HomeMy WebLinkAboutContract 51372-FP1 AWmv
4 N FO RT WO RT H Ot
�° RECEIVED w
DEC 12 2019 "
N CITY OF FORTWOR111 as CSC No.51372-FP1
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CI1Y SECRETARY TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
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City Project Ns: 101604
Regarding contract 51372 for CONCRETE RESTORATION(2019-1)AT VARIOUS LOCATIONS as required by
the TRANSPORTATION AND PUBLIC WORKS as approved by City Council on 09/U/2018 through M&C
C-28826 the director of the TRANSPORTATION AND PUBLIC WORKS upon the recommendation of the
Assistant Director of the Transportation&Public Works Department has accepted the project as complete.
Original Contract Prices: $753,760.00
Amount of Approved Change Orders: $57,350.00 Ns 1
Revised Contract Amount: $811,110.00
Total Cost Work Completed: S806,595.21
Less Deductions:
Liquidated Damages: Days®S210.00/Day
Pavement Deficiencies:
Total Deduction Amount: $0.00
Total Cost Work Completed: S806,595.21
Less Previous Payments: $766,265.45
Final Payment Due S40,329.76
Rkhw-d it MAH& z Dec 11 2019
Richard E Martinez(Dec 11,2019)
Recommended for Acceptance Date
Asst. Director, TPW - Infrastructure Design and Construction
William M.Tohnson
William M.Johnson(Dec 11,2019) Dec 11,2019
Accepted Date
00 Director, TRANSPORTATION AND PUBLIC WORKS
22axa 13 0049(L/
Dana Burghdoff(Dec 11,20 Dec 11,2019
Asst. City Manager Date
Comments:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX
Department f TPW Const. Services
Date rLS
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project Manager G��Gat r
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FoRTWORTH rev 03/05/07
TRANSPORTATION&PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:1
NAME OF PROJECT: Concrete Restoration(2019-1)at Various Locations
PROJECT NO.: 101604 CONTRACTOR: Urban Infraconstruction LLC
DOE NO.: NIA
PERIOD FROM:11/14/18 TO: 06/04/19 FINAL INSPECTION DATE: 4-Jun-19
WORK ORDER EFFECTIVE CONTRACT TIME: 165 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.
I2. 27.
13. 28.
14. 29.
15. 30.
31.
SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS* DAYS TOTAL
& HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS
THIS
187
PERIOD
PREVIOUS
PERIOD
TOTALS
187
TO DATE
*REMARKS:
l� 1�
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
AFFIDAVIT
STATE OF TX
COUNTY OF Tarrant
Before me, the undersigned authority, a notary public in the state
and county aforesaid, on this day personally appeared Anup Tamrakar,
CEO Of Urban Infraconstruction LLC, 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;
That there are no claims pending for personal injury and/or
property damages;
On Contract described as;
Concrete Restoration 2019-1 at Various Loc tions, PN 71604
BY � U. (
C L(�
Subscribed and sworn before me on this date 29th of October, 2019.
•''`ti�f"'� SUBHRATA PIYA.xn'�LY
?r° _Notary Public,State of Texas
' Comm.Expires 05-11-2021
5450
�■
Tarrant County, Texas i
CONSENT OF CONTRACTOR
SURETY COMPANY ARCHITECT
TO FINAL PAYMENT SUBCONTRACTOR
SURETY
AIA DOCUMENT G707(Modified) OTHER
Bond No.2276428
PROJECT: Concrete Restoration 2019-1 at Various Locations,City Project No. 101604
(name,address)
TO(Contractor)City of Fort Worth ARCHITECT'S PROJECT NO:
1000 Throckmorton Street
Fort Worth,TX 76102-6312
CONTRACT FOR:
CONTRACT DATE: 9/11/20I8
SUBCONTRACTOR:
Urban Infraconstruction,LLC
2512 Gravel Drive
Fort Worth,TX 761IS
In accordance with the provisions of the Contract between the Contractor and the Subcontractor as indicated above,the
(Isere insert name and address of Surety Company)
North American Specialty Insurance Company
1200 Main Street,Suite 800
Kansas City,MO 64105 , SURETY COMPANY,
on bond of(here insert name and address of Subcontractor)
Urban Infraconstruction,LLC
2512 Gravel Drive
Fort Worth,TX 76118 , SUBCONTRACTOR,
hereby approves of the final payment to the Subcontractor, and agrees that final payment to the Subcontractor shall not
relieve the Surety Company of any of its obligations to(here insert name and address of Contractor)
City of Fort Worth
1000 Throckmorton Street
Fort Worth,TX 76102-6312 ,CONTRACTOR,
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
the Surety Company has hereunto set its hand this 28th day of October,2019.
North American Specialty Insurance C_ympariy
Surety Company
} '
AAJ
Signature of Authorized Representative
Witness: _ � �,�
(Seal): Andrea Rose Crawford Attorney-In-Fact
Title
NOTE: This form is to he used as a companion document to AIA DOCUMENT G706,CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
AIA DOCUMENT G707 CONSENT Or SURETY COMPANY TO FINAL.PAYMENT APRIL 1970 EDITION AIA ONE PAGE
1970 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 New York Ave.,NW,WAS]IINGTON,D.C. 20006
SWISS RE CORPORATE SOLUTIONS
NORTH AMERICAN SPECIALTY INSURANCE COMPANY
WASHINGTON INTERNATIONAL INSURANCE COMPANY
WESTPORT INSURANCE CORPORATION GENERAL POWER OF ATTORNEY
KNOW ALL.MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under
laws of the State of New Hampshire,and having its principal office in the City of Kansas City,Missouri and Washington International Insurance
Company a corporation organized and existing under the laws of the State of Now I iampshire and having its principal office in the City of Kansas
City,Missouri,and Westport Insurance Corporation,organized under the laws of the State of Missouri,and having its principal office in the City of
Kansas City, and
does hereby make,constitute and appoint:
SAMMY JOE MULLIS,JR.,JOHN WILLIAM NEWBY,CHERI LYNN IRBY,MICHAEL L.TULLIS,SANDRA LEE RONFY,DEBRA LEE MOON,ANDREA ROSE CRAWFORD,
MARY JO ZAKRZL•:WSKI.JAMEiS I3-ROGERS,JR-,TROY RUSSELL KEY,LINDA MICHELLE STALDTA,CI IRISTOPHER CARL SUNDBERG and JOSHUA D.TRITT JOINTLY OR SEVERALLY
Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings
obligatory in the nature of a bond on behaif of each of said Companies.as surety,on contracts or suretyship as are or may be required or permitted by
law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the
amount of: TWO HUNDRED MILLION($200,000,000.00)DOLLARS
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adapted by the Boards of
Directors of North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held
on March 24,2000 and Westport Insurance Corporation by written consent of its Exccutive Committee dated July 18,2011.
"RESOLVED,that any two of the President,any Senior Vice President,any Vice President,any Assistant Vice President,
the Secretary or any Assistant Secretary be.and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named
in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them
hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is
FURTIIBR RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile,and any such Power of Attorney or certificate hearing such facsimile signatures or facsimile seal shall be
binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached."
niunlfrlrJt� yltulanay
p00 By -fir t,An5�1 fi.•:n= a= F• ef _
si—m. enua, nor t ngton ntrnatono aurane company
SEAL &Senior Vice Presiden or North American specialty Insurance Company:n
t_
n &Senior Vice President of Wolpori Insuranre CorporationBy
Z =g
N �•:O• y ta_
�gh
y %like A.Ito,Senior Vire President of WtuhinZton International Insurance Company hilt lilll%%A% '"�r,rrntutr'ati"p
&Senior Viet President or North American Specially lnsur ance Cumpaay
&Senior Vice Presidenr of Westport insurance Corpor.ticn
IN WITNESS WHEREOF,North American Specialty Insurance Company,Washington International Insurance Company and Westport
Insurance Corporation have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this
this 3rd day of September ,20 19 .
North American Specialty Insurance Company
Washington International Insurance Company
State of Illinois Westport Insurance Corporation
County of Cook ss:
On this 3rd day of September 2019 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of
Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Senior Vice President of
Westport Insurance Corporation and Michael A.Ito Senior Vice President of Washington International Insurance Company and Senior Vicc President
of North American Specialty Insurance Company and Senior Vice President of Westport Insurance Corporation,personally known to me,who
being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the
voluntary act and deed of their respective companies.
OFFMAL SEAT.
M KENNY
i
Notary aerhliI-Slate of IIlirtrtw '
stye jypu20Zj F M.Kenny,Notary Public
I, Jeffrey Goldberg the duly elected Vice President and Assistant Secretary of North American Specialty Insurance Company,Washington
International Insurance Company and Westport Insurance Corporation do hereby certify that the above and foregoing is a true and correct copy of a
Power of Attorney given by said North American Specialty Insurance Company,Washington International Insurance Company and Westport Insurance
Corporation which is still in full force and effect.
IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 29th day of October 24 19
Jeffrey Goldberg,Viu Prmident&Assi stain Secretary of Washington lnlemational Insurance Company&.
North American Specialty InsuranCe Company&Vice PmsAmT&Amislant Secretary of Weslport insurance Corporalion
North American Specialty Insurance Company
Washington International Insurance Company
Westport Insurance Corporation
TEXAS CLAIMS INFORMATION
IMPORTANT NOTICE ADVISO IMPORTANTE
In order to obtain information or make a complaint. Para obtener informacion o para someter un queja:
You may contact Jeffrey Goldberg,Vice President Puede comunicarse con Jeffrey Goldberg,Vice
— Claims at 1-800-338-0753 President—Claims,al 1-800-3 3 8-0 7 53
You may call Washington International Insurance LIsted puede IIamr al numero de telefono gratis de
Company and/or North American Specialty Insurance Washington International Insurance Company and/or
Company's and/or Westport insurance Corporation North American Specialty Insurance Company's and/or
toll-free number for information or to make a Westport Insurance Corporation para informacion❑
complaint at: para someter una queja al:
1-800-338-0753 1-800-338-0753
You may also write to Washington International Usted tambien puede escribir a Washington
Insurance Company and/or North American Specialty International Insurance Company and/or]North
Insurance Company and/or Westport Insurance American Specialty Insurance Company and/or
Corporation at the following address: Westport Insurance Corporation al-.
1450 American Lane 1450 American Lane
Suite 1100 Suite 1100
Schaumburg, IL 60173 Schaumburg,IL 60173
You may contact the Texas Department of Insurance Puede escribir al Departmento de Seguros de Texas
to obtain information on companies,coverages. para obtener informacion acerca de companias,
rights or complaints at: coberturas,derechos o quejas a[:
1-800-252-3439 1-800-252-3439
You may write the Texas Department of Insurance: Puede es crib ir al Departmento de Seguros de Texas:
P.D.Sox 149104 P.Q. Box 149104
Austin,TX 78714-9104 Austin,TX 78714-9104
Fax: t512I 475-1771 Fax: (512)475-1771
Web: http://www_tdi_state.tx-us Web: http://www.tdi.state.tx.us
Email:ConsumerProtection@tdi.state.tx.us Email:ConsumerProtection@tdi.state.tx.us
PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS D 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 first contact the reclamo, debe comunicarse con el Washington
Washington International Insurance Company and/or International Insurance Company and/or North
North American Specialty Insurance Company and/or American Specialty Insurance Company and/or
Westport Insurance Corporation. If the dispute is not Westport Insurance Corporation primero. Si no se
resolved,you may contact the Texas Department of resuelve la disputa, puede entonces comunicarse
Insurance. con el Departmento de Seguros de Texas.
ATTACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA
This notice is for information only and does not Este aviso es solo para proposito de infoomacion y no
become a part or condition of the attached se convene en parte o condicion del documento
document. adjunto.
Routing And Transmittal Slip Date 11/14/19 101604
TO: Ini ials: Date:
Alexiz Ramirez
Juan De La Cruz
Jeffrey Perri go
William Johnson
Dana Bur hdoff
�47,
Alexiz Ramirez
ACTION _FILE
_APPROVAL FOR CLEARANCE _PER CONVERSATION
AS REQUESTED _FOR CORRECTION _PREPARE REPLY
—AS
_FOR YOUR INFORMATION _SEE ME
_COMMENT _INVESTIGATE X_SIGNATURE
_COORDINATION JUSTIFY _OTHER
NOTE AND RETURN
N tkkil McLe- ay 1 ,8363
Phone No.