HomeMy WebLinkAboutContract 47672-FP1 CITY SECRETARY -- — --
CITY OF FORT WORTH CONTRACTNO. fPl►
NOTICE OF PROJECT COMPLETION
Regarding Contract No. 47672 for Emulsified Asphalt Fog Seal 2016, CPN 100062 which was
requested by the Transportation and Public Works Department and approved by the City
Council on March 01, 2016`� through M&C C-27631theDirector of the Transportation and
Public Works Department, upon the recommendation of the Assistant Director of the
Transportation and Public Works Department, has accepted the project as complete.
Contractor: Innovative Roadway Solutions, LLC
Original Contract Price: $ 473,178.22.
Amount of Approved Change Orders: $ 11,318.75
Revised Contract Amount: $ 484,496.97✓
Total Cost Work Complete: $ 484,496.97 f
Less Liquidated Damages: $ 0.00 Days_ @ $
Less Penalty: $ 0.00
Total Contract Cost: $ 484,496.97
Less Previous Payments: $ 460,265.24
Final Payment Due: $ 24,231.73
/7
Recommended for Acceptance Date
Assistant Director, Transportation and Public Works
Li W
04o
Accepted Date
Director, Transportation and Public Works
--� -/ 7
City Manager Date
I
OFFICIAL.RECORD
CITY SECRETARY
FT.WORTH,TX
-' TPW Construction Invoice
site,,
Contract: CS47672 P.O.# PO-16-94291 Payment Date: 11/29/2016
TO:INNOVATIVE ROADWAY SOLUTIONS INV.# CS47672-F IT-WL Estimate No. 5 DOE:
HC 64 BOX 96-A ProjManager Tariqul Islam
THAYER MO 65791
FOR: EMULSIFIED ASPHALT FOG SEAL APPLICATION 2016 AT VARIOUS LOCATIONS ACH
Contract Amount: $484,496.97
Completed Ret Adi Pay
Total to Date: $484,496.97 $0.00 $0.00 $484,496.97
Previous Estimate: $484,489.73 $24,224.49 $0.00 $460,265.24
Earned to Date: $7.24 ($24,224.49) $0.00 24,231.73
r
Payments:
30100-0200431-5740010-100062- $484,496.97 -CO#1-$11,318.75
L-00628
Total to Date: $484,496.97 $0.00 $0.00 $484,496.97
Previous Estimate: $484,489.73 $24,224.49 $0.00 $460,265.24
Earned to Date: $7.24 ($24,224.49) $0.00 $24,231.73
RECEIVED
JAN 302017
j-
Transportation& Public Works
BUSINESS SUPPORT GROUP
Contact Person- NDY CRANG-Ext 2
�Dcpartnient prov f Signature tor:
DEP.ARTMENTCHECK PICK-UP YES ❑AL
9
Friday,January 20,2017 Page 1 of 1
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Contractor Final Estimate Approval Final-I-Estimate Page 2 of 2
NUWORTHT.
Contractor Final Estimate Approval
(Must be accompanied by a C-620 Application for Payment in Links)
Date Started: 11/29/2016 MI Date Due: 12/13/2016 '1
Invoiced Amount:
(Amount from Line $ 24,231.73 Request No.: Final-l-Estimat(;
8 of C-620)
Project Name: 100062 - Fog Seal 2016
Project Number: 100062
Invoice No.:
Reference
Contractor: Christopher Kinder
Discussion:
(Limit 5000)
Approval Status:
Approved: Yes
Comments: This final payment is to release the retainage to contractor.
User: Tariqul Islam
Date: 2016-12-06 5:21 PM
,Approved: Yes
Comments:
User: Christopher Kinder
Date: 2016-12-12 9:59 AM
Approved: Yes
Comments:
User: Todd Blomstrom
Date: 2016-12-12 4:09 PM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2016-12-12 3:14 PM
https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 1/11/2017
Contractor Final Estimate Approval Final-l-Estimate Page 1 of 2
Links 1
fortworthgov/Infrastructure Proiects/100062 - Fog Seal 2016/Contractor/Submitted Invoices/Estimate
005/FortWorthFOQSealExt5.XISm
Attachments(0)
No Attachments have been added to this form.
https://projeetpoint.buzzsaw.com/ bz web/Forms/FonnPrint.aspx?SiteId=51500&Processl... 1/11/2017
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Online Accounts Payable Basic Purchasing Department Access
N[GP Code Browse I My A000unt I Customer Servioe I About Current Organization:cnv OF FORT WORTH January 20,2017 2:34:55 PM CST P A` X
Home Documents Brandy Crane
Invoice P GS47672-FINAL Vendor#:0000036624 Vendor Group#:01 Status:41R-Ready for Approval [sj
General Items Subcontractors Accounts Routing Attachments Notes Reminder Change Order Summary Back to PO
General Validation Warnings
i
• You are going to final pay the following partially paid po Items:12].
Header Information
Invoice Number: CS47612-FINAL Invoice Status: 41R-ReaApproval Ready for Invoice Type: mating
Invoice Description: C547672-FINAL EMULSIFIED ASPHALT FOG SEAL APPLICATION 2016 AT Invoice Date: 11/29/2016 Effect Date: OM012017
VARIOUS LOCATIONS
Payment Amount $24,231.73 Handling Code: ACP(DIRECT Payment Date: 12/24/2016
DEPOSIT)
Payment Terms: Payment Term 0 Payment 0.0%
Day: Discount:
Paid-BanldCheck: Alternate Id:
Entered By: Brandy Crane Entered Date: 01/20/2017
Updated By: Brandy crane Updated Date: 01/20/2017
Received Date: 11129/2016 02:14:00 PM
Attachments
Agency Files:
Agency Forms:
Vendor Files:
Vendor Forms:
Purchase Order Information
Purchase order PO-16-00094291 PO Description CS47672100062
Number:
PO Amount: $484,496.97 Remaining To $0.01 Buyer Brandy
Invoice: Crane
PoVendor Infonnation
Vendor: 0000038624-INNOVATIVE ROADWAY SOLUTIONS LLC Address Grp: 01
Vendor Remit-to Kevin AraSmith
Address: HC 64 BOX 96-A
THAYER,MO 65791
USA Fed ID: -6349 Remit Text:
Emat:christopherldnder@yma9.com
Phone:(417)331-4932
FAX:(999)999-9999
Id:120292 (EFT Enabled)
Mise&Freight Invoice Account
EventType Fiscal Year Account Code Transaction Amount
Misc 17 30100-0200431-5740010--100062-006280-2016- $24,224.49
Total: $24,224.49
Item Information
00l11-$11,318.75-EMULSIFIED ASPHALT FOG SEAL APPLICATION 2016 AT VARIOUS LOCATIONS 30100-0200431-5740010--100062-
nvoice Item NPO Item#:2 006280-2016-CS47672
PO Permit Invoice Discount% Original Final !
j Item status To Pay Amount Pay Amount Pay
3PPR-Partial Receipt $0.00 $7.24 0.0% $0.00 Yes
MAKE:
ASSET MODEL:
ASSET_MANUF:
ASSET—SERIAL,
ASSET VIN:
ASSET TAG:
Event Type Fiscal Year Account Code Transaction Amount
E)p. 17 30100-0200431-5740010--100062 006280-2016- $7.24
Enc. 17 30100-0200431-5740010--100062-006280-2016- -$7.24
w
Approval Path:
Delete Approver Order Approval Level Approver Date Date ApprovedlDisapproved/Canceled Comment
Sequence Path Type Requested ApprovediDlsapproved/Gancelad by View
ID
Add ♦ Primary
New
Addlpol6te Approve`-
Copyright®2016 Periscope Holdings,Ina-All Rights Reserved.default
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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 Chris Kinder, Present of Innovative
Roadway Solutions, known to me to be a credible person, who being by me duly
sworn, upon his oath deposed and said:
That all person, 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 damages:
On Contract described as: Fort Worth Fog Seal Application 2016.
BY:
Chris Kinder, President
Subscribed and sworn before me on 2 8 ofNommher. 20L�L.
Dayna Underwood L lfv of
Notary Public-Notary Seal ,
"STATE OF MISSOURI
Oregon County
Commission#15279894 Notary Public
My Commission Expires paoambar 27,2019
CONSENT OF OWNER C
SURETY COMPANY ARCHITECT C
TO FINAL PAYMENT CONTRACTOR
AIA DOCUMENT G707 SURETY
OTHER
BOND NO.4404703
PROJECT: Emulsified Asphalt Fog Seat Application 2016,City Project No.100062
(name,address)
TO(OWNER) City of Fort Worth ARCHITECT'S PROJECT NO:
1000 Throckmorton Street
CONTRACT FOR: General Construction
Fort Worth,TX 76102
CONTRACT DATE: 3/1/16
CONTRACTOR: Innovative Roadway Solutions,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)
SureTee Insurance Company
1330 Post Oak Boulevard
Suite 1100
Houston,TX 77056 , SURETY COMPANY,
on bond of(here insert name and address of Contractor)
Innovative Roadway Solutions,LLC
CH 64 Box 91A
Thayer,MO 65791 ,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)
City of Fort Worth
1000 Throckmorton Street
Fort Worth,TX 76102 OWNER,
as set forth in the said Surety Company's bond.
W WITNESS WHEREOF,
the Surety Company has hereunto set its hand this December 1,2016
SureTec Insuranc mp�Y--,
_
Attest: Surety Comp
By:
Nam . m tanley BY
Title: ure WitnessSi ure of Authorized epresentative
Kevin McQuain,Atto e -In-Fact (Seal
Title
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 ONE PAGE
1970 * THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,NW,WASHINGTON,D.C. 20006
r0A a: 4221392
SureTec Insurance Company
MUTED POWER OF ATTORNEY
Know All Alen by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston,Harris County, Texas, does by these presents
make,constitute and appoint Maxine Elaine Lewis,Rosalyn D.Hassell,Scott D.Chapman,
Kevin McQuain,Justin McQuain,Jeanne M.Buchan,Keith M.Illa,Cheryl R.Colson,Timothy J.Maley
its true and lawful Attorney-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 to include waivers to the
conditions of contracts and consents of surety for:
Five Million and 00/100 Dollars($5,000,000.00)
and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President,sealed with the corporate
seal of the Company and duly attested by its Secretary,hereby ratifying and confirming all that the said Attorney-in-Fact may do in the
premises. Said appointment shall continue in force until 05/18/2017 and is made under and by authority of the following
resolutions of the Board of Directors of the SureTec Insurance Company:
Be it Resolved, that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary 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:
Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute,acknowledge and
deliver,any and all bonds,recognizances,contracts,agreements or 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 binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved, that the signature of any authorized officer and 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 signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 200 of April,
1999.)
In Witness Whereof,SURETEC INSURANCE COMPANY has caused these presents to be signed by its President,and its corporate seal
to be hereto affixed this 741h day of August,A.D. 2016
SURETEC INSURANCE COMPANY
'aUi X By. John ox Jr: resident
t
�1 w nz
State of Texas ss:
County of Harris •••••^'.
On this 24th day of August,A.D. 2016 before me personally came John Knox Jr.,to me known,who,being by me duly sworn,did depose and say,that he
resides in Houston,Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above
instrument;that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the
Board of Directors of said Company;and that he signed his name thereto by like order.
r
UELYN MALDONADONotary PublicStateoiTexasomm.Exp.5/18/2017 Jacq elyn Maldonado,Notary Public
My commission expires May 18,2017
I,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and correct copy
of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set
out in the Power of Attorney are in full force and effect.
el-
Given under my band and the seal of said Company at Houston,Texas this day oA.D.
.Bre t Beaty,Assistant eeretary
Any Instrument issued in excess of the penalty stated above is totally void and without any validity.
For verification of the authority of this power you may call(713)812-0800 any business day between 8:00 am and 5:00 pm CST.
FORt
Payment Advice Page 54 of 108
To:
Supplier Name: INNOVATIVE-038 Reference Information
Supplier Address: HC 64 BOX 96-A Pay Cycle: ACHPAY
Pay Cycle Seq Number: 299
THAYER MO, 65791
USA
Payment Information
Payment Reference: AP0000027780
Payment Date: 02/01/2017
Payment Method: Automated Clearing House
Bank ID Bank Name Branch ID Branch Name
Bank To Information: 082904302
Bank To Account: *****7627
Invoice Number Invoice Date Voucher ID Gross Amount Discount Taken Paid Amt
CS47672-FINAL 11/29/2016 B0097560 24,231.73 0.00 24,231.73
Total: 24,231.73 0.00 24,231.73 USD
Private and Confidential