HomeMy WebLinkAboutContract 54116-FP1 FORTWORTH®
TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
City Secretary No:_54116 -FP1
Date Received: Nov 15,2021
City Project Ns: 102695
Regarding contract 54116 for WATER& SANITARY SEWER REPLAC. CONTRACT 2014 WSM-A-PART 3 as
required by the TRANSPORTATION & PUBLIC WORKS as approved by City Council on 6/16/20 through NI&C
20-0404 the director of the TRANSPORTATION & PUBLIC WORKS upon the recommendation of the Assistant
Director of the Transportation&Public Works Department has accepted the project as complete.
Original Contract Prices: $3,953,565.78
Amount of Approved Change Orders: $92,782.70 Ns 1,2,3,4&5
Revised Contract Amount: $4,046,348.48
Total Cost Work Completed: $3,984,965.37
Less Deductions:
Liquidated Damages: 0 Days @$650.00/Day
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Work Completed: $3,984,965.37
Less Previous Payments: $3,785,717.10
Final Payment Due $199,248.27
zaei e��11e Ge 1, Nov 9 2021
Lauren Prieur(Nov 9,2021 10:27 CST)
Recommended for Acceptance Date l
Asst. Director, TPW - Capital Delivery
WJ( 9,1202 11:32 CST) Nov 9,2021
Accepted Date
Director, TRANSPORTATION & PUBLIC WORKS
Client Department
ama��e _Dana Bur�10,zoz� Nov 10,2021
Asst. City Manager Date
Comments: OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
C-620 Signature Page
Contractor's Application for Payment Invoice No. 15-FINAL
To(Owner) City of Fort Worth Invoicing Period(From-To): Invoice Date:
10/l/21-10/19/21 10/19/2021
P.O. FW020-0000004043 From(Contractor): Remit to(If Not Automatic Deposit):
Number: WOODY CONTRACTORS INC
Project-. 102695
Contractor's CFW Vendor No.:
0000035314
City Secretary Contract 54116 Contract
Number: Name: WATER AND SANITARY SEWER REPLAC.CONTRACT 2014 WSM-A-PART 3
Application For Payment
Change Order Summary
Approved Change Orders 1. ORIGINAL CONTRACT PRICE......................................................... $ $3,953,565.78
Number Additions Deletions 2. Net change by Change Orders............................................................... $ $92,782.70
1 $10,500.00 $10,500.00 3. Current Contract Price(Line 1 t 2)...................................................... $ $4,046,348.48
2 $10,762.00 $10,762.00 4. TOTAL COMPLETED AND STORED TO DATE
3 $296,900.00 $239,375.00 (Progress Estimate,Construction Allowance and Change Orders)...... $ $3,984,965.37
4 $19,950.00 $19,932.90 5. RETAINAGE:
5 $97,983.60 $62,743.00 a. 5.0% X Work Completed......... $
6 b. X Not Used $
7 c. Total Retainage(Line 5a+Line 5b).............................. $
8 6. AMOUNT ELIGIBLE TO DATE(Line 4-Line 5c)............................ $ $3,984,965.37
TOTALS $436,095.60 $343,312.90 7. LESS PREVIOUS PAYMENTS(Line 6 from prior Application)....... $ $3,785,717.10
NET CHANGE BY $92,782 70 8. AMOUNT DUE THIS APPLICATION................................................ $ $199,248.27
CHANGE ORDERS 9.BALANCE TO FINISH,PLUS RETAINAGE
(Column G on Progress Estimate+CA+COs+Line 5 above)............. $ $61,383.11
Contractor's Certification 10. CONTRACT TIME:
The Contractor certifies with the submittal of this document and associated Payment Request a, Days Awarded 400
Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge:(1)all b, Days Added by CO
previous progress payments received from Owner on account of Work done under the Contract have
been applied on account to discharge Contractor's legitimate obligations incurred in connection with C. Total Days 400
Work covered by prior Applications for Payment;(2)title of all Work,materials and equipment
incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass it. Days Charged 3g0
to Owner at time of payment free and clear of all Liens,security interests and encumbrances(except
such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, e, Days Remaining 20
security interest or encumbrances);and(3)all Work covered by this Application for Payment is in
accordance with the Contract Documents and is not defective.
Liquidated damages$650.00 per day
Troy Woody(No , :40 CDT)
Consent of Surety
Affidavit of Bills Paid
This document has been modified from its original form as an EJCDC document and the user did not highlight the
modifications.You are encouraged to read the document carefully and consult Legal Counsel prior to its execution.
FORT WORTU.,
TRANSPORTATION AND PUBLIC WORKS
October 21, 2021
Woody Construction
650 Tower Dr.
Kennedale,Tx 76060
RE: Acceptance Letter
Project Name: WSM-A Part 3 Contract 2014
Project Type: Water, Sewer& Paving
City Project No.: 102695
To Whom It May Concern:
On October 5, 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 October 21, 2021. The final inspection
and the corrected punch list items indicate that the work meets the City of Fort Worth specifications and
is therefore accepted by the City. The warranty period will start on October 21, 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)
392-8902.
Sincerely,
Kristian Suarl_m
Kristian Sugrim(Nov 9,202109:00 CST)
Kristian Sugrim, Project Manager
Cc: Steve Cisneros, Inspector
Mike Glover, Inspection Supervisor
Randy Horton, Senior Inspector
Mary Hanna, Program Manager
Criado Engineering, Shield Engineering,Visintainer Engineering, Consultant
Woody, Contractor
City of Fort Worth, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev.8/20/19
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: CONTRACT 2014 WSM-A PART 3
PROJECT NUMBER: 102695
DOE NUMBER:
WATER
PIPE LAID SIZE TYPE OF PIPE LF
PVC 8" C-900 5,156
PVC 6" C-900 185
PVC 10" C-900 10
PVC 12" C-900 3,388.66
FIRE HYDRANTS: 15 VALVES(16" OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES: YES
NEW SERVICES: 150 1"COPPER 3,142
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
PVC 8" SDR-26 2,109
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES:
NEW SERVICES:
TRANSPORTATION AND PUBLIC WORKS
� F` The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817)392-7941 •Fax: (817)392-7845
( { 2
! fƒ ) !
m & §
\ �
§ �
�
\ / ~
! §
n
> ) E
m �
c
%{ ( �
\ i �
! f
! !
(\ 2e
m!
�(
f(
. 2
�
\\
![
� ^R
\\ / /
!� n
aE® ;
3 9 ®
§ 4 �
a ( k
2 ;
§
E { { 7
& ( ^
« �
¥ \
^ ° �
� \ ,
n ®
/
§
, ° 3
§
, n
k r
k OR
0
� k §
,§
E!
E,
� {|
£ / R.
E ` \ /
.. f
� n
� � \
� 2 ,
. \
� � \
�
{ �
� \
{ # ¥ �
® ® \
� , a/ } f
| r 7
§ § \
!§ E
\ a n
� (\ j �
_ )/ { §
. § � ` � �
. § §
. n
2 �
j §
. o
� !f / I
� \� ) \
� : /} / §§ \
® §° ` ye `
� { ;3
� ;E . ` ` / k (�
(� . � _ (
/E �
. \� /
\%
E/ � � � � � °( }»
� ' ^±
§{ ) � ([ {i
„ � � �
|( `® \
iN \ ({
� k( `
� t} § [[ / `
� {� ;
. ^® ° |!
� �/ \ () \$
� \! . 42 ;\
!E
!¥
/7 { {
7;
I\ ` � (
!, r
f/§ \
� `(\ � R
__ (
° § § *
r ! ]
� ; � \
� ! E &
) \
« a
§
!f{ * ! §
$ ( �
\
) E
§ \
] 4
! : & %
, §
A
2 [
§ §
0
mf \ z
\ k §
\} /
|[ :
{| \ \
\/ ;E
|\
k(
{�
({ (
! 2 !
I f
n
! ;
i \ /
I ! /
r # ]
' k ;
I � �
I
§
/! (| �
§!m E
\ �( \
(\{ ;
! 2 �
, . n
(m \
\k ( \
\\ z
\ i@
(w §
,! :
{| �
\) \] ) Ef
. . !*
. r =
a ( \
§
| / a
\�(k
\
ESE E
SIR;
.fp
/ ` k
! �
m ; 2
§ \
c
({ k $
}
c
\\
. �
§ § c
(¥ �\ \/
�( §
. | :
!( 4a
Sal
\; £
/(
{( R
${
(\ !
.. !
r
. . . . . . . . . . . . . . . . . . E § \ \
§ & 3
� r 2
§
2 { { $
/
f; #
/{ &
¥ \
k
n
> k
§ �
({ \ z
\r .
�® (
§| §
{(
go
eo
[{
\\ k§ ||
!! * § E{
,
}{ § \ |`
!| 1 t
[m }
| ^(a `
; . \
§
!w¥{ ! § A
M
(ƒ �
E
(\ §
! # \
§
A
; «
� \
§ ; 3
« mf
±/ 41
- t
§
\( \6
yl
\\ °
�§
(` E
\ m { {
� n
. ;
� E J
� \ \
� r ;
§
n v o b
x ^
N
^ c
y
a
k
� n
f �
a � �
� uo
r �
n n.
A
a y ~
`P FBI
� <O
b �
R� C
2.
$8
as � nn
3 �a �.•N
o 0 0 0 0 8 0 0
R o
_ _
8�
$" m
c H
ys o
awn �
Y �
n
m R N
3
8
0
0
� \ �
�
!/E a
//\ §
� ¥ \
§
A
�
§ cro
c
)| \\ §
§| !
|�
kE �
E �
� E
m
r
! [
� \ \
! !
§
00CD00000 (n (nw 00000000mmw CD0000oo0 (n (nw
00 00 00
N N 0 N N O N N O (7
0 0 0 0 0 0 O O 0 W
A A A A A A A A A
W W j co co j w W
0 0 0 o O o
A A A A A A A A A 0
000 000 000 - q
000 0 0 0 0 0 0 a °o
N N N n N N N o N N N a F
(Y)0) 0) S D) D) O) W or m ' b
(D(D (D w (D (D (D N (D(D(D
v .
M , Ol (n (n w (n M Ol a
0 0 0 o 0 0 o 0 o a
0 0 0 (D o 0 0 I 0 0 0 �_ o
�I V A 0 J J A J J A p 7
0 0 0 0 0 0 D O O M M N
(D (D (D (D (D(o (D(D(D N p O (n
(D(O (D N (O (D W s (D(D(D
(D(O (D (O (D(D (D(D(D ^ F+
(D(o (D (D (o (D (D(D(D T t+
O
v
I
z n
d �
N H Q
7o O
m A N (Ii A
W v (�7i N
N O C
N O O
0 0 0 -4 cD o i7 77
y 117 �
W Cam"
�I n D
3 �
ffl ka N w
D) A W W
7
N O W(Tw z10 n
CD O W W W N 8. y O
y .0
VI O (n
O � C
N
N O
O
r O
A
O
W
,b `d
� b o
m C
3
II �
O
N
b
w. C!(
O
Z N
r+
000000000alw oo0000000mw o000000o (n (nw
rn(n0 (n (n0 rnrn0
00 0 0 - 0 0
NNO NN OO NNO (']
0 0 0 0 0 0 0 0 0 (n
O O O 0 0 0 O O O
n
W W j W W W W W W
O O O O 0 0
Cn Gl(n (Il Ul Cn Cn Cn (n
O O 000 O O O
O_0 0 O_ O O_ O_ O O 'T1
G
�
N N N n N N N n N N N n a G
(A W (n S (n(n W S Cn (A(fl S to b
(O (O(D N (O(D (D C) (D (O CD a) .._.
cn (n (n = (n(n (n = (n cn cn :3 CL
O o o U3 o 0 0(a 0 0 0 to (D w
000 (D 000 (D o00
-4 -Jo ado O W W oAo O V V A O 5 a
0 0 0 (D o 0 0 (D 0 0 0 c;
(O(O (D I (D (o(o I (D(D (O 0 0' (/l
((D((D (OD N GOO COO COD ((D COO COO W
(D(O (O (0(0 (O (O (() (D
z C7
d �
> O
0 O
Er O
A W N 122 69 t o D
ONA O O W 3
O 0)A (On CN)l O ! r+ ` 0
o� � o o W „ ro 0
0 0 0 0 0 0 o a o
" Cn
3 3
o
co
7 F[1y�y
p p UAi O NEa
W m b
O 0 cn 0 O O 00 Q., �]
H+ N V
Cn O
O )
y O
y � O
O
O
C" o
A
O
A
W
0 z
G
U3 d
(D w
D ti
V t+
O
N
Om
Ut
■+ Vl
O
b
I N O
r+
ii
O O o 0 o 0 0 0 M�0 00000000 m al wO 0 0 0 00 0 00 cncn w
00 � OO C)CF)0
00
N N OO N N O N N O _n
J 0) N J m N 0 0 0
O O O O O (DO O O
A A A ,Op ,O OA O O O
OO w OOw OOw .-.
AA JA AAA A A .P p
O O O 0 0 00 0 0
O_0 0 O O_O_ O_O O T
O O O O O O 0 0 0
NNN 88 C) NNN C1 N888 NN 0 7 a
O (Y) D) S d)m O S O m d) S (a 'aU-
O (D (D CI (D(D (D N (D(D
(T (n Ut 7 Ul (T N = M (T UI 7
l0 (G U3
O O O O O O
O O O O O OID 0 0 O (D .�.r p'
Oo Oo Oo O OD Oo Oho 0 J V A O ro
0 0 O ry 0 0 O (gyp 0 0 0 ry
(D(D (D (D(D (D (D (D(D p O U1
� 00 � � (D ~ m
(D(D (D (D (D (D (D (D(D T F.+
CT
0
a
z C7
d �
ao
a �o O
0
o 5� N a
(D r+
a c O
y C7 Er
r, W Cro" V)
a
3 n 3
m 3
F�
(n' c b C�
8w' y0
o
H+ N
UI O N
o � O
N O
N
a S
r O
A
O
A
W
b d
(1 'o a
N p G
C
ON
D
H+
O
N
Lh
i-+ UI
1.0
N
Z N
(D O
N
r+
0 0 0 0 0 o o 0 0 0 w
rnrno
O o
N N O n
O O O N
A A A
W W W
O O
Ot Ot CTI
A A A n
O O 0
O O O -n
O O O n
z
�mG) C
b
w
CCD
L o000 m o.
{ N
oo co CD 0
G l O O O '
O.
(OD(00(00 j P. A
(O(O c0
�7
z n
d �
> o
0 O '� 'H A T
1
(fl Efl H+ t! O
(O OD W cn p V] -
A O 0)03 W 'O N
co 5
PD� p ID
N O O
" t- C/)
3 " 3
to o
'° 3z
w t9 d N
co w9ODNN 7 zb
(D
C O
ti 7 d
o �
° � o
o c
A
W
vy 'ti
M r� o
CD
a w
c0 9' o' z
A (D b
N "
J
O
N
(I1
O
r+
ffl �
Z N
(O (D O
c° N
N r+
A
W
N
J
i
i CONSENT OF OWNER ❑
SURETY COMPANY CONTRACTOR
TO FINAL, PAYMENT SURETY ❑
OTHER
(SIMILAR TO AIA DOCUMENT G707)
3 Bond No.8245-50-44
I
PROJECT: Contract 2014 WSM-A Part 3
(name,address) Port Worth,TX
TO (Owner)
ARCHITECT'S PROJECT NO:
I City of Fort Worth CONTRACT FOR:
200 Texas Street
Fort Worth,TX 76102
l CONTRACT DATE: June 17,2020
CONTRACTOR: Woody Contractors,Inc.
i .
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(here insert name and
address of Surely Company)
Vigilant Insurance Company
2001 Bryan Street,Suite 3600 ,SURETY COMPANY,
Dallas,TX 75201
on bond of(herb insert name and address of Contractor)
Woody Contractors,Inc.
650 Tower Drive ,CONTRACTOR,
Kennedale,TX 76060
hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the.
Surety Company of any of its obligations to(here insert name and address of Owner)
City of Fort Worth
200 Texas Street ,OWNER,
'i Fort Worth,TX 76102
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
The Surety Company has hereunto set its hand this 3 rd day of November 2021
VIGILANT INSURANCE COMPANY
Surety Company
liA�ZA UIL 42(90C
Signature of Abhorizcd Representative
Attest:
(Seal): Elizabeth Gra Attorney-in-Fact
Title
Mote:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition
......... .
Dower of Attorney
Federal Insurance Company!Vigilant Insurance Company I Pacific fndennity Company
t
Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New York corporation,and PACIFIC
f INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Elizabeth Gray, Charles D. Sweeney, Kyle W, Sweeney and
= Michael A.Sweeney of Fort Worth,Texas-----------------------------------------------------------------------•----------------------------------------------------------------
i
each as their[rue and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seats to and deliver for and on their behalf as surety
j thereon or otherwise,bonds and undertakings and other writings oltgatory in the nature thereof(other than ball bonds)given or executed ItI the course of business,and any
Instruments amending or altering the same,and consents to the modification or alteration of any Instrument referred to to said bonds orobligatlons.
In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these
j presents and affixed their corporate seats on this 161h day ofSoptember,2019.
i
I' Down hi.C:hlt1roi,Assimaut Smrctary migzhcn M.Haney,Vice Preshlcwtf'
((1
I'mo) Asa.n• x
STATE Of?NI3W JERSEY
Countyoft[umerdon ss.
➢n this 1G^ day of September.2049,before me,a Notary Public of New Jersey,personally cattle Dawn M.Chloms,to me known to be Assistant Secretary of FEDERAL INSURANCE
COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney,and the said Dawn M.
E Chloras,being by me duly sworn,did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC
INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney ore such corporate seals and were thereto aff xed by
authority of Bald Companies;and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority;and that she Is acquainted with Stephen M.
Haney,and knows him to be Vice President of said Companies;and that the signature of Stephen M.Haney,subscribed to said Power of Attorney is in the genuine handwriting of
Stephen M.Haney,and was thereto subscribed by authorityof said Companies and In deponents presence.
NotaTiai Seal I � U4TNo. tS J.AaG LAAR
NOTARY PUE)LIO QF NEW Jii:,R SEy
28ta688
Gornlaelon Cxplros Juty 10.2024
�Iwl rary PtAtllr.
€ CERTIFICATION
E Resolutions adopted by the Boards orDirectors ofFEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY on August 30,20K
I "RCSOLVHD,that the Ibllowingauthm•ixations relate to the execution,Ibrand on behalfof the Company,orbonds,undertakings,recognivances,contracts and other written commitments ofthe Company
entered into in the ordinary course ofbusiness(each a"Written Commitment"):
(1) 6ach of the taialrinan,the President and the Vice Presidents of ih*Compmyishereby authorixed toexecute any Written Commitment forandOnbehairoftheWeipany,underthe
seal orthe Company or otherwise.
(2) Each duly appointed anorney-in-fact of the Cnmpany Is hereby autho•lxed to execute any written Commhment(brand on behalfof the Company,under the sea!orihe Company or
othenvise,to the extent that Such action is authorised by the grant of powers provided lbr in such persons written appointmnnt as such attorney-in•fjact.
63) Leach of the Chairman,the President and the vice Presidents of the Couipjay ts hereby authorized.forand on behalfoftheCompanytoappolut lit writing any person the anomily-
hi-fuel of the Company with full power and authority to execute,for and un behairofilteCon[pany,under the sea)orlhe Company orollierwlse,such WriuenCommlmientsorthe
Company as maybe specified in such written appointment,which specification maybe by general type or class of Written Commitments or by spec!lieation or one or more particular
Written Commti tments,
(4) Elicit of the Chairman,the president and the Vice Presidents of the Company 14 hereby authorized,for and on behaiforihe comparly,to deiepte ln writingtoany other officer ofille
Company the authority to execute.Nr Arid onbehali'of the Company,under the Companys seal or otherwise,such Written Conrmltmentsorthe Company as are specified Insuch
written delegation.whlcirspecif nation may be by general lypeor class of Wrinen Commitments or byspeciflcation ofoneormore particular Written Cominitntents,
(5) 'ltteslitaware orally officer or other person executinRany Written Commitment or appointment ordeiegailon pursuant to this Resolution,and[heseat of[Ile Company,maybeaf!bted by
facSlm!!e Oil such Written Commitment or written appoinuneut or delegalion.
PURTHM RF.SOLVRD, that the foregoing Resolution shall not be deemed to be an exclusive statement oi'the powers and authority eforlIcers,employees and other persons to act for anion behalfof
the Company,and such Rtsolallon shall not limit or otherwise alleLt the exeictso ofary such power m'authority otherwise validly gwnted ar vested,"
1,Dawn M.Chloros,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY(the"Companies")do hereby
cerilfy that
(i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true,Correct and in full force and effect,
(19 the foregoing Power or Attorney is true,correct and In full force and effect.
Given under my hand and seals of said Companies at Whitehouse Station,NJ,this 3rd day of November 2021.
flown M.Cblortis.A.k timl Start lutyr
IN THE EVENT'VDU WISH TO VERIPY THE A(TCH16141101'Y OF THIS BOND OR NOMPY US OP ANY O1tiER NIKITER,PI,MSti CON't'ACr US Kn
relc hone(90s)903-3493 Fax(903)903-3656 a-mail:surew@eltubbconj
rCD-VIG-PI(rev.00-19)
AFFIDAVIT
STATE OF TEXAS {
COUNTY OF TARR_ANT
BEFORE ME, THE UNDERSIGNED AUTHORITY, A NOTARY PUBLIC IN THE
STATE AND COUNTY AFORESAID, ON THIS DAY PERSONALLY APPEARED
TROY WOODY PRESIDENT
OF
(NAME) (TITLE)
WOODY CONTRACTORS,INC
KNOWN TO ME TO BE A CREDIBLE
(COMPANY NAME)
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 ESTABLISHED WAGE SCALE HAS BEEN PAID; AND
THAT THERE ARE NO CLAIMS PENDING FOR PERSONAL INJURY AND/OR
PROPERTY DAMAGES;
ON CONTRACT DESCRIBED AS; Water& SS Contract 14 WSM-A Part 3
BY
SUBSCRIBED AND SWORN BEFORE ME ON THIS DAY OF O ' 2020
NOMRY OU&IC IN TARRANT COUNTY, TEXAS
�,..PpY�jjd.y LUZ A RAVELO
Notary Public,State of Texas
*f �•t My Commission Expires
April 29,2023
NOTARY 10128W41O.
i
i CONSENT OF OWNER ❑
SURETY COMPANY CONTRACTOR
TO FINAL, PAYMENT SURETY ❑
OTHER
(SIMILAR TO AIA DOCUMENT G707)
3 Bond No.8245-50-44
I
PROJECT: Contract 2014 WSM-A Part 3
(name,address) Port Worth,TX
TO (Owner)
ARCHITECT'S PROJECT NO:
I City of Fort Worth CONTRACT FOR:
200 Texas Street
Fort Worth,TX 76102
l CONTRACT DATE: June 17,2020
CONTRACTOR: Woody Contractors,Inc.
i .
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(here insert name and
address of Surely Company)
Vigilant Insurance Company
2001 Bryan Street,Suite 3600 ,SURETY COMPANY,
Dallas,TX 75201
on bond of(herb insert name and address of Contractor)
Woody Contractors,Inc.
650 Tower Drive ,CONTRACTOR,
Kennedale,TX 76060
hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the.
Surety Company of any of its obligations to(here insert name and address of Owner)
City of Fort Worth
200 Texas Street ,OWNER,
'i Fort Worth,TX 76102
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
The Surety Company has hereunto set its hand this 3 rd day of November 2021
VIGILANT INSURANCE COMPANY
Surety Company
liA�ZA UIL 42(90C
Signature of Abhorizcd Representative
Attest:
(Seal): Elizabeth Gra Attorney-in-Fact
Title
Mote:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition
......... .
Dower of Attorney
Federal Insurance Company!Vigilant Insurance Company I Pacific fndennity Company
t
Know All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New York corporation,and PACIFIC
f INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Elizabeth Gray, Charles D. Sweeney, Kyle W, Sweeney and
= Michael A.Sweeney of Fort Worth,Texas-----------------------------------------------------------------------•----------------------------------------------------------------
i
each as their[rue and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seats to and deliver for and on their behalf as surety
j thereon or otherwise,bonds and undertakings and other writings oltgatory in the nature thereof(other than ball bonds)given or executed ItI the course of business,and any
Instruments amending or altering the same,and consents to the modification or alteration of any Instrument referred to to said bonds orobligatlons.
In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these
j presents and affixed their corporate seats on this 161h day ofSoptember,2019.
i
I' Down hi.C:hlt1roi,Assimaut Smrctary migzhcn M.Haney,Vice Preshlcwtf'
((1
I'mo) Asa.n• x
STATE Of?NI3W JERSEY
Countyoft[umerdon ss.
➢n this 1G^ day of September.2049,before me,a Notary Public of New Jersey,personally cattle Dawn M.Chloms,to me known to be Assistant Secretary of FEDERAL INSURANCE
COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney,and the said Dawn M.
E Chloras,being by me duly sworn,did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC
INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney ore such corporate seals and were thereto aff xed by
authority of Bald Companies;and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority;and that she Is acquainted with Stephen M.
Haney,and knows him to be Vice President of said Companies;and that the signature of Stephen M.Haney,subscribed to said Power of Attorney is in the genuine handwriting of
Stephen M.Haney,and was thereto subscribed by authorityof said Companies and In deponents presence.
NotaTiai Seal I � U4TNo. tS J.AaG LAAR
NOTARY PUE)LIO QF NEW Jii:,R SEy
28ta688
Gornlaelon Cxplros Juty 10.2024
�Iwl rary PtAtllr.
€ CERTIFICATION
E Resolutions adopted by the Boards orDirectors ofFEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY on August 30,20K
I "RCSOLVHD,that the Ibllowingauthm•ixations relate to the execution,Ibrand on behalfof the Company,orbonds,undertakings,recognivances,contracts and other written commitments ofthe Company
entered into in the ordinary course ofbusiness(each a"Written Commitment"):
(1) 6ach of the taialrinan,the President and the Vice Presidents of ih*Compmyishereby authorixed toexecute any Written Commitment forandOnbehairoftheWeipany,underthe
seal orthe Company or otherwise.
(2) Each duly appointed anorney-in-fact of the Cnmpany Is hereby autho•lxed to execute any written Commhment(brand on behalfof the Company,under the sea!orihe Company or
othenvise,to the extent that Such action is authorised by the grant of powers provided lbr in such persons written appointmnnt as such attorney-in•fjact.
63) Leach of the Chairman,the President and the vice Presidents of the Couipjay ts hereby authorized.forand on behalfoftheCompanytoappolut lit writing any person the anomily-
hi-fuel of the Company with full power and authority to execute,for and un behairofilteCon[pany,under the sea)orlhe Company orollierwlse,such WriuenCommlmientsorthe
Company as maybe specified in such written appointment,which specification maybe by general type or class of Written Commitments or by spec!lieation or one or more particular
Written Commti tments,
(4) Elicit of the Chairman,the president and the Vice Presidents of the Company 14 hereby authorized,for and on behaiforihe comparly,to deiepte ln writingtoany other officer ofille
Company the authority to execute.Nr Arid onbehali'of the Company,under the Companys seal or otherwise,such Written Conrmltmentsorthe Company as are specified Insuch
written delegation.whlcirspecif nation may be by general lypeor class of Wrinen Commitments or byspeciflcation ofoneormore particular Written Cominitntents,
(5) 'ltteslitaware orally officer or other person executinRany Written Commitment or appointment ordeiegailon pursuant to this Resolution,and[heseat of[Ile Company,maybeaf!bted by
facSlm!!e Oil such Written Commitment or written appoinuneut or delegalion.
PURTHM RF.SOLVRD, that the foregoing Resolution shall not be deemed to be an exclusive statement oi'the powers and authority eforlIcers,employees and other persons to act for anion behalfof
the Company,and such Rtsolallon shall not limit or otherwise alleLt the exeictso ofary such power m'authority otherwise validly gwnted ar vested,"
1,Dawn M.Chloros,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY(the"Companies")do hereby
cerilfy that
(i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true,Correct and in full force and effect,
(19 the foregoing Power or Attorney is true,correct and In full force and effect.
Given under my hand and seals of said Companies at Whitehouse Station,NJ,this 3rd day of November 2021.
flown M.Cblortis.A.k timl Start lutyr
IN THE EVENT'VDU WISH TO VERIPY THE A(TCH16141101'Y OF THIS BOND OR NOMPY US OP ANY O1tiER NIKITER,PI,MSti CON't'ACr US Kn
relc hone(90s)903-3493 Fax(903)903-3656 a-mail:surew@eltubbconj
rCD-VIG-PI(rev.00-19)
AFFIDAVIT
STATE OF TEXAS {
COUNTY OF TARR_ANT
BEFORE ME, THE UNDERSIGNED AUTHORITY, A NOTARY PUBLIC IN THE
STATE AND COUNTY AFORESAID, ON THIS DAY PERSONALLY APPEARED
TROY WOODY PRESIDENT
OF
(NAME) (TITLE)
WOODY CONTRACTORS,INC
KNOWN TO ME TO BE A CREDIBLE
(COMPANY NAME)
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 ESTABLISHED WAGE SCALE HAS BEEN PAID; AND
THAT THERE ARE NO CLAIMS PENDING FOR PERSONAL INJURY AND/OR
PROPERTY DAMAGES;
ON CONTRACT DESCRIBED AS; Water& SS Contract 14 WSM-A Part 3
BY
SUBSCRIBED AND SWORN BEFORE ME ON THIS DAY OF O ' 2020
NOMRY OU&IC IN TARRANT COUNTY, TEXAS
�,..PpY�jjd.y LUZ A RAVELO
Notary Public,State of Texas
*f �•t My Commission Expires
April 29,2023
NOTARY 10128W41O.