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HomeMy WebLinkAboutContract 50305-FP2 City Secretary 5C�C5 -FP2 Contract No. FORTWORTH., Date Received Feb 6,2019 FE9 2019 /()(3 c��o�Fo��woazK cC1� p,ETPR� 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: Summer Creek Ranch Section XIII Phase C City Project No.: 100665 Improvement Type(s): ® Paving ❑ Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $242,805.50 Amount of Approved Change Order(s): $49,949.25 Revised Contract Amount: $292,754.75 Total Cost of Work Complete: $292,754.75 �bTa Feb 4,2019 Rop 7.wlcr r,r...,a,1014) Contractor Date AR/Project Coordinator Title Gilco Contracting,Inc. Company Name MattCam(Feb 4.20M Feb 4,2019 Project Inspector Date 5,,,;t, P,,;;eu<.,0Feb 5,2019 Project Manager Date _79&r �S4&Mt ti1v`alef Feb 5 2019 is 5carlett Nl—1,(Feb 5,2019) f CFA Manager Date 9,01— Feb 5 2019 un F�,,,nis:Feb;,2C p,- o Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH,TX Notice of Project Completion Project Name: Summer Creek Ranch Section XIII Phase C City Project No.: 100665 City's Attachments Final Pay Estimate Change Order(s): x❑ Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid ' Consent of Surety Statement of Contract Time Contract Time: 40 CD Days Charged: 193 Work Start Date: 7/16/2018 Work Complete Date: 01/24/2019 Page 2 of 2 City Project Numbers 100665 DOE Number 6650 Contract Name SUMMER CREEK RANCH SECTION XIII PHASE C Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 1/24/2019 Project Funding Project Manager NA City Secretary Contract Number 100665 Inspectors CORDOVA I CAIN Contract Date 6/12/2018 Contractor G1LCO CONTRACTING,INC. Contract Time 40 W 6331 SOUTHWEST BLVD. Days Charged to Date 193 W BENBROOK, TX 76132-1063 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 $292,754.75 Less %Retained $0.00 Net Earned $292,754.75 Earned This Period $292,754.75 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 $292,754.75 Thursday,January 31,2019 Page 4 of 4 FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name SUMMER CREEK RANCH SECTION XIII PHASE C Contract Limits Project Type PAVING City Project Numbers 100665 DOE Number 6650 Estimate Number 1 Payment Number 1 For Period Ending 1/24/2019 W City Secretary Contract Number 100665 Contract Time 4W Contract Date 6/12/2018 Days Charged to Date 193 Project Manager NA Contract is 100.00 Complete Contractor GILCO CONTRACTING,INC. 6331 SOUTHWEST BLVD. BENBROOK, TX 76132-1063 Inspectors CORDOVA / CAIN Thursday,January 31,2019 Page 1 of 4 City Project Numbers 100665 DOE Number 6650 Contract Name SUMMER CREEK RANCH SECTION XIII PHASE C Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 1/24/2019 Project Funding UNrf IV:PAVING IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 2 6"LIME TREATMENT(CO#1) 6145 SY $3.45 $21,200.25 6145 $21,200.25 3 6'CONC PVMT(CO#1) 5760 SY $38.25 $220,320.00 5760 $220,320.00 4 4"CONC SIDEWALK(CO#6,#7) 1198 SY $5.25 $6,289.50 1198 $6,289.50 5 BARRIER FREE RAMP TYPE R-I 2 EA $1,950.00 $3,900.00 2 $3,900.00 6 BARRIER FREE RAMP TYPE M-2 2 EA $1,900.00 $3,800.00 2 $3,800.00 7 BARRIER FREE RAMP TYPE P-1 2 EA $1,750.00 $3,500.00 2 $3,500.00 8 FURNISH/INSTALL ALUM SIGN GROUND 16 EA $100.00 $1,600.00 16 $1,600.00 MOUNT CITY STD.STREET NAME BLADES 9 FURNISH/INSTALL ALUM SIGN GROUND 2 EA $100.00 $200.00 2 $200.00 MOUNT CITY MOUNT CITY STD-STOP SIX 10 FURNISH/INSTALL ALUM SIGN GROUND 8 EA $225.00 $1,800.00 8 $1,800.00 MOUNT CITY STD TRAFFIC SIGNS 11 PAYMENT,PERFORMANCE,AND 1 EA $4,300.00 $4,300.00 1 $4,300.00 MAINTENANCE BONDS(CO 42) 12 HYDRATED LIME(31 LB/SY)CO 43 96 15 $155.00 $14,880.00 96 $14,880.00 13 TYPE III BARRICADE(CO#4) 62 EA $50.00 $3,100.00 62 $3,100.00 14 CONSTRUCTION ENTRACE(CO#4) 1 EA $1,500.00 $1,500.00 1 $1,500.00 15 6"XI"RETAINING WALL(CO#7)(CO#8) 87 LF $45.00 $3,915.00 87 $3,915.00 16 MOVE IN(CO#7) 1 EA $500.00 $500.00 1 $500.00 17 REMOVE&REPLACE RAMP(CO#8) 1 LS $1,950.00 $1,950.00 1 $1,950.00 Sub-Total of Previous Unit $292,754.75 $292,754.75 Thursday,January 31,2019 Page 2 of 4 City Project Numbers 100665 DOE Number 6650 Contract Name SUMMER CREEK RANCH SECTION XIII PHASE C Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 1/24/2019 Project Funding Contract Information Summary Original Contract Amount $242,805.50 Change Orders Change Order Number 1 $31,008.50 Change Order Number 2 $4,300.00 Change Order Number 3 ($2,325.00) Change Order Number 4 $4,600.00 Change Order Number 6 $3,375.75 Change Order Number 7 $4,025.00 Change Order Number 8 $4,965.00 Total Contract Price $292,754.75 Total Cost of Work Completed $292,754.75 Less %Retained $0.00 Net Earned $292,754.75 Earned This Period $292,754.75 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 $292,754.75 Thursday,January 31,2019 Page 3 of 4 0 m 0 � x x Z O C�C � C1 o <_ o z m -i (f) r m y 0 -_� -ri O ;C1 O -D m m > z 0 o � o � � -i mm 4t rn m -o -i m r" < < 0 ° 0 0 0 -ni -q rn rn O -ni rn n a m -zi o D z TJ �] 'l7 m -I Z < v m v 0 D m m y •• O O n D cn m o > z m m -� � v 0 c z � m D n n m -� � -I � y O cn O y n z m X D O n � � -� O c 0 z -a v n v cn cncn CD �Go ERo (C) o z o o D C cn < rn rn D o rt mN o o rn C 0 w w w o ;14 -' O ' Z NCD 0 o N O O W O m , {H W 07 63 J Cfl O O O O on ojo W W �1 w m -) 0 O O m p W, (f� v n oo < 0 0 m 0 o n � ° m rn r o a o m m cn cn n O c o o = m n v CO y < co W n D w w w 0 0 0 CC C (D O D ,p w o 0 o m X .p p CD wm C) = m C) 0 0 O O _ o 'o c� CD cD -p � 0 0 ° o o m O 0C— m mo ^ N {fl N N o ( l^) W N N N C) D w o o vo coO -1 N � Ul ol z O D W o 0 0 o DO � w < n o0 00 ' m o, g o o - c O Z N W 0 0 0 Z �J v coo 000 CD O v cn cn cn ' m o O o 0 -09 0 0 0 v U o 0 0 CD Z c D O c m _ 0 0 < mm D CD 0 0 0 z o m 0 o 1 1 1 1 1 1n v [ - % \ ) 7 . k �\ 7 t!t! j\ } § m . . m- GO / 2 cn \ CD . m! -4 a /( \ 0En ( j) \ m\%)\ , 0 \ ) rn ) _ oa G a / }) ( mm $ ¢ .OID ( mm Gq � 9 ELn D 0 \�}/ \ m \m%») \ ) z q / \ 7 § } \ \ { � k a � § \ 61(n_c ) § § « / §\/§G _69 e§}$4] $\)\\� � m > O 0 x 0 -0 Z m CA * 0 C) () C) T 0 <_ O z m -� 77 Cf) r- m y O -t -n O �J D cn c -1 o 0 -0 m —I m -< D z 0 o � oz � � wD mn ItmmmIt m r < < O O o '0 O CI C-- ;u m -v m z O y D z '0 m —I z < Cl M y O D m m D .. 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( k ] k ¥ k i ( m 2 � E E m §E 7 ) ( I G &n f %\) m k / $ m U2 to mmo ( o z« \ o /( �7 ® a ;§ F i /$ e z » a Q§ ] / § q 2 n E m � \ \ 2:0 » m \ § m k ¥ )§ & 'x F ] m [(ten ] _ »[■ - #�z R 9 k j # § E 2 0 \ } k k \ 0 k . . 0 § 69 6q 69 � c \ �k t\ $ kseQ ; i ----� } . \�§\� ` ) k � \ � } 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, AR/ 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 frill; That there are no claims pending for personal injury and/or property damages; On Contract described as; Paving Improvements to serve: Summer Creek Ranch, Section 13C U BY: Rob Taylor Subscribed and sworn before me on this 23rd of January , 2019. Cry ID CANALES 6529 / - Notary ID J�131652946 My Commission Expires FOr�f July 24. 2022 Notary Public 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 022220214 PROJECT: (name, address)Summer Creek Ranch 13C Fort Worth. TX TO (Owner) FORESTAR(USA)REAL ESTATE GROUP, INC.AND—] ARCHITECT'S PROJECT NO: CITY OF FORT WORTH CONTRACT FOR: Building Two,Suite 500 Summer Creek Ranch Section 13C-Paving Improvements Austin TX 78746 —J 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) FORESTAR (USA) REAL ESTATE GROUP, INC. AND CITY OF FORT WORTH Building Two, Suite 500 Austin TX 78746 , OWNER, as set forth in the said Surety Company's bond. IN WITNESS,WHEREOF, the Surety Company has hereunto set its hand this 23rd day of January, 2019 LIBERTY MUTUAL INSURANCE COMPANY Surety Company 1 Attest:Tina McEwan &". (Seal): Signature of Authorized Representative Soohinie 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 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. Liberly Liberty Mutual Insurance Company u.tuAl. The Ohio Casualty Insurance Company Certificate No: 8200274 West American Insurance Company SURETY 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, Rpbbi Morales,Don E.Cornell,Sophinie Hunter,Tina McEwan,Ricardo J.Reyna,Joshua Saunders,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 surety 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. 1 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 11th day of January , 2019 Liberty Mutual Insurance Company INS(I �q`I INsuA tNsuR The Ohio Casualty Insurance Company J=4oRPORgro2o� U��`oAPORgT�Py2� �P2oaP0 Rgr1P West American Insurance Company 1912 0 1919 1991 U) + yph1 > D !.49) y' N David M.Carey,Assistant Secretary State of PENNSYLVANIA = a :3County of MONTGOMERY ss v a) On this 11th day of January 2019 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o o Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes—C/) a) > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. w 3 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, n o ao c) 00 N � N,ONyy�T16. COMMONWEALTH OF PENNSYLVANIA Q >_ 4✓ u`�' q<r �' Notarial Seal 60 v or Teresa Paslelia,Notary Public 6 OUpper Merton Twp.,Montgomery County By: C (13 My Commission Expires March 28,2021 Teresa Pastella,Notary Public p E ' "S?r� p �,}� Member,Pennsylvania Association of Notaries O FN N O C(u 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 o.a Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: O 2 ARTICLE IV-OFFICERS:Section 12,Power of Attorney, �2 o Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the 7,_Q -a >, President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety >o Cany and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall N L 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 executed, such CO 15 Z 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 the E M 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. o 0 ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. o Co Any officer of the Company authorized for that purpose in writing by the chairman or the president,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,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their 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. 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- 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. 1,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 23rd day of January 2019 0-­q 'it�tP R'Pr'O♦tPORq�.O y� \CjP�OµPORq O2C� F ? F 2 F 1912 0 1919 0 1991 y � o a By: �d SSgcH�s��da y° YAMpSJa� �q '"0100" as Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi CO 062018 �- LibertX utug. SURETY I TEXAS TEXAS IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para someter una quej a: You may call toll-free for information or to Usted puede llamar 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 19406-2755 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 quej as al 1-800-252-3439 You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros Consumer Protection(111-1A) de Texas Consumer Protection(111-1A) P. O. Box 149091 P. O. Box 149091 Austin, TX 78714-9091 Austin,TX 78714-9091 FAX: (512) 490-1007 FAX 4 (512) 490-1007 Web: http://www.tdi.texas.gov Web: http://www.tdi.texas.gov E-mail: ConsumerProtection cgtdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O 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 agente o 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. I ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA: i POLICY: This notice is for information only and does not Este aviso es solo para proposito de informacion oeccrrite a part-ai carrarcrori v7 rri--�.,rrucr�ca—�r�o—�.;�-vry-��rr��.,p����—�v�,:«�a,,.r–�� document. documento adjunto. NP 70 68 09 01 LMS-15292 10115 -_ - Green Sheet CPN 100665 Summer Creek Ranch Section XIII Phase C - Paving -- — - --- - Adobe Sign Document History 02/06/2019 Created: 02/01/2019 w By: Etta Bacy(etta.bacy@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAA4VvJ6zkhd2xT-zfLKAL8k7oKfAd1 KRAk "Green Sheet CPN 100665 Summer Creek Ranch Section XIII P hase C - Paving" History L Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 02/01/2019-2:45:14 PM CST-IP address:209.194.29.100 E-4, Document emailed to Rob Taylor(rob@gilcocontracting.com)for signature 02/01/2019-2:49:07 PM CST CZ Email sent to Rob Taylor(rob@gilcocontracting.com) bounced and could not be delivered 02/01/2019-8:51:32 PM CST Document viewed by Rob Taylor(rob@gilcocontracting.com) 02/04/2019-8:09:47 AM CST-IP address: 12.246.109.114 v Rob Taylor(rob@gilcocontracting.com) uploaded the following supporting documents: File Attachment 1 G File Attachment 2 02/04/2019-8:11:29 AM CST Document e-signed by Rob Taylor(rob@gilcocontracting.com) Signature Date:02/04/2019-8:11:29 AM CST-Time Source:server-IP address: 12.246.109.114 . Document emailed to Matt Cain (mcain@multatech.com)for signature 02/04/2019-8:11:30 AM CST �? Document viewed by Matt Cain (mcain@multatech.com) 02/04/2019-2:57:09 PM CST-IP address:99.61.186.115 6� Document e-signed by Matt Cain (mcain@multatech.com) Signature Date:02/04/2019-2:57:57 PM CST-Time Source:server-IP address:99.61.186.115 FoR �y Adok sign :. Document emailed to Edward D'avila (edward.davila@fortworthtexas.gov)for approval 02/04/2019-2:57:58 PM CST `� Document viewed by Edward D'avila (edward.davila@fortworthtexas.gov) 02/05/2019-3:55:59 PM CST-IP address:209.194.29.100 Document approved by Edward D'avila (edward.davila@fortworthtexas.gov) Approval Date:02/05/2019-3:56:58 PM CST-Time Source:server-IP address:209.194.29.100 E-4Document emailed to G.SAHU, PM (gopal.sahu@fortworthtexas.gov)for signature 02/05/2019-3:57:10 PM CST ` ! Document viewed by G.SAHU, PM (gopal.sahu@fortworthtexas.gov) V 02/05/2019-4:05:14 PM CST-IP address:209.194.29.100 v` Document e-signed by G.SAHU, PM (gopal.sahu@fortworthtexas.gov) I Signature Date:02/05/2019-4:05:34 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales Qanie.morales@fortworthtexas.gov)for signature 02/05/2019-4:05:35 PM CST Document viewed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) 02/05/2019-4:07:10 PM CST-IP address:209.194.29.100 Document e-signed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) Signature Date:02/05/2019-4:07:50 PM CST-Time Source:server-IP address:209.194.29.100 E-',> Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 02/05/2019-4:07:52 PM CST Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 02/05/2019-4:14:39 PM CST-IP address:209.194.29.100 da Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:02/05/2019-4:15:14 PM CST-Time Source:server-IP address:209.194.29.100 C'y Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 02/05/2019-4:15:16 PM CST Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 02/06/2019-8:25:46 AM CST-IP address:209.194.29.100 6o Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:02/06/2019-8:27:17 AM CST-Time Source:server-IP address:209.194.29.100 �-► Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 02/06/2019-8:27:19 AM CST FORT WORTH. Adobe Sign L_; Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 02/06/2019-8:27:51 AM CST-IP address:209.194.29.100 4. Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:02/06/2019-8:28:33 AM CST-Time Source:server-IP address:209.194.29.100 :- Document emailed to Julie A Geho oulie.geho@fortworthtexas.gov)for delivery 02/06/2019-8:28:34 AM CST Document viewed by Julie A Geho Oulie.geho@fortworthtexas.gov) 02/06/2019-8:50:52 AM CST-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:02/06/2019-8:51:09 AM CST-Time Source:server-IP address:209.194.29.100 Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 02/06/2019-8:51:11 AM CST `Li Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 02/06/2019-9:42:24 AM CST-IP address:209.194.29.100 Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:02/06/2019-2:24:10 PM CST-Time Source:server-IP address:209.194.29.100 Signed document emailed to Matt Cain (mcain@multatech.com), Janie Scarlett Morales (Janie.morales@fortworthtexas.gov), Julie A Geho Qulie.geho@fortworthtexas.gov), Allison Tidwell (cso_finaipay@fortworthtexas.gov), and 7 more 02/06/2019-2:24:10 PM CST FORT WORTH, ` � Adobe Sign