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Contract 49929-FP2
r FORTWORTH. CITY SECRETARY CONTRACT N0, TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION (Developer Projects) Fan 415h8 11-'0' Project Ns: 101137 r:#-;q Regarding contract 101137 for GOLDEN CHICK RESTAURANT 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: ` .a $4,501.00 Amount of Approved Change Orders: 1 j NQ w d = d Revised Contract Amount: pIr m E Total Cost Work Completed: _ $4,501.00 c Q > d � V C V 200 m d v' v N ..r H d d v TS 0)i `Cn 'O 0 E CX c . d N1 C p ++ U1 Q C tM d MV y m t0 v d C+_ �r R o C •C M d V V V2 2 (DLd IL QZ •Q 190Q IL � A LL ►� d C d m , 0 � I Q .1 d [� t3 a � o c� c� E•-• � � cj Recommend Acc ptance Date Asst. Directo W - Development Services L A �-J. 0 �il/ Accepted Date - Direc or, TRANSPORTATION PUBLIC WORKS As' t. ty Manager Date `b omments: co �G �(,� 40 CA �t 22/16 �6$ 1 idl. L4� FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name GOLDEN CHICK RESTAURANT Contract Limits Project Type PAVING City Project Numbers 101137 DOE Number 1137 Estimate Number I Payment Number I For Period Ending 5/22/2018 CD City Secretary Contract Number Contract Time 18aD Contract Date Days Charged to Date 60 Project Manager NA Contract is 100.00 Complete Contractor BVE PRECISION CONCRETE INC P O BOX 161476 FORT WORTH, TX 76161 Inspectors DICKINSON / PITTS Tuesday,May 22,2018 Page I of 4 City Project Numbers 101137 DOE Number 1137 Contract Name GOLDEN CHICK RESTAURANT Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 5/22/2018 Project Funding PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 4"CONC SIDEWALK 450 SF $7.78 $3,501.00 450 $3,501.00 2 BARRIER FREE RAMP TYPE P-1 2 EA $500.00 $1,000.00 2 $1,000.00 ---- --------------- -------------------- Sub-Total of Previous Unit $4,501.00 $4,501.00 ----------------------------------------- Tuesday,May 22,2018 Page 2 of 4 City Project Numbers 101137 DOE Number 1137 Contract Name GOLDEN CHICK RESTAURANT Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 5/22/2018 Project Funding Contract Information Summary Original Contract Amount $4,501.00 Chan1le Orders Total Contract Price $4,501.00 Date (Y�I� Total Cost of Work Completed $4,501.00 Cont actor Less %Retained $0.00 Net Earned $4,501.00 Date CJ Earned This Period $4,501.00 Inspection Supervi or , �� — Date / Retainage This Period $0.00 Less Liquidated Damages *AssJ. P Days @ Day $0.00 Date LessPavement Deficiency $0.00 Less Penalty $0.00 Date Less Previous Payment $0.00 Director Department Plus Material on Hand Less 15% $0.00 Balance Due This Payment $4,501.00 Tuesday,May 22,2018 Page 3 of 4 City Project Numbers 101137 DOE Number 1137 Contract Name GOLDEN CHICK RESTAURANT Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 5/22/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / PITTS Contract Date Contractor BVE PRECISION CONCRETE INC Contract Time 180 CD P O BOX 161476 Days Charged to Date 60 CD FORT WORTH, TX 76161 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 $4,501.00 Less %Retained $0.00 Net Earned $4,501.00 Earned This Period $4,501.00 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 $4,501.00 Tuesday,May 22,2018 Page 4 of 4 FORT WORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:1 NAME OF PROJECT: Golden Chick PROJECT NO.: 101137 CONTRACTOR: B.V.E.Precision Concrete .DOE NO.: N/A PERIOD FROM;03/23/18 TO: 05/21/18 FINAL INSPECTION DATE: 21-May-18 WORK ORDER EFFECTIVE:3/23/2018 CONTRACT TIME: 180 Q WD QQ 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 60 60 PERIOD PREVIOUS 0 0 PERIOD TOTALS 60 60 TO DATE *REMARKS: 42 iVi& CONTRACTOR DAT IN ECTOR DATE ENGINEERING DEPARTMENT The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 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 Vicki Estel, Secretary Of BVE Precision Concrete, 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; Golden Chick,4341 W. Risinger Rd.,Fort Worth,TX B Vicki Estel, Secretary Subscribed and sworn before me on this date 16th of May, 2018. r-- N �L]P,,_,h_lyr, VANCE ESTEL ;. ate ?e° Notary Public,state of Texas a, My Commission Expires +�'' June 30, 2019 — =_ o Document G707T11 - 1994 Consent Of Surety to Final Payment PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: .Golden Chick(S.Hulen St.) ARCHITECT: ❑ 4341 W.Risinger Rd. CONTRACT FOR:City Sidewalks Fort Worth,TX 76123 CONTRACTOR: ❑ TO OWNER:(Name and address) CONTRACT DATED:January 25,2018 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 bond of (Insert name and address of Contractor) BVE Precision Concrete,Inc. PO Box 161476 Fort Worth,TX 76161 ,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 Fort Worth 200 Texas St. 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:May 23,2018 (Insert in writing the month followed by the numeric date and year.) In ors In mni Com an rety nat: o authorized representative) Attest: Jimmy Bradley,Attorney-In-Fact (Seal): (Printed name and title) AIA Document G707T"—1994.Copyright©1982 and 1994 by The American Institute of Architects.All rights reserved.WARNING:This AIA Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIV 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 14:41:32 on 05/23/2018 under Order No.4482013139 which expires on 05/30/2018,and is not for resale. User Notes: (3B9ADA32) INSUMM " INDEMNITY COMPANIES POWER OF ATTORNEY of INSURORS INDEMNITY COMPANY Waco,Texas KNOW ALL PERSONS BY THESE PRESENTS: Number: CNB-30931-00 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 of America, does hereby make, constitute and appoint Jimmy Bradley of the City of Fort Worth, State of TX as Attorney in Fact, with full power and authority 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 AttestBy: Tammy Tieper VIn, Secretaty Dave E. Talbert, President State of Texas County of McLennan On the 11`h 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 sworn, ackno edged that they executed the above Power of Attorney in their capacities as President and Corporate Secretary, respectively, nsurors Indemnity Company, and acicnow ed e i P Mrgf. Attorney to be the voluntary act and deed of the Company. .�_., SHERRI WHITEHOUSE LNotary Public it : Nota Public,State of Texas ,;,ate*` STATE OF TEXAS Notary My Comm.Exp.May 2t,2017 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: RESOLVED, that all bonds, undertakings, contracts or other obligations may be executed in the name of the Company by persons appointed as Attorney 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 terms 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 May 2018 m ammy Tieprc an, ecreta NOTE: IF YOU HAVE ANY QUESTION REGARDING THE VALIDITY OR WORDINF THIS POWER OF ATTORNEY,PLEASE CALL 800 933 7444 OR WRITE TO US AT P.O. BOX 2683,WACO,TEXAS 76702-2683 OR EMAIL US AT CONFIRMATION(aDINSURORSINDEMNITY.COM.