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Street Closure Form
* Required fields
URL
This field is for validation purposes and should be left unchanged.
Street, lane and/or sidewalk closures or any other work on TMC property or TMC private roads requires a fully executed TMC License Agreement prior to work commencing.
MEMBER INSTITUTION INFORMATION
Member Institution
*
Name
*
Email
*
Phone
*
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
CONTRACTOR INFORMATION
Company
*
Name
*
Email
*
Phone
*
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
DESCRIPTION OF REQUEST
Project or Event Name
*
Requested Date(s) of Work and Work Schedule
*
Street Name(s)
*
Reason for Closure
*
Other Campus Impacts (eg. Closure of shuttle or bus stops)
*
Type of Closure (Select all that apply)
*
Total Street
Lane(s)
Sidewalk
Other
Type of Equipment Required (Select all that apply):
*
Ground Crane(s)
Excavator, Backhoe, etc.
Swing Stage
Other (Please specify)
Other Equipment (Please list):
TMC STREET, LANE AND/OR SIDEWALK CLOSURE REQUIREMENTS
Texas Medical Center ("TMC") License Agreement
Street and/or lane closures or any other work on TMC property or TMC private roads requires a fully executed TMC License Agreement prior to work commencing.
TMC Private Roads: Bates, Bellows, Bertner, Breakthrough, Catalyst, Dynamic, E. Cullen, Elliott, Envision, Future, Harvin, Helix Park, John Freeman, Lamar Fleming, Moursund, MD Anderson Blvd, Pressler (except between Main and Fannin), Ross Sterling, Richard JV Johnson and Underwood.
Traffic Control Plan
A Traffic Control Plan must be submitted with this request. The Traffic Control Plan must be signed/sealed by a Professional Engineer. A Pedestrian Mobility Plan must be submitted for all sidewalk closure requests. A Detour Plan must be submitted for full closures.
Please note that coordination with other City of Houston agencies may be required before final approval of a closure request.
The Traffic Control Plan should show general vehicular flow within, to, and from the construction site, detours (if necessary), proposed vehicle and pedestrian directional signage types and locations, and any other pertinent information.
Contractor must provide sufficient police officers, certified flagmen, beacons, barriers, and traffic control signage at the time of closure.
For sidewalk closures, the Pedestrian Mobility Plan must include a safe and accessible passageway for all pedestrians proximal to the construction site, comply with ADA Accessibility Guidelines, and include safety considerations for crossing sidewalks with construction vehicles.
Member Institutions and their Contractors shall at all times maintain full access to all buildings adjacent to the construction site for emergency vehicles, which includes firefighting equipment. Contractors shall, at no time, block or close roadways or fire lanes without alternate roadways and means of entrance approved by the City of Houston.
Lane closure times should focus on weekends and/or non-peak hours during the work week. Major deliveries are not permitted during peak hours (6 AM – 9 AM and 3 PM – 7 PM).
Certificate of Insurance
A certificate of insurance must be submitted listing Texas Medical Center as Additional Insured.
Coverage limits will be defined in the TMC License Agreement and will vary based upon the scope of work.
Certificate Information: Texas Medical Center, 2450 Holcombe Blvd, Suite 1, Houston, Texas 77021.
Return to TMC via email at
TMCCampus@tmc.edu
and
TMCLegal@tmc.edu
.
ADDITIONAL INFORMATION
All Member Institutions and Contractors should be familiar with the TMC Architectural Standards (General Construction Section).
All projects should follow the latest
TMC Architectural Standards
.
Acknowledgments
All required application documents have been included with this request.
I understand that TMC will only accept this request when all required documentation has been provided.
I agree to hold harmless, indemnify and defend TMC, its officers and employees from and against all claims for personal injury or property damage that arise in connection with any street and/or sidewalk closures.
I understand that by submitting this form it does not reserve or guarantee requested dates of work and additional documentation may be required after review to approve and coordinate this request.
I hereby certify and attest that this application and all required documentation is complete and accurate.
I hereby submit this application and attachments for review by TMC.
UPLOAD ADDITIONAL APPLICATION DOCUMENTATION
File
Accepted file types: pdf, doc, docx, Max. file size: 10 MB.
File
Accepted file types: pdf, doc, docx, Max. file size: 10 MB.
File
Accepted file types: pdf, doc, docx, Max. file size: 10 MB.
Agreement
*
I have read and understand the information provided in this form.
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TMC
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TMC Venture Fund
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Overview
Why Houston
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BioPath@TMC
Dementia Prevention Research Institute of Texas (DPRIT)
TMC Campuses
Medical Campus
Overview
Our Members
TMC Clinical Research
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Overview
TMC
i
CDI @ TMC
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