HomeMy WebLinkAboutContract 48725-FP1 City Secretary
Contract No. 48725 -FPI
R CEIVED FORTWORTHODate Received Feb 8,2019
12 2019 /00(05—
NOTICE
00(15—
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:ANDREWS DISTRIBUTING COMPANY
City Project No.: 100615
Improvement Type(s): ❑ Paving ® Drainage ❑ Street Lights ❑ Traffic Signals
Original Contract Price: $336,869.00
Amount of Approved Change Order(s):
Revised Contract Amount: $336,869.00
Total Cost of Work Complete: $336,869.00
�11t C T",akP/U( Feb 7 2019
Jon C Feed"kk IFeh 7_]0191
Contractor Date
Project Managaer
Title
Lee Lewis Construction,Inc.
Company Name
asp- = Feb 8,2019
Project Inspector Date
fredWa Feb 8,2019
FM INA T-b 8.201%
Project Manager Date
Feb 8,2019
t1fF'
Manager Date
5usan Al anis(Feb 8,2019) Feb 8,2019
Asst. City Manager Date
OFFICIAL RECO e 1 of 2
CITY SECRETARY
FT.WORTH,TX
Notice of Project Completion
Project Name:ANDREWS DISTRIBUTING COMPANY
City Project No.: 100615
City's Attachments
Final Pay Estimate ZI
Change Order(s): ❑ Yes ❑x N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time: 365 CD Days Charged: 682
Work Start Date: 3/6/2017 Work Complete Date: 1/16/2019
Page 2 of 2
i,
City Project Numbers 100615 DOE Number 0615oO
Contract Name ANDREWS DISTRIBUTING COMPANY Estimate Number 1
Contract Limits Payment Number 1
Project Type STORM DRAIN For Period Ending 1/16/2019
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors DICKINSON / FARGO Contract Date
Contractor LEE LEWIS CONSTRUCTION,INC. Contract Time 365 CD
171 It PRESTON ROAD Days Charged to Date 682 CD
DALLAS, TX 75379 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 $336,869.00
Less %Retained $0.00
Net Earned $336,869.00
Earned This Period $336,869.00
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 $336,869.00
Thursday,January 24,2019 Page 4 of 4
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name ANDREWS DISTRIBUTING COMPANY
Contract Limits
Project Type STORM DRAIN
City Project Numbers 100615
DOE Number 0615
Estimate Number l Payment Number 1 For Period Ending 1/16/2019
CD
City Secretary Contract Number Contract Time 36FD
Contract Date Days Charged to Date 682
Project Manager NA Contract is 100.00 Complete
Contractor LEE LEWIS CONSTRUCTION,INC.
17111 PRESTON ROAD
DALLAS, TX 75379
Inspectors DICKINSON / FARGO
Thursday,January 24,2019 Pagel of4
I
City Project Numbers 100615 DOE Number 0615
Contract Name ANDREWS DISTRIBUTING COMPANY Estimate Number I
Contract Limits Payment Number 1
Project Type STORM DRAIN For Period Ending 1/16/2019
Project Funding
STORM DRAIN
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
----------------------------------------------
I REMOVE 36"STORM LINE 266 LF $30.00 $7,980.00 266 $7,980.00
2 REMOVE STORM SEWER BOX 162 LF $100.00 $16,200.00 162 $16,200.00
3 LARGE STONE RIPRAP 700 SY $85.00 $59,500.00 700 $59,500.00
4 24"RCP CLASS III 30 LF $106.00 $3,180.00 30 $3,180.00
5 36"RCP CLASS 111 245 LF $115.00 $28,175.00 245 $28,175.00
6 42"RCP CLASS II1 39 LF $206.00 $8,034.00 39 $8,034.00
7 9X4 BOX CULVERT 245 LF $580.00 $142,100.00 245 $142,100.00
8 HEADWALL BOX CULVERT 5.5 CY $1,250.00 $6,875.00 5.5 $6,875.00
9 SET TYPE I FOR BOX CULVERT 7.7 CY $1,250.00 $9,625.00 7.7 $9,625.00
10 36"SET I PIPE 1 EA $6,000.00 $6,000.00 1 $6,000.00
11 10'CURB INLET I EA $3,900.00 $3,900.00 1 $3,900.00
12 6'WIDE CONCRETE FLUME 755 LF $60.00 $45,300.00 755 $45,300.00
---------------------------------------
Sub-Total of Previous Unit $336,869.00 $336,869.00
---------------------------------------
Thursday,January 24,2019 Page 2 of 4
City Project Numbers 100615 DOE Number 0615
Contract Name ANDREWS DISTRIBUTING COMPANY Estimate Number 1
Contract Limits Payment Number 1
Project Type STORM DRAIN For Period Ending 1/16/2019
Project Funding
Contract Information Summary
Original Contract Amount $336,869.00
Change Orders
Total Contract Price $336,869.00
Total Cost of Work Completed $336,869.00
Less %Retained $0.00
Net Earned $336,869.00
Earned This Period $336,869.00
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 $336,869.00
Thursday,January 24,2019 Page 3 of
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Document G706 — 1994
Contractor's Affidavit of Payment of Debts and Claims
PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: OWNER:❑
Andrews Distributing ARCHITECT:❑
500 Northeast Loop 820 CONTRACT FOR: CONTRACTOR:Q
Ft. Worth,TX 76106 SURETY:❑
TO OWNER:(Name and address) CONTRACT DATED:August 31,2016 OTHER:❑
Andrews Distribution Company of
North Texas,LLC
2730 Irving Blvd.
Dallas,TX 75207
STATE OF: Texas
COUNTY OF: Dallas
The undersigned hereby certifies that,except as listed below,payment has been made in full and all obligations have otherwise
been satisfied for all materials and equipment furnished,for all work,labor,and services performed,and for all known
indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the
Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered.
EXCEPTIONS:
SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address)
1. Consent of Surety to Final Payment. Whenever Lee Lewis Construction,Inc.
Surety is involved,Consent of Surety is 17177 Preston Rd.,Ste. 160
requited. AIA Document G707,Consent of
Surety,may be used for this purpose
Indicate Attachment ❑ Yes ® No
f;l .
The following supporting documents should be attached nture. of�ruhori=eel representative)
hereto if•required by the Olvner:
1. Contractor's Release or Waiver of Liens, (Printed name and title)
conditional upon receipt of final payment.
2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me on this date:
Subcontractors and material and equipment
suppliers, to the extent required by the Owner,
accompanied by a list thereof. '" r
`,,\�xyp SHARON STORY
Notary Public. i'Ublic,State of Texas
3. Contractor's Affidavit of Release of Liens(AIA My Commission Expi { I Com Expires 08-15-2021
Document G706A). ''��;;;;���`� Lary ID 4180549
AIA Document G70611—1Copyright m 1970 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"l Document,or any portion of it, 1
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 14:19:20 ET on 01/30/2019 under Order No 3780910300 which expires on 04/25/2019,and is not for resale
User Notes: (3139ADA53)
CITY OF FORT WORTH, TEXAS
STREET AND STORM DRAIN CONTRACTORS BOND
Bond No. SG 0087
THE STATE OF TEXAS )
KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF TARRANT )
That We Mario Sinacola & Sons Excavating, Inc. ,
As, principal, and Travelers Casualty & Surety Company of America ,
As surety, are held and firmly bound unto the City of Fort Worth, Texas, in the penal sum of
twenty-five thousand Dollars ($25,000.00) good and lawful money of the United States of
America, well and truly to be paid for the payment of which we, and each of us, hereby bind
ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by
these presents
THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT
WHEREAS,the above principal desires to engage in the business of laying, constructing,
building, repairing, rebuilding, grading, graveling, paving, surfacing, resurfacing and doing work
in and upon the public streets, alley or thoroughfares within the corporate limits of the City of
Fort Worth and has complied with all the terms and conditions of ordinance No. 3449 of the City
of Fort Worth, Texas, and has applied to the Director of Transportation and Public Works as
provided in said ordinance
NOW, THEREFORE, if said principal shall fully indemnify and save whole and harmless
the said City of Fort Worth, its agents and employees, as well as indemnify and save harmless
any person, firm or corporation with whom the Principal has contracted, from any and all
damages of any character arising from or caused directly or indirectly by any negligence in the
performance of such work as above set forth under the terms of said ordinance and said license
or for any imperfect or inadequate work done by said principal under the terms of said
ordinance and said license, and shall maintain said work in good and workmanlike state of
repair for a period of two (2) years from and after its completion and acceptance by the City of
Fort Worth, then this obligation shall be null and void, otherwise to remain in full force and
effect: provided, however, this bond is executed by the surety on the condition that its liability
shall be limited by and subject to the conditions and provisions hereinunder contained:
$uccessive actions may be brought on this bond for successive breaches of its
conditions or any of them; provided, however, that the total sum of all liability of the surety on
any one or all of such actions shall not exceed a total sum of Twenty-five Thousand Dollars
($25,000.00).
The liability of the Surety under this bond, if not canceled as hereinafter provided, shall
cease and terminate of its own force and effect one year from the date hereon, saving and
excepting for the maintenance of the work performed previous to the date of termination, for
which work the liability of the Surety for maintenance shall continue for two years from and after
the date of the completion and acceptance of said work by the City, but no longer.
The Surety may terminate its liability under this bond at any time by giving the City
Council of the City of Fort Worth, Texas, five (5) days notice in writing of the Surety's intention
to do so, and from and after said date the Surety will no longer be liable for any subsequent act,
save and except as to maintenance as herein above provided.
IN WITNESS WHEREOF, the said Principal and the said Surety have set their hand and
seal this the loth day of Novemher 20 18
Mario Si o & Sons Ex avating, Inc
tMihae Sinacola - ViRkinl3iga-lident
Travelers Casualty & Surety Camany of ATerica
j /Surety
Attrney-in-Fact
Kathleen M. M;Can
I
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.
Paul Fire and Marine Insurance Company are corporations duty organized under the laws of the State of Connecticut (herein collectively called the
Companies"),and that the Companies do hereby make,constitute and appoint Kathleen M.McCann of BINGHAM FARMS
Michigan ,their true and lawful Attomey-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances,
conditional undertakings and other writings obligatory In 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.
: ort , ' ooreiia
State of Connecticut
By: / ..
City of Hartford ss. Robert L.Raney.Se for Vice President
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.
a
My Commission expires the 30th day of June,2021 � mf3fuut. t>1�ItR.Gtmj--k
0•�'# Mane C.Tetreault,Notary Public
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 Comparry 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
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 arty such appointee and revoke
the power given him or her,and it Is
FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,arry 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 tied 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 shad 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,arry Second Vice President,the Treasurer,arry Assistant Treasurer,the Corporate Secretary or any Assistant
Secretary and duty attested and sealed with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,it required)by
one or more Attomeys-In-Fad 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
FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,arry Vice
President,any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be attired by facsimile to any Power
of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fad 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 shin 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 20th day of November 12018
001>
le
,It,*
8
2018
8 8
Kevin E.Hughes,Asst taut Secretary
To verily the autihenthoYy of trfs PowerofAtta-W,pilease call as at 2-800-421 3ma
Please iefer to the above-named Attomey-in-fact and the details of the blond to whit*the power is attadlied.
CITY OF FORT WORTH, TEXAS
STREET AND STORM DRAIN CONTRACTORS BOND
Bond No. SG 0087
THE STATE OF TEXAS )
KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF TARRANT )
That We Mario Si nacol a & Sons Excavating, Inc.
As, principal, and Travelers Casualty & Surety Company of America ,
As surety, are held and firmly bound unto the City of Fort Worth, Texas, in the penal sum of
twenty-five thousand Dollars ($25,000.00) good and lawful money of the United States of
America, well and truly to be paid for the payment of which we, and each of us, hereby bind
ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by
these presents
THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT
WHEREAS, the above principal desires to engage in the business of laying, constructing,
building, repairing, rebuilding, grading, graveling, paving, surfacing, resurfacing and doing work
in and upon the public streets, alley or thoroughfares within the corporate limits of the City of
Fort Worth and has complied with all the terms and conditions of ordinance No. 3449 of the City
of Fort Worth, Texas, and has applied to the Director of Transportation and Public Works as
provided in said ordinance
NOW, THEREFORE, if said principal shall fully indemnify and save whole and harmless
the said City of Fort Worth, its agents and employees, as well as indemnify and save harmless
any person, firm or corporation with whom the Principal has contracted, from any and all
damages of any character arising from or caused directly or indirectly by any negligence in the
performance of such work as above set forth under the terms of said ordinance and said license
or for any imperfect or inadequate work done by said principal under the terms of said
ordinance and said license, and shall maintain said work in good and workmanlike state of
repair for a period of two (2) years from and after its completion and acceptance by the City of
Fort Worth, then this obligation shall be null and void, otherwise to remain in full force and
effect: provided, however, this bond is executed by the surety on the condition that its liability
shall be limited by and subject to the conditions and provisions hereinunder contained:
Successive actions may be brought on this bond for successive breaches of its
conditions or any of them; provided, however, that the total sum of all liability of the surety on
any one or all of such actions shall not exceed a total sum of Twenty-five Thousand Dollars
($25,000.00).
The liability of the Surety under this bond, if not canceled as hereinafter provided, shall
cease and terminate of its own force and effect one year from the date hereon, saving and
excepting for the maintenance of the work performed previous to the date of termination, for
which work the liability of the Surety for maintenance shall continue for two years from and after
the date of the completion and acceptance of said work by the City, but no longer.
The Surety may terminate its liability under this bond at any time by giving the City
Council of the City of Fort Worth, Texas, five (5) days notice in writing of the Surety's intention
to do so, and from and after said date the Surety will no longer be liable for any subsequent act,
save and except as to maintenance as herein above provided.
IN WITNESS WHEREOF, the said Principal and the said Surety have set their hand and
seal this the 20th day of NovPmhpr 20 18
Mario Si,P<6 & Sons Ex avating, Inc
Michae . Sinacola - viPLginpipabident
Travelers Casualty & Sunety Carpany of America
Curety
Jr J d' J�
Attrney-in-Fact
Kathleen M. ttCann
Travelers Casualty and Surety Company of America
'"1111111h. 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.
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 Kathleen M.McCann of BINGHAM FARMS
Michigan ,their true and lawful Attorney-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances,
conditional undertakings and other writings obligatory in 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.
COOLr
4 ? M c W�KJut
State of Connecticut
BY: Z,
:!fir
City of Hartford ss. Robert L.Raney,Seftfor Vice President
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 Sl.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. j
In Witness Whereof,I hereunto set my hand and official seal.
a ,�- .i
0My Commission expires the 30th day of June,2021 mOA�A� C .1
*�/'t M C.Tetreauft,Notary Public
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,arty Senior Vice President,any Vice President,any
Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and
Agents to ad 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 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)duty executed(under seat,if required)by
one or more Attorneys-in-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 mitten delegation of authority;and it is
FURTHER RESOLVED,that the signature of each of the following officers:President,any e=xecutive 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 Attomeys4n-Fad for purposes only
of executing and attesting bonds and undertakings and other wrttings 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 shaft be valid and binding on the Company in the fixture with respect to any bond or understanding to which d 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 20th day of Novembercwwin
2018
t
" •f 'rf � n E.Hughes,Assillant Secretary
To venlfy the autlientWW of Chis Power ofAttarney,please call as at 1-800-421 3880.
Please refer to the above-named Atwmey-in-Fad and the details of the bond fa whidi Me power is attached.
Texas Department of Transportation
Permit Completion of work
I Bill Boothe, Texas Department of Transportation Permit Chief Inspector have verified
the completion of work for the below mentioned permit.
Permit#: 10-DCC-33-17
Location: IH 820 @ Railhead Andrews Distribution
Bill Boothe
Texas Department of Transportation
Permit Chief Inspector
North Tarrant Area Office
817-291-6413
Bill.Boothe@Txdot.gov
AIA
- Document G7
06TM — 1994
Al-
Contractor's Affidavit of Payment of Debts and Claims
PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER:]Q
Andrews Distributing ARCHITECT:❑
500 Northeast Loop 820 CONTRACT FOR: CONTRACTOR:[]
Ft. Worth,TX 76106 SURETY:❑
TO OWNER:(Name and address) CONTRACT DATED:August 31,2016 OTHER:❑
Andrews Distribution Company of
North Texas,LLC
2730 Irving Blvd.
Dallas,TX 75207
STATE OF: Texas
COUNTY OF: Dallas
The undersigned hereby certifies that,except as listed below,payment has been rnade in full and all obligations have otherwise
been satisfied for all materials and equipment furnished,for all work,labor,and services performed,and for all known
indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the
Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered.
EXCEPTIONS:
SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address)
1. Consent of Surety to Filial Payment. Whenever Lee Lewis Construction,Inc.
Surety is involved,Consent of Surety is 17177 Preston Rd.,Ste. 160
required. AIA Document G707,Consent of
Surety,may be used for this purpose
Indicate Attachment ❑ Yes ® No —
131 .
The folloiring supporting documents should be attached rrtrrn. of r,rrhn,i_eil representative)
hereto if required by the Otvner: Pwc-e,_
Celt-) C'r f`Ir r; roc e�
1. Contractor's Release or Waiver of Liens, (Printed name and lisle)
conditional upon receipt of final payment.
2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me on this date:
Subcontractors and material and equipment
suppliers, to the extent required by the Owner,
��u i nr
accompanied by a list thereof. +_�Ya r SHARON STORY
Notary Public. 'ublii.State of Texas
3. Contractor's A ffidavit of Release of Liens(AIA My Commission Expi rs ? 'I Com Expires 08-15 2021
Document G706A). %.;q„ atary ID 4180549
AIA Document G706——1994.Copyright m 1970 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, 1
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 14:19:20 ET on 01/30/2019 under Order No 3780910300 which expires on 04/25/2019,and is not for resale
User Notes: (369ADA53)
CITY OF FORT WORTH, TEXAS
STREET AND STORM DRAIN CONTRACTORS BOND
Bond No. SG 0087
THE STATE OF TEXAS )
KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF TARRANT )
That We Mario Sinacola & Sons Excavating, Inc.
As, principal, and Travelers Casualty & Surety Company of America_ ,
As surety, are held and firmly bound unto the City of Fort Worth, Texas, in the penal sum of
twenty-five thousand Dollars ($25,000.00) good and lawful money of the United States of
America, well and truly to be paid for the payment of which we, and each of us, hereby bind
ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by
these presents
THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT
WHEREAS, the above principal desires to engage in the business of laying, constructing,
building, repairing, rebuilding, grading, graveling, paving, surfacing, resurfacing and doing work
in and upon the public streets, alley or thoroughfares within the corporate limits of the City of
Fort Worth and has complied with all the terms and conditions of ordinance No. 3449 of the City
of Fort Worth, Texas, and has applied to the Director of Transportation and Public Works as
provided in said ordinance
NOW, THEREFORE, if said principal shall fully indemnify and save whole and harmless
the said City of Fort Worth, its agents and employees, as well as indemnify and save harmless
any person, firm or corporation with whom the Principal has contracted, from any and all
damages of any character arising from or caused directly or indirectly by any negligence in the
performance of such work as above set forth under the terms of said ordinance and said license
or for any imperfect or inadequate work done by said principal under the terms of said
ordinance and said license, and shall maintain said work in good and workmanlike state of
repair for a period of two (2) years from and after its completion and acceptance by the City of
Fort Worth, then this obligation shall be null and void, otherwise to remain in full force and
effect: provided, however, this bond is executed by the surety on the condition that its liability
shall be limited by and subject to the conditions and provisions hereinunder contained:
Successive actions may be brought on this bond for successive breaches of its
conditions or any of them; provided, however, that the total sum of all liability of the surety on
any one or all of such actions shall not exceed a total sum of Twenty-five Thousand Dollars
($25,000.00).
The liability of the Surety under this bond, if not canceled as hereinafter provided, shall
cease and terminate of its own force and effect one year from the date hereon, saving and
excepting for the maintenance of the work performed previous to the date of termination, for
which work the liability of the Surety for maintenance shall continue for two years from and after
the date of the completion and acceptance of said work by the City, but no longer.
The Surety may terminate its liability under this bond at any time by giving the City
Council of the City of Fort Worth, Texas, five (5) days notice in writing of the Surety's intention
to do so, and from and after said date the Surety will no longer be liable for any subsequent act,
save and except as to maintenance as herein above provided.
IN WITNESS WHEREOF, the said Principal and the said Surety have set their hand and
seal this the ?oth day of Nnvemher 20_ 98
Mario Si o & SoW— ViLPkinlAA-Aident
avating, Inc
( Michae Sinacola
Travelers Casualty & Surety Caipany of Pmerica
Surety
Attrney-in-Fact
Kathleen M. McCan
6
Travelers Casualty and Surety Company of America
�` Travelers Casualty and Surety Company
TRAVELERS J SL 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 Fire and Marine Insurance Company are corporations duty organized under the laws of the State of Connecticut (herein collectively called the
"Companies"),and that the Companies do hereby make,constitute and appoint Kathleen M.McCann of BINGHAM FARMS
Michigan ,their true and lawful Attomey-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances,
conditional undertakings and other writings obligatory In 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.
\m�AT�rdr�ff
V Q MvmlgliD. ' OOir01i�
State of Connecticut
City of Hartford ss. Robert L.Raney.Se or Vice President
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. O
My Commission expires the 30th day of June,2021 mO A~ lanxaih�
tr • ♦ Mane C.Tetreautt,Notary Public
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casually and
Surety Comparry 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,arty Senior Vice President,any Vice President,any
Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attomeya-in-Fact and
Agents to ad 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 arry of said officers or the Board of Directors at any time may remove arty such appointee and revoke
the power given him or her,and it Is
FURTHER RESOLVED,that the Chairman,the President,arty 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 in the nature of a bond,recognizance,or conditional
undertaking shall be valid and binding upon the Company when(a)signed by the President.ary 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 Attomeys-Iry-Fad 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
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.arty Assistant Secretary,and the seal of the Company may be affixed by facsimile to arty Power
of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fad 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 Casually 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 20th day of November 12018
er� �' •�ter/.F� �� SSG C`� ,
Kevin E.Hughes,Assi tant Secretary
To verify the authentrc3ly of this Power of Attorney,please call us atl-80"21 388Q
Please refer to the above-named Attnrney4n-Fad and the details of die bond to which the power is attached.
CITY OF FORT WORTH, TEXAS
STREET AND STORM DRAIN CONTRACTORS BOND
Bond No. SG 0087
THE STATE OF TEXAS )
KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF TARRANT )
That We Mario Si nacol a & Sons Excavating, Inc.
As, principal, and Travelers Casualty & Surety Company of America ,
As surety, are held and firmly bound unto the City of Fort Worth, Texas, in the penal sum of
twenty-five thousand Dollars ($25,000.00) good and lawful money of the United States of
America, well and truly to be paid for the payment of which we, and each of us, hereby bind
ourselves, our heirs, executors, administrators and successors, jointly and severally, firmly by
these presents
THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT
WHEREAS, the above principal desires to engage in the business of laying, constructing,
building, repairing, rebuilding, grading, graveling, paving, surfacing, resurfacing and doing work
in and upon the public streets, alley or thoroughfares within the corporate limits of the City of
Fort Worth and has complied with all the terms and conditions of ordinance No. 3449 of the City
of Fort Worth, Texas, and has applied to the Director of Transportation and Public Works as
provided in said ordinance
NOW, THEREFORE, if said principal shall fully indemnify and save whole and harmless
the said City of Fort Worth, its agents and employees, as well as indemnify and save harmless
any person, firm or corporation with whom the Principal has contracted, from any and all
damages of any character arising from or caused directly or indirectly by any negligence in the
performance of such work as above set forth under the terms of said ordinance and said license
or for any imperfect or inadequate work done by said principal under the terms of said
ordinance and said license, and shall maintain said work in good and workmanlike state of
repair for a period of two (2) years from and after its completion and acceptance by the City of
Fort Worth, then this obligation shall be null and void, otherwise to remain in full force and
effect: provided, however, this bond is executed by the surety on the condition that its liability
shall be limited by and subject to the conditions and provisions hereinunder contained:
Successive actions may be brought on this bond for successive breaches of its
conditions or any of them; provided, however, that the total sum of all liability of the surety on
any one or all of such actions shall not exceed a total sum of Twenty-five Thousand Dollars
($25,000.00).
The liability of the Surety under this bond, if not canceled as hereinafter provided, shall
cease and terminate of its own force and effect one year from the date hereon, saving and
excepting for the maintenance of the work performed previous to the date of termination, for
which work the liability of the Surety for maintenance shall continue for two years from and after
the date of the completion and acceptance of said work by the City, but no longer.
The Surety may terminate its liability under this bond at any time by giving the City
Council of the City of Fort Worth, Texas, five (5) days notice in writing of the Surety's intention
to do so, and from and after said date the Surety will no longer be liable for any subsequent act,
save and except as to maintenance as herein above provided.
IN WITNESS WHEREOF, the said Principal and the said Surety have set their hand and
seal this the 20th day of—Noyembpr 2018
Mario Sio & : av Ex ating, Inc
tMicly.eiii7.acola -�
ViFginpo&ident
Travelers Casualty & Surety Carpany of America
urety
Attrney-in-Fact
Kathleen M. McCann
Travelers Casualty and Surety Company of America
'd1W 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.
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 Kathleen M.McCann Of BINGHAM FARMS
Michigan ,their true and lawful Attorney-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances,
conditional undertakings and other writings obligatory in 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.
oR
�am
State of Connecticut
By: ' L
City of Hartford ss. Robert L.Raney.Se or Vice President
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. 4
My Commission expires the 30th day of June,2021
� UlurL �. :LWt[Du
*�!r Mane C.Tetreault,Notary Public
This Power of Attorney is granted under and by the authority of the following resol��utions 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
Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact end
Agents to ad 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 arry 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 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
one or more Attomeys-in-Fad 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
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-Fad 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 SL 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 Comparles,which remains in full force and effect.
Dated this 20th day of November .2018
,A A t.CZ—
`�'`��'�xw ,;Q
iii ' ,*~
♦'be-
Kevin E.Hughes,Assr Cant Secretary
To verify the aathent kyty of this Power ofAttorrhey,please call as at 1-800-421-3880.
Please refer to the above-named Attorney-in-Fad and the details of the bond to which the power is attached.
ffTexas Department of Transportation
Permit Completion of work
I Bill Boothe, Texas Department of Transportation Permit Chief Inspector have verified
the completion of work for the below mentioned permit.
Permit#: 10-DCC-33-17
Location: IH 820 @ Railhead Andrews Distribution
I'
Bill Boothe
Texas Department of Transportation
Permit Chief Inspector
North Tarrant Area Office
817-291-6413
Bill.Boothe@Txdot.gov
Fnur�p. .-.—.
Green Sheet CPN 100615
Andrews Distributing Company
Drainage
__ - -- Adobe Sign Document History 02/11/2019
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"Green Sheet CPN 100615 Andrews Distributing Company Drai
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