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Contract 57282-FP1
AC Coded 03.24.23 Vendor Name: Woody Contractors Invoice No. 57282 - FPI Release Retainage $79,702.11 FID 56002-2060000-102785-RETAIN FORT WORTH® fi WATER DEPARTMENT NOTICE OF PROJECT COMPLETION CSC No. 57282-FP1 City Secretary No:_57282 Date Received: City Project Ne: 102785 Regarding contract 57282 for Sanitary Sewer Rehabilitation Contract 113 Part 1 as required by the WATER DEPARTMENT as approved by City Council on 2/22/2022 through M&C 22-0127 the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Water Department has accepted the project as complete. Original Contract Prices: Amount of Approved Change Orders: $0 N4 Revised Contract Amount: Total Cost Work Completed: $1,594,042.18 Less Deductions: Liquidated Damages: 0 Days @ $650.00/ Day !Iirm Pavement Deficiencies: Total Deduction Amount: $0.00 Total Cost Work Completed: Less Previous Payments: Final Payment Due _ 7:0 AL Recommended for Acceptance Asst. Director, WATER DEPARTMENT L�'l iQiz 7i% 4- Christopher arder(Mar.24,2023 13:25 CDT) Accepted Director, WATER DEPARTMENT Client Department Dam Ear,ghki-- Dana Burghdoff (Mar 24, 20231 42 CDT) $1,711,952.50 $1,594,042.18 $1,514,340.07 $79,702.11 Asst. City Manager Comments: 3 ;' 17/2 Date Date Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page !To (Owner): P. O. Number: Project: Contractor's Application for Payment City of Fort Worth Invoicing Period (From - To): FW060-0000018007 City Secretary Contract Number: 102785 From (Contractor): Woody Contractors, Inc. Contractor's CFW Vendor No.: Invoice No.) Invoice Date: 10 FINAL 2/28/2023 Remit to ( If Not Automatic Deposit ): 57282 Contract Sani Name: y tat Sewer Rehabilitation Contract 113 Part 1 Application For Payment Change Order Summary Approved Change Orders I. ORIGINAL CONTRACT PRICF S S1,711,952.50 Number Additions Deletions 2. Net cbnnge by Chnnge Orders S 1 3. Current Contract Price (Line 1 f 2) S 2 4. TOTAL COMPLETED AND STORED TO DATE 3 (Progress Estimnte, Construction Allowance and Change Orders) S S1,594,042.18 4 5, RETAINAGE: 5 n. X S1,594,042.I8 Work Completed S 6 b. X Not Used S 7 c. 'Total Retainage (Line Su + Line 5b) S 8 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c) S S1,594,042.18 TOTALS 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application) S 51,514,340.07 NET CHANGE BY 8. AMOUNT DUE 771IS APPLICATION S S79,702.11 CHANGE ORDERS 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + COs + Lino 5 above) S Contractor's Certification 10. CONTRACT TIM E: The Contractor certifies with the submittal of this document and associnted Payment Request Submittal on the City of Fort Worth Buzrsaw system that to the best of their knowledge: (1) all previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Applications for Payment; (2) title of n11 Work, materials and equipment incorpomled in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and encumbrances (except such as me covcrcd by n Bond acceptable to Owner indemnifying Owner against any such Liens, security interest or encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and ' not defective. 4 Z7u 3/17/23 3/16/23 n, Days Awarded 240 b. Days Added by CO Total Dnys 240 d. c. Dnys Charged Dnys Rcmnining This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consul) Legal Counsel prior to Its execution. 220 20 C520 UM Pike Progress Estimate Progress Estimate Fa (am6ae°' Sanitary Sewer Rehabilitation Contract 113 Part 1 Application wiea 1a Bid hem No. A City Secretary Cadan Num: 57282 ..pplkaim Numb, Application Duct Contractor's Application 10 FINAL 2282023 C D F 0 F06dOid7Spmifwim Balsam.F6 ilidQusrdity L.aapdValue myd �uearidgad(onm5grad AinCayT4(p1®Ep)kd (5-1) Section No. Vutohlaoa B D$'rY Waterlmnmverrmne - - - - - - 1 A Water P' a 3311.0241 LF 2.542 $67.00 $227,151m 2587.000W000 0221631m $124,eum $tu631m 101.615 40.4Bom 2 6" Water Ffj8e 3311.0141 LF 35 576.00 f2,ea0.m 36.00000000 3236023 $2,ee000 $2,6m.00 10oD% Ductile Iron Water Fittings w/ Restraint 3 3311.0001 TN 1.0 $12,000.00 912,000.00 09BDOWm $1/,760.a0 S117e0.0O 571,76D.00 98.015 j14000 0-Inch through 124nch doel 4 8 Gate Valve 3312.3002' EA 3 $�1.300,00 123031p 3.0p0g0ppp S3,9 0.pp 3jaW.00 S3,B00.00 1000% 5 6' Gale Valve 3312.3003 EA 18 Si.700.00 k70.80000 1600000000 $30600.90 f3090DA0 530,6p000 1000% 6 Fire H2drant 3312.0001, EA 3 $4.000.00 5141�00 000000000 $1410000 514.100.00 S14,100.00 1990% 7 Connection 00 Ezistirfg 4'-17 Water Main 3312.011 / EA 10 $4.000.00 $40000.00 10A0900000 34000030 SIO,000m $4000400 1000% 8 1" Water Service. Metter Reconnection 3312.2001 EA 38 $350A0 573,30D.00 41.009WOro 314950.00 51195D.00 571,350.00 1079% 41,050m 9 1' Water Service 3312.2003 EA 36 01.650.00 36270003 41000W000 587,660.00 967,850.00 987,650.00 1079%-54,96D.00 10 1' Private Water Service 3312.2004 LF 100 Aajp2.00 $3200m 51,030GG 11 112" Water Service, Meter Reconnection 3312.2101 EA 1 5880.00 5650Ap 5860.80 12 112'Water Service 3312.2103 EA 1 200.00 $1200.00 $32pp00 13 SaNaa06'Water Valve 0241.1302 EA 4 5100,Q� 5100.00 4,OlIDOW90 34oD.o0 $4p000 34003 1000% 14 Sa(ago 8' Water Valve 0241.1303 EA 9 3100.00 290oA0 9.00000000 5900.00 59W_03 890000 1000% 15 Abandon 6" Water Valve 0241.1402 EA 3 100.00 530090 000000000 930D.00 5300.00 53110A0 7000% 16 Salvage Flre Hydrant 0241.1510 EA 3 300.00 590D.00 3,03002003 590000 $9p00p 590000 1000% 17 SaNq F 1 12' Water Meter 3201.011121.1513 EA 1 50.D6 55800 50pm 18 4' Wide Asphalt Pvmt Riga r. Residential LF 100 3 0.00 99, 0000 6530090000 5694am 5e 645a0 5694000 e53x 51,15000 Temporary Asphalt Paving Repair 19 3201.0400 LF 3,013 $20.00 580R60.00 31750m00000 J83,ts00.00 563300.W $63,500.00 108.415 -f3,210.00 ((2" HMAC on 6" Fioxbasel 20 Asoha$ Pvml Repair Beyond Defined Width. Residential 3201.0201 SY 100 //��49.00 31900.00 4090000000 519m.a0 57 56o.00 $136000 400% 52,640.m 21 Conc Pvml R000(r Residential 3201.0614 SY 50 52D0.06 St0.00aa0 8100000000 510.60000 Stssm.00 31630330 1660% 456OOm 22 11-Inch PBvemBn�PUNer¢alion (50/50) 3211.0600241.1700 SY 2 000 a$3�9.3 ' 51000000 1797.a0)0000U S/6,Bo195 316,eot.05 f16,90t96 6B9% 51,686.63 23 Cement -Lime. 321b5./sv. )50/50\\ TN 25 S i4.00 56.85000 28.78g70000 f7977.50 57,97750 37977.50 1150%-f7,02730 24 3-Mch Asphalt Pavement Type aD''150/501 32)2.0303 SY 2/000 18.50 13700100 1768.70230900 533,tOB.50 53370960 5d3,10B30 BOS% $399050 25 6'Conc Curb and Gutter (50/501 3216.0101 LF 1,150 4.`0y/ 550,600.00 102860000000 $45,i66.a0 S451660o - - 345,1e690 89315 50434 pp 26 Instal New 6-Inch Concrete Driveway (50/501 3213.0401 SF 1.786 $12.75 $22,797.ro 1731I.90p00000 522,134.0p f2213100 f12,13400 971% 586500 27 7emRore�v Water Services 3304.0101 LS 1 $51.000.00 551p00.00 I.00000000 351000.m 35I o0o a0 f5170000 1000% 28 8' Waterline Loweril�u 00 3305.0003 EA 3 $6.000.00 351 00 _ _ _ _ Step90.m 30 mporte29 tory d Embcova6on of ack(81IICSStitities 3305.0202 EA3305.0103 50 51.f00.00 55,500.00 50000:003 $5,50000 S0,Sa000 - $5,60000 1000% 4100.00 55,000.00 55,000.00 31 Imported Embedmen116ackff CLSM 3305.0203, CY 50 5130.00 800.00 56,600.00 38581 p 32 Ion�Prted EmbedmenU33��BackMi, Select Fill 3305.020/ CY 50 ,j 530.06 51903.00 10.00000000 530000 5300.00 _ $3o09p 209% $7,a70p0 O 3 34 SWPPP 21 acre a(We\ell� 3125.3471.0001 01 lLS 1 31.500.06 St,50D90 1170000000 330100 fl,soo1.03003000 �a0 _ _ 92 108 Survey35 ult ( (( _ _ !A¢00 1000% 36 Construction 0081(4941 (Water) 9999.0002 LS 1 SS.Oo0.0A 10.000.90 1.00000000 $6300.00 58,000.00 S6pp0pp 100015 52000.00 100.0% 37 Water Construction Allowance 9999.0003 LS 1 555.000.06 $50,00000 - - - $503O000 Unt 2: 5at4av Seer 1 6' Sewer lrlpe 3331.4115 LF 1.490 391.06 913559950 1509.00000000 3136,68250 $130,1367 CO _ $13669t7 100611 4108290 2 11' Sewer PipeCSS Backfdl 3331.4116 LF 49 3167.00 5018a00 2600990000 94,67600 $4,676.03 54,t7%600 57.1% 33,507A0 3 4" Sewer Service 3331.3311 EA 30 S ,000.06 54500090 32000E0000 56130100 051,200.00 $51,20103 108.715 -53,20000 4 Pre -CCTV Inspection 3301.0001 LF 1.225 54.06 9490000 305.000 CCO3 $1,220.03 51,22000 31,220.03 24915 $3,85000 5 Post -CCTV Inspection 3301.0002 LF 1.539 $6.00 19234.00 15306000090C 39,16060 $9,1e0.03 -- 9976055 99.411 15499 6 Sanitary Line Groutlnq 0241.2001 CY 9 S00.00 34,60203 930000009 54,500.00 _ 5470002 84300.00 100015 7 6" Sewer Abandonment Plus 0241.2102 EA 3 5.00 56713,0000(000 3675.00 $675.00 _ 561500 1000% 6 Remove 4' Sewer Manhole 0241.2201 EA 4 .00 _ _ _ _ 52000 /.000OWOD 3290000 $7,0W.00 5200000 1000% 9 Abandon Manhole 0241.5001 EA 2 sS�j .06 52.000.00 1.00300000 51,03000 51,630o0 5100 .03 53.015 $1900.00 10 4' Manhole 3339.1001 EA 4 55.600.00 822.40000 4.00000000 922,40000 577400 CO - - - 522,40003 1000% 7/ 4' Drop ManholejDouble Drop) 3339.1002 EA 1 310.000.00 31030003 1.000OW09 venom 510,000.00 _ _ 51000000 1000% 12 4' Extra Death Manhole 3339.1003 VF 7 60.00 31, 92 4.840:0203 5868.03 _ 59690o 59E603 88.171 513200 13 4' Shalow Manhole 3339.1004 EA 1 $4 0.00 $4,000A0 1.00000000 S4A00ao 94800.00 - - - 34,000.03 100.0% 14 Manhole Vacuum Testyp 3301.0101 EA s ��v150.00 $000m 500(IW WO 590000 $900,00 590090 100.0%____11Epoxv Manhole Liner( amen or Chesterson) 3339.0001 VF 9 3, 50.00 13.160m 9.90000000 S3A65.00 53,465.00 _ 3348500 1100% 43f6m 16 Concrete Collar 3305.0112 EA 6 SSiTi6�0.00 $3,90000 2.03000000 31,3o0m 51,300 co _ $1,300.00 333% $22XtC0 Temporary Asphalt Paving Repair 3201.0400 LF 1,531 $25.00 17 (2' HMAC on 6" Flexbasel 53897509 19540330X00 $49150.00 54915500 5/015000 1254% 410.875G0 8 A6halt Pvmt Regale Beyond Defined Width. Residential 3201.0201 SY 100 9.00 $4905m 0WO9m90 5245.00 $245.00 - --- - $24500 50% $4 W5.00 19 11 -Inch Pavement PU7cerza5on (50/501 0241.1700 SY 2.000 rj�9.351 $1570000 1797.000p0009 31830125 516,80195 _ 516001.95 809% 31,898.05 A Cement -Lime. 321b9./sv.150/50 3211.0600 TN 25 �204.001 36.85501 25Ri000000 37.877.50 37,877.50 37,977.60 1150% 41,02730 21 3-Mch Asnnllah Pavement Tyy0ne �' (50/501 3212.0303 SY 2.000 18.501 $37,00000 1769.7025:030 $33,109.50 $33,109.60 $33,109.60 MS% $3,80850 23 6' Conc Corb and Gutter (S0) 07 3216.0101 LF 1.150 $44.001 $50911000 /02660000000 $45,16800 545,166.00 --- _ _ 945,1e630 69.5% 55,43403 23 Instal New 6-6166 Concrete Driveway (50/501 3213.0401 SF 1.787 RR12.75II 522,76425 173500000000 922,131.00 522,734.00 $Y2,131.00 87.1% $65025 u Exploratory Excavation of Ex sling Utilities 3305.0103 EA 2 $7.{00.06� 32209.00 2000om00 9220000 S2pooro 52200.m 100.0% 25 Trench Safety (SenBary Sewer 3305.0109 LF 1.539 ,,sji.09 $1,5�.00 15300:00:030 $1,590.0D N.5M.00 $1,530.00 90.4% 39.00 28 Imported Em etlmen ackU( SS 3305.0202 CY 50 31Eb.0 35,000.00 _ $5p0003 27 Imported Embedmenleackf4 CLSM 3305.0203, CY 50 9s130.001 $63naro $63pipp 2a Irr1 rted EmbedmenUBackf I, Select Fill 3305.020/ CY 50 30.00 $1,500.00 rySpppp 29 Trey: Control(Senkary Sewer) 3471.0001 MO 3 $1.800.00 $5.40000 225000000 34,050m 94,050.00 _ $495030 75.0% 51,330.00 30 _ SWPPP 21 acre (Sanitary Sewerl 3125.0101 LS 1 31.500.00 91,5013.90 1.00000000 $1,50303 41,50030 5700000 103.0% 31 As-B98t Survey (Red -Line Survevl 9999.0004 LS 1 $1.500.00 $1�A0 1.00000000 3130000 3190000 $190000 100015 32 Construction Slakino (Sanitary Sewerl 9999.0005 LS 1 m53.000.00 5300003 1.Ooo9000O $3900.00 $3,00000 5300300 1000% 33 San9ary Sewer Construction Allowance 9999.0006 LS 1 $30.000.00 530,000.00 920708pp Thhdmvmmt Ns Nan ramified from its aisimlf asanFJCDC&+mmmt and the ma did nits highlight the modifications. You are mcouraged b ad the dammmt carcfuny and semen Legal Cmmel pia to ita memtim. C420 Unl Pitce Progress EO/oeS Progress Estimate Em (aaeag): Sanitary Sewer Rehabilitation Contract 113 Part 1 A.V6wwa Paiwk A It® 8/d eon. No. Uri( 3: Mmovemris Utility Ad us mentJlrraah Remove idewa 1 ionl 2 3 Remove Existing 6-Inch Concrete Driveway 4 Remove Asikha Drive5 Remove Existina Concrete Curb and Gutter R E axl 13emove xlstConcrete Valley Gutter 7 I11-loch Pavement PuNertaation 50/501 9 Cement -Lime. 321bs./sv. 150/501 9 I4' Conc Sidewalk 10 Instal New 6-Inch Concrete Driveway (50/501 11 IUnclassified Street Excavation 12 3-inch Asj),halt Pavement Tyne 13 8' Curb (50l501 Conc and Gutter/59/5 14 tnatal New 7' Concrete Valey Gutter 15 HMAC Transition 16 ,Strip Bars Pavement Mark/n7o 17 �Nater Value Box Adjustment wlh Concrete Collar 16 Water Meter Box Adjustment 19 Manhole Adustmenl With Concrete Collar 20 Pelntin(1 Cur Addresses 21 TObck gqeoi 22 BSod Replacement 23 24-Inch and Larger Tree Removal 24 Conc Curb at Back of Sldewa0( 25 Traffic Control (Pa ''9y1 26 SWPPP z 1 acreJfyavn9) 27 Construction Stakino fPavnol 28 IPasina Construction Ammance Spm,f oo Una ofAGuun s gLa Nw City 8 0e7 Coning ttm: Bid Quantity (Minim 57282 8 C D 01dValoe Estimated Quantity Value Presiously Initelled Value Value Ili, Period [mined 1 3305.01061 LS 1 310.000.001 mance 071634500 57163.45 57,16345 57,163.45 71.6% 323538.55 0241.0100 1 SF 100 51.50 315000 78E0033E03 Si1L00 -- - 5n2oo 5117.00 76A% $7300 0241.0401 SF 2,270 51.50 S3,4o5.m 4371.000m000 58,558.50 $6,556'A _ - 56,768.50 1928% 43,15150 0241.0902 SF 2.000 51.00 32.00000 2045.ODOW000 $2,045.00 52,045.00 32, 5503 1023% -54500 0241.1300I LF 4.600 $4.00� 815400.00 2182.c00000]0 55728.0) 58,T28.1x) _ f872A0D 47.46 f9,6/2t10 0241.14001 SY 50 58.00J Sdm.00 159.000)0000 stance f12]2 o0 5127200 318A% 467290 0241.1700 SY 4.000 59.3 53740000 3594.00000000 533603.93 533,50.90 333,60393 8996 53,798.10 3211.0600 TN 50 S274.001 S13,700.03 57.50E03030 515,755.00 515755.03 315,75500 115.06 42,065.00 3213.0301 SF 100 512.00) 51,200.00 34a0a00o00 $406.00 540800 _ $408.00 34.06 $78200 3213.0901 SF 3.575 tt2.3' 545,581.25 3470.003E0300 54424250 544242.50 $4424250 97.16 81,338.76 3123.0101 CY 500 t 1.00 512,58 E0 1374.5400(000 $34,363.50 5340E0.50 _ - 5333345350 27496 -521,863.50 3212.0303 SY 4.000 S18.50 57400300 3579.40550000 565219.80 $68,9.00 366219.00 8956 57,761.03 3216.0101 IF 2.350 $� 4.00 S103,40000 2051.0E02E000 590244.00 .i90244.00 _ 990.4480 87.3% 513,15600 3216.0301 SY 50 5178.00 58,750.00 237.0c000000 541475.03 541 475 03 $41,47500 474.06 -532.72500 3212.0401 TN 50 5200.00 510000.410 1399020020 52,798E0 52,758.00 $2,798.00 290% 5720200 3217.0305 LF 60 �5, l.00 51,8130.03 127.0303E003 53,937.00 53,837.00 33337.80 211.714 42,07780 3305.0111 EA 10 5450.00 51,500.00 221E030000 59,800.55 5900000 5955000 220.0% 45480.00 3305.0108 EA 3 S75.00 622500 322500 3305.0107 EA 8 5650.00 120400 11.00c00000 57,15003 57,150.03 87,150.0) 137.5% 41.95090 3217.5001 EA 50 372.00 1360045 32.00000000 52,304.00 52,304.00 $2,304.00 84.0% $1290.00 3291.0100 CY 200 S28.00 5200.00 152E000030 5421200 51,21200 5421200 8106 398580 3292.0100 SY 1.100 $5.50 5408000 15500E030300 510.17500 51417500 31517500 18626 44,12300 321 3EA 1 13.0105 .0322 17 100 6282.700.00 ,70000 1.00055C0p 5270000 52,70000 527000 1000% ,ii5,00 31,500.00 31,500.03 3471.0001 MO 2 51.9bbA0 _ 53,600.00 1.5coocnao 5270000 5270000 5220580 7506 590000 3125.0101 LS 1 $1.500.00 31,630.00 1.0cn00000 81,50000 $1,600.03 31,500.80 1000% 9999.0007 LS 1 S5.000.00 3555055 1.c0000000 35,00090 8eo3045 55,000.00 100.016 9999.0008 LS 1 550.000.00 55400000 350,00000 Applkuim Number Appl',euien Duc \WciaBRomay Stmd (not in C) Contractor's Application 10 FINAL 2/28/2023 F D ToolCmpkO3 !: Balance bF6W, and Stored to Due (0) (8-F) (D*E) a Thk daamentbu hm nwSswl from its m455 ken. uanE/CDC decummt and the veer didndbightIgh, De mdifiuiam I'm m mcoungd to read dee dommmt cacPolly and wuuk Up' Deemed primp i4 acwim C-62011ni Price Progress Eaten -ale Progress Estimate Sanitary Sewer Rehabilitation Contract 113 Part 1 IAtque.tion Patio& Item Bid hem No. A Spzd aim Unit of\Actor. BidQeawiy SWion Na City Secretary Contract Num: Unit Prim 57282 D Bid Value E tim.td Quantity Iw.tld D Value Preiotelylmmtld Value Value ThisPeriod 'Application Numb. Appl'tcnwt Date awcialaanantly Stssd(not in C) Contractor's Application 10 FINAL 2/28/2023 Q TSIC®pNnf Data., to Finish and Staid is D.te (F) (D•E) (D+E) D This d°vmmt h.a been mes ifid tam its original rum.. an FJCDC dwmct and the user did not highlight the mdJutime Ilya are mmumgd le read the doom. ountly and°mush Legal Camp! pier to its cuastion C-610 Una Price Progress Estmale Progress Estimate For (centred): ryglintun Poi Did hem No. Sanitary Sewer Rehabilitation Contract 113 Part 1 Ili A 4'6'i' Unit o(Mosso Bid Quantity ClS thy Num: 57282 Unit Prim Bidl'Jue EsliWoaWd Quantity Imtalld NV's: tim Nembc Application Dn.. D E Value Previously lmullo\hlor Value This Pnicsi .(Wanes l'mmtiy Steed Dot in Cl Contractor's Application 10 FINAL 2/2812023 Tou1C®pMed End Stored to Deco (F) (0+0) O Bases lo Finish (1-F) Totals 8).711953.60 51,545341.74 $1,545341.74 51.645341J/ 50.35 S186,610.76 This dmummt has Ice modified hue its origins(fvm es en FJCDC dommmt end the otc did eel highlight the molt tiau You ammmumsd to mad Usedmmmt noefully sodmmull legal Counselpin to its creation. Progress Estimate For (contract): Application Pedal: C-620 Change Order Construction Allowance Usage Contractor's Application ADDITIONS 102785 Sanitary Sewer Rehabilitation Contract 113 Part 1 City Secretary 57282 Application Number: Contract Nuns Application Dale: A U C D E 10 FINAL 2/28/2023 Item Total Completed •• Balance to Finish Estimated Quantity Preciously Value This Mderiels Presently Specification Unit of Quantity to Add Unit Price Addition Value Value and Stored to Date IF/ N-F) Item Number Description Section No. Measure Installed Installed Value Period Seared (not in C) N'M H 34 Remove 12'- 18'Tree EA 1.00000030 S1,700.00 S1,700.00 200000000 5.3400.00 50,400.00 S3100.00 200.010 -01,702.00 35 Major Stone Drain Adjustment EA 1.00000000 S4500.00 S4,500.00 1.00000000 S4.500.00 S4,500.00 54,500.00 100.0% 36 Moja Man Hole Adjustrent FA 2.00009000 S.200.00 SS400.00 2.00000000 SS400.00 58p00.00 Sit400.00 100.0% 36 Major ManHde Adjustment PA 3.00000000 S4,200.00 S12,603.00 3.00000000 SI2,600.00 512600.00 S12,600.00 100.0% 29 4-inch side calk adjustment to curb SF 95.00000000 515.00 S1,425.00 95.00000000 SI025A0 SI,425.00 S1,425.00 100.00 30 Hug abandoned stormdrian lateral _ _ _ IS 1.00000000 S2325.00 S2,325.00 1.00000000 52325.00 52325.00 S2325.00 100.0% 37 IIMAC LEVEL -UP TN 105.59500000 S76.00 SS02522 105.59500000 58,02522 58,02522 $8,02522 100.004 31 HMAC LEVEL -UP TN 105.59500000 S76.00 N I:0522 105.5950600D S11,02522 $8,02522 - 09/17522 100.054 Totals 547.000.44 345700.44 S48.700.44 040.700.44 103.610 -51.700.00 This document Fos been modified from its original form as an EICDC document and the user did not highlight the modifications. You an encouraged to read the document artfully and moult Legal Counsel prim to its execution. Progress Estimate Construction Allowance Usage Contractor's Application CONSTRUCTION ALLOWANCE I_TE_MS TO BE REDUCED Fer(contract): 102785 Sanitary Sewer Rehabilitation Contract 113 Part 1 'Application Number. 10 FINAL Application Period: Application Date: 2/28/2023 A D C D F Item ©id Item Number Description Spedficatias Unit of Quantity to Delete Unit Price Reduction Value Nat Uscd Not Used Not Used Not Used Not Used Not Used Not Used Not Used Section No. Measure ConstmelionAllowance Na 1 EA 1.00000000 S14,600.06 S14600.06 Construction Maslow Na 2 EA 1.00000000 $12,600.00 512,600.00 Construction AllownnoeNo. 3 EA 1.00000000 S3,750.00 S3750.00 Construction AlIoos,n a No.4 EA 1.00000000 S16,050.44 316,050.44 C.620 Change Order Totals S47.000.44 This document has been modified from its origjnsl form as an FJCDC document and the user did not highlight the trn di0cations. You are encamped to read the document carefully and consult Legal Counsel prior to its execution. City Secretary Contract Num: I 57282 Application Period: City of Fort Worth Summary of Charges Sanitary Sewer Rehabilitation Contract 113 Part 1 IP. O.: FW060-0000018007 0 I Application I 10 FINAL Number: Funding Identification IFID) Total Completed 1 ( Amt Remaining 1 ( Gross Project Number: Application Date: Retainage 102785 2/28/2023 Net I1 I Original Contract 56002-0600430-5740010-102785-001780-9999 $706,233.17 $75,817.83 $0.00 $0.00 $0.00 56002-0700430-5740010-102785-001780-9999 $471,464.95 $26,615.30 $0.00 $0.00 $0.00 30100-0200431-5740010-102785-002480-9999 $416,344.07 $15,477.18 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 S0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 1 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 I $0.00 $0.00 $0.00 I $0.00I Change Order 1 1 56002-0600430-5740010-102785-001780-9999 $0.00 $0.00 $0.00 $0.00 $0.00 56002-0700430-5740010-102785-001780-9999 50.00 80.00 80.00 50.00 80.00 .'. 30100-0200431-5740010-102785-002480-9999 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 ... $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 o $0.00 $0.00 $0.00 $0.00 $0.00 1 o $0.00 $0.00 $0.00 I $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 I 0 $0.00 $0.00 $0.00 S0.00 $0.00 1 0 ( $0.00 -- $0.00 - $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 I Change Order 2 56002-0600430-5740010-102785-001780-9999 $0.00 $0.00 $0.00 $0.00 $0.00 56002-0700430-5740010-102785-001780-9999 $0.00 $0.00 • $0.00 S0.00 $0.00 30100-0200431-5740010-102785-002480-9999 $0.00 $0.00 $0.00 $0.00 $0.00 1 0 0 0 0 0 0 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 l ( $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 City of Fort Worth Summary of Charges City Secretary Contract Num: 1 57282 I Sanitary Sewer Rehabilitation Contract 113 Part 1 IP. O.: FW060-0000018007 Application Period: 0 I Application I 10 FINAL Number: Funding Identification (FID) Total Completed 1 1 Amt Remaining Gross Project Number: Application Date: 102785 2/28/2023 Retainage Net Change Order 3 56002-0600430-5740010-102785-001780-9999 56002-0700430-5740010-102785-001780-9999 30100-0200431-5740010-102785-002480-9999 0 0 0 0 0 0 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0..00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Change Order 4 56002-0600430-5740010-102785-001780-9999 56002-0700430-5740010-102785-001780-9999 30100-0200431-5740010-102785-002480-9999 0 0 0 I0 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Change Order 5 56002-0600430-5740010-102785-001780-9999 56002-0700430-5740010-102785-001780-9999 30100-0200431-5740010-102785-002480-9999 0 0 0 0 0 0 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 City Secretary Contract Num: I 57282 Application Period: City of Fort Worth Summary of Charges Sanitary Sewer Rehabilitation Contract 113 Part 1 I P. O.: FW060-0000018007 0 I Application I 10 FINAL Number: Funding Identification (FID) Total Completed Amt Remaining 1 r Gross Project Number: Application Date: Retainage 102785 2/28/2023 Net Change Order 8 56002-0600430-5740010-102785-001780-9999 $0.00 $0.00 $0.00 S0.00 $0.00 I56002-0700430-5740010-102785-001780-9999 $0.00 $0.00 $0.00 $0.00 $0.00 130100-0200431-5740010-102785-002480-9999 $0.00 $0.00 $0.00 $0.00 $0.00 10 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 Change Order 7 56002-0600430-5740010-102785-001780-9999 $0.00 $0.00 $0.00 $0.00 $0.00 56002-0700430-5740010-102785-001780-9999 $0.00 $0.00 $0.00 $0.00 $0.00 130100-0200431-5740010-102785-002480-9999 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 o $0.00 $0.00 $0.00 $0.00 - $0.00 - 10 $0.00 $0.00 $0.00 $0.00 $0.00 Change Order 8 56002-0600430-5740010-102785-601780-9999 $0.00 $0.00 $0.00 $0.00 $0.00 56002-0700430-5740010-102785-001780-9999 $0.00 $0.00 $0.00 $0.00 $0.00 30100-0200431-5740010-102785-002480-9999 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 0 S0.00 $0.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 $0.00 $0.00 10 $0.00 I $0.00 $0.00 $0.00 $0.00 City Secretary Contract Num: I 57282 Application Period: City of Fort Worth Summary of Charges Sanitary Sewer Rehabilitation Contract 113 Part 1 0 p o FW060-0000018007 Application I 10 FINAL Number: Funding Identification (FID) 1 1 Total Completed 1 Amt Remaining 1 1 Gross II Totals I 56002-0600430-5740010-102785-001780-9999 $706,233.17 $75,817.83 $0.00 56002-0700430-5740010-102785-001780-9999 $471,464.95 $26,615.30 $0.00 30100-0200431-5740010-102785-002480-9999 $416,344.07 $15,477.18 $0.00 0 $0.00 $0.00 $0.00 O $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 O $0.00 $0.00 $0.00 0 $0.00 $0.00 1 $0.00 O $0.00 $0.00 1 $0.00 10 $0.00 $0.00 $0.00 10 50.00 1 50.00 I $0.00 1 Grand Total $1,594,042.19 1 I $117,910.32 I Project Number: Application Date: 102785 2/28/2023 Retainage 1 1 Net $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 I I $0.00 I I $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $79,702.11 FORT WORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Sanitary Sewer Rehabilitaion, Contract 113, Part 1 CITY PROJECT NUMBER: WATER PIPE LAID SIZE TYPE OF PIPE Open Trench 8" PVC Open Trench 6" PVC LF FIRE HYDRANTS: 3 VALVES (16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: PIPE LAID Open Trench 41 (1") Copper SIZE 8" SEWER TYPE OF PIPE PVC LF PIPE ABANDONED SIZF, TYPE OF PIPE LF DENSITIES: NEW SERVICES: 32 (4") PVC TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 2,582 35 1,502 FORT WORTH® TRANSPORTATION AND PUBLIC WORKS March 17, 2023 Woody Contractors Inc. 650 Tower Dr. Kennedale Tx. 76060 RE: Acceptance Letter Project Name: Church St. Water and Sewer Improvements Project Type: 01,02 & 03 City Project No.: 102785 To Whom It May Concern: On January 26, 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 27, 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 27, 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- 392-7866. Sincerely, a Ck,t. Dena Johnson, Project Manager Cc: Rodrick Wallace, Inspector Wade Miller, Inspection Supervisor Ariel Duarte, Senior Inspector John Kasavich, Program Manager RLG, Consultant Woody Contractors Inc., Contractor N/A, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 AFFIDAVIT STATE OF Texas COUNTY OF Tarrant Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Troy Woody, President Of Woody Contractors, 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; That there are no claims pending for personal injury and/or property damages; On Contract described as; SS REHAB CONTRACT 113 PART 1 BY oody - President Subscribed and sworn before me on this date 5TH Day of December, 2022. `i • /2aa/(/,r» Notary blic Tarrant, Texas �1 •'Qy 4 . LUZ A RAVELO ^` '`': Notary Public, State of Texas .My Commission Expires April 29, 2023 NOTARY 1012860410-0 CONSENT OF SURETY COMPANY TO FINAL PAYMENT (SIMILAR TO ALA. DOCUMENT G707) OWNER ❑ ARCHITECT 0 CONTRACTOR ❑ SURETY OTHER El Bond No. K40201877 PROJECT: Sanitary Sewer Rehabilitation, Contract 113, Part 1, City Project No. 102785 (name, address) Fort Worth, TX TO (Owner) City of Fort Worth 200 Texas Street Fort Worth, TX 76102 CONTRACTOR: Woody Contractors, Inc. ARCHITECTS PROJECT NO: CONTRACT FOR: CONTRACT DATE: 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) Vigilant Insurance Company 2001 Bryan Street, Suite 3600 Dallas, TX 75201 on bond of (here insert name and address of Contractor) Woody Contractors, Inc. 650 Tower Drive Kennedale, TX 76060 hereby approves of the final payment to the Contractor, and agrees that the 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 Attest (Seal): 29th day of , SURETY COMPANY, ,CONTRACTOR, , OWNER, November , 2022 VIGILANT INSURANCE COMPANY Surety Comp By !u e' •e__e Signatu of Authorized Representative Kyle W. Sweeney Title Attorney —in —Fact Note: This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims, Current Edition i U E E Power of Attorney Federal Insurance Company I Vigilant Insurance Company Pacific Indemnity Company Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY,.I New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Elizabeth Gray, Charles D. Sweeney, Kyle W. Sweeney and Michael A. Sweeney 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 ball bonds) given or executed In the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to !n said bonds or obligations. in Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this I6t° day ofSeptember, 2019. Qc3sus'1-m. 6tt19DA, Dawn id.Chlorrz�.AssistantSecreuiry STATE OF NEW JERSEY County ofHunterdon On this 1611' day of September, 2019, before me, a Notary Public of Newiersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY. VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals Milked to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that she signed said Power or Attorney as Assistant Secretary of said Companies by like authority and that she is acquainted with Stephen M. Haney, and knows hint to be Vice President of said Companies; and that the signature of Stephen M. Haney, subscribed to said Power of Attorney Is in the genuine handwriting of Stephen M. Haney, and was thereto subscribed by authority of said Companies and in deponent's presence. Stephen M. !buoy, ucy, Vice Presiden ( Notarial Seal SS KATHERINrS J. ADELRAR NOTARY•PUBUc OF NeW J2rrSEY No, 231e6B6 Commission expires July 10, 2024 CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August30,2016: "RESOLVEn.drat the following authorizations relate to the execution, for and nn behalf of the Company, of bonds, undertakings, recognlrances, contracts and other written commitments of the Company entered into in the ordinary course of business (each a "Written Commitment'); (p Each or the Chairman, the President and the Vice Presidents, of the Companyfshereby authorized to execute any Written commitment lbrand anbehalfoftheCompany, under the seal of the Company or otherwise. (2) Uach duly appointed atterney.hr-fact of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company, under the scd ol'the Company or otherwise, to the extent that such action is authorized by the stunt of powers provided for in such peison's to ken appointment as such attorney -in -fact (3) Mach of the Chairman. the President and the Vice Presidents of rheConipanyishereby authorized, forand on behalf Mlle Company, toappoint lnwriting any person the attorney - In -fact of the Company with hill power and authority to execute, for and on behalf of the Company, under the seal of the Company or otherwise, such Written Commitmentsofthe Company as maybe specified in such written appointment, which specification may be by general type or class of written Conunitruents or by specincatlonof one ormore particular Written Commitments, (4) Each of the Chairman, the President end the Vice Presidents ofthe Company is hereby authorized, for and on behalfof the company, to delegate in writing to any other °Mem. of the Company the authority toexecute, for and onbehalf of the Company, under the Company's seal or otherwise. suchWritten Commiunentsofthe Convoy esare specified insuch written delegation, which specification may be by general type or class of Written Commitments or byspecificatlon ofone or more particular Written Commitments, (5)'rite signature ofany officer °ruttier person excepting any Written Commitment or appointment or cielegatIOFIpurstiant to this Resolution, and the seal of the Company, muy anIxed by facsimile on such Written Commitment or written appolntmentordetegation. FURTHER RESOLVED. that the foregoing Resolution shall not be deemed to be exclnslva statement or powers and authority ofolllCers, employees and other persons total for and on behalf of theComimny,and such Resolution shall notllmh or otherwise affect the exercise of any sedi power ornuthorlty otherwise validly granted or vested," I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies") do hereby certify that (1) the foregoing Resolutions adopted by the Board of Directors oftheCompanies are true. correct and in full force and effect, di) the foregoing Power of Attorney is true, correct and In full force and effect. Given underrny hand andsealsofsaid Companies at Whitehouse Station, NJ. this 29th day of November 2022. tintay1ubllc ���it �1`•&' I'kwln M.dhlcwt.a.,1::5istaut Secretory' INl'i11t1+VEN'rYOU WISH TO VERIFY'tHEriur srericn'YOPTHISaONU OR NOTIFY US OF ANY OTHER MAT!'Rit,PLEASE COMM' USAID '1'eleplonp(9(1E)903.3493 Fax (908) 903- 36So e-rrra11, suretyeschuhbc to FED-YlG-PI (rev, ea -la)