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HomeMy WebLinkAboutContract 57298-FP1-FP1 FORT WORTH. City Secretary Contract No. 57298 Date Received 06/14/2023 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: TMS Champions HAPT City Project No: 103772 Improvement Type(s): Water x❑ Original Contract Price: Amount of Approved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: ancun W, 2023 08:29 CDT) Contractor Vice President of Operations Title Embrey Builders LLC Company Name 7R�- V-- Kevin Jackson (Jun 14.2023 08:38 CDT) Project Inspector Project Manager ,1^ Rehecca uiane Owen (Jun 14. 202309:23 CDT) CFA Manager Lauren Prieur (Jun 14, 2023 09:26 CDT) TPW Director William JohnsoR'Ju 6.202306:63 CDT) Asst. City Manager Sewer x❑ $389,482.00 $650.00 $390,132.00 $390,132.00 Jun 14, 2023 Date Jun 14, 2023 Date Jun 14, 2023 Date Jun 14, 2023 Date Jun 14, 2023 Date Jun 16, 2023 Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: TMS Champions HAPT City Project No.: 103772 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 I Statement of Contract Time Contract Time 90 WD Days Charged: 107 Work Start Date: 10/3/2022 Work Complete Date: 5/17/2023 Soil Lab Number of Tests: 182 Water Number of Tests: 28 Page 2of2 FoRTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name TMS CHAMPIONS HAPT Contract Limits Project Type WATER & SEWER City Project Numbers 103772 DOE Number 3772 Estimate Number 1 Payment Number 1 City Secretary Contract Number Contract Date 4/11/2022 For Period Ending 5/25/2023 WD Contract Time 9WD Days Charged to Date 107 Project Manager NA Contractor EMBREY BUILDERS, LLC 1020 NE LOOOP 410, SUITE 700 SANANTONIO, TX 78209 Inspectors CORDOVA / JACKSON Contract is 100.00 Complete Thursday, May 25, 2023 Page 1 of 5 City Project Numbers 103772 Contract Name TMS CHAMPIONS HAPT Contract Limits Project Type WATER & SEWER Project Funding UNIT I: WATER IMPROVEMENTS DOE Number 3772 Estimate Number 1 Payment Number 1 For Period Ending 5/25/2023 Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 4"-12" PRESSURE PLUG 3 EA $450.00 $1,350.00 3 $1,350.00 2 TRENCH SAFETY 1244 LF $1.00 $1,244.00 1244 $1,244.00 3 DUCTILE IRON WATER FITTINGS 4.35 TN $6,200.00 $26,970.00 4.35 $26,970.00 W/RESTRAINT 4 4" PVC WATER PIPE 20 EA $45.00 $900.00 20 $900.00 5 8" PVC WATER PIPE 20 EA $55.00 $1,100.00 20 $1,100.00 6 12" DIP WATER 42 LF $120.00 $5,040.00 42 $5,040.00 7 12" DIP WATER CLSM BACKFILL 20 LF $120.00 $2,400.00 20 $2,400.00 8 12" PVC WATER PIPE 1142 LF $80.00 $91,360.00 1142 $91,360.00 9 FIRE HYDRANT ASSEMBLY (CO #3) 2 EA $4,100.00 $8,200.00 2 $8,200.00 10 CONNECTION TO EXISTING 4"-12" WATER 1 EA $3,500.00 $3,500.00 1 $3,500.00 MAIN 11 1" WATER SERVICE 2 EA $2,800.00 $5,600.00 2 $5,600.00 12 4" WATER METER AND VAULT (CO #1) 0 EA $26,500.00 $0.00 0 $0.00 13 6" GATE VALVE 2 EA $1,800.00 $3,600.00 2 $3,600.00 14 8" GATE VALVE 2 EA $2,100.00 $4,200.00 2 $4,200.00 15 12" GATE VALVE (CO #2) 8 EA $3,100.00 $24,800.00 8 $24,800.00 16 16" GATE VALVE W/VAULT 1 EA $20,500.00 $20,500.00 1 $20,500.00 17 24" X 16" TAPPING SLEEVE & VALVE 1 EA $21,500.00 $21,500.00 1 $21,500.00 18 AUTOMATIO FLUSHING ASSEMBLY (BID BY 2 EA $12,500.00 $25,000.00 2 $25,000.00 ETA) 19 3" WATER METER & VAULT (CO #1) 2 EA $25,525.00 $51,050.00 2 $51,050.00 20 1 1/2 WATER METER FOR FLUSHING DEVICE 1 EA $3,600.00 $3,600.00 1 $3,600.00 (CO #3) Sub -Total of Previous Unit $301,914.00 $301,914.00 UNIT II: SANITARY SEWER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 POST -CCTV INSPECTION 561 LF $2.00 $1,122.00 561 $1,122.00 2 MANHOLE VACUUM TESTING 4 EA $325.00 $1,300.00 4 $1,300.00 3 TRENCH SAFETY 561 LF $1.00 $561.00 561 $561.00 4 CONCRETE COLLAR A $615.00 $615.00 1 $615.00 Thursday, May 25, 2023 Page 2 of 5 City Project Numbers 103772 DOE Number 3772 Contract Name TMS CHAMPIONS HAPT Estimate Number I Contract Limits Payment Number 1 Project Type WATER & SEWER For Period Ending 5/25/2023 Project Funding 5 TRENCH WATER STOPS 3 EA $375.00 $1,125.00 3 $1,125.00 6 8" SEWER PIPE 541 LF $45.00 $24,345.00 541 $24,345.00 7 8" SEWER PIPE CLSM BACKFILL 20 LF $65.00 $1,300.00 20 $1,300.00 8 EPDXY MANHOLE LINER 63.5 VF $275.00 $17,462.50 63.5 $17,462.50 9 4' MANHOLE 4 EA $7,600.00 $30,400.00 4 $30,400.00 10 4' EXTRA DEPTH MANHOLE 23.5 VF $425.00 $9,987.50 23.5 $9,987.50 Sub -Total of Previous Unit $88,218.00 $88,218.00 Thursday, May 25, 2023 Page 3 of 5 City Project Numbers 103772 Contract Name TMS CHAMPIONS HAPT Contract Limits Project Type WATER & SEWER Project Funding Contract Information Summary Original Contract Amount Chanhe Orders Change Order Number 1 Change Order Number 2 Change Order Number 3 Total Contract Price DOE Number 3772 Estimate Number 1 Payment Number 1 For Period Ending 5/25/2023 $389,482.00 ($1,950.00) $3,100.00 ($500.00) $390,132.00 Total Cost of Work Completed $390,132.00 Less % Retained $0.00 Net Earned $390,132.00 Earned This Period $390,132.00 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 $390,132.00 Thursday, May 25, 2023 Page 4 of 5 City Project Numbers 103772 Contract Name TMS CHAMPIONS HAPT Contract Limits Project Type WATER & SEWER Project Funding Project Manager NA Inspectors CORDOVA / JACKSON Contractor EMBREY BUILDERS, LLC 1020 NE LOOOP 410, SUITE 700 SAN ANTONIO , TX 78209 DOE Number 3772 Estimate Number 1 Payment Number 1 For Period Ending 5/25/2023 City Secretary Contract Number Contract Date 4/11/2022 Contract Time 90 WD Days Charged to Date 107 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 $390,132.00 Less % Retained $0.00 Net Earned $390,132.00 Earned This Period $390,132.00 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 $390,132.00 Thursday, May 25, 2023 Page 5 of 5 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: TMS CHAMPIONS HAPT CHANGE CONTRACT: PUBLIC WATER, WASTEWATER, STORM DRAIN, DRIVEWAYS & STREET LIGHT ORDER No: CFA # 21-0155 1 CITY PARTICIPATION: NO CITY PROJECT # 103772 FID # 30114-0200431-103772-EO7685 FILE # K-2872 X-27128 INSPECTOR: Kevin Jackson Phone No: (682) 328-7823 REVIEWED PROJECT MANAGER: Debbie J. Willhelm, PE Phone No: (817) 392-2481 By Debbie J. Willhelm at 3:08 pm, Jul 28, 2022 CONTRACT UNIT WATER SEWER PAVING DRAINAGE STREET LIGHTS CONTRACT Developer Developer Developer Developer Developer DAYS Cost City Cost Cost City Cost Cost City Cost Cost City Cost Cost City Cost ORIGINAL CONTRACT $301,264.00 $0.00 $88,218.00 $0.00 $63,567.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 90 EXTRAS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 CREDITS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 CONTRACT TO DATE $301,264.00 $0.00 $88,218.00 $0.00 $63 567.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 90 AMOUNT OF PROP. CHANGE ORDER $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 REVISED CONTRACT AMOUNT $299,314.00 $0.00 $88,218.00 $0.00 $63,567.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 90 TOTAL REVISED CONTRACT AMOUNT PER UNIT $299,314.00 $88,218.00 $63,567.00 $8,510.00 $11,509.00 REVISED COST SHARE Dev. Cost: $471,118.00 City Cost: $0.00 TOTAL REVISED CONTRACT $471,118.00 Revised: 10-12-2011 Page 1 UNIT I: WATER IMPROVEMENTS You are directed to make the following rhanges in the contract documents CITY BID ITEM PAY ITEM # # QUANTITY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL 12 3312.2802 -2 EA 4" WATER METI=R AND VAULT $26,500.00 ($53,000.00) NEW 3312.2801 2 EA 3" WATER METER AND VAULT $25,525.00 $51,050.00 SUBTOTAL UNIT I: WATER IMPROVEMENTS ($1,950.00)1 REASONS FOR CHANGE ORDER Revised size of water meter from 4" to 3". Changes correspond to Plan Revision 01 as shown on sheets 7 & 8 of the construction plans. NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100% OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE CITY WILL BE SOUGHT BY THE DEVELOPER. RECOMMENDED: Engirte\ring 8 Design By: Name: David Pitcher Title: Professional Enqineer APPROVED: Embrey lAVrNQ14► By: �--- Name: eerremy W' ' mms Title: • V.f APPROVED: By: Name: e c...� Title:lie Revised: 10-12-2011 Page 3 PROJECT NAME: CONTRACT: CFA # CITY PROJECT # FID # FILE # INSPECTOR: PROJECT MANAGER ORIGINAL CONTRACT EXTRAS TO DATE CREDITS TO DATE CONTRACT TO DATE AMOUNT OF PROP. CHANGE ORDER REVISED CONTRACT AMOUNT TOTAL REVISED CONTRACT AMOUNT PER UNIT REVISED COST SHARE TOTAL REVISED CONTRACT DEVELOPER -AWARDED -PROJECT CHANGE ORDER TMS CHAMPIONS HAPT PUBLIC WATER, WASTEWATER, STORM DRAIN, DRIVEWAYS & STREET LIGHT 21-0155 CITY PARTICIPATION: NO 103772 30114-0200431-103772-EO7685 K-2872 X-27128 Kevin Jackson Debbie J. Willhelm, PE WATER Developer Cost City Cost $301,264.00 $0.00 $0.00 $0.00 $1,950.00 $0.00 $299,314.00 $0.00 $3,100.00 $0.00 $302,414.00 $0.00 $302,414.00 Dev. Cost: CHANGE ORDER No: 2 Phone No: (682) 328-7823 REVIEWED Phone No: (817) 392-2481 By Debbie J. Willhelm at 5:05 pm, Jan 04, 2023 SEWER Developer Cost City Cost $88,218.00 $0.00 $0.00 $0.00 $0.00 $0.00 $88,218.00 $0.00 $0.00 $0.00 $88,218.00 $0.00 $88,218.00 $474,218.00 CONTRACT UNIT PAVING Developer Cost City Cost $63,567.00 $0.00 $0.00 $0.00 $0.00 $0.00 $63,567.00 $0.00 $0.00 $0.00 $63,567.00 $0.00 $63,567.00 City Cost: $474,218.00 DRAINAGE STREET LIGHTS Developer Developer Cost City Cost Cost City Cost $8,510.00 $0.00 $11,509.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 $0.00 $0.00 $0.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 $8,510.00 $11,509.00 $0.00 CONTRACT DAYS 90 0 0 90 0 90 Revised: 10-12-2011 Page 1 You are directed to make the following changes in the contract documents CITY BID ITEM PAY ITEM # # QUANTITY UNIT 15 3312.3005 1 EA UNIT I: WATER IMPROVEMENTS ITEM DESCRIPTION 12" GATE VALVE SUBTOTAL UNIT I: WATER IMPROVEMENTS valve REASONS FOR CHANGE ORDER Additon of 12" waterrnefeo for isolation. Changes correspond to Plan Revision 02 as shown on sheet 7 of the construction plans. UNIT PRICE TOTAL $3,100.00 $3,100.00 NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100% OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE CITY WILL BE SOUGHT BY THE DEVELOPER. RECOMMENDED: 7ineen &Design By: Name: David Pitcher Title: Professional Engineer APPROVED: Embrey piNiicUS ned by Jeremy Williams E-lvAlliams@amhraydc.com, Jeremy Williams 0-Embray Ra„nars,0U-SVR, CN-Jeremy Williams By: Date: 2023 01.03 08:29 08 06'00' Name: Jeremy Williams Senior Vice President Title: $3,100.00 APPROVED: Digitally signed by Richard Bnnkmann EN C=US, E=rbnnkmann@embreydc.com, O-Embrey Builders LLC. OU=Construction. Richard Brinkmann CN=RicrZd Brinkman, Reason' I am approving this document By: Date. 2023 01 04 09:2342-0600' xicnara Erinxmann Name: benior erojecc manager Title: Revised: 10-12-2011 Page 2 DocuSign Envelope ID: 4A7CD817-AC3D-45AB-8BF9-84A89E9079BB DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: TMS CHAMPIONS HAPT CHANGE CONTRACT: PUBLIC WATER, WASTEWATER, STORM DRAIN, DRIVEWAYS & STREET LIGHT ORDER No: CFA # 21-0155 CITY PARTICIPATION: NO CITY PROJECT # 103772 3 FID # 30114-0200431-103772-EO7685 FILE # K-2872 X-27128 INSPECTOR: Kevin Jackson Phone No: (682) 328-7823 REVIEWED PROJECT MANAGER: Debbie J. Willhelm, PE Phone No: (817) 392-2481 By Debbie J. Willhelm at 4:39 pm, May 17, 2023 CONTRACT UNIT WATER SEWER PAVING DRAINAGE STREET LIGHTS CONTRACT Developer Developer Developer Developer Developer DAYS Cost City Cost Cost City Cost Cost City Cost Cost City Cost Cost City Cost ORIGINAL CONTRACT $301,264.00 $0.00 $88,218.00 $0.00 $63,567.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 90 EXTRAS TO DATE $3,100.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 CREDITS TO DATE $1,950.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 CONTRACT TO DATE $302,414.00 $0.00 $88,218.00 $0.00 $63,567.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 90 AMOUNT OF PROP. CHANGE ORDER ($500.00) $0.00 $0.00 $0.00 ($2,520.00) $0.00 $0.00 $0.00 $0.00 $0.00 0 REVISED CONTRACT AMOUNT $301,914.00 $0.00 $88,218.00 $0.00 $61,047.00 $0.00 $8,510.00 $0.00 $11,509.00 $0.00 90 TOTAL REVISED CONTRACT AMOUNT PER UNIT $301,914.00 $88,218.00 $61,047.00 $8,510.00 $11,609.00 REVISED COST SHARE Dev. Cost: $471,198.00 City Cos $0.00 TOTAL REVISED CONTRACT $471,198.00 Revised: 10-12-2011 Page 1 DocuSign Envelope ID: 4A7CD817-AC3D-45AB-8BF9-84A89E9079BB You are directed to make the following changes in the contract documents: UNIT I: WATER IMPROVEMENTS CITY BID ITEM PAY ITEM # # QUANTITY UNIT ITEM DESCRIPTION 9 3312.0001 -1 EA Fire Hydrant Assembly NEW 9999.0002 1 EA 1 1 /2" Water Meter for Flushing Device SUBTOTAL UNIT I: WATER IMPROVEMENTS UNIT IV: PAVING IMPROVEMENTS CITY BID ITEM PAY ITEM # # QUANTITY UNIT ITEM DESCRIPTION 4 3217.0203 -26 LF 8" SLID Pvmt Marking Tape 7 3441.4003 -1 EA Furnish/Install Alum Sign Ground ouni City Std. SUBTOTAL UNIT IV: PAVING IMPROVEMENTS REASONS FOR CHANGE ORDER Removed private items from contract. Reconciled quantities to match construction plans. UNIT PRICE TOTAL i $4,100.00 ($4,100.00) i $3,600.00 3,600.00 i i ($500.00)i i UNIT PRICE TOTAL 1 $20.00 $520.001 i $2,000.00 ($2,000.00) i ($2,520.00)1 i TOTAL ($3,020.00)1 NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100 % OF THE CHANGE ORDER COST AND NO REIMBURSEMENT FROM THE CITY WILL BE SOUGHT BY THE DEVELOPER. RECOMMENDED: APPROVED: KFM Engineering &P�pl,2e.oa itlP n„ Embrey Partners, LLC B David Pitcher �e,�.,a - B (uM.S v v �remy Williams Name: David Pitcher Name: Title: Professional Engineer Title: SVP APPROVED: Embrey Builders, LLC By: Name: Yancey Hayes Title: V.P. of construction operations Revised: 10-12-2011 Page 2 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: TMS Champions HAPT CITY PROJECT NUMBER: 103772 WATER PIPE LAID SIZE TYPE OF PIPE LF C-600 Water Pipe 12" PVC 1142 DIP Water Pipe 12" DIP 42 FIRE HYDRANTS: 2 VALVES (16" OR LARGER) 1 PIPE ABANDONED SIZE TYPE OF PIPE LF N/A DENSITIES: YES NEW SERVICES: 1" Copper 2 EA 3" DIP 2 EA SEWER PIPE LAID SIZE TYPE OF PIPE LF SDR-26 Sewer Pipe 8" PVC 561 PIPE ABANDONED SIZE TYPE OF PIPE LF N/A DENSITIES: YES NEW SERVICES: N/A TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 FORTWORTH. M, TRANSPORTATION AND PUBLIC WORKS May 23, 2023 Embrey Builders, LLC. 1020 NE Loop 410, Suite 700 San Antonio, TX 78209 RE: Acceptance Letter Project Name: TMS Champions HAPT Project Type: Water/Sewer/Paving/StreetLights City Project No.: 103772 To Whom It May Concern: On May 17, 2023 a final inspection was made on the subject project. There were punch list items identified at that time. The punch list items were completed on May 25, 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 May 25, 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 Debbie J. Willhelm, PE (817) 392-2481 Office Debbie.Willhelm(&fortworthtexas.2ov. . Sincerely, Debbie Willhelm, Project Manager Cc: Kevin Jackson, Inspector Gary Deyon, Inspection Supervisor Troy Gardner, Senior Inspector Victor Tornero, Program Manager KFM Engineering and Design, Consultant Embrey Builders, Contractor Embrey Partners, LLC., Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 AFFIDAVIT STATE OF TEXAS COUNTY OF COLLIN Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared M. Jeffrey Hicks, President Of Bandera Utility Contractors, LLC., known to me to be a credible person, who being by me duly sworn, upon his oath deposed and said; That all persons, firms, associations, corporations, or other organizations furnishing labor and/or materials have been paid in 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; Champions Way DFW, LP / BYk Name or Title Subscribed and sworn before me on this date 5th of June, 2023. SHERRI L. SHORT N0tary Public, State of Taxes comm. Expires W22-2026 Notary 10 13397M2 Notary Public ` County, State N 0 i w =_ TM Document G707 -1994 Consent Of Surety to Final Payment PROJECT: (Name and address) ARCHITECT'S PROJECT NUMBER: TMS Champions HAPT Project Number 103772 CONTRACT FOR: TMS Champions HAPT Maintenance Bond Number 4453379 Water, Sewer, Paving, Drainage and Streetlights TO OWNER: (Name and address) CONTRACT DATED: April 11, 2022 City of Fort Worth 1000 Throckmorton Street Forth Worth, TX 76012-6311 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address of Surety) SureTec Insurance Company 9500 Arboretum Blvd., Suite 400 Austin, TX 78759 on bond of (Insert name and address of Contractor) Embrey Builders, LLC 7600 Broadway, Suite 300 San Antonio, TX 78209 OWNER: ARCHITECT: CONTRACTOR: SURETY: ❑ OTHER: ❑ ,SURETY, ,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 (Insert name and address of Owner) City of Fort Worth 1000 Throckmorton Street Forth Worth, TX 76012-6311 OWNER, as set forth in said Surety's bond, IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: 2nd Day of June, 2023 (Insert in writing the month followed by the numeric date and year.) SureTec Insurance Company (Surety) (Signature of authorized representative) Attest: Cassie C. Patton, Attorney -in -Fact (Seal): (Printed name and title) GGMP�� yi `�313tln�' AIA Document G707TM —1994. Copyright © 1982 and 1994 by The American Institute of Architects. All rights reserved. WARNING: This AIAe Document Is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIAe Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 15:04:04 on 02/09/2009 under Order No.1000374646_1 which expires on 10/13/2009, and is not for resale. User Notes: (1452131059) POA# 4221964 JOINT LIMITED POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That SureTec Insurance Company, a Corporation duly organized and existing under the laws of the State of Texas and having its principal office in the County of Harris, Texas and Markel Insurance Company (the "Company"), a corporation duly organized and existing under the laws of the state of Illinois, and having its principal administrative office in Glen Allen, Virginia, does by these presents make, constitute and appoint: Catherine M. Martinez, Michael N. Venson, S. West Warren, Thomas E. Whitney, Donald E. Miller, Jr., Cassie C. Patton Their true and lawful agent(s) and attorney(s)-in-fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on their own behalf, individually as a surety or jointly, as co -sureties, and as their act and deed any and all bonds and other undertaking in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: Ten Million and 00/100 Dollars ($10,000,000.00) This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolutions adopted by the Board of Directors of SureTec Insurance Company and Markel Insurance Company: "RESOLVED, Thatthe President, any Senior Vice President, Vice President, Assistant Vice President, Secretary, Assistant Secretary, Treasurer or Assistant Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the company, qualifying the attorney or attorneys named in the given power of attorney, to execute in behalf of, and acknowledge as the act and deed of the SureTec Insurance Company and Markel Insurance Company, as the case may be, all bond undertakings and contracts of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, Markel Insurance Company and SureTec Insurance Company have caused their official seal to be hereunto affixed and these presents to be signed by their duly authorized officers on the 14th day of December , 2022 . SureTec Insurance Company ssssttrrrrrMarke3fisurance C pany 6VFtAlVp Q�� rb By: w w >9 = .SEAL 'yv= By/ Michael C. Keimig, Preside a�il'j 5 t� �.��r''•,�� ,•' �?� ndey.len4l s, Vice President State of Texas County of Harris: On this 14th day of December , 2022 A. D., before me, a Notary Public of the State of Texas, In and for the County of Harris, duly commissioned and qualified, came THE ABOVE OFFICERS OF THE COMPANIES, to me personally known to be the individuals and officers described In, who executed the preceding instrument, and they acknowledged the execution of same, and being by me duly sworn, disposed and said that they are the officers of the said companies aforesaid, and that the seals affixed to the proceeding instrument are the Corporate Seals of said Companies, and the said Corporate Seals and their signatures as officers were duly affixed and subscribed to the said Instrument by the authority and direction of the said companies, and that Resolutions adopted by the Board of Directors of said Companies referred to in the preceding instrument is now In force, IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed my Official Seal at the County of Harris, the day and year first above written. .loci... -----� XENIA RIVAS Notary Public State of Texas Commission # 129117659 Commission Expires 9/10/24 By: x as, Not ry Public My co mission expires 9/10/2024 We, the undersigned Officers of SureTec Insurance Company and Markel Insurance Company do herby certify that the original POWER OF ATTORNEY ofwhich the foregoing is a full, true and correct copy is still in full force and effect and has not been revoked. IN WITNESS WHEREOF, we have hereunto set our hands, and affixed the Seals of said Companies, on the 2nd day of June • 2023 0 �wr ASTecinsup;:nceComp y o p s vH By: y�`0�131in By M. Br t Beaty, As scant secre ry /arquis, elan ance Company A drew Assistanq Any Instrument Issued in excessof the penalty stated above is totally void and without any validity. 4221964 For verification of the authority of this Power you may call (713)812-0800on any businessday between 8:30 AM and 5:00 PM CST. SureTec Insurance Company IMPORTANT NOTICE Statutory Complaint Notice/Filing of Claims To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or to make a complaint or file a claim at: 1-866-732-0099. You may also write to the Surety at: SureTec Insurance Company 9500 Arboretum Blvd., Suite 400 Austin, TX 78759 You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or complaints at 1-800-252- 3439. You may write the Texas Department of Insurance at: PO Box 149104 Austin, TX 78714- 9104 Fax#: 512-490-1007 Web: htto://www.tdi.state.tx.us Email: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIMS DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of Insurance. SIC TX Rider TDI Required Notices rev 07_2022