HomeMy WebLinkAboutContract 54497-FP2City Secretary 54497
Contract No.
FORTWORTHo
Date Received Mdy 4, 2021
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: Raising Cane's #506
City Project No.: 102536
Improvement Type(s): Water 0
Original Contract Price:
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete:
ti�;t�e�- G�
MaLLhcw Clark (May 3, 2021 08:01 CDTI
Contractor
Division Manager
Title
Embree Construction Group Inc
Company Name
Sewer 0
s�-eveh Aguirre
Steven Aguin e ay 3, 202114:08 CDT)
Project Inspector
Patrick acdeV(Ma 3.202114:46CDT)
Project Manager
�7q�rie ���Gett�lo�qC�t
Janie Scarlett Morales (May 3, 20211632 CDT)
CFA Manager
b� Bcr�AGcda�F
Dana Burghdoff ( y4, 20 10322 CDT)
Asst. City Manager
M ay 3, 2021
Date
May 3, 2021
Date
M ay 3, 2021
Date
M ay 3, 2021
Date
M ay 4, 2021
Date
$70,333,00
$2,457.95
$72,790,95
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
-FP2
Page 1 of 2
Notice of Project Completion
Project Name: Raising Cane's #506
City Project No.: 102536
City's Attachments
Final Pay Estimate ❑
Change Order(s): � Yes ❑ N/A
Pipe Report: 0 Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid ��
Consent of Surety ��
Statement of Contract Time
Contract Time: 100 WD Days Charged: 71
Work Start Date: 10/26/2021 Work Complete Date: 2/26/2021
Completed number of Soil Lab Test: 49
Completed number of Water Test: 4
Page 2 of 2
FORTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name RP.ISING CANES NO 506
Contract Limits
Project Type V✓ATER & SEWER
City Project Numbers 102536
DOE Number 2536
Estimate Number 1 Payinent Number 1 For Period �nding 3/9/2021
W
City Secreta�y Contract Number Contract Time ���
Contract Date 8/20/2020 Days Charged to Date 71
Project A4anager NA Contract is 100.00 Complete
Contractor EMBREE CONSTRUCTION GROUP, INC.
8050 AIRPORT RD.
GEORGETOWN , TX 78628
Inspectors CORDOVA, R/ AGUIRRE, S
Monday, May 3, 2021 Page 1 of4
City Project Numbe�s 102536
Contract Name RAISWG CANES NO 506
Contract Limits
Project Type WATER & SEWER
Project Funding
UNTT I: WAT�R I��IPROVENIENTS
DOE Number 2536
Estimate Number I
Payment Number 1
For Period Ending 3/9/2021
Item Descriptioa of Items Estimated Unit Uoit Cost Esfimated Completed Completed
No. Quanity Total Quanity Total
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
1 REMOVE 1" WA'I'ERSERVICE 98 LF $10.00 $980.00 98 $980.00
2 SALVAGE 1" WATER MET'ER 6 EA $500.00 $3,000.00 6 $3,000.00
3 TRENCH SAiETY 15 LF $10.00 $150.00 I S $150.00
3 6" PVC WATERPIPE 15 LF $28.00 $420.00 IS $420.00
4 CONNECTION TO EXISTING 4"-16" WATER 1 EA $2,500.00 $2,500.00 1 $2,500.00
MAIN
5 1" PRIVATE WATER SERVICE IS LF $20.00 $360.00 18 $360.00
6 2" PRIVATE WATER SERVICE IS LF $25.00 $375.00 15 $375.00
7 6" GATE VALVE 1 EA $950.00 $950.00 1 $950.00
9 16" GEARED BEVELED VALVE (CO AI) i EA $8,443.50 $8,443.50 1 $8,443.50
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Sub-Total of Previous Unit $17,178.50 $17,178.50
UNTI' IL• SANiTARi' S�WER ID�IPROVEt14�NTS
Item �stimated �stimated Completed Completed
Description of Items Unit Unit Cost
No. Quanity Total Quanity TataP '
- - - - - - - - - - - - - - - - - - - - - - - -
1 REMOVE 8" SEWER LINE 126 LF $I5.00 $1,890.00 126 $1,890.00
2 8" SEWER ABANDONMENT PLUG 1 EA $350.00 $350.00 1 $350.00
3 TRENCH SAFETY 498 LF $3.00 $1,494.00 498 $1,494.00
4 6" SEWER PIPE 16 LF $25.00 $400.00 16 $400.00
5 8"SEWERPIPE 482 LF $30.00 $14,460.00 482 $14,460.00
6 8" SEWER PIPE CSS BACKFILL 482 LF $33.00 $15,906.00 482 $15,906.00
7 6" SEWER PIPE CSS BACKFILL 16 LF $28.00 $448.00 16 $448.00
8 4' MANHOLE (CO A1) 4 EA $4,000.00 $16,000.00 4 $16,000.00
9 MANHOLE VACUUM TESTING 5 EA $250.00 $1,250.00 5 $1,250.00
10 CONCRETECOLLAR 6 EA $]50.00 $900.00 6 $900.00
11 REMOVE EXISTING 4' MANHOLE RISER (CO 1 EA $1,800.00 $1,800.00 1 $1,800.00
AI &A2)
12 SANITARY MANHOLE GROUDING (CO A1, A2) 1 EA $714.45 $714.45 1 $714.45
Sub-Total of Previous Unit $SS,612.45 $55,612.45
Monday, May 3, 2021 Page 2 of 4
City Project Numbers 102536
Contr•act Name RAISING CANES NO 506
Contract Limits
Project Type WATER & SEWER
Project Tunding
Contract Information Summary
Original Contract Amount
Change Orders
Change Order Number AI
CUange Order Number A2
Total Contract Price
DOE Number 2536
�stimate Number 1
Payment Number 1
Tor Period Encling 3/9/2021
$7Q333.00
($56.50)
$2,514.45
$72,790.95
Tota1 Cost of Work Completed g72,790.95
Less °/a Retained $0.00
Net Earned $72,790.95
Earned This Period $72,79095
Retainage This Period $0.00
Less Liquidatecl Damages
Days @ / Day
LessPavement Deficiency
Less Penalty
Less Previous Payment
Plus I14aterial on Hand Less 15°/a
I3alance Due This Payment
$0.00
$0.00
$0.00
$0.00
$0.00
$72,790.95
Monday, May 3, 2021 Page 3 of 4
City Project Numbers 102536
Contract Name 12AISING CANES NO 506
Contract Limits
Project Type WATER & SEWER
DOE Number 2536
Estimate Number 1
Payment Number 1
For Period �nding 3/9/2021
Project Fimding
Project A�Ia��ager NA
Inspectors CORDOVA, R/ AGUIRRE, S
Contractor EMBREE CONSTRUCTION GROUP, INC.
8050 AIRPORT RD.
GEORGETOWN , TX 78628
City Secretary Contract Number
Contract Date 8/20/2020
Contract Time 100 W
Days Charged to Date 71 W
Contract is 000000 Complete
CITY OF FORT WORTH
SUMMARY OF CIIARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of Work Completed
Less % Retained
Net Earned
Earned This Period $72>790.95
Retainage This Period $0.00
Less Liquidatecl Damages
� Days @ $0.00 / Day
LessPavement Deficiency
Less Penalty
Less Pi•evious Pa,yment
Plus A4aterial on Hand Less 15%
Balance Due This Payment
$72,790.95
$0.00
$72,790.95
$0.00
$0.00
$0.00
$0.00
$0.00
$72,790.95
Monday, May 3, 2021 Page 4 of 4
W �
� Z
Z � �
=a a
U �
0
O
Z
Z
�
Q
�
U
�-'
�
Q
t0..
I�-'
U
Q
�
X
W
3
� �
O �
�
N �
QI �
o Q
� W � � �
c � O � M
.� Q �
� � N � Y
� �
�jj � U U
� ~ ��
Z 1-
�-- U O a�. a�.
a.'
�- � W W �k
p Z Q W f-' � W
� Q J
��U U c� 0� cWi) u.
O �
M
N N
M �
� �
O O
Z Z
N N
C C
O O
L L
a �
N �
•� Y
�U
Q m
j U
� @
�a
�
W
�
Q
Z
O �
� ~
U U
W W
� �
� �
Z �
�
U
� � o 0
0 0
Z p
O
U
N
O o 0
� V o 0
_ �' '�n w o
� U o
J �
F- a?
WO O O N
� O O O �
� �' m m m
o _
m ai m
> N 1N1� � N
N O
O U
0 0 0
V o 0
W � w '�" a
� U o
a o
z m
� o 0 0
� o 0 0 �
`m o 0 0
a � m �
0
m a•
m o en » en
O U
F- t j oa o ' o.
� ,�` w w U �
� � U � �'
U Z M U o
Q > °� o
�
M
F-- 4' � � � � N
Z �
� a aMo `�w w
U �
> N � m m
m O 69 tn M
O U
0 0 0
V o 0
�' e�n � o �
� U � p
W m
� o �
fq � � �= � v`�i o
0 0 0 � tA N
y` m o0 o w eA
p o o a o
d N N `? N
N O Ni vi v' tA
O U
N
0 0 0
V o 0
� � �
U �
� �
W �
F- �
a o
� � � � � �
0 o M � ••
vi Vi `r m � N
� N N M e` V
ri ri t�
� U � � � � O
�
� Z
w
� � UQ
O F- a K K
CW') � V 2 Z
oa
r- �,
I- U F � � � O
U � U O � O �
�� F o o� o a o >
0 0 o a Z N uWi �
O � O U � � K a' �
Q F= � Z W J F-
� ❑ �. � �n a
Fx W Z O 0
O W U �U 6 � ~
4.'
W
�
�
O
W
C7
2
Q
2
U
Q.'
O
LL
N
Z
O
N
�
�
N
U
C
O
�
0
�
E
0
rn
C
U
m
�
m
m
0
� •
u
� �
�3 c
G V
O �
c �
a�
o �
U o
L v
N
2 N
�y
N
� 3
a�m
a� �
� U
II
a _,l°
� c
� U
01 N
Zo `0
m
� o
�
•3 �
N
U �
ro �
Q �
� ��
ay
m �
� �"
� �'
� C
� O
�
� O
C �
4 �
�
I@ o
��
co �
� c
o c°�
� 3
O y
m N
O�
�
rn >
C �
m n
U m
0
Z
O
Z
¢
ao
�w
� �
W 2
a�
or
J m
W
> H
W� �
�
U N
�W
Fm
Z J
J
� �
N �
I=- U
? W
W ~
�
O �
Z f-
�Z
ow
Z �
� W
LL �
��
�
U�
Z �
�
�
�
u
�
0
�
�
�
�
�
LL
��
� �
� O
�S
� h-
�
O�
G 5W!
�m
u�y
� V
2 W
�O
��
��
��
��
v�
� o�
�
S.
99
.�
�y
C
�E
W
�
�
�
�
�
X
d �
� u{
� a
�' �
�
� �
�I �
2
F
�
G
�
�
�c
U
�
�
�
�
W
�
�
�
WM
`
�
N
O
N
Qi
O
L
4
Q
C
�
M
n
�
�
0
�
�
�
V
�
�
Y
V
�
a
W�
N
N
m
N
a
0
N
N
0
a
m
N
.�
d'
W �
Z
z W N
_� a
U �
Z
Z
�
H
Q
�
U
�
�
�
�
U
CD
O
� i
N Q
C �
(d �
U �
rn
�
C � � � N
�N �i O N N
� lA c��l � Y
� �
�jj � U U
� U W W
Q O O
Z j-
U Q O � o�.
� ��
� � � 0- � W W �k
Q� a��
a�. �U U U ��� LL
O VM'
c*� 'V'
N N
M M
ti �
� �
O O
Z Z
N N
C C
L .�C
d d
N �
� U
�
Q m
� U
� �C.
� �
�
W
Q
Z
O �
F-' f
UV
W W
�- O
� �
Z a
U
� } o 0
F, Q o 0
Z p
O
U
N
p O O
� U o 0
�. � o 0
_ � � o
� U o
J N
m
W o 0 o m
� o 0 0 �
y` o 0 0
� a m m m
0
'm o w � � �'�
� U
0 0 0
V o 0
W � � � o
� U o
a �
Z � �
�o 0 0
0 o a o &,
y` o 0 0 �
p m m m j
'm o in «n w
O U �
0 0 0 �
F- U � � p
z �' e�» � V o
� U � �` �
U > w U vNi
� a � �n � � ro
F- m m �n � N
Z m ri ri ri ty
� �' w m �
U o
y y M M M
> N O1 QI Ol
N O M fA In
O U
° o 0
U .
.� o 0
� U w w � �'
LL1 N N
�
N N
(O
(/1 � O � � N N �
V �
CI a0 � 00 N N � tA
D � p � N �
y ti ,p M N
N O � � � 6�9
� U �
N
p o 0
U � �
�+' � �
U �
�W N
F- �
a�-�
� O 0 O O �
O N N tA � ..
W N M c � �
a a
w., `o M � � V
> � �q w � u> �
� U �
2
K �
W
� Q
F-
O F a K K
(W9 � V S 2
Q � � F" ul O
F- U
x a Zz cn p
U H U U� K � �
¢ a � � � w °- w w
0 0 o a a z �n �n �
J � O CJ � O Q,' 0.' 1-
C� � � � p � � O
Iy-� 0
O W U �U Q K~
�
w
0
�
O
w
c�
z
¢
x
U
Q'
O
LL
N
Z
O
�
Q
Il.�
�
�
�
O
u
�
O
�
�µ
9
�
�
O
LL
� W
�M Q
6 �
R W
0. �
��
G�
.'
� m
� �
��
V
zw
�o
��
�
� a�D
v�z
�
�
�
.�
�
V
�
�
�
�
�
E
�
�
8 �
c ��1
� a
� �
� �
� �
m �
u
F
�
C
�
�
�
�
c'�5
�
W
�
W
�
W
�
�
N
O
N
oi
0
L
4
Q
�
co
�
ti
�
�
�
d
V
�
m
V
w
a
m�1
N
N
m
N
a
0
N
N
0
ti
a�
N
._
N
�
PROJ�CT NAM�:
PROJ�CT NUMB�R
DOE NUMB�R:
PIP� LAID
C900
FIRE HYDRANTS: None
PIP� ABANDON�D
D�NSITIES:
1VEW SERVICES:
PIP� LAID
SDR-26
SDR-26
PIP� ABANDONED
SDR-26 on Red Lines
DENSITI�S:
N�W SERVICES:
F4RTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
Raising Cane's #506
102536
WAT�R
SIZE TYPE OI' PIPE LF
6" PVC 15
SIZE
Yes
2" Copper
1 " Copper
S�W�R
TYPE OF PIP�
PVC
PVC
SIZ�
8��
6"
SIZE
g��
VALV�S (16" OR LARGER)
TYP� OF PIPE
NONE
TYP� OF PIP�
PVC
YES
'I'Rr1NSPORTATION AND PUBLIC ``VORKS
��i F�' The City of FoLt Woidi • 1000 Thxockmorron Stieet • Fort �`Voith, TL 7G012-6311
0
(817) 392 - 7941 • Fas: (817) 392 - 7845
LF
15LF
18LF
LF
482
16
LF
126
F�ORT �VORTH�
TRANSPORTATION AND PUBLIC WORI<S
March 1, 2021
Embree Construction Group, Inc.
4747 William Drive
Georgetown, Tx 78633
RE: Acceptance Letter
Project Name: Raising Cane's #506
Project Type: Water,Sanitary Sewer,Paving,Drainage and Street Light
City Project No.: 102536
To Whom It May Concern:
On February 23, 2021 a final inspection was made on the subject project. There were punch list items
identified at that time. The punch list items were completed on February 26, 2021. The final inspection
and the corrected punch list items indicate that the worl< meets the City of Fort Worth specifications and
is therefore accepted by the City. The warranty period will start on February 26, 2021, which is the date
of the punch list completion and will extend of two (2) years in accordance with the Contract
Documents.
If you have any questions concerning this letter of acceptance, please feel free to contact me at
(817�392-2443.
Sincerely,
Patrick dey (Ma , 2021 14:46 CDT)
Patrick Bucl<ley, Project Manager
Cc: Steven Aguirre, Inspector
Ron Cordova, Inspection Supervisor
Edward Davila, Senior Inspector
VictorTornero, Program Manager
Kimley-Horn, Consultant
Embree Construction Group Inc., Contractor
Raising Cane's Resturant's L.L.C., Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
AFFIDAVIT
STATE OF Texas
COUNT� QF Tarrant
Before me, the undersigned authority, a notaz'y public in the state
and county aforesaid, on Ehis day personally appeared Matt Clark,
Division Manager Of Embree Construction Group, Inc., known to me to
be a credible person, who being by me duly sworn, upon his oath deposed
and said;
That all persons, �rms, associations, corporations, or ather
organizations furnishing labor andlor cnaterials 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 na claims pending for persanal injury andlor
property damages;
On Contract described as;
CFA#20-0019 CP# 102356 IPRC#20-0OOb
BY
Matt Clark, Division Manager
Subscribed and sworn before me on this date 27th of April, 2Q21.
�
Natar � ublic
Williamson, Texas
`��,�ti►, i t i n 1 r r,,,,���
.�`��\ �N1 A w�< �''�.
. ! �
�:�\Q�,o,�p,RY AG�I /.9 �..
` •. •fi y
_ ���' N—
=.��� �. �� l3� 35 y�,� ' ``�:
i �'p�'' �... ••'' ^j ��
���i����ft0?! s? 11►24� \`\`•
006213 � i
FERFORi1AANtE BQND
Pagf 1 of 3
BOND NO.: 58S293719
1
2
3
4
5
s
THE STATE OF TExAS
COUNtY OF TARRANT
$
§
SECTION 00 b2 �3
PERFQRMANCE 60Nd
§ KNOW ALL BY THfSE PRESENTS:
7 That we, Embree �anstruc�iort Group. Inc. ,_ , known as
8 "P�indpal" herein and � Liberty Mutual lnsurance Company , a torp�rate
9 surety(sureties, if more than onej duly authorized #a do 6usiness in the State af Texas, knawn as
10 "Suret�' herein jwhether one or morej, are held and firmly baund unta the �evelaper, Ralsing
11 Cane's Rettaurants, LLC authorized to do bu5iness iq Texas ("Developer") and the City af Fort
f2 Worth, a Texas municipal carporation ("Cit�i`}, in the penal sur� of, Two Hundred Six fihausand
13 Eight Hundred 5ixteen & 65l10Q Dallar5 {SZOS,825.65�.
14 lawful money of the United States, to be paid �n Fort Worth, Tarrant Caunry, Texas far the
15 payment of which sum well and truly to be made joindy u�to the Develaper and the Clty as dual
16 obligees, we bind ourselves, our heirs, executors, adrrsinistra#ors, successors and assigns, jointly
17 and severally, firmly by these presents.
18 WHEREAS, Oeveloper and City fiave entered into an Agreement for the construction of
19 community #acitlties in t�e City af Fort Warth by and through a Community Facilities Agreement�
20 CFA Number CFA20-0019;and
21 WHEREAS, the Principal has entered into a certain written cantract wlth the Develnper awarded
22 the day of 20_, which Contract is hereby referrecf to and rttade a
23 part hereof fdr afl purpases as if fully set forth herein, to fumish al I materials, equipment labor
24 and other accessories deflned by law, in the prosetution of the Work, including any Change
25 Orders, as prnvided for in said Contract des�gnated as RaisiRg Cane's �506.
26 NOW, THERFFORE, the candition af this obligation is such that if the sald Principal shall
27 faithfully pe�form it obligations under the Centract and shaU in all respects duty and faithfuily
28 perform the Work, including Change Orders, under the Contract, accarding to the plans,
29 specifications, and cantract dnruments therein referred to, an�l as wei! during any period of
arr o� r�Rr wo�N
STANDARD CITY CONDITiONS — DENEi,OPER AWARDED PROlEC75
Revlsed lanuary 31, 201�
Ralsh+gCane'e a506
C1TY PRO1fCTlY0.1�IS36
oa a2 ia - 2
PERFQRAAkhCE BONO
P�aa 2 0# 3
1
2
3
extenstan of the Contract that may be granted on the part of the De�efoper and/or City, then
this nbligation shall be and become null and void, otherwise to remain in #ull force and effect.
PROVIDED FURTHEit, that if any legal attlon be filed on this Bond, venue shail lie in
4 iarrant Caunty, Texas or the United States District Cou�t for the Northern District of Texas, Fort
5 Worth Divisian.
6
7
8
9
10
11
12
i3
ia
is
�s
17
18
19
za
zi
zz
23
24
�S
z�
27
28
29
30
31
32
33
3d
35
36
asu a�rr:
Liberty Mutual Insurance Campany
dTY Of FOA7 WORTH Roisinp Cone's p506
STA NDARD CITY CONDiTtpNS - OEVEIOFER AWIIROED PRQIECTS a1i� PR�IECT N0.10153b
Reased January 31, 2012
This bond is made and executed in compliance with the provisions of Chapter 2253 of
the Texas Govemment Cade, as amended, and afi liabifities o� this bond st�all be determined in
accordance with the pravisians of said statue.
iN WRNESS WNEREOF, #he Princlpal and the Surety have SIGNED and SEAIED this
instrument by duly authorized agents and officers an this the 2�st day �f �ugust
.2020 .
ATTES7:
Shannon Roberson
{principal) Secretary
_ ll * = _ • i - �i h. • � • • �
� BY� .
Signature
Matthew Clark, P�oject Manager
Name and Title
address: 4747 Witliams Drive
Georgetown, TX 78fi33
�ness as to Principal
0062f3-3
PERFQRMANCE BOND
Pa�e 3 of 3
1
3
4
5
5
7
a
9
IO
11
I2
I3
24
1S
16
17
I8
19
2Q
2i
zz
23
za
25
26
���{ �
Witness as to Surety tca�en�a aoss, Searetary)
BY: �/�7Jt�d�-,��� -
Signature
Kenneth �litsche, Aftomay-tn-Fact
Name and Title
Address:
P.O. Box 34526
Seattls, WA 98124
Telephflne Number: 246-473-6210
•Note: If signed by an ofticer af the Surety Company, there m�st be on fiie a certi�ed extract
from the by-laws shawing thac this person has autharity ta sign such abtigatinn. !f
5uret�s physital address is different fram its mailing address, bath must be provided.
The date of the bond shaN not be prior ta the date the Contract is awarded.
CtiY OF fORT WOR7tl
SYANOARD GTY CON017tONS - OENELOPER AWAIldED PROlECTS
Revisrd Janudry 31, 2012
RoJslnq Cn»e's p506
tt7YPROJFCF N0.102536
006214-1
PAYMENT 80ND
Pa`eiof3
BONp NO.: 583213719
1
z
3
4
5
6
7
$
9
10
li
12
I3
14
15
16
17
SECTION 00 6214
PAYMENT 80ND
TH E STAtE Of TEXAS
COUNTY OF TARRANT
$
§
$
KNOW All BY 1'HESE PRESENTS:
tF,at we, Embree Construction Group: Inc. , known as
"PrinCipal" herein, and — Liberty Mutual Insurance Company �
corporate surety ( or sureties if more than one}, duiy autfiorixed to do business in the State of
Texas, known as "Suret�' herein {whether one or morej, are held and firmly bound unto the
�evelape�, Raising Car�e's Restaurants, LLC, authorized to do business in Texas "(Qevelope�),
anc! the City nf Fort Worth, a iexas municipaf corporation {"Cit�''j, in the penal sum
af Two Hundred Six Titousand Ei�ht„ Hundred Sixteen & 6511�0 Doliars iS206,826.651,
lawful money of the United States, to be patd in Fort Worth, Tarrant Caunty, iexas, for the
payment of which sum well and truly be made jointly unto the developer and the City as dual
obligees, we bind ourselves, our heirs, executors, administratars, successors and assigns, jointiy
and severaqy, firmly by these presents:
18 WNEREAS, Develaper and City have entered into an Agreement for the tonstruction of
i9 communfty facHities in the City of Fort Warth, by and through a Cammunity Facilities
20 Agreement, CFA Number C�AZO-0019;and
2i WHER�AS, Principal has entered into a certa�n written Contract with Developer,
22 awarded the day of __ . 20�,, which Contract is hereby
23 referred to and made a part hereof for all purposes as if fuily set farth herein, to furnish all
24 materials, equipment, labor and other accessories as defined by law, in the prasecutian of the
25 Work as provided for in sald Contract and designated as Rarsing Cane's7i506.
26 NOW, THFREFCRE, THE CONDITION OF THIS OBLiGAT10N is suth that if Principal sh�l!
27 pay ail manies awfng to any {and all) payment bond beneficiary (as defined in Chapter 2253 of
28 the Texas Government Code, as amended) in the prosecution of the Work under the Contract,
CITY Of FORT wORTH Aohing Cone's +�506
5'fAN0AR0 pTY CONDIT10N5—GfVELOPER AWAFtDEp PRQIEGTS CITYAROJECFNo. ]02536
Revised lanuary 31, 20i2
00 6214 2
PAYMENT BONd
Page 2 oF 3
1 then this obligatian shall be an� became null and void; atherwise to remain in full fo�ce ar�d
2 effect.
3 This bond is made and executed in campliance wit�t the provisions of Chapter 2253 af
4 the iexas Government Cade, as amended, and all I€abilities an #his band shall be cletermirted in
5 accordance with the pravisions of said statute.
5 IN WITNf.55 WHEREQF, the Printipal and Surety have each SIGNED and SEALED this
7 instrument by duly authorized agents and officers on this the 21st day af
g Augusi , z� 20
r7
RRINCiPAI:
Embree Canstruction Group, Inc.
ATTESi': BY: f �
—�=-- ------------
Signature
Shannan Roberson
(F�incipalj Secretary
Matthew Clark, Project Manager
Name and Title
Address; 4747 Williams Drive
� --
Witness as to P�incipai
C1TV Of FOAi WQRTH
STANDARO CI7Y tONOR10N5 - DEVELOPER AWAROE D PR01Eti5
Revised lanuary 31, 2Q12
Georgetown, TX 78633
SUREiY: �
Liberty Mutual Insurance Company
Rctsing Cone's A�50b
CRi' AROlECT No. 102536
006214-3
PAYMENT BOND
Paat 3 ai 3
AITEST: BY: ,� ,_ ����
Signature
{Suretyj Secretary
Witness �s to Surety (Canellia Doss, Secretary}
1
Kenneth Nitsche, Attorney-In-Fact
Name and Title
Address: �.0. Box 3d52s
Seattle, WA 98124
Telephone Number: 206-473-6210
2 Nate: If signed by an afficer of ihe 5urety, there must be on file a certlfled extract from the
3 bylaws shawirtg that this persan has authority to sign such obligation. If Suret�/s physical
4 address is different from its maEling address, both must be provided.
5
6 The date of the bond shall not be prior to the date the Contract is awarded.
7
8
L�;LZ•I�����I
ClTlf Cf FORT WORTH Rprs��y Carte's Ar506
STANOAAD dTY CONDITIONS - UEVELOPER AWARDED PRp1ECT5 GTl'PRO1fC7 No. ]02536
Revised January 31, 2012
OOb219-!
MAINTENANCE BOND
page i of 4
BOND NO.: 58S213719-0Q
1
2
3
4
5
6
7
SECTION 00 6Z 19
MAiNTENANC� BONO
TH� STATE OF TD(AS
COUFITY OF TARRANT
That we Embre
8 "Prin�ipal" herein and
�
§
�
KNOW ALL BY TMESE PRESfNTS:
y Mutual Insurance Com
known as
a corporate surety
9 ��ureties, if more than one� duly authorized to dn business in the 5tate nf Texas, known as
10 "Surety"' herei� (whether one or morej, are heEd and firmly bound unta the Devekoper, Raisir�g
11 Cane's Restaurants, LLC autharized to do l�usiness in Texas ("aevelope�") and the City of Fort
12 Worth, a Texas municipal corporatian {"Cit�'f, in the sum of Two Hundred 51x Thousand
13 Ei�ht Hunclred Si�een & 651100 pollars fS206,8�6.651,
14 lawful money of the United States, ta be paid in Fflrt Worth, Tarrant County, Texas, for payment
iS af which sum weil and truly be made jointly unto the Devaloper and the City as duai obl'rgees
16 and thei� successors, we bind ourselves, our heirs, executars, adminlstratars, �uccessvrs and
17 assigns, jainily and severally, flrmly by these presents.
18
19 WFIEREAS, �eveloper and tity have entered inta an Agreement for the construction of
20 community fatilities in the City of Fort Worth hy and through a Community Facilfties Agreement,
21 CFA Number CFA20-0019;and
22 WHEItEAS� the Principal has entered into a certain written co�#�act wl#h the Developer
23 awa�cfed the day af _, __ . 20 , which Contract is
24 hereby referred ta artd a made part hereof for all purpases as if fully set forth herein, ta furnish
25 a{I materials, equ3pment labor and ather aecessories as defned by law, in the prasecution of the
26 Warlc, including any Work �esuEting from a duly authorized Change Order {collectively herein,
27 the "Workaj as provided for in said Contract and designated as Raising Cane's A�SQ6 and
28
pTY 4F F�RT WORTFf Rahlrtg Cane's A�506
STANDARD EI iY COND�i[ON S— DEVEEB?ER AWMDE� PRQ1EC75 GIY PR01fCE Ne. 102536
Revised January 31, 2Q11
00 6219 2
MAINTENANCE BBhD
Pa`e 2 of 4
1 WFIEREAS, Principal binds itself ta use such materials and to sa const�uct the Work in
2 accordance with the pfans, specifications a�d Contrect Qocuments that the Work is and will
3 cemain free from defects in mate�ials or workmanship for and during the period of !wo (2j years
4 after the date of Final Acceptance of the Work by the City ("Maintenance Per�od"); and
5
6 WHE�tEAS, Principal 6inds i#seff to repair or reconstruct the Work in whole o� in part upon
7 receiving notice from the Qeveloper andjor City of the need thereaf at any time w3tF�in the
S Maintenance Period.
9
1C1 NOW 7HEREfORE, the conditio� of this obtigation is 5uch that if Principai shall remedy
11 any defective Wark, for which timely notice was provided ny Developer dr City, to a completion
12 satisfactory to the City, then this obligation shall became null and vaid; atherwise to remain in
13 fuEl force and effect.
14
15 PROVIDEd, HOWEVER, if Principal shall fai! so ta repai� or recanstruct any timely
16 naticed defective Work, it is agreed that the Developer or City may cause any and all such
�7 deiective Work to be repaired and/or retonstructed with all assocfated tosts thereof being
18 borne by the Principa! and the Surety under this Maintenance Bond; and
19
2a PROVID�D FURTHER, that if any legal action be filed art this Bond, venue shall Ife in
2i Tarrant Gounty, TexaS or the Unfted 5ta#es Oistrict Court far #he Northe�n District of Texas, Fort
22 Worth bivision; and
23
24 PRQViDED FURTHElt, that this obligatian shall be tontinuous in nature and suuessive
25 reco�eries may be had hereon for 5uccessive breaches.
xs
CiTY OF FORT WORTN RohlnQ Cone's +M505
STANDARO CITY CONDIT10N5—DfVELOPER AWARDED PROiECTS CnYPRO1fC7No. 102536
Eterlaed lanuary 31, 2G12
00 6219 • 3
MAINTENANCE 80N0
Page 3 of 4
1
z
3
4
5
6
7
$
9
ia
�x
12
13
14
15
16
17
18
19
Zo
zl
22
23
za
25
zs
27
2$
29
30
31
32
33
S
36
37
38
39
iN WITNESS WHEREOF, the Princfpal and the Surety have each SIGMED and SEALED this
instrument by dvly authorized agents and officers on this the 2�st day of August
zo zo .
AiTE57:
PR! NCIPAL:
Embree Constr�c#ion Group, �nc.
BY: •
� Signature
Shannon Roberson
{princlpalj Secr�tary
Matthew Clark, Pro ect Mana er
Name and Titie
Address: �747 wiltlams Drive
Georgetown, TX 78633
-�
�
Witness as to Principal
CITY Of F4Ri WORTH
SiqNE?ARO CITY CONDI710NS — p�1/ELOPER AWARDED pItOJECTS
Ravisedlaeuary 31, 2012
SU RE7Y:Q
Liberty Mutual Insurance Company
BY: _,'��1�' �,�
Signature
Retslnp larte't N506
dTYPRQlfCT No. ID2536
00 6219 - 4
MAIN�ENANCE BONO
Pa�e a ot a
1
2
3
4
5
6
7
8
9
10
il
AiTEST;
(Suretyj Secre#ary
WitnQSS ds to Su�ety (Canellia Doss, Secretary)
Kenneth Nitsche, Attomey-In-Fact
Name and Title
Address: P.o. Box 3a�26
Seattle, WA 34526
Te{ephone Number: 206-473-6210
12 �Note: If signed by an offlcer of the Surety Company, there must be on file a certified extract
13 from the by-laws shawing that this person has authority to sign such obligation. If
14 Surety�s physical address is different from its maifing address, both must be provided.
15
16 The date of the bond sF�all not be priar to the date the Contract is awarded.
17
pTY �f FORT WORTH RcislnQCorte's R50b
STANDARO CI lY CONDiT10N5 — DEVElOPER AWARDEO PIEOlECTS Cl1YPROIEGT No. 10�536
Revisedlanuiry 31, 2012
Liberty
Mutual.
SURE7Y
Liberty Mutual tnsurance Company
The Ohio CasuaSty Insurance Company
West American Insurance Company
POWER OF ATTORNEY
Certificate No: 8203793 - 974127
KNOWN ALL PERSONS BY YHESE Pi2ESENTS: Thet The Ohio Casualty Insurance Company is a corporation duly organized uMer the laws of the State oi New Fiempshire, thai
Liberty Mulual Insurance Company is a corporation duly organized under fhe laws oi ihe State oi Massachusetts, and West American lnsurance Canpany is a corporation dufy organixed
under lhe laws of the Stake oi Indisna (herein cdlectively called the'Companies ), pursuant to and by authodly herein set forth, does hereby name, constihrte and appoint, Kenneth
Nitsche; Ga A. Nitsche, Robert James Nitsche; Robeft K. Nitsche; Ccai Parker; T�lina Smitki
all of the city of Giddin�2s stete oi TX each mdividually if there be more than one named, its true and la►vhil sttomeyin•fact to make,
execute, sea1, acknowledge and deliver fa and on ds behaff as surety end as its act and deed, any and all undertakings, bonds, recognizanoes and other surety obligations, in pursuenca
of these presents and shall be as binding upon the Companies as if they have been duly s+gned by Ihe president and attested by the seaelary of tha Companies in their awn proper
persans.
IN WRNESS WHEREOF, this Power ot qttomey has been subs�xibed by an authorized o�icer ar oihcial of tha Compan�es and the corporate seals oi the Compenies have been affuced
thereto 1hi5 22nd day of May , 2020 .
Slate oi PENNSYIVANiA
Counly of MONTGOMERY ss
Liberty Mutual Insurance Compeny
��Nsu tr iNB� � 1N8Uq� The Ohio Casualty Insurance Company
��,cjPO'�+r���,� �,�o+�'O�4f�Rty� � r�,o�*a4r� n� Wesi Amencan Insurance Company
� 1812 � a 1919 � � 7881 � A��� /` ��
y d ( O >
d'`�O°�cNu+�ra: s� �h�MM'� D� �lS, 'aoun* ,�a /
�9j� * ►`t� ��'1 r 1�� �M + �� By' -
David M. Carey, Assistant Secretary
N
N
c
.�
�
� On tha 22nd day of May 2020 before me personally appeared Dawd M. Carey, who acknowledged himsel! to be fhe Assistent Secretary of Liberty Mutual Insurance �
� Company, The Ohio Cesualty Company, and Wes1 American Insurance Comparry, and that he, as such, being authorized so to do, execute the taegoing ins6rument for the purposes � w
� therein contained by sgning an behaN of fhe corporations by himself as a duy aulhorized oSficer.
� � —
'
�
.y
�
�
�
�
y
�
d
c
1N WITNESS WHEREOF, I have hereunta subsaibed my name and affixed my notanal seal al King ot Prussia, Pennsylvania, on the day and year first ebove writlan.
,,��,ON WEq.,,.:.
O �t
Thie Power o( Attomey limits the acts of those named herein, and they have no aut�ority fo
bind the Company except In the mdnner and to the extent herein slated.
�v
z:�. �,�r-�, �e�`��,.
COMAAONWEALTH OF PENNSYLV/WIA
NOfa�al $epl
Tarese Peglgllp. Np18ry Ple41iC
Upper Merqn Twp Mpnlgornery Counly 8]t:
My Commissqn E�pres March 28.2p21
R+n-+�a. PanneYh'anir Aasatlalion of NOWr4ee
/
This Power oi Attomey is made and exewted pursuant to and by authority of the tollowing Bylaws and Authorirations oi The Oh o Casualty Insurance Canpany, Liberry Mutual
Insurance Company. and West American Insurance Canpany which resduUons are now in fu0 force and etiect reading as idlows:
ARTICLE N- OFFICERS: Section 12. Power oi Attamey.
Any officer ar other aifipal oi the Corpotation authorized far theS purpose in writing by 1he Cheirman or the President, and subject lo such bmitation as the Chaimtan a the
President mey prescnbe, shall appo'nt such attomeys-in-fact, as may be necessary to act in bahaH of the Corpcxation to make, execute, seal. acknowledge and deliner as sureiy
a�y and all undeRakings, bonds, recagnizances and other surety o6lgations. Such ariomeys-in-fect, subject ta the limitahons sel fath in their respecdve pa�rers o! attomey, shall
have hrll power to 6ind the Corporation by their signature and execution af any such instruments and to aitach thereto the seal oi the Carporation. When so executad, such
instruments shaA be as binding as d signed by the President and attested to by the Secretary. Any power a authority granted to any representative or attomey-in-fact under the
provisiorts of this article may 6e revoked at any time by the Board, tt�e Chairman, the Presidant or by the officer or officers granting such power a autltarity.
ARTICLE XI11- ExecuUon o! Cantracts: 5ection 5. Surely Bonds and Undertekings.
Any officer of fhe Comparry authorized fa ihal purpose in wnting by the chairtnan or the president, and subject to such limitations as the chauman a tha president may prescribe,
shall appant such attomeys-in-fact. as may be necessary to act in behalf oi the Compa�y to make, execute, saal, acknowledge and defirrer es surety any and aN undertakings.
bonds, recagnizances and olher surety obligatians. Such attomeysin-fact subject lo the limitations set forth in their respective powers oi ettamey, shan have fuA power io bind the
Comparry by their signalure and execution of any such instruments and to attach Shereto the seal ot {ha Canpany. When sa execuled such insduments sha7 be as binding as it
sgned by the president and attested by she secretary.
Certiflcate o! �ealgnaGon - The President of t�e Campany, ac6ng pursuant lo the Bylaws of the Company, a�thorizes David M. Carey, Assistani Secrelary to appant such attomeys-in
fact as may be necessary io act on behalf of the Comparry to make, execute, seal, acknowledge end deliver as surety ar�y and af undertakings. bonds, recognizances and other surety
obligations.
AutharizaUon - By unanimous consent nt the Company's Board of Directars, the Canpany consents that tacsimile or mechanica ly reproduced signalure of any assistant seaetary ot the
Company, wherever appesring upon a cer6fied copy of any power ot adomey issued by the Company in connaction wilh surely bonds, shall be vand and binding upon the Company vntlt
tfie same torce and ef}ed as though manually affixed.
I, Renee C. I.lewellyn, the undersgned, Assistant Secretary, The Ohia Casualty Insurance Company, Liberty MuWal Insurance Company, and West Americen Insurance Company do
hereby oertilly that fhe origina' power of attomey oT which the fcNegoing is a full, true and coRect capy oi the Power of Aitomey executed by said Companies, is �n ►ull iorce and etfect and
has nat heen revaked.
IN TESTIMONY WHEREOF. i have hereunto set my hend and atfixed Ihe seals of said Companies Ih's 21 st day of August , 2020 .
'V SNSUR9 �,tY IN9V � 1NSU�p,f
j�'�u�'6 C�� J y,,'qpa4r� `Vr o�r 'yC+
� S �O m Q' � FO i�
� 1912 � o� 1919 4 0 4 1991 0 ��,l„(�ly�
d�+��� *�° aaa ��,y",r.*��ae ra�M�*"���a $y. Ftenee C. LlewelFyn, AssisWn#Seaebry ---
LMS-12873 LMIC OCIC WAIC Mulii Co iifi3
O M
��
� �
d �
O N
1p
N �
G O�
o�
o�
ea �
�o
C N
.• cp
��
��
cd
��
o�
_�
_ Liberty
1VIu#.ua1.
SURETY
TEXAS
IMPORTANT NQTICE
To obtain information ar make a complaint:
You may call tall-free for informatian or to make
a complaint at:
2Q6-473-621d
You may also write to:
Liberty Mutual Surety Claims
P.O. Box 34525
Seattle, WA 98124
You may contact the Texas Department of
Insuranee ta abtain information an eompanies,
coverages, rights ar complaints at
I -800-252-3439.
You may write the Texas Degartrment of
Insurance Consumer Protection { 111- l A)
P. O. Box 149091
Austin, TX 78714-9091
FAX: {S 12) 490-1 OQ7
Web: http:/(www.tdi.texas.gov
&mail: CansumerProtectionCc�tdi.texas.gov
FREMIUM OR CLAIM DISPUTES:
Should you have a dispute concerning your
premium ar about a claim you should first
cantact the agent or call 1-$00-843-6446.
If the dispute is not resolved, you may contact the
Texas Department af Insurance.
ATTACH THIS NOTICE TO YOUR POLICY:
This notice is far information only and does not
become a part or condition of the attached
document.
1►1 ilil�:�fi�I�jl
Liberty Mutual Surety
Attention: LMS Claims
P.O. Box 3452fi
Seattle, WA 98124
Phone: 206•473-6210
F�x; 866•548-6837
Email: HOSCt@Iibertymut�FsLcom
www,LibertyMutual5uretyCiarms.com
TEXAS
AVISO IMPORTANTE
Para obtener informacion a para someter una queja:
Usted puede llamar al numero de telefono gratis
para informacion o para sameter una queja al:
206-473-6210
Usted tambien puede escribir a:
Liberty Mutual Surety Claims
P.O. Box 34526 -
�eattle, WA 98124
Puede comunicarse con el Departamento de
Seguros de Texas para obtener informacion acerca
de companias, cober[uras, derechas o quejas al
1-80�-252-3439.
Puede escribir al Departamento de Seguros
de Texas Consumer Protection { I 11-1 A)
F. O. Box 149091
Austin, TX 78714-9091
FAX # {512) 490-1007
Web: http://www.tdi.texas.gov
E-mail: ConsumerProtection tdi.texas. ov
DISPUTAS SOBRE PRIMAS 0 RECLAM4S:
Si tiena una disputa concerniente a su prima o a
un reclamo, debe comunicarse con el agente o
primero. Si no se resuelve la disputa, puede
entonces comunicarse con el departamento (TDI}
UNA ESTE AVISO A SU POLIZA:
Este aviso es solo para proposito de informacion y
no se canvierte en parte o condicion del
dacumento adjunto.
�Ms-�sssse �a�s