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HomeMy WebLinkAboutContract 45838-FP4 Depa t of-rr�jwnUanm services Pr,o saner�ri.l Dat Risk Management S.C ad r ` ��✓ tT WORT Ho ���$ � -M ' D.O.E. Brotherton CONTOM NO..�..�+ CFA Westerman/Scanned❑ q ne Proceeding poop*We been Contacted concerning the request for Real payment&have released rias project for sac),payment. ATION AND PUBLIC WORKS F PROJECT COMPLETION C5 2y 0 .33 Clearance Conducted By Etta Bacy D.O.E.NO: 7201 Regarding contract 217201 for TRAILS OF FOSSIL CREEK PHASE IV as required by the WATER DEPARTMENT as approved by City Council on N/A through M&C N/A the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project as cooTete. M 1 1)1 Original Contract Prices: D L4 C $629,463.95 Amount of Approved Change Orders: FE 8 15201 L4 Ns 1 Revised Contract Amount: $629,463.95 Total Cost Work Completed: $629,463.95 Less Deductions: Liquidated Damages: Days®$210.00/Day Pavement Deficiencies: Total Deduction Amount: $0.00 Total Cost Work Completed: $629,463.95 Less Previous Payments: Final Payment Due $629,46395 t Reco end for Acceptance �^ Date Asst. Director,TPW -Infrastructure Design and Constwction Accepted Date Asst. Director, WATER DEP TMENT <�' -0��-�--s / /', -, 2 Asst. City Manager Date Comments: FUND WATER P265-475260-6071502251/SEWER.P275-475220-2073202251 FEB 2 2016 IL.itiali - U rFEB1 City Project Numbers 02251 DOE Number 7201 Contract Name TRAILS OF FOSSIL CREEK PHASE IV WATER,SEWER AND DRAINA Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 1/31/2016 i Project Funding i I i Project Manager Long City Secretary Contract Number 217201 Inspectors RODGERS / DEYON Contract Date Contractor BURNSCO CONSTRUCTION,INC. Contract Time 180 W 6331 SOUTHWEST BLVD Days Charged to Date 469 W FORT WORTH, TX 76132 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded Total Cost of Work Completed $629,46395 Less %Retained $0.00 Net Earned $629,463.95 Earned This Period $629,463,95 Retainage This Period $0.00 Less Liquidated Damages 0 Days @a $0.00 /Day $0,00 LessPavement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $629,463.95 Friday.,January 29,2016 PAP 5 of 5 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name TRAILS OF FOSSIL CREEK PHASE N WATER,SEWER AND DRAINAGE Contract Limits Project Type WATER&SEWER City Project Numbers 02251 DOE Number 7201 Estimate Number 1 Payment Number 1 For Period Ending 1/31/2016 W City Secretary Contract Number 217201 Contract Time 18W Contract Date Days Charged to Date 469 Project Manager Long Contract is 100.00 Complete Contractor BURNSCO CONSTRUCTION,INC. 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 Inspectors RODGERS / DEYON i Friday,January 29,2016 Papa 1 of 5 i F City Project Numbers 02251 DOE Number 7201 Contract Name TRAILS OF FOSSIL CREEK PHASE IV WATER,SEWER AND DRAINA Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 1/31/2016 Project Funding UNIT I:WATER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ----------------------------------------- 1 3311.01416"WATER PIPE 16 LF $35.75 $572.00 16 $572.00 2 3311.02418"WATER PIPE 4691 LF $37.75 3177,08525 4691 $177,085.25 3 3305.0109 TRENCH SAFETY 4707 LF $1.00 $4,707.00 4707 $4,707.00 4 3312.3002 6"GATE VALVE 8 EA $820.00 $6,560.00 8 $6,560.00 5 3312.3003 8"GATE VALVE 12 EA $1,200.00 $14,400.00 12 $14,400.00 6 3312.0001 FIRE HYDRANT 8 EA $2,600.00 $20,800.00 8 $20,800.00 7 3311.0001 DUCILE IRON WATER FITTINGS W/ 2.3 IN $4,100.00 $9,430.00 2.3 $9,430.00 RESTRAINT 8 3312.0117 CONNECTION TO EXISTING 4"-12" 5 EA $600.00 $3,000.00 5 $3,000.00 WATER MAIN 9 3312.2003 1"WATER SERVICE 148 EA $700.00 £103,600.00 148 $103,600.00 Sub-Total of Previous Unit $340,154.25 $340,154.25 UNIT II:SANITARY SEWER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 3331.5304 8"PVC SEWER PIPE,GTO 8'(MISC 522 LF $71.90 $37,531.80 522 $37,531.80 ONLY) 2 3331.5307 8"PVC SEWER PIPE,8'TO 10'(MISC 1834 LF $72.90 £133,698.60 1834 $133,698.60 ONLY) 3 3331.5310 8"PVC SEWER PIPE,10'TO 12'(MISC 139 LF $73.90 $10,272.10 139 $10,272.10 ONLY) 4 3331.5308 8"PVC SEWER PIPE,8'TO 10'(MISC 80 LF $79.90 $6,392.00 80 $6,392.00 ONLY,CSS BACKFILL 5 3331.53118"PVC SEWER PIPE,10'TO 12'(MISC 35 LF $80.90 $2,831.50 35 $2,831.50 ONLY)CSS BACKFILL 6 3331.5314 8"PVC SEWER PIPE,12'TO 14'(MSC 19 LF $83.90 $1,594.10 19 $1,594.10 ONLY),CSS BACKFILL 7 3305.0109 TRENCH SAFETY 2629 LF $1.00 $2,629.00 2629 $2,629.00 8 3339.1001 4'MANHOLE 8 EA $2,500.00 $20,000.00 8 $20,000.00 9 3339.1102 5'DROP MANHOLE 1 EA $5,070.00 $5,070.00 1 $5,070.00 10 3339.1003 4'EXTRA DEPTH MANHOLE 18 VF $60.00 $1,080.00 18 $1,080.00 11 3339.1103 5'EXTRA DEPTH MANHOLE 6 VF $100.00 $600.00 6 $600.00 12 3301.0101 MANHOLE VACUUM TESTING 12 EA $110.00 $1,320.00 12 $1,320.00 Friday,January 29,2016 Page 2 of 5 City Project Numbers 02251 DOE Number 7201 Contract Name TRAILS OF FOSSIL CREEK PHASE IV WATER,SEWER AND DRAINA Estimate Number I Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 113 1 120 1 6 Project Funding 13 3305.0106 MANHOLE ADJUSTMENT,MAJOR 1 EA $1,200.00 $1,200.00 1 $1,200.00 (ECCENTRIC CENTER) 14 3339.0001 EPDXY MANHOLE LINER 43 VF $170.00 $7,310.00 43 $7,310.00 15 3331.31014"SEWER SERVICE I00 EA $400.00 $40,000.00 100 $40,000.00 16 3331.31024"2-WAY CLEANOUT 100 EA $100.00 $10,000.00 100 $10,000.00 17 3301.0002 POST-CCTV INSPECTION 2629 LF $1.40 $3,680.60 2629 $3,680.60 18 9999.0001 CONNECT TO EXISTING MANHOLE 2 EA $800.00 $1,600.00 2 $1,600.00 19 9999.0002 CONNECT TO EXISTING MANHOLE I EA $2,500.00 $2,500.00 1 $2,500.00 WITH EXTERNAL DROP CONNECTION Sub-Total of Previous Unit $289,309.70 $289,309.70 I i i I Friday,January 29,2016 Page 3 of 5 City Project Numbers 02251 DOE Number 7201 Contract Name TRAILS OF FOSSIL CREEK PHASE IV WATER,SEWER AND DRAINA Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 1/31/2016 Project Funding Contract Information Summary Original Contract Amount $629,463.95 Change Orders Total Contract Price $629,463.95 Date 2' Total Cost of Work Completed $629,463.95 Con tr ctor Less %Retained $0.00 W� Net Earned $629,463.95 Inspection Supervisor Date ( Earned This Period $629,463.95 Retainage This Period $0.00 Da to /" P�v Less Liquidated Damages Project Manager Days @ /Day $0.00 Date LessPavement Deficiency $0.00 Asst.D* oo,PW-Infrastructure Design and Cons ction Less Penalty $0.00 Date / Less Previous Payment $0.00 R�y� . r/Gontrncting Dep t nPlus Material on Hand Less 15% $0.00 Directo Balance Due This Payment $629,463.95 Friday,January 29,2016 Page:4 of 5 I AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT i Before me,the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared John Burns, President Of Burnsco construction, Inc.,known to me to be a credible person, who being by me duly sworn, upon his oath deposed and said; That all persons, firms, associations, corporations, or other organizations furnishing labor and/or materials have been paid in full; That the wage scale established by the City Council in the City of Fort Worth has been paid in full; That there are no claims pending for personal injury and/or property damages; On Contract described as; Trails of Fossil Creek IV-Water, Sewer, Drainage Improvements BY John Burns,President i Subscribed and sworn before me on this date 29th of December,2015. Nota-r Public Tarrant County,Texas +. MARY PANNELL Notary Public,state of Texas I y�> My Commission Expires ...... .... October 19. 2018 i I i I CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ Conforms with the American Institute of OTHER Architects,AIA Document G707 Bond No 022048353 PROJECT: Trails of Fossil Creek Phase IV (name, address) Fort Worth,TX TO (Owner) FOSSIL CREEK A2A DEVELOPMENT LLC AND CITY? ARCHITECT'S PROJECT NO: OF FORT WORTH CONTRACT FOR: 548 Silicon Drive Suite 100 Trails of Fossil Creek Phase IV-Water,Sewer and Drainage Improvements southlake Tx 76092 —J CONTRACT DATE: CONTRACTOR:BURNSCO CONSTRUCTION, INC. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (here Insert name and address of Surety Company) LIBERTY MUTUAL INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of (here Insert name end address of Contractor) BURNSCO CONSTRUCTION, INC, i 6331 Southwest Boulevard Benbrook TX 76132 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here Insert name and address of Owner) FOSSIL CREEK A2A DEVELOPMENT LLC AND CITY OF FORT WORTH 548 Silicon Drive Suite 100 Southlake TX 76092 , OWNER, as set forth in the said Surety Company's bond. I IN WITNESS,WHEREOF, the Surety Company has hereunto set its hand this 22nd day of December,2015 LIBERTY MUTUAL INSURANCE COMPANY — Surety Company Attest:Robbi Morales (Seal): Signature of Authorized Representative Soohinie Hunter Attomey-in-Fact Title NOTE; This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. 7111477 American Fire and Casualty Company Liberty Mutual Insurance Company The Ohio Casualty Insurance Company WestAmerican Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: ThatAmedcan Fire&Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of New Hampshire,that liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and WestAmerican Insurance Company is a corporation duly organized under the laws of the Stale of Indiana(herein collectively called the'Companies7,pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Don E.Cornell;Kelly A.Westbrook;Ricardo J.Reyna;Robbi Morales;Sophinie Hunter;V.DeLene Marshall all of the city of Dallas ,state of TX each Individually if there be more than one named,its true and lawful attomey-in•fact to make,execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,reoognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 11th day of September 2015 ,AD cosG -(Y INS(, 1NSUq INSUA American Fire and Casualty Company �p y+�P ` fHA VJP�oMaser g9 S�� �Rkr a��ct~' ++�r4�C' The Ohio Casualty Insurance Company H I j 4 fi'yr' J a F R, o Liberty Mutual Insurance Company 1906 $ o f919 n o a > 3 o 1912 g a 1991 o West merican Insurance Company r%� �(y, iiav]ti rd. d,�l•Nn Y+`".�e(r' �f'°i�A r !r � ^.-,.vr� ! .a M.David MCara ,Assistant Secretary C STATE OF PENNSYLVANIA as t0 COUNTY OF MONTGOMERY _ C dO da of September 2015 before me personally appeared David M.Care who acknowledged himself to be the Assistant Secrete of American Fire and to pl On this t t th y pe Y PP Yr 9 Secretary v H ib Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Insurance Company,and West American Insurance Company,and that he,as such,being authorized so to do, _W O execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer, c E IN WITNESS WHEREOF,I have hereunto subscribed m name and affixed my notarial seal at Plymouth Meeting,Pennsylvania,on the day and year first above written. Q a lr1 Pq COMMONWEALTH OF PENNSYLVANIA i3 O 4�.ONW srFf Notarial Seal /�,� ,�J� I� ,� w Taman Postallo,Notary Public By; Oreor Plymouth Twp.,Montgomery County Teresa Pastella,Notary Public p ` My Commission Expirea March 28,2017 O ` � Wrober,PannsYlvanla Association of Notaries ItL C This Power of Attlxney is made and executed pursuant to an by authority of the following Bylaws and Authorizations of American Fire and Casually Company,The Ohio Casualty Insurance M m a+ Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: ARTICLE IV—OFFICERS—Section 12,PowerofAltomay.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject O e & to such limitation as the Chairman or the President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, d O= acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-tact,subject to the limitations set forth in their respective �O E powers of attorney,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so fb executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under > a the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. 4)N = ARTICLE XIII—Execution of Contracts—SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, E oQ > a! and subject to such limitations as the chairman or the president may prescribe, pp shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute, •-M O seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations, Such attomeys-in•facl subject to the limitations set forth in their c up v respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so u o executed such instruments shall be as binding as if signed by the president and attested by the secretary. o Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- feet as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Gregory W.Davenport,the undersigned,Assistant Secretary,of American Fire and Casualty Company,The Ohio Casualty insurance Company,Liberty Mutual Insurance Company.and West American Insurance Company do hereby cerfily that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attomey executed by said Companies.is in full force and effect and has not been revoked. T , k ` r 1 1 )l 4 f11 Y,t` 1 ? IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this(�_day of C .20 GC4 �PI.NS& {�w��fie ChitaSLq J�7 J f 1906 a 1919 0 1912 a 1991 3 By: r Gregory tiv.Dave,-,port,Assistant Secretary 24901500 lA1S 12813 1213 I i i 10�. Liberty I utual. T SURETY j II I Important Notice j TO OBTAIN INFORMATION OR TO MAKE A COMPLAINT: i You may write to Liberty Mutual Surety at: Liberty Mutual Surety Interchange Corporate Center 450 Plymouth Road, Suite 400 Plymouth Meeting, PA 19462-8284 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection(-tdi.state.tx.us Premium or Claim Disputes Should you have a dispute concerning a premium, you should contact the agent first. If you have a dispute concerning a claim, you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Attach This Notice To Your Policy: This notice is for information only and does not become a part or condition of the attached document. I LMIC-3500 I SERENE HOMES January 22, 2016 Mr. John Burns Burnsco construction, Inc. 6331 Southwest Blvd. Benbrook, Texas 76132 RE: Trails of Fossil Creek Phase IV—Water, Sanitary Sewer and Storm Drain Improvements CoFW Project No. 02251 CoFW File No. W-2310 CoFW DOE No. 7201 Mr. Burns, This letter will document that Fossil Creek A2A Development LLC confirms that Burnsco Construction, Inc, has completed the Work associated with the above referenced contract in an appropriate timeframe, subject to completion of any warranty or maintenance work as identified and required by the City of Fort Worth, and that no liquidated damages will be assessed by Fossil Creek A2A Development LLC in connection with the Work. Fossil Creek A2A Development LLC By: Em Ron Ramirez, P.E. Executive Vice-President Engineering Serene Development. LLC 55 ;riccn Drive Suite 100 So,tf,[Clke 7k' 76092 USA Tet: 1 689 333 01C 1 =max: 1 8 1 7 778, 8505 woia°i.5"e re n e h o m e S.c Om FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Trails Of Fossil Creek Phase IV PROJECT NUMBER: 2251 DOE NUMBER: 7201 i WATER PIPE LAID SIZE TYPE OF PIPE LF PVC 6" AWWA C900-07 16 PVC 8" AWWA C900-07 4691 FIRE HYDRANTS: 8 VALVES(16"OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: YES/PASS NEW SERVICES: 1" Water Service Copper 148 SEWER PIPE LAID SIZE TYPE OF PIPE LF PVC 8" SDR-26 2629 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: YES/PASS NEW SERVICES: 4" Sewer Service PVC 100 ea 4" 2-Way Cleanouts 100 ea TRiANSPORTAMON AND PUBLIC WORKS The City of Fort Words•1000 Throckmorton Street•Fort Worth,Thi 76012-6311 (817)392-7941 •Fay(817)392-7845 i FoRTWORTHREV:02/20/07 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR 1) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Btunsco Construction Trails Of Fossil Creek Phase IV DOE Inspector DOE Number Gary De on 7201 DOEGtspector Project Manager 21 Water 2l Waste Water❑ Storm Drainage❑ Pavement Aaron Long Initial Contract Amount Project Difficulty $629,463.95 O Simple OO Routine O Complex Final Contract Amount Date $629,463.95 1/22/2016 II)PERFORMANCE EVALUATION 0-Inadequate 1-Deficient 2-Standard 3-Good 4-Excellent ELEMENT WEIGHT x APPLICABLE(Y/N) RATING 0-4 MAX SCORE SCORE 1 Submission of Documents 2 Y 4 8 8 2 Public Notifications 5 Y 4 20 20 3 Plans on Site 5 Y 4 20 20 4 Field Su ervision 15 Y 3 60 45 5 Work Performed 15 Y 3 60 45 6 Finished Product 15 Y 3 60 45 7 Job Site Safety 15 Y 3 60 45 8 Traffic Control Maintenance 15 Y 2 60 30 9 Daily Clean Up 5 Y 2 20 10 t0 Citizen's Complaint Resolution 5 Y 4 20 20 11 Property Restoration 5 Y 4 20 20 12 After Flours Response 5 Y 4 20 20 13 Project Completion 5 Y 4 20 1 20 TOTAL ELEMENT SCORE(A) 348 j BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 348 111)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating QTS/MS]*100%) 348 / 448 = 78% Performance Category Good <20%=Inadequate 20?1.to<40%=Deficient 40%to<60%=Standard 60%to<80%=Good 380%=Excellent Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS A%VARDED) l Signature DOE Inspector �— Signature Contractor Signature DOE Inspector's Supervisor Z (b CONTRACTOR'S COMMENTS TB--)NSPORTATION AND PUBLIC WORKS (a The City of Fort Worth-1000 Throdanorton Street-Fort Worth,Thi 76012-6311 (817)392-7941 -Far-(817)392-7845 FORTWORTHREV:02/22/07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I PROJECT INFORMATION _ Date: 1/22/2016 ~�� Name of Contractor Project Name Burnsco Construction Trails Of Fossil Creek Phase IV _ DOE Inspector Project Manager Ga De on Aaron Lon DOE Number Project Dcu11)+ Ti pe of Contract 7201 10 Simple OO Routine O Complex El Water 0 Waste Water Storm DrainageO Pavement Initial Contract Amount Final Contract Amount $629,463.95 $629,463.95 Ii)PERFORMANCE EVALUATION 0-Inadequate 1-Deficient 2-Standard 3-Good 4-Excellent ELEMENT RATING ELEMENT RATING 0-4) 0-4 INSPECTION EVALUATION PLANS&SPECIFICATIONS l Availability of Inspector 1 Accuracy of Plans to Existing Conditions 2 Knowledge of Ins ector ,1 2 Clarity&Sufficienc of Details y 3 Accuracy of Measured guantities 3 Apvlicabiliof Specifications 4 Dis lay Of Professionalism_ 4 Accuracy of Plan Quantities - 5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION 6 Performance-Setting ue Valve Crews Labs 1 Knowledge And/Or Problem Resolution ADMINISTRATION 2 Availabili�t of Project Manager - I Change Order processingTime 3 Communication U 2 Tim Iiness of Contractor Pa ents I t4 14 Resolution of Utility Conflicts 3 Bid 02ening to Pre-Con Meeting Timeframe III)COMMENTS&SIGNATURES COMMENTS Signature Contractor 1 Signature DOE Inspector ` Signature DOE Inspector's Supervisor INSPECTOR'S COMMENTS MNNSPORTkTION_AND PUBLIC WORKS The City of FortWorth•1000 Throckmorton Street•Fort Worth,TK 76012-6311 (817)392-7941•Fax:(817)392-7845 FORT WORTH TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME STATEMENT# FINAL STATEMENT# 1 DOE 7201 NAME OF PROJECT: Trail of Fossil Creek Phase IV Water,Sewer,Storm,Paving Contractor Surnsco YEAR: 2016 PROJECT NO.: FINAL INSPECTION DATE g -Z01 2251 WD CD CONTRACT TIME 180 x PERIOD FROM: 1/16/2016 TO: 1/31/2016 BEG - Month DEVELOPMENT (Y/N) N WORK ORDER EFFECTIVE: 8/20/1014 BEG I n MID /n n DAY OF MONTH DAN'S REASON FOR DAYOF N! )NTH DAYS REASON FOR CHARGED DAYS CREDITED CHARGED DAYS CREDITED 1 Sat 0 na 16 2 Sun 0 na 17 3 Mon 0 na 18 4 Tue 0 na 19 5 Wed 0 na 20 6 -Thu 0 na 21 7 -- Fri 0 na 22 - 8 Sat 0 no 23 I 9 Sun 0 no 24 - 10 Mon 0 no 25 11 Tue 0 na 26 12 Wed 0 na 27 13 Thu 0 na 28 14 Fri 0 na 29 15 Sat 0 na 30 31 NA Wkn&Hol Wea Utl Oth Not Applicable SAT,SUN,and \1TATHER UTILITIES OTHERS DAYS TOTAL DAYS HOLIDAYS RELOCATE CHARGED THIS PERIOD 0 0 0 0 0 0 PREVIOUS PERIOD 0 469 469 TOTAL TO DATE 0 0 0 0 469 469 RENIARKS: Completed and Final on 12/1/2015 1 5ignaturc: CIA t } Signature: t (Print Name) (Print Name) Ga-ry.Dcy0-11t CONTRACTOR "J�i L�i'SPECfOR DATE f