HomeMy WebLinkAboutContract 48336-FP2 Departme t of . &W Const. ServicesDate
CPN# l Z
Projec Manager
Risk Managemen Cana — TWORTH, CITY SECRETARY
D.O.E. BrothertonCONTRACT NO. bIV, r
CFA WestermanlScanned
Esteban Perez/Scanned
The Proceeding people have been Contacted
concerning the request for final payment& have TION AND PUBLIC WORKS
released this project for such payment.
PROJECT COMPLETION
%!� ���� eveloper Projects)
Clearance Conducted By City Project Ns: 026087�� � jCay� �/ 6
Regarding contract 117466 for WEST FORK RANCH PHASE 9B as requited by die
TRANSPORTATION&PUBLIC WORKS as approved by City Council on N/A through M&C N/A the director
of the TRANSPORTATION&PUBLIC WORKS upon the recommendation of the Assistant Director of the
Transportation&Public Works Department has accepted the project as complete.
Original Contract Price: $196,872.80
Amount of Approved Change Orders: N'o
Revised Contract Amount:
Total Cost Work Completed: $196,872.80
Recommen ed for cceptance Date
Asst. Direct r, 1 RW/1 Infrastructure Design and Construction
r
`JJ Accepted -- Date
Direct r TRANSPORTATION & PUBLIC WORE<S / -/K
f_
Asst. City Manager Date
Comments: E+ MAIIoED
OFFICIALRA�iQRa
CITY SCCWARY JAN 10 2017
FT WORM
TX
Rev.9/22/16
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name WEST FORK RANCH PHASE 9B
Contract Limits
Project Type STORM DRAIN
City Project Numbers 02608
DOE Number 7466
Estimate Number 1 Payment Number 1 For Period Ending 11/16/2016
CD
City Secretary Contract Number 117466 Contract Time 180;D
Contract Date Days Charged to Date 338
Project Manager Long Contract is 100.00 Complete
Contractor BURNSCO CONSTRUCTION,INC.
6331 SOUTHWEST BLVD
FORT WORTH, TX 76132
Inspectors LAYER/ ODEN
Wednesday,November 16,2016 Page I of 4
City Project Numbers 02608 DOE Number 7466
Contract Name WEST FORK RANCH PHASE 9B Estimate Number I
Contract Limits Payment Number I
Project Type STORM DRAIN For Period Ending 11/16/2016
Project Funding
STORM DRAIN
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 21"RCP CLASS III 233 LF $42.00 $9,786.00 223 $9,366.00
2 24"RCP CLASS III 747 LF $47.00 $35,109.00 747 $35,109.00
3 27"RCP CLASS III 747 LF $54.00 $40,338.00 747 $40,338.00
4 33"RCP CLASS III 34 LF $73.00 $2,482.00 34 $2,482.00
5 33"STRAIGHT HEADWALL 1 PIPES 1 EA $2,400.00 $2,400.00 1 $2,400.00
6 24"STRAIGHT HEADWALL 1 PIPE 3 EA $2,000.00 $6,000.00 3 $6,000.00
7 10'CURB INLET 12 EA $3,400.00 $40,800.00 12 $40,800.00
8 CONCRETE RIPRAP 146 SY $64.50 $9,417.00 146 $9,417.00
9 4'STORM JUNCTION BOX 3 EA $3,800.00 $11,400.00 3 $11,400.00
10 TRENCH SAFETY 1761 LF $0.50 $880.50 1761 $880.50
11 SEEDING,HYDROMULCH 8424 SY $0.30 $2,527.20 8424 $2,527.20
12 TOPSOIL 4212 CY $2.00 $8,424.00 4212 $8,424.00
13 UNCLASSIFIED EXCAVATION BY PLAN 11074 CY $2.15 $23,809.10 11074 $23,809.10
14 CONCRETE COLLAR 2 EA $250.00 $500.00 2 $500.00
15 PAYMENT,PERFORMANCE&MAINTENANCE I LS $3,000.00 $3,000.00 1 $3,000.00
BONDS
Sub-Tota(of Previous Unit $196,872.80 $196,452.80
Wednesday,November 16,2016 Page 2 of 4
City Project Numbers 02608 DOE Number 7466
Contract Name WEST FORK RANCH PHASE 913 Estimate Number I
Contract Limits Payment Number I
Project Type STORM DRAIN For Period Ending 11/16/2016
Project Funding
Contract Information Summary
Original Contract Amount $196,872.80
Change Orders
Total Contract Price $196,872.80
Date 2, ��" G Total Cost of Work Completed $196,452.80
Cont Less %Retained $0.00
J'�� Net Earned $196,872.80
Date L�5
Earned This Period $196,872.80
Inspection Su r
y,J Retainage This Period $0.00
Date Less Liquidated Damages
Pr6iect a ger �'
Days @ /Day $0.00
Date LessPavement Deficiency $0.00
Direc r W-Infrastructure Design and Construction Less Penalty $0.00
�h�
Date Less Previous Payment $0.00
l -�<
�( Contracting Department Plus Material on Hand Less 15% $0.00
Balance Due This Payment $196,872.80
/y
Wednesday,November 16,2016 Page 3 of 4
City Project Numbers 02608 DOE Number 7466
Contract Name WEST FORK RANCH PHASE 9B Estimate Number i
Contract Limits Payment Number I
Project Type STORM DRAIN For Period Ending 11/16/2016
Project Funding
Project Manager Long City Secretary Contract Number 117466
Inspectors LAYER / ODEN Contract Date
Contractor BURNSCO CONSTRUCTION,INC. Contract Time 180 CD
6331 SOUTHWEST BLVD Days Charged to Date 338 CD
FORT WORTH, TX 76132 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 $196,452.80
Less %Retained $0.00
Net Earned $196,872.80
Earned This Period $196,872.80
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 $196,872.80
Wednesday,November 16,2016 Page 4 of 4
4
FORTWORTHREV:02/22/07
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
I)PROJECT INFORMATION Date: 11/3/2016
Name of Contractor Project Name
Burnsco Constrution West Fork Ranch Phase 913
DOE Inspector Project Manager
Weyman Oden Aaron Long
DOE Number Project Difficulty Tjpe of Contact
7466 0 Simple QQ Routine Q Complex ❑ Water❑ Waste Water❑✓ Storm Drainage[:] Pavement
Initial Contract Amount Final Contract Aniount
$196,872.80 $196,872.80
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 V) 2 Clarity&Sufficiency of Details
3 Accuracy of Measured Quantities 3 Applicability of Specifications
4 Display Of Professionalism 4 Accuracy of Plan Quantities `y
5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION
6 Performance-Setting up Valve Crews,Labs G) 1 Knowledge And/Or Problem Resolution
ADMINISTRATION 2 Availability of Project Manager
1 Change Order Processing Time U 3 Communication U
2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts Q
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
(D The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817)392-7941 •Fax: (817)392-7845
FORTWORTHREV:02/20/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
I) CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
Burnsco West Fork Ranch Ph.9B
DOE Inspector DOE Number
Woman Oden 7466
DOE Inspector Project Manager
❑ Water❑ Waste WaterO Storm Drainage❑ Pavement Aaron Long
Initial Contract Amount ProjectDifjiculty
$196,872.80 O Simple Routine Q Complex
Final Contract Amount Date
$196,872.80 11/3/2016
I1)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 3 60 45
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 4 20 20
11 Property Restoration 5 Y 4 20 20
12 After Hours Response 5 Y 3 20 15
13 Project Completion 5 Y 3 20 15
TOTAL ELEMENT SCORE(A) 418
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(TS) 418
III)CONTRACTOR'S RATING
Maximum Score(MS)=448 or sum of applicable element score maximums which= 448
Rating(ITS/MS] x 100%) 418 / 448 = 93%
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 Inspector . . _ , Signature Contractor
Signature DOE Inspector's Supervisor
CONTRACTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
`t The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311
0r
(817)392-7941 •Fax: (817)392-7845
*PulteGroup
September 29th, 2016
Mr.John Burns
Burnsco Construction, Inc.
6331 Southwest Blvd.
Benbrook,Texas 76132
Re: Contract for West Fork Ranch Phase 9B—Water, Sanitary Sewer&Storm Improvements
CoFW Project No. 02608
CoFW File No. W-2393
CoFW DOE No.7466
Dear John Burns:
This letter will document that Pulte Homes of Texas, L.P. confirms that Burnsco Construction, Inc. has
completed the Work associated with the above-referenced contract in an appropriate time frame,
subject to completion of any warranty or maintenance work as identified and required by the City of
Fort Worth, and that no liquidated damages will be assessed by Pulte Homes in connection with the
Work.
Pulte Homes of TX, L.P.
By:
Curt M. Millward
Land Development Project Manager
Cc: City of Fort Worth
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 Ab Grantges,
Contract Mgr, Of Burnsco construction, Inc., 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;
West Fork Ranch Ph. 9B Water, Sanitary Sewer and Stonn Drain
BY
Ab Grantges, C tr Manager
Subscribed and sworn before me on this date 26th of September, 2016.
Notary Public
Tarrant County, Texas �,aYP// LEIA MCQUIEN
r°�' '•nom:Notary Public,State of Texas
Gomm.Expires 06.26.2018
w;01 NotorY I0 125446481
rnu
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
CONTRACTOR ❑
TO FINAL PAYMENT SURETY ❑
Conforms with the American Institute of OTHER
Architects, AIA Document G707
Bond No 022053010
PROJECT: West Fork Ranch Phase 913 -Water, Sanitary Sewer, and Storm Drain Improvements
(name, address)
Fort Worth TX
TO (Owner)
PULTE HOMES OF TEXAS,L.P.AND CITY OF FORT? ARCHITECT'S PROJECT NO:
WORTH CONTRACT FOR:
4800 Regent Blvd. Suite 100 West Fork Ranch Phase 96-Water,Sanitary Sewer,and Storm Drain
Improvements
Irving TX 75063 CONTRACT DATE:
CONTRACTOR: BURNSCO CONSTRUCTION, INC.
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the
there Insert name and address of Surety Company)
LIBERTY MUTUAL INSURANCE COMPANY
175 Berkeley Street
Boston MA 02116 , SURETY COMPANY
on bond of there insert name and address of Contractor)
BURNSCO CONSTRUCTION, INC.
6331 Southwest Boulevard
Benbrook TX 76132 , 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)
PULTE HOMES OF TEXAS, L.P. AND CITY OF FORT WORTH
4800 Regent Blvd. Suite 100
Irving TX 75063 , OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS,WHEREOF,
the Surety Company has hereunto set its hand this 23rd day of September,2016
LIBERTY MUTUAL INSURANCE COMPANY
Atte4���.Do�. Surety Company
1eA.Westbrook -il ")
(Seal); Signa re of Authorized Representative
Sophinie Hunter Attorney-in-Fact
Title
NOTE: This forn' is to bo used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated.
Certificate No.7443912
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: That American Fire&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 West American Insurance Company
is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute
and appoint, Don E Cornell;Kelly A WestbrookRicardo J Reyna;Robbi Morales;Sophinie Hunter;Tina McEvvan'V.DeLene Marshall
all of the city of Dallas state of TX each individually if there be more than one named,its true and lawful attorney-in-fact to make,execute,seal,acknowledge
and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall
be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 5th day of August 2016
American Fire and Casualty Company "a
PND
CA S.G N,'i
INS6 PLtNSUgq `PNtNSUgA� The Ohio CasualtyInsurance Company �►
�Go"'°aATF N!T yJ ya-°�oaAT�-92 `J�pnrort9�'I'rm tea`�eeo++al�c�, N
Liberty Mutual Insurance Company c
1906 0 0 1979 co 1912 3 ¢ 1991 9West merican Insurance Company
NN ba�2y`'NaR+Fs`'R;2aD o�'y'rzk'�;anest"Q�j-a� i2Jr�SSAcrusE�hl� � �naae�°` � �
By: ! �
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G STATE OF PENNSYLVANIA ss David M.Care ;Assistant Secretary =
MCOUNTY OF MONTGOMERY =
O
dOn this 5th day of August 2016 before me personally appeared David M. Carey,who acknowledged himself to be the Assistant Secretary of American Fire and v F—
V w Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Insurance Company,and West American Insurance Company,and that he,as such,being authorized so to do, W
p M execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. ` E
a`s > 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. 0 o
0P PASA COMMONWEALTH OF PENNSYLVANIA /^/�/�) A) Q M
QQ KONw�F� Notarial Seal �/ _ a'�' ' d
t2 y FPly-..th
Pastella,Notary Public By: ,a
t� d of Twp.,MontgomeryCounty Teresa Pastella,Notary Public N =O � g sion Expires March 28,2017 3 M
L N C
1' yLVP �G Member,Pennsylvania Association of Notaries O G
O O �qH1 P��
� aro
_ 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 .00
a>; Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows:
ARTICLE IV—OFFICERS—Section 12.Power of Attorney.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject O C
r 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,
.F.,
O c 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 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 a)
` executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under >.0
,a the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority.
cm
U E c?
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,
> L and subject to such limitations as the chairman or the president may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute, _M
co
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 `~
Z v respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so v T—
executed such instruments shall be as binding as if signed by the president and attested by the secretary. FO
Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in-
fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,,bonds,recognizances and other surety
obligations.
Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company,wherever appearing upon a certified copy of any 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 affixed.
I,Gregory W.Davenport,the undersigned,Assistant Secretary,of American Fire and Casualty Company,The Ohio Casualty Insurance Company;Liberty Mutual Insurance Company,and
West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said
Companies,is in full force and effect and has not been revoked.
3r
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of /IUCY 20� .
,?F.�paconq�q�� eJ�"�o�Fcg2r, J�Js'f'oR o��4yrF Mo2�rA�Ci'
a 1906 0 0 1919 n 1912 3 Y 1991 3:3 a
By:
y ab y a Gregory W.Davenport,Assistant Secretary
e b y 2
d''�vy'Haencs��r�aaa dy�"aa�aes��-a �ij�'JSAcmis�`T �' �nmar�r- t
71 of 300
LMS 12873 122013
10Liberty
, � -1Mutual,.
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 llamar al numero de telefono gratis
make a complaint at para informacion o para someter una queja al
1-877-751-2640 1-877-751-2640
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 19462-1644 Plymouth Meeting, PA 19462-1644
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-IA) 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: http://www.tdi.texas.gov Web: http://www.tdi.texas.gov.
E-mail: Con sumerProtection@tdi texas.Pov E-mail: ConsumerProtection@tdi.texas.gov.
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
FOR7WORTH rev 03/05/07
TRANSPORTATION & PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:1
NAME OF PROJECT: West Fork Ranch Phase 9B
PROJECT NO.: 2608 CONTRACTOR: Burnsco Construction
DOE NO.: 7466
PERIOD FROM:12/16/15 TO: 11/17/16 FINAL INSPECTION DATE: 17-Nov-16
WORK ORDER EFFECTIVE:12/16/2015 CONTRACT TIME: 338 0 Wfl* 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.
8. 23.
9. 24.
10. 25.
11. 26.
12. 27•
13. 28.
14. 29.
15. 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS
THIS 0 0 0 0 338 338
PERIOD
PREVIOUS 0 0 0 0 0
PERIOD
TOTALS 0 0 0 0 7338 338
TO DATE
*REMARKS:
CONTACTOR DATE INSPECTOR DATE
ENGINEERING DEPARTTAENT
The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817)392-7941 •Fax: (817)392-7845