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Home My WebLink AboutContract 49809-FP3 City Secretary Contract No. 49809 -FP3 FORT WORTH Date Received Jan 16,2019 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 4 City Project No.: 101052 Improvement Type(s): ❑ Paving ® Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $58,432.00 Amount of Approved Change Order(s): Revised Contract Amount $58,432.00 Total Cost of Work Complete: $58,432.00 &7� Jan 15, 2019 Contractor Date Contract Manager Title Burnsco Construction, Inc. Company Name At"..t v. WjiA- Jan 15,2019 VAd"V.Fk tsUan LS.20M Project Inspector Date �„a„Lmff,,n L5 zQ1,, Jan 15,2019 Project Manager Date 47"4,2w4g,&lDhZ4�r Jan 1s 2019 Jank SWIM Monks Pm15.20191 CFA Manager Date 'skA*.o&''1AMk- usan Jan 15 2019 SAlanls 1,lan 15,1019) f Asst. City Manager Date Page 1 of 2 OFFICIAL RECORD CITY SECRETARY FT. (NORTH,TX Notice of Project Completion Project Name: Marine Creek Ranch Section 4 City Project No.: 101052 City's Attachments Final Pay Estimate 0 Change Order(s): ❑ Yes 0 N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 180 CD Days Charged: 180 Work Start Date: 11/20/2017 Work Complete Date: 1/8/2019 Page 2 of 2 P -/01 o s-A City Project Numbers 101052 DOE Number 1010 Contract Name MARINE CREEK RANCH SECTION 4 Estimate Number I Contract Limits Payment Number 1 Project Type DRAINAGE For Period Ending 1/15/2019 Project Funding Project Manager NA City Secretary Contract Number 3101052 Inspectors GREGORY / FLUTE Contract Date 8/30/2017 Contractor BURNSCO CONSTRUCTION,INC. Contract Time 180 CD 6331 SOUTHWEST BLVD Days Charged to Date 180 CD FORT WORTH, T\ 76132 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES f Line Fund Account Center Amount Gross Retainage Net —— Funded— — —— ———— - - – -------------- —--- I 1 Total Cost of Work Completed $58,432.00 I Less %Retained $0.00 Net Earned $58,432.00 j Earned This Period $58,432.00 •� i Retainage This Period $0.00 j Less Liquidated Damages k� 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 $58,432.00 Monday,January 14,2019 Page 4 of 4 FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name MARINE CREEK RANCH SECTION 4 Contract Limits Project Type DRAINAGE City Project Numbers 101052 DOE Number 1010 Estimate Number 1 Payment Number 1 For Period Ending 1/15/2019 CD City Secretary Contract Number 3101052 Contract Time 18(ED Contract Date 8/30/2017 Days Charged to Date 180 Project Manager NA Contract is 100.00 Complete Contractor BURNSCO CONSTRUCTION,INC. 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 Inspectors GREGORY / FLUTE Monday,January 14,2019 Page 1 of 4 I' City Project Numbers 101052 DOE Number 1010 Contract Name MARINE CREEK RANCH SECTION 4 Estimate Number 1 Contract Limits Payment Number 1 Project Type DRAINAGE For Period Ending 1/15/2019 Project Funding UNIT III:DRAINAGE IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total I MEDIUM STONE RIPRAP DRY 182 SY $48.00 $8,736.00 182 $8,736.00 2 TRENCH SAFETY 408 LF $0.50 $204.00 408 $204.00 3 21"RCP CLASS I11 99 LF $65.00 $6,435.00 99 $6,435.00 4 24"RCP CLASS 11I 309 LF $73.00 $22,557.00 309 $22,557.00 5 4'STORM JUNCTION BOX I EA $4,100.00 $4,100.00 1 $4,100.00 6 24"FLARED HEADWALL 1 PIPE 1 EA $2,400.00 $2,400.00 1 $2,400.00 7 10'CURB INLET 4 EA $3,500.00 $14,000.00 4 $14,000.00 Sub-Total of Previous Unit $58,432.00 $58,432.00 Monday,January 14,2019 Page 2 of 4 City Project Numbers 101052 DOE Number 1010 Contract Name MARINE CREEK RANCH SECTION 4 Estimate Number 1 Contract Limits Payment Number I Project Type DRAINAGE For Period Ending 1/15/2019 Project 1,unding Contract Information Summary Original Conti•actAmount $58,432.00 Chanae Orders Total Contract Price $58,432.00 Total Cost of Work Completed $58,432.00 Less %Retained $0.00 Net Earned $58,432.00 Earned This Period $58,432.00 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 $58,432.00 Monday,January 14,2019 Page 3 of 4 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 Ab Grantges, Contract Manager of Burnsco Construction, Inc., known to me to be a credible person, who being 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; Marine Creek Ranch Section 4—Water,Sanitary Sewer and Storm Drain BY Ab Grantges, Contract Manager Subscribed and sworn before me on this date 15`x'of January, 2019. No ary Public Tarrant County,Texas MARY PANNELL Notary Public, 9[a[e of Texas Comm.Expires 1().19-2022 9j } Noiary IQ 15744239 �I1111�� Sq Q CONSENT OF OWNARCHITECT ❑ SURETY COMPANY CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ Conforms with the American Institute of OTHER Architects,AIA Document G707 Bond No 022059319 PROJECT: (name, addreSS)Marine Creek Ranch Section 4 Fort Worth TX TO (Owner) CRYSTAL LAKE DEVELOPMENT,LLC AND CITY OF—I ARCHITECT'S PROJECT N0: FORT WORTH CONTRACT FOR: 3825 Camp Bowie Road Marine Creek Ranch Section 4-Water,Sanitary Sewer and Drainage Improvements Fort Worth TX 76107 CONTRACT DATE: CONTRACTOR:BURNSCO CONSTRUCTION, INC. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (hero insert name and address of Surety Company) LIBERTY MUTUAL INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of (here insert name and address of Contractor) BURNSCO CONSTRUCTION, INC. 6331 Southwest Boulevard Benbrook TX 76132 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) CRYSTAL LAKE DEVELOPMENT.LLC AND CITY OF FORT WORTH 3825 Camp Bowie Road Fort Worth TX 76107 , OWNER, as set forth in the said Surety Company's bond. IN WITNESS, WHEREOF, the Surety Company has hereunto set its hand this 14th day of January,2019 LIBERTY MUTUAL INSURANCE COMPANY J;Ao�- Surety Company Attest:Tiinaa McEwan lAav, 44caw (Seal): Signa re of Authorized Representative Soohinie Hunter Attorney-in-Fact Title NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE 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. Liberty Mutual Insurance Company Liberty, The Ohio Casualty Insurance Company Certificate No: 8200274 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Robbi Morales,Don E.Cornell,Sophinic Hunter,"Fina McEwan,Ricardo J.Reyna Joshua Saunders.Kelly A Westbrook all of the city of Dallas state of TX each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this I I th day of January 1 2019 . Liberty Mutual Insurance Company P�INSri� P-,I1 INSV iNSURq The Ohio Casualty Insurance Company J 3°°�Po royOc+t QJ3°oapor,QF'Pgy VQ'4°nvorryrmyn West American Insurance CompanyZF T ¢ 1912go 0 1919 2 �1991 � 4 / a. O O / �p1vs`rACH°`'�'.aaS, yO�k"AMCS ,dL `ls NOIANP da cC. �:e„j/Lf'f�<""'i�T N e to David M.Carey,Assistant Secretary 0- State of PENNSYLVANIA LrC5 (U County of MONTGOMERY ss to 0 N On this I l th day of January 2019 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of liberty Mutual Insurance o o Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes=� a> > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. u LU (U IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written, a c•� f Pas, o 0 Q N ;'fir f \` COMMONWEALTH OF PENNSYLVANIA /L,B4 �? ot- , 1 Ttrnsa Pastella.Nvtary Public c p n CU Upper Ivlerion'rwp.,Montgomery County By: i My Co n fission E.pvcs 1A.—.28.2021 ?j E Teresa Pastella,Notary Public �� `f6�?`'^-U / Mnnlber.Ponr,sylvrn,o Associ8lion of Notin--, aO CU N to O .0 a� This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company,Liberty Mutual o c Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: o a> W ARTICLE IV-OFFICERS:Section 12.Power of Attorney. 3 o Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or them 0 a >1 President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety >o any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall to N have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such" CO Z0 instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the co provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority, o 0 ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. 0— Any —Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe,E° shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of allomey issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 14th day of Januar, 2019 P�INSU,p4 P\Z,( INSV 1NSUR� J `°nro ?o2� �J=Gonooryyr � `P�oRp°RAJo�+m T. 1972 0 1919 1991 c� g d�,'ssAC1Us��da� yo A41psr�a� rs vO1A"" aa3 y Renee C.8�) Llewellyn,Assistant Secretary � �� Hyl * 1`� �M • 1`a Y Y LMS-1873 L1IC OCIC VVAIC Multi Co 062018 0Liberty _�Mutual- SURETY TEXAS TEXAS IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para someter Una queja: You may call toll-free for information or to Usted puede hamar al numero de telefono gratis make a complaint at para informacion o para someter una queja al 1-877-751-2640 1-877-751-2640 You may also write to: Usted tambien puede escribir a: 2200 Renaissance Blvd., Ste. 400 2200 Renaissance Blvd., Ste.400 King of Prussia, PA 19406-2755 King of Prussia, PA 19406-2755 You may contact the Texas Department of Puede comunicarse con el Departamento de Insurance to obtain information on companies, Seguros de Texas para obtener informacion coverages, rights or complaints at acerca de companias, coberturas, derechos o 1-800-252-3439 quejas al 1-800-252-3439 You may write the Texas Department of Insurance Puede escribir al Departamento de Seguros Consumer Protection (I 11-I A) de Texas Consumer Protection (I I 1-1 A) P. 0. Box 149091 P. 0. Box 149091 Austin, TX 78714-9091 Austin,TX 78714-9091 FAX: (512)490-1007 FAX#(512)490-1007 Web: http://www.tdi.texas.gov Web: littp://ww-vv.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov E-mail: ConsumerProtectionc tdi.texas.gov PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your Si tiena una disputa concerniente a su prima o a premium or about a claim you should first un reclamo, debe comunicarse con el agente o contact the agent or call 1-800-843-6446. primero. Si no se resuelve la disputa, puede If the dispute is not resolved,you may contact the entonces comunicarse con el departamento (TDI) Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR UNA ESTE AVISO A SU POLIZA: POLICY: This notice is for information only and does not Este aviso es solo para proposito de informacion become a part or condition of the attached y no se convierte en parte o condicion del document. documento adjunto. NP 70 68 09 01 lWS-15292 10115 Green Sheet CPN 101052 =- ---� Marine Creek Ranch Section 4 Drainage - _ Adobe Sign Document History 01/17/2019 Created: 01/14/2019 w By: Etta Bacy(etta.bacy@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAAv_OGI-2_S6NjQhZQdWndHXQupsBGwPaD "Green Sheet CPN 101052 Marine Creek Ranch Section 4 Drain age" History "off Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 01/14/2019-11:31:17 AM CST-IP address:209.194.29.100 C� Document emailed to Albert Grantges (burnscoinc2@aol.com)for signature 01/14/2019-11:35:28 AM CST Document viewed by Albert Grantges (burnscoinc2@aol.com) 01/15/2019-9:39:36 AM CST-IP address:69.147.93.14 �i Albert Grantges (burnscoinc2@aol.com) uploaded the following supporting documents: (i File Attachment 1 Ci File Attachment 2 01/15/2019-9:41:14 AM CST b Document e-signed by Albert Grantges (burnscoinc2@aol.com) Signature Date:01/15/2019-9:41:14 AM CST-Time Source:server-IP address: 12.246.109.114 C Document emailed to Michael V. Flute (michael.flute@freese.com)for signature 01/15/2019-9:41:15 AM CST ! Document viewed by Michael V. Flute(michael.flute@freese.com) 01/15/2019-10:28:43 AM CST-IP address:107.77.197.17 Document e-signed by Michael V. Flute (michael.flute@freese.com) Signature Date:01/15/2019-10:29:31 AM CST-Time Source:server-IP address: 107.77.197.17 �. Document emailed to Ariel Duarte(ariel.duarte@fortworthtexas.gov)for approval 01/15/2019-10:29:32 AM CST FORT WORTH, Adobe Sign Document viewed by Ariel Duarte (ariel.duarte@fortworthtexas.gov) 01/15/2019-11:33:13 AM CST-IP address:174.206.6.147 � . Document approved by Ariel Duarte (ariel.duarte@fortworthtexas.gov) Approval Date:01/15/2019-11:35:19 AM CST-Time Source:server-IP address:174.206.6.147 !4. Document emailed to Aaron Long (edward.long@fortworthtexas.gov)for signature 01/15/2019-11:35:20 AM CST u Document viewed by Aaron Long (edward.long@fortworthtexas.gov) 01/15/2019-2:50:17 PM CST-IP address:209.194.29.100 5c. Document e-signed by Aaron Long (edward.long@fortworthtexas.gov) Signature Date:01/15/2019-2:50:28 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales aanie.morales@fortworthtexas.gov)for signature 01/15/2019-2:50:29 PM CST Document e-signed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) Signature Date:01/15/2019-4:48:38 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Susan Alanis(susan.alanis@fortworthtexas.gov)for signature 01/15/2019-4:48:39 PM CST 5 Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 01/15/2019-6:31:35 PM CST-IP address:209.194.29.100 c. Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:01/15/2019-6:31:55 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 01/15/2019-6:31:55 PM CST Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 01/16/2019-8:14:58 AM CST-IP address:209.194.29.100 J . Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:01/16/2019-8:15:16 AM CST-Time Source:server-IP address:209.194.29.100 C� Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 01/16/2019-8:15:17 AM CST L Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 01/16/2019-10:37:03 AM CST-IP address:209.194.29.100 Lc. Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:01/16/2019-10:37:16 AM CST-Time Source:server-IP address:209.194.29.100 FORTWORTH. I Adobe Sign ':- Document emailed to Julie A Geho Qulie.geho@fortworthtexas.gov)for delivery 01/16/2019-10:37:17 AM CST 5 Document viewed by Julie A Geho Oulie.geho@fortworthtexas.gov) 01/16/2019-12:05:55 PM CST-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:01/16/2019-12:06:08 PM CST-Time Source:server-IP address:209.194.29.100 ,. Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 01/16/2019-12:06:09 PM CST 5 Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 01/17/2019-8:57:00 AM CST-IP address:209.194.29.100 Do Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:01/17/2019-8:57:07 AM CST-Time Source:server-IP address:209.194.29.100 Signed document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov), Janie Scarlett Morales Qanie.morales@fortworthtexas.gov), Etta Bacy(etta.bacy@fortworthtexas.gov),Albert Grantges (burnscoinc2@aol.com), and 7 more 01/17/2019-8:57:07 AM CST Foxes_ ..,,: Adobe a Sign