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Contract 59557-FP1
FORT WORTH, TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION -FP 1 City Secretary No. 59557 Date Received: 7/18/2024 City Project N!?: 103020 & 103708 Regarding contract 59557 2022 CDBG Reconstruction Project for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 5/23/2023 through M&C 23-0429 the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT upon the recommendation of the Assistant Director of the Transportation & Public Works Department has accepted the project as complete. Original Contract Amount: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Work Completed: Less Deductions: Liquidated Damages: Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: Less Previous Payments: Final Payment Due Lissette Acevedo (Jul 17, 202414:08 CDT) Recommended for Acceptance Asst. Director, TPW - Capital Delivery $1,602,187.50 Days 150 $ (60.45) Ns 1 Days Added by CO 30 $ 1,602,127.05 Total Days 180 $ 1,405,889.15 Days Charged 180 Days @ $ / Day $ 1,405,889.15 $ 1,335,594.69 $ 70,294.46 J u 117, 2024 Date Lauren Prleur(� 17, 202414:13 CDT) Jul 17, 2024 Accepted Date Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Jul 17, 2024 Asst. City Manager Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment Invoice No. 8 FINAL To (Owner): City Of Fort Worth Invoicing Period (From - To): Invoice Date: 6/21/2024 P. O FW020-������9981 From (Contractor): Remit to ( If Not Automatic Deposit ): Number: 2022 CDBG Reconstruction Project Project: 103020 & 103708 Contractor'sCFW Vendor No.: 0000007231 City Secretary Contract 59557 Contract Peachtree Construction, Ltd Number: Name: Application For Payment Change Order Summary Approved Change Orders 1. ORIGINAL CONTRACT PRICE............................................................. $ $1,602,187.50 Number Additions Deletions 2. Net change by Change Orders................................................................... $-$60.45 1 $76,789.55 $76,850.00 3. Current Contract Price (Line 1 t 2).......................................................... $ $1,602,127.05 2 4. TOTAL COMPLETED AND STORED TO DATE 3 (Progress Estimate, Construction Allowance and Change Orders)....... $ $1,405,889.15 4 5. RETAINAGE: 5 a. X $1,405,889.15 Work Completed.......... $ 6 b. X Not Used $ 7 c. Total Retainage (Line 5a + Line 5b)................................. $ 8 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c) ............................... $ $1,405,889.15 TOTALS $76,789.55 $76,850.00 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)......... $ $1,335,594.69 NET CHANGE BY-$60.45 8. AMOUNT DUE THIS APPLICATION...................................................1 $ $70,294.46 CHANGE ORDERS 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + COs + Line 5 above) ............... $ $196,237.90 Contractor's Certification 10. CONTRACT TIME: The Contractor certifies with the submittal of this document and associated Payment Request a, Days Awarded 150 Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all b. Days Added by CO 30 previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in C. Total Days 180 connection with Work covered by prior Applications for Payment; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and d. Days Charged 180 encumbrances (except such as are covered by a Bond acceptable to Owner indemnifying Owner e. Days Remaining against any such Liens, security interest or encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Liquidated Damages $650.00 x day 8 r&p B Taylor (Au 16, 202416:21 CDT) This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Progress Estimate City Secretary s9ss� Contract Num: For (contract): Peachtree Construction, Ltd Application Period: A D B C Item Bid Item No. Description Specification Section No. Unit of Measure But Quantity Unit Pnee Bid Value Estimated Quantity Installed 1 0135.0201 REMOBILIZATION 017000 EA 1.000OO6 $1,000.00 $1,000.0 1 2 0241.1300 REMOVE CONC CURB & GUTTER 0241 13 LF 3400.000000 $10.00 $34,000.00 2447.250000001 3 3216.0102 7" CONC CURB AND GUTTER 32 16 13 LF 9300.000000 $46.25 $430,125.00 7437.080000001 4 0241.0401 O C G EY EWAY 024113 SF 3670.000006 $5.50 $20,185.00 5591.320000001 5 3213.0401 ��L� 32 13 20 SF 3925.000000 $13.50 $52,987.50 8593.660000001 6 0241.0100 0 S 024113 SF 650.000000 $4.50 $2,925.00 3022.000000001 7 3213.0301 4" CONC SIDEWALK 32 1320 SF 650.000000 $10.56 $6,825.00 9398.851000001 $J�RVALK (6 to 12 Inch max) T�LEY 32 13 20 LF 170.000000 $17.00 $2,890.00 1 9 0241.1400 REMOVE CONIC � f (ITT�R 024113 SY 100.000000 $48.50 $4,850.00 36.140000001 10 3216.0301 7" CONC VALLEY GUTTER 32 16 13 SY 170.000000 $142.00 $24,140.00 308.730000001 11 0241.0300 REMOVE ADA RAMP 024113 EA 25.000000 $1,250.00 $31,250.00 8.000000001 12 13 3213.0501 3213.0506 P&RkFF` QREkMMP, TYPE R-1 B/j(jf2��Ef2`FR�E ft(��v1P, TYPE P-1 32 1320 32 1320 EA EA 40.000000 10.000000 $3,100.00 $2,700.06 $124,000.00 $27,000.00 17.000000001 15.000000001 14 3110.0103 2°-{ its E AL 311000 EA 5.000000 $2,000.00 $10,000.00 2.000000001 15 3110.0104 18"-24" TREE REMOVAL 311000 EA 5.000000 $2,300.00 $11,500.00 8.000000001 9999.0000 REMOVE CONCRETE AND REPLACE WITH 7 INCH 99 99 90 OfJ,C HjEYEfj'�ENT, $$23.00 ;� 3EjEP/)yE(y1FJ�i TYPE D $HrM,4ACpTTRRAANSpITI0 321216 SY 15500.000000 $356,500.00 12494.050000001 18 19 3212.0401 0241.1700 11" PAVEMENT PULVERIZATION 321216 024115 TN SY 10.000000 15500.000000 $150.00 $11.56 $1,500.00 $178,250.00 1 12494.050000001 20 3211.0122 FLEX BASE, TYPE A, GR-2 32 1123 CY 100.000000 $115.06 $11,500.00 220.490000001 21 3211.0600 CEMENT MODIFICATION, 261bs/sv 32 1133 TN 200.000000 $340.00 $68,000.00 162.410000001 22 3123.0101 UNCLASSIFIED EXCAVATION 3123 16 CY 150.000000 $42.00 $6,300.00 119.900000001 23 3292.0100 BLOCK SOD REPLACEMENT 3292 13 SY 2000.000000 $9.00 $18,000.00 3839.000000001 24 3217.5001 CURB ADRESS PAINTING 32 1725 EA 2.000000 $60.00 $120.00 1 25 3291.0100 TOPSOIL 329119 CY 135.000000 $110.00 $14,850.00 120.000000001 26 3232.0100 CONIC RETAINING WALL ((�2FT -4 FTJ 32 1320 SF 200.000000 $90.06 $18,000.00 1 27 3305.0108 MISCELLANEOUS ADJUSTMENT UTILITIES` 3305 14 LS 1.000000 $10,000.00 $10,000.00 1 3305.0112 WATER VALVE BOX ADJUSTMENT (WITH CONCRETE 33 05 14/33 05 28 COLLAR, 17 EA 3.000000 $1,100.00 $3,300.00 5.000000001 29 �,1� J� 33 12 10 EA 1.000000 $340.00 $340.00 1 30 3312 2003 \,� 1- INCH STANDARD C GI�ETE y& BOX 33 12 10 EA 1.000000 $ 50.00 $550.00 1 3305.0112 MANHOLE ADJUSTMENT (WITH CONCRETE COLLAR) 33 05 14/33 05 31 17 EA 15.000000 $2,200.00 $33,000.00 15.00000000 32 3110.0101 SITECLEARING 311000 SY 100.000000 $11.00 $1,100.00 1 33 9999.0096 PAVING CONSTRUCTION ALLOWANCE LS 1.000000 $70,000.00 $70,000.001 0.061405291 This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Unit Price Progress Estimate Value Previously Installed Value Value This Period $24,472.50 124,472.50 $343:964.95 $343,964.95 $30,752.26 $30,752.26 $116,014.41 $116,014.41 $13,599.00 $13,599.00 $98,687.94 $98,687.94 $1,752.79 $1,752.79 $43,839.66 $43,839.66 $10,000.00 $10,000.00 $52,700.001 $52,700.00 $40,500.00 $40,500.00 $4,000.00 $4,000.00 $18,400.00 $18,400.00 $287,363.15 $287,363.15 $143,681.581 $143,681.59 $34,551.00� $34,551.00 $13,200.001 $13,200.00 $33,000.001 _ $33,000.00 $4,298.371 _ $4,298.37 1 C-620 Change Order Progress Estimate Construction Allowance Usage ADDITIONS For (eontract) 103020 & 103708 Peachtree Construction, Ltd APplicafion Period: A Item I[em Number Description City secretary 59557 Contract Num: B Specification Unit of Quantity to Add Unit Price Addition Value Section No Measure C D Estmaated Quantity Value Installed This document has been modified from its original form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document carefully and consult Legal Counsel prior to its execution Previously Value This Installed Value Period Contractor's Application Application Number: 8 FINAL Application Date 6/21/2024 E F Total Completed / Balance to Finish MaterialsPresently and Stored to Date (1) (B -F) Stored (not in C) (D+E) B C-620 Change Order Totals This document has been modified from its o gmal form as an E1CDC document and the user did nol highlight the modifications You are encouraged to read the document carefully and consult Legal Counsel prior to its execution C-620 Change Order Progress Estimate For(eonaact) 103020 & 103708 Peachtree Construction, Ltd Application Period: A I Item Bid Item Number Description Totals Construction Allowance Usage CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED E C Specification Unit of Quantity to Delete Unit Price Reduction Value Not Used Section No Measure Contractor's Application AppheaSon Number: 8 FINAL Application Date. 6/21/2024 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document carefully and consult Legal Counsel prior to its aeoeation C-620 Change Order Progress Estimate Change Order Number 1 1 Contractor's Application ADDITIONS F.,(ommacl)t 020 & 103 Peachtree Construction, Ltd City Secretary 59557 Application Number 8 FINAL Contract Num Application Period: Application Date 6/21/2024 A B C D E F Item Balance m Finish Add Price Addison Estimated Quantity Value Previously Value This Materials Presently Total Completed Date (B - F) Change Order Rem Description Specification Unit of CO Quantity m Unit Change Order Installed Ivsdllad Value Period Scored (vot in C) and Stored to (F) No Sactron No Maasure Value (D+E) B 4 Remove Concrete Dnveway 0241 13 SF 880.00000000 $5.50 $4,940.00 $4,840.00 5 6" Concrete Driveway 32 1320 SF 1000.00000000 $13 50 $13,500 00 $13,500 00 6 Remove Sidewalk 0241 13 SF 2500.00000000 S4 50 $11,250 00 $11,250 00 7 4" Concrete Sidewalk 321320 SY 137,67100000 $10.50 $1,445.55 $1,445.55 10 7" Concrete Valley Gutter 32 16 13 SY 137.00000000 $142.00 $19,454.00 $19,454.00 13 Bamer Free Ramp, Type P-1 32 1320 EA 5.00000000 $2,700 00 $13,500 00 $13,500 00 15 18"-24" Tree Removal 31 1000 EA 4.00000000 $2,300 00 $9,200 00 $9,200 00 23 Block Sod 329119 SY 400,00000000 $9.00 $3,600.00 $3,600.00 Totals $76,789.55 $76,789.55 This document has been modified from its original form as an E1CDC document and the user did not highlight the modifications You are encouraged m read the document careflly and consult Legal Counsel prior to its execution C-620 Change Order Progress Estimate Change Order Number 1 1 DELETIONS For (contract): 020 & 103 Peachtree Construction, Ltd Application Period: � Item Change Order Item Desorption No. 17 3"Asphalt Pavement TyV D 19 11" Pavement Pulverization 12 Ba— Free Ramp, Type R-1 Totals A B C CO Quantity to Deletion Specification Section No. Unit of Measure Delete Unit Price Change Order Not Used Value 321216 SY 300.00000000 $23.00 $6,900.00 024115 SY 1500.00000000 $11.50 $17,250.00 32 1320 EA 17.00000000 $3,100.00 $52,700.00 Application Number: Application Date' D E Not Used Not Used Not Used Not Used This document has been modified from its crigmal form as an E1CDC document and the user did not highlight the modifications You are encouraged 10 read the document carefully and consult Legal Counsel prior to its execution Contractor's Application 8 FINAL 6/21/2024 F Not Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 2 ADDITIONS Contractor's Application For(omthaa): 020 &c 1O3 Peachtree Construction, Ltd City Secretary 59557 Apphcahon Number: 8 FINALC..—Num: Apph-no, P—od: Appbcahon Dale 6/21/2024 A B C D E F Item Balance to Finish Total Completed % Change Orda Item AM —Change Specification Unit of CO Quantity to Add Unit Price Specification Estimated Q-1ay Previously Value This Materials Presently Value and Stored to Date B P (F) ( ) No. Description No. Measure Order Valve Installed Installed Value Penod Stored (not m C) (D+E) B Totals This dowment has been modified from ❑s ongmal form as m EJCDC document and the user did not htghlrght the modifications You aze encouraged m read the document carefully and consult Legal Counsel prior to ns execunon. C-620 Change Order Progress Estimate Change Order Number 1 2 Contractor's Application DELETIONS For ('soonaoq: 020 & 103 Peachtree Construction, Ltd Apphcauon Number: 8 MAL Application Potted: Application Date: 6/21/2024 A B C D E F Item CO Quantity to Deletion Change Change Order Item Description Specification Delete Delete Uni[Price Order Value Not Used Not Used Not Used Not Used Not Used No[Used No[Used Net Used No � � I I I I I I I I I I I I I I I I I I I I I I Sudon No Measure Mess I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Totals I I I I I I I I I I I I I I I I I I I I I This d—meat has been modified from its ougmal form as se E1CDC document and the user did not highlight the modifications Yon are encouraged to read the document cmflly and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 3 ADDITIONS Contractor's Application For (contract): UZU & ]O3 Peachtree Construction, Ltd City Secretary 59557 Application Number g FINAL Contract Nora Appltcation P—od: Applicator Date: 6/21/2024 A B C D E F Item Balance to Finish Addttion Total Completed % Change Order Item Specification Unit of CO Quantity to Add Unit Price Change Order Estimated Qvavfity Prevmvsly Value This Matenals Presently Value and Stored to Date (B-F) (F) No. Dascriptiou Section No. Measure Value Installed Installed Valve Period St d (not tv C) (D+E) B Totals This d—n000t has been modified from to ongmal form as an EICDC document and the user did tot htghlrght the modifi-aims You are encouraged m read the document careflly and consult Legal Covvsel prior to ns execoton. C-620 Change Order Progress Estimate Change Order Number 1 3 Contractor's Application DELETIONS F., (oontiaot): 020 & 103 Peachtree Construction, Ltd Application Numbt, 8 FINAL Application Penod: Application Dane: 6/21/2024 A B C D E F It CO Q� tit to y Deletion Change Order hem No Description Specification Unit of Sudoo No Marion, Delene Unit Price Change Order Not Used Vale Not Used Not Used Not Used Not Used Not Used Not Used Not Used I I I I Totals This d—recut has been modified from its ongmal form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document cmflly and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 4 ADDITIONS Contractor's Application For (contract): UZU & ]O3 Peachtree Construction, Ltd City Secretary 59557 Application Number g FINAL Connect N— Apphcahon Penod: Applicanon Date: 6/21/2024 A B C D E F Item Balance to Finish Addition Total Completed % Change Order Item Specification Umt of CO Quantity to Add Unit Price Change Order Estimated Quantity Previously Value This Ma[enals Presently Value and Stored to Date (F) B _ F) No. Dascripnou Section No. Memon, Vnlua Installed Installed Valve Period Stored (no[ m C) tD+E) B Totals This dowment has been modified from as ongmal form as m EICDC document and rho user did not htghhght the modifications Yon are encouraged to read the document carefully and consult Legal Counsel prior to ns a—ohon. C-620 Change Order Progress Estimate Change Order Number 1 4 Contractor's Application DELETIONS F., (oontiaot): 020 & 103 Peachtree Construction, Ltd Application Numbt, 8 FINAL Application Penod: Application Dane: 6/21/2024 A B C D E F It CO Q� tit to y Deletion Change Order hem No Description Specification Unit of Sudoo No Marion, Delene Unit Price Change Order Not Used Vale Not Used Not Used Not Used Not Used Not Used Not Used Not Used I I I I Totals This d—recut has been modified from its ongmal form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document cmflly and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 5 ADDITIONS Contractor's Application For (contract): UZU & ]O3 Peachtree Construction, Ltd City Secretary 59557 Application Number g FINAL Connect N— Apphcahon Penod: Applicanon Date: 6/21/2024 A B C D E F Item Balance to Finish Addition Total Completed % Change Order Item Specification Umt of CO Quantity to Add Unit Price Change Order Estimated Quantity Previously Value This Ma[enals Presently Value and Stored to Date (F) B _ F) No. Dascripnou Section No. Memon, Vnlua Installed Installed Valve Period Stored (no[ m C) tD+E) B Totals This dowment has been modified from as ongmal form as m EICDC document and rho user did not htghhght the modifications Yon are encouraged to read the document carefully and consult Legal Counsel prior to ns a—ohon. C-620 Change Order Progress Estimate Change Order Number 1 5 Contractor's Application DELETIONS F., (oontiaot): 020 & 103 Peachtree Construction, Ltd Application Numbt, 8 FINAL Application Penod: Application Dane: 6/21/2024 A B C D E F It CO Q� tit to y Deletion Change Order hem No Description Specification Unit of Sudoo No Marion, Delene Unit Price Change Order Not Used Vale Not Used Not Used Not Used Not Used Not Used Not Used Not Used I I I I Totals This d—recut has been modified from its ongmal form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document cmflly and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 6 ADDITIONS Contractor's Application For (contract): UZU & ]O3 Peachtree Construction, Ltd City Secretary 59557 Application Number g FINAL Connect N— Apphcahon Period: Applicavon Date: 6/21/2024 A B C D E F I— Balance f Finish Addition Estimated Quantity Total Completed Previously Valve This Materials Presently (B-F) Changa Order Item No Description Specification Uvit of CO Quantity m Add Unit Pvice Change Order Section No Measure Value Installed Value and Stored m Date Installed Valve Period Stored(notin C) (D+E) (F) B Totals This dowmevt has been mod,fied from as ongu,al form as m E1CDC document and the user d,d not h,ghl,ght the modifications You are encouraged m read the document careflly and consult Legal Counsel prior to ns —hon. C-620 Change Order Progress Estimate Change Order Number 1 6 Contractor's Application DELETIONS F., (oontiaot): 020 & 103 Peachtree Construction, Ltd Application Numbt, 8 FINAL Application Penod: Application Dane: 6/21/2024 A B C D E F It CO Q� tit to y Deletion Change Order hem No Description Specification Unit of Sudoo No Marion, Delene Unit Price Change Order Not Used Vale Not Used Not Used Not Used Not Used Not Used Not Used Not Used I I I I Totals This d—recut has been modified from its ongmal form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document cmflly and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 7 ADDITIONS Contractor's Application For (contract): UZU & ]O3 Peachtree Construction, Ltd City Secretary 59557 Application Number g FINAL Contract N— Apphcahon P—od: Applicavon Date: 6/21/2024 A B C D E F Item Balance f Finish Addition Esamand Quantity Previously Value This Matenals Presently Toml Completed (B _ F) Change.— Item Description Specification Unit of CO Quantity to Add Uti[ Price Change Order Installed Value Installed Value Period Stored (not in C) and Stored to Data (F) No. Sactiov No. Measure Value (D+E) B Totals This dowment has been modified from as ongmal form as m E1CDC document and the user did not h,ghl,ght the modifications You are encouraged m read the document careflly and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 7 Contractor's Application DELETIONS F., (oontiaot): 020 & 103 Peachtree Construction, Ltd Application Numbt, 8 FINAL Application Penod: Application Dane: 6/21/2024 A B C D E F It CO Q� tit to y Deletion Change Order hem No Description Specification Unit of Sudoo No Marion, Delene Unit Price Change Order Not Used Vale Not Used Not Used Not Used Not Used Not Used Not Used Not Used I I I I Totals This d—recut has been modified from its ongmal form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document cmflly and consult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 8 ADDITIONS Contractor's Application For (contract): UZU & ]O3 Peachtree Construction, Ltd City Secretary 59557 Application Number g FINAL Connect N— Apphcahon Penod: Applicanon Date: 6/21/2024 A B C D E F Item Balance to Finish Addition Total Completed % Change Order Item Specification Umt of CO Quantity to Add Unit Price Change Order Estimated Quantity Previously Value This Ma[enals Presently Value and Stored to Date (F) B _ F) No. Dascripnou Section No. Memon, Vnlua Installed Installed Valve Period Stored (no[ m C) tD+E) B Totals This dowment has been modified from as ongmal form as m EICDC document and rho user did not htghhght the modifications Yon are encouraged to read the document carefully and consult Legal Counsel prior to ns a—ohon. C-620 Change Order Progress Estimate Change Order Number 1 8 Contractor's Application DELETIONS F., (oontiaot): 020 & 103 Peachtree Construction, Ltd Application Numbt, 8 FINAL Application Penod: Application Dane: 6/21/2024 A B C D E F It CO Q� tit to y Deletion Change Order hem No Description Specification Unit of Sudoo No Marion, Delene Unit Price Change Order Not Used Vale Not Used Not Used Not Used Not Used Not Used Not Used Not Used I I I I Totals This d—recut has been modified from its ongmal form as an E1CDC document and the user did not highlight the modifications You are encouraged to read the document cmflly and consult Legal Counsel prior to its execution. City Secretary Contract Num: I 59557 Application Period: Funding Identification (FID) Original Contract 21001-0200431-5740010-103708-A01912 21001-0200431-5740010-103020-A01912 0 0 0 0 0 0 0 0 0 Change Order 1 21001-0200431-5740010-103708-A01912 21001-0200431-5740010-103020-A01912 0 0 0 0 0 0 0 0 0 Change Order 2 21001-0200431-5740010-103708-A01912 21001-0200431-5740010-103020-A01912 0 0 0 0 0 0 0 0 0 City of Fort Worth Summary of Charges Peachtree Construction, Ltd I P. D FW020-0000009981 Project Number: 103020 & 103708 0 ApplicNumber:ation 8 FINAL Application Date: 6/21/2024 Total Completed $1,287,361.61 $118,527.54 Amt Remaining $179,748.85 $16,549.50 ($55.36) ($5.10) Gross Retainage Net City Secretary Contract Num: I 59557 Application Period: Funding Identification (FID) I Change Order 3 121001-0200431-5740010-103708-A01912 121001-0200431-5740010-103020-A01912 10 10 10 10 10 10 10 10 10 I I Change Order 4 121001-0200431-5740010-103708-A01912 121001-0200431-5740010-103020-A01912 10 10 10 10 10 10 10 10 10 I I Change Order 5 121001-0200431-5740010-103708-A01912 121001-0200431-5740010-103020-A01912 10 10 10 10 10 10 10 10 10 I City of Fort Worth Summary of Charges Peachtree Construction, Ltd I P. O: 0 Application Number: Total Completed Amt Remaining FW020-0000009981 I Project Number: 1103020 & 103708 8 FINAL I Application Date: I 6/21/2024 Gross Retainage Net City Secretary Contract Num: I 59557 Application Period: Funding Identification (FID) I Change Order 6 121001-0200431-5740010-103708-A01912 121001-0200431-5740010-103020-A01912 10 10 10 10 10 10 10 10 10 I I Change Order 7 121001-0200431-5740010-103708-A01912 121001-0200431-5740010-103020-A01912 10 10 10 10 10 10 10 10 10 I I Change Order 8 121001-0200431-5740010-103708-A01912 121001-0200431-5740010-103020-A01912 10 10 10 10 10 10 10 10 10 I City of Fort Worth Summary of Charges Peachtree Construction, Ltd I P. O: 0 Application Number: Total Completed Amt Remaining FW020-0000009981 I Project Number: 1103020 & 103708 8 FINAL I Application Date: I 6/21/2024 Gross Retainage Net City Secretary Contract Num: I 59557 Application Period: Funding Identification (FID) Totals 21001-0200431-5740010-103708-A01912 21001-0200431-5740010-103020-A01912 0 0 0 0 0 0 0 0 0 Grand Total City of Fort Worth Summary of Charges Peachtree Construction, Ltd I P. C FW020-0000009981 Project Number: 103020 & 103708 0 Application 8 FINAL Application Date: 6/21/2024 Number: Total Completed Amt Remaining Gross Retainage Net $1,287,361.61 $179,693.49 $118,527.54 $16,544.40 I I I I I I $1,405,889.15 1 1 $196,237.90 1 1 $0.00 1 1 ($70,294.46)1 1 $70,294.46 1 FORT WORTK> Routing and Transmittal Slip Transportation and Public Works Department DOCUMENT TITLE: Chanae Order No. 1 for 2022 CDBG Reconstruction Proiect — W. Riau Street Improvements M&C 23-0429. CPN 103020 & 103708 CSO # 59557 DOC# DATE: 4/ 1 9/ 2 0 2 4 INITIALS DATE OUT 1. Alexandra Ripley 9�pl May 17, 2024 2. J. Barry Clark - Peachtree Construction, Ltd. U FC May 16, 2024 1 3. Fabian Diaz-Aguinaga (Inspector) p- May 16, 2024 4. Donald Watson (Sr. Inspector) - Dw May 16, 2024 5. Riad Nusrallah Islam (PM) l-^� May 24, 2024 6. Zelalem Arega (PGM) �� May 24, 2024 7. Mary Hanna (SCPO) N�11/ May 24, 2024 8. Patricia Wadsack (AD) r Y May 28, 2024 9. Lauren Prieur (Director) May 28, 2024 10. Doug Black (ACA) IDE May 30, 2024 11. Jesica McEachern (ACM) May 31, 2024 1�` 12. Jannette Goodall (CS) DOCUMENTS FOR CITY MANAGER'S SIGNTURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: U Yes FV No RUSH: ❑ Y ❑✓ Jo SAME DAY: ❑Yes ❑✓ No NEXT DAY: ❑C Yes 1 No ROUTING TO CSO: F% Yes ❑No Action Reauired: ❑ As Requested ❑ Attach Signature, Initial and Notary Ta ■ Signature/Routing and or Recording ❑ Comment ❑ File Return to: Please call Riad Nusrallah at ext. 2729 for pick up when completed. Thank CSC No. 59557-COI FOR, _ T WORTH. City of Fort Worth Change Order Request Project Namel 2022 CDBG Reconstruction Project - W. Ripy Street Improvements Client Project #(s)l 103020 & 103708 Project) Reconstruction of W. Ripy Street Description Contractorl Peachtree Construction, Ltd. Change Order #1 1 City Project Mgr.l Riad Nusrallah Dept. Original Contract Amount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date Amount of Proposed Change Order Revised Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) TPW $1,602,187.50 City Sec # l 59557 Datel 5/13/2024 City Inspector Fabian Diaz-Aguinaga Contract Time Totals (CD) $1,602,187.50 150 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.00% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $2,002,734.38 This Change Order includes an expansion of the scope of work and an increase in quantities within the existing bid items, such as sidewalks, driveways, and valley gutters along W. Ripy Street, due to existing conditions found on site that required the removal and replacement of these items. Details of the changes in bid item quantities are in the addition section. No additional funds are needed for this change order. Time - This change order will add 30 calendar days to the project contract time due to the required additional quantities. Here is the breakdown for these additional days: 3 days to remove concrete driveways, 5 days to install 6" driveways, 2 days to remove sidewalk, 4 days to install 4" concrete sidewalk, 6 days to install valley gutters, 6 days to install barrier -free ramps, 2 days to remove trees, and, 2 days to install block sod. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting reauirements. Peachtree Construction, Ltd. J. Barry Clark May 16, 2024 Inspector/Inspection Supervisor Project and Contract Compliance Manager s. tanager May 16, 2024 May 24, 2024 Date Senior Capital Project Officer Date Zel.a�kniN May 24, 2024 /Y-- May 24, 2024 —,M,,,a.,,,,. o. Date May 28, 2024 D racting Department (Dept) , ,.,>,.1a"&=,.=o=<, 1 Date May 28, 2024 ssistant City Attorne Date Assistant Cify- Manager Date a e� � May q21111111 „ May 30, 2024 May 31, 2024 Council Action (if required) M&C Number M&C Date Approved ATTEST: Jannette Goodall, City Secretary FORTWORTH City of Fort Worth 1'V1--- Change Order Additions Project Name 1 2022 CDBG Reconstruction Project -W. Ripy Street Improvements I City Sec # 1 59557 Client Project # 1 103020 & 103708 1 Contractor Peachtree Construction, Ltd. PMI Riad Nusrallah Inspector rauian uinc- Change Order Submittal # O1 Date 1 5/13/2024 1 ADDITIONS 11 EM UESCRIP I ION UEP I Oty Unit Unit Cost I otal 1 4 Remove Concrete Driveway I PW 88U 5F $5.50' $4,841JIMI 5 6" Concrete Driveway TPW 1,000 SF $13.50 $13,500.001 6 Remove Sidewalk TPW 2,500 SF $4.50 $11,250.001 7 4" Concrete Sidewalk TPW 138 SY $10.50 $1,445.551 10 T' Concrete Valley Gutter TPW 137 SY $142.0U' $19,454.001 13 Barrier Free Ramp, Type P-1 TPW 5 Ea $2,700.00' $13,500.001 15 18"-24" Tree Removal TPW 4 Ea $2,300.00 $9,200.001 23 Block Sod TPW 400 SY $9.00' $3,600.001 I 1 I 1 I 1 I 1 I 1 1 I 1 I 1 I 1 I 1 I 1 1 I 1 I 1 I 1 I 1 1 TPW 1 I I 1 I 1 I 1 I 1 I 1 I I 1 I 1 I 1 I 1 I 1 I 1 1 I 1 I 1 1 $76,789.55 Sub Total Additions $76,789.55 Change Order Additions Page 2 of 4 FORTWoRTH City of Fort Worth Change Order Deletions Project Name 1 2022 CDBG Reconstruction Project - W. Ripy Street Improvements City Sec # 59557 1 Client Project # 1 103020 & 103708 I Contractor Peachtree Construction, Ltd. PMI Riad Nusrallah Inspector renal " J Change Order Submittal # Date 1 5/13/2024 1 I I EM UESI:ItIF' I IUN 1 / 3"Asphalt Pavement 1 ype u 19 11 "Pavement Pulvenzation 12 Barrier Free Ramp, Type R-1 DELETIONS UEF'1 Uty Unit unit cost Iotal I F'uv 3uumuiJ SY $2; $b,M.uUi TPW 1,500.0000 SY $1I.bu $1/,2bu.uui TPW 17.0000 Ea $3,100.00 w, tuu.uuI TFW $76,850.001 1 1 Sub Total Deletions $16,8b0.001 Change Order Deletions Page 3 of 4 N/A MISBE for this Chanae Order M/SBE Sub I Tvpe of Service I Amount for this CO Total $0.00 Previous Change Orders co# DATE I AMOUNT Total I $0.00 1 103020 & 103708-CNCO-Change Order No. 1 for 2022 CDBG Reconstruction Project— W. Ripy Street Improvements Final Audit Report 2024-05-17 Created: 2024-05-16 By: Andrea Munoz (Andrea. Munoz@fortworthtexas.gov) Status: Canceled / Declined Transaction ID: CBJCHBCAABAAmLUukCDbAmnhxLSliPO ht 01tz104h "103020 & 103708-CNCO-Change Order No. 1 for 2022 CDBG Reconstruction Project — W. Ripy Street Improvements" History Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) 2024-05-16 - 6:17:14 PM GMT- IP address: 204.10.90.100 Document emailed to Alexandra Ripley (alexandra.ripley@fortworthtexas.gov) for filling 2024-05-16 - 6:40:39 PM GMT Document emailed to jbclark@peachtreecon.com for signature 2024-05-16 - 6:40:39 PM GMT Document emailed to Fabian Diaz-Aguinaga (Fabian.Diaz-Aguinaga@fortworthtexas.gov) for signature 2024-05-16 - 6:40:39 PM GMT Document emailed to Donald Watson (Donald.Watson@fortworthtexas.gov) for signature 2024-05-16 - 6:40:39 PM GMT Email viewed by jbclark@peachtreecon.com 2024-05-16 - 6:51:45 PM GMT- IP address: 66.182.214.203 Email viewed by Alexandra Ripley (alexandra.ripley@fortworthtexas.gov) 2024-05-16 - 6:54:02 PM GMT- IP address: 204.10.90.100 Signer jbclark@peachtreecon.com entered name at signing as J. Barry Clark 2024-05-16 - 6:56:16 PM GMT- IP address: 66.182.214.203 Document e-signed by J. Barry Clark Qbclark@peachtreecon.com) Signature Date: 2024-05-16 - 6:56:18 PM GMT - Time Source: server- IP address: 66.182.214.203 FORTWORTH. I Paw "'Y Adobe Acrobat Sign Email viewed by Fabian Diaz-Aguinaga (Fabian.Diaz-Aguinaga@fortworthtexas.gov) 2024-05-16 - 7:10:19 PM GMT- IP address: 107.77.201.142 Document e-signed by Fabian Diaz-Aguinaga (Fabian.Diaz-Aguinaga@fortworthtexas.gov) Signature Date: 2024-05-16 - 7:12:34 PM GMT - Time Source: server- IP address: 107.77.201.142 Email viewed by Donald Watson (Donald.Watson@fortworthtexas.gov) 2024-05-16 - 8:57:06 PM GMT- IP address: 204.10.91.100 Document e-signed by Donald Watson (Donald.Watson@fortworthtexas.gov) Signature Date: 2024-05-16 - 8:57:27 PM GMT - Time Source: server- IP address: 204.10.90.100 Document declined by Alexandra Ripley(aexandra.ripley@fortworthtexas.gov) Decline reason: M&C number needs to be revised to 23-0429 2024-05-17 - 6:33:15 PM GMT- IP address: 204.10.90.100 FORT WORTH. I P— ed by Adobe Acrobat Sign 103020 & 103708-CNCO-Change Order No. 1 for 2022 CDBG Reconstruction Project-W. Ripy Street Improvements Final Audit Report 2024-06-03 Created: 2024-05-17 By: Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAAp3dnydJpY5105W1MpkLu3bu6gBdH51u7 "103020 & 103708-CNCO-Change Order No. 1 for 2022 CDBG Reconstruction Project-W. Ripy Street Improvements" History Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) 2024-05-17 - 8:29:33 PM GMT- IP address: 204.10.90.100 Document emailed to Alexandra Ripley (alexandra.ripley@fortworthtexas.gov) for filling 2024-05-17 - 8:39:51 PM GMT Document emailed to Riad Nusrallah (Riad.Nusrallah@fortworthtexas.gov) for signature 2024-05-17 - 8:39:51 PM GMT Email viewed by Alexandra Ripley (alexandra.ripley@fortworthtexas.gov) 2024-05-17 - 9:47:25 PM GMT- IP address: 204.10.90.100 -f;. Form filled by Alexandra Ripley (alexandra.ripley@fortworthtexas.gov) Form filling Date: 2024-05-17 - 9:47:34 PM GMT - Time Source: server- IP address: 204.10.90.100 Email viewed by Riad Nusrallah (Riad.Nusrallah@fortworthtexas.gov) 2024-05-22 - 1:55:27 PM GMT- IP address: 166.205.58.15 Email viewed by Riad Nusrallah (Riad.Nusrallah@fortworthtexas.gov) 2024-05-24 - 3:28:35 PM GMT- IP address: 204.10.90.100 Document e-signed by Riad Nusrallah (Riad.Nusrallah@fortworthtexas.gov) Signature Date: 2024-05-24 - 3:28:57 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) for signature 2024-05-24 - 3:28:59 PM GMT FoRTWORTH, I P—e'b' Adobe Acrobat Sign �' -, Email viewed by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) 2024-05-24 - 3:29:42 PM GMT- IP address: 204.10.90.100 . Document e-signed by Zelalem Arega (Zelalem.Arega@fortworthtexas.gov) Signature Date: 2024-05-24 - 3:30:44 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Mary Hanna (Mary.Hanna@fortworthtexas.gov) for signature 2024-05-24 - 3:30:46 PM GMT Email viewed by Mary Hanna (Mary.Hanna@fortworthtexas.gov) 2024-05-24 - 4:51:53 PM GMT- IP address: 204.10.90.100 Document e-signed by Mary Hanna (Mary.Hanna@fortworthtexas.gov) Signature Date: 2024-05-24 - 4:52:28 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) for signature 2024-05-24 - 4:52:30 PM GMT ;Q. Signer Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) entered name at signing as Patricia L. Wadsack 2024-05-28 - 8:51:07 PM GMT- IP address: 204.10.90.100 ;Q. Document e-signed by Patricia L. Wadsack (patricia.wadsack@fortworthtexas.gov) Signature Date: 2024-05-28 - 8:51:09 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) for signature 2024-05-28 - 8:51:11 PM GMT Email viewed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) 2024-05-28 - 8:56:52 PM GMT- IP address: 76.227.105.128 Document e-signed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) Signature Date: 2024-05-28 - 8:57:39 PM GMT - Time Source: server- IP address: 76.227.105.128 Document emailed to Priscilla Ramirez (Priscilla.Ramirez@fortworthtexas.gov) for approval 2024-05-28 - 8:57:41 PM GMT Email viewed by Priscilla Ramirez (Priscilla.Ramirez@fortworthtexas.gov) 2024-05-29 - 8:32:30 PM GMT- IP address: 204.10.90.100 ;Q. Document approved by Priscilla Ramirez (Priscilla.Ramirez@fortworthtexas.gov) Approval Date: 2024-05-29 - 8:33:11 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Douglas Black (Douglas.Black@fortworthtexas.gov) for signature 2024-05-29 - 8:33:13 PM GMT FoRTWORTH, I P—e'b' Adobe Acrobat Sign ;Q. Document e-signed by Douglas Black (Douglas.Black@fortworthtexas.gov) Signature Date: 2024-05-30 - 4:05:15 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Jesica McEachern (jesica.mceachern@fortworthtexas.gov) for signature 2024-05-30 - 4:05:17 PM GMT f,. Document e-signed by Jesica McEachern(jesica.mceachern@fortworthtexas.gov) Signature Date: 2024-05-31 - 6:19:16 AM GMT - Time Source: server- IP address: 204.10.90.100 Document approval automatically delegated to Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) by Ronald Gonzales (Ronald.Gonzales@fortworthtexas.gov) 2024-05-31 - 6:19:18 AM GMT Document emailed to Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) for approval 2024-05-31 - 6:19:19 AM GMT Document emailed to Ronald Gonzales (Ronald.Gonzales@fortworthtexas.gov) for approval 2024-05-31 - 6:19:19 AM GMT Email viewed by Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) 2024-05-31 - 1:42:36 PM GMT- IP address: 104.47.65.254 ;Q. Document approved by Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) Approval Date: 2024-05-31 - 1:45:48 PM GMT - Time Source: server- IP address: 204.10.91.100 Document signing automatically delegated to Ronald Gonzales (Ronald.Gonzales@fortworthtexas.gov) by Jannette Goodall (jannette.goodall@fortworthtexas.gov) 2024-05-31 - 1:45:49 PM GMT Document signing automatically delegated to Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) by Ronald Gonzales (Ronald.Gonzales@fortworthtexas.gov) 2024-05-31 - 1:45:49 PM GMT Document emailed to Ronald Gonzales (Ronald.Gonzales@fortworthtexas.gov) for signature 2024-05-31 - 1:45:50 PM GMT Pw Document emailed to Jannette Goodall (jannette.goodall@fortworthtexas.gov) for signature 2024-05-31 - 1:45:50 PM GMT Pw Document emailed to Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) for signature 2024-05-31 - 1:45:50 PM GMT Ck Document e-signed by Ronald Gonzales (Ronald.Gonzales@fortworthtexas.gov) Signature Date: 2024-05-31 - 2:15:47 PM GMT - Time Source: server- IP address: 204.10.91.100 FoRTWORTH, I P—e'b' Adobe Acrobat Sign _I Form filling automatically delegated to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) by Allison Tidwell (allison.tidwell@fortworthtexas.gov) 2024-05-31 - 2:15:48 PM GMT Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for filling 2024-05-31 - 2:15:48 PM GMT Document emailed to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) for filling 2024-05-31 - 2:15:48 PM GMT Form filled by Allison Tidwell (allison.tidwell@fortworthtexas.gov) Form filling Date: 2024-06-03 - 4:01:58 PM GMT - Time Source: server- IP address: 204.10.91.100 Agreement completed. 2024-06-03 - 4:01:58 PM GMT FoRTWORTH, I P—e'b' Adobe Acrobat Sign FORTWORTH. TRANSPORTATION AND PUBLIC WORKS March 26, 2024 Peachtree Construction, LTD. 5801 Park Vista Circle Fort Worth, TX 76244 RE: Acceptance Letter Project Name: 2022 CDBG Street Reconstruction — W Ripy St Project Type: 03 City Project No.: 103020 & 103708 To Whom It May Concern: On March 6, 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 26, 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 26, 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- 392-2729. Sincerely, v zefalewl Ayva Zelalem Arega (Jul17, 202414:08 CDT) Riad Nusrallah, Project Manager Zelalem Arega, PE, Program Manager Cc: Victor Gutierrez, Inspector Donald Watson, Inspection Supervisor Oscar Aguillon, Senior Inspector Zelalem Arega, Program Manager Riad Nusrallah, Consultant Peachtree Contruction, LTD., Contractor NA, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 CONSENT OF OWNER]X ARCHITECT SURETY COMPANY CONTRACTOR TO FINAL PAYMENT SURETY OTHER AIA DOCUMENT G707 Bond #107709101 PROJECT: 2022 CDBG Street Reconstruction Project -City Project No.:103020 & 103708 (name, address)Fort Worth, TX TO (Owner) ARCHITECT'S PROJECT NO: City of Fort Worth 200 Texas Street CONTRACT FOR: Construction Fort Worth, TX 76102 CONTRACT DATE: May 23, 2023 J CONTRACTOR: Peachtree Construction, Ltd. 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) Travelers Casualty and Surety Company of America 9601 McAllister Freeway, Suite 700, San Antonio, TX 78216 SURETY, on bond of (here insert name and address of Contractor) Peachtree Construction, Ltd. 5801 Park Vista Cir., Keller, TX 76244 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) City of Fort Worth 200 Texas Street, Fart Worth, TX 76102 OWNERS, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 13th day of June, 2024 V _ J~ Travelers Casualty and Surety Company of America Surety C pany Ana re of Authorized Representative Attest: _ C' (Seal): Brisa Reyes Linda K Edwards, Attornev-in-Fact Title NOTE: This form is to he used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition AIA DOCUMENT G707 - CONSENT OF SURETY COMPANY TO FINAL PAYMENT • APRIL 197o EDITION • AIA ONE PAGE © 1970 • THE AMERICAN INSTITUTE OF ARCHITECTS. 1735 NEW YORK AVE., NW, WASHINGTON, D.C. 20006 Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company �TRAVELERS'J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Linda K Edwards of FT WORTH , Texas , their true and lawful Attorney(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 21st day of April, 2021, !r �Jzair AN, {k ti0.9i{6 �a «e pm /JJJJ/ HACONN. ), CONK. State of Connecticut �/ 1� By: Y� Y City of Hartford ss. Robert L. Rane , Feni,, Vice President On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission expires the 30th day of June, 2026 i ruc��c Anna P. Nowik, Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in - Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. 1, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect. Dated this 13th day 4f, Jifnf �y -2024 that the above and foregoing is a Kevin E. Hughes, Assistant Secretary Tc verify the authenticity of this Power ofAttorney, please Cali us at 1-800-42.1 3880. Please refer to the, above -named A ttorney(s)-in-Fact and the details of the bond to which this Power ofA ttorney is attached. 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 Brendan Taylor (name), Project Manaizer (title), of Peachtree Construction, Ltd., 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 City of Fort Worth has been paid; and That there are no claims pending for personal injury and/or property damages; On Contract described as; 2022 CDBG Reconstruction Project By Subscribed and sworn before me on this 1 3-81 day of 'T�VMQ. ,2aA Notary qPuPnarrant County, Texas lane, Lynn Reiter I,;y Commission Expires _ 8/28/2027 - %�/ Notary ID130350671