Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Contract 53950-FP2
FORT WORTH. City Secretary Contract No. 53950 -FPz Date Received Mar 16, 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: Cooks Children Medical Center City Project No.: 102507 Improvement Type(s): Water x❑ Original Contract Price: Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: Contractor Project Manager Title Fort Worth Civil Constructors, LLC Company Name 40�-- Brandon Phillips (Mar 16, 202308:23 CDT) Project Inspector ae66� Q crJuv Project Manager Q,dry Rebecca Diane Owen (Mar 16, 202312:47 CDT) CFA Manager , &..' Lauren Prieur IMar 16, 202312:53 CDT) TPW Director l� William Johnson (Ma 16. 202312:58 CDT) Asst. City Manager Sewer x❑ $1,080,416.65 -$22,234.36 $1,058,182.29 $1,058,182.29 M a r 16, 2023 Date M a r 16, 2023 Date M a r 16, 2023 Date M a r 16, 2023 Date Mar 16, 2023 Date M a r 16, 2023 Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: Cooks Children Medical Center City Project No.: 102507 City's Attachments Final Pay Estimate ❑x Change Order(s): ❑x Yes ❑ N/A Pipe Report: ❑x Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Please attach Affidavit of Bills Paid. Consent of Surety Please attach Consent of Surety. Statement of Contract Time Contract Time 170 WD Days Charged: 279 Work Start Date: 4/28/2020 Work Complete Date: 2/6/2023 Completed number of Soil Lab Test: 58 Completed number of Water Test: 8 Page 2of2 FoRTWoRTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name COOK CHILDREN'S MEDICAL CENTER Contract Limits Project Type WATER & SEWER City Project Numbers 102507 DOE Number 2507 Estimate Number 1 Payment Number 1 For Period Ending 2/8/2023 WD City Secretary Contract Number Contract Time 17WD Contract Date Days Charged to Date 279 Project Manager NA Contract is 100.00 Complete Contractor FORT WORTH CIVIL 1675-B SOUTH MAIN STREEET KELLER , TX 76248 Inspectors Watson / Phillips Tuesday, March 14, 2023 Page 1 of 5 City Project Numbers 102507 Contract Name COOK CHILDREN'S MEDICAL CENTER Contract Limits Project Type WATER & SEWER Project Funding WATER DOE Number 2507 Estimate Number 1 Payment Number 1 For Period Ending 2/8/2023 Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 4"-12" PRESSURE PLUG (COI & 2) 3 EA $3,500.00 $10,500.00 3 $10,500.00 4 TRENCH SAFETY (CO 1&2) 70 LF $14.00 $980.00 70 $980.00 5 IMPORTANT EMBEDMENT/BACKFILL, CSS 18 CY $165.00 $2,970.00 18 $2,970.00 6 DUCTILE IRON WATER FITTINGS 0.3 TN $28,325.00 $8,497.50 0.3 $8,497.50 W/RESTRAINT (CO1) 7 8" PVC WATER PIPE (COI) 26 LF $503.00 $13,078.00 26 $13,078.00 8 12" DIP WATER 31 LF $477.00 $14,787.00 31 $14,787.00 10 CONNECTION TO EXISTING 4" 12" WATER 4 EA $5,675.00 $22,700.00 4 $22,700.00 MAIN (COI) 11 1" WATER SERVICE 1 EA $6,397.00 $6,397.00 1 $6,397.00 12 12" GATE VALVE 2 EA $8,760.00 $17,520.00 2 $17,520.00 13 24" DIP CASING BY OPEN CUT 31 LF $1,605.00 $49,755.00 31 $49,755.00 14 (CO1) 6" PVC PIPE 38 LF $501.00 $19,038.00 38 $19,038.00 15 (CO1) 12X6 TOPPING SLEVE & VALVE 2 EA $16,499.00 $32,998.00 2 $32,998.00 16 (CO1) RELOCATE EXISTING HYDRANT I EA $5,715.00 $5,715.00 1 $5,715.00 17 (CO1) 7" WIDE ASHPALT PVMT REP ART 11 LF $234.00 $2,574.00 11 $2,574.00 18 (CO1) 6" CONC CURB & GUTTER 7 LF $98.00 $686.00 7 $686.00 19 (CO2 12"x8" TOPPING SLEEVE & VALVE 1 EA $16,875.00 $16,875.00 1 $16,875.00 20 (CO5) KILL 2" WATER SERVICE 1 EA $20,511.30 $20,511.30 1 $20,511.30 21 (CO5) REMOVE CONC PVMT 130 SY $137.85 $17,920.50 130 $17,920.50 Sub -Total of Previous Unit $263,502.30 $263,502.30 SEWER Item Description of Items No. 1 REMOVE CONCRETE DRIVE 2 REMOVE FENCE 3 REMOVE CONCRETE CURB & GUTTER 4 REMOVE 8" SEWER LINE 5 8" SEWER ABANDONMENT PLUG 6 REMOVE 4' SEWER MANHOLE 7 1 O' WIDE ASPHALT PVMT REPAIR Estimated Unit Unit Cost Estimated Completed Completed Quanity Total Quanity Total 122 SF $18.80 $2,293.60 122 $2,293.60 14 LF $53.30 $746.20 14 $746.20 25 LF $59.00 $1,475.00 25 $1,475.00 257 LF $61.05 $15,689.85 257 $15,689.85 1 EA $2,835.00 $2,835.00 1 $2,835.00 2 EA $4,300.00 $8,600.00 2 $8,600.00 214 LF $234.00 $50,076.00 214 $50,076.00 Tuesday, March 14, 2023 Page 2 of 5 City Project Numbers 102507 Contract Name COOK CHILDREN'S MEDICAL CENTER Contract Limits Project Type WATER & SEWER Project Funding 8 CONC PVMT REPAIR (C05) 60.13 SY 9 6" CONCRETE DRIVEWAY 122 SF 11 PRE CCTV INSPECTION 436 LF 12 POST CCTV INSPECTION 436 LF 13 MANHOLE VACUUM TESTING (CO 1, 2 & 5) 7 EA 14 BYPASS PUMPING 1 LS 15 MANHOLE ADJUSTMENT I EA 16 TRENCH SAFETY (CO2) 451 LF 17 CONCRETE COLLAR (C05) 4 EA 18 TRENCH WATER STOPS 2 EA 19 IMPORTANT EMBEDMENT/BACKFILL, CSS 38 CY 20 20" CASING BY OPEN CUT (CO2) 66 LF 21 6" DIP SEWER SERVICE l EA 22 6" SEWER SERVICE (CO 1&2) 1 EA 23 8" DIP SEWER PIPE (CO2) 135 LF 24 EPDXY MANHOLE LINER (CO 1 & 5) 70 VF 25 4' MANHOLE 6 EA 26 T DROP MANHOLE 1 EA 27 T EXTRA DEPTH MANHOLE (COI &2) 28 VF 28 20" DIP CASING BY OPEN CUT (CO2) 110 LF 29 (CO1 & 4) 4" SEWER SERVICE 2 EA 30 (CO 1& 4) SEWER PIPE 264 LF 31 (CO1 & 4) CONC EASEMENT FOR UTILITY I CY 32 (CO 1 &4) IMPORTATED BACKFILL EMBED 375 CY 33 (CO 1&4) TEMP MANHOLE ACCESS 1 LS 34 (CO 1 &4) MANHOLE ADJ MINOR 1 EA 35 (CO 1 &4) REMOVE CONCRET PVMT 238.13 SY 36 (CO 1 &4) 7" CONC PVMT 60.13 SY Sub -Total of Previous Unit DOE Number 2507 Estimate Number 1 Payment Number 1 For Period Ending 2/8/2023 $314.00 $18,880.82 $41.00 $5,002.00 $4.00 $1,744.00 $4.00 $1,744.00 $800.00 $5,600.00 $12,500.00 $12,500.00 $1,600.00 $1,600.00 $14.00 $6,314.00 $981.00 $3,924.00 $3,550.00 $7,100.00 $159.00 $6,042.00 $1,058.00 $69,828.00 $6,265.00 $6,265.00 $5,500.00 $5,500.00 $225.00 $30,375.00 $360.00 $25,200.00 $13,820.00 $82,920.00 $17,920.00 $17,920.00 $544.00 $15,232.00 $977.00 $107,470.00 $5,445.00 $10,890.00 $268.60 $70,910.40 $2,347.00 $2,347.00 $380.00 $142,500.00 $6,878.00 $6,878.00 $4,860.00 $4,860.00 $137.85 $32,826.22 $176.15 $10,591.90 $794,679.99 60.13 $18,880.82 122 $5,002.00 436 $1,744.00 436 $1,744.00 7 $5,600.00 1 $12,500.00 1 $1,600.00 451 $6,314.00 4 $3,924.00 2 $7,100.00 38 $6,042.00 66 $69,828.00 1 $6,265.00 1 $5,500.00 135 $30,375.00 70 $25,200.00 6 $82,920.00 1 $17,920.00 28 $15,232.00 110 $107,470.00 2 $10,890.00 264 $70,910.40 1 $2,347.00 375 $142,500.00 1 $6,878.00 1 $4,860.00 238.13 $32,826.22 60.13 $10,591.90 $794,679.99 Tuesday, March 14, 2023 Page 3 of 5 City Project Numbers 102507 Contract Name COOK CHILDREN'S MEDICAL CENTER Contract Limits Project Type WATER & SEWER Project Funding Contract Information Summary Original Contract Amount Change Orders Change Order Number 1 Change Order Number 2 Change Order Number 5 Change Order Number 1 Change Order Number 2 Change Order Number 4 Change Order Number 5 DOE Number 2507 Estimate Number 1 Payment Number 1 For Period Ending 2/8/2023 $1,080,416.65 ($3,120.50) $39,799.00 ($4,836.20) ($18,099.00) $15,906.40 $5,445.00 ($57,329.06) Total Contract Price $1,058,182.29 Total Cost of Work Completed $1,058,182.29 Less % Retained $0.00 Net Earned $1,058,182.29 Earned This Period $1,058,182.29 Retainage This Period $0.00 Less Liquidated Damages Days @ / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $0.00 $0.00 $0.00 $0.00 $0.00 $1,058,182.29 Tuesday, March 14, 2023 Page 4 of 5 City Project Numbers 102507 Contract Name COOK CHILDREN'S MEDICAL CENTER Contract Limits Project Type WATER & SEWER Project Funding Project Manager NA Inspectors Watson / Phillips Contractor FORT WORTH CIVIL, 1675-B SOUTH MAIN STREEET KELLER , TX 76248 DOE Number 2507 Estimate Number 1 Payment Number 1 For Period Ending 2/8/2023 City Secretary Contract Number Contract Date Contract Time 170 WD Days Charged to Date 279 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 $1,058,182.29 Less % Retained $0.00 Net Earned $1,058,182.29 Earned This Period $1,058,182.29 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 $1,058,182.29 Tuesday, March 14, 2023 Page 5 of 5 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Cook's Children Medical Center PROJECT NUMBER: 102507 DOE NUMBER: 2507 WATER PIPE LAID SIZE TYPE OF PIPE 8" PVC LF 22 12" Ductile Iron pipe 31 12" PVC 10 24" Ductile Iron pipe casing 31 FIRE HYDRANTS: 7 VALVES (16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF 8" DIP 399 20 Ductile iron pipe casing 135 DENSITIES: NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 REVIEWED By D Willhelm at 9:26 am, Aug 24, 2020 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: Cook Ch7drelis Medlcal Cenler CONTRACT: Wnler, Saxc-r, Drama o, Davin ,and Shoot Light]"ORDER CJbVlGE No: CFA It 20-0022 CRY PARTICIPATION: NO CITY PROJECT 11 102507 DOE MA 1 FID N 30114-0200431-102507-EO7605 FILE A K-2733 , X-26320 INSPECTOR: R2ey Roberson Phone No: 002-213-1037 PROJECT MANAGER: Oebble WB f1eInL P.E. Phone No: 017.392-2401 CONTRACT UNIT IVATER EEIyER PAVPIO NAGE STREET Iffs WORIONG DAYS D-10111 Cml C Corl Osnto011 Cut CI Cotl D-.01 Cost CRY Cot1 D11� "' Cost C Co,t CI CoH ORIGRNL CONTRACT 5211.660.0E low S6/106665 $0.00 5261,107.22 10.0E 5616,6310E $0.00 4116.1H.T5 $0.00 170 EXTRAS TO GATE CRFDT75 TO DATE CONTRACT TO DATE 5211.049,0E SO.OJ 1611.761,53 too 123S.t0Al2 $0.00 SAMOS)IM 70.0E SIMM75 300" 170 AMOUNT OF PROP. C HANG ORDER S 0.1204 { 11,OSA001 S 7.721-4 $ 1130=M1 5 i2T1,62S601 0 REVISED CONTRACT MOUNT 12n,MS5 $0.00 SM(M.61 SOM 521 MU 10.0E tIAIT,011M 10.00 1HOA— AS 10.00 170 TOTAL REVISEO CONTRACT AMOUNT PER Utur 721ksms0 5437.E37.13 524021.61 561 T,111.00 Si SI0.15 RMSED CO3T SHARE 17o —t'.• 31,525.701,12 city Co6L SO.cO TOTAL REVISED CONTRACT $1,4123.781,12 Ravi,od: 10.12-2011 Pape 1 Yw - dllodod to A. Oro fNlorArg NLsrges In IAa cA.,i doarn4H4: Vhl" Lromv .-, PAYr]L1.17 CITY BID ITEIA Y OUAII ITY UNIT ITFJA DESCRIPTION UNITPRICE TOTAL 1 0241.1012 1 EA 4'-12-PraMM Pl 5 3.500.00 5 3 .00 2 3201.0614 JI BY Com P-1R a7, Rosld. S 373.00 f 113,801.00 3 3305.0005 •1 EA 12, Y7alerORO laved S 38,580.00 S 38.550.00 4 3305.0109 30 LF Tmrrh Sal 3 14.00 3 420.00 6 3311,0001 0.1 TON 0". Von lVolor FaV swl Rostralm S 2a,325.00 3 2.832.50 7 3311.0261 •6 LF a'PVC 1ValerH00 3 603.00 S 3.018.00 9 3711.0461 •t0 LF 12-PVC MIN Pipa 3 897.00 S 10.970.00 10 3312.0117 -1 EA Conmaw WHOSUno4'A2'Waler Maln 5 6.570.00 S 5,675.00 t7orl 14 3311.0161 38 LF 6'PVC Vlolor Pl o J 601.00 S 19038A0 Naw 15 1 3312.41106 1 2 FA 12, .bolo A Vdva 5 16.499.00 3 32*998.00 Non 10 5993.001 1 EA Raloalo EtWri danl S 6,715.D0 3 5.715.00 No.v 17 3201.0124 11 LF 7'Wide As II RTrd Ra Ir Al" S 234.00 3 7674A0 Naw 10 3218.0101 7 lF 8 COne Qrb a Outlay 3 98.00 S 680.00 SUBTOTAL 3 3120-50 PAY ITEM LTTYDID17EA4 S QUANTITY I UNIT ITEI.IDESCRIPRON UNNPRICE TOTAL 13 3301.0101 •1 EA htwiwlo VBCCVTn Tvw S Boom S 800.00 22 J331.32O1 •1 EA 6' So (SWca S 5.500.D0 f 5,500.00 24 5379.0001 d VF Eipow M.-M. floe, 3 360.00 f 268000 25 3339.1D01 •1 EA VM". 3 13.620.00 5 13.820.00 27 3339.lM3 1 VF 4' MSewttSmanhdo 3 544.00 5 544.00 flow 29 3331.3101 1 FA W ica S 5.445.00 3 6.44600 SUBTOTAL 5 16.O99.D0 PAY ITEM DE CRYI OYUh I PRICE TOTAL 9 3213.070f �7 SF 4'Cona Sid-N 3 10.50 S 493.50 Naw 16 3213.0501 1 EA Dardor Frae Ran .T R-1 S 6,215.00 S 6.215.00 1- 17 3441A110 1 FA Rerrare a RNnaIo4 E Penal end Pont S 1.500.00 f 1,500.00 SUBTOTAL Is 7221.50 PAY ITEMS CITYBIDITEIA 8 OUAMfIY UNIT ITEM DESCRIPTION UNTPRICE TOTAL 2 2605.3016 90 LF 2'6ond1 PVCSCH 00 0 3 109.25 S 9.03250 3 3441.1406 180 LF NO 6 Nsdalad Floc CQTdr f 2.28 S 410.10 4 3441.1409 90 LF NO B b d t d V. Candy $ 2-17 S 195.30 5 3441.1502 1 EA Grand 8"T B. ll on S 379.76 S 379.76 6 1441.1771 -1 EA Fsr AtftUaS 120.240 VNI SI Io Phase Alalerod Pedestal f 4.991.00 3 4.991.00 6 9999.ODO4 919 EA Flrni A.tall Migl`.1 Vlul ua SUeel fan S 9,929.00 S 169,651.00 9 9999W0000 440 LF .Sedea 1' Cordt FVC SCNBO 3 30.92 3 19.76660 10 1 0999.0007 -3$ EA Chdstnn UqMRaco lados S 314.65 S 11.012.73 SUBTOTAL S J213.625.601 TOTAL 13(246.65a.6011 Rovlsad: ID-12.2011 Page 2 REAS0MS FOR CIUVIOEOROEn Reduced Fse lap(rtm a' to 6'ba fttl Sbeal R.lowlod FYe hldrw4 for curb nmp R.—I's wale,!.. low,,Mq b 12'aah R.duaad.mw, lap f— 6' to 4' (rvmow cequsad meMa'e) edd.dAeccnllpured curb r,w 24'RCP quenRy I—cl h h+4) bIIdpmposel .W1(ad NphI fum must N. dphl'sipn an 61h Ch.npes mTaspond fop1w R.ssshn 1.e Maim on sheals 46, fl9.IJ.1S 16, A 41 Sbe.l Lgblanokngar semdbypub/kchM Charges carespoM to P/en Ro�isbn 1 es shonn m shoals 29-32 6 36 NOCRYFUNDS IRVOLVED IN THIS CON TRACT, DEVELOPER IS RESPONSIBLE FOR 1 OOY. OF THECIIASIGEORDERCOST AN ONO REIMBURSEMEIITFROLI TME CRY WILL BE SOUGITT DYTNE DEVELOPER I 1a,r -yA—dxles Cook Ch2dronY ' en a, FodM DY Jus'nWells,P•E• By, BY: ti Nxmo !� Namo: P - Nam: Discipline Lead nue: kLP. ESTArG Rvfsod: 10A2-2011 Page J DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: Cook Chlldren's Medal Center GW2GE CONTRACT: Waler. Seapr, DreiI000. Pavi ,and SUeel Ughlbq ORDER No: CFA # 20-0022 CRY PARTICIPATION: No CITYPROJECT# 1102507 DOE# WA 2 ROD 30114-0200431-102507-E07695 FILE # K-2733 . X-26320 INSPECTOR: Riley Roberson Phone No: 682413-1837 PROJECT MANAGER: Debble WBlhelm, P.E. Phone No: 817-392-2481 REVIEWED By D Willhelm at 2; 07 pm, Sep 21, 2020 CONTRACT UNIT WATER SEWER PAWIrG DRAOIAGE STREETL101 WORWHO DAYS Dlv ", Ce11 clr con 0awle erceal CM Cen Cvl UN Cent Oewbw Coal T.'N+con Da1YlePar Coal CR C= 1 ORIOINALCONSRAL7 f2]IA10.01 tam le1e.75A05 l0.00 f2nSA07.]3 1a00 SU&M64 10.00 s]It.mis 50.00 170 EXTRAS TO DATE C REDIIS TO DATE f1121.5D fIA099.OD t11.01100 13I],QASO CONNUCT TO DATE 7t21 s39.59 ICAO U0A1S7.e5 1000 t210p11.e] SOAO U116ML00 $MOO $104.540.15 $000 170 AIAOUHTOFPROP.CHINGE ORDER { ]f,79300 f 15,90110 f t 1 0 R EVIS¢D CONIIULTANWNT fOU,]]e.50 10.00 tale}U.OS t0.00 fN1.011.11 1400 .1101A00 ]0.00 {10/,530.15 SA00 170 TOTALREYISED CONTRAOTAMOUNT PER UNIT f2N.f]e10 3e/t.S".05 f211,07A42 1/17.OIL. 210{S10.13 nEvtm" COST SHARE mv.Cos11 f1,579,409.52 CIIy C.L• 30.00 TOTAL fWaHD CONTRACT SI.079,409.52 R.Awd: 1D.12.2011 P0g01 Yw am diredod to makn Ih0 Wlwdng M.Ws In IM -t-i docixnonls: Water 4nOmremeds PAY ITEM dTY DID RFI.I / gUAInRY .1REM DESCRIPTION uNrTPMCE TOTAL 1 0211.1012 1 EA 4'-12' Plassuo PI S 3.500.00 S ] 500.00 2 3201.0614 23 SY C-P-1 aV RMrfiial S 073.00 S 8679.00 4 3305,6109 10 LF Trend, Safe 5 14.00 S 140.00 7 3711.IN 10 LF 6'PVC Wale( Pl S 503.00 S 5030.00 10 3312.0117 1 EA Com Um to EaisS 4'-121 WaterM 7n S 6.075.00 3 6.675,00 Nr, 19 3312-4107 1 EA 12'a6'To Slw.A W,u 5 16.075.00 S 16.876.00 SUBTOTAL 3 39.799.00 PAY REMS CITY 010ITEAI o OumnNY UIIIT REM DESCRIPTION UNITPNCE TOTAL M 3301.0101 1 EA 1.1aNwb Vawun T.0. S $00.00 4 800.0 I6 3305.0109 15 LF Trench SaWy S 14.00 S 210.00 20 3305.1003 034 LF 20'Casl 11O nCUI S 1056.00 3 14177200 22 3331.3201 1 FA 6'Saxn SeMw $ 6,500.00 S 6.500.00 23 3331AM -264 IF 6'DIP Sewer P' $ 225. 3 59AOO.00 24 3339.0001 9 VF Ep,,y Mutda Llnar 5 360.00 3 3240.00 25 3339.1001 1 EA 41Matlwla 3 10.620.00 3 13520.00 21 3339.1003 4 VF 4' E.I. Ou Marhdo $ SM.00 3 2 170.00 28 9999.0009 -25 LF 20'DIP CasI 9 n0A S 9T7.00 S 21425.00 N"30 3331.4115 26d LF 6'S.-Pl S 266.60 S ,taw 31 3305.0116 1 CY Cola Enr sonx lW Utility Pipes S 2,947A0 1: Ni S 2.347.00 Naw32 1 3305.0203 i 315 1 CY I IMOMod E,MedmWWAL ill. CLSM S 380.00 is S 142,500.00 SUBTOTAL S 16.906.40 TOTAL 55.705.40 Ftos4sed: 10.12-2011 Paga 2 REASONS FOR CHANGE ORDER Add6'Fietep Add 6'samiswka end -Mole amp DIP Ia SDR 26, Remora oft not mquied. Chops mm.pand el plan R.YWwI 2InshmI on sheets 1-6, 9,98 6 13 NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100;l OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE CRY WILL BE SOUGHT BY THE DEVELOPER R.h.d 10-122011 Page 3 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: Cook Children'sMedical Cenler CHANGE CONTRACT: Water Sewer Draina a Pavin , and Street Lighting OROER No: CFAH 20-0022 CITY PARTICIPATION:1 NO CITY PROJECT 8 102507 DOE N NIA 4 FID # 30114-0200431-102507-EO7685 FILE S K-2733 X-26320 INSPECTOR: Brandon Phillips Phone No: 682-715-7010 PROJECT MANAGER: Debbie Wilhelm, P.E. Phone No: 817-392-2481 CONTRACT UNIT WATER SEWER PAVING DRAINAGE STREETLIGHTS WORKING DAYS Developtrc Cost CN,C. Developer Cost City cost Developer cost CI cost Developer cost Clry cost Ocvelo ercost City cost ORIGINAL CONTRACT $231,660.00 $0.00 $648,796.65 $0.00 $235,807.32 $0.00 $436,053.00 $0.00 $318,165.75 10.00 170 EXTRAS TO DATE $39.799.00 $15,906.40 $7.221.50 110,080.00 CREDITSTODATE $1.120.90 $fe,099.00 $19,035.00 $213,675.60 CONTRACTTODATE $269.338.50 10.00 $844,664.05 $0.00 $243.028.52 $0.00 $421,998.00 $0.00 3104,640.15 $0.00 170 AMOUNT OF PROP. CHANGE ORDER $ $ 5,445.00 1 $ i 0 REVISED CONTRACT AMOUNT $268,335.50 $0.00 $852.009.05 $0.00 1140.026,62 10.00 $427.998.00 30.00 $104.540.15 110,00 170 TOTAL REVISED CONTRACT AMOUNT PER UNIT $268.330.50 SIS2009.05 $243,028.82 $427. 96.00 $104,540.15 REVISED COST SHARE Day. Cosl: $1.895,914.52 City C-l: Sam TOTAL REVISED CONTRACT $1,895,914.52 You are directed to make the following changes in the contract documents REAtB CITY BID ITEMPAY 8 QUANTITY UNIT ITEM DESCRIPTION UNIT PRICE I TOTAL 29 3331.3101 1 as 4'Sewer Service $ 5.445.001 5 5,445.00 TOTAL $ 5.445.00 REASONS FOR CHANGE ORDER add servxe connection la south 0ulpercel Chmrpes correspond to ravision 4 on sheet 9 Revised: 10.12-2011 P.O. I DocuSign Envelope ID: FA49BAAD-OEOC-44D7-99CA ODOA602CACOB NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100'A OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROIA THE CITY WALL BE SOUGHT BY THE DEVELOPER RECOMMENDED: APPROVED: APPROVED: Dunaway Nsociates Cook ChiA*.n. Medical Center Fort W.n7h �Civil Const cf—, L�L�C��� / By, By:,liM1'uv s' A, By: Name: JUStln Wells, PE Nan,.: Spencer seals Name: Doug Alumbaugh no.: Sr. DisCipllne Lead Tid.: VP, CG,AStI-Uttion & Real Estate Tige: Project Manager ReNs.d: 10-12-2011 Page 2 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: CookChildren's Medical Center CHANGE CONTRACT: Water Sewer, 0re1ne e, P ving, and Street Unhilng ORDER No: CFA# 20-0022 CITY PARTICIPATION: NO CITY PROJECT # 102507 DOE # NIA 5 FID # 30114-0200431-102507-EO7665 FILE # K-2733 X-26320 INSPECTOR: Brandon Phillips Phone No: 682-715-7010 PROJECT MANAGER: Debbie Wilhelm. P.E. Phone No: 817-392-2481 CONTRACT UNIT WATER SEWER PAVING DRAINAGE STREETLIGHTS WORKING DAYS Developer Coil Clty Cosl Developer Cost .CI. _Cost .Coil Developer Clly Cost CityCost Develo er Cost City Cost ORIGINAL CONTRACT $231.640.00 10.00 184sysese5 f0,,V0 _�. $235.807.32 $0.00 00 $0.00 $318,165.75 $0.00 WO EXTRASTODATE $39,799.00 $21,351.40 $7.221.50 0CREDITS TO DATE f3,120.60 $18,099.00 #$436.03.00 00 $213.625.60 CONTRACTTODATE f26s,338.60 50.00 5851,009.05_JOpO f243,02e.62 1D.00 .00 $0.00 $104,540.13 som 170 AIAOUNi OF PROP. CHANGE ORDER j N,876,20t j 157,729.Ofi) _S S;674.39 .41 117 REVISED CONTRACT AMOUNT $263.502.30 10,00 $794.679.09 40i00 �' 11U.lI07.21 30.00 .41 $0.00 $104.640.15 30.00 287 TOTAL REVISED CONTRACTAMOUNT PER UNIT $263,S02.30 $791670.99 $32S,903.21 1440,231.4t 1104.540AS REVISED COST SHARE D.V. Cost' $1.928.857.06 ICIty Cosl: $0.00 TOTAL REVISED CONTRACT $1.920,857.06 You are directed to make the follovAng changes in the contract documents Water Imorovements PAYITEM# CITY BID ITEM # OUANTITY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL 2 3201.0614 -116 SY I Cono Pvmt Repair. Residential I 5 373.00 S 43268.00 New20 9999,0011 1 1 LS 1 1017'Water Service I 5 20.511.30 S 20.511.30 New21 0241.0100 130 1 BY I Remove Cerro Pvml I S 137.65 S 17920.50 TOTAL 5 4,63&20 Revised:10-12.2011 Page i 9evrer lmnr nnm PAYITEMA CITY 810ITEM 8 OUANTITY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL 8 3201,0674 -379.87 BY Cone Pvml Re air, Resldenllal $ 314.00 S 119,279.10 10 3231.0412 -14 LF 6'Fences, Wood S 72.00 S 1.00e,00 13 3301.0101 1 EA Manhole Vacwm Testing S 600.00 S 800.0c 17 3305.0112 2 EA Concrete Collar S 981.00 $ 1962.W 24 3339.0001 14 VF Epoxy Manhole liner S 360.00 S 5,040.00 New33 9§99.0012 1 LS Temporary Manhole access S 6,878.00 $ 6,878.00 New34 3305.0101 1 EA Manhole Adjustment Minor S 4,860.W $ 4860.00 New35 0241.0100 238.13 SY RemwoCone Pvml S 137.85 S 32.626.22 New 36 3213.0102 60.13 SY T'Cono Pvml S 17&15 $ 10.591.go TOTAL S 57,329.W PAY ITEMS CITY BID ITEM 8 OUAHTITY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL 2 0241.1300 -23.9 LF Remove Concrete Curb& Gutter $ 62.00 S 1,481.80 3 3201.0124 -16 LF 7"Wele Asphalt PvmtRepalr, Adedal S 234.00 S 3.744.00 4 3201.0616 29.88 BY Conc Pvml Re a'r, ArelerlaVlndusldal $ 31&DO S 9.412.20 6 3216.0101 61.6 LF V Conc Curb and Gutter 5 98.00 $ 6056.80 7 3301.WD1 11 LF Pre -CCTV Ins cllan S 4.00 S 44.00 8 3301.0002 1 LF Post -CCTV Inspection 5 4.00 S 4.00 9 3305.0109 1 LF Trench Safe S 14.W S 14,00 12 9999.ODD1 -10.78 BY Concrete Crossvnkr avin 'Llght Peach' $ 330.00 $ 3,557.40 13 i9999.0002 0.63 SY Concrete Crosswalk avin hl Blue' $ 360.00 S 226.80 New 14 0241A100 46.9 SY Remove Conc Pvml $ 6DU5 5 2,816.35 New 15 3212.03D3 46.9 SY 34 As haft Fvm1 Type D $ 73.401 S 3.442.46 TOTAL S 12,233.41 Paving immewsmenls PAY ITEM CITY OID ITEM 7 QUANTITY UNIT ITEM DESCRIPTION UNITPRICEj$3. AL 3 0241.0300 1 EA Remove ADA Ram S 2,780.00 2,780.00 6 3110.0102 -4 EA 6'-12'Tree Removal S 885.00 .540.00 7 3212.0302 -131 BY TPvmtT D S 24.00 144.W8 3212.0501 -131 SY 4'Pv.1 T e B S 44.00 ,7649 3213.0301 -3 SF 4"Conc Sldevnik $ 10.50 31.So11 3213.0507 1 EA Barrier Free Ram.T P-2 $ 3,900.00 3,900.W 14 3471.0001 3.25 MO Traffic Control S 13.550.00 S 44.037.50 Nevi 18 3213.0206 281.5 SY 11" Conc Pvmt HES $ 19.86 S 5.590.59 New 19 3201.0115 35.75 LF &Wide Asphalt Pavement Re 8 Residential S 234.00 S 8365.50 Nevr20 9999.0013 1 LS Pruitt Tem ra As ell Pavement S 1%821.00 S 19.821.00 New21 9999.0014 101 CY Maledal Cosllncreaselor FlaNbrk S 71.30 $ 7.201.30 New22 9999.0016 62 LF I 7-W Variable Height Curb S 59.00 S 3658.00 TOTAL $ 82,874.39 Shift .1-t 9N bcarbns. Tree renuvab and,w d fenNrg removal are private: removed hom CFA scope. Reounstrutllon of ramp at PennsyMania and &h, halakaflan of temporary pavement H Prufi. tint eddibnal pavemeN repave required at venous bcarhns This Change order Is eW a reconciliation 016na1 REASONS FOR CHANGE ORDER quam44stonwtch As-Bula oond4lunt Changes oonsspond to Plan Revision 5 sheers 28. 29, J 1, & 32 and Plan Revision 6 Sheets 4, 3. & IJ Due to delays, 117 working days added to contrad. Revised: 10-12-2011 Page 2 W 1011n E1.111>1e 10.1 NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100% OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE CITY WILL BE SOUGHT BY THE DEVELOPER RECOMMENDED: APPROVED: APPROVED: Du—.yy Ass Nil, Cook Chid—'. Aleckal Center Fort 144rth Civil ConstruUaa. LLC By: %� W. By. �Sr.11u�ly By: .A�irin6 Ppuy.� Name: JuslinWells Name: Samuel Werschky Mama: DougAlunnbaugh Title: Sr. Discipline Lead Title: Director of construction Tit1o: ProjectMenager Revised: 10.12-2011 Page 3 FORTWORTH. M, TRANSPORTATION AND PUBLIC WORKS February 9, 2023 Fort Worth Civil Construction, LLC 4860 Mark IV Pkwy Fort Worth, TX 76106 RE: Acceptance Letter Project Name: Cook's Children Medical Center Project Type: Developer City Project No.: 102507 To Whom It May Concern: On February 9, 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 February 21, 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 February 21, 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- 392-2481. Sincerely, T�e66� a U),g Debbie Wilhelm, P.E, Project Manager Cc: Brandon Phillips, Inspector Donald Watson, Inspection Supervisor Aaron Ybarra, Senior Inspector Victor Tornero, P.E, Program Manager Dunaway Associates, LP, Consultant Fort Worth Civil Construction, LLC, Contractor Cook's Children Medical Center, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 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 Austin Alumbaugh, President Of Fort Worth Civil Constructors, LLC, 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 fiill; 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 damages; On Contract described as; Sanitary Sewer, Water, Storm Drain, Paving & Street Light Improvements to Serve Cook Children's Medical Center CVN: 10afD7--, 4 ustin Alumbaugh, President Subscribed and sworn before me on this date 8th of March, 2023" `aotvA! P6e� ; MANDI OLDHAM Notary Public, State of Texa ZO-* i t Public Comm. Expires 08-28-2026 �ryF4F �;` „l„gyp Notary ID12431710-4 Tarrant County, Texas CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ SURETY ❑ AIA DOCUMENT G707 OTHER Bond No. SUIZOO58795 PROJECT: Sanitary Sewer, Water, Storm Drain, Paving & Street Light Improvements to serve Cook (name, address) Children's Medical Center TO (Owner) [ City of Fort Worth ] ARCHITECT'S PROJECT NO: 200 Texas Street Fort Worth, TX 76102 CONTRACT FOR: [ ] CONTRACT DATE: CONTRACTOR: Fort Worth Civil Constructors, LLC P.O. Box 161727 Fort Worth, TX 76161 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) Argonaut Insurance Company P.O. Box 469011 San Antonio, TX 78246 , SURETY COMPANY, on bond Of (here insert name and address of Contractor) Fort Worth Civil Constructors, LLC P.O. Box 161727 Fort Worth, TX 76161 , 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 200 Texas Street Fort Worth, TX 76102 as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 8th Attest: (Seal): ,OWNER, day of March 2Q23 Argonaut Insurance Company Surety Company Sig turc of Xuthorized Representative Andrea Rose Crawford Attorney -In -Fact Title NOTE: This form is to 6e used as a companion document to AIA DOCUMENT 0706, 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 a THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 New York Ave., NW, WASHINGTON, D.C. 20006 Argonaut Insurance Company Deliveries Only: 225 W. Washington, 24th Floor Chicago, IL 60606 United States Postal Service: P.O. Box 469011, San Antonio, TX 78246 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the Argonaut Insurance Company, a Corporation duly organized and existing under $1 c laws ofthe State of Illinois and having its principal office in the County of Cook, Illinois does hereby nominate, constitute and appoint: - LL 51 Their true and lawful agent(s) and attomey(s)-in-fact, each in their separate capacity if more than one is named i�?%v to,mike, execute, seal and deliver for and on its behalf as sure'y surety, and as its act and deed any and all bonds, contracts, agreements of indemnity and'othei`.undertakings in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: S97.550.000.00 This Power of Attorney is granted and is signed and sealed under and by the authority of the folldwing Resolution adopted by the Board of Directors of Argonaut Insurance Company: r. art "RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice P�est ent, Secretary, Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of faczimile signature, which may be attested or acknowledged by any officer or attorney, of the Company, qualifying the attorney or attorneys named n the giver power of attorney, to execute in behalf of, and acknowledge as the act and deed of the Argonaut Insurance Company, all bond undertakings, and:contracts of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, Argonaut Insurance Company has caused its%fficial`seal to be hereunto affixed and these presents to be signed by its duly authorized officer on the 19th day of November, 2021. Argonaut Insurance Company ..... :'.`"�'URq",',' Jq� oRaoit+NCFn .. .0. :,:SEAL*---= by: Z d. 1949 STATE OF TEXAS COUNTY OF HARRIS SS: ' '_+. Yt "'���„•.���`''" Gary E. Grose, President On this 19th day of November, 2021MA D:, bef ie me, a Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and qualified, came THE ABOVE OWIICEER OPtHE COMPANY, to me personally known to be the individual and officer described in, and who executed the preceding instrument, and he acknovt+,fedged the execution of same, and being by me duly sworn, deposed and said that he is the officer of the said Company aforesaid, and that the sedl`a' fiked to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affi�etltiand 4scribed to the said instrument by the authority and direction of the said corporation, and that Resolution adopted by the Board of DirectWof said'CS-o6pany, referred to in the preceding instrument is now in force. IN TESTIMONY'WHEREOF, 1 have hereunto set my hand, and affixed my Official Seal at the County of Hams, the day and year first above written. KATtiLEEN M MEEK$ NOTARY PVSLIC STATE OF TEXAS MY COMM. EXP. 0711 s125 NOTARY ID SS7902-8 (Notary Public) I, the undersigned Officer of the Argonaut Insurance Company, Illinois Corporation, do hereby certify that the original POWER OF ATTORNEY of which the foregoing is a full, true and correct copy is still in full force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand, and affixed the Seal of said Company, on the Bth day of March 2023. '2iiNO�S' Austin W. King Secretary IF YOU HAVE QUESTIONS ON AUTHENTICITY OF THIS DOCUMENT CALL (833) 820 - 9137. IMPORTANT NOTICE To obtain information or make a complaint: You may call Argonaut Insurance Company and its affiliates by telephone for information or to make a complaint: ARGONAUT INSURANCE COMPANY Please send all notices of claim on this bond to: Argo Surety Claims (413) 773-6359 Deliveries Only: 225 W. Washington, 24' Floor, Chicago, IL 60606 United States Postal Service: P.O. Box 469011, San Antonio, TX 78246 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: (512) 490-1007 You may write the Texas Department of Insurance: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection(&-tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact your agent or Argo Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR BOND: This notice is for information only and does not become a part or condition of the attached document and is given to comply with Texas legal and regulatory requirements.