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Contract 49220-FP1
City Secretary Contract No. 49220 -FP1 FORTWORTH, Date Received Oct 5,2018 10015-3-3 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): ® Paving ® Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $912,579.29 Amount of Approved Change Order(s): Revised Contract Amount: $912,579.29 Total Cost of Work Complete: $912,579.29 eitI5�,,�- Sep 24, 2018 Contractor Date Office Manager Title Jackson Construction,Ltd Company Name hue-ca"`' Oct 3,2018 Matt Gln{OK 3,10151 Project Inspector Date Oct 3, 2018 Project Manager Date 4;k&4&A P-4&4tIAf Janie Scw*U Morales(Oct S,101{ Oct 5) } 2018 CFA Manager Date sm&ALyu�:, Oct 5, 2018 Susan Manis(Oct 5,2010) Asst. City Manager Date Page 1 of 2 FT. W%-.-,rim w o., I—A i City Secretary Contract No. 49220 -FPI FORTWORTH, Date Received Oct 5,2018 Q pS33 i 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): ❑x Paving ❑x Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $912,579.29 Amount of Approved Change Order(s): Revised Contract Amount: $912,579.29 Total Cost of Work Complete: $912,579.29 61-99VSep 24, 2018 Carmen Estop(Sep 24,20h) Contractor Date Office Manager Title Jackson Construction,Ltd Company Name Ma (oo 8) Oct 3,2018 Project Inspector Date Oct 3, 2018 Project Manager Date 791fle SV491ttI AyaGer Oct 5, 2018 Janca ie Srlett.Mor ales(Oct 5,2018) CFA Manager Date Sw,n,,t,Aan Oct 5, 2018 , Alanis(Ocl i,2013) Asst. City Manager Date Page 1 of 2 Notice of Project Completion Project Name:WATERSBEND SOUTH PH. 2A City Project No.: 100533 1 City's Attachments Final Pay Estimate © i Change Order(s): ❑ Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety 0 Statement of Contract Time Contract Time: 180 CD Days Charged: 390 Work Start Date: 8/14/2017 Work Complete Date: 9/7/2018 Page 2 of 2 C i 9 loo — /00-5- City Project Numbers 100533 DOE Number 0533 Contract Name WATERSBEND SOUTH PHASE 2A Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN&PAVING For Period Ending 9/7/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / GREENWOOD Contract Date Contractor JACKSON CONSTRUCTION LTD Contract Time 180 CD 5112 SUN VALLEY DRIVE Days Charged to Date 390 CD FORT WORTH, TX 76119 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 $912,579.29 Less %Retained $0.00 Net Earned $912,579.29 Earned This Period $912,579.29 Retainage This Period $0.00 Less Liquidated Damages 0 Days a $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 $912,579.29 Friday,September 14,2018 Pagc 5 of 5 FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WATERSBEND SOUTH PHASE 2A Contract Limits Project Type STORM DRAIN&PAVING City Project Numbers 100533 DOE Number 0533 Estimate Number 1 Payment Number 1 For Period Ending 9/7/2018 CD City Secretary Contract Number Contract Time ISCD Contract Date Days Charged to Date 390 Project Manager NA Contract is 100.00 Complete Contractor JACKSON CONSTRUCTION LTD 5112 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors DICKINSON / GREENWOOD Friday,September 14,2018 Pagel of 5 City Project Numbers 100533 DOE Number 0533 Contract Name WATERSBEND SOUTH PHASE 2A Estimate Number 1 Contract Limits Payment Number 1 Project Type STORM DRAIN&PAVING For Period Ending 9/7/2018 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ———————————----——————————————————————————- 1 10'CURB INLET 2 EA $4,000.00 $8,000.00 2 $8,000.00 2 15'CURB INLET 6 EA $5,450.00 $32,700.00 6 $32,700.00 3 21"CLASS III RCP 235 LF $82.00 $19,270.00 235 $19,270.00 4 24"CLASS III RCP 291 LF $91.00 $26,481.00 291 $26,481.00 5 27"CLASS III RCP 462 LF $104.00 $48,048.00 462 $48,048.00 6 30"CLASS III RCP 55 LF $118.00 $6,490.00 55 $6,490.00 7 36"CLASS III RCP 143 LF $147.00 $21,021.00 143 $21,021.00 8 42"CLASS III RCP 63 LF $190.00 $11,970.00 63 $11,970.00 9 4'STORM JUNCTION BOX 1 EA $4,900.00 $4,900.00 1 $4,900.00 10 5'STORM JUNCTION BOX I EA $8,400.00 $8,400.00 1 $8,400.00 11 21"SET 1 EA $1,400.00 $1,400.00 1 $1,400.00 12 30"SET 1 EA $2,850.00 $2,850.00 1 $2,850.00 13 42"SET I EA $5,600.00 $5,600.00 1 $5,600.00 14 TRENCH SAFETY 1249 LF $1.00 $1,249.00 1249 $1,249.00 15 MEDIUM STONE RIPRAP,GROUTED 71 SY $87.00 $6,177.00 71 $6,177.00 16 24"END&PLUG 1 EA $90.00 $90.00 1 $90.00 ---------------------------------------- Sub-Total of Previous Unit $204,646.00 $204,646.00 PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total -- ————————————————————————————————————- 1 6"CONCRETE PAVEMENT 11336 SY $31.35 $355,383.60 11336 $355,383.60 2 6"LIME TREAT SUBGRADE 12071 SY $3.75 $45,266.25 12071 $45,266.25 3 HYDRATED LIME @ 30LBS 240 TN $163.00 $39,120.00 240 $39,120.00 4 8"CONC PVMT COLLECTOR 3718 SY $39.80 $147,976.40 3718 $147,976.40 5 8"LIME TREATED SUBGRADE COLLECTOR 3904 SY $3.75 $14,640.00 3904 $14,640.00 6 CONNECT CURB&GUTTER 66 LF $10.00 $660.00 66 $660.00 7 P-1 RAMP 20 EA $1,400.00 $28,000.00 20 $28,000.00 8 M-1 RAMP 4 EA $1,400.00 $5,600.00 4 $5,600.00 9 5"CONC SIDEWALK 173 LF $25.00 $4,325.00 173 $4,325.00 10 TRAFFIC CONTROL 1 LS $3,000.00 $3,000.00 1 $3,000.00 Friday,September 14,2018 Page 2 of 5 City Project Numbers 100533 DOE Number 0533 Contract Name WATERSBEND SOUTH PHASE 2A Estimate Number 1 Contract Limits Payment Number I Project Type STORM DRAIN&PAVING For Period Ending 9/7/2018 Project Funding Sub-Total of Previous Unit $643,971.25 $643,971.25 ST LIGHT Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ------------ -- --- - ------------------------ 1 LED LIGHTING FUCTURE 19 EA $3,084.00 $58,596.00 19 $58,596.00 2 ST MARKER BLADE 10 EA $75.00 $750.00 10 $750.00 3 2"CONDUIT PVC SCH 40 429 LF $10.76 $4,616.04 429 $4,616.04 Sub-Total of Previous Unit $63,962.04 $63,962.04 ----------------------------------------- Friday,September 14,2018 Page 3 of 5 City Project Numbers 100533 DOE Number 0533 Contract Name WATERSBEND SOUTH PHASE 2A Estimate Number I Contract Limits Payment Number 1 Project Type STORM DRAIN&PAVING For Period Ending 9/7/2015 Project Funding Contract Information Summary Original Contract Amount $912,579.29 Change Orders Total Contract Price $912,579.29 Total Cost of Work Completed $912,579.29 Less %Retained $0.00 Net Earned $912,579.29 Earned This Period $912,579.29 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 $912,579.29 Friday,September 14,2018 Page 4 of 5 ) ) \ o 7 / 2 / 5 2 / > _ _0 D o e / M z 2 / $ / / CO G » \ / / 2 / / i § ; o j / m m m # m m / _ 2 \ k j / / \ \ / \ \ / \ \ - 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GJACKSON CONSTRUCTION LTD. 51 12 SUN VALLEY DRIVE FORT WORTH,TX 76119 TEL:817-572-3303 FAX:817-478-0443 AFFIDAVIT STATE OF TEXAS COUNTY OF TARR.ANT 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 I,/Jackson, President Subscribed and sworn before me on this date 31 st of August, 2018. Notary Public Tarrant,Texas """"•. CARMEN L.ESTEP paY PVp I Notary Public,state of Texas or: r"a Comm.Expires 04-06-2020 Notary ID 2910611 ,�,�.. z CONSENT OF SURETY OWNFR 4 TO FINAL PAYMENT ARCHITECT n AIA Document G707 CONTACTOR 11 SURETY X7 Bond No. BCD1054921 OTHER D TO OWNER: ARCHITECT'S PROfECT N0.: rNa>nr amtad�j Lackland Holdings, LLC 3045 Lackland Rd. CONTRACT FOR:Water and Sewer Improvements Fort Worth TX 76116 PROJECT: CONTRACT DATED: {ldaa»randaa6rbu� Watersbend South Phase 2A Tn accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the !)runt"=eandaW1MofsIV c 1 The Hanover Insurance Company 440 Lincoln Street Worcester MA 01653 SURETY, on bond of f1 en name and addrzwgf C wractor) Jackson Construction, Ltd. 5112 Gun Volley Drve r ort`avarth TX 76119 CONTRACTOR, hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not r leve the Surety of any of its obligations to r)im w nameacrd addms ofou—) Lackland Holdings, LLC 3045 Lackland Rd. Fort Worth TX 76116 OAR, as set forth in said Surety s bond. W WITNESS WHEREOF,the Surety has hereunm set its hand on this date: August 27, 2018 rj;wrtiAxviMr WrruontbfatfoxedhNrlrrmuncritdaararrd)cwr.) The Hanover Insurance Company {Srrrrrr) By: - fsC4+ ambonrzaa,rprayrnrar,'!rJ Jack M Crowley Attomey-in-Fact (Seal)_ _ fPrt�rrart:mace acral r�dr) Surety Phone No. 508-853-7200 x-4476 G707-1994 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 underthe 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 otherwritings obligatory in the nature thereof,with powerto attach thereto the seal of the Company.Any such writings so executed by such Attorneys-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 Company to 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:rfanover Insurance company Massachusetts Bay Ins�ance Company The Ha htrse is aaInsurance C y Cd Bens Insurance Com of America Massachusetts SayCorn ranee Company Wnit � CRizens Iaasura nax�Company of America 14 t# t .tars Sohn C.Roche,EW andPtesident James H_Kav iecki,Lice 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 duly affixed and subscribed to said instrument by the authority and direction of said Corporations. l �.W11tl/N0C'OYMMIYIIY+a� M Drone I.: .NcAwy Public My Co Mn,jaion C pjr Ni.mh-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 certify that the said Powers of Attorney are still in force and effect. GIVEN un_dermy fiand-arid the seals of said Companies,at Worcester,Massachusetts,this 27thday of August,2018 CERTIFIED COPY 74.6, , Theodore G.Nlwtinc4'ice Pm --------- -------� == Watersbend South Ph 2A CPN 100533 P&D Adobe Sign Document History 10/29/2018 Created: 09/17/2018 By: Etta Bacy(etta.bacy@fortworthtexas.gov) ---v ____-- ----- Status: Signed Transaction ID: CBJCHBCAABAAVIOW9gwNnpPk761KOw6OJRd53QurcLgl ) "Watersbend South Ph 2A CPN 100533 P&D" History Document created by Etta Bacy (etta.bacy@fortworthtexas.gov) 09/17/2018-9:02:30 AM CDT-IP address:209.194.29.100 E1, Document emailed to Carmen Estep (steveh@jacksontx.net)for signature 09/17/2018-9:08:53 AM CDT `J Document viewed by Carmen Estep (steveh@jacksontx.net) 09/24/2018-9:17:10 AM CDT-IP address:75.140.225.246 G Carmen Estep(steveh@jacksontx.net) uploaded the following supporting documents: File Attachment 1 Gv File Attachment 2 09/24/2018-4:05:28 PM CDT da Document e-signed by Carmen Estep (steveh@jacksontx.net) Signature Date:09/24/2018-4:05:28 PM CDT-Time Source:server-IP address:75.140.225.246 E''4 Document emailed to Matt Cain (mcain@multatech.com)for signature 09/24/2018-4:05:29 PM CDT Document viewed by Matt Cain (mcain@multatech.com) 10/02/2018-7:29:22 PM CDT-IP address: 107.77.200.129 Vic, Document e-signed by Matt Cain (mcain@multatech.com) Signature Date:10/03/2018-7:10:11 AM CDT-Time Source:server-IP address:209.194.29.100 E`4' Document emailed to Edward Davila (edward.davila@fortworthtexas.gov)for approval 10/03/2018-7:10:12 AM CDT 5 Document viewed by Edward Davila (edward.davila@fortworthtexas.gov) 10/03/2018-10:50:17 AM CDT-IP address:209.194.29.100 Adobe Sign 650 Document approved by Edward D'avila (edward.davila@fortworthtexas.gov) Approval Date: 10/03/2018-10:56:26 AM CDT-Time Source:server-IP address:209.194.29.100 E-o Document emailed to Fred Ehia (freidoon.ehia@fortworthtexas.gov)for signature 10/03/2018-10:56:29 AM CDT l Document viewed by Fred Ehia (freidoon.ehia@fortworthtexas.gov) 10/03/2018-11:09:42 AM CDT-IP address:209.194.29.100 Document e-signed by Fred Ehia (freidoon.ehia@fortworthtexas.gov) Signature Date:10/03/2018-11:15:03 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales oanie.morales@fortworthtexas.gov)for signature 10/03/2018-11:15:05 AM CDT bo Document e-signed by Janie Scarlett Morales oanie.morales@fortworthtexas.gov) Signature Date:10/05/2018-12:24:53 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/05/2018-12:24:53 PM CDT Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/05/2018-3:12:59 PM CDT-IP address:209.194.29.100 da Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date: 10/05/2018-3:13:11 PM CDT-Time Source:server-IP address:209.194.29.100 C`-o- Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/05/2018-3:13:12 PM CDT Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/05/2018-4:46:58 PM CDT-IP address:209.194.29.100 Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date: 10/05/2018-4:49:24 PM CDT-Time Source:server-IP address:209.194.29.100 Po- Document emailed to therese.brotherton@fortworthtexas.gov for delivery 10/05/2018-4:49:24 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) 10/11/2018-6:22:14 AM CDT-IP address:209.194.29.100 Document emailed to Zelalem Arega. Okay for final (Zelalem.Arega@fortworthtexas.gov)for delivery 10/11/2018-6:22:14 AM CDT Document viewed by Zelalem Arega. Okay for final (Zelalem.Arega@fortworthtexas.gov) 10/17/2018-2:55:02 PM CDT-IP address:209.194.29.100 FOR--'!`rd Adobe Adobe Sign Document receipt acknowledged by Zelalem Arega. Okay for final (Zelalem.Arega@fortworthtexas.gov) Receipt Acknowledgement Date: 10/17/2018-2:55:36 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Julie A Geho Qulie.geho@fortworthtexas.gov)for delivery 10/17/2018-2:55:39 PM CDT Document viewed by Julie A Geho (julie.geho@fortworthtexas.gov) 10/17/2018-3:23:36 PM CDT-IP address:209.194.29.100 . Document receipt acknowledged by Julie A Geho Qulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:10/17/2018-3:23:48 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Monica De Anda (monica.deanda@fortworthtexas.gov)for delivery 10/17/2018-3:23:49 PM CDT Document viewed by Monica De Anda (monica.deanda@fortworthtexas.gov) 10/17/2018-4:45:32 PM CDT-IP address:209.194.29.100 Document receipt acknowledged by Monica De Anda (monica.deanda@fortworthtexas.gov) Receipt Acknowledgement Date:10/17/2018-4:45:41 PM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 10/17/2018-4:45:41 PM CDT 5 Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 10/29/2018-12:04:09 PM CDT-IP address:209.194.29.100 6p Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date: 10/29/2018-1:20:59 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to Carmen Estep (steveh@jacksontx.net), Monica De Anda (monica.deanda@fortworthtexas.gov), Etta Bacy(etta.bacy@fortworthtexas.gov), Fred Ehia (freidoon.ehia@fortworthtexas.gov), and 9 more 10/29/2018-1:20:59 PM CDT l FORTWORTH, Adobe Sign