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Home My WebLink AboutContract 57679-FP1FORTWORTH, TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION -FP1 City Secretary No:_57679 Date Received: 6/22/2023 City Project Ns:101579 Regarding contract 57679 2018 CIP Intersection Improvements Alta Mesa Boulevard & Crowley Road for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 5/10/2022 through M&C 22-0346 the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of the Assistant Director of the Transportation & Public Works Department has accepted the project as complete. Original Contract Prices: 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 Recommended for Acceptance Asst. Director, TPW - Capital Delivery A. - Lauren Prieur(Jun 22, 202315:39 CDT) Accepted Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Client Department William Johnson (Ju 22, 202315:47 CDT) Asst. City Manager $635,155.95 $7,450.00Ne 1 $642,605.95 $632,459.87 0 Days @ $650.00/ Day $0.00 $632,459.87 $600,836.88 $31,622.99 J u n 22, 2023 Date J u n 22, 2023 Date J u n 22, 2023 Date Comm tits: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment To (Owner) City of Fort Worth Invoicing Period (From - To): 5/26/23-6/14/23 P. O. FW020-0000007928 From (Contractor): Number: McClendon Construction Company Project. 101579 Contractor's CFW Vendor No.: 0000007403 City Secretary Contract Number: Approved Change Orders Number 1 2 3 4 5 6 7 8 TOTALS NET CHANGE BY CHANGE ORDERS Contractor's Certification 57679 Application For Payment Change Order Summary Additions $7,450.00 $7,450.00 Invoice No. oice Date: 1 9 Final I 6/14/2023 to (If Not Automatic Deposit): Contract Nam e: : Altamesa Blvd & Crowley Rd Intersection Improvement Nam $7,450.00 1. ORIGINAL CONTRACT PRICE.......................................................... $ $635,155.95 Deletions 2. Net change by Change Orders................................................................. $ $7,450.00 3. Current Contract Price (Line 1 + 2)........................................................ $ $642,605.95 4. TOTAL COMPLETED AND STORED TO DATE (Progress Estimate, Construction Allowance and Change Orders)....... $ $632,459.87 5. RETAINAGE: a. X $632,459.87 Work Completed.......... $ b. X Not Used $ c. Total Retainage (Line 5a + Line 5b) ............................... $ 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c)............................. $ $632,459.87 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)........ $ $600,836.88 8. AMOUNT DUE THIS APPLICATION ................................................. $ $31,622.99 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + Cos + Line 5 above) .............. $ $10,146.09 The Contractor certifies with the submittal of this document and associated Payment Request Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Applications for Payment; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, security interest or encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Liquidated Damages $500.00 x day 10. CONTRACT TIME: a, Days Awarded 120 b, Days Added by CO 67 C. Total Days 187 d, Days Charged 187 e, Days Remaining 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. 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Addition e S-om No Maae C D Esfiontwd Quantity Value metalled Contractor's Application Application Number' 9 Final Appli°anon Date 6/14/2023 E F Previously Valued Md(Presently Total Coroplatad / Balance to Finish Installed Value Period Stood (oot m C) and Stored to Date (P) (B -P) (D+B) B Tbie document has been modified fiom it, orrgioal fumt ae an FJCDC document and the user did urn highlight the modifica ims. You are encouraged to read the document croefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Construction Allowance Usage For (contract)' Appl—fion Penod' I Bid Item Number CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Item D—pfion Totals 5/26/23-6/14/23 A B spedficafion Una of Qaanhly to Delete Umt Pnce Redaction Valae Section No Measure Tbie document has been mrMW 6om as onginnl fuvn es en HICDC docament and the user did urn highlight the modificafions. You are encouraged to read the document cmefully and consult Legal Counsel pnor to its execution. Contractor's Application Applicanon Number' 9 Final Applicatmn Date 6/14/2023 C-620 Change Order Progress Estimate Change Order Number I 1 ADDITIONS Contractor's Application IF., (coatma) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement City Secretary 57679 Application Numbar 9 Final Contract Num: IApplrratimiParrad 5/26/23-6/14/23 Applicati°°Data 6/14/2023 A B C D E F Imn Addition Total Completed Change Order Imn Spedficafion Unit of CO Quantity Add UUnitPrice Change Estimated Quantity Value Previously Value This Materials Presently and Stored to Date (F) No. Desaipnon Seaton No Measure Value is Installed Nstalled Value Period Stored (not m C) (D I E) B 80 34 41 10 Powder Coating For Traffic Signals TPW LS 1.00000000 $5,250.00 $5,250.00 L00000000 $51250.00 $5,250.00I $5,250.00 IWO% 81 32 13 73 Crack Sealing for Concrete Paving TPW LF 550.00000000 $4.00 $2,200.00 550.00000000 I $2,200.00 $2,200.00 I $2,200.00 100.0 Tbie document has been modified from its origuml forin us un EJCDC document and the user did urn highlight tha modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Balance to Finish (B -F) C-620 Change Order Progress Estimate Change Order Number I I DELETIONS For (connact) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Application Pevod 5/26/23-6/14/23 A B C Item nh CO Qaaty to Dald Change Order Item Descr i spedfication Una of Delete Unit Price Change Order Not Usad Section No. P No Measure Value � Totals Application Number Applicatmn Dale' D E Na Used Not Used Not Used Na Used Tbie documaut has beau modified fiom its origioul fovn as an EJCDC document and the user did urn highlight the modifications. You are encouraged to read the document cazefully and consult L gal Counsel prior to its execution. Contractor's Application 9 Final 6/14/2023 F N. Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 2 I Contractor's Application ADDITIONS For (aontiaa) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Crty Secretary 57679 Applioat an Nambar 9 Final Contract Num Apphcztim Panod 5/26/23-6/14/23 Applioatton Date 6/14/2023 A B C D E F Itcm Balance to Finish Change Order Item Specification Umt of CO Quantity to Add Addition Change Unit Price Estimated Quantity Prevroady Was This Materials Presently Value Total Completed % end Storod to Date (F) (B - P) No. Dcscnption Section No. Measure Order Value Lnstalled L�stallad Was Panod Stored (not m C) (1) � E) B This document has bee. ma ltfied from its onginel form as an EJCDC document and the user did not highlight the modifications. You are enwmaged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 2 DELETIONS IFor (contrmot) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Applicmon Number Apphcafinn Parma 5/26/23-6/14/23 Applicmhon Date A 6 C D E Item CO Qaanhty to Dalahou Change Change Order Item Descrrpfion Spsaficafion Umt of Delete Unit Price Order Value Na Used Not Used Na Used Not Used Na Used No. Sactmn No. Measure Totals This document has been modified from ns ongiml form as an EJCDC document and the user did not highlight the modifications. You are enwuraged to read the document carefully and consult Legal Counsel pnor to its execution. Contractor's Application 9 Final 6/14/2023 F Not Used N. Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 3 ADDITIONS IF., (— mot) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement IApplication Penad 5/26/23-6/14/23 City Secretary 57679 Contract Nam: A B Item Addition Change Order Item Desorrption Specification Umt of CO Quantity to Add Unit Price Change Order No. Section No Measure Value C D Estimated Quanhly Value hatalled Contractor's Application Appl—tinv Number: 9 Final Appl—tion Date; 6/14/2023 E F Balance to Fmtah Total Completed Previously Value Thrs Materials Presently (B - F) Installed Value Period Stored (not in C) and Stored to Date (F) D+E) B This document has bee. modified from na onginal form as an EJCDC document and the user did not highlight the modifications. You are enwmaged to read the document carefully and consult Legal Counsel pnor to its execution. C-620 Change Order Progress Estimate Change Order Number 1 3 DELETIONS IFor (contrea) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Apphoafion Numbec Apphcafio. Fermd 5/26/23-6/14/23 Apphoafion Date: A 6 C D E Item CO Quantity to Deleti on Chung. Order Item Desa non Spsaficsfion Umt of Delae Unit Price Chung. Order Not Used No[ Used N. Used Not Used Not Used No. P Section No Measure Value Totals This document has bee. modtfied from ns onginol form as an EJCDC document and the user did no( highlight the modifications. You are enwuraged to read the document carefully and consult Legal Counsel pnor to its execution. Contractor's Application 9 Final 6/14/2023 F Na Used Not Used Na Used C-620 Change Order Progress Estimate Change Order Number 1 4 ADDITIONS Contractor's Application IFor (comma) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement City Secretary 57679 Appl—tiov Number 9 Final Cnotract Nam: Application Pan d 5/26/23-6/14/23 Application Date: 6/14/2023 A B C D E F Item Balance to Fmtsb Additiov Chavge Order Item Speafication Umt of CO Quantity to Add Unit Prica Chavge Order Estimated Q.auhty Total Completed Prevtously ValuemMaterials Presently an Valae d Storad to Data (g _ (P) No. Dcscrrption Seamn No Measure Value Installed Nstalled Value Period Stoted (notes C) (D+E) B This do—t has bee. modified from ns ongiml form as an EJCDC document and the user did not highlight the modifications. You are enwmaged to read the document carefully and consult Legal Counsel pnor to its execution. C-620 Change Order Progress Estimate Change Order Number 1 4 DELETIONS IFor (contrea) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Apphoafion Numbec Apphcafio. Fermd 5/26/23-6/14/23 Apphoafion Date: A 6 C D E Item CO Quantity to Deleti on Chung. Order Item Desa non Spsaficsfion Umt of Delae Unit Price Chung. Order Not Used No[ Used N. Used Not Used Not Used No. P Section No Measure Value Totals This document has bee. modtfied from ns onginol form as an EJCDC document and the user did no( highlight the modifications. You are enwuraged to read the document carefully and consult Legal Counsel pnor to its execution. Contractor's Application 9 Final 6/14/2023 F Na Used Not Used Na Used C-620 Change Order Progress Estimate Change Order Number 1 5 ADDITIONS Contractor's Application IFor (comma) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement City Secretary 57679 Appl—tion Number 9 Final Cnotract Nam: Apphcmim Pan d 5/26/23-6/14/23 ` ppl'eati°n Date: 6/14/2023 A B C D E F Item Balance to Fmtsb Addition Chevge Order Item Specification Umt of CO Quantity t-Add Unit Prica Change Order Estimated Q-auhty T-1 Complaed Previously ValemMaterials Presently Val -and Storad to Data (g _ (P) No. Description Seam -No. Measure Value Installed Nstalled Value Period Stored (na NC) (D+E) B This document has been modified from its ongiml form as an EJCDC document and the user did not highlight the modifications. You are enwmaged to read the document carefully and consult Legal Counsel pnor to its execution. C-620 Change Order Progress Estimate Change Order Number 1 5 DELETIONS IF.,( —tract) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Appl—tiou Numbec Apphcafio. Pertod 5/26/23-6/14/23 Application Date: A B C D E Item CO Qaanhty to Del& Change Order Item non p D— Specification Umt of Delete Unit Price Change Order Not Used Not Used Not Used Not Used Not Used No. Sectm. No. Measure Value Totals This do—t has bee. modified from ns ongiml form as an EJCDC document and the user did not highlight the modifications. You are enwuraged to read the document carefully and consult Legal Counsel pnor to its execution. Contractor's Application 9 Final 6/14/2023 F N. Used Not Used Na Used C-620 Change Order Progress Estimate Change Order Number 1 6 ADDITIONS Contractor's Application IFor (comma) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement City Secretary 57679 Apphoatiov Number 9 Final Cnotract Num: Application Pennd 5/26/23-6/14/23 Application Date: 6/14/2023 A B C D E F Item Balance to Frmsb Addition Qveonty Total Completed Previously Valueml M Preaeatry %Psfimaled (B - F) Change Order Item No. 6peaficafion Uvn of CO Quanfiry W Add Unit Price Change Order Desarphon Sea— No. Measure Value Inetmled Value and Stored W Date Stated Installed Valve Period Stored (vo[ m C) (D 7 E) (P) B This document has been modified from ns onginal form as an EJCDC document and the user did not highlight the modifications. You are enwmaged to read the document carefully and consult Legal Counsel pnor to its execution. C-620 Change Order Progress Estimate Change Order Number 1 6 DELETIONS IFor (contrea) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Apphoafion Numbec Apphcafio. Fermd 5/26/23-6/14/23 Apphoafion Date: A 6 C D E Item CO Quantity to Deleti on Chung. Order Item Desa non Spsaficsfion Umt of Delae Unit Price Chung. Order Not Used No[ Used N. Used Not Used Not Used No. P Section No Measure Value Totals This document has bee. modtfied from ns onginol form as an EJCDC document and the user did no( highlight the modifications. You are enwuraged to read the document carefully and consult Legal Counsel pnor to its execution. Contractor's Application 9 Final 6/14/2023 F Na Used Not Used Na Used C-620 Change Order Progress Estimate Change Order Number 1 7 I Contractor's Application ADDITIONS For (comma) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement City Secretary 57679 Appl—tion Number 9 Final Contract Num: Apphcmim Parma 5/26/23-6/14/23 ` ppl—ti°n Date: 6/14/2023 A B C D E F Item Balance m Fm,sb Change Order Item Specification Umt of CO Quantity to Add Addition Unit Prica Change Order Estimated Qnauhty T-1 Complaed Pravtously Vmue Thrs Materials Presently Value and Stored m Data (F) (B - F) No. Dcscnption Seclmn No Measure Value h stmled Installed Value Period Stored (na in C) (D+E) B This document has bee. modified from its ongiml form as an EJCDC document and the user did not highlight the modifications. You are enwmaged to read the document carefully and consult Legal Counsel pnor to its execution. C-620 Change Order Progress Estimate Change Order Number 1 7 DELETIONS IFor (contrea) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Apphoafion Numbec Apphcafio. Fermd 5/26/23-6/14/23 Apphoafion Date: A 6 C D E Item CO Quantity to Deleti on Chung. Order Item Desa non Spsaficsfion Umt of Delae Unit Price Chung. Order Not Used No[ Used N. Used Not Used Not Used No. P Section No Measure Value Totals This document has bee. modtfied from ns onginol form as an EJCDC document and the user did no( highlight the modifications. You are enwuraged to read the document carefully and consult Legal Counsel pnor to its execution. Contractor's Application 9 Final 6/14/2023 F Na Used Not Used Na Used C-620 Change Order Progress Estimate Change Order Number 1 8 ADDITIONS Contractor's Application IFor (comma) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement City Secretary 57679 Appl—tiov Number 9 Final Cnotract Nam: Application Pan d 5/26/23-6/14/23 Application Date: 6/14/2023 A B C D E F Item Balance to Fmtsb Additiov Chavge Order Item Speafication Umt of CO Quantity to Add Unit Prica Chavge Order Estimated Q.auhty Total Completed Prevtously ValuemMaterials Presently an Valae d Storad to Data (g _ (P) No. Dcscrrption Seamn No Measure Value Installed Nstalled Value Period Stoted (notes C) (D+E) B This do—t has bee. modified from ns ongiml form as an EJCDC document and the user did not highlight the modifications. You are enwmaged to read the document carefully and consult Legal Counsel pnor to its execution. C-620 Change Order Progress Estimate Change Order Number 1 8 DELETIONS IFor (contrea) 101579 Altamesa Blvd & Crowley Rd Intersection Improvement Apphoafion Numbec Apphcafio. Fermd 5/26/23-6/14/23 Apphoafion Date: A 6 C D E Item CO Quantity to Deleti on Chung. Order Item Desa non Spsaficsfion Umt of Delae Unit Price Chung. Order Not Used No[ Used N. Used Not Used Not Used No. P Section No Measure Value Totals This document has bee. modtfied from ns onginol form as an EJCDC document and the user did no( highlight the modifications. You are enwuraged to read the document carefully and consult Legal Counsel pnor to its execution. Contractor's Application 9 Final 6/14/2023 F Na Used Not Used Na Used City of Fort Worth Summary of Charges City secretary Contract Num: I 57679 I Altamesa Blvd & Crowley Rd Intersection Improvement I P. 0.: FW020-0000007928 Application Period: I 5/26/23-6/14/23 I Application I 9 Final Number: Funding Identification (FID) Total Completed Amt Remaining Gross Origq71 Contract 139008-0200431-5740010-101$-003980 $226,241.46 $3,672.69 130108-0200431-5740010-101579-003980 $398,768.40 $6,473.40 10 10 10 10 10 10 10 10 10 Change Order 1 1 39008-0200431-5740010-101579-003980 $7,450.00 1 30108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Change Order 2 1 39008-0200431-5740010-101579-003980 1 30108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Project Number: 101579 Application Date: 6/14/2023 Retainage Net City of Fort Worth Summary of Charges City secretary Contract Num: I 57679 I Altamesa Blvd & Crowley Rd Intersection Improvement I P. 0.: FW020-0000007928 Application Period: I 5/26/23-6/14/23 I Application I 9 Final Number: Funding Identification (FID) Change Order 3 1 39008-0200431-5740010-101579-003980 1 30108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Change Order 4 1 39008-0200431-5740010-101579-003980 130108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Change Order 5 1 39008-0200431-5740010-101579-003980 1 30108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Total Completed Amt Remaining Gross Project Number: 101579 Application Date: 6/14/2023 Retainage Net City of Fort Worth Summary of Charges City secretary Contract Num: I 57679 I Altamesa Blvd & Crowley Rd Intersection Improvement I P. 0.: FW020-0000007928 Application Period: I 5/26/23-6/14/23 I Application I 9 Final Number: Funding Identification (FID) Change Order 6 1 39008-0200431-5740010-101579-003980 1 30108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Change Order 7 1 39008-0200431-5740010-101579-003980 130108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Change Order 8 1 39008-0200431-5740010-101579-003980 1 30108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 Total Completed Amt Remaining Gross Project Number: 101579 Application Date: 6/14/2023 Retainage Net City of Fort Worth Summary of Charges City Secretary Contract Num: I 57679 I Altamesa Blvd & Crowley Rd Intersection Improvement I P. O.: FW020-0000007928 Project Number: 101579 Application Period: I 5/26/23-6/14/23 I Application I 9 Final Application Date: 6/14/2023 Number: Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Net Totals 1 39008-0200431-5740010-101579-003980 1 30108-0200431-5740010-101579-003980 10 10 10 10 10 10 10 10 10 $233,691.46 $3,672.69 $398,768.40 $6,473.40 Grand Total 1 1 $632,459.87 1 1 $10,146.09 1 1 $0.00 1 1 ($31,622.99)1 1 $31,622.99 1 FORT WORTU., Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Change order No 1 McClendon Constr. Altamesa and Crowley M&C: 23-0346 Date: CPN: 101579 CSO: DOC#: To: Name Jaylyn Harrelson Department ?H Initials Date Out 1. jblair@mcclendonconstruction.com Contractor -Signature gS May 12, 2023 2. Kevin Jackson TPW Signature K92* May 11, 2023 3. Brad Radovich TPW - Signature B May 11, 2023 4. Chad Allen TPW -Signature Ck May 15, 2023 5. Lissette Acevedo TPW -Signature May 16, 2023 6. Michael Owen TPW - Signature May 16, 2023 7. Lauren Prieur TPW - signature (/�/l.(� May 16, 2023 8. Doug Black Legal - signature d May 17, 2023 9. William Johnson ACM - signature LF W, May 17, 2023 10. 11. DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑YES ®No RUSH: []YES ®No SAME DAY: ❑YES ❑No NEXT DAY: ❑YES ❑No ROUTING TO CSO: ®YES ❑No Action Required: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return To: TPWContracts(a�FortWorthTexas.2ov at ext. 7233 or 8363, for pick up when completed. Thank you! Updated 03.29.2023 mdhm CSC No. 57679-COl FOR, _ TwORTH® City of Fort Worth Change Order Request Project Name Altamesa and Crowley Intersection Improvements I City Sec # 1 57679 Client Project #(s)l 101579 Project) Addition of two additional Left Turn lanes using existing median space, installation of new signals and new ADA compliant curb ramps. Description Contractorl McClendon Construction Change Order #1 1 1 Datel 4/25/2023 City Project Mgr.l Bradley Radovich City Inspectorl Kevin Jackson Dept. TPW Contract Time Totals (CD) Original Contract Amount $635,155.95 $635,155.95 120 Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $635,155.95 $635,155.95 120 Amount of Proposed Change Order $7,450.00 $7,450.00 67 Revised Contract Amount $642,605.95 $642,605.95 187 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 Additional Funding (if necessary) $7,450.00 $7,450.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 1.17% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $793,944.94 JUSTIFICATION (REASONS) FOR CHANGE ORDER M6 This change order includes three items. The first item is powder coating of the new traffic signal poles and mast arms in accordance with current City specifications and the requirements of the Transportation Management Department. This project was originally bid with a previous version of the traffic signal specifications that did not include powder coating. The second item is joint filling of a large gap between the back of curb and a new concrete median constructed as part of the project. This work was not included in the original plans and was requested by the City of Fort Worth after observing the large joint gap during the final punch list inspection. The third item is the addition of 67 days of contract time that was the result of a longer than expected delivery time of traffic signal equipment for the project. Neither of the two cost items described in this change order were included in the original bid. Unit prices for these items not included in the original bid were evaluated by City staff and the design consultant. The prices included in this change order have been compared to unit prices for similar items from recent bids by TXDOT and the City of Fort Worth and were found to be reasonable and comparable. The price evaluation is available in the project files. 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 Date McClendon Construction Co, Inc. Justin Blair '— -- May 12, 2023 Ins ector/Ins ection Supervisor and Contract Com liance Mana er Date May a May 11, 2023 ram Mana er EDateProject Senior Ca ital Project Officer Date May May 16, 2023 r De t Director, ContractingDepartment (Dept) Date -"41:- (9 ►+a► May 16, 2023 � May 16, 2023 Assistant City Attorney Date lAssistant Cit Manager Date t May 17, 2023 1 w"^q� May 17, 2023 M&C Number l l M&C Date Approved ATTEST: O.n— A A Jannette Goodall, City Secretary PORT WORTH City of Fort Worth -T.,Change Order Additions Project Name I Altamesa and Crowley Intersection Improvements City Sec # 57679 Client Project # I 101579 1 Contractorl McClendon Construction I PM1 Bradley Radovich I Inspectorl Kevin Jackson l Change Order Submittal # O Date i 4/25/2023 j ADDITIONS IItM UtJUKIPIIUN UtNI Uty Unit Unit host total 1 34 41 10 Powder Coating for Trafic Signals TPW 1.00000000 LS $5,250.00 $5,250.00 2 3213 73 Crack Sealing for Concrete Paving TPW 550.00000000 LF $4.09 $2,200.00 TPW TPVV $7,450.00 Sub Total Additions $7,450.00 Change Order Additions Page 2 of 4 I I tivi FORT WORTH City of Fort worth "r Change Order Deletions Project Name I Altamesa and Crowley Intersection Improvements I City Sec # 1 57679 Client Project # 1 101579 1 Contractorl McClendon Construction PM1 Bradley Radovich Inspectorl Kevin Jackson Change Order Submittal # 0 Date 1 4/25/2023 DELETIONS UtbUKn'I IDIV utrI uty unit una Lost Iotai I rvv $u.uu' I I I I II I lI II I 1 1 1 lI I I lI I I I 1 I I lI lI I I �I I I 1 I 1 I 1 I 1 lI I 1 I 1 I I I Pvv $0.00 Sub Total Deletions $0.00 Change Order Deletions Page 3 of 4 M/SBE for this Change Order M/SBE Sub Type of Service T Amount for this CO Total $0.00 Previous Change Orders co # DATE I AMOUNT Total I $0.00 1 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS June 15, 2023 McClendon Construction Company, Inc. P.O. Box 999 Burleson, Tx 76097 RE: Acceptance Letter Project Name: 2018 CIP Intersection Improvements AltaMesa Boulevard and Crowley Road Project Type: Paving/Street Lights City Project No.: 101579 To Whom It May Concern: On April 5, 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 April 20, 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 April 20, 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 Bradley Radovich, PE Senior Project Manager 817-392-7817 1 Bradlev.RadovichWortworthtexas. gov . Sincerely, Brad Radovich, Project Manager Cc: Kevin Jackson, Inspector Gary Deyon, Inspection Supervisor Troy Gardner, Senior Inspector Chad Allen, Program Manager AECOM, Consultant McClendon Construction, Contractor City Of Ft. Worth, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 CONSENT OF OWNER El SURETY COMPANY ARCtIrruCT o TO FINAL PAYMENT CONTRACTOR ❑ SURETY ❑ AIA DOCUMENT G707 OTHER Bond No. TXC614184 PROJECT: 2018 CIP Intersection Improvements A1taMesa Blvd & Crowley Road (name, address) TO (Owner) [ City of Fort Worth, Texas ] ARCI-ITECT'S PROJECT NO: 200 Texas Street Fort Worth, TX '76102 CONTRACT FOR: [ ] CONTRACT DATE: May 10, 2022 CONTRACTOR: McClendon Construction Company, Inc. 548 Memorial Pima Burleson, TX 76024 lit accordance with the provisions of the Contract between the Owner anti the Contractor as indicated abo ve. the (here insert name turd address of Surety Company) Merchants Bonding Company (Mutual) P.O. Box 14498 Des Moines, IA 50306-3498 , SURETY COMPANY, on bond of (here insert name and address O' Contractor) McClendon Construction Company, Inc. 548 Memorial Plaza Burleson, TX 76024 , CONTRACTOR, hereby approves of the final payment to the Contractors, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its oblisations to (here insert name and address ofO%vner) City of Fort Worth, Texas 200 Texas Street Fort Worth, TX 76102 ,OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 15th day of June Attest (Seal). 2023 Merchants Bonding Company (Mutual) St-ir�f Company IgnaIWeAlt;; Betty J. Reeh Title Representative Attornev-In-Fact NOTE: This Form is to he used as a wmpanion docsment it) AIA iX)('t]ME:N'T 6706. CONTRACTOR'S AFFIDAVIT OF 1'AYMI.NT OF DE13TS AND CLAIMS. Current Edition AEA DOCUMENT G707 ► CONSENT OF SURETY COMPANY 'rO 171NA1. PAYMENT • APRIL 1970 EDITION ■ AIAO @ 1970 • Tl IE AMFRICAN INSTITUTE OF ARCHITECTS, 1735 New York Avc., NW, WAS[ IINGTON, D.C. 20006 ONF PAGF `q M E FCC HA,N T7� BONDING COMPANY, POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the Stale of Iowa, dlbla Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Allyson W Dean: Ana Owens; Andrea Rose Crawford; Andrew Gareth Addison; Betty J Reeh; Bryan Kelly Moore; Clayton A Johnson; Colin E Conly; Debra Lee Moon; Elizabeth Ortiz; Emily Allison Mikeska; John R Ward; Michael Donald Hendrickson; Monica Ruby Veazey: Patrick Thomas Coyle; Sandra Lee Roney; Thomas Douglas Moore; Troy Russell Key their true and lawful Attorneys) -in -Fact, Ic sign its name as surety(ies) and to execute, seat and acknowledge any and all bonds, undertakings, contracts and other written instruments n the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adapted by the Board of Directors of Merchants National Bonding, Inc., on OcW),-r 16, 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer an J the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the Execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal whr�n so used shall have the same force and effect as though manually fixed:' In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all cnnsents for the release of retained percentages andfor final estimates on engineering and construction contracts required by the State of Florida Department of Transportation, It is fully understood that consenting to the Stale of Florida Department of Transportation making payment of the frnal estimate to the Contractor andfor its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of thE! Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modifi&d or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwi"llh of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 15th day of March 2023 .+' ' .,........ MERCHANTS BONDING COMPANY (MUTUAL) +`,�A��• q'i' •�Q\H....�4/jjA. MERCHANTS NATIONAL BONDING, INC. RQaRy�pZ_ : m4,�gp�QOgg9��: d1b1aMERCHANTS NATIONAL INDEMNITYCOMPANY ee v . 2003 • d •` 1933 c: By =J `r. •. d :'� • d . 0•. :,'�Ly '' '': r? : • . •'1d . 7ent STATE OF IOWA Presi COUNTY OFDALLASss.•"`•+• On this 15th day of March 2023 before me appeared Larry Taylor, to me personally known, who being by we duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seats affixed to the foregoing instrument ire the Corporate Seals of the Companies; and that the said instrument was signed and sealed In behalf of the Companies by authority of their respective Boards of Directors. Kim Lee Commis Number 702737 Af�yJiL� • rmyCOmmi;cgn ExprrES fy;ril 14, Z424 - 412 Public of notary's commission does not invalidate this instrument} I, Wiliam Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a tr to and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full farce and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this /�y of 1.l Z D 0.. ' mU•.4jk 0,99. x • 20,)3 rcy� • �' 1933 e; Secretary •yrj � a. r� •r-f POA 0018 (10/22) MERCHANTS k16 BONDING COMPANY IMPORTANT NOTICE To obtain information or make a complaint: You may contact your insurance agent at the telephone number provided by your insurance agent. You may call Merchants Bonding Company's toll -free telephone number for information or to make a complaint at: 1-800-678-8171 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-262-3439 You may write the Texas Department of Insurance at: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512) 475-1771 Web: http://www.tdi.state.tx.us E-mail: ConsumerProtection@tdi.state.tx.us PREMIUM AND CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. SUP 0032 TX (1/09) MERCHANTS BONDING COMPANY. MERCHANTS BONDING I_ ClNWANY (M IUAI-) • 1'.0. BOX 1.1.198 • DES ,NWIN S, 10WA 5030b-3498 PHONE: (800) 678-8171 • FAX: (515) 243-3854 ADDENDUM TO BOND T hi s A ddendum is i n reference to the bond(s) to which it i s attached. Merchants B ondi r€; Company (Mutual) ('Merchants_) deems the digital or electronic image of Merchants' corporate seal Lc4ow affixed to the bond(s) to the same extent as if a raised corporate seal was physically stamped or i mpr{-,ssed upon the bond(s). T he digital or electroni c seal be] ow shall have the same force and effect as though rnanualIy fixed to the bond(s), A I I terms of the bogs) rerrai n the same. Signed and effective March 23, 2020. MERCHANTS BONDING COMPANY (MUTUAL) By:------ -r------------- L arry Taylor, President 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 Justin Blair, Vice President of McClendon Construction Company, Incorporated, 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 there are no claims pending for personal injury and /or property damages; On Contract described as; Altamesa and Crowley Road Intersection Improvement (CPN 101579) Subscribed and sworn before me on this MISTY WEBB pjtY PVe ii 2 _ "--'Notary Public, State of Texas =� •°�� Comm. Expires 01-09-2026 Notary ID 126838467 Justin Blair 1y day of 20Z otary P liifn Tarrant C9t Xty, Texas