The URL can be used to link to this page

Home My WebLink AboutContract 49456-FP2 FoRTWORTH. r TRANSPORTATION AND PUBLIC WORKS J. ..�—•�'••••'••�� NOTICE OF PROJECT COMPLETION (Developer Projects) City Project Ns: 100880 rlQ Sea hrl e0� S/u�/8 A!M esm -ef f4J Regarding contract 100880 for WEST EVERMAN PARKWAY 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. m Original Contract Price: a .f0c $779,909.47 Amount of Approved Change Orders: _ +; ($9,036.40) Ne 1 0E = Au Revised Contract Amount: p c E, $770,873.07 Total Cost Work Completed: ; _ w s $770,873.07 y o > 0 a ai .Mc L >, ?� R V c o 3 L = m ad •o and � ami tM -a rs� E c = .c o m U) ca +r v_! = CM mMma�'t V ocn0 = � R avi2W2 tea. 0 M L ma o HOU. c m 0 (� CLR'17 0 (� C9H L (� Recommen r eptance Date Asst. Direct , T W - Development Services Accepted Date 4w Director TRANSPORTATIONUBLIC WORKS Asst. city Man ger Date If=]OFFICIAL RECORD CITY 88COWARY a 1A Al 2 � tvamlawo9m FT.vmww1 Tx d CCClS� ti c,.e Rev.9/22/1 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WEST EVERMAN PARKWAY Contract Limits Project Type PAVING City Project Numbers 100880 DOE Number 0880 Estimate Number I Payment Number 1 For Period Ending 4/16/2018 CD City Secretary Contract Number Contract Time 12aD Contract Date Days Charged to Date 147 Project Manager NA Contract is 100.00 Complete Contractor PAVECON PUBLIC WORKS,LP 3022 ROY ORR BLVD GRAND PRAIRIE, TX 75050 Inspectors OWEN/ SMITH Tuesday,April 17,2018 Page 1 of 5 City Project Numbers 100880 DOE Number 0880 Contract Name WEST EVERMAN PARKWAY Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 4/16/2018 Project Funding ROADWAY IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 REMOVE ASPHALT PVMT 578 SY $7.60 $4,392.80 578 $4,392.80 2 6"-12"TREE REMOVAL 3 EA $800.00 $2,400.00 3 $2,400.00 3 UNCLASSIFIED EXCAVATION BY PLAN 6100 CY $13.00 $79,300.00 6100 $79,300.00 4 SWPPP>1 ACRE 1 LS $9,400.00 $9,400.00 1 $9,400.00 5 HYDRATED LIME 141 TN $162.81 $22,956.21 141 $22,956.21 6 8"LIME TREATMENT 5885 SY $6.30 $37,075.50 5885 $37,075.50 7 9"CONC PVMT 5605 SY $76.00 $425,980.00 5605 $425,980.00 8 4"CONC SIDEWALK 15580 SF $4.34 $67,617.20 15580 $67,617.20 9 BARRIER FREE RAMP 2 EA $1,900.00 $3,800.00 2 $3,800.00 10 4"SLD PVMT MARKING HAS 256 LF $1.68 $430.08 256 $430.08 11 4"BRK PVMT MARKING HAS 3491 LF $1.68 $5,864.88 3491 $5,864.88 12 TOPSOIL 912 CY $30.00 $27,360.00 912 $27,360.00 13 SEEDING,HYDROMULCH 9074 SY $1.30 $11,796.20 9074 $11,796.20 14 TRAFFIC CONTROL 4 MO $2,500.00 $10,000.00 4 $10,000.00 15 6"CONC CURB&GUTTER 175 LF $30.00 $5,250.00 175 $5,250.00 16 REMOVE FENCE 20 LF $20.00 $400.00 20 $400.00 17 REMOVE SIGN PANEL AND POST 1 EA $650.00 $650.00 1 $650.00 -------------------------------------- Sub-Total of Previous Unit $714,672.87 $714,672.87 -------------------------------------- STREET LIGHT IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 LED LIGHTING FIXTURE 8 EA $1,100.00 $8,800.00 8 $8,800.00 2 LED LIGHTING FIXTURE 7 EA $300.00 $2,100.00 7 $2,100.00 3 RDWY ILLUM TY 8 POLE 2 EA $6,000.00 $12,000.00 2 $12,000.00 Sub-Total of Previous Unit $22,900.00 $22,900.00 DRAINAGE IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total I TRENCH SAFETY CO#1 168 LF $3.90 $655.20 168 $655.20 Tuesday,April 17,2018 Page 2 of 5 City Project Numbers 100880 DOE Number 0880 Contract Name WEST EVERMAN PARKWAY Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 4/16/2018 Project Funding 2 24"RCP CO#1 139 LF $115.00 $15,985.00 139 $15,985.00 3 27"RCP 29 LF $150.00 $4,350.00 29 $4,350.00 4 10'RECESSED INLET 1 EA $5,100.00 $5,100.00 1 $5,100.00 5 15'RECESSED INLET 1 EA $7,210.00 $7,210.00 1 $7,210.00 Sub-Total of Previous Unit $33,300.20 $33,300.20 ----------------------------------------- Tuesday,April 17,2018 Page 3 of 5 City Project Numbers 100880 DOE Number 0880 Contract Name WEST EVERMAN PARKWAY Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 4/16/2018 Project Funding Contract hiformation Summary Original Contract Amount $779,909.47 ChanjZe Orders Change Order Number 1 ($9,036.40) Total Contract Price $770,873.07 Date / v r8 Total Cost of Work Completed $770,873.07 Contr for Less %Retained $0.00 (.� Net Earned $770,873.07 Date �/"Z I""� Inspection Supervisor Earned This Period $770,873.07 � Retainage This Period $0.00 Date 7 Less Liquidated Damages ProjeLanager /� Days @ /Day $0.00 Date /' " LessPavement Deficiency $0.00 Asst. Less Penalty $0.00 ate S1�7 n Less Previous Payment $0.00 Director/ ontracting Department Plus Material on Hand Less 15% $0.00 Balance Due This Payment $770,873.07 Tuesday,April 17,2018 Page 4 of 5 City Project Numbers 100880 DOE Number 0880 Contract Name WEST EVERMAN PARKWAY Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 4/16/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors OWEN / SMITH Contract Date Contractor PAVECON PUBLIC WORKS,LP Contract Time 120 CD 3022 ROY ORR BLVD Days Charged to Date 147 CD GRAND PRAIRIE, TX 75050 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 $770,873.07 Less %Retained $0.00 Net Earned $770,873.07 Earned This Period $770,873.07 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 $770,873.07 Tuesday,April 17,2018 Page 5 of 5 DEVELOPER-AWARDED-PROJECT CHANGE ORDER PROJECT NAME: Paving,Drainage,and Street Light Improvements-West Everman Parkway CHANGE CONTRACT: 49456 ORDER No: CFA# 2017-071 CITY PARTICIPATION: No CITY PROJECT# 100880 DOE# 1 WATER PROJECT# SEWER PROJECT# FILE# K-2516 INSPECTOR: Kendric Smith Phone No: 682.552.9438 PROJECT MANAGER: Aaron Long Phone No: 817.392.7818 CONTRACT UNIT WATER SEWER PAVING DRAINAGE STREETLIGHTS CONTRACT Developer Developer Developer Developer DAYS Developer Cost City Cost Cost City Cost Cost City Cost Cost City Cost Cost City Cost ORIGINAL CONTRACT $35,162.50 $0.00 $0.00 x$0.00 $714,672.87 $42,336.60 $22,900.00 120 EXTRAS TO DATE $0.00 $0.00 $0.00 -$0.00 $0.00 $0.00 $0.00 0 CREDITS TO DATE $0.00 $0.00 $0.00 1$0.00 $0.00 $0.00 $0.00 0 CONTRACT TO DATE $35,162.50 $0.00 1 $0.00 .$0.00 $714,672.87 $42,336.60 $22,900.00 120 A1190UNT OF PROP.CHANGE ORDER $ (30,762.50) $0.00 $0.00 x$0.00 i $ i $ (9,036.40) $0.00 0 REVISED CONTRACT AMOUNT $4,400.00 $0.00 $0.00 `$0.00 $714,672.87 $33,300.20 $22,900.00 120 TOTAL REVISED CONTRACT AMOUNT PER UNIT $4,400.00 $0.00 $714,672.87 $33,300.20 $22,900.00 REVISED COST SHARE Dev.Cost: $775,273.07 City Cosh. $0.00 TOTAL REVISED CONTRACT $775,273.07 You are directed(o make the to'iaw6;0 cltan0o31n the Contract documents: PAY11CM0 GtY ep tTE)A tlUAttlitY UNIT (TE)ADESCRIPTIOH UNIT PRICIP TOTAL DRAINAGE 1 33050100 76 LF T(ondlSa(ot 5 3,90 :d0 2� 76 - LF 2CRCIP Class 11 S 115.00 6,7.10.00 WATEn 2 3311.0551 1 12S) L1 16'DIP Water $ ilwoo 32751%1.00 3 3312.O10D 2 EA CaulaeWn to Ews#n 16"Wotor Main S 1350.00 $ 2?OO.IX} 4 3305.0109 25 EA _ ,_, TranchSatnty ____ $ 22.50 $ 5G?.5o TOTAL __.._--...-_ $34,706,90 REASONS FOR CHANGE ORDER Tho 15lmessed curb Inlet at slallon 3470.62 o?S(orm Orate ttna A was moved 76 feel east to avoid having to loiveren acute 16-11"waterline. Thistela(was 1' on grade,so no adddlonal pavement madihcalkns were needed. 140 CITY FUNDS INVOLVED IN THIS CONTRACT.DEVELOPER 1S RESPONSIBLE FOR 100%OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE CITY WILL BE BOUGHT BY THE DEVELOPER, RECOMMENDED: APPROVED: APPROVED: oway-HA end Asaact (n Commerce Cons/ruction Co,LP Pvekeeif h` kr- T�fly: -Set t. `j Name: Brandon Middleton.RE Name _ t 1 t j 6 dam, Nem � 1�� ✓ E Title,Civil En noar ...__.Title: t# _._ - T _ S' 1 t.' TWO: ��/,i`�7 a✓t`.�I�'�"_ Revised:10-12-2011 Pagel FORT WORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO. 1 NAME OF PROJECT: W.Everman Parkway PROJECT NO.: 100880 CONTRACTOR: Pavecon Public Works DOE NO. N/A PERIOD FROM 10/02/17 TO: 03/20/18 FINAL INSPECTION DATE: 18-Apr-18 WORK ORDER EFFECTIVE 10/2/1017 CONTRACT TIME 120 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 0 0 0 0 0 0 PERIOD PREVIOUS 0 0 0 0 0 0 PERIOD TOTALS 0 0 0 0 147 147 TO DATE *REM S CO RACTOR DATE INS ECTOR DATE ENGINEERING DEPARTl/IENT The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax:(817)392-7845 FORTWORTHREV.8/20/16 TRANSPORTATION AND PUBLIC WORKS PERFORMANCE EVALUATION OF CONTRACTOR n CONTRACTOR&PROJECT DATA Name of Contractor Project Name Pavecon Public Works W.Everman Parkway Inspector City Project Number Kedric Smith 100880 Construction Components Signal Lights Project Manager 11 Water ❑ Waste Water o Storm Drainage o Pavement Aaron Long Initial Contract Amount Project Difficulty $779,909.47 D Simple o Routine O Complex Final Contract Amount Date $770,873.07 3/22/2018 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 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 4 20 20 12 After Hours Response 5 Y 4 20 1 20 13 Project Completion 5 Y 4 20 20 TOTAL ELEMENT SCORE(A) 448 BONUS POINTS(25 Maximum)(B) TOTAL SCORE(TS) 448 III)CONTRACTOR'S RATING Maximum Score(MS)=448 or sum of applicable element score maximums which= 448 Rating([TS/MS] x 100%) 448 / 448 = 100% 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 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: 3/22/2018 Name of Contractor Project Narne Pavecon Public Works W.Everman Parkway DOE Inspector Project Manager Kedric Smith Aaron Long DOENumber Project Difficulty Type of Contract Q Signal Lights 100880 P Simple O Routine O Complex ❑ Water ❑ Waste Water o Storm Drainage o Pavement Initial Contract Aniount Final Contract Amount $779,909.47 1$770,873.07 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 2 Clarity&Sufficiency of Details 3 Accuracy of Measured Quantities 3 Applicability of Specifications 4 Display Of Professionalism 4 Accuracy of Plan Quantities 5 Citizen Complaint Resolution PROJECT MANAGER EVALUATION 6 Performance-Setting up Valve Crews,Labs 1 Knowledge And/Or Problem Resolution ADMINISTRATION 2 Availability of Project Manager 1 Change Order Processing Time 3 Communication 2 Timliness of Contractor Payments 4 Resolution of Utility Conflicts 3 Bid Opening to Pre-Con Meeting Timeframe III)COMMENTS&SIGNATURES COMMENTS Signature Contractor Signature DOE Inspector Signature DOE Inspector's Supervisor INSPECTOR'S COMMENTS TRANSPORTATION AND PUBLIC WORDS E The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311 `d (817)392-7941 •Fax: (817)392-7845 AFFIDAVIT OF BILLS PAID STATE OF TEXAS COUNTY OF Dallas Before me,the undersigned authority, a Notary Public in the state and county aforesaid, on this Day personally appeared Brian Cottle Vice President , Name Title of Pavecon Public Works,LP , known to me to be a credible person,who being by Company Name me duly sworn, on his oath deposed and said: That all persons, firms, associations, corporations or other organizations furnishing labor and/or Materials have been paid in full; and that there are no claims pending for personal injury and/or property damages; On Contract described as; W Everman Parkway By Subscribed and sworn before me on this 19th day of April 2018 `x t, TIFFANY ANN GILDNER ;- try Notary ID#130416067 Expires October 22,2019otaly I'ub1 c i Dallas County. Texas Bond Number 30016918 CONSENT OF SURETY COMPANY TO FINAL PAYMENT PROMM W. Everman Parkway-Job# 1703508 (name,uddrew) TO(O%vner) Fort Worth Everman/Risinger Development LLC CONTRACT FOR: Construction 131 E Exchange Ave Ste. 212 Fort Worth,TX 76164 CONTRACTOR: CONTRACT DATE: Pavecon Public Works,LP 3022 Roy Orr Blvd. { Pjailiy TX 75050 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(hem inKrt ruime and address of Surety Co.) Continental Casualty Company 333 S. Wabash Ave. Chicago,IL 60604 ,SURETY C07HPANY, on bond of(here tnoort mime and addrem of tomtntctor) Pavecon Public Works,LP 3022 Roy Orr Blvd. Grand Prairie,TX 75050 ,CONTRACTOR hereby approves of the final payment to the Contractor and agrees that final payment to the Contractor shall not relieve the Surety Company of any of Its obligations to(herr invert name and address orowneri Fort Worth Everman/Risinger Development LLC 131 E Exchange Ave Ste. 212 Fort Worth,TX 76164 OWNER. as set forth in the said Surety Company's Dana, IN WITNESS WHEREOF, Continental Casualty Company tho Surotv Companv has horounto eat Its hand thio 24th aav o f April 2018 Continental.Casualty Cc)mpany MO Sigunture orAutharixed Repre c tati%x Patricia Ann Lyttle Attorney-in-Fact POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That Continental Casualty Company,an Illinois insurance company,National Fire Insurance Company of Hartford,an Illinois insurance company,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company(herein called "the CNA Companies"),are duly organized and existing insurance companies having their principal offices in the City of Chicago,and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make,constitute and appoint Gary W Wheatley,Bryan K Moore,Clark D Fresher,Betty J Reeh,Individually,of San Antonio,TX Michael D Hendrickson,Patricia Ann Lyttle,Individually,of Irving,TX their true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on their behalf bonds, undertakings and other obligatory instruments of similar nature -In Unlimited Amounts- and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney,pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law and Resolutions,printed on the reverse hereof,duly adopted,as indicated,by the Boards of Directors of the insurance companies. In Witness Whereof,the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto affixed on this 24th day of August,2016. GAASl Alf 1N5uggHc co�aaxrvo Continental Casualty Company National Fire Insurance Company of Hartford p6PP:RATfi 4 �S,409vOR4rA American Cas lty Company of Reading,Pennsylvania JULY 31, GU SEAL Y 190E �. 1897 '� HASCtF� � Paul T.Bruflat Vice President State of South Dakota,County of Minnehaha,ss; On this 24th day of August,2016,before me personally came Paul T.Bruflat to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is a Vice President of Continental Casualty Company,an Illinois insurance company, National Fire Insurance Company of Hartford,an Illinois insurance company,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company described in and which executed the above instrument;that he knows the seals of said insurance companies;that the seals affixed to the said instrument are such corporate seals;that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said insurance companies. J.MOHR Qbllo nwrau6(a �a�@WfF164%tlTA My Commission Expires June 23,2021 J.Mohr Notary Public CERTIFICATE I,D.Bult,Assistant Secretary of Continental Casualty Company,an Illinois insurance company,National Fire Insurance Company of Hartford,an Illinois insurance company,,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force,and further certify that the By-Law and Resolution of the Board of Directors of the insurance companies printed on the reversQ hereof is still in fore., In testi ony whereof I have h eunto subscribed my name and affixed the seal of the said insurance companies this day of GAAS tigt} tasu,�4 mak+o� Continental Casualty Company � National Fire Insurance Company of Hartford r, MPOAAt,t r n ORPORp h rfn American Casualty Company of Reading,Pennsylvania '' Jisoi I' s v SEAL HARTk� i 897 D.Butt Assistant Secretary Form F6853-4/2012 Mate of Texas Claim Notice Endorsement To be attached to and form a part of Bond No. 30016918 In accordance with Section 2253.021(f) of the Texas Government Code and Section 53.242(6) of the Texas Property Code any notice of claim to the named surety under this bond(s) should be sent to; CNA Surety 333 South Wabash Chicago, IL, 60604 Telephone: (392)822-5000 Form F6944 Figure: 28 TAC§1.601(a)(3) 1 IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para someter una queja: 2 You may contact Continental Casualty Company, Puede comunicarse con Continental Casualty National Fire Insurance Company,American Company,National Fire Insurance Company, Casualty Company or Continental Insurance American Casualty Company or Continental Company at 312-822-5000. Insurance Company al 312-822-5000. 3 You may call Continental Casualty Company, Usted puede Ilamar al numero de telefono gratis de National Fire Insurance Company,American Continental Casualty Company, National Fire Casualty Company or Continental Insurance Insurance Company,American Casualty Company or Company's toll-free telephone number for Continental Insurance Company's para informacion o information or to make a complaint at: para someter una queja al: 1-877-672-6115 1-877-672-6115 4 You may also write to Continental Casualty Usted tambien puede escribir a Continental Casualty Company, National Fire Insurance Company, Company,National Fire Insurance Company, American Casualty Company or Continental American Casualty Company or Continental Insurance Company at: Insurance Company: CNA Surety CNA Surety 333 South Wabash 333 South Wabash Chicago, IL 60604 Chicago, IL 60604 5 You may contact the Texas Department of Puede comunicarse con el Departamento de Seguros Insurance to obtain information on companies, de Texas para obtener informacion acerca de coverages, rights or complaints at: companias,coberturas, derechos o quejas al: 1-800-252-3439 1-800-252-3439 6 You may write the Texas Department of Puede escribir al Departamento de Seguros de Insurance: Texas: P.O. Box 149104 P.O. Box 149104 Austin,TX 78714-9104 Austin,TX 78714-9104 Fax: (512)475-1771 Fax:(512)475-1771 Web: http://www.tdi.state.tx.us Web: http://www.tdi.state.tx.us E-Mail: ConsumerProtection@tdi.state.tx.us E-Mail: ConsumerProtection@tdi.state.tx.us 7 PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your Si tiene una disputa concerniente a su prima o a premium or about a claim you should contact un reclamo,debe comunicarse con el Continental Continental Casualty Company, National Fire Casualty Company, National Fire Insurance Insurance Company,American Casualty Company Company,American Casualty Company or or Continental Insurance Company first. If the Continental Insurance Company primero. Si no se dispute is not resolved,you may contact the Texas resuelve la disputa,puede entonces comunicarse Department of Insurance. con el departamento (TDI). 8 ATTACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA: Este aviso es This notice is for information only and does not solo para proposito de informacion y no se become a part or condition of the attached convierte en parte o condition del documento document. adjunto. Farm F8277