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Contract 51200-FP1
FORTWORTH. CSC No.51200-FP1 TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION City Project Ne: 100733 Regarding contract 51200 for CAMPBELL STREET as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 08/07/2018 through M&C C-28771 the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of the Assistant Director of the Transportation&Public Works Department has accepted the project as complete. Original Contract Prices: $1,306,909.48 Amount of Approved Change Orders: $16,543.95 Ns 1 Revised Contract Amount: $1,323,453.43 Total Cost Work Completed: $1,113,453.27 Less Deductions: Liquidated Damages: Days @$650.00/Day Pavement Deficiencies: Total Deduction Amount: $0.00 Total Cost Work Completed: $1,113,453.27 Less Previous Payments: $1,057,780.61 Final Payment Due $55,672.66 Lauren Prieur Jul 14,2020 Lauren Prieur(Jul 14,202011:20 CDT) Recommended for Acceptance Date Asst. Director, TPW - Capital Delivery �' Jul 14,2020 Accepted Date Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Client Department z?a'V'tz' Jul 14,2020 Dana Burghdaff(Jul 14,20 4:46 CD Asst. City Manager Date Comments: FORT WORTH(n) TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME STATEMENT# FINAL STATEMENT# 15 Final CPN# 1 100733 NAME OF PROJECT: Campbell Street Contractor JLB Contracting YEAR:j 2020 PROJECT NO.: FINAL INSPECTION DATE 11/5/2019 NIA I CD CONTRACT TIME 309 1 x PERIOD FROM: 1 5/1/2020 TO: 1 5/30/2020 1 Month CITY" Be of Month End of Month -f WORK ORDER EFFECTIVE: 10/8/2018 BEG n/a MID n/a 100.0% LIP YR /n DAY OF MONTH DAYS REASON FOR DAY OF MONTH DAYS REASON FOR CHARGED DAYS CREDITED CHARGED DAYS CREDITED 1 Fri 1 16 Sat 1 2 Sat 1 17 Sun 1 3 Sun 1 18 Mon 1 4 Mon 1 19 Tue 1 5 Tue 1 20 Wed 1 6 Wed 1 21 Thu 1 7 Thu 1 22 Fri 1 8 Fri 1 23 Sat 1 9 Sat 1 24 Sun 1 10 Sun 1 25 Mon 1 11 Mon 1 26 Tue 1 12 Tue 1 27 Wed 1 13 Wed 1 28 Thu 1 14 Thu 1 29 Fri 1 15 Fri 1 30 Sat 1 31 Sun 1 NA Wkn&Hol Wea Uti Oth a=add Not Applicable SAT,SUN,and WEATHER UTILITIES OTHERS DAYS TOTAL DAYS HOLIDAYS RELOCATE CHARGED THIS PERIOD 0 0 0 0 31 31 PREVIOUS PERIOD 0 278 278 TOTAL TO DATE 0 0 0 0 309 309 REN,IARKS: Campbell Street: Complete. TDLR Inspection 09/03/19. TDLR Punch List Completed 11/13/2019. Work Order Start Date: 10/08/2018. Final Inspection held: 11/05/19. Punch List Completed: 12/17/2019. Time used 100% t,JS iLL(1 �OQ"�'p�L�C, Y�i ` � �ll)�V D T E: Signature: Signature: h (Print Name) I/Q �o INSP�CTO ype Name) Edward CONTRACTOR 7A DATE INSPECTOR DATE 9 �(� N a m c m in N 7 N N b VN 00 M 'o M ^� 6g 69 69 b9 b9 6N9 � 69 bA 69 69 N9 69 b9 b9 69 69 69 o •o u 44 v .Y nn o •o c eaa A Q A � 'O O O Q U bs u F U CL W v� ca w � a u¢¢ ° o c aJ- O E u W j A o U o Z U U h z Z a Z U o O Z U F a. a d a Q w N z O O rTl p Q O b tC CA C ci O O O ,7.. ti p O O Fil l " P4a�3ERoo� � _ @ a� o o .o a a, 'o F US �y-- p ❑❑❑ R.td y.0 O O 0 O W U M o o U U Q a aR c c C ❑❑ X N N 13 T O C O a w L O o'C y F � q is .D ti aCi N �r o u vi o n 00 O O o c a o v d s� 'o "o i.i O N u ubo � a o°°o" -" ftl�p_3 "b❑❑ cw° �'!� M C d .-. M 7 O .'-". 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(n D o c o o o o F Cl) Cl) M M M Cl) M M co co M M 'IT 'V 'ITt't V' 'V 'V V O O O O CD CD O O O O O O Cl) O O O O O CD CD O O Co O CDCO r N N (O r N N .r N CA�,. O O O O O O O O O O O O U 0 0 0 0 O O O O O O O O j O O c- '7 0 0 V' 0 0 d' (O (OOO (O (O O O) (0 (OOO (n LO M M 0 0 0 0 0 0 0 (n (n M M 0 0 0 0 0 0 0 LO 4) M M 0 0 0 0 0 0 0 AFFIDAVIT STATE OF Texas COUNTY OF Tarrant Before me,the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Pedro Alonso, Project Manager Of Texas Bit,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; Campbell St. From Crenshaw ave . to Avenue J BY Pedro Alonso /Project Manager Subscribed and sworn before me on this date 02 of March, 2020. ,;'P�.,,� MARY LOVELESS �=Notary Public,State of Texas Comm.Expires 03-27-2023 �9 •..• F� Notary ubliC Notary ID 130169690 County, State 'DaRa,&' -T-�aJ s CONSENT OF OWNER ❑ SURETY COMPANY CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT G707) Bond No. 9848074 PROJECT: Campbell Street, City Project No. 100733 (name,address) Fort Worth,TX TO (Owner) ARCHITECTS PROJECT NO: F City of Fort Worth CONTRACT FOR: 200 Texas Street Fort Worth,TX 76102 CONTRACT DATE: August 7,2018 CONTRACTOR: JLB Contracting,LLC In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the(here insert name and address of Surety Company) Westfield Insurance Company 555 Republic Drive,Suite 450 ,SURETY COMPANY, Plano,TX 75074 on bond of(here insert name and address of Contractor) JLB Contracting,LLC P.O.Box 24131 ,CONTRACTOR, Fort Worth,TX 76124 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 ,OWNER, Fort Worth,TX 76102 as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, The Surety Company has hereunto set its hand this 17th day of March 2020 WESTFIELD I URANCE COMPANY i Surety Comp B Signature of Authorized Representative Attest: (Seal): Kyle W.Sweeney Attorney—in—Fact Title SV RA V, Note:This form is intended to be used as a companion document to the Contractor's Affidavit of Paymenti jr9bts and Claims,Cel Edition c� THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARINU I HIZS JAML POWER#AND ISSUED PRIOR TO 04120/11, FOR ANY PERSON OR PERSONS NAMED BELOW. POWER NO, 4220052 06 General Westfield Insurance Co. Power of Attorney Westfield National Insurance Co. Ohio Farmers Insurance Co. CERTIFIED COPY 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 p4cipal office in Westfield Center, Medina County, Ohio, do 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 Attorney(s)-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 duly 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 OHIO FARMERS INSURANCE COMPANY: 'Be 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 Attorneys)-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 Attorney-in-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 adopted 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 rp•e.�UFIAr.,, ,�\ONAC/'. NSUq�'�., WESTFIELD INSURANCE COMPANY Seals trQ�,.•••••. Cep ,* �sP.•• ' !1'SG, ••••=�!�=� WESTFIELD NATIONAL INSURANCE COMPANY Affixed �v: .a. .•:ip ;=o 9: ``4 ,• ••<'' OHIO FARMERS INSURANCE COMPANY 4 e SEA •b cc~n, SEAL ;m_ So: �aE •""".•••,1113 By State of Ohio L. Kinnaird, Jr., National Surety Leader and Y County of Medina ss.: Senior Executive On this 20th day of APRIL A.D.,2011 , 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 Exectftive of WESTFIELD INSURANCE COMPANY,WESTFIELD NATIONAL INSURANCE COMPANY and OHIO 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 .. „„•,.:..««,.», Seal el �\A L S � Affixed O.....I�%9 • William J. Kahelin,A rney at Law, Notary Public State of Ohio My Commission Does Not Expire(Sec.147.03 Ohio Revised Code) County of Medina ss.: 4 �od�, ti� OE I,Frank A.Carrino,Secretary of 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 Attor ey are in full force and effect. 7 fn Wit ess Whereof I have hereunto set my hand and affixed the seals of said Co F(r Iual//Ai) stfield Center, Ohio, this ! of AD C\DNA( r�., r ��SVR��,4 �� •• a •.� Sri (1 Tt A S. :9Z _�vv�,�{�RiFR •.E�� ��. �O' I ~i '� N: A. 1 m- "o• :s= N i Secretary ' q%• .,.. ,FN� ., ?p s3:,•1848 ; _ FranYrarri�n seorgt y 4)''1/1101111111111111\\0�`` BPOAC2 (combined) (06-02) FORTWORTH. TRANSPORTATION AND PUBLIC WORKS June 26, 2020 JLB Contracting P.O. Box 24131 Fort Worth,Texas 76124 RE: Acceptance Letter Project Name: Campbell Street Project Type: Paving City Project No.: 100733 To Whom It May Concern: On November 5, 2019 a final inspection was made on the subject project. There were punch list items identified at that time. The punch list items were completed on December 17, 2019. The final inspection and the corrected punch list items indicate that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on December 17, 2019, which is the date of the punch list completion and will extend of two (2)years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at(682) 774-3210. Sincerely, Maged Zaki, Project Manager Cc: Edward D'avila, Inspector Ron Cordova, Inspection Supervisor Edward D'avila, Senior Inspector Mary Hanna, Program Manager MV Engineering, Consultant JLB Contracting, Contractor N/A, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev.8/20/19 \ § � ) ! ) ) ` ) \// Q ^� , !! At >~ \\ ,! || � - \ ` i! d § . _ ) = w © ]\\! ) - : A - -- # } .�_, & i! §! ; / ! 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