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Contract 50393-FP3
City Secretary _ c Contract No. 3039 5 -FP3 RECEIVED FORT WORTH,) Date Received Mar 13,2019 LIAR 13 2019S(�po$_ 101 CITY OF FORT WORTH CITY ECRETARy NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: The Construction Water, Sewer, Storm, Paving to Serve Nursery Lane City Project No.: 101144 Improvement Type(s): ❑ Paving ❑ Drainage © Street Lights ❑ Traffic Signals Original Contract Price: $10,476.40 Amount of Approved Change Order(s): Revised Contract Amount: $10,476.40 Total Cost of Work Complete: $10,476.40 Feb 18, 2019 Contractor Date President Title Independent Utility Construction,Inc. Company Name tiiriri�lc taai� Feb 26 2019 F11n Fet;26.7,019V Project Inspector Date Fred Chia Feb 27 2019 r!, El,,iF.1,Z7.7,019, � P ject Manager Date sarlrtrbtnra,eslf•b7,-.201W Feb 27, 2019 CFA Manager Date .p,7..p19) Feb 27, 2019 Asst. City Manager Date A Page 1 of 2 rFT. CIAL RECORD SECRETARY WORTH,TX Notice of Project Completion Project Name:The Construction Water, Sewer, Storm, Paving to Serve Nursery Lane City Project No.: 101144 City's Attachments Final Pay Estimate Change Order(s): ❑ Yes ❑x N/A Contractor's Attachments Affidavit of Bills Paid F Consent of Surety Statement of Contract Time Contract Time: 120 CD Days Charged: 30 Work Start Date: 11/5/2018 Work Complete Date: 12/5/2018 Page 2of2 City Project Numbers 101144 DOE Number 1144 Contract Name THE CONSTRUCTION OF WATER,SEWER,PAVING,STORM DRAIN, Estimate Number I Contract Limits Payment Number 1 ProjectType STREET LIGHTING For Period Ending 1/8/2019 Project Funding Project Manager NA City Secretary Contract Number Inspectors CORDOVA / MCFADIN Contract Date I/15/2018 Contractor INDEPENDENT UTILITY CONSTRUCTION Contract Time 120 CD 5109 SUN VALLEY DRIVE Days Charged to Date 30 CD FORT WORTH, TX 76119 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 $10,476.40 Less %Retained $0.00 Net Earned $10,476.40 Earned This Period $10,476.40 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 $10,476.40 Monday,February 18,2019 Page 4 of 4 FORT NORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name THE CONSTRUCTION OF WATER,SEWER,PAVING,STORM DRAIN,ST Contract Limits Project Type STREET LIGHTING City Project Numbers 101144 DOE Number 1144 Estimate Number 1 Payment Number 1 For Period Ending 1/8/2019 CD City Secretary Contract Number Contract Time 120;D Contract Date 1/15/2018 Days Charged to Date 30 Project Manager NA Contract is 100.00 Complete Contractor INDEPENDENT UTILITY CONSTRUCTION 5109 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors CORDOVA / MCFADIN Monday,February 18,2019 Page I of4 City Project Numbers 101144 DOE Number 1144 Contract Name THE CONSTRUCTION OF WATER,SEWER,PAVING,STORM DRAIN, Estimate Number I Contract Limits Payment Number I Project Type STREET LIGHTING For Period Ending 1/8/2019 Project Funding UNIT V:STREET LIGATING IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total I 2"CONDT PVC SCH 89(T) 120 LF $18.81 $2,257.20 120 $2,257.20 2 NO 10 INSULATED ELEC CONDR 240 LF $1.47 $352.80 240 $352.80 3 NO 10 BARE ELEC CONDR 120 LF $1.47 $176.40 120 $176.40 4 FURNISHANSTALL TYPE 33B ARM 1 EA $317.00 $317.00 1 $317.00 5 FURNISH/INSTALL LED LIGHTING FIXTURE 2 EA $427.00 $854.00 2 $854.00 (70)WATT ATBO COBRA HEAD) 6 RDWY ILLUM FOUNDATION TY 1,2,AND 2 1 EA $2,792.00 $2,792.00 1 $2,792.00 7 FURNISHANSTALL RDWAY ILLUM TY 11 POLE 1 EA $3,313.00 $3,313.00 1 $3,313.00 8 REMOVE STREET LIGHT,ARM,AND 1 EA $207.00 $207.00 1 $207.00 CONDUCTORS ON ONCOR POLE 9 SALVAGE STREET LIGHT ON ONCOR POLE 1 EA $207.00 $207.00 1 $207.00 Sub-Total of Previous Unit $10,476.40 $10,476.40 Monday,February 18,2019 Page 2 of 4 City Project Numbers 101144 DOE Number 1144 Contract Name THE CONSTRUCTION OF WATER,SEWER,PAVING,STORM DRAIN, Estimate Number 1 Contract Limits Payment Number 1 Project Type STREET LIGHTING For Period Ending 1/8/2019 Project Funding Contract Information Summary Original Contract Amount $10,476.40 ChanIze Orders Total Contract Price $10,476.40 Total Cost of Work Completed $10,476.40 Less %Retained $0.00 Net Earned $10,476.40 Earned This Period $10,476.40 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 $10,476.40 Monday,February 18,2019 Page 3 of 4 FORTWORTH� rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.: 1 NAME OF PROJECT: The Construction of Water,Sewer,Storm,Paving of Nursery Lane PROJECT NO.: �E;;/�y�{ CONTRACTOR: Independent DOE NO.: PERIOD FROM: ;;- TO: FINAL INSPECTION DATE: 8-Jan-19 WORK ORDER EFFECTIVE: - CONTRACT TIME: O WD o CD DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS MONTH CHARRINGGE HA CREDITED MONTH NG CREDITED 1. DU 16. 2. 17. 3. 18. 4. 19. 5. 20. 6. 21. 7. 22. S. 23. 9. 24. 10. 25. 11. 26. 12. 27. 13. 28. 14. 29. 15. 30. 31. SAT,SUN, RAIN,TOO WET UTILITIES DAYS TOTAL &HOLIDAYS &TOO COLD RELOCATIONS OTHERS CHARGED DAYS THIS 30 30 PERIOD PREVIOUS 0 0 PERIOD TOTALS 30 30 TO DATE *REMARKS: CONTRACTOR DATE INSPECTOR DATE ENGINEERING DEPART2\1 NT f The City of Fort Worth•1000 Throclunorton Street•Fort Worth,TS.76012-6311 (817)392-7941 •Fax:(817)392-7845 AFFIDAVIT STATE OF TEXAS COUNTY OFTARRANT Before me, the undersigned authority, on this day personally appeared RICHARD WOLFE, President of INDEPENDENT UTILITY CONSTRUCTION. INC.. known to me to be a credible person, and after being duly sworn by me, 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: Nursery Phase 2—City Project No 101144 BY: kic and Wolfe, President i 411 SUBSCRIBED AND SWORN TO BEFORE ME on this day of U ,2018. RYp��ii CHRISTINA GARCIA I �tiP Gq __?. :Notary Public,State of Texas / Comm.Expires 12-20-2020 Notary ID 130940785 v�"✓�•.• Notary Public, State of Texas CONSENT OF OWNER ❑ ARCHITECT SURETY COMPANY CONTRACTOR D TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT G707) Bond No. 8368036 PROJECT: Street Lighting Improvements to serve Nursery Phase 2 (name,address)Fort Worth, Texas TO (Owner) ARCHITECT'S PROJECT NO: F—City of Fort Worth CONTRACT FOR: Above Project 200 Texas Street Fort`North,Texas 76102 CONTRACT DATE: CONTRACTOR: Independent Utility Construction, Inc. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(here insert name and address of Surety Company) Westfield Insurance Company 555 Republic Drive, Suite 450 Plano,Texas 75074 SURETY COMPANY, on bond of(here insert name and address of Contractor) Independent Utility Construction, Inc. 5109 Sun Valley Drive CONTRACTOR, Fort Worth,Texas 76119 hereby approves of the final payment to the Contractor, and agrees that the 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 200 Texas Street OWNER, Fort Worth, Texas 76102 as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, The Surety Company has hereunto set its hand this 13th day of August 2018 WESTFIELD INSURANCE COMPANY Surety Company r�\. % , � By Signature of Au orized Representative Attest: (Seal): &yle W Sweeney Attorney—in—Fact Title Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARINU I hlS SAMt POWER#AND ISSUED PRIOR TO 04120111, FOR ANY PERSON OR PERSONS NAMED BELOW. POWER NO. 4220052 06 General Westfield Insurance Co. Power of Attorney Westfield National Insurance Co. Ohio Farmers Insurance Co. CERTIFIED COPY Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a "Company" and collectively as "Companies," duty organized and existing under the laws of the State of Ohio, and having its principal office in Westfield Center, Medina County,Ohio, do by these presents make,constitute and appoint CHARLES D. SWEENEY, MICHAEL A.SWEENEY, KYLE W.SWEENEY,ELIZABETH GRAY,JOINTLY OR SEVERALLY of FORT WORTH and State of TX its true and lawful Attorneys)-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- - - - - - - - -- - - - - - - - LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent.as if such bonds were signed by the President,sealed with the corporate seal of the applicable Company and duty attested by its Secretary, hereby ratifying and confirming all that the said of Directors s Fact may do in the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY: "Be It Resolved,that the President,any Senior Executive,any Secretary or any Fidelity& Surety Operations Executive or other Executive shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of 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 as binding upon the Company as if signed by the President and seated and attested by the Corporate Secretary." "Se it Further Resolved,that the signature of any such designated person and the seat 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 signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.- (Each adopted at a meeting held on February 8,2000). CE In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS N COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20t0thh day of APRIL A.D.,2011 . w• '•�. ~" " WESTFIELD INSURANCE COMPANY Corporate � VR,(Arc•., :,.jP-�1<?NAL/Ns.,' �S�NS!!_R_,{,; ,. WESTFIELD NATIONAL INSURANCE COMPANY Seals �'o �'; -�' NCE COMPANY Affixed v_ .rs. p �^� OHIO FARMERS INSURANCE SEAL sm= 4�`• ��'� (n: "'k'' By: '•w,,,,,,„, ,,,,, "'•+•••••••'•'•�• Richard L. Kinnaird, Jr.,National Surety Leader and State of Ohio Senior Executive County of Medina ss.: On this 20th day of APRIL A.D.,2011 , before me personally came Richard L. Kinnaird, Jr. to me known,who, being by me duly sworn, did depose and say,that he resides-in Medina, Ohio;that he is Senior Execttive of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which executed the above instrument;that he knows the seals of said Companies;that the seals affixed to said instrument are such corporate seals;that they were so affixed by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order. ' Notarial Seat SAL S . Affixed A,p William J. Kahelin,A rney at Law,Notary Public d o My Commission Does Not Expire(Sec.147.03 Ohio Revised Code) State of Ohio County of Medina ss QrE OF o 1,Frank A.Carrino, Secretary of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OH 10 FARMERS INSURANCE COMPANY, do hereby.certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies,which is still in full force and effect;and furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are in full force and effect. e seals of said Companies at Westfield Center, Ohio, this 13th day of In Witness Whereof, I have hereunto set my hand and affixed th August wA°; 2018 Nr �t C �. ,;• 7,,%o .......ik .,_ SG;- .",0.5,......x.•Cer�'�s' �/'��, a ryryT� =c' io. %$y3 Secretary =o, �v't i848 Frank A. Carrino,.Secretary n7\