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Contract 50137-FP2
City Secretary Contract No. 50137 -FP2 FORTWORTH, Date Received Oct 5,2018 ) 01ogc) 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: Morningstar Section 6 Phase 3 City Project No.: 101090 Improvement Type(s): ® Paving ❑ Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $398,250.75 Amount of Approved Change Order(s): Revised Contract Amount $398,250.75 Total Cost of Work Complete: $398,250.75 Saw Oct 3,2018 Contractor Date President Title JLB Contracting, LLC Company Name HA-big-r Oct 4 2018 H,bt, OC4,20191 Project Inspector Date Oct 5�2018 Ca[ cF 9diey!Gct S,20`F Project Manager Date 47V14 cf4pi tci�v'haw Oct 5 2018 Janie Scarlett Morales(Oct S.2018) CFA Manager Date su'ar>„4lasrc- Oct 5 2018 Susan Alan is(Oct S.20181 a Asst. City Manager Date OFFICIAL RECORD Page 1 of 2 CITY SECRETARY o��SGQ�P��c FT. WORTH,TX G c��Ls Notice of Project Completion Project Name: Morningstar Section 6 Phase 3 City Project No.: 101090 City's Attachments Final Pay Estimate Change Order(s): ❑ Yes © N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 60 CD Days Charged: 60 Work Start Date: 2/12/2018 Work Complete Date: 9/20/2018 Page 2 of 2 I ()I Da 0 City Project Numbers 101090 DOE Number 1090 Contract Name MORNINGSTAR-SECTION 6 PHASE 3 Estimate Number I Contract Limits Payment Number 1 Project Type PAVING For Period Ending 920/2013 Project Funding Project Manager NA City Secretary Contract Number Inspectors MILLER,W / RAINES Contract Date 1/30/2018 Contractor JLB CONTRACTING,L.L.C. Contract Time 60 CD PO BOX 24131 Days Charged to Date 60 CD FORT WORTH, TX 76 124-1 13 1 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 $398,250.75 Less %Retained $0.00 Net Earned $398,250.75 Earned This Period $398,250.75 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 $398,250.75 Tuesday,October 2,2018 Page 4 of 4 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name MORNINGSTAR-SECTION 6 PHASE 3 Contract Limits Project Type PAVING City Project Numbers 101090 DOE Number 1090 Estimate Number 1 Payment Number I For Period Ending 9/20/2018 CD City Secretary Contract Number Contract Time 6G:D Contract Date 1/30/2018 Days Charged to Date 60 Project Manager NA Contract is 100.00 Complete Contractor JLB CONTRACTING,L.L.C. PO BOX 24131 FORT WORTH, TX 76124-1131 Inspectors MILLER,W / RAINES Tuesday,October 2,2018 Page I of 4 City Project Numbers 101090 DOE Number 1090 Contract Name MORNINGSTAR-SECTION 6 PHASE 3 Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 9/20/2018 Project Funding UNIT IV:PAVING IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --- - - --------------------------------------- 1 6"CONC PVMT 8197 SY $41.75 $342,224.75 8197 $342,224.75 2 6"LIME TREATMENT 8730 SY $2.10 $1.8,333.00 8730 $18,333.00 3 HYDRATE LIME 131 TN $165.00 $21,615.00 131 $21,615.00 4 BARRIER FREE RAMP TYPE R-I 6 EA $1,218.00 $7,308.00 6 $7,308.00 5 BARRIER FREE RAMP TYPE M-2 1 EA $1,145.00 $1,145.00 1 $1,145.00 6 FURNISH&INSTALL GROUND MOUNT POST I 1 EA $475.00 $5,225.00 11 $5,225.00 W/STOP&DIRECTIVE 7 STREET NAME PLATES FOR STREET 16 EA $150.00 $2,400.00 16 $2,400.00 INTERSECTION(4-BLADES) -------------------------------------- Sub-Total of Previous Unit $398,250.75 $398,250.75 -------------------------------------- Tuesday,October 2,2018 Page 2 of 4 City Project Numbers 101090 DOE Number 1090 Contract Name MORNINGSTAR-SECTION 6 PHASE 3 Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 920/2018 Project Funding Contract Information Summary Original Contract Amount $398,250.75 Change Orders Total Contract Price $398,250.75 Total Cost of Work Completed $398,250.75 Less %Retained $0.00 Net Earned $398,250.75 Earned This Period $398,250.75 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 $398,250.75 Tuesday,October 2,2018 Page 3 of 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; Morningstar Section 6 Phase 3 — City Project No. 101090 BY �---s— -----" Sam Davis President JLB Contracting, LLC A Subscribed and sworn before me on t d y o 2018. iuuq, JAMIE CREENWAY t _ 1z Notary Public,State of Texas °. T= Comm.Expires 09-25-2020 Notary ID 1211545-4 TA PU LIC IN AN OR AR NT COUNTY,TEXAS My commission expires CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ TO FINAL PAYMENT S cTOR OTHER (SIMILAR TO AIA DOCUMENT G707) Bond No. 8966725 PROJECT: Paving Improvements to serve Morningstar- Section 6, Phase 3 (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 76IO2 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 insert name and address ofSumtyCompany) Westfield Insurance Company 555 Republic Drive, Suite 450 Plano, Texas 75074 ,SURETY COMPANY, on bond of(here insert name and add=s 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(here insert name 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 September 2018 WFS FIELD INSURANCE NCE COMPANY Surety Company B Signature of KP&fa entative Attest: (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,Current Edition i' 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 C . Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a -Company- and collectively as -Companies,- duly 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,sealed with the corporate seal of the applicable Company and duly attested by its Secretary,hereby ratifying and confirming all that the said Attorneys)-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 01110 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 Attorney(s)-in-Fact to represent 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 8,2000). 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 e^~•"""Y'W"M .„a,"a•"•• ,.....+••ua...•. r� tL�.Uif.(N %%NAL j Asa a WESTFIELD INSURANCE COMPANY Seals �r��,...• •.;qP •��o.• WESTFIELD NATIONAL INSURANCE COMPANY °tft �o'_ a' ipi Z_ ' CHI� •�� OHIO FARMERS INSURANCE COMPANY 4 '` 'UL 1 ro :LL: SEAL . State of Ohio .."' """""•'" 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 duty 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 seals 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 •-""•"""• Seal .`* Affixed `.... William J. Kahelin,A rney at Law,Notary Public Stats:of Ohio J 0 My Commission Does Not Expire(Sec.147.03 Ohio Revised Code) County of Medina ::s.: '� 4 `, TC O F I,Frank A.Carrino,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 Companles,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 effect. to Witness Whereof, I have hereunto set my hand and affixed the seats of said Companies at Westfield Center. Ohio, this 9th day of September A"•°I,.,,,, 2018 ,, �....,. 1 .� SUft `�oN r "`•• �„y ler• k��` ?A�,.. ^�:ysG �r�glllS�11P,f, SEAL 'm- _ rCFti�RTfR�j: Jam./� t S,tia A ? :n =�': :,vs= r secr Bary ,k•:� ran �*� ,-O, �•;•I848,• Frank A.Carrina, Secretary BPOAC2 (combined)(06-02) Green Sheet Morningstar Section 6 Phase 3 CPN 101090 Paving ----- Adobe Sign Document History 10/17/2018 Created: 10/03/2018 ----------- By: Etta Bacy(etta.bacy@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAA7y8uDMKnTp8BzZclBaf6z-fNmn-tKvZn "Green Sheet Morningstar Section 6 Phase 3 CPN 101090 Pavi ng" History Document created by Etta Bacy(efta.bacy@fortworthtexas.gov) 10/03/2018-7:20:26 AM CDT-IP address:209.194.29.100 E41 Document emailed to siuchman@jlbcontracting.com for signature 10/03/2018-7:24:32 AM CDT EZ. Email sent to sluchman@jlbcontracting.com bounced and could not be delivered 10/03/2018-7:24:57 AM CDT r0l Etta Bacy(efta.bacy@fortworthtexas.gov) replaced signer sluchman@jlbcontracting.com with Sam Davis (sdavis@jlbcontracting.com) 10/03/2018-1:50:04 PM CDT-IP address:209.194.29.100 Document emailed to Sam Davis (sdavis@jlbcontracting.com)for signature 10/03/2018-1:50:04 PM CDT Email sent to sluchman@jibcontracting.com bounced and could not be delivered 10/03/2018-1:50:13 PM CDT Document viewed by Sam Davis (sdavis@jlbcontracting.com) 10103/2018-2:53:45 PM CDT-IP address:64.233.172.157 CO/ Sam Davis (sdavis@jlbcontracting.com) uploaded the following supporting documents: Chi File Attachment 1 File Attachment 2 10/03/2018-3:12:41 PM CDT FORTWORTH. Adobe Sign d Document e-signed by Sam Davis (sdavis@jlbcontracting.com) Signature Date:10/03/2018-3:12:41 PM CDT-Time Source:server-IP address:47.51.207.250 Document emailed to Habte Taezaz(habte.taezaz@fortworthtexas.gov)for signature 10/03/2018-3:12:43 PM CDT CZ- Email sent to Sam Davis (sdavis@jlbcontracting.com) bounced and could not be delivered 10/03/2018-3:13:07 PM CDT Document viewed by Habte Taezaz(habte.taezaz@fortworthtexas.gov) 10/04/2018-7:30:27 AM CDT-IP address:209.194.29.90 c Document e-signed by Habte Taezaz(habte.taezaz@fortworthtexas.gov) Signature Date: 10/04/2018-7:31:22 AM CDT-Time Source:server-IP address:209.194.29.90 Document emailed to Ariel Duarte (ariel.duarte@fortworthtexas.gov)for approval 10/04/2018-7:31:24 AM CDT Document viewed by Ariel Duarte(ariel.duarte@fortworthtexas.gov) 10/04/2018-10:10:55 AM CDT-IP address:209.194.29.100 Cap Document approved by Ariel Duarte (ariel.duarte@fortworthtexas.gov) Approval Date: 10/04/2018-10:11:57 AM CDT-Time Source:server-IP address:209.194.29.100 Cb Document emailed to Patrick Buckley (patrick.buckley@fortworthtexas.gov)for signature 10/04/2018-10:11:58 AM CDT Document viewed by Patrick Buckley(patrick.buckley@fortworthtexas.gov) 10/05/2018-11:14:39 AM CDT-IP address:209.194.29.100 CSQ Document e-signed by Patrick Buckley (patrick.buckley@fortworthtexas.gov) Signature Date:10/05/2018-11:14:57 AM CDT-Time Source:server-IP address:209.194.29.100 C'► Document emailed to Janie Scarlett Morales Qanie.morales@fortworthtexas.gov)for signature 10/05/2018-11:14:58 AM CDT Document viewed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) 10/05/2018-11:56:56 AM CDT-IP address:209.194.29.100 bo Document e-signed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) Signature Date:10/05/2018-11:58:16 AM CDT-Time Source:server-IP address:209.194.29.100 E7- Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/05/2018-11:58:18 AM CDT ''2j Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/05/2018-3:14:29 PM CDT-IP address:209.194.29.100 Foxe I Adobe Sign Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:10/05/2018-3:14:42 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/05/2018-3:14:42 PM CDT � Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/05/2018-4:55:02 PM CDT-IP address:209.194.29.100 bo Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:10/05/2018-4:55:28 PM CDT-Time Source:server-IP address:209.194.29.100 C'. Document emailed to therese.brotherton@fortworthtexas.gov for delivery 10/05/2018-4:55:29 PM CDT Etta Bacy(etta.bacy@fortworthtexas.gov) replaced certified recipient therese.brotherton@fortworthtexas.gov with Zelalem Arega. Okay for final (Zelalem.Arega@fortworthtexas.gov) 10/11/2018-6:21:31 AM CDT-IP address:209.194.29.100 E'14 Document emailed to Zelalem Arega. Okay for final (Zelalem.Arega@fortworthtexas.gov)for delivery 10/11/2018-6:21:32 AM CDT Document viewed by Zelalem Arega. Okay for final (Zelalem.Arega@fortworthtexas.gov) 10/17/2018-2:56:37 PM CDT-IP address:209.194.29.100 a Document receipt acknowledged by Zelalem Arega. Okay for final (Zelalem.Arega@fortworthtexas.gov) Receipt Acknowledgement Date: 10/17/2018-2:56:58 PM CDT-Time Source:server-IP address:209.194.29.100 C'. Document emailed to Julie A Geho Oulie.geho@fortworthtexas.gov)for delivery 10/17/2018-2:56:59 PM CDT Document viewed by Julie A Geho Qulie.geho@fortworthtexas.gov) 10/17/2018-3:23:10 PM CDT-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:10/17/2018-3:23:24 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Monica De Anda (monica.deanda@fortworthtexas.gov)for delivery 10/17/2018-3:23:25 PM CDT v Document viewed by Monica De Anda (monica.deanda@fortworthtexas.gov) 10/17/2018-4:45:15 PM CDT-IP address:209.194.29.100 Document receipt acknowledged by Monica De Anda (monica.deanda@fort worthtexas.gov) Receipt Acknowledgement Date:10/17/2018-4:45:23 PM CDT-Time Source:server-IP address:209.194.29.100 '. Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 10/17/2018-4:45:24 PM CDT FORTWORTH. Adobe Sign Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 10/17/2018-5:06:56 PM CDT-IP address:209.194.29.100 Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:10/17/2018-5:07:08 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Habte Taezaz(habte.taezaz@fortworthtexas.gov), Ariel Duarte (ariel.duarte@fortworthtexas.gov), Janie Scarlett Morales (Janie.morales@fortworthtexas.gov), Susan Alanis (susan.alanis@fortworthtexas.gov), and 10 more 10/17/2018-5:07:08 PM CDT Fox Jo Adobe Sign