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Home My WebLink AboutContract 48336-FP3 Department of TP&W Const.Services CPN# .0L,(e19&,3 "� Date Project Manager t�NIG J Z'1(,-►� 1 Risk Management Canad J CI'1 Y SECRETARY �T ®RT HL D.O.E. Brotherton z,—I -i ° CONTRACT N0. CFA Westerman/Scanned /(e Esteban Perez/Scanned 12-1(e,l The Proceeding people have been Contacted concerning the request for final payment& have ATION AND PUBLIC WORKS released this project for such payment. F PROJECT COMPLETION 3eveloper Projects) 0&f -746 Clearance Conducted By OLMO, z AWIM4 City Project Ns: 02608 Ls77'983 36 Regarding contract 117466 for WEST FORK RANCH PHASE 9B 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. DEC EOVE Original Contract Price: $578,491.40 JAN 0 9 20f7 Amount of Approved Change Orders: Ns By Revised Contract Amount: Total Cost Work Completed: $578,491.40 Recommende0or Acceptance Date Asst, Director, TPW - Infrastructure Design and Construction Accepted Date Asst. Director, WATER DEPARTMENT vz//s/� Ass�. 0y Manager Dat Comments: BMA-MBID OFFICIAL RECORD CITY SECRETARY JAN 11 2017 p a CDS-- o a 0 FT. WORTHY TX 1<aitlal: Rev.9/22/16 o � � � av� �JAN 0 9 2017 B -9(po I— Co'-2(00? City Project Numbers 02608 y DOE Number 7466 Contract Name WEST FORK RANCH PHASE 9B Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 1111612016 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 $578,491.40 Less %Retained $0.00 Net Earned $578,491.40 Earned This Period $578,491.40 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 $578,491.40 Wednesday,November 16,2016 Page 5 of 5 6 g FART WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WEST FORK RANCH PHASE 9B Contract Limits Project Type WATER&SEWER 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 18(YD 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 1 of City Project Numbers 02608 DOE Number 7466 Contract Name WEST FORK RANCH PHASE 9B Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 11/16/2016 Project Funding WATER Item Description of Items EstimatedUnit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 8"PVC WATER PIPE 5030 LF $19.20 $96,576.00 5030 $96,576.00 2 8"GATE VALVE 17 EA $1,220.00 $20,740.00 17 $20,740.00 3 FIRE HYDRANT 5 EA $3,410.00 $17,050.00 5 $17,050.00 4 DUCTILE IRON WATER FITTINGS 3.08 TN $3,300.00 $10,164.00 3.08 $10,164.00 W/RESTRAINT 5 1"WATER SERVICE 93 EA $720.00 $66,960.00 93 $66,960.00 6 2"WATER SERVICE 4 EA $11,640.00 $6,560.00 4 $6,560.00 7 CONNECTION TO EXISTING 4"-12"WATER 3 EA $820.00 $2,460.00 3 $2,460.00 MAIN 8 TRENCH SAFETY 5030 LF $0.10 $503.00 5030 $503.00 9 8"WATERLINE LOWERING 3 EA $1,700.00 $5,100.00 3 $5,100.00 10 PAYMENT,PERFORMANCE&MAINTENANCE 1 LS $4,500.00 $4,500.00 1 $4,500.00 BONDS Sub-Total of Previous Unit $230,613.00 $230,613.00 SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity ——_ —————— Total Quanity Total 1 8"SEWER PIPE 4642 LF $25.00 $116,050.00 4642 $116,050.00 2 8"SEWER PIPE CSS BACKFILL 320 LF $38.00 $12,160.00 320 $12,160.00 3 10"SEWER PIPE 954 LF $27.00 $25,758.00 954 $25,758.00 4 10"SEWER PIPE CSS BACKFILL 120 LF $42.00 $5,040.00 120 $5,040.00 5 4'MANHOLE 26 EA $2,300.00 $59,800.00 26 $59,800.00 6 4'DROP MANHOLE 2 EA $2,800.00 $5,600.00 2 $5,600.00 7 4'EXTRA DEPTH MANHOLE 66.4 VF $110.00 $7,304.00 66.4 $7,304.00 8 MANHOLE VACUUM TESTING 28 EA $110.00 $3,080.00 28 $3,080.00 9 4"SEWER SERVICE 138 EA $560.00 $77,280.00 138 $77,280.00 10 POST CCTV INSPECTION 6036 LF $1.40 $8,450.40 6036 $8,450.40 11 TRENCH SAFETY 6036 LF $1.00 $6,036.00 6036 $6,036.00 12 TRENCH WATER STOPS 13 EA $250.00 $3,250.00 13 $3,250.00 13 CONCRETE ENCASEMENT FOR UTILITY PIPES 40 CY $120.00 $4,800.00 40 $4,800.00 14 EPDXY MANHOLE LINER 33 VF $190.00 $6,270.00 33 $6,270.00 Wednesday,November 16,2016 Page 2 of 5 City Project Numbers 02608 DOE Number 7466 Contract Name WEST FORK RANCH PHASE 9B Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 11/16/2016 Project Funding 15 PAYMENT,PERFORMANCE&MAINTENANCE 1 LS $7,000.00 $7,000.00 1 $7,000.00 BONDS Sub-Total of Previous Unit $347,878.40 $347,878.40 Wednesday,November 16,2016 Page 3 of 5 City Project Numbers 02608 DOE Number 7466 Contract Name WEST FORK RANCH PHASE 913 Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 11/16/2016 Project Funding Contract Information Summary Original Contract Amount $578,491.40 Chanae Orders Total Contract Price $578,491.40 Date STI I5 1 _ Total Cost of Work Completed $578,491.40 Contra q `l Less %Retained $0.00 / DIZ//- �/ Net Earned $578,491.40 ateY' Inspection S is Earned This Period $578,491.40 �— Retainage This Period $0.00 % Date Project is ger Less Liquidated Damages Ii Days @ /Day $0.00 Date LessPavement Deficiency $0.00 Asst.Direcct r/T W-Infrastructure Design and Construction Less Penalty $0.00 /L- `'/ Date /—F—�7 Less Previous Payment $0.00 Director/Contracting Department ,�, Plus Material on Hand Less 15% $0.00 �/,�� '4 — Balance Due This Payment $578,491.40 /Z Wednesday,November 16,2016 Page 4 of 5 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: West Fork Ranch PH 9 B PROJECT NUMBER: 2608 DOE NUMBER: 7466 WATER PIPE LAID SIZE TYPE OF PIPE LF Water 8in PVC SDR-14 5,030 FIRE HYDRANTS: 5 VALVES(16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: yes NEW SERVICES: I Inch Copper 985 2 Inch Copper 30 SEWER PIPE LAID SIZE TYPE OF PIPE LF Sewer 8in PVC-SDR-26 4642 Sewer loin PVC-SDR-26 320 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes NEW SERVICES: 4 inch PVC-SDR-26 990 TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817) 392-7845 FORTWORTHREV:02122107 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 11/3/2016 Name of Contractor Project Name Bumsco Constrution West Fork Ranch Phase 913 DOE Inspector Project Manager Weyman Oden Aaron Long DOE Number Project DzcuJZy Type of Contract 7466 7 Simple (i Routine Q Complex L$578,491.40 Water[] Waste Water[] Storm Drainages Pavement Initial Contract Amount l Contract Amount $578,491.40 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 L 1 Accuracy of Plans to Existing Conditions 2 Knowledge of Inspector L) 2 Clarity&Sufficiency of Details 3 Accuracy of Measured Quantities Ll 3 Applicability of Specifications LS 4 Display Of Professionalism C 4 Accuracy of Plan Quantities g 5 Citizen Complaint Resolution L' PROJECT MANAGER EVALUATION 6 Performance-Setting up Valve Crews,Labs C 1 Knowledge And/Or Problem Resolution ADMINISTRATION 2 Availability of Project Manager 1 Change Order Processing Time 13 Communication 2 Timliness of Contractor Payments L 4 Resolution of Utility Conflicts E 3 Bid Opening to Pre-Con Meeting Timeframe \ III)COMMENTS&SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor 5 INSPECTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS t The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TY 76012-6311 (817) 392-7941 •Fax: (817)392-7845 FORTWORTHREV:02/70/07 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR n CONTRACTOR&PROJECT DATA Name of Contractor Project Name Burnsco West Fork Ranch Ph. 913 DOE Inspector DOE Number Woman Oden 7466 JOE Inspector Project Manager Water 0 Waste Water❑ Storm Drainage[] Pavement Aaron Lona Initial Contract Amount Project Difficulty $578,491.40 O Simple Routine Q Complex Final ContractAmount Date $578,491.40 11/3/2016 11)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 1 3 20 15 TOTAL ELEMENT SCORE(A) 418 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 418 IIn CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/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 \-,)e-�,, c-, 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 tPulteCirollp 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: z4az 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 Storm Drain BY Ab Grantges, CQfi—trad Manager Subscribed and sworn before me on this date 26th of September, 2016. r Lal Notary Public Tarrant County, Texas aauue, LEIA(y1C61UlEN >�n s Notary PUbIIC, State of Texas 4$ Comm.Expires 06-262018 Notary ID 125446481 puna OWNER CONSENT OF ARCHITECT ❑ SURETY COMPANYARCHITECT ❑ 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 9B-Water, Sanitary Sewer,and Storm Drain Improvements Irving TX 75063 _f CONTRACT DATE: CONTRACTOR: BURNSCO CONSTRUCTION, INC. 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) LIBERTY MUTUAL INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of (here insert name and address of Contractor) BURNSCO CONSTRUCTION, INC. Southwest Boulevard Ben , CONTRACTOR, Benbrook TX 76132 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 Surety Company Atte4KeA.Westbrook (Seal): Signature of Authorized Representative Sophinie Hunter Attorney-in-Fact Title NOTE: This form 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 KNIOWN ALL PERSONS BY THESE PRESENTS: ThatAmerican 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 WestAmerican Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies°),pursuant toa,nd by authority herein set forth,does hereby name,constitute and appoint, Don E.Cornell;Kelly:A.Westbrook::FFicaydo J.Reyna ;Fiobbi=Morales;Sophlli're Hunter,Tina IVfct=wari;-V:DeLene Marshall all of the city of Dallas state-of TX: each mdlvidually if there be more thaij 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 anyand all undertakings,bonds_:recognlzances and other,surety obligations In pursuance of these presents and shall be as binding upon the Companies as if they have'been duly signed yi-ihe president and attested by;fhe secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attoey has been subscribed by an authorized offrcar or official of the Compaiies and the corporate seals of the Companies have been affixed thereto this Stn day of August 2016 QN0 CAS, �t�INs� Nsu� NiNsuR American Fire and Casualty Company ��v�ppeow TF9�T yJP�ovPo2T�9Z The Ohio Casualty Insurance Company V z �P 1912 n Liberty Mutual Insurance Company 1906 0 0 1919 ' n a F 1991 Company West merican Insurance Com • N d�vy HAM1tI"+�\`�� OJ�y KFiAMp'�\Q�'aD ��/y�SSgGHUS�`Pt= � ?,'JIANP � By /I STATE OF PENNSYLVANIA ss David M.Care ,'Assistant Secretary C R +_ COUNTY OF MONTGOMERY _ c,s m_ On 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 01- I L) a) 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, V p o execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. L 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 C ++ RS P PqS COMMONWEALTH OF PENNSYLVANIA 1-1 +4-'C wFQr�!! Notarial Seal f/ /^\/n , ) /�� ) 4-r N Teresa Pastella,Notary Public By: / 0 O- of Plymouth Twp.,Montgomery County Teresa Pastella,Notary Public C My Commission Expires March 28,2017 3 0 4 y .yNStrLNP `G d-O. - �T �, Member,Pennsylvania Association of Notaries _ O O r ARY P� a r 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 Ur C ai Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: r e c R 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 s F; 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 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 j E m 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 < asexecuted,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 >s 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. 19 i..c r rARTICLE 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, -! 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 —P 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 executed such instruments shall be as;binding as if signed by ihepresidentandattesfed bythe secretary t Certificate of Designation-The Presider1 of the Company`ading pursuant to the Bylaws of the:Company authorizes David M.Carey Asslstaht Secretary to appoint such attorneys-in- ~ I fact as may be necessary to act on behalf;of the Company,to make execute,seal,acknowled s and deliver as suret an :and all undertaken §`:.bonds,recognizances and other surety Y ry p. Y.. g g.. . 9 Y Y Y. obligations. Authorization-By unanimous consent of the Companys 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§urety bonds,shall be valid and binding upon the Company with 1 the same force and effect as though manually affiXed 1,Gregory W.Davenport,the undersigned AssrstantSecretaryofArnerican Fire and CasualtyCompan y,The Ohio Casualty-lnsurahce_Company:Liberty Mutual Insurance Company,and West American Insurance Company do hereby certliy that the original power o.attorney of wbish the foregoing is a fW1,true and correct copy:of the Power of Attorney executed by said Companies,is in full force and effect and has not beeh=revoked. g j IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of 20 B f P;pD CAs� - �-�Y INSU �,1NSU,? �NINV- Q�.�0;�>o2yrFo9�� JP�oNeox,;T,o92 J,�JP�aPofcq`oy�F ��;AxPwt�r��<" a 1906 0 o y 1919 n 1 1912 00 1991 t: By: Gregory W.Davenport,Assistant Secretary 1� d�l2y'HnM4`.,�ram .)'y�'HAh1PS;0.a'�D gid�SSgtHUS��= �N�IANP �' _ V 71 of 300 'i LMS_12873_122013 Liberty Lltl..lal.. SURETY TEXAS TEXAS IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or snake a complaint: Para obtener informacion o para someter una queja: You may call toll-free for information or to Usted puede Ilamar 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 Depart'amento de Seguros Consumer Protection (111-1A) de Texas Consumer Protection (111-1A) P. 0. Box 149091 P. 0. Box 149091 Austin, TX 78714-9091 Austin, TX 78714-9091 FAX: (512) 490-1007 FAX 9 (512) 490-1007 Web: http•//www.tdi.texas.gov Web: http•//www.tdi.texas. ov E-mail: ConsumerProtection@tdi.texas.gov E-mail: ConsumerProtectionna tdi.texas.gov PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS 0 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 September 26, 2016 City of Fort Worth CFA Administration 1000 Throckmorton St. Fort Worth_ TX 76102) RE: Final Waiver of Lien; Water, Sanitary Sewer& Drainage Improvements to serve West Fork Ranch 913: DOE # 7466 City Project 402608 The purpose of this letter is to acknowledge that we have been paid in full by Pulte Group for the public improvements constructed to serve West Fork Ranch 913, 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 At Ab Grantges Contract Manager 6331 Southwest Blvd Benbrook, Texas 76132 Office: 817-738-3200 Fax: 817-738-3435 FORTWORTH rev 03/05/07 _ 'S 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 Q WO 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. SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL &HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS THIS 0 0 0 PERIOD 0 338 338 PREVIOUS 0 0 0 0 0 PERIOD TOTALS 0 0 0 TO DATE 0 338 338 *REMARKS: CONTRA OR DATE INSPECTOR DATE ENGINEERING DEPARTMENT The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TZ 76012-6311 (817) 392-7941 •Fax: (817) 392-7845