HomeMy WebLinkAboutContract 44545-FP2 (2)/
Depart ijt ofTp &W Const. Services
DOE# G%/l � Dat
Projec anager V� ��� ��
Risk Management J. Paqe
D.O.E, Brotherton —
CFA Kni htlScanned • � �
The Procaeding people have 6een Contacted concerning the requast for final
j payment 8 have released this proJect tor such payment.
Clearance Conducted By Shameka Kennedy
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�TION AND PUBLIC WORKS
� PROJECT COMPLETION
CS# ��57 ��..�
Regarding conuact 116919 fox IMPROV�MENTS TO SERVE UNT SCIENCE CENTER as required by the
TRANSPORTATION & PUBLIC WORKS as approved by City Council on N/A through M&C N/A the director
of the TRANSPORTATION & PUBLIC WORKS upon the recommendation of the Assistant DiuectoY of die
Transportarion & Public Works Departcr� . asactep.tesl the project as complete.
Original Contract Prices:
Amount of Approved Chauge Orders:
Revised Contract Amount:
Total Cost Work Completed:
Less Deductions:
Liquidated Damages:
Pavement Deficiencies:
Total Dedaction Amount:
Total Cost Work Completed:
Less Previous Payments:
C������ ,,:_ -
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� FEB Y 9 2015 !� �;
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$425,503.48
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D.O.E. Ne: 6919
Ns
Days @ $210.00/ Day
$425,503.48
$0.00
Final Payment Due
- -- - - --- - - - __ _-- — --- ------- - -
Recommended for Acceptance
Asst. [�irector, TPW - Infrastructure Design and Construction
� � �. C.�-�
- - -- - --- _ _ _
Accepted • � �
Director, TRANSPORTATION & PUBL C WORKS �� %/�°//�
$425,503.48
$425,503.48
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_ _ —. �-Z—�.f — ----- - - -- - -------- -
Date
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_ _ _ ___ _ _ -
Date
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City Manager Date
Comments: C205-541200-207760199183, C205-541200-207710199183
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CITY OF FORT WORTH
F1NAL PAYMENT REQUEST
Contrnct Name IMPROVEMENTS TO SERVE IJNT SCIENCE CENTER
Contract Limits
Project Type PAVING, STREET LIGHT & SIGNALS
City Project Numbers 01991
DOE Number 6919
�stimate Number 1 Payment Number 1
City Secret�ry Contract Number I16919
Contrnct Date
Project Mnnngcr Tornero
Contractor ALL-FAIR ELECIRIC, INC.
P O BOX 137033
FORT WORTH, TX
Inspectors LAYER / MILLER
Tuesday, January 28, 2014
I'or Period Ending 1/27/2014
CD
ContCact Tiroe iB�D
Days Chnrged to Dnte 180
Contract is .000000 Complete
73136
Page 1 of 5
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�
City Project Numbers O1991
Contract Name IMPROVEMENT'S TO SERVE UNT SCIENCE CENTER
Contract Limits
Project Type PAVING, STttEET LIUH7' & SIGNALS
Project runding
PAVING
C205
DO� Number G919
Estimate Number 1
Paymeni Nwnber �
For Period Ending 1/27/2014
Item Description of Items �stimated Unit Unit Cost �stimated Com�leted Completed
No. Quanity Totfll Quanity Total
- - --- - - - - - - - - - - - - - - - - - - - - - - - - - -
1 REMOVE SIDEWALK 2559 SF $3.00 $7,677.00 2559 $7,677.00
2 REMOVE CONCRETE DRIVE 553 SF $4.00 $2,212.00 553 $2,212.00
3 REMOVE CONC CURB & GUTTER 465 LF $5.00 $2,325.00 465 $2,325.00
4 18"-24" Tf2EE REMOVAL 1 EA $300.00 $300.00 1 $300.00
S lINCLASSIFIED EXCAVATION 131 CY $5.00 $655.00 131 $655.00
6 LIME 8.7 TN $175.00 $1,522.50 8.7 $1,522.50
7 6" LIME TREATMENT S45 SY $6.50 $3,542.50 545 $3,542.50
8 6" HMAC TRANSITION 41 TN $210.00 $8,610.00 41 $8,610.00
9 6" CONC PVMT 60 SY $45.00 $2,700.00 60 $2,700.00
10 6" CONCRETE DRIVEWAY 486 SF $5.00 $2,430.0� 486 $2,430.00
I 1 4' BARRIER FREE RAMP, TYPE A 2 EA $1,450.00 $2,900.00 2 $2,900.00
12 4' BAf212IEIi FREE RAMP, TYPE D 1 EA $1,550.00 $1,550.00 1 $1,550.00
13 JOINT SEALANT 520 LF $4.00 $2,080.00 520 $2,080.00
14 7" CONC CURB & GUTT�R 364 LF $23.00 $8,372.00 364 $8,372.00
15 18" SLD PVMT MARKING HAE 6D LF $12.00 $720.00 60 $720.00
16 4" CONCRETE SIDEWALK 4339 SF $4.00 $17,356.00 4339 $17,356.00
17 BROOM FIN[SH 4" CONCRETE 4340 SF $4.00 $17,360.00 43A0 $17,360.00
18 ROCK SALT SEEDED 4" CONCRET'E 1480 SF $4.85 $7,178.00 1480 $7,178.00
19 COLORED & STAMPED CONCRETE 595 SF $5.50 $3,272.50 59S $3,272.50
20 SOD PLACEMENT AT CONDiJIT LOCATIONS- 217 SY $5.00 $1,085.00 217 $1,085.00
INS1'ALL
21 TRAFFICCONTROL 3 MO $4,050.00 $12,150.00 3 $12,150.00
Sub-Total of Previous Unit $105,997.50 $105,997,50
STREET C205
Item DescripHon of Items �stimated Unit Unit Cost Lstimated Completed Completed
No. Quanity Totai Quauity Total
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
1 TOPSOIL 23 CY $30.00 $690.00 23 $690.00
?. BLOCK SOD PLACEMBNT 1244 SY $4.00 $4,976.00 1244 $4,976.00
3 BED NREP WSTALL 1466 SF $0.85 $1,246.10 146G $1,246.10
4 T'OP DRESS INSTALL 1466 SF $0.65 $952.90 1466 $952.90
5 DRIP IRRIGATION INSTALL 1466 SF $2.80 $4,104.80 10.66 $4,104.80
Tuesday, January 28, 2014 Page 2 of 5
City Project Number
Contract Name
Contract Limits
Project Type
Project P'unding
s 01991
IMPROVEMENTS TO SERVG UNT SCIENCE CENTER
PAViNG, STREET LIGHT & SIGNALS
DO� Numbe►• 6919
Estimate Number I
Payment Number 1
Tor Period Ending 1/27i2014
G QUERCUS VII2GINIANA 3" 8 EA $350.00 $2,A00.00 8 $2,800.00
7 ILEXDECIDUA30GAL 6 EA $250.00 $1,500.00 6 $1,500.00
8 ILEX VOMI"PORIA 5 GAL 28 EA $25.00 $700.00 28 $700.00
9 R05A X Ct1RPE'C ROSE RED 1.5 GAL 36 EA $9.00 $324.00 36 $324.00
10 HEMERCILLAS X STELLA DE ORO 3 GAL 102 EA $18.00 $1,836.00 102 $1,836.00
il RiJELLIA BR11"I'ONIANA 1 GAL 144 EA $5.25 $756.00 144 $756.00
12 SALVIA GREGGI DEEP RED 3 GAL 77 EA $21.00 $1,617.00 77 $1,617.00
13 LONICERA JAI'ONICA'PURPUR�A' 1 GAL 148 EA $5.25 $777.00 148 $777.00
Sub-Total oiPrevious Unit $22,279.so $22,279.80
STREBT LIGH'I' C205
Item DescriptionoFItems �sHmated Unit UnitCost �stimated Completed Completed
No. Quanity Total Quanity Total
— — — — — — — — — — — — — — — — — — — — — — — — — — — — -
1 2° CONDUIT 2482 LF $29.48 $73,169.36 2482 $73,16936
2 #4 WIRE 8912 LF $1.95 $17,378.40 8912 $17,378.40
3 1l2 WIItE 60 LF $6.87 $412.20 60 $412.20
4 CONTRACTOR PAD MOUNTED CONTROL BOX 1 EA $8,213.00 $8,213.00 I $8,213.00
5 PULL BOX 12 EA $2,125.00 $25,500.00 12 $25,500.00
6 ANTIQUE STYLE STREET L1GHT 19 EA $3,885.00 $73,815.00 19 $73,815.00
7 STREET L1GHT BASES l9 EA $1,686.00 $32,034.00 19 $32,034.00
8 DEMO STREET LIUHT POLE 4 EA $930.00 �3,720.00 4 $3,720.00
Sub-Total oCPrevious Unit $234,241.96 $234,241.96
SIGNALS C205
Item Description of Items �sHmated Iluit UnitCost �sHmated Coruplcted Completed
No. Quanily Totni Quenity Total
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — ---- — -
1 2" CONDUIT 1078 LF $28.31 $30,518.18 ]078 $30,518.18
2 N4 WIRE A312 LF $1.92 $8,279.04 4312 $8,279.04
3 WAI2NING PLASHER POLES, LIGH1'S & 2 EA $4,482.00 $8,9Cu1.00 2 $8,964.00
SIGNAGE
4 PULLBOX 2 EA $2,125.00 $4,250.00 2 $4,250.00
5 #8 BLACK POWDER POLES 2 EA $3,315.50 $6,631.00 2 $6,631.00
6 POLES BASES 2 EA $2,171.00 $4,342.00 2 $4,342.00
Sub-Toial of Previous Unit $62,984.22 $62,984.22
Tuesday, January 28, 2014 Page 3 of 5
City Project Numbers o1991
Contract Name IMPROVEMENTS TO SERVE [JNT SCIENCE CENTER
Contract Limits
Project Type PAVING, STREET LIGHT & SIGNALS
Project Tunding
Coutract Information Summary
Inspection Sup€
/
��
Project Man�
DO� Number G919
Gstimete Num6er 1
Payment Number 1
ror Period �nding 1/27/2014
$425,503.48
Total Contract Price $425,503.48
Original Cantrnct Amount
C}�an e Orders
0
/�(� ��� Total Cost of Work Completed
Less % Retained
� `��,/ Net �Arned
7
Earned This Period $425,503.48
Retainage This Period $0.00
zl��cl''
Less Liquidated Dmm�ges
Days n / Dny
����'o%/I�a'�i�/f Date Z Z� ;�� LessPavement Deficiency
Ass . irector/TPW - Lifrastructure Design and Construction Less Penalty
o- �.� C� (�v Date �- L7 ��� Less Previous Payment
Director / C ntracting Department Plus Mnterinl on Hand Less 15%
�/��'�" �K Bnlance Due This Payment
Tuesday, January 28, 2014
$425,503.48
$0.00
$425,503.48
$0.00
$0.00
$0.00
$0.00
�o.00
$425,503.48
Page 4 of 5
�� ' DC�����V�
FEB 1 9 2015
City Project Numbers 01991 gY ----
Conh•act Name IMPROVEMENTS TO SERVE iJNT SCIENCE CENTER
Contract Limits
Project Type PAVING, STREET L1GHT & SIGNALS
� ��s-6�a�1
DOE Number 6919
Gstimate Number i
Payment Number i
ror Pe�•iod �nding I/27/2014
Project Fuuding
Project Manager Tornero
Inspectors LAYER / M[LLER
Contractor �L-FAIR ELECTRIC, INC.
P O BOX 137033
FORT WORTH , TX 73136
City Secretary Contract Number 116919
Contract Date
Contract Time 180 CD
Days Churged to Date l80 CD
Contract is .000000 Compiete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line I'und Account Center Amount Gross Retainage Net
i'unded
Total Cost of Worlc Completed
Less % Retained
Net �arned
�arned This Period $425,503.48
Retainage Tl�is Period $0.00
Less Liquidnted Damages
0 Days @ $0.00 / Day
LessPnvement Derciency
Less Penr►Ity
Less Previous Pnyment
Plus Materinl on Hand Less 15%
Balance Due Tl�is Payment
$425,503,48
$0.00
$425,503.48
$0.00
$0.00
$0.00
$0.00
$0.00
$425,503.48
1'uesday, January 28, 2014 Page 5 of 5
FO RT w0 RT H rev 03/OS/07
TRANSPORTATION & PUBLIC WORKS
FINAL STATEMENT OF CONTRACT TIME
FINAL STAT�MENT NO.:1
NAM� OF PRO.T�CT: Improvements to seive UNT Health Science Center Library Cow�tyard
PROJ�CT NO.: 01991 CONTRACTOR: All Fair Eletric, Inc.
DOE NO.: 6919
P�RIOD FROM;O1/O1/14 TO: O1/15/14 FINAL INSPECTION DAT�: 14-Dec
WORK ORD�R GFFGCTNE: 6/17/2013 CONTRACT TIM�: 180 O WD �O CD
DAY OF DAYS R�ASON FOR DAYS DAY OF DAYS R�ASON FOR DAYS
MONTH CHARG�D CR�DIT�D MONT�-1 CHARG�D CREDIT�D
DURING DURING
1. wed 1 16. thu 1
2. thu 1 l7, fi•i 1
3. fri 1 18. sat 1 Stop Time.
4. sat 1 19.
5. sun 1 2p,
6. mon I 21,
7. tue 1 22,
8. wed 1 23.
9. thu 1 24,
10. fi•i 1 25.
11. sat 1 26,
12, sun 1 2�,
13. tnon 1 2g,
14. tue 1 ' 29,
15. wed 1 30.
31.
SAT, SUN, RAIN, TOO W�T, UTILITIES DAYS TOTAL
& HOLIDAYS & TOO COLD R�LOCATIONS OTHERS * CHARG�D DAYS
THIS 0 0 0 0 18 18
PERIOD
PR�VIOUS 0 0 0 0 162 162
P�RIOD
TOTALS � 0 0 0 180 180
TO DAT�
*R�MARKS:
��
ENGINEERING DEP�1tTT-�NT
�� T7�e City of Foxt Worth • 1000 Throckmoiton Street • Fort ��!/orth,'T� 7G012-G311
(817) 392 - 7941 • I'ax: (817) 392 - 7845
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PERFORMANCE EVALUATION OF CONTRACTOR
I) CONTRACTOR & PROJ�CT DATA
Nawe of Conh�aclor
All-Fair Elech•ic Inc.
DOL Inspecla•
Wade Miller
DOC Inspedw•
❑ Water ❑ Waste Water ❑ Storm Drainage � Pavement
Iniliaf Cono•nc1 An�oroil
$425,503.48
Final Conlracl Aurounl
II) P�RFORMANC� �VALUATION
Project Nante
Improvements
DOE Nrurtber
6919
Projec! Manager
Victor Tornero
Projecl D�culq�
Q Simple
Dale
2/4/2014
to serve UNT Science Centei•
REV: 02/20/07
0 Routine � Complex
0- Inadequate I- Deficient 2- Standard 3- Good 4- Excellent
ELEMENT WE1GH'I' ( x) APPLICABLE (Y / N) RATING (0 - 4) MAX SCORE SCORE
1 Submission of Documents 2 Y 4 8 8
2 Public Notifications 5 Y 4 20 20
3 Plans on Site 5 Y 4 20 20
4 Field Su ervision 15 Y 4 60 60
5 Work Performed 15 Y 3 60 45
6 Finished Praduct 15 Y 3 60 45
7 Job Site Safety 15 Y 4 60 60
8 Traffic Conh•ol Maintenance 15 Y 4 60 GO
9 Daily Clean U 5 Y 3 20 15
10 Citizen's Complaint Resolution 5 Y 4 20 20
11 Property Restoration 5 Y 4 20 20
12 After Hours Response 5 Y 4 20 20
13 Project Com letion 5 Y 3 20 15
TOTAL ELEMENT SCOFtE (A) 408
BONUS POINTS (25 Maximum) (B)
TOTAL SCOR� (TS) 408
III) CONTRACTOR'S RATING
Maximum Score (MS) = 448 or sum of applicable element score maximums which = 448
Rating ([TS / MS] * 100%) 408 / 448 = 91%
Performance Category Excellent
<20% = Inadegttate 20% to <40% = Deficienl 40% to <60% = Standard 60% to <80% = Good >_80% = Fxcel/enl
Inspeetm°s Comments (INCLUDING �XPLANATION OT BONUS POINTS AWARD�D)
7 '' A
i ��
Signature DOE Inspector '� ' 7 Signature Conh•actor ,,, � G[w- ����
Signature DOE Inspector's Super•visoi• �,,�... �) `
CONTRACTOR'S COMMENTS
TRANSPORTr1TION �ND PUBLIC WORKS
The Cit�� of Fort Worth • 1000 Throclunorton Sueet • Port Worth, 'I� 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
CON'TRACTOR'S EVALUATION OF CITY
n PROJECT INFORMATION Date: 2/4/2014
Na�ne afCa�h'aclor
All-Fair Elech•ic Inc.
DOE Inspecla•
Wade Miller
DOG Nroti6er Project D�c�dty
6919 � Simple � Routine
Tnitial Conlract A�notrnt
$425,503.48
II) PERFORMANC� �VALUATIOIV
0- Inadequate 1- Deficient 2- Standard
ELEMENT
Projec! Nan�e
to serve iJNT Science Center
REV: 02/22/07
Projecl Manage�•
Victor Torneco
Tjpe ofConh•ac!
� Complex ❑ Water ❑ Waste Water ❑ Storm Drainage � Pavement
Fina! Carh•acl Au�onnl
$425,503.48
3 - Good 4 - Excellent
RAT[NG ELEMENT RATING
rn_a� (0-41
INSPECTION EVALUATION
1 Availability of Lispector
2 ICnowledge of Inspector
3 Accuracy of Measured Quantities
4 Display Of Professionalism
5 Citizen Complaint Resolution
6 Performance - Setting up Valve Crews, Labs
ADMINISTRATION
1 Change Order Processing T'vne
2 Timliness of Contcactor Payments
3 Bid Opening to Pre-Con Meeting Timefi•ame
IIn COMM�NTS & SIGNATURES
COMM�NTS
Signatui•e Conh•actor
Signature DOE Inspector
Signature DOE Inspector's Supeivisor
INSP�CTOR'S COMM�NTS
PLANS & SPECIFICATIONS
1 Accuracy of Plans to Existing Conditions
2 Clarity & Suffciency of Details
3 Applicability of Specifications
4 Accw•acy of Plan Quantities
PROJECT MANAG�R �VALUATION
1 Knowledge And/Or Problem Resolution
2 Availability of Project Manager
3 Communication
4 Resolution of Utility Conflicts
TTt�NSPORTt1TION r�ND PUBLIC WORK.S
,��� The City of Fort Woxtli • 1000 Thioclunoxton Stieet • Foxt Woith, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
COIrISEI�IT OF c��v�i�:iz a
5�1��T1' COIVIPt��i'1' ���zciii�ri:c•�r ❑
`�'O �'INAI. �'AYI�I��1'I� co�Ti�;�c�r�>>z ❑
SURG"C1` ❑ 13ond No. 541360G
O'flil?R
PRO,1 FC�T: lVaier, Paving, Street Ligh( �: 5h�ee�tse;�pc lmprovements tu Ser��e Uniti�crsit�� of V'orth 'T'e���s tic:�lth
Science Center Libr.irl' Coin�h�ard
TO: (O�vner) The University of North 'I'ext�s
i i 12 D;�Ilas Drive Ste 400
Denton,`1'X 76205
r�ftoJccr �vo. zo�3-22-cr�
CONTRACT FOR: Paving :ntd Lightinh
CON`l'RACTOR: AII-i'�iir Glech�ic
P.O. 60� 137033
�ort 1:'�rth, "C\ 7613G
CONTRACT DA�"C: Septembcr 14, 20i I
(n accordtince �t�ith the provisi��ns of the Cunu�.lci bet���een the U���ner and lhc Ce�ntractor as ii�dicat�d abo��c, thc
Emplu��ers il�luiuui Gisu�l(,y Company
. SUI:1;"ll'.
��n I3ond ol'
.an-r:���• ri��r��ir
cc» r�t�ac i c�it.
herchy appr�>ves of ihL I'inal ��a��ment to lhc Contractor. and �igrcrs that Cinal pa��ment to �hc Contr,�ctor shall not
relieve the Sw�c;t�� Company of an}' uf iis oblie�uions to
The Universit�� of NorU�'texas
, 0\\'\I�IZ.
tis set forlh in the said SuretY Compiiii�•'s bond.
IN WITNESS WHrRLOi=,
thc Surely has hcreunto sct its h;uid this
�� /��
A4t�;sE: . �-�--{:.�
( Sra i ) -----�
IGth day ui' April , 2i)14
t�;mDlo�'ers \Tutua�l Casu�lt�� Comnan�
Surei)' Comp�im
Signaium uf i�uthoriz�t Z rescnt li��c
Steven J. 'Linecker, A �ney-In-Fnci
l itle
CO�SI:NPOF'SURL'I�'CO�4Pf\Rl"POPINALPAY�4I-,tir1� --- — UNLPAOf�
.�EMC No. A73599
1 N S U R A N C E P.O. Box 712 • Des Moines, IA 50306-0712
CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY-IN-FACT
KNOW ALL MEN BY THESE PRESENTS, that;
1. Employers Mutual Casualty Company, an lowa Corporation
2. EMCASCO Insurance Company, an lowa Corporation
3. Union Insurance Company of Providence, an lowa Corporation
4. Illinois EMCASCO Insurance Company, an lowa Corporation
hereinaiter referretl lo severally as "Company" and colleclively as "Companies", each does, by these presents, make, conslitute and appoint:
SHANNON LEWIS, CHARLES K. MILLER, STEVE RIC{<ENBACHER, DAVID C. OXFORD, CLINTON NORRIS, SHERREL M. BREAZEALE, SaPHINIE
HUNTER, STEVEN J. ZINEC{<ER, PEGGY G. HOGAN, SHERI R. ALLEN, BRET TOMLINSON
iIs tn�e and lawful allomey-in-(act, willi full power antl autf�ority conferred lo sign, seal, antl execute ils latvful bonds, underiakings, and olher obliga�ory instrumenls of a
sirnilar nalure as follo�vs:
ANY AND ALL BONDS
and lo bind each Company liiereby as fully and to lhe same exlent as if such instrumenls were signed by the duly authorized o(ficers of each such Company, and all of
lhe acls of said attomey pursuant to the aulhonly hereby given are hereby ralified and confirmed.
The auihority hereby granled shall expire _ APRI� 1, 2017 unless sooner revoked.
AUTHORITY FOR POWER OF ATTORNEY
This Power-of-Atlorney is made and execuled pursuant to antl by the authority oi Ihe following resolulion of lhe Boards of Direclors oi each of the Companies at a
regulariy scheduled meeling of each company duly called and held in 1999:
RESOLVED; Ti�e President and Chief Execulive Officer, any Uce Presidenl, lhe Treasurer and lhe Secretary of Employers Mutual Casually Company shall have power
antl aulhorily lo (1) appoint allorneys•in•fact and aulhorize ihem lo execule on behalf oi each Company and atlach Ihe seal o( lhe Company lhereto, bonds and
underiakings, recognizances, conlracfs of indemniry and other �vrilings obiigatory in fhe nature thereof; and (2) to remove any such altorney-in-facl at any lime and revoke
Ihe power and authorily given lo him or her. Altorneys-in-tact shall have power and aulhority, subjecl to lhe lerms and limilalions o( lhe power-of-altorney issued to Ihem,
to execute and deliver on behaif of lhe Company, and to aUach ihe seal of lhe Company lhereto, bonds and untlerlakings, recognizances, conlracts ol indemnity and
other wrilings obligalory in the nature lhereof, and any such instrument execuled by any such allomey-in-facl shall be (ully and in all respecls binding upon the Company.
Ceriificalion as to !he validity of any power•o(-altomey aulhonzed herein made by an officer of Employers Mulual Casualty Company shall be fully and in all respecls
binding upon Ihis Company. The facsimile or mechanically reproduced signaWre of such officer, eihelher made herelo(ore or hereafler, wherever appearing upon a
certified copy o( any pov�er-o(-attomey of lhe Company, shall be valid antl binding upon the Company with lhe same force and e(fect as Ihough manually affixed.
IN WITNESS THEREOF, llie Cornpanies have caused lhese presents to be signed (or each by lheir officers as shotivn, antl the Corpora(e seais to be I�ereto affixed liiis
Dakota Fire Insurance Company, a North Dakota Corporation
EMC Property � Casualty Company, an lowa Corporation
Hamilton Mutual Insurance Company, an lowa Corporation
17th day of FEBRUARY 2014
Seals
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:°�� G�mmisslon Number 780769
My Commisalon F�Irea
Octob2r 10, 2016
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Bruce G. Keiley, hairman
of Companies 2, 3, 4, 5& 6; President
of Company 1; Vice Chairman and
CEO of Company 7
�
Michael Freel '
Assisfant Uce Presidenf
On this 17th day of FEBRUARY AD 2014 be(ore me a
Nolary Public in and for the State of lowa, personally appeared Bruce G. I<elley and Michael Freel,
who, being by me duly s�vorn, tlid say lhal lhey are, antl are known lo me to be lhe Chairman,
Presitlent, Vice Chairman and CEO, andlor Assistanl Vice PresidenUAssistant Secretary,
respeclively, of each of The Companies above; lhal the seals affixed lo lhis inslrumenl are lhe
seals of said corporalions; lhal saitl instrument was signed and sealed on behalf of each o( the
Companies by aulhorily o( lheir respeclive Boards of Direclors; and that lhe said Bruce G. Keliey
and Michael Freel, as such officers, acknowiedged Ihe execulion of said inslrumenl to be ti�e
volunlary acl and tleed of each of the Companies.
My Commission Expires Oclober 10, 2016.
��i"�.�P ��d,l��� �IlU�/L(G�l/i�,
Nola Public i and for Ihe State of lowa
CER7IFICATE
I, James D. Clough, Vice President of ti�e Companies, do hereby ce�iify thal Ihe foregoing resolulion of the Boards of Direclors by each o( ilie Companies,
and this Power of A(lomey issued pursuant lhereto on FEBRUARY 17, 2014 on behaif of:
SHAtlNON LE�NIS, CHARLES K. MIlLEf2, STEVE RICI<ENBACHER, DAVID C. OXFORD, CLINTON NORRIS, SHERRE� Ivl. BREAZEAIE, SOPHINIE HUNTER, STEVEN J.
ZIPlECf(ER, PEGGY G. HOGAN, SH[RI R. AILEN, �RET TOMLINSOPJ
are true and correcl and are slill in full force antl etfecl.
In Teslimony Whereof I have subscribed my name and a(fxed the (acsimile seal of
each Company Ihis 16th day of April ,'1014
Vice Presidenl
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O OBTAIN INFORMATION OR MAKE A COMPLAI
You may contact Employers Mutuai Casualty Company, Union Insurance of
Providence, and/or �MCASCa Insurance Company for information or to make
a campiaint at:
Employers Mutual Casualty Company
Attn: Surety Claims
P.O. Box 712
Des Moines, IA 50303
(515) 280-2689
(515) 280-2994 Fax
You may contact the Texas Department of insurance to obtain information on
companies, coverages, rights or complaints at:
Texas Department of Insurance
P.O. Box 149104
Austin, TX 78714-9104
(800) 252-3439
ATT,4CH THIS NQTICE TO YOUR BOND. This notice is for information only
and does not become a part or a condition of the attached document and is
given to comply with Section 2253-04$, Government Code, and Section
53.202, Property Code, effective September 1, 2001.
7209
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�'f�\'I�I: OI� 'I'cxas
C'OUN"I'Y Ol� 'farrant
13cli�rc mc, thr uncicrsi�nccl EIUIIIOCIII', �l I101ary ��ublic in lhc statc
ancl cc�unl�� al'oresaid, on this da�� personally a����carccl .lohn Puticr, Vicc
I'residcnt Of i\II I�air Elcct�•ic. tnc., knc����n to mc to bc a crcdiblc persun.
who bcin� by mc cluly s���orn, up��n his o�ith dc�x�scd and s��id;
'1'h�it all ��crsc�ns, lirms, associati�ns, cor����r�tions, c�r othcr
OI'�,ilil "V.�ll1011ti �Ul'ill5�llil� �ill)OP �lIlCV01' I11�11C1'I21I5 I12lVC �7�CI1 �7�lICI 111 IIIII;
I�hat the wa��c scalc cstablishcd b�� thc C'it�� Council ii� thc City of
I�ort ���c�rth h��s hccn ��aicl in Ilill:
fhat thcrr arc nc� rIQlI11S �)l'11CI111� IOI' �)CCSOIIQI II1�U1'1' �111CU01'
pro��crty dama�cs;
On C'ontract dc�crihcd as;
('I��� lor I.ibr�n'y Courlyarcf �:- _
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I31' --'4 � � - l� _ ��- _ �� �
j` John Poltcr, Vicc I'residc�lt
Subscribr�l �incl s�vc�ri� bcli�rc m�.\� tl is datr I.ith c�f����ril. 2014.
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�� Notttry I'uhlic
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JUpAWN POT'iER . �, � ' '
Notary Pubilc
� STATE O� ���5 • •
1dy Comm, Exp. :;ep. 30, 2�16; �.
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