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Home My WebLink AboutContract 46950-FP2 Department of TP &W Const. Services CPN# 6 6 Dat Project Manager 76 Risk Management Canad 9 ITWORTH, CITY SECRETARYl�D.O.E. Brotherton R RACONTCTNO., `1 CCFA Westerman/Scanned aJ � "lo . Esteban Perez/Scanned �— The Proceeding people have been Contacted concerning the request for final payment& have 'ATION AND PUBLIC WORKS released this project for such payment. IF PROJECT COMPLETION Developer Projects) Clearance Conducted By �/amze�izry n e �7� � City Project Ns: 02440 rn � Regarding contract 117379 for BEECHWOOD CREEKS PHASE 4 as required by the 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. 0 Original Contract Price: $58,469.21 Amount of Approved Change Orders: Tj'o Revised Contract Amount: Total Cost Work Coinpleted: $58,469.21 Recommends f r Acceptance Date Asst. Director, W - Infrastructure Design and Construction Accepted /' Date 4W Directdr, TRANSPORTATI ' N & PUBLIC WORKS -D-V Asst. City Manager Date Comments: EMAILE" OFFICIAL RECORD JAN 17 7017 CITY SECRETARY FT.WORTH,TX lwtidS Rev.9/22/16 { FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name BEECHWOOD CREEKS PHASE 4 Contract Limits Project Type STREET LIGHT City Project Numbers 02440 DOE Number 7379 Estimate Number I Payment Number 1 For Period Ending 10/5/2016 WD City Secretary Contract Number 117379 Contract Time 2WD Contract Date Days Cbarged to Date 261 Project Manager Ehia Contract is 100.00 Complete Contractor INDEPENDENT UTILITY CONSTRUCTION 5109 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors RODGERS / SALAZAR Wednesday,October 5,2016 Page I of 4 City Project Numbers 02440 DOE Number 7379 Contract Name BEECHWOOD CREEKS PHASE 4 Estimate Number I Contract Limits Payment Number 1 Project Type STREET LIGHT For Period Ending 10/5/2016 Project Funding STREET LIGHTING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No, Quanity Total Quanity Total I 100W HPS PC LIGHTING FIXTURE 14 EA $3,016.00 $42,224.00 14 $42,224.00 2 2"CONDT PVC SCH 40 783 LF $11.16 $8,738.28 783 $8,738.28 3 NO 10 INSULATED ELEC CONDR 2349 LF $2.57 $6,036.93 2349 $6,036.93 4 GROUND BOX TYPE B 5 EA $294.00 $1,470.00 5 $1,470.00 Sub-Total of Previous Unit $58,469.21 $58,469.21 Wednesday,October 5,2016 Page 2 of 4 City Project Numbers 02440 DOE Number 7379 Contract Name BEECHWOOD CREEKS PHASE 4 Estimate Number I Contract Limits Payment Number 1 Project Type STREET LIGHT For Period Ending 10/5/2016 Project Funding Contract Information Summary Original Contract Amount $58,469.21 Chante Orders Total Contract Price $58,469.21 Date Total Cost of Work Completed $58,469.21 Contra r Less %Retained $0.00 / Net Earned $58,469.21 Date Inspection S pe Earned This Period $58,469.21 Retainage This Period $0.00 Date , I� Less Liquidated Damages Project Manager �f Days @ /Day $0.00 Date ��'� ! LessPavement Deficiency $0.00 As t. re tor/TPW-Infrastructure Design and Construction Less Penalty $0.00 -' -, Date I Less Previous Payment $0.00 Directo ontracting Departure.t Plus Material on Hand Less 15% $0.00 fv" LL✓ Balance Due This Payment $58,469.21 r Wednesday,October 5,2016 Page 3 of 4 City Project Numbers 02440 DOE Number 7379 Contract Name BEECHWOOD CREEKS PHASE 4 Estimate Number I Contract Limits Payment Number 1 Project Type STREET LIGHT For Period Ending 10/5/2016 Project Funding Project Manager Ehia City Secretary Contract Number 117379 Inspectors RODGERS / SALAZAR Contract Date Contractor INDEPENDENT UTILITY CONSTRUCTION Contract Time 20 WD 5109 SUN VALLEY DRIVE Days Charged to Date 261 WD 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 $58,469.21 Less %Retained $0.00 Net Earned $58,469.21 Earned This Period $58,469.21 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 $58,469.21 Wednesday,October 5,2016 Page 4 of 4 FORTWORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.: NAME OF PROJECT: Beechwood Creeks Phase 4 PROJECT NO.: 02440 CONTRACTOR: Independent Utility Const. DOE NO.: 7379 PERIOD FROM;09/28/15 TO: 09/29/16 FINAL INSPECTION DATE: 9/29/2016 WORK ORDER EFFECTIVE:9/28/2015 CONTRACT TIME: 85 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. 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 107 261 368 PERIOD PREVIOUS PERIOD TOTALS 107 261 368 TO DATE *REMARKS: CONTRACTOR DATE 1 CTO DATE ENGINEERING DEPAR r T 1 s` The Cit} of Fort Worth• 1000 Throckmorton Street•Fort Worth,TZ 76012-6311 (817) 392-7941 •Fax: (817)392-7845 FORTWORTH REV:8/20/16 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR I) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Independent Utility Construction Beechwood Creeks Phase 4 Inspector City Project Number Edwin R.Rodriguez,Sr. 2440 Construction Components Project Manager 0 Water❑✓ wastewater[:] Storm Drainage[] Pavement Fred Ehia,PE Initial Contract Amount Project D ff culty $58,469.21 0 Simple Routine 0 Complex Final Contract Amount Date $58,469.21 10/7!2016 I1)PERFORMANCE EVALUATION 0-Inadequate I-Deficient 2-Standard 3-Good 4-Excellent ELEMENT WEIGHT(x) APPLICABLE(Y/N) RATING(0-4) MAX SCORE SCORE I Submission of Documents 2 Y 4 8 8 2 Public Notifications 5 Y 4 20 20 3 Plans on Site 5 Y 3 20 15 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 N 12 After Hours Response 5 N 13 Project Completion 5 N TOTAL ELEMENT SCORE(A) 383 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 383 III)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 388 Rating([TS/MS] *100%) 383 ! 388 = 99% 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) Inspector Signature /�/� Contractor Signature Inspector's Supervisor Signature �--- CONTRACTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth•8851 Camp Bowie West Blvd. •Fort Worth,TK 76116•(817)392-8306 FORTWORTH REV:02/22/07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 10/10/2016 Name of Contractor Project Name Independent Utility Construction Beechwood Creeks Phase 4 DOE Inspector Project Manager Edwin Rodriguez Fred Ehia,PE DOE Number PrqjectDifficulh, Type of Conowet vj.I&#*rt A/C7 7379 O Simple QQ Routine Q Complex ❑ water[] Waste Water❑ Storm Drainage[] Pavement Initial Contractdmount Final ContractAinount $58,469.21 $58,469.21 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 Lf 12 Clarity& Sufficiency of Details 3 Accuracy of Measured Quantities 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 1 Knowledge And/Or Problem Resolution ADMINISTRATION 2 Availability of Project Manager 1 Change Order Processing Time 3 Communication 2 Timliness of Contractor Payments 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 (D The Cit) of Fort'Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT G707) Bond No. 4075941 PROJECT: Street Lighting Improvements to serve Beechwood Creeks,Phase 4, City Project No. 02240 (name,address) Fort Worth, Texas TO (Owner) ARCHITECT'S PROJECT NO: F—City of Fort Worth CONTRACT FOR: Above Project 1000 Throckniorton Street Fort Worth, Texas 76102 CONTRACT DATE: CONTRACTOR: Independent Utility 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) Ohio Farmers Insurance Company 555 Republic Drive, Suite 450 Plano, Texas 75074 ,SURETY COMPANY, on bond of(here insert name and address of Contractor) Independent Utility Construction, Inc. 5109 Sun Valley Drive ,CONTRACTOR, Fort Worth, Texas 76119 hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the Surety Company of any of its obligations to(here insert name and address of Owner) City of Fort Worth 1000 Throckmorton Street Fort Worth, Texas 76102 ,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 October 2016 OHIO FARMERS INSURANCE COMPANY Surety Company By( t Signature of uthorized Representative Attest: (Seal): -' Elizabeth Gray Attorney—in—Fact Title Note:This form is intended io.be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition POWER#AND ISSUED PRIOR TO 04/20/11, FOR ANY PERSON OR PERSONS NAMED BELOW. POWER NO. 4220052 06 General Westfield Insurance Co. Power of Attorney Westfield National Insurance Co. Ohio Farmers Insurance Co. CERTIFIED COPY Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as 'Companies," duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County,Ohio,do by these presents make,constitute and appoint CHARLES D. SWEENEY, MICHAEL A.SWEENEY, KYLE W.SWEENEY, ELIZABETH GRAY,JOINTLY OR SEVERALLY of FORT WORTH and State of TX its true and lawful Attorney(s)-in-Fact,with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other.instruments or contracts of suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - -- - - - -- LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. i and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President,sealed with the corporate seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the.premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: 'Be It Resolved,that the President, any Senior Executive,any Secretary or any Fidelity&Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and deliver,any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary.' 'Be It Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.- (Each adopted at a meeting held on February 8,2000). In Witness Whereof,WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of APRIL A.D.,2011 •�y.un WlMp, ,p•n,uu..y,, ,.,,w.rttr4,y',i Corporate -'e'OURANC.,,•t = ,• ,PK�nNACZ r, ENSU��"� WESTFIELD INSURANCE COMPANY Seats ,0'v . 4<'`: <:• •.G':- .•••••=~;�1�;% WESTFIELD NATIONAL INSURANCE COMPANY Affixed �v: aft— ►� Q. ••-p; �•' + F` OHIO FARMERS INSURANCE COMPANY SEAL g N % im: •ti= in , :n= 18.48 �y 7 ''..• � d .ice!•• '.0 i�% •ice 4!` ',��""°"^•"`" { *�•�' """"'•��•• BY: Richard State of Ohio L. Kinnaird, Jr., National Surety Leader and County of Medina ss.: Senior Executive On this 201h day of APRIL A.D.,2011 , before me personally came Richard L. Kinnaird, Jr. to me known,who, being by me duly sworn, did depose and say,that he resides`in Medina, Ohio;that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above Instrument;that he knows the seals of said Companies,that the seals affixed to said instrument are such corporate seals;that they were so affixed by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order. Notarial Seal Affixed0. ,�P.��1//%SF'•�z William J.Kahelin,A rney at Law, Notary Public State of Ohio 1P +r o My Commission Does Not Expire(Sec.147.03 Ohio Revised Code) County of Medina ss.: y off` r� °,«�••• I,Frank A.Carrino,Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies,which is still in full force and effect;and furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are In full force and effect. In Witness Whereof, I have hereunto set;mv t•and and affixed the seals of said Companies at Westfield Center, Ohio, this IOth day of October..,..A°r 2016 •,,,,,.!„ , ,dguR�t�l�+ t' ,•�,.��CSC?NAt NSG r ItAsui a7 'Aro =t-. .m SEAN _ - ZZ � � Secretary VV :.o :%1846: = Frank A.Carrino,-Secretary BPOAC2 (combined) (06-02) AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersigned authority, on this day personally appeared RICHARD WOLFE, Vice President of INDEPENDENT UTILITY CONSTRUCTION, INC.,known to me to be a credible person, and after being duly sworn by me, 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: Beechwood Creeks Phase 4 - City Project No. 02240 BY: 'ch Wo e,Vice President SUBSCRIBED AND SWORN TO BEFORE ME on this 10 day of ('C4-0 pP�' , 2016. neo, DANA P. JETTY 1 �: Notary Public,state of Texas ; ;�` My Commission Expires Notary Public, State of T ".,'„F g;:�' June 30, 2019 CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT G707) Bond No. 4075941 PROJECT: Street Lighting Improvements to serve Beechwood Creeks, Phase 4, City Project No. 02240 (name,address) Fort Worth, Texas TO (Owner) ARCHITECT'S PROJECT NO: City of Fort Worth CONTRACT FOR: Above Project 1000 Throckniorton Street Fort Worth, Texas 76102 CONTRACT DATE: CONTRACTOR: Independent Utility 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) Ohio Farmers Insurance Company 555 Republic Drive, Suite 450 Plano, Texas 75074 ,SURETY COMPANY, On bond of(here insert name and address of Contractor) Independent Utility Construction, Inc. 5109 Sun Valley Drive 'CONTRACTOR, Fort Worth, Texas 76119 hereby approves of the final payment to the Contractor, and agrees that the fmal payment to the Contractor shall not relieve the Surety Company of any of its obligations to(here insert name and address of Owner) City of Fort Worth 1000 Throckniorton Street Fort Worth, Texas 76102 ,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 October 2016 OHIO FARMERS INSURANCE COMPANY Surety Company B Signaturedf-Authorized Representative Attest: (Seal): Elizabeth Gray Attorney-in-Fact Title Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME POWER#AND ISSUED PRIOR TO 04120111, FOR ANY PERSON OR PERSONS NAMED BELOW. POWER NO. 4220052 06 General Westfield Insurance Co. Power of Attorney Westfield National Insurance Co. Ohio Farmers Insurance Co. CERTIFIED COPY Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as 'Companies," duly organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County,Ohio, do by these presents make,constitute and appoint CHARLES D. SWEENEY, MICHAEL A. SWEENEY, KYLE W.SWEENEY, ELIZABETH GRAY,JOINTLY OR SEVERALLY of FORT WORTH and State of TX its true and lawful Attorney(s)-in-Fact,with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other,instruments or contracts of suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - -- - - . LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. 1' and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President,sealed with the corporate seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: "Be It Resolved,that the President, any Senior Executive, any Secretary or any Fidelity&Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary." "Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting held on February 8,2000). In Witness Whereof,WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of APRIL A.D.,2011 . •�,wuoly.....1, ,.,,l , ...,., Corporate aa�a. `��SULQi:•, WESTFIELD INSURANCE COMPANY seals �rrQ�4sUANC�p�s� aaP��(�NA(�NSG i ,... ."',��; WESTFIELD NATIONAL INSURANCE COMPANY Affixed v: .oa. tin FQ. A= -��' :<'' OHIO FARMERS INSURANCE COMPANY OAF SEAL ` 11348 ; State of Ohio '"'""`" """"*""'alaaaa, """"''f•aa.•`a BY: yRichard L. Kinnaird, Jr.; National Surety leader and County of Medina ss.: Senior Executive On this 20th day of APRIL A.D.,2011 , before me personally came Richard L. Kinnaird, Jr. to me known, who, being by me duly sworn, did depose and say,that he resides'in Medina, Ohio;that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument;that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order. Notarial Seal Affixed •........ F,�= 2' `�► =f • - William J. Kahelin,A rney at Law, Notary Public State of Ohio =,N� o My Commission Does Not Expire(Sec. 147.03 Ohio Revised Code) County of Medina ss.: y r 4,�;- 1, Frank A..Carrino,Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies,which is still in full force and effect;and furthermore,the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 1 oth day of October,. A ,2.; 2016 ,Ila + N1I1IH1441 IIIf 4 11 a a't\�N.�� i/ •. .r' 1l{JYLQI:H4 Vol Vy six s ro N SEAL - m." n•-2 is s' j ► Secretary 10; ;•1848.4; Frank A. Carrino,-Secretary '111111111111\Ila 'II.IIIIIfM11\,a•,. BPOAC2 (combined) (06-02) AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersigned authority, on this day personally appeared RICHARD WOLFE, Vice President of INDEPENDENT UTILITY CONSTRUCTION, INC., known to me to be a credible person, and after being duly sworn by me, 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: Beechwood Creeks Phase 4 - City Project No, 02240 BY: 'ch Woe, Vice President SUBSCRIBED AND SWORN TO BEFORE ME on this day of 2016. DANA P. JETTY Notary Public,state of texas 1 mi/^l iy My Commission Expires =,;;. ��;,• Notary Public, State of T June 30, 2019