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Contract 50393-FP4
r. t� s� RECEIVED City Secretary 50393 -FP4 Contract No. MAR 1 2019 Mar 19,2019 CIN GF FORT WORTH FORT WORTHO Date Received cUTYJECJETARY 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): Water ® Sewer Original Contract Price: $47,260.00 Amount of Approved Change Order(s): $3,550.00 Revised Contract Amount: Total Cost of Work Complete: $50,810.00 69,01- 1-1-r( Mar 4,2019 Contractor Date CFO/Partner Title Rumsey Construction Company Name /14 n mel?t`A7 Mar 5,2019 Mark Mcfadin(Mar 5,20191 Project Inspector Date Fred ia9,201 Mar 18,2019 Project Manager Date �7Gl`!/2 Janie Scarlett Morales(Mar 19,2019) Mar 19,2019 CFA Manager Date Sam,y 'Lyu,�' Mar 19 2019 Susan Alanis(Mar 19,2019) f Asst. City Manager Date OFNUoA6'L RECORD CITY SECRETARY Page 1 of 2 FT, WORTH,Tia 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 ❑x Change Order(s): ❑x Yes ❑ N/A Pipe Report: ❑x Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety I Statement of Contract Time Contract Time: 60 CD Days Charged: 79 Work Start Date: 6/24/2018 Work Complete Date: 9/11/2018 Page 2 of 2 FORT WORTH CITY OF FORT WORTH N FINAL PAYMENT REQUEST Contract Name THE CONSTRUCTION OF WATER,SEWER,PAVING,STORM DRAIN,ST Contract Limits Project Type WATER&SEWER 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 6CD Contract Date 1/3/2018 Days Charged to Date 79 Project Manager NA Contract is 100.00 Complete Contractor RUMSEY CONSTRUCTION,LLC 6617 VILLAGE SPRINGS DRIVE PLANO, TX 75024 Inspectors CORDOVA / MCFADIN Monday,February 18,2019 Page 1 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 WATER&SEWER For Period Ending 1/8/2019 Project Funding UNIT I:WATER IMPROVEMENTS Item Description of Items Unit Unit Cost Estimated Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 6"WATER PIPE 40 LF $28.00 $1,120.00 40 $1,120.00 2 6"DIP WATER 25 LF $41.00 $1,025.00 25 $1,025.00 3 SALVAGE 3/4"WATER METER 5 EA $950.00 $4,750.00 5 $4,750.00 4 Y WIDE ASPHALT PVMT REPAIR, 65 LF $60.00 $3,900.00 65 $3,900.00 RESIDENTIAL 5 ASPHALT PVMT REPAIR,WATER SERVICE 80 LF $60.00 $4,800.00 80 $4,800.00 6 FIRE HYDRANT 1 EA $5,500.00 $5,500.00 1 $5,500.00 7 6"WATERLINE LOWERING 1 EA $3,500.00 $3,500.00 1 $3,500.00 8 TRENCH SAFETY 65 LF $1.00 $65.00 65 $65.00 9 DUCTILE IRON WATER FITTINGS W/ 1 TN $1,250.00 $1,250.00 1 $1,250.00 RESTRAINT 10 P WATER SERVICE 1 EA $750.00 $750.00 1 $750.00 11 2"WATER SERIVE 1 EA $4,250.00 $4,250.00 1 $4,250.00 12 6"GATE VALVE 1 EA $2,500.00 $2,500.00 1 $2,500.00 13 NEW 2"WATER SERVICE(PLUG EXISTING)CO 1 EA $1,950.00 $1,950.00 1 $1,950.00 #1 14 PAVEMENT REMOVAL&REPLACE CO#1 1 LS $1,600.00 $1,600.00 1 $1,600.00 -------------------------------------- Sub-Total of Previous Unit $36,960.00 $36,960.00 UNIT 11:SANITARY SEWER IMPROVEMENTS ItemDescription of Items EstimateUnit Unit Cost Estimated Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 REMOVE 4"SEWER LINE 140 LF $10.00 $1,400.00 140 $1,400.00 2 ASPHALT PVMT REPAIR,SEWER SERVICE 100 LF $60.00 $6,000.00 100 $6,000.00 3 MANHOLE VACUUM TESTING 1 EA $100.00 $100.00 1 $100.00 4 TRENCH SAFETY 150 LF $1.00 $150.00 150 $150.00 5 CONCRETE COLLAR 1 EA $200.00 $200.00 1 $200.00 6 6"SEWER SERVICE I EA $2,500.00 $2,500.00 1 $2,500.00 7 4'MANHOLE 1 EA $3,500.00 $3,500.00 1 $3,500.00 -------------------------------------- Sub-Total of Previous Unit $13,850.00 $13,850.00 -------------------------------------- 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 I Contract Limits Payment Number I Project Type WATER&SEWER For Period Ending 1/8/2019 Project Funding Contract Information Summary Original Contract Amount $47,260.00 Chanl4e Orders Change Order Number 1 $3,550.00 I I Total Contract Price $50,810.00 Total Cost of Work Completed $50,810.00 I Less %Retained $0.00 I Net Earned $50,810.00 j Earned This Period $50,810.00 Retainage This Period $0.00 I 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 $50,810.00 i li I a i I Monday,February 18,2019 Page 3 of 4 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 WATER&SEWER For Period Ending 1/8/2019 Project Funding Project Manager NA City Secretary Contract Number Inspectors CORDOVA / MCFADIN Contract Date 1/3/2018 Contractor RUMSEY CONSTRUCTION,LLC Contract Time 60 CD 6617 VILLAGE SPRINGS DRIVE Days Charged to Date 79 CD PLANO, TX 75024 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 $50,810.00 Less %Retained $0.00 Net Earned $50,810.00 Earned This Period $50,810.00 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 $50,810.00 Monday,February 18,2019 Page 4 of 4 C f -' � d - 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CONSTRUCTI4N Project: Nursery Phase 2 Date 11/6/2018 Location: Fort Worth,TX Plan Date: 10/30/2018 No. Item Description Unit Qty Unit Price Total Irrigation Service Change 13 New 2" Water Service (Plug Existing) EA 1 $1,950.00 $1,950.00 - � ;Pavement Removal & Replace LS 1 $1,600.00 $1,600.00 I Change Order#02 Total $3,550.00 * Excludes survey. * Excludes aquiring a traffic control permit * Minimum Haul-off and Asphalt Patch cost applies 4329 Reeder Dr. Rumsey Construction Carrollton,TX 75010 CO 2-Nursery Phase 2 11062018 Office:214-614-8140 Fax:214-556-1110 11/612018-1:56 PM WWW.RUMSEYLLC.COM Page 1 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: The Consrtuction Water,Sewer,Storm,Paving for Nursery Lane PROJECT NUMBER: Water 56008-0600430-101144-001580, S 56008-0700430-101144-001380 DOE NUMBER: 101144 WATER PIPE LAID SIZE TYPE OF PIPE LF DI 6" DI 25' PVC 6" PVC 40' FIRE HYDRANTS: 1 VALVES(16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: yes Passed NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF 6" PVC 33' PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes Passed NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth•1000 Throckmorton Street•Fort Worth,TX 76012-6311 P 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.: j© u��/ CONTRACTOR: Rumsey Construction DOE NO.: PERIOD FROM: �, �-J� TO: cj qj. /'j- FINAL INSPECTION DATE: 8-Jan-19 WORK ORDER EFFECTIVE:4/8/2018 CONTRACT TIME: o WD ® CD DAY OF DAYS CHARGED REASON FOR DAYS DAY OF DAYS CHARGED REASON FOR DAYS MONTH DURING CREDITED MONTH DURING CREDITED 1. 16. 2. 17. 3. 18. 4. 19. 5. 20. 6. 21. 7. 22. 8. 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 79 79 PERIOD PREVIOUS 0 0 PERIOD TOTALS 79 79 TO DATE *REMARKS: CONTRACTOR DATE INSPECTOR DATE ENGINEERING DEPARTMENT The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 BILLS PAID AFFIDAVIT FOR CONTRACTOR State of Texas § County of Dallas § BEFORE ME, the undersigned authority, on t his day personally appeared { Joe Geer ), known to me to be a credible person and officer of { Rumsey Construction,LLC ) and who, being duly sworn, upon his oath declares and acknowledges as follows: 1. I am a duly authorized agent of(Rumsey Construction, LLC ) which has authorized me to make this affidavit,and all of the recitations herein are true and correct. 2. Pursuant to Private Development Contract No. ;01149 between (Fort Capital, LP _ ) and (Rumsey Construction, LLC)for(Nursery Phase 2 ) (Rumsey Construction, LLC )has supplied materials and performed labor in connection with the construction of improvements on real property owned by LFort Capital, LP 3, (Rumsey Construction,LLC )has actual knowledge that all bills owed by(iyursery Phase 2 ) to Rumsey Construction, LLC for materials supplied or labor performed in connection with the improvements have been fully paid and satisfied. 4 (R-ey Constx ction, LLC ) has actual knowledge that all bills owed by (Rumsey Construction,LT to others for materials supplied or labor performed in connection with the improvements have been fully paid and satisfied. 5. (:2umsey Constzuction, LLC 1 has actual knowledge that there are no claims or liens for tmaterials supplied or labor performed in connection with the Private Development Contract. 6. (Rumsey Construction, LLC ) further warrants that should any claim or lien be filed for material supplied or labor performed in connection with the Private Development Contract, (Rumsey construction, LL will immediately furnish a bond pursuant to Texas Property Code Sections 53.236 through 53.238 for release of each the claim or lien, obtain settlement of any claim or lien, and furnish written full release. ( Rumsey Construction, LLC ) agrees to fully indemnify and hold harmless from any and all costs that may occur by reason of such claims or liens. EXECUTED this 01 day of March 20 19 Rumse stru tion, LLC By ( " N o Geer TITLE: FO/Partner STATE OF TEXAS COUNTY OF DALLAS This instrument was acknowledged before me on 03/0112019 by Joe Geer CFO/Partner of Rumsey Construction a LLCcorporation, on behalf of said corporation. '0!V41P11,,, SARAH PEREZ Le Public,State of Texas 308 Notary 10 [NOTARY _ .aBEI�'� I A��D NOTARY PUBLIC Comm.Expires 11-21-7.020 CONSENT OF OWNER 0 SURETY COMPANY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ SURETY [] AIA DOCUMENT G707 OTHER PROJECT: Nursery Phase 2 (name, address) Fort Worth, TX TO (Owner) CITY PROJECT NO: Fort Capital, LP and the City of Fort Worth CONTRACT FOR: Drainage Improvements Fort Worth, TX CONTRACT DATE: 01/03/2018 BOND NO: 1848002 CONTRACTOR: Rumsey Construction, LLC 4329 Reeder Drive Carrollton, TX 75010 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 as it appears in the bond). The Hanover Insurance Company SURETY COMPANY, on bond of(here insert name and address of Contractor as it appears in the bond), Rumsey Construction, LLC ' CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (here insert name and address of owner) Fort Capital, LP and the City of Fort Worth, TX OWNER, as set forth in the said Surety's bond. IN WITNESS WHEREOF , the Surety has hereunto set its hand this 28th day of February 2019 The Hanover Insurance Company Sure#y Signature of Aut rized Re en a WL Attes Allyson Dean,A orney-in-Fact (Seal). Title V k 11 AIA DOCUMENT G707•CONSENT OF sORFTY TO PINAL P YM NT.APRIL 1970 ONE PAGE EDITION-AIA 0-O 1970•THE AMERICAN INSTITUTE OFE5PHITECTS, 1735 NEW YORK AVE., NW,WASHINGTON,D.C-20006 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWER OF ATTORNEY THIS Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. KNOW ALL PERSONS BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY,both being Corporations organized and existing under the laws of the State of New Hampshire,and CITIZENS INSURANCE COMPANY OF AMERICA,a corporation organized and existing under the laws of the State of Michigan,(hereinafter individually and collectively the"Company')does hereby constitute and appoint John R.Ward,Douglas Moore,Emily Mikeska,Eva O.Limmer andlor Allyson Dean Of Ward&Moore Insurance Services LP of Dallas,TX,Gatesville,TX and Temple,TX each individually,if there be more than one named,as its true and lawful attorney(s)-in-fact to sign,execute,seal,acknowledge and deliver for,and on its behalf,and as its act and deed any place within the United States, any and all surety bonds, recognizances, undertakings, or other surety obligations. The execution of such surety bonds, recognizances, undertakings or surety obligations,in pursuance of these presents,shall be as binding upon the Company as if they had been duly signed bythe president and attested by the secretary of the Company,in their own proper persons.Provided however,that this power of attorney limits the acts of those named herein;and they have no authority to bind the Company except in the manner stated and to the extent of any limitation stated below: Any such obligations in the United States,not to exceed Thirty Five Million and No1100($35,000,000)in any single instance That this power is made and executed pursuant to the authority of the following Resolutions passed by the Board of Directors of said Company,and said Resolutions remain in full force and effect: RESOLVED- That the President or any Vice President, in conjunction with any Vice President, be and they hereby are authorized and empowered to appoint Attorneys-in-fact of the Company,in its name and as it acts,to execute and acknowledge for and on its behalf as surety, any and all bonds,recognizances,contracts of indemnity,waivers of citation and all other writings obligatory in the nature thereof,with powerto attach thereto the seal of the Company.Any such writings so executed by such Attorneys-in-fact shalt be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons. RESOLVED:That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto,granted and executed by the President or Vice President in conjunction with any Vice President of the Company,shall be binding on the Company to the same extent as if all signatures therein were manually affixed,even though one or more of any such signatures thereon may be facsimile. (Adopted October 7, 1981—The Hanover Insurance Company;Adopted April 14, 1982—Massachusetts Bay Insurance Company;Adopted September 7,2001 --Citizens Insurance Company of America) IN WITNESS WHEREOF,THE HANOVER iNSURANCE COMPANY,MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals,duly attested bytwo Vice Presidents,this 4th day of April,2018. The Hanover Insurance Company Massachusetts$ay Insuf a.nce Company The Hanover Insurance Company Citizens Insurance Company of America ........ merica ',„ syr Massachusetts eay rnsu ra ace Csa mpa-y 11Citi Insurance Company of America 04 >� t � John C.Roche,E%T and President lames H.I{axnecki, 1-ice President THE COMMONWEALTH OF MASSACHUSETTS ) COUNTY OF WORCESTER )ss. On this 4th day of April,2018 before me came the above named Vice Presidents of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America,to me personally known Io be the individuals and officers described herein,and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company,Massachusetts Bay Insurance Company and Citizens Insurance Company of America,respectively,and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. Ak DIANE J. MARINO NM( Futile •,Q� tls wy�pt�Rt7� (,(1 a1°^E+�w L]oanc 1 , io.Ko1:,r5 Ph i, I,the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America,hereby certify that the above and foregoing is a full,true and correct copy of the Original Power of Attorney issued by said Companies,and do hereby further certify that the said Powers of Attorney are still in force and effect. GIVEN under my hand and the seals of said Companies,at Worcester,Massachusetts,this 2811 day of February 2019 CERTIFIED COPY -raw Theodarc C.Martinez Via Presiden� Hanover Insurance Group- Texas Complaint Notice Commercial Lines IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener information o para someter una queja: You may call The Hanover Insurance Company/ Usted puede Ilamar al numero de telefono gratis de Citizens Insurance Company of America's toll-free The Hanover Insurance Company/Citizens Insurance telephone number for information or to make a Company of America's para informacion o para complaint at: someter una queja al: 1-800-608-8141 1-800-608-8141 You may also write to The Hanover Insurance Company/ Usted tambien puede escribir a The Hanover Insurance Citizens Insurance Company of America at: Company/Citizens Insurance Company of America al: 440 Lincoln Street 440 Lincoln Street Worcester, MA 01615 Worcester, MA 01615 You may contact the Texas Department of Insurance Puede comunicarse con el Departamento de Seguros to obtain information on companies, coverages, de Texas para obtener information acerca de rights or complaints at: companias, coberturas, derechos o quejas al: 1-800-252-3439 1-800-252-3439 You may write the Texas Department of Insurance: Puede escribir al Departamento de Seguros de Texas: P. O. Sox 149104 P. O. Box 149104 Austin, TX 78714-9104 Austin, TX 78714-9104 Fax: (512) 475-1771 Fax: (512) 475-1771 Web: http://www.tdi.texas,gov Web: http://www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your premium Si tiene una disputa concerniente a su prima o a un or about a claim you should contact the agent or the reclamo, debe comunicarse con el agente o la com- company first. If the dispute is not resolved, you may panic primero. Si no se resuelve la disputa, puede contact the Texas Department of Insurance. entonces comunicarse con el departamento (TDI). ATTACH THIS NOTICE TO YOUR POLICY: This UNA ESTE AVISO A SU POLIZA: Este aviso es solo notice is for information only and does not become para proposito de information y no se convierte en a part or condition of the attached document. parte o condition del documento adjunto. The Hanover Insurance company 1440 Lincoln Street,Worcester,MA 01653 let.145102/19)Pagel all Citizens Insurance Company of America 1 808 North Highlander Way,Howell,MI 48843 hanover.com