HomeMy WebLinkAboutContract 56759-FP1.FORT WORTH,
WATER DEPARTMENT
NOTICE OF PROJECT COMPLETION
-FP1
City Secretary No:_56759
Date Received:5/26/2023
City Project N!?:103098
Regarding contract 56759 for 2021 Bridge Rehabilitation Contract 1 as required by the TRANSPORTATION
& PUBLIC WORKS DEPARTMENT as approved by City Council on 9/14/2021 through M&C 21-0667
the director of the TRANSPORTATION & 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:
Amount of Approved Change Orders:
Revised Contract Amount:
Total Cost Work Completed:
Less Deductions:
Liquidated Damages:
Pavement Deficiencies:
Total Deduction Amount:
Total Cost Work Completed:
Less Previous Payments:
Final Payment Due
� A6)We."-
Recommended for Acceptance
Asst. Director, TPW- CAPITAL DELIVERY
Accepted
Director, TRANSPORTATION PUBLIC WORKS DEPARTMENT
Client Department
Asst. City Manager
Conlin nts:
$444,053.84
$0 Ne 1
$444,053.84
0 Days @ $650.00/ Day
$0.00
$402,678.69
$382,544.76
$20,133.93
May 24, 2023
Date
May 24, 2023
Date
May 26, 2023
Date
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
C-620 Signature Page
Contractor's Application for Payment
Invoice No.
11 FINAL
To (Owner) City of Fort Worth Invoicing Period (From - To):
Invoice Date:
4/l/2023 to 4/4/2023
4/17/2023
P. O. F{ W020-0000007022 From (Contractor):
Remit to ( If Not Automatic Deposit ):
Number: Ragle, Inc.
Project: 103098 Contractor's CFW Vendor No.:
0000040643
City secretary contractumber: 56759 Contract
2021 Bridge Rehabilitation, Contract 1
Number: Name:
Application For Payment
Change Order Summary
Approved Change Orders
1. ORIGINAL CONTRACT PRICE..........................................................
$ $444,053.84
Number Additions Deletions
2. Net change by Change Orders.................................................................
$
1 $96,997.21 $96,997.21
3. Current Contract Price (Line 1 f 2)........................................................
$ $444,053.84
2
4. TOTAL COMPLETED AND STORED TO DATE
3
(Progress Estimate, Construction Allowance and Change Orders).......
$ $402,678.69
4
5. RETAINAGE:
5
a. X $402,678.69 Work Completed..........
$
6
b. X Not Used
$
7
c. Total Retsina a Line Sa +Line Sb ...............................
g ( )
$
8
6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c).............................
$ $402,678.69
TOTALS $96,997.21 $96,997.21
7, LESS PREVIOUS PAYMENTS (Line 6 from prior Application)........
$ $382,544.76
NET CHANGE BY
8. AMOUNT DUE THIS APPLICATION .................................................
$ $20,133.93
CHANGE ORDERS
9. BALANCE TO FINISH, PLUS RETAINAGE
(Column G on Progress Estimate+ CA + Cos + Line 5 above) ..............
$ $41,375.15
Contractor's Certification
10. CONTRACT TIME:
The Contractor certifies with the submittal of this document and associated Payment Request Submittal
a. Days Awarded
150
on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all previous progress
b, Days Added by CO
20
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
C. Total Days
170
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
d. Days Charged
170
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);
e, Days Remaining
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
Consent of Surety
Affidavit of Bills Paid
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 Unit Price Progress Estimate
Progress Estimate
1-Iwnt ay
2021 Bridge Rehabilitation, Contract 1
Apphcaaon Penad
4/1/2023 to 4/4/2023
In-
Brdltw No
Descnpnon
I 1
REMOBILIZATION
2
REMOVING CONC lRIPRAP)
5
CURB (TYPE ID
6
CEM STABIL BKFL
7
CL C CONC(MISC)
8
COONjCC STIR REPAIR (VERTICAL B OVERHEAD)
Bn
10
CLfArl GOANb�`EA�I GEXISTING JOINTS
11
CLEAN 8 PAINT EXISTING RAIL
12
RAIL HANDRAIL)
13
RAIL/TYPR11)
14
CLEAN EXIST CULVERTS
[�1y1(/YFMST
,IS 7
`RWIFNGTH)
1AT
8
DDROLWWNSBTRAEEAAAM ANCHOR TERMINAL SECTION
19
REMOVE METAL BEAM GUARD FENCE
20
GUARDRAIL END TREATMENT XNSTALL,
21
TREE REMOVAL(4" -12" DIA,
22
TREEREMOVAL(18"-24"DIA,
23
REPAIR RAIL ELEMENT (W-BEAM)
24
REM I REPL TIMBER/STL POST W/O CONIC FND
25
REPLACE (STEEL RAIL,
26
CNC CRPE.� F%JVI[j /{1leCtj2ETE11SURF SEAL)
%
27
RAILROA R �FIQT Fl
28
PAVING CONSTRUCTION ALLOWANCE
City Sa,< 56759
Cowed Num:
A
B
Sps firatiw
Brd Quawty I
Umt Pnce
Brd Value
Section No.
Umt ofMwsure
EA
((JI
1.00000 J
$500.06
$500.06
104fi009
1041 11
BY
LF
3.00000
34.30000 J
$140.X0
$25.OG
$420.00
$857.56
36_27
104fifi
CY
LF
4.00
32.30
$250.E
$75.
$1.000.00
12422.56
064
400
CY
E
5E
.o.
$5]5.005
74
0
,0000G
$42- 9.000.06
429fi 07
SF
677.50000E
$120.00
S81.30000
43- 06
CY
1.OXXXXE
$,.SOO.OE
$,.500:06
438fi001
LF
120.00000E
$200.00
$24.000.00
446610
LS
1.0XXXXE
$S.000.OE
$5.000.OE
450-
LF
69.60000E
$200.00
$13.920.0
45-103
LF
65.XXXXOE
$425.0E
127.625.0E
480fi 02
EA
2.00000E
$1,500.00
$3.000.00
4966 09
EA
1.00000E
$102.500.OE
$,02.SOO.OE
540fi 01
LF
75.00000E
$100.00
$7,500.0�
540fi 07
540fi 16
EA
EA
4.aa000E
2.00000E
$1.011.23
$,.035.1b4
$a.044.5'
$2.070.32
542fi 01
LF
156.50000E
$2.4E
$375.66
544fi 01
EA
200000E
$2.1]8.00
1356.00
752fi 05
EA
1.00000E
17.500.0E
$7.5.0.O6
752fi 07
EA
200000E
$,.500.00
S3.000.00
77nfi 01
LF
2.00000E
$100.0E
$200.0E
770fi 10
EA
2100000E
$40.00
$840.00
776fi 53
LF
188.50000E
$190.OE
$35.815.06
780fi 04
LF
7280000E
$65.00
1.732:00
0o 1010
LS
1.00000E
15o.000.:
150.000.0E
000000
LS
1.00000E
S50.000.00
$50.000.00
C
E,ft.tM Qaanaty
Installed
623.13000000
120.00000000
26.(YYX0000
59.1XXX0000
Contractor's Application
Applrcaaon Nnmber
11 FINAL
Awl -non Date
4/17/2023
D
E
F
G
Total Co 1-1 % Balaou m Frmsh
Value
Pr -Iy lr 11a Value
Value Thn Penod Ma[enals t'reeen[ly
and St-1 to Date IT,L-F)
3mred (vot �v C)
ID -IQ B
$500.00
$]9.80'
$975.OG
$19.80
$975.
$]9.80 190%
$975.OE 113.7%
$340.20
-$117.50
$1.000.00
$2.775.0
$1.000.00
$2.775.0
$1.000.00 100.0%
$2.775.OE 114.6%
-$352.50
J
$13.000.00
JI
113.000.0
$13.000.OG 144.4%
$5]5.00
-S4.000.00
$74,775.60
$74.7]5.60
$74.]]5.6X 920%
S6.524.4X
$,.500.00
$24.000.00
$24.000.00
$24.000.00 100.0%
$5.000.00
$13.920.00
$27.62UOo
$13.920.00
$27.62Noo
$13.920.00 100.0%
127.625.0E 100.0%
$4.SOO.o
$, 02.50N�
$, 3.]50.0'
$4.500.00
$102.500.0
$13.]50.09J
$4.SOO.XX 150.0%
1102.500.0E 100.0%
$13.]50.OQ 183.3%
$1.SOO.XO
-$6.250.00
1a.o44. l
1a.o44. l
1a.o44. 2 100.0%
$2.070.32
$375.6
S4.356.00
$2.070.32
$375.6
$4,356.00
$2.0]0.32 100.0%
$375.6E 100.0%
1356.00 100.0%
$7.500.0 �
$7.500.0 �
17.500.0E 100.0%
$3.000.00J.
$200.0066
$3.000.XOJ
$200.00(6(
$3.000.00 100.0%
$200.OE 100.0%
$1.040.00
$1.040.X0
$1.040.00 123.8%
-$200.X0
$35.815.00
S3.841.50
$3.841.50
S3.841.50 812%
$890.50
$50.000.00
$50.000.00
This documwt has been modified 6om ns wgnul I.. as an EJCDC document and the user drd not hrgblrgbt the
modrficaaws You are encouraged mread the documentca InIty and coreuIt Legal Counsel pnor tons execunon
C-620 Change Order
Progress Estimate Change Order Number I 1
ADDITIONS
Contractor's Application
For (contract):
103098 2021 Bridge Rehabilitation, Contract 1
City Secretary
56759
Application Number:
11 FINAL
Contract Num:
Application Period:
4/1/2023 to 4/4/2023
Application Date:
4/17/2023
A
B
C D
E
F
Item
Addition
Total Completed
Balance to Finish
Change Order Item
Specification
Unit of CO Quantity to Add
Unit Price Change Order
Estimated Quantity
Value
Previously Value This Materials Presently
and Stored to Date
(F) (B - F)
No.
Description
Section No.
Measure
Value
Installed
Installed Value Period Stored (not in C)
(D+E)
B
29
Retrofit Plate for euardrail
TPW
LS 100000000
$8341.89 $8341.89
1.00000000 $8.341 89I
$8,341.891
i
1 $8.341 89
100.0%
30
Two T1F Steel Handrail
TPW
LF 377.00000000
$235.16 $88,655.32
378 50000000 $89,008 06�
$89,008.06
$89,008 06
100.4%-$352.74
This document has been modified from its original f as an E1CDC 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 $96,997.21 $97349.9$ $97.349.95 $97349.9$ 100.4%-5352.74
Progress Estimate
Change Order Number I I
Contractor's Application
DELETIONS
For (eontiact): 2021 Bridge Rehabilitation,
103098
Contract 1
Application Number:
11 FINAL
Application Period:
4/1/2023 t0 4/4/2023
Application Date:
4/17/2023
A
B C
D E
F
I Item
COQuantity to
Deletion
Change Order Item Description
Specification Unit of Delete
Unit Price
Change Order Not Used
Not Used Not Used Not Used Not Used
Not Used Not Used Not Used
No.
Section No. Measure
Value
I 25 lteglacc Steel Rail
TPW LF 188.50000000
$190.00
$35.815.00
I 27 Rail road Coordination
TPW LS 1.00000000
$50.000.00
$50.000.00
I 28 Pao-c Construction Allowance
TPW LS 0.22364420
$50.000.00
$11.182.21
Totals $96.997.21
This document has been modified from its originalf as an E1CDC 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.
City of Fort Worth Summary of Charges
City Secretary Contract Num: I 56759 I 2021 Bridge Rehabilitation, Contract 1 P. 0.: FW020-0000007022
Application Period: I 4/1/2023 to 4/4/2023 I Application I 11 FINAL
Number:
Funding Identification (FID)
Ori_gqfinal Contract
130100-0200431-5740010-1030J8-E02680-9999
10
10
10
10
10
10
10
10
10
10
Change Order 1
130100-0200431-5740010-103098-E02680-9999
10
10
10
10
10
10
10
10
10
10
Change Order 2
130100-0200431-5740010-103098-E02680-9999
10
10
10
10
10
10
10
10
10
10
Change Order 3
30100-0200431-5740010-103098-E02680-9999
0
Total Completed
$305,328.74
$97,349.95
Amt Remaining
$138,725.10
($97,349.95)
Gross
Project Number: 103098
Application Date: 4/17/2023
Retainage Net
City Secretary Contract Num: 56759
Application Period:
Funding Identification (FID)
0
0
0
0
0
0
0
0
0
Change Order 4
30100-0200431-5740010-103098-E02680-9999
0
0
0
0
0
0
0
0
0
0
Change Order 5
30100-0200431-5740010-103098-E02680-9999
0
0
0
0
0
0
0
0
0
0
Change Order 6
30100-0200431-5740010-103098-E02680-9999
0
0
0
0
City of Fort Worth Summary of Charges
2021 Bridge Rehabilitation, Contract 1 P. 0.: FW020-0000007022 project Number: 103098
4/l/2023 to 4/4/2023 Application 11 FINAL Application Date: 4/17/2023
Number:
Total Completed Amt Remaining Gross Retainage Net
City of Fort Worth Summary of Charges
City Secretary Contract Num: I 56759 I 2021 Bridge Rehabilitation, Contract 1 P. 0.: FW020-0000007022
Application Period: I 4/1/2023 to 4/4/2023 I Application I 11 FINAL
Number:
Funding Identification (FID) Total Completed Amt Remaining Gross
10
10
10
10
10
10
I
Change Order 7
130100-0200431-5740010-103098-E02680-9999
10
10
10
10
10
10
10
10
10
10
I
Change Order 8
130100-0200431-5740010-103098-E02680-9999
10
10
10
10
10
10
10
10
10
10
I
I Totals
130100-0200431-5740010-103098-E02680-9999 $402,678.69 $41,375.15
10
10
10
10
10
10
10
Project Number: 103098
Application Date: 4/17/2023
Retainage Net
City of Fort Worth Summary of Charges
City Secretary Contract Num:
I 56759
I
2021 Bridge Rehabilitation, Contract 1
P. 0.:
FW020-0000007022
Project Number:
103098
Application Period:
I 4/1/2023 to 4/4/2023
I Application I
Number:
1 l FINAL
Application Date: 4/17/2023
Total Completed Amt Remaining
Retainage Net
Funding Identification (FID)
Gross
10
1 $0.00
$0.00
$0.00
$0.00
10
$0.00 1 1
$0.00 1 1
$0.00 1 1
$0.00
to
1 1
$0.001 1
$0.001 1
-- I I
I Grand Total
$402,678.69 1 1
$41,375.15 1 1
$0.00 1 1
($20,133.93)1 1 $20,133.93
FORT WORTH,
Routing and Transmittal Slip
Transportation and Public Works
Department
DOCUMENT TITLE: 2021 Bridge Rehabilitation Contract 1, CO 1
M&C CPN 103098
DATE: 11 /29/2022
To: Alexiz Ramirez
1.
Ragle Inc
2.
s.Ozzie Ouimette (Inspector)
4.Tariqul Islam (PM)
5 Omar Elbagalati (PGM)
6 Leon Wilson (Interim SCPO)
7. Michael Owen (Interim AD)
s Lauren Prieur (Interim Director)
9 Doug Black (ACA)
10. William Johnson (ACM)
11, Jannette Goodall (CS)
CSO # 56759 DOC#
INITIALS DATE OUT
Dec 2, 2022
Dec 5, 2022
RD Dec 6, 2022
R
a Dec 6, 2022
06- Dec 6, 2022
of
/-a) Dec 6, 2022
Dec
7, 2022
M
ILL P
Dec 7, 2022
Dec
8, 2022
Dec
9, 2022
Dec
9, 2022
J-
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: U Yes❑✓ No
RUSH: ❑ ❑✓ SAME DAY: ❑Yes ❑✓ No NEXT DAY: ❑Yes ❑✓ No
ROUTING TO CSO: ❑✓ Yes [—]No
Action Required:
❑ As Requested ❑ Attach Signature, Initial and Notary Ta
■ Signature/Routing and or Recording
❑ Comment
❑ File
Return to: Please call
at ext. for pick up when completed. Thank you.
CSC No. 56759-COl
Fox_ T� x;
Project Namel 2021 Bridge Rehabilitation Contract 1
Client Project #(s)l 103098
Project Description)
Contractorl Ragle, Inc.
City Project Mgr.l Tariqul Islam
Dept.
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)
TPW
$444,053.84
City of Fort Worth
Change Order Request
City Sec # I 56759
Bridge Rehabilitation at Eight Locations
Change Order#1 1 Date) 11/29/2022
City Inspector Ozzie Ouimette
Contract Time
Totals (CD)
$444,053.84 150
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.00%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 15%) $555,067.30
JUSTIFICATION (REASONS) FOR CHANGE ORDER
This change order is to add $0 dollar and 20 calendar days to contract # 56759.
During construction it was identified that the fabrication of missing old handrail per plan at E. Seminary Dr (north side) needs compromise to type of material. The fabrication of
the rail post needs significant additional effort to match with old design also . Considering these issues, for E. Seminary Dr bridge, it was decided to install TxDOT approved T1 F
metal rail instead of old nonstandard handrail. Also, as south side handrail of the same bridge was completely damaged prior to start construction by an accident, it was decided
to install same type of handrail (T1 F) on both sides of the bridge. A quote for T1 F metal handrail was received from contractor and compared with last few months TxDOT
average bid price for same item and found reasonable. To cover the cost of additional work, a portion of construction allowance has been deleted, and railroad coordination pay
item also deleted as it was not required in this contract. This change order also includes a guardrail retrofit item for Vickery Blvd bridge.
To fabricate and install additional 188.5 LF of T1 F type handrail and guardrail retrofit work, 20 calendar days are proposed to add to the contract.
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) Contract Signature I Date 41
Ragle, Inc. Nishant Gupta I Dec 5, 2022
Inspector/Inspection Supervisor
Date
Project and Contract Compliance Manager
Date
R 'alnhOuimHtP
Dec 6, 2022
*Ar
Dec 6, 2022
Date
Senior Capital Project Officer
Date
o�
Dec 6, 2022
Dec 6, 2022
Assistant Director (Dept)
Date
Director, Contracting Department (Dept)
Date
A., 1;-�<9—„►
Dec 7, 2022
.-...,-11
Dec 7, 2022
ssistant City Attorney
Date
lAssistant City Manager
Date
iz03z ��n
Dec 8, 2022
1w,„am on,o ce z0uogu
Dec 9, 2022
Council Ac
M&C Number I
ATTEST:
Jannette Goodall, City Secretary
M&C Date Approved
FORT WORTH City of Fort Worth
�'*`--- Change Order Additions
Project Name 1 2021 Bridge Rehabilitation Contract 1 City Sec # 1 56759 1 ###
Client Project # 1 103098 1
Contractorl Bridge Rehabilitation at Eight Locations I PMI Tadqul Islam Inspectorl Ozzie Ouimette I
Ragle, Inc. O1 Date 1 11/29/2022 1 4/28/2022
ADDITIONS
I I EM DESURIP I ION DtP I Oly Unit Umt (:ost I otal 1
29 - New Retrofit Plate for guardrail TPW 1.00000000 LS $8,341.89 $8,341.891
30 - New Type T1 F Steel Handrail TPW 377.00000000 LF $235.16 $88,655.321
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
TF W $96,997.211
I I
I I
I I
Sub Total Additions $96,997.211
Change Order Additions Page 2 of 4
FORTWORTH City of Fort Worth
Change Order Deletions
Project Name j 2021 Bridge Rehabilitation Contract 1 City Sec # 1 56759 ###
Client Project # 103098 1
Contractorl Bridge Rehabilitation at Eight Locations PMI Tariqul Islam I Inspector Ozzie Ouimette
Ragle, Inc. Date 1 11/29/2022 4/28/2022
ITEM DESCRIPTION
25 Replace Steel Rail
27 Railroad Coordination
28 Paving Construction Allowance
DELETIONS
DEPT
Oty
Unit
Unit Cost
Total
IPW
188.b0000000
LF
$190.0
$35,815.001
TPW
1.00000000
LS
$50,000.0 "
$50,000.001
TPW
0.22364420
LS
$50,000.00
$11,182.211
TF W $96,997.211
1
1
1
Sub Total Deletions $96,997.21 1
Change Order Deletions Page 3 of 4
M/SBE for this Change Order
M/SBE Sub Type of Service Amount for this CO
2021 Bridge Rehabilitation Contract 1
103098
Bridge Rehabilitation at Eight Locations
Total $0.00
Ragle, Inc.
Previous Change Orders
CO # DATE I AMOUNT
Total I $0.00 1
CPN 103097
RAGLEProject: Ft Worth Bridge Rehab
//VC,. Highway NA
DYI70 HIGHWAYS AND DRIDGES County Tarrant
FOR AMERIC6 Date 18-Oct-22
Change Order
Item
NEW T202 Retrofit Plates
Total
Description
Quantity UM Bid Price
1.000 LS $ 8,341.89 $
Amount
8,341.80
8,341.89
Page 1 of 2 10/18/2022 1:48 PM
CPN
103097
RAGL E
Project:
Highway
Worth Bridge Rehab
NA
/NC.
County
Tarrant
BUILDING NIONWAIS AND BRIDGES
FOR AMERICA
Date
18-Oct-22
Cost Breakdown
Quantity
Labor
1 Equipment
Materials I Supplies
Subcontract
Description
Sub Total
Quantity
UM
Unit Price
Amount
Unit Price
Amount
Unit Price Amount
I Unit Price
Amount
T202 Retrofit Plates
$ -
$
$
$
$
Labor:
Traffic Control Laberor
10.00
HR
$ 20.00
$ 200.00
$
$
$
$ 200.00
Traffic Control Foreman
10.00
HR
$ 40.00
$ 400.00
$
$
$
$ 400.00
$
$
$
$
$
Equipment:
IMP'
MIN=
Pickup Truck
10.00
HR
$ 30.62 $
306.20
$
$
$ 306.20
Crash Truck
10.00
HR
$ 40.00 $
400.00
$ 400.00
Material:
$
$
$
$
I
$
$
$
Subcontractor:
MIMEMEMENEEM
JE Casey (Retrofit Plates)
4.00
EA
$
$
$
$ 1,054.00
$ 4,216.00
$ 4,216.00
JE Casey (14 Inch Diamter Hale)
9
EA
$
$
$
$ 205.33
$ 1,847.97
$ 1,847.97
btotals Su
$ 600.00
$
706.20
$
$ 6,063.97
$ 7,370.17
Labor Insurance/Taxes
55%
$ 330.00
$ 330.00
Total Direct Costs
60.00
$ 930.00
$
706.20
$
$ 6\Q63.97
$ 7,700.17
Contractor's Markup
25%
$ 150.00
15% $
105.93
25% $
5%
$ 303.20
$ 559.13
Subtotals with Markup
$ 1,080.00
$
812.13
$
$ 6,367.17
$ 8,259.30
Bond
1.0%
$ 82.59
Total Change Request
$ 8,341.89
JEC 629-2021
BID DATE 7/21/2021
REVISION ch002
JE CASEY,LLC
DBE, SBE & HUB
DBE/SBE/MBE Certification BMDB83337YO518
HUB Certification Number 1463368581400
629-2021 TARRANT CITY OF FT WORTH 2O21 BRIDGE REHAB 103098
Unit
Bid Item Description UM QTY Price Extended
********* CHANGE ORDER ***********
5406007 MTL BEAM GD FEN TRANS (TL2)CH002 - T202 Retrofit Plates - required b/c
wingwall is only 28 in EA 4.00 1054.00 4216.00
LINE 1 CH002 - CORE DRILL 14 INCH DIAMETER HOLE, LEAVOUT IN RIPRAP AS REQUIRED
FOR POST PLACEMENT EA 9.00 205.33 1847.97
TOTAL $6,063.97
Terms
All freight and all material INCLUDED, unless noted otherwise
FURNISH AND INSTALL, unless noted otherwise
STEEL portion of rail ONLY, concrete by others
All material is stored at jobsite at the expense of other
All permits provided by other
Safety cable and installation provided by others when required
Traffic Control provided by other
Grading provided by others
All concrete drilling is performed by hammer drilling, unless noted otherwise
Rail installation will follow grade unless noted otherwise
Any product modification shall be handled by contractor, unless noted otherwise
If material is supplied by other, JEC is not resposible for material quantity, inspection, compliance, workmanship, offloading, nor rail
placement. If equipment available, but no operator, JEC will provide equipment operator at cost.
N
Installation schedule shall not be influenced by construction of mow strip, sidewalk, signs, curb, or any other construction task, which can
prohibit JEC installation.
Any location which does not allow for use of skid steer to install, due to height, grade, etc.., contractor is repsonible for providing
adequate equipment to perform work
CCA's unit price DO NOT INCLUDE concrete pad unless noted otherwise.
FHWA equipment rental bluebook rate supplied by contractor
This quote is valid for 30 days from date quoted.
Prices do not include state or local sales or use taxes, should any apply.
Prices quoted are FOB jobsite (unless noted otherwise) with full freight allowed.
Upon credit approval, terms are COD with 1.1% late charge for accounts past 1 day.
Out of state orders are required to pay 50% down & 50% upon delivery of material pending credit approval
Terms apply to partial shipments.
Quote is to be taken as a whole. Changes in quantities, elimination and/or addition of line items may affect unit prices at JEC's discretior
John Casey Accepted By
469-316-6851 Organization
iohn casev(&iecinstall.com Requested Date
RAGLE
C P N
Project:
103097
Ft Worth Bridge Rehab
liv .
Highway
NA
6YlLDINO HIGHWAYS AMP BRIDGES
County
Tarrant
FOR AMERICA
Date
07-Nov-22
Change Order #
Item Description
Quantity UM Bid Price
Amount
1 REPLACE (STEEL RAIL) - NEW ITEM FOR E SEMINARY
377.000 LF $ 235.16
$
88,655.05
2 REPLACE (STEEL RAIL) - OMMIT ORIGINAL ITEM
-188.500 LF $ 190.00
$
(35,815.00)
Total
$
52,840.05
Page 1 of 2 11/7/2022 5:02 PM
RAGLE
INC.
UILDING NIGH,- AND BRIDGES
R ANIERICA
Replace Rail B E Seminary
CPN
103097
Project:
Worth Bridge Rehab
Highway
NA
County
Tarrant
Date
07-Nov-22
Description
Quantity Labor
I Equipment
Materials 1 Supplies
Subcontract
Sub Total
M Unit Price Amount
Unit Price I Amount
Unit Price Amount
Unit Price Amount
Rem 1 $ $ - $ - $ $ -
Labor:
structures Laberor
Structures Laberor
Structures Laberor
Structures Laberor
Structures Foreman
Equipment:
Pickup Truck
Material:
Rail (GSI)
Subcontractor:
Subtotals
Labor Insurance/Taxes
Total Direct Costs
Contractor's Markup
Subtotals with Markup
Bond
Total Change Request
bU.UU HK $ 3U.UU $ 1,bUU.UU $ $ $ $ 1,buu.UU
50.00 HR $ 30.00 $ 1,500.00 $ $ $ $ 1,500.00
50.00 HR $ 30.00 $ 1,500.00 $ $ $ $ 1,500.00
50.00 HR $ 30.00 $ 1,500.00 $ $ $ $ 1,500.00
$ 8,000.00 $ 1,531.00 $ 57,293.30 $ $ 66,824.30
55% $ 4,400.00 $ 4,400.00
160.00 $ 12,400.00 $ 1,531.00 $ 57,293.30 $ $ 71,224.30
25% $ 2,000.00 15% $ 229.65 25% $ 14,323.33 5% $ $ 16,552.98
$ 14,400.00 $ 1,760.65 $ 71,616.63 $ $ 87,777.28
1.0% $ 877.77
$ 88,655.05
GSI Highway Products
720 W Wintergreen Road
Hutchins, TX 75141 USA
Phone: (972)225-1660
Fax: (972)225-6662
SBE Vendor number 11092
What we build here SAVES LIVES!
Attention: Maqsood Khan
Makou, Inc.
7100 S. Cooper Street
Suite 15
Arlington, TX 76001
Phone: 817-798-5426
Fax: 817-494-0404
July 22, 2021
2021 Bridge Rehab Contract 1 103098
Bid Item
Line: 4
Line: 5
HIGHWAY PRODUCTS
Quote No:
23704ADD2
Thursday, November 3, 2022
Page 1 of 2
TERMS: No Terms Established
Prepay and Add FOB: GSI YARD
Ship Payment Type: Prepay and Add
Fort Worth, TX.
Quantity Price Description
189.00 LF 149.85000 T1 F Alum/Steel Rail
1T1F-LF STD Galvanized
Galvanized Steel Post with Anodized Aluminum Rails. Excludes Epoxy.
1.00 EA 325.00000 Outbound Freight
FREIGHT REV1
Per Delivery. Estimate Only- Subject to change at time of Shipment.
Salesperson: Reece, Steve Quote Total.•
Prices are Valid Until Saturday, December 3, 2022
Extended
$28,321.65
$325.00
$28,646.65
GSI Highway Products _
720 W Wintergreen Road
Hutchins, TX 75141 USA
Phone: (972) 225-1660 HIGHWAY PRODUCTS
Fax: (972)225-6662
SBE Vendor number 11092 Quote NO: 23704ADD2
What we build here SAVES LIVES! Thursday, November 3, 2022
Page 2 of 2
*This offer stipulates that delivery may be made in ONE SHIPMENT, any additional shipment
changes or events will result in additional freight and handling charges per event and is
governed by the terms and conditions below.
1. Unless noted otherwise, prices quoted are FOB as per above and do not include state or
local sales or use taxes should any apply.
2. All material is estimated as being built in the most efficient manner for GSI; should
contractor require the project to be built on a per structure basis a change order will apply.
3. GSI will store material up to the agreed upon ship date, any storage beyond that date will
incur storage fees.
4. GSI reserves the right to request progress payments. Contractor's P.O. must specifically
allow progress payments. GSI's normal terms, stated below, will apply.
5. If drawings and/or material take -offs are to be submitted, no work shall commence on
fabrication until full approval has been received. Submittals must be returned within 45 days of
submission to maintain pricing for project. Any changes from original plans and specifications
will consider the project canceled unless a proper change order has been executed. GSI
CANNOT PROMISE ANY FIRM COMPLETION DATES UNTIL A FULL APPROVAL IS GIVEN ON ANY
NECESSARY SUBMITTALS.
6. Terms are as listed above, with a 1 1/2% per month late charge for accounts past the listed
term. Terms apply to partial shipments and progress payments. Payments are to be made at
720 West Wintergreen Rd, Hutchins Texas 75141. Customers with established credit terms with
GSI may opt to pay with a credit card, however, 1-1/2% interest will be calculated from the
date of shipment.
7. Freight is an Estimate Only- given our best efforts and may change. Freight charges will be
at our cost +15% handling fee. Subject to change at time of Shipment.
8. A restocking Fee of 25% will be charged for any material returned in the same condition as
sold, after material staging or booking.
9. Due to the volatility of the materials and steel markets, all GSI project prices in this
proposal are firm for acceptance within 30 days of quotation date.
10. Should the base material and or steel cost increase by more than 2% between the time of
quote, and the time of shipment, then the difference in excess of 2% will be evidenced and
charged directly to the client.
11. No addenda are acknowledged unless otherwise noted.
SPECIAL NOTES: Subject to material availability.
SBE Vendor number 11092
Accepted By:
Company:
Requested Delivery Date:
FORTWORTH.
M,
TRANSPORTATION AND PUBLIC WORKS
April 4, 2023
Ragle,lnc
9003 Airport Fwy # G270
North Richlnd Hills, Texas 76180
RE: Acceptance Letter
Project Name: 2021 Bridge Rehabilitation, Contract 1
Project Type: Bridge Rehab
City Project No.: 103098
To Whom It May Concern:
On April 4, 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 April 4, 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 817-
392-2486.
Sincerely,
Tariqul islam (May 24, 2023 14:20 CDT)
Tariqul Islam, Project Manager
Cc: Patrick Jones, Inspector
Donald Watson, Inspection Supervisor
Aaron Ybarra, Senior Inspector
Omar Elbagalati, Program Manager
Thomas G. Ashcraft, Consultant
Ragle , Inc, Contractor
City of Fort Worth, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 08/20/19
(To be executed prior to acceptance of project)
STATE OF TEXAS CITY OF FORT WORTH
Personally, before me the undersigned authority, on this day appeared
Trov A. Racile , who, being duly sworn, on oath, says that he is a legal representative
of
Ragle Inc.
and that the contract for the construction of the project, designated as
2021 Bridge Rehabilitation Contract 1; City Project No.103098
has been satisfactorily completed and that all bills for materials, apparatus, fixture, machinery and labor
used in connection with the construction of this project have, tothe best of my knowledge and belief,
been fully paid.
ignature
Vice President
Title
r�
Sworn to and subscribed before me this Z 3 day of A
Notary Public in d for
- t..,/ � ICA-I County Texas
ABP-1
2023
'4 MATTHEW A. HALLMAN
#� Notary Put gic, State of taxaa
' mac Comm. Explr" O6-20,2026
'', Notary ID 133920695
CONSENT OF SURETY
TO FINAL PAYMENT
AM Document G707
Bond No. 9388761
TO O\VN1;R:
(Minna mrd ad(brrr)
City of Fort Worth
200 Texas Street
Fort Worth, TX 76180
PROJECT:
(nla naand-khwso
OWNER
ARCHITRCr
CONTRACTOR
SURETY
OTHER
ARCHITECT'S PROJECT NO.:
CONTRACT FOR: Bridge Work
CONTRACT DATED: September 14, 2021
2021 Bridge Rehabilitation Contract 1, City Project Number 103098
In accordance with the provisions of the Contract between the Owner and the Contractor as Indicated above, the
flaw►tmmtendw0mmofa r9l
Colonial American Casualty and Surety Company/
Fidelity and Deposit Company of Maryland
1299 Zurich Way, 5th Floor
Schaumburg, IL 60196-1056
on bond of
Unwn rtarne and addm; gr0wimaur)
Ragle, Inc.
P.O. Box 444
Newburgh, IN 47629
I
SURF.IY,
, CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of
any of its obligations to
Uoawrr nameamd addrw gouwer)
City of Fort Worth
200 Texas Street
Fort Worth, TX 76180
as set forth in said Surety's bond.
IN V NESS WHERECIP, the ,%rely has hereunto set its hand on this date: May 12, 2023
(Inver! 101a-PiNiW1bw nMtbJWAW% d hV rbr n om.-(e darn an(l mmar.)
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c•'' Vey.d¢y a.70.
SEAL`��r'
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OWNER,
Colon al American Casualty and Surety Company.'
Fidelity and Deposit Company of Maryland
(S?nrYY)
By' -
(SZgrmturr grarnbotitad rrprra!ntafirrl
Debra Hutts
(Mtnlw( rrarur and &1t)
Attorney -in -Fact
0707-1994
Bond Number: 9388161
Obligee Citv of Fort Worth
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY TI il:SF PRI•:SLN I'S: l'hat the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY
AND DEPOSIT COMPANY OI' MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert
1). Murray, Vice President, in pursuance of authority granted by Article V. Section 8, of the By -Laws of said Companies, which arc set forth on
the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint
Debra Hutt s , its true and lawful agent and Attorney-in-l-act, to make. execute. seal and deliver, for,
and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in
pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly
executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,
New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURti fY COMPANY at its office in Owings
Mills, Maryland.. and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings
Mills, Maryland., in their own proper persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8. of the
By -Lams of said Companies, and is nDm in force.
IN WITNESS W14EREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 18th day of April, A.D. 2023.
„aaairnr�rr �snaar�r�+y y �,•asr� 3
G0
SEAL SEAL -s , (�io
�sy SEAL
X+eaq ,ff
A r` y'y 11dnOati ��
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COI.ONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
By: Robert D. Murray
Vice President
�GLt'tht, � {LyL�
By: Dawn E. Brower
Secretary
State of Maryland
County of Baltimore
On this 181h day of April. A.D. 2023, before the subscriber, a Notary Public of the State of Maryland. duly commissioned and qualified,
Robert D. Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and sailh. that
he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument arc the Corporate Seals ofsaid Companies, and that
the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said
Corporations.
W 'i'IisTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and ycar first above written.
Ira J,,�L�G
My Cnmmisam Espira September 30. 2023
Authenticity of this bond can be confirmed at bondvalidator,zurichna.com or 410-559-8790
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V, Section 8, Attornc)s-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds. policies.
recognirances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such
attorney -in -fact to affix the corporate seal thcrelo: and may with or without cause modify of revoke any such appointment or authority at any
time."
CERTIFICATE
1, the undersigned. Vice President of theLURICII AMERICAN INSURANCI: COMPANY, the COLONIAL AMERICAN
CASUAL;rY AND SURETY COMPANY, and the FIDliLITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certib, that the
foregoing Power of Attorney is still in full force and effect on the date of this certificate: and I do further certify that Article V. Section 8, of
the By -Laws of the Companies is still in force.
This E'ower of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICI I AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998.
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seal of the Company may be affixed by facsimile on any flower of Altorney...Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of
May, 1994. and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY Of- MARYLAND at a
meeting duly called and held on the loth day of May, 199o.
RESOLVED: ""I hat the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature
of any Vice -President. Secretary, or Assistant Secretary of the Company, whether made heretofore or hercalicr, wherever appearing upon a
certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company �% ith the same force and effect
as though manually affixed.
IN TESTIMONY WHEREOF. I have hereunto subscribed my name and affixed the corporate seats of the said Companies.
this 12th day of May , 2023
m
By: Mary Jean Pethick
Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO:
Zurich Surety Claims
1299 Zurich Way
Schaumburg, 1L 60196-1056
renottsfclaims0zurichna.com
800-626-4577
Authenticity of this bond can be confirmed at bondvalidator.zurichnn.com or 410-559-8790
(To be executed prior to acceptance of project)
STATE OF TEXAS CITY OF FORT WORTH
Personally, before me the undersigned authority, on this day appeared
Trov A. Racile , who, being duly sworn, on oath, says that he is a legal representative
of
Ragle Inc.
and that the contract for the construction of the project, designated as
2021 Bridge Rehabilitation Contract 1; City Project No.103098
has been satisfactorily completed and that all bills for materials, apparatus, fixture, machinery and labor
used in connection with the construction of this project have, tothe best of my knowledge and belief,
been fully paid.
ignature
Vice President
Title
r�
Sworn to and subscribed before me this Z 3 day of A
Notary Public in d for
- t..,/ � ICA-I County Texas
ABP-1
2023
'4 MATTHEW A. HALLMAN
#� Notary Put gic, State of taxaa
' mac Comm. Explr" O6-20,2026
'', Notary ID 133920695
CONSENT OF SURETY
TO FINAL PAYMENT
AM Document G707
Bond No. 9388761
TO O\VN1;R:
(Minna mrd ad(brrr)
City of Fort Worth
200 Texas Street
Fort Worth, TX 76180
PROJECT:
(nla naand-khwso
OWNER
ARCHITRCr
CONTRACTOR
SURETY
OTHER
ARCHITECT'S PROJECT NO.:
CONTRACT FOR: Bridge Work
CONTRACT DATED: September 14, 2021
2021 Bridge Rehabilitation Contract 1, City Project Number 103098
In accordance with the provisions of the Contract between the Owner and the Contractor as Indicated above, the
flaw►tmmtendw0mmofa r9l
Colonial American Casualty and Surety Company/
Fidelity and Deposit Company of Maryland
1299 Zurich Way, 5th Floor
Schaumburg, IL 60196-1056
on bond of
Unwn rtarne and addm; gr0wimaur)
Ragle, Inc.
P.O. Box 444
Newburgh, IN 47629
I
SURF.IY,
, CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of
any of its obligations to
Uoawrr nameamd addrw gouwer)
City of Fort Worth
200 Texas Street
Fort Worth, TX 76180
as set forth in said Surety's bond.
IN V NESS WHERECIP, the ,%rely has hereunto set its hand on this date: May 12, 2023
(Inver! 101a-PiNiW1bw nMtbJWAW% d hV rbr n om.-(e darn an(l mmar.)
,�`OrZ . QP Oq •• ��
,`°iUSEALm a E
•., Peso
r ,J, I nots „l````'
c•'' Vey.d¢y a.70.
SEAL`��r'
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OWNER,
Colon al American Casualty and Surety Company.'
Fidelity and Deposit Company of Maryland
(S?nrYY)
By' -
(SZgrmturr grarnbotitad rrprra!ntafirrl
Debra Hutts
(Mtnlw( rrarur and &1t)
Attorney -in -Fact
0707-1994
Bond Number: 9388161
Obligee Citv of Fort Worth
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
POWER OF ATTORNEY
KNOW ALL MEN BY TI il:SF PRI•:SLN I'S: l'hat the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New
York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY
AND DEPOSIT COMPANY OI' MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Robert
1). Murray, Vice President, in pursuance of authority granted by Article V. Section 8, of the By -Laws of said Companies, which arc set forth on
the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint
Debra Hutt s , its true and lawful agent and Attorney-in-l-act, to make. execute. seal and deliver, for,
and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in
pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly
executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,
New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURti fY COMPANY at its office in Owings
Mills, Maryland.. and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings
Mills, Maryland., in their own proper persons.
The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8. of the
By -Lams of said Companies, and is nDm in force.
IN WITNESS W14EREOF, the said Vice -President has hereunto subscribed his/her names and affixed the Corporate Seals of the said
ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 18th day of April, A.D. 2023.
„aaairnr�rr �snaar�r�+y y �,•asr� 3
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SEAL SEAL -s , (�io
�sy SEAL
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A r` y'y 11dnOati ��
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COI.ONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
By: Robert D. Murray
Vice President
�GLt'tht, � {LyL�
By: Dawn E. Brower
Secretary
State of Maryland
County of Baltimore
On this 181h day of April. A.D. 2023, before the subscriber, a Notary Public of the State of Maryland. duly commissioned and qualified,
Robert D. Murray, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and sailh. that
he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument arc the Corporate Seals ofsaid Companies, and that
the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said
Corporations.
W 'i'IisTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and ycar first above written.
Ira J,,�L�G
My Cnmmisam Espira September 30. 2023
Authenticity of this bond can be confirmed at bondvalidator,zurichna.com or 410-559-8790
EXTRACT FROM BY-LAWS OF THE COMPANIES
"Article V, Section 8, Attornc)s-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President
may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds. policies.
recognirances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such
attorney -in -fact to affix the corporate seal thcrelo: and may with or without cause modify of revoke any such appointment or authority at any
time."
CERTIFICATE
1, the undersigned. Vice President of theLURICII AMERICAN INSURANCI: COMPANY, the COLONIAL AMERICAN
CASUAL;rY AND SURETY COMPANY, and the FIDliLITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certib, that the
foregoing Power of Attorney is still in full force and effect on the date of this certificate: and I do further certify that Article V. Section 8, of
the By -Laws of the Companies is still in force.
This E'ower of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the ZURICI I AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998.
RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary
and the Seal of the Company may be affixed by facsimile on any flower of Altorney...Any such Power or any certificate thereof bearing such
facsimile signature and seal shall be valid and binding on the Company."
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of
Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of
May, 1994. and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY Of- MARYLAND at a
meeting duly called and held on the loth day of May, 199o.
RESOLVED: ""I hat the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature
of any Vice -President. Secretary, or Assistant Secretary of the Company, whether made heretofore or hercalicr, wherever appearing upon a
certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company �% ith the same force and effect
as though manually affixed.
IN TESTIMONY WHEREOF. I have hereunto subscribed my name and affixed the corporate seats of the said Companies.
this 12th day of May , 2023
m
By: Mary Jean Pethick
Vice President
TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION
OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT
INFORMATION TO:
Zurich Surety Claims
1299 Zurich Way
Schaumburg, 1L 60196-1056
renottsfclaims0zurichna.com
800-626-4577
Authenticity of this bond can be confirmed at bondvalidator.zurichnn.com or 410-559-8790