HomeMy WebLinkAboutContract 50041 COMMUNITY FACILITIES AGREEMENT
WITH CITY PARTICIPATION
Developer Company Name: Walton Development&Management TX,LLC
Address,State,Zip Code: 5420 LBJ Freeway,Suite 790,Dallas,TX
Phone&Email: 214-838-2101,jvick@walton
Authorized Signatory,Title: John Vick,President
Project Name: Chisholm Trail Ranch Sec2 Ph2
Brief Description: Water,Sewer,Paving,Storm Drain,Street Lights
Project Location: Northeast Comer of Mcpherson Boulevard and Brewer Rd
Plat Case Number: FP-16-034 Plat Name: Chisholm Trail Ranch
Mapsco: ;103W Council District: 6 City Project Number: 100542
CFA Number: 2017-074 DOE Number: None
To be completed toff• /1.1a
Received by: ! Date: _ J
RECEIVED
DEC 1 1 2011 z
CIT/OF FORT WORTH / .!
cmrsECRErARY OFFICIAL RECORD
. r ° CITY SECRETARY
_ FT-WORTH,TX
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 1 of 12
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COMMUNITY FACILITIES AGREEMENT
WITH CITY PARTICIPATION
THE STATE OF TEXAS § City Secretary /
COUNTY OF TARRANT § Contract No. 5 lam)
WHEREAS, Walton Development & Management TX. LLC , ("Developer"), desires to
make certain specific improvements as described below and on the exhibits attached hereto
("Improvements")related to a project generally described as Chisholm Trail Ranch Section 2 Ph2
("Project")within the City of Fort Worth,Texas("City"); and
WHEREAS, the City has reviewed the proposed Improvements and desires to have
the Developer oversize the proposed Improvements to provide capacity for future
development in the area("Oversized Improvements"); and
WHEREAS,the Developer and the City desire to enter into this Community Facilities
Agreement ("CFA" or"Agreement") in connection with the collective Improvements for the
Project;and
WHEREAS,the City has reviewed the Project and desires to participate in the Project
in accordance with this Agreement as presented by the Cost Summary Table and Exhibits
attached hereto;and
WHEREAS,on January 24,2017,through M&C C-28068,the City Council authorized
the City to participate in oversizing the street Improvements in the CFA in an amount not to
exceed$300,000.00; and
WHEREAS, on October 10, 2017, through M&C C-28428, the City Council
authorized the City to participate in oversizing the water Improvements in the CFA in an
amount not to exceed$159,829.97;and
WHEREAS, The City's total cost participation in the Improvements under the CFA
shall be in an amount not to exceed("Participation"); and
WHEREAS,the City has requested the Developer to cause,and the Developer agrees
to cause,the design,permitting and construction of the Project for which the City will, subject
to City Council approval, reimburse the Developer for the City's portion of those costs after
City's final acceptance of the Project.
NOW, THEREFORE, for and in consideration of the covenants and conditions
contained herein,the City and the Developer do hereby agree as follows:
General Requirements OFFICIAL RECORD
City of Fort Worth,Texas CITY SECRETARY
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2 FL WORTNj TX
CFA Official Release Date:01.22.2017
Page 2 of 12
A. The Policy for the Installation of Community Facilities ("Policy") dated March 2001,
approved by the City Council of the City of Fort Worth, as amended, is hereby
incorporated into this Agreement as if copied herein verbatim.Developer agrees to comply
with all provisions of said Policy in the performance of its duties and obligations hereunder
and to cause all contractors hired by Developer to comply with the Policy in connection
with the work performed by said contractors.
B. Developer shall provide financial security in conformance with paragraph 6, Section II,of
the Policy and recognizes that there shall be no reduction in the collateral until the Proj ect
has been completed and the City has officially accepted the Improvements. Developer
further acknowledges that said acceptance process requires the Developer's
contractor(s) to submit a signed affidavit of bills paid signed by its contractor and
consent of surety signed by its surety to ensure the contractor has paid any sub-
contractor(s)and suppliers in full. Additionally, the contractor will provide in writing
that the contractor has been paid in full by Developer for all the services provided
under their contract.
C. Developer agrees to cause the construction of the Improvements contemplated by this
Agreement and that said construction shall be completed in a good and workmanlike
manner and in accordance with all City standards and the City-approved construction
plans,specifications and cost estimates provided for the Project and the exhibits attached
hereto.
D. The following checked exhibits describe the Improvements and are incorporated herein:
Water (A) 0, Sewer (A-1) N, Paving (B) ®, Storm Drain (B-1) 0, Street Lights &
Signs(C) Z.
E. The Developer shall award all contracts for the construction of community facilities in
accordance with Section II,paragraph 7 of the Policy and the contracts for the construction
of the public infrastructure shall be administered in conformance with paragraph 8,
Section II, of the Policy. Developer shall ensure its contractor(s) pays the then-current
City-established wage rates.
F. For all Improvements included in this Agreement for which the Developer awards
construction contract(s),Developer agrees to the following:
i. To employ a construction contractor who is approved by the director of the
department having jurisdiction over the infrastructure to be constructed, said
contractor to meet City's requirements for being prequalified, insured, licensed
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 3 of 12
and bonded to do work in public ways and/or prequalified to perform
water/wastewater construction as the case may be.
ii. To require its contractor to furnish to the City a payment and performance bond
in the names of the City and the Developer for one hundred percent(100%) of
the contract price of the infrastructure, and a maintenance bond in the name of
the City for one hundred percent (100%) of the contract price of the
infrastructure for a period of two (2) years from the date of final acceptance
insuring the maintenance and repair of the constructed infrastructure during the
term of the maintenance bond. All bonds to be furnished before work is
commenced and to meet the requirements of Chapter 2253,Texas Government
Code.
iii. To require the contractor(s) it hires to perform the construction work
contemplated herein to provide insurance equal to or in excess of the amounts
required by the City's standard specifications and contract documents for
developer-awarded infrastructure construction contracts. The City shall be
named as additional insured on all insurance required by said documents and
same will be evidenced on the Certificate of Insurance(ACORD or other state-
approved form) supplied by the contractor's insurance provider and bound in
the construction contract book.
iv. To require its contractor to give 48 hours advance notice of intent to commence
construction to the City's Construction Services Division so that City inspection
personnel will be available; to require the contractor to allow the construction
to be subject to inspection at any and all times by City inspection forces,to not
install or relocate any sanitary sewer, storm drain, or water pipe unless a
responsible City inspector is present and gives his consent to proceed, and to
make such laboratory tests of materials being used as may be required by the
City.
V. To require its contractor to have fully executed contract documents submitted
to the City to schedule a Pre-Construction Meeting.The submittal should occur
no less than 10 working days prior to the desired date of the meeting. No
construction will commence without a City-issued Notice to Proceed to the
Developer's contractor.
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 4 of 12
vi. To delay connections of buildings to service lines of sewer and water mains
constructed under this Agreement, if any,until said sewer and water mains and
service lines have been completed to the satisfaction of the Water Department.
G. Developer shall provide,at its expense,unless otherwise agreed to by City,all engineering
drawings and documents necessary to construct the Improvements under this Agreement.
H. Developer shall cause the installation or adjustment of the required utilities to serve the
development or to construct the Improvements required herein.
I. City shall not be responsible for payment of any costs that may be incurred by Developer
in the relocation of any utilities that are or may be in conflict with any of the community
facilities to be installed hereunder. City will be responsible for the costs of utility relocation
necessitated by the City's participation in this Agreement.
J. Developer hereby releases and agrees to indemnify, defend and hold the City harmless
for any inadequacies in the preliminary plans,specifications and cost estimates supplied
by the Developer for this Agreement.
K. Developer agrees to provide, at its expense, all necessary rights of way and easements
across property owned by Developer and required for the construction of the current and
future improvements provided for by this Agreement.
L. The Developer further covenants and agrees to, and by these presents does hereby,fully
indemnify,hold harmless and defend the City,its officers,agents and employees from all
suits, actions or claims of any character, whether real or asserted, brought for or on
account of any injuries (including death) or damages sustained by any persons or to any
property, resulting from or in connection with the construction, design,performance or
completion of any work to be performed by said Developer, his contractors,
subcontractors, officers, agents or employees, or in consequence of any failure to
properly safeguard the work, or on account of any act, intentional or otherwise, neglect
or misconduct of said Developer, its contractors, sub-contractors, officers, agents or
employees.
M. The Developer will further require its contractors to indemnify, defend and hold
harmless the City,its officers,agents and employees from and against any and all claims,
suits or causes of action of any nature whatsoever, whether real or asserted, brought for
or on account of any injuries or damages to persons or property, including death,
resulting from or in any way connected with the construction of the infrastructure
contemplated herein, whether or not such injuries, death or damages are caused, in
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 5 of 12
whole or in Part, by the allezed nezlikence of the City of Fort Worth, its officers,
servants, or employees. Further,Developer will require its contractors to indemnify and
hold harmless the Cityfor any losses, damages, costs or expenses suffered by the City or
caused as a result of said contractor's failure to complete the work and construct the
improvements in a good and workmanlike manner,free from defects, in conformance
with the Policy, and in accordance with all plans and specifications.
N. Upon completion of all work associated with the construction of the Improvements,
Developer will assign to the City a non-exclusive right to enforce the contracts entered into
by the Developer with its contractor along with an assignment of all warranties given by
the contractor, whether express or implied. Further, Developer agrees that all contracts
with any contractor shall include provisions granting to the City the right to enforce such
contracts as an express intended third party beneficiary of such contracts.
O. Inspection and material testing fees are required as follows and further apportioned in the
Cost Summary Table below
i. Developer shall pay in cash water and wastewater inspection fees and material
testing fees equal to two percent(2%)for a total of 4%of the Developer's share
of the total construction cost as stated in the construction contract.
ii. Developer shall pay in cash paving and storm drain inspection fees equal to
four percent(4%)and material testing fees equal to two percent(2%)for a total
of 6% of the Developer's share of the total construction cost as stated in the
construction contract.
iii. Developer shall pay in cash the total cost of streetlights or if the City is not
installing the streetlights, inspection fees equal to four percent (4%) of the
Developer's share of the streetlight construction cost as stated in the
construction contract.
iv. Developer shall pay in cash the total cost of street signs necessary for
Developer's portion of the Project.
P. COMPLETION WITHIN 2 YEARS
i. The City's obligation to participate (exclusive of front foot charges) in this
Agreement shall terminate if the Improvements are not completed within two
(2) years; provided, however, if construction of the Improvements has started
within the two year period,the Developer may request that the CFA be extended
for one(1)additional year. If the Improvements are not completed within such
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 6 of 12
extension period, there will be no further obligation of the City to participate.
City participation in this CFA shall be subject to the annual availability of City
funds as approved by the City Council.
ii. Subject to paragraph i,above,the City shall reimburse Developer for the City's
costs upon presentation of proper documentation of completion of installation
of the Oversized Improvements.
iii. Nothing contained herein is intended to limit the Developer's obligations
under the Policy, this Agreement, its financial guarantee, its agreement
with its contractor or other related agreements.
iv. The City may utilize the Developer's financial guarantee submitted for this
Agreement to cause the completion of the construction of the Improvements if
at the end of two (2)years from the date of this Agreement(and any extension
period)the Improvements have not been completed and accepted.
V. The City may utilize the Developer's financial guarantee to cause the payment
of costs for construction of the Improvements before the expiration of two (2)
years if the Developer breaches this Agreement, becomes insolvent or fails to
pay costs of construction and the financial guarantee is not a Completion
Agreement. If the financial guarantee is a Completion Agreement and the
Developer's contractors and/or suppliers are not paid for the costs of supplies
and/or construction, the contractors and/or suppliers may put alien upon the
property which is the subject of the Completion Agreement.
Q. Developer acknowledges that in accordance with Chapter 2270 of the Texas Government
Code, the City is prohibited from entering into a contract with a company for goods or
services unless the contract contains a written verification from the company that it: (1)
does not boycott Israel; and (2) will not boycott Israel during the term of the contract.
The terms "boycott Israel" and "company" shall have the meanings ascribed to those
terms in Section 808.001 of the Texas Government Code. By signing this contract,
Developer certifies that Developer's signature provides written verification to the City
that Developer: (1)does not boycott Israel;and(2)will not boycott Israel during the term
of the contract.
(REMAINDER OF PAGE INTENTIONALLY LEFT BLANK)
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 7 of 12
Cost Summary Sheet
Project Name: Chisholm Trail Ranch Sec.2 Ph.2
CFA No.: 2017-074 City Project No.: 100542
Items Developer's Cost City's Cost Total Cost
A. Water and Sewer Construction
1. Water Construction $ 534,558.25 $ 123,899.20 $ 658,457.45
Contingency 25% $ 30,974.80 $ 30,974.80
2.Sewer Construction $ 322,798.50 $ - $ 322,798.50
Water and Sewer Construction Total $ 857,356.75 $ 154,874.00 $ 1,012,230.75
B. TPW Construction
1.Street $ 1,017,262.90 $ 185,000.00 $ 1,202,262.90
2.Storm Drain $ 122,745.00 $ - $ 122,745.00
3.Street Lights Installed by Developer $ 202,664.52 $ - $ 202,664.52
4. Signals $ $ $ -
TPW Construction Cost Total $ 1,342,672.42 $ 185,000.00 $ 1,527,672.42
Total Construction Cost(excluding the fees): $ 2,200,029.17 $ 339,874.00 $ 2,539,903.17
Construction Fees:
C. Water/Sewer Inspection Fee(2%) $ 17,147.14 $ 2,477.98 $ 19,625.12
D. Water/Sewer Material Testing Fee(2%) $ 17,147.14 $ 2,477.98 $ 19,625.12
Sub-Total for Water Construction Fees $ 34,294.28 $ 4,955.96 $ 39,250.24
E. TPW Inspection Fee(4%) $ 45,600.32 $ 7,400.00 $ 53,000.32
F. TPW Material Testing(2%) $ 22,800.16 $ 3,700.00 $ 26,500.16
G. Street Light Inspsection Cost $ 8,106.58 $ - $ 8,106.58
H. Signals Inspection Cost $ - $ - $ -
J.Project Contingencie,CP Quality Control Assuances
&Coordintion Engineering&Survey $ - $ 103,900.00 $ 103,900.00
TPW Construction Fees Subtotal $ 76,507.06 $ 115,000.00 $ 191,507.06
Total Construction Fees $ 110,801.34 $ 119,955.96 $ 230,757.30
TOTAL PROJECT COST $ 2,310,830.51 $ 459,829.96 $ 2,770,660.47
Financial Guarantee Options,choose one Amount Choice
(Mark one)
Bond=100% $ 2,539,903.17 x
Completion Agreement=100%/Holds Plat
Cash Escrow Water/Sanitary Sewer=125%
Cash Escrow Paving/Storm Drain=125%
The costs stated herein may be based upon construction estimates rather than actual costs. The
City's portion of inspection and material testing fees are directly allocated to the City's
accounts for charges and does not reimburse the Water Inspection and Material Testing Fees
to the Developer.The City's participation estimate shall be limited to the unit prices contained
in City of Fort Worth Ordinance No. 19192-06-2010,as amended, ("Unit Price Ordinance")or
as determined by public competitive bid. The City's cost participation (excluding inspection
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 8 of 12
depending upon actual quantities as shown on the Notice of Final Completion package(`Green
sheet') and based on unit prices from the construction contract documents. In no event shall
the City pay more per unit than as determined pursuant to the Unit Price Ordinance or public
competitive bid.
(REMAINDER OF PAGE INTENTIONALLY LEFT BLANK)
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 9 of 12
IN TESTIMONY WHEREOF,the City of Fort Worth has caused this instrument to be
executed in quadruplicate in its name and on its behalf by its Assistant City Manager,
attested by its City Secretary,with the corporate seal of the City affixed, and said Developer
has executed this instrument in quadruplicate, effective as of the date subscribed by the
City's designated City Manager. FART
nrry����n u ATTEST:
0 r vnT WORTI :3:
U
............J
Jesus J. Chapa Mary J. Kar
Assistant City Manager City Secreta
Date: 12 - 7
DEVELOPER
Recommended by: Walton Development&Management TX,LLC
Wendy Chi abulal, MBA,P.E. Name: John Vick
Development Engineering Manager Title: President
Water Department
Date:
Kara Shuror ATTEST: (Only if required by Developer)
Acting Director
Water Department
W 0 Signature
Dougla W.Wiersig,P.E. Name: <Name>
Director
Transportation&Public Works Department Contract Compliance Manager:
Approved as to Form &Legality: By signing I acknowledge that I am the person
responsible for the monitoring and
administration of this contract, including
ensuring all performance and reporting
Richard A. McCracken requirements.
Assistant City Attorney
M&C No. C^ZbC)60.1• G-z,b42ZS3
Date: 1 2411-11141, 1 12j?&J,
I o to 17
Form 1295: �611a-122 21 Name: nie Morales
zo 1-7 - 26&191
Title: Planning Manage
®FFIC1At. RECORD
CITY SECRETARY
City of Fort Worth,Texas "'WORTH,TX
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec
l 12h2
CFA Official Release Date:01.22.2017
Page 10 of 12
Check items associated with the project being undertaken; checked items must be
included as Attachments to this Agreement
Included Attachment
® Attachment 1 -Changes to Standard Community Facilities Agreement
with City Participation
® Location Map
® Exhibit A:Water Improvements
® Water Cost Estimate
® Exhibit A-1: Sewer Improvements
® Sewer Cost Estimate
® Exhibit B: Paving Improvements
® Paving Cost Estimate
® Exhibit B-1; Storm Drain Improvements
® Storm Drain Cost Estimate
® Exhibit C: Street Lights and Signs Improvements
® Street Lights and Signs Cost Estimate
® Exhibit D:Water Cost Share Breakdown
(Remainder of Page Intentionally Left Blank)
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 11 of 12
ATTACHMENT"1"
Changes to Standard Agreement
Community Facilities Agreement
City Project No.tOW2
Ilion E
City of Fort Worth,Texas
Standard Community Facilities Agreement with City Participation-Chisholm Trail Ranch Sec2 Ph2
CFA Official Release Date:01.22.2017
Page 12 of 12
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TRANSFORMER ON PAD ` H6" APPRECIATE THE LAND
CIVIL ENGINEERS-PLANNERS-SURVEYORS SUITE 4775,1445 ROSS AVENUE
HAND HOLE 240E Mu" Or".G"sYor,Te 7 1 DALLAS,TX,UNITED STATES,75202
0 Moho P17)928.1979 (972)7130000
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X PROPOSED STREET NAME SIGN GOO DWWO W1, I,' V
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CML ENGINEERS—PLANNERS—SURVEYORS SUITE 4775,1445 ROSS AVENUE
2406 Muwrq Wm,Gmpw m,TW 70MI DALLAS,TX,UNFrED STATES,75202
Mo (817)SM-073 (972)713-OOM
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SECTION 00 42 43
Developer Awarded Projects-PROPOSAL FORM
Chisholm Trail Ranch Section 2 Phase 2
UNIT PRICE BID
Project Item Information CONATSER
Bidlist
Specification knit of Bid
Item Description Section No. N":asurc Quantity Unit Price Bid Value Sheet Number&Quantity
No.
0n-1,le 11 atrr 1'01N6es 3 4
1 13,lt 02H fl'11% Aatnr Yim 33 11 12 LF 4.333 $34.00 $147,322.00 1944 2389
2 3312.3003 8"6,t,Va:vc&\dila Bas 3372 20 --- EA 14 $1,150.00 $16 100.00 7
_._..:.
312.,01 Fre>l,dram 1.-.nhk 331240 EA 5 $4,500.00 $22-50000 1 i
4 3',t2 2003 1"D,,,,,,.'d1ar- •arse 33 12 10 EA 135 $950.005128.50.00 36
i2 0117 Connect t..:n.I 1 1 331225 _ EA 5 $600.00 53,000.00 3 _
6 ? I�0117 Connect to 1'-i n;I"'11:.1.. 33 12 25 EA 1 $600.00 $600.00 1 u
7 1 010' DLct or.V-,, 33 11 11 TON 3 9 $4,000.00 _ $15 600 00 1.8
e an -...�__, -
8 171_'A 107 :> 51 d l'alve 33 12 25 EA 1 $3,500.00 $3.500 00 1
9 0241.1118 8"Ltd on I flue '� 02 41 15 EA _ 4 $750 CC $3,000 00
10 3305.0109'frcndi.M J ut lu LF $1,08325 1917 2989
On-Site Water Subtotal $340,955.25
SII,.,,?-isnhs&Quaittily
On-Sit,R,- 1-acili[lei
15 :31',.not,'._4"1'1+ 1Aaw,Pi r 3311 12 1 LF 1 1,452 $123.00 _ $174,240.00M11
17 331 Dl^dH k-e l hJram Asauubh 331240 EA 1 5450 6(I $L,600 0021 +1'u 1,,,Conned to Existing 24"t1'.L $31225 EA 2 S2_WD Db $t CM 0022 ?3I Leumi I)ucule Iron Water Plum a E,trsox 33 t1 11 TON15 $4.000 00 c6 000.3024 ;;I'Ina'='(o,nbi tnon Air VRlrcAs .Ilbl for Water 3312 30 FA 1 $4.500.00 $4500006 - _ Y a _______ 3109f 6,4a1i`t LF .$0'5 5630p
On-Site Brewer Water Subtotal
Sheet Number&Q-tity
Oro-Titc Sanintrs ticwerParllllicv 8 9 10
" 1 C Sews; re 33 11 10,33 31
19 3331 90 LF 3,729 S38 00 $141.702.00 1784 1443 502
28 •-I J;I Existm 8"5.5 3331 50 EA 4 5900.00 $3,200.00 3 I 0
29 3339.1001 4'Std,Dia.S.S.Manhole 33 39 10,33 39 EA
20 19 $3.600.00 $68,400.00 9 7 3
30 ??3x.1003 Extra Depth for 4'Std.Dia 33 39 10,33 39 Manhole VF 49.5 $175.00 $8,662.50 32.9 lCil 1.8
1 4116 8"PW'Sewer 7Nw/CSS Backfill 3311 10.33 31
12 3331 20 LF 121 $54.00 $6534.00 20 61 40
32 -,�l 1v11' 1 ti -t Se81 511,2-2F1 33 31 50 EA 113 $650.00 $73,450.00 47 49 17
33 1 33 05 10 1 LF 1 3,850 1 $2.001 $7,700.00 1804 1504 542
34 I'•:•:_po,, �-1\ 1 I nn _ 330131 LF 3,850 $2.00 $7700.00 1804 1504 542
33 05 15 EA 8 1 $250.00 $1,50000 2 2 2
36 .}u101'.11 �innil;,leVl,e,uuu 1 $50.00 $950.00 9 7 3
3I 17 Din11 I[po.cAlauholc1 mm J3 J9 bu I EA 1 3 1 $1,000,001 $3,000.00 2 1 0
On-Site Sanitary Sewer Subtotal 322,798.60
car or roRT waxen
STANDAROCONSTRrxY[ON BID PRDPDRAL-DEVF APFB AwARUFD PROR'CTi CNhdm TmY R�eW 3eN.3•Ph.2
Fom,Retiwd Nov�mbwi,DJ15 Page 1 of 2 ...aid Pmpoul
SECTION 00 42 43
Developer Awarded Projects•PROPOSAL FORM
Chisholm Trail Ranch Section 2 Phase 2
UNIT PRICE BID
Project Item Information CONATSER
di.<t
Description
Specification No. Measure
Bid Unit Price Bid Value
Section No. Measwe Quantity Sheet Number&Quantity
On-Site Sturm Drain Facilities
35 ;141)50D'I 10 11,1,,—d(irt, rdut 33 49 20 EA 12 $2,500.00 $30 000.00 2 4 0 01 6
40 1739.5002 IS Uc:ms.ed Curt+Inlet 33 49 20 FA 2 $4,000.00 $8 000 DO 0 G 0 0 2
42 `)`i'N 0001 Neenah<R-4180 Grate Intel or Equal 33 49 20 EA 7 $400.00 $2.800 00 0 0 0 7 0
43 i'31,4302 Rere.nc i .'ung 3'z 3'Drop Inlet 0241',4 EA 2 $750.00 $4.50000 0 1 D 0 1
44 ,,Y),00026"P\' .x 3341 10 LF 96 $30 D0 $2,040 00 0 0 0 98 0
45 99`w.00038"[IN'('1'Ipc 334110 LF 47 $34.00 $1,598,00 0 0 0 47 0
46 91)99.0004 10'PA 1 re 3341 10 LF 105 $38 00 $7.410.00 0 0 0 195. 0
47 9+99.000512"P`.ti 334410 _ LF 110 $42.00 $4,?72.D0 0 0 0 11G 0
`i ra
48 _i 11.020121`(k—I I I Ri'1'' 334110 LF 204 $4500 $9,18000 56 44 0 0 104
__._
49 3341.0205 24"!'Ia—I1'.f;<'I' 334'10 '_F 405 1 $50 W $20,250.00 380 0 0 0 45
51 9999.00060 1 Iaal 1 >icnot", 0030 OD EA 5 $40000'1 $2,7"000 0 4 0 1 0
62 9999.0007 Camret t�.l-.�nmw,.t'4 arm Rteu 00 00 00 _ EA 1 $1,50 00� $450.00 1 0 0 0 3
53 0241,3015 Re,,, .c 1> _I-R i'.I`S,o_n,1 m� 02 41 14 LF 1 515 DO 515.00 0 1 0 0 0
_ _ —_
SR 0211 301 i Rr;mnre Ili 34"K.('P Storm Lme 0241 14 LF 5 $18.00 590-00 0 0 0 0 i
55 ?1D�0112 Concrete Collar 330517 EA 6 $30000 $1,800.00 2 2 0 0
3
?1G�u100 Trench Safe 330810 LF 1,085 $1 CD $1,08500 116 44 0 456 149
33 1`i;iu:�1 4'Storm Junction Box _49'I D 4 006 00 $8,000 dd ? 0 0 0 0
On-Site Storm Drain Subtotal 101,990.00 _
tiLcc1 Gun b_t.0 huamvn
'On-�Jtr 9'rc»er tilurm DrEin Facilities 45
t
58 000000 .F. 1 $2000. 52.000 OCi' 1 0 G
61 =141I;u C 11!R«c=x:G C'ut6 inlet 334920 EA 1 $2.200,00 52200 0o 1 0 0
68 ;1.1P.a1 2."('9as=Lit R(1P 334110 LF 60 $45.00 $2,100.00 GO 0 0
69 2 1.i „1a H[1' 334110 LF 67 $50.00 5335000 0
70 %i 0208 27"Cl—til RCP 3341 10 LF 68 $60.00 S4 060 DO OS 0 0
76 3105.0109 Trench Salr�, 330510 LF 175 $1,00 $1i5-00 195 0 0
77 3349.0001 4'Storm Junctional 1- 334910 EA 1 $4,000.00 $4.000.00 1 0 D
78 3136.0104 Gabion Mattress 31 3600 SY 18 1 $2 250.00 18 0 0
Onsite Brewer Storm Drain Subtotal $20,755.00
Bid Sumntary
Water/Sanitary SewedStorm Drain Facilities Subtotal .,680.101
Pa me_n1JPerfonnancelMainten once Bonds SG W
TOTAL BID 980,101.75
an of rwcT wDarx
STAln]ARD CONSTILUCrON am PROrosALDEYEWPERAWARUfin PROJECTS Chi�hdm irtil
Page 2 f 2 1243 Ser 1 2
Foem RaviwelVov<mberl,A115 o 0043 a3 Bid Pmp<sl
SECFION w vi 13
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UNIT PMCE BBD
Pryxl Im0lofumetiun OB,CO
Rr.,
Specif e4m Uoild Bid
H� Ovnp� Seelim Nv. Meaaue Qua0tity Uwl liia Did Value 5hal Nmo�rb.Qrwliry
6 b H
1 "121]ll 1pl 6'Cuncatn Pevomenl Nesidanlinl' 1 11 v 0 11 2x59 IdiA 2575 1$34 l4
r 211.05016'Limc Taaad Jub ndc(R<=idcrrral'2 321129 SY 19,279 $2 a' 3191.15 U p 0 2514 IIM P90 IF.o1 _tui r7 iu n:i =s: I
1 MtY111vdrntrill me/�3>Iba l3 V.lkmi.fenbul 3217 9 ON JOB $15500 uT740.W 0 D R3.6 il.i 36l
__ ,_I'irv.r.,Bunn Frtc Rnm s.Tv M-I 321320 26 160000 1800.00 11 0 0 II
_ �I Hu.ierFm.Rnm v T' M-2 21 0 A 8 1900A0 11100.00 0 0 1
10 5..Concrcrcl'uvemmr 000 0 LF 1 0 0 2P --
r r11 R,nncct 0 _
_ ISI I<cunl�c End of Rood 13.,x 000 00 EA 1 250.00 1.0000 0 0 10 1
77,320 1 5150000 1. 0.00
__ irc Sdcwelk 3213203.2 37S33-00 11 0 91
icadc•
00 LF
woo 0
314 00 3580.00
woo 00 EA
2i s 0 Ea 000.00 U 0 0 0 0
1
On.34e F—,n g 5ubintal
snau Nemxrs 4eaautr
On S:te Bre'rvor Pav,n Fir.-i- 15b
3213M EA 2 0 3,200 C0 0
0
00 L 29 E9.a0 233.G :'r 0 0
0 w E 350.-0 250.00 -
IS .3I�n 1 0 0
31113 LS 1 500..... .O.
321713 SY 1 5377 .41..1-�- $222.33665 ;� 2S4fi 0
IS _ r'Lime`rcorct irm n:v l.lncnel' 331179-- SY 5295 16152_.
_ OW 1Nyed Lrc �n 4111ll.Y Mcnal 1 29 TON I 12C SlIs. ESa�c�
21- 1r±5'Cnncmm S,leualk 321320 LF 1 78 32125 51 R'.j 5D U
M Corx;nt.5idcuelk 321320 L 1,541 52]00
] bt 550
5a3,1er,]p II?r
21 0
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000 C
'Z �I S1n U L.01
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lwl
2d -,,laslic 3(n� W 00 2F 580 _'51.30 -i Gt OG U 5(A
0000 LF 25 518- 5<r35p 0 25
Onsite Brenner Paving 5nbtotal ]1Q.509.50
OttSite Brewer Par n Lac lines
27 1999.0121 nU 31,_ -- -
:. -..
23
_9 0)22 Remuve M.nd 1 Raaf Bmnaede 00 00 A 1 5250 00
H 34710001 7 .Convol 31]1 13 LS 1 50 00
30 321331 t049'Ccncroa PaaroodulMcrial' 1313 V 2,115 41]5 58
7i
31 32'1105028'Luneiaual sub de Anmal' 331129 SY 2260 5%05 X567 C0
32 321 LOSpl livdraled l.inrc'r2521bs.5.Y. -J ]2 11 TON 18 51'_500 E74sr,a —JO'. ( "•
33 3213030i5'Cnneiele Sidewalk 1 20 LF 71 5]790 10 r2090
34 59 W l�:1u('n1 dR.movc bxisYn fi['nxb S4 l4U.U0 � ___
OffSRa Brswer Paving Bubtnlal 124,905.15
On53e 31ree1 3'n FaclNlles
35 9x977
,�--�75 1ft00 tl� 6 2
On Ste 5lreel Slgn Su of u.nl 5,6 0.00
O Ste B:vw..r1' r..�li'inv 29 3n 51
Jr - EA 5350.0 - 0
OnSue Hrevrer 91ree1 Sign Subtotal SOO.OD
Ott 5�4 Bre-xer 9cree19r nFacilrClas 2a 36
11 X 3
000000 EA $375001
10
OffSile Brewer SAreel Sryn SublolaY --- 2.335.00
Bin Samm
Paving FacNNNs Buhbotal
Ehaat BlgnTOTAL AeNMiaa BUMolal
PavmanWartormancaMalate+mnw B BID
e..a.uas.mri2m maysuL.psmavm Aauaaolanaa m earyva
SECTION 00 42 43
Developer Awarded Projects-PROPOSAL FORM
Chisholm Trail Ranch Section 2 Phase 2
UNIT PRICE BID
Project Item Information IUC
Specification Unit of Bid
Description Unit Price Bid Valu+:
n Section No. Measure Quantity saes Number a Qu.miry
Shw Number and Quaimity
On-Site Street Lighting Facilities 47
1 �:Lll
11 :_r l 14ft non decorative light le wffull-cutoff LED luminaire 3441 20 EA 24 $3 5'1 C0 ,24:' d 24
�u30 T 7 con--:,,;;foundation 24"x 5' 00 00 00 EA 24 S,,302 QC a31,392CG 24
_ •1>3011 2"Condwt P\CSCH40 26 05 33 LF 3,217 $635 $20,427.95 32171408 Insulated C, Condr,#6 XHHW 3441 10 LF 3,217 1 93 $6,208.81 3217
On-Site Street Lighting Subtotal 1 $142,772.7$
Sheet Number and Quantity
On-Sate Brewer Street Lighting Facilities 47
ATB2LEDLuminaire 344120 EA 7 _ _$42100 $2,947,00 7
p3 concrete foundation 24"x 8"1 000000 EA 7 51 315200 59,464,00 m 7
�1%;c IBA pole 33.5" red steel.c:Prenvc,lfiureh) 000000 EA 7 S�t25�G 5'4.875.00 7
£ Tv a 33A luminaire arm 8"lon,5 1 i•e1 00 00 00 EA 7 S<49 51,743.00 7
2"Conduit PVC SCH 40 - 26 05 33 LF 1,403 56.35 - _$8,908.05 1403
10 1111 1409 Insulated Elec Condr,Alu Quad 2"_1 R41 10 LF 1,403 $3.891 $5.457.67 1403
On-Site Brewer Street Lighting Subtotal 543,395.72
Sheet Number and Quantity
O11-Site Brewer Street Lighting Facilities
11 3441.3201 LED LiOung Fixture 34 41 20 EA 3 $421.00 $1,263.00 3
12 9999.0034 Type 3 aa)rete foundation 24"x 8" 000000 EA 3 $1,352.00 $4,056.00 3
r 9999.0035 Type 18.i hole{33 5" tapered steel galvanized000000 EA 3 $2,125.00 $6,375.00 3
"4 9 0036 Type 33A:uiuir,re amn 8"long,5"rise 000000 EA 3 $249.00 $747.00 3
15 -0,5.3011 2"Cmdra;l'\c.MCH 40 26 05 33 LF 396 $6.35 $2,514.60 396
16 ;4,11 1409 IT-i1 cd E line(ondr,Alum Quad 2224 41 L 3.89 51,540 4e 396
Off-Site Brewer Street Lighting Subtotal $16,496.04
Bid Sannuary
Street Light Facilities Subtotal 1 $202,664.52
Pa ent/Performance/Maintenance Bonds $0.00
TOTAL BM S202,664"62
mT'OF FORT WORTH
SPAlmARD COPSPRUCr10N M PROPOSAL�AWARDED PaOFL'IS Ck"b TruerR &Z&2
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Chisholm Trail Sec 2 Ph 2,City Project#100542
WATER COST SHARE(The City pays for 12"124"water offsite cost particpaton for upsize)
Lower Price
City Contractor Lowest Difference Difference or Total City
Item No. Description Unit Qty Unit Price Unit Price Pice Dev/City Percentage Participation Comment
1 12"PVC Water LF $40.77 $49.50 $40.77 $79.23 79.23 $115,041.96 Lowest price
2 24"Water LF 1452 $313.00 $120.00 $120.00
Ductile Iron Water Fittings 1.5 $4,349.87 $4,000.00 $4,000.00 $4,000.00 $3,000.
3 w/Restraint and Blocking TN $3,000.00 City Cost participation is 50%
4 Trench Safety LF 1452 $7.85 $0.25 $0.25 $0.25 $181 50 City cost participation is 50%
5 Fire Hydrant Assembly EA 1 $2,851.48 $4,500.00 $2,851.48 $2,851.48 $1,425.74
6 Connect to Exting 24" EA 2 $5,650.00 $2,000.00 $2,000.00 $2,000.00 $2,000.00 City cost partici ation is 50%
2'Combination Air Valve 1 $8,491.13 $4,500.00 $4,500.00 $4,500.00 $2,250.01
7 Assembly for Water EA Cit Cost participation Is 50%
Sub Total $123 899 20
Total $123.899.20
Plus Contingency 25% S 154.874X0
Inspection $ 2,477.98
Material testing S 2,477 98
Grand total $159,829.97
A. Construction Developer Cost City Cost Total Cost
1 Water $ 534,558.25 $ 123,899.20 $ 658,457.45
2. Sewer $ 322,798.50 $ - $ 322,798.50
Construction Cost Sub-Total $ 857,356.75 $ 123,899.20 $ 981,255.95
Contingency 25% $ - $ 30,974.80 $ 30,974.80
Total Construction $ 857,356.75 $ 154,874.00 $ 1,012,230.75
Construction Fees:
B. Water/Sewer Inspection Fee (2%) $ 17,147 14 $ 2,477.98 $ 19,625.12
C. Material Testing Fee (2%) $ 17,147 14 $ 2,477.98 $ 19,625.12
Construction Fees Sub-Total $ 34,294.27 $ 4,955.97 $ 39,250.24
Total Project Cost $ 891,651.02 $ 159,829.97 $ 1,051,480.99
City of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 1/24/2017 -Ordinance No.22566-01-2017
DATE: Tuesday,January 24,2017 REFERENCE NO.: **C-28068
LOG NAME: 20BREWER BOULEVARD
SUBJECT:
Authorize Execution of a Community Facilities Agreement with Walton
Development&Management TX,LLC,in the Estimated Project Amount of
$862,193.00,Including City Participation in an Amount Not to Exceed
$300,000.00 to Construct the Western Two Lanes of Brewer Boulevard and
Adopt Appropriation Ordinance for City Project No. 100679 for the Fiscal
Year 2017 Budget of the 2014 Bond Program Fund(COUNCIL DISTRICT 6)
RECOMMENDATION:
It is recommended that City Council:
1.Adopt the attached appropriation ordinance increasing the estimated
receipts and appropriations in the Fiscal Year 2017 Budget of the 2014 Bond
Program Fund(CPN 100679)in the amount of$300,000.00 for the Brewer
Boulevard project;and
2. Authorize the execution of a Community Facilities Agreement with Walton
Development&Management TX,LLC,in the estimated project amount of
$862,193.00 to construct the western two lanes of Brewer Boulevard from
approximately 700 feet south of Risinger Road to Rockrose Street including
City participation in the amount of$300,000.00 for construction of the
western two lanes of Brewer Boulevard from west Risinger Road to the
northern boundary of Section Two,Phase Two of the Chisholm Trail Ranch
development.
DISCUSSION:
The 2014 Bond Program provides funding in the amount of$1,000,000.00 for
improvements to Brewer Boulevard from Risinger Road West to Section Two,
Phase Two of the Chisholm Trail Ranch development.The purpose of this
Mayor and Council Communication(M&C)is to authorize the execution of a
Community Facilities Agreement(CFA)with Walton Development&Management
TX,LLC,the developer of Section Two,Phase Two of the Chisholm Trail
Ranch development located generally at Brewer Boulevard north of McPherson
Boulevard for the construction of two lanes of Brewer Boulevard from
approximately 700 linear feet south of west Risinger Road to Rockrose
Street. The development plans have been reviewed and accepted by the City
through City Project No. 100542.
The City will participate in the Developer's road construction requirement
in order to complete the 700 linear foot gap between west Risinger Road and
Section Two,Phase Two of the Chisholm Trail Ranch development.Upon
completion of the project,there will be a two-lane connection of Brewer
Boulevard from Risinger Road to McPherson Boulevard.Construction of the
700 foot gap in the roadway between the Developer's project and Risinger
Road was included in the 2014 Bond Program with a projected cost of
$1,000,000.00. The remaining two lanes of West Risinger Road will be
constructed at a later date. The Developer will competitively bid the
construction and provide initial funding for the roadway design and
construction while the City will use 2014 Bond Program Funds to reimburse
the Developer for the City's share of the construction cost through
periodic draws.
PROJECT EXPENDITURES:
Project Component Developer's City's Cost Total Cost
Cost
Estimated $429,302.00 $185,000.00 $614,302.00
Construction Cost
Engineering and
Surveying $55,810.00 $25,000.00 $80,810.00
Project
Contingencies $64,396.00 $28,000.00 $92,396.00
Material Testing $12,685.00 $8,000.00 $20,685.00
and Inspection Fees
City Project
Management,Quality N/A $54,000.00 $54,000.00
Control Assurances
and Coordination
Project Total Costs 5562,193.00 S300,000.00 IS862,193.00
A portion of this project will include 2014 Bond Funds.Available resources
within the General Fund will be used to provide interim financing for these r
expenses until debt is issued. Once debt associated with this project is
sold,bond proceeds will reimburse the General Fund in accordance with the r'
statement expressing official intent to reimburse,that was adopted as part ,
of the ordinance canvassing the bond election and the subsequent approvals
to issue debt.
FISCAL INFORMATION/CERTIFICATION:
The Finance Director certifies that upon approval of the above
recommendations and adoption of the attached appropriation ordinance,funds
will be available in the current capital budget,as appropriated,in the
Fiscal Year 2017 Budget of the 2014 Bond Program Fund.
Existing
Appropriated
Proposed
Descriptioner this
Appropriations M&C Appropriations
2014 Bond $0.00 $300,000.00 $300,000.00
Program
(Fund 34014 1 I
FUND IDENTIFIERS (FIDs):
I4
Fund Department Account Project program Activity Budget Reference# Amount
ID ID Year (Chartfield 2)
FROM
Fund Department Account Project program Activity Budget Reference# Amount
ID ID Year (Chartfield 2)
CERTIFICATIONS:
Submitted for City Manager's Office by: Jay Chapa (5804)
Originating Department Head: Douglas Wiersig (7801)
Additional Information Contact: Martin Phillips (8447)
Mirian Spencer (8702)
ATTACHMENTS
1. 100679-Brewer Road-FID Identifier2.xlsx (CFw Intemah
2. 20BR_F.WER BOLJL.EVARD 34014_BOND A017.docx (Public)
3. 20BUW-ER ROAD Location Map. do f (Public)
4. 20BREWER ROAD-WALTON DEVELOPMENT 1295 FORM. (Public)
C-28068 - C
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
of
Complete Nos.a-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3.5,and 6 If there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2016-122993
Walton Development&Management TX,LLC
Dallas,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 10!12!2016
being filed.
City of Fort Worth DateAcn ged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
100542
Brewer Road Extension
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
Vick,John Dallas,TX United States X
Robinson,Matthew Dallas,TX United States X
5 Check only if there is NO Interested Party. ❑
6 AFFIDAVfT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
MAGDALENA M.MCCAULEY
Notary Public.State of Texas
My Commission Expires ?
Q t March 03,2017 V
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP SEAL ABOVES;wo (,,,,eA �
�-
m to subscribed before me,by the said ! M 1(.�f I �t4Y� this the day of t�nL
fi to certify which,witness my hand and seal of office.
r z ilk t1�rA 1
$19'n)ture of officer administering oath Printed nan3k of officer administering oath rre of officer 6dministpring oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us V1.0.277
M&C Review Page 1 of
Official
CITY COUNCIL AGENDA FORT_ T11
COUNCIL Ad.mow FIO1� i4ppaen #0/1.0/2017
. .�
REFERENCE 06CHISHOLM TRAIL
DATE: 10/10/2017 NO.: C-28428 LOG NAME: RANCH SECTION 2
PHASE 2
CODE: C TYPE: NOW PUBLIC NO
CONSENT HEARING:
SUBJECT: Authorize Execution of Community Facilities Agreement with Walton Development &
Management TX, LLC, in the Amount of$1,051,480.99 with City Participation in an Amou
Not to Exceed $159,829.97 for the Construction and Oversizing of 1,500 Linear Feet of
Water Line in the Brewer Road Right-of-Way (COUNCIL DISTRICT 6)
RECOMMENDATION:
It is recommended that the City Council authorize execution of a Community Facilities Agreement
with Walton Development & Management TX, LLC, in the amount of$1,051,480.99 with City
participation in an amount not to exceed $159,829.97 for the construction and oversizing of 1,500
linear feet of waterline in the Brewer Road Right of Way.
DISCUSSION:
Walton Development& Management TX, LLC (Developer) is constructing the Chisholm Trail Ranch
Section 2 Phase 2 development in far southwest Fort Worth. The development requires a 12-inch
water main to serve the site. The City of Fort Worth is cost participating in the oversizing of the wate
main to a 24-inch line to serve anticipated future development growth in the surrounding area. The
City's cost participation in the construction of the water main is estimated to be $159,829.97 as
shown in the table below
Developer Ci Cost Total Cost
A. Construction Cost City
1. Water 534,558.25 123,899.20 658,457.45
2. Sewer 322,798.50 0.00 322,799 00
Construction Cost 85,356.75 123,899.20 981,255.95
Sub-Total
Contingency 25% 0.00 30,974.80 30,974.80
Total Construction 857,356.75 154,874.00 1,012,230.75
Construction Fees:
B. Inspection Fee (2%) 17,147.14 2,477.98 19,625.12
C. Material Testing 17,147 14 2,477.98 19,625.12
Fee (2%)
Construction Fees 34,294.27 4,955.97 39,250.24
Sub-Total
Total Project Cost $891,651.02 $159,829.97 1,051,480.99
Staff recommends execution of a Community Facilities Agreement with the Developer, with City
participation, to construct the project to its ultimate configuration.
http://apps.cfwnet.org/council_packet/mc review.asp?ID=25146&councildate=10/10/2017 12/12/2017
M&C Review Page 2 of 2
The costs stated herein are based upon City Council approved CFA unit prices rather than public bic
cost. The reimbursement of the participation, excluding inspection and material testing fees, is not a
lump-sum amount and may be less than stated above depending upon actual quantities from the
Notice of Final Completion Package, commonly referred to as the Green Sheet Package. The work
is anticipated to begin after the approval of this M&C.
This project is located in COUNCIL DISTRICT 6.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendation funds will be
available in the current capital budgets, as appropriated, of the Water Capital Projects Fund.
TO
__..._
Fund Department � Account Project Program Activity Budget Reference # Amour7
ID j ID Year (Chartfield 2)
FROM
Fund Department Account Project Program Activity Budget Reference# Amoun
ID ID Year (Chartfield 2)
Submitted for City Manager's Office by: Fernando Costa (6122)
Originating Department Head: Randle Harwood (6101)
Additional Information Contact: Kara Shuror(8819)
ATTACHMENTS
Location Map Chisholm Trail Ranch.pdf
SKM C36817100409360.pdf
http://apps.cfwnet.org/council_packet/mc review.asp?ID=25146&councildate=10/10/2017 12/12/2017
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
of 1
Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-268199
Walton Development&Management TX, LLC
Dallas,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 10/03/2017
being filed.
City of Fort Worth Date Acknowledged-
/()
cknowledged:10 (;L(✓ I I
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
CFA#2017-074; FP-16-037
Construction of water,sanitary sewer, storm sewer, paving and street light infrastructure
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
Vick,John Dallas,TX United States X
Robinson, Matt Dallas,TX United States X
5 Check only if there is NO Interested Party. ❑
6 AFFIDAVIT I swear,or affirm,under penalty of pori disclosure is t^
p ,, ., ,, ,, ry,that the above �e and correct.
==M. CCAULEYe of Texas-03-2021� 18977
ignature authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said Matt Robinson this the 4th day of October
20 17 to certify which,witness my hand and seal of office.
�OS"wre)of officer administering oath Printed ame of officer administering oath Title of offic r administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337