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HomeMy WebLinkAboutContract 48603-FP1 City Secretary 48603 -FP1 Contract No. FoRTWORTH.) Date Received Jan 28,2020 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: PARK VISTA BLVD City Project No.: 02319 Improvement Type(s): Water N Sewer ❑ Original Contract Price: $1,316,407.56 Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: $1,316,407.56 `fe �0`l Mike Farrington(Jan 24, 20) Jan 24,2020 Contractor Date Division Manager Title Crossland Construction Co., Inc. Company Name 7A"aa11F_MZW Jan 24 2020 Thomas Miller(Jan 24,2020) Project Inspector Date A z�4- Jan 24,2020 Patrick Buckley(Jan 24,2020) Project an ger Date 47a&W ye&att�o/ka/101f Janie scarlett Morales(Jan 27,2020) Jan 27,2020 CFA Manager Date guela DanaaB ghdoff(Mn 27,20 Jan27,2020 Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: PARK VISTA BLVD City Project No.: 02319 City's Attachments Final Pay Estimate Change orders): ❑ Yes ® NIA Pipe Report: © Yes ❑ NIA Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 358 CD Days Charged: 670 Work Start Date: 1/30/2017 Work Complete Date: 11/30/2018 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name PARK VISTA BOULEVARD Contract Limits Project Type WATER City Project Numbers 02319 DOE Number 2319 Estimate Number 1 Payment Number 1 For Period Ending 7/1/2019 City Secretary Contract Number Contract Time Contract Date Days Charged to Date 670 Project Manager NA Contract is 100.00 Complete Contractor CROSSLAND CONSTRUCTION COMPANY,iNC. 861 N COLEMAN,STE 100 PROSPER, TX 75078 Inspectors LAYER j MILLER Monday,July 1,2019 Pagel of 5 City Project Numbers 02319 DOE Number 2319 Contract Name PARK VISTA BOULEVARD Estimate Number I Contract Limits Payment Number 1 Project Type WATER For Period Ending 71I12019 Project Funding WATER PARK VISTA BLVD Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total I REMOVE 36"WATER LINE 382 LF $44.24 $16,899,68 382 $16,899.68 2 REMOVE 20"WATER LINE 341 LF $37.91 $12.927.31 341 $12,927.31 3 REMOVE 16"WATER LINE 251 LF $25.28 $6,345.28 251 $6,345.28 4 36"CONCRETE AWWA C303 WATER PIPE 321 LF $284.36 $91,279.56 321 $91,279.56 5 36"WATER CARRIER PIPE 68 LF $195.90 $13,321.20 68 $13,321.20 6 54"CASING BY OPEN CUT 68 LF $1,124.82 $76,487.76 68 $76,487.76 7 20"WATER CARRIER PIPE 71 LF $94.79 $6,730.09 71 $6,730.09 8 30"CASING BY OPEN CUT 85 LF $505.53 $42,970,05 85 $42,970.05 9 36"CASING BY OPEN CUT 71 LF $612.93 $43,518.03 71 $43,518.03 10 36"AWWA BUTTERFLY VALVE WNAULT 1 EA $96,684.00 $96,684.00 1 $96,684.00 11 20"GATE VALVE WIVAULT 2 EA $48,342,00 $96,684,00 2 $96,684.00 12 C303 FITTINGS 1 LS $150,327.00 $150,327,00 1 $150,327.00 13 C303 FITTINGS 1 LS $91,628.00 $91,628.00 1 $91,628.00 14 UTILITY MARKERS 3 LS $809,00 $2,427.00 3 $2,427.00 15 DUCTILE[RON WATER FITTINGS 3 TN $2.527.85 $7,583.55 3 $7,583.55 W/RESTRAINT 16 CONNECTION TO EXISTING 36"WATER MAIN 2 EA $12,006.00 $24,012.00 2 $24,012,00 17 CONNECTION TO EXISTING 20"WATER MAIN 2 EA $9,668,00 $19,336.00 2 $19,336.00 18 CONNECTION TO EXISTING 16"WATER MAIN 2 EA $7,204.00 $14,408.00 2 $I4,408.00 19 CONNECTION TO EXISTING 4"-12"WATER 2 EA $2,401.00 $4,802.00 2 $4,802.00 MAIN 20 V WATER SERVICE 2 EA $1,612.00 $3,224.00 2 $3,224.00 21 6"BLOW OFF VALVE l EA $35,451.00 $35,451.00 1 $35,451.00 22 4"COMBINATION AIR VALVE ASSEMBLY FOR 1 EA $7,204.00 $7,204.00 1 $7,204.00 WATER 23 TRENCH SAFETY 1869 LF $1.26 $2,354.94 1869 $2,354.94 24 6"PVC WATER PIPE 82 LF $69.51 $5,699,82 82 $5,699.82 25 10"PVC WATER PIPE 553 LF $82.15 $45,428.95 553 $45,428.95 26 16"PVC C905 WATER PIPE 181 LF $157.98 $28,594.38 181 $28,594.38 27 16"WATER CARRIER PIPE 85 LF $101.10 $8,593.50 85 $8,593.50 28 6"GATE VALVE 5 EA $1,201.00 $6,005A0 5 $6,005.00 29 16"GATE VALVE W/VAULT 1 EA $27,804.00 $27,804.00 1 $27,804.00 Monday,July 1,2019 Page 2 of 5 City Project Numbers 02319 DOE Number 2319 Contract Name PARK VISTA BOULEVARD Estimate Number 1 Contract Limits Payment Number I Project Type WATER For Period Ending 7/1/2019 Project Funding 30 FIRE HDYRAIVT ASSEMBLY 2 EA $3,792,00 $7,584,00 2 $7,584,00 31 10"GATE VALVE 1 EA $2,528.00 $2,528.00 1 $2,528.00 32 12"PVC WATER PIPE 208 LF $88A7 $19,401.76 208 $18,401.76 33 20"CONCRETE AWWA C303 WATER PIPE 205 LF $183,26 $37,568.30 205 $37,568,30 34 6"BLOW OFF VALVE 1 EA $21,486.00 $21,486,00 1 $21,486,00 35 6"BLOW OFF VALVE I EA $22,560.00 $22,560.00 1 $22,560.00 36 4"COMBINATION AIR VALVE ASSEMBLY I EA $29,532.00 $29,532.00 1 $29,532.00 37 4"COMBINATION AIR VALVE ASSEMBLY I EA $30,614.00 $30,614.00 1 $30,614.00 Sub-Total of Previous Unit $1,159,004.16 $1,159,004.16 WATER PART{VISTA BLVD Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total u ` -T 1 48"CASING BY OPEN CUT 330 LF $462.41 $152,595.30 330 $152,595.30 2 TRENCII SAFETY 330 LF $14.57 $4,808.10 330 $4,808.10 -- - - --- - --------- ------ ------- - ---- --- Sub-Total of Previous Unit $157,403.40 $157,403.40 -- ------------------------------------ Mosiday,July 1,2019 Page 3 of 5 City Project Numbers 02319 DOE Number 2319 Contract Name PARK VISTA BOULEVARD Estimate Number I Contract Limits Payment Number 1 Project Type WATER For Period Ending 7/1/2019 Project Funding Contract Information Summal Original Contract Amount $1,316,407.56 Change Orders Total Contract Price $1,316,407.56 Total Cost of Work Completed $1,316,407.56 Less %Retained $0.00 Net Earned $1,316,407.56 Earned This Period $1,316,407.56 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 Nand Less 15% $0.00 Balance Due This Payment $1,316,407.56 Monday,July 1,2019 Page 4 of 5 City Project Numbers 02319 DOE Number 2319 Contract Name PARK VISTA BOULEVARD Estimate Number 1 Contract Limits Payment Number I Project Type WATER For Period Ending 7/1/2019 Project Funding Project Manager NA City Secretary Contract Number Inspectors LAYER/ MILLER Contract Date Contractor CROSSLAND CONSTRUCTION COMPANY,INC. Contract Time 861 N COLEMAN,STE 100 Days Charged to Date 670 PROSPER, TX 75078 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 $1,316,407.56 Less %Retained $0.00 Net Earned $1,316,407.56 Earned This Period $1,316,407.56 Retainage This Period $0.00 Less Liquidated Damages 0 Days Q $0.00 /Day $0.00 LessPavement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Nand Less 15% $0.00 Balance Due This Payment $1,316,407.56 Monday,July 1,2019 Page 5 of FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Park Vista Bivd PROJECT NUMBER: 02319 DOE NUMBER: WATER PIPE LAID SIZE TYPE OF PIPE LF 6" PVC 82 10" PVC 553 16" ❑I 266 FIRE HYDRANTS: 2 VALVES(16"OR LARGER) 1 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS A The City of Fort Words•1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax-.(817)392-7845 AFFIDAVIT OF TOTAL RELEASE AND CERTIFICATION OF ALL BILLS PAID THE UNDERSIGNED hereby certifies that he(or she)has examined and is authorized and empowered to execute this Affidavit as the owner,partner,or officer as the case may be,of the contractor named below("the Contractor")employed in connection with the construction project("the Project")mentioned below. In consideration for the full and final payment to the Contractor for all services in connection with the Project, the Contractor hereby releases and waives all liens and claims to liens which the Contractor may have on or affecting the Project or Project property as a result of the Contractor's contract(s) for the Project or for performing labor and/or furnishing materials that are in any way connected with any construction of any building(s)or improvement(s) for the Project whether on the Project property or elsewhere. The Contractor further certifies and warrants that all subcontractors of labor and/or materials supplied to,for,through or at the direct or indirect request of the Contractor and/or subcontractor have been paid. 1. _ Crossland Construction (Print or type the firm or individual name of the Contractor) 2. 833 SE Ave Columbus KS 66725 (Print or type the Contractor's address) 3. Todd Ketterman Print or type the name of the person signing for the Contractor) 4. Vice President (Print or type the position of the person signing for the Contractor) 5. Description of the Project(use an additional page,if necessary): WM Ft.Worth 2834-00 6. Date that the project was totally completed: 4/20/18 The undersigned certifies that the foregoing information is true and correct and acknowledges that the owner of the Project has placed a material reliance on such information in directing final payment to the Contractor. EXECUTED this 1 A day of 20 1 R (To be s gned by the per n hown in Item 3 above) Subscribed and swom before me this 19 day of January ,2oL 18 Notary Public: 1VT_ My Commission Expires: c 0-4 END OF AFFIDAVIT �A 4,�, CINDY SKAHAfo! NOTARY PUBLIC STATE OF KAN AS x STATE OF KANSAS My App.Exp V 01770-9 WM 2834 Ft.Worth,TX CONSENT OF SURETY OVINFR El TO FINAL PAYMENT ARCHITECT ALA Document G707 CONTRACTOR ❑ SURIi"fY ❑ Bond No. 8244-48-77/09231119 OTHFR ❑ TO OWNEfL ARCHITECT'S PROJECT NO.: 1n,Wme rr aa&rymi Wal-Mart Stores Texas, LLC and the City of Fort Worth.Texas 1000 Throckmorton Street CC1WTftACi FOR: Construction Fort Worth,TX 76102-6311 PROJECT: CONTRACT GATED: CAr ww and addro&r} Park Vista Boulevard (From Keller-Hicks Rd. to Ray White Rd.), City Project#02319 In accordance with the provisions of the Contract between the Owner and the Contractor as iiidicatext above,the rhrserf name and addtxsv❑f Snrrr.y) Federal Insurance Company, 202B Hall's Mill Road, Whitehouse Station, NJ 08889 and Colonial American Casualty and Surety Company 1 Fidelity and Deposit Company of Maryland 1 Zurich American Insurance Company, 1299 Zurich Way, 5th Floor, Schaumburg, IL 60196 SURETY, on 13ond of flairrr rrarrrr a++d nddress q f Cuar+rucru+) Crossland Construction Company, Inc. P❑ Box 45, 833 S. East Avenue Columbus, KS 66725 CONTRACTOR, hereby approves of the final payment to the Conti-actor,and agrees that final payment to the Contractor shall not relieve the Surety vF any of its obligations to (r„wn.arneandadd„&afOirfrar) Wal-Mart Stores Texas, LLC and the City of Fort Worth,Texas 1000 Throckmorton Street Fort Worth, TX 76102-6311 OWNER. as set forsh in said Surety's bond. IN WITNESS WHEREOF,the Surety Isar hereunto set its hand on this date; December 17, 2019 !Guu+r li+u?*1iN 4rbe wanthfuiom4 dhr the rrrrmcrk date a+rd near,y Federal Insurance Company and Colonial American Casualty and Surety Company/Fidelity and Deposit Company of Maryland 1 Zurich American Insurance Company (Swrnr) By: - .�2-�- �S h q urrr.GarY�1 rr�vxrrrrari+r� .; .ti +m�rnr++:err. tal f y+4 s it ill. eit,AttCxr tC'1 �1•r`�.. nica ; a Witness 4W.W, ,;fired+ ,+Jeatenr �• GG ` y�. - AArr t! •may k ,:�n� �" • � • ■ 1 ,f''"++ 0707-1994 `C H U E3 8 Power of Attorney Federal insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Know All by These Presents.Thal FEDERAL INSURANCE COMPANY.an Indiana corporation,VIGILANT INSURANCE COMPANY.a New York curfmrttiin.and PACIFIC INDEMNITY COMPANY.a WV scinsfn cirpuration,du each hereby o ins hnne and appoint Bret 5.Burton,Timothy H.HefIe1,David B.McKinney,Todd Alan Rambo, Timothy Craig Smith, Myriah A. Valdivia and Desiree E. Westmoreland of Wichita, Kansas; Katherine J. Breit, Monica F. Donatelli, Carolyn J.Johnson,Kelly E.Kimmel,and S.Mark Wilkerson of Overland Park,Kansas---------------------------------------------------------- ----- each as their true and lawful Atturney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver far and on their behalf as surety thereon or❑therwise,bonds and undertaking and tither writings obligaton in the nature thereof(other than bail bonds)given or executed in the course of business.and any instruments amending or altering the same,and consents to the modification or a]teratiun if any instrument referred to in.aid hands nor nhligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY.VIGILANT INSURANCE COMPANY.and PACIFIC INDEMNITY COMPANY have each executed and anested these presents and affixed their corporate seab on this 201 day of March,2D19• ltne.lt 11 Cltk xr(N..I ti;pill%tVlvlar) 1,1 whol lJ lI:nleA 1 t..• I'rt-rkilI STATE OF NEW JERSEY Count yofIIonlerdun on this 2011 day of March,2019.before me.a No it Public(if New Jersey.personally came Dawn►,Chloros,to me kntrAn to Ix•Assistant Secretan•of FEDERAL INSURANCE COMPANY.VIGILANT INSURANCE COMPANY.and PACIFIC INDEMNITY COMPANY.the companies which executed the firregiing,Power of Autlme},and the said!lawn M. Chlonls,being by me duly s%%oum.did dupase and say that she Ls.Asshaarn Secretary of FEDERAL INSURANCE COYSPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COM[it\NV and knows the corporate seals therein'.that the seals affixed to the foregoing Power of Attirnev are such corporate seals and were thereto affixed by authority of said Companies;and that she signed said INswer orAtwmey as Assistant Secretary of said Companies by Inke authority;and tbar she is anquainted with Stephen Af. IIanev.anti knnws him t❑be V1ce.President of-.,.aid Companies;and that the Signature of Stephen SI.I Ianey,suhscribed to said Power of Attorney is in the genuine handwriting of Stephen M.Harley.anti was thereto subscribed by authority il'said Companies and in depunent's presence. ..Notarial seal R D7240 CURTis WTURr PUBDC OF NEW JERSEY W S tb 067��OC Cu,,mudon Erntie Ibrrmtw a,aCQ2 CER.TIFICKMN Rc,solutions adopted by the Boards if Directors of FEDERAL INSURANCE C010PANY.VIGILANT INSUR.•17CE CON]PANY,and PACIFIC IN DEN I\IT}COMPANY on August 30.2016! 'XWl-V W,that the litlluw•Ing aWNPrization]relate to the e•xetvtlnn,for and ire he of the Cuanpany.ofbtmds-underfakings+re'ct>platrtceti-cnntracis and tither urilten uummitments of the Umipany emend into in the ordinary'txtu use of humneti,teach a'Unuen Cummhmen-I- (I1 Each of the Chairman.the Premdenr anti the Fitt Presalents of the Cump:my h hereby authorized to exetiure any IVriuen CA)mmttineni fur and Ire behalf of the tkrmpany.under the seal of the Company or ntWrwi e. 12) Lach duly apMrittd atlumcyindaa o1 the Company 6 htreln authorized tit exex'mte any wiriuen tAM11-mlme111.for and on behalf of Its Ciimpany.under the sal of the Cnmpam•or ntbermise,in the extent That.nth aetiiin is authurixed by the Want of puwers pan ided For tit.itch perstfc x riven appmoment as such;it urney-in•fatt. M Each of the Chairman.the I'reAdvio l and the viw Presklemts Iif the Company is herby authurtzmL Fur acid tin behalf ul the Companv,it)apix.tni In it nurIA any persoal the atlnrney• in-Fins of the Company with full power and authnnt7 to exectite.Cur and on behalfuf the Gumpuny,under the seal of the Company or inhenrbe,such writ en Cnmmaments of the Company as nay he:gulf-led In such wrhien appefmmtem.which sioucifitzrion may he by gelecal rye or done oil'w'riuen CtimmltmlemS or by gvdfiit:ni,in of 1me ru mtsre particuLir written C11m11itrlu'tlts. 1;l Each of the Chairman.the Prestderlt and the VIt'e I'rtidenia of the t;nmpan)is hereby aulhrrized,Itwand tin beha ll of the Cnmpany,it deltime in m rhinµ tv:my ether nRtcer of the Company The authority to execute.foram$on hehalr of the Campmv.under the Cump:Iny's.gal f it vthenvLw,such%%noien Gimmhmenis of the Ctunpany as are gwolliied in such written delegation.which spxYiBcirh in may be by general l type tor cbk%of%V rinen C4 tmrntt menu ter by spe011mi ton of one or more puticuhar written Grimmitmente (5) The signature of any officer or other pervin exetuurrg any"mien Ct mmkmem or appnmtmrnr 4ir delaption pursuant to this Re-st Phil ion.and the scat iif the Crmlpmy.may be affixed tg• fatNmile on such Written Commitment ur written appnmracro l or delepitinn. FL'R'I'HER HE-tiULV'ED.that the for?4nlz He,ttlutitm shall not Ix deemed to beam exclusim mement of the powers and authority otnnicert empinyex,arid either ptTr in.,To tit for and un behalf of Ihu Camp ny,and such R onion shall tit limit or nrherwtse ah'ttil the vNerow of any such r4mur or aurhonim vihermw valldh granted urte+xd.- I,Dawn M.Chloros.Assistant Secretary of FEDER.41 INSURANCE COMPANY.VIGILANT INSURANCE COMPANY.and PACIFIC 1NDENINITY COMPA:NV uhe-Companies")do hereby certify that Ill the foregoing Resolutions adopted by the guard O'Directors of the I;umpanie+are true.correct and in full force anti elhct, city the foregoing Power of Attorney is true.correct and in full force and effect. Gii,en under my hand and;eahe of said Ctimpanles at WITitehouse Station.NJ,this 17th day of December, 2019 +i1rW I tiv it VI C11h 9-i n.:l V•l:IllI%Lo'tt:tf}V I%I I Ir ll 3FN�1 W1 H IS11 {ylllPil x 7I i 13h rn t Fa Ti its Hy mi o N;TIFS L OF AN) wr 11R'ul IrrEkl.1111A.1 E Cn%TACT l SAT: e.�sstiµtilrwery�py.'e • � eR T. FED-VIG-PI(rev.08-18) �*•• � 7� f�+r+'ret,I�itrl�ttt�e't ZURICH AMERICAN 1NSI1RANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY.a corporation of the State of New York. the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D.Murray.Vice President.in pursuance of authority granted by Article V.Section 8,of the By-Laws of said Companies,which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate,constitute. and appoint S. Mark WILKERSON, Kelly E. KIMMEL, Morgan DEWLY, Monica F. DONATELLI, Debra L.WALZ, Carolyn J. JOHNSON and Katherine J. BREIT,all of Overland Park, Kansas, EACH, its true and lawful agent and Attorney-in-Fact, to make. execute.seal and deliver.for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents•shall be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZUR[CH AMERICAN INSURANCE COMPANY at its office in New York. New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills. Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills. Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his'her names and affixed the Corporate Seals of the said "ZURICH AMERICAN INSI,'RANC'E COMPANY, COLONIAL. AMERICAN CASUALTY AND SItRETY COMPANY, and FIDELITY AND DEPOSIT C ONI PANT'OF MARYLAND,this 12th day of June.2019. r 3=; BJEAL I i 190i ��jr R4 i � ^�... r✓' ATTEST: Zt1RICH AMERICAN INSURANCE COMPANY COLONIAL AMERIC:ANI CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D.Aturrar Vice President B}•: Dawn E. Brown Secrelaw State of Maryland County of Baltimore On this 12th day of June, A.D. 2019. before the subscriber,a Notary Public of the State of Maryland.July cominissioned and qualified,Robert D. Murray.Vice President and Dann E.Brown.Secretary of the Companies,to me personally known to be the individuals and officers described in and who cx"uted the preceding instrument,and acknowledged she execution of same,and being by me duly swam,deposeth and saith,that he,shc is the said officer of the Company aforesaid.and that the seals affixed to the preceding instrument arc the Corporate Scals of said Companies,and that the said Corpuratc Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. 1N TESTIMONY WHEREOF,1 have hereunto set my hand and affixed my Official Seal the day and year First abotr«Tittcm '��,!41n54i{flit►���of _ s Q.z Lva J�,y Il I�[tgr�'��rri fir'' r Ua Gp s d public:`C :�cLrm '+ry L�'rt�s cif ry +v cJbiy, omssiun �i4+ �t.'_�' 1 G ►N +7 •t'7 % "EAL " : - SEAL :C _ r _ its *M.A '•• � •i'rerlj'ntlLlti���',,, EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V.Section 8,Attomevs-in-Fact. The Chief Executive Officer.the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint auomcys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any Stich appointment or authority at any time." CERTIFICATE 1, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V.Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly caIIed and held on the 15th day of December 1998. RESOLVED: "That the signature oftlie President or a Vice President and the attesting signature o f a Secretary or an Assistant Sccretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company-" This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution oI"the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May. 1994.and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I Uth day of May, 1990. RESOLVED: 'Thai the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President.Secretary,or Assistant Secretary of the Company.whether made heretofore or hereafter,wherever appearing upon a ecrtified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF.I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 17th day of December 2019 SEAL t Ion r+r Brian M. Hodge.,Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND,PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND,THE BOND NUMBER,AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 �vww.rcportsfclainis u,zurichna.com 800-626-4577 Policyholder Information Notice IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener information o para someter una queja: You may call Chubb's toll-free telephone number Usted puede llamar al numero de teldfono gratis for information or to make a complaint at de Chubb's para informaci6n o para someter una queja al 1-800-36-CHUBB 1-800-36-CHUBB You may contact the Texas Department of Puede comunicarse con el Departamento de Insurance to obtain information on companies, Seguros de Texas para obtener informacion acerca coverages, rights or complaints at de companies, coberturas, derechos o quejas al 1-800-252-3439 1-800-252-3439 You may write the Texas Department of Insurance Puede escribir a] Departament❑ de Seguros de Texas P.O. Box 149104 P.O. Box 149104 Austin, TX 78714-9104 Austin, TX 78714-9104 FAX # (512) 475-1771 FAX # (512) 475-1771 Web: http://www.tdi.state.tx.us Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: DISPUTES SOBRE PRIMAS 0 RECLAMOS: Should you have a dispute concerning your premium Si tiene una disputa concemiente a su prima o a un or about a claim you should contact the agent first. reclamo, debe comunicarse con el agente primero. If the dispute is not resolved, you may contact the Si no se resueve la disputa, puede entonces Texas Department of Insurance. comunicarse con el departamento(TDI). 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 prop6sito de information y become a part or condition of the attached no se convierte en parte o condici6n del documento document. adjunto. Form 99-1 it-0299(Rev. 1-08) ZURICH Texas Important Notice IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informaci6n o para presentar una queja: You may call Zurich North America's toll-free telephone lasted puede Ilamar al numeeo de telefono gratuito de number for information or to make a complaint at: Zurich North America's para obtener informaci6n o para 1-800-382-2150 presentar una queja al: 1-800-382-2150 You may contact the Texas Department of Insurance to obtain information on companies,coverages, rights, or Usted puede comunicarse con el Departamento de Se- complaints at: gurus de Texas para obtener informaci6n sobre com- 1-800-252-3439 panias, coberturas, derechos, o quejas al: 1-800-252-3439 You may write the Texas Department of Insurance: Usted puede escribir al Departamento P.O. Box 149104 de Seguros de Texas a: Austin, TX 78714-9104 P.O. Box 149104 Fax: (512)490-1007 Austin, TX 78714-9104 Web: www.tdi.texas.gov Fax: (512)490-1007 E-mail: ConsumerProtection@tdi.texas.gov Sitio web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas,gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or DISPUTAS POR PRIMAS DE SEGUROS O about a claim, you should contact the company first. If RECLAMACIONES: the dispute is not resolved, you may contact the Texas Si tiene una disputa relacionada con su prima de seguro Department of Insurance. o con una reclamaci6n, usted debe comunicarse con la compaFita primero. Si la disputa no es resuelta, usted ATTACH THIS NOTICE TO YOUR POLICY: puede comunicarse con el Departamento de Seguros de This notice is for information only and does not become Texas. a part or condition of the attached document. ADJUNTE ESTE AVISO A SU POLIZA: Este aviso es solamente para prop6sitos informativos y no se con- vierte en parte o en condici6n del documento adjunto. 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