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Home My WebLink AboutContract 57453-FP1FORT WORTII® TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION -FP1 City Secretary No:_57453 Date Received: 3/30/2023 City Project Ne: 103456 Regarding contract 57453 Bridge Repair for Twenty Locations for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 3/08/2022 through M&C 22-0150 the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of the Assistant Director of the Transportation & Public Works Department has accepted the project as complete. Original Contract Prices: $679,646.60 Amount of Approved Change Orders: $32,544.0M 2 Revised Contract Amount: $712,190.60 Total Cost Work Completed: $712,037.73 Less Deductions: Liquidated Damages: 0 Days @ $650.00/ Day Pavement Deficiencies: Total Deduction Amount: $0.00 Total Cost Work Completed: $712,037.73 Less Previous Payments: $676,435.84 FinalinIPayment Due $35,601.89 �'"';•44" Mar 30, 2023 Recommended for Acceptance Date Asst. Director, TPW - Capital Delivery Lauren Prieur (Mar 30, 2023 10:05 CDT) Accepted Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Client Deartment William Mar 30, 2023 Date Mar 30, 2023 Asst. City Manager Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page To (Owner) P. O. Number. Project: 103456 City Secretary Contract Number: Approved Change Orders Number 1 2 3 4 5 6 7 8 TOTALS NET CHANGE BY CHANGE ORDERS Contractor's Certification Contractor's Application for Payment Invoice No.1 City of Fort Worth Invoicing Period (From - To): Invoice Date: 02/01/2023 - 02/28/2023 FW020-007730 From (Contractor): Gibson & Associates Inc Contractor's CFW Vendor No.: 0000009564 57453 CoName:ntract 2022 Bridge Rehabilitation Contract 2 Application For Payment Change Order Summary Additions $10,219.00 $22,325.00 $32,544.00 $32,544.00 Deletions The Contractor certifies with the submittal of this document and associated Payment Request Submittal on the City of Fort Worth Buzzsaw 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 all Work, materials and equipment incorporated 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 are covered by a 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 is not defective. Liquidated Damages $650.00 x day ,7o,ret Montaotktetti Joseph Illontgomery (Mar'28, 202311:5 CDT) 9 & Final 3/7/2023 Remit to (If Not Automatic Deposit ): 1. ORIGINAL CONTRACT PRICE $ $679,646.60 2. Net change by Change Orders $ $32,544.00 3. Current Contract Price (Line 1 ± 2) $ $712,190.60 4. TOTAL COMPLETED AND STORED TO DATE (Progress Estimate, Construction Allowance and Change Orders) $ $712,037.73 5. RETAINAGE: a. X $712,037.73 Work Completed $ b. X Not Used $ c. Total Retainage (Line 5a + Line 5b) $ 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c) $ $712,037.73 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application) $ $676,435.84 8. AMOUNT DUE THIS APPLICATION $ $35,601.89 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + COs + Line 5 above) $ $152.87 10. CONTRACT TIME: Consent of Surety Affidavit of Bills Paid a. Days Awarded b. Days Added by CO c. Total Days d. e. Days Charged Days Remaining 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 consult Legal Counsel prior to its execution. 180 30 210 210 Progress Estimate F"`I`°n"'"' 2022 Bridge Rehabilitation Contract 2 APPbc.una Peru, 02/01/2023 -02/28/2023 9N Item Na Dacromon C,ry Sea., Cow. Num: 57453 ADDbe.uon Number. AwlEatrun Date: Contractor's Application 9 A Find 3/7/2023 Er mated Qunmiry blmm4 (P05500) Toul ComDluud Bala. to Ewalt SDecPicatmn Gm of Bid QuanUty Uml Pr¢v BN Value Wulted Value Prwmu.ly N.uSN Veuu Value T. Period Stumd (rim in C) and Smmdu Deu (F) (B•F) SccuanNo Musters (Da E) _ 1 REMOBILOATON EA 1.000000 SSOOAB ,500,0E _ 5500.00 2 REMOVE CONCRETE(PAV) _ 1044001 SY 151.100000 $110m 53]196.00 20342000000 SJ6,59].60 126,397A0 -__ 5]6,591m 134.5% 39399.50 J REMOVE CONCRETE (SIDEWALKS) 1044015 SY 273W000 3100m 52,]50.00 31A00000v0 - _ 50,150.00 5],150A0 53,150m 1149%-9410.00 4 REMOVE CONCRETE (APPROACH SLAB) 104.5027 SY 151.100000 8100m $ 3],196m 15535000000 52T,99B.W 52)p99A0 52]A9Dm 1029% 3501.00 S - -- EXCAVATION (ROADWAY) 1106W1 CY 160A00000 553m 513250m 15].00W0000 512380.00 512A99A0512,595m _95.6% 5561.00 6 EMBANKMENT (FlNAL)(ORD COMP)(IY B) 1Ytl00] CY 25.OW000 513am SS TSOm 25.00000000 $3,750.00 $3,]SOAD _.... _.. _._____.-,SS.75Om 10G0% ] - -CONCRETE PAVEMENT (COHTREWF-CRCPJ(1j 360.6001 SY 152m0000 Si9Sm S44,MOm 20]A3000000 SS9A]9.40 555479A0 _. _... _ _... _ _... -.. - 559A79.40 1]]A% 315,1]9.40 6 _ CEMENT STABRPEDMCKFLL 4004005 _ CY 155,0000011 S1Nm S29,TOIm 15]A0000000 525,]W.00 525,TMm 515.]51m _9fA% 5910m 9 PLOWABLE BACKFILL 401-6001 CY 2003000 SSDOm S1AWm 425000000 f2.125.00 f2,125m 52,125A0 3133% $1,125.00 10CLC CONC (415C) __. _ -- 42060]4 CY S.000OOD f12A00m 560AOOm 435000W0 i$$300.W .$SSA00m $55A00.00 9JA%_ _ 54,200A0 11 APPROACH SLAB 4225015 CY 55.000000 St,t62m 3550tOm 70.ODWDWO 562740.OD 562,740m 552,]40m 137.]% St),Tw.Oo 12 ___CONCRETE STR REPAIR (VERTIGL5OVERHEAD) 429-500] SF 455.000000 StOSm 947,775m T952]0110000 $]0.999.15 S]OA9D.15 930A99.15 54.5% 515,]]5.05 13 CONCRETE SIR REPAIR (STANDARD) 43&6DD9 _ SF 43.000000 f50m 53,440m 15AB000000 _- S5,006.40 i5,006A0 SS,OOEAO 114.!% 52.566.40 14 RIPRAP (205005TE)(CLB) 4]3SOD6 CY 0.500000 S2,OODm f1ADDm 03000W00 51,000.00 51,OODm S1,000AO 100A% 15 RIPRAP (STONE PROTECTION) (121M 4]2d0]1 CY 6300000 yTUDm S6,2Mm 53000D000 56205A0 55,205m 38,2a5.00 100.0% 10 CLEAN AND SEAL EXISTING JOINTS 4]56D01 LF 470.000000 i]Dm 5/4,100• 470.00000000 314,100A0 $14,100A0 514,100.00 100.0% 17 CLEAN AND PAINT E%ISTG STRUCTURE 40010 LS _ 1.000000 $252 5.00 f2D 500,00 1,ODOl10WD S10,500:00 S20,S00A0-__--_-_ i20.5D0.00 100.0%_ 16 MIL (NANOMIL)(TV A) 4504047 LF B1.000D00 5215m $16,060.00 15.70000000 515,050,00 f15,05000 516,050,00 100,0% 19 RAIL (TYPR11) 4504103 LF 305.000000 519030 _ f54303.00 215.70000W0 _ _ f41,090A5 $ 41,09035 941,O90A5 ]OS% it],202.15 ?D CLEAN EXISTING CULVERTS 4606002 00 5.000000 87,000m ie+000m 5.00000000 f3000.00 55,000m 55000.00 100.0% 21---REMOVE STR (RAIL) _ _ --__ 4966W9 LF 250.000000 _9OOM 211,600.00 i90.00000000 S110Wm 511,500m ._. _-- _.-$11,500A0 100.0% 22 CONCRETE SIDEWALKS (5) 5314002 5Y 00.000000 S10DA0 $15 000.00 5T.65000000 515355.00 t15,55540 - 515355A0 105.7% 3655m 23 _ MTL W-0EAM GO FEN (RM POST) 5400001 LF ]55m0000 f]3.15 f25,35220 524500000011 515,]67.15 $ ]5,]51.15 535.36726 1352% 39,9MS5 24 _ _ MTL VABEAM GD FEN (IHRIE-0BEAM) 5406W6 EA - 6m0000 32A5430 f17,127.00 7.00000000 _ S19A61m 519A61m _ - _ 552,951.00 116.0% 33A5430 25 MIL W.9EAL1 GO FEN (7L2) _ 51p6WT G 1m0000 52,145m 52145m 1.000000W 52145m f2,145m 52,145A0 100DX m OOwNSREAM ANCHOR TERMINALSEOTION _._... 5404K115 EA000000 i1.G.5UD0_ S4s950.00 J.00000000 S•.950.W 54,950m _.. 11ASOA5100.7%_ 2T REMOVE METAL BEAM GUARD FENCE 54241001 LF NO.ODO.IO0 - 54.13 51715]0 605A0001.0 52496AS 52496.5T - .254.550...00 3 �95A5 140.TA ---Sia.Ts 26_-_ REMOVE METAL BEAM GUARD FENCE TRANS (11011 54SSW5 FA 2.000000---SMDm 3660.00 3.00000000 _51A20m 31 A20AD SI,ROAO 150.0% _-- 5410.00 29 _ GUARDRAIL END TREATMENT (INSTALL) _ 5M0001 EA 6.000000 N,T2530 _ f37.TB6.00 .--_ 6A000OWO A).196A0 _ $3),796m _ 33),]%.OD 100,0% 30 GUARDRAIL END TREATMENT (REMOVE) 5144W] FA 2400000 5355m 5770.OD 2.000OOOOp f110.00 $T70A0 5710m 1WA% 31 CRASH CUSHION ATTENUATOR BNSTALL)(RJ(I!)(ILt) 7524003_ _FA_ 1.000000 $33,OODJp X 9250.OD 200000000 SV,000.00 SSt 000A0 533A00m 100.0% 32 _ TREE REMOVAL ]521W5 FA 1.000000 5250m 5250.00 _ _ 2AD000000 5500.00 _ _ SsaoaD SSOOAO 200.0% 425040 33 REMOVEIREPLACE 51051P OST - _7706010 EA 1.000OW 5935m S935.0 _ 240000000 5935.00 59]5.00 5460.00 600.0% 30 _ REMOVERtEPLACE STEEL POST _ ]106010 EA 1.000OW SWSm _ S9]5.00 6.00000000 S],460.00 5),460.00 - 57480.00 500,0% 46,545.00 15 _ REMOVE/REPLACE BLOCKOUT T705019 EA_ 1.000000 S907,50 590).50 tA0000000 _ 5907.50 S90)30 SBO]SO t00A% 36 REPAIR (EXISTING METAL PED. RAIL) 778-60]] LF 7 5.00W00 S1JOm _ 513,650.00 T5930000000 S]J,T]5.00 2]],)]SAO 5]S,TJSAO 24].1% 33D,055m J] CONCRETE CRACK REPAIR (ROUT AND SEAL) _ >50-0004 LF 190.000000 550.00 50,500.00 145.75000000 $]A3].50 5],]]T.50 _ $T,JJ130 _T2% 32,16330 34 _ REPULE NUTS, WASHERS 6OTHER HARDWARE _ _ 500D61 D5 EA 12.000000 520m ,95.00 2200000000 5440.00 N40.00 54AOA0 100A% ]9 CONSTRUCTION ALLOWANCE 000000 LS 1.000000 SSO,o00m 550,000.00 - _ 550.000.00 TWsdocummt has been modified Born to onoo4 farm as an EICOC document and Mc user dN not 119.819 the mod,0emors You ma ene0ur.5ed TO read Nv downs. catalb1hand consult Legal Counsel pour to esnaavu0n Progress Estimate For (contract): Application Period: Item Number Construction Allowance Usage ADDITIONS 2022 Bridge Rehabilitation Contract 2 103456 A Item Description 4' White TYI THERMOPLASTIC 02/01/2023 - 02/28/2023 City Secretary Contract Num: 57453 B D Specification Unit of Quantity to Add Unit Pricc Addition Value Estimated Quantity Installed Section No. Measure LF 160.00000000 $8.21 51313.60 160.00000000 Value Application Number: Application Date: E Previously Value This Materials 1' o.ntly Installed Value Period Stored (not in C) $I313.60 51313.60 2 4' Yellow TYl THERMOPLASTIC (DOUBLE YELLOW) LF 120.00000000 $822 $986.40 120.00000000 3 Minimum Trip Charge LS 1.00000000 $1.000.00 $1.000.00 1.00000000 $986.40 $986.40 $1.000.00 $1.000.00 C-620 Change Order Contractor's Application 9 & Final 3/7/2023 F Total Completed % and Stored to Date (F) (D+E) B $1313.60 100.0% Balance to Finish (13-F) $986.40 100.0% $1.000.00 100.0% This document has been modified from its original form as m EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Totals S3300.00 S3300.00 S3300.00 S3300.00 100.0% I This document has been modified from its original form as an EJCDC document and the user did not highlight the modifcotions. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Progress Estimate 'For (contract): 'Application Period: 103456 2022 Bridge Rehabilitation Contract 2 Construction Allowance Usage CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED 02/01/2023 - 02/28/2023 Bid Item Number A Item Description Construction Allowance 1 Specification Section No. Unit of Measure Quantity to Delete 0.02627200 Unit Price $50,000.06 B Reduction Value $1313.66 T Construction Allowance 1 0.01972800 $50000.00 $986.40 Construction Allowance l 0.02000000 $50,000.00 $1,000.00 C bt Used D Not Used This document hos been modified from its original form os an EJCDC document and the user did not highlight the modJcotions. You arc encouraged to mad the document carefully and consult Legal Counsel prior to its execution. Not Used Not Used Application Number: Application Date: B Not Used C-620 Change Order Contractor's Application Not Used F 9 & Final 3/7/2023 Not Used Not Used Totals S3,300.001 This document has been modified from its original form as an EJCDC document and the use did not highlight the modifications. You am encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate For (contract): Application Period: Change Order Item No. 29 Change Order Number ADDITIONS 103456 2022 Bridge Rehabilitation Contract 2 Item Description GUARDRAIL END TREATMENT (INSTALL) A 02/01/2023 -02/28/2023 Specification Unit of Section No. Measure 1 City Secretary Contract Num: Addition CO Quantity to Add Unit Price Change Order Value C-620 Change Order Contractor's Application 57453 Application Number. Application Date: C D E F Estimated Quantity Installed Value Previously Value This Materials Presently and Stored to Date (F) (B -F) Installed Value Period Stored (not in C) (D + E) B 9 & Final 3/7/2023 Total Completed % Balance to Finish EA 2.00000000 54.724.50 $9.449.00 2.00000000 S9.449.00 $9.449.00 $9.449.00 100.0% 30 GUARDRAIL END TREATMENT (REMOVE) EA 2.00000000 S385.00 S770.00 2.00000000 S770.00 S770.00 5770.00 100.0% This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You am encouraged to mad the document carefully and consult Legal Counsel prior to its execution Totals C-620 Change Order S10,219.00 S10,219.00 S10.219.00 S10,219.00 100.0% This document has been modified from its original form as an E]CDC document and the user did not highlight the modifications. Von are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Progress Estimate Change Order Number For (contract): Application Period: Change Order Item No. 1 C-620 Change Order Contractor's Application DELETIONS 103456 2022 Bridge Rehabilitation Contract 2 Application Number. 9 & Final 02/01/2023 - 02/28/2023 Application Date: 3/7/2023 A B C D E F Item Deletion CO Quantity to Description Speccation Unit of DeleteUnit Price Change Order Not Used Not Uscd Not Used Not Used Not Used Not Used Not Used Not Uscd Section No. Measure Value This document has been modified from its original fomt as an EJCDC document and the user did not highlight the modifications. You am encouraged to read the document carefully and consult Legal Counsel prior to its execution. Totals C-620 Change Order This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You am encouraged to mad the document carefully and consult Legal Counsel prior to its execution. Progress Estimate Change Order Number I 2 ADDITIONS For(nnntn1o) 103456 2022 Bridge Rehabilitation Contract 2 City Secretary 57453 Application Number: Contract Nun: Application Need: 02/01/2023 — 02/28/2023 Application Date: A B C D E Item Chan Order Item Spcn cation Unit or CO Quantity Unit Price Addition Change Estimoted Quantity Previously Value This Materials Presently Description Order Value Installed lmidled Value Period Stored (not in C) No. Section No. Measure 15 RIPRAP(STONE PROTECTION/ (1215) 17 CLEAN AND PAINT EXISTING STRUCTURE CY 2.50000000 S730.00 0i625.00 2.50000000 01.825.00 51.825.00 IS 1.00000000 520,500.00 S20.500.00 1.00000000 _ 520,50000 S20,500.00 Contractor's Application 9 & Final 3/7/2023 Total Completed and Stored to Dote (D+E) S1 S25.00 100.0% Balance to Finish 6-F) 520500.00 100.0% Totolo 522.325.00 52232.500 522.32500 522.325.00 100.0% This document has been modified from its original !form us an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document oarelLlly and consult Legal Counsel prior to its execution. 0-620 Change Order Progress Estimate Change Order Number DELETIONS For (contt0ct) 103456 2022 Bridge Rehabilitation Contract 2 Application Period: 02/01/2023 - 02/28/2023 Change Oder Item No. Item Description Totals 2 Application Number. Application Dole: Contractor's Application A D E F Speelieatmn Una of Section No. Measure CO Quantity to Delete Unit Price Deletion Change Order Value Not Uscd 9 & Final 3/7/2023 Not Uscd Not Used Not Uscd Not Uscd Not Uscd Not Used Not Used This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You arc encouraged to read the document carctully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number I 3 Contractor's Application ADDITIONS em(camraeD: 103456 2022 Bridge Rehabilitation Contract 2 City Secretary 57453 Application Number 9 S Final Convect Num: Application Period: 02/01/2023 - 02/28/2023 Application note: 3/7/2023 A B C D E F lam Balance to Finish Addition Total Completed �° s' Estimated Qmntiry Prniously Value This Materials Presently B-F) c Chan order llem Specification Unit of CO Quantity to Add Unit Price Change Order Value and Stand to Dole (F) g No. Description Section No. Measure Value Installed Installed Value Period Stored (not in C) (D*E) B Totals This document has been modified from its original form as on FJCDC document and the user did not highlight the modifications. You are encouraged to rod the document orofully and consult Legal Counsel prior to its oncoulion. C-620 Change Order Progress Estimate Change Order Number I DELETIONS For (contract): 103456 2022 Bridge Rehabilitation Contract 2 Application Period: 02/01/2023 - 02/28/2023 A Item Change Order Item Spcciticauon Unit ol Despli No. enon Section No. Measure 3 CO Quantity to Delete Application Number. Application Date: Contractor's Application 9 & Final 3/7/2023 Deletion Unit Bice Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used Value Tonne This document has been modified from its original form as an EICDC document and the user did not highlight the modifications. You arc encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number ADDITIONS For (contract). 103456 2022 Bridge Rehabilitation Contract 2 Application Period: 02/01/2023 - 02/28/2023 Change Order Item No. Item Description Totals A 4 I Contractor's Application City Secretary Contract Num: B 57453 Addition Fstimvted Qmntiry Specification Unit of CO Quantity to Add Unit Price Change Order Installed Value Section No. Measure Value Application Number. Application Date: F 9 & Final 3/7/2023 Previously Value This Materials Presently Total Completed Installed Value Period Stored (not in C) °1d StmedkDak (F) (D+E) B 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 doemnent carefully and consult Legal Counsel prior to its execution. Balance to Finish (B-F) C-620 Change Order Application Period: Change Order item Description No. Progress Estimate Change Order Number DELETIONS For (contract) : 103456 2022 Bridge Rehabilitation Contract 2 D2/01/2023 - 02/28/2023 4 Application Number. Application Date: Contractor's Application 9 & Final 3/7/2023 A B C D E F Item CO Quantity to Deletion Spcciticahon Unit of DeleteUnit Price Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used Section No. Measure Value Totals This document has been modified from its original form as an EICDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number I ADDITIONS For (contmeB 103456 2022 Bridge Rehabilitation Contract 2 Application Pedal: 02/01/2023 - 02/28/2023 Change Order Item No. Item Description Totals A 5 1 Contractor's Application City Secretary Contract Num: 57453 C D Addition Specification Unit of CO Quantity to Add Unit Price Change Order Estimated Quantity Value Section No. Measure Value Installed Application Number. Application Date: 9 & Final 3/7/2023 Total Completed Ts Previously Value This Materiels Presently "d S""I" r"" (F) Installed Value Period Stored (not in C) Balance to Finish (3-F) This document has been modified from its original form as an EICDC document and the user did not highlight the medificationc. You ate encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number DELETIONS For (contract): 103456 2022 Bridge Rehabilitation Contract 2 Application Poriod: 02/01/2023 - 02/28/2023 A Item Change °fact Item Specitication that or Dcscription No, Section No. Measure 5 CO Quantity to unit pd. Dcictc Application Number. Application Date: Contractor's Application 9 & Final 3/7/2023 Delebon Change Order Not Used Not Used Not Uscd Not Used Not Used Not Used Not Used Not Used Value Totals This document hos boon modified from its original form ooun EJCDC document and the user did not highlight the modifications. You are cneouragal to mad the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Application Period: Change Order Item No. Progress Estimate Change Order Number I 6 ADDITIONS For (contract): 103456 2022Bridge Rehabilitation Contract 2 City Secretary 57453 Application Number: Contract Num: 02/01/2023 - 02/28/2023 Application Date: A B C D E Item Dos«iption Totals Specification Unit of Section No. Measure Contractor's Application 9 & Final 3/7/2023 Addition Total Completed % Eslimotcd CO Quantityto Add Unit Prim Change Order (Zuan"'Y P oValue Value This Materials Presently Installed VoValueInstalledtaIIlled Value Period Stored (not in C) and Stored to Date (F) Value N+E) Balance to Finish (B-F) This document has been modified from its original form as an FJCDC document and the user did not highlight the modifications. You arc encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number DELETIONS For (contract): 103456 2022 Bridge Rehabilitation Contract 2 Application Period: 02/01/2023 - 02/28/2023 Change Order Item No. A Item Description Specification Unit or Section No. Measure 6 CO Quantity to Delete Application Number. Application Date: B C D B Contractor's Application 9 & Final 3/7/2023 Deletion Unit Price Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Uxd Value Tarots This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You me encouraged to read the document carefully and consult legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number ADDITIONS For (contract): 103456 2022 Bridge Rehabilitation Contract 2 Application Penal: 02/01/2023 - 02/28/2023 Change Order Item No_ Item Description Total 7 1 Contractor's Application City Secretary Contract Num: A 57453 C D Addition QuantityQ d ate Specification Unit of CO Quantity to Add Unit Price Change Order Estimated Section No. Measure Value Application Number. Application Date: 9 & Final 3/7/2023 Value Previously Value This Materials Presently Total Completed Installed Stored to Date (F)lled Value Period Stored (not in C) (D+E) B Balance to Finish (B-F) This document has been modified from its original form as an E)CDC document and the user did not highlight the modifications. You are encouraged to read the document catching and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number I 7 I Contractor's Application DELETIONS Fnr(contfBc): 103456 2022 Bridge Rehabilitation Contract 2 Application Number. 9 & Final Application Period: 02/01/2023 — 02/28/2023 Application Dote: 3/7/2023 A B C D E Item DeletionCO Quantity to Change Order Dom Specification umt or Unit Price Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used No. DescriptionDeleteNo. Measure Delete Value MINIS 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 consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number i 8 I Contractor's Application ADDITIONS For (connect): 103456 2022Bridge Rehabilitation Contract 2 City Secretary 57353 Application Number. 9&Final Convect Num Application Period: 02/01/2023 - 02/28/2023 Application Date: 3/7/2023 A B D E F Item Balance to Finish Addition Total Completed % E+timalW quantity Previously Value This Materials Presently (B-F) Change Order Item Description Specifimtion Unit of CO quantity to Add Unit Price Change Order Installed Value Installed Value Period Stored (not in C) and Stored to Date (F) No- P Smtion No. Measure Value (D. E) B Totals This document has been modified from its original form as an FJCDC document and the user did not highlight the modi6mtions. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Application Period: Change Odor Item No. Progress Estimate Change Order Number DELETIONS For (contract): 103456 2022 Bridge Rehabilitation Contract 2 02/01/2023 - 02/28/2023 Item Description A Specification Unit of Section No. Measure 8 1 Contractor's Application CO Quantity to unit Price Delete Application Number. Application Date: B D B Deletion Change Order Not Used Not Used Not Used Not Used Not Used Value Totals 9 & Final 3/7/2023 Not Used Not Used Not Used This document has limn modified from its original f as an EJCDC document and the user did not highlight the modifications. You arc encouraged to reed the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order City Secretary Contract Num: 57453 Application Period: City of Fort Worth Summary of Charges 2022 Bridge Rehabilitation Contract 2 02/01/2023 - 02/28/2023 Funding Identification (FID) Total Completed IP.O.: Application Number: FW020-007730 9 & Final Project Number. Application Date: 103456 3/7/2023 Amt Remaining Gross Retainage Net Original Contract 30100-0200431-5740010-103456-E02680-9999 $679,493.73 $152.88 0 0 0 0 0 0 o o 0 0 Change Order 1 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 Change Order 2 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 $10, 219.00 $22,325.00 City Secretary Contract Num: 57453 Application Period: City of Fort Worth Summary of Charges 2022 Bridge Rehabilitation Contract 2 [P. O. : 02/01/2023 - 02/28/2023 Application Number: Funding Identification (FID) Total Completed Change Order 3 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 Change Order 4 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 Change Order 5 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 FW020-007730 9 & Final Project Number. Application Date: 103456 3/7/2023 Amt Remaining Gross Retainage Net City Secretary Contract Num: 57453 Application Period: City of Fort Worth Summary of Charges FW020-007730 2022 Bridge Rehabilitation Contract 2 02/01/2023 - 02/28/2023 Funding Identification (FID) Total Completed Change Order 6 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 Chan_ a Order 7 30100-0200431-5740010-103456- 02680-9999 0 0 0 0 0 0 0 0 0 0 Change Order 8 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 (P.O.: Application Number: 9 & Final Amt Remaining Gross Project Number: Application Date: Retainacle 103456 3/7/2023 Net City Secretary Contract Num: I 57453 Application Period: City of Fort Worth Summary of Charges 2022 Bridge Rehabilitation Contract 2 02/01/2023 - 02/28/2023 Funding Identification (FID) Total Completed Totals 30100-0200431-5740010-103456-E02680-9999 0 0 0 0 0 0 0 0 0 0 (P. 0.: Application Number: FW020-007730 9 & Final Project Number: Application Date: 103456 3/7/2023 Amt Remaining Gross Retainage Net $712,037.73 $152.88 Grand Total I I $712,037.73 I I $152.88 $0.00 I I ($35,601.89)1 I $35,601.89 FORT WORTH Routing and Transmittal Slip Transportation and Public Works Department DOCUMENT TITLE: Change Order # 1 — 2022 Bridge Rehab Contract 2 M&C CPN: 103456 Date: 11/30/2022 FM To: 1. Trey Meador (Contractor) 2. Robert Riley (Inspector) 3. lretomiwa Otuyelu (PM) 4. Omar Elbagalati (PgM) 5. Leon Wilson (Sr CPO) 6. Michael Owen (AD) 7. Lauren Prieur (Director) 8. Doug Black (ACA) 9. William Johnsom (ACM) 10. Jannette Goodall (CSO) CSO # 57453 Department Gibson & Associates Inc trevm(@.aibsonassoc.net TPW-Signature TPW-Signature TPW-Reviewer TPW-Reviewer TPW-Signature TPW-Signature LAW -Signature CMO-Signature CSO-Signature DOC# C01 Initials Date Out Dec 5, 2022 TM RR. Dec 5, 2022 Dec 2, 2022 .t Dec 5, 2022 Ltd Dec 5, 2022 Dec 5, 2022 /1P Dec 5, 2022 dew Dec 7, 2022 61— Dec 9, 2022 Dec 9, 2022 DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑ Yes X No RUSH: ❑ Yes X No SAME DAY: ❑ Yes X No NEXT DAY: ❑ Yes X No ROUTING TO CSO: ❑ Yes ❑ No Action Required: ❑ As Requested o For Your Information X Signature/Routing and or Recording ❑ Comment o File ❑ Attach Signature, Initial and Notary Tabs Return to: Please call lretomiwa Otuvelu at ext. 6747 for pick up when completed. Thank you. CSC No. 57453-CO1 FORT WORTH.•. City of Fort Worth Change Order Request Project Name' 2022 Bridge Rehabilitation Contract 2 Client Project #(s)I 103456 Project Description) Contractor' Gibson & Associates Inc. City Project Mgr.' lretomiwa Otuyelu Repair and maintenace of bridges at various locations in the city. Change Order#I 1 City Inspector' City Sec # 57453 Date' 11 /23/2022 Robert Riley Contract Time Dept. TPW Totals (CD) Original Contract Amount $679,646.60 $679,646.60 180 Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $679,646.60 $679,646.60 180 'Amount of Proposed Change Order $10,219.00 $10,219.00 30 Revised Contract Amount $689,865.60 $689,865.60 210 Original Funds Available for Change Orders $20,000.00 $20,000.00 Remaining Funds Available for this CO $20,000.00 $20,000.00 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) JUSTIFICATION (REASONS) FOR CHANGE ORDER This Change Order is to increase the number of days, and scope of work in Construction Contract 57453. I$849,558.25 1.50% Multiple RFI's were submitted by the contractor which resulted in modifications to the details provided for metal railings at two bridge locations. Contractor was unable to proceed with fabrication until after receiving approved shop drawings. Time taken to provide answers to the RFIs, receive new shop drawings, and get them approved by the engineer was approximately 42 days. Fabricators are expected to deliver the metal rails by the end of the week ending on 11/25/2022. PM also proposes to the replacement of two Guardrail End Treatment on E 1st St over West Fork Trinity River (#4) and Trinity Blvd WB over Railtran (#19) which were not part of the original scope of work, but got damaged, by citizens, during construction. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Contractor's Company Name Gibson & Associates Inc (Inspector/Inspection Supervisor 'Robert Riley,_,_ (Program Manager (Assistant Director (Dept) 'Assistant City Attorney Contractor (Name) Trey Meador Dec 5, 2022 .311 Dale (Director, Contracting Department (Dept) Dec 5, 2022 ( Date (Assistant City Manager Dec 7, 2022 1 Contract Signature T 1i ,4lendo - Project and Contract Compliance Manager Senior Capital Project Officer Date Dec 5, 2022 Dat Dec 2, 2022 Dat Dec 5, 2022 Date Dec 5, 2022 Dat Dec 9, 2022 Web0n`ctlMtbn(ifrequired) ' ` M&C Number M&C Date Approved ATTEST: Jannette Goodall, City Secretary FORT Project Name 12022 Bridge Rehabilitation Contract 2 Client Project# I 103456 Contractor) Gibson & Associates Inc. City of Fort Worth Change Order Additions PMI lretomiwa Otuyelu Change Order Submittal # ADDITIONS HEM tM UESURIP I ION UtP I 29 GUARURAILEND IREAIMEN I INSIALL) IPW 30 GUARDRAIL END TREATMENT (REMOVE) TPW 1 I City Sec # I 57453 Inspector) Robert Riley I Date I 11/23/2022 Uty Unit undCost ' total 2.00000000 to 34,(24.59 59,449.1.111 2.00000000 EA $385.00 5170,00 TPW $10,219.0 Sub Total Additions $10,219.0 Change Order Additions Page 2 of 5 FORT WORTH City of Fort Worth "s' Change Order Deletions Project Name I 2022 Bridge Rehablitation Contract 2 Client Project # 1103456 Contractor' Gibson & Associates Inc. PMI Iretomiwa Otuyelu I Change Order Submittal # DELETIONS IILM DLSCRIPIION UEPI Oty 1 I City Sec # 1 57453 Inspector) Robert Riley Date 11/2312022 Unit Unit Cost total T('W 50.0 Sub Total Deletions 50.0 Change Order Deletions Page 3 of 5 MISBE for this Change Order MISBE Sub Type of Service Amount for this CO I co # i Total Previous Change Orders DATE I AMOUNT Total $0.00 FORT WORTH Routing and Transmittal Slip Transportation and Public Works Department DOCUMENT TITLE: Change Order # 2 — 2022 Bridge Rehabilitation Contract 2 M&C CPN: 103456 Date: 01/12/2023 AE To. 1. Trey Meador (Contractor) 2. Kevin Jackson (Inspector) 3. Iretomiwa Otuyelu (PM) 4. Omar Elbagalati (PgM) 5. Leon Wilson (Sr CPO) 6. Michael Owen (AD) 7. Lauren Prieur (Interim Director) 8. Doug Black (ACA) 9. William Johnson (ACM) 10. Jannette Goodall (CSO) CSO # 57453 Department Gibson & Assoc. Inc trevm(a�aibsonassoc. net TPW-Signature TPW-Signature TPW-Signature TPW-Reviewer TPW-Signature TPW-Signature LAW -Signature CMO-Signature CSO-Signature TN TM OE I- (I) 7,11 ue� DOC# CO2 Initials Date Out Jan 30, 2023 Jan 26, 2023 Jan 27, 2023 Jan 30, 2023 Jan 30, 2023 Jan 30, 2023 Jan 30, 2023 Jan 30, 2023 Jan 31, 2023 Feb 1, 2023 DOCUMENTS FOR CITY MANAGER'S SIGNTURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑ Yes X No RUSH: ❑ Yes X No SAME DAY: ❑ Yes X No NEXT DAY: ❑ Yes X No ROUTING TO CSO: ❑ Yes ❑ No Action Reauired: ❑ As Requested ❑ For Your Information X Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return to: Please call Iretomiwa Otuvelu at ext. 6747 for pick up when completed. Thank you. CSC No. 57453-0O2 Project Name' 2022 Bridge Rehabilitation Contract 2 Client Project #(s)I 103456 Project Description) Contractor' City Project Mgr.1 Gibson & Associates Inc. Iretomiwa Otuyelu Dept, TPW Original Contract Amount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date !Amount of Proposed Change Order Revised Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) $679,646.60 $10,219.00 $689,865.60 $22,325.00 $712,190.60 $20,000.00 $9,781.00 $12,544.00 City of Fort Worth Change Order Request Repair and maintenace of bridges at various locations in the city. Change Order#I 2 City Inspector' CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) JUSTIFICATION (REASONS) FOR CHANGE ORDER This Change Order is to increase the scope of work and contract amount in Construction Contract 57453. City Sec # I 57453 Date 1/23/2023 Kevin Jackson Totals $679,646.60 $10,219.00 $689,865.60 $22,325.00 $712,190.60 $20,000.00 $9,781.00 $12,544.00 4.79% $849,558.25 Contract Time (CD) 180 30 210 210 PM approved to Clean and Paint Existing Structure (#17) of the WB Bridge on Trinity Blvd over Boyd Branch, as well as extra 2.5 CY of Riprap (Stone Protection) for the Bridge at NW 30TH St over Marine Creek. These extra quantities were not estimated in the original contract but were determined to be necessary during construction. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Contractor's Company Name Contractor (Name) Date Gibson & Associates, Inc Trey Meador I InspectorMspection Supervisor (Program Manager (Assistant Director (DeptIMIIIIIr I-"4,.44-7"&—+— 'Assistant Cityaigia I�- ATTEST: Jannette Goodall, City Secretary Date Jan 26, 2023 Jan 30, 2023 Date Jan 30, 2023 Contract Signature TeMeado7- Project and Cont act Compliance Manager Senior_Capital Project officer Director, Contracting Department (Dept) Assistant City Manager Jan 30, 2023 Council Action (if required) M&C Number M&C Date Approved Jan 30, 2023 Date Jan 27, 2023 Jan 30, 20231 le Jan 30, 20231 ID - Jan 31, 2023 FORT WORTH Project Name I 2022 Bridge Rehabilitation Contract 2 Client Project# I 103456 Contractor' Gibson & Associates Inc. ITEM ' DESCRIPTION 15 NIPRAP(SIUNEPRO IECIIONI(12IN) 17 CLEAN AND PAIN] EXISIINUSIRULtIURE City of Fort Worth Change Order Additions PMI Iretomiwa Otuyelu I Change Order Submittal # ADDITIONS DEPT IPW IPW 2 City Sec # I 57453 Inspector' Kevin Jackson Date I 1/23/2023 Qty Unit Unit Cost ' total 2.511110110011 CY $7311.0U $1,825.00 1.00000000 LS $20,500.00 $20,5110.00 TPW $22,325.00] Sub Total Additions $22,325.001 Change Order Additions Page 2 of 4 Project Name I 2022 Bridge Rehabilitation Contract 2 Client Project # j 103456 Ccnlracto I Gibson & Associates Inc. City of Fort Worth Change Order Deletions PM' IretomiwaOtuyelu I Change Order Submittal # DELETIONS IFEM ' DESCRIPTION DEPT 2 j City Sec # j 57453 Inspector' Kevin Jackson I Date 1/23/2023 I Oty Unit ' Unit Cost ' Total TPW SO.00 Sub Total Deletions $0.00 Change Order Deletions Page 3 of 4 M/SBE for this Change Order M/SBE Sub Type of Service Amount for this CO I Total Previous Change Orders $0.00 co# DATE AMOUNT Total FORT WORTH Routing and Transmittal Slip Transportation and Public Works Department DOCUMENT TITLE: Construction Allowance 1 — 2022 Bridge Rehabilitation Contract 2 M&C 22-0150 CPN: 103456 Date: 10/25/2022 FM To: 1. Trey Meador (Contractor) 2. Robert Riley (Inspector) 3. lretomiwa Otuyelu (PM) 4. Omar Elbagalati (PgM) 5. Martin Philips (Sr CPO) 6. Martin Phillips (AD) 7. Lauren Prieur (Director) 8. Doug Black (ACA) 9. William Johnson (ACM) 10. Jannette Goodall (CSO) CSO # 57453 Department Gibson and Associates trevm(@.aibsonasoc.net TPW-Signature TPW-Signature TPW-Reviewer TPW-Reviewer TPW-Signature TPW-Signature LAW -Signature CMO-Signature CSO-Signature DOC# CA#1 YrrP LLP jSa Date 10/28/22 10/31/22 10/31/22 10/31/22 10/31/22 10/31/22 10/31/22 11/04/22 11/04/22 11/07/22 DOCUMENTS FOR CITY MANAGER'S SIGNTURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑ Yes X No RUSH: ❑ Yes X No SAME DAY: ❑ Yes V No NEXT DAY: ❑ Yes X No ROUTING TO CSO: ❑ Yes ❑X No Action Required: ❑ As Requested o For Your Information X Signature/Routing and or Recording ❑ Comment o File ❑ Attach Signature, Initial and Notary Tabs Return to: Please call lretomiwa Otuvelu at ext. 6747 for pick up when completed. Thank you. CSC No. 57453-AR1 FOR TWORTH9 City of Fort Worth Construction Allowance Request Project Name' 2022 Bridge Rehabilitation Contract 2 Client Project #(s)l 103456 ProjectlBridge rehabilitation at various locations, city wide. Description ContractorlGibson and Associates Inc City Project Mgr.l Iretomiwa Otuyelu UNIT or DEPT I TPW Original Contract Amount 1 $679,646.60 Extras to Date Credits to Date Current Contract Amount $679 646.60 (Amount of Proposed Allocation $3,300.00 Original Allowance Available to Allocation $ i0,000.00 Allowance Funds Previously Allocated Revised Allowance Balance $46,700.00 $0.00 $0.00 l City Sec # l 57453 CA ri1 1 I Date' 10/18/2022 City Inspector) Robert Riley UNIT 2 or Dept UNIT 3 or Dept UNIT 4 or Dept Totals $0.00 $0.00 $679,646.60 $679,646.60 i 300.00 $td000.00 $0.00 $0.00 $46,700.00 $0.00 JUSTIFICATION (REASONS) FOR CONSTRUCTION ALLOWANCE IN ACCORDANCE WITH THIS CONSTRUCTION ALLOWANCE REQUEST, THE CONTRACT SHALL: Furnish all labor and material as per attached proposed Construction Allowance Request (with attachments): Replacement of existing pavement striping on the approach slab at the Meacham Boulevard Bridge over BNSF Railroad. During preliminary estimates, this line item was not thought to be needed and therefore not provided in the contract. However, after the work was completed, staff determined that there would need to be pavement markings on the replaced concrete slabs, for proper traffic control. The attached email shows that this is the most reasonable price we could achieve to mobilize a crew for the job. It is understood and agreed that the acceptance of this Construction Allowance Request by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Construction Allowance Request. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Contractor's Company Name Gibson & Associates Inc Inspector/Inspection Supervisor Program Manager Assistant Director (Dept) Assistant City Attorney 167,1 ATTEST: r,n,.,ftes ,aednx Jannette Goodall, City Secretary Contractor (Name) Trey Meador MINIM Date 10/31/22 Date 10/31/22 Date 10/31/22 Date 11/04/22 Contractor Signature ??: f hlerular Project and Contract Compliance Manager Senior Capital Project Officer Ate. Pl.Gy�, Director, Contracting Department (Dept) Assistant City Manager Date 10/28/22 Date 10/31/22 Date 10/31/22 Date 10/31/22 Date 11/04/22 Construction Allowance SUMMARY Page 1 of 4 FORT Project Name 12022 Bridge Rehabilitation Contract 2 Client Project # 1103456 Contractor Gibson and Associates Inc City of Fort Worth Construction Allowance Additions PMI lretomiwa Otuyelu Construction Allowance Submittal # I I I I City Sec # I 57453 I Inspector' Robert Riley Date 110/18/20221 ADDITIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 1 4" White TY1 THERMOPLASTIC TPW 160.00000000 LF $8.21 $1,313.601 2 4" Yellow TY1 THERMOPLASTIC (DOUBLE YELLOW) TPW 120.00000000 LF $8.22 $986.401 3 Minimum Trip Charge TPW 1.00000000 LS $1,000.00 $1,000.001 TPW $3,300.00 UNIT 2 or Dept $0.00 UNIT 3 or Dept $0.00 UNIT 4 or Dept $0.00 Total Additions $3,300.00 Construction Allowance Additions Page 2 of 4 FORT WORTH.. Project Name 1 2022 Bridge Rehabilitation Contract 2 Client Project # 1103456 Contractor' Gibson and Associates Inc ITEM City of Fort Worth Construction Allowance Value PMI Iretomiwa Otuyelu I Construction Allowance Submittal # 1 I City Sec # I b/453 Inspector' Robert Riley Date I 10/1612022 I CONSTRUCTION ALLOWANCE VALUE BEING USED DESCRIPTION Qty Unit Unit Cost Total Construction Allowance Value 3 of 4 M/SBE for this Construction Allowance Request M/SBE Sub Type of Service Amount for this CAR Total Previous Construction Allowance Requests $o.00 I CAR # DATE I AMOUNT 1 Total Construction Allowance MSBE Data Page 4 of 4 From: Joe Montaomery To: Otuvelu. Iretomiwa S Cc: Cordova. Ron; Devon, Gary; Trey Meador; Mark Person; Taufa Tuoou; Riley. Robert D Subject: FW: 2022 Bridge Rehabilitation Contract 2 CPN 103456- Meacham Blvd. Final Striping Proposal Date: Wednesday, October 19, 2022 3:56:04 PM Attachments: doc06287620221006142551.odf CAUTION: This email originated from outside of the City of Fort Worth email system. Do not click any links or open attachments unless you recognize the sender and know the content is safe. Tommy, We have reached out to multiple striping contractors and we received three quotes for this work. The other two striping quotes we received are both $1,000 more than the quote we included with our proposal. The cost is high primarily due to mobilization costs for such a small amount of work. The striping sub must pull crew and equipment from another project for less productive work. The price submitted by American Striping is the minimum cost for which they are willing to perform the work and we highly doubt a qualified striping contractor would perform this work for any less. Please let us know how you would like to proceed or let us know if the City plans on performing this work with its own forces. Thank you, Joe Montgomery Project Coordinator Office- (972) 557-1199 Cell- (214) 301-2474 Gibson & Associates, Inc. 11210 Ryliecrest Drive Balch Springs, TX 75180 From: Joe Montgomery Sent: Thursday, October 6, 2022 2:40 PM To: Otuyelu, Iretomiwa S <Iretomiwa.Otuyelu@fortworthtexas.gov> Cc: Cordova, Ron <Ronald.Cordova@fortworthtexas.gov>; Deyon, Gary <Gary.Deyon@fortworthtexas.gov>; Trey Meador <treym@gibsonassoc.net>; Mark Person <markp@gibsonassoc.net>; Taufa Tupou <taufat@gibsonassoc.net>; Riley, Robert D <robert.riley@fortworthtexas.gov> Subject: 2022 Bridge Rehabilitation Contract 2 CPN 103456- Meacham Blvd. Final Striping Proposal Tommy, Please see attached change order proposal as requested for replacement of existing striping at the Meacham Blvd. bridge location. This will be limited to the area of the approach slabs and concrete pavement we are currently working on. Please let us know if approved and we will proceed with scheduling the work. If you have any questions or need any additional information, please let me know. Thank you, Joe Montgomery Project Coordinator Office- (972) 557-1199 Cell- (214) 301-2474 Gibson & Associates, Inc. 11210 Ryliecrest Drive Balch Springs, TX 75180 GIBSON & ASSOCIATES, INC. Engineers and Contractors 11210 Ryliecrest P.O. Box 800579 Balch Springs, Texas 75180-0579 972/557-1199 FAX 557-1552 October 6, 2022 Mr. Iretomiwa S. Otuyelu, E.I.T. City of Fort Worth Transportation and Public Works Department City Hall, 2" d Floor 200 Texas Street Fort Worth, TX 76102 RE: Project: 2022 Bridge Rehabilitation, Contract #2 Project No.: 103456 County: Tarrant Dear Sir: Below please find the pricing requested for replacement of the existing striping following the approach slab and concrete pavement work at the Meacham Blvd. bridge location. ADD Meacham Blvd. Final Striping 1 LS @ $3,000/LS x 10% markup = $3,300.00 Please see attached quote from our striping subcontractor for reference. We would like to request one additional day be added to the contract for this work. If there are any questions regarding this matter, please call me. Very truly yours, GIBSON & ASSOCIATES, INC. ?p_ IYIAirjr- Joe Montgomery Project Coordinator F f--" AMERICAN STRIPING COMPANY Billed To GIBSON & ASSOCIATES PO BOX 800579 11210 Rylie Crest BALCI-I SPRINGS, TX 75180-0579 Specs NONE SEEN 11551 Ravenview Road Dallas, TX 75253 972-557-8565 estimating@americanstriping.net Job Name MEACI-IAM BLVD STRIPING MEACIIAM BLVD FORT WORTH, TX Material Addenda/alts TYI TI-IERMO Description BASED ON nil THERMOPLASTIC W/ FLAIL MILL GRINDING PREP 4" WHITE TY 1 THERMOPLASTIC 4" YELLOW TY1 TI-IERMOPLASTIC (DOUBLE YELLOW) MINIMUM TRIP CHARGE NONE Proposal Date Estimate # 10/6/2022 Terms Net 30 EXCLUSIONS: 2 YEAR WARRANTY, ALL MAJOR TRAFFIC CONTROL, FLAGGERS, CRASH CUSHIONS, MMA, 3M TAPE, PREFAB TAPE, WATER BLASTING, SAND BLASTING, SODA BLASTING, SHOP BLAST PREP, PROFILE & SHADOW PAVEMENT MARKINGS, RETROREFLECTIVE READINGS, MICROSURFACING, ALL SIGNS, REMOVAL OF EXISTING PAVEMENT MARKINGS (NONE SHOWN), BONDS, PERMITS, TAX CONDITIONS: No Lced Materials. No Prior Cleaning, Exclude All Permits. Insurance not to exceed sample/Evidence of Insurance. Not responsible for damages to underground utilities. Above Work Only. Additional work is for unit price. No guarantee if Concrete less than 90 Days Old. No shop drawings \vill be provided for striping layout. DONNIE WILLIAMS - ESTIMATOR Subtotal Sales Tax (8.25%) Total 8128 Rep BW Qty U/M 160 LF 120 LF I LS $3,000.00 $0.00 $3,000,00 Note: This proposal may be withdrawn by us if not accepted within 30 days. The above prices, specifications and conditions are satisfactory and are hereby accepted. When signed, American Striping Company is authorized to proceed with the above work. This proposal becomes a part of any contract, existing or proposed, will the person or company represented. Payment will be Net 30 days, or as outlined above. Accepted By & Date: FORT WORTH® TRANSPORTATION AND PUBLIC WORKS March 9, 2023 Gibson & Associates, Inc. 11210 Rylicrest Drive Balch Springs, Texas 75180 RE: Acceptance Letter Project Name: Bridge repair for Twenty Locations Project Type: TPW bridge repairs City Project No.: 103456 To Whom It May Concern: On January 23, 2023 a final inspection was made on the subject project. There were no punch list items identified at that time. The final inspection indicates that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on March 9, 2023, which is the date of the final inspection 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 Iretomiwa S. Otuyelu E.I.T. Graduate Engineer City of Fort Worth Transportation and Public Work Department Tel: 817.392.6747 . Sincerely, Iretomiwa Otuyelu, Project Manager Cc: Kevin Jackson, Inspector Gary Deyon, Inspection Supervisor Troy Gardner, Senior Inspector Omar Elbagalati, Program Manager CP&Y, Consultant Gibson & Associates, Inc., Contractor City of Fort Worth, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 08/20/19 CONSENT OF SURETY COMPANY TO FINAL PAYMENT Conforms with the American Institute of Architects, AIA Document G707 PROJECT: (name, address)2022 Bridge Rehabilitation Contract 2 Fort Worth, TX TO (Owner) T CITY OF FORT WORTH 1000 Throckmorton Street Fort Worth TX 76102 CONTRACTOR: GIBSON & ASSOCIATES. INC. OWNER ❑ ARCHITECT ❑ CONTRACTOR ❑ SURETY ❑ OTHER Bond No K40427405 ARCHITECT'S PROJECT NO: CONTRACT FOR: 2022 Bridge Rehabilitation Contract 2 - Project No. 103456 CONTRACT DATE: 3/8/2022 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the there insert name and address of Surety Company) FEDERAL INSURANCE COMPANY 202E Hall's Mill Road Whitehouse Station NJ 08889 on bond of There insert name and address of Contractor) GIBSON & ASSOCIATES. INC. P.0 Box 800579 Balch Springs TX 75180-0579 , SURETY COMPANY , 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 1000 Throckmorton 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): -4„ --- 27th day of March, 2023 FEDERAL INSURANCE COMPANY Surety Company 7 ., Signature of Authorized Representative Robb) Morales Title , OWNER, Attorney -in -Fact 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 Each of the Chairman, the President and the Vice Presidents of the Company lshereby authorized to execute any Written Commitment for and on behalf of the Company, under the seal of the Company or otherwise- (2) Each duly appointed attorney -in -fact of the Company is hereby authorized to execute any Written Commitment far and on behalf of the Company, under the seal of the Company or otherwise, to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such attorney -in -fact Each of the Chairman. the Preskdent and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to appoint in writing any person the attorney -In - fact of the Company with full power and autharityto execute, for and on behalf of the Company, under the seal of the Company or otherwise, such Written Commitments of the Company as may he specified in such written appointment, which specification may he by general type ar class of Written Commitments or by specification of one ar more particular Written Commitments, (4) Each of the Chairman. the President and the Vice Presidents or the Company Is hereby authorised. for and on behalf of the Company, to delegate in writing to any other officer of the Company the authority to execute, for and on behalf of the Company. under the Company's seal cr otherwtse, such Written Commitments of the Company as are specified in such written delegation, which specification may be by general type or class of Written Commitments or by specification of one ar more particular Written Commitments. (5] The signature of any officer or other person executing any Written Commitment nr appointment ar delegation pursuant to this Resolution, and the seal of the Company, may be affixed by Facsimile on such Written Commitment or written appointment or delegation. FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to he an exclusive statement of the powers and authority of officers, employees and other persons to art for and on behalf nfthe Company, and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested," I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY (the "Companies") do hereby certify that (i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect, (ii] the foregoing Power of Attorney is true, correct and in full force and effect. Given under my hand and seals of said Companies at Whitehouse Station, NI. this March 27, 2023 CHUBS Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Westchester Fire Insurance Company I ACE American Insurance Company Know All by These Presents, that FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, WESTCH ESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY corporations of the Commonwealth of Pennsylvania, do each hereby constitute and appoint Don E. Cornell, Sophinie Hunter, Tina McEwan, Robbi Morales, Mikaela Peppers, Tonie Petranek, Ricardo J. Reyna, Joshua Saunders and Kelly A. Westbrook of Dallas, Texas; Steven Dwain Brockinton of Little Rock, Arkansas ------- ---------- 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 therenn or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY have each executed and attested these presents and affixed their corporate seals on this 4ih day of February, 2022. �JaLwm. ehilDA Z I trv. n II t bit iti St t't,'I lry STATE OF NEW JERSEY County of Hunterdon SS. Stephen 11 I lanky .1 ice Prurient On this 4ft day of February, 2022 before me, a Notary Public of New Jersey, personally came Dawn M. Chloros and Stephen M. Haney, to me known to be Assistant Secretary and Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros and Stephen M. Haney, being by me duly sworn, severally and each for herself and himself did depose and say that they are Assistant Secretary and Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and know the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that their signatures as such officers were duly affixed and subscribed by like authority. Notarial Sea] KATHERINE J. ADELAAR NOTARY PUBLIC OF NEW JERSEY No, 2316085 Commisslen Expires July 10. 2024 Naary ti4tlle CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 20I6; WESTCHESTER FIRE INSURANCE COMPANY on December 11. 2006; and ACE AMERICAN INSURANCE COMPANY on March 20,2009: "RESOLVED, that the following authorizations relate to the execution, for and an behalf of the Company, of bonds, undertakings, recognizances, contracts and other written commitments of the Company entered Into in the ordl nary course of business {each a "Written Commitment"): (l) (3) • lirv,n YI iId( in, .ltiwuantksTvtary IN THE. EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER, PLEASE CONTACT U5 AT: Telephone 19091 903-3493 Fax f9091403. 3656 a -mail: suretv@chubb.com Combined. FED-VIG-PI-WFIC-AAIC (rev. 11-19) AFFIDAVIT STATE OF TEXAS COUNTY OF DALLAS Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Alan C. Meador, III, Vice President Of Gibson & Associates, Inc., 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; 2022 Bridge Rehabilitation Contract 2 BY / / Alan C. Meador, III Subscribed and sworn before me on this date 27th of March, 2023. Notary Public Dallas, Texas PAM N DAVIS :��tipPY PVe �i ?i•4 �� Notary Public, State of Texas Trc Comm. Expires 03-30-2025 ,,,„„so Notary ID 283117-2