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Home My WebLink AboutContract 55466-FP2-FP2 City Secretary Contract No. 55466 FORT WORTH. Date Received 12/12/2023 AT NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: Aledo Middle School Addition #2 City Project No.:103119 Improvement Type(s): Water ❑ Sewer x❑ Oriqinal Contract Price: Amount of Approved Chanqe Order(s): Revised Contract Amount: 'Total Cost of Work Complete: Jeremv Routsone (Dec 11, 2023 18 CST) Contractor Vice President Title Southern Mechanical Plumbing, Inc. Company Name 1.tit. L Daniel Rov (Dec 11.202315:47 CST) Project Inspector Project Manager Rebecca Diane owen (Dec 12. 202316:22 CST) CFA Manager Lauren Prieur (Dec 12, 202315:29 MST) TPW Director William Johnson(D c 12. 202317:19 CST) Asst. City Manager Total Amount $194.001.00 $30,863.00 $224.864,00 $224.864.00 Developer Cost $35,344.80 W,097.85 $48,442.65 $48,442.65 Dec 11, 2023 Date Dec 11, 2023 Date Dec 12, 2023 Date Dec 12, 2023 Date Dec 12, 2023 Date Dec 12, 2023 Date City Cost $158,656.20 $17,765.15 $176,421.35 $176,421.35 OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: Aledo Middle School Addition #2 City Project No.: 103119 City's Attachments Final Pay Estimate ❑x Change Order(s): ❑x Yes ❑ N/A Pipe Report: x❑ Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 30 WD Days Charged: 173 Work Start Date: 8/23/2021 Work Complete Date: 7/22/2022 Completed number of Soil Lab Test: 81 Completed number of Water Test: 0 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name ALEDO MIDDLE SCHOOL #2 ADDITION Contract Limits Project Type SEWER City Project Numbers 103119 DOE Number 3119 Estimate Number 1 Payment Number 1 For Period Ending 7/18/2022 WD City Secretary Contract Number Contract Time 3WD Contract Date Days Charged to Date 173 Project Manager NA Contract is 100.00 Complete Contractor SOUTHERN MECHANICAL PLUMBING, INC. 400 S. ASTON SUNNYVALE, TX 75182 Inspectors GLOVER / WATSON Tuesday, March 28, 2023 Page I of City Project Numbers 103119 DOE Number 3119 Contract Name ALEDO MIDDLE SCHOOL #2 ADDITION Estimate Number I Contract Limits Payment Number I Project Type SEWER For Period Ending 7/18/2022 Project Funding SEWER Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total - - 1 - - - - - - - - - - - - Sanitary Line Grouting - - - - - - - 4 CY - - - $195.00 - - - - $780.00 - - - - 4 - - - - - $780.00 2 Remove 5' Sewer Manhole l EA $1,000.00 $1,000.00 1 $1,000.00 3 Post -CCTV Inspection 935 LF $1.00 $935.00 935 $935.00 4 Manhole Vacuum Testing 5 EA $170.00 $850.00 5 $850.00 5 Trench Safety 935 LF $1.00 $935.00 935 $935.00 6 Concrete Collar 6 EA $250.00 $1,500.00 6 $1,500.00 7 Imported Embedment/Backfill, CSS 422 CY $70.00 $29,540.00 422 $29,540.00 8 8"Sewer Pipe 35 LF $45.00 $1,575.00 35 $1,575.00 9 2 1 " Sewer Pipe 900 LF $120.00 $108,000.00 900 $108,000.00 10 Epoxy Manhole Liner 65 VF $150.00 $9,750.00 65 $9,750.00 1 t 4' Manhole I EA $3,200.00 $3,200.00 1 $3,200.00 12 4' Extra Depth Manhole 7.4 VF $200.00 $1,480.00 7.4 $1,480.00 13 5' Manhole 3 EA $4,800.00 $14,400.00 3 $14,400.00 14 5' Drop Manhole I EA $5,200.00 $5,200.00 I $5,200.00 15 5' Extra Depth Manhole 4 L6 VF $285.00 $11,856.00 41.6 $11,856.00 t6 Connect to Existing Manhole I EA $2,000.00 $2,000.00 1 $2,000.00 17 Seeding, Hydronmlch 7333 SY $3.00 $21,999.00 7333 $21,999.00 18 Temporary Irrigation( No City Participation) 1 LS $9,864.00 $9,864.00 I $9,864.00 Sub -Total of Previous Unit $224,864.00 $224,864.00 Tuesday, March 28, 2023 Page 2 of 4 City Project Numbers 103119 Contract Name ALEDO MIDDLE SCHOOL #2 ADDITION Contract Limits Project Type SEWER Project Funding Contract Information Summary Original Contract Amount Change Orders Change Order Number I Total Contract Price DOG Number 3119 Estimate Number I Payment Number I For Period Ending 7/18/2022 $194,001.00 $30,863.00 $224,864.00 Total Cost of Work Completed $224,864.00 Less % Retained $0.00 Net Earned $224,864.00 Earned This Period $224,864.00 Retainage This Period $0.00 Less Liquidated Damages Days @ / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $0.00 $0.00 $0.00 $0.00 $0.00 $224,864.00 Tuesday, March 28, 2023 Page 3 of 4 City Project Numbers 103119 Contract Name ALEDO MIDDLE SCHOOL I12 ADDITION Contract Limits Project Type SEWER Project Funding DOG Number 3119 Estimate Number I Payment Number I For Period Ending 7/18/2022 Project Manager NA City Secretary Cont►•act Number Inspectors GLOVER / WATSON Cont►•act Date Contractor SOUTHERN MECHANICAL PLUMBING, INC. Cont►•act Time 30 WD 400 S. ASTON Days Charged to Date 173 WD SUNNYVALE, TX 75182 Cont►•act is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Funded ------------------ Net Total Cost of Work Completed $224,864.00 Less % Retained $0.00 Net Earned $224,864.00 Earned This Period $224,864.00 Retainage This Period $0.00 Less Liquidated Damages 0 Days @ $0.00 / Day $0.00 LessPavement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $224,864.00 Tuesday, March 28, 2023 Page 4 of IF0P",I, Wow rH 'I'RANSPORTA'TZON AND PUBLIC WORDS PIPE REPORTFOR: PROJECT NAME: Aledo Middle School Addition 112 PROJECT NUMBER: 103119 DOENUMBER, WATER PIPE LAID SIZE 'TYPE OF PIPE FIRE HYDRANTS: PIPE ABANDONED DENSITIES: NEW SERVICES: PIPE LAID PVC PVC PIPE ABANDONED DENSITIES: NEW SERVICES: VALVES (16" OR LARGER) SIZE TYPE OF PIPE SEWER SIZE TYPE OF PIPE 8" Scwcr 21" Sewer SIZE TYPE OF PIPE LF 7'llANSPORTA'1I014 AND PUBLIC NOIUCS e The City of Port 1Voclh - '1000Throckmorton Slccct' Port 1Voclh, TJK 76012-6311 (017) 392 - 79,1'1 - Fnx: (017) 392 - 70,15 LF LF 35 LF, 900 LP LF PROJECT NAME: CONTRACT: CFA # CITY PROJECT# CITY SECRETARY CONTRACT # FID # SEWER PROJECT# FILE # INSPECTOR: PROJECT MANAGER: DEVELOPER -AWARDED -PROJECT CHANGE ORDER Sanitary Sewer Improvements to Serve Aledo Middle School #2 Addition 20-0149 1 CITY PARTICIPATION: 103119 55466 30114-0200431-103119-EO7685 N/A X-26762 YES Donald Watson Phone No: Drew Goodman Phone No: 817-392-6251 CONTRACT UNIT WATER SEWER DRAINAGE Developer Developer Developer Cost City Cost Cost City Cost Cost City Cost ORIGINAL CONTRACT $35,344.80 $158,656.20 EXTRAS TO DATE CREDITS TO DATE CONTRACT TO DATE $35.344.80 $158,656.20 AMOUNT OF PROP. CHANGE ORDER $13,097.85 $17,765.15 REVISED CONTRACT AMOUNT $48,442.65 $176,421.35 TOTAL REVISED CONTRACT AMOUNT PER UNIT $0.00 $224,864.00 $0.00 REVISED COST SHARE Dev. Cost: $48,442.65 City Cost: TOTAL REVISED CONTRACT $224,864.00 CHANGE ORDER No: 1 PAVING Developer Cost City Cost $0.00 CSC No. 55466-CO1 STREET LIGHTS Developer Cost City Cost $176, 421.35 $0.00 (CONTRACT i DAYS Revised: 12-17-2018 Page 1 You are directed to make the following changes in the con ract documen s CITY BID ITEM PAY ITEM # # QUANTITY UNIT 2 0241.2202 -1 EA 17• 3292.0400 7333 SY 18• 9999.9999 1 LS Asterisk (') indicates New Pay Item REASONS FOR CHANGE ORDER ITEM DESCRIPTION Remove 5' Sewer Manhole Seeding, Hydromulch Temporary Irrigation (No City Participation) UNIT PRICE TOTAL $1,000.00-S1,000.00 S3.00 S21,999.00 S9,864.00 S9,864.00 TOTAL $30,863.00 Change order required to eliminate the removal of an existing manhole located on the main sewer line. Change order also includes re-establishment of vegetation within the distrubed area of the sewer installation. Revised: 12-17-2018 Page 2 RECOMMENDED: (Consulting. BY �,/ /W1fi�+/wj Name: /�A,t�, 444 Ot'hb4 Title: Aloc -k PrinGrP� / APPROVAL RECOMMENDED: CFW- sponsoring Department � 7�` Name: Taylor Gunderman rdle: Engineering Manager RECOMMENDED: CFW - 'Contract Compliance Manager By-. CJ ,,A�J—P4. Name: Andrew Goodman Tide: Professional Engineer M&C Number. N/A M&C Date Approved: N/A APPROVED: APPROVED: (De (Coniraun �� 2�4 >i r; V. Bv. a'.Name: Ear4H.usfeld Name: G a rV R. Shelton Tide: Chief Financial Officer Title: President APPROVED: CFW - Assistant City Manager �t211G18NY1Ii1R'0>� Name: Dana Burghdoff Tide: Assistant City Manager APPROVED AS TO FORM AND LEGALITY: CFW - Assistant City Aftomey Name: Richard McCracken ride: Senior Assistant City Attorney ATTEST • Contract Compliance Manager (Project Manager): By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract Include ensuring all performance and reporting requirements. Ronald Gonzales City Secretary []There are NO City Funds assodated with this Contract OThere are City Funds associated with this Contract Revised: 12-17-2018 Page 3 Qa1A fAQ/IYUSDrDV/ ATE AN73,.T1R NlP.GT� 1 / - r . I ----a ITS-' 7A r�"�P1� /• r�- I UTILITY NOTE ME UTILITIES 910- ON n E PLANS RETIE COMPILED FROM VARIOUS SOURCES AND ARE INTENDED TO SHOW THE GENERAL EXISTENCE AND LOCATION OF UTIU"ES IN 7NE AREA OF CONSTRUCTION DIE ENGINEER ASSUMES NO RESPONSIBILITY FOR DIE ACCURACY OF ME URRIIY INFORNATION SHORN ON THE PLANS TINE CONTRACTOR SHALL 4ERIFY ME EXACT LOCATION OF ALL URU77ES PRIOR TO CONSTR LICRON THE CONTRACTOR SHALL CONTACT UTIU1Y COMPANIES 48 HOURS IN ADVANCE OF ANY CWSIRUC77M ACTINRES IN ORDER TO OE7ERMINE X THERE IS ANY CONFUCT WTII iWIE PROPOSED FAOURES. ME CON/RACIOR SHALL NO RFY ME ENCMEER IMMEDIATELY MIEN CONFUCIS WTN EXISRNC U71URES ARE DISCOKREO 21" SS LINE 'A' su r+maT.ss cai �•.'� cd GRAPHIC SCALE CRevroC $C— I ..a OEMOURON NOTES, 1. CONTRACTOR SHALL REPLACE AREA OF MANHOLE TO BE REM WO MTII 30" PH: TO NEAREST EXRSI7NC PIPE .ONT. Z CONTRACTOR SHALL COORDINATE WTII PWUC "ORKS FOR PLUGGING OF UPSTREAM MANHOLE PRIOR 70 REMOVAL OF EXISTING MANHOLES IN LIEU OF PUMPING. GRADING NOTES I. CONTRACTOR SHALL MAINTAIN ALL EXISRNC GRADES AND DRAINAGE PATTERNS WERE NO PROPOSED GRADING IS 70 OCCUR. 8" SS LINE '6' I eAmu Ib4 LIETAt s m raFaacL ■■E mom Ow ■■■■■■■ IN ■ME ■■■ MEMO .. ■■un J► ■u��i.Co �� ..:..� ■■■■ M�■ ■■■■M ■■■ ,_ it . , 1111 1 ■MEME MEMO �....E..N..1 :..:. MOM ... Am .■� ■■■■ ....... li zMEN mom 17T7 .■■!MEMO! anomoson 1:: ■■■■■n ■■■i■■■■■■�■■■■■■■■■■ NEE■■■■■ ■Ew■uEMMi®NI■■■u■■■■�M ��■ !■■■ME■■E®NN■■■■!■ tN ■ ■E■■■■ I�N �MAi ■� ■.■ . ■■■■■■■■■■■■■■■■■■■!■■■■■ .N1100 �N ■■ \p ..■■■M ig■■. MOM ■■=NM■■■■■■ ■r ■■■ n■■N! !■■N ■■!■■ME■■■EENN■NM■■■E ■E�■ lMN: ■Ei�■■■ ■ Oiiili—iE! „ ■I .. ...... :HE Ili■ C R ■E■ °:: :� E■ 1 1 . N EO■M :1111 OEM 10 �■ E■ ■ �. �`I ■ NN . 1� I OEM O■■■MEMO .... N �■ ME : �� 11 :;f: E■■N tl� ME ME mmmo ■ O:■: ■■ : :1:1:::� ■::■1: ....■. .■.■.■.!N■11■M11�i■N11 ME■N ■E�■E■ ■■:: 880 I OIL` e 860 a 8501 E E 0+00 1+00 2+ b 3�bq 4+00 5 00 6 00 7400 8+60 9+0C 0+00 1+00 a 7 SEY%R RENSIONS IMsvIIDo/o9/211 teogue nail and perkins, inc I A• 2:a:Tsr1, �iy of Fort Worth, Texas �L 4� J I ` ,,, ^•w,��. Iw FORT WORTH t^-RD ,1, I! Public Sanitary Sre Sc Improvements sheet I ou.nsms ova,e.»u7" s' <' , uiuuLi s Inisay; / // I to Serve Aledo Middle School #2 Addition tnpSANITARY SEWER PLAN 8 PROFILE iI "5 ne.l nvl.lsn br dW. 11' •na n.w swllaoa, law7w1. so1w,o1 DEC 2020 FORT WORTHO) �.J TRANSPORTATION AND PUBLIC WORKS July 27, 2022 Southern Mechanical Plumbing, Inc. 400 S Aston Drive Sunnyvale, Texas 75182 RE: Acceptance Letter Project Name: Aledo Middle School Addition 112 Project Type: Sewer City Project No.: 103119 To Whom It May Concern: On July 22, 2022 a final Inspection was made on the subject project. There were punch Ilst Items Identified at that time. The punch list Items were completed on July 27, 2022. 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 July 27, 2022, which Is the date of the punch list completion and will extend of two (2) years In accordance with the Contract Documents, If you have any questions concerning this letter of acceptance, please feel free to contact me at 817- 392-6251. Sincerely, Qd'rJew=o2odWman,M Protect Manager Cc: Riley Roberson, Inspector Mike Glover, Inspection Supervlsol' Daniel Roy, Senior Inspector Victor Tornero, Program Manager TNP, Consultant southern Mechanical Plumbing, Inc., Contractor Aledo Independent School District, Developer File E-Mail: TPW_Acceltance@fortwortlitexas.gov Rev.0/20/19 AFFIDAVIT STATE OF TL`IXAS COUNTY OF TARRANT Before me, the undersigned authority, a notary public in the state and County aloresaid, on this day personally appeared Anthony Gilbert, Assistant Project Manager Of Southern Mechanical Plumbing, Inc, 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 lull; That the wake scale established by the City COlnlCil 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; Alecto ISD, Alecto Middle School #2 BY l �� Anthony Gilbert Subscribed and sworn belore me on this date 27 of March, 2023. Notary Dallas, Texas MISTY ROUTSONO Notary ID #131303301 My Commission Expires '1c.N October 4, 2025 CONSENT OF SURETY COMPANY TO FINAL PAYMENT DOCUMENT G707 PROJECT: (name, address) Aledo Middle School Addition #2 TO: (Owner) Aledo Independent School District 1008 Bailey Ranch Road Aledo. TX 76008 CONTRACTOR: Southern Mechanical Plumbing, Inc. 400 S. Aston Drive Sunnyvale, TX 75182 OWNER O ARCHITECT O CONTRACTOR a SURETY a OTHER a ARCHITECTS PROJECT NO: 103119 CONTRACT FOR: Site Utilities CONTRACT DATE: May 13, 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) INTERNATIONAL FIDELITY INSURANCE COMPANY SURETY COMPANY, One Newark Center, 20th Floor Newark, New Jersey 07102 on bond of (here insert name and address of Contractor) Southern Mechanical Plumbing, Inc. CONTRACTOR, 400 S. Aston Drive, Sunnyvale, TX 75182 hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of Its obligations to (here Insert name and address of Owner) Aledo Independent School District OWNER, 1008 Bailey Ranch Road, Aledo, TX 76008 as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, 27th March 23 the Surety Company has hereunto set its hand this day of 20 INTERNATIONAL FIDELITY INSURANCE COMPANY Surety Company Lauren Lane, Attorney -in -Fact Title Note: This form Is to be used as a companion document to Document G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, current edition Printed In cooperation with the American Institute of Architects (AIA) by International Fidelity Insurance Company. International Fidelity Insurance Company vouches that the language In the document conforms exactly to the language In AIA Document G 707, April 1970 edition. Wy J STATE OF NEW JERSEY STATE OF ILLINOIS G 4pPp0�� County of Essex County of Cook SEAL o y 1904 JERS aa3` Kenneth Chapman Executive Vice President, Harco National Insurance Company and International Fidelity Insurance Company POWER OF ATTORNEY Bond# HSHNS0793041 HARCO NATIONAL INSURANCE COMPANY INTERNATIONAL FIDELITY INSURANCE COMPANY Member companies of IAT Insurance Group, Headquartered: 702 Oberlin Road, Raleigh, North Carolina 27605 KNOW ALL MEN BY THESE PRESENTS: That HARCO NATIONAL INSURANCE COMPANY, a corporation organized and existing under the laws of the State of Illinois, and INTERNATIONAL FIDELITY INSURANCE COMPANY, a corporation organized and existing under the laws of the State of New Jersey, and having their principal offices located respectively in the cities of Rolling Meadows, Illinois and Newark, New Jersey, do hereby constitute and appoint RICK CLEMENTS, TRACY VELASQUEZ, LAUREN LANE, CORY B. BENTLEY, ROBERT B. BENTLEY Amarillo, TX their true and lawful attorney(s)-In-fact to execute, seal and deliver for and on its behalf as surety, any and all bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof, which are or may be allowed, required or permitted by law, statute, rule, regulation, contract or otherwise, and the execution of such instrument(s) in pursuance of these presents, shall be as binding upon the said HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY, as fully and amply, to all intents and purposes, as if the same had been duly executed and acknowledged by their regularly elected officers at their principal offices. This Power of Attorney is executed, and may be revoked, pursuant to and by authority of the By -Laws of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY and is granted under and by authority of the following resolution adopted by the Board of Directors of INTERNATIONAL FIDELITY INSURANCE COMPANY at a meeting duly held on the 13th day of December, 2018 and by the Board of Directors of HARCO NATIONAL INSURANCE COMPANY at a meeting held on the 13th day of December, 2018. "RESOLVED, that (1) the Chief Executive Officer, President, Executive Vice President, Senior Vice President, Vice President, or Secretary of the Corporation shall have the power to appoint, and to revoke the appointments of, Attorneys -in -Fact or agents with power and authority as defined or limited in their respective powers of attorney, and to execute on behalf of the Corporation and affix the Corporation's seal thereto, bonds, undertakings, recognizances, contracts of indemnity and other written obligations in the nature thereof or related thereto; and (2) any such Officers of the Corporation may appoint and revoke the appointments of joint -control custodians, agents for acceptance of process, and Attorneys -in -fact with authority to execute waivers and consents on behalf of the Corporation; and (3) the signature of any such Officer of the Corporation and the Corporation's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seals when so used whether heretofore or hereafter, being hereby adopted by the Corporation as the original signature of such officer and the original seal of the Corporation, to be valid and binding upon the Cotporation with the same force and effect as though manually affixed." IN WITNESS WHEREOF, HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY have each executed and attested these presents on this 31 st day of December, 2019 ItNSU• •, .......... r' �?n' z SEAL o of ioa.+ On this 31 st day of December, 2019 , before me came the individual who executed the preceding instrument, to me personally known, and, being by me duly sworn, said he is the therein described and authorized officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY; that the seals affixed to said instrument are the Corporate Seals of said Companies; that the said Corporate Seals and his signature were duly affixed by order of the Boards of Directors of said Companies. ., A..�Gj'�; IN TESTIMONY WHEREOF, I have hereunto set my hand affixed my Official Seal, at the City of Newark, O'�:� New Jersey the day and year first above written. �\Q��aO:A/? FW �Eps`�.� Shirelle A. Outley a Notary Public of New Jersey My Commission Expires April 4, 2023 CERTIFICATION I, the undersigned officer of HARCO NATIONAL INSURANCE COMPANY and INTERNATIONAL FIDELITY INSURANCE COMPANY do hereby certify that I have compared the foregoing copy of the Power of Attorney and affidavit, and the copy of the Sections of the By -Laws of said Companies as set forth in said Power of Attorney, with the originals on file in the home office of said companies, and that the same are correct transcripts thereof, and of the whole of the said originals, and that the said Power of Attorney has not been revoked and is now in full force and effect. IN TESTIMONY WHEREOF, I have hereunto set my hand on this day, March 27, 2023 A02200 Irene Martins, Assistant Secretary IMPORTANT NOTICE To obtain information or make a complaint: You may contact Harco National Insurance Company at: 1-800-333-4167 You may also write to: Harco National Insurance Company c/o IAT Surety at: Attn: Claims Department One Newark Center, 201h Floor Newark, NJ 07102 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512) 490-1007 Web: www.tdi.texas. eov E-mail: ConsumerProtection()..tdi.texas.eov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent or the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR BOND: This notice is for information only and does not become a part or condition of the attached document. AVISO IMPORTANTE Para obtener informacion o para presentar una queja: Usted puede comunicarse con su Harco National Insurance Company al: 1-800-333-4167 Usted tambien puede escribir a Harco National Insurance Company c/o IAT Surety at: Attn: Claims Department One Newark Center, 201h Floor Newark, NJ 07102 Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companias, coberturas, derechos o quejas al: 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas: P. O. Box 149104 Austin, TX 78714-9104 Fax: (512) 490-1007 Web: www.tdi.texas.Qov E-mail: ConsumerProtection(iDtdi.texas.Qov DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiene una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente o la compania primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI). UNA ESTE AVISO A SU FIANZA DE GARANTIA: Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adjunto.