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HomeMy WebLinkAboutContract 46690-FP2 Depart t of PW Const. Services DOE#,' . Date CITY SECRETAW. Prosect Manager�, CONTRACT NO. � y�� Risk Management S. Canday ITWORTH. D.O.E. Brotherton i CFA Westerman/Scanned ❑ The Proceeding people have been Contacted concerning the requestATION AND PUBLIC WORKS 110r final payment&have released this project for such payment. IF PROJECT COMPLETION Clearance Conducted By Etta Bacy D.O.E.Ns: 7376 e-FA SRZ/� 4 c 4zf 9a Regarding contract 117376 for WATER/SANITARY SEWER& STREET LIGHTING HSC INDUSTRIAL as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on N/A through M&C N/A the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project as complete. Original Contract Prices: $24,640.00 Amount of Approved Change Orders: N2 1 Revised Contract Amount: $24,640.00 Total Cost Work Completed: $23,935.00 Less Deductions: Liquidated Damages: Days Q$210.00/Day Pavement Deficiencies: Total Deduction Amount: $0.00 Total Cost Work Completed: $23,935.00 Less Previous Payments: Final Payment Due $23,935.00 ;z•out• Zeal 4., Recommended for Acceptance Date Asst. Director, TPW - Infrastructure Design and Construction may tj -- ----2,/�-Xg Accepted A Date Directo , - Y TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Asst. City Manager Date j i r Comments: FUND ACCT:C205-2023202435 E�rA.aLE.�► I FEB 1 1 2016 h fI )ranitiaXt � 'w� ��I FORT NORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WATER,SANITARY SEWER&STREET LIGHTING HSC INDUSTRIAL B Contract Limits Project Type STREET LIGHTING City Project Numbers 02435 DOE Number 7376 Estimate Number I Payment Number 1 For Period Ending 10/26/2015 CD City Secretory Contract Number 117376 Contract Time 120;D Contract Date 4/9/2015 Days Charged to Date 113 Project Manager Ehia Contract is 97.000 Complete Contractor TRI DAL EXCAVATION&UTILITIES INC 540 COMMERCE ST SOUTHLAKE, TX 76092 Inspectors RODGERS / SALINAS t I Wednesday,November 04,2015 Page 1 of4 f City Project Numbers 02435 DOE Number 7376 Contract Name WATER,SANITARY SEWER&STREET LIGHTING HSC INDUSTRIAL Estimate Number 1 Contract Limits Payment Number 1 Project Type STREET LIGHTING For Period Ending 10/26/2015 Project Funding UNIT IR:STREET LIGHTING IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ---------------------- -------------------- 1 2"SCH 80 PVC CONDUIT 645 LF $9.00 $5,805.00 600 $5,400.00 2 1#12 G 645 LF $3.00 $1,935.00 250 $750.00 3 1 ALUMINUM QUAD 2224#6 645 LF $2.00 $1,290.00 600 $1,200.00 4 PULL BOX 1 EA $975.00 $975.00 2 $1,950.00 5 INSTALL PAD MOUNTED CONTRACTOR WITH 1 FA $6,125.00 $6,125.00 1 $6,125.00 METER 6 NEW STREET LIGHT TYPE 18 WITH 33A ARMS 2 EA $4,255.00 $8,510.00 2 $8,510.00 Sub-Total of Previous Unit $24,640.00 $23,935.00 --------------------------------------- r f i f t e f E { I Wednesday,November 04,2015 Page 2 of 4 I t City Project Numbers 02435 DOE Number 7376 Contract Name WATER,SANITARY SEWER&STREET LIGHTING HSC INDUSTRIAL Estimate Number 1 Contract Limits Payment Number I Project Type STREET LIGHTING For Period Ending 10/26/2015 Project Funding Contract Information Summary Original Contract Amount $24,640.00 Chanize Orders Total Contract Price $24,640.00 Jewjwel�_ D t �/ �z% Total Cost of Work Completed $23,935.00 Mont actor Less %Retained $0.00 Date I Net Earned $23,935.00 Inspection Supe ►s f - Earned This Period $23,935.00 �CC /� /2 / t r Retainage This Period $0.00 --C," Date i� Less Liquidated Damages Project Manager Drays Q /Day $0,00 D to ?'Gtr'• /(P LessPaventent Deficiency $0.00 ctorlfPW/infrastructure Design and Construction Less Penalty $0.00 Less Previous Payment $0.00 Director/C tracting Department Plus Material on Land Less 15% $0.00 Balance Due This Payment $23,935.00 I i II i Wednesday,November 04,2015 P*ge3 o1`4 City Project Numbers 02435 DOE Number 7376 Contract Name WATER,SANITARY SEWER&STREET LIGHTING HSC INDUSTRIAL Estimate Number I Contract Limits Payment Number I Project Type STREET LIGHTING For Period Ending 10/26/2015 Project Funding Project Manager Ehia City Secretary Contract Number 117376 Inspectors RODGERS / SALINAS Contract Date 4/9/2015 Contractor TRI DAL EXCAVATION&UTILITIES INC Contract Time 120 CD 540 COMMERCE ST Days Charged to Date 113 CD SOUTHLAKE, TX 76092 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded i Total Cost of Work Completed $23,935.00 Less %Retained $0.00 Net Earned $23,935.00 i Earned This Period $23,935.00 Retainage This Period $0.00 i 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 $23,935.00 Wednesday,November 04,2015 Page 4 of 1 E E i F 540 Commerce ,M. UTILITIES Metro (817)481-2886- - Southlake; TX 76092 Fax {817) 410-8024 AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me,the undersigned authority a Notaq Public: n the state and cowity aforesaid, ori this day personally appeared ScDttLangham,PioiOct Manager of Tri Dal, Ltd,known tome to be a credible jrcrson,who being`by me duly sworn,upou,his oath deposed and said; That all person,ffrnis,associations, corporations or other organizations furnishing labor and/or materials have.been paid hi Rill; That the wage scale established by the City Council in the City of Fort Worth has been paid;and That there are no ch inns pend ing_for persolial injury and/or property c{��rinages; Oji C'Ohftac.-t described aS;. IISC Industrial Buf1din DOE'#:Z37b;Ciiy.Pigiect#: 02435 i ujaterProject# P26S:b02I50243.5= 0 SarufarY Setiver=# P275 702130243500 - RM jv Scat-Ungham tbselil ed _sero 11 t efore°rne on t .11-s 28th;cia5r o;.'July,2.6 3 N. r Janine D4.hazo�� { i r Jl1t�IttL>;f�=Si�A'O NO a1`y p - i t ublle in Tai aitt p 'r�.� f`Ic�ctg3ublfe �Fsf¢off as �OIIll s��laS a� z iYf+�C'a�rrr3fsKron� iris � - , - t f CONSENT OF OWNER ❑ ARCHITECT ❑ SURETY COMPANY CONTRACTOR ❑ ,TO FINAL PAYMENT SURETY OTHER AIA DOCUMENT C70-7 PROJECT: HSC Industrial Building (name, address) Fort Worth, TX TO (Owner) FCity of Fort Worth CFA No.- 2014-051 100 Throckmorton Street CONTRACT FOR: Water, Sanitary and Street Fort Worth, TX 76102 Lighting CONTRACT DATE: April 9, 2015 CONTRACTOR: TRI DAL UTILITIES, LTD. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA ONE TOWER SQUARE., HARTFORD, CT 06183 SURETY COMPANY, on bond Of(here insert name or Contractor) TRI DAL UTILITIES, LTD.- 540 TD.540 COMMERCE ST., SOUTHLAKE, TX 76092 CONTRACTOR, hereby approves of the 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 (here insert name and address of Owner) CITY OF FORT WORTH 100 THROCKMORTON STREET, FORT WORTH, TX 76102 OWNER, as set forth in the said Surety Company's bond, Bond No. 106229771 IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 28th day of July, 2015. TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Stl?e y Company Signature of Authorized Representative A tt.est: /�-- 0eal): Toni Petranek, Witness Trena-e Donovan Title Attorney-In-Fact NOTE:.This form is to used as a companion document to AIA--DOCUMENT G706, CONTRACTORS AFFIDAVIT OF PAYM-ENT ANTTDEBTB AND CLAIMS, Current Edition — — AIA DOCUMENT 0707 - CONSENT OF SURETY COMPANY TO FINAL PAYMENT APRIL-1970 EDITION 'AIA® ONE PAGE t3 1970 - THE AMERICAN INSTITUTE OF ARCHTTECTS, 1735 NEW YORK-AVE., NW,WASHINGTON, D.C. 20006 — f I K WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER !! e POWER OF ATTORNEY L�AVE>L�RJ Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian,Insurance Company Attorney-In Fact No. 229569 Certificate No, 006-399'528 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company,St, Paul Fire and Marine Insurance Company,St, Paul Guardian Insurance Company,St.Paul Mercury Insurance Companyi Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc„is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Clem F.Lesch.Steven W.I-ewis.Eric Lesch,lZoecr Bules,Jennifer Picchi.Trenuc Donovan,and Tonic Petranck of the City of Irving State of Texas their true and lawful Attorneys)-in-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. 1N:WPT14F 8S`AYHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 24th d5y ofJmt�: 2015 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance'lnderwrlters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St,Paul Guardian Insurance Company pASV,{r � �•4tFE6 �*µ.,rNsa {1N9Vq ftY AH° W°� .51�Y� � Zb^O � RyyYb..,.._ Y <��OAPo•Aa>�2 P: `^ F;'t� tT '' � � � t 1977 c' � `�im iJ.°0 0l � twtnonn. < tt_ State of Connecticut By: City of Hartford ss. Robert L.Raney, enior Vice President On this the 24th day of June 2015 before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty ru d_Surety Company of America,and United States Fidelity and Guaranty Company,and,that he,as such,being authorized so to do,executed the foregoing instrument for the-purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 0.1ET , In Witness Whereof,I hereunto set my hand and official seal. My Commission expires the 30th day of June,2016. Or �UbUG Marie C.Teircauli,Notary Public - l 58440-8-12 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER j WARNING:THIS POWER OFATTORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company,Ffdeli1 and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,-Inc.,St.Paul Fire and Marine Insurance Company,St. Paul Guardian Insurance Company,St_Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty mid Surety Company of America,and United States Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-jn-Fact and Agents to act for and on.behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power-given-him or her;and it is FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Viee-President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature ofd bond,recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,-or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President, any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds ' and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. 1,Kevin E.Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.;St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company do hereby certify that the above and"foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked. - - IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this'81h day of f Kevin E.Hughes,Assistant Sect9tary GA6LAl �11RC Q �i�1�S0 �INSLq �JT,Wpr - ~ 19 S 2 0 � 1977 �+ m j x i n HNrIFOPD, � �7 tiL'itPJnA� < � i 4 's a o o SB1i1;•.e W S To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.tmvelersbond.com.Please refer to the Attorney-In-Fact number,the above-named individuals and the details of the bond to which the power is attached. I WARNING:THIS POWER OF ATTORNEY IS INVALID WrfHOUTTHE RED-BORDER x� �y l 540 Commerce UTILITIES Metro (817) 481-2886 Southlake,-TX 76092 Fax (817) 410-8024 AFFIDAVIT STATE OF TEXAS COUNTY OF`1"ARRANT Before me, the tindersigned authority a Notary Public in the shite lud county aforesaid,.on this city Personally appeared Scott Langham,Project Manager of Tri Dal, Ltd;known to the to he a credible person,who being by me duly sworn, tlpon his oath. deposed and said; That all person,finlls; associations, corporations or other organizations f irnishing labor`and/or materials have been Haid 111 Rill; That the wage-scale establislied by the City Council in the City of Fort Worth has been paid; and That there are no claims pending for personal injury and/or property daniages; On Contract described as; HSC Industrial Buildint DOE#: 7376 City Project#: 02435 Water Proicet#:P265-6021502435-00 Sanitary Sewer#: P275-7021302435-00 BY: i Scot all lam Subscribed and sNvoln before me ori this 12th day of November, 2015 - BY: rtiC �, J Wit' "�� ;{t: � > 4' = JI�NIME e�slia�o h Janine DeSlia a C1 _' � Noteiy EublIG,Slate of iafc -IV GOMM'tsston Exptaes Notary Public in Taii•ant July 0 , 2019 ` County,Texas 9 d i k f I I A o ,rte R H REV:02/22107 TRANSPORTATION AND PUBLIC WORKS' CONTRACTOR'S EVALUATION OF,CITY 1)PROJECT INFORMATION Date: F11/10/2015 Name gfcorr/raclor r Pr( ecl,i'arpe Tri-Dal Utilities I.1SC Industrial DOF.hispsctor' Projecl,I tare i-ei' Martina Salinas — Red Elea 110E r1'uumer Projecl Df j%ictthy 7}pe ojC.'onlract 7376_ O Simple OO Routine 0 Complex ❑Water i]Waste Water ❑Storm Drainage L Pavement Irrilial Contract Aniaunl - Final contract Amount $2,460.00 $23,935.00 11)PERFORMANCE EVALUA'T'ION 0-Inadequate I -Deficient 2-Standard 3-Good 4-Excellent _ FLF\1FNT RATING FI,FNIE'Nl RMING INSPECTION EVALVATION PLANS Sz SPECIFICATIONS ---- _ _ I Availability of Inspector F l Accuracy of Plans to Existing Conditions j - r -- nspttor 3 Ac Knowledge -�21__ 3 Applicabili[3 otfSpocifieltions[s 4 Display Of Professionalism �4 Accuracy of Plan.Quantities S Citizen Complaint Resolution �C PROJECT MANAGE,R EVALUATION 6 Performance-setting ith Valve Crews,Labs -1 KtiotiN,ledge Aii(VOr Problem Resolution AllM.INISTRATION 2 Availability of'.Project Manager f` l Change Order Processing Time _ - 3 Comtnunlcattolt _ 2 Timliness,of Contractor Paymenise 4 Resohttion o_f Utilitjt Conflicts — 3 Bid Opening to Pre-Con Meeting Titnefi•attte III)COMMENTS&SIGNATURES COMAJENTS T� Signature Contractor '� s Signature DOE Inspector A i Signature DOE Inspector's Supervisor t Imspm,roTt'5 COMI ENTS a 'iRANTSPDXIWrION'A-NND PUBLIC 1CTORKS j. The City of Fort\North 1000'Throckinorton Street•Fort ZNortli, ,06012-63`11 f (817)392-7941 Fqx:(317)392-7845 i E i { { FORT WORTHV:0z,2o,0' TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR I) CONTRACTOR&PROJECT DATA iVame of Contractor Project Name Tri-Dal Utilities HSC Indush•ial Building DOL Inspeclor DOE Number Martina Salinas 7376 DOE Ltspeclor Project Manager ❑ water El Waste Water❑ Storm DrainageD Pavement Fred Ehia Inittal Contract Amount Project Diffilculty $2,460.00 0 Simple Q Routine 0 Complex Final Contract Amount Dale $23,935.00 11/10/2015 II)PERFORMANCE EVALUATION 0-Inadequate I-Deficient 2-Standard 3-Good 4-Excellent ELEMENT IWEIGHT(x) APPLICABLE(Y/N) RATING(0-4) 1 MAX SCORE ISCORE I 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 3 60 45 6 Finished Product 15 Y 4 60 60 7 Job Site Safety 15 Y 4 60 60 8 Traffic Control Maintenance l5 Y 4 60 60 9 Daily Clean Up 5 Y 3 20 15 10 Citizen's Complaint Resolution 5 N II Property Restoration 5 Y 4 20 20 12 After Hours Response 5 N 13 Project Completion 5 Y 2 20 10 TOTAL ELEMENT SCORE(A) 356 BONUS POINTS(25 Maximum)(B) III)CONTRACTOR'S RATING TOTAL SCORE(TS) 356 Maximum Score(NIS)=448 or sum of applicable element score maximums whiclt= 408 Rating(ITS/MSI a 100%) 356 1 408 = 87% Performance Category Excellent <20%=Inadequate 20%to<40%=Deficient 40%to<60 o=Standard 60'�b to<80%=Good ?S(1%=Excellent Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS ANVVARDED) ff� f � I Signature DOE Inspector Signature Contractor "--Q Signature DOE Inspector's Supervisor CONTRACTORS col+*AEIVTs TR-A-Nt SPORTATIO'd AND PUBLIC FORKS ' The City of Fort Worth•1000 Throckmorton Street•Fort Word,T-X-76012-6311 (817)392-7941•Fat-(817)392-7845 FORT WORTH , TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME STATEMENT# 1 FINAL STATEMENTH Final DOE 7376 NAME OF PROJECT: HSC Industrial Building Conn actor ;. .. A YEAR:j 2015 PROJECT NO.: FINAL INSPECTION DATE 181-21)E; #/02435 1 WD D CONTRACTTIME 1 120 1 x PERIOD FROM: 9/16/2015 TO: 1 9/21/2016 1 MID Month IDEVELOPNIM11(Y/N y WORK ORDER EFFECTIVE: 6/1/2015 BEG !n n MID /n DAY OF MONTH DAYS REASON FOR DAY OF MONTH DAYS REASON FOR CIIARCED DAYS CREDITED CHARGED DAYS CREDITED 1 Tue 16 Tue 1 2 Wed 17 Wed 1 3 Thu 18Thu 1 4 Fri _19 Fri 6_ Sat 20 Sat 1 6 ---_Sun21 Sun 1 -7 Mon 22 Mon 1 8 Tue_ 23 Tue 1 9 Wed __ 24 Wed_ 1 10 Thu _ _ _ 26 Thu 1 11 Fri 26_ Fri 1 12 Sat 27 Sat 1 13 Sun 28 Sun 1 i 14 Mon 29 15 Tue 30 31 NA Wkn&Hol Wea utl Oth Not Applicable SAT,SUN,and WEATHER UTILITIES OTHERS DAYS TOTAL DAYS HOLIDAYS RELOCATE CHARGED THIS PERIOD 0 0 0 0 13 13 PREVIOUS PERIOD 0 100 100 TOTAL TO DATE 0 0 0 0 113 113 REMARRS: _/ sa Signature: `; Signature: 'yl (Print Name) (Print Name) Martina Salinas CONTRACTOR "!'i j ft's- DATE INSPECTOR nAzs 7 0/2712015 } I