HomeMy WebLinkAboutContract 55495-FP1 City Secretary 55495 -FP1
Contract No.
FORT WORTH, Date Received Aug9,2022
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: Keller ISD- Parkview Elementary School
City Project No.: 103157
Improvement Type(s): Water ❑x Sewer ❑x
Original Contract Price: $64,669.55
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete: $64,669.55
.70,fh/v/G( qee Aug 2022
Josh McCann(Aug 4,2022 09:35 CDT) g
Contractor Date
Sr. Project Manager
Title
Steele & Freeman, Inc
Company Name
Aug 5,2022
Riley Ru 15,1201207:37 CDT)
Project Inspector Date
G ,P.f. Aug 5,2022
Project Manager Date
Y&iwel sc'qrle1t MorWels Aug 8,2022
Janie Scarlett Mom les(Aug 8 202213:42 CDT)
CFA Manager Date
,7�1a,V� Aug 9,2022
Dana Burghd off(Aug 9 202 6:38 CDT)
Asst. City Manager Date
OFFICIAL RECORD
CITY SECRETARY Page 1 of 2
FT.WORTH, TX
Notice of Project Completion
Project Name: Keller ISD- Parkview Elementary School
City Project No.: 103157
City's Attachments
Final Pay Estimate 0
Change Order(s): ❑ Yes 0 N/A
Pipe Report: 0 Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety 0
Statement of Contract Time
Contract Time: 14 WD Days Charged: 36
Work Start Date: 6/2/2021 Work Complete Date: 5/11/2022
Completed number of Soil Lab Test: 14
Completed number of Water Test: 6
Page 2 of 2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name KELLER ISD-PARKVIEW ELEMENTARY SCHOOL
Contract Limits
Project Type WATER&SEWER
City Project Numbers 103157
DOE Number 3157
Estimate Number 1 Payment Number 1 For Period Ending 8/11/2021
WD
City Secretary Contract Number Contract Time IWD
Contract Date Days Charged to Date 36
Project Manager NA Contract is 100.00 Complete
Contractor STEELE-FREEMAN,INC
1301 LAWSON ROAD
FORT WORTH, TX 76131
Inspectors GLOVER/ ROBERSON
Tuesday,May 17,2022 Page I of 5
City Project Numbers 103157 DOE Number 3157
Contract Name KELLER ISD-PARKVIEW ELEMENTARY SCHOOL Estimate Number 1
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 8/1 1/2021
Project Funding
WATER
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
---------------------------------------
I TRENCH SAFETY 90 LF $1.25 $112.50 90 $112.50
2 6"PVC WATER PIPE 15 LF $39.23 $588.45 15 $588.45
3 6"PVC WATER PIPE CSS BACKFILL 20 LF $24.00 $480.00 20 $480.00
4 8"PVC WATER PIPE 35 LF $43.25 $1,513.75 35 $1,513.75
5 8"PVC WATER PIPE CSS BACKFILL 20 LF $26.00 $520.00 20 $520.00
6 4"WATER PIPE 3 LF $36.00 $108.00 3 $108.00
7 DUCTILE IRON WATER FITTINGS 0.5 TN $11,752.00 $5,876.00 0.5 $5,876.00
W/RESTRAINT
8 6"GATE VALVE 1 EA $1,069.00 $1,069.00 1 $1,069.00
9 8"GATE VALVE 2 EA $1,654.00 $3,308.00 2 $3,308.00
10 12"CUT IN GATE VALVE 2 EA $3,752.00 $7,504.00 2 $7,504.00
11 CONNECTION TO EXISTING 4"-12"WATER 3 EA $1,066.67 $3,200.01 3 $3,200.01
MAIN
12 3"WATER METER AND VAULT 1 EA $21,964.00 $21,964.00 1 $21,964.00
13 2"WATER SERVICE I EA $1,380.98 $1,380.98 1 $1,380.98
14 SALVAGE 3"METER I EA $2,051.00 $2,051.00 1 $2,051.00
15 1"IRRIGATION METER BOX 1 EA $652.00 $652.00 1 $652.00
- ------------------------------ -------
Sub-Total of Previous Unit $50,327.69 $50,327.69
SEWER
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
------------------------------- - - ------
I TRENCH SAFETY 40 LF $2.00 $80.00 40 $80.00
2 POST CCTV INSPECTION 40 LF $2.50 $100.00 40 $100.00
3 MANHOLE VACUUM TESTING 2 EA $225.00 $450.00 2 $450.00
4 15"SEWER PERE,CLSM BACKFILL 27 LF $75.00 $2,025.00 27 $2,025.00
5 4"SEWER SERVICE 1 EA $563.00 $563.00 1 $563.00
6 4"2 WAY CLEANOUT 1 EA $544.75 $544.75 1 $544.75
7 4'MANHOLE 1 EA $5,051.64 $5,051.64 1 $5,051.64
8 4'EXTRA DEPTH MANHOLE 4 VF $393.50 $1,574.00 4 $1,574.00
9 CONNECT TO EXISTING MANHOLE 1 EA $1,024.00 $1,024.00 1 $1,024.00
10 8"SEWER PIPE 40 LF $42.00 $1,680.00 40 $1,680.00
Tuesday,May 17,2022 Page 2 of 5
City Project Numbers 103157 DOE Number 3157
Contract Name KELLER ISD-PARKVIEW ELEMENTARY SCHOOL Estimate Number 1
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 8/1 1/2021
Project Funding
1 I REMOVE EX 4"SEWER 27 LF $29.61 $799.47 27 $799.47
12 EPDXY MANHOLE LINER 10 VF $45.00 $450.00 10 $450.00
--------------------------------------
Sub-Total of Previous Unit $14,341.86 $14,341.86
--------------------------------------
Tuesday,May 17,2022 Page 3 of 5
City Project Numbers 103157 DOE Number 3157
Contract Name KELLER ISD-PARKVIEW ELEMENTARY SCHOOL Estimate Number 1
Contract Limits Payment Number I
Project Type WATER&SEWER For Period Ending 8/1 1/2021
Project Funding
Contract Information Summary
Original Contract Amount $64,669.55
ChanjZe Orders
Total Contract Price $64,669.55
Total Cost of Work Completed $64,669.55
Less %Retained $0.00
Net Earned $64,669.55
Earned This Period $64,669.55
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 $64,669.55
Tuesday,May 17,2022 Page 4 of 5
City Project Numbers 103157 DOE Number 3157
Contract Name KELLER ISD-PARKVIEW ELEMENTARY SCHOOL Estimate Number I
Contract Limits Payment Number 1
Project Type WATER&SEWER For Period Ending 8/11/2021
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors GLOVER / ROBERSON Contract Date
Contractor STEELE-FREEMAN,INC Contract Time 14 WD
1301 LAWSON ROAD Days Charged to Date 36 WD
FORT WORTH, TX 76131 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 $64,669.55
Less %Retained $0.00
Net Earned $64,669.55
Earned This Period $64,669.55
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 $64,669.55
Tuesday,May 17,2022 Page 5 of 5
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: Keller ISD-Parkview Elementary School
PROJECT NUMBER: 103157
DOE NUMBER:
WATER
PIPE LAID SIZE TYPE OF PIPE LF
Water 6" PVC 15'
Water 8" PVC 3 5'
Water 4" DIP 3
Water 2" Copper 20'
FIRE HYDRANTS: VALVES(16"OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES:
NEW SERVICES:
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
Sewer 8" PVC 40'
PIPE ABANDONED SIZE TYPE OF PIPE LF
Sewer 4" PVC 27'
DENSITIES:
NEW SERVICES: 4" PVC 1
TRANSPORTATION AND PUBLIC WORKS
WRT WORTH(i)
TRANSPORTATION AND PUBLIC WORKS
May 13, 2022
Steele& Freeman
1301 Lawson Road
Fort Worth,Texas 76131
RE: Acceptance Letter
Project Name: Keller ISD-Parkview Elementary School
Project Type:Water,Sewer,Paving
City Project No.: 103157
To Whom It May Concern:
On August 11,2021 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 May 16, 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 May 16, 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 817-
727-5702.
�Sincerely,
Andrew Goodman, Project Manager
Cc: Riley Roberson, Inspector
Mike Glover, Inspection Supervisor
Daniel Roy, Senior Inspector
Victor Tornero, Program Manager
Pelton Land Solutions,Consultant
Steele & Freeman, Contractor
Keller isd, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev.8/20/19
City of Fort Worth
Inspector's Estimate Worksheet
City Project Numbers 103157
Contract Name: KELLER ISD-PARKVIEW ELEMENTARY SCHOOL DOE Number 3157
Contract Limits: Estimate Number; 1
Project Type WATER&SEWER Payment Number: 1
Control Number 315701 For Period Ending 08 /11 /21
Contract:
Contract Date: Contract Time 14 W D
Inspectors GLOVER / ROBERSON Days Charged to Date 36 WD
/Dale Prepared by Inspector
05 11 2022 Contract is 100 %Complete
/
--------------------------------------
Construction ID: 13836
Item Description of Items Estimated Unit Unit Cost Previous Quanity Completed Total Cost
No. Quanity Quanity for Month Quanity
--------------------------------------
WATER
1 TRENCH SAFETY 90 LF $1.25 0 90 $112.50
2 6"PVC WATER PIPE 15 LF $39.23 0 15 $588.45
3 6"PVC WATER PIPE CSS 20 LF $24.00
BACKFILL 0 20 $480.00
4 8"PVC WATER PIPE 35 LF $43.25 0 35 $1,513.75
5 8"PVC WATER PIPE CSS 20 LF $26.00
BACKFILL 0 20 $520.00
6 4"WATER PIPE 3 LF $36.00 0 3 $108.00
7 DUCTILE IRON WATER 0.5 TN $11,762.00
FITTINGS W/RESTRAINT 0 0.5 $5,876.00
8 6"GATE VALVE 1 EA $1,069.00 0 1 $1,069.00
9 8"GATE VALVE 2 EA $1,654.00 0 2 $3,308.00
10 12"CUT IN GATE VALVE 2 EA $3,752.00 0 2 $7,504.00
11 CONNECTION TO EXISTING 4"- 3 EA $1,066.67
12"WATER MAIN 0 3 $3,200.01
12 3"WATER METER AND VAULT 1 EA $21,964.00 0 1 $211964.00
13 2"WATER SERVICE 1 EA $1,380.98 0 1 $1,380.98
14 SALVAGE 3"METER 1 EA $2,051.00 0 1 $2,051.00
15 1"IRRIGATION METER BOX 1 EA $652.00 0 1 $652.00
Wednesday,July 21,2021 Page 1
i
City of Fort Worth
Inspector's Estimate Worksheet
City Project Numbers 103157
Contract Name: KELLER ISD-PARKVIEW ELEMENTARY SCHOOL DOE Number 3157
Contract Limits: Estimate Number: 1
Project Type WATER&SEWER Payment Number: 1
$50,327.69
--------------------------------------
;stimated Total This Unit $50,327.69 Completed Total This Unit
---------------------- --------------
Construction ID: 13837
Item Description of Items Estimated Unit Unit Cost Previous Quanity Completed Total Cost
No. Quanity Quanity for Month Quanity
-------------------------
SEWER
1 TRENCH SAFETY 40 LF $2.00 0 40 $80.00
2 POST CCTV INSPECTION 40 LF $2.50 0 40 $100.00
3 MANHOLE VACUUM TESTING 2 EA $225.00 0 2 $450.00
4 15"SEWER PIPIE,CLSM 27 LF $75.00
BACKFILL 0 27 $2025.00
5 4"SEWER SERVICE 1 EA $563.00 0 1 $563.00
6 4"2 WAY CLEANOUT 1 EA $544.75 0 1 $544.75
7 4'MANHOLE 1 EA $5,061.64 0 1 $5,051.64
8 . 4'EXTRA DEPTH MANHOLE 4 VF $393.50 0 4 $1,574.00
9 CONNECT TO EXISTING 1 EA $1,024.00
MANHOLE 0 1 $1,024.00
10 8"SEWER PIPE 40 LF $42.00 0 40 $1,680.00
11 REMOVE EX 4"SEWER 27 LF $29.61 0 27 $799.47
12 EPDXY MANHOLE LINER 10 VF $45.00 0 10 $450.00
14,341.86
--------------------------------------
;stimated Total This Unit $14,341.86 Completed Total This Unit
-----------------------------------------
Wednesday,July 21,2021 Page 2
City of Fort Worth
Inspector's Estimate Worksheet
City Project Numbers 103157
Contract Name: KELLER ISD-PARKVIEW ELEMENTARY SCHOOL DOE Number 3157
Contract Limits: Estimate Number: 1
Project Type WATER&SEWER Payment Number: 1
Total Itemized Amount(Including Change Orders) $64,669.56
Riley Roberson DATE 05/11/22 Total Cost of Work Completed $64,669,55
Inspector Less 100 %Retained N/A
Net Earned $64,669.55
Previous Payment $0.00
Material on Hand 15% N/A
Balance Due This Payment $64,669.55
Wednesday,July 21,2021
Page 3
1A1A
Document G706- . 1994
Contractor's Affidavit of Payment of Debts and Claims
PROJECT:(Name and address) ARCHITECT'S PROJECT NUMBER: OWNER:
Keller ISD-Parkview Elementary City Project No. 103157 ARCHITECT:❑
School CONTRACTOR:❑
6900 Bayberry Dr. CONTRACT FOR: 64,669.55 SURETY: ❑
Fort Worth,TX 76137 City of Fort Worth:
TO OWNER:(Name and address) CONTRACT DATED:2/25/21
Keller Independent School District
350 Keller Parkway
Keller,TX 76248
STATE OF: Texas
COUNTY OF: Tarrant
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:
SUPPORTING DOCUMENTS ATTACHED HERETO: CONTRACTOR: (Name a address)
1. Consent of Surety to Final Payment. Whenever Steele&Freeman,I
Surety is involved,Consent of Surety is 1301 Lawson Rd.
required. AIA Document G707,Consent of Fort Worth,T 6131
Surety,may be used for this purpose
Indicate Attachment ® Yes ❑ No
BY:
The following supporting documents should be attached Lhacl�.
atu authorized representative)
hereto if required by the Owner: Freeman,President
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 gas+ 4l ao a-3-
suppliers,to the extent required by the Owner, J
accompanied by a list thereof. J
Notary Public:
3. Contractor's Affidavit of Release of Liens(AIA My Commissio Expires:4/26/26
Document G706A).
I(ELLI NEELY
My Notary ID#131545434
ExPIMAprH 26,2026
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 1
software at 10:29:02 ET on 08/04/2022 under Order No.2114240960 which expires on 10/04/2022,is not for resale,is licensed for one-time use only,and may
only be used in accordance with the AIA contract Documents®Terms of Service.To report copyright violations,e-mail copyright@aia.org.
User Notes: (3139ADA50)
TI
CONSENT OF SURETY TO
REDUCTION IN OR
RELEASE OF RETAINAGE Bond #K4022581A M
Project: Keller ISD—Parkview Elementary School
To (Owner):
City of Fort Worth, Texas
200 Texas Street Contract For: See above
Fort Worth, TX 76102
Contract Date:
Contractor:
Steele & Freeman, Inc.
In accordance with the provision of the Contract between the Owner and the Contractor as
defined above,the Federal Insurance Company
202B Hall's Mill Road
Whitehouse Station,NJ 08889
,Surety Company,
on bond of Steele&Freeman,Inc.
1301 Lawson Rd
Fort Worth,TX 76131
,Contractor
hereby approves the reduction in or release of retainage to the contractor as follows:
Full Release of Retainage
The Surety agrees that such reduction in or release of retainage to the Contractor shall not relieve
the Surety of any of its obligations to the
City of Fort Worth,Texas
200 Texas Street
Fort Worth,TX 76102
,Owner
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
the Surety Company has hereunto set its hand this 25th day of July,2022.
Federal Insurane Company
Witness: {�
&Iza�
J
Tracy Tucker, ttorney-in-Fact
^- n
CHUBB
Power of Attorney
Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company
Westchester Fire Insurance Company I ACE American Insurance Company
Know All by These Presents, that FEDERAL INSURANCE COMPANY, an Indiana corporation,VIGILANT INSURANCE COMPANY, a New York corporation, PACIFIC
INDEMNITY COMPANY, a Wisconsin corporation, WESTCHESTER FIRE INSURANCE COMPANY and ACB AMERICAN INSURANCE COMPANY corporations of the
Commonwealth of Pennsylvania, do each hereby constitute and appoint Bennett Brown, W. Lawrence Brown, Roberta H. Erb, Steven M. Tucker and
TracyTucker of Fort Worth,Texas---------------------------------------------------------------------------------------------------------------------------------------------------
each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise,bonds and undertakings and other writings obligatory in the nature thereof(other than bail bonds)given or executed in the course of business,and any
instruments amending or alteringthe same,and consents to the modification or alteration of any instrument referred to in said bonds or obligations.
In Witness Whereof, said FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,PACIFIC INDEMNITY COMPANY,WESTCHESTER FIRE INSURANCE
COMPANY and ACE AMERICAN INSURANCE COMPANY have each executed and attested these presents and affixed their corporate seals on this 7th day of November,2019.
Daum hl.Chloral,,.=lscistan t St_vrefary Stephen M.Ilaney,Vice President
STATE OF NEW JERSEY
County of Hunterdon ss.
on this 7th day of November,2019,before me,a Notary Public of New Jersey,personally came Dawn M.Chloros and Stephen M.Haney,tome known to be Assistant Secretary and
Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE
COMPANY and ACE AMERICAN INSURANCE COMPANY,the companies which executed the foregoing Power of Attorney,and the said Dawn M.Chloros and Stephen M.Haney,
being by me duly sworn,severally and each for herself and himself did depose and say that they are Assistant Secretary and Vice President,respectively,of FEDERAL INSURANCE
COMPANY,VIGILANT INSURANCE COMPANY,PACIFIC INDEMNITY COMPANY,WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and
know the corporate seals thereof,that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies;and
that their signatures as such officers were duly affixed and subscribed by like authority.
Notarial Seal * KATHERINE J.ADELAAR
TNtY NOTARY PUBLIC OF NEW JERSEY
No.2316585
pUBL� CominIsWon Expires July 16,2024 Nourry Pubtle
CERTIFICATION
Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY,VIGILANT INSURANCE COMPANY,and PACIFIC INDEMNITY COMPANY on August 30,2016;
WESTCHESTER FIRE INSURANCE COMPANY on December 11,2006;and ACE AMERICAN INSURANCE COMPANY on March 20,2009:
"RESOLVED,that the following authorizations relate to the execution,for and on behalfof the Company,of bonds,undertakings,recognizances,contracts and other written commitments of the Company
entered into in the ordinary course of business(each a"Written Commitment"):
(1) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized to execute any Written Commitment for and on behalfof the Company,underthe
seal of the Company or otherwise.
(2) Each duly appointed attorney-in-fact of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company,under the seal of the Company or
otherwise,to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such attorney-in-fact.
(3) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized,for and on behalfof the Company,to appoint in writing any person the attorney-
in-fact of the Company with full power and authority to execute,for and on behalfof the Company,under the seal of the Company or otherwise,such Written Commitments of the
Company as may be specified in such written appointment,which specification may be by general type or class of Written Commitments or by specification of one or more particular
Written Commitments.
(4) Each of the Chairman,the President and the Vice Presidents of the Company is hereby authorized,for and on behalf of the Company,to delegate in writing to any other officer of the
Company the authority to execute,for and on behalf of the Company,under the Company's seal or otherwise,such Written Commitments of the Company as are specified in such
written delegation,which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments.
(5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution,and the seal of the Company,may be affixed by
facsimile on such Written Commitment or written appointment or delegation.
FURTHER RESOLVED,that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of officers,employees and other persons to act for and on behalfof
the Company,and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested."
I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE
INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY(the"Companies")do hereby certify that
(i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true,correct and in full force and effect,
(ii) the foregoing Power of Attomey is true,correct and in full force and effect.
Given under my hand and seals of said Companies at Whitehouse Station,NJ,this 25th day of July, 2022.
Drrv;n 19.Chloros.A�sist:tnt Strcl;tryo
IN THE EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER PLEASE CONTACT US AT:
Tele one(908)903-3493 Fax(908)903-3656 a-mail:surety@chubb.com
Combined:FED-VIG-PI-WFIC-AAIC(rev.11-19)