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HomeMy WebLinkAboutContract 47902-FP2 City Secretary 47902 -FP2 Contract No. FoRTWORTH, Date Received Feb 14,2019 1001x,0 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: STALLION POINTE City Project No.: 100120 Improvement Type(s): Water i] Sewer 71 Original Contract Price: $291,581.64 Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: $291,581.64 /��Yy/�I�AGfY2C L2�10�lJ �,rpt�en,oK,,Feb 13,2019; Feb 13,2019 Contractor Date Sec./Treasurer Title Wind Terrace,Inc. Company Name a&--Dee-wa4cer%% Eddie Dee Walker II(Feb 13,2019) Feb 13,2019 Project Insgector Date "iLe"f, 2019; Feb 13 2019 A,,run--n (Feb li, Project Manager Date �7q t/2 SW,4ecc i�iyrur,�i Janie Scarlett Morales(Feb 13,20191 Feb 13,2019 CFA Manager Date S--AI��14,2019) Feb 14,2019 Asst. City Manager Date Page 1 of 2 p OFFICIAL RECORD F�0 wog CITY SECRETARY FT. WORTH,TX Notice of Project Completion Project Name: STALLION POINTE City Project No.: 100120 City's Attachments Final Pay Estimate Change Order(s): ❑ Yes © N/A Pipe Report: © Yes ❑ N/A Contractor's Attachments i Affidavit of Bills Paid Consent of Surety i Statement of Contract Time r Contract Time: 480 CD Days Charged: 691 Work Start Date: 8/8/2016 Work Complete Date: 6/29/2018 i Page 2 of 2 I �I 'r City Project Numbers 100120 DOE Number 0120 Conti-act Name STALLION POINTE Estimate Number 1 I. Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 7/24/2018 Project Funding Project Manager NA City Secretary Contract Number Inspectors DICKINSON / VEGA Contract Date Contractor WIND TERRACE,INC. Contract Time 480 CD 1201 EAST 13TH ST Days Charged to Date 691 CD FORT WORTH, TX 76102 Contract is .000000 Complete i CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded ---- ----------------------- (�( I 1 Total Cost of Work Completed $291,581.64 Less %Retained $0.00 Net Earned $291,581.64 Earned This Period $291,581.64 Retainage This Period $0.00 , Less Liquidated Damages 0 Days @ $0.00 /Day $0.00 i 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 $291,581.64 ai Wednesday,July 25,2018 Page 5 of 5 �I I �I d FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name STALLION POINTE Contract Limits Project Type WATER&SEWER y City Project Numbers 100120 DOE Number 0120 Estimate Number I Payment Number I For Period Ending 7/25/2018 CD City Secretary Contract Number Contract Time 48(1D Contract Date Days Charged to Date 691 Project Manager NA Contract is 100.00 Complete Contractor WIND TERRACE,INC. 1201 EAST 13TH ST FORT WORTH, TX 76102 Inspectors DICKINSON / VEGA Wednesday,July 25,2018 Page I of 5 City Project Numbers 100120 DOE Number 0120 Contract Name STALLION POINTE Estimate Number I Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 7/25/2018 Project Funding WATER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ------------------------------------------ 1 WATER LINE GROUTING 50 CY $230.00 $11,500.00 50 $11,500.00 2 REMOVE 6"WATERLINE 529 LF $18.31 $9,685.99 529 $9,685.99 3 REMOVE 10"WATER LINE 204 LF $23.33 $4,759.32 204 $4,759.32 4 REMOVE 12"WATERLINE 52 LF $25.50 $1,326.00 52 $1,326.00 5 4"-12"WATER ABANDONMENT PLUG 14 EA $1,150.00 $16,100.00 14 $16,100.00 6 REMOVE 6"WATER VALVE 3 EA $135.00 $405.00 3 $405.00 7 REMOVE 10"WATER VALVE 5 EA $500.00 $2,500.00 5 $2,500.00 8 REMOVE 12"WATER VALVE 5 EA $800.00 $4,000.00 5 $4,000.00 9 SALVAGE FIRE HYDRANT 2 EA $281.94 $563.88 2 $563.88 10 EXPLORATORY EXCAVATION OF EXISTING 3 EA $508.86 $1,526.58 3 $1,526.58 UTILITIES I I TRENCH SAFETY 750 LF $7.85 $5,887.50 750 $5,887.50 12 UTILITY MARKERS I LS $300.00 $300.00 1 $300.00 13 DUCTILE IRON WATER FITTINGS 2.2 TN $4,349.87 $9,569.71 2.2 $9,569.71 W/RESTRAINT 14 10"WATER PIPE 788 LF $39.38 $31,031.44 788 $31,031.44 15 12"WATER PIPE 841 LF $40.77 $34,287.57 841 $34,287.57 16 FIRE HYDRANT 2 EA $2,851.48 $5,702.96 2 $5,702.96 17 CONNECTION TO EXISTING 4"-12"WATER 3 EA $2,901.01 $8,703.03 3 $8,703.03 MAIN 18 4"WATER METER AND VAUKT 1 EA $14,375.00 $14,375.00 1 $14,375.00 19 10"GATE VALVE 1 EA $2,694.39 $2,694.39 1 $2,694.39 20 12"GATE VALVE 3 EA $2,145.47 $6,436.41 3 $6,436.41 21 6"CUT-IN GATE VALVE 1 EA $1,500.00 $1,500.00 1 $1,500.00 22 12"CUT-IN GATE VALVE 1 EA $2,145.47 $2,145.47 1 $2,145.47 --------------------------------------- Sub-Total of Previous Unit $175,000.25 $175,000.25 SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total ——————————————————————————————————————- I SANITARY LINE GROUTING 14 CY $158.73 $2,222.22 14 $2,222.22 2 REMOVE 8"SEWER LINE 10 LF $11.62 $116.20 10 $116.20 Wednesday,July 25,2018 Page 2 of 5 City Project Numbers 100120 DOE Number 0120 Contract Name STALLION POINTE Estimate Number I Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 7/24/2018 Project Funding 3 REMOVE 10"SEWER LINE 10 LF $20.00 $200.00 10 $200.00 4 8"SEWER ABANDONMENT PLUG 4 EA $600.00 $2,400.00 4 $2,400.00 5 10"SEWER ABANDONMENT PLUG 2 EA $850.00 $1,700.00 2 $1,700.00 6 REMOVE 4'SEWER MANHOLE 2 EA $859.26 $1,718.52 2 $1,718.52 7 4'WIDE ASPHALT PVMT REPAIR,RESIDENTIAL 56 LF $38.60 $2,161.60 56 $2,161.60 8 PRE CCTV INSPECTION 900 LF $1.52 $1,368.00 900 $1,368.00 9 POST CCTV INSPECTION 867 LF $1.60 $1,387.20 867 $1,387.20 10 MANHOLE VACUUM TESTING 5 EA $107.16 $535.80 5 $535.80 I 1 BYPASS PUMPING 1 LS $3,600.00 $3,600.00 1 $3,600.00 12 'TRENCH SAFETY 867 LF $7.85 $6,805.95 867 $6,805.95 13 UTILITY MARKERS 1 LS $300.00 $300.00 1 $300.00 14 CONCRETE ENCASEMENT FOR UTILITY PIPES 25 CY $142.71 $3,567.75 25 $3,567.75 15 IMPORTED EMBEDMENT/BACKFILL, 280 CY $40.00 $11,200.00 280 $11,200.00 CRUSHED ROCK 16 4"SEWER SERVICE 2 EA $313.60 $627.20 2 $627.20 17 8"SEWER SERVICE 2 EA $1,000.00 $2,000.00 2 $2,000.00 18 8"SEWER PIPE 130 LF $29.03 $3,773.90 130 $3,773.90 19 10"SEWERPIPE 717 LF $65.87 $47,228.79 717 $47,228.79 20 10"SEWER PIPE,CSS BACKFILL 20 LF $23.25 $465.00 20 $465.00 21 EPDXY MANHOLE LINER 32 VF $161.94 $5,182.08 32 $5,182.08 22 4'MANHOLE 3 EA $2,413.66 $7,240.98 3 $7,240.98 23 4'DROP MANHOLE 1 EA $4,307.40 $4,307.40 1 $4,307.40 24 4'EXTRA DEPTH MANHOLE 24 VF $169.95 $4,078.80 24 $4,078.80 25 4'SHALLOW MANHOLE 1 EA $2,394.00 $2,394.00 1 $2,394.00 -------------------------------------- Sub-Total of Previous Unit $116,581.39 $116,581.39 -------------------------------------- Wednesday,July 25,2018 Page 3 of 5 City Project Numbers 100120 DOE Number 0120 Contract Name STALLION POINTE Estimate Number 1 Contract Limits Payment Number I. Project Type WATER R SEWER For Period Ending 7/24/2018 Project Funding Contract Information Summary Original Contract Amount $291,581.64 Change Orders Total Contract Price $291,581.64 Total Cost of Work Completed $291,581.64 Less %Retained $0.00 Net Earned $291,581.64 Earned This Period $291,581.64 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 $291,581.64 Wednesday,July 25,2018 Page 4 of 5 i.. rr,- ORT L , TRA.NSPORTA'I'ION AND PUBLIC WORDS PIPE REPORT FOR: PROJECT NAME: STALL101, POTINTTE, PROJECT NUMBER: 100120 _��— DOE,NUMBER: ------____ WATER PIPE LAID SIZE TYPE OF PIPE LF YES 10" PVC 788 t'ES,_..�..—____________.�._.�. 12" PVC 841 d{IRE lEIY DRANTS: 2 VALVES(16"OR LARGER) 0 PIPEABANDONED SIZE TYPE OF PIPE LF roc, DENSITIES: YES NEW SERVICES: SEWER PIPE I,,,4,j � SIZE TYPE OF PIPE LF YES PVC _ 130 I(_ _ AVC 717 PaPI,AB SIDE_ TYPE OF PIPE LF NO YES q1,W SERVICES:h: 4" 2 00-jPAZ.1; 'TRANSPORTATION SPORTATION AND PUBLIC WORKS j 7 �y The City of F ort Word-i^'1000'I"hIxockinoxton Street^ oxt-North,TY 76012-6311 c�fifj( (817)392•-7941 ^rax:(817)392-7845 wo' TRANSPORTATION AND PUBLIC WORKS INSPECTION PUNCH LIST ti 1.Clean out sloping Headwall Drain Sta-0+00 Line B 2.Clean out Sloping Headwall Drain Sta- 1+00 Line A 3.Clean out Sloping Headwall Drain Line C 4.Replace concrete panels mark with white paint dot running off the public drain 5.More Rock needed at the Rock Rip Rap 6.Replace concrete panels behind the Apartment complex on the public drain 7. Curlex on the public road Scarlet Way backfield the sidewalk 8.Valve extension on Scarlet Way 9.Clean and repair all Manholes(5)and(1)inlet on Russet Trail Contractor"Al r, E Inspector CONSENT OF OWNER SURETY COMPANY ARCHITECT ❑ CONTRACTOR TO FINAL PAYMENT SURETY ❑ OTHER AIA DOCUMENT G707 Bond No. 3380524 PROJECT: Wind Terrace (name,address) Fort Worth,TX TO(Owner) ARCHITECT'S PROJECT NO: CFA Number 2016-039 City of Fort Worth Texas CONTRACT FOR:Development Improvements-Stallion Pointe 1000 Throckmorton Street Ft.Worth,TX 76102 CONTRACT DATE: L CONTRACTOR: LDG Stallion Pointe, LP 1469 S. Fourth Street Louisville, KY 40208 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surely Company) SureTec Insurance Company 1330 Post Oak Boulevard, Suite 1100 Houston,TX 77056 SURETY COMPANY, On bond of(here Insert name and address of Contractor) LDG Stallion Pointe, LP 1469 S. Fourth Street Louisville, KY 40208 CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to(here insert name and address of owner) City of Fort Worth Texas 1000 Throckmorton Street Ft. Worth, TX 76102 OWNERS, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 21 st day of August, 2018 SureTec Insurance Company Surety Company PAN w� Signature of Authorize Representa Attest: Paula J. Teague Attorney-in-Fact (Seal): Monic a ess 9 Y- in-Fact d; 5 {>= Title NOTE: This form f panlon document to AIA DOCUMENT G706,CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,Cur 1 Edilypn m' it AIA DOCUMENT G707•CONSENT OF SURETY COMPANY TO FINAL PAYMENT•APRIL 1970 EDITION•AIA® ONE PAGE ©1970-THE AMERICAN INSTITUTE OF ARCHITECTS.1735 NEW YORK AVE.,NW,WASHINGTON,D.C.20006 SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Mei: by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston,Harris County,Texas,does by these presents make,constitute and appoint Paula J.Teague Louisville, KY its true and lawful Attorney-in-fact,with full power and authority hereby conferred in its name,place and stead,to execute,acknowledge and deliver any and all bonds,recognizances,undertakings or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Surety Bond No.: 3380524 Principal: LDG Stallion Pointe,LP Obligee: City of Fort Worth Texas Amount: See Bond Form and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President,sealed with the corporate seal of the Company and duly attested by its Secretary,hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: Be it Resolved,that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute,acknowledge and deliver,any and all bonds,recognizances,contracts,agreements or indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary, Be it Resolved,that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 200 of April, 1999) In Witness Whereof,SURETEC INSURANCE COMPANY has caused these presents to be signed by its President,and its corporate seal to be hereto affixed this 6th day of April,A.D.2017. SwV�CF SURETEC C CO ANY 4-11 X 5 / By. w w John Knox .,/edin t State of Texas ss: 7s 1 f r County of Harris ..., On this 6th day of April,A.D.2017 before me personally came John Knox,Jr.,to me known,who,being by me ,did depose and say,that he resides in Houston,Texas, that he is President of SURETEC INSURANCE COMPANY,the company descrd which executed the above instrument,that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the Board of Directors of said Company;and that he signed his name thereto by like order. �,0OYPf/. JACQUELYN GREENLEAF .z; zoz Notary Public,State of Texas Z Comm.Expires 05-18-2021 — ''n°;.;:��� Notary f0 126903029 Ja uelyn Greenleaf,Notary Public My commission expires May 18,2021 1,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY',do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set out in the Power of Attorney are in full force and effect. Given under my hand and the seal of said Company at Houston,Texas this 21 St day ugust 2018 A.D. M.Brent Baty,Assistant Secretary Any instrument issued In excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call(713)812.0800 any business day between 8:00 am and 5:00 pm CST. AFFIDAVIT STATE OF: TEXAS COUNTY OF: TARRANT Before me,the undersigned authority, a notary public in the state and county aforesaid, on this day personal appeared Mary-Margaret Lemons, Secretary/Treasurer of Fort Worth Affordability Inc„ sole member of LDG Stallion Pointe GP LLC general of LDG Stallion Pointe LP, known to me to be a credible person, who being by me duly sworn, upon this 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 Stallion Pointe CFA#47902. By: LDG Stallion Pointe LP, A Texas limited partnership By: LDG Stallion Pointe GP, LLC, Its general partner ],A,I ILA J If AM.41Y By. ' ' Mary-Mar aret Le ons, Ye etary/Treasurer Fort Wo Afford ility, c., its sole member Subscribed and sworn before me on the 3rd of Januar 2 EVA C.KEY =_ �= Notary Pu is =P •_ My Notary ID#70943269 Tarrant County, of Texas oP Expires August 15,2021 Greensheet for Stallion Pointe CPN#100120 WS — - --- - Adobe Sign Document History 02/15/2019 Created: 07/26/2018 By: Shameka.Kennedy@fortworthtexas.gov -- Status: Signed — Transaction ID: CBJCHBCAABAAKpJ58Pm–y7melmPrBXMJbFGLcvMXmJJd "Greensheet for Stallion Pointe CPN#100120 WS" History Document created by Shameka.Kennedy@fortworthtexas.gov 07/26/2018-8:51:43 AM CDT-IP address:209.194.29.100 Document emailed to dbell@fwbs.org for signature 07/26/2018-8:56:48 AM CDT ca Email sent to dbeil@fwbs.org bounced and could not be delivered 07/26/2018-8:56:52 AM CDT rO Shameka.Kennedy@fortworthtexas.gov replaced signer dbell@fwbs.org with dbell@fwhs.org 07/26/2018-3:13:48 PM CDT-IP address:209.194.29.100 E'er Document emailed to dbell@fwhs.org for signature 07/26/2018-3:13:48 PM CDT ca Email sent to dbell@fwbs.org bounced and could not be delivered 07/26/2018-3:14:07 PM CDT m� Document viewed by dbell@fwhs.org 07/27/2018-7:12:32 AM CDT-IP address:68.113.214.28 J Document signing delegated to tkanaly@ldgdevelopment.com by dbell@fwhs.org 07/27/2018-10:00:03 AM CDT-IP address:68.113.214.28 C'' Document emailed to tkanaly@ldgdevelopment.com for signature 07/27/2018-10:00:03 AM CDT Document viewed by tkanaly@ldgdevelopment.com 07/27/2018-10:28:48 AM CDT-IP address:96.11.42.82 Foxe Adobe_F. _sign �� Shameka.Kennedy@fortworthtexas.gov replaced signer dbell@fwbs.org with tarbogast@fwhs.org 12/26/2018-9:52:04 AM EST-IP address:209.194.29.100 E-7r Document emailed to tarbogast@fwhs.org for signature 12/26/2018-9:52:05 AM EST W Email sent to dbell@fwbs.org bounced and could not be delivered 12/26/2018-9:52:22 AM EST u Document viewed by tarbogast@fwhs.org 12/26/2018-9:55:39 AM EST-IP address:207.207.25.202 2Document emailed to Mary-Margaret Lemons (mmlemons@fwhs.org)for signature 02/13/2019-9:58:27 AM EST Document viewed by Mary-Margaret Lemons (mmlemons@fwhs.org) 02/13/2019-11:43:59 AM EST-IP address:207.207.25.202 �i Mary-Margaret Lemons (mmlemons@fwhs.org) uploaded the following supporting documents: �i File Attachment 1 Gv File Attachment 2 02/13/2019-11:47:45 AM EST GSA Document e-signed by Mary-Margaret Lemons (mmlemons@fwhs.org) Signature Date:02/13/2019-11:47:45 AM EST-Time Source:server-IP address:207.207.25.202 124 Document emailed to Eddie Dee Walker II (eddie.walker@fortworthtexas.gov)for signature 02/13/2019-11:47:46 AM EST Ob Email sent to Mary-Margaret Lemons (mmlemons@fwhs.org) bounced and could not be delivered 02/13/2019-11:47:48 AM EST �I Document viewed by Eddie Dee Walker II (eddie.walker@fortworthtexas.gov) 02/13/2019-12:53:21 PM EST-IP address:99.203.87.156 cYo Document e-signed by Eddie Dee Walker II (eddie.walker@fortworthtexas.gov) Signature Date:02/13/2019-1:05:20 PM EST-Time Source:server-IP address: 174.206.58.158 Document emailed to Michael O. Glover(michael.glover@fortworthtexas.gov)for approval 02/13/2019-1:05:21 PM EST Document viewed by Michael O. Glover(michael.glover@fortworthtexas.gov) 02/13/2019-2:37:57 PM EST-IP address:209.194.29.100 6p Document approved by Michael O. Glover(michael.glover@fortworthtexas.gov) Approval Date:02/13/2019-2:40:00 PM EST-Time Source:server-IP address:209.194.29.100 FORTWORTH. :•�v, =��Y Adobe Sign Document emailed to Aaron Long (edward.long@fortworthtexas.gov)for signature 02/13/2019-2:40:01 PM EST Document viewed by Aaron Long (edward.long@fortworthtexas.gov) 02/13/2019-3:03:51 PM EST-IP address:209.194.29.100 Document e-signed by Aaron Long (edward.long@fortworthtexas.gov) Signature Date:02/13/2019-3:04:14 PM EST-Time Source:server-IP address:209.194.29.100 Document emailed to Janie Scarlett Morales Qanie.morales@fortworthtexas.gov)for signature 02/13/2019-3:04:15 PM EST Document viewed by Janie Scarlett Morales(Janie.morales@fortworthtexas.gov) 02/13/2019-3:49:29 PM EST-IP address:209.194.29.100 C , Document e-signed by Janie Scarlett Morales Qanie.morales@fortworthtexas.gov) Signature Date:02/13/2019-3:51:16 PM EST-Time Source:server-IP address:209.194.29.100 C� Document emailed to Susan Alanis (susan.alanis@fortworthtexas.gov)for signature 02/13/2019-3:51:18 PM EST Document viewed by Susan Alanis (susan.alanis@fortworthtexas.gov) 02/14/2019-9:31:59 AM EST-IP address: 107.77.209.91 Document e-signed by Susan Alanis (susan.alanis@fortworthtexas.gov) Signature Date:02/14/2019-9:32:33 AM EST-Time Source:server-IP address:107.77.209.91 E_i Document emailed to Allison Tidwell (cso_finalpay@fortworthtexas.gov)for filling 02/14/2019-9:32:34 AM EST Document viewed by Allison Tidwell (cso_finalpay@fortworthtexas.gov) 02/14/2019-9:59:42 AM EST-IP address:209.194.29.100 Dc Form filled by Allison Tidwell (cso_finalpay@fortworthtexas.gov) Form filling Date:02/14/2019-10:00:42 AM EST-Time Source:server-IP address:209.194.29.100 Document emailed to Trudy Brotherton (therese.brotherton@fortworthtexas.gov)for delivery 02/14/2019-10:00:44 AM EST Document viewed by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) 02/14/2019-11:23:37 AM EST-IP address:209.194.29.100 Document receipt acknowledged by Trudy Brotherton (therese.brotherton@fortworthtexas.gov) Receipt Acknowledgement Date:02/14/2019-11:23:59 AM EST-Time Source:server-IP address:209.194.29.100 C' Document emailed to Julie A Geho Qulie.geho@fortworthtexas.gov)for delivery 02/14/2019-11:24:00 AM EST Adobe Sign M Document viewed by Julie A Geho Qulie.geho@fortworthtexas.gov) 02/14/2019-11:37:38 AM EST-IP address:209.194.29.100 r Document receipt acknowledged by Julie A Geho Oulie.geho@fortworthtexas.gov) Receipt Acknowledgement Date:02/14/2019-11:37:59 AM EST-Time Source:server-IP address:209.194.29.100 �, Document emailed to TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov)for delivery 02/14/2019-11:38:00 AM EST 5LDocument viewed by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) 02/14/2019-12:34:07 PM EST-IP address:209.194.29.100 G4, Document receipt acknowledged by TPW Fiscal Staff(tpwcfafiscal@fortworthtexas.gov) Receipt Acknowledgement Date:02/15/2019-6:06:17 PM EST-Time Source:server-IP address:209.194.29.100 C ' Signed document emailed to dbell@fwbs.org, Julie A Geho Oulie.geho@fortworthtexas.gov), TPW Fiscal Staff (tpwcfafiscal@fortworthtexas.gov), Shameka.Kennedy@fortworthtexas.gov, and 11 more 02/15/2019-6:06:17 PM EST FORTWORTH. 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