HomeMy WebLinkAboutContract 58791-FP3-FP3
FORT WORTH.
City Secretary
Contract No. 58791
Date Received 6/11/2024
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: Ventana Phase 6B
City Project No.: 103677
Improvement Type(s): x❑ Paving ❑x Drainage ❑ Street Lights ❑ Traffic Signals
Original Contract Price: $954,717.00
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete: $954,717.00
Jun 11, 2024
Jacob D. Gatewood (Jun 11, 202414:02 CDT)
Contractor Date
Manager
Title
Conatser Construction
Company Name
Matt Caii,
Jun 11 2024
MzttCzln (Jun 11, 202414:33 CDT)
Project Inspector
Date
Jun 11, 2024
Project Manager
Date
Jun 117 2024
7*1^
Rebecca Owen (Jun 11. 202415:33 CDT)
CFA Manager
Date
A.
Jun 11, 2024
Lauren P,202415:33CDT)
TPW Director
Date
(�P�
Jun 12, 2024
Asst. City Manager
Date
OFFICIAL RECORD
CITY SECRETARY Page 1 of 2
FT. WORTH, TX
Notice of Project Completion
Project Name: Ventana Phase 6B
City Project No.: 103677
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑ Yes ❑x N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety Q
Statement of Contract Time
Contract Time 120 WD Days Charged: 159
Work Start Date: 7/10/2023 Work Complete Date: 3/26/2024
Completed number of Soil Lab Test: 341
Completed number of Water Test: 10
Page 2 of 2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name VENTANA PHASE 6B
Contract Limits
Project Type DRAINAGE & PAVING
City Project Numbers 103677
DOE Number 3677
Estimate Number 1 Payment Number 1
City Secretary Contract Number
Contract Date
For Period Ending 3/26/2024
WD
Project Manager NA
Contractor CONATSER CONSTRUCTION TxLP
5327 WICHITA ST
FORT WORTH, TX 76119
Inspectors G. DEYON / M. CAIN
Contract Time 129VD
Days Charged to Date 159
Contract is 100.00 Complete
Wednesday, April 17, 2024 Page 1 of 5
City Project Numbers 103677 DOE Number 3677
Contract Name VENTANA PHASE 613 Estimate Number 1
Contract Limits Payment Number 1
Project Type DRAINAGE & PAVING For Period Ending 3/26/2024
Project Funding
UNIT III: DRAINAGE IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
1
REMOVE RIP RAP
297 SF
$5.00
$1,485.00
297
$1,485.00
2
LARGE STONE TYPE "A" DRY RIP RAP (24"
72 SY
$125.00
$9,000.00
72
$9,000.00
DEEP)
3
TRENCH SAFETY
1258 LF
$2.00
$2,516.00
1258
$2,516.00
4
21" RCP, CLASS III
152 LF
$73.00
$11,096.00
152
$11,096.00
5
24" RCP, CLASS III
439 LF
$83.00
$36,437.00
439
$36,437.00
6
33' RCP, CLASS lII
635 LF
$138.00
$87,630.00
635
$87,630.00
7
36' RCP, CLASS III
32 LF
$148.00
$4,736.00
32
$4,736.00
8
4'X4' STORM JUNCTION BOX
4 EA
$5,500.00
$22,000.00
4
$22,000.00
9
10' CURB INLET
5 EA
$3,800.00
$19,000.00
5
$19,000.00
10
IT CURB INLET
2 EA
$4,800.00
$9,600.00
2
$9,600.00
11
24" 4:1 SLOPED END HEADWALL
2 EA
$3,500.00
$7,000.00
2
$7,000.00
12
33" 4:1 SLOPED END HEADWALL
1 EA
$4,500.00
$4,500.00
1
$4,500.00
13
INLET PROTECTION
7 EA
$250.00
$1,750.00
7
$1,750.00
14
REMOVE 33" 4:1 SLOPED END HEADWALL
1 EA
$3,500.00
$3,500.00
1
$3,500.00
15
CONCRETE WEIR & DROP STRUCTURE
1 EA
$29,750.00
$29,750.00
1
$29,750.00
Sub -Total of Previous Unit $250,000.00 $250,000.00
-------------
UNIT IV: PAVING IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
1
HYDRATED LIME (30 LBS/SY)
174 TN
$235.00
$40,890.00
174
$40,890.00
2
6" LIME TREATMENT
11495 SY
$4.00
$45,980.00
11495
$45,980.00
3
6" CONC PVMT
10784 SY
$52.00
$560,768.00
10784
$560,768.00
4
4" CONC SIDEWALK
2878 SF
$4.50
$12,951.00
2878
$12,951.00
5
BARRIER FREE RAMP, TYPE P-1
8 EA
$2,200.00
$17,600.00
8
$17,600.00
6
BARRIER FREE RAMP, TYPE R-1
4 EA
$2,000.00
$8,000.00
4
$8,000.00
7
TOPSOIL
8 CY
$30.00
$240.00
8
$240.00
8
BLOCK SOD PLACEMENT
241 SY
$8.00
$1,928.00
241
$1,928.00
9
REMOVE BARRICADE & CONNECT TO
2 EA
$500.00
$1,000.00
2
$1,000.00
EXISTING PAVEMENT
10
CONSTRUCT TYPE III BARRICADE
3 EA
$750.00
$2,250.00
3
$2,250.00
Wednesday, April 17, 2024
Page 2
of 5
City Project Numbers 103677 DOE Number 3677
Contract Name VENTANA PHASE 613 Estimate Number 1
Contract Limits Payment Number 1
Project Type DRAINAGE & PAVING For Period Ending 3/26/2024
Project Funding
11 CONSTRUCT. STD PVMT HEADER 87 LF
$30.00
$2,610.00
87 $2,610.00
12 STOP SIGNS 6 EA
$750.00
$4,500.00
6 $4,500.00
13 STREET NAME BLADE PAIR 6 EA
$350.00
$2,100.00
6 $2,100.00
14 STREET SIGN POLE 6 EA
--------------------------------------
$650.00
$3,900.00
6 $3,900.00
Sub-Total of Previous Unit
--------------------------------------
$704,717.00
$704,717.00
Wednesday, April 17, 2024 Page 3 of 5
City Project Numbers 103677
Contract Name VENTANA PHASE 613
Contract Limits
Project Type DRAINAGE & PAVING
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Total Contract Price
DOE Number 3677
Estimate Number 1
Payment Number 1
For Period Ending 3/26/2024
$954,717.00
$954,717.00
Total Cost of Work Completed $954,717.00
Less % Retained $0.00
Net Earned $954,717.00
Earned This Period $954,717.00
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
$954,717.00
Wednesday, April 17, 2024 Page 4 of 5
City Project Numbers 103677
Contract Name VENTANA PHASE 613
Contract Limits
Project Type DRAINAGE & PAVING
Project Funding
Project Manager NA
Inspectors G. DEYON J M. CAIN
Contractor CONATSER CONSTRUCTION TxLP
5327 WICHITA ST
FORT WORTH, TX 76119
DOE Number 3677
Estimate Number I
Payment Number 1
For Period Ending 3/26/2024
City Secretary Contract Number
Contract Date
Contract Time 120 WD
Days Charged to Date 159 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 $954,717.00
Less % Retained $0.00
Net Earned $954,717.00
Earned This Period $954,717.00
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
$954,717.00
Wednesday, April 17, 2024 Page 5 of 5
FORTWORTH.
M"
TRANSPORTATION AND PUBLIC WORKS
April 2, 2024
Conatser Construction
5327 Wichita St.
Fort Worth, TX. 76119
RE: Acceptance Letter
Project Name: Ventana Ph. 6B
Project Type: Water, Sewer, Paving, Drainage
City Project No.: 103677
To om It May Concern:
On March 28, 2024 a final inspection was made on the subject project. There were no punch list items
identified at that time. The final inspection indicates that the work meets the City of Fort Worth
specifications and is therefore accepted by the City. The warranty period will start on March 28, 2024,
which is the date of the final inspection 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,?"&'r
George Marquez, Project Manager
Cc: Matt Cain, Inspector
Gary Deyon, Inspection Supervisor
Edward D'Avila, Senior Inspector
Andrew Goodman, Program Manager
UA Engineering, Inc., Consultant
Conatser Construction, Contractor
PMB Ventana Developer South, LLC, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 08/20/19
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me, the undersigned authority, a Notary Public in the state and county aforesaid,
on this day personally appeared Brock Huggins, President of Conatser Management Group, Inc.,
general partner of Conatser Construction TX. LP, 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; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
VENTANA PH. 6B
WATER, SANITARY SEWER, DRAINAGE,
PAVING, & STREET LIGHT IMPROVEMENTS
CFA PRJ #: 22-0178
CITY PROJECT #: 103677
CITY OF FORT WORTH
STATE OF TEXAS
CONATSER CONSTRUCTION TX, LP
Brock Ilugg s
Subscribed and sworn to before me this 19`h day of April, 2024.
=o �¢ Notary Public, Slate of Texas Notary Public in Tarrant County, Texas
IN 133467933
vTFOF`�t My Commission Expires
November 30, 2025
CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
PROJECT:
(name, address)Ventana Phase 6B
Fort Worth, TX
TO (Owner)
PMB VENTANA DEVELOPER, LLC AND CITY OF
FORT WORTH
4001 Maple Avenue, Suite 270
Dallas TX 75219
CONTRACTOR: CONATSER CONSTRUCTION TX, L.P.
OWNER
❑
ARCHITECT
❑
CONTRACTOR
❑
SURETY
❑
OTHER
Bond No 0249372
ARCHITECT'S PROJECT NO: CFA22-0178
CONTRACT FOR:
Water, Sanitary Sewer, Drainage, Paving, & Street Lighting
improvements for Ventana Phase 6B
_I CONTRACT DATE:
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)
BERKLEY JNSURANCE COMPANY
475 Steamboat Road
Greenwich CT 06830 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
CONATSER CONSTRUCTION TX, L.P.
5327 Wichita St.
Fort Worth TX 76119-6035
,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)
PMB VENTANA DEVELOPER, LLC AND CITY OF FORT WORTH
4001 Maple Avenue, Suite 270
Dallas TX 75219 , OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS, WHEREOF,
the Surety Company has hereunto set its hand this
Attest:
(Seal): "�-
18th day of April, 2024
BERKLEY INSURANCE COMPANY
Surety Company
r'_
Signature of Authorized Representative
Robbi Morales
Title
Attornev-in-Fact
NOTE: This form is to be used as a companion document to AIA DOCUMENT 0706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
No. BI-7280k
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WILMINGTON, DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted
and appointed, and does by these presents make, constitute and appoint: Ricardo J. Reyna; Don F_ Cornell; Sophinie Hunter;
Robbi Morales; Kelly A. Westbrook, Tina McEivan; Joshua Saunders; Tonie Petranek; or Mikaela Peppers. of Aon Risk
Services Soutlnvest, Inc. of Dallas, TX its true and lawful Attorney -in -Fact, to sign its name as surety, only as delineated below
and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty
Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the
same .extent as if such bonds had been duly executed and acknowledged by the regularly elected officers .of the Company at its
principal office in their own proper persons.
This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
without giving effect. to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following
resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January.25, 2010:
RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief
Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant
Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney -in -fact named therein
to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the
corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such
attorney -in -fact and revoke any power of attorney previously granted; and further
RESOLVED, that suchpower of attorney limits the acts of those named therein to the bonds, undertakings, recognizances,
or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the
manner and to the extent therein .stated; and further
RESOLVED, that such power of attomey revokes all previous powers issued on behalf of the attorney -in -fact named; and
further
RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any
power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or
other suretyship obligation of the Company; and such signature and seal when so used. shall have the same force and effect as
though .manually affixed_ The Company may continue to use for the purposes herein stated the facsimile signature of any
person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have
ceased to be such at the time when such instruments shall be issued.
IN VMNIE.SS 'WEIEREOF, the Company .has caused these presents to, be signed and attested by its appropriate officers and its
corporate seal hereunto affixed this I I -day of
Attest Berk] Insurance Company
.(Seal) Py �� By
lra'S.. dertttan Je iter
Executive Vice President & Secretary " S_ 1 ice. esident
' A.RN:ING: T111S'POWERL: INVALID %i{ NOT PRRgTED ON) UE `BT EY" SECURITY PAPER.
STATE OF CONNECT1CUT )
) SS:
C01jNTY OF FATRFIEMD }
S)+orn to before ace, a Notary Public in the State of Connecticut; this _I (t day of. , )''tau a0by Ira. S. Lederman
and Jeffrey N1, Hafter who are sworn to me to be the Executive Vice PreZot
Secretary, and j Sen1ior ��ice President
respcctivel.y,-of Berkley Insurance Company_ E,ANOTARY Tina 10
CONNECTICUT
MY COMMISSION EXPIRES
AML 50, 2n24 ub]1Ca State Pl. Connecticut
CI RT.TFICATE.
I, the undersigned, Assistant Secretary-af BERKLEY INSURANCE COMPANY, DO.HEREBY CERTIFY that the foregoing is a
true, correct and complete copy of the oiri&al.Power of Attorney; that said Power of Attorney has not beea revoked or rescinded
and that the authority of the Attorney-in-F act:set forth therein, who executed the bond or undertalang to which this Power of
Attorney is attached -is_ in full force.and effect as of this d1te.
Given under my hand and seal of the Company. this _day of
(Scat) - -
Vincent P. Forte_
'
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 Brock Huggins, President of Conatser Management Group, Inc.,
general partner of Conatser Construction TX. LP, 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; and
That there are no claims pending for personal injury and/or property damages;
On Contract described as:
VENTANA PH. 6B
WATER, SANITARY SEWER, DRAINAGE,
PAVING, & STREET LIGHT IMPROVEMENTS
CFA PRJ #: 22-0178
CITY PROJECT #: 103677
CITY OF FORT WORTH
STATE OF TEXAS
CONATSER CONSTRUCTION TX, LP
Brock Ilugg s
Subscribed and sworn to before me this 19`h day of April, 2024.
=o �¢ Notary Public, Slate of Texas Notary Public in Tarrant County, Texas
IN 133467933
vTFOF`�t My Commission Expires
November 30, 2025
CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
PROJECT:
(name, address)Ventana Phase 6B
Fort Worth, TX
TO (Owner)
PMB VENTANA DEVELOPER, LLC AND CITY OF
FORT WORTH
4001 Maple Avenue, Suite 270
Dallas TX 75219
CONTRACTOR: CONATSER CONSTRUCTION TX, L.P.
OWNER
❑
ARCHITECT
❑
CONTRACTOR
❑
SURETY
❑
OTHER
Bond No 0249372
ARCHITECT'S PROJECT NO: CFA22-0178
CONTRACT FOR:
Water, Sanitary Sewer, Drainage, Paving, & Street Lighting
improvements for Ventana Phase 6B
_I CONTRACT DATE:
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)
BERKLEY JNSURANCE COMPANY
475 Steamboat Road
Greenwich CT 06830 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
CONATSER CONSTRUCTION TX, L.P.
5327 Wichita St.
Fort Worth TX 76119-6035
,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)
PMB VENTANA DEVELOPER, LLC AND CITY OF FORT WORTH
4001 Maple Avenue, Suite 270
Dallas TX 75219 , OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS, WHEREOF,
the Surety Company has hereunto set its hand this
Attest:
(Seal): "�-
18th day of April, 2024
BERKLEY INSURANCE COMPANY
Surety Company
r'_
Signature of Authorized Representative
Robbi Morales
Title
Attornev-in-Fact
NOTE: This form is to be used as a companion document to AIA DOCUMENT 0706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
No. BI-7280k
POWER OF ATTORNEY
BERKLEY INSURANCE COMPANY
WILMINGTON, DELAWARE
NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully.
KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly
organized and existing under the laws of the State of Delaware, having its principal office in Greenwich, CT, has made, constituted
and appointed, and does by these presents make, constitute and appoint: Ricardo J. Reyna; Don F_ Cornell; Sophinie Hunter;
Robbi Morales; Kelly A. Westbrook, Tina McEivan; Joshua Saunders; Tonie Petranek; or Mikaela Peppers. of Aon Risk
Services Soutlnvest, Inc. of Dallas, TX its true and lawful Attorney -in -Fact, to sign its name as surety, only as delineated below
and to execute, seal, acknowledge and deliver any and all bonds and undertakings, with the exception of Financial Guaranty
Insurance, providing that no single obligation shall exceed Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the
same .extent as if such bonds had been duly executed and acknowledged by the regularly elected officers .of the Company at its
principal office in their own proper persons.
This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware,
without giving effect. to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following
resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January.25, 2010:
RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief
Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant
Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney -in -fact named therein
to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the
corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such
attorney -in -fact and revoke any power of attorney previously granted; and further
RESOLVED, that suchpower of attorney limits the acts of those named therein to the bonds, undertakings, recognizances,
or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the
manner and to the extent therein .stated; and further
RESOLVED, that such power of attomey revokes all previous powers issued on behalf of the attorney -in -fact named; and
further
RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any
power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or
other suretyship obligation of the Company; and such signature and seal when so used. shall have the same force and effect as
though .manually affixed_ The Company may continue to use for the purposes herein stated the facsimile signature of any
person or persons who shall have been such officer or officers of the Company, notwithstanding the fact that they may have
ceased to be such at the time when such instruments shall be issued.
IN VMNIE.SS 'WEIEREOF, the Company .has caused these presents to, be signed and attested by its appropriate officers and its
corporate seal hereunto affixed this I I -day of
Attest Berk] Insurance Company
.(Seal) Py �� By
lra'S.. dertttan Je iter
Executive Vice President & Secretary " S_ 1 ice. esident
' A.RN:ING: T111S'POWERL: INVALID %i{ NOT PRRgTED ON) UE `BT EY" SECURITY PAPER.
STATE OF CONNECT1CUT )
) SS:
C01jNTY OF FATRFIEMD }
S)+orn to before ace, a Notary Public in the State of Connecticut; this _I (t day of. , )''tau a0by Ira. S. Lederman
and Jeffrey N1, Hafter who are sworn to me to be the Executive Vice PreZot
Secretary, and j Sen1ior ��ice President
respcctivel.y,-of Berkley Insurance Company_ E,ANOTARY Tina 10
CONNECTICUT
MY COMMISSION EXPIRES
AML 50, 2n24 ub]1Ca State Pl. Connecticut
CI RT.TFICATE.
I, the undersigned, Assistant Secretary-af BERKLEY INSURANCE COMPANY, DO.HEREBY CERTIFY that the foregoing is a
true, correct and complete copy of the oiri&al.Power of Attorney; that said Power of Attorney has not beea revoked or rescinded
and that the authority of the Attorney-in-F act:set forth therein, who executed the bond or undertalang to which this Power of
Attorney is attached -is_ in full force.and effect as of this d1te.
Given under my hand and seal of the Company. this _day of
(Scat) - -
Vincent P. Forte_
'