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Contract 45893
CRY EECRIMAW op CONMCT No. FORT WORTh PROJECT MANUAL FOR THE CONSTRUCTION OF SH 121T Southwest Parkway Water& Sanitary Sewer Main Relocations, Part 25: From Dirks Road to FM 1187 Water Project No.P265-606170089987 Sewer Project No.P275-706170089987 TPW/DOE No.7183 City Project No.00899 Betsy Price Tan Higgins Mayor City Manager S. Frank Crumb,P.E. Director, Water Department OF r � eij,Q •¢�+bD o ` •� 1 Prepared for yes.t0¢e90e.¢a¢¢o¢¢oeo*coo 4'& � The City of Fort Worth r �OS�K�kc�� a s�,�• 113Q02 w,¢e..� Water Department a '3 OR 2014 �' I Kimley-Horn and Associates, Inc. Texas Registered Engineering Firm F-928 KRA No.061018049 100"41A.RMRD CITY SUREM 1f FT. WQRM'fX AVG26 2Qi4 5 M&C Review Page 1 of 2 Official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA F° " COUNCIL ACTION: Approved on 7/22/2014 DATE: 7/22/2014 REFERENCE NO.: C-26891 LOG NAME: 60SH121TP25- JACKSON CODE: C TYPE: CONSENT HEARING. NO SUBJECT: Authorize Execution of a Contract with Jackson Construction, Ltd., in the Amount of $1,912,315.50 for Water and Sanitary Sewer Main Relocations for State Highway 121T, Chisholm Trail Parkway F/KA Southwest Parkway, Part 25 from Farm-to-Market Road 1187 to Dirks Road and Provide for Staff Costs and Contingencies for a Total Project Amount of$2,041,715.50 (COUNCIL DISTRICT 6) RECOMMENDATION: It is recommended that the City Council authorize execution of a contract with Jackson Construction, Ltd., in the amount of$1,912,315.50 for Water and Sanitary Sewer Main Relocations for State Highway 121T, Chisholm Trail Parkway F/K/A Southwest Parkway, Part 25 from Farm-to-Market Road 1187 to Dirks Road and provide for Staff costs and contingencies for a total project amount of $2,041,715.50. DISCUSSION: On June 4, 2013, Mayor and Council Communication (M&C C-26296), the City Council authorized the mutual termination to City Secretary Contract No. 42968 with S. J. Louis Construction of Texas, Ltd., for Water and Sanitary Sewer Main Relocations for State Highway 121 T, Chisholm Trail Parkway Part 15 (SH121T Pt.15) from Farm-to-Market Road 1187 to Dirks Road. The original design for SH121T Part 15 provided for open cut installation of an 18-foot deep sanitary sewer main on Big Spruce Road which had no houses at the time the project was advertised for bid. However, due to protracted easement negotiations with an adjacent property owner, construction could not commence as scheduled. By the time the necessary easement was acquired, seven homes and other conflicts had been constructed which required sewer main installation by trenchles: means in order to avoid severe disruption to the residents. The necessary design revisions and y subsequent change order for the trenchless installation would have caused the contract to exceed 2! percent of the original contract amount. Therefore, Staff recommended the termination of the contras so that the remaining work could be repackaged and rebid. This project, Part 25 will provide for construction of the following: The installation of sanitary sewer main beginning from a point located 150 feet south of the Big Spruce Lane/Seawood Drive intersection northerly, along Big Spruce Lane 900 feet, to cul-de-sac then northerly 950 feet, then easterly 300 feet parallel to Sycamore School Road right-of-way, then northerly 400 feet to an existing 12-inch sanitary sewer main The installation of sanitary sewer main beginning from the Big Spruce Lane/Seawood Drive intersection, northerly 540 feet on Big Spruce Lane The installation of sanitary sewer main beginning from the Big Spruce Lane/Old Orchard Drive intersection southerly 250 feet on Big Spruce Lane The installation of a concrete screen wall along the north right-of-way line of Big Spruce Lane The project was advertised for bid on February 13, 2014 and February 20, 2014 in the Fort Worth Star-Telegram. On April 7, 2014, the following bids were received: http://apps.cfwnet.org/council_packet/mc—review.asp?ID=I 9916&councildate=7/22/2014 7/23/2014 M&C Review Page 2 of 2 Bidder Amount Time of Completion Jackson Construction, Ltd. $1,912,315.50 18 s alendar Y William J. Schultz d/b/a Circle " C" $1,975,103.00 Construction Company Conatser Construction TX, LP $2,113,300.50 ' North Texas Construction Inc. $2,162,466.00 S. J. Louis Construction of Texas, Ltd. $2,289,928.05 Atkins Brothers Equipment Co., Inc. $4,415,348.00 In addition to the contract amount $64,000.00 (sewer: $54,000.00; screen wall: $10,000.00) is required for construction staking, project management, inspection, and material testing; and $65,400.00 (sewer: $47,000.00; screen wall: $18,400.00) is provided for project contingencies. M/WBE Office -Jackson Construction Ltd., is in compliance with the City' s BDE Ordinance by committing to six percent MBE participation and documenting good faith effort. Jackson Construction, Ltd., identified several subcontracting and supplier opportunities. However, the MBE's contacted in the areas identified did not submit the lowest bids. The City's MBE goal on this project is 13 percent. 4 The project is located in COUNCIL DISTRICT 6. FISCAL INFORMATION/CERTIFICATION: The Financial Management Services Director certifies that funds are available in the current capital budget, as appropriated, of the Sewer Capital Projects Fund and the SH121T Southwest Parkway Fund. TO Fund/Account/Centers FROM Fund/Account/Centers P275 541200 706170089983 $1.545.302.5( C221 541200 303210000580 $367.013.0( Submitted for City Manager's Office by: Fernando Costa (6122) Originating Department Head: S. Frank Crumb (8207) Additional Information Contact: Liam Conlon (6824) ATTACHMENTS 60SH121TP25-JACKSON MAP.pdf http://apps.cfwnet.org/council_packet/mc review.asp?ID=19916&councildate=7/22/2014 7/23/2014 ADDENDUM NO. 1 CITY OF FORT WORTH WATER DEPARTMENT SH 121T SOUTHWEST PARKWAY WATER& SANITARY SEWER MAIN RELOCATIONS,PART 25: FROM DIRKS ROAD TO FM 1187 City Project No.00899 DOE No.7183 Addendum No. 1.Issue Date: March 11,2014 This addendum forms part of the contract documents referenced above and modifies the original Contract Documents. Acknowledge receipt of this addendum by signing and attaching it to the Contract Documents (inside). Note receipt of the Addendum in the Bid Proposal and on the outer envelope of your bid. GENERAL • As indicated in Section 00 11 13—Invitation to Bidders,Section 00 21 13—Invitation to Bidders, Section 00 4100—Bid Form,and Section 32 35 00—Concrete Screen Walls,the responsive bidder shall indicate the prequalified Pre-Cast Concrete Screen Wall,Column and Drilled Pier Fabricator/Installer to be used for this project on the Bid Form. Failure to do so shall result in the rejecting of the bid as non-responsive.Previously prequalified Fabricator/Installers are indicated in Section 32 35 00—Concrete Screen Wails.Additionally,procedures for contractors wishing to be prequalified as a Pre-Cast Concrete Screen Wall,Column and Drilled Pier Fabricator/Installer are indicated in Section 32 35 00—Concrete Screen Walls and Section 00 45 11—Bidders Prequalifications. For all Fabricators/Installers seeking prequalification as Pre-Cast Concrete Screen Wall, Column and Drilled Pier Fabricator/Installer, all prequalification materials must be submitted to the City fourteen(14)days prior to the bid opening date. The City will release a list of all prequalified Fabricators/Installers seven(7)days prior to the bid opening date. SPECIFICATIONS • Specification 00 73 00—Supplementary Conditions SC-4.02A, "Subsurface and Physical Conditions" o SC-4.02A, "Subsurface and Physical Conditions: ADD between the fourth and fifth paragraphs: "A Geotechnical Report No. DG0712641.2, dated February 28,2014, prepared by HVJ Associates, Inc., a sub-consultant of Kimley-Hom and Associates, Inc., a consultant of the City, providing design recommendations for the proposed pavement section." 4 • Appendix GC-4.02 Subsurface and Physical Conditions o ADD to this section of the Appendix: Geotechnical Report No. DG0712641.2, dated February 28, 2014, prepared by HVJ Associates, Inc., included herein and hereby made a part of the contract documents. ADDENDUM NO. 1 ADDENDUM NO.1 CONSTRUCTION PLANS • Sheet 13A—DELETE Sheet 13 and REPLACE with Sheet 13A as attached All other provisions of the contract documents,plans and specifications shall remain unchanged Failure to return a signed copy of the addendum with the Proposal shall be grounds for rendering the bid non-responsive. A signed copy of this addendum shall be placed into the Proposal at the time of bid submittal. Water Department S.Frank Crumb, P.E. RECE T ACKNOWLEDGED: Director 1 r, Lamy H.Jackson Tony Company: 5nstnieflon, LTD Engineering Manager(Water Dept.) P IP ADDENDUM NO. l ADDENDUM NO.2 CITY OF FORT WORTH WATER DEPARTMENT SH 121T SOUTHWEST PARKWAY WATER& SANITARY SEWER MAIN RELOCATIONS, PART 25: FROM DIRKS ROAD TO FM 1187 City Project No.00899 DOE No. 7183 Addendum No.2.Issue Date: March 25,2014 ' Bid,Reeeipt Date(revised):April 3;2014 This addendum forms part of the contract documents referenced above and modifies the original Contract Documents. Acknowledge receipt of this addendum by signing and attaching it to the Contract Documents (inside). Note receipt of the Addendum in the Bid Proposal and on the outer envelope of your bid. GENERAL • Prequalified Pre-Cast Concrete Screen Wall, Column and Drilled Pier Fabricator/Installers: e The following Pre-Cast Concrete Screen Wall,Column and Drilled Pier Fabricator/Installers are Prequalified to work on this project: ■ Hawk Construction Co.LLC • Failure to identify a prequalified Pre-Cast Concrete Screen Wall, Column and Drilled Pier Fabricator/Installer on the Bid Form(Section 00 4100), shall result in the rejecting of the bid as non-responsive. .. SPECIFICATIONS • Specification 00 11 13—Invitation to Bidders ' RECEIPT OF BIDS: o The bid opening date is hereby changed to be April 3,2014. • Specification 33 05 24—Installation of Carrier Pipe in Casing or Tunnel Liner Plate 2.2 MATERIALS o 2.2.B.1,REPLACE"16"PVC C905 DR14",with"16"PVC C905 DR18" CONSTRUCTION PLANS • Sheet 11—DELETE Sheet I I and REPLACE with Sheet 11 A as attached. • Sheet 12—DELETE Sheet 12 and REPLACE with Sheet 12A as attached. • Sheet 13A—DELETE Sheet 13A and REPLACE with Sheet 13B as attached. All other provisions of the contract documents, plans and specifications shall remain unchanged. Failure to return a signed copy of the addendum with the Proposal shall be grounds for rendering the bid non-responsive. A signed copy of this addendum shall be placed into the Proposal at the time of bid submittal. ADDENDUM NO. 2 ADDENDUM NO.2 Water Department S.Frank Crumb,P.E. RECEIPT ACKNOWLEDGED: Director 7 By':;���, � H.J��ckson By: o n LA" Tony Sholola,P.E. � company: .Engineering Manager(Water Dept.) �lacks©n Construction, M ADDENDUM NO.2 f ADDENDUM NO.3 CITY OF FORT WORTH WATER DEPARTMENT SH 121T SOUTHWEST PARKWAY WATER& SANITARY SEWER MAIN RELOCATIONS, PART 25:FROM DIRKS ROAD TO FM 1187 City Project No.00899 DOE No.7183 Addendum No. 3.Issue Date: April 1,2014 4 Bid Receipt Date(revised): April 3,2014 This addendum forms part of the contract documents referenced above and modifies the original Contract Documents. Acknowledge receipt of this addendum by signing and attaching it to the Contract Documents (inside). Note receipt of the Addendum in the Bid Proposal and on the outer envelope of your bid. CLARIFICATIONS CONTRACTOR QUESTIONS Below is a summary of significant or repetitive questions received: • A majority of the sanitary sewer pipe and some of the manholes will be supplied by the City. Will the City also supply drop fittings for the drop manholes? • A summary of City provided materials can be found in Part 2.1 of Section 33 39 20— Precast Concrete Manholes. • Additionally,for all City provided materials, the Contractor shall review Part 2—Products of each associated specification to determine which material will, and will not be, supplied by the City. • Will the Contractor be required to provide machinery and personnel to load materials at Rolling Hills Water Treatment Plant,or will the City provide machinery and personnel to load the Contractor's trucks? • The Contractor will be required to provide machinery and personnel to load all City provided materials onto their vehicles. All costs associated with this work shall be considered subsidiary to the installation of those specific bid items and no separate payment shall be made. • Additionally, the Contractor shall contact Juan Reyes (817-688-2249)to coordinate retrieval of City provided materials, at least 72 hours in advance. • Is the Exploratory Excavation of Sanitary Sewer Services paid under Bid Item No. 3305.0103 Exploratory Excavation of Existing Utilities,or will this work be considered subsidiary to the Sanitary Sewer Service Reconnection bid item? o The Exploratory Excavation of Existing Utilities is intended to provide payment for Exploratory Excavation associated with locating existing sanitary sewer services at the point of connection at the City ROW. This work shall be performed prior to installation of Sanitary Sewer Lines A-1 and A-2 as indicated on Plan Sheets 14 and 15. Exploratory Excavation will not be included in the Sanitary Sewer Service Reconnection bid item as indicated in Part 1.2.A—Measurement and Payment of Section 33 3150—Sanitary Sewer Service Connections and Service Line. ADDENDUM NO.3 r rADDENDUM NO.3 SPECIFICATIONS r • Specification 00 42 43—Proposal Form c The proposal form is hereby replaced with the form attached to this document. rAll other provisions of the contract documents, plans and specifications shall remain unchanged. Failure to return a signed copy of the addendum with the Proposal shall be grounds for rendering the bid non-responsive. A signed copy of this addendum shall be placed into the Proposal at the time of bid submittal. Water Uc,Imriment S.Frank.Crumb.P.E, RECEIPT ACKNOWLEDGED: Dideetor By .t By A H. Jackson Tarty- Shotola, RK Company: K11 1„s.ring Nli lia cr(Nk"Iter Dept.,) Jackson Construction, LM r r r r r f ADDENDUM NO. 3 005243-1 _ Agreement Page 1 of 4 1 SECTION 00 52 43 2 AGREEMENT 3 THIS AGREEMENT, authorized on 22 July 2014 is made by and between the City of Fort 4 Worth, a Texas home rule municipality, acting by and through its duly authorized City Manager, 5 ("City"), and JACKSON CONSTRUCTIOIN.LTD., authorized to do business in Texas, acting 6 by and through its duly authorized representative,("Contractor"). 7 City and Contractor, in consideration of the mutual covenants hereinafter set forth, agree as 8 follows: 9 Article 1.WORK *� 10 Contractor shall complete all Work as specified or indicated in the Contract Documents for the 11 Project identified herein. 12 Article 2.PROJECT 13 The project for which the Work under the Contract Documents may be the whole or only a part is 14 generally described as follows: 15 SH 121T Southwest Parkway Water and Sanitary Sewer Relocation,Part 25: from Dirks 16 Roads to FM 1187,City Proiect Number 00899 17 Article 3.CONTRACT TIME 18 3.1 Time is of the essence. 19 All time limits for Milestones, if any, and Final Acceptance as stated in the Contract 20 Documents are of the essence to this Contract. 21 3.2 Final Acceptance. 22 The Work will be complete for Final Acceptance within 180 days after the date when the 23 Contract Time commences to run as provided in Paragraph 2.03 of the General Conditions. 24 3.3 Liquidated damages 25 Contractor recognizes that time is of the essence of this Agreement and that City will 26 suffer financial loss if the Work is not completed within the times specified in Paragraph 27 3.2 above, plus any extension thereof allowed in accordance with Article 12 of the 28 General Conditions. The Contractor also recognizes the delays, expense and difficulties 29 involved in proving in a legal proceeding the actual loss suffered by the City if the Work 30 is not completed on time. Accordingly, instead of requiring any such proof, Contractor 31 agrees that as liquidated damages for delay (but not as a penalty), Contractor shall pay 32 City Four Hundred and Twenty Dollars ($420.00) for each day that expires after the 33 time specified in Paragraph 3.2 for Final Acceptance until the City issues the Final Letter 34 of Acceptance. CITY OF FORT WORTH SH 121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocation,Part 25:from Dirks Road to FM 1187 Revised June 4,2012 City Project No.00899 005243-2 Agreement Page 2 of 4 35 Article 4. CONTRACT PRICE 36 City agrees to pay Contractor for performance of the Work in accordance with the Contract 37 Documents an amount in current funds of ONE MILLION NINE HUNDRED TWELVE 38 THOUSAND THREE HUNDRED FIFTEEN DOLLARS AND FIFTY CENTS 39 ($1,912,315.50). 40 Article 5.CONTRACT DOCUMENTS 41 5.1 CONTENTS: 42 A.The Contract Documents which comprise the entire agreement between City and 43 Contractor concerning the Work consist of the following: 44 1. This Agreement. 45 2. Attachments to this Agreement: 46 a. Bid Form 47 1) Proposal Form 48 2) Vendor Compliance to State Law Non-Resident Bidder 49 3) Prequalification Statement 50 4) State and Federal documents(project specific) 51 b. Current Prevailing Wage Rate Table 52 c. Insurance ACORD Form(s) 53 d. Payment Bond 54 e. Performance Bond 55 f. Maintenance Bond 56 g. Power of Attorney for the Bonds 57 h. Worker's Compensation Affidavit 58 i. MWBE Commitment Form 59 3. General Conditions. 60 4. Supplementary Conditions. 61 5. Specifications specifically made a part of the Contract Documents by attachment 62 or, if not attached, as incorporated by reference and described in the Table of 63 Contents of the Project's Contract Documents. 64 6. Drawings. 65 7. Addenda. 66 8. Documentation submitted by Contractor prior to Notice of Award. 67 9. The following which may be delivered or issued after the Effective Date of the 68 Agreement and, if issued, become an incorporated part of the Contract Documents: 69 a. Notice to Proceed. 70 b. Field Orders. 71 c. Change Orders. 72 d. Letter of Final Acceptance. 73 74 CITY OF FORT WORTII SH 121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocation,Part 25:from Dirks Road to FM 1187 Revised June 4,2012 City Project No.00899 005243-3 Agreement Page 3 of 4 75 Article 6.INDEMNIFICATION 76 6.1 Contractor covenants and agrees to indemnify, hold harmless and defend, at its own 77 expense, the city, its officers, servants and employees, from and against any and all 78 claims arising out of, or alleged to arise out of,the work and services to be performed 79 by the contractor, its officers, agents, employees, subcontractors, licenses or invitees 80 under this contract. This indemnification provision is specifically intended to operate 81 and be effective even if it is alleged or proven that all or some of the damages being 82 sought were caused, in whole or in part, by any act, omission or negligence of the city. 83 This indemnity provision is intended to include, without limitation, indemnity for 84 costs,expenses and legal fees incurred by the city in defending against such claims and 85 causes of actions. 86 87 6.2 Contractor covenants and agrees to indemnify and hold harmless, at its own expense, 88 the city,its officers,servants and employees,from and against any and all loss,damage 89 or destruction of property of the city,arising out of,or alleged to arise out of,the work 90 and services to be performed by the contractor, its officers, agents, employees, 91 subcontractors, licensees or invitees under this contract. This indemnification 92 provision is specifically intended to operate and be effective even if it is alleged or 93 proven that all or some of the damages being sought were caused, in whole or in part, 94 by any act,omission or negligence of the city. 95 96 Article 7.MISCELLANEOUS 97 7.1 Terms. 98 Terms used in this Agreement which are defined in Article 1 of the General Conditions will 99 have the meanings indicated in the General Conditions. 100 7.2 Assignment of Contract. 101 This Agreement, including all of the Contract Documents may not be assigned by the 102 Contractor without the advanced express written consent of the City. 103 7.3 Successors and Assigns. 104 City and Contractor each binds itself, its partners, successors, assigns and legal 105 representatives to the other party hereto, in respect to all covenants, agreements and 106 obligations contained in the Contract Documents. 107 7.4 Severability. 108 Any provision or part of the Contract Documents held to be unconstitutional, void or 109 unenforceable by a court of competent jurisdiction shall be deemed stricken, and all 110 remaining provisions shall continue to be valid and binding upon CITY and 111 CONTRACTOR. ,. 112 7.5 Governing Law and Venue. 113 This Agreement, including all of the Contract Documents is performable in the State of 114 Texas. Venue shall be Tarrant County, Texas, or the United States District Court for the 115 Northern District of Texas,Fort Worth Division. CITY OF FORT WORTH SH 121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocation,Part 25:from Dirks Road to FM 1187 Revised June 4,2012 City Project No.00899 005243-4 Agreement Page 4 of 4 116 7.6 Other Provisions. 117 The Contractor agrees to pay at least minimum wage per hour for all labor as the same is 118 classified, promulgated and set out by the City, a copy of which is attached hereto and 119 made a part hereof the same as if it were copied verbatim herein. 120 7.7 Authority to Sign. 121 Contractor shall attach evidence of authority to sign Agreement, if other than duly 122 authorized signatory of the Contractor. 123 124 IN WITNESS WHEREOF, City and Contractor have executed this Agreement in multiple 125 counterparts. 126 127 This Agreement is effective as of the last date signed by the Parties 128 Contractor: City of Fort Worth Jackson Construction,LTD. By45j;Z*4 Fernando Costa B 2 Assistant City Manager (Sig ature) Date 8 , O LARRY H. JACKSON Attest: (Printed Name) Kaor, OR lty Secreta 010000000 GG Title Of JCI Pow Inc,Gmmal Rvtr r (Seal) A. ° 8 0°•/ Address: $° ° Date: z Z—t!K AS City/State/Zip:j j".W 7)C 7 WDouggas s to Form and Legality: e Black Assistant City Attorney 129 130 ad 131 APPR AL RECOMMENDED: 132 133 # 135 OFFICIAL RECORD Frank Crumb 136 CITY SECRETARY DIRECTOR, 137 FTC WORTH,TX Water Department 138 CITY OF FORT WORTH SH 121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocation,Part 25:from Dirks Road to FM 1187 Revised June 4,2012 City Project No.00899 0061 13-1 PERFORMANCE BOND Page 1 of 2 1 SECTION 00 6113 Bond1032106 2 PERFORMANCE BOND 3 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § 7 That we,Jackson Construction,LTD.,known as"Principal"herein and The Hanover Insurance* 8 a corporate surety(sureties, if more than one)duly authorized to do business in the State of Texas, 9 known as"Surety"herein(whether one or more),are held and firmly bound unto the City of Fort 10 Worth, a municipal corporation created pursuant to the laws of Texas, known as"City"herein, in 11 the penal sum of, ONE Million NINE Hundred TWELVE Thousand THREE Hundred 12 FIFTEEN Dollars and FIFTY Cents ($1,912,315.50)lawful money of the United States,to be 13 paid in Fort Worth,Tarrant County, Texas for the payment of which sum well and truly to be 14 made,we bind ourselves,our heirs, executors, administrators, successors and assigns,jointly and 15 severally, firmly by these presents. *Company 16 WHEREAS,the Principal has entered into a certain written contract with the City 17 awarded the 22 day of JULY,2014,which Contract is hereby referred to and made a part hereof 18 for all purposes as if fully set forth herein,to furnish all materials,equipment labor and other 19 accessories defined by law, in the prosecution of the Work, including any Change Orders, as 20 provided for in said Contract designated as SH 121T Southwest Parkway Water and Sanitary 21 Sewer Relocation,Part 25: from Dirks Roads to FM 1187,City Project Number 00899. 22 NOW,THEREFORE,the condition of this obligation is such that if the said Principal 23 shall faithfully perform it obligations under the Contract and shall in all respects duly and 24 faithfully perform the Work, including Change Orders, under the Contract,according to the plans, 25 specifications,and contract documents therein referred to,and as well during any period of 26 extension of the Contract that may be granted on the part of the City,then this obligation shall be 27 and become null and void,otherwise to remain in full force and effect. 28 PROVIDED FURTHER,that if any legal action be filed on this Bond,venue shall lie in 29 Tarrant County,Texas or the United States District Court for the Northern District of Texas, Fort 30 Worth Division. CITY OF FORT WORTH SH121T Southwest Parkway Water Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocations part 251'rom Dirks Road to FM 1187 Revised July 1,2011 City project 00899 0061 13-2 PERFORMANCE BOND Page 2 of 2 1 This bond is made and executed in compliance with the provisions of Chapter 2253 of the 2 Texas Government Code, as amended, and all liabilities on this bond shall be determined in 3 accordance with the provisions of said statue. 4 IN WITNESS WHEREOF,the Principal and the Surety have SIGNED and SEALED 5 this instrument by duly authorized agents and officers on this the 1st day of August, 2014 6 PRINCIPAL: 7 Jackson Construction, LTD 8 9 10 B 11 Sign ure 12 ATTEST: Larry H Jackson, President of JCI 130"'o- 15 Partners, Inc. , General Partner 1 (Pr' cipal)Secr Name and Title 16 17 Address: 5112 Sun Valley Drive 18 19 Fort Worth, TX 76119 20 21 1 ess as to Principal 22 SURETY: 23 24 25 26 BY: 27 gnature 28 29 Jack M Crowley, Attorney in Fact 30 Name and Title 31 32 Address: 15305 North Dallas Parkway 33 #1100 34 Addison, TX 75001 35 36 Witness as to urety Telephone Number: 973-385-9800 37 38 39 40 *Note: If signed by an officer of the Surety Company, there must be on file a certified extract 41 from the by-laws showing that this person has authority to sign such obligation. If 42 Surety's physical address is different from its mailing address, both must be provided. 43 The date of the bond shall not be prior to the date the Contract is awarded. 44 CITY OF FORT WORTH SH121T Southwest Parkway Water Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocations part 25From Dirks Road to FM 1187 Revised July 1,2011 City project 00899 THE HANOVER INSURANCE COMPANY ,. MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint Steven R.Foster,Jack M.Crawley,Patricia A.Smith and/or Marie Perryman of Dallas,TX and each is a true and lawful Attorney(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,recognizances,undertakings, contracts of indemnity or other writings obligatory in the nature thereof,as follows: Any such obligations in the United States,not to exceed Thirty Five Million and Noll 00($35,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED,That the President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered to appoint Attomeys-in-fact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances, contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company.Any such writings so executed by such Attomeys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons."(Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14, 1982- Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents, this 5th day of December 2011. THE HANOVER INSURANCE COMPANY � •r MASSACHUSETTS BAY INSURANCE COMPANY oq�z'.. CITIZENS. SURANCEOMPANY OF AMERICA 18P9 , 1 t 074 ` �'' Robert Thonum Vice Pres:ident THE COMMONWEALTH OF MASSACHUSETTS ) ""�"• COUNTY OF WORCESTER )ss. Joe, t ns=n,Vici Pmsident On this 5th day of December 2011 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged 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, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. BARBARA A.GARtiCK � Notary Public Common«eallh of Massadwaehe - a` 61y;,pmmssioe.rt�r s Se{�.2",Cie '� I( Barbara A.Garlick, Notary Public My Commission Expires September 21,2018 I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED,That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile." (Adopted October 7 1981 -The Hanover Insurance Company;Adopted April 14,1982-Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) r GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 1 st day of August 2014. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA kerin Margosian,Vice President 0061 14-1 PAYMENT BOND Page 1 of 2 1 SECTION 00 6114 Bond 1032106 2 PAYMENT BOND 3 - 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § 7 That we, Jackson Construction LTD., known as "Principal' herein, and g The Hanover Insurance Company , a corporate surety 9 (sureties), duly authorized to do business in the258- State of Texas, known as "Surety" herein 10 (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal 11 corporation created pursuant to the laws of the State of Texas, known as "City" herein, in the 12 penal sum of ONE Million NINE Hundred TWELVE Thousand THREE Hundred 13 FIFTEEN Dollars and FIFTY Cents ($1,912,315.50), lawful money of the United States, to be 14 paid in Fort Worth,Tarrant County,Texas,for the payment of which sum well and truly be made, 15 we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and 16 severally, firmly by these presents: 17 WHEREAS,Principal has entered into a certain written Contract with City,awarded the 22 18 day of July 2014,which Contract is hereby referred to and made a part hereof for all purposes 19 as if fully set forth herein,to furnish all materials,equipment, labor and other accessories as 20 defined by law, in the prosecution of the Work as provided for in said Contract and designated as 21 SH 121 T Southwest Parkway Water and Sanitary Sewer Main Relocation ,Part 2S: From 22 Dirks Road to FM 1187. 23 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if 24 Principal shall pay all monies owing to any (and all) payment bond beneficiary (as defined in 25 Chapter 2253 of the Texas Government Code, as amended) in the prosecution of the Work under 26 the Contract, then this obligation shall be and become null and void; otherwise to remain in full 27 force and effect. 28 This bond is made and executed in compliance with the provisions of Chapter 2253 of the 29 Texas Government Code, as amended, and all liabilities on this bond shall be determined in 30 accordance with the provisions of said statute. 31 CITY OF FORT WORTH SH 121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocations,Part 25:From Dirks Road to FM 1187 Revised July 1,2011 City Project No.00899 0061 14-2 PAYMENT BOND Page 2 of 2 1 IN WITNESS WHEREOF, the Principal and Surety have each SIGNED and SEALED 2 this instrument by duly authorized agents and officers on this the 1st day of August, 2014 3 PRINCIPAL: Jackson Gnnstructinn, T.TD ATTEST: BY. A � SignaLarry H Jackson, President of JCI Partners, Inc. , General Partner (Pri cipal) SecregWy Name and Title Address: 5112 Sun Valley Drive Fnrt Wnrth, TX 75001 A(neas to rinclpa- SURETY: The Hanover Insurance Company ATTEST: BY: Signa e Jack M Crowley, Attorney in Fact (Suko Secretary Name and Title Address: 15305 North Dallas Parkway 41100 w — Addison, TX 75001 itn as o Kuretf Telephone Number: 972-385-9800 4 5 Note: If signed by an officer of the Surety, there must be on file a certified extract from the 6 bylaws showing that this person has authority to sign such obligation. If Surety's physical 7 address is different from its mailing address, both must be provided. 8 9 The date of the bond shall not be prior to the date the Contract is awarded. 10 END OF SECTION 11 CITY OF FORT WORTH SH 121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocations,Part 25:From Dirks Road to FM 1187 Revised July 1,2011 City Project No.00899 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint Steven R.Foster,Jack M.Crowley,Patricia A.Smith and/or Marie Perryman of Dallas,TX and each is a true and lawful Attorney(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,recognizances,undertakings, contracts of indemnity or other writings obligatory in the nature thereof,as follows: Any such obligations in the United States,not to exceed Thirty Five Million and No/100($35,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fad may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED,That the President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered to appoint Attomeys-in-fact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances, contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company.Any such writings so executed by such Attomeys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons."(Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14, 1982- Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents, this 5th day of December 2011. THE HANOVER INSURANCE(COMPANY MASSACHUSETTS BAY INSURANCE COMPANY iia94 �*' CITIZENS SURANCE OMPANY OF AMERICA 8FJiL� 1 1 974 j7'r T Robert Thomas,Vic/e/President - THE COMMONWEALTH OF MASSACHUSETTS ) �` COUNTY OF WORCESTER )ss. Jot renstrc M 1 iC Presidew On this 5th day of December 2011 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged 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, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. �"°`r.S BARBARA A.GARLICK Notary Public �Cemmon:veaAhNMassadwselrs �''Lk karn�ision F Barbara A.Garlick,Notary Public My Commission Expires September 21,2018 I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED,That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed -dP by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile." (Adopted October 7,1981-The Hanover Insurance Company;Adopted April 14,1982-Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 1st day of August 2014. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA qlyhn Margosian,Vice President 0061 19-1 MAINTENANCE BOND Page 1 of 3 Bond 1032106 1 SECTION 00 6119 2 MAINTENANCE BOND 3 4 THE STATE OF TEXAS § 5 § KNOW ALL BY THESE PRESENTS: 6 COUNTY OF TARRANT § ,.. 7 That we,Jackson Construction,Ltd., known as"Principal"herein and The Hanover Insurance 8 Company ,a corporate surety(sureties, if more than one)duly authorized to do 9 business in the State of Texas, known as"Surety"herein(whether one or more),are held and 10 firmly bound unto the City of Fort Worth, a municipal corporation created pursuant to the laws of 11 the State of Texas,known as"City"herein, in the sum of ONE Million NINE Hundred 12 TWELVE Thousand THREE Hundred FIFTEEN Dollars and FIFTY Cents 13 ($1,912,315.50),lawful money of the United States,to be paid in Fort Worth, Tarrant County, 14 Texas,for payment of which sum well and truly be made unto the City and its successors,we 15 bind ourselves, our heirs, executors, administrators,successors and assigns,jointly and severally, 16 firmly by these presents. 17 18 WHEREAS,the Principal has entered into a certain written contract with the City awarded the 19 22 day of July,2014,which Contract is hereby referred to and a made part hereof for all 20 purposes as if fully set forth herein,to furnish all materials,equipment labor and other accessories 21 as defined by law, in the prosecution of the Work, including any Work resulting from a duly 22 authorized Change Order(collectively herein,the"Work")as provided for in said contract and 23 designated as SH121T Southwest Parkway Water and Sanitary Sewer Relocation,Part 25: 24 From Dirks Road to FM 1187 City Npiect Number 00899; and 25 26 WHEREAS, Principal binds itself to use such materials and to so construct the Work in 27 accordance with the plans, specifications and Contract Documents that the Work is and will 28 remain free from defects in materials or workmanship for and during the period of two(2)years 29 after the date of Final Acceptance of the Work by the City("Maintenance Period")-,and 30 31 WHEREAS, Principal binds itself to repair or reconstruct the Work in whole or in part 32 upon receiving notice from the City of the need therefor at any time within the Maintenance Y 33 Period. 34 CITY OF FORT WORTH SH121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocation,Part 25:From Dirks Road to FM 1187 Revised July 1,2011 City Project No.00899 0061 19-2 MAINTENANCE BOND ' Page 2 of 3 1 NOW THEREFORE,the condition of this obligation is such that if Principal shall 2 remedy any defective Work, for which timely notice was provided by City,to a completion 3 satisfactory to the City,then this obligation shall become null and void; otherwise to remain in 4 full force and effect. 5 6 PROVIDED,HOWEVER, if Principal shall fail so to repair or reconstruct any timely 7 noticed defective Work, it is agreed that the City may cause any and all such defective Work to 8 be repaired and/or reconstructed with all associated costs thereof being borne by the Principal and 9 the Surety under this Maintenance bond; and 10 11 PROVIDED FURTHER,that if any legal action be filed on this Bond,venue shall lie in 12 Tarrant County, Texas or the United States District Court for the Northern District of Texas,Fort 13 Worth Division; and 14 �. 15 PROVIDED FURTHER,that this obligation shall be continuous in nature and 16 successive recoveries may be had hereon for successive breaches. 17 18 19 CITY OF FORT WORTH SH121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocation,Part 25:From Dirks Road to FM 1187 Revised July 1,2011 City Project No.00899 0061 19-3 MAINTENANCE BOND Page 3 of 3 1 IN WITNESS WHEREOF,the Principal and the Surety have each SIGNED and SEALED this 2 instrument by duly authorized agents and officers on this the 1st day of Augus t 2014. 3 4 PRINCIPAL: 5 Jackson Construction, LTD 6 7 8 BY: 4,6yL_ 9 Signaifire 10 ATTEST: Larry H Jackson, President of JCI 11 Partners, Inc. , General Partner 12 13 / etar dGn� Name and Title 14 15 Address: 5112 Sun Valley Drive 16 Fort Worth, TX 75001 17 18 yvbo 19 ess as to alf 20 SURETY: 21 The Hanover Insurance Com 22 23 24 BY: 25 S igfature 26 27 Jack M Crowley, Attorney in Fact 28 TTEST: Name and Title 29 30 Address: 15305 North Dallas Parkway 31 (S ety) tart' #1100 32 Addison, TX 75001 33 ' 34 Litne-Ss alto Surety Telephone Number: 972-385-9800 35 36 *Note: If signed by an officer of the Surety Company, there must be on file a certified extract 37 from the by-laws showing that this person has authority to sign such obligation. If 38 Surety's physical address is different from its mailing address, both must be provided. 39 The date of the bond shall not be prior to the date the Contract is awarded. 40 CITY OF FORT WORTH SH121T Southwest Parkway Water and Sanitary Sewer STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Relocation,Part 25:From Dirks Road to FM 1187 Revised July 1,2011 City Project No.00899 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY _ CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint Steven R.Foster,Jack M.Crowley,Patricia A.Smith and/or Marie Perryman of Dallas,TX and each is a true and lawful Attorneys)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,recognizances,undertakings, contracts of indemnity or other writings obligatory in the nature thereof,as follows: Any such obligations in the United States,not to exceed Thirty Five Million and No/100($35,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED,That the President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered to appoint Attomeys-in-fact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances, contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company.Any such writings so executed by such Attomeys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons."(Adopted October 7,1981 -The Hanover Insurance Company;Adopted April 14, 1982- Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents, this 5th day of December 2011. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY $NN k r CME14S SUtR,gNCEPOMPANY OF AMERICA 187'1 � ' ����� ,t' 1i7. A-ZW Robert Thomas,Vice President -� THE COMMONWEALTH OF MASSACHUSETTS ) COUNTY OF WORCESTER )ss. 36e_Arensum Vid President On this 5th day of December 2011 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged 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, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. BARBARA A.LGARLIC1 +� kotary Public ComnonweaAhofMaetadrua�aa `'�LFl Carm>4uia.Fspq'Sapr.27.2418 Barbara A.Garlick, Notary Public My Commission Expires September 21,2018 I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED,That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile." (Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14,1982-Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 1st day of August 2014. THE HANOVER INSURANCE COMPANY MASSACHUSETTS 13AY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA T Ap`t Slat .. q!gphn Margosian,Vice President The HanoverThe Hanover Insurance Company 1 440 Lincoln Street Worcester,MA 01653 .� Insurance Group® Citizens Insurance Company of America 1 645 West Grand River Avenue,Howell,MI 48843 Texas Complaint Notice IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para someter una queja: You may call The Hanover Insurance Company/Citizens Usted puede Ilamar al numero de telefono gratis de The Insurance Company of America's toll-free telephone Hanover Insurance Company/Citizens Insurance Company number for information or to make a complaint at: of America's para informacion o para someter una queja al: 1-800-608-8141 1-800-608-8141 z You may also write to The Hanover Insurance Company/ Usted tambien puede escribir a The Hanover Insurance Citizens Insurance Company of America at: Company/Citizens Insurance Company of America al: 440 Lincoln Street 440 Lincoln Street Worcester, MA 01615 Worcester, MA 01615 You may contact the Texas Department of Insurance to Puede comunicarse con el Departamento de Seguros de obtain information on companies, coverages, rights or Texas para obtener informacion acerca de companias, complaints at: coberturas, derechos o quejas al: 1-800-252-3439 1-800-252-3439 You may write the Texas Department of Insurance: Puede escribir al Departamento de Seguros de Texas: P. O. Box 149104 P. O. Box 149104 Austin,TX 78714-9104 Austin,TX 78714-9104 Fax: (512) 475-1771 Fax: (512) 475-1771 Web: httpl/www.tdi.texasgov Web: httpl/www.tdi.texasgov E-mail: ConsumerProtection @tdi.state.tx.us E-mail: ConsumerProtection @ tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: 1 Should you have a dispute concerning your premium or Si tiene una disputa concerniente a su prima o a un rec- about a claim you should contact the agent or the com- lamo, debe comunicarse con el agente o la compania pany first. If the dispute is not resolved, you may contact primero. Si no se resuelve la disputa, puede entonces the Texas Department of Insurance. comunicarse con el departamento (fDI). ATTACH THIS NOTICE TO YOUR POLICY: This notice is UNA ESTE AVISO A SU POLIZA: Este aviso es solo para for information only and does not become a part or con- proposito de informacion y no se convierte en parte o dition of the attached document. condicion del documento adjunto. 187-,457(W12) JACKCON-02 CHARLIEJU TE CERTIFICATE OF LIABILITY INSURANCE DA D 7/130/2301201114 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES y BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). w PRODUCER CONTACT Willis Of Texas,Inc. PHONE certificates WIIIis.COm FAX Go 26 Century Blvd A/C No Ell,(877)945-7378 A/c N.I,.(888)467-2378 P.O.Box 305191 E-MAIL Nashville,TN 37230-5191 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Liberty Mutual Fire Insurance Company 23035 INSURED INSURER IS:Starr Indemnity&Liability Company 38318 Jackson Construction Ltd. INSURER C:Texas Mutual Insurance Company 22945 JCI Partners,Inc. 5112 Sun Valley Drive INSURER D: Fort worth,TX 76119 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1�TR TYPE OF INSURANCE L POLICY NUMBER MM/DDY/YYYY MM/DD/YYYY LIMITS _JM GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A I X I COMMERCIAL GENERAL LIABILITY X X TB2-Z91-460041-023 10/1/2013 10/1/2014 PREMISES Eaoccurrence $ 300,00 CLAIMS-MADE FK OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- T LOC 1 1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident $ A X ANY AUTO X X AS2-Z91-460041-013 10/1/2013 10/1/2014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ + NON-OWNED Peraccident) PROPERTY DAMAGE $ HIRED AUTOS AUTOS $ X UMBRELLA LAS X OCCUR EACH OCCURRENCE $ 10,000,00 B EXCESS LIAB CLAIMS-MADE 1000020379 10/1/2013 10/1/2014 AGGREGATE $ 10,000,00 DED I I RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY T RY LIMIT ER C ANY PROPRIETOR/PARTNER/FXECUTIVE YIN TSF 0001161633 20131001 10/1/2013 10/1/2014 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? NI NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is required) Re:Project-Water P265-606170089987,Sewer P275-706170089987 The City of Fort Worth is included as an Additional Insured as respects to General Liability and Auto Liability. General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured. SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. = The City of Fort Worth AUTHORIZED REPRESENTATIVE Purchasing Division �/ // d� 1000 Throckmorton Street Fort Worth TX 76102 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:JACKCON-02 CHARLIEJU LOC#: 1 ACCOREV ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Willis of Texas,Inc. Jackson Construction Ltd. JCI Partners,Inc. POLICY NUMBER 5112 Sun Valley Drive SEE PAGE 1 Fort Worth,TX 76119 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECnvE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liabliity Insurance Description of Operations/LocationsNehicles: Waiver of Subrogation applies in favor of The City of Fort Worth with respects to General Liability,Auto Liability and Workers Compensation as permitted by law. Umbrella Liability Follow Form. r. w r ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD