HomeMy WebLinkAboutContract 47679-FP4 t ,
FORTWORTHO CITY SECRETARY
CONTRACT N0.
TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
(Developer Projects)
/)/�j (wA ,l �+'L%',/ 11'2 Cit Project,N2: 100059
Regarding contract 100059 for THE VILLAGES OF EAGLE MOUNTAIN PHASE II as required by the
TRANSPORTATION&PUBLIC WORKS as approved by City Council on N/A through M&C N/A the director
of the TRANSPORTATION&PUBLIC WORKS upon the recommendation of the Assistant Director of the
Transportation&Public Works Department has accepted the project as complete.
Original Contract Price: $131,310.94
Amount of Approved Change Orders: Ns
Revised Contract Amount:
Total Cost Work Completed: $131,310.94
Recommended for Acceptance Dat
Asst. Director, TPW - Infrastructure Design and Construction
— UL G� /
Accepte Date
Director, TRANSPORTATION & PUBLIC WORKS
`
a" , 2
A . City Manager _ Date
Depart `ent of TP&W Const.Services
CPN
.
Project Manager r
Comments: Risk Management Canad
D.O.E. Brotherton OFFICIAL RECORD
��r����•�CFA Morales/Scanned
Gutzler►scanned CITY SECRETARY
The Proceeding people have been Con acted
OCT 2 017 concerning the request for final payment&have FT.WORTH,TX
released this Project for such payment.
Rev.9/22/16 , r .
Clearance Conducted By. ��'ofa A 1.
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name THE VILLAGES OF EAGLE MOUNTAIN PHASE H
Contract Limits
Project Type STREET LILGHTS
City Project Numbers 100059
DOE Number 0059
Estimate Number I Payment Number I For Period Ending 8/28/2017
CD
City Secretary Contract Number Contract Time 15aD
Contract Date 3/17/2016 Days Charged to Date 319
Project Manager NA Contract is 100.00 Complete
Contractor INDEPENDENT UTILITY CONSTRUCTION
5109 SUN VALLEY DRIVE
FORT WORTH, TX 76119
Inspectors DICKINSON / WATSON
Monday,August 28,2017 Page I of 4
City Project Numbers 100059 DOE Number 0059
Contract Name THE VILLAGES OF EAGLE MOUNTAIN PHASE II Estimate Number I
Contract Limits Payment Number I
Project Type STREET LILGHTS For Period Ending 8/28/2017
Project Funding
STREET LIGHTS
ItemDescription of Items Unit Unit Cost
Estimated Estimated Completed Completed
No. Quanity Total Quanity Total
1 2"CONDT PVC SCH 80(T) 3181 LF $5.99 $19,054.19 3181 $19,054.19
2 GROUND BOX TYPE B W/APRON 18 EA $196.00 $3,528.00 18 $3,528.00
3 RDWY ILLUM FOUNDATION TY 4 31 EA $1,074.00 $33,294.00 31 $33,294.00
4 RDWY ILLUM POLE D25-6 31 EA $1,719.50 $53,304.50 31 $53,304.50
5 RDWY ILLUM ASSEMBLY 100W HPS COBRA 31 EA $483.00 $14,973.00 31 $14,973.00
FLAT HEAD
6 38 ALUMINUM CONDUCTOR 9543 LF $0.75 $7,157.25 9543 $7,157.25
Sub-Total of Previous Unit $131,31094 $131,310.94
Monday,August 28,2017 Page 2 of 4
City Project Numbers 100059 DOE Number 0059
Contract Name THE VILLAGES OF EAGLE MOUNTAIN PHASE II Estimate Number I
Contract Limits Payment Number I
Project Type STREET LILGHTS For Period Ending 8/28/2017
Project Funding
Contract Information Summary
Original Contract Amount $131,310.94
Chane Orders
Total Contract Price $131,310.94
Total Cost of Work Completed $131,310.94
C'ontrarLr Less %Retained $0.00
Net Earned $131,310.94
/,t,
Date j
i
Inspec ion Sup ,isor Earned This Period $131,310.94
Retainage This Period $0.00
D,te q c Less Liquidated Damages
oject Manager
ka
Days@ /Day $0.00
4 Date i�ft"[Ili LessPavement Deficiency $0.00
V7Dir lamto/r/-T(� C
PW-Infrastructure Design an o/nstruction Less Penalty $0.V700
. Date )6 (� Less Previous Payment $0.00
Director/Contracting Depart ent 7 Plus Material on Hand Less 15% $0.00
Balance Due This Payment $131,310.94
Monday,August 28,2017 Page 3 of 4
City Project Numbers 100059 DOE Number 0059
Contract Name THE VILLAGES OF EAGLE MOUNTAIN PHASE 1I Estimate Number 1
Contract Limits Payment Number 1
Project Type STREET LILGHTS For Period Ending 8/28/2017
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors DICKINSON / WATSON Contract Date 3/17/2016
Contractor INDEPENDENT UTILITY CONSTRUCTION Contract Time 150 CD
5109 SUN VALLEY DRIVE Days Charged to Date 319 CD
FORT WORTH, TX 76119 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 $131,310.94
Less %Retained $0.00
Net Earned $131,310.94
Earned This Period $131,310.94
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $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 $131,310.94
Monday,August 28,2017 Page 4 of 4
FORT WORTH rev 03/05/07
TRANSPORTATION & PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:1
NAME OF PROJECT: The Villages of Egale Mountain
PROJECT NO.: 100059 CONTRACTOR: Independent Utility Construct
DOE NO.: 59
PERIOD FROM 05/09/16 TO: 03/16/17 FINAL INSPECTION DATE: 16-Mar
WORK ORDER EFFECTIVE:3/24/2017 CONTRACT TIME: 319 Q WR 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.
S. 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 0 0 0 0 319 319
PERIOD
PREVIOUS 0 0 0 0 0 0
PERIOD
TOTALS 0 00 0 319 319
TO DATE
*REMARKS:
aA
CON RA TO ATE I INSPECTOR DATE
ENGINEERING DEPARTA�1ENT
S Es` The City of Fort Worth• 1000 Throclnnorton Street•Fort Worth,TX 76012-6311
(817)392-7941 •Fal: (817) 392-7845
FORTWORTHREV:02/20/07
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
I) CONTRACTOR&PROJECT DATA
Name of Contractor Project Name
Indepemdent Utility Construction The Villages Of Eagle Mountain Phase 11
DOE Inspector DOE Number
Donald Watson 59
DOE Inspector Project Manager
❑ Water❑ Waste Water❑ Storm Drainage0 Pavement Sahu Gopal
Initial Contract Amount ProjectDculty
$131,310.94 O Simple QQ Routine O Complex
Final Contract Amount Date
$131,310.94 8/29/2017
In 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 3 20 15
3 Plans on Site 5 Y 3 20 15
4 Field Supervision 15 Y 3 60 45
5 Work Performed 15 Y 3 60 45
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 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 1 4 20 1 20
TOTAL ELEMENT SCORE(A) 406
BONUS POINTS(25 Maximum)(B)
TOTAL SCORE(TS) 406
III)CONTRACTOR'S RATING
Maximum Score(MS)=448 or sum of applicable element score maximums which= 448
Rating([TS/MS] * 100%) 406 / 448 = 91%
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 O�lit/ a"�- Signat re Contractor
Signature DOE Inspector's Supervisor
CONTRACTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
(D The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817) 392-7941 •Fax: (817)392-7845
FORTWORTHREV:0212210'
TRANSPORTATION AND PUBLIC WORKS
CONTRACTOR'S EVALUATION OF CITY
I)PROJECT INFORMATION Date: 8/29/2017
Name of Contractor Project Name
Independent Utility Construction The Villages of Eagle Mountain Phase I 1
DOE Inspector Project Manager
Donald Watson Sahu Gopal a�
DOE Number Project Difficulty Tj pe of Contract
100059 1 O Simple Q Routine r Complex ❑� Water[] Waste Water Storm Drainagr Pavement
Initial Contract Amount Final ContractAniount
$131,310.94 $131,310.94
]It)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 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&SIGNATURES
COMMENTS
Signature Contractor
Signature DOE Inspector .�.Signature DOE DOE Inspector's Supervisor
Aee—
INSPECTOR'S COMMENTS
TRANSPORTATION AND PUBLIC WORKS
(D The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817)392-7941 •Fax: (817)392-7845
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT Q
CONTRACTOR ❑
TO FINAL PAYMENT SURETY ❑
OTHER
(SIMILAR TO AIA DOCUMENT G707)
Bond No. 7992088
PROJECT: The Villages of Eagle Mountain- Phase II
(name,address)Fort Worth, Texas
TO (Owner)
ARCHITECT'S PROJECT NO:
F_City of Fort Worth CONTRACT FOR: Above Project
1000 Throclanorton Street
Fort Worth, Texas 76102
CONTRACT DATE:
CONTRACTOR: Independent Utility 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) Westfield Insurance Company
555 Republic Drive, Suite 450
Plano, Texas 75074 ,SURETY COMPANY,
on bond of(here insert name and address of Contractor)
Independent Utility Construction, Inc.
5109 Sun Valley Drive ,CONTRACTOR,
Fort Worth, Texas 76119
hereby approves of the final payment to the Contractor, and agrees that the 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 Throclanorton Street
Fort Worth, Texas 76102 ,OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
The Surety Company has hereunto set its hand this 21st day of March 2017
WESTFIELD,INSURANCE COMPANY
Surety Comp
By
Signatu ut
Ahorized Representative
Attest:
(Seal): Kyle W. Sweeney Attorney—in—Fact
Title
Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition
POWER#AND ISSUED PRIOR TO 04/20/11, FOR ANY PERSON OR PERSONS NAMED BELOW.
POWER NO. 4220052 06
General
Power Westfield Insurance Co.
of Attorney Westfield National Insurance Co.
Ohio Farmers Insurance Co.
CERTIFIED COPY Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company- and collectively as 'Companies,' duly
organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio,do by these
presents make,constitute and appoint
CHARLES D. SWEENEY, MICHAEL A. SWEENEY, KYLE W.SWEENEY, ELIZABETH GRAY,JOINTLY OR SEVERALLY
of FORT WORTH and State of TX its true and lawful Attorneys)-in-Fact, with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - -
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent.as if such bonds were signed by the President,sealed with the corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
'Be It Resolved,that the President,any Senior Executive,any Secretary or any Fidelity& Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney-in-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary.-
'Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.- (Each adopted at a meeting
held on February 8,2000).
-In Witness Whereof,WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of
APRIL A.D.,2011 .
Corporate •��Uf7�1, C\ONA(_/' �tA U, �
WESTFIELD INSURANCE COMPANY
Seals .. •••. 0 r``a?• NS''' %'' WESTFIELD NATIONAL INSURANCE COMPANY
Affixed v r. .qr = 4 Q: G� "... ��,s
ti$ ;�,. :yam' =�'GttARTfQE.�;� OHIO FARMERS INSURANCE COMPANY
SEAL . _ �. 0 -
.,� as 4 a
a
State of Ohio ................ Richard L. Kinnaird, Jr.,National Surety Leader and
County of Medina ss.: Senior Executive
On this 20th day of APRIL A.D.,2011 , before me personally came Richard L. Kinnaird, Jr. to me known,who, being by me duly
sworn, did depose and say,that he resides in.Medina, Ohio;that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above
instrument;that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed
by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order.
Notarial `N„«..Nw. ,4
Seal �1 A L 4,
Affixed
0 ,.....j;y s
2:ti. _.* ~
William J. Kahelin,A rney at Law,Notary Public
State of Ohio N ✓ •• jo My Commission Does Not Expire(Sec.147.03 Ohio Revised Code)
County of Medina ss.: y
,ti�'IaFo.
I,Frank A..Carrino, Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies,which is stili in full force and effect;and furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 21 st day of
March 201.;,
N A,.w.nrr
,.�`\�Stl i7��C'•.� .�¢-�,� :`k/IyS% r 1EtSUR,�;•,i
,SEAL m= 3�' sac Secretary
1848
•.ti_ »..-•-{ s ¢. Frank A. Carrino, Secretary
BPOAC2 (combined) (06-02)
5109 Sun Valley Drive
° ` Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
March 21,2017
I
City of Fort Worth
CFA Administration
1000 Throckmorton St.
Fort Worth,TX 76102
Project Name: The Villages of Eagle Mountain Phase 2
City Project No.: 100059
The purpose of this letter is to acknowledge that Independent Utility Construction, Inc. (the
"Contractor")has been paid in full by D.R. Horton, Inc.(the"Developer")for the public improvements
constructed to serve The Villages of Eagle Mountain Phase 2 in Fort Worth, Texas. As a result, we
hereby waive,release and relinquish all rights to assert any claim or demand for lien in connection with
this project.
Please feel free to contact me with any questions you may have.
Sincerely,
Richard Wolfe
Vice President
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me, the undersigned authority, on this day personally appeared RICHARD
WOLFE,Vice President of INDEPENDENT UTILITY CONSTRUCTION INC., known
to me to be a credible person, and after being duly sworn by me, 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: The Villages of Eagle Mountain Phase 2 - City Project
No. 100059
BY:
Richard Wolfe,Vice President
SUBSCRIBED AND SWORN TO BEFORE ME on this ,2) i st day of
20 1
".%19"yP�/// CHRISTINA GARCIA L
.r° �s Notary public,State of Texas
_ Comm.Expires 12-20-2020 Notary Public, State of texas
Notary ID 1.30940786
5109 Sun Valley Drive
i' Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
March 21,2017
Project Name: The Villages of Eagle Mountain Phase 2
City Project Number: 100059
Please accept this letter as our formal acknowledgement to the City of Fort Worth that
Independent Utility Construction, Inc., the Street Light Contractor for The Villages of Eagle
Mountain Phase 2, has not been assessed any liquidated damages under its contract with D.R.
Horton, Inc.
If you need any further information in regards to this matter,feel free to contact me.
Sincerely,
Richard Wolfe,Jr.
Vice President
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me, the undersigned authority, on this day personally appeared RICHARD
WOLFE, Vice President of INDEPENDENT UTILITY CONSTRUCTION, INC., known
to me to be a credible person, and after being duly sworn by me, 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: The Villages of Eagle Mountain Phase 2 - City Project
No. 100059
BY:
Richard Wolfe, Vice President
SUBSCRIBED AND SWORN TO BEFORE ME on this day of
J2
w,ZPVPU�i�� CHRISTINA GARCIA
Notary Public, State of Texas
Comm, Expires 12-20-2020 Notary Public, State of texas
Not ID 130940785
5109 Sun Valley Drive
I i ' Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
March 21,2017
City of Fort Worth
CFA Administration
1000 Throckmorton St.
Fort Worth,TX 76102
Project Name: The Villages of Eagle Mountain Phase 2
City Project No.: 100059
The purpose of this letter is to acknowledge that Independent Utility Construction, Inc. (the
"Contractor") has been paid in full by D.R. Horton, Inc. (the"Developer")for the public improvements
constructed to serve The Villages of Eagle Mountain Phase 2 in Fort Worth, Texas. As a result, we
hereby waive,release and relinquish all rights to assert any claim or demand for lien in connection with
this project.
Please feel free to contact me with any questions you may have.
Sincerely,
Richard Wolfe
Vice President
5109 Sun Valley Drive
I I Fort Worth,Texas 76119
817-478-4444
www.iuctx.com
f
I March 21,2017
I
Project Name: The Villages of Eagle Mountain Phase 2
City Project Number: 100059
Please accept this letter as our formal acknowledgement to the City of Fort Worth that
Independent Utility Construction, Inc., the Street Light Contractor for The Villages of Eagle
Mountain Phase 2, has not been assessed any liquidated damages under its contract with D.R.
Horton, Inc.
If you need any further information in regards to this matter,feel free to contact me.
Sincerely,
Richard Wolfe,Jr.
Vice President
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT El
CONTRACTOR ❑
TO FINAL PAYMENT SURETY ❑
OTHER
(SIMILAR TO AIA DOCUMENT G707)
Bond No. 7992088
PROJECT: The Villages of Eagle Mountain- Phase II
(name,address)Fort Worth, Texas
TO (Owner)
ARCHITECT'S PROJECT NO:
F—City of Fort Worth CONTRACT FOR: Above Project
1000 Throckmorton Street
Fort Worth, Texas 76102
CONTRACT DATE:
CONTRACTOR: Independent Utility 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) Westfield Insurance Company
555 Republic Drive, Suite 450
Plano, Texas 75074 ,SURETY COMPANY,
on bond of(here insert name and address of Contractor)
Independent Utility Construction, Inc.
5109 Sun Valley Drive ,CONTRACTOR,
Fort Worth, Texas 76119
hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the
Surety Company of any of its obligations to(here insert name and address of Owner)
City of Fort Worth
1000 Throckmorton Street
Fort Worth, Texas 76102 ,OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
The Surety Company has hereunto set its hand this 21st day of March 2017
WESTFIELD.INSURANCE COMPANY
Surety Comp
By
SignatutWAutfionzed Representative
Attest:
(Seal): Kyle W. Sweeney Attorney—in—Fact
Title
Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING I H15 SAML
POWER#AND ISSUED PRIOR TO 04/20/11, FOR ANY PERSON OR PERSONS NAMED BELOW.
POWER NO. 4220052 06
General Westfield Insurance Co.
Power
of Attorney Westfield National Insurance Co.
Ohio Farmers Insurance Co.
CERTIFIED COPY Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company- and collectively as -Companies," duly
organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these
presents make, constitute and appoint
CHARLES D. SWEENEY, MICHAEL A. SWEENEY, KYLE W.SWEENEY, ELIZABETH GRAY, JOINTLY OR SEVERALLY
of FORT WORTH and State of TX its true and lawful Attorneys)-in-Fact,with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - -
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent-as if such bonds were signed by the President,sealed with the corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in
the_premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
'Be It Resolved,that the President, any Senior Executive, any Secretary or any Fidelity& Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney-in-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary."
'Be it Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.' (Each adopted at a meeting
held on February 8,2000).
In Witness Whereof,WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of
APRIL A.D.,2011 .
Corporate
e.\OIIIRAI",, .• �pNA( �' WESTFIELD INSURANCE COMPANY
Seals •..�C�;.� `�P,.• ••NSG, " � SU .fc-a WESTFIELD NATIONAL INSURANCE COMPANY
Affixedv .as► a :o: A; �� '•e^ OHIO FARMERS INSURANCE COMPANY
-�..
SEAL _'���1tARTEREO$!
• , ,t ;.il: :n; :� 184EI ;•��
.,�• ...rte�Sd .,�.• •.O, * 4 ,�
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State of Ohio "'"•"^" """" Richard L. Kinnaird, Jr., National Surety Leader and
County of Medina ss.: Senior Executive
On this 20th day of APRIL A.D.,2011 , before me personally came Richard L. Kinnaird, Jr. to me known, who, being by me duly
sworn, did depose and say,that he resides in Medina, Ohio; that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above
instrument:that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed
by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order.
Notarial "N••°i°11°'°1°ll o '
Seal A L S
Affixed A ......
. F
William J. Kahelin,A rney at Law, Notary Public
State of Ohio so d 'woo My Commission Does Not Expire(Sec. 147.03 Ohio Revised Code)
County of Medina ss.: ,y
I, Frank A.-Carrino, Secretary of WESTFIELD f,NSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies,which is still in full force and effect;and furthermore,the resolutions of the Boards of Directors, set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 21 st day of
March A.D., ,201'7 .......,,
oNA "'fD
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Secretary
148 ;•�_ Frank A. Carrine, Secretary
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BPOAC2 (combined) (06-02)