HomeMy WebLinkAboutContract 43471-FP1 P CITY SECRETARY - t `
FORT WORTHr�
ELAPR `� ares- oat 4
N)15 WATER DEPARTMENT ENGINEERING AND FISCAL SERVICES
NOTICE OF PROJECT COMPLETION
DOE.Ns: 6359
Regarding contract 43471 for Water Main Phase I&East Side Pump Station Discharge Header as required by
the Water Department as approved by City Council on 7/10/12 through M&C C-25715 the Assistant Director of the
Water Department,upon the recommendation of the Engineering Manager,Water Engineering and Fiscal Services
Division,has accepted the project as complete.
Original Contract Prices: $8,442,158.00
Amount of Approved Change Orders: $1,563,508.00 Ns 7
Revised Contract Amount: $10,005,666.00
Total Cost Work Completed: $9,938,974.08
Less Deductions:
Liquidated Damages: Days Q$210.00/Day
Other Deductions(see comments):
Total Deduction Amount: $0.00
Total Cost Work Completed: $9,938,974.08
Less Previous Payments: $9,660,678.11
Final Payment Due $278,295.97
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Recommended for Acceptance Date
Engineering Manager, Water Engineering and Fiscal Services
w Division
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Accepted Date
Assist t Dir tor, Water De art nt
ity an Date
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
pEC EOV
APR 17 2015 -P (1-5- -ba 3
City Project Numbers 00369 gy DOE Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water Unit 2 For Period Ending 12131/2014
Project Funding
Project Manager Schwmger City Secretary Contract Number 43471
Inspectors JOHNSON I BRICE Contract Date 7/10/2012
Contractor S.J.LOUIS CONSTRUCTION OF TEXAS,LTD Contract Time 497 CD
P.O.BOX 834 Days Charged to Date 624 CD
MANSFIELD, TX 76063-0834 Contract is .000000 Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES MOICE # C�
Line Fund Account Center Amount Gross Retainage Net
Funded
a a �oo� q �7, a •s2L7,43q.
Total Cost of Work Completed $9,938,974.08
Less 0 %Retained $0.00
Net Earned $9,938,974.08
WATER DEPARTMENT
ENGINEERING AND FISCAL SERVICES Earned This Period $278,295.97
Contact Person- Berdena Diggs-Ext.8429 Retainage This Period $0.00
=D =Val Less Liquidated Damages
y
1711S- 0 Days(g $0.00 /Day $0.00
DEPARTMENT CHECK PI -U YES LemPavemeat Deficiency $0.00
Less Penalty $0.00
Less Previous Payment $9,660,678.11
Plus Material on Hand Less 15% $0.00
Balance Due This Payment $278,295.97
Thursday,March 19,2015 Page 10 of 10
Project Name: DOE.Ns:6359
Water Main Phase I&East Side Pump Station Discharge Header
Comments:
N
RECORDRETARYTH, TX
FORTWORTH
January 14,2015
SJ Louis Construction Ltd of Texas
520 S 6th Ave.
Mansfield,Tx 76063
Re:Acceptance Letter
Project Name: Eastside U 54"Water Main,Phase I
Project Type: Water and Sewer
Project NQ: 00369
DOE.JW: 6359
Contract NQ: 43471 Dated: N/A
Gentleman:
On August 25,2014 a final inspection was made on the subject project. There were punch list items identified at
the time. The punch list items were completed on September 03,2014. 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 September 03,2014,which is the date of punch list completion and
will extend for(2)years in accordance with the Contract Documents.
If you have any questions concerning this letter of acceptance,please feel free to contact me at(817)392-6054
Yours Truly,
Tony Sholola,P.E.,Engineering Manager
TS/
cc: Frank Crumb,P.E.,Director,Water Department
Andy Cronberg,P.E.,Assistant Director,Water Department
Captain Michael Skains,Fire Department
Rick Davis,Field Operations Superintendent,Water Department
Roger Hauser,Assistant Water Systems Superintendent,Water Department
Susan Schwinger,Project Manager
David Johnson,Supervisor,Water Engineering and Fiscal Services
Raymond Brice,Inspector,Water Engineering and Fiscal Services
Freese and Nichols,Consultant
SJ Louis Construction of Texas,Contractor
File
WATER DEPARTMENT
ENGeayuNG ANI)FISCAL StRvm
Tw Cmr or Foxy WoRm * 1000 TkRoclimoum S * Foar Womx,Teras 76102
817-392-8240 * FAx 817-392-8195
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FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name Water Main Phase I&East Side Pump Station Discharge Header
Contract Limits Replacement on Beach St,Scant Ave,&Avenue B
Project Type Water
City Project Numbers 00369
DOE Number 6359
Estimate Number 44 Payment Number 44 For Period Ending 12/312014
CD
City Secretary Contract Number 43471 Contract Time 48ED
Contract Date 7/102012 Days Charged to Date 624
Project Manager Schwinger Contract is 99•000 Complete
Contractor SJ.LOUIS CONSTRUCTION OF TEXAS,LTD
P.O.BOX 834
MANSFIELD, TX 76063-0834
Inspectors JOHNSON / BRICE
Thursday,March 19,2015 Page 1 of 10
City Project Numbers 00369 DOE Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water For Period Ending 12/31/2014
Project Funding
Unit 1:East Side 1154"Water Main Phase I
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 54"Water Pipe Installed in Trench(CO#I)&(CO#2) 2775 LF $464.00 ,287,600.00 2775 1,287,600.00
2 54"Water Pipe Installed in Tunnel(CO#1)&(CO#2) 1206 LF $444.00 $535,464.00 1206 $535,464.00
3 54"Water Pipe Fittings 1 LS $1.00 $1.00 1 $1.00
4 42"Water Pipe Installed in Trench(CO#I)(CO#7) 637 LF $426.00 6271,362.00 623 $265,398.00
5 42"Water Pipe Installed in Tunnel(CO#1) 53 LF $420.00 $22,260.00 56 $23,520.00
6 42"Water Pipe Fittings 1 LS $1.00 $1.00 1 $1.00
7 36"Water Pipe Installed in Trench(CO#1)(CO#7) 682 LF $723.00 6493,086.00 672 $485,856.00
8 36"Water Pipe Installed in Tunnel C 54 LF $723.00 $39,042.00 54 $39,042.00
9 36"Water Pipe Fittings I LS $1.00 $1.00 1 $1.00
10 24"Water Pipe Installed In Trench(CO#1) 0 LF $234.00 $0.00
11 24"Water Pipe Installed In Tunnel(CO#1) 0 LF $228.00 $0.00
12 24"Water Pipe Fittings(CO#1) 0 LS $1.00 $0.00
13 Cathodic Protection I LS $26,300.00 $26,300.00 1 $26,300.00
14 12"Water Pipe(CO#1) 0 LF $64.00 $0.00
15 12"Water Carrier Pipe(CO#1) 0 LF $74.00 $0.00
16 8"Water Pipe(CO#1) 200 LF $50.00 510,000.00 172 $8,600.00
17 6"Water Pipe CO#1) 10 LF $50.00 $500.00 9 $450.00
18 72"Casing/Tuanel Lines Plate by Oth(CO#1&2) 1206 LF $1,940.00 .,339,640.00 1206 2,339,640.00
19 60"Steel Casing by Open Cut(CO#1) 0 LF $394.00 $0.00
20 60"Casing/Tunnel Liner Plate by Oth 53 LF $843.00 $44,679.00 56 $47,208.00
21 54"Casing/Tunnel Line Plate by Othe 53 LF $813.00 $43,089.00 54 $43,902.00
22 36"Casing/Tunnel Liner Plate by Oth(CO#1) 0 LF $716.00 $0.00
23 20"Casing by Other than Open Cut(CO#I) 0 LF $520.00 $0.00
24 20"Casing By Open Cut(CO#1) 0 LF $53.00 $0.00
25 16"Casing By Open Cut(CO#1) 35 LF $45.00 $1,575.00 35 $1,575.00
26 54"AWWA Butterfly Valve,w/vault&(CO#1) 0 EA $89,000.00 $0.00 0 $0.00
27 42"AWWA Butterfly Valve,w/vault&(CO#1) 0 EA $60,000.00 $0.00
28 36"Gate Valve w/Vault&by-pass(CO#1)(CO#7) 3 EA $50,500.00 6151,500.00 3 $151,500.00
29 24"Gate Valve w/Vault&by-pass(CO#1) 0 EA $27,900.00 $0.00
30 12"Gate Valve (CO42) 0 EA $2,000.00 $0.00
31 8"Gale Valve (CO#2) 3 EA $1,200.00 $3,600.00 3 $3,600.00
Thursday,March 19,2015 Page 2 of 10
City Project Numbers 00369 DOE Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water For Period Ending 12/31/2014
Project Funding
32 8"Combination Air Valve Assembly to 3 EA $13,100.00 $39,300.00 3 $39,300.00
33 4"Water Air Release Valve&Vault(CO#1) 1 EA $9,700.00 $9,700.00 1 $9,700.00
34 8"Blow Off Valve(CO#1) 1 EA $10,500.00 $10,500.00 1 $10,500.00
35 Fire Hydrant (CO#2) 1 EA $4,600.00 $4,600.00 1 $4,600.00
36 1"Water Service (CO#2) 0 EA $900.00 $0.00
37 2"Water Service (CO#2)(CO#7) 1 EA $1,800.00 $1,800.00 1 $1,800.00
38 6"Water Service Connection (CO#2) 0 EA $1,800.00 $0.00
39 TemporaryWater Services (CO#2) 0 LS $2,000.00 $0.00
40 6"Cone Curb and Gutter (CO#2)(CO#7) 969 LF $15.00 $14,535.00 723 $10,845.00
41 7"Concrete Driveway and Sidewalk (CO#2) 20 SY $48.00 $960.00 274 $13,152.00
42 7"Cone Pvmt Repair including stripi (CO#2) 814 SY $54.00 $43,956.00 167.8 $9,061.20
43 10'Asphalt Pvmt Repair including st (CO92) 700 LF $51.00 $35,700.00 1482.7 $75,617.70
44 Asphalt Pvmt Repair Beyond Defined W(CO#7) 430 SY $46.00 $19,780.00 930.05 $42,782.30
45 Temporary Asphalt Paving Repair incl 3954 LF $5.00 $19,770.00 38 $190.00
(CO#2)(CO#7)
46 8"Flex Base,Type D,GR-2 950 SY $7.00 $6,650.00 2038.4 $14,268.80
47 Seeding,Hydromulch 14730 SY $0.30 $4,419.00 22187 $6,656.10
48 Block Sod Placement 400 SY $3.00 $1,200.00
49 Exploratory Excavation of ExistingU(CO#7) 65 EA $1.00 $65.00 10 $10.00
50 Trench Safety 7800 LF $0.01 $78.00 4782 $47.82
51 Ductile Iron Water Fittings 4.3 TO $10.00 $43.00
52 SWPPP>1 Acre 1 LS $7,000.00 $7,000.00 1 $7,000.00
53 Flowable Fill Encase Pipe(C0#1) 300 CY $69.00 $20,700.00 310 $21,390.00
54 Remove 36"Water Line(CO#7) 426 LF $15.00 $6,390.00 426 $6,390.00
55 Remove 42"Water Line 250 LF $15.00 $3,750.00 250 $3,750.00
56 Remove 54"Water Line(CO#1) 120 LF $15.00 $1,800.00 120 $1,800.00
57 Remove 6"Sewer Line 200 LF $10.00 $2,000.00 200 $2,000.00
58 Remove 54"Sewer Line 40 LF $15.00 $600.00 40 $600.00
59 Water Line Grouting (CO#2)(CO#7) 150 CY $110.00 $16,500.00 150 $16,500.00
60 42"Water Abandonment Plug (CO#2) 2 EA $1,000.00 $2,000.00 2 $2,000.00
61 36"Water Abandonment Plug 2 EA $800.00 $1,600.00 2 $1,600.00
62 30"Water Abandonment Plug 2 EA $700.00 $1,400.00 2 $1,400.00
63 6"Water Abandonment Plug (CO#2) 1 EA $400.00 $400.00 1 $400.00
64 6"Sewer Abandonment Plug 1 EA $100.00 $100.00 1 $100.00
65 54"Sewer Abandonment Plug 4 EA $1,000.00 $4,000.00 4 $4,000.00
Thursday,March 19,2015 Page 3 of 10
N
RECORDCRETARYRTH,TX
City Project Numbers 00369 DOE Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water For Period Ending 12/31/2014
Project Funding
66 Salvage 42"Water Valve 1 EA $2,000.00 $2,000.00 1 $2,000.00
67 Salvage 36"Water Valve (CO02) I EA $2,000.00 $2,000.00 1 $2,000.00
68 Salvage 30"Water Valve 2 EA $2,000.00 $4,000.00 2 $4,000.00
69 Remove 8"Water Valve (CO42) 0 EA $1,000.00 $0.00
70 Remove 6"Water Valve (CO#2) 0 EA $700.00 $0.00
71 Salvage Fire Hydrant (CO#2) 1 EA $700.00 $700.00 1 $700.00
72 Traffic Control 1 LS $15,000.00 $15,000.00 1 $15,000.00
73 Utility Markers 1 LS $1.00 $1.00 1 $1.00
74 Imported Backfill,CLSM(Flowable 3242 CY $60.00 £194,520.00 2875 $172,500.00
Fi(CO#7)(CO#8)
75 Imported Embedment/Backfill,Crushed 50 SY $20.00 $1,000.00
76 Imported Embedment/Backfill,Select 50 SY $15.00 $750.00
77 Connection to Existing 6"Water Main 2 EA $1,000.00 $2,000.00 2 $2,000.00
78 Connection to Existing 8"Water Main(CO#2) t EA $1,000.00 $1,000.00 1 $1,000.00
79 Connection to Existing 36"Water Mai 9 EA $4,400.00 $39,600.00 9 $39,600.00
(CO#1)(CO#7)
80 Connection to Existing 42"Water Mai(CO#2) 2 EA $5,900.00 $11,800.00 2 $11,800.00
81 Connection to Existing 54"Water Mai(CO#1) 3 EA $6,400.00 $19,200.00 3 $19,200.00
82 Bypass Pumping 1 LS $1.00 $1.00 1 $1.00
83 8 S6werPipe,includes connections(CO#i) 150 LF $811.00 $11,150.00 136 $11,016.00
84 6"Sewer Carrier Pipe includes tonne 50 LF $66.00 $3,300.00
85 Remove and Transplant Tree 2 EA $500.00 $1,000.00 1 $500.00
86 54"C303 pipe installed in trench(C0#1) 809 LF $718.00 080,862.00 803 $576,554.00
87 30"C303 pipe installed in trench(CO#1) 60 LF $766.00 $45,960.00 60 $45,960.00
88 54"Butterfly Valve&Smaller Vault(CO41) 8 EA $87,000.00 8696,000.00 8 $696,000.00
89 54"Butterfly Valve&Thrust Restrain Vault(CO#1) 1 EA $87,000.00 $87,000.00 1 $87,000.00
90 42"Butterfly Valve&Smaller Vault(CO41) 6 EA $57,000.00 8342,000.00 6 $342,000.00
91 36"Butterfly Valve&Smaller Vault(CO#1) 4 EA $53,000.00 8212,000.00 4 $212,000.00
92 36"Butterfly Valve Direct Bury(CO#1) 1 EA $30,000.00 $30,000.00 1 $30,000.00
93 30"Butterfly Valve Direct Bury(CO#1) 2 EA $27,000.00 $54,000.00 2 $54,000.00
94 10'Asph Pvmt Repair including stripping 963 LF $63.00 $60,669.00 0 $0.00
(CO#I)(CO#8)
95 Asph Pvmt Repair Beyond Defined w/stripe 94 SY $57.00 $5,358.00
(C0#1)(C048)
96 Remove 30"Water Line(CO41) 330 LF $15.00 $4,950.00 330 $4,950.00
97 Connect to Existing 30"Water Main(CO#1) I EA $4,400.00 $4,400.00 1 $4,400.00
Thursday,March 19,2015 Page 4 of 10
City Project Numbers 00369 DOE Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water For Period Ending 12/31/2014
Project Funding
98 10"Sewer Pipe 86 LF $85.00 $7,310.00
99 4'Manhole w/Cone Collar and Vacuum Test(CO#1) 1 EA $3,000.00 $3,000.00 1 $3,000.00
100 4'Drop MH w/Cont Collar and Vacuum Test 3 EA $4,000.00 $12,000.00 3 $12,000.00
(CO#])(CO#7)
101 Cathodic Protection for Lines AA BB,CC(CO#1) 1 LS $8,000.00 $8,000.00 1 $8,000.00
102 54"Bend-cutting a new miter into 1 end(C042) I EA $1,500.00 $1,500.00 1 $1,500.00
103 Existing 54"pipe chipping mortar on spigot(CO92) 28 EA $285.00 $7,980.00 28 $7,980.00
104 Cut existing 54"B303 Pipe Bell x Spg(CO#2) 2 EA $432.00 $864.00 2 $864.00
105 Trim spg on exist 54"B303 Pipc for mod(CO#2) 2 EA $210.00 $420.00 2 $420.00
106 54"B303 Pipe BS/BB LLr20"w/EBC(CO#2) 2 EA $3,540.00 $7,080.00 2 $7,080.00
107 54"x CE 54"Gkt Tee w/Ellip Plug(CO#2) 2 EA $22,420.00 $44,840.00 2 $44,840.00
108 54"Gkt x 54"E Flg 54"Gkt Tee w/4"out(CO#2) 1 EA $40,280.00 $40,280.00 1 $40,280.00
w/54"x 4"FORF w/54"Buttstrap(CO#2) 1 EA $40,710.00 $40,710.00 1 $40,710.00
110 2"Type D asphalt surface w/6"Flex Base(CO#2) 3884 SY $20.00 $77,680.00 3884 $77,680.00
for guy wire relocation(CO#2) 1 LS $6,040.00 $6,040.00 1 $6,040.00
Timberland&Alta Vista(CO#2) 106.26 LF $135.70 $14,419.48 106.26 $14,419.48
113 Short Pipe Cut changes(CO#2) 6 EA $358.80 $2,152.80 6 $2,152.80
114 42"Dished Head Plug(CO#2) 1 EA $2,205.70 $2,205.70 1 $2,205.70
115 96"Precast Combo ARV and Acc MH @ N&S River 2 EA $37,325.00 $74,650.00 2 $74,650.00
Risers(CO 94)
116 Remove&Replace Existing Valve w/CFW 1 LS $56,846.87 $56,846.87 1 $56,846.87
Furnished 36"GV(CO#6)
117 36"DIP non restrained waterline w/flow fill(C0#7) 112 LF $830.00 $92,960.00 112 $92,960.00
118 24"DIP non restrained waterline w/flow fill(C0#7) 29 LF $898.00 $26,042.00 29 $26,042.00
119 24"Gare Valve direct bury(CO#7) 1 EA $18,600.00 $18,600.00 1 $18,600.00
120 Connect to Existing 24"WL(CO#7) 2 EA $3,800.00 $7,600.00 2 $7,600.00
121 Remove and Salvage Exisitng 36"DIP WL(CO#7) 100 LF $72.00 $7,200.00 100 $7,200.00
122 Remove and Salvage Existing 24"GV(CO#7) 1 EA $600.00 $600.00 1 $600.00
123 Remove and Salvage Existing 20"GV(CO#7) 3 EA $500.00 $1,500.00 3 $1,500.00
124 Cut&Plug Existing 20"WL(C0#7) 4 EA $1,200.00 $4,800.00 4 $4,800.00
125 Temporary Pavement PatchCurb-Curb(CO#7) 1067 SY $30.00 $32,010.00 2153 $64,590.00
126 8"C-900 DR14 PVC WL(CO#7) 379 LF $175.00 $66,325.00 379 $66,325.00
127 36"xg"Tapping Sleeve and Valve(CO#7) 2 EA $11,000.00 $22,000.00 2 $22,000.00
128 Fire Hydrant Assembly(CO#7) 1 EA $3,600.00 $3,600.00 1 $3,600.00
129 6"Gate Valve(CO#7) 1 EA $900.00 $900.00 1 $900.00
Thursday,March 19,2015 Page 5 of 10
City Project Numbers 00369 DOE.Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water For Period Ending 12/31/2014
Project Funding
130 1"Bull Head Water Service Assembly(CO#7) 8 EA $1,300.00 $10,400.00 8 $10,400.00
131 2"Water Service Service Assembly(CO#7) 2 EA $1,700.00 $3,400.00 2 $3,400.00
132 1"Water Service Pipe(C0#7) 64 LF $30.00 $1,920.00 64 $1,920.00
133 2"Water Service Pipe(C047) 48 LF $40.00 $1,920.00 48 $1,920.00
134 8"C-900 DR25 PVC S.S.Line(CO47) 303 LF $165.00 $49,995.00 303 $49,995.00
135 Flowable Fill of S.S.(CO#7) 12 CY $70.00 $840.00 12 $840.00
136 4'Diameter Hyd.Slide M110-6'(CO#7) 1 EA $5,700.00 $5,700.00 2 $11,400.00
137 4'Diameter Extra Depth MH(CO#7) 13 VF $150.00 $1,950.00 13 $1,950.00
138 Epoxy Lining fo 4'DiaMH(CO#7) 31 VF $140.00 $4,340.00 31 $4,340.00
139 Pre-TV Inspection(CO#7) 400 LF $1.00 $400.00 400 $400.00
140 Post-TV Inspection(CO#7) 303 LF $1.00 $303.00 303 $303.00
141 Remove Existing MH(CO#7) 4 EA $1,500.00 $6,000.00 4 $6,000.00
142 Remove Existing 10"S.S.(CO#7) 303 LF $25.00 $7,575.00 303 $7,575.00
143 8'Wide Asphalt Pavement Repair(CO#7) 95 LF $59.00 $5,605.00 95 $5,605.00
144 Bypass Pumping for S.S.(CO97) 1 LS $12,000.00 $12,000.00 1 $12,000.00
145 Trench Water Stop(CO#7) 1 EA $1,000.00 $1,000.00 1 $1,000.00
146 Special Shoring at S.S.Line Sia 4+07&5+02(CO#7) 2 EA $3,995.00 $7,990.00 2 $7,990.00
147 Remove 10"WL(CO#7) 65 LF $20.00 $1,300A0 65 $1,300.00
148 Remove 20 W1.(CO#7) 15 LF $25,00 $375.00 1 c $375.00
149 Remove 30"WL(CO#7) 45 LF $26.00 $1,170.00 45 $1,170.00
150 Relocate Light Standard(CO#7) 1 EA $6,000.00 $6,000.00 0.33 $1,980.00
151 Salvage 20"WL(CO97) 2 EA $2,000.00 $4,000.00 2 $4,000.00
152 Salvage 30"WL(CO#7) 1 EA $700.00 $700.00 1 $700.00
153 Remove 10"Water Valve(CO97) 2 EA $700.00 $1,400.00 2 $1,400.00
154 Ductile Iron Water Fittings 16"-30"(CO#7) 7.32 TN $9,869.00 $72,241.08 7.32 $72,241.08
155 Ductile Iron Water Fittings>30"(CO#7) 12.87 TN $17,249.00 £221,994.63 12.87 $221,994.63
156 10"DIP WL(CO#7) 70 LF $180.00 $12,600.00 66 $11,880.00
157 20"DIP W1, 65 LF $240.00 $15,600.00 31.6 $7,584.00
158 Connection to Existing 20"Water Main(CO#7) 2 EA $3,500.00 $7,000.00 2 $7,000.00
159 Connection to Existing 30"Water Main(CO#7) 1 EA $4,300.00 $4,300.00 1 $4,300.00
160 Connection to 20"pipe inside pump station(C097) 3 EA $3,500.00 $10,500.00 3 $10,500.00
161 Wall Penetration fo 20"WL(CO#7) 3 EA $3,000.00 $9,000.00 3 $9,000.00
162 1"Air ReleaseValve(CO#7) 1 EA $14,000.00 $14,000.00 1 $14,000.00
163 10"Gate Valve(CO#7) 2 EA $1,800.00 $3,600.00 2 $3,600.00
Thursday,March 19,2015 Page 6 of 10
City Project Numbers 00369 DOE Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water For Period Ending 12/31/2014
Project Funding
164 20 Gate Valve w/Vault(CO#7) 5 EA $24,000.00 $120,000.00 5 $120,000.00
165 42"BFV and MH(CO#7) 1 EA $43,700.00 $43,700.00 1 $43,700.00
166 Removal&Replacement of Existing 16"at Beach& 1 LS $15,961-65 $15,961.65 1 $15,961.65
Ave A(CO#7)
167 Rotate Worm Gear on 36"Butterfly V(CO#7) 1 LS $1,734.84 $1,734.84 1 $1,734-84
168 4"x20"Tapping Sleeve for PACS pool Ave B(CO#8) 1 LS $5,084.84 $5,084.84 1 $5,084.84
169 Ernest Asphalt Pavement Level-up(CO#8) 69 TN $200.00 $13,800.00 69 $13,800.00
170 Ernest Asphalt Pavement Type D(CO#8) 2060 SY $15.30 $31,518.00 2060 $31,518.00
171 Ernest Crack Joint Sealing(CO#8) 1823 LF $0.41 $747.43 1823 $747.43
172 Ernest Remove and Reset Ext.MH ring and cover 3 EA $363.00 $1,089.00 3 $1,089-00
(CO#8)
Sub-Total of Previous Unit $9,417,087-32 $9,352,385.24
Unit 2:East SIDE Pump Sta Discharge Header Replcm
ItemEstimated Estimated Completed Completed
Description of Items Unit Unit Cost
No. Quanity Total Quanity Total
---------- ------ ----------- - --- -- --- -- -----
1 Remove 16"Water Line(CO#7) 151 LF $24.00 $3,624.00 151 $3,624.00
2 Remove 18"Water Line(CO#7) 39 LF $25.00 $975.00 39 $975.00
3 Remove 24"Water Line(CO#7) 600 LF $26.00 $15,600.00 600 $15,600.00
4 Remove esphaltP�.rmt(CO#7) 265 SY $5.00 c" c 00 265 $1,325.00
5 20"Pressure Plug 2 EA $1,500.00 $3,000-00 2 $3,000.00
6 20"Water Abandonment Plug 4 EA $600-00 $2,400.00 1 $600-00
7 Remove Cone Curb&Gutter(CO#7) 40 LF $5.00 $200.00 40 $200.00
8 Salvage 16"Water Valve 3 EA $700.00 $2,100.00 3 $2,100.00
9 Salvage 18"Water Valve 1 EA $700.00 $700.00 1 $700.00
10 Salvage 24"Water Valve(CO#7) 10 EA $700.00 $7,000-00 10 $7,000.00
11 Remove Concrete Water Vault(CO#7) 13 EA $1,400.00 $18,200.00 13 $18,200.00
12 Electrical Facilities 1 LS $75,000.00 $75,000.00 1 $75,000.00
13 Salvage Electrical 1 LS $3,000-00 $3,000.00 1 $3,000.00
14 10'Wide Asphalt Pvmt Repair,Reside(C0#8) 0 LF $51.00 $0.00
15 Asphalt Pvmt Repair Beyond Defined W(CO#8) 0 SY $46.00 $0.00
16 8"Cement Treatment(CO#8) 0 SY $30.00 $0.00
17 6"Cone Curb and Gutter 10 LF $15.00 $150.00
18 6'Chain Link,Steel(CO#7)(CO#8) 280 LF $20.00 $5,600.00 280 $5,600.00
19 Seeding,Hydromuleh(CO#7) 1920 SY $0-30 $576.00 1920 $576.00
Thursday,March 19,2015 Page 7 of 10
City Project Numbers 00369 DOE Number 6359
Contract Name Water Main Phase I&East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Ave,&Avenue B Payment Number 44
Project Type Water Unit 2 For Period Ending 12/31/2014
Project Funding
20 Miscellaneous Structure Adjustment 1 EA $25,000.00 $25,000.00 1 $25,000.00
21 Trench Safety(C0#7) 895 LF $0.20 $179.00 895 $179.00
22 Imported Embedment/Backfill,CLSM(F 20 CY $70.00 $1,400.00 20 $1,400.00
23 Imported Embedment/Backfill,Crushed(CO#7) 250 CY $20.00 $5,000.00 250 $5,000.00
24 Ductile Iron Water Fittings 6.5 TO $2.00 $13.00 10.78 $21.56
25 16"DIP Water(CO#7) 106 LF $182.00 $19,292.00 106 $19,292.00
26 18"DIP Water(CO#7) 29 LF $210.00 $6,090.00 29 $6,090.00
27 24"DIP Water(C0#7)(C0#8) 448 LF $242.00 $108,416.00 447.8 $108,367.60
28 Connection to Existing 10"Water Mai 1 EA $1,200.00 $1,200.00 1 $1,200.00
29 Connection to Existing 16"Water Mai(CO#7) 4 EA $2,200.00 $8,800.00 4 $8,800.00
30 Connection to Existing 18"Water Mai(CO#7) 4 EA $3,100.00 $12,400.00 4 $12,400.00
31 Connection to Existing 24"Water Mai(CO#8) 3 EA $3,800.00 $11,400.00 3 $11,400.00
32 16"Gate Valve 4 EA $6,200.00 $24,800.00 4 $24,800.00
33 24"Gate Valve w/Vault(CO#7)(CO#8) 8 EA $24,500.00 $196,000.00 8 $196,000.00
34 Traffic Control 1 MO $1.00 $1.00 1 $1.00
35 24"Cross(CO#2) 1 EA $2,100.00 $2,100.00 1 $2,100.00
36 24"Plug(CO#2) 1 EA $570.00 $570.00 1 $570.00
37 24"Hymax Coupling(CO#2) 1 EA $1,765.00 $1,765.00 1 $1,765.00
38 20"Hymax Coupling(COU?.) 1 EA $1,350.00 $1,350.00 1 $1,350.00
39 24"Sleeve(CO#2) 1 EA $600.00 $600.00 1 $600.00
40 24"Megalug and accessories(CO#2)(CO43) 0 EA $2,772.00 $0.00
41 18"Megalug and accessories(CO#2) I EA $250.00 $250.00 1 $250.00
42 Roll of Polywrap(CO#2) 1 EA $200.00 $200.00 1 $200.00
43 Additional Labor for yard piping(CO#2) 1 LS $9,917.60 $9,917.60 1 $9,917.60
44 Additional Equipment cost for yard piping(CO#2) 1 LS $9,613.08 $9,613.08 1 $9,613.08
40a 24"Megalug and Accessories(CO#3) 9 EA $308.00 $2,772.00 9 $2,772.00
Sub-Total of Previous Unit $588,578.68 $586,588.84
Thursday,March 19,2015 Page 8 of 10
City Project Numbers 00369 DOE Number 6359
Contract Name Water Main Phase 18t East Side Pump Station Discharge Header Estimate Number 44
Contract Limits Replacement on Beach St,Scott Avc,&Avenue B Payment Number 44
Project Type Water Unit 2 For Period Ending 11!312014
Project Funding
Contract Information Summary
Original Contract Amount 58,442,158.00
Chance Orders
Change Order Number 1 ($40,979.00)
Change Order Number 2 545,832.98
Change Order Number 2 551,313.68
Change Order Number 3 ($22,176.00)
Change Order Number 4 574,650.00
Change Order Number 6 $56,846.87
Change Order Number 7 $1,186,524.20
Change Order Number 7 $211,592.00
Change Order Number 8 ($28,133.73)
Change Order Number 8 $28,037.00
Total Contract Price 510,005,666.00
Date 'J'2'3 ' Total Cost of Work Completed $9,938,974.08
Less 0 %Retained $0.00
Date p �g—r`� Net Earned $9,938,974.08
Inspection Supervisor Earned This Period 5278,295.97
�� Retainage This Period 50.00
Less Liquidated Damages
Proj Manage��"���
Days @ /Day $0.00
Date LessPavement Deficiency $0.00
Asst Db,.A ITPW- Design an C structi,n Less Penalty 50.00
Date Less Previous Payment $9,660,678.11
Director/Contracting Department Plus Material on Hand Less 15% $0.00
Balance Due This Payment $278,295.97
Thursday,March 19,2015 Page 9 of 10
FORT WORTH City of Fort Worth CITY SECWAW _
Change Order Request CONTRACT N0
ProjectNamel East Side 54'Water Main Phase land ESPS CitySec No. 43471
Project No.(s)P262-608140036983,P265-608160036983 DOE No. 6359 City Pro.No. 0369
Project Description 544 nch Water Main Installation on Beach Street and Avenue B and Discharge Header Replacement at East Side Pump
Station
Contractorl S.J.Louis Construction of Texas,Ltd. Change Order# ® Date: 11211012014
City Project Mgr.I Susan Schwinger City Inspector I Raymond Brice
Phone Number 817-392-65299 Phone Number 817-392-8452
Dept. Water(Unit 1) Water(Unit 2) Totals Contract Time
(Calender days)
Original Contract Amount $8,122,346.00 $319,812.00 $8,442,158.00 260
Extras to Date $1,363,854.05 $262,905.68 $1,626,759.73 227
Credits to Date $40,979.00 $22,176.00 $63,155.00
Pending Change Orders(n M&C Process)
Contract Cost to Date $9,445,221.05 $560,541.68 $10,005,762.73 487
Amount of Proposed Change Order -$28,133.73 $28,037.00 -$96.73 0144
Revised Contract Amount $9,417,087.32 $588,578.68 $10,005,867.57 631
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding(if necessary) 1 1 $28,037.00 $28,037.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 18.52%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $10,552,697.50
The change order will provide for the following:
• 24-inch gate valve on the discharge header at the East Side Pump Station as requested by Water Field
Operations.
• Level up and asphalt pavement replacement on Ernest Avenue.
• 4-inch x 20-inch tapping sleeve for swimming pool meter on Avenue B.
• Replacement of damaged 6-ft chain link fence at the swimming pool.
• The deletion of pay item quantites that are no longer ne nt he project. OFFICIAL RECORD
Staff recommends an additional 144 came r days o F O/r CITY SECRETARY
y = $0 _ FT.WORTH,TX
Il o�
3 e uuc,00
A da
It is understood and agreed that the acceptance of this Change Order by the tutes 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.
Conjta Com an Name Contractor.Name Cqntrj6r Si naiture Data
S.J.Lou Cons uction of Texas,Ltd Pete Stahl !2-//_/
In actor Date Project Manag Date
Tuns SW. " �r �,"A -.It/rt /l(4
As t c aterD t) CcAstruction Supervisor Mater DepQ Date
jZ is V
Da Assistant CJManager Date
Council Action a required)
M&C Number NIA MSC Date Approyed NIA
FORT WORTH City of Fort Worth
Change Order Additions
Project Name I East Side 54'Water Main Phase 1 and ESPS City Sec No. 43471
Project No.(s) P262-608140036983,P265-608160036983 DOE No. 6359 City Pro.No. 00369
Project 54-Inch Water Main Installation on Beach Street and Avenue B and Discharge Header Replacement at East Side Pum
Description Station
Contractor S.J.Lacs Construction of Texas,Ltd. Change Order# ® Date: 12/10/'1014
City Project Mgr. Susan Sdt ' City Inspector I Raymond Brice
ADDITIONS
ITEM ESCRIPTION DEPT Qty Unit Unit Cost Total
168 4'x20'Tapping sleeve for PACS swimming pool meter on Ave B Water(Unit 1) 1.00 LS $5,084.84 $5,084.84
169 Ernest Asphalt Pavement Level-up Water Unit 1 69.00 TN $200.00 $13,800.00
170 Ernest Asphalt Pavement Type D Water Unit 1 2060.00 SY $15.30 $31,518.00
171 Ernst Crack Joint Sealing Water Unit 1 1823.00 LF $0.41 $747.43
172 Ernst Remove and Reset Eiasting MH ring and cover Water nit 1 3.00 EA J$363.00 $1,089.00
18 6'Chain Link Fence Water Unit 2 220.00 LF $20.00 $4,400.00
33 24'Gate Valve with Vault Water(Unit 2) 2.00 EA $24,500.00 $49,000.00
Water Unit 1 $52,239.27
Water Unit 2 $53,400.0
Additions Sub Total 1 $105,639.27
Page 2 of 4
FORT WORTH City of Fort Worth
Change Order Deletions
Project Name East Side 54'Water Main Phase 1 and ESPS City Sec No. 1 43471
Project No.(s) P262-608140036983,P265-608160036983 DOE No. 6359 City Pro.No. 00369
Project Description 54-Inch Water Main Installation on Beach Stmt and Avenue B and Discharge Header Replacement at East Side
Pump Station
Contractor S.J.Louis Construction of Texas,Ltd. Change Order#EE Date 12/10014
City Project Mgr. Susan Schwinger City Inspector Raymond Brice
DELETIONS
ITEM DESCRIPTION DEPT City JUnit Unit Coat Total
74 Imported Backfill,CLSM(Flowable fill) Water(Unit 1) 758.00 ICY $60.00 $45,480.00
94 10'Asph Pvmt Repair including stripping Water(Unit 1) 277.00 LF $63.00 $17,451.00
95 Asph Pvmt Repair Beyond Defiend w/stripe Water(Unit 1) 306.00 SY $57.00 $17,442.00
14 10'Wide Asphalt Pvmt Repair,Residential Water(Unit 2) 55.00 LF $51.00 1$2,805.00
15 Asphalt Pvmt Repair Beyond Defined Width,Residential Water(Unit 2) 25.00 SY $46.00 $1,150.00
16 8'Cemeent Treatment Water(Unit 2) 65.00 ISY $30.00 $1,950.00
27 24'DIP Water Water(Unit 2) 49.00 ILF $242.00 $11,858.00
31 Connection to Existing 24'Water Main Water(Unit 2) 2.00 JEA $3,800.00 $7,600.00
Water(Unit 1) $80,373.00
Water(Unit 2) $25,363.00
Deletions Sub Total $105,736.00
Page 3 of 4
s
i
M/WBE Breakdown for this Change Order
IN
2
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3
3
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6
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Total .O
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Previous Change Orders
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Total _ = _ _ i
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FORTWORTH my 03/03/07
WATER ENGINEERING&FISCAL SERVICES
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:44
NAME OF PROJECT: East Side Il 54"Water Main Phase I&East Side Pump Station
PROJECT NO.: Water:P265-6081600369 CONTRACTOR: SI Louis Construction of Tx.
P255-6081400369 DOE NO.: 6359
PERIOD FROM:12/15/14 TO: 12/31/14 FINAL INSPECTION DATE: 825/2014
WORK ORDER EFFECTIVE:10/152012 CONTRACT TIME: 631 0 CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH CHARGED DURING CREDITED MONTH CHARGED DURING CREDITED
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 OTHERS* DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS
THIS
PERIOD 0 0
PREVIOUS
PERIOD 624 624
TOTALS
TO DATE 624 624
*REMARKS:
CONTRAWTA DATE PECTOP,// CITV SUNTARY
WATER ENGINEERING&FISCAL SERVICESTX
The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 760 r
(817)392-4477•Fay(817)392-8460
FORT WORTH
WATER ENGINEERING&FISCAL SERVICES
PIPE REPORT FOR:
PROJECT NAME: FaMide II 54"Water Main Phase I
PROJECT NUMBER: 369
DOE NUMBER: 6359
WATER
PIPE LAID SIZE TYPE OF PIPE LF
54" concrete cylinder 4784
42" concrete cylinder 679
36" concrete cylinder 838
24" DIP 477
18" DIP 29
16" DIP 106
8" PVC 172
6" PVC 9
FIRE HYDRANTS: 1 VALVES(161"OR LARGER) 38
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES: Every 200 LF
NEW SERVICES:
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
8" PVC 515
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES:
NEW SERVICES:
WATER ENGINEERING&FISCAL SERVICES
The City of Fort Worth•1000 Throckmorton Sweet•Fort Worth,TX 76012-6311
(817)392-4477•F=(817)392-8460
FORTWORTHREV:02/22/07
WATER ENGINEERING AND FISCAL SERVICES
CONTRACTOR'S EVALUATION OF CITY
I)PROJECT INFORMATION Date:
Now ofContractar Project Name
SJ Louis Const action Eastside II 0/65"Water:Main Phase I
Water Engineering Irupector Project Manager
Raymond H.Brice Susan Schwinger
DOE Number Type oJContract
6359 0 Simple 0 Routine Complex P9 water waste waterO Storm lxainagep �-�l
Pavement
Initial Contract Amount Final Contract Amount
$8,442,158.00 $10,552,697.50
IT)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 4 1 Accuracy of Plans to ExistinConditions �j
2 Knowledge of Inspector 2 Clarity&Sufficiency of Details 3
3 Accuracy of Measured Quantities 3 Applicability of Specifications
4 Display Of Professionalism 4 Acc of Plan Quantities 10)
5 Citizen Com hint Resolution PROJECT MANAGER EVALUATION
6 Performance-Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution Or
ADNIINISTRATION 2 Availability of Project Manner
1 Change Order Processing Time 3 Communication
2 Timliness of Contractor Payrnents 4 Resolution of Utility Conflicts
3 Bid Opening to Pre-Con M Timeframe
III)COMMENTS&SIGNATURES
COMMENTS
Signature Contractor
Signature Inspector
Signature Inspector's Supervisor
INSPECTOR'S COMMENTS
Water F.ngueering and Fiscal Services
The City of Fort Worth•1000 Thmoctmorton Street•Fort Worth,TX 76012-6311
(817)392-4477•Fax,(817)392-MW
/
FORT WORTH REV:0212
0/07
WATER ENGINEERING&FISCAL SERVICES
PERFORMANCE EVALUATION OF CONTRACTOR
CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
SJ Lotus Construction Eastside 11 54"Water Main Phase I
Rater Engineering Inspector DOE Number
RN Brice 6359
JYar-F-g---ghvpector Project Manager
® Water❑ Waste Water❑ Storm Drainage❑ Pavement Susan Schwin er
Initial Contract Amount Project Doculty
$8,442,158.00 O Simple O Routine QQ Complex
Final Contract Amount Date
$10,552,697.50
II)PERFORMANCE EVALUATION
0-Inadequate 1-Deficient 2-Standard 3-Good 4-Excellent
ELEMENT WEIGHT(x) APPLICABLE(Y/M RATING(0-4) MAX SCORE SCORE
1 Submission of Documents 2 Y 3 8 6
2 Public Notifications 5 Y 3 20 15
3 Plans on Site 5 Y 4 20 20-
4 Field Supervision 15 Y 3 60 45
5 Work Performed 15 Y 4 60 60
6 Finished Product 15 Y 4 60 60
7 Job Site Safety 15 Y 4 60 60
8 Traffic Control Maintenance 15 Y 3 60 45
9 Daily Clean Up 5 Y 3 20 15
10 Citizen's'Complaint Resolution 5 Y 3 20 15
11 Property Restoration 5 Y 4 20 20
12 After Hours Response 5 Y 4 20 20
13 Project Completion 5 Y 3 20 15
TOTAL ELEMENT SCORE(A) 396
BONUS POINTS(25 Maximum)(B) 25
TOTAL SCORE(TS) 421
III)CONTRACTOR'S RATING
Maximum Score(MS)=448 pl sum of applicable element score maximums which= 448
Rating([TS/MS]*100%) 421 / 448 — 94%
Performance Category Excellent
<20'/*—Inadequate 20%to<40%—Deficient 40%to<60%—Standard 60316 to<80%—Good >_80*/=Excellent
bspeetor's Commeub(INCL U PIN ATION OF BONUS POWs AWARDED)
Bonus Points awarded due to ery c mplex ity River crossing.
Signature Inspector - Signature Contractor
Signature Inspector's Supervisor
CONTRACTOR'S COMMENTS
WATER ENGINEERING&FISCAL SERVICES
The City of Fort Worth•1000 Thmckmorton Street•Fort Worth,TX 76012-6311
(817)392-4477•Fax:(817)392-9460
FORT WORTH CONTRACTOR'S AFFIDAVIT OF
PAYMENT OF DEBTS AND CLAIMS
City of Fort Worth,TX
PROJECT: East Side II 54'Water Main Phase I(Unit 1)and East Side Pump Station PROJECT NUMBER:
Discharge Header(Unit 2)
OWNER: _ Cityof Fort Worth 00369
CONTRACTOR: S.J.Louis Construction of Texas Ltd. 21217-10
ENGINEER: Freese and Nichols Inc.
The Contractor,in accordance with the Contract Documents,hereby certifies that, except as listed below,all
obligations for all materials and equipment fumished,for all work labor, and services performed,and for all known
indebtedness and claims against the Contractor for damages arising in any manner in connection with the
penbr mance of the Contract referenced above for which the Owner or his property might in any way be held
responsible have been paid in full or have otherwise been satisfied in full.
EXCEPTIONS: (If none,write"NONE". The Contractor shall fumish a bond,acceptable to the Owner,
for each exception.)
CONTRACCToO'Rj S.J. Louis Construction of Texas. Ltd.
BY Idb � Les V. Whitman
TITLE General Manaoer
Subscribed and sworn to before me this 19th day of January , 2015
Notary Public: ,.,� .„
,.*L. P&1,; ELIZABETH ANN INGRAM
Notary Public,Smote of Texas
My Commission Expires: May 10, 2017 "� - My Commission Expires
�';F' �:' May 10, 2017
FORT WORTH
CONTRACTOR'S AFFIDAVIT
OF RELEASE OF LIENS
The City of Fort Worth
PROJECT: East Side 11 54"Water Main Phase I(Unit 1)and East Side Pump Station PROJECT NUMBER:
Discharge Header Unit 2
OWNER: City of Fort Worth,Texas 00369
CONTRACTO S.J.Louis Construction of Texas,Ltd. 21217-10
ENGINEER: Freese&Nichols,Inc.
The Contractor,in accordance with the Contract Documents,and in consideration for the full and final payment to
Me Contractor for all services in connection with the project,does hereby waive and release any and all liens,or
any and all claims to liens which the Contractor may have on or affecting the project as a result of its contract(s)
for the Project or for performing labor and/or furnishing materials in any way connected with the construction of
any aspect of the project The Contractor further certifies and warrants that all subcontractors of labor and/or
materials for the Project,except as listed below,have been paid in full for all labor and/or materials supplied to, for,
through or at the direct or indirect request of the Contractor prior to, through and including the date of this affidavit.
EXCEPTIONS: (If none,write"NONE". The Contractor shall fumish a bond,acceptable to the Owner,for
each exception.)
OFFM=RECORD
M SECRETARY
F%WORTH,TX
CONTRACTOR S.J. Louis Construction of Texas. Ltd.
By Les V.Whitman
Title General Manager
Subscribed and om to before me this 19th day of January , 2015
Notary Public:
My Commission Expires: May 10 2017
' ELIZABETH ANN INGRAM
Notary Public,State of Texas
My Commission Expires
" `' May 10, 2017
FORT WORTH
CONSENT OF SURETY COMPANY
City of Fort TO FINAL PAYMENT
Worth,Texas
Bond No. 190025976
PROJECT: East Side 11 54'Water Main Phase I(Unit 1)and East Side Pump Station PROJECT NUMBER:
Discharge Header Replacement(Unit 2)
OWNER: City of Fort Worth 00369
CONTRACTOR: S.J.Louis Construction of Texas, Ltd. 21217-10
ENGINEER: Freese and Nkfwls,Inc.
The Surety Company, on bond of the Contractor listed above for the referenced project,in accordance with the
Contract Documents,hereby approves final payment to the Contractor,and agrees that final payment to the
Contractor shall not relieve the Surety Company of any of its obligations to the Owner under the terms of the
Contract and as set forth in said Surety Company's bond.
In witness whereof,the Surety Company has hereunto set its hand this 16th. day of Janua 2015.
Liberty Mutual Fire Insurance Company
Surety Corm ny-
By
Ak, — , 0---"'\
Authorized Representative
Title Bruce N. Telander.Attorney-in-Fact
Address:
450 Plymouth Road,Suite 400,Plymouth Meeting,PA 29462
Attach Power of Attorney
THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the
extent herein stated. 6195186
LIBERTY MUTUAL FIRE INSURANCE COMPANY
WAUSAU,WISCONSIN
POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS
That Liberty Mutual Fire Insurance Company(the"Company"),a Wisconsin stock insurance company,through its Assistant Secretary,pursuant to and by
authority of the Board of Directors hereinafter set forth,does hereby name,constitute and appoint R W.FRANK,DONALD R.OLSON,
JOHN E.TAUER,BRUCE N.TELANDER,LINDA K.FRENCH,JOSHUA R.LOFTIS,RACHEL THOMAS,CRAIG REMICK,BRIAN J.OESTREICH,
NICOLE NELSON,JEROME T.OUIMET,SANDRA M.DOZE,D.R.DOUGHERTY,JACK CEDARLEAF II,KURT C.LUNDBLAD,CHRISTINE M.HANSEN,
PAMELA T.CURRAN,MELINDA C.BLODGETT,ALL OF THE CITY OF MINNEAPOLIS STATE OF MINNESOTA
,each individually if there be more than one named,its true and lawful attomey-in-fact to make,execute,seal,acknowledge and deliver,for and on its behalf as
surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations and the execution of such undertakings,bonds,
recognizances and other surety obligations,in pursuance of these presents,shall be as binding upon the Company as if they had been duly signed by the president and
attested by the secretary of the Company in their own proper persons.
That this power is made and executed pursuant to and by authority of the following Unanimous Consent and Vote of the Board of Directors dated June 28,2006
wherein,among other things,it was:
VOTED that the Secretary and each Assistant Secretary be, and each of them is, authorized to execute powers of attomey qualifying the attorney '00
named in the given power of attorney to execute on behalf of the Company surety undertakings, bonds, recognizances and other surety In
obligations;and that the Secretary and each Assistant Secretary be,and each or any of them hereby is,authorized to attest to the execution In
of any such power of attorney,and to affix thereto the corporate seal of the Company. C
N
y That the Resolution set forth above is a true copy thereof and is now in full force and effect. 3
d �
w �
c
R IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Company and the corporate seal of R
M Liberty Mutual Fire Insurance Company has been affixed thereto in Plymouth Meeting,Pennsylvania this 9th day of July
2013 IC
LIBERTY MUTUAL FIRE INSURANCE COMPANY �.y
O
`
m OCL
By o
David M.Carey, distant Secretary
"12
to COMMONWEALTH OF PENNSYLVANIA ss 0 O
O COUNTY OF MONTGOMERY 1.
d C
C °y On this 9th day of July 2013 before me, a Notary Public, personally came David M. Carev, to me known, and d M
C` acknowledged that he is an Assistant Secretary of Liberty Mutual Fire Insurance Company; that he knows the seal of said corporation; and that he w O
ti , executed the above Power of Attorney and affixed the corporate seal of Liberty Mutual Fin: Insurance Company thereto with the authority and at the
direction of said corporation.
tIN TESTIMONY WHEREO .ba0,4Wr o subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania,on the day and year '
O•— first above written. •O
d �'.��'
V ate+ t` sC' 4 r l i /�'� �,®B •{Q
fvF I.:.L J R By
tom'" Tere Pastella,Notary Public w N
m C CERTIFICATE
a dVsy�°t cr
O 7 1,the undersigned, an Assis � of Liberty Mutual Fire Insurance Company,do hereby certify that the original power of attomey of which the c 00
Z 0 foregoing is a full, true and correc copy, is in full force and effect on the date of this certificate; and I do further certify that the officer or official who 00
executed the said power of attorney was one of the officers or officials specially authorized by the Board of Directors to appoint attomeys-in-fact as p
provided in the Unanimous Consent and Vote of the Board of Directors of Liberty Mutual Fire insurance Company dated June 28,2006. ~ '"
This certificate and the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of the Board
of Directors of Liberty Mutual Fire Insurance Company evidenced by the Unanimous Consent and Vote of the Board of Directors dated June 28,2006
wherein it was
VOTED that the signatures of such officers and the seal of the Company may be affixed to any such power of attorney or to any certificate relating
thereto by facsimile,and any such power of attorney or certificate bearing such facsimile signature and facsimile seal shall be valid and binding
upon the Company when so affixed and in the future with respect to any surety undertakings, bonds, recognizances and other surety
obligations to which it is attached.
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said company, this SGth, day of
January
Gregory ryWDavenport,Assistant Secretary