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Home My WebLink AboutContract 53724-FP1 City Secretary 53724 -FP1 Contract No. FORTWORTH., Date Received Dec 8,2020 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: ALTAMESA BLVD TURN LANE IMPROVEMENTS City Project No.: 102259 Improvement Type(s): ® Paving ❑ Drainage ® Street Lights ❑ Traffic Signals Original Contract Price: $149,065.71 Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: $149,065.71 7" vMeC'er*wv-e- Dec 7 2020 Tim McLemore(Dec 7,202015:36 CST) f Contractor Date project Manager Title Pavecon LTD Company Name C"�� Dec 7,2020 Project Inspeptor Date Mitch Holmes(Dec 7,202019:43 CST) Dec 7 f2020 Project Manager Date 464yl2 zolkI J' Dec 8 2020 '-au He Lewis(Dec 8,2020 09:04 CST) f CFA Manager Date 044,0t,aa"A&J7 E Dec 8 2020 Dana Burghdoff( c8,202 9:05CST) f Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 1 of 2 Notice of Project Completion Project Name:ALTAMESA BLVD TURN LANE IMPROVEMENTS City Project No.: 102259 City's Attachments Final Pay Estimate Change Order(s): ❑ Yes ® N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety £- Statement of Contract Time Contract Time: 60 CD Days Charged: 60 Work Start Date: 6/1/2020 Work Complete Date: 11/4/2020 Completed number of Soil Lab Test: 33 Completed number of Water Test: 0 Page 2of2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name ALTAMESA BLVD TURN LANE IMPROVEMENTS Contract Limits Project Type PAVING&ST LIGHT City Project Numbers 102259 DOE Number 2259 Estimate Number 1 Payment Number 1 For Period Ending 12/7/2020 WD City Secretary Contract Number Contract Time 69M Contract Date Days Charged to Date 60 Project Manager NA Contract is 100.00 Complete Contractor PAVE CON,INC. 3022 ROY ORR GRAND PRAIRIE, TX 75050 Inspectors OWEN / HORTON Monday,December 7,2020 Page 1 of 4 City Project Numbers 102259 DOE Number 2259 Contract Name ALTAMESA BLVD TURN LANE IMPROVEMENTS Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING&ST LIGHT For Period Ending 12/7/2020 Project Funding PAVING Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 REMOVE CONCRETE SIDEWALK 1188 SF $1.33 $1,580.04 1188 $1,580.04 2 REMOVE CONCRETE PAVEMENT 94 SY $20.32 $1,910.08 94 $1,910.08 3 UNCLASSIFIED EXCAVATION BY PLAN 355 CY $42.25 $14,998.75 355 $14,998.75 4 4"CONCRETE SIDEWALK 993 SF $8.71 $8,649.03 993 $8,649.03 5 11"CONCRETE STREET PAVEMENT 535 SY $126.80 $67,838.00 535 $67,838.00 6 TYPE P-2 BARRIER FREE RAMP 1 EA $688.00 $688.00 1 $688.00 7 TOPSOIL 122 CY $53.93 $6,579.46 122 $6,579.46 8 BLOCK SOD PLACEMENT 243 SY $10.48 $2,546.64 243 $2,546.64 9 SEEDING,HYDROMULCH 764 SY $1.37 $1,046.68 764 $1,046.68 10 TRAFFIC CONTROL 1 LS $16,994.00 $16,994.00 1 $16,994.00 11 SAWCUT CONCRETE FULL DEPTH 467 LF $4.98 $2,325.66 467 $2,325.66 12 EROSION CONTROL 1 LS $5,935.00 $5,935.00 1 $5,935.00 13 6"MONOLITHIC CONCRETE CURB 456 LF $6.39 $2,913.84 456 $2,913.84 14 WHITE REFLECTIVE TRAFFIC BUTTON TYPE II- 95 EA $9.23 $876.85 95 $876.85 4 15 LONGITUDINAL CONSTRUCTION JOINT 467 LF $4.51 $2,106.17 467 $2,106.17 16 EXPANSION JOINT 50 LF $16.72 $836.00 50 $836.00 17 RELOCATE SIGN 1 EA $274.35 $274.35 1 $274.35 18 TEMPORARY 6FT CHAIN LINK FENCE AT 346 LF $3.36 $1,162.56 346 $1,162.56 STAGING AREA -------------------------------------- Sub-Total of Previous Unit $139,261.11 $139,261.11 ST LIGHT Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 2"CONDUIT PVC SCH 80 190 LF $10.00 $1,900.00 190 $1,900.00 2 REPLACE ALUM QUAD INSULATED ELECTRIC 190 LF $36.34 $6,904.60 190 $6,904.60 CONDUCTOR 3 RE-CONNECT TO EXISTING LIGHT POLE& 2 EA $500.00 $1,000.00 2 $1,000.00 TEST -------------------------------------- Sub-Total of Previous Unit $9,804.60 $9,804.60 -------------------------------------- Monday,December 7,2020 Page 2 of 4 City Project Numbers 102259 DOE Number 2259 Contract Name ALTAMESA BLVD TURN LANE IMPROVEMENTS Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING&ST LIGHT For Period Ending 12/7/2020 Project Funding Contract Information Summary Original Contract Amount $149,065.71 Change Orders Total Contract Price $149,065.71 Total Cost of Work Completed $149,065.71 Less %Retained $0.00 Net Earned $149,065.71 Earned This Period $149,065.71 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 $149,065.71 Monday,December 7,2020 Page 3 of 4 City Project Numbers 102259 DOE Number 2259 Contract Name ALTAMESA BLVD TURN LANE IMPROVEMENTS Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING&ST LIGHT For Period Ending 12/7/2020 Project Funding Project Manager NA City Secretary Contract Number Inspectors OWEN / HORTON Contract Date Contractor PAVE CON,INC. Contract Time 60 WD 3022 ROY ORR Days Charged to Date 60 WD GRAND PRAIRIE, TX 75050 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 $149,065.71 Less %Retained $0.00 Net Earned $149,065.71 Earned This Period $149,065.71 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 $149,065.71 Monday,December 7,2020 Page 4 of 4 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS November 9, 2020 Pavecon, LTD. 3022 Roy Orr Blvd Grand Prairie,TX 75050 RE: Acceptance Letter Project Name:Altamesa Turn Lane Improvements Project Type: Developer City Project No.: 102259 To Whom It May Concern: On November 9, 2020 a final inspection was made on the subject project. There were no punch list items identified at that time. The final inspection indicates that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on November 9, 2020,which is the date of the final inspection 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 817- 392-6826. Sincerely, hz&11101 Mitch Holmes(Dec 7,202019:43 CST) Mitchell Holmes, P.E., Project Manager Cc: Cody Horton, Inspector Mark Owen, Inspection Supervisor Edwin Rodriguez,Senior Inspector Victor V.Tornero,Jr., P.E., Program Manager Cates-Clark, Consultant Pavecon, LTD., Contractor Dirk Branch, LP, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev.08/20/19 v � �. Document G706T" - 1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT:(dNr�#tte c�nd airldress� ARCHITECT'S PROJECT NUMBER: 102259 OWNER:❑ Altamesa Blv urn .anc mpreiv menu 5943 Dirks Road City of Fort Worth ARCHITECT:❑ Ft.Worth Tx 76132 CONTRACT FOR: Tarrant County,Tx CONTRACTOR:❑ TO OWNER:(Name and address) CONTRACT DATED: 05/05/2020 SURETY:❑ City of Fort Worth OTHER:❑ Tarrant County Texas 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: None SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR:Pavecon, Ltd. Co. 1. Consent of Surety to Final Payment. Whenever 3022 Roy Orr Blvd. Surety is involved,Consent of Surety is Grand Prairie,TX 75050 required. AIA Document G707,Consent of Surety,may be used for this purpose Indicate Attachment ❑ Yes ❑ No BY: The following supporting documents should be attached 7377gnSture 4f authorized representative) hereto if required by the Owner: / /0,(.W "'V . akT OC6,K 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: 1 2�07 120 Subcontractors and material and equipment suppliers,to the extent required by the Owner, \ accompanied by a list thereof. [l_ Notary Public: L3� 3. Contractor's Affidavit of Release of Liens My Commissio : 01- 22- Za14 (AIA Document G706A). `ptY►�r +��or;*, a'•y POOJA BABj r Notary Public, State.*A4Comm.Expires 01-2'� Notary 10 132322 AIA Document G706TM—1994.Copyright 01962 and 1994 by The American Institute of Architects. All rights reserved. WARNING:This Ale Document Is protected by U.S.Copyright low and International Treaties.Unauthorized reproduction or distribution of this A10 Document,or any 1 portion of It,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law. Usei Notes: (109979064) Bond No. 30074261 CONSENT OF SURETY OWNER c TO FINAL PAYMENT ARCHITECT El AIA Docu?nent G707 CONTRACTOR ❑ St'RF.TY ❑ (Instructions on reverse side) OTHER ❑ TO OWNER: City of Fort Worth, ARCHITECT'S PROJECT NO.: 102259 (.vain and adrlrra�) ty Tarrant County Texas CONTRACT FOR: City of Fort Wort Tarrant County Texas PROJECT: Altamesa Blvd.Turn Lane Improvements CONTRACT DATED: 0 510 512 02 0 Ove"lleandaelkl . 5943 Dirks Road Ft. Worth,TX 76132 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated ahoVe,the (rn*n rrame and addrmv rI/.tiumn l Continental Casualty Company 151 North Franklin,Chicago, IL 60606 SURETY, on bond of (!alert name ultd addrmA of Contractor) Pavecon, LTD. 3022 Roy Orr Blvd. Grand Prairie,TX 75050 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 Un. n name and ar&irrwl4(kmer) City of Fort Worth, Tarrant County, Texas OWNER, asset forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date:December 7, 2020 dawrt in u riling rix nrurtlh fallow cYl he die nunrc ric date(rlrri tvxrr.) Continental Casualty Company (.tirrreh r rSii;nalrnx r(Jardhorized rxpa.ntrrlit�) Attest: ��c.- v� Patricia Ann Lyttle, Attorney-in-Fact (Sea]): -- J ry'rinler!urruw crud riNe) E CAUTION: You should sign an original AIA document that has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced. See Instruction Sheet for Limited License for Reproduction of this document. AIA WGUMENT G?W•CONSFNI'OF 5URM TO FINAL PAYMFIYI'•I'M EDMON•'AIA 0199-,•n4E AMP.RICA.V INS nTV'7?OF ARCHMECTS,1-31,NF.W'YORK AVF.NI'F,WC,VL'ASl l- INGTO;-,1).C.20006-5292 •WARNING:Unlicensed photocopying violetas U.S.copy- G707-1 994 right laws and will sutl M the violator to legal prasetaitlon. POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents,That Continental Casualty Company,an Illinois insurance company,National Fire Insurance Company of Hartford,an Illinois insurance company,and American Casualty Company of Reading.Pennsylvania,a Pennsylvania insurance company(herein called "the CNA Companies"),are duly organized and existing insurance companies having their principal offices in the City of Chicago,and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make,constitute and appoint Gary W Wheatley,Bryan K Moore,Clark D Fresher,Betty J Reeh, Individually,of San Antonio,TX Michael D Hendrickson,Patricia Ann Lyttle, Individually,of Addison,TX their true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on their behalf bonds, undertakings and other obligatory instruments of similar nature - In Unlimited Amounts- and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney,pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law and Resolutions,printed on the reverse hereof.,duly adopted,as indicated,by the Boards of Directors of the insurance companies. In Witness Whereof;the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto affixed on this 21 st day of April.2020. (`,ASf! �pv <rj 1NSUR4rc� „s,OA' Continental Casualty Company National Fire Insurance Company of Hartford coaPopArF ./ C= 'm 4RP aRaTfa American Ca Ity Company of Re ing, Pennsylvania SEAL �2 JULY 31. 190! x r tegl Ham ° a �.. State of South Dakota,County of Minnehaha,ss: Paul T.Bruflat cc President On this 21 st day of April,2020,before me personally came Paul T.Bruflat to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls.State of South Dakota:that he is a Vice President of Continental Casualty Company,an Illinois insurance company, National Fire Insurance Company of Hartford,an Illinois insurance company,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company described in and which executed the above instrument;that he knows the seals of said insurance companies;that the seals affixed to the said instrument are such corporate seals;that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said insurance companies. ------------ [arwJ.MOHR NDTAgY W riLIC[,�G�� 90M DAQTA My Commission Expires June 23,2021 J. Mohr Notary Public CERTIFICATE I,D.Johnson,Assistant Secretary of Continental Casualty Company,an Illinois insurance company.National Fire Insurance Company of Hartford. an Illinois insurance company,and American Casualty Company of Reading,Pennsylvania,a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force,and further certify that the By-Law and Resolution of the Board of Directors of the insurance companies printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance companies this tl\,day of ,�'yf'�` ts tN51JJiV Continental Casualty Company h+ National Fire Insurance Company of Hartford co+ ,xu °f"D1urio American Casualty Company of Reading,Pennsylvania SEAL _ JULY 31, • t 1902 Vogl HARZF • O;V_V�� Form F6853-412012 D.Johnson PAssistant Secretary Go to www.cnasurety.com>Owner/Obligee Services>Validate Bond Coverage,if you want to verify bond authenticity. Authorizing By-Laws and Resolutions ADOPTED BY THE BOARD OF DIRECTORS OF CONTINENTAL CASUALTY COMPANY: This Power of Attorney is made and executed pursuant to and by authority of the follow ing resolution duly adopted by the Board of Directors of the Company at a meeting held on May 12. 1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents. agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents,agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary ofthe Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T. Bruflat.Vice President,who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of Continental Casualty Company. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 25"day of April.2012: "Whereas.the bylaws of the Company or specific resolution ofthe Board of Directors has authorized various officers(the"Authorized Officers"Ito execute various policies.bonds.undertakings and other obligatory instruments of like nature;and Whereas,from time to time,the signature ofthe Authorized Officers,in addition to being provided in original,hard copy format,may be provided via facsimile or otherwise in an electronic format(collectively,"Electronic Signatures");Now therefore be it resolved:that the Electronic Signature of any Authorized Officer shall be valid and binding on the Company." ADOPTED BY THE BOARD OF DIRECTORS OF NATIONAL FIRE INSURANCE COMPANY OF HARTFORD: This Power of Attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the Board of Directors of the Company by unanimous written consent dated May 10,1995: "RESOLVED: That any Senior or Group Vier, President may authorize an officer to sign specific documents. agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents,agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary of the Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T.Bruflat.Vice President,who has been authorized pursuant to the above resolution to execute power of attorneys on behalf of National Fire Insurance Company of Hartford. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 25"day ofAprii.2012: "Whereas,the bylaws ofthe Company or specific resolution ofthe Board of Directors has authorized various officers(the"Authorized Officers")to execute various policies,bonds,undertakings and other obligatory instruments of like nature;and Whereas,from time to time,the signature of the Authorized Officers,in addition to being provided in original,hard copy format,may be provided via facsimile or otherwise in an electronic format(collectively,"Electronic Signatures");Now therefore be it resolved:that the Electronic Signature of any Authorized Officer shall be valid and binding on the Company." ADOPTED BY THE.BOARD OF DIRECTORS OF AMERICAN CASUALTY COMPANY OF READING,PENNSYLVANIA: This Power of Attorney is made and executed pursuant to and by authority ofthe following resolution duly adopted by the Board of Directors of the Company by unanimous written consent dated May 10,1995: "RESOLVED: That any Senior or Group Vice President may authorize an officer to sign specific documents, agreements and instruments on behalf of the Company provided that the name of such authorized officer and a description of the documents,agreements or instruments that such officer may sign will be provided in writing by the Senior or Group Vice President to the Secretary-of the Company prior to such execution becoming effective." This Power of Attorney is signed by Paul T.Bruflat.Vice President,who has been authorized pursuant to the above resolution to execute power of attorneys on bebalf of American Casualty Company of Reading,Pennsylvania. This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company by unanimous written consent dated the 25"day ofAprii.2012: "Whereas,the bylaws ofthe Company or specific resolution ofthe Board of Directors has authorized various officers(the"Authorized Officers")to execute various policies.bonds,undertakings and other obligatory instruments of like nature:and Whereas,from time to time,the signature of the Authorized Officers,in addition to being provided in original,hard copy format,may be provided via facsimile or otherwise in an electronic format(collectively."Electronic Signatures"),Now therefore be it resolved:that the Electronic Signature of any Authorized Officer shall be valid and binding on the Company." State of Texas Claim Notice Endorsement To be attached to and form a part of Bond No. 30074261 In accordance with Section 2253.021(f) of the Texas Government Code and Section 53,202(6) of the Texas Property Code any notice of claim to the named surety under this bond(s) should be sent to: CNA Surety 151 North Franklin, 17th Floor Chicago, IL 60606 Telephone: 1-877-672-6115 Form F6844-6.2018 Figure: 28 TAC §1.601(a)(3) 1 IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para someter una queja: 2 You may contact Continental Casualty Company, Puede comunicarse con Continental Casualty National Fire Insurance Company of Hartford, Company, National Fire Insurance Company de American Casualty Company of Reading, PA and Hartford, American Casualty Company de Reading, PA Continental Insurance Company at 312-822-5000. y Continental Insurance Company al 312-822-5000. 3 You may call Continental Casualty Company, Usted puede Ilamar al numero de telefono gratis de National Fire Insurance Company of Hartford, Continental Casualty Company, National Fire American Casualty Company of Reading, PA and Insurance Company de Hartford, American Casualty Continental Insurance Company's toll-free telephone Company de Reading, PA y Continental Insurance number for information or to make a complaint at: Company's para informacion o para someter una queja al: 1-877-672-6115 1-877-672-6115 4 You may also write to Continental Casualty Usted tambien puede escribir a Continental Casualty Company, National Fire Insurance Company of Company, National Fire Insurance Company de Hartford, American Casualty Company of Reading, Hartford, American Casualty Company de Reading, PA and Continental Insurance Company at: PA y Continental Insurance Company: CNA Surety CNA Surety 151 North Franklin, 17th Floor 151 North Franklin, 17th Floor Chicago, IL 60606 Chicago, IL 60606 5 You may contact the Texas Department of Puede comunicarse con el Departamento de Seguros Insurance to obtain information on companies, de Texas para obtener informacion acerca de coverages, rights or complaints at: companias, coberturas, derechos o quejas al: 1-800-252-3439 1-800-252-3439 6 You may write the Texas Department of Puede escribir al Departamento de Seguros de Insurance: Texas: 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.gov Web: www.tdi.texas.gov E-Mail: ConsumerProtection@tdi.texas.gov E-Mail: ConsumerProtection@tdi.texas.gov 7 PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your Si tiene una disputa concerniente a su prima o a premium or about a claim you should contact un reclamo, debe comunicarse con el Continental Continental Casualty Company, National Fire Casualty Company, National Fire Insurance Insurance Company of Hartford, American Casualty Company de Hartford, American Casualty Company Company of Reading, PA and Continental Insurance de Reading, PA y Continental Insurance Company Company first. If the dispute is not resolved, you primero. Si no se resuelve la disputa, puede may contact the Texas Department of Insurance. entonces comunicarse con el departamento (TDI). 8 ATTACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA: Este aviso es This notice is for information only and does not solo para proposito de informacion y no se become a part or condition of the attached convierte en parte o condition del documento document. adjunto. Form F8277-6-2018