Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Contract 57252 (2)
FORT WORTH® TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION 57252-FP1 City Secretary No: 57252 Date Received: 10/04/23 City Project Ns: 103445 2022 Concrete Restoration Contract Regarding contract 57252 for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 2/22/2022 through M&C 22-0116 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: $ 929,690.00 Amount of Approved Change Orders: $ 63,320.00 No 3 Revised Contract Amount: $ 993,010.00 Total Cost Work Completed: $ 935,495.60 Less Deductions: Liquidated Damages: Days @ $ / Day Pavement Deficiencies: Total Deduction Amount: $ Total Cost Work Completed: $ 935,495.60 Less Previous Payments: $ 936,155.07 Final Payment Due PafriGia 1-. WadsaG/< Patricia L. Wadsack (Oct 2, 2023 13:09 CDT) $-659.47 Oct 2, 2023 Recommended for Acceptance Date Asst. Director, TPW - Capital Delivery Lauren Prieur (Oct 2, 202313:11 CDT) Oct 2, 2023 Accepted Date Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT William Johnson (O2, 2023 13:12 CDT) Oct 2, 2023 Asst. City Manager Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page 11-FINAL Invoice No. r.+ 5 Cs - 0 N 00 00 City of Fort Worth Remit to (If Not Automatic Deposit ): U a FW020-007521 z b 0 00 69 0 0 0 0 0 0 00 00 0 00 00 00 0 0 00 ER - a ER 0 0 0 69 69 69 69 69 69 00 69 69 69 69 69 1. ORIGINAL CONTRACT PRICE Net change by Change Orders Current Contract Price (Line 1 ± 2) F a a F 0 TOTAL COMPLETED ruction Allowance and Change Ord U a d 5. RETAINAGE: Work Completed 0 0 7 O O z DC DC m A 00 LESS PREVIOUS PAYMENTS (Line 6 from prior Application) AMOUNT DUE THIS APPLICATION 00 9. BALANCE TO FINISH, PLUS RETAINAGE Approved Change Orders N Q O o O 00 N 0 O 0 O Vl N 6699 O o 0 O M O 49 O 0 C $34,820.00 N M 0 ER 0 0 0 0 G 0 0 0 0 0 N 000 O 00 QN 0 69 00 69 0 .69 00 z — N 00 V 01 00 t 00 TOTALS NET CHANGE BY CHANGE ORDERS (Column G on Progress Estimate+ CA + COs + Line 5 above) 000 Days Awarded 10. CONTRACT TIME: O Days Added by CO 0 Ya F Affidavit of Bills Paid Consent of Surety Contractor's Certification a o a o Y �°�' > a o� a a 0 -- U N 1 V � qq� o b : N • U U G U • g O 5 U b U_ T V a y O c7 g a 0 0 O ' '�iC. U m b o • o m o.° a v a Oiw0 N a 0 C. end. i3 w0 Q'Q'� O9 y ❑❑❑7 q U N i3 C4 UUH.D �i Uw.a a N 0 N N Tip 00 E�i U 0 W N O �084,17 ,°311 O O N O d c a0 .ao�k7 ro Liquidated Damages $650.00 a day Contractor's Application Progress Estimate z w z 0o lio tioo Date: 8/18/2023 o E . .1 " 4 8 8 $12,705.72 $8,310.75 4$ Rm 7g $24,926.001 $12,643.75 8FMv.8888 as- MIM§my V? I00'OOSS 00'00SS 88 88 as 00'00S'LS 00'000'0le 8888888888 RRRIOnal aaatiaa°7-a ° o s mere m m,_mmemm eoMmgq o m 4Ngo eao gs F" $ F� gmo HIV' 7 w 1 s� L•L' Em m 1 i. $6,000.00 $2,212.80 $1,650.00 r°`('''°")' 2022 Concrete Restoration Contract 1 APPueotmn resod: 7/26/2023-8/18/2023 o , 8 » 844R8488888 ioa -aaaa 8 - 8 a $2,212.801 $1,650.00 8 J� mHm ^m m 2.00000000 221.28000000 5.50000000 N a 888888 6.4a 4' I0D000'Lke 00'000'0E6 88 a' $10,000.00I 2,500.00 88 FF «,«, I00'OOSS 00'00SS 00'00SS 00'00SS 88 as Ion-005'le 00'000'0ke 8888 «.aaa loonoons 00'00S'LS 8888 a-aa 18 7, ggggggggggggggggggggggygggggggggggggggggggggggggggg»gg»gg»gg»ggggggggy 88888888888888888888888888888888 1 Lu mm000mo mennwwwwww,,,,,,wwwwenwww z B N A A. 01 70 00 34 71 13 024113/ 321320 024115/321313 31 2316 3211 23 321313 _ 32 92 13 32 91 19 _ 32 13 73 718 88 32 17 23 32 17 23 32 17 23 32 17 23 32 17 23 32 17 23 AA 32 17 23 32 17 23 32 17 23 32 17 23 32 17 23 32 17 23 024113/ 321320 _ 024113/ 321320 024113/ 321320 _ 330514 32 17 25 E i. 0135.0201 Remobil¢ation 3471.0002 Portable Message Sign 9999.0000 Remove and Replace 6" Concrete Driveway 9999.0000 Remove and Replace 7" Concrete Pavement HES 3123.0101 Unclassified Excavation 3211.0122 Flex Base. Type A. GR-2 3213.0208 Concrete HES lexlra depth) 3292.0100 Sod replacement 3291.0100 Topsoil 3213.0700 Joint Sealant 3305.0108 Miscellaneous Adiustment (Utilities) 9999.0000 Geoerid Tenser (TRIAX 140-475) or Approved equal I3217.2001 Raised Marker TY W 3217.2002 Raised Marker TY Y 3217.2101 REFL Raised Marker TY I -A 3217.2102 REFL Raised Marker TY I-C 3217.2103 REFL Raised Marker TY II -A -A 3217.2104 REFL Raised Marker TY II-C-R 3441.1301 Loop Detector Cable Sawcut 3441.1302 14 AWG Loop Detect Cable 3217.0001 6" Solid Thermoplastic (HAS) Lane Line 3217.0201 6" Solid Thermoplastic (HAS) Lane Line 3217.0401 18" SLD Pvmt Marking HAE 3217.0501 24" SLD Pvmt Marking HAE 3217.1001 Lane Legend RR 3217.1002 Lane Legend Arrow 3213.0501 Remove and Replace Barrier Free Ramp. Type P-1/P-2 3213.0501 Remove and Replace Barrier Free Ramp. Type R-1 kr gt rcl 70 Ea` Et rcE 1! PA 3217.5001 Curb Address Painting 9999.0096 Construction Allowance Contractor's Application Progress Estimate z w fiy z Application Date: 8/18/2023 A 4 1. �3c we 3 fi s1 1 'a I 1 i. r°`1eO°t'°")2022 Concrete Restoration Contract 1 applicat on redon: 7/26/2023-8/18/2023 o a 81 a 7.6 71 z i 4. e A. c z e 4 41 41 I; St cw g3,1 Contractor's Application Progress Estimate z w z Aq Application Date: 8/18/2023 O w 4 Ft m sa F� gt , s� r. 7 1 r. r°`1eO°t'°")2022 Concrete Restoration Contract 1 applicat on redon: 7/26/2023-8/18/2023 o a 81 s. a 6 z E 1 0 e 1 c 7. e w cw C-620 Change Order Contractor's Application Construction Allowance Usage Progress Estimate 0 Application Number: 11-FINAL Application Date. 8/18/2023 m e g,p, Total Completed and Stored to Date (D+E) Materials Presently Stored (not in C) HB a ij For (contract) 2022 Concrete Restoration Contract 1 City Secretary 103445 Contract Num 57252 Application Period: 7/26/2023-8/18/2023 Q U A g� C 3 z 7 Q W d g Specification Unit of Measure Section No. c g I z e C-620 Change Order Contractor's Application Construction Allowance Usage Progress Estimate a w -" g z c Application Date. 8/18/2023 Not Used 72, z z w Not Used z Not Used For (contract) 103445 2022 Concrete Restoration Contract 1 o N M eq V N r c w 1 G ] z U z Reduction Value a G a. Item Bid Item Number Description Specification Unit of Measure Section No. 1 H i.5 479 C-620 Change Order Contractor's Application Change Order Number Progress Estimate \ # S Application Number 11-FINAL Application Date: 8/18/2023 Balance to Finish (B - F) !E_ / Total Completed and Stored to Date (D + E) Is, \Ei )) \� Previously Installed Value $32,633.04 For (contract): 103445 2022 Concrete Restoration Contract 1 City Secretary 57252 Contract Num: Application Period' 7/26/2023-8/18/2023 ° ) : /; {/ / } = j/! '' k 5 \ CO Quantity to Add Specification Unit of Section No. Measure ) , 2. il Change Order Item No. \\ C-620 Change Order Contractor's Application H Change Order Number Progress Estimate 0 E I4 A Application Number: 11-FINAL Application Date: 8/18/2023 Not Used 3 z Not Used Not Used 3 z 3 z For (contact) 103445 2022 Concrete Restoration Contract 1 Application Period 7/26/2023-8/18/2023 z 0 z k 'y0 Qj Vr Vi . Vr . Vr Vr . Ei C K i i 150.00000000 2.00000000 2.00000000 3.00000000 9.00000000 ,L'I',i W aaaa.a W W W,3 ri Item Description 3217.2102 REFL Raised Marker TY I-C _ 3217.2103 REFL Raised Marker TY II -A -A 3217.2104 REFL Raised Marker TY II-C-R 3441.1301 Loop Detector Cable Sawcut 3441.1302 14 AWG Loop Detector Cable Sawcut 3217.0001 6" Solid Thermoplastic (HAS) Lane Liine 3217.0201 8" Solid Thermoplastic (HAS) Lane Line 3217.0401 18" SLD Pvmt Marking HAE 3217.0501 24" SLD Pvmt Marking HAE 3217.1001 Lane Legend RR 3217.1003 Lane Legend Arrow 3213.0501 Remove and Replace Barrier Free Ramp, Type P-1/P-2 3471.0002 Portable Message Sign 1 E+ 22 23 24 25 26 27 U V C-620 Change Order Contractor's Application Change Order Number Progress Estimate Apphcation Number: 11-FINAL Application Date. 8/18/2023 Balance to Finish (B - F) egm m Total Completed and Stored to Date (D+E) W Materials Presently Stored (not in C) F p m A+ d 0.. Yi For (contract): 103445 2022 Concrete Restoration Contract 1 City Secretary 57232 Contract Num: Application Period' 7/26/2023-8/18/2023 a 7 L i V a. g W ro Addition Change Order Value a CO Quantity to Add Z 3 y Wz .P. Item Description z 1 5 oz a C-620 Change Order Contractor's Application N Change Order Number Progress Estimate Application Number: 11-FINAL Application Date: 8/18/2023 w Not Used AZ � z w Not Used z z For (contract) 103445 2022 Concrete Restoration Contract 1 Application Period: 7/26/2023-8/18/2023 z 0 z W Deletion Change Order Value $24,000.00 $12,750.00 K W "a V Y i4 CO Quantity to Delete 50.00000000 1300.00000000 Item Description 3291.0100 Topsoil 9999.0000 Geogrid Tensor (TRIAX 140-475) or Approved Equal 3213.0501 Remove and Replace Barrier Free Ramp, Type P-1/P-2 1 H 01 U V C-620 Change Order Contractor's Application M Change Order Number Progress Estimate 0 Application Number 11-FINAL Application Date: 8/18/2023 W Balance to Finish (B - F) e E� ee � Total Completed and Stored to Date (D + E) $22,896.00 $3,137.20 W Materials Presently Stored (not in C) a > 2 A For (contract): 103445 2022 Concrete Restoration Contract 1 City Secretary 57252 Contract Num: Application Period' 7/26/2023-8/18/2023 1.1 > F» U Estimated Quantity Installed a-8 o 5 o Q i » Q "a ❑ Li CO Quantity to Add 5.00000000 Specification Unit of Section No. Measure . U U Item Description i W o U v 6 Q W 0 CL U Change Order Item No. C-620 Change Order Contractor's Application M Change Order Number Progress Estimate DELETIONS Application Number: 11-FINAL Application Date: 8/18/2023 w 3 z 3 z Not Used w Not Used 3 z 3 z For (contact) 103445 2022 Concrete Restoration Contract 1 Application Period: 7/26/2023-8/18/2023 . z z W 9.s 1, yo; Qi 2 o a CO Quantity to Delete Item Description 1 E° 711 0 4,5 U V 1 7 M Project Number: Application Date 0 0) c3 U 4- 0 c3 E E V J L 0 0 LJ- - 0 U FW020-007521 2022 Concrete Restoration Contract 1 cd z 7/26/2023-8/18/2023 N I N N in City Secretary Contract Num: Application Period N Z r- 0 co O) m V 69 Retainage 0.00 c o o c < Gross r- 0 co 0) 0) 69 o oc 69 c Amt Remaining $145,839.64 Cr- M co (O () c7 FA 0 0) I-. V (0 co 69 coo 6o co I-. 00 69 EF Total Completed CO co 0 Lc) a0 CO CO I- 69 -,^^ V O C') c) co N (+) 0 0 O O) I-- O) N 0) V3 0 0 O • O 64 0000000000 0 0 0 0 0 0^^ O N C') co O - CO N 69- Change Order 1 30100-0200431-5740010-103445-E03380-9999 0000000000 Change Order 2 30100-0200431-5740010-103445-E03380-9999 Change Order 3 30100-0200431-5740010-103445-E03380-9999 0 Funding Identification (FID) Original Contract 130100-0200431-5740010-103445-E03380-9999 0000000000 Project Number: Application Date 0 0) c3 U 4- 0 U FW020-007521 2022 Concrete Restoration Contract 1 Cd ¢z 7/26/2023-8/18/2023 N I N N in City Secretary Contract Num: Application Period Retainage Gross Amt Remaining 00 00 0 6', o 'DO DO n 0000000000 0000000000 Total Completed Change Order 4 30100-0200431-5740010-103445-E03380-9999 Change Order 5 30100-0200431-5740010-103445-E03380-9999 1 Change Order 6 30100-0200431-5740010-103445-E03380-9999 0000 Funding Identification (FID) 000000000 Project Number: Application Date 0 0) c3 U 0 U FW020-007521 2022 Concrete Restoration Contract 1 7/26/2023-8/18/2023 N I N N in City Secretary Contract Num: Application Period 15 r- 0 co co cri V v3 Retainage Gross --, oc 0 O 0 a '9 -- 0 I- 0 co 0) ea Amt Remaining 0 0 d 0 00 c 0 0 0 c 0 0.00 0.00 0 0 D O H rn 0 V in un EG 0000000000 ••, oo D o 0 Fa Totals 30100-0200431-5740010-103445-E03380-9999 $935,495.60 Total Completed Change Order 7 30100-0200431-5740010-103445-E03380-9999 Change Order 8 30100-0200431-5740010-103445-E03380-9999 0000000000 0000000 Funding Identification (FID) 000000 M 7 M Project Number: Application Date 0 0) c3 U 4- 0 ca E E 0 1O ILL 0 U FW020-007521 2022 Concrete Restoration Contract 1 7/26/2023-8/18/2023 City Secretary Contract Num: Application Period d O O 0 ta E d 0 69 0 0 69 c O 0) 0 w c LL LL 0 0 L) EA M r N O Efl 0 co rn Lri M O EA Grand Total 0 0 FORT WORTH Routing and Transmittal Slip Transportation and Public Works Department DOCUMENT TITLE: Change Order # 1 — 2022 Concrete Restoration Contract 1 M&C 22-0116 CPN: 103445 CSO # 57252 DOC#_CO1 Date: 8/02/2022 FM Department Initials Date Out To: 1. Maqsood Khan (Contractor) Makou Inc makouinc@gmail.com Aug 2, 2022 Maktik 2. James Ruiz (Inspector) TPW-Signature- Aug 2, 2022 3. Iretomiwa Otuyelu (PM) TPW-Signature , . Aug 3, 2022 4. Omar Elbagalati (PgM) TPW-Reviewer Aug 3, 2022 5. Lane Zarate (Sr CPO) TPW-Reviewer Aug 3, 2022 6. Lauren Prieur (AD) TPW-Signature 4 Aug 3, 2022 7. William Johnson (Director) TPW-Signature I- Aug 4, 2022 8. Doug Black (ACA) LAW -Signature Awb Aug 8, 2022 9. Dana Burghdoff (ACM) CMO-Signature ' Aug 9, 2022 10. Jannette Goodall (CSO) CSO-Signature 4,- Aug 9, 2022 DOCUMENTS FOR CITY MANAGER'S SIGNTURE: 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: El Yes X No RUSH: ❑ Yes X No SAME DAY: ❑ Yes X No NEXT DAY: ❑ Yes X No ROUTING TO CSO: ❑ Yes ❑ No Action Required: ❑ As Requested ❑ For Your Information X Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return to: Please call Iretomiwa Otuyelu at ext. 6747 for pick up when completed. Thank you. CSC No. 57252-001 FORT TWoRT WORTH Project Name Client Project #(s) Project Description Contractor City Project Mgr. City of Fort Worth Change Order Request 2022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 103445 Repair and replacement of concrete pavement, curb & gutter, driveway, and sidewalks. Makou Inc Iretomiwa Otuyelu 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) Change Order # 1 City Inspector Date 8/2/2022 James Ruiz TPW Totals Contract Time (CD) $929,690.00 $929,690.00 180 $929,690.00 $0.00 $929,690.00 $0.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $929,690.00 180 $929,690.00 180 $0.00 0.00% $1,162,112.50 JUSTIFICATION (REASONS) FOR CHANGE ORDER This Change Order is to increase the scope of work in Construction Contract 57252. The installation of curb and gutter on Churchill Rd (Rockwood Dr - City Limits) requires adding the new line item #33 to this contract. The change order also provides for the installation of approximately 1100 SF of driveways along this curb line. This increase in scope of work can be funded within the existing contract amount. 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 MAKOU INC Maqsood Khan Aug 2, 2022 M„hi„,�,„„x,m1�oGM., Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date f Aug 2, 2022 - Aug 3, 2022 - Program Manager Date Senior Capital Project Officer Date wo Aug 3, 2022 ?�30;g Aug 3, 2022 ,„ Assistant Director De Date Director, Contracting Department (Dept) Date Ga -em R-414- Aug 3, 2022 Aug 4, 2022 ,, 7, Assistant City A Date Assistant City Manager Date Aug 8, 2022 7� Aug 9, 2022 ,ka4�sea, og=1<D., >a,a g,on�>„g.I Council Action (if required) M&C Number ATTEST: 9R t".#{8 go07941.4 Jannette S. Goodall (Aug 9, 202210:38 CDT) Jannette Goodall, City Secretary M&C Date Approved Foa�RTH Project Name Client Project # City of Fort Worth Change Order Additions 2022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 103445 Contractor Makou Inc PM Iretomiwa Otuyelu Change Order Submittal # ADDITIONS 1 Inspector Date James Ruiz I 8/2/2022 I ITEM 33 DESCRIPTION 3216.0102 T' Conc. Curb & Gutter DPW DEPT Qty 1,200.00000000 Unit LF Unit Cost $44.00 Total $52,800.00 TPW $52,800.00 Change Order Additions Page 2 of 5 Sub Total Additions $52,800.00 FORT RTH City of Fort Worth Change Order Deletions Project Name Client Project It 2022 CONCRETE RESTORATION CONTRACT 1 City Sec It 57252 103445 Contractor Makou Inc PM Iretomiwa Otuyelu Change Order Submittal It DELETIONS Inspector Date James Ruiz 8/2/2022 ITEM 16 DESCRIPTION 321 /.2102 REFL Raised Marker TY I-C TPW DEPT Qty 100.00000000 Unit EA Unit Cost $5.00 Total $500.00 17 3217.2103 REFL Raised Marker TY II -A -A TPW 100.00000000 EA $5.00 $500.00 18 3217.2104 REFL Raised Marker TY II-C-R TPW 100.00000000 EA $5.00 $500.00 19 3441.1301 Loop Detector Cable Sawcut TPW 200.00000000 EA $30.00 $6,000.00 20 3441.1302 14 AWG Loop Detctor Cable Sawcut TPW 200.00000000 LF $40.00 $8,000.00 21 3217.0001 6" Solid Thermoplastic (HAS) Lane Line TPW 1,000.00000000 LF $10.00 $10,000.00 22 3217.0201 8" Solid Thermoplastic (HAS) Lane Line TPW 120.00000000 LF $10.00 $1,200.00 23 3217.0401 18" SLD Pvmt Marking HAE TPW 150.00000000 LF $12.00 $1,800.00 24 3217.0501 24" SLD Pvmt Marking HAE TPW 150.00000000 LF $24.00 $3,600.00 25 3217.1001 Lane Legend RR TPW 2.00000000 EA $1,500.00 $3,000.00 26 3217.1003 Lane Legend Arrow TPW 2.00000000 EA $1,500.00 $3,000.00 27 3213.0501 Remove and Replace Bamer Free Ramp, Type P-1/P-2 TPW 3.00000000 EA $2,500.00 $/,500.00 2 3471.0002 Portable Message Sign TPW 9.00000000 WK $800.00 $/,200.00 TPW $52,800.00 Sub Total Deletions $52,800.00 Change Order Deletions Page 3 of 5 M/SBE for this Change Order M/SBE Sub Type of Service Amount for this CO Total Previous Change Orders $0.00 co# DATE AMOUNT Total $0.00 103445-CNCO- Change Order # 1 — 2022 Concrete Restoration Contract Final Audit Report 2022-08-09 Created: 2022-08-02 By: Andrea Munoz(Andrea.Munoz@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAAjdbC9dsyLcNFNzwHwtENR5ca59CR-ab_ "103445-CNCO- Change Order # 1 — 2022 Concrete Restoration Contract 1" History Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) 2022-08-02 - 4:12:21 PM GMT- IP address: 204.10.91.100 Document emailed to makouinc@gmail.com for signature 2022-08-02 - 4:16:05 PM GMT Email viewed by makouinc@gmail.com 2022-08-02 - 4:16:27 PM GMT- IP address: 66.249.81.52 Signer makouinc@gmail.com entered name at signing as Maqsood khsn 2022-08-02 - 4:50:44 PM GMT- IP address: 57.190.1.30 Document e-signed by Maqsood khsn (makouinc@gmail.com) Signature Date: 2022-08-02 - 4:50:45 PM GMT - Time Source: server- IP address: 57.190.1.30 Document emailed to james.ruiz@fortworthtexas.gov for signature 2022-08-02 - 4:50:48 PM GMT Email viewed by james.ruiz@fortworthtexas.gov 2022-08-02 - 8:12:45 PM GMT- IP address: 107.77.196.175 Signerjames.ruiz@fortworthtexas.gov entered name at signing as James Ruiz 2022-08-02 - 8:13:50 PM GMT- IP address: 107.77.196.175 Document e-signed by James Ruiz (james.ruiz@fortworthtexas.gov) Signature Date: 2022-08-02 - 8:13:51 PM GMT - Time Source: server- IP address: 107.77.196.175 Document emailed to Iretomiwa.Otuyelu@fortworthtexas.gov for signature 2022-08-02 - 8:13:54 PM GMT FORT WORTH. PowCred by Adobe Acrobat Sign Signer Iretomiwa.Otuyelu@fortworthtexas.gov entered name at signing as Iretomiwa Otuyelu 2022-08-03 - 2:57:15 PM GMT- IP address: 204.10.91.100 Document e-signed by Iretomiwa Otuyelu (Iretomiwa.Otuyelu@fortworthtexas.gov) Signature Date: 2022-08-03 - 2:57:17 PM GMT - Time Source: server- IP address: 204.10.91.100 Document emailed to omar.elbagalati@fortworthtexas.gov for signature 2022-08-03 - 2:57:19 PM GMT Email viewed by omar.elbagalati@fortworthtexas.gov 2022-08-03 - 5:50:46 PM GMT- IP address: 47.185.62.153 Signer omar.elbagalati@fortworthtexas.gov entered name at signing as Omar Elbagalati 2022-08-03 - 5:51:18 PM GMT- IP address: 47.185.62.153 Document e-signed by Omar Elbagalati (omar.elbagalati@fortworthtexas.gov) Signature Date: 2022-08-03 - 5:51:19 PM GMT - Time Source: server- IP address: 47.185.62.153 Document emailed to Lane.Zarate@fortworthtexas.gov for signature 2022-08-03 - 5:51:22 PM GMT Email viewed by Lane.Zarate@fortworthtexas.gov 2022-08-03 - 7:34:23 PM GMT- IP address: 204.10.91.100 Signer Lane.Zarate@fortworthtexas.gov entered name at signing as Lane Zarate 2022-08-03 - 7:34:55 PM GMT- IP address: 204.10.91.100 Document e-signed by Lane Zarate (Lane.Zarate@fortworthtexas.gov) Signature Date: 2022-08-03 - 7:34:56 PM GMT - Time Source: server- IP address: 204.10.91.100 Document emailed to Lauren.Prieur@fortworthtexas.gov for signature 2022-08-03 - 7:34:58 PM GMT Email viewed by Lauren.Prieur@fortworthtexas.gov 2022-08-03 - 9:00:33 PM GMT- IP address: 108.209.194.42 Signer Lauren.Prieur@fortworthtexas.gov entered name at signing as Lauren Prieur 2022-08-03 - 9:01:21 PM GMT- IP address: 108.209.194.42 Document e-signed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) Signature Date: 2022-08-03 - 9:01:22 PM GMT - Time Source: server- IP address: 108.209.194.42 Document emailed to William.Johnson@fortworthtexas.gov for signature 2022-08-03 - 9:01:25 PM GMT Email viewed by William.Johnson@fortworthtexas.gov 2022-08-04 - 9:59:16 AM GMT- IP address: 104.28.97.18 FORT W❑RTH.., PowCred by Adobe Acrobat Sign Signer William.Johnson@fortworthtexas.gov entered name at signing as WJ 2022-08-04 - 4:37:36 PM GMT- IP address: 209.194.29.100 Document e-signed by WJ (William.Johnson@fortworthtexas.gov) Signature Date: 2022-08-04 - 4:37:37 PM GMT - Time Source: server- IP address: 209.194.29.100 Document emailed to Priscilla.Ramirez@fortworthtexas.gov for approval 2022-08-04 - 4:37:39 PM GMT Email viewed by Priscilla.Ramirez@fortworthtexas.gov 2022-08-05 - 0:17:46 AM GMT- IP address: 174.69.40.18 Signer Priscilla.Ramirez@fortworthtexas.gov entered name at signing as Priscilla Ramirez 2022-08-05 - 0:18:21 AM GMT- IP address: 174.69.40.18 Document approved by Priscilla Ramirez (Priscilla.Ramirez@fortworthtexas.gov) Approval Date: 2022-08-05 - 0:18:22 AM GMT - Time Source: server- IP address: 174.69.40.18 Document emailed to Douglas.Black@fortworthtexas.gov for signature 2022-08-05 - 0:18:25 AM GMT Email viewed by Douglas.Black@fortworthtexas.gov 2022-08-08 - 2:50:31 PM GMT- IP address: 209.194.29.100 Signer Douglas.Black@fortworthtexas.gov entered name at signing as DBlack 2022-08-08 - 2:51:23 PM GMT- IP address: 209.194.29.100 Document e-signed by DBlack (Douglas.Black@fortworthtexas.gov) Signature Date: 2022-08-08 - 2:51:25 PM GMT - Time Source: server- IP address: 209.194.29.100 Document emailed to Dana Burghdoff (Dana.Burghdoff@fortworthtexas.gov) for signature 2022-08-08 - 2:51:27 PM GMT Email viewed by Dana Burghdoff (Dana.Burghdoff@fortworthtexas.gov) 2022-08-09 - 2:28:00 PM GMT- IP address: 209.194.29.100 Document e-signed by Dana Burghdoff (Dana.Burghdoff@fortworthtexas.gov) Signature Date: 2022-08-09 - 2:28:27 PM GMT - Time Source: server- IP address: 209.194.29.100 Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for approval 2022-08-09 - 2:28:29 PM GMT Email viewed by Allison Tidwell (allison.tidwell@fortworthtexas.gov) 2022-08-09 - 3:36:57 PM GMT- IP address: 209.194.29.100 Document approved by Allison Tidwell (allison.tidwell@fortworthtexas.gov) Approval Date: 2022-08-09 - 3:37:29 PM GMT - Time Source: server- IP address: 209.194.29.100 FORT W❑RTH.., Powered by Adobe Acrobat Sign Document emailed to jannette.goodall@fortworthtexas.gov for signature 2022-08-09 - 3:37:31 PM GMT Email viewed by jannette.goodall@fortworthtexas.gov 2022-08-09 - 3:37:51 PM GMT- IP address: 209.194.29.100 Signerjannette.goodall@fortworthtexas.gov entered name at signing as Jannette S. Goodall 2022-08-09 - 3:38:21 PM GMT- IP address: 209.194.29.100 Document e-signed by Jannette S. Goodall (jannette.goodall@fortworthtexas.gov) Signature Date: 2022-08-09 - 3:38:23 PM GMT - Time Source: server- IP address: 209.194.29.100 Document emailed to Vania Soto (Vania.Soto@fortworthtexas.gov) for filling 2022-08-09 - 3:38:25 PM GMT Email viewed by Vania Soto (Vania.Soto@fortworthtexas.gov) 2022-08-09 - 7:09:13 PM GMT- IP address: 209.194.29.100 Form filled by Vania Soto (Vania.Soto@fortworthtexas.gov) Form filling Date: 2022-08-09 - 7:10:02 PM GMT - Time Source: server- IP address: 209.194.29.100 Agreement completed. 2022-08-09 - 7:10:02 PM GMT FORT WORTH. Powered by Adobe Acrobat Sign FORT WORTH Routing and Transmittal Slip Transportation and Public Works Department DOCUMENT TITLE: Change Order # 2 — 2022 Concrete Restoration Contract 1 M&C 22-0116 CPN: 103445 CSO # 57252 DOC#_CO2 Date: 10/10/2022 FM Department Initials Date Out To: 1. Maqsood Khan (Contractor) Makou Inc makouinc(6Jgmail. com OCt 10, 2022 M k 2. James Ruiz (Inspector) TPW-Signature Oct 10, 2022 3. Iretomiwa Otuyelu (PM) TPW-Signature Oct 10, 2022 4. Omar Elbagalati (PgM) TPW-Reviewer -` Oct 10, 2022 5. Lane Zarate (Sr CPO) TPW-Reviewer Oct 13, 2022 6. Martin Phillips (AD) TPW-Signature Oct 13, 2022 7. Lauren Prieur (Director) TPW-Signature Oct 13, 2022 8. Doug Black (ACA) LAW -Signature 40, Oct 18, 2022 9. William Johnson (ACM) CMO-Signature Oct 19, 2022 10. Jannette Goodall (CSO) CSO-Signature Oct 19, 2022 tfz DOCUMENTS FOR CITY MANAGER'S SIGNTURE: 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 X No RUSH: ❑ Yes X No SAME DAY: ❑ Yes X No NEXT DAY: ❑ Yes X No ROUTING TO CSO: ❑ Yes ❑ No Action Reauired; ❑ As Requested ❑ For Your Information X Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return to: Please call Iretomiwa Otuyelu at ext. 6747 for pick up when completed. Thank you. CSC No. 57252-0O2 Fox T�M Project Name Client Project #(s) Project Description Contractor City Project Mgr. City of Fort Worth Change Order Request 2022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 103445 Repair and replacement of concrete pavement, curb & gutter, driveway, and sidewalks. Makou Inc Iretomiwa Otuyelu 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) Change Order # 2 City Inspector Date 9/20/2022 11 James Ruiz TPW Totals Contract Time (CD) $929,690.00 $929,690.00 180 $929,690.00 $28,500.00 $958,190.00 $30,000.00 $30,000.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $929,690.00 $28,500.00 $958,190.00 $30,000.00 $30,000.00 ' 3.07% $1162,112.50 180 180 JUSTIFICATION (REASONS) FOR CHANGE ORDER This Change Order is to adjust the quantities in Construction Contract 57252. The repair and panel replacement of approximately 900 SY concrete pavement at the intersection of Hemphill St and Archbury Rd requires an increase in the contract amount, to complete the work. Pricing for this item remains the same as existing bid item pricing. No additional days needed for this change order. 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 (Name MAKOU INC Maqsood Khan Contract Signature Date Oct 10, 2022 a`!lad 10202,0,„LOT , spector/Inspection Supervisor Date Project and Contract Compliance Manager Date Oct 10, 2022 ' Oct 10, 2022 2,7 ., kragaiganager Date Seniorfgka2roject Officer — Date o„...ca Oct 10, 2022 437.7. Oct 13, 2022 „,,,,,q,,, Assistant Director (Dept) Date Director, Contracting Department (Dept) Date Oct 13, 2022 '-''- Oct 13, 2022 nt City Attorney Date Assistant City Manager Date Oct 18, 2022 Oct 19, 2022 „wlo„w r ouncil Action (if required) M&C Number M&C Date Approved ATTEST:/ 7alrirette c i 6,000(G1� Jannette 5. Goodall (Oct 19, 202208:50 CDT) Jannette Goodall, City Secretary FORT WORTH Project Name Client Project # City of Fort Worth Change Order Additions 2022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 I 103445 Contractor Makou Inc PM Iretomiwa Otuyelu Change Order Submittal # ADDITIONS 2 Inspector Date James Ruiz 9/20/2022 ITEM 4 DESCRIPTION 9999.0000 Remove and Replace 7" Concrete Pavement HES TPw DEPT Qty 900.00000000 Unit SY Unit Cost $90.00 Total $81,000.00 TPW S81,000.00 Change Order Additions Page 2 of 5 Sub Total Additions $81,000.00 City of Fort Worth Change Order Deletions Project Name Client Project # 2022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 103445 Contractor Makou Inc PM Iretomiwa Otuyelu Change Order Submittal # DELETIONS 2 Inspector Date James Ruiz I 9/20/2022 I IIEM 3 DESCRIPTION 3999.0000 Remove and Replace 6" Concrete Driveway TPW DEPT Qty 2,000.00000000 Unit SF Unit Cost $12.00 Total $24,000.00 8 3292.0100 Sod Replacement TPW 1,500.00000000 SY $8.50 $12,750.00 9 3291.0100 Topsoil TPW 50.00000000 CY $35.00 $1,750.00 12 9999.0000 Geognd Tensar (TRIAX 140-475) or Approved equal TPW 1,300.00000000 SY $5.00 $6,500.00 27 3213.0501 Remove and Replace Barrier Free Ramp, Type P-1/P-2 TPW 3.00000000 EA $2,500.00 $/,500.00 TPW $52,500.00 Sub Total Deletions $52,500.00 Change Order Deletions Page 3 of 5 M/SBE for this Change Order M/SBE Sub Type of Service Amount for this CO Total Previous Change Orders $0.00 co # DATE AMOUNT 1 8/9/2022 $0.00 • Total $0.00 • FORT WORTH Routing and Transmittal Slip Transportation and Public Works Department DOCUMENT TITLE: Change Order # 3 — 2022 Concrete Restoration Contract 1 M&C CPN: 103445 CSO # 57252 DOC# CO3 Date: 01/12/2023 AE Department Initials Date Out To: 1. Maqsood Khan (Contractor) Makou Inc makouinc©gmail.com M Jan 25 2023 Mk 2. James Ruiz (Inspector) TPW-Signature 0— Jan 25, 2023 3. Iretomiwa Otuyelu (PM) TPW-Signature Jan 25, 2023 4. Omar Elbagalati (PgM) TPW-Signature Jan 26, 2023 5. Leon Wilson (Sr CPO) TPW-Reviewer L.w Jan 26, 2023 6. Michael Owen (AD) TPW-Signature Jan 27, 2023 7. Lauren Prieur (Interim Director) TPW-Signature Jan 27, 2023 8. Doug Black (ACA) LAW -Signature ,dwh Jan 27, 2023 9. William Johnson (ACM) CMO-Signature Jan 27, 2023 10. Jannette Goodall (CSO) CSO-Signature Jan 27, 2023 ,7r6 DOCUMENTS FOR CITY MANAGER'S SIGNTURE: 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 X No RUSH: ❑ Yes X No SAME DAY: ❑ Yes X No NEXT DAY: ❑ Yes X No ROUTING TO CSO: ❑ Yes ❑ No Action Required: ❑ As Requested ❑ For Your Information X Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return to: Please call Iretomiwa Otuyelu at ext. 6747 for pick up when completed. Thank you. CSC No. 57252-CO3 FOR Project Name Client Project #(s) Project Description Contractor City Project Mgr. City of Fort Worth Change Order Request 2022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 103445 Repair and replacement of concrete pavement, curb & gutter, driveway and sidewalks. Makou Inc. Iretomiwa Otuyelu 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) Change Order # 3 City Inspector Date 1/23/2023 James Ruiz TPW Totals Contract Time (CD) $929,690.00 $929,690.00 180 $28,500.00 $28,500.00 $958,190.00 $34,820.00 $993,010.00 $0.00 $34,820.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) JUSTIFICATION (REASONS) FOR CHANGE ORDER $958,190.00 $34,820.00 $993,010.00 180 30 210 $0.00 $34,820.00 6.81% $1,162,112.50 This Change Order is to increase the quantities and contract amount in Construction Contract 57252. The use of Flexbase to adjust pavement height and replacement of panels at the intersection of Hemphill St & Archbury Rd requires an increase in the contract amount, to complete the work. Pricing for this item remains the same as existing bid item pricing. 30 Additional days are required for this extra work, as we have used up the number of days provided in the original contract. 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 MAKOU INC _ ontractor (Nam- MAQSOOD Khan Contract Signature Jan25,2023 wo210an25202512.0927, Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Jan 25, 2023 Jan 25, 2023 Program Manager = Date Senior Capital Project Officer Ilh Date 0 Jan 26, 2023 z---ww w, Jan 26, 2023 Assistant Director (Dept) Date Director, Contracting Department (Dept) Date ?/174w44-1260)4,06,..., Jan 27, 2023 Jan 27, 2023 2?f1p L -,,„ Assistant City Attorney Date Assistant City Manager Date Wee, - Jan 27, 2023 W 49L^, Jan 27, 2023 Council Action (if required) M&C Number M&C Date Approved ATTEST: �.. . A Jannette Goodall, City Secretary FORT Project Name Client Project # City of Fort Worth Change Order Additions 12022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 103445 Contractor Makou Inc. PM Iretomiwa Otuyelu Change Order Submittal # ADDITIONS 3 Inspector Date James Ruiz 1/23/2023 ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 4 9999.0000 Remove and Replace 7" Concrete Pavement HES TPW 300.00000000 SY $90.00 $27,000.00 6 3211.0122 Flex Base, Type A, GR-2 TPW 110.00000000 CY $62.00 $6,820.00 7 3213.0208 Concrete HES (Extra Depth) TPW 5.00000000 CY $200.00 $1,000.00 TPW $34,820.00 Change Order Additions Page 2 of 4 Sub Total Additions $34,820.00 FORT WORTH Project Name Client Project # Contractor City of Fort Worth Change Order Deletions 2022 CONCRETE RESTORATION CONTRACT 1 City Sec # 57252 103445 Makou Inc. PM Iretomiwa Otuyelu Change Order Submittal # DELETIONS 13 I Inspector Date James Ruiz 1/23/2023 ITEM T DLSCRIP I ION DLPI Oty Unit Unit Cost otal TPW $0.00 Sub Total Deletions $0.00 Change Order Deletions Page 3 of 4 MISBE for this Change Order M/SBE Sub Type of Service Amount for this CO Total Previous Change Orders $0.00 co # DATE AMOUNT Total $0.00 FORT WORTHM TRANSPORTATION AND PUBLIC WORKS August 18, 2023 Makou Inc 7100 S. Cooper St #15 Arlington, TX 76001 RE: Acceptance Letter Project Name: 2022 Concrete Restoration Contract 1 Project Type: Paving, Sidewalk, Driveways, and Ramps City Project No.: 103445 To Whom It May Concern: On April 4, 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 August 18, 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 August 18, 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 (682) 444-8921. Sincerely, Iretomiwa Otuyelu, Project Manager Cc: James Ruiz, Inspector Gary Deyon, Inspection Supervisor Edward Davila, Senior Inspector Omar Ubaldo, Program Manager City of Fort Worth, Consultant Makou Inc, Contractor City of Fort Worth, 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 Maqsood Khan, Owner of MAKOU INC., known to me to be credible person, who being 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, for City of Fort Worth Conc. Rest. 2022-1 Project# 103445 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 BY MAQSOOIIJ KHAN, PRICIPAL, MAKOU INC. SUBSCIBED & SWORN BY ME ON THIS DATE At66zytk kivia a /4. 0e k er ?eltbk ?zo-:_s> NOTARY PUBLIC TEXAS Af'i PtOMELIA AGUIRRE-CRUZ ~*' G�nF Notary Public, State of Texas •`�= Comm. Expires 06-09-2026 pi,,,. Notary tD 129905744 MAKOU Inc. 7100 S. Cooper St. Suite #15 Arlington, TX 76001 makouinc@gmail.com 1 817-798-5426 BOND #: 1023163 CONSENT OF SURETY TO FINAL PAYMENT AIA Document G707 (Instructions on reverse side) OWNER ARCHITECT ❑ CONTRACTOR 0 SURETY 0 OTHER ❑ TO OWNER: (Name and aJdn,r City of Fort Worth 200 Texas St. Fort Worth, TX 76102 PROJECT: (Name and addre.vst 2022 Concrete restoration contract 1, Project No. 103445 ARCHITECT'S PROJECT NO.: CONTRACT FOR: CONTRACT DATED: In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address of Surety) Oklahoma Surety Company 1437 South Boulder, Suite 200 Tulsa, Oklahoma 74119 on bond of (Insert nave and addrevv afCbmtrmctat! Makou, Inc. , SURETY, 6204 Parkside Dr Arlington, TX 76001 CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Invert name and addrecc of Duller) City of Fort Worth 200 Texas St. Fort Worth, TX 76102 , OWNER, as set forth in said Surety's bond, IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: September 28, 2023. (Invert in n ruing the month followed hr the ,aoreric date and .rear) Attest: (Seal) Angie As AIA Oklahoma Surety Company (9nx q) tra (Sryn more ofandmri4E rcc an d 04,vo. (Printed 'rank and title) Brent M. Blonigan, Attorney -in -fact CAUTION: You should sign an original AIA document that has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. See Instruction Sheet for Limited License for Reproduction of this document. AIA DOCUMENT G707 - CONSENT OF SURETY TO FINAL PAYMENT- 1994 EDITION - AIA 1994 - THE AMFRICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N\V, WASH- INGTON. D C 20006-5292 - WARNING: Unlicensed photocopying violates U.S. copy- right laws and will subject the violator to legal prosecution. Page I of 2 G707-1994 INSTRUCTION SHEET FOR AIA DOCUMENT G707, CONSENT OF SURETY TO FINAL PAYMENT A. GENERAL INFORMATION 1. Purpose This document is intended for use as a companion to AIA Document G706, Contractor's Affidavit of Payment of Debts and Claims, on construction projects where the Contractor is required to furnish a bond. By obtaining the Surety's approval of final payment to the Contractor and its agreement that final payment will not relieve the Surety of any of its obligations, the Owner may preserve its rights under the bond. 2. Related Documents This document may be used with most of the AIA's Owner -Contractor agreements and general conditions, such as A201 and its related family of documents. As noted above, this is a companion document to AIA Document G706. 3. Use of Current Documents Prior to using any AIA document, the user should consult the AIA, an AIA component chapter or a current AIA Documents List to determine the current edition of each document. 4. Limited License for Reproduction AIA Document G707 is a copyrighted work and may not be reproduced or excerpted from in substantial part without the express written permission of the AIA. The G707 document is intended to be used as a consumable -that is, the original document pur- chased by the user is intended to be consumed in the course of being used. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce G707. A cautionary notice is printed in red on the original of this document. This notice distinguishes an original AIA document from copies and counterfeits. To ensure accuracy and uniformity of language, purchasers should use only an original AIA document or one that has been reproduced from an original under a special limited license from the AIA. A limited license is hereby granted to retail purchasers to reproduce a maximum of ten copies of a completed or executed G707, but only for use in connection with a particular project. Further reproductions are prohibited without the express permission of the AIA. B. CHANGES FROM THE PREVIOUS EDITION Changes in the location of various items of information were made, without revision to the substance of the document. C. COMPLETING THE G707 FORM GENERAL: The bond form is the usual source of required information such as the contract date and the names and addresses of the Surety, Owner, Contractor and Project. ARCHITECT'S PROJECT NO.: this information is typically supplied by the Architect and entered on the form by the Contractor. CONTRACT FOR: This refers to the scope of the contract, such as "General Construction" or "Mechanical Work". D. EXECUTION OF THE DOCUMENT The G707 form requires both the Surety's seal and the signature of the Surety's authorized representative. 4.94 INSTRUCTION SHEET FOR AIA DOCUMENT C707 CONSENT OF SURETY TO FINAL PAYMENT 1994 EDITION AIRS THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006-5292 Pagc 2 of 2 G707-1994 OKLAHOMA SURETY COMPANY 1437 South Boulder, Suite 200, Tulsa, Oklahoma 74119 • Ph: 918-587-7221 • Fax: 918-588-1296 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the Oklahoma Surety Company a corporation organized and exist,ng under and by iertue of the laws of the State of Ohio does hereby nominate. constitute and appoint the person or persons named below each indivdualiy if more than one is named its true and lawful attorney -in -fact for it and in its name place and stead to execute on behalf of the said Company as surety any and all bonds undertakings and contracts of suretyship or other written obligations in the nature thereof Brent M Blonigan, Raul F Campa Rob Dreiling Debbie Palmer, Kara Pierce all of RICHARDSON TX IN WITNESS WHEREOF the Oklahoma Surety Company has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 20 day of September 2021 ;'off:•' .on�.•co� ;3-1. SEAL ATTEST • A• .(02.4-( 14C6rtr Sharon Hackl Assistant Secretary OKLAHOMA SURETY COMPANY Todd Bazata.Vice President On this 20 day of September, 2021 before me personally appeared Todd Bazata to me known, being duly sworn. deposes and says that she resides in Broken Arrow. Oklahoma. that s/he is a Vice President of Oklahoma Surety Company, the company descnbed in and which executed the above instrument. that s/he knows the seal of the said Company that the seal affixed to the said instrument is such corporate seal. that it was so affixed by authority of her -his office under the By -Laws of said Company and that s/he signed his name thereto by like authority STATE OF OKLAHOMA COUNTY OF TULSA >55 Notary Public Slate of Oklahoma JULIE CALLAHAN TULSA COUNTY COuu SSFON , t t008253 Comm B.0 00 0e 2023 Commission # 11008253 My Commission Expires 09-08-23 f1eL (eL { Julie Callahan. Notary Public This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Oklahoma Surety Company by unamrnous written consent dated September 25, 2009 RESOLVED That the President the Executive Vice President. the several Senior Vice Presidents and Vice Presidents or any one of them he and hereby is aulhcrized from time to time to appoint one or more Attorneys -in -Fact to execute on behalf of the Company as surety an/ and all bonds undertak•ngs and contracts of suretyship or other written obligations in the nature thereof to prescribe their respecb•.e duties and the respective limits of their authority. and to revoke any such appointment at any time RESOLVED FURTHER That the Company seal and the signature of any of the aforesaid officers and any Secretary or .Assistant Secretar, of the Company may be affixed by facsmile to any power of attorney or certificate of either given for the execut on of any bond undertaking contract cf suretyship or other written obligation in the nature thereof, such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION 1 Sharon Hackl Assistant Secretary :I Oklahoma Surety Company do hereby certify that the foregoing Power of Attorney and tr e Resciut ons cf the Board of Directors of September 25 2009 ha. e .1 oeen re✓oked and are row •r- full force and effect Signed ara sewed 'h s / r • •L(lEk � EFatC �r Sharon Hackl Assistant Secretary IA\ MID-CONTINENT GROUP Mid -Continent Casualty I Oklahoma Surety Surety Bond Seal Addendum Oklahoma Surety Company During the COVID-19 pandemic, the use of traditional raised corporate seals has been made impractical due to government stay-at-home orders and social distancing guidelines. As a result, Oklahoma Surety Company has authorized its Attorneys -in -Fact to affix Oklahoma Surety Company's corporate seal to any bond or related instruments executed on behalf of Oklahoma Surety Company by any such Attorney -in -Fact by attaching this Addendum to said bond or related instrument. To the extent this Addendum is attached to a bond or related instrument that is executed on behalf of Oklahoma Surety Company by its Attorney -in -Fact, Oklahoma Surety Company agrees that the seal below shall be deemed affixed to said bond or related instrument to the same extent as if its raised corporate seal were physically affixed to the face of the bond or related instrument Dated this 1 day of April, 2020 A Todd 8azata Vice President MID-CONTINENT CASUALTY COMPANY OKLAHOMA SURETY COMPANY STATE OF TEXAS CLAIM NOTICE ENDORSE\IL\1 In accordance ith Section 2253.021 (f) of the Texas Go\ ernment Code and Section 53 202(6) of the Texas Property Code. any notice of claim to the named surety under this bond(s) sh.,uld be sent to: Mailing: Physical: \IID-(O\ I I\F\ r C.\SL'.\L1 1" CO\1PA\y OKI \I IO\I \ SURETY COMPANY P O I3OX 1409 1LLSA OK 74101 TELLPIIONL NO. 1-800-722-4994 F \\ NO 1-918-iS6-u840 C-\I.\Il CI AI\1S 1 \1CG-INs C O\1 141- S BOLI_DER SUITE 200 11'1 S \ ()KI .\N('►\I-\ 7a) 1� �1 T-ACH 1111S NOTICE TO 1 OI. R BOND UPON EXECUTION OF THE BOND