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Contract 49314-FP1
City Secretary Contract No. a93ia -FPl FoRTWORTH, Date Received Oct 22,2018 /005,3° 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: Lasater Ranch Phase 2 City Project No.: 100539 Improvement Type(s): M Paving ❑ Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $672,780.10 Amount of Approved Change Order(s): Revised Contract Amount: $672,780.10 Total Cost of Work Complete: $672,780.10 S91W 04?1-/J Oct 19 2018 Sam Davrs(Oct 19.2019) Contractor Date President Title AB Contracting, LLC Company Name sMA&'y Oct 19, 2018 J—d Scud-10ct 19,1013) Project Inspector Date Saha.�IMi0.t 22.201.4' Oct 22, 20188 v Project Manager Date jgnh &c gM,,,/�ioemt f Oct 22 2018 Janie Scarlett Mo [,� IOct 22,2018) 7 CFA Manager Date Susan A1,11is(Oct 22,2615` Oct 22 2018 Asst. City Manager Date OF (RECORD CITY SECRETARY Page 1 of 2 FT.W®RTHI-TX Notice of Project Completion Project Name: Lasater Ranch Phase 2 City Project No.: 100539 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: 70 CD Days Charged: 90 Work Start Date: 3/12/2018 Work Complete Date: 10/12/2018 Page 2 of 2 106-!!�_3 9 City Project Numbers 100539 DOE Number 0539 Contract Name LASATER RANCH P14ASE 2 Estimate Number I Contract Limits Payment Number 1 Project Type PAVING For Period Ending 10/15/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors CORDOVA / SOUDERS,J Contract Date Contractor JLB CON'1'RAC'I'ING,L.L.C. Contract Time 220 CD PO BOX 24131 Days Charged to Date 90 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 $672,780.10 Less %Retained $0.00 Net Earned $672,780.10 Earned This Period $672,780.10 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 $672,780.10 Thursday,October 18,2018 Page 4 of 4 FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name LASATER RANCH PHASE 2 Contract Limits Project Type PAVING City Project Numbers 100539 DOE Number 0539 Estimate Number I Payment Number 1 For Period Ending 10/15/2013 CD City Secretary Contract Number Contract Time 220;D Contract Date Days Charged to Date 90 Project Manager NA Contract is 100.00 Complete Contractor JLB CONTRACTING,L.L.C. PO BOX 24131 FORT WORTH, TX 76124-1131 Inspectors CORDOVA / SOUDERS,J I Thursday,October 18,2018 Page 1 of 4 City Project Numbers 100539 DOE Number 0539 Contract Name LASATER RANCH PHASE 2 Estimate Number I Contract Limits Payment Number 1 Project Type PAVING For Period Ending 10/15/2018 Project Funding PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ----------------------------------------- 1 6"CONC PVMT 15111 SY $3 .60 $537,951.60 15111 $537,951.60 2 6"LIME TREATMENT 16617 SY $2.30 $38,219.10 16617 $38,219.10 3 HYDRATED LIME 316 TN $163.00 $51,508.00 316 $51,508.00 4 BARRIER FREE RAMP 8 EA $1,130.00 $9,040.00 8 $9,040.00 5 BARRIER FREE RANvIP 4 EA $760.00 $3,040.00 4 $3,040.00 6 BARRIER FREE RAMP 4 EA $820.00 $3,280.00 4 $3,280.00 7 CONST STD STREET HEADER&INSTALL 2 EA $1,320.00 $2,640.00 2 $2,640.00 BARRICADE 8 4"CONC SIDEWALK 3619 SF $5.40 $19,542.60 3619 $19,542.60 9 BARRICADES,SIGNS&TRAFFIC HANDLING 1 MO $1,440.00 $1,440.00 1 $1,440.00 10 FURNISH AND INSTALL STREET SIGNS AND 12 EA $389.90 $4,678.80 12 $4,678.80 POST 1 I FURNISH AND INSTALL STREET NAME BLADE 32 EA $45.00 $1,440.00 32 $1,440.00 ----------------------------------------- Sub-Total of Previous Unit $672,780.10 $672,780.10 ------------------------------------- i Thursday,October 18,2018 Page 2 of 4 City Project Numbers 100539 DOE Number 0539 Contract Name LASATER RANCH PHASE 2 Estimate Number I Contract Limits Payment Number I Project Type PAVING For Period Ending 10/15/2018 Project Funding Contract Information Summary Original Contract Amount $672,780.10 Chante Orders Total Contract Price $672,780.10 Total Cost of Work Completed $672,780.10 Less %Retained $0.00 Net Earned $672,780.10 Earned This Period $672,780.10 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 $672,780.10 Thursday,October 18,2018 Page 3 of 4 81�_b � �A� '3"� 4 Ayq AA q,fv j�j$x,j AAA RAy9� 7�4 ARR Np m � CD 0 C v 11 0 mm mm zmmm qq mm mmm Imn 11II 11nn 11nn 11nn 11nn 111111 ![mm mm CC mm mmmmmmm m m1111mm 11nn GG11 yy yyqq 11nn � �1»Y�8>)KSi ri1}Y>�1Y Y)T)K»ril�i�i Sl rn rilT»'I�YY>)»i�np ril>Sli>YT<K2«SiY� 'D ZZ 4� R y u 8888C888888YY8YYYaaaaaaaaaaaaaaafJaF3lSaaaaaktlSgkSi3afiY`:Blsp !� 8888_8888885-83-=6dddddt"ttasaaaas;HN;,,;stis;a=sW:�„+,Wrsytls=3 � assasaeassasaasetaaaasoaasaooaoeaaosaaooaaN�ea�sasa�aaasa:r tlffi C p I: N a ar rNrNN�aS{ENNS��r„DNNIt Ag 7Yar.�{�OxrV4PI+U�UDf00„OOrVaL ��� ���g8��� 888�SSg�8 �8�888�888888888 �� Sg8888�88 �� � �� "ads p asa Asa R as ” p 8 88 88888888 8888888888 8 88898989888889898 8888E988N8 i �a a��� �xpgs"-na �aps�3Qgffi=aas xan8,�� -p-paa"� sg�=a > 8'888888$888888$$8$888$888888$8884888888$ 88858888$0§888$3 a " E$a as "aa x 8888SSSSsgB" is888s8888ss88SSSSs8888�$9SSSa8888 F a=apse "�cpr=3 E�xa-� � ��as n xp v�la#-p=a ao1i9aEa=a ass$ s $$sa$ss a $ $$a $ a $$ $$��s$s $-$ $$$3 v.,%n tt."-x x-." p �sp�y �L"aass� 9p#_ a "p"naffs- gs yes��S���������������NSS���� ���������xo����88 � 8t $$ SS$8a8 $88 SS$8 8$8$8 8 a888 $ 8 88 8$8$a8o s8 8E + �I8888888r8888888888888888888+888888888838----- $� 88+888 88 818 SSs88s8888e88s8sss888�8s8�8�888SSS888s88�sa8��888888s8888s � tORTWORTH rev 03/05/07 TRANSPORTATION& PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.: NAME OF PROJECT: Lasater Ranch Ph 2 PROJECT NO.: 100539 CONTRACTOR: JLB Contracting,LLC DOE NO.: PERIOD FROM: TO: (0/12/18 FINAL INSPECTION DATE: 12-Oct-18 WORK ORDER EFFECTIVE: CONTRACT TIME: 70 0 WD Q CD DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS MONTH CHARGED CREDITED MONTH CHARGED CREDITED DURING DURING 1. 16. 2. 17. 3. 18. 4. 19. 5. 20. 6. 21. 7. 22. 8. 23. 9. 24. 10. 25. 11. 26. 12. 27. 13. 28. 14. 29. 15. 30. 31. SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL &HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS THIS PERIOD PREVIOUS PERIOD TOTALS 90 TO DATE 'REMARKS: 70 contract days+20 days over contract Total days:90 CONTRACTOR DATE INSPE R DATE ENGINEERING DEPARTMENT The City of Fort Worth•1000 Throckmorton Street•Fort Worth,T176012-6311 (817)392-71941 •Fax:(817)392-7845 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]LB 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; Lasater Ranch — Phase 2 - City Project # 100539 BY Sam Davis President JLB Contracting, LLC Subscribed and sworn before me on this �D of �t� 2018. ' "", JAMIE GREENWAY ;¢�ENotary Publfc,State of Texas „ 4�a Comm.Expires 09.25.2020 NOT RY PUBLIC IN AND F I-Jj ;; Notary ID 1211545-4 T RANT COUNTY, TEXAS r' My commission expires , CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY OTHER ❑ (SIMILAR TO AIA DOCUMENT G707) Bond No. 8028451 PROJECT: Paving Improvements for Lasater Ranch Phase 2 (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 insert name and address of Surety Company) Westfield Insurance Company 555 Republic Drive, Suite 450 Plano, Texas 75074 ,SURETY COMPANY, on bond of(here insect name and address 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 insctt name and address of owner) City of Fort Worth 200 Texas Street Fort Worth, Texas 76102 °OAR' as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, The Surety Company has hereunto set its hand this 8th day of October 2018 WESTFIELD INSURANCE COMPANY Surety Camp — By Signatu f Authorized Representative Attest: (Seal): W. Sweene Attorney-3n—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 THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEANINU I HIS JAM-, POWER#AND ISSUED PRIOR TO 04120111,FOR ANY PERSON OR PERSONS NAMED BELOW, General POWER NO. 4220052 06 Power Westfield s ra ce Co. of Attorney Westfield National Insurance Co. CERTIFIED COPY ®hi® Farmers Insurance Co. Westrleld Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OH?O FARMERS INSURANCE COMPANY, corporations, here'nafter referred to individually as a "Company- and collectively as -Companies," du'y organized and existing under the laws or the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohic, 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, undertakingsor 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 du°ry attested by its Secretary,hereby ratifying and confirming all that the said Attorney(s)-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-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 certlGcate 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 6,2000). 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 . cote " � l�N���N - `•" WESTFIELD INSURANCE COMPANYSeatsFy * . ��AffixedWESTFIELD NATIONAL INSURANCE COMPANY OHIO FARMERS INSURANCE COMPANY "`:_� SEAL :fvt�ai>F; a � rw%.✓'r'r'` *y-. State of OhiotQ""" 'F."' ""' "'" Bichard 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 Execdtive 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 at A t. Affixed to--0'_ William J.Kahelin,A rney at Law,Notary Public State of Ohio - ✓ �11p My Commission Does Not Expire(Sec.147.03 Ohio Revised Code) County of Medina ss:. 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 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 ettect. 1n Witness Whereof, I have hereunto set my hand and affixed the seats of said Companies at Westfield Center, Ohio, this 8th day of uctober A.D., 2418 Ale w€SEAL '� SEAL : �= :b� I i sectwary ro .1848 4�_ Frank A. Carrino,Secretary BPOAC2(combined)(06-02) Green Sheet CPN 100539 =� Lasater Ranch Phase 2 Paving Adobe Sign Document History 10/29/2018 �- - Created: 10/19/2018 w By: Etta Bacy(etta.bacy@fortworthtexas.gov) Status: Signed u � Transaction ID: CBJCHBCAABAAJFJOXWjiPxZslmklBjajbxYgsZH2o_QV "Green Sheet CPN 100539 Lasater Ranch Phase 2 Paving" Hist o ry i� Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 10/19/2018-9:57:02 AM CDT-IP address:209.194.29.100 E Document emailed to Sam Davis (sdavis@jlbcontracting.com)for signature 10/19/2018-10:02:06 AM CDT Q Document viewed by Sam Davis (sdavis@jlbcontracting.com) 10/19/2018-10:04:27 AM CDT-IP address:66.249.80.36 Sam Davis (sdavis@jlbcontracting.com) uploaded the following supporting documents: cv File Attachment 1 & File Attachment 2 10/19/2018-10:07:03 AM CDT do Document e-signed by Sam Davis (sdavis@jlbcontracting.com) Signature Date:10/19/2018-10:07:03 AM CDT-Time Source:server-IP address:47.51.207.250 C'-. Document emailed to Jarad Souders (farad.souders@fortworthtexas.gov)for signature 10/19/2018-10:07:04 AM CDT Document viewed by Jarad Souders (farad.souders@fortworthtexas.gov) 10/19/2018-11:18:49 AM CDT-IP address:76.198.239.107 6a Document e-signed by Jarad Souders Qarad.souders@fortworthtexas.gov) Signature Date: 10/19/2018-11:20:25 AM CDT-Time Source:server-IP address:76.198.239.107 C'w Document emailed to william mason (william.mason@fortworthtexas.gov)for approval 10/19/2018-11:20:26 AM CDT Adobe Sign 71 n Document viewed by william mason (william.mason@fortworthtexas.gov) 10/19/2018-11:25:21 AM CDT-IP address: 107.77.197.51 Document approved by william mason (william.mason@fortworthtexas.gov) Approval Date: 10/19/2018-4:06:45 PM CDT-Time Source:server-IP address:209.194.29.100 ;J C, Document emailed to G.Sahu, PM (gopal.sahu@fortworthtexas.gov)for signature 1 10/19/2018-4:06:46 PM CDT `J Document viewed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) 10/22/2018-8:53:12 AM CDT-IP address:209.194.29.100 Document e-signed by G.Sahu, PM (gopal.sahu@fortworthtexas.gov) Signature Date:10/22/2018-8:53:47 AM CDT-Time Source:server-IP address:209.194.29.100 L Document emailed to Janie Scarlett Morales (Janie.morales@fortworthtexas.gov)for signature 10/22/2018-8:53:48 AM CDT i Document viewed by Janie Scarlett Morales oanie.morales@fortworthtexas.gov) 10/22/2018-8:54:36 AM CDT-IP address:209.194.29.100 6r� Document e-signed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) Signature Date:10/22/2018-8:55:50 AM CDT-Time Source:server-IP address:209.194.29.100 C'y Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 10/22/2018-8:55:51 AM CDT J Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 10/22/2018-9:42:04 AM CDT-IP address:209.194.29.100 6G, Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:10/22/2018-9:42:22 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 10/22/2018-9:42:23 AM CDT Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 10/22/2018-11:48:39 AM CDT-IP address:209.194.29.100 60, Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:10/22/2018-11:50:14 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to Zelalem Arega (Zelalem.Arega@fortworthtexas.gov)for delivery 10/22/2018-11:50:15 AM CDT Document viewed by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) 10/26/2018-9:32:45 AM CDT-IP address:209.194.29.100 FORT WORTH. Adobe sign r Document receipt acknowledged by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) Receipt Acknowledgement Date: 10/26/2018-9:32:58 AM CDT-Time Source:server-IP address:209.194.29.100 > Document emailed to Julie A Geho Qulie.geho@fortworthtexas.gov)for delivery 10/26/2018-9:32:59 AM CDT SIL 1 Document viewed by Julie A Geho Qulie.geho@fortworthtexas.gov) 10/26/2018-10:35:38 AM CDT-IP address:209.194.29.100 dc. Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:10/26/2018-10:35:55 AM CDT-Time Source:server-IP address:209.194.29.100 Document emailed to TPW Flscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 10/26/2018-10:35:56 AM CDT �i Document viewed by TPW Flscal Staff(tpwcfafiscal@fortworthtexas.gov) 10/29/2018-1:06:09 PM CDT-IP address:209.194.29.100 60 Document receipt acknowledged by TPW Flscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:10/29/2018-1:06:18 PM CDT-Time Source:server-IP address:209.194.29.100 Signed document emailed to TPW Flscal Staff(tpwcfafiscal@fortworthtexas.gov), G.Sahu, PM (gopal.sahu@fortworthtexas.gov), Susan Alanis (susan.alanis@fortworthtexas.gov), Jarad Souders (farad.souders@fortworthtexas.gov), and 7 more 10/29/2018-1:06:18 PM CDT Adobe Sign