Loading...
HomeMy WebLinkAboutContract 45721-FP1 (2)Depart 7t of PW Const. Services O E# / Date Project Manager Risk Management S. Canadv D.O.E. Brotherton CFA Westerman/Scanned o The Proceeding people have been Contacted concerning the request for final payment & have released this project for such payment. Clearance Conducted By Etta Bacy tT WORTH ATION AND PUBLIC WORKS F PROJECT COMPLETION CITYSECRETARY /i� CONTRACTN4. S%bJ- OpQqt2 D.O.E. N9: 7199 7f- q5 z( Regarding contract 11.7199 for CENTRE STATION DRIVE as required by the WATER DEPARTMENT as approved by City Council on N/A through ICI&C N/A the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Transportation & Public Works Department has accepted the project as complete. Original Contract Prices: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Work Completed: Less Deductions: Liquidated Damages: Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: Less Previous Payments: Final Payment Due • Recommended for Acceptance Asst. Director, TPW - Infrastructure Design and Construction L Accepted Asst. Director, WATER DEPARTMENT Asst. City Manager Comments: FUND ACCT: P265-6051502247-83 / 2275-7051302247-83 EMS ILED NOV 9 2015 Initla6 •__ SCANNeD $136,001.00 $136,001.00 $136,001.00 $0.00 $136,001.00 $136,001.00 Date Date N2 1 Days @ $210.00/ Day OFFICIAL RECORD CITY SECRETARY FTJ,WOIITH, TX zi7 Project Manager Ehia Contractor WRIGHT CONSTRUCTION COMPANY, INC. 601 W. WALL ST. GRAPEVINE , TX 76051- Inspectors RODGERS / KLENK FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name CENTRE STATION DRIVE Contract Limits Project Type WATER & SEWER City Project Numbers 2247 DOE Number 7199 Estimate Number 1 Payment Number City Secretary Contract Number 117199 1 For Period Ending 8/31/2015 CD Contract Time 18(ED Contract Date 6/30/2014 Days Charged to Date 171 Contract is 100.00 Complete Friday, September 04, 2015 Page 1 of 5 City Project Numbers 2247 Contract Name CENTRE STATION DRIVE Contract Limits Project Type WA1ER & SEWER Project Funding UNIT A - WATER LINE Item No. Description of Items 1 10-INCH PVC DR-14 WATER PIPE 2 8-INCH PVC DR-14 WATER PIPE 3 6-INCH PVC DR-14 WA1ER PIPE 4 10" GATE VALVE WITH BOX 5 8" GATE VALVE WITH BOX 6 6" GATE VALVE WITH BOX 7 DUC 1ILE IRON FITTINGS LESS THAN 16" DIAMETER FOR PVC PIPE 8 FIRE HYDRANT ASSEMBLY 9 IRRIGATION SERVICE WITH METER IN BOX 10 8" WATER SERVICE WITH COMBINATION TURBINE METER AND BYPASS IN VAULT COMP 11 CONNECT TO EXISTING 10" WATER LINE 12 TRENCH SAFETY UNIT Al - SANITARY SEWER LINE Item No. Estimated Quanity Unit Unit Cost 50 LF $96.00 20 LF $84.00 10 LF $85.00 1 EA $2,302.00 4 EA $1,514.00 1 EA $1,350.00 1 TN $2,474.00 1 EA 2 EA 1 EA DOE Number 7199 Estimate Number 1 Payment Number 1 For Period Ending 8/31/2015 Estimated Total $4,800.00 $1,680.00 $850.00 $2,302.00 $6,056.00 $1,350.00 $2,474.00 $3,250.00 $3,250.00 $4,628.00 $9,256.00 $24,823.00 $24,823.00 1 EA $7,491.00 $7,491.00 80 LF Sub -Total of Previous Unit Description of Items 1 8-INCH SANITARY SEWER (PVC) OPEN CUT ALL DEPTHS 2 8-INCH SANITARY SEWER (DIP) OPEN CUT ALL DEPTHS 3 STANDARD SEWER MH 48" LD TO 6' DEPTH W/ 32 INCH RING & COVER & 30" OPEN 4 EXTRA DEPTH 5 CONNECT TO EXISTING SANITARY SEWER LINE 6 CONNECT TO EXISTING SANITARY SEWER MANHOLE 7 VACUUM 1ESTNEW SANITARY SEWER MANHOLE 8 POST CCTV -INSPECTION OF SWER LINES Friday, September 04, 2015 Estimated Quanity $42.00 $3,360.00 Unit Unit Cost 290 LF 72 LF 3 EA $81.00 $120.00 $4,319.00 10 VF $184.00 1 EA $2,463.00 1 EA $8,100.00 3 EA $115.00 362 LF $1.00 $67,692.00 Estimated Total $23,490.00 $8,640.00 $12,957.00 $1,840.00 $2,463.00 $8,100.00 $345,00 $362.00 Completed Completed Quanity Total 50 $4,800.00 20 $1 680.00 10 $850.00 1 $2,302.00 4 $6,056.00 1 $1,350.00 1 $2,474.00 1 $3,250.00 2 $9,256.00 1 $24,823 00 I $7,491.00 80 $3,360.00 $67,692.00 Completed Completed Quanity Total 290 $23,490.00 72 $8,640.00 3 $12,957.00 10 $1,840.00 1 $2,463.00 1 $8,100.00 3 $345.00 362 $362.00 Page 2 of 5 City Project Numbers 2247 DOE Number 7199 Contract Name CENTRE STATION DRIVE Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER & SEWER For Period Ending 8/31/2015 Project Funding 9 CEMENT STABILIZIED BACKFILL OF SEWER 72 LF $60.00 $4,320.00 72 $4,320.00 PIPE 10 TRENCH SAFETY 362 LF $16.00 $5,792.00 362 $5,792 00 Friday, September 04, 2015 Sub -Total of Previous Unit $68,309.00 $68,309.00 Page 3 of 5 City Project Numbers 2247 Contract Name CENTRE STATION DRIVE Contract Limits Project Type WATER & SEWER Project Funding Contra Inspection Supervi Project Mana Contract Information Summary Original Contract Amount Chance Orders Date Date Date IL I =f; Date/7-/‘-/5 Asst. Director/ I PW Infrastructure Design and Construction I/ -�--- Date /l 7' S _Director / Contracting Department DOE Number 7199 Estimate Number Payment Number For Period Ending $136,001.00 Total Contract Price $136,001.00 Total Cost of Work Completed 1 1 8/31/2015 $136,001.00 Less % Retained $0.00 Net Earned $136,001.00 Earned This Period Retainage This Period $136,001.00 $0.00 Less Liquidated Damages Days @ / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $0.00 $0.00 $0.00 $0.00 $0.00 $136,001.00 Friday, September 04, 2015 Page 4 of 5 S1&OI_caa�7 City Project Numbers 2247 DOE Number 7199 Contract Name CENTRE STATION DRIVE Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER & SEWER For Period Ending 8/31/2015 Project Funding Project Manager Ehia City Secretary Contract Number 117199 Inspectors RODGERS / KLENK Contract Date 6/30/2014 Contractor WRIGHT CONSTRUCTION COMPANY, INC. Contract Time 180 CD 601 W. WALL ST. Days Charged to Date 171 CD GRAPEVINE , TX 76051- Contract is .000000 Complete Line Fund Account Center • CITY OF FORT WORTH SUMMARY OF CHARGES Amount Funded Gross Retainage Net Total Cost of Work Completed $136,001.00 Less % Retained $0.00 Net Earned $136,001.00 Earned This Period Retainage This Period $136,001.00 $0.00 Less Liquidated Damages 0 Days @ $0.00 / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $0.00 $0.00 $0.00 $0.00 $0.00 $136,001.00 Friday, September 04, 2015 Page 5 of 5 'Pais- 0 Qgqt7 Document G706A Contractor's Affidavit of Release of Liens PROJECT: (Name and address) CentrePort Centre Station Drive Lot 2, Block 104 Fort Worth, Texas TO OWNER: (Name and address) CentrePort Venture, LP Two Seaport Lane Boston, MA 02210-2021 STATE OF: TEXAS COUNTY OF: TARRANT ARCHITECT'S PROJECT NUMBER: OWNER: City Project: 02247 CFA. 2014-003 CONTRACT FOR: Water, Sewer, Paving, Storm Drain, Street Lights, Traffic Signals to serve Centre Station Drive CONTRACT DATED: June 17, 2014 ARCHITECT ■ CONTRACTOR: Ej SURETY: OTHER: The undersigned hereby certifies that to the best of the undersigned's knowledge, information and belief, except as listed below, the Releases or Waivers of Lien attached hereto include the Contractor, all Subcontractors, all suppliers of materials and equipment, and all performers of Work, labor or services who have or may have liens or encumbrances or the right to assert liens or encumbrances against any property of the Owner arising in any manner out of the performance of the Contract references above. EXCEPTIONS: NONE SUPPORTING DOCUMENTS ATTACHED HERETO: 1. Contractor's Release or Waiver of Liens, conditional upon receipt of final payment. 2 Separate Releases or Waivers of Liens from Subcontractors and equipment suppliers, to the extent required by the Owner, accompanied by a list thereof - ,\$$,.. 71"0/; ZINA CHRISTINE GOOLSBY I _ . ° Notary Public ;:* • ��• STATE OF TEXAS .�c- "f.`;,2f v% tvly Comm. Exp. May 14, 2017 k. • ': 'S •-e.,r "r. ,fir y..s 4..••0 Jar... +rr .—r CONTRACTOR: (Name and address) Wright Construction Co., Inc. 601 W�WaII St., Grapevine, X 76051 BY: (Siga Fur of aut orize• representative) ■ ■ Gary A. Oostveen, Controller (Printed name and title) Gary A Oostveen, Controller, personally appeared before me, the undersigned notary public, and provided satisfactory evidence of identification to be the person who signed this document in my presence and swore or affirmed to me that the contents of this document are truthful and accurate to the best of his/her knowledge and belief. Date'. 9/Z1/5 Notary Public: My Commission expires: £a/7 • CAUTION You should sign an Original Document. on i.t.ihich text appears ,n RED An Original Document assures that changes will not be obscured. TORGO SOFTWARE tw.w TorgoSoftware corn ©1996-2012 Alt RIGHTS RESERVED Contractor's Affidavit of Payment of Debts and Claims Document G706 TO OWNER: (Name and address) CentrePort Venture, LP Two Seaport Lane Boston, MA 02210-2021 PROJECT: (Name and address) CentrePort Centre Station Drive Lot 2, Block 104 Fort Worth, Texas STATE OF: TEXAS COUNTY OF: TARRANT ARCHITECT'S PROJECT NUMBER: City Project: 02247 CFA: 2014-003 CONTRACT FOR: Water, Sewer, Paving; Storm Drain, Street Lights, Traffic Signals to serve Centre Station Dave CONTRACT DATED: June 17, 2014 OWNER: ARCHITECT: CONTRACTOR: SURETY: OTHER: The undersigned hereby certifies that, except as listed below, payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished, for all work, labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner's property might in any way be held responsible or encumbered. EXCEPTIONS: None SUPPORTING DOCUMENTS ATTACHED HERETO: 1. Consent of Surety to Final Payment. Whenever Surety is involved, Consent of Surety is required. Indicate Attachment M. yes U no The following supporting documents should be attached hereto if required by the Owner: 1. Contractor's Release or Waiver of Liens, conditional upon receipt of final payment. 2 Separate Releases or Waivers of Liens from Subcontractors and equipment suppliers, to the extent required by the Owner, accompanied by a list thereof. 3. Contractor's Affidavit of Release of Liens. ZINA CHRISTINE GOOLSBY Notary Public STATE OF TEXAS My Comm. Exp. play 14, 2017 CAUTION You should sign an Origin ni. .... ..s a rrost I Document. on which this te»t appears CONTRACTOR: (Name and address) Wright Construction Co., Inc. 601 W. Wall St., Grapevine,6051 BY: (Si orize Ti? represen tive) ■ ■ Gary A. Oostveen, Controller (Printed name and title) Gary A. Oostveen, Controller, personally appeared before me, the undersigned notary public, and provided satisfactory evidence of identification to be the person who signed this document in my presence and swore or affirmed to me that the contents of this document are truthful and accurate to the best of his/her knowledge and belief Date: 9/2/15 Notary Public: My Comrnission expires: in RED An Original Document assure that changes will not be obscured TORGO SOFTWARE vAnv TorgoSoftware com ©1996-2012 ALL RIGHTS RESERVED Merchants Bonding Company 2100 FLEUR DRIVE • DES MOINES, IOWA 50321-1158 (515) 243-8171 • (515) 243-3854 FAX CONSENT OF SURETY TO FINAL PAYMENT OWNER ARCHITECT CONTRACTOR SURETY OTHER Bond No, TXC605350 Printed in cooperation with The American Institute of Architects (AIA) by Merchants Bonding Company (Mutual). Merchants Bonding Company (Mutual) vouches that the language in this document conforms exactly to the language used in AIA Document G707, 1994 Edition. TO OWNER: (Plante and address) CentrePort Venture, LP City of Fort Worth PROJECT: (Name and address) CentrePort ARCHITECT S PROJECT NO.: CONTRACT FOR: CONTRACT DATED: June 30, 2015 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (insert name and address of Ssarety) Merchants Bonding Company (Mutual) 2100 Fleur Drive Des Moines, Iowa 50321- I 158 SURETY, on bond of (Insert name and address of Contractor) Wright Construction Co., Inc., 601 W. Wall St., Grapevine, Texas 76051 , 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 ofOwner) CentrePort Venture, LP City of Fort Worth as set forth m said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: August 26, 2015 (Insert in writing the month followed by the numeric date and year.) Attest: (Seal): CON 0405 (02/01) Merchants Bonding Company (Mutual) (Surety) Oft 1, , i 1 (Signature of authored re' sen&nive) Kathy Sells (Printed name and fine) , OWNER, Attorney -In -Fact ERC TS BONDING COMPANY,' POWER OF ATTORNEY Bond No TXC605350 Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa (herein collectively called the "Companies') do hereby make, constitute and appoint, individually, Casey Hege; Dustin Parker; Kathy Sells; Martin Day their true and lawful Attorneys) -in -Fact, to make, execute, seal and deliver an behalf of the Companies, as Surety, bonds, undertakings and other written obligations in the nature thereof, subject to the limitation that any such instrument shalt not exceed the amount of: TWENTY MILLION (S20,000,000.00) DOLLARS This Power-of-Attomey is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October24, 2011. 'The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seat of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attomey-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attomey-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 15th day of August 2015 ,,,,.,,,1,,,,,.j, `,` -0- a :c. z ' 241i3 l,Gi: STATE OF IOWA '++e Of 't„Y,,,ao„```� COUNTY OF Dallas ss. • ` ` ~ ° ° MERCHANTS BONDING COMPANY (MUTUAL) • ° aO�N -CQ�, • MERCHANTS NATIONAL BONDING, INC. ah-•:__ -O- s • 6'• 1933 ; c; 15 • .• By President On this 15th day of August , 2015 , before me appeared Larry Taylor, to me personally known, who being by me sworn did say that he is President of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. WENDY WOODY Commission Number 784654 My Commission Expires June 201 2017 Notary Pub!! 2Th' County, fowa (Expiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies. which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 26th day of August , 2015 . 'I,,0411,tt65,4k, • ty Z003 .44 --- -- POA 0014 (6/15) Y..............r.Otfb t•aW cad•. 1)• (1 ����-5•• "",r.C/x c/ i� e, • a • 1933 ry �• • o ♦:: Secretary ERCHANTS BONDING COMPANY.' MERCHANTS BONDING COMPANY (M.UTUAL) MERCHANTS NATIONAL BONDING. INC. 2100 FLEURDRIVE • DES MOINES. IOWA 50321-1158 - (800) 678-8171 (515) 243-3854 FAX IMPORTANT NOTICE, To obtain information or make a complaint: You may contact your insurance agent at the telephone number provided by your insurance agent. You may call complaint at: Merchants Bonding Company (Mutual) toll -free telephone number for information or to make a 1-800-678-8171 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-262-3439 You may write the Texas Department of Insurance at: P. O. Box 149104 Austin, TX 78714-9104 Fax (512) 475-1771 Web: http-//www.tdi.state.tx.us E-maii ConsumerProtection@tdi.texas.gov PREMIUM AND CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. SUP 0032 TX (12/13) PROJECT NAME PROJECT NUMBER: DOE NUMBER PIPE LAID Water Water Water FIRE HYDRANTS: PIPE ABANDONED DENSITIES NEW SERVICES: PIPE LAID Sewer Sewer PIPE ABANDONED DENSITIES NEW SERVICES: FORT WORTH j TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: Centre Station Drive P265-6051502247-83,P275-7051302247-83 7199 SIZE 10" 8" 6" WATER TYPE OF PIPE PVC DR-14 PVC DR-14 PVC DR-14 VALVES (16" OR LARGER) SIZE TYPE OF PIPE SIZE 8" 8" SEWER TYPE OF PIPE PVC DIP SIZE TYPE OF PIPE TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 LF LF LF LF 50 20 10 290 72 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I) PROJECT INFORMATION Name of Contractor Wright Construction DOE Inspector Candace Klenk DOE Nunnber Project Difficult.), 7199 I 0 Simple 0 Routine Initial Contract Amount $431,sk i a II) PERFORMANCE EVALUATION 0 - Inadequate 1 - Deficient 2 - Standard ELEMENT INSPECTION EVALUATION 1 Availability of Inspector 2 Knowledge of Inspector 3 Accuracy of Measured Quantities 4 Display Of Professionalism 5 Citizen Complaint Resolution 6 Performance - Setting up Valve Crews, Labs ADMINISTRATION 1 Change Order Processing Time 2 Timliness of Contractor Payments 3 Bid Opening to Pre -Con Meeting Timeframe III) COMMENTS & SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor INSPECTOR'S COMMENTS Date: Project Nance Centre Station Driv Project Manager Fred Ehia Type of Conti act 0 Complex n Water %/1 Waste Water Final Contract Amount $ tap. 00 co • 3 - Good 4 - Excellent RATING ELEMENT (0 - 4) J 9/10/2015 Storm Drainag PLANS & SPECIFICATIONS 1 Accuracy of Plans to Existing Conditions 2 Clarity & Sufficiency of Details 3 Applicability of Specifications 4 Accuracy of Plan Quantities PROJECT MANAGER EVALUATION 1 Knowledge And/Or Problem Resolution 2 Availability of Project Manager 3 Communication 4 Resolution of Utility Conflicts TRANSPORTATION AND PUBLIC WORKS The City of Fort North • 1000 Throckrnorton Street • Fort Worth, '1'X 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 REV: 02/22/07 Pavement RATING (0 - 4) ,'9i(P "I9J 1 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR I) CONTRACTOR & PROJECT DATA Name of Contractor Wright Construction DOE Inspector Candace Klenk DOE Inspector Water ❑ Waste Water Storm Dratnag Initial Contract Amount $: (.0) 00 00 Final Contract Amount $[%Q)COL. 06 Project Name Centre Station Drive DOE Number 7199 Project Manager Pavement Fred Ehia Project Difficulty 0 simple Date 9/10/2015 II) PERFORMANCE EVALUATION 10 - Inadequate 1 - Deficient 2 - Standard 3 - Good 4 - Excellent ELEMENT 1 Submission of Documents 2 Public Notifications 3 Plans on Site 4 Field Supervision 15 Work Performed 16 Finished Product 17 Job Site Safety 8 Traffic Control Maintenance 9 Daily Clean Up 10 Citizen's Complaint Resolution 11 Property Restoration 12 After Hours Response 13 Project Completion WEIGHT ( x ) 2 5 5 15 15 15 15 15 5 5 5 5 5 Routine APPLICABLE (Y / N) RATING (0 - 4) Y 4 Y Y Y Y Y Y Y Y Y Y Y Y REV: 02/20/07 0 Complex MAX SCORE SCORE 8 8 4 20 20 3 20 15 3 60 45 4 60 60 4 60 60 4 1 60 60 4 1 60 60 4 1 20 20 4 1 20 20 4 1 20 20 4 1 20 20 4 1 20 20 TOTAL ELEMENT SCORE (A) 428 BONUS POINTS (25 Maximum) (B) TOTAL SCORE (TS) 428 III) CONTRACTOR'S RATING Maximum Score (MS) = 448 or sum of applicable element score maximums which = 448 Rating ( [TS / MS] * 100%) 428 / 448 = 96% Performance Category Excellent <20% = Inadequate 20% to <40% = Deficient 40% to <60% = Standard 60% to <80% = Good >_80% = Excellent Inspector's Comments (INCLUDING EXPLANATION OF BONUS POINTS AWARDED) Signature DOE Inspector Signature DOE Inspector's Supervisor CONTRACTOR'S COMMENTS Signature Contractor TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throcicnorton Street • Fort Worth, '1'X 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 i 1 1 I 1 STATEIIENT# FINAL STATEMENT# NAME OF PROJECT: YEAR:I 2015 PROJECT NO.: FORT WORTH:, TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME I 1 Centre Station Drive P-265-6051502247-83 P275-7051302247-83 'PERIOD FROM: I 8/16/2015 'WORK ORDER EFFECTIVE: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 I I Contractor 1 FINAL INSPECTION DATE WD CONTRACT TIME ITO: I 8/31/2015 I MID - Month I 1 8/18/2014 DAY OF MONTHDAYS REASON FOR CHARGED DAYS CREDITED NA Wkn & Hol Not Applicable THIS PERIOD PREVIOUS PERIOD TOTAL TO DATE SAT,SUN,and HOLIDAYS 0 I BEG (v / n) I N 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Wea WEATHER 0 I MID (v / n DAY OF MONTH Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Utl Oth UTILITIES OTHERS RELOCATE 0 0 180 I DEVELOPMENT' ('' / N) I DAYS CHARGED 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 DOE I 7119 Wright Const. I 4/30/2015 CD X N I REASON FOR DAYS CREDITED NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA DAYS TOTAL DAYS CHARGED 0 0 0 171 0 0 0 REMARKS: Stopped time on 2-4-15. Walked Wrights final on 4-30-15, punchlist was completed 6-10-15. Signature: (Print Name) CONTRACTOR art- 74V A,,/Lt DATE Signature: 0 171 Candace Klenk INSPECTOR 171 171 OPPICIAL RdCOR CITY SECRETAR i I DATE I 9/3/2015 1 1