HomeMy WebLinkAboutContract 51536-FP1 FORTWORTH
Routing and Transmittal Slip
Water
Department
DOCUMENT TITLE: Greensheet UCO1-2018
M&C C-28921 CPN UCO1-2018 CSO 51536 DCC# 19pgs
DATE:
TO: INITIALS DATE OUT
J. Chris Underwood '
tL,I
TPW Contracts (Amber Lawson), 30
Chris Harder C• 1j•
William Johnson electronic
Dana Burghdoflf electronic
Needs to be notarized: [DYES ®NO
Action Required:
❑As Requested
❑ For Your Information
M Signature/Routing and or Recording
❑ Comment
n File
Return to: Please call Amber Lawson at ext. 7233 for pick up when completed.
Thank you
FOR CMO USE ONLY: Routing to CSa: ❑ Yes ❑ No
� 1
le ��� FORT CVORTHO CSC No.51536-FP1
y
a C17Y 4 15?020 TRANSPORTATION AND PUBLIC WORKS
C/7ys � � NOTICE OF PROJECT COMPLETION City Project
NQ 01 S
�� qRY jecf : U 2
R c, 6 for UTILITY CUT REPAIR CONTRACT 2018 as required by the
WATER TMENT as approved by City Council on 11/6/2018 through M&C C-28921 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: $1,674,395.00
Amount of Approved Change Orders: Ns
Revised Contract Amount: i
Total Cost Work Completed: $793,827.28
Less Deductions:
Liquidated Damages: Days®S210.00/Day
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Work Completed: $793,827.28
Less Previous Payments: $793,827.28
Final Payment
.�Due $0.00
/.
William JoAson(Jan14,2020) Jan 14,2020
Recommended for Acceptance Date
Director, Transportation and Public Works Department
4 t ZO
Accepted Date
Asst. Director, WATER DEPARTMENT
�!(J Rya
Dana Burghdaff(J 14,202 Jan 14,2020
Asst. City Manager Date
Comments:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX
Sao Q-0(PO r7D)
City Project Numbers UCO I-2018 DUE Number 2018
Contract Name UT11.rfY CUT REPAIR CONTRACT 2018 Estimate Number 13
Contract Limits Payment Number 13
Project Type PAVING For Period Ending 1 013 0/20 1 9
Project Funding
Project Manager NA City Secretary Contract Number 51536
Inspectors DICKINSON 1 WATSON Contract Date
Contractor WESTHILL CONSTRUCTION,INC. Contract Time 365 CD
P.O.BOX 2D16 Days Charged to Date 345 CD
CLEBURNE, TX 76031 Contract is 000WO Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of Work Completed $793,827.28
Less %Retained $0.00
Net Earned $793,827.28
Earned This Period s0.00
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 1 Day $0.00
LessPavement Deficiency $0,00
Less Penalty $0.00 `+
Less Previous Payment $793,827.28 {1
Plus Material on Hand Less 15% $0.00
Balance Due'"his Payment $0.00
Wednesday,October 30,2019 Page 6 of 6
'5-6� 0o;2 —
FORT WORTH
CITY OF FORT WORTH 1
FINAL PAYMENT REQUEST
Contract Name UTILITY CUT REPAIR CONTRACT 2018
Contract Limits
Project Type PAVING
City Project Numbers UC01-2018
DOE Number 2018
Estimate Number 13 Payment Number 13 For Period Ending 10/30/2019
CD
City Secretary Contract Number 51536 Contract Time 366D
Contract Date Days Charged to Date 345
Project Manager NA Contract is 46,000 Complete
Contractor WESTHILL CONSTRUCTION,INC.
P.O.BOX 2016
CLEBURNE, TX 76031
Inspectors DICKINSON / WATSON
Wednesday,October 30,2019 Page I of 6
City Project Numbers UCOI-2018 DOE Number 2018
Contract Name UTILITY CUT REPAIR CONTRACT 2018 Estimate Number 13
Contract Limits Payment Number 13
Project Type PAVING For Period Ending 10/30/2019
Project Funding
UNIT I;CUTS LESS THAN 200 SQ FT
Item Description of Items Estimated [knit Unit Cost Estimated Completed Completed
No. Quanity Total_ Quanity Total
I 3-inch Asphalt Pavement,Type❑ 4000 SY $36-00 $144,000.00 15.11 $543.96
2 3-inch Asphalt Base,Type B 1200 SY $10.00 112,000.00
3 9-inch Concrete Pavement 700 SY $90.00 $63,000,00 44.86 $4,037.40
4 1 1-inch Concrete Pavement 300 SY $99.00 $29,700.00
5 Min.8-inch Concrete Base Material 3200 SY $45.00 $144,000.00 56.94 $2,562.30
6 Min.5-inch Reinforced Concrete Base Soo SY $63.00 $50,400.00
7 Brick Pavement Repair ]so SY $36.00 $5,400.00
Sub-Total of Previous Unit $448,500.00 $7,143.66
UNIT 11:CUTS GREATER THN 200 LESS THAN 1000 SQ
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total
Quanity Total
l 3-inch Asphalt Pavement,Type D 4000 SY $36.00 $144,000.00 588.23 $21,176.28
2 3-inch Asphalt Base,Type B 1200 SY $20.00 $24,000.00
3 9-inch Concrete Pavement 700 SY $90.00 $63,000.00 173.55 $15,619.50
4 1 1-inch Concrete Pavement 300 SY $99.00 $29,700.00 227.89 $22,561.1 1
5 Min.8-inch Concrete Base Material 3200 SY $90.00 S288,000.00 150 $13,500,00
6 Min.5-inch Reinforced Concrete Base 800 SY $63.00 $50,400.00
7 Brick Pavement Repair ]so SY $54,00 $8,100.00
A-5 6"CONC PARKING 4412.5 SF $10.00 $44J25.00 4412.5 $44,125.00
A-5 6"CONC CURB ATTTACHED TO CONC PAVING 32 LF $15.00 $480.00 32 $480.00
A-6 II"HES CONCRETE 2086.12 SY $11.50 $23,990.38 208&12 $21990.38
Sub-Total of Previous Unit $675,795.38 $141,452,27
UNIT III:CUTS GREATER THN 1000 SQ FT
Item Description of Items Estimated Estimated Completed Completed
No.� P Unit ]Intl Cast P P
Quanity 'Total Quanity Total
1 3-inch Asphalt Pavement,Type D 3000 SY $36.00 $108,000.00 3227,95 $116,206.20
2 3-inch Asphalt Base,Type B 900 SY $12.00 $10,800.00
3 9-inch Concrete Pavement 700 SY $90.00 $63,000,00 1287,07 $115,836,30 ;
4 11-inch Concrete Pavement 300 SY $99.00 $29,700.00 628.62 $62,233,38
Wednesday,October 30,2019 Page 2 of 6
City Project Numbers UCOI-2018
DOE Number 2418
Contract Name UTILITY CUT REPAIR CONTRACT 2018 Estimate Number 13
Contract Limits Payment Number 13
Project Type PAVING For Period Ending 10/30/2019
Project Funding
5 Min.8-inch Concrete Base Material 2400 SY $72,00 $172,800.00 1967,56 $141,664.32
6 Min.5-inch Reinforced Concrete Base 600 SY $72.00 $43.200.00
7 Brick Pavement Repair 150 SY $45.00 $6,750.00
Sub-Total of Previous Unit $434,250,00 $435,940.20
UNIT TV:ALL CUTS ASPHALT W/O BASE REGARDLE$
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
I 3-inch Asphalt Pavement,Type D 2000 SY $27.00 $54,000.00 260.55 $7,034.85
2 3-inch Asphalt Base,Type B 600 SY $10.00 $6,000.00
3 4-inch Asphalt Base,Type B 200 5Y $27.00 $5,400.00
4 5-inch Asphalt Base,Type B 200 SY S27.00 $5.400.00
5 6-inch Asphalt Base,Type B 200 SY $36.DD $7,200.00
Sub-Total of Previous Unit $78.000.00 $7,034.85
LTNIT V-ADDL ITEMS REQ OTHER THAN PAVING
Item Description of Items Estimated Unit If nit Cost Estimated Completed Completed
No. Quanity
Total Quanity I'nta]
1 7-inch Concrete Curb and Gutter 400 LF $35.00 $14,000.00 568 $19,880,00
2 7-inch Concrete Curb and Gutter Attached to 400 LF $20.00 $8.000.00
Concrete Pavement
3 6-inch Reinforced Concrete Driveway 100 SF $10.00 $1,000.0o 741.75 $7,417,50
4 4-inch Reinforced Concrete Driveway and 150 SF $50.00 $7,500,00 147,34 $7,367.00
Wheelchair Ramp
5 Topsoil 50 CY $30.00 $1,500.00
6 Manhole Adjustment,Minor I EA $500.00 $500,00 2 $1,00D.00
7 MiscelIaneous Structure Adjustment,Valve Vault I EA $500.00 $500.00
Adjustment
8 Imported Embedment 1 Backfll,Crushed Rack 50 CY $50,00 $2,500.00
9 2-inch Asphalt Pavement,Type D.Parking 1.01 Repair 50 SY $63.00 $3J 50.00
10 6-inch Lime Treatment 50 SY $19.00 $950.00
11 2-inch Asphah Pavement,Type D,Driveway Repair 50 SY $72,00 $3,600.00
12 4-inch Flexible Base,Type A,Grade 1 -Crushed 75 SY $27.00 $2,025.00
Limestone
13 6-inch Flexible Base,Type A,Grade I -Crushed 75 SY $36.00 $2,700.00
Limestone
Wednesday,October 30,2019 Page 3 of 6
City Project Numbers UCOI-2018
DOE Number 2018
Contract Name UTILITY CUT REPAIR CONTRACT 2018 Estimate Number 13
Contract Limits Payment Number 13
Project Type PAVING For Period Ending 10/30/2019
Project Funding
Contract Information Summary
Original Contract Amount $1,674,395.00
Chanee Orders
Total Contract Price $1,743312.38
I
Date ' ''q Total Cost of Work Completed $793,827.28
Cc ar Less %Retained $0.00
04&1 ;/� Net Earned $793,827.28
ate I
Inspection Supervisor Earned This Period S0.00
Retainage This Period %00
Bate r esl Manager Less Liquidated Damages
oj
Days @ 1 Day $0.00
Date LessPavement Deficiency %00
Ass ire rfTP Less Penalty $0.00
_Date t ?D Less Previous Payment $793,827.28
Director/Contracting Department Plus Material on Hand Less 15% $0.00
Balance Due This Payment $0.00
Wednesday,October 30,2019 Page 5 of
FORT WORTH rev 03/05/07
TRANSPORTATION& PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:13
NAME OF PROJECT: Utility Cut Repair Contract 2018
PROJECT NO.: UCO1-2018 CONTRACTOR: West Hill Construction
DOE NO.: 2018
PERIOD FROM 10/111I9 TO: 10/29/19 FINAL INSPECTION DATE: 29-Oct
WORK ORDER EFFECTIVE:I I/1212018 CONTRACT TIME; 3651CD W 0 CD
DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS
MONTH CHARGED CREDITE❑ MONTH CHARGED CREDITE❑
DURING DURING
1. 16.
2. 17.
3. 18.
4. 19.
5. 20.
6. 21.
7. 22.
8. 23.
9. 24.
10. 25.
IL 26.
12. 27.
13. 28.
14. 29.
15. 30.
3I.
SAT,SUN, RAIN,TOO WET, UTILITIES DAYS TOTAL
&HOLIDAYS &TOO COLD RELOCATIONS OTHERS* CHARGED DAYS
THIS PERIOD 0 0 0 0 20 20
PREVIOUS 0 0 0
PERIOD 0 32S 325
TOTALS 0 0
TO DATE FO -
345 345--7
*REMARKS:
CO DATE INSPECTOR DATE
ENGINEERING DEPARTi1IENT
The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311
(a (817)392-7941 •Fax:(817)392-7845
AIA
Document Glo7rat -- 1994
Consent Of Surety to Final Payment
Bond# 4423875
PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER:Utility Cut Repair Contract 2018;
City Project No. UC-01 2018 CONTRACT FOR: Utility Cut Repair ARCHITECT:
TO OWNER:(Name and address) CONTRACT DATED: 10/18/2018 CONTRACTOR:
City of Fort Worth SURETY:
927 Taylor Street,
Fart Worth,Texas 76102 OTHER:
El
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the
(Insert name and address of Surety)
SureTec Insurance Company
9737 Great Hills Trail,Suite 320
Austin,Texas 78759
on bond of SURETY,
(Insert name and address of Contractor)
Westhill Construction, Inc.
P.O.Box 2016
Cleboume,Texas 76031
CONTRACTOR,
hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the
Surety of any of its obligations to
(Insert name and address of Owner)
City of Fort Worth
927 Taylor Street,
Fort Worth,Texas 76102
as set forth in said Surety's bond. OWNER,
IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date: November 7,2019
(Insert In writing the month followed by the numeric date and year.)
SureTec Insurance Company
(Su )
{Si natters of authorized represenraiiveJ l
Attest Teresa Godsey, Attorney-In-Fact 1
(Sea]): (Printed name and title)
AIA Document G707 1994.Copyright 01982 and 1994 by The American institute of Architects. All rights reserved. WARNING:This AIA7 Document
is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAe Document•or any portion of it, y
may result In severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. This document was produced
by AIA software at 15:04:04 on 02/09/2009 under Order No.1000374646_7 which expires on 1 oil W009•and Is not for resale.
User Notes: (1452131059)
• 4221056
SureTec Insurance Company
LIMITED POWER OF ATTORNEY
Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas,does by these presents
make,constitute and appoint
Teresa Godsey,Scott McCluer Miller,Marry D.Johnson,John Charles Reynolds
its true and lawful Attorney-in-fact,with foil 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 to include waivers to the
conditions of contracts and consents of surety for,providing the bond penalty does not exceed
Five Million and 001100 Dollars($5,000,00Q00)
and to bind the Company thereby as fully and to the same extent as if such bond were signed by the CEO,sealed with the corporate seal
of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the
premises. Said appointment is made under and by authority of the following resolutions of the Board of Directors of the SureTec
Insurance Company:
Be it Resolved, that the President,any Vice-President,any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is
hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fact to represent and act for and on
behalf of the Company subject to the following provisions:
Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company,to execute,acknowledge and
deliver,any and all bonds,recognizanccs,contracts,agreements or 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
Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved,that the signature of any authorized officer and 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 signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 206 of April,
1999.)
In Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its CEO,and its corporate seal to
be hereto affixed this 31 st day of October A.D.2019 .
3PANc SURETEC INS ANY
u, uJ j John ICn'a ,CE
State of Texas ss: 7� »1 Y
County of Harris ....•
On this 31sy day of ociober ,A.D.2ol9 before me personally came John Knox Jr.,to me known,who,being by me duly sworn,did depose and say,
that he resides in Houston,Texas,that he is CEO of SURETEC INSURANCE COMPANY,the company described in and which executed the above
instrument;that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so 2ufflxed by order of the
Board of Directors of said Company;and that he signed his name thereto by like order,
.IACGtJELYN GREENLEAF 1
r+n Notary Public,State of Texas
-_`°• '; Comm Expires05-18.2021
4r
,•,,,a;,,:� Notary 10 1269f13029 Jacq lyn Greenleaf,Notary Public
My commission expires May 18,2021
1,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and correct copy
of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set
out in the Power of Attorney are in full force and effect.
Given under my hand and the seal of said Company at Houston,Texas this day of ,A.D.
fy
RBrenBeaty,Vista tar
Any instrument issued in excess of the penalty stated above is totally void and without arty validity.
For verification of the authority of this power you may tali(713)812-0800 any business day between 8:30 am and 5:00 pm CST.
AFFIDAVIT
STATE OF TEXAS
COUNTY OF JOHNSON
Before me,the undersigned authority, a notary public in the state and county aforesaid,
on this day personally appeared Angela Reynolds,Secretary of Westhiil Construction, Inc.,
known to me to be a credible person, who being by me duly sworn, upon her 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 Utility Cut Repair Contract 2018
Y
Angela Reynolds of Westhil onstruction, Inc.
Subscribed and sworn before me on this date 19thof November, 2019
f�(jz:��4-W A
otary Public l
Johnson Coun , Texas
MELODY N ARMSTRONG
f Notary Public,State of Texas
Comm Expires 03-21.2020
wii�'` Notary 1D 587765.1
CONSENT OF OWNER ❑
SURETY COMPANY ARCHITECT ❑
CONTRACTOR ❑
TO FINAL. PAYMENT SURETY ❑
"nfarms with the American institute of OTHER ❑
Puciriltects,AtA Opcumont 6707
Bond No 070206559
54-Inch Sanitary Sewer Relocation and Storm Water Improvements Tor the Stockyards,City Project Number 101266
PROJECT:
(name, address)
TO (Owner)
ARCHITECT'S PROJECT NO: MCTX 88040
Fort Worth f Heritage MS, LLC C4AlTRACT FOR:54-Inch Sanitary Sewer Relocation and storm
Water Improvaments for Ihe stockyards,Cily
Project Number 101266
LTX —J CONTRACT DATE:
CONTRACTOR: Mountain Cascade of Texas LLC
In accordance with the provisions of the Contract botwccn the 0wncr and the Contractor as Indicated above,the
(hare Ina an name M4 woo0r of?uff IV Company}
Liberty Mutual Insurance Company
175 Berkeley Street,Boston,MA 02116 ,SURETY COMPANY
on band of (he+a ttuarl name and eddrrr�er Contraatar]
Mountain Cascade of Texas LLC
11729 East FM 917,Alvarado,TX 76009 , CONTRACTOR,
hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor Shall not TO lave
this Surety Company of any of its ab)Igations to there mate name and addrarr of Ownl?4
Fort Worth Heritage MB, LLC J
TX ,OWNER,
as seat forth in the said Surety Company's bond.
W WITNESS,WHEREOF,
the Surety Comparty has hereunto set its hand this 21 st day of November,2019 41r+sz
a'�,r
a �
Liberty Mutual I ranee Companyr 11912
z.
Surety Comps '
mom)7'rStiRN !_
Attest,' By:
(Se4i);Joshu Ord Signzture of u orixed a resentative
Bethany Ste a son At'ornny-in•F=
Title
NOTE:TNr rum Ts to ba uaod am a Campullon document to AtA OQCUMENT 0700. CONTRACTOR'S AFFIDAVIT OF PAYMENT OF VaTS A
Cement Edlllan
ONE PAGE
This Power of Attemey lim€N the acts o1 those named herein,and they have no authority to bind the Company except in the manner and to the extent herein slated.Not
valid for mortgage,naIn,loan,leller of credit,bank deposit,currency rate,interest rate or residual value guarantees.To confirm the validity of this Power of Attorney call
619.832.82de between 9:9ri am and 110 pm EST on any business day.
Liberty Liberty Mutual Insurance Company
Mutual. The Ohio Casualty Insurance Company
West American Insurance Company
SURETY POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS:Thal The Ohio Casually Insurance Company is a Corporation duly organized under the laws of the Slate of New Hampshire,that Liberty
Mulual Insurance Company is a corporafion duly organized under the laws of the State of ktassachmeTts,and West American Insurance Company is a corporation duly organized under
the laws of The Slate of Indiana therein called➢veiy called the"Companies'),pursuant to and by authority herein set forth,does hereby name,coe stdute and appoint
,$glhany
Stevenson of lire ufy of _San.Francisco .state of, CA its We and lawful attorney-in-fact,wilh full power and authorily hereby conf ni ed to sign,
execule and adrnowfedge the foPrnving surety bond:
Principal Name:Mau 0 taia
OUSea Namo: )cart Worth Heritage M8.LLj'
Surety Bond Numb or;jVja06559 Bond Amount:See Bond Form
IN WITNESS WHEREOF,Ines Povier of Attorney has been subscribed by an authorized of➢eer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this lP day of December.201B.
r�hr+suR� a�1-1 INs(t. INSU The Ohio Casualty Insurance Company
Liberty Mutual Insurance Company
Wes edcan Insurance Company
1912 z 1919 1991 s p Y
A ,�AOIV� \ti �'Sd�rfRMPSp� rh'aIAH� YZ �Y'
* t * l7avid .'Carey,Assistant Secretary
STATE OF PENNSYLVANIA ss
COUNTY OF MONTGOMERY
On this 1r day of December,2018 before me personally appeared Cavo M.Carey,who acknowledged himself to be the Assistanl Secretary of Liberty kiutual Insurance Company.
The Ohio Casually Company,and WestAmerlcan Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes therein contained
by signing on behalf of the corporalions by himself as a duly aulhcuhed°(fiver.
IN WITNESS WHEREOF.I have hereunto subscribed my name and afruced my notadat seal at King of Prussia,Pennsylvania,on the day and year first above written.
yA PAS), COMMONWEAL7H OF PENNSYLVANIA
We o w'GFC Nolaf a,Sea
Teraea Pasialla,Nctary Publlc
OF Upper Me[Ion7wp.,MonngprneryCounty gY=
L^��p My Com rniswcn Eapima March 28,2021 —7'-Teriesa Paslella,Notary Pubflc
�arRyr Member,Pamayi—is Aasoc[atlon of NoUAoa
This Power of Al 1pnade and executed pursuant to and by authority of the folliming By-laws and Authorizations of Uberty Mutual fasurance Company,The Ohio Casualty Insurance
Company,and West Amercan Insurance Company which resolutiora are now in full force and effect reading as follovrs:
ARTICLE IV-OFFICERS•-Section 12.Pourer of Attorney.Any officer or other official of the Corporalion authorized for that purpose in writing by the Chairman or the Presiderhl,and
subject to Such timiiatipn as the Chairman or the President may prescribe,shall appo nt such allomeysin-fact,as may be necessary to act in behalf of the Corporation to make,execute,
seal,acknowledge and deliver as surety any and all undertakings,bands,recognirances and Other surety obligations. Such attorneys-la-last,subled to the limitations set lorlh in Their
respective powers of attorney,shall have hit power to bind the Corporation by their sgnature and execution of any such InsVumenis and to attach thereto the seal of the Corporation-
When so executed,such Instroments shall be as bending as if signed by the President and allested to by the Secretary.Any power or authority granted 10 any representative or attorney-
in fact under the provisions of this article may be revoked at any WrLe by the Board,she Chhairnw.Me President or by the officer cr officers granting such pourer or authority.
ARTICLE xhl-Execution of Contracts-SECTION 5-Surety Bends and Undertakings.Any officer of the Company aulhorized for Ihat purpose in wrlfing by the c heirman or the president,
and subject to such tmilalions as the dtafrman or the president mayprescnbe,shall appoint such ahomeys•indacl.as maybe necessary to act in behalf of the Company 10 make,execute,
seal,arknovAedge and deliver as surely any and all undertakings,bonds,F"Nzances and other surety obligations. Such nttameys-in•fad sultiecl W the frrrfations set lorth In their
respective pourers of attorney,shall have hill power to bind the Company by Iheir signature and execution of any such Instruments and to attach Iherelo the seal of the Company.When
so executed such instruments shall be as binding as if signed by the president and allested by the secretary.
Certificate of Uslgnatlon-The President of the Company,acting pursuant to the By-am of the Company,authorizes David M.Carey,Assistant Seorelaly to appoint such altomeys•ln-
fact as may be necessary Io act on behalf of the Company to make,execute.Seat,acknowedge and deliver as surety arty and all undertakings,bonds,reaugntxances and other surety
obligations.
Authorization-By unanimous consent of the Company's Board of Dimdors,the Company rorimts that lacsimda or mechanically reproduced Noalure of any assislant secretary of the
Company,wherever appearing upon a oerhked copy of any power of afioiney Issued by the Company in connection with surety bands,shall be valid and bind4 upan the Company with
the same force and effect as though manually affixed.
I,Renee C-Llewellyn,the undersigned,Assistant Secretary,of Liberty Mulual Insurance Company,The Ohio Casualty Insuraom Company,and Wesi American Insurance Company
do hereby verily that this power of altomey executed by said Companies is in MI force and effect and has not been revoked.
IN 7 EST IMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this__Z sct day of N yarrnl7P! _�2019 _
aS¢�lxSugr ,��Y INSU� �n sNSUR.- ---
P h O
r 19i 2 � iQ 1914 L3y:
d ya 0 �a m = a ee C.Lie tI is1 Secretary
�)�SfAT} yl7ta1,A4`+ * IAN* t
City of Fort Worth
Inspector's Estimate Worksheet
City Project Numbers UC01-2018
Contract Name UTILITY CUT REPAIR CONTRACT 2018 DOE Number 2018
Contract Limits: Estimate Number 13
Project Type PAVING Payment Number 13
5 Min.8-inch Concrete Base Material 3200 SY $90.00 150
6 Min.5-inch Reinforced Concrete 800 SY $63.00
Base
7 Brick Pavement Repair 150 SY $54.00
A-5 6"CONC.PARKING 4412.5 SF $10.00 4412.5
A-5 6"CONIC CURB ATTTACHEi7 TO 32 LF $15.00 32
CONIC PAVING
A-6 11"HES CONCRETE 2086,12 SY $11.50 2086.12
i.stimated Total This Unit $675,795.38 Completed Total This Unit S141,452.27
Construction IQ: 12334
Item description of Items Estimated Uni Unit Cost Previous Quanity Completed Total Cost
No. Quanity Quanity for Month Quanity
UNIT III CUTS GREATER THIN 1000 SQ FT I
1 3-inch Asphalt Pavement,Type b 3000 SY $36.00 3227.95
2 3-inch Asphalt Base,Type B 900 SY $12.00
3 9-inch Concrete Pavement 700 SY $90.00 128T07
4 11-inch Concrete Pavement 300 5Y $99.00 628.62
5 Min.8-inch Concrete Base Material 2400 SY $72.00 1967,56
6 Min.5-inch Reinforced Concrete 600 SY $72.00
Base
7 Brick Pavement Repair 150 SY $45.00
'stimated Total This Unit 5434.250.00 Completed Total This Unit $435,940.20
Tuesday,October 79,2019 Page 2
4
City of Fort Worth
Inspector's Estimate Works heet
City Project Numbers UC01-2018
Contract Name UTILITY CUT REPAIR CONTRACT 2018 DOE Number 2018
Contract Limits: Estimate Number 13
Project Type PAVING Payment Number 13
Construction ID: 12335
Item Description of Items Estimated Uni Unit Cost Previous Quanity Completed Total Cost
No- Quanity Quanity for Month Quanity
UNIT IV:ALL CUTS ASPHALT W/O SASE RE
1 3-inch Asphalt Pavement,Type D 2000 SY $27.00 260.55
2 3-inch Asphalt Base,Type B 600 SY $10.00
3 4-inch Asphalt Base,Type 6 200 SY $27-00
4 5-inch Asphalt Base,Type B 200 SY $27.00
5 6-inch Asphalt Base,Type B 200 SY $36.00
Atimated Total This Unit $78,000.00 Completed Total This Unit $7,034.85
Construction ID: 12336
Item Description of Items Estimated Uni Unit Cost Previous Quanity Completed Total Cost
No. Quanity Quanity for Month Quanity
UNIT V-ADDL ITEMS REQ OTHER THAN PA
1 7-inch Concrete Curb and Gutter 400 LF $35.00 568
2 7-inch Concrete Curb and Gutter 400 LF $20,00
Attached to Concrete Pavement
3 6-inch Reinforced Concrete 100 SF $10.00 741.75
Driveway
4 4-inch Reinforced Concrete 150 SF $50.00 147,34
Driveway and Wheelchair Ramp
5 Topsoil 50 CY 530.00
6 Manhole Adjustment,Minor 1 EA $500.00 2
7 Miscellaneous Structure 1 EA $500.00
Adjustment,Va;ve Vault
Adjustment
8 Imported Embedment 1 Backfill, 50 CY $50.00
Crushed Rack
Tuesday,October 29,2019 Page 3
u
City of Fort Worth
Inspector's Estimate Worksheet
City Project Numbers UC01-2018
Contract Name UTILITY CUT REPAIR CONTRACT 2018 DOE Number 2018
Contract Limits: Estimate Number 14
Project Type PAVING Payment Number 14
9 2-inch Asphalt Pavement,Type D, 50 SY $63.00
Parking Lot Repair
10 6-inch Lime Treatment 50 SY $19,00
11 2-inch Asphalt Pavement,Type D, 50 SY $72.00
Driveway Repair
12 4-inch Flexible Base,Type A, 75 SY $27.00
Grade 1-Crushed Limestone
13 6-inch Flexible Base,Type A, 75 SY $36,00
Grade 1-Crushed Limestone
14 C lass'A'Cencrete(3,000#) 10 CY $200.00
15 Repair Storm Drain Structures 5 CY $300.00
16 Concrete Manhole Collar 1 EA $300.00
17 Joint Sealing-Silicone 200 LF $2.00 307
18 Relocate Water Meter and Box 1 EA $150.00
19 Water Meter Adjustment 1 EA $100.00
20 Saw-cut Concrete Pavement 200 LF $3.00
21 6-inch Concrete Pavement,High 150 SY $108.00
Early Strength Concrete(HES)
22 Utility Adjustment 1 LS $1,000.00
23 9-inch Concrete Valley Gutter, 70 SY $99.00
Residential
24 Raised Traffic Markers,All Types 20 EA $10,00 146
25 Pavement Marring,All Types 100 LF $30.00 742
26 Concrete Riprap 30 SY $54.00
27 Medium Stone Riprap,Dry 60 SY $54,00
28 Large Stone Riprap,Dry 60 SY $63.00
29 Concrete Retaining Wall 20 CY $300.00
30 Street Use Permit 100 EA $10o.a0
31 Traffic Control Plan Design and 15 EA $100.00 1
Install as Required
Tuesday,October 29,2019
Page 4
City of Fort Worth
Inspector's Estimate Worksheet
City Project Numbers UC01-2018
Contract Name UTILITY CUT REPAIR CONTRACT 2018 DOE Number 2018
Contract Limits: Estimate Number 14
Project Type PAVING Payment Number 14
32 REMOVAL OF SURFACE 1 CY $100.00 72
COURSE OF ASPHALT OVER
EXISTING BASE
33 STAMP AND STAIN CONCRETE 1 SF $14.00 270
34 5"ASPHALT PAVEMENT 1 SY $60.00 1269,38
35 HAUL OFF 5"ASPHALT 1 CY $100,00 400.39
36 4"ASPHALT PAVEMENT TYPE D 1 SY $48.00 312
:stimated Total This[Unit $I06,767.00 Completed Total This Unit $202,256.30
Total Itemized Amount(Including Change Order $1.743,312.38 p
h't �bATE_ D7g Total Cost of Work Completed 7 $ d
Inspector Less — ~} %Retained L✓
Net Earned
Previous Payment $793,827,28
Material on Hand 15%
Y�
Bafance Due This Payment
Tuesday,October 29,2019
Page 5