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HomeMy WebLinkAboutContract 48248-FP1 FORT WORT Ho CITY SE CR C0NTRACT . "-f TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION City Project Ns: 100363-""- Regarding Q0363✓Regarding contract 48246or BRIDGE REHABILITATION AT NINETEEN LOCATIONS 201 -2 as required by the TRAN,,�PORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 08/30/201tt'through M&C G2788etthe director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of they Assistant Director of the Transportation&Public Works Department has accepted the project as complete. Original Contract Prices: $634,907.50 Amount of Approved Change Orders: $158,620.45 NO Z Revised Contract Amount: $793,527.95 v Total Cost Work Completed: $793,527.95 >/ Less Deductions: Liquidated Damages: Days®$216.001 Day Pavement Deficiencies: Total Deduction Amount: $0.00 Total Cost Work Completed: $793,527.95 Less Previous Payments: $734,851.55' Fina!Payme $58,676.40 JrzV Xtr�' ommended for Acceptance Date Asst. Director,TPW - Infrastructure Design and Construction Accepted Date AM Director, TRANSPORTATION AND PUBLIC WORK DEPARTMENT As t. C y Manager Date Is---im TPW Construction Invoice Contract: CS48248 P.O.# PO-16-96005 . r .4.. . ,. Payment Dater TO:Gibson&Associates Inc. INV.# CS48248-9 Estimate No. 9 DOE: 11210 Ryliecrest ProjManager TARIQUL ISLAM Balch Springs TX 75180 FOR: 2016-2 BRIDGE REHABILITATION Contract Amount: $793,527.95 Completed Ret Pen Ad' Pa Total to Date: $793,527.95 $0.00 $0.00 $0.00 $793,527.95 Previous Estimate: $773,527.95 $,0.00 $0.00 $0.00 $734,851.55 Earned to Date: $20,000.00 ($38,676.40) $0.00 $0.00 $58,676.40 Payments: 30100-0200431-5740010--100363-002680-2016- $793,527.95 Original -$634,907.50 CO#1- Comments:CO#1:$99,850.80 Comments:CO#2:$58.769.65 $99,850.80 Total to Date: $793,527.95 $0.00 $0.00 $0.00 $793,527.95 Previous Estimate: $773,527.95 $38,676.40 $0.00 $0.00 $734,851.55 Earned to Date: $20,000.00`� ($38,676.40)✓ $0.00 $0.00 $58,676.40 PURCHASE ORDER tNUST APPEAR ON INVOICE 1rarsportation&Public Works BUSINESS SUPPORT GROUP Contact Person/Phone Number DANA GUTHEIL X 8972 Department Approval Signature(Printed) CAROL BUKOVIC X 8648 D?prent Approval Srtur e; LA Tuesday,August 28,20����� ��� ��� t� �_�–1 L4 _ �� 0—,5(p 3PU)0�- � �`Y 'lel l/v1 �,4 0 3 v 1 DD 2 0 LP C. -) - 00`3(03 m m CL a� com C m N 1 °� N 6�9 69 6r9 6�9 6�9 6r9 � Q fig 69 6H 69 b9 69 b9 69 69 b4 69 N L � OL �J •-� L v R � C a .. Q on o o G• � p Q q �' ..Mr O + .m a) E z p u a o �s u a m aX + e w 4 t w + 0 0 •� i w W N O ¢ oma, c '� a F F U � a O ,+d, N a Q � � c yI-C z s a R o F o pp Q a)E w L i' Rf d u W O q O C F l J N C^ O y U C Q a z z x z v �_ Ca (!J, o ? W C7 L F O F O H O z © m T o w O Z U 0.v C ¢ ,.a d U U w � WJ A G P E a) C O TA Q © C O O Q ti-I O O\ > q X E A G L a vj F— > E c c`d LJ O Q co r a .g c o ° c as m 'yy U 12 > o o U 3 c .a o �j o z c�c'a •oE U 00 i/� ,ly f6 8 kn t,j V } O O a R ¢ vov N o y o a o L o m a t0a F > O G T G z z UU L G m O -•Y�JJ(� oG¢ C ro M G O O C R w A m ro Contractor Final Estimate Approval Final-2-Estimate Page 1 of 3 Routing Assigned To: TPW AP Reconciliation Due Date: 7/5/2018 Assigned By: Joe Montgomery Due Time: 9:30 AM Links 1 fortworthgov/Infrastructure Proiects/100363 - Bridge Rehabilitation (2016-2)/Contractor/Submitted Invoices/Estimate 009/Invoice #9 and Final- 05.01.17 thru 05.31.18.xlsm Attachments(0) No Attachments have been added to this form. https://projectpoint.buzzsaw.com/ bz web/Forms/FonnPrint.aspx?Siteld=51500&ProcessI... 8/28/2018 Contractor Final Estimate Approval Final-2-Estimate Page 2 of 3 FORTWORTH, contractor Final Estimate Approval Date Started: 6/4/2018 Date Due: 6/18/2018 Invoiced Amount: (Amount from $ 58,676.40 Request No.: Final-2-Estimate Line 8 of C-620) Project Name: 100363 - Bridge Rehabilitation (2016-2) Project Number: 100363 Invoice No.: 9 Reference: Contractor: Joe Montgomery Discussion: (Limit 5000) Approval Status: https://projectpoint.buzzsaw.com/ bz_web/Forms/FormPrint.aspx?Siteld=51500&ProcessI... 8/28/2018 Contractor Final Estimate Approval Final-2-Estimate Page 3 of 3 Approved: Yes Comments: User: Tommy McKinnon Date: 2018-06-04 11:54 AM Approved: Yes Comments: User: Etta Bacy Date: 2018-06-04 12:10 PM Approved: Yes Comments: User: Joe Montgomery Date: 2018-06-04 12:27 PM Approved: Yes Comments: User: Edward Davila Date: 2018-06-29 2:32 PM Approved: Yes Comments: User: Tariqul Islam Date: 2018-07-02 9:01 AM Approved: Yes Comments: User: Lauren Prieur Date: 2018-07-02 2:30 PM https://proj ectpoint.buzzsaw.com/_bz_web/Forms/FormPrint.aspx?Siteld=51500&ProcessI... 8/28/2018 AFFIDAVIT i 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 John N. Welch, Vice President Of Gibson&Associates, 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; Bridge Repair and Rehabilitation at Nineteen Locations (2016-2) BY d- John N. Welch Subscribed and sworn before me on this date I I h of July, 2018. e av P� � PAM N DAVIS <s.....e Notary Public , ,a; ;. ri._zr o_Notary Public,State of?oxas Dallas, Texas r. '�; � Comm.Expires 03-30-2021 "'/1" Notary ID 283117-2 o CD CD CD r o co id N LO O Z 69 N R M tnO O i V Q CO d r 00 Q CD z o d a Q 0 o O o OO o 0 CD O 0 0 C O N O O N N cn r EA EA L U O z p C o o ¢z H Eo Z a [� N L m - rn d O H N W d C-4 OC O £O a Cl) L LL Ua w A a p 0 O O N Oco N ( O - F O O of A R Cl) Q C O z 3 0 LL o c o 0 LO � O a O N O U 3 O !� N O Cl O O O.O O O O O ------------- 0 Q Q io 0 0000 5 c, 6- 6 5 c) C:) 0 C) C) CD C) CD CD �n 0 711 C)- 00 C) O Z 64 en M O m 0 r_ P. ¢ IL C� O F— C) 00 ci C\ LoO 0CN cn CY, Oz LO Lo 'D D C) m or E E = " 00 a M CD O G 0 m (D O a) CD 10 CD C, ID --D rD 0 ID 0 m O cc� co Q L6 E ! rl- 0 M 61) LL Ow Ua as 00 00CD C', .0 0 ca (N N 04 —, c, a) C:) C) U co w w OD 00 0 (c) (.0 (D C'4 0 (N 0 N CD 0, C) a, C) O C) a C) 10 Cl) r_ Cl) Cl) (.0 (0 m (D Cl) co cl) 0 CD C) U CD 13 LL o CD C) CD C) O LO O CCCDD � CDD C O CD C 0C (LNC i� CCCCCd lDCD; [ . I OLL----------- ————————————— Z N � I M M O O k I p Ca o c r � I 0 O y W Q i a U o j 4- - oz o 0..z � F Q E O a � f^� w 00 a Gtr M Oz o w Z O N O F C L Q O 1..1.. [r C !F Q Ua to j N O 'a -`gyp co 00 't N �0N ON 0 y O y 0 O O cr,O CD C Cl) C Cl) �C co 1a c0 a3 c0 N (D .0 co t M t ch cUo Uo Uo z II m o 0 0 LL O O O U r- r LO LO y M M M V t V O O Co O O O T N N N O t O O r. I U o I o o 0 0 0 0 0 0 0 0 0 0 C:) 0 0 0 0 0.11 0 o co 0 0 0 0 0 0 0 0 0 C) 017) 7 C) ID 00 0 C)-- C) CD -D ID 0 0 C-- C) C) C, b C) O o b -D oc C= M O O --TFF 0 CD CD CD cn M 0n�71 b 'D 10 In c 8 ? ID :�) S ID Q ID C, C, C O 0 D CD CD CD 'D CD �-, C. O 14 O CA cn cr -E CD LL Ch Cq 00 1- CD coO (N C*4 C) 0 CD a) CD 'E Go cc) (D � C-4 6 CN C)C:) rr, cr, C) C)(D CM C co m m co cr, Cl) C) (D C) CD CD C) C) C) C) O I-- Cl) co C) (D V) C) C) C) CN 04 C14 C) (D ] R ID CD CD C) ,::�H J CD C:,� 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 82443281 PROJECT: (name, addreSS)Bridge Rehab.at Nineteen Locations(2016-2) Fort Worth,TX TO (Owner) City Project No. CITY OF FORT WORTH ARCHITECTS PROJECT NO: 100363 CONTRACT FOR: 1000 Throckmorton Street Bridge Rehabilitation at Nineteen Locations(2016-2) Fort Worth TX 76102 —J CONTRACT DATE: 8/30/2016 CONTRACTOR:GIBSON&ASSOCIATES, 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) FEDERAL INSURANCE COMPANY 15 Mountain View Road Warren NJ 07059 , SURETY COMPANY on bond of (here insert name and address of Contractor) GIBSON &ASSOCIATES, INC. P.O. Box 800579 Balch Springs TX 75180-0579 , 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) CITY OF FORT WORTH 1000 Throckmorton Street Fort Worth TX 76102 , OWNER, as set forth in the said Surety Company's bond. IN WITNESS,WHEREOF, the Surety Company has hereunto set its hand this 6th day of June,2018 FEDERAL INSURANCE COMPANY ll Surety Company Attest: `�✓Ia-a (Seal): Signature of Authorized Representative Robb!Morales 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 ONE PAGE CH U B B' Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New York corporation,and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Don E. Cornell, Sophinie Hunter, V. DeLene Marshall, Tina McEwan, Robbi Morales,Ricardo J.Reyna and Kelly A.Westbrook of Dallas,Texas;Steven Dwain Brockinton of Little Rock,Arkansas----------------_ each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory in the nature thereof(other than bail bonds)given or executed in the course of business,and any instruments amending or altering the same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their `corporate t �15?iJ�l.Cbseals o�,n�this �8`s/day ofMarch,2017. fit, x 1 �X` �L t 1 Dawn M.Chlores.Assis(=Secretmy Stephen A Haney,Vice President �f fk wouMr.' • w.pp� aaa�. •Aw»� STATE OF NEW JERSEY Countyof ifunterdon On this 81`day of March,2017 before me,a Notary Public of New Jersey,personally came Dawn M.Chloros,to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney,and the said Dawn M. Chloros,being by me duly sworn,did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC ' INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies;and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority;and that she is acquainted with Stephen M. Haney,and knows him to be Vice President ofsaid Companies;and that the signature of Stephen M.Haney,subscribed to said Power of Attorney is in the genuine handwriting of Stephen M.Haney,and was thereto subscribed by authority ofsaid Companies and in deponent's presence. Notarial Sea] KATHERINE E R O N �TAgy;. NOTARYPUBL11 OF NEWJERSEY No.2318886 PUBLIC COMAS hln Exg4ee July 18,2019 Naary Public JERS� CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY on August 30,2016: "RESOLVED,that the following authorizations relate to the execution,for and on behalf of the Company,of bonds,undertakings,recognizances,contracts and other written commitments of the Company entered Into in the ordinary courseof business(each a-Written Commitment'): (r) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company,under the seal of the Company or otherwise. (2) Each duly appointed attorney-in-fact of the Company Is hereby authorized to execute any Written Commitment for and on behalf of the Company,under the seal of the Company or otherwise,to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such attorney-in-fact (3) Each of the Chairman,the President and the Vice Presidents of the Companyis hereby authorized,forand on behalfofthe company,to appoint in writing any person the attorney- in-fact of the Company with full power and authoritytoexecute,for and on behalfofthe Company,under the seal ofthe Company or otherwise,such Written Commitments ofthe Company as may be speed in such written appointment,which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized,for and on behalf of the Company,to delegate in writing to any other officer of the Company the authority to execute,for and on behalf of the Company,under the Company's seal or otherwise,such Written Commitments of the Company as are specified in such written delegation,which specification may be by general type or class of Written Commitments or by specification ofone or more particular Written Commitments. (5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution,and the seal of the Company,may be affixed by facsimile on such Written Commitment or mitten appointment or delegation. FURTHER RESOLVED,that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority ofotficers,employees and other persons to act for and on behalf of the Company,and such Resolution shall not limit or otherwise affect the exercise of anysuch power or authority otherwise validly granted or vested." I,Dawn M.Chloros,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY(the"Companies")do hereby certify that (i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true,correct and in full force and effect, (fi) the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U.S.TreasuryDepamner t;further,Federal and Vigilant are licensed in the U.S.Virgin Islands,and Federal is licensed in Guam,Puerto Rico, and each of the Provinces of Canada except Prince Edward Island;and (lb) the foregoing Power of Attomey is true,correct and in full force and effect. Given under my hand and seals ofsaid Companies at Whitehouse Station,NJ,this June 6, 2018 Dawn,fL Chlores.Assistant Secretary IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIdf,VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER,PLEASE CONTACT US AT: Tele hone(908)903-3493 Fax(908)903-3656 a-mall:surety@chLibb.com M&C Review Page 1 of 2 Official site of the City of Fort Worth, Texas FORT IVoRTA CITY COUNCIL AGENDA COUNCIL ACTION: Approved on 8/30/2016 REFERENCE ** 20BRIDGE DATE: 8/30/2016 NO.: C-27888 LOG NAME: REHABILITATION 2016-2 CODE: C TYPE: CONSENT PUBLIC NO HEARING: SUBJECT: Authorize Execution of a Contract with Gibson &Associates, Inc., in the Amount of $634,907.50 for Bridge Rehabilitation at Nineteen Locations and Provide for Project Costs and Contingencies for a Total Project Amount of$709,907.50 (COUNCIL DISTRICTS 2, 3, 4, 5, 7, 8 and 9) RECOMMENDATION: It is recommended that the City Council authorize the execution of a contract with Gibson & Associates, Inc., in the amount of$634,907.50 for Bridge Rehabilitation 2016-2 at nineteen locations. DISCUSSION: This contract provides for the repair and rehabilitation of nineteen bridges listed on the attachment provided (City Project No. 100363). Description Amount Design $0.00 Construction $634,907.50 Project Management/Inspection/Contingencies, Etc. $75,000.00 Total Project Budget $709,907.50 Funding for this project is included in the Fiscal Year 2016 General Capital Projects Fund. Construction for this project is expected to start approximately October 2016 and to be completed by approximately April 2017. Upon completion of the project there will be no anticipated impact on the general fund operating budget. This project was advertised for bid on June 2, 2016 and June 9, 2016 in the Fort Worth Star- Telegram. On June 30, 2016, the following bids were received: Bidders Amount Gibson &Associates, Inc. $634,907.50 North Rock Construction $667,465.00 Iowa Bridge & Culvert, LC $759,455.00 Structural Assurance LLC 1 $1,073,860.00 M/WBE Office-Gibson &Associates, Inc., is in compliance with the City's BDE Ordinance by committing to 12 percent MBE participation. The City's MBE goal on this project is six percent. The City reserves the right to increase or decrease quantities of individual pay items within the contract provided that the total contract amount remains within plus or minus 25 percent of the contract award. This project is located in COUNCIL DISTRICTS 2, 3, 4, 5, 7, 8 and 9, Mapsco 5L, 36Q, 36S, 62M, 67W, 73M, 74E, 74T, 75A, 76G, 76K, 77D, 77W, 79P, 79X, 79Y, 88H, 90R and 105R. FISCAL INFORMATION/CERTIFICATION: M&C Review Page 2 of 2 The Director of Finance certifies that funds are available in the current capital budget, as appropriated, of the General Capital Projects Fund. Description Existing Additional Proposed Appropriation Appropriations per Appropriations this M&C Bridge Rehabilitation 2016- $709,907.50 $0.00 $709,907.50 2 Fund 30101 TO Fund Department Account Project Program Activity Budget Reference# Amount ID 1D Year (Chartfield 2 FROM Fund I Department Account Project Program Activity Budget Reference# Amount ID I ID I I Year I (Ch field 2) 1301001 0200431 1 5740010 1100363 1 1 002680 1 2016 1 1 $634,907.50 Submitted for City Manager's Office bv: Jay Chapa (5804) Originating Department Head: Douglas W. Wiersig (7801) Additional Information Contact: Tariqul Islam (2486) ATTACHMENTS Form 1295 Gibson.pdf Locations List Gibson.pdf Map Bridge Rehab 2016-2.pdf FORHT O R 1 rev 03/05/07 TRANSPORTATION&PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:1 NAME OF PROJECT: Bridge Rehabilition at Nineteen Locations(2016-2) PROJECT NO.: 100363 CONTRACTOR: Gibson and Assiocates,Inc. DOE NO.: N/A PERIOD FROM:0 1/04/17 TO: 01/09/18 FINAL INSPECTION DATE: 9-Jan-18 WORK ORDER EFFECTIVE: CONTRACT TIME: O WD*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. S. 23. 9. 24. 1 10. 25, 11. 26. j 12. 27. i 13. 28. 14. 29. 15. 30. 31. SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL &HOLIDAYS &TOO COLD RELOCATIONS OTHERS'-- CHARGED DAYS THIS PERIOD 370 370 PREVIOUS PERIOD TOTALS T 370 370 O DATE *REMARKS. C CTOR DATE SPECTOR DATE ENGINEERINg4EPARTMENT The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 BuySpeed Online Page 1 of 2 RP,, Accounts Payable Department Ac ``+.�.r. d Onli (�[�d NIGP Code Browse I My Account I Customer Service I About Current Organization:CITY OF FORT WORTH� September 20,2018 3:15:13 PM CDT Y 4 Home Documents Dana Gu status: 41R- Invoice #: CS48248-9 FINAL Vendor #:0000009564 Vendor Group #:01 Rea - y Approval General Items Subcontractors Accounts Routing Attachments Notes Reminder Change Order Summary Back to PO General Validation Warnings • The following complete receipt PO items are fully paid(current invoice amount+previous approved/paid invoice amount=total received dollar amount),but their final pay indicators are not checked.These items will not be closed the time the invoice is approved[t,2,3] Header Information Invoice Number: CS48248-9 FINAL Invoice Status: 41R-Ready for Approval Invoice Type: 3way matching Invoice Description: CS48248-9 FINAL 2016-2 BRIDGE REHABILITATION Invoice Date: 06/04/2018 Effect Date: 09/20/2018 Payment Amount: $58,676.40 - Handling Code: Payment Date: 06129/2018 Payment Terms: Payment Term Day: 0 Payment Discount: 0.0% Paid-Bank/Check: Alternate Id: Entered By: Dana Gutheil Entered Date: 09120/2018 Updated By: Dana Gutheil Updated Date: 09/20/2018 Received Date: 05/31/2018 03:13:00 PM Attachments Agency Files: Agency Forms: Vendor Files: Vendor Forms: Purchase Order Information Purchase order Number: PO-17-00096005 PO Description CS48248 100363 PO Amount: $793,527.95 Remaining To Invoice: $0.00 Buyer: Karen Striker PoVendor Information Vendor: 0000009564-GIBSON 8 ASSOCIATES INC Address Grp: 01 Vendor Remit-to Address: BRAD MILAM 11210 RYLIECREST BALCH SPRINGS,TX 75180 USA Fed ID: """7660 Remit Text: Email:bradm@gibsonassoc.net Phone:(972)557-1199 Id:115362(EFT Enabled) Misc&Freight Invoice Account Event Type Fiscal Year Account Cade Transaction Amount Misc 18 30100-2060000-100363-RETAIN— $38,676.40 Total: $38,676.40 Item Information Invoice Item#/PO Item#:1 2016-2 BRIDGE REHABILITATION 30100-0200431-5740010-100363-002680-2016-CS48248 M&C C-27888 DATE 083016 PO Permit Invoice Discount% Original Final Item Status To Pay Amount Pay Amount Pay 3PCR-Complete Receipt $0.00 $0.00 0.0% $0.00 No MAKE: ASSET MODEL: ASSET MANUF: ASSET SERIAL: ASSET VIN: ASSET TAG: Event Type Fiscal Year Account Code Transaction Amount Exp 18 30100-0200431-5740010-100363-002680-2016- $0.00 Enc. 18 30100-0200431-5740010-100363-002680-2016- $0.00 Invoice Item#/PO Item#:2 CS48248 COApp01 Pro.100363-Bridge Rehabilitation(2016-2)Replace additional failed concrete panel next to bridge approach slab on Weatherford and Belknap St. PO Permit Invoice Discount% Original Final Item Status To Pay Amount Pay Amount Pay 3PCR-Complete Receipt $0.00 $0.00 0.0% $0.00 No MAKE: https://bso.fortworthtexas.gov/bso/purchaseorder/invoice/invoiceSummary.sdo?vendorld=... 9/20/2018 BuySpeed Online Page 2 of 2 ASSET MODEL: ASSET MANUF: ASSET SERIAL: ASSET VIN: ASSET TAG: Event Type Fiscal Year Account Code Transaction Amount Exp. 18 30100-0200431-5740010-100363-002680-2016- $0.00 Enc. 18 30100-0200431-5740010-100363-002680-2016- $0.00 Invoice Item#/PO Item#:3 CO#2-$58,769.65-2016-2 BRIDGE REHABILITATION-30100-0200431-5740010-100363-002680-2016-CS48248 M&C G-27888 DATE 083016 PO Permit Invoice Discount% Original Final Item Status To Pay Amount Pay Amount Pay 3PCR-Complete Receipt $0.00 $20,000.00 0.0% $0.00 No MAKE: ASSET MODEL: ASSET MANUF: ASSET SERIAL: ASSET VIN: ASSET TAG: Event Type Fiscal Year Account Code Transaction Amount Exp. 18 30100-0200431-5740010-100363-002680-2016- $20,000.00 Enc. 18 30100-02004315740010-100363-002680-2016- -$20,000.00 Approval Path: Delete Approver Order Approval Level Approver Date Date Approved/Disapproved/Canceled Comme Sequence Path Type Requested Approved/Disapproved/Canceled by View ID Add Primary New AddlDelete Approver Print Copyright®2018 Periscope Holdings,Inc.-All Rights Reserved.default https://bso.fortworthtexas.gov/bso/purchaseorder/invoice/invoiceSummary.sdo?vendorld=... 9/20/2018