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Tax2014D-CS15118 DART DALLAS AREA RAPID TRANSIT LICENSE PROCEDURES Dallas Area Rapid Transit (DART) purchased various railroad properties with public funds for future public transit uses. Other uses, compatible with current and future transit and freight railroad use, may be allowed depending on the proposed use, the impact on current or future uses, and the income generated. The following information must be submitted for review: 1. A letter from the owner(s) or their representative requesting a license to use the corridor. 2. The attached completed Application Form. Describe "Proposed Improvements", and provide written details; "See attached drawings" is not a description. 3. Engineering plans and plats showing ALL Details Directly on Drawings, including all information on the Plan Data Sheet (attached), the proposed license area with dimensions, profile and tie-ins to physical features on the ground (i.e. centerline of roadway, DART right of way lines, end of a bridge or culvert, etc.). Any proposed utility crossing must meet DART specifications and/or American Railway Engineering and Maintenance of Way Association (AREMA) standards. 4. The DART engineering checklist pertinent to the project type. 5. A $2,500.00 non-refundable engineering review and application fee. 6. If application is approved a License Agreement will be sent to the Applicant. The License includes, but is not limited to,sections that require: • A 30-day notice of termination enforceable by either party. • An annual payment based on the market value of the license area. ■ Insurance naming DART and Railroads as additional insureds (see attached list of insurance requirements). • A Standard Construction Agreement and Contractor's Right of Entry executed by Licensee's contractor prior to any construction activities. Applications are processed by two departments of DART, depending on the location of the rail corridor. Mail application packages to: Freight or Commuter Rail corridors, to: Light Rail corridors, to: Dallas Area Rapid Transit Dallas Area Rapid Transit Attn: Commuter Rail & Railroad Management Attn: Real Estate P. O. Box 660163 P. O. Box 660163 Dallas, Texas 75266-7210 Dallas, Texas 75266-7230 Copyright© DART, all rights reserved, 2009 lrr ` ` STANDARD APPLICATION FOR USE OF DART PROPERTY SECTION I—Application Information for a License Agreement r 1) LICENSEE'S full legal name: C 1T' O � V L Type of Legal Entity: [AMU All' For example: Company, Corporation, Partnership, Individual, Municipality, or Other Specific type of entity and, if applicable, state of incorporation Mailing Address: 266 P PY C11JlrD • Physical Address (if different): City: CPP L / State: Zip: 1 ((A Billing Address (if different from mailing address): Contact Perso i e J Email: JITkt ? c -eA[l r.) �tf �•• � Office Phone: Ot12' 4e Z,' X7151 Cell Phone tS40-- O7c 2)APPLICANT: t OlS a � (if Agent for Licensee) Email: Agent's Firm's Name: Office Phone: Cell Phone: Mailing Address: City: State: Zip: 3) CONTRACTOR, if known: a) Legal Name to appear in Agreement: F Coqc,re1k LLC b) Mailing Address: \22.2 0 C_ LA City: AV.\‘‘rNA State: Zip: 7 50 c) Contact Person: *acOi Q Email: 5ra cl e E-`c (cm o\L 42 I lc• c,cevx d) Office Phone: 4‘11-- 2o'Z � ' Z- Cell Phone: Page 1 of 3 Copyright© DART, all rights reserved, 2009 rr °'" `` STANDARD APPLICATION FOR USE OF DART PROPERTY SECTION II–Proposed Improvements Check All Appropriate Boxes: �/ New ❑ Existing: Agreement No. ❑ Relocation I Modification Use: IPublic ❑ Private Within Public ROW: Les❑No /Crossing tracks: Angledr( ok ❑ Paralleling tracks: Distance: TYPE OF ENCROACHMENT: l'w Surface use: Describe: C&Vl C/LLAi re,pct 11- al -e IP ❑ Wire line: ❑ Electric ❑ Telephone ❑ Fiber Optic ❑ Cable TV ❑ Other: ❑ Underground LI Overhead ❑ Transmission ❑ Distribution No. of Wires/Cables: Voltage: Material: Phase: Size: Vertical clearance above top of rail: (ft.) ❑ Pipeline: LI Transmission — Distribution ❑ Flammable ❑ Non Flammable ❑Pressurized Contents: Carrier Pipe Size/Thickness: Casing Pipe Size/Thickness: Length (encased full width of ROW): Distance below base of rail: ❑ Drainage: ❑Open Ditch LI Buried Pipe ❑Culverts Size: ❑ Road Crossing ❑ New LI Upgrade ❑ Public ❑ Private ❑ Other Improvements: Describe: Describe Proposed Improvements: Rtlittwe, dawned .axorretevF ` Y-erkCQ Z43o5466•L1636 g $0l3 LOCATION OF ENCROACHMENT: Latitude: Longitude: 703 2221. Name of nearest road crossing: f1AV11 Ta D.O.T. No.: ^^,p ' Distance to centerline of nearest road crossing: '�y✓,2 e Railroad Mile Post: 4 c oSC Is the work to be performed within twenty-five feet (25') of the railroad tracks? ❑Yes ✓No Page 2 of 3 Return Completed Application and Fee to: DART ■ P. O. Box 660163 ■ Dallas,Texas 75266-72_0 Use zip extension 7210 for Commuter Rail & RR Mgmt. OR 7230 for Light Rail/Real Estate Copyright© DART, all rights reserved, 2009 ACCPREP CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/11/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Linda Nichols NAME: Keystone Southwest Insurance Agency PHONE (972)771-3861 (AA /C,No):(972)772-1021 P 0 Box 1747II"lnichols@kswins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Rockwall TX 75087 INSURERA BITCO Insurance Company INSURED INSURER B: F & F Concrete, LLC INSURER C: _ 1222 Montclair INSURERD: INSURER E: Garland TX 75040 INSURERF: COVERAGES CERTIFICATE NUMBER:15/16 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR' POLICY EFF POLICY EXP LIMITS LTRINSD WVD POLICY NUMBER (MM/DDIYYYY) IMM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO A CLAIMS-MADE X OCCUR PREMISES(Ea occu RENTED $ 100,000 CLP3610005 9/17/2015 9/17/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY x JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Additional Insured $ Blanket AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED CAP3610006 9/17/2015 9/17/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OPROPERTY HIRED AUTOS AUTOS (Per a cid nt)AMAGE PIP-Basic $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION xPER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A A (Mandatory in NH) CLP3610005 9/17/2015 9/17/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability includes Blanket Waiver of Subrogation, Blanket Additional Insured and Per Project Aggregate, when required by written contract. Workers Compensation provides Blanket Waiver of Subrogation when required by written contract. The addition of special wording in this space DOES NOT provide or alter the coverage that is currently provided by the policies referenced above. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Dallas Area Rapid Transit THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Dart Risk Management Dept. ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE James Leeker/LINDA h ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(2014011 ---- 11/18/2015 PavementRepair—DentonTop.dwg MATCHLINE 15+00 MATCHLINE 10+00 =Ilt�inilii='ia' SEE THIS SHEET SEE SHEET 5 iliPail flip. 0.) e8l �� i I I t' E.s I -41/ I 1 .1 I �A' @iilli lfri as I /O g a€EB :}s Ri 1 I I x1115i@.1$'z I e d�I •i VII H gr l ' ,/,,1 1_.1a - - 1.___J- .-- , /i -1 I- ----17j---- 111• t a I 1 , oil ,_ I I . 1 Ier , i i I:% Y v 1 1 i '��1�. Ni ,,_ — . • 1 r a 2 ; ri 1 V Ii I O rn ! I f'. y I I _L�_. 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