HomeMy WebLinkAboutContract 51536-R1FP1FORTWORTHo
TRANSPORTATIONAND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
CSC No. 51536-R1FP1
City Pzoject Ns: UC01-209.8
RegaYding contract 51536-R1 for UTILITY CUT REPAIR CONTRACT 2018 as required by the WATER
DEPARTMENT as approved by City Council on 11/6/2018 thYough M&C C-28921 the directox of the WATER
DEPARTMENT upon the recommendation of the Assistant DiYectoY of the T�anspoYtation & Public �Iorks
Depaxtment has accepted the pYoject as complete.
Original Contract Prices: $1,6�4,395.00
Amount of Approved Change Orders;
Revised Contract Amount:
Total Cost Worlc Completed:
Less Deductions:
Liquidated Damages:
Pavement Deficiencies:
Total Deduction Amount:
Ns
$1,674,395.00
Days @ $210.00/ Day
Total Cost Worlt Completed:
Less Previous �'ayments:
Final Payment Due
L�e� P�ceu�
Lauren Prieur;Mar22 202118:48 CD �
Recommended for Acceptance
Asst. Director, TPW - Capital Delivery
christo her Na��fer
������co�herh��� , ��,202106:46CDT)
Accepted
Director, WATERDEPARTMENT
Client Department
T c'�.r�� Uju�z�%�e�
or.�„c�rgi,dof°1n��rza,zo oasicoT�
Asst. City Manager
Comments:
$0.00
$0.00
$0.00
M a r 23, 2021
Date
Mar 23, 2021
Date
M a r 23, 2021
Date
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
�'o��r W���r�
CITY OF FORT WORTH
F1NAL PAYMENT REQUEST
Conti•act Name U'I'II-ITY CiJT REPAIR CONTRACT 2018
Conti•act Limits 1ST RENEWAL
ProjectType PAVING
City Project NumUers UCOI-2018
DO� Number 2018
Estimate Nuutber IS Payment Nuruber 15 Foi• Pe►•iod Ending 2/5/2021
CD
City Secretaiy Contract Number 51536-R1 Contract Time 36�D
Conh•act Date Days Charged to Date 365
Project Manager NA Contract is 44.000 Complete
Contractor WESTH]LL CONSTRUCTION, INC.
P.O. BOX 2016
CLEBURNE � TX 76031
Inspectors DICKINSON / WATSON
Tuesday, March 9, 2021 Page 1 of 6
CityProjectNumbers UCoI-201s
Contract Nan�e UTILITY CUT REPAIR CONTRACT 2018
Cmitract Limits IST RENEWAL
Project Type PAVING
Project Tunding
UNIT I: CUTS L�SS THAN 200 SQUARE IT
DO� Nmnber 2018
�stimate Number IS
PaymentNmnUer IS
i'or Period �nding 2/5/2021
Item �sHmated �stimated Completed Completed
DescripHon of Items Unit Uuit Cost
No. Quanity Total Quanity Tota►
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
1 3-incli Asp(�alt Pavement, Type D 4000 SY $36.00 £ 144,000.00 7.44 $267.84
2 3-inch Asphalt Base, Type B 1200 SY $10.00 � 12,000.00
3 9-inch Concrete Pavement 700 SY $90.00 $63,000.00 23 $2,070.00
4 11-inch Concrete Pavement 300 SY $99.00 $29,700.00
5 Min. 8-incli Concrete Base Material 3200 SY 545.00 $144,000.00 1333 $599.85
6 Min. 5-inch Reinforced Concrete Base 8U0 SY $63.00 SSQ400.00
7 BrickPavementRepair 150 SY $36.00 $5,400.00 50.83 $1,829.88
Sub-Total of P►•evious Unit $448,500.0o 54,767.57
UNIT II: CUTS GREAT�R THAN 200 BUT LTSS THAiV
Item Description of Items �stimated Unit Unit Cost �stimated Completed Completed
No. Quanity Total Quanity Totul
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
l 3-inch Asphalt Pavetnent, Type D 4000 SY $36.00 $144,000.00 459.23 � 1G,532.28
2 3-incli Asphalt Base, Type B 1200 SY $20.00 524,000.00
3 9-inch Concrete Pavement 700 SY $90.00 $63,000.00 278.89 $25,100.10
4 I 1-inch Concrete Pavement 300 SY $99.00 �29,700.00 222.44 $22,021.56
5 Min. 8-inch Concrete Base Material 3200 SY $90.00 £288,000.00 45235 $40,71 L50
6 Min. 5-inch Reinforced Concrete Base 800 SY $63.00 �50,400.00
7 BrickPavementRepair I50 SY $54.00 $8,100.00 L25.56 $6,780.24
Sub-Total of Previous Unit $6o7,zoo.00 �11t,145.68
UNIT III: CUTS GR�ATGR THAN 1000 SQ IT
Item DescripNon of Items �sHmated Uuit Unit Cost �stimated Cmupleted Completed
No. Quanity Totnl Quauit}� Total
---------------------------------------
1 3-inclt Asplialt Paveme�it, Type D 3000 SY $36.00 S 108,000.00 47G4.89 � 171,536.04
2 3-inch Asphalt Base, Type B 900 SY $ I2.00 $10,800.00
3 9-inch Coiicrete Pavement 700 SY $90.00 $63,000.00 453.61 $40,824.90
4 11-inch Concrete Pavement 300 SY $99.00 �29,700.00 286 $28,314.00
5 Min. 8-inch Concrete Base Material 2400 SY $72.OD S 172,800.00 1285.03 $92,522.16
6 Min. 5-inch Reinforced Concrete Base 600 SY $72.00 $43,200.00
7 Brick Pavement Repair I50 SY $45.00 $6,750.00
Tuesday, March 9, 2021 Page 2 of6
City Project Numbers UCO1-2018
Contract Nante UTILITY C[JT REPAIR CONTRACT 2018
Cmrtract Limits 1 ST RENEWAL
Pi•oject Type PAVING
Praject Funding
DOE Number 2018
�stimate Number 15
Payment Number 15
roi• Period �nding 2/5/2021
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
Sub-Total of Previous Unit $434,250.00 $333,197.10
UN1T IV: ALL CUTS ASPHALT W/O BAS� 12�GARDI.�
Item EsHmated Estimated Completed Completed
DescripNon of Items Unit Unit Cost
No. Quanity Total Quanity Total
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — -
I 3-inch Asphalt Pavemeul, Type D 2000 SY $27.00 $54,000.00
2 3-incli Aspl�alt Base, Type B 600 SY $10.00 $G,000.00
3 4-incL Aspl�alt Base, Type B 200 SY �27.00 $5,400.00
4 5-incliAsphaltBase,TypeB 200 SY $27.00 $5,400.00
5 6-inch Asphalt Base, Type B 200 SY $36.00 $7,200.00
Sub-Total of Previous Unit $78,000.00
UNIT V; ADDITIONAL 1'TGMS R�Q OTH�R THAN PA
Item Description oCItems �sHmated Unit Unit Cost �stimated Completed Completed
No, Quanity Totol Quanity Total
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — -
( 7-incli Concrete Curb and Guttcr 400 LF $35.00 $14,000,00 866 $30,310.00
2 7-inch Concrete Curb aud Gutter Attaclied to Concrele 400 LF $20.00 $8,000.00
Pavement
3 6-inch Reinforced Concrete Driveway 100 SF $10.00 $1,000.00 4928 �49,280.00
4 4-inch Reiuforced Concrete Drive�vay and Wlieelchair I50 SF $50.00 $7,500.00 88 $4,400.00
Ramp
5 Topsoil 50 CY $30.00 $1,500.00 46 $1,380.00
6 ManholeAdjustment,Minor 1 EA $500.00 $500.00
7 Miscellaneous St�vcture Adjustment, Valve Vault I EA $500.00 $500.00 2 $1,000.00
Adjustment
8 Imported Embedment / Backfill, Crushed Rock 50 CY $50.00 $2,500.00 4 $200.00
9 2-i��ch Asplialt Pavemeut, Type D, Parking Lot Repair 50 SY $63.00 $3,150.00
10 6-inch Lime Treatment 50 SY $19.00 $950.00
1 l 2-incli Asphalt Pavcment, Type D, Driveway Repair 50 SY $72.00 $3,600.00
12 4-incli Flexible Base, Tyye A, Grade l- Ciushed 75 SY $27.00 $2,025.00
Limesto��e
13 6-inci� Flexible Base, Type A, Grade 1- Cruslied 75 SY $36.00 $2,700.00
Limestone
14 Class'A' Concrete (3,000 #) 10 CY $200.00 $2,000.00
IS RepairStormDrainShuctures 5 CY $300.00 $1,500.00
16 Coucrete Manhole Collar 1 EA $300.00 $300.00
17 JointSealing-Silicone 200 LF $2.00 $400.00
Tuesday, Marcit 9, 2021 Page 3 of 6
City Project Numbers UCOI-201s
Contract Name i1TILITY CUT REPAtR CONTRACT 2018
Cmitract Limits IST RENEVVAL
Project Type PAVING
Project I'unding
18 Relocate Water Meter and Box
19 Water Meter Adjustment
20 Saw-cut Conerete Pavement
21 6-incl� Concrete Pavemeut, High Early Sh�engtl�
Concrete (HES)
DOE Numbei• 2018
Estimate NumUer IS
Payment Number 15
Fm• Period �nding 2/5/2021
1 EA $150.00 5150.00
1 EA $100.00 � 100.00
200 LF $3.00 5600.00
150 SY �108.00 �16,200.00
22 IltilityAdjushnenl 1 LS $1,000.00 $(,000.00
23 9-inch Concrete Valley Gutter, Resideutial 70 SY $99.00 �6,930.00
24 Raised Traffic Markeis, All Types 20 EA $10.00 $200.00 19 $190.00
25 Pavement Marking, All Types 100 LF $30.00 $3,000.00 2349 570,470.00
26 ConcreteRiprap 30 SY $54.00 $1,620.00
27 Medium Stone Riprap, Dry 60 SY $54.00 $3,240.00
28 Large Stone Riprap, Dry 60 SY $63.00 $3,780.00
29 Concrete Retaining Wall 20 CY $300.00 $6,000.00
30 St�eet Use Penuit 100 EA $100.00 $ I 0,000.00
3 I Traflic Conh�ol Plan Design and Install as Required 15 EA $100.00 $1,500,00
32 HAUL OFF OF ASPHALT 200 EA $100.00 �20,000.00 466.32 $46,632.00
G2 STAMP AND STAIN CONCRETE 549 SF $14.00 $7,686.00 549 $7,68G.00
33 12' CONCRETE INLET l EA $6,750.00 $6,750.00 1 $6,750.00
35 4" REINFORCED CONCRETE 20 SF $8.00 $160.00 752 $6,OI6.00
34 CRUSHED ROCK 8 CY �50.00 $400.00 8 $400.00
35 5" ASPHALT PAVEMENT TYPE D I l 1 l SY $60.00 SG6,660.00 l l 1 I $66,660.00
36 HAi7I,OFF 38.07 CY $100.00 $3,807.00 38.07 $3,807.00
37 3" MILL 4145 SY $5.00 $20,725.00 4145 $20,725.00
65 12' CONCRETE STORM DRAINAGE INLET 1 EA $6,750.00 $6,750.00 1 $6,750.00
G2 STAMP & STAIN CONCRETE 140 SF $14.00 $1,960.00 140 $1,960.00
GG 4" ItEINFORCED CONCRETE SIDEWALK 300 SF �8.00 $2,400.00 300 $2,400.00
G7 3"MILLING 4438.2G SF 55.00 �22,19130 4438.2G $22,19L30
Sub-Total of Previous Unit $265,93430 �349,20730
Tuesday, March 9, 2021 Page 4 of 6
City Project Numbers UCO1-2018
Contract Name UTILITY CUT REPA]R CONTfiACT 2018
Conh�act Limits IST RENEWAL
Project Type PAVING
Pi•oject Funding
DOE NumUei• 2�1g
�stimate Number 15
Payment Number 15
Toi• Period �nding 2/5/2021
Contract Information Surrunary
Original Contract Amount
$ I,674,395.00
Change Orders
3 - 9V 2 bz �
wuu ciui V
'/"L1G�� G�!s�Date y ����2 J
0
Ir,spe�tion Supei�isor �
/
4 - Date � << 2U2�
P� ect Manager �,
��
Liti.tNe� P�ieuN
IaurenVncur(Mar77,707178�.�8C�T) Date
Asst. DirectorlTPW
Ch✓istaphe✓ Harcler
�� � �,�������� � 3,:�,,;�;; :;��r� Date
Director / Contracting Depm�tment
Total Contract Price $1,833,88430
Total Cast of Woi•lc Completed $'798,317.65
Less % Retained �0.00
Net �arned $798,317.G5
Earned This Period 50.00
Retainage This Pe►�iod $0.00
Less Liquidated Damages
Days n / Day
LessPavement De�ciency
Less Penalty
Less Previous Payment
Plus Material ou Hand Less 15%
Balance Due This Payment
50.00
�o.00
$�.�0
$798,317.65
$0.00
$0.00
Tuesday, March 9, 2021 Page 5 of 6
City Project Numbers UCO1-2018
Contract Name UTILITY CiTI' REPAIR CONTRACT 2018
Contract Limits 1ST RENEWAL
Pi•oject Type PAVING
DOE NumUer 2018
�stimate Number 15
PaymentNumber IS
I'or Period �nding 2/5/2021
Project Tunding
Project Manager NA
Iiispectoi•s DICKINSON / 1VATSON
Contcactm• �STHILL CONSTRUCTION, INC.
P.O. BOX 2016
CLEBURNE� TX 76031
City Secretary Contract Nmnber 51536-R1
Cm►tract Date
Contract Time 365 CD
Days Charged to Date 365 CD
Contract is .000000 Complete
CITY OF FORT WORTH
SLTIvIlV1ARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
runded
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
Total Cost of Worlc Completed
Less % Retained
Net �arned
Ea►•ned Tliis Period $0.00
Retaivage This Period �0.00
Less Liquidated Damages
0 Days @ �0.00 / Day
LessPavement Deticiency
Less Penalty
Less Previous Payment
Plus Matei•ial on Hand Less 15%
Balance Due TJiis Paymeiit
$798,317.65
$0.00
$798,317.65
$0.00
$0.00
$0.00
$798,317.65
$0.00
$0.00
Tuesday, March 9, 2021 Page G of 6
FO RT �0 RT H rcv 03/OSl07
TRANSPORTATION & PUBLIC WORKS
FINAL STATEMENT OP CONTRACT TIME
FINAL STAT�MENT NO.;15
NAM� OT PRO,T�CT: Utility Cut Repair Conh•act 2018 lst Renewa]
PROJ�CT NO.: UCO1-2018 CONTIiACTOR: West Hill Conshuction
DOE NO.: NA
P�RIOD FROM:O1/06/20 TO: 02/OS/21 I'INAL INSP�CTION DATE: 26-Feb
WORK ORD�R EI'FECTIVG:1/6/2020 CONTRACT TIME: 365 O WD QQ CD
DAY OF DAYS R�ASON FOR DAYS DAY OF DAYS �ASON FOR DAYS
MONTH CHARGED CR�DITED MONTH CHARG�D CREDITED
DURING DURING
1. 16.
2. 17.
3, 1 S.
4. 19.
5. 20.
6. 21.
7. 22.
8, 23.
9. 24.
10. 25.
11. 26.
12. 27.
13. 28.
1 d. 29.
15. 30.
31.
SAT, SUN, RAIN, TOO W�T, UTILITI�S DAYS TOTAL
& HOLIDAYS & TOO COLD R�LOCATIONS OTN�RS '� CHARG�D DAYS
THIS � 0 0 0 0 0
P�RIOD
PR�VIOUS 0 0 0 0 36S 365
TOTALS IO 0 IO IO I365
TO DAT�
'`I2�MARKS;
�U �� F P � �b Z �.���.._ �•--� <� o� —� 6 07
�T DATE 1NSPECTOR DATE
ENGINEERING DEPARTI�LENT
� The City of Faxt ti��ortl� • 1000 Tliroclm�orton Street • I'ort �`Voith, Tl 7G012-6311
(817) 392 - 7941 • Fax: (II17) 392 - 7845
AFFIDAVIT
STATE 0 F TEXAS
COUNTY OF JOHNSON
Before me, the undersigned authority, a notary public in the state and county eforesaid,
on this day personally appeared Angela Reynolds, Secretary of Westhill Construction, Inc.,
known to me to be a credible person, who being by me duly sworn, upon her oath deposed and
said;
That all persons, firms, associations, corporations, or other organizations furnlshing
labor and/ar materials have been paid in full;
That the wage scale established by the City Council in the Cfty 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 Utility Cut Repalr Contract 2018 15t Renewal
gy
Angela Reynol s of Westhill struction, Inc.
Subscribed and sworn before me on this date 22"d day of January, 2021
%� ta✓r���c�i � —��"" ,,"
Notary Public ��
Johnson County, Texas
�^h��:;1;4 MARILYN K, NEWBY
��; ��4� NataryPublic
� ¢ � � i * STATG OP TEXAS
ti,���a ,�,}r" Notary ID 1d 11916fi9�9
'+u �e��` CW�YB. �7y. May 1B, 202A
����J �
=; Documen� G707T'A - �994
Consenf Of Surefy to Final Payment
Bond # 4423875-R1
PROJECT; (Nanie nnd nddress) ARCHITECT'S PROJECT NUMBER: OWNER; �
Ulility Cut Repafr Contract 2018
�irst Renewal CONTRACT FOR; General Constructlon ARCHITECT: �
City Project No. UC-0'I 201a
70 OWNER: (Nm»e a�+d addr•ess) CONTRACT DATED: CONTRACTOR: �
City of Fort Worth SURETY: �
1�00 Throcl<morton
Fort Worth, Texas 76102 OTHER: �
In accordance wilh the provisions of the Cont��uct between the Owner and the Cont��actor as indicated above, the
(Insert nnuie mid address of Sureh�)
Markel Insurance Company
4521 Highwood Parlcway
Glen Allen, VA 23060
on boud of
(Inserr name and address of Conrracloi )
Westhill Construction, Inc.
P.O. Box 2a� 6
Cleburne, Texas 76031
, SURflTY,
,CONTRACTOR,
hereby approves oFthe final payment to the Conh�actor, and agrees thatfinal paymen[ to the Conhactor shall not relieve lhe
Surety of any of its obligaGons to
(Insert name nnd nddress of Ownei)
city of Fort wo�tn
1000 Throckmorton
Fort Worth, Texas 76102
ns set foith in said Surety's bond.
, OWNL�R,
IN WITNESS WHEREOP, the Surety has liereunto set its hand on this date: February 24th, 2021
(Liser! in ivriling 11ie mo�dL foflowed Gy Oie u�nneric dale and year.)
Attest:
(Seal):
Markel Insurance Company
(S��refy)
(Signnlin•e of nulliori2ed re�resentntive)
Teresa Godsey, Attorney-In-Fact
(Printed name nnd tide)
AIA Docwnenl G707T�� —1994. Copyrlght O 1902 and 1994 by The Amedcan Inslllute ol Archltocts. All Nghls reserved. WAHNING: Thls AIA� Documenl
Is prolecled by U.S. Copyrl�ht Law nnd InlernaUonnl Treatles. Unnulhorizod reproducllon ordlslri�ullon of lhis AIA° Documenl, or any porllon ol II,
may tesull In severe clvll and ctlminal penalUos, and wlll be proseculed to Ihe maximum exlent posslble under Ihe law. Thls documentwas produced
by AIA solltvare el 15:OA:Od on 02/09/2009 under OrdeY No.100037A64G_i �vfdch explres on 1 0/1 312 0 0 9, end Is not lor resale.
User Noles: (1 •152131059)
. ' � • . : - . • . . • Pon.ir: 4423875-R'I
� � � � � Markel lnsuran�e Company � .
' � � . .' � � LIMI7EQ POWER QF ATTORIVEY •
: Know All Men hyJ�ese Presents, 7hat MARKELJtJ�URANCE COMPANY (tfie "Compan�'), a corporation dulyorganized and existing under the laws di the Stat@ of
Illinols, and having Its principal admiri(strative of(Ice In. Glen Allen, Virpinia, does by these prese'nts rriake, constltute an� appolnf
� � Teresa Godsey � � � � .
Its true and lawFul Attorney-ln-facf, wlth full potver and authority hereby con(erred in its name; place and �tead, td execute, acknowledge and.deilver any a�d all .
.� bonds, recognizances, undertakings oi other instruments or contracts of suretyship:to Include waivers to the condltlons of contract's and consents of surety for,
.•provid(ng the bond penalty does not exceed - • • �
� • Prn,�ipai: • Westhill Construction, Inc. • � � �.
.. . � -obllgee: 'Cit�7 of Folt Worth, Texas • . . � � , .
� - Amouncs: $'SeJeii �Hundred Ninety-Eight Thousand Three Hundred Seventeen and 65/100 Dollars ($798,317:65)
and to bind the tompany therebyas fully and to the Same extent as If such bond were slgned by the Presldent, sealed with the corporat�seal of the Company and .
�•;dulyattested by its Secretary, hereby ratifying and conflrming all that tiie sald Attorney-In,-Fact may do In the premises, Sald appointment Is made under and by
authoriry of the following resolution of the Board of Directors ot Markel Insurance Contpany:
• RESOLV.ED, that the Presldent, any Senlor Vlce PreSident, V.Ice President, Asslstant Vice President, Secretary, Asslstant Secretary or Assistant
•• Treasurer shall he and is hereby, vested•with full;pdwer and authority to appbirlt any one.or more su(fable persons as •Attorney(s)-I�i-Fact to �
� represent and act'for on behalf oY the Company, su6)ect'to tli� Following-provistops: ' � �
Att6rney-in-Fact may 6e given"full power and authoriry for and in the namQ of and on Uehalf oF Ihe Company, to execute, acknowledge end. ,.
� ' delfver, any and all bonds, recognizances, con[racts, agreemenu�or indemnit'y and other conditional or obligatory ondertakings and any and all �
' noticesanddocumentscancel(ngorterminatingtlieCompan�slla6111tythereunder,andanysachlnsCrumentssoexecuted6yanysuchAttomey- �
�. Jn-Factshall be binding upon the Company as If slBned by the Pre's)dent and:sealed and effected tiy the•Secr,etdry• . , .
FUR7HERRESOLVED,thattheslgnatureo(anyauthorizeddfffc�randsealoftheCorrlpanyhefetofore:orhereakeraffixedtoanypowerofattorney '
.'. ''or any certiflca[e felating thereto by facsirrille, and any potv�r of attbrney orcertlflcate bearing,fa�csimile signature ariacslmlle seal'shall be valid '
• ,and 6lnding.upon the Comp'any p�ith respect.tu any bond or und'ettaking to whish k Is attached. . '
In'WltngssWhereof,MARKELINSURANC�COMPhNYhascausedthesepresentsto6eslgiieiltylts5enior�/IcePresldent,andltscorporatesealtobehereto ' •
afflxed this24th �day oF FebrualV ; 20' 21.. , � � . . . , • -
. � . • . , • . MARKEUINSU CE OMPANY �
. . . . r._.;....
CommonwealthofVirglnla . . � ... � � , ey: �'`F' y ��� ' .
Henrlto County . . . , ' • . � • flohl Russo,• enlorVlce Presldent• • �
on thts 24ih day of Feb�UB,ry �., 20 2'I before me persbnally,came RdBin Russoi to'me known, wha heing by me dulysworn, did depose.and say that he resides .
.in Henrito County, Virginla, the he.is Senior Vlce P�esldent of MARKEL INSURANCE COtv1PANY, the company descrlbed In and.tvhich executed tlie above instr�ment; ' .
�• that he knows the seal of sa18 Company;_ tl�af•tlie seal afflxed to said instrument Is such colporate seal; that It Was so AHixed by or.der•oFthe ooard of �Irectors of said
'• Company; and that he signed his name th�reto'6y like order. •• . • " � ' .
� (1�} ^ ���t-��'���" � .
• . _`=O1Fpr1?Up�•. VLtSEs.y l ' • �.�. �/!'�'�(..
a�untt By. , G � �'
. , � ; '�� �''��` : Nolory Pu�llc, sia�e ol taxas � . . � � J !
• =#i �*'-' NolaryliJll122�J13�0 CaseyGauntt,NotaryPublic' •
, ' . ' , ; i; , ,�ti.",�l I,ty Oomnllssla� 6xp'uos - .. . .
. . • . . "F,°%,;,., March �0 2q21 ' � . . ' . . .
'' I; Richaril R. Grinnan, Vice Presldent and Setretary�of MARKEL INSURANCE'COMPANY, do hereby certify that the ahove and foregoing Is true and correct c4py of a • ,
• Power of Attorney, executed by said'Company, which Is stlll in full'iorce and effect; and, furtliermore, the resolutions oF tlie Board of �.Irectors, set oubin•the Power� '
of Attomey are (n full force aiid effect. � � . . ' ' , ' , _ .
Gfven under my hand'and'the seal of sald�Company at Glen AJIeh, Vlrginla this . day b( •'. 20 ��_. � ••
; � � . � . � : � � . � � . - ay: ��G,�.,.�Q ,'�.�-�.___.�- � � . .
' , ' • . • � . , ftichard�R. Grinnan, • .
. • • ; UlcePreSldentand5ecretary
Ahy instrument Issued In exces's of the penaltys.tated ahove Is totall� vold and wlthout any valldity: " • ••
, For veriFleatlon of the authority of thls Pov,rer yau may.call �713) £312•0800 on any business ilay between 8:30 AM and 5:OD PM CST. , '
Markel Insurrance Company
THiS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATI�N
Statutory Compla[nt Notice
To obtain information or make a complaint: You may call the Sureiy's toll free telephone number for information or to
mal<e a complaint at:1-866-732-0099. You may also write to the Surety at:
Markel Insurance Company
9737 Great Hills Trail, Suite 320
� Austin, TX 78759
Non-Texas Rider 010106