HomeMy WebLinkAboutContract 59575-A1CSC No. 59575-A1
AMENDMENT No . 1
TO CITY SECRETARY CONTRACT No. 59575
WHEREAS, the City of Fort Worth (CITY) and Freese and Nichols, Inc.,
(ENGINEER) made and entered into City Secretary Contract No. 59575 , (the
CONTRACT) which was authorized by M&C 23-0433 on the 23rd day of May, 2023
in the amount of $ 1,000,000; and
WHEREAS, the CONTRACT involves engineering services for the following
project:
Lebow Channel Flood Mitigation, CPN 103061; and
WHEREAS, it has become necessary to execute Amendment No. 1 to the
CONTRACT to include an increased scope of work and revised fee.
NOW THEREFORE, CITY and ENGINEER, acting herein by and through their
duly authorized representatives, enter into the following agreement, which
amends the CONTRACT:
1.
The CONTRACT is amended to include additional engineering services
consistent with those described in Attachment "A" of Article I. The cost
to City for the additional services to be performed by Engineer totals
$1,000,000. (See Attached Funding Breakdown Sheet, Page -3-)
2.
Article II of the CONTRACT is amended to provide for an increase in
the fee to be paid to Engineer for all work and services performed under
the Contract, as amended, so that the total fee paid by the City for all
work and services shall be an amount of $2,000,000.
3.
Article IV of the CONTRACT is amended the replace Attachment "C"
with the version attached hereto in order to enact additional provisions
of the CONTRACT requiring conformance to certain federal statutes.
4. OFFICIAL RECORD
CITY SECRETARY
City of Fort Worth, Texas FT. WORTH, TX Lebow Channel Flood Mitigation
Prof Services Agreement Amendment Template City Project No. 103061
Revision Date: 03/08/2024
Page 1 of 3
All other provisions of the Contract, which are not expressly amended
herein, shall remain in full force and effect.
EXECUTED and EFFECTIVE as
designated Assistant City Manager.
APPROVED:
City of Fort Worth
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Jesica McEachern
Assistant City Manager
DATE: Oct 21, 2024
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Jannette Goodall
City Secretary
APPROVED AS TO FORM AND LEGALITY:
Douglas Black (Oct 18, 2024 09:38 CDT)
Douglas W. Black
Sr. Assistant City Attorney
City of Fort Worth, Texas
Prof Services Agreement Amendment Template
Revision Date: 03/08/2024
Page 2 of 3
of the date subscribed by the City's
ENGINEER
Freese and Nichols, Inc.
Sco�t�i��
Scott Hubley (Oct 16, 203,f10:35 CDT)
Scott Hubley
Vice President/Principal
DATE: Oct 16, 2024
M&C No.#: 24-0646
M&C Date: 08/13/24
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Lebow Channel Flood Mitigation
City Project No. 103061
FUNDING BREAKDOWN SHEET
City Secretary No. 59575
Amendment No. 1
Project CF1- CF2 -
Fund Dept ID Account Bond Amount
ID Activity
Reference
52008 0200431 5330500 103061 002830 1,000,000.00
Total: $
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Prof Services Agreement Amendment Template City Project No. 103061
Revision Date: 03/08/2024
Page 3 of 3
City of Fort Worth, Texas
Mayor and Council Communication
DATE: 08/13/24 M&C FILE NUMBER: M&C 24-0646
LOG NAME: 20SWM LEBOW ENGINEERING SERVICES AMENDMENT
SUBJECT
(CD 2) Authorize Amendment No. 1, in the Amount of $1,000,000.00, to the Engineering Agreement with Freese and Nichols, Inc. for Project
Development and Design Services for the Upper Lebow Flood Mitigation Project, Adopt Appropriation Ordinances and Amend the Fiscal
Years 2024-2028 Capital Improvement Program
RECOMMENDATION:
It is recommended that the City Council:
1. Authorize execution of Amendment No. 1, in the amount of $1,000,000.00, to the engineering agreement with Freese and Nichols, Inc. (City
Secretary No. 59575) for project development and design services for the Lebow Channel Flood Mitigation project (City Project No.
103061);
2. Adopt the attached appropriation ordinance adjusting estimated receipts and appropriations in the Stormwater Revenue Bonds 2020 Fund
by increasing estimated receipts and appropriations in the Lebow Channel Flood Mitigation project (City Project No. 103061) in the amount
of $800,000.00 and decreasing estimated receipts and appropriations in the Grand Avenue Phase 2 project (City Project No. 103664) by
the same amount;
3. Adopt the attached appropriation ordinance adjusting estimated receipts and appropriations in the Stormwater Capital Projects Fund by
increasing estimated receipts and appropriations in the Lebow Channel Flood Mitigation project (City Project No. 103061) in the amount of
$700,000.00 and decreasing estimated receipts and appropriations in the Grand Avenue Phase 2 project (City Project No. 103664) by the
same amount; and
4. Amend the Fiscal Years 2024-2028 Capital Improvement Program.
DISCUSSION:
This Mayor and Council Communication (M&C) is to authorize Amendment No. 1 to the engineering contract with Freese and Nichols, Inc. (FNI) in
the amount of $1,000,000.00, to continue to perform project development and design services for the Lebow Channel Flood Mitigation project. The
Lebow Channel Flood Mitigation project is a high priority project which seeks to mitigate structure and property flooding along Lebow Channel and
to mitigate hazardous roadway overtopping within the project area.
The original contract was awarded for $1,000,000.00 by M&C 23-0433 on May 23, 2023 (CSC No. 59575). It was intended to be amended to add
additional funds as the project progressed since the Lebow Channel Flood Mitigation project is multi -phase. This is a task order contract with each
task order serving to advance project development and design of the Lebow Channel Flood Mitigation project. This includes, but is not limited to:
• Survey
• Engineering design
• Geotechnical analysis and design
• Utility conflict coordination
• Hydrologic and hydraulic modeling
• Funding application assistance
Under the original contract, FNI has assisted the City with applications for two Federal Emergency Management Agency (FEMA) grants (M&C 23-
1058) and for funding from the Texas Water Development Board (TWDB) from the Flood Infrastructure Fund (M&C 24-0280). The information
provided in the funding applications included the identification of right-of-way needs for project construction, project phasing plans, and preparation
of a benefit -cost analysis. Concepts for the detention pond at Long Avenue have been developed, potential utility conflicts have been identified,
and mitigation plans are being developed.
This amendment will provide capacity for the engineer to continue project development efforts for the channel sections beginning at Northeast 36th
Street and moving upstream, begin design on the detention pond, and be ready to respond quickly if funding is awarded from any of the above -
mentioned grants or funding applications. This amendment will also add language to the contract to satisfy FEMA contracting guidelines if FEMA
funding is awarded.
The additional $500,000.00 funding above the contract amendment amount appropriated with this M&C is intended for property acquisition in
support of the detention pond at Long Avenue.
Funding for this project was not included in the FY2024-2028 Capital Improvement Program due to the project not being identified yet. The action
in this M&C will amend the FY2024-2028 Capital Improvement Program as approved in connection with Ordinance 26453-09-2023.
Capital Fund Name Current Appropriations Budget Adjustment Totals
52002 — Stormwater Capital Projects (CPN 103061) $0.00 $700,000.00 $700,000.00
52007 — Stormwater Revenue Bonds 2020 (CPN 103061) $60,399.00 $800,000.00 $860,399.00
52008 — Drainage Rev Bonds Series 2023 (CPN 103061) $1,000,000.00 $0.01 $1,000,000.00
Project Total $2,560,399.00
M&C 23-0433, 23-0158, and 24-0280 provide additional details regarding the Lebow Channel Flood Mitigation project.
Funding is budgeted in the Stormwater Rev Bonds 2020 and Stormwater Capital Projects Funds for the TPW Dept Highway &
Streets Department for the purpose of funding the Lebow Channel Flood Mit project.
Business Equity Office: Freese and Nichols, Inc. agrees to maintain its initial M/WBE commitment of 11 % that it made on the original agreement
and extend and maintain that same M/WBE commitment of 11 % to this first amendment. Therefore, Freese and Nichols, Inc. remains in
compliance with the City's M/WBE Ordinance and attests to its commitment by its signature on the Acceptance of Previous M/WBE Commitment
form executed by an authorized representative of its company.
This project is located in COUNCIL DISTRICT 2.
FISCAL INFORMATION / CERTIFICATION:
The Director of Finance certifies that funds are available in the current capital budget, as previously appropriated, in the FWCC Grand Ave Ph 2 Pt
2 project within the Stormwater Rev Bonds 2020 and Stormwater Capital Projects Funds and upon approval of the above recommendations and
adoption of the attached appropriation ordinances, funds will be available in the Stormwater Rev Bonds 2020 and Stormwater Capital Projects
Funds for the Lebow Channel Flood Mit project to support the above recommendations. Prior to any expenditure being incurred, the Transportation
& Public Works Department has the responsibility to validate the availability of funds.
Submitted for Citv Manaaer's Office bv: Jesica McEachern 5804
Oriainatina Business Unit Head: Lauren Prieur 6035
Additional Information Contact: Monty Hall 8662
ATTACHMENT "A"
Scope for Enaineerina Desian Related Services for Storm Water Improvements Proiects
The scope set forth herein defines the work to be performed by the ENGINEER in
completing the project. Under this scope, "ENGINEER" is expanded to include any sub -
consultant, including surveyor, employed or contracted by the ENGINEER.
OBJECTIVE
The purpose of this project is to perform project development and final design services for
the Lebow Channel Flood Mitigation Project. The improvements are intended to resolve
100-year flooding in the Upper Lebow area by implementing a deepened vertical walled
channel to replace the existing channel. It is expected this will require the acquisition of
portions of private property and in some cases may require the acquisition of entire lots.
This reconstruction is expected to require significant removal of existing features and the
relocation and/or reconstruction of existing roads, utilities, and other infrastructure. The
project is expected to demonstrate no adverse hydrologic impacts downstream of the
improvements by implementing a large detention pond. The project has been authorized by
the USACE through an individual permit under Section 404 of the Clean Water Act.
The goal of project development is to identify an acceptable, affordable and effective project
or project phases for implementation. This effort includes identifying, documenting and
mitigating risks, engaging with internal and external stakeholders and developing a
schematic plan for implementation. The schematic plan will be developed for the full project
limits and include phasing options for implementation. Detailed cost estimates and
schedules will be developed to accompany the schematic. It is intended that all permits
(local, state, and federal) will be identified along with a plan for compliance.
The final design phase will build upon the work done in the project development phase and
will result in a complete design. This phase will include the preparation of plans,
specifications and cost estimates, securing necessary permits as well as bid and
construction phase services. It is intended that the improvements will be implemented in
phases with the design of the final phase completed within 5 years unless delayed due to
lack of funding or delays due to factors beyond the control of the Engineer.
WORK TO BE PERFORMED
Based on the complexity of project and the wide variety of tasks that may be needed to
advance this project, task orders will be issued for individual work tasks. Task orders will be
provided on a task authorization form and will be approved in writing by the project
manager.
These tasks may include but are not limited to:
• Project Data Collection and Screening
• Geomorphologic Assessment
• Stakeholder Coordination and Meetings
• Structural Condition Assessments
• Hydrology and Hydraulic Studies
• Geotechnical Analysis
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment A City Project No. 103061
PMO Release Date: 07/23/2012
Page 1 of 22
• Downstream Impact Analysis
• Schematic Design (25% level)
• Traffic Detour and Impact Analyses
• Topographic and Boundary Surveying
• Risk Analysis
• Subsurface Utility Engineering
• Permitting and Regulatory Assessments
• Cost Estimating
• iSWM Checklists
• FEMA CLOMR/LOMR
• Preliminary and Final Designs
• Construction Phase Services
• ROW and Easement Services
• Design and Construction Schedules
• Community Meetings
• Funding Assistance
• Other Related Tasks Which May Arise During the Execution of the Project
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment A City Project No. 103061
PMO Release Date: 07/23/2012
Page 2 of 2
ATTACHMENT "C"
CHANGES AND AMENDMENTS TO STANDARD AGREEMENT
Design Services for
Lebow Channel Flood Mitigation
City Project No. 103061
Where this Amendment is subject to an award of FEMA funding and Appendix II to Part
200 — Contract Provisions for Non -Federal Entity Contracts Under Federal Awards, the
following provisions are included in the Standard Agreement for Engineering Related
Professional Services:
Clean Air Act:
The Engineer agrees to comply with all applicable standards, orders, or regulations issued
pursuant to the Clean Air Act, as amended, 42 U.S.C. § 7401 et seq.
The Engineer agrees to report each violation to the City of Fort Worth and understands and
agrees that the City of Fort Worth will, in turn, report each violation as required to assure
notification to the Federal Emergency Management Agency (FEMA), and the
appropriate Environmental Protection Agency Regional Office.
The Engineer agrees to include these requirements in each subcontract exceeding
$150,000 financed in whole or in part with federal assistance provided by FEMA.
Federal Water Pollution Control Act:
The Engineer agrees to comply with all applicable standards, orders, or regulations issued
pursuant to the federal Water Pollution Control Act, as amended, 33 U.S.C. § 1251 et seq.
The Engineer agrees to report each violation to the City of Fort Worth and understands and
agrees that the City of Fort Worth will, in turn, report each violation as required to
assure notification to the, Federal Emergency Management Agency (FEMA), and the
appropriate Environmental Protection Agency Regional Office.
The Engineer agrees to include these requirements in each subcontract exceeding $150,000
financed in whole or in part with federal assistance provided by FEMA.
Suspension and Debarment:
This Agreement is a covered transaction for purposes of 2 C.F.R. Part 180 and 2 C.F.R.
Part 3000. As such, the Engineer is required to verify that none of the Engineer's principals
(defined at 2 C.F.R. § 180.995) or its affiliates (defined at 2 C.F.R. § 180.905) are excluded
(defined at 2 C.F.R. § 180.940) or disqualified (defined at 2 C.F.R. § 180.935).
The Engineer must comply with 2 C.F.R. Part 180, subpart C and 2 C.F.R. Part 3000,
subpart C, and must include a requirement to comply with these regulations in any lower
tier covered transaction it enters into.
This certification is a material representation of fact relied upon by City of Fort Worth. If
it is later determined that the Engineer did not comply with 2 C.F.R. Part 180, subpart C
and 2 C.F.R. Part 3000, subpart C, in addition to remedies available to the City of Fort
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment C City Project No. 103061
PMO Release Date: 05.19.2010
Page 1 of 6
Worth, the federal government may pursue available remedies, including but not limited
to suspension and/or debarment.
The Engineer agrees to comply with the requirements of 2 C.F.R. Part 180, subpart C and
2 C.F.R. Part 3000, subpart C throughout the period of the contract. The Engineer further
agrees to include a provision requiring such compliance in its lower tier covered
transactions.
Byrd Anti -Lobbying Amendment, 31 U.S.C. § 1352 (as amended)
Engineer shall file the required certification. Each tier certifies to the tier above that it will
not and has not used federally appropriated funds to pay any person or organization for
influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, officer or employee of Congress, or an employee of a Member of Congress in
connection with obtaining any federal contract, grant, or any other award covered by 31
U.S.C. § 1352. Each tier shall also disclose any lobbying with non-federal funds that takes
place in connection with obtaining any federal award. Such disclosures are forwarded from
tier to tier up to the recipient who in turn will forward the certification(s) to the federal
awarding agency.
Required certification:
If applicable, Engineer must sign and submit the following certification to the City of Fort
Worth:
APPENDIX A, 44 C.F.R. PART 18 — CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
No federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
federal contract, the making of any federal grant, the making of any federal loan, the
entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any federal contract, grant, loan, or cooperative
agreement.
If any funds other than federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee
of a Member of Congress in connection with this federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and submit Standard Form-
LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients
shall certify and disclose accordingly.
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment C City Project No. 103061
PMO Release Date: 05.19.2010
Page 2 of 6
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, Title
31, U.S.C. Any person who fails to file the required certification shall be subject to a
civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The Contractor, Freese and Nichols Igccertifies or affirms the truthfulness and accuracy
of each statement of its certification and disclosure, if any. In addition, the Contractor
understands and agrees that the provisions of 31 U.S.C. Chap. 38, Administrative
Remedies for False Claims and Statements, apply to this certification and disclosure,
if any.
Scott Hubley (Oct 16, 20:35 CDT)
Signature of Contractor's Authorized Official
Scott Hubley, Vice -President
Name and Title of Contractor's Authorized Official
Oct 16, 2024
Date
Procurement of Recovered Materials
In the performance of this Agreement, the Engineer shall make maximum use of products
containing recovered materials that are EPA -designated items unless the product cannot be
acquired —
Competitively within a timeframe providing for compliance with the contract performance
schedule;
Meeting contract performance requirements; or
At a reasonable price.
Information about this requirement, along with the list of EPA -designated items, is
available at EPA's Comprehensive Procurement Guidelines webpage:
https://www.epa.gov/smm/comprehensive- procurement-guideline-cpg-program.
The Engineer also agrees to comply with all other applicable requirements of Section 6002
of the Solid Waste Disposal Act.
Prohibition on Contracting for Covered Telecommunications Equipment or Services
(a) Definitions. As used in this clause, the terms backhaul; covered foreign country;
covered telecommunications equipment or services; interconnection arrangements;
roaming; substantial or essential component; and telecommunications equipment
or services have the meaning as defined in FEMA Policy 405-143-1, Prohibitions
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment C City Project No. 103061
PMO Release Date: 05.19.2010
Page 3 of 6
on Expending FEMA Award Funds for Covered Telecommunications Equipment
or Services (Interim), as used in this clause—
(b) Prohibitions.
(1) Section 889(b) of the John S. McCain National Defense Authorization Act
for Fiscal Year 2019, Pub. L. No. 115-232, and 2 C.F.R. § 200.216 prohibit
the head of an executive agency on or after Aug.13, 2020, from obligating or
expending grant, cooperative agreement, loan, or loan guarantee funds on
certain telecommunications products or from certain entities for national
security reasons.
(2) Unless an exception in paragraph (c) of this clause applies, the Engineer and
its subcontractors may not use grant, cooperative agreement, loan, or loan
guarantee funds from the Federal Emergency Management Agency to:
i. Procure or obtain any equipment, system, or service that uses
covered telecommunication equipment or services as a substantial
or essential component of any system, or as critical technology of
any system;
ii. Enter into, extend, or renew a contract to procure or obtain any
equipment, system, or service that uses covered telecommunications
equipment or services as a substantial or essential component of any
system, or as critical technology of any system;
iii. Enter into, extend, or renew contracts with entities that use covered
telecommunications equipment or services as a substantial or
essential component of any system, or as critical technology as part
of any system; or
iv. Provide, as part of its performance of this Agreement, any
equipment, system, or service that uses covered telecommunications
equipment or services as a substantial or essential component of any
system, or as critical technology as part of any system.
(c) Exceptions.
(1) This clause does not prohibit contractors from providing—
(i) A service that connects to the facilities of a third -party, such as
backhaul, roaming,
or interconnection arrangements; or
(ii) Telecommunications equipment that cannot route or redirect user data
traffic or
permit visibility into any user data or packets that such equipment transmits
or
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment C City Project No. 103061
PMO Release Date: 05.19.2010
Page 4 of 6
otherwise handles.
(2) By necessary implication and regulation, the prohibitions also do not apply
to:
(i) Covered telecommunications equipment or services that:
i. Are not used as a substantial or essential component of any
system; and
ii. Are not used as critical technology of any system.
(ii) Other telecommunications equipment or services that are not
considered covered
telecommunications equipment or services.
(d) Reporting requirement.
(1) In the event the Engineer identifies covered telecommunications equipment or
services used as a substantial or essential component of any system, or as critical
technology as part of any system, during contract performance, or the contractor
is notified of such by a subcontractor at any tier or by any other source, the
contractor shall report the information in paragraph (d)(2) of this clause to the
recipient or subrecipient, unless elsewhere in this contract are established
procedures for reporting the information.
(2) The Engineer shall report the following information pursuant to paragraph
(d)(1) of this clause:
(i) Within one business day from the date of such identification or
notification: The contract number; the order number(s), if applicable;
supplier name; supplier unique entity identifier (if known); supplier
Commercial and Government Entity (CAGE) code (if known); brand;
model number (original equipment manufacturer number, manufacturer
part number, or wholesaler number); item description; and any readily
available information about mitigation actions undertaken or
recommended.
(ii) Within 10 business days of submitting the information in paragraph
(d)(2)(i) of this
clause: Any further available information about mitigation actions
undertaken or recommended. In addition, the contractor shall describe
the efforts it undertook to prevent use or submission of covered
telecommunications equipment or services, and any additional efforts
that will be incorporated to prevent future use or submission of
covered telecommunications equipment or services.
(e) Subcontracts. The Engineer shall insert the substance of this clause, including this
paragraph (e), in all subcontracts and other contractual instruments.
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment C City Project No. 103061
PMO Release Date: 05.19.2010
Page 5 of 6
Domestic Preferences for Procurements
As appropriate, and to the extent consistent with law, the Engineer should, to the greatest
extent practicable, provide a preference for the purchase, acquisition, or use of goods,
products, or materials produced in the United States. This includes, but is not limited to
iron, aluminum, steel, cement, and other manufactured products.
For purposes of this clause:
Produced in the United States means, for iron and steel products, that all manufacturing
processes, from the initial melting stage through the application of coatings, occurred in
the United States.
Manufactured products mean items and construction materials composed in whole or in
part of non-ferrous metals such as aluminum; plastics and polymer -based products such as
polyvinylchloride pipe; aggregates such as concrete; glass, including optical fiber; and
lumber.
City of Fort Worth, Texas Lebow Channel Flood Mitigation
Attachment C City Project No. 103061
PMO Release Date: 05.19.2010
Page 6 of 6
FORT WORTH.
Routing and Transmittal Slip
Transportation & Public Works Department
DOCUMENT TITLE: CS59575 Lebow Flood Mitigation Amend 1
M&C: 24-0646 CPN: 103061
CSO: 59575
DOC#:
Date:
I
To:
Name
Department
Initials
Date Out
1.
Scott Hubley FnN
Contractor
5
Oct i6, 2024
2.
Mike Crenshaw
TPW PM/Approver/Agiloft
M C
Oct 18, 2024
3.
Lauern Prieur
TPW/Approver/Agiloft
LP
Oct 18, 2024
4.
Doug Black
Legal
OH
Oct 18, 2024
5.
Jesica McEachern
ACM
a`
Oct 21, 2024
6.
Jannette Goodall
CSO
Oct 21, 2024
7
Allison Tidwell
CSO
Oct 22, 2024
8
TPW/Contracts
TPW
9
10.
DOCUMENTS FOR CITY MANAGER'S SIGNATURE: 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: ❑YES ®No
RUSH: ❑YES ❑No SAME DAY: ❑YES ❑No NEXT DAY: ❑YES ❑No
ROUTING TO CSO: ®YES ❑No
Action Required: ❑ Attach Signature, Initial and Notary Tabs
❑ As Requested
❑ For Your Information
® Signature/Routing and or Recording
❑ Comment
❑ File
Return To: Please notify tnw sw contracts(a/fortworthtexas.gov when complete. Call ext. 817 229
3283 or ext. 6254 with questions. Thank you!