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HomeMy WebLinkAboutContract 49314-FP3 I City Secretary 49314 -FP3 Contract No. FORTWORTH, Date Received Oct 25,2018 /005539 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: Project Name: Lasater Ranch Phase 2 City Project No.: 100539 Improvement Type(s): ❑ Paving ® Drainage rl Street Lights ❑ Traffic Signals Original Contract Price: $640,044.00 Amount of Approved Change Order(s): Revised Contract Amount: $640,044.00 Total Cost of Work Complete: $640,044.00 M'40hi ivM�gtt Cotton Tottett(Oct Oct 19,2018 Contractor Date Vice President Title D.T. Utility Contractors Inc. Company Name 1"A47 Sa"d k Oct 22,2018 Project Inspector Date fa,f f4' Oct 23 2018 VSrhu.Pm oo't 23.20'5, Project Manager Date ,7anre Stai-leAtivlayaler Oct 24 2018 J.,,—Scarlett M-1 10,t 24.20131 CFA Manager Date Oct 24 2018 Asst. City Manager Date Page 1 of 2 Notice of Project Completion Project Name: Lasater Ranch Phase 2 City Project No.: 100539 City's Attachments Final Pay Estimate El Change Order(s): ❑ Yes ® N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 120 CD Days Charged: 210 Work Start Date: 9/5/2017 Work Complete Date: 10/12/2018 Page 2 of 2 i � 0039 f City Project Numbers 100539 DOE Number 0539 f Contract Name LASATER RANCH Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 10/15/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors CORDOVA / SOUDERS,J Contract Date Contractor D'I'UTILr1'Y CONTRACTORS,INC. Contract Time 220 CD 2614 CAUSBIE RD Days Charged to Date 210 CD WEATHERFORD, TX 76087 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES i i Line Fund Account Center Amount Gross Retainage Net Funded ---------------------- ------------------ Total Cost of Work Completed $640,044.00 Less %Retained $0.00 Net Earned $640,044.00 Earned This Period $640,044.00 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 $640,044.00 Thursday,October 18,2018 Page 4 of FQRTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST E Contract Name LASATER RANCH Contract Limits Project Type STORM DRAIN f i City Project Numbers 100539 DOE Number 0539 G Estimate Number 1 Payment Number 1 For Period Ending 10/15/2018 r CD City Secretary Contract Number Contract Time 22(rD Contract Date Days Charged to Date 210 Project Manager NA Contract is 100.00 Complete I� Contractor D T UTILITY CONTRACTORS,INC. 2614 CAUSBIE RD WEATHERFORD, TX 76087 f Inspectors CORDOVA / SOUDERS,J f!( f r I I Thursday,October 18,2018 Page 1 of City Project Numbers 100539 DOE Number 0539 Contract Name LASATER RANCH Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 10/15/2018 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 21"RCP 241 LF $66.00 $15,906.00 241 $15,906.00 2 24"RCP 562 LF $72.00 $40,464.00 562 $40,464.00 3 30"RCP 165 LF $110.00 $18,150.00 165 $18,150.00 4 36"RCP 435 LF $102.00 $44,370.00 435 $44,370.00 5 7X4 BOX CULVERT 484 LF $368.00 $178,112.00 484 $178,112.00 6 8-4 BOX CULVERT 449 LF $395.00 $177,355.00 449 $177,355.00 7 5'CURB INLET 2 EA $3,500.00 $7,000.00 2 $7,000.00 8 10'CURB INLET 4 EA $5,200.00 $20,800.00 4 $20,800.00 9 15'CURB INLET 4 EA $6,100.00 $24,400.00 4 $24,400.00 10 4'DROP INLET I EA $3,800.00 $3,800.00 1 $3,800.00 11 4'STACKED MANHOLE 2 EA $3,500.00 $7,000.00 2 $7,000.00 12 4'STORM JUNCTION BOX 2 EA $5,800.00 $11,600.00 2 $11,600.00 13 LARGE STONE RIPRAP,DRY 64 SY $110.00 $7,040.00 64 $7,040.00 14 LARGE STONE RIPRAP,GROUTED 253 SY $160.00 $40,480.00 253 $40,480.00 15 HEADWALL,BOX CULVERT 10 CY $650.00 $6,500.00 10 $6,500.00 16 21"TXDOT SET CONCRETE HEADWALL 2 EA $3,500.00 $7,000.00 2 $7,000.00 17 REMOVE 18"STORM LINE 43 LF $12.00 $516.00 43 $516.00 18 REMOVE HEADWALL/SET 4 EA $1,500.00 $6,000.00 4 $6,000.00 19 REMOVE 2-5'X2'MCB 100 LF $150.00 $15,000.00 100 $15,000.00 20 SALVAGE ROCK RIP RAP 263 SY $5.00 $1,315.00 263 $1,315.00 21 5'X5'BOX CULVERT 12 LF $325.00 $3,900.00 12 $3,900.00 22 24"RCP PLUG 1 EA $500.00 $500.00 1 $500.00 23 30"RCP PLUG I EA $500.00 $500.00 1 $500.00 24 TRENCH SAFETY 2336 LF $1.00 $2,336.00 2336 $2,336.00 Sub-Total of Previous Unit $640,044.00 $640,044.00 --------------------------------------- Thursday,October 18,2018 Page 2 of 4 City Project Numbers 100539 DOE Number 0539 Contract Name LASATER RANCH Estimate Number 1 Contract Limits Payment Number I Project Type STORM DRAIN For Period Ending 10/15/2018 Project Funding Contract Information Summa>y Original Contract Amount $640,044.00 Chanl7e Orders Total Contract Price $640,044.00 Total Cost of Work Completed $640,044.00 Less %Retained $0.00 Net Earned $640,044.00 Earned This Period $640,044.00 Retainage This Period $0.00 Less Liquidated Damages Days @ 1 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 $640,044.00 Thursday,October 18,2018 Page 3 of 4 All v m I (D 0 -o —0. y 111 h 9 9 � O assansssssaY�axxYnnnannnnaant�annnnnnnnntsstnnnonaaaaaau;38sB N 8888e888888»8sea6s60080as�R2�Nftlatl�-NHGGN'�s&_svS�W�,s��aae_ � 88889888888a882in0'a`Ptpt600'a'00000'oy'oo8o}SDS2tooDtBN-oS�P3Pt8`PS&QtQ188fi.: —� 16Isffi O u13u N n « x p nnn nn nn s it n $8$$8$$8 g8a$i�$88Ss$S$ 8g $$111188 $a8$$Sn888 sss 8$ga88 �,�ft�=p= nx=�$�E�=n Q p 3 $$�X883918 8889898889 13888 8$8s$ $8 $sassas8&88$888$$ 8s8 SssBHnssaas8 _. lad, «nn nen nx «nte x r n $s $$$8$$8s8Hh$$$$$8$5888888$88888$$888$ 8888$88$b8$gQ88 -aa�x� 8$ $ 88 g $8 $8 8$8$$Sg88$8 8$88 $$$88$$8885$88$9o999 89 8 88$ $888888888888888-088 8888088-8888$$88$8888-881898888888 � r �"�` 1 1, U) isi7 rev osiosio� �i ���►�`I1' VYb) ��`�iaJ111 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.: NAME OF PROJECT: Lasater Ranch Ph 2 PROJECT NO.: 100539 CONTRACTOR: DT Utilities DOE NO.: PERIOD FROM:09/05/17 TO: 10/12/18 FINAL INSPECTION DATE: 12-Oct-18 WORK ORDER EFFECTIVE: CONTRACT TIME: 120 0 WD @)CD DAY OF DAYS MASON 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 DAYS TOTAL &HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS THIS PERIOD PREVIOUS PERIOD TOTALS 210 TO DATE *REMARKS: 120 contract days+90 days over contract Total days:210 CONTRACTOR DATE INSPE R DATE ENGINEERING DEPARTMENT a The City,of Fort Worth- 1000 Throckmorton Street-Fort Worth,TX,76012-6311 0J (817)392-7941 -Fax:(817)392-7845 AFFIDAVIT STATE OF TEXAS COUNTY OF PARKER Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Colton Tollett,Vice President Of D.T. Utility Contractors 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; Lasater Ranch Ph 2 BY Colton Tollett, Vice President Subscribed and sworn before me on this date 19 of October, 2018. Lorry Public Nota Public STATE OF TEXAS Notary Public N,�TF; �P ID#2008259 Parker, Texas My Comm.Exp,Sep.5,2021 CONSENT OF SURETY OWNER ❑ ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ SURETY ❑ Conforms with the American Institute of Architects G707 form OTHER ❑ Bond No: PB11509801127 TO OWNER: ARCHITECT'S PROJECT NO.: (Name and address) City of Fort Worth 200 Texas Street CONTRACT FOR: Water, Sewer and Drainage Fort Worth, TX 76102 PROJECT: CONTRACT DATED: 6/29/2017 (Name and address) Lasater Ranch Phase 2 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (insert name and address of Surety) Philadelphia Indemnity Insurance Company One Bala Plaza, Suite 100 Bala Cynwyd, PA 19004 SURETY on bond of (Insert name and address of Contractor) D. T. UTILITY CONTRACTORS, INC. 2614 Causbie Road Weatherford, TX 76087 CONTRACTOR hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of Fort worth 200 Texas Street Fort Worth, TX 76102 OWNER as set forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: October 17, 2018 (Insert in writing the month followed by the numeric date and year.) Philadelphia Indemnity Insurance Company (Surety) �'/1�� Signature ofouthorized reFresentative) Attest: Diane Brown. Attorney-in-fact (Seal): (Printed name and title) 5919 PHILADELPHIA INDEMNITY INSURANCE COMPANY Bond No: PB 11509801127 One Bala Plaza,Suite 100 Bala Cynvyd,PA 19004-0950 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS:That PHILADELPHIA INDEMNITY INSURANCE COMPANY(the Company),a corporation organized and existing under the laws of the Commonwealth of Pennsylvania,does hereby constitute and appoint Jared Young,Fred A.Thetford,Jr.,Tobin Tucker,Tom Young, Diane Brown,Fred A.Thetford IV and/or Fred A.Thetford, III of Contract Bond Agency, LLC., its true and lawful Attorney-in-fact with full authority to execute on its behalf bonds, undertakings,recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby,in an amount not to exceed$25,000.000. This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14"'of November,2016. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company: (1) Appoint Attorney(s) in Fact and authorize the Attorney(s) in Fact to execute on behalf of the Company bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attorney-in-Pact and revoke the authority given. And,be it FURTHER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attomey or certificate relating thereto by facsimile,and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 27"',DAY OF OCTOBER,2017. (Seal) Robert D.O'Leary Jr.,President&CEO Philadelphia Indemnity Insurance Company On this 27"'day of October,2017,before me came the individual who executed the preceding instrument,to me personally known,and being by me duly sworn said that he is the therein described and authorized officer ofthe PHILADELPHIA INDEMNITY INSURANCE COMPANY;that the seal affixed to said instrument is the Corporate seal of said Company;that the said Corporate Seal and his signature were duly affixed. f,MMONWEA TSI Or NN.. — n NOTAR4V,S AL �� 1 n+raven RnuDv an:my wwae Notary Nota Public: IOwN Nenon r��,.Mnnl;gmeryccunly A1YCummSFnn P•Nm$pDl.5.t�.'Y KYGI+-i�SR+�. residing at: Bala Cvnwvd.PA (Notary Seal) My commission expires: September 25,2021 1,Edward Sayago,Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY,do hereby certify that the foregoing resolution of the Board of Directors and the Power of Attorney issued pursuant thereto on the 27"'day of October,2017 are true and correct and are still in full force and effect.I do further certify that Robert D.O'Leary Jr.,who executed the Power of Attomey as President,was on the date of execution of the attached Power of Attorney the duly elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 17th day of QCtober".--,1,L0 18 I 1 Edward Savage,Corporate Secretary PHILADELPHIA INDEMNITY INSURANCE COMPANY, ' '' w Green Sheet CPN 100539 Lasater Ranch Phase 2 Drainage Adobe Sign Document History 10/29/2018 --- - Created: 10/19/2018 -w- By: Etta Bacy(etta.bacy@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAAmuXTN13L1edVpfpu49YiXM7mCEcQ4b5_ "Green Sheet CPN 100539 Lasater Ranch Phase 2 Drainage" H istory `i i Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 10/19/2018-12:44:18 PM CDT-IP address:209.194.29.100 Document emailed to Colton Tollett(Colton@dtutility.com)for signature 10/19/2018-12:50:53 PM CDT T5 Document viewed by Colton Tollett(colton@dtutility.com) 10/19/2018-3:44:28 PM CDT-IP address:142.147.114.57 Colton Tollett(colton@dtutility.com) uploaded the following supporting documents: & File Attachment 1 & File Attachment 2 10/19/2018-3:45:32 PM CDT c5q Document e-signed by Colton Tollett(colton@dtutility.com) Signature Date:10/19/2018-3:45:32 PM CDT-Time Source:server-IP address:142.147.114.57 . Document emailed to Jarad Souders oarad.souders@fortworthtexas.gov)for signature 10/19/2018-3:45:33 PM CDT �I Document viewed by Jarad Souders Qarad.souders@fortworthtexas.gov) 10/22/2018-7:46:34 AM CDT-IP address: 107.77.196.143 d4 Document e-signed by Jarad Souders Qarad.souders@fortworthtexas.gov) Signature Date: 10/22/2018-7:48:09 AM CDT-Time Source:server-IP address:107.77.196.143 E7+' Document emailed to William Mason (william.mason@fortworthtexas.gov)for approval 10/22/2018-7:48:10 AM CDT FORTWORTH. i Ado ,obe Sign Li Document viewed by William Mason (william.mason@fortworthtexas.gov) 10/22/2018-8:12:04 AM CDT-IP address:209.194.29.100 G& Document approved by William Mason (william.mason@fortworthtexas.gov) Approval Date: 10/23/2018-7:19:40 AM CDT-Time Source:server-IP address:209.194.29.100 C'• Document emailed to G.Sahu, PM (gopal.sahu@fortworthtexas.gov)for signature 10/23/2018-7:19:41 AM CDT Document viewed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) 10/23/2018-8:42:21 AM CDT-IP address:209.194.29.100 : L: Document e-signed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) Signature Date:10/23/2018-8:43:18 AM CDT-Time Source:server-IP address:209.194.29.100 • Document emailed to Janie Scarlett Morales oanie.morales@fortworthtexas.gov)for signature 10/23/2018-8:43:19 AM CDT Document viewed by Janie Scarlett Morales oanie.morales@fortworthtexas.gov) 10/24/2018-10:08:46 AM CDT-IP address:209.194.29.100 . Document e-signed by Janie Scarlett Morales oanie.morales@fortworthtexas.gov) Signature Date: 10/24/2018-10:09:20 AM CDT-Time Source:server-IP address:209.194.29.100 g E*7�, Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/24/2018-10:09:21 AM CDT Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/24/2018-10:14:32 AM CDT-IP address:209.194.29.100 Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date: 10/24/2018-10:14:45 AM CDT-Time Source:server-IP address:209.194.29.100 E-4 Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/24/2018-10:14:46 AM CDT J Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/25/2018-5:00:20 PM CDT-IP address:209.194.29.100 6© Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:10/25/2018-5:00:43 PM CDT-Time Source:server-IP address:209.194.29.100 C'-► Document emailed to Zelalem Arega (Zelalem.Arega@fortworthtexas.gov)for delivery 10/25/2018-5:00:44 PM CDT Document viewed by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) 10/26/2018-9:31:30 AM CDT-IP address:209.194.29.100 FORTWORTH, JV Adobe Sign do Document receipt acknowledged by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) Receipt Acknowledgement Date: 10/26/2018-9:31:45 AM CDT-Time Source:server-IP address:209.194.29.100 P4 Document emailed to Julie A Geho oulie.geho@fortworthtexas.gov)for delivery 10/26/2018-9:31:46 AM CDT Document viewed by Julie A Geho Oulie.geho@fortworthtexas.gov) 10/26/2018-10:36:44 AM CDT-IP address:209.194.29.100 d Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date: 10/26/2018-10:36:57 AM CDT-Time Source:server-IP address:209.194.29.100 C Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 10/26/2018-10:36:58 AM CDT Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 10/29/2018-11:40:59 AM CDT-IP address:209.194.29.100 by Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:10/29/2018-1:09:24 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Colton Tollett(colton@dtutility.com),Zelalem Arega (Zelalem.Arega@fortworthtexas.gov), Julie A Geho Oulie.geho@fortworthtexas.gov), TPW Fiscal Staff (tpwcfafiscal@fortworthtexas.gov), and 7 more 10/29/2018-1:09:24 PM CDT FORTWORTH. Adobe Sign Green Sheet CPN 100539 Lasater Ranch Phase 2 Drainage - -- Adobe Sign Document History 10/29/2018 Created: 10/19/2018 w By: Etta Bacy(etta.bacy@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAAmuXTN13L1edVpfpu49YiXM7mCEcQ4b5_ "Green Sheet CPN 100539 Lasater Ranch Phase 2 Drainage" H istory Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 10/19/2018-12:44:18 PM CDT-IP address:209.194.29.100 -; Document emailed to Colton Tollett(Colton@dtutility.com)for signature 10/19/2018-12:50:53 PM CDT 5 Document viewed by Colton Tollett(colton@dtutility.com) 10/19/2018-3:44:28 PM CDT-IP address: 142.147.114.57 CO/ Colton Tollett(colton@dtutility.com) uploaded the following supporting documents: di File Attachment 1 (R/ File Attachment 2 10/19/2018-3:45:32 PM CDT CSS Document e-signed by Colton Tollett(colton@dtutility.com) Signature Date:10/19/2018-3:45:32 PM CDT-Time Source:server-IP address: 142.147.114.57 E'- Document emailed to Jarad Souders Qarad.souders@fortworthtexas.gov)for signature 10/19/2018-3:45:33 PM CDT 'D Document viewed by Jarad Souders Qarad.souders@fortworthtexas.gov) 10/22/2018-7:46:34 AM CDT-IP address:107.77.196.143 dQ Document e-signed by Jarad Souders Qarad.souders@fortworthtexas.gov) Signature Date:10/22/2018-7:48:09 AM CDT-Time Source:server-IP address:107.77.196.143 �-► Document emailed to William Mason (william.mason@fortworthtexas.gov)for approval 10/22/2018-7:48:10 AM CDT Adobe Sign Li Document viewed by William Mason (william.mason@fortworthtexas.gov) 10/22/2018-8:12:04 AM CDT-IP address:209.194.29.100 0'". Document approved by William Mason (william.mason@fortworthtexas.gov) Approval Date:10/23/2018-7:19:40 AM CDT-Time Source:server-IP address:209.194.29.100 17> Document emailed to G.Sahu, PM (gopal.sahu@fortworthtexas.gov)for signature 10/23/2018-7:19:41 AM CDT 5 Document viewed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) 10/23/2018-8:42:21 AM CDT-IP address:209.194.29.100 Document e-signed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) Signature Date:10/23/2018-8:43:18 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales oanie.morales@fortworthtexas.gov)for signature 10/23/2018-8:43:19 AM CDT `u Document viewed by Janie Scarlett Morales Oanie.morales@fortworthtexas.gov) 10/24/2018-10:08:46 AM CDT-IP address:209.194.29.100 Document e-signed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) Signature Date:10/24/2018-10:09:20 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/24/2018-10:09:21 AM CDT 5 Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/24/2018-10:14:32 AM CDT-IP address:209.194.29.100 be Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date: 10/24/2018-10:14:45 AM CDT-Time Source:server-IP address:209.194.29.100 r, Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/24/2018-10:14:46 AM CDT Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/25/2018-5:00:20 PM CDT-IP address:209.194.29.100 Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date: 10/25/2018-5:00:43 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Zelalem Arega (Zelalem.Arega@fortworthtexas.gov)for delivery 10/25/2018-5:00:44 PM CDT ` Document viewed by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) 10/26/2018-9:31:30 AM CDT-IP address:209.194.29.100 FoRTWORTH, ;•ameae�ev Adobe Sign Document receipt acknowledged by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) Receipt Acknowledgement Date: 10/26/2018-9:31:45 AM CDT-Time Source:server-IP address:209.194.29.100 L Document emailed to Julie A Geho oulie.geho@fortworthtexas.gov)for delivery 10/26/2018-9:31:46 AM CDT �i Document viewed by Julie A Geho oulie.geho@fortworthtexas.gov) 10/26/2018-10:36:44 AM CDT-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:10/26/2018-10:36:57 AM CDT-Time Source:server-IP address:209.194.29.100 ;> Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 10/26/2018-10:36:58 AM CDT �i Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 10/29/2018-11:40:59 AM CDT-IP address:209.194.29.100 Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:10/29/2018-1:09:24 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Colton Tollett(colton@dtutility.com), Zelalem Arega (Zelalem.Arega@fortworthtexas.gov), Julie A Geho Qulie.geho@fortworthtexas.gov), TPW Fiscal Staff (tpwcfafiscal@fortworthtexas.gov), and 7 more 10/29/2018-1:09:24 PM CDT u' FORT WORTH. Adobe Sign