HomeMy WebLinkAboutContract 47251-FP1 R
D re ' FORT NORTH C�- �N � 1
OCT 13 2017 ;
WATER DEPARTMENT
- - -- --.---!=J ENGINEERING AND FISCAL SERVICES —� p
NOTICE OF PROJECT COMPLETION SC4C�O 1' C0090
c s J4`7 a 51
DOE.Ns: 7418
Regarding contract 47251 for Water&S.S.Main Relocation for the Trinity River Vision Project Part 4 as required
by the Water Department as approved by City Council on 9/29/15 through M&C C-27502 the Assistant Director of the
Water Department,upon the recommendation of the Engineering Manager,Water Engineering and Fiscal Services
Division,has accepted the project as complete.
Original Contract Prices: $2,225,409.00
Amount of Approved Change Orders: $38,071.72 Ns 1
Revised Contract Amount: $2,263,480.72
Total Cost Work Completed: $2,238,706.98
Less Deductions:
Liquidated Damages: Days @$210.00/Day
Other Deductions(see comments):
Total Deduction Amount: $0.00
Total Cost Work Completed: $2,238,706.98
Less Previous Payments: $2,171,545.77
Final Payment Due $67,161.21
TV�l � a it, 0 0 / � / -7
Recommended for Acceptance Date
Engineering Manager, Water Engineering and Fiscal Services
Division
Accepted Date
Assistant Director, Water Department
City Manager Date
EMAII,ED1PIRRI3
OCT 2 %201 CITY 3ECRETARY
FT.WORTH,TX
IaiitiRl; _
Project Name: DOE. Ns: 7418
Water&S. S. Main Relocation for the Trinity River Vision Project Part 4
Comments:
OCT 13 2017 S6 40 '7 -- c4ogtpq
C'5
City Project Numbers 00969 DOE Number 7418
Contract Name Wtr&Sanitary Sewer Main Reloc for the Trinity River Vision Estimate Number 21
Contract Limits Cntrl Cry Prjct/Trinity Uptwn Srvc Area-Bridge&Channel Reloc Payment Number 21
Project Type Water For Period Ending 9/15/2017
Project Funding
Project Manager Conlon City Secretary Contract Number 47251
Inspectors Johnson / Gieger Contract Date 9/29/2015
Contractor S.J.LOUIS CONSTRUCTION OF TEXAS,LTD Contract Time 285 CD
P.O.BOX 834 Days Charged to Date 276 CD
MANSFIELD, TX 76063-0834 Contract is .000000 Complete
CITY OF FORT WORTH PO l=')9-P.4 -1S-
r?oo6S4�9�
SUMMARY OF CHARGES INVOI ,,
Line Fund Account Center Amount Gross Retainage Net
Funded
0,0L) �GI, 2cv GS , ZLr
Total Cost of Work Completed $2,238,706.98
Less 0 %Retained $0.00
Net Earned $2,238,706.98
ENGINE RjER !11 Earned Earned This Period $67,161.21
Contact Pe G A ND FIS T
DePa�e_A fakes
°' ►�earher CAL SEft.` V��(CrS Retainage This Period $0.00
r _
P °%°1 sisnaruref Eht'8252 Less Liquidated Damages
or;
OEPARTMENTCHECK PICKU0 Days @ $0.00 /Day $0.00
P
YES LessPavement Deficiency $0.00
Less Penalty $0.00
Less Previous Payment $2,171,545.77
Plus Material on Hand Less 15% $0.00
Balance Due This Payment S67,161.21
Friday,September 22,2017 Page 6 of 6
=;ter
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name Wtr&Sanitary Sewer Main Reloc for the Trinity River Vision
Contract Limits Cntrl Cty Prjct/Trinity Uptwn Srvc Area-Bridge&Channel Reloc
Project Type Sewer
City Project Numbers 00969
DOE Number 7418
Estimate Number 21 Payment Number 21 For Period Ending 9/15/2017
CD
City Secretary Contract Number 47251 Contract Time 28ED
Contract Date 9/29/2015 Days Charged to Date 276
Project Manager Conlon Contract is 99.000 Complete
Contractor S.J.LOUIS CONSTRUCTION OF TEXAS,LTD
P.O.BOX 834
MANSFIELD, TX 76063-0834
Inspectors Johnson / Gieger
Friday,September 22,2017 Page I of 6
City Project Numbers 00969 DOE Number 7418
Contract Name Wtr&Sanitary Sewer Main Reloc for the Trinity River Vision Estimate Number 21
Contract Limits Cntrl Cry Prjct/Trinity Uptwn Srvc Area-Bridge&Channel Reloc Payment Number 21
Project Type Sewer For Period Ending 9/15/2017
Project Funding
Unit I:Sanitary Sewer
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1B* 3305.1303 48"Tunnel Liner Plate By 288 LF $1,590.00 $457,920.00 288 $457,920.00
2 3305.1106 36"Casing By Other Than 261 LF $1,390.00 $362,790.00 261 $362,790.00
3 3305.3010 24"Sewer Carrier Pipe 549 LF $414.00 $227,286.00 549 $227,286.00
4 3331.4108 6"Sewer Pipe 44 LF $250.00 $11,000.00 44 $11,000.00
5 3331.4115 8"Sewer Pipe 1030 LF $260.00 $267,800.00 1030 $267,800.00
6 3331.4324 24"Fiberglass Sewer Pipe 415 LF $427.00 $177,205.00 415 $177,205.00
7 3331.4326 24"Fiberglass Sewer Pipe 136 LF $438.00 $59,568.00 136 $59,568.00
8 3341.0302 30"RCP,Class III 12 LF $80.00 $960.00 32 $2,560.00
9 0135.0101 Railroad Coordination 1 LS $1.00 $1.00 1 $1.00
10 0241.2012 Remove 6"Sewer Line 120 LF $40.00 $4,800.00 120 $4,800.00
11 0241.2013 Remove 8"Sewer Line 191 LF $40.00 $7,640.00 151 $6,040.00
12 0241.2014 Remove 10"Sewer Line 73 LF $40.00 $2,920.00 73 $2,920.00
13 0241.2016 Remove 15"Sewer Line 150 LF $50.00 $7,500.00 109 $5,450.00
14 0241.2021 Remove 24"Sewer Line 359 LF $60.00 $21,540.00 107 $6,420.00
15 0241.2027 Remove 54"Sewer Line 337 LF $80.00 $26,960.00 87 $6,960.00
16 0241.2001 Sanitary Line Grouting 390 CY $120.00 $46,800.00 467 $56,040.00
17 0241.2102 6"Sewer Abandonment Plug 2 EA $300.00 $600.00 2 $600.00
18 0241.2103 8"Sewer Abandonment Plug 1 EA $300.00 $300.00
19 0241.2104 10"Sewer Abandonment Plu 1 EA $300.00 $300.00 1 $300.00
20 0241.2106 15"Sewer Abandonment Plu 2 EA $400.00 $800.00 1 $400.00
21 0241.2111 24"Sewer Abandonment Plu 2 EA $500.00 $1,000.00 2 $1,000.00
22 0241.2117 54"Sewer Abandonment Plu 3 EA $1,200.00 $3,600.00 5 $6,000.00
23 0241.2201 Remove 4'Sewer Manhole 15 EA $1,800.00 $27,000.00 14 $25,200.00
24 0241.2202 Remove 5'Sewer Manhole 3 EA $2,100.00 $6,300.00 2 $4,200.00
25 3110.0102 6"-12"Tree Removal 9 EA $400.00 $3,600.00 9 $3,600.00
26 3110.0103 12"-18"Tree Removal 1 EA $600.00 $600.00 1 $600.00
27 3110.0104 18"-24" Tree Removal 3 EA $800.00 $2,400.00 3 $2,400.00
28 3110.0105 24"and Larger Tree Remov 1 EA $1,000.00 $1,000.00 1 $1,000.00
29 3201.0133 6'Wide Asphalt Pvmt Repa 706 LF $48.00 $33,888.00 737 $35,376.00
30 3201.0616 Conc Pvmt Repair,Arteria(CO#1) 1458 SY $73.00 $106,434.00 1288.87 $94,087.51
31 3211.0122 6"Flexible Base,Type A, 69 SY $10.00 $690.00 1969.8 $19,698.00
Friday,September 22,2017 Page 2 of 6
City Project Numbers 00969 DOE Number 7418
Contract Name Wtr&Sanitary Sewer Main Reloc for the Trinity River Vision Estimate Number 21
Contract Limits Cntrl Cty Prjct/Trinity Uptwn Srvc Area-Bridge&Channel Reloc Payment Number 21
Project Type Sewer For Period Ending 9/15/2017
Project Funding
32 3291.0100 Topsoil 964 CY $17.00 $16,388.00 1610 $27,370.00
33 3292.0100 Block Sod Placement 1875 SY $3.50 $6,562.50 260 $910.00
34 3292.0400 Seeding,Hydromulch 17344 SY $0.40 $6,937.60 29294 $11,717.60
35 3301.0001 Pre-CCTV Inspection 6400 LF $1.00 $6,400.00 2542.2 $2,542.20
36 3301.0002 Post-CCTV Inspection 2130 LF $1.00 $2,130.00 2174 $2,174.00
37 3301.0101 Manhole Vacuum Testing 15 EA $100.00 $1,500.00 12 $1,200.00
38 3303.0001 Bypass Pumping 1 LS $1.00 $1.00
39 3305.0109 Trench Safety 1030 LF $0.01 $10.30 1625 $16.25
40 3305.0110 Utility Markers I LS $1,000.00 $1,000.00 1 $1,000.00
41 3331.3101 4"Sewer Service(CO#1) 6 EA $3,500.00 $21,000.00 8 $28,000.00
42 3331.3311 4"Sewer Service,Reconne(CO#1) 6 EA $1.00 $6.00 7 $7.00
43 3339.0001 Epoxy Manhole Liner 71 VF $155.00 $11,005.00 71 $11,005.00
44 3339.1001 4'Manhole(CO#1) 6 EA $4,200.00 $25,200.00 5 $21,000.00
45 3339.1003 4'Extra Depth Manhole(CO#1) 23 VF $100.00 $2,300.00 24.4 $2,440.00
46 3339.1101 5'Manhole 5 EA $6,300.00 $31,500.00 7 $44,100.00
47 3339.1102 S Drop Manhole 1 EA $8,500.00 $8,500.00
48 3339.1103 5'Extra Depth Manhole 43 VF $154.00 $6,622.00 43 $6,622.00
49 3339.1105 5'Type A Manhole 2 EA $15,400.00 $30,800.00 1 $15,400.00
50 3125.0101 SWPPP >1 acre 1 LS $8,000.00 $8,000.00 1 $8,000.00
51 9999.0002 Non-Standard Item,Plug S 2 EA $3,000.00 $6,000.00 2 $6,000.00
52 9999.0003 Abandon Sanitary Sewer Ju 2 EA $20,000.00 $40,000.00 2 $40,000.00
53 3471.0001 Traffic Control 3 MO $1.00 $3.00 3 $3.00
54 9999.0005 Construction Survey 1 LS $1,000.00 $1,000.00 1 $1,000.00
55 9999.0006 Construction Staking 1 LS $1,000.00 $1,000.00 1 $1,000.00
56 9999.0007 5'Type A Manhole,SS Line 1 EA $21,900.00 $21,900.00 1 $21,900.00
57 9999.0008 10'Precast Flat Top Manho 1 EA $30,000.00 $30,000.00 1 $30,000.00
58 9999.0009 Levee Crossing Shaft,SS L 1 LS $1.00 $1.00
59 9999.0010 Levee Crossing Shaft,SS L 1 LS $1.00 $1.00 1 $1.00
60 0135.0101 Railroad Coordination 1 LS $1.00 $1.00 1 $1.00
61 6"Sewer Service(CO#1) 1 EA $5,000.00 $5,000.00 1 $5,000.00
62 6"Sewer Service reconnection(CO#1) 1 EA $1.00 $1.00 1 $1.00
63 Adjust MH @ Sta.0+43 on Line Al(CO#1) 1 LS $3,500.00 $3,500.00 1 $3,500.00
64 Existing Encasement Conflicts @ Sta.0+00 on Line 1 LS $48,714.32 $48,714.32 1 $48,714.32
B(CO#1)
Friday,September 22,2017 Page 3 of 6
City Project Numbers 00969 DOE Number 7418
Contract Name Wtr&Sanitary Sewer Main Reloc for the Trinity River Vision Estimate Number 21
Contract Limits Cntrl Cry Prjct/Trinity Uptwn Srvc Area-Bridge&Channel Reloc Payment Number 21
Project Type Sewer For Period Ending 9/15/2017
Project Funding
65 Asphalt Pavement Repai,Industrial beyond trench 298 SY $71.95 $21,441.10 298 $21,441.10
width(CO#1)
Sub-Total of Previous Unit $2,235,626.82 $2,211,286.98
Unit II:Water
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total
Quanity Total
1 0241.1001 Water Line Grouting 12 CY $200.00 $2,400.00 12 $2,400.00
2 0241.1012 Remove 6"Water Line 359 LF $40.00 $14,360.00 359 $14,360.00
3 0241.1013 Remove 8"Water Line 74 LF $40.00 $2,960.00 74 $2,960.00
4 0241.1118 4"-12"Pressure Plug 3 EA $500.00 $1,500.00 3 $1,500.00
5 0241.1218 4"-12"Water Abandonment 4 EA $500.00 $2,000.00 4 $2,000.00
6 0241.1302 Remove 6"Water Valve 3 EA $200.00 $600.00 3 $600.00
7 0241.1303 Remove 8"Water Valve 2 EA $200.00 $400.00 2 $400.00
8 0241.1510 Salvage Fire Hydrant 2 EA $200.00 $400.00 2 $400.00
9 3312.2001 1"Water Service,Meter R 1 EA $300.00 $300.00 1 $300.00
10 3312.2003 1"Water Service 1 EA $2,500.00 $2,500.00 1 $2,500.00
11 3312.2004 1"Private Water Service 10 LF $50.00 $500.00
Sub-Total of Previous Unit $27,920.00 $27,420.00
----------------------------------------
Friday,September 22,2017 Page 4 of 6
City Project Numbers 00969 DOE Number 7418
Contract Name Wtr&Sanitary Sewer Main Reloc for the Trinity River Vision Estimate Number 21
Contract Limits Curd Cry Prjct/Trinity Uptwn Srvc Area-Bridge&Channel Reloc Payment Number 21
Project Type Water For Period Ending 9/15/2017
Project Funding
Contract Information Summary
Original Contract Amount $2,225,409.00
Chance Orders
Change Order Number 1 $38,071.72
Total Contract Price $2,263,546.82
K Date �O y / Total Cost of Work Completed $2,238,706.98
Contr for Less 0 %Retained $0.00
Date-G
�,/- -/7 Net Earned $2,238,706.98
Inspec i n Supervisor Earned This Period $67,161.21
r
roject Manager D �y Retainage This Period $0.00
�? � Date (/{L
Less Liquidated Damages
Days @ /Day $0.00
Date LessPavement Deficiency $0.00
Asst.Director/TPW-Infrastructure Design and Construction Less Penalty $0.00
/I (' Date �' �� Less Previous Payment $2,171,545.77
Director/Contracting Department Plus Material on Hand Less 15% $0.00
Balance Due This Payment $67,161.21
Friday,September 22,2017 Page 5 of 6
FORTWORTH rev 03/05/07
WATER ENGINEERING & FISCAL SERVICES
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:21
NAME OF PROJECT: Trinity River Vision : Part 4-Channel Segement B : Water& Sanitary Sewer Relocations
PROJECT NO.: Water: P266-609170096983 & CONTRACTOR: S.J. Louis Construction
Sewer: P266-709170096983 CITY PROJECT 969
PERIOD FROM 09/01/17 TO: 09/15/17 FINAL INSPECTION DATE: 8/14/2017
WORK ORDER EFFECTIVE:6/13/2016 CONTRACT TIME: 280 O WD* 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.
11. 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
PERIOD 0 0
PREVIOUS
PERIOD 276 276
TOTALS
TO DATE
276 276
*REMARKS:
A41 fp we ,
CONIRACTORt7 DATE INSPECTOR DATE
WATER ENGINEERING&FISCAL SERVICE
The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TZ 76012-6311
(817) 392-4477 •Fat: (817) 392-8460
FORTWORTH
WATER ENGINEERING & FISCAL SERVICES
PIPE REPORT FOR:
PROJECT NAME: Trinity River Vision :Part 4-Channel Segement B :Water&Sanitary Sewer Relocations
PROJECT NUMBER: Water:P266-609170096983 & Sewer:P266-70917009698
DOE NUMBER: 7418
WATER
PIPE LAID SIZE TYPE OF PIPE LF
0
FIRE HYDRANTS: 0 VALVES(16" OR LARGER) 0
PIPE ABANDONED SIZE TYPE OF PIPE LF
Cast Iron 8" Cast Iron 816'
Cast Iron 6" Cast Iron 1,321 '
DENSITIES:
NEW SERVICES:
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
Hobas 24 " Hobas 1,100'
SDR-26 PVC 8 " SDR-26 PVC 1,030'
SDR-35 PVC 611
SDR-35 PVC 44'
PIPE ABANDONED SIZE TYPE OF PIPE LF
Concrete 54 " Concrete 1,131 '
Concrete 24 Concrete 209'
Clay 15 " Clay 648'
Clay 10 " Clay 2,015'
DENSITIES: 0
NEW SERVICES:
WATER ENGINEERING&FISCAL SERVICES
The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817)392-4477•Fax: (817)392-8460
FORTWORTH
WATER ENGINEERING & FISCAL SERVICES
PIPE REPORT FOR:
PROJECT NAME: Trinity River Vision:Part 4-Channel Segement B : Water&Sanitery Sewer Relocations
PROJECT NUMBER: Water:P266-609170096983 & Sewer:P266-70917009698
DOE NUMBER: 7418 *******Abondoned Sewer Pipe Continued*******
WATER
PIPE LAID SIZE TYPE OF PIPE LF
FIRE HYDRANTS: VALVES(16" OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES:
NEW SERVICES:
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
PIPE ABANDONED SIZE TYPE OF PIPE LF
Clay 8 " Clay 1,110'
Clay 611
Clay 704'
DENSITIES:
NEW SERVICES:
WATER ENGINEERING&FISCAL SERVICES
The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817) 392-4477•Fax:(817)392-8460
FORTWORTH
CONTRACTOR'S AFFIDAVIT
OF RELEASE OF LIENS
The City of Fort Worth
PROJECT: Water and Sanitary Sewer Main Relocations for the Trinity River Vision—Central PROJECT NUMBER:
City Project and the Trinity Uptown Area—Bridge and Channel Relocations Part 4
City Project Number 0969 Sewer Project Number P266-541200—709170096983
and Water Project Number P266—541200-609170096983
OWNER: City of Fort Worth,Texas 00969
CONTRACTOR: S.J. Louis Construction of Texas, Ltd. 21511
ENGINEER: _Kimley Horn
The Contractor, in accordance with the Contract Documents, and in consideration for the full and final payment to
the Contractor for all services in connection with the project, does hereby waive and release any and all liens, or
any and all claims to liens which the Contractor may have on or affecting the project as a result of its contract(s)
for the Project or for performing labor and/or furnishing materials in any way connected with the construction of
any aspect of the project. The Contractor further certifies and warrants that all subcontractors of labor and/or
materials for the Project, except as listed below, have been paid in full for all labor and/or materials supplied to, for,
through or at the direct or indirect request of the Contractor prior to, through and including the date of this affidavit.
EXCEPTIONS: (If none, write"NONE". The Contractor shall furnish a bond, acceptable to the Owner, for
each exception.)
None
CONTRACTOR S.J. Louis Construction of Texas, Ltd.
By `- Adam H. Lunsford
Title Vice President
Subscribed and sworn to before me this 3rd day of October 12017
Notary Public:
����,PYP��/, CODY LEWIS SEARS
My Commission Expires: 08/01/2020 �tv.,.,.o ,
° ec=Notary Public,State of Texas
Q� Comm. Expires 08-01-2020
ma
FORT WORTH CONTRACTOR'S AFFIDAVIT OF
PAYMENT OF DEBTS AND CLAIMS
City of Fort Worth,TX
PROJECT: Water and Sanitary Sewer Main Relocations for the Trinity River vision—Central PROJECT NUMBER:
City Project and the Trinity Uptown Area—Bridge and Channel Relocations Part 4
City Project Number 0969 Sewer Project Number P266-541200—709170096983
and Water Project Number P266—541200-609170096983
OWNER: —City of Fort Worth Texas 00969
CONTRACTOR: S.J. Louis Construction of Texas Ltd. 21511
ENGINEER: Kimlev Horn
The Contractor, in accordance with the Contract Documents, hereby certifies that, except as listed below, all
obligations for all materials and equipment furnished, for all work labor, and services performed, and for all known
indebtedness and claims against the Contractor for damages arising in any manner in connection with the
performance of the Contract referenced above for which the Owner or his property might in any way be held
responsible have been paid in full or have otherwise been satisfied in full.
EXCEPTIONS: (If none, write"NONE". The Contractor shall furnish a bond, acceptable to the Owner,
for each exception.)
None
CONTRACTOR S.J. Louis Construction of Texas. Ltd.
BY Agt= Adam H. Lunsford
TITLE Vice President
Subscribed and sworn to before come this 3rd day of October _, 2017
G .L .•��1YP'',
Notary Public: �- � � � , CODY LEWIS SEARS
Notary Public, State of Texas
My Commission Expires: 08/01/2020 9: Comm, Expires 08-07-2020
�''�;oF v`� Notary ID 130760871
FORT WORTH ISSUED IN THREE (3)COUNTERPARTS
BOND NUMBER: 190034121
'-0 CONSENT OF SURETY COMPANY
City of Fort Worth,TX TO FINAL PAYMENT
PROJECT: Water and Sanitary sewer Main Relocations for the Trinity River Vision—Central PROJECT NUMBER:
City Project and the Trinity Uptown Area—Bridge and Channel Relocations Part 4
City Project Number 0969 Sewer Project Number P266-541200—709170096983
and Water Project Number P266—541200-609170096983
OWNER: City of Fort worth,Texas 0969
CONTRACTOR: S.J. Louis Construction of Texas, Ltd. 21511
ENGINEER: Kimley Horn
The Surety Company, on bond of the Contractor listed above for the referenced project, in accordance with the
Contract Documents, hereby approves 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 the Owner under the terms of the
Contract and as set forth in said Surety Company's bond.
In witness whereof, the Surety Company has hereunto set its hand this 2nd day of October 2017
Liberty Mutual Insurance Company
Surety Company
By
& --� \
Aut orized Representative
Title V. DeLene Marshall Attorney-In-Fact
Address:
175 Berkeley Street
Boston, MA 02116
Attach Power of Attorney
r`• ��-��r��M�aon,,..�,,,,rnniccnir nr ci iocry�nnnonniv-rn nolo i onvnncnrr nor
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.
Liberty Mutual Insurance Company Certificate No.7876942
The Ohio Casualty Insurance Company West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS;That The Ohio Casualty Insurance Company is a corporation 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,
Don E.Cornell;Kelly A.Westbrook;Ricardo J. Repot; Robbi Morales:Sophinie Hunter;Tina McEwan•V DeLene Marshall
all of the city of Dallas state of TX each individually if there be more than one named,its true and lawful attorney-in fact to make,execute,seal,acknowledge
and deliver,for and on its behalf as surety and as its act and deed anv 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 25th day of August 2017
Irt sta<li
cc
The Ohio Casualty Insurance Company rn
P _
ply �� T2T � - � roti, Liberty Mutual Insurance Company �
a West American Insurance Company
m
= STATE OF PENNSYLVANIA ss David M.Carey,Assistant Secretary
COUNTY OF MONTGOMERY
On this 25th da of August 2017 O
m Y before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance v I—
v cU Company, The Ohio Casualty Company,and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes >,,�
O therein contained by signing on behalf of the corporations by himself as a duly authorized officer. O W
'45
0
� > IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. p CL
d Cyt* PAS"Nwc COMMONWEALTH OF PENNSYLVANIA �) Q
_.. _.._.._ T/J
..'a_ �Q".O�,vAorJW��^P<' NotariPI Seal y.. 4
Cc Teresa PastaOa.Notary Putiic By: O
ti
O OF upper MenonTwp_Montgomery County Teresa Pastella,Notary Public L
LO 25vGvrMy Commission Expires March 28.2021
O ?ugh` Mernber,Pennsylvania Assocotiorn.of NotPnes a C
c M This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual m o
y^�, Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: =o
�+
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
5 to such limitationasthe 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,
O= 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 la 3
E+: 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 C)
O to executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under > Q
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. d
m
ARTICLE Xlll-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, E w
> m 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, M
O seal,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 o0
L) 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 O o
executed such instruments shall be as binding as if signed by the president and attested by the secretary. U
O T
Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,assistant Secretary to appoint such attorneys-in-
fact as maybe 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, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Nlutual Insurance Company, and WestArr:erican_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.
x ^ �7
IN TESTIMONY WHEREOF, have hereunto set my hand and affixed the seals of said Companies this day of 20 _-��7
rI` T9il i991 By[
1 J
Renee C.Llewe ,Assistant Secretary
77 of 400
I-MS 12873 022017
Liberty
Mutual,,
SURETY
TEXAS TEXAS
IMPORTANT NOTICE AVISO IMPORTANTE
To obtain information or make a complaint: Para obtener informacion o para someter una
queja:
You may call toll-free for information or to Usted puede hamar al numero de telefono gratis
make a complaint at para informacion o para someter una queja al
1-877-751-2640 1-877-751-2640
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2200 Renaissance Blvd., Ste. 400 2200 Renaissance Blvd., Ste. 400
King of Prussia, PA 19406-2755 King of Prussia, PA 19406-2755
You may contact the Texas Department of Puede comunicarse con el Departamento de
Insurance to obtain information on companies, Seguros de Texas para obtener informacion
coverages, rights or complaints at acerca de companias, coberturas, derechos o
1-800-252-3439 quejas al
1-800-252-3439
You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros
Consumer Protection (11 I-I A) de Texas Consumer Protection (111-1 A)
P. O. Box 149091 P. O. Box 149091
Austin, TX 78714-9091 Austin, TX 78714-9091
FAX: (512) 490-1007 FAX # (512)490-1007
Web: http://www.tdi.texas.gov Web: htti2://www.tdi.texas.gov
E-mail: ConsumerProtection&tdi texas gov E-mail: ConsumerProtection@tdi.texas ov
PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS:
Should you have a dispute concerning your Si tiena una disputa concerniente a su prima o a
premium or about a claim you should first un reclamo, debe comunicarse con el agente o
contact the agent or call I-800-843-6446. primero. Si no se resuelve la disputa, puede
If the dispute is not resolved, you may contact the entonces comunicarse con el departamento (TDI)
Texas Department of Insurance.
ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA:
POLICY:
This notice is for information only and does not Este aviso es solo para proposito de informacion
become a part or condition of the attached y no se convierte en parte o condicion del
document. documento adjunto.
NP 70 68 09 01
LMS-15292 1 011 5
FORT WORTH
S
September 22,2017
S.J.Louis Construction of Texas,LTD.
P.O. Box 834
Mansfield,TX 76063-0834
Re:Acceptance Letter
Project Name: Water&Sanitary Sewer Main Relocation for the Trinity River Vision Project Part 4
Project Type: Water&Sanitary Sewer
Project Ns: 00969
DOE. Ns: 7418
Contract Ns: 47251 Dated: 9/29/2015
Gentleman:
On August 14,2017 a final inspection was made on the subject project. There were punch list items identified at
the time. The punch list items were completed on September 06,2017. The final inspection and the corrected
punch list items indicate that the work meets the City of Fort Worth specifications and is therefore accepted by
the City. The warranty period will start on September 06, 2017,which is the date of punch list completion and
will extend for(2)years in accordance with the Contract Documents.
If you have any questions concerning this letter of acceptance,please feel free to contact me at(817) 392-6054
Yours Truly,
(b R � a o U
Tony S olola,P.E.,Engineering Manager
TS /
cc: Kara Shuror,Acting Director,Water Department
Chris Harder,P.E.,Assistant Director,Water Department
Captain Michael Skains,Fire Department
Bill Lundval,Sanitary Sewer Systems Superintendent,Water Department
Roger Hauser, Water Systems Superintendent,Water Department
Liam Conlon,Project Manager
David R Johnson,Supervisor,Water Engineering
Paul Gieger,Inspector,Water Engineering
Joshua Kercho,P.E.,Kimley Horn, Consultant
S.J.Louis Construction of Texas,LTD., Contractor
File
WATER DEPARTMENT
ENGINEERING AND FISCAL SERVICES
THE CITY OF FORT WORTH * 1000 THROCKMORTON STREET * FORT WORTH, TEXAS 76102
817-392-8240 * FAX 817-392-8195
Q. Printed on recycled paper