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Resolution - 2022-R0174 - TXDOT Right of Way Closure for Mayor's Marathon 2022
Resolution No. 2022-RO 174 Item No. 7.25 April 12, 2022 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 behalf of the City of Lubbock, an Agreement for the temporary closure of State right-of-way, and between the City of Lubbock and the State of Texas acting through the Texas Department Transportation (TxDOT), regarding a temporary closure of State right-of-way during the 20, Mayor's Marathon. Said Agreement is attached hereto and incorporated in this resolution as fully set forth herein and shall be included in the minutes of the City Council. THAT the City Council finds it in the best interest of the public safety and welfare of the citiz( of Lubbock to expedite all other traffic matters related to the 2022 Mayor's Marathon, and doing so hereby delegates authority to the City Manager, or his designee, to execute necessary or related documents or amendments associated with this agreement. Passed by the City Council on April 12, 2022 DANIEL M. POPE, MAYOR ATTEST: Rebecc t Garza, City Secre APPROVED AS TO CONTENT: 1 Brooke Witcher, Assistant City Manager APPROVED AS TO FORM: Ryan B e, ssistant City Attorney ccdocs/RES.TXDOT-Mayor's Marathon 2022 3.21.22 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 Agreement No. 050922-01 STATE OF TEXAS § COUNTY OF TRAVIS § AGREEMENT FOR THE TEMPORARY CLOSURE OF STATE RIGHT OF WAY THIS AGREEMENT is made by and between the State of Texas, acting by and through the Texas Department of Transportation, hereinafter called the "State," and the City of Lubbock. TX , a municipal corporation, acting by and through its duly authorized officers, hereinafter called the "local government." WITNESSETH 1. WHEREAS, the State owns and operates a system of highways for public use and benefit, including _ 2. Intersection of US 62/SH 114 (East 19th) and Canyon Lakes Drive 3. Intersection of US 82 (Parkway Drive) and Cesar Chavez Drive 4. Intersection of IH 27 and Cesar Chavez Drive 5. Intersection of US 82 (MSF) & Buddy Holly Ave 6. Intersection of IH 27 & East Broadway 7. Intersection of US 84 (Ave Q) and Glenna Goodacre Blvd 8. Intersection of US 82 (MSF) and 9th St 9. Intersection of FM 2255 (4th ST) and Indiana Ave 10. Intersection of FM 2255 (4th ST) and Quaker Ave 11. Intersection of SH 114 (19th ST) and Chicago Ave 12. Intersection of US 62/82 (MSF) and Chicago Ave in Lubbock , County; and 1. WHEREAS, the local government has requested the temporary closure of Intersection of US 62/SH 114 (East 19th) and Canyon Lakes Drive 2. Intersection of US 82 (Parkway Drive) and Cesar Chavez Drive 3. Intersection of IH 27 and Cesar Chavez Drive 4. Intersection of US 82 (MSF) & Buddy Holly Ave 5. Intersection of IH 27 & East Broadway 6. Intersection of US 84 (Ave Q) and Glenna Goodacre Blvd 7. Intersection of US 82 (MSF) and 9th St 8. Intersection of FM 2255 (4th ST) and Indiana Ave 9. Intersection of FM 2255 (4th ST) and Quaker Ave 10. Intersection of SH 114 (19th ST) and Chicago Ave 11. Intersection of US 62/82 (MSF) and Chicago Ave for the purpose of conducting a portion of the 26.2 mile run of the Mayors Marathon to as described in the attached "Exhibit A," hereinafter identified as the "Event," and WHEREAS, the Event will be located within the local government's incorporated area; and WHEREAS, the State, in recognition of the public purpose of the Event, wishes to cooperate with the City so long as the safety and convenience of the traveling public is ensured and that the closure of the State's right of way will be performed within the State's requirements; and WHEREAS, on the 12th day of April , 2022 the Lubbock City Council passed Traffic Closure Incorporated (TEA30A) Page 1 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 Agreement No. 050922-01 Resolution / Ordinance No. 2022-RO174 , attached hereto and identified as "Exhibit B," establishing that the Event serves a public purpose and authorizing the local government to enter into this agreement with the State; and WHEREAS, 43 TAC, Section 22.12 establishes the rules and procedures for the temporary closure of a segment of the State highway system; and WHEREAS, this agreement has been developed in accordance with the rules and procedures of 43 TAC, Section 22.12; NOW, THEREFORE, in consideration of the premises and of the mutual covenants and agreements of the parties hereto, to be by them respectively kept and performed as hereinafter set forth, it is agreed as follows: AGREEMENT Article 1. CONTRACT PERIOD This agreement becomes effective upon final execution by the State and shall terminate upon completion of the Event or unless terminated or modified as hereinafter provided. Article 2. EVENT DESCRIPTION The physical description of the limits of the Event, including county names and highway numbers, the number of lanes the highway has and the number of lanes to be used, the proposed schedule of start and stop times and dates at each location, a brief description of the proposed activities involved, approximate number of people attending the Event, the number and types of animals and equipment, planned physical modifications of any man- made or natural features in or adjacent to the right of way involved shall be attached hereto along with a location map and identified as "Exhibit C." Article 3. OPERATIONS OF THE EVENT A. The local government shall assume all costs for the operations associated with the Event, to include but not limited to, plan development, materials, labor, public notification, providing protective barriers and barricades, protection of highway traffic and highway facilities, and all traffic control and temporary signing. B. The local government shall submit to the State for review and approval the construction plans, if construction or modifications to the State's right of way is required, the traffic control and signing plans, traffic enforcement plans, and all other plans deemed necessary by the State. The State may require that any traffic control plans of sufficient complexity be signed, sealed and dated by a registered professional engineer. The traffic control plan shall be in accordance with the latest edition of the Texas Manual on Uniform Traffic Control Devices. All temporary traffic control devices used on state highway right of way must be included in the State's Compliant Work Zone Traffic Control Devices List. The State reserves the right to inspect the implementation of the traffic control plan and if it is found to be inadequate, the local government will bring the traffic control into compliance with the originally submitted plan, upon written notice from the State noting the required changes, prior to the event. The State may request changes to the traffic control plan in order to ensure public safety due to changing or unforeseen circumstances regarding the closure. Traffic Closure Incorporated (TEA30A) Page 2 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 Agreement No. 050922-01 C. The local government will ensure that the appropriate law enforcement agency has reviewed the traffic control for the closures and that the agency has deemed them to be adequate. If the law enforcement agency is unsure as to the adequacy of the traffic control, it will contact the State for consultation no less than 10 workdays prior to the closure. D. The local government will complete all revisions to the traffic control plan as requested by the State within the required timeframe or that the agreement will be terminated upon written notice from the State to the local government. The local government hereby agrees that any failure to cooperate with the State may constitute reckless endangerment of the public and that the Texas Department of Public Safety may be notified of the situation as soon as possible for the appropriate action, and failing to follow the traffic control plan or State instructions may result in a denial of future use of the right of way for three years. E. The local government will not initiate closure prior to 24 hours before the scheduled Event and all barriers and barricades will be removed and the highway reopened to traffic within 24 hours after the completion of the Event. F. The local government will provide adequate enforcement personnel to prevent vehicles from stopping and parking along the main lanes of highway right of way and otherwise prevent interference with the main lane traffic by both vehicles and pedestrians. The local government will prepare a traffic enforcement plan, to be approved by the State in writing at least 48 hours prior to the scheduled Event. Additionally, the local government shall provide to the State a letter of certification from the law enforcement agency that will be providing traffic control for the Event, certifying that they agree with the enforcement plan and will be able to meet its requirements. G. The local government hereby assures the State that there will be appropriate passage allowance for emergency vehicle travel and adequate access for abutting property owners during construction and closure of the highway facility. These allowances and accesses will be included in the local government's traffic control plan. H. The local government will avoid or minimize damage, and will, at its own expense, restore or repair damage occurring outside the State's right of way and restore or repair the State's right of way, including, but not limited to, roadway and drainage structures, signs, overhead signs, pavement markings, traffic signals, power poles and pavement, etc. to a condition equal to that existing before the closure, and, to the extent practicable, restore the natural and cultural environment in accordance with federal and state law, including landscape and historical features. Article 4. OWNERSHIP OF DOCUMENTS Upon completion or termination of this agreement, all documents prepared by the local government will remain the property of the local government. All data prepared under this agreement shall be made available to the State without restriction or limitation on their further use. At the request of the State, the Local Government shall submit any information required by the State in the format directed by the State. Article 5. TERMINATION A. This agreement may be terminated by any of the following conditions: (1) By mutual written agreement and consent of both parties. (2) By the State upon determination that use of the State's right of way is not feasible or is not in the best interest of the State and the traveling public. (3) By either party, upon the failure of the other party to fulfill the obligations as set forth herein. (4) By satisfactory completion of all services and obligations as set forth herein. Traffic Closure Incorporated (TEA30A) Page 3 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 Agreement No. 050922-01 B. The termination of this agreement shall extinguish all rights, duties, obligations, and liabilities of the State and local government under this agreement. If the potential termination of this agreement is due to the failure of the local government to fulfill its contractual obligations as set forth herein, the State will notify the local government that possible breach of contract has occurred. The local government must remedy the breach as outlined by the State within ten (10) days from receipt of the State's notification. In the event the local government does not remedy the breach to the satisfaction of the State, the local government shall be liable to the State for the costs of remedying the breach and any additional costs occasioned by the State. Article 6. DISPUTES Should disputes arise as to the parties' responsibilities or additional work under this agreement, the State's decision shall be final and binding. Article 7. RESPONSIBILITIES OF THE PARTIES The State and the Local Government agree that neither party is an agent, servant, or employee of the other party and each party agrees it is responsible for its individual acts and deeds as well as the acts and deeds of its contractors, employees, representatives, and agents. Article 8. INSURANCE A. Prior to beginning any work upon the State's right of way, the local government and/or its contractors shall furnish to the State a completed "Certificate of Insurance" (TxDOT Form 1560, latest edition) and shall maintain the insurance in full force and effect during the period that the local government and/or its contractors are encroaching upon the State right of way. B. In the event the local government is a self -insured entity, the local government shall provide the State proof of its self-insurance. The local government agrees to pay any and all claims and damages that may occur during the period of this closing of the highway in accordance with the terms of this agreement. Article 9. AMENDMENTS Any changes in the time frame, character, agreement provisions or obligations of the parties hereto shall be enacted by written amendment executed by both the local government and the State. Article 10. COMPLIANCE WITH LAWS The local government shall comply with all applicable federal, state and local environmental laws, regulations, ordinances and any conditions or restrictions required by the State to protect the natural environment and cultural resources of the State's right of way. Article 11. LEGAL CONSTRUCTION In case one or more of the provisions contained in this agreement shall for any reason be held invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provisions hereof and this agreement shall be construed as if such invalid, illegal or unenforceable provision had never been contained herein. Article 12. NOTICES All notices to either party by the other required under this agreement shall be delivered Traffic Closure Incorporated (TEA30A) Page 4 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F64-4698-8ED8-A33415B34CC8 Agreement No. 050922-01 personally or sent by certified U.S. mail, postage prepaid, addressed to such party at the following respective addresses: Local Government: City of Lubbock Attn: City Manager 1314 Ave K Lubbock, Texas 79401 State: Texas Department of Transportation Terry Harris & Steve Warren _135 Slaton Road Lubbock, Texas 79404-5201 All notices shall be deemed given on the date so delivered or so deposited in the mail, unless otherwise provided herein. Either party hereto may change the above address by sending written notice of such change to the other in the manner provided herein. Article 13. SOLE AGREEMENT This'agreement constitutes the sole and only agreement between the parties hereto and supersedes any prior understandings or written or oral agreements respecting the within subject matter. Traffic Closure Incorporated (TEA30A) Page 5 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 Agreement No. 050922-01 Each party is signing this agreement on the date stated beside that party's signature. THE CITY O LUBBOCK Exec ted o e alf of the local government by: By Date April 12, 2022 City Official Typed or Printed Name and Title Daniel M. Pope Mayor THE STATE OF TEXAS Executed for the Executive Director and approved for the Texas Transportation Commission for the purpose and effect of activating and/or carrying out the orders, established policies or wo gpg:heretofore approved and authorized by the Texas Transportation Commission. By Px�- r Date 4/20/2022 sa2CW5E40DjSt.rict Engineer Traffic Closure Incorporated (TEA30A) Page 6 of 9 Rev. 02/22/2019 Agreement No Exhibit A Traffic Closure Incorporated (TEA30A) Page 7 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F644B98-8ED8-A33415B34CC8 4 050922-01 O z �q SRd i P¢c e St ¢ Erskine Erskine St � St '� a 2 a5o0 � •� � � � - - ? 2 14 ARNETT BENSON e :. PARKWAY AND 4 ?� CHERRY POINT JACKSON-MAHON Mackenzie '+ ze9 Te}�sw�ry3 `rf' �t S ®j�l Park �• Y 84 G U A D A L U P E JoylandAMmsement Park lotOpen March 7 fo dal ' pa 4th St atn sr e2 H qL � D A + ' op. • 1G a University Q 11 A 24 to H O V E R T O N n Y Medical Center j J A n 7 Texas Tech Broadway St EBroadway A► Alow- University D o w N 07 A SOUTH OVERTON 26 V e2 A DEPOT", STRICT _ubbock E bz 14 Lubbock E19th St i,a m Ervt "hristian ez MEDICAL lniversity DISTRICT - N CORONADO F Rations, Color meads it's a stop that is hit twice A, A, .0 A TECH ' ER ` MaxayPark Mile 1.5 - Ave J 1 1st Place -LOW I E `= j� We 2.75 - Joyland Mile 4.5 - Mae Simmons (near pedestrian bridge used for LISR cross country meets) Mile 6 - same spot as above 34th St 34th St 34th St Mile 7.75 - Broadway/Ave F A CTd Mile 9 - Ave 0/9th St 62 Mile 10.25 - Akron / Glenna Goodacre Mile 13 - Erskine (between Memphis/Indiana) Mile 14.75 - Quaker/4th (south of 4th) Mile 15-75 - Uticall3th Mile 16-8 - Chicago/15th Mile 18.9 - City Bank Parkway (between US 62 and Slide) Mile 26.1 - Salem/31 st We 22 - Flint/28th Mile 22.8 - Flint/18th Mile 23.8 - Akron/Glenna Goodacre Mile 25.1 -Ave 0/9th Agreement No. Exhibit B Traffic Closure Incorporated (TEA30A) Page 8 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 Mayor's Marathon Half Marathon Course Q CHERRY POINT JACKSON-MAHON Z � Mackenzie Park _ 62 326 84 G U A D A L U I E Joylank ,mlisemen ark ' p� 82 - OpC 1, arch 20 Walmart Supercenter Q • ® Lubbock P �morial R T H O V E R T O N Civic Cent Y J 'anh a South 62 Texas Tech F iins ounds E Broadway Broadway St Broadway St y University n WIND SOUTH OVERTON M Buddy Homy 62 Lubbock E19thSt ae R ns E19 1hSt E19thSt 3 < (gyp D N x M fp � 07 7 N N y A < D D � HEART OF LUBBOCK i RRACE Pyco Industries O Eastlawn sa Memorial Gardens 34th St 34th St E 34th St b Agreement No. Exhibit C Traffic Closure Incorporated (TEA30A) Page 9 of 9 Rev. 02/22/2019 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 2020 MAYOR'S MARATHON 5K = Ian Park ,outh TURN BY TURN El • Start at Crickets by Buddy Holly 19 Sys( Center CMD • Head North on Crickets ?.nd St • Left on 17th st. 2nd PI • Right on Buddy Holly Ave A D A L U P E • Left on 1 st Pl. • Turn around at AveJ & 1 st Place Flying J Ti tel Center • Out and back course . 3rd P1 • Finish on Crickets by Buddy Holly ® United Stat Center Postal Servi a Marsha Course sth st n C c 0 ` nth St 8th St a TckCounty1f < c use N WN- x — N to mi41 t 151 It erson fr,tn Winery Buddy Holly Cente 10 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 KIDS FUN RUN 2020 TURN BY TURN DIRECTIONS • NORTH ON CRICKETS • RIGHT ON 15TH ST. • LEFT ON AvE F 3 Li' nR • LEFT ON 13TH ST. • LEFT ON BUDDY HOLLY AvE ; Pr' • LEFT ON 17TH ST. • RIGHT ON CRICKETS • FINISH )bo COURSE 's am( 'he 3rs Veterans 13th Y West Texas � ito Colo Lubbo c Count, � Juror I irking sine Day B yak Coffee Row ers ■ y t Services ids Dental l l ® United Stag T Postal Sery Crawford -adiator QDriveline xpress I pry Diosa Celidl s 9 Housing Authority -The City t �% o Triple J's Choi use & Brew Pul 1W F < I Th Buddy Holly Center Cast Iron Grill �W DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 Article 3. OPERATIONS OF THE EVENT A. The local government shall assume all costs for the operations associated with the Event, to include but not limited to, • plan development, . Donated by Marti Greer BSLT Triathlon Inc • materials, . Donated by Marti Greer BSLT Triathlon Inc • labor, • Donated by Volunteers • public notification, Donated by Primitive Social • providing protective barriers and barricades, • Donated by Marti Greer BSLT Triathlon Inc. • protection of highway traffic and highway facilities, • Due to the Mayors Fitness Council being a 501 (c) (3), the protection of highway traffic and highway facilities is being donated • all traffic control and temporary signing. • Due to the Mayors Fitness Council being a 501 (c) (3), the traffic control and temporary signing is being donated The required paperwork and plan development and execution have been submitted to TXDOT by Marti Greer as of 1/17/2022. DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 0 k%l FM A Y O R S MARATHON TRAFFIC ENFORCEMENT PLAN Traffic control for the Mayors Marathon will consist of lead and/or trail vehicles with signs having the legend "Runners Ahead". The Lubbock Police Department will provide any additional traffic control deemed necessary for the safety of motorists and participants. A letter from the Lubbock Police Department to this affect is included. Thank you, Marti Greer 806.438.0893 marti@buffalospringslaketriathlon.com DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 Ohl, WM A Y O R S MARATHON January 17, 2022 Jeremy Dearing Texas Department of Transportation 135 Slaton Rd. Lubbock,Texas 79404 Mr. Dearing, The Lubbock Police Department will provide traffic control for the Mayors Marathon on April 24, 2022.. Sincerely, Lt. Eric Quijada 36 E Lakeshore Dr Ransom Canyon, Texas 79366 www bdWospringdakdddWon.c= DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 0 �%'�M A Y O R S e> MARATHON January 17, 2022 Terry Harris Texas Department of Transportation 135 Slaton Rd. Lubbock, Texas 79404 Mr. Harris, We are preparing for the Mayors Marathon on April 24, 2022. The letter sent to Captain James Shavers of the Lubbock Police Department is enclosed. Please let me know if this information is sufficient. Thank you for all your help. Sincerely, Marti Greer 806.438.0893 marti@buffalospringslaketriathlon.com 36 E Lakeshore Dr. Ransom Canyon, Texas 79366 www.buffalospringslaketriathion.com DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 _,WM A Y O R S e> MARATHON January 17, 2022 Captain James Shavers PO Box 10536 Lubbock, Texas 79408 Captain Shavers, Thank you so much for your help in supporting the Mayors Marathon. Enclosed please find a letter to be signed by you and forwarded to the Texas Dept. of Transportation. Your men are great. Thank you for allowing them to serve in this position. I have also enclosed a copy of the map of the run for your convenience. Please let me know if you need anything further from me. I look forward to working with you. Sincerely, Marti Greer 36 East Lakeshore Dr. Ransom Canyon, Texas 79366 IM7031bk.marti@gmail.com cell: 438.0893 DocuSign Envelope ID: A278CF74-3F64-4B98-8ED8-A33415B34CC8 050922-01 ACORO® CERTIFICATE OF LIABILITY INSURANCE 164.� DATE(MMIDD/YYYY) 1 03/25/2022 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 terns 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 CONTACT Margaret Mayers NAME: Insurance Management Group 12730 Coldwater Road, Suite 103 PHONE (260) 338-2925 FAXAIC No (765) 664-0761 LAICN Ex E-MAIL ADDRESS: mmayerS@insmgt.com INSURER(S) AFFORDING COVERAGE NAIC # Fort Wayne IN 46845 INSURERA: National Casualty Company 11991 INSURED INSURER B : Nationwide Life Insurance Company 66869 Road Runners Club of America/2022 and Its Member Clubs INSURER C : INSURER D : 1501 Langston Boulevard, Suite 140 INSURER E : Arlington VA 22209 INSURER F : COVERAGES CERTIFICATE NUMBER: ZUZZ$IMA.I. RFVIRIAN Nt1MRFRr 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER POLICY EFF MMIDDNYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ 5,000 Legal Liability to Participant$1,000,000 PERSONAL & ADV INJURY $ 1,000,000 A KR00000008971200 12/31/2021 12/31/2022 GEN'LAGGREGATELIMITAPPLIESPER: POLICY1:1 JEa LOC GENERAL AGGREGATE $ 5,000,000 PRODUCTS-COMP/OPAGG $ 1,000,000 X OTHER: Per Event Basis Abuse and Molestation $ 500,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS KR00000008971200 12/31/2021 12/31/2022 BODILY INJURY (Per accident) $ X HIRED HNON-OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N / A I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below Excess Medical &Accident Excess Medical $10,000 B ($250 Deductible/Claim) BAX0000031850400 12/31/2021 12/31/2022 AD & Specific Loss $2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED AS RESPECTS TO THEIR INTEREST IN THE OPERATIONS OF THE NAMED INSURED. DATE OF EVENT(S): 04/24/22 Mayor's Marathon INSURED RRCA CLUBiEVENT MEMBER: Mayor's Fitness Council, Atfn: Jonathan Botros, PO Box 93726, Lubbock, TX 79493 Attached: Texas DOT Form Processed by MMM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 04/24/22 Texas Department of Transportation ACCORDANCE WITH THE POLICY PROVISIONS. 135 Slaton Road I AUTHORIZED REPRESENTATIVE /Jn Lubbock TX 79404 cJogU. (�• 1� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: A278CF74-3F64-4B98.8ED8-A33415B34CC8 050922-01 CERTIFICATE OF INSURANCE Form 1560 (Roar 07112) Prevous enore of ws form may � uuM Agents should compete the form providing as requested information Ikon either fax or mail this form directly to the address listed on page two of this form Copies of endorsements fisted below are riot required as atlachments to On certifrate This certificate Is Issued as a matter of information only and centers no rights upon the celide'dte holder. This certificate does not confer any rights or obligations other than the rights and obligations conveyed by the policies referenced on this eeftificate The toms of the policies referenced! n this certificate control over the terms of the certificate Insured: Road Runners Club of Amerfca2022 and Its Member Clubs, Indud ng Mayor's Fitness Coundi Street/Mailing Address. PO Box 93726 CdylState/Zip. Lubbock, TX 79493 Phone Number: ( 8W ) 535 - 7612 WORKERS' COMPENSATION INSURANCE COVERAGE: Endorsed with a Waiver of Subrogation in favor of TxDOT. Carrier Name: N/A Carrier Phone #: ( ) - Address: City, State, Zip: Type of Insurance Policy Number Effective Date Expiration Date Limits of Liability: Workers' Compensation Not Less Then: Statutory - Texas COMMERCIAL GENERAL LIABILITY INSURANCE: Cartier Name: National Casualty Group Carrier Phone #: ( 800 ) 423 - 7675 Address: 8877 North Gainey Center Drive City, State, Zip: Scottsdale, AZ 85258 Type of Insurance: Policy Number. Effective Date: Expiration Date: Limits of Liability: Commercial General Liability Insurance KR00000008971200 12/312021 12/312022 Not Leis Than: S 600.000 each occurrence BUSINESS AUTOMOBILE POLICY: Carrier Name: National Casualty Group Carrier Phone #: ( 800 ) 423 - 7675 Address: 8877 North Gainey Center Drive CitY, State Zip: Scottsdale, AZ 85258 Type of Insurance: I Policy Number Effective Date: I Expiration Date: Limits of Liability: Business Automobile Policy KR00000008971200 11/312021 12/312022 Not Less Than. $ 600.000 combined single limit UMBRELLA POLICY (if applicable): Cartier Name- N/A Carrier Phone #: ( ) Address: City, State, Zip: Type of Insurance: Policy Number. Effective Date: Expiration Date: Limits Of Liability: Umbrella Policy Should any of the above described polraes be cancelled before the expiration date thereof, notice wfe be delivered in accordance with the policy provisions. THIS IS TO CERTIFY to the Texas Department of Transportation acting on behalf of the State of Texas that the insurance policies named are in full force and effect. 1f this form is sent by fecsanile machine (fax), the sender adopts the document received by TxDOT as a duplicate original and adopts the signature produced by the receiving fax machine as the sender's ongtnat srgnattrm. Agency Name Address Insurance Management Group 12730 Coldwater Road, Suite 103 ( 260 ) 338 - 2925 Authorized Agent's Phone Number City, State, Zip Code Fort Wayne, IN 46845 03/252022 Date The Texas Department of Transportation maintains the information collected through this form With few exceptions, you are entilled on request to be informed about the information that we collect about you. Under §§552.021 and 562.023 of the Texas Government Code, you also are envied to receive and review the information. Under §559 004 of the Government Code. you are also ontided to have us correct information about you that Is Incorrect Fax completed form to: 512/416-2536