HomeMy WebLinkAboutContract 53950-FP1City Secretary 53950 -FP1
Contract No.
FORT WORTH®
Date Received
NOTICE OF PROJECT COMPLETION
(Developer Projects)
3/9/2023
The Transportation and Public Works Department upon the recommendation of the Project
Manager has accepted the following project as complete:
Project Name: Cook Children's Medical Center
City Project No.: 102507
Improvement Type(s): ❑x Paving El Drainage ❑x Street Lights ❑ Traffic Signals
Original Contract Price:
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete:
Austin Aiumbau�,h Mar 9 2023
Austin Alumbau h Mar9 2 309:45
CST)
g (
Contractor Date
President
Title
Fort Worth Civil Constructors, LLC
Company Name
Brandon Phillips (Mar 9.2o23o9:46CST) Mar 9, 2023
Project Inspector Date
u/dizban, Mar 9, 2023
Project Manager Date
Rebecca Diane Owen (Mar 9. 2023 13:24 CST) Mar 9, 2023
CFA Manager Date
��- Mar 9 2023
amen Prienr War 202314'37 CST)
Interim TPW Director Date
(Ma Mar 9 2023
William Inhngnn9 210317,76 CST) 7
Asst. City Manager Date
$990,026.07
-$119,351.30
$870,674.77
$870,674.77
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Page 1 of 2
Notice of Project Completion
Project Name: Cook Children's Medical Center
City Project No.: 102507
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑x Yes
❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time 170 WD Days Charged: 279
Work Start Date: 4/28/2020
Completed number of Soil Lab Test: 58
Completed number of Water Test: 8
Work Complete Date 2/6/2023
Page2of2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name COOK CHILDREN'S MEDICAL CENTER
Contract Limits
Project Type STORM DRAIN & PAVING
City Project Numbers 102507
DOE Number 2507
Estimate Number 1
Payment Number 1
City Secretary Contract Number
Contract Date
Project Manager NA
Contractor FORT WORTH CIVIL
1675-B SOUTH MAIN STREEET
KELLER, TX 76248
Inspectors Watson / Phillips
For Period Ending 2/8/2023
WD
Contract Time 17WD
Days Charged to Date 279
Contract is 100.00 Complete
Monday, March 6, 2023 Page 1 of 5
City Project Numbers 102507 DOE Number 2507
Contract Name COOK CHILDREN'S MEDICAL CENTER Estimate Number 1
Contract Limits Payment Number 1
Project Type STORM DRAIN & PAVING For Period Ending 2/8/2023
Project Funding
STORM DRAIN
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 REMOVE ADA RAMP 1 EA $2,780.00 $2,780.00 1 $2,780.00
2 REMOVE CONCRETE CURB & GUTTER (CO3 91.6 LF $62.00 $5,679.20 91.6 $5,679.20
&5)
4 CONC PVMT REPAIR (CO 3&5) 585.88 SY $315.00 $184,552.20 585.88 $184,552.20
5 BARRIER FREE RAMP 1 EA $5,890.00 $5,890.00 1 $5,890.00
6 6" CONC CURB AND GUI 1hR(CO5) 91.6 LF $98.00 $8,976.80 91.6 $8,976.80
7 PRE CCTV INSPECTION (C05) 431 LF $4.00 $1,724.00 431 $1,724.00
8 POST CCTV INSPECTION (CO3&5) 431 LF $4.00 $1,724.00 431 $1,724.00
9 TRENCH SAFETY (CO3&5) 431 LF $14.00 $6,034.00 431 $6,034.00
10 24" RCP CLASS III (CO1&3) 383 LF $405.00 $155,115.00 383 $155,115.00
11 4' STORM JUNCTION BOX 2 EA $10,715.00 $21,430.00 2 $21,430.00
12 CONCRETE CROSSWALK PAVING "LIGHT 8.22 SY $330.00 $2,712.60 8.22 $2,712.60
PEACH"(CO3&5)
13 CONCRETE CROSSWALK PAVING "LIGHT 35.63 SY $360.00 $12,826.80 35.63 $12,826.80
BLUE" (CO 3&5)
14 18" RCP, CLASS IV 48 LF $511.00 $24,528.00 48 $24,528.00
15 (C05) REMOVE CONC PVMT 46.9 SY $60.05 $2,816.35 46.9 $2,816.35
16 (C05) 3" ASPHALT PVMT TYPE D 46.9 SY $73.40 $3,442.46 46.9 $3,442.46
Sub -Total of Previous Unit
PAVING
$440,231.41 $440,231.41
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 REMOVE CONC PVMT 22 SY $85.00 $1,870.00 22 $1,870.00
2 REMOVE SIDEWALK 3557 SF $6.00 $21,342.00 3557 $21,342.00
3 REMOVE ADA RAMP (CO5) 3 EA $2,780.00 $8,340.00 3 $8,340.00
4 REMOVE ASPHALT PVMT 225 SY $46.00 $10,350.00 225 $10,350.00
5 REMOVE CONCRETE CURB & GUTTER 52 LF $40.00 $2,080.00 52 $2,080.00
7 2" PVMT TYPE D (C05) 94 SY $24.00 $2,256.00 94 $2,256.00
8 4" PVMT TYPE B(C05) 94 SY $44.00 $4,136.00 94 $4,136.00
9 4" CONC SIDEWALK(CO1&5) 4000 SF $10.50 $42,000.00 4000 $42,000.00
10 BARRIER FREE RAMP 1 EA $3,900.00 $3,900.00 1 $3,900.00
Monday, March 6, 2023 Page 2 of 5
City Project Numbers 102507 DOE Number 2507
Contract Name COOK CHILDREN'S MEDICAL CENTER Estimate Number 1
Contract Limits Payment Number 1
Project Type STORM DRAIN & PAVING For Period Ending 2/8/2023
Project Funding
11 BARRIER FREE RAMP ( COS) 2 EA $3,900.00 $7,800.00 2 $7,800.00
12 6" CONC CURB AND GUTTER 86 LF $89.00 $7,654.00 86 $7,654.00
13 BLOCK SOD PLACEMENT 326 SY $7.32 $2,386.32 326 $2,386.32
14 TRAFFIC CONTROL (CO5) 7.25 MO $13,550.00 $98,237.50 7.25 $98,237.50
15 LANDSCAPE AND IRRIGATION 1 LS $61,200.00 $61,200.00 1 $61,200.00
16 (CO1) BARRIER FREE RAMP, TYPE R 1 1 EA $6,215.00 $6,215.00 1 $6,215.00
17 (COI) REMOVE & INSTALL SIGN PANEL/PSOT 1 EA $1,500.00 $1,500.00 1 $1,500.00
18 (CO5) 11" CONC PVMT HES 281.5 SY $19.86 $5,590.59 281.5 $5,590.59
19 (CO5) 8" WIDE ASHPALT PVMT REPAIR 35.75 LF $234.00 $8,365.50 35.75 $8,365.50
RESIDENTIAL
20 (C05) PRUITTTEMPORARY ASHPHALT 1 LS $19,821.00 $19,82.1.00 1 $19,821.00
PAVMENT
21 (CO5) MATERIAL COST INCREASE FOR 101 CY $71.30 $7,201.30 101 $7,201.30
FLATWORK
22 (CO5) 7-8" VARIABLE HEIGHT URB 62 LF $59.00 $3,658.00 62 $3,658.00
ST LIGHT
Item
No.
Sub -Total of Previous Unit
Description of Items
$325,903.21 $325,903.21
Estimated Unit Unit Cost Estimated Completed Completed
Quanity Total Quanity Total
1 2" CONDT PVC SCH 80
2 2" CONDT PVC SCH 80 (CO0)
3 NO 6 INSULATED ELEC CONDR (CO 1)
4 NO 8 INSULATED ELEC CONDR (CO1)
5 GROUND BOX TYPR B W/APRON (CO1
7 RDWY ILLUM ASSEMBLY
640 LF $77.66 $49,702.40 640 $49,702.40
310 LF $109.25 $33,867.50 310 $33,867.50
1900 LF $2.28 $4,332.00 1900 $4,332.00
950 LF $2.17 $2,061.50 950 $2,061.50
3 EA $379.75 $1,139.25 3 $1,139.25
2 EA $6,718.75 $13,437.50 2 $13,437.50
Sub -Total of Previous Unit
$104,540.15 $104,540.15
Monday, March 6, 2023 Page 3 of 5
City Project Numbers 102507 DOE Number 2507
Contract Name
Contract Limits
Project Type
Project Funding
COOK CHILDREN'S MEDICAL CENTER
STORM DRAIN & PAVING
Contract Information Summary
Original Contract Amount
Change Orders
Change Order Number 1
Change Order Number 3
Change Order Number 5
Change Order Number 1
Change Order Number 5
Change Order Number 1
Total Contract Price
Estimate Number 1
Payment Number 1
For Period Ending 2/8/2023
$990,026.07
($19,035.00)
$10,980.00
$12,233.41
$7,221.50
$82,874.39
($213,625.60)
$870,674.77
Total Cost of Work Completed $870,674.77
Less % Retained $0.00
Net Earned $870,674.77
Earned This Period $870,674.77
Retainage This Period $0.00
Less Liquidated Damages
Days @ / Day $0.00
LessPavement Deficiency $0.00
Less Penalty $0.00
Less Previous Payment $0.00
Plus Material on Hand Less 15% $0.00
Balance Due This Payment $870,674.77
Monday, March 6, 2023 Page 4 of 5
City Project Numbers 102507 DOE Number 2507
Contract Name COOK CHILDREN'S MEDICAL CENTER Estimate Number 1
Contract Limits Payment Number 1
Project Type STORM DRAIN & PAVING For Period Ending 2/8/2023
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors Watson / Phillips Contract Date
Contractor FORT WORTH CIVIL Contract Time 170 WD
1675-B SOUTH MAIN STREEET Days Charged to Date 279 WD
KELLER, TX 76248 Contract is .000000 Complete
Line Fund Account Center
CITY OF FORT WORTH
SUMMARY OF CHARGES
Amount
Funded
Gross
Retainage Net
Total Cost of Work Completed $870,674.77
Less % Retained $0.00
Net Earned $870,674.77
Earned This Period $870,674.77
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 / Day
LessPavement Deficiency
Less Penalty
Less Previous Payment
Plus Material on Hand Less 15%
Balance Due This Payment
$0.00
$0.00
$0.00
$0.00
$0.00
$870,674.77
Monday, March 6, 2023 Page 5 of 5
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME: Cook Children's Medical Center
CONTRACT: Water. Sewer, Drainage, Paving, and Street Liohlino
CFA# 20-0022 1 CRY PARTICIPATION:I NO
CITY PROJECT# 102507
DOE # I WA
FID # 30114-0200431-102507-E07665
FILE # IK-2733 , X-26320
INSPECTOR: Riley Roberson Phone No:
PROJECT MANAGER: Debbie Willhelm, P.E. Phone No:
WATER
682-213-1837
817392-2481
Ij CHANGE
ORDER N0:
1
CONTRACT UNIT
SEWER PAVING DRAINAGE
Oeveioper DenNoper Denloper DevNOPer
Coat CRy.Coat Cott cky Colt Coat ;City Coat Cost
ORIGINAL CONTRACT 5231,600.00 20.00 8666.750.65 1000 $235,607.32 50.00
EXTRAS TO DATE
CREDITS TO DATE
CONTRACT TO DATE 8231,660.00 5d56 1656,750.55 50.00. S235,607,32 S0.00 8436,053.00 00.00. 1310.165.75 50.00. 170
�/AA4E`MUNT OF PROP_CRAN00 ORDER$ 0,12050) 6 j16,09A001 I6 7,221$0 5 11A035.001 6 Rt3.625.601 0
2
15
IaAMNn s579.50 I $6J0.557,650.� 'I �� 525�3.07A620.00 i i177,Of�W .076.�T06S10.f5 0.00 31045eQ•30.00. 170
f226.
REVISED COST SHARE Dov.cost 51,123,764,12 CJty Q.estx $d.Q0
I
REVIEWED
By D Willhelm at 9:26 am, Aug 24, 2020
STREET LIGHTS
. C11y, Cost Dr'ebper Coat CITY CCft
WORKING DAYS
TOTAL REVISED CONTRACT 51,523,764.12
6230.05100 50.00 6515.165.75 '90.00 170
Ravlsod: 10-12-2011 Page 1
Yau are dlredod to make Ore following changes In the wired documents:
rater lmprovemAYn1L75 EM y CITYBIOO ITEMPUUAN17'lY UNR Jj�J1}.5 5CRIPTJ�N UNIT PRICE l TOTAL
r 1 0241.1012 1 EA dr-TY\ jr78s5Y0)'lo•l 5 3,500.00 S 3.500.001
2 3201.0614 -37 SY Coot Pvml ��Ijjjwry�ai es:leaks!
5 373m $ 113.601.00
3 3305.0005 -1 FA 17 Waterline lowerino 5 38,580.00 $ I38,580.00]
4 3305.0109 -30 11 Trerrh Safely $ 14.00 S /420,001
6 3311.0001 0.1 TON DuallaIron Water FlWre({w/Restraint S 28,325.00 S 2.832,50�
7 3311.0261 -6 LF 8' PVC 1Ya(erF S 503,00 3 (3,018.001
9 3311.0461 -10 LF 12'PVC Water PloyS 897.00 $ 8,970.001
(0 3312.0117 -1 EA _ Connection to End 4'-12 Wafer Main 3 5.670.00 $ 5.575.00 1
Now 14 3311,0161 I 38 LF 1 6' PVC Water Pipe 3 501.00 S 8,038.001
Now 15 3312.4106 ! 2 _ EA I 12 ic6- Te°�j� Sleeve E Valve 5 16.499,00 $ 32,998.001
New 16 8999.001 1 FA Rehrale EIEs0n(�tivd�nl 1 S 5,715.00 $ 5.715.001
New 17 3201.0124 11 LF 7' Wide Asphalt Plant Hoymr, Arterial I $ 234.00 3 2,574,00 1
New 18 3218.0101 I 7 5' _ _ 6` Cono Cub d 0'u(� I S 96.00 S 888.00 1
SUBTOTAL 5 (3,120.5011
rawer Improvements
I( PAY REM
13
22
24
25
27
Now 29
Drainage ir080050ments
CITY BID ITEM
3301,0101
3331.3201
3339.0001
3339.1001
3339.1003
3331_3101 I
CUMIN"?
1
1
1
UNR
EA
FA
VF
EA
VF
EA
CITY BID ITEM
PAY ITEM e Y QUANTITY UNIT
10 3341.0204 -47 LF
I
Paving Improvements
cRY BID ITEM
PAY REM 8 / OUAt7RTY UNIT
9 3213.0301 -47 SF
New 16 3213,0501 1 EA
Now 17 3441,4110 1 EA
Skeet Dahl Imokovements
CITY BID ITEM
PAY ITEM 6 # QUANTITY UNIT
2 2505.3016 90 LF
3 3441.1408 180 LF
4 3441.1409 90 LF
5 3441.1502 1 FA
6 3441.1771 -1 EA
6 1 9999.0004 I -19 _ FA 1
9 1 9999.0006 I -840 LF 1
10 I 9999.0007 I .35 EA I
Revised: 10-12-2011
SUBTOTAL
SUBTOTAL
SUBTOTAL
1[EI�I QF.SCRIPT) UNIT PRICE TOTAL I
µM d Varyun a nn ; 800.00 S 600001
6' Sower Servke 5 5.500,00 $ A„0011
E o' Manhole Liner S 360.00 5Sod' Manhole S 13.
544,20 4Il'�
4' Extra Manhole S
4'Sewer e5 5.445.00 5 5. 445,00
(18.099. 01
•
'F {lam Class 11(
REM DESCRIPTION
r(WFin 4t' C�one Sidewalk
Remove & Nm'nvlell Sion Panel end Post
ITEM DESCRIPTION
2- Condl PVC SCN 8018
NO 6 Insulated l:lec C
NO 8 Insulated Elec Con&
G0-2.dBoz Typep hose (pR
FuMSMns60 1 Vdl �e hose Metered Pedestal
FuniWlnslall CCMC Fort W odes Ante. Street Lams
1' Condi PVC SCN 801j)'
Christmas Uaht Receptacles
SUBTOTAL
TOTAL
UNR PRICE TOTAL
5 405.00 5 (19.035.001j
3 (19,035,001
UNIT PRICE TOTAL
S 10.50 5 493.50)
5 6`2�15�. J S 5.215.00
S 1.500.WI S S 1.500.00
7,221.50 1
UMT PRICE TOTAL
5 10925 5 9.832.50
S 228 S 410401
$ 217 $ 195.301
5 379,75 $ // 379.78)1
4991-00 $ 9,929.00 S 1188,651.0((i
S 30.92 5 19,768.80
$ 314.65 $ 111.012Y f
5 I(`213.625.61J
S 246.658.601
Page 2
REASONS FOR CHANGE ORDER Reduce FM lap from 8'lo Gm PrullSbeei
Relocated Fee hydrool for curb ramp
Remove waferine lowering In 12' mein
Reduced senor lap from 8' le 4' (remove required manhole)
eddedheconflgured curb tamp
24' RCP quendly Mcorrec1 in Inlbl bid proposal
rofacaled'right fum must tom dghl'sign on 81h
Changes correspond to plan Revsbn 1 es shown on sheets 4-6, 8,9,13,15,18, d 4f
Sbael lights no longer served bypublk circuit
Changes correspond to Plan Revision f es shown 00 sheets 29-32 d 36
NO CRY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100%OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE
CITY WILL BE SOUGHT BY THE DEVELOPER 1 -
RECOMMENDED:
Dunaway Assoc:ales
By; Jusj'n Wells, P.E.
Name/ bL lrl!/
ue: Discipline Lead
Revised: 10-12-2011
APPROVED:
Cook Chldren
By.
APPROVED:
Fa
1W
/1
orihLh4C 1nrdonr.C�
jj l/./yip 1 f�j.
Title: 4I lAV 'ie.s[.iNl...k \ TIBo:
EyrAre
Page 3
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME: Kook Chlidren's Medical Center
CONTRACT: Water, Sewer. Drainage. Paving. and Street Lighting
CFA# I20-0022 I CRY PARTICIPATION:I NO_
CITY PROJECT# 1102607
DOE# IWA
FID # 130114-0200431.102507-E07685
FILE # Itc 2733 . X-20320
INSPECTOR: Riley Roberson Phone No:
PROJECT MANAGER Debbie Wmlelm, P.E Phone No:
(ORIGINAL CONTRACT
EXTRAS TO DATE
'CREME TO DATE
(CONTRACT TO DATE
(AMOUNT OF PROP. CHANGE ORDER
TerrMKN®0 NH70AAGTAMOUNTI lIM,138.64
REVISED COST SHARE Dov. Cop:
TOTAL REVISED CONTRACT
1 WORKING DAYS
D.vdopor - D.vNop.r-Dewbp.r -
Cost CA�'.l.aft 0.w101H Cop f;1(y.c4.t_ Cost - ,CIOyCoit_ Coe 08M 8Ct : D114np.r Cost C(7.Cot_..
8231,s0e11 _ $0AU 1141,7E410 :SL00`. 5235,807,12 V10.00_.. 0431,11100 _ RCO...._ 1341,116.76 1000. 170
131,711,00 814,114.40 17,22151
__ ! - -
11,120.N 10 _. 311,011-_ - -
St1,Mi.N '' 017,626.10 —
f211,33214 10,p'. 10N.11411 i00.001 -. 124 .02112 -- bbS01u...I $I7,ML00 : i30DU:. 1114,040.1i
_ _ Oa. 170
S - 0 - $ - _ 11 S 10,0100 _. _ - S 0
1281.33001 ',50.000140.644D4 , .$0.00'. Satps112 , 40,0044 1 4427,11L00 ' 41.00''... 1104.04410 170
11840.664.05 1243,010./2 I 5417,1/8.00 I 1104,140.14
$1,010,461.62 ,C6j'Gat: $0,00
$1,510,469.62
802-213-1837
817-392-2481
7 CHANGE
ORDER No:
1
3
REVIEWED
By D Willhelm at 8:31 am, Oct 09, 2020
•
CONTRACT UNIT
N
WRIER SEWER PAYING DRAINAGE STREET LIGHTS
Ravcod:10-12-2011
Peon 1
You are directed to make 01e following changes is the centred documents
Oreimape Improvements
COY 131D ITEM
PAY ITEMI 5 I QUANTITY UNIT ITEM DESCRIPTION UNIT PRICE.1 TOTAL
f(1.860.001
4 3201.0616 1 38 SY Corr Pvml Renoir,. Arterialandueldal 3 315.00I 5 11.070.00�
0 3301.0001 1 10 LF Pos4CCTV1p- oc0an 3 4.00) S 40.001
9 3365.0109 I 10 IF Trench b _ S 14.021 S 140.001
10 3341.0204 1 10 LF 24. RCP, as II 3 405.00, 3 4050.001
12 9999.0001 4 SY Concrete CrosswakA02no "1,khl Pcatfi' S 330.00' S 1.320.001
13 9999.0002 1 -13 SY Concrete Crrsswala laving 1U0hl0lue' 5 360.001 5 fj 680.001I
TOTAL S i .980.00
Revised: 10-12-2011
Page 2
REASO?S FOR CHANGE ORDER Shift stoan drain connccton In cooper sfreetsOoflL and oMuge hendmpie
Changes correspond to rovision Jon sheets 1, 11, 23 and 24
By
NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER{$ RESPONSIBLE FOR 100% OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE
CITY WILL BESOUGHT BY THE DEVELOPER
RECOMMENDED:
iToci
psaity
Justin Wells, PE
Tea: Discipline Lead
Revised: 10-12-2011
APPROVED:
Cook ChfM 0 Me6 nt Pat!,C4iCons1 Yor 1LLC
�: r/ 1r 11./ r/li, _ l/ ,
Neme ptilLSy>_•S Nam:` ,, i .':\;;k ''4• �• -Y,4,,,. �' E �l
rnk: \� Cease ,.-r-,..� kc Tree: ''G� i5.T1\`,E '"'t7�i\�f! rr "
1
APPROVED:
PROJECT NAME:
CONTRACT:
CFA #
CITY PROJECT #
DOE#
FID #
FILE #
INSPECTOR:
PROJECT MANAGER:
ORIGINAL CONTRACT
EXTRAS TO DATE
CREDITS TO DATE
CONTRACT TO DATE
AMOUNT OF PROP. CHANGE ORDER
REVISED CONTRACT AMOUNT
TOTAL REVISED CONTRACT AMOUNT
PER UNIT
REVISED COST SHARE
TOTAL REVISED CONTRACT
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
Cook Children's Medical Center
Water, Sewer. Drainage, Paving, and Street Lighting
20-0022 I CITY PARTICIPATION:1
102507
NIA
30114-0200431-102507-E07685
K-2733 . X-26320
Brandon Phillips
Debbie Willhelm, P.E.
WATER
Developer
Cost
$231,660.00
$39,799.00
53,120.50
$268,338.50
$ (4,836.20)
$263,502.30
$263,502.30
Dev. Cost:
City Cost
$0.00
$0.00
$0.00
Phone No:
Phone No:
SEWER
Developer Cost
$848,756.65
$21,351.40
$18.099.00
$852.009.05
$ (57,329.06)
S794,679.99
$794.679.99
$1,928,857.06
You are dlreGed to make the follovAng changes In the contract documents
Water Improvements
PAY ITEM#
2
New20
New21
TOTAL
CITY BID ITEM
#
3201.0614
9999.0011
0241.0100
QUANTITY
-116
1
130
Clty Cost
$0.00
$0.00
$0.00
UNIT
SY
LS
SY
NO
682-715-7010
817-392-2481
CHANGE
ORDER No:
CONTRACT UNIT
PAVING DRAINAGE
Developer Developer
Cost City Cost Cost
$235,807.32 $0.00 0436,053.00
$7,221.50 $10,980.00
$19,035.00
$243,028.82 $0.00 $427.998.00
$ 82,874.39 $ 12,233.41
$325,903.21 $0.00 $440,231.41
$325,903.21
CityCost:
$1,928,857.06
5
City Cost
$0.00
$0.00
tomb
$440.231.41
ITEM DESCRIPTION
Cone Pvmt Repair. Residential
Kill 7' Water Service
Remove Conc Pvmt
STREET UGHTS
Developer Cost
$318,165.75
$213,625.60
$104,540.15
$104,540.15
$0.00
1
WORKING DAYS
City Cost
$0.00
$0.00
50.00
$104,540.15
UNIT PRICE
$ 373.00
$ 20,511.30
$ 137.85
170
17TH
117 1
287 1
TOTAL
$ (43,268.00)1
$ _ 20.511.301
$ 17.920.501
$ (4,836.20)1
Revised: 10-12-2011
Page 1
Sewer improvements
CITY BID ITEM
PAY ITEM # # QUANTITY UNIT ITEM OESCRIPTION _ UNIT PRICE TOTAL
8 3201.0614 -379.87 SY Conc Pvmt Repair, Residential $ 314.00 $ (119.279.181
10 3231.0412 -14 LF 6' Fences, Wood $ 72.00 $ (1.008.0011
13 3301.0101 1 EA _ Manhole Vacuum Testing_ $ 800.00 $ 800.00 J
17 3305.0112 2 EA Concrete Collar 5 981.00 S 1.962.00
24 3339.0001 14 VF Epoxy Manhole Liner 5 360.00 $ 5,040.00
New33 9999.0012 1 LS Temporar`( Manhole access $ 6,878.00 $ 6.878,00
New 34 3305.0101 1 EA Manhole Ad stment Minor $ 4,860.00 $ 4.860.00
New35 0241.0100 238.13 SY Remove oncPvmt $ 137.85 $ 32,826.22
New36 3213.0102 60.13 SY T' Conc Pvmt $ 176.15 $ 10,591.90
TOTAL 5 (57,329.061
Drainage improvements
CITY BID ITEM
PAY ITEM # # QUANTITY UNIT ITEM OESCRIPTION UNIT PRICE TOTAL
2 0241.1300 -23.9 LF Remove Concrete Curb & Gutter 5 62.00 5 11.481.80)
3 3201.0124 -16 LF T' Wide As haft Pvmt Re Pair, Arterial 5 234.00 5 (0,744.00)
4 3201.0616 29.88 SY Conc Pvmt Repair, Aretenal/lndustdal S 315.00 5 9,412.20
6 3216.0101 51.6 LF 6" Conc Curb and Gutter 5 98.00 $ 5,056.80
7 3301.0001 11 LF Pre -CCTV Inspection 5 4.00 5 44.00
8 3301.0002 1 LF Post -CCTV Inspection $ 4.00 $ 4.00 I
9 3305.0109 1 LF Trench Safety 5 14.00 S 14.00
12 9999.0001 -10.78 SY Concrete Crosswalkpavinp "Light Peach" $ 330.00 5 (3,557.401
13 9999.0002 0.63 SY Concrete Crosswalk owing 'tight Blue" $ 360.00 $ 226.80
New 14 0241.0100 46.9 SY Remove Conc Pvmt 5 60.05 $ 2,816.35
New 15 3212.0303 46.9 SY 3' Asphalt Pvmt Type D $ 73.40 $ 3,442.46
TOTAL $ 12,233.41 I
Paving improvements
CITY BID ITEM
PAY ITEM # # QUANTITY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL
3 0241.0300 1 EA Remove ADA Rare $ 2,780.00 $ 2.780.001
6 3110.0102 -4 EA 6"-17' Tree Removal $ 885.00 $ 3,540.00))
7 3212.0302 -131 SY 2' Pvmt Type D $ 24.00 $ 3,144.00j
8 3212.0501 -131 SY 4" Pvmt Type B $ 44.00 $ (,764.00)
9 3213.0301 -3 SF 4" Cone Sidewalk 5 10.50 $ ((31.501
11 3213.0507 1 EA Barrier Free Ramp, Type P-2 5 3,900.00 $ 3,600.00
14 3471.0001 3.25 MO Traffic Control $ 13,550.00 5 44.037.50
New 18 3213.0206 281.5 SY 11" Conc Pvmt HES _ 5 19.86 5 5,590.59
LF
ent
New 20 9999.0013 31 LS 8 Prut errpora,rolipalt m��alt lavemeint n5a11 5 19,821.00 $ 19,821.00
New21 9999.0014 101 CY Material Cost Increase for FlatAork $ 71.30 $ 7,201.30
New22 9999.0016 62 LF 7-8" Variable Height Curb $ 59.00 $ 3,658.00
TOTAL
$ 82,874.39
REASONS FOR CHANGE ORDER
Shift streetlight locations. Tree removals and wood fencing removal are private: removed from CFA scope, Reconstruction of ramp at Pennsylvania and &h.
installation of temporary pavement in Pruitt, and additional pavement repairs required at various locations. This Change order is also a reconciliation of final
quantities to match As -Built conditions.
Changes correspond to Plan Revision 5 sheets 28, 28, 31, 8 32 and Plan Revision 6 Sheets 4, 5, 8 13.
Due to delays. 117 uorfohg days added to contract.
Revised: 10-12-2011
Page 2
nocuSyn Envelope ID: D63F245C-2263d33OSOFD-702B49659911
NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100% OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE
CITY WILL BE SOUGHT BY THE DEVELOPER
RECOMMENDED:
Dunaway Associates
By.
Name: Justin Wells
Tire: Sr. Discipline Lead
APPROVED:
Cook Children's Medical Center
By. iii:70;:nkti
Name: Samuel werschky
Tire: Di rector of Construction
APPROVED:
Fort Worth Cin7 Constructors. LLC
By: Peat- .Ar?uhc6arr/
Name: Doug Atumbaugh
Title: Project Manager
Revised: 10-12-2011 Page 3
FORT WORTH®
TRANSPORTATION AND PUBLIC WORKS
February 9, 2023
Fort Worth Civil Construction, LLC
4860 Mark IV Pkwy
Fort Worth, TX 76106
RE: Acceptance Letter
Project Name: Cook's Children Medical Center
Project Type: Developer
City Project No.: 102507
To Whom It May Concern:
On February 9, 2023 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 21, 2023. 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 February 21, 2023, 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-
392-2481.
Sincerely,
T a666e C, u),1// m
Debbie Wilhelm, P.E, Project Manager
Cc: Brandon Phillips, Inspector
Donald Watson, Inspection Supervisor
Aaron Ybarra, Senior Inspector
Victor Tornero, P.E, Program Manager
Dunaway Associates, LP, Consultant
Fort Worth Civil Construction, LLC, Contractor
Cook's Children Medical Center, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
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 Austin Alumbaugh,
President Of Fort Worth Civil Constructors, LLC, known to me to be a
credible 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 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;
Sanitary Sewer, Water, Storm Drain, Paving & Street Light Improvements
to Serve Cook Children's Medic.1 ente C N: 10
Austin Alumbaug President
Subscribed and sworn before me on this date 8th of March, 2023.
X
otary Public
Tarrant County, Texas
MANDI OLDHAM
- =2r = Notary Public, State of Texas
0. T; Comm. ExTres08-2E-2026
Notary ID 12431710-4
CONSENT OF OWNER 0
SURETY COMPANY ARCHITECT 0
TO FINAL PAYMENT CONTRACTOR ❑
SURETY ❑
AIA DOCUMENT G707 OTHER
Bond No. SUR0058795
PROJECT: Sanitary Sewer, Water, Storm Drain, Paving & Street Light Improvements to serve Cook
(name, address) Children's Medical Center
TO (Owner) [
11
City of Fort Worth
200 Texas Street
Fort Worth, TX 76102
] ARCHITECT'S PROJECT NO:
CONTRACT FOR:
] CONTRACT DATE:
CONTRACTOR: Fort Worth Civil Constructors, LLC
P.O. Box 161727
Fort Worth, TX 76161
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the
(here insert name and address of Surety Company)
Argonaut Insurance Company
P.O. Box 469011 , SURETY COMPANY,
San Antonio, TX 78246
on bond of (here insert name and address of Contractor)
Fort Worth Civil Constructors, LLC
P.O. Box 161727
Fort Worth, TX 76161 , CONTRACTOR,
hereby approves of the final payment to the Contractors, and agrees that 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
Fort Worth, TX 76102 ,OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
the Surety Company has hereunto set its hand this 8th day of March 2Q23
Argonaut Insurance Company
Surety Company
Attest:
(Seal):
tI•J1.t.A.\MI J J-I
Sigtuthorized Representative
Andrea Rose Crawford
Title
Attorney -In -Fact
NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
AIA DOCUMENT G707 • CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 1970 EDITION • AIA® ONE PAGE
OO 1970 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 Ncw York Ave., NW, WASHINGTON, D.C. 20006
Argonaut Insurance Company
Deliveries Only: 225 W. Washington, 24th Floor
Chicago, IL 60606
United States Postal Service: P.O. Box 469011, San Antonio, TX 78246
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the Argonaut Insurance Company, a Corporation duly organized and existing under riie laws of the State
of Illinois and having its principal office in the County of Cook, Illinois does hereby nominate, constitute and appoint:
Andrea Rose Crawford. Troy Russell Kev. Debra Lee Moon. John William Newby. Sandra Lee Ronev. Jnghua D::ffritt:ISuzanne Elizabeth Niedzwiedz
Their true and lawful agent(s) and attomey(s)-in-fact, each in their separate capacity if more than one is named i►liove'tq,)niike, execute, seal and deliver for
and on its behalf as sure'f rta
surety, and as its act and deed any and all bonds, contracts, agreements of indemnity and'otftervundertakings in suretyship provided,
however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: ; ` .
S97.550.000.00
This Power of Attorney is granted and is signed and sealed under and by the authority of the following (tcsolution adopted by the Board of Directors of
rat
Argonaut Insurance Company:
"RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice F esilient, Secretary, Treasurer and each of them hereby is
authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any
officer or attorney, of the Company, qualifying the attorney or attorneys named,; i the given power of attorney, to execute in behalf of, and acknowledge as
the act and deed of the Argonaut Insurance Company, all bond undertakings, and"contracts of suretyship, and to affix the corporate seal thereto."
IN WITNESS WHEREOF, Argonaut Insurance Company has caused itsTVficiaTseal to be hcrcunto affixed and these presents to be signed by its duly
authorized officer on the 19th day of November, 2021.
` iiaoiiiiicYn
SEAL;;
1948
STATE OF TEXAS
COUNTY OF HARRIS SS:
by:
Argonaut Insurance Company
Gary E. Grose President
On this 19th day of November, 20.21i'tA�.D:t `, befit me, a Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and
9y
qualified, came THE ABOVE 0$I:II4R OV THE COMPANY, to me personally known to be the individual and officer described in, and who executed the
preceding instrument, and he acknot};fedged the execution of same, and being by me duly sworn, deposed and said that he is the officer of the said Company
aforesaid, and that the sealaM1 ed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as
officer were duly aff_ xxeg, nd ?scribed to the said instrument by the authority and direction of the said corporation, and that Resolution adopted by the
Board of Directors of saikorhpany, referred to in the preceding instrument is now in force.
IN TESTIMONY WHEREOF, 1 have hcreunto set my hand, and affixed my Official Seal at the County of Harris, the day and year first above written.
,fr;1/4,‘ok
�1.i�, 1.�R'1
KATHLEEN M MEEKS L
NOTARY PUBLIC
STATE OF TEXAS
MY COMM. EXP. 07/15/25
NOTARY ID 557902-8 (Notary Public)
I, the undersigned Officer of the Argonaut Insurance Company, Illinois Corporation, do hereby certify that the original POWER OF ATTORNEY of which
the foregoing is a full, true and correct copy is still in full force and effect and has not been revoked.
IN WITNESS WHEREOF, I have hcrcunto set my hand, and affixed the Seal of said Company, on the 8th day of March . 2023 .
Austin W. King , Secretary
IF YOU HAVE QUESTIONS ON AUTHENTICITY OF THIS DOCUMENT CALL (833) 820 - 9137.
IMPORTANT NOTICE
To obtain information or make a complaint:
You may call Argonaut Insurance Company and its affiliates by
telephone for information or to make a complaint:
ARGONAUT INSURANCE COMPANY
Please send all notices of claim on this bond to:
Argo Surety Claims
(413) 773-6359
Deliveries Only: 225 W. Washington, 24th Floor, Chicago, IL 60606
United States Postal Service: P.O. Box 469011, San Antonio, TX 78246
You may contact the Texas Department of Insurance to obtain
information on companies, coverages, rights or complaints at:
(512) 490-1007
You may write the Texas Department of Insurance:
P. O. Box 149104
Austin, TX 78714-9104
Fax: (512) 475-1771
Web: htto:l/www.tdi.state.tx.us
E-mail: ConsumerProtectionetdi.state.tx.us
PREMIUM OR CLAIM DISPUTES:
Should you have a dispute concerning your premium or about a claim
you should contact your agent or Argo Surety first. If the dispute is
not resolved, you may contact the Texas Department of Insurance.
ATTACH THIS NOTICE TO YOUR BOND:
This notice is for information only and does not become a part or
condition of the attached document and is given to comply with Texas
legal and regulatory requirements.