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HomeMy WebLinkAboutContract 48670-FP1 FORTWORTH. CITY SECRETARY)1'�f CONTRACT NO. TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION (Developer Projects) City Project Ns: 1004$0 Regarding;contract 1004$0 for WILLOW RIDGE ESTATES PRASE 5 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: $2,224,160.40 Amount of Approved Change Orders: NO Revised Contract Amount: Total Cost Work Completed: $2,224,160.40 Recommended Acceptance Date Asst. Director, W - Development Services — L /-.- . LJ / . F-. Date Director, TRANSPORTATION & PUBLIC WORKS Asst. Cita Manager U Date Department of TP&W Const.Services CPN# 100" Date Project Manager' — Risk Management Canady —146—IV Comments: D.O.E. Brotherton —ICA CFA Morales/Scanned -- Gutzler/Scanned (—�� OFFICIAL RECORD The Proceeding people have been Contacted CITY SECRETARY concerning the request for final payment& have 1=6 FEB ` 2 ZO released this project for such payment. '. D "O TX Clearance Conducted By �AwwI6 � FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WILLOW RIDGE ESTATES PHASE 5 Contract Limits Project Type STORM DRAIN&PAVING City Project Numbers 100480 DOE Number 0480 Estimate Number I Payment Number I For Period Ending 1/22/2018 CD City Secretary Contract Number Contract Time 24(YD Contract Date Days Charged to Date 317 Project Manager NA Contract is 100.00 Complete Contractor GILCO CONTRACTING,INC. 6331 SOUTHWEST BLVD. BENBROOK, TX 76132-1063 Inspectors LAYER / MATTEGAT Monday,January 22,2018 Page I of 5 !I� City Project Numbers 100480 DOE Number 0480 Contract Name WILLOW RIDGE ESTATES PHASE 5 Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 1/22/2018 Project Funding STORM DRAIN ItemDescription of Items Unit Unit Cost Estimated Estimated Completed Completed No. Quanity Total Quanity Total I REMOVE RIPRAP 900 SF $0.80 $720.00 900 $720.00 2 REMOVE FW-0 HEADWALL 1 EA $1,500.00 $1,500.00 1 $1,500.00 3 MEDIUM STONE RIPRAP 165 SY $46.00 $7,590.00 165 $7,590.00 4 CONCRETE COLLAR 15 EA $300.00 $4,500.00 15 $4,500.00 5 21"RCP 1177 LF $50.00 $58,850.00 1177 $58,850.00 6 21"RCP 53 LF $56.00 $2,968.00 53 $2,968.00 7 24"RCP 1543 LF $57.00 $87,951.00 1543 $87,951.00 8 24"RCP 16 LF $67.00 $1,072.00 16 $1,072.00 9 27"RCP 135 LF $64.00 $8,640.00 135 $8,640.00 10 30"RCP 91 LF $72.00 $6,552.00 91 $6,552.00 11 33"RCP 672 LF $80.00 $53,760.00 672 $53,760.00 12 36"RCP 417 LF $95.00 $39,615.00 417 $39,615.00 13 42"RCP 1313 LF $127.50 $167,407.50 1313 $167,407.50 14 48"RCP 268 LF $154.00 $41,272.00 268 $41,272.00 15 54"RCP 186 LF $238.00 $44,268.00 186 $44,268.00 16 5'X5'BOX CULVERT 237 LF $267.00 $63,279.00 237 $63,279.00 17 4'STORM JUNCTION BOX 5 EA $3,800.00 $19,000.00 5 $19,000.00 18 5'STORM JUNCTION BOX 3 EA $4,000.00 $12,000.00 3 $12,000.00 19 T MANHOLE RISER 2 EA $2,400.00 $4,800.00 2 $4,800.00 20 10'CURB INLET 12 EA $3,400.00 $40,800.00 12 $40,800.00 21 15'CURB INLET 17 EA $4,650.00 $79,050.00 17 $79,050.00 22 SETP-CD HEADWALL AT 21"RCP 7 EA $1,900.00 $13,300.00 7 $13,300.00 23 SETP-CD HEADWALL AT 24"RCP I EA $2,100.00 $2,100.00 1 $2,100.00 24 SETP-CD HEADWALL AT 30"RCP I EA $2,300.00 $2,300.00 1 $2,300.00 25 SETP-CD HEADWALL AT 48"RCP 1 EA $3,300.00 $3,300.00 1 $3,300.00 26 TRENCH SAFETY 6108 LF $0.50 $3,054.00 6108 $3,054.00 Sub-Total of Previous Unit $769,648.50 $769,648.50 PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total Monday,January 22,2018 Page 2 of 5 City Project Numbers 100480 DOE Number 0480 Contract Name WILLOW RIDGE ESTATES PHASE 5 Estimate Number 1 Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 1/22/2018 Project Funding 1 HYDRATED LIME 493 TN $150.00 $73,950.00 493 $73,950.00 2 6"LIME TREATMENT 32857 SY $2.60 $85,428.20 32857 $85,428.20 3 6"CONC PVMT 30968 SY $31.65 $980,137.20 30968 $980,137.20 4 5'CONC SIDEWALK 10417 SF $4.75 $49,480.75 10417 $49,480.75 5 BARRIER FREE RAMP 13 EA $1,950.00 $25,350.00 13 $25,350.00 6 BARRIER FREE RAMP 13 EA $1,900.00 $24,700.00 13 $24,700.00 7 BARRIER FREE RAMP 13 EA $1,600.00 $20,800.00 13 $20,800.00 8 TRAFFIC CONTROL 1 LS $1,000.00 $1,000.00 1 $1,000.00 9 CONNECT TO EXISTING PAVEMENT 184 LF $20.00 $3,680.00 184 $3,680.00 10 PROVIDE AND INSTALL STREET NAME 68 EA $245.00 $16,660.00 68 $16,660.00 BLADES Sub-Total of Previous Unit $1,281,186.15 $1,281,186.15 ST LIGHT Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 RDWY ILLUM ASSEMBLY 46 EA $1,684.00 $77,464.00 46 $77,464.00 2 INSTALLATBO-20BLEDE70 46 EA $358.00 $16,468.00 46 $16,468.00 3 RDWY ILLUM FOUNDATION 46 EA $955.00 $43,930.00 46 $43,930.00 4 2"CONDT PVC SCH 80 3675 LF $7.10 $26,092.50 3675 $26,092.50 5 NO 6 INSULATED ALUM ELEM CONDR 11025 LF $0.70 $7,717.50 11025 $7,717.50 6 NO 10 INSULATED COPPER ELEC CONDR 3675 LF $0.45 $1,653.75 3675 $1,653.75 Sub-Total of Previous Unit $173,325.75 $173,325.75 Monday,January 22,2018 Page 3 of 5 City Project Numbers 100480 DOE Number 0480 Contract Name WILLOW RIDGE ESTATES PHASE 5 Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 1/22/2018 Project Funding Contract Information Summary Original Contract Amount $2,224,160.40 ChanIze Orders Total Contract Price $2,224,160.40 I Date 1_ Total Cost of Work Completed $2,224,160.40 i ractor Less %Retained $0.00 Date —/� Net Earned $2,224,160.40 Inspection Supervisor Earned This Period $2,224,160.40 / ^� Retainage This Period $0.00 " Date l / — a Less Liquidated Damages Proje anager � Days @ /Day $0.00 Date "h K LessPavement Deficiency $0.00 Asst. ctor/TPW-Infrastn b i� �/4 /VIIV� Less Penalty $0.00 W Date �� t�� Less Previous Payment $0.00 Director/Con acting Depa vent Plus Material on Hand Less 15% $0.00 Balance Due This Payment $2,224,160.40 1.% Monday,January 22,2018 Page 4 of 5 City Project Numbers 100480 DOE Number 0480 Contract Name WILLOW RIDGE ESTATES PHASE 5 Estimate Number I Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 1/22/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors LAYER / MATTEGAT Contract Date Contractor GILCO CONTRACTING,INC. Contract Time 240 CD 6331 SOUTHWEST BLVD. Days Charged to Date 317 CD BENBROOK, TX 76132-1063 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 $2,224,160.40 Less %Retained $0.00 Net Earned $2,224,160.40 Earned This Period $2,224,160.40 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 $2,224,160.40 Monday,January 22,2018 Page 5 of 5 FORTWORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:I NAME OF PROJECT: Willow Ridge Eastates Phase 5 PROJECT NO.: 100480 CONTRACTOR: Gilco Contracting DOE NO.: PERIOD FROM;03/13/17 TO: 01/23/18 FINAL INSPECTION DATE: 24-Jan-18 WORK ORDER EFFECTIVE:3/13/2017 CONTRACT TIME: 180 O WO* 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 0 0 0 0 0 0 PERIOD PREVIOUS 0 0 0 0 0 0 PERIOD TOTALS 0 0 0 0 317 317 TO DATE REMARKS: CONTRACTOR DATE /GDEIPARTaLT N Cwz DAT ENGINEE a The Cite of Fort Worth• 1000 Tli dckmorton Street•Port W rth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 FORTWORTHREV:02/22/07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 19-Jan-18 Name of Contractor Project Name Gilco Contracting Willow Ridge Esates Phase 5 DOE Inspector Project Manager William Mattegat Fred Ehia DOE Number ProjectDoiculty Type of Contract CPN 100480 Q simple QQ Routine Q Complex ❑ Water[:] Waste Water❑ Storm Drainage0 Pavement Initial Contract Amount Final Contract Amount $2,224,160.40 $2,224,160.40 II)PERFORMANCE EVALUATION 0-Inadequate 1 -Deficient 2-Standard 3 -Good 4-Excellent ELEMENT RATING ELEMENT RATING (0-4) (0-4) INSPECTION EVALUATION PLANS&SPECIFICATIONS T 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 PF 14 Accuracy of Plan Quantities i 5 Citizen Complaint Resolution I I PROJECT MANAGER EVALUATION 6 Performance-Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution —4— ADMINISTRATION 2 Availability of Project Manager 1 Change Order Processing Time S 3 Communication 3 2 Timliness of Contractor Payments ; 4 Resolution of Utility Conflicts ti 3 Bid Opening to Pre-Con Meeting Timeframe '1 III)COMMENTS&SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector Signature DOE Inspector's Superv' or INSPECTOR'S COMMENTS l i TRANSPORTATION AND PUBLIC WORKS . ;` The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 I I it I FORTWORTHREV:8/20/16 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR 1) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Gilco Contracting Willow Ridge Esates Phase 5 Inspector City Project Number William Mattegat 100480 Construction Components Project Manager E] Water❑ wastewater[:] Storm Drainage Pavement Fred Ehia Initial Contract Amount Project Di $2,224,160.40 0 Simple Routine 0 Complex Final Contract Amount Date $2,224,160.40 19-Jan-18 II)PERFORMANCE EVALUATION 0-Inadequate 1-Deficient 2-Standard 3-Good 4-Excellent ELEMENT WEIGHT(x) APPLICABLE(Y/N) RATING(0-4) MAX SCORE SCORE 1 Submission of Documents 2 Y 4 8 8 2 Public Notifications 5 N 3 Plans on Site 5 Y 4 20 20 4 Field Supervision 15 Y 4 60 60 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 2 20 10 10 Citizen's Complaint Resolution 5 Y 4 20 20 I 1 Property Restoration 5 N 12 After Hours Response 5 N 13 Project Completion 5 Y 4 20 20 TOTAL ELEMENT SCORE(A) 363 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 363 III)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 388 Rating([TS/MS] *100%) 363 / 388 = 94% 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) i Inspector Signature s Contractor Signature Inspector's Supervisor ignature CONTRACTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth•8851 Camp Bowie West Blvd. •Fort Worth,TX 76116• (817)392-8306 i I AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Rob Taylor, Project Coordinator of Gilco Contracting, Inc., 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; Paving Improvements to serve: Willow Ridge Estates, Phase 5 BY Rob Taylor Subscribed and sworn before me on this 24th of January, 2018. """" THERESA R BOARDMAN 0,tsk true i�, S Notary Public, State of Texas Notary Public Comm. Expires 04-13-2020 Notary ID 10589053 Tarrant County, TX Interchange Corporate Center .i ✓Z 450 Plymouth Road,Suite 400 1 T-, �I1 i Plymouth Meeting,PA 19462-1644 U 1 t E i Y Ph.(610)832-8240 CONSENT OF SURETY TO FINAL PAYMENT TO: Pulte Homes of Texas,LP 4800 Regent Blvd.,Suite 100,Irving,TX 75063 City of Fort Worth 200 Texas Street,Fort Worth,TX 76102 RE: Bond Number 022056804 Principal: Gilco Contracting,Inc. Obligee: Pulte Homes of Texas,LP and the City of Fort Worth Contract Number: Contract Date: January2017 Contract/Project Description: Willow Ridge Estates Phase 5-Water and Sanitary Sewer Improvements City Project#100480 Water Project#59601-0600430-100480-001580,Sanitary Sewer Project#59607-0700430-100480-001380,File#W-2417 "X"No.23751 In accordance with the provisions of the contract between the Obligee and the Principal described above, LIBERTY MUTUAL INSURANCE COMPANY, a Massachusetts stock insurance company, as Surety (the"Surety"), on the Principal's bond number 022056804 (the"Bond") hereby consents to the final payment to the Principal by the Obligee and agrees that final payment to the Principal shall not relieve the Surety of any of its obligations to Obligee as set forth in the Bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand and seal this 24th day of January 2018 LIBERTY MUTUAL INSURANCE COMPANY (Suret By: r' (Seal) V.DeLene Marshall,Attorney-In-Fact �" LMIC-3100 Rev.03104 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. Certificate No.7877196 Liberty Mutual Insurance Company 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 Stale 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.Reyna;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,any 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 >, tv The Ohio Casualty Insurance Company fes/) v Liberty Mutual Insurance Company m 1912 1991 s C s � � West American Insurance Company.1.1 •N a) By: Z42'117�11-1 a) STATE OF PENNSYLVANIA ss David M.Carey.Assistant Secretary COUNTY OF MONTGOMERY O d On this 25th day of August 2017 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance V H V a) 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 AW p therein contained by signing on behalf of the corporations by himself as a duly authorized officer. O L L E Gs > 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. O CL y � gP P'`tST { COMMONWEALTH OF PENNSYLVANIA � lwl�%��� Q� o�ornvFa{�f Notarial Sea' 4— •N }' = v I Teresa Pastella,Notary Public BY 4) OP Upper Merton Twp.,Montgomery County Teresa Pastella,Notary Public 0 L 4 L c My Commission Expires March 28.2021 ?i ill N O Z Svt�Pa a C � Orq �g�i hiern6er.Pennsylvania Association of Notaries d O d C MThis 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 0 p y^r 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 C to such limitation as the 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, Y d O.S 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 'O 2 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 is a) O 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 >c 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. t d � r ARTICLE XIII—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, , 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 C o0 Z v 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 V o executed such instruments shall be as binding as if signed by the president and attested by the secretary. 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 may be 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 Mutual Insurance Company, and.West American 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 lit fall force add effect and has not been revoked. l 1 IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of t 0 19 '3 1912 = 1991 By: x Renee C.LIewWR7rXssista,nt secretary 331 of 400 LMS.12873 022017 101NMutual, I r 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 Ilamar 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 You may also write to: Usted tambien puede escribir a: 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 (1 l 1-I A) de Texas Consumer Protection (I 1 I-I 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: http://Nvww.tdi.texas.gov E-mail: ConsumerProtectionatdi.texas.gov E-mail: ConSumerProtectionatdi.texas. oovv 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 1-800-843-6446. 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 10/15 December 13, 2017 Mr. Dale Gilreath Gilco Contracting, Inc. 6331 Southwest Blvd. Benbrook,Texas 76132 Re: Willow Ridge Phase 5 Paving,Water,Sanitary Sewer,Storm &Street Light Improvements CoFW Project No. 100480 CoFW File No. W-2417 Dear Mr. Gilreath: This letter will document that Pulte Homes confirms that Gilco Contracting, Inc. has completed the Work associated with the above-referenced contract in an appropriate time frame,subject to completion of any warranty or maintenance work as identified and required by the City of Fort Worth, and that no liquidated damages will be assessed by Pulte Homes in connection with the Work. Pulte Homes of Texas LP Curt M Millward Manager of Land Development Cc: Fred Ehia,City of Fort Worth William Mattegat, City of Fort Worth January 24, 2018 City of Fort Worth CFA Administration 1000 Throckmorton St. Fort Worth, TX 76102 RE: Final Waiver of Lien; Paving Improvements to serve Willow Ridge Estates, Phase 5 City Project#100480 Water Project No. 59601-0600430-100480-001580 Sanitary Sewer Project No. 59607-0700430-100480-001380 File No. W-2417 File No. X-23751 The purpose of this letter is to acknowledge that we have been paid in full by Pulte Homes of Texas LP for the public improvements constructed to serve Willow Ridge Estates, Phase 5 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, X?— Rob Taylor for y Project Coordinator 6331 Southwest Blvd. Benbrook, Texas 76132 Office: 817.735.1600 Fax: 817.735.1613