HomeMy WebLinkAboutTUP2017-1396 ITY OF GRAPEVINE
TEMPORARY
& PUBLIC ENTERTAINMENT
PERMIT APPLICATION
SEC. 15-9. The application for the permit shall be filed not less than thirty (30) days before the first
performance and shall contain the following information.
1. Applicant
04C 11vir
Address r
4 411,
o fax no.
2. Property owner
2"' 4 q e.
Name 4V.5 17AJ
Address 2-001 Ario4jelorl 014POPIR04 01e®If e o
Phone no. fax no.
3. Address of temporary use or entertainment i
4. Date or dates of proposed entertainment to
5. Kind or type of entertainment
6. Total number of off-street or highway parking space
7. Total number of people participating in the event at this location
91
E
Number of restrooms available within facility
Time and hours of temporary use
CITY OF GRAPEVINE. DEVELOPMENT SERVICES.P O BOX 95104.GRAPEVINE.TEXAS.76099.(817)410-3154.FAX (817)410-3018
O.\ZCU\Forms\app.temp use public ent.doc
2
10. Number of outdoor speakers, all speakers shall face away from residential areas, please show
location of speakers and the direction they are facing on site plan.
1
hereby authorize
to request a temporary
use on property I own at Z c'�D �v--S0
Owner (print)
Owner signature
r` .te e r14 C ej
The State of1'e"A(
County Of
Before Me i' i✓1 f dr -i cK, (notary) on this day personally
appeared 2 i cce �l 0 n (property owner) known to me (or proved
to me on the oath of card or other document) to be the person whose name is subscribed to the
foregoing instrument and acknowledged to me that he executed the same for the purposes and
consideration therein expressed.
(Seal) Given under my hand and seal of office this day of
A.D. 2-01'1
,��eHrry ERIN NICOLE HEDRICK.
ri
p� RY P4 4
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SN otary Public, state of Texas Notary Signature
:"a • rte; Comm. Expires 02-01-2020
�yrFQF`�`�• Notary ID 130518858
'�flIr111+*�
FOR OFFICIAL USE O Y
CITY MANAGER [ iRTK MANAGER DEVELOPMENT SERVICES�DIR _
FI(E E r �4 t ¢ `'' POLICE 0 HEALTH _
CITY OF GRAPEVINE. DEVELOPMENT SERVICES.P O BOX 95104.GRAPEVINE.TEXAS.76099.(817)410-3154.FAX (817)410-3018
O:\ZCU\Forms\app.temp use public ent.doc
3
usan Batte
From: Haley Kilar <
Sent: Monday, April 17, 2017 12:51 PM
To: Susan Batte
Cc: Hayden Adcock
Subject: Event - Wednesday 4/19
Hello,
Please see below for a description of our event this Wednesday 4/19:
Our event on Wednesday, 4/19 will take place at Austin Ranch at the Hilton
Grapevine. From 7:OOPM to 8:30PM, the event will be inside. Inside, there
will be house music and an acoustic old western band called Latigo Crossing
(with Lagniappe Productions). Inside, there will be appetizers served and an
open bar. The food provided is being catered internally from the hotel. This
event is for the company Nest, and is being produced by Encore Live out of
Fort Worth Texas. No guests are paying to attend this event. It is a thank you
celebration for their retailers visiting Grapevine from New York City.
The outside entertainment will be 38 Special. We are using Eagle AVL for
production. They will be performing outside of Austin Ranch, on the Austin
Ranch Hilton property. They will be performing from 8:3OPM - 10:OOPM.
There will be approximately 175 guests in attendance.
Get Outlook for iOS
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Nest Retailer Night Out: Site Map Key
Speaker
LLJ
ENCOLIV-01
CERTIFICATE OF LIABILITY INSURANCE
DATE04!117!2017`71201'7
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(les) must have ADDITIONAL INSURED provisions or 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
UWCT
Gus Bates Insurance & Investments
3221 Collinsworth St
PHONE FAX
(AIC, No, Ext): (817) 335-9547 (AIC, No):(817) 338-1422
Fort Worth, TX 76107
ADDREss:
INSURER(S) AFFORDING COVERAGE NAIL
INSURERA : Union Insurance Company 25844
08/0712016
INSURED
Encore Live, LLC dba Encore Live Productions
Encore Event Services LLC
INSURERS:
INSURER C :
INSURER D :
1635 Rogers Rd
INSURER E :
Fort Worth, TX 76107
INSURER F :
COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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
LTR
TYPE OF INSURANCE
ADDL
INSD
UBR
WVD
POLICY NUMBER
POLICY EFF
MIDDIYYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
08/0712016
08/07/2017
EACH OCCURRENCE 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence $ 100'000
MED EXP (Any oneperson) $ 3'000
PERSONAL &ADV INJURY 1,000,000
GEN'LAGGREGATE I-WiTAPPLIESPER ,
X POLICY ❑ QCT 7 LOC
GENERALAGGREGATE $ 2,000'000
PRODUCTS - COMP/OP AGG $ 2,000,000
CONTRACTORS ENH $ 5,000,000
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident $
BODILY INJURY Perperson) $
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY Peraccident $
HIREDNON-OWNED
AUTOS ONLY AUTOS ONLY
P OPERTY MAGE
pA
{ eraccident) $
UMBRELLA LIAR
HOCCUR
EACH OCCURRENCE $
AGGREGATE $
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
A
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY YIN
0 PRO ERIME TORJPARTNER/EXECUTIVE
OFFICERRvtEMBEREXCLUDED? �
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
C 4681916 -12
12/08/2016
12/0812017
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE -EA EMPLOYEE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000'000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Blanket Primary and Excess CL CG 01 14 1110
Contractors General Liability Ultra Endorsement -CL CG 04 43 11 10 -Per Project aggregate limit increased, blanket Waiver of Subrogation. Misc. Blanket
Additional insured
Blanket Waiver of Subrogation WC 42 03 04 B
CERTIFICATE HOLDER reNrI:I I ATlnnl
ACORD 25 (20i61U3) O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Grapevine
200 S. Main Street
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Grapevine, TX 76051
AUTHORIZED REPRESENTATIVE
ACORD 25 (20i61U3) O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
CL CG 01 1411 10
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
INSUREDS)AMENDMENT OF PRIMARY AND EXCESS PROVISIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Paragraph (v) is added to Paragraph (1)(a) of Paragraph b. Excess Insurance under Paragraph 4. Other
Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, as follows:
(1) This insurance is excess over:
(a) Any of the other insurance, whether primary, excess, contingent or on any other basis:
(v) That is available to any person or organization who has been added as an additional insured to
this policy by endorsement,
However, with respect to an additional insured added by endorsement for liability caused, in
whole or in part:
1. By your acts or omissions, or the acts or omissions of those acting on your behalf:
(a) In the performance of your ongoing operations; or
(b) In connection with your premises; or
2. By your maintenance, operation or use of equipment leased to you by such person or
organization;
this insurance shall be primary for such acts or omissions as described in subparagraphs
(1)(a)(v)1. and (1)(a)(v)2. above if you and such additional insured have agreed prior to loss in a
written contract or written agreement, in effect during this policy period, that this insurance be
primary for same.
When required by such written contract or written agreement, we will treat as "non-contributory"
any other primary premises/operations liability insurance available to such additional insured for
liability described in subparagraphs (1)(a)(v)1. and (1)(a)(v)2. above and for which such person
or organization has been added as an additional insured by endorsement to this policy. However,
this insurance, in all cases, is excess over any other liability insurance available to the additional
insured to which such person or organization has been added as an additional insured by
endorsement.
B. With respect to the changes made by this endorsement, the following definition is added to Section V,
DEFINITIONS:
"Non-contributory" means that other insurance available to the additional insured will apply as excess and will
not contribute as primary to the insurance provided by this endorsement.
CL CG 0114 11 10 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1
with its permission.
COMMERCIAL GENERAL LIABILITY
CL CG 04 43 11 10
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
♦ I♦ �`
"'11111:4 11! 11111191-'
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUMMARY OF COVERAGE EXTENSIONS
Paragraph
No_
Name Of Extension
Limit
or
Included
A.
Miscellaneous Additional Insureds
Included
B.
Aggregate Limits Of Insurance For Construction Projects:
1. Single Construction Project Aggregate Limit (Away From
Premises
Equal to General
Aggregate Limit
2, Cap For All Damages From All Ongoing Construction Projects
$5,000,000
C.
Expected Or Intended Injury Or Damage
Included
D,
Joint Venture / Partnership / Limited Liability Company Coverage
Included
E.
Knowledge Of Occurrence
Included
F
Legal Liability - Damage To Premises Rented To You (Fire, Lightning,
Explosion, or Leakage From Automatic Fire Protective Systems)
$300,000
G.
Medical Payments
$10,000
H.
Mobile Equipment .Redefined
Included
I.
Newly Formed Or Acquired Organizations - Extended Period Of
Included
ncluded
J.
Non -Owned Watercraft (increased to maximum length of less than)
51 feet
K.
Supplementary Payments - Increased Limits:
1. Bail Bonds
$3,000
2. Loss Of Earnings
$1,{}00
L.
Unintentional Omission In Disclosure
Included
M.
Waiver Of Subrogation
Included
The above is a summary only. Please consult the specific provisions that follow for complete
information on the extensions provided. If there is a conflict between this summary and the
endorsement provisions that follow, the endorsement provisions shall prevail.
CL CG 04 4311 10 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 8
with its permission
The provisions of the Commercial General Liability
Coverage Part apply except as otherwise provided in
this endorsement. This endorsement applies only if
such Coverage Part is included in this policy.
A. MISCELLANEOUS ADDITIONAL INSUREDS
Section 11 - Who Is An Insured is amended to
include as an insured any person or organization
(referred to as additional insured below)
described in Paragraphs A.3.a. through A.3.d.
below when you and such person or organization
have agreed in writing in a contract or agreement
that such person or organization be added as an
additional insured on your policy, provided that:
1. The written contract or written agreement is:
(a) Currently in effect or becoming effective
during the term of this policy; and
(b) Fully executed by you and the additional
insured prior to the bodily injury, property
damage, or personal and advertising
injury.
2. The insurance afforded by this provision
does not apply to any person or organization
included as an additional insured by a
separate endorsement issued by us and
made a part of this policy or coverage part.
3. Only the following persons or organizations
are additional insureds under this provision,
with coverage for such additional insureds
limited as provided herein:
a. Managers or Lessors of Premises
A manager or lessor of premises but only
with respect to liability arising out of the
ownership, maintenance or use of that
part of the premises leased to you and
subject to the following additional
exclusions:
This insurance does not apply to:
(1) Any "occurrence" which takes place
after you cease to be a tenant in that
premises.
(2) Structural alterations, new
construction or demolition operations
performed by or on behalf of such
additional insured.
b. Lessor Of Equipment
Any person or organization from whom
you lease equipment but only with
respect to liability for "bodily injury",
"property damage" or "personal and
advertising injury" caused, in whole or in
part, by your maintenance, operation or
use of equipment leased to you by such
person or organization.
A person's or organization's status as an
additional insured under this
endorsement ends when their contract or
agreement with you for such leased
equipment ends.
This insurance does not apply to any
"occurrence" which takes place after the
equipment lease expires.
c. Controlling Interest
Any person(s) or organization(s) with a
controlling interest in the Named Insured,
but only with respect to their liability
arising out of:
1. Their financial control of the Named
Insured; or
2. Premises they own, maintain or
control while the Named Insured
leases or occupies these premises.
This insurance does not apply to
structural alterations, new construction
and demolition operations performed by
or for such additional insured.
d. Owners Or Contractors For Whom
You Are Performing Ongoing
Operations
1. Any person or organization for whom
you are performing operations but
only with respect to liability for "bodily
injury„ "property damage" or
"personal and advertising injury"
caused, in whole or in part, by:
a. Your acts or omissions; or
b. The acts or omissions of those
acting on your behalf;
in the performance of your ongoing
operations for the additional insured.
A person's or organization's status as
an additional insured under this
provision ends when your operations
for that additional insured are
completed.
Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., CL CG 04 4311 10
with its permission
2. With respect to the insurance
afforded to these additional insureds,
the following additional exclusions
apply:
This insurance does not apply to:
a. "Bodily injury""property
damage" or "personal and
advertising injury" arising out of
the rendering of, or the failure to
render, any professional
architectural, engineering or
surveying services, including.
(1) The preparing, approving, or
failing to prepare or approve,
maps, shop drawings,
opinions, reports, surveys,
field orders, change orders
or drawings and
specifications; or
(2) Supervisory, inspection,
architectural or engineering
activities.
b. 'Bodily injury" or "property
damage" occurring after:
(1) All work, including materials,
parts or equipment furnished
in connection with such
work, on the project (other
than service, maintenance or
repairs) to be performed by
or on behalf of the additional
insured(s) at the location of
the covered operations has
been completed; or
(2) That portion of "your
work"out of which the injury
or damage arises has been
put to its intended use by
any person or organization
other than another contractor
or subcontractor engaged in
performing operations for a
principal as a part of the
same project.
With respect to coverage provided by this
provision A. Miscellaneous Additional
Insureds, the following additional provisions also
apply:
(1) Any insurance provided to an additional
insured designated under Paragraphs A.3.a
through A.3.d above does not apply:
(a) To "bodily injury" or "property damage"
included within the products -completed
operations hazard; or
(b) To "bodily injury.' "property damage" or
"personal and advertising injury" arising
out of the sole negligence of such
additional insured.
(2) Paragraph 4.b. of Section IV - Commercial
General Liability Conditions is deleted and
replaced with the following:
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance,
whether primary, excess,
contingent or on any other basis
that is available to the additional
insured unless you and the
additional insured have
specifically agreed in writing that
this insurance be primary. Then
we will treat any other insurance
maintained by the additional
insured for injury or damage
covered by provision A.
Miscellaneous Additional
Insureds, except such other
insurance as noted in Paragraph
b -(1)(b), below, as excess to this
insurance.
If specifically required by such
written contract or written agreement,
we will not seek contribution from
any other liability insurance available
to the additional insured for injury or
damage covered by provision A.
Miscellaneous Additional
Insureds, except for such other
insurance as noted in Paragraph
b.(1)(b) below.
(b) Any other primary liability insurance
available to the additional insured for
damages arising out of premises or
ongoing operations for which such
person or organization has been
added as an additional insured by
attachment of an endorsement.
(2) When this insurance Is excess, we
will have no duty under Section I
Coverage A Bodily Injury And
Property Damage Liability or
Coverage B Personal And
Advertising Injury Liability to
defend the insured against any "suit"
if any other insurer has a duty to
defend the insured against that "suit".
If no other insurer defends, we will
undertake to do so, but we will be
entitled to the insured's rights against
all those other insurers.
CL CG 04 4311 10 Includes copyrighted material of insurance Services Office, Inc., Page 3 of 8
with its permission
(3) When this insurance is excess over
other insurance, will
share of the amount of the loss, if
any, that exceeds the sum ot
<a\ The total amount that all such
other insurance would pay for
the loss inthe absence ofthis
insurance: and
(b) The total ofall deductible and
self-insured amounts under all
that other insurance.
(4) We will ahonc the remaining |oom, if
any, with any other insurance that is
not described in this Eumaas
Insurance provision and was not
bought specifically toapply inexcess
of the Limits of Insurance shown in
the Declarations of this policy or
coverage part.
B. AGGREGATE LIMITS OF INSURANCE FOR
CONSTRUCTION PROJECTS
1, For all sums which the insured becomes
legally obligated to pay as damages omuemd
by occurrences under Section I Coverage
A. and for all medical expenses caused L
accidents under Section i - Coverage C,
which can be attributed only to ongoing
operations at construction projects
premises owned byorrented tothe insured:
a. The most we Will pay will be capped at
$5,000,R00.regardless ofthe number of:
(1) "Occurrences";
(2) Insureds;
(3)Claims made nv"suits"
(4) Persons or organizations making
claims prbringing suits; ur
(5) Separate construction projects.
b' Subject toParagraph BA'm.above:
(1) A separate Single Construction
Project
applies to each construction project
_..y ..... premises.~...e° by or
rented tothe /naunsd. and that limit is
equal to the amount of the General
Aggregate Limit shown in the
Declarations.
(2) The Single Construction Project
General Aggregate Limit is the most
we will pay for, the sum of all
damages under Section I -
Coverage A, except damages
because of "bodily injury" or
"property damage" included in the
"products -completed operations
hazard", and for medical expenses
regardless of the number of:
(a) Insureds;
(b) Claims made or "suits" brought;
or
(c) Persons or organizations making
claims or bringing "suits".
Any payments made under Section I
- Coverage A for damages or under
Section I - Coverage C for medical
expenses shall reduce the Single
(3) Construction Project General
Aggregate Limit for that c°=""cum.
project away from premises owned
by or rented to the insured. Such
payments shall not reduce the
General Aggregate Limit shown in
the Declarations nor shall they
reduce any other Single Construction
Project General Aggregate Limit for
any other separate construction
project away from premises owned
by or rented to the insured,
(4) The limits shown in the Declarations
for Each Occurrence, Phe Damage
and Medical Expense continue to
apply. However, instead of being
subject to the General Aggregate
Limit shown in the Declarations, such
limits will be subject to the applicable
Single Construction Project General
Aggregate Limit
2. For all sums which the insured becomes
legally obligated to pay as damages caused
by "occurrences" under Section I -
Coverage A, and for all medical expenses
caused by accidents under Section I .-
Coverage C, which cannot be attributed only
to ongoing operations at a single construction
project away from premises owned by or
rented to the insured:
Page 4wf 8 Includes copyrighted material of Insurance Services Office, |nc' CL CG 0443 1110
with its permission
a. Any payments made under Coverage A
(i) The provisions of section B.
for damages or under Coverage C for
Aggregate Limits Of Insurance
medical expenses shall reduce the
For Construction Projects in
amount available under the General
this endorsement; and
Aggregate Limit or the Products-
Completed Operations Aggregate Limit,
(ii) The provisions of such CG 25 03
whichever is applicable; and
endorsement (or a similar such
construction projects) aggregate
b. Subject to Paragraph B.1.a. above, such
endorsement)
payments shall not reduce any Single
Construction Project General Aggregate
both apply,
Limit.
is subject to Paragraph B.1.a. above.
3. When coverage for liability arising out of the
6. The provisions of Section III - Limits Of
"products -completed operations hazard" is
Insurance not otherwise modified by this
provided, any payments for damages
endorsement shall continue to apply as
because of "bodily injury" or property
stipulated.
damage included in the "products -completed
'
operations hazard" will reduce the Products-
C. EXPECTED OR INTENDED INJURY OR
Completed Operations Aggregate Limit, and
DAMAGE
not reduce the General Aggregate Limit nor
Exclusion 2.a, Expected Or Intended Injury of
the Single Construction Project General
Section I - Coverage A - Bodily Injury And
Aggregate Limit.
Property Damage Liability is replaced entirely
4. If a single construction project away from
with the following:
premises owned by or rented to the insured
a. Expected Or Intended Injury
has been abandoned, delayed, or
abandoned and then restarted, or if the
"Bodily injury" or "property damage" expected
authorized contracting parties deviate from
or intended from the standpoint of the
plans, blueprints, designs, specifications or
insured. This exclusion does not apply to
timetables, the project will still be deemed to
"bodily injury" or "property damage" resulting
be the same construction project.
from the use of reasonable force to protect
5. If endorsement CG 25 03, Designated
persons or property.
Construction Project(s) General Aggregate
D. JOINT VENTURE I PARTNERSHIP / LIMITED
Limit (or a similar construction project(s)
LIABILITY COMPANY COVERAGE
aggregate endorsement) is also a part of this
1. The following is added to Section 11 - Who Is
policy or coverage part, the most we will pay
An Insured:
for the total of:
a. All sums which the insured becomes
4. You are an insured when you had an
interest in a joint venture, partnership or
legally obligated to pay as damages
limited liability company which terminated
caused by occurrences under Section I -
or ended prior to or during this policy
Coverage A; and
period, but only to the extent of your
b. All medical expenses caused by
interest in such joint venture, partnership
accidents under Section I - Coverage C,
or limited liability company.
which can be attributed only to ongoing
However, this coverage does not apply:
operations at:
a. Prior to the termination or end date of
(1) Any construction . project(s)
any joint venture, partnership or
designated in such CG 25 03
limited liability company;
endorsement (or in a similar such
b. If there is other valid and collectible
construction project(s) aggregate
insurance purchased specifically to
endorsement);
insure the joint venture, partnership
(2) Any construction project(s) to which
or limited liability company; or
the provisions of section B.
Aggregate Limits Of Insurance For
c. To a joint venture, partnership or
Construction Projects in this
limited liability company which is, or
endorsement apply; and/or
ever was, insured under a
consolidated (wrap-up) insurance
(3) Any construction project(s) to which:
program (also Known as an owner -
controlled insurance program,
OCIP).
CL CG 04 4311 10 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 8
with its permission
2. With respect to the coverage provided by this
section G. Joint Venture t Partnership /
Limited Liability Company Coverage, the
last Paragraph of Section Ii - Who Is An
Insured is replaced by the following:
Except as provided in 4. above, no person or
organization is an insured with respect to the
conduct of any current or past partnership,
joint venture or limited liability company that
is not shown as a Named Insured in the
Declarations.
3. As used in this endorsement, "consolidated
(wrap-up) insurance program" (also known
as an owner -controlled insurance program,
O.C.i.P.) means a construction, erection or
demolition project for which the prime
contractor/project manager or owner of. the
construction, erection or demolition project
has secured general liability insurance
covering some or all of the contractors or
subcontractors involved in the project,
sometimes referred to as an a Contractor
Controlled Insurance Program (C.C.I.P.)
E. KNOWLEDGE OF OCCURRENCE
Sub -paragraph a. under 2. Duties In The Event
Of Occurrence, Offense, Claim Or Suit of
Section IV - Commercial General Liability
Conditions is replaced by the following:
a. You must see to it that we are notified as
soon as practicable of an "occurrence" or an
offense which may result in a claim only
when the occurrence or offense is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) A manager, if you are a limited liability
company; or
(4) An "executive officer" or the "employee"
designated by you to give such notice, if
you are an organization other than a
partnership or a limited liability company.
To the extent possible, notice should include:
(5) How, when and where the "occurrence"
or offense took place;
(6) The names and addresses of any injured
persons and witnesses; and
(7) The nature and location of any injury or
damage arising out of the "occurrence"
or offense.
F. LEGAL LIABILITY - DAMAGE TO PREMISES
RENTED TO YOU (Fire, Lightning, Explosion,
Leakage From Automatic Fire Protective
Systems)
If damage by fire to premises rented to you is not
otherwise excluded from this policy or coverage
part, then the following provisions apply:
1. The last Paragraph of Section I - Coverage
A(after the exclusions) is replaced in its
entirety by the following:
Exclusions c, through n. do not apply to
damage by fire, lightning, explosion, or
leakage from automatic fire protective
systems to premises while rented to you or
temporarily occupied by you with the
permission of the owner. A separate limit of
insurance applies to this coverage as
described in LIMITS OF INSURANCE
(SECTION 111).
2. The Paragraph immediately after Sub-
paragraph j.(6) of Paragraph 2. Exclusions
of Section I - Coverage A - Bodily Injury
And Property Damage Liability is replaced
by the following:
Paragraphs (1), (3) and (4) of this exclusion
do not apply to "property damage" (other
than damage by fire, lightning, explosion, and
leakage from automatic fire protective
systems) to premises, including the contents
of such premises, rented to you for a period
of 7 or fewer consecutive days. A separate
limit of insurance applies to Damage To
Premises Rented To You as described in
Section III - Limits Of Insurance.
3. Paragraph 6. of Section III - Limits of
Insurance is replaced in its entirety by the
following:
6. Subject to Paragraph 5. above, the
greater of:
a. $300,000; or
b. The Damage To Premises Rented
To You Limit shown in the
Declarations,
is the most we will pay under Coverage
A for damages because of "property
damage" to premises while rented to
you, or in the case of damage by fire,
lightning, explosion, or leakage from
automatic fire protective systems, white
rented to you or temporarily occupied by
you with permission of the owner.
Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., CL CG 04 4311 10
with its permission
This limit will apply to all damage
proximately caused by the same event,
whether such damage results from fire,
lightning, explosion, leakage from
automatic fire protective systems, or
other covered causes of loss or any
combination thereof.
4. Sub -paragraph b.(1)(a)(ii) of Paragraph 4.
Other Insurance of Section IV -
Commercial General Liability Conditions, ,
is replaced by the following:
(11) That is fire, lightning, explosion, or
leakage from automatic fire protective
systems insurance for premises rented to
you or temporarily occupied by you with
permission of the owner; or
5. Sub -paragraph a. of definition 9. "insured
contract" of Section V - Definitions, --is
replaced in its entirety by the following:
a. A contract for a lease of premises.
However, that portion of the contract for
a lease of premises that indemnifies any
person or organization for damage by
fire, lightning, explosion, or leakage from
automatic fire protective systems to
premises while rented to you or
temporarily occupied by you with
permission of the owner is not an
"insured contract".
G. MEDICAL PAYMENTS
If Coverage C - Medical Payments is not
otherwise excluded from this policy or coverage
part, the Medical Expense Limit is changed,
subject to the terms of Section III - Limits Of
insurance, to the greater of:
a. $10,000; or
b. The Medical Expense Limit shown in the
Declarations of this policy or coverage part.
H. MOBILE EQUIPMENT REDEFINED
Sub -paragraph f.(1) of definition 12. mobile
equipment of Section V - Definitions is entirely
replaced by the following:
(1) Equipment with a gross vehicle weight of
1,000 pounds or more and designed primarily
for:
1. NEWLY FORMED OR ACQUIRED ORGANIZA-
TIONS - EXTENDED PERIOD OF COVERAGE
Paragraph 3. of Section 11 - Who Is An Insured
is replaced by the following.
3. Any organization you newly acquire or form,
other than:
(1) a partnership, joint venture, or limited
liability company; or
(ii) An organization excluded either by
the provisions of this policy or
coverage part, or by endorsement,
and over which you maintain ownership
or majority interest of more than 50% will
qualify as a Named Insured if there is no
other similar insurance available to that
organization. However:
a. Coverage under this provision is afforded
only until the next anniversary date of
this policy's effective date after you
acquire or form the organization or the
end of the policy period, whichever is
earlier;
b. Section I - Coverage A - Bodily Injury
And Property Damage Liability does
not apply to "bodily injury" or "property
damage" that occurred before you
acquired or formed the organization; and
c. Section I - Coverage B - Personal And
Advertising Injury Liability does not
apply to "personal and advertising injury"
arising out of an offense committed
before you acquired or formed the
organization.
J. NON -OWNED WATERCRAFT
Sub -paragraph (2) of Exclusion 2.g. of Section I
- Coverage A - Bodily Injury And Property
Damage Liability is replaced by the following:
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not used to carry persons or property for
a charge;
K. SUPPLEMENTARY PAYMENTS - INCREASED
LIMITS
(a) Snow removal; Under Section I - Supplementary Payments -
(b) Road maintenance, but not construction Coverages A and B:
or resurfacing; or 1. The limit shown in Paragraph 1.b. for the
(c) Street cleaning; cost of bail bonds is changed from $250 to
$3,000; and
CL CG 04 4311 10 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 8
with its permission
2. The limit shown in Paragraph 1.d. for loss of
earnings because of time off work is changed
from $250 a day to $1,000 a day.
L. UNINTENTIONAL OMISSION IN DISCLOSURE
The following provision is added to Paragraph 6.
Representations of Section IV - Commercial
General Liability Conditions:
However, the unintentional omission of any
information given or provided by you shall not
prejudice your rights under this insurance.
This provision does not affect our right to collect
additional premium or to exercise our right of
cancellation or non -renewal.
i
M. WAIVER OF SUBROGATION "
Paragraph 8. Transfer Of Rights Of Recovery
Against Others To Us of Section IV -
Commercial General Liability Conditions is
amended by the addition of the following:
Notwithstanding anything to the contrary in
previous paragraph, we waive any right of
recovery we may have against a person or
organization- because of payments we make for
injury or damage arising out of your ongoing
operations or "your work included in the
"products -completed operations hazard", if:
a. Such operations or work were done under a
written contract or written agreement
between you and such person or
organization that contained a provision
requiring such waiver; and
b. Such written contract or written agreement
was:
(1) Made prior to the covered injury or
damage; and
(2) In effect at the time of the covered injury
or damage.
This waiver applies only with respect to such
person or organization.
page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., CL CG 04 43 1110
with its permission
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B
(Ed. 6-14)
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the
Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule, but this waiver applies only with
respect to bodily injury arising out of the operations described in the Schedule where you are required by a written
contract to obtain this waiver from us.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
The premium for this endorsement is shown in the Schedule.
Schedule
Specific Waiver
Name of person or organization
X ) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this
waiver.
2. Operations:
"All Texas Operations"
3. Premium:
The premium charge for this endorsement shall be 2 percent of the premium developed on payroll in connection
with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Advance Premium:
$38
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective
12/08/2016
Insured
Encore Live LLC
Insurance Company:
Union Insurance Company
WC 42 03 04 B
(Ed. 6-14)
Policy No.
WCA 4661916 12
Countersigned by
Endorsement No.
Premium
usan Batte
From: Melanie Hill
Sent: Monday, April 17, 2017 3:26 PM
To: Susan Batte
Subject: RE: Temp Use App - Austin Ranch
Approve
Melanie Hill, ARM
City of Grapevine
Risk Manager
Office: 817-410-3114
Fax: 817-410-3013
-----Original Message -----
From: Susan Batte
Sent: Monday, April 17, 2017 2:05 PM
To: Renee L. Minnfee <RLMinnfee@TarrantCounty.com>; Bryan K. Parker <bparker@grapevinetexas.gov>; Randie
Frisinger<rfrisinger@grapevinetexas.gov>; Barry Bowling <bbowling@grapevinetexas.gov>; Robert Eberling
<reberling@grapevinetexas.gov>; Melanie Hill <mhill@grapevinetexas.gov>
Subject: Temp Use App - Austin Ranch
Please see attached application and let me know if you approve
Susan Batte
Planning Technician
City of Grapevine
P 0 Box 95104 1 Grapevine, TX 7609°
p: (817) 410-3155 1 f: (817) 410-3018
-----Original Message -----
From:
Sent: Monday, April 17, 2017 12:57 PM
To: Susan Batte <
Subject: Message from KMBT C652DS
Susan Batte
From:
Robert Eberling
Sent:
Tuesday, April 18, 2017 8:02 AM
To:
Susan Batte
Subject:
RE: Temp Use App - Austin Ranch
Approved by PD. Encore has hired two off-duty police officers.
-----Original Message -----
From: Susan Batte
Sent: Monday, April 17, 2017 2:05 PM
To: Renee L. Minnfee < ; Bryan K. Parker < ; Randie
Frisinger < ; Barry Bowling < ; Robert Eberling
< ; Melanie Hill <
Subject: Temp Use App - Austin Ranch
Please see attached application and let me know if you approve
Susan Batte
Planning Technician
City of Grapevine
P 0 Box 95104 1 Grapevine, TX 76099
p: (817) 410-3155 1 f: (817) 410-3018
-----Original Message -----
From:
Sent: Monday, April 17, 2017 12:57 PM
To: Susan Batte <
Subject: Message from KMBT_C652DS
Susan Batte
From: Renee L. Minnfee <
Sent: Tuesday, April 18, 2017 8:19 AM
To: Susan Batte
Subject: Re: Temp Use App - Austin Ranch
I am okay with this.
Renee Minnfee, MPH RS
Sanitarian I
1101 S. Main Street, Rm 2300
Fort Worth, TX 76104
817.321.4979 (office) 817.321.4961 (fax)
From: Susan Batte <
Sent: Monday, April 17, 2017 2:04 PM
To: Renee L. Minnfee; Bryan K. Parker; Randie Frisinger; Barry Bowling; Robert Eberiing; Melanie Hill
Subject: Temp Use App - Austin Ranch
Please see attached application and let me know if you approve
Susan Batte
Planning Technician
City of Grapevine
P 0 Box 95104 1 Grapevine, TX 76099
p: (817) 410-3155 1 f: (817) 410-3018
-----Original Message -----
From:
Sent: Monday, April 17, 2017 12:57 PM
To: Susan Batte <
Subject: Message from KMBT_C652DS
Susan Batte
From:
Bryan K. Parker
Sent:
Tuesday, April 18, 2017 2:20 PM
To:
Susan Batte
Cc:
Randie Frisinger
Subject:
RE: Temp Use App - Austin Ranch
Fire Department Comments: Outside entertainment and stage shall not use fire lanes. Maintain fire lane access at all
times during the event.
Bryan K. Parker I Asst. Fire Marshal 1817.410.4421 1
This message may be confidential and/or privileged. If you are not the intended recipient, please notify the sender
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Internet communications are not secure. You should scan this message and any attachments for viruses. Under no
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attachments.
-----Original Message -----
From: Susan Batte
Sent: Tuesday, April 18, 2017 12:01 PM
To: Bryan K. Parker < ; Randie Frisinger <
Subject: FW: Temp Use App - Austin Ranch
I have not heard from yall and this event is tomorrow.
-----Original Message -----
From: Susan Batte
Sent: Monday, April 17, 2017 1:03 PM
To: 'Renee L. Minnfee' < ; Bryan K. Parker < ; Randie
Frisinger < ; Barry Bowling < ; Robert Eberling
< ; Melanie Hill <
Subject: Temp Use App - Austin Ranch
Please see attached application and let me know if you approve
Susan Batte
Planning Technician
City of Grapevine
P O Box 95104 1 Grapevine, TX 76099
p: (817) 410-3155 1 f: (817) 410-3018