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Contract 51902-FP4
City Secretary 51902 -FP4 Contract No.— FORT WORTH., Date Received Dec 31,2019 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: ROSEMARY RIDGE ADDITION PHASE 4 City Project No.: 101466 Improvement Types): ❑ Paving ❑ Drainage © Street Lights ❑ Traffic Signals Original Contract Price: $51,766.48 Amount of Approved Change Orders): Revised Contract Amount: Total Cast of Work Complete: $51,766.48 i&hw--d iWfe Dec 27, 2019 Contractor Date President Title Independent Utility Construction, Inc. Company Name W4(s; r Dec 27, 2019 Matthew Wilson(De, Project Inspector Date og�Pdlelli,cuiy� - Dec 31, 2019 Project Manager Date 47&/% Mt#01-q401f Dec 31 2019 Janie scarlett Morales(Dec 31,21 ) CFA Manager Date OAXA/au.4 Dec 31 2019 Dana Burghdoff(d c 31,20 ) Asst. City Manager mate 2Page 1 a` Notice of Project Completion Project Name: ROSEMARY RIDGE ADDITION PHASE 4 City Project No.: 101466 City's Attachments Final Pay Estimate d Change Orders): ❑ Yes ® N/A Contractor's Attachments Affidavit of Sills Paid Consent of Surety Statement of Contract Time Contract Time: 145 CD Days Charged: 273 Work Start ❑ate: 3/18/2019 Work Complete Date: 12/16/2019 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name ROSEMARY RIDGE ADDITION PHASE 4 Contract Limits Project Type STREET LIGHT City Project Numbers 101466 DOE Number 1466 Estimate Number I Payment Number 1 For Period Ending 12126MI9 CD City Secretary Contract Number Contract Time 3aD y Contract Date Days Charged to Date 273 Project Manager NA Contract is 100.00 Complete Contractor INDEPENDENT UTILITY CONSTRUCTION 5I09 SUN VALLEY DRIVE FORT WORTH, TX 76119 Inspectors OWEN J WILSON Thursday,December 26,2019 Page 1 of 4 City Project Numbers I01466 DOE Plumber 1466 Contract Name ROSEMARY RIDGE ADDITION PHASE 4 Estimate Number I Contract Limits Payment Number I Project Type STREET LIGHT For Period Ending 12/26/2019 Project Funding ST LIGHT Item Description of Items Estimated Unit 'Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total f 1 LED LIGHTING FIXTURE 12 EA $293,44 $3,521,29 12 $3,521.28 2 TYPE II POLE W133 BB ARM 12 EA $1,899.00 $22,788.00 12 $22,788.00 3 RDWY ILLUM FOUNDATION 12 EA $1,439.00 $17,269.00 12 $17,268,00 4 410 COPPER CABLE 1416 LF $1.24 $1,755.84 1416 $1,755.84 5 2"CONDT PVC SCH 80 472 LF $13.63 $6,433.36 472 $6,433.36 -------------- - ------- ---- - - ------------ Sub-Total of Previous Unit $51,766.48 $51,766.48 Thursday,December 26,2019 Page 2 of City Project Numbers 101466 DOE Number 1466 Contract Name ROSEMARY RIDGE ADDMON PHASE 4 Estimate Number 1 Contract Limits Payment Number I Project Type STREETLIGHT For Period Ending 12/26/2019 Project Funding Contract Information Summary Original Contract Amount $51,766.48 Change Orders Total Contract Price $51,766.49 Total Cost of Worts Completed $51,766.49 Less %Retained $0.00 Net Earned $51,766.48 Earned This Period $51,766,48 Retainage This Period $0.00 Less Liquidated Damages Days @ 1 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 $51,766.48 Tliursday,December 26,2019 Page 3 of 4 l City Project Numbers 101466 DOE Number 1466 Contract Name ROSEMARY RIDGE ADDITION PHASE 4 Estimate Number I Contract Limits Payment Number I Project Type STREET LIGHT For Period Ending 12/26/2019 Project Funding Project Manager NA City Secretary Contract Number Inspectors OWEN / WILSON Contract Date Contractor INDEPENDENT UTILITY CONSTRUCTION Contract Time 30 CD 5109 SUN VALLEY DRIVE Days Charged to Date 273 CD FORT WORTH, TX 76119 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 $51,766.48 Less %Retained $0.00 Net Earned $51,766.48 Earned This Period $51,766.48 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 $51,766.48 Thursday,December 26,2019 Page 4 of 4 AFFIDAVIT STATE OF TEXAS COUNTY OFTARRANT Before me, the undersigned authority, on this day personally appeared RICHARD WOLFE, President of INDEPENDENT U T I L I T Y C O N S T R U C T I O N INC. known to me to be a credible person, and after being duly sworn by me, 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: Rosemary Ridge Addition Phase 4—City Project No. 101466 BY: and Wolfe,President SP *SCRIBIT AND SWORN TO BEFORE ME on this Ivkdayof 2019. .•�'''rP'4 CHRISTINA GAfiCfA z° Notary Public, State of Texas =`�• �� Comm, Expires 12-20-2020 Notary Public' State of Texas •,,,,ti.• Notary!D 130940785 CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT WCEIVED Bond No. 012675J PROJECT: Street Lighting Facilities to serve Rosemary Ridge Addition Phase 4 (name,address)Fort Worth, Texas TO (Owner) ARCHITECTS PROJECT NO: City of Fort Worth CONTRACT FOR: Above Project 200 Texas Street Fort Worth, Texas 76102 CONTRACT DATE: CONTRACTOR: Independent Utility Construction, Inc. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(hcre insert name and address of Surety Company) Westfield Insurance Company 555 Republic Drive, Suite 450 Plano,Texas 75074 ,SURETY COMPANY, on bond of{here insert name and address of Contractor) Independent Utility Construction, Inc. 5109 Sun Valley Drive CONTRACTOR, Fort Worth, Texas 76119 hereby approves of the final payment to the Contractor, and agrees that the 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 200 Texas Street Fort Worth, Texas 76102 OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, The Surety Company has hereunto set its hand this 18th day of November 2019 -3MESTFIELD MURANCE COMPANY Surety Company S Attest: Signature orix Represen ve (Seal); W. Sweeney Attorney—in—Fact Title Note:This form is intended to be used as a immpanion document to the Contractor's Affidavit of Payment of Debts and Claims,Current Edition - —"-1 R fw". "" '"lu![ I U4ri0111, FOR ANY PERSON OR PERSONS NAMED BELOW. General POWER NO. 4220052 06 Power Westfield Insurance Co. of Attorney Westfield National Insurance Co. CERTIFIED COPY Ohio Farmers Insurance Co. Westfield Center, Ohio Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a -Company" and collectively as -Companies," duly organized and existing under the laws of the State of Ohio, and having its prktcipal office in Westfield Center, Medina County, Ohio,d❑ by these Presents make, constitute and appoint CHARLES D. SWEENEY, MICHAEL A.SWEENEY, KYLE W.SWEENEY,ELIZABETH GRAY,JOINTLY OR SEVERALLY of FORT WORTH and State of TX its true and lawful Attorneys]-in-Fact,with full power and authority hereby conferred in Its name, place and stead, to execute, acknowledge and deliver any and all bonds recognizances, undertakings, or other instruments or contracts of , suretyship- - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - • - - -- - - - LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED To EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE GUARANTEE, OR BANK DEPOSITORY BONDS. and to bind any of the Companies thereby as fully and to the same extent as If such bonds were signed by the President,sealed with the corporate seal of the applicable Company and duty attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do In the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OH10 FARMERS INSURANCE COMPANY: "Se It Resolved,that the President,any Senior Executive, any Secretary or any Fidelity& Surety Operations Executive or other Executive shall be and is hereby Vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such Attorney4n-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary.- 'Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signatures or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached.- (Each adapted at a meeting held on February 8,2000). In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY have caused these presents to be signed by their Senior Executive and their corporate seals to be hereto affixed this 20th day of APRIL A.D.,2011 . Corporate Seals r\�l?V�?fir h ., t1oN�+C;tif'' L1tSf1 f WESTFIELD INSURANCE RANCE COMPANY Affixedrr�`• -' �+�,, WESTFIELD NATIONAL INSURANCE COMPANY Zr " ��!-� 1OHIO FARMERS INSURANCE COMPANY N; SEAL ;Mc-1E °y: 3r 3 'x' s. 4 1848 B `WwfMf �fH.effl...•��•• y� State of Ohio •�•� Richard L. Kinnaird, Jr.,National Surety Leader and County of Medina ss.: Senior Executive On this lath day of APRIL A.D.,2011 p before me personally came Richard L. Kinnaird, Jr. to me known, who, being by me duly sworn, did depose and say, that he resides-in Medina, Ohio;that he is Senior Executive of WESTFIELD fNSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and CHID FARMERS INSURANCE COMPANY, the companies described in and which executed the above Instrument:that he knows the seals of said Companies;that the seals affixed to said Instrument are such corporate seals;that they were so affixed by order of the Boards of Directors of said Companies;and that he signed his name thereto by like order. Notarial ,f,4 Seal ,aR L wwti4y Affixed State of Ohio = �rir,fl William J. Kahelin,A rney at Law, Notary Public o County of Medina My Commission Does Not Expire(Sec. 147.03 Ohio Revised Code) sS-: �' �'�� q TE o F Q� I,Frank A. Carrino, Secretary or WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies,which is still in full force and effect;and furthermore,the resolutions of the Boards of Directors,set out in the Power of Attorney are in full force and effect. In Witness Whereof I have hereunto set my hand and affixed the seals of said Companies at Westfield Center, Ohio, this ;+\ cf � l �Nree th day ofNovemb�Ao;; 2019 ............,. 1$ dSYR[� • nNg S`% ��LKSll yy SEAL sea-eary 'ly':,�yraey+t� .O :. 1B4Br - Frank A. Carrina, Secretary BPOAC2 (combined) (06-02)