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Home My WebLink AboutContract 57186-FP2-FP2 City Secretary Contract No. 57186 FORT WORTH Date Received 08/21/2023 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: Rainbow Ridge Phase 2B City Project No.: 103145 Improvement Type(s): Water ❑x Sewer ❑x Original Contract Price: $446,650.20 Amount of Approved Change Order(s): $305,323.60 Revised Contract Amount: $751,973.80 Total Cost of Work Complete: $751,973.80 � Aug 14, 2023 Contractor Date Vice President Title Burnsco Construction, Inc. Company Name A':�' Aug 14, 2023 --J'A William Rodgers (Au214, 202316:51 CDT) Project Inspector Date Lt' P.'e. Aug 18, 2023 Khal Jaafari P.E. (AA 18. 2023 21:05 CDT) Project Manager Date 21, 2023 AugW-o0—n(An, Ra 21. 202308:07 CDT) ' CFA Manager Date Aug 21, 2023 Lauren Prieur (Au¢ 21, 202308:35 CDT) TPW Director Date WIi (22,2 :53CDT) Aug 22, 2023 Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 1 of 2 Notice of Project Completion Project Name: Rainbow Ridge Phase 2B City Project No.: 103145 City's Attachments Final Pay Estimate x❑ Change Order(s): ❑x Yes ❑ N/A Pipe Report: x❑ Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 180 WD Work Start Date: 5/2/2022 Completed number of Soil Lab Test: 377 Completed number of Water Test: 14 Days Charged: 246 Work Complete Date: 8/14/2023 Page 2of2 FoRTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name RAINBOW RIDGE PHASE 2B Contract Limits Project Type WATER & SEWER City Project Numbers 103145 DOE Number 3145 Estimate Number 1 Payment Number 1 For Period Ending 8/14/2023 WD City Secretary Contract Number Contract Time 9WD Contract Date 7/27/2021 Days Charged to Date 246 Project Manager NA Contract is 100.00 Complete Contractor BURNSCO CONSTRUCTION, INC. 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 Inspectors HORTON.R / RODGERS.W Monday, August 14, 2023 Page 1 of 5 City Project Numbers 103145 DOE Number 3145 Contract Name RAINBOW RIDGE PHASE 2B Estimate Number I Contract Limits Payment Number 1 Project Type WATER & SEWER For Period Ending 8/14/2023 Project Funding UNIT I: WATER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 12" WATERLINE LOWERING (CO #1) 0 EA $5,700.00 $0.00 0 $0.00 2 8" PVC WATER PIPES 963 LF $37.00 $35,631.00 963 $35,631.00 3 12" PVC WATER PIPE (CO #1) 0 LF $67.40 $0.00 0 $0.00 4 3" WATER SERVICE 66 EA $1,110.00 $73,260.00 66 $73,260.00 5 8" GATE VALVE 2 EA $1,400.00 $2,800.00 2 $2,800.00 6 12" GATE VALVE (CO #1) 0 EA $2,655.00 $0.00 0 $0.00 7 FIRE HYDRANT 6 EA $4,750.00 $28,500.00 6 $28,500.00 8 DUCTILE IRON WATER FITTINGS 1.6 TN $6,400.00 $10,240.00 1.6 $10,240.00 W/RESTRAINT 9 CONNECTION TO EXISTING 4"-12" WATER 5 EA $1,600.00 $8,000.00 5 $8,000.00 MAIN 10 CONNECTION TO EXISTING 16" WATER MAIN 1 EA $4,300.00 $4,300.00 1 $4,300.00 11 TRENCH SAFETY 2674 LF $0.10 $267.40 2674 $267.40 12 REMOVE FIRE HYDRANT 1 EA $600.00 $600.00 1 $600.00 13 12" WATER PIPE, CLSM BACKFILL (CO 91) 0 LF $37.00 $0.00 0 $0.00 14 16" WATERLINE LOWERING (CO #1) 2 EA $13,800.00 $27,600.00 2 $27,600.00 15 16" PVC DR18 WATER PIPE (CO #1) 1711 LF $174.00 $297,714.00 1711 $297,714.00 16 16" GATE VALVE W/ VAULT (CO #1) 4 EA $19,000.00 $76,000.00 4 $76,000.00 17 16" PVC WATER PIPE, CLSM BACKFILL (CO #1) 40 LF $60.00 $2,400.00 40 $2,400.00 18 DUCTILE IRON WATER FITTINGS W/ 4.7 TN $6,600.00 $31,020.00 4.7 $31,020.00 RESTRAINT (FOR 16" WL) (CO #1) 19 DUCTILE IRON WATER FITTINGS 0.16 TN $6,600.00 $1,056.00 0.16 $1,056.00 W/RESTRAINT (FOR 16" WL) (CO #2) Sub -Total of Previous Unit $599,388.40 $599,388.40 UNIT H- SANITARY SEWER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 MANHOLE ADJUSTMENT MINOR 7 $900.00 $6,300.00 7 $6,300.00 2 8" SEWER PIPE 879 $38.00 $33,402.00 879 $33,402.00 3 4" SEWER SERVICE 65 $1,100.00 $71,500.00 65 $71,500.00 4 6" SEWER SERVICE 1 $1,600.00 $1,600.00 1 $1,600.00 5 4' MANHOLE 4 $3,100.00 $12,400.00 4 $12,400.00 Monday, August 14, 2023 Page 2 of 5 City Project Numbers 103145 Contract Name RAINBOW RIDGE PHASE 2B Contract Limits Project Type WATER & SEWER Project Funding DOE Number 3145 Estimate Number 1 Payment Number 1 For Period Ending 8/14/2023 6 TRENCH SAFETY 879 $1.00 $879.00 879 $879.00 7 MANHOLE VACUUM TESTING 4 $130.00 $520.00 4 $520.00 8 POST -CCTV INSPECTION 879 $3.60 $3,164.40 879 $3,164.40 9 TRAFFIC CONTROL 1 $12,900.00 $12,900.00 1 $12,900.00 10 EPDXY MANHOLE LINER 31 $320.00 $9,920.00 31 $9,920.00 Sub -Total of Previous Unit $152,585.40 $152,585.40 Monday, August 14, 2023 Page 3 of 5 City Project Numbers 103145 Contract Name RAINBOW RIDGE PHASE 213 Contract Limits Project Type WATER & SEWER Project Funding Contract Information Summary Original Contract Amount Chanhe Orders Change Order Number 1 Change Order Number 2 Total Contract Price DOE Number 3145 Estimate Number 1 Payment Number 1 For Period Ending 8/14/2023 $446,650.20 $304,267.60 $1,056.00 $751,973.80 Total Cost of Work Completed $751,973.80 Less % Retained $0.00 Net Earned $751,973.80 Earned This Period $751,973.80 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 $751,973.80 Monday, August 14, 2023 Page 4 of 5 City Project Numbers 103145 Contract Name RAINBOW RIDGE PHASE 2B Contract Limits Project Type WATER & SEWER Project Funding Project Manager NA Inspectors HORTON.R / RODGERS.W Contractor BURNSCO CONSTRUCTION, INC. 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 DOE Number 3145 Estimate Number 1 Payment Number 1 For Period Ending 8/14/2023 City Secretary Contract Number Contract Date 7/27/2021 Contract Time 90 WD Days Charged to Date 246 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 $751,973.80 Less % Retained $0.00 Net Earned $751,973.80 Earned This Period $751,973.80 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 $751,973.80 Monday, August 14, 2023 Page 5 of 5 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Rainbow Ridge Phase 2B CITY PROJECT NUMBER: 103145 WATER PIPE LAID SIZE TYPE OF PIPE LF Water Main 8" P.V.C. 963 Water Main 16" P.V.C. 1711 FIRE HYDRANTS: 7 VALVES (16" OR LARGER) 4 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Densities taken all passed NEW SERVICES: 1" Copper 83 SEWER PIPE LAID SIZE TYPE OF PIPE LF Sewer Main 8" P.V.C. 879 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: Densities taken all passed NEW SERVICES: 4" P.V.C. 83 TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 PROJECT NAME: CONTRACT: C FA # CITY PROJECT # DOE # FID # SEWER PROJECT # FILE # INSPECTOR: PROJECT MANAGER: DEVELOPER -AWARDED -PROJECT CHANGE ORDER Pavinq, Water, Sanitary Sewer & Streetlight Improvements to Serve Rainbow Ridge 2B A - Water, Sanitary Sewer & Storm Drain Improvements 21-0014 CITY PARTICIPATION: I NA 103145 30114-0200431-103145-E07685 I W-2764 CHANGE ORDER No: Al Cristobal Fuentes Phone No: 682-213-0475 RECEIVED Khal Jafari Phone No: 817-392-7872 By Khal Jaafari at 6:55 pm, Jun 06, 2022 I CONTRACT UNIT WATER SEWER PAVING DRAINAGE STREET LIGHTS Developer Developer Developer Developer Cost City Cost Cost City Cost Developer Cost City Cost Cost City Cost Cost City Cost ORIGINAL CONTRACT $294,064.80 $152,585.40 $0.00 $725,843.50 $0.00 EXTRAS TO DATE $0.00 $0.00 $0.00 I $0.00 $0.00 CREDITS TO DATE I $0.00 $0.00 I $0.00 I $0.00 $0.00 CONTRACT TO DATE I $294,064.80 $0.00 I $152,585.40 $0.00 I $0.00 $0.00 I $725,843.50 $0.00 $0.00 $0.00 AMOUNT OF PROP. CHANGE ORDER I $ 304,267.60 REVISED CONTRACT AMOUNT 1 $598,332.40 1 $0.00 TOTAL REVISED CONTRACT AMOUNT PER UNIT $598,332.40 REVISED COST SHARE Dev. Cost: TOTAL REVISED CONTRACT I I $152,585.40 I $0.00 $0.00 $0.00 I $725,843.50 I $0.00 I $0.00 $0.00 $152,585.40 $0.00 $725,843.50 I $0.00 $1,476,761.30 City Cost: $1,476,761.30 CONTRACT DAYS 90 90 Revised: 10-12-2011 Page 1 RECEIVED By Khal Jaafari at 6:55 pm, Jun 06, 2022 You are directed to make the following :hanges in the :ontract documents CITY BID ITEM PAY ITEM # # QUANTITY UNIT I ITEM DESCRIPTION UNIT PRICE TOTAL 1 3305.0005 -1 EA I REMOVE - 12" Waterline Lowering $ 5,7D0.00 $ (5,700.00) 3 3311.0461 -1711 LF I REMOVE - 12" PVC Water Pipe $ 67.40 $ (115,321.40) 6 3312.3005 -3 EA I REMOVE - 12" Gate Valve $ 2,655.00 $ (7,965.00) 13 3311.0447 -40 LF REMOVE - 12" PVC Water Pipe, CLSM Backfill I $ 37.00 $ (1,480.Do) 3305.0005 2 EA ADD - 16" Waterline Lowering I $ 13,800.00 $ 27,600.00 3311.0561 1711 LF ADD - 16" PVC DR18 Water Pipe I $ 174.00 $ 297.714.DD 3312.3006 4 EA ADD - 16" Gate Valve w/ Vault I $ 19,000.00 $ 76,OD0.00 3311.0547 40 I LF ADD - 16" PVC Water Pipe, CLSM Backfill I $ 60.00 $ 2,400.001 3311.0001 4.7 1 TN ADD - Ductile Iron Water Fittings w/Restraint (For 16" WL) I $ 6,600.00 $ 31,020.001 I TOTAL I I $ 304,267.60 REASONS FOR CHANGE ORDER 1 Revision of 12" Min Cleburne Crowley Road to be 16" WL at request of COFW staff incoordination with Bloomfield Homes 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: Dunaway Associates By. //jn/ '4 �/Y< Name: ucre Windell, PE Title: Project Engineer APPROVED: Impressiort,Ho e By:( i Name::, ev`Q Title: APPROVED: Bumsco Co t ctio n By: Name: Ab Grantges 0 Vice President Title: Revised: 10-12-2011 Page 2 PROJECT NAME: CONTRACT: C FA # CITY PROJECT # DOE# FID # SEWER PROJECT # FILE # DEVELOPER -AWARDED -PROJECT CHANGE ORDER Pavinq, Water, Sanitary Sewer & Streetlight Improvements to Serve Rainbow Ridqe 2B A - Water, Sanitary Sewer & Storm Drain Improvements 21-0014 CITY PARTICIPATION:( NA 103145 30114-0200431-103145-EO7685 W-2764 CHANGE ORDER No: A2 INSPECTOR: Cristobal Fuentes Phone No: 682-213-0475 PROJECT MANAGER: Khal Jafari Phone No: 817-392-7872 I CONTRACT UNIT WATER SEWER PAVING DRAINAGE STREET LIGHTS 1 CONTRACT (Developer Developer Developer Developer DAYS Cost C1tyCost : Cost Clty Cost Developer Cost _ City Cost Cost --Clty Cost Cost City Cost ORIGINAL CONTRACT I $294,064.80 $152,585.40 $0.00 $725,843.50 $0.00 IEXTRAS TO DATE I $304,267.60 $0.00 $0.00 _ _ $0.00 $0.00 CREDITS TO DATE $0.00 $0.00 J $0.00 $0.00 $0.00 ICONTRACT TODATE I $598,332.40 $0.M $152,585.40 $0:00. $0.00 $0.00' `-_ $725,843.50 $0.00 ,-- $0.00 $O.OD '_'I 180 (AMOUNT OF PROP. CHANGE ORDER $ 1,056.00 IREVISED CONTRACT AMOUNT I $599,388.40 $0.00-. $152,585.40 $0.00 $0.00 $0.00' _ $725,843.50 $0.00 $0.00 I $D.00 I 180 TOTAL REVISED CONTRACT AMOUNT PER UNIT $599,388.40 $152,585.40 $0.00 $725,843.50 $0.00 REVISED COST SHARE Dev. Cost: $1,477,817.30 City Cost:, $0 00 TOTAL REVISED CONTRACT I $1,477,817.30 Revised: 10-12-2011 Page 1 You are directed to make the following ;hanqes in the contract documents CITY BID ITEM PAY ITEM # # QUANTITY UNIT 3311.0001 0.16 TN TOTAL REASONS FOR CHANGE ORDER 1 Lowering of 16" WL along Cleburne Crowley Road ITEM ADD - Ductile Iron Water Fit ingsPw�R slraint (For 16" WL) $ NI6 600.00 $ PRICE TO TAL 1.056.001 $ 1,056.001 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: D way Associates Name: Darrell Howard Title: Civil Project Manager 10-6-22 APPROVED: Impression Homes By: Name: 5kp--,p— �i✓.O 1 Title: Y>f V r ri / �\ J [I/e5 f �1—_ APPROVED: Bumsco Cons lion By: Name: Albert Grantges Title: Vice President Revised: 10-12-2011 Page 2 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS August 14, 2023 Burnsco Construction, Inc. 6331 Southwest Blvd. Benbrook, Tx 76132 RE: Acceptance Letter Project Name: Rainbow Ridge Phase 2B Project Type: Water, Sanitary Sewer City Project No.: 103145 To Whom It May Concern: On July 21, 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 August 14, 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 August 14, 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- 392-7872. Sincerely, KhaI Jaafari P.E. (Aug 18, 2023 21:05 CDT) Khal Jafaari, Project Manager Cc: William Rodgers, Inspector Mike Glover, Inspection Supervisor Randy Horton, Senior Inspector Victor Tornero, Program Manager Dunaway Associates, L.P., Consultant Burnsco Construction, INC., Contractor Impression Homes, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 AFFIDAVIT STATE OF TEXAS LKSMUM/ ::::► Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Ab Grantges, Contract Mgr, Of Burnsco Construction, 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; Rainbow Ridge Ph. 213 - Water, Sanitary Sewer and Storm Drain BY 4 4AGrantges, C-66ract anager Subscribed and sworn before me on this date 14th of August, 2023. C4-L 0�1 C(A4 11 kq-� Notary Public Tarrant County, Texas CESILIA CANALES Motary IA #131652996 Commission Expires uky 24, 2026J CONSENT OF SURETY COMPANY TO FINAL PAYMENT Conforms with the American Institute of Architects, AIA Document G707 PROJECT: (name, address)Rainbow Ridge Phase 2B OWNER ❑ ARCHITECT ❑ CONTRACTOR ❑ SURETY ❑ OTHER Bond No 022230617 Fort Worth TX TO (Owner) ARCHITECT'S PROJECT NO: RAINBOW RIDGE, LLC AND CITY OF FORT WORTH CONTRACT FOR: 6751 North Freeway Rainbow Ridge Phase 2B - Water, Sanitary Sewer, and Drainage Improvements Fort worth TX 76131 --J CONTRACT DATE: CONTRACTOR: BURNSCO CONSTRUCTION, INC. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) LIBERTY MUTUAL INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY on bond of (here insert name and address of Contractor) BURNSCO CONSTRUCTION, INC. 6331 Southwest Boulevard Benbrook TX 76132 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to Ihere insert name and address of Owner) RAINBOW RIDGE, LLC AND CITY OF FORT WORTH 6751 North Freeway Fort Worth TX 76131 , OWNER, as set forth in the said Surety Company's bond. 1N WITNESS, WHEREOF, the Surety Company has hereunto set its hand this Attest: (Seal): 21st day of July, 2023 LIBERTY MUTUAL INSURANCE COMPANY Surety Company Signature of Authorized Representative ,,onhinie Hunter Title Attorney -in -Fact NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company Mutual. The Ohio Casualty Insurance Company Certificate No: 8206467-022020 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Don E. Cornell; Joshua Saunders; Kelly A. Westbrook; Mikaela Peppers; Ricardo J. Reyna; Robbi Morales; Sophinie Hunter; Tina McEwan; Tonic Petranek all of the city of Dallas state of TX each individually if there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 23rd day of April , 2021 . Liberty Mutual Insurance Company 0� \NSU4 P��Y INS& 1NSURThe Ohio Casualty Insurance Company j rG°RP°RgToy�m �co'. —4TQ�y� �GPr oRPORgq r y� West American Insurance Company 1912 n U m W F� Ui a) '%I y� yy1919�a a 1991 0 d�0 -aD O y "A Mp6��.da� Ys� �"DIANP�,da3 E *�5� By: `m David M. Carey, Assistant Secretary State of PENNSYLVANIA Cr N p) County of MONTGOMERY ss E � as m On this 23rd day of April 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being to do, 0 D (D > FU authorized so execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. tJ n cy 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. > o fD �a PAST 0 — ` O O O Q� 1g°ta4yp t~`4. �W mob°*'ng 7, OF Commonwealth of Pennsylvania;Notary seal Teresa Pastella, Notary Public Montgomery County /%� n N •� ` E L N � tie My commission expires March 28, 2025 Commission number 1126044 By: /1"1"iu�r-yc✓ T� Teresa O O = `O N +X, 3i 0 eG Member, Pennsylvania Association or Notaries Pastella, Notary Public a&Y P Q o 0 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 v 3 ccoo •� EInsurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: a M a) ARTICLE IV — OFFICERS: Section 12. Power of Attorney. - 00 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 � o cPresident 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 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 Corporation by their signature and execution of any such instruments to thereto the -0c0 Z 0 and attach seal of the Corporation. When so executed, such 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 o W W provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. 0-2 ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings. LL n 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 Secretaryto appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of 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, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the -Power- of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 21 st day of July , 2023 . PV INSURq Y.�`Q3�i4j19*1"5grFoq �aCFo "yQo5�P3G1O"Y" *INSg�T&ody�cren �GSSaa `�\NSgUgR r o'o"P° 2 199Fa19910 y.4v ra��o 0' By P°*"P'�L,�`--- Renee C. Llewellyn, Assistant Secretary LMS-12e73 LMIC OCIC WAIC Multi Co 02/21 TEXAS IMPORTANT NOTICE To obtain information or make a complaint You may call toll -free for information or to make a complaint at 1-877-751-2640 You may also write to: 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-252-3439 You may write the Texas Department of Insurance Consumer Protection (I I I-1A) P. O. Box 149091 Austin, TX 78714-9091 FAX: (512) 490-1007 Web: httn://www.tdi.texas.eov E-mail: ConsumerProtection(c�i,tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should first contact the agent or call 1-800-843-6446. 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. NP 70 68 09 01 LMS-15292 10/15 TEXAS AVISO IMPORTANTE Para obtener informacion o para someter una queja: Usted puede Ilamar al numero de telefono gratis para informacion o para someter una queja al 1-877-751-2640 Usted tambien puede escribir a: 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companias, coberturas, derechos o quejas al 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas Consumer Protection (I I I-1A) P. O. Box 149091 Austin, TX 78714-9091 FAX # (512) 490-1007 Web: httn://www.tdi.texas.aov E-mail: ConsumerProtection c(�i,tdi.texas.gov DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiena una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente o primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI) UNA ESTE AVISO A SU POLIZA: Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adjunto.