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Contract 47862-FP1
Depart . TPI&W Const. Services CPN# Date Project anager to _711-0 Risk Management an ) WO D.O.E. Brotherton 1 l `1- T RT H® CFA Morales/Scanned CITY SECRETARY Gutzler/Scanned ta- —l^1 CONTRACT N0. The Proceeding people have been Contacted concerning the request for final payment&haveATION AND PUBLIC WORKS released this project for such payment. ;p PROJECT COMPLETION Clearance Conducted By A'wm& Developer Projects) 6-'q*07- uD2-71 y City Project e- 02714 0---�-6eWZ Regarding contract 02714 For THE MANSIONS AT TIMBERLAND PHASE II as required by the WATER DEPARTMENT as approved by City Council on N/A through M&C N/A the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project as complete. LK I t Original Contract Price: �� '� 217 $52,956.00 Amount of Approved Change Orders: Revised Contract Amount: . Total Cost Work Completed: $52,956.00 7 eP Recomn d for Acceptance Date Asst. Di r, TPW - v-P n anH"CaTISITtrct Accepted Date Asst. Director, WATER DEPARTMENT Asst. City Ma ger Date Comments: RIVA Z1,19" OFFICIAL RECORD NQV " CITY SECRETARY Iuii4.ieL FT-WORTH,TX Rev.9/'22/16 017 City Project Numbers 02714 DOE Number 2714 Contract Name THE MANSIONS AT TIMBERLAND PHASE 11 Estimate Number i Contract Limits Payment Number 1 Project Type SEWER For Period Ending 10/9/2017 Project Funding Project Manager NA City Secretary Contract Number Inspectors LAYER / SLATEN Contract Date Contractor RUMSEY CONSTRUCTION,LLC Contract Time 180 CD 6617 VILLAGE SPRINGS DRIVE Days Charged to Date 462 CD PLANO, TX 75024 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded Total Cost of Work Con-,p feted $52,956.00 Less %Retained $0.00 Net Earned $52,956.00 Earned This Period $52,956.00 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 $52,956.00 Monday,October 9,2017 Page 4 of 4 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name THE MANSIONS AT TIMBERLAND PHASE 11 Contract Limits Project Type SEWER City Project Numbers 02714 DOE Number 2714 Estimate Number 1 Payment Number 1 For Period Ending 10/9/2017 CD City Secretary Contract Number Contract Time 18GD Contract Date Days Charged to Date 462 Project Manager NA Contract is 100.00 Complete Contractor RUMSEY CONSTRUCTION,LLC 6617 VILLAGE SPRINGS DRIVE PLANO, TX 75024 Inspectors LAYER / SLATEN Monday,October 9,2017 Page 1 of 4 City Project Numbers 02714 DOE Number 2714 Contract Name THE MANSIONS AT TIMBERLAND PHASE II Estimate Number 1 Contract Limits Payment Number 1 Project Type SEWER For Period Ending 10/9/2017 Project Funding SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --- ------ --------------- - ----- 1 8"SDR-26 173 LF $40.00 $6,920.00 173 $6,920.00 2 WASTEWATER ACCESS CHAMBER 1 EA $1,800.00 $1,800.00 1 $1,800.00 3 4'DIA STD MANHOLE 1 EA $3,500.00 $3,500.00 1 $3,500.00 4 ADDITIONAL DEPTH MANHOLE 3 VF $500.00 $1,500.00 3 $1,500.00 5 MANHOLE CONCRETE COLLAR 1 EA $1,900.00 $1,900.00 1 $1,900.00 6 CONNECTION TO EXISTING SEWER MAIN 1 EA $1,800.00 $1,800.00 1 $1,800.00 7 PRE CONSTRUCTION TV INSPECTION 173 LF $8.00 $1,384.00 173 $1,384.00 8 POST CONSTRUCTION TV INSPECTION 173 LF $8.00 $1,384.00 173 $1,384.00 9 VACUUM TEST MANHOLE 2 EA $1,000.00 $2,000.00 2 $2,000.00 10 INTERIOR PROTECTIVE COATING 9 VF $230.00 $2,070.00 9 $2,070.00 11 TRENCH SAFETY 173 LF $1.00 $173.00 173 $173.00 12 UNCLASSIFIED EXCAVATION BY PLAN 231 CY $20.00 $4,620.00 231 $4,620.00 13 EMBANKMENT BY PLAN 203 CY $20.00 $4,060.00 203 $4,060.00 14 REMOVE CONC PVMT 85 SY $25.00 $2,125.00 85 $2,125.00 15 4"CONC SIDEWALK 760 SF $22.00 $16,720.00 760 $16,720.00 16 HYDROMULCH SEEDING 20 SY $50.00 $1,000.00 20 $1,000.00 Sub-Total of Previous Unit $52,956.00 $52,956.00 Monday,October 9,2017 Page 2 of 4 City Project Numbers 02714 DOE Number 2714 Contract Name THE MANSIONS AT TIMBERLAND PHASE II Estimate Number Y Contract Limits Payment Number 1 Project Type SEWER For Period Ending 10/9/2017 Project Funding Contract Information Summary Original Contract Amount $52.956.00 Chance Orders Total Contract Price $52.956.00 Date/P Total Cost of Work Completed $52,956.00 Contractor Less %Retained $0.00 Date 16')Z 6/7 Net Earned $52,956.00 Inspection Supervisor Earned This Period $52.956.00 Retainage This Period $0.00 Date Less Liquidated Damages TAsstre Days @ /Day $0.00 Date LessPavement Deficiency $0.00 PW-h nLess Penalty $0.00 Ite << < ll� Less Previous Payment $0.00 ��Diir�ector/Contracting Department Plus Material on Hand Less 15% $0.00 (IC Balance Due This Payment $52.956.00 Monday,October 9,2017 Page 3 of 4 FoRTWORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO. 1 NAME OF PROJECT: The Mansions at Timberland Phase 2 PROJECT NO.: 02714 CONTRACTOR: Rumsey Construction,LLC. DOE NO. N/A PERIOD FROM 07/05/16 TO: 10/09/17 FINAL INSPECTION DATE: 9-Oct-17 WORK ORDER EFFECTIVE 7/5/2016 CONTRACT TIME 462 O WD O 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 DAYS TOTAL &HOLIDAYS &TOO COLD RELOCATIONS OTHERS CHARGED DAYS THIS 462 PERIOD PREVIOUS 0 PERIOD TOTALS 462 TO DATE "REMARKS iOli"I�ACTOR �- DATE INSPECTOR DATE ENGINEERING DEP:-=-TIENT The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TZ 76012-6311 (817) 392-7941 • Fat: (817) 392-7845 `�L FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: The Mansions at Timberland Phase 2 PROJECT NUMBER: 02714 DOE NUMBER: WATER PIPE LAID SIZE TYPE OF PIPE LF FIRE HYDRANTS: 5 VALVES(16" OR LARGER) n/a PIPE ABANDONED SIZE TYPE OF PIPE LF no DENSITIES: NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF Yes 8" PVC 173 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: yes NEW SERVICES: 4" PVC 20 TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000 Throckmorton Street*Fort Worth,TX 76012-6311 (817)392-7941 •Fat: (817) 392-7845 FORTWORTHREV:02/20/07 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR n CONTRACTOR&PROJECT DATA Name of Contractor Project Name Ru nsey Construction,LLC. The Mansions at Timberland Phase 2 DOE Inspector DOE Number Connor Slaten 02414 DOE Inspector Project Manager ❑Water Q Waste Water ❑ Storm Drainage ❑ Pavement Gopal Sahu Initial Contract Amount Project Difficulty $52,956.00 O Simple OO Routine O Complex Final Contract Amount Date $52,956.00 10/9/2017 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 8 2 Public Notifications 5 Y 1 20 5 3 Plans on Site 5 Y 1 20 5 4 Field Supervision 15 Y 1 60 15 5 Work Performed 15 Y 1 60 15 6 Finished Product 15 Y 2 60 30 7 Job Site Safety 15 Y 2 60 30 8 Traffic Control Maintenance 15 Y 2 60 30 9 Daily Clean Up 5 Y 2 20 10 10 Citizen's Complaint Resolution 5 Y 1 2 20 10 11 Property Restoration 5 Y 1 20 5 12 After Hours Response 5 Y 4 20 20 13 Project Completion 5 Y 1 20 5 TOTAL ELEMENT SCORE(A) 180 BONUS POINTS(25 Maximum)(B) III)CONTRACTOR'S RATING TOTAL SCORE(TS) 180 Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/MS] x 100%) 180 / 448 = 40% Performance Category Standard <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, r Sign e Contractor Signature DOE Inspector's Supervi ! r ✓ CONTRACTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TK 76012-6311 (817) 392-7941 •Fax: (817) 392-7845 FORTWORTHREV:02'7/07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 10/917 Name of Contractor Project Naine Rumsey Construction,LLC. The Mansions at Timberland Phase 2 DOE Inspector Project Manager Connor Slaten Gopal Sahu DOE Number Project Difficulty Type of Contract 02714 O Simple OO Routine O Complex ❑ Water Q Waste Water ❑ Storm Drainage ❑ Pavement Initial Contract Amount Final Contract Amount $52,956.00 $52,956.00 II)PERFORMANCE EVALUATION 0-Inadequate 1 -Deficient 2 -Standard 3 -Good 4-Excellent ELEMENT RATING ELEMENT RATING (0-4) (p-4) INSPECTION EVALUATION PLANS& SPECIFICATIONS 1 Availability of Inspector p `? 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 c� 5 Citizen Complaint Resolution h' ', PROJECT MANAGER EVALUATION 6 Performance- Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution i' ADMINISTRATION 2 Availability of Project Manager c,! 1 Change Order Processing Time N114 3 Communication 2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts u 3 Bid Opening to Pre-Con Meeting Timeframe III)COMMENTS& SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor r l/ INSPECTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TZ 76012-6311 d (817) 392-7941 •Fat: (817) 392-7845 AFFIDAVIT STATE OF TEXAS COUNTY OF DENTON Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Joe Geer, CFO/Partner Of Rumsey COnstruction, LLC, 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; 1560-Mansions at Timberland Undergroud'TJt> ties BY l Joe Geer, CFO/Partner Subscribed and sworn before me on this date 17 of October, 2017. Notary Public Denton, Texas SARAH PEREZ _Notary PUbliC, State of Texas = °A.•, v, Comm. Expires 11-21-2020 11,nry 10 126731),567 p CONSFEEM7 OF OWNER ❑ S'❑R77Y COMP r; MY ARCH-7ECT ❑ ?C0J FXALL G'AYMEEM i7 CONTRACTOR SURETY ❑ AiA DOCUMENT G707 OTHER PROJECT: The Hand©n5 at Timberland (name, address) Fo® t Wc� 'Lrh, 7X TO (Owner) CITY PROJECT NO: 02714 Miansions at Tirnberland, LP he City of Fort Worth,TX CONTRACT FOR: CONTRACT ®ATE: I CI&Bi1 E BOND NO: 1047840 CONTRACTOR-. Rumsey Construction, LLC 4329 Reeder ®rove Carrollton, TX 75010 In accordance with the provisions of the Contract between the Owner and the Contractor as inaicatec above, L-he (here insert name and address of Surety as it appears in the bond). The Hanover Insurance Company SURETIU° COMPANY', On bond Of(here insert name and address of Contractor as it appears in the bond), Rumsey Construction, LLC CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shaiG not relieve the Surety Of any Of its obligations to(here insert name and address of Owner) Mansions at Timberland, LP. and City of Fort WorthN����R, as set forth in the said Surety's bond. IN WITNESS WHEREOF , the Surety has hereunto set its hand this 12th day of October ,201 7 The Hanover Insurance Company t 1�_ /� � Signature of Authorized Representative Attest:?/2a ttest: / _ Douglas Moore,Attorney-in-Fact (Seal).(((//// �` Title AIA DOCUMENT G707•CONSENT OF SURETY TO FINAL PAYMENT•APRIL 1970 ONE PAGE EDITION•AIA 0.©1970•THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE.,NW,WASHINGTON,D.C.20006 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 John R.Ward,Douglas Moore,Emily Mikeska and/or Eva O.Limmer of Ward&Moore Insurance Services LP of Gatesville,TX and each is a true and lawful Attorney(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 Attomeys-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 other writings 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 22nd day of May 2014. THE HANOVER INSURANCE COMPANY _.ss1U1tU4t Nle MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS SUR ANCE OMPANY OF AMERICA 1974 *?4 12obert Thorna&Vice President THE COMMONWEALTH OF MASSACHUSETTS ) COUNTY OF WORCESTER )ss. .toe grenstrom.1,/icc President On this 22nd day of May 2014 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. 3s"`�'4.r BARBARA A.GARLICK E � Noary Public Cornnx nweaAh of Massadtusens r, '�bty Comrrssis�ExpirT�s Sept.21.Ztl18 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 of Attorney and Certified Copies of such Powers ofAttomey and certification in respect thereto,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 12th day of October 2017. THE HANOVER INSURANCE COMPANY MA SA HUSETT BAY I CE COMPANY CI EN I SU CE OF AMERICA J. h I ete,Vice as ent