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Contract 47298-FP1
Depa e t of P&W Const.Services JOE# 1%, Date Project a a ZTWORTH, SECRETARY '7 Risk Management Canadv -'1 COAI,I,i�pCT ISO. �"la D.O.E. Brothe o 1 CFA Westerman/Scanne The Proceeding people have been Contacted concerning the request for final payment&have 'ATION AND PUBLIC WORKS sq �0 I released this project for such payment. IF PROJECT COMPLETION o o� 1{O Clearance Conducted By Shameka Kennedy D.O.E.Ns: 7364 e s��-.Z�pg Regarding contract 117364 for LAKE CREST ESTATES as required by the WATER DEPARTMENT as approved by City Council on N/A through M&C N/A the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project as complete. Original Contract Prices: $151,691.00 Amount of Approved Change Orders: ]fib Revised Contract Amount: Total Cost Work Completed: $151,691.00 Less Deductions: Liquidated Damages: Days @$210.00/Day Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: $151,691.00 Less Previous Payments: $0.00 Final r7�— $151,691.00 F- II1� Recomm nde for Acceptance Date Asst. Dir or, TPW - Infrastructure Design and Construction l.�vL �6 Accepted J� Date Asst. Director, WATER DEPARTMENT / ll Asst. City Manager Date Comments: P265-541200-6021502416833 P275-541200-702130241683 ,VMAILE" OFFICIAL RECORD AUG CITY SECRETARY a(05 - b a (o '77. WORTHfTX aoiti� - 5- 1 (0 O' - City Project Numbers 02416 DOE Number 7364 Contract Name LAKE CREST ESTATES Estimate Number I Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 729/2016 Project Funding Project Manager Ehia City Secretary Contract Number 117364 Inspectors LAYER / ODEN Contract Date Contractor JACKSON CONSTRUCTION LTD Contract Time 90 CD 5112 SUN VALLEY DRIVE Days Charged to Date 201 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 $151,691.00 Less %Retained $0.00 Net Earned $151,691.00 Earned This Period 5151,691.00 Retainage This Period $0.00 Less Liquidated Damages 0 Days a@ 50.00 /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 $151,691.00 Friday,July 29,2016 Page 4 of 4 '� ;?toy- o ; y 1 U F'ORTWORTH CITY OF FORT WORTH FINAL PAYIENT REQUEST Contract Name LAKE CREST ESTATES Contract Limits Project Type WATER&SEWER City Project Numbers 02416 DOE Number 7364 Estimate Number 1 Payment Number 1 For Period Ending 7/292016 CD City Secretary Contract Number 117364 Contract Time 90ED Contract Date Days Charged to Date 201 Project Manager Ehia Contract is 100.00 Complete Contractor JACKSON CONSTRUCTION LTD 5112 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors LAYER / ODEN Friday,July 29,2016 Page 1 of 4 City Project Numbers 02416 DOE Number 7364 Contract Name LAKE CREST ESTATES Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 7/29/2016 Project Funding WATER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 8"WATERLINE LOWERING 4 EA $1,000.00 $4,000.00 4 $4,000.00 2 TRENCH SAFETY 834 LF $1.00 $834.00 834 $834.00 3 8"WATER PIPE 834 LF $24.00 $20,016.00 834 $20,016.00 4 FIRE HYDRANT 2 EA $3,400.00 $6,800.00 2 $6,800.00 5 CONNECTION TO EXISTING 4"-12"WATER 4 EA $2,000.00 $8,000.00 4 $8,000.00 MAIN 6 8"GATE VALVE 8 EA $1,250.00 S10.000.00 8 $10,000.00 7 1"WATER SERVICE 28 EA $675.00 518,900.00 28 $18,900.00 8 DUCTILE IRON WATER FITTINGS 2 TN $6,500.00 $13,000.00 2 $13,000.00 W/RESTRAINT 9 8"PVC WATER PIPE SELECT BACKFILL 80 LF S75.00 $6,000.00 80 $6,000.00 10 ASPHALT PVMT REPAIR,WATER SERVICE 50 LF S70.00 $3,500.00 50 $3,500.00 11 PRESSURE/STERILIZATION TESTING 834 LF $150 $1,251.00 834 $1,251.00 Sub-Total of Previous Unit $92,301.00 $92,301.00 SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 4"SEWER SERVICE 28 EA $535.00 $14,980.00 28 $14,980.00 2 8"SEWER PIPE 725 LF $28.00 $20300.00 725 $20,300.00 3 8"SEWER PIPE CSS BACKFILL 65 LF $79.00 $5,135.00 65 $5,135.00 4 4'MANHOLE 2 EA $3,800.00 $7,600.00 2 $7,600.00 5 4'DROP MANHOLE 1 EA $5,400.00 $5,400.00 1 $5,400.00 6 TRENCH SAFETY 790 LF S1.00 $790.00 790 $790.00 7 MANHOLE VACUUM TESTING 3 EA $200.00 $600.00 3 $600.00 8 CONNECT TO EXISTING MANHOLE 1 EA $1.325.00 S1,325.00 1 $1,325.00 9 ASPHALT PVMT REPAIR,SEWER SERVICE 24 LF $70.00 $1,680.00 24 $1,680.00 10 POST CCTV INSPECTION 790 LF S2.00 $1,580.00 790 $1,580.00 Sub-Total of Previous Unit $59,390.00 $59,390.00 Friday,July 29,2016 Page 2 of 4 City Project Numbers 02416 DOE Number 7364 Contract Name LAKE CREST ESTATES Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 7/29/2016 Project Funding Contract Information Summary Original Contract Amount 3151,691.00 Chan:?e Orders Total Contract Price 3151,691.00 Total Cost of Work Completed 3151,691.00 Con r l Less %Retained $0.00 Net Earned $151,691.00 Date Inspection Su R Earned This Period $151,691.00 � � � � / etainage This Period 50.00 (� Less Liquidated Damages Project Manager 0%41 Days @ /Day $0.00 Date ( LessPavement Deficiency 50.00 Asst. ire or/TP /W In tructure Design and Construction Less Penalty 50.00 (`L 6 Date Less Previous Payment $0.00 Dir Contracting Department Plus Material on Hand Less 15% 50.00 / Balance Due This Payment $151,691.00 Friday,July 29,2016 Page 3 of 4 FORTWORTH nw 03/05/07 TRANSPORTATION&PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:1 NAME OF PROJECT: Late Crest Estates PROJECT NO.: 02416 CONTRACTOR Jackson Consbuclion DOE NO.: 7364 PERIOD FROM:01/04116 TO: 07/28/16 FINAL INSPECTION DATE: 28-Jul-16 WORK ORDER EFFECTIVE:1/4/2016 CONTRACT TIME: 90 --o--ww CD DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS MONTH CHARGED CREDITED MONTH CHARGED CREDITED DURING DURING 1. 16. 2. 17. 3. 18. 4. 19. 5. 20. 6. 21. 7. 22. S. 23. 9. 24. 10. 25. 11. 26. 12. 27. 13. 28. 14. 29. 15. 30. 31. r SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS* DAYS TOTAL &HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS THIS 0 9 0 0 201 201 PERIOD PREVIOUS 0 0 0 0 0 0 PERIOD TOTALS 0 9 0 0 201 201 TO DATE *REMARKS: I CONTRACTOR DATE INSPECTOR DATE ENGINEERING DEPARTMENT � ? The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311 --"`- (817)392-7941 •Fax:(817)392-7845 OFFICIAL RECORD CITY SECRETARY FT. WORTH � FORTWORTHREV:02t20/07 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR 1) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Jackson Construction Lake Crest Estates DOE Inspector DOE Number We an Oden 7364 ELaSoector Project Manager Q Water[] Waste Water❑ Storm Drainage0 Pavement Fred Ehia Initial Contract Amount Project Diffikulty $151,691.00 0 Simple OQ Routine 0 Complex Final Contract Amount Date $151,691.00 7/25/2016 II)PERFORMANCE EVALUATION 0-Inadequate 1-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 4 60 60 6 Finished Product 15 Y 4 60 60 7 Job Site Safety 15 Y 4 60 60 8 Traffic Control Maintenance 15 Y 4 60 60 9 Daily Clean Up 5 Y 3 20 15 10 Citizen's Complaint Resolution 5 Y 3 20 15 11 Property Restoration 5 Y 3 20 15 12 After Hours Response 5 Y 3 20 15 13 Project Com letion 5 Y 4 20 20 TOTAL ELEMENT SCORE(A) 428 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 428 IIl)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating(ITS/MS]•100%) 428 / 448 - %% Performance Category Excellent <20%—Inadequate 20%to<40%-Defrelent 40%to<60%-Standard 60%to<80%—Good _>80'/=Excellent Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED) Signature DOE Inspector Signature Contractor / Signature DOE Inspector's Supervisor CONTRACTORS COMMENTS TRANSPORTATION AND PUBLIC WORKS (a The City of Fort Worth-1000 Throd=orton Street-Fort Worth,TX 76012-6311 (817)392-7941 -Fax:(817)392-7845 FORTWORTH RE";0 07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 7/25/2016 Name of Contractor Project Name Jackson Construction Lake Crest Estates DOE Inspector Project Manager Weyman Oden Fred Ehia DOE Number 1,project Diffreulry Tvpe Of Contract 7364 10 Simple Q Routine O Complex ❑ WaterO Waste Water(] Storm Drainage Pavement Initial Contract Amount Final Contract Amount $151,691.00 $151,691.00 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 inspector 1 Accuracy of Plans to Existing Conditions 2 Knowledge of Inspector 2 Clarity&Sufficiency of Details 3 Accuracy of Measured Quantities 3 ApplicabiIity Applicability of Specifications 4 Display Of Professionalism 4 Accuracy of Plan Quantities 5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION 6 Performance-Setting Valve Crews,Labs 1 Knowledge And/Or Problem Resolution ADMINISTRATION 2 Availability of Project Manager 1 Change Order Processing Time 13 Communication 2 Timliness of Contractor Payments 14 Resolution of Utility Conflicts 3 Bid Opening to Pre-Con Meeting Timeframe HI)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,TX 76012-6311 (817)392-7941 •Fax:(817)392-7845 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Lake Crest Estates PROJECT NUMBER: 02416 DOE NUMBER: 7364 WATER PIPE LAID SIZE TYPE OF PIPE LF Water 8in PVC SDR-14 834 Wa'cr 6in PVC SDR 14 12 FIRE HYDRANTS: 2 VALVES(16"OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: yes NEW SERVICES: 1 Inch Copper 560 SEWER PIPE LAID SIZE TYPE OF PIPE LF Sewer 8in PVC-SDR-26 725 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes NEW SERVICES: 4 inch PVC-SDR 26 200 TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth-1000 Throckmorton Street-Fort Worth,TX 76012-6311 (817)392-7941 -Fax:(817)392-7845 &ac:LKKOoO CONSTRUCTION LTD. 5112 SUN VALLEY DRIVE FORT WORTH.TX 76119 TEL 817-572-3303 FAX 817-478-0443 AFFIDAVIT STATE OF TEXAS COUNTY OF TAlZRANT Before me,the undersigned authority,a notary public in the state and county aforesaid,on this day personally appeared Larry H. Jackson. 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; Lake Crest Estates BY 1CT2_ Larry l . Jackson, Vice President Subscribed and sworn before me on this date 25th of July,2016. otary b is Tarrant,Texas CARMEN L.ESTEP Notary Public.State of Texas % Comm.Expires 04-06-2020 •412,�,.�` Notary ID 2910611 �o 6ross np�aniens To: Weyman Oden,City of Fort Worth Re: Lake Crest Estates, FP14-063,Project#2416 Mr.Oden, Per our conversation at the final site inspection for Lake Crest Estates,this letter addresses the additional time taken by Jackson Construction to complete the contracted scope of work. Whereas the time specified in the contract documents expired a couple of months ago,JennCro LLC/Cross Companies Inc.,the developer and owner of the project will not seek any damages or reduction in contract amount due to the extended time to complete project. JennCro LLC/Cross Companies Inc. hereby releases Jackson Construction from any recourse or penalty for the extended time to complete the scope of work. Sin , Richard Cross Owner/Manager of JenCro LLC and Cross Companies Inc. July 30,2016 6012 Reef Point Lane, Suite A• Ft. Worth, TX 76135 • 817-237-8466 • 817-237-7203(FAX) GONSENT OF SURETY owmm ❑ TO FINAL PAYMENT rRMTECr - ❑ AIADoczwneazt G707 CONTRACTOR ❑ SUiRM r) Bond No. BCD1032169 MUM p TOMMM ARC11MECr°S PROJECT -NO- ok"eandammw City of Fort Worth,TX CONTRACT POR Utilities, Paving, Lighting PROJDC'L• CONTRACT DATED: Lake Crest Estates 1DXw0aW1wm w h Zhe pt+vr510M of t1x Contraa between the Owner and the Conuamm m htditozcd above,the 174&WaQVmceiaataA I i—qj2 � The Hanover Insurance Company 440 Lincoln Street Worcester, MA 01653 SUEMY. on bond of amen em�dad�asscd l ,Jackson Construction, Ltd. 5112 Sun Valley Drive Fort Worth,TX 76119 CbTVZRACPOR. hereby approves of the final payment to the Con=dor,and agrees that final payment to the Con=mr shalt not r kve the Sueay of any of im abiigatiorss to lt+aerr nemread adabaxr o/OIIsa� City of Fort Worth,TX ovvh*�q as set fmTb in said Suety s bond W VMMS WHFM©F,the Surety has hereunto set its hand on this date July 25,2016 ti�*at fnx+tfi�it+ea�b�tai�nrF�r,6e�o�icdeemedp�.1 The Hanover Insurance Company By: Anem- Jack M.Crowley Attomey4n-Fact r �mrr�y Surety Phone No. 508-853-7200 x-4476 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 Attorney(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 No/100($35,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attomey(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,Thatthe President orany Vice President,in conjunction 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 ail bonds,recognizances, 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 Attomeys-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 HANOVER INSURANCE COMPANY �,+ MASSACHUSETTS BAY INSURANCE COMPANY , �JTO�rF 43 CITIZENS SURANCE fOMPANY OF AMERICA 78q'l t9S4 8074 �► 1p71 U, Robert Thomas Vicc Prrsidertt THE COMMONWEALTH OF MASSACHUSETTS COUNTY OF WORCESTER )ss. Joy Arenstrom. Vice 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,tome 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. kr BAABAR A.GARLICK Notary Public '^ CemmanweaRh of ssad�usens ' L1y�omm_scr E:}�gs SeC.21.2�SB yLLL -S°� G 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 of America, 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 Attomey 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 September'7,2001-Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 25th day of.ice 2016- THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA O jnn Margosian,Vice President