HomeMy WebLinkAboutContract 55443-FP2-FP2
City Secretary
Contract No. 55443
FORT WORTH. Date Received 11/5/2024
AT
NOTICE OF PROJECT COMPLETION
(Developer Projects)
The Transportation and Public Works Department upon the recommendation of the Project
Manager has accepted the following project as complete:
Project Name: Improvements to serve Oak Grove Road
City Project No.: 102802
Improvement Type(s): 0 Paving
0 Drainage 0 Street Lights ❑ Traffic Signals
City Costs
Transportation
Developer Impact Fee and 2018
Costs Bond Program Fund
Total Costs
Original Contract Price: Paving
$2,088,156.49 $1,200,000.00
$3,288,156.49
Original Contract Price: Storm Drain
$1,544,429.30 $0.00
$1,544,429.30
Original Contract Price: Street Lights
$281,392.25 $0.00
$281,392.25
Amount of Approved Change Order 1:
$257,239.99 $0.00
$257,239.99
Amount of Approved Change Order 2:
$77,548.21 $15,196.20
$92,744.41
Amount of Approved Change Order 3:
$186,858.43-$15,196.20
$171,662.23
Revised Contract Amount:
$4,435,624.67 $1,200,000.00
$5,635,624.67
Total Cost of Work Complete:
$4,435,624.67 $1,200,000.00
$5,635,624.67
Richard Henderson (Nov 4, 202413:02 CST)
Nov 4, 2024
Contractor
Date
Area Manager
Title
Texas Sterling
Company Name
1111,-
Nov 4, 2024
RussellRog—(vov4,m 413.09CST)
Project Inspector
Date
a�6� uJl
Nov 5, 2024
Project Manager
Date
Rebecca Owen (Nov 5, 2024 14:46 CST)
Nov 5, 2024
CFA Man a r
�
Date
X
Nov 5, 2024
TPW Director
Date
op��
Nov 5, 2024
Asst. City Manager
Date
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Notice of Project Completion
Project Name: Improvements to serve Oak Grove Road
City Project No.: 102802
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑x Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time 444 WD Days Charged: 415 WD
Work Start Date: 3/29/2021 Work Complete Date: 3/13/2024
Completed number of Soil Lab Test: 834
Completed number of Water Test: 4
FoRTWORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name WATER, PAVING, DRAINAGE AND LIGHTING IMPROVEMENTS TO SER
Contract Limits
Project Type DRAINAGE, PAVING & STREETLIGHTS
City Project Numbers 102802
DOE Number 2802
Estimate Number 1 Payment Number I For Period Ending 3/13/2023
WD
City Secretary Contract Number Contract Time 17WD
Contract Date 1/14/2021 Days Charged to Date 415
Project Manager NA Contract is 100.00 Complete
Contractor TEXAS STERLING CONSTRUCTION, INC.
2100 N. HWY 360, STE. 106-A
GRAND PRAIRIE, TX 75050
Inspectors G.DEYON / R.ROGERS
Friday, November 1, 2024 Page 1 of 7
City Project Numbers 102802 DOE Number 2802
Contract Name WATER, PAVING, DRAINAGE AND LIGHTING IMPROVEMENTS TO S Estimate Number 1
Contract Limits Payment Number 1
Project Type DRAINAGE, PAVING & STREETLIGHTS For Period Ending 3/13/2023
Project Funding
UNIT III: DRAINAGE IMPROVEMENTS
Item
Description of Items
Estimated Unit
No.
Quanity
1
CONSTRUCTION STAKING
1 LS
2
AS BUILT SURVEY
1 LS
3
30" STORM ABANDONMENT PLUG
1 EA
4
36" STORM ABANDONMENT PLUG
I EA
5
MEDIUM STONE RIPRAP DRY
271 SY
6
POST CCTV INSPECTION OF STORM DRAIN
4855 LF
7
TRENCH SAFETY
4730 LF
8
42" CASING BY OTHER THAN OPEN CUT
60 LF
9
18" RCP CLASS M
49 LF
10
21" RCP CLASS HI
8 LF
11
24" RCP CLASS III
1408 LF
12
30" RCP CLASS III
209 LF
13
36" RCP CLASS III
976 LF
14
4X3 BOX CULVERT
483 LF
15
5X4 BOX CULVERT
422 LF
16
7X4 BOX CULVERT
90 LF
17
4' STORM JUNCTION BOX
4 EA
18
6' STORM JUNCTION BOX
1 EA
19
4' SLACKED MANHOLE
6 EA
20
HEADWALL, BOX CULVERT
1 CY
21
30" FLARED HEADWALL 2 PIPES
I EA
22
10' CURB INLET
1 EA
23
10' RECESSED INLET
2 EA
24
15' RECESSED INLET
1 EA
25
20' RECESSED INLET
I EA
26
10' TYPE 2 INLET
4 EA
27
15' TYPE 2 INLET
I EA
28
20' TYPE 2 INLET
1 EA
29
8X3 BOX CULVERT
1210 LF
30
CL C CONC (CAP)
1 CY
Unit Cost
Estimated
Completed
Completed
Total
Quanity
Total
$20,000.00
$20,000.00
1
$20,000.00
$1,000.00
$1,000.00
1
$1,000.00
$410.00
$410.00
1
$410.00
$440.00
$440.00
1
$440.00
$61.00
$16,531.00
271
$16,531.00
$1.06
$5,146.30
4855
$5,146.30
$1.00
$4,730.00
4730
$4,730.00
$960.00
$57,600.00
60
$57,600.00
$92.00
$4,508.00
49
$4,508.00
$118.00
$944.00
8
$944.00
$94.00
$132,352.00
1408
$132,352.00
$120.00
$25,080.00
209
$25,080.00
$153.00
$149,328.00
976
$149,328.00
$260.00
$125,580.00
483
$125,580.00
$340.00
$143,480.00
422
$143,480.00
$630.00
$56,700.00
90
$56,700.00
$7,400.00
$29,600.00
4
$29,600.00
$12,700.00
$12,700.00
1
$12,700.00
$3,000.00
$18,000.00
6
$18,000.00
$10,200.00
$10,200.00
1
$10,200.00
$3,700.00
$3,700.00
1
$3,700.00
$7,500.00
$7,500.00
1
$7,500.00
$7,800.00
$15,600.00
2
$15,600.00
$9,800.00
$9,800.00
1
$9,800.00
$12,100.00
$12,100.00
1
$12,100.00
$10,700.00
$42,800.00
4
$42,800.00
$14,000.00
$14,000.00
1
$14,000.00
$17,400.00
$17,400.00
1
$17,400.00
$500.00
$605,000.00
1210
$605,000.00
$2,200.00
$2,200.00
1
$2,200.00
Friday, November 1, 2024 Page 2 of 7
City Project Numbers 102802 DOE Number 2802
Contract Name WATER, PAVING, DRAINAGE AND LIGHTING IMPROVEMENTS TO S Estimate Number 1
Contract Limits Payment Number 1
Project Type DRAINAGE, PAVING & STREETLIGHTS For Period Ending 3/13/2023
Project Funding
31
STORM DRAIN MATERIAL ESCALATION COST
1 LS
(CO#1)
32
7X4 BOX CULVERT ADJUSTMENTS FOR
10 LF
EXISTING RBC (CO#3)
33
HEADWALL, BOX CULVERT ADJUSTMENT
6 CY
FOR EXISTING RBC (CO#3)
34
18" ARCH PIPE & INLET TIE-IN (CO#3)
16 LF
Sub -Total of Previous Unit
-------------------
UNIT IV: PAVING IMPROVEMENTS
Item
Description of Items
Estimated Unit
No.
Quanity
1
CONSTRUCTION STAKING
1 LS
2
AS -BUILT SURVERY
1 LS
3
REMOVE SIDEWALK
99 SF
4
REMOVE CONCRETE DRIVE
7824 SF
5
REMOVE FENCE
4117 LF
6
REMOVE REP RAP
372 SF
7
REMOVE GUARDRAIL
87 LF
8
REMOVE HEADWALL/SET
3 EA
9
REMOVE ASPHALT PVMT
10761 SY
10
REMOVE CONC CURB & GUTTER (CO#3)
336 LF
11
REMOVE 33" STORM LINE
160 LF
12
SITE CLEANING
1 LS
13
6"-12" TREE REMOVAL
3 EA
14
UNCLASSIFIED EXCAVATION BY PLAN (CO#3)
8371 CY
15
EMBANKMENT BY PLAN (CO#3)
8371 CY
16
BORROW BY PLAN (CO#2)
6544.8 CY
17
SWWPPP >/ 1 ACRE
1 LS
18
4" FLEXIABLE BASE, TYPE A, GR-1 (CO#2)
6295 SY
(CO#3)
19
8" LIME TREATMENT (54 LBS/SY) (CO#2)
29895.7 SY
20
HYDRATED LIME (CO#2)
716.5 TN
21
2" ASPHALT PVMT TYPE D (CO#3)
308 SY
22
8" ASHPALT BASE TYPE B(CO#3)
308 SY
23
10" CONC PVMT (4,000 PSI) (CO#3)
27230 SY
$27,045.42 $27,045.42 1 $27,045.42
$866.18
$8,661.80
10
$8,661.80
$1,295.57
$7,773.42
6
$7,773.42
$541.08
$8,657.28
16
$8,657.28
$1,596,567.22
$1,596,567.22
Unit Cost
Estimated
Completed Completed
Total
Quanity
Total
$46,800.00
$46,800.00
1
$46,800.00
$1,000.00
$1,000.00
1
$1,000.00
$5.30
$524.70
99
$524.70
$1.34
$10,484.16
7824
$10,484.16
$1.00
$4,117.00
4117
$4,117.00
$5.80
$2,157.60
372
$2,157.60
$9.92
$863.04
87
$863.04
$640.00
$1,920.00
3
$1,920.00
$1.77
$19,046.97
10761
$19,046.97
$21.50
$7,224.00
336
$7,224.00
$11.35
$1,816.00
160
$1,816.00
$9,000.00
$9,000.00
1
$9,000.00
$1,000.00
$3,000.00
3
$3,000.00
$12.50
$104,637.50
8371
$104,637.50
$6.15
$51,481.65
8371
$51,481.65
$15.35
$100,462.68
6544.8
$100,462.68
$29,700.00
$29,700.00
1
$29,700.00
$12.00
$75,540.00
6295
$75,540.00
$4.50
$134,530.65
29895.7
$134,530.65
$170.00
$121,805.00
716.5
$121,805.00
$36.18
$11,143.44
308
$11,143.44
$93.11
$28,677.88
308
$28,677.88
$70.00
1,906,100.00
27230
1,906,100.00
Friday, November 1, 2024 Page 3 of 7
City Project Numbers 102802 DOE Number 2802
Contract Name WATER, PAVING, DRAINAGE AND LIGHTING IMPROVEMENTS TO S Estimate Number 1
Contract Limits Payment Number 1
Project Type DRAINAGE & PAVING For Period Ending 3/13/2023
Project Funding
24 8" CONCRETE DRIVEWAY (CO#3)
25356 SF
$7.00
$177,492.00
25356
$177,492.00
25 4" CONC SIDEWALK (CO#3) (CO#3)
70867 SF
$4.74
$335,909.58
70867
$335,909.58
26 4" CONC SIDEWALK, ADJACENT TO CURB
6899 SF
$7.10
$48,982.90
6899
$48,982.90
(CO#3)
27 BARRIER FREE RAMP, TYPE P-1
2 EA
$2,200.00
$4,400.00
2
$4,400.00
28 4" SLD PVMT MARKING HAS (W) (CO#3)
1095 LF
$0.89
$965.65
1085
$965.65
29 4" SLD PVMT MARKING HAS (Y)
10433 LF
$0.89
$9,285.37
10433
$9,285.37
30 8" SLD PVMT MARKING HAS (W) (CO#3)
1420 LF
$2.00
$2,840.00
1420
$2,840.00
31 8" SLD PVMT MARKING HAS (Y)
48 LF
$2.00
$96.00
48
$96.00
32 4" BRK PVMT MARKING HAS (Y)
2440 LF
$1.20
$2,928.00
2440
$2,928.00
33 4" BRK PVMT MARKING HAS (W)
2390 LF
$1.20
$2,868.00
2390
$2,868.00
34 24" SLD PVMT MARKING HAE (W)
22 LF
$15.00
$330.00
22
$330.00
35 RTFLRAISED MARKER TYI-C(CO#3)
276 EA
$4.00
$1,104.00
276
$1,104.00
36 REFL RAISED MARKER TY 11-A-A
246 EA
$4.00
$984.00
246
$984.00
37 REMOVE 4" PVMT MARKING
6356 LF
$0.65
$4,131.40
6356
$4,131.40
38 REMOVE 8" PVMT MARKING
1225 LF
$1.75
$2,143.75
1225
$2,143.75
39 REMOVE RAISED MARKER
160 EA
$1.00
$160.00
160
$160.00
40 TOPSOIL
2221 CY
$8.50
$18,878.50
2221
$18,878.50
41 BLOCK SOD PLACEMENT
13329 SY
$4.00
$53,316.00
13329
$53,316.00
42 REMOVE AND REINSTALL SIGN PANEL AND
2 EA
$575.00
$1,150.00
2
$1,150.00
POST
43 FURNISH/INSTALL ALUM SIGN GROUND
7 EA
$685.00
$4,795.00
7
$4,795.00
MOUNT CITY STD. (CO#3)
44 TRAFFIC CONTROL
12 MO
$980.00
$11,760.00
12
$11,760.00
45 PORTABLE MESSAGE SIGN
50 WK
$128.00
$6,400.00
50
$6,400.00
46 TRAFFIC CONTROL DETAILS
2 EA
$900.00
$1,800.00
2
$1,800.00
47 REMOVE GRAVEL DRIVE
6592 SF
$0.73
$4,812.16
6592
$4,812.16
48 RAIL (HANDRAIL) (TY F)
179 LF
$118.00
$21,122.00
179
$21,122.00
49 SPECIFIED REMOBILIZATION (CO#1)
1 EA
$92,962.34
$92,962.34
1
$92,962.34
50 PAVING MATERIAL ESCALATION COST (CO#1)
1 LS
$110,859.08
$110,859.08
1
$110,859.08
51 PAVING MATERIAL ESCALATION COST - CO2
1 LS
$51,099.58
$51,099.58
1
$51,099.58
(CO#2)
52 DRILL & DOWEL NEW TURN LANE(CO#3)
474.5 LF
$37.08
$17,594.46
474.5
$17,594.46
53 REMOVE CONC PVMT(CO#3)
213 SY
$24.92
$5,307.96
213
$5,307.96
54 SPECIFIED REMOBILZATION(CO#3)
1 EA
$62,782.05
$62,782.05
1
$62,782.05
Friday, November 1, 2024 Page 4 of 7
City Project Numbers 102802 DOE Number 2802
Contract Name WATER, PAVING, DRAINAGE AND LIGHTING IMPROVEMENTS TO S Estimate Number 1
Contract Limits Payment Number 1
Project Type DRAINAGE & PAVING For Period Ending 3/13/2023
Project Funding
-------------
Sub -Total of Previous Unit
$3,731,292.05
$3,731,292.05
UNIT V: STREET LIGHTING
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
1
2" CONDT RM (RISER)
60 LF
$25.00
$1,500.00
60
$1,500.00
2
2" CONDT PVC SCH 80 (T)
7400 LF
$9.00
$66,600.00
7400
$66,600.00
3
2" CONDT PVC SCH 80 (B)
1240 LF
$10.50
$13,020.00
1240
$13,020.00
4
EXPLORATORY EXCAVATION OF EXISTING
100 EA
$50.00
$5,000.00
100
$5,000.00
UTILITES
5
NO 6 INSULATED ELEC CONDR
30520 LF
$1.00
$30,520.00
30520
$30,520.00
6
NO 6 BARE ELEC CONDR SLD
7990 LF
$1.00
$7,990.00
7990
$7,990.00
7
GROUND BOX TYPE B W/APRON
23 EA
$550.00
$12,650.00
23
$12,650.00
8
FURNISH/INSTALL TYPE 33A ARM
41 EA
$199.50
$8,179.50
41
$8,179.50
9
FURNISH/INSTALL240-480 VOLT SINGLE
2 EA
$6,000.00
$12,000.00
2
$12,000.00
PHASE METERED PED
10
FURNISH/INSTALL LED LIGHTING FIXTURE
41 EA
$377.85
$15,491.85
41
$15,491.85
(137 WATT ATBC2 C
11
RDWY ILLUM FOUNDATION TY 3,5,6, AND 8
41 EA
$1,050.00
$43,050.00
41
$43,050.00
12
FURNISH/INSTALL RDWAY ILLUM TY 18 POLE
41 EA
$1,594.90
$65,390.90
41
$65,390.90
13
STREET LIGHTING MATERIAL ESCALTION
1 LS
$26,373.15
$26,373.15
1
$26,373.15
COST (CO#1)
Sub -Total of Previous Unit
$307,765.40
$307,765.40
Friday, November 1, 2024 Page 5 of 7
City Project Numbers 102802 DOE Number 2802
Contract Name WATER, PAVING, DRAINAGE AND LIGHTING IMPROVEMENTS TO S Estimate Number 1
Contract Limits Payment Number 1
Project Type STREET LIGHTING For Period Ending 3/13/2023
Project Funding
Contract Information Summary
Original Contract Amount $5,113,978.04
Change Orders
Change
Order
Number
1 $27,045.42
Change
Order
Number
1 $203,821.42
Change
Order
Number
2 $77,548.21
Change
Order
Number
3 $25,092.50
Change
Order
Number
3 $161,765.93
Change
Order
Number
1 $26,373.15
Total Contract Price $5,635,624.67
Total Cost of Work Completed $5,635,624.67
Less % Retained $0.00
Net Earned $5,635,624.67
Earned This Period $5,635,624.67
Retainage This Period $0.00
Less Liquidated Damages
Days @ / Day
LessPavement Deficiency
Less Penalty
Less Previous Payment
Plus Material on Hand Less 15%
Balance Due This Payment
$0.00
$0.00
$0.00
$0.00
$0.00
$5,635,624.67
Friday, November 1, 2024 Page 6 of 7
City Project Numbers 102802 DOE Number 2802
Contract Name WATER, PAVING, DRAINAGE AND LIGHTING IMPROVEMENTS TO S Estimate Number 1
Contract Limits Payment Number 1
Project Type STREET LIGHTING For Period Ending 3/13/2023
Project Funding
Project Manager NA
Inspectors G.DEYON / R.ROGERS
Contractor TEXAS STERLING CONSTRUCTION, INC.
2100 N. HWY 360, STE. 106-A
GRAND PRAIRIE, TX 75050
City Secretary Contract Number
Contract Date
1/14/2021
Contract Time
170 WD
Days Charged to Date
415 WD
Contract is .000000
Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of Work Completed $5,635,624.67
Less % Retained $0.00
Net Earned $5,635,624.67
Earned This Period $5,635,624.67
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 / Day
$0.00
LessPavement Deficiency
$0.00
Less Penalty
$0.00
Less Previous Payment
$0.00
Plus Material on Hand Less 15%
$0.00
Balance Due This Payment
$5,635,624.67
Friday, November 1, 2024 Page 7 of 7
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME: Oak Grove Road (From Enon Ave to Joel East Rd)
CONTRACT: CS-55443 rt, CS-55443-CAI
CFA # CFA21-0004 I CITY PARTICIPATION:
CITY PROJECT # 102802
CITY SECRETARY CONTRACT # CS-55443 8 CS-55443-CAI
FID # 30114-0200431-102802-EO7685
FILE # X-26673, W-2796
YES
INSPECTOR: Russell Rogers Phone No: 214-980-2068
PROJECT MANAGER: Debbie J. Willhelm Phone No: 817-392-2481
WATER
Developer
City Cost
Cost
ORIGINAL CONTRACT
S 491,481.00
$
EXTRAS TO DATE
CREDITS TO DATE
CONTRACT TO DATE
S 491,461.00
S
AMOUNT OF PROP. CHANGE ORDER
3 ti7,U42.ti :
$
REVISED CONTRACT AMOUNT
S 414,438.96
$
TOTAL REVISED CONTRACT AMOUNT
$414,438.96
PER UNIT
REVISED COST SHARE
Dev. Cost:
TOTAL REVISED CONTRACT
SEWER
Developer City Cost
Coat
S $ -
s -
S -
S -
So.00
$4,585,656.99
CONTRACT UNIT
DRAINAGE
Developer City Cost
Cost
S 1,544,429.30 S
$ 1,544,429.30 $ -
$ 27,045.42 $ -
$ 1,571,474.72 $ -
$1,57IA74.72
City Cost:
$5,785,656.99
CHANGE
ORDER No: CSC NO. 55443-COI
1
REVIEWED
By Debbie J. Wilhelm at 5.21 pm, Jun 24, 2024
I
PAVING STREET LIGHTS CONTRACT
DeveloperDAYS
Cost I City Cost Developer Cost I City Cat
S 2,088,156.49 S 1,200,000.00 $ 281,392.25 $ 170
S 2,088,15B.49 S 1,200,000.00 $ 281,392.25 $
$ 203.821.42 S • $ 26.373.15 S
S 2,291,977.91 $ 1,200,000.00 S 307,705.40 S
$3,491,977.91 $307,765.40
$1,200,000.00
170
145
315
Revised: 10-12-2011 Page 1
You are directed to make the following changes in the contract documgnts
PAY ITEM q
I CITY BIDITEM
( QUANTITY
UNIT
I ITEM DESCRIPTION I
UNIT PRICE
I DE TER I
CITY
I
COS
COST
UNIT I: WATER IMPROVEMENTS
4
3305.0103 -2 EA Wofatory Excavation of Existing Utilities
$ 1.465.00
S (2,930.00) S -
8
3305.0109 -416 LF Trench Safetv
1.00
S (416.00) -
11
3305.0116 -2 CY Concrete Engpsemgnt for Utility Pi
150.00
S �300.00) - -
14
3311.0001 -0.5 TN Ductile Iron Water Fittings w/Restrain
2500.00
$ (1,250.00) - -
15
3311.0451 -31 LF 12" DIP Water0.
S 9,300.00) - -
18
3311.0457 14 LF 12' DIP Water. CLSM Backfill
530.
S 420.00) - -
17
3311.0461 -385 LF 12" PVC Water Pipe
140.1
S (3,900.00) -
19
3312.0106 -1 EA Connection to Existing 16' Water Main
2.715.00
S
((2,715.00)
-
21
3312.0117 -1 EA Connection to Existing 4"-12' Water Main
3 100.00
S
{3,100.00)
-
22
3312.3005 -2 EA 12' Gate Valve
31�00. (1
S
+7,600.00)
-
23
3312.4114 EA 16'X12' Taooing Sleeve & Valve
6 800.
S
{6,800.00)
-
NEW
9999.9999 1 LS Water Material Escalation Cost
18-188.
18,688.96
-
UNIT I: WATER IMPROVEMENTS SUBTOTAL
`4)
-
UNIT 111: DRAINAGE IMPROVEMENTS
NEW
9999.9999
1
LS
Drain Material Esca5.42
$ 27,045.42
45.42
I
IStorm
I
uNlT Ition IIoDRAINAGE IMPROVEMENTS SUBTOTAL
I'1 27. 15
iS
-
UNIT IV: PAVING J�![PROVEMENTS
NE
0170.0101
1
EA�Soa-cified
Remoylizapon
92�962.34
92 962.34
NEW
9999.9999
1
LS
Paving Material Escalation Cost
110,859.06
�10 859.08
_
NIT IV: PAVING IMPROVEMENTS SUBTOTAL
S 03.i21.42
UNIT V: STREET LIGN I ING IMPROVE ENTS
NEW
9999.9999
1
LS
Lighting Material
CLIGHTING
$ 26'373.15
I
I
IStreet
UNIT V: STREET IMPROVEMENTS SUBTOTAL
I
I
26,373.15
$ -
GRAND'
5180.197.95I
50.00
REASONS FOR CHANGE ORDER
1. Watedines Band C were removed from the scope and added to CPN 102807, X-26675. Changes correspond to Revision 01 as shown on
Sheets C-07 & C-08 of the
construction plans. No change in the number of working days. This cost will be 100% Developer funded.
2. Substantial Completion date for Waterlines A & B are hereby removed from the Bid Form Section 00 4100 Item 4.1.
3. Realignment of Storm Drain Line B was required due to franchise utility conflicts. Changes correspond to Revision 02 as shown on Sheets
C-36, 39, 41, 42, & 54. No
change in cost or number of working days.
4. Due to delays in franchise utility relocations, demobilization and remobilization were required. An additional 145 working days are requested for this change order. This
cost will be 100% Developer funded.
5. Due to delays in franchise utility relocations, cost of materials escalated at the beginning of 2022 par contract with suppliers. This cost will be 100% Developer funded.
CITY FUNDS ARE INVOLVED ON THIS CONTRACT, BUT DEVELOPER IS RESPONSIBLE FOR 100% OF THIS CHANGE ORDER COST.
NO REIMBURSEMENT FROM
THE CITY WILL BE SOUGHT BY THE DEVELOPER.
[SIGNATURES APPEAR ON THE FOLLOWING PAGE]
Revised: 10-12-2011 Page 2
RECOMMENDED:
Kimlley�-.Hom and Associates, Inc.
By:
:.odybrlwer (Apr I1, M0 1425 CDT)
Name: Cody Brewer, PE
Title: Associate
APPROVED:
Carter Park East Land, LLC
By:
Name: Matt Colter
Title: Senior Manaoinq Director
APPROVAL RECOMMENDED: APPROVED:
(CFW - Sponsoring Department) (CFW - Assistant City Manager)
By: By;
Name: Tammy Lewis Name: Dana Burghdoff
Title: Development Svc. Bus. Process Analyst I Title: Assistant City Manaaer
RECOMMENDED:
(CFW - 'Contract Compliance Manager)
By:
Name: Debbie J. Willhelm
Title: Senior Professional Engineer
M&C Number: MC 23-0099
M&C Date Approved: 2/14/2023
ATTEST:
By:
Name: Jannette S. Goodall
Title: City Secretary
APPROVED:
Texas Sterling Construction Co.
By:
Name: Justin Wild
Title: North Texas Area Manaaer
APPROVED AS TO FORM AND LEGALITY:
(CFW - Assistant City Attomey )
By:
Name: Richard McCracken
Title: Senior Assistant City Attorney
Contract Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, include
ensuring all performance and reporting requirements.
❑ There are NO City Funds associated with this Contract
F] There are City Funds associated with this Contract
Revised: 10-12-2011 Page 3
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME:
Oak Grove Road (From Enon Ave to Joel East Rd)
CONTRACT:
CS-55443 & CS-55443-CAI
CFA #
CFA21-0004 I CITY PARTICIPATION:
CITY PROJECT #
102802
CITY SECRETARY CONTRACT #
CS-55443 & CS-55443-CAI
FID #
30114-0200431-102802-EO7685
FILE #
X-26673, W-2796
INSPECTOR:
PROJECT MANAGER:
Russell Rogers Phone No:
Debbie J. Willhelm Phone No:
WATER
Develspsr
Cost
City Cost
ORIGINAL CONTRACT
S 491.481.00
S
EXTRAS TO DATE
CREDITS TO DATE
$ 77,047-04
CONTRACT TO DATE
S 414,438.96
$
AMOUNT OF PROP. CHANGE ORDER
i
$
REVISED CONTRACT AMOUNT
$ 414,438.96
$
TOTAL REVISED CONTRACT AMOUNT
$414,438.96
PER UNIT
REVISED COST SHARE
Dw. Cost:
TOTAL REVISED CONTRACT
SEWER
Developer City Cost
Cost
S S -
S
S
S
S
S
S
$0.00
$4,663,205.20
YES
214-980-2068
817-392-2481
CONTRACT UNIT
DRAINAGE
Dmloper City Cost
Cost
S 1,544,429.30 $
$ 27,045.42
$ 1,571,474.72 $
-
$ 1,571,474.72 $ -
$1,571,474.72
City Cost:
$5,879,401.40
CHANGE
ORDER No:
2
55443-0O2
REVIEWED
By Debbie J. Willhelm at 5.22 pm, Jun 24, 2024
PAVING
STREET LIGHTS
CONTRACT
Developer
DAYS
Cost
City Cost
Developer Cost
City Cost
$ 2,088,156.49
S 1,200,000.00
S
281,392.25
$
170
$ 203,821.42
$
26,373.15
145
$ 2,291,977.91
$ 1,200,000.00
$
307,765.40
$
315
$ 77,548.21
$ 15,196.20
S
$
0
S 2,369,526.12
S 1,215,196.20
$
307,7a5.40
S
315
$3,584.722.32
$307,765.40
$1,215,196.20
Revised: 10-12-2011 Page 1
You are directed to make the following changes in the contract documents
PAY ITEM #
I CITY BID ITEM I
QUANTITY I
UNIT
UNIT IV: PAVING IMPROVEMENTS
16
3123.0103
1544.8
CY
18
3211,0111
5276
SY
19
3211.0502
-3303.3
SY
20
3211.0400
-179.5
TN
NEW
3211.xxxx
1
LS
ITEM DESCRIPTION
UNIT PRICE I DE CITY
COST ER I COST
Borrow By Plan 15.35 $ 15 059.92 $ 8,652.76
4" Flexible Base, Type A, GR-1 12.00 $ 40 ?09.45 $ 23.102.55
8" Lime Treatment (54 LBS/SY) $ 4.50 �" (9, t40.67) $ (5,424.18)
Hydrated Lime 170.00 $ (19,380.08) $ (11,134.92)
Paving Material Escalation Cost- CO2 51,099.58 1 51,099.58 $ -
UNIT IV: PAVING IMPROVEMENTS SUBTOTAL 77,548.21 $ 15.196.20
GRAND TOTAL $77.548.21 $15.196.20
REASONS FOR CHANGE ORDER 1. Adjustment to roadway profile due to conflict between lime subgrade and storm box culvert. Replaced lime treatement with Rex base subgrade for sections where box
culvert was in conflict with subgrade. Changes correspond to Revision 03 as shown on Sheets C-18, 36, 53, 56, & 57 of the construction plans.
2. Due to delays in franchise utility relocations, cost of paving materials escalated at the beginning of 2022 per contract with suppliers. This cost will be
100% Developer funded.
3. No change in the number of working days for this change order.
CITY FUNDS ARE INVOLVED ON THIS CONTRACT. DEVELOPER WILL BE RESPONSIBLE FOR $77,555.04 AND CITY WILL BE RESPONSIBLE FOR $15,196.20 FOR
THIS CHANGE ORDER.
[SIGNATURES APPEAR ON THE FOLLOWING PAGE)
Revised: 10-12-2011 Page 2
RECOMMENDED: APPROVED:
Kimley-Horn and Associates, Inc. Carter Park East Land, LLC
By: By:
Name: Cody Brewer, PE Name: Matt Colter
Title: Associate Title: Senior Managing Director
APPROVAL RECOMMENDED: APPROVED:
(CFW - Sponsoring Department) (CFW - Assistant City Manager)
By: By:
Dana Rarghdaff
Name: Tyson W. Thompson Name: Dana Burghdoff
Title: Assistant Development Services Director Title: Assistant City Manager
RECOMMENDED:
(CFW - 'Contract Compliance Manager)
By:
Name: Debbie J. Willhelm
Title: Senior Professional Enlaineer
M&C Number: MC 23-0099
M$C Date Approved: 2/1412023
ATTEST:
By: BEENEENEEP
Name: Jannette S. Goodall
Title: City Secretary
APPROVED:
Texas Sterling Construction Co.
By:
Name: Justin Wild
Title: North Texas Area Manager
APPROVED AS TO FORM AND LEGALITY:
(CFW - Assistant City Attorney)
By:
Name: Richard McCracken
Title: Senior Assistant City Attorney
' Contract Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, include
ensuring all performance and reporting requirements.
There are NO City Funds associated with this Contract
There are City Funds associated with this Contract
Revised: 10-12-2011 Page 3
PROJECT NAME:
CONTRACT:
ICFA#
ICITY PROJECT #
CITY SECRETARY CONTRACT #
FID #
FILE #
INSPECTOR:
PROJECT MANAGER:
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
Oak Grove Road (From Enon Ave to Joel East Rd)
Water, Paving, Drainage, and Street Lighting
CFA21-0004
102802
CS-55443 & CS-55443-CAI
30114-0200431-102802-EO7685
X-26673, W-2796
CITY PARTICIPATION:
Russell Rogers Phone No:
Debbie J. Willhelm Phone No:
WATER
Developer Cost
City Cost
ORIGINAL CONTRACT
$491,481.00
$0.00
EXTRAS TO DATE
CREDITS TO DATE
$77,042.04
CONTRACT TO DATE
$414,438.96
$0.00
AMOUNT OF PROP. CHANGE ORDER
$ 114,698.76
$0.00
REVISED CONTRACT AMOUNT
$529,137.72
$0.00
TOTAL REVISED CONTRACT AMOUNT PER
UNIT
$529,137.72
REVISED COST SHARE
Dev. Cost:
TOTAL REVISED CONTRACT
SEWER
Developer
Cost City Cost
$0.00 $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$4,964,762.39
YES
CHANGE
ORDER No:
3
Revised
(214) 980-2068
(817)392-2481
CONTRACT UNIT
DRAINAGE
PAVING
LveloperCost
Developer Cost
CityCost
City Cost
$1,544,429.30
$0.00
I $2,088,156.49
$1,200,000.00
$27,045.42
$281,369.63
$15,196.20
$1,571,474.72
$0.00
$2,369,526.12
$1,215,196.20
$ 25,092.50
$0.00
$ 161,765.93
$ (15,196.20)
$1,596,567.22
$0.00
$2,531,292.05
I $1,200,000.00
$1,596,567.22
$3,731,292.05
CSC No. 55443-0O3
REVIEWED
By Debbie J. Willhelm at 1:29 pm, Oct 09, 2024
STREET
LIGHTS
Developer
Cost
City Cost
$281,392.25
$0.00
$26,373.15
$307,765.40
$0.00
$
$0.00
$307,765.40
$0.00
$307,765.40
City Cost: $1,200,000.00
$6,164,762.39
CONTRACT
DAYS
170
145
315
129
444 1
Change Order 03
Revised: 12-17-2018
Page 1
i
iYou are directed to make the following changes in the contract documents:
PAY ITEM #
CITY BID ITEM # I
QUANTITY
UNIT
I ITEM DESCRIPTION
UNIT PRICE
I DEVELOPER
COST
CITY COST
UNIT 1: WATER IMPROVEMENTS
3
3305.0102
3
EA
Cathodic Protection Test Station Adjustment
$ 1,700.00
$
5,100.00 $
6
3305.0108
2
EA
Miscellaneous Structure Adjustment
$ 3,400.00
$
6,800.00 $
10
3305.0114
1
EA
Manhole Adjustment, Major w/ cover
$ 5,000.00
$
5,000.00 $
NEW
9999.9999
1
LS
Water Material Escalaltion Cost
$ 26,104.64
$
26,104.64 $
NEW
9999.0004
1
EA
8" Waterline Lowering
$ 69,011.05
$
69,011.05 $
NEW
0170.0101
1
EA
Specified Remobilization for 8" WL Lowering
$ 2,683.07
$
2,683.07 $
UNIT I: WATER IMPROVEMENTS SUBTOTAL
$
114.698.76 $
JUNIT III: DRAINAGE IMP OVEMENTS
NEW
3341.1402
10
LF
Box Culvert Adjustments for Existing RBC
$ 866.18
$
8,661.80
$
NEW
3349.1000
1
6
1
CY
17x4
Headwall, Box Culvert Adjustment for Existing RBC
$ 1,295.57
$
7,773.42
$
NEW
9999.0003
16
LF
18" Arch Pipe & Inlet Tie-in
$ 541.08
$
8,657.28
$
UNIT III: DRAINAGE IMPROVEMENTS SUBTOTAL
$
25.092.50
$
UNIT IV: PAVING IMPROVEMENTS
10
0241.1300
316
LF
Remove Conc Curb & Gutter
$ 21.50
$
6,794.00 $
j
14
3123.0101
171
CY
Unclassified Excavation by Plan
$ 12.50
$
2,137.50 $
15
3124.0101
171
CY
Embankment by Plan
$ 6.15
$
1,051.65 $
j 16 (Back out City funds/Add to Dev for CO2)
3123.0103
CY
Borrow By Plan
$
8.652.76 $
(8,652.76)1
18 (Back out City funds/Add to Dev for CO2)
3211.0111
SY
4" Flexible Base, Type A, GRA
$
23,102.55 $
(23,102.55)]
18
3211.0111
555
SY
4" Flexible Base, Type A, GR-1
$ 12.00
$
6,660.00 $
-
19 (Back out City funds/Add to Dev for CO2)
3211.0502
SY
8" Lime Treatment (54 LBS/SY)
$
(5,424.19) $
5,424.19
20 (Back out City funds/Add to Dev for CO2)
3211.0400
TN
Hydrated Lime
$
(11,134.92) $
11,134.92
21
3212.0302
213
SY
2" Asphalt Pvmt Type D
$ 36.18
$
7,706.34 $
- j
22
3212.0505
213
SY
8" Asphalt Pvmt Type B
$ 93.11
$
19,832.43 $
j 23
3213.0105
9
SY
10" Conc Pvmt (4,000 PSI)
$ 70.00
$
630.00 $
24
3213.0403
-432
SF
8" Concrete Driveway
$ 7.00
$
(3,024.00) $
j
j 25
3213.0301
3129
SF
4" Conc Sidewalk
$ 4.74
$
14,831.46 $
25
3213.0301
-828
SF
4" Conc Sidewalk
$ 4.74
$
(3,924.72) $
26
3213.0311
828
SF
4" Conc Sidewalk, Adjacent to Curb
$ 7.10
$
5,878.80 $
28
3217.0010
420
LF
4" SLID Pvmt Marking HAS (W)
$ 0.89
$
373.80 $
30
3217.0201
276
LF
8" SLID Pvmt Marking HAS (W)
$ 2.00
$
552.00 $
35
3217.2102
4
EA
REFL Raised Marker TY 1-C
$ 4.00
$
16.00 $
43
3441.4110
2
EA
Furnish/Install Alum Sign Ground Mount City Sid.
$ 685.00
$
1,370.00 $
NEW
9999.0002
474.5
LF
Drill & Dowel New Turn Lane
$ 37.08
$
17,594.46 $
NEW
0241.1000
213
SY
Remove Conc Pvmt
$ 24.92
$
5,307.96 $
NEW
0170.0101
1
EA
Specified Remobilizaloin
$ 62,782.05
$
62,782.05 $
UNIT IV: PAVING IMPROVEMENTS SUBTOTAL
$
161.765.93 $
(15,196.20)
GRAND TOTAL
$
301,557.19 1 $
(15,196.20)
Asterisk (') indicates New Pay Item
Change Order 03
Revised: 12-17-2018 Page 2
REASONS FOR CHANGE ORDER 1. Adjustments to driveways along the East side of Oak Grove, and addition of a turn lane. Changes correspond to Revision 04 as shown on Sheets C-53, 54, 55, 56, 60, & 64. Thirty
one additional working days required due to revision.
2. Additional cathodic protection test stations, miscellaneous structures, and manholes found in the field during demolition of existing asphalt roadway. Adjustments made to these
structures to match proposed roadway elevation. Additional working days required for these adjustments.
3. Adjustment to light pole locations due to newly installed overhead electric lines. Sidewalk bumpouts installed to allow for new light pole locations within parkway.
4. Adjustment to asphalt tie in at north end due to ongoing construction of Joel East & Oak Grove intersection. Additional striping and signage needed for new tie in at this intersection.
5. Lowering of existing 8" waterline found to be in conflict with Storm Line B just south of Enon Avenue.
6. Depth of inlets on laterals A-8 & B-2 not sufficient to allow for 24" pipe and full paving section. Lateral connection to inlet altered to arch pipe to avoid conflict with roadway pavement
section.
7. Connection to existing box culverts at north outfall found to be lower in field. Additional CIP box culvert required to tie into existing culverts. Headwall extended to match existing
flowline found in field. Additional concrete required to pour extended headwall. Additional working days required for this adjustment.
8. Remobilization required to complete the paving improvements. This Change Order No. 3 will be the final change order requested for close-out.
CITY FUNDS ARE INVOLVED ON THIS CONTRACT. DEVELOPER WILL BE RESPONSIBLE FOR $301,557.22 AND CITY WILL BE REFUNDED $15,196.20 FOR
THIS CHANGE ORDER.
[SIGNATURES APPEAR ON THE FOLLOWING PAGE]
Change Order 03
Revised: 12-17-2018
Page 3
RECOMMENDED: APPROVED:
KKiim`lleyy-Horn and Associates, Inc. Carter Park East Land, LLC,
By: U By:
Name: Cody Brewer, PE Name: Matt Colter
Title: Associate Title: Senior Managing Director
APPROVAL RECOMMENDED: APPROVED:
CFW- Sponsoring Department CFW- Assistant City Manager
, Dana Burandof•F
By: - By: u,, e�dddgan. e, xc9con
Name: Tyson W. Thompson Name: Dana Burqhdoff
Title: Assistant Development Services Director Title: Assistant City Manager
RECOMMENDED: ATTEST:
CFW - 'Contract Compliance Manager
By: O By:
Name: Debbie J. Willhelm Name: Jannette S. Goodall
Title: Senior Professional Engineer Title: City Secretary
M&C Number: MC 24-0139
M&C Dale Approved: 2/27/2024
Revised: 12-17-2018
APPROVED:
Texas Sterling Construction Co.
R&h"d Hen.Jertot�
kkh,rd lleMEwn((xli, }ol U95(CUiI
By:
Name: Richard Henderson
Title: North Texas Area Manager
APPROVED AS TO FORM AND LEGALITY:
CFW - Assistant City Attorney
Name: Richard McCracken
Title: Senior Assistant City Attorney
• Contract Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, include
ensuring all performance and reporting requirements.
There are NO City Funds associated with this Contract
� Fhere are City Funds associated with this Contract
Change Order 03
Page 4
FORTWORTH.
M,
TRANSPORTATION AND PUBLIC WORKS
July 24, 2024
Texas Sterling
1441 Air Port Fwy, Suite 350
Euless TX 76040
RE: Acceptance Letter
Project Name: Paving ,drainage, street lights to serve Oak Grove Road
Project Type: Water ,paving , drainage, street lights
City Project No.: 102802
To Whom It May Concern:
On June 25, 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 18, 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 18, 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-
392-2481.
Sincerely,
TJe66ie �. uJ'N49.,
Debbie Willhelm, Project Manager
Cc: Russell Rogers, Inspector
Gary Deyon, Inspection Supervisor
Lorri Pitts, Senior Inspector
Victor Toreno, Program Manager
Kimley Horne, Consultant
Texas Sterling, Contractor
Carter Park East, Land, LLC, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
DocuSign Envelope ID: 12D2CC94-7045-4D64-920C-84424B97C468
ATTACHMENT NO. 7
Final Release of Lien
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
STATE OF TEXAS
COUNTY OF TARRANT
PROJECT: OAK GROVE ROAD
JOB NO.: 2102-
On receipt by the signer of this document of a check from Texas Sterling Construction Co. (maker of check) in the
sum of $ 1,858.29 payable to REYNOLDS ASPHALT AND CONST. (payee or payees of check)
and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document
becomes effective to release any mechanic's lien right, any right arising from a payment bond that complies with a
state or federal statute, any common law payment bond right, any claim for payment, and any rights under any
similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the
signer has or may have on the property of CARTER PARK EAST LAND. LLC (Owner) located at 1717 McKINNEY
AVENUE, SUITE 1900, DALLAS TX 76202 (location) to the following extent: ;IAK GROVE ROAD.
This release covers the FINAL PAYMENT to the signer for all labor, services, equipment, or materials furnished to
the property or to Texas Sterling Construction Co. (person with whom signer contracted).
Before any recipient of this document relies on it, the recipient should verify evidence of payment to the signer.
The signer warrants that the signer has already paid or will use the funds received from this FINAL PAYMENT to
pay promptly and in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work,
materials, equipment, or services provided for or to the above referenced project up to the date of this Conditional
Waiver and Release on Final Payment.
The signer warrants that the signer receives funds from this FINAL PAYMENT in trust for others to the extent that
final payment corresponds to those others.
THE SIGNER ACKNOWLEDGES AND AGREES THAT UPON RECEIPT OF THE FINAL PAYMENT SUM AND IN
CONSIDERATION FOR THE FINAL PAYMENT SUM, SUBCONTRACTOR FOREVER RELEASES CONTRACTOR,
CONTRACTOR'S SURETY, AND THE OWNER FROM ANY CLAIM OR CLAIMS NOW EXISTING AND FROM ANY
AND ALL FUTURE CLAIM OR CLAIMS RELATED TO THE SUBCONTRACT WORK. SUBCONTRACTOR AGREES
TO INDEMNIFY AND HOLD HARMLESS THE CONTRACTOR; ITS SURETIES, IF ANY; AND, THE OWNER FROM
ALL LIENS, CLAIMS, AND DEMANDS (INCLUDING ATTORNEYS FEES) ARISING OUT OF OR RELATED TO
WORK, SERVICES, LABOR AND/OR MATERIALS PROVIDED; ARISING FROM, BY OR THROUGH THE
SUBCONTRACTOR; AND/OR RELATED TO LABOR, MATERIAL, EQUIPMENT OR SERVICES PROVIDED TO OR
THROUGH THE SUBCONTRACTOR FOR USE ON THE PROJECT.
The signer warrants that the signer has authority to sign this Conditional Waiver and Release on Final Payment and
that the signer has not assigned any claim for payment, any right to perfect a lien claim, or any contractual, statutory
or constitutional lien against the property in connection with the above -described Work.
In the event that any provision(s) or portion(s) of this Conditional Waiver and Release on Final Payment is/are
determined by a court of competent jurisdiction to be contrary to law or otherwise to be unenforceable, the signer or
anyone standing in the signer's stead agrees to be bound to those provisions and those portions of this Conditional
Waiver and Release on Final Payment that conform to state law and are enforceable.
Date 7/18/2024
REYNOLIrS_�j$PHALT NND C_QNBr (Company -tame)
Retainage Release
By (Signature)
GARY REYNOL (Printed Name)
PRESIDENT / (Title)
SUBSCRIBEF''AND SWORN to before me this 18th day of July 2024, by Gary E. Reynolds,
President of Rkynoids Asphalt & Construction Co.
BY 1<
N ublic, State of Texas
2102SL08-RAC -OAK GROVE ROAD
Page loft
LAURA BETH MAYO
=z;PaY Pue�=Notary Public, state of Texas
Comm. Expires 06 17 2027
}� Notary ID 7070545
DocuSign Envelope ID. EES36BD6-B923467A-BA9&72F8A4CFB450
ATTACHMENT NO. 7
Final Release of Lien
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
STATE OF TEXAS
COUNTY OF
PROJECT: OAK GROVE ROAD
JOB NO. 2102-
On receipt by the signer of this document of a check from Texas Sterling Construction Co. (maker of check) in the
sure of $ 555.83 payable to TFXOP CONSTRUCTION LP !payee or payees of check) and when
the check has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes
effective to release any mechanics lien right, any right arising from a payment bond that complies with a state or
federal statute, any common law payment bond right, any claim for payment, and any rights under any similar
ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the signer has
or may have on the property of CARTER PARK EAST LAND LLC (Owner) located at 1717 McKinney Avenue,
Suite 1900. Dallas. TX 75202 (location) to the following extent: 6AK GROVE ROAD.
This release covers the FINAL PAYMENT to the signer for all labor, services, equipment, or materials furnished to
the properly or to Texas Sterling Construction Co. (person with whom signer contracted).
Before any recipient of this document relies on it, the recipient should verify evidence of payment to the signer.
The signer warrants that the signer has already paid or will use the funds received from this FINAL PAYMENT to
pay promptly and in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work,
materials, equipment, or services provided for or to the above referenced project up to the date of this Conditional
Waiver and Release on Final Payment.
The signer warrants that the signer receives funds from this FINAL PAYMENT in trust for others to the extent that
final payment corresponds to those others
THE SIGNER ACKNOWLEDGES AND AGREES THAT UPON RECEIPT OF THE FINAL PAYMENT SUM AND IN
CONSIDERATION FOR THE FINAL PAYMENT SUM, SUBCONTRACTOR FOREVER RELEASES CONTRACTOR,
CONTRACTOR'S SURETY, AND THE OWNER FROM ANY CLAIM OR CLAIMS NOW EXISTING AND FROM ANY
AND ALL FUTURE CLAIM OR CLAIMS RELATED TO THE SUBCONTRACT WORK. SUBCONTRACTOR AGREES
TO INDEMNIFY AND HOLD HARMLESS THE CONTRACTOR; ITS SURETIES, IF ANY; AND, THE OWNER FROM
ALL LIENS, CLAIMS, AND DEMANDS (INCLUDING ATTORNEYS FEES) ARISING OUT OF OR RELATED TO
WORK, SERVICES, LABOR ANDIOR MATERIALS PROVIDED; ARISING FROM, BY OR THROUGH THE
SUBCONTRACTOR; ANDIOR RELATED TO LABOR, MATERIAL, EQUIPMENT OR SERVICES PROVIDED TO OR
THROUGH THE SUBCONTRACTOR FOR USE ON THE PROJECT.
The signer warrants that the signer has authority to sign this Conditional Waiver and Release on Final Payment and
that the signer has not assigned any claim for payment, any right to perfect a lien claim, or any contractual, statutory
or constitutional lien against the property in connection with the above -described Work,
In the event that any provision(s) or portion(s) of this Conditional Waiver and Release on Final Payment islare
determined by a court of competent jurisdiction to be contrary to law or otherwise to be unenforceable, the signer or
anyone standing in the signer's stead agrees to be bound to those provisions and those portions of this Conditional
Waiver and Release on �Final Payment that conform to state law and are enforceable.
Retainage Release
TEXDP� C71 N LP (Company name)
(Signature)
(Printed Name)
y5
(Title)
SUBSCRIBED AN6,9 ORN to before me this I v day o
2102SL03-TF-XOP - OAK GROVE ROAD
rage 1of1
B
Notar"uNic, State of Texas
e TONIA RENE MCCLOUD
Notary ID #126386356
my Commission Expires
-J January 24, 2028
DocuSign Envelope ID: F8CC9197-3A7C-4C89-A86E-703BDE4A2F3C
ATTACHMENT NO. 7
Final Release of Lien
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
STATE OF TEXAS
COUNTY OF
PROJECT: OAK GROVE ROAD
JOB NO.: 2102-
On receipt by the signer of this document of a check from Texas Sterling Construction Co. (maker of check) in the
sum of $ 21..359.77 payable to NORTH TEXAS CONTRACTING, INC. (payee or payees of check)
and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document
becomes effective to release any mechanic's lien right, any right arising from a payment bond that complies with a
state or federal statute, any common law payment bond right, any claim for payment, and any rights under any
similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the
signer has or may have on the property of CARTER EAST PARK LAND, LLC (Owner) located at 11717 McKINNEY
AVENUE. SUITE 1900, DALLAS, TX 75202 (location) to the following extent: OAK GROVE ROAD.
This release covers the FINAL PAYMENT to the signer for all labor, services, equipment, or materials furnished to
the property or to Texas Sterling Construction Co. (person with whom signer contracted).
Before any recipient of this document relies on it, the recipient should verify evidence of payment to the signer.
The signer warrants that the signer has already paid or will use the funds received from this FINAL PAYMENT to
pay promptly and in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work,
materials, equipment, or services provided for or to the above referenced project up to the date of this Conditional
Waiver and Release on Final Payment.
The signer warrants that the signer receives funds from this FINAL PAYMENT in trust for others to the extent that
final payment corresponds to those others.
THE SIGNER ACKNOWLEDGES AND AGREES THAT UPON RECEIPT OF THE FINAL PAYMENT SUM AND IN
CONSIDERATION FOR THE FINAL PAYMENT SUM, SUBCONTRACTOR FOREVER RELEASES CONTRACTOR,
CONTRACTOR'S SURETY, AND THE OWNER FROM ANY CLAIM OR CLAIMS NOW EXISTING AND FROM ANY
AND ALL FUTURE CLAIM OR CLAIMS RELATED TO THE SUBCONTRACT WORK. SUBCONTRACTOR AGREES
TO INDEMNIFY AND HOLD HARMLESS THE CONTRACTOR; ITS SURETIES, IF ANY; AND, THE OWNER FROM
ALL LIENS, CLAIMS, AND DEMANDS (INCLUDING ATTORNEYS FEES) ARISING OUT OF OR RELATED TO
WORK, SERVICES, LABOR AND/OR MATERIALS PROVIDED; ARISING FROM, BY OR THROUGH THE
SUBCONTRACTOR; AND/OR RELATED TO LABOR, MATERIAL, EQUIPMENT OR SERVICES PROVIDED TO OR
THROUGH THE SUBCONTRACTOR FOR USE ON THE PROJECT.
The signer warrants that the signer has authority to sign this Conditional Waiver and Release on Final Payment and
that the signer has not assigned any claim for payment, any right to perfect a lien claim, or any contractual, statutory
or constitutional lien against the property in connection with the above -described Work.
In the event that any provision(s) or portion(s) of this Conditional Waiver and Release on Final Payment is/are
determined by a court of competent jurisdiction to be contrary to law or otherwise to be unenforceable, the signer or
anyone standing in the signer's stead agrees to be bound to those provisions and those portions of this Conditional
Waiver and /Rel JJase on Final Payment that conform to state law and are enforceable.
Date Retainage Release
NORTH T S C �(Signature)
ING, INC. (Company name)
By `��
�j wCfrST�� (Printed Name)
P1?o TeZ r✓If)-pJ►h6(s.V- (Title)
SUBSCRIBED AND SWORN to before me this day of T�S.I--y 2�27 �.` �G.••••••
�v Pue`z i BY
Notary gbiic, late of Texas
Zp r
2102SL10-NORTH TEXAS CONTRACTORS, INC. - OAK GRO1 ROAD '%.:t 'E or
Page lofl ;y 'L��
- ; ANWA e19 .-;-sAl - VENDOR — - `
815046 INORTH TEXAS CONTRACTING, INC. 509310
521 487
1
04/30/21 2102SL10 APR'21 )N
87,950.00
0.00
0.00
83,552.50
0.00
4,397.50
-521 206
2
05/31/21 2102SLIO MAY-21 )N
87,820.00
0.00
0.00
83,429.00
0.00
4,391.00
721 309
210251-10.0621
06/25/21 2102SLIO )UNE'21 )N
72,080.00
0.00
0.00
68,476.00
0.00
3,604.00
'921 201
2102SLIO AUG 21
08/31/21 2102SL10 AUGUST 2W
9,000.00
0.00
0.00
8,610.00
0.00
390.00
•4221166
2102SL10 APR22
04/30,122 2102 APR 22 Pay EstirrCCO
10,800.00
0.00
0.00
10,260,00
0.00
540.00
.5221057
2102SLIO 05/22
05/25/22 MAY 2022 PAY APP )WI
37,600.00
0.00
0.00
35,720.00
0.00
1,880.00
-2231241
210251-10 FEB23
01/25/23 2102Feb23SL )WI
123,145.46
0.00
0.00
116,988.19
0.00
6,157.27
815046 428,395.46 1 0.00 1 0.001 407,035.691 0.00 1 21,359.771
-1014 „la:i by J•i' li:lii.Li'.isY'�►SIcK v�;d:�i�tia miv'sJ'sE�a:BtlVdl:c' .L�4.i1E:ti,Ilu.1.su,�ia.tri.:w�.,ua.%:�j'•9;xSr:ia �u�:si'.I. rd •�,w 4�li•�i,E.�� wo!i•+ rv, r*i'm - AMEG-
TEXAS STERLING CONSTRUCTION PORT BANK ORTER,TE%ASAS
20810 FERNIIUSH LANE 35-1058/1131
HOUSTON, TEXAS 77073 DATE CHECK NO. AMOUNT
(281)821-9091
07/17124 509310 $21,359.77
PAY
***Twenty-one thousand three hundred fifty-nine and 77 / 100 Dollars***
TO
THE ORDER NORTH TEXAS CONTRACTING, INC.
OF 4999 KELLER HASLET RD.
KELLER, TX 76244
1 1EH.„
+vf
�O�ES
118S0931011' 1:1131105861: 11'04444129?4u'
AP Retainage Summary Drilidown
Jobs: 2102- - 2102- Through Month: 07124
Invoice Total Held Released
Mth Trans Date AP Reference Description Retainage Retainage Retainage
!JC Company: 2 Texas Sterling Construction Co.
Job: 2102- OAK GROVE ROAD
Vendor: 815046 NORTH TEXAS CONTRACTING, INC
05/21
487
04/30/21
1 2102SL10 APR'21
4,397.50
06/21
206
05/31/21
2 2102SL10 MAY'21
4,391.00
07/21
309
06/25/21
2102SL10.0621 2102SL10 JUNE'21
3,604.00
09/21
201
08/31/21
2102SL10 AUG 21 2102SL10 AUGUST 2021
390.00
04122
1166
04/30/22
2102SL10 APR22 2102 APR 22 Pay Estimate
540.00
05/22
1057
05/25/22
2102SL10 05/22 MAY 2022 PAY APP
1.880.00
02/23
1241
01/25/23
2102SL10 FEB23 2102Feb23SL
6,157.27
Total For Vendor : 815046
21,359.77
Total For Job: 2102-
21,359.77
Total For JC Company: 2
21,359.77
Grand Totals :
21,359.77
4,397.50
4,391.00
3,604.00
390.00
540.00
1,880.00
6,157.27
21,359.77
21,359.77
21,359.77
21,359.77
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0,00
0.00
0.00
0.00
Paid
Retainage
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2 Texas Sterling Construction Co. Page 1 07/14/24 05:31:23 PM
Date Format - MM/DD/YY APRetain.rpt
Docu3ign Envelope ID: EBBCCOE5-1B12-457C-9D2B-83C22BAC0DE0
ATTACHMENT NO. 7
Final Release of Lien
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
STATE OF TEXAS
COUNTY OF
PROJECT: OAK GROVE ROAD
JOB NO.: 2102-
On receipt by the signer of this document of a check from Texas Sterling Construction Co. (maker of check) in the
sum of $ 15.785.13 payable to C&S UTILITY CONTRACTORS, INC. (payee or payees of check)
and when the check has been properly endorsed and has been paid by the bank on which it is drawn, this document
becomes effective to release any mechanic's lien right, any right arising from a payment bond that complies with a
state or federal statute, any common law payment bond right, any claim for payment, and any rights under any
similar ordinance, rule, or statute related to claim or payment rights for persons in the signer's position that the
signer has or may have on the property of CARTER EAST PARK LAND, LLC (Owner) located at 1717 McKinnev
Avenue. Suite 1900. Dallas, TX 75202 (location) to the following extent: OAK GROVE ROAD.
This release covers the FINAL PAYMENT to the signer for all labor, services, equipment, or materials furnished to
the property or to Texas Sterling Construction Co. (person with whom signer contracted).
Before any recipient of this document relies on it, the recipient should verify evidence of payment to the signer.
The signer warrants that the signer has already paid or will use the funds received from this FINAL PAYMENT to
pay promptly and in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work,
materials, equipment, or services provided for or to the above referenced project up to the date of this Conditional
Waiver and Release on Final Payment.
The signer warrants that the signer receives funds from this FINAL PAYMENT in trust for others to the extent that
final payment corresponds to those others.
THE SIGNER ACKNOWLEDGES AND AGREES THAT UPON RECEIPT OF THE FINAL PAYMENT SUM AND IN
CONSIDERATION FOR THE FINAL PAYMENT SUM, SUBCONTRACTOR FOREVER RELEASES CONTRACTOR,
CONTRACTOR'S SURETY, AND THE OWNER FROM ANY CLAIM OR CLAIMS NOW EXISTING AND FROM ANY
AND ALL FUTURE CLAIM OR CLAIMS RELATED TO THE SUBCONTRACT WORK. SUBCONTRACTOR AGREES
TO INDEMNIFY AND HOLD HARMLESS THE CONTRACTOR; ITS SURETIES, IF ANY; AND, THE OWNER FROM
ALL LIENS, CLAIMS, AND DEMANDS (INCLUDING ATTORNEYS FEES) ARISING OUT OF OR RELATED TO
WORK, SERVICES, LABOR AND/OR MATERIALS PROVIDED; ARISING FROM, BY OR THROUGH THE
SUBCONTRACTOR; AND/OR RELATED TO LABOR, MATERIAL, EQUIPMENT OR SERVICES PROVIDED TO OR
THROUGH THE SUBCONTRACTOR FOR USE ON THE PROJECT.
The signer warrants that the signer has authority to sign this Conditional Waiver and Release on Final Payment and
that the signer has not assigned any claim for payment, any right to perfect a lien claim, or any contractual, statutory
or constitutional lien against the property in connection with the above -described Work.
In the event that any provision(s) or portion(s) of this Conditional Waiver and Release on Final Payment is/are
determined by a court of competent jurisdiction to be contrary to law or otherwise to be unenforceable, the signer or
anyone standing in the signer's stead agrees to be bound to those provisions and those portions of this Conditional
Waiver and Releas/�� on_ Final Payment that conform to state law and are enforceable.
Date �/10 Retainage Release
C&S UTILITY C rACTORS, INC. (Company name)
By/�(Signature)
(Printed Name)
P/2 y�fi— (Title)
SUBSCRIBED AND SWORN to before me this K, day of � z
BY -
Notary Publi , f Texas
2102SLOS-C&S UTILITY CONTRACTORS - OAK GROVE ROAD
Page 1ofl
�►*Y'�r SLAKE MENAPACE
= r Notary ID #130991676
My COMMission Expires
cr February 2, 2025
DocuSign Envelope ID. 6FDEA2C3-E245AD62-AC2E-DD46934653DF
ATTACHMENT NO. 7
Final Release of Lien
CONDITIONAL WAIVER AND RELEASE ON FINAL PAYMENT
STATE OF TEXAS
COUNTY OF
PROJECT: OAK GROVE ROAD
JOB NO.: 2102-
On receipt by the signer of this document of a check from Texas Sterling Construction Co. (maker of check) in the
sum of $ 614.30 payable to GJ SEEDING, LLC (payee or payees of check) and when the check
has been properly endorsed and has been paid by the bank on which it is drawn, this document becomes effective
to release any mechanic's lien right, any right arising from a payment bond that complies with a state or federal
statute, any common law payment bond right, any claim for payment, and any rights under any similar ordinance,
rule, or statute related to claim or payment rights for persons in the signer's position that the signer has or may have
on the property of CARTER PARK EAST LAND. LLC (Owner) located at 1717 McKinnev Avenue, Suite 1900,
Dallas, TX 75202 (location) to the following extent: OAK GROVE ROAD.
This release covers the FINAL PAYMENT to the signer for all labor, services, equipment, or materials furnished to
the property or to Texas Sterling Construction Co. (person with whom signer contracted).
Before any recipient of this document relies on it, the recipient should verify evidence of payment to the signer.
The signer warrants that the signer has already paid or will use the funds received from this FINAL PAYMENT to
pay promptly and in full all of the signer's laborers, subcontractors, materialmen, and suppliers for all work,
materials, equipment, or services provided for or to the above referenced project up to the date of this Conditional
Waiver and Release on Final Payment.
The signer warrants that the signer receives funds from this FINAL PAYMENT in trust for others to the extent that
final payment corresponds to those others.
THE SIGNER ACKNOWLEDGES AND AGREES THAT UPON RECEIPT OF THE FINAL PAYMENT SUM AND IN
CONSIDERATION FOR THE FINAL PAYMENT SUM, SUBCONTRACTOR FOREVER RELEASES CONTRACTOR,
CONTRACTOR'S SURETY, AND THE OWNER FROM ANY CLAIM OR CLAIMS NOW EXISTING AND FROM ANY
AND ALL FUTURE CLAIM OR CLAIMS RELATED TO THE SUBCONTRACT WORK. SUBCONTRACTOR AGREES
TO INDEMNIFY AND HOLD HARMLESS THE CONTRACTOR; ITS SURETIES, IF ANY; AND, THE OWNER FROM
ALL LIENS, CLAIMS, AND DEMANDS (INCLUDING ATTORNEYS FEES) ARISING OUT OF OR RELATED TO
WORK, SERVICES, LABOR AND/OR MATERIALS PROVIDED; ARISING FROM, BY OR THROUGH THE
SUBCONTRACTOR; AND/OR RELATED TO LABOR, MATERIAL, EQUIPMENT OR SERVICES PROVIDED TO OR
THROUGH THE SUBCONTRACTOR FOR USE ON THE PROJECT.
The signer warrants that the signer has authority to sign this Conditional Waiver and Release on Final Payment and
that the signer has not assigned any claim for payment, any right to perfect a lien claim, or any contractual, statutory
or constitutional lien against the property in connection with the above -described Work.
In the event that any provision(s) or portion(s) of this Conditional Waiver and Release on Final Payment is/are
determined by a court of competent jurisdiction to be contrary to law or otherwise to be unenforceable, the signer or
anyone standing in the signer's stead agrees to be bound to those provisions and those portions of this Conditional
Waiver and Release on Final Payment that conform to state law and are enforceable.
Date .4 _ 18 021q Retainage Release
GJ SEEDING LLC (Company name)
By 0og", (Signature)
nr 1 'Dct2.v'Y (Printed Name) (jP• �'y
(Title)
SUBSCRIBED AND SWORN to before me this dLhay of I (A ILI
���,p' 1305�R����
BY (> / \, �%
Notary Public, State of Texas ',,RES103
2102SL02-GJ SEEDING - OAK GROVE ROADp�
Page t of I = ta...�e� VALERIA SUPE
Notary Public
*' * STATE OF TEXAS
ID# 134722923
My Comm. Exp. January 22, 2028
CONSENT OF SURETY
TO FINAL PAYMENT
AIA Document G707
Bond No. 107333128
TO OWNER
(!dame emd addre-)
Carter Park East Land, LLC
1717 McKinney Avenue, Suite 1900
Dallas, TX 75202
PROJECT:
(Nome and vddrac-3
OWNER
ARCHITECT CI
CONTRACTOR
SURD FY )�
OTHFR
ARCHITECT'S PROJECT NO.:
Water, Paving, Drainage & Lighting Improvements -
CONTRACf FOR: Oak Grove Road - City Project #102802
CONTRACT DATED: January 27, 2021
Water, Paving, Drainage & Lighting Improvements - Oak Grove Road - City Project #102802
In accordance with she prov%lans of the Contract between [he Owner and the Contractor as indk2mcl above, the
Onsw rMum died addre-sx of.514"J
Travelers Casualty and Surety Company
One Tower Square
Hartford, CT 06183
on bond of
ryrra�n rrararanc8exddre.�QjContracrur)
Texas Sterling Construction Co.
1441 Airport Freeway, Suite 350
Euless, TX 76040
r-ON 1.'R4CTOR,
hereby approves of the final payment to the Contractor, and agrees that teal payment to the Contractor shall not relieve the Surety of
any of its obligations to
(it .7tn r umaam 4addhays afOttwer)
Carter Park East Land, LLC
1717 McKinney Avenue, Suite 1900
Dallas, TX 75202
as set forth in said Surety's bond.
IN WITNESS WREREOF, the Surety ims hereunto set its hand on this daze: September 10, 2024
(Itxw# fit xaft/erg tl� rtavnth jallnu�erl ht� tfar nrwnerre clarrarrrl rcrarl
.Attest:
(Sea)):
, OWNER,
Travelers Casualtv and Surety Comoanv_
(Y3 J��T RNO s
V
u-ARTFORD,tu
c
(Sgnuriarofuritbnr�izedrrraurutnri CONN.
Jessica L. Piccirillo, Attorney -in -Fact
(Pearled rtarne auel fifk)
G707--1994
Travelers Casualty and Surety Company of America
TRAVELERS J k Travelers Casualty and Surety Company
St. Paul Fire and Marine Insurance Company
Farmington Casualty Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, St. Paul
Fire and Marine Insurance Company, and Farmington Casualty 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 Jessica L. Piccirillo of Farmington, CT ,
their true and lawful Attorney(s)-in-Fact, to sign, execute, seal and acknowledge the following bond:
Surety Bond No.: 107333128 Principal: Texas Sterling Construction Co.
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.
• •O SUAEJy ".,,, �Z�ANr �.+� OASU,�
Uzi �• Jf * p�'cooPoq��rA.
HARTFORD, Ei'- W ! HAt71FOFm, a CLMO�M �.. s' • 0
''_CONN. ;o< 1N, s� +q Z 1982( O
yybl it V'� � P y • P
State of Connecticut
City of Hartford ss.
By:
Robert L. Raney, Senior 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.
NOTA:� i
My Commission expires the 30th day of June, 2026 PD,c ai
- 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 Attomeys-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.
I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a true and
correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect.
Dated this 101h day of September 2024.
•° OSUAF}Y"•c, P�tr M�`�_ 0/•SU4,
' HARTFORD, K W F1AiilFOAD, < OOMOAYI ''
5"'• CONN. ;o 661 CpJN. a+b 1 9 & 2 O
?�� eir
Kevin E. Hughes, Assistant Secretary
To verify the authenticity of this Power of Attorney, please call us at 1-800-421-3880.
Please refer to the above -named Attorney(s)-in-Fact and the details of the bond to which this Power of Attorney is attached.
IMPORTANT NOTICE
To obtain information or make a complaint:
You may call Travelers Casualty and Surety Company of America and its affiliates' toll -
free telephone number for information or to make a complaint at:
1-800-328-2189
You may contact the Texas Department of Insurance to obtain information on
companies, coverages, rights or complaints at:
1-800-252-3439
You may write the Texas Department of Insurance:
P. O. Box 149104
Austin, TX 78714-9104
Fax: (512) 475-1771
Web: httD://www.tdi.state.tx.us
E-mail: ConsumerProtection(a)tdi.state.tx.us
PREMIUM OR CLAIM DISPUTES:
Should you have a dispute concerning your premium or about a claim you should
contact your Agent or Travelers first. If the dispute is not resolved, you may contact the
Texas Department of Insurance.
ATTACH THIS NOTICE TO YOUR BOND:
This notice is for information only and does not become a part or condition of the
attached document and is given to comply with Texas legal and regulatory requirements.
(PN-042-B) Ed.10.18.07