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Contract 57092-FP1
FORTWORTH, TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION -FP1 City Secretary No: 57092 Date Received: 8/3/2023 City Project JV!?: 101009-2 Regarding contract 57092 Intersection Improvements at Bonds Ranch & FM 156 for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 10/12/2021 through M&C 21-0786 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: $ 1,180,676.20 Amount of Approved Change Orders: $ 34,259.46 No 3 Revised Contract Amount: $ 1,214,935.66 Total Cost Work Completed: $ 1,212,179.94 Less Deductions: Liquidated Damages: _ Days @ $ Pavement Deficiencies: Total Deduction Amount: $ Total Cost Work Completed: $ 1,212,179.94 Less Previous Payments: $ 1,151,570.94 Final Payment Due $ 60,609.00 pa-f cia L. INGlGl5an(l Aug 1, 2023 Patricia L. Wadsack (Aug 1, 202316:10 CDT) Recommended for Acceptance Date Asst. Director, TPW - Capital Delivery A....,,? Aug 1, 2023 Lauren Prieur (Aug 1, 2023 16:34 CDT) Accepted Date Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT William Johnson ALf, 3, 202311:13 CDT) Aug 3, 2023 Asst. City Manager Date / Day Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX To (Owner) P. O. Number: Project: C-620 Signature Page Contractor's Application for Payment Invoice No. 13-FINAL City of Fort Worth Invoicing Period (From - To): Invoice Date: 6/16/2023-7/12/2023 7/12/2023 FW020-0000007368 From (Contractor): Remit to ( If Not Automatic Deposit): 101009-2 City Secretary Contract ���� Number: Application For Payment Change Order Summary (Approved Change Orders Number I 1 I 2 I 3 I 4 I 5 I 6 I 7 I 8 TOTALS NET CHANGE BY CHANGE ORDERS Contractor's Certification Additions $148,702.35 $14,630.00 $2,566.31 $165,898.66 Texas Materials Group, Inc dba Texas Bit Contractor's CFW Vendor No.: 0000000257 Contract Nam: Intersection Improvements on Bonds Ranch Road at Farm to Market Roadl56 $34,259.46 1. ORIGINAL CONTRACT PRICE............................................................. $ Deletions 2. Net change by Change Orders.................................................................... $ $124,482.35 3. Current Contract Price (Line 1 t 2)........................................................... $ $7,156.85 4. TOTAL COMPLETED AND STORED TO DATE (Progress Estimate, Construction Allowance and Change Orders)....... $ 5. RETAINAGE: a. X $1,212,179.94 Work Completed.......... $ b. X Not Used $ c. Total Retainage (Line 5a + Line 5b)................................. $ 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c) ............................... $ $131,639.20 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)......... $ 8. AMOUNT DUE THIS APPLICATION.................................................... $ 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + COs + Line 5 above) ............... $ 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 Liquidated Damages $1250 x day �I GCCL/)Z V Y P�J�SD/�Z 10. CONTRACT TIME: a, Days Awarded b, Days Added by CO C. Total Days d, Days Charged e, Days Remaining Consent of Surety Affidavit of Bills Paid $1,180,676.20 $34,259.46 $1,214,935.66 $1,212,179.94 $1,212,179.94 $1,151,570.94 $60,609.00 $2,755.72 300 50 350 350 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. Progress Estimate I-- W—fi- Improvements on Bonds Ranch Road at F— t, Market R,,d156 6I 6nO23-7/12/2023 �N—a 2�1 11= ffil YON w La sib TVono Ww%M— MIAMI - W�11 TL111=1 —El 41 4.alll 61 1:.1: 1., 11 4110011' oo .411. '4 4 w000 YA YK X, I a Z, WrA LIS(en am,...... .41��' 14 I'll 1 STIM 0'1.-,Z—u- .411' 144 1 _1 �. 11 1� 11 Y, 144111 11 ME 11 14 RF//W, MINKINIA-1 0.. —.4 0.= 1 010.0 inuium LT .0 0 =5 R9L(;1.11.111, r —0— .=O-z 100 �4 4;' 4 57092 Contractor's Application ti id 121. 02�i�o I LIM o1ol, I as A.. l o --k! 1.k —2 , 4, 2� 21 N 4= 0 4 4 0 jr2 2 M i 4 —M M, 2. o—vj o11 HNI. Progress Estimate 57092 Contractor's Application f0"""' Intersection Improvements on Banda Ranch Road at F.— t. Market R-d156 61t6/202}7/=On .-d C-620 Change Order Progress Estimate Construction Allowance Usage ADDITIONS For (wno-aa0 101009-2 Intersection Improvements on Bonds Ranch Road at Farm to Market Road156 Clry 9ewe,ery 57092 Cl— N— Apptlwhmi Pe"Od 6/16/2023-7/12/2023 A B C Bm Specifi lion Q..ry W Add Umt Price Addi,ion Value Esn -a Quantity Item Numbs Descnpnon Sation No. Unit ofMeesure Installed Totals Prev dy Installed Value E Value This Matenals Presently P... sno (not. C) Contractor's Application 13-FINAL 7/12/2023 F Tool Completed % Balance,. Finish aM Sto to Date (T) (B -F) MI E) B Thee documrnl has barn moMfled 6om its original form ea an EICDC dowmeot and the user didoo[ Idghlight the modifications. Vou 11 rnwuraged m read the document carefully and —It Legal Couruel prior to its execution. C- 20 Change Order Progress Estimate Construction Allowance Usage CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED For (rotmact): 101009-2 I mersection Improvements on Bonds Ranch Road at Farm to Market Road156 IAppnwhonPmad: 6/16/2023-7/12/2023 A R I Rem Ridl—Number Deseriptlon Speolfication Umt of Measure Q—ityb Delete Uoit Price Ret0. Value Sation No. I I I I I roosts Contractor's Application C D Noc Uses Noc Usea Not Ured NM Ured A,-fi nNnmber: 13-FINAL Appnwcion Date: 7/12/2023 F F Noc Used NM Ured NM Ured NM Ured rn�s documwl nos. bern momaea vom ns odgn�al roan ea an elcDc aowmwt aoa me user manor lagnngnt the modifications. Vou 11 enwuragea c re ad the aaumenc carefully and —It Legal Cou 1 prior to its execution. C 620 Change Order Progress Estimate Change Order Number 1 1 1 ADDITIONS Fore ee-t) I01009-2 Intersection Improvements on Bonds Ranch Road at Farm to Market Road156 Cay Secrerary 57092 Cormact Num: Apple—Penod 6/16/2023-7/12/2023 A B C D Item Addition Change Order Item SPeoificatloa QuanatY to Add Unit Pnce Change Order Estimated Qvanhty mewled Valve No D— ti0n Umt of MeasuaCO P Section No. Value 95 9" W17 Ire Trf SIOPIAm(s)1Arm(48')Lum Powder Coat Black - 200000000 $20.80000 $41.60000 200000000 $41.60000 96 9" W18b Trf SIOPIAm(s)IArm(55')Lum Powder Coat Blank F.A 200000000 $48.10700 $96.21400 200000000 $96.21400 97 9999 WI9 Ped Pole Assembly Powder Coat Black - 3 00000000 $3.62945 $10.888.35 3.00000000 $10.888 35 Totals S148.702.35 $148,702.35 Contractor's Application Appli--Number 13-FINAL Applicama Daze 7/12/2023 E F Total Completed % Balance to Fmisb Previously Value Ibis Materials y -Stored W Date (F) I. -F) Installed Value Penod $toted (.11. C)C) (D +E) B $41.60000 S41.600.00 IW 0% $96.21400 $96.214.00 IN 0% $10.88835 $10,888.35 1000% $148.702.35 $148,702.35 IW O% This document bas been modified from its onginal form as an E1CDC docamcnt and the user hd — laghhgbt the modffi—ions. You are wwwraged to read the document c=Uly W wroult Legal Counsel pnor to O[ ex —m. C 620 Change Order Progress Estimate Change Order Number 1 1 DELETIONS For (.ousel) 101009-2 Intersection Improvements on Bonds Ranch Road at Farm to Market Road156 ApplmamnPenod: 6/16/2023-7/12/2023 A B C Item CO n to Deletion Change Order Item Descnpti. Specifi.non Umt of Measure Delete Una Pnce Change Order. Not Used No. 9999999 WWFI76 ]]7B SS,APPI hGis TTrfrf Section No. 20WWW0 $417.5900[[ $Va5,u18006 It(s1 5'IL= 9]9 99W19 PedPole EA 200000 30WWW0 $0.857W $2.5294i $81,71406 $7,5883? I I I I Tobla $124,482.39 Appli.—Nsmber Application Dale. D E Not Used Not Used Not Used Not Used Contractor's Application 13-FINAL 7112/2023 F Not Used Not Used Not Used This docum.t has been modified from its onginal form as. E1CDC de—M and the —dtd.t laghhght the moddicatim. You are e.wraged to read the document emNly and —It Legal Counsel pno, to td meafteo. Progress Estimate Change Order Number 1 2 Contractor's Application ADDITIONS IPor—wn ) 101009-21ntersectinn Improvements on Rnnds Ranch Road at F.— to Mnr Road156 2S11_ 5]092 c olrem Nnm tO"No"'Pm 13-FINAL 6/16/2023-7/12/2023 A 0 c PP °on um` 7/12n023 � P P Chv�ge Oo min+n Ian 9eemfi<anon Unsnrt COQoennt Add Unn Pnm Add'non Chen noted Quennry Vmoe `°°'oudy ]d Mmme a P1.Q Vmmods B.—m �n�A oral CamplO % P entlS 0. (B-P) tort e N U P Sxho No M Udv Vil N ata ed stallMValue P Slo�(rotm C)P B ov 9r090ma'Sera_ mmes mrcMeua nrcl nuo7seec 6a 7ssa] en l0000000o s.zao oo 001 200000000o svi 000l n4000o1 nz20 s7a0o00117 a]a30 oo szv000 moat m�h�lm �a6E�m�o�a von art a�aom�saa a rtaa n, nnor,�t oartMllr :a ao.anl—coo ,o m �m-anon Progress Estimate Change Order Number 1 2 DELETIONS F0 rCO°n8f11 101009-2 Intersection Improvements on annds Ranch Road at F.—to Market Road156 n°°h`°non veriod 6/16/2023-7/12/2023 n B C I lam Up Q°°nnrya la ch C Iw° O P Seemn No Uelele Uml Pnro UOrder Vilue� Nol Uxd i sow ozou i at sass oom ser7vuza crnv ralw an �0000000o ss_tsa xs ss_tsa xs Contractor's Application no°hrnnon Nnnaa 13-FINAL noohwnon uele 7/12n023 U E F Nol Ueed Nor Uaetl Nol Used Nol Used Not Used Nor Uaed N., used rm�h�lrh �a6r�v�°°, von as a°en��a a �a n, nn«n�r �rnur �a ro°s,i� �i con a. e°o to m e.alno° C 620 Change Order Progress Estimate Change Order Number 1 3 ADDITIONS For (eonvact) I0I009-2 Intersection Improvements on Bonds Ranch Road at Farm to Market Road156 Crty Secrerary 57092 Cormact Nmn: Applrea°°a Penod 6/16/2023-7/12/2023 A � Item Chaoge Order Item Descnptim No. 18 9999 W12 Drmh Gradrne 20 3211 0113 8" Flexfblc Bes, Twe A. GR-1 23 3212 0503 6" Asphalt Bess T— B 82 9999 W22 REFL PAV MR TY H (W) 4" (SLD) Total, B C D Addaion Specification CO Quarmty m Add Unit Pnce Change Order Estunated QuanOry Valne Sttlion No. Una of Measure Valac Installed TPW CY 1000000000 $2235 $223.50 10.00000000 $2235 TPW SY 14100000000 $1010 $1,42410 14100000000 $ AN TPW SY 13 00000000 $45 67 $593.71 13.00000000 $593 ] TPW LF 25000NNN $130 $325.00 25000000000 $3250 $2,566.31 $2.5663 Contractor's Application Apphcanoa Namber 13-FINAL Apphoahon Date 7/12/2023 E F To Completed % Pre�ioosly Valae'11ds Materials Presently and Stored to Date (F) Installed Val- Penod Stored (curt m C) (D+E) B 122350 $223.'a 1001W/ $L4241a t AN la IN 0% E593 ]I $593.71 1001W/ 8325 00 $325.00 100 0a/ $2.566.31 1000% Balance to Fau h (B -F) This document has been modified from d8 onginal form as an E1CDC docamern and the aser drd curt M d hght the moddications. You are wwwraged to read the document mf dly W consolt Legal Counsel pnor to rm exe—m. C-620 Change Order Progress Estimate Change Order Number 1 3 DELETIONS For (wnrcac0 101009-2 Intersection Improvements on Bonds Ranch Road at Farm to Market Road156 A.hcafion Number App1—renod 6/16/2023-7/12/2023 Awlicafion Date A B C D E Item CO n to Deleaon Change Order Item Descnptlon 6peoificatiov Umtof Measure Delete U."Pnce Change Order Not Used Not Used Not Used Not Used Not Used No Section No. Value I I I I I torah Contractor's Application 13-FINAL 7/12/2023 F Not Used Not Used Nol Used Tl document has been modified from its onginal form as an E1CDC docamem and the aser drd — lughhght the modrtications. You are wwwraged to read the document =Uly W —It Legal Counsel pnor to td exe—m. ON of Fort Worth Summary of Charges City Secretary Contract Num: 57092 intersection Improvements on Bonds Ranch Road at I, armto P. O.: FW020-0000007368 Project Number: 101009-2 Market Road156 Application Period: I 6/16/2023-7/12/2023 Applica ion 13-FINAL Application Date: 7/12/2023 Number: Funding Identification (FID) Total Completed Aral Remaining Gross Retainage Net I Oriy)nal Contract 134018 0200431 5740010 101009 003980 9999 18010199 $1,046,281.28 $134,394.92 to 10 Io 10 10 10 10 10 10 10 I I Change Order 134018 02004315740010 101009 003980 9999 18010199 10 10 Io 10 10 10 10 10 10 10 I 1 Chany0 Order 2 134018 02004315740010 101009 903980 9999 18010199 10 10 Io 10 10 10 10 10 10 10 I $148,702.35 ($124,482.35) $14,630.00 ($7,156.85) City Secretary Contract Num: I 57092 Application Period: ON of Fort Worth Summary of Charges intersection Improvements on Bonds Ranch Road at r'arm to P D : FW020-0000007368 Project N nber: �101009-2 Market Road156 6/16/2023-7/12/2023 Applica ion 13-FINAL Application Date: 7/12/2023 Number: Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Net I I Cha Order3 134018 0200431 5740010 101009 803980 9999 18010199 $2,566.31 Io l0 10 10 10 10 10 10 10 10 I I I I Cha a Order4 134018 0200431 5740010 101009 (503980 9999 18010199 Io to 10 10 10 10 10 10 10 10 I I I the orders 134018 02004315740010 101009 a03980 9999 18010199 Io l0 10 10 10 10 10 10 10 10 I I I I I I I I I I I City Secretary Contract Num: I 57092 Application Period: ON of Fort Worth Summary of Charges intersection Improvements on Bonds Ranch Road at r'arm to P D : FW020-0000007368 Project N nber: �101009-2 Market Road156 6/16/2023-7/12/2023 Applica ion 13-FINAL Application Date: 7/12/2023 Number: Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Net I I Cha OrderB 134018 02004315740010 101009 803980 9999 18010199 Io l0 10 10 10 10 10 10 10 10 I I I I Cha Order? 134018 0200431 5740010 101009 8 3980 9999 18010199 Io to 10 10 10 10 10 10 10 10 I I I the orders 134018 02004315740010 101009 a03980 9999 18010199 Io l0 10 10 10 10 10 10 10 10 I I I I I I I I I I I ON of Fort Worth Summary of Charges City Secretary Contract Num: 57092 intersection Improvements on Bonds Ranch Road at "'arm to FW020-0000007368 P. O.: Project Number: Market Road156 � �101009-2 Application Period: I 6/16/2023-7/12/2023 Applica ion 13-FINAL Application Date: 7/12/2023 Number: Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Net I � I Totals 34018 02004315740010 101009 003980 9999 18010199 $1,212,179.94 $2,755.72 to 10 10 10 10 10 10 10 10 10 I Grand Total $1,212,179.94 1 $2,755.72 1 $0.00 1 ($60,609.00)1 1 $60,609.00 1 FORT WORTH(,, Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Construction Change Order No. 1 - Bonds Ranch at FM 156 M&C: 21-0786 CPN: 101009 CSO: 57092 DOC#: 1 Date: To: Name Department Initials Date Out 1. Bus. Support Partner - Sara Cox TPW-initial sc 04/19/22 2. Adam Newsom- Contractor TexasBit adam.newsom@texasbit.com ,i/ 04/19/22 3. Rudy Medellin - Inspector TPW - sign 04/19/22 4. Brendan McInnes - Project Manger TPW-initial gAz 04/19/22 5. Shweta Rao -Contract Compliance Mngr TPW -sign ,�a- 04/19/22 5. Lisette Acevedo - Program Manager TPW - signs- 04/22/22 6. Martin Phillips - Senior CPO TPW - sign Signature 11A1 04/22/22 7. Lauren Prieur - Asst. Director TPW - sign ILL 04/22/22 8. William Johnson - Director TPW - sign W 04/24/22 9. Doug Black - City Attorney Legal - sign signature ,gZg� 04/25/22 10. Dana Burghdoff - ACM CMO - sign signature D 04/25/22 11. Jannette Goodall - CSO CSO - signsa JSG 04/26/22 12. TPW Contracts TPW 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: ❑ Attach Signature, Initial and Notary Tabs ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File Return To: TPWContracts(a)fortworthtexas._oov, for pick up when completed; list "Please call Brendan �a ext # 2817 for questions. Thank you, " CSC No. 57092-COI FORT WORTH-, City of Fort Worth Change Order Request Project Name Intersection Improvements at Bonds Ranch & FM 156 City Sec # I 57092 Client Project #(s)� 101009-2 Intersection improvements including widening Bond Ranch Rd to provide left turn lanes onto Farm to Market Road 156, improve raddi for northbound to Project Description eastbound traffic, minor storm drian improvemnets and a new traffic signal with pedestrain access. Contractor Texas Materials Group, Inc. dba TexasBit Change Order #1 1 1 Datel 4/14/2022 City Project Mgr.1 Brendan McInnes, PE City Inspector Habte Taezaz Dept. TPW Contract Time Totals (CD) Original Contract Amount $1,180,676.20 $1,180,676.20 300 Extras to Date Credits to Date Pending Change Orders (in M&C Process) $0.00 Contract Cost to Date $1,180,676.20 $1,180,676.20 300 Amount of Proposed Change Order $24,220.00 $24,220.00 Revised Contract Amount $1,204,896.20 $1,204,896.20 300 Original Funds Available for Change Orders $24,220.00 $24,220.00 Remaining Funds Available for this CO $24,220.00 $24,220.00 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 2.05% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $1,475,845.25 JUSTIFICATION (REASONS) FOR CHANGE ORDER Adding a powder coat finish to all signal and pedestrain pole equipment 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 I Contractor (Name) I IT911111het Signature I Date TexasBit Adam Newsom — d", /✓ew onz 04/19/22 Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date 04/19/22 Pi`0,{9d6fP#4/PP9f 04/19/22 Program Manager Date Senior Capital Project Officer Date e 04/22/22 P 04/22/22 Assist Date Director, Contracting Department (Dept) Date _ PN 04/22/22 04/24/22 16 Date Date 04/25/22ra;Y,Pon 04/25/22 Council Action (if required) M&C Number M&C Date Approved ATTEST: T nn� s caoe u Jannette Goodall, City Secretary FORT WORTH City of Fort Worth Change Order Additions Project Name I Intersection Improvements at Bonds Ranch & FM 156 City Sec # 57092 Client Project# 1 101009-2 1 Contractorl Texas Materials Group, Inc. dba TexasBit PMJ Brendan McInnes, PE Inspector" Habte Taezaz Change Order Submittal # O1 Date 1 4/14/2022 1 ADDITIONS I I EM UESGRIP I IUN UEP I Uty Unit Unit lost I otal 9b 9999.UU1 I Ins I It 6iU PI Arrs 1 Ann148'(1Lum Powder Goal Black I PVV z.000UUUUU EA $2U,6uu.UU $41,6UU.UUJ 96 9999.UU16 Ins 1I? 5i U PI Am�)l Arri1l55'�Lum Powaer Coat Black TPW 2.00000000 EA $48,107.00 $96,214.001 97 9999.0019 Ped Pole Assembly Powder Coal Black TPW 3.00000000 EA $3,629.45 $10,888.351 1 1 TFW $148,702.35 Sub Total Additions $148.702.35 Change Order Additions Page 2 of 4 FORTWORTH City of Fort Worth Change Order Deletions Project Name Intersection Improvements at Bonds Ranch & FM 156 I City Sec # 1 57092 1 Client Project # I 101009-2 1 Contractorl Texas Materials Group, Inc. dba TexasBit I PMI Brendan McInnes, PE I Inspeclorl Hable Taezaz Change Order Submittal # O1 Date 1 4/14/2022 1 DELETIONS IILM ULSUKIPIIUN ULPI U Unit Unit Uost total I 9999.UU'I! Ins I rt JIU PI HR14I7s11 Arm 48' LUm I YVv ' .000UUUUu LA V l,b9U.UU $Jb,1bu.UU 78 9999.uu'18Ins nS)UPIAmis11Arn�bb'�Lum TPW 2.00000000 EA $40,857.OU $81,714.00 79 9999.0019 Ped Pole Assembly TPW 3.000OOOOU EA $2,529.45 $7,588.35 TFW $124,482.35 Sub Total Deletions $124,482.35 Change Order Deletions Page 3 of 4 M/SBE for this Change Order M/SBE Sub Tvpe of Service Amount for this CO Total $0.00 Previous Change Orders co # DATE I AMOUNT Total 1 $0.00 1 FORT WORTH,,, Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Construction Change Order No. 2 — Bonds Ranch at FM 156 M&C: 21-0786 CPN: 101009 CSO: 57092 DOC#: 1 Date: To: Name Department Initials Date Out 1. Bus. Support Partner — Sara Cox TPW-initial Aug 3, 2022 2. Adam Newsom — Contractor TexasBit Contractor Aug 3, 2022 3. Habte Taezaz - Inspector TPW - sign Aug 5, 2022 4. Brendan McInnes — Project Manager TPW-initial - Aug 5, 2022 5. Shweta Rao — Contract Compliance Mngr TPW - sign - Aug 5, 2022 5. Lissette Acevedo — Program Manager TPW - sign 1W Aug 10, 2022 6. Martin Phillips — Senior CPO TPW - sign MAMA➢ Aug 10, 2022 7. Lauren Prieur — Acting Director TPW - sign uLI ' Aug 11, 2022 8. 9. Doug Black — City Attorney Legal - sign ,� Aug 15, 2022 10. William Johnson - ACM CMO - sign W,. Aug 15, 2022 11. Jannette Goodall - CSO CSO - sign 1 Aug 16, 2022 12. TPW Contracts TPW 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 Reauired: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return To: TPWContracts(d)fortworthtexas,00v, for pick up when completed; list "Please call Brendan Cad ext # 2617 for questions. Thank you. " CSC No. 57092-CO2 FORT WORTH.. City of Fort Worth Change Order Request Project Name Intersection Improvements at Bonds Ranch & FM 156 City Sec # I 57092 Client Project #(s)l 101009-2 Project Intersection improvements including widening Bonds Ranch Rd to provide left turn lanes onto Farm to Market Road 156, improve raddi for northbound Description to eastbound traffic, minor storm drain improvements and a new traffic signal with pedestrian access. Contractor Texas Materials Group, Inc. dba TexasBit Change Order #I 2 1 Date 8/2/2022 City Project Mgr.1 Brendan McInnes, PE City Inspector Habte Taezaz Dept. TPW Contract Time Totals (CD) Original Contract Amount $1,180,676.20 $1,180,676.20 300 Extras to Date $148,702.35 $148,702.35 Credits to Date $124,482.35 $124,482.35 Pending Change Orders (in M&C Process) $0.00 Contract Cost to Date 7 $1,204,896.20 $1,204,896.20 300 Amount of Proposed Change Order $7,473.15 $7,473.15 Revised Contract Amount $1,212,369.35 $1,212,369.35 300 Original Funds Available for Change Orders $24,220.00 $24,220.00 Remaining Funds Available for this CO $0.00 Additional Funding (if necessary) $7,473.15 ME $7,473.15 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 2.68% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 2551p) $1,475,845.25 JUSTIFICATION (REASONS) FOR CHANGE ORDER Existing plans indicated a 24" CMP being in the field to be tied into and extended. During field construction kickoff meeting it was noted that the existing pipe was not a 24" CMP but a DES 4 Arch pipe. Contractor has submitted pricing for the revised pipe and end treatment. 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. is Company Name Contractor (Name) ire �Texas&t Adam Newsom s9d�r N�,sa L �Auo Date Project and Contract Compliance Manager Aug 5, 2022 or Aug 5, 2022 Aug 10, 2022 Aug 10, 2022 o-P Aug 11, 2022 �' o Aug 11, 2022 Assistant City Manager „..�,,...,., Aug 15, 2022 Aug 15, 2022 M&C Number I I M&C Date Approved ATTEST: 4OVdA li Jannette S. Goodall (Aug 16, 2022 07:16 CDT) Jannette Goodall, City Secretary FORT WORTH City of Fort worth V---- Change Order Additions Project Name j Intersection Improvements at Bonds Ranch & FM 156 City Sec # 57092 Client Project # j 101009-2 1 Contractor) Texas Materials Group, Inc. dba TexasBit PMI Brendan McInnes, PE Inspectorl Habte Taezaz l Change Order Submittal # O2 Date j 8/2/2022 ADDITIONS I I EM ULSCHIP I ION UEPI 98 9999.0033 CMP AK (UAL S 1 L DES 4) 1xUUI SPEC U46U 6011 1PW 99 9999.UU34 SL I (I Y I)(ULS 4)(CMP) 4:1)(C) I XUU I SPLC Mbf bb47 TPW Unit Unit Cost total 1 2 .000UUUUU Lh $37U.UU $1,400.001 1.00000000 EA $7,230.00 $7,23uml 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 TF W $14,630.00 Sub Total Additions $14,630.00 Change Order Additions Page 2 of 4 FORT City of Fort Worth Change Order Deletions Project Name Intersection Improvements at Bonds Ranch & FM 156 City Sec # i 57092 j Client Project # 101009-2 1 Conbactorj Texas Materials Group, Inc. dba TexasBlt PMI Brendan McInnes, PE Inspectorl Habte Taezaz Change Order Submittal # o Date 1 8/2/2022 DELETIONS IILM ULSUKIPI IUN UEHI Unit Unit host total 38 9999.000t 24" UMP I PW Lu. UUUUUU LI- $19U.1U, $3,80'2.00 41 9999.1010110St I 1 Y 11 Z4" UMP (4:1)(U) TPW 1.00000000 EA $3,3b4.87 $3,3b4.8b THM $7,156.85 Sub Total Deletions $7,156.85 Change Order Deletions Page 3 of 4 MISBE for this Change Order M/SBE Sub Type of Service Amount for this CO Total $0.00 Previous Change Orders CO# DATE AMOUNT 1 4/28/2022 $24,220.00 Total I $24,220.00 FORT WORTH,,,, Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Construction Change Order No. 3 — Bonds Ranch at FM 156 M&C: 21-0786 CPN: 101009 Date: To: Name 1. Bus. Support Partner — Alexiz Ramirez 2. Adam Newsom — Contractor TexasBit 3. Habte Taezaz - Inspector 4. Brendan McInnes — Project Manger 5. Shweta Rao — Contract Compliance Mngr 6. Chad Allen — Program Manager 7. Lissette Acevedo - Sur CPO 8. Michael Owen — Interim Asst. Director 9. Lauren Prieur — Director 10. Doug Black 11. William Johnson 12. Jannette Goodall 13. TPW Contracts CSO: 57092 DOC#: 1 Department Initials Date Out TPW-initial AR Jun 2, 2023 Contractor - sign —' Jun 5, 2023 TPW - signature Jun 4, 2023 TPW-initial e Jun 5, 2023 TPW - signature BLMC Jun 5, 2023 TPW - signature C-Ph-- Jun 5, 2023 TPW - signature Jun 6, 2023 TPW - signature Jun 6, 2023 TPW - signature Jun 6, 2023 Legal - signature Jun 7, 2023 CMO - signature W Jun 7, 2023 CSO - signature J. — Jun 8, 2023 TPW 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 Reuuired: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return To: TPWContracts(a)fortworthtexas,00v, for pick up when completed; list "Please call Brendan Cad ext # 2617 for questions. Thank you. " CSC No. 57092-CO3 Fowl Ni'`OR-1 II _ _� City of Fort Worth Change Order Request Project Name Intersection Improvements at Bonds Ranch & FM 156 I City Sec # l 57092 Client Project #(s)l 101009-2 Project Description) Intersection improvements including widening Bond Ranch Rd to provide left turn lanes onto Farm to Market Road 156, improve raddi for northbound to eastbound traffic, minor storm drian improvemnets and a new traffic signal with pedestrain access. Contractorl Texas Materials Group, Inc. dba TexasBit I Change Order#1 City Project Mgr.I Brendan McInnes, PE 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 $1,180,676.20 $163,332.35 $131,639.20 $0.00 Date 5/30/2023 City Inspectorl Habte Taezaz $1,212,369.35 $2,566.31 $1,214,935.66 0.00 $0.00 $2,566.31 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) Contract Time Totals (CD $1,180,676.20 �00 $163,332.35 $131,639.20 $1,212,369.35 300 2,566.31 50 $1,2 4,935.66 350 $0.00 $2,566.31 2.90% $1,475,845.25 Construction began April 11, 2022 with an anticipated signal pole delivery in installation of September 6, 2022. Signal poles were approved for production on March 3, 2022 with an anticipated 6-month lead time. The new poles were required to be installed in order to remove the old poles and widen the roadway as detailed in the plans. Contractor completed available work on the project during the time that the poles were being fabricated. In late September notice was provided that there was a delay in a mast arm and delivery would be in early November (over 60 days later than anticipated in the schedule). This delay prevented removal of the existing pole and progression of the project completion. The mast arms were installed in November and the signal work completed, signal activated, and the old poles removed. The contractor then worked on finishing the widening, grading, and MBGF installation. Additional grading and base items are needed to match field conditions and additional pavement markings being added to the radius of the intersection to better delineate the pavement edges. Time - Additional contract time has been reviewed and the amount of days being granted is deemed reasonable for the work when reviewed in relation to the critical path of the work activities. 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 NameW pContractor Nam ntract Si nature TexasBit Adam Newsom ,4d /Vec Jon Jun 5, 2023 s ector/Ins ection Supervisor Date Project and Contract Compliance Manager Date Vo Jun 4, 2023 BrP"d "M°i""Ps Jun 5, 2023 ram Manager Date Senior o Capital Project C t Officer Date Jun 5, 2023 Jun 6, 2023 t Director (Dept) Date Director, Contracting Department (Dept) Date ?��M�"'��l.��► Jun 6,2023 = Jun 6, 2023 Assistant CityAttorneyDate Assista t City a nt Ci Manager Date I Jun 7, 2023 ,'�"� Jun 7, 2023 Council Action fif re uire M&C Number I I M&C Date Approved ATTEST: q- A ..&-a Jannette Goodall, City Secretary T'nu-r V!,kowrri City of Fort Worth Change Order Additions Project Name Intersection Improvements at Bonds Ranch & FM 156 City Sec # 57092 Client Project # 101009-2 1 Contractorl Texas Materials Group, Inc. dba TexasBit I PMI Brendan McInnes, PE Inspectorl Habte Taezaz Change Order Submittal # 0 Date 1 5/3012023 ADDITIONS I I EM UESGRIP I IUN UEP I Uly Unit Unit Gosl I otal 18 9999.0002 Urtch Grading I PVV 10.00000U0u GY $22.35 $223.bu 20 3211.0113 8" Flexible Base, Type A, GR-1 TPW 141.00000000 SY $10.10 $1,424.10 23 3212.0503 6" Asphalt Base Type B TPW 13.00000000 SY $45.67 $593.71 82 9999.0022 REFL PAV MIRK TY II (W) 4" (SLD) TPW 250.00000000 LF $1.30 $325.00 TPW $2,566.31 Sub Total Additions $2,566.31 Change Order Additions Page 2 of 4 r }ter_V6) City of Fort Worth T Change Order Deletions Project Name I Intersection Improvements at Bonds Ranch & FM 156 1 City Sec # 1 57092 1 Client Project # 1 101009-2 1 contractorl Texas Materials Group, Inc. dba TexasBit I PMI Brendan McInnes, PE Inspectorl Hable Taezaz Change Order Submittal # Date 1 5130/2023 1 DELETIONS IItM UtSUKINIIUN ULVI Uty Unit Unit lost total TPW $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 Amount for this CO Total $0.00 Previous Change Orders CO # DATE I AMOUNT 4/28/2022 $24,220.00 8/16/2022 $7,473.15 Total I $31,693.15 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS July 13, 2023 Texas Bit 420 Becker Dr. Ste. 200 Irving, Tx. 75061 RE: Acceptance Letter Project Name: INTERSECTION Improvements at Bonds Ranch and FM 156 Project Type: 01 City Project No.: 101009-2 To Whom It May Concern: On March 24, 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 27, 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 27, 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 817- 392- 2817. Sincerely, Brendan McInnes, Project Manager Cc: Habte Taezaz, Inspector Wade Miller, Inspection Supervisor Ariel Duarte, Senior Inspector Mary Hanna, Program Manager Kimley Horn, Consultant Texas Bit, Contractor N/A, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 CONSENT OF SURETY TO FINAL PAYMENT AIA Document G707 (Instructions on reverse side) Bond No. TO OWNER: (Nattre and address) City of Fort Worth 200 Texas Street Forth Worth, TX 76102 OWNER ARCHITECT _ CONTRACTOR _ SURETY 014246315 OTHER ARCHITECT'S PROJECT NO: CONTRACT FOR: Intersection Improvements at Bonds Ranch Road & FM 156 City project No. 101009-2 PROJECT: CONTRACT DATED: (Name and address) Intersection Improvements at Bonds Ranch Road & FM 156 City project No. 101009-2 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address of Surety) Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 on bond of (Insert name and address of Contractor) Texas Materials Group, Inc. dba TexasBit, A CRH Company ,SURETY, 420 Decker Drive ##200 Irving, TX 75062 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 Oivner) City of Fort Worth 200 Texas Street Forth Worth, TX 76102 OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: (Insert in tvriting the month folloeved by the mrnreric elate and year.) Attest/Witness: (Seal): n Qsspic, Richmond, Witness July 26, 2023 Liberty Mutual Insurance Company (Surety) (SignZii—re of aat4i, representative) Stephanie Gross, Attorney -in -Fact (Printed name and title) AIA DOCUMENT G707 w CONSENT OF SURETY TO FINAL PAYMENT w 1994 EDITION w AIA 0)1094 w THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, NW, WASH- INGTON, R.C. 20006-5292 w WARNING: Unlicensed photocopying violates U.S. copy- right laws and will s0lecl the violator to legal prosecution. G707-1994 This Power of Attorney limits the acts of those named heroin, and they have no authority to Liberty hind the Company except in the manner and to the extent herein stated. mutual. Liberty Mutual Insurance Company SURETY The Ohio Casualty Insurance Company Certificate No: 8204866 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 Stale of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Stephanie Gross all of the city of Houston state of Texas each individually If there be more than one named, its true and lawful attomey-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 awn 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 15th day of February, 2021. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company P� 1NSu p� Pot( fNs& tNsu,q West American Insurance Company hJ c°ar°Ryr Lo �iJ a°apo�r �gy �VPGoaro� qYO r;1912gQ 0a1919wo 1991 o By: rd�gs�acHUSaaS� yo yA90;dad leS, AV— da �h'1 David M. Carey, Assistant Secretary N STATE OF PEN NSYLVANIA ss COUNTY OF MONTGOMERY On this 15Ih day of February, 2021, before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, 0 m 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 therein D contained by signing on behalf of the corporations by himself as a duly authorized officer. a) IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. Q) yA PAST +°Nwgq<� Commonwealth of Pennsylvania - Notary Seal Ir + 2 F Teresa Pastella, Notary Public °! Montgomery County ©j a �,.¢ My commisslon expires March 28, 2025 By: o a) 4 a YLVH��.G Commission number 1126044 Teresa Pastella, Notary Public C r' Member, Pennsylvania Association of Notaries o) N This Power 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 CD N Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: - s? ARTICLE IV— OFFICERS: Section 12. Power of Attorney. 0 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 E�? 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 O fa any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, 7. shall have full power to bind the Corporation by their signature and execution of any such instruments and to allaeh thereto the seal of the Corporation. When so executed, such WC 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 _ (D provisions of this article may be revoked at any Limo by the Board, the Chairman, the President or by the officer or officers granting such power or authority. 0 :3ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings. Z c� 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 attorneys -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 attorneys -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 - infect 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 attorney 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. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, of Liberty Mutual Insurance Company, The Ohio Casualty Insurance Company, and West American Insurance Company do hereby certify that this 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 26th day of July 2023 {NSrJR �11 INsV N 1N5(/R �JP4°nporr9?��, roJPouaPo�tQ9Z .�'P°°geOk9A?�n 1912 0 1919 1991 5� �_Iaa6ll_ r� a s wo a a By: Yd� SyACHOs� S0 ` NAMvgd`,da `e 14'010 da Renee C. Llewellyn, Assistant Secretary 9i7 * a6 t= a� 'L 0U to 0 Q � d A_ -0 N Q p o(D � N fi C"! ao L , Q c� CO v -0 0 L Li co Q. Marsh MSure[y POA LMIC OCIC WAIL Multi Co 022021 CONTRACTOR'S AFFIDAVIT OF FINAL PAYMENT THE STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF ( Tarrant ) BEFORE ME, the undersigned authority, on this day personally appeared Adam Newsom ("Affidant"), who, after being by me duly sworn, deposes, and says that he is Area Manager of Texas Materials Group, Inc. , a Delaware (corporation, partnership, trade name) of Dallas County, State of Texas (the "Contractor"), which said Contractor was awarded the contract dated the 1st day of August , 2023 for the construction of Intersection Improvements at Bonds Ranch Road & FM (the "Work"), for a total consideration of One million two hundred twelve thousand one hundred seventy nine 9 Dollars ($ 1,212,179.94 ) to be paid to the said Contractor (the "Contract'), and that Affidant has frill power of authority to make this affidavit. That City of Forth Worth, Texas (the "Owner") has approved the final estimate on said Work, and that the said Contractor has fully satisfied and paid any and all claims that may be covered by Chapter 53 of the Texas Property Code and Article 5160 of the Revised Civil Statutes of the State of Texas, or any other applicable statutes or charter provisions, and that all just bills for labor and materials have been paid and discharged by said Contractor insofar as they pertain to the work in question. That in addition to any fiends which may have been previously paid by the Owner, the Contractor hereby accepts the amount of One million two hundred twelve thousand one hundred seventy nine 94/100 Dollars ($1,212,179,94 ) as FULL AND FINAL PAYMENT under the aforementioned Contract, and hereby waives and releases any right Affidant and/or the Contractor may have to pursue claims of any nature against the Owner arising out of or in any manner connected with the performance of the Work and/or the Contract, including but not limited to claims of third parties that supplied material and/or labor for the Work for or through the Contractor ("Subcontractors"), as well as claims for delay, additional compensation or for recovery of liquidated damages which may have been withheld by the Owner. The Contractor shall defend, hold harmless and indemnify the Owner from any such claims of such Subcontractors. The Contractor further releases the Owner from any claim or liability arising from any act or neglect of the Owner related to or connected with the Contract. This affidavit is given pursuant to the final payment provisions of the Contract, and shall not be deemed to alter or modify the terms and provisions of said Contract. By: *f1ant) Area Manage) (Title) Adam Newsom (Printed Name) SUBSCRIBED AND SWORN TO BEFORE ME, this 1 st day of August , 2023 Jody, and for the State of Texas) (Printkd Name of Notary) My commission expires CYNTHIA FRERICHS 1 Notary Public, Stale of Texas �'�'•+t Comm. Expires 08.22-2025 Notary ID 125052592