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HomeMy WebLinkAboutContract 50304-FP3 City Secretary 50304 -FP3 Contract No. Cate Received Dec 16,2019 FORT WORTH. 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 XII PHASE C City Project No.: 100684 Improvement Type(s): ❑ Paving N Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $174,393.00 Amount of Approved Change Orders): Revised Contract Amount: Total Cost of Work Complete: $174,393.00 Gbe G�a�rt9�t Dec 11, 2019 Al Contractor Date Contract Manager Title Burnsco Construction,Inc. Company Name Kevin Barnes(Dec 11,2019) Dec 11, 2019 Project Inspector Date Aaron Lan Dec 12 2019 Aaron Long(Dec l ,2019) P 'ect Mang per Date escarlett Morales(Dec 16,2 711~Ae1 Dec 16, 2019 CFA Manager Date Dec 16 2019 Dana 6u rghdoff(D 16,2019) Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT.WORTH, TX Notice of Project Completion Project Name: SUMMER CREEK RANCH XII PHASE C City Project No.: 100684 City's Attachments Final Pay Estimate Cxl Change order(s): ❑ Yes © N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 190 CD Days Charged: 268 Work Start Date: 2/25/2019 Work Complete Date: 11/26/2019 Page 2of2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Flame SUMMER CREEK.RANCH XII PHASE C Contract Limits Project Type STORM DRAIN City Project Numbers 100684 DUE Number 4684 Estimate Number I Payment Number 1 For Period Ending 12/11/2019 CD City Secretary Contract Number Contract Time 12al) Contract Date hays Charged to Date 268 Project Manager NA Contract is 100.00 Complete Contractor BURNSCO CONSTRUCTION,INC. 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 Inspectors DICKINSON / DIVER Wednesday,December I I,20I9 Page 1 of 4 City Project Numbers I00684 DOE Number 0684 Contract Name SUMMER CREEK RANCH XII PHASE C Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN For Period Ending 12/11/2019 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity 'Total I MEDIUM STONE RIPRAP DRY 84 SY $56.00 $4,704,00 T 84 $4,704.00 2 TRENCH SAFETY 1386 LF $0.50 $693.00 1386 $693.00 3 21"RCP CLASS III 270 LF $74.00 $19,980.00 270 $19,980.00 4 24"RCP CLASS III 907 LF $84.00 $76,188.00 907 $76,188.00 5 27"RCP CLASS III 209 LF $92.00 $19,228.00 209 $19,228.00 6 4'STORM JUNCTION BOX I EA $4,000.00 $4,000.00 1 $4,000.00 7 24"FLARED HEADWALL 1 PIPE 2 EA $2,800.00 $5,600.00 2 $5,600.00 8 27"FLARED HEADWALL 1 PIPE 1 EA $3,000,00 $3,000,00 1 $3,000.00 9 10'CURS INLET 10 EA $3,600.00 $36,000,00 10 $36,000.00 10 15'CURB INLET 1 EA $5,000,00 $5,000.00 1 $5,000.00 Sub-Total of Previous Unit $174,393.00 $174,393.00 Wednesday,December 11,2019 Page 2 of City Project Numbers 100684 DOE Number 0684 Contract Name SUMMER CREEK RANCH X1I PHASE C Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 1 2/1 1120 1 9 Project Funding Contract Information 8uinniary Original Contract Amount $174,393.00 Change Orders Total Contract Price $174,393,00 Total Cost of Work Completed $174,393.00 Less %Retained $0.00 Net Earned $174,393.00 Earned This Period $174,393.00 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 Nand Less 15% $0.00 Balance Due This Payment $I74,393.00 i Wednesday,Dccembcr 11,2019 Page 3 of I I City Project Numbers 100684 DOE Number 0684 Contract Name SUMMER CREEK RANCH X11 PHASE C Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN For Period Ending 1 211 1/20 19 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / DIVER Contract hate Contractor BURNSCO CONSTRUCTION.INC. Contract Time I20 CD 6331 SOUTHWEST BLVD Days Charged to Date 268 CD FORT WORTH, TX 76132 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 $174,393.00 Less %Retained $0.00 Net Earned $174,393.00 Earned This Period $174,393.00 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% $0.40 Balance Due This Payment $174,393.00 Wednesday,December 11,2019 Page 4 of 4 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 Ab Grantges, Contract Mgr, Of Burnsco Construction,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; Uminer Creels Ranch Ph. 12C- Water, Sanitary Sewer and Storm Drain BY W k+'77:77� Ab Grantges, ct Manager Subscribed and sworn before me on this date 11th of December,2019. P�ALID LES x 52496 Notary Public ; a xpiresTarrant County,Texas o� 7_ CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ Conforms with the American Institute of OTHER Architects, AIA Document G707 Bond No 022221119 PROJECT: (name, address)Summer Creek Ranch Section XII Phase C-Water, Sewer and Storm Improvements Fort Worth TX TO (Owner) FORESTAR(USA)REAL ESTATE GROUP,INC.AND ARCHITECT'S PROJECT NO: CITY OF FORT WORTH CONTRACT FOR: 14755 Preston Road,Suite 130 Summer Creek Ranch Section X I I Phase C-Water,Sewer and Storm Improvements Dallas Tx 75254 CONTRACT DATE: CONTRACTOR:BURNSCO CONSTRUCTION, INC. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the there insert name and address of Surety Company) LIBERTY MUTUAL INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of there insert name and address of Contractor] BURNSCO CONSTRUCTION, INC. 6331 Southwest Boulevard Benbrook TX 75132 , 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 14755 Preston Road, Suite 130 Dallas TX 75254 . 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 November,2019 LIBERTY MUTUAL INSURANCE COMPANY Surety Company Attest: rll7 (Seal): ,y Signa re of Authorized Representative [�v'_ Soohi�nie Hung _ Attorney-in-Fact Title NOTE: This torm 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. Liberty Liberty Mutual Insurance Company mutum. The Ohio Casualty Insurance Company Cerlificate No: 8200743 SURETY 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(he(ein collectively called the"Companies").pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Robb Morales,Dan E.Ccrncl1,Sophinie Hunter,Tina Me Ewan,Tonie Petranek,Ricardo J.Rev na, Joshua Saundcrs, 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 attomey-in-fact to make, execute,seal,acknowledge and deliver,for and on ils behalf as surety and as ifs act and deed,any and all undertakings,bonds,recog n izances 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 authorzed officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 19th day of March 2019 Liberty Mutual Insurance Company surance 4, gaPLoaPON rv. cv�v�4ONa.1 West American Insurr any ance Company T � 1912 � 0 1919 � � 1991 r v w� y� d 7 CHUg�aD O 0 3 . BY: 4MO da 1S 'Notn1+P db � C oi 8z Ar 1tv �y1 y David M.Carey,Assistant Secretary n State of PENNSYLVANIA � County of MONTGOMERY ss a) On this 19th day of March 20I9 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance 0 0 @ 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 � a5 a therein contained by signing on behalf of the corporations by himself as a duly authorized officer. OW 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 wri Ran. CL C'� A PAS OQ Q 4yo:rw�TF! COMMONWEALTH OF PENNSYLVANIA Notarial Seal 0-0 T do Teresa Pastella,Notary Public p 4] OF Upper MeNonTwp.,Montgomery County By: �� d C @Q' My Commission Expires March 28.2021 E y�vr tiO Teresa Pastella,Notary Public O M 07� fig,. Member,Pennsywania Associallon or Notaries Q co a) N� This Power of Attomey 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.0 insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a m ARTICLE IV—OFFICERS:Section 12.Power of Attorney. 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 ) 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 surely a o M any and all undertakings,bonds,recog n izences and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall N have foil 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"0D Z � instruments shall be as binding as if signed by the President and attested to by file Secretary.Any power or authority granted to any representative or attorney-in-fact under the E"Mprovisions 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. a v ARTICLE XI II—Execution of Contracts:Section 5.Surety Bonds and Undertakings. 0 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,F- shall appoint such attorneys-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, bands,recog nizan ces and other surety obligations.Such attomeys-in-fact subject to the limitations set forth in their respective powers of attomey,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 aft 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 farce 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 cardfy 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 effed and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 13th day of November , 2019 pL I'su P�11 INS&A 1NS[Jig4 JGagvoq,4r 1L q.]oOaPOR4 `7 40gv0`�T�C+ 541,CA� 1912 1919 L4 1991 0 'agcKuS��da na�P' '"� a*� 4 3 Fay, Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIL Multi Co 062018 10, Liberty �Mutuil. SURETY TEXAS TEXAS IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener information 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 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 cornpanias, coberturas, derechos o 1-800-252-3439 quejas al 1-800-252-3439 You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros Consumer Protection (1 I I-I A) de Texas Consumer Protection(I I I-I A) P. O. Box 149091 P. O. Box I49091 Austin,TX 78714-9091 Austin,TX 78714-9091 FAX: (512)490-I007 FAX#(512)490-1007 Web: http://www.tdi.texas.gov Web:htt _ www.tdi.texas.gov E-mail: ConsumerProtection a.tdi.texas.goy E-mail: ConsumerProtection a tdi.texas.goy 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. ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA: POLICY: This notice is for information only and does not Este aviso es solo para proposito de informacion become a part or condition of the attached y no se convierte en parte o condicion del document. documento adjunto. NP 70 68 09 01 LMS-15292 Mi5