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HomeMy WebLinkAboutContract 48623-FP1 2 AAA A O City Secretary 6y 48623 -FPl Contract No. C W �� 9 FORT WORTH, Date Received Jan 10,2019 W0, 'n sq�al � 106WQ � w G� C,� r0 NOTICE OF PROJECT COMPLETION b Vyd Z (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: WATERSIDE PHASE II City Project No.: 100342 Improvement Type(s): Water ® Sewer Original Contract Price: $936,205.57 Amount of Approved Change Order(s): $133,395.34 Revised Contract Amount: $1,069,600.91 Total Cost of Work Complete: $1,069,600.91 2Ljtod ,4 Palwol-a Christ�a[more(Jan 7,2019) Jan 7,2019 Contractor Date I Project Manager Title EMJ Construction Company Name Juliusin(Jan7,2019)(.�ri Jan 7,2019 Project Inspector Date Aaron Long(J-7,2019) Jan 7,2019 Projgct�an er Date Iahla J('0� AAkalaf Jan 7 2019 Janie Scarlett Morales(Jan 7,2019) 7 CFA Manager Date Scruity'4/VUu :- Jan 8,2019 Susan Alanis(Jan S,2019) Asst. City Manager Date OFFICIAL RECORD Page 1 of 2 CITY SECRETARY y FT. NORTH,TX Notice of Project Completion Project Name:WATERSIDE PHASE II City Project No.: 100342 d .i `1 i City's Attachments !I Final Pay Estimate Change Order(s): x❑ Yes ❑ N/A �I Pipe Report: © Yes ❑ N/A 1 I Contractor's Attachments !' Affidavit of Bills Paid I Consent of Surety Statement of Contract Time Contract Time: 473 CD Days Charged: 518 Work Start Date: 2/27/2017 Work Complete Date: 5/9/2018 i� �I , Page 2of2 i{ rl S9 o I 1 vo3�a City Project Numbers 100342 DOE Number 0342 Contract Name WATERSIDE PRASE 11 Estimate Number I Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 8/9/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / MCLAURIN Contract Date Contractor EMJ CORPORATION Contract Time 473 CD 5525 N.MACARTIIUR BLVD.,4400 Days Charged to Date 518 CD IRVING, TX 75038-2604 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 $1,069,600.87 Less %Retained $0.00 Net Earned $1,069,600.87 Earned This Period $1,069,600.87 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 $1,069,600.87 Thursday,August 9,2018 Page 5 of 5 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WATERSIDE PHASE II Contract Limits Project Type WATER&SEWER City Project Numbers 100342 DOE Number 0342 Estimate Number I Payment Number 1 For Period Ending 8/9/2018 CD City Secretary Contract Number Contract Time 479D i Contract Date Days Charged to Date 518 a� Project Manager NA Contract is 100.00 Complete 4) Contractor EMJ CORPORATION 5525 N.MACARTHUR BLVD.,#400 IRVING, TX 75038-2604 Inspectors DICKINSON / MCLAURIN I I i{ t II k� Thursday,August 9,2018 Page I of 5 'S City Project Numbers 100342 DOE Number 0342 Contract Name WATERSIDE PHASE II Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 8/9/2018 Project Funding WATER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ----------------------------------------- I TRENCH SAFETY 4523 LF $0.99 $4,477.77 4523 $4,477.77 2 12"DIP WATER 508 LF $86.91 $44,150.28 508 $44,150.28 3 6"PVC WATER PIPE CO#1 302 LF $13.93 $4,206.86 302 $4,206.86 4 8"PVC WATER PIPE CO#1 151 LF $21.45 $3,238.95 151 $3,238.95 5 12"PVC WATER PIPE 3805 LF $62.63 $238,307.15 3805 $238,307.15 6 FIRE HYDRANT 6 EA $4,708.33 $28,249.98 6 $28,249.98 7 CONNECTION EXISTING 4"-12"WATER MAIN 2 EA $1,557.00 $3,114.00 2 $3,114.00 8 2"COMBINATION AIR VALVE ASSEMBLY FOR 1 EA $10,000.00 $10,000.00 1 $10,000.00 WATER 9 2"WATER SERVICE 1 EA $1,900.00 $1,900.00 1 $1,900.00 10 6"GATE VALVE CO#1 19 EA $1,264.77 $24,030.63 19 $24,030.63 11 8"GATE VALVE CO#1 11 EA $1,790.00 $19,690.00 11 $19,690.00 12 12"GATE VALVE C0#1 27 EA $2,796.43 $75,503.61 27 $75,503.61 13 8"X 8"TAPPING SLEEVE&VALVE I EA $3,000.00 $3,000.00 1 $3,000.00 14 6"BLOW OFF VALVE 1 EA $11,000.00 $11,000.00 1 $11,000.00 15 4"-12"PRESSURE PLUG 32 EA $500.00 $16,000.00 32 $16,000.00 16 24"CASING BY OTHER THAN OPEN CUT 527 LF $320.74 $169,029.98 527 $169,029.98 17 3"WATER METER AND VAULT 1 EA $12,600.00 $12,600.00 1 $12,600.00 18 6"WATER METER AND VAULT 1 EA $34,000.00 $34,000.00 1 $34,000.00 19 1 1/2"WATER SERVICE 1 EA $2,900.00 $2,900.00 1 $2,900.00 20 EBAA IRON FLEX TEND FORCE BALANCED 2 EA $14,000.00 $28,000.00 2 $28,000.00 FLEXIBLE EXPANSION JOINT 21 SMITH BLAIR 6111 EXPANSION JOINT WITH I EA $8,000.00 $8,000.00 1 $8,000.00 LIMIT RODS 22 DUCTILE IRON WATER FITTINGS 0.97817 TN $26,800.00 $26,214.96 0.97817 $26,214.96 W/RESTRAINT CO#1 23 12"WATER CARRIER PIPE 187 LF $86.91 $16,252.17 187 $16,252.17 24 12"PVC WATER PIPE 80 LF $65.00 $5,200.00 80 $5,200.00 25 2"BULLHEAD SERVICE CO#1 9 EA $3,566.00 $32,094.00 9 $32,094.00 26 3/4"SINGLE SERVICE CO#1 2 EA $2,586.50 $5,173.00 2 $5,173.00 27 LAYOUT CO#1 16 HR $137.50 $2,200.00 16 $2,200.00 28 HAUL OFF CO#1 450 CY $10.00 $4,500.00 450 $4,500.00 29 1.5"IRRIGATION SERVICE CO#2 1 EA $4,500.00 $4,500.00 1 $4,500.00 Thursday,August 9,2018 Page 2 of 5 City Project Numbers 100342 DOE Number 0342 Contract Name WATERSIDE PHASE R Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 8/9/2018 Project Funding Sub-Total of Previous Unit $837,533.34 $837,533.34 -- SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Qaanity Total ------------------------------------------ 1 POST CCTV INSPECTION 1 EA $2,100.00 $2,100.00 1 $2,100.00 2 EXPLORATORY EXCAVATION OF EXISTING 8 EA $2,000.00 $16,000.00 8 $16,000.00 UTILITIES 3 MANHOLE ADJUSTMENT 11 EA $3,390.91 $37,300.01 11 $37,300.01 4 TRENCH SAFETY 412 EA $1.21 $498.52 412 $498.52 5 4"2 WAY CLEAN OUT 2 EA $1,600.00 $3,200.00 2 $3,200.00 6 6"2 WAY CLEAN OUT 6 EA $1,600.00 $9,600.00 6 $9,600.00 7 4"SEWER FORCE MAIN 71 LF $86.00 $6,106.00 71 $6,106.00 8 6"SEWER FORCE MAIN 161 LF $88.00 $14,168.00 161 $14,168.00 9 8"SEWER FORCE MAIN 180 LF $92.00 $16,560.00 180 $16,560.00 10 WASTEWATER ACCESS CHAMBER 3 EA $4,133.00 $12,399.00 3 $12,399.00 11 4"SEWER ABANDONMENT PLUG 2 EA $500.00 $1,000.00 2 $1,000.00 12 6"SEWER ABANDONMENT PLUG 6 EA $500.00 $3,000.00 6 $3,000.00 13 8"SEWER ABANDONMENT PLUG 3 EA $500.00 $1,500.00 3 $1,500.00 14 6"SEWER PIPE CSS BACKFILL 126 LF $65.00 $8,190.00 126 $8,190.00 15 4"SANITARY SEWER SERVICE CO#1 20 EA $3,632.30 $72,646.00 20 $72,646.00 16 CONNECT TO EX 8"SAN SEWER CO#2 1 EA $1,500.00 $1,500.00 1 $1,500.00 17 8"PVC SANITARY SEWER CO#2 100 LF $38.00 $3,800.00 100 $3,800.00 18 4'DIA SEW MH C092 l EA $4,800.00 $4,800.00 1 $4,800.00 19 REM/REP CONCRETE PAVING CO#2 600 SF $18.00 $10,800.00 600 $10,800.00 20 SAN SEW TRENCH SAFETY&TESTING C042 I LS $1,200.00 $1,200.00 1 $1,200.00 21 SAN SEW STAKING CO#2 1 LS $500.00 $500.00 1 $500.00 22 REMOVE/REPLACE ADDITIONAL CONCRETE 60 SF $20.00 $1,200.00 60 $1,200.00 CO#3 23 REPAIR STORM DRAIN CO#3 1 LS $1,500.00 $1,500.00 1 $1,500.00 24 FLOW FILL PAVING VOID CO#3 10 CY $250.00 $2,500.00 10 $2,500.00 --------------------------------------- Sub-Total of Previous Unit $232,067.53 $232,067.53 --------------------------------------- Thursday,August 9,2018 Page 3 of 5 ?3 City Project Numbers 100342 DOE Number 0342 Contract Name WATERSIDE PHASE 11 Estimate Number I Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 8/9/2018 Project Funding Contract Information Summary Original Contract Amount $936,205.57 Chance Orders Change Order Number 1 $101,095.34 Change Order Number 2 $27,100.00 Change Order Number 3 $5,200.00 Total Contract Price $1,069,600.87 Total Cost of Work Completed $1,069,600.87 Less %Retained $0.00 Net Earned $1,069,600.87 Earned This Period $1,069,600.87 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 $1,069,600.87 Thursday,August 9,2018 Page 4 of 5 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Water and Sanitary Sewer Improvements To Serve Waterside Phase II PROJECT NUMBER: CPN# 100342 DOE NUMBER: N/A WATER PIPE LAID SIZE TYPE OF PIPE LF Yes 6" PVC 386 Yes 8" PVC 235 Yes 12" PVC 3 805 Yes 12" DIP 508 Yes 12" Carrier Pipe 187 Yes 12" PVC 80 Yes 24" Casing 527 +i e FIRE HYDRANTS: 6 VALVES(16" OR LARGER) PITE ABANDONED SIZE TYPE OF PIPE LF 1 1 DENSITIES: Yes NEW SERVICES: 3/4" Copper 10 1.5" Copper 5 SEWER PIPE LAID SIZE TYPE OF PIPE LF Yes 4" PVC 74 Yes 6" PVC 179 Yes 8' PVC 236 f� 1 PIPE ABANDONED SIZE TYPE OF PIITE LF DENSITIES: Yes NEW SERVICES: 4" PVC 100 TRANSPORTATION AND PUBLIC WORKS The City of Fort"vlordi• 1000 Tluockmorton Street•Fort Wordi,TK 76012-6311 (817)392-7941 •Fax:(817)392-7845 G; r; T7 ,i D O O �! 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S G °2 { , / { { & 2 mm c < m 0 / j \ r ( 0 CD I _ nk \ \ / _ - co ° f \ ) 2 2 co § ° 00 \ O 0 CD (1) \ 00 \ o s \ 0 § n ( z CD § 0 0 - o / m 0 } § \ .. c ; m 00 = 2 � . e 0 3 %o 2 o ® $\ z to CD /[ ] CO \ § 0 § { } 2 2 § ) e I / m « Cl) CD E CL - 3 »25 m CD / § a / .±3 ( § 2 / _ XCD z- \ p C6 m 2 0 % CL } § ) ) ] CD } ® 2 2 : Q_ m m m -_I m CD o « § } \ � 0 i } j } ( \ \ CO ` a z w » \ CD / 2 ( 7 \ < 2 < zi ) m P- - m \ (D / (D \ © / ` I ƒ a - \ / / _ \ / \ \/CD C\ » \ \ $ & a 2ƒ \ ) £ / e z o m » / \ / ƒ \ \ q 9 � ( m_m\ (»\ \(() & � eeee T \ \() EMJ CONSTRUCTION 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 William Mosher, Executive Vice President Of EMJ Corporation,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; 40104-00 Waterside-Island 3400 Bryant Irvin Road Ft. Worth, TX 76109 BY William Mosher Subscribed and sworn before me on this date 4th of January, 2019. •Q/��� �- +`" SHEILA M NAZARIO THOMAS NelaryID#129623291 My Commission Expires November 12,2021 5525 N MacArthur Blvd • Suite 400 - Irving, TX 75038 972.580,1210 WWW,EMJCORP,COM CON x , LLC 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 John Kolb, President of Wildstone Construction, 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: Waterside Phase II BY John /President Subsc ' and s be ore me on this da a 19 of December,2018. Notary Public Tarrant,Texas Rig 22 i 12850Mghway 287 Office: 817-847-8660 Fort Worth,TX 76052 Fax: 817-847-8019 rnIM 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 Trent Prim, COO Of PRIM Construction, 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; Waterside Phase 2 BY Trent Prim,COO Subscribed and sworn before me on this date 19'h of December,2018. Pu lic Tauttly ,ounty,Texas { AMY WOMACK Notary Public,State 01 Texas priinconstruction.com :4,z Comm.Expires 06-16.2020 817.885.7951 ph Notary ID 124957868 817.885.7852 tx 252 RoberisCut Ott r Fort WoOh,Tx 76114 coves Ytw7m I8us».ss Fn:vprrae `9�j¢ =- Document G707TM — 1994 Consent Of Surety to Final Payment PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: Paving,Grading,Drainage&Street ARCHITECT:❑ Lighting for Watercourse Drive to Serve Waterside Phase II,CFA#2016-084 CONTRACTOR: CONTRACT FOR:General Construction SURETY: TO OWNER:(Name and address) CONTRACT DATED: OTHER:❑ FW Waterside Land LLC and City of Fort Worth,Texas In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Insert name and address ofSurety) Continental Casualty Company 5565 Glenridge Connector NE,6th Floor Atlanta GA 30342 ,SURETY, on bond of (Insert name and address of Contracto)) EMJ Corporation 5525 N MacArthur Blvd,Suite 400,Irving TX ,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) FW Waterside Land LLC and City of Fort Worth,Texas OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date:July 12,2018 (Insert in writing the month followed by the numeric date and year.) Western Surety Company (Stn• n') (Sigr antre gfautho•-ed re •e ntative) Attest: Patricia S.Kleehammer,Attorney-in-fact (Seal): (Printed name and title) AIA Document G7071m—1994.Copyright©1982 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 17:16:18 on 07/12/2018 under Order No.1286863630 which expires on 04/04/2019,and is not for resale. User Notes: (3B9ADA43) Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota,and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint Mark R Brock, Patricia S Kleehammer, Emily K Fant, Tucker H Compton, Mark Ramsey Brock Jr, John D Brock, Cecil Ray Vaughan III, T Michael Langley, Dana Keith Davis, Individually of Rossville,GA,its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts- and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted,as indicated,by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 25th day of April,2018. WESTERN SURETY COMPANY IS I `'4c0�a l 1_ FAV��rE aul T.Brufla[,Vice President Slate of South Dakota l JT ss County of Minnehaha On this 25th day of April,2018,before me personally came Paul T.Bruflat,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal; that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said corporation. My commission expires J.MOHt2 } June 23.2021 10"01my"I"CM ` o J.Mohr,Notary Public CERTIFICATE I.L. Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this day of moo/%GLl�1 !�� Q(aysQ�°� Yeo WESTERN SURETY COMPANY s f!y" ��1ips Form F4280-7-2012 L on,Assistant Secretary Go to www.cnasurety.com>Owner/Obligee Services>Validate Bond Coverage,if you want to verify bond authenticity. Authorizing By-Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary,Treasurer, or any Vice President,or by such other officers as the Board of Directors may authorize. The President,any Vice President, Secretary,any Assistant Secretary,or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds,policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies,undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. r Greensheet for Waterside Phase II CPN#100342 WS Adobe Sign Document History 01/14/2019 Created: 08/09/2018 By: Shameka.Kennedy@fortworthtexas.gov -- Status: Signed -- Transaction ID: CBJCHBCAABAA-GRizQ5sHdei42Q3yAG4Yu9ZuExgdMb8 "Greensheet for Waterside Phase II CPN#100342 WS" History Document created by Shameka.Kennedy@fortworthtexas.gov 08/09/2018-3:39:18 PM CDT-IP address:209.194.29.100 Document emailed to Christopher A. Palmore (christopher.palmore@emjcorp.com)for signature 08/09/2018-3:45:49 PM CDT �1 Document viewed by Christopher A. Palmore(christopher.palmore@emjcorp.com) 08/09/2018-3:50:54 PM CDT-IP address: 174.206.40.152 Cvi Christopher A. Palmore(ch ristopher.pal more@emjcorp.com) uploaded the following supporting documents: & File Attachment 1 (9 File Attachment 2 01/07/2019-11:50:35 AM EST Document e-signed by Christopher A. Palmore(christopher.palmore@emjcorp.com) Signature Date:01/07/2019-11:50:35 AM EST-Time Source:server-IP address:66.196.211.98 Document emailed to Julius McLaurin (Julius.mclaurin@fortworthtexas.gov)for signature 01/07/2019-11:50:36 AM EST " Document viewed by Julius McLaurin Qulius.mclaurin@fortworthtexas.gov) 01/07/2019-11:51:32 AM EST-IP address:209.194.29.100 Document e-signed by Julius McLaurin (Julius.mclaurin@fortworthtexas.gov) Signature Date:01/07/2019-11:56:37 AM EST-Time Source:server-IP address:209.194.29.100 Document emailed to Michael O. Glover(michael.glover@fortworthtexas.gov)for approval 01/07/2019-11:56:38 AM EST Document viewed by Michael O. Glover(michael.glover@fortworthtexas.gov) 01/07/2019-1:31:47 PM EST-IP address:209.194.29.100 FORTWORTHd Adobe Sign 0c. Document approved by Michael O. Glover(michael.glover@fortworthtexas.gov) Approval Date:01/07/2019-1:32:39 PM EST-Time Source:server-IP address:209.194.29.100 C'w Document emailed to Aaron Long (edward.long@fortworthtexas.gov)for signature 01/07/2019-1:32:40 PM EST Document viewed by Aaron Long (edward.long@fortworthtexas.gov) 01/07/2019-1:46:28 PM EST-IP address:209.194.29.100 Document e-signed by Aaron Long (edward.long@fortworthtexas.gov) Signature Date:01/07/2019-1:46:48 PM EST-Time Source:server-IP address:209.194.29.100 y Document emailed to Janie Scarlett Morales Oanie.morales@fortworthtexas.gov)for signature 01/07/2019-1:46:49 PM EST Document viewed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) 01/07/2019-2:03:32 PM EST-IP address:209.194.29.100 GSp Document e-signed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) Signature Date:01/07/2019-2:06:39 PM EST-Time Source:server-IP address:209.194.29.100 Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 01/07/2019-2:06:40 PM EST Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 01/07/2019-8:49:54 PM EST-IP address: 162.202.109.213 da Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:01/08/2019-11:15:06 PM EST-Time Source:server-IP address:209.194.29.100 C` Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 01/08/2019-11:15:07 PM EST Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 01/10/2019-9:08:09 AM EST-IP address:209.194.29.100 6a Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:01/10/2019-9:08:54 AM EST-Time Source:server-IP address:209.194.29.100 P'-► Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 01/10/2019-9:08:56 AM EST !n Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 01/10/2019-9:37:04 AM EST-IP address:209.194.29.100 GSp Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:01/10/2019-9:37:18 AM EST-Time Source:server-IP address:209.194.29.100 FORT WORTH. , Adobe sign L-w Document emailed to Julie A Geho Qulie.geho@fortworthtexas.gov)for delivery 01/10/2019-9:37:19 AM EST Document viewed by Julie A Geho Oulie.geho@fortworthtexas.gov) 01/10/2019-9:49:36 AM EST-IP address:209.194.29.100 FS& Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:01/10/2019-9:49:52 AM EST-Time Source:server-IP address:209.194.29.100 L4 Document emailed to TPW Flscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 01/10/2019-9:49:53 AM EST Document viewed by TPW Flscal Staff(tpwcfafiscal@fortworthtexas.gov) 01/14/2019-9:16:59 AM EST-IP address:209.194.29.100 60 Document receipt acknowledged by TPW Flscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:01/14/2019-9:17:05 AM EST-Time Source:server-IP address:209.194.29.100 Signed document emailed to Julius McLaurin (Julius.mclaurin@fortworthtexas.gov),Allison Tidwell (cso_finalpay@fortworthtexas.gov), Trudy Brotherton (therese.brotherton@fortworthtexas.gov), Janie Scarlett Morales Qanie.morales@fortworthtexas.gov), and 7 more 01/14/2019-9:17:05 AM EST FORT WORTH. r Adobe Sign