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Contract 58743-FP1
FORT WORTH, TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COMPLETION -FP1 City Secretary No. 58743 Date Received: 8/20/2024 City Project N!?: 102976 Regarding contract 58743 2022 Bond Year Contract 3 for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 11/29/2022 through M&C 22-0972 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 A&I.— Z— G(/acel. c Patricia L. Wadsack (Aug 16, 202413:18 CDT) Recommended for Acceptance Asst. Director, TPW - Capital Delivery $ 7,776,825.07 Days 400 $-21,030.00, Ns 2 Days Added by CO 3 $ 7,755,795.07 Total Days 403 $ 6,306,499.66 Days Charged 403 Days @ $ / Day $ 6,306,499.66 $ 5,991,174.68 $ 315,324.98 Aug 16, 2024 Date _Z......,? Lauren Prieur (Aug 16, 2024 13:25 CDT) Accepted Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT Asst. City Manager Comments: Aug 16, 2024 Date Aug 20, 2024 Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment Invoice No.16-FINAL To (Owner) City of Fort Worth Invoicing Period (From - To): Invoice Date: 7-1-24 to 7-31-24 8/l/2024 P.O. FW020-0000009147 From (Contractor): Remit to(IfNot Automatic Deposit ): Number: MCCLENDON CONSTRUCTION Project: 102976 Contractor's CFW Vendor No.: 0000007403 City Secretary Contract 58743 Contract 2022 Bond YrlContract 3 ame: Number. Name: umber: Application For Payment Change Order Summary Approved Change Orders 1. ORIGINAL CONTRACT PRICE............................................................ $ $7,776,825.07 Number Additions Deletions 2. Net change by Change Orders................................................................... $ -$21,030.00 1 $196,280.00 $217,310.00 3. Current Contract Price (Line 1 t 2).......................................................... $ $7,755,795.07 2 $6,125.00 $6,125.00 4. TOTAL COMPLETED AND STORED TO DATE 3 (Progress Estimate, Construction Allowance and Change Orders)......, $ $6,306,499.66 4 5. RETAINAGE: 5 a. X $6,306,499.66 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).............................. $ $6,306,499.66 TOTALS $202,405.00 $223,435.00 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)........ $ $5,991,174.68 NET CHANGE BY-$21,030.00 8. AMOUNT DUE THIS APPLICATION................................................... $ $315,324.98 CHANGE ORDERS 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + COs + Line 5 above) ............... $ $1,449,295.41 Contractor's Certification 10. CONTRACT TIME: The Contractor certifies with the submittal of this document and associated Payment Request a. Days Awarded 400 Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all b, Days Added by CO 3 previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with C. Total Days 403 Work covered by prior Applications for Payment; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and encumbrances (except d. Days Charged 403 such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, e. Days Remaining 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. a Liquidated Damages $650.00 x day 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 58743 2022 Bood YrlContract3 7-1-24 t07-31-24 e I lam edQu ry �311105fi1 j P g[er Pipe LF j $24500 59,600.00 I 33" 02618^VVL �aIeS��j�'a LF fi200ryJ g1150 I 33tt ot6t6PVCwaterf t�q LF IIII 33331t22330000320'GE4 0ud 4t1216 G $6.80000 E8.80000 V$1,-00 E200 $2.S500 $U.-Ml 6"D V 7 33050003 ED W1- II 306 ILrgGnnec rsonI�oLownsmn 9$10400 1-001 $ 2$3 175 0000 $71o0011 131221]] 2' Water Service Meier Reconnectlan EA f $1.10000 E110000 I 331222032'Weer Service EA f $5.26000 3626000 I 3312210111/2'Water Serv�Meier Recannec[ron EA I $1.t000Jf St t0o.00 I 1312210311/2'Water Service FA '1 $4,95001(f $495600 I 33122001 1"Water Service Meier Reconnecbon FA fA $55001�1 $69 e50.0o I 3312'0031'Weter Service E4 12� Ei 500�``''((JJ $336550 a0 I 331220041' Private Water Service LF 31r1 $50001 $t6500.0 I 024t 1218 4'-12' Water Abandonment Plu E4 1'2 $55000f $6,600,00 I 3311 0001 C ron Water Flltlnos wl Re lralnl TON J MI. 01�ff $29,850001 I 3312 D00t �1. Iranttry' yymm E4 if $1.-01�ff W.-oo I 024t 100E WT�°G eolaroul rip SV fi33f $17 N1jj $11-50 I 0241 10111 Was L CV 81J, $40001�ff $32.00000 I 2 01411303 Remove 8 Sa vane 8" W alai Valve EA 1 /f, 12500�`1'�//1, I 3 02411302 RemoveBSavaae 6"Water Valve J $25000 E 45000I, I d 02411301 Remove85e pe �4'Weter Valve EA 5000 I 5 02411510 SR: vaae Fire F�% Irt EA J1J $62500f E2 )500 I 26 02411514 Sa vaae 2" Water Meier { $16501if 65W. I 21 02411511 Sa vaae 1 l/2' Weser Meier $t251 Ea mwl I 26 02411512 Sa vaae 1" Water Meter EA I 29 02411511 S ��((++e 3l4' Water MHer EA 6lJ S60 0 ff E6.72000 30 024117001 YPav Rn17/u���er IVaptB CrensM1awl SY 3600J 61601(f $57.6W.001 3t 024177��'9{((�1{{II IjFI�I 71:%/ e� LF 756G666J 510511(( E7.8]500 I 32 3123 Uf01 Ilnc ass ed Exnvatlon Man CV 10�1J 5780J ",-ml 33 110t D1225' G1al ep�r. Arterial LF fiil $121M $7.50o 0111 320t Ot 125'Wlltle Asphalt Pvmt Re rr Resitlen5al LF 3�1 $12500 E3.75000 I 35 32010202 AspM1all wmt Re pair 6evond CeSnetl Wltltn. Arterial SY Sw 00 $1.00o001 320t 020t As.2 Wmt Repair beyond CeSnetl WItltM1, ResltlenUal SY I 6 20 woo 1100000I I37 Flexible Ra )LF 8S33$85 0 1.1-W Cone Cu bsandlGutter9 B" Repair (2'HMAC on LF 051 0 I 30 32160101 b�, I 39 0.1.01 Remove Concrete Drive SF 5 JJ S75O f3,150001 I IIII 321306'Cov}n IF 5' 6160w $79.ot0206.00 I 320,0614 C..P7n,� SY $120500: me321106 CeTN $34$70o 1 3pVewTN 302E 11214nsUo$05 DW $21.1-11 6030t 7' CoSY g130'e $1i001 1113/1/1 4F 19 $115,9320 3291 Ot OD Topsoil CY 51 $w of $1.500001 I 3292 D10001ock Sod Placement SY 10i, E24000001 E2AO OOo 001 I 33o4 of of Te ryv Water Services LS f 33050103 Ej'�'�/Q' f��`Ex�avation of Exlsenn Utilities EA 2 $2.00000 E16000001 I 51 33050109 frencTrS'a1pjy. LF $100 E2.WI I 52 33050111 Valve Sax /usbnent I 1 $45000 E585000 I 53 7 t• ncr for Valve I. $600 OJ E3,o06001 I Sd CSS CY 1 $1250d 112500.00 I 5 3 moarte m edmenl�cW,II CLSM CY 1Dy I $1500J $t75a0.0o I 56 3305 0- 3151207 Ill�qrted EmbetlmenUBecM111 S.-F,F,II CV 12 $ 13b500E $1z.650.00 I 34710001 TraMlc Con.1 MO 14f111J I 01710f O1 ConsbOCUon StakinP LS 12.W OU E9.1m001 I 3125.01Of SWPPP i 1 acre LS JMi. I 0171 D102 A-111 Survev(Redline Survevl LS 1J $5.25000 $1.250001 I 9999 D00t Miscellaneous UtlUty Adiu-.1(IIII-ions LS fffJ $5.-00 $5.000001 11 3111/012 Water ConsU0c0on Al1-- LS 11 E100.0.00 E100000001 -T 2 - I IB' Se11llllj'•�ll 1CR-21. A- bleB Idll LF 100,�f 51300E E13o.o00001 I 33314tt96' IPSV'i .Yo nlll�e at-4Qr .lino LF 2100J 51550E E3265000D I 333t Ot03 6' f r LF 2 $11000 $1.50o001 I 3331 1t02 6 ipe�nlaraemenl LF 5', F, $10300 $54A]5001 I 33311102 o8 P-EEnlaraemge�nt q LF 2571 $12000 $30.000001, 6 33//1201 viceH ns em Pe Enlar9eme lw/2 WaY E4 26f $1$18000 83220000 1 8 33313101 4"Sewer Service EA 5 $2.35000 113395DW I9 III-01�Me ale M1ole Liner (Warren EnvrronmaRel or VF 1 $82500Jwo ff 23050001 I 333910034: ExtrafJe01M1 Man1lol. VF 1 $$75001(f $3�.000.001 I 33391004 4' S�M1�alplogw� 1.lanlrale8],ry� E4 1I(( I11 3339/006 Manhole AdSulstmenL'M���M1ppMa IM1Cwer VF �JJ E$5500J1I£$7950001 I 16 0241130E Remove Cone CUN80dHerw LF 21 /1 v6VVI"aaeva° c ref Q°av�N meW Q V ue v Ius eon Y el Ve VelueT Pm 1m I 571 t,W600 $4,900.001 $8,800001 $. 2.0W E7756o01 $93600uni $71,500001 I I $6.W 51,00 $8.-01 E4,d0000 $2736501 $18,ool attaz 91 , $3,7-111 $1. 0000 $25000: 12,d75Dol I $0M $7606001 $4,750001 $-.899.1 $76253.751 $163-01 $102210001 I I 1 :240,o00001 $16 ow EtOowl $e?160.00 $12,6.0W $9,150001 $5,250001 1 E116950.001 $!III. .0M 1 $5,500 $32,00001 Ef3do1 D ,oDI $133.1-W1 $17.06D.001 $140211W1 $2,751111 $7,95_I E25E0 M�vl6e 1 Contractor's-AppKizatladh 16-FINAL PP °On O00' WIO024 6 6 m mws erese"dr i ¢aaws a 61andlnplve) 10 ue11e IQ+61� 1711:1 00 99.7% Sd.90000 6t3% f..eoo oo 1 $86-d 9 1771101 6 f83600 CE 889% f71 Soo CE too o% 16.75o000E 114%% $3160 101 200.00 E467 d002% $0362d 9 N1loE 4 $375000 e % 3100000 e % 1250t oo 00 0 1247501 11� .00 105t6% f760600 tOp.O :4.750011 W3% 121.MW .41 E76253 iE 95.1% 115.3000E 6t6% $1.2.-oo 9d 6% 124111 00 1 f11-�E t f1o000 500% 562.1600E t000%J 512.6500E 100.0% f9.z5o 15o 000 1 o% :5,o too St 1695000 91.5% 596.7200E A7% f53,5zoCl tm $340000 100% E3-IIII Ell 00 1 l $27500tOO o 82325Eof70-1$23200h $7,-.0 E?100 St700.$1IIJ-0f1- Fa6m.la c eVNielvw Qrrvrury (nulled ilus v oa m I $9.6000 $1.9550 I $3.1000 I I E3,o80 dI I 111701 I f11004455001 I J I E11000666J I 562600E I $1.10021QE $10l 1 $70� 200 5EE4A0000 $2,487 12.0oo C d%$..00IIIIIIII f21.21111 dE I -III:, I 125000 I I 11650E I 0 $ze0 i4 50A 78750E I I 2.75o9I :3.75o'I I E1,000 EE I E, 000 00 I :147" 563.7500E I 0II0 II U.- I $3.d000l I $171100J I Em.5000E I 113.1670E I EL93z dE I $1,500 dE I E].DDDde I I I 110000 I 15850.E 53.0000E I 1125000E�J I En.soo I $60o00EE I -.0od I I I I I $5.0o0 dE I WO.- 0o I E11.0,. of I $221-0. I $5.50E 4sdE II 42 ld I I I270000000 I $1.-.00 4W 0 IIIIII $77500E 510.7000E I E2,,7.A I .1..00-.0 49 WW0000 $711 500 $4,90000 $8,80000 $. 2d000 $1711011 $8360DW f715 1250 9000 $31 1600000 E6,10000 .Do B OOOODOOD n,36z o $,8,0 fttotz 93 fto,,aoo 00000000 $3,75000 :,00000 00000000 $25000 300000000 $21750D 12501gO1g00 $1010 30-CM000 $.,512 10000D00000 17-W $4,71- 7- a250.e9900 602030 W. E75,25371 d500000000 $15,30000 3d070D000000 $10221000 $240 si$,o Oo I. E1o000 a OOOW. E6216000 1 ADOOD000 III ,65000 f9,l- 00000000 f5,25o00 11500000000 $1 MAI`00 62d 00000000 I.,-00 f..a f3.oo $3,40000 :31.0 5711-0- $13500 31 W000000 $17100000 17-110 $140,25000 33610000000000000000000D000000000EE0 E2750,00 EEE tite u65211f72N3,296M5551000W0000 Progress Estimate c°w�i rv"m 58743 2022 Bood Yr1C.Mr-t 3 7-1-24 to 7-31-24 9 c 1 find lean rva 1arc Q P s«6o"rvo umi ofMesurc end Qummry uxi P"ee end value H WWav I 02410100 Remove Sld.lk SIF 2 W E450 SMwI I I 02410300 Remove ADA Ram�Ve 0241 NO Remove Concrete EA SF / 5 $05000 $5 0 ff S900w 12,100.001 I 321300016'Convete Dnvewav SF 52 $1701{1 E8,500.001 I 02410j50�01 Remove Fenw �n �ola LF SY 25//yyJ1J,'1' 65{J $3D 011((f $1,650001 9000000i $1 AOoO01 12.00oi I21 0241286i olej $g o01( I 311001026212'Tree Removal EA Ii $75000 $7.500001 I 3„00, 0312- EA /J $1,000 OU $7.000001 I 3110010018'20"ire Removal E4 $1,-00 $4.500001 I I 30 31f00f0520'antl Lareer Tree Removal 32010112 5' Wltle Ayy++1I11 Reoa" Resitle"" E4 LF a 1{ $3.000 OU $17500 E9.0o000 $1925001 3201020,ASPI1all Z.T.palr Beyond O.ZZ WltltM1, Resltlen0a{ 7 SV 31 32010400 Temporary AspM1alt Paving Repair HMAC 6" J E2500 S17- 32 IT an Fl--Basel LF 3000 $3d 00 E102.00V.00I 2J2900000i 1 33 I 3l 3201 0614 Pv ,Revdentral 32130301 !"llonc TITLlk SV SF fi3¢i 22U $1109J $130� $70.OM 071 f2,9600d 1 35 I 36 32130501 Barrier Free Ramp, Type 11 32180301 ]'Coot Vary GOVar, Resl0en0al EA SV 2 25 $3.1.06JJ $12500J E6.30o Oo1 E3.t250o 1 3J I 30 321601016' Conc Cu and Gutter 323101t38'CM1aln Link, $ted LF LF 21J G $fiOUJ EBSOU $17.3.001 ES.t000o 1 3231012, 4' CM1am Link, Aluminum LF Efio6�1 f5.700001 I 3231//12 e' Fences, Wood LF ,0 E60.0 J E8.o0o Ool I I 2 32910,00 TyHgail 32920100 B�locllcc 8otl Placement CY SV 1S 0 E300�1 $] Oil fd 50o 0o1 E2,'0' I 3 32920400 Bwd�'{!� Hy/1 ICM1 SV 110 E]0�1 fJ ]0o 00 I u nl spPeectSllon LF 180 E10.0� 1 81e.30 o0p.0o 1d10.ODM 46 Ia3IIa3IIp0y1110p00'1f01ry'1 PP}reC'�j[,:�/IV 1111H �1111 r�lanlM1ole�cuum'1e . LF 3JJ1 L450011 Sf9.90o.00 3J21 �000OOi I 1 33050103 Explo2tol1''((Exwvatlon of ExlsOng Utllitles 3.05.10'7 ManM1ole Adt linen[, Minor EA EA / $2.000011 $35001J S14 OW 001 )000Wi E3,15liod 900o00i I 1 I 33050, 09 TrencM1S ta,�1yy 33050112 Cancreleoller far ManM1ole 3305 D2021—Od EmOe—VBackfill, GAS LF EA CY 330 1�JJ IUUf E1011 $80001J $125011 E330o got 1woo0 $tt.zW.0o1 2�800o0Di 5,2500 o01 1 330502031 E pP_dl I� II, CLSM yyyyyy Ijj11��� CV 3 $190011 $61.]w 0o1 �Ow� I 1 I, C—h. Rock 3305020d //^^ 1E[[mm``�p[[�ll_l%%/1/--AA'' 3305020J ImpgEmbetlmenMll, Selec[Fill CY CV i0 16�� $50oil E4501J E5000001 E0.500001 I 999900,d Remove Bearer Vault EA I $,.000 OQJ E1.000 00l 100o0Di 1 I 34J1.001 Traffic Control O1J, 01O1 ConsVOctlon Staking MD LS �� I $20.5502 $9.35000JJJ $61,650001 00000i E9.35000 10po00i 1 3125.0101 SWPPP zi acre LS I $J,500 OOJ $7.500001 wo00i I 1 Ito 017101/2 ASB011t Survvjjl1,,Y {Retlline Survey) 999900156" b B'EseankrsRetluwr LS EA I I $20000QJJJ $BOO OOJ E2o000o 100o00i $500001 I 61 62 9999000d Miswllaneous Utility AdluStment//Orrigallon) 99990005 Sanitary Sewer Construction Ae—nw LS LS I $5.0000 .0000 E50000o1 S. ow Oo iB I zB 0241 JJ/�ljj�=/yA ttwl�t yPlan 3,23 {0{ IJ classll(e��xpvallo q CY SY u/I 1640U E330SS � JJJ 1- 0001 $211 0000 i6d000D000i I 3B 32110400 fjy/N0 Lime 40I— TN 384 $29$500J f11328000 d081200; I dB I SB I BB 3211050' lJdl. eTrwtment 32130f 0, 8'Conc Pvml 3305010J ManM1ole Adlus[ment, Minor SV SV EA 19195J 1664 1 E]OQJ ES]OW $3000QJ E13d.3650D 1. "0""0i $951387 00 93: f4,e0o11 �1500000i I )B 33050111 Valve Box —1 E4 3G((11/I $2500 E)5O000 o0000i 390000Di I 8 1 9 1 ,0 01710101 Cams[ruc[ren {eking 02410100 Remove SId—Ik 02410200 Remove Step 1 LS SF 1 SF 1l 678{J 1���000� E18.5000 Jj E4 vfOJ $75�6J $t6.500.001 S305d800 5128MOWi $)50.001 I if 1 12 {{��QQ QQ�� v ADA Ramp 02a�04���emov Crete Dnve 1 1 EA 1 SF 1 000 $4000, $4 �JJ $0401011 900000i NO.Soo 0o1 58988oWi I 13 02410402 Remove ASpllalt Drive SF '00J1 $d �OJj E450000 9015.90000i 1 14 02410500 Remove Fenw 1 1 LF 2 Bf $500J $1A00001 1900W00. 1 15 020, 0600 Remove Well <d' LF 10(1I E30 00JJJ E"0"'! 1 16 I iJlaj�I 02410J04Remove end Replaw MailOgx-TradNonal MallOox-Brick .Iy EA EA 31 $20000J $1.35000 EJA0000 7o—Oi $5.do001 3500ooDi 19 1 20 8�i1 PbBs remove �C�o ` /vmf 02412 1 ��8��emove Cone Ve y`G1uHerr 1 LF SY 1 SV 316) 3� $270J E] 50JJJ $2400J .11 $3d.500.001 393.0C. $7.No 001 14155000. I 21 1 22 I 23 3„00, 0, Sile Clean �� 31100.102 6'Trea —.-I 31f00103 ,Y-16"Tree Removal SV BA EA 5 12 f ES0 $3500 J $JOO OOJ :2.501,01 f J0000 wows Ed.zoll.00 100o00i 1 24 I 25 I 2fi 1 2J 311001ot 18'-24' Tree Removal 31f00f0520'antl Larll acreree Removal 3125.01Of SWPPP z 3211.1126- FIew01e Bew, Type A, GR-1 E4 EA LS SV ` 1 { 200 1 %�h $2.60001, $J.5000 J $100 $4,60000 812.0.00 10Do00i $750000 100000i $20.000.001 I 28 3212 D40t HMAC Transition TN 20j $2500� S50 ow Oo 3288000� 1 29 I 30 1 31 32160301 )'Cone Vellay GuOer, RwMenOal 1 3213 D3014^Conc S0-1, 32130311 4- Conc Sidewalk, Adl--W Curl 1 1 SV 1 SF 1 SF 2 2336" 1.27'�6pB8i $1230 $2d.600 001 If°mtme,M& f928,46901 LA'I1 Contractor's-AppdierAI F,6ma1e 16-FINAL SIMON f2.)0000 3531 f5600.00 260% f1oZ" ]50% f),50o 00 1 f5.aoo oo ) f,,50000 3 '0 oo9p ,999 f39,, 568) 559% 18.301i0o 1.0% $5.40000 047% $M817111 t $st1.20o 0o t.1.1 $11980540 1 $123666 so 92o% S938 deSol 97e% f4.. o0 f]21101 E155oo0o t0080% f230]]80 % E3.6000o 8�. e% fd3,, 5358 1 $0,0 to g50% f95o 00 f)A0o 0o 1 E6.)50o0 1255% f1n,e3z o6 1z s3z.635 o6 $3.—N d]z% Ezd000d 200% f7 Soo Oo iW $821500 164% 521409J 95 131% $1d1.J90 eo s42% e)m� Qre"ury lnu Ns fWo oo PmW f93o 00 $250005 St. 'Oo 05 N.9500� E2,.4s4 9d E14.4000Al $3,60o 0 E900 00 $2,000 0 $3.owde $30.865 20 11),36000 $5.10006 two 0o $600006 32.Bo0 06 S]J000o $3.900 06 E 96 0o 1450 0 f35900 $6.400 oo '1250000 feo.e950o $500o06 —to o0 f 0o 00 $500006 1. olio 00 4J No 50 4852540 E10.69666 1.01] 99 f30o 00 f25o 00 $]08830 EJS1 00 EB3o 00 42,053 ss 1411 00 $3.o0o 06 I I 41a5o o6 I 1746e] 94 I $1.B65o6 I $3.a12 So I $250o 06 I 1241 to I $650o 06 I Xuo 00 I 3.B0006 I :2.0oo 06 41 J85 00 E24600 0o :41423 55 E26.533 20 Progress Estimate 2022 Bood YrlContr-t 3 7-1-24 to 7-31-24 I Bid Iran rva I 32 Icem Uesenpnon 32130321 C.panc Sidewalk, Adlecenl to Rel Well {'%nalCBVc—kef Sidewalk I 35 I 36 31,3050, Barrier Free Ram,R-1 32160101 6' _ Curb and GuNer I 3] 321]0502 Preformed T6ennoplas9c Conbasi Markings-24" I 38 321]'001 Curb Addrem Peinbng I 39 I 40 32310121 d'C6aln Link, Aluminum 32320100 Cace R4 Wall Adj-0. Sidewalk I 41 I 3291 0100 Topsoil 32920100 Black Sod Placement 42 I 43 I H I 5 I 334500a8 ^ Pipa Untlerdreln, Tpa8 jvQjF 4��a ean^pnace rlet Tog, ,P a still $ign Panel and Posl U710001 Traffic Conbpl 46 I 4] 33050109 Mate%reB@o. Adl,—mt I 49 I 50 9999 UIrer%reatlump, TyyP R-1 MotllOed 99990009 Earner Free Ramp. Typ \�-1 Muddied I 51 I 52 99990010 Barrier Free Ramp, fypa 2 ModOetl 99990011 Earner Free Remp Tyy \M-3 Madlfied I 53 99990012 Barrier Free Ramp fAyI7. S I 54 9999000]Miscallaneous Utll//ty AdlOslment(Irrigallon) 55 I JJ9990013 Paving Canstruclion Allowance I I I I I I I I I Twale ° rvm 58743 Contractor'&- dh F.eamaie 16-FINAL pp �m"prc". r M024 9aoon No 0to1 °fMeesurc end Qumv 9' umpue end value &m"a m WWav'tl vaue Prcn Y mellM ve ue value TN PmM $1�rcadt°lnpareimce"cd)Y wreEe 'o alekNtlE2v+t2WE"]1 Bele�$tF$'m22]WH0 2 11 13SFF 135 1323200000 2558 $t25W.80 5IS 0e % IIIIII 0� 00J $..WO 216333% % 6 SF 1141 .-00— tB]OOOOOO $5,28 f252:—W $522. 0 01 139.3230 EEAA 14.6500 1465600 1 $4,-00 $4,65000 f465006idd{ 8>80 815OOO2� $BF Ee0% f$16.92td0 LF 3� �J 11500 EB.d]O.00 10p 00000000 i].00000 $i.000.00 Ei200 825% 17WW $0.9dW00 0 IIIIIIIII S 2% E9.d5000 500 1WWWW 0000000 0,W000 $11,900 $3,50000 $11,90000 3.W002 0 $11,90000 1 0% 0 43.1.N2(gI 3W00CY 420WOWW i120000 $t28W.00 E12.5000 EA.i600000 SY ]OO $7 OJJ N9.00000 400 WOW $.3.00 $28,350 OD 3.W8% 8 F 2/ $10.41.01 E10do0o0o0 $8520J $7000 0 . $16,W000 83000 8. 000 MAO SF EFErAAAn ] 4d $21000 OJJ $50 3.600J 5 E147.110 W E5,35000 200 1t $122 W ]00000O —0— O WoW0 $14].00oo 5 $915o0 $8,0000 f147,0000 f50650 $11t,2W25 $O'l100. $8,90000 $147.000 oo 1000% 005 / $11.250 1 $91500S0 ] 0% fW00500% $3.4J $$58.93W000 $100 005 IIIII LS I I I I I I I I I I I I I I I I I 2% � E26o0 1006� 0000 E100.0000d� $50. m0001 tW000 00 I I I I I I I I $].nc 625.o7I 999999W9 WW 019002 $V0909 E10,2000 10.— f5900. $t020p.00 $0,50140 I I I I I I I I I I I I 2o90 10.96 10%AS 0Ml 40 190% salo].219.6c ]asx f40496 e0 I $1o0.W00 I I I I I I I I I I I I f1...eoe.411 ac19].219se $c1o]21e.ecl mi mem�9 Construction Allowance Usage Contractor's Application C-620 Change Order ADDITIONS For (contract): 2022 Bond YrIContract 3 102976 City Secretary 58743 Application Number: 16-FINAL Contract Num: Application 7-1-24 to 7-31-24 Application Date: 8/1/2024 Period: A B C D E F Item Balance to Estimated Previously Total Completed % Value This Materials Presently Finish Quantity to Add Unit Price Addition Value Quantity Value Installed and Stored to Date (F) Period Stored in C) Quantity Item Number Description Specification Unit of Installed (not Value (D+E) B (B-F) Installed This Section No. Measure Period Totals 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 Construction Allowance Usage Contractor's Application C-620 Change Order CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED IF., /COm—f 102976 2022 Bond YrlContract 3 Application Number: 16-FINAL (Application Perin 7-1-24 to 7-31-24 Application Date: 8/l/2024 A B C D E F Item Bid Item Quantity to Reduction Specification Unit of Unit Price Not Used Not Used Not Used Not Used Not Used Not Not Used Not Used Number Description Delete Value Secdon No. Measure Used Totals 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 Change Order Number I 1 I Contractor's Application Fa(awtrw) 102976 2622e0.d W1C0.tr.ct3 APPhcahw Penod Item Cl�avgc OMa Item Deempuw No 0 8"Sewa PVCPip,SDR-26CI 160PSI ADDITIONS 09xremy 58743 APPlvmmn Number 16-F] Cwtiact N.. 7-1-24 to 7-31-24 APPlvanw Date A B C D E F AM —Change ESM1 WQuantity Pre. Iy Valw TWs M—.6Preswdy Taal Co,= Speafiaatlon CO Quamnyra Add Uvn ofMesaure Unn Pace Order Value Ina�slled Value Inamlled Value Pmotl Slmed (vam C) and 9[ored to Dare (FJ 9eclrw Na 1D+E) B Sewer-2 LF 1402.00000000 $I. a0 $196.280.00 1402.000OIg00 $196,280. S196,280.00 $1%.280.00 100.0% 5196,180.Ip 5196380.00 $196,280.00 $1%.M.00 10— This dwoment has been mWlfiM fiwn its -gmt form as en EICDC d-1 and the user dM na highlight the modtfiwaws Yw areencouragN to read the dwnment cmefiilly end cwsuR Legal Cowsel poor w ns execution CE20 Change OM., Balwu b F—i M-Fl Quanatylnsmlled This Penal C-620 Change OM., Progress Estimate Change Order Number 1 Contractor's Application DELETIONS 102976 2022BondY,1Cont—t3 Apph—Namba: 16-FINAL IAPPhwtiw Penod. 7-1-24 t0 7-31-24 APPhwtiw Dat, 8/1/2024 A B C D E F em Changel0o ahem D-01-It Cp QuwmYto 3cea'aov Nan u.., e — Ihlae Deleuw Change Unn Price ada Valor Na Used Not Used Nm Ueed Nm Ueed Not Uaed Not Used No�Used Not Used 2 S'DIP Sewer Pme,-d mo4°tive 401 awfi= I I S--2 LF 1402.W( 0)0 17,3104 I I I I I Tahb / SEl],310.W I I I This dwumenr has been mWlfiW flan its original form as an EICDC dwumwt and the user dM na highlight the modtfiwhws Yw areencomagN to read the dwnment cmefiilly end cwsuh Legal Cowsel poor w ns execution Progress Estimate e«cwno-a«> 102976 2022 eood YrlCoo-vaa 3 AppLwnan Pmiad 31 � ltem Change ONm Itnn 0 ceampRw� Wide Asphalt Pavemoot Rewic Ntmial 64 Plpa 6'Valve Change Order Number 1 2 ADDITIONS CcmWrca<a rvom 58743 7-1-24 to 7-31-24 peafiwtian nit of COQwudyto Ada Unn Pn« Aaa uonCMnB< —d Q-1y S«non No Mweur< Ner Value Ru Iled III- n: 9�2500 53. 12500 ware. U. 1.s �O000o000 s3000 o0 s300000 1m0o00o0 rm: aowm<m h,a x<n moa�R<a a«n �u o�gn.i row. as en e3CDc aowm<m ana m<w« ma not h�ghhsxt m< moa�Rwnona. vw a« <e<o,pag<a m «aa m<aowm<m <aremnr a,a <o�w,h 1«i town«� pn«m eta <a«nppn Penod sl—(.1,. qP Contractor's Application 16-FINAL 8/1/2024 e Ragan« m e�n�ax Ow caopietea A Bta«d to Raa B �'R) (p+) $3,125001 s3Odo oo 1op re� 0-820 COange 0.., C-0 Ch. 0.., TMs d., h. ..V-1 f asw PJCDC d., and the— &d nor hlghhghl Progress Estimate Change Order Number 1 2 DELETIONS ...... no-aN> 102976 2022600d YAC-n .d3 IApphwhwp.;.a 7-1-24 to 7-31-24 A B Imm COD U to awon Chang< Change Omm Imm mp w 6pa.fi®lion nit of slam °1 nm mar Valoe WSanw No I 63 Wamr Cmsrmcuw Allowanaa ML eaUnnl S < 000612500 81.000.000 aG 8612506 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 Tdvlr 56.125.06 Apphcanw Nmnbm App-1. Dam Nd Used Nm Uxd Nm Uxd Nd Used Nd Used TMs dowmem hu ..V-1 Pam as w PJCDC dowmem and the —Ad nor hlghhghr m< modrficauom. Yw arc <mowag<d m read m<dowm<m earemllY and comuh Legal Counxl poor m rts uavow Contractor's Application 16-FINAL 8/1/2024 Nm Uxd Nd. Used Nor Uxd C-620 Gh.n Omer Progress Estimate 102976 2022 a..d Y,1C, d 3 AppLwnan Pmi.d Change Order Number 1 3 ADDITIONS cwo-.c«rvum 58743 7-1-24 to 7-31-24 aam... co Qwmll—d —I PH. cn.suom« Iw 1 a rm.d ..<m h...V-1r ....urnc a..w.<m..a m<..« md... nlgeegnl m< m.aawn«.. vw.« <......g<a m «.a m<a..w.<m «remnr.m <w..1.1<g.l cw.«I p•«m.. <.«.... Contractor's Application 16-FINAL 8/1/2824 1 �l compmma ^r. (—E) sm a (o+e( G620 mange Omer C-0 Ch. 0.., TMs d., h. ..V-1 f asw PJCDC d., and the— &d nor hlghhghl 0-020 Ohange Omer Progress Estimate Change Order Number 1 3 Contractor's Application DELETIONS ...... no-aN> 102976 2022B..d YrlContrvct3 pp] —°"°robe` 16-FINAL IApphwnw Peri.d 7-1-24 to 7-31-24 APPlmahon Unte 8/12024 A a o e P lkm COO nary ro <I<°w Change Omer l�em amT�w Sce.ficatiw Mtod elate Unn Pnce ChO.nge Order Not Used Nm Uced Nm Uced Nd Used Nm Used Not Used NU Used Nol Ua<d N Sanw No Valve 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 idvlr Tlns dowmem h. ..gnd f asw PJCDC dowmem and the— Ad rot hlghhghl th< modrficauws. Yw arc <wowag<d to read th<dowm<m carePollY aM aonwh Legal Counul poor m rta uxuow c-620 G0.n Omer Progress Estimate Change Order Number 1 4 Contractor's Application ADDITIONS Por (mntraa) 102976 2022 Bood YclConlracl 3 Cry&a< 58743 c trnclry App],—N—. 16-FINAL Apphmh.n Period 7-1-24 to 7-31-24 A B Application Once O E 8/1/2024 � Item Change Omm fern COQ pe.fimtion nit of oantitym Add Omt Prim ChangetOrder a mam�Qoanury Vnke m�waly 77n E cnaB Prce<uly ealanm m F�mah -F) end storm tolcDaw f 1 No DmmT�°o 6meon No. Mmsure Vak< ns Iled hut.11ed Valoe Pnoda tined (nmmQ NLE e Tlns dowm<m hu ..V-1f as ao PJCDC docmn<m and Ik— Ad rot hlghhghr the modrficauons. Yw arc c�wowaged m read the domm<m mrePo11Y and c.nanh Legal Counul poor m rts uavnon C-0 Ch. 0.., TMs d., h. ..V-1 f asw PJCDC d., and the— &d nor hlghhghl 0-020 Ohange Omer Progress Estimate Change Order Number 1 4 Contractor's Application DELETIONS ...... no-aN> 102976 2022B..d YrlContrvct3 pp] —°"°robe` 16-FINAL IApphwnw Peri.d 7-1-24 to 7-31-24 APPlmahon Unte 8/12024 A a o e P lkm COO nary ro <I<°w Change Omer l�em amT�w Sce.ficatiw Mtod elate Unn Pnce ChO.nge Order Not Used Nm Uced Nm Uced Nd Used Nm Used Not Used NU Used Nol Ua<d N Sanw No Valve 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 idvlr Tlns dowmem h. ..gnd f asw PJCDC dowmem and the— Ad rot hlghhghl th< modrficauws. Yw arc <wowag<d to read th<dowm<m carePollY aM aonwh Legal Counul poor m rta uxuow 0-620 00a.ge Omer Progress Estimate Change Order Number 1 5 Contractor's Application ADDITIONS e«(m.traa) 102976 2022 B-d YclC,,U, l3 Q,&«< 58743 c trans Ape],—Nom . 16-FINAL Apphwe.. em.d 7-1-24 to 7-31-24 A B AepBc.fi.. o.m o B 8/12024 B m.a�Qo..nry <o.m .n.r co Q...riroa Aaa was.« cn.ose ome< m�u.a v.me m�u,u.ay.m. a�.a a(.m�.Q . as�.� t ) S.—Ne m<n,u« v.m< min B rm. a«w«m n„..V-1r ....urncd .<m..a m<..« md... nlgnngnl m< C-0 Ch. 0.., TMs d., h. ..V-1 f asw PJCDC d., and the— &d nor hlghhghl 0-020 Gh.n Omer Progress Estimate Change Order Number 1 5 Contractor's Application DELETIONS ...... no-aN> 102976 2022B..d YrlContrvct3 pp] —°"°robe` 16-FINAL IApphwhw— 7-1-24 to 7-31-24 AnPhaahon.ale 8/12024 A E o E P Ikm COD naryw ww Change Omm l�em Da mTw 6pa.fi®tiw Mwmtod slab Unn P.m ChOd.nga Urdar Nol Usod Not Umd Nm Umd Not Usod Nm Uaad Not Umd NU Usod Nol Uand N Sanw No Valve 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 idvla TMs dowmem h. ..gnd f asw PJCDC dowmem and the— Ad nor hlghhghl rh< modrficauom. Yw arc <wowag<d ro read rh<dowm<m carePollY aM aonwh Legal Cowin poor m rta uxuow Progress Estimate 102976 2022 aood Yrlcunl d 3 AppLwnan Pmi.d Change Order Number 1 6 ADDITIONS cwo-.c«rvum 58743 7-1-24 to 7-31-24 aamo-.. n��e°an. co Q,..n —d —1 PH. cn.suua« Iw 1 a y rm. a«w«m h...V-1r ....urnc a..w.<m..a m<..« md... nlgeegnl m< m.aawn..,. vw.« <.<....g<a m «.a m<a..w.<m «remnr.m <w�..1.1<g.l cw.«I p•«m.. <.«..o. Appli-fi.. D.te mnal. --y Contractor's Application 16-FINAL 8/1/2824 1 1 cw.pmma •r. (o -E) .a s.orea m D.m a (—E) G620 mange Omer C-0 Ch. 0.., TMs d., h. ..V-1 f asw PJCDC d., and the— &d nor hlghhghl 0-020 Ohange Omer Progress Estimate Change Order Number 1 6 Contractor's Application DELETIONS ...... no-aN> 102976 2022B..d YrlContrvct3 pp] —°"°robe` 16-FINAL IApphwnw Peri.d 7-1-24 to 7-31-24 APPlmahon Unte 8/12024 A a o e P lkm COO nary ro <I<°w Change Omer l�em amT�w Sce.ficatiw Mtod elate Unn Pnce ChO.nge Order Not Used Nm Uced Nm Uced Nd Used Nm Used Not Used NU Used Nol Ua<d N Sanw No Valve 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 idvlr Tlns dowmem h. ..gnd f asw PJCDC dowmem and the— Ad rot hlghhghl th< modrficauws. Yw arc <wowag<d to read th<dowm<m carePollY aM aonwh Legal Counul poor m rta uxuow c-Sp0 c0ange Omer Progress Estimate Change Order Number 1 7 Contractor's Application ADDITIONS Per (mntraa) 102976 2022 Bood YclConlracl 3 Cry&a< 58743 c tramN ApphcmaoN—. 16-FINAL Apphwhon Period 7-1-24 to 7-31-24 A B Application oete U E 8/1/2024 Item Change Omm Item 6pemfi®lion nit of CA Qmm,tyb AdAtion Add Umt Pna CIwoB<Ud« a Q milled oanmy rcv� Vak< TM Mal<nala Prce< ml ealana m F�mah dal Completed and 8torcd to Uaa (B �"F) N aamT�w� o S.—No M <anu< Vnke Imtalled Imtnlled Yilne Penoda tored (rim in SQ (U+) Tlns dowm<m hu h<m modrfi<d from 1u..grim f asan PJCDC doemn<m and 1k— Ad rot hlghhght th< modrficauons.—ar<<d to read th< docmn<m ca-< ,and 1-14gnl1—mrt11avuon C-0 Ch. 0.., TMs d., h. ..V-1 f asw PJCDC d., and the— &d nor hlghhghl 0-020 Ohange Omer Progress Estimate Change Order Number 1 7 Contractor's Application DELETIONS ...... no-aN> 102976 2022B..d YrlContrvct3 pp] —°"°robe` 16-FINAL IApphwnw Peri.d 7-1-24 to 7-31-24 APPlmahon Unte 8/12024 A a o e P lkm COO nary ro <I<°w Change Omer l�em amT�w Sce.ficatiw Mtod elate Unn Pnce ChO.nge Order Not Used Nm Uced Nm Uced Nd Used Nm Used Not Used NU Used Nol Ua<d N Sanw No Valve 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 idvlr Tlns dowmem h. ..gnd f asw PJCDC dowmem and the— Ad rot hlghhghl th< modrficauws. Yw arc <wowag<d to read th<dowm<m carePollY aM aonwh Legal Counul poor m rta uxuow c-620 G0.n Omer Progress Estimate Change Order Number 1 8 Contractor's Application ADDITIONS Por (mntraa) 102976 2022 Bood YclConlracl 3 Cry&a< 58743 c trnclry App],—N—. 16-FINAL Apphmh.n Period 7-1-24 to 7-31-24 A B Application Once O E 8/1/2024 � Item Change Omm fern COQ pe.fimtion nit of oantitym Add Omt Prim ChangetOrder a mam�Qoanury Vnke m�waly 77n E cnaB Prce<uly ealanm m F�mah -F) end storm tolcDaw f 1 No DmmT�°o 6meon No. Mmsure Vak< ns Iled hut.11ed Valoe Pnoda tined (nmmQ NLE e Tlns dowm<m hu ..V-1f as ao PJCDC docmn<m and Ik— Ad rot hlghhghr the modrficauons. Yw arc c�wowaged m read the domm<m mrePo11Y and c.nanh Legal Counul poor m rts uavnon C-0 Ch. 0.., TMs d., h. ..V-1 f asw PJCDC d., and the— &d nor hlghhghl 0-020 Ohange Omer Progress Estimate Change Order Number 1 8 Contractor's Application DELETIONS ...... no-aN> 102976 2022B..d YrlContrvct3 pp] —°"°robe` 16-FINAL IApphwnw Peri.d 7-1-24 to 7-31-24 APPlmahon Unte 8/12024 A a o e P lkm COO nary ro <I<°w Change Omer l�em amT�w Sce.ficatiw Mtod elate Unn Pnce ChO.nge Order Not Used Nm Uced Nm Uced Nd Used Nm Used Not Used NU Used Nol Ua<d N Sanw No Valve 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 idvlr Tlns dowmem h. ..gnd f asw PJCDC dowmem and the— Ad rot hlghhghl th< modrficauws. Yw arc <wowag<d to read th<dowm<m carePollY aM aonwh Legal Counul poor m rta uxuow City Secretary Contract Num: I 58743 Application Period: Funding Identification (FID) Or' l!nal Contract 34027-0200431-5740010-10216�5-002480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 Change Order 34027-0200431-5740010-102976-002480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 Chan gqe Order 2 34027-0200431-5740010-102976-002480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 City of Fort Worth Summary of Charges 2022 Bond YrlContract 3 P. O.: FW020-0000009147 Project Number: 7-1-24 to 7-31-24 I Application I 16-FINAL Application Date: �102976 8/l/2024 Number: I Total Completed Amt Remaining I Gross Retainage Net $2,725,501.61 $675,547.89 $2,357,725.18 $432,194.33 $1,023,992.87 $561,863.20 $196,280.00 ($217,310.00) $3,000.00 ($3,000.00) City Secretary Contract Nam: I 58743 Application Period: Funding Identification (FID) Chan-qe Order 3 34027-0200431-5740010-102976-002480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 Change Order 34027-0200431-5740010-102976%02480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 Chan-qe Order 5 34027-0200431-5740010-102976%02480-9999-22010199 56002-0600430-5740010-1021ig_88�jgg_gggg 56002-0700430-5740010-102 0 0 0 0 0 0 0 0 City of Fort Worth Summary of Charges 2022 Bond YrI Contract 3 P. 0.: FW020-0000009147 Project Number: �102976 io 7-1-24 to 7-31-24 I ANumber:tr:a lication I 16-FINAL AppDate: 8/l/2024 Numb I Total Completed I Amt Remaining I Gross Retainage Net City Secretary Contract Nam: I 58743 Application Period: Funding Identification (FID) Chan-qe Order 6 34027-0200431-5740010-102976%02480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 Change Order? 34027-0200431-5740010-102976%02480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 Chan-qe Order 8 34027-0200431-5740010-102976%02480-9999-22010199 56002-0600430-5740010-1021ig_88�jgg_gggg 56002-0700430-5740010-102 0 0 0 0 0 0 0 0 City of Fort Worth Summary of Charges 2022 Bond YrI Contract 3 P. 0.: FW020-0000009147 Project Number: �102976 io 7-1-24 to 7-31-24 I ANumber:tr:a lication I 16-FINAL AppDate: 8/l/2024 Numb I Total Completed I Amt Remaining I Gross Retainage Net City of Fort Worth Summary of Charges City Secretary Contract Num: 58743 2022 Bond YrlContract 3 P. O.: FW020-0000009147 Project Number: 102976 Application Period: I 7-1-24 to 7-31-24 I Application pplicaulication on I 16-FINAL AppDate: 8/l/2024 Number: Funding Identification (FID) I Total Completed Amt Remaining I Gross Retainage Net Totals 34027-0200431-5740010-102976-002480-9999-22010199 56002-0600430-5740010-102976-001780-9999 56002-0700430-5740010-102976-001780-9999 0 0 0 0 0 0 0 0 I Grand Total $2,725,501.61 $675,547.89 $2,360,725.18 $429,194.33 $1,220,272.87 $344,553.20 I I $6,306,499.661 1 $1,449,295.41 I 1 $0.001 1 ($315,324.98)1 1 $315,324.981 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Bond Year 1 Contract 3 CITY PROJECT NUMBER: 102976 WATER PIPE LAID SIZE TYPE OF PIPE 8" PVC 6" PVC FIRE HYDRANTS: 3 PIPE ABANDONED DENSITIES: NEW SERVICES: I PIPE LAID PIPE ABANDONED VALVES (16" OR LARGER) SIZE TYPE OF PIPE 1"(129) Copper SEWER SIZE TYPE OF PIPE 8" PVC SDR 26 8" DIP 8" Pipe Enlargement SIZE TYPE OF PIPE DENSITIES: NEW SERVICES: 4" (84) PVC SDR26 TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 LF 6183 49 LF LF 2317 624 797 LF FORT WORTH. TRANSPORTATION AND PUBLIC WORKS August 1, 2024 McCleandon Construction Co. Inc. PO Box 999 Burlenson, TX 76097 RE: Acceptance Letter Project Name: 2022 Bond Year 1 Contract 3 Project Type: Water, Sewer, & Paving City Project No.: 102976 To Whom It May Concern: On June 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 July 31, 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 July 31, 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- 392-8785. Sincerely, Jose Orozco, Project Manager Cc: Eric Tinner, Inspector Troy Gardner, Inspection Supervisor Ariel Duarte, Senior Inspector Gregory Robbins, Program Manager Shield Engineering Group, PLLC, Consultant McClendon Construction Co. Inc., Contractor City Fort Worth, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 AFFIDAVIT STATE OF TEXAS Before me, the undersigned authority, a Notary Public in the state and county aforesaid, on this day personally appeared Justin Blair, Vice President of McClendon Construction Company, Incorporated, 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 there are no claims pending for personal injury and /or property damages; On Contract described as; CPN 102976 -- 2022 Bond Year I — Contract 3 Subscribed and sworn before me on this MISTY W£BB' - ��{P•gY Pie �i ?x° n-Notary Public, State of Texas Comm. Expires 01-09-2026 Notary ID 126838467 i Blair ! A" day of �7 CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ TO FINAL PAYMENT CONTRACTOR ❑ SURETY ❑ AIA DOCUMENT G707 OTHER Bond No. TXC616278 PROJECT: 2022 Bond Year I Contract 3 CPN 102976 (name, address) TO (Owner) [ City of Fort W orth, Texas ] ARCHITECTS PROJECT NO: 200 Texas Street Fort Worth, TX 76102 CONTRACT FOR: ] CONTRACT DATE: November 29, 2022 CONTRACTOR: McClendon Construction Company, Inc. 548 Memorial Plaza Burleson, TX 76024 In accordance with the provisions o'the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) Merchants Bonding Company (Mutual) P.O. Box 1449E. Des Moines, IA 50306-3498 , SURETY COMPANY, on bond of (here insert name and address of Contractor) McClendon Construction Company, Inc. 548 Memorial Plaza Burleson, TX 76024 , CONTRACTOR, hereby approves of the final payment to the Contractors, 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, Texas 200 Texas Street Fort Worth, TX 76102 ,OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto sot its hand this 18th day of July 2Q24 Merchants Bonding Company (Mutual) Atte t: (Seal): Sure Company Q '" Signature Authdrized Representative Betty J. eeh Attornev-In-Fact Title NOTE: This form is to be used as a companion d )cument to AIA DOCUMENT 0706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition AIA DOCUMENT G707 - CONSENT OF SURETY COMPANY TO FINAL PAYMENT - APRIL 1970 EDITION - AIAO ONE PAGE © 1970 - THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 New York: Ave., NW, WASHINGTON, D.C. 20006 MERCHANTS � BONDING COMPANY,. POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of lo%a, dlbla Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Allyson W Dean, Ana Owens; Andrea Ruse Crawford; Andrew Gareth Addison; Betty J Reeh; Bryan Kelly Moore; Colin E Ccnly; Debra Lee Moon; Elizabeth Ortiz; Emily Allison MikesXa; '=a1h Ann Hilty; John R Ward; Michael Donald Hendrickson; Monica Rub Veazey; Patrick Thomas Coyle: Sandra Lee Roney; Thomas Douglas Moore; Troy Russell Key their true and lawful Attorney(s)-in-Fact, �o sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance cf contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Comp;rny (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. "The President, Secretary, Treasurer, o any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fad, arc to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, c )ntracts of indemnity and other writings obligatory in the nature thereof." 'The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the eKecution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal wh 3n so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of tf a Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modifier or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwcsalth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 11th day of April 2024 ,•111 •l.r•• . .. - •• •-AXO .••�d,�G CQA �. MERCHANTS BONDING COMPANY (MUTUAL) ... MERCHANTS NATIONAL BONDING, INC. •DFtPOR4, p : �o.9y. dlbla MERCHANTS NATIONAL INDEMNITY COMPANY •o v'y 2003 :*�• :SJ - 1933 �'�; By •��%. :�Ct�•-� d,��•... ' •�-�dC•♦ STATE OFIOWA President � �•.•�} l� • .��.•�•• COUNTY OF DALLAS ss. ""• 4 , On this 11th day of April 2024 before me appeared Larry Taylor, to me personally known, who being by me duly swam did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument a -e the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respi:clive Boards of Directors. hP�'A�sfi Penni Miller J^ z Commissior Number 787952 4 ' • My Comr)ission Expires +OwP Janua ry 20, 2027� 1 (Expiration of notary's commission dries not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a tru � and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full force and effect and has not been amendec or revoked. }}¢ In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this L U' `day of ,,••P�tOnq�••, .•a�NG C •. ;2 9%��; .2' Tr,-0- . !mot/ ��/r�•t✓!/7' 2003 : �, 1933 c; Secretary POA 0018 (1/24) ••.... . _.MERCHANTS BONDING COMPANY. MERCHANTS BONDING COMPANY P.O. BOX 14498 DES MOINES, [A 50306-3498 PHONE: (800) 678-8171 FAX: (515) 243-3854 Have a complaint or need help? If you have a problem with a claim or your premium, call your insurance company or HMO first. If you can't work out the issue, the Texas Department of Insurance may be able to help. Even if you file a complaint with the Texas Department of Insurance, you should also file a complaint or appeal through your insurance company or HMO. If you don't, you may lose your right to appeal. To get information or file a complaint with your insurance company or HMO: Merchants Bonding Company Call: Compliance Officer at (800) 671-8171 Toll -free: (800) 671-8171 Email: regulatory@merchantsbonding.com Mail: P.O. Box 14498, Des Moines, Iowa 50306-3498 The Texas Department of Insurance To get help with an insurance question or file a complaint with the state: Call with a question: 1-800-252-3439 File a complaint: www.tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: fDnciimar Prntartinn. MC- CQ-CP, Texas l e-Wmant of Insurance, 9 :�. i 111MIRR ME W013A I W1118 iTIPr1P llrla Cll1PIA Q r1Pr'PSIt VII Si tiene un problema con una reclamaci6n o con su prima de seguro, (lame primero a su compania de seguros o HMO. Si no puede resolver el problema, es posible que el Departamento de Seguros de Texas (Texas Department of Insurance, por su nombre en ingl6s) pueda ayudar. Aun si usted presenta una queja ante el Departamento de Seguros de Texas, tambi6n debe presentar una queja a trav6s del proceso de quejas o de apelaciones de su compania de seguros o HMO. Si no to hace, podria perder su derecho para apelar. SUP 0032 TX (7/23) Para obtener informaci6n o para presentar una queja ante su compania de seguros o HMO: Merchants Bonding Company Llame a: Compliance Officer al (800) 671-8171 Telefono gratuito: (800) 678-8171 Correo electr6nico: regulatory@merchantsbonding.com Direcci6n postal: P.O. Box 14498, Des Moines, Iowa, 50306-3498 El Departamento de Seguros de Texas Para obtener ayuda con una pregunta relacionada con los seguros o para presentar una queja ante el estado: Llame con sus preguntas al: 1-800-252-3439 Presente una queja en: www.tdi.texas.gov Correo electr6nico: ConsumerProtection@tdi.texas.gov Direcci6n postal: Consumer Protection, MC: CO-CP. Texas Department of Insurance, PO Box 12030, Austin, TX 78711-2030 SUP 0032 TX (7/23) ,q" MERCHANTS BONDING COMPANY. MERCHANTS BONDING COMPANY (MUTUAL) • P.O. BOX 14498 • DES MOINES, IOWA 50306-3498 PHONE: (800) 678-8171 • FAX: (515) 243-3854 ADDENDUM TO BOND This Addendum is in reference to the bond(s) to which it is attached. Merchants Bonding Company (Mutual) ('Merchants_) deems the digital or electronic image of Merchants" corporate seal below affixed to the bond(s) to the same extent as if a raised corporate seal was physically stamped or impressed upon the bond(s). The digital or electronic seal below shall have the same force and effect as though manual ly fixed to the bond(s). A I I terms of the bond(s) remai n the same. Signed and effective March 23, 2020. MERCHANTS BONDING COMPANY (MUTUAL) By: ---------- ---------------- Larry Taylor, President