ 120 8.12 Fences................................................................................................................................ 125 8.13 Salvage of Asphalt Paving..................................................................................................... 126 8.14 Traffic Control...................................................................................................................... 126 8.15 Prosecution of the Work and Working Days............................................................................ 127 8.16 Measurement and Payment................................................................................................... 128 8.17 Restoration and Clean Up...................................................................................................... 131 8.18 Certificate of Completion and Warranty .................................................................................. 131 SECTION9.....................................................................................................................................132 CHECK LIST FOR STREETS AND DRAINAGE CONSTRUCTION PLANS............................................133 9.01 Plan Submittal Requirements................................................................................................. 133 9.02 Plan Details......................................................................................................................... 136 SECTION10...................................................................................................................................139 TYPICAL DETAILS OF CONSTRUCTION..........................................................................................139 10.01 General Details........................................................................................................................A 10.02 Water Details...........................................................................................................................B 10.03 Sewer Details...........................................................................................................................0 10.04 Street and Drainage Details...................................................................................................... D 2020 Design Standards and Specifications Water Standards SECTION 1 MINIMUM DESIGN STANDARDS FOR WATER DISTRIBUTION 1.01 General 1.01.01 All water distribution system design shall be in accordance with the requirements of TCEQ Chapter 290, AWWA Standards, City of Lubbock Water System Master Plan, current City ordinances and the City of Lubbock Minimum Design Standards for Water Distribution. 1.02 Desian Flow 1.02.01 The design of the water distribution system shall be based on the following: A. Design flow for residential use: Design Criteria Design Value Units Peak Hourly Demand 1,000 gpcd Maximum Daily Demand 650 gpcd Average Daily Demand 240 gpcd Capita per Household (Single Family) 3.2 persons Capita per Household(Multi-family) 2.5 persons i. Domestic water service shall be provided from an alley or easement. ii. Lines in alleys or easements shall be adequate to provide for a maximum size water meter of 1-1/2 inches per lot for each 75 feet of frontage. iii. Property owner may acquire a maximum domestic water tap and meter of 1-1/2 inches or the equivalent in two meters per lot for each 75 feet of frontage. iv. Minimum size water tap and meter shall be one inch. B. Design flow for fire protection: Proposed Use Minimum Fire Flow (gpm) 1- and 2-Family Residential 1,000 Other Than 1- and 2-Family Residential 1,500-8,000 i. Fire protection service shall be provided from a street right-of-way or comparable easement. ii. Flow may be from more than one fire hydrant, provided the additional hydrants are accessible to any possible fire location. iii. Fire protection must comply with Fire Marshall's Office regulations, and in no case be less than currently adopted International Fire Code requirements. iv. Additional infrastructure may be required to provide fire protection service when existing water distribution lines are inadequate. Section 1 1 2020 Design Standards and Specifications Water Standards C. Design flow for development other than residential use shall be based on the following or as directed by the City Engineer or designee: Type of Development Average Daily Demand (gal/person/day) Restaurant 18 Without cafeteria or showers 18 School With cafeteria; no showers 24 With cafeteria and showers 30 Without cafeteria, restrooms or showers 6 Youth With restrooms; no cafeteria or showers 24 camp With restrooms and showers; no cafeteria 30 With restrooms, showers and cafeteria 42 Office building 18 Hospital(per bed 720 Institution other than hospital) 240 Factories exclusive of industrialprocesses) 24 Recreational Parks 6 Swimming pools 12 Country clubs 120 Airport(per passenger) 6 Self-service laundry 60 Service station/convenience store 12 i. Peak hourly demand for other than residential flows shall be 2.5 times the average daily demand. 1.03 Design Pressure 1.03.01 Distribution system shall have a maximum operating pressure of 150 pounds per square inch (psi) and a minimum operating pressure of 40 psi. 1.03.02 Distribution system shall maintain a 20 psi residual pressure during required fire flow and a 40 psi residual pressure during peak hourly demand. 1.04 Hydraulic Design 1.04.01 Distribution mains shall be designed to have a maximum velocity of 10 feet per second. 1.04.02 Distribution mains shall be designed using a Hazen -Williams friction coefficient "C" equal to 140. 1.05 Typical Layout 1.05.01 Unless approved otherwise by the City Engineer or designee, water distribution mains shall be located: A. In north -south alleys or streets, 5 feet west of centerline. B. In east -west alleys or streets, 5 feet north of centerline. 1.05.02 Water mains to provide service connections shall be located within an alley or easement. A. Service connections shall not be allowed within street right-of-way without written approval of the City Engineer or designee. 2 Section 1 2020 Design Standards and Specifications Water Standards B. Service lines shall not cross property boundaries into adjacent private property without coverage by a dedicated easement. 1.05.03 Where a water distribution main crosses a street, the crossing shall be made at as near to perpendicular as possible. 1.05.04 Valves shall be installed at each junction such that no more than one connecting leg is unvalved. A. At street intersections, valves shall be located at right-of-way lines unless flanged fittings are required. B. At alley intersections with streets, valves shall be located 2 feet from the right of way line towards the centerline of the street where possible. C. Where possible, valves in streets should be designed to fall outside of wheel paths. 1.05.05 Water mains shall be designed as looped systems. 1.05.06 Minimum radius of curvature and maximum deflection angle of pipe joints shall be restricted to 80% of manufacturer's recommendation, after which the use of horizontal or vertical bends will be required. 1.05.07 In all instances water mains shall extend to the extremities of the platted property or the subdivision served, and further when required to tie into existing mains adjacent to the development. 1.06 Beddina and Cover 1.06.01 Water distribution mains shall ordinarily have a minimum of 4 feet of cover from top of pipe to finished ground surface. 1.06.02 All water lines shall be laid as horizontal as possible, avoiding excessive numbers of high or low points. 1.06.03 Pipe bedding and embedment shall be in accordance with the Standard Specifications for Water Main Construction but in all cases shall be not less than manufacturer recommendations. 1.07 Relation to Sanitary Sewer Mains and Appurtenances 1.07.01 No physical connection shall be made between a drinking water supply and a sewer line. A. Appurtenances shall be designed and constructed so as to prevent any possibility of sewage entering the drinking water system. 1.07.02 Water lines shall be located a minimum of 9 feet horizontally outside to outside from existing or proposed sanitary sewer lines or appurtenances. A. Where the 9 foot separation distance cannot be achieved, the following criteria shall apply: i. New waterline installation —parallel lines: a. Where a new potable waterline parallels an existing, non -pressure or pressure rated sanitary sewer main and the Design Engineer is able to determine that the existing sanitary sewer main is not leaking: Section 1 3 2020 Design Standards and Specifications Water Standards (1) The new potable waterline shall be located a minimum of 2 feet above and a minimum of 4 feet horizontally between outside diameters from the existing sanitary sewer main. (2) Every effort shall be exerted not to disturb the bedding and backfill of the existing sanitary sewer main. b. Where a new potable waterline parallels an existing, non -pressure or pressure rated sanitary sewer main and it cannot be determined by the Design Engineer if the existing line is leaking: (1) The existing sanitary sewer main shall be replaced with at least 150 psi pressure rated pipe. (2) The new potable waterline shall be located a minimum of 2 feet above and a minimum of 4 feet horizontally between outside diameters from the existing sanitary sewer main. c. Where a new potable waterline parallels a new sanitary sewer main: (1) The sanitary sewer main shall be constructed of at least 150 psi pressure rated pipe. (2) The new potable waterline shall be located a minimum of 2 feet above and a minimum of 4 feet horizontally between outside diameters from the existing sanitary sewer main. ii. New waterline installation —crossing lines: a. Where a new potable waterline crosses over an existing, non -pressure rated sanitary sewer main: (1) A minimum 2 foot separation distance between outside diameters shall be maintained. (2) One segment of the waterline pipe shall be centered over the sanitary sewer main such that the joints of the waterline pipe are equidistant and at least 9 feet horizontally from the centerline of the sanitary sewer main. (3) Whenever possible, the crossing shall be centered between the joints of the sanitary sewer main. (4) Every effort shall be exerted not to disturb the bedding and backfill of the existing sanitary sewer main. (5) If the existing sanitary sewer main is disturbed or shows signs of leaking, it shall be replaced for at least 9 feet in both directions (18 feet total) with at least 150 psi pressure rated pipe. b. Where a new potable waterline crosses over an existing, pressure rated sanitary sewer main: (1) An absolute minimum separation distance of 6 inches between outside diameters shall be maintained. (2) One segment of the waterline pipe shall be centered over the sanitary sewer main such that the joints of the waterline pipe are equidistant and at least 9 feet horizontally from the centerline of the sanitary sewer main. (3) Whenever possible, the crossing shall be centered between the joints of the sanitary sewer main. (4) Every effort shall be exerted not to disturb the bedding and backfill of the existing sanitary sewer main. (5) If the existing sanitary sewer main is disturbed or shows signs of leaking, it shall be replaced for at least 9 feet in both directions (18 feet total) with at least 150 psi pressure rated pipe. 4 Section 1 2020 Design Standards and Specifications Water Standards c. Where a new potable waterline crosses over a new, non -pressure rated sanitary sewer main: (1) A minimum 2 foot separation distance between outside diameters shall be maintained. (2) One segment of the waterline pipe shall be centered over the sanitary sewer main such that the joints of the waterline pipe are equidistant and at least 9 feet horizontally from the centerline of the sanitary sewer main. (3) Whenever possible, the crossing shall be centered between the joints of the sanitary sewer main. (4) The sanitary sewer main shall be embedded in flowable fill from one quarter of the diameter of the sanitary sewer main below the centerline of the pipe up to 12 inches above top of pipe for the total length of one pipe segment, minimum 9 feet in each direction from water line, plus 12 inches beyond the joint on each end. d. Where a new potable waterline crosses over a new, pressure rated sanitary sewer main: (1) An absolute minimum separation distance of 6 inches between outside diameters shall be maintained. (2) The sanitary sewer main shall be constructed of at least 150 psi pressure rated pipe. (3) One segment of the waterline pipe shall be centered over the sanitary sewer line such that the joints of the waterline pipe are equidistant and at least 9 feet horizontally from the center line of the sanitary sewer main. (4) Whenever possible, the crossing shall be centered between the joints of the sanitary sewer main. (5) The sanitary sewer main shall be embedded in flowable fill from one quarter of the diameter of the sanitary sewer main below the centerline of the pipe up to 12 inches above top of pipe for the total length of one pipe segment, minimum 9 feet in each direction from water line, plus 12 inches beyond the joint on each end. e. When a new potable waterline crosses under a sanitary sewer main: (1) An absolute minimum separation distance of 1 foot between outside diameters shall be maintained. (2) The waterline shall be encased in an 18-foot or longer section of pipe or be constructed of ductile iron or steel pipe with mechanical or welded joints as appropriate. (3) The encasing pipe shall be centered on the sewer line and shall be at least 2 nominal pipe diameters larger than the water line. (4) The carrier pipe shall be supported at 5-foot or less intervals with spacers. (5) Each end of the casing shall be sealed with watertight non -shrink cement grout or a manufactured watertight seal. (6) Both the waterline and sanitary sewer main must pass a pressure and leakage test as specified in AWWA C600. iii. The use of brown coloring in flowable fill for pressure rated sanitary sewer main embedment is recommended for identification during future construction. iv. In all cases, suitable backfill or other structural protection shall be provided to preclude settling and/or failure of the higher pipe. Section 1 5 2020 Design Standards and Specifications Water Standards B. Location of fire hydrants i. Fire hydrants shall not be installed within 9 feet vertically or horizontally of any sanitary sewer main, manhole or service line regardless of construction. C. Location of potable or raw water supply or suction lines i. Suction mains to pumping equipment shall not cross sanitary sewer mains or sanitary sewer service lines. ii. Raw water supply lines shall not be installed within 5 feet of any tile or concrete sanitary sewer main or sanitary sewer service line. D. Proximity of septic tank drain fields i. Waterlines shall not be installed closer than 20 feet to septic tank drain fields. 1.07.03 Water and sewer lines shall be installed in separate trenches. 1.07.04 For other instances not covered in these design standards, consult current TCEQ regulations. 1.08 Pine Size and 1.08.01 Distribution mains shall be located and sized in accordance with the current City of Lubbock Water System Master Plan and current TCEQ rules: Water Line Size Spacing 16-inch or larger Section Line mile 10- or 12-inch Half -Section Line 1/2 mile 6- or 8-inch Eighth -Section Line (660 feet) 1.08.02 The standard pipe sizes that shall be used are 4-, 6-, 8-, 10-, 12-, 16-, 20- and 24-inch. Pipe sizes not listed here are considered non-standard and shall not be used in the City of Lubbock water distribution system, unless approved by the City Engineer or designee. 1.09 Pipe Materials 1.09.01 All pipe used in the City of Lubbock water distribution system shall be Cement -lined Ductile Iron, C900 PVC, C905 PVC, C301 Prestressed -Concrete Steel Cylinder Pressure or Concrete Bar -wrapped Steel Cylinder Pressure Pipe. 1.09.02 See City of Lubbock Standard Specifications for Water Main Construction for details on materials and methods of construction. 1.10 Methods of Connection 1.10.01 Tapping Sleeves A. Tapping sleeves with tapping valves shall be used whenever possible for connections to existing mains in order to avoid interruption of water service. B. Maximum tap size shall be no larger than one standard size smaller than the main to be tapped. C. Size -on -size taps shall not be allowed without prior approval by the City Engineer or designee. D. Using a tapping sleeve of one standard size smaller than the main to be tapped and immediately increasing the pipe to a larger size shall not be allowed without prior approval by the City Engineer or designee. 6 Section 1 2020 Design Standards and Specifications Water Standards 1.10.02 Cut -in Tees A. When it is necessary for a size -on -size connection and interruption of water service is not an issue, a cut -in tee with valve shall be used. B. Cut -in tees shall not be used without prior approval by the City Engineer or designee. 1.10.03 Service Connections A. Taps shall be provided in water main lines for service connections at each lot or building site. B. Service connections shall ordinarily be located 5.0 feet north or west of the centerline of the lot. C. Service lines shall not cross property boundaries into adjacent private property without coverage by a dedicated easement. D. Typical sizes of service connections are 1 inch, 1 1/2 inch, or 2 inch diameter for residential, commercial, or industrial service. Service taps 3 inches or larger are available for commercial and industrial only. E. Maximum size service connection shall be no larger than one standard size smaller than the main to be tapped. F. Size -on -size service connections are not allowed. 1.11 Flanaed Outlets 1.11.01 All side outlets for valve attachments on lines 16-inches and larger shall be flanged. 1.12 Valve Spacing 1.12.01 Valves shall be provided in the distribution system so that no single accident, break or repair will necessitate shutting down a length of pipe greater than 600 feet. A. On distribution mains 12-inch diameter and smaller, valves shall be located at each tee, cross or other junction. B. Valves shall be installed at each junction such that no more than one connecting leg is unvalved. 1.12.02 On 16-inch arterial mains, valves shall be spaced no greater than 800 feet as the arterial feeder main traverses undeveloped land or is not intersected by other distribution mains. 1.12.03 Transmission mains 20-inch diameter and larger shall be equipped with valves at one-half mile intervals unless intersected by arterial mains or other distribution mains, or it is determined that more valves are required. 1.13 Fire Protection Requirements 1.13.01 Fire protection must comply with Fire Marshall's Office regulations, and in no case be less than currently adopted International Fire Code requirements. A. Each building in the city limits shall be within 500 feet of a fire hydrant, as measured by lay - of -hose length. IL. 13.02 In all cases, the following criteria shall be adhered to: A. Fire hydrant leads shall be minimum 6-inch diameter, sole purpose and shall not exceed 150 feet in length. The entire length of the lead shall be mechanically restrained. Section 1 7 2020 Design Standards and Specifications Water Standards B. Private fire protection lines and hydrant leads shall connect at the main with a gate valve or tapping valve of at least equal size to the fire protection line. C. A fire hydrant is required within 200 feet of a Fire Department Connection. D. Fire lines from public mains to buildings shall be installed by a state certified fire sprinkler firm and tested to Fire Marshall's Office requirements. E. Fire hydrants shall be located at intersections wherever possible. i. Consult Section C-104 of the International Fire Code for requirements on hydrants that may obstruct access during fire fighting operations. F. A hydrant shall be placed at the throat or beginning of each cul-de-sac at the intersecting street. i. Additional fire hydrants may be required based on length of cul-de-sac. ii. Fire hydrants placed at the bulb end of cul-de-sacs should be avoided. G. On divided highways hydrants shall be placed on each side of the highway wherever possible. H. Fire hydrants shall be installed with the 4-inch nozzle facing the required access way or street. I. Fire hydrants shall be installed and maintained so that the center of the lowest water outlet is 18 inches above the ground. J. Fire hydrants shall be placed so that they are readily visible from the street and shall be no closer than 2 feet nor further than 5 feet from back of curb. K. A reflective, blue, raised pavement marker shall be placed at the center of the required access way or street for any new fire hydrant installation, in line with the 4-inch nozzle. L. No bushes, ground cover over 6 inches in height, or other obstructions shall be placed within a 5 foot radius in all directions of a hydrant or fire department connection. M. Where fire hydrants are vulnerable to vehicular damage, appropriate crash posts shall be provided. i. No obstructions shall exist within a 3-foot working area of each fire hydrant. ii. Crash posts shall be 4-inch, cement -filled pipe with a minimum of 3 feet above finished grade and 2 feet of pipe anchored in concrete below grade. N. Fire hydrants shall be in operation before framing is started or combustibles are stored on any construction site. 0. Streets and fire access roadways shall be able to support fire apparatus in wet weather before framing is started or combustibles are stored on any construction site. P. Fire hydrant shall be installed with flange 0.2 to 0.4 foot above finished grade so that the bury line will be between finished grade and 0.2 foot above finished grade. Q. No size -on -size taps for fire suppression shall be allowed. 1.14 Easements 1.14.01 When it is determined not to be feasible to construct a public water distribution main in a street or alley, the installation may be made in a dedicated easement or right-of-way. 1.14.02 The minimum width of an easement or right-of-way for a public water distribution main is 10 feet exclusive, 20 feet if shared with a public sanitary sewer main or other utilities or if depth of water distribution main is greater than 10 feet. 1.14.03 Easements will not be allowed between residential lots unless they are in combination with a drainage easement or with prior approval from the City Engineer or designee. 8 Section 1 2020 Design Standards and Specifications Water Standards 1.14.04 When a fire hydrant is to be installed on private property, an easement shall be dedicated which provides a minimum of 5 feet clearance in all directions from the center of the fire hydrant. 1.15 Soil Ana 1.15.01 The Contractor or Design Engineer may be required to submit a report showing the types and characteristics of the soils to be encountered, water table elevations along the proposed water distribution main, recommended methods of dewatering for water distribution main construction, and the recommended methods of backfilling and compacting to be used. 1.16 Pipe Restraints and Reaction Blocking 1.16.01 The size of required pipe restraints and reaction blocks shall be determined by the Design Engineer for the project based on the allowable soil pressure and the anticipated working pressure plus water hammer of the line. 1.16.02 For restrained joint lengths required, refer to Appendix A as derived from EBAA Iron, Inc. 1.17 Tunneling, Jacking and Bori 1.17.01 Tunneling, jacking and boring are methods used for water line placement under restrictive conditions when open cut construction is not allowed. A. Only straight pipe alignments for both horizontal and vertical alignment are allowed. B. Casing shall extend full width of right-of-way or as directed by the City Engineer or designee. C. Casing pipe shall be a minimum of two standard sizes larger than encased pipe. D. Casing pipe thickness shall be: Casing Diameter Minimum Casing Thickness <24 inches 3/8 inch >_24 inches 1/2 inch E. Manufactured centralizers or spacers shall be required at minimum 5-foot intervals or as recommended by the manufacturer. Only purpose-built centralizers may be used. F. Coal tar coating for casing pipe shall conform to AWWA C203. G. For bores in excess of 100 feet, purpose-built fused or restrained joint pipe shall be used. H. All bores must comply with City Utility Excavation Manual. 1.17.02 Slick boring or directional drilling without encasement shall be considered on a case -by - case basis by the City Engineer or designee. All slick bores shall be restrained or encased. 1.17.03 No annular space shall remain between casing, or uncased pipe, and bored hole. 1.17.04 Unbraced, uncased bore holes shall be left open no more than 24 hours. Section 1 9 2020 Design Standards and Specifications Water Standards 1.18 Dead-end Mains 1.18.01 A dead-end main is defined as a length of water line greater than 150 feet with no looped connection. 1.18.02 Dead-end mains shall not be allowed unless approved by the City Engineer or designee. 1.18.03 Where dead-end mains are necessary as a stage in the growth of the system, they shall be designed so that: A. The system may be periodically flushed by use of a blow -off valve or fire hydrant, or B. A temporary looped connection is installed. 1.19 Abandonment of Water Mains 1.19.01 When a water line is to be abandoned, allowances shall be made so that existing and new water mains may be in service simultaneously, thereby providing a means for transferring customer's service from the old main to the new main with minimal interruption. 1.19.02 If the construction of a proposed main necessitates the abandoning of the existing main prior to the new main's placement into service, provisions for a temporary water main with services must be addressed. 1.19.03 On mains to be abandoned, the designer shall note locations of cut and plug as close as possible to the main that remains in service. 1.19.04 Fire hydrants, valves and other fittings located on mains to be abandoned shall be removed and delivered to the City of Lubbock Water Utilities Department. 10 Section 1 2020 Design Standards and Specifications Water Check List SECTION 2 CHECK LIST FOR WATER DISTRIBUTION CONSTRUCTION PLANS 2.01 Plan Submittal Requirements 2.01.01 All water main construction plans shall be checked for conformance with City of Lubbock Minimum Design Standards for Water Distribution prior to submittal to the Engineering Department. Approval of plans is for general conformance with the City of Lubbock Minimum Design Standards and Specifications. Approval of plans shall not relieve the Engineer or Developer from any City, State or other governing requirements nor for errors or omissions in plans and specifications. 2.01.02 Plan Review A. The Design Engineer shall submit water main construction plans to the City Engineer or designee for review and comment. The Design Engineer shall use the City of Lubbock Customer Self Service (CSS) website to submit plans. http://egovaccess.ci.lubbock.tx.us/EnerGov Prod/SelfService/#/home B. Please call 806-775-2347 if you have any questions regarding the CCS submission process. C. Upon completion of review and receipt of payment for appropriate Plan Review fees, comments shall be returned to the Design Engineer on the CSS website. i. Plans requiring resubmittal for substantial changes as determined by City Engineer or Designee may require payment of an additional Plan Review fee. D. After comments have been addressed and changes have been made the Design Engineer will submit the revised plan using CSS website. i. If comments have not been addressed on plans submitted for final approval for construction the plans will be rejected. ii. Plans will not be approved unless testing and inspection fees have been paid. iii. If the design engineer does not submit plans for approval within 6 months of comments being issued or if fees are not paid within 6 months then the review will be terminated and the design engineer will have to start the plan review process over. E. Upon approval, the city will return an electronic copy of the plan stamped "Approved for Construction" through the CSS web site. i. The design Engineer will be required to submit two half size copies of the approved for construction stamped plans. F. Final construction plans should not be submitted for Engineering Department approval for work that will not be installed within 6 months of the approval date. i. Delays between approval date and construction may require resubmittal of the plans for review under current standards. 2.01.03 Pro Rata Estimate and Fees A. The Pro Rata Cost Estimates shall be submitted for review at the time of plan review submittal. B. Plan Review Fees in the amount of 0.5% of the Pro Rata Cost Estimate (minimum $50) shall be submitted at the time of plan review submittal. Section 2 11 2020 Design Standards and Specifications Water Check List C. Inspection and Testing Fees in the amount of 1.5% of the Pro Rata Cost Estimate (minimum $125) shall be submitted prior to construction. D. In the event of significant changes in design, an updated Pro Rata Cost Estimate shall be submitted and resulting differences in fee amounts settled. 2.01.04 Checklist A. A copy of the completed "City of Lubbock Municipal Water and Sewer Submittal Checklist" shall be submitted at the time of plan review submittal. The checklist can be found in the Appendix. 2.01.05 Construction Plans A. All plans to be used or kept on the job site shall be original or reproduced plan sets clearly marked "Approved for Construction" with the signature of reviewer and date approved by the Engineering Department. B. Should circumstances during construction warrant changes from the approved plans or specifications, a written approval must be obtained from the Engineering Department. i. Copies of the written approval shall be attached to the construction plans and maintained on the job site. 2.01.06 Record Drawings A. The Design Engineer shall be responsible for recording constructed dimensions and information on a set of Record Drawings during the progress of construction. i. The City of Lubbock Engineering Department shall monitor this process to assure that changes in construction are kept up to date on the Record Drawings. B. Digital PDF "Record Drawings" certified by the Design Engineer shall be submitted to the Engineering Department on the CSS website within 30 days of completion of the construction. i. Record Drawings shall include locations of all valves, valve vaults, fire hydrants, bends and tees or other changes in main pipe direction, material or size. a. GPS Coordinates or property ties are acceptable. C. Where the construction is phased and a lapse of more than 60 days occurs between phases, then Record Drawings shall be submitted to the Engineering Department reflecting the completed construction prior to issuance of the Certificate of Acceptance of Utility Construction. D. Items required to be submitted with Record Drawings: i. Letter of Transmittal ii. Record Drawing iii. Updated Pro Rata Cost Estimate iv. Certificate of Completion (Provided to Contractor from City Inspector) v. Developer's Warranty Statement (See Appendix) vi. Adjacent Mains Refund Contract (see Apendix) 2.01.07 Acceptance A. Upon completion of construction, satisfactory system tests and submittal of Record Drawings, the Design Engineer shall submit a request to the City Engineer or designee for a Certificate of Acceptance of Utility Construction. i. Water distribution system improvements shall not be put online or brought into service without written approval by the Engineering Department. 12 Section 2 2020 Design Standards and Specifications Water Check List ii. A newly constructed system will not be accepted until the supplying, adjacent system has been accepted. iii. A Certificate of Acceptance of Utility Construction shall not be issued until Record Drawings are provided to the Engineering Department. iv. When all paperwork has been completed and provided to the City with a written notification, utilities will be accepted within 30 days if there is no exception by the City. B. Building Permits for residential developments and Certificates of Occupancy for commercial facilities to be serviced by a newly constructed water system will not be released by the Engineering Department until said system has been brought into service. 2.02 Plan Details 2.02.01 Plan Format A. Standard drawing size shall be 22-inch by 34-inch. 2.02.02 The following information shall be shown on the plans: A. General i. Title Block (lower right hand corner preferred) ii. Scale iii. Original Date and Revision Dates iv. Name of Professional Engineer v. Professional Engineer's Seal vi. Firm Name and Contact Information vii. City of Lubbock Engineering Department Contact Information: a. Development Services Engineering: (806) 775-2347 b. Senior Inspector: (806) 548-4152 viii. Drawings Number(s) ix. Legal Description of Property Being Improved x. Location Map or Plat (if available) A. Statement: "All work shall be performed in accordance with the current version of the City of Lubbock Minimum Design Standards and Specifications." B. Plan i. Bench Marks ii. North Arrow iii. Property Lines iv. Street Names and Easements with Width Dimensions v. Other Pertinent Details (Buildings, Curbs, Water Courses, Etc.) vi. Proposed Water Mains (Bold) a. Stationing b. Size c. Length d. Material and Type of Joints e. Location Dimensions f. Fittings Section 2 13 2020 Design Standards and Specifications Water Check List g. Tees h. Crosses i. Reducers j. Bends k. Plugs I. Blow -offs m. Thrust Blocks n. Valves o. Fire Hydrants vii. Existing Utility Lines (Gray) with Location and Depth According to the Following Standard: WWw WATER LINE s s s SANITARY SEWER LINE G G G GAS LINE FOc FIBER OPTIC CABLE FOc CATV CATV CABLE TELEVISION SWSw- STORM WATER LINE UGE UGE UNDER GROUND ELECTRIC OHE OHE OVER HEAD ELECTRIC UGT UGT UNDER GROUND TELEPHONE OHT OVER HEAD TELEPHONE OHT Ts TS TRAFFIC SIGNAL LINE 14 Section 2 2020 Design Standards and Specifications Water Check List C. Profile (required for water lines greater than 12-inch diameter) i. Ground Surface - Existing (Dotted) and Proposed (Solid) ii. Station Numbers iii. Existing and Proposed Utilities Where Crossed iv. Proposed Water Main Control Elevation and Grades D. Plan, Profile and Complete Details for Off -Site Transmission Mains, Pump Stations, Special Valves and Vaults, Tanks, Etc. E. Detail Sheet - As Required i. Standard Bedding Detail ii. Thrust Block and Joint Restraint Tables iii. Fire Hydrant Detail iv. Tapping Details v. Air Valve Detail vi. Blow -off Detail vii. Crossing Detail F. Overall Layout Sheet - If Required i. Scale 1 "=100' ii. Lot Lines iii. Streets and Street Names iv. Water Line Sizes and Material v. Valves vi. Fire Hydrants vii. Connections to Existing System Section 2 15 2020 Design Standards and Specifications Water Check List 16 Section 2 2020 Design Standards and Specifications Sewer Standards SECTION 3 MINIMUM DESIGN STANDARDS FOR SANITARY SEWERS 3.01 General 3.01.01 All sanitary sewer system design shall be in accordance with the requirements of TCEQ Chapter 217, AWWA Standards, City of Lubbock Sewer System Master Plan, current City ordinances and the City of Lubbock Minimum Design Standards for Sanitary Sewers. 3.02 Desian Flow 3.02.01 The design of the sanitary sewer system shall be based on the following: A. For sewers in new developments sewer main lines and lift stations shall be designed for the estimated future population to be served plus adequate allowance for future institutional and commercial flows. Minimum flow capacity for sizing of sewers for peak flow conditions shall not be less than the following: Design Criteria Design Value Units Average Daily Flow 100 gpcd Peak Factor, 2-hour flow <0.5 MGD 5 - Peak Factor, 2-hour flow >0.5 MGD 4 Capita per Household (Single Family) 3.2 persons Capita per Household(Multi-family) 2.5 persons C. Minimum residential population density shall be figured on a basis of 6 houses per acre, and 70 percent of total land area developed as residential, unless detailed analysis of the area to be served indicates differently. D. Design flow for development other than residential use shall be based on the following or as directed by the City Engineer or designee: Type of Development Design Criteria Daily Flow - gpcd Trailer Park — transient 2.5persons/trailer 50 Mobile Home Park 3persons/trailer 75 School with cafeteria With showers 20 Without showers 15 Recreational Parks Day Use 5 Overnight Use 30 Commercial/Industrial Building 20 Motel 50 Restaurant Per meal served 5 Hospital Per bed 200 Nursing Home Per bed 100 Section 3 17 2020 Design Standards and Specifications Sewer Standards 3.03 Hvdraulic Desian 3.03.01 The minimum velocity at the design flow rate shall be 2.0 feet per second. 3.03.02 Maximum allowable velocity shall be 10 feet per second. 3.03.03 Manning's coefficient for design purposes shall be n=0.013 for PVC pipe. 3.03.04 Manhole inverts shall be designed in such a manner that the energy gradient is consistently falling in the direction of flow. 3.04 Desian Details 3.04.01 Sewer Pipe A. The standard pipe sizes that shall be used are 6-, 8-, 10-, 12-, 15-, 18- and 21-inch. Pipe sizes not listed here are considered non-standard and shall not be used in the City of Lubbock sanitary sewer system, unless approved by the City Engineer or designee. B. The following City slope standards shall apply to sanitary sewer mains: (refer to TCEQ guidelines 30 TAC Section 217.53.1.2.A Table C. I.) Pipe Diameter Minimum Slope (%) Maximum Slope (%) 6 inch 0.60 [0.50 TCEQ] 12.35 8 inch 0.40 [0.33 TCEQ] 8.40 10 inch 0.28 [0.25 TCEQ] 6.23 12 inch 0.22 [0.20 TCEQ] 4.88 15 inch 1 0.15 [0.15 TCEQ] 3.62 18 inch 1 0.12 [0.11 TCEQ] 2.83 C. Sewer main lines shall be straight between manholes both in line and grade. D. All sewer main lines shall terminate in a manhole. i. Cleanouts on sewer main lines shall not be permitted without written approval of the City Engineer or designee. 3.04.02 Manholes A. Manholes shall be a minimum of 48-inch diameter and shall be provided at every change in direction, grade, or connection with other sewer main lines. B. Manhole spacing and depth shall be as follows: Pipe Diameter Manhole Depth Manhole Diameter Max. Spacing Between Manholes 15 inches or smaller 0-16 Ft. 48 in. 500 Ft. 15 inches or smaller Over 16 Ft. 60 in. 500 Ft. Over 15 inches All depths 60 in. 800 Ft. C. Manholes greater than 16 feet deep or serving pipes larger than 15 inches shall be 60-inch diameter and include a protective coating system per the Approved Materials List. D. Connections at manholes shall be designed such that the crowns of connecting pipes are equal elevation if possible. E. Force mains shall discharge directly into a manhole through a 900 downspout connection. 18 Section 3 2020 Design Standards and Specifications Sewer Standards F. Manholes receiving force main discharge shall include a protective coating system per the Approved Materials List. G. Minimum elevation difference across manhole inverts shall be as follows: Deflection Angle Between Inlet/Outlet Min. Elevation Difference Less than 3011 0.10 Ft. Greater than 300 0.20 Ft. H. Drop manholes shall be provided for sewer main lines entering a manhole at an elevation 24 inches or more above the manhole invert. i. Drop connections on new manholes shall be constructed with an exterior or "outside" drop system on all 48 inch manholes. All "outside" drops shall be flow filled against undisturbed soil up to the depth of the main. ii. Drop connections on existing manholes shall be constructed with an interior or "inside" drop system. "Inside" drops shall be allowed for existing 60 inch manholes only. I. Where the difference in elevation is less than 24 inches, the invert shall be filleted to prevent solids deposition. J. Manholes shall be stubbed out with suitable size pipe wherever future extension of the sewer is anticipated. i. Stub -outs shall extend beyond the edge of existing or proposed paving. K. Inflow Prevention Devices (IPDs) shall be specified on all new manhole installations. 3.04.03 Service Connections A. Tees or wyes shall be provided in sewer main lines for service connections at each lot or building site. B. Service connections shall ordinarily be located 5.0 feet south or east of the centerline of the lot. C. Service lines shall not cross property boundaries into adjacent private property without coverage by a dedicated easement. D. Minimum size service connections shall be 4 inch diameter. E. Maximum size service connection shall be no larger than one standard size smaller than the main to be tapped. F. Size -on -size service connections are not allowed. G. Gravity sewer taps shall connect to sewer main lines at or above the spring line. H. No gravity service lines shall discharge directly into a manhole. I. Service connections shall not be installed within 5 feet of the outside wall of a manhole. 3.05 Typical Layout 3.05.01 Unless approved otherwise by the City Engineer or designee, sanitary sewer mains shall be located: A. In north -south alleys or streets, 5 feet east of the centerline. B. In east -west alleys or streets, 5 feet south of the centerline. Section 3 19 2020 Design Standards and Specifications Sewer Standards 3.05.02 Sanitary sewer mains to provide service connections shall be located within an alley or easement. A. Service connections shall not be allowed within street right-of-way without written approval of the City Engineer or designee. B. Service connections shall not be deeper than 12 foot without prior written approval from the City Engineer or designee. 3.05.03 Where a sanitary sewer main crosses a street, the crossing shall be made at as near to perpendicular as possible. 3.05.04 Manholes shall be located as to provide access for maintenance crews and equipment. A. Where possible, manholes in streets should be designed to fall outside of wheel paths. B. Where possible, manholes in alleys should be designed to fall at the projected intersection of perpendicular lot lines. 3.05.05 In all instances sanitary sewer mains shall extend to the extremities of the platted property or the subdivision served. 3.06 Beddina and Cover 3.06.01 Sewer mains shall have a minimum of 4 feet of cover from top of pipe to proposed finished ground surface unless approved by City Engineer or designee. A. Where less than 5 feet of elevation difference between the finished lot grade at building line and the top of the sewer main is provided, the plans shall indicate that the lot is served by a "shallow sewer" and appropriate elevation information shall be given. B. Where a sewer main has less than 4 feet of cover, provisions shall be made to protect the pipe from impact loading when located in a street or alley. C. Maximum sanitary sewer depth in alleys shall be 12 feet unless approved by the Engineering Department. 3.06.02 Pipe bedding and embedment shall be in accordance with the Standard Specifications for Sanitary Sewer Main Construction but in all cases shall be not less than manufacturer recommendations. 3.07 Relation to Water Mains 3.07.01 No physical connection shall be made between a drinking water supply and a sewer line. A. Appurtenances shall be designed and constructed so as to prevent any possibility of sewage entering the drinking water system. 3.07.02 Sewers shall be located a minimum of 9 feet horizontally outside to outside from existing or proposed water mains. A. Where the 9-foot separation distance cannot be achieved, the following guidelines shall apply: i. New sanitary sewer installation — parallel lines: a. Where a new sanitary sewer main parallels a water line: (1) The sewer shall be constructed of ductile iron or PVC meeting ASTM specifications with a pressure rating for both the pipe and joints of 150 psi. (2) The vertical separation shall be a minimum of 2 feet and the horizontal separation shall be a minimum of 4 feet between outside diameters. 20 Section 3 2020 Design Standards and Specifications Sewer Standards (3) The sewer shall be located below the water line. ii. New sanitary sewer installation — crossing lines: a. Where a sanitary sewer crosses under a water line and the sewer is constructed of ductile iron or PVC with a minimum pressure rating of 150 psi: (1) An absolute minimum separation distance of 6 inches between outside diameters shall be maintained. (2) One segment of the sewer pipe shall be centered on the water line such that the joints of the sewer pipe are equidistant and at least 9 feet horizontally from the centerline of the water line. (3) Whenever possible, the crossing shall be centered between the joints of the waterline. (4) The sanitary sewer main shall be embedded in flowable fill from one quarter of the diameter of the sanitary sewer main below the centerline of the pipe up to 12 inches above top of pipe for the total length of one pipe segment, minimum 9 feet in each direction from water line, plus 12 inches beyond the joint on each end. b. Where a sanitary sewer crosses under a water line and the sewer is constructed of ABS truss pipe, similar semi -rigid plastic composite pipe, clay pipe or concrete pipe with gasketed joints (Non -pressure rated pipe): (1) A minimum 2 foot separation distance between outside diameters shall be maintained. (2) One segment of the sewer pipe shall be centered on the water line such that the joints of the sewer pipe are equidistant and at least 9 feet horizontally from the centerline of the water line. (3) Whenever possible, the crossing shall be centered between the joints of the waterline. (4) The sanitary sewer main shall be embedded in flowable fill from one quarter of the diameter of the sanitary sewer main below the centerline of the pipe up to 12 inches above top of pipe for the total length of one pipe segment, minimum 9 feet in each direction from water line, plus 12 inches beyond the joint on each end. c. Where a sanitary sewer crosses over a water line: (1) An absolute minimum separation distance of 1 foot between outside diameters shall be maintained. (2) All portions of the sewer within 9 feet of the water line shall be encased in a joint of 150 psi pressure class pipe at least 18 feet long and 2 nominal sizes larger than the new conveyance. (3) The carrier pipe shall be supported at 5-foot or less intervals with spacers. (4) The encasement pipe should be centered on the crossing and each end sealed with watertight non -shrink cement grout or a manufactured watertight seal. (5) Both the waterline and sanitary sewer main must pass a pressure and leakage test as specified in AWWA C600. iii. The use of brown coloring in flowable fill for pressure rated sanitary sewer main embedment is recommended for identification during future construction. iv. In all cases, suitable backfill or other structural protection shall be provided to preclude settling and/or failure of the higher pipe. B. Sanitary sewer manhole and clean out separation from water i. Manholes and clean outs must be installed so as to provide a minimum of 9 feet of outside to outside clearance from an existing or proposed water line. Section 3 21 2020 Design Standards and Specifications Sewer Standards ii. Where the 9-foot separation distance cannot be achieved, an encasement pipe as described in subparagraph (c.) above may be used for the water line. 3.07.03 Water and sewer lines shall be installed in separate trenches. 3.07.04 For other instances not covered in these design standards, consult current TCEQ regulations. 3.08 Abandonment of Sewer Mains and Manholes 3.08.01 When a sewer system is to be abandoned the Design Engineer shall ensure that all existing mains and service connections are properly plugged or transferred to the new system prior to decommissioning of the existing system. 3.08.02 Sewer Mains A. If a line to be abandoned terminates in a manhole that will remain in service, the existing main to be decommissioned shall be plugged from within the manhole and clearly marked on the plans. i. Cutting and plugging of existing lines directly outside of manholes should be avoided. B. If a portion of a line is to be abandoned a manhole must be installed on the new terminus of the portion of line to remain in service. 3.08.03 Sewer Manholes A. Manholes may be decommissioned by either of the following methods or as approved by the City Engineer or designee: i. Complete removal of the manhole structure including ring, lid, cone, riser sections, base and all appurtenances. The excavation shall be backfilled with compacted native material or flowable fill. ii. Remove cone, ring and lid sections and backfill to top of remaining structure with flowable fill. Remaining excavation shall be backfilled with compacted native material or flowable fill. 3.09 Easements 3.09.01 When it is determined not to be feasible to construct a public sanitary sewer line in a street or alley, the installation may be made in a dedicated easement or right-of-way. 3.09.02 The minimum width of easement or right-of-way for a public sanitary sewer is 10 feet exclusive, 20 feet if shared with a public water main or other utilities or if depth of sewer main is greater than 10 feet. 3.10 Soil Analysis 3.10.01 The Contractor or Design Engineer may be required to submit a report showing the types and characteristics of the soils to be encountered, water table elevations along the proposed sewer, recommended methods of dewatering for sewer main construction, and the recommended methods of backfilling and compacting to be used. 22 Section 3 2020 Design Standards and Specifications Sewer Standards 3.11 Tunneling, Jacking and Bori 3.11.01 Tunneling, jacking and boring are methods used for sewer line placement under restrictive conditions when open cut construction is not allowed. A. Only straight pipe alignments for both horizontal and vertical alignment are allowed. B. Casing shall extend full width of right-of-way or as directed by the City Engineer or designee. C. Casing pipe shall be a minimum of two standard sizes larger than encased pipe and must allow for the required casing spacers. D. Casing pipe thickness shall be: Casing Diameter Minimum Casing Thickness <24 inches 3/8 inch >_24 inches 1/2 inch E. Manufactured centralizers or spacers shall be required at minimum 5-foot intervals or as recommended by the manufacturer. i. Only purpose-built centralizers may be used. F. Coal tar coating for casing pipe shall conform to AWWA C203. G. For bores in excess of 100 feet, purpose-built fused or restrained joint pipe shall be used. 3.11.02 Slick boring or directional drilling without encasement shall be considered on a case -by - case basis by the City Engineer or designee. 3.11.03 Annular space between casing or uncased pipe and bored hole shall be injection grouted. 3.11.04 All pipe longer than 50' installed by bore, jacking or tunneling must be video inspected by the developer after running water through the pipe to identify low areas. Video inspection shall conform to Section 6.08.07. 3.12 Lift Station 3.12.01 A thorough engineering analysis must be performed on physical and economic factors to determine if a lift station is required. A. A preliminary engineering report will be required to list all factors including TCEQ regulations as outlined in the Standard Specifications for Sanitary Sewer Construction. B. The City Engineer or designee will review the preliminary report and reserves the right to determine if there is merit to require a lift station. C. After approval of the preliminary report design shall follow the Standard Specifications for Sanitary Sewer Main Construction. D. Design of a lift station facility shall take into consideration the entire drainage basin, as well as local runoff. The top slab of the lift station shall be higher than the adjacent ground and the 100 year flood event. E. The review and approval process for lift station design could be subject to addition rules and requirements more comprehensive than those listed in these specifications. Section 3 23 2020 Design Standards and Specifications Sewer Standards 24 Section 3 2020 Design Standards and Specifications Sewer Check List SECTION 4 CHECK LIST FOR SANITARY SEWER CONSTRUCTION PLANS 4.01 Plan Submittal Requirements 4.01.01 All sanitary sewer main construction plans shall be checked for conformance with City of Lubbock Minimum Design Standards for Sanitary Sewer prior to submittal to the Engineering Department for approval. Approval of plans is for general conformance with the City of Lubbock Minimum Design Standards and Specifications. Approval of plans shall not relieve the Engineer or Developer from any City, State or other governing requirements nor for errors or omissions in plans and specifications. 4.01.02 Plan Review A. The Design Engineer shall submit sanitary sewer main construction plans to the City Engineer or designee for review and comment. The Design Engineer shall use the City of Lubbock Customer Self Service (CSS) website to submit plans. http://egovaccess.ci.lubbock.tx.us/EnerGov Prod/SelfService/#/home B. Please call 806-775-2347 if you have any questions regarding the CCS submission process. C. Upon completion of review and receipt of payment for appropriate Plan Review fees, comments shall be returned to the Design Engineer on the CSS website. i. Plans requiring resubmittal for substantial changes as determined by City Engineer or Designee may require payment of an additional Plan Review fee. D. After comments have been addressed and changes have been made the Design Engineer will submit the revised plan using CSS website. i. If comments have not been addressed on plans submitted for final approval for construction the plans will be rejected. ii. If testing and inspection fees have not been paid, plans will be rejected. E. Upon approval, the city will return an electronic copy of the plan stamped "Approved for Construction" through the CSS web site. i. The design Engineer will be required to submit two half size copies of the approved for construction stamped plans. F. Final construction plans should not be submitted for Engineering Department approval for work that will not be installed within 6 months of the approval date. i. Delays between approval date and construction may require resubmittal of the plans for review under current standards. 4.01.03 Pro Rata Estimate and Fees A. Two (2) sets of Pro Rata Cost Estimates shall be submitted for review at the time of plan review submittal. B. Plan Review Fees in the amount of 0.5% of the Pro Rata Cost Estimate (minimum $50) shall be submitted at the time of plan review submittal. C. Inspection and Testing Fees in the amount of 1.5% of the Pro Rata Cost Estimate (minimum $125) shall be submitted prior to construction. D. In the event of significant changes in design, an updated Pro Rata Cost Estimate shall be submitted and resulting differences in fee amounts settled. Section 4 25 2020 Design Standards and Specifications Sewer Check List 4.01.04 Checklist A. A copy of the completed "City of Lubbock Municipal Water and Sewer Submittal Checklist" shall be submitted at the time of plan review submittal. The checklist can be found in the Appendix. 4.01.05 Construction Plans A. All plans to be used or kept on the job site shall be original or reproduced plan sets clearly marked "Approved for Construction" with the signature of reviewer and date approved by the Engineering Department. B. Should circumstances during construction warrant changes from the approved plans or specifications, a written approval must be obtained from the Engineering Department. i. Copies of the written approval shall be attached to the construction plans and maintained on the job site. 4.01.06 Record Drawings A. The Design Engineer shall be responsible for recording constructed dimensions and information on a set of Record Drawings during the progress of construction. i. The City of Lubbock Engineering Department shall monitor this process to assure that changes in construction are kept up to date on the Record Drawings. B. Digital PDF "Record Drawings", certified by the Design Engineer, shall be submitted to the Engineering Department within 30 days of completion of the construction. i. Record Drawings shall include locations of all lift stations, manholes or other changes in main pipe direction, material or size. a. GPS Coordinates or property ties are acceptable. C. Where the construction is phased and a lapse of more than 60 days occurs between phases, then Record Drawings shall be submitted to the Engineering Department reflecting the completed construction prior to issuance of the Certificate of Acceptance of Utility Construction. D. Items required to be submitted with Record Drawings: i. Letter of Transmittal ii. Record Drawing iii. Updated Pro Rata Cost Estimate iv. Certificate of Completion (Provided to Contractor from City Inspector) v. Developer's Warranty Statement (See Appendix) vi. Adjacent Mains Refund Contract (see Apendix) 4.01.07 Acceptance A. Upon completion of construction, satisfactory system tests and submittal of Record Drawings, the Design Engineer shall submit a request to the City Engineer or designee for a Certificate of Acceptance of Utility Construction. i. Sanitary sewer system improvements shall not be put online or brought into service without written approval by the Engineering Department. ii. A newly constructed system will not be accepted until the receiving, downstream system has been accepted. iii. A Certificate of Acceptance of Utility Construction shall not be issued until Record Drawings are provided to the Water Utilities Department. 26 Section 4 2020 Design Standards and Specifications Sewer Check List iv. When all paperwork has been completed and provided to the City with a written notification, utilities will be accepted within 30 days if there is no exception by the City. B. Building Permits for residential developments and Certificates of Occupancy for commercial facilities to be serviced by a newly constructed system will not be released by the Engineering Department until said system has been brought into service. 4.02 Plan Details 4.02.01 Plan Format A. Standard drawing size shall be 22-inch by 34-inch. 4.02.02 The following details shall be shown on the plans: A. General i. Title Block (lower right hand corner preferred) ii. Scale iii. Original Date and Revision Dates iv. Name of Professional Engineer v. Professional Engineer's Seal vi. Firm Name and Contact Information vii. City of Lubbock Engineering Department Contact Information: a. Development Engineering Services: (806) 775-2347 b. Senior Inspector: (806) 548-4152 viii. Drawings Number(s) ix. Legal Description of Property Being Improved x. Location Map or Plat (if available) xi. Statement: "All work shall be performed in accordance with the current version of the City of Lubbock Minimum Design Standards and Specifications." B. Plan i. Bench Marks ii. North Arrow iii. Property Lines iv. Street Names and Easements with Width Dimensions v. Other Pertinent Details (Buildings, Curbs, Water Courses, Etc.) vi. Proposed Sanitary Sewer Mains (Bold) a. Stationing b. Size c. Materials d. Gradients e. Length between Manholes f. Proposed Manholes g. Elevation of Inverts In And Out Of Manhole h. Elevation of Manhole Rim i. Location Control Dimensions Section 4 27 2020 Design Standards and Specifications Sewer Check List j. Manhole Stub -Outs k. Proposed Future Extensions I. Proposed Service Connections or Stub -Ins m. Standard Bedding Cross -Section n. Proposed Concrete Encasement o. Proposed Cut -Off Walls vii. Existing Utility Lines (Gray) with Location and Depth According to the Following Standard: I I WATER LINE 5 5 5 SANITARY SEWER LINE G G G GAS LINE FOC FOC FIBER OPTIC CABLE CATV CATV CABLE TELEVISION SWSw STORM WATER LINE UGE UGE UNDER GROUND ELECTRIC OHE OHE OVER HEAD ELECTRIC UGT UGT UNDERGROUND TELEPHONE OHT OHT OVER HEAD TELEPHONE TS TS TRAFFIC SIGNAL LINE C. Profile i. Ground Surface - Existing (Dotted) and Proposed (Solid) ii. Station Numbers iii. Existing and Proposed Utilities Where Crossed iv. Existing Manhole Invert and Rim Elevations D. Plan, Profile and Complete Details for Off -Site Force or Gravity Mains, Lift Stations, Special Valves and Vaults, Tanks, Etc. E. Detail Sheet - As Required i. Standard Bedding Detail ii. Standard Manhole Detail iii. Drop Manhole Details iv. Tapping Details F. Overall Layout Sheet - If Required i. Scale 1 "=100' ii. Lot Lines iii. Streets and Street Names iv. Sewer Line Sizes and Material v. Manholes vi. Connections to Existing System 28 Section 4 2020 Design Standards and Specifications Water Specifications SECTION 5 STANDARD SPECIFICATIONS FOR WATER MAIN CONSTRUCTION 5.01 General 5.01.01 All water main construction within the City of Lubbock water system or for future connections to the City of Lubbock water system shall be accomplished in accordance with the requirements of these specifications. 5.02 Plan Reauirements 5.02.01 Water main construction shall be done in accordance with engineered construction plans for the work, prepared under the direction of a Professional Engineer and approved by the City of Lubbock Engineering Department. 5.02.02 Plans shall conform to the City of Lubbock's Minimum Design Standards for Water Distribution and shall show all information called for on the City of Lubbock Check List for Water Distribution Construction Plans. 5.03 Plan Approval 5.03.01 The Engineering Department shall review, approve and issue plans stamped "Approved for Construction" to the Design Engineer. 5.04 Inspection 5.04.01 Engineer and/or Contractor shall notify the Engineering Department 48 hours prior to the planned construction is to commence and also before starting up when construction is interrupted for any reason. 5.04.02 All work shall be inspected by a representative of the Engineering Department who shall have the authority to halt construction when, in their opinion, construction is being performed contrary to these specifications or other approved plans. 5.04.03 Whenever any portion of these specifications is violated, the City Engineer or designee, by written notice, may order that portion of construction in violation of these specifications or other approved plans, specifications and material to cease until such violation is corrected. 5.05 Specifications 5.05.01 All standard specifications and quality standards; i.e., ASA, AWWA, ASTM, etc., which are made a portion of these specifications by reference shall be the latest edition and revision thereof. 5.06 Materials of Construction 5.06.01 Water Pipe A. All pipe used in the City of Lubbock water distribution system shall be C900 PVC, C905 PVC, C906 High Density Polyethylene (HDPE), Cement -lined Ductile Iron, C301 Prestressed - Section 5 29 2020 Design Standards and Specifications Water Specifications Concrete Steel Cylinder Pressure Pipe or C303 Concrete Bar -wrapped Steel Cylinder Pressure Pipe and shall conform to the Approved Materials List. B. The following are approved materials for water main construction: i. PVC Pipe a. Polyvinyl chloride (PVC) pipe shall be manufactured in accordance with AWWA C900 or C905 specifications and shall be minimum DR-18, Pressure Class 235 PSI. b. Pipe shall be furnished with bell and spigot joint with rubber gasket joint conforming to the above specification. c. Spigot ends shall be beveled and reference marked to facilitate joining and insure proper seating depth. d. Water pipe shall be blue. ii. High Density Polyethylene (HDPE) a. HDPE pipe shall be made of high density, high molecular weight polyethylene pipe material meeting the requirements of the latest revision of AWWA C906, PE 4710, Minimum DR11, Pressure Class 200 PSI. b. Use of HDPE pipe must be preapproved by the City Engineer or designee in writing prior to use within the City of Lubbock service area. iii. Cement -lined Ductile Iron Pipe a. Ductile iron pipe shall conform to AWWA C150 — ANSI A21.50 and AWWA C151 — ANSI A21.51. b. All ductile iron pipe shall be cement lined in accordance with AWWA C104 - ANSI A21.4 specifications. The external surface shall be coated with an asphalt base paint. c. All joints for ductile iron pipe shall be of the rubber gasket bell and spigot type, except where connecting flanged fittings, and shall otherwise conform to the base specifications to which the pipe is manufactured. d. The joint shall be the latest approved type of rubber gasket joint for ductile iron pipe. e. All joints of ductile iron pipe and fittings shall be sealed with a continuous ring rubber gasket meeting standards specified by AWWA C111 - ANSI A21.11 or its latest revision. f. Flanged joints shall conform to AWWA C115 — ANSI A21.15 iv. Concrete Cylinder Pipe a. Pre -stressed Concrete Steel Cylinder Pressure Pipe shall be manufactured in accordance with the latest revision of AWWA C301. b. Concrete Bar -wrapped Steel Cylinder Pressure Pipe shall be manufactured in accordance with the latest revision of AWWA C303. c. Concrete Cylinder Pipe shall withstand a minimum pressure of 150 psi longitudinally and helically. d. The joints of the pre -tensioned concrete cylinder pipe and fittings shall be sealed with a continuous ring rubber gasket meeting standards specified in AWWA C303. e. A Portland cement mortar shall be used to fill the annular space both inside and outside of joints in the pre -tensioned concrete cylinder pipe. (1) Portland cement used in the mortar shall conform to ASTM C150 and C77. (2) Sand for the mortar shall conform to ASTM C33 for fine aggregate. f. The exterior joints on pre -tensioned concrete cylinder pipe shall be poured with a heavy duty diaper. The width of the diaper shall be 9 inches. The band shall be provided with 3/8 inch x 0.20 steel straps on each side. 30 Section 5 2020 Design Standards and Specifications Water Specifications 5.06.02 Service Saddles A. 1-inch and 2-inch Service Connection i. Service connections shall be made through an approved service saddle. a. Service saddles shall be manufactured to conform to ASTM A240 Type 304 stainless steel. b. Service saddles shall be 4-bolt, double band type. c. Service saddle shall be fusion bonded epoxy or nylon coated. d. 1-inch service saddles shall have AWWA Tapered (CS/CC) threaded connection. e. 2-inch service saddles shall have iron pipe sized (IPS) threaded connection. 5.06.03 Tapping Procedures A. Tapping Sleeves i. General a. Clean, disinfect, and prepare the main line, valve, and tapping machine with NSF approved disinfectant prior to operation. b. Ensure shell cutter will clear valve walls. ii. Tapping Machine a. Use the appropriate pilot bit for the pipe material being tapped; follow pipe and bit manufacturer's requirements. b. Upon request, contractor shall provide specification for pilot bit and shell cutter. c. If it is determined by the inspector that the bit or shell cutter is dull or damaged a new bit or shell cutter must be provided for all taps. d. If tapping machine is a solid body machine and the bit/shell cutter travels, the full weight of the tapping machine must be supported with cribbing. e. If the tapping machine is a two-piece body machine and moves with the bit/shell cutter, the valve must be supported with cribbing or concrete. iii. 4-inch through 12-inch Main Line Connection a. Tapping sleeves shall be ductile iron or stainless steel, mechanical joint and conform to the latest revision of ASTM Standard Designations. The tapping sleeve shall withstand a working pressure of 200 psi. b. Gaskets shall be compounded from new materials, and the shape of cross-section of gasket shall provide adequate seal for the design pressure. Gaskets shall be shop glued to the groove provided in the body section. c. Bolts and hex nuts shall be stainless steel. iv. 16-inch through 24-inch Main Line Connection a. Tapping sleeves shall be ductile iron or stainless steel, mechanical joint and conform to the latest revision of ASTM Standard Designations. Tapping sleeves shall be capable of withstanding a working pressure of 200 psi. b. Flanges shall be fabricated from steel plate conforming to ASTM Standard Designation A36 or A285, Grade C. c. Dimensions shall conform to AWWA Standard C207, "Steel Pipe Flanges," Class D. (1) Flanges shall be machined to a flat face with finish of 250 micro -inches or machined to a flat surface with a serrated finished in accordance with AWWA Standard C-207, "Steel Pipe Flanges." (2) Machined face shall be recessed for tapping valves in accordance with the MSS Standard SP-60. Section 5 31 2020 Design Standards and Specifications Water Specifications d. Gaskets shall be compounded from new materials, and the shape of cross-section of gasket shall provide adequate seal for the design pressure. Gaskets shall be shop glued to the groove provided in the body section. e. Bolts and hex nuts shall be stainless steel. B. Testing Outlet i. A 3/4-inch NPT by welded coupling shall be attached to the outlet nozzle of each tapping sleeve assembly complete with a 3/4-inch square head pipe plug. C. Painting i. All surfaces of the saddle shall be clean, dry, and free from grease and dirt before painting. ii. All surfaces of tapping sleeve except face of flange, bolts and nuts, shall be given a shop coat of a two-part thermosetting epoxy. Face of flanges shall be shop coated with a rust preventive compound. iii. Bolts and nuts shall be shipped bare (no paint or protective coating). 5.06.04 Ductile Iron Fittings A. Fittings shall be mechanical joint or rubber gasket AWWA Class D bell with transition gasket for the type of pipe used. B. All fittings shall be lined with cement or coal tar and coated with an asphaltic paint. C. Fittings shall conform to AWWA C104, AWWA C110 and AWWA C111 latest revision. 5.06.05 Double Disc Gate Valves A. Double disc gate valves 12-inch and smaller shall be parallel seat, ductile iron body and bronze mounted throughout. In line valves shall be flanged or mechanical joint. Side outlets shall be flanged. i. Gate valves 12-inch and smaller shall be direct bury. ii. Valves shall have non -rising stems, shall open by turning to the left (counter- clockwise), and shall be furnished with a 2-inch square operating nut. iii. Valves shall comply with the latest revision of AWWA C500 standards. 5.06.06 Resilient Seat Gate Valves A. Resilient seat gate valves 12-inch and smaller shall be ductile iron. In line valves shall be flanged or mechanical joint. Side outlets shall be flanged. i. Gate valves 12-inch and smaller shall be direct bury. ii. Valves shall have non -rising stems, shall open by turning to the left (counter- clockwise), and shall be furnished with a 2-inch square operating nut. iii. Valves shall comply with the latest revision of AWWA C509 or C515 standards. 5.06.07 Butterfly Valves A. Butterfly valves 16-inch and larger shall be ductile iron and may be either short body or long body lengths. i. Butterfly valves shall be installed in a concrete valve vault and shall be equipped with a hand wheel, a 2-inch square operating nut, a locking device and a position indicator. ii. Valve shall open by turning to the left (counter -clockwise). iii. Valves shall be designed for positive stop in the closed position. 32 Section 5 2020 Design Standards and Specifications Water Specifications iv. Valve shall be manually operated with enclosed worm gear or traveling nut operation and shall be designed to operate at maximum torque with a maximum pull of 80 pounds. v. The design water pressure differential shall be 150 psi upstream and 0 psi downstream. vi. Valves shall comply with the latest revision of AWWA C504 for Class 150B. B. Valves installed in vaults shall be painted with heavy-duty machinery paint with color and type to be approved by Engineering Department. 5.06.08 Pressure Regulating Valves A. The function of a pressure regulating valve is to reduce an existing high pressure to a pre - adjusted lower downstream pressure for varying rates of flow without causing shock or water hammer on the system. i. The pressure reducing valve shall be hydraulically operated with a free floating guided piston having a seat diameter equal to the size of the valve. ii. A pilot valve for controlling operation of the main valve shall be a single seated, diaphragm operated and spring loaded type. iii. Pilot valve shall be attached to the main valve with piping and isolation valves so arranged for easy access in making adjustments and also for its removal from the main valve while the main valve is under pressure. iv. Needle valve shall be all bronze and included with the main valve to control the speed of piston travel. v. An indicator rod shall be furnished as an integral part of the valve to show the position of the piston within the valve body. vi. The valve shall be designed to provide an access opening in the valve body for removing the piston and other internal parts without removing the main valve body from the line. B. The valve shall be fully bronze -mounted and all packing shall have either leather or rubber seals to provide tight closure and prevent metal to metal friction. i. Valves shall be ductile iron body. ii. Bronze casting or parts for internal trim shall conform to ASTM B62. C. All valves shall be furnished with flanged ends sized and drilled in accordance with ANSI B16.1, Class 125. i. Flanges and covers shall conform to ASTM A126, Class B. ii. Flanges shall be machined to a flat face with a finish of 250 micro -inches or machined to a flat surface with a serrated finish in accordance with AWWA C207. D. Pressure regulating valves shall be capable of withstanding an operating pressure of 150 psi. E. Body of the pressure reducing valve shall be given a hydrostatic test of 50% more than the operating pressure specified herein. A second test of check seating of the cylinder shall be made at the operating pressure. F. All surfaces of the valve shall be clean, dry, and free from grease and dirt before painting. i. Ductile iron surfaces, except the machined face of the flange, shall be evenly coated with a suitable primer to inhibit rust, or a black asphalt varnish in accordance with Federal Specification TT-V-51e. ii. The face of flanges shall be shop coated with a rust preventive compound. G. Pressure regulating valves shall be installed in an approved concrete valve vault. Section 5 33 2020 Design Standards and Specifications Water Specifications 5.06.09 2-inch Combination Air and Vacuum Release Valves A. The function of a combination air and vacuum release valve is to allow air to escape during pipeline filling and to enter during draining of the pipeline. Valve shall close water tight when liquid enters the valve. The valve shall also be capable of releasing small pockets of trapped air after the pipeline is filled and under pressure. i. Combination air and vacuum release valves shall be shop assembled and shipped as a complete unit ready for field installation. ii. The combination air valve shall be the single body type. iii. The valve body and cover shall be designed to operate under a maximum working pressure of 250 psi. iv. Material shall be one of the following: a. Valve body (1) Cast Iron - ASTM A48-CIass 35 (2) Cast Steel - ASTM A27 GR U60-30 (3) Ductile Iron - ASTM A536 GR 65-45-12 (4) Bosses for tapping pipe threads shall be cast integrally with each valve body and cover. v. The diameter of the large orifice of the combination air valve shall be 2 inches and the small orifice diameter shall be 3/32 inch. vi. Inlet shall be 2 inches in diameter with tapered iron pipe thread conforming to AWWA C800. vii. For valves not found in the approved materials and vendors list, all other components shall conform to the following additional specifications: a. Float shall be stainless steel. b. All other internal parts shall be fabricated from bronze. c. Valve seat shall be fabricated from oil resistant synthetic rubber. B. Guard Valve and Connecting Pipe i. Guard valve to be used with air valve shall be bronze ball valve with female iron pipe thread ends. ii. Connections between the air valve and the guard valve shall be made using brass nipples with tapered iron pipe threads conforming to AWWA Standard C800. C. All components shall be capable of withstanding an operating pressure of 250 psi. D. Each shop assembled valve shall be given a hydrostatic test of 2 times the rated operating pressure. During the test, air shall be injected into the body chamber of the valve to check its ability to release entrained air to the atmosphere under operating pressure. E. All surfaces of the valve shall be clean, dry and free from grease before painting. Exterior and interior surfaces except the stainless steel trim and the seating surface of the flange face shall be evenly coated with a suitable primer, or a black asphalt varnish in accordance with Federal Specification TT-V51 C or Military Specification C-450-C, Type II. 5.06.10 Swing Check Valves A. Swing check valves shall be manufactured in accordance with AWWA Standard C508, "Swing - Check Valves for Ordinary Waterworks Service", with the following additional requirements or exceptions. B. All valves shall be iron body, fully bronze -mounted, metal to metal seating with a swing -type disc. 34 Section 5 2020 Design Standards and Specifications Water Specifications i. Valves installed in vaults shall be in a horizontal position with exterior lever and adjustable spring or weight operation. ii. Valves which are buried shall be installed in a horizontal position and shall be gravity operated with no external levers or weights. C. Swing check valves shall be capable of withstanding an operating pressure of 150 psi. D. Bolts and hex nuts used for attaching top cap to the body shall be the manufacturer's standard, either fabricated from a low -alloy steel for corrosion resistance or electroplated with zinc or cadmium. i. The hot -dip process in accordance with ASTM A135 is not acceptable for the threaded portions of the bolts and nuts. E. Flat gasket, either ring type or full faced type, required at the body and cap connection, shall be fabricated from compressed asbestos sheet with a rubber compound binder. i. Use of a homogeneous rubber or vegetable fiber sheets is not acceptable. F. All check valves shall be furnished with flanged ends. The size and drilling shall be in accordance with ANSI B16.1 Class 125; flanges shall be machined to a flat face with a finish of 250 micro -inches or machined to a flat surface with a serrated finish in accordance with AWWA Standard C207. G. All surfaces of the valve shall be clean, dry and free from grease before painting. i. All ferrous surfaces, exterior and interior, except the seating surfaces of flange faces, shall be evenly coated with a suitable primer to inhibit rust or black asphalt varnish in accordance with Federal Specification TT-V-51f. ii. Flange faces shall be shop coated with a rust preventive compound. 5.06.11 Blowoffs A. Temporary or permanent blowoffs may be fabricated from 2-inch pipe with a 2-inch gate valve. B. Valve to be iron bodied bronze mounted with 2-inch square operating nut complete with valve box. C. Valve and valve box shall be as specified in the Approved Materials List. 5.06.12 Fire Hydrants A. Fire hydrants shall be standard AWWA C502 hydrants, iron body, bronze mounted throughout including drain seat ring, and shall be designed for a working pressure of 150 psi. B. Fire hydrants shall be traffic model type and shall have a 5-1/4 inch valve opening, two 2-1/2 inch hose nozzles, one 4-inch steamer nozzle with 4 threads per inch and a crest to crest dimension of 4.995 inches, and shall open by turning counter -clockwise. C. Hydrants shall be for 6-inch mechanical joint connection and shall be 4-1/2 foot bury unless otherwise shown on plans. D. When required, a single fire hydrant extension section shall be used to bring the fire hydrant to the appropriate elevation. No more than one extension will be allowed per installation. E. Operating nuts shall be 1-1/2 inch pentagons measured to a point. F. Hydrants shall be painted orange. G. Fire hydrants that are not yet in service or have been taken out of service shall be covered completely and securely with black plastic wrap or bags. H. Hydrants shall meet the requirements as detailed in the Approved Materials List. Section 5 35 2020 Design Standards and Specifications Water Specifications 5.06.13 Valve Boxes, Vaults, Frames and Covers A. Valve boxes for 12-inch or smaller valves shall be as specified in the Approved Materials List. i. The boxes shall be designed to fit over a section of 6-inch C900 PVC pipe which will be used as an extension from the top of the valve. Align riser pipe to ensure continuity between box and pipe, using couplers if spliced. ii. Top of valve box shall be set flush with surrounding finished grade. iii. Valve boxes set in HMAC or brick pavement shall have a 2-foot square by 6-inch thick reinforced concrete collar. iv. Valve box shall be heavy cast iron. v. Valve box shall have a heavy cast iron cover marked "Water Valve". vi. Valve box shall have a flange type base approximately 2 inches larger in diameter than the outside diameter of the barrel of the box. B. Valve vaults for butterfly valves and gate valves 16-inches and larger shall be poured concrete or pre -cast construction. i. Valve vaults shall be constructed with the dimensions as called for on the plans or as approved by the City Engineer or designee. ii. Valve vault cover opening shall be centered over operating nut. C. Manhole frames and covers shall be of good quality gray iron casting of a pattern similar to that shown on the plans and with a clear opening of not less than 30 inches. i. Frame and cover shall be designed with a full bearing ring so as to provide a continuous seat between frame and cover. ii. Cover shall be furnished with lifting ring cast into the cover in such manner as to prevent leaking through. iii. The cover shall be marked "City of Lubbock Water". iv. Frame and cover shall be as specified in the Approved Materials List. 5.06.14 Boring Encasement Pipe A. Encasement pipe shall be smooth steel pipe conforming to the following: Casing Diameter Minimum Casing Thickness <24 inches 3/8 inch >_24 inches 1/2 inch B. Boring encasement steel pipe shall have welded joints. 5.06.15 Concrete A. Proportioning of the constituents of the concrete shall produce a dense and workable mixture and the designed mix shall be approved by the Engineer before any concrete is placed. i. The concrete shall be of such consistency that it will flow without separation of the aggregates. B. Concrete mix shall be based on the water -cement ratio, and shall be as follows for the different applications: i. Concrete for manhole bases, valve vaults and other reinforced concrete structures shall contain not more than 7.0 gallons of water per sack of cement and yield a 28-day compressive strength of not less than 3,000 psi. ii. Concrete for pipe cradling, thrust blocking or fittings and other non -reinforced concrete shall contain not more than 9 gallons of water per sack of cement and yield a 28-day compressive strength of not less than 2,500 psi. 36 Section 5 2020 Design Standards and Specifications Water Specifications C. Concrete shall be made with Portland cement which conforms to "Standard Specifications for Portland Cement", ASTM C150. D. Concrete aggregates shall consist of natural washed and screened sand, and washed and screened gravel or clean crushed limestone conforming to "Standard Specifications for Concrete Aggregate", ASTM C33. Aggregates shall be well graded from coarse to fine and shall be free from injurious amounts of clay, soft or flaky materials, loam or organic impurities. ii. Aggregates shall be approved by the City Engineer or designee before use. Water used in mixing concrete shall be clear, clean, free from oil, acid or organic matter and free from injurious amounts of alkali, salts or other chemicals and shall conform to ASTM C1602/C1602M "Standard Specification for Mixing Water Used in the production of Hydraulic Cement Concrete." Surface moisture or moisture carried by the aggregates shall be included as part of the mixing water. G. Reinforcing steel used in concrete shall be deformed bars conforming to ASTM A615 "Standard Specification for Deformed and Plain Carbon -Steel Bars for Concrete Reinforcement" or ASTM A996 "Standard Specification for Rail -Steel and Axel -Steel Deformed Bars for Concrete Reinforcement" grade 40 or grade 50. i. All reinforcement shall be permanently marked with grade, identification marks or shall, on delivery, be accompanied by a manufacturer's guarantee. H. Forms shall be of wood or metal and shall be of sufficient strength to support the concrete without bulging between supports and sufficiently water tight to hold the concrete mortar. i. Forms shall be so constructed that the finished concrete shall be of the form and dimensions shown on the plans. ii. Form work for exposed surfaces shall be of such material and so constructed as to produce a wall with a smooth, even surface when the concrete is poured. iii. Wall forms shall be set plumb and true and rigidly braced to maintain them in correct position and alignment. iv. Walls for all reinforced concrete work shall be formed inside and outside. v. Form ties shall be adjustable in length and of such type as to leave no metal closer than 1-inch of the surface, and shall not be fitted with lugs, cones, washers, or other devices acting as a spreader which will leave a hole larger than 7/8-inch in diameter or depth back of the exposed surface of the concrete. vi. Temporary openings for cleaning and inspection shall be provided at the base of vertical forms or other places where necessary. Such openings shall be neatly and securely closed before concrete is placed. vii. Forms shall be oiled before use. viii. No forms shall be removed without permission of the City Inspector. However, in general, wall forms may be removed after the concrete has been in place for 24 hours and on roof slabs after the concrete has been in place for 10 days. ix. Immediately upon removal of the forms any honey -combed sections shall be repaired as directed by the City Inspector. Compounds used to form an air tight membrane over a fresh concrete surface shall be in accordance with Texas Department of Transportation Item 360.2.0 (DMS-4650). i. Curing compound shall be applied with a pressurized sprayer in an even coating or as recommended by the manufacturer. Section 5 37 2020 Design Standards and Specifications Water Specifications 5.06.16 Bedding, Embedment and Backfill A. Water Pipe 12-inch diameter and smaller i. Bedding and embedment shall be native, sandy soil material free from rocks, clods, roots or other debris larger than 1-inch diameter. ii. Backfill material shall be native, sandy soil material free from rocks, clods, roots or other debris larger than 2-inch diameter. B. Water Pipe 16-inch diameter and larger i. Bedding shall be select sand or aggregate free from rocks, clods, roots or other debris larger than 3/8-inch. a. Bedding material shall be free from injurious amounts of clay, dust, blow sand, caliche or slag. ii. Embedment material shall be crushed stone with irregular surfaces and comply with the following gradation requirements: Standard Crushed Rock Aggregate Cumulative Percent Retained (by weight) Retained on 1" Sieve 0 Retained on 1/2" Sieve 0-20 Retained on 3/8" Sieve 15-40 Retained on No. 4 Sieve 60-90 Retained on No. 8 Sieve 95-100 a. Embedment shall extend to 12 inches above top of pipe. iii. Backfill material shall be native, sandy soil material free from rocks, clods, roots or other debris larger than 2-inch diameter. C. Compaction i. Bedding, embedment and backfill shall be compacted to 95% Modified Proctor Density by approved mechanical means. a. Compaction shall be in maximum 6-inch compacted lifts. ii. Water jetting will not be allowed. 5.06.17 Flowable Fill A. Flowable fill shall consist of a concrete mixture of pea gravel and sand with a cement content of 1-1/2 sacks per cubic yard. i. Utility ditches in Right of Way shall be backfilled in accordance with Details UEM-01 through UEM-07 in the appendix. ii. Use of concrete in place of flowable fill is not acceptable, and if used in place of flowable fill shall be removed by the Contractor at their expense. 5.07 Methods of Construction 5.07.01 Scope A. The work covered by this section consists of constructing water distribution mains and other appurtenances normally installed as a part of this system. Construction may include surface preparation; trench excavation; shoring; dewatering; laying, aligning and joining pipe; installation of pipe, valves, valve boxes, and fittings; cradling, blocking and anchorage; bedding, embedment and backfilling; and other related work. 38 Section 5 2020 Design Standards and Specifications Water Specifications 5.07.02 Quality Standards Standard Topic Standard Test Methods for Laboratory Compaction ASTM D698 Characteristics of Soil Using Standard Effort AWWA C600 ANSI Installation of Ductile Iron Mains and Their Appurtenances Polyvinyl Chloride (PVC) Pressure Pipe and Fabricated AWWA C900 Fittings, 4-inch through 12-inch for Water Transmission and Distribution Polyvinyl Chloride (PVC) Pressure Pipe and Fabricated AWWA C905 Fittings, 14-inch through 48-inch for Water Transmission and Distribution AWWA M23 Polyvinyl Chloride PVC Pie Design and Installation ACPA Concrete Pipe Installation Manual (Published by American Concrete Pipe Association ASTM C891 Installation of Underground Pre -cast Utility Structures 5.07.03 Materials A. The Contractor shall install water distribution pipe of the type, diameter, wall -thickness and protective coating that is defined in the Approved Materials List or designated by the City Engineer or designee. B. One or more acceptable types of pipe may be used. As such, the Contractor shall have the option of installing any of the acceptable types, provided only one type is used throughout any single size designation or run of pipe. 5.07.04 Storm Water Pollution Prevention Plan (SWPPP) A. Prior to disturbance of construction area, Contractor shall coordinate with the City of Lubbock Engineering Department to develop a site -specific Storm Water Pollution Prevention Plan. B. SWP3 measures shall conform to the integrated Stormwater Management (iSWM) criteria developed by the North Central Texas Council of Governments. C. SWP3 measures shall be installed prior to construction and shall be maintained throughout the construction until final stabilization. 5.07.05 Surface Preparation A. Within Easements, Cultivated or Agricultural Areas i. All vegetation such as brush, sod, heavy growth, grass, weeds, decayed vegetable matter, rubbish and other unsuitable material within the area of excavation and spoils storage shall be stripped and properly disposed. ii. Topsoil shall be removed to a depth of 8 inches or the full depth of topsoil, whichever is less. iii. Removed topsoil shall be stockpiled during construction in an approved location. B. Within Unpaved Roadway Areas i. Contractor shall strip the cover material from graveled roadways or other developed but unpaved traffic surfaces to the full depth of the existing surfacing. ii. Surfacing shall be stockpiled to the extent that it is acceptable for restoration purposes. C. Within Paved Areas i. All pavement cuts and repairs shall be in accordance with the current City of Lubbock Street Ordinance. Section 5 39 2020 Design Standards and Specifications Water Specifications ii. Wherever it is necessary to make cuts in existing pavements, sidewalks, driveways, or curbs and gutters, the cuts shall be made in such a manner as to cause the least possible damage to adjoining surfaces. iii. Asphalt Paving a. Asphalt surfaces shall be saw cut along each side of the trench ahead of the trenching machine and the paving and base removed with the trenching machine as the trench is excavated. b. The width of surface removed by the Contractor is not to exceed the outside limits of the trench plus 12 inches. iv. Concrete Paving a. Removal of any sidewalks, concrete pavement, concrete base, concrete curbs and gutters shall be made by saw cutting the concrete to a straight line on each side of the trench and removing the concrete ahead of the trenching. b. Concrete shall be saw cut vertically in straight lines and avoiding acute angles. c. Concrete pavement, sidewalks, driveways or curb and gutter shall be cut with a power saw to a depth of not less than 2 inches prior to breaking. d. Overbreak, separation or other damage to the existing bitumen or concrete outside the designated cut lines shall be replaced at the Contractor's expense. e. Tunneling may be required under curb and gutters. f. The width of surface removed by the Contractor of concrete paving is not to exceed the outside limits of the trench plus 12 inches. v. All spoil piles must be 3' from travel lanes or have a traffic barrier that will prevent the soil from encroaching on travel lanes. vi. If roll off dumpsters are placed on street paving, then the paving must be protected from damage. 5.07.06 Barricades and Safety Measures A. Contractor shall, at their own expense, furnish and erect barricades and safety measures for the protection of persons, property and the works as may be necessary. B. All barricades and safety measures shall meet the rules and regulations of Federal, state and local authorities, including but not limited to: i. OSHA regulations for excavation, trenching and shoring ii. Texas Manual on Uniform Traffic Control Devices iii. City of Lubbock Barricade Ordinance C. Contractor will be held responsible for all damage to the work due to failure of barricades and safety measures. i. If damage is incurred, the damaged portion shall be immediately removed and replaced by Contractor at their own cost and expense. D. Contractor's responsibility for maintenance of barricades and safety measures shall not cease until the project is accepted by the City. 5.07.07 Water for Construction A. The City will furnish water from fire hydrants for construction purposes. i. To use City water for construction the contractor shall acquire a water meter for use on a City fire hydrant, and will be charged the applicable rate for the quantity of water used. 40 Section 5 2020 Design Standards and Specifications Water Specifications ii. The contractor shall contact Lubbock Power and Light Customer Service Department and establish a utility account. The contractor must pay the current deposit for each fire hydrant meter and will be responsible for all charges associated with that account. iii. Once an account is established and the deposit is paid, the contractor may pick up a meter from the City Water Department at 600 Municipal Drive. iv. The contractor shall be responsible for reporting monthly water usage. v. All water used shall be in accordance with City Ordinance, all water shall be used within City Limits. B. Fire hydrants shall be operated only by use of an approved fire hydrant wrench. No pipe wrenches, or other unapproved devices, shall be used to open or close a fire hydrant. C. For top loading trucks or containers the contractor shall provide a back flow prevention assembly on the discharge side of the meter. i. The backflow prevention assembly shall be in the form of two spring loaded ball check valves. ii. When filling the truck or container there shall be an air gap of at least two times the opening diameter of the truck or container. D. For bottom loading trucks the contractor shall provide a Reduced Pressure Zone (RPZ) type backflow prevention assembly. i. All RPZ type back flow prevention assemblies must be tested and the test results approved by the City prior to use. ii. The test results shall be sent to the City of Lubbock Public Works Department, Meter and Customer Service Supervisor for approval. E. In accordance with City of Lubbock Ordinance No. 10208 "Pertaining to Backflow Prevention", City representatives are authorized to suspend water use from a fire hydrant by a contractor until the proper and correct backflow prevention device is installed. 5.07.08 Protection of Existing Utilities A. It shall be the Contractor's responsibility to properly mark (white line) the work area and notify the Texas Excavation Safety System, 1-800-DIG-TESS (1-800-344-8377) a minimum of 48 hours prior to construction or excavation. B. Contractor shall locate all utility lines, including customer service lines, far enough in advance of the trenching to make proper provisions for protecting the lines and to allow for any deviations that may be required from the established lines and grades. C. If required, the Contractor shall "pothole" or physically locate existing underground utilities ahead of trench excavation. D. A contractor shall not be allowed to disrupt water service without permission from the Engineering Department. i. When a service disruption is planned, the Contractor shall notify the Engineering Department a minimum of 48 hours in advance. E. Contractor shall notify local utilities whenever working near gas mains or services or near electrical or telephone cables or when the presence of these utilities is suspected in the area of construction. F. Contractor shall proceed with caution in the excavation and preparation of the trench so that the exact location of underground structures, both known and unknown, may be determined. G. Hand excavation shall be used where necessary. H. All utility lines shall be properly supported to prevent settlement or damage to the line both during and after construction. Section 5 41 2020 Design Standards and Specifications Water Specifications I. Contractor shall be held responsible for the repair of any utilities when broken or otherwise damaged because of carelessness on their part. J. The Contractor shall immediately notify the proper utility company of any damage to utility lines in order that service may be established with the least possible delay. Any damage to existing lines and the repair of customer lines which are authorized to be cut shall be at the Contractor's expense, and as directed by an official representative of the utility company involved. K. Any permanent relocation of existing utility lines shall be done by the proper utility company. 5.07.09 Excavation and Trenching A. Minimum width of the trench shall be the outside diameter of the pipe plus 12 inches. B. Maximum width of the trench shall be the outside diameter of the pipe plus 18 inches. i. The City Engineer or designee shall review instances where trench widths are required to be greater than the maximum allowable due to installation techniques or shoring. C. Contractor shall take all necessary precautions for protecting paved streets and drives from being damaged by the trenching and backfilling equipment. D. Grade shall be such that the pipe will rest firmly on the bedding material throughout the entire length of the pipe cylinder. i. Bell holes of ample dimensions shall be dug at each joint to permit the proper jointing of the pipe. E. In order to obtain a true, even grade, the trench shall be fine -graded. i. Material for fine grading shall be free of rocks, roots, grass or any other debris. The depth of the fine grading material shall not exceed 3 inches. ii. Where the trench is excavated in excess of 3 inches below grade, the bedding material shall be compacted to 95% Modified Proctor Density. iii. If the material being excavated is rock or other unyielding material, it shall be removed to a depth of 3 inches below grade and replaced with approved bedding material to grade. F. All excavated material shall be placed in a manner that will not endanger the work or damage existing structures. 5.07.10 Methods of Connection A. Service and main line taps and connections shall comply with current City of Lubbock Utilities Ordinance. B. Service Taps i. All service taps on existing mains shall be installed by City personnel or a City - designated contractor. C. Main Line Taps i. All taps on existing mains in service shall comply with current TCEQ requirements. ii. Persons installing main line taps shall hold a Class "C" or higher TCEQ Water Operator's License. iii. A person holding a Class "D" TCEQ Water Operator's License may install main line taps only if they are in direct communication with a person holding a Class "C" or higher TCEQ Water Operator's License. iv. City Inspector must be present for any tap being installed on an existing main. D. Valve Operating Procedures 42 Section 5 2020 Design Standards and Specifications Water Specifications i. Contractors shall not operate valves within the existing City of Lubbock water distribution system. ii. Operation of valves shall be done by authorized City of Lubbock personnel only. iii. Contractors shall arrange opening or closing of valves by notifying the Engineering Department at least 24-hours prior to needing a valve operated. 5.07.11 Pipe Installation A. Pipe, fittings, valves and other accessories shall be inspected, handled, laid and joined in the manner herein specified. B. Pipe, fittings, valves, and accessories shall be inspected upon delivery and during the progress of the work and any material found to be defective may be rejected. i. If rejected, the Contractor shall remove and replace such defective material at their own expense. C. Pipe, fittings, valves, and other accessories shall be handled in accordance with manufacturer's specifications. i. Before lowering into the trench the pipe, fittings, valves and accessories shall be inspected for defects. a. Any defective, damaged, or unsound pipe or other incidental materials shall not be incorporated into the work. b. Contractor shall remove and replace such defective material at their own expense. ii. All pipe, fittings, valves and accessories shall be carefully lowered into the trench piece by piece using suitable tools or equipment in such a manner as to prevent damage to the material. iii. Under no circumstance shall pipe, valves, fittings, accessories or tools be dropped directly into the trench. D. All foreign matter shall be removed from the inside of the pipe, bells, spigots or parts of the pipe used in forming the joint before the pipe is lowered into the trench; i. Pipe shall be kept clean by approved means during and after laying. ii. The open end of the pipe in the trench shall be plugged when pipe is not being laid. E. Pipe shall be laid to the alignment as established on the approved plans. i. Where grade is being maintained as shown on the plans, the use of batter boards or laser beam will be required to fine grade the trench. ii. Whenever it is necessary to deflect pipe from a straight line either in a vertical or horizontal plane to avoid obstructions, to plumb valves, or where vertical or horizontal curves are required, the allowable angle of curvature shall be 80% of the manufacturer's maximum recommended curvature. iii. Deflection at each joint shall not exceed 80% of the manufacturer's maximum recommended deflection. F. Pipe shall be laid so that the pipe label is facing up. G. Pipe shall be jointed per manufacturer's requirements. i. Pipe shall be laid with bells facing in the direction of laying. a. For lines on appreciable slopes, the Engineer may specify the pipe to be installed with the bell ends facing up grade. ii. Bell, spigot and gasket of pipe to be laid shall be wiped clean prior to jointing. iii. Cutting of pipe for inserting valves, fittings or closure pieces shall be done in a neat workmanlike manner without damage to the pipe or lining. iv. Jointing shall be completed for all pipe laid each day. Section 5 43 2020 Design Standards and Specifications Water Specifications a. At the times when pipe laying is not in progress, the open ends of pipe shall be properly plugged and sealed to prevent contamination. b. No trench water shall be permitted to enter the pipe. v. No pipe shall be laid in conditions unsuitable for such work as determined by the City Inspector. 5.07.12 Trace wire for nonmetallic pipe installation A. Conductive trace wire shall be installed in the same trench and inside bored holes and casing with all nonmetallic pipe during pipe installation. i. Trace wire shall be 12 gauge minimum solid copper with 30 mil HDPE insulation recommended for direct bury. ii. Trace wire shall be secured to the pipe as required to insure that the wire remains directly on top of the pipe. iii. Trace wire shall be securely bonded together at all wire joints with wire connectors that are watertight and provide for electrical continuity. iv. Trace wire shall be made accessible at water valve boxes and fire hydrants. a. Trace wire shall not be placed inside valve box risers. b. Trace wire shall be installed such that no less than 6 inches but no more than 12 inches of wire remain accessible. 5.07.13 Marking Tape A. Marking tape shall be installed in the same trench with all pipe during pipe installation. i. Marking tape for water mains shall be 3-inch, blue in color and clearly labeled "Caution: Buried Water Line." ii. Marking tape shall be installed directly above the centerline of the pipe a minimum of 24 inches above top of pipe. iii. Depth of bury shall be 18 inches below top of trench. 5.07.14 Setting Valves, Valve Boxes and Fittings A. Valves and fittings shall be set at the locations shown on the approved plans. B. Valves and fittings shall be adequately blocked for thrust with concrete or mechanically restrained. i. Refer to thrust blocking details or Appendix A — Restrained Joint Lengths. 5.07.15 Cradling, Blocking and Anchorage A. Contractor will be required to install concrete pipe cradle at all valve vaults and properly block or mechanically restrain all fittings including tees, bends and valves. B. Where concrete cradling or blocking is used, concrete shall conform to the concrete specifications. C. Before placing the concrete, all loose earth shall be removed from the trench. D. Concrete shall be placed in the trench by the use of chutes extending to within 3 feet of the bottom of the trench and shall be deposited uniformly on each side of the pipe in such a manner as to not disturb the grade and alignment of the pipe. E. Blocking shall be placed between solid ground and the fitting to be anchored. The area of bearing on pipe and on the ground in each instance shall be that required by the Engineer. F. Blocking shall be placed so that the joints of all pipe and fittings are accessible for repair. 44 Section 5 2020 Design Standards and Specifications Water Specifications G. Soil bearing value for thrust blocking shall be as recommended by the Engineer based on soil analysis of the site. In the absence of such recommendation, the allowable soil bearing value shall not exceed 2,500 pounds per square foot. 5.07.16 Backfilling A. Backfilling of all trenches and excavations shall comply with the current City of Lubbock Street Ordinance as well as the City of Lubbock Utility Excavation Manual. B. After the trench has been backfilled, the disturbed area shall be cleared of all rocks larger than 1-1/2 inches in diameter and leveled so that the surface will have the same slope and appearance as it possessed before construction. C. All surplus material shall be loaded and legally disposed of at the Contractor's expense at an approved location. D. Contractor shall compact backfill and clean up as close behind the pipe laying and backfilling as possible. E. Following completion of backfill and cleanup, the Contractor shall maintain the street and trench surfaces in a satisfactory manner until final acceptance of the work. i. Maintenance shall include blading, filling depressions caused by settlement, sprinkling to settle dust, brooming and other work required to keep the streets and disturbed areas in satisfactory condition as determined by the City Engineer or designee. ii. The Contractor shall maintain and be responsible for all paving cuts until such time as repairs can be completed. 5.08 Pneumatic Testina for Taooin4 Sleeves 5.08.01 Upon completion of tapping sleeve installation, the tapping sleeve shall be subjected to a pneumatic pressure test according to the most recent City of Lubbock requirements. 5.08.02 Pneumatic Pressure Test A. Contractor shall be responsible for performing a pneumatic pressure test witnessed by a City Inspector. i. Tapping sleeve shall be pressurized through 3/4-inch NPT port at a minimum test pressure of 50 psi. ii. Duration of the pressure test shall be a minimum of 10 minutes or as directed by the City Inspector. 5.09 Hydrostatic Pressure Testing 5.09.01 Upon completion of pipe installation, the line shall be subjected to a hydrostatic pressure test and leakage test according to the most recent AWWA standards, TCEQ rules and City of Lubbock requirements. 5.09.02 Hydrostatic Pressure Test A. Contractor shall be responsible for performing a hydrostatic pressure test witnessed by a City Inspector. i. Minimum test pressure shall be 100 psi or 150% of static operating pressure, whichever is greater. ii. Duration of each pressure test shall be a minimum of 2 hours or as directed by the City Engineer or designee. B. Hydrostatic Test Procedure Section 5 45 2020 Design Standards and Specifications Water Specifications Each valved section of pipe shall be slowly filled with water. ii. As the line is being filled, all air shall be expelled from the pipe. a. Taps shall be made, if necessary, at points of highest elevation. b. Taps shall be tightly plugged upon satisfactory completion of the test. iii. Pressure shall be applied and maintained by means of a pump connected to the pipe in a manner satisfactory to the City Inspector. iv. The pump, pipe connection, and all necessary apparatus except meters shall be furnished by the Contractor. v. Contractor shall furnish all necessary labor for connecting the pump, meter, and gages. vi. Water for filling and making tests may be obtained at a location designated by the Engineering Department. a. No charge will be made for the first 2 pipe volumes of water. b. Contractor will be charged for water used in subsequent tests at the current rate of bulk usage. vii. The line shall be carefully checked at regular intervals for breaks or leaks. viii. Any joints showing appreciable leaks shall be repaired and any cracked or defective pipes or fittings shall be removed and replaced at the Contractor's own expense. ix. The test shall be repeated until satisfactory results are obtained. C. Leakage Test i. For pipe of 12-inch diameter or smaller, no leakage or pressure drop shall be allowed over a two hour period at the test pressure. ii. For pipe 16-inch diameter or larger, the allowable leakage (gallons per hour) shall not be greater than: L _ NDJ 7400 L = Gallons per Hour N = Number of Joints D = Nominal Pipe Diameter (in.) P = Test Pressure (PSI) iii. The leakage shall be determined by measuring the quantity of water supplied to each valved section of the lines, during the test period, when the various sections of the lines are under pressure. iv. If individual sections show leakage greater than the limits specified above, the Contractor shall locate and repair the defective portions at their own expense. 5.10 Sterilization and Bacteriological Testing 5.10.01 Upon completion of pipe installation, the line shall be sterilized and tested according to the most recent AWWA standards, TCEQ rules and City of Lubbock requirements including AWWA C651. A. Contractor shall notify City of Lubbock inspector a minimum of 24 hours in advance of intended filling, chlorinating or flushing a new water main. B. Contractor shall furnish all labor, equipment and material necessary for the chlorination and testing of the new pipe lines which shall be sterilized before being placed into service. C. Sterilization Procedure i. Contractor shall advise City Inspector of filling and chlorinating plan. 46 Section 5 2020 Design Standards and Specifications Water Specifications ii. Contractor shall verify that all valves adjacent to test section are closed. a. Valves shall be operated in accordance with the current City of Lubbock valve operating procedures, and only when a City of Lubbock inspector is on site. iii. Lines shall be sterilized by the application of an approved chlorinating agent. iv. Chlorinating agent may be liquid chlorine, or a calcium hypochlorite solution, which shall be fed into the lines through a suitable solution -feed device or other methods approved by the City Engineer or designee. v. All newly installed pipes and related products must conform to American National Standards Institute / National Sanitation Foundation (ANSI/NSF) Standard 61 and must be certified by an organization accredited by ANSI, including chlorine for disinfection. vi. Chlorinating agent shall be applied at or near the point from which the line is being filled, and through a corporation stop or other approved connection inserted in the horizontal axis of the newly laid pipe. vii. Water being used to fill the line shall be controlled to flow into the section to be sterilized very slowly. viii. Rate of application of the chlorinating agent shall be at least 50 parts per million. ix. Chlorinated water shall be retained in the pipe lines for a period of not less than 24 hours. D. Testing/Sampling Procedure i. Sample ports shall be protected from contamination. ii. Every sample port shall have a "NON -POTABLE WATER" tag and cap that require tools to remove. iii. The sampling riser shall be located at the farthest point possible from the chlorination point. a. The riser shall be above ground and equipped with a faucet for control of flow during sampling. iv. Samples shall be taken by City of Lubbock Inspectors from the line and will be tested for bacteriologic growth at a City of Lubbock certified laboratory. a. Samples will be taken twice in a 48 hour period not less than 24 hours apart. b. Initial samples may only be taken on Monday, Tuesday or Wednesday prior to 2:00 p.m. E. Chlorinated water used for sterilization shall be legally disposed of per current TCEQ or other applicable regulations. i. A temporary blow off may be required to achieve adequate flushing flow rates. ii. Under no circumstances shall chlorinated water used for sterilization be released directly into the storm drain system or a body of water. iii. Contractor must dechlorinate water before it reaches a curb and gutter, storm drain or body of water. iv. All flushing must conform with the City of Lubbock Storm Water Permit and SWP3 Best Practices. 5.11 Restoration and Clean Up 5.11.01 The Contractor shall restore or replace all removed or damaged paving, curbing, sidewalks, gutters, sod, shrubbery, fences, irrigation systems, pipe, or other structures or surfaces to a condition equal to that before the work began and to the satisfaction of the City Engineer or designee. Section 5 47 2020 Design Standards and Specifications Water Specifications 5.11.02 All streets, alleys, driveways, sidewalks, curbs or other surfaces broken, cut or damaged by the Contractor shall be reconstructed as required by the current City of Lubbock Street Ordinance. 5.11.03 Topsoil material shall be replaced to pre -construction conditions or better. 5.11.04 All rubbish, unused materials and other non-native materials shall be removed from the jobsite. 5.11.05 The right-of-way shall be left in a state of order and cleanliness as determined by the City Engineer or designee. 5.12 Warrantv and Acceptance 5.12.01 Within 30 calendar days after the Developer or Developers Engineer has given written notice that the improvements have been substantially completed, the City shall inspect the completed improvements and provide a punch list if necessary. A. If it is mutually determined that the improvements have been constructed in accordance with the engineering plans and the City of Lubbock Engineering Minimum Design Standards and Specifications, the Developers Engineer shall submit Record Drawings, Certificate of Completion and Developers Warranty Statement (Copies of the Certificate of Completion and the Developers Warranty Statement are included in the City of Lubbock Engineering Minimum Design Standards and Specifications) B. Upon receipt of the Developers Certificate of Completion, Record Drawings and the Developers Warranty Statement, the City will accept improvements within 30 calendar days; unless exception is given in writing. C. Neither the Final Payment nor the Certificate of Completion shall relieve the Developer or Contractor of responsibility related to warranty of materials or workmanship. D. The Developer shall remedy any defects due to faulty materials or workmanship that appear within 1 year from the date of acceptance by the City of Lubbock. 48 Section 5 2020 Design Standards and Specifications Sewer Specifications SECTION 6 STANDARD SPECIFICATIONS FOR SANITARY SEWER MAIN CONSTRUCTION 6.01 General 6.01.01 All sanitary sewer main construction within the City of Lubbock sanitary sewerage system or for future connections to the City of Lubbock sanitary sewerage system shall be accomplished in accordance with the requirements of these specifications. 6.02 Plan Requirements 6.02.01 Sanitary sewer main construction shall be done in accordance with engineered construction plans for the work, prepared under the direction of a Professional Engineer and approved by the City of Lubbock Engineering Department. 6.02.02 Plans shall conform to the City of Lubbock's Minimum Design Standards for Sanitary Sewer and shall show all information called for on the City of Lubbock Check List for Sanitary Sewer Construction Plans. 6.03 Plan Approval 6.03.01 The Engineering Department shall review, approve and issue plans stamped "Approved for Construction" to the Design Engineer. 6.04 Insuection 6.04.01 Engineer and/or Contractor shall notify the Engineering Department 48 hours before the planned construction is to commence and also before starting up when construction is interrupted for any reason. 6.04.02 All work shall be inspected by a representative of the Engineering Department who shall have the authority to halt construction when, in their opinion, construction is being performed contrary to these specifications or other approved plans. 6.04.03 Whenever any portion of these specifications is violated, the City Engineer or designee, by written notice, may order that portion of construction which is in violation of these specifications or other approved plans, specifications and material to cease until such violation is corrected. 6.05 Specifications 6.05.01 All standard specifications and quality standards; i.e., ASA, AWWA, ASTM, etc., which are made a portion of these specifications by reference shall be the latest edition and revision thereof. Section 6 49 2020 Design Standards and Specifications Sewer Specifications 6.06 Materials of Construction 6.06.01 Sewer Pipe A. All pipe used in the City of Lubbock sanitary sewer collection system shall be SDR 35 PVC, SDR 26 PVC, PVC Corrugated Sewer Pipe with Smooth Interior, High Density Polyethylene (HDPE), Ductile Iron, Steel Reinforced Polymer Concrete or Polypropylene Corrugated Single Wall or Dual Wall Pipe and shall conform to the Approved Materials List. B. PVC Pipe - Gravity Flow i. Gravity flow PVC pipe and fittings shall conform to the requirements of ASTM F679 and D3034 for SDR 35 sewer pipe. ii. The pipe shall be jointed with an integral bell and spigot type rubber gasketed joint. a. Each integral bell joint shall consist of a formed bell complete with a single rubber gasket. b. Gaskets shall conform to ASTM F477. iii. Standard joint length shall be 14 or 20 feet f one inch. iv. Gravity flow PVC pipe shall be installed in accordance with the manufacturer's recommendations and shall not exceed 80% of the manufacturer's recommended maximum deflection. v. The minimum pipe stiffness factor shall be 46 psi. vi. Gravity flow sewer pipe shall be green. C. PVC Pipe - Pressure Rated i. Pressure rated PVC sewer pipe and fittings shall conform to the requirements of ASTM D2241 for SDR 26 sewer pipe. ii. The pipe shall be joined with an integral bell and spigot type rubber gasketed joint. a. Each integral bell joint shall consist of a formed bell complete with a single rubber gasket. b. Gaskets shall conform to ASTM F477. iii. Pressure rated PVC pipe shall be installed in accordance with the manufacturer's recommendations and shall not exceed 80% of the manufacturer's recommended maximum deflection. iv. Standard joint length shall be 14 or 20 feet t one inch. v. Pressure rated sewer pipe shall be green. D. PVC Pipe - Spiral Wound i. Spiral wound PVC pipe and fittings shall conform to the requirements of the latest revision of ASTM F794 for large diameter ribbed gravity sewer pipe. ii. Spiral wound PVC pipe shall be installed in accordance with the manufacture's recommendations and shall not exceed 80% of the manufacturer's recommended maximum deflection. iii. The minimum pipe stiffness factor shall be 46 psi. E. High Density Polyethylene Pipe i. The pipe shall be made of high density, high molecular weight polyethylene pipe material meeting the requirements of ASTM F894. ii. Rubber gaskets shall comply in all respects with the physical requirements specified in the non -pressure requirements of ASTM Specifications C443. iii. Polyethylene pipe shall be installed in accordance with the manufacturer's recommendations. 50 Section 6 2020 Design Standards and Specifications Sewer Specifications F. Ductile Iron Pipe i. Ductile iron pipe shall conform to ANSI/ASTM specifications A746 for Ductile Iron Sewer Pipe. a. Pipe and fittings shall have a 30-mil thickness epoxy lining on the interior. b. Pipe and fittings shall have an exterior coating of coal tar pitch conforming to requirements of Federal Specifications WW-P-421. ii. Joints for Ductile Iron shall be of the rubber gasket bell and spigot, except when otherwise shown on the plans and where connecting to flanged fittings, and shall conform to the base specifications to which the pipe is manufactured. iii. Fittings shall be AWWA Standard Class "Y bell and spigot type or an approved gasket joint for the particular type of pipe used and designed for the pressures of the pipe except as shown on the plans. G. Steel Reinforced Polymer Concrete Pipe i. Steel Reinforced Polymer Concrete Pipe and fittings shall conform to ASTM C76, D6783 and A615 and all other applicable standards. ii. Steel Reinforced Polymer Concrete Pipe shall be installed in accordance with the manufacturer's recommendations and shall not exceed 80% of the manufacturer's recommended maximum deflection. H. Polypropylene Corrugated Dual Wall and Triple Wall Pipe i. Polypropylene Corrugated Dual Wall Pipe and fittings shall conform to ASTM F2736. ii. Polypropylene Corrugated Triple Wall Pipe and fittings shall conform to ASTM F2764. iii. Polypropylene Corrugated Dual Wall and Triple Wall Pipe shall be installed in accordance with the manufacturer's recommendations and shall not exceed 80% of the manufacturer's recommended maximum deflection. 6.06.02 Pre -cast Reinforced Concrete Manholes A. Manhole barrel, cone, and extension sections shall be constructed of pre -cast concrete. i. Manhole products shall be smooth, uniform in size and dimensions, consistent in components throughout and free of voids or honeycombs. ii. No grouting shall be applied to the edges or inside surfaces of manholes during the manufacturing process. iii. A plant inspection may be required for production facility inspection and to review record -keeping for material certification. iv. Steps are prohibited in a manhole. B. Manufacturer must provide certification that all materials used for manufacturing meet with the following ASTM Specifications: Specification Material ASTM C-33 Aggregates ASTM C-150 Cement ASTM C-39 Sampling Specimens ASTM A-615 or A-996 Reinforcing ASTM C-144 Sand and Mortar C. Pre -cast Concrete Manhole Sections i. Pre -cast concrete manhole sections shall conform to ASTM C478 specifications. ii. Compressive strength test results must verify concrete strengths meet or exceed 4,000 psi. Section 6 51 2020 Design Standards and Specifications Sewer Specifications iii. Coarse aggregate shall consist of 95% crushed limestone. iv. Manholes shall be designed to withstand H-20 AASHTO loading. v. Manholes shall have lifting holes that do not protrude through manhole wall; one full inch of concrete thickness must remain between lift hole and outside or inside wall of manhole. D. Joints Other Than Grade Rings i. Joints other than grade rings shall be tongue and groove or an equivalent male and female type joint. ii. Joints shall be effectively joined with water -tight sealant to prevent leakage and infiltration. Sealant shall comply with the Approved Materials List. E. Cones and Grade Rings i. Cones and grade rings shall maintain a clear 30-inch opening. ii. Grade rings shall be reinforced with the same percentage of steel as risers and tops and shall also meet ASTM C478 specifications. 6.06.03 Inflow Prevention Device (IPD) A. All new manholes shall be equipped with an approved IPD to prevent unwanted inflow into the sanitary sewer system. B. IPDs shall be constructed of corrosion proof material and load tested to withstand 800 pounds. C. IPDs shall be equipped with a handle or lifting strap capable of supporting a minimum uniform load of 500 pounds. D. IPDs shall be equipped with ventilation valves or holes. i. Release of water through vent valves or holes shall not exceed 5 gallons per 24 hour period. ii. Vent valves or holes shall vent sewer gas at one p.s.i. or less. E. IPDs shall comply with the Approved Materials List. 6.06.04 Manhole Frames and Cover A. Manhole frames and covers shall be of good quality gray iron casting and conform to ASTM Designation A48, having a clear opening of not less than 30 inches. B. Casting shall be designed with a full bearing ring so as to provide a continuous seat between frame and cover. C. Cover shall be furnished with lifting ring or pick bar cast into the cover in such a manner as to prevent water leaking through. D. Frame and cover shall have a weight of not less than 275 pounds, shall include lettering "City of Lubbock, Texas Sanitary Sewer" and shall comply with the Approved Materials List. 6.06.05 Concrete A. Proportioning of the constituents of the concrete shall be such as to produce a dense and workable mixture, and the designed mix shall be approved by the Engineer before any concrete is placed. i. The concrete shall be of such consistency that it will flow without separation of the aggregates. B. Concrete mix shall be based on the water -cement ratio, and shall be as follows for the different applications: 52 Section 6 2020 Design Standards and Specifications Sewer Specifications i. Concrete for manholes, valve vaults and other reinforced concrete structures shall have a water -cement ratio of no more than ASTM C-478 max of 0.53 (by weight) and yield a 28-day compressive strength of not less than 3,000 psi. ii. Concrete for pipe cradling, blocking of fittings, manhole inverts and other non - reinforced concrete shall contain not more than 9.0 gallons of water per sack of cement and yield a 28-day compressive strength of not less than 2,500 psi. C. Concrete to be used in manhole bases, sections, cones, grade rings and inverts shall be made with Portland cement which conforms to "Standard Specifications for Portland Cement", ASTM C150. D. Concrete coarse aggregates shall consist of natural washed and screened sand, and clean crushed limestone conforming to "Standard Specifications for Concrete Aggregate", ASTM C33. i. Aggregates shall be well graded from coarse to fine and shall be free from injurious amounts of clay, soft or flaky materials, loam or organic impurities. ii. Aggregates shall be approved by the City Engineer or designee before use. Sand to be used in cement mortar shall conform to ASTM C144 specifications. F. Water used in mixing concrete or mortar shall be clear, clean, free from oil, acid or organic matter and free from injurious amounts of alkali, salts or other chemicals. G. Surface moisture or moisture carried by the aggregates shall be included as part of the mixing water. H. Reinforcing steel used in concrete shall be deformed bars conforming to ASTM A615 "Standard Specification for Deformed and Plain Carbon -Steel Bars for Concrete Reinforcement" or ASTM A996 "Standard Specification for Rail -Steel and Axel -Steel Deformed Bars for Concrete Reinforcement" grades 40, 50, or 60. i. All reinforcement shall be permanently marked with grade, identification marks or shall, on delivery, be accompanied by a manufacturer's guarantee. I. Forms shall be of wood or metal and shall be of sufficient strength to support the concrete without bulging between supports and sufficiently water tight to hold the concrete mortar. i. Forms shall be so constructed that the finished concrete shall be of the form and dimensions shown on the plans. ii. Form work for exposed surfaces shall be of such material and so constructed as to produce a wall with a smooth, even surface when the concrete is poured. iii. Wall forms shall be set plumb and true and rigidly braced to maintain them in correct position and alignment. iv. Walls for all reinforced concrete work shall be formed inside and outside. v. Form ties shall be adjustable in length and of such type as to leave no metal closer than 1-inch of the surface, and shall not be fitted with lugs, cones, washers, or other devices acting as a spreader which will leave a hole larger than 7/8-inch in diameter or depth back of the exposed surface of the concrete. a. Wire ties will not be permitted. vi. Temporary openings for cleaning and inspection shall be provided at the base of vertical forms or other places where necessary. Such openings shall be neatly and securely closed before concrete is placed. vii. Forms shall be oiled before use. viii. No forms shall be removed without permission of the City Inspector. However, in general, wall forms may be removed after the concrete has been in place for 24 hours and on roof slabs after the concrete has been in place for 10 days. Section 6 53 2020 Design Standards and Specifications Sewer Specifications ix. Immediately upon removal of the forms any honey -combed sections shall be repaired as directed by the City Inspector. 1. Compounds used to form an air tight membrane over a fresh concrete surface shall be in accordance with Texas Department of Transportation Item 360.2.0 (DMS-4650). i. Curing compound shall be applied with a pressurized sprayer in an even coating or as recommended by the manufacturer. 6.06.06 Bedding, Embedment and Backfill A. Sewer Pipe, All Diameters i. Bedding shall be select sand or aggregate free from rocks, clods, roots or other debris larger than 1/2-inch. a. Bedding material shall be free from injurious amounts of clay, dust, blow sand, caliche or slag. b. Bedding shall be 6 inches below pipe. ii. Embedment material shall be crushed stone with irregular surfaces and comply with the following gradation requirements: Standard Crushed Rock Aggregate Cumulative Percent Retained (by weight) Retained on 1" Sieve 0 Retained on 1/2" Sieve 0-20 Retained on 3/8" Sieve 15-30 Retained on No. 4 Sieve 60-90 Retained on No. 8 Sieve 90-100 a. Embedment shall extend to 12 inches above top of pipe. iii. Backfill material shall be native, sandy soil material free from rocks, clods, roots or other debris larger than 2-inch diameter. 6.06.07 Flowable Fill A. Flowable fill shall consist of a mixture of Portland cement, pea gravel and sand with a cement content of 1-1/2 sacks per cubic yard. i. Utility ditches in Right of Way shall be backfilled in accordance with Details UEM-01 through UEM-07 in the appendix. ii. Use of concrete in place of flowable fill is not acceptable, and if used in place of flowable fill shall be removed by the Contractor at their own expense. 6.07 Methods of Construction 6.07.01 Scope A. The work covered by this section consists of constructing gravity flow sanitary sewers, manholes and other appurtenances normally installed as a part of this system. Construction may include surface preparation; trench excavation; shoring; dewatering; laying, aligning and jointing pipe; installation of appurtenances; construction of pre -cast, pre -assembled or field assembled manholes; manhole bases; placement and assembly of manhole risers, cones, or tops; installation of manhole rings, covers and grade rings; bedding, embedment and backfilling; and other related work. 54 Section 6 2020 Design Standards and Specifications Sewer Specifications 6.07.02 Quality Standards Standard Topic Standard Test Methods for Laboratory Compaction ASTM D698 Characteristics of Soil Using Standard Effort ASTM A746 ANSI Ductile Iron Gravity Sewer Pipe Installation of Ductile Iron Mains and Their AWWA C600 (ANSI) A urtenances AWWA M23 Polyvinyl Chloride PVC Pipe Design and Installation Recommended Practice for Polyvinyl Chloride (PVC) UNI B 5 Sewer Pipe ASTM C891 Installation of Underground Pre -cast Utility Structures 6.07.03 Materials A. The Contractor shall install sanitary sewer pipe of the type, diameter, wall -thickness and protective coating that is defined in the Approved Materials List or designated by the City Engineer or designee. One or more acceptable types of pipe may be used. As such, the Contractor shall have the option of installing any of the acceptable types, provided only one type is used throughout any single size designation or run of pipe. 6.07.04 Storm Water Pollution Prevention Plan (SWP3) A. Prior to disturbance of construction area, Contractor shall coordinate with the City of Lubbock Engineering Department to develop a site -specific Storm Water Pollution Prevention Plan. B. SWP3 measures shall conform to the integrated Stormwater Management (iSWM) criteria developed by the North Central Texas Council of Governments. C. SWP3 measures shall be installed prior to construction and shall be maintained throughout the construction until final stabilization. 6.07.05 Surface Preparation A. Within Easements, Cultivated or Agricultural Areas i. All vegetation such as brush, sod, heavy growth, grass, weeds, decayed vegetable matter, rubbish and other unsuitable material within the area of excavation and spoils storage shall be stripped and properly disposed. ii. Topsoil shall be removed to a depth of 8 inches or the full depth of topsoil, whichever is less. iii. Removed topsoil shall be stockpiled during construction in an approved location. Within Unpaved Roadway Areas i. Contractor shall strip the cover material from graveled roadways or other developed but unpaved traffic surfaces to the full depth of the existing surfacing. ii. Surfacing shall be stockpiled to the extent that it is acceptable for restoration purposes. C. Within Paved Areas i. All pavement cuts and repairs shall be in accordance with the current City of Lubbock Street Ordinance and the City of Lubbock Engineering Minimum Design Standards and Specifications. ii. Wherever it is necessary to make cuts in existing pavements, sidewalks, driveways, or curbs and gutters, the cuts shall be made in such a manner as to cause the least possible damage to adjoining surfaces. Section 6 55 2020 Design Standards and Specifications Sewer Specifications iii. Asphalt Paving a. Asphalt surface shall be cut along each side of the trench ahead of the trenching machine and the surfacing and base removed with the trenching machine as the trench is excavated. b. The width of surface removed by the Contractor is not to exceed the outside limits of the trench plus 12 inches. iv. Concrete Paving a. Removal of any sidewalks, concrete pavement, concrete base, concrete curbs and gutters shall be made by cutting the concrete to a straight line on each side of the trench and removing the concrete ahead of the trenching. b. Concrete shall be cut vertically in straight lines and avoiding acute angles. c. Concrete pavement, sidewalks, driveways or curb and gutter shall be cut with a power saw to a depth of 2 inches prior to breaking. d. Overbreak, separation or other damage to the existing bitumen or concrete outside the designated cut lines shall be replaced at the Contractor's expense. e. Tunneling may be required under curb and gutters. f. The width of surface removed by the Contractor of concrete paving is not to exceed the outside limits of the trench plus 12 inches. v. All spoil piles must be 3' from travel lanes or have a traffic barrier that will prevent the soil from encroaching on travel lanes. vi. If roll off dumpsters are placed on street paving, then the paving must be protected from damage. 6.07.06 Barricades and Safety Measures A. Contractor shall, at their own expense, furnish and erect barricades and safety measures for the protection of persons, property and the works as may be necessary. B. All barricades and safety measures shall meet the rules and regulations of Federal, state and local authorities, including but not limited to: i. OSHA regulations for excavation, trenching and shoring ii. Texas Manual on Uniform Traffic Control Devices iii. City of Lubbock Barricade Ordinance C. Contractor will be held responsible for all damage to the work due to failure of barricades and safety measures. i. If damage is incurred, the damaged portion shall be immediately removed and replaced by Contractor at their own cost and expense. D. Contractor's responsibility for maintenance of barricades and safety measures shall not cease until the project is accepted by the City. 6.07.07 Water for Construction A. Water is available from fire hydrants for construction purposes. i. To use City water for construction the contractor shall acquire a water meter for use on a City fire hydrant, and will be charged the applicable rate for the quantity of water used. ii. The contractor shall contact Lubbock Power and Light Customer Service Department and establish a utility account. The contractor must pay the current deposit for each fire hydrant meter and will be responsible for all charges associated with that account. iii. Once an account is established and the deposit is paid, the contractor may pick up a meter from the City Water Department at 600 Municipal Drive. 56 Section 6 2020 Design Standards and Specifications Sewer Specifications iv. The contractor shall be responsible for reporting monthly water usage. B. Fire hydrants shall be operated only by use of an approved fire hydrant wrench. No pipe wrenches, or other unapproved devices, shall be used to open or close a fire hydrant. C. For top loading trucks or containers the contractor shall provide a back flow prevention assembly on the discharge side of the meter. i. The backflow prevention assembly shall be in the form of two spring loaded ball check valves. ii. When filling the truck or container there shall be an air gap of at least two times the opening diameter of the truck or container. D. For bottom loading trucks the contractor shall provide a Reduced Pressure Zone (RPZ) type backflow prevention assembly. i. All RPZ type back flow prevention assemblies must be tested and the test results approved by the City prior to use. ii. The test results shall be sent to the City of Lubbock Public Works Department, Meter and Customer Service Supervisor for approval. E. In accordance with City of Lubbock Ordinance No. 10208 "Pertaining to Backflow Prevention", City representatives are authorized to suspend water use from a fire hydrant by a contractor until the proper and correct backflow prevention devices are installed. 6.07.08 Protection of Existing Utilities A. It shall be the Contractor's responsibility to properly mark (white line) the work area and notify the Texas Excavation Safety System, 1-800-DIG-TESS (1-800-344-8377) a minimum of 48 hours prior to construction or excavation. B. Contractor shall locate all utility lines, including customer service lines, far enough in advance of the trenching to make proper provisions for protecting the lines and to allow for any deviations that may be required from the established lines and grades. C. If required, the Contractor shall "pothole" or physically locate existing underground utilities ahead of trench excavation. D. Contractor will not be allowed to disrupt the service on any utility lines except customer service lines, which may be taken out of service for short periods of time, provided the Contractor obtains permission from the Engineering Department and from the owner of the premises being served by the utility. i. When a customer outage is planned, Contractor shall notify effected customer a minimum of 24 hours in advance. E. Contractor shall notify local utilities whenever working near gas mains or services or near electrical or telephone cables or when the presence of these utilities is suspected in the area of construction. F. Contractor shall proceed with caution in the excavation and preparation of the trench so that the exact location of underground structures, both known and unknown, may be determined. G. Hand excavation shall be used where necessary. H. All utility lines shall be properly supported to prevent settlement or damage to the line both during and after construction. I. Contractor shall be held responsible for the repair of such structures when broken or otherwise damaged because of carelessness on their part. J. The Contractor shall immediately notify the proper utility company of any damage to utility lines in order that service may be established with the least possible delay. Any damage to Section 6 57 2020 Design Standards and Specifications Sewer Specifications existing lines and the repair of customer lines which are authorized to be cut shall be at the Contractor's expense, and as directed by an official representative of the utility company involved. K. Any permanent relocation of existing utility lines shall be done by the proper utility company. 6.07.09 Excavation and Trenching A. The width of the trench shall provide adequate working room for installation, joining and proper compaction along both sides of the pipe. Trenches shall conform to the following dimensions, unless otherwise shown on the Plans: Pipe Size Min. Trench Width Max. Trench Width 4" thru 12" Pipe O.D. +12" Pipe O.D. +18" 15" thru 21" Pipe O.D. +18" Pipe O.D. +24" B. Contractor shall take all necessary precautions for protecting paved streets and drives from being damaged by the trenching and backfilling equipment. C. Grade shall be such that the pipe will rest firmly on the bedding material throughout the entire length of the pipe cylinder. i. Bell holes of ample dimensions shall be dug at each joint to permit the proper jointing of the pipe. D. In order to obtain a true, even grade, the trench shall be fine -graded. i. Material for fine grading shall be free of rocks, roots, grass or any other debris. The depth of the fine grading material shall not exceed 3 inches. ii. Where the trench is excavated in excess of 3 inches below grade, the material shall be compacted to 95% Modified Proctor Density or shall be replaced with approved bedding material. iii. If the material being excavated is rock or other unyielding material, it shall be removed to a depth of 3 inches below grade and replaced with approved bedding material to grade. E. Excavation for manholes, structures and other appurtenances shall be sufficient to provide clearances adequate for proper backfill and compacting on all sides. F. All excavated material shall be placed in a manner that will not endanger the work or damage existing structures. 6.07.10 Dewatering A. All pipe trenches and excavation for structures and appurtenances shall be kept free of water during pipe laying and other related work. B. The method of dewatering shall provide for a dry foundation at the final grades of the excavation. C. Water shall be disposed of in accordance with current City of Lubbock Engineering Department requirements and in a manner that does not inconvenience the public or result in a menace to public health. D. Pipe trenches shall contain enough backfill to prevent pipe flotation before dewatering is discontinued. E. Dewatering shall continue until such time as it is safe to allow the water to rise in the excavation. 6.07.11 Methods of Connection 58 Section 6 2020 Design Standards and Specifications Sewer Specifications A. Service and main line taps and connections shall comply with current City of Lubbock Utilities Ordinance. B. Service Taps i. Service taps on newly constructed mains shall be installed by the utility contractor at the time of pipe installation. ii. Service taps on existing, in-service mains shall be installed by City personnel or a City - designated contractor. C. Main Line Connections i. Connections on existing mains shall comply with current TCEQ requirements. ii. Connection to existing main shall be by a new manhole constructed on the existing main or connection to an existing manhole. iii. City Inspector must be present for any connection being installed on an existing main. 6.07.12 Pipe Installation A. The Contractor shall be responsible for all materials intended for the Work including the safe and proper storage of such materials until incorporated into the work. B. Gravity sanitary sewer pipe and other accessories shall be inspected, handled, laid and joined in the manner herein specified. i. Force mains shall be installed according to water pipe installation specifications and current TCEQ requirements. C. Pipe and accessories shall be inspected upon delivery and periodically during the progress of the work. Any material found to be defective may be rejected. i. If rejected, the Contractor shall remove and replace such defective material at their expense. D. Pipe and accessories shall be handled in accordance with manufacturer's specifications. i. Before lowering into the trench, the pipe and accessories shall be inspected for defects. a. Any defective, damaged, or unsound pipe or other incidental materials shall not be incorporated into the work. ii. All pipe and accessories shall be carefully lowered into the trench piece by piece using suitable tools or equipment in such a manner as to prevent damage to the material. iii. Under no circumstance shall pipe, accessories or tools be dropped directly into the trench. E. Pipe shall be laid to the alignment as established on the approved plans. i. Pipe shall be laid from lowest point to highest point. ii. Pipe shall be laid with spigots facing in the direction of flow. iii. Batter boards or laser beam will be required to fine grade the trench. iv. Each time the instrument used to verify grades is moved, a shot off the hub is required to verify setup. v. All foreign matter shall be removed from the inside of the pipe, bells, spigots, or parts of the pipe used in forming the joint before the pipe is lowered into the trench; a. Pipe shall be kept clean by approved means during and after laying. b. At the times when pipe laying is not in progress, the open ends of pipe shall be closed by approved means. vi. Bell holes shall be dug at each joint of sufficient depth to allow the entire length of the barrel of the pipe to rest on the bottom of the trench and to allow ample space for properly jointing the pipe. Section 6 59 2020 Design Standards and Specifications Sewer Specifications F. Pipe shall be laid so that the pipe label is facing up. G. Pipe shall be jointed per manufacturer's requirements. i. Bell, spigot and gasket of pipe shall be wiped clean prior to joining. ii. Cutting of pipe for inserting accessories or closure pieces shall be done in a neat workmanlike manner without damage to the pipe or lining. iii. If the pipe is disturbed from line and grade after being laid and jointed, the pipe shall be removed from trench, the joints cleaned and the pipe re-laid. iv. Jointing shall be completed for all pipe laid each day. v. No pipe shall be laid in conditions unsuitable for such work as determined by the City Inspector. vi. No trench water shall be permitted to enter the pipe. H. The Engineering Department shall be notified at least 24 hours in advance of when pipe is to be laid in any trench. i. No pipes shall be covered or authorized for cover until they have been inspected by the City's Inspector. 6.07.13 Marking Tape A. Marking tape shall be installed in the same trench with all pipe during pipe installation. i. Marking tape for sewer mains shall be 3-inch, green in color and clearly labeled "Caution: Buried Sewer Line" for gravity mains or "Caution: Buried Sewer Force Main" for force mains. ii. Marking tape shall be installed directly above the centerline of the pipe a minimum of 24 inches above top of pipe. iii. Depth of bury shall be 18 inches below top of trench. 6.07.14 Backfill around Pipe A. Bedding i. Bedding material shall be fine graded select sand or aggregate material conforming to the Materials of Construction section of these Specifications and shall be a minimum of 2 inches thick. B. Embedment i. Embedment, including haunching under pipe and to a point 12 inches above the top of the pipe shall be carefully placed and shall be graded embedment material conforming to the Materials of Construction section of these Specifications. C. Compaction i. Bedding and embedment shall be compacted to in accordance with pipe manufacturer's specifications and approved mechanical means. ii. Compaction shall be in maximum 6-inch compacted lifts. D. Backfill i. The remainder of the backfill shall conform to the current City of Lubbock Street Ordinance and the City of Lubbock Utility Excavation Manual. ii. In street or alley Right of Way or paved easements backfill shall be compacted to a minimum of 95% modified Proctor Density. iii. In unpaved easements the backfill shall be compacted to a minimum of 90% modified Proctor Density. Top 12" of backfill shall be uncompacted. Top 2" of backfill shall be top soil. 60 Section 6 2020 Design Standards and Specifications Sewer Specifications iv. A minimum of 12" flow fill cap under paving will be required with a minimum of 18" under Arterial paving. v. Flowable fill may be substituted for compacted backfill. vi. Special situations such as state highway or railroad crossings may be subject to more stringent requirements and shall be addressed on a case -by -case basis. vii. Water jetting will not be allowed. viii. See plates UEM-01 to UEM-05 for backfill details. E. Following the completion of the backfilling, the Contractor shall maintain the trench surfaces in a satisfactory manner until final completion and acceptance of the work. i. The maintenance may include blading from time to time as necessary, filling depressions caused by settlement, sprinkling to settle dust, brooming or flushing at the request of the City Engineer or designee and other work required to keep the streets and roads in satisfactory condition for traffic. ii. The Contractor shall maintain and be responsible for all paving cuts until such time as permanent repairs are made. 6.07.15 Manhole Construction A. The Contractor shall be responsible for all materials intended for the Work including the safe and proper storage of such materials until incorporated into the work. B. Manholes and other accessories shall be inspected, handled, and installed in the manner herein specified. C. Fiberglass manholes shall be installed per detail SS-5b. D. Manhole components and accessories shall be inspected upon delivery and periodically during the progress of the work. Any material found to be defective may be rejected. i. If rejected, the Contractor shall remove and replace such defective material at their expense. E. Manhole Base i. Field poured concrete bases shall be at least 12 inches thick and not less than 12 inches greater diameter than the outside diameter of the manhole riser section. ii. Concrete shall be minimum 3,000 psi. iii. Concrete placement shall conform to ACI and good construction practices. iv. Concrete shall be consolidated and struck -off to a horizontal surface within the forms or pouring rings. v. Field poured concrete bases shall be reinforced. vi. Pre -cast reinforced concrete bases shall be of the size and shape detailed on the Plans. F. Manhole Inverts i. Invert channels shall be smooth and semi -circular in shape conforming to the inside of the adjacent sewer section. ii. Changes in direction of flow shall be made with a smooth curve of as large radius as the size of the manhole will permit. iii. Changes in size and grade of the channels shall be made gradually and evenly. iv. The invert channels may be formed directly in the concrete of the manhole base or may be half -pipe laid in concrete. v. The floor of the manhole outside the channel shall be smooth and shall slope toward the channel not less than one inch per foot or more than two inches per foot. G. Manhole Barrels Section 6 61 2020 Design Standards and Specifications Sewer Specifications i. Manhole barrels shall be assembled of pre -cast riser sections. Riser sections shall be placed vertically with tongues and grooves properly keyed. ii. Free drop inside the manhole shall not exceed 24 inches measured from the invert of the inlet pipe to the invert of the outlet pipe. a. Where the drop exceeds 24 inches, an approved drop manhole shall be required. iii. All connections between the riser or base sections and the sewer pipe shall be joined in such a manner as to make the manholes watertight. a. Preformed rubber waterstop gaskets shall be cast into the riser or base section. b. Approved preformed flexible plastic sealing compounds are also acceptable, provided water tightness is achieved. H. Top or Cone Sections i. Cone shaped top sections shall be assembled on top of the manhole barrel with tongues and grooves properly keyed. ii. On shallow lines where standard cone sections will not conform to specified elevations, flat top sections may be considered with prior approval of the City Engineer or designee. I. Grade Rings i. Grade rings shall be used for adjusting the top elevation. a. Grade rings shall be set to the elevations shown on the Plans or established by the City's Inspector. b. Each manhole shall have a minimum of 6 inches of grade adjustment. c. Total height of the grade rings shall not exceed 18-inches at any manhole. d. Non -shrink grout shall be placed around and under the rings to provide a seal and properly seat the rings at the required elevation. 1. Manhole Frame and Cover i. Manhole frame and cover shall be set to the elevation shown on the plans. ii. Non -shrink grout shall be placed around and under the frame to provide a seal and properly seat the frame at the required elevation. K. Inflow Prevention Device (IPD) i. All newly installed manholes shall be equipped with an approved IPD to prevent unwanted inflow into the sanitary sewer system. ii. IPDs shall be installed such that lifting strap is to the North. iii. IPDs shall comply with the Approved Materials List. L. Water Tightness i. Finished manholes are expected to be as watertight as the pipe system they are incorporated into. Infiltration or exfiltration shall not exceed the limits established in these specifications. ii. All connections between riser sections, bases and tops shall be sealed with an approved preformed flexible plastic joint sealing compound. iii. Application of primer and sealing compound shall be accomplished in conformance with the manufacturer's recommendations. iv. Grade of materials, quantity of materials and application temperatures shall conform to the manufacturer's recommendations. M. Protective Lining System i. When required for rehabilitation of an existing manhole, construction of a new 60-inch diameter manhole or construction of a manhole serving an 18-inch diameter or larger 62 Section 6 2020 Design Standards and Specifications Sewer Specifications pipe, an approved protective lining or coating system shall be installed per manufacturer's instructions. Protective lining and coating systems shall conform to the Approved Materials List. N. Backfilling Around Manholes i. Backfilling around manholes shall conform to the requirements as specified for backfilling around pipe. ii. Embedment material shall be placed up to a point equal to that required for the adjacent pipe. O. Following the completion of the backfilling, the Contractor shall maintain the excavated surfaces in a satisfactory manner until final completion and acceptance of the work. i. The maintenance may include blading from time to time as necessary, filling depressions caused by settlement, sprinkling to settle dust, brooming or flushing at the request of the City Engineer or designee and other work required to keep the streets and roads in satisfactory condition for traffic. ii. The Contractor shall maintain and be responsible for all paving cuts until such time as permanent repairs are made. 6.07.16 Service Connections A. Service connections on newly constructed mains shall be installed by the utility contractor at the time of pipe installation. B. Service connections on existing sewer mains shall be made by City of Lubbock Water Utility forces. C. Contractor shall place wyes and tees for service connections where required by the approved construction plans on new sewer mains. i. Wyes and tees shall be of like material as the sewer pipe. ii. Service lateral lines shall be installed to 2 feet inside adjacent property line at a typical depth of between 4 feet and 6 feet, or deeper when required. iii. Watertight plugs shall be installed in each branch pipe or stub. iv. Service locations shall be marked with a piece of two-inch by four -inch lumber extended from the end of the pipe to above ground level with the above -ground portion painted green. 6.08 Inspection, Testing, Approval and Acceptance of Gravity Flow Sanitary Sewer Pipe and Manholes 6.08.01 Scope A. The work covered by this section consists of the inspection, testing, approval and acceptance of gravity flow sanitary sewers and manholes and other appurtenances normally installed as part of this system. The work may include inspection, cleaning, leakage testing, deflection testing and television inspection of the interior of the finished sewer system. Section 6 63 2020 Design Standards and Specifications Sewer Specifications 6.08.02 Quality Standards A. The latest published revision of: Standard Topic ASTM C969 Infiltration and Exfiltration Acceptance Testing of Installed Sewer Lines ASTM C828 Low Pressure Air Test of Sewer Lines UNI B 6 Recommended Practice for Low Pressure Air Testing of Installed Sewer Pipe ASTM C1214 Standard Test Method for Concrete Pipe Sewer Lines by Negative Air Pressure (Vacuum) Test Method ASTM C1244 Standard Test Method for Concrete Sewer Manholes by the Negative Air Pressure (Vacuum) Test Prior to Backfill 6.08.03 Materials A. Water used for exfiltration tests shall be potable or as otherwise approved by the City Inspector. B. Equipment for tests shall be of the type, quality and capacity to perform the operations required and shall be furnished by the Contractor. C. All labor and materials, including water, shall be furnished at the Contractor's expense. 6.08.04 Inspection A. City Inspector shall inspect and approve all work accomplished. i. Testing shall be performed at the discretion of the City Inspector. B. It shall be the responsibility of the Contractor to coordinate inspection and testing with the Engineering Department. 6.08.05 Cleaning A. Contractor shall remove all foreign matter from the interior of the system prior to testing any section of sewer pipe. i. Chunks of concrete, mortar or other debris including dirt, small gravel, and grit shall be removed from the interior of the newly installed system. ii. Flushing debris into the downstream system shall not be allowed. B. Watertight plugs or other methods approved by the City Inspector shall be used to prevent dirt or debris from entering the system. C. After cleaning manholes, manhole cover shall be positioned to prevent dirt or debris from entering the system. Other means of preventing intrusion of dirt or debris may be employed if approved by the City Inspector. 6.08.06 Pipe Testing A. Contractor shall have the option of conducting a hydrostatic exfiltration test or a low-pressure air test. An infiltration test may also be required if the pipeline is continuously subjected to an exterior hydrostatic head. B. Contractor shall notify the City Inspector a minimum of 24 hours in advance of any testing. C. Testing shall be conducted by the Contractor at their own expense. 64 Section 6 2020 Design Standards and Specifications Sewer Specifications D. Testing shall be accomplished in the presence of the City Inspector or his authorized representative. E. Testing shall not commence on any portion of the pipeline until all field placed concrete in contact with the pipe, fittings or appurtenances is adequately cured. F. Exfiltration Test i. The sewer line being tested may be filled with water for a period long enough to allow water absorption in the pipe wall. The saturation period shall be a minimum of 4 hours and not more than 72 hours. ii. Each section of the pipeline shall be tested between successive manholes or other structures. The lower end of the section shall be closed with a watertight device. The inlet end of the section to be tested shall be filled with water to a point 4 feet above the pipe invert at the centerline of the upper manhole or structure. a. If the ground water level is above the pipe invert, the water level in the upper manhole shall be 4 feet above the adjacent ground water level. Ground water level shall be determined by the Contractor, subject to approval by the City Inspector. iii. Allowable exfiltration shall not exceed 10 gallons/inch diameter/mile of pipe/24 hour period. iv. For construction within the 25-year flood plain, the infiltration shall not exceed 5 gallons/ inch diameter/mile of pipe/24 hour period at the same minimum test head. v. Leakage shall be measured by checking the drop in the water level in the upper manhole or structure over a period of 4 hours. vi. Contractor shall repair obvious or concentrated leaks and other repairs as necessary to reduce exfiltration leakage to an acceptable rate. vii. Contractor shall repeat the 4 hour exfiltration test after repairs are made until an acceptable leakage rate is attained. viii. Repairs required shall be at the Contractor's own expense. G. Low -Pressure Air Test i. Low-pressure air test shall be conducted in accordance to the provisions of UNI-13-6, "Recommended Practice for Low -Pressure Air Testing of Installed Sewer Pipe," published by Uni-Bell Plastic Pipe Association. ii. Low pressure air shall be slowly introduced into the sealed line until the internal air pressure reaches 4.0 psig greater than the average backpressure of the groundwater above the pipe. iii. The air supply shall be throttled to maintain that internal pressure for at least 2 minutes to permit the temperature of the entering air to equalize with the temperature of the pipe wall. iv. When temperatures have been equalized and the pressure stabilized at 4.0 psig, the air supply shall be shut off or disconnected. v. Time shall be recorded for the pressure inside the pipe to drop 4.0 psig to 3.0 psig. Section 6 65 2020 Design Standards and Specifications Sewer Specifications vi. Time shall not be less than that outlined in the following table: Pipe Diameter (inches) Minimum Time (seconds) Max Length for Min Time (feet) Time for Longer Length seconds/foot 6 340 398 0.855 8 454 298 1.520 10 567 239 2.374 12 680 199 3.419 15 850 159 5.342 18 1020 133 7.693 21 1190 114 10.471 vii. City Inspector shall witness and verify results of the test. viii. The City Inspector may stop a test if no pressure drop loss has occurred during the thirst 25% of the calculated testing time. ix. Contractor shall repair obvious or concentrated leaks and other repairs as necessary to reduce leakage to an acceptable rate. x. Contractor shall repeat the low-pressure air test after repairs are made until an acceptable pressure drop for the test is attained. xi. Repairs required shall be at the Contractor's expense. H. Infiltration Test i. Infiltration tests are acceptable only if the pipeline is continuously subjected to an external hydrostatic head (ground water level) of at least 2 feet above the top of the pipe at the upstream manhole or structure. ii. Infiltration test shall be made by sealing the inlet and outlet ends of this pipeline and measuring the volume of water that infiltrates into the section being tested. a. Flow measurement may be measured by collecting the discharge into a volumetric measuring container, weir or other approved method. iii. The test shall be continued over a period of at least 4 hours. Time shall be allowed to soak lines and manholes in advance of performing test. iv. Allowable infiltration shall not exceed 10 gallons/inch diameter/mile of pipe/24 hour period. v. For construction within the 25-year flood plain, the infiltration shall not exceed 5 gallons/ inch diameter/mile of pipe/24 hour period at the same minimum test head. vi. Contractor shall repair obvious or concentrated leaks and other repairs as necessary to reduce the infiltration to an acceptable rate. vii. Contractor shall repeat the 4 hour infiltration test after repairs are made until an acceptable infiltration rate is attained. viii. All repairs required shall be at the Contractor's own expense. ix. Whenever the rate of infiltration is found to repeatedly exceed the prescribed amount, the Contractor shall be notified in writing. The Contractor may then be required to provide, at their own expense, video inspection of the interior of the conduit. The Contractor shall make appropriate repairs by methods approved by the City Engineer or designee and shall continue to test the conduit until it is proven satisfactory. 66 Section 6 2020 Design Standards and Specifications Sewer Specifications 6.08.07 Video Inspection A. Where determined to be necessary, the new sewer pipe shall be inspected by video camera prior to final acceptance. i. Initial video inspection shall be at the Contractor's own expense. Video equipment expressly designed for pipeline inspection purposes and operated by experienced and qualified personnel shall be pulled through the entire pipeline. i. Video equipment operator shall maintain a log of all inspections and note location, type and extent of any deficiencies. ii. Video equipment operator shall also photograph all deficiencies and not less than one "typical" location per each 500 feet of pipeline inspected. C. Contractor shall bear all costs incurred in correcting deficiencies found during the video inspection, including cost of additional video inspection required to verify correction of noted deficiencies. D. Video inspection conducted solely for the Contractor's benefit shall be at the Contractor's own expense. 6.08.08 Deflection Test A. Deflection tests shall be conducted in the presence of the City Inspector after the pipe has been installed and backfilled. i. The deflection test shall be conducted by pulling a mandrel (go no-go device) through the pipe. ii. The mandrel shall be designed and sized for each size and type of pipe and shall be at least 1.5 pipe diameters in length. iii. The mandrel shall be constructed with an odd number of runners placed parallel to the pipe centerline and equally spaced around the perimeter of the mandrel. iv. Test mandrel shall be furnished by the Contractor and approved by the City Inspector. v. Test equipment, calibration data and procedures shall be subject to the approval of the City Inspector. vi. Deflection test cannot be performed until 30 days after final backfill per Title 30 Texas Administrative Code Chapter 217.57(b)(4). Ring or diametric deflection of the installed pipe shall not exceed 5% of the design internal diameter of the pipe. Pipe sections that restrict free passage of the mandrel shall be removed and replaced or excavated, re -bedded, backfilled and retested. C. All repairs, replacement, remedial work and retesting shall be performed by the Contractor at their own expense. D. Deflection test may be conducted concurrently with the video inspection of the pipe interior, subject to approval by the City Inspector. 6.08.09 Manhole Testing A. Manholes shall be tested for leakage separately and independently of the sanitary sewer lines by vacuum testing, hydrostatic exfiltration testing or other methods approved by the City Inspector. An infiltration test may also be required if the manhole is continuously subjected to an exterior hydrostatic head. Contractor shall notify the City Inspector a minimum of 24 hours in advance of any testing. C. Testing shall be conducted by the Contractor at their own expense. Section 6 67 2020 Design Standards and Specifications Sewer Specifications D. Testing shall be accomplished in the presence of the City Inspector or his authorized representative. E. Testing shall not commence on any portion of the pipeline until all field placed concrete in contact with the pipe, fittings or appurtenances is adequately cured. F. Vacuum Test i. All inlet and outlet pipes in the manhole shall be plugged with an airtight device. ii. All lift holes and exterior joints shall be plugged with a non -shrink grout. a. No grout shall be placed in horizontal joints prior to testing. iii. The manhole opening shall be sealed by a method approved by the City Inspector. iv. Vacuum test shall be in accordance with ASTM 1244-11. v. The Contractor shall have the option to repeat the vacuum test one time after repairs vi. If a vacuum test is failed twice, the manhole shall be repaired and an exfiltration test shall be performed. vii. All repairs required shall be at the Contractor's own expense. G. Exfiltration Test i. All inlet and outlet pipes in the manhole shall be plugged with a watertight device. ii. The manhole being tested may be filled with water for a period long enough to allow water absorption into the manhole. The saturation period shall be a minimum of 4 hours and not more than 72 hours. iii. Test shall be conducted with the manhole filled with water to the top of the cone section. iv. Allowable leakage shall not exceed 0.025 gallon/foot diameter/foot of manhole depth/hour over a 4 hour period. v. The Contractor shall repeat the exfiltration test after repairs until an acceptable leakage rate is attained. vi. All repairs required shall be at the Contractor's own expense. H. Infiltration Test i. Infiltration tests are acceptable only if the connecting conduit is continuously subjected to an external hydrostatic head (ground water level) at least 2 feet above the top of the conduit. Ground water level shall be determined by the Contractor, subject to approval by the City Inspector. ii. All inlet and outlet pipes in the manhole shall be plugged with a watertight device. The volume of water that infiltrates into the manhole during a 4 hour period shall be measured in a manner determined by the City Inspector. iii. The test shall be conducted after the manhole has been subjected to the maximum ground water level for at least 4 hours to thoroughly saturate the manhole wall. iv. The allowable infiltration shall not exceed 0.025 gallon/foot of diameter/foot of manhole depth/hour during a 4 hour test. v. The Contractor shall repeat the 4 hour infiltration test after repairs until an acceptable leakage rate is attained. vi. All repairs required shall be at the Contractor's own expense. 6.08.10 Approval A. Final approval of sewer lines and manholes shall be based on an inspection covering all items in this specification and other approved plans and material. The inspection shall be done in an appropriate manner by representatives of the City Engineer or designee. 68 Section 6 2020 Design Standards and Specifications Sewer Specifications B. Contractor shall remedy any defects in workmanship or materials revealed by inspection at their own expense. C. Final approval will be based on re -inspection of the sewer after the appropriate repairs and corrections are completed. 6.08.11 Acceptance A. Flow of any kind into the existing sanitary sewer collection system shall not be allowed until the new sewer lines and manholes has been satisfactorily completed and accepted for use by the City Engineer or designee. B. Portions of the work completed may be placed in operation after all cleaning, testing and inspection requirements have been fulfilled. Such partial use or partial acceptance shall be subject to approval of the City Engineer or designee. 6.09 Lift Station 6.09.01 Lift station design must conform to the most recent TCEQ design criteria. 6.09.02 Site Layout A. Lift station site location shall be approved by the City Engineer or designee. B. Site shall be chosen to provide the least negative impact to surrounding existing and future development. C. The station site shall be located so it may serve as much of the entire sewer drainage basin as possible. This may require that the station be located off -site of the development. D. The station site shall be protected from the 100-year flood plain and shall be accessible during the 25-year storm event. E. Lift station site and associated access road shall be located in a dedicated right-of-way or permanent easement. i. Access road shall be a minimum 12-foot wide all-weather surface. ii. Additional staging and parking area shall be provided. iii. Station grounds shall be minimum 5-inch thick, aggregate road base material. F. Lift station site shall be fully enclosed by intruder -resistant fence and include a 14-foot vehicle gate and 3-foot man gate. Vehicle gate shall be situated such that pumps and equipment are accessible by service vehicles. G. Lift station shall have bypass capability. H. Lift station shall have lightning protection for all electronic components. I. Lift station site shall be illuminated by a security light system. J. Lift station shall be fitted with SCADA antennae. 6.09.03 Dry Well A. Dry well shall have separate, dedicated entrance with ladder. B. The dry well or valve vault shall have an approved, lockable, 26-inch x 36-inch pedestrian - rated aluminum hatch. C. Provisions shall be made for water removal from the dry well. D. Dry well shall be adequately vented with a minimum of two 4-inch vent pipes with one having an active ventilation blower. Section 6 69 2020 Design Standards and Specifications Sewer Specifications 6.09.04 Wet Well A. Wet wells must be enclosed by water -tight and gas -tight walls. B. Interior walls of wet wells shall be lined with a lining system per the Approved Materials List. C. Wet well shall have a maintenance hatch for servicing pumps and a separate, dedicated entrance. i. Dedicated entrance shall have an approved, lockable, 26-inch x 36-inch pedestrian - rated aluminum safety hatch. ii. Maintenance hatch shall be an approved, double -door, lockable, 48-inch x 72-inch pedestrian -rated aluminum hatch or as required to adequately maintain the wet well pumps and components. D. A gravity sewer pipe discharging to a wet well must be located so that the invert elevation is above the level of the system's "on" setting. E. All piping within wet well shall be PVC with flanged fittings. F. All interior components shall be stainless steel including nuts, bolts, other fasteners and all base plates. G. Each pump shall be fitted with minimum 25 feet of stainless steel lifting chain. H. Each pump shall be fitted with dual -rail stainless steel guide bar and upper guide bar brackets. I. Wet well shall have a sloped bottom toward the pump intake to avoid solids deposition. J. Wet well shall be adequately vented with a minimum of two 4-inch vent pipes with one having an active ventilation blower. K. Piping associated with lift stations shall be approved gravity or pressure rated sewer pipe. 6.10 Restoration and Clean U 6.10.01 The Contractor shall restore or replace all removed or damaged paving, curbing, sidewalks, gutters, sod, shrubbery, fences, irrigation systems, pipe, or other structures or surfaces to a condition equal to that before the work began and to the satisfaction of the City Engineer or designee. 6.10.02 All streets, alleys, driveways, sidewalks, curbs or other surfaces broken, cut or damaged by the Contractor shall be reconstructed as required by the current City of Lubbock Street Ordinance. 6.10.03 Irrigation systems affected by construction shall be properly repaired by a licensed irrigator, with materials equal to the existing system and in compliance with current applicable codes. 6.10.04 All rubbish, excess excavated materials, unused materials and other non-native materials shall be removed from the jobsite and legally disposed. 6.10.05 The right-of-way shall be left in a state of order and cleanliness as determined by the City Engineer or designee. 70 Section 6 2020 Design Standards and Specifications Sewer Specifications 6.11 Warrantv and Acceptance 6.11.01 Within 30 calendar days after the Developer or Developers Engineer has given written notice that the improvements have been substantially completed, the City shall inspect the completed improvements and provide a punch list if necessary. A. If it is mutually determined that the improvements have been constructed in accordance with the engineering plans and the City of Lubbock Engineering Minimum Design Standards and Specifications, the Developers Engineer shall submit Record Drawings, Certificate of Completion and Developers Warranty Statement (Copies of the Certificate of Completion and the Developers Warranty Statement are included in the City of Lubbock Engineering Minimum Design Standards and Specifications) B. Upon receipt of the Developers Certificate of Completion, Record Drawings and the Developers Warranty Statement, the City will accept improvements within 30 calendar days; unless exception is given in writing. C. Neither the Final Payment nor the Certificate of Completion shall relieve the Developer or Contractor of responsibility related to warranty of materials or workmanship. D. The Developer shall remedy any defects due to faulty materials or workmanship that appear within 1 year from the date of acceptance by the City of Lubbock. Section 6 71 2020 Design Standards and Specifications Sewer Specifications 72 Section 6 2020 Design Standards and Specifications Approved Materials List SECTION 7 APPROVED MATERIALS AND MANUFACTURERS LIST 7.01 Introduction 7.01.01 This section lists specific products and manufacturers that have been approved for use within the City of Lubbock water and sanitary sewer system. 7.01.02 This listing is intended to be used as a reference source for Water Utilities employees, design engineers, developers, contractors and vendors. 7.01.03 Materials produced by manufacturers not listed herein are not acceptable for use within the City's system. 7.01.04 Manufacturers interested in submitting products for evaluation and possible approval should submit a written request in accordance with the procedures listed below. 7.02 Product Submittal Procedures 7.02.01 Written requests should be sent to the attention of "City Engineer, City of Lubbock, PO Box 2000, Lubbock, Texas 79401". 7.02.02 Written requests shall include the following: A. A complete Application for New Product(s) (See Appendix A-1) B. Four (4) copies of the following documents: i. A list of all applicable standards regarding the product and certification (AWWA, ANSI, ASTM, etc.) ii. Adequate shop drawings and design information (brochures and other product information) iii. Location of the manufacturer's plant iv. Location of the nearest local distribution point and retail outlet v. A list of any special tools, fittings or methods of construction required for installation and/or maintenance vi. Spare parts and service availability information vii. A 5-year history of the product documenting its performance viii. Warranties ix. Product sample (where appropriate) x. User references, with contact person and telephone numbers (Specifically in the State of Texas) A. Life cycle costs (where appropriate) xii. A statement of why the approval of the product would be beneficial to City of Lubbock C. Applicant shall send a formal review meeting request to the City Engineer or designee. D. All submissions shall be made at least 30 days prior to the meeting at which review is requested. Section 7 73 2020 Design Standards and Specifications Approved Materials List 7.03 Evaluation Process 7.03.01 Product evaluation will be conducted by the City Engineer or designee or their designee. A. Review shall include: i. Conformance with the City of Lubbock Minimum Design Standards and Specifications. ii. Comments made by contractors, engineers, developers, suppliers, etc. iii. Any other matters regarding the design, construction and implementation of the proposed product into the City of Lubbock water and sanitary sewer system. B. Applicant may be requested to make a brief presentation regarding the product. Representatives shall be knowledgeable on product use, locations, design and reference checks. The representative shall also have the authority to approve a trial run in City of Lubbock. 7.04 Approval Process 7.04.01 The decision of the City Engineer or designee is final. 7.04.02 For each product that has been submitted, one of the following recommendations will be made: A. Approval for Use i. This approves a product for use throughout the City's service area. ii. The City Engineer or designee may withdraw the Approval for Use status for violation of the City of Lubbock Minimum Design Standards and Specifications. iii. All use of the product will be in conformance with the manufacturer's specifications and good engineering practices. B. Conditional Approval for Use i. This approves a product for use throughout the City's service area; however, the product will be reviewed periodically to ensure that no unforeseen installation or maintenance problems have risen and that quality assurance/quality control meet City Standards. ii. After a suitable period of field observation, this approval may be upgraded to Approval for Use status. The frequency of review and the length of field observation period will be determined by the City Engineer or designee. iii. If, during the field observation period, problems with installation, operation or maintenance of the product are observed, the City Engineer or designee may downgrade the status of the product to Disapproved for Use. iv. The City Engineer or designee may withdraw the Conditional Approval for Use status for violation of the City of Lubbock Minimum Design Standards and Specifications. v. All use of the product will be in conformance with the manufacturer's specifications and good engineering practices. C. Limited Approval for Use i. This approves a product for use only in certain sites or projects within the City's service area. The City Engineer or designee will determine where the product can be used. ii. The product will be reviewed periodically to ensure that no unforeseen installation, operation or maintenance problems have arisen. iii. After a suitable period of field observation, this approval may be upgraded to Conditional Approval for Use or Approval for Use status. The frequency of review and 74 Section 7 2020 Design Standards and Specifications Approved Materials List the length of the field observation period will be determined by the City Engineer or designee. iv. If, during the field observation period, problems with the installation, operation or maintenance of the product are observed, the City Engineer or designee may downgrade the status of the product to Disapproved for Use. v. The City Engineer or designee may withdraw the Limited Approval for Use status for violation of the City of Lubbock Minimum Design Standards and Specifications. vi. All use of the product will be in conformance with manufacturer's specifications and good engineering practices. D. Disapproved for Use i. The product may not be used anywhere within the City's service area. ii. If a product has been given a Disapproved for Use status by the City Engineer or designee, the product may not be resubmitted for review unless significant changes have been made to the product. iii. The City Engineer or designee will not reconsider a product Disapproved for Use until at least twelve (12) months have passed from the date of disapproval. E. Insufficient Information i. Not enough information was provided to evaluate the product. ii. Upon receipt of requested additional information, the City Engineer or designee will reevaluate the product. iii. If, upon reevaluation, it is determined that not enough information was provided a Disapproved for Use status will be given. 7.04.03 Design Changes of Approved Products A. After the approval of a product, the manufacturer or their representative shall inform the City Engineer or designee, in writing, of any modifications in design or material. Such changes may require further evaluation and approval. 7.04.04 Withdrawal of Approval A. The City Engineer or designee may withdraw any approval as a result of a design change, field observation, testing, product failure, or other factors that, in the opinion City Engineer or designee, warrant such withdrawal. Section 7 75 2020 Design Standards and Specifications Approved Materials List 7.05 Water 7.05.01 Water Pipe A. Polyvinyl Chloride (PVC) 4-inch to 24-inch i. AWWA C900 or C905; Minimum DR-18 ii. Manufacturers: a. CertainTeed (1) Certa-Lok b. Diamond Plastics c. JM Eagle (1) Blue Brute (2) Big Blue (3) Eagle Loc 900 d. North American Pipe e. Northern Pipe Products f. Pipelife Jetstream g. VinylPlex, Inc. h. Royal Building Products B. High Density Polyethylene (HDPE) i. AWWA C906, PE 4710, Minimum DR11, Pressure Class 200 ii. Manufacturers a. Chevron b. JM Eagle c. Plexco C. Cement -lined Ductile Iron (DIP) - Push -On or Mechanical Joint i. AWWA C151 Minimum Thickness Class 50 ii. Manufacturers a. American Cast Iron Pipe b. Griffin Pipe Products c. McWane Pipe d. U.S. Pipe and Foundry D. Concrete Cylinder Pipe i. AWWA C301, Pre -stressed Concrete Steel Cylinder Pressure Pipe ii. AWWA C303, Concrete Bar -wrapped Steel Cylinder Pressure Pipe iii. Manufacturers: a. Forterra 7.05.02 Fittings: (Bends, Crosses, Tees and Offset Glands) A. Ductile Iron; Compact B. AWWA C110 and C-153 C. Manufacturers: i. American Cast Iron Pipe ii. Griffin Pipe Products 76 Section 7 2020 Design Standards and Specifications Approved Materials List iii. McWane Pipe iv. Sigma Corporation v. Star Pipe Products, Inc. vi. Tyler Pipe and Foundry Utilities vii. U.S. Pipe and Foundry 7.05.03 Couplings (Transition or Straight), Non -Restrained A. Low -alloy or stainless steel bolts and nuts; outside finish: heat fused nylon coating or fusion bonded epoxy coating; standard length body. B. Manufacturers i. Dresser ii. Ford iii. JCM Industries iv. Romac v. Smith -Blair 7.05.04 Resilient Wedge Gate Valves, 4-inch through 12-inch A. Ductile Iron Body; Outside finish: heat fused nylon coating or fusion bonded epoxy coating. B. AWWA C509 and C515 C. Manufacturers i. American AVK ii. Clow iii. Darling iv. EJIW v. Mueller vi. M & H Model 4067 7.05.05 Butterfly Valves — 16-inch and Greater, with gearing if required by manufacturer A. Ductile Iron Body; Outside finish: heat fused nylon coating or fusion bonded epoxy coating. B. AWWA C504 C. Manufacturers i. DeZurik ii. Mueller iii. M & H 7.05.06 Fire Hydrants A. AWWA C502 B. 5-1/4-inch valve opening; 2-1/2-inch hose nozzles; 4-inch steamer nozzle C. Factory painted orange D. Manufacturers i. American Darling Model B-84-B ii. East Jordan Iron Works Section 7 77 2020 Design Standards and Specifications Approved Materials List iii. Clow Medallion iv. Mueller Centurion v. M & H Style 129-09 vi. American AVK 7.05.07 Fire Hydrant Raised Pavement Marker A. Manufacturer i. Stimsonite Model 80 7.05.08 Service Saddles A. Epoxy coated ductile iron body; Double band with SS bands and bolts B. AWWA C800 C. 1-inch i. Female AWWA Taper threads (CC or CS) ii. Manufacturers a. Ford b. JCM Industries c. Mueller d. Romac Industries, Inc. e. Smith -Blair f. PowerSeal Pipeline Products D. 2-inch i. Female iron pipe threads ii. Manufacturers a. Ford b. JCM Industries c. Mueller d. Romac Industries, Inc. e. Smith -Blair f. PowerSeal Pipeline Products 7.05.09 Corporation Stops A. Full Port Ball Valve B. AWWA C800 C. 1-inch i. Male AWWA Taper threads (CC or CS) by flared copper or compression ii. Manufacturers a. A. Y. McDonald b. Ford c. Mueller D. 2-inch i. Male iron pipe threads by flared copper or compression ii. Manufacturers a. A. Y. McDonald 78 Section 7 2020 Design Standards and Specifications Approved Materials List b. Ford c. Mueller 7.05.10 Service Tubing A. Copper Tubing i. ASTM B88 ii. Flared copper fittings iii. 1-inch a. Type K - Soft iv. 2-inch a. Type K - Hard B. Polyethylene Tubing (PET and PEXa); i. ASTM D2737 - Copper Tube Size (CTS), 200 PSI Minimum, Black or Blue ii. Slip Fittings a. Ford - Ultratite b. Mueller - Instatite iii. Manufacturers a. Endot — Endopure PE 4710 — 1-inch only b. NuMex PE 4710 — 1-inch only c. Rehau — Municipex PEXa — 1-inch, 1.5-inch or 2-inch d. Silverline — Sil-O-Flex PE 3408 or 4710 — 1-inch only e. Ultraline — Driscoplex 5100 Series PE 4710 — 1-inch only 7.05.11 Curb Stops A. Full Port Ball Valve B. 360 degree rotation C. AWWA C800 D. Curb stops shall include meter swivel nut (meter spud) connection on outlet side such that meter nut can be replaced without removing valve from operation. E. Reductions for smaller meter sizes shall be accomplished by use of appropriately sized iron pipe threaded brass bushing on outlet side of curb stop. F. 1-inch and 2-inch i. Flared copper or compression by female iron pipe threads with meter swivel nut. ii. Manufacturers a. A. Y. McDonald b. Ford c. Mueller 7.05.12 Compression Fittings A. Compression fittings shall be quick joint type. B. Manufacturers i. Mueller Insta-Tite Connection ii. Ford Ultra-Tite Connection Section 7 79 2020 Design Standards and Specifications Approved Materials List 7.05.13 Tapping Sleeves A. Stainless Steel Sleeves with Stainless Steel or Carbon Steel Flange B. Epoxy coated with stainless steel bolts and nuts C. Manufacturers i. Ford FAST ii. JCM Industries #469 iii. Smith Blair #662 iv. ROMAC #SST v. PowerSeal Pipeline Products 7.05.14 Resilient Seat Wedge Tapping Valves A. AWWA C509 B. Manufacturers: i. American ii. Clow iii. EJIW iv. Mueller v. M & H vi. U. S. Pipe 7.05.15 Water Meter Boxes and Vaults A. Manufacturers i. Boxes for 1" meters a. DFW Plastics model DFW38FWP-18-AF1QF1 SMALL LID ii. Boxes for 1.5" or 2" meters a. DFW Plastics model DFW1324C-AFiQF SMALL LID 7.05.16 Double Check, Double Detector Check and Reduced Pressure Principle Devices A. American Society of Sanitary Engineering Seal Approval B. Call City of Lubbock backflow coordinator at (806) 775-2589 for specific applications. C. Manufacturers i. Ames ii. Febco iii. Watts iv. Wilkins 7.05.17 Backflow Preventer Box A. Polyester or Aluminum Enclosure, Heated and Insulated ASSE 1060 B. Manufacturers i. EZ Box Model HEZ ii. Hot Box iii. Safe-T-Cover 80 Section 7 2020 Design Standards and Specifications Approved Materials List 7.05.18 Air Release Valves A. Manufacturers i. APCO ii. ARI iii. Crespin 7.05.19 Flushing Hydrants A. Manufacturers i. Kupferle 7.05.20 Sampling Stations A. Manufacturers i. Kupferle 7.05.21 Valve boxes A. Cast -Iron slip type B. Manufacturers i. EJIW ii. Sigma iii. Star Pipe 7.05.22 Pipe Restraints A. ASTM F1674 B. Manufacturers i. EBAA Iron, Inc. ii. Ford iii. Romac iv. Sigma v. Smith -Blair vi. Star Pipe Products, Inc. vii. Tyler Union viii. AccuCast 7.05.23 Casing Spacers A. Manufacturers i. Advance Products ii. BMW iii. Cascade iv. CCI Pipeline V. Culpico vi. PSI 7.05.24 Precast Concrete Vaults, HS-20 Rated A. Manufacturers i. Hanson Pipe and Products Section 7 81 2020 Design Standards and Specifications Approved Materials List ii. Vaughn Concrete Products 7.05.25 Waterline Marker Manufacturers a. Blackburn b. Carsonite International 82 Section 7 2020 Design Standards and Specifications Approved Materials List 7.06 Sanitary Sewer 7.06.01 Gravity Sewer Pipe A. Polyvinyl Chloride (PVC) Pipe i. 6-inch thru 15-inch: ASTM D3034, Minimum Class SDR 35 ii. 18-inch thru 48-inch: ASTM F679, Minimum Class PS-46 iii. Fittings ASTM D1784 iv. Gaskets ASTM F477 v. Manufacturers a. Certainteed Corporation b. Diamond Plastics c. GPK (Fittings Only) d. Harco (Fittings Only) e. JM Eagle f. Multi Fittings (Fittings Only) g. National Pipe and Plastics Ever -Green Sewer Pipe h. North American Pipe ASTM D3034 i. Plastic Trend (Fittings Only) j. VINYL Plex (Fittings Only) k. Royal Building Products B. PVC Corrugated Sewer Pipe with Smooth Interior i. ASTM F949, ASTM F794 ii. Manufacturer a. Diamond Plastics C. High Density Polyethylene (HDPE) i. ASTM F714 ii. Manufacturers a. Chevron b. JM Eagle c. Plexco D. Ductile Iron (DIP) i. AWWA C151 Minimum Thickness Class 50 with Sewer Gas Resistant Interior Lining ii. Manufacturers a. American Ductile Iron Pipe b. Griffin Pipe Corporation c. McWane d. U.S. Pipe and Foundry Company E. Steel Reinforced Polymer Concrete i. ASTM D6783 ii. Manufacturers a. U. S. Composite Pipe F. Polypropylene Corrugated Dual Wall and Triple Wall i. 12-inch thru 30-inch: ASTM F2736 Section 7 83 2020 Design Standards and Specifications Approved Materials List ii. 30-inch thru 60-inch: ASTM F2764 iii. Manufacturer a. ADS Sanitite HP 7.06.02 Pressure Sewer Pipe A. Polyvinyl Chloride (PVC) i. AWWA C900 Minimum Class DR25 a. Manufacturers (1) Diamond Plastics (2) JM Eagle (3) North American Pipe ii. SDR26 Class 160 a. Manufacturers (1) Diamond Plastics (2) JM Eagle (3) North American Pipe B. Ductile Iron (DIP) i. Minimum Thickness Class 50 with Sewer Gas Resistant Interior Lining ii. Manufacturers a. American Ductile Iron Pipe b. Griffin Pipe Corporation c. U. S. Pipe and Foundry Company C. High Density Polyethylene (HDPE) i. AWWA: C906, Minimum Pressure Class 160 ii. Manufacturers a. Chevron b. JM Eagle c. Plexco 7.06.03 Manholes A. Precast Concrete Manholes i. ASTM C478 ii. Manufacturers a. Hanson Building Products b. South Plains Concrete Products c. The Turner Company d. Vaughn Concrete Products B. Glass -Fiber -Reinforced Polyester Manholes, Wetwells and Manhole Liners i. ASTM D3753 ii. Manufacturer a. LF Manufacturing b. Containment Solutions C. Composite Manholes i. Amarok 84 Section 7 2020 Design Standards and Specifications Approved Materials List ii. US Composite Pipe 7.06.04 Manhole Frames and Covers A. ASTM A48, Class 3513, AASHTO M-306 B. Standard Solid Cover i. Manufacturers a. East Jordan Iron Works C. Watertight Frame and Cover i. Manufacturers a. East Jordan Iron Works b. Rexus 7.06.05 Manhole Coatings/Protective Lining System A. Manufacturers i. A-Lok - Dura Plate 100 PVC Liner ii. Raven 405 iii. Tnemec — Series 436 PermaShield 7.06.06 Gaskets and Flexible Manhole Connections A. Flexible cast -in -place seal or flexible boots installed with hydraulic pressure after manhole manufacture. Manhole openings shall be made by hole -formers inserted during manufacture. B. Manufacturers i. Press -Seal Gasket Corp. ii. A-Lok iii. International Precast Supply iv. NPC 7.06.07 Internal Chimney Seals A. ASTM C923 B. Manufacturers i. Cretex ii. NPC 7.06.08 Manhole Joint Seals A. Sealant per ASTM C990 B. 0-ring gaskets meeting ASTM C443 and ASTM C1628. 7.06.09 Manhole Joint Wrap (in addition to O-ring specified above) A. Manufacturers i. Ram Nek ii. ConSeal CS 102 7.06.10 Manhole Joint Sealers A. Butyl Mastic Section 7 85 2020 Design Standards and Specifications Approved Materials List B. Manufacturers i. Ram Nek 7.06.11 ConSeal CS 102Inflow Prevention Device A. Non -Corrodible with self cleaning gas relief and vacuum relief valves B. Manufacturers i. L.F. Manufacturing Inc. - Rain Guard ii. No Flow -In Flow iii. The Man Pan iv. Southwestern Packing and Seals, Inc. - Rainstopper 7.06.12 Polyethylene Slope Adjusting Ring A. ASTM D1248 B. Manufacturers i. Ladtech 7.06.13 Saddles A. Manufacturer i. NDS 7.06.14 Cleanout Cover A. Manufacturer i. East Jordan Iron Works 7.06.15 Valves — Must Be Approved for Use in Wastewater Application A. Plug, Full Port i. Manufacturers a. DeZurik B. Resilient Seat Gate i. AWWA C509 ii. Manufacturers a. American Flow Control b. Clow c. M & H d. Mueller e. U.S. Pipe C. Swing Check i. Manufacturer a. Golden Anderson b. M & H c. Val-Matic 7.06.16 Backwater Valve for Manhole Vent A. Manufacturer 86 Section 7 2020 Design Standards and Specifications Approved Materials List i. Josam 7.06.17 Lateral Backwater Valve A. Diaphram Operated Stainless Steel Knife Valve ASME Al 12.14.1 B. Manufacturer i. John Stephens ii. Plastic Trends iii. Smith Floodgate 7.06.18 Sewage Combination Air/Vacuum Valve A. Manufacturers i. APCO/Willamette ii. ARI iii. Golden Anderson Industries 7.06.19 Sanitary Sewer Marker A. Manufacturers i. Blackburn ii. Carsonite International 7.06.20 Wastewater Pumps A. Manufacturer i. Flygt N-Pump Section 7 87 2020 Design Standards and Specifications Approved Materials List 7.07 Water and Sanitary Sewer Svstems 7.07.01 Modular Wall Seal A. EPDM with stainless steel nuts and bolts B. Manufacturer i. Thunderline ii. Pipe Seal iii. Link Seal 7.07.02 Vault Doors A. Type K heavy duty aluminum double leaf door, H-20 rated B. Manufacturers i. Bilco ii. Halliday iii. USF Fabrication, Inc. 7.07.03 Tracer Wire A. 12-gauge B. Manufacturers i. Copperhead ii. Southwire 7.07.04 Marking Tape A. 3-inch width, Sewer — green, Water - blue B. Manufacturers i. Presco Prodcuts ii. Terra Tape 88 Section 7 2020 Design Standards and Specifications Approved Materials List 7.08 Street Construction 7.08.01 Detectable warning surface for handicap ramps A. Manufacturers StronGo Industries — Tek Way Dome Tiles 7.08.02 Fiber Reinforcement A. Manufacturers i. BASF macro fibers Section 7 89 2020 Design Standards and Specifications Approved Materials List 90 Section 7 2020 Design Standards and Specifications Streets and Drainage Specifications SECTION 8 STANDARD SPECIFICATIONS FOR STREETS AND DRAINAGE CONSTRUCTION 8.01 General 8.01.01 The construction and materials for any City of Lubbock Engineering paving or drainage improvements project shall conform to the following specifications and associated standard details. A. Any construction or materials failing to meet the requirements of these specifications or the standard details shall be removed and replaced at the Contractor's own expense. B. No consideration will be given to requests for reduced payments for construction or materials not in conformance with these specifications and the plan sheets. 8.01.02 The term Engineer used in these specifications shall refer to the City of Lubbock City Engineer or an individual designated by the City Engineer to administer these specifications and associated plans. 8.01.03 The Engineer may require certificates from manufacturers certifying that materials or equipment to be incorporated into the work meet these specifications. A. Material Safety Data Sheets (MSDS) shall be required on all materials. B. All materials or equipment shall be subject to approval by the Engineer before being incorporated into any project. C. After approval, the source and/or character of materials shall not be changed without written authorization by the Engineer. 8.01.04 Streets to be constructed in a location where the traffic is expected to consist of an unusual number of trucks or other heavy vehicles shall have an approved pavement structure design specific to that loading condition. 8.01.05 All construction covered by these specifications shall be in compliance with the City of Lubbock Code of Ordinances, Chapter 30 Lakes and Water Ways, Chapter 36 Streets, Sidewalks, and Other Public Ways, Chapter 38 Subdivisions, and other chapters as applicable. 8.01.06 Any references to these specifications, ASTM, AASHTO, TxDOT, or other designated tests, procedures, quality standards, or requirements which are included in these specifications or any associated plans shall be the latest edition and revision thereof. A. When information indicated on the plan sheets is in conflict with these specifications, the more stringent requirement shall govern, unless the City Engineer or designee gives written approval for a specific variance. 8.01.07 Storm Water Pollution Prevention Plan (SWP3) A. Prior to disturbance of construction area, Contractor shall coordinate with the City of Lubbock Engineering Department to develop a site -specific Storm Water Pollution Prevention Plan. B. SWP3 measures shall conform to the integrated Stormwater Management (iSWM) criteria developed by the North Central Texas Council of Governments. Section 8 91 2020 Design Standards and Specifications Streets and Drainage Specifications C. SWP3 measures shall be installed prior to construction and shall be maintained throughout the construction until final stabilization. 8.02 Design Standards 8.02.01 The following design standards shall apply to all paving and drainage improvements associated with construction of new subdivisions. A. If unusual site conditions necessitate design criteria different from these requirements, changes will be permitted only if specifically approved by the City Engineer. 8.02.02 Street Crown Elevations A. All street paving shall incorporate a centerline crown at the following listed elevation unless otherwise indicated on plans, or as directed by the Engineer: Pavement Width Face of Curb to Face of Curb Finished Paving Surface Above Gutter 32 feet 0.52 feet 36 feet 0.58 feet 42 feet 0.67 feet 46 feet 0.73 feet 66 feet 1.03 feet 88 feet 1.18 feet i. The widths listed above refer to the total proposed future full width of street. ii. Where there is a difference in elevation between top of opposite street curbs, the crown elevation shall be adjusted such that the cross slopes are 2.0 percent minimum and 4.0 percent maximum. 8.02.03 Minimum Grades A. All street paving shall comply with the following minimum slopes unless otherwise approved by the City Engineer: Location Finished Grade Sloe Linear Curb and Gutter 0.20 Curb and Gutter in Cul-De-Sacs 0.30 Concrete Dips, Valley Gutters and Fillets 0.35 Concrete Alley Paving 0.20 Concrete Drainage Channel 0.20 Fall Around Curb Radii 0.80 B. Asphalt dips shall not be used in the place of concrete dips or valley gutters. 8.02.04 Vertical Alignment Requirements A. Vertical curves are required if the change in grade is greater than the following maximums: Street Classification Maximum change in grade Residential 2 Collector 1 Thoroughfare 0.5 92 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications B. Vertical curves are to be a minimum of 100' long and shall be designed for a speed of 5 MPH greater than the posted speed limit. C. The minimum gutter slope in a sag vertical curve shall be 0.2%, while a crest vertical curve has no minimum. 8.03 Testina and Inspection 8.03.01 All work shall be inspected and tested by a representative designated by the City Engineer, who shall have the authority to halt construction when, in their opinion, construction is being performed contrary to these specifications or associated plans. A. Whenever any portion of these specifications or associated plans is violated, the Engineer may order the portion of construction that is in violation to cease until such violation is corrected. 8.03.02 Contractor shall cooperate with the Engineer in providing for sampling and testing procedures. A. The contractor shall provide at least a 2 hour notification to the City Inspection Staff prior to requesting any inspection services. B. In the event the City tests indicate out of specification materials, additional tests may be provided by the contractor at their own expense. C. Conflicting tests provided by the contractor will not automatically be considered as compliance with City specifications, but will be considered only as additional information to be used by the Engineer to determine the compliance of the material or construction in question. 8.03.03 The testing and inspection provided by the City is intended only to verify that materials and construction comply with plans and specifications. The City's testing and inspection efforts are not intended to replace the contractor's responsibility to comply with the specifications. A. With respect to new material sources, or where the City lab has determined materials or construction do not comply with these specifications, the City will not re -test until the contractor has provided their own testing to demonstrate the materials and construction are in compliance with the plans and specifications. 8.03.04 Upon completion of construction, the Contractor will apply sufficient water to all paving improvements within the project to ensure all surfaces meet drainage requirements and are in compliance with these specifications. 8.04 Notification of Property Owners 8.04.01 The contractor shall be responsible for maintaining positive communication with adjacent property owners. 8.04.02 The contractor shall provide two days notice to all affected property owners with respect to pending construction, and restriction of access or driveway locations. 8.05 Protection of Utilities and Irrigation Systems 8.05.01 The plans show only approximate locations of utilities as obtained from various utility companies. A. It is not implied that all utilities or their accurate locations are shown on the plans. 8.05.02 It is the contractor's responsibility to become familiar with all utilities and locations. Section 8 93 2020 Design Standards and Specifications Streets and Drainage Specifications A. The contractor shall comply with all laws, ordinances, and regulations with respect to utility notification and protection, including Underground Facility Damage Prevention Notification Centers. The contractor shall call DIG TESS (1-800-344-8377) and provide sufficient time for all utilities to be identified prior to construction. 8.05.03 On all projects the contractor shall exercise care not to damage any sanitary sewer pipe, manholes, storm sewers, water lines, valves and boxes, communication cables, power cables, gas lines, nor any other pipe or utility. The contractor will be responsible during the construction period for damages to any utilities. 8.05.04 Irrigation systems affected by construction shall be properly repaired by a licensed irrigator, with materials equal to the existing system, and in compliance with current applicable codes. The repairs shall be pressure tested to the satisfaction of the Engineer prior to being covered. 8.05.05 If construction activities block the flow of water, then standing water shall be pumped off existing paving daily. 8.06 Water for Construction 8.06.01 Water is available from fire hydrants for construction purposes. A. To use City water for construction the contractor shall acquire a water meter for use on a City fire hydrant and will be charged the applicable rate for the quantity of water used. The contractor shall contact Lubbock Power and Light Customer Service Department to establish a utility account. The contractor must pay a deposit for each fire hydrant meter and will be responsible for all charges associated with that account. C. Once an account is established and the deposit is paid, the contractor may pick up a meter from the City Water Department at 600 Municipal Drive. 8.06.02 Fire hydrants shall be operated only by use of an approved fire hydrant wrench. No pipe wrenches, or other unapproved devices, shall be used to open and close a fire hydrant. 8.06.03 For top loading trucks or containers the contractor shall provide a back flow prevention assembly on the discharge side of the meter. A. The backflow prevention assembly shall be in the form of two spring loaded ball check valves. When filling the truck or container there shall be an air gap of at least two times the opening diameter of the truck or container. 8.06.04 For bottom loading trucks the contractor shall provide a Reduced Pressure Zone (RPZ) type backflow prevention assembly. A. All RPZ type back flow prevention assemblies must be tested and the test results approved by the City prior to use. The test results shall be sent to the City of Lubbock Public Works Department, Meter and Customer Service Supervisor for approval. 8.06.05 In accordance with City of Lubbock Ordinance No. 10208 "Pertaining to Backflow Prevention", City representatives are authorized to suspend water use from a fire hydrant by a contractor until the proper and correct backflow prevention devices are installed. 94 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications 8.07 Concrete 8.07.01 These specifications shall govern Portland cement concrete used for curb and gutter, valley gutters and fillets, alley paving, sidewalks, street paving, curb ramps, medians, and drainage improvements. A. The concrete shall be produced at a Ready -Mix Concrete Batch Plant conforming to ASTM C94. B. The concrete shall be transported to the project location in approved Revolving Drum Agitator Trucks, and shall be placed within one hour of mixing time. The concrete shall be continuously mixed during transit. C. Concrete shall have a temperature of less than 90 degrees at time of placement. Concrete above this temperature will be rejected and shall be removed from the job site. D. No more than eight cubic yards of concrete shall be loaded in a Revolving Drum Agitator Truck and transported to the job site. Loads in excess of eight cubic yards will be rejected and shall be removed from the job site. E. Admixture for increasing and or decreasing air shall be a temporary solution while the batch plant makes adjustments. A maximum of three loads may be treated per plant per day. F. No patching of any nature shall be allowed in repairing any damage to concrete improvements. Where damage occurs, the section shall be removed to the nearest joints and shall be replaced with new construction. Small cracks with no evidence of displacement may be repaired with epoxy, only where approved by the Engineer. G. All concrete shall have 5 percent, minus 1.5 percent to plus 1.5 percent, air content in conformance with ASTM C231. H. When delivered to the jobsite, each truck shall provide the load ticket indicating weights of all concrete ingredients, including cement, aggregates, water, and admixtures. I. Load tickets must be computer generated. 8.07.02 Classification A. The following City of Lubbock classes of concrete shall be used: Class Typical Uses A Curb and gutter, sidewalks, curb ramps, drainage channels, medians, inlet boxes, headwalls, junction boxes, driveways, and retaining walls. B Valley gutters and fillets, alley returns, and alley paving. C Concrete street pavement. D Utility encasements E Fast setting concrete pavement such as "Fast Track" Concrete Pavement or, otherspecial design. 8.07.03 Thickness of Concrete Pavement A. The following City of Lubbock minimum concrete pavement thickness shall be used: Street Classification Minimum Concrete Pavement Thickness Residential and Collector R-1/R-1A/R-2/C-1/Industrial 6" Minor Arterial 7" Principal Arterial 9" Section 8 95 2020 Design Standards and Specifications Streets and Drainage Specifications B. Concrete alley paving shall have a minimum thickness of 7-1/2 inches at edge and 5 inches at flow line. i. No tolerance on minimum thickness will be allowed. ii. No additional compensation will be made to the contractor for thickness greater than specified. C. All other proposed concrete pavement thickness and steel requirements not meeting the COL minimum design standards and specifications shall be approved in writing by the City Engineer. 8.07.04 Drainage Easements A. All drainage easements shall have, at a minimum, a 10-foot wide concrete flow line to be constructed with the street and alley paving improvements. B. Drainage easements shall not be used as alleys or garbage collection. 8.07.05 Mix Design A. Thirty (30) days prior to beginning any concrete construction the contractor shall submit an engineer's recommended concrete mix design. The following shall be included in the submittal: i. Test certificates from an approved commercial testing laboratory on all proposed aggregate. (1) Certificates shall indicate material source, gradation, and loss from 5 cycle Magnesium Sulfate test not to exceed 25 percent. ii. Mix design based on water -cement ratio. iii. Results of compressive strength tests in conformance with ASTM C 39 and/or flexural strength tests in conformance with ASTM C78, made by an approved commercial testing laboratory. (1) Tests shall be made on 6 cylinders and/or 6 beams at curing times appropriate to the class of concrete. B. The Engineer will approve or reject the mix design and materials based on these submittals. C. Mix design approval shall be subject to additional testing during construction. D. Mix designs for various classes of concrete shall conform to the following: Class Min. Sacks Cement er cubic yard Water/Cement Ratio Max. Slump Inches A 5.0 0.40 — 0.60 5 B 5.5 0.40 — 0.60 5 C 6.0 0.35-0.45 3 D 4.5 0.40 — 0.60 5 E As required for specific cure time and strength. i. New mix designs shall be submitted annually, or when material properties or sources change. ii. New mix design submittal will be required for any deviation from the mix design during construction. 96 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications 8.07.06 Strength Requirements A. The various classes of concrete shall conform to the following minimum strengths in pounds per square inch (psi) as determined by the average of two test cylinders or beams: Class Min. Com ressive Strength 3 Day 7 Day 28 Da A - 2100 3000 B - 2500 3600 C - 2500 3600 D - - 1 2500 E 3000 psi at 24 hours B. ACI Testing will be followed. C. When cores are subsequently used to prove compressive strength where test cylinders indicate failures or the quality of installation is of concern, the cores shall be tested in accordance with ACI C42. The cores shall meet the minimum 28 day compressive strength in the table above and meet 85% of the mix design strength. D. To place concrete in service the strength must meet 75% of the 28 day minimum compressive strength in the table above. 8.07.07 Cement A. Cement shall be Type I, Type II, or Type I -II cements, conforming to ASTM C150 "Standard Specification for Portland Cement". B. The contractor shall notify the Engineer prior to any changes of the cement supplier or source during construction. The Engineer may require a new mix design if changes of supplier or source occur. C. Supplementary Cementitious Materials may replace up to 50% of the Cement with the following limits. i. Fly Ash conforming to ASTM C618, Class C or F no more than 30% by weight. ii. Slag Cement conforming to ASTM C989, Class 100 or 120 no more than 50% by weight. iii. Silica Fume conforming to ASTM C1240 no more than 10% by weight. iv. Metakaolin conforming to ASTM C618 no more than 10% by weight. 8.07.08 Aggregate A. Concrete aggregate shall consist of natural, washed and screened sand, and washed and screened gravel or clean crushed stone conforming to ASTM C33. B. All aggregate shall be free of injurious amounts of clay, soft or flaky materials, loam, organic impurities, or other deleterious materials. C. Fine aggregate shall be graded from fine to coarse and shall conform to ASTM C136. i. The gradation for fine aggregate shall meet the following requirements: Fine Aggregate Cumulative Percent Passing (by weight) 3/8" Sieve 100 No. 4 Sieve 95-100 No. 8 Sieve 80-100 No. 16 Sieve 50-85 No. 30 Sieve 25-65 Section 8 97 2020 Design Standards and Specifications Streets and Drainage Specifications No. 50 Sieve 10-35 No. 100 Sieve 0-10 No. 200 Sieve 0-3 D. Coarse aggregates shall be well graded from coarse to fine with a maximum size of 1-1/2 inches, and shall conform to ASTM C136. i. The gradation for coarse aggregate shall meet the following requirements: Coarse Aggregate Cumulative Percent Passing (by weight 1-3/4" Sieve 100 1-1/2" Sieve 95-100 3/4" Sieve 60-90 1/2" Sieve 25-60 No. 4 Sieve 0-5 E. Coarse aggregate for Class C or E concrete shall be crushed limestone . Crushed gravel will be allowed if on the TxDOT Quarterly Monitoring Program, or if specifically approved by the engineer. F. Aggregate shall comply with the following limits: Material Property Max. Allowable Limit Deleterious Material 2.0% Decantation 1.5% Flakiness Index 17 Magnesium Sulfate Soundness 25% G. Stockpiles shall be protected from dusty conditions by drift fences or other methods approved by the Engineer. i. Stockpiling methods used shall not allow aggregate to roll down the slope as it is added to existing stockpiles. ii. Stockpiles shall be built in layers of uniform thickness. iii. Equipment shall not be permitted to operate over the same lift repeatedly. 8.07.09 Flowable Fill A. Flowable fill shall consist of a concrete mixture of pea gravel and sand with a cement content of 1-1/2 sacks (141 Ibs) per cubic yard. B. Utility ditches in Right of Way shall be backfilled in accordance with Details UEM-01 through UEM-07 in the appendix. C. Use of concrete in place of flowable fill is not acceptable, and if used in place of flowable fill shall be removed by the contractor at their expense. 8.07.10 Water A. Water shall be clean, clear, free from oil, acid or organic matter and free from injurious amounts of alkali, salts, or other chemicals and shall conform to AASHTO T26. 8.07.11 Admixtures A. Admixtures may be included in the concrete mix when approved by the Engineer to achieve any desired special properties. Chemical admixtures shall conform to ASTM C494 or ASTM C260. Chemical admixtures shall not be used as a substitute for Cement. 98 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications B. Admixture for increasing and or decreasing air shall be a temporary solution while the batch plant makes adjustments. A maximum of three loads may be treated per plant per day. 8.07.12 Reinforcing Material A. All concrete shall incorporate reinforcement as follows: i. Curb and gutter - horizontal paving steel shall extend to within 2" of back of curb. When poured monolithically with adjacent concrete pavement. ii. Residential (R-1/R-1A/R-2) and Collector (C-1/Industrial) Street Pavement — Refer to Plate No. 38-7 through Plate No. 38-11 for more information. iii. Valley Gutters and Fillets — A minimum of #4 deformed bars 12 inches on center both ways. iv. Drainage Channel — A minimum of #5 deformed steel bars 12 inches on center both ways or design approved in writing by the City Engineer. v. Alley Paving - No. 6 deformed steel bars on both edges as indicated on detail sheets and fiber reinforcement as specified in section 8.07.12 (C). vi. Alley Returns - #4 deformed steel bars 12 inch on centers both ways or 6-inch x 6-inch - 6 gauge welded wire fabric. vii. Sidewalk, Driveways (other than commercial), and Wheelchair Ramps - Fiber reinforcement, or as required by the City of Lubbock Building Official, or design approved in writing by the City Engineer. viii. Commercial driveways, including pedestrian crossing area — #3 deformed steel bars through the gutter section as indicated on the detail sheets and either #4 deformed bards 12 inches on center both ways or 6 -inch x 6-inch — 6 gauge welded wire fabric. B. Steel i. All steel reinforcing materials shall be securely held in proper position with devices appropriate to the type of reinforcement used, subject to approval by the Engineer. ii. Welded wire reinforcement shall conform to ASTM A1064, and shall be 6-inch x 6-inch - 6 gauge welded wire fabric as specified. iii. Reinforcing bars shall be grade 60 (60 KSI), open-hearth, basic oxygen or electric furnace new billet steel manufactured in accordance with ASTM A615. a. Steel reinforcing materials shall be stored off the ground in a manner as to be protected from accumulations of grease, mud, other foreign matter and rust producing materials. b. When incorporated into construction, steel reinforcement shall be free from rust, scale, oil, mud, and structural defects. iv. Dowels for slip joints shall be smooth plain round bars free from burrs, rough surfaces, and deformations. Caps, sleeves, or wrapping shall be as indicated on plan sheets. v. Chairs shall be used to support the reinforcing steel in the correct position while concrete is being placed. Chairs shall be made of plastic (preferred) or steel, and shall be of adequate size to positively hold the reinforcing materials in position. C. Fiber a. Fiber reinforcement shall be either 100 percent virgin polypropylene, collated, fibrillated fibers specifically manufactured for use as concrete reinforcement, containing no reprocessed olefin materials, or steel fibers. b. The manufacturer shall provide calculations for equivalent amounts of fiber to replace steel reinforcement, with a minimum of 1.5 pounds per cubic yard. The amount of fiber used may be less than the equivalent steel for residential streets if approved by the City Engineer or designee. When submitting less fiber than the equivalent steel, the design must be stamped by a licensed engineer. Section 8 99 2020 Design Standards and Specifications Streets and Drainage Specifications c. Fiber calculations must be done in accordance with ACI standards. d. The physical characteristics on the fiber shall be as follows: Physical Characteristic Value Sp ecific Gravity 0.91 Tensile Strength 70,000 psi to 110,000 psi Minimum Length 3/4 inch 8.07.13 Joints A. Curb and gutter (Class A concrete) shall be constructed with an expansion joint at the tangent point of each return at intersections and at intervals not more than 40 feet between the intersections. i. Construction joints formed by removable metal templates accurately shaped to the cross-section of the curb and gutter shall be located at the midpoint of each section between expansion joints, or as directed by the Engineer. ii. Tooled contraction joints cut at least one quarter the concrete depth shall be placed at 10 foot intervals. iii. Expansion joint material shall be placed full depth of the concrete curb. B. Alley paving (Class B concrete) shall be constructed with an expansion joint at each cold joint and at a maximum spacing of 130 feet. i. Alley returns shall be poured monolithically with curb radii and fillets with joints as indicated in Standard Detail 36-7. ii. Tooled contraction joints, cut 1/2 inch wide 2 inch deep, shall be placed as shown on Standard Detail 36-11. iii. Alley paving contraction joints shall be sealed with an elastomeric sealer. iv. Expansion joints shall include bituminous pre -molded expansion joint board. C. Street Paving (Class C or E concrete) shall be constructed with contraction and expansion joints as indicated on plan and detail sheets. i. Unless otherwise specified, the joints shall be sawed 1/2 inch wide and to depth equal to 1/4 of the pavement thickness plus one half inch. ii. Joints shall be saw cut within 12 hours of placement of the concrete paving. iii. Joints shall be sealed with an elastomeric sealer. iv. Joints shall be cleaned thoroughly with high pressure air prior to installation of any sealing materials. D. Valley gutters and fillets shall be constructed with tooled construction joints. i. Joints shall be sealed with an elastomeric sealer. ii. Joints shall be cleaned thoroughly with high pressure air prior to installation of any sealing materials. E. Joint Sealing Materials i. Zip Strip or Bituminous pre -molded expansion joint board material shall conform to ASTM D1751 and shall be placed as indicated on plan sheets or in these specifications. a. Expansion joint material shall be placed full depth of the concrete slab. ii. Elastomeric sealant for contraction joints shall be, or shall be equivalent to, W.R.Meadows "SOF-SEAL", W.R. Meadows #158 cold applied, or "GARDOX" as required by plan sheets. a. Hot poured sealant for joints between Portland cement concrete and Bituminous concrete shall conform to ASTM D3405. 100 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications b. Hot poured joint sealant for all other joints in Portland cement concrete pavement shall conform to ASTM D3406. c. Cold poured joint sealant shall conform to ASTM C920. iii. Elastomeric joint sealant shall be mixed and applied in accordance with the manufacturer's recommendations. a. Prior to application, joints shall be cleaned by sandblasting and otherwise prepared so that the sealant adheres to the surfaces to form an effective seal against moisture and solid particles. b. The sealant shall be a soft, highly flexible, rubber like material after curing which shall not track, flow, crack, or break when exposed to hot and cold temperature extremes typical of local conditions. iv. Backer rod used with elastomeric sealant shall be 25 percent greater in diameter than the joint width. It shall be made of polyethylene foam or other material as recommended by the sealant manufacturer. a. Compression of the backer rod material shall be approximately 25 percent shrinkage at 8 psi applied stress. b. The material shall not melt, shrink, evaporate, or absorb water, and shall be compatible with the application of the sealant to be used. 8.07.14 Curing Compounds A. All fresh concrete surfaces shall be completely sprayed with a liquid membrane forming curing compound at a rate of one gallon per every 180 square feet. Its application shall conform to DMS - 4650 and TxDOT Item "Concrete Structures - Curing Materials". i. Fresh concrete is defined as less than 10 minutes after finishing B. No other methods of moisture retention on fresh concrete shall be used unless specifically approved by the Engineer. 8.07.1S Forms A. Forms for curb and gutter, paving, and flatwork may be of wood or metal, of a section satisfactory to the Engineer, straight, free of warp, and of a depth equal to the depth of the concrete section formed. B. Forms shall be constructed accurately to the line and grade as established in the field, shall be adequately braced so that they will not move during the placing of the concrete, and shall remain in place at least 12 hours after placing of the concrete. C. Forms shall be treated with a light oil or release agent before each use, and forms which are to be re -used shall be cleaned immediately after each use and maintained in good condition. D. Curb forms shall be such that the face of the curb can be formed by use of a face form held in place by steel templates. E. Forms used for curb radii shall meet all of the above specifications, except that face forms on curb radii may be omitted if a true section and an accurate flow line can be obtained by other methods approved by the Engineer. F. In no case will concrete placement be started without the approval of the Engineer. G. No forms shall be placed until the subgrade is within one inch of its finished grade. H. Forms for paving slabs may be used as a guide for screeding. I. Where longitudinal construction joints are required, the form shall be so constructed as to provide an approved load transfer mechanism in the face. Section 8 101 2020 Design Standards and Specifications Streets and Drainage Specifications 8.07.16 Placing and Finishing Concrete A. Placing of concrete shall not start before sunrise, and shall stop one hour before sunset. i. Concrete shall be placed as close to its proper location as practical. ii. Sufficient concrete shall be placed to allow for shrinkage and extra material for finishing. iii. The concrete shall be floated and troweled to the approximate section. iv. When water is needed for finishing purposes it must be dispensed by a pressurized canister with a misting nozzle. B. Removal of face forms and finishing of curb and gutter shall be started only after a partial set occurs. i. Only construction approved forms, templates, and tools shall be used to form the cross -sections indicated on plan or detail sheets. C. Concrete shall not be placed when the ambient temperature and the surface temperature is below 40 degrees F or if sustained winds are 25 mph or higher as determined by field measurements by city inspector, or if field measurement is not available then the Texas Tech University Mesonet sites in Lubbock. If the sustained winds exceed the 25 miles per hour all placement operations will cease immediately. i. The contractor shall have available sufficient covering material, approved by the Engineer, to immediately protect concrete should the air temperature fall below 33 degrees F. This protection and forms shall remain in place as long as the temperature continues below 32 degrees, to a maximum of 5 days. ii. No salt or other chemical admixtures shall be added to the concrete to prevent freezing. D. All concrete placed for pavement shall be consolidated by use of mechanical vibrators approved by the Engineer and designed to vibrate the concrete internally. i. Vibrators shall be operated in a manner not to interfere with joints, and shall not come in contact with forms. ii. Vibrators shall not be used to move concrete within the forms. E. The surface of concrete street paving shall incorporate a tined finish perpendicular to the travel direction. F. All other concrete surfaces shall be completed with a light broom finish. G. When forms are used for concrete paving the forms must stay in place for a minimum of 12 hours. H. No equipment shall be placed on concrete until it has reached 75 percent of the specified 28 day compressive strength. I. Finished concrete surfaces shall not have irregularities in excess of 1/8 inch when tested with a 10 foot straightedge using the TxDOT Item 585 Surface Test Type A. J. Prior to acceptance, the Contractor shall apply sufficient water to all gutters and paving to determine locations of ponding. i. Ponded areas deeper than 1/8 inch shall be removed and replaced, or rectified as directed by the Engineer. K. Where the surface of Major or Minor Arterial paving is noticeably uneven, the City may require measurement of the ride quality using the TxDOT Surface Test Type B. i. If the International Roughness Index (IRI) is determined to exceed 65 inches per mile corrective action shall be performed by diamond grinding, or other methods acceptable to the Engineer. 102 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications ii. If the IRI exceeds 95 inches per mile the pavement shall be removed and replaced. L. Any concrete construction damaged by equipment, tools, vandals, or other influences shall be replaced at the contractor's own expense. 8.07.17 Tolerance in Elevation and Grade A. Curb and gutter or other concrete surfaces shall be constructed to the elevations and grades as indicated on plan sheets. Deviation from elevations indicated on plans resulting in a longitudinal slope of less than 0.15%, will be considered to be deficient, and shall be removed and replaced at the correct elevations as indicated on the plans, unless curb and gutter surfaces drain with flood testing and approved in writing by the City Engineer or designated staff. 8.07.18 Concrete Alley Paving Cuts A. Refer to Standard Detail UEM-06. B. Transverse Cuts i. Minimum width between transverse joints shall be 4 feet. ii. No more than 2 transverse joints shall be added between existing 13 foot tooled joints. iii. Transverse joints shall be doweled 6 inches into existing pavement with #5 dowel bars at 3 foot spacing. When installed at expansion joints, slip dowels shall be used. C. Longitudinal Cuts i. Longitudinal cuts along the edge of existing alley pavement shall be a minimum width of 3 feet. ii. Maximum width of longitudinal cuts shall be 4 feet. iii. Longitudinal cuts wider than 4 feet, regardless of location, shall replace the full width of existing alley paving. iv. Longitudinal joints shall be doweled 6 inches into existing pavement with #5 dowel bars at 3 foot spacing. D. Potholing for Locating Existing Utilities i. Pavement cuts for potholing purposes shall be circular cored holes or clean square cutouts. a. Cored holes in asphalt pavement shall be filled with cold -mix asphalt to match the depth of existing pavement. b. Cored holes in concrete pavement shall be filled with concrete to match the depth of existing pavement. c. Cutouts shall be repaired as specified in Plate No. UEM-02 8.08 Subgrade and Base 8.08.01 Subgrade A. Subgrade material for concrete or asphalt construction shall consist of suitable native soil or off -site soil, free from vegetation or other objectionable matter. B. All unstable or objectionable material shall be removed from the subgrade and replaced with approved material. Section 8 103 2020 Design Standards and Specifications Streets and Drainage Specifications C. Subgrade material shall be suitable for forming a stable embankment and shall meet the following requirements: Material Property Wet ASTM 4318 — 05.10.1 Dry ASTM 4318 — 05.10.2 Liquid Limit Max 45 Max 45 Plasticity Index Min 5; Max 20 Min 10; Max 25 Linear Shrinkage Min 2• Max 10 Min 2; Max 10 D. Subgrade Construction i. All testing of subgrade will be completed prior to any placement of curb and gutter. Subgrade will be processed the entire width of the roadway including under the curb and gutter section. ii. Subgrade shall be prepared in conformance with the lines and grades shown on the plans, or as directed by the Engineer, by scarifying and compacting to a minimum of 95 percent of Modified Proctor Density at optimum moisture content, plus or minus 2 percent. iii. Subgrade shall be constructed in maximum of 6 inch lifts, and each 6 inch lift tested for moisture and density. iv. Subgrade thickness shall be a minimum of 12 inches for all streets, regardless of street width or classification. v. The compaction method for subgrade shall provide for each lift to be compacted to the specified density using appropriate equipment. a. After each section of subgrade is complete, moisture/density testing will be performed by the City of Lubbock inspection staff. b. At any time the City Engineer may require proof rolling on streets or alleys with a 25 ton pneumatic roller, to test the uniformity of compaction. c. Rollers will be completely loaded with water or wet sand to ensure they meet the manufacturer's weight requirements. vi. All utility ditches shall be determined to be stable prior to construction of subgrade over such utility ditch. vii. Any fill placed within existing or proposed street right-of-way in execution of an approved cut and fill plan shall be in compliance with these specifications for materials and construction. a. Cut and fill operations shall comply with Chapter 38 of the City of Lubbock Code of Ordinances. viii. Subgrade which has become wet, or otherwise altered, after completion may be subject to retesting and reprocessing as determined by the Engineer. ix. Special care shall be exercised in grading street intersections where dips or valley gutters are located so that the cross profiles present a smooth riding surface, and so that the compacted subgrade thickness will not be less than specified above. a. Crown section shall begin transition at a distance equal to one-half of the lip -to -lip roadway width from concrete intersection or valley gutter, as indicated on Standard Detail 36-11. E. Rejected Subgrade Material i. Rejected subgrade material, either from the construction area or delivered to the job site, shall be dumped on the job site outside the area of construction, and remain there until all construction is completed. 104 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications a. If it is determined that unapproved material has been incorporated into the construction, all in place material shall be considered unapproved and shall be removed. b. No payment will be made for rejected material or construction. 8.08.02 Flexible Base (Caliche) A. Material for flexible base shall consist of crushed caliche, limestone, and calcareous clay particles produced from oversize quarried aggregate, sized by crushing and produced from a naturally occurring single source. i. All base material sources are subject to approval by the Engineer. ii. If material characteristics within an approved source change, the material shall be subject to retesting and re -approval prior to continued use. iii. The Contractor shall not change material sources without approval by the Engineer. B. Crushed concrete may be blended with quarried material only to the extent necessary to produce material in compliance with these specifications, to a maximum of 20 percent crushed concrete by weight. i. Crushed concrete shall be produced from parent material consisting of structural strength concrete, such as City of Lubbock Class A, B, and C. ii. Lower strength materials, such as flowable fill, are not acceptable. iii. Crushed concrete shall be free of reinforcing steel and any objectionable material, and have a maximum of 1.5 percent deleterious material when tested in accordance with Tex-413-A. iv. When crushed concrete is used, the final product shall be entirely in compliance with the specifications for single source material. C. Recycled Asphalt Pavement (RAP) will not be approved for use in flexible base. D. Prior to construction the contractor shall build stockpiles of sufficient quantity of base material as required to complete the entire project or subdivision. i. Each stockpile shall be dedicated, and identified as to the project or subdivision it is for. ii. Stockpiles may be on site or at the plant. iii. After a stockpile is completed the contractor shall not add material to that stockpile. iv. The contractor's methods, plant, and equipment are subject to approval by the Engineer, and shall be appropriate and in suitable condition to produce stockpiles in compliance with these specifications. E. Material Tests Flexible base material shall be tested yearly to confirm that the material conforms to the following requirements: a. Sieve Analysis Standard Crushed Rock Aggregate Cumulative Percent Passing(by weight) 1-3/4" Sieve 100 7/8" Sieve 65-90 3/8" Sieve 50-70 No. 4 Sieve 45-55 No. 40 Sieve 15-30 Section 8 105 2020 Design Standards and Specifications Streets and Drainage Specifications b. Atterberg Limits (1) Material passing the No. 40 Sieve shall be known as "Soil Binder" and shall meet the following requirements: Material Property Value Liquid Limit Max 35 Plasticity Index Min 3; Max 15 c. Wet Ball Mill (1) When tested in accordance with Tex-116-E (Wet Ball Mill) the base material shall have a value not to exceed 45. (2) The percent of material passing the #40 sieve shall not increase by more than 20 during the test. F. Flexible Base Construction i. Areas behind curbs shall be backfilled and leveled with approved topsoil prior to placing base material. ii. Approved flexible base material shall be hauled in vehicles of uniform capacity and dumped evenly along the project length for processing and compaction. iii. Flexible base thickness shall be a minimum of 6 inches for Ria, R1 and R2 streets. Flexible base thickness shall be a minimum of 8" for collector streets. Flexible base thickness shall be 10" for industrial Streets. Flexible base thickness shall be 12" for arterial streets. Alternative designs may be approved by the City Engineer. iv. Processing shall be accomplished in lifts of 6 inches compacted thickness. v. Each course shall be wetted and rolled with a pneumatic roller as required to produce a uniform compaction to a minimum of 95 percent of Modified Proctor Density with a moisture content of 2 percent above to 2 percent below optimum a. Densities will be taken by City of Lubbock inspection staff b. At any time the Engineer may require proof rolling with a 25 ton pneumatic roller to ensure uniform compaction of base. c. Processing for compaction of caliche base with a sheep's foot type roller will not be permitted. vi. The base shall be allowed to cure a minimum of 3 days, or until determined by the Engineer to be adequately cured, before placing prime or surface course. a. During the cure time the base shall be maintained by blading or other methods until the wearing surface is placed. b. Windrow caliche shall not be removed until the base has passed finish inspection. c. Base which becomes wet, or otherwise altered, may be subject to retesting and reprocessing as determined by the Engineer. vii. The compacted flexible base shall be finished and shaped immediately preceding the application of the surface treatment a. All loose or unconsolidated material shall be removed and the surface moistened and rolled with a steel wheel roller. b. All irregularities, depressions, or weak spots which develop shall be corrected by scarifying, adding or removing material as required, reshaping, and recompacting, or other methods approved by the Engineer. viii. Special care shall be exercised in grading street intersections where dips or valley gutters are located so that the cross profiles present a smooth riding surface and so that the compacted base thickness will not be less than 6 inches, or thickness otherwise specified by the engineer. 106 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications a. Crown section shall begin transition at a distance equal to one-half of the lip -to -lip roadway width from concrete intersection or valley gutter, as indicated on Standard Detail 36-11. ix. Any deviation in the surface of the finished base in excess of 3/8 inch from the established grade or true cross-section, using a 10 foot long straight edge, shall be corrected as provided above. x. The compaction method for flexible base shall provide for each lift to be compacted to the specified density using appropriate equipment. A. After each section of flexbase is complete, moisture/density testing will be performed by the City of Lubbock inspection staff. a. All irregularities, depressions, weak or soft spots which develop shall be corrected immediately by the contractor. G. Rejected Flexible Base Material i. Rejected material, either from the construction area or delivered to the job site, shall be dumped on the job site outside the area of construction, and remain there until all construction is completed. ii. If it is determined that unapproved material has been incorporated into the construction, all in place material shall be considered unapproved and shall be removed. iii. No payment will be made for rejected material or construction. 8.08.03 Asphalt Stabilized Base (ASB) A. Asphalt stabilized base shall consist of a uniform mixture of mineral aggregate and asphalt cement mixed hot in a mixing plant in accordance with these specifications. i. Caliche is not an acceptable aggregate for ASB. B. The contractor's plant and equipment are subject to approval by the Engineer, and shall be appropriate and in suitable condition to produce the base material consistently in compliance with these specifications. C. In place compaction control is required for all ASB. i. Locations of Cores, when required, will be determined by City of Lubbock personnel and marked ii. The ASB will be cored by the City inspection staff to determine composition, compaction, thickness, and density. iii. The contractor shall replace the pavement removed from core holes at no cost to the City. iv. ASB found to be deficient in composition, compaction, thickness, or density shall be corrected at the contractor's expense as directed by the Engineer. D. ASB Mix Design i. The contractor shall submit an ASB mix design less than one year old, prepared by a qualified lab, in compliance with these specifications using approved materials indicating gradation and optimum asphalt content. Section 8 107 2020 Design Standards and Specifications Streets and Drainage Specifications ii. The aggregate mixture shall conform to the following master gradation: Standard Crushed Rock Aggregate Cumulative Percent Passing (by weight) Passing 1" Sieve 98-100 Passing 3/4" Sieve 84-98 Passing 3/8" Sieve 60-80 Passing No. 4 Sieve 40-60 Passing No. 8 Sieve 29-34 Passing No. 30 Sieve 13-28 Passing No. 50 Sieve 6-20 Passing No. 200 Sieve 2-7 a. Design produced Minimum VMA 13.0 percent b. Plant produced Minimum VMA 12.0 percent iii. Material passing the No. 40 sieve shall be known as "soil binder" and shall meet the following requirements: Material Property Value Liquid Limit Max 45 Plasticity Index Max 15 Linear Shrinkage Max 5 iv. The mineral aggregate shall not contain more than 0.5 percent moisture prior to entering the pug mill for mixing with asphalt. v. The mix design shall have optimum asphalt content determined in accordance with Tex-204-F, with a target lab molded density of 96.5 percent. vi. Asphalt content of the Job Mix Formula shall not vary during construction from the design by more than 0.3 percent. vii. Asphalt for the mixture shall be a Performance Grade (PG) 64-28, or better. viii. New mix designs must be submitted annually, or when material properties change. ix. A maximum of 20 percent approved rap material can be added to ASB. E. ASB Placement i. The ASB material shall be placed on the approved prepared surface using an approved lay down machine. ii. ASB thickness shall be a minimum of 9 inches, or as required by the Engineer. iii. Asphalt Stabilized Base shall be placed and compacted in 4 inch lifts to form the specified thickness of compacted base, unless otherwise directed by the Engineer. a. Prior to placing ASB, the subgrade shall be prepared as previously specified. iv. The cross-section shall be constructed to form the specified crown on the ASB surface at the centerline of the street, or as indicated on the plans. v. ASB shall not be placed when the air temperature, as measured by city inspector in field or if field measurement is not avalible as reported by the Texas Tech University Mesonet sites in Lubbock, less than 50 degrees F ambient or 60 degrees surface temperature. vi. ASB maximum temperature is 350 degrees. ASB minimum temperature in truck is 325 degrees. ASB minimum lay down temperature is 265 degrees. vii. Any ASB material that is outside the specified temperature ranges, shall be rejected by the Engineer. 108 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications viii. The material shall be placed in such a manner that when properly compacted the finished course is smooth, of uniform density, and in conformance with the cross - sections and grades shown on the associated plans. ix. Special care shall be exercised in grading street intersections where dips or valley gutters are located so that the cross profiles present a smooth riding surface and so that the compacted base thickness is not less than 9 inches. a. Crown section shall begin transition at a distance equal to one-half of the lip -to -lip roadway width from concrete intersection or valley gutter, as indicated on Standard Detail 36-11. ASB Compaction i. ASB shall be compacted thoroughly and uniformly with approved rollers to a density between 93 percent and 98 percent of the maximum theoretical gravity, with a lab molded target of 96.5 percent using the Texas Gyratory compaction method. a. All results will be calculated using the maximum theoretical Rice gravity. ii. Compaction less than 93 percent or greater than 98 percent will be considered deficient. All deficient pavement shall be removed and replaced as determined by the Engineer at the contractor's expense. iii. ASB shall meet all compaction requirements at the time of inspection. Re -rolling is not an approved method for achieving compaction requirements. iv. Contractor shall set rolling patterns using a thin lift nuclear gauge in order to ensure maximum compaction. v. All roller marks shall be removed and compaction completed prior to the ASB mixture cooling below 185 degrees F. G. Rejected ASB Material i. Rejected ASB material, either from the construction area or delivered to the job site, shall be dumped on the job site outside the area of construction, and remain there until all construction is completed. ii. If it is determined that unapproved material has been incorporated into the construction, all in place material shall be considered unapproved and shall be removed. iii. No payment will be made for rejected material or construction. 8.09 Hot Mix Asphalt Concrete Surface (HMAC) 8.09.01 Hot mix asphalt concrete surface shall consist of a uniform mixture of mineral aggregate (coarse aggregate, fine aggregate, mineral filler) and asphalt cement mixed hot in a mixing plant in accordance with these specifications. 8.09.02 The contractor's methods, plant, and equipment are subject to approval by the Engineer, and shall be appropriate and in suitable condition to produce the HMAC surface material consistently in compliance with these specifications. 8.09.03 Strip paving is a substandard, temporary improvement and does not satisfy the paving requirements of the platting process. Strip paving may be used only in special circumstances and must be approved by the City Council. If strip paving is used, the developer is still responsible for providing for the required permanent curb and gutter and paving. A. Unless otherwise specified, the materials and construction shall conform to TxDOT Item 340 - Dense -Graded -Hot -Mix Asphalt (Method). Section 8 109 2020 Design Standards and Specifications Streets and Drainage Specifications B. Approval of the source and character of the materials shall be obtained from the Engineer prior to use. i. The combined mineral aggregate, after final processing by the mixing plant and prior to addition of asphalt and mineral filler, shall have a sand equivalent value of not less than 45 when tested in accordance with Test Method Tex-203-F. ii. The percent of flat and elongated slivers of stone for any aggregate shall not exceed 25 percent when tested in accordance with Test Method Tex-224-F. iii. Asphaltic mixtures with aggregates which exhibit stripping characteristics shall be conditioned with either minimum 1 percent lime in accordance with DMS-6350, or liquid anti -stripping agent approved by the Engineer. a. Anti -stripping agents shall meet requirements of TXDOT Item 301 - Asphalt Anti - stripping Agents, and shall be added at the manufacturer's recommended dosage and temperature range. 8.09.04 A minimum of two sets of cores per day will be taken to determine thickness and density of HMAC surfaces. A. Core locations will be marked and cored at random locations by City of Lubbock inspection staff. B. Cores will be taken in pairs and averaged to determine the percent air voids based on the theoretical maximum gravity. C. HMAC surface found to be deficient shall be corrected at the contractor's own expense as directed by the Engineer. D. The contractor shall replace the pavement removed from core holes immediately after testing at no cost to the City. 8.09.05 Thickness of HMAC Surfaces A. HMAC thickness shall be a minimum of 2 inches for Residential and Collector, 2.5 inches for industrial, 3" for minor arterial and 5" for principal arterial, or as indicated on the plans. No tolerance on minimum thickness will be allowed. B. If a core shows less than the specified minimum thickness, prior to being trimmed, the HMAC surface shall be considered deficient with respect to thickness, and the deficiency shall be rectified by removal and replacement at the specified thickness. i. Additional cores will be taken at 25 foot spacing to define the limits of deficiency. C. No additional compensation will be made to the contractor for thickness of HMAC surface greater than specified. 8.09.06 HMAC Mix Design A. The contractor shall provide a current HMAC mix design using the approved materials, indicating gradation and optimum asphalt content as determined by Test Method Tex-204-F. i. The mix design shall have a lab molded density of 96.5 percent using the Texas Gyratory compaction method. ii. New designs shall be submitted annually, or when material properties change. 110 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications iii. The aggregate mixture shall conform to the following master gradation: a. Type "C" Coarse Graded Surface Course — Curb and gutter street widths greater than 36 feet: Standard Crushed Rock Aggregate Cumulative Percent Passing (by weight) Passing 3/4" Sieve 95-100 Passing 3/8" Sieve 70-85 Passing No. 4 Sieve 43-63 Passing No. 8 Sieve 32-44 Passing No. 30 Sieve 14-28 Passing No. 50 Sieve 7-21 Passing No. 200 Sieve 2-7 (1) Design Produced Minimum VMA 14 percent (2) Plant Produced Minimum VMA 13 percent b. Type "D" Fine Graded Surface Course — Curb and gutter street widths of 36 feet or less and strip paved streets of any width: Standard Crushed Rock Aggregate Cumulative Percent Passing (by weight) Passing 1/2" Sieve 98-100 Passing 3/8" Sieve 85-100 Passing No. 4 Sieve 50-70 Passing No. 8 Sieve 35-46 Passing No. 30 Sieve 15-29 Passing No. 50 Sieve 7-20 Passing No. 200 Sieve 2-7 (1) Design Produced Minimum VMA 15 percent (2) Plant Produced Minimum VMA 14 percent c. HMAC Type is in reference to the ultimate full width street, not half width. iv. Material passing the No. 40 sieve shall be known as "soil binder" and shall maximum linear shrinkage value of 5. v. Mineral aggregate shall not contain more than 0.5 percent moisture prior to entering the pugmill for mixing with asphalt. vi. HMAC mixture shall consist of a uniform mixture of mineral aggregate and asphalt material. vii. The contractor's materials and mix design shall meet all the performance criteria addressed in these specifications. B. Coarse Aggregate i. Coarse aggregate must be approved for use by the Engineer and must be on the TXDOT source rating catalog or approved in writing by the City Engineer. ii. Coarse aggregate shall be the material retained on a No. 4 sieve, and shall consist of clean, washed, tough, durable fragments of crushed stone of uniform quality. a. Mixing or combining of crushed gravel and crushed stone will not be permitted. iii. Coarse aggregate shall be crushed to the extent that produces a minimum of 80 percent crushed faces for both Type "C" HMAC, and Type "D" HMAC, when tested in accordance with Test Method Tex-460-A Part I "Determination of Crushed Face Count". iv. Decantation shall be a maximum of 1.5 percent when tested in accordance with Tex- 217-F. Section 8 111 2020 Design Standards and Specifications Streets and Drainage Specifications v. Deleterious materials shall be a maximum of 2.0 percent when tested in accordance with Tex-217-F. vi. Coarse aggregate shall have a maximum loss of 25 percent when subjected to 5 cycles of the Magnesium Sulfate Soundness Test ASTM C-88. vii. The amount of organic matter, clays, loams, or particles coated therewith, or other undesirable materials shall not exceed 1.5 percent. C. Fine Aggregate i. Fine aggregate shall be that part of the aggregate passing the No. 10 sieve and shall be of uniform quality throughout. ii. A maximum of 15 percent of the total virgin aggregate may be field sand or other crushed fine aggregate. iii. Sand which exhibits no variation in particle size shall be limited to a maximum of 7 percent of the total virgin aggregate. iv. Screenings shall be of the same or similar material as specified for coarse aggregate. v. Linear shrinkage shall be a maximum of 3 percent. vi. Mineral filler shall consist of thoroughly dry stone dust, slate dust, Portland cement or other material dust approved by the Engineer. a. The mineral filler shall be free of foreign and other injurious matter and shall meet the following gradation: Standard Crushed Rock Aggregate Cumulative Percent Passing (by weight) Passing No. 8 Sieve 100 Passing No. 200 Sieve 55-100 D. Asphalt i. Asphalt shall be a Performance Graded (PG) 64-28, or better, unless otherwise shown on plans. ii. The contractor shall notify the Engineer of the source of asphaltic material for approval prior to production of the asphaltic mixture. a. The contractor shall notify the Engineer prior to any changes of the asphalt supplier or source. b. The Engineer may require a new mix design if changes of supplier or source occur. iii. Asphalt content shall not vary more than plus or minus 0.3 percent of design during production a. Asphalt content within that range is considered to be acceptable if no other defects are noted, with the requirement that adjustments shall be made during production to achieve the optimum asphalt content. b. If the asphalt content falls outside these parameters immediate action is required. c. If at any time the asphalt content varies to plus or minus 0.5 percent of optimum, production shall immediately cease and all affected material shall be removed. d. Production shall not be resumed until the contractor has provided sufficient evidence of the problem being corrected. e. A maximum of 10 percent approved RAP will be allowed within the surface course, as included in the submitted design. 112 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications 8.09.07 HMAC Placement A. Prior to production beginning, contractor must submit in writing a job mix formula (JMF) for the mix design proposed to be run on that project. The JMF will be held to tolerances as outlined. B. Prime and Tack Coats i. Prior to placing HMAC on flexible base, the surface shall be primed and cured 48 hours or until determined by the Engineer to be adequately cured, using an application of 0.20 gallons of asphalt per square yard of surface. a. The contractor shall strap the asphalt distributor in the presence of the inspector to verify the application rate. ii. Before any asphaltic mixture is laid, the surfaces against which the pavement is to be placed shall be cleaned, primed, and tacked to the satisfaction of the Engineer. a. The surfaces shall be given a uniform application of tack coat using asphaltic materials of this specification. (1) Prime coat will not be used as a tack coat. b. The tack coat shall be evenly and thoroughly applied with an approved sprayer as directed by the Engineer. (1) Mopping or brooming of tack coat is not allowed, unless prior approval by City Inspection Staff. (2) Minimum thickness shall be no less than 2 mil. thickness. c. All contact surfaces of curb and gutter, structures, and joints shall be sprayed with a thin uniform tack coat. iii. The prime coat shall be MC 30, and shall be applied in accordance with TxDOT Item 310 Prime Coat. iv. The tack coat shall be an asphalt material such as PG, AC-10. a. Asphalt materials cut with kerosene, diesel, or other petroleum solvent may not be used. C. HMAC Installation Requirements i. Pavement shall only be constructed on previously approved base. ii. HMAC surface shall not be placed until at least 48 hours after the application of the prime coat. iii. Placing of HMAC shall not start until 30 minutes after sunrise, and must stop and all equipment off the right of way 30 minutes prior to sunset. iv. Air temperature requirements for placing HMAC shall be as follows: a. HMAC shall not be placed when the air temperature is below 45 degrees F and falling. b. HMAC may be placed when the air temperature is above 45 degrees F and rising. c. The forecasted high must be 50 degrees or above for the day by the National Weather Service. v. Surface of roadway must be 60 degrees or higher prior to placing HMAC pavement, as determined in the field. vi. Air temperature and wind speed shall be determined by City of Lubbock inspector field measurement. If field measurement by inspector is not available the Texas Tech University Mesonet sites in Lubbock shall be used. vii. HMAC shall be placed at a temperature between 265 and 325 degrees F. a. Any HMAC material that is above or below the specified temperature range, measured at any point, shall be rejected by the Engineer. Section 8 113 2020 Design Standards and Specifications Streets and Drainage Specifications viii. When high winds occur, contractor must provide a water truck in order to minimize blowing dust. a. If the sustained winds reach 25 mph, all concrete and HMAC operations will cease production immediately. ix. The asphaltic mixture shall be dumped and spread on the approved prepared surface using an approved spreading and finishing machine. a. The material shall be placed in such a manner that when properly compacted the finished course is smooth, of uniform density, and in conformance with the cross - sections and grades shown on the associated plans. b. Wings of the laydown machine may not be dumped unless they are dumped after every load. c. The loose aggregate along the edge may not be raked back onto the mat. x. A level up course 1/2 inch to 2 inch in thickness shall require the use of Type D HMAC. xi. A level up course greater than 2 inch shall require the use of ASB. xii. When the asphaltic mixture is placed in a small area where use of a finishing machine is not practical, the contractor may use other methods approved by the Engineer provided a satisfactory surface can be obtained. xiii. Adjacent to curbs gutters or other flush structures, the surface shall be finished uniformly high so that when compacted it will be 1/4 inch above the curb or other concrete surface. xiv. All concrete structures shall be complete before asphalt is placed. xv. All joints shall present the same texture, density, and smoothness as other sections of the course. a. The joints between old and new pavements or between successive day's work shall be made to insure a continuous bond between the old and new sections of the course. xvi. The transverse edges of old pavement and, if required by the Engineer, the successive day's pavement shall be cut with an approved concrete saw to expose an even vertical surface for the full thickness of the course. xvii.All contact surfaces of previously constructed pavement shall be painted with a thin uniform coat of approved tack coat before the fresh mixture is placed. xviii. Special care shall be exercised in grading street intersections where dips or valley gutters are located so that the cross profiles present a smooth riding surface and so that the compacted asphalt thickness is not less than 2 inches. a. Crown section shall begin transition at a distance equal to one-half of the lip -to -lip roadway width from concrete intersection or valley gutter, as indicated on Standard Detail 36-11. xix. If the laydown machine is idling, the temperature of the asphalt shall remain between 230 and 345 degrees. If the temperature is outside this range the contractor must create a clean joint in the asphalt. xx. Any Utilities installed after placement of pavement but before certificate of completion will require pavement to be removed to the next joint. All edges shall be sawcut. D. HMAC Compaction i. HMAC surfaces shall be constructed to the following compacted thickness stated in 8.09.05(A) with a maximum of 0.5 inches more thickness for Type D and a maximum of 1.0 inches more thickness for Type C. No allowance will be made for less than minimum thicknesses. ii. Using appropriate rollers approved by the Engineer, the HMAC surface shall be compacted thoroughly and uniformly to a density between 94 percent and 98 percent 114 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications of the theoretical maximum gravity, with a lab molded target of 96.5 percent using the Texas Gyratory compaction method. a. All results will be calculated using the maximum theoretical Rice gravity. iii. Compaction less than 94 percent or greater than 98 percent will be considered deficient. iv. All deficient HMAC shall be removed and replaced as determined by the Engineer at the contractor's expense. v. HMAC shall meet all compaction requirements at the time of inspection. Re -rolling is not an approved method for achieving compaction requirements. vi. The contractor shall set rolling patterns using a thin lift nuclear gauge in order to ensure correct compaction. vii. Gasoline, oil, grease, solvents, or other foreign matter shall not be permitted to fall on the pavement when rollers are in operation or standing. viii. Places inaccessible to the rollers may be compacted using lightly oiled tamps. ix. Trenches and other limited areas where required compaction cannot be obtained using a three wheel roller shall be compacted with a trench type roller. x. The surface of the pavement after compaction shall be smooth and true to the established line, grade, and cross-section. xi. Finished surfaces, including asphalt and concrete, shall not have irregularities in excess of 1/8 inch when tested with a 10 foot straightedge. xii. Prior to acceptance, the contractor shall apply sufficient water to all paving surfaces, asphalt and concrete, to determine location of ponding. a. Ponded areas deeper than 1/8 inch shall be removed and replaced, or rectified as directed by the Engineer. xiii. Where the surface of Major or Minor Arterial paving is noticeably uneven the City may require measurement of the ride quality using the TxDOT Surface Test Type B. a. If the International Roughness Index (IRI) is determined to exceed 65 inches per mile corrective action shall be performed by diamond grinding, or other methods approved by the Engineer. b. If the IRI exceeds 95 inches per mile the pavement shall be removed and replaced. E. Emulsified Asphalt Sealer i. All HMAC surface courses shall be sprayed with an emulsified asphalt sealer consisting of a 15/85 mixture of CSS-1H, or 20/80 SS-1, liquid anionic asphalt and distilled water. ii. The emulsified asphalt sealer shall be applied after the HMAC surface has cooled to below 70 degrees F, and shall be applied at a rate of 0.10 to 0.12 gallons per square yard of surface. F. Release Agents i. Diesel shall not be used as a release agent. ii. Only approved agents (such as Black Magic or equivalent) will be used. iii. Diesel will not be permitted to be used on any tools or machinery that comes into contact with the HMAC. 8.09.08 Sampling of HMAC A. When sampling HMAC for testing purposes, the City of Lubbock representative will determine when the sample is taken and will split the sample with the contractor (at the contractor's request). B. A "referee" sample will be taken at the same time and held at the city laboratory until all test results are completed. Section 8 115 2020 Design Standards and Specifications Streets and Drainage Specifications C. If the contractor's results differ from the City's results the referee will be utilized and it will be run at an independent laboratory at the expense of the contractor, at which time all tests are final. D. If the contractor does not run quality control samples then no referee will be utilized and the City of Lubbock test results will be final. 8.09.09 Rejected HMAC Material A. Rejected HMAC material, either from the construction area or delivered to the job site shall be dumped on the job site outside the area of construction, and remain there until all construction is completed. If it is determined that unapproved material has been incorporated into the construction, all in place material shall be considered unapproved and shall be removed. C. No payment will be made for rejected material or construction. 8.09.10 Islands In Streets A. Islands in streets require City Council approval. i. As a condition of approval, persons requesting approval of islands within a street shall be required to submit to the City Engineer a street pavement structural design that exceeds the minimum standard specifications for street paving. ii. In general that shall mean an approved reinforced concrete pavement design. iii. The paving design shall apply to all street paving adjacent to, and 50 feet beyond any proposed island. The submitted request shall include the proposed pavement design, surface treatment of the island, types of plant materials, and methods and details of irrigation systems. 8.10 Micro-Surfad 8.10.01 Micro -surfacing materials and construction shall conform to TxDOT Specification Item # 350. There shall be no deviation from these specifications unless so directed by the Street Superintendent. 8.10.02 It shall be the responsibility of the Contractor to produce, transport, and place the micro - surfacing pavement and to ensure that the finished surface has a uniform texture and the micro -surfacing mat is fully adhered to the existing roadway surface. 8.10.03 Materials of Construction A. All materials that are to be stockpiled shall be protected from dust and other contamination. Mineral filler shall be stored in a manner that will keep it dry and free from contamination. C. All asphalt materials shall be kept free from contamination. D. Cationic Polymer -Modified Asphalt Emulsion i. Provide CSS-1P in accordance with TOOT Item # 300.2.D "Emulsified Asphalt". Aggregate i. Aggregate shall consist of clean, washed, tough, durable fragments of crushed stone of uniform quality and from a single source. ii. Aggregate shall meet TxDOT Class "A" surfacing classification. iii. Contractor shall include the amount of mineral filler added to the mix determining the total minus No. 200 sieve aggregate fraction. 116 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications iv. Aggregate shall meet the following gradation requirements: Standard Crushed Rock Aggregate Cumulative Percent Retained (by weight) Retained on 1/2" Sieve 0 Retained on 3/8" Sieve 0-1 Retained on No. 4 Sieve 6-14 Retained on No. 8 Sieve 35-55 Retained on No. 16 Sieve 54-75 Retained on No. 30 Sieve 65-85 Retained on No. 50 Sieve 75-90 Retained on No. 100 Sieve 82-93 Retained on No. 200 Sieve 85-95 v. Maximum Magnesium Sulfate Soundness shall be 30 percent (5 cycles) based upon TxDOT Test Method Tex-411-A vi. Minimum Sand Equivalent shall be 70 percent based upon TxDOT Test Method Tex- 203-F. F. Mineral Filler shall be free of lumps and foreign matter consisting of Type S Lime. G. Contractor shall adjust the mix design to attenuate the usage of Lime. H. Water shall be potable and free of harmful soluble salts. I. Use only approved additives as recommended by the emulsion manufacturer in the emulsion mix or in any of the component materials when necessary to adjust mix time in field. 8.10.04 Methods of Construction A. Equipment i. Equipment shall be kept in good working conditions with no leaks. ii. Any equipment that shows signs of leaks shall be fixed immediately and shall not be used until such leaks are fixed. iii. The mixing machine shall be a self-propelled micro -surfacing mixing machine with self - loading devices to promote continuous laying operations. iv. Mixing machine shall have sufficient storage capacity for mixture materials with individual volume or weight controls that will proportion each material to be added to the mixture. v. Mixing machine shall have a water pressure system and nozzle -type spray bar immediately ahead of spreader box capable of spraying the roadway for the width of the spreader box. vi. Scales used for weighing materials and emulsion must be calibrated and meet the requirements of TxDOT Item # 520. vii. Electronic Monitoring System a. The micro -surfacing machine shall be equipped with an electronic monitoring system that consists of pulse sensors measuring material delivery rates, a radar gun to monitor distance traveled, and programmable micro -controller, and operators display/input board and an on -board printer. b. System shall be capable of monitoring and displaying application rates and use of aggregate, emulsion, fines, water and additives. c. System shall be capable of calculating and displaying ratios of emulsion to aggregate, fines to aggregate, additive to aggregate, water to aggregate, and application rate in pounds per square yard. Section 8 117 2020 Design Standards and Specifications Streets and Drainage Specifications d. System shall be capable of printing a hard copy report on demand which displays the date, weight of aggregate, emulsion, fines, number of gallons of additive and gallons of water, and all of the above mentioned ratios since last reset. e. A computer -generated report providing statistics for the full work day shall be provided with each hand calculated daily run sheet. f. This system shall be accurate to within 1/2 of a percent of actual weights and measures for all parameters noted above. The system is not expected to calculate quantities and ratios for materials used in handwork and cul-de-sac areas. B. Air temperature requirements for placing micro -surfacing pavement shall be as follows: i. November 1 to April 1 a. Micro -surfacing shall not be placed when the air temperature is below 60 degrees F and falling. b. Micro -surfacing may be placed when the air temperature is above 50 degrees F and rising. ii. April 1 to November 1 a. Micro -surfacing shall not be placed when the air temperature is below 50 degrees F and falling. b. Micro -surfacing may be placed when the air temperature is above 50 degrees and rising. iii. Surface of roadway must be 60 degrees or higher prior to placing micro -surfacing pavement, as determined in the field. iv. Air temperature shall be determined by the Texas Tech University Mesonet sites in Lubbock, Texas. C. Placement of Micro -Surfacing i. The existing roadway surface shall be thoroughly clean and free of all vegetation, loose aggregate, and soil. ii. Existing raised pavement markers and thermoplastic markings shall be thoroughly removed. iii. When existing roadway surface conditions require, provide a water spray immediately ahead of the spreader box. a. Apply water at a rate that dampens the entire surface without any free -flowing water ahead of the spreader box. iv. Micro -surfacing shall be spread uniformly at a rate of not less than 25 pounds per square yard and no more than 30 pounds per square yard, or as directed. v. The spreader box shall be kept clean to minimize lumps. vi. Set and maintain the skis on the spreader box as to prevent chatter in the finished mat. vii. Adjust the rear seal to provide the desired spread viii. Adjust the secondary strike -off to provide the desired surface texture. ix. The finished mat shall be protected from traffic until it has cured and traffic will not harm it. x. Adjustments shall be made to the mixture to allow rolling traffic back on the surface in one hour. xi. Locations with turning or stop -and -go traffic shall be protected for longer periods of time. xii. Special care shall be taken by the Contractor to ensure that all manholes, water valves, and other surface structures are sufficiently protected from the micro -surfacing process by the use of a plastic membrane covering or other approved method. 118 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications xiii. The Contractor shall be responsible for uncovering each manhole, water valve, and other structure after the micro -surfacing pavement has been applied to the roadway surface. D. Rutting on Major Thoroughfares and Collector Streets i. Shallow ruts that are less than 1/2 inch in depth may be covered by a full width scratch box utilizing a steel primary strike -off plate. ii. Ruts that are between 1/2 inch and 1 inch in depth shall be filled independently with a fixed width spreader box no more than 6 feet wide. The rut filling box shall have a steel primary strike -off plate that is the same width as the spreader box. iii. Ruts that are in excess of 1 inch in depth shall be filled with a 5-foot wide rut filling spreader box specifically designed to fill wheel path ruts. This operation will require multiple placement passes to restore the pavement to its original cross section. Special care shall be used by the Contractor to ensure that the material has proper time to dry between applications to promote bonding between the original pavement and the micro -surfacing pavement. iv. Maximum micro -surfacing thickness applied as rut filling shall not exceed 1 inch for each pass required to restore pavement to the original profile. E. Asphalt Milling at Concrete Intersections i. All thoroughfares and collector streets which have concrete intersections or where concrete valley gutters intersect the street shall have the asphalt surface milled to such a depth as to allow a smooth transition between concrete and the completed micro - surfacing pavement. F. Scratch Course i. All "Scratch Course" applications shall be performed utilizing a steel primary strike -off plate. ii. This will allow the bottom, or "scratch course", to mitigate any irregularities and have a more uniform profile for the micro -surfacing pavement to be applied to. G. Finished Surface i. Micro -surfacing pavement finished grade shall be uniform in texture and free from excessive scratch marks, tears, and other surface irregularities. a. All such irregularities shall be repaired by the Contractor at their own expense. ii. Longitudinal joints shall be place on lane lines unless otherwise directed by the Engineer. iii. Joints shall be uniform in appearance when placed adjacent to existing joints. iv. Joints and edges shall be uniform and neat in appearance. v. All ruts, utility cuts, and depressions in the surface shall be filled in a separate pass from the final pass. 8.10.05 Hours of Operation A. Operating hours will be Monday through Saturday as outlined in Section 8.15 of these Specifications, unless otherwise directed by the Engineer. B. Hours of operation shall be: i. Major Thoroughfare: 7:00pm to 7:00am (Night) ii. Residential Areas: 7:00am to 7:00pm (Day) C. On major thoroughfares the micro -surfacing pavement shall be traffic ready by 7:00am, including all traffic control devices and barricades being removed from the roadway. Section 8 119 2020 Design Standards and Specifications Streets and Drainage Specifications 8.11 Storm Sewer 8.11.01 Storm sewer shall include installation of pipe, manholes, inlet structures, outlet structures, and all appurtenances associated with these items. 8.11.02 Contractor shall use only materials, tools, methods, and equipment considered standard by the pipeline construction industry, and approved by the Engineer. 8.11.03 Grade and horizontal alignment shall be maintained using a laser or batter boards. 8.11.04 Materials of Construction A. Storm Sewer Pipe i. As a standard, storm sewer shall be constructed using reinforced concrete pipe, either precast or cast in place. ii. Pipe shall conform to the requirements of AASHTO M170 or ASTM C76. Pipe shall be Class III unless otherwise noted on plan sheets. iii. Other pipe materials may be considered for approval by the Engineer based on engineering and design criteria. B. Mortar i. Mortar shall be used for grouting and filling between pipe and drainage structures. ii. Mortar shall be composed of 1 part, by volume, of Portland cement and 2 parts of mortar sand. a. Portland cement shall conform to the requirements of ASTM C150, Type I. b. Sand shall conform to the requirements of ASTM C144. iii. Hydrated lime may be added to the mixture of sand and cement in an amount equal to 15 percent of the weight of cement used. a. Hydrated lime shall meet the requirements of ASTM C6. iv. Mortar which has not been used after 45 minutes of having water added shall be discarded. a. Mortar may not be retempered by having water added. C. Preformed Bituminous Gasket Joints i. Preformed bituminous gaskets for concrete non -pressure pipe shall conform to the requirements ASTM D994, and shall be Ram-Nek or approved equal. ii. Gaskets shall be installed in accordance with manufacturer's recommendations and shall form a water -tight joint. D. Manholes, Frames, and Covers i. Manhole barrel, cone and extension sections shall be constructed of precast concrete. ii. A plant inspection may be required for production facility inspection and to review record -keeping for material certification. iii. The manufacturer must provide certification that all materials used for manufacturing meet with the following ASTM Specifications: ASTMSpecification Material ASTM C33 Aggregates ASTM C150 Cement ASTM C39 Sampling Specimens ASTM A-615 or A-996 Reinforcing ASTM C144 Sand and Mortar 120 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications iv. Precast concrete sections for manholes shall conform to ASTM C478 specifications. a. Compressive strength test results must verify concrete strengths meet or exceed 4,000 psi. v. Joints, excepting grade rings, shall be tongue and groove or an equivalent male and female type joint as approved by the Engineer. a. Joints shall be effectively jointed to prevent leakage and infiltration. b. Connections between wall sections shall be joined with Conseal Joint Sealant or approved equal to provide a watertight manhole. (1) Sealant will be provided by supplier and will be considered an essential part of each shipment. vi. Cones and adjusting rings shall maintain a clear 30-inch opening. a. Adjusting rings shall be reinforced with the same percentage of steel as risers and tops and will also meet ASTM C478 specifications. b. Adjusting rings, as well as all precast concrete manhole products, shall be smooth, uniform in size and dimensions, consistent in components throughout and free of voids or honeycombs. vii. Manholes shall be designed to withstand H-20 AASHTO loading. viii. Manholes shall also have lifting holes that do not protrude through manhole wall. a. One full inch of concrete thickness must remain between lift hole and outside wall of manhole. ix. Manhole barrels shall be assembled of precast riser section. a. Riser sections and top cone sections shall be placed vertically with tongues and grooves properly keyed. x. Invert channels shall be smooth and semi -circular in shape conforming to the inside of the adjacent pipe section. a. Changes in direction of flow shall be made with a smooth curve of as large a radius as the size of the manhole will permit. b. Changes in size and grade of the channels shall be made gradually and evenly. c. Invert channels may be formed directly in the concrete of the manhole base or may be half -pipe laid in concrete. d. The floor of the manhole outside the channel shall be smooth and shall slope toward the channel not less than one inch per foot, nor more than two inches per foot. xi. Connections between the riser or base sections and the sewer pipe shall be joined in such a manner as to make the manholes watertight. a. Preformed rubber waterstop gaskets cast into the riser or base section are acceptable. b. Preformed flexible plastic sealing compounds equivalent to "Ram-nek" or "Kent Seal" may be used provided a watertight seal is achieved. xii. Adjusting rings may be used for adjusting the top elevation of manholes. a. Each manhole shall have a minimum of 6 inches of grade adjustment. b. Total height of the adjusting rings shall not exceed 12 inches at any manhole. c. Concrete shall be placed around and under the rings to provide a seal and seat the ring at the proper elevation. xiii. Frames and Covers a. Manhole frames and covers shall be of good quality gray iron casting and conform to ASTM A48, having a clear opening of not less than 22 inches. b. The casting shall be designed with a full bearing ring so as to provide a continuous seat between frame and cover. Section 8 121 2020 Design Standards and Specifications Streets and Drainage Specifications c. The cover shall be furnished with lifting ring cast into the cover in such manner as to prevent water leaking through. d. Frame and cover shall have a weight of not less than 275 pounds. e. The manhole ring and cover shall conform with Plate SS-2. 8.11.05 Methods of Construction A. All equipment necessary and required for the proper construction of storm sewers, manholes and culverts shall be on the project, in first-class working condition, and approved by the Engineer before construction is permitted to start. B. If precast concrete pipe or manhole sections are used, the Contractor shall provide appropriate hoisting equipment to handle the pipe or sections while unloading and placing it in its final position without damage to the pipe. C. The Contractor shall provide hand tampers and pneumatic tampers to obtain the required compaction of the pipe bed, the manhole bed and the backfill, as specified. D. Excavation and Trenching i. The Contractor shall do all excavation to the depth shown on the plans. ii. Where rock, or soil containing rocks or gravel, hard pan or other unyielding foundation material is encountered in trench excavation, the pipe shall be bedded in accordance with the requirements of one of the classes of bedding, and the hard unyielding material shall be excavated below the elevation of the bottom of the pipe or pipe bell to a depth of at least 8 inches or 1/2 inch for each foot of fill over the top of the pipe, whichever is greater, but not more than three -fourths the nominal diameter of the pipe. a. The cushion shall consist of a fine compressive material, such as silty clay or loam, lightly compacted, and shaped as required for the specified class of bedding. b. The cost of furnishing and placing the cushion material shall be included in the bid price per linear foot of pipe in place. c. The bottom of the trench shall be excavated to a horizontal section as far as practicable. iii. Excavated material not required or acceptable for backfill shall be disposed of by the Contractor as directed by the Engineer. iv. Excavation shall not be carried below the required depth; but when it is, the trench shall be backfilled at the Contractor's expense with material approved by the Engineer and compacted to the density of the surrounding earth material as determined by AASHTO T180. v. When directed, unstable soil shall be removed for the full width of the trench and replaced with sand or with approved granular material. a. The Engineer shall determine the depth of removal of unstable soil and the amount of backfill necessary. vi. Backfill shall be compacted and shaped to a firm but slightly yielding condition to form the bed for the pipe. vii. Grades for pipe shall be as shown on the drawings. No changes in grade will be made unless so directed by the Engineer. viii. The minimum width of the trench at the top of the pipe, when placed, shall be a width which will permit the proper construction of joints and compaction of backfill around the pipe. ix. The sides of the trench shall be vertical, unless otherwise approved by the Engineer. x. The width of the trench shall provide adequate working room for installation, joining and proper compaction along both sides of the pipe. 122 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications a. Trenches shall conform to the following dimensions, unless otherwise shown on the Plans: Pipe Size Min. Trench Width Max. Trench Width Less than 18" Pipe O.D. +12" Pipe O.D. +18" 18" thru 36" Pipe O.D. +18" Pipe O.D. +24" 37" thru 60" Pipe O.D. + 24" Pipe O.D. + 30" b. The width of the trench above the top of the pipe may be as wide as necessary for shoring, bracing or proper installation of the pipe. c. Excavation in paved areas shall be confined to a minimum practical width. A. The bed for pipe shall be so shaped that at least the lower quarter of the pipe circumference shall be in continuous contact with the bottom of the trench. xii. Manholes a. The excavation for manholes shall be essentially the same as that for the piping. b. The sides of the excavation shall be vertical unless otherwise approved by the Engineer. c. The Contractor shall do such trench bracing, sheathing or shoring necessary to perform and protect the excavation as required for safety and conformance to applicable laws and regulations. d. Bracing, sheathing, or shoring shall not be removed in one operation but shall be done in successive stages to prevent overloading of the pipe during backfilling operations. e. The cost of the bracing, sheathing, or shoring and the removal of same, shall be included in the unit price bid per foot for the pipe. xiii. Surface water shall be prevented from entering the excavation. xiv. Heavy equipment, except for excavating equipment, shall not be operated within 20 feet of the edge of the excavation. xv. Excavated materials shall be stockpiled no closer than 3 feet from the edge of the excavation. E. Pipe Installation i. Contractor shall provide the appropriate tools and methods to insure installation of the pipe to line and grade, as shown on the drawings. ii. Contractor's method for lowering pipe into the trench shall be such that neither the pipe nor the trench will be damaged or disturbed. iii. The Engineer shall inspect all pipe before it is placed in the trench. iv. Any section that is damaged by handling or is defective to a degree which, in the opinion of the Engineer, will materially affect the function and service of the pipe shall be rejected and removed from the job site. v. Installing pipe in the finished trench shall be started at the lowest point and laid upgrade. a. For tongue and groove pipe, the grooved end shall be laid upgrade. vi. The pipe shall be firmly and accurately installed to line and grade so that the invert will be smooth and uniform. vii. The pipe shall be protected from water during placing and until the concrete, for cast - in -place pipe, or the mortar, for joints of precast or cast in place pipe, has thoroughly set. a. The contractor shall provide temporary diversions as necessary to prevent surface water flow into the excavation. viii. Pipe shall not be laid or installed on frozen ground. Section 8 123 2020 Design Standards and Specifications Streets and Drainage Specifications ix. Pipe which is not true in alignment, or which shows any change in grade after laying or installing, shall be taken up and re-laid or re -installed without additional compensation. x. Mortar shall be used for caulking and filling between the pipe and the drainage structures. xi. Mortar that is not used within 45 minutes after water has been added shall be discarded. a. Retempering of mortar shall not be permitted. xii. Pipe joints for precast concrete pipe shall be of the tongue and groove type. xiii. Joints shall be made water tight by means of a preformed bituminous gasket. a. Gaskets shall be installed as recommended by the pipe manufacturer. xiv. Field poured concrete bases shall be at least 12 inches thick and not less than 12 inches greater diameter than the outside diameter of the manhole riser section. xv. Concrete shall be Class A at a minimum 3000 psi 28 day compressive strength. xvi. Concrete placement shall conform to ACI and good construction practices. xvii.Concrete shall be consolidated and struck -off to a horizontal surface within the forms or pouring rings. xviii. Field poured concrete bases shall be reinforced as detailed on the Plans or as shown in the Standard Details. xix. Manholes shall be constructed to ASTM C-891 standards. xx. Precast reinforced concrete bases shall be of the size and shape detailed on the Plans or as shown in the Standard Details. F. Backfilling i. All trenches and excavations shall be backfilled as the pipes and manholes are installed, unless otherwise directed by the Engineer. ii. Outside of street right of way the backfill material shall be selected granular material from excavation or borrow; material which is placed at the sides of the pipe and manhole and 1 foot over the top shall be material which can be readily compacted. a. It shall not contain stones retained on a 2-inch sieve, frozen lumps, chunks of highly plastic clay, or any other material which is objectionable to the Engineer. b. The material shall be moistened or dried, if necessary, to be compacted by the method in use. c. Backfill material shall be approved by the Engineer. iii. The backfill shall be placed in loose layers not to exceed 6 inches in depth along each side of the pipe and manhole. a. Special care shall be taken to secure thorough compaction under the haunches and at the sides of the pipe and manhole. b. This backfill shall be brought up evenly on each side of the structure to an elevation of 1 foot over the top of the pipe, or such greater elevation as directed by the Engineer. c. Backfilling shall be done in a manner as to avoid injurious top or side pressures on the pipe and manhole. d. Backfill shall be compacted to minimum 95 percent Modified Proctor Density. iv. Unless otherwise directed by the Engineer or plans, excavation within street right of way shall be backfilled with flowable fill material (2-sacks of cement per cubic yard concrete mix) to 2 inches below the asphalt surface. a. The pipe shall be restrained so that during the pour the pipe shall not be displaced. v. Movement of construction machinery over a culvert, pipeline, or manhole shall be at the Contractor's risk. 124 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications a. Any damaged construction shall be removed and replaced at the Contractor's own expense. 8.11.06 Trench Protection A. Trench excavations not exceeding five feet in depth shall be protected in accordance with applicable OSHA, state, and local requirements. B. Trench excavations greater than five feet in depth shall be protected in accordance with the following specifications. i. All work performed under this section shall also comply with OSHA Part 1926, Subpart P and all State and Local codes. ii. The Contractor shall be responsible for complying with all trench safety requirements, the requirements of the specifications, drawings and all applicable codes. iii. Trench protection shall be performed by forces having at least two years experience with similar types of trench safety systems. iv. The manufacturer of prefabricated items used in trench safety systems shall have at least two years of experience in fabricating the items. v. The contractor shall provide detailed drawings for proposed trench safety systems. a. The drawings shall identify where each system is proposed for use and type of system to be used. vi. Trench excavations shall not be started until trench safety systems have been submitted and approved by the Engineer. vii. If trench boxes are to be used, the contractor shall submit manufacturer's standard data sheet and certificate of compliance stating the maximum allowable depth for the given design pressure for each type of trench box proposed for use. viii. If alternative systems composed of steel, aluminum, wood or a combination of materials are proposed, the contractor shall submit design data demonstrating the ability of the proposed materials to provide the necessary trench protection. ix. Materials used for trench safety shall be capable of withstanding imposed loads without excessive deflections. x. Materials shall be clean, free of rust, holes, knots and other defects, and shall conform to the following: a. Steel — Steel shall be of type and thickness as required and shall have a minimum yield stress of 36 ksi. b. Aluminum — Type 6061-T6, thickness as required. c. Wood in Contact with Earth — Pressure treated woods. d. Wood not in Contact with Earth — Soft or hardwood as required. 8.12 Fences 8.12.01 Unless otherwise indicated on plans, existing fences which must be adjusted or relocated shall be reconstructed using the same or equivalent materials, height, and construction in the proper location. 8.12.02 The contractor shall remove existing fences and either store for reuse or legally dispose of the fence materials, as directed by the Engineer. 8.12.03 New fence construction shall be in accordance with specifications and details included on plan sheets. Section 8 125 2020 Design Standards and Specifications Streets and Drainage Specifications 8.13 Salvaae of Asphalt Pavi 8.13.01 All salvaged asphalt material shall be broken into pieces not more than 2 inch in size and stockpiled at a location indicated in the plans. 8.13.02 Any non -asphaltic materials, such as flexible base and soil, shall be kept separated from the salvaged asphalt. 8.14 Traffic Control 8.14.01 Prior to starting work on any project covered by these specifications, the contractor shall submit a Traffic Control Plan for approval by the Engineer. A. The contractor shall have the sole responsibility for providing, installing, moving, replacing, maintaining, cleaning, and removing upon completion of work, all traffic control devices. B. The Traffic Control Plan and devices shall be in compliance with the Texas Manual of Uniform Traffic Control Devices (MUTCD). 8.14.02 The Traffic Control Plan approved by the Engineer shall be considered the minimum requirement for the project. A. The contractor shall provide additional devices as determined to be necessary during the project. B. If at any time during construction the approved plan does not accomplish the intended purpose, due to weather or other conditions affecting the safe handling of traffic, the contractor shall immediately make necessary changes to correct the unsatisfactory conditions. 8.14.03 The contractor shall provide and maintain at least one driveway to each property open directly to the project corridor, at all times during construction. A. Driveway width to remain open shall be appropriate for the character and volume of traffic accessing the property, and shall require approval by the Engineer. B. No driveways shall be closed along the project corridor without either a comprehensive access management plan approved by the Engineer, or approval for individual closures from the Engineer. C. The contractor shall notify affected property owners a minimum of two (2) days in advance of any driveway restriction or closure. 8.14.04 All signing and barricading shall be in place before construction operations are started and during all times construction is in progress. A. All hazards shall be clearly marked and adequately protected. 8.14.05 If pedestrian walkways are blocked, pedestrian control shall conform to "Typical Sidewalk and Curb -Lane Closure for Pedestrian Control" as indicated in Texas MUTCD. 8.14.06 If traffic control is not specifically stated in the bid proposal, no separate payment will be made for traffic control. The required plan and devices shall be considered to be subsidiary to pay items. 8.14.07 During the period the Contractor is directing traffic over the base, the surface shall be satisfactorily maintained by the use of sprinkling and blading as required, so that no hazard will result. A. The base course shall be maintained until the wearing surface is placed thereon. 126 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications B. At no time during the period of construction shall driveways and/or alleys be left impassable between the night hours of 6:00 PM to 6:00 AM, except during the construction of curb and gutter for which the driveways and/or alley's shall remain closed not more than 4 days. C. Contractor shall give a minimum of one (1) day advance notice of the work schedule to affected property owners, and shall conduct construction efforts so as not to create a disturbance or nuisance. 8.14.08 All spoil piles must be 3' from travel lanes or have a traffic barrier that will prevent the soil from encroaching on travel lanes. 8.14.09 If roll off dumpsters are placed on street paving, then the paving must be protected from damage. 8.15 Prosecution of the Work and Working Days 8.15.01 As a standard, no work will be performed on weekends, nights, or holidays. A. Requests by the contractor to work evenings, weekends, or holidays must be made and processed in accordance with current City of Lubbock Administrative Policies and Procedures "Construction on Weekends, Nights, or Holidays". B. If the request is approved, the contractor shall be responsible for all City personnel costs associated with the work. C. If the Engineer determines that it is necessary and appropriate to work after dark or before daylight, the contractor shall provide adequate lighting as required to allow prosecution of the work equivalent to that in daylight hours. 8.15.02 Working Days Definition A. City contracted paving projects will be based on working days allowed. i. No requests for extensions of time will be considered. B. A working day is defined as a calendar day, not including Saturdays, Sundays, or City of Lubbock designated holidays, in which weather or other conditions beyond control of the contractor will permit the performance of the principal unit of work for a continuous period of not less than 7 hours between 7:00 am and 6:00 pm. i. Work on Saturdays, Sundays, or City of Lubbock designated holidays must be authorized by the Engineer. ii. For each Saturday, Sunday, or City of Lubbock designated holiday on which the Contractor chooses to work and has authorization from the Engineer to work, 1 day will be charged against the contract working time. iii. Work on Sunday will not be authorized except in cases of extreme emergency, as determined by the Engineer. C. Working days will be considered to begin on the effective date stated in the Notice to Proceed, unless the contractor is unable to begin work on that date due to factors beyond their control as determined by the Engineer. i. In that event, time charged against the project will begin on the date the contractor could first work a minimum of 7 hours as described above. D. The Engineer will furnish the contractor a monthly statement showing the number of working days used and the working days remaining. i. The contractor shall be allowed 10 calendar days in which to protest the correctness of each statement. Section 8 127 2020 Design Standards and Specifications Streets and Drainage Specifications ii. The protest shall be in writing, addressed to the Engineer, and shall indicate basis of the protest. iii. The Engineer shall respond to the protest within 10 calendar days of receiving the protest. iv. Failure to file a protest within the allotted 10 days for any statement shall indicate the contractor's approval of the time charges as shown on that period's time statement, and future consideration of that time statement will not be permitted. 8.15.03 Work Between November 1 and January 2, and on Other City Holidays A. If conditions are such that, in the opinion of the Engineer, construction will negatively affect local businesses during holiday periods, the Engineer may suspend construction operations from November 1 to January 2. B. The City of Lubbock observes specific holidays, and City staff is not required to work those days. i. As standard procedure, construction operations that require testing/inspection may not be performed on those holidays. ii. If the contractor needs to perform construction operations that require City personnel on holidays, the contractor shall make a written request for authorization to work from the Engineer. iii. The request shall state the reason the work is necessary, and shall state that the contractor agrees to pay the City for the related personnel expenses including salary, overtime, and benefits. iv. If City personnel are available, the Engineer may approve the request. 8.16 Measurement and Pavment 8.16.01 The unit price bid for all bid items shall include furnishing and installing all materials, excavation, filling, backfilling, reinforcement, forming, finishing, joint cutting, joint sealing, and all incidentals necessary to complete the work, except as otherwise specified, necessary or incidental to complete the various items of work in accordance with the plans and specifications. A. Cost of work or materials shown on the plans or called for in the specifications and for which no bid item is indicated shall be considered subsidiary to the various bid items. i. No separate payment shall be made for such subsidiary work or materials. B. Payment will not be made for any item that is not complete, including all associated incidental work. C. All of the items covered by these standard specifications may not be included in a particular project. D. Only those items indicated on bid documents and plan sheets shall be included for construction and payment. 8.16.02 Separate Curb and Gutter A. Measurement will be made of the linear feet of separate curb and gutter actually constructed. B. Separate curb and gutter will be paid for at the unit price bid per linear foot. C. The 24-inch curb and gutter shall be considered standard; The 30-inch curb and gutter shall be used only if specifically indicated on plans or bid documents. 128 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications D. Curb on a slab that is part of a sidewalk, driveway, alley return, alley paving, valley gutter and fillets, drainage channel, or wheelchair ramp will be considered to be subsidiary to those items, and no separate payment will be made for such curb. 8.16.03 Concrete Flat Slabs - Sidewalk, Driveway, Alley Return, Alley Paving, and Valley Gutters and Fillets A. Measurement will be made of the area, in square feet, of flat slab actually constructed. B. Flat slabs will be paid for at the unit price bid per square foot for each specific type of slab. C. Curb on sidewalks, driveways, alley returns, alley paving and valley gutters and fillets shall be included in the area measured for the slab and will not be paid for as a separate item as curb and gutter. 8.16.04 Curb Ramps (Handicap Ramps) A. Measurement will be made of the area, in square feet, of curb ramp actually constructed, including surface treatments and top surface area of any curb above the slab. B. Landings, wings, and ramps will be paid for per square foot as 4 inch thick sidewalk. C. Curb ramps will be paid for at the unit price bid per square foot. No separate payment will be made for curb as part of a ramp. 8.16.05 Concrete Drainage Channel A. Measurement will be made of the area, in square feet, of drainage channel actually constructed, including top surface area of any curb above the slab. B. Drainage channel will be paid for at the unit price bid per square foot. 8.16.06 Retaining Walls A. Retaining wall will be considered as that portion of concrete construction which constitutes a separate reinforced structural member for soil retention, extending above and below a surface slab. B. Measurement will be made of the linear feet of retaining wall actually constructed. C. Retaining wall will be paid for at the unit price bid per linear foot. 8.16.07 Concrete Median A. Measurement will be made of the area, in square feet, of median actually constructed. B. Median will be paid for at the unit price bid per square foot. 8.16.08 Concrete Street Paving A. Measurement will be made of the area, in square yards, of concrete street paving actually constructed. B. Concrete street paving will be paid for at the unit price bid per square yard. 8.16.09 Sawing and Sealing of Joints in Concrete Street Paving A. Measurement will be made of the linear feet of sawed and sealed joints actually constructed. B. Sawing and sealing of joints will be paid for at the unit price bid per linear foot. 8.16.10 Curb and Gutter Removal A. Measurement will be made of the linear feet of curb and gutter actually removed. Section 8 129 2020 Design Standards and Specifications Streets and Drainage Specifications B. Payment will be made at the unit price bid per linear foot of curb and gutter removed. C. The contractor shall ensure that the Engineer has the opportunity to measure the linear feet of curb and gutter prior to removal. D. If curb and gutter is removed without measurement by the Engineer, no payment will be made for that removal. 8.16.11 Concrete Slab Removal and Disposal A. Measurement will be made of the area in square feet of concrete slab actually removed and legally disposed of. B. The contractor shall ensure that the Engineer has the opportunity to measure the area of concrete slab prior to removal. C. If concrete slab is removed without measurement by the Engineer, no payment will be made for that removal and disposal. D. Payment will be made at the unit price bid per square foot of concrete slab removed and disposed of. 8.16.12 1-1/2 Sack (141 Ibs) Flowable Fill A. Quantities of 1-1/2 sack (141 Ibs) flowable fill will be determined from tickets provided by the drivers of the delivery trucks. B. Payment will be made at the unit price bid per cubic yard of in place 1-1/2 sack (120 Ibs) flowable fill. 8.16.13 Asphalt Paving A. Measurement will be made of the area, in square yards, of asphalt paving actually constructed. B. The unit price bid shall include furnishing and installing all materials, subgrade preparation, construction of caliche or asphalt stabilized base as specified, excavation, filling, tack and prime coats, HMAC surface, emulsion seal, and all incidentals necessary to complete the work C. Payment will be made at the unit price bid per square yard of asphalt paving. 8.16.14 Asphalt Paving Repair A. Measurement will be made of the area, in square yards, of in place asphalt paving repair. B. The unit price bid shall include removal of existing surface materials, furnishing and placing all asphaltic materials, sawing of existing paving edges, smoothing and preparation of the existing base, tack and prime coats, compaction, and all incidentals necessary to complete the work. C. Payment will be made at the unit price bid per square yard of paving repair. 8.16.15 Micro -Surfacing A. Micro -surfacing will be measured by the ton of composite micro -surfacing mixture used, defined as the asphalt emulsion, aggregate, and mineral filler. B. The unit price bid shall include surface preparation, furnishing, hauling, preparing, and placing materials, and all required equipment, labor, tools and incidentals necessary to complete the work. C. Payment will be made at the unit price per ton of composite micro -surfacing mixture used. 130 Section 8 2020 Design Standards and Specifications Streets and Drainage Specifications 8.16.16 Excavation and Grading Outside Limits of Construction A. Volume of excavation or fill, in cubic yards, will be determined by average end area method. B. The unit price bid shall include all labor, equipment, and incidentals necessary to excavate or fill the site to the grades established by the Engineer. C. No separate payment will be made for disposing of excess material. D. Payment will be made at the unit price bid per cubic yard of completed excavation or fill. 8.16.17 Ditch Grading and Unpaved Street Surface Grading A. Measurement will be made of the linear feet of ditch or street grading. B. No separate payment will be made for disposing of excess material. C. Payment will be made at the unit price bid per linear foot of completed ditch or street grading. 8.16.18 Traffic Control A. Set up and maintenance of traffic control plans indicated as a bid item in the contract will be paid for on a per day basis for each day the control plan devices are required to be in place. B. If no bid item for traffic control is included in the contract it shall be considered to be subsidiary to bid items, and no separate payment shall be made for traffic control. 8.16.19 Mobilization A. Contractor mobilization indicated as a bid item in the contract shall be paid for as a lump sum. If no separate bid item for mobilization is included in the contract it shall be considered subsidiary to contract bid items, and no separate payment shall be made for mobilization. 8.17 Restoration and Clean Up 8.17.01 After any construction covered by these specifications is completed, the Contractor shall remove all equipment, surplus materials, and rubbish from the site. 8.17.02 The contractor shall restore all disturbed areas to their original condition satisfactory to the Engineer, including sidewalks, driveways, curb or curb and gutter, sprinkler systems, and turf or landscaping disturbed outside the defined construction area. 8.18 Certificate of Completion and Warranty 8.18.01 Within 30 calendar days after the Developer or Developers Engineer has given written notice that the improvements have been substantially completed, the City shall inspect the completed improvements and provide a punch list if necessary. A. If it is mutually determined that the improvements have been constructed in accordance with the engineering plans and the City of Lubbock Engineering Minimum Design Standards and Specifications, the Developers Engineer shall submit Record Drawings, Certificate of Completion and Developers Warranty Statement (Copies of the Certificate of Completion and the Developers Warranty Statement are included in the City of Lubbock Engineering Minimum Design Standards and Specifications). Upon receipt of the Developers Certificate of Completion, Record Drawings and the Developers Warranty Statement, the City will accept improvements within 30 calendar days; unless exception is given in writing. Section 8 131 2020 Design Standards and Specifications Streets and Drainage Specifications C. Neither the Final Payment nor the Certificate of Completion shall relieve the Developer or Contractor of responsibility related to warranty of materials or workmanship. D. The Developer shall remedy any defects due to faulty materials or workmanship that appear within 2 years from the date of acceptance by the City of Lubbock. 132 Section 8 2020 Design Standards and Specifications Streets and Drainage Check List SECTION 9 CHECK LIST FOR STREETS AND DRAINAGE CONSTRUCTION PLANS 9.01 Plan Submittal Reauirements 9.01.01 All street and drainage improvements construction plans shall be checked for conformance with City of Lubbock Standard Specifications for Street and Drainage Construction prior to submittal to the Engineering Department. Approval of plans is for general conformance with the City of Lubbock Minimum Design Standards and Specifications. Approval of plans shall not relieve the Engineer or Developer from any City, State or other governing requirements nor for errors or omissions in the plans and specifications. 9.01.02 Plan Review A. The Design Engineer shall submit Paving and drainage construction plans to the City Engineer or designee for review and comment. The Design Engineer shall use the City of Lubbock Customer Self Service (CSS) website to submit plans. http://egovaccess.ci.lubbock.tx.us/EnerGov Prod/SelfService/#/home B. Please call 806-775-2347 if you have any questions regarding the CCS submission process. C. Upon completion of review and receipt of payment for appropriate Plan Review fees, comments shall be returned to the Design Engineer on the CSS website. i. Plans requiring resubmittal for substantial changes as determined by City Engineer or Designee may require payment of an additional Plan Review fee. D. After comments have been addressed and changes have been made the Design Engineer will submit the revised plan using CSS website. i. If comments have not been addressed on plans submitted for final approval for construction the plans will be rejected. ii. If testing and inspection fees have not been paid, plans will be rejected. E. Upon approval, the city will return an electronic copy of the plan stamped "Approved for Construction" through the CSS web site. i. The design Engineer will be required to submit two half size copies of the approved for construction stamped plans. F. Final construction plans should not be submitted for Engineering Department approval for work that will not be installed within 6 months of the approval date. i. Delays between approval date and construction may require resubmittal of the plans for review under current standards. 9.01.03 Construction Cost Estimate and Fees A. Two (2) sets of preliminary Cost Estimates shall be submitted for review at the time of plan review submittal. i. The preliminary Estimate shall be based upon reasonable estimates for the work as established by the Design Engineer. B. Two (2) sets of final Cost Estimates shall be submitted for review and reference at the time that a contract is awarded for the work. i. The final Cost Estimate shall be based upon actual contract values. C. Plan Review Fees in the amount of 0.5 percent of the final Estimate amount (minimum $50) shall be submitted prior to construction. Section 9 133 2020 Design Standards and Specifications Streets and Drainage Check List D. Inspection and Testing Fees in the appropriate amount of the final Cost Estimate amount (minimum $125) shall be submitted prior to construction. E. Inspection and Testing Fees shall be based on the following requirements: Cost Estimate Range Testin and Inspection Fee Percent Multiplication Factor Up to $20,000 4.0 0.04 $20 001 - $25 000 3.75 0.0375 $25,001 - $30,000 3.5 0.035 $30,001 - $40,000 3.25 0.0325 $40 001 - $50 000 3.0 0.03 $50,001 - $75,000 2.5 0.025 $75,001 - $150,000 2.0 0.02 Greater than $150,000 1.5 0.015 9.01.04 Checklist A. A copy of the completed "City of Lubbock Pavement Submittal Checklist" shall be submitted at the time of plan review submittal. The checklist can be found in the Appendix. 9.01.05 Construction Plans A. All plans to be used or kept on the job site shall be original or reproduced plan sets clearly marked "Approved for Construction" with the signature of reviewer and date approved by the Engineering Department. B. Should circumstances during construction warrant changes from the approved plans or specification, as determined by the City Inspector, a written approval must be obtained from the City Engineer. i. Copies of the written approval shall be attached to the construction plans and maintained on the job site. 9.01.06 Record Drawings A. The Design Engineer shall be responsible for recording constructed dimensions, grades, elevations and additional information on a set of Record Drawings during the progress of construction. i. The City of Lubbock Engineering Department shall monitor this process to assure that changes in construction are kept up to date on the Record Drawings. B. Digital PDF "Record Drawings", certified by the Design Engineer and the City of Lubbock Engineering Department, shall be submitted to the City within 30 days of completion of the construction. C. Where the construction is phased and a lapse of more than 60 days occurs between phases, then Record Drawings shall be presented to the City of Lubbock Engineering Department reflecting the completed construction prior to issuance of the Certificate of Acceptance of Streets and Drainage Improvements. D. Items required to be submitted with Record Drawings: i. Letter of Transmittal ii. Record Drawing iii. Updated Construction Cost Estimate iv. Certificate of Completion (Provided to Contractor from City Inspector) v. Developer's Warranty Statement (See Appendix) 134 Section 9 2020 Design Standards and Specifications Streets and Drainage Check List 9.01.07 Acceptance A. Upon completion of construction, satisfactory tests, completion of punch list items, and submittal of Record Drawings, the Design Engineer shall submit a request to the City Engineer for a Certificate of Acceptance of Streets and Drainage Improvements. Section 9 135 2020 Design Standards and Specifications Streets and Drainage Check List 9.02 Plan Details 9.02.01 Plan Format A. All drawings shall be no larger than 22-inch by 34-inch in size. 9.02.02 The following information shall be shown on the plans: A. General i. Title Block (lower right hand corner preferred) ii. Scale a. Horizontal 1"=20' or 1"=50' b. Vertical 1"=1' (preferred) or 1"=2' (maximum) iii. Original Date and Revision Dates iv. Name of Professional Engineer v. Professional Engineer's Seal vi. Firm Name and Contact Information vii. Legal Description of Property Being Improved viii. Drawings Number (s) ix. City of Lubbock Engineering Department Contact Information: a. Streets Inspector: 775-3750 x. Statement: "All work shall be performed in accordance with the current version of the City of Lubbock Minimum Design Standards and Specifications." B. Plan i. Bench Marks and USGS Datum ii. North Arrow iii. ROW Lines, Property Lines and Lot Numbers iv. Street Names and Easements with Width Dimensions v. Existing Curbs and Paving (Gray) vi. Proposed Curbs and Paving (Bold) vii. Spot Elevations on Radii, Dips, Grade Breaks, and Ditches viii. Location and Direction of Dips ix. Other Pertinent Details (Buildings, Utilities, Water Courses, Etc.) C. Profile i. Existing Ground Surface at Curb Lines (Gray) ii. Existing Gutters or Flow Lines (Gray) iii. Proposed Gutters or Flow Lines (Bold) iv. Stationing with Profiles Indexed to Plan View v. Intermediate Station Numbers and Elevations at Points of Grade Change and Radii vi. Ditch Grades vii. Existing and Proposed Utilities Where Crossed D. Detail Sheet i. Details are not required when engineers plans refer to City standards ii. Include all non-standard details 136 Section 9 2020 Design Standards and Specifications Streets and Drainage Check List Overall Layout Sheet — As Required i. Scale 1 "=100' ii. Lot Lines iii. Streets and Street Names Section 9 137 2020 Design Standards and Specifications Streets and Drainage Check List 138 Section 9 Design Standards and Specifications Construction Details SECTION 10 TYPICAL DETAILS OF CONSTRUCTION Section 10 A Design Standards and Specifications Construction Details A Section 10 Design Standards and Specifications Construction Details 10.01 General Details 10.01.01 Construction shall be in accordance with the following standard details unless otherwise indicated on plans or directed by the Engineer. Section 10 A 2' HOUSE SERVICE JI TYPICAL LOT 5' 5' WATER LINE WATER GAS LINE SEWER LINE 5 jI� TYPICAL LOT 20' 10, 7' 6" 5' 10, 7' 5" 5' 3' 9" 2' 0 m UTILITY POLE UTILITY G POLE m FINISHED RADE No N z_ V z � BURIED T.V. CABLE URIED AT&T CABLE BURIED GAS MAIN NTS CABLE ;T z CONCRETE PAD "v OVER BURIED ELECTRIC CONDUIT WATER MAIN HOUSE SERVICE Nor L2' BURIED ELECTRICAL BURIED ELECTRICAL 9' MINIMUM SEWER CABLE MIN CABLE 2' TYPICAL LOCATIONS a(� City of REVISED MAR. 2019 FOR UTILITIES IN ALLEYS *Lubbock DRAWING NUMBER G-1 COMPROMISED SOIL DUE TO MOISTURE FROM A WATER LEAK OR RAIN EVENT PIPE SPRINGLINE ZONE NOTES: ORIGINAL EXCAVATED TRENCH WIDTH OVEREXCAVATED FOR COMPACTION 1. BEDDING, EMBEDMENT, AND BACKFILL SHALL BE CAREFULLY PLACED MATERIAL AS SPECIFIED IN THESE SPECIFICATIONS. 3. BACKFILL REQUIREMENTS SHALL COMPLY WITH CURRENT CITY OF LUBBOCK STREETS ORDINANCE. FINISHED GRADE SURFACE FINAL BACKFILL H INITIAL w BACKFILL m 0 w m w w a a HAUNCHING BEDDING FOUNDATION (MAY NOT BE REQUIRED) *1141 W REVISED TRENCH CROSS-SECTION 11E o C;tv of DEC. 2015 SHOWING TERMINOLOGY Lubb6ck DRAWING NUMBER TEXAS G-2 Design Standards and Specifications Construction Details 10.02 Water Details Section 10 No Text FINISHED GRADE SURFACE NOTES: 1. BEDDING, EMBEDMENT, AND BACKFILL SHALL BE CAREFULLY PLACED MATERIAL AS SPECIFIED IN THESE SPECIFICATIONS. 2. BACKFILL REQUIREMENTS SHALL COMPLY WITH CURRENT CITY OF LUBBOCK STREETS ORDINANCE. WATER LINE TRENCH DETAIL f#r ■ City of ll�Lubbock REVISED DEC. 2012 DRAWING NUMBER W-1 THRUST BLOCK SIZING CHART DIA. INCHES TEES CROSS & PLUGS CF 4 3 6 6 8 15 10 27 12 37 16 53 18 64 20 77 24 104 30 149 ANCHORAGE FOR CROSS N.T.S. REMOVE PIPE SECTION, TRIM AND REPLACE FOLLOWING INSTALLATION METAL OF PLUGS PLATE LINE TO BE - - - - LINE TO REMAIN ABANDONED IN SERVICE CONCRETE BLOCKING TYPICAL 2,500 PSI CONCRETE CONCRETE THRUST BLOCK I ='� TEE I ANCHORAGE FOR TEE N.T.S. PLUG W/EARS THRUST BLOCK SIZING CHART DIA. INCHES TEES CROSS & PLUGS CF 4 3 6 6 8 15 10 27 12 37 16 53 18 64 20 77 24 104 30 149 CAP OR PLUG ON PRESSURE SIDE CONCRETE -A.- THRUST - BLOCK - - - ANCHORAGE FOR PLUG N.T.S. THRUST BLOCK SIZING CHART DIA. INCHES TEES CROSS & PLUGS CF 4 3 6 6 8 15 10 27 12 37 16 53 18 64 20 77 24 104 30 149 NOTES: THRUST BLOCK SIZING CHART DIA. INCHES TEES CROSS & PLUGS CF 4 3 6 6 8 15 10 27 12 37 16 53 18 64 20 77 24 104 30 149 1. FOR BLIND TEE INSTALL ONE JOINT OF PIPE WITH PLUG AND TREAT AS A DEAD END LINE. 2. BEARING SURFACES SHALL BE AGAINST UNDISTURBED GROUND. 3. CONCRETE BLOCKING SHALL BE TYPICAL 2,500 PSI CONCRETE. 4. DUCTILE IRON FITTINGS SHALL BE WRAPPED WITH POLYETHYLENE ENCASEMENT PRIOR TO PLACEMENT OF CONCRETE FOR THRUST BLOCKING. SIZE ACCORDING TO AWWA & PIPE MANUFACTURER SPECIFICATIONS REVISED CONCRETE �', o City- of DEC. 2012 THRUST BLOCKING Lubb6ck DRAWING NUMBER TEXAS W_2 THRUST BLOCK THRUST BLOCK SIZING CHART SIZING CHART DIA. 11.250 DIA. 22.50 INCHES CF INCHES CF 4 1 4 1 6 1 6 1 CONCRETE 0 2CONCRETE 0 3 THRUST 12 3 THRUST 12 8 BLOCK —— BLOCK 16 4 16 11 — 18 4 — — —= -- 18 13 20 5 20 16 11.25 p 24 7 22.5° BEND --� __ 24 21 BEND — 30 10 30 30 ANCHORAGE FOR A 11.25° BEND ANCHORAGE FOR A 22.5° BEND N.T.S. N.T.S. -= _- _ — - CONCRETE = THRUST — — —__ BLOCK 45°BEND ANCHORAGE FOR A 45° BEND THRUST SIZING BLOCK CHART DIA. INCHES 450 CF 4 1 6 2 8 4 10 7 12 15 16 21 18 25 20 30 24 40 30 58 N.T.S. CONCRETE THRUST BLOCK _ _ — -n- -r- NO.3 BARS je EACH WAY VERTICAL BEND N.T.S. CONCRETE THRUST BLOCKING 90° BEND ANCHORAGE FOR A 90° BEND N.T.S. NOTES: CONCRETE THRUST BLOCK THRUST SIZING BLOCK CHART DIA. INCHES 900 CF 4 2 6 4 8 9 10 17 12 27 16 38 18 46 20 55 24 30 74 1 106 1. BEARING SURFACES SHALL BE AGAINST UNDISTURBED GROUND. 2. CONCRETE BLOCKING SHALL BE TYPICAL 2,500 PSI CONCRETE. 3. DUCTILE IRON FITTINGS SHALL BE WRAPPED WITH POLYETHYLENE ENCASEMENT PRIOR TO PLACEMENT OF CONCRETE FOR THRUST BLOCKING. SIZE ACCORDING TO AWWA & PIPE MANUFACTURER SPECIFICATIONS City of Lubbock TEXAS REVISED DEC. 2012 DRAWING NUMBER W-3 3 1/2" X 3/8" DEEP RECESS METER OFOR AMR PAD WITH 2' HOLE FOR ENDPOINT O D U p Q p p Q 17„ QopoQoQopoQ � 00 17,E opopopopopopop Q�Q�Q�Q2131b'MQ�Q� F� 18" - 18" 2" LID N.T.S. �21z"� u" 28 16 NOTES: 1. LID MATERIAL: HDPE 2. BODY MATERIAL: LLDPE 3. WALL THICKNESS: 3/8" MINIMUM TYPICAL 1" NON -TRAFFIC RATED METER BOX METER 0�0�0�0�0� �0 0.0� �popopopopopop 2131bMQ�p� i � 20Z 1. u 27 16" Lubbity ock TEXAS REVISED JAN. 2020 DRAWING NUMBER W-4 TYPICAL 2,500 PSI CONCRETE THRUST BLOCK EXISTING MAIN RETAINER GLANDS TAPPING VALVE NOTES: 45° 45° TYPICAL TAPPING SLEEVE 1. TAP SHALL BE HORIZONTAL TO MAIN. 2. TAPPING SLEEVE & VALVE SHALL BE AT LEAST ONE STANDARD SIZE SMALLER THAN MAIN TO BE TAPPED. 3. SERVICE TAPS ON EXISTING MAINS SHALL BE EXECUTED BY CITY FORCES. 4. MAIN LINE TAPS ON EXISTING MAINS SHALL BE EXECUTED IN ACCORDANCE WITH THE METHODS OF CONNECTIONS SECTION OF THESE SPECIFICATIONS. TYPICAL TAPPING SLEEVE AND VALVE LIMIT OF WORK FOR TAP -IN War City of Lubbock T E X A 5 REVISED DEC. 2012 DRAWING NUMBER W-5 900 BEND METER BYPASS SERVICE LINE GATE VALVE \ o I TYPICAL VALVE BOX & COVER MI X MI X THREAD TEE REDUCER GATE VALVE O p WATER METER O GATE VALVE REDUCER (IF REQUIRED) 900 BEND MI X MI X THREAD TEE ❑ TAPPING SLEEVE AND VALVE EXISTING MAIN NOTE: 1. ALTERNATIVELY, METER BYPASS SERVICE LINE AND GATE VALVE CAN BE LOCATED INSIDE METER VAULT. REVISED TYPICAL LARGE C;tv of DEC. 2012 DOMESTIC METER TAP Lubb 6 C% DRAWING NUMBER TEXAS W_6 TYPICAL FIRE - HYDRANT TYPICAL VALVE BOX AND COVER WITH CONCRETE COLLAR PROPOSED FINISHED GRADE SURFACE C-900 PVC RISER 4' MIN COVER 6" GATE WATER'W VALVE MAIN W TYPICAL 2,500 PSI VALVE BLOCKING VARIES BACK OF CURB OR r (SEE NOTE #1) EDGE OF PAVEMENT 0.2' MIN 18 0.4' MAX CONC. CURB SOLE -PURPOSE FIRE HYDRANT LINE L 2' X 2' SQ. 6" OUTLET M.J. X FLG. OR ANCHOR TEE (OPTIONAL) WITH M.J. X M.J. VALVE NOTES: 1. IN SPACE BETWEEN CURB AND SIDEWALK, DIMENSION FROM BACK OF CURB OR EDGE OF PAVEMENT SHALL BE 6" MINIMUM AND 18" MAXIMUM. IN PUBLIC AREAS OR COMMERCIAL AREAS, OR WHERE SIDEWALK ABUTS CURB, DIMENSION FROM BACK OF CURB OR EDGE OF PAVEMENT SHALL BE 3' MINIMUM AND 6' MAXIMUM. FIRE HYDRANTS SHALL NOT BE PLACED WITHIN SIDEWALK AREAS. MAINTAIN T MINIMUM CLEARANCE TO ANY OBSTRUCTION. 2. 4" STEAMER NOZZLE SHALL FACE FIRE LANE OR STREET ACCESS 3. FIRE LINE PIPING SHALL BE SAME MATERIAL AS MAIN OR MINIMUM C900 PVC DR18 CLASS PIPE AND HAVE RESTRAINED JOINT FITTINGS FROM WATER MAIN TO FIRE HYDRANT. LENGTH SHALL NOT EXCEED 1501. 4. FOR BURY DEPTHS GREATER THAN 5', ONE BARREL EXTENSION NOT EXCEEDING 2' IN LENGTH SHALL BE INSTALLED DIRECTLY BELOW THE FIRE HYDRANT. 5. TYPICAL 1/2" ROCK PIPE EMBEDMENT MATERIAL SHALL BE PLACED AROUND THE BOTTOM OF THE HYDRANT FOR A RADIUS OF AT LEAST V AND EXTEND AT LEAST V ABOVE THE OUTLET. DO NOT BLOCK DRAIN HOLES. I=iII, II - DO NOT BLOCK DRAIN TYPICAL 2,500 PSI CONCRETE THRUST BLOCK TYPICAL BLUE RAISED PAVEMENT MARKER PLACED AT CENTERLINE 3' MIN OF ROADWAY 12" MIN oxv War TYPICAL FIRE HYDRANT � c'tv"f Lubb o ck T E X A 5 REVISED MAY 2015 DRAWING NUMBER W-7 MATCH PAVING THICKNESS TYPICAL VALVE BOX MIN. 6" AND COVER I FINISHED GRADE SURFACE H.M.A.C. PAVEMENT III CONCRETE COLLAR (NOT REQUIRED IN —III—� CONCRETE PAVEMENT) I-I I II I= FLOW FILL WHEN CONCRETE COLLAR _ I=1 11=1 I IS CUT IN AFTER ASPHALT PAVING 6" PVC C900 =1 11-1 11-1 11-1 RISER PIPE 1-111-111— d �v TYPICAL TRACER WIRE -- — - — - — - — I °p 1-1/ I °�e TYPICAL PIPE BEDDING & EMBEDMENT NOTES: TYPICAL GATE VALVE WATER MAIN L 8" X 8" X 6" MIN. 2,500 PSI CONCRETE BLOCK UNDER BODY OF BURIED VALVES 1=1 1 1-1 1 VALVE COVER SHALL BE STAMPED "WATER VALVE" 1. TREAT EACH SIDE OF VALVE AS A DEAD END OF EQUAL SIZE. INSTALL THE CORRESPONDING LENGTH (FOR A DEAD END) OF FULLY RESTRAINED PIPE THE FULL DISTANCE ON EACH SIDE OF VALVE 2. CONCRETE SUPPORT CRADLE AND SUPPORT PAD SHALL BE 3,600 P.S.I. CONCRETE. 3. POLYWRAP BURIED GATE VALVES AND FITTINGS 4. TORQUE BOLTS PRIOR TO BACKFILL PER MANUFACTURERS RECOMENDATIONS 5. TOP OF VALVE NUT SHALL BE LESS THAN 6 FEET FROM FINISHED GRADE. IF MORE THAN 6 FEET, INSTALL EXTENSION SO THAT TOP OF NUT IS LESS THAN 6 FEET FROM FINISHED GRADE. 6. SET COVER OF VALVE BOX AND COLLAR 1/4" BELOW GRADE IN PAVEMENT OR SHOULDER, AND 2" ABOVE GRADE ELSEWHERE. BURIED VERTICAL GATE VALVE DETAIL 2- SQUARE City Of Lubb o ck TEXAS VALVE BOX AND COVER CONCRETE COLLAR (NOT REQUIRED IN CONCRETE PAVEMENT) N0. 4 BARS EACH WAY ORIENT SQUARE PARALLEL OR PERPENDICULAR TO SREET OR CURB REVISED APRIL 2019 DRAWING NUMBER W-8 0 zo HORIZANTAL GATE VALVE IN VAULT T\/!1T!`A1 I.A AI.I LIl11 G GI'1 AI.AL A�II'l !`/1\/LR City of Lubbock T E X A 5 NO. 5 BARS 10" O.C. VERT. NO. 5 BARS 8" O.C. HORZ. REVISED DEC. 2012 DRAWING NUMBER W-9 4" D.I. PIPE "GOOSENECK" WITH WIRE BUG SCREEN LIP T-0" ABOVEGROUND VARIES IIII�IIII ' 12" BLIND FLANGE I —I 1I—CCI I 4" BEDDING=IJ o• FINISHED GRADE SURFACE 9" SLABIFE1 I I-- ' III -III- I —I ° 2„LIP '-1 I I- HANDWHEEL — 3/4" CRUSHED ROCK —" I-11 III—III- 4' MIN. =I I I- I— I 1-1 I I- II1I1III1I1III11 1III TYPICAL MANHOLE FRAME & COVER —III—III—I I —III—i #6 BARS 6" I, O.C. EA. WAY =1 I I II e COMB. AIR I I I ° RELEASE a I- 2" FLANGED & AIR INL e GATE VALVE 111 ° 0 1— #5 VERT. INNER 12" BLIND — I FACE 10" O.C. FLANGE III I #5 HORIZ. OUTER e . FACE 8" O.C. ° --- ---- �e — ----� 0 8III H_ 6'IMIN. ^&rr REVISED AIR & VACUUM A*A'aI City of DEC. 2012 RELIEF VALVES '■ Lubbock DRAWING NUMBER W-10 CONCRETE ROCK CONCRETE VALVE BOX City of Lubbock TEXAS REVISED DEC. 2012 DRAWING NUMBER W-11 CONCRET�+v� ,. O.C. EACH WAY BUTTERFLY VALVE IN VAULT City of Lubbock TEXAS REVISED DEC. 2012 DRAWING NUMBER W-12 A �3pROAN IROry 1 " RAISED LETTERING A T E R (RECESSED FLUSH) CUSTOM LOGO pF L I B �-1 66 V B n PI) EPIC CKB RSA MADE IN 115p A 32" DIA 21 3/4" r � v � N 23 SECTION A -A V-1430 A PROD.NO. SECTION B-B MO/DAY/YR ASTM A48 CL35B NOTES: 1. SANITARY SEWER MANHOLE FRAME AND COVER I.D.: 4143009OA01 BOTTOM VIEW 2. STORM SEWER MANHOLE FRAME AND COVER I.D.: 41430091AOI REVISED TYPICAL WATER � IV,, Cityof DEC 2015 VAULT COVER ll�Lubbock DRAWING NUMBER W-13 • m A A N Q 0 O • • B ��1y M9�rN v 1a2o BB �/Sq ® • 1 �� 1/2" l AA 32 3/16" 1 1/2" 4 1/2" 30" 40 3/4" ��r r REVISED TYPICAL WATER �'aI City of DEC. 2012 ll�T . VAULT FRAME ubb o Ck DRAWING NUMBER W-14 2 T ,,-CARSONITE MARKER GROUND SURFACE R II -I I I -I I I -I I „III-u =I I i= _.. 114" MI IIi li lI I 16" =-III SQUARE TRAFFIC RATED / OR NON FOR HDPE OR PEX-A USE=I = 24" MIN - TRAFFIC RATED METER BOX APPROVED THREAD II - X SLIP FITTING 4' TYP. CORPORATION STOP �_lillil�r' CURB STOP 45' FOR HDPE OR PEX-A USE APPROVED WATER MAIN + THREAD X SLIP FITTING COPPER OR APPROVED HDPE PEX-A TAPPING SADDLE NOTES: 1. STANDARD 1" SERVICE TAP 2. 1" SERVICE SADDLES SHALL HAVE AWWA TAPERED THREADS. 3. METER BOX SHALL BE INSTALLED PLUMB & LEVEL WITH TOP OF LID 2" ABOVE FINISHED GROUND SURFACE. 4. TOP OF METER SHALL BE 16" FROM BOTTOM OF METER BOX LID. 5. MATERIALS AND INSTALLATION OF SERVICE LINES SHALL COMPLY WITH THE CITY OF LUBBOCK PUBLIC WORKS ENGINEERING MIN DESIGN STANDARDS AND SPECIFICATIONS. TYPICAL 1" WATER SERVICE DETAIL oxv War City of Lubbock TEXAS REVISED DEC. 2015 DRAWING NUMBER W-15 W 2 T ,-CARSONITE MARKER GROUND SURFACE R -IIi II- IT m m m 14 IvIliliil�iiliii 16 SQUARE TRAFFIC RATED / OR NON 24" MIN iii TRAFFIC RATED METER BOX 4' TYP. CORPORATION STOP CURB STOP 45' CORPORATION STOP WATER MAIN TAPPING SADDLE COPPER SERVICE TUBING NOTES: 1. STANDARD 2" SERVICE TAP 2. 2" SERVICE SADDLES SHALL HAVE IPS THREADS. 3. METER BOX SHALL BE INSTALLED PLUMB & LEVEL WITH TOP OF LID 2" ABOVE FINISHED GROUND SURFACE. 4. TOP OF METER SHALL BE 16" FROM BOTTOM OF METER BOX LID. 5. MATERIALS AND INSTALLATION OF SERVICE LINES SHALL COMPLY WITH THE CITY OF LUBBOCK PUBLIC WORKS ENGINEERING MIN DESIGN STANDARDS AND SPECIFICATIONS. REVISED TYPICAL 1 1/2", OR 211olf �',# C;t�. o f DEC. 2015 WATER SERVICE DETAIL Lubb6ck DRAWING NUMBER TEXAS W-16 TYPICAL TAPPING SLEEVE NOTES: 1. THIS DETAIL SHALL APPLY TO ALL WATER LINES < 16" DIAM. 2. TAPPING DISTANCES FOR LARGER LINES SHALL BE CASE BY CASE. TAPPING SLEEVE MINIMUM DISTANCE City of Lubbock TEXAS REVISED DEC. 2015 DRAWING NUMBER W-17 Design Standards and Specifications Construction Details 10.03 Sewer Details Section 10 C W }Z F w I TYPICAL SANITARY SEWER p I MARKER (2" X 4" PAINTED GREEN) a =III III III III III III III III III III III III III III I U a B I I I I-1 I B I I -I I I -I I B I I -I I I -III I 11, I I I I -I I I -I I ' 1-I 11-11 ' 1=1 11=1 I EI I E111=1 I I 1 I I-111- _' I i- 4" 450 BEND H 4" RISER 4" PLUG � 0 4" MIN. TEE MAX. NOT TO EXCEED ONE STANDARD SIZE SMALLER THAN MAIN FLOW SEWER MAIN 4" 450 BEND 4" PLUG J 4" MIN. TEE MAX. NOT \- TO EXCEED ONE STANDARD SIZE SMALLER THAN MAIN FLOW SEWER MAIN NOTES: 1. ALL TAPS MUST BE ABOVE SPRINGLINE OF SEWER MAIN. 2. NO SIZE -ON -SIZE TAPS. 3. SERVICE LATERALS SHALL BE BROUGHT TO THE PROPERTY AND PLUGED AT A DEPTH OF NO GREATER THAN 6' FROM FINISHED GRADE SURFACE, UNLESS REQUIRED TO BE DEEPER BASED ON DEVELOPMENT REQUIREMENTS. 4. PLUG SHALL BE PRESENT AT OR NEAR PROPERTY LINE OR EDGE OF PAVEMENT. TYPICAL SEWER SERVICE TAP wi zl w I TYPICAL SANITARY SEWER a. p I MARKER (2" X 4" PAINTED GREEN) a A$ War City of Lubbock T E X A 5 w J REVISED DEC. 2015 DRAWING NUMBER SS-1 A �3pROAN IROry SUBSTITUTE "STORM" 1 " RAISED LETTERING FOR STORM SEWER (RECESSED FLUSH) APPLICATION P NIT q S R y CUSTOM LOGO p F L (/ V BEPIC n PICKB RSA S E W E R MADE IN 115p A 32" DIA 21 3/4" r � v � N 23 SECTION A -A V-1430 A PROD.NO. SECTION B-B MO/DAY/YR ASTM A48 CL 35B NOTES: 1. SANITARY SEWER MANHOLE FRAME AND COVER I.D.: 4143009OA01 BOTTOM VIEW 2. STORM SEWER MANHOLE FRAME AND COVER I.D.: 41430091AOI REVISED TYPICAL � � ,, City o f DEC. 2015 MANHOLE COVER iliLubbock DRAWING NUMBER SS-2 • m A A N Q 0 O • • B ��1y M9�rN v 1a2o BB �/Sq ® • 1 �� 1/2" l AA 32 3/16" 1 1/2" 4 1/2" 30" 40 3/4" ��r r REVISED TYPICAL A*Asso City of DEC. 2012 MANHOLE FRAME ll�T .ubbock DRAWING NUMBER SS-3 TYPICAL JOINT SEALANT EACH JOINT OF RISER & RING & COVER. MAXIMUM GRADE ADJUSTMENT 18" ELEVATION VIEW NOTES: 1. CONCRETE SHALL BE MINIMUM 4000 P.S.I. 2. REINFORCING SHALL BE MINIMUM GRADE 60. PRECAST CONCRETE ECCENTRIC CONE SECTIONAL VIEW City of Lubbock TEXAS REVISED DEC. 2015 DRAWING NUMBER SS-4 3600 PSI: CONC. MIN. TYPICAL MANHOLE FRAME AND COVER IF PAVED MATCH PAVING THICKNESS NON -SHRINK GROUT OR MIN MIN. 6" it 1 1 r-i-111-'-- -� 30"' GRADE RINGS FOR GRADE ADJUSTMENT (MAX 18") ECCENTRIC CONE SECTION T SEAL ALL JOINTS PER MANUFACTURER REQUIREMENTS H 0 ASTM 478 p -0 9� RISER SECTION (TONGUE & GROOVE) BOTTOM RISER SECTION (BUTT & GROOVE) 1" TO 2" GROUT SPACE CONCRETE BASE FORMED SURFACES } 6" OR 1/4 PIPE DIA.(P) i WHICHEVER IS LARGER #4 BARS-6" O.C. EA. WAY ORIENT SQUARE PARALLEL R PERPENDICULAR TO 2" BELOW BOTTOM OF PIPE S SREET OR CURB 5'SQUARE STANDARD SANITARY SEWER MANHOLE H P D T 4'TO 16' 6" TO 15" MIN. 48" MIN. 5" 18" & OVER MIN. 60" MIN. 6" 16'&DEEPER ALL SIZES MIN. 60" MIN. 6" (a PLAN VIEW FRAME & COVER CONCRETE COLLAR (NOT REQUIRED IN CONCRETE PAVEME NO. 4 BARS EACH WAY 141I, REVISED PRECAST REINFORCED '�� ;t�,{,f DEC. 2015 CONCRETE MANHOLE Lubb6ck DRAWING NUMBER TEXAS SS_5 BACKFILL COMPACTED TO 95% MODIFIED PROCTOR (ASTM D-1557) H MINIMUM WALL THICKNESS OF .5 INCHES 112" MIP 4 CONCRETE BASE AS REQUIRED TO J COUNTERACT FLOTATION, SEE NOTE ANTI -FLOATATION BTM. 54" DIA AND 2" FLANGE SEE MANHOLE COLLAR DETAIL II FACTORY BONDED JOINT 41 NOTES: _ CONTRACTOR TO PROVIDE SUFFICIENT QUANTITY OF CONCRETE OVER ANTI -FLOTATION RING TO COUNTERACT FLOTATION AS SPECIFIED BY THE ENGINEER H FIBERGLASS MANHOLE 3600 PSI CONCRETE MATCH TOP OF ADJACENT 18" MIN PAVNIG o 12" PAVEMENT AND FLOW FILL PER UEM - 01 BACKFILL COMPACTED TO 95% MODIFIED PROCTOR DENSITY 18" MIN I STD 30" MH FRAME & LID FRP OR CONCRETE MANHOLE RISER SECTION 18" MIN ' 4 H P D 470 16' 6" TO 15" MIN. 48" 18" & OVER MIN. 60" 16'&DEEPER ALL SIZES MIN. 60" INTEGRAL FIBERGLASS BENCH W/ NON-SKID COATING. MIN 1/4 INCH THICKNESS CONCRETE - 3000 PSI @ 28 DAYS PVC STUB PROVIDE 4" - 6" OF CRUSHED STONE LEVELING COURSE 3/4" CHAMFER TYP. FINAL GROUND SURFACE 3600 PSI CONCRETE BACKFILL COMPACTED TO 95% MODIFIED PROCTOR DENSITY 1410 REVISED War � City- of APRIL 2019 FIBERGLASS MANHOLE LL1bb6Ck DRAWING NUMBER TEXAS SS-5b OMING SEWER 450 BEND PVC PIPE 900 BEND NOTE: 1. FILL EXCAVATED SPACE OUTSIDE OF MANHOLE & UNDER PIPE WITH FLOWABLE FILL. OUTSIDE DROP REVISED REVISED � City of MAY 2014 MANHOLE (PVC) Lubbock DRAWING NUMBER (NEW MANHOLE INSTALL) TEXAS SS-6 NOTE: 1. FILL EXCAVATED SPACE OUTSIDE OF MANHOLE & UNDER PIPE WITH FLOWABLE FILL. INSIDE DROP ON EXISTING MANHOLE **Ivor City of Lubbock TEXAS TYPICAL EPDXY REVISED DEC. 2012 DRAWING NUMBER SS-7 STRAIGHT THROUGH MANHOLE SLOPE TYPICAL MANHOLE FLOORS BEND AT MANHOLE JUNCTION AT MANHOLE CUT OUT TOP OF PIPE OR SHAPED CONCRETE INVERT SHAPED CONCRETE INVERT Mr1d41ZKi1110 741:811WA iA oxv War City of *Lubb6ck TEXAS REVISED DEC. 2015 DRAWING NUMBER SS-8 5'- MAXIMUM CARRIER PIPE BETWEEN SPACERS I' MAX PIPE JOINT CASING SPACERS SHALL BE FOUR CASING SPACERS ADDITIONAL SPACERS, SPACED A MAXIMUM OF ONE PER PIPE JOINT AS REQUIRED TYPICAL EACH END FOOT FROM EACH SIDE OF JOINT TO MEET MAXIMUM SPACING OF CASING PIPE STEEL SPACER BODY STEEL CASING PIPE 45° 45 CADMIUM PLATED 45° 45 STUDS, NUTS, AND PIPELINE WASHERS, TYP. 30° i " 30 45 4 FILL SPACE BETWEEN EXCAVATED BORE AND CASING PIPE WITH CEMENT GROUT L = D, WITH L MAX. = 16" 1. BEVEL END OF CASING PIPE TO REMOVE ALL SHARP EDGES TO PREVENT DAMAGE TO THE CARRIER PIPE. 2. THE END -SEAL SHALL BE ATTACHED TO THE PIPE AND CASING SO AS TO PROVIDE A WATER -TIGHT END SEAL. 3. FOR CASINGS OVER 12 INCHES IN DIAMETER, PROVIDE TWO CLAMPS OR BANDS ON EACH END OF EACH SEAL. 4. CASING PIPE SHALL HAVE END -SEALS INSTALLED ON BOTH ENDS PRIOR TO BACKFILLING ADJACENT PIPE TRENCHES. L L )/2 �r REVISED PIPELINE ENCASEMENT m''+I77r�7 City of DEC. 2012 DETAIL L �1 bock DRAWING NUMBER TEXAS SS-9 FINISHED GRADE SURFACE 1 IIEl I I-1 I I =1II II1I1= III III1I1=�' �-III-1 I I I -I I -I I �- -III- I -1 1 ElI- IIIII IIIII 11� � IIIIII IIIII 11 FINAL ( IIIII 11111 BACKFILL PIPE WIDTH 12" COVER EMBEDMENT w MATERIAL z o m PIPE SPRINGLINE w ZONE a; HAUNCHING 6" BEDDING FOUNDATION (MAY NOT BE REQUIRED) -1 I-111-III-111-1 I 1-1 11-1 I El NOTES: 1. BEDDING, EMBEDMENT, AND BACKFILL SHALL BE CAREFULLY PLACED MATERIAL AS SPECIFIED IN THESE SPECIFICATIONS. 3. BACKFILL REQUIREMENTS SHALL COMPLY WITH CURRENT CITY OF LUBBOCK STREETS ORDINANCE. REVISED TRENCH CROSS-SECTION City of APRIL 2019 SHOWING TERMINOLOGY Lubbock DRAWING NUMBER TEXAS SS'10 Design Standards and Specifications Construction Details 10.04Street and Drainage Details Section 10 D NOTE: 1. DRIVEWAYS MUST CONFORM TO ORDINACE SECTION 36.04.126 2. SPACING OF DRIVEWAYS "C" ALONG A ARTERIAL: • WHEN INTERSECTING A RESIDENTIAL STREET - 50' • WHEN INTERSECTING ANOTHER ARTERIAL, A COLLECTOR OR AN INDUSTRIAL STREET- 150' ENTERING AND 100' EXITING v A v m z m m R ISLAND, 50 SQ.FT. MIN. AREA IF USED. R PROPERTY LINE 1 F R i VISIBILITY TRIANGLE N 25' C LR ) ly DIMENSION REFERENCE RESIDENTIAL STREET ARTERIAL STREET COLLECTOR STREET INDUSTRIAL STREET (ROADWAY CLASSIFICATION, (R1A, 32') MINOR, 66' R2, 42' N" (I, 42 ) ROADWAY WIDTH (RI, 36') MAJOR, 88'� 46'� ONE-WAY WIDTH W 12' 15' 15' 20' -------- --- - -- TWO-WAY -MINIMUM WIDTH ------ W ------- 12' -------- 30' -------- 30' -------- 40' -------------- TWO-WAY -MAXIMUM WIDTH -------------- ------ W ------ ------- 30' ------- -------- 40' -------- -------- 40' -------- -------- S0' -------- MINIMUM RADIUS R 5' 15' 15' 20' -------- ------ MINIMUM SPACING ------ ------- R -------- R -------- R+5' -------- R+5' FROM PROPERTY LINE ------------ -- MINIMUM SPACING FROM STREET CORNER - - - - -- C - - - - - -- A+R -- - - - - -- SEE NOTE 2 -- - - - - -- A+R -- - - - - - - A+R -- - - - - - - - - - - -- MINIMUM SPACING BETWEEN - - - - -- S - - - - - -- 3' -- - - - - -- 60' -- - - - - -- 60' -- - - - - - - 30' TWO WAY DRIVEWAYS MINIMUM SPACING BETWEEN S N/A 0' 0' 0' ONE WAY DRIVEWAYS -------------- MINIMUM ANGLE ------ D ------- 45° - ------- 45° -------- 300 -------- 300 "A" IS 25' FOR MOST STREET INTERSECTIONS. IF THE STREET INTERSECTION IS BETWEEN A ARTERIAL AND A COLLECTOR THEN "A" IS 401. IF THE STREET INTERSECTION IS BETWEEN TWO ARTERIAL STREETS THEN "A" IS 40'. IF THE EXISTING STREET INTERSECTION RADIUS IS LARGER THAN ANY OF THE SCENARIOS ABOVE THEN "A" WILL BE THE EXISTING STREET INTERSECTION RADIUS. 01RkyjATI%MA STANDARDS �A bbCity of Luock IIxAS REVISED APR. 2020 PLATE NO. 36-1 J a g a �g fa No A A PROP "'L PROPERTY LINE . poD paD. pn 7oD p D. ° . voD ° EXPANSION 4' SIDEWALK a Ln EXPANSION JOINTS SPACED 36' MAX. ALONG D D. JOINTS p D' W SIDEWALK RUN. g FIRE HYDRANT, POWER cn POLE, ETC. MUST HAVE EXPANSION w EXPANSION JOINT BLOCK - JOINT YY OUT WHEN ENCLOSED IN CONCRETE. EXTEND 6" PAST EDGE OF AL HYDRANT/POLE CONTRACTION MARKINGS 1/2 WAY THROUGH 0 SLAB AT 4' INTERVALS. SECTION A -A w z J VARIABLE 4SIDEWALK Wa 3' MIN. @ 2% MAX. SLOPE O CURB REMOVED. NOTE: SEE PLATE NO. 36-4 FOR ASPHALT REPAIR ADJACENT TO CURB AND GUTTER OR DRIVEWAY. FOR COMMERCIAL DRIVEWAY: CURB AND GUTTER TO BE COMPLETELY REMOVED AND RECONSTRUCTED WITH #3 BARS RUNNING ENTIRE LENGTH OF NEW GUTTER. NOTES: SECTIONS B-B (RESIDENTIAL) VARIABLE — 4' SIDEWALK 3' MIN. @ 2% MAX. SLOPE #4 DEFORMED STEEL BARS 12" O.C. BOTH WAYS, CENTERED IN SLAB OR W 6"X6" 6 GAUGE WELDED WIRE FABRIC. ?Y w ZY i0� �= SECTIONS B-B (COMMERCIAL) TMR 1. MAINTAIN GUTTER FLOWINE THROUGH DRIVEWAY. 2. ALL EXPANSION JOINTS TO BE )4"" THICK. 3. 30' TO 45° FLARE MAY BE USED IN LIEU OF RADII ON RESIDENTIAL DRIVEWAYS. 4. SEE PLATES 36-16 AND 36-16(A) FOR CURB RAMP DETAILS. 4' SIDEWALK CONSTRUCTION DETAILS PROPERTY LINE SECTION C-C 3'a.T'o, *0" City of Lubbock INNER CURB AS REQUIRED. REVISED MAR. 2019 PLATE NO. 36-2 (A) a x EXPANSION JOINTS <a SPACED 36' MAX. �0 o O ALONG SIDEWALK RUN. B ins N� PROPERTY LINE ------------ --- D ..;°. -- LANDSCAPE CONCFZ�E CONCRETE A A v eD, D 5' OR 6' EXPANSION : . ° SIDEWALK ° D °. JOINTS D; C ° C v'- ° ° ° v ,000 FIRE HYDRANT, POWER POLE, ETC. MUST HAVE EXPANSION JOINT BLOCK - OUT WHEN ENCLOSED IN CONCRETE. EXTEND 6" PAST EDGE OF EXPANSION HYDRANT/POLE JOINT. b, ° 4" MIN. THICKNESS OF SIDEWALK. a .D CONTRACTION MARKINGS 1/2 WAY THROUGH SLAB AT 6' INTERVALS. SECTION A -A VARIES 3' MIN. @ 2% MAX. SLOPE w aW O CURB T SIDEWALK d J REMOVED. v oD. n D. SECTIONS B-B 4" MIN. NOTE: (RESIDENTIAL) THICKNESS. I} SEE PLATE NO. 36-4 w FOR ASPHALT REPAIR VARIES a w ADJACENT TO CURB 3' MIN. @ 2% MAX. SLOPE a z AND GUTTER OR DRIVEWAY. 6' SIDEWALK 6" #4 DEFORMED STEEL BARS 12" O.C. z 4 z_ BOTH WAYS, CENTERED IN SLAB OR INNER CURB FOR COMMERCIAL DRIVEWAY, 6"X6" 6 GAUGE WELDED WIRE FABRIC. io AS REQUIRED. COMPLETELY REMOVE CURB AND iO SECTION B-B GUTTER AND RECONSTRUCT WITH (COMMERCIAL) #3 BARS RUNNING ENTIRE LENGTH OF NEW GUTTER. NOTES: 1. MAINTAIN GUTTER FLOWINE THROUGH DRI` 2. ALL EXPANSION JOINTS TO BE X4" THICK. 3. 300 TO 45° FLARE MAY BE USED IN LIEU OF RADII ON RESIDENTIAL DRIVEWAYS. 4. SEE PLATES 36-16 AND 36-16(A) FOR CURB RAMP DETAILS. 5. 5' CURB BACK ON RESIDENTIAL STREETS. 6' CURB BACK ON COLLECTOR AND ARTERIAL STREETS. 5' OR 6' SIDEWALK CONSTRUCTION DETAILS PROPERTY LINE SECTION C-C *City Of Lubbock REVISED APR. 2020 PLATE NO. 36-2 (B) w Z i iw ;Z J IJ G/TC G/TC 0 I0 I G I G/TP/TW G/TP/TW (OPTIONAL) - - (OPTIONAL) I I I (OPTIONAL) - - I G/TP/TW G I (OPTIONAL) - - I G/TP/TW G/TP/TW AT THE PROPERTY LINE I G/TP/TW AT THE PROPERTY LINE G/TC SHALL BE 6" HIGHER THAN G/TC I SHALL BE 6" HIGHER THAN THE ADJACENT GUTTER I I THE ADJACENT GUTTER I I LEGEND G GUTTER TC TOP OF CURB TP TOP OF PAVEMENT TW TOP OF WALK X SPOT GRADES REQUIRED REVISED City of MARCH 2O18 DRIVEWAY GRADES Lubbock PLATE NO. TEXAS 36-3 6" 18" TYPICAL NEW CONCRETE DRIVEWAY NOTES: TOE FORM - TO BE REMOVED PRIOR TO INSTALLATION OF FLOWABLE FILL AND PAVING SURFACE. 1. MAINTAIN VERTICAL AND HORIZONTAL ALIGNMENT OF CURB, LIP, AND GUTTER FLOW LINE. 2. REMOVE CURB TO LIP LINE AND POUR NEW DRIVEWAY FLUSH AGAINST TOE FORM. ASPHALT REPAIR ADJACENT TO CURB AND GUTTER OR DRIVEWAY 12" SMOOTH H.M.A.C. SURFACE, 2" MIN. TYPE "C" Z SAWCUT `TO REMAIN H.M.A.C. SURFACE. / IN PLACE. BASE D D VERTICAL SURFACES) TO RECEIVE TACK COAT City Of Lubb 0 ck TEXAS FLOWABLE FILL REVISED APRIL 2019 PLATE NO. 36-4(A) 6" 18" TYPICAL NEW CONCRETE DRIVEWAY NOTES: 1. MAINTAIN VERTICAL AND HORIZONTAL ALIGNMENT OF CURB, LIP, AND GUTTER FLOW LINE. 2. REMOVE CURB TO LIP LINE AND POUR NEW DRIVEWAY FLUSH AGAINST TOE FORM. CONCRETE PAVING REPAIR ADJACENT TO CURB AND GUTTER OR DRIVEWAY SMOOTH SAWCUT -7 EXISTING CONCRETE PAVING City of Lubbock TEXAS REVISED DEC. 2012 PLATE NO. 36-4(B) R=VARIES 15'-40' / VARIES 4' PROPERTYlim LINE SIDEWALK L� �O/�C� 3' CLEARANCE may LJ / tiP AROUND OBSTRUCTIONS r /QO ti a LU- LU / VARIES 8'-10' I'' M 4' SIDEWALK ALONG PROPERTY LINE TMIN. ALLEY RETURN (TYPICAL) City of Lubbock TEXAS YMIN. DRIVEWAY APPROACH (TYPICAL) REVISED FEB. 2017 PLATE NO. 36-5 5' OR 6' SIDEWALK ALONG CURB BACK OBSTRUCTION **Ivor City of Lubbock TEXAS DRIVEWAY APPROACH (TYPICAL) REVISED FEB. 2017 PLATE NO. 36-6 CURB AND GUTTER, FILLETS AND SLAB TO BE POURED TOGETHER. PAY LIMIT FOR CURB AND GUTTER SIDEWALK 2.5' 1'* \ PROPERTY LINE \ OR \ \ \ \ \ 6" CONCRETE SLAB WITH 6"X6" - 6 3/4" BITUMINOUS GAUGE WELDED WIRE FABRIC OR #4 PREMOLDED EXP. DEFORMED STEEL BARS 12" O.C. BOTH JOINT. WAYS, CENTERED IN SLAB. < °a° PAY LIMIT FOR CURB AND GUTTER CURB HEIGHT TRANSITIONS TO CONTRACTION 0" AT THIS POINT. JOINTS. a.-,7�%lJ/�'/lam IS POINT OF ALLEY RETURN 4. TO BE NO MORE THAN 7" HIGHER THAN GUTTER ON HIGH _2.5'_ SIDE END OF RADIUS AT STREET. 1'* Y2" BITUMINOUS EXPANSION JOINT. S PLAN VIEW s .--I N LU B C).Z. Z 0 °•D a V z 6"X6" - 6 GAUGE WELDED W FABRIC OR #4 DEFORMED S y BARS 12" O.C. BOTH WAYS, w °> ° CENTERED IN SLAB. J o CONTRACTION JOINT. * TO BE USED WHEN ALLEY R.O.W. WIDTH IS 15'. A A 20' w 5' 10, 5' � a Z Lu a SECTION A -A NO. 6 REBAR SPACED 6" FROM EDGE OF SLAB U 6"X6" - 6 GAUGE WELDED WIREJ AND 132" FROM BOTTOM OF SLAB EACH SIDE. FABRIC OR DEFORMED STEEL LOCATE BY MEANS OF CHAIRS OR PLASTIC BARS 12" O.C. BOTH WAYS, STAKES (NOT METAL OR WOOD). CENTERED IN SLAB. CONSTRUCTION OF THIS TYPE IS ALLOWED ONLY W.R. MEADOWS #158, WHERE THE EXISTING ALLEY RETURN, ALLEY SEALTIGHT SAFE -SEAL 3405, PAVING OR STREET GUTTER IS IN GOOD CONDITION SONNEBORN SL-1 OR AND GRADE AND ALIGNMENT ARE SATISFACTORY. APPROVED EQUIVALENT. Y2" BITUMINOUS ALLEY SLAB. - EXPANSION JOINT. oEXISTING ALLEY RETURN, ALLEPAVING fCONCRETE OR STREET GUTTER.TRANSVERSE 4 — 6"X6" - 6 GAUGE WELDED WIRE FABRIC OR #4 CONTRACTION JOINT 6"�J DEFORMED STEEL BARS 12" (REQUIRED AT COLD JOINTS AND ! 12"�' 1 O.C. BOTH WAYS, EVERY 13 FEET OF PAVING.) SFC'TTCIN R-R CENTERED IN SLAB. ALL CONCRETE SHOWN TO BE 3,000 P.S.I. AT 7 DAYS. (CLASS B) War REVISED TYPICAL ALLEY �# c;tv of MAY 2014 RETURN Lubb 4 C% PLATE NO. TEXAS 36-7 5' 10' 5' ' w p J �Ww ~Nz 0 a 10, 10' N °p ' PROPERTY p a LINE 15' 51 SEE 20' NOTE 2 13' w z J N a CONTRACTION a a 10' zZJOINTSa 0 wwn a v•, 20' 5Eo SE aa .° .1 NOTE 2 5' PROPERTY LINE oN 10' a. 10 p, d d Q •, N LLJ NwL Z J a v' ~vz 7 LOUa 0 a 5' 10, 5' TRANSVERSE CONTRACTION JOINT (REQUIRED AT COLD JOINTS AND EVERY 13 FEET OF PAVING.) NOTE: 1/2" —j 6"X6" - 6 GAUGE WELDED 1. TRANSVERSE CONTRACTION JOINT _ WIRE FABRIC OR #4 (REQUIRED AT COLD JOINTS AND — — — — — DEFORMED STEEL BARS EVERY 13 FEET OF PAVING.) ° 12' O.C. BOTH WAYS, CENTERED IN SLAB. 2. NO OBSTRUCTIONS SUCH AS METERS, POLES, PEDESTALS, TREES, BOULDERS, ECT. TYPICAL 1711 ALLEY REVISED �,�, of' APRIL 2020 INTERSECTION WITH Lubbock PLATE NO. CONTRACTION JOINTS TEXAS 36-8 6" 4" �. 2"R 3"R00 J- --- — -- o N (TDON URB SECTION. v . D 6 1248.337 TYPE "A" 9" R a . a • ? NOTE: 9 R 1. THIS SECTION TO BE USED FOR RESIDENTIAL APPLICATIONS ONLY. APPROVAL WILL DEPEND o v ON TRAFFIC AND DRAINAGE a o v °• a: a o CONSIDERATIONS. a :a .a. •v.p.a v p a F� 12" I 12" ROLLOVER CURB TYPE "B" 9 11/16" :. a a , 00 °o — a : a •.a •. i— •v'D a 6" 3" � 9�� ,� 9�� M 3" M in TYPE "C" NOTE: 1. REINFORCED TYPE "C" GUTTER SECTION SHALL BE CONSTRUCTED WITH THREE #3 BARS RUNNING THE ENTIRE LENGTH OF THE DRIVEWAY SECTION WITH CHAIRS SPACED TO GIVE ACCURATE PLACEMENT. (TO BE USED AT DRIVEWAYS ONLY.) REVISED TYPICAL 24"CURB c;tv {,f MAY 2014 AND GUTTER SECTIONS Lubb6ck PLATE NO. TEXAS 36-9 t 12" 18" TYPE "A" 5 3/4" 4 1/4" �I boa 2"R = 3"R --- DOWN CURB SECTION. 6" a . a .a •. � D,a �9 11/16" 20 5/16" NOTE: CONTRACTOR MAY USE EITHER OF THE ABOVE SECTIONS. TYPE "B" a ' a .a o.p a o'p 3 12" 611 � o a 3" Ll 3" �9 11/16" -� 20 5/16" TYPE "C" NOTES: 1. REINFORCED TYPCE "C" GUTTER SECTION SHALL BE CONSTRUCTED WITH THREE #3 BARS RUNNING THE ENTIRE LENGTH OF THE DRIVEWAY SECTION WITH CHAIRS SPACED TO GIVE ACCURATE PLACEMENT. (TO BE USED AT DRIVEWAYS ONLY.) 2. 30" CURB AND GUTTER IS NOT STANDARD AND SHALL ONLY BE USED WITH PERMISSION OF CITY ENGINEER. REVISED TYPICAL 30" CURBS �'� C;tv of MAY 2014 AND GUTTER SECTIONS Lubb6ck PLATE NO. TEXAS 36-10 FLOWABLE FILL SHALL BE USED TO REPLACE BASE MATERIAL CONTRACTION REMOVED. SEE PLATE NO. 36-4 JOINT #4 DEFORMED STEEL BARS @ 12" O.C. BOTH WAYS. A — — \ FLOWLINE-10' — — CONTRACTION TRACTIONJOINT Tq rTRANSITIONS z 36-16EGARDINGzIONS F- r L n X=DISTANCE LIP TO LIP z DO NOTES: 1. CLASS "B" CONCRETE 3,000 P.S.I. @ 7 DAYS 2. MAINTAIN LIP UP GUTTER SECTION WITH 1" INVERT TO VALLEY GUTTER 3. TRANSITION FLOWLINE AND MAINTAIN 1" PLAN VIEW INVERT FOR POSITIVE DRAINAGE THROUGH VALLEY GUTTER DEPTH: 6"- RESIDENTIAL STREETS 8"- COLLECTORS & ARTERIALS BASE -----, 3" 5'___T____5� SECTION A -A 2" MIN. TYPE "C" H.M.A.C.SURFACE. BASE _ FLOWABLE FILL SEE PLATE NO. 36-4. REVISED CONCRETE VALLEY CityAPR. 2020 GUTTER & FILLET DETAIL kLubbo'c3'k PLATE NO. 5 36-11 CALICHE BASE HMAC SURFACE 6" 2" RESIDENTIAL 8" 2" COLLECTOR 10" 2.5" INDUSTRIAL 12" 3" MINOR ARTERIAL 12" 5" PRINCIPAL ARTERIAL H.M.A.C. SURFACE. NOTE: WIDTH AND CROWN VARY SEE SECTION 8.2.02 7 CALICHE BASE 1. STREETS WITH ANTICIPATED ABNORMAL TRAFFIC LOADS, SUCH AS TRUCKS AND BUSES, SHALL REQUIRE A SPECIFIC DESIGN TO BE APPROVED BY THE CITY ENGINEER. RESIDENTIAL/COLLECTOR/IN DUSTRIAL I V V %-Mkl ECTION CONTINUOUSLY REINFORCED CONCRETE PAVEMENT 6" THICK RESIDENTIAL, COLLECTOR, AND INDUSTRIAL 7" THICK MINOR ARTERIAL 9"THICK PRINCIPAL ARTERIAL TYPICAL STREET CROSS -SECTIONS City. of Lubbock TEXAS 6" 12 5/8" REVISED ]AN. 2020 PLATE NO. 36-12 EXISTING SIDEWALK YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANEL VARIES 0" C. C. OR 3& G. SECTION A -A ONLY APPLIES AT DEPRESSED ALLEY RETURNS A A STREET ALLEY STREET NOTES: 1. ALLEY RADII MAY VARY. 2. SEE OTHER PLATES FOR RAMP DETAILS TYPICAL LOCATIONS FOR CURB RAMP EXISTING SIDEWALK 1:12 SLOPE TO BE CONSTRUCTED YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANEL INSET 2B I YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANEL i 1:12 SLOPE LENGTH VARIES, DUE TO 1:12 MAX. wd SLOPE OF RAMP. , r r oxv War City of Lubbock TEXAS REVISED FEB. 2017 PLATE NO. 36-13 r� VARIES 4'VARIES T.O.C. �1 1:12 SLOPE �1;12 SLOPE FLOWLINE SIDEWALK SLOPE REQUIREMENTS LONGITUDINAL -- 1:20 MAX. TRANSVERSE -- 1:50 MAX. i PROPERTY LINE F- < ? ss CURB &. GUTTER 4' MIN. 4" MIN. J THICKNESS. MINIMUM FINISHED THICKNESS TO BE 4" -VARIES- (10' TYPICAL) R=VARIES 9 YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANEL. VARIES 24" MIN. 1:1�EOP MAX YELLOW CAST IN PLACE - REPLACEABLE TRUNCATED DOME PANEL. 4" MAX SECTION A -A SEE PLATE NO. 36-16(A) FOR GENERAL NOTES ON A.D.A. RAMPS CONSTRUCTION. 6 SLOPE 5% MAX BITUMINOUS Y4" EXPANSION JOINT AS REQUIRED BEHIND CURB. CORNER CURB RAMP �'� '� 11� REVISED (WITH TYPICAL 4' SIDEWALK � C't` of FEB.2017 Lubbock PLATE NO. ALONG PROPERTY LINE) TEXAS 36-14 T.O.C. r--VARIES4'VARIES�1 1 i LOPE FLOWLINE FRONT VIEW VARIES - (10' TYPICAL) I I SIDEWALK SLOPE REQUIREMENTS LONGITUDINAL -- 1:20 MAX. ,{ TRANSVERSE -- 1:50 MAX. i 1 i i PROPERTY LINE CURB & GUTTER SEE PLATE NO. 36-16(B) FOR GENERAL NOTES ON A.D.A. RAMP CONSTRUCTION. R=VARIES RAMP = 50.8 SQ. FT. OF CONCRETE FLATWORK YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANEL. VARIES 24" MINN 1:12 SLOPE MAX. z YELLOW CAST IN PLACE REPLACEABLE TRUNCATED v DOME PANEL. 4" MAX r 6 SLOPE 5% MAX BITUMINOUS Y4" EXPANSION JOINT AS REQUIRED BEHIND CURB. CORNER CURB RAMP 10V REVISED �'� '� (WITHTYPICAL 5' OR 6' SIDEWALK �o City of FEB.2017 Lubbock PLATE NO. ALONG CURB BACK) TEXAS 36-15 A IN RADIUS RAMPS SHALL BE CENTERED IN CURB & GUTTER RADIUS TO THE MAXIMUM EXTENT PRACTICABLE. IN STRAIGHT C. & G. GROOVE JOINTS EACH SIDE OF RAMP o . TOP OF CURB BITUMINOUS -" EXPANSION JOINT (FULL DEPTH)LOCATED ALONG BACK OF CURB NEW CONSTRUCTION. _o0 0 A YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANELS AFFIXED, FOLLOWING MANUFACTURER'S INSTRUCTIONS, TO PROPERLY CONSTRUCTED, CURED AND PREPARED 4" CONCRETE SLAB. MAINTAIN GUTTER FLOWLINE. m N ZVARIES g g o 0 0 0 0 00 00goO O O O — VARIES ev v'D.a v'Daa v'D.a RAMPS SHALL BE CENTERED IN CURB & GUTTER RADIUS TO THE MAXIMUM EXTENT PRACTICABLE. SHEET 1 OF 2 0�� REVISED TYPICAL ADA . ,# rL' C;t�. of FEB. 2017 RAMP PLAN L {.� I b 6 ck PLATE NO. TEXAS 36-16(A) �4' M. VARIES 24" MIN. 1:I2 SLOPE (MAX.) vpv 4" MIN. THICKNESS. YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANEL. 4" MAX SECTION A -A g SLOPE 5% MAX BITUMINOUS -" EXPANSION JOINT AS REQUIRED BEHIND CURB. CLASS "A" CONCRETE SHALL YELLOW CAST IN PLACE CONFORM TO APPLICABLE REPLACEABLE TRUNCATED DOME. SPECIFICATIONS. �4" MIN. THICKNESS SECTION B-B NOTES: 1. CAST IN PLACE REPLACEABLE TRUNCATED DOME, DETECTABLE WARNING SYSTEM PANELS, USED HEREIN, SHALL BE MANUFACTURED BY ADA SOLUTIONS (WWW.ADATILE.COM), OR APPROVED EQUAL, AND SHALL BE LAID TO WHERE THE DOMES ARE UP AND THE LONG AXIS OF THE PANEL SHALL BE PERPENDICULAR TO THE DIRECTION OF TRAVEL. 2. RAMP TEXTURES SHALL CONSIST OF TRUNCATED DOMES SURFACES. TRUNCATED DOME DIAMETER, HEIGHT AND SPACING SHALL COMPLY WITH THE TEXAS ACCESSIBILITY STANDARDS (TAS), ADMINISTERED BY THE TEXAS DEPARTMENT OF LICENSING AND REGULATION (TDLR). TEXTURES ARE REQUIRED TO BE DETECTABLE UNDERFOOT. SURFACES THAT WOULD ALLOW WATER TO ACCUMULATE ARE PROHIBITED. THE PANELS SHALL BE AFFIXED AT THE PRESCRIBED LOCATION, TO THE PROPERLY CURED AND PREPARED CONCRETE IN THE MANNER AND USING THE MATERIALS SPECIFIED BY THE MANUFACTURER. two F31(P991Cy3E9:/1No 3;wiO4)iPd111►Iq;Xy19l 29001 ya�ZleIIPI0 71 4. ALL SLOPES SHOWN ARE MAXIMUM ALLOWABLE. THE LEAST POSSIBLE SLOPE THAT WILL STILL DRAIN PROPERLY SHOULD BE USED. RAMP LENGTH OR GRADE OF SIDEWALK APPROACH MAY BE ADJUSTED AS DIRECTED BY THE ENGINEER. TAS REQUIRED DIMENSIONS AND SLOPES ARE PARAMOUNT. IF SITE CONDITIONS PREVENT A RAMP FROM BEING CONSTRUCTED, AS -DRAWN, TO WORK AS INTENDED AND COMPLY WITH THE REQUIRED SLOPES, THEN THE RAMP CONSTRUCTION MUST BE ADJUSTED TO COMPLY WITH THE REQUIRED SLOPES. ALL CONSTRUCTION QUESTIONS SHALL BE DIRECTED TO THE ENGINEER. 5. MAXIMUM ALLOWABLE CROSS -SLOPE ON SIDEWALK AND RAMP SURFACES IS 2%. ALL CONCRETE SURFACES SHALL RECEIVE A LIGHT BROOM FINISH UNLESS NOTED OTHERWISE ON THE PLANS. ADDITIONAL INFORMATION ON CURB RAMP LOCATION, DESIGN, LIGHT REFLECTIVE VALUE AND TEXTURE MAY BE FOUND IN THE CURRENT EDITION OF THE TAS. SHEET 2 OF 2 �� REVISED TYPICAL ADA rL' C;t�. of FEB. 2017 RAMP PLAN L' 7 Il.f b 6 ck PLATE NO. TEXAS 36-16(B) 2 2' i SLOPE ALONG GUTTER VARIES SLOPE ALONG GUTTER VARIES SEE PLATE NO. 36-16 FOR DETAILS REGARDING CURB TRANSITIONS ADA RAMP AT FILLET KEYED NOTES (1 SLOPE ALONG BACK OF CURB AT RAMP OPENING SHALL NOT EXCEED 2%. 2) SLOPE FROM BACK OF CURB AT RAMP OPENING TO LIP LINE SLOPE ALONG SHALL NOT EXCEED 5%. GUTTER VARIES 2' -4" MIN. - THICKNESS. TYPICAL ADA RAMP DETAIL SLOPE ALONG GUTTER VARIES P VARIES 24" N 1:12 SLOPE (MAX.) YELLOW CAST IN PLACE REPLACEABLE TRUNCATED DOME PANEL. 4" MAX SECTION A SEE PLATE NO. 36-16 FOR DETAILS REGARDING CURB TRANSITIONS ADA RAMP AT CURB r (' SLOPE 5% MAX '•<.°.I BITUMINOUS Y4" EXPANSION JOINT AS REQUIRED BEHIND CURB. City of Lubbock TEXAS REVISED FEB. 2017 PLATE NO. 36-17 I I I I i i i TOOLED i JOINT � � I I I I I I I I � � � � I I I I i i i F- a i Z I M 10' Z I 0 I I i I p aLu I Z� w I w u- I I I I m I o TOOLED JOINT I I o � I I � I I I � � I I I I I^ I 5' i i � I I I I I I � � EXPANSIONJOINT I I I I i I I A A 20' ROW 20' w 5' 10' 5' LUZw w � v. Oz 6"X6" - 6 GAUGE WELDED WIRE SECTION A -A NO. 6 REBAR SPACED 6" FROM EDGE OF SLAB FABRIC OR #4 DEFORMED STEEL AND 1" FROM BOTTOM OF SLAB EACH SIDE. BARS 12" O.C. BOTH WAYS, LOCATE BY MEANS OF CHAIRS OR PLASTIC CENTERED IN SLAB. STAKES (NOT METAL OR WOOD). REVISED � City- of FEB. 2017Lubb4C% TYPICAL ALLEY PAVING PLATE NO. TEXAS 37-1 R—IA RESIDENTIAL 52' ROW 32' FF R-2 SCHOOL AND R-1 RESIDENTIAL COMMERCIAL 56' ROW 60' ROW �FF 42' FF COLLECTOR INDUSTRIAL �64'ROW� 60'ROW� lt746' FF 42' FF MINOR ARTERIAL MAJOR ARTERIAL 100' ROW 110' ROW 66' FF 88' FF NOTE: FF DIMENSIONS ARE FROM FACE OF CURB TO FACE OF CURB. REVISED CITY OF LUBBOCK *e City of APRIL 2020 STREET STANDARDS Lubbock PLATE NO. TEXAS 38-1 COLLECTOR FLARE AT INTERSECTION WITH A ARTERIAL MINOR OR MAJOR ARTERIAL - *City Of Lubbock REVISED APR. 2020 PLATE NO. 38-2 MINOR ARTERIAL RIGHT TURN LANE (FLARE) MINOR OR MAJOR ARTERIAL - *City Of Lubbock REVISED APR. 2020 PLATE NO. 38-3 MAJOR ARTERIAL RIGHT TURN LANE (FLARE) - MINOR OR MAJOR ARTERIAL *City Of Lubbock REVISED APR. 2020 PLATE NO. 38-4 R=40' (MIN.) FACE OF CURB R=50' (MIN.) FPO OF Gv�g PROVIDE A CONCRETE CURBED CHANNEL AND ACCESSIBLE RAMPS FOR DRAINAGE WHERE NECESSARY. 4' PEDESTRIAN ACCESS EASEMENT --< �I (REQUIRED ONLY WHERE CUL-DE-SAC LOTS ARE ADJACENT TO A STREET) I IF NEEDED FOR DRAINAGE, A 20' MINIMUM I I I DRAINAGE EASEMENT SHALL BE REQUIRED. I I I I I i I I R=40' ADJACENT ALLEY OR STREET REVISED 50' R.O.W. RADIUS STANDARD �';# C;tv of FEB. 2017 CUL-DE-SAC LuI b 6 ck PLATE NO. TEXAS 38-5 (52') OR (56') RIGHT OF WAY FACE TO OR 10' R=40' (MIN.) R=40' FRCE OF CURB 10' 50'(MIN.) 8' PROVIDE A CONCRETE CURBED CHANNEL AND ACCESSIBLE RAMPS FOR DRAINAGE WHERE NECESSARY. 4' PEDESTRIAN ACCESS EASEMENT �I (REQUIRED ONLY WHERE CUL-DE-SAC LOTS ARE ADJACENT TO A STREET) I I I I IF NEEDED FOR DRAINAGE, A 20' MINIMUM I I I DRAINAGE EASEMENT SHALL BE REQUIRED. I I I I I I I I I I I 43' R.O.W. RADIUS R-1 & (R-IA) CUL-DE-SAC ADJACENT ALLEY OR STREET oxv War City of Lubbock T E X A 5 REVISED FEB. 2017 PLATE NO. 38-6 2% MIN 4% MAX DEPTH OF CURB AND GUTTER MATCHES PAVING DEPTH #4 BARS @ 36" O.C. TRANSVERSE #4 @ 12" O.C. LONG OR EQUIVALENT FIBER 6" PORTLAND CEMENT CONCRETE PAVEMENT MIN. CEMENT CLASS C. COMPRESSIVE STRENGTH OF 3,600 PSI @ 28 DAYS) 0:•11(»►IIf_1I&I1:14:11 CONCRETE PAVING N.T.S. 2% MIN 4% MAX 12" COMPACTED SUBGRADE 12" -I F- @ 95% MODIFIED DENSITY TYPICAL SIDEWALK oxv War *Lubbi6 ckXAS REVISED FEB. 2017 PLATE NO. 38-7 20%lb MIN 2% MIN 4% MAX 4% MAX i- 0 DEPTH OF CURB AND GUTTER MATCHES PAVING DEPTH #4 BARS @ 24" O.C. TRANSVERSE #5 @ 12" O.C. LONG 7"PORTLAND CEMENT CONCRETE PAVEMENT MIN. CEMENT CLASS C. COMPRESSIVE TRENGTH OF 3,600 PSI @ 28 DAYS) MAJOR COLLECTOR (C-1) (I-1) CONCRETE PAVING N.T.S. 12" COMPACTED SUBGRADE 12" -I F- @ 95% MODIFIED DENSITY TYPICAL SIDEWALK City of Lubbock T E X A 5 REVISED FEB. 2017 PLATE NO. 38-8 TRAVEL LANE Z TRANSVERSE CONSTRUCTION JOINT TRAVEL LANE ADDITIONAL STEEL BARS Z Y LONGITUDINAL CONTRACTION JOINT Fx Y LONGITUDINAL CONSTRUCTION JOINT c X LONGITUDINAL STEEL TRANSVERSE STEEL � N � N N a c c c c c d TIE BARS a ISINGLE —c/2 TIE PIECE a BARS c/ 2 PAVEMENT OR SHOULDER EDGE GENERAL NOTES —LUNCil I UUINAL CONTRACTION JOINT LONGITUDINAL CONSTRUCTION JOINT TYPICAL PAVEMENT LAYOUT PLAN VIEW (NOT TO SCALE) PAVEMENT OR SHOULDER EDGE 1. ALL THE REINFORCING STEEL AND TIE BARS SHALL BE DEFORMED 7. TRANSVERSE STEEL SHALL BE PLACED TO WITHIN 2" OF THE STEEL BARS CONFORMING TO ASTM A 615 (GRADE 60) OR ASTM A 996 BACK OF CURB. (GRADE 60) OR ABOVE. STEEL BAR SIZES AND SPACINGS SHALL CONFORM TO TABLE NO.1 AND TABLE NO.2. S. (b) = TRANSVERSE STEEL AND TIE BARS SPACING (c) = LONGITUDINAL STEEL AND TIE BARS SPACING 2. STEEL BAR PLACEMENT TOLERANCE SHALL BE +/- 1 IN. HORIZONTALLY AND +/- 0.5 IN. VERTICALLY. CALCULATED AVERAGE BAR SPACING (SEE TABLE 1 AND 2 PLATE 38-10) (CONCRETE PLACEMENT WIDTH / NUMBER OF LONGITUDINAL BARS) SHALL CONFORM TO TABLE NO.1 3. PAVEMENT WIDTHS OF MORE THAN 25 FT. SHALL HAVE A LONGITUDINAL JOINT (SECTION Z-Z OR SECTION Y-Y). THESE JOINTS SHALL BE LOCATED WITHIN 6 IN. OF THE LANE LINE UNLESS THE JOINT LOCATION IS SHOWN ELSEWHERE ON THE PLANS. 4. THE SAW CUT DEPTH FOR THE LONGITUDINAL CONTRACTION JOINT (SECTION Z-Z) SHALL BE ONE THIRD OF THE SLAB THICKNESS (T/3). 5. OMIT TIE BARS LOCATED WITHIN 18 IN. OF THE TRANSVERSE CONSTRUCTION JOINTS (SECTION X-X). USE HAND -OPERATED IMMERSION VIBRATORS TO CONSOLIDATE THE CONCRETE ADJACENT TO ALL FORMED JOINTS. 6. LONGITUDINAL REINFORCING STEEL SPLICES SHALL BE A MINIMUM OF 25 IN. STAGGER THE LAP LOCATIONS SO THAT NO MORE THAN 1/3 OF THE LONGITUDINAL STEEL IS SPLICED IN ANY GIVEN 12-FT. WIDTH AND 2-FT. LENGTH OF THE PAVEMENT. RESIDENTIAL AND COLLECTOR STREET City REVISED FEB. 2017 CONCRETE PAVING DETAILS of Lubbock PLATE N0. 1 OF 3 TEXAS 38-9 L=50" ADDITIONAL JOINT SEALING L/2 STEEL BARS MATERIAL dT TZ2 TRANSVERSE BARS LONGITUDINAL BARS NO SPLICES ALLOWED WITHIN 10 FT OF THE JOINT. TRANSVERSE CONSTRUCTION JOINT SECTION X - X 50" FOR #5 BAR 42" FOR #4 BAR 25" FOR #5 BAR TIE BARS MAY BE JOINT SEALING 21" FOR #4 BAR IN SAME PLANE AS MATERIAL TRANSVERSE BARS TIE BARS,SINGLE OR MULTIPLE -PIECE ---- T MIN.CLEAR-Z"� ----- ------------------ -- T/2 c ' c ' a' a, c Ic LONGITUDINAL BARS TRANSVERSE BARS LONGITUDINAL CONSTRUCTION JOINT SECTION Y - Y 50" FOR #5 BAR, 42" FOR #4 BAR LONGITUDINAL JOINT SEALING 25" FOR #5 BAR BARS MATERIAL SAW CUT T/3 T /2 I I I I I I I f T T T T T l c c c/2c/2 c c TRANSVERSE BARS SINGLE PIECE TIE BARS SHOULD BE IN SAME PLANE AS TRANSVERSE BARS. LONGITUDINAL CONTRACTION JOINT SECTION Z - Z TABLE NO.1 LONGITUDINAL STEEL FIRST ADDITIONAL STEEL SLAB THICKNESS REGULAR SPACING BARS AT TRANSVERSE AND BAR SIZE STEEL BARS AT EDGE CONSTRUCTION JOINT OR JOINT (SECTION X-X) T BAR SPACING SPACING SPACING LENGTH (IN.) SIZE (c) (a) 2 x c L (IN.) (IN.) (IN.) (IN.) 6.0 #4 12 3 24 42 7.0 #5 12 3 24 50 TABLE NO.2 TRANSVERSE STEEL AND TIE BARS TIE BARS TIE BARS SLAB TRANSVERSE AT LONGITUDINAL AT LONGITUDINAL THICKNESS STEEL (b) CONTRACTION JOINT CONSTRUCTION JOINT SECTION Z-Z SECTION Y-Y (IN.) BAR SPACING BAR SPACING BAR SPACING SIZE (IN.) SIZE (IN.) SIZE (IN.) 6.0 #4 36 #4 72 #4 36 7.0 #4 24 #4 48 #4 24 RESIDENTIAL AND COLLECTOR STREET J10lvt � City- of CONCRETE PAVING DETAILS *Lu b6ck 2 OF 3 T E X A 5 REVISED MAY 2014 PLATE NO. 38-10 JOINT �„ XV SEALING COTINI4TIAL M ~\ CUT �1 F" SAWED LONGITUDINAL JOINT XV z JOINT SEALING COMPOUND CLASS 4,5 OR 7 a' BACKER ROD INITIAL SAW CUT TRANSVERSE SAWED CONTRACTION JOINT GENERAL NOTES JOINT Y„ XV SEALING COMPOUND V p ' f JOINT SEALING COMPOUND LONGITUDINAL OR TRANSVERSE CONSTRUCTION JOINT JOINT SEALING COMPOUND CLASS 1 Y2" 4,5 OR 7 F TRANSVERSE FORMED EXPANSION JOINT 1. THE JOINT RESERVOIR FOR SEALANT SHALL BE SAWED UNLESS OTHER WISE SHOWN ON THE PLANS FOR THE LONGITUDINAL AND TRANSVERSE CONSTRUCTION AND THE TWO SAWED JOINTS. 2. THE JOINTS SHALL BE CLEANED IN ACCORDANCE WITH THE MANUFACTURES REQUIREMENT AND PRIOR TO BEGINNING OPERATIONS, THE CONTRACTOR SHALL SUBMIT A STATEMENT FROM THE SEALANT MANUFACTURER SHOWING THE RECOMMENDED EQUIPMENT AND INSTALLATION PROCEDURES TO BE USED. 3. THE SAW CUT FOR THE LONGITUDINAL JOINT SHALL BE ONE FOURTH THE SLAB THICKNESS. 4. TRANSVERSE EXPANSION JOINT SHALL BE PLACED AT THE RADII OF INTERSECTING STREETS. 5. TRANSVERSE CONTRACTION JOINTS SHALL BE PLACED AT THE RADII OF INTERSECTING ALLEYS. RESIDENTIAL AND COLLECTOR STREET REVISED CONCRETE PAVING DETAILS*Lubbock City of APRIL 2019 PLATE NO. 3 OF 3 38_11 TYPE 'C' HMAC MINIMUM OF THE UPPER 12" (18" MINIMUM ON ARTERIAL STREETS) OF TRENCH BACKFILL- 1 1/2 SACK CONTROLLED LOW STRENGTH MATERIAL (FLOWABLE FILL) WITH PEA GRAVEL, IF USING COMPACTED BACKFILL. BACKFILL COMPACTED TO 95%t MODIFIED PROCTOR(ASTM D 698) 2% OF OPTIMUMMOISTURE CONTENT.(MAX. 6" LIFTS.) ALTERNATIVE BACKFILL FULL DEPTH OF TRENCH BACKFILL 1 1/2 SACK CONTROLLED LOW STRENGTH MATERIAL(FLOWABLE FILL) WITH PEA GRAVEL. ASPHALT PAVEMENT CUT REPAIRS 2' MIN. [V NO SCALE 6' r/-- ASPHALT TACK COAT. ALL JOINTS TO BE SAWCUT. ASPHALT TACK COAT. COMPROMISED SOIL DUE TO MOISTURE FROM A WATER LEAK OR RAIN EVENT PIPE BEDDING (IN ACCORDANCE WITH THE ENGINEERS AND MANUFACTURERS RECOMMENDATIONS). NOTE: 1. ALL MATERIALS AND CONSTRUCTION PRACTICES SHALL BE IN CONFORMANCE WITH CITY OF LUBBOCK PUBLIC WORKS ENGINEERING DESIGN STANDARDS AND SPECIFICATIONS. 2. GREATER THAN 5' WIDTH LONGITUDE CUTS WILL REQUIRE PAVING REPAIR APPROVAL BY THE CITY ENGINEER. 'Alo lr� - -% City of Lubbock rEYAS REVISED APR. 2020 PLATE NO. UEM-01 i L u SPLICE LENGTH 4" SAW CUT EXISTING CONCRETE PAVING COMPROMISED SOIL DUE TO MOISTURE FROM A WATER LEAK OR RAIN EVENT BACKFILL COMPACTED TO 95%t MODIFIED PROCTOR (ASTM D 698) 2% OF OPTIMUM MOISTURE CONTENT. (MAX. 6" LIFTS.) FULL DEPTH CUTS T MIN CONCRETE PAVING PREFERED METHOD EXISTING CONCRETE PAVING MAKE FULL DEPTH CUTS THEN REPAIR UTILITY. BACKFILL OR COMPACT TRENCH. SAW CUT 18" PERIMETER AND JACK OUT CONCRETE TIE STEEL TO MATCH EXISTING. DRILL AND DRIVE DEFORMED TIE BARS 10" CLASS 'B' CONCRETE 3000 PSI INTO EXISTING PAVING. EPDXY GROUT BAR AT 7 DAYS. ARTERIAL INTO EXISTING PAVING MATCH EXISTING BAR STREETS; CLASS "C" CONCRETE SIZE AND SPACING. SPLICE ALL CONCRETE JOINTS LENGTH 10" TO BE SAW CUT. EXISTING CONCRETE EXISTING CONCRETE PAVING • • • • PAVING T8" MINIMUM w °' �O ul y LnJ W J Z u� COMPROMISED SOIL DUE TO MOISTURE FROM A WATER LEAK OR RAIN EVENT BACKFILL COMPACTED TO 95%t MODIFIED PROCTOR (ASTM D 698) 2% OF OPTIMUM MOISTURE CONTENT. (MAX. 6" LIFTS.) ALTERNATIVE BACKFILL NOTE: BAR SIZE MIN. SPLICE LENGTH 3 18" 4 18" 5 21" 6 25" 7 29" 8 33" PIPE EMBEDMENT (IN ACCORDANCE WITH THE ENGINEERS AND MANUFACTURERS RECOMMENDATIONS). FULL DEPTH OF TRENCH 1. MIN RESIDENTIAL CUT TX 4' SEE UEM-07 FOR COLLECTOR 3. FLOW FILL CAP OR STEEL PLATES REQUIRED BACKFILL; 1 1/2 SACK AND ARTERIAL IF PAVEMENT IS NOT REPAIRED IMMEDIATELY. CONTROLLED LOW STRENGTH 2. ALL MATERIALS AND CONSTRUCTION PRACTICES SHALL BE IN MATERIAL (FLOWABLE FILL) CONFORMANCE WITH CITY OF LUBBOCK STANDARD PAVING WITH PEA GRAVEL. SPECIFICATIONS. CONCRETE STREET REVISED City of APR. 2020 AND ALLEY Lubbock PLATE NO. CUT REPAIRS I x a s UEM-02 CONCRETE CAP CLASS 'B' CONCRETE 3000 PSI AT 7 DAYS. # 4 BARS, 12" O.C. MAX. SPACING IN BOTH DIRECTIONS. BACKFILL COMPACTED TO 95%f MODIFIED PROCTOR (ASTM D 698) 2% OF OPTIMUM MOISTURE CONTENT. (MAX. 6" LIFTS.) ALTERNATIVE BACKFILL 1 1/2 SACK CONTROLLED LOW STRENGTH MATERIAL (FLOWABLE FILL) WITH PEA GRAVEL. BRICK PAVING NOTE: 1. SEE CONCRETE CAP DETAIL. PLATE NO. 36.09.05 2. #5 DOWELS NEEDED IF TIED INTO EXISTING CONCRETE BASE. 3. ALL MATERIALS AND CONSTRUCTION PRACTICES SHALL BE IN CONFORMANCE WITH CITY OF LUBBOCK STANDARD PAVING SPECIFICATIONS. 4. FLOW FILL CAP OR STEEL PLATES REQUIRED IF PAVEMENT IS NOT REPAIRED IMMEDIATELY. BRICK STREET CUT REPAIRS BRICK JOINTS TO BE FILLED WITH SAND/CEMENT AT A 50-50 BLEND, OR AS APPROVED BY THE STREET SUPERINTENDENT. DRILL AND DRIVE DEFORMED TIE BARS 10" INTO EXISTING PAVING. EPDXY GROUT BAR INTO EXISTING PAVING MATCH EXISTING BAR SIZE AND SPACING. 7 1" SAND CUSHION MINIMUM. 8" MIN COMPROMISED SOIL DUE TO MOISTURE FROM A WATER LEAK OR RAIN EVENT BAR SIZE MIN. SPLICE LENGTH 3 18" 4 18" 5 21" 6 25" 7 29" 8 33" PIPE BEDDING (IN ACCORDANCE WITH THE ENGINEERS AND MANUFACTURERS RECOMMENDATIONS). City 0f Lubb o ck TEXAS REVISED MAR. 2019 PLATE NO. UEM-03 Z O <z w0.> dQ ad w>- a� �J Q CONCRETE ALLEY PAVING. mw `n z o o 0 0 0 0 o e — — — — — — — — — — — — — BACKFILL COMPACTED TO 95%t MODIFIED PROCTOR DENSITY (ASTM D 698) 2% OF OPTIMUM MOISTURE CONTENT. (MAX. 6" LIFTS.) ALTERNATIVE BACKFILL FULL DEPTH OF TRENCH BACKFILL 1 1#2 SACK CONTROLLED LOW STRENGTH MATERIAL (FLOWABLE FILL) WITH PEA GRAVEL. NOTE: 1. ALL MATERIALS AND CONSTRUCTION PRACTICES SHALL BE IN CONFORMANCE WITH CITY OF LUBBOCK PUBLIC WORKS ENGINEERING DESIGN STANDARDS AND SPECIFICATIONS. 2. THE ALLEY PAVING CONTRACTOR SHALL BE REQUIRED TO OBTAIN 95%f MODIFIED PROCTOR DENSITY (ASTM D 698) 2% OF OPTIMUM MOISTURE IN THE 6" DEPTH OF SUBGRADE IMMEDIATELY BELOW THE ALLEY PAVING. TRENCH BACKFILL REQUIREMENT ON ALLEYS TO BE PAVED WITHIN RIGHT-OF-WAY THE ALLEY PAVING CONTRACTORS SHALL BE REQUIRED TO OBTAIN 95%± MODIFIED PROCTOR DENSITY (ASTM D 698) 2% OF OPTIMUM MOISTURE IN THE 6" DEPTH OF SUBGRADE IMMEDIATELY BELOW THE ALLEY PAVING. PIPE EMBEDMENT (IN ACCORDANCE WITH THE ENGINEERS AND MANUFACTURERS RECOMMENDATIONS). Alf War �# *Lubb'o of TEXAS REVISED DEC. 2012 PLATE NO. UEM-04 BACKFILL COMPACTED TO 95%t MODIFIED PROCTOR DENSITY (ASTM D 698) 2% OF OPTIMUM MOISTURE CONTENT. (MAX. 6" LIFTS.) ALTERNATIVE BACKFILL FULL DEPTH OF TRENCH BACKFILL 116 SACK CONTROLLED LOW STRENGTH MATERIAL (FLOWABLE FILL) WITH PEA GRAVEL. NOTE: 1. ALL MATERIALS AND CONSTRUCTION PRACTICES SHALL BE IN CONFORMANCE WITH CITY OF LUBBOCK PUBLIC WORKS ENGINEERING DESIGN STANDARDS AND SPECIFICATIONS. TRENCH BACKFILL REQUIREMENTS ON UNPAVED STREETS AND ALLEYS WITHIN RIGHT-OF-WAY EXISTING GROUND SURFACE. 12" PIPE BEDDING (IN ACCORDANCE WITH THE ENGINEERS AND MANUFACTURERS RECOMMENDATIONS). Alf. War City of Lubbock TEXAS REVISED FEB. 2017 PLATE NO. UEM-05 PLACE #4 BARS BOTH WAYS ALONG PAVING 6„ CUT AT 12" MAX. SPACING. AT LEAST 2 6" #4 BARS EACH WAY ARE REQUIRED. LIE #4 BARS, 12" O.C. MAX V NO SCALE DRILL AND DRIVE 12" SPACING IN BOTH DEFORMED #5 DOWEL DIRECTIONS, CENTERED BARS 6" INTO EXISTING IN SLAB SLAB ON 3' SPACING NOTE: 1. ALL MATERIALS AND CONSTRUCTION 2. ALL JOINTS SHALL BE PRACTICES SHALL BE IN CONFORMANCE DOWELED AS SPECIFIED WITH CITY OF LUBBOCK PUBLIC WORKS 3. MAXIMUM OF TWO TRANSVERSE ENGINEERING DESIGN STANDARDS AND CUT JOINTS BETWEEN EXISTING SPECIFICATIONS 13' TOOLED JOINTS (ONE SLAB). .11410 Ivor TYPICAL ALLEY PAVING CUT � city"f *Lubb6ck REVISED FEB. 2017 PLATE NO. UEM-06 LEGEND ® UTILITY/STREET CUT .CITY STANDARD RESTORATION REQUREMENTS FOR CONCRETE PAVEMENT BAR SIZE MIN. SPLICE LENGTH 3 18" 4 18" 5 21" 6 25" 7 29" 8 33" DOWEL MAY BE USED IN LIEU OF SPLICING REBAR WITH APPROVAL. SEE UEM-02 FOR DOWEL SIZE SPACING. J = SPACING BETWEEN JOINTS CONCRETE ARTERIAL 'Alwo'. REVISED City of APR. 2020 AND COLLECTOR WLubbock PLATE NO. PAVEMENT REPAIR Ilxns UEM-07 No Text No Text No Text G..bL( No Text A-1.3 Restrained Joint Table for Reducers Minimum length to be restrained on larger pipe (Feet): PVC Pipe Small Pipe Size (in.) Large Pipe Size (in.) 4 6 8 10 12 16 20 24 4 - 22 40 54 69 95 119 142 6 - - 23 41 57 86 112 137 8 - - - 23 42 75 103 129 10 - - - - 23 61 92 120 12 - - - - - 44 78 109 16 - - - - - - 44 80 20 - - - - - - - 44 24 - - - - - - - - D.I. Pipe Branch Pipe Size (in.) Run Pipe Size (in.) 4 6 8 10 12 16 20 24 4 - 12 21 29 36 50 63 75 6 - - 13 22 30 46 59 72 8 - - - 12 22 40 54 68 10 - - - - 13 32 49 63 12 - - - - - 23 42 57 16 - - - - - - 23 42 20 - - - - - - - 24 24 1 - - - - - - - - Table is based on Soil Type SC, Safety Factor 2, Trench Type 3, Depth of Bury 3 feet, Test Pressure 100 psi, and minimum restrained length of small size pipe to be 1/2 that listed here. Values derived from the EBAA Iron, Inc. Restrained Length Calculation Program. Revised 3/11 City of Lubbock Water Utilities Engineering Department Minimum Design Standards and Specifications for Water and Sewer No Text A � -2�r c6"�'k Iubb TEXAS Approved Materials and Manufacturers List Application For New Product(s) Note: Incomplete applications will be returned unprocessed. Date of Application: Company Name Address Contact Person Position Phone Number Email Fax Number Manufacturer (If not applicant) Supplier (If not applicant) Product Nomenclature Model No. Series Description/Use of Product Have you included a sample? Would you like this sample returned? List Testing Certifications (Required) 1. List Attached Items (Provide five copies of each) 1. 2. 2. 3. 3. 4. 4. 5. 5. 6. 6. 7. 7. Application No. Comments: ****Do not write below this line - - For City use only**** (Ex. 2014-01) Approved By: Title: Accepted Rejected No Text CERTIFICATE OF COMPLETION DATE: PROJECT DATA SUBDIVISION NAME: PLAT DESCRIPTION: TYPE OF MUNICIPAL IMPROVEMENT ❑ WATER ❑ SEWER ❑ PAVING ❑ DRAINAGE ❑ OTHER CONTRACTOR'S AFFIDAVIT TO DEVELOPER I certify that the work under the above named project, including all amendments thereto, has been satisfactorily completed in accordance with the engineering plans and specifications and in accordance with the City of Lubbock Public Works Engineering Minimum Design Standards and Specifications; that no liens have been or will be attached against the property and improvements of the owner; that no suits are pending by reason on the project under the contract; and no public liability claims are pending. CONTRACTOR/DEVELOPER ADDRESS: PHONE: SIGNED: PRINTED: TITLE: RECOGNITION BY CITY OF LUBBOCK An inspection of the work on the above referenced Project was conducted on Those participating in the inspection (final walk-through) were and The inspection revealed that the infrastructure inspected has been completed substantially in accordance with the plans and specifications and is recommended for acceptance on City of Lubbock By Printed Name Title Rev. 05-01-2014 No Text DEVELOPER WARRANTY STATEMENT DATE: PROJECT DATA SUBDIVISION NAME: PLAT DESCRIPTION: TYPE OF MUNICIPAL IMPROVEMENT ❑ WATER ❑ SEWER ❑ PAVING ❑ DRAINAGE ❑ OTHER WARRANTY STATEMENT TO THE CITY OF LUBBOCK As the developer of the above referenced development, I guarantee the improvements installed by my Contractor and inspected, tested, and accepted by the City of Lubbock to be free from defects for a period of one year for water and/or sewer improvements and two years for paving and or drainage improvements from the date the infrastructure is accepted by the City of Lubbock. Upon receipt of the Developers Certificate of Completion, Record Drawings and the Developers Warranty Statement, the City will accept improvements within 30 calendar days; unless exception is given in writing. The Contractor, Engineer/Surveyor, Record Drawing submittal date, and the Substantial Completion Date are listed below. CONTRACTOR ENGINEER/SURVEYOR: RECORD DRAWING SUBMITTAL DATE: SUBSTANTIAL COMPLETION DATE: DEVELOPER CONTACT INFORMATION DEVELOPER ADDRESS: PHONE: EMAIL: SIGNED: PRINTED: LIMITATIONS This warranty does not include damage to underground utilities caused by others due to excavation or boring activities after the date of the infrastructure is accepted by the City of Lubbock. This warranty does not include any cosmetic damages or the results of any cosmetic damages to either above ground utility infrastructure or paving/drainage improvements occurring after the date of substantial completion. These cosmetic damages may include but are not limited to gouges in asphalt from vehicular traffic excluding all construction equipment related to the development, the failure of asphalt due to water ponding beyond the control of the Developer, any natural disaster, or utility work within dedicated Public Right of Way. Rev. 05-01-2014 No Text Ar,�City of Lubb o ck SO T E X A 5 LEGAL DESCRIPTION: ENGINEERING FIRM: E-MAIL: PHONE NUMBER: PAVEMENT MUNICIPAL IMPROVEMENTS SUBMITTAL CHECKLIST ADDRESS: CONTACT: DATE: � w a w o Q CRITERIA ua a NOTES w F W � z z General Requirements Provide 2 sets of plan for review Provide review fee calculations Provide payment for review fee Drawings shall be no larger than 24"x36". Include a Location map Include a Title Block (lower right corner preferred) Drawing Scale shall be Horizontal 1"=50' or 1"=20' Vertical 1"=1' or 1"=2' Include original date and revision dates Include Name of Professional Engineer Include Firm Name and Contact Information Include Legal Description of Property Being Improved Include Drawings Numbers Include City of Lubbock Inspector Contact Information 806-775-3751. Include Note on Plans "All work shall be in accordance with the City of Lubbock Minimum Design Standards and Specifications." Plan Include Benchmark and Datum Include North Arrow V/ o w rl w z a CRITERIA �ww a NOTES � Q A z w w z Include ROW lines, property lines and lot numbers Include Street Names and Easements with Width Dimensions Include Existing Curbs and Paving (Gray) Include Proposed Curbs and Paving (Bold) Include Spot Elevations on Radii, Dips, Grade Breaks, and Ditches Include Location and Direction of Dips Include Other Pertinent Details (Buildings, Utilities, Water Courses, Etc.) Profile Include Existing Ground Surface at Curb Lines (Gray) Include Existing Gutters or Flow Lines (Gray) Include Proposed Gutters or Flow Lines (Bold) Include Stationing with Profiles Indexed to Plan View Include Intermediate Station Numbers and Elevations at Points of Grade Change and Radii Include Ditch Grades Include Existing and Proposed Utilities Where Crossed Detail Sheet Details are not required when engineers plans refer to City standards Include all non-standard details Overall Layout Sheet — As Required Drawing Scale shall be 1 "=100' Include Lot Lines Include Streets and Street Names City of Lubbock TEXAS LEGAL DESCRIPTION: ENGINEERING FIRM: E-MAIL: PHONE NUMBER: WATER AND SEWER MUNICIPAL INFRASTRUCTURE SUBMITTAL CHECKLIST ADDRESS: CONTACT: DATE: 0 w y F .a � Q CRITERIA w z NOTES U .a C1. W y � W W General Requirements Provide 2 plan sets for review Provide fee calculations (Pro Rata) Provide payment of review fee Include a Location map All drawings shall be approximately 24-inch by 36-inch in size Include the legal description of property being improved Include a title block (Lower right hand corner preferred) Make the drawings to standard engineering scale (with graphic scale representation shown on plans) Include original date and revision dates Include the name of the Professional Engineer Include Professional Engineer's seal Include the Firm name and contact information Include City of Lubbock Engineering Department Contact Information: Development Engineering Services: (806) 775-2347 Senior Inspector: (806) 548-4152 Include Drawing number(s) Includes statement: "All work shall be performed in accordance with the City of Lubbock Design Standards and Specifications." Plans Include Bench Marks H O 'a W CRITERIA w z .a NOTES Include Location control dimensions Include North Arrows Include Property Lines Include Street Names and Easements with Width Dimensions Include Existing Buried Utility Lines Location and Depth (Gray -Dashed) • Water • Gas • Communications • Storm drains • Sanitary sewers • Electric Include Other Pertinent Details (Structures, Curbs, Water Courses, Etc.) Include Proposed water/sewer mains (Bold — Solid) Label proposed diameters Label proposed materials Include proposed manholes Label water line elements (fittings, tees, crosses, reducers, bends, plugs, blow -offs, thrust blocks, valves and fire hydrants) Include stationing and other number designations Include elevation of inverts in and out of manhole Include elevation of manhole rim Label manhole stub -outs Include proposed future extensions Include proposed service connections or stub - ins Include proposed concrete encasement Include proposed cut-off walls Include easement description for offsite easements. Make utility easements have correct orientation and offsets (water north & west, sewer 10ft from water lines) Profiles Include ground surface — existing (dotted) and proposed (Solid) Include station numbers Include length between manholes and depth of cut Include existing and proposed utilities where crossed H O 'a W CRITERIA w z .a NOTES Include existing manhole invert and rim elevations Include Plan, Profile, and Complete Details for off -site transmission mains, lift stations, special valves and vaults, tanks, etc. Water Design Include water line summary Include overall layout (scale 1" = 100') Include Profiles at large utility crossings including sewer mains >10", fiber or electric duct banks, storm sewers, etc. Include profiles for 12" or larger water lines. Verify existing lines for tie-in Abandoned line procedure followed Boring and casing standards followed Include shutoff valves (12" or < dist. mains <600ft, larger mains <800ft) Include a fire hydrant within 500ft of each structure Make a looped system Water lines shall be 2 ft. above existing sewer lines (and force mains) Make joint spacing and clearances of 9ft at sewer crossing No stub outs under paving No dead end mains > 150ft No developed lines that cut off adjacent plots from future water No service taps off streets No size on size municipal taps without approval Sewer Design Include overall layout (scale 1" = 100') Include profiles Verify existing line for tie-in Abandoned line procedure followed Gradients follow: • 6 in diam 0.60-12.35% • 8 in diam 0.40-8.40% • 10 in diam 0.28-6.23% • 12 in diam 0.22-4.88% • 15 in diam 0.15-3.62% • 18 in diam 0.12-2.83% All shallow manholes (<16ft) on small sewer lines (<15in diam) have 48in diam manholes spaced at <500ft All deep manholes (>16ft) on small sewer lines (<15in diam) have 60in diam manholes spaced at <500ft H O 'a W CRITERIA w z .a NOTES All manholes on large sewer lines (>15in diam) have 60in diam manholes spaced at <800ft Protective coatings specified on all large and drop manholes and manholes receiving force main discharge Max sewer service tap depth of 12ft (or Engineering Department approval) Water lines shall be 2 ft. above existing sewer lines (and force mains) Joint spacing and clearance of 9ft at sewer crossing Inlet drops in manholes follow: • Inlet angle <30 degree drop 0.10ft min • Inlet angle >30 degree drop 0.20ft min Inlet with <24 in drop must be filleted Drop manhole (>24in drop) follow: • Existing manholes drop inside • New manholes drop outside No stub outs under paving REFUND CONTRACT NO. City of *Lubbock TEXAS REFUND CONTRACT DECLARATION DEVELOPMENT LEGAL DESCRIPTION OF PROPERTY: DEVELOPER/OWNER: ADDRESS: NUMBER STREET CITY CERTIFIED REFUND INTENT STATE ZIP ❑ I accept the terms of this Refund Contract (the "Contract') and request the adjacent mains fees collected by the City of Lubbock (the "City"), for the infrastructure improvements ("Improvements") on the developed property listed above (the "Property"), be released to me as a refund within 6 (six) months of receipt. ❑ I hereby knowingly, and willingly waive the right to a refund for adjacent mains fees for Improvements accepted by the City on behalf of the Property (including all lines not shown in "Exhibit A") due to separate agreements made with adjacent property owners or for any other reason. The City and the undersigned developer, Property owner, and/or authorized representative of the developer or Property owner, pursuant to Section 22.05.015 of the City of Lubbock Code of Ordinances, does hereby enter into this Contract for Water and/or Sewer Infrastructure. The execution of which is upon acceptance of infrastructure by the City, which requires infrastructure development that is performed in accordance with Section 22.05.010, including, but not limited to receipt of as-builts of the water and sewer improvements as outlined in the City of Lubbock Public Works Engineering Minimum Design Standards and Specifications. The parties hereto, by execution of this Contract, acknowledge and agree that the amount of the refund, if any, shall ultimately be determined, in part, on the number of adjacent property owners electing to connect to the infrastructure during the term of the Contract, and further paying the appropriate adjacent main fee. During the term of this Contract, the City shall hold, in trust, adjacent main fees collected in connection with the Property, and periodically release funds therefrom, to eligible applicants, for any associated extensions. The City makes no representation as to, nor does it warrant, the amount of refund eligible under the Contract, and the City is under no obligation to pay, from its own funds, any portion of the refund. The lines subject to this Contract are attached as "Exhibit A" (which shall include record p. 1of2 Refund Contract drawings including the water and sewer refund calculation spreadsheet for each line the developer is requesting the refund of fees collected), attached REFUND CONTRACT NO. and incorporated herein. The term of this refund contract shall be fifteen (15) years from the date of execution, and in no case shall the City be liable to issue refunds after such term. No interest shall accrue or be paid on any funds held by the City. PRINTED NAME OF DEVELOPER/ PROPERTY OWNER OR AUTHORIZED REPRESENTATIVE SIGNATURE BELOW TO BE COMPLETED BY THE CITY Lines Accepted On: Authorized By the City: LUBBOCK ASSISTANT CITY MANAGER DATE DATE p. 2of2 Refund Contract