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Contract 49496-FP1
i PM p� City Secretary 49496 -FPI Contract No. '`� FORTWORTH, date Received Jan 10,2019 00 GAJ'���' �, /00Co�.1 0�o 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:WIMBERLY-LINWOOD ADDITION City Project No.: 100642 Improvement Type(s): ® Paving ❑ Drainage 0 Street Lights ❑ Traffic Signals Original Contract Price: $114,983.75 Amount of Approved Change Order(s): -$3,800.00 Revised Contract Amount: $111,183.75 Total Cost of Work Complete: $111,183.75 IJ7awOh 1ti� Jason Warton(Jan 2.2019)20191 Jan 2,2019 Contractor Date VP Title DFW Services LLC Company Name Eav'eit R. Rde , ' s_. Jan 2 2019 Edwin R.Rodnguez,Sr.(Jan , 019) Project Inspector Date ,Hczo�,Le Jan 2 2019 Mion Long(Jan 2,2019 a Project Manager Date My 2QYG 'MOlakf Jan 6 2019 Annie S—Jea Morales(Jan 6.2019) CFA Manager Date Scasap24lasccJy Jan 7 2019 Suzan atonia(Jan T.2019) � Asst. City Manager Date OFFICIAL RECORD Page 1 of 2 CITY SECRETARY FT. WORTH,TX Notice of Project Completion Project Name:WIMBERLY-LINWOOD ADDITION City Project No.: 100642 City's Attachments Final Pay Estimate Fx-] Change Order(s): © Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 120 CD Days Charged: 428 Work Start Date: 10/2/2017 Work Complete Date: 12/3/2018 Page 2 of 2 5" 60 )- /006C2 2 City Project Numbers 100642 DOE Number 0642 Contract Name WIMBERLY-LINWOOD ADDITION Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING&ST LIGHT For Period Ending 12/4/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors OWEN / RODRIGUEZ Contract Date Contractor DPW SERVICES,LLC Contract Time 120 CD 5848 HWY 78,STE 118 Days Charged to Date 428 CD SACHSE, TX 75048 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 $111,183.75 Less %Retained $0.00 Net Earned $111,183.75 Earned This Period $111,183.75 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 $111,183.75 Tuesday,December 4,2018 Page 4 of 4 FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WINIBERLY-LINWOOD ADDITION Contract Limits Project Type PAVING&ST LIGHT City Project Numbers 100642 DOE Number 0642 Estimate Number 1 Payment Number 1 For Period Ending 12/4/2018 CD City Secretary Contract Number Contract Time 120;D Contract Date Days Charged to Date 428 Project Manager NA Contract is 100.00 Complete Contractor DFW SERVICES,LLC 5848 HWY 78,STE 118 SACHSE, TX 75048 Inspectors OWEN / RODRIGUEZ Tuesday,December 4,2018 Page 1 of 4 i City Project Numbers 100642 DOE Number 0642 Contract Name WIMBERLY-LINWOOD ADDITION Estimate Number 1 Contract Limits Payment Number I Project Type PAVING&ST LIGHT For Period Ending 12/4/2018 Project Funding PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ------------------------------------------ I 10'WIDE ASPHALT PVMT REPAIR 260 LF $67.00 $17,420.00 260 $17,420.00 2 4"CONC SIDEWALK 2805 SF $8.75 $24,543.75 2805 $24,543.75 3 7"CONCRETE DRIVEWAY 900 SF $10.00 $9,000.00 900 $9,000.00 4 BARRIER FREE RAMP CO#1 4 EA $950.00 $3,800.00 4 $3,800.00 5 6"CONC CURB&GUTTER 130 .LF $28.00 $3,640.00 130 $3,640.00 ----------------------------------------- Sub-Total of Previous Unit $58,403.75 $58,403.75 ST LIGHT Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 --------------------------------------1 2"CONDT PVC SCH 80 835 LF $18.00 $15,030.00 835 $15,030.00 2 2"CONDT PVC SCH 80 FOR RISER I EA $650.00 $650.00 1 $650.00 3 250-250-3/0 TRIPLEX ALUM ELEC CONDUCTOR 30 LF $8.00 $240.00 30 $240.00 4 6-6-6 TRIPLEX ALUM ELEC CONDUCTOR 710 LF $6.00 $4,260.00 710 $4,260.00 5 RDWY ILLUM FOUNDATION 5 EA $1,550.00 $7,750.00 5 $7,750.00 6 FURNISIVINSTALL 10'-14' 5 EA $3,750.00 $18,750.00 5 $18,750.00 WASHINGTONSTANDARD 7 GROUND BOX TYPE B. 6 EA $850.00 $5,100.00 6 $5,100.00 8 SALVAGE STREET LIGHT POLE 1 EA $1,000.00 $1,000.00 1 $1,000.00 ----------------------------------------- Sub-Total of Previous Unit $52,780.00 $52,780.00 ------------------------------------------ Tuesday,December 4,2018 Page 2 of 4 i City Project Numbers 100642 DOE Number 0642 Contract Name WIMBERLY-LINWOOD ADDITION Estimate Number i Contract Limits Payment Number 1 Project Type PAVING&ST LIGHT For Period Ending 12/4/2018 i Project Funding Contract Information Summary Original Contract Amount $114,983.75 Change Orders Change Order Number 1 ($3,800.00) Total Contract Price $111,183.75 Total Cost of Work Completed $111,183.75 Less %Retained $0.00 Net Earned $111,183.75 Earned This Period $111,183.75 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 $111,183.75 Tuesday,December 4,2018 Page 3 of 4 i • Li r� p n n N (F y g a a o 'v -i m M O �i 0 5 jiy j r�iz'� 2 2 (mj D i p O N ' w 57� 11.h 1 C, y C f a N ,7n 0 c b •y m N N m rr CD n N a = rn g w w c _ en o a 9 � fD rn ,$ & •z z • � rn �d $ $ o o m �' n W W W to co W N S o' D z co co N !^•tyn Ni ,cji �ji'�; p C )y m 0 :iiY�•o st' C,yi ••'L•' y' � m zb m j � � �� �y iii• n 00 | � } 2 2 4 ( � .. 0 § / E # B � 2 q 7 | @ � 7 m q§ 7 k » ]( / /2 ( } }§-$ � } o � & � # | .I 2 } ƒ 2 } 8 � / � §� § � \ ' @( g ( / k �w � ■E � QI] \ k k � § � ® c + % \ B)} � 9 ) & 22] � # . AFFIDAVIT STATE OF Texas COUNTY OF Dallas Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Deidra Warren, President Of DFW Services 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; Wimberly Linwood Addition BY UL'Ll (/✓�' / Deidra Warren Subscribed and sworn before me on this date �2 of "",' Notary Pu lic Dallas TX ""`"`, KATHY TULLOCK F Notary 10 4i& 101164496 My Commisslon Expires ��'��� Pray 1,2019 y AIA Document G707�tllt - 1994 Consent Of Surety to Final Payment PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: Wimberly-Linwood Addition 100642 ARCHITECT:❑ CONTRACT FOR:Linwood Addition CONTRACTOR:❑ TO OWNER:(Name and address) CONTRACT DATED:7-14-2017 SURETY:❑ City of Fort Worth 200 Texas St. OTHER:❑ Fort Words,TX 76102 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Insert name and address of Surety) Insurots Indemnity Company 225 S.5th St. Waco,TX 76701 SURETY, on bond of (Insert name and address of Contractor) DFW Services,LLC 4309 Industrial Drive Sachse,TX 75048 CONTRACTOR, hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of Fort Worth 200 Texas St. Fort Worth,TX 76102 OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date:August 20,2018 (Insert in writing the month followed by the numeric date and year.) Insurors Indemnity Company (Surety) (Signatu "Iautlforized representative) Attest: Mary //Ellen Moore,Attorney-In-fact (Seal): (Printed name and title) AIA Document G707T —1994.Copyright(41982 and 1994 by The American Institute of Architects.All rights reserved.WARNING:This AIA°Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it, may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was produced by AIA software at 09:09:33 on 08/21/2018 under Order No.8705792261 which expires on 05/30/2019,and is not for resale. User Notes: (389ADA48) POWER OF ATTORNEY of INSURORS INDEMNITY COMPANY Waco, Texas KNOW ALL PERSONS BY THESE PRESENTS: Number: CNB-24768-00 That INSURORS INDEMNITY COMPANY, Waco, Texas, organized and existing under the laws of the State of Texas, and authorized and licensed to do business in the State of Texas and the United States of America, does hereby make, constitute and appoint Mary Ellen Moore of the City of Corpus Christi, State of TX as Attorney in Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed, all of the following classes of document, to-wit: Indemnity, Surety and Undertakings that may be desired by contract, or may be given in any action or proceeding in any court of law or equity: Indemnity in all cases where indemnity may be lawfully given and with full power and authority to execute consents and waivers to modify or change or extend any bond or document executed for this Company. INSURORS INDEMNITY COMPANY Attest: By- TaFFy Tieperme., Secretary Dave E.Talbert, President State of Texas County of McLennan On the 11th day of November, 2014, before me a Notary Public in the State of Texas, personally appeared Dave E. Talbert and Tammy Tieperman,who being by me duly sworn, acknowledged that they executed the above Power of Attorney in their capacities as President, and Corporate Secretary, respectively, of Insurors Indemnity Company, and acknowledged said Power of Attorney to be the voluntary act and deed of the o pany. sham CMIN otary Public,State of Texas 140"roe Insurors Indemnity Company certifies that this Power of Attorney is granted under and by authority of the following resolutions of the Company adopted by the Board of Directors on November 11, 2014: RESOLVED,that all bonds,undertakings,contracts or other obligations may be executed in the name of the Company by persons appointed as Attorney in Fact pursuant to a Power of Attorney issued in accordance with these Resolutions. Said Power of Attorney shall be executed in the name and on behalf of the Company either by the Chairman and CEO or the President, under their respective designation. The signature of such officer and the seal of the Company may be affixed by facsimile to any Power of Attorney, and, unless subsequently revoked and subject to any limitation set forth therein, any such Power of Attorney or certificate bearing such facsimile signature and sea]shall be valid and binding upon the Company and any such power so executed.and certified by facsimile signature and seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is validly attached. RESOLVED, that Attorneys in Fact shall have the power and authority, subject to the terms and limitations of the Power of Attorney issued to them, to execute and deliver on behalf of the Company and to attach the seal of the Company to any and all bonds and undertakings, and any such instrument executed by such Attorneys in Fact shall be binding upon the Company as if signed by an Executive Officer and seated and attested to by the Secretary or Assistant Secretary of the Company. 1, Tammy Tieperman, Secretary of Insurors Indemnity Company, do hereby certify that the foregoing is a true excerpt from the Resolutions of the said Company as adopted by its Board of Directors on November 11,2014, and that this Resolution is in full force and affect. I certify that the foregoing Power of Attorney is in full force and effect and has not been revoked. In Witness Whereof. I have set my hand and the seal of INSURORS INDEMNITY COMPANY on this 20th day of August 2018 t T rirth qecrelal Tarry e per NOTE: IF YOU HAVE ANY QUESTION REGARDING THE VALIDITY OR WORDING OF THIS POWER OF ATTORNEY, PLEASE CALL 800 933 7444 OR WRITE TO US AT P.O. BOX 2683,WACO,TEXAS 75702-2683 OR EMAIL US AT CON FIRMATION(c),I NSURORS-COM, Greensheet for Wimberly- ; _ - - Linwood Addition CPN#100642 = Y4 PSL Adobe Sign Document History 01/10/2019 Created: 12/05/2018 By: Shameka.Kennedy@fortworthtexas.gov Status: Signed Transaction ID: CBJCHBCAABAASnZN6TiWcjVm9tgNpZA7xoQQiCoWoYpF "Greensheet for Wimberly-Linwood Addition CPN#100642 PSL" H istory 1 Document created by Shameka.Kennedy@fortworthtexas.gov 12/05/2018-10:42:54 AM CST-IP address:209.194.29.100 Document emailed to Jason Warren (Jason@dfwservicesllc.com)for signature 12/05/2018-10:47:10 AM CST Document viewed by Jason Warren Qason@dfwservicesllc.com) 01/02/2019-7:53:27 AM CST-IP address:68.203.146.37 69i Jason Warren (Jason@dfwservicesllc.com) uploaded the following supporting documents: �i File Attachment 1 (� File Attachment 2 01/02/2019-7:55:50 AM CST c Document e-signed by Jason Warren (Jason@dfwservicesllc.com) Signature Date:01/02/2019-7:55:50 AM CST-Time Source:server-IP address:68.203.146.37 4. r Document emailed to Edwin R. Rodriguez, Sr. (edwin.rodriguez@fortworthtexas.gov)for signature 01/02/2019-7:55:51 AM CST Document viewed by Edwin R. Rodriguez, Sr. (edwin.rodriguez@fortworthtexas.gov) 01/02/2019-7:58:34 AM CST-IP address:209.194.29.100 ba Document e-signed by Edwin R. Rodriguez, Sr. (edwi n.rod riguez@fortworthtexas.gov) Signature Date:01/02/2019-7:59:25 AM CST-Time Source:server-IP address:209.194.29.100 -► Document emailed to Billy Owen (billy.owen@fortworthtexas.gov)for approval 01/02/2019-7:59:25 AM CST FORTWORTH. dobe �J Adobe Si Sign L-i Document viewed by Billy Owen (billy.owen@fortworthtexas.gov) 01/02/2019-8:23:04 AM CST-IP address:209.194.29.100 Document approved by Billy Owen (billy.owen@fortworthtexas.gov) Approval Date:01/02/2019-8:25:46 AM CST-Time Source:server-IP address:209.194.29.100 ,. Document emailed to Aaron Long (edward.long@fortworthtexas.gov)for signature 01/02/2019-8:25:47 AM CST Document viewed by Aaron Long (edward.long@fortworthtexas.gov) 01/02/2019-9:38:12 AM CST-IP address:209.194.29.100 U Document e-signed by Aaron Long (edward.long@fortworthtexas.gov) Signature Date:01/02/2019-9:38:41 AM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales oanie.morales@fortworthtexas.gov)for signature 01/02/2019-9:38:42 AM CST u, Document e-signed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) Signature Date:01/06/2019-10:01:06 AM CST-Time Source:server-IP address:209.194.29.100 C. Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 01/06/2019-10:01:07 AM CST �u Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 01/07/2019-7:43:53 AM CST-IP address:209.194.29.100 0 . Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:01/07/2019-7:44:08 AM CST-Time Source:server-IP address:209.194.29.100 �1 �ll E> Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 01/07/2019-7:44:08 AM CST u Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 01/10/2019-8:29:23 AM CST-IP address:209.194.29.100 .. Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) , Form filling Date:01/10/2019-8:30:56 AM CST-Time Source:server-IP address:209.194.29.100 �I Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 01/10/2019-8:30:57 AM CST 1 Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 01/10/2019-8:38:16 AM CST-IP address:209.194.29.100 Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:01/10/2019-8:38:34 AM CST-Time Source:server-IP address:209.194.29.100 FORT WORTH. Adobe Sign r• Document emailed to Julie A Geho Qulie.geho@fortworthtexas.gov)for delivery 01/10/2019-8:38:35 AM CST Document viewed by Julie A Geho Qulie.geho@fortworthtexas.gov) 01/10/2019-8:49:05 AM CST-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho Qulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:01/10/2019-8:49:24 AM CST-Time Source:server-IP address:209.194.29.100 C; Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 01/10/2019-8:49:25 AM CST Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 01/10/2019-8:55:31 AM CST-IP address:209.194.29.100 Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:01/10/2019-8:55:48 AM CST-Time Source:server-IP address:209.194.29.100 Signed document emailed to Aaron Long (edward.long @fortworthtexas.gov),Allison Tidwell (cso_finalpay@fortworthtexas.gov), Janie Scarlett Morales Qanie.moral es@fortworthtexas.gov), Jason Warren Qason@dfwserviceslic.com), and 7 more 01/10/2019-8:55:48 AM CST FORT WORTH. � � Adobe Sign