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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 ------------------------------------- i i I t t Friday,January 29,2016 Page 2 of 4 i F d 6E� i 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 a Friday,January 29,2016 Page 4 of 4 i P E i i 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 Ib a i i -- 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 } i i 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