The URL can be used to link to this page

Home My WebLink AboutContract 58317-FP1FORT WORTH, WATER DEPARTMENT NOTICE OF PROJECT COMPLETION -FP1 City Secretary No: 58317 Date Received: 8/24/2023 City Project N!?: 102785-4 Regarding contract 58317 Sanitary Sewer Rehabilitation Contract 113, Part 4 for as required by the WATER DEPARTMENT as approved by City Council on 9/27/2022 through M&C 22-0738 the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Water 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, WATER DEPARTMENT Christopher H der(Aug 24, 202308:31 CDT) Accepted Director, WATER DEPARTMENT Z)ana &Whgoff Dana Burghd off (Aug , 202318!.51 CDT) Asst. City Manager $ 1,797,081.00 $ 58,882.00 Na 2 $ 1,855,963.00 $1,576,079.92 Days @ $650.00/ Day $1,576,079.92 $ 1,497,275.91 $ 78,804.01 Aug 24, 2023 Date Aug 24, 2023 Date Aug 24, 2023 Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page To (Owner) P. O. Number: Project: Contractor's Application for Payment City of Fort Worth Invoicing Period (From - o): ` ' ' ^n^' FW060-00000-20270 102785-4 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 58317 Application For Payment Change Order Summary Additions $69,675.00 $108,207.00 $177,882.00 From (Contractor): Woody Contractors, Inc. Contractor's CFW Vendor No.: Invoice No. ,oice Date: 7/19/2023 to ( If Not Automatic Deposit): Contract Namme:: Sanitary Sewer Rehabilitation Contract 113, Part 4 $58,882.00 Deletions $30,000.00 $89,000.00 $119,000.00 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. Tro~ug 17, 202311:53 CDT) Final 1. ORIGINAL CONTRACT PRICE.........................................................., $ $1,797,081.00 2. Net change by Change Orders................................................................. $ $58,882.00 3. Current Contract Price (Line 1 f 2)........................................................ $ $1,855,963.00 4. TOTAL COMPLETED AND STORED TO DATE (Progress Estimate, Construction Allowance and Change Orders)....... $ $1,576,079.92 5. RETAINAGE: a. X $1,576,079.91 Work Completed.......... $ b. X Not Used $ c. Total Retainage (Line 5a + Line 5b)................................ $ 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c)............................. $ $1,576,079.92 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)......... $ $1,497,275.91 8. AMOUNT DUE THIS APPLICATION ................................................. $ $78,804.01 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + Cos + Line 5 above) ............... $ 10. CONTRACT TIME: a, Days Awarded 240 b, Days Added by CO C. Total Days 240 d, Days Charged 191 e, Days Remaining 49 FAffidavit of Bills Paid Consent of Surety 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. C-620 Unit Price Pr ress Estimate Progress Estimate City$ECe Contract Nam. sa3t7 Sanitary Sewer Rehabilitation Contract 113, Part 4 Applipation Penoa. 7-1-2023 to 7-13-2023 A B I Bid lrem No. Item Spmfication UmtofNkasure Section No. Bid Qaaauy Umt Price Bid Valae UNIT I - WATER TMPRMEMEW 8"Water Pipe 3311.0241 LF 1,290 $118.00 $152,220.00 2 6"WaterPipe 3311.0141 LF 10 $91.00 $910.00 3 Ductile Iron Water Fittings vat Restraint (6- 3311.0001 TN 1.0 $1,000.00 inch through 12-inch pipe) $1,000.00 4 Fire Hydrant 3312.0001 EA 1 $6,200.00 $6,200.00 5 6" Gate Valve 3312.3002 EA 1 $1,830.00 $1,830.00 6 8" Gate Valve 3312.3003 EA 7 $2,580.00 $18,060.00 1 7 Connection to Existing 4"-12" Water Main 3312.0117 EA 6 $5,000.00 $30,000.00 8 " Water Service, Meter Reconnection 3312.2001 EA 14 $920.00 $12880.00 1 9 " Water Service 3312.2003 EA 14 $3,230.00 $45:220.00 10 Remove Existing Wheelchair Ramp (50/50) 1 0241.0300 EA 3 $500.00 $1,500.00 11 ReoExisting Concrete Driveway (50/50) 1 0241.0401 SF 500 $2.00 $1,000.00 12 Remmve ove Concrete Curb & Gutter (50/50) 1 0241.1300 LF 250 $2.00 $500.00 13 Remove 6" Water Valve 0241.1302 EA 2 $100.00 $200.00 14 Remove 8" Water Valve 0241.1303 EA 4 $100.00 $400.00 15 2" Surtace Milling (50/50) 0241.1506 SY 833 $4.00 $3,332.00 16 2" Asphalt Pvmt Type D (50/50) 3212.0302 SY 833 $17.00 $14,161.00 17 5' Wide Asphalt Pvmt Repair, Arterial 3201.0122 LF 1,650 $100.00 $165,000.00 1 18 Asphalt Pvmt Repair Beyond Defined Width, Arterial 3201.0202 SY 100 $100.00 $10,000.00 19 Install New 6-Inch Concrete Driveway (50/50) 3213.0401 SF 500 $12.00 $6,000.00 20 6" Concrete Curb and Gutter (50/50) 3216.0101 LF 250 $53.00 $13,250.00 21 Install New ADA Wheelchair Ramp 9999.00111 EA 3 $4,000.00 (w/detectable warning dome -file surface) (50150) $12,000.00 22 Temporary Water Services 3304.0101 LS 1 $56,700.00 $56,700.00 1 23 8" Waterline Lowering 3305.0003 EA 7 $8,700.00 $60,900.00 24 Water Valve Box Adjustment with Concrete 3305.0111 EA 4 $750.00 Collar(50/50) $3,000.00 25 Imported Embedment/Backfill, CSS (Water) 3305.0202 CY 50 $100.00 $5,000.00 1 26 Imported Embedment/Backfill, CLSM (Water) 3305.0203 CY 50 $170.00 $8,500.00 27 Imported Embedment/Backfill, Select Fill (Water) 3305.0207 CY 50 $42.00 $2,100.00 1 28 Traffic Control (Water) 3471.0001 MO 3 $3,300.00 $9,900.00 1 29 SWPPP z 1 acre (Water) 3125.0101 LS 1 $500.00 $500.00 30 ,Remove and Replace Inlet Top (50150) 9999.0002 EA 1 $5,000.00 $5,000.00 31 ASBuilt Survey (Red -Line Survey) 9999.0003 LS 1 $2,500.00 $2,500.00 32 Construction Staking (Water) 9999.0004 LS 1 $3,000.00 $3,000.00 1 33 I Water Construction Allowance 9999.0005 LS 1 $40,000.00 $40,000.00 UNIT 2 - St NITARY SEWER IMPROVEMENT 1 8" Sewer Pipe 3331.4115 LF 1,223 $119.00 $145,537.00 1 2 6" to 8" Pipe Enlargement 3331.1102 LF 1,015 $102.00 $103,530.00 1 3 8" to 8" Pipe Enlargement 00 33 31 LF 321.000000 $102.00 $32,742.00 4 Service Reinstatement, Pipe Enlargement 00 33 31 EA 10.000000 $2,000.00 $20,000.00 5 4" Sewer Service, Reconnection 3331.3311 EA 11 $1,750.00 $19,250.00 6 8" Sewer Pipe, Point Repair 3331.0103 LF 100 $100.00 $10,000.00 7 Pre-CCry Inspection 3301.0001 LF 1,336 $8.00 $10,688.00 8 Post -CCTV Inspection 3301.0002 LF 2,525 $4.00 $10,100.00 9 Remove 4' Sewer Manhole 0241.2201 EA 12 $460.00 $5,520.00 10 4' Manhole 3339.1001 EA 15 $5,630.Oil $84,450.00 1 11 4' Extra Depth Manhole 3339.1003 VF 30 $292.00 $8,760.00 1 12 4' Shallow Manhole 3339.1004 EA 1 $5,000.00 $5,000.00 1 13 Manhole Vacuum Testing 3301.0101 EA 16 $200.00 $3,200.00 1 14 Epoxy Manhole Liner (Warren or Chesterson) 3339.0001 SF 200 $35.00 $7,000.00 1 15 Concrete Collar 3305.0112 EA 16 $550.00 $8,800.00 16 Remove Existing Wheelchair Ramp 50/50 1 0241.0300 EA 2 $1,200.00 $2,400.00 17 Remove Existing Concrete Driveway (50150) 1 0241.0401 SF 500 $2.00 $1,000.00 18 Remove Concrete Curb & Gutter (50/50) 1 0241.1300 LF 250 $2.00 $500.00 19 2" Surface Milling (50/50) 1 0241.1506 SY 833 $4.00 $3,332.00 20 2" Asphalt Pvmt Type D (50/50) 1 3212.0302 SY 833 $17.00 $14,161.00 21 5' Wide Asphalt Pvmt Repair, Residential 3201.0112 LF 40 $75.00 $3,000.00 1 22 5' Wide Asphalt Pvmt Repair, Arterial 3201.0122 LF 1,260 $100.00 $126,000.00 1 23 Asphalt Pvmt Repair Beyond Defined Width, Residential 3201.0201 SY 20 $135.00 $2,700.00 1 24 Asphalt Pymt Repair Beyond Defined Width, Arterial 3201.0202 SY 100 $100.00 $10,000.00 1 25 Conic Pvmt Repair, Residential 3201.0614 SY 150 $135.00 $20,250.00 26 Install New 6-Inch Concrete Driveway (50/50) 3213.0401 SF 500 $12.00 $6,000.00 27 6" Concrete Curb and Gutter (50/50) 3216.0101 LF 310 $53.00 $16,430.00 Contractor's Application Application Number. final Application Date. 7/19/2023 E P Tmal Compined % G Balance to Finish Valise This Peal Matuials Presently, mW Smadm Dare -� Storms (oot io Cl (D +B) B $152,810.00 100.496 I -$590.001 $819.00 90.0% $91.001 $980.00 98.0% $20.00 $6,200.00 100.0I 1 $1,830.00 100.0°° 1 $18,060.00 100.0% 1 $30,000.00 100.0/ 1 $12,880.00 100.0 `/ $45,220.00 100.0°° 1 $1,000.00.00.001 $1,0 $500.001 $500.00 250.0°° 4300.001 $100.00 25.0% $300.001 $3,332.001 $14,161.001 $154,400.00 93.6% $10,600.001 $440.00 4.4% $9,560.001 $6,000.001 $13,250.001 $12,000.001 $56,700.00 100.0 1/ 1 $60,900.001 $3,000.001 $5,000.001 $8,500.001 $2,100.001 $9,900.00 100.0 �JJJ $500.00 100.0°/ 1 J $5,000.001 $2,500.00 100.0.o $3,000.00 100.0°°I 1 $40,000.001 $150,416.00 103.4% -$4,879.001 $97716.00 94.4% $5,814.001 $32:742.00 100.().. $20,000.00 100.0% $19,250.00 100.0%J $20,500.00 205.0%J -$10,500.001 $16,120.00 150.8/°oJ -$5,432.00 $10,172.00 100.7 /°0 -$72.001 $4,600.00 83.3% $920.001 $95:710.00 113.3°° $11,260.001 $7,221.16 82.4% $1,538.84 $5,000.001 $3,200.00 100.0°° $10,325.00 147.5° $3,325.001 $8,800.00 100.096 1 $2,400.001 $1,000.001 $500.001 $3,332.001 $14,161.001 $8,400.00 280.0IJJJ 45,400.001 $131,000.00 104.0°°/ 45,000.001 J $2,700.001 $10,900.00 109.0°oJ -$900.001 $33,561.00 165.7°/° 413,311.001 $6,000.001 $16,430.001 This document has been modified It- its origi.] form as an F.1CDC d, a aa,.a and rise user did cot highlight the modificanoos. You are encouraged to read the --a -(filly aad aaalt Legal Counsel poor tons a ,aaon. C-620 Unit Price Progress Estimate Progress Estimate F"r(eO°'rvdGn: Sanitary Sewer Rehabilitation Contract 113, Part 4 (Application Period. 7-1-2023 to 7-13-2023 A Bid Item No. Pem SpenOcation Umt ofm.,.. Section No. Install New ADA Wheelchair Ramp 9999.0006 EA 28 (w/detectable warning dome -file surface) (50150) 29 Manhole Adjustment With Concrete Collar (50/50) 3305.0107 EA 30 opsoil (Sanitary Sewer) 3291.0100 CY 1 31 Block Sod Replacement (SanitarySewer) 3292,0100 SY 1 32 Trench Safety (Sanitary Sewer) 3305.0109 LF Imported Embedment(Backfill, CSS (Sanitary 3305.0202 CY 33 Sewer) Imported Embedment/Backfill, CLSM 3305.0203 CY 34 (Sanitary Sewer) Imported Embedment(Backfill, Select Fill 3305.0207 CY 35 (Sanitary Sewer) 1 36 Traffic Control (Sanitary Sewer) 3471.0001 MO 1 37 Swoop >_ 1 acre (Sanitary Sewer) 3125.0101 LS 38 A emove and Replace Inlet Top (50150) 1 9999.0007 EA 39 moltSurvey (Red -Line Survey) 9999.0008 LS 1 40 Construction Staking (Sanitary Sewer) 9999.0009 LS 1 41 Sanitary Sewer Construction Allowance 9999.0010 LS UNIT 3-PAVINGEA%„ VEMENTS 1 Utility Adjustment (( 7ISSOO)) 3305.0108 LS 2 Remove Concrete Sidewalk 0241.0100 SF 3 Remove Existing Wheelchair Ramp (50/50) 0241.0300 EA 4 Remove Existing Concrete Driveway (50/50) 0241.0401 SF 5 Remove Existing Concrete Curb and Gutter (50/50) 0241.1300 LF 6 move Exi}rtng Cp rate Valley Gutter 0241.1400 SY 7 4 Concrete $l ewa 3213.0301 SF 8 Install New 6-Inch Concrete Driveway (50/50) 3213.0401 SF 1 9 Cone Sidewalk, Adjacent to Rat Wall 3213.0321 SF 1 10 Concrete Curb, Back of Sidewalk 3213.0322 LF 11 6" Concrete Curb and Gutter (50/50) 3216.0101 LF Install New ADA Wheelchair Ramp 99990011 EA 12 surface) (50/50) 1 13 r/��{�y)ab`�j rming�p�e-tile Install New 7" Concrete Valley Gutter 3216.0302 SY 1 14 2" Surface Milling (50/50) 0241.1506 SY 1 15 2" Asphalt Pvmt Type D (50/50) 3212.0302 SY 6" BRK Yellow Thermoplastic Hot Applied Spray 3217.0002 LF 16 (HAS) Centerline(s) 1 17 6" SLD Pvmt Marking HAS (Y) 3217.0102 LF 1 18 6" BRK Pvmt Marking HAS (W) 321 7.0 103 LF 1 19 REFL Raised Marker TY II -A -A 3217.2103 EA 1 20 REFL Raised Marker TY II-C-R 3217.2104 EA 1 21 Painting Curb Addresses 3217.5001 EA 22 Manhole Adjustment With Concrete Collar (50/50) 3305.0107 EA 23 Water Valve Box Adjustment with Concrete Collar (50150) 3305.0111 EA 24 Retaining Wall 3232.0100 SF 25 Topsoil 3291.0100 CY 26 Block Sod Replacement 3292.0100 SY 27 Traffic Control 3471.0001 MO 28 SWPPP>_l acre 3125.0101 LS 29 Remove and Replace Inlet Top (50150) 9999.0012 EA 30 Paving Construction Allowance 9999.0013 LS City Secretary Contract N"m. 58317 Bid Queooty Umt Poce B Bid Value C E,000tod Quantity ..11W D Value Previously Leashed Value Value This Penod 2 $4,000.00 $8,000.001 I I 1 4 $1,000.00 $4,000.001 1 1 1 6 $75.00 $450.001 40.000000001 $3,000.001 $3,000.001 27 $15.00 $405.001 650.000000001 $9,750.001 $9,750.001 1,206 $1.00 $1,206.001 1264.000000001 $1,264.001 $1,264.001 50 $100.00 $5,000.001 1 1 1 50 $170.00 $8,500.001 I I 1 50 $42.00 $2,100.001 70.000000001 $2,940.001 $2,940.001 3 $3,300.00 $9,900.001 1.000000001 $3,300.001 $3,300.001 1 $500.00 $500.001 1.000000001 $500.001 $500.001 2.000000 $5,000.00 $10,000.001 1 1 1 1.000000 $3,000.00 $3,000.001 1.000000001 $3,000.001 $3,000.001 1 $6,000.00 $6,000.001 1.000000001 $6,000.001 $6,000.001 1 $50,000.00 $50,000.001 1 1 1 1 $5,000.00 $5,000.001 5,000 $2.00 $10,000.001 3345.360000001 $6,690.721 $6,690.721 5 $500.00 $2,500.001 7.000000001 $3,500.001 $3,500.001 1,000 $2.00 $2,000.001 175.750000001 $351.501 $351.501 500 $2.00 $1,000.001 597.870000001 $1,195.741 $1,195.741 50 $9.00 $450.001 24.300000001 $218.701 $218.701 1,000 $8.00 $8,000.001 2612.860000001 $20,902.881 $20,902.881 1,000 $12.00 $12,000.001 175.750000001 $2,109.001 $2,109.001 4,000 $10.00 $40,000.001 732.500000001 $7,325.001 $7,325.001 100 $20.00 $2,000.00 1 500 $43.00 $21,500.001 597.870000001 $25,708.411 $25,708.411 5 $4,000.00 $20,000.001 6.000000001 $24,000.001 $24,000.001 50 $126.00 $6,300.001 24.300000001 $3,061.801 $3,061.801 1,667 $4.00 $6,668.001 3333.000000001 $13,332.001 $13,332.001 1,667 $17.00 $28,339.001 3333.000000001 $56,661.001 $56,661.001 1,000 $2.00 $2,000.001 580.000000001 $1,160.001 $1,160.001 2,400 $2.00 $4,800.001 2360.000000001 $4,720.001 $4,720.001 1,000 $2.00 $2,000.001 600.000000001 $1,200.001 $1,200.001 100 $4.50 $450.001 62.000000001 $279.001 $279.001 100 $4.50 $450.001 62.000000001 $279.001 $279.001 10 $50.00 $500.001 10.000000001 $500.001 $500.001 4 $1,000.00 $4,000.001 8.000000001 $8,000.001 $8,000.001 4 $750.00 $3,000.001 8.000000001 $6,000.001 $6,000.001 2,000 $30.00 $60,000.001 270.200000001 $8,106.001 $8,106.001 10.000000 $75.00 $750.001 16.000000001 $1,200.001 $1,200.001 500.000000 $15.00 $7,500.001 150.000000001 $2,250.001 $2,250.001 4.000000 $3,300.00 $13,200.001 1.000000001 $3,300.001 $3,300.001 1.000000 $500.00 $500.001 1.000000001 $500.001 $500.001 2.000000 $5,000.00 $10,000.001 1 1 1 1.000000 $40,000.00 $40,000.001 1 1 1 Contractor's Application Application Number. Final AMIi-ko Date. 7/19/2023 E F G Tmal C-1-d % Balance roFioish Matuials Presently 9tor�(ootio Cl and Smredm Dare D+B) (F) B (B-F) $3,000.00 666.7 �JJ $9,750.00 $1,264.00 104.8% $2,940.00 140.0% $3,300.00 33.3% $500.00 100.0 $3,000.00 100.0 $6,000.00 100.0 $6,690.72 66.9% J $3,500.00 140.0%I $351.50 17.6% $1,195.74 119.600� $218.70 411.6% $20,902.88 261.3°0 $2,109.00 17.6 $7,325.00 18.3% $25,708.41 119.6% $24,000.00 120.0 $3,061.80 4 6.31 $13,332.00 199.9° $56,661.00 199.9°° $1,160.00 58.0% $4,720.00 98.3% $1,200.00 60.0% $279.00 62.0% $279.00 62.0% $500.00 100.0 �J $8,000.00 200.0%J $6,000.00 200.0°� $8,106.00 13.5% $2250.00 30.. 0° $2,250.00 30.0 $3,300.00 25.0% $500.00 100.0°0 $8,000.001 $4,000.001 -$2,550.001 -$9,345.001 -$58.001 $5,000.001 $8,500.001 -$840.001 $6,600.001 $10,000.001 I $50,000.001 $5,000.001 $3,309.281 -$1,000.001 $1,648.501 -$195.741 $231.301 -$12,902.881 $9,891.001 $32,675.001 $2,000.001 -$4,208.411 $4,000.001 $3,238.201 $6,664.001 $28,322.001 $840.001 $80.001 $800.001 $171.001 $171.001 44,000.001 43,000.001 $51,894.001 -$450.00 $5,250.00 $9,900.001 $10,000.001 $40,000.001 This document has been modified fiom its ongiool Jo..,. -CDC document and tlio user did not highlight the modificadoos. Youare enc .,d toreadthe d"cume"tcaroPollyandconsult Legal Counselpoortons --- C-620 Unit Price Pr° —. Estimate Progress Estimate Sanitary Sewer Rehabilitation Contract 113, Part 4 Applipation Penoa. 7-1-2023 to 7-13-2023 A I[em Bid Item No. City Secretary 58317 Contract Nam. B C O Bsemated Quantity SpePifieatiOn U-17Mwsure Bid Qumaty Umt Pnce Bid Value InsOHI,d Value Section No. Contractor's Application Application Number. Final AMIi-ion Date. 7/19/2023 B P G Tmal Compined / Balance to Finish Previously Ltafalled Valne Valiie This Penod Matuials Presently Stored m Date (F) (B -F) 9t.,Od do C) (D+B) B This document has been modified It— its origi.] form as an WDC document and the user did not highlight the modificanoos. You are encouraged to read the document—Offily and fq It Legal Counsel Pnor tons exeeuaon. C-620 Unit Price Prp —. Estimate Progress Estimate Sanitary Sewer Rehabilitation Contract 113, Part 4 Applipation Penoa. 7-1-2023 to 7-13-2023 °iry$ 58317 Contractor's Application CityNam. N. Application Number. Final Application Date. 7/19/2023 B C D E F G Tmal Complded / Balance to Finish Spe-ificatiOn Bid Qamaty Umt Pnce B,H—O d Quantity Brd Value lnelalled Matuials Presently Value PreviouslyL lled Value Value This Penod 9torO(not in C7 and Smredto Date (F) (B -F) Section No. Umt ofMwsua /D+B) B $1,797,081.001 1 $1,409.776.91 $1,409,M911 $1,409,776.91 184% $387."4.091 This docament has been modified It— its origi.] JO. as a" B1CDC document and the aser did not highlight the modifi°edons. You are encoareged to read the document—Offily and fq It Legal Counsel Pnor tons exeeuaon. C-620 Change Order Progress Estimate Construction Allowance Usage ADDITIONS For (wntiacx): Sanitary Sewer Rehabilitation Contract 113, Part 4 City Secretary ),027g$-4 Contract alum: 58317 Application Period: 7-1-2023 to 7-13-2023 A Item Item Number Descuptum B C D Specification Quantity to Add Unit Price Addition Value Estimated Quantity Value Section No. Una of Measure Installed This document has been modified from its original form as an E]CDC document and the user did not highlight the mrshficatmas. You are encouraged to read the document carefully and consult Legal Counsel pnor lots execution. Prevmusly Value Thcs Installed Value Period Contractor's Application nppnca ar,mmncr: Final Application Date: 7/19/2023 E F Total Completed / Balance to Finish Mattel( Presently and Stored to Date (F) (B - F) Stared (not in C) (DIE) B C-620 Change Order Totals Progress Estimate Construction Allowance Usage Contractor's Application CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED IF., (..-et): 102785-4 Sanitary Sewer Rehabilitation Contract 113, Part4 Application Number. Final Application Period. 7-1-2023 to 7-13-2023 Application Date: 7/19n023 A B C D E F Item Bid Item Number Description Spation ecificUnit of Measure Quantityto Delete Unit Price Reduction Value Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used Section No. Tohls This document has been modified from its original form as an EJCDC document and the user did net highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number I 1 Contractor's Application ADDITIONS IFor (wntac[} 102785-4 Sanitary Sewer Rehabilitation Contract 113, Part 4 City Seererary 58317 Application Number: Final Contact Num: (Application Period: 7-1-2023 to 7-13-2023 Application Date: 7/19/2023 A B C D E F Item Addmon Tonal Completed Balance to Fmish Change Order Item Specification Add CO Quantity to Add Unit Price Change Order Quantity Value eviously Value This Matenals Prese ntly and Stored to Date (F) (B -F) No. Descvpho° Section No. Unit of Measure Value Installed InPrstalled Value Period Stared (not in C) (D I E) B 1 8"Sewer Pipe LF 19.00000000 $119.00 $2,261.00 18.00000000 $2,142.00 $2,142.00 $2,142.00 94.7% $119.001 10 14' Manhole I EA 1.00000000 $5,630.00 S5,630.00 1.00000000 $5,630.00 $5,630.00 $5,630.00 100.0% I 11 14' Extra Depth Manhole VF 2.00000000 $292.00 _ $584.00 2.00000000 $584.00 $584.00 $584.00 100.0% I 13 ( Manhole Vacuum Testing EA 2.00000000 $200.00 $400.00 1.00000000 $200.00 $200.00 $200.00 50.0% $200.001 15 Concrete Collar EA 2.00000000 $550.00 $1,100.00 1.00000000 $550.00 $550.00 $550.00 50.0% $550.001 42 Cu[-In 4'Manhole EA 1.00000000 $8,000.00� $8,000.00 1.00000000 $8,000.00 $8,000.00 $8,000.00 100.0% 43 (Remove (011, Inlet EA 1.00000000 $2,200.00 $2,200.00 1.00000000 $2,200.00 $2,200.00 $2,200.00 100.0% I 44 Install IOft Standard Inlet EA 1.00000000 $12,100.00 $12,100.00 1.00000000 $12,100.00 $12,100.00 $12,100.00 100.0% I 45 Exploratory Excavation EA 2.00000000 $2,200.00 $4,400.00 2.00000000 $4,400.00 $4,400.00 $4,400.00 100.0% I 46 Major Manhole Adjustment EA 1.00000000 S4,400.00 $4,400.00 1.00000000 $4,400.00 S4,400.00 $4,400.00 100.0% I 47 (Vertical Shaft for Existing M.H. Removal VF 10.00000000 $1,925.00 $19,250.00 10.00000000 $19,250.00 $19,250.00 $19,250.00 100.0% I 48 I I I I I I I I I I I I I I I I IBOTC Repair loft of Sewer Main I I I I I I I I I I I I I I I I LS I I I I I I I I I I I I I I I I 1.00000000 $9,350.00� $9,350.00 1.00000000 $9,350.00^ $9,350.00 $9,350.00 100.0% I I I I I I I I I I I I I I I I I This document has been modified from its original form as an E]CDC document and the user did net highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel pan, to rts execution. C-620 Change Order Tntals $69,675.00 $68,806.00 $68,806.00 $68,806.00 98.8% $869.001 Progress Estimate Change Order Number 1 Contractor's Application DELETIONS For(contmct): Sanitary Sewer Rehabilitation 102785-4 Contract 113, Part 4 Apphcabon Number. Final (Application Period. 7-1-2023 to 7-13-2023 Applieation Date. 7/19/2023 A B C D E F Item CO Quantity to Deletion Change Order Item Description Specification Unit of Measure Delete Unit Price Change Order Not Used Nat Used Not Used Not Used Not Used Not Used Not Used Not Used No. Section No. Value I 41 Saintary Sewer Construction I I I I I I I I I I I I I I I I I I I LS 0.60000000 $50,000.00 $30,000.00 I I I I I I I I I I I I I I I I I I I This document has been modified from its original farm as an E7CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel pnor tons execution. C-620 Change Order Totals I I I 1 1 $30,000.001 This document has been modified from its original form as an EJCDC document and the user did not highlight the mrshficatmns. You are encouraged to read the document carefully and consult Legal Counsel poor to rts execution. C-620 Change Order Progress Estimate Change Order Number 1 2 ADDITIONS IFor (covtraot) 1027854 Sanitary Sewer Rehabilitation Contract 113, Part 4 City Secretary 58317 Contract Num: Application Period 7-1-2023 to 7-13-2023 A B C D Item Addition Change Estimated Quantity Previously Value This Change Order Item Descnptiov Specification ov of CO Quantity to Add Unit Price Order Value Installed Value Installed Value Period No. NNo. Measure assUnit 15 2" Surface Milling (50/50) Water SY 2483 50000000 $4.00 S9,934.00 2228 50000000 S8,9I4.00 $8,9I4.00 19 2" Surface Milling (50/50) Sewer SY 2483 50000000 $4.00 S9,934.00 2228 50000000 S8,914.00 58,914.00 16 2" Asphalt Pvmt Two D (50/50) Water SY 2483 50000000 $17.00 $42,219.50 2228 50000000 537,884.50 $37,884.50 20 2"Asphalt Pvmt Two D (50/50) Sewer SY 2483 50000000 SIT00 $42,219.50 2228 50000000 537,884.50 $37,884.50 49 Epoxy ME Liner on Ex. M.H. - 250 MIL Sewer VF 6.00000000 $650.00 $3,900.00 6.00000000 $3,900.00 $3,900.00 Totals This document has been modified fiom 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. Contractor's Application Final 7/19/2023 E F Total Completed % Materials Presently and Stored to Date (F) Stored (not in C) (D+E) B $8,914.00 89 7% S8,914.00 897% $37,884.50 897% $37,884.50 897% $3,900.00 100 0% $97,497.00 90 1% Balance to Finish (B -F) $1,020 00 1 S1,020 001 S4,335001 $4,335 00 1 C-620 Change Order Progress Estimate Change Order Number 1 2 DELETIONS IFar (contract): 1027854 Sanitary Sewer Rehabilitation Contract 113, Part 4 Application Pencil: 7-1-2023 to 7-13-2023 A B C D I he CO Quantity to Deletion Change Change Order Item Description Specification Unit of Delete Unit PriceOrder Value Not Used Not Used Not Used Not Used N. Section No. Measwe water Con —,on Allowance ($60,000 Una Cost includes 33 $20,000.00 (half of the $40,000) from paving construction Water IS 0.55000000 $60,000.00 $33,000.00 allowance; Pay Item 30 of Unit 3). Unit 3 paid for by water Sanitary Sewer Construction Allowance $10,000 -it Cost includes 41 $20,000 (half ofthe S40,000) fiom paving construction allowance; Sewer IS 0.80000000 $70,000.00 $56,000.00 Pay Item 30 of Unit 3 paid for by Water Totals $89,000.04. This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are euceureged to read the document carefully and consult Legal Counsel prior to its execution. Contractor's Application Application Number: Filial Application Date: 7/19/2023 E F Not Used Not Used Not Used Not Used City Secretary Contract Num: 1 58317 Application Period: Funding Identification (FID) Original Contract 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 I0 I0 I0 Change Order 1 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 I0 I0 I0 Change Order 2 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 I0 I0 I0 Change Order 3 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) City of Fort Worth Summary of Charges Sanitary Sewer Rehabilitation Contract 113, Part 4 I p. 0.: FW060-00000-20270 7-1-2023 to 7-13-2023 Application I Final Number: Total Completed Amt Remaining Gross $598,114.38 $252,102.13 $811,662.54 $135,201.97 $68,806.00 ($29,131.00) $46,798.50 ($27,645.00) $50,698.50 $50,645.00) Project Number: 102785-4 Application Date: 7/19/2023 Retainage Net City of Fort Worth Summary of Charges City secretary Contract Num: 58317 Sanitary Sewer Rehabilitation Contract 113, Part 4 I p. 0.: FW060-00000-20270 Application Period: 7-1-2023 to 7-13-2023 Apphcauon I Final Number: Funding Identification (FID) Total Completed Amt Remaining Gross Change Order 4 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 I0 I0 I0 Change Order 5 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 I0 I0 I0 Change Order 6 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 Project Number: 102785-4 Application Date: 7/19/2023 Retainage Net City of Fort Worth Summary of Charges City secretary Contract Num: 58317 Sanitary Sewer Rehabilitation Contract 113, Part 4 I P. p.: FW060-00000-20270 Application Period: 7-1-2023 to 7-13-2023 Application I Final Number: Funding Identification (FID) Total Completed Amt Remaining Gross Change Order 7 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 I0 I0 I0 Change Order 8 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 I0 I0 I0 Totals 156002-0600430-5740010-102785-001780-9999 (water 156002-0700430-5740010-102785-001780-9999 (sewer) I0 I0 I0 I0 I0 I0 $644,912.88 $224,457.13 $931,167.04 $55,425.97 Project Number: 102785-4 Application Date: 7/19/2023 Retainage Net City of Fort Worth Summary of Charges City Secretary Contract Num: 58317 Sanitary Sewer Rehabilitation Contract 113, Part 4 I p. O.: FW060-00000-20270 project Number: 102785-4 Application Period: 7-1-2023 to 7-13-2023 Application I Final Application Date: 7/19/2023 Number: Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Net 10 1.00 $0.00 $0.00 $0.00 10 .00 H $0.00 $0.00 H $0.00 10 10.00 $0.00 $0.00 $0.00 1 Grand Total $1,576,079.91 $279,883.09 1 1 $0.00 1 1 ($78,804.01)1 1 $78,804.01 FO wr WORTH[ _V_ Change Order Request Project NamelSanitary Sewer Rehabilitation, Contract 113, Part 4 Project No.(s)j56002106W4301000430157400101001780 Projectl SanitarySewer Rehabilitation Contract 113, Part 4 Description Contractor Woody Contractors, Inc. I City Project Mgr.I Dena Johnson Phone Numbed 817-392-7866 Dept, Original Contract Amount Extras to Date Credits to Date Pending Change Orders (In M&C Process) Contract Cost to Date Amount of Pro osed Change Order Revised Contra� Amount Orig, Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) M&C CSC No. 58317-CO1 I City Sec No, i58317 22-0738 i City Pro. No.j 102785 Change Order# Dale: I4/512023 City Inspector I Kevin Jackson i Phone Number.I (682) 328-7823 i Water Sewer Paving $692,763.00 $789,411.00 $314,907.00 $692,763.00 $789.411.00 $314,907.00 $0.00 $39,675,00 $0.00 $692,763.00 $829,086.00 $314,907.00 $51,013.00 $56,812,00 $0.00 $51.013.00 $56,812,00 $0.00 Totals ContractTima (Calandar Days) $1,797,081.00 240 $1,797,081.00 240 $39,675.00 $1,836,756.00 240 $107,825.00 $107,825.00 CHANGE ORDERS to DATE (INCLUDING THiS ONE) AS % OF ORIGINAL CONTRACT 2.211Y.I $2,246,351.25 JUSTIFICATION (REASONS) FOR CHANGE ORDER a Change Order No. 1 will provide compensation for the following: During sanitary sewer installation on Hulen Street, a previously unknown sewer service line from an I apartment complex was encountered necessitating the Installation of a cut -in manhole, an additional sanitary sewer manhole and the extension of the 8-inch sewer pipe in order to maintain sewer service to the complex. In order to eliminate conflict at a location where a project sanitary sewer main was encountered encased in concrete and connected to a storm drain inlet, it Is necessary to conduct exploratory excavation to determine the limits of the conflict. Due to the close proximity of an unstable power pole to a manhole that is scheduled for replacement, it is necessary to install a shaft to successfully replace the manhole and stabilize the pole in order to prevent it from toppling over. It is also necessary to replace about 10 feet of the sanitary sewer main that connects to the manhole by other than open cut installation. __J 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. Contractor's Company Name I Contractor Name 11 Cop4otor Signature I Date I Woody Contractors, Inc, Troy Woody 14. 7 3 Inspector - Project Manager ` Date C 4/10/23 Director (Water Dept) dim a !so (TPW Dept) Dale Senior Assistant City Attorney Assttsiagwf y Mano6Wr Date 5 & Apr13,2023 Council Action (if required) M&C Number i NIA i M&C Dale Approved j NIA j FORTWORTH City of Fort Worth Change Order Additions Project Name j Sanitary Sewer Rehabilitation, Contract 113, Part 4 City Sec No. j 58317 Project No.(s) j 56002106004301000430157400101001780 DOE No. 22 07 City Pro. No. 102785 Project I Sanitary Sewer Rehabilitation Contract 113, Part 4 Description Contractor Woody Contractors, Inc, Change Order # Date: j 41512023 City Project Mgr. j Dena Johnson City Inspector j Kevin Jackson j ADDITIONS Ilrm UESURlNlwN DEPT Qty 'Unit 'Unit Cost Total 1 8" Sewer Pipe Sewer 19.0 LF $119.00 $2,261.00 10 4' Manhole Sewer 1.0 EA $5,630.00 $5,630.00 11 4' Extra Depth Manhole Sewer 2.0 VF $292.06 $584.00 13 Manhole Vacuum Testing Sewer 2.0 EA $200.00 $400.00 15 Concrete Collar Sewer 2.0 EA $550.00 $1,100.00 42 Cut -in 4' Manhole Sewer 1.0 EA $8,000.00 $8,000.00 43 Remove 1Oft Inlet Sewer 1.0 EA $2,200.00 $2,200.00 44 Install 10ft Standard Inlet Sewer 1.0 EA $12,100.00 $12,100.00 45 Exploratory Excavation Sewer 2.0 EA $2,200.00 $4,400.00 46 Major Manhole Adjustment Sewer 1.0 EA $4,400.00 $4,400.00 47 Vertical Shaft for Existing M.H. Removal Sewer 10.6 VF $1,925.00 $19,250.00 48 BOTC Repair 1Oft of Sewer Main Sewer 1.0 LS $9,350.00 $9,350.00 Water Sewer $69,675.00 Paving Additions Sub Total $69,675.00 Page 1 of 1 FORT WOR-FH City of Fort Worth --� Change Order Deletions Project Name Sanitary Sewer Rehabilitation, Contract 113, Part 4 City Sec No. 58317 Project No.(s) 56002106004301000430157400101001780 DOE No. 1 22-0738 City Pro. No. 102785 Project Description I Sanitary Sewer Rehabilitation Contract 113, Part 4 Contractor Woody Contractors, Inc. Change Order #0 Date 41512023 City Project Mgr. Dena Johnson City Inspector I Kevin Jackson ITEM DESCRIPTION 41 Sanitary Sewer Construction DELETIONS DEPT City Unit Unit Cost Total Sewer 0.60 LS $50,000.00 $30,000.00 Page 1 of 1 Water ,Sewer $30,000.00 Paving (Deletions Sub Total $30,000.00 MMSE Breakdown for this Change Order Total 01• Previous Change Orders Total 4/5/2023 Sanitary Sewer Rehabilitation, Contract 113, Part 4 CSC: 58317 CPN: 102785 Change Order 2 Notes Staff has reviewed the requested prices and considers them to be fair and reasonable. .Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Dena ►7ohlvoii Signature Dena Johnson Name of Employee Project Manager Title ATTEST: Jannette Goodall City Secretary CSC No. 58317-0O2 FORT'WORTHt —V— Change Order Request Project NamelSanilary Sewer Rehabilitation, Contract 113, Part 4 f City Sao No.150317 Project No.(s)15W02/0600430i000430i5740010f0Oi78O N M&C j 22-0738 City Pro. No. i102785 i Project Doscripllon SanitarySevier Rehabilitation Contract 113, Pan 4 Contraclorl Woody contractors, Inc. Change Orders! I� Date: I6/112023 City Project Mgr.1 Dena Johnson City Inspector I Kevin Jackson Phone Numbecl 817-392-7066 Phone Number:l (682) 328-7823 Dept, Water Senior Paving Totals Con The (calandar Days) Original Conlracl Amount $050,216,50 $946,864.60 $1,797,081.00 240 Extras to Dale $6,00 $39,676.00 $39,676.00 Credits to Dale Pending Change Orders (In M&C Process) Contract Cost to Dole $050,216.60 $986,639,60 $1,036,766.00 240 (Amount of Pro�osad Change Order $19,153.60 $53,60 $19,207.00 Revised Conlrac Amount $869,370.00 $986.693.00 $1,855,963.00 240 Orig. Funds Available for Change Orders $51,013,00 $56,012.00 $107,826.00 Remaining Funds Available for this CO $51,013.00 $17,137.00 $60,150.00 Additional Funding (If necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 3.28% 1 $2,246,351.26 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 2 will provide compensation for the following: Increased pay Item quantities of milling and asphalt pavement that are necessary on the project Epoxy lining of an existing manhole that was scheduled for replacement but was determined to be Indecent shape during construction. It Is understood and agreed that the acceptance of this Change Order by the conlraclor constitutes an accord and satisfaction and represents payment In full (both lime and money) for all costs arising out of, or Incidental to, Ilia above Change Order. Conlraclor's Company Name Contractor Name Contractor Signature Date Woody Contractors, Inc. I Troy Woody I I �- 6 -.731 1 Inspector Project Manager , Dale �� 6/6/23 Director (Waif Dept) C lio or (TPW Depl) Dale c Gt�lkomel- ffal-den P S, 1 Sedlor Assistant City Attorney Assistant airs' er a Dale Jun 12, 2023 I i'�ounc�I c�(on �It <epu�red) M&C Number j NIA I M&C Dale Approved i NiA ]FC_ -RT WORTiA City of Fort Worth ... IV " Change Order Additions Project Name I Sanitary Sewer Rehabllitalion, Contract 113, Pad 4 City Sec No. 58317 Project No.(s) j 56002106004301000430157400101001780 DOE No, 22 07 City Pro. No, 102786 Project I Sanitary Sewer Rehabilitation Contract 113, Part 4 Description Contractor Woody Contractors, Inc. Change 0rder# �I Date;1 61112023 City Project Mgr, I Dena Johnson City Inspector I Kevin Jackson ADDITIONS ITEM DESCRIPTION DEPT Qty Unit 'Unit Cost Total 15 2" Surface Milling (50150) Water 2,403.5 SY $4.00 $9,934.00 19 2" Surface Milling (50160) Sewer 2,483.5 SY $4.00 $9,934.00 16 2" Ashphalt Pvmt Type D (60/50) Water 2,483.E SY $17,00 $42,219.60 20 2" Ashphalt Pvmt Type D (50150) Sewer 2,483.5 SY $17.00 $42,219.50 49 Epoxy M.H. Liner on Ex. M.H. -250 MIL Sewer 6.0 VF $660.00 $3,900.00 Water 1 $52,153,50 Sewer $56,053.50 Paving Additions Sub Total $108,207.00 Page 2 of 4 Fc>R-r W6P'1< H City of Fort Worth -VP Change Order Deletions Project Name Sanitary Sewer Rehabilitation, Contract 113, Part 4 City Sec No. 58317 Project No.(s) 56002106004301000430157400101001780 DOE No. 1 22-0738 City Pro, No. 102785 Project Description I Sanitary Sewer Rehabilitation Contract 113, Part 4 I Contractor Woody Contractors, Inc. Change Order 01 Dale 61112023 City Project Mgr, Dena Johnson City Inspector I I(evin Jackson DELETIONS ITEM 'DESCRIPTION DEPT City Unit Unit Cost Total Water Construction Allowance ($60,000.00 Unit Cost includes $20,000.00 (half of the $40,000.00) from paving construction 33 allowance; Pay Item 30 of Unit 3). Unit 3 paid for by Water Water 0.55 LS $60,000.00 $33,000.00 Sanitary Sewer Construction Allowance $70,000.00 Unit Cost includes $20,000.00 (half of the $40,000.00) from paving construction allowance; Pay Item 30 of Unit 3. Unit 3 paid for 41 by Water Sewer 0.80 LS $70,000.00 $56,000.00 ,Water $33,000.00 Sewer $56,000.00 Paving Page 3 of 4 Deletions Sub Total $89,000.00 MWBE Sub 0011 WIMBP Breakdown for this Change Order Type of Service .Amount for this CO Total Previous Change Orders DATE AMOUNT' . Total $0.00 6/1/2023 Sanitary Sewer Rehabilitation, Contract 113, Part 4 CPN: 102785 Change Order 2 Notes Staff has reviewed the requested prices and considers them to be fair and reasonable. .Contract Compliance Manaeer By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Deha �7ohlisoli Signature Dena Johnson Name of Employee Project Manager Title ATTEST: Jannette Goodall City Secretary FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Sewer Rehabilitation Contract 113, Part 4 CITY PROJECT NUMBER: 102785-4 WATER PIPE LAID SIZE TYPE OF PIPE LF C-900 8" PVC 1295 C-900 6" PVC 9 FIRE HYDRANTS: 1 VALVES (16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF N/A DENSITIES: YES NEW SERVICES: 1" 14 14 EA I SEWER PIPE LAID SIZE TYPE OF PIPE LF SDR-26 8" PVC 1264 PIPE ABANDONED SIZE TYPE OF PIPE LF N/A DENSITIES: YES NEW SERVICES: 4" SDR-26 PVC 11 EA TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS July 20, 2023 Woody Contractor, Inc 650 Tower Drive Kennedale, TX, 76060 RE: Acceptance Letter Project Name: Sanitary Rehabilitation Contract 113, Part 4 Project Type: Water/Sewer/Paving City Project No.: 102785-4 To Whom It May Concern: On July 19, 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 2, 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 2, 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 Dena Johnson, Office (817) 392-7866 or Email Dena.Johnson@fortworthtexas.gov. Sincerely, Dena Johnson, Project Manager Cc: Kevin Jackson, Inspector Gary Deyon, Inspection Supervisor Troy Gardner, Senior Inspector Tony Sholola, Program Manager RLG Consulting Engineers, Consultant Woody Contractor,lnc, Contractor City Of Ft.Worth, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 AFFIDAVIT STATE OF Texas COUNTY OF Tarrant Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Troy Woody, President Of Woody Contractors, 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; SS Rehab, Contract 113 Part 4, City Project No. 102785 BY 000dy - President Subscribed and sworn before me on this date 3rd of August, 2023. Notary Iie Tarrant, Texas � •�"Y-".tea' LUZARAVELO NOW,� 1•: ry Public, State of Texan MY Commission Expires •y11E.... .k*!� (VOTARY 18 12860410.0 CONSENT OF OWNER ❑ SURETY COMPANY ARC141TECT CI CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT G707) .Bond No. K4020197A PROJECT: Sanitary Sewer Rehabilitation, Contract 113, Part 9, City Project No, 102785 (name, address) Port Worth, TX TO (Owner) City of Fort Worth 200 Texas Street II Dort Worth, TX 76102 L— CONTRACTOR: Woody Contractors, Inc. ARCHITECTS PROJECT NO: CONTRACT FOR: CONTRACT DATE: September 27, 2022 Q 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) Vigilant Insurance Company 2001 Bryan Street, Suite 3600 , SURETY COMPANY, Dallas, TX 75201 on bond of (here insert name and address of Contractor) Woolly Contractors, Inc. 650 Tower Drive CONTRACTOR, Kennedale, TX 76060 hereby approves of the Final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) City of Fort Worth 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 Attest: (Seal): 3rd day of August , 2023 VIGILANT INSURANCE COMPANY Surety Compa �+ ? By Signature of Authonze epresenta#ive Kyle W. Sweeney Attorney —in —Fact Title Note: This form is intended to be used as a companion document to the, Contractor's Affidavit of Payment of Debts and Claims, Current Edition Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Know Ali by These Presents, That VMURAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constlrute and appoint Elizabeth Gray, Charles D. Sweeney, Kyle W. Sweeney and MichaelA. Sweeney of Fort Worth, Texas----------------------------------------------------------•---------------••------------------------------------------------------------ each as their true and lawful Attorney -in -Fact to execute under such designation in their names and to aft their corporate seals to and deliver for and on their behalfas surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than ball bonds) given or executed In the course of business, anal any instruments amending or altering the same, and consents to the modification or alteration ofany instrument referred to in said bonds or Obligations. in Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 161^ day of September, 2019, Iwin NI, Q lcu•rx;. Asssistani SL rotary I't **g,' 100 STATE OF NEW JERSEY County of Hunterdon f _ vv Su_ythrn 11.It;tnr�y, Vlecl'rc'~idi:nt on this 1611 day of September, 2019, before me, a Notary Public of New jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDI3RAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. ChIcros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC: INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that she signed said Power of Attorney As Assistant Secretary ofsaid Companies by like authority; and that she Is acquainted with Stephen M, Haney, and knows him to be Vtce President ofsaid Companies; and that the signature of Stephen M. tfaney, subscribed to said Power of Attorney is in the genuine handwriting of Stephen M. Haney, and was thereto subscribed byauthority ofsaid Companies and In deponent's presence. Notarial Seat (� �A.R�,y m a pU@Lla ,IERg� KATHERINE 1 AMLAAR NOTARY PUMAO OF NCW JLw,RS&Y No, MGM Oommlmlon Expirao Jury 10, 2024 No�aryPishllr. CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT 1NSURANCP COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 20167 "RESOLVED, that the following aurlioi lzation,s relate to tho execution, for and on behalf of the Company, ol'bunds, undertakings, recognlzuui;es, conwacts and olher wriiten tomtnitntenis of the Company entered tntoin the ordinary coume orbusiness(each a"Wr tten Contmttment" ): (1) Lrach of ate Chairman, the president and rite Vice Presidents OrilleCompanylshoreby authurixed toexecuteanyWrlttenCommittnent IbrantlonbehalfefiheContpany,underthe seat or the Company or otherwise. (2) Hach duty appointed altoweyln-Fact of the Company Is hereby atehurixed to execute any Written Commitment far and on behalf of the Company, under the seal of the Company or otherwise, to the extent that Bach acllon is authorised by the grant of powers provided 1'or in such petson's written ;appointment as sudi atiorney-In-fact. (1) Bach of the Chafrmur, the president and the Vice Presdents of the Company Is hereby autharized,for and on behalfofthe(toinpany,loappohulitivriting ;my person the anorrey in -fact or the Company with full power an(]authorltytoexecute, for and on behalfoftheCompany, under the seal ofiheanapanyorwherwise,suebWrlttenGomntitmentsofthe Company as may he specified In such wrihen appointment, which speelRudon may he by general type or class of Written Commitments or by specific;dlon of one or more particular Written Commitments. (A) Rach of fire Chairman, the president and the Vice Presidents of the company is hereby aulhoi Ned, for and on behalfortbe company, to delegate in %vi l0nglo any Other Officer ofille Company the nothorlty to execute, lorand on belulif of the Company, under the Company's seal or uthurwise, such Written Comntltmeals of the Company as arespecilied In such wrluehdetegadon,whlchspeclgtatinn may be by general typeor classol' Wrlaen Commitments or byspecificationOrono ornoreparticularwriltenCommitmenis. (9)Thitsignalure of any offlcor or ol1wripersollexecuting ally Written Connictinentorappoirument or deloevuJon pursuant to L1118 Resolution, and tliusmloftheCompany, may be affixed by facslmila on such Written Commitment of written appointment or delegation, FURTHERHSOLVIID, that the fonegolltg Resolution shall not be deemed to be an exclusivestatememot'the powers and authority ol'Officers, employees and otherpersonstoact for anilonbeludl'of' the Company, and suchResoludon shall not Ilmit or otherwise afrbct the exercise ufanysuch power or authorltyotherwlse validly granted or vested," I, Dawn M. Chloros, Assistant Secretary orFEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the 'Companies') do hereby certify tha( (1) the foregoing Resolutions adopted by the Board of Directors of the Companies are true. correct and in full force and effect, (10 the foregoing Power OfAttorney is true, correct and in full forceand effect. Given under my hand and seals ofsaidCompanies atWhitehouse Station, NJ, this 3rd day of August 2023. Ow0 V lkiwn 11,l:hkalt,x,,ttil f;nu�ttrctary` IN THE EVENTYOUWiSII'MVITRIFYTI1HAUrlii:NTicrrYOF'I'IifSBOND ORNO'I'IPVUsorANV(rl' HMA'i-I'ER,ItLGASECON't'AG'I'USA'i': Telephoite(908)903-3.193 I+ax(903)903-3656 c-maill surawchubb.com FEO- VIG-PI (rev.O3-t8)