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Contract 49148-FP1
City Secretary 49148 P1 Contract No. FORTWORTH. Date Received Oct 4,2018 S4c�o/- 100$33 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: WATERSBEND SOUTH PH 2A City Project No.: 100533 Improvement Type(s): Water ® Sewer Original Contract Price: $928,690.00 Amount of Approved Change Order(s): $2,220.00 Revised Contract Amount: Total Cost of Work Complete: $930,910.00 E Sep 24,2018 Qirm-Ft—iSen 24 2Q& Contractor Date Office Manager Title Jackson Construction, Ltd Company Name MA41-644n /^��� p Malt U.JW 3.2018} Oct 3,2018 Project Inspector Date Fred Elila(Oct 3,2018) Oct 3,2018 Project Manager Date .7m4 S�N�ttNoAalat Oct 3 2018 j-".Scarlett M-1l,(Oct 170131 7 CFA Manager Date Sam AL uk- Susan Alanis(Oct 4,2D18) Oct 4,2018 Asst. City Manager Date DECEIVED LOFFICIAL _. _OCT -9 2018 Page 1 of 2 CITYUPORTWORTH ,TX CITY SECRETARY Notice of Project Completion Project Name:WATERSBEND SOUTH PH 2A City Project No.: 100533 City's Attachments Final Pay Estimate Change Order(s): ❑x Yes ❑ N/A Pipe Report: ® Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 180 CD Days Charged: 180 Work Start Date: 8/14/2017 Work Complete Date: 9/7/2018 Page 2 of 2 i' 605.33 City Project Numbers 100533 DOE Number 0533 Contract Name WATERSBEND SOUTH PHASE 2A Estimate Number I Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 9/7/2018 Project Funding i Project Manager NA City Secretary Contract Number Inspectors DICKINSON / GREENWOOD Contract Date Contractor JACKSON CONSTRUCTION L'I'D Contract Time 180 CD 5112 SUN VALLEY DRIVE Days Charged to Date 390 CD FORT WORTH, TY 76119 Contract is .000000 Complete �B CITY OF FORT WORTH q SUMMARY OF CHARGES ! Line Fund Account Center Amount Gross Retainage Net Funded ------------ --------------------------- �Ii — - j b ! ! 4� Total Cost of Work Completed $930,910.00 Less %Retained $0.00 ` Net Earned $930,910.00 Earned This Period $930,910.00 Retainage This Period $0.00 l r Less Liquidated Damages 0 Days @ $0.00 /Day $0.00 �I II LessPavement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 y 6 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $930,910.00 i Friday,September 14,2018 Page 4 of i FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WATERSBEND SOUTH PHASE 2A Contract Limits Project Type WATER&SEWER N i City Project Numbers 100533 DOE Number 0533 Estimate Number I Payment Number 1 For Period Ending 9/7/2018 CD i City Secretary Contract Number Contract Time 1811:D Contract Date Days Charged to Date 390 Project Manager NA Contract is 100.00 Complete Contractor JACKSON CONSTRUCTION LTD II 5112 SUN VALLEY DRIVE FORT WORTH, TX 76119 'I Inspector DICKINSON / GREENWOOD l II �I IppI '1 i �I h t II i i f Friday,September 14,2018 Page I of 4 4 City Project Numbers 100533 DOE Number 0533 Contract Name WATERSBEND SOUTH PHASE 2A Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 9/7/2018 Project Funding WATER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total -------------------------------------- - 1 ------------------------------------- - 1 8"PVC WATER PIPE 3770 LF $32.00 $120,640.00 3770 $120,640.00 2 12"WATER PIPE 840 LF $60.00 $50,400.00 840 $50,400.00 3 12"GATE VALVE&VALVE BOX 3 EA $2,200.00 $6,600.00 3 $6,600.00 4 8"GATE VALVE&VALVE BOX 14 EA $1,100.00 $15,400.00 14 $15,400.00 5 STD FIRE HYDRANT ASSEMBLY W/G'GATE 5 EA $3,800.00 $19,000.00 5 $19,000.00 VALVE&VALVE BOX 6 DUCTILE IRON WATER FITTINGS I TN $8,500.00 $8,500.00 I $8,500.00 W/RESTRAINT 7 TRENCH SAFETY 4610 LF $0.10 $461.00 4610 $461.00 8 1"DOMESTIC WATER SERVICES 104 EA $940.00 $97,760.00 104 $97,760.00 9 END&PLUG 8"W.L. 5 EA $175.00 $875.00 5 $875.00 10 CONNECT TO EXISTING 8"W.L.STUB OUT 2 EA $795.00 $1,590.00 2 $1,590.00 11 CONNECT TO EXISTING 12"W.L.STUB-OUT 1 EA $795.00 $795.00 l $795.00 12 1"IRRIGATION WATER SERVICE(CO#1) 1 EA $820.00 $820.00 1. $820.00 13 4"CONDUIT PVC SCH 40(CO#1) 100 LF $14.00 $1,400.00 100 $1,400.00 ---------------------------------------- Sub-Total of Previous Unit $324,241.00 $324,241.00 SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ----------------------------------------- 1 -----_— _- .------------------------------- 1 8"SDR-26 PVC SEWER PIPE 5666 LF $48.50 5274,801.00 5666 $274,801.00 2 CONNECT TO EXISTING STUB-OUT I EA $800.00 $800.00 1 $800.00 3 SDR-26 4"SEWER SERVICES 152 EA $1,215.00 $184,680.00 152 $184,680.00 4 4'STD DIA MANHOLE 21 EA $4,900.00 $102,900.00 21 $102,900.00 5 4'EXTRA DEPTH MANHOLE 69 VF $380.00 $26,220.00 69 $26,220.00 6 8"PVC SEWER PIPE CSS BACKFILL 152 LF $76.00 $11,552.00 152 $11,552.00 7 END&PLUG 2 EA $25.00 $50.00 2 $50.00 8 TRENCH SAFETY 5666 LF $1.00 $5,666.00 5666 $5,666.00 Sub-Total of Previous Unit $606,669.00 $606,669.00 Friday,September 14,2018 Page 2 of 4 City Project Numbers 100533 DOE Number 0533 Contract Name WATERSBEND SOUTH PHASE 2A Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 9/7/2018 Project Funding Contract Information Summal��y Original Contract Amount $928,690.00 Change Orders Change Order Number 1 $2,220.00 Total Contract Price $930,910.00 Total Cost of Work Completed $930,910.00 Less %Retained $0.00 Net Earned $930,910.00 Earned This Period $930,910.00 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 $930,910.00 Friday,September 14,2018 Page 3 of 4 G m ) \ \ § \ / a 2 Cl) > 0 _0 0 0 � / ° i Q 2 > ° © / m » j m \ > / 0 4 m m \ \ § ) § § ® q % © ] ~ m c ; G -u / \ 2 ) ® 0 $ / C- / \ ) m 0 § \ t m m o 0 m a > m { Cf) \ j \ \ ` G) \ / \ \ S § § \ m 2 # # \ Fes ; om 2 20 t 3 z - R > $ \ } e \ & / < m m ) § \ } n q n \ 2 8 a \ / / S « i g » J / 0 2 m 2 / ƒ r 0 / / c $ / ) _ Nj (31 10 & 2 [ CD Cl \ ° \ > _ \ 0 ° ° \ / 2 0 ; q ; { { ; 6 \ y > r ? _ 2 \ ff § / 0 O / \ C> § �/ ^ ~ # \ , m > � 2 qz _ § § z g § � [ { § S e m ] § ( < x , co > 0 ! [ � � k � g � / ©§a \ n § § k(2 a 2 ` 2 d ( m ( ! CRr / mmo k � o§n §§] ( 2 e \ §\ _ 2e \ 0 2 = J el n ; )2 Q9\ J an ; R ; R 72 P §kms a §® �k kms) Q -sc m ]g§ 2 n#� _ G 7 : fn ° I g 2 I � � ( n Q � \ / �k\ § / k�kk 8� FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Watersbend South Ph.2A PROJECT NUMBER: 100533 DOE NUMBER: WATER PIPE LAID SIZE TYPE OF PIPE LF C900-DR14 12" PVC 840 C900-DR14 8" PVC 3770 FIRE HYDRANTS: 5 VALVES(16"OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes NEW SERVICES: I" Copper 104 EA. SEWER PIPE LAID SIZE TYPE OF PIPE LF SDR 26 8" PVC 5666 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes NEW SERVICES: 4" PVC 152 EA. TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000'nirockmorton Street•Fort Worth,TX 76012-6311 d (817)392-7941 •Fax:(817)392-7845 @JACKSON CONSTRUCTION LTD. 5112 SUN VALLEY DRIVE FORT WORTH,TX 76119 TEL:817-572-3303 FAX:817-478-0443 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 Troy L. Jackson, President Of Jackson Construction, Ltd,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; Watersbend South PH 2A BY Troy VJackson,President Subscribed and sworn before me on this date 31 st of August, 2018. Notary Public Tarrant,Texas CARMEN L.ESTEP Notary Public,state of Texas - comm.Expires 04-06-2020 Y Notar ID 2910611 nan�a CONSENT OF SURETY OWNFR 4 TO FINAL PAYMENT AMMTECT o .AIADocuntera G707 CONTRACTOR Q SURETY 91 Bond No. BCD1054921 OTR D TO OWNER: ARC=crs PROJECT gvmnrandaddressj Lackland Holdings, LLC 3045 Lackland Rd. CONTRAC`!'FOR Water and Sewer Improvements Fort Worth TX 76116 FROJRCT: CONTRACT DATED: {A6aiuemutad�� Watersbend South Phase 2A In accordance with the provisions of the Contract between the Owner and the Coaa=crc as indicated above,the answ name and mwrw q'smrc!r) The Hanover Insurance Company 440 Lincoln Street Worcester MA 01653 SUW-q"Y, on bond of {Jason name and addmz gfConrraoar) Jackson Construction, Ltd. 5112 Fzun Valley Drive r ort Vwrth TX 76119 CONTRACTOR, hereby approves of the finai payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (itm'rnammdaddrmofowner) Lackland Holdings, LLC 3045 Lackland Rd. Fort Worth TX 76116 OWNER, as set huTh in said Surety's bona. IN wmgmS WHEREOF,the Surety has hereunto set its hand on this date: August 27, 2018 r)nwait,&.9**Vawmomrbfdkxadbrdkmanerkdawand varJ The Hanover Insurance Company {Strnw.r) � By: aurboNzcd rrprx�nran2r) Attest: ,. Jack M Crowley Attorney-in-Fact rAi�rted rmxxeaixrtir)r) Surety Phone No. 508-853-7200 x-4476 0707-1994 a THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWER OF ATTORNEY 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. KNOW ALL PERSONS BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,(hereinafter individually and collectively the"Company")does hereby constitute and appoint, Steven R.Foster,Jack M.Crowley and/or Tonie Petranek Of Willis of Texas,Inc.of Dallas,TX each individually,if there be more than one named,as its true and lawful attorneys)-in-fact to sign,execute,seal, acknowledge and deliver for,and on its behalf,and as its act and deed any place within the United States,any and all surety bonds,recognizances, undertakings,or other surety obligations.The execution of such surety bonds,recognizances,undertakings or surety obligations,in pursuance of these presents,shall be as binding upon the Company as if they had been duly signed by the president and attested by the secretary of the Company,in their own proper persons.Provided however,that this power of attorney limits the acts of those named herein;and they have no authority to bind the Company except in the manner stated and to the extent of any limitation stated below: Any such obligations in the United States,not to exceed Thirty Five Million and Noll 00($35,000,000)in any single instance That this power is made and executed pursuant to the authority of the following Resolutions passed by the Board of Directors of said Company,and said Resolutions remain in full force and effect: RESOLVED: That the President or any Vice President, in conjunction with any Vice President, be and they hereby are authorized and empowered to appoint Attomeys-in-fact of the Company,in its name and as it acts,to execute and acknowledge for and on its behalf as surety, any and all bonds,recognizances,contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with power to attach thereto the seal of the Company.Any such writings so executed by such Attomeys-in-fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons. RESOLVED:That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed by the President or Vice President in conjunction with any Vice President of the Company,shall be binding on the Companyto the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile. (Adopted October 7,1981—The Hanover Insurance Company;Adopted April 14,1982—Massachusetts Bay Insurance Company;Adopted September 7,2001—Citizens Insurance Company of America) IN WITNESS WHEREOF,THE HANOVER INSURANCE COMPANY,MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested by two Vice Presidents,this 12th day of February,2018. The;rianover Insurance Company The Hanauer Insurance Camp." Massachusetts Bay.insurance Company Massachusetts Say:InsuranCa Company Cd zens Insurance Company of America Citizens Insurance Campany-f Arne a John C.Roche,EVP andPresident 3arnesH.Kawiecki, Vior President THE COMMONWEALTH OF MASSACHUSETTS } COUNTY OF WORCESTER )ss. On this 1 e day of February,2018 before me came the above named Vice Presidents of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known to be the individuals and officers described herein,and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay insurance Company and Citizens Insurance Company of America,respectively,and that the said corporate seals and their signatures as officers were duty affixed and subscribed to said instrument by the authority and direction of said Corporations. oiAMrt J.r+►mwo eorr9itrarwwrau w Gtirwinlw iaoYw Da—1. NOWY Public Yana A=W My Cwrumssion r- pini March 4.2022 I,the undersigned Vice President of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further ceaifythat the said Powers of Attorney are still in force and effect. GIVEN un_dermy handarO the seals of said Companies,at Worcester,Massachusetts,this 27thday of August,2018 CERTIFIES COPY --'� ;r Ihirodoop:U hlmninei,Vice PrL.4dcut,. F�zrRuc n. •--- Watersbend South Ph 2A CPN _ . p44. ' - 100533 W&S rm Adobe Sign Document History 10/08/2018 -- - Created: 09/17/2018 By: Etta Bacy(etta.bacy@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAAmNKyJiVOrjJVelyvfleB7dN89gnhvShC "Watersbend South Ph 2A CPN 100533 W&S" History Q Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 09/17/2018-9:11:50 AM CDT-IP address:209.194.29.100 Document emailed to Carmen Estep (steveh@jacksontx.net)for signature 09/17/2018-9:15:33 AM CDT Document viewed by Carmen Estep (steveh@jacksontx.net) 09/24/2018-9:16:52 AM CDT-IP address:75.140.225.246 (91 Carmen Estep(steveh@jacksontx.net) uploaded the following supporting documents: (0/ File Attachment 1 & File Attachment 2 09/24/2018-4:07:34 PM CDT & Document e-signed by Carmen Estep (steveh@jacksontx.net) Signature Date:09/24/2018-4:07:34 PM CDT-Time Source:server-IP address:75.140.225.246 C'Y Document emailed to Matt Cain (mcain@multatech.com)for signature 09/24/2018-4:07:36 PM CDT Document viewed by Matt Cain (mcain@multatech.com) 10/03/2018-7:08:42 AM CDT-IP address:209.194.29.100 Document e-signed by Matt Cain (mcain@multatech.com) Signature Date: 10/03/2018-7:09:07 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Edward Davila (edward.davila@fortworthtexas.gov)for approval 10/03/2018-7:09:08 AM CDT Document viewed by Edward Davila (edward.davila@fortworthtexas.gov) 10/03/2018-10:58:05 AM CDT-IP address:209.194.29.100 FoRJ, < ; Adobe Sign drl Document approved by Edward D'avila (edward.davila@fortworthtexas.gov) Approval Date:10/03/2018-11:02:55 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Fred Ehia (freidoon.ehia@fortworthtexas.gov)for signature 10/03/2018-11:02:57 AM CDT i Document viewed by Fred Ehia (freidoon.ehia@fortworthtexas.gov) 10/03/2018-11:03:39 AM CDT-IP address:209.194.29.100 6Q Document e-signed by Fred Ehia (freidoon.ehia@fortworthtexas.gov) Signature Date:10/03/2018-11:15:48 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales Qanie.morales@fortworthtexas.gov)for signature 10/03/2018-11:15:49 AM CDT Document viewed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) 10/03/2018-11:18:13 AM CDT-IP address:209.194.29.100 6a Document e-signed by Janie Scarlett Morales Oanie.morales@fortworthtexas.gov) Signature Date:10/03/2018-11:18:56 AM CDT-Time Source:server-IP address:209.194.29.100 C'-1 Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/03/2018-11:18:58 AM CDT Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/04/2018-8:50:09 AM CDT-IP address:209.194.29.100 t5a Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date: 10/04/2018-8:50:31 AM CDT-Time Source:server-IP address:209.194.29.100 C'y Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/04/2018-8:50:33 AM CDT Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/04/2018-4:07:40 PM CDT-IP address:209.194.29.100 b@ Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:10/04/2018-4:08:35 PM CDT-Time Source:server-IP address:209.194.29.100 Ley Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 10/04/2018-4:08:37 PM CDT Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 10/05/2018-6:55:36 AM CDT-IP address:209.194.29.100 6a Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:10/05/2018-6:56:02 AM CDT-Time Source:server-IP address:209.194.29.100 Foxy Adobe Sign E-1> Document emailed to JAGeho oulie.geho@fortworthtexas.gov)for delivery 10/05/2018-6:56:03 AM CDT Document viewed by JAGeho oulie.geho@fortworthtexas.gov) 10/05/2018-7:51:25 AM CDT-IP address:209.194.29.100 �. Document receipt acknowledged by JAGeho oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date: 10/05/2018-7:51:37 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Monica De Anda (monica.deanda@fortworthtexas.gov)for delivery 10/05/2018-7:51:38 AM CDT Document viewed by Monica De Anda (monica.deanda@fortworthtexas.gov) 10/08/2018-2:22:02 PM CDT-IP address:209.194.29.100 d Document receipt acknowledged by Monica De Anda (monica.deanda@fortworthtexas.gov) Receipt Acknowledgement Date:10/08/2018-2:22:10 PM CDT-Time Source:server-IP address:209.194.29.100 E� Document emailed to Sylvia Kelley (tpwcfafiscal@fortworthtexas.gov)for delivery 10/08/2018-2:22:11 PM CDT l Document viewed by Sylvia Kelley(tpwcfafiscal@fortworthtexas.gov) 10/08/2018-2:32:24 PM CDT-IP address:209.194.29.100 6� Document receipt acknowledged by Sylvia Kelley(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:10/08/2018-2:32:35 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Fred Ehia (freidoon.ehia@fortworthtexas.gov), Monica De Anda (monica.deanda@fortworthtexas.gov), Edward D'avila (edward.davila@fortworthtexas.gov), Trudy Brotherton (therese.brotherton@fortworthtexas.gov), and 8 more 10/08/2018-2:32:35 PM CDT Fox J, Adobe Si Sign