HomeMy WebLinkAboutContract 57428-FP3FORT WORTH,
57428
City Secretary
Contract No. 57428-FP3
Date Received 03/26/2024
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: Hemphill Road and Street A
City Project No.: 103517
Improvement Type(s): Water ❑x Sewer ❑x
Original Contract Price: $1,376,521.97
Amount of Approved Change Order(s) $797,612.37
Revised Contract Amount: $2,174,134.34
Total Cost of Work Complete: $2,174,134.34
?�YOlect Manaael- M a r 26, 2024
Pro iect Man a eer(M a r 26. 2024i3:47 CDT)
Contractor Date
&O. ect Manager
Project Manager (Mar 26, 2024 3:47 CDT)
Title
Commerce Construction
Company Name
777 Manry jp, r 26, 2024 14:31 CDT)
Mar 26, 2024
�Pr ject in a for
�"��
Date
Mar 26, 2024
Project Manager
Date
Ow Rebecca Owen (Mar 26, 2024 15:48 CDT)
M a r 26, 2024
CFA Manager
Date
Mar 26, 2024
Lauren Prieur(Mar26,202415:49CDT)
TPW Director
Date
C�P�
M a r 27, 2024
Asst. City Manager
Date
OFFICIAL RECORD
CITY SECRETARY
Page 1 of 2
FT. WORTH, TX
Notice of Project Completion
Project Name: Hemphill Road and Street A
City Project No.: 103517
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: 231 WD Days Charged: 355
Work Start Date: 5/24/2022 Work Complete Date: 3/5/2024
Completed number of Soil Lab Test: 838
Completed number of Water Test: 32
Page 2of2
FoRTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name HEMPHILL ROAD AND STREET A
Contract Limits
Project Type WATER & SEWER
City Project Numbers 103517
DOE Number 3517
Estimate Number 1 Payment Number 1
City Secretary Contract Number
Contract Date 3/4/2022
For Period Ending
Project Manager NA
Contractor COMMERCE CONSTRUCTION
13191 CROSSROADS PKWY N, 6TH FLR
CITY OF INDUSTRY, CA 91746
Inspectors MILLER, W / MORALES, P
Contract Time
Days Charged to Date
Contract is 100.00
3/5/2024
WD
23WD
355
Complete
Tuesday, March 26, 2024 Page 1 of 6
City Project Numbers 103517 DOE Number 3517
Contract Name HEMPHILL ROAD AND STREET A Estimate Number I
Contract Limits Payment Number 1
Project Type WATER & SEWER For Period Ending 3/5/2024
Project Funding
UNIT I: WATER IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
1
EXPLORATORY EXCAVATION OF EXISTING
0 EA
$4,277.00
$0.00
0
$0.00
UTILITIES (CO #3)
2
24" CASING BY OTHER THAN OPEN CUT (CO
0 LF
$223.38
$0.00
0
$0.00
#3)
3
FIRE HYDRANT (CO #2 & 3)
0 EA
$4,060.00
$0.00
0
$0.00
4
DUCTILE IRON WATER FITTING W/RESTRAINT
0 TN
$15,011.33
$0.00
0
$0.00
(CO #3)
5
2" WATER SERVICE (CO #1 & 2 & 3)
1 EA
$3,614.28
$3,614.28
1
$3,614.28
6
6" WATER PIPE (CO #2 & 3)
0 LF
$40.80
$0.00
0
$0.00
7
8" PVC WATER PIPE (CO #2 & 3)
0 LF
$63.24
$0.00
0
$0.00
8
12" DIP WATER (CO #3)
0 LF
$107.30
$0.00
0
$0.00
9
12" PVC WATER PIPE (CO #2 & 3)
0 LF
$77.61
$0.00
0
$0.00
10
6" GATE VALVE (CO #2 &3)
0 EA
$1,390.00
$0.00
0
$0.00
11
8" GATE VALVE (CO #2 & 3)
0 EA
$2,249.00
$0.00
0
$0.00
12
4"-12" PRESSURE PLUG (CO #2 & 3)
0 EA
$327.25
$0.00
0
$0.00
13
12" GATE VALVE (CO #2 & 3)
0 EA
$2,774.85
$0.00
0
$0.00
14
CONNECTION TO EXISTING 16" WATER MAIN
0 EA
$7,244.00
$0.00
0
$0.00
(CO #2)
15
CONNECTION TO EXISTING 4"-12" WATER
0 EA
$3,181.00
$0.00
0
$0.00
MAIN (CO #3)
16
12" X 8" TAPPING SLEEVE & VALVE (CO #3)
0 EA
$424.38
$0.00
0
$0.00
17
TRENCH SAFETY (CO #2)(CO #3)
0 LF
$1.19
$0.00
0
$0.00
18
EXPLORATORY EXCAVATION OF EXISTING
3 EA
$7,450.74
$22,352.22
3
$22,352.22
UTILITIES (CO #3)
19
24" CASING BY OTHER THAN OPEN CUT (CO
260 LF
$389.14
$101,176.40
260
$101,176.40
#3)
20
FIRE HYDRANT (CO #3)
10 EA
$7,072.71
$70,727.10
10
$70,727.10
21
DUCTILE IRON WATER FITTINGS W/
3 TN
$26,150.46
$78,451.38
3
$78,451.38
RESTRAINT (CO #3)
22
2" WATER SERVICE (CO #3)
6 EA
$6,296.25
$37,777.50
6
$37,777.50
23
6" WATER PIPE (CO #3)
218 LF
$71.08
$15,495.44
218
$15,495.44
24
8" PVC WATER PIPE (CO #3)
544 LF
$110.17
$59,932.48
544
$59,932.48
25
12" DIP WATER (CO #3)
260 LF
$186.92
$48,599.20
260
$48,599.20
26
12" PVC WATER PIPE (CO #3)
5283 LF
$135.20
$714,261.60
5283
$714,261.60
Tuesday, March 26, 2024 Page 2 of 6
City Project Numbers 103517
Contract Name HEMPHILL ROAD AND STREET A
Contract Limits
Project Type WATER & SEWER
Project Funding
DOE Number 3517
Estimate Number 1
Payment Number 1
For Period Ending 3/5/2024
27
6" GATE VALVE (CO #3)
9 EA
$2,421.45
$21,793.05
9
$21,793.05
28
8" GATE VALVE (CO #3)
12 EA
$3,917.87
$47,014.44
12
$47,014.44
29
4"-12" PRESSURE PLUG (CO #3)
13 EA
$570.09
$7,411.17
13
$7,411.17
30
12" GATE VALVE (CO #3)
31 EA
$4,833.92
$149,851.52
31
$149,851.52
31
CONNECTION TO EXISTING 4"-12" WATER
3 EA
$5,541.46
$16,624.38
3
$16,624.38
MAIN (CO #3 & 4)
32
12" X 8" TAPPING SLEEVE & VALVE (CO #3)
11 EA
$739.29
$8,132.19
11
$8,132.19
33
TRENCH SAFETY (CO #3)
5473 LF
$2.07
$11,329.11
5473
$11,329.11
34
1 1/2" WATER SERVICE (CO #4)
1 EA
$3,752.11
$3,752.11
1
$3,752.11
Sub -Total of Previous Unit
$1,418,295.57
$1,418,295.57
UNIT H: SEWER IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed Completed
No.
Quanity
Total
Quanity
Total
1
8" SEWER PIPE (CO #3)
0 LF
$13.70
$0.00
0
$0.00
2
10" SEWER PIPE (CO #3)
0 LF
$50.68
$0.00
0
$0.00
3
8" SEWER PIPE, CSS BACKFILL (CO #3)
0 LF
$40.93
$0.00
0
$0.00
4
10" SEWER PIPE CSS BACKFILL (CO #3)
0 LF
$63.57
$0.00
0
$0.00
5
T MANHOLE (CO #3)
0 EA
$4,239.80
$0.00
0
$0.00
6
T DROP MANHOLE (CO #3)
0 EA
$3,628.00
$0.00
0
$0.00
7
REMOVE 4' SEWER MANHOLE (CO #3)
0 EA
$1,219.99
$0.00
0
$0.00
8
EPDXY MANHOLE LINER (CO #3)
0 VF
$236.12
$0.00
0
$0.00
9
REMOVE 10" SEWER LINE (CO #3)
0 LF
$34.98
$0.00
0
$0.00
10
MANHOLE VACUUM TESTING (CO #3)
0 EA
$137.56
$0.00
0
$0.00
11
POST CCTV INSPECTION (CO #3)
0 LF
$0.65
$0.00
0
$0.00
12
TRENCH SAFETY (CO #3)
0 LF
$0.65
$0.00
0
$0.00
14
8" SEWER PIPE (CO #3)
1542 LF
$23.87
$36,807.54
1542
$36,807.54
15
10" SEWER PIPE (CO #3)
2262 LF
$88.29
$199,711.98
2262
$199,711.98
16
8" SEWER PIPE, CSS BACKFILL (CO #3)
80 LF
$71.30
$5,704.00
80
$5,704.00
17
10" SEWER PIPE, CSS BACKFILL (CO #3)
104 LF
$110.74
$11,516.96
104
$11,516.96
18
T MANHOLE (CO #3)
15 EA
$7,385.93
$110,788.95
15
$110,788.95
19
T DROP MANHOLE (CO #3)
3 EA
$6,320.15
$18,960.45
3
$18,960.45
20
REMOVE 4' SEWER MANHOLE (CO #3)
8 EA
$2,125.28
$17,002.24
8
$17,002.24
21
EPDXY MANHOLE LINER (CO #3)
67 VF
$411.33
$27,559.11
67
$27,559.11
22
REMOVE 10" SEWER LINE (CO #3)
5167 LF
$60.94
$314,876.98
5167
$314,876.98
Tuesday, March 26, 2024
Page 3 of 6
City Project Numbers 103517
Contract Name HEMPHILL ROAD AND STREET A
Contract Limits
Project Type WATER & SEWER
Project Funding
DOE Number 3517
Estimate Number 1
Payment Number 1
For Period Ending 3/5/2024
23 MANHOLE VACUUM TESTING (CO #3) 18 EA $239.64 $4,313.52 18 $4,313.52
24 POST -CCTV INSPECTION (CO #3) 3804 LF $1.13 $4,298.52 3804 $4,298.52
25 TRENCH SAFETY (CO #3) 3804 LF $1.13 $4,298.52 3804 $4,298.52
Sub -Total of Previous Unit $755,838.77 $755,838.77
Tuesday, March 26, 2024 Page 4 of 6
City Project Numbers 103517
Contract Name HEMPHILL ROAD AND STREET A
Contract Limits
Project Type WATER & SEWER
Project Funding
Contract Information Summary
Original Contract Amount
Chanhe Orders
Change Order Number 1
Change Order Number 3
Change Order Number 2
Change Order Number 3
Change Order Number 4
Change Order Number
DOE Number 3517
Estimate Number 1
Payment Number 1
For Period Ending 3/5/2024
$1,376,521.97
$3,614.28
$321,965.63
($135,895.12)
$598,634.01
$9,293.57
Total Contract Price $2,174,134.34
Total Cost of Work Completed $2,174,134.34
Less % Retained $0.00
Net Earned $2,174,134.34
Earned This Period $2,174,134.34
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
$2,174,134.34
Tuesday, March 26, 2024 Page 5 of 6
City Project Numbers 103517
Contract Name HEMPHILL ROAD AND STREET A
Contract Limits
Project Type WATER & SEWER
Project Funding
Project Manager NA
Inspectors MILLER, W / MORALES, P
Contractor COMMERCE CONSTRUCTION
13191 CROSSROADS PKWY N, 6TH FLR
CITY OF INDUSTRY, CA 91746
DOE Number 3517
Estimate Number 1
Payment Number 1
For Period Ending 3/5/2024
City Secretary Contract Number
Contract Date
3/4/2022
Contract Time
231 WD
Days Charged to Date
355 WD
Contract is .000000
Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of Work Completed $2,174,134.34
Less % Retained $0.00
Net Earned $2,174,134.34
Earned This Period $2,174,134.34
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
$2,174,134.34
Tuesday, March 26, 2024 Page 6 of 6
PROJECT NAME:
CONTRACT:
CFA #
CITY PROJECT #
DOE #
(WATER PROJECT#
SEWER PROJECT#
IFILE It
INSPECTOR:
PROJECT MANAGER:
(ORIGINAL CONTRACT
EXTRAS TO DATE
(CREDITS TO DATE
CONTRACT TO DATE
AMOUNT OF PROP. CHANGE ORDER
REVISED CONTRACT AMOUNT
TOTAL REVISED CONTRACT AMOUNT
PER UNIT
REVISED COST SHARE
TOTAL REVISED CONTRACT
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
WATER, SEWER, PAVING, DRIANAGE, & STREET LIGHT IMPROVEMENTS TO SERVE
HEMPHILL ROAD & STREET A CHANGE
ORDER No:
CFA21-0137 CITY PARTICIPATION:( NO
103517
NA 1
NA
NA
K-2054
ALEX ALDACO Phone No: 817.647.2562
PATRICK BUCKLEY Phone No: 817.392.2443
WATER
I SEWER
Developer
Dovoloper Cost City Cost
Cost
City Cost
$942,640.03 I $0.00
$433,073.14
$0.00
$0.10
$0.0
$0.00 I $0.00
$0.00
$0.00
$0.00
I $0.00
$942,640.03 I $0.00
$433,873.14
$0.00
$ 3,614.26 $0.00
$0.00
$0.00
$946,203.11 $0.00
$433,873.14
$0.00
$948,263.11
$433,873.14
Dov. Cost:
$3,735,643.15
CONTRACT UNIT I
PAVING I DRAINAGE STREET LIGHTS I CONTRACT
ovolopor Developer Developer 1 DAYS
oat City Cost Cost Illy Cost Cost City Cost
$653,943.66 $0.00 $1,327.314.69 $0.00 $374,090,66 $0.00 231
$0.00 $0.00 $0.00 $0,00 $0.00 $0.00 0
$0.00 $0.00 $0.00 I $0,00 $0.00 $0.00 0
$653,fl43.66 30.00 $1,327,364.69 $D.00 $374,090.65 $0.00231
$15 $o.00 $0.00 o.00 $0.00
$0.00
0
$653,943.66 0.00 $1,327,304.:0 00 $374,098.55 $0.00 I 231
$653,943.66 $1.327,304.09 $374.090.66
$3,735,643.16
You are directed to make the following changes in the contract documents:
CITY BID ITEM
PAY ITEM 11 11 QUANTITY UNIT ITEM DESCRIPTION
6 3312.2203 1 EA 2" Water Service
I
TOTAL
REASONS FOR CHANGE ORDER Addlllonel 2" waterservlce Is noeded to serve Bulldlnrg 5 - CFA will be updated to Include this bld Item.
UNIT PRICE TOTAL
$ 3,614.28 $ 3.614.20
$ 3,614.28
Revised:10-12-2011
Page 1
RECOMMENDED:
APPROVED:
Kimley-Horn and Associates, Inc. Fort Worth Everman/RI iger LLC
C', JBy; MaJeslic Rea
By: ., � �� • By,
Name: Crislalzubla Name: Edward P. Ros%i, Jr
Title: Civil Enalneer
Title: President
APPROVED:
Commerce Construction Co., L.P.
By: /��� k
Name: ✓ John R. Burrou
Title: President
fill.1714 F4 YAJ
By Patrick Buckley at 1:05 pm, Oct 21, 2022
Revised; 10.12-2011 Page 2
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PROJECT NAME:
CONTRACT:
CFA #
CITY PROJECT #
DOE #
WATER PROJECT #
SEWER PROJECT #
FILE #
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
WATER, SEWER, PAVING, DRIANAGE, & STREET LIGHT IMPROVEMENTS TO SERVE
HEMPHILL ROAD & STREET A
CFA21-0137 CITY PARTICIPATION: NO
103517
NA
NA
NA
K-2854
INSPECTOR: JOSH MANRY
PROJECT MANAGER: GEORGE MARQUEZ
WATER
Developer Cost
City Co
ORIGINAL CONTRACT
$942,648.83
I $0.00
EXTRAS TO DATE
$3,614.28
I $0.00
CREDITS TO DATE
$0.00
CONTRACT TO DATE
$946,263.11
AMOUNT OF PROP. CHANGE ORDER
($135,895.12)
REVISED CONTRACT AMOUNT
$810,367.99
I $0.00
TOTAL REVISED CONTRACT AMOUNT
PER UNIT
$810,367.99
REVISED COST SHARE
Dev. Cost:
TOTAL REVISED CONTRACT
Phone No: 817-647-2564
Phone No: 817-392-6826
REVIEWED
By George Marqeuez, P.E. at 11:56 am, Feb 23, 2024
CHANGE
ORDER No:
2
CONTRACT UNIT
SEWER
PAVING
I DRAINAGE
eveloper
veloper
(Cost
Cost
City Cost
City Cost
Developer Cost
City Co
$433,873.14
$0.00
I $653,943.66
$0.00
I $1,327,364.69
$0.00
$0.00
$0.00
I $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
I $0.00
$0.00
$0.00
$0.00
$433,873.14
$0.00
I $653,943.66
$0.00
I $1,327,364.69
$0.00
$0.00
$0.00
$ 213,637.94
$0.00
I ($415.00)
$0.00
$433,873.14 I
$0.00
I $867,581.60
$0.00
I $1,326,949.69 I
$0.00
$433,873.14
$867,581.60
$1,326,949.69
$3,812,870.97
City Cost:
$3,812,870.97
STREET LIGHTS
CONTRACT
eveloper
DAYS
t Cost City Cost
$374,098.55 $0.00
231
$0.00 $0.00
0
$0.00 $0.00
0
$374,098.55 $0.00
231
$0.00 $0.00
0
$374,098.55 r $0.00
231
$374,098.55
$0.00 -
Revised: 10-12-2011 Page 1
You are directed to make the following changes in the contract documents:
CITY BID ITEM
PAY ITEM # # QUANTITY
3 3312.0001 (1)
5 3312.2203 (1)
6 3311.0141 (70)
7 3311.0261 59
9 3311.0461 (1406)
10 3312.3002 (2)
11 3312.3003 1
12 0241.1118 2
13 3312.3005 (4)
14 3312.0117 (1)
17 3305.0109 (1476)
UNIT
ITEM DESCRIPTION
UNIT PRICE
TOTAL
UNIT I - WATER
EA
Fire H_ drant
$ 4,060.00
$ (4,060.00)
EA
2" WateNervice
$ 3,614.28
$ (3,614.28)
LF
6" Water Pipe
$ 40.80
$ 2,856.00)
LF
8" PVC Water Pipe
$ 63.24
$ 3,731.16
LF
12" PVC Water Pipe
$ 77.61
$ (109,119.66)
EA
6" Gate Valve
$ 1,390.00
$ (2,780.00)
EA
8" Gate Valve
$ 2,249.00
$ 2,249.00
EA
4"-12" Pressure Plug
$ 327.25
$ 654.50
EA
12" Gate Valve
$ 2,774.85
$ (11,099.40)
EA
Connection to Existin�16" Water Main
$ 7,244.00
$ (7,244.00)
EA
Trench Safety
$ 1.19
$ (1,756.44)
SUBTOTAL UNIT I - WATER IMPROVEMENTS
$ (135,895.12)
You are directed to make the following changes in the contract documents:
CITY BID ITEM
PAY ITEM # # QUANTITY UNIT
UNIT III - DRAINAGE
4 I 3341.0205 I (5) I LF I
You are directed to make the following changes in the contract documents:
CITY BID ITEM
PAY ITEM # # QUANTITY
2 0241.0401 207
3 3213.0104 19
9 3211.0400 25
10 3212.0505 325
*24 0241.1000 1265
*25 3213.0105 1265
*26 0241.0402 162
*27 0241.1100 325
UNIT
UNIT IV - PAVING
SF
SY
TN
SY
SY
SY
SF
SY
ITEM DESCRIPTION
UNIT PRICE TOTAL
24" RCP, Class III I $ 83.00 $ (415.00))
SUBTOTAL UNIT III - DRAINAGE IMPROVEMENTS $ (415.00)
IIII :I LIFA1U*Is]V13N[SP
hP1IlUZI[yCSJf/_1j
Remove Concrete Drive $
9" Conc Pvmt $
Hydrated Lime $
8" Asphalt Base Type B $
Remove Concrete Pavement $
10" Concrete Pavement $
Remove Asphalt Drive $
Remove Asphalt Pavement $
SUBTOTAL UNIT IV - PAVING IMPROVEMENTS
1.55 $ 320.85
3.75 $ 71.25
22.62 $ 565.50
25.74 $ 8,365.50
39.07 $ 49,423.55
107.98 $ 136,594.70
37.57 $ 6,086.34
37.57 $ 12,210.25
$ 213,637.94
Revised: 10-12-2011 Page 2
REASONS FOR CHANGE ORDER Revision to the alignment of the proposed extension of Hemphill Road; Removal of the extension of the proposed water main within Hemphill Road to the existing water
main within future Everman Parkway Right -of -Way; Replacing existing concrete and asphalt pavement along Southwest Drive.
RECOMMENDED:
Kimley-Horn and Associates, Inc.
By: �#
Name: Jeff Landon
Title: Project Engineer
APPROVED:
Fort Worth Everman/Risinger
Development, L
Name: CD
Title: Prp-gidpnUnd ChWanan of the Board
IOU e
1 ".
APPROVED:
Commerce Construction Co., L.P.
' , • _ _ _
Name: John R. BurroUgh�
Title: President
Revised: 10-12-2011 Page 3
PROJECT NAME:
CONTRACT:
CFA #
CITY PROJECT #
FID #
FILE #
INSPECTOR:
PROJECT MANAGER:
ORIGINAL CONTRACT
EXTRAS TO DATE
CREDITS TO DATE
CONTRACT TO DATE
AMOUNT OF PROP. CHANGE ORDER
REVISED CONTRACT AMOUNT
TOTAL REVISED CONTRACT AMOUNT
PER UNIT
REVISED COST SHARE
TOTAL REVISED CONTRACT
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
HEMPHILL ROAD AND STREET A
WATER, SEWER, LIGHTING, PAVING, & DRIANAGE IMPROVEMENTS
CFA21-0137 CITY PARTICIPATION: NO
103517
30114-0200431-103517-EO7685
K-2854
JOSH MANRY Phone No: 817-647-2564
GEORGE MARQUEZ Phone No: 817-392-6826
i
REVIEWED
By George Marqeuez, P.E. at 11:56 am, Feb 23, 2024
CHANGE
ORDER No:
3
CONTRACT UNIT
WATER
SEWER
I PAVING
DRAINAGE
ILLUMINATION
eveloper
I
Developer Cost
City Cost
Cost City Cost
Developer Cost City Cost
Developer Cost
City Cost
Developer Cost
City
$942,648.83 I
$0.00
I $433,873.14 I $0.00
I $653,943.66 $0.00
$1,327,364.69
$0.00
I $374,098.55
I $1
$3,614.28 I
$0.00
I $0.00 I $0.00
I $213,637.94 $0.00
$0.00
$0.00
I $0.00
I $1
$135,895.12 I
$0.00
I $0.00 I $0.00
I $0.00 $0.00
$415.00
$0.00
$0.00
I $1
$810,367.99 I
$0.00
I $433,873.14 I $0.00
I $867,581.60 $0.00
$1,326,949.69
$0.00
I $374,098.55
I $1
$ 598,634.01 I
$0.00
I $ 321,965.63I $0.00
I $ 492,134.08 $0.00
$ 984,654.71
$0.00
$ 277,586.10I
$1
$1,409,002.00 I
$0.00
I $755,838.77 I $0.00
I $1,359,715.68 $0.00
$2,311,604.40
$0.00
I $651,684.65
$1,409,002.00
$755,838.77
$1,359,715.68
$2,311,604.40
$651,684.65
Dev. Cost:
$6,487,845.50
Ci�t:
$0.00 -
$6,487,845.50
Cost
CONTRACT DAYS
231
0
0
231
0
231
Revised: 10-12-2011 Page 1
You are directed to make the following changes in the contract documents
PAY ITEM #
I CITY BID ITEM # I
QUANTITY I
UNIT I
ITEM DESCRIPTION
UNIT PRICE
TOTAL I
UNIT I - WATER
1-1
3305.0103
(3)
EA
Exploratory Excavation of Existing Utilities
$ 4,277.00
$
(12,831.00)1
1-2
3305.1104
(260)
LF
24" Casing By Other Than Open Cut
$ 223.38
$
1-3
3312.0001
(10)
EA
Fire Hydrant
$ 4,060.00
$
�58,078.80)1
40,600.00 1
1-4
3311.0001
(3)
TON
Ductile Iron Water Fittings wl Restraint
$ 15,011.33
$
5(45,033.991r 1
1-5
3312.2203
(6)
EA
2" Water Service
$ 3,614.28
$
(21,685.68�1
1-6
3311.0141
(218)
LF
6" Water Pipe
$ 40.80
$
(8,894.40)1
1-7
3311.0261
(544)
LF
8" PVC Water Pipe
$ 63.24
$
(34,402.56)1
1-8
3311.0451
(260)
LF
12" DIP Water
$ 107.30
$
(27,898.001r 1
1-9
3311.0461
(5283)
LF
12" PVC Water Pipe
$ 77.61
$
(410,013.63)1
1-10
3312.3002
(9)
EA
6" Gate Valve
$ 1,390.00
$
(12,510.00)1
1-11
3312.3003
(12)
EA
8" Gate Valve
$ 2,249.00
$
26,988.00 1
1-12
241.1118
(13)
EA
4"-12" Pressure Plug
$ 327.25
$
(4,254.25)1
1-13
3312.3005
(31)
EA
12" Gate Valve
$ 2,774.85
$
(86,020.35)1
1-15
3312.0117
(2)
EA
Connection to Existing 4"-12" Water Main
$ 3,181.00
$
5(6,362.00)1
1-16
3312.4107
(11)
EA
12" x 8" Tapping Sleeve & Valve
$ 424.38
$
(4,668.18)1
1-17
3305.0109
(5473)
LF
Trench Safety
$ 1.19
$
(6,512.87)1
*1-19
3305.0103
3
EA
Exploratory Excavation of Existing Utilities
$ 7,450.74
$
22,352.221
*1-20
3305.1104
260
LF
24" Casing By Other Than Open Cut
$ 389.14
$
101,176.401
*1-21
3312.0001
10
EA
Fire Hydrant
$ 7,072.71
$
70,727.101
*1-22
3311.0001
3
TON
Ductile Iron Water Fittings wl Restraint
$ 26,150.46
$
78,451.381
*1-23
3312.2203
6
EA
2" Water Service
6,296.25
$
37,777.501
*1-24
3311.0141
218
LF
6" Water Pipe
1 71.08
$
15,495.441
*1-25
3311.0261
544
LF
8" PVC Water Pipe
$ 110.17
$
59,932.481
*1-26
3311.0451
260
LF
12" DIP Water
$ 186.92
$
48,599.201
*1-27
3311.0461
5,283
LF
12" PVC Water Pipe
$ 135.20
$
714,261.601
*1-28
3312.3002
9
EA
6" Gate Valve
$ 2,421.45
$
21,793.051
*1-29
3312.3003
12
EA
8" Gate Valve
$ 3,917.87
$
47,014.441
*1-30
241.1118
13
EA
4"-12" Pressure Plug
$ 570.09
$
7,411.171
*1-31
3312.3005
31
EA
12" Gate Valve
$ 4,833.92
$
149,851.521
*1-32
3312.0117
2
EA
Connection to Existing 4"-12" Water Main
$ 5,541.46
$
11,082.921
*1-33
3312.4107
11
EA
12" x 8" Tapping Sleeve & Valve
$ 739.29
$
8,132.191
*1-34
3305.0109
5,473
LF
Trench Safety
$ 2.07
$
11,329.111
SUBTOTAL UNIT I - WATER IMPROVEMENTS
$
598,634.01 1
Revised: 10-12-2011 Page 2
You are directed to make the following changes in the contract documents
PAY ITEM #
I CITY BID ITEM # I
QUANTITY I
UNIT I
ITEM DESCRIPTION
UNIT PRICE
TOTAL I
UNIT II - SEWER
2-1
3331.4115
(1542)
LF
8" Sewer Pipe
$ 13.70
$
(21,125.40) 1
2-2
3331.4201
(2262)
LF
10" Sewer Pipe
$ 50.68
$
(114,638.16)1
2-3
3331.4116
(80)
LF
8" Sewer Pipe, CSS Backfill
$ 40.93
$
(3,274.40)1
2-4
3331.4202
(104)
LF
10" Sewer Pipe, CSS Backfill
$ 63.57
$
(6,611.28)1
2-5
3339.1001
(15)
EA
4' Manhole
$ 4,239.80
$
(63,597.00)1
2-6
3339.1002
(3)
EA
4' Drop Manhole
$ 3,628.00
$
(10,884.00
2-8
241.2201
(8)
EA
Remove 4' Sewer Manhole
$ 1,219.99
$
(9,759.92��
2-9
3339.0001
(67)
VF
Epoxy Manhole Liner
$ 236.12
$
(15,820.04
2-10
241.2014
(5167)
LF
Remove 10" Sewer Line
$ 34.98
$
(180,741.66�
2-11
3301.0101
(18)
EA
Manhole Vacuum Testing
$ 137.56
$
(2,476.08)1
2-12
3301.0002
(3804)
LF
Post -CCTV Ins ection
$ 0.65
$
2,472.60)1
2-13
3305.0109
(3804)
LF
Trench Safety
$ 0.65
$
(2,472.60)1
*2-14
3331.4115
1542
LF
8" Sewer Pipe
$ 23.87
$
36,807.541
*2-15
3331.4201
2262
LF
10" Sewer Pipe
$ 88.29
$
199,711.981
*2-16
3331.4116
80
LF
8" Sewer Pipe, CSS Backfill
$ 71.30
$
5,704.001
*2-17
3331.4202
104
LF
10" Sewer Pipe, CSS Backfill
$ 110.74
$
11,516.961
*2-18
3339.1001
15
EA
4' Manhole
$ 7,385.93
$
110,788.951
*2-19
3339.1002
3
EA
4' Drop Manhole
$ 6,320.15
$
18,960.451
*2-20
241.2201
8
EA
Remove 4' Sewer Manhole
$ 2,125.28
$
17,002.241
*2-21
3339.0001
67
VF
Epoxy Manhole Liner
$ 411.33
$
27,559.111
*2-22
241.2014
5167
LF
Remove 10" Sewer Line
$ 60.94
$
314,876.981
*2-23
3301.0101
18
EA
Manhole Vacuum Testing
$ 239.64
$
4,313.521
*2-24
3301.0002
3804
LF
Post -CCTV Ins ection
$ 1.13
$
4,298.521
*2-25
3305.0109
3804
LF
Trench Safety
$ 1.13
$
4,298.521
SUBTOTAL UNIT II - SEWER IMPROVEMENTS
$
321,965.63 1
Revised: 10-12-2011 Page 3
You are directed to make the following changes in the contract documents
PAY ITEM #
I CITY BID ITEM # I
QUANTITY I
UNIT
ITEM DESCRIPTION
UNIT PRICE
TOTAL I
UNIT II -DRAINAGE
3-1
3137.0104
(346)
SY
Medium Stone Riprap, dry
$ 77.76
$
(26,904.96)1
3-2
3301.0012
(3898)
LF
Post CCTV Inspection of Storm Drain
$ 0.96
$
(3,742.08)1
3-3
3341.0201
(470)
LF
21" RCP, Class III
$ 55.06
$
(25,878.20)1
3-4
3341.0205
(655)
LF
24" RCP, Class III
$ 83.00
$
(54,365.00)1
3-5
3341.0309
(68)
LF
36" RCP, Class III
$ 125.00
$
(8,500.00)1
3-6
3341.0302
(145)
LF
30" RCP, Class III
$ 218.00
$
(31610.00
3-7
3341.0409
(792)
LF
48" RCP, Class III
$ 276.00
$
(218:592.00�
3-8
3341.0502
(204)
LF
54" RCP, Class III
$ 295.00
$
((60,180.00)1
3-9
3341.0602
(117)
LF
60" RCP, Class III
$ 352.00
$
(41,184.00)1
3-10
3341.0701
(1119)
LF
72" RCP, Class III
$ 414.00
$
5(463,266.00 1
3-11
3341.1403
(323)
LF
7 x 5 Box Culvert
$ 523.00
$
(168,929.00) j
3-12
3349.0002
(5)
EA
5' Storm Junction Box
$ 5,914.05
$
(29,570.251 1
3-13
3349.0003
(1)
EA
6' Storm Junction Box
$ 7,096.80
$
(7,096.8%
3-14
3349.0005
(5)
EA
8' Storm Junction Box
$ 9,462.48
$
((47,312.40
3-15
3339.1001
(3)
EA
4' Manhole
$ 9,953.00
$
(29,859.00�
3-16
3339.1101
(1)
EA
5' Manhole
$ 7,465.00
$
(7,465.00)1
3-17
3349.6001
(7)
EA
10' Recessed Inlet
$ 8,925.00
$
(62,475.00)1
3-18
3349.6003
(1)
EA
20' Recessed Inlet
$ 9,695.00
$
(9,695.00)1
3-19
(1)
EA
TXDOT FW-0 Headwall
$ 15,245.00
$
(15,245.00)1
3-20
(1)
EA
TXDOT CH-FW-0 Headwall
$ 15,080.00
$
(15,080.00)1
*3-21
3137.0104
346
SY
Medium Stone Riprap, dry
$ 135.46
$
46,869.161
*3-22
3301.0012
3,898
LF
Post CCTV Inspection of Storm Drain
$ 1.67
$
6,509.661
*3-23
3341.0201
470
LF
21" RCP, Class III
$ 95.92
$
45,082.401
*3-24
3341.0205
655
LF
24" RCP, Class III
$ 144.59
$
94,706.451
*3-25
3341.0309
68
LF
36" RCP, Class III
$ 217.76
$
14,807.681
*3-26
3341.0302
145
LF
30" RCP, Class III
$ 379.77
$
55,066.651
*3-27
3341.0409
792
LF
48" RCP, Class III
$ 480.81
$
380,801.521
*3-28
3341.0502
204
LF
54" RCP, Class III
$ 513.90
$
104,835.601
*3-29
3341.0602
117
LF
60" RCP, Class III
$ 613.20
$
71,744.401
*3-30
3341.0701
1,119
LF
72" RCP, Class III
$ 721.21
$
807,033.991
*3-31
3341.1403
323
LF
7 x 5 Box Culvert
$ 911.09
$
294,282.071
*3-32
3349.0002
5
EA
5' Storm Junction Box
$ 10,302.56
$
51,512.801
*3-33
3349.0003
1
EA
6' Storm Junction Box
$ 12,362.97
$
12,362.971
*3-34
3349.0005
5
EA
8' Storm Junction Box
$ 16,484.09
$
82,420.451
*3-35
3339.1001
3
EA
4' Manhole
$ 17,338.60
$
52,015.801
*3-36
3339.1101
1
EA
5' Manhole
$ 13,004.39
$
13,004.391
*3-37
3349.6001
7
EA
10' Recessed Inlet
$ 15,547.38
$
108,831.661
*3-38
3349.6003
1
EA
20' Recessed Inlet
$ 16,889.15
$
16,889.151
*3-39
1
EA
TXDOT FW-0 Headwall
$ 26,557.52
$
26,557.521
*3-40
1
EA
TXDOT CH-FW-0 Headwall
$ 26,270.08
$
26,270.081
SUBTOTAL UNIT III - DRAINAGE IMPROVEMENTS
$
984,654.71 1
Revised: 10-12-2011 Page 4
You are directed to make the following changes in the contract documents
PAY ITEM #
I CITY BID ITEM # I
QUANTITY I
UNIT
ITEM DESCRIPTION
UNIT PRICE
TOTAL I
UNIT V - PAVING
4-1
171.0102
(1)
LS
As -Built Survey
$ 3,930.00
$
(3,930.00)1
4-2
241.0401
(16641)
SF
Remove Concrete Drive
$ 1.55
$
525,793.551
4-3
3213.0104
(15268)
SY
9" Conc Pvmt
$ 3.75
$
(57,255.00)
4-4
3110.0101
(1)
LS
Site Clearing
$ 1,704.00
$
(1,704.00)1
4-5
3123.0101
(17923)
CY
Unclassified Excavation by Plan
$ 5.20
$
(93,199.60)1
4-6
3124.0101
(15507)
CY
Embankment by Plan
$ 5.40
$
583,737.801r
4-7
3123.0103
(2416)
CY
Borrow by Plan
$ 12.54
$
(30,296.64)
4-8
3125.0101
(1)
LS
SWPPP >_ 1 acre
$ 5,240.00
$
(5,240.00)1
4-9
3211.0400
(2495)
TN
Hydrated Lime
$ 22.62
$
(56,436.90)1
4-10
3212.0505
(828)
SY
8" Asphalt Base T_.1pe B
$ 25.74
$
(21,312.721r 1
4-11
3213.0301
(42214)
SF
4" Conc Sidewalk
$ 4.99
$
(210,647.86) 1
4-12
3213.0506
(7)
EA
Barrier Free Ramp, Type P-1
$ 3,575.00
$
(25 025.00)1
4-13
3217.0001
(285)
LF
4" SLD Pvmt Marking HAS W)
$ 1.90
$
(541.50)1
4-14
3217.0002
(6477)
LF
4" SLID Pvmt Marking HAS Y%,
$ 1.90
$
(12,306.30 1
4-15
3217.0201
(571)
LF
8" SLD Pvmt Marking HAS W)
$ 3.00
$
(1,713.0%
4-16
3217.0202
(94)
LF
8" SLD Pvmt Marking HAS Y
$ 3.00
$
(282.00)1
4-17
3217.0004
(300)
LF
4" BRK Pvmt Marking HAS
$ 1.90
$
570.00)1
4-18
3217.0003
(195)
LF
4" BRK Pvmt Marking HAS W
$ 1.90
$
((370.50)1
4-19
3217.0501
(105)
LF
24" SLD Pvmt Marking HAE )
$ 6.00
$
(630.00)1
4-20
3292.01
(5620)
SY
Block Sod Placement
$ 2.92
$
(16,410.40�1
4-21
3441.4003
(7)
EA
Furnish/Install Alum Sign Ground Mount City Std.
$ 928.57
$
(6,499.99 �
4-22
3471.0001
(1)
MO
Traffic Control
$ 8,500.00
$
(8,500.00)1
4-23
9999.0001
(5,400)
SF
Remove Gravel Drive
$ 0.16
$
(864.00)1
*4-28
171.0102
1
LS
As -Built Survey
$ 6,846.25
$
6,846.251
*4-29
241.0401
16641
SF
Remove Concrete Drive
$ 2.70
$
44,930.701
*4-30
3213.0104
15268
SY
9" Conc Pvmt
$ 6.53
$
99,700.041
*4-31
3110.0101
1
LS
Site Clearing
$ 2,968.45
$
2,968.451
*4-32
3123.0101
17923
CY
Unclassified Excavation by Plan
$ 9.06
$
162,382.381
*4-33
3124.0101
15507
CY
Embankment by Plan
$ 9.41
$
145,920.871
*4-34
3123.0103
2416
CY
Borrow by Plan
$ 21.85
$
52,789.601
*4-35
3125.0101
1
LS
SWPPP z 1 acre
$ 9,128.33
$
9,128.331
*4-36
3211.0400
2495
TN
Hydrated Lime
$ 39.41
$
98,327.951
*4-37
3212.0505
828
SY
8" Asphalt Base Type B
$ 44.84
$
37,127.521
*4-38
3213.0301
42214
SF
4" Conc Sidewalk
$ 8.69
$
366,839.661
*4-39
3213.0506
7
EA
Barrier Free Ramp, Type P-1
$ 6,227.82
$
43,594.741
*4-40
3217.0001
285
LF
4" SLD Pvmt Marking HAS W
$ 3.31
$
943.351
*4-41
3217.0002
6477
LF
4" SLD Pvmt Marking HAS
$ 3.31
$
21,438.871
*4-42
3217.0201
571
LF
8" SLD Pvmt Marking HAS W
$ 5.23
$
2,986.331
*4-43
3217.0202
94
LF
8" SLD Pvmt Marking HAS M$
5.23
$
491.621
*4-44
3217.0004
300
LF
4" BRK Pvmt Marking HAS Y
$ 3.31
$
993.001
*4-45
3217.0003
195
LF
4" BRK Pvmt Marking HAS )
$ 3.31
$
645.451
*4-46
3217.0501
105
LF
24" SLID Pvmt Marking HAE (W)
$ 10.45
$
1,097.251
*4-47
3292.01
5620
SY
Block Sod Placement
$ 5.09
$
28,605.801
*4-48
3441.4003
7
EA
Furnish/Install Alum Si Ground Mount City Std.
$ 1,617.61
$
11,323.271
*4-49
3471.0001
1
MO
Traf is Control
$ 14,807.41
$
14,807.411
*4-50
9999.0001
5400
SF
Remove Gravel Drive
$ 0.28
$
1,512.001
SUBTOTAL UNIT IV - PAVING IMPROVEMENTS
$
492,134.08 1
Revised: 10-12-2011 Page 5
You are directed to make the following changes in the contract documents
PAY ITEM #
I CITY BID ITEM # I
QUANTITY I
UNIT I
ITEM DESCRIPTION
UNIT PRICE
TOTAL I
UNIT V - STREET LIGHTING
5-1
2605.3014
(20)
LF
2" CONDT RM (Riser)
$ 206.09
$
(4,121.80)1
5-2
2605.3015
(3375)
LF
2" CONDT PVC SCH 80 ((T
$ 53.95
$
(182,081.25)1
5-3
2605.3016
(490)
LF
2" CONDT PVC SCH 80 (B�
$ 62.95
$
(30,845.50)1
5-4
3305.0103
(50)
EA
Exploratory Excavation of Existing Utilities
$ 300.00
$
((15,000.00 1
5-5
3441.1502
(19)
EA
Ground Box Type B, w/Apron
$ 1,140.00
$
(21,660.00)j
5-6
3441.1645
(17)
EA
Furnish/Install Type 33A Arm
$ 450.00
$
(7,650.00)1
5-7
3441.1772
(1)
EA
Furnish/Install 240-480 Volt Single Phase Metered Pedestal
$ 11,400.00
$
(11,400.00)1
5-8
3441.3201
(17)
EA
LED Lighting Fixture
$ 1,020.00
$
((17,340.00 1
5-9
3441.3302
(14)
EA
Rdwy Ilium Foundation TY 3,5,6, and 8
$ 2,100.00
$
(29,400.00)1
5-10
3441.3352
(14)
EA
Furnish/Install Rdway Ilium TY 18 Pole
$ 3,900.00
$
(54,600.00) 1
*5-11
2605.3014
20
LF
2" CONDT RM (Riser)
$ 359.02
$
7,180.401
*5-12
2605.3015
3375
LF
2" CONDT PVC SCH 80 (T)
$ 93.98
$
317,182.501
*5-13
2605.3016
490
LF
2" CONDT PVC SCH 80 (B)
$ 109.66
$
53,733.401
*5-14
3305.0103
50
EA
Exploratory Excavation of Existing Utilities
$ 522.61
$
26,130.501
*5-15
3441.1502
19
EA
Ground Box Type B, w/Apron
$ 1,985.93
$
37,732.671
*5-16
3441.1645
17
EA
Furnish/Install Type 33A Arm
$ 783.92
$
13,326.641
*5-17
3441.1772
1
EA
Furnish/Install 240-480 Volt Single Phase Metered Pedestal
$ 19,859.35
$
19,859.351
*5-18
3441.3201
17
EA
LED Lighting Fixture
$ 1,776.89
$
30,207.131
*5-19
3441.3302
14
EA
Rdwy Ilium Foundation TY 3,5,6, and 8
$ 3,658.30
$
51,216.201
*5-20
3441.3352
14
EA
Furnish/Install Rdway Ilium TY 18 Pole
$ 6,793.99
$
95,115.861
SUBTOTAL UNIT V - STREET LIGHTING IMPROVEMENTS
$
277,586.10 1
Revised: 10-12-2011 Page 6
REASONS FOR CHANGE ORDER
Revision to unit prices from the executed CFA; Contract days added
RECOMMENDED:
Kimley-Horn and Associates, Inc.
By: (�#
Name: Jeff Landon
Title: Project Enqineer
APPROVED:
Fort Worth Everman/Risinger
Development, L /�
BY: v iy/
Name: r:nWA.RD R ROSK!, JR.
Title: President and Chairman of the Board
APPROVED:
Commerce Construction Co., L.P.
BY: /
Name: John R. Burr hs
Title: President
Revised: 10-12-2011 Page 7
FORT WORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: Hemphill Road and Street A
CITY PROJECT NUMBER: 103517
WATER
PIPE LAID SIZE TYPE OF PIPE LF
6" Water Pipe 6" PVC 218
8" Water Pipe 8" PVC 544
12" Water Pipe 12" DIP 260
12" Water Pipe 12" PVC 5283
FIRE HYDRANTS: 10 VALVES (16" OR LARGER) NA
PIPE ABANDONED SIZE TYPE OF PIPE LF
NA
DENSITIES:
Yes
NEW SERVICES:
2" Service
Copper
7 ea
1.5" Service
Copper
1 ea
SEWER
PIPE LAID
SIZE
TYPE OF PIPE
LF
8" Sewer Pipe
8"
SDR-26 PVC
1622
10" Sewer Pipe
10"
SDR-26 PVC
2366
PIPE ABANDONED SIZE TYPE OF PIPE LF
NA
DENSITIES: Yes
NEW SERVICES: N/A
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
FORTWORTH.
M"
TRANSPORTATION AND PUBLIC WORKS
March 5, 2024
Commerce Construction Co. LP
13191 Crossroads Parkway N. 6t" FI
City of Industry, CA 91746
RE: Acceptance Letter
Project Name: Hemphill Road and Street A
Project Type: 01, 02, 03, 04, 06
City Project No.: 103517
To Whom It May Concern:
On February 1, 2024 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 March 5, 2024. 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 March 5, 2024, 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-
392-6826.
Sincerely,
George Marquez, Project Manager
Cc: Joshua Manry, Inspector
Troy Gardner, Inspection Supervisor
Cody Horton, Senior Inspector
Andrew Goodman, Program Manager
Kimley Horn, Consultant
Commerce Construction Co. LP, Contractor
Fort Worth Everman/Risinger Development LLC, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
JECOMMERCE
CONSTRUCTION CO., L.P.
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
131 E. Exchange Avenue, Suite 220
Fort Worth, TX 76164
(972) 726-0700
Before me, the undersigned authority, a notary public in the state
and county aforesaid, on this day personally appeared Dan Bell, VP,
District Manager Of Commerce Construction Co. L.P., 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;
13513 FWS IRPC
City Project # 103517, CFA21-0137
Dan Bell, VP, District Manager
CommerceLP.com
Subscribe4 and sworn before me on this date 26th of February, 2024.
Notary Public
Tarrant County, TX aTYR
ICIA JOYCE sHEFFIELD
NotryID 4 6491003
MExpiresFebruary 27, 2027
COMMERCE CONSTRUCTION CO., L.P.
131 E. Exchange Avenue, Suite 220 - Fort Worth, TX 76164
Office (972) 726-0700 - FAX (972) 232-3761
NOTICE:
This document waives rights unconditionally and states that you have been paid for giving up those
rights. It is prohibited for a person to require you to sign this document if you have not been paid the
payment amount set forth below. If you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project FWS Ph2 IPRC
Job No. 13513
The signer of this document has been paid in full for all labor, services, equipment, or materials
furnished to the property or to Commerce Construction Co., L.P. (person with whom signer
contracted) on the property of Fort Worth Everman/Risinger Development LLC (Owner) located at
W. Risinger & Hemphill St, Fort Worth, T (location) to the following extent: ,� r
ob description). The signer therefore waives and releases an mechanic's lien right, a��ht arisen
p� )� I; Y g y l; g
from a payment bond that complies with a state or federal statute, any common law payment bond
right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim
or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received from this progress
payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers
for all work, materials, equipment, or services provided for or to the above referenced project up to the
date of this waiver and release. 2
Date: o`(o
Company Name: _ ,
Signature:
By: (name and title) &j ,Jo"aA
STATE OF TEXAS §
COUNTY OF §
This instrument was acknowledged before me on this day of Ct&Lgza , 20_2?y
by (name), 01JYLe r- (job title)
Of 5C S An &A /-,IAdZALFA . (co pa name).
NOTARY PUBLIC, STATE OF TEXAS
230d Unconditional on Final TX (6/21) Fe
MELANIE DURKEE
NO o iD #129ssion 67215
xpireµy Cortamltstan Expires
October 17, 2026
"'e
Ic
COMMERCE CONSTRUCTION CO., L.P.
131 E. Exchange Avenue, Suite 220 - Fort Worth, TX 76164
Office (972) 726-0700 - FAX (972) 232-3761
NOTICE:
This document waives rights unconditionally and states that you have been paid for giving up those
rights. It is prohibited for a person to require you to sign this document if you have not been paid the
payment amount set forth below. If you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project FWS Ph2 IPRC
Job No. 13513
The signer of this document has been paid in full for all labor, services, equipment, or materials
furnished to the property or to Commerce Construction Co., L.P. (person with whom signer
contracted) on the property of Fort Worth Everman/Risinger Development LLC (owner) located at
W. Risinger & Hemphill St. Fort Worth, (location) to the following extent: Electrical
(job description). The signer therefore waives and releases any mechanic's lien right, any right arising
from a payment bond that complies with a state or federal statute, any common law payment bond
right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim
or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received from this progress
payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers
for all work, materials, equipment, or services provided for or to the above referenced project up to the
date of this waiver and release.
Date: 2/23/24
Company Name: Core Electric TX
Signature:
By: (name and title) Mark Purvis President
STATE OF TEXAS §
COUNTY OF -1`"rVVJ §
This in trument was acknowledged before me on thirsta3rJ day ofPtbrmcr, , 20
by %:.-�2a�+ (name), / VC per, 6 1 r C 00b title)
of (c
cy 7►- �exu S
Y )
BRANDON LEE SLOAN
Notary Public, State of Texas
My Commission Expires
„� s ?� 2 7 __ NOTARY PUBLIC, STATE OF TEXAS
230d Unconditional on Final TX (6/21)
COMMERCE CONSTRUCTION CO., L.P.
131 E. Exchange Avenue, Suite 220 - Fort Worth, TX 76164
Office (972) 726-0700 - FAX (972) 232-3761
NOTICE:
This document waives rights unconditionally and states that you have been paid for giving up those
rights. It is prohibited for a person to require you to sign this document if you have not been paid the
payment amount set forth below. If you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project SFW PH 2 IPRC Sitework
Job No. 13513
The signer of this document has been paid in full for all labor, services, equipment, or materials
furnished to the property or to Commerce Construction Co., L.P. (person with whom signer
contracted) on the property of Fort Worth Everman Risinger Dev LLC (owner) located at
Risinger Rd & Hemphill St., Fort Worth (location) to the following extent: SFW PH2 IPRC
(job description). The signer therefore waives and releases any mechanic's lien right, any right arising
from a payment bond that complies with a state or federal statute, any common law payment bond
right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim
or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received from this progress
payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers
for all work, materials, equipment, or services provided for or to the above referenced project up to the
date of this waiver and release.
Date: 02/26/2024
Company Name: Earth asks on, c ng Corp.
Signature:
.�
By: (name and title) Ti odside, Controller
STATE OF TEXAS §
COUNTY OF §
This instrument was acknowledged before me on this ay of , 20
by (name), � Qob title)
of . (company name).
230d Unconditional o
NOTARY PUBLIC, STATE OF TEXAS
HED CA NOTARY
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Orange
On 02/26/2024 before me,
Date
personally appeared Tina Woodside
Nohel A. Meiia. Notary Public
Here Insert Name and Title of the Officer
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s),
or the entity upon behalf of which the person(s) acted, executed the instrument.
NOHEL A. MEJIA
��- Notary Public - California r Los Angeles County
' Commission # 2339717
' My Comm, Expires Dec 8, 2024 `
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and offic'pi
Signature
Signature oI�F� a ublic
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
:F.>[=G.�4`CG�t`c4`C�:`�JG%G`�Ge'.4`c%4e:.f..'�:�C.`c{:[=<.`�`r,{".t_'T'%'_I'fn-":CG'[:<Jc%C.`e:..�.uw. ,,www�r�.•..w...:.,.:�..:� �.�.,...�...vr�(:�Grl1�:t
02014 National Notary Association • www.NabonalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
Ic
COMMERCE CONSTRUCTION CO., L.P.
131 E. Exchange Avenue, Suite 220 - Fort Worth, TX 76164
Office (972) 726-0700 - FAX (972) 232-3761
NOTICE:
This document waives rights unconditionally and states that you have been paid for giving up those
rights. It is prohibited for a person to require you to sign this document if you have not been paid the
payment amount set forth below. If you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project FWS Ph2 IPRC
Job No. 13513
The signer of this document has been paid in full for all labor, services, equipment, or materials
furnished to the property or to Commerce Construction Co., L.P. (person with whom signer
contracted) on the property of Fort Worth Everman/Risinger Development LLC (owner) located at
W. Risinger & Hemphill St. Fort Worth,ri (location) to the following extent: Paving improvements for Hemphill Rd & Streeli
(job description). The signer therefore waives and releases any mechanic's lien right, any right arising
from a payment bond that complies with a state or federal statute, any common law payment bond
right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim
or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received from this progress
payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers
for all work, materials, equipment, or services provided for or to the above referenced project up to the
date of this waiver and release.
STATE OF TEXAS
COUNTY OF Tarrant
Date:
Company Name:
Signature:
By: (name and title)
§
02/23/2024
Ja on Construction, Ltp
Carmen Estep, Office Manager
This instrument was acknowledged before me on this 23rd day of February , 2024_
by Carmen EsteD (name), Office Manaaer (job title)
Of (company name).
Nicole McCollum M
My C �I/(/
Fa-
1 Expires
0/30/2026 r
Notary ID129952646 NOTARY PUBLIC, STATE OF TEXAS
1 -
230d Unconditional on Final TX (6/21)
Ic
COMMERCE CONSTRUCTION CO., L.P.
131 E. Exchange Avenue, Suite 220 - Fort Worth, TX 76164
Office (972) 726-0700 - FAX (972) 232-3761
NOTICE:
This document waives rights unconditionally and states that you have been paid for giving up those
rights. It is prohibited for a person to require you to sign this document if you have not been paid the
payment amount set forth below. If you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project FWS Ph2 IPRC
.lob No. 13513
The signer of this document has been paid in full for all labor, services, equipment, or materials
furnished to the property or to Commerce Construction Co., L.P. (person with whom signer
contracted) on the property of Fort Worth Everman/Risinger Development LLC (owner) located at
W. Risinger & Hemphill St. Fort Worth, T (location) to the following extent: Fence
(job description). The signer therefore waives and releases any mechanic's lien right, any right arising
from a payment bond that complies with a state or federal statute, any common law payment bond
right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim
or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received from this progress
payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers
for all work, materials, equipment, or services provided for or to the above referenced project up to the
date of this waiver and release.
Date:
Company Name:
Signature:
By: (name and title)
STATE OF TEXAS §
COUNTY OF Imam— §
2-123lem
Rustic Fence Specialists, Inc
Edga�lar, , Pro' ct Manager
This instrument was acknowledged before me on this 79, day of W, 20 2-4
by ^ { jr' (name),lu
� Q. (� YYIi�(]�(�f� fob title)
of U. ,r �eya q iv S, inr (company name)).
OTARY PUBLIC, STATE OF TEXAS
230d Unconditional on Final TX (6/21)
=o�- i+ Lesley Rivera
%•: ;� 0lJcB/202a Fxp s
2 ID No. 132432376
Ic
COMMERCE CONSTRUCTION CO., L.P.
131 E. Exchange Avenue, Suite 220 - Fort Worth, TX 76164
Office (972) 726-0700 - FAX (972) 232-3761
NOTICE:
This document waives rights unconditionally and states that you have been paid for giving up those
rights. It is prohibited for a person to require you to sign this document if you have not been paid the
payment amount set forth below. If you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project SFW PH2 IPRC Sitework
Job No. 13513
The signer of this document has been paid in full for all labor, services, equipment, or materials
furnished to the property or to Commerce Construction Co., L.P. (person with whom signer
contracted) on the property of Fort Worth Everman/Risinger Development LLC (owner) located at
W. Risinger Rd & Hemphill Rd, Ft Worth (location) to the following extent: Pavement Markings and Signage
(job description). The signer therefore waives and releases any mechanic's lien right, any right arising
from a payment bond that complies with a state or federal statute, any common law payment bond
right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim
or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received from this progress
payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers
for all work, materials, equipment, or services provided for or to the above referenced project up to the
date of this waiver and release.
Date:
Company Name:
Signature:
By: (name and title)
STATE OF TEXAS
COUNTY OF
I, 1 z cl I za z3
Tru Line Servicgs
Gregory Fryman - Owner
This instrument was acknowledged before me on this a2ll""day of Q f203
by G C e � (— �.-� n� Oti (\ (name), Q �,,,J r) (_1 (job title)
of C J In2 2C C (company name).
ELIZASETI ^,EED
Y [+
Notary Public. State ut Texas
c.,,mm. Expires n7-05-2027 NOTAOYPUBLIC, STATE OF TEXAS
Notary ID 1 :' 38651
230d Unconditional on Final TX (6/21)
COMMERCE CONSTRUCTION CO., L.P.
131 E. Exchange Avenue, Suite 220 - Fort Worth, TX 76164
Office (972) 726-0700 - FAX (972) 232-3761
NOTICE:
This document waives rights unconditionally and states that you have been paid for giving up those
rights. It is prohibited for a person to require you to sign this document if you have not been paid the
payment amount set forth below. if you have not been paid, use a conditional release form.
UNCONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
Project FWS Ph2 IPRC
Job No. 13513
The signer of this document has been paid in full for all labor, services, equipment, or materials
furnished to the property or to Commerce Construction Co., L.P. (person with whom signer
contracted) on the property of Fort Worth Everman/Risinger Development LLC (owner) located at
W. Risinger & Hemphill St. Fort Worth, 7 (location) to the following extent: labor & Materials for Site Utilities
(job description). The signer therefore waives and releases any mechanic's lien right, any right arising
from a payment bond that complies with a state or federal statute, any common law payment bond
right, any claim for payment, and any rights under any similar ordinance, rule, or statute related to claim
or payment rights for persons in the signer's position.
The signer warrants that the signer has already paid or will use the funds received from this progress
payment to promptly pay in full all of the signer's laborers, subcontractors, materialmen, and suppliers
for all work, materials, equipment, or services provided for or to the above referenced project up to the
date of this waiver and release.
Date:
Company Name:
Signature:
By: (name and title)
STATE OF TEXAS §
COUNTY OF 1 Arra'"k §
February 26th, 2024
Wri ht Construction Inc.
Kevin Littlefield 1 Controller/
This instrument was acknowledged before me on this Zlr+h day of �c Ko►+��20 ; '
b LJ�1n _�..r-1.1e.�ic.1� —__ >1.r'v1�c,r — y _ _ � _ _ ________ (name), �.p _ _ (job title)
fin_ -- (company name).---- —
of ,�r.�,�t _� vtn��ruc.�-� _ �v�.t�
NOTARY PUBLIC, STATE 00 TEXAS
230d Unconditional on Final TX (6/211
LeeAnn Lindsey -
Notary ID # 1205931-8
e My Commission Expires
me 08/07/2024 _
rd1, . 11111 11 11 1, 1$ 1 ' P,11 1 ,D
CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
Conforms with the American institute of
Architects, AIA Document G707
OWNER
❑
ARCHITECT
❑
CONTRACTOR
❑
SURETY
0
OTHER
Bond No 024257918
PROJECT:
(name, addres5)Fort Worth South Business Park Addition
TO (Owner)
Water, Sanitary Sewer
TX
FORT WORTH EVERMANIRISINGER DEVELOPMENT, l ARCHITECT'S PROJECT NO:
LLC AND THE CITY OF FORT WORTH CONTRACT FOR:
131 E. Exchange Ave., Suite 212 Water, Sanitary Sewer to serve Hempphill Road & Street A, Fort Worth
South Business Park Addition, Lots 1,2,3, Block 2, Lots 1,2, Block 3,
Fort Worth TX 76164 � CoGNTRACTit�PAfEct 103517
CONTRACTOR: COMMERCE CONSTRUCTION CO., L.P.
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the
there insert name and address of Surety Company)
LIBERTY MUTUAL INSURANCE COMPANY
175 Berkeley Street
Boston MA 02117 , SURETY COMPANY
on bond of (here insert name and address of Contractor►
COMMERCE CONSTRUCTION CO., L.P.
13191 Crossroads Parkway North, 6th Floor
City of Industry CA 91746
,CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve
the Surety Company of any of its obligations to (here insert name and address of Owner►
FORT WORTH EVERMANIRISINGER DEVELOPMENT, LLC AND THE CITY OF FORT WORTH
131 E. Exchange Ave., Suite 212
Fort Worth TX 76164
as set forth in the said Surety Company's bond.
IN WITNESS, WHEREOF,
the Surety Company has hereunto set its hand this
Attest:�MZ
(Seal):
8th day of March, 2024
LIBERTY MUTUAL INSURANCE COMPANY
Surety Qyppanyy
Signature of Authorized Representative
Tracv Aston
Title
, OWNER,
Attorney -in -Fact
NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A Notary Public or other officer completing this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached, and not the truthfulness,
accuracy, or validity of that document.
State of California
County of Los Angeles
On MAR'_ 8 2024 before me, Becky Gomez, Notary Public, personally appeared
Tracy Aston who proved to me on the basis of satisfactory evidence to be the
person{} whose name(o is/are subscribed to the within instrument and acknowledged to me that
he/she/they executed the same in authorized capacity4es), and that by 1/herb
signature{} on the instrument the person{fi}, or the entity upon behalf of which the person)
acted, executed the instrument.
*my
BECKY GOMEZ
Notary Puhlsc • CaliforniaOrange CountyCommission A*24559/4
Comm, Expires Jul 30, 2027
I certify under PENALTY OF PERJURY under the laws of the
State of California that the foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Signature YJ4 �j
SignaturAf Notary Public
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated,
Liberty Liberty Mutual insurance Company
Mutum. The Ohio Casualty Insurance Company Certificate No: 8210628-024029
SURETYWest American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint.
Mary Y. Volmar; Meghan Rare Rosa E. Rivas-, Samantha Russell; Tracy Aston; Vanessa Fong
all of the city of l.os Ail-eles state of CA each individually if there be more than one named, its true and lawful attorney -in -fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 18th day of August , 2023
Liberty Mutual Insurance Company
P� INSU�y,� Po"I INS&,p a tt4supq The Ohio Casualty Insurance Company
j =66RraR,y��a'L�t6 gJa���PORAJEa yCPz�Apo�4loym West American Insurance Company
1912 0 1919 0 2 1991 0
`n Y q fiq s yfi �� n a o�� rri ppE
p�j ��SSacnus� da O NAMPS� dD� is NorANP aa1� ���� ` L U
0x1 * �� °'Nt * >� �'M * 1 By: sa
c� David M. Carey, Assistant Secretary c �
ro State of PENNSYLVANIA ss �
County of MONTGOMERY o
On this I xth day of Aupust 2023 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual insurance `�° aa)i
N5 Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes Q
_> therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 7
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notariai seat at Plymouth Meeting, Pennsylvania, on the day and year first above written. O �
[l. O
SQ, PAS,,
_ 4c; N,nNNS +S<, commonwealth of Pennsylvania - Notary Seal
try O 4<R Y TeresaPagomerNotary Public $ � �J O-�
do �' a s v Montgomery County f�/p/'/'�''^� � �
Or My commission eNplres March 28, 2n25
Commission number 1126044 y-
Teresa Pastelia, NotaryPublic o
h� 4Cs Ma nher, Pennsylvania Association of NotariesNr
,T
!! O
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual a) co
-� Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: dCZi
sr a? ARTICLE IV — OFFICERS: Section 12 Power of Attorney- o CD
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such {imitation as the Chairman or the
a President may prescribe, shall appoint such attorneys in fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety `O
M � any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall -o M
a have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such n 4)
Z c0i instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the Co
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ti a
ARTICLE XIII — Execution of Contracts: Section S. Surety Bonds and Undertakings.
Any officer of the Company author+zed for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknow{edge and deliver as surety any and all undertakings,
bonds, recognizanoes and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attomey, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in -
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations,
Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attomey issued by the Company in connection with surety bonds, shalt be valid and binding upon the Company with
the same force and effect as though manually affixed.
1, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked MAR R � 8 202
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this day of �YIH `i
4� i SOO P01f INS&. N 11I5U�pI
`J 66ap6R4r yn `oJ 6oaPo3"r 9y `P0Olt P,R_gT yC)
J �' o
1912 0 oU 1919 0 2 1991 n ��
�o Q gy-
dy�9ssgcnu5��pa yp m�RAMPas �s "VlhANP aa$ Renee C. Llewellyn, n, Assistant
Y Secretary
LMS-12873 LMIC CCIC WAIC Multi Co e2721