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Home My WebLink AboutContract 49550-FP2 City Secretary 49550 -FP2 Contract No. FORTWORTH. Date Received Sep 24,2018 NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: 3 i Project Name: REVELSTOKE, SECTION 1A City Project No.: 100965 j Improvement Type(s): ❑ Paving ® Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $1,563,519.40 Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: $1,563,519.40 eeyih Sep 18, 2018 Kevin Gemenkorn fSep 18,2018) Contractor Date Executive VP of Operations Title PCI Construction Inc. Company Name A,Oerfsa uuee ro Sep 20 2018 Albert S--iego(Sep 20,20 19) , Project inspector Date Sep 20 2018 Fret EhieFreJ 1� , Project Manager Date 7,1*eS �ettRaiiaGa f Sep 20, 2018 Janie Scartett Morales(Sep 20,20181 CFA Manager Date sajw"C'A4 uy Sep 20, 2018 Susan Al.—(Sep 20,2018) Asst. City Manager Date OFFICIAL.RECORDage 1 of 2 CITY SECRETARY FT.WORTH,TX F� � Notice of Project Completion Project Name: REVELSTOKE, SECTION 1A City Project No.: 100965 City's Attachments Final Pay Estimate 0 Change Order(s): ❑ Yes 0 N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 102 CD Days Charged: 334 Work Start Date: 10/9/2017 Work Complete Date: 9/7/2018 Page 2of2 Oa8-1 06q&S City Project Numbers 100965 DOE Number 0965 Contract Name REVELSTOKE,SECTION IA Estimate Number 1 Contract Limits Payment Number 1 Project-Type—— — STORM DRAIN For Period Ending- 9/13/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors OWEN / SLATEN Contract Date Contractor POWELL CONSTRUCTION Contract Time 102 CD P O BOX 2967 Days Charged to Date 334 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 $1,563,519.40 Less %Retained $0.00 Net Earned $1,563,519.40 Earned This Period $1,563,519.40 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 $1,563,519.40 Thursday,September 13,2018 Page 5 of 5 FORT WORTH -OITrOF FORT WORTH - - - - -- FINAL PAYMENT REQUEST Contract Name REVELSTOKE,SECTION I Contract Limits Project Type STORM DRAIN City Project Numbers 100965 DOE Number 0965 Estimate Number 1 Payment Number 1 For Period Ending 9/13/2018 CD City Secretary Contract Number Contract Time IOCD Contract Date Days Charged to Date 334 Project Manager NA Contract is 100.00 Complete Contractor POWELL CONSTRUCTION P O BOX 2967 MCKINNEY, TX 75070 Inspectors OWEN / SLATEN Thursday,September 13,2018 Page I of 5 City Project Numbers 100965 DOE Number 0965 Contract Name REVELSTOKE,SECTION IA Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN For Period Ending 9/13/2015 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity 'rotal Quanity Total 1 21"RCP 174 LF $48.60 $8,456.40 174 $8,456.40 2 24"RCP 103 LF $56.90 $5,860.70 103 $5,860.70 3 24"RCP GASKETED WATER TIGHT JOINTS 42 LF $67.30 $2,826.60 42 $2,826.60 ZI 27"RCP 46 LF $63.90 $2,939.40 46 $2,939.40 5 30"RCP 226 LF $72.90 $16,475.40 226 $16,475.40 6 36"RCP 579 LF $99.00 $57,321.00 579 $57,321.00 7 36"RCP GASKETED WATERTIGHT JOINTS 72 LF $122.80 $8,841.60 72 $8,841.60 8 42"RCP 22 LF $136.70 $3,007.40 22 $3,007.40 9 48"RCP 61 LF $164.20 $10,016.20 61 $10,016.20 10 5X4 BOX CULVERT 11.8 LF $250.60 $29,570.80 118 $29,570.80 11 6X5 BOX CULVERT 16 LF $343.20 $5,491.20 16 $5,491.20 12 6X6 BOX CULVERT 40 LF $368.30 $14,732.00 40 $14,732.00 13 8X4 BOX CULVERT 560 LF $421.50 $236,040.00 560 $236,040.00 14 8X5 BOX CULVERT 126 LF $445.10 $56,082.60 126 $56,082.60 15 9X5 BOX CULVERT 445 LF $533.80 $237,541.00 445 $237,541.00 16 IOX5 BOX CULVERT 113 LF $625.70 $70,704.10 113 $70,704.10 17 3-7'X4'BOXCULVERT 8 LF $1,492.70 $11,941.60 8 $11,941.60 18 8-8'X5'BOX CULVERT 76 LF $3,218.00 $244,568.00 76 $244,568.00 19 CONCRETE COLLAR 9 EA $316.00 $2,844.00 9 $2,844.00 20 10'CURB INLET 12 EA $3,348.00 $40,176.00 12 $40,176.00 21 10'RECESSED INLET 2 EA $3,687.00 $7,374,00 2 $7,374.00 22 15'CURB INLET 4 EA $4,478.00 $17,912.00 4 $17,912.00 23 4'SQUARE MANHOLE I EA $4,555.00 $4,555.00 1 $4,555.00 24 5'X5'DROP INLET 2 EA $3,800.00 $7,600.00 2 $7,600.00 25 INLET PROTECTION 20 EA $31.6.00 $6,320.00 20 $6,320.00 26 5'SQUARE MANHOLE 1 EA $4,894.00 $4,894.00 1 $4,894.00 27 30"SLOPED HEADWALL I EA $2,670.00 $2,670.00 1 $2,670.00 28 36"SLOPED HEADWALL 1 EA $2,896.00 $2,896.00 1 $2,896.00 29 6'X6'SLOPED HEADWALL 1 EA $8,842.00 $8,842.00 1 $8,842.00 30 TXDOT SW-0 HEADWALL 1 EA $4,026.00 $4,026.00 1 $4,026.00 31 TXDOT PW-I WINGWALL 1 EA $40,634.00 $40,634.00 1 $40,634.00 Thwsday,September 13,2018 Page 2 of 5 City Project Numbers 100965 DOE Number 0965 Contract Name REVELSTOKE,SECTION IA Estimate Number I Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 9/13/2013 i i Project Funding 32 TXDOTPW-I WINGWALL 2 EA $103,361.00 $206,722.00 2 $206,722.00 33 TXDOTPW-I WINGWALL 1 EA $41,561.00 $41,561.00 1 $41,561.00 34 WEIR PER TXDOT I EA $71,225.00 $71,225.00 1 $71,225.00 35 REMOVE EXISTING HEADWALL I EA $5,897.00 $5,897.00 1 $5,897.00 36 CONNECT TO EXISTING STORM LINE I EA $2,740.00 $2,740.00 1 $2,740.00 37 CONCRETE RIPRAP 247 SY $105.00 $25,935.00 247 $25,935.00 38 TRENCH SAFETY 2802 LF $0.20 $560.40 2802 $560.40 39 SWPPP 1 ACRES 1 LS i 40 BONDS FOR ALL UTILITY IMPROVEMENTS 1 LS $35,720.00 $35,720.00 1 $35,720.00 Sub-Total of Previous Unit $1,563,519.40 $1,563,519.40 Thursday,September 13,2018 Page 3 of 5 it City Project Numbers 100965 DOE Number 0965 Contract Name REVELSTOKE,SECTION IA Estimate Number I Contract Limits Payment Number I Project Type____ STORM DRAIN For Period Ending 9/13/2018_ Project Funding Contract Information Summary Original Contract Amount $1,563,519.40 Change Orders Total Contract Price $1,563,519.40 Total Cost of Work Completed $1,563,519.40 Less %Retained $0.00 Net Earned $1,563,519.40 Earned This Period $1,563,519.40 Retainage This Period $0.00 Less Liquidated Damages Days @ /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 $1,563,519.40 Thursday,September 13,2018 Page 4 of 5 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 John Starnes _("Affidant"),who,after being by me duly sworn,deposes,and says that he is the Controller ,of 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 Revelstoke 1A at Fort Worth, TX(the "Work"), for a total consideration of Two million three hundred eighty three thousand one hundred ninety-six& 15/100($2,383,196,15) Dollars to be paid to the said Contractor(the"Contract"),and that Affidant has full power of authority to make this affidavit. That Peloton Land Solutions ___(the"Owner") has approved the final pay estimate on said Work, l and that the said Contractor has fully satisfied and paid any and all claims that may be covered by Chapter 53 of the Texas Property Code and Article 5160 of the Revised Civil Statutes of the State of Texas, or any other applicable statutes or charter provisions, and that all just bills for labor and materials have been paid and discharged by said Contractor insofar as they pertain to the work in question. That in addition to any funds which may have been previously paid by the Owner,the Contractor hereby accepts the amount of$_Two hundred forty one thousand six hundred thirty one & 08/100 ($241,631.08) Dollars as FULL AND FINAL PAYMENT under the aforementioned Contract, and hereby waives l 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. PGI Co� �J Ido, By: A 4 It 9I lll.V r&s (Printed Name) SUBSCRIBED AND SWORN TO BEFORE ME, this the j day of �� r.F�� eS By: L_ ✓,jam(/(Noottaary Public in and for the State �off-Texas) ,� `�rev?�a �'y t ( !�/'IT' (Printed Name of Notary) [Notary Seal] n:_ PY� _C fdotary Public Q�Texas M commission ex ires: V MyGomnission,f 1231)44875 0 my comm BP 9eptenber 26 2019 CONSENT OF CONTRAC'T'OR SURETY COMPANY ARCHITECT TO FINAL PAYMENT SUBCONTRACTOR SURETY AIA DOCUMENT G707(Modified) OTHER Bond No. 2260587 PROJECT: Revelstoke,Section IA-Water,Sanitary Sewer and Storm Drain Improvements (name,address) TO(Contractor) [ City of Fort Worth ] ARCHITECT'S PROJECT NO: 1000 Throckmorton Street Fort Worth,TX 76102-6312 CONTRACT FOR: Construction [ ] CONTRACT DATE: 8/1/2017 SUBCONTRACTOR: PCI Construction,Inc. P.O.Box 2967 McKinney,TX 75070 In accordance with the provisions of the Contract between the Contractor and the Subcontractor as indicated above,the (here insert name and address of Surety Company) North American Specialty Insurance Company 5200 Metcalf OPN111 Overland Park,KS 66202 , SURETY COMPANY, on bond of(here insert name and address of Subcontractor) PCI Construction,Inc. P.O.Box 2967 McKinnev,TX 75070 , SUBCONTRACTOR, hereby approves of the final payment to the Subcontractor,and agrees that final payment to the Subcontractor shat l not relieve the Surety Company of any of its obligations to(here insert name and address of Contractor) City of Fort Worth 1000 Throckmorton Street Fort Worth,TX 76102-6312 ,CONTRACTOR, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 17th day of September 12018 North American Specialty Insurance Company Surety Company Signature of Authorized Representative Witness:__ �L l�%�'✓L (Seat): 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 EDITION AIA ONE PAGE 1970 THE AMERICAN fNSTI"1'UTE OF ARCHITECTS,1735 New York Ave.,NW,WAST IINGTON,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 D.ROGERS,JR.,TROY RUSSELL KEY,LINDA MICHELLE STALDER AND CHRISTOPHER CARL SUNDBERG JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact,to make,execute,seat 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($125,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on March 24,2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18,2011. "RESOLVED,that any two of the President,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." L1TY� o-��`majtONA AU yQQ•'.aPF50NSG� d�,pORPo GAnAi gy T _r Steven Anderson,Senior icePresident o as ung on n ernat ono nsurance Company }i 0• SFA. ;mSEAL ta$ &Senior Vice President of North American Specialty insurance company k &Senior Vice President ofWestport Insurance Corporation = 00~ ?%y 4�yf oAMP`•+,' . , `ssb,�••..........��Co By Mike A.Ito,Senior Vice President ofwnshhrgton Internanonnl Insurance Company �''�ilntruwgta�� s? a1nL9l11nIN\h &Senior Vim President of North American Specialty Insurance Company 1 &Senla•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 20th day of August 20 18 North American Specialty Insurance Company Washington International Insurance Company State of Illinois Westport Insurance Corporation County of Cook ss: On this 20th day of August 201 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 g M.KENNY Nataty Public-slate of glinniv My Commission bpiirs J � _ 17Jo4Jaozn M.Kenny,Notary Public _ e r, 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 17th day of September 20 18 h Jeffrey Goldberg.Vice President&Assistant Secretary ofWashington International Insurance Company& North American Specialty Insurance Company&Vice President&Assistant Secretary of Westport Insurance Corporalion it 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 i complaint at: para someter una queja al: i, 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: I 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: hen://www.tdi.atat x_us Web: hen://www.tdi_state.tx.ee Email:ConsumerProtection@tdi.state.tx.us Email:ConsumerProtection@tdi.state.tx.us „ I PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O 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 as 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. Greensheet for Revelstoke, �.w Section 1 A CPN#100965 SD Adobe Sign Document History 10/02/2018 ---- -- - F Created: 09/14/2018 By: Shameka.Kennedy@fortworthtexas.gov Status: Signed Transaction ID: CBJCHBCAABAAfGyXWsFgzt9AoGL2ulv56gy1p7BwzQox "Greensheet for Revelstoke, Section 1A CPN#100965 SD" Histo ry tLI Document created by Shameka.Kennedy@fortworthtexas.gov 09/14/2018-7:46:39 AM CDT-IP address:209.194.29.100 Document emailed to Kevin Gerstenkorn 0asonfuhr@pciconstruction.com)for signature 09/14/2018-7:49:36 AM CDT Document viewed by Kevin Gerstenkorn dasonfuhr@pciconstruction.com) 09/14/2018-8:41:36 AM CDT-IP address: 107.77.196.198 �i Kevin Gerstenkorn dasonfuhr@pciconstruction.com) uploaded the following supporting documents: CO/ File Attachment 1 & File Attachment 2 09/18/2018-2:44:21 PM CDT Document e-signed by Kevin Gerstenkorn Oasonfuhr@pciconstruction.com) Signature Date:09/18/2018-2:44:21 PM CDT-Time Source:server-IP address: 108.178.72.146 C'' Document emailed to Albert Samaniego (albert.samaniego@fortworthtexas.gov)for signature 09/18/2018-2:44:23 PM CDT Document viewed by Albert Samaniego (albert.samaniego@fortworthtexas.gov) 09/20/2018-8:06:09 AM CDT-IP address: 174.206.1.189 ✓ , Document e-signed by Albert Samaniego (albert.samaniego@fortworthtexas.gov) Signature Date:09/20/2018-8:06:36 AM CDT-Time Source:server-IP address:174.206.1.189 try Document emailed to Joe Rogers Qoseph.rogers@fortworthtexas.gov)for approval 09/20/2018-8:06:38 AM CDT FORT WORTHS I Adobe Sign L1 Document viewed by Joe Rogers Qoseph.rogers@fortworthtexas.gov) 09/20/2018-8:19:38 AM CDT-IP address:209.194.29.100 t Document approved by Joe Rogers Qoseph.rogers@fortworthtexas.gov) Approval Date:09/20/2018-8:19:56 AM CDT-Time Source:server-IP address:209.194.29.100 C Document emailed to Fred Ehia (freidoon.ehia@fortworthtexas.gov)for signature 09/20/2018-8:19:58 AM CDT Document viewed by Fred Ehia (freidoon.ehia@fortworthtexas.gov) 09/20/2018-8:40:35 AM CDT-IP address:209.194.29.100 i�16 Document e-signed by Fred Ehia (freidoon.ehia@fortworthtexas.gov) Signature Date:09/20/2018-9:05:17 AM CDT-Time Source:server-IP address:209.194.29.100 C'-. 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Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:09/24/2018-9:16:50 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Monica De Anda (monica.deanda@fortworthtexas.gov)for delivery 09/24/2018-9:16:52 AM CDT ` Document viewed by Monica De Anda (monica.deanda@fortworthtexas.gov) 10/02/2018-9:24:57 AM CDT-IP address:209.194.29.100 L� Document receipt acknowledged by Monica De Anda (monica.deanda@fortworthtexas.gov) Receipt Acknowledgement Date: 10/02/2018-9:25:09 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Sylvia Kelley (tpwcfafiscal@fortworthtexas.gov)for delivery 10/02/2018-9:25:11 AM CDT 5 Document viewed by Sylvia Kelley (tpwcfafiscal@fortworthtexas.gov) 10/02/2018-11:03:49 AM CDT-IP address:209.194.29.100 Document receipt acknowledged by Sylvia Kelley(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date: 10/02/2018-11:04:25 AM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov), Julie A Geho Oulie.geho@fortworthtexas.gov), Albert Samaniego (albert.samaniego@fortworthtexas.gov), Fred Ehia (freidoon.ehia@fortworthtexas.gov), and 8 more 10/02/2018-11:04:25 AM CDT FORT WORTHS Adobe Sign