HomeMy WebLinkAboutContract 46472-FP4 Depa nt of P&W Const.Services
DOE# Date
Project anagen-rAlk •- "ECRETAw �
Risk Management Canady ,� . T WORTH® c®t rrma wo. "Ivyl7 LFP.
D.O.E. Brotherton
CFA Westerman/Scanned
The Proceeding people have been Co4actedfoncer hi the request kr Mal q 1P0 /1 Payl'
a
ent
paym6 have released this project for such payment TION AND PUBLIC WORKS V
Clearance Conducted By Shameka Kennedy PROJECT COMPLETION C#p,Z34%
D.O.E.Ns: 7284
cs#�y7z
Regarding contract 117284 for RICHMOND PHASE I as required by the WATER&SEWER as approved by City
Council on N/A through M&C N/A the director of the WATER&SEWER upon the recommendation of the
Assistant Director of the Transportation&Public Works Department has accepted the project as complete.
Original Contract Prices: "22
$1,851,00238
Amount of Approved Change Orders: $95,358.78 NO 1
Revised Contract Amount: $1,946,361.16
Total Cost Work Completed: BY. $1,946,361.16
Less Deductions:
Liquidated Damages: Days @$210.00/Day
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Work Completed: $1,946,361.16
Less Previous Payments: $0.00
Final Payment Due $1,946,361.16
2&fft=—
Recornm4nded
fkW Acceptance Date
Asst. Director, TPW - Infrastructure Design and Construction
Accepted De
Asst. Director, WATER&SEVWR � �114
'A-
Asst. City Manager Date
Comments: P265-541200-60714023428383,P275-541200-707140234283
OFFICIAL RECORD
CITY SECRETARY
EMAILED FT.WORTH,TX
MAR 2 4016
slitiaal 1- Q �- ? US- 0 :2.3� a
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me,the undersigned authority,a notary public in the state and county aforesaid,
on this day personally appeared Tim Crawford,COO Kodiak Trenching and Boring,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 there are no claims pending for personal injury and/or property damages;
On Contract described as;Richmond Phase 1,Ft.Worth,TX
BY
C
1
Subscribed anL porn before me on this date YJ of AlW Da b
' Jami Cushman
%oar)hWie,
tozPablic sux or•rKe
Tarrant,Texas:ur�ws
NOTICE:
This document waives rights unconditionally and states that you have been
paid for giving up those rights.it Is prohibited for a person to require you to sign
this document if you have not been paid the payment amount set forth below. If
you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project Rich a P 1
Job No. im
The signer of this document has been paid in full for all labor,services, equipment,
or materials furnished to the property or to &wwmb R+tma.LLc (person with
whom signer contracted)on the property of Arwnm Pwo-w uc (owner)
located at Fuitwaeti rx (location)to the following
extend: Lift on*=*n (job description).The signer therefore
waives and releases any mechanic's!'ten right,any right arising from a payment bond
that complies with a state or federal statute,any common law payment bond right,any
claim for payment, and any rights under any similar ordinance,rule,or statute related to
claim or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received
from this final payment to promptly pay in full all of the signer's laborers, subcontractors,
materialmen,and suppliers for all work, materials,equipment,or services provided for
or to the above referenced project up to the date of this waiver and release.
Signature: :
Date: v$—
Company Nagle: w' 'T1i t•��N 7-vG �'t P�'�'�' LL t
By(w/title): e0m
STATE OF TEXAS §
COUNTYOF_
This instrument was acknowledged before me on#ft day of e ! 20�
by ✓ i Co, d (name), e-h i of Q&Q,-g r ren S 7 Ob
We) of yaiwt-T"l#,nehin -1-69;--iglcompany name).
A-»u
Nf7
Jami Cushman fARY PLMJC.STATE OF TEXAS
Nola"Paint,
SW�CUrTuas
Expires:GI/M2079
i
FORTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name RICHMOND PHASE 1
Contract Limits
Project Type WATER&SEWER
City Project Numbers 02342
DOE Number 7284
Estimate Number I Payment Number 1 For Period Ending 3!3/2016
CD
City Secretary Contract Number 117284 Contract Time 6ED
Contract Date Days Charged to Date 444
Project Manager Ehia Contract is 100.00 Complete
Contractor KODIAK TRENCHING 7 BORING,LLC
P O BOX 93929
SOUTHIAKE, TX 76092
Inspectors LAYER / DOVERS
Monday,March 07,2016 Page 1 of 5
City Project Numbers 02342 DOE Number 7284
Contract Name RICHMOND PHASE 1 Estimate Number I
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 3/3/2016
Project Funding
WATER
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
-------- -- — — .- - --- — --------- -
1 TRENCH SAFETY WATER co#1 15248.5 LF $0.10 $1,524.85 15248.5 $1,524.85
2 CONCRETE ENCASEMENT FOR UTILITY PIPES 45 LF $30.00 $1,350.00 45 $1,350.00
3 DUCTILE IRON WATER FITTINGS W/RES co#1 7.4 TN $6,711.00 $49,661.40 7.4 $49,661.40
4 8"WATER PIPE co#1 12753.5 LF $20.15 6256,983.03 12753.5 $256,983.03
5 12"WATER PIPE co#1 3380 LF $36.15 6122,187.00 3380 $122,187.00
6 16"WATER PIPE co#1 1306 LF $51.50 $67,259.00 1306 $67,259.00
8 FIRE HYDRANT co#1 17 EA $3,685.00 $62,645.00 17 $62,645.00
9 CONNECT TO EXISTING 16"WATER MAIN I EA $4,882.00 $4,882.00 1 $4,882.00
10 2"COMBINATION AIR VALVE ASSMEBLY FOR 2 EA $4,889.00 $9,778.00 2 $9,778.00
WATER
11 I"WATER SERVICE 299 EA $690-00 6206,310.00 299 $206,310.00
12 1 1/2"WATER SERVICE 1 EA $2,255.00 $2,255.00 1 $2,255.00
13 2"WATER SERVICE 5 EA $2,234.00 $11,170.00 5 $11,170.00
14 8"GATE VALVE cc#1 37 EA $1,100.00 $40,700.00 37 $40,700.00
15 12"GATE VALVE 6 EA $1,925.00 $11,550.00 6 $11,550.00
16 16"GATE VALVE WNAULTco#1 4 EA $16,145.00 $64,580.00 4 $64,580.00
17 6"BLOW OFF VALVE I EA $6,142.00 $6,142.00 1 $6,142.00
20 SWPPP MAINTENANCE 1 LS $300.00 $300.00 1 $300.00
21 BORE FOR UTILITY 120 LF $438.30 $52,596.00 120 $52,596.00
2 24"CASING BY OPEN CUT CO#1 45 LF $80.00 $3,600.00 45 $3,600.00
3 24"CASING BY OTHER THAN OPEN CUT CO#1 120 LF $80.00 $9,600.00 120 $9,600.00
4 16"WATER CARRIER PIPE C041 171 LF $94.53 $16,164.63 171 $16,164.63
Sub-Total of Previous Unit $1,001,237.91 $1,001,237.91
SEWER
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
I POST CCTV INSPECTION CO#1 16144 LF $1.10 $17,758.40 16144 $17,758.40
2 MANHOLE VACUUM TESTING 69 EA $135.00 $9,315.00 69 $9,315.00
3 BYPASS PUMPING I LS $3,500.00 $3,500.00 1 $3,500.00
4 TRENCH SAFETY CO#1 15808 LF $0.10 $1,580.80 15808 $1,580.80
Monday,March 07,2016 Page 2 of 5
i
City Project Numbers 02342 DOE Plumber 7284
Contract Name RICHMOND PHASE 1 Estimate Number I
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 3/3/2016
Project Funding
5 TRENCH WATER STOPS CO#1 42 EA $50.00 $2,100.00 42 $2,100.00
6 4"WATER SEWER SERVICE 151 EA $454.00 $68,554.00 151 $68,554.00
7 4"SEWER SERVICE 145 EA $489.00 $70,905.00 145 $70,905.00
9 8"SEWER PIPE CO#1 8260 LF $22.95 £189,567.00 8260 $189,567.00
10 8"SEWER PIPE,CSS BACKFILL CO#1 1010 LF $27.20 $27,472.00 1010 $27,472.00
11 I0"SEWER PIPE CO#1 3213 LF $28.95 $93,016.35 3213 $93,016.35
12 10"SEWER PIPE CSS BACKFILL CO#1 590 LF $33.65 $19,853.50 590 $19,853.50
14 EPDXY MANHOLE LINER 155.9 VF $191.00 $29,776.90 155.9 $29,776.90
15 4'MANHOLECO#1 55 EA $2,442.00 3134,310.00 55 $134,310.00
16 4'DROP MANHOLE 10 EA $3,364.00 $33,640.00 10 $33,640.00
17 4'EXTRA DEPTH MANHOLE CO#1 353.1 VF $80.00 $28,248.00 353.1 $28,248.00
18 CONNECT TO EXISTING MANHOLE 1 EA $810.00 $810.00 1 $810.00
19 CONCRETE CAP 165 LF $28.00 $4,620.00 165 $4,620.00
21 4"SDR 26 SEWER SERVICE 3 EA $1,770.00 $5,310.00 3 $5,310.00
22 T WATER TIGHT MANHOLE W/LID BOLTED 7 EA $2,890.00 $20,230.00 7 $20,230.00
DOWN CO#1
23 4'WATER TIGHT MANHOLE WUD BOLTED 1 EA $3,838.00 $3,838.00 1 $3,838.00
DOWN OVER EXISTING LINE
24 SWPPP MAINTENANCE 1 LS $300.00 $300.00 1 $300.00
3 CONCRETE COLLAR CO#1 5 EA $250.00 $1,250.00 5 $1,250.00
10 12"SEWER PIPE CO#1 940 LF $37.75 $35,485.00 940 $35,485.00
12 15"SEWER PIPE CO#1 1880 LF $41.35 $77,738.00 1880 $77,738.00
13 15"SEWER PIPE CSS BACKFILL CO#1 20 LF $58.65 $1,173.00 20 $L 173.00
14 EPDXY MANHOLE LINER CO#1 10 VF $165.00 $1,650.00 10 $1,650.00
18 CONCRETE ENCASEMENT CO#1 220 LF $45.00 $9,900.00 220 $9,900.00
21 REMOVE EXISTING 4'MANHOLE CO#1 4 EA $1,000.00 $4,000.00 4 $4,000.00
22 REMOVE 8"SEWER PIPE C041 1424 LF $12.00 $17,088.00 1424 $17,088.00
23 REMOVE CONCRETE ENCASEMENT CO#1 30 LF $20.00 $600.00 30 $600.00
24 REMOVE&REPLACE FENCE CO#1 48 LF $28.00 $1,344.00 48 $1,344.00
25 PROTECT&OR REPLACE PLANTER C041 1 EA $2,000.00 $2,000.00 1 $2,000.00
26 REMOVE&REPLACE 4'SIDEWALK CO#1 14.2 SY $42.00 $596.40 14.2 $596.40
27 REMOVE&REPLACE PAVEMENT CO#1 193 SY $150.00 $28,950.00 193 $28,950.00
16 4'EXTRA DEPTH MANHOLE CO#1 -7.1 VF $191.00 ($1,356.10) -7.1 ($1,356.10)
Sub-Total of Previous Unit $945,123.25 $945,123.25
Monday,March 07,2016 Page 3 of 5
City Project Numbers 02342 DOE Number 7284
Contract Name RICHMOND PHASE I Estimate Number 1
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 313/2016
Project Funding
Contract Information Summary
Original Contract Amount $1,851,002.38
Change Orders
Change Order Number 1 $95,358.78
Total Contract Price $1,946,361.15
Date b Total Cost of Rork Completed $1,946,361.15/
Con ) Less %Retained $0.00
/Jy f Net Earned $1,946,361.16
Date Earned This Period $1,946,361.16
Inspection r
� j Retainage This Period 50.00
Date /I Less Liquidated Damages
Project Manager Days @ /Day $0.00
LessPavement Deficiency $0.00
Asst Direej—or W 7t�ru7weignandCo truction Less Penalty $0.00
te 3 2 3 �� Less Previous Payment $0.00
Director/Contracting Dep n Plus Material on Hand Less 15% $0.00
Balance Dae This Payment $1,946,361.16
Monday,March 07,2016 Page 4 of 5
ECEU
MAR 2 2 tots
City Project Numbers 02342 1 1 DOE Number 7284
Contract Name RICHMOND PHASE 1 .`� Estimate Number 1
Contract Limits Payment Number 1
Project Type WATER&SEWER For Period Ending 3!3/2016
Project Funding
Project Manager Ehia City Secretary Contract Number 117284
Inspectors LAYER / DOVERS Contract Date
Contractor KODIAK TRENCHING 7 BORING,LLC Contract Time 65 CD
P O BOX 93929 Days Charged to Date 444 CD
SOUTHLAKE, TX 76092 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 $1,946,361.15
Less %Retained $0.00
Net Earned $1,946,361.16
Earned This Period $1,946,361.16
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $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 $1,946,361.16
Monday,March 07,2016 Page 5 of 5
?Ip 0 a3y--2
FORTWORTH rev 03105/07
TRANSPORTATION&PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.1
NAME OF PROJECT: Richmond PH 1
PROJECT NO.: 02342 CONTRACTOR: ICodisc Tractchiog&Boring:
DOE NO. 7284
PERIOD FROM 12/10/14 TO: 02/26/16 FINAL INSPECTION DATE: 29-Fob-16
WORK ORDER EFFECTIVE CONTRACT TIME 120 O WD SCD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH DINCREDITED MONTH CHARGED CREDITEDG DG
1. 16.
2. 17.
3. 18.
4. 19.
& 20.
6. 21.
7. 22.
& 23.
9. 24.
10. 25.
11. 26.
12. 27.
13. 28.
14. 29.
15. 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES * DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS OTTERS CHARGED DAYS
THIS
444
PERIOD
PREVIOUS
0
PERIOD
TOTALS
TO DATE 444
*REMARKS:
� c
CONTRACTOR DATE IN P OR ATE
ENGINEERING DEPARTMENT
The City o€Fort Worth•1000 T7iroc orlon Street•Fort Worth,TX 76012-6311
(817)392-7941•Fax:(817)392-7845
DEVELOPER-AMRDEO-PROJECT CHANGE ORDER
PROJECT NAME: BtM2M Phase 1 CHANGE
CONTRACT: A Utibes:Water Sewer b Drawme ORDER No:
CFA f 20142 1 CITY PARTICIPATIOW.1 NO
CRY PROJECT/ 02342
DOE= 7284 NET A
WATER PROJECT i P266-6071402342XX
PROJECT i P27S7071402342)0C
FILE/ X-22739 W-2335
INSPECTOR: Keith Dovers Phone No.
PROJECT MANAGER: Fred Ehle Phone No: 817392-8424
CONTRACT UNR
MOLTER fEWBt PALARo ORADME E STREET LIGHTS CONTRACT
D-wbpo DAYS
CoN Cost Cast CoN GN
ORIGINAL CONTRACT .40 mw "00,512." Mr $7
eXTRAS TO DATE _ lam -
CREDITS TO OATE
CONTRACT TO DATE Ie0A0 5000 12.00 __ _ 0
AMOUNT OF PROP.CHANGE ORDER 000748A7 W.610.3s 774.10
REVISED CONTRACT AMOUNT 01001 !1 3040121.20 1 0
TOTAL.REVISED CONTRACT AMOUNT
1'81 LMT 31 Jt 004 121.3E 1E/.90
REVISED COOT SITARS Dsv.Cost 32.738AIIIA0
TOTAL Re6"M CONTRACT $Z710,AUA6
ROAYOd 10-12-2011 Paps 1
WATER
1 3305.0109 167 LF Trench Safe $0.10 $16.70
2 3305.1004 45 LF 24"Cas!nA By Open Cut $80.00 $3,60D.00
3 3305.1104 120 LF 24"Casina By Other Than O Cut $80.00 $9,600.00
4 3305.2005 171 LF 18"Water cam er Pi $94.53 $16,16463
5 3311.0001 0.6 TON Water Fillings $6711.00 54,026.60
6 3311.0241 305 LF 8"Water Pi $20.15 S6,145.75
7 3311.0441 5 LF 1TWater Pipe $36.15 3180.75
8 3311.0541 -259 LF 16"Water Pie $51.50 -$13,338.50
9 1 3311.0542 35 LF 16"Water Pipe,CSS Backfill $57.80 -5 601.00
10 3312.0001 1 I FA Fire Hydrant 53685.00 53685.00
11 3312.3003 2 EA 8"Gate Valve 51 100.00 52200.00
12 3312.3006 2 FA 16"Gale Valve W VauX I$16 145.00 I $32 290.00
13 9999.0001 1 -45 1 LF Concrete C $28.00 -$1,260.00
14 9999.00021 -120 1 LF 1 24"Steel En®sement $80.00 i9 600.00
SEWER
1 3301.0002 1616 LF Post-CCN Inspection $1.10 $1777.60
2 3305.0109 1280 LF Trench Safety $0.10 $128.00
3 3305.0112 5 EA Concrete Colter $250.00 $1.250.00
4 3305.0113 3 FA Trench Water Stops $50.00 $150.00
5 3331.3312 -1 FA 6'Sever Service Reconnection $650.00 4650.00
6 3331.4115 -741 LF 8"Sewer Pi $22.95 -577 00.5.95
7 3331.4116 440 LF 8"Serer Pipe,CSS Backfil $2720 $11,968.00
8 3331.4201 560 LF 10"Serer Pie $28.95 416 212.00
9 3331.4202 180 LF 10"Serer Pipe,CSS Backfill $33.85 58057.00
10 3331.4208 940 1 LF 12"Sewer Pi $37.75 $35,485.00
11 3331.4215 -774 LF 15"Sewer Pie $39.90 -530 882.60
12 3331.4215 1880 LF 15"Sewer Pip, $41.35 $77,738.00
13 3331.4216 20 LF 15"Sewer Pipe,CSS Backfin $56.85 1 S1.17100
14 3339.0001 10 VF Epoxy Manhole Liner $165.00 $1650.00
15 3339.1001 1 EA 4'Manhole $2,44200 $ 442.00
16 3339.1003 -7.1 VF 4'Extra Dqith Manhole C 5191. 51356.10
17 9999.0002 -180 LF 24"Steel Encasement 314 400.00
18 9999.0003 220 LF Concrete Fscasament 545.00 $9900.00
19 9999.0007 2 FA 4'Water Tight Manhole with Lid Boited Down $2 890.00 $5,780.00
20 9999.0038 -180 LF Bore for Utility $472.00 --W.960.00
21 9999.0042 4 EA Remove EAstln 4'Manhole $1,000.00 $4000.00
22 9999.0043 1424 LF Remove 8'Sewer Pipe $12.00 17 088.00
23 9999.0044 30 LF Remove Concrete Encasement .0 15800.00
24 9999.0045 48 LF Remove 6 Replace Fence $28.00 $1 344.00
25 9999.0046 1 LS Prated and/or Replace Median Plante 8 Landscavino $2,000.00 $2,00D.00
26 9999.0047 142 SY Remove 8 Replace 4'Sidewalk $42.00 1 $596.40
27 9999.0048 193 SY Remove&-Replwe Pavement-Heritage Trace Parkwe 5150.00 228 950.00
STORM
1 3137.0101 15 SY Concrete Ripmp $73.05 $1095.75
2 3305.0109 191 LF Trench Safety $0.10 $19.10
3 3305.0112 -1 EA Concrete Collar $350.00 -$350.00
4 3341.0201 31 LF 21"RCP Class III $37.90 $1.174.90
5 3341.0205 35 LF 24"RCP Class III $42.90 $1,501.50
6 3341.0208 585 LF 2T'RCP Class III $48.35 -$23,449.75
7 3341.0302 443 LF 30"RCP Class III $54.05 $23 944.15
8 3341.0309 326 LF 36"RCP Class IN $69.85 $22,771.10
9 3341.0402 118 LF 42"RCP Class IN $8825 $10,413.50
10 3341.0409 -277 LF 48"RCP Class III $102.35 -$25,350.95
11 3349.5001 -5 EA 10'Curb Inlet $2800.00 -$14000.00
12 3349.5002 7 EA 15'Curb Inlet $3,865.00 $27,055.00
13 3349.5003 -2 EA 20'Curb Inlet $4925.00 59850.00
14 9999.0012 -2 FA Parallel Win 1-8x5 MBC $36,190.00 -$72,360.00
15 9999.0012 2 FA Parallel Wi 1-8x5 MBC $47,360.00 S94 720.00
16 9999.0016 -1 FA 48"Sloped Fad Headwall $4,030.00 $4030.00
17 9999.0040 1 EA Dual 36"and 42"Sloped End Headwall $8450.00 $9450.00
TOTAL 5735 093.08
Revised 10-12-2011 Pape 2
NO CITY FUNDS INVOLVED IN THIS CONTRACT.DEVELOPER 15 RESPONSIBLE FOR 100%OF THE CHANGE ORDER COST AND NO
RIF WBURSGW NT FROM THE CITY 1NLL BE SOUGHT BY THE DEVELOPER.
AEC p: APPROVED: APPROVED:
JAaohs&LEI Otaq,loc. / IL�efitnerch
By. .BY BY. -
Naaa Namo:B-LuedlkA Nees TknCy4NJ
TOE:Jeola Fnotrmmkg Prolcam-my msts—.YPdc,.,mm--d bwwawakeciF-
Re.aed:to-�23ott POpe a
FoRTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: Richmond PH 1
PROJECT NUMBER: 02342
DOE NUMBER: 7284
WATER
PIPE LAID SIZE TYPE OF PIPE LF
Yes 8" PVC 12753.5
yes 12" FVC 3380
Yes 16" PVC 1306
FIRE HYDRANTS: 17 VALVES(16"OR LARGER) 3
PIPE ABANDONED SIZE TYPE OF PIPE LF
no
DENSITIES: yes
NEW SERVICES: V Copper 8970
1 12" Copper 30
Tr Copper 150
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
yes 8" PVC 8260
yes 10" PVC 3213
yes 12" PVC 940
yes 15" PVC 1880
PIPE ABANDONED SIZE TYPE OF PIPE LF
no
DENSITIES: yes
NEW SERVICES: 4" PVC SSW
TRANSPORTATION AND PUBLIC WORKS
�! The City of Fort Worth•1000 Mwock orton Street•Fort Worth,TX 76012-6311
(817)392-7941 •Fag:(817)392-7845
FORTWORTH REV:02/20/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
I) CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
Kodiac Trenching and Boring Richmond PH l
DOE Inspector DOE Number
Connor Slaten 7284
DOE Inspector Project Manager
0 water 2 waste water ❑Storm Drainage ❑Pavement Fred Ehia
Initial Contract Amount Project Difficulty
$1,851,002.38 O Simple OO Routine O Complex
Final Contract Amount Date
$1,946,361.16 2/29/2016
H)PERFORMANCE EVALUATION
0-Inadequate 1-Deficient 2-Standard 3-Good 4-Excellent
ELEMENT WEIGHT(x) APPLICABLE(YIN) 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 3 20 15
4 Field Supemsion 15 Y 4 60 60
5 Work Performed 15 Y 4 60 60
6 Finished Product 15 Y 4 60 60
? Job Site safety 15 Y 4 60 60
8 Traffic Control Maintenance 15 Y 4 60 60
9 Daily Clean Up 5 Y 4 20 20
10 Citizen's Complaint Resolution 5 Y 4 20 20
11 Property Restoration 5 Y 4 20 20
12 After Hours Response 5 Y 4 20 20
13 Project Completion 5 Y 4 20 20
TOTAL ELEMENT SCORE(A) 443
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(TS) 443
Ell)CONTRACTOR'S RATING
Maximum Score(MS)=448 or sum of applicable element score maximums which= 448
Rating([TS/MS]*100%) 443 / 448 — 99'K
Performance Category Excellent
<20%=Inadequate 20.95 to<40%-Deficient 40%to<60%—Standard 60%to<80%=Good >_80%=Excellent
Impeetor's Comment(INCLUDING EXPLANATION OF BONUS POINTS AWARDED)
Signature DOE Inspector ignature Contractor
Signature DOE Inspector's Supervisorj�_�---
CONTRACTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
(3) The City of Fort Worth•1000 Thmckmorton Street•Fort Worth,TX 76012-6311
(817)392-7941 •F2x:(817)392-7845
CONSENT OF SURETY
TO OWNER/OBLIGEE: SUBCONTRACTOR/PRINCIPAL:
Annabella Partners LLC c/o Jacobs EngineeringGroup Kodiak Trenching and Boring,LLC
777 Main Street,Fort Worth TX 76102 P.O.Box 93929,Southlake TX 76092
PROJECT: ALLEGHENY BOND NUMBER:
Richmond Phase 1 DSAC SU0662120
In accordance with the request of the referenced Owner/Obligee and Subcontractor/Principal,Allegheny
Casualty Company,as Surety under the bond above referenced hereby approves and consents to the release
of the following payment under the terms and conditions noted below:
Owner/Obligee shall remit all funds that would be otherwise payable to Subcontractor/Principal under
Subcontractor/Principal Payment Application for Final Retainage in the amount as detailed below,such
payment shall be made in the name of and payable to Kodiak Trenching and Boring,LLC.
Pa ee Amount
Kodiak Trenching and Boring,LLC 276,701.1 I
Payments via check should be sent in accordance with the mailing directions listed below. Payments via
wire transfer should be directed in accordance with the wiring instructions listed below.
Mailine Directions: Wire Instructions:
Syrberus,Inc
4164 Austin Bluffs Parkway#362,
Colorado Springs,CO 80918
Allegheny Casualty Company agrees that this payment by the Owner/Obligee shall not otherwise relieve the Surety of
any obligations set forth in said Surety's bond it being further understood that this Consent of Surety is issued under a
full and complete reservation of all rights,claims and defenses available to Allegheny Casualty Company whether at
law or in equity and that this reservation of rights shalt remain in full force and effect unless expressly waived by us,in
writing.
IN WITNESS WMEOF,the Surety has hereunto set its hand on this date:
March 11,2016
Allegheny Casualty Co an
(Surety)
(Signature of Authorized Representative)
Witness:
Linda)L Edwards.ABgm®v rtnFact
(Printed Title Name and Title)
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ir
A ,
'TO
ATTOR . IT
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INTERNATIONAL FIDELITY INSURANCE COMPANY
ALLEGHENY CASUALTY COMPANY
ONE NEWARK CENTER,20TH FLOOR NEWARK,NEW JERSEY 07102-5207
KNOW ALL MEN BY THESE PRESENTS: That INTERNATIONAL FIDELITY INSURANCE COMPANY,a corporation gig otw and under
the laws of the State of New Jersey, and ALLEGHENY CASUALTY COMPANY a corporation organized and existing under Ilhe tows of 11he of
Pennsylvania,having their principal office in the City of Newark,New Jersey,do hereby constitute and appoint
LINDA K. EDWARDS,STEVEN B.SIDDONS,SHIRONG.CHEN. LORRIE SCOTT HOLLY A.GRAVENOR
Fort Worth,TX
their true and lawful aftomey(s)-h-fact to execute,seal and deliver for and on its behalf as surety,any and all bonds and undertakings,contacts of kidenInity
and other obligatory in the nature thereof, which are or may be allowed,required or pernitted by law,statute 'a n r1a contract or Solherwise
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and the ex d such lnshsT*3nt(s or these presents,shall be Znbl;�i%upon the saldrNtORkA NZWLITY IN RANCk
CASUATq
COMPANY,
t
COMPANY and ALLEGHENY as fully arid amply, to ail purposes,as if the same had been duly executed and
acknowiedged by their regularly elected officers at their principal offices.
This Power of Attorney ad
CASUALTY
TYW be revoked, pursuant to and
Vd=wd of the By- of INTERNATIONAL FIDELITY INSURANCE
COMPANY and ALLEGHENY MPANY and Is granted under and au__ of Itie W rng resolution adopted W the Board of Directors
of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duty held on the 20th day of July.2010 and by the Board of Directors of ALLEGHENY
CASUALTY COMPANY at a meeting duly held on the 15th day of August 2000-
'RESOLVED.that (1)the Pms!dTt Vice President,Executive Vice President or Secretary of the Corporation shall have the power to=nt,and to revoke
the appoinbrients ,Attomem -4n-Fact or agents with power and authority as dented or firrited in their respective wers of adorney,a execute on behalf
ys
of Via Corporation and affix the Corporation's seal thereto,bonds,undlerlakings, recognizances, contacts of and other written obligations in to
nature thereof or related thereto; and(2)any such Officers of the Corporation my appoint and revoke him ap of joint-gontrd cus=, is
p
for acceptance of process.and Aftneys4nfiact with authority b execute waivers and consents an behalf of-1 mCorporaW;and (3)the signature I many
such Officer of the Corporation and thd Corporation's seal may be affixed by facsimile to any power of attorney or certification giv�for the execution
bond,undertakft recognizance contract of kxWm* or other written obQ§a*m In the nature thereof or related thereto,such signahm old seals =
so used whether Siib&6r_e or hereafter, being hereby adopted by the corporation as to original signature of such offloer and the original seal of the
Corporation,to be valid and binding upon the Coi0oratlon with the same force and effect as though manually affixed.'
114 WHER150F.1 M3MTIONAL FIDELITY INSURANCE COMPANY wd ALLEGHENY CASUALTY COMPAtV hmamh wmxdad and
8111111511M.— this 22nd day a0uly.2014.
STATE OF NEW JERSEY
UAL County of
IN6
1904 ey
dit't - Executive Vice ROBERT W.MINISTER
President/Chief Operating Officer
Company)
and President(Allegheny Casualty Cornpany)
On this 22nd day of July 2014, before me came the Individual who executed the preceding ImWment.to me personally kriom,and, being by rne
sworn, said he Is the therein described and authorized officer d INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY
COMPANY,,that the seals afted to said Instrument are the Corporals Seals of said Companies;that the said Corporate Saab RW him slgnabue were
duly afroced by order of to Boards of Directors of said Companies. IN TESTIMONY WHEREOF, I have hereunto set n1 hand attired llmed thy OSOW,
at this City of Newark,Now Jersey ft day and yearlyM ft
above wil -
�.'Op 14Y C�'?4"-,
o.-
d
PUBLIC Z
z A NOTARY PUBLIC OF NEW JERSEY
4M.00 My Corrirniasion Expires April 16,2019
NEVI
CEKnnCATK)N
1,the undersigned officer of INTERNATIONAL FIDELITY INSURANCE COMPANY and ALLEGHENY CASUALTY COMPANY.0o hereby certify that I hVe f.
compared the foregoing copy of the Power of Attorney and effidLmik and the copy of the Sections d to By-Laws of said Companies as set forth In said
Power of Attorney, with the originals on file in the home office of said cornpanies. and that the same are correct transcripts thereof,and of the whole
of the said originals,and that the said Power of Attorney has not been revoked and is now In full force and effect
IN TWT#XWWHEREOF. I have hereunto oat my hand 26 day 9( L
V
6t, Ne;.
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Annabelle Partners, Ltd.
3001 Knox Street, Suite 207
Dallas, 7X 75205
2141445-2200
March 8,2016
To whom it may concern
In connection with the Richmond Phase 1 project,Annabelle Partners,Ltd. does not intend to
collect liquidated damages related to the contracts it has entered into with Bean Electrical,Inc.,
L.H.Lacy Company,Ltd.,and Kodiak Trenching and Boring,LLC,
Annabelle Partners,Ltd.
a Texas limited partnership
By: Hanover Services Group,Inc.,
its general partner
By: ti CA,
(i b4%0•1
Richard E. LeBlanc,President
e
i
FORT WORTH REV:0
=2107
TRANSPORTATION AND PUBLIC WORKS
CON'TRACTOR'S EVALUATION OF CITY
n PROJECT INFORMATION Date: 2/29/2016
Name of Conowfor Project Name
Kodiac Trenching and Boring Richmond PH 1
DOE Inspector Project Manager
Connor Staten Fred Ehia
DOENuntber Project Di„fct4 Type of Conimcr
7284 O Simple OO Routine O Complex p water 0 waste water ❑Storm Drainage ❑Pavement
Initial Cono=t Amount Ffnat Contract Arrtourrt t
$1,851,002.38 $1,946,361.16
II)PERFORMANCE EVALUATION
0-Inadequate 1-Deficient 2-Standard 3-Good 4-Excellent
ELEMENT RATING ELEMENT j RATING
(0-4) (0-4)
INSPECTION EVALUATION PLANS&SPECIFICATIONS
1 Availability of Inspector 1 Accuracy of Plans to Existing Conditions
2 Y% a of hispector il 2 Clarity&Sufficiency of Details
3 Accuracy of Measured Quantities L4 3 Applicability of Specifications
4 Display Of Professionalism 4 Accuracy of Plan Quantities
T Citizen Complaint Resolution PROJECT MANAGER EVALUATION
6 Performance-Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution
ADMINISTRATION 2 Availability of Project Manager
1 Change Order Processing Time 3 Communication
2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts
T Bid Opening to Pre-Con Meeting Timeframe
EM COMMENTS&SIGNATURES
COMMENTS
Signature Contractor
i
Signature DOE Inspector
Signature DOE Inspectot's Supervisor
INSPECTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth-1000 Throckmorton Street-Fort Worth,TX 76012-6311
(817)392-7941 -Ftua:(817)392-7845