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Contract 46046-R1FP1
'Department T &W Const.;Services CPN# Date Px��ec Manager 11 CITY SECRETARY Risk l�lanagement lea,gad - ������ D.O.E. Drot, erton _ ® 'T CFA Morales/Scanned l Hutzler/Scapned The Proceeding people have been Contacted Scl concerning the request for final payment&have rATION.AND PUBLIC WORKS released this project for such payment. DF PROJECT COMPLETION '° Ci Project bd 0229 Clearance Conducted By �� . ld, n contract 46046-R1 coax SANIT,ARYSEWER CIP CONTRACT 2014 as required by the WATER DEPARTMENT as approved by Cite Council on-6/28/2016 through M&C C-27812 the director of the WATER DEPARTMENT upon the recomnxenl tsar of the Transportation&Public Works Department has accepted the project as complete,. Original Contract Prices: , j $500,000.00 Amount of Approved Change Orders: Revised Contract Amount; Total Cost Work Completed: $372,602.00 Less Deductions: Liquidated DamagesDays 210.00/Day Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: S37 ,602.00 s Previous Payments: $0.00 Final Payzn t Due S372;602.00 �Ixr - Reconnme for cceptance Date Ass . Dirk W11 Infrastructure Design and Construction Accepted jm Date Am*. Director, WATER DEPART ENT - .... ` Asst. City Manager Date Comments: F m OFFICIAL RECORD cj 1 S � ' ° RY 41 � " r M4"? 14 20�q %2 C' CO" City Project Numbers 02298 DOE Number 2298 Contract Name SANITARY SEWER CIP CONTRACT 2014 Estimate Number I Contract Limits Payment Number I Project Type SEWER For Period Ending 1/10/2019 Project Funding Project Manager NA City Secretary Contract Number 46046-RI Inspectors DICKINSON / WATSON Contract Date Contractor INSITUFORM TECHNOLOGIES,INC Contract Time 365 CD 702 SPIRIT 40 PARK DR Days Charged to Date 365 CD CHESTERFIELD, MO 63005 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded ------ 6. 9 o ............ ------ --------- ----------—----- Total Cost of Work Completed $372,602.00 Less %Retained $0.00 Net Earned $372,602.00 ------AIER Earned This Period $372,602.00 W DEPARTMEENT ENGINEERING !',M) FISCAL,SERVICES Retainage This Period $0.00 Contact Person- Less Liquidated Damages for, 0 Days@ $0.00 /Day S0.00 LessPavement Deficiency $0.00 DEPARTNIENT CHECK PICK-UP -YES Less Penalty MOO Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $372,602.00 Thursday,January 31,2019 Page 5 of 5 FORTWOiRTH �r CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name SANITARY SEWER CIP CONTRACT 2014 Contract Limits Project Type SEWER City Project Numbers 02298 DOE Number 2298 Estimate Number I Payment Number 1 For Period Ending 1/10/2019 CD City Secretary Contract Number 46046-R1 Contract Time 36ED Contract Date Days Charged to Date 365 Project Manager NA Contract is 24.000 Complete Contractor INSITUFORM TECHNOLOGIES,INC 702 SPIRIT 40 PARK DR CHESTERFIELD, MO 63005 Inspectors DICKINSON / WATSON Thursday,January 31,2019 Page 1 of 5 City Project Numbers 02298 DOE Number 2298 Contract Name SANITARY SEWER CIP CONTRACT 2014 Estimate Number 1 Contract Limits Payment Number 1 Project Type SEWER For Period Ending 1/10/2019 Project Funding SANITARY SEWER CIP CONTRACT 2014 Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 6 inch X 4.5 mm CIPP 500 LF $50.00 $25,000.00 2 8 inch x 6.0 mm CIPP 6000 LF $45.00 $270,000.00 90 $4,050.00 3 10 inch x 6.0 mm CIPP 1000 LF $50.00 $50,000.00 4 12 inch x 6.0 mm CIPP 500 LF $65.00 $32,500.00 5 15 inch x 7.5 mm CIPP 500 LF $80.00 $40,000.00 6 18 inch x 9.0 mm CIPP 300 LF $93.00 $27,900.00 7 21 inch x 9.0 mm CIPP 300 LF $125.00 $37,500.00 8 24 inch x 10.5 mm CIPP 300 LF $175.00 $52,500.00 1365 $238,875.00 9 27 inch x 10.5 mm CIPP 300 LF $175.00 $52,500.00 10 30 inch x 12.00 mm CIPP 300 LF $180.00 $54,000.00 11 6&8 inch CIPP Additional 1.5 mm th 200 LF $0.01 $2.00 12 10&12 inch CIPP Additional 1.5 mm 200 LF $5.00 $1,000.00 13 15&18 inch CIPP Additional 1.5 mm 100 LF $8.00 $800.00 14 21&24 inch CIPP Additional 1.5 mm 100 LF $13.00 $1,300.00 1029 $13,377.00 15 27 inch CIPP Additional 1.5 mm thick 100 LF $14.00 $1,400.00 16 30 inch CIPP Additional 1.5 mm thick 100 LF $15.00 $1,500.00 17 6 to 8 inch Clean and TV Sanitary S 6500 LF $7.00 $45,500.00 18 10 to 12 inch Clean and TV Sanitary 1500 LF $7.00 $10,500.00 19 15 to 18 inch Clean and TV Sanitary 800 LF $8.00 $6,400.00 20 21 to 24 inch Clean and TV Sanitary 600 LF $12.00 $7,200.00 21 27 inch Clean and TV Sanitary Sewer 300 LF $12.00 $3,600.00 22 30 inch Clean and TV Sanitary Sewer 300 LF $12.00 $3,600.00 23 Root Removal 3000 LF $1.15 $3,450.00 24 Other remote obtruction removal 10 DY $750.00 $7,500.00 25 Operate 4 inch Bypass Pumping System 90 DY $250.00 $22,500.00 1 $250.00 26 Operate 6 inch Bypass Pumping Syste 90 DY $350.00 $31,500.00 5 $1,750.00 27 Operate 8 inch Bypass Pumping Syste 5 DY $2,000.00 $10,000.00 28 Operate 12 inch Bypass Pumping Syst 5 LS $3,000.00 $15,000.00 29 Traffic Control-Design and Install 15 EA $7,500.00 $112,500.00 3 $22,500.00 30 4 foot Manhole 10 EA $4,500.00 $45,000.00 31 5 foot Manhole 5 EA $5,000.00 $25,000.00 Thursday,January 31,2019 Page 2 of 5 City Project Numbers 02298 DOE Number 2298 Contract Name SANITARY SEWER CIP CONTRACT 2014 Estimate Number I Contract Limits Payment Number 1 Project Type SEWER For Period Ending 1/10/2019 Project Funding 32 4 foot Fiberglass Manhole 5 EA $4,500.00 $22,500.00 33 5 foot Fiberglass Manhole 5 EA $5,000.00 $25,000.00 34 Wastewater Access Chamber(WAC) 10 EA $2,500.00 $25,000.00 35 4 foot Manhole Rehabilitation 20 VF $350.00 $7,000.00 36 5 foot Manhole Rehabilitation 20 VF $425.00 $8,500.00 37 Epoxy Manhole Liner 50 VF $180.00 $9,000.00 38 Permanent Asphalt Paving Repair 800 LF $40.00 $32,000.00 39 Temporary Asphalt Paving Repair 1000 LF $20.00 $20,000.00 40 6 inch Concrete Payment Repair 500 SY $50.00 $25,000.00 41 Manhole Adjustment,Minor 10 EA $1,100.00 $11,000.00 42 Manhole Adjustment,Major w/Cover 10 EA $2,600.00 $26,000.00 43 Concrete Collar 50 EA $600.00 $30,000.00 44 4 inch Service Reconnection,CIPP 2000 EA $0.01 $20.00 45 6 inch Service Reconnection,CIPP 200 EA $0.01 $2.00 46 Street Use Permit 50 EA $350.00 $17,500.00 1 $350.00 47 Post CCTV Inspection 50 LF $10.00 $500.00 1455 $14,550.00 48 Pre CCTV Inspection 50 EA $10.00 $500.00 1455 $14,550.00 49 Manhole Vacuum Testing 50 LF $225.00 $11,250.00 50 6-12 inch Sewer Pipe,Point Repair 100 LF $300.00 $30,000.00 51 18-24 inch Sewer Pipe,Point Repair 100 LF $350.00 $35,000.00 52 24-30 inch Sewer Pipe,Point Repair 100 LF $450.00 $45,000.00 53 4 foot Extra Deep Manhole 10 VF $425.00 $4,250.00 54 5 foot Extra Deep Manhole 5 VF $625.00 $3,125.00 55 4 foot Extra Deep Fiberglass Manhole 5 VF $625.00 $3,125.00 56 5 foot Extra Deep Fiberglass Manhole 5 VF $825.00 $4,125.00 57 Mobilization/Demobilization Cost for 48'Cleaning 1 LF $9,650.00 $9,650.00 58 Clean and TV 48" 1230 LF $58.95 $72,508.50 59 External Reconnect on 24" 11-14'Deep 9 EA $5,250.00 $47,250.00 9 $47,250.00 60 External Reconnect on 24" 12'DeeP 4 EA $3,775.00 $15,100.00 4 $15,100.00 Sub-Total of Previous Unit $1,537,057.50 $372,602.00 ------------------------------------------- Thursday,January 31,2019 Page 3 of 5 City Project Numbers 02298 DOE Number 2298 Contract Name SANITARY SEWER CIP CONTRACT 2014 Estimate Number I Contract Limits Payment Number I Project Type SEWER For Period Ending 1/10/2019 Project Funding Contract Information Summary Original Contract Amount $500,000.00 ChanLye Orders Total Contract Price $1,537,057.50 Date Total Cost of Work Completed $372,602.00 Less %Retained $0.00 Net Earned $372,602.00 "Ile bateeO Earned This Period $372,602.00 Inspection Supervisor Retainage This Period $0.00 Cont4ontra t6, 141 A Z4 Date,3 //3 Less Liquidated Damages Projoc anagor� Days g Day $0.00 Date -7 LessPavement Deficiency $0.00 Z Asst.D c Less Penalty $0.00 Date Less Previous Payment $0.00 Director Contracting Department Plus Material on Hand Less 15% $0.00 Balance Due This Payment $372,60100 Thursday,January 31,2019 Page 4 of 5 FORTWORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:I NAME OF PROJECT: Sanitary Sewer CIP Contract 2014 PROJECT NO.: CONTRACTOR: Insituform Technologies DOE NO.: 7264 PERIOD FROM:07/01/16 TO: 0 1/07/19 FINAL INSPECTION DATE: 7-Jan WORK ORDER EFFECTIVE:7/l/2016 CONTRACT TIME: 365/CD 0 WO* CD DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS MONTH CHARGED CREDITED MONTH CHARGED CREDITED DURING DURING 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 OTHERS * DAYS TOTAL & HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS THIS 0 0 0 556 365 921 PERIOD PREVIOUS 0 0 0 0 0 0 PERIOD TOTALS 0 0 0 556 365 921 ,TO DATE *REMARKS: 'W , 71�7 70NTRXC'f0R DATE INSPECTOR DATE ENGINEERING DEPARTMENT The City of Fort Worth- 1000 Throckmorton Street-Fort Wortll,TX.76012-6311 (a (817)392-7941 -Fax: (817)392-7845 (U& Insituform it t;hnologies, CLC September 18,2018 Mr.Tony Sholola City of Fort Worth,TX R for Additional Line Items Project Name: City of Fort Worth Sanitary Sewer CIPP Contract 2014—City Project No.02298 Work Order#3 DOE#7624 We request that these line items be added to this project as they are not covered in the scope of the Term Contract Bid Items and are items necessary to complete the CIPP work. Bid Item Description Units Qty Unit Price Subtotal . External Reconnects on 24"-Isbell (11-14' Deep) C01.1 in street w/restoration EA Xr $ 5,250.00 $ %500-00 External Reconnects on 24"-Longleaf(12' Deep) EA 4 C01.2 in street w/restoration $ 3,775.00 $ 15,100.00 T TAD_ $ 67 6;2, Upon review and approval,please sign and return via email tobliawkins@aegion.com. ®r_ I L- A --p Please let me know if you have any questions. Accepted By: Signature: Date: Name Title Organization Respectfully, Ben Hawkins Project Manager Insituform Technologies,Inc. Page 1 of 1 AFFIDAVIT OF BILLS PAID THE STATE OF TEXAS COUNTY OF TARRANT Ben Hawkins, Being first duly sworn, state that he is Project Manager of Insituform Technologies LLC of Tarrant County of Texas, hereinafter called "Company", and The said Company has performed work and/or furnished City of Fort Worth, hereinafter called "Owner" pursuant to a contract, dated with Owner(hereinafter called"Contract") for the construction of: PROJECT: Sanitary Sewer CIPP Contract 2014 PROJECT NO: 2298 First Renewal That all just and lawful invoices against the Company for Labor, materials and expendable equipment employed in the performance of the Contract and have been paid in full (with the exception of the attached invoice) prior to acceptance of payments from the Owner, and That the Company agrees to indemnify and hold the Owner and Engineers harmless from all liability arising from claims by subcontractors, materialmen and suppliers under Contract, and That no claims have been made or filed upon the payment bond, That the Company has not received any claims or notice of claims from the subcontractor, materialmen and suppliers. INSITUFORM TE HNOLOGIES, L.L.C. By: Be Hawkins Project Manager Title THE STATE OF TEXAS COUNTY OF TARRANT BEFORE ME, The undersigned authority, on this day personally appeared Ben Hawkins of Insituform Technologies LLC , a Delaware Corporation, known to me to be the person and officer whose name is subscribed to the foregoing instrument, and acknowledged to me that the executed the same as the act and deed of such corporation, for the purpose of consideration therein expressed and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE ON THIS THE 22nd day of February, 2019 MY COMMISSION EXPIRES: 10/02/2022 .w OTARY PUBLIC k&AND FOR THE STATE OF TEXAS Y j''. JULIE A. HATFIELD Notary Public, State of Texas Qc` Comm. Expires 10-02-2022 .,,,,, Notary ID 12997953-4 CONSENT OF SURETY OWNER _ TO FINAL PAYMENT ARCHITECT _ AIA DOCUMENT G707 CONTRACTOR _ SURETY _ (Instructions on reverse side) OTHER Bond No. 106155701 TO (OWNER) (Name and address) ARCHITECT'S PROJECT NO: City of Fort Worth 1000 Throckmorton Street Contract For: Fort Worth, TX 76102 Contract Date: 7/13/2016 PROJECT: (Name and address) Sanitary Sewer CIPP Contract 2014-City Project No. 2298 -..First Renewal 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) Travelers Casualty And Surety Company One Tower Square Hartford, CT 06183 SURETY, on bond of (here insert name and address of Contractor) INSITUFORM TECHNOLOGIES, LLC 17988 Edison Avenue Chesterfield, MO 63005 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 1000 Throckmorton Street Fort Worth, TX 76102 OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF,the Surety Company has hereunto set its hand this 19th day of February, 2019. (Insert in writing the month following by the numeric date and year) Travelers Casualty And Surety Company Surety Company By: Attest. Amanda I L.Williams,Witness Andrew P.Thome,Attorney-in-Fact AIA DOCUMENT G707 CONSENT OF SURETY COMPANY TO FINAL PAYMENT 1994 EDITION AIA® One Page ©THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., NW State of Missouri County of St. Louis On February 19, 2019, before me, a Notary Public in and for said County and State, residing therein, duly commissioned and sworn, personally appeared Andrew P. Thome known to me to be Attorney-in-Fact of TRAVELERS CASUALTY AND SURETY COMPANY the corporation described in and that executed the within and foregoing instrument, and known to me to be the person who executed the said instrument in behalf of said corporation, and he duly acknowledged to me that such corporation executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and year stated in this certificate above. Amanda L. Williams,Notary Public AMANDAL.WLUAMS NOTARY PUBLIC-NOTARY SEAL STATE OF MISS RI COMMISSIONED FOR ST.LOUIS COUNTY ,.IY COMMISSION EXPIRES JUL.24,2021 My Commission Expires: I®#13507257 Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERSJ 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 Andrew P.Thome,of Chesterfield, Missouri,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. 1Y 4,vo kA J 6G eme- MOM CONK, State of Connecticut City of Hartford ss. Robert L.Raney,Sefiior 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. G T� My Commission expires the 30th day of June,2021 Q1V R. C �link0 o jDUQ.��* Marie C.Tetreault,Notary Public ct� 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, 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 Attomeys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances,contracts of indemnity, and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory 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 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 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 Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which 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 19 day of February 2019 �,yi63LRIT4 JpL,JY AA, P sL ti Kevin E.Hughes,Assistant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421 3880. Please refer to the above-named Attorney-in-Fact and the details of the bond to which the power is attached. IMPORTANT NOTICE To obtain information or make a complaint: You may call Travelers Casualty and Surety Company of America and its affiliates' toll-free telephone number for information or to make a complaint at: 1-800-328-2189 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection(d�tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact your Agent or Travelers first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR BOND: This notice is for information only and does not become a part or condition of the attached document and is given to comply with Texas legal and regulatory requirements. (PN-042-B) Ed.10.18.07 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Sanitary Sewer CIPP Contract 2014 R-I PROJECT NUMBER: 2298 DOE NUMBER: NA WATER PIPE LAID SIZE TYPE OF PIPE LF FIRE HYDRANTS: VALVES(16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF 6 linch x 4.5mm 6" CIPP 0 8 Inch x 6.Omm 811 CIPP 0 10 Inch x 6.00mm 1011 Cipp 0 24 Inch x 10.5mm 24'--- Cipp 1,365 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817) 392-7941 •Fax: (817) 392-7845