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Contract 49586-FP4
RECEIVED City Secreta'}49586 -FP4 DEC 2 ID 2018 Contract No. CITY OF F T WORTH FORTWORTH. Date Received Dec 18,2018 C SE RETARY f d0 (0 3S 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: MARINE CREEK RANCH SECTION 12 City Project No.: 100635 Improvement Type(s): ❑ Paving ❑ Drainage ® Street Ughts ❑ Traffic Signals Original Contract Price: $62,499.56 Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: $62,499.56 Nov 19,2018 Contractor Date President Title Independent Utility Construction, Inc. Company Name 7ecr��}z�ir Nov 27,2018 Projecctt Inspector Date m��TTi ioA=av, Nov 27,2018 Project Manager Date Nov 28 2018 Amwrerrdaw�Norirr.��«.wnio.�.�mq � CF�`A�Ma�n e Date S,g,,A1Wftr,,,,,&XM;MaxNov 28,2018 Asst. City Manager Date OFFICIAL c, Page 1 of 2 r CITY SECRETARY FT. WORTH,TX P f' Notice of Project Completion Project Name: MARINE CREEK RANCH SECTION 12 City Project No.: 100635 City's Attachments Final Pay Estimate Change Order(s): ❑ Yes © NIA Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 30 CD Days Charged: 400 Work Start Date: 10/2/2017 Work Complete Date: 11/6/2018 Page 2 of 2 P I. i s /06635 City Project Numbers 100635 DOB Number 0635 Contract Name MARINE CREEK RANCH SECTION 12 Estimate Number I Contract Limits Payment Number I Project Type ST LIGHT For Period Ending 11/19/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / DAVIS Contract Date Contractor INDEPENDENT UTILITY CONSTRUCTION Contract Time 30 CD 5109 SUN VALLEY DRIVE Days Charged to Date 400 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 $62,499.56 Less %Retained $0.00 Net Earned $62,499.56 Earned This Period $62,499.56 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 $62,499.56 Page 4 of 4 Monday,November 19,2018 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name MARINE CREEK RANCH SECTION 12 Contract Limits Project Type ST LIGHT City Project Numbers 100635 DOL Number 0635 Estimate Number 1 Payment Number 1 For Period Ending 11/19/2018 CD City Secretary Contract Number Contract Time 3(ID Contract Date Days Charged to Date 400 Contract is 100.00 Complete Project Manager NA Contractor INDEPENDENT UTILITY CONSTRUCTION 5109 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors DICKINSON / DAVIS Monday,November 19,2018 Page 1 of 4 l w" City Project Numbers 100635 DOL Number 0635 Contract Name MARINE CREEL{RANCH SECTION 12 Estimate Number 1 Contract Limits Payment Number 1 C Projectlyhe ST LIGHT For Period Ending 11/19/2018 i Project Funding I ST LIGHT Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total -------- -------------------------------- 1 2"CONDT PVC SCH 80 1267 LF $5.04 $6,385.68 1267 $6,385.68 2 RDWY I LLUM ASSEMBLY 18 EA $1,504.00 $27,072.00 18 $27,072.00 3 LED LIGHTING FLYTURE 18 EA $433.00 $7,794.00 18 $7,794.00 4 6-6-6 TRIPLEX ALUM ELEC CONDUCTOR 1267 LF $1.64 $2,077.88 1267 $2,077.88 5 RDWY ILLUM FOUNDATION 18 EA $1,065.00 $19,170.00 18 $19,170.00 --------------------------------------- Sub-Total of Previous Unit $62,499.56 $62,499.56 Monday,November 19,2018 Page 2 of 4 City Project Numbers 100635 DOE Number 0635 Contract Name MARINE CREEK RANCH SECTION 12 Estimate Number 1 Payment Number 1 Contract Limits ` Project Type ST LIGHT For Period}Jnding 11/19/2018 i �i Project Funding i Contract Information Summary Original Contract Amount $62,499.56 Change Orders Total Contract Price $62,499.56 Total Cost of Work Completed $62,499.56 Less %Retained $0.00 Net Earned $62,499.56 Earned This Period $62,499.56 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 $62,499.56 Monday,November 19,2018• Page 3 of 4 I AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT i; Before me, the undersigned authority, on this day personally appeared RICHARD WOLFE, President of INDEPENDENT UTILITY CONSTRUCTION, INC., known to me to be a credible person, and after being duly sworn by me, upon his oath deposed and said; "That all persons, firths, 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: Marine Creek Ranch Section 12—City Project No. 100635 BY:Je6 Richard Wolfe,President SUBSCRIBED AND SWORN TO BEFORE ME on this ( day of b 2r,2018. CHRISTINA GARCIA `��P'PY pG6�i =Notary Public,State of Texas =� 'P- Comm.Expires 12-20-2020 1�°'�• t��CY ,,,,, Notary ID 130940785 Notary Public, State of Texas CONSENT OF OWNER ❑ SURETY COMPANY CONTIRA TOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT G707) Bond No. 5063182 5 }' —77T . 1 PROJECT: Street Lighting Improvements for Marine Creek Ranch Section 12 (name,address)Fort Worth,Texas TO (Owner) ARCHITECTS PROJECT NO: City of Fort Worth I CONTRACT FOR: Above Project 200 Texas Street Fort Worth, Texas 76102 CONTRACT DATE: CONTRACTOR: Independent Utility Construction, Inc. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(here inert name and address of Surety Company) Westfield Insurance Company 555 Republic Drive, Suite 450 Plano,Texas 75074 ,SURETY COMPANY, on bond of(here insert name and address of Contractor) Independent Utility Construction, Inc. 5109 Sun Valley Drive ,CONTRACTOR, Fort Worth,Texas 76119 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 inert name and address of Owner) City of Fort Worth 200 Texas Street OWNER, Fort Worth,Texas 76102 , as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, The Surety Company has hereunto set its hand this 10th day of September 2018 WESTFIELD I URANCE COMPANY Surety Comp By Signa e f Authorized Representative 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 THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARINU I H15 JAMt POWER#AND ISSUED PRIOR TO 04/20111, FOR ANY PERSON OR PERSONS NAMED BELOW. POWER NO. 4220052 06 Powerai Westfield Insurance Co. of Attorney Westfield National Insurance Co. Ohio Farmers Insurance Co. CERTIFIED COPY 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," duty 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 Attorneys)-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 GUARANIEE, MORIUAGE 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 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 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 . ,,,N1Mq,N, ,I,t...l..„e,, ,•A•.IlII,, Corporate •”. "�.,, NA "'•. WESTFIELD INSURANCE COMPANY Seals �a'.u.StirC •aP��n• ��NS`' ;•' S�SUo� WESTFIELD NATIONAL INSURANCE COMPANY Affixed r• = w: •�'7� '��:' '•,<r` OHIO FARMERS INSURANCE COMPANY ` Sri -tn: SEAL ''S.V''• '�'r •:o: = : 184EI 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 duly sworn, did depose and say,that he resides1n•Medina, Ohio;that he is Senior Exectitive 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;arid that he signed his name thereto by like order. Notarial Seal .••`�¢I A I_ S" Affixed o ��4/ % :p Z: FIs it William J. Kahelin,A rney at Law,Notary Public State of Ohio •N ✓. 'do My Commission Does Not Expire(Sec.147.03 Ohio Revised Code) County of Medina ss.: �q02�- rE d 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 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 effect. In Witness Whereof, 1 have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this 10th day of Septembe�;•R;4, 2018 .............. ..,.,,...,, �NO AC el .r: SEMI. im'- Secretary u>� /� y: 'p; :, 1848 Frank A. Carrino,•�ecretary Greensheet for Marine Creek Ranch Section 12 CPN#100635 SL Revised _---------- +---- Adobe Sign Document History 12/18/2018 Created: 12/18/2018 B Shameka.Kennedfortworthtexas. ov Status: Delivered Transaction ID: CBJCHBCAABAA-4ARu2APDMOle0aa_EdikzSn-EmO5SQG "Greensheet for Marine Creek Ranch Section 12 CPN#100635 SL Revised" History Document created by Shameka.Kennedy@fortworthtexas.gov 12/18/2018-9:12:47 AM CST-IP address:209.194.29.100 E-4 Document emailed to Janie Scarlett Morales Qanie.morales@fortworthtexas.gov)for filling 12/18/2018-9:13:33 AM CST Document viewed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) 12/18/2018-9:22:55 AM CST-IP address:209.194.29.100 Form filled by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) Form filling Date:12/18/2018-9:24:04 AM CST-Time Source:server-IP address:209.194.29.100 C> Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 12/18/2018-9:24:05 AM CST ; Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 12/18/2018-10:02:37 AM CST-IP address:209.194.29.100 bc, Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:12/18/2018-10:02:57 AM CST-Time Source:server-IP address:209.194.29.100 a Document emailed to Pedro Hernandez(zelalem.arega@fortworthtexas.gov)for delivery 12/18/2018-10:02:57 AM CST Document viewed by Pedro Hernandez(zelalem.arega@fortworthtexas.gov) 12/18/2018-11:59:44 AM CST-IP address:209.194.29.100 FoR �e I ;love Adobe Sign 6c; Document receipt acknowledged by Pedro Hernandez(zelalem.arega@fortworthtexas.gov) Receipt Acknowledgement Date:12/18/2018-12:43:29 PM CST-Time Source:server-IP address:209.194.29.100 C� Document emailed to Julie A Geho Oulie.geho@fortworthtexas.gov)for delivery 12/18/2018-12:43:29 PM CST I Document viewed by Julie A Geho Oulie.geho@fortworthtexas.gov) 12/18/2018-12:50:28 PM CST-IP address:209.194.29.100 b. Document receipt acknowledged by Julie A Geho Qulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:12/18/2018-12:51:20 PM CST-Time Source:server-IP address:209.194.29.100 C`4 Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 12/18/2018-12:51:21 PM CST TJ Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 12/18/2018-3:39:30 PM CST-IP address:209.194.29.100 Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:12/18/2018-3:39:35 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales Qanie.morales@fortworthtexas.gov), TPW Fiscal Staff (tpwcfafiscal@fortworthtexas.gov), Julie A Geho Oulie.geho@fortworthtexas.gov),Allison Tidwell (cso_finalpay@fortworthtexas.gov), and 2 more 12/18/2018-3:39:35 PM CST Adobe Sign