CM-11-02-046ROUND ROCK, TEXAS
PURPOSE. PASSION. PROSPERITY.
Item Caption:
Approval Date:
2/18/2011
City Manager Approval Summary Sheet
Consider executing three Use of Salvaged Vehicle Agreement with State Farm Mutual
Automobile Insurance Company for use by the Fire Department during the Department
Wide ISO Night Fire Drill.
Department: Fire
Project Manager: Lewis King
Item Summary:
The approval of these three agreements between State Farm Mutual Automobile Insurance Company and the City
will give the firefighters the means to practice their extrication skills during the Department Wide ISO Night Fire
Drill. These vehicles will be donated and the City will not be charged for the use of these vehicles. There will be nine
nights of extrication training, starting on February 22, 2011.
Strategic Plan Relevance:
30.0 Residents, Visitors, and Businesses continue to experience a high and timely level of public safety, and
security.
Cost: None
Source of Funds: N/A
REV. 6/10/10
Claim #59-A691-696
Agreement Regarding the Requested Use of a Salvage Vehicle
This agreement between State Farm Mutual Automobile Insurance Company ("State Farm") and
(identify specific State Farm Company)
Round Rock Fire Department ("Requester") reflects the understanding of each party with respect to the temporary use of
a Described Salvage Vehicle ("salvage") owned by State Farm by Requester for the following specific purpose:
Department Wide ISO Night Fire Drill.
Whereas State Farm is willing to donate use of said salvage for the specific purpose stated herein. State Farm will not
accept any liability for injury or property damage that might directly or indirectly result from such use. Requester therefore
expressly acknowledges the following:
A. Requester agrees that it accepts the salvage in an "as is" condition, and that State Farm has neither warranted the
condition of, nor expressed or implied a fitness for any specific purpose or use of said salvage by Requester.
B. Under no circumstances shall State Farm be liable to requester or requester's employees or agents for
damages of any kind whatsoever relating to requester's use of the salvage.
C. Requester at its own expense shall defend and hold State Farm fully harmless against any loss, damages, claims,
or expenses of any kind whatsoever, including attorney's fees, incurred by State Farm as a result of the use of the
salvage by Requester or Requester's employees or agents.
Requester agrees its use of said salvage encompasses the entire period of time beginning when actions are taken to move or
transport the described salvage from its present location, and ending when said salvage is returned to State Farm's control at
that same location, (or at some other location mutually agreed upon by the parties.) If Requester's use of said salvage does
not require movement from its present location, Requester's use begins when preparations begin to test, demonstrate,
display, or otherwise use said salvage, and ends at the conclusion of activity associated with such tests, demonstrations,
displays, or other usage. Requester agrees to be responsible for all transportation set up and other costs incurred during the
actual period of use of said salvage.
State Farm acknowledges the described salvage may sustain additional damage while being used by Requester, and agrees
to make no claim against Requester for damage to said salvage if sustained as a direct result of the specific purpose stated
herein. Requester agrees it will make no claims against State Farm for actual or alleged increases in the value of the
described salvage, resulting from Requester's use of said salvage for the specific purpose described herein.
Requester may not assign any of its duties under this agreement.
DESCRIBED SALVAGE VEHICLE: YEAR: 1999
MAKE: Mazda
MODEL: Millenia
VIN #7M1TA2217X1517621
ANTICIPATED PERIOD OF USE: February 22, 2011 thru March 10, 2011
NAME OF REQUESTER: City of Round Rock
REPRESENTATIVE/TITL teve No ood, City. nager
SIGNATURE: X
DATE: ala Sia bii
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
(Identify specific State Farm Company that owns the described salvage)
REPRESS TATIVE/'TITLE: ,
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SIGNAT
CWIO2O4t
DATE: ? '/ e:747)��
Claim #53-G578-135
Agreement Regarding the Requested Use of a Salvage Vehicle
This agreement between State Farm Mutual Automobile Insurance Company ("State Farm") and
(identify specific State Farm Company)
Round Rock Fire Department ("Requester") reflects the understanding of each party with respect to the temporary use of
a Described Salvage Vehicle ("salvage") owned by State Farm by Requester for the following specific purpose:
Department Wide ISO Night Fire Drill.
Whereas State Farm is willing to donate use of said salvage for the specific purpose stated herein. State Farm will not
accept any liability for injury or property damage that might directly or indirectly result from such use. Requester therefore
expressly acknowledges the following:
A. Requester agrees that it accepts the salvage in an "as is" condition, and that State Farm has neither warranted the
condition of, nor expressed or implied a fitness for any specific purpose or use of said salvage by Requester.
B. Under no circumstances shall State Farm be liable to requester or requester's employees or agents for
damages of any kind whatsoever relating to requester's use of the salvage.
C. Requester at its own expense shall defend and hold State Farm fully harmless against any loss, damages, claims,
or expenses of any kind whatsoever, including attorney's fees, incurred by State Farm as a result of the use of the
salvage by Requester or Requester's employees or agents.
Requester agrees its use of said salvage encompasses the entire period of time beginning when actions are taken to move or
transport the described salvage from its present location, and ending when said salvage is returned to State Farm's control at
that same location, (or at some other location mutually agreed upon by the parties.) If Requester's use of said salvage does
not require movement from its present location, Requester's use begins when preparations begin to test, demonstrate,
display, or otherwise use said salvage, and ends at the conclusion of activity associated with such tests, demonstrations,
displays, or other usage. Requester agrees to be responsible for all transportation set up and other costs incurred during the
actual period of use of said salvage.
State Farm acknowledges the described salvage may sustain additional damage while being used by Requester, and agrees
to make no claim against Requester for damage to said salvage if sustained as a direct result of the specific purpose stated
herein. Requester agrees it will make no claims against State Farm for actual or alleged increases in the value of the
described salvage, resulting from Requester's use of said salvage for the specific purpose described herein.
Requester may not assign any of its duties under this agreement.
DESCRIBED SALVAGE VEHICLE: YEAR: 2001
MAKE: Pontiac
MODEL: Sunfire
VIN # 1G2713524717214279
ANTICIPATED PERIOD OF USE: February 22, 2011 thru March 10, 2011
NAME OF REQUESTER: City of Round Rock
REPRESENTATIVE/TI : Steve Norwood, City Manager
SIGNATURE: X
DATE: `45-47 Cil
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
(Identify specific State Farm Company that owns the described salvage)
REPRESEN TIVE/TIyFLE: -� d ' F' / -���ti r /Pk/ %' t' ✓-
DATE: 3 - -c 1/
SIGNATURE:
attvt.i (..Oo4&
Claim #53-G527-737
Agreement Regarding the Requested Use of a Salvage Vehicle
This agreement between State Farm Mutual Automobile Insurance Company ("State Farm") and
(identify specific State Farm Company)
Round Rock Fire Department ("Requester") reflects the understanding of each party with respect to the temporary use of
a Described Salvage Vehicle ("salvage") owned by State Farm by Requester for the following specific purpose:
Department Wide ISO Night Fire Drill
Whereas State Farm is willing to donate use of said salvage for the specific purpose stated herein. State Farm will not
accept any liability for injury or property damage that might directly or indirectly result from such use. Requester therefore
expressly acknowledges the following:
A. Requester agrees that it accepts the salvage in an "as is" condition, and that State Farm has neither warranted the
condition of, nor expressed or implied a fitness for any specific purpose or use of said salvage by Requester.
B. Under no circumstances shall State Farm be liable to requester or requester's employees or agents for
damages of any kind whatsoever relating to requester's use of the salvage.
C. Requester at its own expense shall defend and hold State Farm fully harmless against any loss, damages, claims,
or expenses of any kind whatsoever, including attorney's fees, incurred by State Farm as a result of the use of the
salvage by Requester or Requester's employees or agents.
Requester agrees its use of said salvage encompasses the entire period of time beginning when actions are taken to move or
transport the described salvage from its present location, and ending when said salvage is returned to State Farm's control at
that same location, (or at some other location mutually agreed upon by the parties.) If Requester's use of said salvage does
not require movement from its present location, Requester's use begins when preparations begin to test, demonstrate,
display, or otherwise use said salvage, and ends at the conclusion of activity associated with such tests, demonstrations,
displays, or other usage. Requester agrees to be responsible for all transportation set up and other costs incurred during the
actual period of use of said salvage.
State Farm acknowledges the described salvage may sustain additional damage while being used by Requester, and agrees
to make no claim against Requester for damage to said salvage if sustained as a direct result of the specific purpose stated
herein. Requester agrees it will make no claims against State Farm for actual or alleged increases in the value of the
described salvage, resulting from Requester's use of said salvage for the specific purpose described herein.
Requester may not assign any of its duties under this agreement.
DESCRIBED SALVAGE VEHICLE: YEAR: 2003 MODEL: Ranger
MAKE: Ford
VIN # 1FTYR10U33PA75692
ANTICIPATED PERIOD OF USE: February 22, 2011 thru March 10, 2011
NAME OF REQUESTER: City Of Round Rock
REPRESENTATIVE/TIT Steve Norwood, Cit ► anager
44141"%!;0%,..0.01
SIGNATURE: X
DATE: J5J.QI c
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
(Identify specific State Farm Company that owns the described salvage)
REPRESENTATIVE/TITLE:
SIGNATURE:
CJVf(Oz-o'4Lp
DATE: 3---/ _ 2-44 (