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Contract 48584-FP1
FORTWORTH. CITY SECRETARY CONTRACT N0. ��q_m TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION (Developer Projects) City Project Ns: 100516 712,07 e9 t#y85By Regarding contract for QUIKTRIP NO.1871-STORM DRAIN&PAVING as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on N/A through M&C N/A the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project Nr as complete Original Contract Price: $323,088.00 . Amount of Approved Change Orders: $5,714.00 Ns I r r z Revised Contract Amount: $328,802.00 � � 2"" a� r Total Cost Work Completed: $328,802.00 „„ n r JUL 2 b 2017 Recommended for Acceptance Date Ass . Director, TPW - Infrastructure Design and Construction Accepted Date TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Asst. City Manager Departent f &W Const.Services ate CPN# D to Project an ger Risk Management Ca ad ' D.O.E. Brotherton Comments: CFA Morales)ScannedRECORD Gutzler/Scanned The Proceeding people have been Contacted ditY 614WARY concerning the request for final payment&have it`r Vmmtm TX released this project for such payment. Rev.9/22/16 Clearance Conducted By 0k Idia FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name QUIKTRIP NO. 1871 Contract Limits Project Type STORM DRAIN&PAVING City Project Numbers 100516 DOE Number 0516 Estimate Number I Payment Number 1 For Period Ending 6/30/2017 CD City Secretary Contract Number Contract Time 9ED Contract Date Days Charged to Date 137 Contract is 100.00 Complete Project Manager NA Contractor HARMAN CONSTRUCTION,INC. 1633 ROGERS RD FORT WORTH, TX 76107 Inspectors LAYER / RODRIGUEZ Friday,June 30,2017 Pagel of 5 n �' City Project Numbers 100516 DOE Number 0516 Contract Name QUIKTRIP NO. 1871 Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 6/30/2017 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 24"RCP CLASS 6 LF $172.00 $1,032.00 6 $1,032.00 2 30"RCP CLASS 81 LF $189.00 $15,309.00 81 $15,309.00 3 5X4 BOX CULVERT 244 LF $331.00 $80,764.00 244 $80,764.00 4 TXDOT STD HEADWALL BOX CULVERT 2 EA $4,500.00 $9,000.00 2 $9,000.00 5 10'CURB INLET I EA $5,000.00 $5,000.00 1 $5,000.00 6 TRENCH SAFETY 87 LF $1.00 $87.00 87 $87.00 Sub-Total of Previous Unit $111,192.00 $111,192.00 PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed Na, Quanity Total Quanity Total 1 SWPPP I ACRE 1 LS $6,500.00 $6,500.00 1 $6,500.00 2 9"CONC PVMT(CO#2) 1390 SY $89.00 $123,710.00 1390 $123,710.00 3 6"LIME TREATMENT(CO#2) 1498 SY $21.00 $31,458.00 1498 $31,458.00 4 HYDRATED LIME(CO#2) 33 TN $450.00 $14,850.00 33 $14,850.00 5 SEEDING HYDROMULCH 1054 SY $2.00 $2,108.00 1054 $2,108.00 6 8"SLD PVMT MARKING HAS 300 LF $10.00 $3,000.00 300 $3,000.00 7 4"SLD PVMT MARKING HAS 40 LF $5.00 $200.00 40 $200.00 8 24"SLD PVMT MAEKING HAE 36 LF $20.00 $720.00 36 $720.00 9 REMOVE 8"PVMT MARKING 280 LF $1.00 $280.00 280 $280.00 10 FURNISH/INSTALL ALUM SIGN GROUND 2 EA $450.00 $900.00 2 $900.00 MOUNT CITY STD I I TRAFFIC CONTROL I LS $7,000.00 $7,000.00 1 $7,000.00 12 REMOVE CONC PVMT(CO#2) 47 SY $2.00 $94.00 47 $94.00 Sub-Total of Previous Unit $190,820.00 $190,820.00 ST LIGHT Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 RELOCATE STREET LIGHT POLE 2 EA $12,395.00 $24,790.00 2 $24,790.00 2 LED LIGHTING FIXTURE 2 EA $1,000.00 $2,000.00 2 $2,000.00 Friday,June 30,2017 Page 2 of 5 City Project Numbers 100516 DOE Number 0516 Contract Name QUIKTRIP NO. 1871 Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 6/30/2017 Project Funding Sub-Total of Previous Unit $26,790.00 $26,790.00 Friday,June 30,2017 Page 3 of 5 City Project Numbers 100516 DOE Number 0516 Contract Name QUIKTRIP NO. 1871 Estimate Number I Contract Limits Payment Number 1 Project Type STORM DRAIN&PAVING For Period Ending 6/30/2017 Project Funding Contract Information Summary Original Contract Amount $323,088.00 Change Orders Change Order Number 2 $5,714.00 Total Contract Price $328,802.00 Date G / Total Cost of Work Completed $328,802.00 Contr for Less %Retained $0.00 '�% Date -7 �c, Net Earned $328,802.00 In pectin pery or Earned This Period $328,802.00 Retainage This Period $0.00 M414 Date Less Liquidated Damages t ana r Days @ /Day $0.00 Date LessPavement Deficiency $0.00 irecto`r/TrPW-Infrast cture Design`aidd Constru�ti7on Less Penalty $0.00 (,./, L� ' Date // Z� / Less Previous Payment $0.00 Direc r/Contracting Departn nt Plus Material on Hand Less 15% $0.00 Balance Due This Payment $328,802.00 Friday,June 30,2017 Page 4 of 5 City Project Numbers 100516 DOE Number 0516 Contract Name QUIKTRIP NO. 1871 Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 6/30/2017 Project Funding Project Manager NA City Secretary Contract Number Inspectors LAYER / RODRIGUEZ Contract Date Contractor HARMAN CONSTRUCTION,INC. Contract Time 93 CD 1633 ROGERS RD Days Charged to Date 137 CD FORT WORTH TX 76107 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 $328,802.00 Less %Retained $0.00 Net Earned $328,802.00 Earned This Period $328,802.00 Retainage This Period $0.00 Less Liquidated Damages 0 Days a $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 $328,802.00 Friday,June 30,2017 Page 5 of 5 F- \ / \ §_ 10 _ 0 ( � § } to \ ( kG / / / 0 6s « \ \ / a � f k E S ? 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(1) 0 to- i a Q � W ry N � L mabro Q c Cd o w �i o w a � z � r r o N d N y Q_ e \ / \ G G 0 In( CD / 0 u _ to f LU w LU in 00- d, o 64/ 3 \ / 04 \ - » o0 \ u � \ k � ± S CL % 0 0 b g3 « / \ \ 1-- } _ � a _ R / u w & \ z ee a / 2 % % 22 / $ o S \ O .CL 2@ / > \ \ \ " LU © � ° / 3 _ ƒ $ \ \ D m > 0 o * a 3 EE _ _ o L ; e = _ § \ / ` \ Ln 11 co w \ c _ ƒ ) aL E / e \ & / \_ % \ 3 ) > � § ® ® / �64 to / \ 7 / a '\ } ) Ci / Cl) _ } \ ® y R \ \ 1 _ / ( / a C) \ 9 - i \ / C-41 \ f \ \ j k \ 3 = k ) 2 0 ° \ ( ( § # # / \ o » e § 0 < > e _ e o e + o = < Z z m 0 / \ / j \ ) / < \ < § W j § / @ � / j 2 I z < 5 0 ± & + « of F- G / z = / + 5 0 % { % S 3 3 # e e w w LU \ # i 4 / i # / \ \ 2 / ) z E R F- 0 / / \ / < % § j ) [ ( 0 \ \ ( } = o 0 U. 2 R m E < = 0 0 0 < z e ± ° 788 § 8 & CN\ ww & £ « c ® < —f 2 64 ° ° _ { e § % A \ § 44 Cq Lo \ z z f « / \ m o e ° cu E \ \cn \ { z w \ w i E » & « \ \ z / \ b \ 1.cm \ \/ / / {/ ye \ / 2 rEE sa \ k § 7 \ ! oe 0 C a. £ # t § / 0- o 00 C) W Cl- § k \ / /\ \ { k t § LLI w \ \ 22 & e = ± \ IL \ 000 C\ CS \CD § § / k ` �k § { \ § { j � § � / z \ . E 2 = z » z » � co << � � § mummem 2 [ zw \ > -- § � \ \ � � � � � � \> � � 2 f ° C{ f z a / 0 2 (D /z © - � e – & w > \ § 2` ( 2§ \ L) co o .r_ } \ 2 � ) \ / \ E _ ) p w E } k f \ § E z S « U k \ ) FORT WORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:1 NAME OF PROJECT: QuikTrip Number 1871 PROJECT NO.: 100516 CONTRACTOR: Harman Construction, Inc. DOE NO.: N/A PERIOD FROM:02/20/17 TO: 07/06/17 FINAL INSPECTION DATE: 6-Jul-17 WORK ORDER EFFECTIVE: CONTRACT TIME: 137 O WE* 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. it. 26. 12. 27. 13. 28• 14. 29. 15. 30. 31. SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS * DAYS TOTAL & HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS THIS 137 PERIOD PREVIOUS PERIOD TOTALS 137 TO DATE MARKS: v29 tJ 97" CONT NA'Tt EC R DATE ENGINEERING DEPART-MENT s' The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TZ 76012-6311 ' (817)392-7941 •Fax: (817) 392-7845 CONSTF�LJCTION LTD. 5112 SUN VALLEY DRIVE FORT WORTH,TX 76119 TEL:817-572-3303 FAX 817-478-0443 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; QuikTrip #1871 BY 9 Troy L. rdckson, Vice President Subscribed and sworn before me on this date 6th of July, 2017. I I CARMEN L. ESTEP Notary Public,state of Texas Notary P is Comm.Expires 04-06-2020 Notary ID 2910611 Tarrant, Texas "'"" CONSTRUCTION LTD. 51 12 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 QuikTrip #1871 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 6th Day of July, 2017 By: otary Signatur Troy L. Jac son, Vic President Commission Expires: 04/06/2020 CARMEN L. ESTEP ``'P0.Y L04i ?_;: :� Notary Public,State of Texas Comm,Expires 04-06.2020 Notary ID 2910611 till CONSENT OF OWNER SURETY COMPANY ARCHITECT TO FINAL PAYMENT CONTRACTOR SURETY OTHER AIA DOCUMENT G707 Bond#106421791 PROJECT: Quik Trip No. 1871 and City Project No. 100516 (name,address) Fort Worth,TX TO(Owner) 1�I 1 of Fort Worth ARCHITECT'S PROJECT NO: 100516 200 Texas St. Fort Worth,TX 76102 CONTRACT FOR: Construction and Road Improvements Quik Trip Corporation 4705 South 129th Avenue Tulsa,OK 74134 CONTRACT DATE: 11/23/2016 NTRACTOR: Harman 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) Travelers Casualty and Surety Company of America One Tower Square Hartford,CT 06183 ,SURETY COMPANY, On bond of(here Insert name and address of Contractor) Harman Construction, Inc. 1633 Rogers Road Fort Worth,TX 76107 ,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,200 Texas St.Fort Worth,TX 76102 and Qulk Trip Corporation,4705 South 129th Avenue,Tulsa, OK 74134 OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 7th day of July,2017. Travelers Casualty and Surety Company of America /v Signature of Authorized Representative Attest: (Seal). Alicia Grumbles,Attomey-in-Fact 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 i WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER POWER OF ATTORNEY TRAVELERSJ� 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, 231686 Certificate No. 007284009 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 Gary B.McElroy,Tracy L.Miller,Alicia Grumbles,James R,Reid,William Mitchell Jennings,and Katie Rogers of the City of Fort Worth State of Texas their tete and lawful Attorneys)-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 permittetl in any-aenons or proceedings allowed by late. IN WITNESS WHEREOF,the Companies have caused this instruIt be signed and their porporate seals to be hereto affixed,this 30th day of June 2017 \ Farmington Casualty Coxttpany St.Paul Mercury Insurance Company Fidelity and Guaranty 4nsura ce Company ` Travelers Casualty and Surety Company ae Underwriters,Inc. Travelers Casualty and Surety Company of America Fidelity and Guaranty Insuti St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty_C,.gmpany St.Paul Guardian Insurance Company + www pA6UAC YF�FE 4 '�kN,�MfG '�1NS(rR"'ot J��tY ANp Ly�^� 4�Y'UIO t 9 9 2�s 'ORATED q �,oaPoflA,F m '��ppoHAtC.1(�i r aANTFOFVI, b 1977 1951 ;•:sEnr f� >>s>3a'L if can+ gMR r sass bey AHS �j � tis�A NCEo� �y`•,.......�yt`� {v,.......••`fd' �O>° &k1 wwMw State of Connecticut By: {ye !s City of Hartford ss. Robert L.Raney,Senior Vice President On this the 30th day of June 2017 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. G•T� In Witness Whereof,I hereunto set my hand and official seal. W w" M Commission expires the 30th da of June,2021. My p y '011811x$ Marie C.Tetreault,Notary Public 58440-5-16 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors 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,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond,recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President, any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I,Kevin E,Hughes,the undersigned,Assistant Secretary,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 Untte&'SGa,6s Fideli-Wand Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Compames�-which is in full Alf, "d effect and has not been revoked. ti-F IN TESTIMONY'WHEREOF,I have hereunto set my hand and affixed the�e-s anies`thiSA day of V 20 �. Kevin E.Hughes,Assistant Sec. tary e .6a ��T �F1R q ��,W�kSG P.�•1NSbq J�1.t"ANam lM�p sLttYA� � lr}�'��o � ''^ " '�'°� ��roR"wA�r�t's £P+�ppORAlf•�nf i/HA/HTf^��iD\9M .9�` x 9� ,�•� ,19n 1TF0 � ��SEAL�o� ���SBJiI.•fa` �,t __ }o �j�-Edrt•-)� m�� �y�Ct�'�� �j %4 p� �d,......✓'S•�'f d.'••.. JD yiu/$ `rttr�,"�.,+r� �y� t•� 4 � '2t NCE 1S r AM�� !a"'�.•.,*O Vt ,,�y ANt w. To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.travelersbond.com.Please refer to the Attomey-In-Fact number,the above-named individuals and the details of the bond to which the power is attached. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER i FORTWORTHREV:8/20/16 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR I) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Harman Construction,Inc. QuikTrip No. 1871 Inspector City Project Number Edwin R.Rodriguez, Sr. 100516 Construction Components Project Manager ❑ water❑ waste water❑ Storm DrainageE] Pavement Patrick Buckley,P.E. Initial Contract Aniount ProjectDifficulty $323,088.00 Q Simple Routine O Complex Final Contract Amount Date $328,802.00 7/6/2017 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 1 Submission of Documents 2 Y 3 8 6 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 3 20 15 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 4 20 20 TOTAL ELEMENT SCORE(A) 436 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 436 II1)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/MS] *100%) 436 ! 448 = 97% 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,TX 76116 •(817) 392-8306 FORTWORT-H REV:0212210' TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 17/6/2017 Name of Contractor Project Name Harman Construction,Inc. QuikTrip No. 1871 DOE Inspector Project Manager Edwin Rodriguez Patrick Buckley,PE DOE Number Project Difficulty Type of Contract 100516 0 Simple OQ Routine Q Complex ❑ Water❑ Waste water0 Storm Drainage0 Pavement Initial Contract Amount Final Contract Amount $323,088.00 $328,802.00 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 tf 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 4 Resolution of Utility Conflicts 3 Bid Opening to Pre-Con Meeting Timeframe III)COMMENTS&SIGNATURF§ COMMENTS 6 Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor INSPECTOR'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