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Contract 47939-FP1
City Secretary47939 -FP1 Contract No. FORT WORTH., Date Received Aug 10,2018 5940) — Toe-z(03 NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: MARQUIS TRANSPORTATION ADDITION City Project No.: 100263 Improvement Type(s): ❑ Paving ® Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $233,456.70 Amount of Approved Change Order(s): Revised Contract Amount Total Cost of Work Complete: $233,456.70 Aug 2, 2018 Contractor Date CEO Title Vatistra Group LLC Company Name Addkk,cszgr4y Aug 3, 2018 A:lih' Cazurl.,,;AUg 3,2018 Project Inspector Date Aug 8,2018 Project Manager Date 411M,/ c�40rl Llllt Aug 9,2018 Janie Scarlett morales(Aug%2018) CFA Manager Date S"44,,pAug 9 2018 3:an AL!I iAUP 9.20181 Asst. City Manager Date OFFICIAL RECORD RECEIVED CITY SECRETARY e 1 of 2 AUG 14 2018 FT. RT",TX CITY OF FORT WORTH CITY FCRUARY Notice of Project Completion Project Name: MARQUIS TRANSPORTATION ADDITION City Project No.: 100263 City's Attachments Final Pay Estimate N Change Order(s): ❑ Yes N N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 45 CD Days Charged: 688 Work Start Date: 9/7/2016 Work Complete Date: 7/26/2018 Page 2 of 2 5'9Go)- l000-203 City Project Numbers 100263 DOE Number 0263 Contract Name MARQUIS TRANSPORTATION ADDITION Estimate Number I Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 7/26/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / CALORLA Contract Date Contractor VALISTRA GROUP LLC Contract Time 45 CD 2501 BLUE MOUND ROAD W Days Charged to Date 688 CD HASLET, TX 76052 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded i Total Cost of Work Completed $233,456.70 Less %Retained $0.00 Net Earned $233,456.70 Earned This Period $233,456.70 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 $233,456.70 Tuesday,July 31,2018 Page 4 of 4 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name MARQUIS TRANSPORTATION ADDITION Contract Limits Project Type STORM DRAIN City Project Numbers 100263 DOE Number 0263 Estimate Number I Payment Number I For Period Ending 7/26/2018 CD City Secretary Contract Number Contract Time 4ED Contract Date Days Charged to Date 688 Project Manager NA Contract is 100.00 Complete Contractor VALISTRA GROUP LLC 2501 BLUE MOUND ROAD W HASLET, TX 76052 Inspectors DICKINSON / CAZORL.A Tuesday,July 31,2018 Page 1 of r�3. City Project Numbers 100263 DOE Number 0263 Contract Name MARQUIS TRANSPORTATION ADDITION Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 7/26/2018 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ----------------------- — -- -- -- ----- I REMOVE HEADWALUSET I EA $740.00 $740.00 1 $740.00 2 SITE CLEARING 1 LS $5,071.00 $5,071.00 1 $5,071.00 3 MEDIUM STONE RIPRAP DRY 1070 SY $59.85 $64,039.50 1070 $64,039.50 4 SEEDING HYDROMULCH 10700 SY $0.35 $3,745.00 10700 $3,745.00 5 TRENCH SAFETY 2980 LF $1.00 $2,980.00 2980 $2,980.00 6 CONCRETE COLLAR CONNECT TO 42" 2 EA $1,032.00 $2,064.00 2 $2,064.00 7 IMPORTED EMBEDMENT/BACKFILL, 100 CY $44.00 $4,400.00 100 $4,400.00 CRUSHED 8 42"RCP CLASS 111 46 LF $150.00 $6,900.00 46 $6,900.00 9 48"RCP CLASS III 22 LF $179.00 $3,938.00 22 $3,938.00 10 7X4 BOX CULVERT 190 LF $339.00 $64,410.00 190 $64,410.00 11 8X4 BOX CULVERT 44 LF $354.00 $15,576.00 44 $15,576.00 12 HEADWALL,BOX CULVERT 2 EA $7,250.00 $14,500.00 2 $14,500.00 13 HEADWALL,BOX CULVERT 2 EA $8,300.00 $16,600.00 2 $16,600.00 14 42"FLARED HEADWALL,2 PIPES 1 EA $5,390.00 $5,390.00 1 $5,390.00 15 48"FLARED HEADWALL,1 PIPE I EA $3,218.00 $3,218.00 1 $3,218.00 16 PRIMARY POND OUTFALL STRUCTURE I EA $6,600.00 $6,600.00 1 $6,600.00 17 POND EMERGENCY OVERFLOW STRUCTURE 1 EA $6,832.00 $6,832.00 1 $6,832.00 18 TEMPORARY WATERING OF SEEDING 2.21 AC $2,920.00 $6,453.20 2.21 $6,453.20 Sub-Total of Previous Unit $233,456.70 $233,456.70 ------------------------------------- Tuesday,July 31,2018 Page 2 of 4 City Project Numbers 100263 DOE Number 0263 Contract Name MARQUIS TRANSPORTATION ADDITION Estimate Number l Contract Limits Payment Number 1 Project Type STORM DRAIN For Period Ending 726/2018 Project Funding Contract Information Summary Original Contract Amount $233,456.70 ChanIze Orders Total Contract Price $233,456.70 Total Cost of Work Completed $233,456.70 Less %Retained $0.00 Net Earned $233,456.70 Earned This Period $233,456.70 Retainage This Period $0.00 Less Liquidated Damages Days @ J 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 $233,456.70 Tuesday,July 31,2018 Page 3 of AFFIDAVIT STATE OF (F 5 COUNTY OF 7- Before Before me,the undersigned authority,a notary public in the state and county aforesaid,on this day personally appeared Name, Title Of Company,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; Contract Description Y Name or Title Subscribed and sworn before me on this date Day of Month, Year. BLANCA E LEA ;' My Notary 1D#126926852 'G Expires June 12,2021 otary Public County, State (20MII) i SS 0,- I CONSENT OF SURETY COMPANY TO FINAL PAYMENT Bond #S917-7650 Project: Marquis Transportation Addition To (Owner): City of Ft Worth, TX and MKS Real Estate,LLC 200 Texas Street Contract For: See Above Ft Worth,TX 76102 Contract Date: July 15,2016 Contractor: Valistra Group,LLC In accordance with the provision of the Contract between the Owner and the Contractor as defined above,the Washington International Insurance Company 5200 Metcalf OPN111 Overland Park,KS 66202 ,Surety Company, on bond of Valistra Group,LLC 9100 US Highway 287 Ft Worth,TX 76177 ,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 the City of Ft Worth,TX and MKS Real Estate,LLC 200 Texas Street Ft Worth, TX 76102 ,Owner as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 1st day of August,2018. Washington International Insurance Companv Surety Company Wit ss: Tracy Tucker, ttorney-in-Fact SWISS RE CORPORATE SOLUTIONS NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY WESTPORT INSURANCE CORPORATION GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Overland Park,Kansas and Washington International Insurance Company a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Overland Park,Kansas,and Westport Insurance Corporation,organized under the laws of the State of Missouri,and having its principal office in the City of Overland Park,Kansas each does hereby make,constitute and appoint: W.LAWRENCE BROWN,TRACY TUCKER,KEVIN J.DUNN, STEVEN TUCKER,AND ROBERTA H. ERB JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: ONE HUNDRED TWENTY FIVE MILLION($125,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on March 24,2000 and Westport Insurance Corporation by written consent of its Executive Committee dated July 18,2011. "RESOLVED,that any two of the President,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." PAPICe \������ptiALfllTYi4p�io� ��ttgQNq�� �QFORR,qG i� GpF>POij��s'ppp By �,.,..,... S L Steven Anderson,Senior ice President o as ngton n eroahona nsurance Company a p i SEAL Oi im�: &Senior Vice President of North American Specialty Insurance Company %41% 1973 ry cn-- �'• .A &Senior Vice President of Westport Insurance Corporation :fib ��erp` y 6�' .............AMP .•a��� 'i'b !�s'� By - / /!�/ ! ''�MN•�~f 15rMike A.Ito,Senior Vice President of Washington International Insurance Company &Senior Vice President of North American Specialty Insurance Company &Senior Vice President or Westport Insurance Corporation IN WITNESS WHEREOF,North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this this I day of March .20 18 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois Westport Insurance Corporation County of Cook SS: On this 1 day of March ,201 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation and Michael A.Ito Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. O KEN SEAL M.KEN M. NY \✓V \ , � ;, Ntrtary Pubtic•State of luiuois MY Commission Expires 17JO412021M.Kenny,Notary Public 1, Jeffrey Goldberg the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance Corporation which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 1st day of August 20 18 Jeffrey Goldberg,Vice President&Assistant Secretary of Washington]nterrationai Insurance Company& North American Specially Insurance Company&Vice President&Assistant Secretary of Westport Insurance Corporation r� ,. ----_-- Green Sheet for M aq u is Transportation Addition CPN 100263 Drainage Adobe Sign Document History 08/13/2018 Created: 08/01/2018 By: Etta Bacy(etta.bacy@fortworthtexas.gov) _ Status: Signed Transaction ID: CBJCHBCAABAATr_x7O2N087AEVK2OD2cOFvgmiFZ3-EC "Green Sheet for Maquis Transportation Addition CPN 100263 D rainage" History Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 08/01/2018-12:08:41 PM CDT-IP address:209.194.29.100 Document emailed to Luis Leal (luis.leal@valistra.com)for signature 08/01/2018-12:17:35 PM CDT Document viewed by Luis Leal (luis.leal@valistra.com) 08/01/2018-12:36:18 PM CDT-IP address: 107.77.198.56 Chi Luis Leal (luis.leal@valistra.com) uploaded the following supporting documents: G File Attachment 1 File Attachment 2 08/02/2018-4:53:30 PM CDT J0, Document e-signed by Luis Leal (luis.leal@valistra.com) Signature Date:08/02/2018-4:53:30 PM CDT-Time Source:server-IP address:76.204.124.115 E_', Document emailed to Adilia Cazorla (adilda.cazorla@fortworthtexas.gov)for signature 08/02/2018-4:53:32 PM CDT L_; Document viewed by Adilia Cazorla (adilda.cazorla@fortworthtexas.gov) 08/03/2018-9:17:35 AM CDT-IP address:209.194.29.100 ba Document e-signed by Adilia Cazorla (adilda.cazorla@fortworthtexas.gov) Signature Date:08/03/2018-9:18:04 AM CDT-Time Source:server-IP address:209.194.29.100 E_' Document emailed to Edward D'avila (edward.davila@fortworthtexas.gov)for approval D08/03/2018-9:18:07 AM CDT FORT WORTH. PJ Adobe Sign gYI Document viewed by Edward Davila (edward.davila@fortworthtexas.gov) 08/08/2018-3:01:12 PM CDT-IP address:209.194.29.100 o, Document approved by Edward D'avila (edward.davila@fortworthtexas.gov) Approval Date:08/08/2018-3:12:49 PM CDT-Time Source:server-IP address:209.194.29.100 P-► Document emailed to G.Sahu, PM (gopal.sahu@fortworthtexas.gov)for signature 08/08/2018-3:12:50 PM CDT Document viewed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) 08/08/2018-3:22:40 PM CDT-IP address:209.194.29.100 GSp Document e-signed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) Signature Date:08/08/2018-3:23:28 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales aanie.morales@fortworthtexas.gov)for signature 08/08/2018-3:23:29 PM CDT Document viewed by Janie Scarlett Morales aanie.morales@fortworthtexas.gov) 08/09/2018-7:49:34 AM CDT-IP address:209.194.29.100 6� Document e-signed by Janie Scarlett Morales aanie.morales@fortworthtexas.gov) Signature Date:08/09/2018-7:51:33 AM CDT-Time Source:server-IP address:209.194.29.100 P-► Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 08/09/2018-7:51:34 AM CDT Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 08/09/2018-8:35:18 AM CDT-IP address:209.194.29.100 b© Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:08/09/2018-8:35:39 AM CDT-Time Source:server-IP address:209.194.29.100 Py Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 08/09/2018-8:35:40 AM CDT Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 08/10/2018-1:41:26 PM CDT-IP address:209.194.29.100 GSp Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:08/10/2018-1:44:20 PM CDT-Time Source:server-IP address:209.194.29.100 . Document emailed to TRUDY BROTHERTON (therese.brotherton@fortworthtexas.gov)for delivery 08/10/2018-1:44:21 PM CDT Document viewed by TRUDY BROTHERTON (therese.brotherton@fortworthtexas.gov) 08/10/2018-1:54:56 PM CDT-IP address:68.116.135.3 FORTWORTH. If, Adobe Sign Gc: Document receipt acknowledged by TRUDY BROTHERTON (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:08/10/2018-1:55:17 PM CDT-Time Source:server-IP address:68.116.135.3 C' Document emailed to Julie A Geho oulie.geho@fortworthtexas.gov)for delivery 08/10/2018-1:55:18 PM CDT Document viewed by Julie A Geho oulie.geho@fortworthtexas.gov) 08/10/2018-2:17:59 PM CDT-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:08/10/2018-2:18:16 PM CDT-Time Source:server-IP address:209.194.29.100 E,, Document emailed to Sylvia Kelley (tpwcfafiscal@fortworthtexas.gov)for delivery 08/10/2018-2:18:17 PM CDT `il� Document viewed by Sylvia Kelley(tpwcfafiscal@fortworthtexas.gov) 08/10/2018-2:18:41 PM CDT-IP address:209.194.29.100 :lc Document receipt acknowledged by Sylvia Kelley(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:08/13/2018-10:24:28 AM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov), TRUDY BROTHERTON (therese.brotherton@fortworthtexas.gov), Sylvia Kelley (tpwcfafiscal@fortworthtexas.gov), Luis Leal (luis.leal@valistra.com), and 7 more 08/13/2018-10:24:28 AM CDT FoxJ Adobe Sign