Fill - Free fillable Parkway Bond(1) $10,000 Parkway Bond Application (City of Fortworth) PDF form

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To perform construction in the City’s right‐of‐way, Contractors must be licensed and

bonded. The following documents and fee are required by  the City  of Fort Worth for

licensingandbonding:



□ Original$10,000ParkwayContractorsBondwithPower‐of‐Attorney.

□ ApplicationforLicense(fornewcontractorsonly)

□ Licensefeeof$500,payabletotheCityofFortWorth

□(ForCommercialWorkonly)CertificateofLiabilityInsuranceinthe

amountof$1milliongeneralcommercialliabilitycoverage.The

certif

icatemustnametheCityofFortWorthascertificateholderand

additionalinsured.Itmustalsoincludea30‐daycancellationnotice.

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**Pleasereadattachedinstructionsfordetailedinformation**

For more information, please contact the City of Fort Worth Transportation and

Public Works Department, Street Permit Center at 817.392.6594, or visit us at 311

W. 10

St. Fort Worth, TX. 76102. We are located on the southwest corner of 10

and Taylor.

$10,000 BOND

Instructions for completing the Parkway Contractor’s Bond

The bond forms provided must be completed by the bonding company’s insurance agency and signed

by the bonding company’s principal and Attorney-in-Fact.

The Power-of-Attorney for the Attorney-in-Fact must be the same name and have the same date on the

bond. Submit the original bond with seal and Power-of-Attorney with original signatures to the

Street Permit Center.

If you are a new contractor, the license application must be completed in full, signed and dated by the

applicant (principal).

Names must be written and printed in the space provided. (Please attach a sheet with insurance and

bonding company’s name, full address, and phone and fax numbers).

New contractors are required to meet with a parkway construction inspector before the release of a

parkway permit. New contractor meetings with inspectors are held Monday through Friday from

8 a.m. to 9 a.m.

Annual license fee for all contractors

A check/credit card/cash/money order/cashier’s check in the amount of $500 (annual license fee),

payable to the City of Fort Worth, must accompany the application when it is returned to the Street

Permit Center office. This fee is for one year from the date of the bond and is renewed annually.

Existing Contractors: If you are continuing your bond from one year to the next, with no lapse in

coverage, a continuation certificate and the license fee of $500 is all that is required. The continuation

certificate must have a coverage term of 12 months. The license renewal with the Street Permit

Center is valid one year from the bond’s effective date.

CITY OF FORT WORTH, TEXAS

PARKWAY CONTRACTOR’S BOND

THE STATE OF TEXAS )

KNOW BY ALL MEN THESE PRESENTS:

COUNTY OF TARRANT )

That we, _____________________________________________________, as Principal, and

______________________________________, as Surety, are held and firmly bound unto the

City of Fort Worth, Texas, or to any of its Officers, for the use of any persons, firms, or

corporations with whom such Principal shall hereafter contract, in the penal sum of Ten

Thousand ($10,000), good and lawful money of the United States of America, well and truly to

be paid, and for payment of which we and each of us hereby bind ourselves, our heirs,

executors, administrators, and successors, jointly and severally, firmly by these presents.

THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT

WHEREAS, the above-named Principal desires to engage in the business of pouring,

constructing, building, repairing and rebuilding curbs, gutters, sidewalks and driveways in the

City of Fort Worth, and has complied with all of the terms and conditions of Section 30-33 of the

Code of the City of Fort Worth (1986), as amended, and as same may be amended from time to

time, and has applied to the City Engineer of said City for a license to do such work, which

license expires if its own force and effect one (1) year from the date thereof, but may be revoked

by the City of Fort Worth at any rate.

NOW THEREFORE, if said Principal shall, during its continuance of said license,

indemnify and save harmless the City of Fort Worth and any person, firm or corporation with

whom the Principal has contracted, from any and all damages of every character arising from, or

caused directly or indirectly, from imperfect or inadequate work done by said Principal and

maintain said work in good and workmanlike state of repair for and during a period of two (2)

years from and after its completion and acceptance by the City of Fort Worth, then this

obligation shall be null and void, otherwise to remain in full force and effect; provided, however,

this bond is executed by the Surety on the condition that its liability shall be limited by and

subject to the conditions and provisions herein contained.

Successive actions may be brought on this bond for successive breaches of its

conditions or any of them; provided, however, that the sum total of all liability of the Surety on

any one or all of such actions shall not exceed the sum of Ten Thousand Dollars ($10,000).

The liability of the Surety under this bond, if not canceled as hereinafter provided, shall

cease and terminate of its own force and effect only year from the date hereon, saving and

except for the maintenance of the work performed previous to the date of termination, for which

work the liability of the Surety from maintenance shall continue for two years from and after the

date of the completion and acceptance of said work by the City, but no longer.

The Surety may terminate its liability under this bond at any time by giving the City

Council of the City of Fort Worth, Texas, five (5) days written notice of the Surety’s intention to

do so, and from and after said date the Surety will no longer be liable for any subsequent act,

save and except as to maintenance as hereinabove provided.

IN WITNESS WHEREOF, the said Principal; of the said Surety have set their hand and

seal this __________ day of __________, 20______.

____________________________

PRINCIPAL

_________________________

SURETY

____________________________

ATTORNEY-IN-FACT

Parkway Contractor’s Bond

Application for License

Type or print the company name of the applicant in the blank below:

___________________________ Hereby makes application for license as provided for by Section 30-

33 of the Code of the City of Fort Worth (1986), as amended, and as same may be amended from time

to time, stating that applicant is fully qualified to properly complete any work undertaken and will

make available the necessary labor, materials, and equipment; and furnishes the following in support

of this application:

1. The applicant or owner has been in business _____ years as a parkway contractor under the

present business name.

2. Has the applicant or owner engaged in business under any other name(s) in the past ten years?

__________

If yes, what name? ____________________________________________________________

3. Other cities where applicant is licensed: _________________________.

4. Has the applicant or owner ever been licensed as a parkway contractor by the City of Fort Worth?

______If yes, when? __________________________________________________

5. Has the applicant or owner had concrete work he/she started, completed or reconstructed by a

bonding company? ________ If yes, summarize on an attached sheet.

6. Has the applicant or owner failed to complete any contract he entered? _______ If yes, summarize

on an attached sheet.

7. Types of construction company usually performs: __________________________________

8. Type of organization: Individual, Partnership, Corporation, etc.:_______________________

9. Applicant/owner full home address:

__________________________ _____________________________ ___________ _____________

Address City State Zip

10. Applicant/owner full business address:

__________________________ _____________________________ ___________ _____________

Address City State Zip

Owner, partners, or officers and construction experience:

NAME TITLE YEARS

Applicant is familiar with Section 30-33 of the Code of the City of Fort Worth (1986), as amended;

will furnish the required bond satisfactory to the City of Fort Worth, Texas; and agrees to complete

all work in compliance with the requirements established by the City of Fort Worth through its City

Engineer.

City Engineer Approval: _______________________________________

AUTHORIZATION TO SIGN FOR PERMITS:

Name of authorized Phone number for

individuals to receive permits

: Emergencies:

___________________________ ________________________

Name

___________________________ ________________________

Name

___________________________ ________________________

Name

___________________________ ________________________

Name

___________________________ ________________________

Name

___________________________ ________________________

Name

___________________________ ________________________

Name

Licensee/Applicant Signature: _________________________________ Date: __________

TPW/Traffic Engineering

Street Permit Center

BASIC INSURANCE REQUIREMENTS

PARKWAY CONTRACTORS

The following items represent basic insurance requirements. Exceptions to the insurance requirements

may be permitted, depending on the risk exposure in regards to respective services, products procured,

or contractual terms, to name a few. The only non-negotiable item is number 3, Statutory Limits of

Workers’ Compensation, which is required for all public projects.

1. Commercial General Liability (CGL) Insurance Policy

$1,000,000 Each occurrence

$2,000,000 Aggregate limit

2. Automobile Liability Insurance Policy

$1,000,000 Each accident on a combined single limit basis

A commercial business policy shall provide coverage on “Any Auto”

3. Worker’s Compensation Insurance Policy

 Statutory Limits

 Employer’s liability

$100,000 Each accident/occurrence

$100,000 Disease-per each employee

$500,000 Disease-policy limit

4. Policy Endorsements as follows:

 The City of Fort Worth, its Officers and Employees named as an Additional Insured

 Thirty (30) days notice of cancellation or non-renewal. It would be advantageous to the

City to require the following clause:

“This insurance shall not be cancelled, limited in scope or coverage, cancelled

or non-renewed, until after thirty (30) days prior written notice has been given

to the City of Fort Worth”.

 Waiver of rights of recovery (subrogation) in favor of the City of Fort Worth.

5. The insurers for all policies must be licensed/approved to do business in the State of Texas and

have minimum rating of A: VII in the current A. M. Best Key Rating Guide or have reasonably

equivalent financial strength and solvency to the satisfaction of the Risk Manager.

6. The deductible or self-insured retention (SIR) affecting required insurance coverage shall be

acceptable to the Risk Manager of the City of Fort Worth in regards to asset value and

stockholders’ equity. In lieu of traditional insurance, alternative coverage maintained through

insurance pools or risk retention groups must also be approved.

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Parkway Bond(1) $10,000 Parkway Bond Application (City of Fortworth)

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