HomeMy WebLinkAboutContract 45719-FP2 )epartment ol TP&W Const.Services
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)roject Manager .
tisk Management J. age �T WO RT H® a-2 Ja).O.E. Brotherton CITY`SAi _
;FA Westerman/ScannedCONTRACT NO. `1 1
'he Proceeding people have been Contacted coa eming the request for final
)ayment&have released this project for such payment. 'ATI ON AND PUBLIC WORKS
.learance Conducted By Shameka Kennedy IF PROJECT COMPLETION
D.O.E.N>:: 7197
GSA Vs7i
Regarding contract 117197 for SI ONE CREEK RANCH PH IV-PAVING,STRM DRAIN,ST LIGHT as required
by the TRANSPORTATION&PUBLIC WORKS as approved by City Council on N/A through M&C N/A the
director of the TRANSPORTATION&PUBLIC WORKS upon the recommendation of the Assistant Director of
the Transportation&Public Works Department has accepted the project as complete.
Original Contract Prices: $1,030,641.50
Amount of Approved Change Orders: Ne
Revised Contract Amount:
Total Cost Work Completed: $1,030,641.50
Less Deductions:
Liquidated Damages: Days®$210.00/Day
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Work Completed: $1,030,641.50
Less Previous Payments: $0.00
Final Payment Due $1,030,641.50
Recommended for Acceptance Date
Asst. Director, TPW - Infrastructure Design and Construction
J
Accepted G Date
Director, TRANSPORTATION & PUBLIC VLKS
—7 , 4,rowxl- ---. .�-
City Manager Date
Comments: C205-541200-202320224583,C205-541200-202760224583
OFFICIAL RECORD
CITY SECRETARY
FT- WORTH, TX
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name STONE CREEK RANCH PHASE IV
Contract Limits
Project Type PAVING,STORM DRAIN,ST LIGHT
City Project Numbers 02245
DOE Number 7197
Estimate Number I Payment Number I For Period Ending 2/10/2015
CD
City Secretary Contract Number 117197 Contract Time 15ED
Contract Date Days Charged to Date 180
Project Manager laafari Contract is 100.00 %Complete
Contractor CONATSER CONSTRUCTION TxLP
5327 WICHITA ST
FORT WORTH, TX 76119
Inspectors LAYER / DOVERS
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
Tuesday,February IQ,2015 Page 1 of 5
City Project Numbers 02245 DOE Number 7197
Contract Name STONE CREEK RANCH PHASE IN Estimate Number I
Contract Limits Payment Number I
Project Type PAVING,STORM DRAIN,ST LIGHT For Period Ending 2/10/2015
Project Funding
PAVING
ItemDescription of Items Estimated Unit knit Cost
Estimated Completed Completed
No. Quanity Total Quanity Total
- — -- -- -- - - - - - ----- -
I CONCRETE RIPRAP 32 SY $75.00 $2,400.00 32 $2,400.00
2 HYDRATED LIME 260 TN $160.00 $41,600.00 260 $41,600.00
3 6"LIME TREATMENT 16256 SY $2.75 $44,704.00 16256 $44,704.00
4 2"ASPHALT PVMT TYPE C 35 SY $30.00 $1,050.00 35 $1,050.00
5 6"CONC PVMT 15245 SY $29.50 6449,727.50 15245 $449,727.50
6 4"CONC SIDEWALK 2467 SF $3.00 $7,401.00 2467 $7,401.00
7 BARRIER FREE RAMP 12 EA $1,000.00 $12,000.00 12 $12,000.00
8 FURNISHANSTALL ALUM SIGN GROUND 2 EA $500.00 $1,000.00 2 $1,000.00
9 FURNISH/INSTALL ALUM SIGN EX POLE 2 EA $500.00 $1,000.00 2 $1,000.00
10 INSTALL ALUM SIGN GROUND MOUNT 2 EA $500.00 $1,000.00 2 $1,000.00
I I INSTALL ALUM SIGN EX POLE MOUNT 4 EA $500.00 $2,000.00 4 $2,000.00
12 REMOVE EOR BARRICADE 5 EA $300.00 $1,500.00 5 $1,500.00
13 INSTALL STANDARD EOR BARRICADE 6 EA $500.00 $3,000.00 6 $3,000.00
14 CITY BONDS FOR ALL PAVING IMPROVEMENT I LS $4,500.00 $4,500.00 1 $4,500.00
15 PAVEMENTHEADER 145 LF $20.00 $2,900.00 145 $2,900.00
16 SILT FENCE 4730 LF $1.50 $7,095.00 4730 $7,095.00
Sub-Total of Previous Unit $582,877.50 $582,877.50
STORM DRAIN
Item Estimated Estimated Completed Completed
Description of Items Unit Unit Cost
No. Quanity Total Quanity Total
I CONCRETE RIPRAP 46 SY $75.00 $3,450.00 46 $3,450.00
2 4"CONC SIDEWALK 60 SF $20.00 $1,200.00 60 $1,200.00
3 TRENCH SAFETY 3412 LF $1.00 $3,412.00 3412 $3,412.00
4 21"RCP CLASS 111 229 LF $48.00 $10,992.00 229 $10,992.00
5 24"RCP CLASS 111 586 LF $50.00 $29,300.00 586 $29,300.00
6 27"RCP CLASS 111 529 LF $55.00 $29,095.00 529 $29,095.00
7 30"RCP CLASS 111 224 LF $65.00 $14,560.00 224 $14,560.00
8 36"RCP CLASS 111 1233 LF $80.00 $98,640.00 1233 $98,640.00
9 42"RCP CLASS III 520 LF $95.00 $49,400.00 520 $49,400.00
10 60"RCP CLASS 111 91 LF $165.00 $15,015.00 91 $15,015.00
Tuesday,February 10,2015 Page 2 of 5
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
City Project Numbers 02245 DOE Number 7197
Contract Name STONE CREEK RANCH PHASE IV Estimate Number I
Contract Limits Payment Number I
Project Type PAVING,STORM DRAIN,ST LIGHT For Period Ending 2/10/2015
Project Funding
I I 4'STORM JUNCTION BOX 8 EA $3,000.00 $24,000.00 8 $24,000.00
12 STORM JUNCTION STRUCTURE I LS $5,500.00 $5,500.00 1 $5,500.00
13 10'CURB INLET 12 EA $2,200.00 $26,400.00 12 $26,400.00
14 15'CURB INLET 2 EA $2,800.00 $5,600.00 2 $5,600.00
15 20'CURB INLET 2 EA $3,200.00 $6,400.00 2 $6,400.00
16 TREE PROTECTION 1 LS $5,000.00 $5,000.00 1 $5,000.00
17 IRRIGATION REPAIR I LS $3,500.00 $3,500.00 1 $3,500.00
18 42"SLOPED END HEADWALL 1 EA $4,000.00 $4,000.00 l $4,000.00
19 CONNECT TO EXISTING STORM SEWER 4 EA $500.00 $2,000.00 4 $2,000.00
20 CITY BONDS FOR ALL STORM DRAIN IMP I LS $2,500.00 $2,500.00 1 $2,500.00
Sub-Total of Previous Unit $339,964.00 $339,964.00
STREET LIGHT
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 11/4"CONDT PVC SCH 80 1940 LF $12.00 $23,280.00 1940 $23,280.00
2 GROUND BOX TYPE B W/APRON 4 EA $800.00 $3,200.00 4 $3,200.00
3 RDWY ILLUM ASSMBLY 20 EA $2,500.00 $50,000.00 20 $50,000.00
4 100W HPS PC LIGHTING FIXTURE 20 EA $200.00 $4,000.00 20 $4,000.00
5 RDWY ILLUM FOUNDATION 20 EA $1,000.00 $20,000,00 20 $20,000.00
6 #8 ALUMINUM CONDUCTOR 3880 LF $1.00 $3,880.00 3880 $3,880.00
7 #10CU ALUMINUM CONDUCTOR 1940 LF $1.00 $1,940.00 1940 $1,940.00
8 CITY BONDS FOR ALL STREET LIGHT IMP l LS $1,500.00 $1,500.00 1 $1,500.00
Sub-Total of Previous Unit $107,800.00 $107,800.00
Tuesday,February 10,2015 Page 3 of 5
City Project Numbers 02245 DOE Number 7197
Contract Name STONE CREEK RANCH PHASE TV Estimate Number I
Contract Limits Payment Number I
Project Type PAVING,STORM DRAIN,ST LIGHT For Period Ending 2/10/2015
Project Funding
Contract Information Summary
Original Contract Amount 51,030,641.50
Change Orders
Total Contract Price 51,030,641.50
Date2-vt l Total Cost of Work Completed 51,030,641.50
C ntr r Less %Retained $0.00
Date
l�/IS Net Earned $1,030,641.50
—/
Inspection ery
Earned This Period $1,030,641.50
S �
Retainage This Period $0.00
Date 1 Less Liquidated Damages
Project Man
Days Q /Day $0.00
Date-7-23-A LessPavement Deficiency $0.00
Asst Dli ctor/Tw,PWJ lias
-Intructure Design and Construction Less Penalty $0.00
, 0 Datel/Ll /f Less Previous Payment $0.00
Director eContracting Dcpartm f �) Plus Material on Hand Less 15% 50.00
� Balance Due This Payment $1,030,641.50
Tuesday,Febnmy Io,2015 CITYPSMTARY
FT. WORTH, TX
City Project Numbers 02245 DOE Number 7197
Contract Name STONE CREEK RANCH PHASE IV Estimate Number I
Contract Limits Payment Number 1
Project Type PAVING,STORM DRAIN,ST LIGHT For Period Ending 2/10/2015
Project Funding
Project Manager Jaafari City Secretary Contract Number 117197
Inspectors LAYER / DOVERS Contract Date
Contractor CONATSER CONSTRUCTION TxLP Contract Time 150 CD
5327 WICHITA ST Days Charged to Date 180 CD
FORT WORTH, TX 76119 Contract is 000000 Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of Work Completed $1,030,641.50
Less %Retained $0.00
Net Earned $1,030,641.50
Earned This Period $1,030,641.50
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 /Day $0.00
LessPavement Deficiency $0.00
Less Penalty $0.00
Less Previous Payment $0.00
Plus Material on Hand Less 15% $0.00
Balance Due This Payment $1,030,641.50
Tuesday,February 10,2015 OFFICIAL RECORD Page 5 of 5
CITY SECRETARY
FT. WORTH, TX
FORTWORTH rev 03/05/07
TRANSPORTATION&PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:1
NAME OF PROJECT: Stare Creek ranch Phase IV
PROJECT NO.: C205-2027602245 CONTRACTOR: Conatser
DOE NO.: 7197
PERIOD FROM:07/11/14 TO: 01/16/15 FINAL INSPECTION DATE: 9-Feb
WORK ORDER EFFECTIVE:6/30/1014 CONTRACT TIME: 150 0 VVQ) CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH CHARGED CREDITED MONTH CHARGED CREDITED
DURING DURING
1. 16.
2. 17.
3. 18.
4. 19.
5. 20.
6. 21.
7. 22.
8. 23.
9. 24.
10. 25.
11. 26.
12. 27.
13. 28.
14. 29.
15. 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS
THIS
PERIOD 180 180
PREVIOUS
0 0
PERIOD
TOTALS
TO DATE 180 180
*REMARKS:
C RACTOR DATE INSPECTOR
ENGINEERING DEPARTMENT OFFICIAL LaEC ®
The City of Fort Worth-1000 Throckmorton Street-Fort Worth,TX C 1 �T
_RY o (817)392-7941 -Fix(817)392-7845
FT. WORTH, TX
FORTWORTH RE":02W07
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
I PROJECT INFORMATION Date: 2/7/2015
Name of Contractor Project Name
Conatser Stone Creek Ranch PH IV
DOE Inspector Project Manager
Keith Dovers Khal Jaafari
DOENumber JProject D02culty Type of Contract
7197 10 Simple * Routine 0 Complex ❑ Water❑ Waste water0 Storm Drainage Pavement
Initial Contract Amount Final Contract Amount
$1,030,641.50 $1,030,641.50
II)PERFORMANCE EVALUATION
0-Inadequate 1 -Deficient 2-Standard 3-Good 4-Excellent
ELEMENT RATING ELEMENT RATING
(0-4) (0-4)
INSPECTION EVALUATION PLANS&SPECIFICATIONS
1 Availability of Inspector 1 Accuracy of Plans to Existing Conditions
2 Knowledge of Inspector tA 2 Clarity&Sufficiency of Details
3 Accuracy of Measured Quantities 13 Applicability of Specifications
4 Display Of Professionalism Z 14 Accuracy of Plan Quantities
5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION
6 Performance-Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution
ADMINISTRATION 2 Availability of Pro'ect Manager
1 Change Order Processing Time L 3 Communication
2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts
3 Bid Opening to Pre-Con Meeting Timeframe
III)COMMENTS&SIGNATURES
COMMENTS
Signature Contractor
Signature DOE Inspector
Signature DOE Inspector's Supervisor LZI 04 A-,d /4z--5
INSPECTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
ID The City of Fort Worth-1000 Throckmorton Street-Fort Worth,TX 76012-6311
(817)392-7941 -Fax:(817)392-7845 OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX
FORTWORTH REV:00/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
CONTRACTOR&PROJECT DATA
Name of Contractor Project Naine
Conatser Stone Creek Ranch PH IV
DOE Inspector DOE Number
Keith Dovers 7197
DOE Irupecior Project Manager
❑ Water❑ Waste Water Storm Drainage Pavement Khal Jaafari
Initial Contract Amotntt Project Diriculty
$1,030,641.50 0 Simple Q Routine 0 Complex
Final Contract Amount Date
$1,030,641.50 2/7/2015
In PERFORMANCE EVALUATION
0-Inadequate t-Deficient 2-Standard 3-Good 4-Excellent
ELEMENT WEIGHT(x) APPLICABLE(Y/N) RATING(0-4) MAX SCORE SCORE
I Submission of Documents 2 Y 3 8 6
2 Public Notifications 5 Y 2 20 10
3 Plans on Site 5 Y 3 20 15
4 Field Supervision 15 Y 3 60 45
5 Work Performed 15 Y 3 60 45
6 Finished Product 15 Y 3 60 45
7 Job Site Safety 15 Y 3 60 45
8 Traffic Control Maintenance 15 Y 3 60 45
9 Daily Clean Up 5 Y 3 20 15
10 Citizen's Complaint Resolution 5 N
11 Property Restoration 5 Y 3 20 I S
12 After Hours Response 5 N
13 Project Completion 5 Y 3 20 15
TOTAL ELEMENT SCORE(A) 301
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(PS) 301
111)CONTRACTOR'S RATING
Maximum Score(MS)=448 gC sum of applicable element score maximums which= 408
Rating(ITS/MSI"100%) 301 / 408 74%
Performance Category Good
<20'r6—Inadequate 20•/to<40%=llefreient 40%to<60%—Standard 60•/to<80%—Good ?$0%=Excellent
Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED)
Signature DOE Inspector Signature Contractor — `
Signature DOE Inspector's Supervisor
CONTRACTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS �_�The City of Fort Worth-1000 Thr dmorton Street-Fort Worth,TX 76012-6 16FF1CIAL RECORD
(817)392-7941 -Fax:(817)392-7845
CITY SECRETARY
FT.WORTH,TX
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 Brock Huggins, Vice-President of Conatser Management Group,
Inc., general partner of Conatser Construction TX, LP,known to me to be a credible person, who
being by me duly sworn, upon his oath deposed and said:
That all persons, firms, associations, corporations or other organizations furnishing
labor and/or materials have been paid in full;
That the wage scale established by the City Council in the City of Fort Worth, has
been paid in full; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
STONE CREEK RANCH, PH IV
WATER, SANITARY SEWER
PAVING, DRAINAGE AND STREET
LIGHT IMPROVEMENTS
City Project#:N/A
CITY OF FORT WORTH
STATE OF TEXAS
CONATSER CONSTRUCTION TX, LP
A
Brock Huggins
Subscribed and sworn to before me this 9" day of January, 2015.
Bertha Gianulispu in Tarrant
exas
5r �� Notary Public for
state of Texas OFFICIAL RECORD
1
--
CITY SECRETARY
My commission expires:0911812015
FT.WORTH,TX
OWNER
ARCHITECT ❑
CONSENT OF SURETY CONTRACTOR ❑
TO FINAL PAYMENT SURETY ❑
OTHER ❑
BOND NO.: 0185056
TO OBLIGEE:
(Name and Address) CONTRACT FOR: Water,Sanitary Sewer,
LGI HOMES-TEXAS, LLC Paving, Drainage&Street
1450 Lake Robbins Drive,Suite#430 Light Improvements
The Woodlands,TX 77380
PROJECT: CONTRACT DATED:May, 2014
(Name and Address)
Stone Creek Ranch, IV
Fort Worth,TX
PRINCIPAL: CONATSER CONSTRUCTION TX, L.P.
At the request of the Obligee and the Principal indicated above,(Insert name and address of Surety)
Berkley Insurance Company, 412 Mt, Kemble, Suite 310N, Morristown,NJ 07960
,SURETY,
on bond of
(Insert name and address of Contractor) CONATSER CONSTRUCTION TX, L.P.
5327 Wichita Street
Fort Worth, TX 76119
CONTRACTOR,
and conditioned on the representation by Obligee that all Contract provisions relating to the payment of final
payment under the Contract have been satisfied by Principal as of the date of final payment, and that no claims
by Obligee or any third party are known or believed by Obligee or its representatives to exist as of the date of
final payment,representations as to the truth and accuracy of the foregoing conditions being deemed to have
been made by Obligee in connection with this request for Consent of Surety,hereby approves of the final
payment to the Principal,and agrees that final payment in accordance with the terms hereof shall not relieve the
Surety of its obligations to
(Insert name and address of Obligee)
LGI HOMES-TEXAS, LLC
1450 Lake Robbins Drive,Suite#430
The Woodlands, TX 77380 ,OBLIGEE,
as set forth in said Surety's bond.
IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: January 07,2015.
(Insert in writing the month followed by the numeric date and year.)
Berkely Insurance Company
(
are �
ui•. ih 1
(Signatut e ofauthorize representative
V. DeLene Marshall,Attorney-In-Fact
(Printed name and title)
(Seal):
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
No.BI-7280c
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WILMINGTON,DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
— organized and existing under the laws of the State of Delaware,having its principal office in Greenwich, CT,has made,constituted
and appointed, and does by these presents make, constitute and appoint: Ricardo J. Reyna, Don E. Cornell, Lisa M. Bonnot,
Vena DeLene Marshall or Sophinie Hunter of Aon Risk Services South west,Inc. of Dallas, TX its true and lawful Attorney-in-
Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and deliver any and all bonds and
v undertakings, with the exception of Financial Guaranty Insurance, providing that no single obligation shall exceed Fifty Million
and 00/100 U.S.Dollars (U.S.$50,000,000.00),to the same extent as if such bonds had been duly executed and acknowledged by
the regularly elected officers of the Company at its principal office in their own proper persons.
This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
— a without giving effect to the principles of conflicts of laws thereof This Power of Attorney is granted pursuant to the following
resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010:
r RESOLVED, that, with respect to the Surety business written by Berkley Surety Group,the Chairman of the Board, Chief
Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant
U Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein
to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the
C corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such
G attorney-in-fact and revoke any power of attorney previously granted;and further
E RESOLVED,that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances,
or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the
manner and to the extent therein stated;and further
T RESOLVED, that such power of attorney revokes all previous powers issued on.behalf of the attorney-in-fact named; and
further
RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any
" power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or
E other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as
though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any
person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have
ceased to be such at the time when such instruments shall be issued.
IN WITNESS WHEREOF, the Compkny has card these resents to be signed and attested by its appropriate officers and its
corporate seal hereunto affixed this day of 2014.
Attest: //f / Berkley Insurance Company
(Seal) By By
Ira S.Ledermany .Hafter
y Senior Vice President&Secretary 7e or ce President
o N
WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE`BERKLEY"SECURITY PAPER.
STATE OF CONNECTICUT)
ss:
COUNTY OF FAIRFIELD )
N r
Sworn to before me, a Notary Public in the State of Connecticut, this /a�day of ✓�� 2014, by Ira S.Lederman and
77nY Jeffrey M.Hafter who are sworn to me to be the Senior Vice President and Secretary,and ' Senior Vi President,respectively,of
Berkley Insurance Company. MARIA C.RUNDSMEN
NOTARY PUBLIC
C MY COMMISSION EXPIRES Notary Public,State of Connecticut
J APRT19
CERTIFICATE
I,the undersigned,Assistant Secretary of BERKLEY INSURANCE COMPANY,DO HEREBY CERTIFY that the foregoing is a
z� 5 true, correct and complete copy of the original Power of Attorney; that said Power of Attorney has not been revoked or rescinded
Q and that the authority of the Attorney-in-Fact set forth therein, who executed the bond or undertaking to which this Power of
3 Attorney is attached,is in full force and effect as of this date.
Given under my hand and seal of the Company,this day of i
(Seal) OFFICIAL RECORD
Andr .Tu a CITY SECRETARY
FT. WORTH, TX
IMPORTANT NOTICE
To obtain information or make a complaint:
You may call Berkley Surety Group, LLC and its affiliates by
telephone for information or to make a complaint:
BERKLEY SURETY GROUP, LLC
Please send all notices of claim on this bond to:
Berkley Surety Group, LLC
(866) 768-3534
412 Mount Kemble Avenue, Suite 31ON
Morristown, NJ 07960
Attn: Surety Claims Department
You may contact the Texas Department of Insurance to obtain
information on companies, coverages, rights or complaints at:
1-800-252-3439
You may write the Texas Department of Insurance:
P. O. Box 149104
Austin, TX 78714-9104
Fax: (512) 475-1771
Web: http://www.tdi.state.tx.us
E-mail: ConsumerProtection(@tdi.state.tx.us
PREMIUM OR CLAIM DISPUTES:
Should you have a dispute concerning your premium or about a claim
you should contact your agent or Berkley Surety Group, LLC first. If
the dispute is not resolved, you may contact the Texas Department of
Insurance.
ATTACH THIS NOTICE TO YOUR BOND:
This notice is for information only and does not become a part or
condition of the attached document and is given to comply with T exa
legal and regulatory requirements.
OFFICIAL RECORD
CITY SECRETARY
FL
WORTH,TX