HomeMy WebLinkAboutContract 47858-FP1 FORT WORTH, CITY SECRETARY _
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TRANSPORTATION AND PUBLIC WORKS C-S `47975"
NOTICE OF PROJECT COMPLETION ( 7C S
City Project Ne: 02436
Regarding contract 47858 for 2015 WSM-B PART 3 as required by the WATER DEPARTMENT as approved by
City Council on 05/03/2016 through M&C C-27710 the director of the WATER DEPARTMENT upon the
recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project
as complete.
Original Contract Prices: $1,058,681.00
Amount of Approved Change Orders: $69,998.40 Ne 1
Revised Contract Amount: $1,128,679.40
Total Cost Work Completed: $1,128,679.40
Less Deductions:
Liquidated Damages: Days @$210.00/Day
Pavement Deficiencies: ,
Total Deduction Amount:
Total Cost Work Completed: $1,128,679.40
Less Previous Payments: $975,163.08
Final P nt ue $153,51632
Recomrnended f Acceptance Date
C,Asst. Director, TPW - Infrastructure Design and Construction
Accepted Date
Asst. Director, WATER DEPARTMENT
Asst. City Manager Date
Comments:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX
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FORTWORTH®
TRANSPORTATION AND PUBLIC WORKS
STATEMENT OF CONTRACT TIME
STATEMENT#
FINAL STATEMENT# 14R-Final CPN# 1 02436
NAME OF PROJECT: Water and Sanitary Sewer Replacement Contract 2015 WSM-B,Pt 3 Contractor Contatser
YEAR:j 2017 Unit 1 -Water,Unit II-Sanitary Sewer
PROJECT NO.: FINAL INSPECTION DATE 2/27/2018
59601/59607-06004301070430-83 WD CD
CONTRACT TIME 205 1 X
PERIOD FROM: 1 5/1/2017 TO: 1 5/16/2017 1 BEG - Month I I DEVELOPMENT (Y/N)I N
WORK ORDER EFFECTIVE: 1 8/15/2016 BEG( /n) y MID( /n) n 100.0%
LIP YR(y/n)
DAY OF MONTH DAYS REASON FOR DAY OF MONTH DAYS REASON FOR
CHARGED DAYS CREDITED CHARGED DAYS CREDITED
1 Mon 1 16
2 Tue 1 17
3 Wed 1 18
4 Thu 1 19
5 Fri 1 20
6 Sat 1 21
7 Sun 0 na 22
8 Mon 0 na 23
9 Tue 0 na 24
10 Wed 0 na 25
11 Thu 0 na 26
12 Fri 0 na 27
13 Sat 0 na 28
14 Sun 0 1 na 1 29
15 Mon 0 na 30
31
NA Wkn&Hol Wea Utl Oth
Not Applicable SAT,SUN,and WEATHER UTILITIES OTHERS DAYS TOTAL DAYS
HOLIDAYS RELOCATE CHARGED
THIS PERIOD 0 0 0 0 6 6
PREVIOUS PERIOD 0 199 199
TOTAL TO DATE 1 0 0 0 0 205 205
REMARKS:
E.Mulkey Avenue-Complete. Colving Avenue-Complete. E. Devitt Street- Complete. E.Cantey Street-Complete. Alleyway-Complete.
Water and Sewer Complete. Paving Mobilizing under a different TPW contract. Total Calendar Days Used 198 to stop time 2/28/17
Substantially Complete and an additional 7 days to complete Permanate Patch replacement. Total 205 Calendar days including
HMAC on Grover completed on 5106/17. Valve Final Completed 2/27/17. Punch List Completed 5106/17
Signature: Signature:
(Print Name) QZ
Edwar 'a
CONTRACTOR DATE r INSPECTOR DATE V Q
I
FOIZ-g 1 City of Fort Worth CjTYSFCREARY� .!
Change Order Request CONTRACT NO.
ProjectName:1 Water and Sanitary Sewer Replacement Contract 2015 WSM-B,Pt 3 City Sec No.: 47858
Project No.(s): 59601/59607-0600430/070430-63 DOE No, F-7-4-3-5----7 City Proj.No.: 02436
Water and Sanitary Sewer Replacement on Schieffer Street,E.Mulkey Avenue,Colving Avenue,E.Devitt Street,E.
Project Description: Cantey Street and Alleyway
Contractor: Conatser Construction TX,LP Change Order# 4 Date: 6/27/2018
City Project lVlgr,J Walter Norwood—� City lnspector: Edward D'avila
Phone Number: 817-392-5026 —� Phone Number: 817-223-2268
Dept. Water Sewer Totals Contract Time
(Calender days)
Original Contract Amount $787,321.00 $271,360.00 $1058,68100 160
Extras to Date $11,180.00 $13,208.00 $24,388;00 045
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $798,501.00 $284,568:00 11,08317069,W,i 205
Amount of Proposed Change Order $1%9%90 $25,690:50 $45;610,,40,
Revised Contract Amount $818,420.90 $310,258.50 $11128,679.40 205
Original Funds Available for Change Orders $52,079.00 $34,140.00 $.86,2%00
Remaining Funds Available for this CO $40,899;00 $20,932.00 ' $611831:00
Additional Funding(if necessary) $4,7581,50 $4,758.50
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 6;61%,
MAXALLOWABLE CONTRACTAMOUNT(ORIGINAL CONTRACT COST+25%) $1,323,351.25
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Change Order No.4 provides for increased and additional pay item quantities that were necessary to
complete the project.The change order will allow for the deletion of pay item quantities that are no
longer necessary on the project.
I Atte
FOy/ l <<
,T. ti' a� y Secretary .
F .70
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It is understood and agreed that the acceptance of this Change Order by the contra or constitutes an accord and satisfaction and represents payment
in full(both time and money)for all costs arising out of,or incidental to the above Change Order.
Stet§key z f , � z� .�im, yJyt�ey ti'vax:, ;.tk `' p i "� +� v e .'�«e�( tt `ka . �G�'oll(Cra_-_..,.
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Conatser Construction TX,LP Jesse Martinez
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M&C Number NIA M&C Date Approved N/A
®-r WOwr1-1 City of Fort Worth
Change Order Additions
Project Name Water and Sanitary Sewer Replacement Contract 2015 WSM-B,Pt 3 City Sec No.: 47858
Project No.(s): 59601/59607-06004301070430-83 DOE Nol:= City Proj.No.: 02436
Project Water and Sanitary Sewer Replacement on Schieffer Street,E.Mulkey Avenue,Colving Avenue,E.Devitt Street,E.
Description Cantey Street and Alleyway
Contractor Conatser Construction TX,LP Change Order:® Date: 6127l2018
City Project Mgr. Walter Norwood City Inspector Edward Davila
ADDITIONS
DEPT Qty Unit Unit Cost Total
1A 16"PVC C905 Water Pipe Water 40.00 LF $65.00 $2,600.00
3 10"Water Pipe Water 8.00 LF $50.00 $400.00
4 8"Water Pipe Water 156,00 LF $40.00 $6,240.00
9 Remove 6"Water Valve Water 1.00 EA $100.00 $100.00
14 4'Wide Asphalt Pvmt Repair,Residential Water 176.00 LF $48.00 $8,448.00
16 8'Wide Asphalt Pvmt Repair,Residential Water 61.30 LF $65.00 $3,984.50
18 Asphalt Pvmt Repair,Water Service Water 20,00 LF $35.00 $700.00
19 Temp Asphalt Paving Repair(2"Asphalt,6"Cement Treated Base) Water 744.00 LF $15.00 $11,160.00
21 Temp Asphalt Sidewalk Repair(2"Asphalt,6"Cement Treated Base) Water 2.00 LF $30.00 $60.00
22 Temp Asphalt Valley-Gutter Repair(2"Asphalt,6"Cement Treated Base) Water 1.00 LF $45,00 $45.00
23 Conc Pvmt Repair,Residential Water 70.82 SY $65.00 $4,603.30
24 Conc Pvmt Repair,Arteriallindustrial Water 212.43 SY $75.00 $15,932.25
25 6"Conc Curb and Gutter Water 94.00 LF $30.00 $2,820.00
26 9"Conc Valley Gutter,Residential Water 5.88 SY $60.00 $352.80
27 4"Conc Sidewalk Water 29.71 SF $5.00 $148,55
30 Block Sod Placement Water 51.00 SY $8.00 $408,00
42 6"Gate Valve(No collar) Water 3.00 EA $1,000.00 $3,000.00
2 8"D2241 SDR-26 Pipe Sewer 215.00 LF $48.00 $10,320.00
3 8"Pipe Enlargement Sewer 7.00 LF $65.00 $455.00
4 Service Reinstatement,Pipe Enlargement Sewer 1.00 EA $1,500.00 $1,500.00
8 Remove 4'Sewer Manhole Sewer 2.00 EA $500.00 $1,000.00
13 Conc Pvmt Repair,Residential Sewer 203.10 SY $65.00 $13,201.50
22 4"Sewer Service Sewer 11.00 EA $1,000,00 $11,000.00
23 Traffic Control Sewer 1.00 MO $1,200.00 $1,200.00
E
i
Water $61,002.40
Sewer $38,676.50
Page 2 of 4 Additions Sub Total $99,678.90
F0F,--r Wc>P.7t 1-1 City of Fort Worth
Change Carder Deletions
Project Name Water and Sanitary Sewer Replacement Contract 2015 WSM-B,Pt 3 City Sec No.: 47858
Project No.(s): . 59601/59607-06004301070430-83 DOE No. 7435 City Proj.No.: 1 02436
Project Description Water and Sanitary Sewer Replacement on Schieffer Street,E.Mulkey Avenue,Colving Avenue,E.Devitt Street,
E.Cantey Street and Alleyway
Contractor F Conatser Construction TX,LP Change Order: 74 1 Date 6/2712 0 1 8
City Project Mgr. I Walter Norwood City Inspector: F Edward D'avila
DELETIONS
ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total
2 16"DIP Water Pipe by Bore(w/o casing) Water 20.00 LF $100.00$2,000.00
6 8"DIP Water Pipe Water 12.00 LF $70.00$840.00
7 8"DIP Water,CLSM Backfill Water 8.00 LF $85.00$680.00
8 6"Water Pipe Water 16.00 LF $35.00$560,00
15 S Wide Asphalt Pvmt Repair,Residential Water 1.70 LF $55.00 $93.50
17 Asphalt Pvmt Repair Beyond Defined Width,Residential Water 333.00 SY $40.00 $13,320.00
20 TempAsphalt Curb Repair(2"Asphalt,6"Cement Treated Base) Water 12.00 LF $18.00 $216.00
28 6"Concrete Driveway Water 102.00 SF $8.00 $816.00
29 Topsoil Water 37.00 CY $10.00$370.00
32 Trench Safety Water 7,00 LF $1.00$7.00
33 4"-12"Dectile Iron Water Line Fittings(w/restraint as needed) Water 0.10 $4,200.00$420.00
36 Fire Hydrant Water 1.00 EA $3,500.00$3,500.00
41 1"Private Water Service Water 148.00 LF $20.00$2,960.00
43 8"Gate Valve(No collar) Water 1.00 EA $1,200.00$1,200.00
44 16"Gate Valve w/Vault Water 0.50 EA $12,000.00$6,000.00
46 Concrete Collar for Gate Valves Water 17.00 EA $300.00$5,100.00
47 18"RCP,Class III Water 24.00 LF $50.00 $1,200.00
48 27"RCP,Class III Water 24,00 LF $75.00$1,800.00
1 8"Sevier Pipe Sewer 37.20 LF $45.00 $1,674.00
5 Sag Adjustment of Sewer Main,Pipe Enlargement Sewer 20.00 LF $75.00 $1,500,00
9 4'Wide Asphalt Pvmt Repair,Residential Sewer 91.00 LF $48.00$4,368.00
10 Asphalt Pvmt Repair Beyond Defined Width,Residential Sewer 47.60 SY $40.00$1,904,00
14 9"Conc Valley Gutter,Residential Sewer 17.00 SY $60.00$1,020.00
15 6"Concrete Driveway Sewer 165.00 SF $8.00$1,320.00
17 Pre-CCTV Inspection Sewer 3.00 LF $8.00$24.00
18 Post-CCTV Inspection Sewer 2.00 LF $3.00 $6,00
24 6'Fences,Wood Sewer 26.00 LF $45.00$1,170.00
Water $41,082.50
Sewer $12,986.00
Deletions Sub Total $54,068.50
Page 3 of 4
MIVVBE Breakdown for this Change Order
MWBE Sub Type of Service Amount for this CO
Total0.00
Previous Change Orders
co# DATE AMOUNT
Total $0.00
Page 4 of 4
pity of Fort Worth, Texas
Mayor and uncH Communication
COUNCIL ACTION: Approved on 6/26/2018 -Ordinance Nos. 23283-06-2018 & 23284-06-
2018
DATE: Tuesday, June 26,2018 REFERENCE NO.: **C-28750
LOG NAME: 6015WSMBC04CONATSERFUNDING
SUBJECT:
Adopt Appropriation Ordinances in the Collective Amount of$50,611.00 for Increased Project Management
Costs for the Water and Sanitary Sewer Replacement Contract 2016 WSM-B,Which Replaces Water and
Sewer Lines in Various Streets(COUNCIL DISTRICTS 8 and 9)
RECOMMENDATION:
It is recommended that the City Council adopt the attached appropriation ordinances increasing estimated
receipts and appropriations in the Water Capital Fund in the amount of$22,420.00 from available funds
and in the Sewer Capital Fund—Legacy in the amount of$28,191.00 from available funds for the purpose
of funding Water and Sanitary Sewer Replacement Contract 2015, WSM-B (City Project No. 2436)
DISCUSSION:
On May 3, 2016, Mayor and Council Communication (M&C) C-27710 the City Council authorized a
contract with Conatser Construction TX, LP, in the amount of$1,058,681.00 for Water and Sanitary Sewer
Replacement Contract 2015, WSM-B, Part 3, on Shieffer Street., E. Mulkey Avenue, Colvin Avenue,
Alleyway North of Union Pacific Railroad, E. Devitt Street and Cantey Street.The contract was
subsequently revised by three previous change orders as follows: Change Order No. 1 in the amount of
$24,388.00 administratively authorized August 22, 2017; Change Order No.2 with a net zero amount
administratively authorized November 19, 2017; and Change Order No. 3 with a net zero amount
administratively authorized March 20, 2018.
This project requires additional funding in the amount of$5,000.00 for project management and to cover
costs associated with Change Order No. 4 in the amount of$45,611.00 for additional water and sanitary
sewer improvements cost on this project.
The project is located in COUNCIL DISTRICTS 8&9, Mapsco 77 T,X.
This M&C does not request approval of a contract with a business entity.
FISCAL INFORMATION I CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations and adoption of the
attached appropriation ordinances,funds will be available in the current capital budget, as appropriated, of
the Water Capital Fund and the Sewer Capital Fund—Legacy.The Fiscal Year 2018 Water Operating
Fund Budget includes appropriations of$29,069,236.00 for the purpose of providing Pay-As-You-Go
funding for Water Capital Projects. After this transfer for Fiscal Year 20,18,the balance will be
$8,675,491.00.The Fiscal Year 2018 Water Operating Budget includes appropriations of$29,022,689.00
for the purpose of providing Pay-As-You-Go funding for Sewer Capital Projects.After this transfer for
Fiscal Year 2018,the balance will be$7,257,368.00.
Appropriations for Water and Sanitary Sewer Replacements Contract 2015 WSM-B Project by Fund will
consist of the following:
http:Happs.cAvnet.org/Ccolzncil/pri)ltnlc.asp?i(1-25908&1)3'illt=true&DocType=Print 6/27/2018
FUND lExisting Appropriations Additional Appr IProject Total"
Water Capital Fund 59601 11 $3,851,377.00 $22,420.00 $3 873,797.00
Sewer Capital Fund-Le2acy 5960 $983,06U $28,191.00 $1,011,257.00
Pro'ectTotaC $4,834,443.00 $50,611,00 9885,054.00
*Numbers rounded for presentation purposes.
FUND IDENTIFIERS (FIDs):
TO
]F—U�ndDe�parl.Menl Account Project ProgramActivity Budget Reference#___ID I-- - Year �(Chartfield 2)
FROM
Fund Department ccount Project aml�kctivityl Budget Reference# moon
--- ID _..-- -- ID ---- Year Chartfield 2) w
CERTIFICATIONS:
Submitted for City Manager's Office by: Jay Chapa (5804)
Originating Department Head: Chris Harder (5020)
Additional Information Contact: Walter Norwood (5026)
ATTACHMENTS
1. 6015WSMBC04CONATSERFUNDING Map.pdf (Public)
2, 6015WSMBC04CONATSERFUNDING F I D Table (Dan).docx (CFW Internal)
3. 6015WSMBC04CONATSERFUNDING 60 AO 18.docx (Public)
4. 6015WSMBC04CONATSERFUNDING 70 AO 18.docx (Public)
http://apps.cfwnet.t7l-g/ccowlcii/printmc,asp?id=25908&print==true&DocType=Print 6/27/2018
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CD a a a
Contract Compliance Manager
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Signature
Naive of Employee
_5r, !''Yo SS iGs�u J �i� i vt ems✓
Title
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: 2015 WSM-B Part 3
PROJECT NUMBER: 02436
DOE NUMBER: N/A
WATER
PIPE LAID SIZE TYPE OF PIPE LF
C-905 16" PVC 693
C900 10" PVC 20
C900(CLMS BackfiIl 8" PVC 5030
C900 8" PVC 61
C900 6" PVC 31
FIRE HYDRANTS: 4 VALVES(16" OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE LF
i
f DENSITIES: YES
NEW SERVICES: N/A Rehab 127 EA
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
PIPE ABANDONED SIZE TYPE OF PIPE LF
SDR 26 8" PVC 1553
D2241 SDR 26 8" PVC 416
Pipe Enlargement 8" PVC 153
DENSITIES: YES
NEW SERVICES: 4"PVC Rehab-Service Re-enstatement 46 EA.
4"PVC PipeBurstinb Service Re-enstatement 2 EA.
'IRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311
(817)392-7941 • Fax: (817)392-7845
1
< S
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me, the undersigned authority, a Notary Public in the state and county aforesaid,
on this day personally appeared Brock Huggins, President of Conatser Management Group, Inc.,
general partner of Conatser Construction TX LP, known to me to be a credible person, who
being by me duly sworn, 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; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
Contract 2015,WSM-B Part 3
WATER AND SANITARY SEWER
REPLACEMENT
DOE#: 7435
CFA PRJ#:N/A
CITY PROJCT #: 02436
CITY OF FORT WORTH
STATE OF TEXAS
CONATSER CONSTRUCTION TX, LP
Brock Huggins
Subscribed and sworn to before me this 9"'day of January,
BERTHA GIANULI5
public,state of Texas NotaryPublic in Tarrant County, Texas
hty Commission Expires
eptornber t
6
- d
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
CONTRACTOR ❑
TO FINAL PAYMENT SURETY ❑
Conforms with the American Institute of OTHER
Architects,AIA Document G707
Bond No 0201455
PROJECT:
(name, addres Fort Worth,
h,TX WSB-B Part 3
Fort Worth,TX
TO (Owner)
ARCHITECT'S PROJECT NO:
CITY OF FORT WORTH CONTRACT FOR:
1000 Throckmorton Street Water and Sanitary Sewer Re m B laceent Contract 2015,WSB- Part 3
City Project No.02436 DOE 7435
Fon Worth TX 76102 -J CONTRACT DATE: 5/3/2016
CONTRACTOR:CONATSER CONSTRUCTION TX, L.P.
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the
there insert name and address of Surety Company)
BERKLEY INSURANCE COMPANY
475 Steamboat Road
Greenwich CT 06830 > SURETY COMPANY
on bond of (here insert name and address of Contractor)
CONATSER CONSTRUCTION TX,L.P.
5327 Wichita St.
Fort Worth TX 76119-6035 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 16th day of January,2019
BERKLEY INSURANCE COMPANY
i Surety Company
Attest:
(Seal): Signature of Authorized Representative
Robbi Morales Attorney-in-Fact
Title
NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR's AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
No.BI-7280i
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WILMINGTON,DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
organized and existing under the laws of the State of Delaware,having its principal office in Greenwich,CT,has made, constituted
and appointed, and does by these presents make, constitute and appoint: Ricardo J, Reyna; Don E. Cornell;Sophinie Hunter;
Robbi Morales;Kelly A. Westbrook; Tina McEwan;or Joshua A.Saunders of Aon Risk Services Southwest,Inc. of Dallas, TX
its true and lawful Attorney-in-Fact, to sign its name as surety only as delineated below and to execute, seal, acknowledge and
deliver any and all bonds and undertakings, with the exception of Financial Guaranty Insurance,providing that no single obligation
shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly
executed and acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons.
This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following
resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010:
RESOLVED,that,with respect to the Surety business written by Berkley Surety,the Chairman of the Board,Chief Executive
Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are
hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein to execute
bonds,undertakings,recognizances, or other suretyship obligations on behalf of the Company, and to affix the corporate seal
of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such attorney-in-fact and
revoke any power of attorney previously granted;and further
RESOLVED,that such power of attorney limits the acts of those named therein to the bonds,undertakings,recognizances,or
other suretyship obligations specifically named therein,and they have no authority to bind the Company except in the manner
and to the extent therein stated;and further
RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and
further
RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any
power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or
other suretyship obligation of the Company;and such signature and seal when so used shall have the same force and effect as
though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any
person or persons who shall have been such officer or officers of the Company,notwithstanding the fact that they may have
ceased to be such at the time when such instruments shall be issued.
IN WITNESS WHEREOF, the Comany has caused these presents to be signed and attested by its appropriate officers and its
p
corporate seal hereunto affixed this 1CC "lot day of
Attest: Berkle Insurance Cornjpan
(Seal) By r By
Ira 7Led an Jef -e fter fter
Executive Vice President&Secretary en o i esident
WARNING:THIS POWER INVALID IF NOT PRINTED ON BLUE"BERKLEY"SECURITY PAPER.
STATE OF CONNECTICUT)
ss:
COUNTY OF FAIRFIELD
Sworn to before me, a Notary Public in the State of Connecticut, this LU day of-;Lf\1ju crf_q _-,UL0J by Ira S. Lederman
and Jeffrey M. Hafter who are sworn to me to be the Executive Vice Pre e
'd t and Secretary, in the Senior Vice President,
A y
respectively,of Berkley Insurance Compar4IARIA C.RUNDBAKEN
NOTARY PUBLIC
MY COMMISSION EXPIRES Motary Public, State of Connecticut
APRIL30,2019
CERTIFICATE
1,the undersigned, Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the foregoing is a true, correct
and complete copy of the original Power of Attorney;that said Power of Attorney has not been revoked or rescinded and that the authority of the
Attorney-in-Fact set forth therein,who executed the bond or undertaking to which this Power of.A�t6 ttac ed,is in full force and effect as
of this date.
Company,this 16 th 19 day of Januai 2
Given under my hand and seal of the — r3--7 7M
(Seal) J&ttkg��
Vincent P.Forte' V —
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