HomeMy WebLinkAboutContract 49840-FP2 City Secretary 49840 -FP2
Contract No._
FORTWORTH, Date Received Jul 24,2018
596v1 - 100 .21
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:.PINE MEADOWS PHASE II
City Project No.: 100824
Improvement Type(s): ❑ Paving ® Drainage ❑ Street Lights ❑ Traffic Signals
Original Contract Price: $189,076.50
Amount of Approved Change Order(s):
Revised Contract Amount
Total Cost of Work Complete: $189,076.50
a I p. r Jul 19 2018
Ab GraMges(Jul 1 ,2019) ,
Contractor Date
Contract Manager
Title
Burnsco Construction, Inc.
Company Name
TAOW' -W. `ddl&' Jul 192018
Thoma'W.W k,(J.1 19'2c161 1
Project Inspector Date
Jul 19 2018
P'l-k BucFl<'IJuI 13.2olai !
Pro*,ecl rMg� Date
Cv6yn Robe (Jul 23,2018l Ju123,2018
FA M ager Date
Susan nlani:(Jut 24.2019) Jul 24,2018
As)t CitManager Date
qGc cFil�
OFFICIAL.RECORD Page 1 of 2
9Ry ' CITY SECRETARY
FT.wairrm,TX
Notice of Project Completion
Project Name: PINE MEADOWS PHASE II
City Project No.: 100824
City's Attachments
Final Pay Estimate x❑
Change Order(s): ❑ Yes x❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety P
C
Statement of Contract Time
Contract Time: 90 CD Days Charged: 197
Work Start Date: 1/3/2018 Work Complete Date: 7/18/2018
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Page 2of2
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59 Govl— looB.?y
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City Project Numbers 100824 DOE Number 0824
Contract Name PILAF,MEADOWS PHASE lI Estimate Number I
Contract Limits Payment Number 1
Project Type STORM DRAIN For Period Ending 7/19/2018
h
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors OWEN / RODRIGUEZ Contract Date
i
Contractor BURNSCO CONSTRUCTION,INC. Contract Time 90 CD
6331 SOUTHWEST BLVDI
Days Charged to Date 197 CD
FORT WORTH, TX 76132 Contract is .000000 Complete
I�
CITY OF FORT WORTH
SUMMARY OF CHARGES
1
Line Fund Account Center Amount Gross Retainage Net
-- - - -
Funded
Total Cost of Work Completed $189,076.50
Less %Retained $0.00
Net Earned $189,076.50
Earned This Period $189,076.50
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 /Day $0.00
LessPavement Deficiency $0.00
Less Penalty $0.00 Nil
Less Previous Payment $0.00
Plus Material on Hand Less 15% $0.00
Balance Due This Payment $189,076.50
Thursday,July 19,2018 Page 4 of 4
.FORTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
i
Contract Name PINE MEADOWS PHASE II
Contract Limits I
Project Type STORM DRAIN
City Project Numbers 100824 I�
DOE Number 0824
Estimate Number 1 Payment Number 1 For Period Ending 7/19/2018
CD
City Secretary Contract Number Contract Time 9CD
Contract Date Days Charged to Date 197
Project Manager NA Contract is 100.00 Complete
Contractor BURNSCO CONSTRUCTION,INC. !
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6331 SOUTHWEST BLVD
FORT WORTH, TX 76132
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Inspectors OWEN / RODRIGUEZ 1
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Thursday,July 19,2018 Page I of 4
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City Project Numbers 100824 DOE Number 0824
Contract Name PINE MEADOWS PHASE II Estimate Number 1
Contract Limits Payment Number 1
Project Type STORM DRAIN For Period Ending 7/19/2018
Project Funding
STORM DRAIN
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
——————————————————— - - - ---------------
1 TRENCH SAFETY 1351 LF $0.50 $675.50 1351 $675.50
2 5X3 BOX CULVERT 91 LF $267.00 $24,297.00 91 $24,297.00
3 4X3 BOX CULVERT 304 LF $214.00 $65,056.00 304 $65,056.00
4 30"RCP 40 LF $87.00 $3,480.00 40 $3,450.00
5 24"RCP 916 LF $68.00 $62,288.00 916 $62,288.00
6 4'STORM JUNCTION BOX I EA $3,900.00 $3,900.00 1 $3,900.00
7 10'CURB INLET 6 EA $3,500.00 $21,000.00 6 $21,000.00
8 4'STACKED MANHOLE 2 EA $1,300.00 $2,600.00 2 $2,600.00
9 4'DROP INLET 1 EA $4,500.00 $4,500.00 1 $4,500.00
10 REMOVE RIP RAP 128 SY $10.00 $1,280.00 128 $1,280.00
Sub-Total of Previous Unit $189,076.50 $189,076.50
---------------------------------------
Thursday,July 19,2018 Page 2 of 4
City Project Numbers 100824
DOE Number 0824
Contract Name PINE MEADOWS PRASE lI Estimate Number 1
Contract Limits Payment Number 1
Project Type STORM DRAIN For Period Ending 7/19/2018
Project Funding
Contract Information Summary
Original Contract Amount $189,076.50
Change Orders
Total Contract Price $189,076.50
Total Cost of Work Completed $189,076.50
Less %Retained $0.00
Net Earned $189,076.50
Earned This Period $189,076.50
Retainage This Period $0.00
Less Liquidated Damages
Days @ /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 $189,076.50
Thursday,July 19,2018 Page 3 of 4
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 Ab Grantges,
Contract Mgr, Of Burnsco construction, Inc.,known to me to be a credible
person, who being by the 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;
Pine Meadows Phase 2 -Water, Sanitary Sewer and tone Drain
BY j
Ab Graiftges, Contract Manager
Subscribed and sworn before me on this date 6th of July,2018.
Not •y Public
Tarrant County, Texas
�,a'• "; o, (NARY PANNELL
P,otory Public•state 01 IC
Notary ID 5144239
1puRP tcrct;v,
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
TO FINAL PAYMENT CONTRACTOR ❑
SURETY ❑
Conforms with the American Institute of OTHER
Architects, AIA Document G707
Bond No 022059338
PROJECT:
(name, address)Pine Meadows Phase 2-Water, Sanitary Sewer and Stone Drain Improvements
TO (Owner) Fort Worth TX
PINE MEADOW DEVELOPMENT COMPANY,LLC AND I ARCHITECT'S PROJECT NO:
CITY OF FORT WORTH
CONTRACT FOR:
5137 Davis Blvd Pine Meadows Phase 2-Water,Sanitary Sewer and Storm Drain
Improvements
(Fort Worth Tx 76180 -J CONTRACT DATE:
CONTRACTOR:BURNSCO CONSTRUCTION, INC.
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the
(here insert name and address of Surety Company)
LIBERTY MUTUAL INSURANCE COMPANY
175 Berkeley Street
Boston MA 02116 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
BURNSCO CONSTRUCTION, INC.
6331 Southwest Boulevard
Benbrook TX 76132 , 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 (here insert name and address of Owner)
PINE MEADOW DEVELOPMENT COMPANY, LLC AND CITY OF FORT WORTH
5137 Davis Blvd
Fort Worth TX 76180 , OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS, WI-IEREOP,
the Surety Company has hereunto set its hand this 26th day of June,2018
LIBERTY MUTUAL INSURANCE COMPANY
Su Company
Attest:Tina McEwan /Llyu t 17r!G1?(.t/f
(Seal): Sign<ture of Authorized Representative
Sonhinie Hunter Attorney-in-Fact
Title
NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
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.
Liberty Mutual Insurance Company Certificate No.7989050
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 State 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,
Robbi Morales,•Don E.Comell•Scihinie Hunter V.DeLene Marshall•Tina McEwan•Ricardo J.Reyna;Kelly A.Westbrook
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 24th day of_ January 2018
_
tQ
TJ n The Ohio Casualty Insurance Company in
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1912 '( 1991 _ Liberty Mutual Insurance Company m
\ West merican Insurance Company =
rN or`rc'„•v.,v::,•'`ti ,,•�.,..;,•"' t` ��+tie:- /I .
By: nr r, •r�
c STATE OF PENNSYLVANIA ss David M.Care Assislant Secretary
COUNTY OF MONTGOMERY t0
4) 3 _ c
>� On this 24th day of January 2018,before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance cis
o
'~ 3 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 >,CO
p_ therein contained by signing on behalf of the corporations by himself as a duly authorized officer. W
is �
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. `p CL
gP PASS. COMMONWEALTH OF PENNSYLVANIA Q M
Notarial Sealith�
O i pp v Teresa Pastella,Notary Public. By., � 04
Upper Maim Twp.,Montgomery County Teresa Pastella,Nota Public
Q My Commission Expires starch 28,2021 Notary
0 �qRy P �� lember,Pennsylvania Assucrattrrn of Notaries
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C` This 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 y p
6 Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: ,�o
d 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 e
to such limitation as the Chairman or the President may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, ?h y
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 '5
E ye powers of attorney,shalt have full power to bind the Corporation by their signature and execution of any such instruments and to attach the the seal of the Corporation. When so d
,p iexecuted,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 >.Q
,a 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. d 0
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, w OP
? L and subject to such limitations as the chairman or the president may prescribe,shall appoint such attorneys-fn-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 ao
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 0 o
executed such instruments shall be as binding as if signed by the president and attested by the secretary. r.
0
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 surely 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 in full force and effect and
has not been revoked, t
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of_ u 20 _
T,(I ;btNgt/� ,I;aStrF�
�J':pY:PC:21i�A� �:u^,<uP.�p'y�•t� ��j"�FP(:,;q`JiCr.. 7 , `�
1912 y ` `y1991 By:
r, *`� 9�';,ra ,.,:`' Renee C.Hewe ssistant Secretary
h,
347 of 400
LMS 12873_022017
Liberty
Mutual
SURETY
TEXAS TEXAS
IMPORTANT NOTICE AVISO IMPORTANTE
To obtain information or make a complaint: Para obtener information o para someter una
queja:
You may call toil-free for information or to Usted puede Ilamar al numero de telefono gratis
make a complaint at para information 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 1.9406-2755 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 information
coverages, rights or complaints at acerea 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 (111-I A) de Texas Consumer Protection (111-1A)
P. 0. Box 149091 P. 0. 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://www.tdi.texas.gov
E-mail: Cons umerProtecti on@tdi.texas,gov E-mail: ConsumerProtectionnatdi.texas.gov
PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS 0 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 information
become a part or condition of the attached y no se convierte en parte o condition del
document. documento adjunto.
NP 70 68 09 01
LMS-15292 10/15
= -- Greensheet for Pine Meadows
, � --� Phase II CPN#100824 SD
Adobe Sign Document History 08/14/2018
- Created: 07/19/2018
By: Shameka.Kennedy@fortworthtexas.gov
Status: Signed
Transaction ID: CBJCHBCAABAAaPp2zCXOtB4XA81BSLoyQyS0ef3cWlYr
"Greensheet for Pine Meadows Phase II CPN#100824 SD" Histo
ry
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