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Home My WebLink AboutContract 55849-FP1 City Secretary 55849 -FP1 Contract No. FORTWORTHO Date Received Mar 25,2022 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: Sully's Car Wash City Project No.: 103197 Improvement Type(s): Water M Sewer Developer Cost City Cost Total Water $24,395.19 $22,295.81 $46,691.00 Sewer $111,834.30 $27,655.70 $139,490.00 Original Contract Price: $136,229.48 $49,951.52 $186,181.00 Amount of Approved Change Order(s): ($9,039.82) ($5,501.18) ($14,541.00) Revised Contract Amount: $127,189.66 $44,450.34 $171,640.00 Total Cost of Work Complete: $127,189.66 $44,450.34 $171,640.00 -;;z Mar22,2022 Kevin Mezeer(Mar 22,2022 08:34 CDT) Contractor Date Director of Retail/Principal Title Ridgemont Company Name 6 r/l'imwlleei Mar 23 2022 1 Pedro G.Hernandez(Mar 23,2022 07:41 CDT) Project Inspector Date a�6� uJL Mar 23,2022 Project Manager Date E(I�ly a"f/b z M a r 25,2022 Evelyn Moberts on behalf of(Mar 25,202210:3 CDT) CFA Manager Date Dana Burcihdo Mar 25,2022 Dana Burehdoff(Mar 25,202211:33 CDT) OFFICIAL RECORD Page 1 of 2 CITY SECRETARY FT. WORTH, TX Asst. City Manager Date Notice of Project Completion Project Name: Sully's Car Wash City Project No.: 103197 City's Attachments Final Pay Estimate ❑x Change Order(s): ❑x Yes ❑ N/A Pipe Report: ® Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 40 WD Days Charged: 87 Work Start Date: 8/3/2021 Work Complete Date: 3/18/2022 Completed number of Soil Lab Test: 83 Completed number of Water Test: 2 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name SULLY'S CAR WASH Contract Limits Project Type WATER City Project Numbers 103197 DOE Number 3197 Estimate Number 1 Payment Number 1 For Period Ending 2/15/2022 WD City Secretary Contract Number Contract Time 4WD Contract Date 6/16/2021 Days Charged to Date 87 Project Manager NA Contract is 100.00 Complete Contractor RIDGEMONT COMPANY 1520 W.WALNUT HILL LANE IRVING, TX 75038 Inspectors MILLER,W / HERNANDEZ,P Wednesday,March 23,2022 Page 1 of 5 City Project Numbers 103197 DOE Number 3197 Contract Name SULLY'S CAR WASH Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER For Period Ending 2/15/2022 Project Funding UNIT I:WATER IMPROVEMENTS i Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 4"-12"PRESSURE PLUG 2 EA $767.50 $1,535.00 2 $1,535.00 2 TRENCH SAFETY 183 LF $3.00 $549.00 183 $549.00 3 DUCTILE IRON WATER FITTINGS 0.75 TN $6,100.00 $4,575.00 0.75 $4,575.00 4 6"PVC WATER PIPE 5 LF $34.20 $171.00 5 $171.00 5 8"DIP WAER 25 LF $103.00 $2,575.00 25 $2,575.00 6 8"PVC WAER PIPE 149 LF $61.00 $9,089.00 149 $9,089.00 7 8"DIP WATER,CLSM BACKFILL 9 LF $96.00 $864.00 9 $864.00 8 8"PVC WATER PIPE,CLSM BACKFILL 18 LF $78.00 $1,404.00 18 $1,404.00 9 FIRE HYDRANT I EA $5,736.00 $5,736.00 1 $5,736.00 10 CONNECTION TO EXISTING 12"WATER MAIN I EA $4,328.00 $4,328.00 1 $4,328.00 11 1"WATER MAIN SERVICE 2 EA $1,929.00 $3,858.00 2 $3,858.00 12 2"WATER MAIN SERVICE 1 EA $2,949.00 $2,949.00 1 $2,949.00 13 6"GATE VALVE 1 EA $1,614.00 $1,614.00 1 $1,614.00 14 8"GATE VALVE 4 EA $1,861.00 $7,444.00 4 $7,444.00 ------------------- ------------------- Sub-Total of Previous Unit $46,691.00 $46,691.00 UNIT II:SANITARY SEWER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- I REMOVE 4'SEWER MANHOLE 1 EA $1,895.00 $1,895.00 1 $1,895.00 2 POST-CCTV INSPECTION 572 LF $1.00 $572.00 572 $572.00 3 MANHOLE VACUUM TESTING 9 EA $220.00 $1,980.00 9 $1,980.00 4 TRENCH SAFETY 572 LF $1.00 $572.00 572 $572.00 5 TRENCH WATER STOPS 4 EA $1,644.75 $6,579.00 4 $6,579.00 6 4"SEWER SERVICE(CO#1) 2 EA $1,463.00 $2,926.00 2 $2,926.00 7 4"SEWER SERVICE,RECONNECTION I EA $1,168.00 $1,168.00 1 $1,168.00 9 8"SEWER PIPE(CO#1) 414 LF $91.00 $37,674.00 414 $37,674.00 10 8"SEWER PIPE,CSS BACKFILL 90 LF $107.00 $9,630.00 90 $9,630.00 11 4'MANHOLE(CO#1) 7 EA $5,350.00 $37,450.00 7 $37,450.00 12 EPDXY MANHOLE LINER 20 VF $314.00 $6,280.00 20 $6,280.00 13 WASTEWATER ACCESS CHAMBER 1 EA $3,483.00 $3,483.00 1 $3,483.00 Wednesday,March 23,2022 Page 2 of 5 City Project Numbers 103197 DOE Number 3197 Contract Name SULLY'S CAR WASH Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 2/15/2022 Project Funding 14 4'EXTRA DEPTH MANHOLE(CO#1) 22 VF $670.00 $14,740.00 22 $14,740.00 -------------------------------------- Sub-Total of Previous Unit $124,949.00 $124,949.00 -------------------------------------- Wednesday,March 23,2022 Page 3 of 5 City Project Numbers 103197 DOE Number 3197 Contract Name SULLY'S CAR WASH Estimate Number 1 Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 2/15/2022 Project Funding Contract Information Summary Original Contract Amount $186,181.00 Change Orders Change Order Number 1 ($14,541.00) Total Contract Price $171,640.00 Total Cost of Work Completed $171,640.00 Less %Retained $0.00 Net Earned $171,640.00 Earned This Period $171,640.00 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 $171,640.00 Wednesday,March 23,2022 Page 4 of 5 City Project Numbers 103197 DOE Number 3197 Contract Name SULLY'S CAR WASH Estimate Number I Contract Limits Payment Number 1 Project Type WATER&SEWER For Period Ending 2/15/2022 Project Funding Project Manager NA City Secretary Contract Number Inspectors MILLER,W / HERNANDEZ,P Contract Date 6/16/2021 Contractor RIDGEMONT COMPANY Contract Time 40 WD 1520 W.WALNUT HILL LANE Days Charged to Date 87 WD IRVING, TX 75038 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 $171,640.00 Less %Retained $0.00 Net Earned $171,640.00 Earned This Period $171,640.00 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 $171,640.00 Wednesday,March 23,2022 Page 5 of 5 DEVELOPER-AWARDED-PROJECT CHANGE ORDER PROJECT NAME: SuIVsCarWash I CHANGE CONTRACT: Water and Sewer Improvements ORDER No: CFA# CFA21.0052 CITY PARTICIPATION:1 YES CITY PROJECT# 103197 CITY SECRETARY CONTRACT# CS-55849 1 - FID# 3M 14.0200,131-103S97-E07685 FILE# X-26929,K-2837 INSPECTOR: Pedro Hernandez Phone No: (817)992-3991 PROJECT MANAGER: Debbie J.Wilhelm Phone No: (S17)392-2481 CONTRACT UNIT WATER SEINER PAVING ATER) I PAVING(SEWERI TPW CONTRACT ❑eveloper Developer Developer Developer Developer DAYS COST City COst Cost City Cost Cost City C051 Cost City CO51 Coat CIty COSI ORIGINAL CONTRACT $ 24,305.19 $ 22,295,81 $111,634.30 S 27.655.70 $ 12,108.12 S 21.140.68 $ 02,014.27 $ 26,645.35 S 40 EXTRAS TO DATE CREDITS TO DATE CONTRACT TO DATE $ 24,395.19 S 22,295.81 $111,834.30 S 27.655.70 S 12,108.12 $ 21.140.88 $ 82,014.27 $ 28,645.35 S 40 AMOUNT OF PROP.CHANGE ORDER $ S (91039.02)$ (5,501.161 $ $ REVISED CONTRACT AMOUNT $ 24,395.19 I S 22,295.8f S 102,794.48 $ 22.154.52 $ 12,1G8A2 it 21,140.88 S 82,014.27 $ 28,645.35 S -Is - 40 TOTAL REVISED CONTRACT AMOUNT PER $46,691.00 $124,949.00 $33.249.00 S110,659.62 $0.00 UNIT REVISED COST SHARE Dev.Cost: $221.312.06 City Cost: $94,236.58 TOTAL REVISED CONTRACT $315,548.62 Revised:12.17-2018 Pagel You are directed to make the following changes In the contract documents CITY BID ITEM I DEVELOPER CITY PAY ITEMN I 0 QUANTITY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL TOTAL UNIT I-WATER $ S $ - $ $ s SUBTOTAL-UNIT I-WATER $ $ UNIT II-SEWER 6 3331M01 I 1 I EA IVSEWER SERVICE $ 1463.00 $ 1463.00 S 0 3331.4102 -16 LF S'SEWER PIPE $ 73.00 $ 1,168.00 $ 9 3331AIl-5 -16 LF B'SEWER PIPE $ 91.00 $ 916.12 $ 539.88 11 3339.1001 -2 EA 4'MANHOLE $ 5,350.00 $ 6,732.44 $ (3,967.56) 14 3339.1003 -4 VF 4'EXTRA DEPTH MANHOLE $ 670.00 $ 1,686.26 $ 993.74 SUBTOTAL UNIT II-SEWER $ 9039.82 $ 5501.18 UNIT IIIA-PAVING ATER $ $ $ $ $ $ SUBTOTAL UNIT IIIA-PAVING(WATER $ $ UNIT 11113-P9ING SEWER $ - $ $ $ $ $ SUBTOTAL UMT 11113-PAVING(SEWER $ $ GRAND TOTAL $ (9,039.82) $ (5,501.18 Asterisk I')Indicates Novi Pay Item REASONS FOR CHANGE ORDER Revised 6"sewer service wIMH to 4"sewer service wfcieanoul.Revised localkm of proposed MH to avoid conflict with franchise utilities.Connected to existing waterline with TSBV Instead of cut-In lee.Changes correspond to Revision No.1 and 2 as shown on sheets C008-COM No change In number of days. This project has City Participation.This Change Oder reduces the City Participation by$5,501.18 (SIGNATURES APPEAR ON THE FOLLOWING PAGE] Revised:12-17-2018 Page 2 RECOMMENDED: APPROVED: APPROVED: Pelolon Land Solutions The Ridgemonl Company SSR Corwash,LP By ��j�'� By r. v amm� g�,e,.�r•>,rr rmi Name:David Shorter Name:Kevin D.Mezger Name: Daniel Rhea Title:_Project Manager Title: Pdncioal Thle:_Manager APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY: CFW-Sponsoring Department CFW-Assistant City Manager CFW-Assistant City Attorney 1£W 1:7Fpe>(12c Deee. By. By ...,�a,eLisi,!-+uian By, ,..,•-:.- Name:Victor Tomato,PE Name: Dena Burghdoff Name: Richard McCracken Title:Acting Engineering Manager Title: —As,Wa t n'y Manager Title: Senior Assistant City Attorney RECOMMENDED: CFW-'Contract Compilarlce Manager ATTEST •Contract Compliance Manager(Project Manager): wtan W.H�.d. By signing 1 acknowledge Thal I am Ilia person responsible By. d nax� >�.5 OAZ(,& for the monitoring and administration of this contract,Include ensuring all performance and reporting requirements. Name: Debbie J.Willhelm,PE Jannette S.Goodall City Secretary []There are NO City Funds associated wtth this Contract Title:Senior Professional Engineer ❑�There are City Funds associated with this Contract MSC Number. NIA M&C Date Approved: NIA Revised:12-17-2010 Page 3 Fo.RT WORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Sully's Car Wash CPN 11 103197 CITY PROJECT NUMI3ER: "103197" WATER PIPE LAID SIZE TYPE OF PIPE LF 8" DIP 34 8" PVC 167 6" PVC 5 FIRE HYDRANTS: 1 VALVES(16"OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: 2 1"Water service l V Irrigation Water service 1 2"Water service SEWER PIPE LAID SIZE TYPE OF PIPE LF 8" PVC 504 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth-1000 Throclanorton Street•Fort Worth,TX 76012-6311 (817)392-7941 -Fix:(817)392-7845 FORTWORTH, TRANSPORTATION AND PUBLIC WORKS March 18, 2022 Ridgemont Commercial Construction 1520 W. Walnut Hill lane Irving,TX 75038 RE: Acceptance Letter Project Name:Sully's Car Wash Project Type: Water,Sewer, Paving City Project No.: 103197 To Whom It May Concern: On March 7, 2022 a final inspection was made on the subject project. There were punch list items identified at that time. The punch list items were completed on March 18, 2022. The final inspection and the corrected punch list items indicate that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on March 18, 2022,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 Debbie Willhelm—817-392-2481. Sincerely, I T P/yfJL2 V. U/��L Debbie Willhelm, Project Manager Cc: Pedro G. Hernandez, Inspector Wade Miller, Inspection Supervisor Ariel Duarte,Senior Inspector Debbie Willhelm, Program Manager Peloton Land Consutltants,Consultant Ridgemont Commercial Construction, Contractor SSR Carwash LP, Developer File E-Mail: TPW—Acceptance@fortworthtexas.gov Rev.8/20/19 ` A 1A Document G706 - 1994 Contractor's Affidavit of Payment of Debts and Claims PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER: Sully's Car Wash ARCHITECT:❑ 2020 Sycamore School Rd CONTRACT FOR:CFA#21-0052 CFA CONTRACTOR: Fort Worth,TX 9103197 SURETY: TO OWNER:(Name and address) CONTRACT DATED:June 16,2021 OTHER:❑ SSR Carwash LP dba Sully's Car Wash 4532 Cloudview Rd Fort Worth,TX 76109 STATE OF: Texas COUNTY OF: Dallas The undersigned hereby certifies that,except as listed below,payment has been made in full and all obligations have otherwise been satisfied for all materials and equipment furnished,for all work,labor,and services performed,and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered. EXCEPTIONS: Paid complete$330,089.62 SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name and address) 1. Consent of Surety to Final Payment. Whenever Ridgemont Commercial Construction Surety is involved,Consent of Surety is 1520 W.Walnut Hill Lane required. AIA Document G707,Consent of Irving,TX 75038 Surety,may be used for this purpose Indicate Attachment ❑ Yes ® No BY: The following supporting documents should be attached (Signat re of authorized representative) hereto if required by the Owner: Dixie Hanner,Vice Presidnet 1. Contractor's Release or Waiver of Liens, (Printed name and title) conditional upon receipt of final payment. 2. Separate Releases or Waivers of Liens from Subscribed and sworn to before me on this date: Subcontractors and material and equipment suppliers,to the extent required by the Owner, accompanied by a list thereof. o 3. Contractor's Affidavit of Release of Liens(AIA M Sri Exppgq Nry523 otaDocument G706A). STATEOFTEXAS My Comm.Exp.12123/2023 NOTARY ID 1160884-2 AIA Document G706'—1994.Copyright @ 1970 and 1994 by The American Institute of Architects.All rights reserved.The"American Institute of Architects," "AIA,"the AIA Logo,and"AIA Contract Documents'are registered trademarks and may not be used without permission.This document was produced by AIA software at 16:26:41 ET on 03/21/2022 under Order No.7040098398 which expires on 08/26/2022,is not for resale,is licensed for one-time use only,and may only be used in accordance with the AIA Contract Documentse Terms of Service.To report copyright violations,e-mail copyright@aia.org. User Notes: (3139ADA63) CONSENT OF OWNER SURETY COMPANY ARCHITECT TO FINAL PAYMENT CONTRACTOR SURETY AIA.DOCUMENT G707 OTHER Bond No. PRF9370747 PROJECT: Sully's Car Wash,Ft Worth TX (name,address) TO (Owner) [ City of Fort Worth ] ARCHITECT'S PROJECT NO: 1000 Throckmorton Street Fort Worth,TX 76102-6312 CONTRACT FOR: [ ] CONTRACT DATE: CONTRACTOR: The Iidgemont Company 1520 W.Walnut Hill Lane Irving,TX 75038-3701 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (here insert name and address of Surety Company) Colonial American Casualty and Surety Company 1299 Zurich Way,5th Floor Schaumburg,IL 60196-1056 , SURETY COMPANY, on bond of(here insert name and address of Contractor) The Ridgemont Company 1520 W.Walnut Hill Lane Irving,TX 75038-3701 , CONTRACTOR, hereby approves of the final payment to the Contractors,and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to(here insert name and address of Owner) City of Fort Worth 1000 Throckmorton Street Fort Worth,TX 76102-6312 ,OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 21st day of March 2Q22 Colonial American Casualty and Surety Company Surety Company Signature of Authorized Representative Attest: ��—� �� (Seal): Debra Lee Moon Attorney-In--F_act Title NOTE: This ronn is to be used as a companion document to AIA DOCUMI-Nr G706,CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition AIA DOCUMENT G707 CONSENT OF SURETY COMPANY TO FINAL PAYMENT APRIL 1970 EDITION AIA ONE PAGE 1970 THE AMERICAN INSTrru,rl-,OF ARCHITECTS,1735 New York Ave.,NW,WASHINGTON,D.C. 20006 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert D.Murray,Vice President,in pursuance of authority granted by Article V,Section 8,of the By-Laws of said Companies,which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate,constitute, and appoint Sammy Joe MULLIS,JR.,Suzanne Elizabeth NIEDZWIEDZ,John Wiltiam NEWBY,Joshua D.TRITT,Sandra Lee RONEY,Debra Lee MOON,Andrea Rose CRAWFORD,Troy Russell KEY,Cheri Lynn IRBY of Addison,Texas,EACH,its true and lawful agent and Attomey-in-Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents,shall be as binding upon said Companies, as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,New York.,the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 19th day of February,A.D.2021. J�ovaJ�� UAL ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND By: Robert D. Murray Vice President By: Dawn E.Brown Secretary State of Maryland County of Baltimore On this 19th day of February, A.D.2021, before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,Robert D. Murray,Vice President and Dawn E.Brown,Secretary of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith,that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. Sj NN n. / iriv Constance A.Dunn,Notary Public My Commission Expires:July r2023 1. �Ilt11111� - Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-87". \ EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact.The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations,undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE 1, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED:"That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on theCompany." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the I0th day of May,1990. RESOLVED:"That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 21st day of March 2022 ws 86AL By: Brian M.Hodges Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND,PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND,THE BOND NUMBER,AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg,IL 60196-1056 www.reportsfclaimst�zurichna.com 800-626-4577 m ZURICH Texas Important Notice IMPORTANT NOTICE AVISO IMPORTANTE To obtain information or make a complaint: Para obtener informacion o para presentar una queja: You may call Zurich North America's toll-free telephone Usted puede Ilamar al numero de tel6fono gratuito de number for information or to make a complaint at: Zurich North America's para obtener informaci6n o para 1-800-382-2150 presentar una queja al: You may contact the Texas Department of Insurance to 1-800-382-2150 obtain information on companies, coverages, rights, or Usted puede comunicarse con el Departamento de Se- complaints at: guros de Texas para obtener informacion sobre com- 1-800-252-3439 paMlas, coberturas, derechos, o quejas al: 1-800-252-3439 You may write the Texas Department of Insurance: Usted puede escribir al Departamento P.O. Box 149104 de Seguros de Texas a: Austin,TX 78714-9104 P.O. Box 149104 Fax: (512)490-1007 Austin, TX 78714-9104 Web: www.tdi.texas.gov Fax: (512)490-1007 E-mail: ConsumerProtection@tdi.texas.gov Sitio web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or DISPUTAS POR PRIMAS DE SEGUROS O about a claim, you should contact the company first. If RECLAMACIONES: the dispute is not resolved, you may contact the Texas Si tiene una disputa relacionada con su prima de seguro Department of Insurance, o con una reclamaci6n, usted debe comunicarse con la compan(a primero. Si la disputa no es resuelta, usted ATTACH THIS NOTICE TO YOUR POLICY: puede comunicarse con el Departamento de Seguros de This notice is for information only and does not become Texas. a part or condition of the attached document ADJUNTE ESTE AVISO A SU P6LIZA: Este aviso es solamente para prop6sitos informativos y no se con- vierte en parte o en condici6n del documento adjunto. U-GU-296-E(06/15) Page 1 of 1