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HomeMy WebLinkAboutContract 55634-FP1 City Secretary 55634 -FP1 Contract No. FORTWORTH, Date Received Jan 27,2022 NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: Traffic Signal Improvements to Serve Business 287 City Project No.: 102869 Improvement Type(s): ® Paving ❑ Drainage M Street Lights ❑ Traffic Signals Original Contract Price: $275,550.00 Amount of Approved Change Order(s): -$9,430.00 Revised Contract Amount: $266,120.00 Total Cost of Work Complete: $266,120.00 p aq Jan 20,2022 Patrick Bryan Uan U.202214:09 CSTI Contractor Date President Title Durable Specialties,Inc. Company Name Feliberto Bel n 20,2022 14:14 CST) Jan 20,2022 Project Inspector Date K'GJ�tG�7ctJt��/ �Khal Jaafari P.E.(Jan 27,202212:23 CST) Jan 27,2022 Project Manager Date � 's '� Jan 27�'� Janie Scarlett Morales(Jan 27,2022 13:07 CST) 7 2022 CFA Manager Date Dana Burghd off Jan 27 an 27,202213:39 CST) 7 2022 Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name:Traffic Signal Improvements to Serve Business 287 City Project No.: 102869 City's Attachments Final Pay Estimate ❑x Change Order(s): © Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety a Statement of Contract Time Contract Time: 60 Choose an item. Days Charged: 30 Work Start Date: 6/2/2021 Work Complete Date: 11/16/2021 Completed number of Soil Lab Test: 20 Completed number of Water Test: 2 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name TRAFFIC SIGNAL IMPROVEMENTS TO SERVE BUSINESS 287 AND EAG Contract Limits Project Type PAVING,LIGHTS,SIGNALS City Project Numbers 102869 DOE Number 2869 Estimate Number I Payment Number I For Period Ending 1/19/2022 WD City Secretary Contract Number Contract Time 6UM Contract Date 1/25/2021 Days Charged to Date 30 Project Manager Contract is 100.00 Complete Contractor DURABLE SPECIALTIES P O BOX 535969 GRAND PRAIRIE, TX 75053 Inspectors RUFFIN,D / BELTRAN Wednesday,January 19,2022 Page] of 6 City Project Numbers 102869 DOE Number 2869 Contract Name TRAFFIC SIGNAL IMPROVEMENTS TO SERVE BUSINESS 287 AND E Estimate Number I Contract Limits Payment Number I Project Type PAVING,LIGHTS,SIGNALS For Period Ending 1/19/2022 Project Funding Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- -------------------------------------- Sub-Total of Previous Unit UNIT V:STREET LIGHTING IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 RDWY ILLUM ASSBLY TY 18,18A,19 AND D- 1 EA $4,400.00 $4,400.00 1 $4,400.00 2 FURNISHANSATLL LED LIGHTING FIXTURE 1 EA $750.00 $750.00 1 $750.00 (137(CO#1) 3 RDWYILLUM FOUNDATION TYI,2,AND 4 1 EA $1,100.00 $1,100.00 1 $1,100.00 -------------------------------------- Sub-Total of Previous Unit $6,250.00 $6,250.00 UNIT VI:TRAFFIC SIGNAL IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 WORK ORDER MOBILIZATION(MISC ONLY) 1 EA $6,500.00 $6,500.00 1 $6,500.00 2 FURNISH/INSTALL ELEC SERV PEDESTAL 1 EA $7,500.00 $7,500.00 1 $7,500.00 3 2"CONDT PVC SCH 80(T) 335 LF $14.00 $4,690.00 335 $4,690.00 4 2"CONDT PVC SCH 80(B) 385 LF $34.00 $13,090.00 385 $13,090.00 5 3"CONDT PVC SCH 80(T) 245 LF $16.00 $3,920.00 245 $3,920.00 6 4"CONDT PVC SCH 80(T) 65 LF $17.00 $1,105.00 65 $1,105.00 7 4"CONDT PVC SCH 80(B) 280 LF $38.00 $10,640.00 280 $10,640.00 8 24"SLD PVMT MARKING HAE(W)(CO#1) 88 LF $20.00 $1,760.00 88 $1,760.00 9 EXPLORATORY EXCAVATION OF EXISTING 10 EA $250.00 $2,500.00 10 $2,500.00 UTILITIES 10 3-SECT SIGNAL HEAD ASSMBLY 8 EA $1,500.00 $12,000.00 8 $12,000.00 11 5-SECT SIGNAL HEAD ASSMBLY I EA $2,500.00 $2,500.00 1 $2,500.00 12 PED SIGNAL HEAD ASSMBLY 2 EA $1,000.00 $2,000.00 2 $2,000.00 13 AUDIBLE PEDESTRIAN PUSHBUTTON 2 EA $2,500.00 $5,000.00 2 $5,000.00 14 FURNISHANSTALL HYBRID DETECTION 3 AP $9,000.00 $27,000.00 3 $27,000.00 SYSTEM 15 FURNISH/INSTALL HYBRID DETECTION 650 LF $4.00 $2,600.00 650 $2,600.00 CABLE Wednesday,January 19,2022 Page 2 of 6 City Project Numbers 102869 DOE Number 2869 Contract Name TRAFFIC SIGNAL IMPROVEMENTS TO SERVE BUSINESS 287 AND E Estimate Number I Contract Limits Payment Number 1 Project Type PAVING,LIGHTS,SIGNALS For Period Ending 1/19/2021 Project Funding 16 FURNISHANSTALL MODEL 721 PREEMPTION 3 EA $2,700.00 $8,100.00 3 $8,100.00 17 FURNISHIINSTALL PREEMPTION CABLE 635 LF $2.00 $1,270.00 635 $1,270.00 18 5/C 14 AWG MULTI-CONDUCTOR CABLE 795 LF $3.00 $2,385.00 795 $2,385.00 19 7/C 14 AWG MULTI-CONDUCTOR CABLE 100 LF $3.00 $300.00 100 $300.00 20 20/C 14 AWG MULTI-CONDUCTOR CABLE 480 LF $5.00 $2,400.00 480 $2,400.00 21 3/C 14 AWG MULTI-CONDUCTOR CABLE 420 LF $2.00 $840.00 420 $840.00 22 NO 6 INSULATED ELEC CONDR 30 LF $2.00 $60.00 30 $60.00 23 NO 8 INSULATED ELEC DONDR 2200 LF $2.00 $4,400.00 2200 $4,400,00 24 GROUND BOX TYPE B I EA $1,200.00 $1,200.00 1 $1,200.00 25 GROUND BOX TYPE D,W/APRON 7 EA $1,500.00 $10,500.00 7 $10,500.00 26 SIGNAL CABINET FOUNDATION-352i 1 EA $4,500.00 $4,500.00 1 $4,500.00 27 FURNISH/INSTALL ATC SIGNAL CONTROLLER I EA $3,380.00 $3,380.00 1 $3,380.00 28 FURNISH/INSTALL 352i CONTROLLER 1 EA $20,000.00 $20,000.00 1 $20,000.00 CABINET 29 FURNISH/INSTALL ALUM SIGN MAST ARM 9 EA $460.00 $4,140.00 9 $4,140.00 MOUNT 30 FURNISHANSTALL ALUM SIGN GROUND 2 EA $1,100.00 $2,200.00 2 $2,200.00 MOUNT CITY 31 TRAFFIC CONTROL 4 MO $1,200.00 $4,800.00 4 $4,800.00 32 PORTABLE MESSAGE SIGN 2 WK $750.00 $1,500.00 2 $1,500.00 33 FURNISHANSTALL PTZ CAMERA 1 EA $7,500.00 $7,500.00 1 $7,500.00 34 FURNISHANSTALL PTZ CAMERA CABLE 95 LF $4.00 $380.00 95 $380.00 35 FURNISH AND INSTALL 4G LTE I EA $2,500.00 $2,500.00 1 $2,500.00 CELLULAR/WiFi 36 FURNISH/INSTALL INTERNAL BBU UNIT(ZNC I EA $7,500.00 $7,500.00 1 $7,500.00 5) 37 DRILL SHAFT(TRF SIG POLE)(30 IN) I I LF $385.00 $4,235.00 11 $4,235.00 38 DRILL SHAFT(TRF SIG POLE)(36 IN) 13 LF $410.00 $5,330.00 13 $5,330.00 39 DRILL SHAFT(TRF SIG POLE)(49 IN) 22 LF $465.00 $10,230.00 22 $10,230.00 40 INS TRF SIG PL AM(S)1 ARM(28')LUM 1 EA $8,900.00 $8,900.00 1 $8,900.00 41 INS TRF SIG PL AM(S)I ARM(48')LUM 1 EA $11,100.00 $11,100.00 1 $11,100.00 42 INS TRF SIG PL AM(S)1 ARM(65')LUM 1 EA $22,515.00 $22,515.00 1 $22,515.00 43 PED POLE ASSEMBLY 2 EA $1,500.00 $3,000.00 2 $3,000.00 44 2"CONDT PVC SCH 90 CT(CO#1) 70 LF $14.00 $980.00 70 $980.00 45 FURNISH/INSTALL SIGN MAST ARM MOUNT 2 EA $460.00 $920.00 2 $920.00 (CO 1) Wednesday,January 19,2022 Page 3 of 6 City Project Numbers 102869 DOE Number 2869 Contract Name TRAFFIC SIGNAL IMPROVEMENTS TO SERVE BUSINESS 287 AND E Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING,LIGHTS,SIGNALS For Period Ending 1/19/2021 Project Funding -------------------------------------- Sub-Total of Previous Unit $259,870.00 $259,870.00 -------------------------------------- Wednesday,January 19,2022 Page 4 of 6 City Project Numbers 102869 DOE Number 2869 Contract Name TRAFFIC SIGNAL IMPROVEMENTS TO SERVE BUSINESS 287 AND E Estimate Number I Contract Limits Payment Number I Project Type PAVING,LIGHTS,SIGNALS For Period Ending 1/19/2021 Project Funding Contract Information Summary Original Contract Amount $275,550.00 Change Orders Change Order Number 1 ($9,430.00) Total Contract Price $266,120.00 Total Cost of Work Completed $266,120.00 Less %Retained $0.00 Net Earned $266,120.00 Earned This Period $266,120.00 Retainage This Period $0.00 Less Liquidated Damages Days @ /Day $0.00 LessPavement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $266,120.00 Wednesday,January 19,2022 Page 5 of 6 City Project Numbers 102869 DOE Number 2869 Contract Name TRAFFIC SIGNAL IMPROVEMENTS TO SERVE BUSINESS 287 AND E Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING,LIGHTS,SIGNALS For Period Ending 1/19/2021 Project Funding Project Manager City Secretary Contract Number Inspectors RUFFIN,D / BELTRAN Contract Date 1/25/2021 Contractor DURABLE SPECIALTIES Contract Time 60 WD P O BOX 535969 Days Charged to Date 30 WD GRAND PRAIRIE, TX 75053 Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded ---------------------------- Total Cost of Work Completed $266,120.00 Less %Retained $0.00 Net Earned $266,120.00 Earned This Period $266,120.00 Retainage This Period $0.00 Less Liquidated Damages 0 Days @ $0.00 /Day $0.00 LessPavement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $266,120.00 Wednesday,January 19,2022 Page 6 of 6 � N O N O C) / § k j § \ L LU U k W w A3 � � / \ _ / o § � \ o Cc u § } 2 / ® p h \ § r 0 t \ ) \ \ z / = e a > $ \ \ b § ® � cD ƒ R 2 < < I / g ( � C) § j - e & § � j � O 00 w0 \ �/ \ � 0 I ° E CD / \ \ } w / / § 2 / [ ` L / / " J / ° / kj & @ � o � $ g / # d ( § % \ / > : t _ } / E 2 \ ƒ w @ M Cl) } \ } \ ) m 2 \ \ G { \ ) § \ . & G§ G ) k k / \ } \ ek m / 2 § j ) § & \ g # < b u \ � \k )LU j \ § @ § z § § \ ) \ � \ ) § j / \ p k [ K ( § § / cli G / # E # # z E / % & & m oCl ° / _ < / z # u E / y § ) e / m / e ƒ ƒ / \ O \ / ƒ / / o § 3 ( < } 2 \ u m / 0 O N N s s o 0o a N J O O O O O O O O O O N 0 0 0 0 M a F- .0'oo 0, CD N (CD OD (00 C.O W^ O v (o (0 u� r- v ~ 2 w a o 0 0 0 m z Li Z EA EA�EA�M N �` \ a)L9 Q Z a w .- $ Q 4�4 N m mUa ()LLI y m a a o IL a _ O w � a ._, 4 Z > wLLI Q C� c N � c L) a co E ai Fm g o 2 Q U m z H W� MM� we m ¢ a W zco SU 3 ri O nc� c e dU C N M(mjC) `ma o) a a> > (4 m O o n m � E � w o w E F- E� p > y mQ a o c J CL L'O4 cca C)mr 2C) a .o U1a' v a>i J m N V j c Y a O a a w 0 iv a 0 d a N W N m W J N E (0 J C a W W OI ro p 'm O o yOtu- (Oo U m cm LU Jo o w NO`Up- 2 'C > �' a i- ` $ Om (� LL a p mC m L F G m J c o 3 w 2 w a m w H o a F O a > a p c6 y 0 f..) fn a O T o b — .n = Q W Q m z f- c o o m (n U) o u�0i._°p Z J J �= u. u..LL000 m mU U � j J J J w W W N N M Y co r a c o Z E F o a f o f c O Z r r (6 J O ° < C? o o h O d LL 'T "�' ap 2 ~ N O a Z N w LL C c0 j U (n .0 N m p rn `- c, oo r a a Z 2 0 c' � m 0 m W o u0ovoo � (°i y U. y w C c � c ((00 c M o M <t N EE LL a. .� O Q c O N m 6 N C 'S N m y L U O } N M co co CO -O U U C Ul to N b � LU E t o m d LL � Qc� zw v Y Q cm T li 3 m m N Z Q O w r Y z m 0 E w Q F M m N N N o $ } U < 2a Oa N O a O o C m (n 0 Q a) Ix c a> w c o> w Z, U O 0 FORTWORTH, TRANSPORTATION AND PUBLIC WORKS January 19, 2022 Durable Specialties, Inc P.O. Box 535969 Grand Prairie,TX 75053 RE: Acceptance Letter Project Name:Traffic Signals Improvements to serve Bus. 287 & Eagle Mt. PKWY Project Type:Traffic Siganls City Project No.: 102869 To Whom It May Concern: On January 13, 2022 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 January 13, 2022, 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- 392-7872. Sincerely, ,shalt ha4L'Fz 5. Khal Jaafari P.E.(Jan 27,2022 12:23 CST) Khal Jaafari, Project Manager Cc: Feliberto Beltran, Inspector Mike Myers, Inspection Supervisor Darryl Ruffin,Senior Inspector Victor Tornero, Program Manager Abhishek Acharya, Consultant Patrick C. Bryan, Contractor Robert Hall, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev.08/20/19 CONTRACTOR'S AFFIDAVIT OF BILLS PAID STATE OF TEXAS COUNTY OF TARRANT Personally,before me the undersigned authority,on this day appeared Patrick C. Bryan who,being duly sworn,on oath,says that he is a legal representative of Durable Specialties, Inc. (full name of Contractor as in contract) and that Work Order No. f'J1A for the contract designated as TRAFFIC SIGNAL IMPROVEMENTS TO SERVE BUSINESS 287 AND EAGLE NIOUNTAIN PARKWAY PROJECT NO. 102869 has been satisfactorily completed and that all bills for materials,apparatus, fixtures,machinery and labor used in connection with the construction of this Work Order have,to the best of my know) ge and belief,been fully paid. (Signature) President Title Sworn to and subscribed before me this Zak day of 2022. MARK ARCHIBALD Notary Public,State of Texas Notary Public in and for Nv +P� Comm.Expires 10-14-2023 °°„ �� Notary ID 132209304 Tarrant County,Texas Instructions: If the contractor is an individual,he shall sign the affidavit. If the contractor is a partnership,any partner may sign the affidavit. If the contractor is a corporation,a person authorized by the by-laws or by the Board of Directors shall sign the affidavit. If the Contractor is ajoint-venture of individuals,any of the individuals may sign the affidavit. If the Contractor is ajoint-venture of partnerships,or of individuals and partnerships,the affidavit may be signed by the individual or any partner of any partnership. If the contractor is a joint-venture in which a corporation is a party,separate affidavit must be executed in the name of the joint-venture: one by each corporation and one by each individual or partnership. Signatures for corporations should be by a duly authorized officer. If signature is by another,a showing of authority to sign must accompany the affidavit. 28 CONSENT OF SURETY OWNER ❑ TO FINAL PAYMENT ARCI-ll.TrCT ❑ ALA Document G707 CONTRACTOR ❑ SURLrx U Bond No. 3714946 OTHFA TO ONVNER: ARmncrs PROJECT CIO.: (Nmneemdaddre) Developer Merialge Homes of Texas,LP(City of Fort Worth,Tarrant County) CONTRACT FOR: DSI#043 TX PROJECT- CONTRACT DATED;January 19, 2021 {Nkenem:d ad&r&,0 DSI#043;Traffic Signal Improvements to Serve Business 287 and Eagle Mountain Parkway. CPN 102869 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated!above,the (JuserYrrau:paxd addrt�ofSrnrrjy GreatAmerican Insurance Company 301 East Fourth Street Cincinnati OH 45202 SURM, on Bond of f)nserr)rmneand addmxso/fCorzlraaur) Durable Specialties, Inc. P.O. Box 535969 Grand Prairie TX 75050 CONTRACTOR, hereby approves of the final payment to the Contractor,and Wees that Mal payment to the Contractor shall not relleve the Surety of any of its obhgadons to anserr name card addr-eco of owner) Developer Meriatge Homes of Texas, LP(City of Fort Worth,Tarrant County) TX > OWNER, as set forch in said Surety's bond. IN WITNESS tiY1IiMOF,the Surety has hereunto set its band on this date: January 19, 2022 fhrs n Gr tcvl?h�q the ruonrbjaflourd Fit-rkc nronerrcderea rd vem) GreatAmerican Insurance Company By: lSYj{rrarur�oJarrrborYxrd rrpn�rnurir�) Attest: S,�,�,�p�,�, Teuta Luri Attorney-in-Fat;t (S( 7 Shend Sharani (Airued:Prue and rilr) Surety Phone No. 513-369-5000 G707'1994 GREAT AMERICAN INSURANCE C®MPANYB Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 ® 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is.not more than SIX No.0 21394 PO'"TR OFATTORNEY TCNOWALLMEN BY THESE PRESENTS:That the GREATAMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue ofthe laws ofthe State of Ohio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than one is named,its true and lawful attorney-in-fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,any and all bonds, undertakings and contracts of suretyship,or other written obligations in the nature thereof;provided that the liability of the said Company on any such bond, undertaking or contract of suretyship executed under this authority sball not exceed the limit stated below_ Name Address Limit of Power JACK M.CROWLEY DALLAS,TEXAS ALL STEVEN R.FOSTER DALLAS,TEXAS $100,000,000 TEUTA LURI DALLAS,TEXAS LAURIE PFLUG DALLAS,TEXAS CARLOS ALBELO HOUSTON,TEXAS STEPHANIE GUNDERSON HOUSTON,TEXAS This Power ofAttomey revokes all previous powers issued on behalf of the attomey(s)-m-fact named above. IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 24TH day of JUNE 1 2020 Attest GREATAMERICAN INSURANCE COMP ���?�•g 44 tF' Assistant Secretary Divisional Senior Vice President STATE OF OHIO,COUNTY OF I IAMILTON-ss: MARK viCAwo(877-377-2405) On this 24TH day of JUNE 2020 before me personally appeared MARK VICARIO,tome known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President ofthe Boad Division of Great American Insurance Company,the Company described in and which executed the above inst timent;that he knows the seal ofthe said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority ofhis office under the By-Laws of said Company,and that he signed his name thereto by like authority. SUSAN A KCHORST Notary Public State of my Comm.Expires Qcs�- al may 18,2025 &a.1y This Power ofAttomey is granted by authority ofthe following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President,the several Divisional Senior Irce Presidents,Divisional Vice Presidents and Dtvisonal Assistant Vice Presidents,or any one of them,be and hereby is authorized from time to time,to appoint one or more Atiorneys-in Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts ofsuretyship,or other written obligations in the nature thereof,'to prescribe their respective duttes and the respective limits of their authority,-and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of arty ofthe aforesaid officers and arty Secretary or Assistant Secretary ofthe Company may be aff—d by facsimile to any power of attorney or certificate of either gtven for the execution of arty bond.undertaking,contract of suretyship, or other written obligation in the nature thereof,such signature and seal when soused being hereby adopted by the Company as the original signature ofsuch officer and the original seal ofthe Company,to he valid and binding upon the Company with the same force and effect as though manually affixed CERTIII ICATION I,STEPHEN C.BERAHA,Assistant Secretary of GreatAmerican Insurance Company,do hereby certify that the foregoing Power ofAttomey and the Resolutions ofthe Board of D rectors of June 9,2008 have not been revoked and are now in full farce and effect. Signed and sealed this 19th day of January 2022 `W a Y Assistant Secretary S1029AH(oa/20) Great American Insurance Company of New York GIiEATr` rl✓IEItt`CA14. Great American Alliance Insurance Company INSURANCE GROUP Great American Insurance Company IMPORTANT NOTICE: To obtain information or make a complaint: You may contact the Texas Department of Insurance to obtain information on companies, coverages,rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance at: P.O. Box 149104 Austin.TX 78714-9104 FAX: 1-512-475-1771 Your notice of claim against the attached bond may be given to the surety company that issued the bond by sending it by certified or registered mail to the following address: Mailing Address Great American Insurance Company P.O. Box 2119 Cincinnati,Ohio 45202 Physical Address: Great American Insurance Company 301 E.Fourth Street Cincinnati,Ohio 45202 You may also contact the Great American Insurance Company Claim office by: Fax: 1-888-290-3706 Telephone: 1-513 369-5091 Email: bondelaims@gaic.com PREMIUM OR CLAIM DISPUTES: If you have a dispute concerning a premium,you should contact the agent first.If you have a dispute concerning a claim,you should contact the company first.If the dispute is not resolved,you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR BOND: This notice is for information only and does not become a part or condition of the attached document. F.9667A(3/11)