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Contract 46951-FP1
a. Received t CITYSECRETARYRTNO. ��m 8usinRssAsuppo eyup CITY OF FORT WORTH CONTRACT NO. SuVwWpL p roup NOTICE OF PROJECT COMPLETION APR 12.2012 Regarding Contract No. 46951 for Concrete Pavine Joint Sealant 2015, CPN 02618 which was requested by the Transportation and Public Works Department and approved by the City Council on July 21, 2015 through M&C C-27360 the Director 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: SCR Construction,Inc. Original Contract Price: $ _325,000.00 Amount of Approved Change Orders: $ 0.00 Revised Contract Amount: $ 325,000.00 Total Cost Work Complete: $ 325,000.00 Less Liquidated Damages: $ 0.00 Days_ @$ Less Penalty: $ 0.00 Total Contract Cost: $ 325,000.00 Less Previous Payments: $ _292,500x00 Final Payment Due: $ 32,500.00 Recommended for Acceptc Date Assistant Director,Transpo ion and Public Works Accepted Date Director, Transportation and Public Works i City Manager Date 2017 OFFICIAL RECORD SUN ,}� CITY SECRETARY Initia d-' FT.WORTH,TX TPW Construction �1nv�oi�e �, , - ► Date:Payment Contract: CS46951 P.O.# PO-15-89771 Pa Y 2/13/2017 TO:SCR CONSTRUCTION CO INC INV•# CS46951-4 Estimate No. 4 DOE: 5420 FM 2218 ProjManager TARIQUL ISLAM RICHMOND TX 77469 FINAL PAY FOR: CONCRETE PAVING JOINT SEALANT 2015 ACH Contract Amount: $325,000.00 Completed Ret Pen Adj Pay Total to Date: $325,000.00 $32,500.00 $0.00 $0.00 $292,500.00 Previous Estimate: $325,000.00 $65,000.00 $0.00 $0.00 $260,000.00 Earned to Date: $0.00 ($32,500.00) $0.00 50.00 $32,500.00 Payments: C293-537110-201330261883 $325,000.00 Total to Date: $325,000.00 $0.00 $0.00 $0.00 $325,000.00 Previous Estimate: $325,000.00 $32,500.00 $0.00 $0.00 $292,500.00 Earned to Date: $0.00 ($32,500.00) $0.00 $0.00 $32,500.00 Transportation&Public Works BUSINESS SUPPORT GROUP Contact Person-BRANDY CRANE- .2952 Department p rovaf Sign+c s.To / ST ` DEPARTMENT CHECK PICK-UP YES ❑ Friday,May 19,2017 Page 1 of 1 0 0 0 IQ N Cl) � Z � 00 CD O N I N ti N O - O C) n q v LO z o c U U �y .. 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O Wpm,w P.O 41 w N N U Contractor Final Estimate Approval Final Est 1 Pagel of 3 Routin Assigned To: Brandy Crane Due Date: 4/17/2017 Assigned By: Fred Griffin Due Time: 11:10 PM Links 1 fortworthgov/Infrastructure Proiects/02618 - Concrete Paving Joint Sealant 2015/Contractor/Submitted Invoices/Estimate 04/15301-04.xlsm Attachments(0) No Attachments have been added to this form. https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?Siteld=51500&ProcessI... 5/17/2017 Contractor Final Estimate Approval Final Est 1 Page 2 of 3 FORT WORTHP,) Contractor Final Estimate Approval Date Started: 2/21/2017 Date Due: 3/7/2017 , Invoiced Amount: (Amount from $ 32,500.00 Request No.: Final Est 1 Line 8 of C-620) Project Name: 00000 - Project Folder Template Project Number: 00000 Invoice No.: Final Reference: Contractor: DeAnna Witzkoski by fg Discussion: Invoicing for Retainage release (Limit 5000) Approval Status: Approved: Yes Comments: User: Tariqul Islam Date: 2017-02-21 3:23 PM Approved: Yes Comments: User: DeAnna Witzkoski Date: 2017-02-21 9:34 PM Approved: Yes Comments: User: Riad Nusrallah Date: 2017-02-24 3:08 PM Approved: Yes Comments: User: Kim Arnold Date: 2017-04-03 11:40 AM Approved: Yes ,"Comments: User: Doug Wiersig Date: 2017-04-12 11:09 PM https://pro j ectpoint.buzzsaw.com/_bz_web/Forms/FormPrint.aspx?Siteld=51500&Processl... 5/17/2017 Contractor Final Estimate Approval Final Est 1 Page 3 of 3 https://projectpoint.buzzsaw.com/ bz web/Forms/FolmPrint.aspx?Site1d=51500&ProcessI... 5/17/2017 5/19/2017 BuySpeed Online Department t[�YA cc cm, ires s NIGP Code Browse I My Account I Customer Service I About Current Organization:CITY OF FORT WORTH May 19,2017 7:07:40 AM CDT Y 0 ( Home Documents I Brandy Crane low-Ane : -FINAL W,�. �1 ,.:0 V)38938 Vendor Group#:h 1 starns:41R-Ready forApprnval No General Items Subcontractors Accounts Routing Attachments Notes Reminder Change Order Summary Back to PO Invoice Number: CS46951-FINAL Invoice Status: 41R-Ready for Invoice Type: 3 way Approval matching Invoice Description: CS46951-FINAL CONCRETE PAVING JOINT SEALANT 2015 AT VARIOUS Invoice Date: 02/13/2017 Effect Date: 05/19/2017 LOCATIONS Payment Amount: $32,500.00 Handling Code: Payment Date: 03/10/2017 Payment Terms: Payment Term 0 Payment 0.0 Y Day: Discount: Paid-Bank/Check: Alternate Id: Entered By: Brandy Crane Entered Date: 05/19/2017 Updated By: Brandy crane Updated Date: 05119/2017 Received Date: 04/30/2016 07:04:00 AM Agency Files: Agency Forms: Vendor Files: Vendor Forms: Purchase dicier Information Purchase order PO-15-00089771 PO Description CS46951 Number: PO Amount: $325,000.00 Remaining To $0.00 Buyer: Crane Brandy Invoice: s-oVendor information Vendor: 0000038998-SCR CONSTRUCTION CO INC Address Grp: 01 Vendor Remit-to Tom Jahnke Address: 5420 FM 2218 RICHMOND,TX 77469 USA Fed ID: ...`2042 Remit Text: Email:deanna@screonslruction.com Phone:(281)344-0700 FAX:(281)344-0099 Id:119612 (EFT Enabled) Misc& Freight Iilvoice;'.-- Event Type Fiscal Year Account Code Transaction Amount Misc 17 39408-0200431-5330401--CO2618-C03383-- -$0.01 Misc 17 39408--2060000--CO2618-CRETAN-- $32,500.00 Total: $32,499.99 €tern information Invoice Item#/PO Item#:1 CONCRETE PAVING JOINT SEALANT 2015 AT VARIOUS LOCATIONS C293-537110-201330261883 CS46951 M&C C-27360 DATE 072115 PO Permit Invoice Discount% Original Final Item Status To Pay Amount Pay Amount Pay 3PCR-Complete Receipt $0.00 $0.01 0.0% $0.00 Yes MAKE: ASSET MODEL: ASSET MANUF: ASSET SERIAL: ASSET VIN: ASSET TAG: https:/Ibso.fortworthtexas.gov/bso/purchaseorderfii nvoi cefii nvoiceSum mary.sdo?vendorld=0000038998&docld=PO-15-00089771&releaseN br=0&docType=I&mo... 1/2 5/19/2017 BuySpeed Online Event Type Fiscal Year Account Code Transaction Amount Exp. 17 39408-0200431-5330401--CO2618-C03383-- $0.01 Ena 17 39408-0200431-5330401--CO2618-C03383-- -$0.01 Approval Path: Delete Approver Order Approval Level Approver Date DateApproved/Dis approve dlCa nce led Comment Sequence Path Type Requested ApprovedlDisapproved/Canceled by View ID Add IF Primary New Add/Delete Approver Print Copyright©2017 Periscope Holdings,Inc.-All Rights Reserved. https://bso.fortworthtexas.gov/bso/purchaseorder/i nvoi cerinvoiceSum mary.sdo?vendorld=0000038998&docld=PO-15-00089771&rel easeN br=0&docType=I&m o.. 2/2 C? 0 (D CV C) C) LO Lr) CD CN CY) (Y)C14 Co 06 C) L: ca >T 1OD 2 a) cc OD ii E t C) 0 0 i 01 r_ M A 4) / \ � _0 LL 06 LLI p LL ry, C) E co 00 \/ — o6 L) L) Eu CL Q) CO C:) 9 / § . y \ m LL co CD 04 0 t C) CD 9 (C) C) p 2 � \ C) C) Cl) C) 9 0 co 2 � \ C) (D co U) R cn x �� \ 2:Q) I co CL 0 C) it a) C) CL (D L) C: 0 C.0 E'a co a \ \ \ U) -i 0 D co CD r- CD 0 (D -i 2 C) CY) 7D i 0 0 C:) a. 0- cm 0 770 t 0) M r M C (1) Ln C) M M 0- �b LL % .- 4) 4) = LL U- (L —i U- AFFIDAVIT OF BILLS PAID State of Texas County of Fort Bend BEFORE ME, the undersigned authority, on this day personally appeared ^esrr,4� M_ .��►. (` , representing Contractor under the following contract: OWNER: C ray o 4: Y 0"- '-k)0 CONTRACTOR: SC Goy -�c us Ccs f'Si �— DATE OF CONTRACT: S —X 1-1sf— WORK: Construction of for Co�cy�- 'J;wl J0,104- S-1a,r'►- � s31Ito -oZ.o2mZ The undersigned was by me duly sworn and now states upon oath: 1. The improvements required by the Contract have been erected and completed in full compliance with the Contract, including the Plans and Technical Specifications. 2. All bids and claims for materials furnished and labor performed on the Contract have been paid. There are no outstanding unpaid bills or legal claims for labor performed or materials furnished upon the job. 3. This affidavit is being made by the undersigned realizing that it is in reliance upon the truthfulness of the statements contained in this affidavit that final and full settlement of the balance due on the Contract is being made, and in consideration of the disbursement of funds by Owner, the undersigned expressly gives and releases all liens, claims, and rights to assert a lien on said premises and agrees to indemnify and hold Owner safe and harmless from and against all losses, damages, costs, and expenses of any character whatsoever, specifically including court costs, bonding fees, and attorneys' fees, arising out of, or in any way relating to, claims for unpaid labor or material used or associated with construction of improvements under contract. SCR Construction Co. In By: e Name'T�n,e� — Title: V iit rc- rw Subscribed and sworn to before me, the undersigned authority, on 1 i� 11 Lp YP�e; DEANNA D WITZKOSKI Notary Public in for the State of Texas Z; o; NOTARY PUBLIC State of Texas ;f: y ��'�oF Comm.Exp.02-10-2016 CONSENT OF OWNER ❑ ARCHITECT ❑ SURETY COMPANY CONTRACTOR ❑ SURETY ❑ TO FINAL PAYMENT OTHER AIA DOCUMENT G707 Bond No. 58s208298 PROJECT: Concrete Paving Joint Sealant 2015, GG01-537110-0202002 (name, address) TO: (Owner) City of Fort Worth ARCHITECT'S PROJECT NO: 1000 Throckmorton St. Fort Worth, TX 76102 CONTRACT FOR: CONTRACT DATE: CON RACTOR: SCR Construction Co., Inc. 5420 FM 2218 Richmond, Texas 77469 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 13201 Northwest Freeway,#600 SURETY COMPANY, Houston, Texas 77040 on bond of(here insert name and address of Contractor) SCR Construction Co., Inc. 5420 FM 2218 Richmond, Texas 77469 ' 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 St. OWNER, 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 30th day of December, 2015. Liberty Mutual Insurance Company Suret L6zv Attes : R e Si nature of Authorizd, e resentative 9 __ P (Seal) 4 Sue ler,Witn s Sharon Cavanaugh Attorney-in-Fact Title NOTE:This form is to be used as a companion document to AiA DOCUME-N i G?05,°�OtiTFA--- urt S,,ri=ii A`di-icF FA`,'.7E,d" OF DE-STS!V-!D CLAIMS,Current Edition AIA DOCUMENT G707•CONSENT OF SURETY COMPANY TO FINAL PAYMENT•APRIL1970 EDITION•AIA® ONE PAGE ©1970 9 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEIN YORK AVE., NW,WASHINGTON, D.C.20006 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. Certifcate No.7036189 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, Angela P Hyle•Anthony C Gruppo;Beverly A Ireland;C.W.Adams-David R.Groppell,Francine Hay;Kurt A. Risk;Misty D.Amaya; Roxanne G Hebert;Sharen Groppell•Sharon Cavanaugh'Sue Kohler all of the city of Houston state of TX each individually if there be more than one named,its true and lawful attorney-in-factto 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 24th day of June 2015 z,0 coINSI, �,NsuR ptNSUR American Fire and Casualty Company 44.30'R-trFogl� tiJ o�p�r q2 Jo ,roedreR'�� �� ,a4s ,��-�, The Ohio Casualty InsuranceCompanyW V 1991 Liberty Mutual Insurance Company c 1906 0 0 1919 g 1912 y a West mencan Insurance Company V 3. (A b�Ljb a0 O d * 1 * * * By: r- David M.Care ,Assistant Secretary C STATE OF PENNSYLVANIA ss c COUNTY OF MONTGOMERY _ O L pt On this 24th day of June 2015 before me personally appeared David M. Carey,who acknowledged himself to be the Assistant Secretary of American Fire and v v d 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 2 execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. i at > 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 CL $: R pqs� COMMONWEALTH OF PENNSYLVANIA Q M QtiS�Sonwe � Notarial Seal �G%�� Teresa Pastella,Notary Public By: J�!` 0�p dof Plymouth Twp.,Montgomery County Teresa Pastella,Notary Public d O i My Commission Expires March 28,2017 3 tt3 L y '15YL�pd�G Member,Pennsylvania Association of Notaries - O E C °rARYg�. IL tv e M 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 W o y^}, Company,Liberty Mutual Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: q; L 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 +; 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, d 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 E r 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 d L.O tp executed,such instruments shall be as binding as if signed by the President and attested t0 by the Secretary.Any power or authority granted to any representative or attorney-in-fact under >el 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. r N = 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, 00 > ` 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, Cl) ovseal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their o0 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 u o executed such instruments shall be as binding as if signed by the president and attested by the secretary. O�? Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Ass istant: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. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of d�' 20 Pp10 CASG PySY INSU� P�tNSUgqcrNiNSURA �� �4,�Go'�'ORnrF�gl� 4 3SN'�'kr�'92c• J�3c`-woa4rolr� ,Ve`�°vrcggr��n a 1906 p 0 1919 n ^ 2 0 ' 1912 N 1991 By. Gregory W.Davenport,Assistant Secretary y"'<y�"Hati;r�F*a-!ix ��L Q���O 9i�NcfACHUS�l� �' '••finnh t d Hr raF=Y� 464 of 500 LMS 12873 122013 Crane, Brandy From: Islam, Tariqul Sent: Monday, April 3, 2017 10:58 AM To: Crane, Brandy Cc: Sexton, Pamela Rambo Subject: RE: Green Sheet for CS46951 I have been pushing for last couple of weeks for this approval in Buzzsaw. It is on Kim's queue at this moment. Trying my best to get it done ASAP. Thanks, Tariqul Islam Graduate Engineer TPW/Street Services 5001 James Avenue Fort Worth, TX 76115 817-392-2486 tariqul.islam e.fomvorthtexas.gov City of Fort Worth— Working together to build a strong community. FORT WORTH From: Crane, Brandy Sent: Monday, April 3, 2017 10:45 AM To: Islam,Tariqul<Tariqul.Isla m@fortworthtexas.gov> Cc:Sexton, Pamela Rambo<Pamela.Sexton@fortworthtexas.gov> Subject:Green Sheet for CS46951 Importance: High Hi Tariqul, I still haven't received the invoice in Buzzsaw for SCR Construction, Inc for CS46951 in the amount of$32,500.00. Do you know when it will be finished routing? Thank you, Brandy Crane Administrative Assistant 2"ransportation & Pubtic -Works 817-392-2852 Phone 817-392-8092 Fax Brand�.CraneCa) ortworthtexas.,qov i City of Fort Worth— Working together to build a strong community FORT WORTH. Follow Fort Worth �r4 How am I doing? Contact my supervisor: Caren.Striker@fortworthtexas.gov our web address has changed fortworthtexas.gov 2