HomeMy WebLinkAboutContract 53920-FP1 FORTWORTH®
TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
City Secretary No:_53920 -FP1
Date Received:Aug 13,2021
City Project Ns: 101473
Regarding contract 53920 for 2018 CIP YEAR 2 CONTRACT 10 as required by the
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 05/05/2020
through M&C 20-0310 the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon
the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the
project as complete.
Original Contract Prices: $3,496,451.02
Amount of Approved Change Orders: Ns
Revised Contract Amount: $3,496,451.02
Total Cost Work Completed: $2,951,731.49
Less Deductions:
Liquidated Damages: 0 Days @$630.00/Day
Pavement Deficiencies:
Total Deduction Amount: $0.00
Total Cost Work Completed: $2,951,731.49
Less Previous Payments: $2,804,144.92
Final Payment Due $147,586.57
L�e�P�ceuY Lauren Prieur(Aug 11,202109:28 CDT) Aug 11,2021
Recommended for Acceptance Date
Asst. Director, TPW - Capital Delivery
O Aug 12,2021
wj(Aug)2,202 11:20 CDT)
Accepted Date
Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT
Client Department
Dc1n67 24L( hd%ff Aug2 2021
Dana Burghdoff(Aug 12,202112:23 CDT) g
Asst. City Manager Date
Comments:
C-620 Signature Page
Contractor's Application for Payment Invoice No. 11-FINAL
To(011-1) Inmicing Pcdai(From-T.): Imoica Dam:
i City of Fort Worth 7nnoa-7nrr1o:1
P,O. FW020-0000003834 rrem(Contractor): Remit to(IfNol Automatic Deposh):
Number: TEXAS I,IATER1ALS GROUP INC DBA TEXAS BIT
Project: 101473 C.nua"ofa CrW verabr N..:
ogogoggzs7
Citys—taycontraa 53920 Con"'"2018 CIP YEAR 2 CONTRACT 10
Numt- Nam.
Applicallon Far Payment
Chan cOrdcrSummA
A axd Chan Orden 1.ORIGINAL CONTRACT PRICE.........................................__..._5 S3,496,451.02
Number Addilioos tktetions 2.Netchaneeby Chanea Orden..__.....__..........I.............................S
1 3.Current Contract Price(LineIt2l................................................S S3496r151.02
2 4.TOTAL COMPLETED AND SPORED TO DATE
3 (Proz—,E"imale,Co..I—Ilon Alto—.,,and Chance Orders).......S 52,951,731.49
4 S.RETAINACE:
5 a.5.0% X Work Comnleled_..._..S
6 b. X Hot Used S
7 .Tohl Itetabuee(LEae Sa+L(ne 5b)•....................._......5
8 6.AMOUNT ELIGIBLE TO DATE(Line 4-Llne So)—................_......_5 S2.951,731.49
TOTALS 7.LESS PREVIOUS PAYMENTS(Lin,6 from pdorAnnlicalion)..__._S 31,104,144.92
NETCHANGEDY S.AMOUNTDUETHISAPPLICATIGN..._._._.................................S 5147556.57
CHANGEORDERS 9.BALANCE TO FINISH,PLUS RETAINACE
(Column C on ProemsE01-1N CA+Cos,+Line 5ab—)....._.»_..S S544,719.S3
Contractor%Ce"Ir-II.n 10.CONTRACTTRIE:
The ConkxtorcMifies with the submittal of1lJs doeumem and nssaimed Payment Request Submittal ., Dap Awarded 330
on the City of Fort Worth Boosaw system that to dw hest ortheir k—siedge:(1)all Previous Pro&an b. Dap Added by CO
paymentseecaited Dom Otmeron..ounl of Wolf:doneunder the C.nOacl hive been applied on Total Dap 3)0
—.1 to diadurge Contotdoe.kgitim to obligations inctarad in on...donuith 1Vork,.aend by
prior Applications ror Payment;(2)this or sit Work materials and equipment incorporated in said
Nook oro the rritelhted in orco—d by this APPlintion for Payment will Psss to Onner at time of d Days Charged 275
payment fie.e.and alear.f all Liens.—riy interests ood encumbrances(axcept suck as are e.vercd by
a Bond acceptable to On—irdamnif)ing Getter against any such Liens•wudy interest or Dap Remaining 55
umMancet);and(3)all Work coaimd by this Application for Payment is in accordance with the
Coniroel weurrtenta and is not dereeti—
Liquidated Dam ages
@S6�30.00 (ley
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This document has been modified from Its original form as on EJCDC document and the user did not Ngh5ghl the
modifications.You are encouraged to read the document careftlly and consult Legal Counsel prior to its execution.
Progress Lrslinlnle „` 519m Contrnelor's Applienlion
r•I'OL1l 2018 CIP YEAR 2 CONTRACr 10 "++"i IMNAL
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City of Fort Worth Summary of Charges
City Secretory Contract Num: 1 53920 2018 C1P YEAR 2 CONTRACT 10 P.D,; nV020-0000003834 Projmt Number. 101473
Application Period: 7/I/2021-7/16/2021 Application 114INA,, Application Datc: 1/0/1900
Number.
Fundina Idenlllication IFID) Total Completed Aml RemainingGross Retsina a Net
Ori inal Contract
50002 0600430 5740010 1101473 001780 9999 $1008128.69 $145049.01 ".00 5a'70 1nM
66002 0700430 5740010101473 091780 9999 $727 059.28 $65 936.89 11100 :n rx) j n rrl
34018 0200431 6740010101473 D02480 9999 $1 218 543.52 $333 733.63
0 WOO SU an _sn ad :•I,n:. sn 01r
0 ;+on Sn CP cq(U) n n:, $0 ru
0 •,� 1 An On to nn
9 .onl) ]rl(N, rnl I,rl" 1111'Yr
9 }r'll ?.Ir r.lr il•Ir „ly,r rrl f+l
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0 -:rltl ••I. - I!Il '.II r).. '�'•)IYr
9 :.,Ixl },1••rl r,l nfr '(r In;. !,I I.,
Manua Order 1
56002 0600430 5740010 J01473 001760 9999 ;D.tx) 9 n!:n in nn io t n
56002 0700430 5740010101473 001760 9999 %'.+f10 •••.. in on •,a,y, P.r",
34018 0200431 5740010101473 002480 9999 ;n.oa •L,I(•n 19(Y I Cr i m) HI nfr
0 ;a.n9 :pl qrr fin nn `.fr On ;%rn,
0 ;21!0 7nrar #17 nn� •n Ix? pngl
0 ;fi.W },I"Is sn I>.l .`rr 01, nlnl
9 -U.IN7 1r1 r:n it)(nl fy)
0 ;iron }rrrvr :!n rnr •nrl;, Vr!m
;nr-n to ryl 9n 0a Nl rrr
n.lk� 52:x) }q fur SQ.rM, y)lu,
0 s0.!x) vl lxl a0(u) In i')Irr
0
Chancie Order 2
56002 0600430 5740010101473 001780 9999 ,a1xi +�1 U!I c0•!k. :0 m },)n0
56002 0700430 5740010101473 001780 9999 'fS.!k) *a).rnr -sum '+.n^ ;n rnr
34018 0200431 5740010101473 002480 9999 :a.on •.0.0C' W.00
0 ;0.00 5Q00 VIOn •4 rn) ulna
0 �J.nu Shan 4AA) •.n lri+ ;n ral
0 ;allij 10.iwr .cn.0a :rr ry, In an
0 -:a(vr 4r,on 10.00 •'n ry, gn Fill
0 :A.aO i0.00 MIX), r*�a} mnn
0 tt In7 VVIO 1 }a.aCl Glr nh m as
0 ;�Fill erl,nn i0.1*n O.a:) HI.rY_I
I
Citv of Fort Worth Summary of Charges
City Sccmlwy Contract Nunt: 53920 2018 CIP YEAR 2 CONTRACT IO P.O.: MV020-0000003834 PrajatNumbcr. 101473
Application Period: 711/2021-7/16/2021 Application 11-FINAL Application Dam 1/0/1900
Nuntbcr.
Funding Identificatlon FID Total Com feted Amt Remalnln Gross Retains a Net
Change Order 3
56002 0600430 6740010 101473 001780 9999 SI?tHJ 1 n DU bU fin tt'Ji"r Yil UrJ
56002 0700430 5740010 101473 001780 9999 :J3.lW °0.t 57.M :"rla t0 r4t
34018 0200431 5740010 101473 002480 9999 in fat •n ru: 1n nn
O f!ur Rr nn to Ow. ••0.tJn I't(xr
O 16 L1 L�nnl ¢11N1 'It i}: Q,l ref
0 •,�w }n tx; pnxt •.q rvJ 1,1 rof
0 ',0 r.t ptca, vnnl yn.00 In M,
0 yr mt }p'vi t0 txt ^:n!V) 1n nn
0 unt 1'r!x' t.n nn .OU 1000
0 nn A tO rat 1 fin.00 40.00
0 '.n OI ..... fir lvt '0.0•� :j.O On
Change Order 4
56002 0600430 5740010 101473 001780 9999 ;0 rHt n rv; nn •x n: gn M
66002 0700430 5740010 101473 001780 9999 SO.110 �'ou !"M '"+''' .1
34016 02004315740010 101473 002480 9999 ;n trtt ""' "r'.n 'a,°" .10)w
p `000 Inn, 'rT, 1n r41
0 ift.(xl +.n;ar torn 'U'r Jn rxl
0 so.eo J�rx; tglvt 'Plv., inter
0 ;0tq 5n rvi in 1n1 -n!:. n rnr
0 $O.IVI lll•ar tll!'.fi '1rrN 1rt,a1
0 .;U.qn lntvr y,tnu •:n0<I :plr.r
0 i:ti tyr 011x1 iq n0 OA'1 to mr
p ifJ.tHt 1n'di Vun, rnit' Mon
Change Order 5
56002 0600430 5740010 101473 00780 9999 1 S(t Otit }n+f, 60
56002 0700430 5740010 101473 001780 9999 SO.fvJ �,:a� •+!Ui, 'U,4• 10A0
34018 02004315740010 101473 002480 9999 :c.rw wr•vi :.Inn rnre• rnl
0 �un7 :.'1xr
0 ;0 rgl tirUr !non •rr ry, }n nu
0 ai aJ lr1:v, pt on
0 -0 A0 tur1 pinn
0 'irwt ❑Nxl I.n w. ^tr rr' pt nu
0 501eJ Nr:.cr pI nrl .t'1 nu
0 ;•O.tat fn<v, 40 vo •n ir: O.OU
9 :0(xJ 11r!Vr '.r1 rill .....` 1n tN1
Citv of Fort Worth Summary of Charges
cityscerctory Canimcl um: 53920 2018 CIP YEAR 2 CONTRACT 10 P.O.. FIV020-0000003834 Projcd Nwnbm, 101473
Application Pcdod 7/l/2021-7/1G/1021 Application 11-FINAL Application Date: 1/0/1900
Nombcr.
Fundin.tdentirtoaiion FID Total Com leted Amt Remainin Gross Retsina a Net
Chan eOrder6
56002 0600430 5740010 101473 001780 9999 ;i?rn7 +.?,)!? 1U un ,'!On y7!YI
56002 0700430 5740010 101473 001780 9999 ;.:!.M1 1!1 ntr MAIO ::atlo }U.Cx7
34018 0200431 5740010101473 002480 9999 ,^rr, 1n Cxt 10.On gn 0') 1+7.M
0 ;U.t>'7 1utv1 1•U.90 `OM 1R nn
0 nW1 311(y. .i0 p'l sn 00 !ul
0 :.1?.Ml cn(yt 40 im 1d00 ;-0C41
0 W.00 1n i3u 40 Cvt 50 U 1•l CIl
0 G0.n0 14300 }r!P0 rnn•r Inl rp
0 111.00 40 Cm :Ir i;t. $rl rxr
0 S0.M1 40-010 S0.0U jrr.r. ti!!yr
0 stl OU gn Un i0.nr-1 nn1• plm
change Order 7
56002 0600430 5740010101473 001780 9999 +r r7_r St?!?0 40.01)
56002 0700430 5740010 101473 001780 9999 50.110 1 $0.00 ULM S4 00 10 tti_1
34018 0200431 5740010 101473 002480 9999 :'0 rh7 1 1100 Woo 7ri.0fi :V!on
0 St!00 40.0n ui.M 50.00 10 p7
0 :0 tilt 10.00 SO UU :t400 1tLCx7
O FA.00 SU.(r0 ;m.tNl .OD V1.011
0 W.00 8n 110 in.Cxt s00:7 V)0U
0 ;4t00 i0m s(00 Of-)
0 ;tr1q ;nOti ;nrd) 511U0 10rm
0 :•C100 40.0" ;•0An ;0 P-D 10.M1
;n On 50 cat 1,0 0•a ;+!M
Chen a Order 8
56002 0600430 5740010 101473 001780 9999 C•0 ml
56002 0700430 6740010 101473 001780 9999 W.M1 1U.00 $0.00 :!'?Ni 10 00
34018 0200431 5740010 101473 002480 9999 A.M! 31t.t!n Sn.00 <°7n yt V°
0 SO.M! 1U tug MOO :q-tv: 1'11)11
0 01nt $n nn �n.00 ;O.rp; 1n ul
0 �n INI 'yrl•!Il t7 ry7 c!r M; tl,lxl
0 :rr lnl }Ir r4r lU rx,l LLL
0 SO 00 .10 Un P—t :inr, In rxl
0 :,xm 30.00 101a1 rvl
0 3;!ra7 7n Mt 6n pll
0 :0ru� filr0 10in1 .tray, P,P,
City of Fort Worth Summary of Changes
City Secretary Contmct Num: 53920 2018 CIP YEAR 2 CONTRACT 10 P.O.: nY020.0000003834 Projat Number. 101473
Application Period: 711/2021-7/16/2021 Applicolion 11-FINAL Application Data: 1/0/1900
Number.
Funding Idenlificalion IND) Tolal Com leled Amt Remainina Relaina a Net
Totals
:JOY) Uo
$tOOB128.6956002 D60043057400101014 $145049.01
56002 0700430 5740010 101473 001780 9999 5727 059.28 $65 936.89 A0.1u7
34018 0200431 574DO10 101473 002480 9999 S1216543.52 $333733.63 Soux, ^O.rAI V3.at
0 -:nnn inM 12tn Cf!0o 44pn
1a,CO 10 on ?U U0 4U 90
0 :pn V)On io.M ^n rp, 1n n0
0 : ut go•xr 1o0,xr <nn^ 1+um
9 - rbl tp UP 1 ti
� F>'3 ai M1n•4, lA1.Un 'u rqY t•l un
0 .St on 1-0 fn,1 1 •u oo p1 rw,
Grand Total $2,951,731.49 11 $544.719.53 1 1 $0.00 1 (5747,588.57) $147,bB8.57
III
i
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: 2018 CIP Year 2 Contract 10
PROJECT NUMBER: 101473
DOE NUMBER: N/A
WATER
PIPE LAID SIZE TYPE OF PIPE LF
Open Cut 6" PVC C900 Water Pipe 120 LF
Open Cut 8" PVC C900 Water Pipe 4,449 LF
FIRE HYDRANTS: 7 VALVES(16"OR LARGER) None
PIPE ABANDONED SIZE TYPE OF PIPE LF
None
DENSITIES: Passed
NEW SERVICES: I" Domestic/Copper 89 EA
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
Open Cut 8" SDR-26 Sewer Pipe 2,972 LF
Open Cut 8" Ductile Iron Pipe 375 LF
PIPE ABANDONED SIZE TYPE OF PIPE LF
None
DENSITIES: Passed
NEW SERVICES: 4" SDR-26 Sewer Pipe 83 EA
TRANSPORTATION AND PUBLIC WORKS
E The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TZ 76012-6311
(817)392-7941 •Fax:(817)392-7845
FORTWORTH.
' '0'
TRANSPORTATION AND PUBLIC WORKS
July 19, 2021
Texas Materials Group (Texas Bit)
420 Decker Dr Suite 200
Irving,TX 75062
RE: Acceptance Letter
Project Name: 2018 CIP Year 2-Contract 10
Project Type: Water&Sewer
City Project No.: 101473
To Whom It May Concern:
On May 3, 2021 a final inspection was made on the subject project. There were no punch list items
identified at that time. The final inspection indicates that the work meets the City of Fort Worth
specifications and is therefore accepted by the City. The warranty period will start on June 21, 2021,
which is the date of the final inspection 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)
647-2524.
Sincerely,
&9_V9W_z9l(/
Mage Zaki(Aug 11,202109:15 CDT)
Maged Zaki, P.E., Project Manager
Cc: Eustorgio Andrade,Jr, Inspector
Wade Miller, Inspection Supervisor
Emanuel Nieto,Senior Inspector
Mary Hannah, P.E., Program Manager
Arredondo,Zepeda& Burnz, LLC, Consultant
Texas Material Group,Contractor
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev.08/20/19
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, Vice President of TexasBit, Inc.,
known to me to be a credible person,who being by me duly sworn, upon his oath deposed
-..� a
rug u :ya.'A
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;
2018 CIP Year 2 Contract 10
BY ``F
Sam Davis
Vice President
TexasBit, Inc.
Subscribed and sworn before me on this r day of , 2021.
NOT WY OUht IN AND FOR
COUNTY, TEXAS
My commission expiresapLu�&5 �bZ JAMIE GREENWAY
0.
��SOf;. 4
�i
zNotary Public, State of Texas
_'�°• '�= Comm.Expires 09-25-2024
ruP` Notary ID 12115454 11
CONSENT OF SURETY OWNER
TO FINAL PAYMENT ARCHITECT
AIA Document G707 CONTRACTORSURETY
(Instructions on reverse side) Bond No. 014219196 OTHER
TO OWNER: ARCHITECT'S PROJECT NO:
(Name and address)
City of Fort Worth
Zoo Texas Street CONTRACT FOR:
Forth Worth,TX 76102
2018 CIP Year 2-Contract 10-Project No. 101473
PunrFrT: CONTRACT DATED:
(Name and address)
2018 CIP Year 2-Contract 10
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the
(Insert name and address of Surety)
Liberty Mutual Insurance Company
175 Berkeley Street Boston,MA 02116 SURETY,
on bond of
(Insert name and address of Contractor)
Texas Materials Group,Inc.dba TexasBit,A CRH Company
420 Decker Drive#200 Irving,TX 75062 ,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 of Owner)
City of Fort Worth
200 Texas Street Forth Worth,TX 76102
OWNER,
as set forth in said Surety's bond.
IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: August 4,2021
(Insert in writing the month followed by the numeric date and year.)
Liberty Mutual Insurance Company
(Surety)
(Signature of aut orized representative)
Attest/Witness:
(Seal): 06*I v 'orou Stephanie Gross,Attorney-in-Fact
Jessica Richmond,Witness (Printed name and title)
AIA DOCUMENT G7tr7 w CONSENT OF SURETY TO FINAL PAYMENT w 1994 EDITION w AIA
®1994 w THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVENUE,NW,WASH-
INGTON,D.C. 20006-5292 w WARNING: Unlicensed photocopying violates U.S. copy-
right laws and will subject the violator to legal prosecution.
G707-1994
This Parer of Attorney limits the ads of those named hwdr%and they have no athaily to
7 L bind the Canpary except in the nrharhncr and to the extent herein stated
Liberty Liberty Mutual Insurance Company
10�MutuaL The Ohio Casualty Insurance Company Certificate No: 8204862-022001
West American Insurance Company
SURETY
POWER OF ATTORNEY
KNOM ALL PEI;GCNS BY TFESE PRESENTS:That The Ohio Casualty Irstranoe Carp"is a aopo-&on duly ogaized under the laws of the State of New Hanpshire,that
Liberty Mt l Insurance Company is a corporation duty organized under the laws of the State of Wssach usetts,and Vlkst American Irsuanoe Corrpary is a eorpaation city organized
under the laws of the Sate of Indiana(herein collectively called the"Compaiml,pusuart to and by authority herein set forth,does hereby nave,constitute and appoint, Chelsea
Nielson;Jessica Richmond;Joyce A.Johnson;Philip N.Bair,Stephanie Gross
all of the city d Houston state d TX each inxfividualy if there be more than one darned,its he and lawful attorWn-fad to make,
eaec te,seal,adToMedge and deliver,for aid m its behalf as suety and as its ad and deed,ay and all undertakings,bands,reeognizaraes and other suety obligations,in pursuance
of these presents and shall be as binding upon the Carparies as if they have been dry signed by the president and attested by the secretary of the Oarpahies in their own proper
persons,
IN WITNESS V*EI'1EOF,this Pow of Attorney has been subscribed by an authorized officer or official of the Carparies and the corporate seals of the Carpanies have been affoed
thereto this 12th day of February , 2021
Liberty Mtual Insurance Company
��1NSUgq �ZY INS& a 1NSUp_ The Cho Casualty InswanceCOmpany
o°RPO& ok, VVkst American Insdral0e CaTpany
gJd `porn vQ a �o m � _ `poc°
1912 n a 1919 g 1991
(y d�'a'l�CHU6",aD s�ZNAMPsll.aaO `Cs �NDIAMe' .tta� U
c
m David M CaW,Assistant Secretary
d`a Sate of PENVSYLVANA ss
Carty of MONI-GME W g E
2 Cn this 12th day d February 2021 before me personally appeared David M Carey,who adahaMedged himself to be the Assistant Secretary of Liberty Mrhral Insurance m
Company,The Ohio Caualty Carpary,and VVmt American Insurance 'E 72
Carpay,and that h' as suxh being authorized so to do,ezeate the foregoing irstrurrnert for the purposes•——
aim therein contained by silting on half d the corporations by himself as a duly authorized dtioer.
—3 IN WITNESS 1M'tF]EOF,I have hereunto si"clibed rry name and abed rry notarial seal at Kng of Russia,Pennsylvania,on the day and year first above vatttert.
m 5i t' Pis
` Q4�KONW rF! cannw"801M on PomsyNaus-Notary Seal >`
0 1��OOa 4 t y Teresa Paysww.NotaaryµR46C /y/(/{fr//'�//' tut
MdIRM„vTl ww^T U ` l�i�L'�'+/�H�/ L
oP my canmission expires March 28,2D2,5 By: 0 N
a)y `, .In Vy. ,Cofr�° „rNaadw Teresa Patella,Notary Public o 0
This Rmer of Attorney is made and aecuiled pasuat to aid by authority of the fdloWng 13yNaws and Authorizations of The Ohio Casualty Insurance Corrpay, Liberty Mutual °No
0•— Insurance Carpay,and fist American Insurance Carpay which nesolutio s are now in full face and effect reading as fdlam: ri M
�? ARTICLEN-0FRCERS:Section12.PanerdAttaney. "°O
o Any offioer a other official d the Corporation authorized for that purpose in writing by the Chaim-an a the President,and st.4ed to such limitation as the Chairman a the v o
-a > President trey prescribe,shall appoint such altadeys-ir9bict,a>may be necessary to act in behalf of the Corporation to make,amo te,seal,adahanledge and deliver as surely a co
> any and all undertalargs,bonds,remghizanoes and otter surety obligations.Such attorneys in fact sdbjed#to the limitations set forth in their respective peers of attorney,shall-v
— - have full power to bind the Corporation by their signature and execration of any such instruments and to attach thereto the seal of the Corporation.When so execrated,such o 0)Z irstru rents shall be as binding as if signed by the President and attested to by the Secretary.Any p mw or authority granted to any representative,orattarney4n#act under the-2 cu
provisions of this article may be mvdaed at any tirre by the Board,the Chaimhan,the Presider#or by the otfiow or officers parting such power or authority. LL n
ARTICLE)III—Execultion of Caltracts:Section 5.Surety Borars and Uxlertaldrgs.
Any officer of the Company aLthhaiz7ed for that purpose in wetting by the d'eimen or the president,and aut>ject to such lint c s as the dhaimlan or the president may prescribe,
shall appdrt such attorneys-infiad,as may be necessary to act in behalf of the Carrpay to neke,aaeatA seer,a*vAedge and deliver as surly any and all ur dertaldrgs,
bands,recogizarices and other suety dtligations.Such attare wn--fact subied to the liritatos set forth in their respective px>vuehs of altaney,shall have full parer to bind the
Carpary by their signature ad execration of any such inshi rie is and to attach thereto the seal of the Company.Wen so awted such instruments shall be as binding as if
signed by the president and attested by the secretary.
Cwffk ate of Designation—The President of the Corrpary,acting pursuant to the Wava of the Campary,authorizes David M Carey,Assistant Secretary to appoint such attorneys-ir-
fad as may be necessary to act on behalf of the Company to rrake,execute,seal,aclT aNedge ad deliver as suety any and all undertalarnts,bores,recogrizances and other surely
obligations.
Authorization—Bar urnanimcuns consent of fhe Oomparp/s Board of erectors,the Company consents that facsimile or mechanically reprodaoed signature of any assistant secretary of the
Carpay,whenever appearing upon a certified copy of any power of attorney issued by the Company in connection with suety bonds,shall be valid and binding upon the Corrpary with
the sere face and effect as though manually affixed
I,Renee G Llewellyn,the undersigned,AssisW Secretary,The Ohio Casuaatly Irsuanoe Carpay,Liberty Mtual Insurance Carpay,and VJk American Insurance C Tparry do
hereby certiy that the original power of attorney of udich the foregoing is a full,he and correct copy of the Rower of Pdaney aeated by said Companies,is in fill force and effect and
has not been revoked.
IN TESTIMONY VN-EREOF,I have hurvlrtto set my hard allb ed the seals of said Cor panes this 4th day of August 2021 .
VMS I'l IN NU lmsub
191 c 1919 1991 �,�►f, ,�..
_ � o a c
¢j? By:
ACHUg ,�Aa� NAYP`� .�Lr `��f ��'DIwN�'eta$ Rer G Ueve yn1,Assistant Secretary
fix �
LMS-12873 LMIC OCIC WAIC Multi Co 02/21