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Contract 56582-FP1
FORT WORTH, WATER DEPARTMENT NOTICE OF PROJECT COMPLETION -FP1 City Secretary No: 56582 Date Received: 9/22/2023 City Project N!?: 1929-2 56582 Water & Sanitary Sewer Replacement Contract 2011, WSM-D Part 2 Regarding contract for as required by the WATER DEPARTMENT as approved by City Council on 9/28/2021 through M&C 21-0763 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 Chn stop her Har er(Sep 22, 202313:23 CDT) Accepted Director, WATER DEPARTMENT aina uULIG7doAc Dana Burghdoff (Sep 2 , 202313:27 CDT) Asst. City Manager $ 2,946,026.50 $ 312,929.70 2Va- 8 _ $ 3,258,956.20 $3,101,139.29 Days @ $650.00/ Day $ 3,101,139.29 $ 2,946,082.33 $155,056.96 Sep 22, 2023 Date Sep 22, 2023 Date Sep 22, 2023 Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment Invoice No. Final To (Owner) City of Fort Worth Invoicing Period (From - To): Invoice Date: 9-15-2023 to 9-15-2023 9/15/2023 P. O. FW060-00000-16023 From (Contractor): Remit to (If Not Automatic Deposit): Number: Woody Contractor Project: 01929 Contractor's CFW Vendor No.: City secretary Contract 56582 Contract SanitarySewer Replacement Contract 2011 WSM-D Part 2 p Number: umber: Name: Application For Payment Change Order Summary Approved Change Orders 11. ORIGINAL CONTRACT PRICE ........................................................ $ $2,946,026.50 Number Additions Deletions 12. Net change by Change Orders............................................................... $ $312,929.70 1 $17,500.00 $17,500.00 13. Current Contract Price (Line 1 f 2)...................................................... $ $3,258,956.20 2 $159,080.00 $159,080.00 14. TOTAL COMPLETED AND STORED TO DATE 3 $236,072.00 1 (Progress Estimate, Construction Allowance and Change Orders)..... $ $3,101,139.29 4 $72,557.70 $10,700.00 15. RETAINAGE: 5 $9,400.00 I a. X $3,101,139.29 Work Completed......... $ 6 $24,400.00 I b. X Not Used $ 7 $70,512.00 $70,512.00 I c. Total Retainage (Line 5a + Line 5b).............................. $ 8 $59,805.00 $59,805.00 16. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c)........................... $ $3,101,139.29 TOTALS $639,926.70 $326,997.00 17. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)....... $ $2,946,082.33 NET CHANGE BY $312,929.70 8. AMOUNT DUE THIS APPLICATION ............................................... �9. $ $155,056.96 CHANGE ORDERS BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + Cos + Line 5 above) ............. $ $167,216.91 Contractor's Certification 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~ep 19, 2023 08:43 CDT) 10. CONTRACT TIME: a, Days Awarded 485 b, Days Added by CO 105 C. Total Days 590 d, Days Charged 554 e, Days Remaining 36 Consent of Surety Affidavit of Bills Paid This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Progress Estimate "O`1t0"tl8L)` Sanitary Sewer Replacement Contract 2011 WSM-D Part wppbamo"9,"oa- 9-15-2023 to9-15-2023 w Did- 1 2 4 sRaa,.am„6.".a6,-a",2.mc"m°al Uenrnp o os w/R-Id l2M hOIOeI 3 10 d'JJ`yyykir_A°egea°nmenl Pluo LLB �GLL??8��r1����11FF 12 13 ]V/WIre��✓''aa(/ aa eilsl 18eaee 18 Imoobedmenkll6acC5M5CO"tl6iM1 - eV ryJ 7J,y�eM1 Gutler lmaleM1 ensllnal z a 22 25 21 A.PPPdd E111111 alar rdal" 1" 28 0 31 33 a5 3a s dt o32 2�r "cyli Ay8-1 laP�xyrie d Tw AIenFOI(e Adi PI tlilno wlCdlar Meer Bm I" Iee 40 a4.aeb�erel es 6 Ivenzae°" oneyylkii a" y�y,Iy My9yA/�,�°gawaMdSSc ���i era Ia1 4 49 50 6'R��r`�o li �gpj+a�Waler� 9��R'/(cLLq� 2 y'ff� g lFl1T2-San�UrvSewer `e lore -heal e Fvc s.war pa e PVC Sewer P.- Plpa 11S0 PSI Mi"I 4 Cwhaa 8 t m 6 x anal a n 14 galISanI SewerVr°util'mea L°n ie 18 4 Sewer3emce ed Floa 19 4 kanhde 20 4 D, ii-1. 22 [['E ra oCegP�II ManM1de 224 3 Rm °ie"Ecnl'e"Cuk BP,uuer 2s 2] Glm.rrm.mb 29 aal.rna. 31 3322 lud, Add- 11111 a ;e 3] 39 40 n ez N ;"k-K, ; air snarnwr 56582 -1-m I ae Old Q-.I. Una Fnne Brtl Value = 17200000U 411 11 5350 J, 511000 0 $60200 S44 000 = 5780 OOOOW - 82000006 5820 J, S]50(711 -DODO12D( $4]2.320 $81s0 10000 $$1500 = 4]So0000� 1 WOODO 52 ]00 V) $2 ]00 200000LI S OOOOOLI 00000l I 52500N(7JJJ, 53a00(JJ 54 ]00 0(7JJ $SOO $1500 $23 s00 = 00000LI 4000000( 10000000000�1 5200(7J, 31080(7J� s15o a(7J%J, $180.000 1320 $15.0. 40S40 5338 a00U DOD 50 D.ON elo00o0001��1 5163000 $28500 $13932 14]0000IXl 1n 000am 1 $s311 s4 aaa $$s1450 00000ll OOOOOLI 1 82850� 51 1. aR Ss aaa 2) sss 000 Ooo004 4 aaaML 2000000 $e aaa J, $400000 $38000 sB0000 23 000'o 11300 J $$8$88 11880 00000U 511 MM0(7J%J/)7J, $$12.400 1 310. Oil 1l 00000G U.�J s1ao C2o 0000 S150 o0a((ffOJ $1 Soo $21" ,iaeo0000 o00ooU $12OJ, s81Q5 $1s 824 $]3a62 = oa1U = 000U so10o000 52 OW 580(Jl $1000 $4000 = 010U se a6/ $4 000 = 9I5....0(1 25000ooU - 1010111 i54 OOOOOU s]1. a(f 5115 343 51425 524S J, $].00 $22]1 $108 $]ss $3]]30 l000. 100000U 2.0.0 a 100000U 580000(7J S12 aDO$12000 sa4. MI V..0 aU $8000 $18 Boo S100.000 c Eshrlvled Qeeetlry 172 00 ]20000001 3 920000001 $60200,001 .3120.001 $60.200001 143120 001 3799000OOOoo1 $311.518.001 $311,518001 73000000001 $5475001 Ss 4w001 00001 38454]0000001 $9 800 001 $729294I $9.800 001 5]282841 OOOol 231000000001 $48288 $2700001 $462881 527MM 200000001 $500001 $500001 500000001 1 $1500001 1 $1.500001 000001 7992000000001 $28200,001 $159.840.001 528200001 $159.840001 00aool 31440000001 1 DOOM I OSOo000001 00 0l 147000000001 Oaa01 00001 Oaa01 12 00001 Oaa01 00001 OOOoI 00001 172 OOOoI 9226 00001 00001 5 0000000 1 000a01 21 000000001 0001 S] S31000000O-1 331110 22 31110 LF 20000000 512900 $258000 1200000000 $154800 $1548 333120 0 F 396000000 512300 US708,001 39500000000I US 585.00 548585 3 3' 12 LF 388000000 512500 $45750.00 82]00000000 $103.3]5.00 M.- 4]500000il ]OOOOOUJ 3153D' 55a0 a(� $728]s.001 $3500001 S000000001 $2500001 $2.500 I- 0UJJ 1,000OOOOJ' 5230' $3838].001 1448000000001 $33258,001 $332s8 17 2.00a(1 11 S150a(1 $11]0\. $15000.001 $8 AN 001 33200000001 85 000000001 $4980001 $994s 001 $4.980 59945 5000000U 31a0 a(ll :5DOD 001 1 1 3.Oa0(1 123100000U 540' VOOQ $232000 $12350.00 311300000001 00ao1 4i $1245201 $12340.001 51245 $12.340 3110 11'000a6 2 OOOU 'I'op", 51100011 $1 Bs0001 $2200001 000000001 300000aa01 $165-1 $3300001 516R $3.300 35-.6 411000000 vD. $1235001 1234000N-1 $1234001 51234 17K a<1 $8250 DO oaa01 $225o DO iz25o 6 000", S]000�1 -2.00. -01 $19.0001 31980 EA e OOOOOU 3l D-6 5250 a(. 52000 $2....0 $62000.001 Oaa01 18000000001 $2DOD 001 $36000,001 32.000 $36000 333920 800o00o Ss 90000 S47200,001 800000001 $4]200,00 34]200 333810 30oo000 11400000 S42000.00 3000000001 $4200000 342000 343810 VF OOOoo 5lDs $916s 00 38190000001 $]44]Os1 5]46] 10]000000 1a0(1 s35O aC� 520' $37.450.001 $8000001 1a 500000001 3646 470000001 $38875.001 $7292.1 $38675 5]2. 000U Oa0(1 5205 51000 $1500001 $40000.001 231440000aoI HIS 4]0000001 $48288 $36484.]0 54' 1538464 31�1 213 000U 11 000U $38 aL 5182 \1 511 ON $28500.001 $13932,001 $130.680.001 OOM1 00001 OOao1 $8]94]21 $2705401 $101A89.411 $S- 52]OS $101A89 OOOU 14M p1 1241001 13 00001 $5200001 $5200 OOOU 0010 slI aC� 5]500\. $11...0 $15-ol 01a01 00001 $20o DO $3]s0001 $2. 53]50 42 000U o0000a(1 54004. 55o 0O $1.440001 $2100001 1MOM0- 04000000001 S840001 $4700001 $S. 54700 130200.0, 5120E $15824.001 OOM1 SO...21 $6.034 OOU 3815J $]3082.001 9331810000001 $57390.83I Ss]390 1'71001111 25o .6 S11S 54 $227125 $108]s _ 5300000U 5400000il 1100000U 5142SJ, 32652J $755251 $3]]30,001 1 12413R00061 1 $30413,081 530413 6000cDo 52000 MJJJ 528500(1J $2000001 $17100,001 1000000001 ]500000001 $2000001 $21375.001 $2.000 $21375 7123 100000U aaOOU 53 aaa MM7J7 58 000 21 $3DOD 001 $6 000 001 1000000001 100000000I $3000001 $8 Co. 001 MOOD01 58 000 x 411. lF OOOU ooa6 3000000U 5500a0 allJJ 52o OQ- $6, 06 $50000001 $114111 S20,0001 1 1 1 1 Contractor's Application A,,I.- N.- Final np as°a udn E 935l2023 c . m ca1 % a lar�la d$D e anLe°eIFmr -Pi amp( m c�Y I,)� F $60200.O111000p� .3120.0N 980% 58B0001 $311.518.O11 880% $s4]s Olt 890% 3180802001 58]5001 S9800.011 980% $729291, 912% 320000 5]o]OB -2 .1 SO 9% $ $50.0 10003� 3103712 528. 001 $150000 10003�, $2820o.00 1200% 44900001 $159.840.00 999% 3180.1 $24231.SS 5809% 319911981 S 000 00 $84n1 912% 535 $% 11 $27-il 194% 1112261 . $1s0.1s0.0o 03].O. $2170OU 5�s24500001 $sn 000 ou 111a 1 $.A.. Oil 1000� $z]0000J 750% 110d9D $$$64$$5400000� 00000 000DO 111 3s59sl $80000.11 200 J0Win$780 / $1007 a1% 01 A.4 519059n� 1 $J 419% $ $3$200 O7j 182% ]5oozoa� 000 122. as 1 ua000D282DI ]1 3% 1ID 60.06%SS898 ]39% S3] $6a6y.?%13130 $274600% �76NM /Gaa as 52271251 5108 ]5 5]5525 $30.41-S 806% S731693 $12 0000 iooa 1 $16600.OU 1000% 1 V.ODD DO $1 548 00 NO% 51032 DO $48585.00 DO- 5123001 $,03.375.00 2260% 157.5DO1 5]2675001 $25000U 714% 1100000 $33258,00 866% Ss 12900 118000 332% 51002000 SO. OU 1181% 41521001 5500000 $124s21 '%1111SO $12340.01 Ue% 110 as $18s001 '000% $330001 311C000 $12101 991%% $225001 ]a 5100 se aaa as $1 0000 467% 10 52260001 $36.00.0- 581% 526000001 SL]200.00 1000% 1 S42000.00 1000% 1 $]44]Os $388]5.N 813%. l(1`3 3� 5171]85 312250O $]292W 912% 5]0]O81 $4828/ SO 9% 11037121 $36484 ]ll 912% 5353530 $e]94]:` SO 9% 519 ]0121 $2]Os 4d 194% 511228801 $1Ot A894'.i - 1. .1 $ smo o�i ' 1A`1 $3 ]50 OL12s00% 42250001 $840 O/ 238 SBaa 00 $4]0001l 2238% 3280000 $80340'` 388% 3958998 $s]390.BI ]88% 5158]1251 $22]1251 5108 ]5 t S]55251 $$20000'1 806% S]318831 83.0000` 1250 ,1 44275001 $60000d 1000% 11 "1111 11860001 52 DID aal Thia dawmwi banbem modi5ed fiom as o"dualm an m .od r"c d.d"orbidaigbi rbe wuAS<ano"a You an wero n6etlw.1 aynd1-1egl CowIp"orio>tn execam" Progress Estimate Drys°`— 56582 Contractor's Application "sac, Nmn PO`1t0"tl8L) Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 PP —NO"'^°' Final App�,cmon P,noa- 9-15-2023 to 9-15-2023 na tenon °81° 91152023 A e u B c a.m mcnnp� x B °n°°a Em- Sp Bvd ltemNo Ueernp o emEP <anon Umr ofMemun B�tl Qu"nery Und nve Bid W.N�iele�d miry Velu° P�ex y rolled V" V"lu°'IT�v Peri°tl 9�(mten C'''jY a �ore3 �o 6 vl-P) Semon No nd S�+E)�m —document1. been mod --us-&, fo"n m en BICUC do 1 ena. user d.d no, I.Oh&., moAlen—You me mwu W10—Ned--amNllY.nd con 1L,I Cowin p"or m"e execumn Progress Estimate Drys°`— 56582 Contractor's Application "sac, Nmn PO`1t0"tl8L) Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 PP —NO"'^°' Final App�,cmon P,noa- 9-15-2023 to 9-15-2023 na tenon °81° 91152023 A e u B c a.m mcnnp� x B °n°°a Em- Sp Bvd ltemNo Ueernp o emEP <anon Umr ofMemun B�tl Qu"nery Und nve Bid W.N�iele�d miry Velu° P�ex y rolled V" V"lu°'IT�v Peri°tl 9�(mten C'''jY a �ore3 �o 6 vl-P) Semon No nd S�+E)�m —document1. been mod --us-&, fo"n m en BICUC do 1 ena. user d.d no, I.Oh&., moAlen—You me mwu W10—Ned--amNllY.nd con 1L,I Cowin p"or m"e execumn Progress Estimate Drys°`— 56582 Contractor's Application "sac, Nmn PO`1t0"tl8L) Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 PP —NO"'^°' Final App�,cmon P,noa- 9-15-2023 to 9-15-2023 na tenon °81° 91152023 A e u B c a.m mcnnp� x B °n°°a Em- Sp Bvd ltemNo Ueernp o emEP <anon Umr ofMemun B�tl Qu"nery Und nve Bid W.N�iele�d miry Velu° P�ex y rolled V" V"lu°'IT�v Peri°tl 9�(mten C'''jY a �ore3 �o 6 vl-P) Semon No nd S�+E)�m —document1. been mod --us-&, fo"n m en BICUC do 1 ena. user d.d no, I.Oh&., moAlen—You me mwu W10—Ned--amNllY.nd con 1L,I Cowin p"or m"e execumn Progress Estimate aryl°`n " sessz n�lN w �PO`1t0"tl8L1 Sanitary Sewer Replacement Contract 2011 WSM-DPart 2 nppbpmo�P,�oa- 9-15-2023 to9-15-2023 a e &dlnmNo pomp o Spnnfieanon Un�i ofMeazun B�tl Qmnery Unll Pnee B�tl Value Semon No Contractor's Application pP—N.— Final np C°O"p81° 9115/2023 C p B c nded nary V I 111 d V V I 'Ib P ad a Pwuntl il�I M �m Nnfe eua y v n a eue �n nri S1 Tool e o o B Q BW (B P) nd 3�+B)� 32.381-6.26 12 M.-2. 92.38-6.26 — 139C 13Y 2d Thia dawmeni M1ubem mod�fi°a fion, GIs Netlo.d�plm pn dowed Ih< d.deolbidaigM1�ibe moAfi<anoea You are mwu.aped to natl ow—mml anNllY d1- 1 Le,Igl CowiI p.orioon execume C-620 Change Order Progress Estimate Construction Allowance Usage ADDITIONS For (wnvm0 Sanitary Sewer Replacement Contract 2011 WSM-13 Part City Se-Mq 01929 Contract Nam: 56582 Application Pmod A B C D Item Esflmated Quantity Previously iY Item Nambm Descnption Specification UmtofMeasare Qaaaay to Add UmtP. Addition Valae Installed Val- Iretalled Sation Na. 53 REMOVAL OF 36"RCP LP 1600000000 $2100 $33600 1600000000 $33600 $336M 54 INSTALL 36"RCP LP 1600000000 $22500 $3,60000 1600000000 $3,60000 $3,600M 55 36" CONCRETE COLLAR EA 200000000 $1,00000 $2,00000 2000WN $2,00000 $2,000M 47 REMOVAL OF 18"RCP LP 3000000000 $1600 $48000 3000000000 $49000 $480M 48 INSTALL I8"RCP LP 30 W000000 $14100 $4,23000 30000NW $4,230 an .130. 49 18"CONCRETE COLLAR EA 200000000 580000 $1,60000 200000000 $1,60000 $1,600M 50 CONNECT TOW T EA 200000000 $2,20000 $4,40000 200000000 $4,40000 $4,400M 56 1" PRIVATESERVICERELOCATION LP 30000000000 $4300 $12,90000 29400000000 $12,64200 $12,64200 57 8"WATER LOWER G EA 200WWO $8,00000 $16,00000 200000000 $16,00000 $16,000M 59 N4PORT SELECT F. CY 50000OWN $3500 $17,50000 360001,00000 $12,60000 $12,60000 60 2"WATER SERVICE EA 200000000 $3,20000 $6,40000 200000000 $6,40000 $6,400M 61 RECONNECT2"WATER METER EA 200000000 $90000 $1,80000 200000000 $1,80000 $1,800M 51 IMPORT SELECT FD CY 10000000000 $3500 $3,50000 33000000000 $11,55000 $11,55000 52 REMOVE 6"-12"TREES EA 600000000 $90000 $5,40000 600000000 $5,40000 $5,400W 53 REMOVE 12"-18"TREES EA 200000000 $1,50000 $3,00000 200000000 $3,00000 $3,000W 54 SITE CLEARING LS 100000000 $3,00000 $3,00000 100000000 $3,00000 $3,000W Totals SM,146.00 $89,038.00 $89,038.00 Value Thts Period Application Nambm Appheml, Date E Materials Presrndy Sbred(not in C) Contractor's Application FINAL F Total Completed / Balance to Raldi aaiSto wDate (F) (BF) (D+E) B $33600 1000% 1 $3,60000 1000% 1 $2,00000 1000% 1 $49000 1000% $4,23000 1000% 1 $1,60000 1000% 1 $4,40000 1000% 1 $12,64200 980% $259.001 $16,00000 1000% 1 $12,60000 720% $4,9W.00� $6,40000 1000% $1,80000 1000% $11,55000 3300% 48,050.001 $5,40000 1000% 1 $3,00000 1000% 1 $3,00000 1000% 1 $89,038.00 1034% .2,892.001 This documwl has bern moMfled fiom its original form es an EICDC dowmeot and the user dldoo[ Idghlight the modifications.Yoa 11 enwaraged to read the document c silly lad -It Legal Coaaaal prior to its execution. C-620 Change Order Progress Estimate Construction Allowance Usage CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED For (wntraa0 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Pad Application PmN A B C I Item Spxificatmn Qoantityto Delete Unit Price Red —Value N. Used Bidlran Namber Description UmrofMeasure Sectian No CONSTRUCTIONA LOWANCEI EA 10ONN 00 $5,93606 $5, 360S CONSTRUCTION ALLOWANCE I EA 1.00 wwo $10,910.06 $10,910.06 CONSTRUCTION ALLOWANCE2 EA 1.00000000 $28,900.06 528,900.06 C'aitUC4lg�qLWE3 EA 100000000 $14,90006 $14,90006 I I I I Tolals $86,I46.00 Application Number Apphcation Date D E Not USN Not Used Not Used N.UW Contractor's Application FINAL F Nol Used N. Used N. Ure This documwl has bern moMflN bom its original form es an EICDC dowmeot and the user dldoo[ Idghlight the modifications. Vou 11 en 11,,d to read the document ca Wly and wnsolt Legal C—I prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 1 1 Contractor's Application ADDITIONS For (wntraa0 Sanitary Sewer Replacement Contract 2011 WSM-D Part Ory Secretary Application Number 01929 56582 FINAL Apphcatron Pmod Item Chavge Order Item Deuriphon No. 52 C—u.. to Existing 24"RCP Totals Coviraot Num. AMI—Ian Date A B C D E F Addinan Total Camplew % Balance to Fans Specidp In CO Quantity m Add Unit Mn Change Orda Estimated Quantity Valve Previously Value TM1is MatenalSPreswfly avd Scoredm Dare (P) (B -P) Section No. Umt ofMeeaure Valve Ivslall¢d Ivs AldValue Period Stord(vM iv C) (D+E) B EA IONW000 $17,50000 $17,50000 100000000 $17,500M $17,50000 $17,500.00 1000% $17,500.00 $17,500.00 $17,500.00 $17,500.00 1000% This documwl has bern moMfled 6om its origival form es an 21CDC dowmevt and the user didoo[ M1lghlight the modifications. Vou 11 enwuraged to read the document carefully and wosult Legal Couruel prior to its execution. C- 20 Change Order Progress Estimate Change Order Number 1 1 DELETIONS Fm (ron act), 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Pad Apphwdoo Numbm. Applmao0n Pend AI—,.. Date A E C D E Item Daldon Change Order I— D—pt, No on Sp ffi nan UmtofM..COQoantltyWDelete W m Section NO Change Order Not Usd VaWe NM Used NM Used NM Ure Noc Used 27 C.-w Emmng 24" cast�mn Water M— g FA IONW000 $9,00006 $9,ow 000[ 51 Water conso-octmn Allowance LS 0.08500000 $.M.M0.06 suwAO Totals $17,500.0d Contractor's Application FINAL F N. Used Noc Used Noc Used This documwl has bern moMfld bom its original form es an 21CDC dowmeot and the user dldoo[ highlight the codifications. Vou 11 enworaged c read the document ca Wly and —It Legal C-1 prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 2 ADDITIONS Igor (wno-aa0 01929 Sanitary Sewer Replacement Contract 2011 WSM-13 Part Apphca0on Pmod Item Change Ordtt item Dacriphon No. 58 8"PVC tvata pipe DR-I8 Total. City Secretary 56582 Contract Num: A B Specification CO Q...atym Add Unit Mn Addifim Change Sation No. Umt ofMeesure Order Valve LP 194000000000 $8200 $159,0800 1Tuxirrixf C D Esfim WQvavhty Valve Prevmvely Value This Installed Idled VaWe Period 195900000000 1 $160,638.. $160,638001 $160,639.00 Contractor's Application Applaatian Nnmber FINAL A,1-1,.. D- E F Balance to Fmi.h Total Campleted Materuls Pre¢entl y avd SWoAm Dare (F) (B -F) Sb+�(vot iv C) (D+E) B $160,63800 1010% $1,558001 $160,638.00 101 0% -$1,558.001 Thee documnt has bern moMfled fiom its original form ea an EICDC dowmevt and the user didoo[ highlight the modifications. Vou 11 enwuraged to read the document carefNlly and wo alt Legal Covruel prior to its execution. C-820 Change Order Progress Estimate Change Order Number 1 2 DELETIONS For(rottoac0. 01929 Seoit-y Sewer Replacement Contract 2011 WSM-D Pad AMI-till Number: Appliwhon Penod: Application Date: A B C D E Item Deletion Gunge Change Order Item Description Specification Umt ofMeawre CO Quantityto Dele[e Umt Pnce Order Value Not Used Not Used Not UsN Not Used Not UsN No- Section No. 3 8—W.PVC6. LF 1940-000MMQ $82.06 $159,080.06 Tolala $159,080.0d Contractor's Application FINAL F Not UWA Not Us Not Us Thia documwl has barn moMfled bum its original form ea an 81CDC dowmeot and the user didno[ highlight the modifications. Vou 11 enwuraged to read the document carefully and wnsult Legal Couruel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 3 ADDITIONS Igor (wno-ap0 01929 Sanitary Sewer Replacement Contract 2011 WSM-13 Part Gty Secretary Contraet Num: Application Pmod A B Item AddinOn Change Order Item Specifiwd.n COQ...hIym Add Unit Mn Change Order No. Dacriph0n Sation No. Umt ofMeesure Value I —hol,d.ss�onmat Wbondedfibremulch SY 97500000000 $1600 $15,60000 2 Remove Curb and Guner LP 220000000000 $200 M,40000 3 ]" cudr and Gutter 18" LP 220000000000 $4400 $96,80000 4 Block Sad SY 500000000M $1200 $6,000N 5 Remove Sidewalk SF 600000000000 $200 $12,0M 00 6 4" Concrete aldewalk SF WOOM000000 $800 $48,00000 7 Remove ADARamp EA 500000000 $60000 $3,00000 8 Banter Ramp Type Pl SF 298000000M $4000 $11,92000 9 Burner Ramp Typemod Rl SF 87500000000 $4000 $35,00000 10 Type Ill Bamcade LF 2800000000 $3400 $95200 11 G-ollUal.. Timber p..a LF 5000000000 $4800 $2,40000 T.I.I. $236,072.00 Contractor's Application 56582 Application Numb- FINAL Apphcation D- C D E F Balance to Fimeb Total CompletM Estimated Quaoflry Value Previously Value This MaterlalsP"`y aM StorN to Date �) M-r) Installed Installed Value Pma,i S—d(nor in C) fl+E) B 975.00000000 $15,60000 $15,60000 $15,60000 1000% 233456000000 $4,66912 $4,669.12 $4,66912 1061% $269.121 233456000000 $102,72064 $102,720." $102,72064 1061% $5,920.641 500.00000000 $6,00000 16,00000 $6,00000 1000% 1 280079000000 $5,60158 $5,601.59 $5,60158 467% $6,399.421 2800 79000000 $22,406 32 $22,406.32 $22,406 32 46 7% $25,593.691 400000000 $2,40000 $2,400.00 $2,40000 800% $600001 $11,920.001 100399000000 $40,15960 $40,15960 $40,15960 1147% 45,159.601 2800000000 $95200 $95200 $95200 1110% 5000000000 $2,40000 $2,40000 $2,40000 1000% $202,909.26 860% $33,162.741 Tbis documnt has bern moMfled fiom ita original form ea an B1CDC dowmeot and the user dldoo[ Idghlight the modifications. You 11 enwuraged ro read the document carefully and—oah Legal Couruel prior to its execution. C- 20 Change Order Progress Estimate Change Order Number 1 3 Contractor's Application DELETIONS Tor coon"a"'' 01929 Saatt-ySewerReplacemeatc000-act2011WSm-nPad 2 Appneahonxumba: FINAL Appliwhon p-od: Applicalmn Dace: A E C D E F Item Dalotlon Change Order Item Description Sp ifiwtion Umto,...00Q.—tyw Delete Umt Fnce Change Order Not Us Not Us Not Used Not Us Not Used Not Used Not Used Not Used No. Sation No. Wl.e To10. Thee documwl has bern moMfled fiom its original form ea an 21CDC dowmeot and the user dldoo[ Idghlight the modifications. Vou 11 enworaged to read the document—lWly and —It Legal C-1 prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 4 Contractor's Application ADDITIONS For (`Douse[) 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Part cry Secretary 56582 Application Nnmbm FINAL Coviract Num: Application Pmod Apphcation Date A B C D E F Item Balance to Fimsh Addition Total CompletM Chan ¢Order Item B $ fiwtion CO Quantitym Add Umt Pnce Change Orda Estimated Q.It Installed Valne Previously Installed Value Value This Period Malerlale Presen0y Stored (not In C) and StorN to Date M (g-P No. DaeriptiDn S tion No. Umt ofMeeaure Valne (D*E) B 2 8"PVCSEWERPIPE LF 17000000000 $12300 $20,91000 167.00000000 $20,54100 $20,54100 $20,54100 982% $369.001 5 REMOVE 4' SEWER MANHOLE EA 1000MWO $50000 $50000 100000000 $50000 $500 an $50000 1000% 1 6 TEMPASPHALT PVMT REPMR(2"HMAC ON 6"FLEX BASE) LF 185000000M $2300 $4,25500 185.00000000 $4,25500 $4,25500 $4,25500 1000% 11 POSTCCTVINSPECTION LF 17000000000 $1000 $1,70000 16700000000 $1,67000 $1,67000 $1,67000 982% $30.001 12 MANHOLE VACUUM TESTING EA 200000000 $15000 $30000 200000000 $30000 $300M $30000 1000% 1 13 EXPLORATORYEXCAVATIONOFEMSITINGUTILITIES EA 1000000/,0 $1,10000 $1,10000 100000000 $1,10000 $1,100.00 $1,10000 1000% 1 14 TRENCH SAFETY LF 170000000M $100 $170M 170.00000000 $17000 $17000 $17000 1000% 1 15 CONCRETE COLLAR EA 200000000 $75000 $1,50000 $1,500001 18 4"SEWER SERVICE EA 500000000 $2,00000 $10,00000 500000000 $10,00000 $10,000.00 $10,00000 1000% 1 19 4'MANHOLE EA 211100010 $5,90000 $11,80000 2W000000 $11,80000 $11,M0.00 $11,80000 1000% 1 22 EPDXY MANHOLE LINER VF 500000000 $35000 $1,75000 500000000 $1,75000 $1,750.00 $1,75000 1000% 1 55 MOBILIZATION LS I00000000 $2,40000 $2,40000 100000000 $2,40000 $2,400.00 $2,40000 1000% 1 45 REEL RAISED MARKERS, TYPE I]-AA4"(TYP) EA 500000000 M35 $2175 16000000M $6960 $6960 $6960 3200% 447851 46 PAVEMENT MARKINGS, STOP BAR LF 75600000000 $1425 $10,77300 61900000000 $9,80650 $8,80650 $8,80650 917% $1,966.501 62 6" SOLED STMPE(W) LF 15000000000 $195 $29250 1So 00000000 $29250 $29250 $29250 1000% 1 63 6" SOLED DOUBLE STMPE(Y) LF 126000000000 $390 S4,91400 119800000000 $4,67220 $4,672.20 $4,67220 951% $241.801 64 6" DASHED STRPE(Y) LF 50 MWW00 $195 $9750 15000000000 $29250 $29250 $29250 3000% $19500 � 65 REFLECTION MARKERS, TYPE 11 C-R EA 17 M000000 $4 35 $73 95 15 00000000 $65 25 $65 25 $65 25 88 2% $B ]01 Totils $72,557.70 S68,684.55 S68,684.55 $68,684.55 94 7% $3,973.151 This documwl has barn moMfled fiom its original form es an E1CDC dowmevt and the user didoo[ highlight the modifications. You 11 enwuraged to read the document careNlly and wosult Legal Couruel prior to its execution. C- 20 Change Order Progress Estimate Change Order Number 1 4 DELETIONS For(rovoac0. 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Pad Appllcahou Number: Appliwhori Penod: Applicalmo Dace: A E C D E Rem Dalttlov Chavge Order Item Deecsipfi . Sp ifiwtiov Umto,...00Q.ityw Delete Umt Pna Change Order Not Used Not Us Not Used Not Us Not Used No. Sation No. 00 SAMTARY SEWER CONSTRUCTION ALLOWANCE LS 1.00 wwo Wl.e [ $10.700.06 $10,7W.00 Totals $10,700.04 Contractor's Application FINAL F Not Used Not Used Not Used Thee documrnl here barn moMfled fiom ite orlgival form ea an E1CDC dowmevt and the user dldoo[ Idghlight the modifications. Vou 11 rn 11pd Wread the document—lWly and —It Legal C-1 prior to ite execution. C-620 Change Order Progress Estimate Change Order Number 1 5 ADDITIONS Fm (wno-aap 01929 Sanitary Sewer Replacement Contract 20 Apphcanon Pmod A Item Cnange Order Item Dacrip00n No. 56 Maim M.N.k Adjustment Total. 11 WSM-D Part 2 City Secretary 56582 Contract Num: B C Addin°n Eshmatea Quantiry Specification Umt of Measure COQ...atym Add Unit Price Change Order Installed Sation No. Value w 2 00000000 $4,700 00 $9,400 00 2 00000000 $9,400.00 D Value $9,40000 �$•xnrxjm Contractor's Application FINAL Apphcanon Date E F Balance to Fimsh Previoasl Value Tlas Materials Preswa Total Completed Y Y aM StorN to Date (E)in -r BiAalled Value Period Sbred(nor in (D*E) B $9,400.00 $9,400 00 100 0% jflLfPbt�4� Tn�a dmumwt na. hern momnea fiom na orisir�al roan ea an elcDc aowmwt aoa me user manor lagnhgnt the modifications. Vou 11 enwuragea ro read tnc amumcnt carefally and—oalt Legal C-1 prior to its execution. C- 20 Change Order Progress Estimate Change Order Number 1 5 DELETIONS For(rovoac0. 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Pad Appllcahov Number: Appliwhori Penod: Applicalmo Dace: A E C D E I Item Delttlon Chavge Order Item Description Specification U. of Measure COQuemityto Delete Umt Pna Change Order Not Used Not Us Not Used Not Us Not Used No- 18 `S—Service Section No. EA 4.00 MMO $2,000.06 Value $8.0WA 44 SANITARY SEWER CONSTRUCTION ALLOWANCE LS 10Mwwo $1,40006 $1,4W 00 T.W. $9,400.04 Contractor's Application FINAL F Not Used Not Used Not Used Thee documrnl here barn moMfled bum its orlgirial form ea an EICDC dowmevt and the user dldoo[ Idghlight the modifications. You 11 rnwuraged to read the document carefully and —It Legal Cou 1 prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 6 ADDITIONS Igor (wno-aa0 Sanitary Sewer Replacement 01929 Contract 2011 WSM-D Part Gty Secretary sssaz COMramNnm: Apphcaaon Pmod A B C D I Item A.,e, Estimated Quantity ChangeO item Description Specification Umt ofMeesure CO Quantity to Add Umt Pnce 0, Change Order Installed Valae No. Sation No. Value 3 8- cast pce LP 5000000000 $8200 $4,10000 l500000000 $6,15000 5 Ductile Iron W—Ftttina w/restrmnt N 003000000 $10,00000 $3M 00 003000000 $30000 26 Cormectm Exrsitrng6"-12"Wafer Main EA 200cWW0 $5,00000 $10,00000 200000000 $10,00000 55 Mobflimuon LS 100000000, $10,00000 $10,0W 00 1 100000000 $10,00000 Tota1. $24,400.001 1 $26,450.00 Contractor's Application FINAL Apphcanon D- E F Balance to Fimeb Previously Value Thte Materials Preseafly Total Comp= (B-F) Installed Value Penod Stored (not in C) aM S(D t+E)Date (F) (D) B $6,15000 $6,15000 1500% 42,050001 $300W $30000 1000% 1 $10,000.00 $10,00000 1000% 1 $10,000.00 $10,00000 1000% 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I $26,450.00 $25,450.00 1084% .2,050.001 This documwt has barn moMfled fiom its original form ea an BICDC dowmeot and the user didoo[ Idghlight the modifications. Vop 11 enwuraged ro read the document carefully and—oah Legal Couruel prior to its execution. C- 20 Change Order Progress Estimate Change Order Number 1 6 Contractor's Application DELETIONS Tor coon"a"'' 01929 Saatt-ySewerReplacemeatc000-act2011WSm-nPad 2 Appneahonxumba: FINAL Appliwhon p-od: Applicalmn Dace: A E C D E F Item Dalotlon Change Order Item Description Sp ifiwtion Umto,...00Q.—tyw Delete Umt Fnce Change Order Not Us Not Us Not Used Not Us Not Used Not Used Not Used Not Used No. Sation No. Wl.e To10. Thee documwl has bern moMfled fiom its original form ea an 21CDC dowmeot and the user dldoo[ Idghlight the modifications. Vou 11 enworaged to read the document—lWly and —It Legal C-1 prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 7 ADDITIONS Igor (wno-aa0 01929 Sanitary Sewer Replacement Contract 2011 WSM-13 Part 6ty Secretary Coviract Num: Apphcanon Pmod A B m Addino Change Order Item Specification CO Quantitym Add Una Mn Change Oola No. Description Sation No. Umt ofMeesure Value 12 Remove Corume Dn—y SF 140000000000 $200 $2,80000 25 6-inch Concrete Dn.y SF 1532000WWD $1000 $15,32000 6 —6 Concrete Sidewalk-n—,a--11 SF 58000000000 $800 $4,64000 55 Mobdim0on LS 100000000 $10,00000 $10,00000 13 Install Retaimn8Wa11 SF 22500000000 $11000 $24,75000 26 7-mah CDnarem Curb and 18-moh Outten LF 51 M000000 $38 00 $1938 M 56 Rd. te&Adjust Water Service BA 200000000 $2,25000 M,50000 57 Relocate&Adios[S—Service BA 100000000 $6,30000 $6,30000 14 Remove Rock D— SF 13200000000 $200 $26400 56582 C D Estimated Quantity Value Installed 1185 76000000 $2,371 5 175902000000 $17,5902 620.WWM00 $4,9600 10000000o $10,0000 187.25000000 $20,597 5 10150M0000 $3,8570 300000000 $6,7500 300000000 $18,9000 121.M000000 $2420 Tnt� $70,512.001 I $95,269.2 Contractor's Application FINAL Apphca0on D- E F Balance to Fimsh Total Completed Pr ioasl Y Value This Materials Preswd Y aM S[Date ( iH-P1 BiAalled Value Penod Stored (not in C) (D (D+E)B $2,371.52 $2,371 52 M 7% $429.481 $17,590.20 $17,59020 1148% 42,270.201 $4,96000 $4,96000 1069% -$320.001 $10,000.00 $10,00000 1000% I $20,59750 $20,59750 932% $4,152.501 $3,857M $3,85700 1990% -S1,919001 $6,750.00 $6,75000 1500% 42,250.001 $18,900.00 $18,90000 3000% $12,600.001 $24200 $24200 917% $22.001 I I I I I I I I I I I I I I I I I I I I I $85,268.22 $85,268.22 1209% I I I I I I I I I I I I I I I I I I I I I 414,756.221 This documwl has bern moMfled fiom its original form es an HICDC dowmeot and the user didoo[ highlight the modifications. Vou 11 enwuraged to read the document carefully and wnmlt Legal Couruel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 7 DELETIONS For(ronoac0. 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Pad Appflcahov Number: Appliwhon Penod: Applicalwp Dace: A H C D E Item Daletlon Change Order Item Description Specification Umt of Measure COQuantitytp Delete Umt Pna Change Order Not Us Not Us Not Used Not Us Not Used No 39 10-m6 Pavement Pulverlaahov Sation No. SY 497.2350MW $6.1i Value $3,058,W 42 4—. Concrete Sidewalk Wall SF 20000000000 $80d S1,600000 43 4] Miscellaneous Ad'us�r0G�1 sq(ir�:�I stem Cemwt Modificaiian, 2b lbs/sy LS TN 1.00 Wwo 1160N 00 $],000.06 $24506 S],000.W S2,84200 4 8"DIP Sewer p /401 ProceclrveC �epsir �, u 62.00000000 $153.06 S9,486M ] 18 palt Pvmt Heyoud M. 1W' Residevnal t�-S—. SY EA 4048000000 4.00000000 $15006 $2,000.06 S6,0]2N[ $8,0M.W 6 4" Concrete Sidewalk SF 2956750NNO $806 $23,65400 8 Hmrttt Ramp Type P1 SF 220.00000000 $40.06 $8.800N; Total. $70,512.0d Contractor's Application FINAL F Not Used Not Used Not Used This documrnl has barn moMfled fiom its original form es an FJCDC dowmevt and the user dldoo[ Idghlight the modifications. You 11 rnwuraged to read the document carefully and —It Legal Couruel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 8 ADDITIONS Igor (wno-aa0 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Part Gty Secretary Contraet Num: Apphcanon Pmod A B Item Addino Cnange Omer Item -i-d n CO Quantity to Add Umt Pnce Change Orda No. Dacrip0an Sation No. Umt ofMeesure Value 13 Innall Retaimng Wall Sews SF 145000000M $11000 $15,950W 55 Mobilim0on Sewn LS 100000000 $5,50000 $5,500.00 56 Mai or MaMole Adjustment Sewer EA 1000WHO $4,70000 M,7W 00 58 10"Pulvervxnon& Cement Stebaimuon Sewer SY 82800000000 $3000 $24,MOW 59 Canwt (281WSY) Sewer TN 110/00/00 $44500 $4,111M 57 Chain LaA, Fence Water LF 3000000000 $8000 $2,4HW 58 Concrete Steps Water LF 3800000000 $4000 $1,520W 56582 C D Es6matea Quantity Value d 145.00000000 $15,9500 100000000 $5,5000 100000000 $4,7000 828.00000000 $24,8400 11000000M $4,8950 30000000M $2,4000 3800000000 $1,5200 Totem $59,805.001 1 $59,805.0 Contractor's Application FINAL Apphca0on Date E F Balance to Fimeh Total CompletM Previous) Y Value This Materials Presena Y aM StorN to Date (F)-� Binalled Value Period Sbred(notln0) (D+E) B $15,95000 $15,9500, 1000% $5,500.00 $5,50000 1000% $4,700.W $4,700 00 1000% $24,84000 $24,84000 1000% $4,895 00 $4,895 00 1000% $2,4W 00 $2,40000 1000% $1,52000 $1,52000 1000% [xsx:nxarmtinnnwn Tn�a daumwj na. bern momRea 6om na original roan ea an EjcDc aowmwt aoa me user manor laghnght the modifications. You 11 enwuragea to read tnc aaument carefully and—oalt Legal Couruel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 8 DELETIONS For(rottoac0. 01929 Sanitary Sewer Replacement Contract 2011 WSM-D Pad Appflcahov Number: Appli—Penod: Applicatmn Dace: A E C D E Item Dalttion Change Ordtt item Description No. Specidcarlon U. of Measure Section No. COQu.nhtym Delete Umt M. Change Order Not Usml Value Not Usml Not Used Not Usml Not Used 39 10 moh Pavemrnt Pulveri-M1{�{0 Water SY 420.000000W $6.1.i $2,583.W 42 4mch Cartc— Sidewalk wnh Wall Wata SF 167125"W $80K $1,331.W 26 7 inch Concrete Curb d18 ivc (match exiAivp) Sewer u hlr�uira 496.000000W $38.06 $18.M8.w 27 7inch Canasta Vall utter 28 2 inch Awhalt Pavenanr Type "D" Sewer SY Sewer SY 598210WOO 2486.000WW0 $16206/ $11.06 $9,69100[[ $27,346.00 Total. $59A05.0d Contractor's Application FINAL F Not Used Not Used Not Used This document has barn moMfled bum its original form ea an 21CDC dowmevt and the user didoo[ Idghlight the modifications. You 11 enwuraged ro read the document carefully and —It Legal Cou 1 prior to its Inc— City of Fort Worth Summary of Charqes City Secretary Contract Num: 56582 Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 P. O.: rW060-00000-16023Project Number: 01929 Application Period: I 9-15-2023 to 9-15-2023 I Applica ion I Final Application Date: 9/15/2023 Number: Funding Identification (FID) I Ori_ inal Contract (( ll 15¢6Q002-06004433Q0-57449�0019 C819 9-}CC}AA��pyyAA17yA 9999 Zter) 1018wer 08288431-5740810-001929-0O248�-8888 10 10 10 10 10 10 10 10 I Chan- a Order 1 (( ll 156002-0600430-5740019-��1g29_81718=9999(sewer) 1 8�80-8288 �-57�810-001929-0O2480-9999 10 10 10 10 10 10 10 10 I Chaa Order 2 156002-0600430-574009-�8j8k;18=9999(water) �-578-10-82�1C01929-0O2480-9999 10 10 10 10 10 10 10 10 I Total Completed Amt Remaining Gross $1,737,219.24 $294,110.01 $733,265.03 $181,432.22 $17,500.00 ($17,500.00) $160,638.00 ($160,638.00) Retainage I Net City of Fort Worth Summary of Charqes City Secretary Contract Num: 56582 Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 P. O.: rW060-00000-16023Project Number: 01929 Application Period: I 9-15-2023 to 9-15-2023 I Applica ion I Final Application Date: 9/15/2023 Number: Funding Identification (FID) I Chan a Order 3 1780-9999 156002-0700430-5�408 1911,99191119 91g 9-�82118 9999 �sewer� 130100-0200431-57400 ((0- j 1 10 10 10 10 10 10 10 I I Chans�e Order 4 156002-0600430-5740010-001929-CQ01]78Q0-9999(waterl 156002-0700430-57400199-�02�$0-9999(sewerj 130100-0200431-57400 0- 1 g 10 10 10 10 10 10 10 10 I I����QQ 4� 49 Cjhan a Order 5 l �56882-&�88415�40819-�81g 9-�82 8 9999�sewer) 130100-0200431-57400 (0- I 10 10 10 10 10 10 10 I Total Completed Amt Remaining I Gross $202,909.26 $33,162.74 $14,198.55 $1,974.15 $54,486.00 ($8,801.00) $9,400.00 ($9,400.00) Retainage I Net City of Fort Worth Summary of Charqes City Secretary Contract Num: 56582 Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 P. O.: rW060-00000-16023Project Number: 01929 Application Period: I 9-15-2023 to 9-15-2023 I Applica ion I Final Application Date: 9/15/2023 Number: Funding Identification (FID) I Chan a Order 6 1780-9999 156002-0700430-5740019 �01g 9 �828 9999�sewer� 130100-0200431-57400�(0- 1 10 10 10 10 10 10 10 I I Chans�e Order 7 156002-0600430-5740010-001929-CQ01]78Q0-9999(waterl 156002-0700430-57400199-�02�$0-9999(sewerj 130100-0200431-57400 0- 1 g 10 10 10 10 10 10 10 10 I I����QQ 4� 49 Cjhan a Order 8 l �56882-&�88415�40819-�81g 9-�82 8 9999sewer) 130100-0200431-57400 (0- I 10 10 10 10 10 10 10 I Total Completed Amt Remaining Gross $26,450.00 ($2,050.00) $16,750.00 E8,171.02) 6,750.00$40,347.20 $28,171.02 $3,920.00 $3,920.00 $55,885.00 455,885.00) Retainage I Net MOO City of Fort Worth Summary of Charqes City Secretary Contract Num: 56582 Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 P. O.: rW060-00000-16023Project Number: 01929 Application Period: I 9-15-2023 to 9-15-2023 I Applica ion I Final Application Date: 9/15/2023 Number: Funding Identification (FID) Total Completed Arm Remaining I Gross Retainage Net I Totals 156002-0600430-5740010-001929-001780-9999(water 156002-0700430-5740010-001929-001780-9999 sewer 130100-0200431-5740010-001929-0O2480-9999 10 10 10 10 10 10 10 10 Grand Total $1,976,675.79 $95,226.17 $893,383.23 $66,999.02 $231,080.28 $4,991.72 1 1 $3,101,139.291 1 $167,216.911 1 $0.001 1 ($155,056.96)1 1 $155,056.96 1 CSC No. 56582-CO1 FORT WOR'IUVA City of Fort Worth Change Order Request Project Name: Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 1 City Sec No.: 56582 Project No.(s):l 1929.2 1 DOE No. I N/A City Pro]. No.: 1929 Project Descriptlon:1 Replacing water line, Sanitary Sewer lines on various streets. i Conlraclorl Woody Conlraclors Change Order # Dale: 3/2/2022 City Project Mgr.1 Suby Varughese City Inspector: Tamara Vaughn Phone Number: (817) 392-7803 Phone Number.1 682 225 9106 Dept, Water Sewer Totals Contract Time (Calendar days) Original Contract Amount $2,031,329.25 $914,697.25 $2,946,026.50 365 Extras to Dale Credits to Dale Pending Change Orders (in M&C Process) Contract Cost to Dale $2.031,329.26 $914,697.25 $0.00 $2,946,026.50 365 Amount of Proposed Change Order $0.00 $0.00 $0.00 $0.00 0 Revised Contract Amount $2,031,329.26 $914,697.25 $0.00 $2,946,026,50 365 Original Funds Available for Change Orders $101,566.75 $45,733.76 $0.00 $147,300.50 Remaining Funds Available for this CO $101,566.75 $45,733.75 $0.00 $147,300.50 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST +25%) �$3,682,533.13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change order No.1 provide for a 24" RCCP to DIP water line connection. This included the 24" MJxPE fittings, Butt strap, Welding service for tie in and Labor. City records indicated that the existing pipe was cast iron. 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 I Con actor Signature I Date Woody ConIactors/ /� Troy Woody Inspector ,'f �( Date Project Manager Date Tamara Vaugh Y )) )kth" ,I ,f j -- ' f.)�- 0 Suby Varughese " rya 3/8/2022 Director ffater�ept) Date Con lructlon u is P l Date ckr any. H 7. i" 5• Mar 11, 2.22 Assistant City Attorney Date Assistant City anaggr Dale G L ow Mar17,2022 f1" MarI7,2022 I Council Action (If Required) M&C Number I N/A M&C Date Approved j N/A FORT WORTH City of Fort Worth -'d Change Order Additions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: I 56582 Project No.(s): 1929-2 I DOE No.l N/A City Proj. No.: I 1929i Project Description Replacing water line, Sanitary Sewer lines on various streets. I ] Contractor Woody Contractors I Change Order:l—J Date: I 3/2/2022 City Project Mgr. ( Suby Varughese City Inspector I Tamara Vaughn ADDITIONS IIEM WiC'RINIIUN DEPT ' Qty Unit -Unit Cost Total 52 Connection to Existing 24" RCCP Water 1.00 EA $17,500.00 $17,500.00 ..... (Water 1$17,500.00 Sewer Page 1 of 1 (Additions Sub Total Iq FORT WORTH City of Fort Worth 1+14111F` Change Order Deletions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): 1929-2 DOE No. N/A City Proj. No.: 1929 Project Description Replacing water line, Sanitary Sewer lines on various streets. Contractor Woody Contractors Change Order: FT Date I 31212022 City Project Mgr. Suby Varughese City Inspector: [ Tamara Vaughn DELETIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 27 Connect to Existing 24" cast iron Water Main Water 1.00 EA $9,000.00 $9,000.00 51 Water construction Allowance Water 0,085 LS $100,000.00 $8,500.00 lWaler $17,500.00 (Sewer Page 1 of 1 IDelelions Sub Total $17,500.00 MMBE Breakdown for this Change Order .A W.thl '.0 p O..K.I.- Total Previous Change Orders UNTLI Total Page 1 of 1 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. Signature Suby Varughese Name of Employee Professional Engineer Title ATTEST: etCClzl. (21 :8��2 CDT) Jannette Goodall City Secretary CPN-1929-2 Chanse order-1 notes The Contractor provided a price proposal for connecting the proposed 24" DI pipe to the existing RCCP. The proposal covers the additional cost associated with the fittings, butt straps, welding service, equipment, fuel, and labor costs. Compared with other projects and other bid values, this proposed price is fair and reasonable. No additional time needed for the work. CSC No. 56582-CO2 FORT WORTH City of Fort Worth s - Change Order Request Project Name: Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s):1 1929-2 1 DOE No. I N/A I City Proj. No.: 1929 Project Description:I Replacing water line, Sanitary Sewer lines on various streets. I ContractorsWoody Contractors Change Order# 2 Date: 6/2/2022 City Project Mgr.1 Suby Varughese City Inspector: Tamara Vaughn Phone Number: (817) 392-7803 Phone Number: 682 225 9106 Dept. Water Sewer Totals Contract Time (Calender days) Original Contract Amount $2,031,329.25 $914,697.25 $2,946.026.50 .365 Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $2,031,329.25 $914,697.25 $0.00 $2,946,026.50 365 JAmount of Proposed Change Order �0.00 p'00 $0.00 $0.00 0 Revised Contract Amount $2,031,329.25 $914,697.25 $0.00 $2,946, 26.50 165 Original Funds Available for Change Orders $101,566.75 $45,733.75 $0.00 $147,300.50 Remaining Funds Available for this CO $101,566.75 $45,733.75 $0.00 $147,300.50 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.00% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $3,682,533.13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change order No.2 provide for a water PVC pipe DR-18 for replacing existing 6" Cl pipe on Roosevelt ave. This Is one-time waiver request for Roosevelt Street— in an effort to allow the work to be performed during the summer. 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 Woody Contractors Troy Woody I _4� �a t � Inspector M LL__Date Project Manager Tamara Vaughn %G��2CliLCv 6/15/22 Suby Varughese / fi 2 L Director (Water Dept) Date Construction% upervisor (T lu�sfaalar r�arJar T� S, Jun 16, UGG 2022 ,CSl2 i Q& n.nopne, a,ae.r�ie, zozz ismzcop 6/16/22 Assistant City Attorney Date Assistant City Manager a�,,o„s„.p„ gun17,zo2z o a� Jun17 2022 ��a.�nao����.„�a ,6�6�. Council Action (If Required) M&C Number 7—N/A M&C Date Approved NIA FORT WORTH City of Fort Worth Change Order Additions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 1 56682 Project No.(s): 1929-2 1 DOE No.j N/A City Proj. No.: j 1929 Project Replacing water line, Sanitary Sewer lines on various streets. Description I Contractor Woody Contractors Change Order: 0 Date: 1 6/212022 City Project Mgr. Suby Varughese City Inspector I Tamara Vaughn ADDITIONS 11 tM ULbUKIN I IUN 58 8" PVC water pipe DR-18 Page 1 of 1 DEPT Qty 'Unit 'Unit Cost Total Water 1940.00 LF $82.00 $159,080.00 Water Sewer Additions Sub Total $159,080.00 FCaRT WORTH City of Fort Worth s �— Change Order Deletions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): 1929-2 1 DOE No. I N/A City Proj. No.: 1929 Project Description Replacing water line, Sanitary Sewer lines on various streets. Contractor Woody Contractors Change Order: F-2—] Date I 612/2022 City Project Mgr. Suby Varughese City Inspector: I Tamara Vaughn DELETIONS ITEM DESCRIPTION DEPT City Unit Unit Cost Total 3 8" Water PVC pipe Water 1,940.00 LF $82.00 $159,080.00 ,Water $159,080.00 Sewer Pagen 1 cif 1 (Deletions Sub Total $159,080.00 MIWBE Breakdown for this Change Order .5N Total RIO Previous Change Orders Total Page 1 of 1 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. Signature Suby Varughese Name of Employee Professional Engineer Title ATTEST: fit `ceEt2-S. j;&rrdA& Jannette S. Goodall (Jun 21, 202211:22 CDT) Jannette Goodall City Secretary CPN-1929-2 ChanRe order-2 notes The City staff requested for the lowest price quotes, but the contractor provided the current market price for the DR-18 pipes. The proposal covers the additional cost associated with the fittings, equipment, fuel, and labor costs. No additional time needed for the work. CSC No. 56582-CO3 FO R-r WO RT ti City of Fort Worth _ ' Change Order Request Project Name:1 Water and Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 City Sec No.: 1 56582 Project No.(s):l C01929 I DOE No, I N/A I City Proj. No,:l C01929 Project Description:) Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. I Contractor] Woody Contractors, Inc. Change Order# 3 Date: 9/2812022 City Project Mgr.1 Preeti KC City Inspector: Tamara Vaughn Phone Number: (817) 392-5467 Phone Number: (682) 225-9106 Dept. Water Sewer TPW Totals Contract Time (Calenderdays) Original Contract Amount $2,031,329.25 $914,697.25 $2,946,026.50 365 Extras to Dale Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Dale $2,031,329.25 $914,697.25 $0.00 $2,946,026.50 365 (Amount of Proposed Change Order $0.00 $0.00 $236,072.00 $236,072.00 120 Revised Contract Amount $2,031,329.25 $914,697.25 $236,072.00 $3,182,098.50 485 Original Funds Available for Change Orders $101,566.75 $45,733.75 $0.00 $147,300.50 Remaining Funds Available for this CO $101,566.75 $45,733.75 $0.00 $147,300.50 Additional Funding (if necessary) $236,072.00 $236,072.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 8.01% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) 1$3,682,533.13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 3 will provide increased pay item quantities of curb/gutter removal, curb/gutter installation, concrete sidewalk removal, concrete sidewalk installation, block sods, anchored erosion matting, remove A DA ramps, barrier ramp installation and Type III barricades that are necessary to complete paving improvements on the project streets. Staff recommends that the contract time be extended by 120 calendar days for this change order. 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 I / ntractor Signature I Date Woody Contractors, Inc, Troy Woody 10-4-2022 Inspector Date /a4w,ai zz, Ila-41,Hi Oct 4, 2022 Director (Water Dept) )) Date �hrstooh�r Ha��Jer �" s, Oct 17, 2022 Senior Assistant City Attorney Date A,.k( c�a� �,�o,,,a-ss�on Oct 18, 2022 M&C Number T-22-0764 J Project Manager Date r4z4& K(j 10-11-2022 Construction Supervisor (TPW) Date 4u e Pam& 10/4/22 Assistant CitY Manager Date a BgG� p Oct 19, 2022 Council Action (If Required) M&C Date Approved 9/27/2022 FO RT' Wo RT H City of Fort Worth Change Order Additions Project Name J Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): C01929 I DOE No.1 N/A City Proj. No.: C01929 Project Replacing water line, Sanitary Sewer lines, Flat works and Paving on various I streets. Description Contractor Woody Contractors, Inc. Change Order: 3Date: 1 9/28/2022 City Project Mgr. Preeti KC City Inspector Tamara Vaughn ADDITIONS IIhm , UtSI;KINIIUN DEPT Qt 'Unit 'Unit Cost _ Total 1 Anchored errosston matting/bonded fibre mulch TPW 975.00 SY $16.00 $15,600.00 2 Remove Curb and Gutter TPW 2,200.00 LF $2.00 $4,400.00 3 7" curb and Gutter 18" TPW 2200.00 LF $44.00 $96,800.00 4 Block sod TPW 500.00 SY $12.00 $6,000.00 5 Remove sidewalk TPW 6,000.00 SF $2.00 $12,000.00 6 4" Concrete sidewalk TPW 6,000.00 SF $8.00 $48,000.00 7 Remove ADA Ramp TPW 5.00 EA $600.00 $3,000.00 8 Barrier Ramp Type P1 TPW 298.00 SF $40.00 $11,920.00 9 Barrier Ramp Type mod R1 TPW 875.00 SF $40.00 $35,000.00 10 Type III Barricade TPW 28.00 LF $34.00 $952.00 11 GuardRail on Timber posts TPW 50.00 LF $48.00 $2,400.00 lWater JSewer JTPW $236,072.00 Page 2 of 4 (Additions Sub Total $236,072.00 FCC RT Woo RT H City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): C01929 DOE No. I N/A City Proj, No.: C01929 Project Description I Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor I Woody Contractors, Inc. I Change Order: F7 Date I 9/28/2022 City Project Mgr. Preeti KC City Inspector: I Tamara Vaughn DELETIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total (Water Sewer ITPW Page 3 of 4 (Deletions Sub Total MMBE Breakdown for this Change Order MWBE Sub Type of Service I Amount for this CO Total $0.00 Previous Change Orders Co# DATE AMOUNT Total $0.00 Page 4 of 4 Contract Compliance Manager By signing I acknowledge that 1 am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Signature Preeti KC Name of Employee Sr. Professional Engineer Title ATTEST: Tahvreffe S. Goodall Jannette S. Goodall (Oct 19, 202217:56 CDT) Jannette Goodall City Secretary 9/28/2022 Water and Sanitary Sewer Replacement Contract 2011, WSM-D, Part 2 CPN 01929 Change Order 3 Notes Staff has reviewed the requested prices and considers them to be fair and reasonable, FORT WO RT H City of Fort Worth Change Order Request Project Name:1 Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s)] 1929-2 1 DOE No. I N/A City Proj. No.: 1929 Project Description:) Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor: Woody Contractors INC. I Change Order # 4 Date: City Project Mgr.1 Preeti KC City Inspector: Tamara Vaughn Phone Number: (817) 392-5467 Phone Number: (682) 225-9106 Dept. Water Sewer TPW Totals 10/14/2022 1 Contract Time (Calender days) Original Contract Amount $2,031,329.25 $914,697.25 $0.00 $2,946,026.50 365 Extras to Date $0.00 $0.00 $236,072.00 $236,072.00 120 Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $2,031,329.25 $914,697.25 $236,072.00 $3,182,098.50 485 Amount of Proposed Change Order $16,172.70 $45,685.00 $0.00 $61,857.70 30 Revised Contract Amount $2,047,501.95 $960,382.25 $236,072.00 $3,243,956.20 515 Original Funds Available for Change Orders $101,566.75 $45,733.75 $0.00 $147,300.50 Remaining Funds Available for this CO $101,566.75 $45,733.75 $0.00 $147,300.50 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 10.11 % I MAXALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25%) 1$3,682,533.13 1j JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 4 will provide for the following items that are necessary on the project: ■ Additional 170 LF of 8-inch sewer pipe installation. ■ 5 additional sanitary sewer services. ■ 2 additional 4 feet diameter manholes. ■ Street pavement markings at the crosswalk on Roosevelt Ave n u e/25th/26th/27th/28th Street intersections as required by Transportation and Public Works Department. Staff concurs with the contractor's request for 30 additional calendar days on the project. 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 I Contractor Signature I Date Woody Contractors INC. Troy Woody Troy Woody 10-19-2022 Inspector Date Project Manager ct 25, 2022 Director (Water Dept) Date Construction S errvi>solr (T-PWW)) r a r r E ?• S. Oct 26, 2022 ,roP�e.�a.�e.,o�rzsz�zz o Senior Assistant City Attorney Date Assistant City Manager Oct 27, 2022 ✓✓ 219 ,1 .�_�o. _ __...°.. I Council Action (If Required) Ij M&C Number N/A I M&C Date Approved N/A Date 10/26/2022 Date 10/26/22 Date Nov 2, 2022 FORT WORTH City of Fort Worth ,WOO_ Change Order Additions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 Project No.(s): 1 1929-2 Project I City Sec No.: 56582 DOE No.1 N/A I City Proj. No.: 1929 Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Description I Contractor I Woody Contractors INC. I Change Order:4 Date: 1 10/14/2022 1 City Project Mgr. 1 Preeti KC City Inspector I Tamara Vaughn 1 ADDITIONS 11 tM ULSCKIP I IUN DEPT Qty Unit Unit Cost Total 2 8" PVC Sewer Pipe 5 Remove 4' Sewer Manhole 6 Temp Asphalt Pvmt Repair (2" HMAC on 6" Flex Base) 11 Post -CCTV Inspection 12 Manhole Vacuum Testing 13 Exploratory Excavation of Existing Utilities 14 Trench Safety 15 Concrete Collar 18 4" Sewer Service 19 4' Manhole 22 Epoxy Manhole Liner 55 Mobilization 45 REEL Raised Markers, Type I I -A -A 4" (typ) 46 Pavement Markings, Stop Bar 62 6" Solid Stripe (W) 63 16" Solid Double Stripe (Y) 64 16" Dashed Stripe (Y) 65 1Reflection Markers, Type II C-R I I I I I Page 1 of 1 Sewer Sewer Sewer Sewer Sewer Sewer Sewer Sewer Sewer Sewer Sewer Sewer I Water I Water (Water I Water I Water I Water I I 170.00 LF 1.00 EA 185.00 LF 170.00 LF 2.00 EA 1.00 EA 170.00 LF 2.00 EA 5.00 EA 2.00 EA 5.00 VF 1.00 LS 5.00 EA 756.001 LF 150.001LF 1,260.001LF 50.001 LF 17.001 EA I I' $123.00 $500.00 $23.00 $10.00 $150.00 $1,100.00 $1.00 $750.00 $2,000.00 $5,900.00 $350.00 $2,400.00 1$4.35 1$14.25 1$1.95 1$3.90 1$1.95 1$4.35 I I I I I I Water Sewer TPW Additions Sub Total $20,910.00 $500.00 $4,255.00 $1,700.00 $300.00 $1,100.00 $170.00 $1,500.00 $10,000.00 $11,800.00 $1,750.00 $2,400.00 $21.75 $10,773.00 1$292.50 1$4,914.00 1$97.50 1$73.95 I I $16,172.70 $56,385.00 FORT WORTH City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: I 56582 Project No.(s): 1929-2 DOE No. I N/A City Proj. No.: 1929 Project Description Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. I Contractor I Woody Contractors INC. I Change Order: F4 Date I 10/14/2022 City Project Mgr. I Preeti KC City Inspector: I Tamara Vaughn DELETIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 44 Sanitary Sewer Construction Allowance Sewer 1.00 LS $10,700.00 $10,700.00 Page 1 of 1 I I I Water Sewer TPW Deletions Sub Total N 1$10,700.00 1 1$10,700.00 MWWBE Breakdown for this Change Order MWBE Sub I Type of Service I Amount for this CO Total $0.00 + Previous Change Orders CO # I DATE I AMOUNT Total I $0.00 Page 1 of 1 10/14/2022 Water and Sanitary Sewer replacement Contract 2011 WSM-D, Part 2 CPN 1929 Change Order 4 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. Signature Preeti KC Name of Employee Sr. Professional Engineer Title ATTEST: Tahhe�fe S. Goodall Jannette S. Goodall (Nov 2, 2022 11:35 CDT) Jannette Goodall City Secretary CSC No. 56582-005 FORT WORTH City of Fort Worth ., W Change Order Request Project Name:[ Water and Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s):I 1929-2 DOE No. I N/A I City Proj. No.: 1929 Project Description:) Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets, I Contractocl Woody Contractors INC. Change Order# I 5 I Date: I 1217/2022 II City Project Mgr.I Preeti KC ! Ciry Inspector: I Tamara Vaughn I Phone Number: ) (817) 392-5467 I Phone Numbed 682 225 9106 Dept. Water Sewer TPW Totals Contract Time (Calenderdays) Original Contract Amount $2,031,329.25 $914,597.25 $0.00 $2,946,026.50 365 Extras to Dale $16,172.70 $45,685.00 $236,072.00 $297,929.70 150 Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $2,047,501.95 $960,382.25 $236,072.00 $3,243,956.20 515 Amount of Proposed Change Order $0.00 $0.00 $0.00 $0.00 Revised Contract Amount $2,047,501.95 $960,382.25 $236,072.00 $3,243,956.20 515 Original Funds Available for Change Orders $101,566.75 $45,733.75 $0.00 $147,300.50 Remaining Funds Available for this CO $86,394.05 $48.75 $0.00 $85,442.80 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT I 10.11% MAXALLOWABLECONTRACTAMOUNT(ORIGINAL CONTRACT COST+25%) $3,682,533,13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 5 will provide for 2 Major Manhole Adjustment that are necessary on Schadt Ave. 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 Contractor Name orrac)prSj nature Date Woody Conlroclors INC. I Troy Woody I / / f Qi- - P-ea, Inspector Tamara Vauqhn Director (Water Dept) Senior Assistant City Attorney I M&C Number NIA Date Project Mana r 12/8/22 P4" �'�i Date ConstructionSSuervisor (TPW) TS• Dec 8, 2022 • G 471�>UIZ4& 444 Date Assistant City Manager Dec 9, 2022 44414114 Council Action (If Required) M&C Date Approved NIA Date 12/08/2022 Date 12/8/22 Date Dec 12, 2022 Fc3RT' WnRT'" City of Fort Worth Change Order Additions Project Name I Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 , City Sec No.: I 56582 Project No.(s): 1929-2 I DOE No.I N/A I City Proj, No.: I 1929 Project Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. I Description Contractor Woody Contractors INC. ! Change order: 0 Date;1 12/712022 City Project Mgr. I Preeli KC City Inspector I Tamara Vaughn ADDITIONS ITEM UESCRIN I ION DEPT Qty Unit Unit Cost - Total 56 Major Manhole Adjustment Sewer 2.00 EA $4,700.00 $9,400.00 Page 2 of 4 (Water 'Sewer I$9,400,00 ,TPW Additions Sub Total ]FCD RT W" RT t-1 City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): I 1929-2 j DOE No. I N/A City Proj. No.: 1929 Project Description Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. I Contractor I Woody Contractors INC. Change Order; 5 Date I 121712022 City Project Mgr. Preeti I(C City Inspector: I Tamara Vaughn DELETIONS ITEM DESCRIPTION DEPT j City Unit Unit Cost Total 18 4" Sewer Service Sewer 4.00 EA $2,000.00 $8,000.00 44 Sanitary Sewer Construction Allowance Sewer 1.00 LS $1,400.00 $1,400.00 ,Water (Sewer $9,400.00 ITPW Page 3 of 4 (Deletions Sub Total $9,400,00 MWE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO co It Previous Change Orders DATE Total Total AMOUNT $0.00 $0.00 Page 4 of 4 12/7/2022 Water and Sanitary Sewer Replacement Contract 2011 WSM-D, Part 2 CPN 1929 Change Order 5 Notes Staff has reviewed the requested prices and considers them to be fair and reasonable. CSC No. 56582-CO6 FCjRT WORTH City of Fort Worth Change Order Request Project Name: I Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s):l 1929-2 1 DOE No. I N/A City Proj. No.: 1929 Project Description:I Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor: Woody Contractors INC. I Change Order# 6 Date: 1/25/2023 City Project Mgr.1 Preeti KC City Inspector: Tamara Vaughn Phone Number: (817) 392-5467 Phone Number: 682 225 9106 Dept. Water Sewer TPW Totals Contract Time (Calender days) Original Contract Amount $2,031,329.25 $914,697.25 $0.00 $2,946,026.50 %365 Extras to Date $16,172.70 $45,685.00 $236,072.00 $297,929.70 -150 Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $2,047,501.95 $960,382.25 $236,072.00 $3,243,956.20 515 Amount of Proposed Change Order $24,400.00 $0.00 $0.00 $24,400.00 15 Revised Contract Amount $2,071,901.95 $960,382.25 $236,072.00 $3,268.356.20 530 Original Funds Available for Change Orders $101,566.75 $45,733.75 $0.00 $147,300.50 Remaining Funds Available for this CO $85,394.05 $48.75 $0.00 $85,442.80 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 10,94% MAXALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25%) $3,682,533.13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 6 provides for the replacement of 50 If of existing 6-inch cast Iron pipe with an 8-inch PVC across the intersection of Market Ave and 26th Street. TPW proposes to pave through the intersection necessitating the replacement of the cast iron water pipe. Staff concurs with the contractr's request for 15 additional calendar days on the project for the change order. 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'- Co: nr:an y Name Contractor Name Co cto I nature _ Date WoodyConUactorslNC. Troy Woody 7-a3 Inspector / Date Project Mana�Er(� 1/27/23 `lza �l(i 1/27/2023 Director (Water DepT) Date Construction Supervisor (TPW) rls+'he' ffarde, 'T. Jan 27, 2023 11 211a DG6� 1/27/23 Assistant City Attorney Date , jAssistant City Manager Jan 30, 20239 — Jan 30, 2023 Council Action (if Required) M&C Number N/A M&C Date Approved N/A F"wf WoRTH City of Fort Worth Change Order Additions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): 1929-2 1 DOE No.1 N/A C1y Proj. No.: 1929 Project Description Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor Woody Contractors INC. Change Order:® Date: 1 1/25/2023 City Project Mgr, Proeti KC City Inspector I Tamara Vaughn 4 ADDITIONS ll lMtll tJtS{;kll'] ivN DEPT Qty Unit Unit Cost Total 3 8" PVC Water Pipe Water 50.00 LF $82.00 $4,100.00 5 Ductile Iron Water Fit ings w/Restraint Water C.03 TN $10,000.00 $300.00 26 Connect to Existing 6"-12" Water Main Water 2.00 EA $5,000.00 $10,000.00 55 Mobilization Water 1.00 LS $10,000.00 $10,000.00 lWater $24,400.00 ]Sewer JTPW Page 2 of 4 ]Additions Sub Total F0R7r W6RTH City of Fort Worth Change Order Deletions Project Name I Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: I 56582 Project No,(s): I 1929-2 1 DOE No. I N/A City Proj. No.: I 1929 Project Description I Replacing water line, Sanitary Sewer lines, Fiat works and Paving on various streets. Contractor I Woody Contractors INC. Change Order: © Date I 1/25/2023 City Project Mgr. I Preeti ACC I City Inspector: I Tamara Vaughn I DELETIONS ITEM DESCR.IPTIC. I DEPT I Qty (Unit IUnit Cost 'Total Page 3 of 4 Water ,Sewer 'TPW Deletions Sub Total MNVBE Breakdown for this Change Order " T e k, yp I Total Previous Change Orders . . ..... ..... ........... - - ----- 'T DA�, A C.0 # , i I , E I r — IOIJNT Total Page 4 of 4 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. Signature Preeti KC Namc of Employcc Sr. Professional Engineer Title ATTEST: Jannette Goodall City Secretary 1/27/2023 Water and Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 CPN 01929-2 Change Order 6 Notes Staff has reviewed the requested prices and considers them to be fair and reasonable. The contractor initially requested $14,000 for the mobilization costs but staff negotiated it to $10,000. CSC No. 56582-007 FORT Woo.-FH City of Fort Worth Change Order Request Project Name: Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s):l 1929-2 1 DOE No. I N/A City Proj. No.: 1929 Project Description:) Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor: 1 Woody Contractors Inc. Change Order # 1 7 Date: 1 5124/2023 City Project Mgr.1 Preeti KC City Inspector: Rodrick Wallace Phone Number: (817) 392-5467 Phone Number: (817 350-3321 Dept. Water Sewer TPW I Totals Contract Time (Calender days) Original Contract Amount $2,031,329.25 $914,697.25 $0.00 $2,946,026.50 365 Extras to Date $40,572.70 $45,685.00 $236,072.00 $322.329.70 165 Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $2,071,901.95 $960,382.25 $236,072.00 $3,268,356.20 530 Amount of Proposed Change Order $0.00 $0.00 $0.00 $0.00 +30 Revised Contract Amount $2,071,901.95 $960,382.25 $236,072.00 $3,268,356.20 1560 _ Original Funds Available for Change Orders $101,566.75 $45,733.75 $0.00 $147,300.50 Remaining Funds Available for this CO $60,994.05 $48.75 $0.00 I $61,042.80 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 10.94% MAXALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACTCOST+ 2551o) 1$3,682,533.13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 7 will provide for the following items that are necessary to complete the project on Columbus Avenue and Schadt Street: ■ 6-inch concrete driveway ■ 4-inch concrete sidewalk with retaining wall ■ Retaining wall ■ Relocate and adjust 2 additional water services and 1 sewer service that is in conflict with driveway lowerings. Staff concurs with the contractr's request for 30 additional calendar days on the project for the change order. 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 Contractor Name_ CC tractor Signature Date Il Woody Contractors Inc. Troy Woody 3 I Inspector Date Project Manal r _ Date 5/26/23 5/25/20231 Director (Water Dept) Date Construction Supervisor (TPW) Date Jun 1, 2023 ,414a Z L)a4 & 5/30/23 Senior Assistant City Attorney Date Assistant City Manager Date I Jun 2, 2023 1'—Ldd Jun 2, 2023 Council Action (If Required) j I` M&C Number N/A M&C Date Approved NIA Fo a-r WO ax City of Fort Worth Change Order Additions Project Name I Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 f City Sec No.: 56582 Project No.(s): 1 1929-2 i DOE No] N/A City Proj. No.: 1929 DProject I Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. I es Contractor 1 Woody Contractors Inc. I. Change Order:1 7 Date: 1 5/24/2023 City Project Mgr. f Preeti KC City Inspector I Rodrick Wallace I ADDITIONS I I Em UEbl:ttlV I IUN DEPT Qty Unit Unit Cost Total 12 Remove Concrete Driveway TPW 1400.00 SF $2.00 $2,800,00 25 6-inch Concrete Driveway Sewer 1,532.00 SF $10.00 $15,320,00 6 4-inch Concrete Sidewalk with retaining wall TPW I 580.00 SF $8.00 $4,640.00 55 Mobilization Water 1.00 LS $10,000.00 $10,000.00 13 Instals Retaining Wall TPW I 225.00 SF $110.00 $24,750.00 26 7-inch Concrete Curb and 18-inch Gutter Sewer I 51.00 LF $38.00 $1,938,00 56 Relocate & Adjust Water Service Water I 2.00 EA $2,250.00 $4,500.00 57 Relocate & Adjust Sewer Service Sewer 1.00 EA $6,300.00 $6,300.00 14 Remove Rock Drive TPW I I I I I I I I 132.00 SF $2.00 $264.00 I I I I I I Water $14,50D.00 Sewer $23,558.00 TPW $32,454,00 Page i of i Additions Sub Total FOn-r WORTH City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 I City Sec No.: 56582 Project No.(s): 1929-2 I DOE No. I N/A City Proj. No.: 1929 Project Description I Replacing water fine, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor I Woody Contractors Inc. I Change Order: F7 Date I 5/24/2023 City Project Mgr. I Preeti KC I City Inspector: I Rodrick Wallace DELETIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 39 10-inch Pavement Pulverization Water 497.235 SY $6.15 $3,058,00 42 4-inch Concrete Sidewalk With Retaining Wall Water 200.00 SF $8.00 $1,600.00 43 Miscellaneous Adjustments sprinkler system Water 1.00 LS $7,000,00 $7,000.00 47 Cement Modification, 26lbs.lsy Water 11.60 TN $245,00 $2,842,00 4 8" DIP Sewer Pipe w1401 Protective Coating Sewer 62.00 LF $153.00 $9,486,00 7 Asphat Pvmt Repair Beyond Defined Width, Residential Sewer 40.48 SY $150.00 $6,072.00 18 4" Sewer Service Sewer 4.00 EA $2,000.00 $8,000.00 6 4" Concrete Sidewalk TPW 2,956.75 SF $8.00 $23,654,00 8 Barrier Ramp Type P1 TPW 220.00 SF $40.00 $8,800.00 (Water $14,500.00 Sewer $23,558.00 TPW $32,454.00 page 1 of 1 Deletions Sub Total MtWBE Breakdown for this Change Order $ Total 0.00 Previous Change Orders DATE AMOUNT Total Page 1 of 1 5/24/2023 Water & Sanitary Sewer Replacement Contract 2011, WSM-D Part 2 CSC: 56582 CPN: 1929 Change Order 7 Notes Staff has reviewed the requested days 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. Signature Preeti KC Namc of Employcc Sr. Professional Engineer Title ATTEST: Jannette Goodall City Secretary CSC No. 56582-008 FORT WORTH City of Fort Worth Change Order Request Project Name:I Water and Sanitary Sewer replacement Contract 2011 WSM-D Pan 2 City Sec No.: 1 56582 Project No.(s):I 1929-2 1 DOE No. I N/A City Proj. No.:l 1929 Project Description:) Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor] Woody Contractors Inc. Change Order # 8 Date: I 8/8/2023 City Project Mgr.1 Preeti KC City Inspector: Ariel Duarte Phone Number:I (817) 392-5467 I Phone Numbed (817) 392-8306 Dept. Water Sewer TPW Totals Contract Time (Calender days) Original Contract Amount $2,031,329.25 $914,697.25 $0.00 $2,946,026.50 365 Extras to Date $40,572.70 $45,685.00 $236,072.00 $322,329.70 195 Credits to Date Pending Change Orders (in M&C Process) I Contract Cost to Date $2,071,901.95 $960,382.25 $236,072.00 $3,268,356.20 .560 Amount of Proposed Change Order $0.00 $0.00 $0.00 $0.00 30 Revised Contract Amount $2,071,901.95 $960,382.25 $236,072.00 $3,268,356.20 590 Original Funds Available for Change Orders $101,566.75 $45,733.75 $0.00 $147,300.50 Remaining Funds Available for this CO $60,994.05 $48.75 $0.00 $61,042.80 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 1 10,94% MAX ALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 2551o) 1$3,682,533,13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Transportation and Public Worl<s(TPW) Field Operations were scheduled to pulverize and overlay Prospect Avenue (Cliff Street to 300 feet South) subsequent to water main installation. However, TPW crews were not able to conduct pulverization and stabilization due to the grade of the street. Change Order No. 8 will allow Woody Contractors to pulverize and stabilize the street and TPW will install the HMAC overlay. The change order will compensate the contractor for remobilizing to the job site and also providing additional pay item for the retaining wall installation. Staff concurs with the contractr's request for 30 additional calendar days on the project for the change order. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. Contractor's Company Name I Contractor Name Contractor Signature Date' Woody ConlraclorsInc. Troy Woody I _ i I R—�- a 3 Inspector Dale Project Manager Date 424�s Z�Iula-4& 8/8/23 P,' 8/8/2023 Director (Water Dept) - Date Construction Supervisor (TPW) Date — T S. uR 9, 2023 44,4�,e Z�64a, & 8/8/23 Senior Assistant City Attorney Am Date Assistant City Manager Date i al 011( Aug 15, 2023„,a„",$ `-?`f AuR 15, 2023 Council Action (If Required) M&C Number N/A I M&C Dale Approved N/A FcoRr WORTH City of Fort Worth Change Order Additions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): 1929-2 1 DOE No.1 N/A I City Proj. No.: 1929 Project I Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets, Description Contractor Woody Contractors Inc. Change Order:® Date:1 8/8/2023 City Project Mgr. Preeti KC City Inspector I Ariel Duarte ADDITIONS HEM EM UESUKIN I IUN DEPT Qt,`/ Unit -Unit Cost Total 13 Install Retaining Wall Sewer 145.00 SF $110.00 $15,950.00 55 Mobilization Sewer 1.00 LS $5,500.00 $5,500.00 56 Major Manhole Adjustment Sewer 1.00 EA $4,700.00 $4,700.00 58 10" Pulverization & Cement Stabilization Sewer 828.00 SY $30.00 $24,840.00 59 Cement (26lb/SY) Sewer 11.00 TN $445.00 $4,895.00 57 Chain Link Fence Water 30.00 LF $80.00 $2,400.00 58 Concrete Steps Water 38.00 SF $40.00 $1,520.00 (Water $3,920.00 Sewer $55,885.00 ITPW Paige 1 of 1 ;Additions Sub Total $59,805.00 FORT WORTH City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer replacement Contract 2011 WSM-D Part 2 City Sec No.: 56582 Project No.(s): 1929-2 DOE No. I N/A City Proj. No.: 1929 Project Description I Replacing water line, Sanitary Sewer lines, Flat works and Paving on various streets. Contractor Woody Contractors Inc. Change Order: ® Date 8/812023 City Project Mgr. Preeti KC I City Inspector: I Ariel Duarte DELETIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost (Total 39 10-inch Pavement Pulverization Water 420.00 SY $6.15 $2,583.00 42 4-inch Concrete Sidewalk With Retaining Wall Water 167.125 SF $8,00 $1,337.00 26 7-inch Concrete Curb and 18-inch Gutter (match existing) Sewer 496.00 LF $38.00 $18,848.00 27 7-inch Concrete Valley Gutter Sewer 59.821 SY $162.00 $9,691.00 28 2-inch Asphalt Pavement Type "D" Sewer 2,486.00 SY $11.00 $27,346.00 Pag.? 1 cf 1 (Water Sewer ITPW Deletions Sub Total $3,920.00 $55,885.00 MMBE Breakdown for this Change Order ouitt'f6 fffii�00 Total �t;�4�!�!�>{:-'"• :nil !::�' r:.. _�:{ t Previous Change Orders .�i,_.��;;i: 711i � il�:.:. �.: '`:�.���:iS;;: i',•:�!Y�Q �,.` ik�!`;1 .+ '„ ,- ... Total Page 1 of 1 8/8/2022 Water and Sanitary Sewer Replacement Contract 2011, WSM-D, Part 2 CPN 1929 CSC No.: 56582 Change Order 8 Notes Staff has reviewed the requested days 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. Signature Preeti KC Namc of Employcc Sr. Professional Engineer Title ATTEST: Jannette Goodall City Secretary FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Water & Sanitary Sewer Replacement Contract 2011, WSM-D Part 2 CITY PROJECT NUMBER: 1929-2 WATER PIPE LAID SIZE TYPE OF PIPE LF 24" DIP 172 8" PVC 5833 6" PVC 73 FIRE HYDRANTS: 5 PIPE ABANDONED DENSITIES: NEW SERVICES: I PIPE LAID PIPE ABANDONED DENSITIES: NEW SERVICES: VALVES (16" OR LARGER) SIZE TYPE OF PIPE 1" (161) Copper 2" (2) Copper SEWER SIZE TYPE OF PIPE 10" PVC SDR 26 8" PVC SDR 26 8" PVC 150 PSI Min SIZE 4" (23) TYPE OF PIPE PVC SDR26 TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 LF LF LF 12 562 827 FORT WORTH. TRANSPORTATION AND PUBLIC WORKS September 16, 2023 Woody Contractors, Inc. 650 Tower Drive Kenebale, Texas 76060 RE: Acceptance Letter Project Name: Water & Sanitary Sewer Replacement Contract 2011 WSM-D Part 2 Project Type: 01,02 & 03 City Project No.: 1929-2 To Whom It May Concern: On June 16, 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 September 15, 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 September 15, 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 871- 392-5467. Sincerely, P"19__' KC KC Preeti, Project Manager Cc: Adam Payam, Inspector Wade Miller, Inspection Supervisor Ariel Duarte, Senior Inspector Tonny Sholola, Program Manager N/A, Consultant Woody Contractors, Inc., Contractor N/A, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 CONSENT OF OWNER ❑ SURETY COMPANY CONTRACTOR Q❑ TO FINAL PAYMENT o�gTy ❑ (SIMILAR TO AIA DOCUMENT G707) Bond No, K40201841 PROJECT: Water and Sanitary Sewer Replacement Contract 2011 WSM-D Dart 2, City Project No. 01929 (name, address) Port Worth, TX TO (Owner) City of Fort Worth 200 Texas Street Fort Worth, TX 76102 L— CONTRACTOR: Woody Contractors, Inc, ARCHITECT'S PROJECT NO: CONTRACT FOR: __ J CONTRACTDA'I'E: September 28, 2021 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) Woody Contractors, Inc. 650 Tower Drive Kennedale, TX 76060 ,CONTRACTOR, 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 OWNER, Fort Worth, TX 76102 as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, The Surety Company has hereunto set its hand this Attest: (Seat): 24th day of August 2023 VIGILANT INSURANCE; COMPANY Surety Company B}C.t JA A' - S✓, a 1 Signature of Aulhorized Representative Elizabeth Gray Title Attorney -in -Fact 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 CHUMB,: Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a Now York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, tin each hereby constitute and appoint Elizabeth Gray, Charles D. Sweeney, Kyle W. Sweeney and MichaelA. Sweeney of Fort Worth, Texas-------------------------------------------------------------------------------------------------------------------- -------------- --- each as their trite and lawful Artorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, hands and undertakings and other writings obligatory M the namre thereof (ather than ball bonds) given or executed in the course or business, and any instruments amendingor altering the same, and consents to the modification or alteration of any insu•urnent 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 atiesled these presents and affixed their corporate seals on this 1611, day of September, 2019. Iklwn M. Chlcn'rk4. A\'sisl n i Swrewry STATES OF NEW JERSEY County Of Hunrerdon A-&-, vt,� 4�(-, swphru hi. IInTicy, Vier I'hrc-ideal On this 1614 day ofSeptember. 2019, before file, a Notary Public or New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power or Attorney, and the said Dawn M, Chloros, being by me duly sworn, dill 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 or said Conupanles; and that she signed said Power or Attorney as Assistant Secretary of Bald Co npanies by like authority; and that she Is acquainted with Stephen M, Haney, and knows hlin to be Vice President of sald Companies; and that the signature ofStephen M. Haney, subscribed to said Power of Attorney is in the genulne handwriting of Stephen M. Haney, and was thereto subscribed by authority ofsaid Companies and In deponent's presence, Notarial Seal "t TAlty 1WTHERtNC J. ADCLAAR NOTARY AUBt-]C OF hIEV✓JUfi3SY NUBL y Oomati Z� / mlBaton iwxp resEJc,1y 16. 2n2A4 Nola y lh,hlir. P CERTIFICATION Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016: "RBSOLVW. that tits fOlfowhhpluuthotlkallons relate to the execution. for and on behalfof ilieCompany, ofbands, undertaking;, recottnirances, contracts and other written commitments or the Company entered imoln the ordinarycourseofhus1rim(each a "Wrlttou commitment"); (1) Each or tire Chairman, the President and the Vice Presidents of the company is hereby awrhorFeed 10execule;uryWrinenConnnllment On- and anhehalfuftheCompany, under the seal Of the Company Or lAwr tow. (2) Euch duly appointed attorney -in -fact of the Company Is hereby aullimined to exeeuto any Written Commllment Poll. and on behalror the Company, under the seal of the C,ampany or Otherwise, to the exlem that such action ISnIlthOVIZUd by the grant of powers provided I&In such person's written appointment as such attorney-Imf,lo. (3) Each of the Chairman, the president and the Vice Presidents or the Company Is hereby authorlyed,forand on behalf of Oil! Company, to appoint in writing any person the attorney- In-flict of tite Company with rull power arid authorltytouxecate, for and on behalrorthecompany, wider the seal oflhecompanyurinherw1w,such Written ComtnitruLmsofthe Company us may be spedfled in suds written appointment, which specirication may be bygeneral type or class of Written Coramitlttents or by speclllcation of one or more particular Written Commitments. (4) Bach of the Chairman, the President and the Vtcu Prosidenls of the companyIsherebyauthorized,furandfinbehalforthecompany,wdelegateInwritingtoanyutherofficerorthe company lheauthoritytoexecute,for and onbehalf of the Company. under the Company's seal or otherwise, such written ConminitmentsoftheCompanyasawspecflledinsuch written deletrllun,which snecl8catlon may be by general typeor clati'sof Written Commitments or tryspedlicarionol'mheurnrurePartcvlta-Wrinwn Cclnunihnenrs. (s) The signature of any olpcer or other perNonexecuting any whtten Connaftnlent or appolntntent or deieghtion pursuant to this Resolution. and the seal of the Company, maybe affixed by racsimne en such Written Commitment or wrillen appointment or delegation. VVIVIVEIR ABSOLVED, that the foregoing Resolution skull not be deemed to he an exclusive slatumeut of Ile powers and authority ol-olleeis, employees and Other persorato act furand on belralrof the Company, and such Resolution shall not limit or otherwise atl'ect the exercise oranysuch power orauthorhy otherwise validly granted or vested,' 1, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INhEMNITY COMPANY (the "Companies") do hereby certify that (i) the foregoing Rewl ut]ons adopted by the Board of Directors of the Companies are true, correct and in I'uIl force and effect, 01) the foregoing Power of Attorney is true, correct and in fill] force and effect, Given under my hand and seals of said Companies m Whitehouse Station, NJ, this 24th day of August 2023, Dawn :ti I. Ch IUrrii, A\ is all t SL-vrt:`ulry IN THE EVENT' YOU WISH'PO VERIFY'NIE AUfHuivricrl'Y op,rtits BOND OR N(rfIFY US OF ANY OTHER MXITLR, PLEASE CONI'AC'I' Us Nf' Telephono(9W)90.3.3493 Fux(908)9o3.3656 e-mall; surety(nlchubb,com pEn-VIG-PI (rov. 08.18) 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; Contract 2011 WSM-D Part 2, CPN- 01929 BY��- ,,,,.-� r Woody -President Subscribed and sworn before me on this date 6th of Septmber, 2023, ��. Notary blt Tarrant, Texas pNlHly orrvnyi, LIJ; A"AVELO r Notary Public, State of Texas y Commisslgn Expires ry,e :11 N" April20, 2027 NOTARY it) 12860410-0