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HomeMy WebLinkAboutContract 48407-FP2 FORTWORTH® MYSECRETARY CONTRACT NO, l t TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION (Developer Projects) City Project Ns: 100485 CS, [yf yD7 Regarding contract for VICTORY AT HERITAGE-SD&PAVING 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. I d Original Contract Price: d e $485,391.50 CIL Amount of Approved Change Orders: t ± a $281,927.00 Ns 1 Revised Contract Amount: b l g $767,318.50 ❑ u Total Cost Work Completed: U r g U TO Cod, t V /-� f� 1 u CL O 0 !� to d aU0'. R 0U F� U, Recom r Acceptance Date Asst. Dir t , TPW - Development Services Accepted Dae_ go Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT 7 iAss . Ci Manager Dat Comments: OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX � + Rev.9/22/16 FoRTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name VICTORY AT HERITAGE Contract Limits Project Type STORM DRAIN&PAVING City Project Numbers 100485 DOE Number 0485 Estimate Number I Payment Number 1 For Period Ending 3/29/2018 CD City Secretary Contract Number Contract Time 27CD Contract Date Days Charged to Date 393 Project Manager NA Contract is 100.00 Complete Contractor PCI CONSTRUCTION,INC. P.O.BOX 2967 McKINNEY, TX 75070 Inspectors DICKINSON / CHAMBERS Monday,April 2,2018 Page I of 5 City Project Numbers 100485 DOE Number 0485 Contract Name VICTORY AT HERITAGE Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 3/29/2018 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 REMOVE 24"STORM LINE 30 LF $50.00 $1,500.00 30 $1,500.00 2 REMOVE 30"STORM LINE(CO#3) 296 LF $50.00 $14,800.00 296 $14,800.00 3 REMOVE 36"STORM LINE(CO 41&3) 257 LF $50.00 $12,850.00 257 $12,850.00 6 REMOVE 4'STORM JUNCTION INBOX 3 EA $800.00 $2,400.00 3 $2,400.00 7 REMOVE 10'RECESSED INLET 1 EA $4,575.00 $4,575.00 1 $4,575.00 8 REMOVE Y DROP INLET 1 EA $750.00 $750.00 1 $750.00 9 REMOVE HEADWALL/SET 1 EA $750.00 $750.00 1 $750.00 10 REMOVE RIP RAP 90 SF $3.33 $299.70 90 $299.70 11 REMOVE CONC PVMT 20 SY $30.00 $600.00 20 $600.00 12 21"RCP CLASS(CO 43) 118 LF $50.00 $5,900.00 118 $5,900.00 13 24"RCP CLASS(CO#3) 118 LF $80.00 $9,440.00 118 $9,440.00 17 48"RCP CLASS(CO#3) 2132 LF $250.00 $533,000.00 2132 $533,000.00 18 5'STORM JUNCTION BOX(CO#3) 6 EA $8,200.00 $49,200.00 6 $49,200.00 19 48"SET 1 EA $825.25 $825.25 I $825.25 20 10'CURB INLET(CO 33) 5 EA $4,050.00 $20,250.00 5 $20,250.00 21 10'RECESSED INLET 2 EA $4,400.00 $8,800.00 2 $8,800.00 23 CONC COLLAR(CO#3) 2 EA $500.00 $1,000.00 2 $1,000.00 24 TRENCH SAFETY(CO#3) 2368 LF $0.25 $592.00 2368 $592.00 25 MEDIUM STONE RIPRAP 91 SY $71.00 $6,461.00 91 $6,461.00 26 REMOVE T DROP INLET(CO#1) I EA $750.00 $750.00 1 $750.00 27 36"RCP CLASS III(CO#1) 26 LF $135.00 $3,510.00 26 $3,510.00 28 T STORM JUNCTION BOX(CO#1) 1 EA $7,900.00 $7,900.00 1 $7,900.00 29 REMOVE 21"STORM LINE(CO#3) 78 LF $50.00 $3,900.00 78 $3,900.00 30 REMOVE 10'CURB INLET(CO#3) 1 EA $1,000.00 $1,000.00 1 $1,000.00 ------------------ ------ ------------------ Sub-Total of Previous Unit $691,052.95 $691,052.95 PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 REMOVE CONC CURB&GUTTER 375 LF $10.00 $3,750.00 375 $3,750.00 2 UNCLASSIFIED EXCAVATION 165 CY $68.94 $11,375.10 165 $11,375.10 Monday,April 2,2018 Page 2 of 5 City Project Numbers 100485 DOE Number 0485 Contract Name VICTORY AT HERITAGE Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 3/29/2018 Project Funding 3 6"FLEXIBLE BASE 421 SY $27.00 $11,367.00 421 $11,367.00 4 8"CONC PVMT 421 SY $56.25 $23,681.25 421 $23,681.25 5 4"CONC SIDEWALK 3320 SF $4.75 $15,770.00 3320 $15,770.00 6 BARRIER FREE RAMP 2 EA $650.00 $1,300.00 2 $1,300.00 7 6"CONC CURB&GUTTER 388 LF $5.00 $1,940.00 388 $1,940.00 8 8"SLD PVMT MARKING HAS 65 LF $15.88 $1,032.20 65 $1,032.20 9 REFL RAISED MARKER 4 EA $12.50 $50.00 4 $50.00 10 TRAFFIC CONTROL 1 MO $6,000.00 $6,000.00 1 $6,000.00 -------------------------- ------------- Sub-Total of Previous Unit $76,265.55 $76,265.55 ---------------------------------------- Monday,April 2,2018 Page 3 of 5 City Project Numbers 100485 DOE Number 0485 Contract Name VICTORY AT HERITAGE Estimate Number I Contract Limits Payment Number 1 Project Type STORM DRAIN&PAVING For Period Ending 3/29/2018 Project Funding Contract Information Summary Original Contract Amount $485,391.50 Change Orders Change Order Number 1 $12,710.00 Change Order Number 3 $269,217.00 Total Contract Price $767,318.50 t�/�1�Z��� Total Cost of Work Completed $767,318.50 Date Contractor Less %Retained $0.00 Net Earned $767,318.50 Date 4104 Earned This Period $767,318.50 spection e isor Retainage This Period $0.00 Date Less Liquidated Damages Pro anager 1 i1' Days @ /Day $0.00 Date 1 7 � r Y LessPavement Deficiency $0.00 Asst. r/TPW-Infrastructure Design and C/oonstr .tion Less Penalty $0.00 �. Date l r Less Previous Payment $0.00 Director/ ntracting Departm t Plus Material on Hand Less 15% $0.00 Balance Due This Payment $767,318.50 Monday,April 2,2018 Page 4 of 5 City Project Numbers 100485 DOE Number 0485 Contract Name VICTORY AT HERITAGE Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 3/29/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / CHAMBERS Contract Date Contractor PCI CONSTRUCTION,INC. Contract Time 270 CD P.O.BOX 2967 Days Charged to Date 393 CD McKINNEY, TX 75070 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 $767,318.50 ,Less %Retained $0.00 Net Earned $767,318.50 Earned This Period $767,318.50 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 $767,318.50 Monday,April 2,2018 Page 5 of 5 A > 0 0 m O 70 p z -n CA :� O n c-) c) -u �7 r m O —I -n O D co C -j o ➢ c) (' O m : m G D z 0 Q p r o D C!7 y 0- m m k m m -� L a m m n o - o n v C7 —I > n r < < O -n O O O --I -0 O n Z n > O z N) < m D pp - m � D D D 1 m 0� 0 --1 C-) m j D c� n m = v cn z z y c7 —I z = > p mm �tk X z � z m D m D 0 -nt p o 0m Az A 1 p O v X v, C7 N rD N N N 401 < N O) m N O A .. ry w O O z O N O o O �1 y O Na W fn o o ( O 10 C) (100 v w N 0-) oo o � coCD (D .. 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P.O.Box 2967 McKinney,TX 75070 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) North American Specialty Insurance Company 5200 Metcalf OPN111 , SURETY COMPANY, Overland Park,KS 66202 on bond of(here insert name and address of Contractor) PCI Construction,Inc. P.O.Box 2967 McKinney,TX 75070 , CONTRACTOR, hereby approves of the final payment to the Contractors, 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) City of Fort Worth 1000 Throckmorton Street Fort Worth,TX 76102-6312 ,OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 29th day of March 2018 North American Specialty Insurance Company Surety Company Signature of Authorized Representative ,-�— LL,� Attest: (Seal): Debra Lee Moon Attorney-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 AIA DOCUMENT G707 CONSENT OF SURETY COMPANY TO FINAL PAYMENT APRIL 1970 EDrrION AIA ONE PAGE 1970 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 New York Ave.,NW,WASHINGTON,D.C. 20006 SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY WESTPORT INSURANCE CORPORATION GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas and Washington International Insurance Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland Park,Kansas,and Westport Insurance Corporation,organized under the laws of the State of Missouri,and having its principal office in the City of Overland Park,Kansas each does hereby make,constitute and appoint: SAMMY JOE MULLIS,JR.,JOHN WILLIAM NEWBY,CHERI LYNN IRBY,WILBERT RAYMOND WATSON,MICHAEL L.TULLIS,SANDRA LEE RONEY,DEBRA LEE MOON, ANDREA ROSE CRAWFORD,MARY JO ZAKRZEWSKI,JAMES B.ROGERS,JR.,TROY RUSSELL KEY AND LINDA MICHELLE STALDER JOINTLY OR SEVERALLY Its true and lawful Attorneys)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: ONE HUNDRED TWENTY FIVE MILLION($125,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on March 24,2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18,2011. "RESOLVED,that any two of the President,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." .NS i4 cti • .S o y rA(—Z— ,�..-&,Pop :..p� gG $ TSG Steven Anderson,Senior tee rest onto as mgton InternationalnsuranceCompany � OO P ' • .Z O; SEAL &Senior Vice President of North American Specialty Insurance Company e� a¢. SEAL m= 5 r, :M_ &Senior Vice President of Westport Insurance Corporation =W z 1973 �. /O �bONI'PI��a`\ rn��sSd pit Mike A.Ito,Senior Vice President of Washington International Insurance Company y.," .,•''a• &Senior Vice President of North American Specialty Insurance Company &Senior Vice President of Westport Insurance Corporation IN WITNESS WHEREOF,North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this this 12 day of January ,20 18 North American Specialty Insurance Company Washington International Insurance Company State of Illinois Westport Insurance Corporation County of Cook ss: On this 12 day of January ,20 18,before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation and Michael A.Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M.KENNY Notary PuLlit-State of(llin<rL; P�yCommissionExplrts M.Kenny,Notary Public 12104!2021 I, Jeffrey Goldberg , the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 29th day of March 120 18 ( -J Jeffrey Goldberg,Vice President&Assistant Secretary of Washington International Insurance Company& North American Specialty Insurance Company&Vice President&Assistant Secretary of Westport Insurance Corporation North American Specialty Insurance Company Washington International Insurance Company Westport Insurance Corporation TEXAS CLAIMS INFORMATION IMPORTANT NOTICE ADVISO IMPORTANTE In order to obtain information or make a complaint: Para obtener informacion o para someter un queja: You may contact Jeffrey Goldberg,Vice President Puede comunicarse con Jeffrey Goldberg,Vice — Claims at 1-800-338-0753 President— Claims,al 1-800-338-0753 You may call Washington International Insurance Usted puede Ilamr al numero de telefono gratis de Company and/or North American Specialty Insurance Washington International Insurance Company and/or Company's and/or Westport Insurance Corporation North American Specialty Insurance Company's and/or toll-free number for information or to make a Westport Insurance Corporation para informacion o complaint at: para someter una queja al: 1-800-338-0753 1-800-338-0753 You may also write to Washington International Usted tambien puede escribir a Washington Insurance Company and/or North American Specialty International Insurance Company and/or North Insurance Company and/or Westport Insurance American Specialty Insurance Company and/or Corporation at the following address: Westport Insurance Corporation al: 1450 American Lane 1450 American Lane Suite 1100 Suite 1100 Schaumburg,IL 60173 Schaumburg,IL 60173 You may contact the Texas Department of Insurance Puede escribir al Departmento de Seguros de Texas to obtain information on companies, coverages, para obtener informacion acerca de companias, rights or complaints at: coberturas, derechos o quejas al: 1-800-252-3439 1-800-252-3439 You may write the Texas Department of Insurance: Puede escribir al Departmento de Seguros de Texas: P.O. Box 149104 P.O. Box 149104 Austin,TX 78714-9104 Austin,TX 78714-9104 Fax: (512)475-1771 Fax: (512) 475-1771 Web: httn://www.tdo.state.tx.us Web: htta://www.tda.state.tx.us Email: ConsumerProtection@tdi.state.tx.us Email: ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS 0 RECLAMOS: Should you have a dispute concerning your premium Si tiene una disputa concerniente a su prima o a un or about a claim you should first contact the reclamo, debe comunicarse con el Washington Washington International Insurance Company and/or International Insurance Company and/or North North American Specialty Insurance Company and/or American Specialty Insurance Company and/or Westport Insurance Corporation. If the dispute is not Westport Insurance Corporation primero. Si no se resolved,you may contact the Texas Department of resuelve la disputa, puede entonces comunicarse Insurance. con el Departmento de Seguros de Texas. ATTACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA This notice is for information only and does not Este aviso es solo para proposito de infromacion y no become a part or condition of the attached se converte en parte o condicion del documento document. adjunto. CONTRACTOR'S AFFIDAVIT OF FINAL PAYMENT THE STATE OF TEXAS § § KNOW ALL MEN BY THESE PRESENTS: COUNTY OF Collin § 1 BEFORE ME,the undersigned authority, on this day personally appeared John Starnes _("Affidant"),who,after being by me duly sworn, deposes, and says that he is the Controller ,of t PCI Construction Inc. a Texas Corporation (corporation,partnership,trade name)of Collin _County, State of Texas(the"Contractor"),which said Contractor was awarded the contract dated_ 22nd day of December_,2016, for the construction of VictoU at Heritage at Fort Worth,TX (the"Work"),for a total consideration of_$ 1,549,129.25 Dollars to be paid to the said Contractor(the"Contract"), and that Affidant has full power of authority to make this affidavit. s 'r That Peloton Land Solutions _(the"Owner")has approved the final pay estimate on said Work, and that the said Contractor has fully satisfied and paid any and all claims that may be covered by Chapter 53 of the Texas Property Code and Article 5160 of the Revised Civil Statutes of g the State of Texas,or any other applicable Statutes or charter provisions,and that all just bills for labor and materials have been paid and discharged by said Contractor insofar as they pertain to the work in question. That in addition to any funds which may have been previously paid by the Owner,the Contractor hereby accepts the amount of$143,314.53_Dollars as FULL AND FINAL PAYMENT under the aforementioned Contract,and hereby waives and releases any right Affrdant and/or the Contractor may have to pursue claims of any nature against the Owner arising out of or in any manner connected with the performance of the Work and/or the Contract,including but not limited to claims of third parties that supplied material and/or labor for the Work for or through the Contractor ("Subcontractors"),as well as claims for delay, additional compensation or for recovery of liquidated damages which may have been withheld by the Owner.The Contractor shall defend,hold harmless and indemnify the Owner from any such claims of such Subcontractors.The Contractor further releases the Owner from any claim or liability arising from any act or neglect of the Owner related to or connected with the Contract.This affidavit is given pursuant to the final payment provisions of the Contract, and shall not be deemed to alter or modify the terms and provisions of said Contract. Gl Co�T�U �iuN iNU, By: (Affidant) Lit, -4AvAe.-lp (Printed Name) SUBSCRIBED AND SWORN TO BEFORE ME,this the 124 day of (V1 A.D. Zvl� By: (Notary Public in and for the State of Texas) ;.,i;�YPUa;,, GREE MITCHELL I� .:'1*_Notary Public State of Texas (Printed Name of Notary) [Notary Seal] ;=q My Commission dF 123944875 Gil_�/ ^2-vi P li t "•.' oF ''' My Comm.Epp.September 26,20 9 commission expires .v. — CONTRACTOR'S AFFIDAVIT OF FINAL PAYMENT THE STATE OF TEXAS § § KNOW ALL MEN BY THESE PRESENTS: COUNTY OF Collin § BEFORE ME,the undersigned authority,on this day personally appeared David McKinley _("Affidant"),who,after being by me duly sworn,deposes,and says that he is XS Concrete a limited liability company(corporation,partnership,trade name)of_Dallas_County,State of Texas(the"Contractor"),which said Contractor was awarded the contract dated_7th—day of July _,2017,for the construction of site paving at_Victory Shops @ Heritage (the"Work'),for a total consideration of®$458,046.55_Dollars to be paid to the said Contractor(the"Contract"),and that Affidant has full power of authority to make this affidavit. That XS Construction,LLC_(the"Owner")has approved the final pay estimate on said Work, and that the said Contractor has fully satisfied and paid any and all claims that may be covered by Chapter 53 of the Texas Property Code and Article 5160 of the Revised Civil Statutes of the State of Texas, or any other applicable statutes or charter provisions,and that all just bills for labor and materials have been paid and discharged by said Contractor insofar as they pertain to the work in question. That in addition to any funds which may have been previously paid by the Owner,the Contractor hereby accepts the amount of$ 45,804.65_Dollars as FULL AND FINAL PAYMENT under the aforementioned Contract,and hereby waives and releases any right Affidant and/or the Contractor may have to pursue claims of any nature against the Owner arising out of or in any manner connected with the performance of the Work and/or the Contract, including but not limited to claims of third parties that supplied material and/or labor for the Work for or through the Contractor ("Subcontractors"),as well as claims for delay,additional compensation or for recovery of liquidated damages which may have been withheld by the Owner.The Contractor shall defend,hold harmless and indemnify the Owner from any such claims of such Subcontractors.The Contractor further releases the Owner from any claim or liability arising from any act or neglect of the Owner related to or connected with the Contract.This affidavit is given pursuant to the final payment provisions of the Contract,and shall not be deemed to alter or modify the terms and provisions of said Contract. By' (Printed Name) SUBSCRIBED AND SWORN TO BEFORE ME,this the ;e day of Mae&k A.D. I By: (No b c in and for the State of Texas) MELISSA JENKINS LIcS�� k�x ,... . Notary PubifC.Slate of Texos (Printed Name of Notary) [Notary S = +,..i�.: My Commission Expires October 01,2014 My commission expires: ,l7 1 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 Victory Shops @ Heritage_ The signer of this document has been paid in full for all labor, services, equipment, or materials furnished to the property or to_XS Construction, LLC_(person with whom signer contracted)on the property of Victory @ Heritage, LLC_(owner) located at_135 & Heritage Trace Pkwy, Fort Worth, TX (location) to the following extent:_Site_Qob description). The signer therefore waives and releases any mechanic's lien 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. Date_3/20/18 _XS Constr ctio LLC (Company name) By (Signature) _Office Managz��_(Title) NOTE:Section 53.281(b)(2),Texas Property Code,requires that the above form be notarized.See Chapter 121, Texas Civil Practice&Remedies Code,regarding Acknowledgments&Proofs of Written Instruments,or consult an attorney.For short acknowledgement forms that might be suitable,see Section 121.008 in Chapter 121.Click here to go there. FORTWORTHREV:8/20/16 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR 1) CONTRACTOR&PROJECT DATA Name of Contractor Project Name PCI Construction,Inc. Victory at Heritage Inspector City Project Number Matt Cain 100485 Construction Components Project Manager ❑water ❑waste water ❑� Storm Drainage ❑� Pavement Gopal Sahu Initial Contract Amount Project Difficulty $485,391.50 O Simple Routine O Complex Final Contract Amount Date $767,318.50 4/4/2018 M PERFORMANCE EVALUATION 0-Inadequate 1-Deficient 2-Standard 3-Good 4-Excellent ELEMENT WEIGHT(x) APPLICABLE(Y/N) RATING(0-4) MAX SCORE SCORE I 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 Supervision 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 4 60 60 9 Daily Clean Up 5 Y 2 20 10 10 Citizen's Complaint Resolution 5 Y 4 20 20 11 Property Restoration 5 Y 3 20 15 12 After Hours Response 5 Y 4 20 20 13 Project Completion 5 Y 3 20 15 TOTAL ELEMENT SCORE(A) 363 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 363 III)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/MS] * 100%) 363 / 448 = 81% Performance Category Excellent <20%=Inadequate 20%to<40%=Deficient 40%to<60%=Standard 60%to<80%=Good >80%=Excellent Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED) Inspector Signature �--� Contractor Signature Inspector's Supervisor Signature CONTRACTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of FortWorth•8851 Camp Bowie West Blvd. •Fort Worth,TX 76116•(817)392-8306 FORTWORTH, REV:02,22,0' TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 4/4/2018 Name of Contractor Project Name PCI Construction,Inc. Victory at Heritage DOE Inspector Project Manager Matt Cain Gopal Sahu DOE Number Project Difficulty Type of Contract CPN:100485 Q Simple ) Routine Q Complex ❑Water ❑Waste Water 0 Storm Drainage Pavement Initial Contract Amount Final Contract Amount $485,391.50 $767,318.50 II)PERFORMANCE EVALUATION 0-Inadequate 1 -Deficient 2-Standard 3 -Good 4-Excellent ELEMENT RATING ELEMENT RATING INSPECTION EVALUATION PLANS&SPECIFICATIONS 1 Availability of Inspector �/ 1 Accuracy of Plans to Existing Conditions 2 Knowledge of Inspector 2 Clarity&Sufficiency of Details 3 Accuracy of Measured Quantities 13 Applicability of Specifications 4 Display Of Professionalism 14 Accuracy of Plan Quantities If 5 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 V 3 Communication 2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts 3 Bid Opening to Pre-Con Meeting Timeframe "COMMENTS&SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor INSPECTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS d The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax:(817)392-7845 FORTWORTH© TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME STATEMENT# FINAL STATEMENT# 1 CPN# 100485 NAME OF PROJECT: Victory at Heritage Contractor PCI YEAR: 2018 PROJECT NO.: FINAL INSPECTION DATE 7-Mar-18 WTR-59601-0600430-100485-001580 1 WD CD SWR-59607-0700430-100485-001380 ICONTRACT TIME 270 I R PERIOD FROM: —F-311612018 TO: 3/31/2018 MID Month I PMENT (Y/N)I Y WORT{ORDER EFFECTIVE: 1 2/20/2017 BEG(y/n) n MID(y/n) y 145.6% LIP YR(y/n) DAY OF MONTH DAYS REASON FOR DAY OF MONTH DAYS REASON FOR CHARGED DAYS CREDITED CHARGED DAYS CREDITED 1 Fri 16 Fri 1 2 Sat 17 Sat 1 3 Sun 18 Sun 1 4 Mon 19 Mon 1 5 Tue 20 Tue 0 na 6 Wed 21 Wed 0 na 7 Thu 22 Thu 0 na 8 Fri 23 Fri 0 na 9 Sat 24 Sat 0 na 10 Sun 25 Sun 0 na 11 Mon 26 Mon 0 na 12 Tue 27 Tue 0 na 13 Wed 28 Wed 0 na 14 Thu 29 Thu 0 na 15 Fri 30 Fri 0 na 31 Sat 0 na NA Wkn &Hol Wea utl Oth Not Applicable SAT,SUN,and WEATHER UTILITIES OTHERS DAYS TOTAL DAYS HOLIDAYS RELOCATE CHARGED THIS PERIOD 0 0 0 0 4 4 PREVIOUS PERIOD 0 389 389 TOTAL TO DATE 0 0 1 0 1 0 1 393 393 REMARKS: Final inspection was held on 3/7/18. Punch list was complete on 3/19/18. Signature: -'—� Signature: (Print Name) L— t (Print Name) Matt Cain `, 'm CONTRACTOR DATE 7 c/ Z,-/ INSPECTOR DATE 41 Q (Jw