HomeMy WebLinkAboutContract 45838-FP3 Department of TPW Const. Services
DOE# '� Date
Project ManagerLIN/A-1 ,
Risk Management S. Ca ad I� l- RT WORTH, r- 's C % r_0
D.O.E. Brotherton ;�O ��'3� � I.3
C,��E�
CFA Westerman/Scanned ❑ ' �l4�T �'
The Proceeding people have been Contacted concerning the request rATION AND PUBLIC WORKS
for final payment&have released this project for such payment. )F PROJECT COMPLETION /
Clearance Conducted By Etta Bacy 4 II�G D.O.E. Ns: 7201
l(o �S#<f5fJ3�
Regarding contract 117201 for TRAILS OF FOSSIL CREEK PHASE IV 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: $719,685.10
Amount of Approved Change Orders: No 1
Revised Contract Amount: $719,685.10
Total Cost Work Completed: $719,685.10
Less Deductions:
Liquidated Damages: Days @$210.00/Day
Pavement Deficiencies:
Total Deduction Amount: $0.00
Total Cost Work Completed: $719,685.10
Less Previous Payments:
Final Payment Due $719,685.10
Recomm nded for Acceptance Date
Asst. Diector, TPW - Infrastructure Design and Construction
Accepted Date
=Director,
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT
Asst. City Manager Date
Comments: FUND:PAVING C205-475220-2077602251 J STREET LIGHT:C205475220-2073202251
FEB 2 2016
initial...�� '
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name TRAILS OF FOSSIL CREEK PHASE IV
Contract Limits
Project Type PAVING;&STREET LIGHTING
City Project Numbers 02251
DOE Number 7201
Estimate Number 1 Payment Number 1 For Period Ending 1/31/2016
W
City Secretary Contract Number 117201 Contract Time 18W
Contract Date 7/21/2014 Days Charged to Date 469
Project Manager Long Contract is 100.00 Complete
Contractor JACKSON CONSTRUCTION LTD
5112 SUN VALLEY DRIVE
FORT WORTH, TX 76119
Inspectors RODGURS / DEYON
Friday,January 29,2016 Page I of4
L
City Project Numbers 02251 DOE Number 7201
Contract Name TRAILS OF FOSSIL CREEK PHASE IV Estimate Number 1
Contract Limits Payment Number I
Project Type PAVING&STREET LIGHTING For Period Ending 1/31/2016
Project Funding
UNIT I:PAVING IMPROVEMENTS
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
---------- -----------------------------
1 --------- -----------------------------
1 3213.0101 6"CONC PVMT 15195 SY $30.50 063,447.50 15195 $463,447.50
2 3211.0400 HYDRATED LIME 292 TN $164.00 $47,888.00 292 $47,888.00
3 3211.05016"LIME TREATMENT 16213 SY $3.50 $56,745.50 16213 $56,745.50
4 321103014"CONC SIDEWALK 2502 SF $4.30 $10,758.60 2502 $10,758.60
5 3213.0501 BARRIER FREE RAMP,TYPE R-1 7 EA $900.00 $6,300.00 7 $6,300.00
6 3216.0101 6"CONC CURG AND GUTTER 5 LF $30.00 $150.00 5 $150.00
7 3292.0100 BLOCK SOD PLACEMENT 10189 SY $4.00 $40,756.00 10189 $40,756.00
8 3292.0400 SEEDING HYDDROMULCH 2125 SY $1.00 $2,125.00 2125 $2,125.00
9 3441.4003 FURNISHANSTALL ALUM SIGN 4 EA $500.00 $2,000.00 4 $2,000.00
GROUND MOUNT CITY STD.(STOP SIGN)
10 9999.0003 END OF ROAD BARRICADE 1 EA $900.00 $900.00 1 $900.00
11 9999.0004 CONCRETE HEADER 29 LF $3.50 $101.50 29 $101.50
---------------------------------------
Sub-Total of Previous Unit $631,172.10 $631,172.10
UNIT II:STREET LIGHTING IMPROVEMENTS
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 3441.3002 RDWY ILLUM ASSMBLY TY 8,11,D- 24 EA $1,800.00 $43,200.00 24 $43,200.00
25 AND D-30
2 3441.3301 RDWYILLUM FOUNDATION TY 1,2 24 EA $950.00 $22,800.00 24 $22,800.00
AND 4 I
3 2605.3016 2"CONDT PVC SCH 90(B) 1141 LF $10.00 $11,410.00 1141 $11,410.00
4 3441.3101 100W HPS PC LIGHTING FIXTURE 24 EA $320.00 $7,680.00 24 $7,680.00
5 3441.1409 NO 8INSULATED ELEC CONDR 3423 LF $1.00 $3,423.00 3423 $3,423.00
--------------------------------------
Sub-Total
-------------------------------------Sub-Total of Previous Unit $88,513.00 $88,513.00
-------------------------------------
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Friday,January 29,2016 Page 2 of 4
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City Project Numbers 02251 DOE Number 7201
Contract Name TRAILS OF FOSSIL CREEK PHASE IV Estimate Number 1
Contract Limits Payment Number 1
Project Type PAVING&STREET LIGHTING For Period Ending 1/31/2016
Project Funding
Contract Information Summary
Original Contract Amount $719,685.10
Change Orders
Total Contract Price $719,685.10
Date v`- ,rn Total Cost of Worlc Completed $719,685.10
C itra for
Project Manager Less %Retained $0.00�
Date
Net Earned $719,685.10
CJS
Inspection Supervisor Enrned This Period $719,685.10
c� _ Retainage This Period $0.00
Date�� Less Liquidated Damages
711, Days @ /Day $0.00
/ Da 'I •Zol fp LessPavement Deficiency $0.00
Asst irect/or/TP/W-� /Infrastructure Design and Construction Less Penalty $0.00
e 15 ti, t i Date 1//b 4v1e Less Previous Payment $0.00
Director/ ontracting Department Plus Material on Hand Less 15% $0.00
Balance Due This Payment $719,685.10
Friday,January 29,2016 Pane 3 of 4
City Project Numbers 02251 DOE Number 7201
Contract Name TRAILS OF FOSSIL CREEK PHASE W Estimate Number 1
Contract Limits Payment Number I
Project Type PAVING&STREET LIGHTING For Period Ending 1/31/2016
Project Funding
Project Manager Long City Secretary Contract Number 117201
Inspectors RODGERS / DEYON Contract Date 7/21/2014
Contractor JACKSON CONSTRUCTION LTD Contract Time 180 W
5112 SUN VALLEY DRIVE Days Charged to Date 469 W
FORT WORTH, TX 76119 Contract is .000000 Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
_ T J
1
Total Cost of Work Completed $719,685.10
Less %Retained $0.00
Net Earned $719,685.10
Earned This Period $719,685.10
1
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 $719,685.10
r
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Friday,January 29,2016 Page 4 of 4
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PHILADELPHIA
INSURANCE COMPANIES
A Member of the Toklo Marine Group EXHIBIT H f
i
CERTIFICATE REGARDING PROJECT COMPLETION
(Obligee)
The undersigned,Jackson Construction,LTD,hereby certifies to Philadelphia Indemnity Insurance
Company("Sure-V')together with its underwriting manager,Maguire Insurance Agency,Inc.,and Fossil Creek
A2A Developments,LLC,and/or their respective agents,successors and assigns,as follows with respect to the
Pavement,Erosion Control,Illumination at Phase IV The Trails of fossil Creek:
1. All work to be performed by Contractor pursuant to the Contract has been
completed.
i
2. The Obligee has accepted the Project.
3. To the knowledge of Obligee,all persons or entities who have supplied labor,
material or services to the Project at the request of or for the benefit of Contractor
have been paid in full.
4. To the knowledge of Obligee, no person or entity has any claim against the or
Obligee for any labor,material or services provided to the Project.
5. Obligee has no knowledge of any actual or threatened claim against the Bonds or
mechanic's lien against the Project.
Dated:
Jackson Construction,LTD
Signature:
Name:. Troy Jackson
i
Title:_Vice a PreSident
Date:h
otaiy Pub is
SwOYp to and subscribed by me this then/`--day q,�,,,
of
r
' a:ApCARMEN L. ESiEP
��� y Pubtfc.Sfate of ie xos
/� Commission Ex iMy Commission Expires:tJ ... ril 06 20 Pres
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-- PHILADELPHIA.
INSURANCE COMPANIES
AMdmberofthe TaktoMarine croup EXHIBIT G
CERTIFICATE REGARDING PROJECT COMPLETION
(Contractor)
The undersigned,Fossil Creek A2A Developments,LLC,hereby certifies to Philadelphia Indemnity
Insurance Company("Surety")together with its underwriting manager,Maguire Insurance Agency Inc.,and
Jackson Construction,LTD,and/or their respective agents,successors and assigns,as follows with respect to the
Pavement,Erosion Control,Illumination at Phase IV The Trails of Fossil Creek:
1. All work to be performed by Contractor pursuant to the Contract has been
completed.
2. The Obligee has accepted the Project.
3. All persons or entities who have supplied labor, material or services to the Project
at the request of or for the benefit of Contractor have been paid in full.
4. No person or entity has any claim against Jackson Construction,LTD,or
Contractor for any labor, material or services provided to the Project.
5, Contractor has no knowledge of any actual or threatened claim against the Bonds
or mechanic's Iien against the Project.
All capitalized terms used herein and not defined herein shall have the meanings set forth
in that certain Funds Disbursing Agreement between Contractor and Surety dated 6/4/2014,
Dated:
•Int ompany name '
Signatuiey
Name: Troy L. qac a on
Title: / Vice • President
Date: l�oC / o/S
o a Public
Sw rn to and subscribed by me this the day
of/�LQ�--
F �/ j�/ FR(P.aI CARMEN L.
EST
EP
My Commission Expires:V� l�lo�/(P °y' �
z:-Jy�, _ Notary Public,State of Texas
a" F .`°'c M Commission Expires
April 06, 2016
.PHILADELPHIA
INSURANCE COMPANIES
A Member of the 1'okio Marine Group
EXHIBIT F
FINAL RECEIPT WAIVER AND RELEASE OF CLAIMS
Upon receipt of final payment in the amount of$7D,151, /1 on behalf of Fossil Creek A2A
Developments,LLC for labor,materials,equipment and services provided by the undersigned to Contractor on or
with respect to the Pavement,Erosion Control,Illumination at Phase IV The Trails of Fossil Creek,the
undersigned waives any and all mechanics' lien rights and claims it has or may have with respect to the Project,and
releases and forever discharges Jackson Construction,LTD,Fossil Creek A2A Developments,LLC and/or
Philadelphia Indemnity Insurance Company and its underwriting manager,Maguire Insurance Agency Inc.,and
their respective officers,directors,employees,sureties, insurers,disbursing agents and representatives from any and
all claims for payment,including but not limited to payment bond claims.
Dated: JACKSON CONSTRUCTION, LTD
(Print company name)
Signature:
Name: Troy L, Jackson
Title: slice e PreSident
Date: I��J�d/
otary Public
Sworn to and subscribed by me this th�day
o j 41'fi
My Commission Expires.p��o��aaI(e �-
s' CARMEN L. ESTEP
No tory Public,State of Texas
.� My Commission Expires
PLEASE COMPLETE AND RETURN TO: :,;;`4. April ob, 2016
..�
CONSTRUCTION LTD.
5112 SUN VALLEY DRIVE
FORT WORTH,TX 76119
TEL:817-572-3303
FAX:817-478-0443
Affidavit of All Bills Paid
STATE OF TEXAS
KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF TARRANT
I, Troy L. Jackson, of the undersigned principal hereby certify that all
obligations, claims and debts due laborers, materialmen, subcontractors,
suppliers, and others incurred in or contingent to the performance of the
work on the project known as Trails of Fossil Creek, PH IV in the
City of Fort Worth, Texas have been fully paid.
This affidavit is made for the purpose of obtaining payment from the
City of Fort Worth on above construction work.
Subscribed and sworn to before me this Jackson Construction, Ltd.
Principal
Inth Day of December,2015
JAW X By:
k-Nbtary Signatur Troy L.Jacks n,Vice Pr4sident
Commission Expires: 04/06/2016
CARMEN L ESTEP
=_ Notary Public,State of Texas
<c �h Commission Expires
V; ...
April 06, 2016
JER_�I,l� I-IGt1�1��
January22, 2016
Mr. Larry Jackson
Jackson Construction, LTD.
5112 Sunvalley Dr.
Fort Worth, Texas 76119
RE: Trails of Fossil Creek Phase IV—Water, Sanitary Sewer and Storm Drain
Improvements
CoFW Project No. 02251
CoFW File No. W-2310
CoFW DOE No. 7201
Mr. Jackson,
This letter will document that Fossil Creek A2A Development LLC confirms that Jackson
Construction, LTD has completed the Work associated with the above referenced
contract in an appropriate timeframe, subject to completion of any warranty or
maintenance work as identified and required by the City of Fort Worth, and that no
liquidated damages will be assessed by Fossil Creek A2A Development LLC in
connection with the Work.
Fossil Creek A2A Development LLC
By:
Ron Ramirez, P.E.
Executive Vice-President
Engineering
Se:ene Development, LLC
548 Silicon Drire Suite i,30 Sculhlcke TX 7609'_' USA
Lel: 1 682 333 0101 Fax: 1 817 775 blSr_i5
`.e V,'!R•,SErenchORi�S,Ct;6il
CONSENT OF SURETY OWhiFR ❑
TO FINAL PAYMENT AR=TrCT o
ALA Document G707 CONTRACTOR ❑
SURETY 93
Bond No. BCD1032105 OTHR.R ❑
TO ONVNER ARCHITECT'S PROJECT NO.:
(Name turd adttr2.n)
Fossill Creek A2A Developments, LLC
CONTRAC.17 FOR. Paving and Street Light Improvements
PROJECT': CONTRACT DATED:
(Name and aMv..;o
Trails of Fossil Creek Phase IV
i
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the
(Jawtnatneand .19
The Hanover Insurance Company
440 Lincoln Street
Worcester MA 01653
SURF,TY,
on bond of
(Insert Ha1t1BAltd adtlntci q�tblttrrrCtwy
I
Jackson Construction, Ltd.
5112 Sun Valley Drive
Fort Worth TX 76119
i
CONTRACTOR, i
hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor Shall not relleve the Surety of
any of Its obligations to
(limit umna and adtbvs`gfouwar)
Fossill Creek A2A Developments, LLC
own,
as set forth in said Surety's bor4
IN VnTNESS w1AGREOF,the Surety has hereunto set its hand on this date: December 21, 2015
(nnatibajm7htRtbe,#nontbfallouedkPIke wonaicdwevadiwry I
The Hanove surance Company
By:
ffs�vlawir oJetrttborizad trptwr�rtatrl�
' ` Jack M.Crowley Attorney-in-Fact
{Arz7ued rmrne mxl aide)
Surety Phone No. 508-853-7200 x-4476
G707-1994
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 Attorneys)-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
Attorneys-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 ofcitation 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 Attorneys-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 14ANOVt R INSURANCE COMPANY
k r o � . ftAASSACHtfSE I'T5 BAY INSURANCE COMPANYur��P& CITIZENS SURANGEROMPANY OF AMERICA
, }�
a 1rar4 f
Robert Thomas,Vice PEtlsident
THE COMMONWEALTH OF MASSACHUSETTS
COUNTY OF WORCESTER )ss. Joe.8renstrom, _ick 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.SARL{GK
'F Notary Public , s
,g��eT Ccmm�naeallh of MasSdtttuseN9
Aty Gcrrrtrn'Sior.Exp'tii Sey:.2t,2218 . ..
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 ofAmerica,
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 ofAttomey 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 September7,2001-Citizens Insurance Company of
America)
GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 21st day of December 2015.
THE HANOVER INSURANCE COMPANY
MASSACHUSETTS BAY INSURANCE COMPANY
CITIZENS INSURANCE COMPANY OF AMERICA I
ieiin Margosian,Vice President
}
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FORTWORTHREV:02/22/07
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
I)PROJECT INFORMATION Date: 1/22/2016
Naure ofContractor Project Name
Burnsco Construction Trails Of Fossil Creek Phase IV
DOE Inspector _Project Manager
GaEZ Demon Aaron Long
DOE Number - Project D cu/h, Tipe of Contract
7201 O Simple OO Routine O Complex ❑ Water❑ Waste Water LJ Storm DralnageD Pavement
Initial Contract Amount /ina!Contract Amount
$719,685.10 $719,685.10
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 ins ector �- I Accuracy of Plans to Existing Conditions
2 Knowledge of Inspector 2 Clarity&Sufficiency of Details _--
3 _Accu acc off Measured quantities 3 Applicability of Specifications
4 Dimes la Of Professionalism 4 Accuracy of Plan(quantities
5 Citizen Complaint Resolution__ _ PROJECT MANAGER EVALUATION-
6 Performance-Settin u Valve Crews,Labs M I I{nowledge And/Or Problem Resolution i
ADMINISTRATION 2 Availability of Project Manager _ 7
1 Change Order Processing Time meM 3 Communication
2 Titnthtess of Contractor Payments 4 Resolution of Utility Conflicts
L Bid Opening to Pre-Con Meeting Thnefiiame u�g
III)COMMENTS&SIGNATURES
COMMENTS
Signature Contractor
Signature DOE Inspector
Signature DOE Inspector's Supervisor
INSPECTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TY 76012-6311
E_` 1
(817)392-7941 •F2x:(817)392-7845
FORTWORTH REV:02/20/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
I CONTRACTOR&PROJECT DATA
Name of Contraclor Project Name
Jackson Construction Trails Of Fossil Creek Phase IV
DOE Inspector DOG Number
Gary De on . 7201
DOE Inspector Project Manager
❑ Water❑ Waste Water❑ Storm Drainageg Pavement Aaron Lon
Initial Contract Amami Project Difficulty
$719,685.10 O Simple OO Routine O Complex
Final Contract Amount Dale
$719,685.10 1/22/2016
11)PERFORMANCE EVALUATION
0-Inadequate I-Deficient 2-Standard 3-Good 4-Excellent
ELEMENT WEIGHT(x) APPLICABLE Y/N RATING 0-4 MAX SCORE SCORE
1 Submission of Documents 2 Y 4 8 8
2 Public Notifications 5 Y 4 20 20
3 Plans on Site 5 Y 4 20 20
4 Field Supervision 15 Y 4 60 60
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 2 60 30
9 Daily Clean Up 5 Y 2 20 10
10 Citizen's Complaint Resolution 5 Y 1 4 1 20 1 20
11 Property Restoration 5 Y 4 1 20 1 20
12 Atter flours Response 5 Y 4 20 1 20
13 Project Completion 5 Y 4 20 1 20
TOTAL ELEMENT SCORE(A) 363
BONUS POINTS(2S Maximum)(B)
TOTAL SCORE(TS) 363
111)CONTRACTOR'S RATING
Maximum Score(MS)=448 or sum of applicable element score maximums whielt= 448
Rating(JTS/MS) *100%) 363 1448 = 81%
Performance Category Excellent
<20%=htadequale 20YSIn<40%=De/tcienl 40%to<60%=Standard 60%to«p%=Good >-80%=Excellent
Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AIVARDED)
Signature DOE Inspector Signature Contractor-
Signature DOE Inspector's Supervisor GLi�
CONTRACTOR'S COMMENTS
M--kNSPORTATION AND PUBLIC WORKS
City of Fort Worth•1000 Throckmorton Street•Fort Word,TL 76012-6311
(817)392-7941•Fax:(817)392-7845
FORT WORTH
TRANSPORTATION AND PUBLIC WORKS
STATEMENT OF CONTRACT TIME
LNANTE
ATEMENT#
NAL STAT-MLN"T'/{ 1
OF PROJECT': DOE 7201
Trail of Fossil Creek Phase IV Wate7:ii
Contractor Burnsco
AR: 2016
PROJECT NO.: AL INSPECTION DATE Z— -ZO)
2251
WD CD
I 190 X
PMI2TOD FROM; 1/16/2016 'TO: 1/31/2016 BEG - Month I II)LVELOPAIENI Y/N N
WORK ORDER EFFECTIVE; 8/2012014 BEG(v I n) I MID r„)
DAY OF MONTH DAYS REASON FOIL UAV OF MON7'il DAYS REASON FOR
CHARGED DAYS CREDITED CHARGED DAYS CREDITED
1 Sat 0 na 16
2 Sun 0
3 Mon 0 na 18
4 Tue 0 na 19
-6 Wed 0 na 20
6- ---- Thu- 0 na 21 — - -
7 _ Fri 0 na 22
8 Sat 0 na - 23 -
9_ Sun- 0 na 24
10 Mon 0 na 25 _
11 _ Tue 0 na 26
12 Wed 0 na - 27
13 Thu 0 na 28
14 Fri 0 na 29
15 Sat 0 na 30
31
NA Wkn&Hol Wea utl Oth
Not Applicable SAT SUN,mid WEATHER UTILITIES OTHERS DAYS TOTAL DAYS
HOLIDAYS RELOCA'T'E CHARGED
THIS PERIOD 0 0 0 0 0 p
PREVIOUS PERIOD 0 469 469
TOTAL TO DATE 0 0 0 0 469 469
REMARK5:
Completed and Final on 12/1/2015
Signature:g �� Signaturr.
j 4
(Print Name) �' f f � } �j f f— (Pant Name) Gn'ry De�•on
CONTRACTORINSPECTOR
DATE