HomeMy WebLinkAboutContract 47572-FP1 vcpanmenuor I aw 1-onst.services
—,.PN# Z.tl � Date
Project N anager >—L.-ter/ _.
Risk Management Canady 6 — 7 WORTH. CITY SECRETARYD.O.E. Brotherton O-
CFA Westerman/Scanned Z0 CONTRACT NO.
Esteban Perez/Scanned
The Proceeding people have been Contacted Q
concerning the request for final payment& have TION AND PUBLIC WORKS Sq to61 C6
released this project for such payment. ;PROJECT COMPLETION
feveloper Projects) DL)S#7:6'12
Clearance Conducted By AuLiizd City Project Ns: 02658
65#41?5*7,--,
Regarding contract 117512 for PALMILLA SPRINGS PHASE 3 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 Directoz.Qf the Transportation&Public Works Department has accep red the project
� ��
as complete. � -n�
i� - v tj
NOV 0 8 2016
Original Contract Price: $637,754.90
Amount of Approved Change Orders. Y .._.___ ., $35,187.36 Ns 1
Revised Contract Amount: $672,942.26
Total Cost Work Completed: $672,942.26 do
11
&
Recommende fo Acceptance Date
Asst. Director, TP - Infrastructure Design and Construction
Accepted Date
Asst. Director, WATER DEPARTMENT /"5/Z
2-,
Asst. City Manager Date
Comments:
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
}� 105— oa(Os-g
Rev.9/22/16 .. .
Nov o s 2o1s �5-q to b 1- C
City Project Numbers 02658 ►?y� DOE Number 7512
Contract Name PALMILLA SPRINGS PHASE 3 Estimate Number I
Contract Limits Payment Number 1
Project Type WATER&SEWER For Period Ending 10/20/2016
Project Funding
Project Manager Sahu City Secretary Contract Number 117512
Inspectors LAYER/ ROBERTS Contract Date
Contractor C.W.YOUNG CONSTRUCTION Contract Time 120 CD
210 S.SIXTH STREET Days Charged to Date 221 CD
MANSFIELD, TX 76063 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 $672,942.26
Less %Retained $0.00
Net Earned $672,942.26
Earned This Period $672,942.26
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 $672,942.26
Thursday,October 20,2016 Page 5 of 5
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name PALMILLA SPRINGS PHASE 3
Contract Limits
Project Type WATER&SEWER
City Project Numbers 02658
DOE Number 7512
Estimate Number I Payment Number 1 For Period Ending 10/20/2016
CD
City Secretary Contract Number 117512 Contract Time 120;D
Contract Date Days Charged to Date 221
Project Manager Sahu Contract is 100.00 Complete
Contractor C.W.YOUNG CONSTRUCTION
210 S.SIXTH STREET
MANSFIELD, TX 76063
Inspectors LAYER / ROBERTS
Thursday,October 20,2016 Pagel of 5
City Project Numbers 02658 DOE Number 7512
Contract Name PALMILLA SPRINGS PHASE 3 Estimate Number I
Contract Limits Payment Number 1
Project Type WATER&SEWER For Period Ending 10/20/2016
Project Funding
WATER
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
----------------------------------------
1 8"PVC WATER PIPE 4384 LF $22.05 $96,667.20 4384 $96,667.20
2 6"PVC WATER PIPE 55 LF $16.37 $900.35 55 $900.35
3 DUCTILE IRON WATER FITTINGS 1.3 TN $5,085.00 $6,610.50 1.3 $6,610.50
W/RESTRAINT
4 8"GATE VALVE 9 EA $1,151.00 $10,359.00 9 $10,359.00
5 6"GATE VALVE 4 EA $810.00 $3,240.00 4 $3,240.00
6 FIRE HYDRANT 4 EA $4,250.00 $17,000.00 4 $17,000.00
7 1"WATER SERVICE 131 EA $620.00 $81,220.00 131 $81,220.00
8 CONNECTION TO EXISTING 4"-12"WATER 2 EA $500.00 $1,000.00 2 $1,000.00
MAIN
9 TRENCH SAFETY 4439 LF $0.25 $1,109.75 4439 $1,109.75
10 4"-12"PRESSURE PLUG 2 EA $350.00 $700.00 2 $700.00
---------------------------------------
Sub-Total of Previous Unit $218,806.80 $218,806.80
SEWER
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
---------------------------------------
1 8"SEWER PIPE CO#1 4785 LF $39.59 $189,438.15 4785 $189,438.15
2 8"SEWER PIPE CSS BACKFILL CO#I 190 LF $74.09 $14,077.10 190 $14,077.10
3 8"SEWER PIPE METHOD OTHER THAN OPEN 200 LF $343.10 $68,620.00 200 $68,620.00
CUT CO#1
4 12"PVC SLEEVE CO#1 100 LF $81.06 $8,106.00 100 $8,106.00
5 CONCRETE ENCASEMENT FOR UTILITY PIPES 3 CY $335.00 $1,005.00 3 $1,005.00
6 CONNECT TO EXISTING SEWER MANHOLE I EA $1,255.00 $1,255.00 1 $1,255.00
7 T MANHOLE 26 EA $2,938.00 $76,388.00 26 $76,388.00
8 4'DROP MANHOLE CO#1 2 EA $5,022.35 $10,044.70 2 $I0,044.70
9 4'EXTRA DEPTH MANHOLE 90 VF
10 EPDXY MANHOLE LINER CO#1 65 VF $200.00 $13,000.00 65 $13,000.00
11 4"SEWER SERVICE 131 EA $470.21 $61,597.51 131 $61,597.51
12 POST CCTV INSPECTION CO#1 5125 LF $1.10 $5,637.50 5125 $5,637.50
13 MANHOLE VACUUM TESTING CO#1 28 EA $80.00 $2,240.00 28 $2,240.00
14 TRENCH SAFETY 4906 LF $0.25 $1,226.50 4906 $1,226.50
Thursday,October 20,2016 Page 2 of 5
City Project Numbers 02658 DOE Number 7512
Contract Name PALMILLA SPRINGS PHASE 3 Estimate Number 1
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 10/20/2016
Project Funding
15 ADDL 4FT BASES/ASBUILT CO#1 2 EA $750.00 $1,500.00 2 $1,500.00
------------------------------ ------------
Sub-Total of Previous Unit $454,135.46 $454,135.46
---------------------------------- ----
Thursday,October 20,2016 Page 3 of 5
i
City Project Numbers 02658 DOE Number 7512
Contract Name PALMILLA SPRINGS PHASE 3 Estimate Number 1
Contract Limits Payment Number 1
Project Type WATER&SEWER For Period Ending 10/20/2016
Project Funding
Contract Information Summary
Original Contract Amount $637,754.90
Change Orders
Change Order Number 1 $35,187.36
Total Contract Price $672,942.26
Date 14 1 rir Total Cost of Work Completed $672,942.26
Co ac o Less %Retained $0.00
Date JQ)W11 Net Earned $672,942.26
Inspection Su rv' Earned This Period $672,942.26
Retainage This Period $0.00
/tom- Date IJ Less Liquidated Damages
roject Manager
(—AIA / G Days @ /Day $0.00
Date f D��� LessPavement Deficiency $0.00
Asst.Direc r PW l�-/Infrastructure Design and Construction Less Penalty $0.00
Date �l�'b��C Less Previous Payment $0.00
Director/Contracting Department Plus Material on Hand Less 15% $0.00
Balance Due This Payment $672,942.26
Thursday,October 20,2016 Page 4 of 5
FORTWORTH rev 03/05/07
TRANSPORTATION& PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:l
NAME OF PROJECT: Palmilla Springs Ph.3
PROJECT NO.: 02658 CONTRACTOR: C.W.Young
DOE NO.: 7512
PERIOD FROM:10/01/16 TO: 10/18/16 FINAL INSPECTION DATE: 18-Oct-16
WORK ORDER EFFECTIVE:2/22/2016 CONTRACT TIME: 120 O Wfl* CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH CHARGED CREDITED MONTH CHARGED CREDITED
DURING DURING
1. 0 16. 0
2. 0 17. 0
3. 0 18. 0 Held Final
4. 0 19.
5. 0 20.
6. 0 21.
7. 0 22.
8. 0 23.
9. 0 24.
10. 0 25.
11. 0 26.
12. 0 27.
13. 0 28.
14. 0 29.
15. 0 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS
THIS 0 0
PERIOD
PREVIOUS 221 221
PERIOD
TOTALS 221 221
TO DATE
*REMARKS:
/0 2(Na
CONT CTOR DATE ' SP DATE
ENGINEERING DEPARTMENT
(a The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,Thi 76012-6311
(817)392-7941 •Fax:(817)392-7845
DEVELOPER-AWARDED-PROJECT CHANGE ORDER
PROJECT NAME Palmilla Springs.Phase 3 CHANGE
CONTRACT: Water,Sewer.Paving,Drainage&Street Light ORDER No:
CFA# 2015.108 CITY PARTICIPATION: NO
CITY PROJECT# 2658
DOE# 7512 1
WATER PROJECT# P265.603150265883
SEWER PROJECT# P275703130265883
FILE# K-2417
INSPECTOR: David Beardsley Phone No: 713-493-4442
PROJECT MANAGER: Gopal Sahu Phone No: 817-392-7949
CONTRACT UNIT
G DRAINAGE STREETLIGHTS CONTRACT
WATER SEWER PAVIN
DAYS
DeveloperCost CR$iOmt0,-Developer Cost _'CIEy';Coak�..Developer Cost .<;sGiCy:Co3F".Developer Cosh .CpliE' Developer Cost =.C1/y"!CoYG
<s U, � :r, �•wSinsr a 2s'4 ,r; tr?•L�x:,Y�j.
ORIGINAL CONTRACT $218,806.90 „L.ZM n,o� Sata,s4E.to �,�;.:c.;. yxy- S55s,oto.o5 r ;.,�ys,cc,_.�•. 5226,72200 ,. .ccrt`[��.l.+:i: 577,x10.40
EXTRAS TO DATE :RNt?_$r.a S,.;sc. :2�:`,s;..; ...h:ri'"�.�uorta' ,.�-.��zax S:krl �•._o.n_-si:
CREDITS TO DATE •s?..�--�"�',�>. cct h_ ` "�'�.'•J' i Lh_c, �,�.f�m.'�:+'c'`r
CONTRACT TO GATE $219.906.II0 -'.SOA:ciRe 5419,948,10 �.; O.DO'7( SS59At0A5 �`SO'ti�.O,,D',`f $226,722.00 .mow`. :{IDJT S77,210.40 'f 150A0 f 0
535.197.36 xr,.�}`�-.'+ , m5 52,91210
AMOUNTOF PROP.CHANGE ORDER Tc".'c,-. .,'.�.
1«rr tiz�..a;ra "v`� r y� 1r A
REVISED CONTRACT AMOUNT S218,806.80 r.,,,�So.00,1T S4S4,13S.46 .ni`0:00: S559,010A5 i'3...$O.Ob._.:sv 5229S31.i0 'x+.-'50:00._.,t 577,210.40 r:F.._SOADa„ i D '
TOTAL REVISED CONTRACT AMOUNT
PER UNIT 5218.906.80 S4S4,13SA6 SSS9,010.05 $229,534.10 S77,210A0
REVISED COSTSHARE Dev.Cost $1,538,696.81 iCitj�}CdsC,a ,tiS.,St`mt _.„,k, c36'00"�'Lr�x`��'re �� jl3r";
TOTAL REVISED CONTRACT $1,538,696,81
Revised:10-12-2011 Page 1
You are directed to make the folloyAnq chances In the contract documents:
PAY ITEM A CITY BID ITEM# QUANTITY UNIT ITEM DESCRIPTION UNITFRICE TOTAL
A-1.1 3331.4115 29.00 LF 8'SEWER PIPE $39.69 $1,148.11
A-1.2 3331.4116 40.00 LF 8"SEWER PIPE CSS BACKFILL $74.09 $2,98380
A-1.3 9999.9999 50.00 LF 8"SEWER PIPE METHOD OTHER THAN OPEN CUT $343.10 $17165.00
A-1.4 9999.9999 40.00 LF 12'PVC SLEEVE $81.06 S3 42.40
A-1.8 3339.1003 1.00 EA 4:DROP MANHOLE 55:022.35 $6,022.35
A-1.10 3339,0001 20.00 VF EPDXYMANHOL LINER $200,00 $4000.00
A-1.12 3301.0002 69.00 LF PO&T CCTVINSPECTION $1.10 575.80
A-1.13 3301,0101 1.001 EA IMANHOLE VACUUM TESTING $80.00 $80.00
CO 1.1 9999.9999 1 2.00 1 EA I ADDITIONAL 4'BASES THAT HAD TO BE RE13UILTTO ACCOUNT $750,00 $1.600.00
SEWER TOTAL 535187.36
&1.5 3341.0201 18.00 LF 21'RCP.CLASS 111 _ $5320 S9.57.8D
B 1.6 3349.6003 + 1.00 EA 20'CURB INLET S476nD-Sd760.00-
B.1.7 3349.6002 t 2.00 EA 16'CURB INLET $4.300.00 $8.600.00
B-1.8 3349.5001 a. 1.00 EA 10'CURB INLET $3,400.00 43AC0.00
B4.14 3137.0104 t 28.00 SY MEDIUM STONE RIPRAP,DRY S50,00 $1 00.00
B-1.15 3305.0109 18.00 LF TRENCH SAFETY 50.25 54.60
STORM DRAW TOTAL $2 81210
REASONS FOR CHANGE ORDER Due to conficts 4th exisHnggas lines,onsite sanitarysever design mo0caflons sere made.There stere some minor errors M the orlglnal condactquanwes forsform draln.
NO CITY FUNDS INVOLVED IN THIS CONTRACT.DEVELOPER IS RESPONSIBLE FOR 100%OF THE CHANGE ORDER COST AND NO
REIMBURSEMENT FROM THE CITY VALL BE SOUGHT BY THE DEVELOPER,
RECOMMENDED: APPROVED: APPROVED:
TEAGUE NALL&PPGRKINS JABEZ D 60PAI C.V/..YOUNG ColysTRUCTION.
By; 7.1 �.� By: BY:
Name: Jonathan Sengrorl.P.E. Name: Qi /vl s Name:
Tale: Sr.Protect Mana90r Tide: a 110e:
Revised:10-12-20111 Paget
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: Palmilla Springs,Phase 3
PROJECT NUMBER: 2658
DOE NUMBER 7512
WATER
PIPE LAID SIZE TYPE OF PIPE LF
PVC 8" C-900 4384
PVC 6" C-900 55
FIRE HYDRANTS: 4 VALVES(16"OR LARGER) n/a
PIPE ABANDONED SIZE TYPE OF PIPE LF
n/a
DENSITIES: Yes
NEW SERVICES: 1' Copper 131-Ea
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
PVC 8" SDR-26 4985
PIPE ABANDONED SIZE TYPE OF PIPE LF
n/a
DENSITIES: Yes
NEW SERVICES: 4" PVC SDR-26 131-Ea
TRANSPORTATION AND PUBLIC WORKS
� i The City of Fort Worth•1000 Throckmorton Street•Fort Worth,Tx 76012-6311
FORTWORTHREV:02/20/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
I) CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
C W Young Construction,L.P. Pahnilla Springs Phase 3
DOE Inspector DOE Number
David Beardsley 7512
DOE Inspector Project Manager
o Water o Waste Water ❑Storm Drainage ❑ Pavement Gopal Sahu
Initial Contracl Amount Project Dculty
$637,754.90 Simple o Routine o Complex
Final Contract Amount Date
$672,942.26 10/19/2016
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 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)
III)CONTRACTOR'S RATING TOTAL SCORE(TS) 448
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)
Signature DOE Inspec / ignature Contractor
Signature DOE Inspector's
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
BOND NUMBER 022052532
OWNER 11
CONSENT OF SURETY ARCHITECT 0
TO FINAL PAYMENT CONTRACTOR 19
Conforms with the American Institute of SURETY
Architects,AIA Document G707 OTHER
TO OWNER: Jabez Development,L.P.and the City ARCHITECT'S PROJECT NO.:
(Name and address) of Fort Worth
CONTRACT FOR: Water,Sewer and Storm Improvements
PROJECT: Palmilla Springs,Phase 3 CONTRACT DATED:
(Name and address) ov .+k "- 3 C� t Z v(.s-
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the
(Insert mmne and address oJSuret})
Liberty Mutual Insurance Company
175 Berkeley Street,Boston,Massachusetts 02116
,SURETY,
on bond of
(Insert name and address of Conn•aeto))
C.W.Young Construction,L.P.
210 S.Sixth Street,Mansfield,Texas 76063
,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 to
(Insets name and address of'0e•net)
Jabez Development,L.P.and the City of Fort Worth,Tx
OWNER,
as set forth in said Surety's bond.
IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: October, 19,2016
(Insen in irridng the month JbIlmred br the numeric date and rear.)
Liber
utual Insurance Com an
Attest: igar o/'authorisedrepresetttatire)(So �
Sonia Lara,Attorney-in-Fact
(Printed name and tide)
THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON REDBACKGROUND.
This Power of Attorney limits the acts of those named herein;and they have no authority to bind the Company except in manner and to the extent herein stated.
Certificate No.7114493
American Fire and Casualty Company Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: ThatAmerican Fre&Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of
the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and WestAmerican Insurance Company
is a corporation duly organized under the laws of the State of Indiana(herein collectivelycalled the°Companies? pursuantto and byauthoriiy hereinset forth;does hereby name;constitute
and appoint, Tomi J Pope,PadtW`Sower;Bill Ballinger;Richard-S Maxey;Candace Reyrtolds Brian A Smifh.Andrew P Clark Kevin Claborn Hilaria
Tijerina,Rachel Duncan;Melissa:Allaire David.W:Moegan-Diane"Perez,-Colin:E-Coniy-.Mark Rozewicz LaCasha�ri,nds Sonia Lara Bryant Ahmed
Zia Reeves,Teresa Skertchly,Todd_Tschantz,Atisha-Weis -
all of the city of Dallas state of TX each-individually if there be more than one named;its true an-lawful attorney m fact to make,execute;seat,acknowledge
and deliver,for and'on its behalf as surety and assts act and deed;any,and all undertakings;bonds,recognlzances and other surety obligations_in pursuance of these presents and shall
be as binding upon the Companies as if theft* en duly signed by the president and attested by the secretary of the companies in their own.proper persons.
IN WITNESS WHEREOF,this Power of Attomeyhas been subscnbed:by an authorized officer orofficiei of the:Compames and the.corporate seats of the Companies have been affixed
thereto this 16th day of September L L 2015 =
PNo cASG civ INs� LINSU'9 INsu American Fre and Casualty Company a
�,'�� The Ohio Casualt Insurance Company
m
fir° c 0 Yn J o f 0 o Y P Y
z $a 1906 191z " 3 Liberty Mutual Insurance Company aNi
0 0 7919 n , o Q
991
o a WestAmerican Insurance Company
�a',y Pa�� ���'Ssnctn75�y12T$ P Y
d * 1 + t * * By: r Q
STATE OF PENNSYLVANIA ss David M.Care ;Assistant Secretary
+r COUNTY OF MONTGOMERY
On this 16th day of September 2015before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of American Fire and v -
6 Casualty Company,Liberty Mutual Insurance.Company,The Ohio Casualty Insurance Company,and WestAmerican Insurance Company,and that he,as such,being authorized so to do,
O� executethe fore oIn Instrument for purposes therein contained b signing on behalf of the corporations b himself as a dui authorized officer. - tv
9 9 PrP Y 9 9 P y Y _
a)> IN WITNESS WHEREOF,i have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting;Pennsylvania,on the day and year first above written. O Q
d, P PAS;, COMMONWEALTH OF PENNSYLVANIA � w p
�Q�o F�or+w�F�� .Notariafsea, �G% /
C'y Teresa Pasteila,.Nohary Publio- g _ O
O L qa Plyinouth Twp.,Montgomery County Y Teresa Pastella;Notary PublicU.
-
My Commission Expires March 28,2017 �.
d,0 20p �C' -Member.Pennsylvanla Association of Notaries Q_.0_
- D.,..
C This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of American Fire and Casualty Company,The Ohio Casualty Insurance U)c
NCompany,Liberty MdtuaIL Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: Lr
ai Q ARTICLE IV—OFFICERS-Section 12.Power of Attorney.Any officer or otherofficial of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject 0-c
+; to such limitation as the Chairman or the:President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute;seal, +'y
O;� acknowledge and deliveras surety any and all undertakings,bonds,recognizances and other surety obligations:Such attorneys-in-fact;subject to the limitations set forth in their respective -a
E powers of attorney,Shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal;of the Corporation. When so er
O C executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power orauthority granted to any representative or attorney-in-fact > O.
the provisions of this article maybe revoked at any time by the Board,the Chairman,the President or by the officeror officers granting such power or authority.
04
ARTICLE XIII—.Execution of Contracts SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, P°'
> L and subject to such as the chairman or the president may prescribe;shall appoint such attorneys-in-fact,as may be necessary act in-behalf of the Company to make,execute;_ L.CV
O seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their 0 00:
Z v respective powers of attorney,shall hayefull power to bind the Company by their_signature and execution of any_such instruments and to all thereto the seal of the Company: When so OL
executed such instruments shall be d0inding as if signed by the presidentand attested W.hesecretary. _ ~cue
Certificate of Designation-The President of the Company,.acting pursuant_tothe Bylaws:oftfie-Company auftiorizes David M.Carey;=Asslstant:Secretary to appoint such attomeys-in-
>..
fact as may be necessary to act on behalfofftie Company to make:execute;seal,acknowledge acid deliver as.suretyany and all undertakings,bonds;reoognizances and other surety
obligations:
Authorization-By unanimous consent of the Gompanys Board of bI*trors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company,wherever appearing upon a cert�ed dopy ofany power of attorney issued by the Company:in connection with surety bonds,shall be-Valid and binding upon the Company with
the same force and effect as though manually:affxed
I;Gregory W.Davenport;the undersigned AsslstantSecretary,of American Fire.and CasuattyCompany,The Ohio Casualty Insurance.Company Liberty Mutual Insurance Company,and
WestAmerican Insurance Company do hereby certify titaf the original powrof eattomey.of which the foregoing is a fuq irue:a d correct copy of the Power of Attorney executed by said
Companies,is in full force and effect and has not revoked
IN TESTIMONY WHEREOF;I have hereunto set my hand and affixed the seals of said Companies this day of 92W .
PSD
CASL
3`rjnpol,U��/��
a : 1906. o o ' 1919 n 1912 0 1991 BY=
v o Gregory W.Davenport,Assistant Secretary
��b�'x�ntss`�r�.a .9y^'xnrav5��ya ��j°SsnaNs�r � 'anrarir t'
59 of 500
LMS_12873_122013
o Liberty
utu'R
SURETY
TEXAS TEXAS
IMPORTANT NOTICE AVISO IMPORTANTE
To obtain information or make a complaint: Para obtener informacion o para someter una
queja:
You may call toll-free for information or to Usted puede hamar al numero de telefono gratis
make a complaint at para informacion o para someter una queja al
1-877-751-2641 1-877-751-2641
You may also write to: Usted tambien puede escribir a:
Interchange Corporate Center Interchange Corporate Center
450 Plymouth Road, Suite 400 450 Plymouth Road, Suite 400
Plymouth Meeting,PA 79462-8284 Plymouth Meeting,PA 79462-8284
You may contact the Texas Department of Puede comunicarse con el Departamento de
Insurance to obtain information on companies, Seguros de Texas para obtener informacion
coverages,rights or complaints at acerca de companias, coberturas, derechos o
1-800-252-3439 quejas al
1-800-252-3439
You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros
Consumer Protection(111-1A) de Texas Consumer Protection(111-1A)
P. O. Box 149091 P. O. Box 149091
Austin, TX 78714-9091 Austin,TX 78714-9091
FAX: (512)490-1007 FAX#(512)490-1007
Web: hM://www.tdi.texas.gov_ Web: htip://www.tdi.texas.gov
E-mail:1C�onsumerProtection@tdi.texas.gov E-mail: ConsumerProtection@tdi texas gov
PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS:
Should you have a dispute concerning your Si tiena una disputa concerniente a su prima o a
premium or about a claim you should first un reclamo, debe comunicarse con el agente o
contact the agent or call 1-800-843-6446. primero. Si no se resuelve la disputa, puede
If the dispute is not resolved,you may contact the entonces comunicarse con el departamento (TDI)
Texas Department of Insurance.
ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA:
POLICY:
This notice is for information only and does not Este aviso es solo para proposito de informacion
become a part or condition of the attached y no se convierte en parte o condicion del
document. documento adjunto.
NP 70 68 09 01
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 Joe Winchester,
Proj. Manager Of CW Young Construction,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;
Palmilla Springs,Ph. 3 -DOE#7512 - City Project#02658
BY
Joe Winchester-Project Manager
Subscribed and sworn before e on s date 19th of October,2016.
Notary Public f�
Tarrant, TX
F
VERETT W STEWART III
My commission Opires
March 12,2019
210 S. Sixth Ave.
Mansfield, TX 76063
(817) 477-1414
ffi0W3=WrM-V- tV- fax: (817) 473-6077
10/19/2016
City of Fort Worth
CFA Administration
1000 Throckmorton St.
Fort Worth, TX 76102
RE: Palmilla Springs, Ph. 3
DOE# 7512 City Project#02658
The purpose of this letter is to acknowledge that we have been paid in full by Jabez Development, L.P. for
the public improvements constructed to serve Palmilla Springs,Ph. 3 in Fort Worth, Texas. As a result,
we hereby waive, release and relinquish all rights to assert any claim or demand for lien in connection
with this project.
Please feel free to contact me with any questions you may have.
Sincerely,
f V
l�J
Joe inchester
C. Young Construction,L.P
C.W. Young Construction, L.P. -- 210 S. Sixth Ave. -- Mansfield, TX 76063
FORTWORTHREV:02'22/07
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
1)PROJECT INFORMATION Date: 10/19/2016
Name of Contractor Project Name
C W Young Pahnilla Springs,Phase 3
DOE Inspector I Project Manager
David Beardsley Gopal Sahu
DOE Number Project Difficulty Type of Contract
7512 10 Simple a Routine O Complex o Water o Waste Water ❑ Storm Drainage ❑ Pavement
1Initial Contract Amount Final Contract Amount
$637,754.90 $672,942.26
11)PERFORMANCE EVALUATION
0-Inadequate 1 -Deficient 2-Standard 3-Good 4-Excellent
ELEMENT I RATING ELEMENT RATING
INSPECTION EVALUATION PLANS&SPECIFICATIONS
1 Availability of Inspector 1 Accuracy of Plans to Existing Conditions c
2 Knowledge of Inspector 2 Clarity&Sufficiency of Details Y
3 Accuracy of Measured Quantities 3 Applicability of Specifications
4 Display Of Professionalism C 4 Accuracy of Plan Quantities Ll
5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION
6 Performance-Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution �(
ADMINISTRATION 2 Availability of Project Manager
1 Change Order Processing Time 3 Communication
2 Timliness of Contractor Payments t/ 4 Resolution of Utility Conflicts
3 Bid Opening to Pre-Con Meeting Timeframe c
III)COMMENTS
/&'SIGN,ATURES r l
COMMENTS /fc..11 /czi�t�i ��f k�� 1��T?ti5 er►t/o �c/.t
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
T
(817)392-7941 •Fax:(817)392-7845