HomeMy WebLinkAboutContract 53804-FP1FORTWORTHo
TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
City Secretary No:_53804 -FP1
Date Received: �un 7, 2o2i
City Project Ns: 102031,102032,102033
Regarding contract 53804 for ARCADIA TRAIL PARK PLAYGROUND REPLACEMENTS as required by the
PARK & RECREA TION DEPARTMENT as approved by City Council on 2/18/2020 thYough M&C 20-0103 the
director of the PARK & RECREA TION DEPAR TMEN T upon the recommendation of the Assistant Director of
the Transpoxtation & Public Works Depaxtment has accepted the pxoject as complete.
Original Contract Prices:
Amount of Approved Change Orders:
Revised Contract Amount:
Total Cost Worlc Completed:
Less Deductions:
Liquidated Damages:
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Worlc Completed:
Less Previous Payments:
Final Payment Due
�����
David Creek (Jun 4, 2021 0926 CDT)
Recommended forAcceptance
Asst. Director, PARK & RECREATION
DEPARTMENT
�%GLI�G�ZGIVGi�Gi
Richard Zavala jJun 4, 202110:46 CDTj
Accepted
Director, PARK & RECREATION
DEPARTMENT Client
Department
V� � �li,�
ar W !aw
Asst. City Manager
Comments:
$567,289.24
$23,169.42 Ns ]
$590,458.66
$590,458.66
Days @ $650.00/ Day
$590,458.66
$560,935.73
$29,522.93
Jun 4, 2021
Date
J u n 4, 2021
Date
J u n 5, 2021
Date
OFFICIAL REC�RD
CITY SECRETARY
FT. VIIORTH, TX
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FORT��RTH�
TRANSPORTATION AND PUBLIC WORKS
April 15, 2021
L J Design & Construction
6548 Peden Road
Fort Worth, Tx 76179
RE: Acceptance Letter
Project Name: Arcadia Trail Park Plav�round Replacements
Project Type: Parks
City Project No.: 102031, 102032, 102033
To Whom It May Concern:
On October 23, 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 October 23, 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-
392-5967.
Sincerely,
.�,�..d-.���.i...�...�
patrick vlcknair (Jun 3, 202ll6:06 CDT)
Patrick Vicknair, Project Manager
Cc: Daniel Roy, Inspector
Wade Miller, Inspection Supervisor
Manny Nieto, Senior Inspector
Scott Pen, Program Manager
N/A, Consultant
Brian Smith, L J Design & Construction , Contractor
N/A, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Ir"� Before & After Pictures
Rev. 08/20/19
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Praject Arcadaia Trail Park Piayground Replacements
1ob No. � 02031, 102032, 102033
On recei�t by the signer of this document of a check from Ci of Fort Worth (maker of
checfc) in tf�e sum oF $ 29,5223.92 payable to �. �1. Design & Construction, ��C {payee or payees of
checEc) and when the cliec�C has been properly endorsed and has been paid by the bank on which
it is drawn, this document becomes effective to release any mecl�anic's lien ri�ht, any right
arEsing from a payment band that complies with a state ar Federal statute, any cot�mon law
payment bond righi, any ciaim for payment, and any rights under any similar ordinanc�, rule, or
statute related to ciaim or payment rights for persons in the signer's position that the signer has
on the properly of City of Fort Worth (owner} located at Arcadia Trail Park
(lacation) to the following extent: Plav rn��nri ReniacemPnts(]�b description).
This release covers the final payment to the signer for all labor, services, equipment, or
materials furnished to the property or to City of Fort Worth (person with whom signer
contracted).
Before any recipient of this document relies on this document, the recipient shauld verify
evidence oFpayment to the signer.
The signer warrants that the si�ner has a�ready paid ar will use the t�unds received fram
this final paym�nt to promptly pay in full all of the signer's laborers, subcontractors,
materialmen, and suppliers far alf wark, materials, equipr�ent, or services provided far or to the
above referenced project up to the date of this waiver and release.
Date March 5, 2021
��1
L. ]. esi n, nstructinn, LLC {Cornpany name)
By / c� ' (Signature)
Co- anger (Title)
STATE OF TEXAS
COLINTY OF Tarrant
This i�strument was acknowledged befare me an this 5th day of March , 20 21 , by
Gre WooIse (name), Co-Mana�;er (job title) of
L. J. Dcsign & Construction> LLC (�ompany name).
���`'nYP''�, SUSAN J. BOdYCpMB
� ti? L9 .
;z°��� {�=n�Nos-�ry P��blic, 5[ate o# Texas
�4r,v�'.;�e� Comm, Expires 05-31-2022
��'n°i„�'� Nvtary I� 5829785
� ' t-r �
NOT�RY Pll LIC, STF1 E OF TEXAS
Document G70 6
Co��rac�oz�'s ?�ffidav� �� o.�.� .����e�� af Deb�s and C1a.i�s
PROJECT: (Name und address} ARCMITECT'S RROJ�CT [�UMBER: OWN�R: ❑
Arcadia Trails Park Playgrounds 14203 �, 142032, 102033 ARCHITECi: ❑
Replacements CONTRAC�OR: ❑
CONTRACT FOR: #53804 SURETY: ❑
TO OWNER: (Name and addi•ess) CONTRACT DAT�D: April 22, 2020 OTHER: ❑
City a#� Fort Worth
Q2QQ S �'reeway, Sui�e 2200
Fort Wortli, TX 76115
STATE OF: Texas
COUNTY OF: Tarrant
The undersigned hereby certifies that, exc�pt as listed belo�a�, payment has been �nade in full and all obligations liave
otherwise been satisf ied for ail materials and equipment f�rnished, for aiE work, labor, and services performed, and
for all knawn indebtedness and claims a�ainst ihe Cantractor for damages arising in any manner in conneciion with
the performance of tl�e Contract referenced abo�e for �vhich the Owner or Owner's property mi;ht in any way be
held responsible or encumbered.
EXCEPTIONS:
SUPPORTING DOCUMENTS A'�"f'ACH�D HERETC}:
1. Conser�t of Surety to Final Payment. Whenever
Surety is involved, Consent o1� Surety is
required. Document G707, ConsenE of Surety,
may be used for this purpose
Indicate Attachment � Yes ❑ No
The foIlowing supporting documenls should 6e atlached
hereln if r�equired by �he (hvrrer:
Contractor's Release or Waiv�r of Liens,
conditional upon receipt of �inal payme�t.
CONTRACTOR: (Name and address)
L. ,1. Desi�n & Construction, LLC
6548 Peden Rd
Fort Wor�h, X 76179
� '
BY:
(Srgr� ture of au orized represerrtalive)
Gre� Woolsey, Co-Manager
(Printed ncr»re arrd litle)
2. Separate Releases or Waivers of Liens from
Subcontractors and materia! and equiprnent
suppliers, to the extent required by the Owner,
accompanied by a list tl�ereof.
3. Contractor's Affidavit of Release of Liens
(Docume�[ G706A).
Subscribed and swo►-n to befare �ne on this date: ��r�
C�1 � �L-. � �.��c'�r-•b
Notary Public:
My Commission Expires: May 31, 2022
"""' SUSA�! J. BODYCONi6
� �SPRY PU�%.
d .
=r°;•�' �_ Notary Public, 5tate ai 7axas
'�,�..�"�,.: "` Com
�yl,. , }e� m, Expires 05-31-2�22
��''i°;,;ti`�` Notary Ip 5829785
����������� ����i�
Contractor's Affidavit Qf l4elease of Lier�s
PROJECT: (Nanae and crcldr•ess)
Arcadia Trai[ Park Playground
Replacements
TO dWNER: (Na�ne und address)
Ciry of Fort Worth Paric & Recreatio��
Department
4200 S rreeway, 5uite 2200
Fort Worth, TX 751 15
ARCNITECT'S P�OJECT NIJM�ER:
102031,102032,102033
C4NTRACT FaR: #53804
CO[�TRACT QATED: Apri! 22, 202Q
QWNER: ❑
ARCHITECT: ❑
C4N7RAC70�: ❑
SIJRETY: ❑
OTHER: ❑
STATE OF: Te�as
COLINTY QF: `f'arrant
Thc undersigned hereby certifies that to the best of the undersigned`s knawledge, information and bekief, except as
]zsted below, Ehe Releases or Waivers oF Lien attached hereto include the Contractor, a�l SubcantracEars, all suppliers
of materials and eq�tipment, and ali perfonn�rs of Work, labor or services who l�ave or rriay have li�ns or
enc�mbrances or the ri��t to assert liens or encumbrances against any prop�rty of the Owner arising in any manner
out of thc performance of the Contract referenced abo�e.
EXCEPTIONS:
SUPPORTING DOCUMENTS ATTAC�-l�D HERETO:
1. Contractor's Re[ease or Waiver of �iens,
conditional upon receipt of fina] payment.
2. Separate Releases or Wai�ers of Liens from
Subcontractors and materia! and equipment
stippliers, to the extent required by the O�vner,
accom�anied by a list tiiereof.
CONTRACTOR: (Name and address)
L. ]. Design & CoRstruction, �.LC
6548 Peden Etd; F rt orth, X 76179
� �
BY:
(Si a rre af a2rth rzed
repi•esentalive) '
GreQ Woolse , Co-Mana er
(Prinled nume and tille)
Subscribed and sworn to before me on this date: •� �� ��
Nota Puvlic: �; ���, U ��`? � � `��
rY �
My Conunission Expires: May 31, 2022
.�`'Rrp''�� SUSAN J. $ODYCOMB
� SP,.., U!j i
3z°;'-� �p{� �� nx No;ary Publ��, Sta,e of Texas
;��.� �;y,P� Comm. Expires D5-3t-2022
'�„°;,,.�` Notary iD 5$29785
1
CONSENT OF
SURETY C4MPANY
TO FZNAL PAYMENT
.4I�1 DOCUMENT G707
�WI�l�R x
ARCI�1[TL-CT 0
CON7'RACfOR ❑
SURETY �
o-rnC=.rz ❑ Bond # 4436274
PROJECT: Arcadia Trail Park - Playground Replacemenfs, Forth Worth, TX
(name, address}
TQ (Owner) City of Fort Worth ARCI-IITECT'S PROTECT NO: 102031,102032,102033
100fl Throckmorton CONTRACT FOR:
FT. Worth, TX CONTRACT DATE: 2/181202Q
76102
CONTIZACTOR: L.J. Design & Constructivn LLC
In accordance with the provisions of tlle Coiltract between tlle �wner and the Cantracfior as indicated above, the
(here inscrt name uid addr�ss of Suret�� Company)
SureTec Insurance Company
2103 CityWest Slvd., Suitc 1300
Houstan, TX 77042
on bond of
(hcre inscrl name �ind address otCnntractor)
L.J. Design & Constraction LLC
9176 Hyde Rd.
Fort Worth, TX 76179
,SURETY COMPANY,
.CONTRACTOR,
hereby appraves of the final payment to the Contractor, and agrees that final payrrtent to the Contractor shall
not rel�eve the Surery company of any of its obligations to
{hcre insert name and address of C�Fvncr)
City of Fort Worth
IOOfl Tlirockmortori, FT. Worth, TX 76102
,OWNER,
as set i'orth in tlie said Surety Company's bond
IN WITNESS WHEROF,
The Surety Company has hereunto set its hand this ?5t1� day of' Feb�•uary, 2021.
SureTec Insurance Campany
Ailest
(scal):
Surery Comg��n}
Si iatur f Authorized Rcprescnt�uive
lerem r Bamett, !1[tornc��-in-F<ict
Titic
NOTE:: This foan is io he tiscd ;is a comp;miun ducuincnt to AiA DOCUMEi�'7' G70G, CU�ITRAC"fQR'S AI�FIDAVI"f OP PA5'MLN I' OF DEt31 AA:I) CI.AS�15,
Cwrcm Edfuon
r11A UOCU\IF,IV'1' G7117 " CONSI:NT OF' SUREZ'Y COMPANY TO I�iNAL l'A1`MENI''APRIL 1910 EDI"fION'A1A
I97ff i'HE Ah1ERICAI�f INST[TU'I�E OF ARCfi]7E?CTS, 1735 ivE1l' YOfLfL AVE. �fW WASH[NG7'ON, D.C, 200G
WARNING: Unlicensed photoeopying violates U.S. copyright laws and is subject to legal prosecution.
POA#1 a221049
10INT LIMITED POWER OF ATTDRNEY
KNOW ALL MEN 8Y THESE PRESENTS: That SureTec Insurance Cornpany, a Corporatioo duty organfzed and existing under the laws of the State of Texas and having its
principal of�ce in the County of Harri;, Texas and Markel lnsurance Company (the'Compan�'f, a corporation duly organized and existing under the laws of the state
of Illirtois, and having its principal administrative offlce fn Gfen A[fen, �rginia, does by these presenu ma&e, canstitute and appoint:
Tony Fierro, Jay Jo�dan, Johrtn.y Mloss, Steven W. Searcey, Robert J. Shuya, Mistle Beck,
Jeremy Barnett, Robert G. Kanuth, Jade Porter, Jennffer Cisneros, Jamett Willson, Jack Nottingham
Their true and lawful agent(s) and attarney(s)-In-fact, each fn thetr separate capacity if more than one is named abave, to make, execute, seai and defiver for and on
their own behalf, individualtyas a surety or jolntly, as co-suretiPs, and as their ad and deed any and al{ bonds and other undertaking in suretyship provided; however,
that the penal wm oE any one such Instrument executed hereunder shall not exceed the sum of:
Twenty Million and 00/100 Dollars ($20,000,000.00)
This Power of Attemey is granted and is signed and sealed under aad by the authority of the following Resolutions adopted by the Soard of Directo�s of SureTec
Insurance Company and Markel Insurance Company:
"RESOLVfD, That the President, Senior Vice President, Vice Presldent, Assisca�t Yce President, Secretary, Treasurer and each of them hereby is authorized to execute
powers of attomey, and such autho�ity wn be executed by use of facsimtle signatu�e, wh[ch may be attested ar acknowtedged•by aay of8cer or attomey, of the
compa�y, qualtfying the attorney or attomeys �amed in the gtven power of attorney, to execute in behalf oi, and acknowledge as the act and deed ot the SureTec
Insurance Company and Markel Insurance Company, as the case may be, a(I bond unde�takings and contracts of suretyship, and to affix the corporate seal thereto."
fN WITNESS WHEREOF, Markel Insurance Company a�d SureTec tnsurance Gompany have caused thelr offtctal seal to be hereunto affixed and these presents to be
signed by thef� duiy authorized officers on the �nn day of ravemeer � zo�o ,
SureTec Insurance Company
ey: �Michael C. Keimig, President
Commonwealth of �rgEnia
County of Henrico S5:
�yv„�veF
�u�X '9 ��
6�W �
�s �y 1 5 �
...*.�•r
�����V ��CF�i, Markel I�sur ce Company
�� �<P�d`�"'`.�:°o= �.,�1
_Y � �G1L �'D_ ��/�i 1��..._-
�� �:�; gy� ��
'� ��'`��' ��` R tn Russo, Senior �ce Pres3dertt
,''����f f I�11���,`,``
On this t� day of Nwemou. mx A, 0., before me, a Notary Pubtic of the Commo�wealth af Virginia, in and for the County of Henrico, d�ly commissioned and
quafified, came THE ABOVE OFFICERS Qf THE COMPANIES, to me personally known to be the indlviduals and oNicers descrtbed tn, wha executed the precedtng
instrurtent, and they acknowledged the execution ef same, and heing by me duly sworn, disposed and sald that they are the officers af the sald companies atoresaid,
and that the seals afflxed.to the proceedtng inswment are the Corporote Seals of said Companies, and the said Corporate Seals and their sfgnatures as efficen were
duly affixed and subscrihed to the said instrument by the autharity aad diredion of the said cort�panies, and that Resolutions adopted by the Board of Dlrectors of
said Campanies referred to in the precedtng Instrument Is now tn force. �� �������� i r,��
,.,� P o on,,Q �•,,
IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed m�b�� �(�� p e t���Iv�:Flenrico, the day and year first above written.
� v
; Q::��C ���.�� � .
: � MY �' : B � �� �"
� � COAAMISSION . � y; ��
2 �,� NU�dBf�R ; Q: Danna 4onavant, Notary Pubtic
. � t 7083968 � � ;
; �0.��. �..\�V,� My commission expires 1/31/2023
We, the undersigned OffTcers of SureTec Insurance Cornpany and Marke�'�s�fi�tC�o���fiy �q�ierby certifythat the original POWER OF A'fTORNEY of which the
foregoirtg is a full, true and correct copy is stiit in full force and effect and halt�qt�t�a��r� �gyotc4d.
IN WITNESS WHEREOF, we have hereunto set our hands, ar+d affixed the Seals of satd Companies, o� che 25fh day of February 2021
Su eclnsu ce pan
By
M. Br t Beary, Assistant Secreta
„ • •.
Markel losurance Company �". .� • �= �'y
'-1 _ .� � � • �- �
By; ��. � , � -.
Richard R. Grin�an, Vice Presid'ent art � ary t� ; _
_ ��✓ ; f. 1 `a � -
Any Instrument Issued In excess of the penalry stated a6ove Is totally vold and without any valldity. 4221049
for veriftcatlon of the suthorEty of this Power you may p11 �713}812-0500 on any buslness day hetween 8:30 AM and 5:00 PM CST.
.� • �
_ - w��
. iti� ,``�'��
- - �,
F�RT W�RTH�
December 15, 2020
Greg Woolsey, Co-Manager
L..f. Design and Construction, LLC
6548 Peden Ro�td
Fort Wor�h, TX 76179
RE: Final Acceptance
Project Name: Arcadia Trails Park i'lay�rouncE Replacements
City Praject No. ] 02031,102432,102033
O�� October 23, 2019 a final inspection was made of tl�is project. There were punch list items identified at
that time and the puncl� list items were completed on Novemher 6, 2019. The fi��al inspection and the
completed punch list items indicate the work meeis th� City of Fort Worth conErac� documents and is
therefare accepted by the City. The warranty peE•iod will begin on Navecnber 6, 2019 and will extend for
two {2) years in accordance with the conCract documents.
If you have any questions concerning this let#er of final aceeptance, piease do not hesitate to contact �ne at
(G82) 225-6819.
Sincerely.
��-� t/u:.��.
Patrick Vicknair, Project Manager
Paric & Recreatior� Departr�ent
c: 1oe] McEll�any, PARD, Capital Projects Mana�er
Scott Penn, PARD, District Superintende�lt
Le��vis Gregory, TPW, Construction Superintendent
Daniel Roy, TPW, Project Inspectar
Adriar� Za�ala, MIWB�, Sr. Contract Compliance S�ecialist
Project File
PARK AND RECREATION p�PARTMENT
Thc Caty oTFnrt Wurt�i "` 42U0 South I'rceway, 5uilc 220U * Furt Worth, Tcs.ts 7G] 15-Id99
R17-392-PARK • Fax R17-392-57Z4
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Praject Arcadaia Trail Park Piayground Replacements
1ob No. � 02031, 102032, 102033
On recei�t by the signer of this document of a check from Ci of Fort Worth (maker of
checfc) in tf�e sum oF $ 29,5223.92 payable to �. �1. Design & Construction, ��C {payee or payees of
checEc) and when the cliec�C has been properly endorsed and has been paid by the bank on which
it is drawn, this document becomes effective to release any mecl�anic's lien ri�ht, any right
arEsing from a payment band that complies with a state ar Federal statute, any cot�mon law
payment bond righi, any ciaim for payment, and any rights under any similar ordinanc�, rule, or
statute related to ciaim or payment rights for persons in the signer's position that the signer has
on the properly of City of Fort Worth (owner} located at Arcadia Trail Park
(lacation) to the following extent: Plav rn��nri ReniacemPnts(]�b description).
This release covers the final payment to the signer for all labor, services, equipment, or
materials furnished to the property or to City of Fort Worth (person with whom signer
contracted).
Before any recipient of this document relies on this document, the recipient shauld verify
evidence oFpayment to the signer.
The signer warrants that the si�ner has a�ready paid ar will use the t�unds received fram
this final paym�nt to promptly pay in full all of the signer's laborers, subcontractors,
materialmen, and suppliers far alf wark, materials, equipr�ent, or services provided far or to the
above referenced project up to the date of this waiver and release.
Date March 5, 2021
��1
L. ]. esi n, nstructinn, LLC {Cornpany name)
By / c� ' (Signature)
Co- anger (Title)
STATE OF TEXAS
COLINTY OF Tarrant
This i�strument was acknowledged befare me an this 5th day of March , 20 21 , by
Gre WooIse (name), Co-Mana�;er (job title) of
L. J. Dcsign & Construction> LLC (�ompany name).
���`'nYP''�, SUSAN J. BOdYCpMB
� ti? L9 .
;z°��� {�=n�Nos-�ry P��blic, 5[ate o# Texas
�4r,v�'.;�e� Comm, Expires 05-31-2022
��'n°i„�'� Nvtary I� 5829785
� ' t-r �
NOT�RY Pll LIC, STF1 E OF TEXAS
Document G70 6
Co��rac�oz�'s ?�ffidav� �� o.�.� .����e�� af Deb�s and C1a.i�s
PROJECT: (Name und address} ARCMITECT'S RROJ�CT [�UMBER: OWN�R: ❑
Arcadia Trails Park Playgrounds 14203 �, 142032, 102033 ARCHITECi: ❑
Replacements CONTRAC�OR: ❑
CONTRACT FOR: #53804 SURETY: ❑
TO OWNER: (Name and addi•ess) CONTRACT DAT�D: April 22, 2020 OTHER: ❑
City a#� Fort Worth
Q2QQ S �'reeway, Sui�e 2200
Fort Wortli, TX 76115
STATE OF: Texas
COUNTY OF: Tarrant
The undersigned hereby certifies that, exc�pt as listed belo�a�, payment has been �nade in full and all obligations liave
otherwise been satisf ied for ail materials and equipment f�rnished, for aiE work, labor, and services performed, and
for all knawn indebtedness and claims a�ainst ihe Cantractor for damages arising in any manner in conneciion with
the performance of tl�e Contract referenced abo�e for �vhich the Owner or Owner's property mi;ht in any way be
held responsible or encumbered.
EXCEPTIONS:
SUPPORTING DOCUMENTS A'�"f'ACH�D HERETC}:
1. Conser�t of Surety to Final Payment. Whenever
Surety is involved, Consent o1� Surety is
required. Document G707, ConsenE of Surety,
may be used for this purpose
Indicate Attachment � Yes ❑ No
The foIlowing supporting documenls should 6e atlached
hereln if r�equired by �he (hvrrer:
Contractor's Release or Waiv�r of Liens,
conditional upon receipt of �inal payme�t.
CONTRACTOR: (Name and address)
L. ,1. Desi�n & Construction, LLC
6548 Peden Rd
Fort Wor�h, X 76179
� '
BY:
(Srgr� ture of au orized represerrtalive)
Gre� Woolsey, Co-Manager
(Printed ncr»re arrd litle)
2. Separate Releases or Waivers of Liens from
Subcontractors and materia! and equiprnent
suppliers, to the extent required by the Owner,
accompanied by a list tl�ereof.
3. Contractor's Affidavit of Release of Liens
(Docume�[ G706A).
Subscribed and swo►-n to befare �ne on this date: ��r�
C�1 � �L-. � �.��c'�r-•b
Notary Public:
My Commission Expires: May 31, 2022
"""' SUSA�! J. BODYCONi6
� �SPRY PU�%.
d .
=r°;•�' �_ Notary Public, 5tate ai 7axas
'�,�..�"�,.: "` Com
�yl,. , }e� m, Expires 05-31-2�22
��''i°;,;ti`�` Notary Ip 5829785
����������� ����i�
Contractor's Affidavit Qf l4elease of Lier�s
PROJECT: (Nanae and crcldr•ess)
Arcadia Trai[ Park Playground
Replacements
TO dWNER: (Na�ne und address)
Ciry of Fort Worth Paric & Recreatio��
Department
4200 S rreeway, 5uite 2200
Fort Worth, TX 751 15
ARCNITECT'S P�OJECT NIJM�ER:
102031,102032,102033
C4NTRACT FaR: #53804
CO[�TRACT QATED: Apri! 22, 202Q
QWNER: ❑
ARCHITECT: ❑
C4N7RAC70�: ❑
SIJRETY: ❑
OTHER: ❑
STATE OF: Te�as
COLINTY QF: `f'arrant
Thc undersigned hereby certifies that to the best of the undersigned`s knawledge, information and bekief, except as
]zsted below, Ehe Releases or Waivers oF Lien attached hereto include the Contractor, a�l SubcantracEars, all suppliers
of materials and eq�tipment, and ali perfonn�rs of Work, labor or services who l�ave or rriay have li�ns or
enc�mbrances or the ri��t to assert liens or encumbrances against any prop�rty of the Owner arising in any manner
out of thc performance of the Contract referenced abo�e.
EXCEPTIONS:
SUPPORTING DOCUMENTS ATTAC�-l�D HERETO:
1. Contractor's Re[ease or Waiver of �iens,
conditional upon receipt of fina] payment.
2. Separate Releases or Wai�ers of Liens from
Subcontractors and materia! and equipment
stippliers, to the extent required by the O�vner,
accom�anied by a list tiiereof.
CONTRACTOR: (Name and address)
L. ]. Design & CoRstruction, �.LC
6548 Peden Etd; F rt orth, X 76179
� �
BY:
(Si a rre af a2rth rzed
repi•esentalive) '
GreQ Woolse , Co-Mana er
(Prinled nume and tille)
Subscribed and sworn to before me on this date: •� �� ��
Nota Puvlic: �; ���, U ��`? � � `��
rY �
My Conunission Expires: May 31, 2022
.�`'Rrp''�� SUSAN J. $ODYCOMB
� SP,.., U!j i
3z°;'-� �p{� �� nx No;ary Publ��, Sta,e of Texas
;��.� �;y,P� Comm. Expires D5-3t-2022
'�„°;,,.�` Notary iD 5$29785
1
CONSENT OF
SURETY C4MPANY
TO FZNAL PAYMENT
.4I�1 DOCUMENT G707
�WI�l�R x
ARCI�1[TL-CT 0
CON7'RACfOR ❑
SURETY �
o-rnC=.rz ❑ Bond # 4436274
PROJECT: Arcadia Trail Park - Playground Replacemenfs, Forth Worth, TX
(name, address}
TQ (Owner) City of Fort Worth ARCI-IITECT'S PROTECT NO: 102031,102032,102033
100fl Throckmorton CONTRACT FOR:
FT. Worth, TX CONTRACT DATE: 2/181202Q
76102
CONTIZACTOR: L.J. Design & Constructivn LLC
In accordance with the provisions of tlle Coiltract between tlle �wner and the Cantracfior as indicated above, the
(here inscrt name uid addr�ss of Suret�� Company)
SureTec Insurance Company
2103 CityWest Slvd., Suitc 1300
Houstan, TX 77042
on bond of
(hcre inscrl name �ind address otCnntractor)
L.J. Design & Constraction LLC
9176 Hyde Rd.
Fort Worth, TX 76179
,SURETY COMPANY,
.CONTRACTOR,
hereby appraves of the final payment to the Contractor, and agrees that final payrrtent to the Contractor shall
not rel�eve the Surery company of any of its obligations to
{hcre insert name and address of C�Fvncr)
City of Fort Worth
IOOfl Tlirockmortori, FT. Worth, TX 76102
,OWNER,
as set i'orth in tlie said Surety Company's bond
IN WITNESS WHEROF,
The Surety Company has hereunto set its hand this ?5t1� day of' Feb�•uary, 2021.
SureTec Insurance Campany
Ailest
(scal):
Surery Comg��n}
Si iatur f Authorized Rcprescnt�uive
lerem r Bamett, !1[tornc��-in-F<ict
Titic
NOTE:: This foan is io he tiscd ;is a comp;miun ducuincnt to AiA DOCUMEi�'7' G70G, CU�ITRAC"fQR'S AI�FIDAVI"f OP PA5'MLN I' OF DEt31 AA:I) CI.AS�15,
Cwrcm Edfuon
r11A UOCU\IF,IV'1' G7117 " CONSI:NT OF' SUREZ'Y COMPANY TO I�iNAL l'A1`MENI''APRIL 1910 EDI"fION'A1A
I97ff i'HE Ah1ERICAI�f INST[TU'I�E OF ARCfi]7E?CTS, 1735 ivE1l' YOfLfL AVE. �fW WASH[NG7'ON, D.C, 200G
WARNING: Unlicensed photoeopying violates U.S. copyright laws and is subject to legal prosecution.
POA#1 a221049
10INT LIMITED POWER OF ATTDRNEY
KNOW ALL MEN 8Y THESE PRESENTS: That SureTec Insurance Cornpany, a Corporatioo duty organfzed and existing under the laws of the State of Texas and having its
principal of�ce in the County of Harri;, Texas and Markel lnsurance Company (the'Compan�'f, a corporation duly organized and existing under the laws of the state
of Illirtois, and having its principal administrative offlce fn Gfen A[fen, �rginia, does by these presenu ma&e, canstitute and appoint:
Tony Fierro, Jay Jo�dan, Johrtn.y Mloss, Steven W. Searcey, Robert J. Shuya, Mistle Beck,
Jeremy Barnett, Robert G. Kanuth, Jade Porter, Jennffer Cisneros, Jamett Willson, Jack Nottingham
Their true and lawful agent(s) and attarney(s)-In-fact, each fn thetr separate capacity if more than one is named abave, to make, execute, seai and defiver for and on
their own behalf, individualtyas a surety or jolntly, as co-suretiPs, and as their ad and deed any and al{ bonds and other undertaking in suretyship provided; however,
that the penal wm oE any one such Instrument executed hereunder shall not exceed the sum of:
Twenty Million and 00/100 Dollars ($20,000,000.00)
This Power of Attemey is granted and is signed and sealed under aad by the authority of the following Resolutions adopted by the Soard of Directo�s of SureTec
Insurance Company and Markel Insurance Company:
"RESOLVfD, That the President, Senior Vice President, Vice Presldent, Assisca�t Yce President, Secretary, Treasurer and each of them hereby is authorized to execute
powers of attomey, and such autho�ity wn be executed by use of facsimtle signatu�e, wh[ch may be attested ar acknowtedged•by aay of8cer or attomey, of the
compa�y, qualtfying the attorney or attomeys �amed in the gtven power of attorney, to execute in behalf oi, and acknowledge as the act and deed ot the SureTec
Insurance Company and Markel Insurance Company, as the case may be, a(I bond unde�takings and contracts of suretyship, and to affix the corporate seal thereto."
fN WITNESS WHEREOF, Markel Insurance Company a�d SureTec tnsurance Gompany have caused thelr offtctal seal to be hereunto affixed and these presents to be
signed by thef� duiy authorized officers on the �nn day of ravemeer � zo�o ,
SureTec Insurance Company
ey: �Michael C. Keimig, President
Commonwealth of �rgEnia
County of Henrico S5:
�yv„�veF
�u�X '9 ��
6�W �
�s �y 1 5 �
...*.�•r
�����V ��CF�i, Markel I�sur ce Company
�� �<P�d`�"'`.�:°o= �.,�1
_Y � �G1L �'D_ ��/�i 1��..._-
�� �:�; gy� ��
'� ��'`��' ��` R tn Russo, Senior �ce Pres3dertt
,''����f f I�11���,`,``
On this t� day of Nwemou. mx A, 0., before me, a Notary Pubtic of the Commo�wealth af Virginia, in and for the County of Henrico, d�ly commissioned and
quafified, came THE ABOVE OFFICERS Qf THE COMPANIES, to me personally known to be the indlviduals and oNicers descrtbed tn, wha executed the precedtng
instrurtent, and they acknowledged the execution ef same, and heing by me duly sworn, disposed and sald that they are the officers af the sald companies atoresaid,
and that the seals afflxed.to the proceedtng inswment are the Corporote Seals of said Companies, and the said Corporate Seals and their sfgnatures as efficen were
duly affixed and subscrihed to the said instrument by the autharity aad diredion of the said cort�panies, and that Resolutions adopted by the Board of Dlrectors of
said Campanies referred to in the precedtng Instrument Is now tn force. �� �������� i r,��
,.,� P o on,,Q �•,,
IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed m�b�� �(�� p e t���Iv�:Flenrico, the day and year first above written.
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� � COAAMISSION . � y; ��
2 �,� NU�dBf�R ; Q: Danna 4onavant, Notary Pubtic
. � t 7083968 � � ;
; �0.��. �..\�V,� My commission expires 1/31/2023
We, the undersigned OffTcers of SureTec Insurance Cornpany and Marke�'�s�fi�tC�o���fiy �q�ierby certifythat the original POWER OF A'fTORNEY of which the
foregoirtg is a full, true and correct copy is stiit in full force and effect and halt�qt�t�a��r� �gyotc4d.
IN WITNESS WHEREOF, we have hereunto set our hands, ar+d affixed the Seals of satd Companies, o� che 25fh day of February 2021
Su eclnsu ce pan
By
M. Br t Beary, Assistant Secreta
„ • •.
Markel losurance Company �". .� • �= �'y
'-1 _ .� � � • �- �
By; ��. � , � -.
Richard R. Grin�an, Vice Presid'ent art � ary t� ; _
_ ��✓ ; f. 1 `a � -
Any Instrument Issued In excess of the penalry stated a6ove Is totally vold and without any valldity. 4221049
for veriftcatlon of the suthorEty of this Power you may p11 �713}812-0500 on any buslness day hetween 8:30 AM and 5:00 PM CST.
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- - �,
F�RT W�RTH�
December 15, 2020
Greg Woolsey, Co-Manager
L..f. Design and Construction, LLC
6548 Peden Ro�td
Fort Wor�h, TX 76179
RE: Final Acceptance
Project Name: Arcadia Trails Park i'lay�rouncE Replacements
City Praject No. ] 02031,102432,102033
O�� October 23, 2019 a final inspection was made of tl�is project. There were punch list items identified at
that time and the puncl� list items were completed on Novemher 6, 2019. The fi��al inspection and the
completed punch list items indicate the work meeis th� City of Fort Worth conErac� documents and is
therefare accepted by the City. The warranty peE•iod will begin on Navecnber 6, 2019 and will extend for
two {2) years in accordance with the conCract documents.
If you have any questions concerning this let#er of final aceeptance, piease do not hesitate to contact �ne at
(G82) 225-6819.
Sincerely.
��-� t/u:.��.
Patrick Vicknair, Project Manager
Paric & Recreatior� Departr�ent
c: 1oe] McEll�any, PARD, Capital Projects Mana�er
Scott Penn, PARD, District Superintende�lt
Le��vis Gregory, TPW, Construction Superintendent
Daniel Roy, TPW, Project Inspectar
Adriar� Za�ala, MIWB�, Sr. Contract Compliance S�ecialist
Project File
PARK AND RECREATION p�PARTMENT
Thc Caty oTFnrt Wurt�i "` 42U0 South I'rceway, 5uilc 220U * Furt Worth, Tcs.ts 7G] 15-Id99
R17-392-PARK • Fax R17-392-57Z4
Playground Replacements in Arcadia Park
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