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HomeMy WebLinkAboutC2019-111 - 3/21/2019 - NA CITGO Corpus Christi Refinery 1802 Nueces Bay Blvd. Corpus Christi,Texas 78407 CITGO March 11, 2019 CERTIFIED LETTER 7016 0910 0000 0682 2796 Development Services City of Corpus Christi P.O. Box 9277 Corpus Christi, Texas 78469 Re: CITGO Refining and Chemicals Company L.P. Amendment to Access Agreement Dated January 14, 2017 CITGO Deep Sea Terminal—4806 Up River Road, Corpus Christi, Texas City of Corpus Christi Development Services: CITGO Refining and Chemicals Company L.P. (CITGO) prepared the enclosed Amendment to the Access Agreement dated January 14, 2017 between CITGO and the City of Corpus Christi to access the monitoring well installed on City of Corpus Christi property. The City of Corpus Christi property is located south of the CITGO Deep Sea Terminal, between Up River Road and the 1-37 Access Road. The Amendment was prepared to include an additional monitoring well in the Agreement. The new well will be installed west of Van Cura Drive. The location of the well is provided on Exhibit A-1. Please contact me at 361-844-4163 if you have any questions or require additional information. Sincerely, #16 Zu—ma Garcia Group Leader—Water, Waste, Remediation and Transportation CITGO Refining and Chemicals Company L.P. CCRENVO/0140/1/ Enclosure C2019-111 3/21/19 CITGO Refining and Chemicals SCANNED AMENDMENT TO MONITORING WELL PERMIT AGREEMENT THE STATE OF TEXAS § COUNTY OF NUECES § Whereas, on February 3, 2017, the City of Corpus Christi (hereinafter the "City"), and CITGO Refining and Chemicals Company, L.P. (hereinafter the "Permittee") of 1801 Nueces Bay Blvd., Corpus Christi, Texas 78407, entered into a Monitoring Well Permit Agreement, referred to herein as the "Original Monitoring Well Permit Agreement", a copy of which is attached and marked as ATTACHMENT A-1; Whereas, the parties desire to extend said Original Monitoring Well Permit Agreement for an additional 12- month period upon payment of$100 extension fee; Whereas, the parties desire to amend the Original Monitoring Well Permit Agreement to provide for placement of an additional Monitoring Well at the location identified on the attached EXHIBIT A-1 as the "Proposed Well Location"; NOW, THEREFORE, THE PARTIES AGREE TO EXTEND AND AMEND THE MONITORING WELL PERMIT AGREEMENT AS FOLLOWS: 1. Permittee shall place an additional monitoring well at the location on the attached EXHIBIT A-1 labeled "Proposed Well Location". All terms and conditions of the Original Monitoring Well Permit Agreement apply to the construction, installation, monitoring and removal of the additional monitoring well, including requirement for Permittee to pay City the additional fee of$260.00 for additional monitoring well. 2. Upon additional payment of $100.00, the Original Monitoring Well Permit Agreement as amended is extended and continues until February 3, 2020, unless sooner terminated or cancelled pursuant to the terms therein. 3. All other terms and conditions of the Original Monitoring Well Agreement remain in effect unless revised herein. The City of Corpus Christi shall cause this Amendment to the Monitoring Well Permit Agreement to become effective upon date of execution by the City Manager, as indicated below. Page 1 of 4 Acceptance The above Amendment to Monitoring Well Permit Agreement i ereby accepted and its terms and enditio agreed this the I i ;= day of �1 , 1 -- ALL by , on behalf of CI GO Refining and Chemicals Company, L.P. CITGO Refining and Chemicals Compa y, L.P. agrees to keep and perform the conditions imposed by said Permit and to be bound by all of the terms of same. By: a" Name: Trina Martinez Title: VP and GM Corpus Christi Refinery Acknowledgment THE STATE OF TEXAS COUNTY OF NUECES is in:'tru ent was acknowledged before me on 6�k 1. I , 0 ( by IL- , of CITGO Refiningand Chemicals, L.P., a Texas cor oration, P on behalf • _ p ration. Ail •� l �- \.,i1 9 ' Nota 'ublic, State • Tex. . I Printe!Name: --pct1 e ��9kt -1 d2- Expir.tion Dat-: — %(,\ - --S lli JANIE GONZALEZ 'W-41.• Notary ID#123928750 I tai My Commission Expires ,p� July 19,2021 Page 2 of 4 ATTEST: CITY OF CORPUS /.-ISTI a By: Avi/Ii ecca Huerta Name: NI• City SecretaryTitle: a IL Date: 5l a X17 s Date: / • STATE OF TEXAS COUNTY OF NUECES This instrument was acknowledged before me on 1 +M�U,Y 0,V \ 3 , -0,C1 by h-e t• I rvvm , \014,-, ea.4 kw/A:pof the City of Corpus Christi, Texas, a Texas Municipal Corporation, on behAlf of said corporation. —t‘'N,I)VCCLO Notary Public, State o exas ` - \ ' " !�. MARTHA VAZQUEZ MCS'( D, V�( Cd U ¢ My Notary ID# 5,20 5792 Printed Name: 2 2 :�,r...,4*•' Expires March 52022 Expiration Date: \HCl,`461 6-0 a2- APPROVED AS TO LEGAL FORM this .2,1) day of «: By: ._-(./.) Lisa Aguilar Assistant City Attorney For the City Attorney Page 3 of 4 ATTACHMENT A-1 — Copy of the Original Monitoring Well Permit Agreement dated February 3, 2017; EXHIBIT A-1 — DATED MARCH 2019- Location of additional monitoring well to be installed Page 4 of 4 ATTACHMENT A-1 ORIGINAL MONITORING WELL PERMIT AGREEMENT MONITORING WELL PERMIT AGREEMENT THE STATE OF TEXAS § COUNTY OF NUECES § That the City of Corpus Christi (hereinafter the "City"), acting by and through its duly authorized City Manager, or designee, for and in consideration of the sum of Two hundred and sixty dollars ($ 260.00) to be paid in hand by CITGO Refining and Chemicals Company, L.P. (hereinafter the"Permittee")of 1801 Nueces Bay Blvd.,Corpus Christi, Texas 78407, does grant, upon the conditions hereinafter stated, unto said Permittee, a monitoring well permit for the right to install, operate, maintain and remove a monitoring well, approximately two (2)inches in diameter, up to thirty (30)-feet in depth, with a five (5) feet by five (5) feet concrete pad and a nine-inch diameter sealed metal manhole cover flush with relative ground surface elevation, for approximately a 24 month period, to be located within the area of City property shown on the attached Exhibit A, said area outlined in black and to be referred to herein as the"Premises"or the"property". The location of the monitoring well is identified on Exhibit A. The dimensions of the monitoring well are identified on Exhibit B. For purposes of this Agreement, "monitoring well" shall have the meaning as ascribed in Chapter 1901 of the Texas Occupations Code: "an artificial excavation that is constructed to measure or monitor the quantity or movement of substances below the surface of the ground and that is not used in conjunction with the production of oil, gas, or other minerals." TO HAVE AND TO HOLD the same unto Permittee, its successors and assigns, together with the right and privilege under the conditions and terms hereof, at any and all times to enter upon the above described right-of-way for the purpose of constructing operating, maintaining and removing of said monitoring well, and it is further understood that the foregoing monitoring well permit is granted upon the following conditions: A. This monitoring well permit may be revoked at any time upon the giving of 60 days notice in writing by the City of Corpus Christi's City Manager, or designee ("City Manager"). B. PERMITTEE, ITS OFFICERS, MEMBERS, PARTNERS, EMPLOYEES, AGENTS, AND LICENSEES (HEREINAFTER CALLED "PERMITTEE") SHALL FULLY INDEMNIFY, SAVE AND HOLD HARMLESS THE CITY OF CORPUS CHRISTI, ITS OFFICERS, EMPLOYEES, AGENTS, LICENSEES, AND INVITEES ("INDEMNITEES") AGAINST ANY AND ALL LIABILITY, DAMAGE, LOSS, CLAIMS, DEMANDS AND ACTIONS OF ANY NATURE WHATSOEVER ON ACCOUNT OF PERSONAL INJURIES (INCLUDING, WITHOUT LIMITATION ON THE FOREGOING WORKERS' COMPENSATION AND DEATH CLAIMS), OR PROPERTY LOSS OR DAMAGE OF Page 1 of 12 ANY KIND WHATSOEVER, WHICH ARISE OUT OF OR IS IN ANY MANNER CONNECTED WITH THE PERFORMANCE OF THIS PERMIT, INCLUDING SAID INJURY, LOSS OR DAMAGE CAUSED BY THE SOLE OR CONTRIBUTORY NEGLIGENCE OF THE INDEMNITEES OR ANY OF THEM. PERMITTEE SHALL, AT ITS OWN EXPENSE, INVESTIGATE ALL OF SAID CLAIMS AND DEMANDS,ATTEND TO THEIR SETTLEMENT OR OTHER DISPOSITION, DEFEND ALL ACTIONS BASED THEREON WITH COUNSEL SATISFACTORY TO INDEMNITEES AND PAY ALL CHARGES OF ATTORNEYS AND ALL OTHER COSTS AND EXPENSES OF ANY KIND ARISING FROM ANY OF SAID UABILITY, DAMAGE, LOSS, CLAIMS, DEMANDS AND ACTIONS. THIS INDEMNITY SPECIFICALLY INCLUDES ALL CLAIMS, DAMAGES, AND LIABILITIES OF WHATEVER NATURE, FORESEEN OR UNFORESEEN,UNDER ANY HAZARDOUS SUBSTANCE LAWS, INCLUDING BUT NOT LIMITED TO THE FOLLOWING: (A) ALL FEES INCURRED IN DEFENDING ANY ACTION OR PROCEEDING BROUGHT BY A PUBLIC OR PRIVATE ENTITY AND ARISING FROM THE PRESENCE, CONTAINMENT, USE, MANUFACTURE, HANDLING, CREATING, STORAGE,TREATMENT,DISCHARGE, RELEASE OR BURIAL ON THE PROPERTY OR THE TRANSPORTATION TO OR FROM THE PROPERTY OF ANY HAZARDOUS SUBSTANCE WHICH IS ATTRIBUTABLE TO PERMITTEE. THE FEES FOR WHICH THE PERMITTEE SHALL BE RESPONSIBLE UNDER THIS SUBPARAGRAPH SHALL INCLUDE BUT SHALL NOT BE LIMITED TO THE FEES CHARGED BY (I) ATTORNEYS, (II) ENVIRONMENTAL CONSULTANTS, (III) ENGINEERS, (IV)SURVEYORS, AND(V) EXPERT WITNESSES. (B) ANY COSTS INCURRED ATTRIBUTABLE TO (I) THE BREACH OF ANY WARRANTY OR REPRESENTATION MADE BY PERMITTEE IN THIS AGREEMENT, OR (II) ANY CLEANUP, DETOXIFICATION, REMEDIATION, OR OTHER TYPE OF RESPONSE ACTION TAKEN BY PERMITTEE OR PERMITTEE'S CONTRACTOR OR AGENT WITH RESPECT TO ANY HAZARDOUS SUBSTANCE ON OR UNDER THE PROPERTY REGARDLESS OF WHETHER OR NOT THAT ACTION WAS MANDATED BY THE FEDERAL, STATE OR LOCAL GOVERNMENT. THE PERMITTEE RESERVES THE RIGHT TO SEEK REIMBURSEMENT FROM THIRD PARTIES IF THE SOURCE OF ANY HAZARDOUS SUBSTANCE IS DETERMINED TO BE OTHER THAN THE PERMITTEE. THIS INDEMNITY SHALL SURVIVE THE EXPIRATION OR EARLIER TERMINATION OF THE AGREEMENT. C. Permittee must have and maintain commercial general liability insurance pertaining to the Monitoring Well Permit Agreement and the activities authorized by this Agreement, in the minimum amounts set forth in the attached and incorporated Exhibit C. The Page 2 of 12 insurance policies must name the City as an additional insured. The insurance policies may not be canceled, renewed, or materially changed without 30 days advance written notice to the City Risk Manager. The Permittee, or a representative or contractor of the Permittee, may not perform any work authorized by this permit until the Permittee has presented evidence of the insurance coverage specified in Exhibit C sufficient to satisfy the City's Risk Manager. Upon request of the City's Risk Manager, the Permittee shall provide copies of all insurance policies to the Risk Manager. D. Except as otherwise provided herein, all work proposed will comply with the Texas Commission on Environmental Quality (TCEQ), Texas Department of Licensing and Regulations, and the Texas Water Well Drillers Advisory Council rules, regulations, and requirements for the installation, monitoring, and removal of monitoring wells. E. Reporting Requirements: (a) Permittee shall promptly supply City with copies of notices, reports, correspondence, and submissions relating to the project/release of petroleum product from CITGO TK 9824 at Deep Sea Terminal and also relating to the closure of the monitoring well, which are made by Permittee to the Environmental Protection Agency, the TexasCommission on Environmental Quality, the United States Occupational Safety and Health Administration, or any other local, state or federal authority that requires submission of any information concerning environmental matters or hazardous wastes or substances pursuant to the Texas Water Quality Control Act, Water Code Sections 26.001 et seq., the Resource Conservation and Recovery Act, Title 42 of the United States Code, Sections 6901 et seq., and the Comprehensive Environmental Response Compensation and Liability Act,Title 42 of the United States Code, Sections 9601 et seq., and all applicable regulations. Permittee shall also supply City with written confirmation of any notices or reports regarding releases of hazardous wastes or substances relating to CITGO TK 9824 that Permittee makes orally or by telephone to any such governmental agency. (b) Permittee shall promptly notify City in advance of any scheduled meeting between Permittee and any of the agencies specified in subparagraph(a). All Notices or other communications required or permitted by this Agreement will be sufficiently given if in writing and mailed by registered or certified mail, return receipt requested, to the following addresses. Notice by email will be sufficient only upon confirmation of receipt. TO THE COMPANY AS FOLLOWS: City of Corpus Christi Attn: Petroleum Superintendent P. O. Box 9277 Corpus Christi, Texas 78469-9277 / Page 3 of 12 TO THE PERMITTEE AS FOLLOWS: CITGO Refining and Chemicals Company, L.P. 1801 Nueces Bay Blvd. Corpus Christi, Texas 78407 Attn: Zulema Marie Garcia, Environmental Department or other address(es)as hereafter furnished, as provided in this Article. Notices shall be effective upon receipt at the designated address(es). F. At the time of removal, the Permittee is required to backfill the monitoring well. At a minimum, the Permittee will comply with the technical requirements of 16 TAC 76.104. If the well falls inside existing asphalt pavement, the top 10-feet will be filled with 3000 psi concrete and remaining depth with bentonite. The City may elect, however, to fill the top 2-3 feet with soil, the next 10-feet with 3000 psi concrete and any remaining depth with bentonite. The alternate elective applies primarily to those monitor wells which fall outside of existing asphalt pavement G. All applicable Federal, State, County, and City laws and ordinances shall be complied with and all necessary permits shall be secured from the appropriate agencies prior to obtaining this permit. Copies of said permits shall be provided to the City and attached hereto for all purposes as Exhibit"D". H. No public street, or any portion thereof, shall be closed or barricaded to use by the public for the purpose of installing, repairing or maintaining the monitoring well until after the Permittee or its contractor has filed with this office an approved traffic control plan from the City Traffic Engineering Office. I. The City Assistant Director of Gas Operations, Corpus Christi Fire Department, AEP (American Electric Power), AT&T (American Telephone & Telegraph, formerly Southwestern Bell Company), Time Warner, and Grande Communications and any other companies that may be affected by the monitoring wells, must be notified 48-hours prior to construction. The Texas 811 or the Lone Star 811 Notification Center must be notified by calling 8-1-1 or 1-800-545-6005 at least 48 hours prior to construction for existing utility locations. J. Construction plans and specifications for all work proposed will be submitted to the Department of Development Services and City Director of Gas Operations for approval prior to beginning construction. The plans must show the depth and location of the proposed construction and distance from the existing water, storm, wastewater, and gas lines. The City will use best efforts to provide Permittee with an approval or rejection of the submitted plans within fourteen (14)calendar days. Page 4 of 12 K. Permittee shall restore the surface following installation of the subject well to as near the condition existing at the time of the granting of this Permit as reasonably practicable and shall replace or rebuild to the reasonable satisfaction of Grantor,any and all damaged surface and sub-surface installations, construction or facilities, including without limitation, sidewalks, curb and gutter, driveway, street, sanitary sewer, storm sewer, drainage facility, underground lines, wires or pipes owned by the City of Corpus Christi or holders of any franchise from the City, resulting from or caused by reason of construction, operation, maintenance and/or removal of said monitoring well. L Prior to and during the installation of the subject well, a City Inspector may request a utility line to be exposed to verify its depth and/or location. All backfill and repairs of any kind will be made according to City standards and/or City Inspector's request. All work and repairs will be at Permittee's or its contractor's expense. M. If a City Inspector is required at the job site, the Permittee shall pay a daily rate of $310.35 for each day spent inspecting construction, maintenance, repair, replacement, relocation or removal of the monitoring wells pursuant to the monitoring well permit. Any time in excess of eight hours per day and any time on Saturday, Sunday or Holidays shall be calculated at a daily rate of $58.18 per hour. These funds shall be paid to the appropriate City department within the City of Corpus Christi. These amounts will be adjusted annually on October 1 to reflect any pay increase. N. Should damage occur to a utility line so that sand or soil enters service lines causing problems and/or damage to plumbing in private structures, Permittee shall have sole responsibility for resolution with individual owners, including all costs associated with resolution. O. No equipment or material may be stored or left overnight in City right-of-way. P. The Permittee and/or its Contractor will not clean equipment or material on site. Q. Monitoring well will not protrude above the existing natural ground elevation, and a sealed covering will be provided to prevent surface water from entering into said monitoring wells. R. Permittee shall adjust or relocate the above described monitoring well at its own expense, if necessary for the present or future construction of any public utilities, or change in street grade or pattern on the streets or for any other reason of the City stated in writing to Permittee. The parties acknowledge that any modification, plugging, or movement of the well will require TCEQ authorization and will thus be subject to the time constraints associated therewith. S. The construction of the monitoring well and the use of said area hereby granted shall in no way interfere with the construction or operation by the City or any of its franchisees Page 5 of 12 of any existing or future proposed sidewalks, utility lines, or other uses, or the maintenance thereof. If City (or any company with existing utilities located in said right- of-way) needs access to the right-of-way containing the monitoring well, Permittee shall be responsible for either repairing the monitoring well or removing the monitoring well at which time this Monitoring Well Permit shall terminate immediately. T.The rights of construction conferred herein shall not be assigned by Permittee without the prior written consent of the City of Corpus Christi. U. The Monitoring Well Permit remains in effect during the Permittee's investigation and assessment of possible petroleum contamination. However, the Monitoring Well Permit expires 24 months from the date of issuance. Upon completion of the investigation and assessment the monitoring wells will be removed in accordance with the then current requirements of the City of Corpus Christi and the Texas Commission on Environmental Quality, Texas Department of Licensing and Regulation, or their respective successor agency in Austin, Texas. Provided, however, that if at the end of said 24-month period, the TCEQ requires additional monitoring of the well, then the City shall grant to Permittee an additional 12-month period in which to perform the work under this permit provided Permittee pays an additional $100.00 ($100/per yr.) to the City for the 12-month extension. The Permittee shall notify the City's Department of Development Services, ATTN.: Land Development Engineer,and the City Petroleum Superintendent at least five business days prior to removal of said monitoring well. V. Written notice shall be directed as provided in Section E(b)above.: W. Permittee shall be liable for and obligated to clean up and remediate any contamination to City property found to originate from Permittee's property. If the contamination is found to originate from Permittee's property, all liability and obligation shall be borne by Permittee until such time that Permittee remediates the contamination to TCEQ standards. The remediation by Permittee will be in accordance with Texas Risk Reduction Program (Title 30 Texas Administrative Code Chapter 350 as amended). Upon completion of the remediation,TCEQ will provide Permittee with a completion letter after submitting the Response Action Closure Report. Permittee shall keep the City apprised of testing and remediation activities including any notices or verifications of completion. CITGO will do analytical characterization within the Premises to compare the plume within the Premises to the CITGO Deep Sea Terminal TK9824 plume. Permittee has contracted with a third party to perform remediation and collect the samples which are to be provided to a NELAC-certified lab for analysis to determine source of contamination. Permittee shall share results of the third party testing with the City and shall provide City with prior notification of schedule for sample collection. Page 6 of 12 X. Permittee shall reimburse City for reasonable and verifiable costs incurred by City for necessary restoration or remediation work performed by City for repairs to the permitted area or appurtenant City property that (1) has been damaged by the installation, operation, or maintenance of the monitoring well, and (2)has not otherwise already been repaired or restored pursuant to section K(supra) . Y. City's authorization to Permittee does not in any way impair or relinquish City's right to use such property for City purposes. Z. Permittee understands that third-party utility and third-party pipelines owned by others may exist at the City property. Permittee shall provide adequate notice of the work to such third parties potentially impacted by the work to be performed. AA. Permittee shall indemnify the City and accept responsibility for all damages or injury to property of any character, including utilities and pipelines, occurring from any act, omission, neglect, or misconduct on the part of Permittee in performance under this Permit. The City of Corpus Christi shall cause this Permit to become effective upon date of execution by the City Manager, as indicated below. Page 7 of 12 Acceptance The abpyp Permit is hereby a d and its terms and conditions agreed this the A.V-'�3- day of Ori f ,„2124,_ by , on behalf of CITGO Refining and Chemicals_C npany, L.P. CITGO Refining and Chemicals Company, L.P. agrees to keep and perform the conditions imposed by said Permit a be bou by II of the terms of same. r By: Name: Art Klein Title: VP and GM Corpus Christi Refinery Acknowledgment THE STATE OF TEXAS COUNTY OF NUECES his • s mery Was acknowledged before me on 2ly ,p�D17 by �f , A A A e of CITGO Refining and Chemicals, L.Pi aTexas corporation, on b= '=If of said corporation. .... ,it - : ,I i_ Notary - 'lic, Stat •f = as Printed a'vie: :I..& it a 2 A (iC Expirati, Date: .I' It %O 17 i i f ' 1 JANIE GONZALEZ 1 ` I I My Commission Expires � j A / July 19.2017 Page 8 of 12 ATTEST: CITY OF CORPUS CHRISTI J ! C / t.LI & By:4014.efra 042l Rebecca ebe ca Huerta Name: •_A__ �a City Secreta Title: Date: ---)/ 1 7 Date: .2.21,Ar, STATE OF TEXAS COUNTY OF NUECES This instrument was acknowledged before me on re r k t✓ 3, a 017 , , by I ww C C•120 QC- , /\kC vw y$( of the City of Corpus Christi, Texas, a Texas Municipal Corporation, on behalf of said corporation. fin. Notary Public, State of Texas ESTHER YELAZOUEZ ��- Notary ID#2905734 Printed Name: C�s-i-IN e V e t a 2-ci7 My Commission Expires • ^.., .- July 5,2018 Expiration Date: T'-t I j. S� Q.01 S APPROVED AS TO LEGAL FORM this '-J4 day of J A v Q U 4) 2,017 : By: �--� Lisa Aguilar Assistant City Attorney For the City Attorney Page 9 of 12 EXHIBIT A DRAWING WITH THE LOCATION OF THE PREMISES AND THE LOCATION OF THE MONITORING WELL Page 10 of 12 EXHIBIT A I • N •. - ,N. / s '.N ~,<, ,:-.. f, - IN . - . CITGO—DEEP SEA TERMINAL a i A - C., N. '''', i'•:., '--. ' 41kiii#444' ,t,- . ' • N N'k 'K. liffr i.„... t 1 '"-, . ...,7 ti 1Na if s 41 I.1 4' ..• '1 a .. -. ... -...."-?' . ., 4... '-J'-' ....* if' ....,;:i. • VA., , - - N1/4 .,..st ,.." '- tt i'' ''' 'N'N',1"1:111 '''‹' • ' V `,. .• ,. • N Proposed Monitor Well Location , •-,.. --• . , - . .. N. .-- .• :- - Monitor Well DSTDW15 11, -' a (-16(itTle e.-- • ' EXHIBIT B DIAGRAM SHOWING THE DIMENSIONS OF THE MONITORING WELL Page 11 of 12 Proposed Monitor Well Completion Detail 5'-0" < > min. of 2-inch slope 9" from vault < > existin rade 0'-6" V A ry steel reinforced Steel Vault concrete 2'-0" 2-inch dia. lockable well cap V , 2-inch dia. Sch 40 PVCJ_�,�j hydrated bentonite pellets well riser with from concrete pad to filter flush threaded joints '— pack INN-� filter pack to extend approx. 2 feet above top of screen 2-inch dia. 304 screened interval from stainless steel wire E--- approx. 15 to 30 feet below grade level wrapped 0.01"slot well screen with flush threaded joints approx. 8-inch diameter borehole 2-inch dia. 304 16/30 sieve sand filter pack stainless steel end cap with flush threaded joints EXHIBIT C INSURANCE EXHIBIT Page 12 of 12 EXHIBIT C INSURANCE REQUIREMENTS 1. CONTRACTOR'S LIABILITY INSURANCE A. Contractor must not commence work under this contract until all insurance required has been obtained and such insurance has been approved by the City. Contractor must not allow any subcontractor, to commence work until all similar insurance required of any subcontractor has been obtained. B. Contractor must furnish to the City's Risk Manager and Utilities Director one (1) copy of Certificates of Insurance with applicable policy endorsements showing the following minimum coverage by an insurance company(s) acceptable to the City's Risk Manager. The City must be listed as an additional insured on the General liability and Auto Liability policies by endorsement, and a waiver of subrogation endorsement is required on GL, AL and WC if applicable. Endorsements must be provided with Certificate of Insurance. Project name and/or number must be listed in Description Box of Certificate of Insurance. TYPE OF INSURANCE MINIMUM INSURANCE COVERAGE 30-day advance written notice of Bodily Injury and Property Damage canceIIation, non-renewal, material change Per occurrence- aggregate or termination required on all certificates and policies. COMMERCIAL GENERAL LIABILITY $1,000,000 Per Occurrence including: $2,000,000 Aggregate I. Commercial Broad Form 2. Premises—Operations 3. Products/Completed Operations 4. Contractual Liability 5. Independent Contractors 6. Personal Injury- Advertising Injury AUTO LIABILITY(including) $1,000,000 Combined Single Limit 1. Owned 2. Hired and Non-Owned 3. Rented/Leased WORKERS'S COMPENSATION Statutory and complies with Part Il of this (All States Endorsement if Company is not Exhibit. domiciled in Texas) Employers Liability $500,000/$500,000/$500,000 Pollution Liability $1,000,000 Per Occurrence C. In the event of accidents of any kind related to this contract, Contractor must furnish the Risk Manager with copies of all reports of any accidents within 10 days of the accident. II. ADDITIONAL REQUIREMENTS A. Applicable for paid employees, Contractor must obtain workers' compensation coverage through a licensed insurance company. The coverage must be written on a policy and endorsements approved by the Texas Department of Insurance. The workers' compensation coverage provided must be in statutory amounts according to the Texas Department of Insurance, Division of Workers' Compensation. An All States Endorsement shall be required if Contractor is not domiciled in the State of Texas. B. Contractor shall obtain and maintain in full force and effect for the duration of this Contract, and any extension hereof, at Contractor's sole expense, insurance coverage written on an occurrence basis by companies authorized and admitted to do business in the State of Texas and with an A.M. Best's rating of no less than A-VII. C. Contractor shall be required to submit renewal certificates of insurance throughout the term of this contract and any extensions within 10 days of the policy expiration dates. All notices under this Exhibit shall be given to City at the following address: City of Corpus Christi Attn: Risk Manager P.O. Box 9277 Corpus Christi,TX 78469-9277 D. Contractor agrees that, with respect to the above required insurance, all insurance policies are to contain or be endorsed to contain the following required provisions: • List the City and its officers,officials, employees, and volunteers, as additional insureds by endorsement with regard to operations, completed operations, and activities of or on behalf of the named insured performed under contract with the City, with the exception of the workers'compensation policy; • Provide for an endorsement that the "other insurance" clause shall not apply to the City of Corpus Christi where the City is an additional insured shown on the policy; • Workers' compensation and employers' liability policies will provide a waiver of subrogation in favor of the City; and • Provide thirty (30) calendar days advance written notice directly to City of any, cancellation, non- renewal, material change or termination in coverage and not less than ten (10) calendar days advance written notice for nonpayment of premium. E. Within five (5) calendar days of a cancellation, non-renewal, material change or termination of coverage, Contractor shall provide a replacement Certificate of Insurance and applicable endorsements to City. City shall have the option to suspend Contractor's performance should there be a lapse in coverage at any time during this contract. Failure to provide and to maintain the required insurance shall constitute a material breach of this contract. F. In addition to any other remedies the City may have upon Contractor's failure to provide and maintain any insurance or policy endorsements to the extent and within the time herein required, the City shall have the right to order Contractor to stop work hereunder, and/or withhold any payment(s) which become due to Contractor hereunder until Contractor demonstrates compliance with the requirements hereof. G. Nothing herein contained shall be construed as limiting in any way the extent to which Contractor may be held responsible for payments of damages to persons or property resulting from Contractor's or its subcontractor's performance of the work covered under this contract. H. It is agreed that Contractor's insurance shall be deemed primary and non-contributory with respect to any insurance or self insurance carried by the City of Corpus Christi for liability arising out of operations under this contract. 1. It is understood and agreed that the insurance required is in addition to and separate from any other obligation contained in this contract. 2016 Insurance Requirements Utilities Department Mobile Water Monitoring 08/08/2016 my Risk Management Accmor DATE(MINCION TY) ` , CERTIFICATE OF LIABILITY INSURANCE 1/11/2017 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED,the pollcy(les)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). PRODUCE, CONTACT Nikki Howes NAME: Upstream Brokers PION (713)869-3100 1 fIL c,H,x(131964-9920 2020 Worth Memorial Way s IL nhoweslupatreambrokera.com DRESS: ersuangy AFFORDING COVERAGE i NAI:/ _ Houston TX 77007 unman A:LlOydr Of,London—_— _ ___.._...._ ------_-._- INSURED INSURER Bate First Liberty Ins. Corp. ' 33588 RPS JDC, Inc, dba RPS -1___-__ INSURER c:ElSployers Ina Company of_Wausau121458,_ 411 N. Sam Houston Pkwy INSURER D:ACEAmerican Insurance Co 122667 Suite 400 _ _.. ._ ---- INSURER E: Houston TX 77060 INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 MC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED 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. ,NSR I ADDL SUER ----- POLICY EFF j POCKY E%P LTR TYPE OF INSURANCE INS[!.!MIVn[ POLICY NUMBER ,IMMIDOIYYYYI,fieWOOITYYYI[ LIMITS X 1 COMMERCIAL GENERAL LIABILITY I IEACH OCCURRENCE I i 1.000.000 .__ DAMAGE TO-RENTED 1,000,000 A I CLAIMS-MADE ! X I OCCUR I I emit a(Ea.oecurr ) .$- X I Professional Liab 1M t 950255316 11/5/2016 11/5/2017 11EDPJfP{MyOno Mum) S 5,000 c X,I Contr. Pollution f 1M !PERSSONAJ 6 AOV SUJRY $ 1,000,000 GENL AGGREGATE UMIT APPUNS Mgt I GENERAL AGGREGATE S 2,000,000 UCYYY . !LOC i '.PRODUCTS•COMP/OP AGG I S .__ - 2,000,000 x .I JECT j Per Pre*AMEN* ,S 5,000,000 AUT OMOBLUIBI E LUTY �COMBI� j INGLE UNIT S 1,000,000 8 . X ANY AUTO BODILY INJURY(Per parson) S X ;ALLOSWNEO X_:.SCHT0ULED140NOEDn4ED ASS-641-439037-026 11/5/2016 11/5/3017 BODILY INJURY(Pm accident)!S AUTO X ; HIREDAUTOS -, AU5 (---PC+ANAOE $m mckleol) q X UMBRELLA LIAR ' X I OCCUR 1850255416 11/5/2016 11/5/2017 'EACHOCCURRENCE 'S 11,000,000 A L EXCESS UAB i CLNMS4,4ADE AGGREGATE .S 11,000,000 'DED J X I RETENTIONS 25.000 I S WORKERS COMPENSATION iX PER ! !0TH- !AND EMPLOYERS'LIABILITY ,6TATUiE ER I ANY PROPRIETORrPARTNENEXECUTNE Y f N[ EtEACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? W ['NIA; C (MandatoryInNH) ` - wCC-661-439037-016 11/5/2016 11/5/2017 •Et.DISEASE_EAEMPLOYEE S1,000,000 I yyeess.tklsalbe Indsr OESCRIPTION OF OPERATIOIt9 below EL DISEASE•POUCY UMI•S 1,000.000 D ' Foreign Package P11PD39249101-002 11/5/2016 11/5/2017 �iII Sea2n6Pala A 1 Maritime Employer's Liab 550170916 11/5/2016 11/5/2017 Any OroAccidenVmwu $1,000,000 I DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Addtlional Remarks Schedule,may be aMue,W N mon space Is molted) The Certificate Holder and any other party, if required by a written contract, is included as Additional Insured under all policies except Worker's Compensation, with a Waiver of Subrogation in their favor, under all policies. All policies are Primary and Non-Contributory and have a 30 Day Notice of Cancellation to Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Corpus Christi THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Risk Manager ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 9277 Corpus Christi, TX 78469 AUTHORIZEDREPRESENTATWE Susan Fontaine/NH /dGL:. � ID 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(101401) COMMENTS/REMARKS Project Number UECO2032 OFREMARK COPYRIGHT 2000, AMS SERVICES INC. COMMENTS/REMARKS FOREIGN PACKAGE POLICY #PHFD38249101-002 - 11/5/2016-11/5/2017 Commercial General Liability $1,000,000 Each Occurrence $2,000,000 Aggregate / Products Completed Operations $1,000,000 Premises Damage Limit $1,000,000 Personal Injury & Advertising Injury Contingent Auto Liability - $1,000,000 CSL Hired Car Physical Damage- $40,000 Any One Accident Contingent Employers Liability- INCLUDES CANADIAN WORKERS WORKING IN THE USA $1,000,000 Each Accident $1,000,000 Each Employee $1,000,000 Policy Limit $1,000,000 Maritime Employers Liability Insurer F - Lloyds of London-Maritime Employers Liability - Policy # SM0170916- 11/05/2016-11/05/2017 - Limit of Liability $1,000,000 Any one Accident or Illness including indemnity and expense. Maritime Coverage includes USL&H, Death on the High Seas, Outer Continental Shelf Lands Act, Jones Act, In REM. General Liability Includes: Blanket Additional Insured (Your Work) CG2037; Blanket Additional Insured (Completed Ops) CG2010; Non-Owned Watercraft Coverage; Per Project Aggregate Limits; $5,000,000 Aggregate) ; Gulf of Mexico / In Rem Endorsement; Blanket Waiver of Subrogation as required by written contract; Underground Resources and Equipment; Primary/Non-Contributory as required by written contract; Separation of Insureds; Coverage for Independent Contractors; Worldwide Coverage Contractual Liability for Business Contracts; No Exclusions for X,C,U; 30 Day Notice of Cancellation to Certificate Holder except 10 Days for Non-Payment of Premium Pollution Liability Coverage Includes: Separation of Insureds; Blanket Additional Insured as required by written contract; Blanket Waiver of Subrogation as required by written contract; Contractual Liability for Business Contracts; Gulf of Mexico / In Rem; Primary / Non-Contributory as required by written contract Professional Liability Coverage Includes: Separation of Insureds; Blanket Additional Insured as required by written contract; Blanket Waiver of Subrogation as required by written contract; Contractual Liability for Business Contracts; Gulf of Mexico / In Rem; Primary / Non-Contributory as required by written contract Automobile Policy Includes: Blanket Additional Insured as required by written contract; Blanket Waiver of Subrogation as required by written contract; Employees as Insureds; Blanket Additional Insured and Loss Payee for Lessors when required; Primary/Non-Contributory; 30 Day Notice of Cancellation to Certificate Holder Worker's Compensation Policy Includes: USL&H; Outer Continental Shelf Lands Act Endorsement; Maritime Employer's Liability; Voluntary Compensation; Alternate Employer; Blanket Waiver of Subrogation as required by written contract; All States Coverage; Stop Gap Coverage for monopolistic States; 30 Day Notice of Cancellation to Certificate Holder. Umbrella/Excess Policy Includes: Follow form of all underlying policies shown on certificate: General Liability, Professional Liability, Pollution, Employer's Liability, Auto Liability, Maritime (MEL) , and Foreign Package; Drop down coverage; Separation of Insureds; Blanket Additional Insured as required by written contract; 30 Day Notice of Cancellation to Certificate Holder; Blanket Waiver of Subrogation as required by written contract; Primary / Non-Contributory as required by written contract. All carriers are rated "A" or higher by A. M. Best's. OFREMARK COPYRIGHT 2000, ANS SERVICES INC. Policy: SM0255316 COMMERCIAL GENERAL UABIUTY CO 20 10 10 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Blanket where required by written contract. (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) A. Section II—Who Is An Insured is amended to (1) All work, Including materials, parts or Include as an Insured the person or organization equipment furnished In connection with shown in the Schedule, but only with respect to such work, on the project (other than liability arising out of your ongoing operations service, maintenance or repairs)to be performed for that insured. performed by or on behalf of the add- B. With respect to the insurance afforded to these Norval Insured(s)at the site of the cov- additkxrsl Insureds, the Wowing exclusion is r� operations has been completed; added 2. Exclusions (2) That portion of'your work"out of which This Insurance does not apply 10 "bodily in- the Injury or damage arises has been jury"or"property damage'occurring after. organo orItsganization othernded than anyse by nmooncon- tractor ode or subcontractor engaged In performing operations for a prindpal as a part of the same project. CG 20 10 10 01 ®ISO Properties,Inc., 2000 Page 1 of 1 El Policy: SM0255316 COMMERCIAL GENERAL LIABILITY CG 20 37 10 01 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Blanket where required by written conked. Location And Description of Completed Operations: • Additional Premium: 1 (If no entry appears above,Informallon required to complete this endorsement wlp be shown ki the Declarations as applicable to this endorsement) Section 11—Who is An Insured Is amended to include as an insured the person or organization shown in the Schedule,but only with respect to(lability editing out of"your work'at the location designated and described in the schedule of this endorsement performed for that insured and Included in the"products-completed operations him- / ard". CG 20 3710 01 0 ISO Properties,Inc., 2000 Page 1 of 1 13 I'no 33 Policy Number SM0255316 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY JOINT AND SEVERAL LIABILITY ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS I COMPLETED OPERATIONS LIABILITY COVERAGE FORM CONTRACTORS POLLUTION LIABILITY COVERAGE FORM PROFESSIONAL UABILITY COVERAGE FORM SITE POLLUTION LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organisation; Blanket where required by written contract. A This insurance applies to"bodily injury'or'property damage'when the following written contract requirements are applicable: 1. Coverage available under this coverage part shall apply as primary Insurance. Any other insurance available to these additional insured's shall apply as excess and not contribute as primary to the insurance afforded by this endorsement. 2. The term Insured Is used separately and now collectively,but the inclusion of more than one insured shall not increase the limits or coverage provided by this Insurance. Insureds and Agents are advised that certificates of Insurance should be uaed only to provide evidence of Insurance In lieu of an actual copy of the applicable Insurance policy,Certificates cannot be used to amend,expand or otherwise aker the terms of the actual policy. Ail other terms,conditions and exdusions remain unchanged. 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: Policy No.: Endorsement No. Insured: Premium: Insurance Company: Authorized Signature: EGMP 406 0910 Includes copyrighted materiel of insurance Services Office,Inc.,with its Page 1 of 1 permission Cover Note SM0255316 430 Arthur J. Gallagher Page 4of84 INSURER CONTRACT DOCUMENTATION: PERMISSION TO ISSUE CERTIFICATES Permission is granted by underwriters to allow Upstream Brokers of 2020 N Memorial Way,Houston,TX 77007 to issue certificates of insurance evidencing coverage on behalf of the underwriters,copies of which to be kept on file with Upstream Brokers. Permission is also granted by Underwriters hereon to allow Upstream Brokers of 2020 N Memorial Way,Houston,TX 77007 to provide notice of cancellation to Certificate holders when applicable. NOTICE OF CANCELLATION TO CERTIFICATE HOLDERS ENDORSEMENT This endorsement modifies the notice of cancellation of insurance provided hereunder: A. In the event this policy is canceled for any permissible reason within this policy by either the Insured or by underwriters,Upstream Brokers shall endeavor to provide 10 days notice of cancellation for non-payment of premium and 30 days for any other reason,to those certificate holders on file with Upstream Brokers by email as soon as practicable,after notifying the first Named Insured. B. This advance email notification of a pending cancellation of coverage is intended as a courtesy only.Any failure to provide such advance notification will not extend the policy cancellation date,nor negate cancellation of the policy. TEXAS SURPLUS LINES CLAUSE This insurance contract is with an insurer not licensed to transact insurance in this state and is issued and delivered as surplus line coverage under the Texas insurance statutes.The Texas Department of Insurance does not audit the finances or review the solvency of the surplus lines insurer providing this coverage,and the insurer is not a member of the property and casualty insurance guaranty association created under Chapter 462,Insurance Code.Chapter 225,Insurance Code,requires payment of 4.85 percent tax on gross premium. 01104/09 LSW1023A For Canadian business—Subject to Canadian Global Slip Endorsement And Interlocking Clause-LMA5179 as attached Intension For AIF To Bind Clause-LMA5181 (amended).As attached Canadian Endorsement-LMA3105.As attached Arthur J Gallagher(UK}Limited is authorised and regulated by the Financial Conduct Authority Registered Office The Walbrook Building,25 Walbrook,London EC4N 8AW.Registered in England and Wales. Company Number'1193013 www ajgintemational corn VAT Reg No GB 484 7462 09 Policy Number AS6-641-439037-026 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM Wi h respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s) or organization(s) who are "assureds' for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. • SCHEDULE Name Of Persons)Or Onganizatlon(s): Any person or organization whom you have agreed in writing to add as an additional insured,but only to coverage and minimum limits of insurance required by the written agreement.and in no event to exceed ether the scope of coverage or the limb of insurance provided in this policy. Information required to complete this Schedule,if not shown above,will be shown in the Declarations. Each person or organization shown In the Schedule is an 'Insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an"insured"under the Who is An insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.Z.of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 C Insurance Services Office.Inc.,2011 Page 1 of 1 Policy Number: AS6-641-439037-026 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name(s)Of Person(s)Or Organizatlon(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us,but only if the contract Is executed prior to the injury or damage occurring. Premium: $ INCL Information required to complete this Schedule,If not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organizations) shown in the Schedule, but only to the extent that subrogation is waived prior to the 'accident" or the "loss' under a contract with that person or organization. CA 04 44 10 13 C Insurance Services Office,Inc.,2011 Page 1 of 1 Policy Number:AS6-641-439037-026 Issued By: The First Liberty Insurance Corp. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Other Person(s)! Email Address or mailing Number Organization(s): address: Days Notice: Per schedule on file with broker Per schedule on file with broker 30 A. if we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. UM 99 01 05 11 ®2011, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy Number WCC-641-439037-016 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 kern 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 wil 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 1. () Specific Waiver Name of person or organization (x) Blanket Waiver Any person or organization for whom the Named hsured has agreed by written contract to furnish this waiver 2. Operations•. All Texas operations 3. Premium: The premium charge for this endorsement shall be 2.0 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: This endorsement is executed by the Employers Insurance Company of Wausau 15555 Premium$ Effective Date Expiration Date WC 42 03 04 A Page 1 of 1 Ed.1/2000 NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below.We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named Insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Schedule Name of Other Person(s)! Email Address or mailing address: Number Days Notice: Organization(s): Per schedule on file with 30 broker. All other terms and conditions of this policy remain unchanged. Issued by Employers Insurance Company of Wausau 15555 For attachment to Policy No.WCC-641-439037-016 Effective Date Premium$ Issued to RPS Group,Inc. WM 9018 0611 ©2011,Liberty Mutual Group. All Rights Reserved. Page 1 of 1 Ed.06/01/2011 EXHIBIT A-1 WELL LOCATION MAP 1 , ��VII L Apt r: 16 \S„, tai ' =ti.'1111 'Jr , ' :� . ' CITGO DEEP `i,. ,!v \ :: � ,� C. - w; SEA TERMINAL qtr. v • \ •. , 1. � ti.' -.' r'-: ,DSTDW18 � .. N �, y ,,f4 , � . �'OR .� i ' •I N*4464'4, ' 44,..,,,. . . ,, •,: .00 - t, ' _ ,,,„.„ - ..... t.,..:,* • • y , . , , r/ , .• DSTDWI 5 ' ,. � Q� qtr. .i!...--->�� a_ .,. --,,,_ • • . • - • • EDWEL •.� omilim _ i LOCATION . .� �' ��" a — _ _ �, / ,. _ .0_ 11'7-:,,,': ''-',-., ' ,.'.- \ ' . _ — — — fIl1E, -- --- -- --- ------- a IMAGERY SOURCE:GOGGLE EARTH,8/29/2017. LEGEND A-1 MONITORING WELL r- - --1 t 1 WELL LOCATION MAP N L - _I SOUTH OF CITGO i 1111111111111m 0 50 100 gq Environmental,��C DEEP SEA TERMINAL CORPUS CHRISTI, TEXAS SCALE IN FEET SCALE: DATE: PN: 1 IN= 100 FT MAR 2019 1104.001.002 ° SIGNATURE REQUEST 1852 MEMORANDUM To: Keith Selman, Interim City Manager Thru: Daniel McGinn, Director, Planning and ESI p riq From: Sharon Bailey Lewis HMM Environmental Affairs Manager, ESI Date: March 12, 2019 Subject: Amendment to Monitoring Well Permit Agreement with CITGO Explanation of Request: On or about June 2, 2015 , CITCO Refining and Chemicals Company, L.P. had a release of Naptha from a bulk storage tank at their Deep Sea Terminal on Interstate Highway 37 and Up River Road. City Environmental and Legal staff prepared access agreement (attached). Following remedial steps as described in the Remedial Action Plan, CITGO prescribed an institutional control Plume Management Zone(PMZ) which included City property. The City requested that additional monitoring be installed west of Van Cura Drive and the original well location (Exhibit A-1). The Amendment, along with supporting documents and payment of $360.00 in accordance with City Ordinance 49-62, has been signed by CITGO representatives. The agreement (2 copies) require approval by the City Manager and should be signed and dated in order to provide both CITGO and the City of Corpus Christi a copy with original signatures. Return of signed forms by Thursday, March 14, 2019 is requested. Prior Approvals Signature from City Manager is: City Council fl Required City Attorney ® Desired but not required ❑ Department Head ® Routine & Reoccurring ❑ ACM Special Circumstances ❑ Other City Secretary ® If special circumstance, please explain: \\\