HomeMy WebLinkAboutContract 45167-FP1 Depart t t TP ScW Go t. Services
DO.E#� �aVv
Date
Project ager --
Risk Managemen C - T WORTH, ( Y SECRETARYD.O.E. Brothe on — CONTRACT NO. �� I
CFA Westerman/Scanne M—
The Proceeding people have been Contacted
concerning the request for final payment& have ATIO AND PUBLIC WORKS 5q U CO a70
1^
released this project for such payment. F PROJECT COMPLETION /lJ
Clearance Conducted By Shameka Kennedy D.O.E. Ns: 7112
Regarding contract 117112 for 7TH AVE&WEST TERRELL AVE 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: D E O $282,452.00
Amount of Approved Change Orders: OCT 18 2016 ($4,330.00) N21
Revised Contract Amount: BY $278,122.00
Total Cost Work Completed: $278,122.00
Less Deductions:
Liquidated Damages: Days @$210.00/Day
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Work Completed: $278,122.00
Less Previous Payments: S0.00
Final Paym t Due $278,122.00
Recommen ed for Acceptance Date
Asst. Direc or, PW - Infrastructure Design and Construction
Accepted �' Date
Asst. Director, WATER DEPARTMENT
Asst. City Manager Date
Comments: P265-541200-609150217083,P275-541200-709130217083
0 � OFFICIAL RECORD
Cr CITY SECRETARY �a(�S Q a ~]o
1 X016
FT. WORTH, TX
Dr1OCT
0
8 2016 J9 (o� ICity Project Numbers 02170 DOE Number 7112
Contract Name 7TH AVENUE&WE Estimate Number I
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 8/4/2016
Project Funding
Project Manager Jaafari City Secretary Contract Number 117112
Inspectors LAYER / DIESTEL Contract Date
Contractor CONATSER CONSTRUCTION TxLP Contract Time 120 CD
5327 WICHITA ST Days Charged to Date 872 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 $278,122.00
Less %Retained $0.00
Net Earned $278,122.00
Earned This Period $278,122.00
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 $278,122.00
Thursday,August 04,2016 Page 5 of 5
FORTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name 7TH AVENUE&WEST TERRELL AVE
Contract Limits
Project Type WATER&SEWER
City Project Numbers 02170
DOE Number 7112
Estimate Number 1 Payment Number 1 For Period Ending 8/4/2016
CD
City Secretary Contract Number 117112 Contract Time 120:D
Contract Date Days Charged to Date 872
Project Manager Jaafari Contract is 100.00 Complete
Contractor CONATSER CONSTRUCTION TxLP
5327 WICHITA ST
FORT WORTH, TX 76119
Inspectors LAYER / DIESTEL
Thursday,August 04,2016 Pagel of 5
City Project Numbers 02170 DOE Number 7112
Contract Name 7TH AVENUE&WEST TERRELL AVE Estimate Number 1
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 8/4/2016
Project Funding
WATER
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
---------------------- --------- ------- -- -
1 REMOVE 6"WATER LINE CO#2,3 203 LF $22.00 $4,466.00 203 $4,466.00
2 REMOVE 8"WATER LINE 20 LF $24.00 $480.00 20 $480.00
3 REMOVE 12"WATER LINE 20 LF $26.00 $520.00 20 $520.00
4 6'WATER ABANDONMENT PLUG I EA $800.00 $800.00 1 $800.00
5 8"WATER ABANDONMENT PLUG 2 EA $1,000.00 $2,000.00 2 $2,000.00
6 REMOVE 12"WATER VALVE 3 EA $800.00 $2,400.00 3 $2,400.00
7 SALVAGE 2"WATER METER 1 EA $300.00 $300.00 1 $300.00
8 SALVAGE 6"WATER METER 1 EA $1,000.00 $1,000.00 1 $1,000.00
9 REMOVE CONCRETE WATER VAULT 1 EA $1,500.00 $1,500.00 1 $1,500.00
10 TRENCH SAFETY CO#1,2,3 392 LF $4.00 $1,568.00 392 $1,568.00
11 16"CASING BY OPEN CUT 20 LF $120.00 $2,400.00 20 $2,400.00
12 20"CASING BY OPEN CUT 20 LF $150.00 $3,000.00 20 $3,000.00
13 DUCTILE IRON WATER FITTINGS I TN $5,000.00 $5,000.00 1 $5,000.00
14 4"WATER PIPE CO#1 38 LF $45.00 $1,710.00 38 $1,710.00
15 6"WATER PIPE CO#1 79 LF $50.00 $3,950.00 79 $3,950.00
16 8"WATER PIPE CO#1 95 LF $60.00 $5,700.00 95 $5,700.00
17 8"DIP WATER 20 LF $85.00 $1,700.00 20 $1,700.00
18 12"WATER PIPE 142 LF $70.00 $9,940.00 142 $9,940.00
19 12"DIP WATER CO#2,3 8 LF $100.00 $800.00 8 $800.00
20 2"WATER SERVICE I I LF $30.00 $330.00 11 $330.00
21 4"WATER METER&VAULT 1 EA $15,500.00 $15,500.00 1 $15,500.00
22 6"WATER METER&VAULT 1 EA $17,500.00 $17,500.00 1 $17,500.00
23 4"GATE VALVE 1 EA $850.00 $850.00 1 $850.00
24 6"GATE VALVE 2 EA $950.00 $1,900.00 2 $1,900.00
25 8"GATE VALVE 7 EA $1,050.00 $7,350.00 7 $7,350.00
26 12"GATE VALVE CO#2 5 EA $2,000.00 $10,000.00 5 $10,000.00
27 REMOVE 2"WATER LINE 31 LF $10.00 $310.00 31 $310.00
----------------------- -----------------
Sub-Total of Previous Unit $102,974.00 $102,974.00
----------------- ---- -----------------
Thursday,August 04,2016 Page 2 of 5
City Project Numbers 02170
DOE Number 7112
Contract Name 7TH AVENUE&WEST TERRELL AVE Estimate Number 1
Contract Limits Payment Number 1
Project Type WATER&SEWER For Period Ending 8/4/2016
Project Funding
SEWER
Item Description of Items Estimated Estimated Completed Completed
No. Quanity Total Quanity Total
P Unit Unit Cost P P
—________—
1 REMOVE 8"SEWER LINE 550 LF $12.00 $6,600.00 550 $6,600.00
2 6"SEWER ABANDONMENT PLUG 4 EA $1,000.00 $4,000.00 4 $4,000.00
3 8"SEWER ABANDONMENT PLUG I EA $1,000.00 $1,000.00 1 $1,000.00
4 REMOVE 4'SEWER MANHOLE 3 EA $1,200.00 $3,600.00 3 $3,600.00
5 POST CCTV INSPECTION 894 LF $3.00 $2,682.00 894 $2,682.00
6 MANHOLE VACUUM TESTING 7 EA $100.00 $700.00 7 $700.00
7 TRENCH SAFETY 894 LF $4.00 $3,576.00 894 $3,576.00
8 IMPORTED EMBEDMENT/BACKFILL 30 CY $20.00 $600.00 30 $600.00
9 6"SEWER SERVICE 2 WAY CLEANOUT 2 EA $750.00 $I,500.00 2 $1,500.00
10 6"SEWER PIPE 78 LF $55.00 $4,290.00 78 $4,290.00
11 8"SEWER PIPE 9 LF $80.00 $720.00 9 $720.00
12 8"SEWER PIPE CSS BACKFILL 24 LF $85.00 $2,040.00 24 $2,040.00
13 12"SEWER PIPE CO#2 683 LF $105.00 $71,715.00 683 $71,715.00
14 EPDXY MANHOLE LINER CO#2 85 VF $205.00 $17,425.00 85 $17,425.00
15 WASTEWATER ACCESS CHAMBER CO#2 3 EA $2,400.00 $7,200.00 3 $7,200.00
16 4'MANHOLE CO#2 5 EA $4,000.00 $20,000.00 5 $20,000.00
17 4'DROPMANHOLE 3 EA $5,500.00 $16,500.00 3 $16,500.00
18 4'EXTRA DEPTH MANHOLE 55 VF $200.00 $11,000.00 55 $11,000.00
Sub-Total of Previous Unit $175,148.00 $175,148.00
Thursday,August 04,2016 Page 3 of 5
City Project Numbers 02170 DOE Number 7112
Contract Name 7TH AVENUE&WEST TERRELL AVE Estimate Number 1
Contract Limits Payment Number 1
Project Type WATER&SEWER For Period Ending 8/4/2016
Project Funding
Contract Information Summary
Original Contract Amount $282,452.00
Change Orders
Change Order Number 1 ($4,330.00)
Change Order Number
Total Contract Price $278,122.00
Date '��' !� Total Cost of Work Completed $278,122.00
Con r Less %Retained $0.00
Net Earned $278,122.00
Date
Inspection Sy s Earned This Period $278,122.00
Retainage This Period $0.00
Date to � ►3 ��6
Less Liquidated Damages
Project a-er
Days @ /Day $0.00
Date I� /" �( LessPavement Deficiency $0.00
Asst.Dire for T/PW-Infrastructure Design and Construction Less Penalty $0.00
G'lam Date lo-le-ll Less Previous Payment $0.00
Director/Contracting Department Plus Material on Hand Less 15% $0.00
twd-� Balance Due This Payment $278,122.00
Thursday,August 04,2016 Page 4 of 5
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FoRTWORTH rev 03/05/07
TRANSPORTATION&PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.1
NAME OF PROJECT: 7th Ave&West Terrell Ave
PROJECT NO.: 02170 CONTRACTOR: Conatser Construction
DOE NO.: 7112
PERIOD FROM 02/03/14 TO: 04/23/16 FINAL INSPECTION DATE: 1-Jul-16
WORK ORDER EFFECTIVE 2/3/2014 CONTRACT TIME 120 O WD OO CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH DING CREDITED MONTH DURINEG CREDITED
1. 16.
2. 17.
3. 18.
4. 19.
5. 20.
6. 21.
7. 22.
8. 23.
9. 24.
10. 25.
11. 26.
12. 27.
13. 28.
14. 29.
15. 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS* DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS
THIS
PERIOD 0 0 0 0 872 872
PREVIOUS 0
PERIOD 0 0 0 0 0
TOTALS0 0 0
TO DATE 0 872 872
*REMARKS:
CONTRACTOR DATE INSPECTQK DATE
ENGINEERING DEPARTMENT
-�� The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311
O
(817)392-7941 •Fax: (817)392-7845
FORTWORTHREV:02/20/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
1) CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
Conatser Construction 7th Ave and Vilest Terrell Ave
DOE Inspector DOE Number
Garey Houston 7112
DOE Inspector Project Manager
Q water Q waste water ❑Storm Drainage ❑ Pavement Khal Jaafari
Initial Contract Amount Project Difficulty
$282,452.00 O Simple OO Routine O Complex
Final Contract Amount Date
$278,122.00 6/29/2016
In 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 4 20 20
10 Citizen's Complaint Resolution 5 Y 4 20 20
11 Property Restoration 5 Y 4 20 20
12 After Hours Response 5 Y 4 20 20
13 Project Completion 5 Y 4 20 20
TOTAL ELEMENT SCORE(A) 448
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(TS) 448
III)CONTRACTOR'S RATING
Maximum Score(MS)=448 or sum of applicable element score maximums which= 448
Rating([TS/MS]x 100%) 448 / 448 = 100%
Performance Category Excellent
<20%=Inadequate 20%to<40%=Deficient 40%to<60%=Standard 60%to<80%=Good _>80%=Excellent
Inspector's Comments(INCLUDING EXPLANATION OF BONUS POINTS AWARDED)
i
Signature DOE Inspector �.y '� 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
(817)392-7941 •Fax:(817)392-7845
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: 7th Ave.&West Terrell Ave.
PROJECT NUMBER: 02170
DOE NUMBER: 7112
WATER
PIPE LAID SIZE TYPE OF PIPE LF
4"inch PVC 37 LF
6"inch PVC 79 LF
8"inch PVC 95 LF
12"inch PVC 142 LF
8"inch Ductile 20 LF
12"inch Ductile 8 LF
FIRE HYDRANTS:.O VALVES(16"OR LARGER) 0
PIPE ABANDONED SIZE TYPE OF PIPE LF
N/A
DENSITIES: yes
NEW SERVICES: 2"inch copper 11 LF
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
6"inch SDR-26 PVC 78 LF
8"inch SDR-26 PVC 9 LF
12"inch SDR-26 PVC 683 LF
PIPE ABANDONED SIZE TYPE OF PIPE LF
N/A 8"inch PVC 550 LF
DENSITIES: yes
NEW SERVICES: 2"inch SDR-26 PVC 11 LF
TRANSPORTATION AND PUBLIC WORKS
s' The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817)392-7941 •Fax:(817)392-7845
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARR.ANT
Before me, the undersigned authority, a Notary Public in the state and county aforesaid,
on this day personally appeared Brock Huggins, Vice-President of Conatser Management Group,
Inc., general partner of Conatser Construction TX,LP,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; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
7tb AVENUE&WEST TERRELL AVE.
WATER, STORM DRAIN, SANITARY SEWER,
PAVING IMPROVEMENTS
DOE#: N/A
CFA- City Project#: 2013-080
CITY OF FORT WORTH
STATE OF TEXAS
CONAT CONSTRUCTION TX,LP
Brock Huggins
Subscribed and swom to before me this 11 m day of Au ,
BERTHA GIANULIS Notary Public in Tarrant County,Texas
Notary Public,State of Texas
Commission Expires I
September 18, 2019
B
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
CONTRACTOR ❑
TO FINAL PAYMENT SURETY ❑
Conforms with the American Institute of OTHER
Architects,AIA Document G707
Bond No 0174424
PROJECT:
(name, address)Water,Sewer, Paving& Drainage Imprvts.
7th Ave.and West Terrell Ave.
TO (Owner) Fort Worth,Tx
COOK CHILDREN'S MEDICAL CENTER AND THE ARCHITECT'S PROJECT NO: CFA No.2013-080
CITY OF FORT WORTH
CONTRACT FOR:
7th Avenue and West Terrell Avenue Water,Sewer, Paving,&Drainge
Improvements
Tx —J CONTRACT DATE:
CONTRACTOR: CONATSER CONSTRUCTION TX, L.P.
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)
BERKLEY INSURANCE COMPANY
475 Steamboat Road
Greenwich CT 06830 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
CONATSER CONSTRUCTION TX, L.P.
5327 Wichita St.
Forest Hill TX 76119-6035 , CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve
the Surety Company of any of its obligations to (here insert name and address of Owner)
COOK CHILDREN'S MEDICAL CENTER AND THE CITY OF FORT WORTH
TX
OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS,WHEREOF,
the Surety Company has hereunto set its hand this 10th day of August,2016
BERKLEY INSURANCE COMPANY
Surety Company
Attest: I .W�nIU�.,
(Seal): l Signature of Authorized Representative
Robbi Morales Attorney-in-Fact
Title
NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
No. BI-7280f
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WILMINGTON, DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
organized and existing under the laws of the State of Delaware,having its principal office in Greenwich, CT, has made,constituted
and appointed, and does by these presents make, constitute and appoint: Ricardo J. Reyna; Don E. Cornell; Vena DeLene
Marshall;Sophinie Hunter,Robbi Morales;or Kelly A. Westbrook of Aon Risk Services Southwest,Inc. of Dallas, TX its true
and lawful Attorney-in-Fact,to sign its name as surety only as delineated below and to execute,seal,acknowledge and deliver any
and all bonds and undertakings, with the exception of Financial Guaranty Insurance, providing that no single obligation shall
exceed Fifty Million and 00/100 U.S. Dollars (U.S.S50,000,000.00),to the same extent as if such bonds had been duly executed
and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons.
- This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
S without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following
resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010.-
RESOLVED,
010:RESOLVED, that, with respect to the Surety business written by Berkley Surety Group, the Chairman of the Board, Chief
Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant
Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attomey-in-fact named therein
v to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the
vcorporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such
attorney-in-fact and revoke any power of attorney previously granted;and further
RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances,
f ^ or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the
manner and to the extent therein stated;and further
y RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and
further
^r RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any
power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or
other suretyship obligation of the Company;and such signature and seal when so used shall have the same force and effect as
though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any
person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have
P ceased to be such at the time when such instruments shall be issued.
IN WITNESS WHEREOF, the Company has cau these presents to be signed and attested by its appropriate officers and its
o corporate seal hereunto affixed this lay of c'",�Q
u Attest: Berkley Insurance Company
X13 il
ti (Seal) By / B4&art Ira S. a erman rC Senior Vice President&Secretary side
f�!
WARNING, THIS POWER INVALID IF NOT PRINTED ON BLUE"BERKLEY"SECURITY PAPER.
STATE OF CONNECTICUT)
a ) ss:
COUNTY OF FAIRFIELD )
Sworn to before me, a Notary Public in the State of Connecticut, this`JD da of ,2015, by Ira S. Lederman and
v Jeffrey M.Hafter who are sworn to me to be the Senior Vice President and Secre ry�an the Senior Vice Pre dent,respectively,of
Berkley Insurance Company. MARIA C.RUNDBAKEN /�
' r NOTARY PUBLIC `�-
MY COMMISSION EXPIRES otary Public,State of Connecticut
APRIL 30,2019
Z ,w CERTIFICATE
E 1,the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a
true,correct and complete copy of the original Power of Attorney;that said Power of Attorney•has not been revoked or rescinded
5 and that the authority of the Attorney-in-Fact set forth therein, who executed the bond or undertaking to which this Power of
Attorney is attached, is in full force and effect as of this date.
Given under my hand and seal of the Company,thislOth day of August A 2016
(Seal)
A a
FORTWORTHREV:02/22/07
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
I)PROJECT INFORMATION Date: 6/29/2016
Name of Contractor Project Name
Conatser Construction 7th Ave and West Terrell Ave
DOE Inspector Project Manager
Garey Houston I Khal Jaafari
DOE Number Project Difficulty I Type of Contract
7112 O Simple O Routine O Complex 21 Water 10 Waste Water ❑Storm Drainage ❑ Pavement
Initial Contract Amount Final Contract Amount
$282,452.00 1$278,122.00
11)PERFORMANCE EVALUATION
0-Inadequate 1 -Deficient 2-Standard 3-Good 4-Excellent
ELEMENT RATING ELEMENT RATING
INSPECTION EVALUATION (0-4) 1
PLANS&SPECIFICATIONS (0-4)
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 V 3 Applicability 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 401 1 Knowledge And/Or Problem Resolution
ADMINISTRATION 2 Availability of Project Manager
1 Change Order Processing Time 41 3 Communication
2 Timliness of Contractor Payments y 4 Resolution of Utility Conflicts
3 Bid Opening to Pre-Con Meeting Timeframe
III)COMMENTS&SIGNATURES
COMMENTS
Signature Contractor
Signature DOE Inspector
Signature DOE Inspector's Supervisor
INSPECTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
�,Ee The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311
t
(817)392-7941 •Fax:(817)392-7845