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Contract 49621-FP2
City Secretary Contract No. 49621 -FP2 FORTWORTH, Date Received Oct 4,2018 { 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: CVS STORE#10879 City Project No.: 100687 Improvement Type(s): ® Paving ❑ Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $62,325.00 Amount of Approved Change Order(s): Revised Contract Amount: $62,325.00 Total Cost of Work Complete: $62,325.00 (519be hiV-Iwah Oct 2, 2018 Gabe Hannan 10-17.2018) Contractor Date President Title Harman Construction, Inc. Company Name Oct 3,2018 Man caln rnc7 2olsi Project Inspector Date Aaron Lone(Oct 3,2018) Oct 3,2018 Project Manager Date ,7,M4 2 ylete 1t1,5Mkf Oct 3 2018 -. J-ie$ lett M-111,(Oct 7.20181 7 CFA Manager Date S '`UVtzy Oct 4,2018 Su:an♦lams(Oct 4,2018) Asst. City Manager Date 1CIAL RECORD RECEfVED LFT. IITY 3 Cp,2T Ry F ORT , �,� Page 1 of 2 OCT -9 2018 CITY OFFORT WORTH CIiYSECRTARY i Notice of Project Completion Project Name: CVS STORE#10879 City Project No.: 100687 ' i City's Attachments Final Pay Estimate Change Order(s): ❑ Yes ❑x N/A Contractor's Attachments Affidavit of Bills Paid i Consent of Surety , i Statement of Contract Time Contract Time: 154 CD Days Charged: 210 Work Start Date: 2/27/2018 Work Complete Date: 9/24/2018 �i I !I I� Page 2 of 2 City Project Numbers 100687 DOE Number 1006 Contract Name CVS 10879 HERITAGE TRACE&HARMON Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 9/24/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors CORDOVA / CAIN Contract Date 12/8/2017 Contractor HARMAN CONSTRUCTION,INC. Contract Time 154 CD 1633 ROGERS RD Days Charged to Date 210 CD FORT WORTH, TY 76107 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 $62,325.00 Less %Retained $0.00 Net Earned $62,325.00 Earned This Period $62,325.00 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 $62,325.00 Tuesday,October 2,2018 Page 4 of 4 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name CVS 10879 HERITAGE TRACE&I-IARMON Contract Limits Project Type PAVING City Project Numbers 100687 DOE Number 1006 Estimate Number I Payment Number 1 For Period Ending 9/24/2018 CD City Secretary Contract Number Contract Time 15,CD Contract Date 12/8/2017 Days Charged to Date 210 Project Manager NA Contract is 100.00 Complete Contractor HARMAN CONSTRUCTION,INC. 1633 ROGERS RD FORT WORTH, TX 76107 Inspectors CORDOVA / CAIN Tuesday,October 2,2018 Page 1 of 4 City Project Numbers 100687 DOE Number 1006 Contract Name CVS 10879 HERITAGE TRACE&HARMON Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 9/24/2018 Project Funding UNTF 4:PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ----------------------------------------- 1 4"ASPHALT BASE TYPE B 806 SY $30.00 $24,180.00 806 $24,180.00 2 2"ASPHALT PVMT TYPE D 806 SY $15.00 $12,090.00 806 $12,090.00 3 HYDRATED LIME 78 TN $120.00 $9,360.00 78 $9,360.00 4 8"LIME TREATMENT 863 SY $4.00 $3,452.00 863 $3,452.00 5 REMOVE CONC CURB&GUTTER 167 167 LF $4.00 $668.00 167 $668.00 6 TRAFFIC CONTROL I MO $8,000.00 $8,000.00 1 $8,000.00 7 SWPP 1 ACRE I LS $3,500.00 $3,500.00 1 $3,500.00 8 JOINT SEALANT 430 LF $2.50 $1,075.00 430 $1,075.00 --------------------------------- ----- ---- Sub-Total of Previous Unit $62,325.00 $62,325.00 ----------------------------------- Tuesday,October 2,2018 Page 2 of 4 City Project Numbers 100687 DOE Number 1006 Contract Name CVS 10879 HERITAGE TRACE&HARMON Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 9/24/2018 Project Funding Contract Information Summary Original Contract Amount $62,325.00 Chante Orders Total Contract Price $62,325.00 Total Cost of Work Completed $62,325.00 Less %Retained $0.00 Net Earned $62,325.00 Earned This Period $62,325.00 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 $62,325.00 Tuesday,October 2,2018 Page 3 of 4 AFFIDAVIT OF BILLS PAID STATE OF TEXAS COUNTY OF TAI2RANT KNOW ALL MEN BY THESE PRESENTS: Personally, before me the undersigned authority, on this day appeared Gabe Harman who being duly sworn on oath, says that he is a legal representative of Harman Construction, Inc. and that the contract for the construction of the project, designated as: CVS 10879 Heritage Trace&Harmon(Paving)City Project Number 100687 has been satisfactorily completed and that all bills for materials, apparatus, fixtures , machinery, labor, and equipment used in connection with the construction of this project have been fully paid (74L . s Title Sworn to and subscribed before me this,the 2nd day of October, 20 18. ELIZABETH SANTIAGO etey,v __ n,Rw. i Notary Publ(C,state or Texas Not P is in and for ./1.•'� My commission Expires September 17, 2019 Tarrant County,Texas Instructions: If the developer or contractor is an individual, he/she shall sign the affidavit. If the developer or contractor is a partnership, any partner may sign the affidavit. If the developer or contractor is a corporation, a person authorized by the by-laws of by the Board of Directors shall sign the affidavit and a corporate resolution must accompany the affidavit showing such authority. If the developer or contractor is a joint-venture of partnerships, or of individuals and partnerships, the affidavit may be signed by the individual or any partner of the partnership accompanied by proof of authority. If the developer is or contractor is a joint-venture in which a corporation is a party, separate affidavits must be executed in the name of the joint-venture: one by each corporation and one by each individual or partnership accompanied by proof of authority. CONSENT OF OWNER SURETY COMPANY ARCHITECT TO FINAL PAYMENT CONTRACTOR SURETY OTHER AIA DOCUMENT G707 Bond#106421806 PROJECT: Presidio Village, Fort Worth TO(Owner) Cityof Fort Worth ARCHITECT'S PROJECT NO: 100687 200 Texas St. CONTRACT FOR: Water Sewer Paving&Drainage Fort Worth,TX 76102 CONTRACT DATE: 12/8/2017 L CONTRACTOR: Harman 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) Travelers Casualty and Surety Company of America 1301 E Collins Blvd.Ste 111C, Richardson,TX 75081 SURETY COMPANY, On bond Of(here insert name and address of Contractor) Harman Construction, Inc. 1633 Rogers Rd., Fort Worth,TX 76107 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) City of Fort Worth 200 Texas St., Fort Worth,TX 76102 OWNERS, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 21st day of September,2018. Travelers Casualty and Surety Company of America Signature of Authori ed Representative Attest: (Seal): Katie Rogers,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 I AIA DOCUMENT G707•CONSENT OF SURETY COMPANY TO FINAL PAYMENT•APRIL 1970 EDITION•AIA© ONE PAGE ©1970•THE AMERICAN INSTITUTE OF ARCHITECTS.1735 NEW YORK AVE.,NW,WASHINGTON,D.C.20006 1 WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER PONVER OF ATTORNEY TRAVELERS J� Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company t 1 Attorney-In Fact No. 231686 Certificate No. 007284071 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company,St.Paul Fire and.Marine Insurance Company, St. Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United Slates Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organizul under the laws of the State of Wisconsin(herein collectiveiv called the"Companies").and that the Companies do hereby make,constitute and appoint Gary B.McElroy,Tracy L.Miller,Alicia Grumbles,James R.Reid,William Mitchell Jennings,and Katie Rogers of the City of Fort Worth State of Texas their true and lawful Attorney(s)-in-Fact, f; each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances.conditional tmdertakings and 6 other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 30th day of June 2017 Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company ww ph5U _uWtT�� Y,tAE 4"W .�T1� Ik 1rvSV�� T'�AN �4 _c�1TY,�/� �Q?'aPPOq� i (>J •�O t I f�'GIIPO,M 1 ,i4:' V•u u.3t' '"o o s .., MUAPOrJQEO�' � �l� Air+;so, IW;cPaeoAArfy � 3 ,<W� yzi t982 0 1 j977 =;~s' �E i^'I If! n'i W HARTFORn, ri4RTFof�,�l 7898 Z�4_� S L � ! � a 1957 � �^ �`•5ERL ori tai � CONN. n '+�i Cam J? �'�i ry_ ,,w �� 7th "`',��".cti ti:S..;A� <r-• ��` bi ,,.� . +'�` �fJ AtN� State of Connecticut }3} t City of Hartford ss. Robert L.Rancy,Senior Vice President On this the 30t11 day of June 20 1 ,before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do.executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. Cr•jE7' In Witness Whereof,l hereunto set my hand and official seal. &AAA ' My Commission expires the 30th day of June,2021. ��1IBUG * ptaric C.'I'eneault,Notary Public 58440-5-16 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company.Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's sea]bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is tiled in the office of the Secretary;and it is FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond,recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the'President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and scaled with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President, any Assistant Vice President,any Secretary,any Assistant Secretary,and the sea]of the Company may be affixed by facsimile to.any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I,Kevin E.Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company ofAmerica,and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which is in full'force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this V^>� day of U� 20 . Kevin E.Hughes..Assistant Secittaty GAS � VF�t 4� AMAIN y `'�Mgl, ySY 4q yl�j 2 0 � $ + ` -r �O. 9 J,•.........,?y a sc ,}�c\ ~082'0 "� 1.9i/ �tCORPpgAttp � � T ��ORv^q4>�n PW iOpRPOFATf:•.�i�: a 'a 3 � ���� e Z? .n• a HARTFORD, nS4iF0R),.� < To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.travelersbond.com.Please refer to the Attorney-In-Fact number,the above-named individuals and the details of the bond to which the power is attached. i' I WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER .'-• -- Green Sheet CVS Store #10879 FORT 1�. � -_.- CPN 100687 Paving Adobe Sign Document History 10/08/2018 Created: 10/02/2018 By: Etta Bacy(etta.bacy@fortworthtexas.gov) ,�..._ .._.__. Status: Signed ~~ - Transaction ID: CBJCHBCAABAAURK7FIM--sXO[Xsxkkgk2g3WGL4dOCCn "Green Sheet CVS Store #10879 CPN 100687 Paving" History v Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 10/02/2018-12:30:10 PM CDT-IP address:209.194.29.100 Document emailed to Gabe Harman (gabe@harmanconstructioninc.net)for signature 10/02/2018-12:35:51 PM CDT �i Document viewed by Gabe Harman (gabe@harmanconstructioninc.net) 10/02/2018-12:54:01 PM CDT-IP address:24.178.221.10 G Gabe Harman (gabe@harmanconstructioninc.net) uploaded the following supporting documents: G File Attachment 1 File Attachment 2 10/02/2018-2:05:12 PM CDT G Document e-signed by Gabe Harman (gabe@harmanconstructioninc.net) Signature Date: 10/02/2018-2:05:12 PM CDT-Time Source:server-IP address:24.178.221.10 ;- Document emailed to Matt Cain (mcain@multatech.com)for signature 10/02/2018-2:05:15 PM CDT Document viewed by Matt Cain (mcain@multatech.com) 10/02/2018-7:28:47 PM CDT-IP address: 107.77.200.129 CS@ Document e-signed by Matt Cain (mcain@multatech.com) Signature Date:10/03/2018-7:06:50 AM CDT-Time Source:server-IP address:209.194.29.100 C'► Document emailed to Edward D'avila (edward.davila@fortworthtexas.gov)for approval 10/03/2018-7:06:52 AM CDT Document viewed by Edward Davila (edward.davila@fortworthtexas.gov) 10/03/2018-8:31:48 AM CDT-IP address:209.194.29.100 Foxes Adobe Sign C . Document approved by Edward D'avila (edward.davila@fortworthtexas.gov) Approval Date: 10/03/2018-8:36:43 AM CDT-Time Source:server-IP address:209.194.29.100 C'w Document emailed to Aaron Long (edward.long@fortworthtexas.gov)for signature 10/03/2018-8:36:52 AM CDT 5 Document viewed by Aaron Long (edward.long@fortworthtexas.gov) 10/03/2018-10:49:11 AM CDT-IP address:209.194.29.100 Document e-signed by Aaron Long (edward.long@fortworthtexas.gov) Signature Date:10/03/2018-10:49:24 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales (Janie.morales@fortworthtexas.gov)for signature 10/03/2018-10:49:25 AM CDT Document viewed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) 10/03/2018-10:57:19 AM CDT-IP address:209.194.29.100 6c, Document e-signed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) Signature Date:10/03/2018-10:57:46 AM CDT-Time Source:server-IP address:209.194.29.100 C' Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/03/2018-10:57:50 AM CDT �^ Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/04/2018-8:51:42 AM CDT-IP address:209.194.29.100 6r Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:10/04/2018-8:51:57 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/04/2018-8:51:59 AM CDT Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/04/2018-4:15:15 PM CDT-IP address:209.194.29.100 Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:10/04/2018-4:15:37 PM CDT-Time Source:server-IP address:209.194.29.100 C' Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 10/04/2018-4:15:39 PM CDT 5 Document viewed by Trudy Brotherton (therese.brotherton@fortworthfexas.gov) 10/05/2018-6:56:57 AM CDT-IP address:209.194.29.100 be. Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date: 10/05/2018-6:57:12 AM CDT-Time Source:server-IP address:209.194.29.100 FORTWORTH._ I Addoo: eoe✓ be Sign r: Document emailed to JAGeho Qulie.geho@fortworthtexas.gov)for delivery 10/05/2018-6:57:13 AM CDT Document viewed by JAGeho Qulie.geho@fortworthtexas.gov) 10/05/2018-7:50:16 AM CDT-IP address:209.194.29.100 b Document receipt acknowledged by JAGeho Qulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:10/05/2018-7:50:29 AM CDT-Time Source:server-IP address:209.194.29.100 �- Document emailed to Monica De Anda (monica.deanda@fortworthtexas.gov)for delivery 10/05/2018-7:50:30 AM CDT a` Document viewed by Monica De Anda (monica.deanda@fortworthtexas.gov) 10/08/2018-2:21:20 PM CDT-IP address:209.194.29.100 O4. Document receipt acknowledged by Monica De Anda (monica.deanda@fortworthtexas.gov) Receipt Acknowledgement Date:10/08/2018-2:21:30 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Sylvia Kelley (tpwcfafiscal@fortworthtexas.gov)for delivery 10/08/2018-2:21:31 PM CDT z Document viewed by Sylvia Kelley(tpwcfafiscal@fortworthtexas.gov) 10/08/2018-2:36:51 PM CDT-IP address:209.194.29.100 Gta Document receipt acknowledged by Sylvia Kelley(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:10/08/2018-2:37:04 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Gabe Harman (gabe@harmanconstructioninc.net), Etta Bacy (etta.bacy@fortworthtexas.gov), Aaron Long (edward.long@fortworthtexas.gov), Edward D'avila (edward.davila@fortworthtexas.gov), and 8 more 10/08/2018-2:37:04 PM CDT Ford Adobe Si Sign