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HomeMy WebLinkAboutContract 49218-FP1 FORTWORTHe CiTY SECRETARY/) CONTRACT NO. �p G Zlot CCNF� TRANSPORTATION AND PUBLIC WORKS G NOTICE OF PROJECT COMPLETION City Project Ns: 100773 Regarding contract 49218 for HMAC 2017-10 (CDBG) STREET REHABILITATION as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 05/09/2017 through M&C C-28233 the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project as complete. Original Contract Prices: i $1,176,955.50 Amount of Approved Change Orders: v.u Ns 1 Revised Contract Amount: m 1 a $1,176,955.50 Total Cost Work Completed: • .d o w $1,158,366.73 Less Deductions: � Oq Liquidated Damages: ffI U �' c F j� Days @$210.00/Day r•+ w. y d Pavement Deficiencies: o Total Deduction Amount: $0.00 Total Cost Work Completed: $1,158,366.73 Less Previous Payments: a� p., co. .� Q W „w $1,100,448.39 0UwGA3U Fw iJ Final Payment Due $57,918.34 R commended for Acceptance Date Asst. Director, TPW - Infrastructure Design and Construction I 4cep Date AMA. Director, TRAANSP RTATION AND PUBLIC WORKS DEPARTMENT E Asst. City Manager Date Comments: 2 i 0o 1 - 20(cp0©o- 100000 -C-i IWTPr N $S-+ C1 I V- � (OFFICIAL RECORD CITY SECRETARY FT. WORTH,TX y TPW Construction Invoice Contract: CS49218 P.O.# 18-000101379; 1549 Payment Date: 6/7/2019 TO:Peachtree Construction LTD INV•# C S49218-3 5 FINAL Estimate No. 35 DOE: 5801 Park Vista Cir ProjManager Kristian Sugrim Keller TX 76248 FOR: HMAC 2017-10(CDBG)Street Rehabilitation Contract Amount: $1,176,955.50 Completed Ret Pen Adj Pay Total to Date: $1,158,366.73 $0.00 $0.00 $0.00 $1,158,366.73 Previous Estimate: $1,158,366.73 $0.00 $0.00 $0.00 $1,100,448.39 Earned to Date: $0.00 ($57,918.34) $0.00 $0.00 $57,918.34 Payments: 21001-0200431-5740010-100000-A01912 $1,176,955.50 21001--2060000--100000-GRETAN-- Total to Date: $1,158,366.73 $0.00 $0.00 $0.00 $1,158,366.73 Previous Estimate: $1,158,366.73 $57,918.34 $0.00 $0.00 $1,100,448.39 Earned to Date: $0.00 ($57,918.34) $0.00 WOO $57,918.34 Thursday,July 18,2019 Page 1 of 1 C-620 Signature Page Contractor's Application for Payment Invoice No.F 35 Final To(Owner) City of Fort Worth Invoicing Period(From-To): Invoice Date: 4/l/19-4/15/19 6/7/2019 P.O. PO-18-000101379 From(Contractor): Remit to(If Not Automatic Deposit): Number: L( PEACHTREE Project: 100773 Contractor's CFW Vendor No.: 0000007231 City secretary contract 49218 Contract Number: Nam:HMAC 2017-10 (CDBG) STREET REHABILITATIONS Application For Payment Change Order Summary Approved Change Orders I. ORIGINAL CONTRACT PRICE.......................................................... $ $1,176,955.50 Number Additions Deletions 2. Net change by Change Orders................................................................. $ 1 $196,270.70 $196,270.70 3. Current Contract Price(Line 1 t 2)........................................................ $ $1,176,955.50 2 4. TOTAL COMPLETED AND STORED TO DATE 3 (Progress Estimate,Construction Allowance and Change Orders)....... $ $1,158,366.73 4 5. RETAINAGE: 5 a. X $1,158,366.73 WbrkCompleted.......... $ 6 b. X Not Used $ 7 c.Total Retainage(Line 5a+Line 5b)............................... $ 8 6. AMOUNT ELIGIBLE TO DATE(Line 4-Line 5c)............................. $ $1,158,366.73 TOTALS $196,270.70 $196,270.70 7. LESS PREVIOUS PAYMENTS(Line 6 from prior Application)........ $ $1,100,448.39 NET CHANGE BY 8. AMOUNT DUE THIS APPLICATION................................................. $ $57,918.34 CHANGE ORDERS 9.BALANCE TO FINISH,PLUS RETAINAGE (Column G on Progress Estimate+CA+COs+Line 5 above).............. $ $18,588.77 Contractor's Certification 10. CONTRACT TIME: The Contractor certifies with the submittal of this document and associated Payment Request Submittal a. Days Awarded 200 on the City of Fort Worth Buzzsaw system that to the best of their knowledge:(1)all previous progress b, Days Added by CO 120 payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by C. Total Days 320 prior Applications for Payment;(2)title of all Work,materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens,security interests and encu rnbrances(except such as are covered by d. Days Charged 320 a Bond acceptable to Owner indemnifying Owner against any such Liens,security interest or e. Days Remaining encumbrances);and(3)all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Received By T/PW Project Support Itzel Almaguer __ — — t JUL 18 Zola This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications.You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. City of Fort Worth Summary of Charges City Secretary Contract Num: 49218 HMAC 2017-10(CDBG)STREET REHABILITATIONS P.O.: PO-18-000101379 Project Number: 100773 Application Period: 4/1/19-4/15/19 Application 35 Final Application Date: 6/7/2019 Number: Funding Identification(FID) Total Completed � Amt Remaining Gross Retainage Net j Totals ( 7 21 0 01-0200431 5740 01 0-1 0000 0-9-9. G7-+ ��'� $1,158,366.73 $18,588.77 0 a 0 0 0 0 0 '0 0 0 0 Grand Total $1,158,366.73 $18,588.77 $0.00 ($57,918.34) $57,918.34 :FtU) Qe"C'. Z10c) - wU 0000 - 100000 —C,1Z:&Tft-N City of Fort Worth Summary of Charges City Secretary Contract Num: 49218 HMAC 2017-10(CDBG)STREET REHABILITATIONS P.O.: PO-18-000101379 Project Number: 100773 Application Period: 4/1/19-4/15/19 Application 35 Final Application Date: 6/7/2019 Number: Funding Identification(FID) Total Completed Amt Remaining Gross —Retainage Net Original Contract � ��- 21001-02004315740010-100000-991992 $962,096.03 $214,859.47 0 0 0 0 0 0 I 0 0 0 0 i Change Order 1 21001-02004315740010-100000-991992 $196,270.70 ($196,270.70) 0 0 0 0 I 0 I I 0 I 0 0 I 0 0 j Change Order 2 21001-02004315740010-100000-991992 0 0 0 I 0 0 0 0 0 0 0 City of Fort Worth Summary of Charges City Secretary Contract Num: 49218 HMAC 2017-10(CDBG)STREET REHABILITATIONS P.O.: p0-18-000101379 Project Number: 100773 Application Period: 4/1/19-4/15/19 Application 35 Final Application Date: 6/7/2019 Number: Funding Identification(FID) Total Completed Amt Remaining Gross ! j Retsina a Net 6 r i 1 Change Order 3 21001-02004315740010-100000-991992 0 0 0 0 0 0 0 niJ j 0 0 0 4 Change Order 4 21001-02004315740010-100000-991992 0 0 0 0 0 0 0 0 0 0 Change Order 5 21001-02004315740010-100000-991992 0 0 0 0 0 0 d 0 0 0 0 City of Fort Worth Summary of Charges City Secretary Contract Num: 49218 HMAC 2017-10(CDBG)STREET REHABILITATIONS P.O.: PO-18-000101379 Project Number: 100773 Application Period: 4/1/19-4/15/19 Application 35 Final Application Date: 6/7/2019 Number: Funding Identification(FID) Total Completed Amt Remaining . Gross I Retainage i Net Change Order 6 21001-02004315740010-100000-991992 0 0 0 0 0 0 0 0 0 0 Change Order 7 21001-02004315740010-100000-991992 0 0 0 0 0 0 I 0 i 0 0 0 Change Order 8 _. 21001-02004315740010-100000-991992 0 I 0 0 0 0 D 0 0 I 0 I 0 I ! II C-RO Unft Prlw Progreso Eatlmab Progress Estimate CUv5ev- 49218 CpntrnMNum: ea`la°°°°`"n BMAC 2017-10(CDBG)STREET RER"YLITATIONS apv5nrianl'<r'ad; 4111194/15/19 A H C D Ivan HWINm No. Deeanpuon Specific rion Itait of:N-slue BWQ.by Umt Price Bid Val. E�WQ-Ely-u� W. -iu®li lme.11d Vol- VsI.ThoPmwl Sn on No. 1 33W.OtOBMWcelbneous P4 ustmanb UtllRlw OOMOB LS 360.M 3,00D.00 0250 2 15 LF 904 M3900 51,548.00 _ St$48.00 $16.591.97 516591.9] 3 3216.01027"Concreb CUABGuhar ?2.1 LF 9490A00000 _531A0 $294,190.00 8171.3000000D $253,3100 5253,31.30.30 4 0241.0401 Remove Concrete OrWevgy 0_431? SF 13260.W0000 $2.30 330498.00 13M02000000D $3155646 501.556.48 5 3213.ITt01 GCanMete Drlvaway ?2 L'.20 SF 14124000000 $7.W $103,600A0 T-14674,t000000D 3102,]18.T0 31 D2,718.70 6 3241A0016"Contteb Drlvawev,Eyased A9gre_gaM__ ?21320 SF 124.OW060 _ E11.W b1,426.00T ___�._�__ __...,- 0241.0100 Remove Sldatwlk 0.ill SF 17365000000 5230 $3-9939.50 206T0.4WOOW0 E4B4O01.92 548,001.92 8 3213.03114"Concrete ApgMlk --� .--- ,2I320____. SF 2261500WW ........... 54.60 ---__ 5104,029A0.. .I 23----00000 ---_--$1!)]14196 $107.141.36 9 32t3.03S1 4' tl dSldayslk ;21?^_0 SF 124.000OW S11.50 $1,Q66.00 "'._..._.,,,_,____.._..,_ 10 3213.03114"CombinRtl 1Sldayslk _li 2D _ SF 640.000ODO $6,00___ $3,840.00 11 W41J100 Concrete Rebinin WagG Skowalk ._1? -- SF 225.000000 E23.00 55,1]5.00 :139.SOWOWO $3,209.50 : b3108.5D 12 0241.1400Remova Concrete Val GURor .41 tS SY 190.00WW S11S0 S2,t85.00 54S000OWO $624.45 $734 .45 13 3216.D3027"Conttde Vella Gutter 1�1•....,... SY 19DAOD000 $23040 319,450.00 111.81H%10000 $t1T39.00 E11,0=0 14 0241.W00 Re _......._._____�__.._ _ move ADA Ram p2 al l? FA 15.W0000 $2WA0 $3,4$D.DD. 9.00WOWO $2,070.00 ����� §2,DTO.DD 15 9999.W00 ADARomP FA 34.000000 E2,2eA.00 $76,500.00 -24.00000000 554,OOD.00 �r_� 16 0241.170010's aP Ittt ant Td.. l+tfi � SY 16200.c00MO $12.80 52D7,36p.00 t38T/.590D0000 $1]1632438 $1T/,632.38 17 024t.1T0010•Pnvamant PuHarimtlon 02J115 _ SY 16200.000000 36.00 $9i.20D,00 M9 0000000 E4T,970.00 E4T,970.00 18 3211.0600 Csmant MctllRwtlon.131bNay II:, TN 106.WOW0 SIMM $20,140.00-.T-101.290000M $19.233.70 $19_233.70 19 9999.W00 ROa4Ban4EN1� GA 127.-WO $150.W St9,050.00_. s -' 20 3217.OW5 ftp Bars Pavement Markin 172? _ LF 110.WOMO $23.W $2,530.M 21 3305.0112VJabr VaNaBoa ushwnt(vMM1 Concreto Called 017 FA 10.W0000 6250.W 52,SOO.W 9.DWWDW 82.250.W 32254.00 22 3305A107 Mlswlkneoua AtlluaSwnt(Water Meter BorJ- ??05 1y _ FA 25.000000 E350.D0 $B,TSO.W 79.04000000 §25.550.OD ��E25.SSO.OU 33...._ 33050112 Menhab P4.Justrwnt(vMh Concrete Calla)__ ::pl 17 FA 7.WOOW E450.W $3,150.W -S.000OOOW 32250AD-- "E21s0.W 24 321]0100 CurEAtltlreaa Pelntlno _ -- ?2, _ __.E -- ""4cd.000W .._ $2.100.0U 25 3292.01D0 Block Sotl Reds _ _.__-_ .__ w ment ?2 ff_'1? BY 44W.00WW $7.50 S33 W0.00 4300AOWOWO $32,250.00 332250.W 28 01]1.0001 CoruWdbn Sbkln -'-'-'and Su 01712? LS 1.00WW 63,SW.00 $3,SOO:W OS2266286 53;229_32 T' 33229.32 27 9999.W96 Pavin ConstruMlsn P2owanw LS 1.0004W $ 63,9]0.00 563,8]OAO: - ---�- --- Totals f1.1i6956.60 $942,976.06 $94206.06 ..m..................�E1CD%.,. .,.,,,,,.,e",a"•", m.�,.i�.•,e...Y�,..,.......•.u.+<.,..�,,...�......,..,..............„.,..i.L.u..i C.,.,.„i..,... C-620 Change Order Progress Estimate Construction Allowance Usage Contractor's Application ADDITIONS For(contract): HMAC 2017-10(CDBG)STREET REHABILITATIONS City Seorefry Applicatiw Number: 100773 conimctNnm 49218 35Final Application Period: 4/1/19-4/15/19 APPlimtion Dale: 6/7/2019 A B C D E F Ran Total Completed % Balance to Finish Estimated Qtwrtity Previously Value This MoteriASPresently SpccionNon Unit of QaamitytoAdd Unit Price Addition Value Valuc and Stored to Dote (B B-F) Ilem Number Desc^Peon Section No. Mesaure ]nsmlled Insmlled Value Period Stored(not in Cl (D+E) B 1 Tree Remaul W Broad.. r LS 1.00000000 S6,490.00 S6490.00 1.00000000 S i6 490.00 56,490.00 $6,490.00 100.0% 2 Wafr Meter Bos Rewnnecta LS L00000000 $2,168.10 S2168.10 _ 1.00000000__. _ S2,168.10 52,168.10 S2.168.10 100.0% 1 Lane Cl nc Fmrd StrceN BU287 LS 1.00000000 51.835.17 S7.835.17 1.00000000 S1.835.17 $1,835.17 S1,835.17 100.0% 2 Tree Rem nIWB adus LS 1.00000000 S3.025.00 $3.015.00 7.00000000 S3,025.00 $3025.00 53,025.00 100.0% F .Rel h W Broad (S1R 524,532) ___ LS 1.00000000 S3,86%80 $3,869.80 I.00000000 Si369 80 $3;869.80 53.849.80 100,0% 4 GordonACIr fSc RotedW trMeter Ha< Ea 10.00000000 $183.19 $L831.90 10.00000000 $1,83t 90 :.:$1,&'i1.90 $L83t.90 100.0% Totals S19.219.97 S19,219.97 S19.219.97 S39S19.97 100,0% Tlds document has been modified from its oripnal farm as anEJCDC doo—t and the user did not highlight the modificntions.You are me—lud to read the document—fully and eonsult Legal Counsel prior to its csecution. C-620 Change Order Progress Estimate Construction Allowance Usage Contractor's Application CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED Far(warn): 100773 HMAC 2017-10(CDBG)STREET REHABILITATIONS Applimfim xnmbcr: 35 Final Appheatian Period: 4/1119-4115/19 Appfirntion Dam: 6/7/2019 A H C D E F Item Hid Item Number Description SpeafiTt n Unit of Q—fityto Delete Unit Prim Reduction Value Not Used Not Used Not Used Nat Used Not Used Not Used Not Used Nat Umd Secfion No. MGwum 27 9999.0096 Paving Conshuctian Allowance LS 0.135559I7 S63,870.00 58,658.10 27 9999.0096 Psrine Construction All.— LS 0.16536512 S63,970.00 510,561.87 Totnls S19.219.97 This document has been modified from its original t rm as an FJCDC document and the user did not highlight the modifications.You om eneeamged to read the document camfeuy and consult Legal Counsel prior to its--fion. C-620 Change Order Progress Estimate Change Order Number 1 Contractor's Application ADDITIONS For(contract): 100773 HMAC 2017-10(CDBG)STREET REHABIUTATIONS City Secretary 49218 Applietion Number 35 Final Conlmct Nam: Applioation Period: 4/1/19-4/15/19 Application Date: 6/7/2019 A B C D E F Item Balance to Finish Addition Total Completed Estimated Quanfih Preciously Velae This Materials Pmsendy ChanF0,d, SpeciSoation Unit of CO Quantity to Add Unit Prim Change Order Value and Stomd to Dale (F) (B-F) % p6O° SectionNo. Measure Value Installed 1n%tolled Vahk Period Stored(nut in C) (D+E) B Asply, Pas<ment Bsc Rpnu SY 2225.00000000 S65.00 S144,625.00 2225.00000000FS1444,625. S144625.U0 S14462500 100.0% k.LAedge NLuing IF 3644.OD000OOO $4.25 515.487.00 3644.OD000000.- S15,487.ao S15.487.00 100.0% Butt Joint Mlling EA 8,00000000 S350.00 52.80000 800000000 SZ.800.00 S2800.00 100.0% lvdPcement Level Up TN 230.06000000 5145.00 53335870 23006000000 S .358.70 100.0°/a TotalsI S196,270.70 S196.270.70 $196.270.70 5196.270.70 100.0% This dmument has been modified from its original f as an EJCDC document and the user did at higWight the • madilloadons.You aie encouraged to road the document camhuy and consult Legal Counsel prim to its eaoauti— C-620 Change Order Progress Estimate Change Order Number 1 Contractor's Application DELETIONS F°r(c°ntmct): Numb A er,HMAC 2017-10(CDBG)STREET REHABILITATIONS I ti 100773 PP"'"' 35 Final Applimfiw Parimd: 4/S/19-4/15/19 Application Data 6/7/2019 A 13 C D E F Rem Deletion Change Ord m Item Speaficati- Unitof CO Quantity to Unit Prico Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used No. Descnph°n Secfion No. Measure Delete Value I Asphalt Plw BaseR pmr Sy 2225.00002M $65.00 $144,625.00 2 Punt Wed,Milling LF 3644.00000000 S4.25 $15.487.00 Butt Joint Millin FA 1.00000000 $350.00 $289,00 4 halt Pa erd Le IU TN -0.06000000 $145.00 $33,358.70 !!R---- -_ - ---- Totals 51962]0.]0 This dmcument has been modified fram its odgiral form as an EJCDC doeumem and the user did not highlight the modifications.You me rnrouraged to read the document caefullyand consult Legal Counsel prior to its execution. BIM 360 Document Management Page I of 2 B AUTODESK'BIM 360' fortworthgov>100773-HMAC 2017-10 CDBG Street Rehab- 0 IA Document Management FOLDERS REVIEWS TRANSMITTALS ISSUES Reviews > Review detail OPEN #9 - Final Review (D Timeleft:3days FINAL-Construction Invoice Approval Workflow Start review Void entire review Name Description PROGRESS C-620 Contractor's Unit Price Application for Payment Estimate O..-.p.., Initiator Initial Review C-620 Contractor's Unit Price Application for Payment Estimate O._xl... BT Brendan Taylor Jun 10,9:24 AM <btaylor@peachtreecon.com> Submitted to Reviewer 1 -------— --"-,------------- Reviewer I Initial Review 1 SF Shawn Fargo Jun 12,9:36 AM <shawn.fa rgo @fortwo rthtexas.gov> Submitted to Reviewer 2 Reviewer Initial Review 2 KS Kristian Sugrinn Jun 12,3:24 PM <kristian.sugrim@fortworthtexas.gov> Submitted to Reviewer 3 Reviewer 3 Initial Review 3 A LZ Lane Zarate Jul 24,9:56 AM <[a ne.za rate@ fortworthtexa s.gov> Submitted to Reviewer 4 approve Reviewer 4 Initial Review 4 JK Joanne Kamman Jul 26,10:24 AM <joanne.kamman@fortworthtexas.gov> Submitted to Approver No Comments.Approved. ------------- Approver Final Review Tpw Bsap Recon Team Send email notification https://docs.b360.autodesk.com/projects/288a44le-aae9-4bOd-aal 8-215887b0c51/review... 7/26/2019 FO�WU THs Account Inquiry Fiscal Year: 2019 YTD as of 09/30/2019 Period: 17 General Ledger ACTUALS Run Time: 07/18/2019 04:24 PM Report ID: GL0070 Export Ledger Data wort Journal Data Account Description Period Amount a 2060000 Retainage Payable 21001 100000 GRETAN $0.00! ($57,918.34)', Parameter Value Report ID 'GL0070 __............ Fiscal Year 2019 Accounting Period ;17 — --- ledger :ACTUALS Fund Code i21001 Account 2060000 _ I Project ID '100000 FSCM 92 Production Page 1 of 2 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 David Braack(name), GM - Operations (title), of Peachtree Construction,Ltd.,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 City of Fort Worth has been paid; and That there are no claims pending for personal injury and/or property damages; On Contract described as; HMAC 2017-10 (CDGB) Street Rehabilitation City Project 49218 Yam_ _ ---- B Subscribed and sworn before me on this day of Lk u ,201 C1 ....� nY � �� CHERYL JERO�AE P . State of Texas Notary Public, 'z y— Comm.Expires 03-02-2020 Xviz.,, !N�•�.}�.} Notary ID 616044-1 Notary Pub l in want County, Texas 4u n�� CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ Conforms with the American Institute of SURETY Architects,AIA Document G707 OTHER ❑ Bond #106741298 PROJECT: HMAC 2017-10(CDBG) Street Rehabilitation, City Project No. 100773 TO(Owner) City of Fort Worth 200 Texas Street ARCHITECT'S PROJECT NO. Fort Worth, TX 76102 CONTRACT FOR: Construction CONTRACT DATE: May 9, 2017 CONTRACTOR: Peachtree Construction, Ltd In accordance with the provisions of the Contract between the Owner and the Contractor as above, the Travelers Casualty and Surety Company of America 9601 McAllister Freeway, Suite 700 SURETY COMPANY, San Antonio, TX 78216 on bond of Peachtree Construction, Ltd 5801 Park Vista Circle Keller, TX 76244 ,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 City of Fort Worth 200 Texas 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 2nd day of July , 2019 . Travelers Casualty and Surety Company of America aSuraCoany W Witness: Signature of Authorized Representative -�ina Payne Linda K. Edwards, Attorney-in-Fact 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 00438 12/00 ONE PAGE Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS J 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 Linda K.Edwards,of Fort Worth,Texas,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. WYtMY\ ,E �M"�fAITP�, bJny,TY AIjBs ��rl EN a�HARTFORD,G9t yic� M 'y OONN. o .` 1 State of Connecticut By. F City of Hartford ss. Robert L. Raney, Senior 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. p.TR My Commission expires the 30th day of June,2021 TAq n�°UB��p � Marie C.Tetreault, Notary Public MV $ 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 Attorneys-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 end day of JULY 2019 g1Yb a��,•{f?56�n'Y JP4(Y dlyps �-fNRTFORQ�� � HARTFORD, CO�VVSa�.'i 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. FORT WORTH, TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME STATEMENT# FINAL STATEMENT# 1 CPN 1 100773 NAME OF PROJECT: HMAC 2017-10(CDBG)Street Rehabilitation Contractor Peachtree YEAR:j 2019 PROJECT NO.: FINAL INSPECTION DATE 6/12/2019 100773 1 WD CD CONTRACT TIME 320 1 X PERIOD FROM: 1 7/1/2019 TO: 1 7/15/2019 1 BEG - Month I I DEVELOPMENT (Y/N) N WORK ORDER EFFECTIVE: 1 711812017 BEG /n) Y MID y/n) 100.0% DAY OF MONTH DAYS REASON FOR DAY OF MONTH DAYS REASON FOR CHARGED DAYS CREDITED CHARGED DAYS CREDITED 1 Mon 0 OTH 16 2 Tue 0 OTH 17 3 Wed 0 OTH 18 4 Thu 0 OTH 19 5 Fri 0 OTH 20 6 Sat 0 OTH 21 7 Sun 0 OTH 22 8 Mon 0 OTH 23 9 Tue 0 OTH 24 10 Wed 0 OTH 25 11 Thu 0 OTH 26 12 Fri 0 OTH 27 13 Sat 0 OTH 28 14 Sun 0 OTH 29 15 Mon 0 OTH 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 0 PREVIOUS PERIOD 0 320 320 TOTAL TO DATE 0 0 0 0 320 320 REMARKS: OTH:Waiting for final inspection schedule. Signature: f Signature: (Print Name) Shawn Fargo CONTRACTOR DATE ?� INSPECTOR DATE 7/3/2019 -