HomeMy WebLinkAboutContract 48823-FP4 City Secretary 48823 Contract No. 4
FORTWORTH. Date Received Jul 3,2018
/00-61
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: Deer Meadow Phase 4
City Project No.: 100451
Improvement Type(s): ® Paving ❑ Drainage ❑ Street Lights ❑ Traffic Signals
Original Contract Price: $87,047.67
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete: $87,047.67
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Jun 19,2018
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Contractor Date
President
Title
JLB Contracting, LLC
Company Name
fmr(L�c_ J u n 20,2018
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Project Inspector Date
Jun 22,2018
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Project Manager Date
,7ffthI c(Q!1!B A6vd& Jun 26,2018
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CFA Manager Date
R"aAkdadyd Jun 26,2018
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Asst. City Manager Date
e1of2
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
Notice of Project Completion
Project Name: Deer Meadow Phase 4
City Project No.: 100451
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: 180 CD Days Charged: 330
Work Start Date: 5/1/2017 Work Complete Date: 3/26/2018
Page 2 of 2
s q Con I - fps 1
City Project Numbers 100451
DOR Number 0451
Contract Name DEER MEADOW PIIASE 4 Estimate Number 1
Contract Limits Payment Number i
Project Type PAVING For Period Ending 6/19/2018
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors LAYER / SMITH Contract Date
Contractor JLB CONTRACTING,L.L.C. Contract Time 180 CD
PO BOX 24131 Days Charged to Date 330 CD
FORT WORTH, TX 76124-1131 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 $87,047.67
Less %Retained $0.00
Net Earned $87,047.67
Earned This Period $87,047.67
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 $87,047.67
Tuesday,June 19,2018 Page 4 of 4
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name DEER MEADOW PHASE 4
Contract Limits
Project Type PAVING
City Project Numbers 100451
DOE Number 0451
Estimate Number I Payment Number I For Period Ending 6/19/2015
CD
City Secretary Contract Number Contract Time I3GD
Contract Date Days Charged to Date 330
Project Manager NA Contract is 100.00 Complete
Contractor JLB CONTRACTING,L.L.C.
PO BOX 24131
FORT WORTH, TX 76124-1131
Inspectors LAYER / SMITH
Tuesday,June 19,2018 Pagel of4
City Project Numbers 100451 DOE Number 0451
Contract Name DEER MEADOW PHASE 4 Estimate Number 1
Contract Limits Payment Number i
Project Type PAVING For Period Ending 6/19/2018
Project Funding
PAVING
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total
Quanity Total
1 6"R.C.STREET PAVEMENT 2319 SY $31.38 $72,770.22 2319 $72,770.22
2 6"LIME STABILIZED SUBGRADE 2551 SY $2.30 $5,867.30 2551 $5,867.30
3 TYPE III BARRICADE 1 EA $842.00 $842.00 1 $842.00
4 HYDRATED LIME 46 TN $158.00 $7,268.00 46 $7,268.00
5 CONCRETE HEADER 29 LF $10.35 $300.15 29 $300.15
Sub-Total of Previous Unit $87,047.67 $87,047.67
--------------------------------------
Tuesday,June 19,2018 Page 2 of 4
City Project Numbers 100451 DOE Number 0451
Contract Name DEER MEADOW PHASE 4 Estimate Number i
Contract Limits Payment Number 1
Project Type PAVING For Period Ending 6/19/2013
Project Funding
Contract Information Summary
Original Contract Amount $87,047.67
Chance Orders
Total Contract Price $87,047.67
Total Cost of Work Completed $37,047.67
Less %Retained $0.00
Net Earned $87,047.67
Earned This Period $87,047.67
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 $87,047.67
Tuesday,June 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 Sam Davis, President of JLB Contracting, LLC,
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;
Deer Meadow Addition — Phase 4 -City Project# 100451
BY
Sam Davis
President
JLB Contracting, LLC
Subscribed and sworn before me on this day of J 2018.
NO PUBLIC I AND
T � NT COUNTY, TEXAS
My commission expires JAMIE GREENWAY
Notary Public.state of Texas
. Comm.Expires 09-25-2020 L
Notary ED 1211545-4 `!
k
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
TO FINAL PAYMENT
CONTRA
�CTOR o
(SIMILAR TO AIA DOCUMENT C707)
Bond No. 5063157
PROJECT: Deer Meadow Phase 4
(name,address)Fort Worth,Texas
TO (Owner)
ARCHITECTS PROJECT NO:
City of Fort Worth,Texas CONTRACT FOR: Above Project
200 Texas Street
Fort Worth,Texas 76102
CONTRACT DATE:
CONTRACTOR: JLB Contracting,LLC
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(here insmrt name and
address of Surety Company) Westfield Insurance Company
555 Republic Drive, Suite 450
Plano,Texas 75074 ,SURETY COMPANY,
on bond of(here insert name and addr=of Contractor)
JLB Contracting, LLC
P.O. Box 24131 ,CONTRACTOR,
Fort Worth,Texas 76124
hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the
Surety Company of any of its obligations to(hem insert come and address of owner)
City of Fort Worth
200 Texas Street
Fort Worth,Texas 76102 •OWNER,
as set forth in the said Surety Company's bond
IN WITNESS WHEREOF,
The Surety Company has hereunto set its hand this 19th day of June
W FIELD INSURANCE COMPANY
Surety ComeAuthorized�ReFprescntative
71
B
Attest:
Signature of
(Seal): Kyle W. Sweeney Attorney-in--Fact
Title
Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Currant Edition
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING 1 tWi SAMt
POWER#AND ISSUED PRIOR TO 04120111, FOR ANY PERSON OR PERSONS NAMED BELOW
General POWER NO. 4220052 06
Power Westfield Insurance Co.
of Attorney Westfield National Insurance Co.
CERTIFIED COPY Ohio Farmers Insurance Co.
Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, her6nafter referred to indivdually as a -Company' and collectively as -Companies,- du'`;y
organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County,Ohio,do by these
presents make,constitute and appoint
CHARLES D.SWEENEY, MICHAEL A.SWEENEY,KYLE W.SWEENEY,ELIZABETH GRAY,JOINTLY OR SEVERALLY
of FORT WORTH and State of TX its true and lawful Attorney(s)-in-Fact,with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - -- - -
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President,seated with the corporate
seal of the applicable Company and duly attested by its Secretary,hereby ratifying and confirming all that the said Attorney($)-in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
'Be It Resolved,that the President,any Senior Executive,any Secretary or any Fidelity&Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fad to reprt sent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-In-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and
deliver, any and all bonds, recognizances,contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney-In-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary.'
'Be It Further Resolved,that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which It is attached.' (Each adopted at a meeting
held on February 5,2000),
In Witness Whereof,WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of
APRIL A.D.,2011 .
Corporate ,,."w"'«• w„ ,,.«..„..•. « e,.u..a.a.
At, WESTFIELD INSURANCE COMPANY
Seals �r0w=�RAkC�p1is ,•'�P�:�N ,VSG: � �Ksu � WESTFIELD NATIONAL INSURANCE COMPANY
Affixed..: .is. i� iw= y OHIO FARMERS INSURANCE COMPANY
N: SEAL
".3;1-
; •O;
By:
State of Ohio 4«� },.�„•.•� '`may ...,,:.�.»...•••+
Richard L. Kinnaird, Jr.,National Surety Leader and
County of Medina ss,: Senior Executive
On this 20th day of APRIL A.D.,2011 before me personally came Richard L. Kinnaird, Jr.to me known•who, being by me duly
sworn,did depose and say,that he resides In Medina, Ohio;that he is Senior Executive of WESTFIELD INSURANCE COMPANY,WESTFIELD
NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above
instrument;that he knows the seals of said Companies;that the seats affixed to said instrument are such corporate seals:that they were so affixed
by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order.
Notarial
SealIV 4.
t,�'.ti f
Affixed '�Q \\tll�jis�``.`+
William J.Kahelin,A rney at Law,Notary Public
State of Ohio ' $A d O My Commission Does Not Expire(Sec.147.03 Ohio Revised Code)
County of Medina ss.: - .�
?y4 OF0��.
1,Frank A.Carrina,Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies,which Is still In full force and effect;and furthermore,the resolutions of the Boards of Directors,set out In the Power of Attorney are
In full force and ertect.
In Witness Whereof, I have hereunto set my hand and affixed the seals or said Companies at Westfield Center, Ohio, this 19th day of
June A.D.,2018 ,.
�,tlft.tkNAtS•«"�vy
Qe�• �� ..•`,P•-......,NSG,^ 111i Ulj,�,
40
a c' 1 SEAL _ , 3 �i��-
-a 48,-tet-' Frank A. Gsrrino,Secretary
BPOAC2 (combined) (06-02)
Greensheet for Deer Meadow
_- - Phase 4 CPN#100451 P
Adobe Sign Document History 09/20/2018
Created: 06/19/2018
By: Shameka.Kennedy@fortworthtexas.gov
- - Status: Signed
Transaction ID: CBJCHBCAABAA-4E-RKC19Nh-y8KPCG1D5gxy7f01tNMh
"Greensheet for Deer Meadow Phase 4 CPN#100451 P" History
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