The URL can be used to link to this page

Home My WebLink AboutContract 46586-FP1 FORTWORTHO CIMFcREr COONTRACT NO. S TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION D.O.E. Ns: 7393 Regarding contract 6Mi for 2014 CIP STREET RECONSTRUCTION CONTRACT 3%s required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 03/03/2015 through M&C C-27214 chc 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: $5,052,042.50 Amount of Approved Change Orders: Ns 1 r Revised Contract Amount: $5,052,042.50 Total Cost Work Completed: $4,221,722.14 Less Deductions: Liquidated Damages: Days @$210.00/Day Pavement Deficiencies: EM,AMED Total Deduction Amount: $0.00 JUL 2 ?016 Total Cost Work Completed: $4,221,722.14 �{t : Less Previous Payments: $4,000,182.1#3 Final Payment Due $221,539.97' k- 5--1 7 -•/7z0/(v Recomme ded for Acceptance Date Asst. Director, TPW - Infrastructure Design and Construction Accepted Date = Directo , TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Asst. City Manager Date Comments: FUND ACCT: C210 541200 205240243883 L+A OFFICIAL RECORD CITY SECRETARY FT. WORTH,TX TPW Construction Invoice Contract: CS46586 P.O.# PA715187814 Payment Date: -4127/2016'- TO: /27/2016TO:Jackson Construction Ltd INV•# CS46-586-20 Estimate No. 20 DOE: 7393 5112 Sun Valley Dr. ProjManager KRISTIAN SUGRIM Fort Worth TX 76119 FOR: 2014 CIP ST RECONSTRUCTION-CONTRACT 3 FINAL PAY ACH Contract Amount: $5,052,042.50 Completed Ret Ad] Pay Total to Date: $4,221,722.14 $0.00 $0.00 $4,221,722.14 Previous Estimate: $4,210,718.08 $210,535.90 $0.00 $4,000,182.18 Earned to Date: 511,004.Q6 ($210,535.90)`; $0.00.° $221,539196' Payments: C210-541100-205240243883 $5,052,042.50 Total to Date: $4,221,722.14 $0.00 $0.00 $4,221,722.14 Previous Estimate: $4,210,718.08 $210,535.90 $0.00 $4,000,182.18 Earned to Date: $11,004.06 ($210,535.90) $0.00 $221,539.96 Transportation& Public Works BUSINESS SUPPORT GROUP Contact Person-B3 NDY CRANE-Ext.2852 DepartmenLP176wal rg KAREN STRIKER DEPARTMENT CHECK PICK-UP YES ❑ Monday,May 30,2016 Page 1 of 1 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name 2014 CIP STREET RECONSTRUCTION-CONTRACT 3 Contract Limits AT VARIOUS LOCATIONS Project Type PAVING City Project Numbers 02438 DOE Number 7393 Estimate Number 20 Payment Number 20 For Period Ending 4/27/2016 CD City Secretary Contract Number 46586 Contract Time 29CD Contract Date 3/3/2015 Days Charged to Date 289 Project Manager Sugrim Contract is 84.000 Complete Contractor JACKSON CONSTRUCTION LTD 5112 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors RODGERS / MOTAMED Friday,April 29,2016 Page 1 of 5 City Project Numbers 02438 DOE Number 7393 Contract Name 2014 CIP STREET RECONSTRUCTION-CONTRACT 3 Estimate Number 20 Contract Limits AT VARIOUS LOCATIONS Payment Number 20 Project Type PAVING For Period Ending 4/27/2016 Project Funding PAVING Item Description of Items Estimated Unit U+iit Cost Estimated Completed Completed No. Quanity Total Quanity Total I MISCELLANEOUS ADJUSTMENTS(UTILITIES) l LS $6,000.00 $6,000.00 2.0302 $12,181.20 2 REMOVE CONCRETE CURB&GUTTER 49340 LF $4.00 $197,360.00 50612 $202,448.00 3 7"CONCRETE CURB&18"GUTTER 51500 LF $21.50 107,250.00 50612 1,088,158.00 4 REMOVE CONCRETE DRIVEWAY 77033 SF $1.50 $115,549.50 74878 $112,317.00 5 6"CONCRETE DRIVEWAY 80733 SF $6.50 $524,764.50 74878 $486,707.00 6 REMOVE SIDEWALK 76270 SF $1.00 $76,270.00 35589 $35,589.00 7 4"CONCRETE SIDEWALK 127190 SF $4.65 $591,433.50 35589 $165,488.85 8 CONCRETE RETAINING WALL WITH 200 SF $25.00 $5,000.00 351 $8,775.00 SIDEWALK,FACE 9 REMOVE CONCRETE VALLEY GUTTER 350 SY $16.00 $5,600.00 454.4 $7,270.40 10 6"CONCRETE VALLEY GUTTER 500 SY $77.00 $38,500.00 469.7 $36,166.90 11 11"PAVEMENT PULVERIZATION 76640 SY $4.75 $364,040.00 80884.63 $384,201.99 12 3"ASPHALT PAVEMENT TYPE D 76640 SY $17.75 360,360.00 76215 1,352,816.25 13 CEMENT MODIFICATIONI3LBS/SY 498 TN $155.00 $77,190.00 567.57 $87,973.35 14 ROADBONDENI 599 GA $140.00 $83,860.00 567 $79,380.00 15 REMOVE/REPLACE MAILBOX 4 EA $900.00 $3,600.00 16 WATER VALVE BOX ADJUSTMENT WITH 29 EA $150.00 $4,350.00 58 $8,700.00 CONCRETE COLLAR 17 MANHOLE ADJUSTMENTS WITHCONCRETE 31 EA $530.00 $16,430.00 73 $38,690.00 COLLAR 18 MISCELLANEOUS ADJUSTMENT WATER 265 EA $100.00 $26,500.00 METER BOX 19 UNCLASSIFIED STREET EXCAVATION 415 CY $25.00 $10,375.00 20 CURB ADDRESS PAINTING 922 EA $25.00 $23,050.00 753 $18,825.00 21 BLOCK SOD REPLACEMENT 10136 SY $5.00 $50,680.00 12705 $63,525.00 22 REMOVE ADA RAMP 23 EA $100.00 $2,300.00 13 $1,300.00 23 ADA RAMP 61 EA $1,150.00 $70,150.00 23 $26,450.00 24 5'CUT INLET TOP 1 EA $3,100.00 $3,100.00 1 $3,100.00 25 10'CURB INLET TOP 3 EA $3,900.00 $11,700.00 26 4"SOLID YELLOW THERMOPLASTIC(HAS) 100 LF $6.00 $600.00 CENTER LINES 27 12"SOLID PAVEMENT MARKINGS(CROSS- 75 LF $8.00 $600.00 WALK,WHITE) Friday,April 29,2016 Page 2 of 5 City Project Numbers 02438 DOE Number 7393 Contract Name 2014 CIP STREET RECONSTRUCTION-CONTRACT 3 Estimate Number 20 Contract Limits AT VARIOUS LOCATIONS Payment Number 20 Project Type PAVING For Period Ending 4/27/2016 Project Funding 28 STOP BARS PAVEMENT MARKINGS 343 LF $10.00 $3,430.00 29 PAVING CONSTRUCTION ALLOWANCE 1 EA $272,000.00 $272,000.00 0.0061 $1,659.20 Sub-Total of Previous Unit $5,052,042.50 $4,221,722.14 Friday,April 29,2016 Page 3 of 5 I City Project Numbers 02438 DOE Number 7393 Contract Name 2014 CIP STREET RECONSTRUCTION-CONTRACT 3 Estimate Number 20 Contract Limits AT VARIOUS LOCATIONS Payment Number 20 Project Type PAVING For Period Ending 4/27/2016 Project Funding Contract Information Summary Original Contract Amount $5,052,042.50 Chanlie Orders Total Contract Price $5,052,042.50 I(. Total Cost of Work Completed $4,221,722.14 ontra for Less %Retained $0.00 Date �( (�+ Net Earned $4,221,722.14 Inspection Supervisor Earned This Period $221,539.97 L1 Retainage This Period $0.00 Date ` k4 6 Less Liquidated Damages Project Manager /� Days @ /Day $0.00 Date s f 17'j�P LessPavement Deficiency $0.00 t.D tor/TP/W_-Infrastructure Design and Construction Less Penalty $0.00 Date 5 7 Less Previous Payment $4,000,182.17 Dir or/Contracting Depa ent Plus Material on Hand Less 15% $0.00 Balance Due This Payment $221,539.97 Friday,April 29,2016 Page 4 of 5 City Project Numbers 02438 DOE Number 7393 Contract Name 2014 CIP STREET RECONSTRUCTION-CONTRACT 3 Estimate Number 20 Contract Limits AT VARIOUS LOCATIONS Payment Number 20 Project Type PAVING For Period Ending 4/27/2016 Project Funding Project Manager Sugrim City Secretary Contract Number 46586 Inspectors RODGERS / MOTAMED Contract Date 3/3/2015 Contractor JACKSON CONSTRUCTION LTD Contract Time 290 CD 5112 SUN VALLEY DRIVE Days Charged to Date 289 CD FORT WORTH, TX 76119 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded Total Cost of Work Completed $4,221,722.14 PUPWI ocoa f Swvbev Less %Retained $0.00 Net Earned $4,221,722.14 Project Manage f g Earned This Period $221,539.97 Management S. a advl`' Retainage This Period $0.00 Br therton f -' CIA Westerman/Scanned 0 Less Liquidated Damages 0 Days @ $0.00 /Day $0.00 'I'hel'roeeediug people have been Contacted concerning the requedt LessPavement Deficiency $0.00 'for final payment&have released this projectfor such payorsnt, Less Penalty $0.00 I Cbm,#nce Conducted By Etta Hacy + Less Previous Payment $4,000,182.17 -- Pius Material on Hand Less 15% $0.00 Balance Due This Payment $221,539.97 Friday,April 29,2016 Page 5 of 5 5/3012016 BuySpeed Online .9 Trr, Buy%-, Onil" Accounts Payable Basic Purchasing DepartmentV�l1Access NIGP Code Browse I My Account I Customer Service I About Current Organixaden:CITY OF FORT WORTH® May 30,201610:20:30 AM CDT A r x Horne Documents_ Brandy Crane Invoice#: CS4.6586-FINAL Vendor#:0000008063 Vendor Group#:01 Status:41R-Ready for Approval d i General Items Subcontractors Accounts Routing Attachments Notes Reminder Change Order Summary Back to PO Oaneral ValMaflan lsremhrgs • Yeu ars gaN to bw p"ft kkwlng pwu*pw po Ralro:I1]. I Header Information Invoice Number.. CS46586-FINAL Invoice Status: 41R-Ready for Approve! InvoiceType: 3way matching Invoice Description: CS46586-FINAL 2014 CIP St Reconstruction Contract 3 Invoice Date: 04/27/2016 Effect Date: 05130/2016 Payment Amount: $221,539.96 Handling Code: ACH(DIRECT DEPOSIT) Payment Date: 05/22!2016 Payment Terms: Payment Term Day: 0 Payment Discount: 0.0% Paid-Bank/Check: Alternate Id: Entered By: Brandy Crane Entered Date: 05/30/2016 Updated By: Brandy Crane Updated Date: 05W=18 Received Date: 04/271201610:18:00 AM Attachments Agency Files: Agency Forms: Vendor Files: Vendor Forms: Purchase Order information Purchase order Number: PO-15-00087674 PO Description CS46586 PO Amount: $5,052,042.50 Remaining To Invoice: $830,320.36 Buyer Karen Striker PoVendor Information Vendor 0000008063-JACKSON CONSTRUCTION LTD Address Grp: 01 Vendor Remlt-to Address: LARRY JACKSON 5112 SUN VALLEY DR FORT WORTH,TX 76119 USA Enak CARMENGJACKSCNCONSTRUCTION.NET Fed ID: 8585 Remit Text: Phone:(817)6/2-3303 FAX(817),78-0449 Id:115180 (EFT Enabled) Misc&Freight Invoice Account Event Type Fiscal Year Account Code Transaction Amount Mlac 16 34014-2080000—CO2436-CRETAN-- $210.535.90 Total: $210,535.90 Item Information Invoice Item#IPO Item#:1 2014 CIP St Reconstruction Contract 3 C210-541200.205240243883 CS46586 MSC C-27214 Date 030315 PO Permit Invoice Discount% Original Final Item status To Pay Amount Pay Amount Pay 3PPR-Partial Reoelpt $0.00 $11,004.06 0.0% $0.00 Yes MAKE: ASSET MODEL: ASSET MANUF: ASSET SERIAL: ASSET VIN: ASSET TAG: Event Type Fiscal Year Account Code Transaction Amount Etq. 15 340140200431-5740010--CO2430-0O2483-2015-14010199 $11,004.06 hUpsi/bso formcrthtom.gov/bso/purchaseorderfinvoicefirlvoiceSummarysdD7vendorid=0000008063&doclt-PO-15.00087874&reiesseNbr=08docType=l8,mn.. 1/2 6(30(2016 BuySpeed Online 16 34014-OZ0M1-6140010--CGZ4W-002488-2015-14010190 111 00406 Approval Path: Delete Approver Order Approval Level Approver Dane Data ApprovedlDisapproved/Caneeled Comment Sequence Path Type Requested Approved/Olsapprowd/Caneeled by View ID Now .a._---. Primary P CopyrW O 2016 Periscope Holdings,Inc-AN Rights Reserved.default I 4 Mtps://bsofortwor#loxes.gwltudpurchaseorder!nvoicefimraceSurnmary.ado?vert]Drld=0000008063&dock]=PO-15-00087874&eia weNbr=08diocType7-18dnn.. W Arompts ACTUALS 34014 2060000 CO2438 CRETAN $ (76,163.42) ACTUALS 34014 2060000 CO2438 CRETAN $ (11,780.37) ACTUALS 34014 2060000 CO2438 CRETAN 2015 $ - ACTUALS 34014 2060000 CO2438 CRETAN $ (35,940.28) ACTUALS 34014 2060000 CO2438 CRETAN $ (33,389.25) ACTUALS 34014 2060000 CO2438 CRETAN $ (20,471.78) ACTUALS 34014 2060000 CO2438 CRETAN $ (28,543.72) ACTUALS 34014 2060000 CO2438 CRETAN $ (4,247.08) $ (210,535.90) 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 Troy L. Jackson, Vice President Of Jackson Construction, Ltd, known to me to be a credible person, who being by me duly sworn,upon his oath deposed and said; That all persons, 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; 2014 CIP Street Reconstruction Contract 3 BY Troy Jack-son, Vice President Subscribed and sworn before me on this date 10th of May, 2016. P Notary Public Tarrant, Texas aevi��• CARMEN L. ESTEP =_ Notary Public,State of Texas Comm,Expires 04-06-2020 Nolary ID 2910611 �nnua CONSENT OF SURETY OWNFR ❑ TO FINAL PAYMENT ARCHITECT ° CONTRACTOR ❑ ALA Document G707 SURETY XJ Bond No. BCD1032119 CrPHFA 0 TO OWNER: ARCHITECT'S PROJECT NO.: flimnemdaddmisJ City of Fort Worth, Texas CONTRACT FOR. Street Reconstruction PROJECT: f CONTRACT DATED:March 3, 2015 (Name mrd adrh&V 2014 CIPI Contract 3, 02438 In accordance with the provisions of the Contract between rite Owner and the Contractor as indicted above,the pnmrr some acrd addmv of sarrno The Hanover Insurance Company 440 Lincoln Street Worcester, MA 01653 SURETY, on bond of flnnwn naJne and addm.egofCowracrur) Jackson Construction, Ltd. 5112 Sun Valley Drive Fort Worth, TX 76119 CONTRACTOR, hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations ro (h J.9PIY name and addr ect of Orener) City of Fort Worth, Texas OWNER, as set forth in said Surery s.bond. W WITNESS WHEREOF,the Surety has hereunto set its hand on this date: Apri 129, 2016 rhmW Or uvidngthe rnon Ofoikuwd k?ibe wanerkdate arrd Jear.J The Hanover Insurance Company By: (S�q»onrrr arrtborizref Jr nturirrJ , Attests Jack M. Crowley Attorney-in-Fact (Sem: (Printed frame and dde) Surety Phone No. 508-853-7200 x-4476 G7()7--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 Attomey(s)-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 Noll 00($36,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-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 orany Vice President,In oonjunction with any Vice President,be and they are hereby authorized and empowered to appoint Attomeys-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,recagnizances, contracts of indemnity,waivers of citation 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 Attomeys4n-fad shat be as binding upon the Company as if they had been duly executed and acknovAedged 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 Sth day of December 2011. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY 1184"1 t�4 F�`y4" CITIZENS SURANCE OMPANY OF AMERICA ti .� to7s Robert Thomas,Vice Presidcat THE COMMONWEALTH OF MASSACHUSETTS COUNTY OF WORCESTER )ss. Joey lX.ttsEt�tllr.. iPresldastt On this 6th 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 GARLK K Notat�Put Camnanwe�M ar tAnmcAur�na7J . 1,1yConmwcsionEcgir�sSeN.21,271D 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 of Attorney and Certified Copies of such Powers of Attorney and certification in respectthereto,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 September 7,2001-Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 29th day of April 2016. THE HANOVER INSURANCE COMPANY MASSACHUSETTS SAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA Apr;6u q!on Margosian,Vice President FORTWORTHREV:02/20/07 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRAC'T'OR 1) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Jackson Construction,LTD 2014 CIP Street Reconstruction-Contract 3 DOE Inspector DOE Number Ali Motamed 7393 DOElnspector Project Manager ❑ Water❑ Waste Water❑ Storm DrainageRl Pavement Kristian Su Initial Contract Amount Project Dgiculty $5,052,042.50 O Simple Q Routine O Complex Final Contract Amount Date $4,221,722.14 4/27/2016 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 3 8 6 2 Public Notifications 5 Y 3 20 15 3 Plans on Site 5 Y 3 20 15 4 Field Supervision 15 Y 4 60 60 5 Work Performed 15 Y 4 60 60 6 Finished Product 15 Y 4 60 60 7 Job Site Safe 15 Y 4 60 60 8 Traffic Control Maintenance 15 Y 4 60 60 9 Daily Clean Up 5 Y 4 20 1 20 10 Citizen's Com Taint Resolution 5 Y 4 20 20 11 Property Restoration 5 Y 3 20 15 12 After Hours Response 5 Y 4 20 20 13 Project Completion 5 Y 3 20 15 TOTAL ELEMENT SCORE(A) 426 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 426 III)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/MS] *100%) 426 / 448 = 95% Performance Category Excellent <20%=Inadequate 20%to<40%=Deficient 40%to<60%=Standard 60'0 to<80%_Good >_80%=Excellent Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED) Signature DOE Inspector Signature Contractor Signature DOE Inspector's Supervisor CONTRACTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth-1000 Throckmorton Street-Fort Worth,TX 76012-6311 (D (817)392-7941 -Fax:(817)392-7845 w , FORTWORTHREV:02/22/07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY PROJECT INFORMATION Date: 4/27/2016 Name of Contractor Project Name Jackson Construction 2014 CIP Street Reconstruction-Contract 3 DOE Inspector Project Manager Ali Motamed Kristian,Sugrim DOE Number Project Dculty Type of Con&act 7393 O Simple QQ Routine Q Complex ❑ Water❑ Waste Water❑ StormDrainage❑✓ Pavement Initial Contract Amount Final Contract Amount $5,052,042.50 $4,221,722.14 11)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 13 1 Accuracy of Plans to Existing Conditions 2 Knowledge of Inspector 4J 2 Clarity&Sufficiency of Details 3 Accuracy of Measured Quantities 3 A licabili of Specifications 4 Display Of Professionalism 4 Accuracy of Plan Quantities 5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION 6 Performance-Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution t ADMINISTRATION 2 Availability of Project Mana er 1 Change Order Processing Time 3 Communication 2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts 3 Bid Opening to Pre-Con Meeting Timeframe III)COMMENTS&SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector r,4 !� Signature DOE Inspector's Supervisor / 20C(s INSPECTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth-1000 Thtockmorton Street-Fort Worth,TX 76012-6311 ,° 1 (817)392-7941 -Fax:(817)392-7845 FORT WORTH TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME STATEMENT# FINAL STATEMENT# DOE NAME OF PROJECT: Contractor YEAR: 2016 PROJECT NO.: FINAI.INSPECTION DATE WD CjjojjffD CONTRACT TIME PERIOD FROM: TO: MID - Month IDFVELOPMFq(Y/N WORK ORDER EFFECTIVE: BEG /n MID /n DAY OF MONTH DAYS REASON FOR DAY OF MONTH DAYS REASON FOR CHARGED DAYS CREDITED CHARGED DAYS CREDITED 1 16 Sat 0 2 17 Sun 0 3 18 Mon 0 4 19 Tue 0 5 20 Wed 0 6 21 Thu 0 7 22 Fri 0 8 23 Sat 0 9 24 Sun 0 10 25 Mon 0 11 26 Tue 0 12 27 Wed 0 13 28 Thu 0 14 29 15 30 31 Not Applicable SAT,SUN,and WEATHER UTILITIES OTHERS DAYS TOTAL DAYS HOLIDAYS RELOCATE CHARGED THIS PERIOD 0 0 0 0 0 0 PREVIOUS PERIOD 289 TOTAL TO DATE 1 0 1 0 1 0 1 0 1 289 1 289 ! REMARIKS: