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Home My WebLink AboutContract 56001-FP1FORTWORTH, TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION -FP1 City Secretary No:_56001 Date Received: 5/26/2023 City Project N!?: 101472-2 Regarding contract 56001 2018 Bond Year 3 Contract 9 for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 6/8/2021 through M&C 21-0391 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: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Work Completed: Less Deductions: Liquidated Damages: Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: Less Previous Payments: Final Payment Due Recommended for Acceptance Asst. Director, TPW - Capital Delivery ^V� Accepted Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Client Department �� W it li�m Jo hn ton (M r )6 7073 OPo6 FDTI Asst. City Manager Comm tits: $3,891,537.75 $0.00 Ne 2 0 Days @ $650.00/ Day $0.00 $3,628,804.26 $3,447,364.05 $181,440.21 May 25, 2023 Date May 25, 2023 Date May 26, 2023 _ Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment To (owner) City of Fort Worth Invoicing Period (From - To): I 02101/2023-02/01/2023 P. °. FW020-0000006303 From (Contractor): Number: Jackson Construction LTD Contractor'sCFW Vendor No.: Project: 101472-2 0000008063 Invoice No. 18-FINAL Invoice Date: 5/17/2023 Remit to ( If Not Automatic Deposit): City Secretary Contract CS56001 c°ntract 2018 Bond Year 3 Contract 9 Number: Name: Application For Payment Change Order Summary Approved Change Orders 11. ORIGINAL CONTRACT PRICE ........................................................ $ $3,891,537.75 Number Additions Deletions 2. Net change by Change Orders............................................................... $ $0.00 1 $126,667.96 $126,667.96 3. Current Contract Price (Line 1 + 2)...................................................... 14. $ $3,891,537.75 2 $27,420.00 $27,420.00 TOTAL COMPLETED AND STORED TO DATE 3 1 (Progress Estimate, Construction Allowance and Change Orders)..... $ $3,628,804.26 4 15. RETAINAGE: 5 I a. X $3,628,804.26 Work Completed......... $ 6 1 b. X Not Used $ 7 I c. Total Retainage (Line 5a + Line 5b).............................. $ 8 16. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c)........................... $ $3,628,804.26 TOTALS $154,087.96 $154,087.96 17. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)...... $ $3,447,364.05 NET CHANGE BY $0.00 8. AMOUNT DUE THIS APPLICATION ............................................... 19. $ $181,440.21 CHANGE ORDERS BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + Cos + Line 5 above)............ $ $262,733.49 Contractor's Certification 10. CONTRACT TIME: The Contractor certifies with the submittal ofthis document and associated Payment Request Submittal a. Days Awarded 365 on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all previous progress b, Days Added by CO 35 payments received from Owner on account of Work done under the Contract have been applied on Total Days 400 account to discharge Contractor's legitimate obligations incurred in connection with 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 to Owner at time of �, Days Charged 400 payment free and clear of all Liens, security interests and encumbrances (except such as are covered by Days Remaining a Bond acceptable to Owner inde urifying Owner against any such Liens, security interest or e. encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Liquid Damages $650.00 x day Carmen Estep (May 24, 6023 10:22 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. 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S117AO3 A a c B E F 0 6ry BI3 P�TyD' LtitFh:e Bi.t \'z5x �1�'� tax hniou!)4 !N l'ilx \ilx l±�Pm�f 5 Nvl��l iczil CeeP!e1N •' Buve mFvu•A s.16�N�P1 (R-F) B%thm }:o IX.cnPtin Stttim}te l5ir of 5!e�vr � __ ggg9 gggg Barris Free Raryr, TlDZ R1 (5-*ztl) - - - 9)9999 EA 1000000 $500000 S5_00000 100000000 5500000 55.00000 SS ON 00 100095 gggg gggg B311Vi Free Ramp, TlFZ P-111.'ed`adl 939359 EA _ 2000000 5305000 _ SO 10000 200000000 561.N MAN $1IN 00 INO05 gg999gg3 c--tz Edg--. ner Aga n=1 E,t-'I 921 211.000000 $5200 421.014 p0 21500000000 122.55000 $225A00 S2255000 10705 5141fi 00 95999999 — A"onancz 929J 99 LS 1000000 $10000J 00 4100.00000 S1G).00000 0211.1 t00 BtIR 3a-PAVIIIG IIAPROVEPAERTS ALTERIIATE A AzprlaY Parem�n! r±41 I) ST 1653000000 11,N _ 51gfi3600 _ 165300000000 $10 B)600 $19.BJ800 Stgb]fi 00 1000i 0241.1>00 31231 - F� ' - % nC/n 4116 ST 2316 14301.000000 11J 15 St 9663fi]5 14'39300000000 $1938475Q $19).84>.50 St9194]50 9fifii $279125 c*1 3134ptp1 Ernban%rre Eb,P'3rn Cy 31 ±4W GT ]56 M.. 18300N00 -N 54200 S1285200 $I-00 ]S6 NOM000 1S30JC00000 51285200 51.63601 11285200 S.—W 51285200 1000'i S).100 1000:5 32120Jp] 3'A=.F4rat Parerrrent. Tl O 3±1216 Sy 14125 C00000 51900 52.. 31500 1.2000000000 11111,11 0 426638000 52661.Ol 9934 5159111 321601p1 6'Gpnc CuN andGMzf 3±16±3 LF 921500000) 53400 531331000 on50000J000 S31J 9300J 4313.990.00 531399000 '0024 51111- 32160301 Gone Va''ej GNtxr, Pz=dznlal 321613 Sy 1S90p0000 _—. S15000 525.31000 22840MN. 434260N _ 43426000 534260N 1206f6 -51—N 93999999 Va`.e BO. Ad,u:trt'znl, xl ConuHZ Co"4r 9259W EA 220000J0 545000 5990000 2J 00000000 41035000 510,350.00 51035000 1045f5 -50 p0 93999999 Cevn1'mle lg'32 LBSIST7 93599) T(Y,! 233 ONNO 524500 S69.331N 223.00000000 S55.12500 555.12500 555.12500 7951 51421000 JM1Sa a. wL.m owu,!rr��aw�lr�.,.1&cocs wu-<4Reer.:.1-,:3�4ue .�.e5drar. ro. Q. az.ea,�amrela%d �rrulryolarwr!.,wle�4u<!1.iRmme.N.va, CO620 Charge Order Progress Estimate Change Order Number I I Contractor's Application ADDITIONS F°c(` —t): 101472-22018 Bond Ye-3 Cotdsac19 City S—Y C556001 APW'a°eo Number. 18-FINAL Cam.tt No.: APPIka"On Ma : 02/01/2023-02/01/2023 APPliafion D.k: 5/1712023 A B C D E F ltan Additive Totil C—Pkid •� M1_W Roish Chsnge Osda lint Spxificafien CO Qumfiry WAdd Estlm.td Lfiit Price CNnge Osda Quanfiry Value Presiausly Value This hl.taials P.—fly "A Stored to D.k (F) (B-F) No. Dasmlm°n SaEon No. Vtdtofhiusurc V.lue Im411d IsssLlld \htue Paid SWrd (sot vs C) (D-E) B 48 _ 8-DR 18 Gr PVC Sesser Pips Vsdlll LF 842.00000000 $112.93 $95,087.06 75200WW00 S",92336 $84.923.36 _ _ _ _ SS9492336 89.3% S10,163.70 49 8'DRIECr—PVC&—Piper.CLS\(I3actfdl L'nit 11 LF 130.00000000 _ 524293 S31,580.90 130.00000000 S31,580.90 S31,580.90 S31.580.90_100.0% Tomb S126,667.% S116,501.26 S116,501.26 S116._0.26 92.0,. S10,163.70 This davment has barn mMirM Ron its igiod 16no u an FJCDC docvmwl ad 8n uw did not higNight the modificad— You u a gd 0 read the dorummt n ffiliy.d cmmlt L<g.l Cousuei pia W its—oti n C.6M Change Order Progress Estimate Change Order Number I 1 Contractor's Application DELETIONS F«I mw" 101472-2 2018 Bond Year 3 Contract 9 AppliaumNumbe.. 18-FINAL Appliapon Ptno3' 02/01/2023-02/01/2023 Applir tieo Da 5/17/2023 A D C D E F Chmge Oder I., Item CO Q..fi to sp&a xium Unit Pd. Deletion Chge anOtdee Not Usd Not USN Not Uud Not Usd Not Used N.U.M Not USN NM USN Descnpum No. Unitof\1ea°urc ]NWi, Scum No. VA.. 1 VDIPSesscc Pipe Unit 11 LF 731.43992308 S130.M S95.087.06 3 8'DIP Sessxr Pipe, CLS31 DaJ:fll L5u[II LF 12I.46500000 $260.00 531.58g.90 Totals $126."7.96 This document has hen modifM f in aigwl( u an EJCDC document"the uw did not highlight C. mNiuuuoot You w—ged to read fie doom carefully and —It Legal C« 1pi«to its —rim C-M Change Order Progress Estimate Change Order Number 1 2 Contractor's Application ADDITIONS Far(. dy. 101472_22019 Bond Year 3 Contract 9 cdyseaewy CS56001 Ap it aioNumbs. IS -FINAL comae Num A,H.nia„Pedoa: 0210112023-0210112023 .lppliatim Date: 5/17/2023 A ➢ C D E F Rm+ Bd.t.Fwsh C7unge Uder I,— S him Co QnaMay to Add Addition Ctaange Vsut Pria Fsimated Q—Ry \'aloe P ,ioudy Value'D�is Maleria4 Prese Aly, Tadcon'laed and!a—dto Date (F) (➢-F) D` prim S flan No. Dvt of Measure 0edec%.1- WUIIM h lled Vatue Period So—d(nato C) (D+E) ➢ 50 3349.00014'Stamlu dim ➢oa � U.2 S— EA 1.00000000 _.._._.. _ .._— $14,020.00 $14020.00 1.00000000 $14020.00 S14,020.00 314020.00 100.0% .— 31 3141.0103 18'RCP. CIau III E1tit2 Seuv _ IJ• 8.00000000 _ _ 3311.00 __.. ,.. $2,488_00 8.00000000 SE.418.00 52,49309 ._._—_ S2,4I8.00 100.04 49__3232.0100 Can Rd W111 Adj— to Side & thA3 Pacing _ SF 248.00000000 Who S10912.00 24500000000 S10,912.00 $10,912.00 _ ._ S10.912.00 100.0!: ----- __ Tata4 S27.t20.00 S27.420.00 ------------ S27.420.00 527A20.00 100.0% This davmmt hu Mnmodified Ganin arigvlf uan FJCDCd ao—a she user did mthigWight die nedir-lims. Y. as .aged to aaddh d-andd orcMly".11 Ind Cmeuel pinto its —floe. C�20 Change Order Progress Estimate Change Order Number 1 2 Contractor's Application DELETIONS F«(xmran): 101472-22018Bond Year3Confract9 ^Pd"'t10"NO1"'"" 18-FINAL A00EnGw Period: 02101/2023-02101/2023 App1i` 6. De" 5117/2023 A ❑ C D E F Iittn Change Order Item COQ—it)- SPea t10" Deletiw Chv�ge UatPrice NW Usd NM Uad NdU Na(Uud Nat Used NetU 7 Nd Uud Na Uud per,T.piw NP. thin ef\leauve Delete S tiw No. Uder\11ae 9999.9999 Cwnru.Yiw Al-- 1hdt2S . is _ 0.27513333 S60,000.00 $16,509,00 99999999 C—i-MI-- UM3 Pavine M 0.10912000 5100,000.00 S10.91200 _ TPhh S27.Q0.00 ThisdwvnuN hu hen tmdifiedf its «igirulf ssan iJCDC davmrnt ud We user didrwt higNigla the nwdificuiwu 1'w ere ewwngdtonadtha Mvnurd ruefully ard cwault Isgal Cwrael lai« to ils erewtion City of Fort Worth Summary of Charqes City Secretary ContractNum: I CS56001 I 2018 Bond Year 3 Contract 9 Ip, O, : FW020-0000006303 I Project Number: I101472-2 Application Period: I 02/01/2023-02/01/2023 I Application I 18-FINAL Application Date: 5/17/202-3 I Number: Funding Identification (FID) Total Completed Amt Remaining r Gross Retainage I met 1 F Original Contract _ 156002-0600430-5740010-101472-001780-9999 I $1,060,439.62 156002-0700430-5740010-101472-001780-9999 I I $871,593.00 (34018-0200431-5740010-101472-002480-9999-18010199 I I $1,552,847.38 to 10 I0 0 I 10 10 I I I J) tjo I I I I so.00 I I I SD o0 1 I I So 0o I :0o0I I soau I I so 00 I I I I 3D.00 I I I Change Order 1 156002-0600430-5740010-101472-001780-9999 GuiiO 156002-0700430-5740010-101472-001780-9999 I $116,504.261 I 134018-0200431-5740010-101472-002480-9999-18010199 1 1 S(1.D0 I I 10 I I S0 00 I I 10 I I S0.00 I I 10 I I s0 o0 I I 10 I i so.001 I to I I 3000 I I 10 I I 30 001 1 Io I I s0 00 I I 10 I I sov) 1 I (- -- Change Order 2 -- 156002-0600430-5740010-101472-001780-9999 1 156002-0700430-5740010-101472-001780-9999 I 1 $16,508.00 1 134018-0200431-5740010-101472-002480-9999-18010199 I $10,912.00, 1 10 10 I I soy- I SO cn I I So.an 1 I so 0o I 30 I , $79,008.38 $171,710.00 $0.00I 1 so.00 0.001 $155,939.37 so.00 I �0.001 $0.001 ,) I s0.00 I SO 00 I $0.00 1 so.00 I :y0.00 I 30.0o I I $0.0o 1 S0 00 I so.00 11 S0.0o I I ;000 1 So 00 1 $D.00 I 1 $0.00 I I s,0.0o 3o Do I 1 ,0 0D s0.00 I I $0.00 50.()0 I I :;O.o0 1 I 60.00 I I O.DU 50 00 I I so.00 I I £0.00 I I S0.00 S0.00I 1 :,0.001 1 $0.001 I 1;0.n0 ou I 1 :o.00 I I s000 I I $U.uo ($116,504.26)1 1 ".0.00I I $0.00I 1 $000I 50 00 $0.0()I I $0.00 1 I $0.00 1 So DO 1 1 s0.00 I I S0.00 I I So DD 1 SODu I so.oD I I $0.09 I 1 '0.00 1 So 0 1 1 o.oa I 1 o 00 I I $0.0o I so.00 I $000 I I o.00 1 1 so.00 1 $0 00 1 1 $0.o0 1 1 so oo 1 1 s9.00 I co 00 I $o.rn I I $D.00 I .0.00 I 0 0o I 1 30.i 0 i $0 0o i 1 0.00 I 50,00 I I $0.00 I `sU.01� I :;U.OD I $16,508.00)1 1 $0.001 1 .';0001 1 $0.001 1$10,912.00)I 1 ;000I I D.00I 1 $0.001 1 "'0 00 1 1 t40.00 11 u0.00 1 n).aU I I ` 0.00 I I 'u.00 i I 30.00 1 so co I I ; o 00 I I sU.00 1 I so (10 1 ,H) 00 I I $0.00 1 I .o.00 I 1 so.00 1 30 00 I I .,O.0o ( I aoo I I `0.00 i sn.Do I I O.00 1 1 o.00 1 1 =a0o I `i0 00 I I SO 00 0.00 SD.Oo I I $000 I I z0.0,3 I 1 moo 1 City of Fort Worth Summary of Charqes City Secretary ContractNum: CS56001 2018 Bond Year 3 Contract 9 P.O.: FW020-0000006303 Project Number. 101472-2 Application Period: I 02/01/2023-02/01/2023 I Application I 18-FINAL Application Date: 5/17/2023 Number: Funding Identification (FID) Total Completed Punt Remaining I F-Gro-ss --1 L Retalnage I Net I Change Order 3 156002-0600430-5740010-101472-001780-9999 156002-0700430-5740010-101472-001780-9999 134018-0200431-5740010-101472-002480-9999-18010199 10 10 to 10 to 10 to Io I - Change Order 4 156002-0600430-5740010-101472-001780-9999 156002-0700430-5740010-101472-001780-9999 134018-0200431-5740010-101472-002480-9999-18010199 10 to 10 10 to to 10 10 Change Order 5 156002-0600430-5740010-101472-001780-9999 156002-0700430-5740010-101472-001780-9999 134018-0200431-5740010-101472-002480-9999-18010199 10 10 to 10 to to to to �0 00 I I SO OO I I U 00 I I bu 00 I I ,;, 00 S0.0o I I ra.00 -0.00 I 1 ;0.00 1 So 00 I 50 00 I 1 -0.00 ( 1 50.00 I I $rIA0 I 50.00I w.001 1 y.0.001 1 r;0.0O1 1 b0.00 I 0o 00 I SO 00 I I so oo I I som I 1 : 0.00 I i �u.00 1 I mGo 1 1 Zone l 1 s0.001 I $0.00 1 I Oro I S0.00 1 1 Sri 00 1 1 `0.00 I 1 1,0.00 "10.00 I I 0.00 I I $0.00 I I s0.0o eo Gu 1 s0 0o I I :aO 00 ( I sulo I I 000 s0.0o I I ,or,J i :DO.00I I i0.00 I I I c000l 1 s00o1 1 r;oo( 1 O.aol 1 e000I I b0 00 SO 00 � O.00 I I b0.00 50 00 QOU 1 1 so.0(7 I $0.()0 1 ;o 00 I S0 00 I 1 s0 Oo 1 1 s0 0o I SO.OrJ I ; 0 00 1 Sam I I 30 D) I $0.00 I ';;0.09 $0.00 1 -,0 00 30 OG 1 moo I `.o 00 I Q.0n 1 ', I Go 1 1 :i0.00 sc oo 1 I So 00 I 0 Oo 1 1 ;o 0o I a0.00 1 s0.00 1 I so.00 1 j0.00 I 0.00 I 0.00 s0 00 1 1 ,o 00 1 1 r.*0 oo I 1 o.00 I 4:0.0O 1 sa COI 1 SO()() I I v0.0!i I sow) I I I -()00 I I sr"00 1 1 r0.o(JI a.0.00 I 1 ..nor) 1 c'd100 1 'w U0 1 '10 JJ I I aa00 1 I I s0.00 1 I 'r1 c I a0.00 I 1 100 1 I s0 00 I 1 n oa �.o o0 1 -0 00 1 I I I I s0.uo I 1 0.00 I I saoo I I ;O.Cn 1 I I SO 00 I 1 s0.00 I s0.00 1 so or0 1 I I so oo I I 50.00 I "0.00 I I 0 00 1 I I 30 co I I >0.00 I 1 so.00 1 o.00 I l s0.00 i 1 so 00 I s0.0o I I o01 I I ( I So 0o i 1 0.0o I so 00 1 1 � o 0o I I I 30.00 I I o 00 1 1 :G.00 1 1 "0.00 1 I I ::0.c0 I I 0 00 I 40.00 1 s.0.00 City of Fort Worth Summary of Charges City Secretary Contract Num: CS56001 2018 Bond Year 3 Contract 9 P. O.: FW020-0000006303Project Number: 101472-2 Application Period: I 02/0112023-02/01/2023 I Application I 18-FINAL Application Date: 5/17/2023 Number: Funding Identification (FID) I Total Completed Amt Remaining I r Gross --- I Retainage I I Net Change Order 6 156002-0600430-5740010-101472-001780-9999 I So 00 SO ",ISu.00 :,0.00 50.Ou 156002-0700430-5740010-101472-001780-9999 soon I C0 0O I I 0.00 I I :;0.00 I I 'Ono 134018-0200431-5740010-101472-002480-9999-18010199 30 00 I 30 no I 1 F0.00 I I SO.00 I I SU nn I 10 So Go 1 m oo I ( so.DO I I 0.00 I 1 `0.00 1 10 So OU I I 5o 00 1 1 :<.0.00 1 1 yO.00 I I 50.00 I 10 s000 I CYn co I ,,O.00 I I :±o Uo I I 0.00 1 10 so'co 1 1 so 00 I *o 00 1 1 so.00 I I so no 1 10 su.00 I I su.co I w.00 I I <:o.00 I I so.00 1 10 I Sow I I SO n0 1 :30.00 ( I 50.00 1 1 ;'0.00 1 10 I I so.001 I s0.00I 1 $0.001 1 O.00I 1 -,0.001 10 I I 50.co I 1 sn 00 I 1 s,o.00 1 1 `.0.00 1 1 50.00 1 ------------------ --- Change Order? 156002-0600430-5740010-101472-001780-9999 1 n oD ;u 60 s,O.00 „0 00 y0 n0 156002-0700 30-5740010-101472-001780-9999 1 I 1 :0 0o I I :?0.00 1 I :-0.00 1 1 :;0.00 1 134018-0200431-5740010-101472-002480-9999-18010199 I I Go Oo 1 1 So.00 1 ( 3000 I I SO OO I to I I 1 moo 1 1 sn.00 I I ao 00 I I $9.00 1 10 I I i ;n on I I s..o.no I I :o on I f�o.o-, 1 to I I °') ' I cn no I I srJ.00 1 1 � 11.n0 I ;0.00 1 to I I Sr - I o 0o I I sa ro I I :0 00 I ;C0 00 I to I I so r I so 00 I I 0.00 I I io.00 1 0 00 1 to I I �- r' I I "000 1 1 :.o.no I I a0.00 to so (In I I w ao I I "0.00 I I :0.00 1 10 I I s,, ( I 1 s0 00 1 I s0 00 1 1 .o 00 1 1 ;0 o0 1 - - -ChangeOrderil - - - 56002-0600430-5740010-101472-001780 9999 9U 00 O.Uu :,O ou o 00 156002-0700430-5740010-101472-001780-9999 Co 00 1 I 't acio I I a0.0U 1 134018-0200431-5740010-101472-002480-9999-18010199 So 00 1 I so90 1 1 so no I I 0.00 10 so-oo I I lo.00 I I � 0.00 1 1 s.n.00 1 10 So u0 I I s,n.O 1 1 so.00 1 1 "X100 I 10 Sono I I 0.00 I I i0.00 I I io.00 I 10 e.0 00 1 o 0o I 1 0.00 1 1 so 0n I 10 so.no 1 n.00 I I s�O.00 I I $u o01 10 so 00 1 so Oo so 00 1 1 �o 00 j 10 so00I I s0.no I I -O.Oo I I ,om 1 10 =ann I i �-0 00 I I z0 no s o o0 1 City of Fort Worth Summary of Charqes City Secretary ContractNum: I CS56001 I Application Period: I Funding Identification (FID) 1 2018 Bond Year 3 Contract 9 02/01/2023-02/01/2023 Total Completed IP.O.: I Application Number: Amt Remaining I FW020-0000006303 I 18-FINAL Gross Project Number: Application Date: I101472-2 5/17/2023 I Retainage I— Net Totals I56002-0600430-5740010-101472-001780-9999 I $1,060,439.62 $79,008.38 �o 00 a oo g0 00 156002-0700430-5740010-101472-001780-9999 I $1,004,605.26 I I $38,697.74 I I :;0.00 I I bO.OG I I 30,00 I34018-0200431-5740010-101472-002480-9999-18010199 $1,563,759.38 I I $145,027.37 1 I S.0 00 I I �0 00 I I %"0.00 I 10 I ,n uo I I s0.00 '0.00 11 r0.00 I I $O.00 I to I �o o-� I I sa 0o I I '10.63 I 1 30 00 I I sO.Go I 10 I n.0- I I 50 GO I I :;0.00 I :i0.00 I I zo 00 I 10 I :- i 1 Or I I 'so 00 I I aw I I "200 I I om I to I G ao I sn.00 I I !�O.00 I 1 0.00 1 I s0.00 I 10 I 'n U r I :0 00 I I so 0o I 1 0.0o I i so.GO I to ,000I I "0.00I O.00I I aG.oO I 10 I��I I �nI I 0.00I ,11 srnnl I Grand Total I I $3,628,804.26 I I $262,733.49 I I $0.00 I I ($181,440.21)1 1 $181,440.21 CSC No. 56001-COI FORT WORTH City of Fort Worth Change Order Request Project Name] 2018 Bond Year 3 Contract 9 1 City Sec No.: 56001 Project No.(s):I 56002.0600430107000430.34018.0200431 DOE No. I N/A I City Proj. No.: 101472-2 Project Description:) Combined Water, Sewer Raplacement and Pavement Rehabilitation Improvements in Council District 5 I Contractor: Jackson Construction, Ltd. Change Order # 1 Date: 9/13/2021 City Project Mgr. 1 Walter Norwood, PE City Inspector: Eric Tinner Phone Numberd 817-392-5026 Phone Number: � 817-4781783 Dept, Original Contract Amount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date Amount of Proposed Change Order Revised Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) Unit 1: Water Unit 2 Sewer Unit III:Paving $1,139,448.00 $1,043,303.00 $1,708,786.75 $1,139,448.00 $1,043,303.00 $1,708,786.76 $0.00 $0.00 I $0.00 $1,139,448.00 $1,043,303,00 $1,708,786.75 $56,972.00 $52,165.00 $85,439.00 $56,972.00 $52,165.00 $85,439.00 Totals Contract Time (Calendar days) $3,891,537.75 365 $3,891,537.75 -365 $0,00 $3,891,537.75 365 $194,576.00 $194,576.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.00% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $4,864,422.19 l.TIFICATION (REASONS) FOR MANGE ORD Change Order No. 1 will provide for pay item quantities of 8-inch PVC DR 18 for sewer pipe installation in -lieu of ductile iron pipe due to the current non -availability of ductile iron in the market. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Ch nge Order. 51 Contractor's Company Name Contractor Name Co tractor Signatji `' ate Jackson Construction Ltd. I Carmen Estep I %f Inspector Date Project Ma ager Date 9/22/21 �� 9 23121 Director (Water Dept) Date Construction Supervisor, (TPW Dept), . ate eT T l sap 24, 2021 �A/OY D� 9/22/21 Assis7 p Date Assistant _ y Y Manager Date Se 28, 2021 Sep 28, 2021 Council Action (It Required) "' -] OFFICIAL RECORD M&C Number I NA M&C Date Approved I NA CITY SECRETARY FT. WORTH, TX FORT WORTH City of Fort Worth Change Order Additions Project Name 2018 Bond Year 3 Contract 9 City Sec No.: 56001 Project No.(s): 56002-0600430/07000430-34018-0200431 DOE No.1 N/A City Proj. No.: 101472-2 Project I Combined Water, Sewer Raplacement and Pavement Rehabilitation Improvements in Council District 5 Description Contractor Jackson Construction, Ltd. Change Order: 0 Date: 1 9/13/2021 City Project Mgr. Walter Norwood, PE ! City Inspector I Eric Tinner ADDITIONS , I I tM ' MSCKIN I IUN DEPT qty Unit 'Unit Cost Total 48 8" DR 18 Green PVC Sewer Pipes Unit 2 Sewer M2.00 LF $112.93 $95,087.06 49 8" DR 18 Green PVC Sewer Pipes, CLSM Backfill Unit 2 Sewer 130.00 LF $242.93 $31,580.90 Unit 1: Mter Unit 2 Sewer $126,667.96 Unit III:Paving Page 1 of i Additions Sub Total $126,667.96 FORT WORTH City of Fort Worth Change Order Deletions Project Name I 2018 Bond Year 3 Contract 9 City Sec No.: 56001 Project No.(s): I 56002-0600430/07000430-34018-0200431 DOE No. I N/A City Proj. No.: 101472-2 Project Description I Combined Water, Sewer Raplacement and Pavement Rehabilitation Improvements in Council District 5 Contractor Jackson Construction, Ltd. Change Order: I 1 I Date 9/13/2021 City Project Mgr. Walter Norwood, PE ! City Inspector: I Eric Tinner DELETIONS ITEM DESCRIPTION DEPT City Unit Unit Cost Total 1 8" DIP Sewer Pipe Unit 2 Sewer 731.43892308 LF $130.00 $95,087.06 3 8" DIP Sewer Pipe, CLSM Backfill Unit 2 Sewer 121.46500000 LF $260.00 $31,580.90 Unit 1: Water (Unit 2 Sewer $126,667.96 Unit III:Paving Deletions Sub Total $126,667.96 Page 1 of 1 MIWBE Breakdown for this Change Order ti Total 14 Previous ChangeOrders iy a#i "�� #(ry ° Will s,r.'T� ,aW i r �� fdd €F p #S it " ,jil 7 Total Page 1 of 1 Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Signature iuo A "/),0 a 0 CP Name of Bmployee � J Title ATTEST: P.,P Ronald Gonzales Acting City Secretary OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX CSC No. 56001-CO2 Fox_ T� x. Project Name 2018 Bond Contract 9 Client Project #(s)l 101472-2 Project Description City of Fort Worth Change Order Request Water, Sewer and Paving improvements for 4 streets in Council District 5 City Sec # 1 56001 Contractorl Jackson Construction Change Order #I 2 1 Datel 4/18/2023 City Project Mgr. l Greg Robbins City Inspectorl Eric Tinner Dept. Unit 1: Water Unit: 2 Sewer Unit 3 Paving Contract Time Totals (CD� Original Contract Amount $1,139,448.00 $1,043,303.00 $1,708,786.75 $3,891,537.75 65 Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $1,139,448.00 $1,043,303.00 $1,708,786.75 $3,891,537.75 365 IGo to ADD & DEL Tabs to Enter CO Backup $0.00 $0.00 $0.00 $0.00 35 Revised Contract Amount $1,139,448.00 $1,043,303.00 $1,708,786.75 $3,891,537.75 400 Original Funds Available for Change Orders $56,972.00 $52,165.00 $85,439.00 $194,576.00 Remaining Funds Available for this CO $56,972.00 $52,165.00 $85,439.00 $194,576.00 Additional Funding (if necessary) $0.00 $0.00 $0.00 $0.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.00% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $4,864,422.19 JUSTIFICATION (REASONS) FOR CHANGE ORDER IN ACCORDANCE WITH THIS CHANGE ORDER REQUEST, THE CONTRACTOR SHALL: Furnish all labor and material as per attached proposed Change Order Request. This Change Order #2 will adjust the scope to include t two additional bid items needed to alleviate a sewer conflict with a stormwater pipe, and one bid item for retaining walls needed for the placement of ADA ramps. Cost - City of Fort Worth has compared the unit prices which are being proposed to several recent CIP projects bid in the previous three months. The City finds that the prices that are being proposed by the contractor are within reason when compared to unit prices in other recently -bid construction contracts. This change order will have a net cost of $0.00 after offsets from the remaining construction allowances. Time - City of Fort Worth has reviewed the time needed for the additional work and 28 days were added to the contract for the time spent investigating, planning, designing and construction of the junction box, storm pipe, and retaining walls at House and Hampshire. An additional 7 days was added for construction of additional retaining wall on Van Natta. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Contractor's Company Name Contractor Name Contract Signature Date Jackson Construction Carmen Estep Apr 25, 2023 Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date % Apr 24, 2023 Apr 21, 2023 Program Manager Date Senior Capital Project Officer Date Apr25,2023 w Apr25,2023 NNERU—ire—ctor De t Date Director, Contracting Department (Dept) Date Apr25,2023 x-- Apr25,2023 Assistant City Attorney Date Assistant City Manager Date P,ft,iii ( Apr25,2023 OX-Ri— Apr 27, 2023 Council Action if re uired) M&C Number I I M&C Date Approved p4vvvp ATTEST:� �aoI FORT�4 a Jannette Goodall, City Secretary pvo o P. C�a* o *� oa° ° a II4 nEop5�4p OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX FORT WORTH City of Fort Worth I-`- Change Order Additions Project Name 1 2018 Bond Contract 9 City Sec # 56001 Client Project # 1 101472-2 1 Contmctorl Jackson Construction IPMI Greg Robbins I Inspectorl Eric Tinner Change Order Submittal # Date 1 4/18/2023 1 ADDITIONS IILM UESUKIPI IUN UEPI Uty Unit Unit Gost total 50 3349.0001 4' Storm Junction Box Unit: 2 Sewer 1.0000000U EA $14,020.OU $14,020.001 51 3341.0103 18" RCP, Class III Unit: 2 Sewer 8.00000000 LF $311.OU $2,488.001 49 3232.0100 Conc Rat Wall Adjacent to Sidewalk Unit 3 Paving 248.00000000 SF $44.OU $10,912.001 I 1 I I I 1 I I I 1 I 1 I 1 I 1 I 1 I I I 1 I I I 1 I 1 I 1 I 1 I Unit 1: Water 1 I I I 1 I I I 1 I 1 I 1 I 1 I 1 I I I 1 I I I 1 I 1 I 1 I 1 I $0.001 Unit: 2 Sewer $16,508.00 Unit 3 Paving $10,912.00 I Sub Total Additions $27,420.0 Change Order Additions Page 2 of 4 FORT WORTH 'IT, Project Name 1 2018 Bond Contract 9 Client Project # 1 101472-2 Contractorl Jackson Construction HEM UE6(;RIP I IUN 47 9999.9999 Construction Allowance 48 9999.9999 Construction Allowance City of Fort Worth Change Order Deletions City Sec # 1 56001 1 PMl Greg Robbins I Inspectorl Eric Tinner l Change Order Submittal # 0 Date 1 4/18/2023 DELETIONS DEP I Uty Unit Unit Cost I otal 1 I Unit: 2 Sewer 0.27513333 LS $60,000.0U $16,508.001 Unit 3 Paving 0.10912000 LS $100,000.00 $10,912.001 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I 1 I Unit 1: Water 0.001 Unit: 2 Sewer $16,58.001 Unit 3 Paving $10,912.001 Change Order Deletions Page 3 of 4 Sub Total Deletions $27,420.00 MISBE for this Change Order MISBE Sub Type of Service Amount for this CO Total $0.00 Previous Change Orders co # DATE I AMOUNT Total 1 $0.00 I FORT WORTH. Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE' 2018 Bond Contract 9 — Change Order #2 M&C: 21-0391 Date: CPN: 101472-2 CSO: 56001 DOC#: To: Name Department Initials Date Out 1. Filogonio Munoz TPW - initial Apr 21, 2023 2. Carmen Estep Contractor - signature LEL CE Apr 25, 2023 3. Eric Tinner TPW - signatures Apr 24, 2023 4. Greg Robbins TPW - signature a Apr 21, 2023 5. Mary Hanna TPW - signature 7er✓ Apr 25, 2023 6. Leon Wilson TPW - signature z-w Apr 25, 2023 7 Michael Owen TPW - signature M Apr 25, 2023 8 Lauren Prieur TPW - signature � Apr 25, 2023 9 Doug Black Legal - signature 0,64 Apr 25, 2023 10. William Johnson CMO - signature w4 Apr 27, 2023 11. Jannette Goodall CSO - signature T Apr 28, 2023 12. TPW Contracts TPW DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑YES ®No RUSH: []YES ®No SAME DAY: DYES ®No NEXT DAY: ❑YES ®No ROUTING TO CSO: ®YES ❑No Action Required: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return To: TPWContracts((,FortWorthTexas.eov at ext. 7233 for pick up when completed. Thank you! PROJECT NAME: PROJECT NUMBER: DOE NUMBER: PIPE LAID FIRE HYDRANTS: 5 PIPE ABANDONED DENSITIES: NEW SERVICES: PIPE LAID PIPE ABANDONED DENSITIES: NEW SERVICES: FORT WORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: 2018 Bond Year 3, Contract 9 101472 N/A WATER SIZE TYPE OF PIPE LF 6" PVC 79 8" PVC 4629.16 8" DIP 93 16" DIP 60 VALVES (16" OR LARGER) SIZE TYPE OF PIPE LF Yes 88 1"water service Copper SEWER SIZE TYPE OF PIPE LF 8" SDR-26 2520 8" DIP 40 6" SDR-26 17 8" DR-18 972 SIZE TYPE OF PIPE LF 4" (58) SDR26 PVC TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS May 19, 2023 Jackson Construction Co 5112 Sun valley Dr. Fort Worth Tx 76119 RE: Acceptance Letter Project Name: 2018 Bond Year 3, Contract 9 Project Type: 01,02,03 City Project No.: 101472-2 To Whom It May Concern: On November 7, 2022 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 March 28, 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 March 28, 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- 392-2333. Sincerely, ql�R Greg Robbins, Project Manager Cc: Eric Tinner, Inspector Wade Miller, Inspection Supervisor Ariel Duarte, Senior Inspector Mary Hanna, Program Manager BGE Inc, Consultant Jackson Constuction Co, Contractor N/A, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 CONSENT OF SURETY TO FINAL PAYMENT AIA Doc=ennt G707 Bond No. 1083165 TO OWNEL rNarnewid'addim-) City of Fort Worth 200 Texas Street Fort Worth, TX 76102 PROJEC1%. (n'tszrN arrriadrdru.��} 2018 Bond Year 3, Contract 9, City Project No. 101472 07JNFR AM-Z-11TECT CONTRACTOR SURLTY OTHER ARCHITECT'S PROJECT NO.: CONTRACC FOR: Construction CONTRACT DATED: In accordance with the provisions of tl c Contract bemn--en the Owner and the Contractor as indicated above, the flnsr�t riarnr aird aelditsx of.S�r+'rh J The Hanover Insurance Company 440 Lincoln Street Worcester, MA 01653 SURETY, on bcod of flnwrl naone and addma [(Cmztraa,,r) Jackson Construction, Ltd. 5112 Sun Valley Drive Fort Worth, TX 76119 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Sure of any of irs obligations to Crnwn nanzeandaddmror0mver! City of Fort Worth 200 Texas Street Fort Worth, TX 76102 as set forth in said Surety's bona. •''t g IN WITNESS WRERROF, the Surety has hereunto set its hand on this date: May 24, 2023 (Izzst+rl hz kvVing (be nwntb fallauwd kt�The munerk dareand iear ) Aftt}jt. The Hanover Insurance Company (snrx13) By: (A rawrr ofarrl izrd )rpYsrrI W) Holly Clevenger Attorney -in -Fact {Priutrr! nazr+e aznl rrrre! G707---1994 THE HANOVER INSURANCE COMPANY MASSACHUSETTSBAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWER OF A TTORNEY THIS Power of Attorney limits the ads attlmm mmu" heireln, and they have no authority to bind the Company except In the manner and to the extent herein stated. KNOW ALL PERSONS BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing underew laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA. a oorporabon organized and existing under the laws of the State of Michigan. (hereinafter individually and collectively Ihr'Cornpany') does hereby oon%Uk to and appoint. Holly Clevenger Of Dallas, TX indrindualty.ifthere be more than one named. as its true and lawful atlomey(s}m-facito sign. execute. seal. acknowledge and deliver for. and on its behalf, and as its act and deed any place within the United States, any and all surety bonds, recognew es, undertakings, or other surety obligations. The execution of such surety bonds, rrcognizances, undertakings or surety obligations, in pursuance of these presents, shall be as binding upon the Company as dthey had been duty signed by the president and attested by the secretary of the Comparry, in their own proper persons. Provided however, that tit is power of attorney limits the acts of those named herein; and they have no authority to bind the Company except in th a manner stated and to the extent of any limitabon stated below: Any such obligations in the United States, not to exceed Forty Million and No1100 (940,000,000) in any single instance That this power is made and executed pursuant to the authorityof the following Resolutions passed by the Board of Directors of said Company, and said Resolutions remain in full force and effect Surely Bond Number: 1083165 Principal: Jackson Construction, Ltd. Obligee: City of Fort Worth RESOLVED: That the President or any Vice President, in conjunction with any Vice President be and they hereby are authorised and empowered to appoint Attomeys.in-fact of the Company, in its name and as it acts, to execute and acknowledge for and on its behalf as surety, any and all bor.ds. teeogncenoes. Contracts of indemnity, waivers of otation and all other writings obligatory in the nature !hereof, with power to ar-%c h thereto the xal of lie Company. Arry such wnbngs so executed by such Attonteys-in-fact shall be binding upon the Company as d they had been duly executed and acknowledged by the regularly ekcted officers of the Comparry in their own proper persons. RESOLVED: Thai any and all Powers of Aifomey and Certified Copies of such Powers of Attorney and cetSTi abon in respect thereto. granted and executed by the President a trice President in conjunction with any Vioe President of the Company, stall be binding on the Company to the same extent as d all signatures thefein were manually affixed, even though one or more of any such signatures thereon may be facsimile. (Adopted Oc6ober 7,1081 - The Hanover Insuranot Company; Adopted April 14. 1082 - Massachusetts Bay Insurance Company; Adopted September 7, 2001-Clemens Insurance Company of America and atfemed by each Company on March 24. 2914) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHU SETTS BAY INSURANCE COMPANY and CfTtZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with then respective corporate seals, duty attested by two Vice Presidents, this 0 day of April, 2023 1 be I laaevp tarawrsatr Conwa my lfareNartm Ly lawraap Company Cithees libunste Cempasy of America 3,W4 � JHb., VkePre♦ident STATE OF CONNECTICUT ) COUNTY OF HARTFORD �J`► t Q� 'iu�{rt4.rk ) ss. Tlu ltaaosrr lasarsan Caapaay ;I,.. artts Say lowraatecompny rio Compeer of Ars-4 M. Mendota. Vice President On this 6e' day of April 2027 before me Came the above named Executive Vice President and Vase President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. to men personally known to be the indrviduais and of iioers described herein. and acknowiedged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respeetivey, and that the said corporate: seals and their signatures as off4oers were duty affixed and subscnbgd tq _ in m ority and direcbon 4 said Corporabons. Wendy Lataumes No m Pudic, Sete of Cornwkut ` My 04 CWWiNW EV+es Jlh 31. = MyoommisndvFL&toi sis rssJdy 31, 20Z6 I, the undersigrhed %hoe President of The Hanover Insurance Company, Massaithusett! Bay Insurance Company and Citizens Insurance Company of America. hereby owtify that the above and foregoing is a full. true and cofrect copy of the Original Power of Attorney issued by said Companies. and do hereby further certify that die said Powers of Attorney are still in force and effect GIVEN undermy hand and the seals of said Companies, at Worcester. Massachusetts, this 24th day of May 2023 Tbt a lamraatf at"" it ut is say Is pq CERTIFIED COPY ` ra ° " oka R�aNer, Vice Presidral CONSTRUCTION LTD. 51 1 Z SUN VALLEY DRIVE FORT WORTH, TX 76119 TEL 817-572-3303 FAX 817-478-0443 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 Troy L. Jackson, President Of Jackson Construction, Ltd, 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; 2018 Bond Year 3 - Contract 9 BY Tro. Jackson, President Subscribed and sworn before me on this date 24th of May, 2023. Notary Pli — S, Tarrant, Texas CARMEN L. ESTEP Notary Public, State of Texas �Z Comm. Expires 04-06-2024 Notary ID 2910611