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North Texas Mail-CS 881230t ApplicationNo. DALLAS/FORT WORTH INTERNATIONAL AIRPORT BOARD P. O. Drawer 'DFW Dallas/Fort Worth Airport, Texas 75261 TENANT CONSTRUCTION OR GRAPHICS APPLICATION A. INFORMATION FROM APPLICANT (to be completed by Applicant):* Leaseholder: City of Coppel] Telephone No.: - - Company Name of Tenant:tin4 -I-,~¢1 ge~-,:,.~ Pnc:~e_l Service _ Telephone No.: 21~.-~2-10&~__ Tenant ContacRc~y pr-i nr-,~ Description of Work:Median cuts in Royal Lane extension frcmI-635 to Bethel Rd. in Coppell. Cuts are needed for truck and employee access to Royal Lane. Architect/Engmeer: ~DR Jeff Forre£t Project Cost: $30,887,000.00 Telephone No.: 21 z~-96t3-,4RRR Contractor: Spaw-Glass General Contractinq, Inc. Project Superintendent Paul Ralston Contractor Address: 2120 Walnut Hill Ln. Irvinq, TX Signature of Leaseholder Authorized Representative: Typed Name of Representative: * Enclose insurance certificates, bonds, and contracts as outlined on the reverse side of this form, *If any of these areas are not completed, the Application will not be approved. Telephone N o. '2~J~LA_A__ Telephone No.21 - - 75038 B. VERIFICATION OF CONTRACTUAL REQUIREMENTS: Insurance: Bonds: Contract Administration: Cost Systems Administration: Funding Verification: Lease No.:. Contract: Date: Date: Date: C. APPLICATION 19 APPROVED SUBJECT TO THE FOLLOWING CONDITIONS: Reviewed By: Date: Director of Planning and Engineering Applicant must read the terms and conditions printed on the reverse hereof. TERMS AND CONDITIONS The Applicant shall not commence performance of any of the said work prior to posting a fully executed and approved copy of this application in a visible location convenient to the site of work. If construction has not commenced within ninety (90) days of the applica- tion approval date, then this permit is void and Leaseholder must re-submit a new applica- tion for approval. The Applicant shall comply also with such Federal, State, and Municipal laws, statutes, orders, and regulations, if any, as may be legally applicable to the work or the perfor- mance thereof, or its employees therein. The Applicant shall submit the Application and valid insurance certifcates for all projects. Aisc included for construction projects over $25,000 must be copies of all contstruc- tion Contracts including required Performance and Payment Bonds. A final inspection, attended by representatives for the Tenant, General Contractor, host Airline (if applicable), and Airport Board, will be performed on all projects prior to approval of completed work and/or issuance of a Certificate of Occupancy. One set of reproducible, mylar, as-built drawings is required at final inspection prior to is- suance of a final Certificate of Occupancy. The Applicant shall indemnify and hold harmless the Airport Board, the Cities of Dal- las and Fort Worth, their governing officials, officers, agents, and employees, against and from (a) the risk of injuries (including wrongful death) or damage direct or conse- quential, to it or them or to its or their property, arising out of or in connection with the performance of the work, and (b) the risk of claims and demands by third persons arising or alleged to arise out of the performance of the work, whether such risk arise out of acts or omissions of the Applicant, its contractors, the Airport Board, the Cities of Dallas and Fort Worth, or otherwise. The Applicant shall pay all claims lawfully made against it by Contractors, Subcon- tractors, Materialmen, and Workmen. and all claims lawfully made against it by other third persons arising out of or in connection with or because of the performance of the work, and shall cause all Contractors and Subcontractors to pay all such claims lawfully made against them. 6. GRAPHICS APPLICATIONS FOR NON-SIGNATORY AIRLINES - (Airlines not signa- tory to Air'port Use Agreement): The Applicant shall deposit with the Airport's Director of Finance an amount equal to 50% of the cost quotation specified on the reverse side of this form. This deposit shall be held in escrow and applied to the cost of future removal of Graphics. Unused funds held in escrow shall be returned to the Applicant upon release by the Director of Planning and Engineering of any obligations associated with the Work.