Loading...
HomeMy WebLinkAboutContract 50034-FP2 City Secretary 50034 -FP2 Contract No. FORTWORTH, Date Received Oct 19,2018 / 0/ 07 ' 1 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: FOSSIL CREEK PHASE I City Project No.: 101077 Improvement Type(s): ® Paving ® Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $713,718.67 Amount of Approved Change Order(s): $3,532.41 Revised Contract Amount: $717,251.08 Total Cost of Work Complete: $717,251.08 Aym Tam Oct 16, 2018 Rob Taylor( � 16,2013) Contractor Date Project Coordinator/AR Title Gilco Contracting Company Name Gor,-Ze-Pch' Oct 18, 2018 Louie Pitts(Oct 18,20;: Project Inspector Date y2y % � Vcror V.T--J-.Oct 19,2018) Oct 19, 2018 Project Manager Date ,7,1#/e, 44V attX10tal, Oct 19 2018 Janie Scarlett Morales(Oct 19,2018) CFA Manager Date sw.4.,z,.aZu%4r- Oct 19 2018 Susan Alanis(0.t 19,2018) 7 Asst. City Manager Date RECORD Page 1 of 2 C3'r,f SECRETARY FT `ir`ORTH,TX Notice of Project Completion Project Name: FOSSIL CREEK PHASE I City Project No.: 101077 City's Attachments Final Pay Estimate II Change Order(s): © Yes ❑ N/A I Contractor's Attachments II Affidavit of Bills Paid Consent of Surety Statement of Contract Time I Contract Time: 180 CD Days Charged: 240 q Work Start Date: 2/14/2018 Work Complete Date: 10/11/2018 I I I i i I i I I I I t I I I i 0 1 Page 2of2 f I ,4 City Project Numbers 101077 DOE Number 1077 Contract Name FOSSA.CREEK PHASE I Estimate Number I Contract Limits Payment Number 1 Project Type DRAINAGE&PAVING For Period Ending 10/15/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / CHAMBERS Contract Date 1/4/2018 Contractor GILCO CONTRACTING,INC. Contract Time 180 CD 6331 SOUTHWEST BLVD. Days Charged to Date 240 CD BENBROOK, TX 76132-1063 Contract is .000000 Complete N CITY OF FORT WORTH SUMMARY OF CHARGES I� Line Fund Account Center Amount Gross Retainage Net I ------------ Funded------ f 1 Total Cost of Work Completed $717,251.08 Less %Retained $0.00 j Net Earned $717,251.08 Earned This Period $717,251.08 j Retainage This Period $0.00 Ia Less Liquidated Damages it t 0 Days @ $0.00 /Day $0.00 LessPavement Deficiency $0.00 Less Penalty $0.00 j Less Previous Payment $0.00 ! Plus Material on Hand Less 15% $0.00 Balance Due This Payment $717,251.08 i Monday,October 15,2018 Page 5 of 5 r FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name FOSSIL CREEK PHASE 1 Contract Limits Project Type DRAINAGE&PAVING City Project Numbers 101077 DOE Number 1077 IryJ Estimate Number I Payment Number I For Period Ending 10/15,2018 CD City Secretary Contract Number Contract Time 1X1) Contract Date 1/4/2018 Days Charged to Date 240 Project Manager NA Contract is 100.00 Complete Contractor GILCO CONTRACTING,INC. 6331 SOUTHWEST BLVD. BENBROOK, TX 76132-1063 Inspectors DICKINSON / CHAMBERS i i 1 i Monday,October 15,2018 Page I of 5 1 4 City Project Numbers 101077 DOE Number 1077 Contract Name FOSSIL CREEK PHASE 1 Estimate Number 1 Contract Limits Payment Number 1 Project Type DRAINAGE&PAVING For Period Ending 10/15/2018 Project Funding UNIT III:DRAINAGE RMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total - - — - - - -- - --------------------------- t I O'CURB INLET 10 EA $3,600.00 $36,000.00 10 $36,000.00 2 15'CURB INLET 2 EA $4,900.00 $9,800.00 2 $9,800.00 3 4'STORM JUNCTION BOX 6 EA $4,100.00 $24,600.00 6 $24,600.00 4 21"CLASS III RCP 279 LF $57.20 $15,958.80 279 $15,958.80 5 24"CLASS III RCP 483 LF $68.46 $33,066.18 483 $33,066.18 6 27"CLASS 111 RCP 32 LF $82.03 $2,624.96 32 $2,624.96 7 30"CLASS III RCP 125 LF $88.40 $11,050.00 125 $11,050.00 8 33"CLASS III RCP 173 LF $100.83 $17,443.59 173 $17,443.59 9 TRENCH SAFETY 1092 LF $0.52 $567.84 1092 $567.84 10 REMOVE 4'DROP INLET 2 EA $1,100.00 $2,200.00 2 $2,200.00 11 REMOVE 5'DROP INLET 1 EA $1,200.00 $1,200.00 1 $1,200.00 12 CONNECT TO EXISTING 24"RCP 1 EA $100.00 $100.00 1 $100.00 13 CONNECT TO EXISTING 30"RCP 1 EA $100.00 $100.00 1 $100.00 14 CONNECT TO EXISTING 36"RCP I EA $150.00 $150.00 1 $150.00 15 REMOVE 24"STORM LINE 9 LF $25.00 $225.00 9 $225.00 I6 REMOVE 36"STORM LINE 2 LF $50.00 $100.00 2 $100.00 17 CONCRETE COLLAR 3 EA $600.00 $1,800.00 3 $1,800.00 Sub-Total of Previous Unit $156,986.37 $156,986.37 UNIT IV:PAVING IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total - ------------------------------------------ 1 6"CONCRETE PAVEMENT(RESIDENTIAL) 11291 SY $33.30 $375,990.30 11291 $375,990.30 2 6"LIME TREATMENT 12019 SY $2.75 $33,052.25 12019 $33,052.25 3 HYDRATED LIME @ 30LBS./S.Y. 180 TN $155.00 $27,900.00 180 $27,900.00 (RESIDENTIAL) 4 SAW CUT EX.CONCRETE PAVEMENT 207 LF $10.00 $2,070.00 207 $2,070.00 5 CONNECT TO EX.CONCRETE PAVMENT 207 LF $8.00 $1,656.00 207 $1,656.00 6 BARRIER FREE RAMP,TYPE M-2 5 EA $2,000.00 $10,000.00 5 $10,000.00 7 BARRIER FREE RAMP,TYPE P-1 11 EA $1,700.00 $18,700.00 11 $18,700.00 8 BARRIER FREE RAMP,TYPE R-1 9 EA $2,000.00 $18,000.00 9 $18,000.00 Monday,October 15,2018 Page 2 of 5 City Project Numbers 101077 DOE Number 1077 Contract Name FOSSIL CREEK PHASE 1 Estimate Number 1 Contract Limits Payment Number I Project Type DRAINAGE&PAVING For Period Ending 10/15/2018 Project Funding 9 S CONC SIDEWALK 2545 LF $23.75 $60,443.75 2545 $60,443.75 10 FURNISIVINSTALL ALUM SIGN GROUND 66 EA $120.00 $7,920.00 66 $7,920.00 MOUNT CITY STD. 11 TRAFFIC CONTROL 1 MO $1,000.00 $1,000.00 1 $1,000.00 12 SOD CO#1 1 LS $3,532.41 $3,532.41 1 $3,532.41 ------------------------------------------ Sub-Total of Previous Unit $560,264.71 $560,264.71 --------------------------------------- Monday,October 15,2018 Page 3 of 5 f City Project Numbers 101077 DOE Number 1077 Contract Name FOSSIL CREEK PHASE I Estimate Number I Contract Limits Payment Number 1 Project Type DRAINAGE&PAVING For Period Ending 10/15/2018 Project Funding Contract Information Summary Original Contract Amount $713,718.67 Change Orders Change Order Number 1 $3,532.41 Total Contract Price $717,251.08 Total Cost ofWork Completed $717,251.08 Less %Retained $0.00 Net Earned $717,251.08 Earned This Period $717,251.08 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 $717,251.08 Monday,October 15,2018 Page 4 of 5 N Y c o < O � m g m y 0 m 0 �] m z -�-i Z `O m -� m D z O f C m O O -Oi -i 0 r O o I 0O C? < o v o D Ap o ,zr 5 � 0O 0O f`il -i Z m A A 0 O .� -i m � Z m m ny z Z y n m 1 D n C7 4k m O rn z n O z nr m n a � 1 O O C mm 2 1 O 09 ry <n w N o x o D N G V in V V ^p O O O �9 N y o 0 0 o v A ID 0 0 N V rn w _ V O O OC O O !D T 1 m n r N 0 4 m =r0 Ul N C tn. L1 to V O O O "O O O r 3 y O b b p p n<0 0 0 o 0). T m N w n mco 7 N o m O O O W v N N o N N v y IV O� V V J N N A co in < 7 V N M _0 -u - O H .n M = 3 Q 0 0 n N [D � d1 0 0 D5 O N d A N N r o V i c j4 0 s Z XDV N < D [o Co y Vto m (9 0: o a cD CO 0 V OD m co W CAD C) O l n0 O O c {p� J N IT m ii O � m o m m O � Z m y 0 z _a n o � +n N N o a o o io m m V N n � 0 o� �D n v 1 w w m �I i 1 * m ± \ § 3 \ CD G 2 / ( 'co \ ^ mmo \ ° ( \ �©� / ;0 ( m. R \ § \ §§] k i §§§ � % � ■A \ 0 } n ¥ co E 22 2 w z } 2 2 A § mm2 \ m$q \ 7 §%� m ) (2 ) 3 _ $ \ a/ ® mm \ } a < 2m » 0 § 22 ) § «q O.q �) . k \ 0 ) ^ 7 k m � � \ § § m a Q o m , ; k } { � § o $; z � aaa � §&# J �� } AFFIDAVIT 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 Rob Taylor,Project Coordinator of Gilco Contracting, 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 frill; 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; Paving Improvements to serve: Fossil Creek ,Phase 1 G 7 BY: R b Taylor Subscribed and sworn before me on this 13th of September ,2018. E SILIA CANALES ry ID 71131652996 Notary Public ommission Expires July 24,Z022 Tarrant County,TX CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ Conforms with the American Institute of OTHER Architects,AIA Document G707 Bond No 022059373 PROJECT: (name, address)Fossil Creek Phase 1 Fort Worth TX TO (Owner) PULTE HOMES OF TEXAS,L.P.AND CITY OF FORT? ARCHITECT'S PROJECT NO: WORTH CONTRACT FOR: 4800 Regent Blvd. Suite 100 Fossil Creek Phase 1 -Water,Sanitary Sewer, Drainage,Paving and Street Lighting Improvements Irving TX 75063 CONTRACT DATE: CONTRACTOR:GILCO CONTRACTING, 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) LIBERTY MUTUAL INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of (here insert name and address of Contractor) GILCO CONTRACTING, INC. 6331 Southwest Boulevard Benbrook TX 76132 , 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) PULTE HOMES OF TEXAS, L.P.AND CITY OF FORT WORTH 4800 Regent Blvd. Suite 100 Irving TX 75063 , OWNER, as set forth in the said Surety Company's bond. IN WITNESS,WHEREOF, the Surety Company has hereunto set its hand this 13th day of September, 2018 LIBERTY MUTUAL INSURANCE COMPANY Su Company Attest:Robbi Morales Z" (Seal): Signa re of Authorized Representative Sophinie Hunter 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 THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND. This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No.8138449 Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Robbi Morales;Don E.Cornell;Sophinie Hunter;V.DeLene Marshall;Tina McEwan•Ricardo J Reyna;Kelly A Westbrook all of the city of Dallas state of TX each individually if there be more than one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surely obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 26th day of June 2018 R5 , �q;InlSr�r .,�•Iws,;�,� �,;.Vrasi;n,2,. � r ,>. The Ohio Casualty Insurance Company rn /03') ^� 1912 L ° 1( 9Q1 }'_ Liberty Mutual Insurance Company ami I•a la, West American Insurance Company By: .. STATE OF PENNSYLVANIA ss David M.Carey,'Assistant Secretary Ca COUNTY OF MONTGOMERY d On lilts 26th day of June 2018,before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance U 1— v N Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,tieing authorized so to do,execute the foregoing instrument for the purposes >,W 0 therein contained by signing on behalf of the corporations by himself as a duly authorized officer. cc a;> IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. O CL d cc �yP PASTS COMMONWEALTH OF PENNSYLVANIA Q M a Q W n tvpq Notarial Seal ���/�/� .N - v ! Teresa Paslella,Notary Public BY 1 pi °F Upper MenonTwp.,Montgomery County Teresa Pastella,Notary Public My commission Expires March 28,202160 3 n7 ti�A gv Member.Penrisyhrann Association of Notaries a0 E O C This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual ,N p NInsurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: 5 to ARTICLE IV-OFFICERS-Section 12.Power of Attorney.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject O r- t: t:;; to such limitation as the Chairman or the President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, y o S acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attomeys-in-fact,subject to the limitations set forth in their respective 3 E a powers of attorney,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so d o executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under >'0 .0 >1 the provisions of this article may be revoked at any time.by the Board,the Chairman,the President or by the officer or officers granting such power or authority. q C ARTICLE XIII-Execution of Contracts-SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, o? and subject to such limitations as the chairman or the president may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Company to make,execute, L rNn o seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their oo Z respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. o Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- F- r fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this ✓'- day of 20 . .;,Dar"'.'.I a 1919 ^ > 1912 1991 v By:— :. Renee C.Llevrelssistant Secretary O 160 of 300 LMS 12873 022017 Lib erty Mutual. SURETY TEXAS TEXAS IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para someter una queja: You may call toll-free for information or to Usted puede Ilamar al numero de telefono gratis make a complaint at para informacion o para someter una queja al 1-877-751-2640 1-877-751-2640 You may also write to: Usted tambien puede escribir a: 2200 Renaissance Blvd., Ste. 400 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 1.9406-2755 King of Prussia, PA 19406-2755 You may contact the Texas Department of Puede comunicarse con el Departamento de Insurance to obtain information on companies, Seguros de Texas para obtener informacion coverages, rights or complaints at acerca de companias, coberturas, derechos o 1-800-252-3439 quejas al 1-800-252-3439 You may write the Texas Department of Insurance Puede eseribir mearta entotion (dl l 1--1A)os Consumer Protection (111-1A) de Texas Consur P. 0. Box 149091 P. 0. Box 149091 Austin, TX 78714-9091 Austin, TX 78714-9091 FAX: (512) 490-1007 FAX#(512) 490-1007 Web: httl2://www.tdi.texas-gov Web: http://www tdi texas.gov E-mail: ConsumerProtectionna tdi.texas.�ov E-mail: ConsumerProteetion(a?tdi texas.gov PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS 0 RECLAMOS: Should you have a dispute concerning your Si tiena una disputa concerniente a su prima o a premium or about a claim you should first un reclamo, debe comunicarse con el agen contact the agent or call 1-800-843-6446. primero. Si no se resuelve la disputa, puede If the dispute is not resolved, you may contact the entonces comunicarse con el departamento (TDI) Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA: POLICY: � d does not Este aviso es solo para proposito de informacion This notice is for information only an become a part or condition of the attached documenno e onvie oe en parte o condicion del adj document. NP 70 68 09 01 LMS-15292 10115 F� � =---- Greensheet for Fossil Creek Phase I CPN#101077 SDP Adobe Sign Document History 10/29/2018 — --------- Created: 10/15/2018 By: Shameka.Kennedy@fortworthtexas.gov Status: Signed Transaction ID: CBJCHBCAABAAcZvKCgadSKOaln1imQJcv0ilDpMpJiU8 "Greensheet for Fossil Creek Phase I CPN#101077 SDP" Histor Y Document created by Shameka.Kennedy@fortworthtexas.gov 10/15/2018-3:19:28 PM CDT-IP address:209.194.29.100 . Document emailed to Rob Taylor adt@gilcocontracting.com)for signature 10/15/2018-3:23:26 PM CDT Document viewed by Rob Taylor adt@gilcocontracting.com) 10/15/2018-4:16:34 PM CDT-IP address: 107.77.199.98 �i Rob Taylor Qdt@gilcocontracting.com) uploaded the following supporting documents: File Attachment 1 File Attachment 2 10/16/2018-8:51:37 AM CDT ba Document e-signed by Rob Taylor Qdt@gilcocontracting.com) Signature Date:10/16/2018-8:51:37 AM CDT-Time Source:server-IP address:12.246.109.114 C'-► Document emailed to Lorrie Pitts (lorrie.pitts@fortworthtexas.gov)for signature 10/16/2018-8:51:38 AM CDT Document viewed by Lorrie Pitts (lorrie.pitts@fortworthtexas.gov) 10/16/2018-11:46:38 AM CDT-IP address: 107.77.197.6 Document viewed by Lorrie Pitts (lorrie.pitts@fortworthtexas.gov) 10/18/2018-9:29:27 AM CDT-IP address:209.194.29.100 6a Document e-signed by Lorrie Pitts (lorrie.pitts@fortworthtexas.gov) Signature Date:10/18/2018-9:29:50 AM CDT-Time Source:server-IP address:209.194.29.100 FORT WORTH. ` � Adobe sig, Cr Document emailed to Michael Glover(michael.glover@fortworthtexas.gov)for approval 10/18/2018-9:29:51 AM CDT Document viewed by Michael Glover(michael.glover@fortworthtexas.gov) 10/18/2018-1:56:59 PM CDT-IP address:209.194.29.100 1 Document approved by Michael Glover(michael.glover@fortworthtexas.gov) Approval Date: 10/18/2018-1:57:50 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Victor V. Tornero Jr. (victor.tornero@fortworthtexas.gov)for signature 10/18/2018-1:57:51 PM CDT Document viewed by Victor V. Tornero Jr. (victor.tornero@fortworthtexas.gov) 10/18/2018-2:06:22 PM CDT-IP address:209.194.29.100 t Document e-signed by Victor V. Tornero Jr. (victor.tornero@fortworthtexas.gov) Signature Date:10/19/2018-8:43:07 AM CDT-Time Source:server-IP address:209.194.29.100 C Document emailed to Janie Scarlett Morales (Janie.morales@fortworthtexas.gov)for signature 10/19/2018-8:43:08 AM CDT Document viewed by Janie Scarlett Morales oanie.morales@fortworthtexas.gov) 10/19/2018-8:46:44 AM CDT-IP address:209.194.29.100 be Document e-signed by Janie Scarlett Morales Oanie.morales@fortworthtexas.gov) Signature Date:10/19/2018-8:50:55 AM CDT-Time Source:server-IP address:209.194.29.100 > Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/19/2018-8:50:56 AM CDT Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/19/2018-12:22:55 PM CDT-IP address:209.194.29.100 6o Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:10/19/2018-12:23:13 PM CDT-Time Source:server-IP address:209.194.29.100 C. Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/19/2018-12:23:14 PM CDT iJ Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/19/2018-12:32:27 PM CDT-IP address:209.194.29.100 dQ, Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:10/19/2018-12:32:42 PM CDT-Time Source:server-IP address:209.194.29.100 C� Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 10/19/2018-12:32:43 PM CDT FORTWORTH. Adobe Sigi Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 10/29/2018-7:55:05 AM CDT-IP address:209.194.29.100 q %u. Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:10/29/2018-7:55:25 AM CDT-Time Source:server-IP address:209.194.29.100 C; Document emailed to Julie A Geho oulie.geho@fortworthtexas.gov)for delivery 10/29/2018-7:55:26 AM CDT Document viewed by Julie A Geho Qulie.geho@fortworthtexas.gov) 10/29/2018-8:02:30 AM CDT-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho Qulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date: 10/29/2018-8:02:45 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 10/29/2018-8:02:46 AM CDT Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 10/29/2018-12:56:18 PM CDT-IP address:209.194.29.100 c. Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:10/29/2018-12:56:36 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Shameka.Kennedy@fortworthtexas.gov, Janie Scarlett Morales (Janie.morales@fortworthtexas.gov),Allison Tidwell (cso_finalpay@fortworthtexas.gov), Susan Alanis (susan.aianis@fortworthtexas.gov), and 7 more 10/29/2018-12:56:36 PM CDT FORT WORTH. Adobe Sign