Loading...
HomeMy WebLinkAboutContract 46980-FP1 CITY SFS NIV ReC61ved By COM CT Business Support Group Brandy Crane CITY OF FORT WORTH EEB'0 5 2015 NOTICE OF PROJECT COMPLETION Regarding Contract No. 46980 for Emulsified Asphalt Fog Seal 2015, CPN 02537 which was requested by the Transportation and Public Works Department and approved by the City Council on July 21, 2015 through M&C C-27359 the Director of the Transportation and Public Works Department, upon the recommendation of the Assistant Director of the Transportation and Public Works Department, has accepted the project as complete. Contractor: Innovative Roadway Solutions, LLC Original Contract Price: $ 192,000.00 Amount of Approved Change Orders: $ 39,360.00 Revised Contract Amount: $ 231,360.00 Total Cost Work Complete: $. 231,342.78 Less Liquidated Damages: $ 0.00 Days_ @ $ Less Penalty: $ 0.00 Total Contract Cost: $ 231;342.78 Less Previous Payments: $ 208,208.50 Final Payment ue: $ 23,134.28 I - T6 Recommen e fo Acceptance Date Assistant Director, Transportation and Public Works i U. AcceptedDate Director, ransportation an Public Works I �Jp I City anager VDate OFFICIAL RECORD CITY SECRETARY F? WORTH, TX INNTPW Construction Invoice Contract: CS46980 P.O.# PO 15$9772 y h y Payment Date; D�6/201St TO:INNOVATIVE ROADWAY SOLUTIONS INV.# Estimate No. 3 DOE: HC 64 BOX 96-A ProjManager TARIQUL ISLAM THAYER MO 65791 FOR: EMULSIFIED ASPHALT FOG SEAL APPLICATION 2015 AT VARIOUS LOCATIONS Contract Amount: $231,360.00 Completed Ret Adj Pay Total to Date: $231,342.78 $0.00 $0.00 $231,342.73 Previous Estimate: $231,342.73 $23,134.28 $0.00 $208,203.50 Earned to Date: --- $0.00 ($23,131?8) - - $0.00 ---- S23134.28 Payments: C293-541200-201640253783 $237,360.00 -C091-$39,360.00 Total to Date: $231,342.78 $0.00 $0.00 $231,342.78 Previous Estimate: $231,342.73 $23,134.23 $0.00 $208,203.50 EamedtoDate: $0.00 ($23,134.23) $0.00 $23,134.23 . Coninct Pemon-B-RANDY CR-. IE-Cxt.2352 1 3crarin�eat '-.Ppr%� amt ai natu:. o�y�� j DEPA,RTylciJTCHECK.PICK-UP 1'ES ❑ Wednesday,March 02,2016 Page 1 of 1 m a v c m to 0 cNp =- - U o Q o VoiN _ = N N M MM NMN MN O N N9 fR 64 69 (A 6g dt di EA f/i i9 Vf -.- .; �n� `►� T 10 E m o o d � v 0 E.:, a� w U A : o - - � „V„ � vFi � a. F m � a •� i j N - p a \� a ¢ U O d A a DC DC F d w cat 0u a � v U by d en U U w d w F w C7 U a zU II N a = oCd u 22-2 � € G b o w o z o � aEowy °1G � ao it a`_:::3 c % Fi ai a_`J.K • ,"a •a m oa�_a$ y � �cM 12 C > ?ias o 0 0 3 0 I E 8 � r�>8C W V O o y❑o U $ v u �.j � c � �a a R o m o d y o o u'd o •`�v° `�A'a o p N00C a o 0 o a 4�y oda 0 0 0 u o y [� ' o o �°o a v t00 bo eq � a a d ++ '+a y >4a g 3 y � , v F W W � °1 0 oVa V Z 0 FO U O •o w°w y o u bc� a N d (j [� ow� a.3auEV 3/212016 BuySpeed Online Online Accounts Payable Basic Purchasing Department Access N1GP Code Browse I My Account I Customer Service I About Current Organization,MY OF FORT WORTH March 2,201611:45:58 AM CST Home Documents I Brandy Crane ------—-------—-------- Invoice M CS469130-FINAL Vendor#:0000038624 Vendor Group#:01 status:4JR-Reidy for Approval General Items Credits Subcontractors Accounts Routing Attachments Notes Reminder Change Order Summary Back to PO General Validation Warnings You are going to final pay the following partially paid po Items:(1]. ader Information Invoice Number: C846980-FINAL Invoice Status. 41R-Ready for Invoice Type: 3 way Approval matching Invoice Description: CS46980-FINAL EMULSIFIED ASPHALT FOG SEAL APPLICATION 2015 AT Invoice Date: 11/06/2015 Effect Date: 03/02/2016 VARIOUS LOCATION Payment Amount: $23,134.28 Handling Code- ACH(DIRECT DEPOSIT) Payment Date: 12/01/2015 Payment Terms: Payment Tenn 0 Payment 0.0% Day: Discount: Paid-Bank/Check: Alternate Id: Entered By; Brandy Crane Entered Date: 0310 2/201 6 Credit Amount: $0.00 Updated By: Brandy Crane Updated Date: 0310212016 Received Date: 111061201511:41:00 AM Attachments Agency Files: Agency Forms: Vendor Files: Vendor Forms: Purchase Order Information Purchase order PO-15-00089772 PO Description CS46980 Number: PO Amount: $231,360.00 Remaining To $17.21 Buyer: Brandy Invoice: Crane PoVendor Information Vendor: 0000038624-INNOVATIVE ROADWAY SOLUTIONS LLC Address Grp: 01 Vendor Remit-to Kevin AraSmfth Address- INNOVATIVE ROADWAY SOLUTIONS LLC HC 64 BOX 96-A THAYER,MO 65791 USA Fed ID: -6349 Remit Text: EM211:christophorkinder@yinalhoom Phone:(417)270-0021 FAX:(999)999-9999 Id:110840 iNiscvu Freight Invoice Account Event Type Fiscal Year Account Coda Transaction Amount Misc 16 39408-0200410-5740010--0O2537-006483-- -$0.01 Misc 16 39408--2060000--0O2537-CRETAN-- $23,134.28 Total: $23,134.27 Item Information Invoice Item#/PO Item#.1 EMULSIFIED ASPHALT FOG SEAL APPLICATION 2015 AT VARIOUS LOCATIONS C293-541200-201640253783 CS46980 M&C C-27359 DATE 072115 PO Permit Invoice Discount% Original Final Item Status To Pay Amount Pay Amount pay 3PPR-Partial Receipt $0.00 $0.01 0.0% $0.00 Yes MAKE: ASSET MODEL: hftps:/Ibso.fbrtworthtexas.govibsotpurchaseorderfinvoice/invoiceSummary.sdo?vendorld=0000038624&docld=PO-15-00089T72&releaseNbr=O&doGType=l&m... 1/2 3/2/2016 BuySpeed Online ASSET MANUF: ASSET SERIAL: ASSET VIN: ASSET TAG: Event Type Fiscal Year Account Code Transaction Amount Exp. 16 39408.0200410-5740010--CO2537-CO6483-- $0.01 Enc. 16 39408-0200410-5740010--CO2537-CO6483-- -$0.01 Approval Path: Delete Approver Order Approval Levet Approver Date Date [ApprovedM!sapprovedfCanceled Comment Sequence Path Type Requested Approved/DlsapprovedlCanceled by view ID Add New Primary Add/DeleteApprover If?fint i Copyright©2016 Periscope Holdings,Inc.-All Rights Reserved,default i https:Hbso.fortworthtexas.gov/bso/purchaseorderfiinvoice invoiceSummary.sdo?vendorld=0000038624&docld=PO-15-000897/2&releaseNbr=0&docType=Mm... 212 CONSENT OF OWNER F SURETY COMPANY ARCHITECT F-1 TO FINAL PAYMENT CONTRACTOR F-1 AIA DOCUMENT G707 SURETY OTHER Bond# 1121971 PROJECT: Emulsified Asphalt Fog Seal Application 2015 (Name and Address) -— TO(Owner) F ARCHITECT'S PROJECT NO.: (Name and Address) City of Fort Worth 1000 Throck Mortan Street Fort Worth,TX 76102 CONTRACT FOR: L CONTRACT DATED: CONTRACTOR: Innovative Roadway Solutions,LLC (Name and address) HC 64 96A-Thayer, MG 65791 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) Lexon Insurance Company 12890 Lebanon Rd. - Mount Juliet,TN.31122, SURETY COMPANY, on bond-of z r-(here insert name and address of Contractor) - Innovative Roadway Solutions, LLC HC-64.,96A-Thayer,M0 65791 CONTRACTOR,. hereapproves of-the-ftngl payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obiidations to '(here Insert name and address of Owner) City of Fort Worth 1000 Throck Mortan Street Fort Worth,TX 76102 OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 5th day of Jan. 2016 Lexon Insurance Company H en Nadirsha Surety Company t _ .tip -:_•;",;-t-.. �J`- . y<r• Signature of Authorized Representative (Seal): '' 4. = Ted Sherman/Attorney-in-Fact Title NOTE: This form is to be used as companion document to AIA DOCUMENT G706,CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAMIS,Current Edition AIA DOCUMENT G707.CONSENT OF SURETY COMPANY TO FINAL PAYMENT.APRIL 1970 EDITION.AIA® 1970.THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,NW,WASHINGTON,D.C.20006' AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me,the undersigned authority,a notary public in the state and county aforesaid,on this day personally appeared Chris Kinder,President of Innovative Roadway Solutions,known to me to be a credible person,who being by me duly sworn,upon his oath deposed and said; That all person,firms,associations,corporations,or other organizations furnishing labor and/or materials have been paid in full;That the wage scale established by the City Council in the city of Fort Worth has been paid in full; That there are no claims pending for personal injury and/or property damages; On Contract described as;Fort Worth Fog Seal Application 2015. BY: Chris Kinder, President Subscribed and sworn before me on lrr^^l—cf �- 20� Notary Public LESLIE A,ROBERTS Notary Public-Notary Seal State of Missouri Commissioned for Oregon County My Commisslon Expires:September 17, 019 Commission NumberA 5385721 POWER OF ATTORNEY Lx-261373 Lexon Insurance Company KNOW ALL MEN BY THESE PRESENTS, that LEXON INSURANCE COMPANY, a Texas Corporation, with its principal office in Louisville, Kentucky, does hereby constitute and appoint: Ted Sherman, Craig Sherman, Judy Blaige, Karen Genoff its true and lawful Attorneys)-In-Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in nature of a bond. This authority is made under and by the authority of a resolution which was passed by the Board of Directors of LEXON INSURANCE COMPANY on the 1st day of July,2003 as follows: Resolved,that the President of the Company is hereby authorized to appoint and empower any representative of the Company or other person or persons as Attorney-In-Fact to execute on behalf of the Company any bonds, undertakings, policies,contracts of indemnity or other writings obligatory in nature of a bond not to exceed $2,500,000.00, Two Million Five Hundred Thousand dollars, which the Company might execute through its duly elected officers, and affix the seal of the Company thereto.Any said execution of such documents by an Attorney-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.Any Attorney-In-Fact,so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of Attorney. Resolved, that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Assistant Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certificate so executed and sealed shall,with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the Company. IN WITNESS THEREOF, LEXON INSURANCE COMPANY has caused this instrument to be signed by its President, and its Corporate Seal to be affixed this 5th day of August,2015. LEXON INSURANCE COMPANY �t%, ; J SEAL EpL BY X10 David E.Campbell President ACKNOWLEDGEMENT On this 5th day of August,2015, before me, personally came David E.Campbell to me known,who be duly sworn,did depose and say that he is the President of LEXON INSURANCE COMPANY,the corporation described in and which executed the above instrument;that he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation. J00Y TACO�i�,' _ " R AMYTAYLOR °a c BY Notary Public-State of Tennessee „ - Amy ylor ,"m* •` - Davidson County My Commission Expires 07-08-19 Nota Public CERTIFICATE i I, the undersigned, Assistant Secretary of LEXON INSURANCE COMPANY, A Texas Insurance Company, DO HEREBY CERTIFY that the original Power of Attorney of which the forgoing is a true and correct copy, is in full force and effect and has not been revoked and the I resolutions as set forth are now in force. 5th Jan. 16 Signed and Seal at Mount Juliet,Tennessee this Day of ,20 Nd4e, dt'aoE°Ot,� �SEA L� BY 'z"_ ✓ Andrew Smith y ' 10 Assistant Secretary "WARNING: Any person who knowingly and with intent to defraud any insurance company or other person,files and application for insurance of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act,which is a crime and subjects such person to criminal and civil penalties."