HomeMy WebLinkAboutResolution - 2002-R0095 - Transportation Contracts - Acosta Drilling - 03_14_2002Resolution No. 2002-R0095
March 14, 2002
Item No. 27
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, contracts between the City
of Lubbock, Texas Department of Transportation, and Acosta Drilling for temporary use
of highway right-of-way during groundwater nitrate investigations. Said Contracts are
attached hereto and incorporated in this resolution as if fully set forth herein and shall be
included in the minutes of the City Council.
Passed by the City Council this 14th day of March , 2002.
/4LJ
WINDY SITT N, MAYOR
ATTEST:
City Secretary
APPROVED AS TO CONTENT:
Ed Bucy
Right -of -Way Agent
APPROVED AS TO FORM:
William de Haas
Contract Manager/Attorney
Dh/Ccdocs/Acosta,TxDOT,COL.res
February 14, 2002
14 a Resolution No. 2002-R0095
Texas Department of Transportation
P.O. MOX 771 * LUBBOCK, TEXAS 79408-0771 * (806) 745411
02/20/02
Temporary Substance Investigation Permit
FM 835/FM 1729
Lubbock, County
Carrie G. Dorrance
Environmental Compliance Specialist
City of Lubbock, Texas
Dear Mr. Dorrance:
Enclosed for your files is one fully executed copy of the Agreement for Temporary Use of Highway
Rights of Way between the TNRCC and TXDOT.
We urge that proper safety measures as outlined in the Texas Manual Of Uniform Traffic Control
Devises be employed to protect the public at all times.
Drilling must be accomplished on the back slope of the highway facility at three (3) feet from the right of
way line. The Lubbock District records do not indicate any recorded utilities in this area, but this should
be investigated to determine the true on -site situation. It is suggested that the utility locator services be
contracted before any digging commences. The 800 number is 1-800-DIGTESS (344-8377).
At the request of Ron Baker PE., Area Engineer, please advise James Phillippe Maintenance Supervisor
for Lubbock County Maintenance Section Supervisor, by calling (806) 745-4688 or by mail PO Box 771
Lubbock, TX 79408 respectively, when actual work will begin.
Wells must be placed no closer than 3 feet behind the back of curb & gutter sections and no closer
than 16 feet from the edge of travel lanes where no curb & gutter exists.
We appreciate your patience and cooperation in this matter and if additional information is needed, please
advise Mr. Guy Sledge at P.O. Box 771, Lubbock, TX 79408 or Phone (806) 748-4486.
Si .. erely,
aude Kneisley
District R.O.W.Administrator
Lubbock District
CCK/jt
cc: Ron Baker PE., Area Engineer
James Phillippe, Maintenance Supervisor Lubbock, TX
An Equal Opportunity Employer
Resolution No. 2002-R0095
March 14, 2002
Item 27
AGREEMENT
FOR TEMPORARY USE OF HIGHWAY RIGHT OF WAY
DURING GROUNDWATER NITRATE INVESTIGATIONS
State of Texas
County of Lubbock
This Agreement is made by and between the Texas Department of
Transportation, hereinafter referred to as the "State" and both Acosta Drilling,
hereinafter referred to as the "Contractor(s) and the City of Lubbock, hereinafter
referred to as the "Owner(s)".
WITNESSETH
WHEREAS, the Contractor(s) and Owner(s) desire to perform/install a flush
mount monitoring well within highway right-of-way on East 50"` Street and to establish
the presence, extent, or absence of nitrates in ground water in connection with the
Owner's Land Application site, with a Texas Natural Resource Conservation
Commission TPDES Permit No. 10353-002, Agreed Order dated 16 Nov 1989, and the
Ground Water Remediation Plan.
WHEREAS, the Contractor(s) and Owner(s) have requested permission from the
State to use East 50" Street Right-of-way approximately 4100 ft. east of the intersection
of F.M. 835/FM 1729 and about 55 feet south of the road centerline in the County of
Lubbock, for the purpose of constructing, maintaining, and operating a water quality
monitoring well hereinafter referred to as the "Activity" as shown on Exhibit "A" and
hereby made a part of this Agreement.
AND WHEREAS, the Texas Natural Resource Conservation Commission
(TNRCC) has given the State written concurrence that the Contractor(s) and/or Owner(s)
may need to access and temporarily use said highway right-of-way for purposes of
investigation for nitrates in connection with TPDES Permit No. 10353-002, Agreed
Order, and the Groundwater Remediation Plan, and said written concurrence is hereby
attached as Exhibit "B' and made part of this Agreement.
NOW, THEREFORE, in consideration of the premises and of the mutual
covenants and agreements of the parties hereto, to be by them respectively kept and
performed as hereinafter set forth, it is hereby agreed as follows:
1. It is expressly understood that except as set forth herein, the State does not
purport hereby to grant any right, claim, title, or easement in or upon this
highway. Furthermore, approval of this Agreement by the State does not
constitute approval by any other Texas State Agency.
2. The Activity shall be conducted in compliance with all governing laws and State
regulations and policies.
3. The Contractor and Owner shall have the Activity performed in such a manner so
as to minimize inconvenience to or interference with highway traffic. Any traffic
control devices required by said Activity shall be installed by the Contractor or
Owner and shall be in accordance with the Texas Manual on Uniform Traffic
Control Devices for Streets and Highways.
4. The Contractor and Owner shall provide necessary safeguards to protect the
public during the Activity including adequate insurance for payment of any
damages which might result from the Activity, and shall save the State harmless
from damages, to the extent of said insurance coverage and insofar as the
Contractor and Owner can legally do so.
5. The Contractor and Owner agree to indemnify and save harmless the State, its
agents and employees, from all suits, actions or claims, and from all liability and
damages for any and all injuries or damages sustained by any person or property
as a consequence of any neglect in the performance of the Activity and any
related action by the Contractor or Owner and from any claims or losses arising
or recovered under the "Workers' Compensation Laws"; Article 6252-19 of
Vernon's Civil Statutes (Texas Tort Claims Act); or any other laws.
6. The Contractor and Owner shall further indemnify the State and accept
responsibility for all damages or injury to property of any character, including
utilities, occurring during the prosecution of the Activity resulting from any act,
omission, neglect or misconduct on the part of the Contractor or Owner in the
manner or method of executing the Activity.
7. The Contractor's and Owner's attention is directed to the fact that utility
installations owned by others exist in the right-of-way. The Contractor or Owner
shall provide adequate notice of the Activity to all utility companies potentially
impacted by the investigations.
8. The referenced Activity shall conform to a plan of action with intent to:
(a) establish the presence, extent or absence of nitrates in the ground water
within the referenced highway right-of-way,
(b) determine ground water flow direction, or
(c) provide information for proposal of site remediation.
2
9. Prior to termination of this Agreement, the Contractor and Owner agree to
remove the Activity and all of its facilities from the highway right-of-way and
restore the right-of-way to its approximate original condition, free of any right-
of-way damage, including ruts or any other injury to the environment. It is
further agreed that the Contractor and Owner shall be liable for and obligated to
clean up and remediate any contamination of substances in the right-of-way
found to originate from the Owner's property. All liability and obligation shall
be borne by the Contractor and Owner until such time as a letter from the Texas
Water Commission (TWC) is received by the State stating that the said site
investigation and remediation is complete. Any costs incurred by the State for
repairs to the highway facilities, for removal of the Activity, or for any other
necessary restoration/remediation work performed by the State will be billed to
the Contractor and Owner at cost.
10. The Contractor and Owner have provided the State with a Certificate of
Insurance on a Department's standard form covering the below listed insurance
limits for the duration of the Activity. Contractor Certificate of Insurance shall
be endorsed with a Wavier of Subrogation in favor of the State. Such Certificate
of Insurance is attached as Exhibit "C" and is hereby made a part of this
Agreement.
A. Workers' Compensation Insurance
Amount - Statutory
The Contractor and Owner have provided the State a Certificate of Insurance on
a Department standard from covering the below listed insurance limits for the
duration of the Activity. Contractor Certificate of Insurance shall include
Contractual Coverage and shall be endorsed with a Waiver of Subrogation in
favor of the State and shall endorse the State as an Additional Insured.
B. Comprehensive General Liability Insurance
Amounts - Bodily Injury $500,000 each occurrence
Property Damage $100,000 each occurrence
$100,000 for aggregate
or
Commercial general Liability Insurance
Amount $600,000 combined single
limit each occurrence and
in the aggregate
C. Comprehensive Automobile Liability
Amounts - Bodily Injury $250,000 each person
$500,000 each occurrence
Property Damage $100,000 each occurrence
11. It is mutually agreed and understood that this Agreement shall terminate after a
period of not more than one (1) year from the date of the final execution of this
Agreement.
12. The State reserves the right to terminate this Agreement at any time after
notifying the Contractor and Owner in writing thirty (30) days in advance of the
intended termination. The State also reserves the right to extend the period of this
Agreement within thirty (30 days of receipt of a written request from the Owner).
The state shall review the Owner's request for time extension and if acceptable,
shall execute an amendment to this Agreement. Said amendments to this
Agreement shall be executed by the Contractor and Owner, and must include all
supporting documentation from the Contractor and Owner addressing all
proposed revisions to the Activity's limits and period of work. Said amendments
shall be attached hereto and shall be made a part of this Agreement.
In Testimony Whereof, the parties hereto have caused these presents to be executed on
the dates below stated.
city pboc
By. �/
Name: Windy Sitton
Mayor
Address: P.O. Box 2000
1625 13d' Street
Lubbock, TX 79457
Date: March 14, 2002
ATTEST:
By:
Rebecca Garza
City Secretary
Date: March 14, 2002
THE STATE OF TEXAS
Certified as being executed for
the purpose and effect of
activating and/or carrying out
the orders, established policies,
or work programs heretofore
approved and authorized by the
Texas Department Of
Transportation Commission
under the authority of Minute
Order 82513.
-(�; t s District engineer
Lubbock District
Date: Z- Zy- o z
4
APPROVED AS TO CONTENT:
Ed Bucy
Right of Way Agent
Date:
APPROVED AS TO FORM:
By:
William 4e-ass—
Contract Manager/Attorney
Date:
CONTRACTOR NAME:
Acosta Drilling
By:1
Name: Victor M. Acosta
Owner/Operator
Address: P.O. Box 1181
Lamesa, TX 79331
Phone: (806) 872-5850
Date: � — ?--- 02
List of Attached Exhibits
A --Site Layout & Proposed Activity
B_--TNRCC Concurrence
C--Certificate of Insurance
Robert J. Huston, Chairman
R. B. "Ralph" Marquez, Commissioner
Kathleen Hartnett White, Commissioner
Jeffrey A. Saitas, Executive Director
Resolution No. 2002—R 0095 j
LJ �_ , 4 1 2001
DISTRICT FIVE
TEXAS NATURAL RESOURCE CONSERVATION COMMISSION
Protecting Texas by Reducing and Preventing Pollution
December 19, 2001
Mr. Guy Sledge
Texas Department of Transportation
P.O. Box 777
Lubbock, Texas 79408-0771
Re: Request for approval for the installation of additional monitoring wells in TxDOT Right of Way
at the Lubbock Land Application Site. TPDES Permit No. 10353-002
Dear Mr. Sledge:
The Texas Natural Resource Conservation Commission's Ground Water Protection Team is currently
working with the City of Lubbock in their effort to install additional groundwater monitoring wells
at their land application site. During this effort it has come to our attention that up to three (3)
additional monitor wells will need to be installed in the Texas Department of Transportation
(TxDOT) right of way.
Since these additional wells are necessary in the City's effort to define the groundwater conditions
at the site we are requesting approval from TxDOT to install up to three (3) monitor wells in your
right of way.
If you have any questions, please contact Mr. Mike Chadwick at (512)239-0996 of the
Groundwater Protection Team, or if by correspondence, include MC 150 in the letterhead address
following his name.
Sincerely,
Richard Eyster, Team Leader
Groundwater Protection Team
Water Quality Division
RE/sa
ccs: Mr. Keith A. Pardue, Pardue & Associates, 16047 Fontaine Ave., Austin, Texas 78734
Mr. Jim Estes, Region Office 2
Mr. Patrick Cooke, Region-2
Mr. Michael Meyer, MC-149
Mr. Steve Musick, MC-147
Mr. Mark Fisher, MC-150 Exhibit B
P.O. Box 13087 Austin, Texas 78711-3087 ' 512/239-1000 Internet address: www.tnrcc.state.tx.us ,
printed on receded paper using uw-hased ink
CERTIFICATE OF INSURANCE Resolution No. 2002—ROO95
TO: CITY OF LUBBOCK DATE:g J R Jn t
P.O. BOX 2000
LUBBOCK, TX 79457 ITB #193—01/R.TYPE OF PROJECT:Construction of
Acosta Drilling Remediation Manirnrlsampli„g water wells
THIS IS TO CERTIFY THAT P.O. Box 1181, Lamesa, Tx. 79331 (Name and Address of Insured) is, at
the date of this certificate, insured by this Company with respect to the business operations hereinafter described, for the
typed of insurance and in accordance with the provisions of the standard policies used by this company, the further
hereinafter described. Exceptions to standard policy noted hereon.
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
EFFECTIVE
LIMITS
DATE
DATE
GENERAL LIABILITY
Commercial General Liability
MP1924442E
5/8/01
5/8/02
General Aggregate$ 2.000,000
0 Claims Made
Products-Comp/Op AGG $ _
Occurrence
Personal & Adv. Injury S1 ,
0 Owner's & Contactors Protectivi
Each Occurrence $ 1>130U,UUU
Fire amage (Any one Fire)
S
100,000
MedE 5 p (0 y one Person)
0 U
S
AUTOMOTIVE LIABILITY
lK Any Auto
AU1397742E
5/8/01
5/8/02
Combined Single Limit $1 .000,000
0 All Owned Autos
Bodily Injury (Per Person) S
0 Scheduled Autos
Bodily Injury (Per Accident)
0 Hired Autos .
Property Damage S
0 Non -Owned Autos
0
GARAGE LIABILITY
0 Any Auto
Auto Only - Each Accident S
0
Other than Auto Only:
Each Accident S
Aggregate S
0 BUILDER'S RISK
❑ 100% of the Total Contract Price
$
0 INSTALLATION FLOATER
S
EXCESS UABILITY
0 Umbrella Form
Each Occurrence S
Aggregate S
0 Other Than Umbrella Form
S
WORKERS COMPENSATION AND
NW131224 2E
5 / 8 / 01
5/8/02
EMPLOYERS' LIABILITY
The Proprietor/ 0 Included
Statutory Limits
Partners/Executive Z Excluded
Each Accident S 500,000
Officers are:
Disease Policy Limit S 500 0,� 0
Disease -Each Employee S 500,000
OTHER
The above policies either in the body thereof or by appropriate endorsement provide that the may not be changed or
canceled by the insurer in less than the legal time required after the insured has received w%en notice of such change or
cancellation, or in case there is no legal requirement, in less than five days in advance of cancellatio
FIVE COPIES OF THE CERTIFICATE OF INSURANCE
. (Name o :er)
MUST BE SENT TO THE CITY OF LUBBOCK
By:
Title: Partner, Trimble—Batier
Insurance Associates, L.L.P.
Exhibit C "
HIV CERTlFlCATE OF LIABILITY INSURANCE
ACOST-z 09 27 01
asw THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
mble-Bat jer Ins. Assoc LLP HOLDER. ?HIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Box 2480 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Angelo TX 76902-2480
on1e: 915-6'.53-6733 Fax: 915-653-3754 INSURERS AFFORDING COVERAGE
so WUffllA National Aminrican Ins Cc
INS~ a
Acosta Drilling VaURCRC
V . 0. Box 1181 INSUFeR Q
Lamesa TX 79331
INSURER E:
.VERAGE3
•HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
WY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
,AAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
,IOLICIE3. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
%+ TYFB OP INIPVRANCB TOLLY ON
POLICY B-POLICYMODIT)DMI LOAM
a
00AWALLIABILITY EACH OCCURRENCE $1, 000, 000 _
z
Z
COMMERCIAL GENERALLNBIUIY
CLAM MADE ® OCCUR
*SEE SPECIAL
MP1924442E
05/08/01
05/08/02
FIREDAAIAGE(IVvmmrle)
1100,000
MED EXP (Ary or* vmm)
s 5 000
PeRMONAL&ACV INAXiY
s 1,000,000
PROVISIONS
OENERALAGGREGTB
s2,000,000
GEmL AGGREGATE LMT APPLIES PER:.
z PouCY 7'O LOC
PRooucm-coMP/OPAGO
s2,000,000
j A ITOMOERE
z
�+. Z
x
LIABILITY
/WAUTO
ALL OWNED AUTOS
SCHwuLW A/TOS
HIRED AUTOO
N• NOOYNen AUTOS
+++SEE SPECIAL
AU1397742E
05/08/01
05/08/02
coMFFEDAr srjmaLr
(ea acc0m
$1, 000, 000
SOOLY wuar
(Perm—)
=
eoolLr wlurtr
Mw �ccgsAa
s
yMAM
(Pp acOaw G
f
PROVISIONS
DAIUDE L "D"TT
.ANY ALTO
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s
01"mPTHAN VA ACC
AUTO ONLY. AM
$
f
EXCE9E LNBNRY
317 OCCUR Q CLAM MADE
OEOUCTTae
Z RET@NDON Is 10,000
ME1356542E
05/08/01
05/08/02
EACH OCCURRENCE
$1, 000 , 000
AGGREOATB
S1,000,0
s
$
Is
11101440M COAOENEATION AND
EMFLOYEPW LYIEs.ITY
NW1312242E
-s= syscZAL FRAMSZORS
05/08/01
05/0.6/02
TORT MITE EA
eicACNAcccww
s 500000
E.L.Olsrese-VAeMPLOYM
9500000
e.L.OISeAse- POLICY Uwr
s 500000
O►IIMTIONSILOCATIONMnmCLBN%CLUs10Nt ADDED BY VAORS"w lwaCNL PROY1IIII01"
AL PROVISIONS-polls Intl blkt 30 day notice of canal/Taatl chg
nonpay, 10); addl insd (except wc) i waiver of subro in favor of any
Or Organization as required by s1gaed, written contract. Re:
Ition of Rowd-Iatlon Monitor/Sampling Water Well ITS #193-01/RS
:HOLDER N I ADOMONIALINEUKED:W40UMRLETTEIt CANCELLATION
CITLUTZ SHOULD ANT OF THE ASOYE OESCIWOC PQUClss" CANCELLED EBOM THE EXPAMTMON
DATE TMEgOP, THE ISILMM M 5UOMR PILL ETIDEAYOR TO AAA. 3fL- DATE 1MOTTEN
City of Lubbock NOTICE TO THE CIRTIFICATIN HOLOM NAMED TO TM LEFT, EUT FALUAE TO DO so 04N.L
P P.O.Box 2 Dept. WPOSE NO 08UBATION Oft WAEAJTY OP ANY KIND U►ON THE NEUV0% ITS AGENTS Oft
,O. Sox 2000
Lubbock TX 79457 n&I-KESENTArrAL
1988
Resolution No. 2002—R0095
Department of
Human Resources
P.O. Box 2000 • 1625 13th Street
Lubbock, Texas 79457
(806) 775-2311 • Fax: (806) 775-3316
CERTIFICATE OF SELF-INSURANCE
The undersigned officer of the City of Lubbock, Texas, a Texas home rule
municipality, hereby certifies that the City of Lubbock is self -insured for workers'
compensation, auto liability, and general liability in accordance with the laws of the
State of Texas and that the current balance of the self-insurance fund is
$9,264,699.00. The existing cash asset balance is $10,420,094.00 as of the date stated
below.
Leisa Hutcheson
Date: September 30, 2000 Risk Management Coordinator
Resolution No. 2002-R0095
March 14, 2002
Item No. 27
AGREEMENT
FOR TEMPORARY USE OF HIGHWAY RIGHT OF WAY
DURING GROUNDWATER NITRATE INVESTIGATIONS
State of Texas
County of Lubbock
This Agreement is made by and between the Texas Department of
Transportation, hereinafter referred to as the "State" and both Acosta Drilling,
hereinafter referred to as the "Contractor(s)" and the City of Lubbock, hereinafter
referred to as the "Owner(s)".
WITNESSETH
WHEREAS, the Contractor(s) and Owner(s) desire to perform/install a flush
mount monitoring well within highway right-of-way on East 501h Street and to establish
the presence, extent, or absence of nitrates in ground water in connection with the
Owner's Land Application site, with a Texas Natural Resource Conservation
Commission TPDES Permit No. 10353-002, Agreed Order dated 16 Nov 1989, and the
Ground Water Remediation Plan.
WHEREAS, the Contractor(s) and Owner(s) have requested permission from the
State to use East 50" Street Right-of-way approximately 1,040 ft. east of the intersection
of F.M. 835/FM 1729 and about 50 feet south of the road centerline in the County of
Lubbock, for the purpose of constructing, maintaining, and operating a water quality
monitoring well hereinafter referred to as the "Activity" as shown on Exhibit "A" and
hereby made a part of this Agreement.
AND WHEREAS, the Texas Natural Resource Conservation Commission
(TNRCC) has given the State written concurrence that the Contractor(s) and/or Owner(s)
may need to access and temporarily use said highway right-of-way for purposes of
investigation for nitrates in connection with TPDES Permit No. 10353-002, Agreed
Order, and the Groundwater Remediation Plan, and said written concurrence is hereby
attached as Exhibit "B' and made part of this Agreement.
NOW, THEREFORE, in consideration of the premises and of the mutual
covenants and agreements of the parties hereto, to be by them respectively kept and
performed as hereinafter set forth, it is hereby agreed as follows:
It is expressly understood that except as set forth herein, the State does not
purport hereby to grant any right, claim, title, or easement in or upon this
highway. Furthermore, approval of this Agreement by the State does not
constitute approval by any other Texas State Agency.
2. The Activity shall be conducted in compliance with all governing laws and State
regulations and policies.
3. The Contractor and Owner shall have the Activity performed in such a manner so
as to minimize inconvenience to or interference with highway traffic. Any traffic
control devices required by said Activity shall be installed by the Contractor or
Owner and shall be in accordance with the Texas Manual on Uniform Traffic
Control Devices for Streets and Highways.
4. The Contractor and Owner shall provide necessary safeguards to protect the
public during the Activity including adequate insurance for payment of any
damages which might result from the Activity, and shall save the State harmless
from damages, to the extent of said insurance coverage and insofar as the
Contractor and Owner can legally do so.
5. The Contractor and Owner agree to indemnify and save harmless the State, its
agents and employees, from all suits, actions or claims, and from all liability and
damages for any and all injuries or damages sustained by any person or property
as a consequence of any neglect in the performance of the Activity and any
related action by the Contractor or Owner and from any claims or losses arising
or recovered under the "Workers' Compensation Laws"; Article 6252-19 of
Vernon's Civil Statutes (Texas Tort Claims Act); or any other laws.
6. The Contractor and Owner shall further indemnify the State and accept
responsibility for all damages or injury to property of any character, including
utilities, occurring during the prosecution of the Activity resulting from any act,
omission, neglect or misconduct on the part of the Contractor or Owner in the
manner or method of executing the Activity.
7. The Contractor's and Owner's attention is directed to the fact that utility
installations owned by others exist in the right-of-way. The Contractor or Owner
shall provide adequate notice of the Activity to all utility companies potentially
impacted by the investigations.
8. The referenced Activity shall conform to a plan of action with intent to:
(a) establish the presence, extent or absence of nitrates in the ground water
within the referenced highway right-of-way,
(b) determine ground water flow direction, or
(c) provide information for proposal of site remediation.
2
9. Prior to termination of this Agreement, the Contractor and Owner agree to
remove the Activity and all of its facilities from the highway right-of-way and
restore the right-of-way to its approximate original condition, free of any right-
of-way damage, including ruts or any other injury to the environment. It is
further agreed that the Contractor and Owner shall be liable for and obligated to
clean up and remediate any contamination of substances in the right-of-way
found to originate from the Owner's property. All liability and obligation shall
be borne by the Contractor and Owner until such time as a letter from the Texas
Water Commission (TWC) is received by the State stating that the said site
investigation and remediation is complete. Any costs incurred by the State for
repairs to the highway facilities, for removal of the Activity, or for any other
necessary restoration/remediation work performed by the State will be billed to
the Contractor and Owner at cost.
10. The Contractor and Owner have provided the State with a Certificate of
Insurance on a Department's standard form covering the below listed insurance
limits for the duration of the Activity. Contractor Certificate of Insurance shall
be endorsed with a Wavier of Subrogation in favor of the State. Such Certificate
of Insurance is attached as Exhibit "C" and is hereby made a part of this
Agreement.
A. Workers' Compensation Insurance
Amount - Statutory
The Contractor and Owner have provided the State a Certificate of Insurance on
a Department standard from covering the below listed insurance limits for the
duration of the Activity. Contractor Certificate of Insurance shall include
Contractual Coverage and shall be endorsed with a Waiver of Subrogation in
favor of the State and shall endorse the State as an Additional Insured.
B. Comprehensive General Liability Insurance
Amounts - Bodily Injury $500,000 each occurrence
Property Damage $100,000 each occurrence
$100,000 for aggregate
or
Commercial general Liability Insurance
Amount $600,000 combined single
limit each occurrence and
in the aggregate
C. Comprehensive Automobile Liability
Amounts - Bodily Injury $250,000 each person
$500,000 each occurrence
Property Damage $100,000 each occurrence
11. It is mutually agreed and understood that this Agreement shall terminate after a
period of not more than one (1) year from the date of the final execution of this
Agreement.
12. The State reserves the right to terminate this Agreement at any time after
notifying the Contractor and Owner in writing thirty (30) days in advance of the
intended termination. The State also reserves the right to extend the period of this
Agreement within thirty (30 days of receipt of a written request from the Owner).
The state shall review the Owner's request for time extension and if acceptable,
shall execute an amendment to this Agreement. Said amendments to this
Agreement shall be executed by the Contractor and Owner, and must include all
supporting documentation from the Contractor and Owner addressing all
proposed revisions to the Activity's limits and period of work. Said amendments
shall be attached hereto and shall be made a part of this Agreement.
In Testimony Whereof, the parties hereto have caused these presents to be executed on
the dates below stated.
OWNER NAME:
City o ubbock __
By:
Name: Windy Sitton
Mayor
Address: P.O. Box 2000
1625 13`b Street
Lubbock, TX 79457
Date: March 14, 2002
ATTEST:
By:
_ �QL"
Rebecca Garza
City Secretary
Date: March 14, 2002
THE STATE OF TEXAS
Certified as being executed for
the purpose and effect of
activating and/or carrying out
the orders, established policies,
or work programs heretofore
approved and authorized by the
Texas Department Of
Transportation Commission
under the authority of Minute
Order 513.
District Engineer
Lubbock District
Date: Z - ZD - o z
APPROVED AS TO CONTENT:
C /-� u�
Ed Bucy
Right of Way Agent
Date:
APPROVED AS TO FORM:
By:_
William fie -amass--- j� f
Contract Manager/Attorney
Date:
CONTRACTOR NAME:
Acosta Drilling
By:2% - 271- e�Z�
Name: Victor M. Acosta
Owner/Operator
Address: P.O. Box 1181
Lamesa, TX 79331
Phone: (806) 872-5850
Date: 2 — ,' --r 2-
List of Attached Exhibits
A --Site Layout & Proposed Activity
B_--TNRCC Concurrence
C--Certificate of Insurance
Resolution No. 2002—R 0095
City of Lubbock Monitor Wells in Lubbock County.:p�'i °....... }y%1t
IV
UL7, NREED : JR.
SCOPE OF WORK: 83376 ••_
IZCET15��•G���'.
This project shall include the furnishing of all equipment, mate ria1S'`V:�0NAL��'`
power, labor, tools, fuel and transportation necessary or incidental to 101a61o1
completing approximately 10 monitor/sampling type water wells in Lubbock
County. Drawings of the proposed well construction and a general location
map are attached to these specifications. All materials used in this
project shall be NSF approved. Contractor must have a current State of
Texas Well Drillers License.
1.0 Material Specifications:
1.1 Gravel:
The gravel for gravel packing shall be silicate particles of rock, as
obtained from sources near Brady Texas, referred to as Brady 8-16 or an
approved equal. Any other well rock shall be subject to the approval of the
ENGINEER prior to bidding.
Gravel Specifications
100% passing No. 6 screen
40% retained on No. 8 screen
65% retained on NO. 12 screen
25% retained on No. 14 screen
4% retained on No. 16 screen
crushed rock not acceptable
less than 5% soluble in HCL
1.2 Production Casing:
Production casing shall be 5 inch schedule 40 flush threaded joint PVC well
casing as manufactured by Eagle or Jet Stream or an approved equal. Casing
centralizers shall be spaced on approximately 40 foot intervals throughout
the well. A 5 inch slip on cap shall be provided on the bottom section of
casing or screen.
1.3 Screen:
The screen shall be 5 inch schedule 40 flush threaded joint PVC well screen
as manufactured by Eagle or Jet Stream or an approved equal. The screen
shall have the same outside diameter as the production casing and shall have
openings of .035 inch. Each well shall be screened throughout the water
bearing formation.
Exhibit A
1.4 Concrete:
Class B concrete shall be required for the concrete surface seal and well
pad." The cement shall conform to Standard Specifications and tests for
Portland Cement, "A.S.T.M." Serial Designation C-150-41, and C77-40.
Class B concrete shall contain not more than 7 gallons of water per sack of
cement. The concrete mix shall contain not less than 4-1/2 sacks of cement
per cubic yard of mix and shall have a minimum 28 day compressive strength
of 2500 P.S.I. Maximum additional water of 1-1/2 gallons per cubic yard of
mix will be allowed with the approval of the ENGINEER.
Concrete aggregates for class B concrete shall consist of natural clean
washed sand and gravel. The aggregates shall be well graded form coarse to
fine and the maximum size of the coarse aggregate shall not exceed 3/4 inch.
The aggregate shall be free from injurious amounts of clay, soft or flaky
materials, loam or organic impurities.
1.5 Surface Pioe:
The surface pipe shall extend from 2 feet below the surface to 2 feet above
the surface. The pipe shall be 8-inch schedule 40 steel pipe, cleaned and
painted with two coats of red primer. The surface pipe shall include a
lockable cap. Surface pipe is required for 8 wells (see attachment 1).
NOTE: Two of the wells require flush mount completions with manhole cover
embedded in concrete for well access (see attachment 2). Manhole cover
should be a high load capacity cover with the following specification:
Morrison 418XA Limited Access Manhole (or equivalent) Cast Iron, Bolt -Down,
Cover Seal, 12" by 12" .
1.5 Casing Seal:
The five -inch plastic casing shall terminate 2 feet above the surface and be
sealed with a watertight cap.
NOTE: Two of the wells are flush mount and require the plastic casing and
cap/seal shall terminate just below manhole cover (see drawing).
2.0 CONSTRUCTION SPECIFICATIONS:
2.1 Drilling:
The use of slush pit or portable mud boxes will be CONTRACTORS choice
The slush pits shall be dug by the contractor and shall be filled and
leveled by the CONTRACTOR during final cleanup.
Note: Two of the estimated number of wells may be located within road right
of ways.
The drilling shall be standard rotary drilling or air jetting: bentonite mud
additives shall be used sparingly.
The well shall be drilled a minimum of 8.75 inches in diameter from the
surface through the water bearing formation 5 feet into the pre -Pliocene
(redbed) strata. An accurate log showing the changes in the formation shall
be kept by the driller and presented to the OWNER after completion of the
well.
2.2 Installation of Production Casing:.
Before the production casing is installed, the hole shall be clear of sand
and cuttings to a point five feet below the top of the red bed formation.
The casing shall be centered by attaching guides at approximately 40-foot
intervals. Approximately five (5) feet of blank casing shall be installed
below the bottom screen.
2.3 Gravel Packing
The wells shall be gravel packed immediately after the production casing and
screen have been set in place. The drill stem, without the drill bit, shall
be lowered into the casing and screen to a point a maximum of 5 feet from
the bottom of the screen.
Gravel shall then be placed slowly into the annular space from the surface,
taking precautions against mixing the gravel with drill cuttings or other
debris at the surface near the well.
After placement of the gravel pack, water, mud and sand shall be pumped from
the interior of the screen and into the slush pit or mud box through the
drill stem acting as an air lift pump. As the discharge clears the gravel
level shall be checked and maintained at.a point 5 feet above the top of the
uppermost screened section.
2.4 -Concrete-for Surface seal --and Well Pad:
The annular space between the production casing and the wall of the hole
shall be open from the surface to a depth of 10 feet. Bentonite pellets or
clean sand may be used to fill the annular space from the top of the gravel
pack to-10 feet below the surface. The concrete seal shall then be poured
from the surface to a depth of 10 feet. A 6-foot by 6 foot by 6-inch well
pad shall be poured at the surface centered around the casing. The well pad
shall be reinforced with 6 by 6 mesh wire.
NOTE: The two flush mount wells concrete must be sloped in order to allow
for a vehicle to drive. over it easily (see drawing). The concrete may also
conform to the slope of the surrounding terrain.
2.5 Development:
Development shall be high volume airflow through the drill stem adjacent to
the screen throughout the screened section. The volume of air shall be
sufficient enough to separate sand, mud, silt and drilling mud from the
gravel pack. This procedure should begin at the top of the screened section
and proceed slowly to the bottom of the screened section. This procedure
shall be repeated until the gravel level is stable at 5 feet above the
uppermost screened section and the discharge, is clear.
2.6 Clean Up:
During all phases of construction the work site shall remain free of
construction debris, boxes, paper, plastics, bottles and cans. The
CONTRACTOR shall provide a receptacle at each work site and no debris shall
be placed in the slush pits.
2.7 Reports
The drilling company shall be responsible for filing the State of Texas Well
Report. A copy of this report for each well shall be submitted to the OWNER
prior to final payment.
3.0 Special Information:
The CONTRACTOR shall be especially cautious regarding fires. No firearms
shall be allowed on the project. All losses, injuries, damages and claims
for the same that result from activities of the CONTRACTOR shall be the
responsibility of the CONTRACTOR.
Damage to surface shall be kept to a minimum.
Local farm roads provide access to the well sites. Farm roads are
unimproved. The OWNER will provide very limited assistance to free vehicles
that become stuck.
The contractor shall be responsible for all utility locates.
The contractor shall enter into agreement with Owner and the Texas
Department of Transportation, for installation of two wells on highway right
of way (see attachment 4, or equivalent document).
Contractor is required to provide sufficient notification of work schedule,
so that the owner can notify contract farm owners prior to entering private
property. The contract farmers are aware of the project, but require
notification before driller's enter the property.
Water for drilling will be available in the Lubbock area, i.e. a meter hook-
up to a fire hydrant for a $50.00 deposit. The contractor will need to
supply self -owned double check back -flow preventer.
The exact location of all wells will be designated at a later date. However
the attached drawing shows general locations:
- Schoppa Contract SE corner monitoring well 1
- Foerster Contract east side monitoring wells 2 & 3
- Jones Contract monitoring wells 5 & 6
- Adams Contract monitoring wells 7 & 8
- Monitoring well 10 is SW of plot 27 on the far east of the map
- Flush mount monitoring wells 4 & 9 are located east of the intersection
of FM 1729 & FM 835, south side of the road on E. 50th Street in State
Right-of-way.
Robert J. Huston, Chairman
�;-
R. B. "Ralph" Marquez, Commissioner _,�� ;. /` J L C 2 7 Z 0 Q 1
Kathleen Hartnett White, Commissioner i
Jeffrey A. Saitas, Executive Director _ D � S ; � C T � V I
TEXAS NATURAL RESOURCE CONSERVATION COMMISSION
Protecting Texas by Reducing and Preventing Pollution
December 19, 2001
Mr. Guy Sledge
Texas Department of Transportation
P.O. Box 777
Lubbock, Texas 79409-0771
Re: Request for approval for the installation of additional monitoring wells in TxDOT Right of Way
at the Lubbock Land Application Site. TPDES Permit No. 10353-002
Dear Mr. Sledge:
The Texas Natural Resource Conservation Commission's Ground Water Protection Team is currently
working with the City of Lubbock in their effort to install additional groundwater monitoring wells
at their land application site. During this effort it has come to our attention that up to three (3)
additional monitor wells will need to be installed in the Texas Department of Transportation
(TxDOT) right of way.
Since these additional wells are necessary in the City's effort to define the groundwater conditions
at the site we are requesting approval from TxDOT to install up to three (3) monitor wells in your
right of way.
If you have any questions, please contact Mr. Mike Chadwick at (512)239-0996 of the
Groundwater Protection Team, or if by correspondence, include MC 150 in the letterhead address
following his name.
Sincerely,
Richard Eyster, Team Leader
Groundwater Protection Team
Water Quality Division
RE/sa
ccs: Mr. Keith A. Pardue, Pardue & Associates, 16047 Fontaine Ave., Austin, Texas 78734
Mr. Tim Estes, Region Office 2
Mr. Patrick Cooke, Region-2
Mr. Michael Meyer, MC-149
Mr. Steve Musick, MC-147
Mr: 'Mark Fisher, MC-150 Exhibi t B
P.O. Box 13087 • Austin, Texas 78711-3087 • 512/239-1000 • Internet address: wvw.tnrcc.state.tx.us
printed on recycled paper using sov-based ink
CERTIFICATE OF INSURANCE Resolution No. 2002-ROO95
TO: CITY OF LUBBOCK DATE: 4/ 1 R /n i
P.O. BOX 2000
LUBBOCK, TX 79457 ITB #193-01/RTYPE OF PROJECT:Construction of
Acosta Drilling Remediation Manirarjsamgt� warPr WP11s
THIS IS TO CERTIFY THAT P.O. Box 1181, Lamesa, Tx. 79331 (Name and Address of Insured) is, at
the date of this certificate, insured by this Company with respect to the business operations hereinafter described, for the
typed of insurance and in accordance with the provisions of the standard policies used by this company, the further
hereinafter described. Exceptions to standard policy noted hereon.
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
EFFECTIVE
LIMITS
DATE
DATE
GENERAL LIABILITY
-
N Commercial General Liability
MP1924442E
5/8/01
5/8/02
General Aggregate$ 2.000,000
0 Claims Made
Products-Comp/Op AGG S
Occurrence
Personal & Adv. injury $1 ,
❑ Owner's & Contractors ProtectiveEach
Occurrence S 1 , UUU
Fire amage (Any one Fire)
�?100,000
S
.
Med Exp rAn one Person)
$5,000
$
AUTOMOTIVE LIABILITY
Any Auto
AU1397742E
5/8/01
5/8/02
Combined Single Limit $1,000,000
❑ All Owned Autos
Bodily Injury (Per Person) S
❑ Scheduled Autos
Bodily Injury (Per Accident)
S
❑ Hired Autos
Property Damage $
❑ Non -Owned Autos
0
GARAGE LIABILITY
❑ Any Auto
Auto Only - Each Accident $
0
Other than Auto Only:
Each Accident $
Aggregate S
0 BUILDER'S RISK
0 100% of the Total Contract Price
$
0 INSTALLATION FLOATER
$
EXCESS LIABILITY
0 Umbrella Form
Each Occurrence $
Aggregate $
0 • • Other Than Umbrella Form
$
WORKERS COMPENSATION AND
NW1312242E
5/8/01
5/8/02
EMPLOYERS' LIABILITY
The Proprietor/ 0 included
Statutory Limits
Partners/Executive Z Excluded
Each Accident $ 500,000
Officers are:
Disease Policy Limit S 500,000
Disease -Each Employee S 500.000
OTHER
The above policies either in the body thereof or by appropriate endorsement provide that the may not be changed or
canceled by the insurer in less than the legal time required after the insured has received written notice of such change or
cancellation, or in case there is no legal requirement, in less than five days in advance of cancellation
FIVE COPIES OF THE CERTIFICATE OF INSURANCE Narinnat sx/ri ran Tn-z r:l'___�_
MUST BE SENT TO THE CITY OF LUBBOCK
Title: Partner, Trimble—Batier
I Insurance Associates, L.L.P.
Exhibit C
LCQBD CERTIFICATE OF LIABILITY INSURANCE Or10 ME)
ACOST 2
oAre.Am°af..,
1 09 27 01
voeR
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
mble-9atjer Ins. Assoc. LLP
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Box 2 480
ALTER THE COVERAGE AFFORDED 4Y THE POLICIES BELOW.
IN>iURGR>: AFFORDING COVERAGE
Angelo TX 76902-2480
3ne : 915-653-6733 Pax: 915-653-3754
too
MSURERA National American Ins Co
"SURM e
WauaERC'.
Acosta Drilling
P . 0. Box 1181
Lamesa TX 79331
NSURCR a
INSURER E:
NERAGE3
E POLICIES Or INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
WY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
WAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGOREOATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
R
TYPt copWOUMNCt
POUCY NUMBER
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POO T.Y OXP ,PION
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FIREOAMAGEwwamNO)
S100,000
GLARES MADE a OCCUR
MED E)w (Am am pmw)
S 5 000
**SEE SPECIAL
PeRSONAL &AOV MLAMY
31,000,000
PROVISIONS
GENERALAGGREGATG
s 2 000 000
OEM. AOOREOATE LAOr APPLIES PER.
PROOucrs.eawrov AC.O
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*SPECIAL PROVISIONS-Pol's incl blkt 30 day notice of canal/mail chq
adept nonpay, 10); addl insd (except wc) i waiver of subro in favor of any
arson or organization as required by signed, written contract. Re:
astruction of Ramidiation Monitor/Sampling Water Well ITS #193-01/RS
:HOLDER N I AcorrlONALINSWPAW.WeURORLETTRm CANCELLATION
CITL= -OULU ANT OF TMV PAC" DOSCMto POUCes tt CANCELLED WFORt THt EINMTWN
OATO T"wwoP, THS IMUMO WSURON VOLL OMOOAVOR To MAIL .'An DATS WMTTON
City O= Lubbock NOTICE TO TRIO Cfff"ICATR HOLDER NAMED TO THE LEFT, WT FALYRE TO 00 60 SHALL
P BoDept.
P.. O.. Soxx 2000 WOOt NO 0914DATION OR LMtIU" OF ANY KIND UPON THE teURER ITS AONKM OR
Lubbock TX 79457 REPRESENTATIVEO. __
Resolution No. 2002—R0095
Department of
Human Resources
P.O. Box 2000 • 1625 13th Street
Lubbock, Texas 79457
(806) 775-2311 • Fax: (806) 775-3316
CERTIFICATE OF SELF-INSURANCE
The undersigned officer of the City of Lubbock, Texas, a Texas home rule
municipality, hereby certifies that the City of Lubbock is self -insured for workers'
compensation, auto liability, and general liability in accordance with the laws of the
State of Texas and that the current balance of the self-insurance fund is
$9,264,699.00. The existing cash asset balance is $10,420,094.00 as of the date stated
below.
Leisa Hutcheson
Date: September 30, 2000 Risk Management Coordinator
Resolution No. 2002—ROO95
Robert J. Huston, Chairman
R. B. "Ralph" Marquez, Commissioner
Kathleen Hartnett White, Commissioner
Jeffrey A.. Saitas, Executive Director
DEC 2 7 2001
DISTMCT FIVE
TEXAS NATURAL RESOURCE CONSERVATION COMMISSION
Protecting Texas by Reducing and Preventing Pollution
December 19, 2001
Mr. Guy Sledge
Texas Department of Transportation
P.O. Box 777
Lubbock, Texas 79408-0771
Re: Request for approval for the installation of additional monitoring wells in TxDOT Right of Way
at the Lubbock Land Application Site. TPDES Permit No. 10353-002
Dear Mr. Sledge:
The Texas Natural Resource Conservation Commission's Ground Water Protection Team is currently
working with the City of Lubbock in their effort to install additional groundwater monitoring wells
at their land application site. During this effort it has come to our attention that up to three (3)
additional monitor wells will need to be installed in the Texas Department of Transportation
(TxDOT) right of way.
Since these additional wells are necessary in the City's effort to define the groundwater conditions
at the site we are requesting approval from TxDOT to install up to three (3) monitor wells in your
right of way.
If you have any questions, please contact Mr. Mike Chadwick at (512)239-0996 of the
Groundwater Protection Team, or if by correspondence, include MC 150 in the letterhead address
following his name.
Sincerely,
Richard Eyster, Team Leader
Groundwater Protection Team
Water Quality Division
RE/sa
ccs: Mr. Keith A. Pardue, Pardue & Associates, 16047 Fontaine Ave., Austin, Texas 78734
Mr. Jim Estes, Region Office 2
Mr. Patrick Cooke, Region-2
Mr. Michael Meyer, MC-149
Mr. Steve Musick, MC-147
Mt.'Mark Fisher, MC-150 Exhibit B
P.O. Box 13087 • Austin, Texas 78711-3087 • ' 512/239-1000 • Internet address www.tnrcc.state.tx.us
printed on recycled paper using sov-based ink.
CERTIFICATE OF INSURANCE
Resolution No. 2002-ROO95
TO: CITY OF LUBBOCK
P.O. BOX 2000
LUBBOCK, TX 79457 ITB #193-01/RTYPE OF PROJECT:Construction of
Acosta Drilling Remediation Monirnr/samiting wntpr wA11s
THIS IS TO CERTIFY THAT P.O. Box 1181, Lamesa, Tx. 79331 (Name and Address of Insured) is, at
the date of this certificate, insured by this Company with respect to the business operations hereinafter described, for the
typed of insurance and in accordance with the provisions of the standard policies used by this company, the further
hereinafter described. Exceptions to standard policy noted hereon.
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
EFFECTIVE
LIMITS
DATE
DATE
GENERAL LIABILITY
Commercial General Uability
MP1924442E
5/8/01
5/8/02
General Aggregate$ 2,000,000
p Claims Made
Products-Comp/Op AGG S
Occurrence
Personal & Adv. Injury S1 ,
Q Owner's & Contactors Protectiv
Each Occurrence S .
Fire amage (Any one Fire)
f100,000
$
Med E p Anyone Person)
U
g
AUTOMOTIVE LIABILITY
Any Auto
AU1397742E
5/8/01
5/8/02
Combined Single Limit SI,000.000
Q All Owned Autos
Bodily Injury (Per Person) S
p Scheduled Autos
Bodily Injury (Per Accident)
S
❑ Hired Autos
Property Damage $
❑ Non -Owned Autos
0
GARAGE UABIUTY
Q Any Auto
Auto Only - Each Accident S
❑
Other than Auto Only.
Each Accident S
Aggregate S
Q BUILDER'S RISK
Q 100% of the Total Contract Price
S
Q INSTALLATION FLOATER
S
EXCESS LIABILITY
Q Umbrella Form
Each Occurrence S
Aggregate $
❑ . •• Other Than Umbrella Form
S
WORKERS COMPENSATION AND
NW1312242E
5/8/01
5/8/02
EMPLOYERS' UABIUTY
The Proprietor! Q Included
Statutory Limits
Partners/Executive 10 Excluded
Each Accident S 500,000
Officers are:
Disease Policy Limit S 500,Q00
Disease -Each Employee $ 500,900
OTHER
The above policies either in the body thereof or by appropriate endorsement provide that
canceled by the.insurer in less than the legal time required after the insured has received
cancellation, or In case there is no legal requirement, in less than five days in advance of
FIVE COPIES OF THE CERTIFICATE OF INSURANCE
MUST BE SENT TO THE CITY OF LUBBOCK
not be changed or
Itice of such change or
By:_,
Title: Partner, Trimble-Batier
1 Insurance Associates, L.L.P.
Exhibit C
lCjWD CERTIFICATE OF LIABILITY INSURANCE OF 10 blD I "Till PAAIDO""
ACOST-2 09 27 O1
uc�R
THIS CERTIFICATE 13199UED A3 A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
mble-Batjer Ins. Assoc. LLP
Box 2480
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED By THE POLICIES USLOW.
IN>IiURiFiSAFFORDWGCOVGRAGi
Angelo TX 16902-2480
one: 915-653-6733 Fax: 915-653-3754
too
rgVReRA National American Ins Co
ftSVR Re
IN3VRCR Cl.
Acosta Drilling
P . 0. Box 1181
Lamesa TX 79331
eovaeR ¢
NUMMR e:
VERAGES
HE POLICIES Of INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE POR THE POLICY PERIOD INDICATED. NOTWITHSTANOINO
NY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
LAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
10LICIE3. AOOREOATC LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
PE OF INSVRANCE
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05/08/01
05/08/02
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05/08/01
05/08/02
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+SPECIAL PROVISIONS -Polls incl blkt 30 day notice, of eanel/matl ehq
except nonpay, 10) ; addl insd (except we) 4 waiver of subro in favor of any
son oz organization as required by signed, written contract. Re,:
traction of Ram Uation Monitor/Sampling Water Well ITH #193-01/RS
fEHOLDER IN IAoornoNALMsuneu;MsuRERLernIe CANCELLATION
CITLDTZ SHOULD ANT OF THE ANOYI OIfCWEO POUCIES W CANCELLED BSPOM THEdX►BLATNTN
OATS TWMO►, TM ISItIS S WMIRNIR V4" NNWAVpw TO WAIL r f, OATSWOUTTs"
City of Lubbock NOTICE TO TH! CfRMICATI HOLOiR NAMW TO Tme L[FT, fuT FAILUM TO DO to wuLL
PtDept.
P.. O.. Box IMFOSO NO ONLICLIABILITYATION OR LIABILITY OF ANY KM UPON TNa M3URR ITS ACOM OR
Sox 2000
Lubbock TX 79437 REPRaSMITAT^1e1L
1983
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BOLT DOWN WATER -TIGHT
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