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Contract 53040-R1FP1
FORT WORTH, -Ir TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION City Secretary No:_53040-R1 FP1 Date Received:Apr 5, 2022 City Project Ns: 102196 Regarding contract 53040-R1 for SEWER MAIN EXTENSIONS REPLACEMENT AND RELOCATION 2019 as required by the WATER DEPARTMENT as approved by City Council on 09/17/2019 through M&C 19-0162 the director 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: $1,000,000.00 Amount of Approved Change Orders: $ 0 Revised Contract Amount: $1,000,000.00 Total Cost Work Completed: $ 993,027.05 Less Deductions: Liquidated Damages: 0 Days®$500.001 Day Pavement Deficiencies: Total Deduction Amount: $0.00 Total Cost Work Completed: $ 993,027.05 Less Previous Payments: $ 928,443.55 Final Payment Due $64,583.50 `aunen Prow, Apr 4 2022 Lauren Pneur(Apr 4,2022 08:47 CDT) 7 Recommended for Acceptance Asst. Date Director, TPW- Capital Delivery Christopher Hard (Apr 4,202208:53 CDT) Apr 4, 2022 Accepted Date Director, WATER DEPARTMENT Client Department Dana Burghdoff(Ap. .,2022 516 CDT) Apr 4,2022 Asst. City Manager Date Comments: OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX C-620 Signature Page Contractor's Application for Payment Invoice No. Two (Final) To(Owner) City of Fort Worth Invoicing Period(From-To): Invoice Date: 6/25/2021 to 2/16/2022 2/16/2022 P.O. FW060-00000012833 From(Contractor): Remit to(If Not Automatic Deposit): Number: CIRCLE C Project: 102196 Contractor's CFW Vendor No.: Contract City secretaryNumber: 53040 Contract Sewer Main Extensions,Replacements and Relocations 2019 Number: Name: Application For Payment Change Order Summary Approved Change Orders 1. ORIGINAL CONTRACT PRICE......................................................... $ $1,000,000.00 Number Additions Deletions 2. Net change by Change Orders............................................................... $ 1 3. Current Contract Price(Line 1+2)...................................................... $ $1,000,000.00 2 4. TOTAL COMPLETED AND STORED TO DATE 3 (Progress Estimate,Construction Allowance and Change Orders)..... $ $993,027.05 4 5. RETAINAGE: 5 a. X $993,027.05 Work Completed......... $ 6 b. X Not Used $ 7 c.Total Retainage(Line 5a+Line 5b).............................. $ 8 6. AMOUNT ELIGIBLE TO DATE(Line 4-Line 5c)........................... S $993,027.05 TOTALS 7. LESS PREVIOUS PAYMENTS(Line 6 from prior Application)....... $ $928,443.55 NET CHANGE BY 8. AMOUNT DUE THIS APPLICATION................................................ S $64,583.50 CHANGE ORDERSI 9.BALANCE TO FINISH,PLUS RETAINAGE (Column G on Progress Estimate+CA+Cos+Line 5 above)............. $ $1,000,000.00 Contractor's Certification 10. CONTRACT TIME: The Contractor certifies with the submittal of this document and associated Payment Request a. Days Awarded 365 Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge:(1)all b, Days Added by CO previous progress payments received from Owner on account of Work done under the Contract have c. Total Days 365 been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Applications for Payment;(2)title of all Work,materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass d. Days Charged 647 to Owner at time of payment free and clear of all Liens,security interests and encumbrances(except such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, e. Days Remaining 2g2 security interest or encumbrances);and(3)all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Teresa Skelly Teresa Skelly(Mar 29,2022 13:44 CDT) This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications.You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. _E 11N Pr¢e Poo,,,.EM Progress Estimate coy EI 33040 Contractor's Application Feet Sewer Main Extensions,Replacements and Relocations 2019 "T da° 6� Tna(Finaq 6/2512021 to 2/16/2022 AnIE oonI Lz6rs0z2 A B c D E F 0 Sm TylCargkW •; BaRebFvW, BUM1®I:n pmweim sleairaioo IfiaM BiJ Qi.-e113' LFil Pix BM\'Yoe Q 7 VMm nJ+ic`^IY]railk4\'efi>: Y.hnllue PaioJ L-iftc) WSIDNbDu \'lcrk Ordx MoE'zn[ion 0,700102 Ea t00 Po.. 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V 5D W000O S230. $11.SW DO $11 AO DO 10'Wsfg By DNe JY 5.I., V. SOOWOW 3250 DO 412500 DO $1250000 12'Casng By WurTNn Open CW 3Y35.I IUI V IONOND 45W DO S25 No 00 $25,W0 D0 16'Gsng By WxrTMn Open LW 3»5.1102 V. 0W 50OW 455oDO S21.500W 52]00 500 20'Casrg It,WaTMn Open CU 3Y)5.1tUJ V. 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SS 000 Oo 100000000 450000o 5500000 SS W000 1.o, A-30) Yfoo-Tunrel U _ 0000o00 SS5000 $6 no 00 BOpppOp00 45 E000o 56.60000 4580000 10- _ A-300 42-11, .,Tunnel U 30000000 S550. 5155000. 30000o0W0 $155oo oo 51650000 515500.00 1.oS5 p-299 5'T1reADrop NH Oii' Ea 1.000000 311000 p0 51500000 1.00000000 S1500000 $1500p Op 515000.00 ioo oss A-300 5'T1pea Dmp 1.-H E-Depin N 20000000 455000 $1100000 2000000000 $1100000 411,p00 p0 $1100000 1000". Totals ]]60]60 ]99]02>.OS S92B 11165 58160].60 fffl A6 2B JK S3 11 6.TT iltitd hu hm�fN Om iu vW^,If unE1CDCdinmSNO<aa Ai rc4Eiihte�a We mtifiatims Tw.e mavale4brra]Vv d. QefiiyNmnuY lepl Cawel S"kc ra iu emiim City of Fort Worth Summary of Charges City Secretary Contract Num: 53040 Sewer Main Extensions,Replacements and Relocations 2019 P.O' FW060-00000012833 Project Number: 102196 Application Period: 6/25/2021 to 2/16/2022 Application Two(Final) Application Date: 2/16/2022 Number: Funding Identification(FID) Total Completed Amt Remaining Gross Retainage Net original Contract 56002-0700430-5740010-102196-9999 $967,027.05 $2,514 575.77 $4 513.00 50 i7C $4,513.00 0 (c0.00 $0.00 S0.00 50.00 !-.0 Lin 0 $0 00 $0.00 :30,00 50.00 :'.n.no 0 $0.00 $0.00 50.0010.00 50 00 0 :60.00 $Qon 50.00 S0.00 FO.Ori 0 :r-0 Co $0 Oo $0 00 0.00 S10 00 0 :+0.00 $0.00 50.00 .50.00 SO GO 0 $,0.00 $0.00 5O 00 50 00 SO 00 0 50.00 $OA0 FQOo 50.00 :ii0.00 0 S0 00 'k0A0 s0.00 50.00 SO.00 0 s0 00 TO 00 =rn).00 50.00 SO.Co I Chan a Order 1 56002-07004305740010-102196-9999 al 00 $•0 00 SO Go so 00 30.00 0 50 00 SO 00 So 00 0 1 1 '00.00 $0.00 50 00 50.00 SO 00 0 ?o On $0.00 50.00 50.00 so.00 0 V)00 $0,00 50.00 50.00 :7'0.00 0 0 00 50.00 so CD '00.00 SO 00 0 $0.00 $0.00 SOACi 5000 30 00 0 ,t0 00 $0.00 S0 On00 00 50.0_'� 0 :?-0.00 $0.01) 50.00 0 $OAO $0.00 SQOS� O 00 S0.00 0 50.00 $0.00 SO .5000 'i0_o0 Change Order 56002-07004305740010-102196-9999 b0.00 $0.00 50.00 sU 0,i 0 $0.00 $0,00 SO.00 '0 00 0 :;i i.00 $OAO 30.00 50.00 0 $0.00 $0.00 s0.00 c0.00 p 0 00 "m 00 50.00 so 00 0 40 00 g0.00 50.00 SO.00 0 $0.00 $0AO -0,00 50.00 0 W OL) $000 Co 00 S000 p $0.00 $ton 80.00 S0 00 0 $0 00 $0.00 50 00 50.00 0 i0.00 $0.OD So o0 5QC0 City of Fort Worth Summary of Charges City Secretary Contract Num: 53040 Sewer Main Extensions,Replacements and Relocations 2019 P.D. FW060-00000012833 Project Number: 102196 Application Period: 6/25/2021 to 2/16/2022 Application Two(Final) Application Date: 2/16/2022 Number: Funding Identification(FID) I mt Remaining Gross Retaina a Net Change Order 3 �I - 56002-0700430-5740010-102196-9999 I iu o0 50.00 I SoOQ 0 §200 S0.00 0 $0.00 S0.00 50.00 0 :In Q0 so 00 ,0.00 0 0 $0 00 a o0 0 so 00 no 0 .0 SG.OQ 00 0 0 i0.0U I �GO 0 SO.00 0 $o 00 0 SO.QO I � Change Order 56002-0700430-5740010-102196-9999 40 00 $0.00 50 00 0 :1,0.00 $0.00 S000 50.00 0 gO ru) $Q_QQ WOO 30.00 0 $n n; $QQQ MOO 5000 0 ,n0.00 .Soon SO 00 0 -0.00 $0.00 SO.00 0 $0.00 Sri rrn I GO 00 0 :yn QD ,O.On SO Oo 0 ;Q.00 $0.0o 1 0.00 0 $Ooo v0.00 S000 0 $0 OU :':n 00 - 50.00 Change Order 56002-0700430 5740010-102196-9999 :-0.00 50.00 0 $0.00 :;.q i�n ;30.00 0 I $0.00 :;.O.Go so 00 0 I`o.QO ibQ.00 i0.00 I 0 $0 00 lho.00 50.00 0 ,tin 00 $0.00 So.00 0 SO.nO $0 0O SO 00 0 $0.00 50.00 S0.00 0 "0 00 $0.00 S0.00 0 n.00 $0.00 a0.00 0 a O.nn :GO.OQ 50.Oo 50.00 City of Fort Worth Summary of Charges City Secretary Contract Num: 53040 Sewer Main Extensions,Replacements and Relocations 20197 O' FW060-00000012833 project Number: 102196 Application Period: 6/25/2021 to 2/16/2022 Application Two(Final) Application Date: 2/16/2022 Number: Funding Identification(FID) -� Total Completed Arm Remaining Gross I I Retaina a Net Change Order 56002-0700430-5740010-102196-9999 G 00 SO.00 u.('u o 0 OU 0 0 pO U OU So 00 0 00 SO UO 0 $0.00 5.nor) 50.00 SO 00 SO OO 0 $0.00 $G.00 50.0D :-O.Cri SQ00 0 $O.00 "to)0 0.00 ., 50.00 0 30.00 $0.00 SO.00 SO.00 0 ,W 00 $0.00 $0.00 I SO OD 0 :0 00 $0 00 S0,00 JU.00 5000 0 :,{100 $Q.OU - 50.00 *0 CIO 50.00 0 :(0.00 :'0.00 WOO 3000 SO.00 Change Order 56002-0700430-5740010-102196-9999 W CO $0.00 SO.00 50 00 SO 00 0 60.00 g0 UO SU O' $U 00 SO 00 0 ;o 00 $G 00 Sul SQ.00 `0.OU 0 :#0 0 n0 50 On EQ00 0 G fir) 0 IN 20 00 SO 00 0 M�,n. MOO '';u SO 00 SO GO 0 V)000 $0 000 :b0.00 UO0 S�OOn 50.00 so 00 0 ;ll GU SO.OD SO.OG Change Order 56002-0700430-5740010-102196-9999 $u 00 $0.00 SG 00 50.00 0 5,n 00 $DAO SO 00 Sri no 0 30.O11 $0.00 SO.00 :>0.00 0 :0.Go $0.00 :O.UO 50.00 - 0 �"O.Or) 000 $0.00 SO.OG 0 :*O.00 s0.00 :;0.00 50.00 0 q-p)nr) '$0.00 SO AO 100 0 ''Q.00 7t'0.00 SO.UO SO.00 0 $0.00 'A4.Go SO 00 50.00 0 $1)00 $0.00 F,0.00 S0.00 0 $O.UO :SO.GG 50.00 50.00 City of Fort Worth Summary of Charges City Secretary Contract Num: 53040 Sewer Main Extensions,Replacements and Relocations 2019 P.0' FW060-00000012833 project Number: 102196 Application Period: 6/25/2021 to 2/16/2022 Application Two(Final) Application Date: 2/16/2022 Number: Funding Identification(FIC Total Completed Amt Remaining Gross Retainage Net Totals 56002-0700430-5740010-102196-9999 $967,027.05 $2,514,576.77 $4,513.00 Ju4G $4613.00 0 "100 _,0 nn -0.00 S0.00 >0 nQ 0 W.00 :;n.On F0.00 :::0 00 50 OU 0 '$0.00 n.00 50 00 :i0 00 0 $O.Or) bn OO ? SO.00 50.00 0 W 00 $O.pn SO On JO 00 0 11.0.00 50.00 7U.0n ;O.00 p �O np 10 00 0-CO SO AO p .n Un ;--O.OD S0.00 :;0.00 0 '�)iin ;i).00 i;OOrJ SO 00 Grand Total $967,027.05 $2,514,575.77 $4,513.00 $0.00 $4,513.00 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Sewer Main Extensions Replacement and Relocations 1 st Rnewal CITY PROJECT NUMBER: 102196 WATER PIPE LAID SIZE TYPE OF PIPE LF FIRE HYDRANTS: VALVES(16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF 4" PVC SDR26 335.3 6" PVC SDR26 224.8 8" PVC SDR26 3410.07 8" DIP 177.1 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: 4" (45) SDR 26 PVC 4" (3) Cast Iron 6" (18) SDR 26 PVC TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000 Throckmorton Street•Fort Worth,TX 76012-6311 (817)392-7941 •Fax: (817)392-7845 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS March 28, 2022 Circle C Construction Company P.O. Box 40328 Fort Worth,TX 76140 RE: Acceptance Letter Project Name: Sewer Main Extensions, Replacements& Relocations Contract 2019 15t Renewal Project Type: Sewer City Project No.: 102196 To Whom It May Concern: On March 28, 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 March 28, 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 Adolfo Lopez 817-392-7829. Sincerely, A— Adolfo Lopez(Apr4,2022 08:27 CDT) Adolfo Lopez, Project Manager Cc: Pedro G. Hernandez, Inspector Wade Miller, Inspection Supervisor Ariel Duarte, Senior Inspector Adolfo Lopez, Program Manager N/A, Consultant Circle C Construction Company, Contractor N/A, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev.08/20/19 AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersigned authority, a Notary Public in the state and county aforesaid, on this day personally appeared TERESA S SKELLY, PRESIDENT of CIRCLE C CONSTRUCTION, known to me to be a credible person, who being by me duly sworn,upon his oath deposed and said; That all person, firms, associations, corporations or other organizations furnishing labor and/or materials have been paid in 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 damage; On Contract described as; Sanitary Sewer Extensions,Replacements and Relocations First Renewal Project Number 102196 Nu u, {�iiV lax MICHELE 5 LAN KFOR BY a Notary Public — STATE OF TEXAS ►' Notary ID#1175946.6 My CoMx EXp.October 7,2023 Subscribed and sworn before me on this Day of M pLc t,,b , 202,, Notary Public in Tarrant Coun , TX CONSENT OF SURETY OWNER TO FINAL PAYMENT ARCHITECT ❑ ALA Document G707 CONTRACTOR ❑ Bond No.TXC613309 SURETY ❑ OTHER ❑ TO OWNER: ARCHITECT'S PROJECT NO.: City of Fort Worth City Project No. 102196 1000 Throckmorton Street Fort Worth,TX CONTRACT FOR: Utilities CONTRACT DATED: December 01,2020 PROJECT: (name, address) Sewer Main Extensions,Replacements,and Relocations,Contract 2019 in the City of Fort Worth,TX-First Renewal In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (Insert name and address of Surety) Merchants Bonding Company(Mutual) 6700 Westown Parkway West Des Moines,IA 50266 SURETY on bond of (Insert name and address of Contractor) William J.Schultz,Inc.,dba Circle C Construction Company P.O.Box 40328 Fort Worth,TX 76140 'CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of Fort Worth 1000 Throckmorton Street Fort Worth,TX 76102 OWNER, as set forth in the said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand this date: March 29,2022 (Insert in writing the month followed by the numeric date and year.) Merchants Bon ing Company(Mutual) (Surely) L. - ■ (Signature ofauthorized presentative) Witness as to Surety: Sheryl A.Klutts,Attorney-in-Fact (Sea (Printed name and title) JokG A.Miller dr Note: This form is to be used as a companion document to AIA DOCUMENT 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 INSTITUTE OF ARCHITECTS,1735 New York Ave.,NW,Washington,D.C.20006 MERCHANTS BONDING COMPANY,. POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa(herein collectively called the"Companies")do hereby make,constitute and appoint,individually, John A Miller;John R Stockton;Sheryl A Klutts their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc.,on October 16,2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 11th day of February 2020 ...... °�PfIO•N44 1N� Cp • • :•��'' �'�'• MERCHANTS BONDING COMPANY(MUTUAL) 4O'�,D���A'4�9y,�; MERCHANTS NATIONAL BONDING,INC. •x. 2003 ;�� .y_ 1933 :c: By •.�11i "�"�7�.• •• ly � \1•• President STATE OFIOWA ••�''"""''��•• ••'••"•� COUNTY OF DALLAS ss. On this 11th day of February 2020 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. 'Y'llA(s POLLY MASON O Commission Number 750576 ��''� My Commission Expires January 07, 2023 Notary Public (Expiration of notary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies,which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this29th day of March,2022. �.•P�10Nq� •., .•�1N�•Cp�. :'•� 'FtPOR• : ;off. RPOq •'Oq• 2003 1933 c' Secretary s�. :,dui• -.:'��,: '••d.�w--��.••`:�a,•' POA0018 (1/20) "" ••••�•••