HomeMy WebLinkAboutResolution - 5485 - Contract-Graves & Gibson Industries-Separation & Composting Recyclable Materials - 05_08_1997RESOLUTION NO. 5485
Item #27
May 8, 1997
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to
execute for and on behalf of the City of Lubbock a Contract for separation and composting of
recyclable materials, attached herewith, by and between the City of Lubbock and Graves and
Gibson Industries, and any associated documents, which Agreement shall be spread upon the
minutes of the Council and as spread upon the minutes of this Council shall constitute and be a
part of this Resolution as if fully copied herein in detail.
Passed by the City Council this
ATTEST:
City Secretary
APPROVED AS TO CONTENT:
8th
Waste Superintendent
AS TO FORM:
G. Vandiver, First Assistant City
nGv:gs/coa«cs/CravesG.res
April29, 1997
RESOLUTION NO.5485
Item 127
May 8, 1997
F8MPTAEff TEXAS CONTRACT FOR SEPARATION AND
OF RECYCLABLE MATERIALS
. �M • 1- i • -T�
WHEREAS, the city of Lubbock heretofore solicited Request for proposals pursuant
to Bid No. 97063 for the separation and composting of recyclable materials, a copy of which is
attached hereto as Exhibit A and made a part hereof for all purposes; and
WHEREAS, the best proposal for such services was made by Graves and Gibson
Industries; NOW THEREFORE:
WITNESSETH:
THIS, contract, made this 15 f L day of , 1997, by and between the
City of Lubbock, Texas hereinafter called "City," and Grave & Gibson Industries, hereafter
called "GGI."
1.
The City hereby hires GGI to perform the duties set forth in the Request for proposals
attached hereto as Exhibit A attached hereto and GGI hereby agrees to perform such duties as
quoted. In the event of a conflict between the Request for Proposals Terms and Conditions or
General Conditions and this Contract, this Contract shall control. A copy of GGI's proposal is
attached hereto as Exhibit B for establishing the consideration to be paid by the parties hereto
and said exhibit shall be valid for no other purpose.
2.
Nothing herein shall be construed as creating the relationship of employer and employee
between the City and GGI's employees. GGI shall be deemed at all times to be an independent
contractor. In carrying out the terms of this contract, GGI shall select its own employees and such
employees shall be and act under the exclusive and complete supervision and control of GGI.
3.
GGI agrees to indemnify and hold the City harmless from any and all loss or damage and
from all claims for injury, death, loss or damage of any kind or character, and by whomsoever
suffered or occasioned by or in connection with the activities of GGI or its employees as a result
of this contract.
4.
GGI 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.
5.
Payments for recyclables shall be based on local vendor buying prices and made in accordance
with the schedule contained in Exhibit A attached hereto. Payments for separation of recyclables shall
be made in accordance with the schedule contained in Exhibit A attached hereto.
6.
The terms of this contract shall be for a period of three (3) years and it shall be
renewable annually for two additional years. The term shall commence upon the date of
execution hereof.
7.
If GGI defaults in the performance of any of its obligations hereunder and remains in
default for thirty (30) days after receipt of a written notice of such default from the City, the
City may declare this contract terminated immediately.
contract.
8.
The laws of the State of Texas shall control with regard to the interpretation of this
9.
GGI shall not assign or sublet this contract without the prior written approval of
the City. GGI will not accept this contract unless there is a composting facility that will
accept the recyclable material for composting.
Contract for Separation and Composting
of Recyclable Materials - GGI Page 2
10.
The City shall be entitled to inspect GGI's books and records during regular business
hours of the City with regard to such matters as are relevant to this contract. Further, the City
may require certification of the accuracy of the scales used by GGI as required, but not more
than two (2) times per calendar year.
GRAVES & GIBSON INDUSTRIES
BY:
#�JOHIN�RICHARD RAVES
GER
CITY OF LUBBOCK:
ATTEST:
KAYt IE._DARNELL, C7TY SECIZEAR
APPROVED AS TO CONTENT:
p
IT
olid Waste Superintendent
APPROVED AS T FORM:
Attorney
Contract for Seperation and Composting
of Recyclable Materials - GGI Page 3
CITY OF LUROC'K
REQUEST FOR PROPOSALS N 97063
SEPARATION OF RECYCLABLES PROPOSAL
GRAVES R GIBSON INDUSTRIES
P.O. BOX 43
PLAIN VIEW, 'I*ERAS 79073
2.
Separation of recyclable material shall be performed at 6201 M.L.K. Blvd l_uhbock. Texas.
Materials will be received at the cast end or Recycling Building at unloading area inside thi. building.
Material received will be weighed on the truck scales located at the above listed address
Material will be sorted on a conveyor table for the recovery and marketing of
Steel Cans
Aluminum Cans
# I & 4 2 Plastic
Ferrous Metals
cardboard
These items will be processed and sold at the best price available for each market.
Newspaper and other cellulose material will be processed for composting at the
Citv of Lubbock Landfill Compost Site. If the price of these paper items rise to a
level that will afford seperation and baling , this material will be sold at those markets.
3.
GG1's management has been in the recycling industry since 1985, dealing in scrap
metals, aluminum and batteries. Paper, cardboard, plastic and glass have been marketed
for the past three (3) years.
4.
References
Daffern Steel, Plainview, Texas 806/293/2609 Fred Willis
Lubbock American Iron and Metal, Lubbock. Texas 806/765/8837 lack Williamson
Western Fibers, Hollis, Ok. 405/688/9223 Paul Horton
Fiber Horizons Recycling, Inc. Grapevine, Texas 917/329/1929 Tommy Stubblefield
5.
Cost for the Separation and marketing of recyclable material will be Ninety Five ($95.00)
Dollars per ton of material received. This price includes the cost of composting material
that we deliver to the Landfill compost site that is not shipped to other markets. Material
that is taken to the Landfill compost site by GGI will not be charged the Landfill gate fee.
b
The Cite of Lubbock will receive the following ptices for the listed materials
I Metal cans, Aluminum, Steel, N I K a 2 Plastic, and Cardboard will he pair( Ihe-
current foal street price for each item listed
^- Twenty (20) percent of llic material that is composted from the paper and other
cellulose fiber material from the "Blue Bag Program" will be given to the City for their beneficial
reu%c
GGI's manatacmcnt has Three (3) years experience in seperating Comingled rccyci +blc
material with Plainview Recycling Industries Markets have been established during this
time to insure the movement of items to market Composting of paper products with
cattle waste products have also been ongoing for the past three (3) years. Markets have
been local farms for the compost. GGI has a supply of cattle manure available for use in this
composting operation that will allow for the proper mixture of material✓ to make compost.
This supply of cattle manure will be available on a regular basis and a quanity large enough
to do the composting.
The schedule of operation for the sorting of material %,,ill be Monday - Thursday. with
exceptions for holidays and weather, from 8 00 AA1 to 5:OOP.M..
2
GGI will employee six (6) people to provide the sorting service. Four (4) will be general
labor from Texas Rehabilitation Commission, One (I) will be the operations foreman and
one (1) will be the operations manager.
10
The work schedule for the general labor will be Monday - Thursday from 8:00 A.M. to
5:00 P.M. , and the schedule for management will be Monday - Friday from
8:00 A.M to 5:00 P.M. .
The training period for the start up crew will be for two (2) weeks. The training will
be at the Lubbock worksite and in Plainview with Plainview Recycling Industries. As
new employees arc hired: the training will be at the Lubbock worksite for one week.
12
Resumes are attached
13
I Aperience to handle this project has been in Plainview Texas with Plainview Recycling
Industries Sorting residential and commercial comingled material for the City of Plainview
has been ongoing since 1994. Del Essary. . Solid Waste Superintendent for the City of
Plainview. has been involved with the recycling project and directs the City's "Blue Box"
program. Current volume of material being recycled at this site is approximately eighty (80)
tons per month An additional one hundred (100) tons per month of baled cardboard from
the Wal-Mart Distribution Center in Plainview is currently being shipped from this site.
14
Goals and objectives of GGI are to work with the City of Lubbock to improve the current recycling
program by finding methods to increase eliicency and participation in recycling Methods
of collection of current "blue bag" program will be studied to find ways to make improvements.
We will also work with the City of Lubbock to develope a plan for a recycling and transfer
station that will house all recycling and composting services at the current Landfill location.
IS.
Equipment that will be used in the seperation and processing of "blue Bad;" material:
1. Mayfran conveyor with debagger and pit conveyor.
2. Jeffery model paper hammermill.
3. Maren Baler (1972)
4. Toyota Forklift
S. Yale Forklift
6. Glass Crusher
7.70' Certified Truck Scales
8. Enclosed building (work and unloading area)
9. Office
10. paved access and parking lot.
00
GGI will accept this project if NATURE'S WAY RESOURCES. INC. of Houston. Texas
is the company that operates the compost facility at the Landfill.
JOHN RICHARD GRAVES
1103 ITASCA
PLAINVIEW, TEXAS 79072
EDUCATION:
West Texas State University, Canyon, Texas
BS - Biology/Chemistry - 1977
Graduate Work -Environmental Science 1977 - 1979
Jerrico Management Academy, Lexington, Kentucky
Mid -Management Course - November, 1978
Vega High School, Vega, Texas
Graduated 1973
EXPERIENCE RECORD:
July 1, 1996 - Present:
GRAVES & GIBSON INDUSTRIES:
Manager. Responsible for all executive duties _
including bookkeeping, accounts receivable, accounts
payable, payroll, contracts with clients and suppliers.
April,1985 - June 30, 1996:
Daffern Steel & Supply Co.,Inc. Plainview, Texas:
New Steel Products Sales & Service Manager. Job
responsibilities include inventory control, order
processing and shipment, accounts receivable , accounts
payable and computer systems. Special assignment in
development of construction sales and management systems
in the commercial and residential areas.
October,1983 - March,1985:
Dearborn Chemical Co., Amarillo, Texas: Sales.
Responsible for sales and services of Water Treatment
chemicals in commercial accounts. Accounts were in the
Oil and Gas Industry, Beef Packing Plants, and Waste
Water Treatment Plants.
June,1982 - September,1983:
Dubois Chemical Co., Amarillo, Texas: Sales.
Responsible for sales and services of Institutional
Cleaning Chemicals. Accounts were in the Food Service
Industry, Motel/Hotel Industry and Office Buildings.
March,1979 - May,1982:
ASARCO, Inc., Amarillo, Texas: Jr. Development Engineer.
Involved with Research and Development on the plant.
Responsible for Environmental Sampling, maintaining
waste disposal facilities, underground injection wells
for waste acid and water. Direct communication with
Texas Department of Water Resources, Texas Air Control
Board, and Environmental Protection Agency. Responsible
for compliance with State and Federal Environmental
Regulations. Involved with Quality control and physical
.testing of refined copper and analysis of cleaning and
lubricating solutions.
July,1978 - March,1979:
Long John Silvers, Amarillo, Texas: Manager. Responsible
for Public relations, sales, ordering supplies, deposit,
hiring, training, and scheduling of employees,
maintenance of equipment in shop.
August,1974 - July,1978:
West Texas State University, Canyon, Texas. Dormitory
Director/Resident Advisor. Supervising housing of
approximately 150 men in dormitory, planning activities
for the men, mediating problems of dorm residents.
Other Interest:
Boy Scouts of America: Past District Chairman for Haynes
District, ScoutMaster, CubMaster, Council Camping
Chairman, Woodbadge trained.
Optomist Club: Scouting chairman for youth activities.
Baseball concession stand chairman.
First Baptist Church: Sunday School teacher and RA's
leader.
SCOZT A. GIBSON
3511 GARLAND ST
PL/lINVIEW. TEXAS 79072
806-296r6324
EXPERIENCE:
GRAVES 6LGIBSON INDUS'TRIE'S
1'IJNVII'W. TIMAS 74x172
cptenuums nutnivr . lane I'$'Kl 1t# pr eou
tcmgKtstingof rank• ntaimn• atwl waste palu•r . vennirullon• olu•raliuns
WAI: MAlt'1' DISTRIBUTION CI NTLIt
IIIAINVIEW.'ri-MA.ti 74XI72
opcipnctnf aperarco.,Jireyrurn
forklift atul pallet natvinl; t•cluipna n1 ult•ratar
tiOUTIIWisr (xxx 1L DINE1111'VILNT
DAIJAS. '1'1:XAS
rtictilsolmtt olvrator
Ixtilding golf courses miltg t•cpupoK•n1:
doxcra. Ittaciors, atxi srral t-M
EDUCATION
jAC K5IiURU I I IGI I so I( K )I.
1985
VGRNUN IR CAWi(:li
CIVIL (I)N%-MI.K:TK)N
1986
SKILLS
oltrraticnt of different lwnvv c•tptipntt•tt1 used in 11tt• din noting iodostn•
Rf.Sdu'�.Oh Ro. S�$cJ
To:
Fax Number
Attention:
Date:
From:
Universal Surety of er1"
DDI 209 hlorgan leaves .Ins-anvice dba White -Hi
806-296-5922
Lena Faye
July 22, 1997
Anna Hilt
o!CZ,�V
cr g 1 Lea
1997
LU8 �SF,cREr y
Comments: Attached is Performance Bond and Power of Attorney for the
captioned account. We have also attached a Consent to Rate
Form which needs to be signed and mailed back to us along
with the Indemnity Agreement and the Letter of Credit.
Principal Name:
Bond Number:
Bond Amount:
Commission Percent
Premium Amount:
Effective Date:
Expiration Date:
John Ric''s,y''d rave dha'Graves &—Gibson f6dustries
1 � JtJ
$25,000.00
20.00°/0 6
.9 .'-
If you have a fax machine with thermal paper, make a pphotocopp of all following document
pages on bond paper before you sign and seal. Call (512) 346-9290 for more information.
Dedicated to Service
8140 N. Mapac, 8,1d. 46 $site 260, Austin, TX 78759
emamm 11=191 UNIVERSAL SLIRETY OF AMERICA
'KesowTldh SOS
UNIVERSAL SURETY OF AMERICA
950 Echo Lane, Suite 250
Houston, Texas 77024
Bond: TX 0920963 00
STATLrTORY PERFORMANCE BOND
(PUBLIC WORKS)
KNOW ALL MEN BY THESE PRESENTS. That John .Rickard Graves dba Graves & Gibson Industries (hereinafter called the Principal), as
Principal, and Universal Surety of America, a corporation organized and existing under the la -,As of the State of Texas, licensed
to do business in the State of Texas and admined to write bonds, a+ surety. (herein called the Surety), are held and firmly
bound utuo City of Lubbock (herein called the Obligee), in the amount of Twenty -Five Thousand and 4100 DOLLARS (25,000.00 j
for the payment whereof the Said Principal and Surer. bind themselves and their heirs, administrators, executors, succtssors and
Q assigns. jointly and severally, firmly by these presents.
V
--� WHEREAS, the Principal ha; entered into a certain «Tiaen contract with the Obligte, dated May 3, 1997, for for the
stpa.-rttion and composting of recyclable material for the tram bginning S.V97 through 51:98, which connect is hrreby referred
y to and made a part of hereof as fully and to the same extern as ifcopied at length herein.
Q NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Princi a1 shall faithfully p perform the work in
accordance with the plans, specifications :tad contract doczaents, then this obligation shall be null and void, otherwise to
remain in full force and effect;
;r
PROVIDED, HOI'E' ER, that this bovd is executed pursuant to the provisions of Chapter 2253 of the Texas Government Code and all
liabilities on this bond shall be determined in accordance with the provision,,, conditions and limitations of said article to the
-� same extent as if it were copied at length herein.
cs]
IN %TTNESS %'HEREOF, the said Principal and Surety have signed and sealed this instrument on July 22, 1 097, .
John Richard Graves dba Graves d. Gibson Industries
? (Principal)
z
8y:
Universal Surety of America (Surety)
By:
Lena Faye Hill Anomey-in-F:
UNIVERSAL SURETY OF AMERICA
JuL_ _ i rl . 14U �-rul n -,.Le- .cop yt�,r � a U 1vUt��G ���: f HUt. UU4-"UU4
UNIVERSAL SURETY OF AMERICA
UNIVERSAL SURETY OF AMERICA
P.O. BOX 1068 -Houston, Texas 77251-1068
GENERAL POWER OF A'I fORIN)EV - CERTIFIED COPY 802dx,mbor
TIC 09209E3 00
Know All Men by These Presents, That UNIVERSAL SURETY OF A ERICA, a corporation duly otgarrized and existing under the laws of
the State of Texas, and having its principal office in Houston. Texas. dots by these presents make, constitute and appoint
Lena Faye Hill
its date and lawful Altorney(s)-in-Fact, with full power and authority hereby conferred in its name, place and dead, to execute, acknowledge and
deliver bonds for:
priftdpzl: )ohn Richard Graves dba Graves & Gibeon Industries
Obligee: City of Lubbock
Amount: S25,000.00
and to bind the company thereby as fully and to the same extent as if such bonds %were signed by the Presdent, sealed with the corporate seal of the
company and duly attested by its kcretary, hereby ratifying anti confirming all dust the said nttorney(s)-irx-Fact may do within the above stated
limitations. Said appointment is trade under and by authority of the following resoltnion adopted by the Board of Directors of Universal Surety of
America at a oneecirg lid on the 1 ] th day of July
, 199S.
"Be It Resolved. that the President, and any Vice, President, Secretary or any Assistant Secretary shall be and is hereby vtued with full power
and authority to appoint any one or more suitable persons as Attorneys) -in -Fact to repro eot and act for and on behalf of the Company."
"RESOLVED that the signattue of any officer of the corporation, and the seal of the corporation may be affixed or printed by facsbnilie to any
power of attorney of the corporation, and that such printed facsitailie signature and s€al shall be valid. and binding upon the corporation."
In witness Rbereot Universal Surety of America has caused these presents to be signed by its President, John Knox, Jr. and its
corporate seal to be t►ereto affixed this 30tb day of September, A.D.,19%.
UNnTRSAL SURETYOF AMERICA
)o nQox.It 4i'fCS►dZIIt
Stara of Texas 1y`^.,, ...... +�
ss:
County of Harris
On this 3Qttt day of September. in the year of 1996, before me Rhoads Kzv Wilke, a notary public, personally appeared John Knox, Jr.
personalty lxnovm to be ttte person who executed the within inswumear as President, on beb2lf of the corporation therein named and
acknowledged to me that the corporation atetuted it.
MY L J
t r __�Zea
Notary Public
4 the tmdemgoed Secretary of Univer.rel Surery of America, hereby certiy tbar, tht above and foregoing is a full, true and correct copy of the
Original Power of Attorney- is a-M by .aid Company, and do hereby furtber sorb fy tbat the. said Power of Attorney 6 still in affect.
Gr%TN under my hand and the seat of sand company, at Houston, T exa::, ttus 22ND say of _ ! LY 19 97
iIasvut Sccretsry
For verification of rho authority of this power you may telephone (71:) 7:2-1600.
UNIVERSAL SURETY OF AMERICAS
JUL 11: __ FPS H `1= -30 41C8 TO 1806yb5y22 PAGE. uu '/004
CONSENT TO RATE APPLICATION
for
FIDELITY, SURETY AND GUARANTY BONDS AND
POLICIES GOVERNED UNDER ARTICLE 5.15
I€�P�UI: A SEPARATE APPLICATION MUST BE FILED ON EACH POUCY OR BOND
NAME OF SUBMITTING COMPANY: universal Surety of America
ADDRESS: 8140 N. Mopae, Building 4, Suite 260, Austin, TX 78759
TO: TEXAS DEPARTMENT OF INSURANCE
Bond Department MC/104.1 B
P.O. Box 149104
Austin, TX 76714-9104 Date: July 22, 1997
in accordance with the provisions of Article 5.15 (c), Texas Insurance Code, as amended, application is hereby
made for approval of rates or premiums greater than Department standard or our company filed rates or
premiums, as follows:
1. Name and Address of
Principal or Risk: Graves & Gibson Industries, P.O. Box 43, Plainview, TX 79072
2. Policy or Bond:
(a) Effective Date: May 8, 1997
(b) Policy or Bond No.: TX-09 2 096 3
(c) Bond (Contract, Fitt. Inst., Lic., & Permit, etc.): Contract
(d) Bond Type (Perf., Pymt., Form 24, Mixed Bev., etc.): Performance/Payment Bond
(e) Obligee: City of Lubbock
(f) Job Name or Number:
(g) Penalty of Bond: $ 2 5 , 000
(h) Type of CoMract (Class A. Class A-1, Class B): _
(i) Other (Explain):
3. Coveraoe to be written at rates or premiums greater than standard or company filed rates or wemiums:
Com lete a ) c or d
STANDARD or COMPANY FILED
RATES or PREMIUMS
EXCESS RATES
or PREMIUMS
a Entire Risk; or
$21/M
a*30/M
b) Portion of Risk
name n or
c Cover ;or
Other
TOTAL PREMIUM
1 $
4. Reasons for requiring rates or premiums greater than standard or company filed rates: Financial statement
_ preparation and analysis of financial position does not qualify account for
standard rates.•
5. 1 (We) hereby consent to approval ty the Department of rates or premiums for insurance greater than the
standard rates or premiums that haft been Vproved by the Department.
Ngnature of Insured (or Person Authorized to Act for Insured)
Notes: (1) THIS APPLICATION MUST BE COMPLETED IN FULL AND THE ORIGINAL WITH ONE COPY
FILED WITH THE TEXAS DEPARTMENT OF INSURANCE.
(2) Consent rates or premiums greater than standard or company fled rates or premiums should be
expressed either in dollars or in percent above Department standard rates or premiums.
(3) If additional space is required to clearly stow, the proposed rating procedures, use reverse side of
this form for explanation.
FORM No. VCCo0_, (10-9b) '
05MUIN)VE,KS'AIL SUKE,fY 0 AMEKI(.:'A �
UNIVERSAL SURETY OF AMERICA
C
cG
r :a
7E
O
tit
C.G
tot
ts�
Z
P.O. BOX 1068 -Houston, Texas 77251-1068
GENERAL POWER Of AMR-N- rY - CERTIFIED COPY naar.�
TX 0920963 00
Know All Men by These Present,. Thm UNIVERSAL SURETY OF V ERICa, a corporation duly organized and existing under the laws of
tht State of Texas, and having its principal office in Houston, Texas, does by these presents make, constitute aad appoint
Lena Faye Hill
its true and lawful Aaomey(s)-in-Fact, with full power and authority hereby confetTed in its name, plate and stead, to execute, acknowledge and
deliver bonds for.
Principal: John Richard Graves dba Graves & Gibson industries
Obligee: Cicy of Lubbock
Amount: $25,".04
and to bind eke eompxny thereby as fnity and to the same extent as if such bonds were Biped by the President, sealed with the corporate seal Of the
company and duly arrested by its secretary, hereby ratifying and confirming all that the said Atcorney(s)-in-Fact may do Rithin the above stated
1 mRations. Said appoinmenc is trade under and by authority of the following resolution adopted b, the Board of Directors of Universal Surety of
America at a meering held on the 11 Eh day of July, 1984.
"Be it P..esolyed, that the Pre»dent, and any Vice President, Seaetar,� or any Assistant Srcrem-v shall be and is hereby vested with full power
and authority• to appoint any one or more saitable persons as Attornev(s)-in-Fact to repre;tnt and act for and on behalf of tb�Company."
"RESOLVED that the signature of any officer of the corporation, and the seal of the corporation may be affixed or printed by ficsimilit to any
power of attorney of ch, corporation, and that such printed facsimilie signatura zed seal shall be valid and binding upon the corporation."
In Wime-_s aLereof, Universal Surety of America has caused these presents to be signed by its President, John Knox, Jr. and its
corporate seal to be hereto affixed this 30th day of September, A.D., 1996.
t`� ,JRC7► p�'qt
4i
Stare of Tessa
ss:
Court), of Harris
UNIVERSAL SURETY OF AAJERiCA
to X. Jr t., Ptesidew
On this 30th day of September, in the Fear of 1996, before tue kihor..dr liay Wilke, a notary public, personally appeared John Knox, Jr.,
personHiy known to be the person who executed the "Idi in iastratnear as President, on behalf of the corporation therein named and
acknowledged ro me that the corporation ezceuted it.
t 3
Votary Publit
L the undm-igued Secretary of Universal Susrery of America, hereby ceni _ that the above and foregoing i; a full, true and correct copy of the
Otigi-aal Potter. of Attorn�' issued by aid Cnmpmy. and do hereby funbear ecrtify (at the said Power of Aaomey is still in at%ct.
GtiT N under my hand and the seal of said company, at Houston, Texa;, this 22ND .day of JULY — 19 97
- nYaat Secreury
For verification of rhv authority of this power you may telephone (713) 722-1600.
UNIVERSAL SURETY OF AMERICA
UNIVERSAL SURETY OF AMERICA
950 Echo Lane, Suite 250
Houston, Texas 77024
9005209 Billing Advice 8/01/97
Morgan Eaves Insurance dba White -Hi
PO Box 650
Plainview TX 79072
Principal: GRAVES & GIBSON INDUSTRIES
Bond Amt$: 25,000.00
Obligee: City of Lubbock
Bond No.: TX-0920963-00
Term: 5/08/97 to 5/08/98
BOND NB
Premium Comm
750.00 20.0
CONTRACT BONDS
SEPARATION AND COMPOSING OF
RECYCLABLE MATERIAL FOR TERM
5/8/97 - 5/8/98
NEW BUSINESS
Comm Amt Entry Date
150.00 8/01/1997
Exposuz
25,OC
kL°'iAMr`RICAN STATES AMERICAN STATES INSURANCE COMPANY _ PAGE 1
1 AINSURANCE INDIANAPOLIS, INDIANA
.w,+LINCOLNNATIONAL CORPORATION UMBRELLA LIABILITY POLICY
E NAMED JOHN RI CHARD GRAVES IDECLARATIONS
INSURED DBA GRAVES & GI BSON INDUSTRIES
AND MAILING DARI N HAMAKER
(�e- j
ADDRESS 1401 W 5TH ST POLICY NUMBER 01-SU-204505-10
PLAINVIEW, TX 79072 RENEWAL OF NEW 05-97
AGENT MORGAN-EAVES AGENCY
POLICY PERIOD FROM 05-30-97 TO 05-30-98 12:01 AM NAME 716 BROADWAY STREET
AND
STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. ADDRESS P 0 DRAWER 650
PLAINVIEW , TX 79073
"""" ASBESTOS IS EXCLUDED ""'
42-57354 (806) 296-5514
THE TOTAL PREMIUM DUE FOR THE POLICY TERM IS $500.00.
YOU WILL BE BILLED THROUGH YOUR CUSTOMER ACCOUNT ##070-0507-514-01.
YOU NEED NOT PAY ANY PREMIUM AT THIS TIME. WE WILL SEND A BILLING
STATEMENT IN A SEPARATE MAILING.
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, THE COMPANY AGREES
WITH THE NAMED INSURED TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
COMMERCIAL UMBRELLA LIABILITY COVERAGE ...................... $ 500.00
500.00
COUNTERSIGNATURE
THIS POLICY IS ISSUED WITH THE CONDITION THAT THE
UNDERLYING LIMITS AND COVERAGES SHOWN IN THE
SCHEDULE ARE IN FORCE.
BY
(DATE) (AUTHORIZED REPRESENTATIVE)
9-CU (4-93)
COMPANY USE ONLY
SPECIAL RISK 18 (A-347) AGENT COPY PREPARED 07-14-97 AGT * C-UB-14-PRINT001.0035-0001-11
I I ,
Or7hMMICAN STATES COMMERCIAL UMBRELLA LIABILITY POLICY
i JINSURANCE
• nnr LINCOLN NATIONAL CORPORATION
PAGE
NAMED INSURED JOHN RI CHARD GRAVES
POLICY NUMBER: 01—SU-204505-
LIMITS OF LIABILITY
(A) EACH OCCURRENCE $ 1,000,0
(B) AGGREGATE LIMITS - SEPARATELY AS RESPECTS:
(1) PRODUCTS HAZARD AND COMPLETED OPERATIONS HAZARD COMBINED $ 1, 000, 0i
(2) OCCUPATIONAL DISEASE SUSTAINED BY ALL EMPLOYEES OF ANY INSURED $ 1,000,01
(3) ALL OTHER COVERAGES COMBINED (EXCEPT AUTOMOBILE LIABILITY,
WHICH IS NOT SUBJECT TO ANY AGGREGATE LIMIT) $ 3,000,01
(C) RETAINED LIMIT $ 10,01
THE FOLLOWING FORMS CURRENTLY APPLY TO THIS COVERAGE:
CU0002(0493) SCHEDULE OF UNDERLYING INS CU0010(1293) COMML UMB LIAB COV FORM — TN
CUO151(1293) TX — FOL FORM — PUNITIVE DMGS CU2105(0492) EXCLUSION — ASBESTOS
CU2110(0492) EXCL — CONT/POLL — LIMITED CU2006(0492) FOLLOW FORM — AUTO LIAB SCHE
9-CUa (4-93)
COMPANY USE ONLY
SPECIAL RISK IS (A-347) PREPARED 07-14-97 AGT
_ ___ C-UB-14•PRINT001.0035-0003-R
TA
®INSURANCSTATES SCHEDULE OF UNDERLYING INSURANCE cu o0 02 oa ss
• imr LINCOLN NATIONAL CORPORATION
The coverages marked by an "X" and the limits indicated are the minimum coverages and limits required for this policy.
Issued to form a part of policy number 01—SU-204505-1
CARRIER, POLICY NUMBER, MINIMUM
PERIOD TYPE OF POLICY APPLICABLE LIMITS
a) Employers' Liability or Bodily injury by accident $ 500,000 each accident
COMMERCIAL CASUAL Contingent Employers' Liabilit Bodily injury b disease $ employee 500,000 each
T 1-40855A gy yjry y
05-30-97/98 Bodily injury by disease $ 500,000 policy limit
or $ each accident/
occurrence
b) x❑
AMERICAN STATES TX
General Businessowners Farm
$ 2,000,000
general aggregate
04-CC-108976
Liability Liability Liability
(other than products -
05-3o-97/s8
completed operations)
x❑
all premises or operations of the insured
$ 2,000,000
products -completed
operations aggregate
x1
products -completed operations
$ 1,000,000
personal and
advertising injury
x]
personal and advertising injury
$ 1,000,000
each occurrence
or $ combined single limit
c) Automobile Liability Bodily Injury
AMERICAN STATES TX
04-BA-427429 x❑ owned autos $ each person
05-30-97/98 $ each accident
x❑ non -owned autos Property Damage
x❑ hired autos $ each accident
or $ 1,000,000 combined single limit
d) Garage Liability
$
auto only each
❑ owned autos
accident
$
other than auto only
❑ non -owned autos
each accident
❑ hired autos
$
other than auto only
aggregate
❑ broadened coverage garages -CA 2514
or $
combined single
limit
e)
Page 1 of 1
C-UB-I4-PRINTOUT-0035.0005-R
® A:AFAICAN STATES AMERICAN STATES INSURANCE COMPANY OF TEXAS PAGE 1
IN5ISRANCE INDIANAPOLIS, INDIANA -
wpnruNCOLN AnONALCORPORKWN COMMERCIAL INSURANCE POLICY
NAMED JOHN RICHARD GRAVES DECLARATIONS
INSURED DBA GRAVES & GI BSON INDUSTRIES
AND % DARIN HAMAKER POLICY NUMBER 04—CC-108976-1
MAILING I
ADDRESS 1401 W 5TH ST ���Ve'-
PLAINVIEW, TX 79072 RENEWAL OF NEW os-s7
POLICY PERIOD FROM 05-30-97 TO 05-30-98 12:01 AM
STANDARD TIME AT LOCATION OF DESCRIBED PROPERTY.
AGENT MORGAN—EAVES AGENCY
NAME 716 BROADWAY STREET
AND P 0 DRAWER 650
ADDRESS PLAINVIEW, TX 79073
42-57354 (806) 296-5514
THE TOTAL ESTIMATED PREMIUM FOR THE POLICY TERM IS $447.00.
YOU WILL BE BILLED THROUGH YOUR CUSTOMER ACCOUNT #070-0507-514-01.
THIS POLICY IS SUBJECT TO A FINAL AUDIT.
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 COVERAGE PARTS FOR
WHICH A PREMIUM IS INDICATED. THE PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
Commercial Property Coverage Part -Texas Standard Policy ................................. $
Electronic Equipment Protection Coverage Part .......................................... $
Commercial General Liability Coverage Part ............................................ $
Boiler and Machinery Coverage Part ................................................. $
Commercial Crime Coverage Part ................................................... $
Commercial Inland Marine Coverage Part ...................
Commercial Glass Coverage Part .................. �� lrA?g-
Professional Liability Coverage Part ..............` ....+.cr6"
........................$
'�1�, .....................$
...................$
I Provisional Premium $
Premium
447.00
447.00
ARTICLE 6.13 POLICY A LIQUIDATED DEMAND. A FIRE INSURANCE POLICY, IN CASE OF TOTAL LOSS BY FIRE OF PROPERTY
INSURED, SHALL BE HELD AND CONSIDERED TO BE A LIQUIDATED DEMAND AGAINST THE COMPANY FOR THE FULL AMOUNT
OF SUCH POLICY. THE PROVISIONS OF THIS ARTICLE SHALL NOT APPLY TO PERSONAL PROPERTY.
COUNTERSIGNATURE
BY
(DATE) (AUTHORIZED REPRESENTATIVE)
9-CC(TX)(0787)
COMPANY USE ONLY
CENTRAL REGION 41 (11229) CR AGENT COPY PREPARED 06-13-97 AGT *
C•AN-13-PRINT001-0728.0001-F
COMMERCIAL LIABILITY COVERAGE PART DECLARATIONS
NAMED INSURED: JOHN RICHARD GRAVES
FORM OF BUSINESS: INDIVIDUAL
PAGE CG 1-LAST
POLICY NUMBER: 04-CC-108976-1
-------------------------------------
L I M I T S O F I N S U R A N C E
COMMERCIAL GENERAL LIABILITY
GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS -COMPLETED OPERATIONS) 2,000,000
PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT 2,000,000
PERSONAL AND ADVERTISING INJURY LIMIT 1,000,000
EACH OCCURRENCE LIMIT 11,000 000
FIRE DAMAGE LIMIT (ANY ONE FIRE) $ 50,000
MEDICAL EXPENSE LIMIT (ANY ONE PERSON) $ 5,000
---------------------------------------------------------------------------------
LOCATION OF ALL PREMISES YOU OWN. RENT, OR OCCUPY:
1. PO BOX 43
PLAINVIEW,TX 79073
----------------------------------------------------------------------------------
CODE I CLASSIFICATION -PREMIUM BASIS I EXPOSURE I RATE I PREMIUM
----------------------------------------------------------------------------------
PICISM
53077
COMMERCIAL GENERAL LIABILITY
OTHER THAN PRODUCTS -COMPLETED OPERATIONS
** LOCATION # 1
FERTILIZER MFG.
GROSS SALES (PER $1, 000)
TO MEET COVERAGE MINIMUM
COMMERCIAL GENERAL LIABILITY
PRODUCTS -COMPLETED OPERATIONS
** LOCATION # NA
FERTILIZER MFG.
GROSS SALES (PER $1, 000)
TO MEET COVERAGE MINIMUM
COMMERCIAL LIABILITY TOTAL
50,000
50,000
THE FOLLOWING FORMS CURRENTLY APPLY TO THIS COVERAGE PART:
IL0017
11845
- COMMON POLICY CONDITIONS
IL0021
1194
- NUCLEAR ENERGY LIABILITY ENDTS
CG0001
1093
- COMMERCIAL GENERAL LIABILITY
CGO103
1093
- TEXAS CHGS-CONDITIONS REQUIRING NOTICE
IL0275
1187
- TEXAS CHANGES -CANCELLATION & NONRENEWAL
CG2639
0195
- TEXAS CHGS-EMPL. RELATED PRACTICE EXCL.
IL0168
0992
- TEXAS CHANGES - DUTIES
IL7201
0392
- COMPANY COMMON POL CONDITIONS
2.7260
2.2260
1-1
S
136.00
174.00
111.00
26.00
447.00
9-CC (CG) (0787) CENTRAL REGION
(11229) PREPARED 06-13-97 CMD40 SEQ.0001
C-AN-13-PRINT001-0728-=-F
AMERICAN STATES INSURANCE COMPANY OF TEXAS PAGE 1-LAST
POLICY PERIOD: POLICY WORKSHEET NO: 04-CC-108976-1
FROM 05-30-97 TO 05-30-98
INSURED: JOHN RICHARD GRAVES AGENT: 42-57354
LIMITS OF INSURANCE
COMMERCIAL GENERAL LIABILITY
GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS -COMPLETED OPERATIONS) 2,000,000
PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT 2,000,000
PERSONAL AND ADVERTISING INJURY LIMIT 1,000,000
EACH OCCURRENCE LIMIT 1,000,000
FIRE DAMAGE LIMIT (ANY ONE FIRE) 50,000
MEDICAL EXPENSE LIMIT (ANY ONE PERSON) 5,000
---------------------- GENERAL LIABILITY PREMIUM DEVELOPMENT ---------------------
THIS POLICY IS SUBJECT TO ANNUAL AUDIT.
FERTILIZER MFG.
GROSS SALES (PER $1,000)
maw F.
FERTILIZER MFG.
GROSS SALES (PER $1, 000)
FERTILIZER MFG.
GROSS SALES (PER $1, 000)
���1•I������1�I�I�IKN
�I
k k
TOTAL ..... $ 447.00
ATTACHED FORMS: COVERI CGO103 1093 IL0275 1187 CG2639(0195) IL0168(0992) IL7201(0392)
6-3014 1193 6-2978 1293
CENTRAL REGION (11229) PREPARED 06-13-97 CMD30 SEQ.0001
C-AN-1 3- PR I NT001 -0728-M. F
IF
TAMERICAN STATES POLICY NUMBER: 04-CC-108976-1
INSURANCE
• pnr LINCOLN NATIONAL CORPORATION
I IIIIIIIIIIII111�111'III1�'111'�IIIIIIIIIIIIIIIIIIIIIIIIIIIIII
JOHN RICHARD GRAVES
DBA GRAVES & GIBSON INDUSTRIES
% DARIN HAMAKER
1401 W 5TH ST
PLAINVIEW, TX 79072
Thank you for placing your business with AMERICAN STATES INSURANCE COMPANY OF TEXAS
6-2413 (2-91) CENTRAL REGION 41 ( -347 ) CB INSURED COPY PREPARED 06-13-97 AGT
C-AN-I3-PRINT001-0729-ODOI-F
®r]AMERICAN STATES AMERICAN STATES INSURANCE COMPANY OF TEXAS `PAGE 1
INSURANCE INDIANAPOLIS, INDIANA
AP�4UNCOLNNATIONALCORPORATION COMMERCIAL INSURANCE POLICY
NAMED JOHN RICHARD GRAVES DECLARATIONS
INSURED DBA GRAVES & GIBSON INDUSTRIES
AND PO BOX 43 POLICY NUMBER 04—CC-108976-1
MAILING
ADDRESS PLA I NV I EW , TX 79073 C,1)�p
��VI.�! RENEWAL OF NEW 05-97
POLICY PERIOD FROM 05-30-97 TO 05-30-98 12:01 AM
STANDARD TIME AT LOCATION OF DESCRIBED PROPERTY.
AGENT MORGAN—EAVES AGENCY
NAME 716 BROADWAY STREET
AND P 0 DRAWER 650
ADDRESS PLAINVIEW, TX 79073
42-57354 (806) 296-551l�
THE TOTAL ESTIMATED PREMIUM FOR THE POLICY TERM IS $447.00.
YOU WILL BE BILLED THROUGH YOUR CUSTOMER ACCOUNT #070-0507-514-01.
THIS POLICY IS SUBJECT TO A FINAL AUDIT.
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 COVERAGE PARTS FOR
WHICH A PREMIUM IS INDICATED. THE PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
Premium
Commercial Property Coverage Part -Texas Standard Policy ................................. $
Electronic Equipment Protection Coverage Part .......................................... $
Commercial General Liability Coverage Part ............................................ $ 447.00
Boiler and Machinery Coverage Part ................................................. $
Commercial Crime Coverage Part ................................................... $
Commercial Inland Marine Coverage Part .............................................. $
Commercial Glass Coverage Part ....................................................$
Professional Liability Coverage Part ................................................. $
Total Provisional Premium $ 447.00
ARTICLE 6.13 POLICY A LIQUIDATED DEMAND. A FIRE INSURANCE POLICY, IN CASE OF TOTAL LOSS BY FIRE OF PROPERTY
INSURED, SHALL BE HELD AND CONSIDERED TO BE A LIQUIDATED DEMAND AGAINST THE COMPANY FOR THE FULL AMOUNT
OF SUCH POLICY. THE PROVISIONS OF THIS ARTICLE SHALL NOT APPLY TO PERSONAL PROPERTY.
COUNTERSIGNATURE
BY
(DATE) (AUTHORIZEDREPRESENTATIVE)
9-CC(T)0(0787)
COMPANY USE ONLY
CENTRAL REGION 41 (11229) CS AGENT COPY PREPARED 06-04-97 AGT
C-A N-O4- P R I N TO01-0426-0001-1
COMMERCIAL LIABILITY COVERAGE PART DECLARATIONS
NAMED INSURED: JOHN RICHARD GRAVES
FORM OF BUSINESS: INDIVIDUAL
PAGE CG 1-LAST
POLICY NUMBER: 04-CC-108976-1
-------------------------------------
L I M I T S O F I N S U R A N C E
COMMERCIAL GENERAL LIABILITY
GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS -COMPLETED OPERATIONS)2,000,000
PRODUCTS -COMPLETED OPERATIONS AGGREGATE LIMIT 82,000,000
PERSONAL AND ADVERTISING INJURY LIMIT 81,000000
EACH OCCURRENCE LIMIT 1,000:000
FIRE DAMAGE LIMIT (ANY ONE FIRE) $$ 50,000
MEDICAL EXPENSE LIMIT (ANY ONE PERSON) $ 5,000
---------------------------------------------------------------------------------
LOCATION OF ALL PREMISES YOU OWN, RENT, OR OCCUPY-
1. PO BOX 43
PLAINVIEW,TX 79073
----------------------------------------------------------------------------------
CODE I CLASSIFICATION -PREMIUM BASIS I EXPOSURE I RATE PREMIUM
---------------------------------------- ------
53077
53077
COMMERCIAL GENERAL LIABILITY
OTHER THAN PRODUCTS -COMPLETED OPERATIONS
** LOCATION # 1 **
FERTILIZER MFG.
GROSS SALES (PER $1,000)
TO MEET COVERAGE MINIMUM
COMMERCIAL GENERAL LIABILITY
PRODUCTS -COMPLETED OPERATIONS
** LOCATION # NA **
FERTILIZER MFG.
GROSS SALES (PER $1,000)
TO MEET COVERAGE MINIMUM
COMMERCIAL LIABILITY TOTAL
50,000
50,000
THE FOLLOWING FORMS CURRENTLY APPLY TO THIS COVERAGE PART:
IL0017
1185
- COMMON POLICY CONDITIONS
IL0021
1194
- NUCLEAR ENERGY LIABILITY ENDTS
CG0001
1093
- COMMERCIAL GENERAL LIABILITY
CGO103
1093
- TEXAS CHGS-CONDITIONS REQUIRING NOTICE
IL0275
1187
- TEXAS CHANGES -CANCELLATION & NONRENEWAL
CG2639
0195
- TEXAS CHGS-EMPL. RELATED PRACTICE EXCL.
IL0168
0992
- TEXAS CHANGES - DUTIES
IL7201
0392
- COMPANY COMMON POL CONDITIONS
2.7260
2.2260
S
136.00
174.00
111.00
26.00
447.00
9-CC(CG)(0787)CENTRAL REGION (11229) PREPARED 06-04-97 CMD40 SEQ.0001
C-AN-04-PRINT001-0426-M-1
,
Workers' Compensation and Employers' Liability Insurance Policy
COMMERCIAL CASUALTY INSURANCE COMPA NT -
NCCI COMPANY NUMBER 27871
INFORMATION PAGE Policy
1. Named Insured and Address:(No.,Street, Town, County, State, Zip Code) Number: T 1049755A
GRAVES & GIBSON INDUSTRIES n
(A PARTNERSHIP) co
C/O DARIN HAMAKER, WILLIAMS,
MERIWETHERN, SMITH & CO.
1401 W. 5TH ST.
PLAINVIEW TX 79072
Employer is: PARTNERSHIP Renews No. NEW
Other workplaces not shown above:
5200 NORTH COLUMBIA PLAINVIEW TX 79072
2. Policy Period: (Mo.Day Yr.) FEIN # 752706052
12:01 A.M., standard time at the insured's mailing address. Risk ID #
From 5/30/97 to 5/30/98
Producer:
42-600002-00-1000-S-DB
MORGAN-EAVES AGENCY
P. 0. BOX 650
PLAINVIEW TX 79072
3. 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 3.A. The limits
of our liability under Part Two are: Bodily Injury by Accident $1A6 M:5'c0 ''each accident
Bodily Injury by Disease $500, 000 olicy limit
Bodily Injury by Disease $1L00-000Y V-" ach employee
C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here:
CALIFORNIA, COLORADO, KANSAS, NEBRASKA, MISSOURI, TEXAS AND UTAH.
D. This policy includes these endorsements and schedules: WC 00 00 00 A WC 99 06 03
WC 42 03 01 D WC 42 04 03 WC 42 03 08 WC 99 06 02 WC 99 06 02
4. The premium for this policy will be determined by our Manuals of Rules, Classification, Rates and Rating
Plans. All information required below is subject to verification and change by audit.
Classifications
Code Premium Basis
No. Total Estimated
Annual Remuneration
SEE EXTENSION SCHEDULE ATTACHED
PREMIUM DISCOUNT
EXPENSE CONSTANT
ESTIMATED POLICY PREMIUM
Minimum Premium: $250 Deposit Premium:
Payroll reporting and premium adjustment period:
WC 00 04 06
Rate Per Estimated Annual
$100 of Premium
Remuneration
$ 7 , 284 ���,
$192
$140
$7,232
$1,446
SEMI-ANNUAL CHECKING M-643
Countersigned at
on
Copyright 1987 National Council on Compensation Insurance.
PM By
AUTHORIZED REPRESENTATIVE
AGENT WC 00 00 01A
WE 99 06
�• COMMERCIAL CASUALTY INSURANCE COMPANY
EXTENSION SCHEDULE POLICY NO.
T 1049755A
Item j6b4 of the Information Pane Is amended to read: 5/30/97
CODE NOS. POLICY SCHEDULE CLASSIFICATIONS OF PRINCIPLE OPERATIONS
ESTIMATED
ANNUAL
REMUNERATION
RATE PER
$100 OF
REMUNERATION
ESTIMATED
ANNUAL
PREMIUM
TEXAS
4583 COMPOST MFG - COTTON HULLS - & DRIVERS
SUBTOTAL
ESTIMATED STANDARD PREMIUM
92,560 7.87
7,28
7,28
7,28
AGENT
WC 99 06 02
Agency: MORGAN—EAVES AGENCY No. 6 T 1049755A
Employer. GRAVES & GIBSON INDUSTRIES Date: 5/30/97
From: 5/30/97
To: 5/30/98
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
ENDORSEMENT
IT IS AGREED THAT THERE WILL BE MONTHLY ARBITRARY.BILLING(S) OF
ON THIS POLICY.
DUE DATE
am>.ate=e
AMOUNT
m
JUNE
m
30,
1997
;w;
$643
JULY
30,
1997
$643
AUGUST
30,
1997
$643
SEPTEMBER
30,
1997
$643
OCTOBER
30,
1997
$643
NOVEMBER
30,
1997
$643
DECEMBER
30,
1997
$643
JANUARY
30,
1998
$643
FEBRUARY
28,
1998
$643
$643
THE FOLLOWING SPACES ARE TO BE COMPLETED ONLY IF THIS ENDORSEMENT IS NOT ATTACHED TO
THE POLICY WHEN ISSUED.
The effective date of this endorsement is , AT 12:01 A.M.
This endorsement when countersigned by a duly authorized representative of the undermentioned Company and attached to Policy No.
issued to
shall be valid and shall form part of said policy.
Countersigned at COMMERCIAL CASUALTY INSURANCE COMPANY
By
AUTHORIZED REPRESENTATIVE
AGENT
Agency: MORGAN—EAVES AGENCY
Employer. GRAVES & GIBSON INDUSTRIES
WC 42 03 08
No. 4 T 1049755A
Date: 5/30/97
From: 5/30/97
To: 5/30/98
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
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
PARTNER JOHN GRAVES PARTNER
PARTNER SCOTT A. GIBSON PARTNER
SIGNED AND ACCEPTED:
OFFICER/PARTNER/OWNER
THE FOLLOWING SPACES ARE TO BE COMPLETED ONLY IF THIS ENDORSEMENT IS NOT ATTACHED TO
THE POLICY WHEN ISSUED.
The effective date of this endorsement is , at 12:01 A.M.
This endorsement when countersigned by a duly authorized representative of the undermentioned Company and attached to Policy No.
issued to
shall be valid and shall form part of said policy.
Countersigned at COMMERCIAL CASUALTY INSURANCE COMPANY
By
AUTHORIZED REPRESENTATIVE
AGENT
WC420403A
Agency: MORGAN-EAVES AGENCY No. 3 T 1049755A
Employer. GRAVES & GIBSON INDUSTRIES Date: 5/30/97
From: 5/30/97
To: 5/30/98
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
TEXAS EXPERIENCE RATING MODIFIER ENDORSEMENT
The premium for the policy will be adjusted by an experience rating modifier, if any, which was not available when
the policy was issued. We will issue an endorsement to show the proper factor when it is calculated.
THE FOLLOWING SPACES ARE TO BE COMPLETED ONLY IF THIS ENDORSEMENT IS NOT ATTACHED TO
THE POLICY WHEN ISSUED.
The effective date of this endorsement is at 12:01 A.M.
This endorsement when countersigned by a duly authorized representative of the under -mentioned Company and attached to Policy No.
issued to
shall be valid and shall form part of said policy.
Countersigned at COMMERCIAL CASUALTY INSURANCE COMPANY
By
AUTHORIZED REPRESENTATIVE
AGENT
DEDUCTIBLE NOTICE OF ELECTION TO ACCEPT
TEXAS WORKERS COMPENSATION BENEFITS
Texas law permits an employer to obtain workers compensation insurance with a deductible. The deductible applies
to benefits payable under Texas Workers' Compensation Law. The insurance applies only to benefits in excess of the
deductible amount. The deductible applies separately to each accident or disease regardless of the number of people
who sustain injury by such accident or disease or as an annual aggregate or as a combination of both. The deductible
plans have been explained to me. Premium reductions are determined based on the deductible selected and the hazard
group. The hazard group is determined by the classification that produces the largest amount of estimated Texas
standard premium.
You are not required to choose a deductible. If you do choose one, your insurance company will pay the deductible
amount for you, but you must reimburse the insurance company within 30 days after they send you notice that payment
is due. If you fail to reimburse the insurance company, they may cancel the policy upon ten days written notice, and
any resulting premium may be applied to the deductible amount owed.
If a deductible amount is desired, please indicate below.
❑ Yes, I want a deductible of (select only one):
1. $ per accident
2. $
annual aggregate
3. $ /$ per accident/annual aggregate
applied to benefits payable under the Texas Workers' Compensation Law. I understand that the company will pay
the deductible amount and seek reimbursement
(monthly, quarterly or other)
® No, I do not want a deductible applied to benefits payable under the Texas Workers' Compensation Law.
❑ Yes, I do want a deductible policy, but am unable to obtain one for the following reason:
GRAVES & GIBSON INDUSTRIES 5/30/97
Employer Name (print or type)
Signature and Title
Date
T 1049755A
Policy Number
Form 42-3
Agency: MORGAN—EAVES AGENCY
Employer. GRAVES & GIBSON INDUSTRIES
WC42030.1 E
No. 2 T 1049755A .
Date: 5/30/97
From: 5/30/97
To: 5/30/98
TEXAS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY
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.
1 of 3
AGENT
0
WC 42 03 01 E
PART FOUR - YOUR DUTIES IF INJURY OCCURS
Number 6 of this part is amended to read:' T 1049755A
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.
PART FIVE - PREMIUM
A. Our Manuals is amended by adding the sentence:
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 the 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 cancelled 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. Cancelation is amended to read:
1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancelation
is to take effect.
2 We may cancel this policy. We may also decline to renew it. We must give you written notice of
cancelation 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 Workers' Compensation Commission.
3. Notice of cancelation or nonrenewal must be sent -to you not later than the 30th day before the date on
which the cancelation or nonrenewal becomes effective, except that we may send the notice not later
than the 10th day before the date on which the cancelation or nonrenewal becomes effective if we cancel
or do not renew because of:
a. Fraud in obtaining coverage;
b. Failure to pay a premium when payment was due;
c. An increase in the hazard 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;
d. 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.
2 of 3
AGENT
-WC 420301 E
T 1049755A
4. If another insurance company notifies the Texas Workers' Compensation Commission that it is insuring
you as an employer, such notice shall be a cancellation of this policy effective when the other policy
starts.
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 shall 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
Workers' Compensation Commission. You may, in writing, elect to waive this notification requirement.
We shall, on 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: SHOULD ANY DISPUTE ARISE ABOUT YOUR PREMIUM OR ABOUT A CLAIM THAT
YOU HAVE FILED, CONTACT THE AGENT OR WRITE TO THE COMPANY THAT ISSUED THE POLICY. IF
THE PROBLEM IS NOT RESOLVED, YOU MAY ALSO WRITE THE TEXAS DEPARTMENT OF INSURANCE,
P.O. BOX 149091, AUSTIN, TEXAS 78714-9091, FAX# (512) 475-1771. THIS NOTICE OF COMPLAINT
PROCEDURE IS FOR INFORMATION ONLY AND DOES NOT BECOME A PART OR CONDITION OF THIS
POLICY.
THE FOLLOWING SPACES ARE TO BE COMPLETED ONLY IF THIS ENDORSEMENT IS NOT ATTACHED TO
THE POLICY WHEN ISSUED.
The effective date of this endorsement is , at 12:01 A.M.
This endorsement when countersigned by a duly authorized representative of the under -mentioned Company and attached to Policy No.
issued to
shall be valid and shall form part of said policy.
Countersigned at
By
AUTHORIZED REPRESENTATIVE
COMMERCIAL CASUALTY INSURANCE COMPANY
3of3
AGENT
Agency. MORGAN-EAVES AGENCY
Employer. GRAVES & GIBSON INDUSTRIES
• WC 00 04 06
No. 1 T 1049755A '
Date: 5/30/97
From: 5/30/97
To: 5/30/98
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
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 determind by our manuals and your premium basis as determind by audit. Premium
subject to retrospective rating is not subject to premium discount.
Schedule
Estimated Eligible Premium
First Next Next
1. State $5,000 $95,000 $400,000
TEXAS 0% 8.40% 10.50%
2. Average percentage discount: 2.64 %
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:
Balance
11.00%
THE FOLLOWING SPACES ARE TO BE COMPLETED ONLY IF THIS ENDORSEMENT IS NOT ATTACHED TO
THE POLICY WHEN ISSUED.
The effective date of this endorsement is , at 12:01 A.M.
This endorsement when countersigned by a duly authorized representative of the under -mentioned Company and attached to Policy No.
issued to
shall be valid and shall form part of said policy.
Countersigned at COMMERCIAL CASUALTY INSURANCE COMPANY
By
AUTHORIZED REPRESENTATIVE
Copyright 1983 National Council on Compensation Insurance. AGENT
1
vv AMER4CAN STATES AMERICAN STATES INSURANCE COMPANY OF TEXAS
PAGE 1
INSURANCE INDIANAPOLIS, INDIANA
.,.nrUNC.OLNNATIONALCORPORATI COMMERCIAL INSURANCE POLICY
C
NAMED JOHN RI CHARD GRAVES DECLARATIONS
INSURED DBA GRAVES & GI BSON I ND . %
AND MAILING DARIN HAMAKER POLICY NUMBER 04-BA-427429-1
/� R�v�o-I
ADDRESS 1401 W 5TH ST (p RENEWAL OF NEW 05-97
PLAINVIEW, TX 79072
POLICY PERIOD FROM 05-30-97 TO 05-30-98 12:01 AM
STANDARD TIME AT LOCATION SHOWN ABOVE.
AGENT MORGAN-EAVES AGENCY
NAME 716 BROADWAY STREET
AND ADDRESS P 0 DRAWER 650
PLAINVIEW, TX 79073
42-57354 (806) 296-5514
THE TOTAL PREMIUM DUE FOR THE POLICY TERM IS $80.00.
YOU WILL BE BILLED THROUGH YOUR CUSTOMER ACCOUNT #070-1293-180-01.
YOU NEED NOT PAY ANY PREMIUM AT THIS TIME. WE WILL SEND A BILLING
STATEMENT IN A SEPARATE MAILING.
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.
COMMERCIAL AUTO COVERAGE PART .................... $ 80.00
�%t
COUNTERSIGNATURE
BY
(DATE) (AUTHORIZED REPRESENTATIVE)
-w
9-CC(0887)
COMPANY USE ONLY
CENTRAL REGION 41 (11229) CB AGENT COPY PREPARED 06-13-97 AGT
C-AN•13-PFIINT001-0726-0001 •E
0
BUSINESS AUTO COVERAGE PART DECLARATIONS PAGE BA 1 -LAST
ITEM ONE -- NAMED INSURED: POLICY NUMBER: 04-BA-427429-1
-------- JOHN RICHARD GRAVES
FORM OF BUSINESS: INDIVIDUAL
ITEM TWO -- SCHEDULE OF COVERAGES AND COVERED AUTOS
THIS POLICY PROVIDES ONLY THOSE COVERAGES WHERE A CHARGE IS SHOWN IN THE
PREMIUM COLUMN BELOW. EACH OF THESE COVERAGES WILL APPLY ONLY TO THOSE "AUTOS"
SHOWN AS COVERED "AUTOS." "AUTOS" ARE SHOWN AS COVERED "AUTOS" FOR A PARTICULAR
COVERAGE BY THE ENTRY OF ONE OR MORE OF THE SYMBOLS FROM THE COVERED AUTO
SECTION OF THE BUSINESS AUTO COVERAGE FORM NEXT TO THE NAME OF THE COVERAGE.
COVERED
LIMIT OF AUTO
COVERAGES INSURANCE DEDUCTIBLE SYMBOL PREMIUM
LIABILITY $ 11000,000 8,9 $ 80.00
---------------------------------------------
ESTIMATED TOTAL PREMIUM $ 80.00
---------------------------------------------
ITEM THREE -- SCHEDULE OF COVERED AUTOS YOU OWN
NO SCHEDULED VEHICLES
ITEM FOUR -- SCHEDULE OF HIRED OR BORROWED COVERED AUTO LIABILITY COVERAGE
--------- PREMIUMS
RATE
ESTIMATED PER $100 MINIMUM
STATE COST OF HIRE COST OF HIRE PREMIUM PREMIUM
-------------- -- -- - -
TEXAS IF ANY 29.40 $ 29.00 $ 29.00
---------------------------------------------------------�--
(TOTAL PREMIUM $29.00
---------------------------
COST OF HIRE MEANS THE TOTAL AMOUNT YOU INCUR FOR THE HIRE OF "AUTOS" YOU DO NOT OWN
THNOT EIRIFAMIDING "AUTOS" YOU BORROW OR RENT FROM YOUR PARTNERS OR YOUR EMPLOYEES OR
LY COST OF HIRE DOES NOT INCLUDE CHARGES FOR SERVICES PERFORMED BY MOTOR CARRIERS OF
PROPERTY OR PASSENGERS.
ITEM FIVE -- SCHEDULE FOR NON -OWNERSHIP LIABILITY
RATING BASIS NUMBER PREMIUM
------------------ -------- ---------------
EMPLOYEES 3 51.00
------------------------------------------
ITOTAL PREMIUM $ 51.00
------------------------------
THE FOLLOWING FORMS CURRENTLY APPLY TO THIS COVERAGE PART:
E0040
0194
- AMENDATORY ENDORSEMENT - TEXAS
E9917G
0895
- INDIVIDUAL NAMED INSURED
E0001
0392
- BUSINESS AUTO COVERAGE FORM ,
E0017
0392
- COMMON POLICY CONDITIONS
IL0021
1187
- NUCLEAR ENERGY LIAB EXCLUSION-BRD FRM
IL7201
0392
- COMPANY COMMON POL CONDITIONS
E0039B
1292
- AMENDATORY ENDORSEMENT -TEXAS
E9979A
1187
- TEXAS PREMIUM DISCOUNT
6-3015
0995
- LOSS CONTROL SAFETY SERVIC
6-3101
0196
- CUSTOMER BILLING CONVERSION
9-CC(BA)(0787)
CENTRAL REGION (11229) PREPARED 06-13-97 CM2E6 SEQ.0001
C.GN_1 Z_04ll NTM1_n7)AX l.G
i
®^ NSURANCETATES IMPORTANT - PLEASE REVIEW s-a1z4A
1 � (8-94)
A„ .1 LINCOLN NATIONAL CORPORATION
Named Insured: JOHN RI CHARD GRAVES
Policy No: 04—BA-427429-10
Agent: MORGAN—EAVES AGENCY
Address: 716 BROADWAY STREET
Phone: (806) 296-5514
Dear Valued Policyholder,
We appreciate the opportunity to write your commercial auto coverage. Please take a minute to review your policy.
Your policy has been issued based on the drivers listing below. In order to insure that your policy is issued with the most
current information, please review this list and update as necessary. Include employees who drive their own vehicles on
company business or anyone who will drive an insured vehicle. Contact your independent agent to advise of any changes.
Also, remember to report all newly hired employees to your agent during the year.
Thank you for your business!
DRIVERS DATE
NAME OF DRIVER DATE OF BIRTH LICENSE NUMBER STATE OF HIRE
NO DRIVER INFORMATION ON FILE
P_etit-1 I -PA INTMI d1MXMR.F
AMERICAN STATES INSURANCE COMPANY OF TEXAS PAGE 1-LAST
POLICY PERIOD
COMMERCIAL AUTO WORKSHEET
NO: 04-BA-427429-1
FROM 05-30-97 TO 05-30-98
INSURED: JOHN RICHARD GRAVES
AGENT:
42-57354
---------------------------AUTO PREMIUM
DEVELOPMENT-----------------------------
RATING
NUM OF
BASE
SPLIT/INCREASE
PREMIUM
BASIS
EMPLOYEES
PREM
ADJUSTMENT
NON -OWNED LIAB EMP
3
$ 51.00
STATE
COH
ANNUAL COST
PREMIUM
RATE
OF HIRE
HIRED AUTO LIAB
- -
42
29.40
--------
IF ANY
-----------
$ 29.00
FORM NUMBER
------------------------------------------------------------------------
COVERI 0193
COVBK 0193
E0040
0194 E9917G
0895
E0001 0392
E0017 0392
IL0021
1187 IL7201
0392
E0039B 1292
E9979A 1187
6-2845
1092 6-3015
0995
63124A 0894
63124B 0894
6-3101
0196
-----------------------------------
TOTAL POLICY PREMIUM: $ 80.00
-----------------------------------
CENTRAL REGION (11229) PREPARED 06-13-97 CM2H6 SEQ. 0001
®1 NSURANCE STATE TEXAS PREMIUM DISCOUNT TE 99 79A
• m+ (11-87)
UNCOLN NAMNAL CORPORATION
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
TRUCKERS COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below:
Endorsement Effective
Policy Number
05-30-97
04—BA-427429-1
Named Insured
Countersigned by
JOHN RICHARD GRAVES
(Authorized Representative)
Policies included in Texas Estimated standard premium (as
premium discount determination: determined in A. below):
Discount ratios (as determined in B. below) applicable to Texas premium subject to this endorsement:
Public (excluding school buses),
zone rated autos %
All other autos (including school
buses), garages
A. ADDITIONAL DEFINITION
B. TEXAS PREMIUM DISCOUNT
The following are added to the DEFINITION Section
Applicable as follows:
and have special meaning for this Texas Premium
1. For policy periods of one year or less. The Texas
Discount Endorsement.
Standard Premium is subject to the discount ratio
1. Texas Standard Premium means premiums for
shown opposite the column labeled "Standard
auto liability, auto medical payments and
Premium" that appears in the Table of Auto
personal injury protection coverages for covered
Discount Ratios contained in the Texas
autos under the policies shown in this
Automobile Manual.
endorsement which are subject to Texas rates
2. For policy periods of more than one year. The
and premiums, excluding any premiums subject
Texas Standard Premium for each annual period
to retrospective rating.
or portion thereof during the policy period is
2. Standard Premium means all premiums for auto
subject to the discount ratio as explained in 1.
liability, auto medical payments and personal
above.
injury protection coverages for covered autos
3. For Texas premium subject to retrospective
under the policies shown in this endorsement,
rating, the applicable premium discount (using
including premiums for those exposures in states
the table contained in the Texas Automobile
other than Texas, but excluding any premiums
Manual) is the difference between:
subject to any retrospective rating plan.
Page 1 of 2
® AMERICAN STATES
INSURANCE
• wd LINCOLN NATIONAL CORPORATION
6-2845
(10-92)
NOTICE: A fee of $ is payable in addition to the premium due under this policy. This fee reimburses the
insurer, as permitted by 28 TAG §5.205, for the $1.00 fee per motor vehicle year required to be paid to the Automobile Theft
Prevention Fund under Texas Civil Statutes, Article 4413(37), §10, which became effective on June 6, 1991.
C-AN-I3-PRINT001-0726.0011-E
J
® AMERICAN STATES
INSURANCE
A W d UNCOLN NATIONAL CORPORATION
POLICY NUMBER: 04—BA-427429-1
I'IIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111 " IIIIII
JOHN RICHARD GRAVES
DBA GRAVES & GIBSON IND. %
DARIN HAMAKER
1401 W 5TH ST
PLAINVIEW, TX 79072
Thank you for placing your business with AMERICAN STATES INSURANCE COMPANY OF TEXAS
6-2413 (2-91) CENTRAL REGION 41 ( -347 ) CB INSURED COPY PREPARED 06-13-97 AGT *
®rIAMERICAN STATES
INSURANCE
• P.M LINCOLN NATIONAL CORPORATK
Dear Policyholder,
6-3101
(1-96)
We are pleased to offer you a more flexible way to pay your policy premiums with a new billing system we've developed to
give you more choice.
You can choose to pay a monthly installment or choose to pay any amount greater than the installment, up to the entire
account balance.
You need not pay any premium at this time. We will mail you a billing statement at a later date. That statement will
include:
• Your payment options,
• A record of your policy activity, and
• The policy numbers charged to your account.
If you have more than one policy with our company, you may choose to have the premium for any or all of those policies
included in one billing statement. If you would prefer a combined statement, please contact your agent.
Your agent will be pleased to help you with any other questions you may have concerning this new system.
Thank you,
American States Insurance Group
.......,.. .... .• .... 09/19! 9?
..................................
oltoDucea
TMS CERTIRCATE M MSLWB AS A MATTER OF MIFORMATM
ONLY AND CONFERS NO RIGM& UPON THE C£RTEMATE
bdosgaa-Eaves Ayeriey
HOLDER TM CER•TFICATE DM NOT AMEND. EXTEND Oft
716 Htoadway
ALTER THE COVERAGE AFFORDED 6Y THE POLICIES 861MV I.
Pla3aviaw TX 79072
! COMPAMES AFFOROM COVERAGE
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TOM* Faye �1
powo 06- 96-SS14 F*% 6- 6-59
COMPANY
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COMPANY "
a Ca®arci.al Caanaity x=uraare
Staves i Maca Industries
COMPANY
9 Darin Hamakez
A C
1401 Q 5th
COMPANY
1'1aiuviea = 79072
0
6: .............. ....... ....... ........... ............ ....... .......
THM 15 TO CERTIFY THAT THE POLKOES OF NSURANOE LISTED BELOW NAVE SEEN MAUED TO TOE NiSUREO NAMED ABOVE FOR THE P'OLM PERIOD
ND"TEC. NOMTHSTANOMX3 ANY REQUYU ENT. TERM OR CONDMON OF ANY QONTRACr OR OTHER OOCLUEF T WITH RESPECT TO WHICH TKS
CERTIFICATE 1tiAAY BE 9MUED OR MAY PERTAIN. THE &=RANCE AFFORDED BY THE POLICIES DESCRIBED HEM N IS SUMCT TO ALL THE TM4.
EXCUMONS AND CONDMONS OF SUCH POUCIES. LISTS SHOMAN MAY HAVE BEE REDUCEDByPAM CL"AS.
o TVPE OF WSURANCE POLOY NUMO®l
Y j T Lom
I
OQNERAL
LL43LMV
OENERALAMA ELATE
$ 2 000 , 000
z
CBNMOMALGENERALUMU Y
04-CC-108976-3.
05/30M
05/30/96
X
PROO[=-CrOLUKIPAGO
$ 2,040.000
"CLAWS WIDE occuR
:1,000.000
PEAS L:ACVKAARY
OWNS" t CONTRACTO" PROT
EACrt o
s 1,000,000
RRE DAMAGE ON ose full
950,000
MIEOI:xP(Any mapwa*
95,000
ANYAXO
048A-427429-1
05/30/97 {
05/30/97
COON ED&NOLELUT
S1,00 0,000
ALLOWNMAUMS
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i
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$CWMULED AV=
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PROPERTY DAMAGE
s
BAWE LIIBRRY
AUTO ONLY- EA ACCIDENT
i
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-
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s
excess LIANLnY
FJM4 OCCURF4UJCC
: 1 00.0 , 000
A
S UNBRELIJLA*01iIA
01SU204505-1
05/30/97" 05/30/98
AGGREGATE
s
i
CrHER THAN UMBRELLA FORM[
W ORKOM COYPMOATM AND
WC A
e,/PLDYERs LIAAiLRY
i
EL EADI ACCIDENT
S SDG� 00fl
H
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21049755A
j 05/30/97 05/30/98
_
5 600,.000
ELOWME-POLICYLUT'
Tt&-RS0QXLMV6 p
q
I
ELCMEASE-EA EMPLOYEE
$ 500,000
oFFCOSAM EICCL
!
OTma
�
I
t�cwvswN oA: oPEw►TIaN>9A.ocA tries
City of I.tsbboaic additional insured.
•lvSRTF>lCAis! 3�DEF.t:�: TW4t�:
•
CZ cr L ANY oP THE ABOVE OF.SCRIBfD Fouees A3L' e;AeICeLL®BeFolteTeel:
EXPIRATION MATE THOZ OR, THE M5L2 W COMPANY WILLel =VOA TOWAIL
�Q OAlfa WRi7TE71 NOIICETB THE CA,TE HOLDER ItA�ED T07NE LEFT.
City Of Lubbock
WJT FA[LURE TO MAIL SUCH MOTICE SMALL WPM NO 05"TM OR UAOALtrY
Lubbock TY 79404
QFOff "MUPON1NEDOW IWOM Oft RE9RE 0TAna&
AYT►iORia:O REPItEbEMTA
L>eaa Pi il.
.. ..... ......... 't1r1IWe1L�1.
(;RAVES & GIBSON INDUSTRIES
P.O. BOX 43
PLAINVIEW, TEXAS 79073
STATEMENT OF MONTI ILY
RECYCLING ACTIVITY
DATE
Ilntt
Qwnity
Ikunptnni
I Intt I'mm
Date lhlir-d
Tcunl
Ixnind
1700
Aluminum Cuns
a 44/ rwmmd
(9/30/97
S748.00
tan
4000
Wwl fans
S35.0W ton
04/3(I/97
S X00
p„und
2600
K I Plastic
a (I I/p ,und
04/30/97
S260)
pound
2600
M2I'lasmc
0.104xxu►d
041.10/97
S260.00
Total $11(40)
(WAVES & r11MON INDus IES
RESOLUTION NO.5485
Itea #27
May 8, 1997
F6UM -G TEXAS CONTRACT FOR SEPARATION AND
OF RECYCLABLE MATERIALS
CITY OF LUBBOCK
WHEREAS, the city of Lubbock heretofore solicited Request for proposals pursuant
to Bid No. 97053 for the separation and composting of recyclable materials, a copy of which is
attached hereto as Exhibit A and made a part hereof for all purposes; and
WFMREAS, the best proposal for such services was made by Graves and Gibson
Industries; NOW THEREFORE:
WTTNESSETH:
THIS, contract, made this 15 �&_ day of _ - M , 1997, by and between the
City of Lubbock, Texas hereinafter called "City," and GraveY & Gibson Industries, hereafter
called "GGI."
1.
The City hereby hires GGI to perform the duties set forth in the Request for proposals
attached hereto as Exhibit A attached hereto and GGI hereby agrees to perform such duties as
quoted. In the event of a conflict between the Request for Proposals Terms and Conditions or
General Conditions and this Contract, this Contract shall eontroL A copy of GGrs proposal is
attached hereto as Exhsbit B for establishing the consideration to be paid by the parties hereto
and said exhibit shall be valid for no other purpose.
2.
Nothing herein shall be construed as creating the relationship of employer and employee
between the City and GGrs employees. GGI shall be deemed at all times to be an independent
contractor. In carrying out the terms of this contract, GGI shall select its own employees and such
employees shall be and act under the exclusive and complete supervision and control of GOL
3.
GGI agrees to indemnify and hold the City harmless from any and all loss or damage and
from all claims for injury, death, loss or damage of any kind or character, and by whomsoever
suffered or occasioned by or in connection with the activities of GGI or its employees as a result
of this contract
4.
GGI 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.
S.
Payments for recyclables shall be based on local vendor buying prices and made in accordance
with the schedule contained in Exhibit A attached hereto. Payments for separation of recyclables shall
be made in accordance with the schedule contained in Exhibit A attached hereto.
6.
The terms of this contract shall be for a period of three (3) years and it shall be
renewable annually for two additional years. The term shall commence upon the date of
execution hereof.
9.
If GGI defaults in the performance of any of its obligations hereunder and remains in
default for thirty (30) days after receipt of a written notice of such default from the City, the
City may declare this contract terminated immediately.
contract
E:1
The laws of the State of Texas shall control with regard to the interpretation of this
9.
GGI shall not assign or sublet this contract without the prior written approval of
the City. GGI will not accept this contract unless there is a composting facility that will
accept the recyclable material for composting.
Contract for Separation and Composting
of Recyclable Materials - GGI Page 2
10.
The City shall be entitled to inspect GGTs books and records during regular busiaess
hours of the City with regard to such matters as are relevant to this contract. Further, the City
may require certification of the accuracy of the scales used by GGI as mquired, but not more
than two (2) times per calendar year.
GRAVES & GIBSON INDUSTRIES
BY:
,Z�JOHN RICHARD RAVES
MANAGER
CITY OF LUBBOCK.
FNA
ATTEST:
TAYTE DARNELL, CT.TY SECR.ETJi,ItY"
APPROVED AS TO CONTENT:
Contract for Seperation and Composting
of Recyclable Materials - GGI
Page 3
R1:11 #9700. CgP1rat1.X1 and CCWnP1.g51µ 4 It'v%clahlc NbIL- +al.
PROPOSAL SUBMITTAL FORM
CITY OF LUBBOCK
REQUEST FOR PROPOSALS 997063
Separation and Composting of Recyclable Materials
The undersigned hereby offers to furnish and deliver the articles or services as specified herein and in
their proposal and proposed contract (ATTACHED) at the terms stated therein and in strict accordance
with the specifications, all of which are made a part of this offer.
Maximum number of days from signing of contract to inception: 40 THIS PROPOSAL IS VALID
FOR .%Q_ DAYS.
ACKNOWLEDGE receipt of ADDENDA:#1 41-' #2 AP #34e-- #d
Name of Business (Stamp maybe used):A r,kr""
Address: /00• Loy '4'3
City: State:_ Zip 7 9d23
DBE Firm:
By
Woman
Black American
Native American
Hispanic
American
I
Asian Pacific
I American
Other (Specify)
Authorized Representative - must sign by hand
Business Telephone Number_ AyG —,.9.3 — or � Fax Numbers 14? 96 —si 90
The City of Lubbock is always very conscious and extremely appreciative of the time and effort you must
have expended to submit a proposal. We would appreciate you indicating on your ONO PROPOSAL'
response any requirements of this proposal request which may have influenced your decision to `NO
PROPOSAL'.
Do not sell this commodity or service
Cannot meet specifications.
Job too small.
Cannot provide required insurance.
Bid directs by Manufacturer.
Job too large.
Cannot provide required bonding.
Bidding through dealer.
Do not wish to do business with the City of Lubbock. (Letterhead attached with explanation.)
15