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Contract 51210-FP1
City Secretary51210 -FP1 Contract No. FORTWORTH., Date Received May 26,2020 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: Paving, Water, Sewer, Drainage Mistletoe Station City Project No.: 101489 Improvement Type(s): Water ® Sewer Original Contract Price: $198,000.00 Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: $198,000.00 Z,,- May 20,2020 Contractor Date President, Managing Member Title Mistletoe Station, LLC Company Name Jesse Guptin(M y 013:01 CDT) May 20,2020 Project Inspector Date May 21,2020 ges atel(May 21,202012:51 CDT) Project Manager Date Laurie Lewis(May 21,202013:000 CDT) May 21,2020 CFA Manager Date 75AH'a,gain A&J� E Dana Burghdoff( y21,2 20:31 CDT) May21,2020 Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: Paving, Water, Sewer, Drainage Mistletoe Station City Project No.: 101489 City's Attachments Final Pay Estimate Change Order(s): ❑ Yes ® N/A Pipe Report: ® Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 365 CD Days Charged: 585 Work Start Date: 9/10/2018 Work Complete Date: 4/16/2020 Page 2of2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name PAVING,WATER,SEWER&DRAINAGE IMPROVEMENTS TO SERVE M Contract Limits Project Type WATER&SEWER City Project Numbers 101489 DOE Number 1014 Estimate Number 1 Payment Number 1 For Period Ending 4/30/2020 CD City Secretary Contract Number Contract Time 36ED Contract Date 8/6/2018 Days Charged to Date 585 Project Manager NA Contract is 100.00 Complete Contractor MAKER BROS,LLC 4901 KELLER SPRINGS,SUITE 1010 ADDISON, TX 75001 Inspectors CORDOVA / GUPTIN Wednesday,May 20,2020 Page 1 of 5 City Project Numbers 101489 DOE Number 1014 Contract Name PAVING,WATER,SEWER&DRAINAGE IMPROVEMENTS TO SERVE Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 4/30/2020 Project Funding UNIT L•WATER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 REMOVE 4"WATER LINE 35 LF $8.58 $300.30 35 $300.30 2 REMOVE 12"WATERLINE 139 LF $8.00 $1,112.00 139 $1,112.00 3 REMOVE 16"WATER LINE 232 LF $9.50 $2,204.00 232 $2,204.00 4 REMOVE 6"WATER VALVE 1 EA $560.00 $560.00 1 $560.00 5 SALVAGE FIRE HYDRANT 1 EA $400.00 $400.00 1 $400.00 6 24"CASING BY OPEN CUT 53 LF $244.40 $12,953.20 53 $12,953.20 7 DUCTILE IRON WATER FITTINGS 1.32 TN $7,282.57 $9,612.99 1.32 $9,612.99 W/RESTRAINT 8 6"PVC WATER PIPE 53 LF $30.59 $1,621.27 53 $1,621.27 9 8"WATER PIPE 32 LF $28.14 $900.48 32 $900.48 10 12"DIP WATER 94 LF $36.00 $3,384.00 94 $3,384.00 11 12"PVC WATER PIPE 160 LF $53.05 $8,488.00 160 $8,488.00 12 16"PVC C905 WATER PIPE 171 LF $53.08 $9,076.68 171 $9,076.68 13 FIRE HYDRANT 2 EA $2,510.00 $5,020.00 2 $5,020.00 14 CONNECTION TO EXISTING 16"WATER MAIN 1 EA $5,234.08 $5,234.08 1 $5,234.08 15 CONNECTION TO EXISTING 4"-12"WATER 2 EA $4,456.50 $8,913.00 2 $8,913.00 MAIN 16 2"WATER SERVICE 2 EA $2,755.50 $5,511.00 2 $5,511.00 17 3"WATER METER AND VAULT 1 EA $18,860.00 $18,860.00 1 $18,860.00 18 6"GATE VALVE 2 $837.00 $1,674.00 2 $1,674.00 19 12"GATE VALVE VAVE 6 $2,025.00 $12,150.00 6 $12,150.00 20 16"GATE VALVE W/VAULT 1 $16,025.00 $16,025.00 1 $16,025.00 Sub-Total of Previous Unit $124,000.00 $124,000.00 UNIT H.SANITARY SEWER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 REMOVE 6"SEWER LINE 19 LF $26.34 $500.46 19 $500.46 2 REMOVE 24"SEWER LINE 590 LF $16.00 $9,440.00 590 $9,440.00 3 REMOVE S SEWER MANHOLE 1 EA $500.00 $500.00 1 $500.00 4 PRE-CCTV INSPECTION 609 LF $2.52 $1,534.68 609 $1,534.68 5 POST CCTV INSPECTION 142 LF $7.88 $1,118.96 142 $1,118.96 Wednesday,May 20,2020 Page 2 of 5 City Project Numbers 101489 DOE Number 1014 Contract Name PAVING,WATER,SEWER&DRAINAGE IMPROVEMENTS TO SERVE Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 4/30/2020 Project Funding 6 MANHOLE ADJUSTMENT MINOR 1 EA $3,147.00 $3,147.00 1 $3,147.00 7 TRENCH WATER STOPS 2 EA $835.54 $1,671.08 2 $1,671.08 8 36"CASING BY OPEN CUT 47 LF $297.85 $13,998.95 47 $13,998.95 9 15"SEWER PIPE 95 LF $118.32 $11,240.40 95 $11,240.40 10 24"SEWER PIPE 47 LF $258.97 $12,171.59 47 $12,171.59 11 EPDXY MANHOLE LINER 28 VF $215.33 $6,029.24 28 $6,029.24 12 5'MANHOLE 1 EA $10,500.00 $10,500.00 1 $10,500.00 13 5'EXTRA DEPTH MANHOLE 22 VF $97.62 $2,147.64 22 $2,147.64 -------------------------------------- Sub-Total of Previous Unit $74,000.00 $74,000.00 Wednesday,May 20,2020 Page 3 of 5 City Project Numbers 101489 DOE Number 1014 Contract Name PAVING,WATER,SEWER&DRAINAGE IMPROVEMENTS TO SERVE Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 4/30/2020 Project Funding Contract Information Summary Original Contract Amount $198,000.00 Chanize Orders Total Contract Price $198,000.00 Total Cost of Work Completed $198,000.00 Less %Retained $0.00 Net Earned $198,000.00 Earned This Period $198,000.00 Retainage This Period $0.00 Less Liquidated Damages Days @ /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 $198,000.00 Wednesday,May 20,2020 Page 4 of 5 City Project Numbers 101489 DOE Number 1014 Contract Name PAVING,WATER,SEWER&DRAINAGE IMPROVEMENTS TO SERVE Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 4/30/2020 Project Funding Project Manager NA City Secretary Contract Number Inspectors CORDOVA / GUPTIN Contract Date 8/6/2018 Contractor MAKER BROS,LLC Contract Time 365 CD 4901 KELLER SPRINGS,SUITE 1010 Days Charged to Date 585 CD ADDISON, TX 75001 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 $198,000.00 Less %Retained $0.00 Net Earned $198,000.00 Earned This Period $198,000.00 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 $198,000.00 Wednesday,May 20,2020 Page 5 of 5 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Mistletoe Station PROJECT NUMBER: 101489 DOE NUMBER: N/A WATER PIPE LAID SIZE TYPE OF PIPE LF C 900 6" PVC 53 C 900 8" PVC 32 DIP 12" DIP 160 C 900 12" PVC 160 C 905 16" PVC 171 FIRE HYDRANTS: 2 VALVES(16" OR LARGER) N/A PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Yes NEW SERVICES: 2" Copper 2 ea. 3" Meter&Vault lea. SEWER PIPE LAID SIZE TYPE OF PIPE LF SDR 26 15" PVC 95 DIP 24" DIP w/36"casing 47 PIPE ABANDONED SIZE TYPE OF PIPE LF N/A DENSITIES: Yes NEW SERVICES: N/A TRANSPORTATION AND PUBLIC WORK S The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 a (817)392-7941 •Fax: (817)392-7845 Document G706TM - 1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: Mistletoe Station Apartments CFA N/A ARCHITECT: ❑ 1916 Mistletoe Blvd CONTRACT FOR: General Construction CONTRACTOR: ❑ Fort Worth,TX 76104 SURETY: TO OWNER: (Name and address) CONTRACT DATED:August 6,2020 OTHER: ❑ Mistletoe Station,LLC 5501-A Balcones Dr.#302 Austin,TX 78731 STATE OF: Texas COUNTY OF: Dallas The undersigned hereby certifies that,except as listed below,payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished,for all work,labor,and services performed,and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered. EXCEPTIONS: See attached. SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1. Consent of Surety to Final Payment. Whenever Maker Bros.,LLC Surety is involved,Consent of Surety is 4901 Keller Springs,Suite 101 required. AIA Document G707,Consent of Surety,may be used for this purpose Addison,TX 75001 Indicate Attachment ® Yes ❑ No BY: The following supporting documents should be attached ' ign tune of uth sized representative) hereto if required by the Owner: JUSTIN BAILEY,Manager 1. Contractor's Release or Waiver of Liens, (Printed name and title) conditional upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me on this date: Subcontractors and material and equipment March 23rd, 2020 suppliers,to the extent required by the Owner, accompanied by a list thereof. �j� Notary Public: .� 3. Contractor's Affidavit of Release of Liens(AIA My Commissio xpires: May 22, 2022 Document G706A). JASON MARK GRANT ' :�iNotary Public,State of Texas ". vz Comm Expires 05-22-2022 Notary 10 131578381 AIA Document G706TM—1994.Copyright©1970 and 1994 by The American Institute of Architects.All rights reserved.WARNING:This AIA® Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA® Document,or any portion of it, 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 14:55:39 ET on 03/23/2020 under Order No.1918634514 which expires on 03/23/2021,and is not for resale. User Notes: (3B9ADA5F) AP Invoice Aging Maker Bros., LLC AP Invoice Aging Job 1803 to 1803, Period <= 03(Mar 2020) 03/23/20 Record# Invoice# Due Date Current 1 -30 31 -60 61 -90 91-120+ +Retained 270001 Armour Concrete, LP 2067 1803-02700 PA 03/25/19 6,152.40 2555 1803-02700 PA 11/25/19 746.50 2726 1803-02700 PA 01/25/20 72.10 Vendor Totals: 6,971.00 275001 Stripe-A-Zone, Inc. 2821 1803-02750 PA 02/25/20 350.00 Vendor Totals: 350.00 1660002 Bean Electrical, Inc 2142 1803-16200 PA 04/25/19 208.50 2175 1803-16200 PA 05/25/19 738.50 2233 1803-16200 PA 06/25/19 1,865.00 2328 1803-16200 PA 08/25/19 489.50 2442 1803-16200.04 09/25/19 1,752.85 2565 1803-16200 PA 11/25/19 264.75 Vendor Totals: 5,319.10 2510001 Rumsey Construction, LLC 1845 1803-02510 PA 11/25/18 4,318.80 1846 1803-02510 PA 11/25/18 36,367.29 1898 1803-02510 PA 12/25/18 79,872.57 1951 1803-02510 PA 01/25/19 74,403.63 2020 1803-02510 PA 02/25/19 17,767.26 2073 1803-02510 PA 03/25/19 9,354.65 2110 1803-02510 PA 04/20/19 17,002.75 2156 1803-02510 PA 05/25/19 1,607.86 2211 1803-02510 PA 06/25/19 5,397.25 2269 1803-02510 PA 07/25/19 1,310.21 2330 1803-02510 PA 08/25/19 61,928.95 2551 1803-02510 PA 11/25/19 760.00 2638 1803-02510 PA 12/25/19 1,179.60 2720 1803-02510 PA 01/25/20 14,848.13 Report 4-1-3-21 03/23/20 JBailey Page 1 02:14 PM AP Invoice Aging 03/23/20 Continued... Record# Invoice# Due Date Current 1 -30 31 -60 61 -90 91-120+ +Retained 2819 1803-02510 PA 02/25/20 25,599.62 2899 1803-02510 PA 03/25/20 32,662.88 3006 1803-02510 PA 04/20/20 41,139.52 Vendor Totals: 425,520.97 2900001 Foliage Factory Landscape, Inc. 2283 1803-02900 PA 07/25/19 1,152.50 Vendor Totals: 1,152.50 Grand Totals: 439,313.57 Report 4-1-3-21 03/23/20 JBailey Page 2 of 2 02:14 PM Consent of Surety OWNER ❑ to Final Payment ARCHITECT ❑ CONTRACTOR ❑ SURETY ❑ AIA DOCUMENT G707 OTHER ❑ Bond No. 46BCSHW1584 TO OWNER ARCHITECT'S PROJECT NO. (Name and address) Mistletoe Station, LLC CONTRACT FOR: Construction 5501-A Balcones Drive, Suite 302 Austin, TX 78731 PROJECT: Paving,Water, Sewer & Drainage Improvements to Serve Mistletoe Station Aame and address) CONTRACT DATED: August 06, 2018 In accordance with the provisions of the Contract between the Owner and the Contractor as included above, the Hartford Fire Insurance Company One Hartford Plaza, Hartford, CT 06155-0001 (insert name and address of Surety) SURETY; on bond of Maker Bros., LLC _ -- -- - -- (lnsett name and address of Contractor) - — ---- 4901 Keller Springs, Suite101, Addison, TX 75001 _, 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 Mistletoe Station, LLC (insert name and address of Owner) 5501-A Balcones Drive, Suite 302, Austin, TX 78731 __— OWNER, as set forth in the said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: Marrth 7_,�,909 (Insert in wnting the month followed by the numeric date and year) Hartford Fire Insurance Company (S ty) „ Attest: (Seal): (Signatur4authori esentatitreL Amber Jones, Attorney-in-Fast (Printed name and title Printed in cooperation with the American Institute of Architects(AIA) The language in this document conforms exactly to the language used in AIA Document G707-Consent of Surety Company to-Final Payment 1994 Edition. �` Direct Inquiries/Claims to: THE HARTFORD POWER OF ATTORNEY Bond Hartford One Hartford Plaza Hartford,Connecticut 06155 call:888-266-3488 or fax:860-757-5835) KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code:46-508894 © Hartford Fire Insurance Company, a corporation duly organized under the laws ofthe State of Connecticut 0 Hartford Casualty Insurance Company,a corporation duly organized under the laws ofthe State of Indiana © Hartford Accident and Indemnity Company, a corporation duly organized under the laws ofthe State of Connecticut Hartford underwriters Insurance Company,a corporation duly organized under the laws ofthe State of Connecticut Twin City Fire Insurance Company, a corporation duly organized under the laws ofthe State of Indiana Hartford Insurance Company of Illinois,a corporation duly organized under the laws ofthe State of Illinois Hartford Insurance Company of the Midwest,a corporation duly organized under the laws ofthe State oflndiana Hartford Insurance Company of the Southeast,a corporation duly organized under the laws ofthe State of Florida having their home office in Hartford, Connecticut(hereinafter collectively referred to as the "Companies")do hereby make, constitute and appoint, up to the amount of Unlimited Julie Baumberger, Amber Jones, April Penny, Darrin J. Weber of DALLAS, Texas their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above,to sign its name as surety(ies)only as delineated above by®,and to execute,seal and acknowledge any and all bonds, undertakings, contracts and other written instruments 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, and as authorized by a Resolution of the Board of Directors of the Companies on August 1, 2009, the Companies have caused these presents to be signed by its Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. tri�>v '� atitrs,yr /i''co1,r.� �"•� Lee 7, a ��°�rrr�cA�, aaWl► L079 Yet W97 John Gray,Assistant Secretary M.Ross Fisher, Vice President STATE OF CONNECTICUT ss. Hartford COUNTY OF HARTFORD On this 12th day of July,2012, before me personally came M. Ross Fisher,to me known, who being by me duly sworn,did depose and say:that he resides in the County of Hartford, State of Connecticut:that he is the Vice President of the Companies,the corporations described in and which executed the above instrument;that he knows the seals of the said corporations;that the seals affixed to the said instrument are such corporate seals:that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority. �tx r•y / y4 Kathleen T.Maynard CERTIFICATE Notary Public My Commission Expires July 31.2U 16 I,the undersigned,Vice President of the Companies,DO HEREBY CERTIFY that the above and foregoing is a trt�t aM correct copy of the Power of Attorney executed by said Companies,which is still in full force effective as of March 23, 2020. Signed and sealed at the City of Hartford. _ `• -_ truer t�nrs r ��/yra•"icc ��AYr�i �� �:�tco..r.+rri f L 0 SI r •�/0�\71^ W�97 p79 �� �4 I97. _` • l- Kevin Heckman,Assistant Vice President POA 2012 THE Producer Compensation Notice MkTFORD You can review and obtain information on The Hartford's producer compensation practices at www.thehartford.com or at 1-800-592-5717 HR 00 H093 00 0207 ©2007, The Hartford Page 1 of 1 IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para presentar una queja: You may contact your Agent. Usted puede comunicarse con su Agente. You may call The Hartford's Consumer Affairs toll- Usted puede llamar at numero de telefono free telephone number for information or to make gratuito de The Hartford's Consumer Affairs a complaint at: para obtener informacion o para presentar una queja at: 1-800-451-6944 1-800-451-6944 You may contact the Texas Department of Usted puede comunicarse con el Departamento Insurance to obtain information on companies, de Seguros de Texas para obtener informacion coverages, rights, or complaints at: sobre companias, coberturas, derechos, o quejas at: 1-800-252-3439 1-800-252-3439 You may write the Texas Department of Insurance: Usted puede escribir at Departamento de Seguros de Texas a: P.O. Box 149104 P.O. Box 149104 Austin, TX 78714-9104 Austin, TX 78714-9104 Fax: (512) 490-1007 Fax: (512) 490-1007 Web: www.tdi.texas.go v Sitio web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.go v E-mail: ConsumerProtection@tdi.texas.Qov PREMIUM OR CLAIM DISPUTES: DISPUTAS POR PRIMAS DE SEGUROS 0 RECLAMACIONES: Should you have a dispute concerning your Si tiene una disputa relacionada con su prima premium or about a claim, you should contact the de seguro o con una reclamacion, usted debe (agent) (company) (agent or the company) first. If comunicarse con (el agente) (la compania) (el the dispute is not resolved, you may contact the agente o la compania) primero. Si la disputa no Texas Department of Insurance. es resuelta, usted puede comunicarse con el Departamento de Seguros de Texas. ATTACH THIS NOTICE TO YOUR POLICY: ADJUNTE ESTE AVISO A SU POLIZA: Este aviso This notice is for information only and does not es solamente para propositos informativos y no become a part or condition of the attached se convierte en parte o en condicion del document. documento adjunto. ®2018 by The HaMord Clessdication:Internally Controlled.All rights reserved No part of this document may be reproduced,pubkshed or used without the permission of The Hartford.