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Home My WebLink AboutContract 46310-FP1Department of TPW Const. Services DOE#%� / Dat Project Manager C�� ' Risk Management S. Canday D.O.E. Brotherton / CFA Westerman/Scanned ❑ The Proceeding peopie have been Contacted concerning t6e request for final payment & 6ave released this project for such payment. Clearance Conducted By Etta Bacy ' , {�af}��pn�p�� na419�N �l�y�ii9•�Ca9�� / O �� a _ � ' � �) t. �� TION AND PUBLIC WOR&S PROJECT COMPLETION c s .��3/b D.O.E. Ns: 7351 Regarding contract 46310 for WATER & SS REPLACEMENT CONTRACT 2014 WSM as required by the WATER DEPARTMENT as approved by City Council on 12/09/2014 through M&C G27121 the ciixector of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Transportation & Public Works Department has accepted the project 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 Work Completed: Less Previous Payments: Final Paymenf Due Recdmmended for Acceptance Asst. Director, TPW - Infrastructure Design and Construction $748,703.00 $0.00 Ns 1 $748,699.00 $718,627.00 6 Days @ $650.00/ Day $3,900.00 $714,727.00 $682,125.65 $32,601.35 �3•28•Zol Date 3�Z.�f.��6 Date Asst. Director, WATER DEPARTMENT Asst �City Manager `_ � rJ� ,(p Date Comments: F[TND ACCT: �ATER P253-6081702386 / SS: P258-7081702386 r • � �, MA� � � � f� Iaitin�s � - � ' �'�'�:_; ;�, � .._ - ; s> °_ �; ;i �, ~ it ; . �, �� ;� � ,. �.. - �, �•• � 4,�,.• ��''"' V v. ►� '1 i � � � 5'q lcD1 � � 0 .�3 ��O �a�3 - ba38� ��L�VL��U't�� MAR 2 g 2016 �� I`� 2�g � l �� 3i � By_. ____...�. City Project Numbers 02386 'r"—`W� w�� DOE Number 7351 Contract Name WATER & SANITARY SEWER REPLACEIv�N"P CONTRACT 2014 WS Fstimate Number 14 Contract Limits Project Type WATER & SEWER Project Funding Project Manager Conlon Inspectors RODGERS / VASQUEZ Contractor CANARY CONSTRUCTION 523 GREENWICH LANE COPPELL � TX 75019 Payment Number 14 For Period Ending 9l30/2015 �'� � ��%_ I �''��I�� ;��.. �1t�31�' l�( City Secretary Contract Number Contract Date Contract Time Days Charged to Date Contract is .000000 46310 12/9/2014 180 CD 186 CD Complete CITY OF FORT WORTH SiJNIlvIARY OF CI�ARGES Line Fund Account Center Amount Gross Retainage Net Funded I �`3l�f�) -l_(�Z��__ 57(�,�p�l�,UU ��u0 `—, Z3, 7i7,Cn� L�,G�I�, (�t7 2=��tival- C�?3�Q I�Z,�S�j.��J ''��,�o T S,Zrx;�S �, ��,_�-�' WATER DEPARTMENT ERING AND FISCAL SERV[CES Contaq Penon Total Cost of Work Completed Less % Retained Net Earned This Period $36,50135 This Period $650.00 DEP-� RTMI:N 1 �'HECK PIC� Wednesday, March 02, 2016 YES Q $718,627.00 $0.00 $718,627.00 $3,900.00 $0.00 $0.00 $682,125.65 $0.00 $32,60135 Page 6 of 6 +� as 3 � U a3�� Less Liquidated Damages 6 Days @ $650.00 / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Paymer►t i FORTV�QRTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name WATER & SANITARY SEWER REPLACEMENT CONTRACT 2014 WSM- Contract Limits Project Type WATER & SEWER City Project Numbers 02386 DOE Num6er 7351 Estimate Number 14 Payment Number 14 City Secretary Contract Number 46310 Contract Date 12/9/2014 For Period Ending 9/30/2015 CD Project Manager Conlon Contractor CANARY CONSTRUCT[ON 523 GREENWICH I.ANE COPPELL , TX 75019 Inspectors RODGERS / VASQUEZ Contract Time 18�D Days Charged to Date 186 Contract is 96.000 Complete Wednesday, March 02, 2016 Page 1 of 6 City Project Numbers 02386 Contract Name WATER & SANITARY SEWER REPLACEMIN'I' CONTR ACT 2014 WS Contract Limits Project Type WATER & SEWER Project Funding SECTION A - WATER LINE ]MPROVEMENTS DOE Number 7351 Estimate Number 14 Payment Number 14 For Period Ending 9/3 012 0 1 5 Iiem Descripdon of Items ��mated Unit Unit Cost �stimaied Compteted Cosnpieted No. 1 12" DIP WATER 2 8" WATER PIPE 3 8" DIP WATER 4 6" WATER PIPE Quamty Tota[ Quau�ty Total 64 LF $55.00 $3,520.00 64 $3,520.00 321� LF $50.00 $160,850.00 3150 $157,500.00 1180 LF $55.00 $64,900.00 1179 $64,845.00 31 LF $45.00 $1,395.00 31 $I,395.00 5 DUCTILE IRON WATER FITTINGS I.75 TN $4,500.00 $7,875.00 1.75 $7,875.00 W/RESTRAIN'I' 6 REMOVE 6' WATER VALVE 7 REMOVE 8" WATER VAL'VE 8 REMOVE 12" WATER VALVE 9 3ALVAGE FIRE HYDRAN7' 10 TEMPORARY ASPHALT PAVEivIEN'I' REPAIR (WATER) 11 6" WIDE ASPHALT PAVEMENT REPAIR 12 CONC PVMT REPAIR RESIDENTfAI. (WATER) 13 TEMPORARY ASPHALT PVMT REPAIR WATER SERVICE 14 TEMI'OI2ARYASPIIALT SIDEWALK (WATER) 15 TEMPORARY ASPHALT ARIVEWAX REPAIR (WATER) 16 TEMPORARY ASPIIALT CURB AND GL7T"I"ER REPAIIt (WATER) 17 UTILITY SERVICE SURFACE RESTORATION SODDING 18 TEMI'OPtARY WATER SER�ICES 19 8" WATER I.,INE LOWERING 20 TRENCH SAFETY (WATER) 21 FIRE I IYRANT 22 CONNECTION TO EXISTII�IG 4"-12" WATER MAIN 23 SALVAGE 1" WATER METER 24 1" WATER SERVICE METER RECONNECTION 25 1" WA'PER SERVICE 26 1" PRNATE WATER SERVICE 27 6" GATE VALVE 9 EA 7 EA 2 EA 2 EA 4183 LF 2I0 LF 45 SY 650 LF 50 SF 60 SF 190 LF 135 SY 1 LS 6 EA 75 LF 3 EA [[:�y:� 5 EA 62 EA 62 EA 75 LF 3 EA $350.00 $450.00 $500.00 $500.00 $18.00 $3,150.00 $3,150.00 $I,000.00 $1,000.00 $75,294.00 7 7 2 2 4182 $40.00 $8,400.00 210 $65.00 $2,925.00 56 $45.00 $29,250.Q0 650 $45.00 $2,250.00 $45.00 $2,700.00 59 $3,150.00 $3,150.00 $1,000.00 $1,000.00 $75,276.00 $8,400.00 $3,640.00 $29,250.00 $2,655.00 $20.00 $3,800.00 $6_00 $810.00 50 $300.00 $85,000.00 $3,500.00 $2.00 $3,500.00 $950.00 $150.00 $250.00 $150.00 $25.00 $1,100.00 $85,000.00 $21,Q00.40 $150.00 $10,500.00 $17,100.00 $750.00 $15,500.00 $9,300.00 $1,875.00 $3,300.00 1 4 75 3 [E3 2 62 62 30 3 $85,000.00 $14,000.00 $ I50.00 $10,500.00 $17,100.00 $300.00 $15,500.00 $9,300.00 $750.00 $3,300.00 Wednesday, March 02, 2016 Page 2 of 6 CityProjectNumbers 02386 Contract Name WATER & SANI7'ARY SEWER REPLACEIviENT CONTRACT 2014 WS Contract Limits Project Type WATER & SEWER Project Funding DOE Number 7351 Estimate Number 14 Payment Number 14 For Period Ending 9/30I2015 28 8" GATE VALVE 20 EA $1,500.00 $30,000.00 17 $25,500.00 29 12" GATE VALVE 2 EA $2,000.00 $4,000.00 2 $4,000.0� 30 TfZAFFIC CONT'ROL (WATER) 2.83 MO $1,200.00 $3,396.00 2.83 $3,396.00 31 SWPPP' ACRE (WAT'ER) i LS $Z,500.00 $2,500.00 1 $2,500.00 Sub-Total of Previous Unit $576,640.00 $554,252.00 SECTTON B- SANfi'ARY SEWER LINE IMPROVEMEN Item Descripfion of Items �stimated Unit Unit Cost Estimated Completed Completed Nu. Quanity Totat Quanity Tofal — ------------------------- 1 10" SEWERPIPE 333 LF $55.00 $18,315.00 332 $18,260.00 2 8" SEWERPIPE 88 LF $52.00 $4,576.00 88 $4,576.00 3 8" DIP SEWER PIPE 802 LF $54.00 $43,308,00 802 $43,308.00 4 'IRENCH SAFETY (St1NPPARY SEWER) 1223 LF $2.00 $2,446.00 1222 $2,444.00 S PRE-CCTV INSPECTTON 1218 LF $1.50 $1,$27.00 6 POST-CCTV INSPECTION 1223 LF $2.00 $2,446.00 1223 $2,446.00 7 4" SEWERSERVICE 22 EA $1,000.00 $22,000.00 22 $22,000.00 8 4" SEWER SERV[CE RECONNECTION 22 EA $350.00 $7,700.00 22 $7,700.00 4 4" MANIIOLE 5 EA $3,500.00 $17,500.00 5 $17,500.00 10 4' EX'IRA DEPTH MANHOLE 3 VF $200.00 $600.00 3 $600.00 11 EPDXY MANIIOI.E LINER 11 VF $200.00 $2,200.00 I2 CONCRETE COLLAR 8 EA $180,00 $1,440.00 2 $360.00 13 TRENCHWATERSTOPS 2 EA $500.00 $1,000.00 2 $1,000.00 14 MANHOLEVACUUMT'ESTING 5 EA $180.00 $900.00 5 $900.00 15 TEMPORARY ASPIIALT PAVING REPAIR 1068 LF $22.00 $23,496.00 1068 $23,496.00 (SEWER) 16 6' WIDE ASPFIALT PVIviT REPAIR ARTERIAI. (SEWER) 17 TEMPORARY ASPHALT PVMT REPAIR SEWER SERVICE 18 TEMPORARY ASPIiALT DRIVEWAY REPAiR (SEWER) 19 TEMPORARY ASPIiALT CURB AND GII"I'"i'ER REPAIIt 20 i I'I'II..ITY SERVICE SURFACE RESTORATION SODDING 21 CONCRETE ENCASE SEWER PIPE 22 TRAFFIC CONTROL (SAIVITARY SEWER) 155 LF 100 LF 40 SF 65 LF 50 5Y 10 CY 1.5 MO $65.00 $10,075.00 $20.00 $2,000.00 $45.00 $1,800.00 $22.00 $1,430.00 l55 $1Q075.00 198 $3,960.00 $6.00 $300.00 50 $300.00 $250.00 $2,500.00 5 $1,250.00 $2,000.00 $3,000.00 1.5 $3,000.00 Wednesday, Mazch 02, 2016 Page 3 of 6 City Project Numbers 02386 Contract Name WATER & SANITARY SEWER REPLACENIEN'I' CONTRACT 2014 WS Contract Limits Project Type WAT'ER & SEWER Project Funding DOE Number 7351 Estimate Number 14 Payment Number 14 For Period Ending 9/30/2015 23 SWPPP 1 ACRE (SANtI'ARY SEWER) 1 LS $1,200.00 $1,200.00 I $1,200.00 Sub-Total of Previous Unit $172,059.00 � 164,375.00 Wednesday, March 02, 2016 Page 4 of 6 City Project Numbers 02386 Contract Name Coniract Limits Project Type Project Funding WATER & SANITARY SEWER REPLACEMENT CONTRACT 2014 WS WATER & SEWER Contract Information Summary Chanee Orders Change Order Number 1 '�'l�, �b / �� Date 3 � �' l �p .4�sL Directo� - Infrastructure Design and Construction � �(r%f�l.laVG�� l Date 3 �� i (� Director / Contracting Departrnent Original ContractAmount Total Contract Price DOE Number 7351 Estimate Number 14 Payment Number 14 For Periad Endiag 9/30/2015 $748,703.00 $o.00 $7a8,699.00 Total Cost of Work Completed Less % Retained Net Earned Earned This Period $36,501.35 Retainage This Period $650.00 Less Liquidated Damages 6 Days @ �650.00 / Day LessPavement Deficiency Less Pettalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment ��is,6z�.00 � $0.00 $718,627.00� $3,900.00 $0.00 $0.00 $682,125.65 $0.00 $32,601.35 Wednesday, March 02, 2016 Page 5 of 6 inspecuon �u ry o Cany .. H ��l (.� ,�GM �vA�+n Date �11�/�" Project Manager FO RT WO RT H City of Fort Worth Change Order Request Project Name: Water and Sanitary Sewer Replacement ConUact 2014 WSM - E Parf, 3 Project No.(s): P253-608170238688 & P258-708170238688 DOE No. 7351 � < -_ ., P "_ , t .9' - � ,,.�� / / City Sec No.: 46310 City Proj. No.: 01473 Water and Sanitary Sewer Main Replacement on Cain Court, Martha Lane, Normandy Roatl, N.Edgewood Terrace and Project Description: Rand Street. Contractor: Canary Construction, Inc. Change Order# � Date: 2/1212016 City Project Mgr. Liam Conlon City Inspector. Carlos Vasquez Phone Number: Phone Number: 817-992-2600 Dept. Original Coniract Amount Extras to Date Credils to Date Pending Change Orders (in M&C Process) Confract Cost io Date Amount of Proposed Chanae Order Original Funds Available for Change Orders Remaining Funds Available for lhis CO Addilional Funding (if necessary) Water I 5ewer CHANGE ORDERS to DATE (INCLUD/NG TH/S ONEJ AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) JUSTIFICATION (REASQNS) FOR CHANGE ORDER Totais I Contract Time fCalender daysl 0.00% �935,873.75 The conh•actor is requesting SO additional calendar days on the project for the inclement weather that was experienced fi•om Febivary 2014 to July 2014. _��.,.:,,:. Staff concurs with the contr•actor's request and recommends approval. t ? � �y. U �` ��` �� - �1� � % 3 'Z01 i �'i � � 1 y ' l I` `_'� . . . .. . . .. � ( .- . . }-> . % '� �t� ;.��: / fii:� �= a°oc0000< �� It is understood and agreed lhat the acceptance of this Change Order by the contrac�or consli(utes an accord and salisfaction and represents payment in full (bolh lime and money) for all cosls arising out of, or incidental lo, the above Change Order. FORT WORTH City of Fort Worth Change Order Additions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM - E Part, 3 City Sec No.: 46310 Project No.(s): P253-60817023868$ & P258-708170238688 DOE No. 7351 City Proj. No,: 01473 Project Description Water and Sanitary Sewer Main Replacement on Cain Court, Martha Lane, Normandy Road, N.Edgewood Terrace and Rand Street. Contractor Canary Construction, Inc. Change Order; �1 Date: 2/12/2016 City Project Mgr. Liam Conlon City Inspector Carlos Vasquez ADDITIONS Fo �.T wo RT H City of Fort Worth � Change Order De(etions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM - E Part, 3 City Sec No.: 46310 City Proj. No.: 01473 Project No.(s): P253-608170238688 & P258-708170238688 DOE No. 7351 Project Description Water and Sanitary Sewer Main Replacement on Cain Court, Marlha Lane, Normandy Road, N.Edgewood Terrace and Rand Street, Contractor Canary Construcfion, Inc. Change Order: �1 Date 2/12/2016 City Project Mgr. Liam Conlon City Inspector: Carlos Vasquez DELETIONS PROJECT NAME: PROJECT NUMBER: DOE NUMBER: ' 1' • 11 PVC PVC DIP DIP �• �•. '1'�:_ :�1� 1 1' !' ===r_.-- =- _ �� .� . � : �• . _� �. �. Contract 2014, WSM-E, Part 3 2386 7351 SIZ� g�� 6" 12" g�� SIZE 6" 8�� 12" DENSITIES: NEW SERVICES: PIPE LAID SDR SDR DIP ' 1' : • 1 � 1 iorn iron DENSITIES: NEW SERVICES: :%�� :�: 1" SIZE 8�� 10" g�� SIZE 10" g�� 4" WATER TYPE OF PIPE PVC PVC DIP DIP VALVES (16" ( TYPE OF PIPE cast iron cast iron cast uon LARGER) copper SEWER TYPE OF PIPE PVC PVC DIP TYPE OF PIPE � �� irz•�� PVC TRr1NSPORTATION �'u�ID PUBLIC WORKS The City of Fort �orth • 1000 Throckmorton Sueet • Fort Worth, TY 76012-6311 (817) 392 - 7941 • Fas: (81� 392 - 7845 LF 3150 31 64 �, 1179 NA LF 31 4329 64 1395 Z �ra C ' LF 88 , 332 -; 802 LF 332 890 700 �� o� �AG SURETEC INSURANCE COMPANY 9737 Great Hills Trail, Suite 320, Austin, Tx 78759 CONSENT OF SURETY TO FINAL PAYMENT OWNER ARCHITECT CONTRACTOR SURETY BONDNO.: 4394701 TO OBLIGEE: City of Fort Worth (NainenndAddress) purchasing Division 1000 Throckmorton Street Fort Worth, TX 76102-6312 PROJECT: CONTRACT FOR: Water and Sanitary Sewer Replacement CONTRACT DATED: (Nan�emedAddressJ December 9 � 2014 Water and Sanitary Sewer Replacement Contract 2015 WSM-E Part 3 City Project No. 02386 DOE 7351 PRINCIPAL: Canary Construction, Inc. At the request of the Obligee and the Principal indicated aUove, (Insertnanre ond nddress ojS:u•etyJ SureTec filsurance Company, 9737 Great Hills Trail, Suite 320, Austin, Tx 78759 , SURE'TY, on bond of Canary Construction, Inc. (hueiY name mrd address ojCanh-actw) 523 Greenwich Lane Coppell, TX 75019 , corrTRacro�, and conditioned on the representation by Obligee that all Con�act provisions relating to the payment of final payment under the Contract have been satisfied by Principal as of the date of final pa}�ment, and that no claims by Obligee or any third party are known or believed by Obligee or its representatives to exist as of the date of final payment, representations as to the truth and accuracy of the foregoing conditions being deemed to have been made by Obligee in connection with this request for Consent of Surety, hereby approves of the 6na1 payment to the Principal, and agrees that final payment in accordance with the terms hereof shall not relieve the Surety of its obligations to (Inserl name and address ojOblrgee) City of Fort Worth Purchasing Division 1000 Throckmorton Street Fort Worth, TX 76102-6312 ,OBLIGEE, as set forth in said Surery's bond. IN WITNESS �VHEREOF, the Surety has hereunto set its hand on this date: Mareh 10 , 2 016 (Insei7 in iv�iting 7he �nond7 fo/loived G�� the nunreric dale and year.) SureTec IiLsurance Company —�_. of atrthorized Attes r.: (Seal): Susan D. B. Muni z, Attorney-in-Fact (Prirrted i7ante a»d title) SURE;TEC GONSENT TO FINAL PAYMENT REV. 1.1.2004 A� � SureTec Insurance Company THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION Statutory Complaint Notice/Filing of Claims To obtain information or make a complaint: You may call the Surety's toll &ee telephone number for information or to make complaint or file a claim at: 1-866-732-0099. You may also �vrite to the Surety at: SureTec Insurance Company 9737 Great Hills Trail, Suite 320 Austin, Tx 78759 You ma�� contact the Tesas Departrnent of Insurance to obtain information on companies; covera�e, ri�hts or complaints at 1-800-252- 3439. You may ��rite the Texas Departrnent of Insurance at PO Bo� 149104 Austin, TX 78714-9104 Faa#l: 512-490- ] 007 Web: http:/h��.tdi.state.ts.us Email: ConsumerProtectionCtdi.te�as.gov PREMIUM OR CLAIM DISPT_ITES: Should youu have a dispute conceming your premium or about a claim you should contact the Surety fust. If the dispute is not resolved, Srou may contact the Te�as Department of Insurance. Texas Rider 06042014 poA �: 4221025 SureTec Insurance Company LIlVIITED POWER OF ATTORNEY gnow All Men by These Presents, That SURETEC INSUR.ANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make, constitute and appoint Paul G. Adam, Peter S. Batjer, Joseph P. O'Connor, Lisa W. Friend, Casey Simmons, Barbara Newcomb, Susan D.B. Muniz its true and lawful Attorney-in-fact, with full power and authority hereby conferred in its name, place and stead, to execute, acl�owledge and deliver any and all bonds, recognizances, undertaldngs or other instruments or contracts of suretyship to include waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars ($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President, sealed with the corporate seal of the Company and duly attested by its 5ecretary, hereby ratifying and confirming all that the said Attomey-in-Fact may do in the premises. Saic� appointment shall continue in force until 12/31l2016 and is made under and by authority of the following resolutions of the Board of D'uectors of the S�eTec Insurance Company: Be it Resolved that the President, any Vice-President, aoy Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attomey(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, aclmowledge and deliver, any and all bonds, recognizances, con�acts, agreements or indemnity and other condirional or obligatory undertakings and any and all notices and documents canceling or terminaring the Company's liability thereunder, and any such instruments so executed by any such Attomey-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary, Be rt Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attomey or any certificate relating thereto by facsimile, and any power of attomey or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopied at a meeting held on 20`� ofApril, 1999.) In Witness Whereof, SURETEC INSUR.ANCE COMPANY has caused these presents to be signed by its President, and its corporate seal to be hereto affuced this 21st day of March, A.D. 2013. . . .o„�� SURETEC INSURANCE COMPANY State of Texas ss: County of Harris .X 9,, w 5 . �[ _ � By: John On this 21st day of March, A.D. 2013 before me personally came John Knox Jr., to me known, who, being by me duly swom, did depose and say, that he resides in Houston, Texas, that he is President of SURETEC INSLTRANCE COMPANY, the company described in and which executed the above instrument; that be lrnows the seal of said Company; that the seal affixed to said instrument is such corporate seal; that it was so afFviced by order of the Boazd of Directors of said Company; and that he signed his name thereto by like order. �:-�- . ....,.. .;. n` Jacq elyn Maldonado, Notary Public My commission expires May 18, 2017 I, M. Brent Beaty, Assistant Secretary of SURETEC INSiJItANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attomey, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set out in �e Power of Attomey ue in full force and effect. Given under my hand and the seal of said Company at Houston, Texas this �_day of ��_, �•D• Beaty; Assistant Any instrument issued in excess of the penalty stated above is totally void and without any validity. For veriflcation of the authority of this power you may call (713) 812-08D0 any business day between 8:00 am and 5:OD pm CST. AFFIDAVTT STATE OF Texas COLJNTY OF Dallas Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Wayne Borstad, President Of Canary Construction, known to me to be a credible person, who being by me duly sworn, upon liis oath deposed and said; Thai all persons, fums, associations, corporations, or other organizations furnishing labor andlor materials have been paid i.n full; That the wage scale established by the City Council in the City of Fort Worth has been paid in full; That there are no claims pending for personal injury and/or property damages; On Contract described as; Contractar : Subscribed anct-sworn before me on this date 10 of March, 2016. C{�RY E fOGUS !ot�ry Public. State of Texas '•!v Commission Expires June 09, 2019 Dallas iCo., � � �� '� '�` : TRANS��ORTATION AND PUBLIC W4RKS PERFOR:MANCE EVALUATION OF COI�TTR�'OR CONTRACTOR & PROTECT DATA ne of Contractor nary Construction DOE Inspector Carlos Vasquez DOE Inspect�r �✓ Water � Waste Water❑ Storm Drainag� Pavement Initial Contract Amozrnt $748,703.00 Final Contract Amount $748,699.00 In PERFORMANCE EVALUATTON � WSM-E, Part 3 0 Routine �v: o2rzoro� Q Complex 0- Inadequate 1- Deficient 2- Standard 3- Good 4- Excellent ELEMENT WEIGHT ( x) APPLICABLE (Y / N) RATING (0 - 4) MAX SCORE SCORE 1 Submission ofDocuments 2 Y 2 8 4 2 Public Notifications 5 Y 2 20 10 3 Plans on Site 5 Y 2 20 10 4 Field Supervision IS Y 2 60 30 5 Work Performed 15 Y 2 60 30 6 Finished Product 15 Y 2 60 30 7 Job Site Safety 15 Y 2 60 30 8 Traffic Control Ivfaintenance 15 Y 2 60 3Q 9 Daily Clean U 5 Y 1 20 S 10 Citizen's Complaint Resolution 5 Y 2 20 10 11 Property Restoration 5 Y 2 20 10 12 After Hours Res onse 5 Y 1 20 5 13 Project Completion 5 Y 2 20 10 TOTAL EL�;MEN'1' SCUK� (A) BONUS POINTS (25 Masimum) {B) TOTAL SCOI2E (TS) II� CONTRACTOR'S RATING M�imum Score (MS) = 448 or sum of applicable element score m�.�cimums which = Rating ( jTS ! MS] " 100%) 214 ! 448 = 48% 448 Performance Category Standard <20% = Inadeqa�ate 20% to <=�0% = Def ctent 40% to <60% = Standard 60% to <80% = Good >80% = Excellent Inspector's Comments (INCLUDING E,YPI.ANATION OF BONUS POINTS AiVARDED} Si�ature DOE Inspectar � Signature DOE Lnspector's Supervisor CON'I'RACTOR'S COMII�NTS Project Name Contract 2014 DOE Num6er 7351 Project �Ytanager Liam Conlon Project Difficulty Q Simple 10/14/2015 Signature Contractor 7`Itl'1NSPORTATION AND PUBLIC WORKS 114 214 The City of Fort �Ylorth • 1000 Tluockmorton Street • Fort �Vorth, TX 76012-6311 (81� 392 - 7941 • Fax: (81� 392 - 7845 O Routine TRANSPORTATION AND PUBLIC WORKS CONTRACTOR'S EVALUATTON OF CITY PROJECT INFORMATION Construction Carlos SI ContractAmount 703.00 Simple In PERFORMANCE EVALUATION 0- Inadequate 1- Deficient 2- Standard ELENIENT' 1NSPECTION EVALUATION 1 Availabilitv of Inspector 2 Knowledge of Inspector 3 Accuracy of Measured Quantiti 4 Display Of Professionalism 5 Citizen Complaint Resolution 6 Per%rmance - Setting up Valve ADMINISTRATTON O Complex :�' Date: I 10/14/2015 �v: o2i22ro� Project Name Contract 2014 WSM-Part 3 Project Manager Liam Conlon Type of Contract � Water � Waste Water ❑ Storm Drainage ❑ Pavement 3 - Good 4 - Excellent RA`I'II�G ELENIENT (0 - 4) PLANS & SPECIFTCATIONS 1 Accuracy of Plans to E�cisting Conditions 2 Claritv & Sufficiencv of Details 3 Applicability of Specifications 4 Accuracy of Plan Quantities PROJECT MANAGER EVALUATION 1 Knowledge And/Or Problem Resolution 2 Availability of Project Manager 3 Communication 4 Resolution of Utility Conflicts RATING (0 - 4) Labs 1 Change Order Processing Time 2 Timliness of Contractor Payments 3 Bid OneninQ to Pre-Con Meeting Timeframe III} COMMENTS & SIGNATURES COMMENTS Sig�ature Contractor Signature DOE Inspector Signature DOE Tnspector's Supervisor INSPECTOR'S COMMENTS Ey / /' r ✓ � 'lItANSPORTATION AND PUBLIC WORKS � The City of Fort Worth • 1000 T1�sockmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fas: (817) 392 - 7845 FORTW4RTH<, TRANSPORTATION AND PUBLIC WORKS STATEMENT OF CONTRACT TIME STATCM�NT# FIN.aL STATEMENT# NANIE OF PRO.T�CT: YEAR: 2015 PROJECT NO.: 2386 14 DOE & Sanitary Sewer Replacement Contract 2014, WSM- E, part 3 Contractor FINAL INSPECTION DATE WD CONTRACT TIME I 180 7351 8/14/2015 CD X PERIOD FROM: 9/16/2015 TO: 913 012 01 5 M1fID - Month DEVELOPMEN7 (�' / N� N VVORIC ORDER EFI'ECTIVE: 2/16/2015 BEG / n MID / n 103.3% DAY OF MONTH DAYS REASON FOR DAY OF MONTH DAYS R�ASON FOR CHARGED DAYS CREDITED CHARGED DAYS CREDITGD 1 16 Wed 0 oth 2 17 Thu 0 oth 3 18 Fri 0 oth 4 19 Sat 0 oth 5 20 Sun 0 oth 6 21 Mon 0 oth 7 22 Tue 0 oth 8 23 Wed 0 oth 9 24 Thu 0 oth 10 25 Fri 0 oth 11 26 Sat 0 oth 12 27 Sun 0 oth 13 28 Mon 0 oth 14 29 Tue 0 oth 15 30 Wed 0 oth 31 NA Wkn & Hol Wea Utl Oth Not Applicable SAT,SLTN,and WEATHER UTII.ITIES OTHERS DAYS TOTAL DAYS HOLIDAYS RELOCATE CHARGED THIS PERIOD 0 0 0 15 0 15 PREVIOUS PERIOD 0 186 186 TOTAL TO DATE 0 0 0 15 186 201 REMARKS: all project complete � Signature: 1 i i (Print Name)