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HomeMy WebLinkAboutContract 44218-FP1 .cF.au�. • a . .r c%rr VllIWL.QUI VHAM CPN# Date �+ Project anacle -q r ! } Risk Management Canady ' t' �� WOTH.RD.O.E. Brotherton fr'-�7 1CITY SECRETARY CFA Morales/Scanned S`��f--r,L' CONTRACT N0. Gutzler/Scanned if-4a'?a The Proceeding people have been Contacted ���,,�r`` concerning the request for final payment&have kTION AND PUBLIC WORKS 59 CO � � (.t0)`7 released this project for such payment. F PROJECT COMPLETION C-S .�,�-I :;� a 4 City Project No: 00142 Clearance Conducted By /�aznt DDE 631 Regarding contract 00142 for E ROSEDALE ST FROM MILLER AVE TO U.S.HIGHWAY 287 as required by the WATER DEPARTMENT as approved by City Council on 02/12/2013 through M&C C-26098 the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Departrneat has accepted the project as complete.;+. ' ti`t:l ` Original Contract Prices: u t� � $2,723,119.50 Amount of Approved Change Orders: MAY 10 2017 L $168,234.77 No 1,3,4,6,8 Revised Contract Amount: t'�j/ _ $2,891,354.27 Total Cost Work Completed: $2,891,192.27 Less Deductions: Liquidated Damages: Days @$210.00/Day Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: $2,891,192.27 Less Previous Payments: $2,862,280.35 Fina Payment Due $28,911.92 C 5124 1 )' Recommended for Acceptance Da e Asst. Director, TPW - Infrastructure: Design and Construction Accepted Date Asst Director, WATER DEPARTMENT t sst. City Manager,St55,tc7 -144�4 D to Comments: EMAZI-eM I) OFFICIAL RECORD JUN .. X017 CITY SECRETARY FT.WORTH,Tx (� t; MAY 3 0 201711.a CU � ru�•u 0 ILI 2 Eq City Project Numbers 00142 r- _ ..rte DOE Number 6316 Contract Name Construction of East Rosedale Street from Miller Avenue to Estimate Number 78 Contract Limits U.S.Highway 287 Payment Number 78 Project Type WATER&SEWER For Period]Girding 8/9/2016 Project Funding Project Manager Johnson City Secretary Contract Number 4,4218 Inspectors DICKINSON / HORTON Contract Date 2/12/2013 Contractor JACI:SON CONSTRUCTION LTD Contract Time 959 CD 5112 SUN VALLEY DRIVE Days Charged to Date 959 CD FORT WORTH, TX 76119 Contract is .000000 Complete CITY OF FORT WORTH P0 SUMMARY OF CHARGES IWOICE Line Fund Account Center Amount Gross Retainage Net Funded -------------------------------------- -- - Cec��— 2 ; 9_ p U 2y, lit i• _ _LSI I` `lam L Cir Total Cost of Work Completed $2,891,192.27 Less %Retained $0.00 Net Earned $2,891,192.27 Earned This Period $28,911.92 Retainage This Period $0.00 WATER DEPART MENT ENGINEERING AND FISCAL SERVICES Less Liquidated Damages Contact Person- Heather Oakes- 0 Days a� $0.00 /Day $0.00 Depart, nt pprov 1 i, FXI.8252 �� 6nature for: LessPavement Deficiency $0.00 DEPARTMENT CHECK PICK-UP Less Penalty $0,00 YESLess Previous Payment $2,862,28035 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $28,911.92 Monday,May 15,2017 Page 7 of 7 a� 3_ 60/� FORT ORT H CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name Construction of East Rosedale Street from Miller Avenue to Contract Limits U.S.Highway 287 Project Type WATER&SEWER City Project Numbers 00142 DOE Number 6316 Estimate Number 78 Payment Number 78 For Period Ending 8/9/2016 CD City Secretary Contract Number 44218 Contract Time 959D Contract Date 2/12/2013 Days Charged to Date 959 Project Manager Johnson Contract is 100.00 Complete Contractor JACKSON CONSTRUCTION LTD 5112 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors DICKINSON / HORTON Monday,May 15,2017 Page I of 7 City Project Numbers 00142 DOE Number 6316 Contract Name Construction of East Rosedale Street from Miller Avenue to Estimate Number 78 Contract Limits U.S.Highway 287 Payment Number 78 Project Type WATER&SEWER For Period Ending 8/9/2016 Project Funding Unit I:Water Improvements Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 Imported Embedment/Backfill,Accepta 50 CY $15.00 $750.00 2 Imported Embedment/Backfill,Select 50 CY $15.00 $750.00 3 Water Line Grouting 190 CY $130.00 $24,700.00 6 $780.00 4 8"Pressure Plug 3 EA $150.00 $450.00 6 $900.00 5 12"Pressure Plug 2 EA $230.00 $460.00 2 $460.00 6 10"Water Abandonment Plug 2 EA $550.00 $1,100.00 5 $2,750.00 7 20"Water Abandonment Plug 2 EA $1,600.00 $3,200.00 1 $1,600.00 8 Salvage Fire Hydrant 17 EA $300.00 $5,100.00 17 $5,100.00 9 Remove&Salvage 4"Water Valve 1 EA $45.00 $45.00 I $45.00 10 Remove&Salvage 6"Water Valve 23 EA $90.00 $2,070.00 23 $2,070.00 11 Remove&Salvage 8"Water Valve 20 EA $90.00 $1,800.00 20 $1,800.00 12 Remove&Salvage 10"Water Valve 2 EA $90.00 $180.00 2 $180.00 13 Remove&Salvage 12"Water Valve 10 EA $135.00 $1,350.00 10 $1,350.00 14 Ductile Iron Water Fittings 16.1 TO $8,775.00 $141,277.50 18.24 $160,056.00 15 Exploratory Excavation of Existing U 80 EA $600.00 $48,000.00 58 $34,800.00 16 Trench Safety 14220 LF $1.00 $14,220.00 14220 $14,220.00 17 Utility Markers 1 LS $35.00 $35.00 18 4"Water Pipe 70 LF $37.00 $2,590.00 87 $3,219.00 19 6"Water Pipe 690 LF $50.00 $34,500.00 667.5 $33,375.00 20 8"Water Pipe 1250 LF $45.00 $56,250.00 1762 $79,290.00 21 12"Water Pipe 10910 LF $49.00 $534,590.00 11749.5 $575,725.50 22 12"DIP Water 50 LF $72.00 $3,600.00 351 $25,272.00 23 12"Water Carrier Pipe 280 LF $68.00 $19,040.00 195 $13,260.00 24 16"Water Pipe 1240 LF $97.00 $120,280.00 1395 $135,315.00 25 24"Casing By Open Cut 20 LF $114.00 $2,280.00 102 $11,628.00 26 24"Casing By Other Than Open Cut 260 LF $420.00 $109,200.00 203 $85,260.00 27 4"Gate Valve 2 EA $650.00 $1,300.00 2 $1,300.00 28 6"Gate Valve 27 EA $665.00 $17,955.00 24 $15,960.00 29 8"Gate Valve 23 EA $1,100.00 $25,300.00 23 $25,300.00 30 12"Gate Valve 62 EA $2,000.00 $124,000.00 62 $124,000.00 31 16"Gate Valve w/Vault 7 EA $12,700.00 $88,900.00 7 $88,900.00 Monday,May 15,2017 Page 2 of 7 City Project Numbers 00142 DOE Number 6316 Contract Name Construction of East Rosedale Street from Miller Avenue to Estimate Number 78 Contract Limits U.S.Highway 287 Payment Number 78 Project Type WATER&SEWER For Period Ending 8/9/2016 Project Funding 32 2"Water Air Release Valve&Vault 1 EA $6,512.00 $6,512.00 1 $6,512.00 33 Fire Hydrant 25 EA $2,400.00 $60,000.00 25 $60,000.00 34 Connection to Existing 4"Water Main 2 EA $360.00 $720.00 35 Connection to Existing 6"Water Main co#8 16 EA $1300.00 $20,800.00 8 $10,400.00 36 Connection to Existing 8"Water Main 12 EA $1,400.00 $16,800.00 19 $26,600.00 37 Connection to Existing 10"Water Mai 2 EA $1,500.00 $3,000.00 3 $4,500.00 38 Connection to Existing 12"Water Mai 5 EA $1,600.00 $8,000.00 9 $14,400.00 39 Connection to Existing 16"Water Mai 2 EA $3,900.00 $7,800.00 2 $7,800.00 40 Connection to Existing 20"Water Mai 1 EA $4,400.00 $4,400.00 1 $4,400.00 41 Connection to Existing 36"Water Mai 1 EA $7,600.00 $7,600.00 42 1"Water Service,Meter Relocation 162 EA $320.00 $51,840.00 30 $9,600.00 43 1"Bored Service 77 EA $1,200.00 $92,400.00 31 $37,200.00 44 1"Water Service 126 EA $900.00 $113,400.00 247 $222,300.00 45 1"Private Service 1370 LF $17.00 $23,290.00 5 $85.00 46 2"Water Service,Meter Relocation 28 EA $430.00 $12,040.00 47 2"Bored Service 14 EA $2,200.00 $30,800.00 48 2"Water Service 14 EA $2,150.00 $30,100.00 32 $68,800.00 49 2"Private Service 180 LF $29.00 $5,220.00 29 $841.00 50 Temporary Water Services 1 LS $70,000.00 $70,000.00 1 $70,000.00 51 8'Wide Asphalt Pvmt Repair,Residen 670 LF $54.00 $36,180.00 52 4'Wide Asphalt Pvmt Repair,Arteria 40 LF $46.00 $1,840.00 42 $1,932.00 53 8'Wide Asphalt Pvmt Repair,Arteria 730 LF $82.00 $59,860.00 663 $54,366.00 54 Asphalt Pvmt Repair Beyond Defined W 70 SY $64.00 $4,480.00 55 Asphalt Pvmt Repair Beyond Defined W 80 SY $88.00 $7,040.00 220 $19,360.00 56 Temporary Asphalt Paving Repair(6" 3030 LF $12.00 $36,360.00 3070 $36,840.00 57 8"Cone Pvmt Repair 650 SY $74.00 $48,100.00 650 $48,100.00 58 Imported Embedment/Backfill,CLSM 50 CY $70.00 $3,500.00 59 Imported Embedment/Backfill,Crushed 50 CY $15.00 $750.00 60 RPR 1"WATER SERVICE STA 26+50 CO#1 1 LS $3,839.14 $3,839.14 1 $3,839.14 61 RPR 8"W.L.@ MCKENZIE CO#I 1 LS $4,126.39 $4,126.39 1 $4,126.39 62 TWU 2"FUTURE WATER SERVICE LOT E 2 EA $3,700.00 $7,400.00 2 $7,400.00 ROSEDALE VAUGHN CO#4 63 TWU FUTURE FIRE LINE SE CORNER LOT E 1 EA $7,800.00 $7,800.00 1 $7,800.00 ROSEDALE @ VAUGHN CO#4 Monday,May 15,2017 Page 3 of 7 City Project Numbers 00142 DOE Number 6316 Contract Name Construction of East Rosedale Street from Miller Avenue to Estimate Number 78 Contract Limits U.S.Highway 287 Payment Number 78 Project Type WATER&SEWER For Period Ending 8/9/2016 Project Funding 64 REPAIR EXISTING WATER MAIN ROSEDALE 1 LS $1,775.53 $1,775.53 1 $1,775.53 @ BISHOP CO#4 65 REPAIR EXISTING WATER MAIN AYERS @ 1 LS $1,438.01 $1,438.01 I $1,438.01 AVE F CO#4 66 REPAIR EXISTING WATER MAIN AYERS I LS $4,064.38 $4,064.38 1 $4,064.38 NORTH OF ROSEDALE CO#4 67 REPAIR EXISTING FIRE HYDRANT DUE TO 1 LS $1792.12 $2,792.12 1 $2,792.12 INPROPER SHUT OUT CO#4 68 LOWER 8"WATER MAIN UNDER EXISTING 1 LS $11,651.88 $11,651.88 1 $11,651.88 STORM DRAIN AT BEACH ST CO#6 69 RELOCATE FIRE HYDRANT CO#6 I LS $1,638.85 $1,638.85 1 $1,638.85 70 12"X 2"WATER SERVICE CUT 1 PLUG 10" 1 LS $7,330.38 $7,330.38 1 $7,330.38 W/PAVEMENT REPAIR CO#6 71 REPAIR 6"WATER LINE BREAK CO#6 1 LS $1,840.15 $1,840.15 1 $1,840.15 72 REPAIR 4"WATER LINE BREAK CO#6 1 LS $2,819.39 $2,819.39 1 $2,819.39 73 REPLACE 36"X 12"CROSS CONNECTION 1 LS $51,817.76 $51,817.76 1 $51,817.76 WITH RING CONNECTION CO#6 74 12"X 12"X 1"CONCRETE DRAIN BOXES CO#6 6 EA $1,036.91 $6,221.46 6 $6,221.46 75 —ADDITIONAL TRAFFIC CONTROL CO#8 1 LS $51,203.97 $51,203.97 1 $51,203.97 Sub-Total of Previous Unit $2,315,863.91 $2,315,710.91 Unit II:Sewer Improvements Item Description of Items Estimated Estimated Completed Completed No. P Unit Unit Cost P P —— Quanity Total Quanity Total —---— ----- — 8"Sewer Pipe 2290 LF $34.00 $77,860.00— 1865 $63,410.-00- 2 8"DIP Sewer Pipe 690 LF $75.00 $51,750.00 1119.5 $83,962.50 2B 8"DIP Sewer Pipe,CLSM Backfill 1170 LF $84.00 $98,280.00 700 $58,800.00 3 18"Sewer Pipe 70 LF $230.00 $16,100.00 75 $17,250.00 4 16"Casing By Other Than Open Cut 20 LF $400.00 $8,000.00 5 4'Manhole 21 EA $2,500.00 $52,500.00 24 $60,000.00 6 4'Drop Manhole 2 EA $2,900.00 $5,800.00 2 $5,800.00 7 4'Extra Depth Manhole 60 VF $300.00 $18,000.00 52.3 $15,690.00 8 4'Shallow Manhole 1 EA $1,400.00 $1,400.00 1 $1,400.00 9 Epoxy Manhole Liner 60 VF $140.00 $8,400.00 84.2 $11,788.00 10 Manhole Adjustment,Minor 1 EA $425.00 $425.00 1 $425.00 11 Concrete Collar 7 EA $400.00 $2,800.00 7 $2,800.00 12 Imported Embedment/Backfill,CLSM 50 CY $70.00 $3,500.00 Monday,May 15,2017 Page 4 of 7 City Project Numbers 00142 DOE Number 6316 Contract Name Construction of East Rosedale Street from Miller Avenue to Estimate Number 78 Contract Limits U.S.Highway 287 Payment Number 78 Project Type WATER&SEWER For Period Ending 8/9/2016 Project Funding 13 4"Sewer Service 32 EA $910.00 $29,120.00 82 $74,620.00 14 4"Bored Sewer Service 10 EA $1,800.00 $18,000.00 15 4"Sewer Service,Private Relocation 210 LF $16.00 $3,360.00 80 $1,280.00 16 6"Sewer Service 10 LF $1,000.00 $10,000.00 44 $44,000.00 17 6"Bored Sewer Service 7 EA $2,000.00 $14,000.00 18 6"Sewer Service,Private Relocation 90 LF $19.00 $1,710.00 19 8'Wide Asphalt Pvmt Repair,Residen 140 LF $54.00 $7,560.00 19B 4'Wide Asphalt Pvmt Repair,Arteria 70 LF $46.00 $3,220.00 59 $2,714.00 20 8'Wide Asphalt Pvmt Repair,Arteria 570 LF $82.00 $46,740.00 570 $46,740.00 21 Asphalt Pvmt Repair Beyond Defined W 20 SY $64.00 $1,280.00 22 Asphalt Pvmt Repair Beyond Defined W 60 SY $88.00 $5,280.00 15 $1,320.00 23 Temporary Asphalt Paving Repair(6" 280 LF $12.00 $3,360.00 1130 $13,560.00 23B Imported Embedment/Backfill,Crushed 50 CY $15.00 $750.00 23C Imported Embedment/Backfill,Accepta 50 CY $15.00 $750.00 23D Imported Embedment/Backfill,Select 50 CY $15.00 $750.00 24 Sanitary Line Grouting 60 CY $130.00 $7,800.00 25 6"Sewer Abandonment Plug 5 EA $150.00 $750.00 1 $150.00 26 Remove 4'Sewer Manhole 12 EA $500.00 $6,000.00 10 $5.000.00 26B Abandon 4'Sewer Manhole 3 EA $400.00 $1,200.00 27 Pre-CCTV Inspection 3710 LF $2.00 $7,420.00 4333 $8,666.00 28 Post-CCTV Inspection 3980 LF $1.00 $3,980.00 427 $427.00 29 Manhole Vacuum Testing 24 EA $150.00 $3,600.00 20 $3,000.00 30 Bypass Pumping 1 LS $37,000.00 $37,000.00 1 $37,000.00 31 Exploratory Excavation of Existing U 18 EA $600.00 $10,800.00 18 $10,800.00 32 Trench Safety 3970 LF $1.00 $3,970.00 3103.5 $3,103.50 33 Utility Markers 1 LS $500.00 5500.00 35 LOCATE EXISTING UTILITIES FOR SEWER 1 LS $1,058.81 $1,058.81 1 $1,058.81 LINE D REROUTE CO#4 36 SEWER PIPE PRE TV CO#6 1 LS $716.55 $716.55 1 $716.55 Sub-Total of Previous Unit $575,490.36 $575,481.36 Monday,May 15,2017 Page 5 of 7 City Project Numbers 00142 DOE Number 6316 Contract Name Construction of East Rosedale Street from Miller Avenue to Estimate Number 78 Contract Limits U.S.Highway 287 Payment Number 78 Project Type WATER&SEWER For Period Ending 8/9/2016 Project Funding Contract Information Summary Original Contract Amount $2,723,119.50 Chan6e Orders Change Order Number 1 $7,965.53 Change Order Number 3 $49,870.00 Change Order Number 4 ($23,541.15) Change Order Number 6 $84,036.42 Change Order Number 8 $49,903.97 Change Order Number Total Contract Price $2,891,354.27 '7117 Total Cost of Work Completed $2,891,192.27 Contractor Less %Retained $0.00 Net Earned $2,891,192.27 Da e Inspection Supervisor Earned This Period $28,911.92 l -7 Retainage This Period $0.00 Date J'�r�` Less Liquidated Damages Pr ject Man er I Days @ /Day $0.00 Date , ` 1 LessPavement Deficiency $0.00 Asst.Directtorr/TPW-Infras cture Design and Construction Less Penalty $0.00 �� (`� Date /1:50 T Less Previous Payment $2,862,280.35 Director/Contracting Department Plus Material on Hand Less 15% $0.00 Balance Due This Payment $28,911.92 Monday,May 15,2017 Page 6 of 7 CITY SEC ' " FORT WORTH. City of Fort Worth CONTRACT W Change Order Request Project Namel East Rosedale Street Improvements US287 to Miller Ave. City Sec# 44218 Client Project#(s)l C200-205230014283,P253-541200-605170014283 Project Description Water,Sewer,Storm Drain,Paving,Street Lights,Fiber,Bridge Improvements Contractorl Jackson Construction,Ltd. Change Order# 12 Date 4/18/2016 City Project Mgr.1 Mitch Aiton City Inspector Randy Horton Dept. TPW Water Sewer Totals Select Day Type Original Contract Amount $13,866,014.15 $2,149,404.50 $573,715.00 $16,589,133.65 600 Extras to Date $365,186.82 $166,459.41 $50,586.55 $582,232.78 255 Credits to Date $48,811.19 $48,811.19 Pending Change Orders(in M&C Process) Contract Cost to Date $14,231,200.97 $2,315,863.91 $575,490.36 $17,122,555.24 855 Go to ADD&DEL Tabs to Enter CO Backup $0.00 $0.00 $0.00 104 Revised Contract Amount $14,231,200.97 $2,315,863.91 $575,490.36 $17,122,555.24 959 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 $0.00 $0.00 Additional Funding(if necessary) CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 3.22% MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+23/) $20,736,417.06 JUSTIFICATION(REASONS)FOR CHANGE ORDER This change order will provide an additional 104 calendar days on this project in order to complete the installation on irrigation& landscaping along with the repairs to the damaged medians that occured on both roundabouts.. It also reflects to the c metro mast arm mounted signs in several locations. "•x,1'',9�-''�' b �� Mp`t r t� 9�6�� RECORD byeuGJG C� ,o oOUJO� J• u d ,i J U'l1y 7X Cmy p,, cretmy It is understood and agreed that the acceptance of this Change Order by the contractor constitgJys an accord and satisfaction and represents payment in full(both time and money)for all costs arising out of,or incidental to,the above C ge Order. Contractor's Company Name Co for Name) Con Sdnat ate Jackson Construction,Ltd. If Inspector/Inspection Supervisor Date Project Manager/Program Manager bate =28!6 Assis ant Director(Dept) Date Dir c r,Qpntraqting Department(Dept) Date � S•o2•l� � j S3 /t Assi n or%y Date, Assists City Manager Date Council Action(if required) M&C Number M&C Date Approved C2 k � 0 C> G $ 0 $ / f c 0 � 2 6 \ k 41. 2 / c \ E b / o . e ■ 2k o © U. D § 2 <_ « f o0 � / o & / / to ° U § % f � 2 \ 2 / u k / / E \ . § A E / / R / 7 0 p 0 g 2 % % 3 £ / 7 R m / / ƒ / � / / k / cu C14 Lu 0 / > k k E \ § § o p . \ 0 � u C) 0 0 691 0 0 0 c 0 a Fo- .Q N 4- O N fL dA d h C O "O Q ..a O aw on C: m U _ \ o ;C151 # � \ / a I c � k 0 - I ca � ® A k 0 CD 00 4— co ca. g / w m § \ 2 2 2 n @ @ ƒ 2 � � c ° m 22 & & d 0 � \ o / / ° m U c 2 m \ RC-4 G $ E C G / % % / § k & E / t R 2 co 7 G / 0 / Q # » 2 0 7 CO / Cl 5 R & ® 2 2 § k / k 2 § / 0 k C.5 k _ @ o f q # & § a 2 / a D � I w � 0 0 0 0 0 0 y c 0 a a' D C .n N v- O N N w (B d V, c O N N 0 N oz c cc L V MMBE Breakdown for this Change Order Total $000 Previous Change Orders Total 0.00 , TTT CONSENT OF SURETY OWNER o TO FINAL PAYMENT ARCMTF?CT D ALA Doc tent G707 CGNTRACTOR SURM-y Bond No. 1009401 OAR }� TO OAR A.RC-RTECrS PROJECT -N0.: fhrmnezazdad&Ev) City of Fort Worth, Texas 311 W 10th Street COJIURACT FOR: Street Reconstruction Fort Worth, TX 76102 PROJECT: COI TRACT DAT. D: PV--ve—d addr-c Rosedale Street/From 287 to Miller Ave Fort Worth, TX In accordance v+itb The pro,%dseons of tJ-&Contract bets een the Owner and tfze Contract(r as indim-ted above,the (Irrs�rtmrnrasrrd crddr�cfSrrrrt�} The Hanover Insurance Company 440 Lincoln Street Worcester, MA 01653 SUP TYI on bond of flntCn name a»d addrr�s ofCor trncFvrj Jackson Construction, Ltd. 5112 Sun Valley Drive Fort Worth, TX 76119 CONTR&CTOR, hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to atuvrt rulmeundadcFresc of0QWerj City of Fort Worth,Texas 311 W 10th Street Fort Worth, TX 76102 as set€arch in said Surety's borA. IN V/iTNI~5S Wi3F`R OF,the Surety has hereunto set its hand on this date; April 3, 2017 (bzsert{n unatii�tjle rrroar{ifatloxecf:s�tix mrrneric dsrrartda�arl The Hanover Insurance Company {BxrxNY3 By: �� f rr ofutttborlxrtt r�pxxsentatir�j Attest: (gam. 1\,L' P-z4v .— Jack M. Crowley Attorney-in-Fact (Printed umne anxd r 1 Surety Phone No. 508-853-7200 x-4476 G7O7r--1994 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWERS OF ATTORNEY CERTIFIED COPY KNOW ALL MEN BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,do hereby constitute and appoint Steven R.Foster,Jack M.Crowley,Patricia A.Smith and/or Marie Perryman of Dallas,TX and each is a true and lawful Attomey(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and deed any place within the United States,or,if the following line be filled in,only within the area therein designated any and all bonds,recognizances,undertakings, contracts of indemnity or other writings obligatory in the nature thereof,as follows: Any such obligations in the United States,not to exceed Thirty Five Million and No/100($35,000,000)in any single instance and said companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These appointments are made under and by authority of the following Resolution passed by the Board of Directors of said Companies which resolutions are still in effect: "RESOLVED,That the President or any Vice President,in conjunction with any Vice President,be and they are hereby authorized and empowered to appoint Attorneys-in-fact of the Company,in its name and as its acts,to execute and acknowledge for and on its behalf as Surety any and all bonds,recognizances, contracts of indemnity,waivers of citation and all otherwritings obligatory in the nature thereof,with power to attach thereto the seal of the Company.Any such writings so executed by such Attorneys-in-fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons."(Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14, 1982- Massachusetts Bay Insurance Company;Adopted September 7,2001-Citizens Insurance Company of America) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents, this 5th day of December 2011. µW4, THE HANOVERINSURANCE CoMpANY WI... MASSACHUSET"TS:SAY INSURANCE COMPANy , } 1 I ,rP CITIZENS, URAIsIGEROMPANY OFF AMERICA v2c 1274 - .. 47 ! 16 11 Ro,-n Thoma&ly'ict Pr_fi7d_ent THE COMMONWEALTH OF MASSACHUSETTS ) `.,« _.: COUNTY OF WORCESTER )ss. arcltstrorn VIc Przsidwrit On this 5th day of December 2011 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged thatthe seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. OWE s tycommss+crr�gsse�.z,znas <r a!G '�_ - i'� -'J Barbara A.Garlick, Notary Public My Commission Expires September 21,2018 I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America. "RESOLVED,That any and all Powers ofAttomey and Certified Copies of such Powers of Attorney and certification in respectthereto,granted and executed by the President or any Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile." (Adopted October 7, 1981 -The Hanover Insurance Company;Adopted April 14,1982-Massachusetts Bay Insurance Company;Adopted September7,2001-Citizens Insurance Company of America) GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 3rd day of April 2017. THE HANOVER INSURANCE COMPANY MASSACHUSETTS SA.Y INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA f ✓` € Ar /°K E r Z �n Margosian,Vice President CONSTRUCTION LTD. 5112 SUN VALLEY DRIVE FORT WORTH,TX 76119 TEL:817-572-3303 FAX:817-478-0443 Affidavit of All Bills Paid STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF TARRANT I, Troy L. Jackson, of the undersigned principal hereby certify that all obligations, claims and debts due laborers, materialmen, subcontractors, suppliers, and others incurred in or contingent to the performance of the work on the project known as East Rosedale Street Phase 1 from US 287 to Miller in the City of Fort Worth, Texas have been fully paid. This affidavit is made for the purpose of obtaining payment from the City of Fort Worth on above construction work. Subscribed and sworn to before me this Jackson Construction Ltd Principal 30t ay of March, 2017 By: Notary Signature Troy L. Jac son, Vic resident Commission Expires: 04/06/2020 CARMEN L. ESTEP Notary Public.State of Texas Comm.Expires 04-06-2020 Notary ID 2910611 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 Troy L. Jackson, Vice President Of Jackson Construction, Ltd, 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; East Rosedale Street Phase l from US 287 to Miller BY roy L. JqKson, Vice President Subscribed and sworn before me on this date 30th of March, 2017. Notary Pu lic Tarrant, Texas CARMEN L. ESTEP *µY PV 4 ?2 r 'Notary Public,State of Texas Comm.Expires 04-06-2020 �!'�"fill ` Notary(D 2910611 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: East Rosedale US 287 to Miller Avenue PROJECT NUMBER: 142 DOE NUMBER: 6316 WATER PIPE LAID SIZE TYPE OF PIPE LF Yes 4" PVC 87' Yes 6" PVC 667.5' Yes 8" PVC 1,762' Yes 12" PVC 11,749.5' Yes 12" DIP 351' Yes 16" PVC 1,395' FIRE HYDRANTS: 25 VALVES(16" OR LARGER) 7 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes All Passed NEW SERVICES: 1" PVC 247 EA 2" PVC 32 EA SEWER PIPE LAID SIZE TYPE OF PIPE LF YES 8" PVC 1,865' YES 8" DIP 1,119.5' YES 178,- PVC 75' PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: YES All Passed NEW SERVICES: 4" PVC 82 EA 6" PVC 44 EA TRANSPORTATION AND PUBLIC WORKS FORTWORTHREV:02/20/07 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR I) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Jackson Construction East Rosedale US 287 to Miller Avenue DOE Inspector DOE Number Randy Horton 6316 DOE Inspector Project Manager El Water 0 Waste Water ❑ Storm Drainage❑ Pavement Martin Phillips Initial Contract Amount Project Difficulty $2,723,119.50 O Simple O Routine O Complex Final Contract Amount Date ,$2,891,192.27 5/17/2017 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 Trak 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 Y 4 20 20 12 After Hours Response 5 Y 4 20 20 13 Project Completion 5 Y 3 20 15 TOTAL ELEMENT SCORE(A) 428 BONUS POINTS(25 Maximum)(B) I11)CONTRACTOR'S RATING TOTAL SCORE(TS) 428 Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/MS] * 100%) 428 / 448 = 96% 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 Signature Contract Signature DOE Inspector's Supervisor 4�, 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 FOR T WO RT H REV:02'22'0' TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 5/17/2017 Name of Contractor Project Name Jackson Construction East Rosedale US 287 to Miller Avenue DOE Inspector Project Manager Randy Horton Martin Phillips DOE Number iProject Difficulty Type of Contract 6316 O Simple O Routine O Complex O Water p Waste Water❑ Storm Drainage❑ Pavement Initial Contract Amount Final Contract Amount $2,723,119.50 $2,891,192.27 II)PERFORMANCE EVALUATION 0-Inadequate 1 -Deficient 2-Standard 3 -Good 4-Excellent ELEMENT RATING ELEMENT RATING INSPECTION EVALUATION PLANS&SPECIFICATIONS 1 Availability of Inspector 1 Accuracy of Plans to Existing Conditions 2 Knowledge of Inspector 2 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 1 14 Resolution of Utility Conflicts �l 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 fi The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 FORTWORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:78 NAME OF PROJECT: Construction On East Rosedale US 287 To Miller Avenue. PROJECT NO.: 253-541200-60517-0014283 CONTRACTOR: Jackson Construction 258-541200-705170014283 DOE NO.: 6316 PERIOD FROM;05/01/17 TO: 05/15/17 FINAL INSPECTION DATE: 14-Sep-15 WORK ORDER EFFECTIVE:4/l/2013 CONTRACT TIME: 600 O WDO CD DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS MONTH CHARGED CREDITED MONTH CHARGED CREDITED DURING DURING 1. MON 0 16. 2. TUE 0 17. 3. WED 0 18. 4. THU 0 19. 5. FRI 0 20. 6. SAT 0 21. 7. SUN 0 22. 8. MON 0 23. 9. TUE 0 24, 10. WED 0 25. 11. THU 0 26. 12. FRI 0 27. 13. SAT 0 28. 14. SUN 0 29. 15. MON 0 30. 31. SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL & HOLIDAYS &TOO COLD RELOCATIONS OTHERS CHARGED DAYS THIS PERIOD 0 0 PREVIOUS PERIOD 959 959 TOTALS TO DATE 959 959 *REMARKS: Project Complete. ZZ CONTRACTOR 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