HomeMy WebLinkAboutContract 46443-FP1 (2):����° s�e��°��}� L� � � ������f�.l
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CITY OF FORT WORTH
NOTICE OF PROJECT COMPLETION
5q��1- C6 a33a
c. 5 .�.! to y�l3
Regarding Contract Number 46443 for the Timberline Elevated Storage Tank Rehabilitation Project which
was requested by the Water Department and approved by City Council on February 3, 2015 through M&C
C-27178, has been accepted by the Director of the Water Department as complete.
Original Contract Price: $ 1,256,950.00
Amount of Approved Change Orders $ 49,980.00 Number TWO
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Revised Contract Amount:
Total Cost Work Completed:
Less Liquidated Damages:
Less Pavement Deficiencies:
Less Penalty:
Total Contract Cost:
Less Previous Payments
Final Payment Due:
$ 1,306,930.00
$ 1,306,930.00
$ 0.00 (Day 0 @ $ 500•00 )
$ 0.00
$ 0.00 .
$ 1,306,930
$ 1,241,583.00
$ 65,347.00
Recommended: Andrew "I'. Cro er . P.E.
Asst. Director, er Department
f �
J .�
Approved Jesus J. Ch a
Assistant City Manager
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AFFIDAVIT OF BILLS PAID
STATE OF TeYas
COUNTY OF Tarrant
Before r��e, the undersigned authorikp, personally appeared _Ray Witke
(�rante), the _President_ (tifle) of Classic Protective Coatings, Inc^(Carl�pnny),
who upon his/her oath deposed and said:
On City of Fort Wortli Contract described as:
TimUerline Waier Tank Rehabilitation Pro�ect, Project #0233Q_,
� All persons, firms, associafions, coiporations, or other arganizations furnishing
� labor and/ar materials have been paid in full all amounfs due and ouTin� as of fhis date
except for tliose noted on the attaclled scliedule. Any ui�paid future obiigations will be
.paid and satisfied directlyaut of funds.paid in reliance on this afiidavit; alid
' TI�e wage scale establis}ied by the City Council in the City of Fort �Vorth has been
paid in fu11; and
There are no claims pending for personal injury and/or praperty damages,
All of the pravisions of this release shall bind the Classic Protective Coatings,
Inc (Caftpa�ry) and its Iegal representatives, successors aYid assigns and shall inure to
the Uene�t of the City.
The person signing tiais document represents that.he/she is duly authorized to do
so on behalf af Classic Protective Coatings, Inc� (Co�tapc�ra��).
By: _� (.�.���
Nanie: Ra Witke
Title: President
SUBSCRIBED, SWORN TO ANU ACKl�TOWLEDGED BEFORE ME by
i�c��f W 1�'�� on this the � day of QC�'Ob�-i� , 20 15 to certif�r
which witness my hand and official seal of office. ^
���-2.�C-�l� L l��l�r ��i:�i�ar�rre� G�I�Il.S..C1.1L 25, 20��
Notary Public, State of Wi onsin .,,krQt �V tiz�,���'sf� �' ommissi.o eYpires:
,;�`. '�. �'s
� » � � '� :
�r.-; ��ctiy s p
fi� °
_ � ���1� ? � �
'�° ,�'' ',•`pC' a
g''r�, S��'''.,.....•�`�� �,�
`'d�rp�� p��J���A'"
SCHEDULE OF UNPAID AM�UNTS
Contractoz/Vendor Name: Amount Paid Amount Owed Percenta e Owed
None $ $ %
$ $ %
$ $ %
� $ %
� � °J
$ $ %
$ �i %a
� � %
If all contraciars/vendors have been paid in fulI and there are no pending ar known
claims, write N�NE on the first line.
�1 �l �
��Yl"� Document G707TM -1994
'::�.r-
.:.`
Consent of Surety to Final Payment
PROJECT: (Nrnne mtd nddress) ARCHITECT'S PROJECT NUMBER:
Timberline Water Tanl<
Fort Worth, TX CONTRACT FOR:
Rehabilitation of Water Tank
OWNER ❑
ARCHITECT ❑
CONTRACTOR ❑
TO OWNER: (Name cind address) CONTRACT DATED; SURETY ❑
City of Fort Worth Februa�y 3, 2015
Transportation & Public Works OTHER ❑
1000 Tlu�ockmorton St.
�'�fi txr,,,�t, TX 7F1 m
In accordance with the provisions of the Contract between the Uwner and the Contractor as indicated above, the
(b�sert r�arne arrd nddress of Sin•ch�.)
Continental Casualty Cotnpany
5201 Eden Ave., Suite 300
Edina, MN 55436
on bond of
(Insert rrarrre nrrd nddress of Conh•nctor.)
Classic Protective Coatings, Inc.
N 7670 State H��vy 25
Menomonie, WI 54751
,SURETY,
,CONTRACTOR,
hereUy 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
(I�iser� �tame �nd addres,r of Ownert)
City of Fort Worth
Transportation & Public Works
1000 Throckmorton St
Fort Worth, TX 76102
as set forth in said Surety's bond.
� �i.�I�l:lt�
IN WITNESS WHEREOF, the Surety has hereunto set its hand on tl�is date: Septernber 25, 2015
(I�tse�Y in ►vritittg ihe mo�rth fo/lolved by llte �ltnrre��ic clute u�7d J�eur.)
Continental Casualty Company
(Stn• - - -
,
B • Y, INC.
/ '- - (Sign hu•e q/�a � i•izeclrepresentntiv .
�� ;i5�0 N�. Lexington Ave. Ste. 206
Attest: ��� _ John C. Klein Attorne -in-Fact St. Paul, MN 55126
(Sea/) (P►•inted ncn�re nrtd title) - 61
CP.0 fIODJ� You should sign an oriyin.;l AIA Contract docwnent, on whicli this ter.t ap�>cars In RED. !1n oriyinal assures that
chanyes will not be obscured.
AIA Oocument G707T"' —1994. Copyright O 1970 and 1994 by The American Institute of Archilecls. AI� righfs reserved. WARNING: This AIA
Document i� prot=ctecl by U.S. Copyright Law and International Treaties. Unauthurized reproduclion or di,tribution of this AIA Docw�ie:nt, �� ony
purtion o( it, rnay r�_;ult in severc civil and critninel penallies, and will be prosecuted tu the maximum extent possible undur U�u i,�:��. Purchasers
are not permitted to reproduce this document. To report copyrighl violations o( AIA Contract Documents, e-mail The American Institute of Architects' legal
counsel, copyright@aia.org.
POW�R OF AT'I'ORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
I�iow All Men By These Presents, That Continenlal Casualty Company, an Illinois insurance company, National Fire Insurance Company of
Hartford, an Illinois insurance company, and American Casualty Compa��y of Reading, Pennsylvania, a Pennsylvania insurance company (herein called
"the CNA Companies"), are duly organized and exis[ing insurance companies having their principal offices in the City of Chicago, and State of Illinois,
and that tliey do by virtue of the signatures and seals herein affixed hereby make, cons[itute and appoint
J�hn David Klein, John C Klein, Stephen M Klein, Kristin M Bakos, Individually
of Saint Paui, MN, their true and lawfiii Attorney(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on their
behalf bonds, undertakings and other obligatory instrumen[s of similar nature
- In Unlimited Amounts -
and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and
all the acts of said Attomey, pursuant to the authority hereby given is hereby ratified and confirmed.
This Potxier of Attorney is made and executed pursuant to and by authority of the By-Law and Resolutions, printed on the reverse hereof, duly
adopted, as indicated, by the Boazds of Directors of the insurance companies.
In Witness Whereof, the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto
affixed on this 24th day of August, 2015.
�P� GASUq<Ty � 1NSUR H � qpNY pp�
w? O Q�Q �y q cF ,��� � 'yo
2 GOPPOAATF �3' Q �8L O H�NCOAPORq�fp�co
� . � : s ¢
� SEAL � � �� � � �Uisoi �' �
a
1897 � NARYF�� b • �
Continental Casualty Company
National Fire Insurance Company of Hartford
American Casualty Company of Reading, Pennsylvania
�
Paul T. Bruflaf Vice President
State of South Dakota, County of Minnehaha, ss:
On this 24th day of August, 2015, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, did depose and say: that
he resides in the Ciky of Sioux Fa]]s, State oF South Dakota; that he is a Vice President of Continental Casualty Company, an Illinois insurance company,
National Fire Insurance Company of Hm•tford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a
Pennsylvania insurance company described in and which executed the above instrument; that he knows the seals of said insurance companies; that the
seals affixed to the said instrument aze such coiporate seals, that they were so affixed pursuant to authority given by the Boards of Directors of said
insurance companies and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance
co�npanies.
}�.��t1iM444�.�W4�.k*sti�tia4w }
F S. �fCH %
�� NI7[ARY' PU�� +
S�6UTH 4AK4TA�.:Ji
Obir44�44YY4444b1titii�s44�a�s �
My Commission Expires Febcuary 12, 2021
S. Eich Notary Public
CERTIFICATE
I, D. Bult, Assistant Seeretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hu-tford, an
Illinois insurance company, and American Casuaity Company of Reading, Pennsylvania, a Pennsylvinia insurance company do hereby certify that the
Power of Attorney herein lbove set forth is stili in force, and furthcr certify that the By-Law and Resolution of the Board of Directors of the insurance
companies printed on the reverse hereof is still in force. In testimony whereof I liave hereunto subscribed my name and affixed the seal of the said
insurance companies this 25th day of September, 2015 ,
���P� GASUq�r � �� iNSUR ti h p PAHv Op,�, .
�Q' Q Ccc L�' M 90
2 poPPOW1T� �3 �( � O ��N�ppPORqrf y�
Q
� � ,Z p � � e JULY 71. N
a
� SEAL r y �� .� � isoE �
a
1897 � NARZF�� b • �
Continental Casualty Company
National Fire Insurance Company of Hartford
American Casualty Company of Reading, I�ennsy(vania
� ��
D. Bult Assistant Secretary
Form F6853-4/2012
Classic
Protective Coatings
Wisconsin � Texas � Florida
October 1, 2015
Ray Penny
Manager, Southwest Region
Tank Industry Consultants
P.O.Box 130204
The Woodlands, Texas 77393-0204
TIC project #14.164.5465.013
Dear Ray,
Enclosed are three (3) final payment requests for retainage on the Timbecline Water Tank Rehabilitation
Project. Also enclosed are three (3) original copies of the AIA G707 Consent of Surety to Final Payment.
I have sent the executed Change Order #2 back to Chris Harder at the City of Fort Worth. I have enclosed
a copy of it for your records.
According to the specification for the project, an Affidavit of Payment and Release of Liens is required.
Is there a special form the City requires? If so, could you have it sent for us to execute? Also, if there is
any other closeout paperwork that needs to be submitted, please let me know.
Thank you,
��
Barb Bunitvedt
Controller
at�s��
�� a
� �• �
O�'� A`�O
N7670 State Highway 25 � Menomonie Wisconsin 54751-5928
Telephone 715-233-6267 � Facsimile 715-233-6268
www.classicprotectivecoatings.com
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INDUSTRY
CONSUI.TANTS
INC.
7740 West New York Street
Indianapolis, Indiana 46214
317/271-3100 - Phone
317 / 271-3300 - FAX
Plainfield, Illinois
815 / 556-8335
Pittsbtu•gh, Pennsylvania
412 / 262-1586
El Paso, Texas
915 / 790-0790
Houston, Texas
281 / 367-3511
Christopher Harder, P.E.
October 27, 2015
Engineering Manager / Water Production
Fort Worth Water Department
1000 Throckmorton Street
Fort Worth, Texas 76102
RE: Classic Protective Coatings Pay Application #6 for the Rehabilitation of
2,000,000 Gallon Timberline Elevated Water Storage Tank
City Project # 02330; TIC Project # 14.164.5465.013
Dear Mr. Harder:
Classic Protective Coatings has submitted three originals of their Pay Application
#6 for the retainage from pervious pay applications in the net amount of
$65,347.00. Also included with the pay application are three notarized originals of
the Consent of Surety to Final Payment. I recommend payment of the requested
amount. I have enclosed the three originals of the Consent of Surety and Classic's
Pay Application #6 with my signature indicating my recommendation for payment.
Note that I misdated my signature with 10/30/15 instead of 10/27/15, today's date.
Note also that Classic sent their Pay Application $5 directly to you for payment and
have advised that payment was received. Please call if you have questions or
require additional information to process this payment.
Sincerely,
ank dushy on lt ts
t•
s / �
Ray P y
Manager, Southwest Re '
enclosures
cc: Mike Doolittle - TIC Indianapolis w/ copy enclosure
Brad Smith — Classic Protective Coatings w/ copy enclosure
An Employee-Orvned Company