FACILITY ENCROACHMENT AGREEMENT AND COMMUNICATIONS CABLE OR FIBER OPTIC LINE PROTECTION RIDERCSX
TRANSPORTATION Form # OP
OUTSIDE PARTY NUMBER REQUEST FORM o
* All information must be TYPED or CLEARLY PRINTED
Proof of insurance as required by CSX and/or indicated in your agreement
* Note: If flagging protection is required, the average cost is $800.00/day, this is not an invoice. A separate invoice
for actual costs of flagging services will be sent to the Licensee or Project Owner upon completion of the project.
* For Maintenance Only: Please provide a check for $100.00 for processing of the Request form.
* Please submit this form in one of the following manners:
Mail: Property Services Fax: 904.245.3692 Email: OP_Request@csx.com
c/o Flagging Projects
500 Water Street, J180
Jacksonville, FL 32202
l
d
C
C
Section 1: Project Infoi-m
I.??cat?iota! ation
? .. ?,
k ` ? omp
ete
by
ustomer
To be-
t tnf?rrratx
City: Clearwater
......................................................................... CSXT Agreement No.: 21838
X 6
..._CS............. .......................................... _...................................
County: Pinellas ................................................. CSXT Agreement Date: January 19, 2009
............................................................................................
State: FL Agreement Holder: City Of Clearwater
...... .............. .........._.._...............__...............................................................................
Requested Start Date:
.... _..................... Railroad Milepost : SY 870.20
............................... ...... ..
New Maintenance
Duration in Days: Installation : X
Scone of work: o
fsub-grade Pi
Installation line lack & bore. RK.
C
d b
C
l
Section 2: Pi-oliect Contac t Inforniation
f
t
?. Ilbl[IQPr?IYI CCt OWW
't y
ustomer
To be
omp
ete
(z dil eronMom Billing)
Contact Name: Contact Name:
Company Name: Company Name:
Company Billing Address: Company Address
Address (2) Address (2):
City: City:
State/Zip: State/Zip:
Phone: Phone:
Fax: Fax:
Email: Email:
Rte .. ' .......
Name: SaladinJr„John F.
. . . . . . . . . . . . . . . . . . . . . . ................. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I)i 'ision: ,Jacksonville
? ? ? - .............. ? gyp.
Outside Part (OP) Numbe Valid Th Ins ectio REQUIRED
Actual Start Dat
CSX
TRANSPORTATION Instructions
OUTSIDE PARTY NUMBER REQUEST FORM o
Flagging Services:
Flagging services are required when projects are within close proximity to active rail lines and can only be performed by
qualified CSXT personnel. Conditions when CSXT flagging services are required include:
+ When an agency, consultant, or contractor is working on, near or adjacent to active railroad tracks
+ When an outside party is using railroad property or performing operations that may affect railroad property or
facilities
• When work off railroad property could impact CSXT property or operations
41 When off-highway construction equipment is crossing the railroad at a private or public crossing
• When oversized equipment or highway vehicles are to cross the railroad at a private or public crossing
CSXT flagging services may only be performed by qualified CSXT employees who are (i) trained in the proper procedures
related to rail operations and safety requirements, (ii familiar with rail operations and procedures in a project area, and (iii) able
to communicate directly with CSXT dispatching personnel and train crews. Depending on the current schedule of projects
and/or your project scope, it may take 30 or more days to secure a flagman for your project.
Instructions:
0 All information must be TYPED or CLEARLY PRINTED
• Proof of insurance as required by CSX or as indicated in your agreement (Certificate of Insurance which states
CSX Transportation, Inc. as additional insured. Current coverage requirement is $3 million per occurrence. Please
direct any questions to Shawn Schieler at 904.633.1513)
Note: If flagging protection is required, the average cost is $800.00/day, minimum 8 hours plus drive time and
other incurred expenses. This is not an invoice. A separate invoice for actual costs of flagging services will be sent
to the Licensee or Project Owner upon completion of the project. (Please note certain projects may require
engineering review and the Agreement Holder/ Project Owner will be responsible for all costs associated with this
review by CSXT and/or its Contractors.)
* When off-highway construction equipment is crossing the railroad at a private or public crossing
+ When oversized equipment or highway vehicles are to cross the railroad at a private or public crossing
+ Please submit the form with payment of $100.00 [pre-authorization (credit card) form can be found on the CSX
website at: http://www.csx.com/?fuseaction=general.csxp_flag] in one of the following manners:
Mail: Property Services Fax: 904.245.3692 Email: OP_Request@csx.com
c/o Flagging Projects
500 Water Street, J180 [include pre-authorization form with fax or email]
Jacksonville, FL 32202
[Include check or pre- Authorization form]
• In the event that local flagging services are not available at the time of your request work effort, flagging services
from outside the geographical area of your project may be assigned but at extra cost to the Agreement Holder/
Proiect Owner. The cost of flagging services vary based on factors including, but not limited to, type of project,
duration of project, utilization of local or out of town flagging personnel, etc.
* In the event it is necessary to cancel or re-schedule flagging services already scheduled, the following
notice periods are required (failure to provide notice as stated shall result in the customer incurring costs
associated with the scheduled flagging services):
i. 48 hour notice - Short term projects (project time frame of 1 _3 days to completion)
ii. 3 days notice - Medium term projects (project time frame of 4 - 19 days to completion)
iii. 5 days notice - Long term projects (20 or more days to completion)
Instructions: Page 1 of 2
TRANSPORTATION Instructions
OUTSIDE PARTY NUMBER REQUEST FORM 0
Completing the form:
Salton 1: Project Information (W be fx? v* c
Location / Project Description:
City, County, State - Location of the requested work to be performed
Requested Start Date - The day you wish to initiate your work efforts (note: depending
on the work to be performed and the duration in days, 30 days
advance notice is required)
Duration in Days - The number of days you expect your work effort to take place
Project Description - A detailed description of your work effort (note: this information
is required in making the decision as to the necessity of flagging
services - can be submitted on separate page. If an adequate
description is not provided, we can not process your request.)
Agreement Information:
CSXT Agreement No. - Typically located in the top right corner of the agreement
CSXT Agreement Date - Date agreement executed. Typically located on page I of the
agreement
Agreement Holder: - Entity named in agreement - other than CSXT. Typically located
on page I of the agreement
Railroad Milepost - Typically located on page 1 of the agreement
&V0wz--4'*'*C'Cvnf t Infwt md? n (to be 4ed by cat )
Current Billing Information - Billing information for the agreement holder (entity named in
agreement)
Project Contact Information _ Contact information for individual responsible for managing work
efforts
Please direct any questions to Shawn Schieler at 633-1513 or OP_Request@esx.com.
Instructions: Page 2 of 2
r
IMPORTANT NOTICES
Agreement Number: CSX621838
• Your installation may affect an existing fiber optic parallelism/longitudinal located on Railroad right-of-
way. Therefore, you must also give notification in accordance with the "Communication Cable or Fiber Optic
Protection Rider."
• Please note that due to the nature of your project(s), an inspector must be present during construction, in
addition to any flagging services. The costs for these services will be billed separately, and are not included in
the attached Statement of Fees.
AGREEMENT EXECUTION
• Sign all signature pages in order to execute the agreements. One of the following should apply:
Execution on behalf of a CORPORATION should be accomplished by the President, Vice President or an
officer authorized by Board Resolution to execute legal documents on behalf of the Corporation. (Cop,?of
o rd u atian s Quid a furnished . an in of the President or Vice President,) If
the Corporate name is set out erroneously in the Agreement, the document should be executed and the
name corrected and initialed where it appears. (Municipal Corporation, furnish copy of such Resolution.)
If the Agreement is with a PARTNERSHIP, all general members of the partnership should execute the
document unless one member of the firm has been designated managing partner or expressly by the
partnership to execute the Agreement. (Furnish copy of such authority.)
The signature(s) must be WITNESSED by ONE (1) witness in the space(s) provided.
• NAME(S) and TITLE(S) of person(s) executing the agreement must be typed or printed in ink directly
beneath signature(s).
i A Tax Identification Number is required.
* Be sure to provide and/or verify an emergency contact number located in the "Notice" provision of the
Agreements. This should be a number by which someone can be contacted should an emergency arise outside
of normal business hours.
CS
Statement of Fees
City of Clearwater
100 South Myrtle Avenue
Clearwater, FL 33756
Amount Due
Total Current Fees
CSX Federal ID No.
CSX Candlan ID No.
Please remit payment to:
Questions? Contact,
Page
Account/Contract
Customer Project No.
Date
54-6000720
1022382868
loft
CSX 621838
1/19/2009
$ 1285.00
$ 1285.00
CSX Transportation, Inc.
500 Water Street, J-180
Jacksonville, FL 32202
Attention: Rene Kurth
r ku sx. m
904.633,1108
PS - FORM 1001-G
REVISED APRIL, 29, 2008
AGREEMENT NO. CSX621838
FACILITY ENCROACHMENT AGREEMENT
THIS AGREEMENT, Made and effective as of January 19, 2009, by and between CSX
TRANSPORTATION, INC, a Virginia corporation, whose mailing address is 500 Water Street,
Jacksonville, Florida 32202, hereinafter called "Licensor," and CITY OF CLEARWATER, a
municipal corporation, political subdivision or state agency, under the laws of the State of
Florida, whose mailing address is 100 S Myrtle Avenue, Clearwater, Florida 33756, hereinafter
called "Licensee," WITNESSET14:
WHEREAS, Licensee desires to construct (unless previously constructed and designated
as existing herein), use and maintain the below described facility(ies), hereinafter called
"Facilities," over, under or across property owned or controlled by Licensor, at the below
described location(s):
1. One (1) twelve inch (12") diameter sub-grade pipeline crossing, solely for the conveyance
of reclairn,ed/non-potable water, located at or near Clearwater, Pinellas County, Florida,
Jacksonville Division, Clearwater Subdivision, Milepost SY-870.2;
hereinafter, collectively, called the "Encroachment," as shown on print(s) labeled Exhibit "B,"
attached hereto and made a part hereof; other details and data pertaining to said Facilities being
as indicated on Exhibit "A," also attached hereto and made a part hereof;
NOW, THEREFORE, in consideration of the mutual covenants, conditions, terms and
agreements herein contained, the pasties hereto agree and covenant as follows:
1. LICENSE:
1.1 Subject to Article 17, Licensor, insofar as it has the legal right, power and
authority to do so, and its present title permits, and subject to:
(A) Licensor's present and future right to occupy, possess and use its
property within the area of the Encroachment for any and all purposes;
(B) All encumbrances, conditions, covenants, easements, and limitations
applicable to Licensor's title to or rights in the subject property; and
(C) Compliance by Licensee with the terms and conditions herein
contained;
does hereby license and permit Licensee to construct, maintain, repair, renew, operate, use, alter
or change the Facilities at the Encroachment above for the term herein stated, and to remove
same upon termination.
1.2 The term Facilities, as used herein, shall include only those structures and
ancillary facilities devoted exclusively to the transmission usage above within the Encroachment,
and as shown on attached Facility Application Form and plan(s).
Page 1 of 15 0
PS- FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
1.3 No additional structures or other facilities shall be placed, allowed, or
maintained by Licensee in, upon or on the Encroachment except upon prior separate written
consent of Licensor.
2. ENCROACHMENT FEE; TERM:
2.1 Licensee shall pay Licensor a one-time nonrefundable Encroachment Fee of
FIVE HUNDRED U.S. Dollars AND 00/100 U.S. DOLLARS ($500.00) upon execution of this
Agreement. Licensee agrees that the Encroachment Fee applies only to the original Licensee
under this Agreement. In the event of a successor (by merger, consolidation, reorganization
and/or assignment) or if the original Licensee changes its name, then Licensee shall be subject to
payment of Licensor's current administrative and document preparation fees for the cost incurred
by Licensor in preparing and maintaining this Agreement on a current basis.
2.2 However, Licensee assumes sole responsibility for, and shall pay directly (or
reimburse Licensor), any additional annual taxes and/or periodic assessments levied against
Licensor or Licensor's property solely on account of said Facilities or Encroachment.
2.3 . This Agreement shall terminate as herein provided, but shall also terminate
upon: (a) Licensee's cessation of use of the Facilities or Encroachment for the purpose(s) above;
(b) removal of the Facilities; (c) subsequent mutual consent; and/or (d) failure of Licensee to
complete installation within five (5) years from the effective date of this Agreement.
2.4 In further consideration for the license or right hereby granted, Licensee
hereby agrees that Licensor shall not be charged or assessed, directly or indirectly, with any part
of the cost of the installation of said Facilities and appurtenances, and/or maintenance thereof, or
for any public works project of which said Facilities is a part.
3. CONSTRUCTION, MAINTENANCE AND REPAIRS:
3.1 Licensee shall construct, maintain, relocate, repair, renew, alter, and/or remove
the Facilities, in a prudent, workmanlike manner, using quality materials and complying with any
applicable standard(s) or regulation(s) of Licensor (A.R.E.M.A. Specifications), or Licensee's
particular industry, National Electrical Safety Code, or any governmental or regulatory body
having jurisdiction over the Encroachment.
3.2 Location and construction of Facilities shall be made strictly in accordance
with design(s) and specifications furnished to and approved by Licensor and of material(s) and
size(s) appropriate for the purpose(s) above recited.
3.3 All of Licensee's work, and exercise of rights hereunder, shall be undertaken at
time(s) satisfactory to Licensor, and so as to eliminate or minimize any impact on or interference
with the safe use and operation of Licensor's property and appurtenances thereto.
Page 2 of 15 0
PS- FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
3.4 In the installation, maintenance, repair and/or removal of said Facilities,
Licensee shall not use explosives of any type or perform or cause any blasting without the
separate express written consent of Licensor. As a condition to such consent, a representative
will be assigned by Licensor to monitor blasting, and Licensee shall reimburse Licensor for the
entire cost and/or expense of furnishing said monitor.
3.5 Any repairs or maintenance to the Facilities, whether resulting from acts of
Licensee, or natural or weather events, which are necessary to protect or facilitate Licensor's use
of its property, shall be made by Licensee promptly, but in no event later than thirty (30) days
after Licensee has notice as to the need for such repairs or maintenance.
3.6 Licensor, in order to protect or safeguard its property, rail operations,
equipment and/or employees from damage or injury, may request immediate repair or renewal of
the Facilities, and if the same is not performed, may make or contract to make such repairs or
renewals, at the sole risk, cost and expense of Licensee.
3.7 Neither the failure of Licensor to object to any work done, material used, or
method of construction or maintenance of said Encroachment, nor any approval given or
supervision exercised by Licensor, shall be.construed as an admission of liability or
responsibility by Licensor, or as a waiver by Licensor of any of the obligations, liability and/or
responsibility of Licensee under this Agreement.
18 All work on the Encroachment shall be conducted in accordance with
Licensoe's safety rules and regulations.
3.9 Licensee hereby agrees to reimburse Licensor any loss, cost or expense
(including losses resulting from train delays and/or inability to meet train schedules) arising from
any failure of Licensee to make repairs or conduct maintenance as required by Section 3.5 above
or from improper or incomplete repairs or maintenance to the Facilities or Encroachment.
4. PERMITS, LICENSES:
4.1 Before any work hereunder is performed, or before use of the Encroachment
for the contracted purpose, Licensee, at its sole cost and expense, sha11 obtain all necessary
permit(s) (including but not limited to zoning, building, construction, health, safety or
environmental matters), letter(s) or certificate(s) of approval. Licensee expressly agrees and
warrants that it shall conform and limit its activities to the terms of such permit(s), approval(s)
and authorization(s), and shall comply with all applicable ordinances, rules, regulations,
requirements and laws of any governmental authority (State, Federal or Local) having
jurisdiction over Licensee's activities, including the location, contact, excavation and protection
regulations of the Occupational Safety and Health Act (OSHA) (29 CFR 1926.651(b)), et al., and
State "One Call" - "Call Before You Dig" requirements.
4.2 Licensee assumes sole responsibility for failure to obtain such permit(s) or
approval(s), for any violations thereof, or for costs or expenses of compliance or remedy.
Page 3 of 15 0
PS - FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
5. MARKING AND SUPPORT:
5.1 With respect to any subsurface installation or maintenance upon Licensoe's
property, Licensee, at its sole cost and expense, shall:
(A) support track(s) and roadbed in a manner satisfactory to Licensor;
(.B) backfill with satisfactory material and thoroughly tamp all trenches to
prevent settling of surface of land and roadbed of Licensor; and
(C) either remove any surplus earth or material from Licensoe's property or
cause said surplus earth or material to be placed and distributed at location(s) and in such manner
Licensor may approve.
5.2 After construction or maintenance of the Facilities, Licensee shall:
(A) Restore any track(s), roadbed and other disturbed property; and
(B) Erect, maintain and periodically verify the accuracy of aboveground
markers, in a form approved by Licensor, indicating the location, depth and ownership of any
underground Facilities or related facilities.
5.3 Licensee shall be solely responsible for any subsidence or failure of lateral or
subjacent support in the Encroachment area for a period of three (3) years after completion of
installation.
6. TRACK CHANGES:
6.1 In the event that rail operations and/or track maintenance result in changes in
grade or alignment of, additions to, or relocation of track(s) or other facilities, or in the event
future use of Licenser's rail corridor or property necessitate any change of location, height or
depth in the Facilities or Encroachment, Licensee, at its sole cost and expense and within thirty
(30) days after notice in writing from Licensor, shall make changes in the Facilities or
Encroachment to accommodate such track(s) or operations.
6.2 if Licensee fails to do so, Licensor may make or contract to make such
changes at Licensee's cost.
7. FACILITY CHANGES:
7.1 Licensee shall periodically monitor and verify the depth or height of the
Facilities or Encroachment in relation to the existing tracks and facilities, and shall relocate the
Facilities or change the Encroachment, at Licensee's expense, should such relocation or change
be necessary to comply with the minimum clearance requirements of Licensor.
Page 4 of 15 0
PS - FORM 1001-G
REVISED APRIL. 29, 2008
AGREEMENT NO. CSX621838
7.2 If Licensee undertakes to revise, renew, relocate or change in any manner
whatsoever all or any part of the Facilities (including any change in voltage or gauge of wire or
any change in circumference, diameter or radius of pipe or change in materials transmitted in and
through said pipe), or is required by any public agency or court order to do so, plans therefor
shall be submitted to Licensor for approval before such change. After approval, the terms and
conditions of this Agreement shall apply thereto.
8. INTERFERENCE WITH RAIL FACILITIES:
8.1 Although the Facilities/Encroachment herein permitted may not presently
interfere with Licensor's railroad or facilities, in the event that the operation, existence or
maintenance of said Facilities, in the sole judgment of Licensor, causes: (a) interference
(including, but not limited to, physical or interference from an electromagnetic induction, or
interference from stray or other currents) with Licensor's power lines, communication, signal or
other wires, train control system, or electrical or electronic apparatus; or (b) interference in any
manner, with the operation, maintenance or use of the rail corridor, track(s), structures, pole
line(s), devices, other property, or any appurtenances thereto; then and in either event, Licensee,
upon receipt of written notice from Licensor of any such interference, and at Licensee's sole risk,
cost and expense, shall promptly make such changes in its Facilities or installation, as may be
required in the reasonable judgment of the Licensor to eliminate all such interference. Upon
Licensee's failure to remedy or change, Licensor may do so or contract to do so at Licensee's sole
cost.
8.2 Without assuming any duty hereunder to inspect the Facilities, Licensor hereby
reserves the right to inspect same and to require Licensee to undertake repairs, maintenance or
adjustments to the Facilities, which Licensee hereby agrees to make promptly, at Licensee's sole
cost and expense.
9. RISK, LIABILITY, INDEMNITY:
With respect to the relative risk and liabilities of the parties, it is hereby agreed that:
9.1 To the fullest extent permitted by State law (constitutional or statutory, as
amended), Licensee hereby agrees to, defend, indemnify, and hold Licensor harmless from and
against any kind all liability, loss, claim, suit, damage, charge or expense which Licensor may
suffer, sustain, incur or in any way be subjected to, on account of death of or injury to any person
whomsoever (including officers, agents, employees or invitees of Licensor), and for damage to
or loss of or destruction of any property whatsoever, arising out of, resulting from, or in any way
connected with the construction, repair, maintenance, replacement, presence, existence,
operations, use or removal of the Facilities or any structure in connection therewith, or
restoration of premises of Licensor to good order or condition after removal, EXCEPT when
proven to have been caused solely by the willful misconduct or gross negligence of Licensor.
HOWEVER, to the fullest extent permitted by State law, during any period of actual
construction, repair, maintenance, replacement or removal of the Facilities, wherein agents,
equipment or personnel of Licensee are on the railroad rail corridor, Licensee's liability
Page 5 of 15 0
PS- FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
hereunder shall be absolute, irrespective of any joint, sole or contributory fault or negligence of
Licensor.
9.2 Use of Licensor's rail corridor involves certain risks of loss or damage as a
result of the rail operations. Notwithstanding Section 9. 1, Licensee expressly assumes all risk of
loss and damage to Licensee's Property or the Facilities in, on, over or under the Encroachment,
including loss of or any interference with use or service thereof, regardless of cause, including
electrical field creation, fire or derailment resulting from rail operations. For this Section, the
term "Licensee's Property" shall include property of third parties situated or placed upon
Licensor's rail corridor by Licensee or by such third parties at request of or for benefit of
Licensee.
9.3 To the fullest extent permitted by State law, as above, Licensee assumes all
responsibility for, and agrees to defend, indemnify and hold Licensor harmless from: (a) all
claims, costs and expenses, including reasonable attorneys' fees, as a consequence of any sudden
or nonsudden pollution of air, water, land and/or ground water on or off the Encroachment area,
arising from or in connection with the use of this Encroachment or resulting from leaking,
bursting, spilling, or any escape of the material transmitted in or through the Facilities; (b) any
claim or liability arising under federal or state law dealing with either such sudden or nonsudden
pollution of air, water, land and/or ground water arising therefrom or the remedy thereof; and (c)
any subsidence or failure of lateral or subjacent support of the tracks arising from such Facilities
leakage.
9.4 Notwithstanding Section 9.1, Licensee also expressly assumes all risk of loss
which in any way may result from Licensee's failure to maintain either required clearances for
any overhead Facilities or the required depth and encasement for any underground Facilities,
whether or not such loss(es) result(s) in whole or part from Licenser's contributory negligence or
joint fault.
9.5 Obligations of Licensee hereunder to release, indemnify and hold Licensor
harmless shall also extend to companies and other legal entities that control, are controlled by,
subsidiaries of, or are affiliated with Licensor, as well as any railroad that operates over the rail
corridor on which the Encroachment is located, and the officers, employees and agents of each.
9.6 If a claim is made or action is brought against Licensor, and/or its operating
lessee, for which Licensee may be responsible hereunder, in whole or in part, Licensee shall be
notified to assume the handling or defense of such claim or action; but Licensor may participate
in such handling or defense.
9.7 Notwithstanding anything contained in this Agreement, the limitation of
liability contained in the state statutes, as amended from time to time, shall not limit Licensee's
ability to collect under the insurance policies required to be maintained under this Agreement.
Page 6 of 15 0
PS - FORM I (1) 1. -G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
J.O. INSURANCE:
10.1 Prior to commencement of surveys, installation or occupation of premises
pursuant to this Agreement, Licensee shall procure and shall maintain during the continuance of
this Agreement, at its sole cost and expense, a policy of Commercial General Liability Insurance
(CGL), naming Licensor, and/or its designee, as additional insured and covering liability
assumed by Licensee under this Agreement. A coverage limit of not less than THREE
MILLION AND 00/100 U.S. DOLLARS ($3,000,000.00) Combined Single Limit per
occurrence for bodily injury liability and property damage liability is currently required as a
prudent minimum to protect Licensee's assumed obligations. The evidence of insurance
coverage shall be endorsed to provide for thirty (30) days' notice to Licensor, or its designee,
prior to cancellation or modification of any policy. Mail CGL certificate, along with agreement,
to CSX Transportation, Inc., Speed Code J180, 500 Water Street, Jacksonville, FL 32202. On
each successive year, send certificate to Speed Code C907 at the address listed above.
10.2 If Licensee's existing COL policy(ies) do(es) not automatically cover
Licensee's contractual liability during periods of survey, installation, maintenance and continued
occupation, a specific endorsement adding such coverage shall be purchased by Licensee. If said
CGL policy is written on a "claims made" basis instead of a "per occurrence" basis, Licensee
shall arrange for adequate time for reporting losses. Failure to do so shall be at Licensee's sole
risk.
10.3 Licensor, or its designee, may at any time request evidence of insurance
purchased by Licensee to comply with this Agreement. Failure of Licensee to comply with
Licensor's request shall be considered a default by Licensee.
10.4 Securing such insurance shall not limit Licensee's liability under this
Agreement, but shall be security therefor.
10.5 (A) In the event Licensee finds it necessary to perform construction or
demolition operations within fifty feet (50') of any operated railroad track(s) or affecting any
railroad bridge, trestle, tunnel, track(s), roadbed, overpass or underpass, Licensee shall: (a) notify
Licensor; and (b) require its contractor(s) performing such operations to procure and maintain
during the period of construction or demolition operations, at no cost to Licensor, Railroad
Protective Liability (RPL) Insurance, naming Licensor, and/or its designee, as Named Insured,
written on the current ISO/RIMA Form (ISO Form No. CG 00 35 0196) with limits of FIVE
MILLION AND 001100 U.S. DOLLARS ($5,000,000.00) per occurrence for bodily injury and
property damage, with at least TEN MILLION AND 00/100 U.S. DOLLARS ($10,000,000.00)
aggregate limit per annual policy period, with Pollution Exclusion Amendment (ISO CG 28 31
1185) if an older ISO Form CG 00 35 is used. The original of such RPL policy shall be sent to
and approved by Licensor prior to commencement of such construction or demolition. Licensor
reserves the right to demand higher limits.
(B) At Licensee's option, in lieu of purchasing RPL insurance from an insurance
company (but not CGL insurance), Licensee may pay Licensor, at Licensoe's current rate at time
of request, the cost of adding this Encroachment, or additional construction and/or demolition
Page 7 of 15 0
PS - FORM IWI-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
activities, to Licensor's Railroad Protective Liability (RPL) Policy for the period of actual
construction, This coverage is offered at Licenser's discretion and may not be available under all
circumstances.
10.6 Notwithstanding the provisions of Sections 10.1 and 10.2, Licensee, pursuant
to State Statute(s), may self-insure or self assume, in any amount(s), any contracted liability
arising under this Agreement, under a funded program of self-insurance, which fund will respond
to liability of Licensee imposed by and in accordance with the procedures established by law.
11. GRADE CROSSINGS; FLAGGING:
11.1 Nothing herein contained shall be construed to permit Licensee or Licensee's
contractor to move any vehicles or equipment over the track(s), except at public road crossing(s),
without separate prior written approval of Licensor (CSXT Form 7422).
11.2 If Licensor deems it advisable, during any construction, maintenance, repair,
renewal, alteration, change or removal of said Facilities, to place watchmen, flagmen, inspectors
or supervisors for protection of operations of Licensor or others on Licensor's rail corridor at the
Encroachment, and to keep persons, equipment or materials away from the track(s), Licensor
shall have the right to do so at the expense of Licensee, but Licensor shall not be liable for failure
to do so.
11.3 Subject to Licensoe's consent and to Licensor's Railroad Operating Rules and
labor agreements, Licensee may provide flagmen, watchmen, inspectors or supervisors during all
times of construction, repair, maintenance, replacement or removal, at Licensee's sole risk and
expense; and in such event, Licensor shall not be liable for the failure or neglect of such
watchmen, flagmen, inspectors or supervisors.
12. LICENSOR'S COSTS:
12.1 Any additional or alternative costs or expenses incurred by Licensor to
accommodate Licensee's continued use of Licensoe's property as a result of track changes or wire
changes shall also be paid by Licensee.
12.2 Licensoe's expense for wages ("force account" charges) and materials for any
work performed at the expense of Licensee pursuant hereto shall be paid by Licensee within
thirty (30) days after receipt of Licensoe's bill therefor. Licensor may, at its discretion, request
an advance deposit for estimated Licensor costs and expenses.
12.3 Such expense shall include, but not be limited to, cost of railroad labor and
supervision under "force account" rules, plus current applicable overhead percentages, the actual
cost of materials, and insurance, freight and handling charges on all material used. Equipment
rentals shall be in accordance with Licensor's applicable fixed rate. Licensor may, at its
discretion, require advance deposits for estimated costs of such expenses and costs.
page 8 of 15 0
PS- FORM 1001-G
REVISED APRIL 29. 2008
AGREEMENT NO. CSX621838
13. DEFAULT, BREACH, WAIVER:
13.1 The proper and complete performance of each covenant of this Agreement
shall be deemed of the essence thereof, and in the event Licensee fails or refuses to fully and
completely perform any of said covenants or remedy any breach within thirty (30) days after
receiving written notice from Licensor to do so (or within forty-eight (48) hours in the event of
notice of a railroad emergency), Licensor shall have the option of immediately revoking this
Agreement and the privileges and powers hereby conferred, regardless of encroachment fee(s)
having been paid in advance for any annual or other period. Upon such revocation, Licensee
shall make removal in accordance with Article 14.
1.3.2 No waiver by Licensor of its rights as to any breach of covenant or condition
herein contained shall be construed as a permanent waiver of such covenant or condition, or any
subsequent breach thereof, unless such covenant or condition is permanently waived in writing
by Licensor.
13.3 Neither the failure of Licensor to object to any work done, material used, or
naethod of construction or maintenance of said Encroachment, nor any approval given or
supervision exercised by Licensor, shall be construed as an admission of liability or
responsibility by Licensor, or as a waiver by Licensor of any of the obligations, liability and/or
responsibility of Licensee under this Agreement.
14. TERMINATION, REMOVAL:
14.1 All rights which Licensee may have hereunder shall cease upon the date of
(a) termination, (b) revocation, or (c) subsequent agreement, or (d) Licensee's removal of the
Facility from the Encroachment. However, neither termination nor revocation of this Agreement
shall affect any claims and liabilities which have arisen or accrued hereunder, and which at the
time of termination or revocation have not been satisfied; neither party, however, waiving any
third party defenses or actions.
14.2 Within thirty (30) days after revocation or termination, Licensee, at its sole
risk and expense, shall (a) remove the Facilities from the rail corridor of Licensor, unless the
parties hereto agree otherwise, (b) restore the rail corridor of Licensor in a manner satisfactory to
Licensor, and (c) reimburse Licensor any loss, cost or expense of Licensor resulting from such
removal.
1s. NOTICE:
15.1 Licensee shall give Licensor at least thirty (30) days written notice before
doing gai work on Licensor's rail corridor, except that in cases of emergency shorter notice may
be given. Licensee shall provide proper notification as follows:
a. For non-emergencies, Licensee shall complete and submit Licenser's
Outside Party Number Request Form (Form # OP) by facsimile, to facsimile numbers: (904)
245-3692 and (904) 633-3450. Licensee may also scan and email a completed form to email
Page 9 of 15 0
PS- FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
address: OP_Request@csx.com. A blank form, as well as additional instructions and
information, can be obtained from Licensor's web site, via web link:
http://www.csx.com/?fuseaction=general.csxp_fag.
b. For emergencies, Licensee shall complete all of the steps outlined in
Section 15.1 a. above, and shall also include detailed information of the emergency. Licensee
shall also call and report details of the emergency to Licenser's Rail Operations Emergency
Telephone Number: 1-800-232-0144. In the event Licensor needs to contact Licensee
concerning an emergency involving Licensee's Facility(ies), the emergency phone number for
Licensee is: 727-562-4960.
15.2 All other notices and comtnunications concerning this Agreement shall be
addressed to Licensee at the address above, and to Licensor at the address shown on Page 1, c/o
CSXT Contract Management, J180; ar at such other address as either party may designate in
writing to the other.
15.3 Unless otherwise expressly stated herein, all such notices shall be in writing
and sent via Certified or Registered Mail, Return Receipt Requested, or by courier, and shall be
considered delivered upon: (a) actual receipt, or (b) date of refusal of such delivery.
16. ASSIGNMENT:
16.1 The rights herein conferred are the privileges of Licensee only, and Licensee
shall obtain Licensor's prior written consent to any assignment of Licensee's interest herein; said
consent shall not be unreasonably withheld.
16.2 Subject to Sections 2 and 16. 1, this Agreement shall be binding upon and
inure to the benefit of the parties hereto and their respective successors or assigns.
16.3 Licensee shall give Licensor written notice of any legal succession (by
merger, consolidation, reorganization, etc.) or other change of legal existence or status of
Licensee, with a copy of all documents attesting to such change or legal succession, within thirty
(30) days thereof.
16.4 Licensor expressly reserves the right to assign this Agreement, in whole or in
part, to any grantee, lessee, or vendee of Licensor's underlying property interests in the
Encroachment, upon written notice thereof to Licensee.
16.5 In the event of any unauthorized sale, transfer, assignment, sublicense or
encumbrance of this Agreement, or any of the rights and privileges hereunder, Licensor, at its
option, may revoke this Agreement by giving Licensee or any such assignee written notice of
such revocation; and Licensee shall reimburse Licensor for any loss, cost or expense Licensor
may incur as a result of Licensee's failure to obtain said consent.
Page 10 of 15 0
PS - FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
17. TITLE:
17.1 Licensee understands that Licensor occupies, uses and possesses lands,
rights-of-way and rail corridors under all forms and qualities of ownership rights or facts, from
full fee simple absolute to bare occupation. Accordingly, nothing in this Agreement shall act as
or be deemed to act as any warranty, guaranty or representation of the quality of Licensor's title
for any particular Encroachment or segment of Rail Corridor occupied, used or enjoyed in any
manner by Licensee under any rights created in this Agreement. It is expressly understood that
Licensor does not warrant title to any Rail Corridor and Licensee will accept the grants and
privileges contained herein, subject to all lawful outstanding existing liens, mortgages and
superior rights in and to the Rail Corridor, and all leases, licenses and easements or other
interests previously granted to others therein.
17.2 The term "license," as used herein, shall mean with regard to any portion of
the Rail Corridor which is owned by Licensor in fee simple absolute, or where the applicable law
of the State where the Encroachment is located otherwise permits Licensor to make such grants
to Licensee, a "permission to use" the Rail Corridor, with dominion and control over such
portion of the Rail Corridor remaining with Licensor, and no interest in or exclusive right to
possess being otherwise granted to Licensee. With regard to any other portion of Rail Corridor
occupied, used or controlled by Licensor under any other facts or rights, Licensor merely waives
its exclusive right to occupy the Rail Corridor and grants no other rights whatsoever under this
Agreement, such waiver continuing only so long as Licensor continues its own occupation, use
or control. Licensor does not warrant or guarantee that the license granted hereunder provides
Licensee with all of the rights necessary to occupy any portion of the Rail Corridor. Licensee
further acknowledges that it does not have the right to occupy any portion of the Rail Corridor
held by Licensor in less than fee simple absolute without also receiving the consent of the
owner(s) of the fee simple absolute estate, Further, Licensee shall not obtain, exercise or claim
any interest in the Rail Corridor that would impair Licensor's existing rights therein.
173 Licensee agrees it shall not have nor shall it make, and hereby completely and
absolutely waives its right to, any claim against Licensor for damages on account of any
deficiencies in title to the Rail Corridor in the event of failure or insufficiency of Licensoe's title
to any portion thereof arising from Licensee's use or occupancy thereof.
17.4 Licensee agrees to fully and completely indemnify and defend all claims or
litigation for slander of title, overburden of easement, or similar claims arising out of or based
upon the Facilities placement, or the presence of the Facilities in, on or along any
Encroachment(s), including claims for punitive or special damages.
17.5 Licensee shall not at any time own or claim any right, title or interest in or to
Licensor's property occupied by the Encroachments, nor shall the exercise of this Agreement for
any length of time give rise to any right, title or interest in Licensee to said property other than
the license herein created.
17.6 Nothing in this Agreement shall be deemed to give, and Licensor hereby
expressly waives, any claim of ownership in and to any part of the Facilities.
Page 11 of 15 o
PS - FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
17.7 Licensee shall not create or permit any mortgage, pledge, security, interest,
lien or encumbrances, including without limitation, tax liens and liens or encumbrances with
respect to work performed or equipment furnished in connection with the construction,
installation, repair, maintenance or operation of the Facilities in or on any portion of the
Encroachment (collectively, "Liens or Encumbrances"), to be established or remain against the
Encroachment or any portion thereof or any other Licensor property.
17.8 .In the event that any property of Licensor becomes subject to such Liens or
Encumbrances, Licensee agrees to pay, discharge or remove the same promptly upon Licensee's
receipt of notice that such Liens or Encumbrances have been filed or docketed against the
Encroachment or any other property of Licensor; however, Licensee reserves the right to
challenge, at its sole expense, the validity and/or enforceability of any such Liens or
Encumbrances.
18. GENERAL PROVISIONS:
18.1 This Agreement, and the attached specifications, contains the entire
understanding between the parties hereto.
18.2 Neither this Agreement, any provision hereof, nor any agreement or provision
included herein by reference, shall operate or be construed as being for the benefit of any third
person.
18.3 Except as otherwise provided herein, or in any Rider attached hereto, neither
the form of this Agreement, nor any language herein, shall be interpreted or construed in favor of
or against either party hereto as the sole drafter thereof.
18.4 This Agreement is executed undercurrent interpretation of applicable
Federal, State, County, Municipal or other local statute, ordinance or law(s). However, each
separate division (paragraph, clause, item, term, condition, covenant or agreement) herein shall
have independent and severable status for the determination of legality, so that if any separate
division is determined to be void or unenforceable for any reason, such determination shall have
no effect upon the validity or enforceability of each other separate division, or any combination
thereof.
18.5 This Agreement shall be construed and governed by the laws of the state in
which the Facilities and Encroachment are located.
18.6 If any amount due pursuant to the terms of this Agreement is not paid by the
due date, it will be subject to Licensor's standard late charge and will also accrue interest at
eighteen percent (18%) per annum, unless limited by local law, and then at the highest rate so
permitted.
18.7 Licensee agrees to reimburse Licensor for all reasonable costs (including
attorney's fees) incurred by Licensor for collecting any amount due under the Agreement.
Page 12 of 15 o
PS - FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO, CSX621838
18.8 The provisions of this License are considered confidential and may not be
disclosed to a third party without the consent of the other party(s), except: (a) as required by
statute, regulation or court order, (b) to a parent, affiliate or subsidiary company, (c) to an
auditing firm or legal counsel that are agreeable to the confidentiality provisions, or (d) to
Lessees of Licensor's land and/or track who are affected by the terms and conditions of this
Agreement and will maintain the confidentiality of this Agreement.
18.9 Licensor shall refund to Licensee any overpayments collected, plus any taxes
paid in advance; PROVIDED, however, such refund shall not be made when the cumulative total
involved is less than One Hundred Dollars ($100.00).
19. RESERVED:
20. RESERVED:
21. RIDERS:
21.1 The following Rider(s) is/are herewith attached and included herein:
[X] Telecommunication Cable Qr 1~iber Optic Line
4 ,
Page 13 of 15 0
c
E
PS - FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
IN WITNESS WHEREOF, the parties hereto have executed this Agreement in duplicate
(each of which shall constitute an original) as of the effective date of this Agreement.
Witness for Licensor:
CSX TRANSPORTATION, INC
R v:
Print/Type Name:
Print/Type Title:
Marie A. Musfeldt
Director
Witness for Licensee: CITY OF CLEARWATER
By:
Countersigned: Who, by the execution hereof, affirms that he/she has
t authority to do so and to bind the Licensee to the
ernes and conditions of this Agreement.
Fra V. Vbbard ayor
Print/Type Name:William B. Horne II,
proved as t
Print/Type Title: City Manager
Camilo A. Soto -
Tax 1D No. _
Assistant City Attorney
Authority under Ordinance or
Resolution No.
Dated March ?r 2nn4
ATTEST: Wr ?14
Cynt a E. Goudeau, City C t1/ rye,
Page 14 of 15 0
PS- FORM 1001-G
REVISED APRIL 29, 2008
AGREEMENT NO. CSX621838
COMMUNICATIONS CABLE OR FIBER OPTIC LINE PROTECTION RIDER
This Rider is and shall be a part of Agreement No. CSX621838, and is incorporated
therein.
1. No construction of any type pursuant or related in any way to this Agreement
shall be commenced by Licensee, or by any agent, representative, contractor, subcontractor of
Licensee, without Licensee first giving at least thirty (30) days written notice to the following
Parallel Cable Occupier(s):
("MCl") ATTN: Investigations
Mr. Dean Boyers
Worldcom/MCI Telecommunications Corporation
2400 North Glenville Drive
Richardson, TX 75082-4354
Phone No. (800) 624-9675
or (972) 729-6016
(NOTE: WRITTEN NOTICE TO MCI IS ALSO REQUIRED)
2. The notice shall be accompanied by drawing(s) showing the general plan,
elevation, details and methods of Licensee's proposed construction, and the location of
Occupier(s)' cable or facilities in relation to Licensee's proposed construction.
3. Prior to any construction, Licensee must locate and identify, any existing cable,
wire or fiber optic line (including any appurtenances thereto) of said cable occupier(s) traversing
or located in, on, or immediately adjacent to the proposed Crossing, at Licensee's sole risk.
4. Any changes, alteration, relocation or protection of wire(s); cable(s) or facilities
of such Occupier(s), required by said Occupier(s), shall be at Licensee's sole expense exgept as
otherwise negotiated between Licensee and said Occupier(s).
5. Licensee shall be solely responsible and liable for any damage to (e.g., cutting,
dislocating, etc.) said wire(s) or cable(s), and appurtenances thereto, resulting in any way from
Licensee's exercise of rights or privileges under this Agreement.
6. Licensee shall defend, indemnify and hold Licensor harmless from any such
damage claims and any relocation or protection costs of said Occupier(s).
Page 15 of 15 0
"CSX
TRANSPORTATION
V rORM CSXT 7455 - Rev. 07/02/2007 (Page 1 of 4)
APPLICATION FOR PIPELINE CROSSING/PARALLELISM
All applications are to be submitted in accordance with CSXT's Pipeline Specification
Package. Failure to strictly adhere to these specifications will result in delays, additional costs
and possible return of your application. Drawings should either be 8%z" x 11", 8%z" x 14" or
11" x 17" size (refer to Drawing requirement checklist). CSXT reserves the right to approve or
decline any application.
One original and one copy of this application form, together with plan and profile drawings,
and a $750.00 nonrefundable Review Fee are to be submitted to: CSX T'ransportati'on, Inc.,
Property Services Department, J180, 500 Water Street, Jacksonville, FL 32202.
DATE-RECEIVED
• No work may proceed on CSXT's right of way until the Licensee has received a fully executed agreement and obtained
notice to proceed from CSXT's local Roadmaster or its designee,
• Due to future maintenance responsibilities CSXT will not enter into an agreement with a Developer. It is the
Developer's responsibility to coordinate the application with the local governing municipal authority.
• No verbal approvals will be granted. No Blasting on/under/near CSXT right of way. No Directional Boring.
Application Date: 10116/08 CSXT File/Agreement Number:
???et:'ti? %'? ??? :?: ?::•.; .Kti:? ?". ?My,.: _.? _ - •:rr r--.,x.. cm-,•; ;.?:... :c :Tr.:.r. ..
..w, ,?r,? i1;. - ? ?T ` ?;?,•-• ;:;'4c.• .; .;1.,, .Y? •x;?r?"=; ?, •.:.?,,a•?l! • -
r. • •.r,r::::r ?:.; ;a: u??`;;?:r??.?
v!4
W ;2-
'
:'tr5
%, :'-?
r
?
?r
?
y
r''' y
:r
??
'
"?
?
.?
• - .;
.,
;
. r;
,.?e
,
.+ ?.. ;
r
; {r.>
_.•..,
r. ?r-
?.:...•.?
?a'? .
,.
}?{( ?. ..4. In. Y ..
.8:5•? -..?'. :•.??• :???s;r??.. .??? •il?-.
'11W •:? h' ry,l+= _?iti':• - '.•t?-•'fA: $y;S?ti; ?::. t. .. •}. .?•.?:" - - J\2',:•ry???•?::
M.
.
^
Owner's Complete Legal y
Com an Name• City of
Clearwater
_
Contact Nameriitle: Michael Quillen, F'_E. City Engineer
_Legal Address: 100 S. Myrtle Avenue
Ci /State/ i : Clearwater JEorida
Street Address for Overnight
Mail (check if same as legal
address , :
Ci /State/Zi : l
Email Address: michael.quillen@mycfearwater.com
Office/Alternate Phone: 727 562-4750 (727 562-4750 T
*Emer enc No./Fax: 727 562-4960 727 562 4755
* The emer enc number is need ed in the event of derailment, pipe failure etc...
Type of Business: (a) !._.•1 Corporation (b) [
Partnership (c) E
1 Other
State of Inc.: ._
Type: .
Describe:
State: -----_----..--__.___-
T
v
dMuni?ality (e) I Individual
Engineer/Consultant URS Corporation
Company Name:
_ Contact Naure_fritte: Bozhidar V. Handiiev ?? t Manager ?y ? W??
Street Address for Overnight
Mail. 7850 West Courtney Campbell Causeway
----_City/State/ZiP Tampa Flarida ____j33607
Email Address: boxho_handiiey@lursc_orp.com
Office/Fax: 813 636-2177 R?T813 286-6587
Cell/Alternate PhoneW N/A 813 286 1711
Continued on Page 2...
FORM CSXT 7455 -- Rev. 07/0212007 (Page 2 of 4)
Application Date: 10/16/08 CSXT File/Agreement Number:_.
$fwy .:lo i.f~ rtes ti
Your Project Reference No. L810` `
Covered by a Master/General
A reement: A cement No: NA Agreement Date: NA
Work to be erformed b : a i l Owner's em to ees b .- Owner's contractor
Type of Installation: ? i New iL._? *Revision to *Attachment to •.•••., *Upgrade to
Existin Existing Existing
a * ! a.revision, attachment or u ade, you must provide detailed scope o ro ect.
b * For existin Crossin s arallelisms, urnish ca o existin RA reement orA reement No.:
Will pipeline connect to an existing facili within Railroad corridor? Yes ? No
a if es, name of facility owner: _ b If es, describe and show details on drawine.
?t ow tae: Clearwater County. Pinellas State/Province: FL
Occupancy Type: ?J Crossing Only „Crossing & Parallelism Parallel Only
(Complete Section A or (Complete Sections A or B & C) F (Complete Section C)
I3)
A. RR Milepost Location for CC2S51p (non-spur track *Do not measure from a DOT si t
Crossing location: 1,108 ft. / / W direction from RR Mile st: 870
Latitude: N 2y 58 : 39.35 Longitude: W 82 44 17 . 50
If Known: Valuation Station: NA Valuation Ma No,: NA
D. RR Mile ost Location for Crossid s ur track *Do not measure from a DOT si r
Spur Track Crossing Location: N/A ft. (N / S /E/ W) (direction) from RR Milepost: N/A _ to point-of- switch,
then: N/A ft. alon s ur track to Crossin location.
Latitude: N N/A : NA Longitude : W N/A : NA
If Known: Valuation Station; N/A Valuation Ma No.: N/A
C. RR Milepost Location for Parallelism *Do not measure from a DOT sign.
Parallelism location Enters CSXT R/W: N/A ft. (N / S / E / W) (direction) from RR Milepost: _ N/ , and Exits
CSXT R/W: VNN/AE N i S / E / W direction from RR Mile ost: N/A
LatituLon itude• W N/A Entrance
If KnoN/A Val. Ma No.: N/A Entrance
LatituLan itude: W N/A Exit
If Knowtation N/q _ Val, Ma No.: N/A Exit
Crossing Length/Segment 1 S4 Parallel Length/Segment
on RR R/W. on RR R/W: NA Ft.
Will i cline be located entire{ within ublic road R/W? yes, DOT Crossin No.: 626 829 R No
NOTE: Road name, number, and width of R/W are required on drawinp_
Continued on Page 3...
ap u e ,
i?
FORM CSXT 7455 - Rev. 07/02/2007 (Page 3 of 4)
Application Date: 10/16/08 CSXT File/Agreement Number:
S' .t?olx ...1?' e.;I1,?f?i ti ?` _ of?t;'1?e ?_1? .frtil?l?' •:6?:a?xs.??.
PIPE SPECIFICATIONS: CARRIER PIPE: CASING PIPE:
Substance to be conveyed:
(1 Flammable / ? Non-Flammable Reclaimed Water
N/A
Temperature: 65 F - 80 F N/A
Maximum Working Pressure: 100 N/A _
Pipe Material: PVC Steel
Material S ecifications & Grade: AWWA C900 DR 18 ASTM A53 Grade 36
S ecified Minimum Yield Strength: 7,000 35,000
Nominal Size: 12" 24"
Wail Thickness: 0.775 0.375
Type of Seam: Fused Welded
T e of Joints: Fused Welded
Total Length Within CSXT R/W: 154 _ 154
If Tunnel Liner Plates: Attach manufacturer's sho detail and computations that include plate thickness and gauge,
Location of Shut-Off Valves: Firs[ valve is approx. 180 feel wvtmeast and second Is 1,115 feet northwest from center line of Irack along Old Coachman Road
Number of Manholes N/A Number of Other: N/A Describe: N/A
_
Manholes shall be flush with to of round and dimensions of ancilla structures are re aired on drawing.
Method of Installation: (a) .?_J Bore & Jack
(b) H Other:
Protective Coating: Yes I' Na Cathodic Protection: Yes ,JI No
Temporary track support or ripra
requiredl I,,,••? Yes ?..; No
if esLescribe and show details on drawing.
See 'tt:?._ a.?: ,tit R •.M1
. ,::,;':.:;,,;_•;•:;•,•.
J -
;
Diyision: 1(fSC5Y'I1ll Subdivision:
No. of Crossings. Val. Section/Ma No.:
Absolute Ma No.: Yl ; Z PIN No.:
Roadmaster Code: Parcel No.:
Contract Type: _ Fiber:
Val. Station (Crossing): Milepost No. Crossin : -10.2-
Val. Station (Parallelism : From: To:
Milepost No. Parallelism : From: To:
Milepost No.S ur Track : 'hen ft. along spur tracks to crossing location.
Shortline Lease Corridor: Yes No Shortline Lease A mt. No.:
Track Sold to Shortline: Yes .'J No
_ Inspector Require d: Yes , No
En g. Approval Letter: Yes No FDOT En g. Approval Ltr.: i Yes i_.... o
Project Manager: V_,V e7 '1"•t Title:
App roved b : Title.
Comments:
Continued on Page 4...
=XHISIT "A"
r
FORM CSXT 7455 -- Rev. 07/02/2007 (Page 4 of 4)
CSXT DRAWING REQUIREMENTS FOR PIPELINE CROSSING/PARALLELISM
Application Date: 1o/1,g/o8 Agreement Number: 4-?-i ?
Alllnformatlon and measurements are to be dearly labeled and shown on alt drawings. All drawings are to be submitted with CSXT's
pipeline occupancy application form No. 7455. Failure to strictly adhere to these requirements may result in delays, additional costs and
possible return of your application.
Drawings should either be 8%o x 11 " 8%'K 14" or f 1 " x 17" size. CSXT reserves the right to approve or decline any application. Gray or
monochrome scale required. Aerial photos must be separate from the drawing.
All applicable boxes must be checked
)te: Metric Information will NOT be accente
Drawing(s) size 8Y: x11, 8%, x14 or 11x17.
Overall plan view for parallelisms
0 North Arrow
0 Title block with owner's legal name, drawing number and date.
New pipeline In bold lines.
1 Distance and direction from CSXT actual milepost monumantlmorker (not the DOT sign at the road crossing).
J 1 Distance and direction from nearest track and public road Intersection.
LL Public road right-of-way lines (If within the confines of a public road crossing).
J? CSXT right-of-way lines relative to centerline of adjacent track(s).
Width of CSXT right of way.
Angie of crossing at track(s), and number of tracks crossed.
W Plan View, cross-section and profile of casing and carrier pipes.
Points where pipeline enters and leaves CSXT's right-of-way.
Total length of carrier and casing pipe within CSXT tight of way.
Ll Cross-sectlon of track at encroachment, including relevant dimensions.
Depth/minimum cover of casing pipe measured from:
® Top of pipe to bottom of rail
?=- R Within the right-of-way but not beneath the track(s)
0 Below any ditches
L Description of Casing Pipe End Seals
L- Measurament to any manhde(syother(s) from nearest/adjacent track(s) and milepost.
F_ Size and location of Vent pipes on cross section/profile drawing (for flammable substance with sealed casing pipe).
Location of shut off valves:
I1W (a) Crossings: No further than 2,000 feet from centerline of nearest track;
(b) Parallelisms: Within 2.000 feet of entrance and exit point of CSXT right-0f--way
Location of any CSXT signals, signal equipment, road crossing warning devices, poles, pole lines, bridges. and any other facil
pipeline and the location of the pipeline.
Location of all proposed/performed geotechnical borings - This is required for all casings with an O.D. of 48 inches or greater.
Facilities, structures.-obstructions. etc... to be relocated.
Distance of face of Launching & Receiving Pits located from Centerline of adjacent track 0 90'. M_
L
Launching Pit and Receiving Pit Dimensions: Width, Length and Depth.
I affirm that I have reviewed CS)Cr's Pipeline Specifications and the foregoing information complies with the current CSX Pipeline Specifications, governing
laws or regtdations, and accurately reflects the proposed pi Ina crossing/parallelism of CSXT's right of way.
Applicant's Signature: --
EX H 11 BIT " A"" -
. -::`° .:r""7'4i ,T^' tlUlaoli '2131rN Ya31? 1 ? F
K ""?• ?:: 311JOUd dNV NVId a31YMuv3lo j0 A io
9NISSOb3 M/N 1XSJ a:,, [ al!?di'% ,
L73f0ad Nd08 39021 M[IYHOV09 / VfI(WMVH0
i ° SI r i J j
w 1 ;
(`
f T•
w
l f 1 ?
r
_
?
1 !
?
?
•1 a aI..L ? - ? t?illfff?
?fi f?
•
qq .-'--`?•-- _s=.s t
1 -
1_ _ ? ?• ?,
ml
? ?
es
' <v
? %
'
1
1 F
,,
a m w
f ., u
,nA
[?g,
G?
- n
4?i,
,,i
?
L
• ?
k
J
,
: j
J U:`
? c
o? Z' u
?
?
\ \ LM1 r
ppr•
,,Y
k?F6.3
t '.?ti.••* b• - •
,. (.? ? X
k
' at .
?.- a
`S - 7 r
. ?
_
'
Jo-
pbo- +1
l ' 7. 0.I
,
_ CL:
J
I] `w
t