HomeMy WebLinkAboutContract 57697-FP1-FP1
FORT WORTH.
City Secretary
Contract No. 57697
Date Received 06/12/2023
AT
NOTICE OF PROJECT COMPLETION
(Developer Projects)
The Transportation and Public Works Department upon the recommendation of the Project
Manager has accepted the following project as complete:
Project Name: Edwards Ranch — HOTR Addition
City Project No: 103853
Improvement Type(s): Water x❑
Original Contract Price:
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete:
� �
Mor^a McGlothlin (J 9. 202308:01 CDT)
Contractor
Project Manager
Title
Spawglass Contractors, Inc.
Company Name
P roj-e,,Aq�
c-.t./Inspector
(/
Project Manager
Rebecca Diane Owen (Jun 12. 202308:05 CDT)
CFA Manager
_Z
I auren PneurlJun 12, 202308:57 CDT)
TPW Director
Willi-, Johns—f A I?J02314-9?CinI1
Asst. City Manager
Sewer x❑
Jun 9, 2023
Date
Jun 9, 2023
Date
Jun 9, 2023
Date
Jun 12, 2023
Date
Jun 12, 2023
Date
Jun 12, 2023
Date
$21,867.48
$7,271.50
$29,138.98
$29,138.98
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Page 1 of 2
Notice of Project Completion
Project Name: Edwards Ranch — HOTR Addition
City Project No.: 103853
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑x Yes ❑ N/A
Pipe Report: ❑x Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time 15 WD
Days Charged: 32
Work Start Date: 9/22/2022 Work Complete Date: 11/21/2022
Soil Lab Number of Tests: 21
Water Number of Tests: 3
Page 2of2
FoRTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name EDWARDS RANCH CLEARFORK - HOTR ADDITION - EXPRESS CFA
Contract Limits
Project Type WATER & SEWER
City Project Numbers 103853
DOE Number 3853
Estimate Number 1 Payment Number 1 For Period Ending 11/21/2022
WD
City Secretary Contract Number Contract Time 1WD
Contract Date 8/1/2022 Days Charged to Date 32
Project Manager NA Contract is 100.00 Complete
Contractor SPAWGLASS CONTRACTORS, INC
1000 WEST MAGNOLIA AVENUE
FORT WORTH, TX 76104
Inspectors CORDOVA / KOONCE
Wednesday, April 19, 2023 Page 1 of 4
City Project Numbers 103853 DOE Number 3853
Contract Name EDWARDS RANCH CLEARFORK - HOTR ADDITION - EXPRESS CFA Estimate Number I
Contract Limits Payment Number 1
Project Type WATER & SEWER For Period Ending 11/21/2022
Project Funding
UNIT I: WATER IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
1
4"-12" PRESSURE PLUG
1 EA
$625.00
$625.00
1
$625.00
2
TRENCH SAFETY (CO #1)
40 LF
$6.25
$250.00
40
$250.00
3
DUCTILE IRON WATER FITTINGS
0.25 TN
$1,062.50
$265.63
0.25
$265.63
4
6" PVC WATER PIPE (CO #1)
0 LF
$56.25
$0.00
0
$0.00
5
8" PVC WATER PIPE
20 LF
$68.75
$1,375.00
20
$1,375.00
6
CONNECTION TO EXISTING 8" WATER MAIN
1 EA
$1,937.50
$1,937.50
1
$1,937.50
7
1" WATER SERVICE
l EA
$2,235.00
$2,235.00
1
$2,235.00
8
6" GATE VALVE
1 EA
$1,573.75
$1,573.75
1
$1,573.75
9
UTILITY SERVICE RESTORATION SODDING
140 SY
$10.54
$1,475.60
140
$1,475.60
10
6" DIP WATER PIPE (CO #1)
20 LF
$124.45
$2,489.00
20
$2,489.00
11
20" CASING BY OPEN CUT (CO #1)
20 LF
$286.00
$5,720.00
20
$5,720.00
Sub -Total of Previous Unit $17,946.48 $17,946.48
- - - - - - - - - - - - - - - - - - -
UNIT 11: SANITARY SEWER IMPROVEMENTS
Item
Description of Items
Estimated Unit
No.
Quanity
----------------------
1
8" SEWER SERVICE CONNECTION
1 EA
2
POST CCTV INSPECTION
1 EA
3
MANHOLE VACUUM TESTING
1 EA
4
TRENCH SAFETY
10 LF
5
CONCRETE COLLAR
1 EA
6
UTILITY SERVICE RESTORATION SODDING
12 SY
7
EPDXY MANHOLE LINER
7 VF
8
4' MANHOLE
1 EA
----------------------
Sub -Total of Previous Unit
Unit Cost Estimated Completed Completed
Total Quanity Total
-----------------
$1,573.75 $1,573.75 1 $1,573.75
$125.00 $125.00 1 $125.00
$437.50 $437.50 1 $437.50
$6.25 $62.50 10 $62.50
$625.00 $625.00 1 $625.00
$12.50 $150.00 12 $150.00
$93.75 $656.25 7 $656.25
$7,562.50 $7,562.50 1 $7,562.50
$11,192.50 $11,192.50
Wednesday, April 19, 2023 Page 2 of 4
City Project Numbers 103853 DOE Number 3853
Contract Name EDWARDS RANCH CLEARFORK - HOTR ADDITION - EXPRESS CFA Estimate Number I
Contract Limits Payment Number 1
Project Type WATER & SEWER For Period Ending 11/21/2022
Project Funding
Contract Information Summary
Original Contract Amount $21,867.48
Change Orders
Change Order Number 1 $7,271.50
Total Contract Price $29,138.98
Total Cost of Work Completed $29,138.98
Less % Retained $0.00
Net Earned $29,138.98
Earned This Period $29,138.98
Retainage This Period $0.00
Less Liquidated Damages
Days @ / Day
LessPavement Deficiency
Less Penalty
Less Previous Payment
Plus Material on Hand Less 15%
Balance Due This Payment
$0.00
$0.00
$0.00
$0.00
$0.00
$29,138.98
Wednesday, April 19, 2023 Page 3 of 4
City Project Numbers 103853 DOE Number 3853
Contract Name EDWARDS RANCH CLEARFORK - HOTR ADDITION - EXPRESS CFA Estimate Number I
Contract Limits Payment Number 1
Project Type WATER & SEWER For Period Ending 11/21/2022
Project Funding
Project Manager NA
Inspectors CORDOVA / KOONCE
Contractor SPAWGLASS CONTRACTORS, INC
1000 WEST MAGNOLIA AVENUE
FORT WORTH, TX 76104
City Secretary Contract Number
Contract Date
8/l/2022
Contract Time
15 WD
Days Charged to Date
32 WD
Contract is .000000
Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of Work Completed $29,138.98
Less % Retained $0.00
Net Earned $29,138.98
Earned This Period $29,138.98
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 / Day
$0.00
LessPavement Deficiency
$0.00
Less Penalty
$0.00
Less Previous Payment
$0.00
Plus Material on Hand Less 15%
$0.00
Balance Due This Payment
$29,138.98
Wednesday, April 19, 2023 Page 4 of 4
PROJECT NAME:
CONTRACT:
CFA #
CITY PROJECT #
DOE #
WATER PROJECT #
SEWER PROJECT #
FILE #
INSPECTOR:
PROJECT MANAGER:
I ORIGINAL CONTRACT
EXTRAS TO DATE
(CREDITS TO DATE
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
Edwards Ranch Clearfork - HOTR Addition
22-0039 CITY PARTICIPATION: No
103853
IPRC 21-0167
FID NO. 30114-0200431-103853-EO7685
X-27186 / W-2802
Jeremy Koonce Phone No
Andrew Goodman Phone No:
I
WATER
Developer
Cost City Cost
$10,674.98
CONTRACT TO DATE
$10,674.98
$0.00
AMOUNT OF PROP. CHANGE ORDER
$7,271.50
(REVISED CONTRACT AMOUNT
$17,946.48
$0.00
TOTAL REVISED CONTRACT
AMOUNT PER UNIT
$17,946.48
REVISED COST SHARE
Dev. Cost:
TOTAL REVISED CONTRACT
SEWER
Developer
Cost City Cost
$11,192.50
$11,192.50 $0.00
$11,192.50 $0.00
$11,192.50
$31,136.48
817-392-625'
CONTRACT UNIT
PAVING
Developer
Cost City Cost
$1,997.50
$1,997.50 1 $0.00
$1,997.60 1 $0.00
$1,997.50
City Cost:
$31,136.48
CHANGE
ORDER No:
1
DRAINAGE
Developer
Cost City Cost
REVIEWED
By Andrew Goodman at 11:24 am, Nov 22, 2022
I
STREET LIGHTS I CONTRACT
Developer DAYS
Cost City Cost
120
$0.00
$0.00
$0.00
$0.00
$0.00 I 120
$0.00 I 120
$0.00
Revised: 10-12-2011 Page 1
REVIEWED
By Andrew Goodman at 11:24 am, Nov 22, 2022
You are directed to make the following changes in the contract documents
WATER
CITY BID ITEM
PAY ITEM #
#
QUANTITY
UNIT
ITEM DESTRIPTION
UNIT PRICE
TOTAL
2
3305.0109
12
LF
Trench afety
$6.25
$75.00
4
3311.0111
-18
LF
6" Water Pipe
$56.25
-$1,012.50
NEW ITEM
3311.0151
20
LF
6" DIP Water Pipe
$124.45
$2,489.00
NEW ITEM
3305.1003
20
LF
20" Casing_ By Open Cut
$286.00
$5,720.00 1
TOTAL
$7,271.50 1
REASONS FOR CHANGE ORDER
1 Revise locations of water meters to opposite side of entrance driveway. Additional Easement and Encroachment Agreement filed for this change order.
CITY FUNDS ARE NOT INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100% OF THIS CHANGE ORDER COST AND
NO REIMBURSEMENT FROM THE CITY WILL BE SOUGHT BY THE DEVELOPER.
Signatures on Next Page
Revised: 10-12-2011 Page 2
You afe crkwfed ra ffksk* Me fd0&wIrt9 chungcs In 1h9 GpnCa* doanrr_ I%.
WATER
PRY IWAI0
GUON-I Y
Mir
7
33D5.D1Ct4
12
F I
d
3311.D111
_16 i....
f HEYf ITEi41
, 3311_D151
30
�
t ley/ ITeA
33C571003
20 — LF�
tIEll! ^err.'ICN
imrcfi Safaiv
Sa Wmar P!
Ba DIP 1YW .
21YGa.ne By'=^_nut
l REVIEWED 1
lBy ~n Goodman at 11:24 am, Nov 22, 2022 J
UNII PRIG: I T WAL,
k S6.75
375.DIi
1 S56.25 I
S12t.45 _
I
5r:.d89.t:D
I S286.W
S5.72040
1
37 31.60
REASSMIS FOR CHANGE 0R0rxR
T Rewd!9 Iocaffuns of m'mtr melets Jo •mpoVm ;,."a of mifwce zW"vmy. AdSti yW casanxrl and Er,-oachmNn' AW-tvAnW Red. 9r Aig rhmpe 010ar'
CITY FUNDS ARE WOS rNVOLVED 1N TI" CONTRACT. OMLOPER 15 RESPONSIBLE FOR 190% OF THI9 CHANGE ORDER COST AND
NO REIMBURSEMPNT FROM THE CFTYVALL BE S+04 GHT e1V THE OeVEiO ER. A.
RECOMMENDED;
Nerne:
f %P"fow&
F&wisad. 10-12-231 t
TidefEf��iY`
61r_!✓ U ..
r� org. n McGlothlin
T,,tL Project Manaqer
FORT WORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: Edwards Ranch - Heart of the Ranch Addition
CITY PROJECT NUMBER: 103853
WATER
PIPE LAID SIZE TYPE OF PIPE LF
C-900 8" PVC 20
DIP 6" DIP 20
FIRE HYDRANTS: N/A
PIPE ABANDONED
DENSITIES:
NEW SERVICES:
I
PIPE LAID
PIPE ABANDONED
DENSITIES:
NEW SERVICES:
SIZE
1
SIZE
SIZE
4"
VALVES (16" OR LARGER) N/A
TYPE OF PIPE LF
Yes
Copper
SEWER
TYPE OF PIPE
TYPE OF PIPE
Yes
PVC
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
LF
LF
1 EA.
1 EA.
FORT WORTH,
TRANSPORTATION AND PUBLIC WORKS
February 28, 2023
SpawGlass Contractors Inc.
100 West Magnolia Avenue
Fort Worth, TX 76104
RE: Acceptance Letter
Project Name: Edwards Ranch — Heart of the Ranch Addition
Project Type: Developer
City Project No.: 103853
To Whom It May Concern:
On November 21, 2022 a final inspection was made on the subject project. There were punch list items
identified at that time. The punch list items were completed on January 17, 2023. The final inspection
and the corrected punch list items indicate that the work meets the City of Fort Worth specifications and
is therefore accepted by the City. The warranty period will start on January 17, 2023, which is the date
of the punch list completion and will extend of two (2) years in accordance with the Contract
Documents.
If you have any questions concerning this letter of acceptance, please feel free to contact me at
Jeremy.Koonce@FortWorthTexas.gov.
Sincerely,
C'J"'
Andrew Goodman, Project Manager
Cc: Jeremy Koonce, Inspector
Gary Deyon, Inspection Supervisor
Gary Deyon, Senior Inspector
Victor Tornero, Program Manager
Peloton Land Solutions, Consultant
SpawGlass Contractors, Inc., Contractor
Meta Alice Keith Bratten Foundation, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
AFFIDAVIT
STATE OF Texas
COUNTY OF Tarrant
Before me, the undersigned authority, a notary public in the state
and county aforesaid, on this day personally appeared Morgan McGlothlin
SpawGiass 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;
Water, Sewer, and Storm
HOTR Addition
' r
to ''err Edwards Ranch Clearfork
1'
Project Manager
Subscribed and sworn before me on this date Day of Month, Year
a, 00Alme-dbr RobertD
f My Commission
i. 12rsr2o2
' Notarryy 13347$35
Notary Publics
County, State Tarrant County, Texas
19th Day of May, 2023
CONSENT OF SURETY COMPANY
TO FINAL PAYMENT
PROJECT: Community Facilities Agreement
CFA No: 22-0039
TO (Owner): Meta Alice Keith Bratten Foundation (Developer)
& the City of Fort Worth, Texas
CONTRACTOR: SpawGlass Contractors, Inc.
BOND NO.: K40 53 3928 (Federal)
58S216531(Liberty Mutual)
CONTRACT DATED: July 13, 2022
FINAL CONTRACT: $23,86498
BOND DATE: August 15, 2022
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the
FEDERAL INSURANCE COMPANY; LIBERTY MUTUAL INSURANCE COMPANY
15 Mountain View Road 175 Berkeley Street
Warren, NJ 07059 Boston, MA 02116 , SURETY,
on bond of
SPAWGLASS CONTRACTORS, INC.
1000 W. Magnolia
Fort Worth, Texas 76104
,CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that such final payment to the Contractor shall
not relieve the Surety of any of its obligations to
Meta Alice Keith Bratten Foundation (Developer)
& City of Forth Worth, Texas
OWNER,
as set forth in the said Surety's bond.
IN WITNESS WHEREOF, the Surety has hereunto set its hand this 5' day of June, 2023.
Witness: W4--�
Michael Berry !I
FEDERAL INSURANCE COMPANY;
LIBERTY AL INSURANCE COMPANY
John . Prince, Attorney -in -Fact
CHUE3S'
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, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY corporations of the
Commonwealth of Pennsylvania, do each hereby constitute and appoint Andrew A. Adams, Norman E. Adams, Michael Macomber, John A. Prince and
LarryD. Snider of Houston, Texas --- ----- ----------------------------- --------------- ------------------------------------------------------- -------------- -----------------------
each as their true and lawful Attorney,ln-Fact to execute under such designation in their [tames and to afro: their corporate seals to and deliver for and on their behalf as surety
thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the coarse of business, and any
instruments amending or altering the same, and consents to the modification or alteration ofany 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 1" day of June, 2020.
Dawn XI, Chlttrcis, Asw' ant Secretary
STATE OF NEW JERSEY
County of Hunterdon
7& Vq
Stelft, i MA kincy. Via: President
* Kido 0 * �4 (21 V
On this 1" day of June, 2020 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] * KATHERINB j. ADELAAR
t'bPY F NOTARY PUBLIC OF NEW JERS Y �
Na. 2318685
At18L4� C40Wnh9$0n r-xplrea July 18, 2024 YmaryPuDlk
CERTIFICATION
Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016;
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 on behalf orthe Company, of bonds, undertakings, recogrtlzances, contracts and other written commitments of the Company
entered into to the ordinary course of business (each a "Wrinen Commitmeml:
(1) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized to execute any Written Commitment for and on behalrof the Company, under the
seal of the Company or otherwise.
(2) Each duly appointed attorney-m-fact of the Company is hereby authorized to execute any Written Commitment for 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 appuinmaent as such attorney -in -lam
(3) Each of the Chairman, the President and the Vice Presidents ofthe Companyisherebyauthorized.for and on Whaifof the Company, toappomiinwriting any person the attorney -
in -fact of the Company with full power and authority to execute, for and on behalf of the Company, under the seal of the Company or otherwise, such Written Corsunitments of the
Company astray he specified in such written appointment, which specification may be by general type or class, of Written Commitments or by specification of one or more particular
Written Commitments.
(4) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, ferandon behalf ofthe Company, to delegate in writing to any other officer ofthe
Company the authority to execute, for and on behalf of the Company, under the Company's seal or otherwise, 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 or more particular Written Coninaltments.
(5) The signature of any officer or other person executing any Written Corount rrient or appointment or 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.
FURTHERRESOLVED, that the foregoing Resolution shall not he deemed to be an exclusive statement of the powers and authority of officers, employees and other persons to act for and on behalf of
the Company. and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise valldlygranted at vested."
1, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE
INSURANCE COMPANY and ACE A IERICAN 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 frill 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, M, this 5#h day of June, 2023 ,..++�'" "•
"�'" •^' � lktwti 11, F lt#tl*h
IN THE EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OF ANY OTHER MATTER. PLEASE CONTACT GS AT.' - . + �Iy
Telenhone(908)903-3493 Fax (9%1903-36S6 c-mad- Furerryechubbrom a ."
Combined. FED-VL-PI-WF1C-AAIC (rev 11-19)
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutual. The Ohio Casualty Insurance Company Certificate No: 8205857. 974105
SURETY West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Andrew A.
Adams; John A, Prince; Larry D. Snider; Michael Macomber; Norman E. Adams
all of the city of Houston state of fX each individually if there be more than one named, its true and lawful attorney -in -fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 28th day of June , 2021 .
Liberty Mutual Insurance Company
1NstrP 4I1 INS tx tiNsll I The Ohio Casualty Insurance Company
PO
j aroR R4rogym Q,=°IRPO�Tp�n �vPr oRPo��'� West American Insurance Company
10.1 n " 1919 m w 9(% o m
a) o
dVY ss'A CHu9�da s0HAMP`�� ab� �s NOIANP aa�(3)
rriE
V
By:
- David M. Carey, Assistant Secretary
" co State of PENNSYLVANIA
�—
6
:3, County of MONTGOMFRY ss
o E
On this 28th day of June 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance c`°i m
Company,
cz The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes
d) � therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
7 @)
m
W
o IN WITNESS WHEREOF, l have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written
c
ca PAST
a O
O y¢
—• ` Q�iru5orrtvFq E'�f
OF
CommonwealtholPennsylvania-NotarySeak
Teresa Pastella, Notary Public
Montgomery County
�/
V/ -
T_
q� •�
E
C +-�
E
My commission expires March 28, 2025
By:
a) YLI Commission number 1126044
onofTeresa Pastella, Notary Public
N -Mfrs Merthev, Pennsylvania Assnclation al Notaries ry
Q O
•.—
(a ARY
This Power
D
If c of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual
3 oNo
E•S Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows:
C) CN
o ARTICLE IV -OFFICERS: Section 12. Power of Attorney.
o e?
4 Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the
a o
President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety
a)any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fad, subject to the limitations set forth in their respective powers of attorney, shall
-a
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such
o m
Z U instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the
-0. vm
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority
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ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
— shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
—
bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in -
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of allomey issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
1, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked,
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 5th day of June 2023
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NAa Renee C. Llewellyn, Assistant Secretary
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