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HomeMy WebLinkAboutContract 47260-FP2 City Secretary Contract No. 47260 -FP2 �►�J Date Received Jan 14,2019 IK- FORTWORTH. 4,Z6 �oQVQF 'DOC 'x1530 NOTICE OF PROJECT COMPLETION j (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): Water ® Sewer Original Contract Price: $219,268.00 Amount of Approved Change Order(s): $102,954.27 Revised Contract Amount: Total Cost of Work Complete: $322,222.27 Jan 9,2019 Contractor Date Assistant Project Manager Title Balfour Beatty Company Name Arg;W bua it P- Adel Duarte R flan 9.20191 Jan 92019 Project Inspector Date AamntnnelJan �Z Jan 14,2019 Project Manager Date 47"4 c Maz(af Jan 14 2019 Janie Scarlett Wt k.(Jan 14,2019! CFA Manager Date S"CAA,Swun AW* n 14,20�19) Jan 14,2019 Asst. City Manager Date OFFICIAL RECORD page 1 of 2 CITY SECRETARY FT. WORTH,TX a Notice of Project Completion Project Name: 640 Taylor Street City Project No.: 02672 City's Attachments Final Pay Estimate Change Order(s): ❑x Yes ❑ N/A Pipe Report: 0 Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid +wr 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 Cu -Q0.? City Project Numbers 02672 DOE Number 7530 Contract Name 640 TAYLOR STREET Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 12/15/2018 Project Funding Project Manager Long 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 $322,222.27 Less %Retained $0.00 Net Earned $322,222.27 Earned This Period $322,222.27 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 $322,222.27 Thursday,December 13,2018 Page 5 of 5 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name 640 TAYLOR STREET Contract Limits Project Type WATER&SEWER City Project Numbers 02672 DOE Number 7530 Estimate Number I Payment Number 1 For Period Ending 12/15/2018 CD City Secretary Contract Number 117530 Contract Time 730;D 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 5 �• Fs. City Project Numbers 02672 DOE Number 7530 Contract Name 640 TAYLOR STREET Estimate Number 1 Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 12/15/2018 Project Funding WATER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 REMOVE 6"WATERLINE 127 LF $20.11 $2,553.97 127 $2,553.97 2 4"-12"PRESSURE PLUG 4 EA $1,465.20 $5,860.80 4 $5,860.80 3 REMOVE 6"WATER VALVE 2 EA $500.00 $1,000.00 2 $1,000.00 4 SALVAGE FIRE HYDRANT i EA $553.32 $553.32 1 $553.32 5 SALVAGE 1"WATER METER 2 EA $50.00 $100.00 2 $100.00 6 SALVAGE 2"WATER METER l EA $50.00 $50.00 1 $50.00 7 10"WATERLINE LOWERING I EA $12,000.00 $12,000.00 1 $12,000.00 8 12"WATERLINE LOWERING I EA $12,000.00 $12,000.00 1 $12,000.00 9 EXPLORATORY EXCAVATION OF EXISTING 4 EA $2,500.00 $10,000.00 4 $10,000.00 UTILITIES(CO 42) 10 GROUND WATER CONTROL 1 LS $2,500.00 $2,500.00 1 $2,500.00 11 TRENCH SAFETY(CO#1,2,3) 494 LF $2.00 $988.00 494 $988.00 12 DUCTILE IRON WATER FITTING S 10.6 TN $3,838.67 $40,689.90 10.6 $40,689.90 W/RESTRAINT(CO 2&3) 13 6"WATER PIPE(CO#1) 90 LF $63.30 $5,697.00 90 $5,697.00 14 8"WATER PIPE(CO#1,2) 179 LF $115.00 $20,585.00 179 $20,585.00 15 10"WATER PIPE(CO#3) 225 LF $150.00 $33,750.00 225 $33,750.00 16 FIRE HYDRANT 1 EA $3,848.65 $3,848.65 1 $3,848.65 17 4"WATER METER AND VAULT I EA $20,000.00 $20,000.00 1 $20,000.00 18 6"GATE VALVE(CO#2) 3 EA $1,248.05 $3,744.15 3 $3,744.15 19 8"GATE VALVE i EA $1,432.49 $1,432.49 1 $1,432.49 20 10"GATE VALVE(CO 43) 4 EA $2,477.65 $9,910.60 4 $9,910.60 21 18"X 8"TAPPING SLEEVE&VALVE 1 EA $8,514.98 $8,514.98 1 $8,514.98 23 TRAFFIC CONTROL(CO#2) 3 MO $2,006.55 $6,019.65 3 $6,019.65 24 REMOVE WATER SERVICE 3 EA $1,551.92 $4,655.76 3 $4,655.76 25 SPEC.REMOBILIZATION(CO#2) 3 EA $2,500.00 $7,500.00 3 $7,500.00 26 REMOVAL 18"X 6"CROSS I EA $5,000.00 $5,000.00 1 $5,000.00 27 16"X 12"CROSS 1 EA $20,000.00 $20,000.00 1 $20,000.00 Sub-Total of Previous Unit $238,954.27 $238,954.27 Thursday,December 13,2018 Page 2 of 5 City Project Numbers 02672 DOE Number 7530 Conti-act Name 640 TAYLOR STREET Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 12/15/2018 Project Funding SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 SANITARY LINE GROUTING 1 CY $2,124.64 $2,124.64 1 $2,124.64 2 REMOVE 6"SEWER LINE 360 LF $30.00 $10,800.00 360 $10,800.00 3 6"SEWER ABANDOMENT PLUG 3 EA $500.00 $1,500.00 3 $1,500.00 4 ABANDON MANHOLE 1 EA $1,000.00 $1,000.00 1 $1,000.00 5 MANHOLE VACUUM TESTING 2 EA $250.00 $500.00 2 $500.00 6 GROUND WATER CONTROL 1 LS $2,500.00 $2,500.00 1 $2,500.00 7 TRENCH SAFETY 79 LF $2.00 $158.00 79 $158.00 8 TRENCH WATER STOPS 2 EA $250.00 $500.00 2 $500.00 9 WASTEWATER ACCESS CHAMBER 1 EA $1,500.00 $1,500.00 1 $1,500.00 10 6"SEWER SERVICE 1 EA $9,000.00 $9,000.00 1 $9,000.00 11 8"SEWER SERVICE 1 EA $11,000.00 $11,000.00 1 $11,000.00 12 4'DROP MANHOLE 2 EA $15,000.00 $30,000.00 2 $30,000.00 13 4'EXTRA DEPTH MANHOLE 22 VF $100.00 $2,200.00 22 $2,200.00 14 BYPASS PUMPING 1 LS $1,485.36 $1,485.36 1 $1,485.36 15 TRAFFIC CONTROL 1 MO $2,500.00 $2,500.00 1 $2,500.00 16 3500 GALLOON GREASE TRAP 1 EA $1,500.00 $1,500.00 1 $1,500.00 17 GREASE TRAP SAMPLE WELL-PARK 1 EA $5,000.00 $5,000.00 1 $5,000.00 Sub-Total of Previous Unit $83,268.00 $83,268.00 ---------------------------------------- Thursday,December 13,2018 Page 3 of 5 City Project Numbers 02672 DOE Number 7530 Contract Name 640 TAYLOR STREET Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 12/15/2018 Project Funding Contract Information Summary Original Contract Amount $219,268.00 Change Orders Change Order Number 1 $2,367.20 Change Order Number 2 $47,155.83 Change Order Number 3 $53,431.24 Total Contract Price $322,222.27 Total Cost of Work Completed $322,22227 Less %Retained $0.00 Net Earned $322,222.27 Earned This Period $322,222.27 Retainage This Period $0.00 Less Liquidated Damages Days a /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 $322,222.27 Thursday,December 13,2018 Page 4 of 5 . � . i . 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W 4 O H h- U` r x ¢•Z z vfi Q W�W .� � �Zap kt W W Z au ¢ d vijw u v W- u'i E Y•_.�-'Nrt.norm s��� U Q v Z {- IJ (r ICY) o 0 o a rz a N a a ��="Q+�• l.�'I.civ O < w xr. ° ik w LL 3k Ozaw � $ Ij �O CC O tL O r cc ¢ o z til'� o C-)0 U) Vi n_ « 1: L, a N FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: 640 Taylor Street PROJECT NUMBER: 2672 DOE NUMBER: 7530 WATER PIPE LAID SIZE TYPE OF PIPE LF 10" PVC 225 8" PVC 179 6" PVC 90 FIRE HYDRANTS: I VALVES(16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF 6" DIP 225 DENSITIES: NEW SERVICES: 1(4") PVC SEWER PIPE LAID SIZE TYPE OF PIPE LF PIPE ABANDONED SIZE TYPE OF PIPE LF 6" CLAY 360 DENSITIES: NEW SERVICES: 1(6") PVC SDR26 1(8") PVC SDR26 TRANSPORTATION AND PUBLIC WORKS F The Ciq,of Fort Worth•1000 Throckmorton Street•Fort Worth,TY 76012-6311 (817)392-7941 •Fax: (817)392-7845 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 Stepl en Britz,A ist Project Manager Subscribed and sworn before me on this date 7th of Jan, 2019. �,,,%y I$/,,iROBIN THOMAS _Notary Public,State of Texas Comm.Expires 11-12-2022 N tary Public 0 Notary ID 131793219 Tarrant,Texas City Secretary Contract No. FORTWORTH.) Date Received 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 0 Drainage 0 Street Lights ❑x 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 A!xhtz Steph n Britz(Jan 7.2019) Jan 7,2019 Contractor Date Assistant Project Manager Title Balfour Beatty Company Name Project Inspector Date Project Manager Date CFA Manager Date Asst. City Manager Date Page 1 of 2 Notice of Project Completion Project Name: 640 Taylor Street City Project No.: 02672 City's Attachments Final Pay Estimate 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 2 of 2 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 I Payment Number 1 For Period Ending 12/15/2018 CD City Secretary Contract Number 117530 Contract Time 73CD 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 I 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 ---------------------------------------- I ---------------- --------------------I 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 1 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 --------------------- ------ -------------------- I 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) 380 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 6"-12"TREE REMOVAL 6 EA $833.00 $4,998.00 6 $4,998.00 7 5'WIDE ASPHALT PVMT REPAIR(CO 0) 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 I 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 1 Contract Limits Payment Number I 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 I9 REMOVE 6"PVMT MARKING 120 LF $1.50 $180.00 120 $180.00 20 REMOVE LANE LEGEND BIKE 1 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 FURNISHANSTALL 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 FURNISHANSTALL ONE WAY TRAFFIC SIGN 1 EA $300.00 $300.00 1 $300.00 28 FURNISHANSTALL GRATING TELCO VAULT I EA $5,850.00 $5,850.00 1 $5,850.00 29 FURNISH/INSTALL GRATING AN VAULT I 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 I LS $4,200.00 $4,200.00 1 $4,200.00 2 CONDUIT BOY I EA $3,600.00 $3,600.00 1 $3,600.00 3 RELOCATE STREET LIGHT POLE 1 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#3) 1095 LF $10.00 $10,950.00 1095 $10,950.00 2 2"CONDT 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 LIGLIT For Period Ending 12/15/2018 Project Finding 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 15 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 17 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 FURNISH/INSTALL 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 I 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 357I 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 FURNISIUINSTALLATC 3571 1 LS $12,190.00 $12,190.00 1 $12,190.00 CONTROLLER/CABINET POLE MOUNT 27 FURNISH 2070 ATC SIGNAL CONTROLLER I 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- 1 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 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 Project Manager Long 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 rr $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 Page 6 of 6 i i i I � U N 0 0 OO j U j � 5 a R pN qqN N y Ir �St?O 0 d y V s N N o ❑ B z Q ay UaW � qqq � � n a O W q m z f'• in z c` wFPo io oco D o C j d `m' t-- I ® C{�ocli s S M M tz fY n t-: z O m m 7ti N 7� W Z U S C7 O a g o q SR o o a S -•e W ¢ � ° d) � a 4. ri U o o d $ M tl E 0 w a a � � � � S 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U00Stn ` ) � N N v 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, firans, 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 Stepl en Britz,A ist Project Manager Subscribed and sworn before me on this date 7th of Jan, 2019. �"N%,yM", ROBIN THOMAS _Notary Public.State of Texas Comm. Expires 11-12-2022 N tary Public Notary ID 131793219 Tarrant,Texas TRAVELERSJ November 29,2018 i City of Fort Worth 1000 Throckmorton Street Fort Worth,TX 76102 Re: Balfour Beatty Construction,LLC Bond No. 106392270 To Whom It May Concern: 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. 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 Ak P' 4 --- Noah William Pierce,Attorney-In-Fact Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS J 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. 1 Paul Fire 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 William Pierce,of Hartford,Connecticut,their true and lawful Attomey4n-Fact to sign,execute,seal and acknowledge any and all bonds, recognizances,conditional undertakings and other writings obligatory in j 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. may" i 0 9r cows lo f6q State of Connecticut l! 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. i In Witness Whereof,I hereunto set my hand and official seal. I My Commission expires the 30th day of June,2021 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: j RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any 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 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 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 ry in the nature of a bond, recognizance,or conditional i 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 one or more Attorneys4n-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more i Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice i 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 Attorneys-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 if is attached. 1, 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 a�� day of �l�,4,tber 2otP j lol Go Kevin E.Hughes,Assistant Secretary 1 To verity the authenticity of this Power ofAttomey,please callus at i-809-42.1-3880. Please refer to the above named Attorney-in-Fart and the details of the bond to which the power is attached. I . I :-_=:______._:� Green Sheet CPN 02672 640 -- -_=-= Tayor Street W&S ---__.-==_ --==_-_- Adobe Sign Document History 02/06/2019 ---- — _ _— – Created: 12/13/2018 By: Etta Bacy(etta.bacy@fortworthtexas.gov) - ------ -- – Status: Signed _._._.__._._. Transaction ID: CBJCHBCAABAAOajm9CBRIgKugC2w8Hsr2QfwNFjrSg71 "Green Sheet CPN 02672 640 Tayor Street W&S" History Document created by Etta Bacy (etta.bacy@fortworthtexas.gov) 12/13/2018-2:17:11 PM CST-IP address:209.194.29.100 -w Document emailed to Stephen Britz(sbritz@balfourbeattyus.com)for signature 12/13/2018-2:23:34 PM CST ,-i Document viewed by Stephen Britz(sbritz@balfourbeattyus.com) 01/08/2019-9:11:23 AM CST-IP address:47.184.105.117 Li Stephen Britz(sbritz@balfourbeattyus.com) uploaded the following supporting documents: File Attachment 1 File Attachment 2 01/09/2019-8:48:55 AM CST y.. Document e-signed by Stephen Britz(sbritz@balfourbeattyus.com) Signature Date:01/09/2019-8:48:55 AM CST-Time Source:server-IP address: 12.228.203.178 E'-, Document emailed to Ariel Duarte R(ariel.duarte@fortworthtexas.gov)for signature 01/09/2019-8:48:56 AM CST Document viewed by Ariel Duarte R (ariel.duarte@fortworthtexas.gov) 01/09/2019-8:58:36 AM CST-IP address:209.194.29.100 Document e-signed by Ariel Duarte R (ariel.duarte@fortworthtexas.gov) Signature Date:01/09/2019-8:59:20 AM CST-Time Source:server-IP address:209.194.29.100 Document emailed to ron cordova (ronald.cordova@fortworthtexas.gov)for approval 01/09/2019-8:59:22 AM CST `C=i Document viewed by ron cordova (ronald.cordova@fortworthtexas.gov) 01/14/2019-7:18:46 AM CST-IP address:209.194.29.100 FoxJe Ad.b,,Sign �. Document approved by ron cordova (ronald.cordova@fortworthtexas.gov) Approval Date:01/14/2019-7:19:52 AM CST-Time Source:server-IP address:209.194.29.100 C Document emailed to Aaron Long (edward.long@fortworthtexas.gov)for signature 01/14/2019-7:19:54 AM CST v Document viewed by Aaron Long (edward.long@fortworthtexas.gov) 01/14/2019-1:32:58 PM CST-IP address:209.194.29.100 Document e-signed by Aaron Long (edward.long@fortworthtexas.gov) Signature Date:01/14/2019-1:33:20 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales Qanie.morales@fortworthtexas.gov)for signature 01/14/2019-1:33:22 PM CST LD Document viewed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) 01/14/2019-1:34:16 PM CST-IP address:209.194.29.100 J Document e-signed by Janie Scarlett Morales (Janie.morales@fortworthtexas.gov) Signature Date:01/14/2019-1:35:15 PM CST-Time Source:server-IP address:209.194.29.100 C; Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 01/14/2019-1:35:17 PM CST Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 01/14/2019-2:03:00 PM CST-IP address:108.218.148.43 Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:01/14/2019-2:03:18 PM CST-Time Source:server-IP address: 108.218.148.43 Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 01/14/2019-2:03:19 PM CST �J Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 01/14/2019-2:08:57 PM CST-IP address:209.194.29.100 Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:01/14/2019-2:09:50 PM CST-Time Source:server-IP address:209.194.29.100 Document emailed to Trudy Brotherton (pedro.hernandez@fortworthtexas.gov)for delivery 01/14/2019-2:09:52 PM CST Document viewed by Trudy Brotherton (pedro.hernandez@fortworthtexas.gov) 01/31/2019-1:35:36 PM CST-IP address:209.194.29.100 r Document receipt acknowledged by Trudy Brotherton (pedro.hernandez@fortworthtexas.gov) Receipt Acknowledgement Date:01/31/2019-1:35:53 PM CST-Time Source:server-IP address:209.194.29.100 FORTWORTH. . r Adobe Sign C: Document emailed to Julie A Geho Qulie.geho@fortworthtexas.gov)for delivery 01/31/2019-1:35:55 PM CST u Document viewed by Julie A Geho Qulie.geho@fortworthtexas.gov) 02/04/2019-9:01:55 AM CST-IP address:209.194.29.100 !� Document receipt acknowledged by Julie A Geho Qulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:02/04/2019-9:02:16 AM CST-Time Source:server-IP address:209.194.29.100 C� Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 02/04/2019-9:02:17 AM CST "ii Document viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 02/04/2019-9:02:46 AM CST-IP address:209.194.29.100 bQ Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:02/06/2019-2:21:26 PM CST-Time Source:server-IP address:209.194.29.100 Signed document emailed to Stephen Britz (sbritz@balfourbeattyus.com),Allison Tidwell (cso_finalpay@fortworthtexas.gov), Etta Bacy (etta.bacy@fortworthtexas.gov), ron cordova (ronaid.cordova@fortworthtexas.gov), and 7 more 02/06/2019-2:21:26 PM CST FORTWORTH, � � Adobe Sign