HomeMy WebLinkAboutContract 56522-FP1FORT WORTH.
City Secretary 56522 -FP1
Contract No.
Date Received 2/17/2023
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: Creek Side Estates Phase 3
City Project No.: 100825
Improvement Type(s): ❑x Paving
Original Contract Price:
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete:
2�
Jacob Gatewood (Feb 15, 2023 07:53 CST)
Contractor
Proiect Manager
Title
Conatser Construction TXLP
Company Name
Sereio Garcia Pedroza (Feb 15, 2023 08:41 CST)
Project Inspector
k-ha��' �.'
Khal Jaafari P.E. (Feb 16, 202311:25 CST)
Project Manager
Rebecca Diane Owen (Feb 16, 202311:29 CST)
CFA Manager
Lauren Prieur (Feb 16, 202312:23 CST)
Interim TPW Director
William Johnson 202310:52 CST)
Asst. City Manager
❑x Drainage x❑ Street Lights ❑ Traffic Signals
Feb 15, 2023
Date
Feb 15, 2023
Date
Feb 16, 2023
Date
Feb 16, 2023
Date
Feb 16, 2023
Date
Feb 17, 2023
Date
$507,389.25
$507,389.25
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Page 1 of 2
Notice of Project Completion
Project Name: Creek Side Estates Phase 3
City Project No.: 100825
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑ Yes ❑x N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time 120 CD Days Charged: 170
Work Start Date: 3/28/2022 Work Complete Date 12/8/22
Completed number of Soil Lab Test: 274
Completed number of Water Test: 6
Page 2 of 2
FORT WTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name CREEKSIDE ESTATES PHASE 3
Contract Limits
Project Type DRAINAGE,PAVING,STREETLIGHT& SIGNAGE&P
City Project Numbers 100825
DOE Number 0825
Estimate Number 1 Payment Number 1
City Secretary Contract Number
Contract Date 1/18/2022
For Period Ending 1/18/2023
WD
Project Manager NA
Contractor CONATSER CONSTRUCTION TxLP
5327 WICHITA ST
FORT WORTH, TX 76119
Inspectors D.WATSON / S.GARCIA
Contract Time 12BJD
Days Charged to Date 170
Contract is 100.00 Complete
Thursday, February 9, 2023 Page 1 of 5
City Project Numbers 100825 DOE Number 0825
Contract Name CREEKSIDE ESTATES PHASE 3 Estimate Number I
Contract Limits Payment Number 1
Project Type DRAINAGE,PAVING,STREETLIGHT& SIGNAGE&PAVEME For Period Ending 1/18/2023
Project Funding
UNIT III: PAVING
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
18
6" LIME TREATMENT
8452 SY
$3.50
$29,582.00
8452
$29,582.00
19
6" CONC PVMT
7899 SY
$39.00
$308,061.00
7899
$308,061.00
20
HYDRATED LIME
142 TN
$190.00
$26,980.00
142
$26,980.00
21
4" CONC SIDEWALK
1415 SF
$3.75
$5,306.25
1415
$5,306.25
22
BARRIER FREE RAMP. TYPE R-1
6 EA
$1,500.00
$9,000.00
6
$9,000.00
23
BARRIER FREE RAMP, TYPE M-2
1 EA
$1,400.00
$1,400.00
1
$1,400.00
24
BARRIER FREE RAMP, TYPE U-1
2 EA
$1,500.00
$3,000.00
2
$3,000.00
25
BARRIER RAMP, TYPE P-1
2 EA
$1,300.00
$2,600.00
2
$2,600.00
Sub -Total
of Previous Unit
$385,929.25
$385,929.25
UNIT IV: DRAINAGE
Item
Description of Items Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
26
10' CURB INLET
6 EA
$3,400.00
$20,400.00
6
$20,400.00
27
21" RCP, CLASS lII
23 LF
$65.00
$1,495.00
23
$1,495.00
28
24" RCP, CLASS III
51 LF
$70.00
$3,570.00
51
$3,570.00
29
30" RCP, CLASS lII
68 LF
$85.00
$5,780.00
68
$5,780.00
30
4' STORM JUNCTION BOX
1 EA
$5,000.00
$5,000.00
1
$5,000.00
31
CONCRETE COLLAR
3 EA
$1,000.00
$3,000.00
3
$3,000.00
32
TRENCH SAFETY
142 LF
$2.00
$284.00
142
$284.00
Sub -Total of Previous Unit
$39,529.00
$39,529.00
UNIT V:SIGNAGE AND PAVEMENT MARKINGS
Item Description of Items Estimated Unit Unit Cost
Estimated
Completed
Completed
No. Quanity
Total
Quanity
Total
33 TRAFFIC CONTROL 3 MO $2,000.00
$6,000.00
3
$6,000.00
34 FURNISH/INSTALL ALUM SIGN GROUND 5 EA $850.00
$4,250.00
5
$4,250.00
MOUNT CITY STD.
Sub -Total of Previous Unit
$10,250.00
$10,250.00
Thursday, February 9, 2023
Page 2 of 5
City Project Numbers 100825 DOE Number 0825
Contract Name CREEKSIDE ESTATES PHASE 3 Estimate Number I
Contract Limits Payment Number 1
Project Type DRAINAGE,PAVING,STREETLIGHT& SIGNAGE&PAVEME For Period Ending 1/18/2023
Project Funding
UNIT VI: STREETLIGHT
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
35
RDWY MUM ASSMBLY TY 11
9 EA
$2,800.00
$25,200.00
9
$25,200.00
36
LED LIGHTING FIXTURE
9 EA
$650.00
$5,850.00
9
$5,850.00
37
RDWY HUM FOUNDATION TY 11
9 EA
$1,200.00
$10,800.00
9
$10,800.00
38
3" CONDT PVC SCH 80(T)
903 LF
$21.00
$18,963.00
903
$18,963.00
39
2" CONDT PVC SCH 80(T)
572 LF
$19.00
$10,868.00
572
$10,868.00
Sub -Total
of Previous Unit
$71,681.00
$71,681.00
Thursday, February 9, 2023 Page 3 of 5
City Project Numbers 100825
Contract Name CREEKSIDE ESTATES PHASE 3
Contract Limits
Project Type DRAINAGE,PAVING,STREETLIGHT& SIGNAGE&PAVEME
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Total Contract Price
DOE Number 0825
Estimate Number 1
Payment Number 1
For Period Ending 1/18/2023
$507,389.25
$507,389.25
Total Cost of Work Completed $507,389.25
Less % Retained $0.00
Net Earned $507,389.25
Earned This Period $507,389.25
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
$507,389.25
Thursday, February 9, 2023 Page 4 of 5
City Project Numbers 100825
Contract Name CREEKSIDE ESTATES PHASE 3
Contract Limits
Project Type DRAINAGE,PAVING,STREETLIGHT& SIGNAGE&PAVEME
Project Funding
Project Manager NA
Inspectors D.WATSON / S.GARCIA
Contractor CONATSER CONSTRUCTION TxLP
5327 WICHITA ST
FORT WORTH, TX 76119
DOE Number 0825
Estimate Number 1
Payment Number 1
For Period Ending 1/18/2023
City Secretary Contract Number
Contract Date
1/18/2022
Contract Time
120 WD
Days Charged to Date
170 WD
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 $507,389.25
Less % Retained
$0.00
Net Earned
$507,389.25
Earned This Period $507,389.25
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
$507,389.25
Thursday, February 9, 2023 Page 5 of 5
FORTWORTH.
''no,
TRANSPORTATION AND PUBLIC WORKS
January 19, 2023
Conatser Construction TX, LP
5327 Wichita St
Fort Worth, TX, 79119
RE: Acceptance Letter
Project Name: Creekside Estates Phase 3
Project Type: Developer
City Project No.: 100825
To Whom It May Concern:
On January 19, 2023 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 January 19, 2023. 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 January 19, 2023, 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-
392-7872.
Sincerely,
7ag>`a��' � 16haG4 4
Khal Jaafari P.E, (Feb 16, 202311:25 CST)
Khal Jaafari P.E., Project Manager
Cc: Sergio Garcia Pedroza, Inspector
Donald Watson, Inspection Supervisor
Joseph Rogers, Senior Inspector
Kiran Konduru P.E., Program Manager
Dunaway Associates L.P., Consultant
Conatser Construction TX, L.P., Contractor
McCart-Risinger,L.P., Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev.8/20/19
A FFTT) A VTT
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 Brock Huggins, President of Conatser Management Group, Inc.,
general partner of Conatser Construction TX, LP, known to me to be a credible person, who
being by me duly sworn, upon his oath deposed and said:
That all persons, 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; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
CREEKSIDE ESTATES PH. 3
WATER, SANITARY SEWER, PAVING
DRAINAGE, & STREET LIGHT IMPROVEMENTS
DOE#: N/A
CFA PRJ #: 20-0021
CITY PROJECT #: 100825
CITY OF FORT WORTH
STATE OF TEXAS
CONATSER CONSTRUCTION TX, LP
Brock Huggins
Subscribed and sworn to before me this 2nd day of November, 2022.
Pf%6,•. KATHERINE ROSE
k 1W
iPfiY
NOTARY PUBLIC Notary Public in Tarrant County, Texas
*; *: ID# 133467933
�:•, e: State olTexas
"'oF+ Comm. Exp.11-30-2025
`CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
PROJECT:
(name, addreSS)Creekside Estates Phase 3
Fort Worth, TX
TO (Owner)
OWNER
❑
ARCHITECT
❑
CONTRACTOR
❑
SURETY
❑
OTHER
Bond No 0242724
F ARCHITECT'S PROJECT NO: CFA20-0021
CITY OF FORT WORTH & MCCART-RISINGER, L.P CONTRACT FOR:
2111 N. Collins #323 Water, Sanitary Sewer, Paving, Drainage, & Street Light Imprvts. for
Creekside Estates Phase 3
Arlington TX 76011 -J CONTRACT DATE:
CONTRACTOR: CONATSER CONSTRUCTION TX, L.P.
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)
BERKLEY INSURANCE COMPANY
475 Steamboat Road
Greenwich CT 06830 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
CONATSER CONSTRUCTION TX, L.P.
5327 Wichita St.
Fort Worth TX 76119-6035 , CONTRACTOR,
hereby approves of the final payment to the Contractor, 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 & MCCART-RISINGER, L.P.
2111 N. Collins #323
Arlington TX 76011
as set forth in the said Surety Company's bond.
IN WITNESS, WIIEREOF,
the Surety Company has hereunto set its hand this
Attest:
, OWNER,
1st day of November, 2022
BERKLEY INSURANCE COMPANY
Surety Company
Signature of Authorized Representative
Rai Morales Attorney -in -Fact
Title
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
ONE PAGE
No. BI-7280k
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WILMINGTON, DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
a3 KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made; constituted.
b . and appointed, and does by these presents make, constitute and appoint: Ricardo J. Reyna; Don F. Cornell; Sophinie .Hunter;
Robhi Morales; Kelly A. Westbrook, Tina McEtvan; Joshua Saunders; Tonie. Petranek; or Mikaela Peppers of Aon Risk
Services Southwest, Inc. of Dallas, TX its true and lawful Attorney -in -Fact, to sign its name as surety only as delineated below
and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty
m y
Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.S50,000,000.00), to the.
same .extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its
principal office in their own proper persons..
oThis Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
> without giving effect to the principles of conflicts .of laws thereof..This Power of Attorney is granted pursuant to the following
o resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January.25, 2010:
ar
o ,o RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief
Cd o .Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant
o y Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney -in -fact named therein
to execute bonds, undertakings,. recognizances, or other suretyship obligations on behalf of the Company, and to affix the
Qo corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such
attorney -in -fact and revoke any power of attorney previously granted; and further
F� w RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances,
ti .: or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the
�? manner and to the extent therein stated; and further
RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney -in -fact named; and
a on further
¢ ' RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any
power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or
other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as
��— though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any
person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have
ceased to be such at the time when such instruments shall be issued.
o 0 1N WfINESS WB EREOF; the Company has caused these presents to,_be siped and' attested by its appropriate officers and its
o corporate. seal hereunto affixed this _(lay-y ofCZ
�
Y V
Attest Berk] Insurance Company
(Seal) By By kk
o
o eder-nan Je iier
o Executive Vim President Rs Secretary %, S i ice esid
� a
o E WARNING: T_EJS POWER.RWAI,ID IF NOT RRINTED ON BLUE `BERKLEY-' SECURITY PAPE.R
STATE OF CONNECTICUT )
o ? ss:
•r o COUNTY. OF FATRFIELD )
o
Swam to before ma, a Notary Public in the State of Connecticut; this day of. QC , by Ira 5. Lederman
and Jeffrey M. Rafter who are :sworn to me to -be the Executivc Vice Presidentt Secretary, and Sen'►or Vice .Presideni,
� rospectively,-ofAerkleylnsuraneeCornpany. F��'NOT v�l�ai:iq EN
>~ m CONMECT[66T
0 MY GOAtAr�aUL30ExNREa
o no,2ox� otaniPublic; State of Connecticut
� .
Z CERTIFICATE
I the undersigned.,Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the fore-oing is a
a true, correct and complete copy of the on&al Power of Attorney; that said Power ofAttorncy has aot been revoked or rescinded
3 y and that the authority of the irtorney-in-Fact=set forth therein, who executed zhe bond or twdertaking. to which: this 'Power of
Attoirey ig attached;-is_in full force. and effect as of this date,
C,iveu under rnrhand:and seal of the Company, thisl s t day of Novemb 2022
(Seal)
Vincent P. Forte
A FFTT) A VTT
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 Brock Huggins, President of Conatser Management Group, Inc.,
general partner of Conatser Construction TX, LP, known to me to be a credible person, who
being by me duly sworn, upon his oath deposed and said:
That all persons, 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; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
CREEKSIDE ESTATES PH. 3
WATER, SANITARY SEWER, PAVING
DRAINAGE, & STREET LIGHT IMPROVEMENTS
DOE#: N/A
CFA PRJ #: 20-0021
CITY PROJECT #: 100825
CITY OF FORT WORTH
STATE OF TEXAS
CONATSER CONSTRUCTION TX, LP
Brock Huggins
Subscribed and sworn to before me this 2nd day of November, 2022.
Pf%6,•. KATHERINE ROSE
k 1W
iPfiY
NOTARY PUBLIC Notary Public in Tarrant County, Texas
*; *: ID# 133467933
�:•, e: State olTexas
"'oF+ Comm. Exp.11-30-2025
`CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
PROJECT:
(name, addreSS)Creekside Estates Phase 3
Fort Worth, TX
TO (Owner)
OWNER
❑
ARCHITECT
❑
CONTRACTOR
❑
SURETY
❑
OTHER
Bond No 0242724
F ARCHITECT'S PROJECT NO: CFA20-0021
CITY OF FORT WORTH & MCCART-RISINGER, L.P CONTRACT FOR:
2111 N. Collins #323 Water, Sanitary Sewer, Paving, Drainage, & Street Light Imprvts. for
Creekside Estates Phase 3
Arlington TX 76011 -J CONTRACT DATE:
CONTRACTOR: CONATSER CONSTRUCTION TX, L.P.
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)
BERKLEY INSURANCE COMPANY
475 Steamboat Road
Greenwich CT 06830 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
CONATSER CONSTRUCTION TX, L.P.
5327 Wichita St.
Fort Worth TX 76119-6035 , CONTRACTOR,
hereby approves of the final payment to the Contractor, 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 & MCCART-RISINGER, L.P.
2111 N. Collins #323
Arlington TX 76011
as set forth in the said Surety Company's bond.
IN WITNESS, WIIEREOF,
the Surety Company has hereunto set its hand this
Attest:
, OWNER,
1st day of November, 2022
BERKLEY INSURANCE COMPANY
Surety Company
Signature of Authorized Representative
Rai Morales Attorney -in -Fact
Title
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
ONE PAGE
No. BI-7280k
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WILMINGTON, DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
a3 KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made; constituted.
b . and appointed, and does by these presents make, constitute and appoint: Ricardo J. Reyna; Don F. Cornell; Sophinie .Hunter;
Robhi Morales; Kelly A. Westbrook, Tina McEtvan; Joshua Saunders; Tonie. Petranek; or Mikaela Peppers of Aon Risk
Services Southwest, Inc. of Dallas, TX its true and lawful Attorney -in -Fact, to sign its name as surety only as delineated below
and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty
m y
Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.S50,000,000.00), to the.
same .extent as if such bonds had been duly executed and acknowledged by the regularly elected officers of the Company at its
principal office in their own proper persons..
oThis Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
> without giving effect to the principles of conflicts .of laws thereof..This Power of Attorney is granted pursuant to the following
o resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January.25, 2010:
ar
o ,o RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief
Cd o .Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant
o y Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney -in -fact named therein
to execute bonds, undertakings,. recognizances, or other suretyship obligations on behalf of the Company, and to affix the
Qo corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such
attorney -in -fact and revoke any power of attorney previously granted; and further
F� w RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances,
ti .: or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the
�? manner and to the extent therein stated; and further
RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney -in -fact named; and
a on further
¢ ' RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any
power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or
other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as
��— though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any
person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have
ceased to be such at the time when such instruments shall be issued.
o 0 1N WfINESS WB EREOF; the Company has caused these presents to,_be siped and' attested by its appropriate officers and its
o corporate. seal hereunto affixed this _(lay-y ofCZ
�
Y V
Attest Berk] Insurance Company
(Seal) By By kk
o
o eder-nan Je iier
o Executive Vim President Rs Secretary %, S i ice esid
� a
o E WARNING: T_EJS POWER.RWAI,ID IF NOT RRINTED ON BLUE `BERKLEY-' SECURITY PAPE.R
STATE OF CONNECTICUT )
o ? ss:
•r o COUNTY. OF FATRFIELD )
o
Swam to before ma, a Notary Public in the State of Connecticut; this day of. QC , by Ira 5. Lederman
and Jeffrey M. Rafter who are :sworn to me to -be the Executivc Vice Presidentt Secretary, and Sen'►or Vice .Presideni,
� rospectively,-ofAerkleylnsuraneeCornpany. F��'NOT v�l�ai:iq EN
>~ m CONMECT[66T
0 MY GOAtAr�aUL30ExNREa
o no,2ox� otaniPublic; State of Connecticut
� .
Z CERTIFICATE
I the undersigned.,Assistant Secretary of BERKLEY INSURANCE COMPANY, DO HEREBY CERTIFY that the fore-oing is a
a true, correct and complete copy of the on&al Power of Attorney; that said Power ofAttorncy has aot been revoked or rescinded
3 y and that the authority of the irtorney-in-Fact=set forth therein, who executed zhe bond or twdertaking. to which: this 'Power of
Attoirey ig attached;-is_in full force. and effect as of this date,
C,iveu under rnrhand:and seal of the Company, thisl s t day of Novemb 2022
(Seal)
Vincent P. Forte