HomeMy WebLinkAboutContract 52345-FP1FORTWORTHo
TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
City Secietaty No:_52345 -FP1
Date Received: JUn 10, 2021
City Project Ns: 101587
� Regarding conttact 52345 for 2018 CIP CONCRETE RESTORATION CONTRACT 3 as iequired by die
� TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as appioved by City Council on 05/07/2019
Ithrough Iv1&C C-29114 die director of the TRt1NSPORTATION AND PUBLIC WORKS DEPARTMENT upon
the iecommendauon of the Assistant Duector oF the Transpoitation & Public ��/orks Depart�nent has accepted the
jproject as complete.
Original Contract Prices:
Amount of Approved Change Orders:
Revised Contract Amount:
Total Cost Work Completed:
Less Deductions:
Liquidated Damages:
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Worlc Completed:
Less Previous Payments:
Fin�l Payment Due
Lauren Prieur
�.����_� --
Recommended for Acceptance
Asst, Director, TPW - Capital Delivery
$1,574,312.85
$31,900.00 Ne 1,2,3
$1,606,212.85
$1,396,452.29
Days rr $650.00/ Day
$0.00
$1,396,452,29
$1,326,629.68
$69,822.61
Jun 7, 2021
Date
�9� _ J u n 7, 2021
.�
Accepted Date
Director, TRANSPORTATIOIV AND PUBLIC WORKS DEPARTMENT
Client Department
�:��, _ . -E/�� - -�
Jun 8, 2021
Date
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Asst. City Manager
Comments:
Conh��ctor's APP
jO"""' City of Tort \1'm•tI�
� � rwozo-000000issa
Nwib.r.
rr„j�c 101587
ca� s��r�a� c�m�« 52345
Numb.i:
CeNr+clor'i Cetllficntlon �
Th_ Cununclnr cenifiea ��ith ihe s�hni11n1 ofihu dxwrcnt a� msoeivleJ Po��mem Requn� Submival
on tIR City of Pon Wo��h �imsa�r s�'sl<m llui lo J.: hsl of lh.ir V:noulrJge: (Il oll �re�iou� �xu�eu
ry�men� rc.ei�cd frum a�ner un acro�ml of Wnrk done wdcr �F,c Cnnlrwt t�r< hen oppli.J on
um to JiseFurge Conwcmre IaF�i�wie abli�. �iom im�urrd in eamaiion wiih \Vmt aomred F��
�riar /y��lieaiiun+ fnr Paiment: lE) tille af oll 1Vor1:, nu�erinl� and equipmeN incoryoml.d in saiJ
Work ero�hemisz lined in or corernl by Jus Applicaiion f � Pa)-mem ��ill ryss Io Oxner ol lim: u(
ry�mnt frca wd clmr of cl l Li<ns, anuri�y m�ar.�ev nnJ awumLraiwce (csccp� su:h cs orc cocarcd 1p�
u Ilonl ac<epmidc m ouixr indc�mif��ing O,m<r ngaifu� �ny snh Liem. xnvi�y inmrca or
����r�„��7; om v> on wo�:�o �rca M m�, n�r�,c�,� m� ra„Mm �� �� o...,����: �,;m m�
ConU�ucl P�cwrwn� un� i� nol d.frcli�e.
Llquld�teU Unmagu 5650.00: Dq'
anizl Garcia;Jun �, 20�1i�:,-5'L�T�
ORIGINALCOM'RACTPRICE..._ ...................................................._ S 5137JJI2s5
Nel�ha�ee6rChvneeOrden..._........._....._............_.._ .............._......... S 571.900.D0
Currenl Conlra�l Price ILine 1 f E�........._.._......._ ................................. 5 51.606.t12.B5
TOTAL COAIPLETED AND STOR[D TO DATE
(Pn¢rt��E+limole,ConilruclbnAllonanceandCh�neeOrdrnl.._... S SI}96,J52t9
RETAIN,ICE:
x. 5.0•/. X SI.796.�5239 \Vorl<ComN�IcJ......... S
L, \ Noll7�eJ S
e l'olal Relofnaee ILine Sa+ Llne <L)........_._..._ .............. S
A�IOUNTELIGIOLETODATEILine�-LIneS�) ..............................5 SIa96,J5L19
LESSPREVIOUSPAYAfENTS�LincGf(mm�riorAno�irn�ion�......._5 SIJt6679.69
ATIOUMDUETHISAPPLIC,\TIO;1 .............................-..._.............. S 569,82i61
OAI.ANCE TO FINISH, PLUS RETAINACF.
(CalumnGanPrv[�+�EfIlmelc+CA+CO�+LIncSnLore) ............._ S 5209.740.56
. COMMGT71h16:
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Thts documenl has heen modfied from Ils orl9nal faim as an EJC�C documenl and Ihe user dd rwt hi9h7ght Ihe
modficationn. You are encoureped b read Ihe document careNlly and consult Leeal Caunsel pdor lo ils ezeculion.
for Payment
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�"""" 2018 CIP CONCRETE RESTORATION CONTRACT 3
Nnnm.
CE20 Sl�nature Papc
Applirnlion For Pn�'menl
- - >.�:.e
c+:m imrea.*c.fu�nfc ��a�YA�-a Nc.-,in.tua�,..�,+
�,b�-sh..�...�.,y
Proeress Estimate �� szt+5 Contrnctor's Application
C{20 Chango Order
Pt'ogress �stimate Consh�uction Allowance Usngc
Far1<ommcp: 2018 CIP CONCRGTC RESI'ORATION CONTRACT 3 C°`' S"T`�°`>' S2345
101587 co�wa Hw.
n�vtu�itM, r<aa� 1 I/1-11/30/2020
IinnNumbzr
37
;8
.. ..... . ..... .._
A 0 C D
Ilnn
S fiatinn �nito[ WsmitploAdd Unilitic< AJ+titionValue ffi�wl�1@unlilq Prtriomly.
�xci (mtatl.�l Valut Lumliai VuNe
Dettrip�ion SnlionNo. �fessure
PlocenndCanN<tLvaThi4�nessFie-cOattGm-ding6' MI . SY 3�3p�Oq)q]Oo S�.y6 529,810.UU 10J8.73000U00 ....SN,18&29 ... 514,18619
Remm'aAsyhnitP�mnt N21 . SY i69.p1Jo0000. S9.W SS.I21.W .. . . . . . . .. .
. . . .. . .... . . . ... .. . ........ .._ . . ..... . ..._ .. ... . . ..
... . . . ..... .... .. .. ... ...... .. .. . ....... . ._ ... . .
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..._.. . . .. .. ....... ......_ ....... . ........ . ....... .. ._. ._....
.. .._ . . . ._ . . . .. . ... _ . . .. .. . .. .... ... . . . . _. ... .. . . .. . . . ..
. . ....... ... . . . . . . .. .. ... . . . .. ... ... . .. . .. __ .... .
This iknmunt tuz h n meJlficd fcvm its o�igiwl fwm m en L•'1CDC: Jwwnrnt arMt tF.c uur Jid not hipplip�l ihc
nwJifim�iona Ya� oro rn<our�gd io rmd Om dwwnrn� carefulq� nnd miuull Ixgai Connsel priw to its ese.v�ion.
Gb20 Change Oider
Progress Estimate Construction Allowance Usage
ANC� IT�NIS TO B�
�"t �0O1U'o1T 1 OISSi 20I8 CIP CONCRETE [tESTORAT[ON CONTRACT 3
n�ncmirn �ari� 11/I-I I/30/2020
n p C D
f�cm
S{+e:iiica�ion Unitof Qmn�it}�roDel�te [lni�thim RaludionVnlw: h`aU J NaUud �a s
OidltrmMunhr ���W�°� Sn4anNn A4easvre
JS WOUOOiIOPo�'inKCon�W:lonNloxnrct ...._ ARI . 1.5 1.011P��IXM1 529.SSO.W 529.SSo0a . . . .. ..... .. ....
. 75.... uoW.pqOPo�inRcorts.InxUw�Niouance ... ...AR2 . LS oa771571� 57a.OW00 SS.I27W . .. . .. .. .
. . . .. ..._. ... ..... ....... ._.. .. . _.. ... .. ... .... .. :... ... ... . .... ... ....
........ ........ ...._ ....... ....... ........ .. ... . .... . .... . . ... . ...... .. . _.
.. . . . .. .. .... . ... ...... .. ... . .. . ... . . ... . . . .. . .....
.. .. .. ..... ...... ._... ... . .... ..... . . . _ . . . . . . . .. .. . . .. . .. . .
7hia d lmxnt hns � n mcvlifiN from its mi@iwl (onn w an [JCfx dwwnent aml �hc uscr did m1 highli¢In �irc
i�iifi<atioro.Yworcencou�ognllorra3�hedccm�xntcs.fuly�nnJconsultLe�alCounsclprirami� �avtiov.
C�S20 Change Order
Contractor's A�plication
AppUcaiimNwn6er, 27 Pinnl
Appliwtlm uaie: 4f29/2021
G F
To.ei CampletN �6 �alanc. to Finich
VolucThis Ma1<riaislkesently y�SioraftoDatc �F) In-F)
FericJ S1on�l�wlinC) (D+C) ❑
SN,ISfi.29 81.7e Si.661.7i
. . . .... SS,I21.W
. ._ .. ..... .. . .. ...... � .. ..... ...
. .._........ .. ......... ....... . ...._..... .
SSA 188.29 69.24: 51 787.71
This �kcumen� iras 6ccn mW ifinl f rn� i�s crigiwl fmn ¢s an 1'ICUC Jaanknt and �he ux� Jid not hi@hli�t Ihc
realifications. You erc amroungni m reJ tfie�ocwmnl curc�uty� cni <auult Legnl Cows<I �ior to ite ea«wim.
Cb20 C�angeOrder
Contractor's Application
AyplicaiionNuml�c 27 tinnl
nppliwtimwic: -0/29/202t
F. F
Not UsN Nat Uu1 Na UccJ rw Usal tta tlsc.l
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1fiisJwlmxnlhu6ecnm��ifi.}Ifmmileorigin.if nmanlJCD(:dwmmnlmWlhzus.rJidnolM1iphliphl�lu
n�Jifimrioiu Ya� nrc ecrcouragN lo ttsd �hc duwnrnt cuePolty and cunsult L<gal Caunscl priw to its es.�vlion
C-620 Char.go Order
P►•ogress Estimate
F`r(""'t"°p' IOISH% 2018CIP
nooliwtim Perial
cn�,g� ��r urm
Ta.
36
Ilem
Des.'riPlion
S�nxwrc AJjm�mcn�
Tolals
Ci�ange Ordec Number 1
RLSTORATION CONTRACT 3 �'n'��`�'">� 52345
Cmvect Num:
1 �/1-11/3�%2�2�
A p C U
A�Wition pytimatalQy+ntity Pre�iou.ly Velue7fiis
Sp-ificalion Unitaf COQ�untitytoAdd 11nitPrim ChanEeOd<r ��Ii� Value W�IIdValue PerioJ
SectiwNo. t.lrasuro Value
� tl.aWdlalo0 53.9UaW Sli,%�.� . IO.O000W�o 519,00U.oO 529,OOO.W _.... .
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Thisdaumrn�hsst �nn+alltiNGm�itserigiwlf nazanlJCIX:Jwummtnnd�hcus.rJidnothi�lJigM1tthe
m«iifimiicm. You ere.Moumgd m nad ihe Jo.vmrnt <arefuly ervi rn�uvit Leg.l Counul {vior ta i�s e�av�ion.
G620 Change Order
Pi•ogress Estimate Changc Order Number r_ 1�
�cvn1adk 101587 Z018 CIP CONCRETC RGSTORATION CONTRACT 3
I1/1-11/30/2020
� o c u
linn �� � Uk�ion
Chang<o,Jeritem S�eificaiMn Uni�of Co �'�� UnitPrice Chang<OiJer iJwUu.f }totUs..l NdUs.tt NotUuJ
No. Dexriylim S1timNu Rfruwe n`Ie�� Valne
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TLisdmimrnthash�nmwTifialfmmiuwigiwif nnsnnElCOCdnwncnlamliheuserdidnothigfilipJilNe
mwlificalions. You ery <mvumgai lo �md Ihe �k wnrnl cvr.fuliy nnJ cauult Isgel Cows.l priw la il. ecmtliex�.
G&20 Change Order
Contractoi•'s Application
�����,�,WNw„�� x�r„ni
nNPr�n��«�u�«: arzsnazt
r: e
ro�vi comP�z��t �: m��z m r-�n�.n
AfeicrialsPrcsmily anilStomlloDatr (F) (tl-F)
S�ord(w1inC) (D��) �
.... .529,WOW fi.7.: . ... 31.901L00
.. . _ ...... . .... ...
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St9000.00 90.9Y. SS900.00
7LisdwvnxnlhuM nmafifidfmmitsariginalfonnvnnElCIX:S�cumrntvulth<uscrdidno�hipLli�t�lie
mNificnlio�. You nre encourogcd la rc+d Ilw duumenl cunfully and consuil isgai Counsei prior fa ifs <awvlion.
C-620 Changn Order
Contrxctor's Application
^PP�"'"�'N�",�` 27 Rinni
Awli�.,�imDm� a129/2021
¢ F
No1 Ux�l Not Usal Na Usd Nol U�
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7fiisdccwnrnthasM malifiat(mmi�se�igin�llomiesanPJC�C�to��ucenlnnJthcuscrdiSnolhightighllhe
nw�iifi<ationz You nre en.roumgnt la reaJ the du:unicnt ruef dly amf mnsull L<gai Cm�nsel prio� m i�+e.�av�ion.
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C-G20 Changa Order
Progress �stimate
IOI587 2UI8 CIP CONCRL+TC
Clun%<(Mfaittm p�Ay9ption
Ta.
l8 9'Cm:rcteSiJe��31k,Adia�ntloCm6
.. _ _ . .... ..
....... ......
Change Order NumUer � � �
3 ... CirySanlmry 521J5
Con(m:l Nw¢
i��i-ii�aonozo
� c u
n
Mkli4on ��m>tnlQu�aulity Yniuz ���oiuly ValueThis
SFe:ificntica Unitof COQun�i�y�oAd�t UnitPriee Cl.+�gi��r W�IIN ImtnlialVelue 1'rrid
Sn�ionNo. Meuwa
9997.11W1 SP. .171.W�1�1�Otb . S7A5 Sb1065 177.00f:00(!00 5610.65 .. 3610.65 . .. .
.._.. . .... . . . .. _ . .. _ .. . . . . . . . . .. . .. . .... ..
. ...... ....... ...... . ..... . .... ._.. .
.. ....._.._ . ..... .. .. _ . . . . .... ......
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nroJifi<ainnsnYouu�.Y<ncovmgaitomadth<daumrnt�ar.full onJm�dtls� C'omuel(piatoitsFc�a�vtion.
C-b20 Change Order
Progress Estim�te Ciiangc Order Number 3
fO`�`O"�"`��' 101587 2018 CIP CONC[tGTE RC�STORATION CONTRACT 3
nvoli�r«� r:riat I 1/1-11/30/2020
� p C D
IIem Ueletian
COQuaniiq•to UnilPricz CWn (kikr NotilxA NwUsN t�blUsal NaUsN
CAanRtONitllem SFw�ificatian Unilof p2ltle 4L
No. �`��"'� StttionNo i.franuc Valuc
35 1'a�inpCansW<IimAllo��sc< ... . .. . . ...... WW.WG1 .IS.. U.W871357 37f1.WU.OD . 5610.65 . . . .. ... ...
. . . .. . . . .. . . .. ... . . ..... _ ... .. .. ...... . . __ . . . . .. . . . .. .. . . .. . . .. _ .. . . . .... . . . . .
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..... . ..... ... .___ .. .... ...... .. ..... .. ...... ...... ....... ..... .. . ...... . ............
.. . .. .. . .. . .. ..... . . .. . . .. . . . . .. . . . . _ _..... . .. .... ...... ...... ...... . ... .. .. ..... ......
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....... .._.. . ..... ......_.
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._.. ......... .... . .... .. .._ . .. .. . ... ..... . .. ... ... ... ...... . ..... ... ...
.. .... .. ...... . . .. . ........ .. . . . .. .. ....... .. . . . ..... . .. . ... .. . _ . . . . .. ... _ ... ... .......
...._ .._.... . ..... ...... . ...... ..._. . .. ..... ..... _. ... . . . . . . . . ..... . ...
ThisJ«uniio�lusbttnmoJifiaifmmitsori6i�ulfamnsan •L'CIX:Jocw�nlnmltlieuurdidrethipJdigAtO�:
mWifi��ienc. You nrc encwmgat a rcad Ih< dawnent <anfully nnJ ronwii I.a¢al Cowuzl prior Io in ec.�vtiw�.
C-S20 Chango Order
Contractor's Apptication
npptic.,iionNu��hr. 27 Ginnl
npplicetimD�te� 4129/2021
E F
Daivice lo Finisii
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7his daument ha� h�n �m+�lifiN frwn its ori&w� fnnn as an fJCDC d�wmnmi um1 Ihc umr Jid � hi�ldight �
nroJifiwiionx Yw nrc.rommngN le rcad the do:wncnl carcfuiy n�i mnsuil I.<gal Counsel priar to its r�c.vtion.
G620 Changa Order
ContrTctm•'s Application
noo�iwti�uxa,�czr. 27 tinnl
AoniicatimDnc -029k021
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Citv of Fort Worth Summary of Charqes
City Sc<rclop� Contmc� Num: 52345 2018 CIP CONCRGTG R�STORATION CONTRAC'I' 3 p, o. ; 1' \V020.000000188d p�ojcct Number. 101567
ApplicalionPerial: ......... I 11(1-11/30l2020 I nppucmmn . I 27Rinnl I ApplicnlionDatc: I -0129(2021 I
Numbcr.
�l�ii
rwozo•00000mau� p�o��Numbcr. 101587
City Sccretnn� Contrnct Nwn: 523A5 2018 CIP CONCR�TG RCSTORATION CONTRACT 3 P• �.: 1
Applimuon Z� rmn� ppplicalmn Da1c 4/29/2021
I ApplicalionPcriod: ll/1-I1i30/1020 Num6cr.
Cit of Fort Worth Summa of Char es
CitySccretoq'ContmcWune 523d5 2018CIPCONCRETERCSTOItAT10NCONTRACT3 P•���
I�N020-0000001884 p�ojcctNumbcr. 101587
Applicalion 27 rinal APPlication Datc: 4129/2021
.. ppplicationPcriod: ll/I-II/30/2020 Numbcr.
Cit of Fort Worth Summar of Ghar es
rwozo•000000issa proKtNumbcr. 101587
CitySccrc�aq•CommclNum: 52345 20(8CIPCONCRGTCRGSTORATIONCONTRACI'3 P.O.: 1
I1/I-11/30/2020 APP�icalion y7 rjnnl �1pp�kalion Dnlc: 4J29/2021
Applicnlion Pcriod: Nnmbcr.
�� �� � FundfngldenlifioationiFlD1 � � � TotalCompleled : ' AmtRematning G�oss �: ' Refainage Net I
, _.... ........ Toteis. ....... . . . . .. . . ,,:
134018-0200431-5740010.101587•E04080-999318010199 51367 452.29 5206 B60.56 �
' S6002-070043D-5740010-101587•E01780-9999 529 000.00 ' S2 9D0.00 .
ip
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Grend Tolal 57,396,452.29 5209,760.58 30.00 (569,822.61) $69,822.61
crry �r�r,r�e�nczv � ��
c,������i };nr; � N�. , 5a 3 5.�..___
rok��� �voa��'H City oi Fo��� wo��t��
�_� CItAn�o Ordo�� Roquest
ProJocl Nnme 2010 CIP Concrele Reslorallon Conlrecl3 Clly Soo�l 6234G
Cllanl ProJecl il(s) 101607
ProJeol Doscrlp►lon Concrete panel raplaanonel proJacl on Marlln Slreel (Foard Slreol lo SI�e�Nle(ottl Slreel) and Alla Mesa Doulevard (S
I�lulen Sireel lo Wl�llmnn Avenuo
Canlrnolor Omepn Conlrnoling Ina Clianpo Ordar�l �� Dalo 1116f2020
Cily ProJecl Mpr, Grep Robbins Clly Inspoctor John Robinson
Dept, ��N ter� Soworr TPW Conlr1a�c1t7hne
Totnla �
OrlpinolConireclAmounl $0,00 1,674,312,OG $1,674,312,OG 360
Exlres Ib Dele $O,OD $0,00
Cradlls lo Dale SO,OD $0,00
Pendln� ChanDe Orders (hi M&C Pracess) $0,00 $O,OD
ConliaolCostloDnlo _ D;OD S1'674,312;06 $1,674,312,OG 3G0
Origlnai Funda Avellehle forChenpe Orders �u,uu
Romalninp �unds Avallable for Ihle CO $0,00 $0,00
Adtllllonel Fundlnp (If necessnry) '$31',900,OD $31,UOD,OD
CHANOE OfiD�RS fo DATE (lNCLUDINO 7HIS ONEJ AS % OF ORIOIN�IL CONiIUICT 2,03%
MAXALLOW/IBLECONiRACTAMOUNT(ORIaINALCONifUICTCOST+2b%) $1,987,OD1,08
Tlds change order Is needed ae It Is neceseary lo conducl adJusimenls lo all exlslinp 24•Incli eanllary sower manliole covare
pra�ecle Ilmile lo eallefy Il�e currenl Texas Commisslon of Cnvironmenlel Quallly of 30�Inch manholB coyer. _•;:; \_
.'�; r�`' ,��"k.���� � '�%I"� 114;,
/�y�� �y '�'� �r�.,ti ....���..,.��;'r ;�i•,41�:
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II Is underelood anU aDreeU Ilinl Ilis nceoplanee of Ihis Clinnpo Order by Ilie conlraelor conslllules an aecord and snllsfnellon flntl roprosonis pflymonl
In iull (�olli Ilme ond money) tof all cosle arlslnp oul of, or Incldenlel lo, Ilio above Ciion�o Order. 71io ProJeoUProprnm Menaperelgnlnp Uelow
acknowledpas Ilint lielehe le Ilio poison responslblo for Ilie monilodnp an� adminlslrollon ol Ilds conlracl, Including enswlnD oll porformonce ond
roparllnD requlremonle,
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M&C NumBer —26�b8ff— �(% P.. M&C bale Approved .aI�MEB29�
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Contract Compllance Manager:
By signing, I aclaiowledge that I am the person
responsible for the monitoring and admfnistration
of tl�(s contract, Including ensuring all performance
and reportfng requirements,
�( Gls?%
��
Greg Robbins
Sr. ProJect Manager
X X
Cify of Fort l�orlh, Texrrs
Mayor aud Comicil Communicntio�i
*�M&C 20-
DAT�: Tuesdfly, J�nuary 14, 2020 R�F�I�NC� NO.: 0016
LOG NAM�: 202018 CIP CONC RESTOCOS CONTRACTS 3, 4 AND 5
SU_ BJ�CT:
Adopt Appropriation Ordinance iu tlie amount of �78,050.00 to Fund Cliange Orders to Tlu�ee 2018
CIP Concrete Restoration Contracts and Update the FY 2020-24 CIP (COUNCIL DISTItICTS 3,
6 and 8)
It�COMM�NDATION:
It is reconunended that the City Council adopt the attached appropriation ordinance increasing
estimated receipts and appropriations in tlie Water and Sewer Capital Projects Fund in the amount
of $78,050,00 transferred fi�om availaUle funds witliin the Water & Sewer Fund.
DISCUSSION:
It is necessary to condilct adji�stments to all existing 24-inch sanit�ry sewer manhole covers within
the ideirtified projects limits to satisfy the current Texas Coirunission of Enviroruneirtal Qnality of
30-inch manhole cover, The total cost to the Water Department for the tlu�ee change orders is
$78,050.00.
On May 7, 2019, (M&C C-29114) the City Council authorized a contract in the amount of
$1,574,312.85 with Omega Contracting, Inc., for 2018 CIP Concrete Restoration - Contract 3, City
� Secretary Contract No. 52345, for the concrete sireet restorations on Martin Sireet (Fo�rd StreeC to
Shacicleford Street) and Alta Mesa Boulevard (S. Hulen Street to Whitman Avenue). The contract
must be adjusted by Change Order No. 1 in the amount of $31,900,00 to thereby increasing the
contract amoutrt to $1,606,212.85 (City ProjectNo, 101587).
On Apri116, 2019, (M&C C-29093) the City Council authorized a contract in the amount of
$1,618,196.00 with Omega Contracting, Inc,, for 2018 CIP Concrete Restoration — Conh'act 5, City
Secretaty Contract No. 52329, for concrete restorations on W. Vicicery Boulevard (S. Huleu Street
to Ciiy Liinits), The contract was subsequently �'evised by Chauge Order No. 1 iu the amount of
$18,000.00 administratively authorized August 26, 2019, Change Order No. 2, in the amount of
$31,900,00, will increase the contrflct �motmt to $1,650,096.00 (City Project No, 101570),
On September 25, 2018, (M&C C-28872) the City Couticil authorized a contract in the �mount of
$1,699,200,00 with Westhill Construction, Inc,, for 2018 CIP Concrete Restoration— Contract
4, City Secretary Contract No. 51534, for concrete restoralions on Granbury Ro�d (Belclen
Avenue to Dan Danciger Road) and Wentworth Street (South of South Drive to Westhlven
Drive). The contract must Ue adjusted by Change Order No. 1 iu the amount of $14,250,00 thereUy
increasing the coutract amount to $1,713,450.00 (City Project No, 101571),
Appropriations for Concrete Restorations Contcacts 3, � and 5 as depicted Uelow:
d
ting
roni�iatioiis
I 1'rojec
�tio�is Total*
W&S Capital Projects — Fwid
56002
2018 Bond Program 34018
ect Total
$0,0
$7,971,287
$7,971,287
'�`Numbers rounded for presentation purposes.
$78,050.00 $78,050.
$0,00 $7,971,287.
�7II,050.00 $8,049,337.
Funding for this project was not inclttded in the FY2020-2024 Capital Improvement Plan. The
action in tl�is M&C will l�pdate the FY2020-2024 Capital Improvement Plan,
The project is located in COUNCIL DISTItICTS 3, 6 and 8,
I'ISCAL INI'ORMATION / C�RTIrICATIONt
The Director of Finance cei�tiiies that funds will be available in tlie FY20 Water and Sewer Fund,
and upon approval of the aUove recommendations and adoption of the attached appropriation
ordinauce, funds will be available in the current capital budget, �s appropriated, in the Water and
Sewer Capital Projects Flmd (W&S Capital Projects Fund), Prior to any expenditure Ueing incurred,
the Watec Department has the responsibility to validate the availability of funds.
rUND ID�NTII'I�RS (I+IDs):
TO
Tuncl De�nrhnent Account Pl•ojeci Progr�mActivity Budget Reference # Amo�mt
YD rD Year (Cliartfield 2)
rROM
I�'und Department Account P��oject P�,ogi•auiActivity Buclget Reference # Amonnt
ID XD Year (Chartfield 2)
C�RTIrICATIONS:
Submitteci foi• City Mana�er's Office bY:_
Ori�ins�tiu� Depflrtment Head:
Additionnl Tufoj�mation Contact:
Dana Burghdoff (8018)
Williain Johnson (7801)
Monty Hall (8662)
ATTACHM�NTS
1, 202018 CIP CONC RESTOCOS CONTRACTS 3 4 AND 5 FID Ttable (NN
11.04.20191.....docx (CFW Liternal)
2, 202018 CIP CONC RESTOCOS CONTR.ACTS 3 4 AND 5 56002 A020.docx ([�ublic)
3. M& C MAp 202018CIPCONCRESTOCOSCONTRACTS3 4AND5(21.Udf (PuUlic)
4. M& C Map 202018CIPCONCRESTOCOSCONTRACTS3 4AND5(3).pdf (Pt�Ulic)
5. M& C Map 202018CiPCONCRESTOCOSCONTRACTS3 4ANDS.pdf (Public)
CSC No. 52945-0O2
�ORTWORTF w Ciry of Po�'t Worth
Chan�e Oi•der Request
ProJect Namo 201U CIP Concrele Rosloralion Conlracl 3
Cly Sac 11 52346
Clinnl Pro)eel il(s) 101547
ProJect Dosciip�on Concrele Panel Roplacemonl on Alle Mesa Bouleverd ond Madln Slreel
ConUaclor Omepe Gonlracllnc�, Inc. Chenpa Orderll ,2 R bale 0f112020
City ProJecl M9r,
Grog Roh�ins Clty Inspeclor John Robinson
popf. UNIT 1; Waler
Odglnol CanUacl Amounl 50,0(
Exlras lo Dalo $31,�J00.0(
CrndllsloDate � $OA(
Pnnding Chanpe Orders (In M8C Process) $0.0(
ContraclCosl lo Dnle $31,00�,01
r,n ie noD B DEL Ta�s lo Enter CO Dackup �D;01
Unil2; TPW
Tolals
OrlglnalFundsAvolloblo(orChnngo0rdors 0;00 �
Remalninp Funds Available (or Ilds CO SD',00 a
Addi�onel Funding (If necessery) �
CHANGE ORDERS to DA7E (INCLUDINO iHIS ONE) AS % OF ORIGINAL CONTRACT 7,1�1'/0 !
hfAXALLOWABLECONTRACTAMOUNT(ORIGINALCONiRAC7COST+Y5%J $1;96Z;091t06 �
Conlrncl Tlmn
v.,� ';UUFf7JIPIUH'IIIU@U LtpHaulyt�. U��I�!��m��•,f:,,••o, ��a*-' --
The Conlractor requesled addlllone140 calendardays lo be added to lhis proJecl In order lo correcl a pondlnp Issue In eoncrele panels previousiy inslollad noor
of Morlin Slreol end Eralh Slreel. Slaff concurs wllh lhis requesl lo Include Ilme already spenl on plannlnp by 6olli Ilia clly and conlractor, oqulpmenl entl menpower
remobllizallon, work lo bo porfomied, concrele curing, and tvealhor Ilme.
i
M&C Number NIA
NIA
It Is understood and aereed that lhe acceptance oF this ChanGe order by the contractor constltutes an accord and satlsfacHon and represents payment In
full (botii time and money) for all costs arlsing out of, or Incidental to, the above Change Order. The ProJect/Pro�ram Manager slgnlna below acknowledges
lhat I�e/she Is lhe person responsl6le for the monitarin� and adminlstratlon of thls contract, Including ensuring all performance and repariing requiDrQ`e ents'
Cnnlraola�si0onlpeny�Noma ; E� - -,' "� � =�'Q�Iradltin(N�m�! -- � ' t0oijltpbt'9�Atl�1�[� � '
j�$nl, Aug 14, 2020
Omega Contracting, Inc, Qanlel Garcla ,,�,.:�,.: �„� .���
.,,.• Clly of �orl Worlh
ChQupo OrQo�• AdcUUone
CIIySocU 6���5
ProJoctHnmo 2010CIPConuolofioeloiollonConUocW
CllonlPro�oclll 101fi07 Ins ecloi JohnRo6lnson
Conhatloi OmeOaCanhectlnp,lno. PA1 GrapRoh6lns �
Chonpo0rdar5u6mlllalll Dalo Ul712020
�
Change0fderAddlllans Page2ot4
!:n ir\5'o� T�i Clly of Port Worth
ChAn�o order potallons
PtoJoclNsmo ZOIOCIPConcrelollosloinlbnCon�ncl3 ClySncil 62745
C6anI P�oJocl 11 101607
Conlrocla OmopaConVecUn9,lnc. PI.I GmpRobbMs In:poclo� JoAnRobinson
Charqo O�dor Su6mlllal II � P L I Dalo 0/)12020
%�
Clianpe OfJer Dcicllons Pagc 3 of 4
Contract Compllunce MAnAger:
By signing I scknowledge that I am the person responsible
for the monitoring and adminisiration of this contract, including
ensuring all performance and reporting requirements.
Greg Robbins � �����
Name ofEmployee/Signature
Senior Project Manager
Title
❑ This form Is N/A as No C(ty Funds are assocfafied with thls Contract
Printed Name
Attested by
i / � • '
Mary J. Kayser
Signature
4��boon4�
� o�;F��Rr��O
Op
A � o o���d
�po oxd
o ° d
��Q and Unpoa pp�
City Secretary
OFFlCIAL RECORD
CITY SECRETARY
FT. WORTH, TX
FURTWORTH�
Routing and Transmittal Slip
Transportation & Public Worlcs
Department
DOCUMENT TITLE: 2018 CIP Concrete Restor:�tioii Contract 3— Cliange Oi•der #3
DOCUMENTS FOR CITY MA[VAC:LK'1 J1l:LVA l UKL: /-�i� uucuuicu�� «����'�� ������ <���y �����• ����
City Departments rcqucsting City M�nagcr's signahire for 1pproval MUST BE ROUTED TO THE
APPROPRIATE ACM for approval first, Once the ACM has signed the routing slip, D�vid will review
�nd t�ke thc ncxt stcps.
N��DS TO B� NOTARiZ�D: ❑Y�S �No
RUSH: ❑YES [�No SAM� DAYt []YGS �No NEXT DAY: ❑YES �No
ROUTING TO CSO: �Y�S ❑No
Action Requii•ed: ❑ Attach Sign�ture, lnitial and Notnry Tnbs
❑ As Requested
❑ For Yonr Information �
� Signaturc/Ronting and or Recordiug
❑ Comment '
❑ File I
I
Return To: TPWContrTcts�FortWorthTexas.gov at ext. 7233 for picic up when completed.
Thanlc you!
M&Ct C-2�114 CPN: 101587 CSO: 52345 DOC#:
'ORTWORT � City of Fort Worth
Change Order Request
Cily Sec 11 52345
ProJecl Name ZO10 CIP Concrete Reslorallon Conlracl 3
CIIenIProJectll�s) 101507
ProJecl Descripllon Concrele Panel Replacemenl on Alle Mesa Bouleverd end Medln Slreet
Chan e0rder1l 9 Dale 031�0121
Conlractor Omefla Conlraclinp, Inc, �J
Clly Pro)ect Mpr.
Greg Robbins Cily Inspeclor Gary Deyon
Depf,
Odginal Conlracl hmount
Exlias lo Dale
Credils lo Dale
Pending Chanpe Orders (In M8C Process)
Conlrecl Cosl lo Dale
Water � TPW
Tolals
Conlracl
Odpinal Funds Avollable for Chanpe Orders
Remalning Funds Avallable for Ihis CO
Addilional Funding (If necossery)
CHANOE ORDERS lo DA7E (INCLUDING TNIS ONEf AS'/e OF ORIGINAL CONIRACT 2,03%
MAXALLOWABLECONTRACTAMOUNT(ORIGINALCONiRACTCOST+25%J $1,fl67,691.06
.uuoi�n�ni��m �....,....�._ ,. _._ _...._- - �
ils chenpo order Is requlred lo add an addlllonel bld Ilem for �J' Ihlck concrele sidewalk dlscoveretl near n large relalnirq vrall near Mariin and Eralh. To avofd Issues ���il
relefning wall fooler, TPW reques(ed Ihe conlractor roplace wllh 9' Ihlek concrele lo malch whal was removed. 7he Conlraclor also requested eddilional 20 calendar days lo
added lo Ihis proJecl for planning, equipmenl and manpower remobllizalion, work lo be performed, concrele curfng, and weallier lime.
It Is understood and agreed that the acceptance of this Change Order by tlie contractor constitutes an accord and satistattlon and represents payment In full
�bo[h tlme and money) for all costs arlsing out of, or Incidental to, the a6ove Change Order, The ProJecl/Program Manager slgning 6elow acknowledges [ha[
he/she Is llie person responslble (or ihe monitoring and adminlstrallon o( thls contract, Including ensuring all per(ormance and reporting requlre Dele
CoNraclor (Nemo) Coniraol Slgnelure
Conl(aolor'a.0om any Nema �y���;A� ���.�;,,, Apr 5, 2021
Ome�a Contracting, Inc, Danlel Garcia _�;; ., — ^
�,,.,. ,.:,� . �-..,,��
Dale P(o ool i
r5,2021 < <
Date SeplofCa�
A� r6,2021 �
�r,�r;c.
oala olrec o ,
�
A rG,2021 iupa�.-
7, 2021
M&C Number
pr 6, 2021
Dele
pr6,2021
�8�0
?r6,2o21
Dale
pr a, 2021
M8C Dale Approved �
ATTEST:
n���J9yPy��
Mary 1. Kayser, City Secretary
ro:i• W��'�' � Clty of Fort Worlh
Ghanpe Order Addllions
qty5ocl! 623A5
Pto�odNamo 201UCIPConaeloRoslaeVonConlrecl9
CBonl ProJocl l� 101607
—� p�,� Grep Ro6Elns , �nspectoi Jnhn Robinson
Contmcla OmepnConUeclinp,lnc. � Dale 1012612020
Chnngo0rdorSuAmMtalil �
ChangeOrderAddfqons Page2of4
,� �•Wn� •i� City of Fort Worth
r�t-?-'1L Change Order poletions
ProJecl Nemo 2010 CIP Conueto Rosloreibn Conirecl3 CIy Secl1 62345
C[anlProJecl# 101601
Cor,tnqa OmegeCo�trecUnp,inc. Ptd GregRob�ins InspaGor GeryDayon
Chanc�o0�darSu6m%Inlll � Dalo 020
Change Order �elctlons Paye 3 of A
�i
Signature: ��`h�`a '�y0�
Baibara Pryor (Apr2, 7 l ll:al CDIj
Email: Barbara.Pryor@fortworthtexas.gov
nni�RF fnr this Chanae Order
FORTWoRTH�
TRANSPORTATION AND PUBLIC WORI<S
May 27, 2021
Omega Contracting Inc.
2518 Chall< Hill Rd.
Dallas, Tx 75212
RE; Acceptance Letter
Project Name; 2018 CIP Concrete Restoration Contract 3
Project Type: Paving
C(ty Project Na.: 101587
To Whom It May Concern:
On October 12, 2020 a final inspection was made on the subject project. There were punch list items
identified at that t(me. The punch list items were completed on March 5, 2021. The final inspection and
the corrected punch list items indicate that the worl< meets the City of Fort Worth specifications and is
therefore accepted by the City, The warranty period will start on March 5, 2021, 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 817-
392-2333,
Sincerely,
-�7�,`� l��"�
Gregory Robbins, Project Manager
Cc: John Robinson,,lnspector
Ron Cordova, Inspection Supervisor
Gary Deyon, Senior Inspector
Mary Hanna, Program Manager
N/A, Consultant
Omega Contracting Inc, Contractor
N/A, Developer
File
E-Mall: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
�
r, `�I : ^ .
���� '
,fr
2200 Renatssance Bivd., Suite 40Q
King of Prussia, PA 99A08-2755
i'ii. (610) 83?_-82A0
• • ' • ' '` �—
To: (Ob1(gee or Obligee's representative}
City of Fort Warth
200 Texas Street
Fort Worth, TX 76902
R�:
Principal: ��ega Contracting, Inc.
2518 Chalk HiEI Road
Dallas, 'TX 75212
Contract Number:
Confract/Projec# Description:
2018 C1P Concrete Restoration, Contract 3, 10�587
Obligae: City of �ort Wo�th
200 Texas Street
Fort Worth, TX 76102
Cflntract Clate:
In accordance with ihe pravisions of ftte contract between the Obligee and the Princlpa( described above, I..IBERTY
MU7UAL WSURANCE COME�ANY, a Massachusetts sfock (nsurance company, as Surety (ihe "Surefy"), on the
Princlpaf's Bond number p��223729 (the "Bond") he�eby consents to fhe final
paymenf to the Principal by the Ob!(gee arid agrees that �nai payment to the Principal shall not relieve the Surety af
any of its abligations Eo pbligee as set forth in the sond.
1N WITNESS WH�REOF, the Surety has hereunto set ifs hand and seai this 5th day of M�y �
2021 ,
LIB�RTY MUTUAL INSURANC� COMPANY
(Surety}
— �
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Liberty Mutual tnsurance Company
The Ohio Casuaity insurance Company
West American Insurance Company
POWER C}� AiTORNEY
Certificale No; 8204952-9718tl1
KN01MJ ALL PER50NS BY 7NE5� pRESENTS: That The Ohio Casuafty Insurance Gompany is a corporation duly organized uader the laws of fhe Slate of New Hampshire, that
Liberfy Mutual Insurance Company is a corporation duiy or8anized untler ihe laws of Ihe State of Massachusetfs, and West American Insurance Company is a corporation duty organizetl
undar lhe laws of the Siate of Intliana (herein collecGvely called the'Companles"), pursuant to and hy authority herein set fodh, does hereby neme, constitute and appoint, Alyson
Carniiclisel• Ashley Brift� Barry K. McCord� David T. Miclattc Lacey Mayfield• I,auren O. Moudy� Niko(e Jcannefte; Robart C. Dpvis; Robert M. Overbey, Jr.;
Tabitha Dorma�t
a11 oC the city of Houston state of TX aach individually if thera be more ihan one named, its We and lawful atEomey�in-fact to make,
execute, seal, acknowledge and deliver, for and on Ils 6ehalf as surety and as its acf and deed, any and ai! undedakings, bonds, recognizances and other surety obligations,ln pursuance
of these presents and shafl be as binding upon the Companies as it ihey have been duly signed by ihe president and attesled by ihe secretary of ihe Companies in their own proper
persons.
iN WfTNESS WHEREOF, this Power ofAKomey has been subscribed by an aulhorized o�icer or official of ihe Companies and the corporate seals of the Companies have been affixed
thereto this t5th day of March , 2021 .
State oE PENNSYLVANIA
Countv of MONTGOMERY ss
Li6erty Mutual tnsurance Company
� tiNsq �qv iNSU � �xsu The Ohio Casualty Insurance Gompany
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David M. Carey, AsslslantSecretary
� On this i 5th day of March , 2021 before me person�ly appeared �avid M. Carey, who acknowledged himseif to ba fhe Asslstant Secretary of Libarty Mutual fnsurance
cu Company, The Ohlo Casually Company, and Wes[ American lnsurance Company, antl lhat he, as such, peing aufharized so io do, execute Ihe foregoing insWment for the purposes
� therein contained by signing on Behalf of lhe corporations by himself as a duly authorizetl oificer.
�' -� IN WITNESS WH�R�0�,1 have hereunto suhscribed my name and atftted my notaria! seal at King of Prussia, Pennsylvania, on 1he day and year flrsl above written.
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� m Thls Aovrer of Atiomay is made and executed pursuant to and by authority of the following By-laws and Authorizadons of 7he Ohlo Casualty Insurance Company, Liberty Mutual
�� insurance Company, and West American insurance Gompany which resolu�ons are now in (uli force and effect reading as Eollows:
� ARTICL�IV—QFFlCERS:Seceoo12.PowerofAltorney,
�� Any officer or ather oHicial of lhe Corporatlon authorized for ittat purpose in wriUng by the Chairman or [he President, and subject to such limitalion as fhe Cha(rman or the
'° � President may preseribe, shall appoint such aKomeys-in-fact, as may be necessary to act in hehalf of the Corporation ta make, execute, seal, acknowledge and deliver as surety
�` any and ail underiakings, bonds, recognlzances and other surety obiigaUons. Such alfomeys-fn-hact, subject to !he limitationS set fadh in their respecUve powers of attotney, shall
p � have full power to bind I�e Corpora�on by thelr signature and sxecuUon of any such insVuments and io aftach liiereto ihe seai of Ihe Corpora8on. When so executad, such
� � instNments sha116e as binding as if signed by the President and attestetl lo by fhe Secretary. Any power or auUaodty granted to any representaGve or attomey-in•fact under the
provislons of this ar�cle may be revoked at any Ume by khe Board, lhe Chaitman, the President or by the offlcer or officers granting such power or authority.
ARTICLEXIII—fxecution of Contracts: Section 5. Surety Bonds and llridedakings.
Any o�icer ot lhe Company authorized for ihat purpose in wriUng by the chairman or ihe presidenl, and subjeck to such limitations as the chairman or Ihe president may prescribe,
sha0 appoint sueh attomeys-in-facY, as may be necessary lo act in behali o( the Company to make, execute, seal, ackno�viedge and deliver as surety any and all undedak(ngs,
bonds, recognizances and olher surety obligafions. Such attomeys-in-fact subJect to lhe pmitatlons set torth fn their respective powers of aflomey, shail have fulf power to bind the
Company by their sfgnature and execution of any such fnsWments and to altach fhereto Ihe seal of U�e Gompany. When so executed such insWments sha�� be as binding as if
signed by the president and attested by the secretary.
Certificato ot Designatian — The President of the Company, acOng pursuant to the Bylaws of 1he Company, autharizes bavid M. Carey, Assistant Secretary to appoint such attomeys-in-
fact es may be necessary to act on behalf of the Gompany to make, execute, seal, acknow(edge and deliver as surety any and all undertaicings, bonds, recognizances and other surety
obligations.
Author{zaUon— By unanimous consenl of ihe Gompany's 6oard of Direclors, ihe Company consents ihaF tacsimile or mechanicaliy reproduced slgnature of any assistant secretary of the
Company, wherever appearing upon a cer�fied copy of any power ot attomey issued hy ihe Company in connscbon with surery bonds, shall be valitl and hinding upon the Company with
the same forCe and eftect as Ihough manually a�lxed.
I, Renee C, l.leweilyn, the undersigned, Assistank Secreiary, The Ohio Casualty Insurance Company, Libedy Mutual Insurance Gompany, and Wes! American.lnsurance Company do
hereby cerUfy that ihe originai power of aftomey of whlch the loregoing is a full, Uue and correct copy of ihe Power of Aifomey executed by saitl Companies, is in fufE force and ef(ect and
has not been revoked. ` ,' '
IN TESTIMONY WN�REOF, I have hereunfo Set my hand and a(fixed the seals of said Companies this ��' day of ,���� �
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7his Power of Attomey limfts the acis of those named herein, and they have no auihority to
bind ihe Company except 3n the manner and t0 the exient herein st�ted.
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Renee C. Uelvellyn, Assistant Secrelary
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SURETY
TEXAS
IMPORTANT NOTICE
To obtain infot•mation or Ynake a complaint:
Yau may catl toll-free for information or to
make a coniptait�t at
1-$'77-751-2640
You may also write to:
2200 Renaissance Blvd., Ste. 400
I�ing of I'russia, PA 19406-2755
You niay contact the Texas Departtnent of
Insurat�ce ta obtain informaiion on companies,
coverages, rights or coznplaints at
1-800-252-3439
You may write the Texas Departmetit af Insurance
ConsumerProtection (111�1A)
�', O. Box 149091
Austin, TX 78714�9091
FAX: (S 12} 490-1007
Wsb: http://wWw.edi.texas.�ov
E-mail; ConsutnerProtectio�tdi texas av
PREMIUM OR CLAIM DISPUTES:
Should you �ave a dispute concerning yaur
premittrn or about a claim yau should itrst
contact tha age��t ar aa11 1-800-843-6446.
If the dispute is not z•esolved, you may contaci the
Te�as Department af Insurance.
ATTACH THIS NOTICE TO YOUR
POLICY:
This »otice is for informaiion only and does not
becozne a paxt or condition of the attached
document.
TEXAS
AVISO IMP4RTANTE
Para obtener informacion a para someter una
queja:
Usted puede llamar al numero de telefono gratis
para informacion o para someter una queja a3
1-877-751-2640
Usted tambien puede escribit� a:
2200 Renaissance Bivd,, Ste. 404
I�ing of Pi�ussia, PA 19406-2755
Puede comunicarse con el Depai�tamenta de
Seguros c3e Texas para obtene�• infor�nacion
acerca de companias, cobez-tut•as, derechos o
quejas al
1-80Q-252-3439
Puede escribir aI Departamento de Seguros
de Texas Consumet• Protection (111-1A)
P. O. Box 149091
Austin, T� 78714-4091
FAX # {S 12) 490-1007
Web: �ittp:!/www.tdi,texas.�ov
E-mail: ConsumerProtection cr,tdi.texas.gav
DISPUTAS S�BRE PRTM�S O RECLAMOS:
Si tiena una disputa conce��niente a su pritna a a
un reclamo, debe comunicarse con el agente o
primero. Si na se i•esuelve la disputa, puede
en#onces camunicarse con el departamenta (TDl)
UNA ESTE AVISO A SU POLIZA:
Este aviso es soto pa�•a �roposiia de informacio�i
y no se convier�e en parte o condicion deL
documento adjunto.
NP70b80901
LMS-15292 10N5
AFFIDAV�T
STATE OF TEXAS
C�UNTY OF DALLAS
Before me, the undersigiled authority, a noiaiy public in the staie
and county afaresaid, on. this day pex•sonally appeared Daniel Garcia,
Opez•atiozls Managei �f Omega Contracting, Inc., lffiown to me io be a
credible person, who being by me duly swar�z, upon 1us oath deposed and
said;
Thai a11 persoiis, fums, associations, corporations, or other
organizations furnishing labor and/or materials have been paid zn full;
That the wage scale establisl�ed by the City Council in the City of
Fort �Vorth has been paid in full;
That there are no claims pending for personal injuty a�dlor
property damages;
On Coniract described as;
2018 CiP Concreie Restoration�Contract 3 City Project No. 101587
BY
Daniel Gaz ca, Opexations Manager
Si�bsczzbed and swoz-n before me on this date 5th of May, 2021.
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Notar Public �d-�d�� �>" 'Nj �v: com�. �ti��-�� o�-ca-z�za �
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COl1Ti�� .��atf: ��{;�;�(� '�Prrii.t�`` Not4�y !� i24345�27