HomeMy WebLinkAboutContract 48033-FP3 FORT WDRTH@ C
sECRETARr
CONTRACT NO.
TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
�1(Developer Projects)
City est W"3 100227
Regarding contract for MARINE CREEK RANCH SECTION 11-STREET LIGHTS as required by the
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on N/A through
M&C N/A the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the
recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project
as complete.
Original Contract Price: $78,625.40
Amount of Approved Change Orders: Ns 1
Revised Contract Amount: $78,625.40
Total Cost Work Completed:
I ., k-Ae 6(?.711:2
Recommended for Acceptance Date
Asst. Director, TPW - Infrastructure Design and Construction
2�/�
Accepted Date
IS Director,
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT
Asst. ity Mana " ry Date
Department of TPW Const. Services
CPN# 16 2,Z7 D ✓/�
Project Manager /
Risk Management S. Cana v OFFICIAL RECORD
Comments: D.O.E. Brotherton CITY SECRETARY
Water V. Gutzier
CF J ' orales/Scanned ❑ ®RTH�TX
The Proceeding people have been contacted concerning the request
for final payment&have released this project for such payment.
Rev.9/22/16
Clearance Conducted By Etta Bacy
FART WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name MARINE CREEK RANCH SECTION II
Contract Limits
Project Type ST LIGHT
City Project Numbers 100227
DOE Number 0227
Estimate Number I Payment Number 1 For Period Ending 6/8/2017
CD
City Secretary Contract Number Contract Time XD
Contract Date Days Charged to Date 21
Contract is 100.00 Complete
Project Manager NA
Contractor INDEPENDENT UTILITY CONSTRUCTION
5109 SUN VALLEY DRIVE
FORT WORTH, TX 76119
Inspectors DICKINSON / BARKLEY
Thursday,June 8,2017 Page I of 4 ��, /
City Project Numbers 100227 DOE Number 0227
Conti-act Name MARINE CREEK RANCH SECTION II Estimate Number I
Contract Limits Payment Number I
Project Type ST LIGHT For Period Ending 6/8/2017
Project Funding
STREET LIGHT
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 2"CONDT PVC SCH 80 1880 LF $4.78 $8,986.40 1880 $8,986.40
2 RDWY ILLUM ASSEMBLY 23 EA $1,885.00 $43,355.00 23 $43,355.00
3 6-6-6 TRIPLEX ALUM ELEC CONDUCTOR 1880 LF $1.60 $3,008.00 1880 $3,008.00
4 RDWY ILLUM FOUNDATION TY 4 23 EA $1,012.00 $23,276.00 23 $23,276.00
Sub-Total of Previous Unit $78,625.40 $78,625.40
Thursday,June 8,2017 Page 2 of 4
City Project Numbers 100227 DOE Number 0227
Contract Name MARINE CREEK RANCH SECTION II Estimate Number I
Contract Limits Payment Number I
Project Type ST LIGHT For Period Ending 6/8/2017
Project Funding
Contract Information Summary
Original Contract Amount $78,625.40
Change Orders
Total Contract Price $78,625.40
Date J Total Cost of Work Completed $78,625.40
Contractor ^ Less %Retained $0.00
Net Earned $78,625.40
e Earned This Period $78,625.40
Inspection Supervisor
Retainage This Period $0.00
Date Less Liquidated Damages
zPr 'ect Manager
/,, '') Days @ /Day $0.00
Datk Z • LessPavement Deficiency $0.00
Ass.Director//PP11W-Infrastructure Design an/d Con ruction Less Penalty $0.00
Date Z� 7 Less Previous Payment $0.00
Direct /Contracting Departnt Plus Material on Hand Less 15% $0.00
Balance Due This Payment $78,625.40
Thursday,June 8,2017 Page 3 of 4
City Project Numbers 100227 DOE Number 0227
Contract Name MARINE CREEK RANCH SECTION II Estimate Number I
Contract Limits Payment Number 1
Project Type ST LIGHT For Period Ending 6/8/2017
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors DICKINSON / BARKLEY Contract Date
Contractor INDEPENDENT UTILITY CONSTRUCTION Contract Time 30 CD
5109 SUN VALLEY DRIVE Days Charged to Date 21 CD
FORT WORTH, TX 76119 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 $78,625.40
Less %Retained $0.00
Net Earned $78,625.40
Earned This Period $78,625.40
Retainage This Period $0.00
Less Liquidated Damages
0 Days n $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 $78,625.40
Thursday,June 8,2017 Page 4 of 4
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT D
CONTRACTOR ❑
TO FINAL PAYMENT SURETY ❑
OTHER
(SINULAR TO AIA DOCUMENT G707)
RECEIVED
Bond No. 4598208
20
�a PROJECT: Marine Creek Ranch Section 11, City Project No. 100227
(name,address)Fort Worth, Texas
TO (Owner)
ARCHITECTS PROJECT NO:
City of Fort Worth � CONTRACT FOR: Above Project
1000 Throcknlorton Street
Fort Werth. Texas 76102
CONTRACT DATE:
CONTRACTOR: Independent Utility Construction, Inc.
hi 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) Westfield Insurance Company
555 Republic Drive, Sttite 450
Plano, Texas 75074 SURETY COMPANY,
on bond Of(herr;insert name and address of Contractor)
Independent Utitity Construction, Inc.
5109 Sun Vallev Drive CONTRACTOR,
Fort Worth. Texas 76119
hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the
Surety Company of any of its obligations to(here insert narnc and address of Owner)
City of Fort Worth
1000 Throcicmorton Street
Fort Worth. Texas 76102 OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
The Surety Company has hereunto set its hand this Kith day of May 2)017
,
WESTFIELD INSURANCE COMPANY
Surety Comp
B l � 'f
Signature uthorized Representative t
Attest:
(Seal): Kyle W. .Sweeney Attorney-in-Fact
Title
Note:11is form is intended to be used as a companion document to the C'ontractor's Affidavit of Payment of Debts and Claims,Current Edition
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING I IIS SAMt
POWER##AND ISSUED PRIOR TO 04/20/11, FOR ANY PERSON OR PERSONS NAMED BELOW.
General POWER NO. 4220052 06
Power Westfield Insurance Co.
of Attorney Westfield National Insurance Co.
CERTIFIED COPY Ohio Farmers Insurance Co.
Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as "Companies," duly
organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County,Ohio,do by these
presents make,constitute and appoint
CHARLES D.SWEENEY, MiCHAEL A.SWEENEY,KYLE W.SWEENEY, ELIZABETH GRAY,JOINTLY OR SEVERALLY
of FORT WORTH and State of TX its true and lawful Aftorney(s)-in-Fact,with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - --
LIMITATION: THiS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE,OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent.as if such bonds were signed by the President,sealed with the corporate
seal of the applicable Company and duly attested by its Secretary,hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
'Be It Resolved,that the President,any Senior Executive,any Secretary or any Fidelity&Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney-in-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary,'
'Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.' (Each adopted at a meeting
held on February 8,2000).
in Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of
APRIL A.D.,2011 .
y,.NlfblN •ttlf I il.,t,,,
Corporate O �yb . , , pNiWp„
a �ttRA 4z '�0NAC r S WESTFIELD INSURANCE COMPANY
Affixed ' .es+ � ` G ;•� U . 3 WESTFIELD NATIONAL INSURANCE COMPANY
kcsr °P rys f'= : � "'' OHiO FARMERS INSURANCE COMPANY
NL . '_ SEAL
It •max _ 'GNARTE$fll �
A :to
State of Ohio °"""a ”*" "'"""""• By:
yRichard L. Kinnaird,Jr., National Surety Leader and
County of Medina ss.: Senior Executive
On this 20th day of APRIL A.D.,2011 ,before me personally came Richard L. Kinnaird, Jr. to me known,who, being by me duly
sworn, did depose and say,that he resides'in Medina, Ohio;that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above
instrument;that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed
by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order.
Notarial k-04"
Seal ?"•�1 A t.
Affixed
O
• William J. Kahelin,A rney at Law,Notary Public
State of Ohio :'A d o My Commission Does Not Expire(Sec. 147.03 Ohio Revised Code)
County of Medina ss.:
e o F
.... ,,....
I,Frank A..Carrino,Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies,which is stili in full force and effect;and furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 16th day of
May .mow�;.,, 2017 •„Lt,.......,,,
Q.
4 M=j b `�� SEAL �� _'�=C1IARTEk�j:3C �� ,
= '; 8 ; _ Secretary
�'b'.,,,. %�•. •.o; � 184 ,a Frank A. Carrino,secretary
'••...
..........
olnpf•••'•• ''o�••4U...........•
BPOAC2 (combined) (06.02)
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me,the undersigned authority, on this day personally appeared RICHARD
WOLFE,Vice President of INDEPENDENT UTILITY CONSTRUCTION INC., known
to me to be a credible person, and after being duly sworn by me, 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: Marine Creek Ranch Section 11 -City Project No. 100227
BY:
Richard )*�'Ife,Vice President
SUBSCRIBED AND SWORN TO BEFORE ME on this day of
2017.
i
,uurr
,� CHRISTINA GARCIA
' lsNotary Public,State of Texas ary Public, State of Texas
� Comm.Expires 12.20.2020
�''!iio�ti .``` NOtQ ID 1349447$5
5109 Sun Valley Drive
Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
X
ky; May 16',2017
City of Fort Worth
CFA Administration
1000 Throckmorton St.
Fort Worth,TX 76102
Project Name: Marine Creek Ranch Section 11
City Project No.: 100227
The purpose of this letter is to acknowledge that Independent Utility Construction. Inc. (the
"Contractor") has been paid in full by M&C Development, Ltd. (the "Developer") for the public
improvements constructed to serve Marine Creek Ranch Section 11 in Fort Worth,Texas. As a result,
we hereby waive, release and relinquish all rights to assert any claim or demand for lien in connection
with this project.
Please feel free to contact me with any questions you may have.
Sinc ly,
Richard Wolfe
Vice President
5109 Sun Valley Drive
x
Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
May 16th,2017
Project Name: Marine Creek Ranch Section 11
City Project Number: 100227
Please accept this letter as our formal acknowledgement to the City of Fort Worth that
Independent Utility Construction,Inc.,the Street Light Contractor for Marine Creek Ranch Section
11, has not been assessed any liquidated damages under its contract with M&C Development,
Ltd.
if you need any further information in regards to this matter,feel free to contact me.
Si e ly,
Richard Wolfe,Jr.
Vice President
M & C Development, Ltd.
3825 Camp Bowie Boulevard
Ft.Worth, Texas 76107
May 18,2017
Mr.Eddie Walker
Construction Inspector
City of Fort Worth
8851 Camp Bowie Blvd., Ste.300
Ft.Worth,Texas 76116
Re:Marine Creek Ranch, Section 11—Project#100227
Dear Mr.Walker,
Please be advised that the owner of Marine Creek Ranch, Section 11 (M&C Development,Ltd.)
does not intend to pursue damages from the contractors to include Burnsco Construction,Gilcn
Contracting,Inc.or Independent Utility Construction,Inc.or any party due to delays in
completion of the subdivision. Please feel free to contact me if you have any questions or need
additional information.
Since Y
Ran ockhart
D elopment Manager
Phone: (817)336-2425 Fax: (817)335-5045
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me,the undersigned authority, on this day personally appeared RICHARD
WOLFE, Vice President of INDEPENDENT UTILITY CONSTRUCTION,INC., known
to me to be a credible person, and after being duly sworn by me, 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: Marine Creek Ranch Section I I -City Project No. 100227
BY:
Richard lfe,Vice President
SUBSCRIBED AND SWORN TO BEFORE ME on this day of
a , 2017.
,�PpYPV@/,, CHRISTINA GARCIA v.
Notary Public,State of Texas ary Public, State of Texas
��.f�f FY�1 Comm.Expires 12.20-2020
COMM.
Notary ID 130940785
5109 Sun Valley Drive
I I Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
May 16`h,2017
City of Fort Worth
CFA Administration
1000 Throckmorton St.
Fort Worth,TX 76102
Project Name: Marine Creek Ranch Section 11
City Project No.: 100227
The purpose of this letter is to acknowledge that Independent Utility Construction, Inc. (the
"Contractor") has been paid in full by M&C Development, Ltd. (the "Developer") for the public
improvements constructed to serve Marine Creek Ranch Section 11 in Fort Worth,Texas. As a result,
we hereby waive, release and relinquish all rights to assert any claim or demand for lien in connection
with this project.
Please feel free to contact me with any questions you may have.
Sinc ly,
Richard Wolfe
Vice President
5109 Sun Valley Drive
f Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
May 16"',2017
Project Name: Marine Creek Ranch Section 11
City Project Number: 100227
Please accept this letter as our formal acknowledgement to the City of Fort Worth that
Independent Utility Construction, Inc.,the Street Light Contractor for Marine Creek Ranch Section
11, has not been assessed any liquidated damages under its contract with M&C Development,
Ltd.
If you need any further information in regards to this matter,feel free to contact me.
Si e eIy,
Richard Wolfe,Jr.
Vice President
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
CONTRACTOR ❑
TO FINAL PAYMENT BUROTHET ❑
(SIMILAR TO AIA DOCUMENT G707)
Bond No. 4598208
PROTECT: Marine Creel: Ranch Section 11, City Project No. 100227
(name,address)Fort Worth, Texas
TO (Owner)
ARCHITECT'S PROJECT NO:
F—City of Fort Worth CONTRACT FOR: Above Project
1000 Throckmorton Street
Fort Worth, Texas 76102
CONTRACT DATE:
CONTRACTOR: Independent Utility 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) Westfield Insurance Company
555 Republic Drive, Suite 450
Plano, Texas 75074 ,SURETY COMPANY,
on bond Of(here insert name and address of Contactor)
Independent Utility Construction, Inc.
5109 Sun Valley Drive CONTRACTOR,
Fort Worth, Texas 76119
hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the
Surety Company of any of its obligations to(here insert name and address of Owner)
City of Fort Worth
1000 Throckmorton Street
Fort Worth, Texas 76102 OWNER,
as set forth in the said Surety Company's bond.
IN WI'TNESS WHEREOF,
The Surety Company has hereunto set its hand this 16th day of May 2017
WESTFIELDONSURAhLQ COMPANY
Surety Comp
By // 'N Noe,�
Signature o d Representative
Attest:
(Seal): Kyle W. Sweeney Attorney—in—Fact
Title
Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING I HIS SAMt
POWER#AND ISSUED PRIOR TO 04120/11, FOR ANY PERSON OR PERSONS NAMED BELOW.
POWER NO. 4220052 06
General
Power Westfield Insurance Co.
`
of Attorney Westfield National Insurance Co.
Ohio Farmers Insurance Co.
CERTIFIED COPY Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as "Companies," duly
organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these
presents make,constitute and appoint
CHARLES D. SWEENEY, MICHAEL A.SWEENEY, KYLE W.SWEENEY, ELIZABETH GRAY,JOINTLY OR SEVERALLY
of FORT WORTH and State of TX its true and lawful Attorney(s)-in-Fact,with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - -
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President,sealed with the corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
"Be It Resolved,that the President, any Senior Executive, any Secretary or any Fidelity& Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney-in-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary."
"Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting
held on February 8,2000).
-In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of
APRIL A.D.,2011 .
,,apau.walMiyn N••",11.mp,h ,,,,..n•yp4',
Corporate SYft,( , �pNAtr WESTFIELD INSURANCE COMPANY
Seals , .«....kC''s `'p�........ N•' .r %%SullP,{�,
tro f. ;sG � ..•_..,•c ,� WESTFIELD NATIONAL INSURANCE COMPANY
Affixed v: •n. - OHIO FARMERS INSURANCE COMPANY
4 NSEAL 'ro u SE ' Zz
:vim ',�'LIIARIERfp _
fan t } yam. .:0, :•1 48 = `
...r• t
�� •.•. _,.� ''.,, aur u„1````,`,`` '''•/IUaPH`••`,•„
State of Ohio `""""` By:Richard L. Kinnaird, Jr., National Surety Leader and
County of Medina ss.: Senior Executive
On this 20th day of APRIL A.D.,2011 , before me personally came Richard L. Kinnaird, Jr. to me known, who, being by me duly
sworn, did depose and say,that he residesin Medina, Ohio;that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above
instrument.that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed
by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order.
Notarial ,,,,N•N��u,„, r
Seal .����i A I_ S '
Affixed A,Q������//% F,•
2'•�' �'9
• ^l William J. Kahelin, A rney at Law, Notary Public
State of Ohio d. O My Commission Does Not Expire(Sec.147.03 Ohio Revised Code)
County of Medina ss.: q
I,Frank A.Carrino, Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies,which is still in full force and effect;and furthermore,the resolutions of the Boards of Directors, set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 16th day of
May A.D.,"'u�� ,, •20.1.7 ,,,...O�.Ac,...,,, - .....:...........
Baa:«:�kc ; p�+,.", utis r ,
SEAL _ 'o41, Cf�1 3a //� Secret
;:1•,� ��
X_ .c ? 18419 ; = 1Frank A. Carrino, Secretary
BPOAC2 (combined) (06-02)
FORTWORTHREV:02/20/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
I) CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
INDEPENDENT UTILITY CONSTRUCTION,INC MARINE CREEK RANCH SECTION 11
DOE Inspector DOE Number
EDDIE DEE WALKER II
DOE Inspector Project Manager
❑ Water ❑ Waste Water ❑ Storm Drainage ❑ Pavement AARON LONG
Initial Contract Amount Project Dfficulty
$1,498,557.11 0 Simple O Routine O Complex
Final Contract Amount Date
$1,498,557.11 6/7/2017
II)PERFORMANCE EVALUATION
0-Inadequate I-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 N
3 Plans on Site 5 Y 3 20 15
4 Field Supervision 15 Y 4 60 60
5 Work Performed 15 Y 4 60 60
6 Finished Product 15 Y 4 60 60
7 Job Site Safety 15 Y 4 60 60
8 Traffic Control Maintenance 15 Y 4 60 60
9 Daily Clean Up 5 Y 3 20 15
10 Citizen's Complaint Resolution 5 Y 4 20 20
11 Property Restoration 5 Y 3 20 15
12 After Hours Response 5 N
13 Project Completion 5 Y 4 20 20
TOTAL ELEMENT SCORE(A) 393
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(TS) 393
III)CONTRACTOR'S RATING
Maximum Score(MS)=448 or sum of applicable element score maximums which= 408
Rating(ITS/MS] * 100%) 393 / 408 = 96%
Performance Category Excellent
<20%=Inadequate 20%to<40%=Deficient /0%to<60%=Standard 60%to<80%=Good >80%=Excellent
Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED)
Signature DOE Inspector a-lqa�� Signature Contractor
Signature DOE Inspector's Supervisor Q
CONTRACTOR'S COMMENTS
TRANSPOR'T'ATION AND PUBLIC WORKS
(a The City of Fort Worth• 1000 Throckrnorton Street•Fort Worth,Tx 76012-6311
(817) 392-7941 •Fax: (817) 392-7845
FORTWORTHREV:02/22/07
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
I)PROJECT INFORMATION Date: 6/7/2017
Name of Contractor Project Name
INDEPENDENT UTILITY CONSTRUCTION,INC. MARINE CREEK RANCH SECTION 11
DOE Inspector Project Manager
EDDIE DEE WALKER II AARON LONG
DOE Number JProject Difficulty Type of Contract
O Simple O Routine O Complex ❑ Water ❑ Waste Water ❑ Storm Drainage ❑ Pavement
Initial Contract Amount Final Contract Amount
$1,498,557.11 $1,498,557.11
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
1 Availability of Inspector _ 1 Accuracy of Plans to Existing Conditions
q-
T Knowledge of Inspector 2 Clarity&Sufficiency of Details
3 Accuracy of Measured Quantities 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
T Timliness of Contractor Payments 4 Resolution of Utility Conflicts
3 Bid Opening to Pre-Con Meeting Timeframe
III)COMMENTS&SIGNATURES
COMMENTS
I
Signature Contractor
Signature DOE Inspector J �
Signature DOE Inspector's Supervisor
INSPECTOR'S COMMENTS
TRANSPORTATION_AND PUBLIC WORKS
s° The City of Fort Worth• 1000 Throcktnorton Street•Fort Worth,TX 76012-6311
�''� (817)392-7941 •Fax:(817)392-7845
FORTWORTH rev 03/05/07
TRANSPORTATION & PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO,
NAME OF PROJECT:MARINE CREEK RANCH SECTION 11
PROJECT NO.: 100227 CONTRACTOR: INDEPENDENT UTILITY
CONSTRUCTION INC. DOE NO.
PERIOD FROM 08/19/16 TO: 06/07/17 FINAL INSPECTION DATE: 7-Jun-17
WORK ORDER EFFECTIVE 8/19/2016 CONTRACT TIME 30 O WD O CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH CHARGED CREDITED MONTH CHARGED CREDITED
DURING DURING
1. 16.
2. 17.
3. 18.
4. 19.
5. 20.
6. 21.
7. 22.
8. 23.
9. 24.
10. 25.
11. 26.
12. 27.
13. 28.
14. 29.
15. 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS * DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS
THIS
21
PERIOD
PREVIOUS
0
PERIOD
TOTALS
21
TO DATE
*REMARKS
all
C T TOR 75ATE INSPECTOR DkTff
ENGINEERING DEPARTMENT
0 The City of Fort Worth• 10001`hrockmorton Street•Fort Worth,Thi 76012-6311
(817)392-'7941 .,Fax: (817)392-7845