HomeMy WebLinkAboutContract 46021-FP2 Department of TP&W Const. Services
CPNt/ 1.? f Dpte
Project PJlagager —a ITWORTH, '�
17,
Risk Mana ement Canad �� CiTYSECRET
D.O.E. Brotherton - CONTRACT NO. �/ Z
CFA Westerman/Scanned
4
Esteban Perez/Scanned Z
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
rl D.O.E. Ns: 7246
Clearance Conducted By �/urmze�r� Cv z.9G
Regarding contract 117246 for WESTPORT PKWY&HASLET ROANOKE RD (WB) as required by the
TRANSPORTATION& PUBLIC WORKS as approved by City Council on N/A through 1v1&C N/A the director
of the TRANSPORTATION&PUBLIC WORKS upon the reconunendation of the Assistant Director of the
Transportation&Public Works Department has accepted the project as complete.
Original Contract Prices: $1,095,255.88
Amount of Approved Change Orders: $1,000.00 Ne l
Revised Contract Amount: $1,099,255.88
Total Cost Work Completed: $1,099,255.88
Less Deductions:
Liquidated Damages: Days rr $210.00/Day
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Work Completed: $1,099,255.88
Less Previous Payments: $0.00
Final Pa ment Due $1,099,255.88
t�� Cl "fin
Recommended for Acceptance Date
Asst. Director, TPW - Infrastructure Design and Construction
I.J. Ili
-- - -_- -- - - l
Accepted Date
Direct r, TRANSPORTATION & PUBLIC WORI<S
Asst. City Manager Date o`
Comments: C205-541200-207760229683
OFFICIAL RECORD JAN 3 0 2017
CITY SECRETARY
Initial:FT.WORTH,TX
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name WESTPORT PARKWAY&HASLET ROANOKE RD
Contract Limits
Project Type STORM DRAIN&PAVING
City Project Numbers 02296
DOE Number 7246
Estimate Number 1 Payment Number 1 For Period Ending 7/29/2016
CD
City Secretary Contract Number 117246 Contract Time 12(ED
Contract Date Days Charged to Date 606
Project Manager Long Contract is 100.00 Complete
Contractor INTEGRATED CONSTRUCTION&DEVELOPMEN
3110 W.SOUTHLAKE BLVD,STE 120
SOUTHLAKE, TX 76092
Inspectors LAYER / VEGA
Friday,July 29,2016 Page 1 of 6
L
City Project Numbers 02296 DOE Number 7246
Contract Name WESTPORT PARKWAY&HASLET ROANOKE RD Estimate Number I
Contract Limits Payment Number 1
Project Type STORM DRAIN&PAVING For Period Ending 7/29/2016
Project Funding
STORM DRAIN
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quaaity Total
1 72"RCP 694 LF $243.00 $168,642.00 694 $168,642.00
2 60"RCP 619 LF $177.00 $109,563.00 619 $109,563.00
3 42"RCP 756 LF $96.00 $72,576.00 756 $72,576.00
4 36"RCP 286 LF $68.58 $19,613.88 286 $19,613.88
5 21"RCP CO#1 206 LF $36.82 $7,584.92 206 $7,584.92
6 5'X T BOX CULVERT 282 LF $167.48 $47,229.36 282 $47,229.36
7 10'CURB INLET 2 EA $2,640.00 $5,280.00 2 $5,280.00
8 10'RECESSED INLET 2 EA $2,704.00 $5,408.00 2 $5,408.00
9 20'RECESSED INLET 1 EA $3,638.00 $3,638.00 1 $3,638.00
10 72"6:1 SET I EA $4,508.00 $4,508.00 1 $4,508.00
11 5'X2'4:1 SET 2 EA $4,113.00 $8,226.00 2 $8,226.00
12 TXT DROP INLET I EA $8,983.00 $8,983.00 1 $8,983.00
13 8'STORM JUNCTION BOX 1 EA $7,718.00 $7,718.00 1 $7,718.00
14 MEDIUM STONE RIPRAP 165 SY $56.07 $9,251.55 165 $9,251.55
15 REINFORCED CONCRETE COLLAR 4 EA $634.00 $2,536.00 4 $2,536.00
16 REMOVE 36"STORM LINE 68 LF $7.29 $495.72 68 $495.72
17 REMOVE 21"STORM LINE 56 LF $4.43 $248.08 56 $248.08
18 REMOVE STORM SEWER BOX 10 LF $24.79 $247.90 10 $247.90
19 REMOVE HEADWALUSET 4 EA $371.91 $1,487.64 4 $1,487.64
20 REMOVE RIP RAP 121 SY $4.10 $496.10 121 $496.10
21 TRENCH SAFETY 2833 LF $2.10 $5,949.30 2833 $5,949.30
22 REMOVE&REPLACE BARBED WIRE FENCE 420 LF $7.00 $2,940.00 420 $2,940.00
23 ASPHALT PVMT REPAIR BEYOND DEFINED 75 SY $65.56 $4,917.00 75 $4,917.00
WIDTH
24 CONC PVMT REPAIR 113 SY $40.12 $4,533.56 113 $4,533.56
25 REMOVE CONC CURB&GUTTER 119 LF $3.00 $357.00 119 $357.00
26 7"CONC CURB AND GUTTER 64 LF $18.00 $1,152.00 64 $1,152.00
27 18"STORM ABANDONMENT PLUG 6 EA $165.00 $990.00 6 $990.00
28 EARTHEN CHANNEL 1100 CY $8.43 $9,273.00 1100 $9,273.00
29 SEEDING 2800 SY $0.85 $2,380.00 2800 $2,380.00
30 TOPSOIL 467 CY $29.29 $13,678.43 467 $13,678.43
Friday,July 29,2016 Page 2 of 6
City Project Numbers 02296 DOE Number 7246
Contract Name WESTPORT PARKWAY&HASLET ROANOKE RD Estimate Number I
Contract Limits Payment Number I
Project Type STORM DRAIN&PAVING For Period Ending 7/29/2016
Project Funding
31 REMOVE&REPLACE GRAVEL DRIVE 37 SY $18.00 $666.00 37 $666.00
32 4'DROP INLET CO#1 1 EA $4,000.00 $4,000.00 1 $4,000.00
33 MODIFY 7'X7'DROP INLET TO 7 STORM 1 EA $3,131.80 $3,131.80 1 $3,131.80
DRAIN CO#I
Sub-Total of Previous Unit $537,701.24 $537,701.24
PAVING
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 10"CONC PYMT CO#1 3480 SY $70.00 $243,600.00 3480 $243,600.00
2 8"LIME TREATMENT 5292 SY $6.50 $34,398.00 5292 $34,398.00
3 HYDRATED LIME 80 TN $160.00 $12,800.00 80 $12,800.00
4 8"ASPHALT TRANSITION 94 SY $36.00 $3,384.00 94 $3,384.00
5 7"CONC CURB AND GUTTER CO#1 2368 LF $12.00 $28,416.00 2368 $28,416.00
6 BARRIER FREE RAMP TYPE R-1 CO#1 1 EA $3,500.00 $3,500.00 1 $3,500.00
7 BARRIER FREE RAMP TYPE M-2 1 EA $3,500.00 $3,500.00 1 $3,500.00
8 BARRIER FREE RAMP TYPE P-1 5 EA $1,750.00 $8,750.00 5 $8,750.00
9 4"CONC SIDEWALK 13388 SF $5.00 $66,940.00 13388 $66,940.00
10 REMOVE ADA RAMP 1 EA $750.00 $750.00 1 $750.00
11 REMOVE SIDEWALK 660 SF $1.00 $660.00 660 $660.00
12 REMOVE CONC PVMT 136 SY $6.00 $816.00 136 $816.00
13 REMOVE ASPHALT PVMT 65 SY $5.00 $325.00 65 $325.00
14 REMOVE AND REINSTALL SIGN PANEL AND 5 EA $250.00 $1,250.00 5 $1,250.00
POST
15 FURNISH/INSTALL ALUM SIGN GROUND 6 EA $1,750.00 $10,500.00 6 $10,500.00
MOUNT CITY STD
16 24"SLD PVMT MARKING HAE(W) 40 LF $15.00 $600.00 40 $600.00
17 LANE LEGEND ARROW 4 EA $100.00 $400.00 4 $400.00
18 4'SLD PVMT MARKING HAS(Y) 2230 LF $1.50 $3,345.00 2230 $3,345.00
19 8"SLD PVMT MARKING HAS(Y) 445 LF $3.00 $1,335.00 445 $1,335.00
20 REFL RAISED MARKER TYII-CR 36 EA $7.00 $252.00 36 $252.00
21 REFL RAISED MARKER TY I-C 31 EA $7.00 $217.00 31 $217.00
22 REMOVE RAISED MARKER 1 LS $275.00 $275.00 1 $275.00
23 4"SLD PVMT MARKING HAS(W) 380 LF $1.50 $570.00 380 $570.00
24 REMOVE CONC CURB&GUTTER 850 LF $5.50 $4,675.00 850 $4,675.00
26 6"CONCRETE DRIVEWAY 2592 SF $5.67 $14,696.64 2592 $14,696.64
Friday,July 29,2016 Page 3 of 6
City Project Numbers 02296 DOE Number 7246
Contract Name WESTPORT PARKWAY&HASLET ROANOKE RD Estimate Number I
Contract Limits Payment Number I
Project Type STORM DRAIN&PAVING For Period Ending 7/29/2016
Project Funding
27 7"FLEXIBLE BASE,TYPE B CO#1 1510 SY $37.00 $55,870.00 1510 $55,870.00
28 3"ASPHALT PVMT TYPE D CO#1 1510 SY $33.00 $49,830.00 1510 $49,830.00
29 7"TEMPORARY ASPHALT CURB CO#1 700 LF $12.00 $8,400.00 700 $8,400.00
30 LANDSCAPING AROUND SIGN CO#1 1 EA $1,500.00 $1,500.00 1 $1,500.00
Sub-Total of Previous Unit $561,554.64 $561,554.64
Friday,July 29,2016 Page 4 of 6
City Project Numbers 02296 DOE Number 7246
Contract Name WESTPORT PARKWAY&HASLET ROANOKE RD Estimate Number I
Contract Limits Payment Number I
Project Type STORM DRAIN&PAVING For Period Ending 7/29/2016
Project Funding
Contract Information Summary
Original Contract Amount $1,095,255.88
Change Orders
Change Order Number 1 $4,000.00
Total Contract Price $1,099,255.88
/d
Total Cost of Work Completed $1,099,255.88
Contractor �
Less Retained $0.00
` °/a
� Net Earned $1,099,255.88
Date
Inspection Supervisor Earned This Period $1,099,255.88
Retainage This Period $0.00
Date / J ( Less Liquidated Damages
r 'ect Manager
Days rr /Day $0.00
CDate LessPavement Deficiency $0.00
tlDirector/TPW, ` -Infrastructure Design and Cons ction Less Penalty $0.00
U. Date 0412 Less Previous Payment $0.00
Dire(#r/Contracting Dep rent Plus Material on Hand Less 15% $0.00
Balance Due This Payment $1,099,255.88
Friday,July 29,2016 Page 5 of 6
City Project Numbers 02296 DOE Number 7246
Contract Name WESTPORT PARKWAY&HASLET ROANOKE RD Estimate Number I
Contract Limits Payment Number I
Project Type STORM DRAIN&PAVING For Period Ending 7/29/2016
Project Funding
Project Manager Long City Secretary Contract Number 117246
Inspectors LAYER / VEGA Contract Date
Contractor INTEGRATED CONSTRUCTION&DEVELOPMEN Contract Time 120 CD
3110 W.SOUTHLAKE BLVD,STE 120 Days Charged to Date 606 CD
SOUTHLAKE, TX 76092 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 $1,099,255.88
Less %Retained $0.00
Net Earned $1,099,255.88
Earned This Period $1,099,255.88
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 $1,099,255.88
Friday,July 29,2016 Page 6 of 6
FORT WORTH rev 03/05,07
z -
TRANSPORTATION & PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:1
NAME OF PROJECT: Westport Parkway&Haslet Roanoke Road
PROJECT NO.: 02296 CONTRACTOR: Integrated Construction
DOE NO.: 7246
PERIOD FROM:12/01/14 TO: 07/28/16 FINAL INSPECTION DATE: 28-Jul-16
WORK ORDER EFFECTIVE:5/4/2015 CONTRACT TIME: 120 0 WE* CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH CHARGED
CREDITED MONTH CHARGED
URNCREDITED
IG
1. 16.
2. 17.
3. 18.
4. 19.
5. 20.
6. 21.
7. 22.
8. 23.
9. 24.
10. 25.
]1. 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 606
PERIOD
PREVIOUS 0
PERIOD
TOTALS 606
TO DATE
*REMARKS:
CONTRA TOR 'y DATE WSPECTOR A
ENGINEERING DEPARTIJENT
� r The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311
s (817)392-7941 •Fax:(817)392-7845
C. NSENT OF OWNER
ARCHITECT
SURETY COMPANY CONTRACTOR
TO FINAL PAYMENT SURETY
AIA DOCUMENT G707 Bond No. 106094639 OTHER
PROJECT: Water, Sewer, Paving Drainage and Stet Improvements to serve Westport Parkway and Haslet Roanoke Road
TO (Owner) ARCHITECT'S PROJECT NO:
I City of Fort Worth CONTRACT FOR:
1000 Throckmorton Street
Fort Worth,TX 76102 CONTRACT DATE:
CONTRACTOR: RES IHS, LLC
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).
Travelers Casualty and Surety Company of America , SURETY,
4650 Westway Park Blvd.
Houston, TX 77041
on bond of(here insert name and address of Contractor)
RES IHS, LLC , CONTRACTOR,
3110 W. Southlake Blvd., 4120
Southlake,TX 76092
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)
City of Fort Worth , OWNER,
1000 Throckmorton Street
Fort Worth,TX 76102
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
the Surety Company has hereunto set its hand this 28th day of July 2016
Travelers Casual nd Sure Company of America
.ure Company
l
Witness:
(Seal): Si ature of Authorized Representative
Richard Covin oseph R. Aulbert, Attorney-in-Fact
t
NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF
PAYMENT OF DEBTS AND CLAIMS,Current Edition
AIA DOCUMENT G707 • CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 1970 EDITION • AIA® C 1970 • THE
AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE.,NW,WASHINGTON,D.C.2000
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
I' d w POWER OF ATTORNEY
Il VELERS J Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
Attorney-In Fact No. 229808 Certificate No.O O O J 1 O 2 V O
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St.Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the
laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint
Marc W.Boots,Vickie Lacy,P.T.Osburn,Susan Golla,Maria D.Zuniga,Richard Covington,Joseph R.Aulbert,and Ashley Koletar
of the City of Houston State of Texas ,their true and lawful Attorney(s)-in-Fact,
each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 27th
day of July 2016
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
GASU.� tTYt�Jn. 1.NSU...1P
� m v PICOflDORptFD� `- zfr �fL A)C,m IW itOPPOggTf
t v s z o � 9 --- w NarrrFORo, wflrFo�S tsss
1.77 E _� JJJ
r SEAL;o i '•�'.SSAL:'a
y` ctE'N� d0j� ��! / T�FFN�F c v1S'..N D r •'%,.y r��" eb ��a �� J A�
State of Connecticut BY _J94-
City of Hartford ss. Robert L.Raney,Senior Vice President
On this the 27th day of July 2016 before me personally appeared Robert L.Raney,who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul
Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers
Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
GT�
In Witness Whereof,I hereunto set my hand and official seal. ��
My Commission expires the 30th day of June,2021. tk A0800 * Marie C.Tetreault,Notary Public
C�4NW
58440-5-16 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
Integrated Construction
Development
integrated 3110 W. Southlake Blvd.
. ,.sae
ri=a
9 ' " u P Suite 120 Integrated Housing
Southlake, Texas 76092 Solutions
Phone (817) 742-1851 Integrated Property
Fax (817) 742-1852 Management
Integrated Senior Living
November 8,2016
City of Fort Worth
CFA Administration
1000 Throckmorton St.
Fort Worth,TX 76102
RE: Enclave at Westport
DOE#: 7246 City Project#: 02296
The purpose of this letter is to acknowledge that RES ICD,LP d/b/a Integrated Construction&
Development has been paid in full by RES IHS,LLC for the public improvements constructed to serve
Enclave at Westport 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. RES IHS,LLC will not charge RES
ICD,LP liquidated damages.
Please feel free to contact me with any questions.
Sincerely,
e:
taZbro,H
Vice President
RES IHS,LLC
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 Kenneth W. Fambro, II,Vice President of RES ICD, LP, known
to me to be a credible person, who being by me duly sworn,upon his oath deposed and said:
That all persons, firms, associations, corporations, or other organizations furnishing labor
and/or materials have been paid in full;
That there are no claims pending for personal injury and/or property damage;
On Contract described as:
Westport Parkway and Haslet-Roanoke Road
BY:
Ke o, II
Subscribed and sworn before me on this datok 2016.
CHRWMW►, WARTZ
My ComnWlon E x p tf es
Notary Public MM h 16,?o l s
Tarrant County,Texas
WORTHREV:02/22107
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATIONOF
CITY
1)PROJECT INFORMATION Date:
i'ame of Contractor l :Project
JklaameAb, le� �/j"/,. �fn/��/J�(�
DOE Inspector Pr ect:blanc er
DOE Number Project Dcuity7jpe of Contract
7 O Simple O Routine O Complex Water Waste Water storm Drainage f%Pavement
Initial Contract.4mount in IContractAmount
41 Q ,
II)PERFORMANCE EVALUATION
0-Inadequate I -Deficient 2-Standard 3 -Good 4-Excellent
ELEMENT RE
RATING LEMENT RATING
[
(0-4) 4 t" 4)
INSPECTION EVALUATION - PLANS&SPECIFICATIONS^ _--
I Availabil ity of Inspector _..._ 1 Accuracy of Plans to Existing Conditions
Knowledge of Inspector ; tL 2 Clarity&Sufficiency of Details 4
3 Accuracy of Measured Quantities ___. 3 x Applicability of Specifications ( y
4 Display Of Professionalism L 4 Accuracy of Plan Quantities mm �
Citizen Complaint Resolution PROJECT MANAGER EVALUATION
b Performance Setting up Valve Crews,Labs Y I Knowledge And1Or Problem Resolution j k
ADMINISTRATION _ 2 Availability of Project Manager
1 Change Order Processing Time '13 Communication tt
2 Timliness of Contractor Payments 'Y 4 Resolution of Utility Conflicts F
3 Bid Opening to Pre-Con Meeting Time tame
III)COMMENTS{&SIGNATURES
COMMENTS __I ►ls M _ �A.-, '1__ l fl r?vlwG _.t+� ,L +! .`i_£J.�+ __. '1.1►'{ .G i"'y .cr.' 1t1+.t'1_C ..K.
Signature Contractor
Signature DOE Inspector
Signature DOE Inspector's Supervisor
INSPECTOR'S COMMENTS
TR:-U SPORTATION AND PUBLIC WORKS
., The City of Fort t`Croxth• 1000 Throckmorton Street•Fort��orth,`I'Y 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
RES ICD, LP WESTPORT PKWY&HASLET ROANOKE RD.
DOE Inspector DOE Number
Alex Vega 7246
DOE Inspector Project Manager
O Water O Waste Water P1 Storm Drainage O Pavement Aaron Long
Initial Contract Amount Project Difficulty
$410,580.18 0 Simple O Routine O Complex
Final Contract Amount Date
$410,580.18 8/30/2016
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
I Submission of Documents 2 Y 4 8 8
2 Public Notifications 5 N
3 Plans on Site 5 Y 3 20 15
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 3 20 15
12 After Hours Response 5 N
13 Project Completion 5 Y 3 20 15
TOTAL ELEMENT SCORE(A) 373
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(TS) 373
III)CONTRACTOR'S RATING
Maximum Score(MS)=448 or sum of applicable element score maximums which= 408
Rating(ITS/MSI * 100%) 373 / 408 = 91%
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 NWARDED)
Signature DOE Inspector (� A Si nature Contractor
Signature DOE Inspector's Supervisor
CONTRACTOR'S COMMENTS
MI NSPORTATION AND PUBLIC WORKS
The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,Thi 76012-6311
(817) 392-7941 •Fax: (817)392-7845
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