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Home My WebLink AboutContract 49272-FP1 Department of TP &W Const. Services G-N# 0 � Da Project Manager I �� Risk Management Canad I —1 '11'r WORTH. D.O.E. Brotherton IQ CITY SECRETARY GFA Morales/Scanned -{� r� Tr�p.�`TMQ. A� -' Gutzler/Scanned The Proceeding people have been Contacted concerning the request for final payment& have ATION AND PUBLIC WORKS 5(,Dog t 1 oo released this project for such payment. F PROJECT COMPLETION Developer Projects) Clearance Conducted By PAwu&` City Project Ne: 100939 _ c '#1 7 Regarding contract 100939 for REVELSTOKE BLOCS 1 LOT 1-GAS STATION 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 Original Contract Price: $183,270.00 Amount of Approved Change Orders: $22,900.00 Ns 1 Revised Contract Amount: $206,170.00 Total Cost Work Completed: $206,170.00 7f.-, Recomme d or cceptance Date Asst. Direc - Infrastructure Design and Construction z kz e Accepted Date Asst. Director, WATER DEPARTMENT Asst. City Manager Date Comments: OFFICIAL F CORD CITY SECRETARY RECEIVED FEB - 5 2018 FT-WORTH, TX 31-sn�6 � 5600-- /66931 City Project Numbers 100939 DOE Number 0939 Contract Name REVELSTOKE BLOCK 1 LOT I Estimate Number I Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 1/8/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors OWEN / SLATEN Contract Date Contractor BLACK CANYON CONSTRUCTION Contract Time 120 CD 139 OAK ACRES LANE Days Charged to Date 121 CD BOERNE, TX 78006 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 $206,170.00 Less %Retained 50.00 Net Earned $206,170.00 Earned This Period $206,170.00 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 $206,170.00 Monday,January 8,2018 Page 4 of 4 FoRTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name REVELSTOKE BLOCK 1 LOT 1 Contract Limits Project Type WATER&SEWER City Project Numbers 100939 DOE Number 0939 Estimate Number 1 Payment Number 1 For Period Ending 1/8/2018 CD City Secretary Contract Number Contract Time 12aD Contract Date Days Charged to Date 121 Project Manager NA Contract is 100.00 Complete Contractor BLACK CANYON CONSTRUCTION 139 OAK ACRES LANE BOERNE, TX 78006 Inspectors OWEN / SLATEN Monday,January 8,2018 Page 1 of 4 s City Project Numbers 100939 DOE Number 0939 Contract Name REVELSTOKE BLOCK 1 LOT 1 Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 1/8/2018 Project Funding WATER Item Description of Items Estimated Estimated Com leted Com leted No. P Unit Unit Cost P P Quanity Total Quanity Total --------------- -------------------- --- 1 CONCRETE ENCASEMENT FOR UTILITY PIPES 10.2 CY $350.00 $3,570.00 10.2 $3,570.00 2 12"WATER PIPE 1620 LF $50.00 $81,000.00 1620 $81,000.00 3 12"GATE VALVE 5 EA $3,500.00 $17,500.00 5 $17,500.00 4 FIRE HYDTANT W/6"GATE VALVES 3 EA $3,500.00 $10,500.00 3 $10,500.00 5 LOWER 12"C-900 UNDER 15"SANITARY 1 EA $4,500.00 $4,500.00 1 $4,500.00 SEWER 6 CONNECT EXISTING 16"TO NEW 12" 1 EA $3,500.00 $3,500.00 1 $3,500.00 WATERLINE 7 1"DOMESTIC WATER METER ON WL-I CO#1 1 EA $4,000.00 $4,000.00 1 $4,000.00 8 1"IRRIGATION METER ON WL-1 CO#1 1 EA $3,500.00 $3,500.00 1 $3,500.00 Sub-Total of Previous Unit $128,070.00 $128,070.00 SEWER Item Description of Items Estimated Estimated Com leted Com Ieted No. P Unit Unit Cost P P Quanity Total Quanity Total 1 CONCRETE ENCASEMENT FOR UTILITY PIPES 6 CY $350.00 $2,100.00 6 $2,100.00 2 8"SEWER PIPE CO#1 665 LF $60.00 $39,900.00 665 $39,900.00 3 4'MANHOLE 3 EA $6,500.00 $19,500.00 3 $19,500.00 4 REVISED SANITARY SEWER STUB FROM 8" 20 LF $30.00 $600.00 20 $600.00 TO 6"CO#1 5 SANITARY SEWER MANHOLE RAISE TO 5 EA $2,500.00 $12,500.00 5 $12,500.00 GRADE CO#1 6 SANITARY SEWER MANHOLE ADJUSTMENT 1 EA $500.00 $500.00 1 $500.00 CO#1 7 MANHOLE VACUUM TESTING CO#1 6 EA $500.00 $3,000.00 6 $3,000.00 Sub-Total of Previous Unit $78,100.00 $78,100.00 Monday,January 8,2018 Page 2 of 4 City Project Numbers 100939 DOE Number 0939 Contract Name REVELSTOKE BLOCK 1 LOT 1 Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 1/8/2018 Project Funding Contract Information Summary Original Contract Amount $183,270.00 Chante Orders Change Order Number 1 $22,900.00 Total Contract Price $206,170.00 Total Cost of Work Completed $206,170.00 Contractor Less %Retained $0.00 Net Earned $206,170.00 Date Inspection Supervi r Earned This Period $206,170.00 Retainage This Period $0.00 _- late Proj ctaziager Less Liquidated Damages Days @ /Day $0.00 Date ��1V Y� LessPavement Deficiency $0.00 Asst. t r/TPW-iftfMtl/ b ��W 0-W& Less Penalty $0.00(, Z Z ?ve Date �' Less Previous Payment $0.00 Director/Contracting Department Plus Material on Hand Less 15% $0.00 Balance Due This Payment $206,170.00 Monday,January 8,2018 Page 3 of 4 FORTWORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.: 1 NAME OF PROJECT: Revelstoke Block 1 Lot I -Gas Station PROJECT NO.: 100939 CONTRACTOR: Black Canyon DOE NO.: N/A PERIOD FROM:09/07/17 TO: 01/05/18 FINAL INSPECTION DATE: 5-Jan-18 WORK ORDER EFFECTIVE:9/7/2017 CONTRACT TIME: 120 o WD o CD DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS MONTH CHARGED CREDITED MONTH CHARGED DURING DURING CREDITED 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 PERIOD 121 121 PREVIOUS PERIOD TOTALS TO DATE *REMARKS: CONTRACTOR DATE INSPEC OR DATE ENGINEERING DEPARTMENT The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 m � m o x z Cl) O n (7 C7 71 0 m a (n cc 7 O -0 m DI mm D O O r 0 a � � n ` m k m m > m m O 0 O O n (7 0 .(7 .0 D n N M w Fn Z -0 O o0 Oz �7 `O -� Z c m -av o � m n z n n m "' y Z .. O O n D 0 o Z Z > = "' --ID n C) 0 m 1 Z -I D j I D 0 z m �7 m 3 O 0 0 c m z A 1 < w i N m N O (O z O O D (ID m A O O D O C n o o o 0 w O O CO V (D- 0 o Cn in a O (b W p w o N N O N [n o c 0 o m O -4 w v (D O N O O O O Q Q (D O O O O C D C A A C) o T 7 B O co m C 0o 0 0 O (D m CL O O (D (D 0 o O m (n w w C) r v m m °' O (0 6 o W 00 D Q o o m v+ v, p CD w cn c) �7 V O O) T co W T. 1 OJ (T N N Q O D A V V O o 0 0 0 Q D N V CD o 0 0 0 cn m _ m � V o m T -a n m 0 o C7 0 0 0 o p CD (D N O O �7 o o n C7 m 0 0 0 o n D C7 a O N o O o Z O D D XZ Z n oo O P n o z i m o n o CD n o o O N V m � v N z Z7 coo 41 o °m < 0 0 0 0 0 0 0 0 o z o D _n O 0 0 m O = 0 o p D 70 Z N z � 0 o m CD o 0 o m N G V/ 4A tf1 "" fD O O O p O O O .Zl m m o i o � C7 ) 2 0 0 0 1 0 o n cn 0 o p rn C7 0 O O j _ (n D � n m -i / ƒ\ / « \ \ % \ CL c - to ) n ƒ -< { - _ ƒ ƒ ® 2 ± ± o ( { \ } \ ( } g \ « 0 \ \\ } §ƒ 7 ƒ \ $ 2 2 m j / { Q A 7 \ \ $ ( / A m m e © e ®E \ a & {a % n - \ } k \co / \ \ 0 \ Cl) CD® K CDo o } Ct % % R g ) - ( } \ / } j \ $ § § 7 $ 2 aCD % 7D (D ƒ \ / E 6 e ; § § 9pp \ / § § $ \ / S A $ z 2 - ( ( / / ] G a m / \ b ( ( ) ) \ a \ 7 7 & & = y= _ * J ƒ( % ® $ } 2 $ } L / a E\ M \ / Z7*(D Q � / ° ® ® E\} @ \ 0 j @ & 2 { f ° m p ƒ) § K $ m = 3 2 Cl) - , e C. ® ° E(:ED ID ( ; :03 m / $ e @ \ co( m / }/ \ \ . ( lb N � _ C 2 / - $ § k § ( \ \ K ( f \ ( ' QL \ -u - - -0 § } CD \ f � { ® » / _ _ f d k \ / § 9 ] § CCD r 8 2 0 C CDQ 0 N N O Z 3 3 W T W x Z m m p (D W � p go m Q rg CD 0. m T s 5m z e m - v z m vJ m m cn 5 v Z _ 1 Z O m O v O < m = v m z 0 -r ? < cn � o ,r- Z z W D o7 m 3 ` m m D w W n O O -� < p ? rn m (D C { o O m TmJ Z v �, <m (D (D rm- m 0 -0 -* -00 m O m (D m n o o � o O m _� lU D 2 m 3 v m m O 2 < D 3 m o D v 0 CD n m O 0 (D 3 v m 0 DC7 � O O I SU Q \ D v Z CD O N w CD CD w FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Revelstoke Block 1 Lot 1 PROJECT NUMBER: 100939 DOE NUMBER: N/A WATER PIPE LAID SIZE TYPE OF PIPE LF 12" PVC 1620 FIRE HYDRANTS: 3 VALVES(16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: 1" copper 10' P, copper 10' SEWER PIPE LAID SIZE TYPE OF PIPE LF 8" PVC 665 6" PVC 20 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS '�9 The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 FORTWORTHREV:8/20/16 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR I) CONTRACTOR&PROJECT DATA Name of Contractor Project Name Black Canyon Revelstoke Block 1 Lot 1 Inspector City Project Number Albert Samaniego 100939 Construction Components Project Manager o Water o Waste Water ❑ Storm Drainage ❑ Pavement Fred Ehia Initial Contract Amount Project Difficulty / ?3 L 769 Simple o Routine o Complex Final Contract Amount Date $206,170.00 1/16/2018 11)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 Y 4 20 20 3 Plans on Site 5 Y 4 20 20 4 Field Supervision 15 Y 4 60 60 5 Work Performed 15 Y 4 60 60 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 3 20 15 12 After Hours Response 5 Y 4 20 20 13 Project Completion 5 Y 4 20 20 TOTAL ELEMENT SCORE(A) 443 BONUS POINTS(25 Maximum)(B) III)CONTRACTOR'S RATING TOTAL SCORE(TS) 443 Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/MS]* 100%) 443 ! 448 = 99% 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) Inspector Signature ,�- �� Contractor Signature Inspector's Supervisor Signature t CONTRACTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth•8851 Camp Bowie West Blvd.•Fort Worth,TX 76116• (817) 392-8306 FORTWORTHREV:02'22/07 TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATION OF CITY I)PROJECT INFORMATION Date: 1/16/2018 Nance of Contractor Project Name Black Canyon Construction Revelstoke Block 1 Lot 1 DOE Inspector Project Manager Albert Samaniego Fred Ehia DOE Number I Project Difficulty Type of Contract N/A 10 Simple O Routine O Complex IQ water o waste water ❑ Storm Drainage ❑ Pavement Initial Contract Amount Final Contract Amount R-06�_ — 8� L?a $206,170.00 In 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 a 2 Clarity&Sufficiency of Details 3 Accuracy of Measured Quantities a 3 Applicability of Specifications + 4 Display Of Professionalism 4 Accuracy of Plan Quantities 5 Citizen Complaint Resolution 4, 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 3 Communication zv- 2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts „3 Bid Opening to Pre-Con Meeting Timeframe 4 III)COMMENTS&SIGNATURES COMMENTS .} Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor INSPECTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORKS � s The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 AFFIDAVIT STATE OF (e S COUNTY OF -�— Before me,the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Matthew Rodriguez,Project Manager of Black Canyon Construction,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; Revelstoke Block 1, Lot 1- Gas Station BY pM 'Name or Title Subscribed and sworn before me on this date 18 of January, 2018 a�Public 01 AFY PV6 County, State ` SHAMEKA D KENNEDY My commission Expires (CW rww-fDecember 9, 2018 SE Of TES I A 707TM - 1994 PROJECT:(Name and add- _,7„r..-_77S PROJECT NUMBER: :�IIVNER: Revelstoke Block 1 Lot i 7,a:e a:_ Sewer Improvements ARG;-!TECT:❑ 307 SACT FOR:General Construction CONTP',---G3R:❑ TO OWNER:(Name and address) vv,o u:-RACT DATED: SURETY:❑ City of Fort Worth OTHER:❑ 200 Texas St Fort Worth,TX 76102 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above.the (Insert name and address of Surety) Insurors Indemnity Company 225 S 5th St Waco,TX 76701 SURETY. on bona.of (Inserr (.ne and address of Contractor) Black C_-.r, --onstruction Company 139 OF,.,,,Acres Ln Boerne,TX 78006 .CONTRACTOR hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of For- o:,h 200 Tests S- Fort Worth.TX 76102 OWNER. as set forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date:January 23,2018 (Insert in writing the month followed by the numeric date and year.) Insurors Indemnity Company (Surety) a (Signature ofauthori. wwe"ati vel Attest: Monica Hernandez,Attom- Cv-in-Fact (Seal): (Printed name and title) AIA Document G707TM—1994.Copyright®1982 and 1994 by The American Institute of Architects.All rights reserved.WARNING:This AIAe Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA Document,or any portion of it, ) may result in severe civil and criminal penalties.and will be prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 11:37:40 on 01/23/2018 under Order No.4482013139 which expires on 05/30/2018,and is not for resale. User Notes: (389ADA2F) POWER OF ATTORNEY of INSURORS INDEMNITY COMPANY Waco, Texas KNOW ALL PERSONS BY THESE PRESENTS: Number: CNB-24891-00 That INSURORS INDEMNITY COMPANY, Waco. Texas, organized and existing under the laws of the State of Texas, and authorized and licensed to do business in the State of Texas and the United States o'America, does hereby make, constitute and appoint Monica Hernandez of the City of Waco State of TX as Attorney in Fact, with full power and auhority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, all of the following classes of document, to-wit: Indemnity, Surety and Undertakings that may be desired by contract, or may be given in any action or proceeding in any court of law or equity; Indemnity in all cases where indemnity may be lawfully given and with full power and authority to execute consents and waivers to modify or change or extend any bond or document executed for this Company_ INSURORS INDEMNITY COMPANY Attest: Tammy Tieperm�rr'. Secretay Dave E.Talbert, President State of Texas County of McLennan On the 11th day of November, 2014, before me a Notary Public in the State of Texas, personally appeared Dave E. Talbert and Tammy Tieperman,who being by me duly swom, acknowledged that they executed the above Power of Attorney in their capacities as President, and Corporate Secretary, respectively, of Insurors Indemnity Compa-ly, and acknowledged said Power of Attomey to be the voluntary act and deed of the o parry. - st"c� Melry MMEMLISMIM s Yy comm owe arrrs� otary Public,State of Texas IS Nowi,02W=ww? Insurors Indemnity Company certifies that this Power of Attorney is granted under and by authority of the following resolutions of the Company adopted by the Board of Directors on November 11, 2014: RESOLV=D, that all bonds, undertakings,contracts or other obligations may be executed in the name of the Company by persons appointed as Attomey in Fact pursuant to a Power of Attorney issued in accordance with these Resolutions. Said Power of Attorney shall be executed in the name and on behalf of the Company either by the Chairman and CEO or the President, under their respective designation. The signature of such officer and the seal of the Company may be affixed by facsimile to any Power of Attorney, and, unless subsequently revoked and subject to any limitation set forth therein, any such Power of Attorney or certificate bearing such facsimile signature and seal shall be valid and binding upon the Company and any such power so executed and certified by facsimile signature and seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is validly attached. RESOLVED, that Attorneys in Fact shall have the power and authority, subject to the terns and limitations of the Power of Attorney issued to them, to execute and deliver on behalf of the Company and to attach the seal of the Company to any and all bonds and undertakings, and any such instrument executed by such Attorneys in Fact shall be binding upon the Company as if signed by an Executive Officer and sealed and attested to by the Secretary or Assistant Secretary of the Company. I, Tammy Tieperman, Secretary of Insurors Indemnity Company, do hereby certify that the foregoing is a true excerpt from the Resolutions of the said Company as adopted by its Board of Directors on November 11, 2014,and that this Resolution is in full force and effect. I certify that the foregoing Power of Attorney is in full force and effect and has not been revoked. In Witness Whereof, I have set my hand and the seal of INSURORS INDEMNITY COMPANY on this 23rd day of January 2018 Tarnrny Tiepennan. S`ecreiar' NOTE: IF YOU HAVE ANY QUESTION REGARDING THE VALIDITY OR WORDING OF THIS POWER CF ATTORNEY, PLEASE CALL 800 933 7444 OR WRITE TO US AT P.O. BOX 2683,WACO,TEXAS 76702-2683 OR EMAIL US AT ;✓ori=l�IVt=.T��t�ra,�rss+..+i?�€z�.conn.