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Contract 52136-FP1
�-N lI (n� _., CSC No.52136-FP1 ��) /V 0) 'Ar TRANSPORTATION AND PUBLIC WORDS NOTICE OF PROJECT COMPLETION City Project Ns: 101663 Regarding contract 52136 for BRIDGE REHABILITATION AT FOUR LOCATIONS (2018-2) as required by the TRANSPORTATION&PUBLIC WORDS as approved by City Council on 3/19/2019 through M&C C-29058 the director of the TRANSPORTATION&PUBLIC WORDS upon the recommendation of the Assistant Director of the Transportation&Public`works Department has accepted the project as complete. Original Contract Prices: $468,060.00 Amount of Approved Change Orders: Ns Revised Contract Amount: Total Cost Work Completed: $448,130.00 Less Deductions: Liquidated Damages: Days @$210.00/Day Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: $448,130.00 Less Previous Payments: $425,723.50 Final Payment Due $22,406.50 .LlLLG1.2JL'1014¢r.�2 Aug 10,2020 Lauren Prieur(Aug 10,202010:36 CDT) Recommended for Acceptance Date Asst. Director, TPW.- Capital Delivery Aug 19,2020 Accepted Date Director, TRANSPORTATION & PUBLIC WORKS Client Department #q aujd �z Aug 20,2020 Dana Burghdoff(A 20,202 :38 CDT) Asst, City Manager Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX 0 c to 0 z z fD O C7 ° rrr 2 w y C) G N 8 'wJ'. WONo of OH a °n Oil n otoo � ® n rn ° rn o p Oig EL A9 cl. N IQ y CD ti °cw w vID 00 3 0 ° r -gtJ c o. . m C w - P.co G .• �1 0 O. c 0 & o oZ o F. p N rn o rn ww � tU 7 C b DD 1 O� Vt P W N r+ 'P 00 o m A o a 13 cl o 0 to w tf N n a 77 n n' x k y Cy 7y 5 CD N w rn H a tQ 7. 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O N N O 00 Q w W N N O O p O > O 00 (D Q O` H r�- - __ O :37 N ! ) o � C 03 y3 � v 0 �b w C) - v � (D W N O R° O (n{ O � O O O Efl � � O O r+ O J W b 0 XT. y o in N w CD CN z d o o .. 0 0 �l W o, A � O O FORTWORTH rev 03/05/07 TRANSPORTATION & PUBLIC WORKS FINAL STATEMENT OF CONTRACT TIME FINAL STATEMENT NO.:1 NAME OF PROJECT: Bridge Rehab Four Location(White Settlement&Western Center) PROJECT NO.: 101663 CONTRACTOR: Gibson&Assoc. DOE NO.: N/A PERIOD FROM:12/16/19 TO: 06/19/20 FINAL INSPECTION DATE: June 29th 2020 WORK ORDER EFFECTIVE:10/1/2019 CONTRACT TIME: 150 O WD O CD DAY OF DAYS REASON FOR DAYS DAY OF DAYS REASON FOR DAYS MONTH CHARGED CREDITED MONTH CHARGED CREDITED DURING DURING 1. 16. 2. 17. 3. 18. 4. 19. 5. 20. 6. 21. 7. 22. 8. 23. 9. 24. 10. 25. 11. 26. 12. 27. 13. 28. 14. 29. 15. 30. 31. SAT,SUN, RAIN,TOO WET, UTILITIES OTHERS DAYS TOTAL & HOLIDAYS &TOO COLD RELOCATIONS CHARGED DAYS THIS PERIOD PREVIOUS PERIOD TOTALS 148 148 TO DATE *REMARKS: C TRACTOR DATE INSPECTOR DATE ENGINEERING DEPARTI\IENT (D The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817) 392-7941 •Fax: (817)392-7845 AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersigned authority, a notary public in the state and coanty aforesaid, on this day personally appeared Alan C. Meador, III, Vice President Of Gibson & Associates, Inc., 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; I On Contract described as; Bridge Rehabilitation at Four Locations (2018-2) BY Alan C. Meador, III Subscribed and sworn before me on this date 29th of July, 2020. Notary Public Dallas, Texas ;'c�;PY P�6: PAM N DAVI S <�Notary Public,State of Texas F �+Q Comm.Expires 03-30-2021 Notary ID 233117-2 4'&cQ CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ Conforms with the American Institute of OTHER Architects,AIA Document G707 Bond No 82521360 PROJECT: (name, T: SS)Bridge Rehabilitation at Four Locations Fort Worth,TX TO (Owner) City Project No. ARCHITECT'S PROJECT NO: 101663 CITY OF FORT WORTH CONTRACT FOR: 1000 Throckmorton Street Bridge Rehabilitation at Four Locations(2018-2) Fort Worth TX 76102 --J CONTRACT DATE: 3/19/2019 CONTRACTOR: GIBSON 8,ASSOCIATES, INC. 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) FEDERAL INSURANCE COMPANY 202B Hall's Mill Road Whitehouse Station NJ 08889 , SURETY COMPANY on bond of (here insert name and address of Contractor) GIBSON &ASSOCIATES, INC. P.O. Box 800579 Balch Springs TX 75180-0579 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that 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 1000 Throckmorton Street Fort Worth TX 76102 , OWNER, as set forth in the said Surety Company's bond, IN WITNESS,WHEREOF, the Surety Company has hereunto set its hand this 29th day of July,2020 FEDERAL INSURANCE COMPANY Surety Company / Attest: Z Gi e- (Seal): Signature of Authorized Representative Robbi Morales Attorney-in-Fact Title NOTE; This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE CHUBB ' Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Rnow All by These Presents,That FEDERAL INSURANCE COMPANY,an Indiana corporation,VIGILANT INSURANCE COMPANY,a New York corporation,and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Don E. Cornell, Sophinie Hunter, Tina McEwan, Robbi Morales, Tonle Petranek,Ricardo J.Reyna,Joshua Saunders and Kelly A.Westbrook of Dallas,Texas;Steven Dwain Brockinton of Little Rock,Arkansas----------- eachas their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise,bonds and undertakings and other writings obligatory 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 alteration of any instrument referred to in said bonds or obligations. In Witness Whereof,said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 201`day of March,2019. 'bCA9-a-S�r.-�'�6l• �St1�l�..� -'� Rtwn M. slephen M.I l:mcy.Vice PrhidenI (00 STATE OF NEW JERSEY County of Hunterdon SS' On this 201"day of March,2019,before me,a Notary Public of New Jersey,personally came Dawn M.Chloros,to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY,the companies which executed the foregoing Power of Attorney,and the said Dawn M. Chloros,being by me duly sworn,did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies;and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority;and that she is acquainted with Stephen M. Haney,and knows him to be Vice President of said Companies;and that the signature of Stephen M.Haney,subscribed to said Power of Attorney is in the genuine handwriting of Stephen M.Haney,and was thereto subscribed by authority of said Companies and in deponent's presence. Notarial Seal c ROSE CURTIS t PUBUC 7 400 JERSEY uo��� No.50072�00 a CommbSm EOn No ero0er 22,2o22 t\otari.Public CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY on August 30,2016: "RESOLVED,that the following authorizations relate to the execution,for and on behalf of the Company,of bonds,undertakings,recognizances,contracts and other written commitments of the Company entered into in the ordinary course ofbusiness(each a"Written Commitment'): (1) Each of the Chairman,the President and the Vim Presidents of the Company is hereby authorized to execute any written Commitment for and on behalf of the Company,under the seal of the Company or otherwise. (2) Each duly appointed attorney-in-fact of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company,under the seat of the Company or otherwise,to the extent that such action is authorized by the grant of powers provided for in such persons written appointment as such attorney-in-fact. (3) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized,for and on behalf of the Company,to appoint in writing any person the attorney- in-fact of the Company with full power and authority to execute,for and on behalf of the Company,under the seal of the Company or otherwise,such Written Commitments of the Company as may be specified in such written appointment,which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized,for and on behalf of the Company,to delegate in writing to any other officer of the Company the authority to execute,for and on behalf of the Company,under the Company's seal or otherwise,such Written Commitments of the Company as are specified in such written delegation,which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution,and the seal of the Company,may be affixed by facsimile on such Written Commitment or written appointment or delegation. FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of officers,employees and other persons to as for and on behalf of the Company,and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested." 1,Dawn M.Chloros,Assistant Secretary of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY(the"Companies")do hereby certify that (I) the foregoing Resolutions adopted by the Board of Directors of the Companies are true,correct and in full force and effect, (ff) the foregoing Power of Attorney is true,correct and in full force and effect. Given under my hand and seals of said Companies at Whitehouse Station,�U,this July 29, 2020 _ [krvm\I.Chlorcn.:\NsisL•mt sccrdat•? IN THE EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER,PLEASE CONTACT US AT: Telephone(908)903-3493 Fax(908)903-3656 e-mail:surety@chubb.com FED-VIG-PI(rev.08-18)