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HomeMy WebLinkAboutContract 47260-FP1 City Secretary 47260 -FP1 RECEIVED Contract No. FEB 12 2019 FORTWORTH.9 Date Received Jan 10,2019 CIN 01 FORT WORTH O 21 CITY' ECRETARY 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: 640 Taylor Street City Project No.: 02672 Improvement Type(s): ® Paving ® Drainage ® Street Lights 29 Traffic Signals Original Contract Price: $302,918.00 Amount of Approved Change Order(s): $9,765.00 Revised Contract Amount: $312,683.00 Total Cost of Work Complete: $312,683.00 Steph�Jar 7,2019fT. Jan 7,2019 Contractor Date Assistant Project Manager Title Balfour Beatty Company Name T`tYW,Z5mw,(y-R Jan? 2019 Ariel Duarte R(Jan T,2019) Project Inspector Date Aran-Long(Jon T>2019) Jan 7,2019 Project Manager Date 47k#4 c aAhalar Janie SeaAett Morales Uan S.20191 Jan 8,2019 CFA Manager Date : (Jan 8,2wd;01111Jan 8,2019 Asst. City Manager Date OFFICIAL RECORD Page 1 of 2 CITY SECRETARY FT. WORTH,TX Notice of Project Completion Project Name: 640 Taylor Street City Project No.: 02672 City's Attachments Final Pay Estimate N Change Order(s): ® Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety , + Statement of Contract Time Contract Time: 730 CD Days Charged: 730 Work Start Date: 3/1/2016 Work Complete Date: 3/1/2018 Page 2of2 5%001- coa�a City Project Numbers 02672 DOE Number 7530 Contract Name 6,10 TAYLOR STREET Estimate Number I Contract Limits Payment Number I Project Type PAVING,DRAINAGF&ST LIGHT For Period Ending 12/15/2018 Project Funding Project Manager Lona City Secretary Contract Number 117530 Inspectors MILLER,W / DUARTE,A Contract Date Contractor BALFOUR BEATTY CONSTRUCTION Contract Time 730 CD 3100 MCKINNON ST,7TH FLR Days Charged to Date 730 CD DALLAS, TX 75201 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 $312,683.00 Less %Retained $0.00 Net Earned $312,683.00 Earned This Period $312,683.00 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 $312,683.00 Thursday,December 13,2018 Pale 6 of 6 I FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name 640 TAYLOR STREET Contract Limits Project Type PAVING,DRAINGE&ST LIGHT City Project Numbers 02672 DOE Number 7530 Estimate Number 1 Payment Number I For Period Ending 12/15/2018 CD City Secretary Contract Number 117530 Contract Time 73(ED Contract Date Days Charged to Date 730 Project Manager Long Contract is 100.00 Complete Contractor BALFOUR BEATTY CONSTRUCTION 3100 MCKINNON ST,7TH FLR DALLAS, TX 75201 Inspectors MILLER,W / DUARTE,A Thursday,December 13,2018 Page 1 of 6 City Project Numbers 02672 DOE Number 7530 Contract Name 640 TAYLOR STREET Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING,DRAINGE&ST LIGHT For Period Ending 12/15/2018 Project Funding STORM DRAIN Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 REMOVE 18"STORM LINE 38 LF $40.00 $1,520.00 38 $1,520.00 2 REMOVE 10'CURB INLET 2 EA $1,000.00 $2,000.00 2 $2,000.00 3 GROUND WATER CONTROL 1 LS $2,500.00 $2,500.00 1 $2,500.00 4 TRENCH SAFETY 145 LF $2.00 $290.00 145 $290.00 5 18"RCP,CLASS 111 145 LF $175.00 $25,375.00 145 $25,375.00 6 10'TYPE 2 INLET 2 EA $7,450.00 $14,900.00 2 $14,900.00 7 TRAFFIC CONTROL I MO $2,500.00 $2,500.00 1 $2,500.00 8 SWPPP 1 LS $1,000.00 $1,000.00 1 $1,000.00 Sub-Total of Previous Unit $50,085.00 $50,085.00 PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 REMOVE SIDEWALK — 6580 SF $0.56 $3,684.80 6580 $3,684.80 2 REMOVE ADA RAMP 3 EA $150.00 $450.00 3 $450.00 3 REMOVE CONCRETE DRIVE 880 SF $5.00 $4,400.00 880 $4,400.00 4 REMOVE ASPHALT PVMT(CO#2) 880 SY $6.00 $5,280.00 880 $5,280.00 5 REMOVE CONC CURB&GUTTER 680 LF $6.00 $4,080.00 680 $4,080.00 6 V-12"TREE REMOVAL 6 EA $833.00 $4,998.00 6 $4,998.00 7 5'WIDE ASPHALT PVMT REPAIR(CO#3) 320 LF $21.00 $6,720.00 320 $6,720.00 8 ASPHALT PVMT REPAIR BEYOND DEFINED 220 SY $21.00 $4,620.00 220 $4,620.00 W IDTH(CO#2) 9 6"LIME TREATMENT 350 SY $64.00 $22,400.00 350 $22,400.00 10 BARRIER FREE RAMP 3 EA $2,100.00 $6,300.00 3 $6,300.00 11 6"CONC PVMT 350 SY $79.20 $27,720.00 350 $27,720.00 12 BRICK PVMT 546 SY $56.70 $30,958.20 546 $30,958.20 13 6"CONC CURB&GUTTER 546 LF $24.00 $13,104.00 546 $13,104.00 14 24"SLD PVMT MARKING HAE 472 LF $13.00 $6,136.00 472 $6,136.00 15 LANE LEGEND ARROW 7 EA $150.00 $1,050.00 7 $1,050.00 16 LANE LEGEND ONLY I EA $200.00 $200.00 1 $200.00 17 LANE LEGEND BIKE 1 EA $250.00 $250.00 1 $250.00 Thursday,December 13,2018 Page 2 of 6 City Project Numbers 02672 DOE Number 7530 Contract Name 640 TAYLOR STREET Estimate Number I Contract Limits Payment Number 1 Project Type PAVING,DRAINAGE&ST LIGHT For Period Ending 12/15/2018 Project Funding 18 REMOVE 4"PVMT MARKING 400 LF $1.00 $400.00 400 $400.00 19 REMOVE 6"PVMT MARKING 120 LF $1.50 $180.00 120 $180.00 20 REMOVE LANE LEGEND BIKE I EA $75.00 $75.00 1 $75.00 21 PLANT 6"TREE 10 EA $500.00 $5,000.00 10 $5,000.00 22 TRAFFIC CONTROL 3 MO $125.00 $375.00 3 $375.00 23 FiJRNISHANSTALL RIGHT TURN ONLY SIGN 2 EA $300.00 $600.00 2 $600.00 24 FURNISH/INSTALL COFW PAY TO PARK SIGN 5 EA $300.00 $1,500.00 5 $1,500.00 &POLE 25 FURNISHANSTALL COFW ELECTRONIC 2 EA $1,500.00 $3,000.00 2 $3,000.00 PARKING METER 26 FURNISH/INSTALL ONE WAY TRAFFIC SIGN 1 EA $300.00 $300.00 1 $300.00 28 FURNISHIINSTALL GRATING TELCO VAULT 1 EA $5,850.00 $5,850.00 1 $5,850.00 29 FURNISHANSTALL GRATING A/V VAULT 1 EA $4,200.00 $4,200.00 1 $4,200.00 Sub-Total of Previous Unit $163,831.00 $163,831.00 STREET LIGHT Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------------------- I ELECTRICAL FACILITIES 1 LS $4,200.00 $4,200.00 1 $4,200.00 2 CONDUIT BOY 1 EA $3,600.00 $3,600.00 1 $3,600.00 3 RELOCATE STREET LIGHT POLE I EA $4,800.00 $4,800.00 1 $4,800.00 4 TRAFFIC CONTROL I MO $125.00 $125.00 1 $125.00 Sub-Total of Previous Unit $12,725.00 $12,725.00 TRAFFIC SIGNALS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 2"CONDT PVC SCH 80(CO 43) 1095 LF $10.00 $10,950.00 1095 $10,950.00 2 2"CONDI PVC SCH 80 70 LF $20.00 $1,400.00 70 $1,400.00 3 3"CONDT PVC SCH 40 40 LF $12.00 $480.00 40 $480.00 4 3"CONDT PVC SCH 40 230 LF $24.00 $5,520.00 230 $5,520.00 5 3-SECT SIGNAL HEAD ASSMBLY 7 EA $1,050.00 $7,350.00 7 $7,350.00 6 PED SIGNAL HEAD ASSMBLY 2 EA $700.00 $1,400.00 2 $1,400.00 7 INSTALL PREEMPTION CABLE 260 LF $1.00 $260.00 260 $260.00 8 4/C 14 AWG MULTI CONDUCTOR CABLE 78 LF $1.50 $117.00 78 $117.00 Thursday,December 13,2018 Page 3 of 6 City Project Numbers 02672 DOE Number 7530 Contract Name 640 TAYLOR STREET Estimate Number I Contract Limits Payment Number 1 Project Type PAVING,DRAINAGE&ST LIGHT For Period Ending 12/15/2018 Project Funding 9 7/C 14 AWG MULTI CONDUCTOR CABLE 75 LF $2.00 $150.00 75 $150.00 10 8/C 14 AWG MULTI CONDUCTOR CABLE 180 LF $2.00 $360.00 180 $360.00 11 20/C 14 AWG MULTI CONDUCTOR CABLE 1280 LF $3.00 $3,840.00 1280 $3,840.00 12 6/C 14 AWG MULTI CONDUCTOR CABLE 204 LF $2.00 $408.00 204 $408.00 13 NO 6 INSULATED ELEC CONDR(CO#3) 2585 LF $1.00 $2,585.00 2585 $2,585.00 14 NO 8 INSULATED ELEC CONDR 1582 LF $1.00 $1,582.00 1582 $1,582.00 1.5 NO 6 BARE ELEC CONDR SLD 1250 LF $1.00 $1,250.00 1250 $1.,250.00 16 NO 8 BARE ELEC CONDR 1935 LF $1.00 $1,935.00 1935 $1,935.00 L7 GROUND BOX TYPE B W/APRON(CO#3) 9 EA $800.00 $7,200.00 9 $7,200.00 18 GROUND BOX TYPE D W/APRON 5 EA $825.00 $4,125.00 5 $4,125.00 19 FURNISHANSTALL TYPE 41 SIGNAL POLE 1 EA $4,400.00 $4,400.00 1 $4,400.00 20 FURNISH/INSTALL MAST ARM 16'-36' 1 EA $3,800.00 $3,800.00 1 $3,800.00 21 TY 3 SIGNAL FOUNDATION 1 EA $2,750.00 $2,750.00 1 $2,750.00 22 SALVAGE TRAFFIC SIGNAL 1 EA $3,100.00 $3,100.00 1 $3,100.00 23 RDWY ILLUM FOUNDATION TY 1,2 AND 4 1 EA $1,815.00 $1,815.00 1 $1,815.00 24 FURNISHANSTALL ATC 3571 1 EA $300.00 $300.00 1 $300.00 CONTROLLER/CABINET POLE MOUNT 25 TRAFFIC CONTROL 2 MO $125.00 $250.00 2 $250.00 26 FURNISI-VINSTALLATC 3571 1 LS $12,190.00 $12,190.00 1 $12,190.00 CONTROLLER/CABINET POLE MOUNT 27 FURNISH 2070 ATC SIGNAL CONTROLLER 1 LS $4,255.00 $4,255.00 1 $4,255.00 28 12 PAIR/19 AWG(INTERCONNECT)CABLE 540 LF $3.00 $1,620.00 540 $1,620.00 29 FURNISH/INSTALL LED LUMINAIRE AT132- I LS $650.00 $650.00 1 $650.00 60BLED Sub-Total of Previous Unit $86,042.00 $86,042.00 Thursday,December 13,2018 Page 4 of 6 City Project Numbers 02672 DOE Number 7530 Contract Name 640 TAYLOR STREET Estimate Number I Contract Limits Payment Number I Project Type PAVING,DRAINAGE&.ST LIGHT For Period Ending 12/15/2018 Project Funding Contract Information Summary Original Contract Amount $302,918.00 Change Orders Change Order Number 2 $5,400.00 Change Order Number 3 $4,365.00 Total Contract Price $312,683.00 Total Cost of Work Completed $312,683.00 Less %Retained $0.00 Net Earned $312,683.00 Earned This Period $312,683.00 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 $312,683.00 Thursday,December 13,2018 Page 5 of 6 i . � I � ; k] (o I( m s ! a - ,a | � 0 § ] m z F i o o lz w a \S/` § / ( co _CQ 0 ` ` . : 04le § \ ° ( a § » & I a z P / \ ! 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O ¢ w O # it w0 w w ¢�¢ C) v o v ww d d LIl U U Q �- U 1¢- p 19i E 1 w w z o UQU� t1 o Z F- ' K f- ¢ O a s 0� J / N U F 0 b z # �'9k w w # W z < F z u9:-1 r Q 'C+i7 l7 Ci, O O Qw4 � � a0 z o d'-O tL O w Z2 n: o w� a v U v a u a 0 u N 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 Stephen Britz, Assistant Project Manager Of Balfour Beatty Construction,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; New Office Building at 640 Taylor BY Stephen Britz,A ist Project Manager Subscribed and sworn before me on this date 7th of Jan, 2019. �"NA1y '. ROBIN THOMAS O P•...(4 =,:� Notary Public,State of Texas .'�= Comm.Expires 11-12-2022 N tary Public %lF. F};� Notary ID 131793219 Tarrant,Texas TRAVELERS J November 29,2018 I i i City of Fort Worth 1000 Throckmorton Street Fort Worth,TX 76102 Re: Balfour Beatty Construction,LLC Bond No. 106392270 i i To Whom It May Concern: i Balfour Beatty Construction, LLC, the contractor for the Water, Sewer, Paving, Drainage, Signal and Street Light Improvements to Serve 640 Taylor Street project,whose performance we have guaranteed by our Bond No. 106392270 has requested that we acknowledge and consent to the final payment on this project. Our acknowledgement further confirms that all conditions in the contract are in full force and effect and these change orders will not invalidate our Performance and Payment Bonds. i Should you have any questions or require any additional information regarding this bond,please do not hesitate to contact us. Sincerely, TRAVELERS CASUALTY AND SURETY COMPANY Noah William Pierce,Attorney-In-Fact Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS,! St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company,and St Paul Fre and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut(herein collectively called the "Companies"),and that the Companies do hereby make,constitute and appoint Noah Witham Pierce,of Hartford,Connecticut,their true and lawful I Attorney-in-Fact to sign,execute,seal and acknowledge any and all bonds, recognizances,conditional undertakings and other writings obligatory in I the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,.guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 3rd day of February, 2017. � ' IUIRrFOFiU, < � 00� State of Connecticut By. City of Hartford ss. Robert L Raney,Se or Vice President I On this the 3rd day of February,2017,before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company,and St.Paul Fire and Marine Insurance Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof,I hereunto set my hand and official seal. My Commission expires the 30th day of June,2021 mwu. C *gyp * Marie C.Tetreault,Notary Public i i This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company,and St.Paul Fire and Marine Insurance Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President, any Senior Vice President,any Vice President,any j Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances,contracts of indemnity, and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her,and it is FURTHER RESOLVED,that the Chairman,the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice i President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation i is in writing and a copy thereof is filed in the office of the Secretary,and it is FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond, recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President, any Second Vice President,the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by I one or more Attomeys4n-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is i FURTHER RESOLVED,that the signature of each of the following officers;President,any Executive Vice President,any Senior Vice President,any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attomeys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company,and St.Paul Fire and Marine Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. Dated this day of ,ter 104ber 2c�tg $si��hi' 4cep*t�v Alvp pL9 ��� a FIARIFCN r }IARiFOFlD. � ��i Q�MI yr I Y Kevin E.Hughes,Assistant Secretary Toverl the of this PowerofAttorne �' ty y,please cal/us at 1-300-42.1-3880. Please refer to the above-named Attorney-in-Factand the details of the hand to which the power is attached. Green Sheet CPN 02672 640 - Taylor Street P&D SL & TS ----------- . ............. . .... Adobe Sign Document History 02/06/2019 _ Created: 12/13/2018 --------=-- By: Etta Bacy(etta.bacy@fortworthtexas.gov) __.-_.._..---.----------.._..__ Status: Signed Transaction ID: CBJCHBCAABAAoBYalzZ9prNWR8BIa9ollWzT_GLTIOS2 "Green Sheet CPN 02672 640 Taylor Street P&D SL & TS" Hist ory � Document created by Etta Bacy(etta.bacy@fortworthtexas.gov) 12/13/2018-2:25:44 PM CST-IP address:209.194.29.100 E_ Document emailed to Stephen Britz (sbritz@balfourbeattyus.com)for signature 12/13/2018-2:29:23 PM CST Document viewed by Stephen Britz(sbritz@balfourbeattyus.com) 12/17/2018-8:15:16 AM CST-IP address:24.240.251.134 Stephen Britz(sbritz@balfourbeattyus.com) uploaded the following supporting documents: 0 File Attachment 1 6 File Attachment 2 01/07/2019-1:40:50 PM CST CSa Document e-signed by Stephen Britz (sbritz@balfourbeattyus.com) Signature Date:01/07/2019-1:40:50 PM CST-Time Source:server-IP address: 12.228.203.178 Document emailed to Ariel Duarte R(ariel.duarte@fortworthtexas.gov)for signature 01/07/2019-1:40:51 PM CST Document viewed by Ariel Duarte R (ariel.duarte@fortworthtexas.gov) 01/07/2019-3:07:33 PM CST-IP address:209.194.29.100 G , Document e-signed by Ariel Duarte R (ariel.duarte@fortworthtexas.gov) Signature Date:01/07/2019-3:18:22 PM CST-Time Source:server-IP address:209.194.29.100 c'-r Document emailed to Ron Cordova (ronald.cordova@fortworthtexas.gov)for approval 01/07/2019-3:18:24 PM CST F011 v I : Adobe e SSign �i Document viewed by Ron Cordova (ronald.cordova@fortworthtexas.gov) 01/07/2019-3:37:01 PM CST-IP address:209.194.29.100 6c� Document approved by Ron Cordova (ronald.cordova@fortworthtexas.gov) Approval Date:01/07/2019-3:38:10 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Aaron Long (edward.long@fortworthtexas.gov)for signature 01/07/2019-3:38:11 PM CST Document viewed by Aaron Long (edward.long@fortworthtexas.gov) 01/07/2019-3:48:24 PM CST-IP address:209.194.29.100 i 60 Document e-signed by Aaron Long (edward.long@fortworthtexas.gov) Signature Date:01/07/2019-3:48:42 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales Oanie.morales@fortworthtexas.gov)for signature 01/07/2019-3:48:44 PM CST I ``) Document viewed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) 01/08/2019-7:47:26 AM CST-IP address:209.194.29.100 6c� Document e-signed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) Signature Date:01/08/2019-7:49:21 AM CST-Time Source:server-IP address:209.194.29.100 C4. Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 01/08/2019-7:49:22 AM CST Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 01/08/2019-10:10:28 PM CST-IP address:209.194.29.100 6o Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:01/08/2019-10:10:44 PM CST-Time Source:server-IP address:209.194.29.100 C'-. Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 01/08/2019-10:10:45 PM CST Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 01/10/2019-8:09:20 AM CST-IP address:209.194.29.100 tda Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:01/10/2019-8:10:15 AM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Trudy Brotherton (pedro.hernandez@fortworthtexas.gov)for delivery 01/10/2019-8:10:17 AM CST Document viewed by Trudy Brotherton (pedro.hernandez@fortworthtexas.gov) 01/31/2019-1:33:53 PM CST-IP address:209.194.29.100 FORTWORTH. .� Adobe Sign r Document receipt acknowledged by Trudy Brotherton (pedro.hernandez@fortworthtexas.gov) Receipt Acknowledgement Date:01/31/2019-1:34:31 PM CST-Time Source:server-IP address:209.194.29.100 -• Document emailed to Julie A Geho aulie.geho@fortworthtexas.gov)for delivery 01/31/2019-1:34:32 PM CST `"i Document viewed by Julie A Geho Oulie.geho@fortworthtexas.gov) 02/04/2019-9:02:29 AM CST-IP address:209.194.29.100 Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:02/04/2019-9:02:44 AM CST-Time Source:server-IP address:209.194.29.100 Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 02/04/2019-9:02:45 AM CST `i Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 02/04/2019-9:38:59 AM CST-IP address:209.194.29.100 Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:02/06/2019-2:23:11 PM CST-Time Source:server-IP address:209.194.29.100 Signed document emailed to Ron Cordova (ronald.cordova@fortworthtexas.gov), TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov), Julie A Geho Qulie.geho@fortworthtexas.gov), Etta Bacy (etta.bacy@fortworthtexas.gov), and 7 more 02/06/2019-2:23:11 PM CST Foxed Adobe Sign