HomeMy WebLinkAboutContract 48582-FP1 City Secretary 48582 -FP1
Contract No.
RECEIVED FORT WORTH..) Date Received Nov 4,2019
NOV -42019
CITYOFFdRTWCRTH
C'TYSECRETARY
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: BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD
City Project No.: 02621
Improvement Type(s): ® Paving ® Drainage 0 Street Lights ❑ Traffic Signals
Original Contract Price: $2,970,036.11
Amount of Approved Change Order(s): $185,973.70
Revised Contract Amount: $3,156,009.78
Less Previous Payment $1,216,698.67
Total Cost of Work Complete: $1,939,311.11
Sam Davis(Oct 25,2019) Oct 25,2019
Contractor Date
President
Title
JLB Contracting,LLC
Company Name
Joe r- Oct 25,2019
Project Inspector Date
Oal Taafari
Khal Jaafari(Oct 29,2019, Oct 29,2019
P ject Mana er Date
J e Scarlett Morale,(Oct 30,2019) Oct 30,2019
CFA Manag r Date
Dana Burghdoff(N 1,2019) Nov 1,2019
Asst. City Manager Date
OFFICIAL RECORD Page 1 of 2
CITY SECRETARY
FT WORTH,TX
Notice of Project Completion
Project Name: BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD
City Project No.: 02621
City's Attachments
Final Pay Estimate ❑x
Change Order(s): x❑ Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid .
Consent of Surety
Statement of Contract Time
Contract Time: 325 CD Days Charged: 1069
Work Start Date: 5/16/2016 Work Complete Date: 4/25/2019
Page 2 of 2
FORTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD
Contract Limits
Project Type DRAINAGE,PAVING&ST LIGHT
City Project Numbers 02621
DOE Number 7481
Estimate Number 4 Payment Number 4 For Period Ending 9/26/2019
CD
City Secretary Contract Number 117481 Contract Time 326:1)
Contract Date Days Charged to Date 1069
Project Manager Buckley Contract is 100.00 Complete
Contractor JLB CONTRACTING,L.L.C.
PO BOX 24131
FORT WORTH, TX 76124-1131
Inspectors LAYER/ GRINDSTAFF
Monday,October 21,2019 Page 1 of 8
City Project Numbers 02621 DOE Number 7481
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD Estimate Number 4
Contract Limits Payment Number 4
Project Type DRAINAGE,PAVING&ST LIGHT For Period Ending 9/26/2019
Project Funding
DRAINAGE
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
-----------------------------
1 REMOVE 15"STORM LINE 41 LF $10.85 $444.85 41 $444.85
2 REMOVE 18"STORM LINE 24 LF $13.00 $312.00 24 $312.00
3 REMOVE 27"STORM LINE 56 LF $16.00 $896.00 56 $896.00
4 REMOVE HEADWALL/SET 3 EA $435.00 $1,305.00 3 $1,305.00
5 TRENCH SAFETY 3115 LF $1.08 $3,364.20 3115 $3,364.20
6 21"RCP CLASS III CO#1 669 LF $89.00 $59,541.00 669 $59,541.00
7 24"RCP CLASS III 32 LF $99.00 $3,168.00 32 $3,168.00
9 36"RCP CLASS III CO#1 808 LF $152.00 $122,816.00 808 $122,816.00
10 5X3 BOX CULVERT 68 LF $305.00 $20,740.00 68 $20,740.00
11 7X4 BOX CULVERT CO#1 1144 LF $467.00 $534,248.00 1144 $534,248.00
12 8X4 BOX CULVERT 702 LF $505.00 $354,510.00 702 $354,510.00
14 4"STORM JUNCTION BOX 1 EA $4,820.00 $4,820.00 1 $4,820.00
15 4'STACKED MANHOLE 4 EA $1,400.00 $5,600.00 4 $5,600.00
16 10'CURB INLET CO#1 4 EA $4,280.00 $17,120.00 4 $17,120.00
17 10'RECESSED INLET 2 EA $4,500.00 $9,000.00 2 $9,000.00
18 4'DROP INLET 3 EA $7,150.00 $21,450.00 3 $21,450.00
19 LARGE STONE RIPRAP 40 SY $130.00 $5,200.00 40 $5,200.00
20 10'X8'STORM JUCTION BOX 1 EA $11,760.00 $11,760.00 1 $11,760.00
21 CONNECT TO EXISTING 6'X3'BOX CULVERT I EA $3,250.00 $3,250.00 1 $3,250.00
22 CONNECT TO EXISTING WINGWALL 1 EA $1,515.00 $1,515.00 1 $1,515.00
23 8'X6'JUNCTI0NBOX-CONSTRUCT I NS $11,975.00 $11,975.00 1 $11,975.00
24 CONNECTION TO EXISTING 6'X6'JUNCTION 1 EA $3,800.00 $3,800.00 1 $3,800.00
BOX
25 SINGLE GUARDRAIL TERMINAL-INSTALL 2 EA $3,410.00 $6,820.00 2 $6,820.00
26 STANDARD GUARDRAIL-INSTALL 69 LF $22.50 $1,552.50 69 $1,552.50
27 WINGWALL AT STA 0+00.00 1 EA $11,270.00 $11,270.00 1 $11,270.00
28 33"RCP CLASS III CO#1 23 EA $135.00 $3,105.00 23 $3,105.00
29 CONC COLLAR FOR 7 X 4 J.BOX CO#1 1 EA $5,850.00 $5,850.00 1 $5,850.00
30 30"RIM&COVER FOR J.BOX CO#1 3 EA $425.00 $1,275.00 3 $1,275.00
--------------------------------------
Sub-Total of Previous Unit $1,226,707.55 $1,226,707.55
--------------------------------------
Monday,October 21,2019 Page 2 of 8
City Project Numbers 02621 DOE Number 7481
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD Estimate Number 4
Contract Limits Payment Number 4
Project Type DRAINAGE,PAVING&ST LIGHT For Period Ending 9/26/2019
Project Funding
PAVING
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 REMOVE ASPHALT DRIVE 2773 SF $0.81 $2,246.13 2773 $2,246.13
2 REMOVE MAILBOX 1 EA $57.00 $57.00 1 $57.00
3 REMOVE 8"WATER LINE CO#3 1125 LF $7.60 $8,550.00 1125 $8,550.00
4 REMOVE ASPHALT PVMT 10520 SY $6.50 $68,380.00 10520 $68,380.00
5 SITE CLEARING 1 LS $90,180.00 $90,180.00 1 $90,180.00
6 UNCLASSIFIED EXCAVATION BY PLAN 7300 CY $15.55 $113,515.00 7300 $113,515.00
7 10'WIDE ASPHALT PVMT REPAIR 1115 LF $101.00 $112,615.00 1115 $112,615.00
8 6"FLEXIBLE BASE TYPE A 1530 SY $6.80 $10,404.00 1530 $10,404.00
9 8"FLEXIBLE BASE TYPE A 347 SY $9.50 $3,296.50 347 $3,296.50
10 HYDRATED LIME 302 TN $160.00 $48,320.00 302 $48,320.00
11 8"LIME TREATMENT 12563 SY $2.73 $34,296.99 12563 $34,296.99
12 8"CTB FOR TEMP ASPHALT 957 SY $36.30 $34,739.10 957 $34,739.10
13 2"ASPHALT PVMT TYPE D 1530 SY $11.26 $17,227.80 1530 $17,227.80
14 3"ASPHALT PVMT TYPE D 2193 SY $15.04 $32,982.72 2193 $32,982.72
15 4"ASPHALT PVMT TYPE D 957 SY $23.79 $22,767.03 957 $22,76T03
16 4"ASPHALT BASE TYPE B 1530 SY $20.04 $30,661.20 1530 $30,661.20
17 10"CONC PVMT 11806 SY $61.61 $727,367.66 11806 $727,367.66
18 4"CONC SIDEWALK 14607 SY $4.75 $69,383.25 14607 $69,383.25
19 BARRIER FREE RAMP 11 EA $885.00 $9,735.00 11 $9,735.00
20 6"CONC CURB AND GUTTER 6205 LF $2.85 $17,684.25 6205 $17,684.25
21 6"SLD PVMT MARKING HAS(W) 1419 LF $1.90 $2,696.10 1419 $2,696.10
22 6"BRK PVMT MARKING TAPE(W) 3692 LF $1.90 $7,014.80 3692 $7,014.80
23 18"SLD PVMT MARKING HAE(W) 297 LF $14.90 $4,425.30 297 $4,425.30
24 24"SLD PVMT MARKING HAE(W)CO#3 143 LF $15.45 $2,209.35 143 $2,209.35
25 LANE LEGEND ARROW CO#3 7 EA $230.00 $1,610.00 7 $1,610.00
26 TOPSOIL 250 CY $16.40 $4,100.00 250 $4,100.00
27 BLOCK SOD PLACEMENT 839 SY $3.58 $3,003.62 839 $3,003.62
28 SEEDING,HYDROMULCH 1496 SY $1.73 $2,588.08 1496 $2,588.08
29 TRAFFIC CONTROL CO#CO#3 10.8 MO $2,840.00 $30,672.00 10.8 $30,672.00
30 6"COMPACTED SUBGRADE 345 SY $6.00 $2,070.00 345 $2,070.00
31 MEDIAN CONCRETE 4479 SF $4.03 $18,050.37 4479 $18,050.37
Monday,October 21,2019 Page 3 of 8
City Project Numbers 02621 DOE Number 7481
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD Estimate Number 4
Contract Limits Payment Number 4
Project Type DRAINAGE,PAVING&ST LIGHT For Period Ending 9/26/2019
Project Funding
32 1"RETAINING WALL ADJACENT 10'WALK 65 LF $87.85 $5,710.25 65 $5,710.25
33 BINDER FOR TRENCH REPAIR 1 LS $1.08 $1.08 1 $1.08
34 JERSEY BARRIERS 30"WL CO#1 1 LS $30,000.00 $30,000.00 1 $30,000.00
35 TEMP SIGNAGE FOR 30"WL CO#1 1 LS $5,000.00 $5,000.00 1 $5,000.00
36 4"SLD PVMT MARK HAS(Y)CO#3 1372 LF $1.25 $1,715.00 1372 $1,715.00
37 8"SLD PVMT MARK HAS(Y)CO#3 458 LF $2.50 $1,145.00 458 $1,145.00
38 8"SLD PVMT MARK HAS(W)CO#3 817 LF $2.50 $2,042.50 817 $2,042.50
39 6"DOT PVMT MARK HAS(W)CO#3 209 LF $1.95 $407.55 209 $407.55
42 LANE LEGEND ONLY CO#3 3 EA $275.00 $825.00 3 $825.00
43 REMOVE LANE LEGEND ARROW COU 3 EA $38.50 $115.50 3 $115.50
44 REMOVE LANE LEGEND ONLY CO#3 2 EA $49.50 $99.00 2 $99.00
45 REMOVE 8"PVMT MARKING CO#3 214 LF $1.00 $214.00 214 $214.00
46 REMOVE 4"PVMT MARKING CO#3 1110 LF $1.00 $1,110.00 1110 $1,110.00
47 4"CONCRETE SIDEWALK CO#3 605 SF $9.60 $5,808.00 605 $5,808.00
48 REMOVE CURB CO#3 22 LF $20.00 $440.00 22 $440.00
Sub-Total of Previous Unit $1,587,481.13 $1,587,481.13
STREET LIGHT
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
---------------- --------------------------
1 GROUND BOX TYPE B 8 EA $650.00 $5,200.00 8 $5,200.00
2 SALVAGE TRAFFIC SIGNAL 4 EA $270.00 $1,080.00 4 $1,080.00
3 RDWY ILLUM ASSMBLY 9 EA $2,220.00 $19,980.00 9 $19,980.00
4 2-2-2-4 QUADPLEX ALUM ELEC CONDUCTOR 1765 LF $3.25 $5,736.25 1765 $5,736.25
5 RDWY ILLUM FOUNDATION 9 EA $1,512.00 $13,608.00 9 $13,608.00
6 2"SCH 80 PVC 1765 LF $10.84 $19,132.60 1765 $19,132.60
7 3"SCH 80 PVC 394 LF $16.25 $6,402.50 394 $6,402.50
8 PAD MOUNTED CONTACTOR W/METER 1 EA $5,960.00 $5,960.00 1 $5,960.00
9 POWER POLE W/240480V TRANSFORMER 1 EA 1
10 PROVIDE POWER TO STREET LIGHTING 1 LS $2,700.00 $2,700.00 1 $2,700.00
Sub-Total of Previous Unit $79,799.35 $79,799.35
--------------------------------------
Monday,October 21,2019 Page 4 of 8
City Project Numbers 02621 DOE Number 7481
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD Estimate Number 4
Contract Limits Payment Number 4
Project Type DRAINAGE,PAVING&ST LIGHT For Period Ending 9/26/2019
Project Funding
TRAFFIC SIGNAL
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
---------------------------------------
1 FURNISH/INSTALL ELEC SERV PEDESTAL 1 EA $2,790.00 $2,790.00 1 $2,790.00
2 2"CONDT PVC SCH 40 72 LF $10.85 $781.20 72 $781.20
3 3"CONDT PVC SCH 40 CO#1CO#2 242 LF $16.25 $3,932.50 242 $3,932.50
4 3"CONDT PVC SCH 40 368 LF $19.50 $7,176.00 368 $7,176.00
5 3-SECT SIGNAL HEAD ASSEMBLY CO#1 13 EA $895.00 $11,635.00 13 $11,635.00
6 4-SECT SIGNAL HEAD ASSEMBLY 2 EA $1 030.00 $2 060.00 2 $2 060.00
7 PED SIGNAL HEAD ASSEMBLY CO#1 12 EA $705.00 $8,460.00 12 $8,460.00
8 AUDIBLE PEDESTRAIN PUSHBUTTON 16 EA $1,670.00 $26,720.00 16 $26,720.00
STATION CO#1 CO#2
9 FURNISH/INSTALL BBU SYSTEM EXT 1 EA $7,370.00 $7,370.00 1 $7,370.00
MOUNTED
10 5/C 14 AWG MULTI-CONDUCTOR CABLE CO#1 675 LF $1.08 $729.00 675 $729.00
11 7/C 14 AWG MULTI-CONDUCTOR CABLE C091 410 LF $1.30 $533.00 410 $533.00
12 20/C 14 AWG MULTI CONDUCTOR CABLE 583 LF $4.33 $2,524.39 583 $2,524.39
CO#1CO#2
13 3/C 14 AWG MULTI CONDUCTOR CABLE CO#1 2308 LF $1.08 $2,492.64 2308 $2,492.64
CO#2
14 NO 6 INSULATED ELEC CONDR 57 LF $1.35 $76.95 57 $76.95
15 NO 8 INSULATED ELEC CONDR 800 LF $1.08 $864.00 800 $864.00
16 NO 8 BARE ELEC CONDR CO#1CO#2 1259 LF $1.08 $1,359.72 1259 $1,359.72
17 GROUND BOX TYPE B W/APRON 1 EA $650.00 $650.00 1 $650.00
18 GROUND BOX TYPE D W/APRON 4 EA $760.00 $3,040.00 4 $3,040.00
19 FURNISH/INSTASLL 10'-14'PED POLE 7 EA $920.00 $6,440.00 7 $6,440.00
ASSMBLY CO#1
20 FURNISHANSTALL TYPE 41 SIGNAL POLE 2 EA $3,370.00 $6,740.00 2 $6,740.00
21 FURNISH/INSTALL TYPE 42 SIGNAL POLE 1 EA $2,815.00 $2,815.00 1 $2,815.00
22 FURNISH/INSTALL TYPE 42 SIGNAL POLE 1 EA $4,020.00 $4,020.00 1 $4,020.00
23 FURNISHANSTALL MAST ARM 16'-36' 3 EA $2,500.00 $7,500.00 3 $7,500.00
24 FURNISH/INSTALL MAST ARM 40'-48' 1 EA $3,200.00 $3,200.00 1 $3,200.00
25 SIGNAL FOUNDATION CO#1 7 EA $920.00 $6,440.00 7 $6,440.00
26 SIGNAL FOUNDATION 3 EA $2,170.00 $6,510.00 3 $6,510.00
27 SIGNAL FOUNDATION 1 EA $2,765.00 $2,765.00 1 $2,765.00
28 SIGNAL CABINET/BBU FOUNDATION 1 EA $2,165.00 $2,165.00 1 $2,165.00
Monday,October 21,2019 Page 5 of 8
City Project Numbers 02621 DOE Number 7481
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD Estimate Number 4
Contract Limits Payment Number 4
Project Type DRAINAGE,PAVING&ST LIGHT For Period Ending 9/26/2019
Project Funding
29 FURNISH/INSTALL CONTROLLER&CABINET 1 EA $19,775.00 $19,775.00 1 $19,775.00
ASSEMBLY GROUND MNT
30 LED LIGHTING FIXTURE 3 EA $870.00 $2,610.00 3 $2,610.00
31 FURNISH/INSTALL ITERIS VANTAGE VECTOR 4 EA $7,855.00 $31,420.00 4 $31,420.00
DETECTION SYSTEM
32 PREEMPTION SYSTEM 2 EA $3,715.00 $7,430.00 2 $7,430.00
33 INSTALL/FURNISH ALUM SIGN MAST ARM 4 EA $1,030.00 $4,120.00 4 $4,120.00
MOUNT
34 5 SECT SIGNAL HEAD ASSEMBLY CO#1 3 EA $1,250.00 $3,750.00 3 $3,750.00
35 RELOCATE SIGNAL HEAD CO#1 6 EA $300.00 $1,800.00 6 $1,800.00
36 INSTALL VIVDS CO#1 1 EA $625.00 $625.00 1 $625.00
40 SALVAGE TRAFFIC SIGNAL CO#1 I EA $2,750.00 $2,750.00 1 $2,750.00
42 TEMP TRAFFIC SIGNALS CO#1 1 LS $20,000.00 $20,000.00 1 $20,000.00
43 INSTALL ALUM MAST ARM MOUNT CO#1 1 EA $1,030.00 $1,030.00 1 $1,030.00
44 4"CONC SIDEWALK CO#2 160 SF $4.75 $760.00 160 $760.00
45 REMOVE SIDEWALK CO#2 128 SF $1.50 $192.00 128 $192.00
46 RADAR CABLE CO#2 5 LF $4.65 $23.25 5 $23.25
47 2/C 12AWG MULTI-COND CABLE CO#2 1936 LF $2.25 $4,356.00 1936 $4,356.00
48 48"X22"TXDOT FOUNDATION CO#2 1 EA $18,350.00 $18,350.00 1 $18,350.00
49 RELOCATE EX POLE&65'MAST ARM CO#2 I EA $5,750.00 $5,750.00 1 $5,750.00
50 DEMO EX FOUNDATION CO#2 I EA $1,500.00 $1,500.00 1 $1,500.00
51 TRAFFIC CONTROL POLE RELOCATE CO#2 I EA $1,275.00 $1,275.00 1 $1,275.00
52 VIVDS CABLE CO#2 154 LF $4.65 $716.10 154 $716.10
53 INSTALL ALUM SIGN MAST ARM MOUNT CO#2 1 EA $2,000.00 $2,000.00 1 $2,000.00
--------------------------------------
Sub-Total of Previous Unit $262,021.75 $262,021.75
--------------------------------------
Monday,October 21,2019 Page 6 of 8
City Project Numbers 02621 DOE Number 7481
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD Estimate Number 4
Contract Limits Payment Number 4
Project Type DRAINAGE,PAVING&ST LIGHT For Period Ending 9/26/2019
Project Funding
Contract Information Summary
Original Contract Amount $2,970,036.11
Change Orders
Change Order Number 1 $164,745.76
Change Order Number 2 $1,919.78
Change Order Number 3 $19,308.16
Total Contract Price $3,156,009.78
Total Cost of Work Completed $3,156,009.78
Less %Retained $0.00
Net Earned $3,156,009.78
Earned This Period $1,939,311.11
Retainage This Period $0.00
Less Liquidated Damages
Days @ /Day $0.00
LessPavement Deficiency $0.00
Less Penalty $0.00
Less Previous Payment $1,216,698.67
Plus Material on Hand Less 15% $0.00
Balance Due This Payment $1,939,311.11
Monday,October 21,2019 Page 7 of 8
City Project Numbers 02621 DOE Number 7481
Contract Name BAILEY BOSWELL WIND RIVER TO OLD DECATUR RD Estimate Number 4
Contract Limits Payment Number 4
Project Type DRAINAGE,PAVING&ST LIGHT For Period Ending 9/26/2019
Project Funding
Project Manager Buckley City Secretary Contract Number 117481
Inspectors LAYER/ GRINDSTAFF Contract Date
Contractor JLB CONTRACTING,L.L.C. Contract Time 325 CD
PO BOX 24131 Days Charged to Date 1069 CD
FORT WORTH, TX 76124-1131 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 $3,156,009.78
Less %Retained $0.00
Net Earned $3,156,009.78
Earned This Period $1,939,311.11
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 $1,216,698.67
Plus Material on Hand Less 15% $0.00
Balance Due This Payment $1,939,311.11
Monday,October 21,2019 Page 8 of 8
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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 Sam Davis, President of]LB Contracting, LLC,
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;
Bailey Boswell —Wind River to Old Decatur Road
City Project # 02621
Sam Davis
President
]LB Contracting, LLC
Subscribed and sworn before me on this o f 2019.
%Orirrrr JAM4E r7r. vmy� ,
`� Y PUe�;Notary Public,State of Texas -
fV.•`7` Comm,Expires 09 25-2020
Notary ID 1211545-4 NO RUB IC IN AND F R.
T R NT COUNTY, TEXAS
My commission expires �tr �
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
TO FINAL PAYMENT U CTOR 0
(SIMILAR TO AIA DOCUMENT G707)
Bond No. 7992089
PROJECT: Bailey Boswell- Wind River Drive to Old Decatur Road, City Project No. 02621
(name,address)Fort Worth, Texas
TO (Owner)
ARCHITECTS PROJECT NO:
City of Fort Worth CONTRACT FOR: Above Project
200 Texas Street
Fort Worth, Texas 76102
�.1 CONTRACT DATE: April 1, 2016
CONTRACTOR: JLB Contracting, LLC
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(here inset name address of surety Company) Westfield Insurance Company a
nd
555 Republic Drive, Suite 450
Plano, Texas 75074 ,SURETY COMPANY,
on bond Of(here insert name and address of Contractor)
JLB Contracting, LLC
P.O. Box 24131 ,CONTRACTOR,
Fort Worth, Texas 76124
hereby approves of the final payment to the Contractor, and agrees that the fmal payment to the Contractor shall not relieve the
Surety Company of any of its obligations to(here insert name and address of owner)
City of Fort Worth
200 Texas Street
Fort Worth, Texas 76102 ,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 October
2019
W STFIELD INSMANCE COMPANY
Surety Company
By
Attest:
Signature of AifthWeAepresentative
(Seal): KOe W. Sweeney Attorney—in—Fact
Title
Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING I Iris aAML
POWER#AND ISSUED PRIOR TO 04/20111, FOR ANY PERSON OR PERSONS NAMED BELOW.
General POWER NO. 4220052 06
Power Westfield Insurance Co.
of Attorney Westfield National Insurance Co.
Ohio Farmers Insurance Co.
CERTIFIED COPY Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as -Companies," duly
organized and existing under the laws of the State of Ohio, and having its p41cipal office in Westfield Center, Medina County, Ohio, do by these
presents make, constitute and appoint
CHARLES D. SWEENEY, MICHAEL A. SWEENEY, KYLE W.SWEENEY, ELIZABETH GRAY, JOINTLY OR SEVERALLY
of FORT WORTH and State of TX its true and lawful Attorney(s)-in-Fact,with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - _
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE,OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent as if such bonds were;signed by the President,sealed with the:corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
-Be It Resolved,that the President, any Senior Executive, any Secretary or any Fidelity& Surety Operations Executive or other Executiveshall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and
deliver,any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney4n-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary.-
'Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.- (Each adopted at a meeting
held on February 8, 2000).
In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of
APRIL A.D.,2011 .
Corporate
Sealste�rQsgR`tNC�:•o+ •``Q��ONAL��;'G' xSU�"p"�'4, WESTFIELD INSURANCE COMPANY
Affixed ..: .a. •`,' •• '.S �t3 •=M". WESTFIELD NATIONAL INSURANCE COMPANY
4. `;Q = •'Z _ �N�� ••�� OHIO FARMERS INSURANCE COMPANY
SEAL
xv :p �'t 1848 :� c
nnn.K^" k By
State of Ohio "" Richard L. Kinnaird, Jr., National Surety Leader and
County of Medina ss.: Senior Executive
On this 20th day of APRIL A.D.,2011 before me personally came Richard L. Kinnaird, Jr. to me known, who, being by me duly
sworn,did depose and say,that he resides-in Medina, Ohio;that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above
instrument that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed
by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order.
Notarial
Seal ,.•` R%AL. ~��
Affixed ,rp; S�
J William J. Kahelin,A rney at Law, Notary Public
State of Ohio "s:N o My Commission Does Not Expire (Sec.147.03 Ohio Revised Code)
County of Medina ss.:
•Vti M,O�O.
I, Frank A. Carrino,Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies, which is still in full force and effect;and furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this day of
October A° 2019
••.......s '7
oakRTW
SEAL a N: SEAL m= cm Secretary
'f`'•� '�` {�: �7, •o_ =.184a = Frank A. Carrino, Secretary
BPOAC2 (combined) (06-02)