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Contract 58316-FP2
FORT WORTH, WATER DEPARTMENT NOTICE OF PROJECT COMPLETION -FP2 City Secretary No: 58316 Date Received: 11/20/2024 City Project No: 100962-2 Regarding contract 58316 Lake Worth Water and Sewer Improvements Part 2 for as required by the WATER DEPARTMENT as approved by City Council on 9/27/2022 through M&C 22-0753 the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Water Department has accepted the project as complete. Original Contract Prices: 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 77 S614D Recommended for Acceptance Asst. Director, WATER DEPARTMENT Christopher Ha - er(Nov 18, 202407:28 CST) Accepted Director, WATER DEPARTMENT Daum But Hdoff Dana Burghdoff (Nov 1 , 2024 11:03 CST) Asst. City Manager $ 6,232,406.50 $ 83,423.10 N.a- 3 _ $ 6,315,829.60 $ 5,664,866.48 Days @ $650.00/ Day $ 5,664,866.48 $ 5,381,623.16 $ 283,243.32 Nov 14, 2024 Date Nov 18, 2024 Date Nov 18, 2024 Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment 1To (Owner) City of Fort Worth Invoicing Period (From -To): 7-10-2024 P O FW060-000020155 From(Contractor): Number: Woody Contractors, Inc. JProject: 100962-2 Contractor's CFW Vendor No.: I 000003531 City Secretary Contract Number: (Approved Change Orders Number I 1 I 2 I 3 I 4 I 5 I 6 I 7 I 8 TOTALS NETCHANGEBY CHANGE ORDERS Contractor's Certification 58316 Application For Payment Change Order Summary Additions $409.939.10 $906.232.00 $9,350.00 $1,325.521.10 Invoice No. Final - Retainage Invoice Date: 7/10/2024 Remit to ( If Not Automatic Deposit ): Contract Lake Worth Water Line Sanitary Sewer Improvements Project Name: �' I) .1 $83,423.10 1. ORIGINAL CONTRACT PRICE.......................................................... S $ 6,237,4 06.5 0 Deletions 12. Net change by Change Orders................................................................. $ $ 83, 45.10 $409,242.00 13. Current Contract Price (Line I t 2)........................................................ $ $6,315,929.60 $823,506.00 14. TOTAL COMPLETED AND STORED TO DATE $9,350.00 1 (Progress Estimate, Construction Allowance and Change Orders)....... $ $5,664.866.48 15. RETAINAGE: 1 a. X $5.664.866.48 Work Completed.......... $ 1 b. X Not Used $ 1 c. Total Retainage (Line 5a + Line 5b)................................ $ 16. AMOUNT ELIGIBLE TO DATE (Line 4 - Line Sc}............................ $ $5,664,866.48 $1.242,098.00 17. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)........ $ $5,381,623.16 S. AMOUNT DUE THIS APPLICATION... ... .......................................... $ $283,243.32 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + Cos + Line 5 above) .............. $ S65 0, 9&11 The Contractor certifies with the submittal ofthis document and associated Payment Request Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all previous progress payments received fi om Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Applications for Payment; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, security interest or encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Liquidated Damages $650.00 x day TrofJul 17, 2024 09:41 CDT) 10. CONTRACT TIME: Consent of Surety Affidavit of Bills Paid a, Days Awarded 500 b, Days Added by CO 75 C. Total Days 575 d. Days Charged 539 e. Days Remaining 36 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. C44o Unit Prlce Progress EsBnmm Progress Estimate Lake Worth Water Line Sanitary Sewer Improvements Project IApPgmum,N W: 7-10-2024 I I - Bid lr®No. I p�pdp, spcNirnlion Sccuu, Nv. 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SSW.00 __ E40.D0 ESOOAO _ __ f440.00 10.43750000 541 ].50 -_ $4175D $41750 _94.9% _57230 49 3305,01it Walar Votw BPx Atllustmonl MConerMO Cdbr I50r`.+0) E\ S.OD000WO00 _ E750.00 _ _ $3,750.00 6.25000DW S4,687,50 E4,687.51) _ $4,687.50 125.0% 4937S0 50 3305.0107 Menholo Adlmtmont WBh Cd¢roto Calkf(SD60) . _ _ _.. EA 3.000OOW000 _ EI,DODAO _____33,OD0.00 735MOM) $7,250.00 37,750.DD ]% $7,250.00 _241._ 34,250AD 51 321750D1 Pelntln9 Co, Addrmam(SD`SD) E\ 10.0000000000 550.00 =.Do 537500DW -_ _. $20.75 $268.75 _ - - - $268.75 538% _ _ f231.25 52 32B1.D100 T-11(Saw) CY....- 20.0000000000 _ $75.00 f1,500A0 4250D000D0 $3,187.5) _ $3.187.50 E3,187.50 _ _ 41,68750 S3 329ZOIM Block Sotl R.pb..-(5a/50) SY B75.0000DOOODO _ $15.00 _ _ $13,125.00 _ -- D90.56000000 _...- - -. $16,858.40 -. _ ._ E14,65B.d0 .__ ._..._ _. _- - _2125%. _ $14,858.4U 113.2%- 41,733.40 54 3110.0102 W-12•Troo mov Rod E\ 4.0000D00000 51.0D_O.00 E4,ODO.OD _ __10.00XODOO $10,000.00- _ _ _-_$10,000.00 E10,000.w _250.0%_ 'gooOm � 55 3710.0703 12"-1B•Trroan,ow Rl EA 3.0000000000 51500.00 ,._.-.__ _- f4500.00 _ 8.00000000 _S _._B4O00.00 __. _..__..... SB,OOD.OD .__---_- �,000.W 200.0% 34,500.00 56 311..0104 IF-26- Troe Ronrmml E\ .. _ 1.0000000000 f2,00D.00 __ 32,OD0.00 5W00000D _ $ID,D00.00 _. - . _ S10,000A0 $10,000.00 _500.0% SQ000.00 57 3110.Ot03 64rx:a-184nch Troo Removal (5N50) E\ 1.0000000000 - $1500.00 _--_ _---f1,500.00 _ 1.00000000 --__51,500.00 _i1,500.00 _._ .__.- -- _._ S1,500.00 100.0% 58 :3231.04126'Ferrea,Wootl - LF _ - 2D.DDODDWDW E65.00_ 31 .D0 0W0 _25.0000 31,625.00 _-.. $1,625.00 $1,625.00_1250% 33_25_.W 59 4 C:1 Llnk, Alundnum I.F- 12D+DDOOW0000 _E35.00 ,200 $4.DD _ 2D4.000OOD00 $7.140.00 $7,140.00 _ __- _ $7,14OOD _170D% _ 42,940.00 SD 13231.0121 3231.0124 & Cheln Unk. Aluadnum LF 30.DDMD0M00 555.00 51,611,00 70.00000000 E3,BSO.OD _ _ _ _ $3,850.00 33,850.00 333%_ 42,200.00 61 I3471=01 T.M. Comml (5050) _ MO S.000OOOOOOD 33,30D.D0 E16,500A0 5.0000000D $16,500.00 $16,500.00 _ - _ _ - - $16.500.00 100.0% _ 03125.0101 SWPPP .1...(5050) LS t.DD000WDW S4,000.00 _S4,0D0.00 _ 1.OD000000 f4,00100 S4,00000 S4,000.00 100.0% 01=11=1 _ NMAC Tmnduan(5Dr50) .. TN 20000000- E140.OD .1787.E _328000 64 99 .=7 TImbd and Wlro GuoNmll Rommel 3 RoplacemM -- - LS 1.000Nm0m _---SB,170.00 $8,170A0 1400DOM $9,170.00 __. $8,170.00 $8,170.00100.0% 09999.ODOB Mdd Guardmll Remaoi 6 Ropb mont LB 2OD,000000000p ._ E90.00 51B4O00A0 _ 200.00000000 $18,000.00 _ f18,000.00 _ _ Ste,ac0.0o 100.0%. _ _..-- _ 66 SM.0004 Senb7S-,r Cm t=bm Allovarrs _ _ 1S tA0000000W $80,000.00 560100040 _ - ___- __.. ___ - _ SB000000. UNIT 3: PAVING IMPROVEMENTS _ 1 3305.0108 UtlIM/AEluab (Ill9Oml _ 1.0000OOOODD 31000DA0 310000A0 _ 51D,000A0 2 0241.1300 Remae ExlLtlm Car¢rde Curb antl Gutter (5Dr50) LF 3000.000OOOOD0 _ _5200 f6000.00 _ 1787.0000000) _ _-$3,594,00 __- _ 33,594.01) -_ _ __. 53,594.00 _SB.B% -_- 52,40600 3 3218.01016"Corx:rde Cwb.MGuttd(SO'SO) LF 3000.OD00-D00_ S53.00 315E OOO.00 1797.00D00000 595241.00 $95,241,0D 595,241.OD _59.9% $0,759.00 i 4 -_ 0261.04m Remove Exlatlm Cmcrote Driveway (Sd50) SF 345D.000OD0ODW __. _3200 _ 369DD.D3 _ --- _._iB0'd.8BL00000 _ _. 53,207.79 _ _$3,207.78 _ _ .-. - _- _ $3,207.78 465% 53,89234 5 32130401 Imtdl New64n0Cmcrete Ddveway(SD30) �_ SF_ _ 345D,000)DDOD00 E12DO 341,400.00_ _ _ _1B03.B8000000_ E19;4656 $19,248.56 E19,24656 464%____ $2ZIS1.44 I 6 I0241.0100 Romova Canada SldomIk(50,W) SF 1000.O0D0D00000 _ $200 f20D0.00 23D8.DDD00000 34616.OD $4,6160D _ _ .$4,6160D _230.8% _32616.00 i 7 3213.0301 4"Corrsde Sld,-Ik(5050) I SF 10CMD00DD000DO S8,00 f9,000.00 2308,D0000000 _ 318,464.00 $18,464.00 518,46{.OD 230.8% _ 410,464.00 8 0241.0300 Rdrove Exidino ADA R=P (SOr50) EA 3.DDDDDOOWO _ _ =.Do $1400.00 5.00000003 S2.50100 $2.500.00 _ - _-_ _ _ -.. - - 32.S00.OD 166.7% _ _ Si,000.OD 9 3213OSM Bed. F-Ramp. TY R-1(5050) �_ Im 3.D000OOODO0 S3,00D.00 $12,000.00 5.ODOODOOD 520,00000_ 32D,OOD.00 __$20,0000D 1667% d9000.00 10 _ 0241.1400 Roman ExleUna Ca Valle GMd 15N50) -_---SY _ SOAOODDOOD00 SB.DO 3450.00_ 113.03000000 $1,01737. _ 51,017.27 _ E1,01727 726.1 %_ _ _ 4SG1.27 I 11 I3216.0301 TComrob VWWrMr(5D150) �_ SY 50.0DWW0000 S126.00 _$6,300.10_ 113.0.1000000 -E14,241.713 _. $14,241.78 _$14;241.78 _226.1-A 47,941.78 i 12 0241.17DO 114mh PP u��hrorlrntlo%1Sd50) SY BB75.0000000000 _ $9.25 SB2,093.75 _ _ - SM3700M ._ S80.432.17 - S80,432.17 _ __.-. SB0,432.17 _SILO%_ $1,66158 13 32I1.06002610.1 lhe8on (50.50) � TN 176.000OOOW00 _E180.00__520,880.00 110.11ODD000 E18B19.80 __- $18,819.80 $19019.80 949%_ f1,0=0 14 3123.0101 Umlm•Inod Sbeot Exmvdlm(50d50) CY 100.DDOODOW00 $60.M _ $6.000.00 _. - - _206.000OOOW -_ _ E12,360.W ;12,360.00 -- _-_ $12,360.00 206.0%_ _ 46,360.00 15 3212.0303 Slydh SWece Couroe Aephek, TYPe" D"(SOW) �_----_ SY W75.DDOOD00000 $21.40_ 57BB,9]5.00- _ B6B537000000 $186,080.92 _$186,OB0.92 _f186,09U.82 _98.0% $SWOS i 16 SMOD02 Rnnmva Spmd C.N. W S91PIm(50r50) - E\ 7.DOO110000W _-_E500.00 __. $5000D _ --_ _. -. -_ - -__---_- __$=Do 17 3217.= Stop Ben P-Markln0a(SYSO) LF 220000DDMM $40.00 E880.00 20.875MMD $SL5.00 .$MS.OD _ _S835.00 _9"% SISA_0 1B 3305.0111 W Valve 3-Atlluetmeni wlgl Comrde Collar (SUM) E\ 10.0000000000 5750.00 - - � 57,500.00 12.50000000 59375.DD _ SR375.00 _ _ _EB375.00 125.09A _ 41,875.00 I 19 I3305A707 Mmhole AdfotmoM Wlm Concrote Colter (50150) 8A000OODOM S1,000.DO EB,ODD.00 14.50000000 $14,500.00 $14,500.00 _$14,500.00 1813% 36.50100 20 32175001 Polntlm Curb Addroeem (SN501 EA 18.0000000000 ESD.DD _ $950.00 10.75000000_ 3537.50 553750 _ $53750 _566% _-_- 3/12.50 21 3291.0100 Tome11(50150) CY 40.0000000000 $75.00 $3,000.00 115.00000000 _ _$6375.00 $8,375.00 375.00 212,TM.OD $86% 33 � 22 100 Blink God Roplacarmd(SOTA) SY 1750.00DOODOOW E1500 _ $262W,Do 1861.11000000 $2791685 _... $27,916.65 _ -- _ - _ .._._ $2781665 7083% S1,B68.85 23 3110.0103 64neh- 184neh Trm Removd(50r5D) E\ _E\-. 14000DDDDDD _ S1_50000 515w.w 1.00000000 $150000 _ _S1,500.00 ___ 51,5D0,00 IWO% 132910 md I)ddTOP(SNW) 7A.000O000_ _f50D0D0 _ ZOO OD00 $10D000__. .__. $10.0W.00 ._ --__ _266% _ �,00600 2 347ODD 1eIkCond( .7, =ac 8.000OOOW 300.00 _$WODO.00 $26,400.00 7.000000 52100.00 323,10D.OD _23,10000 _87.5X 53,300.00 25 1.1.-010WPPPai . 52,000.00 S2ODOOO 1.0DOODMI0_ $ZDW.OD _30ODO _ .._ ...$100M..00 -szoOM00 100.0% 27 I322.401 NMACT-5 _ TN _ S.00D000ODDO $140.00 5 W.M _ - - _ _ S700.0D i 28 9999.0006 Pavd9 Co "din Alawnco LS 1.000OOOOD00 _-$5nOD0.DO _._ _ E50.000.00 .- _ - _. -._ -. _ - - _- _ - -_ _ _.. -_._ _.- _90,00MOD Tde dmummrlm. bcm madifidf is migwlf asm, FJCOC detainers amldb madidnmbigdieht rim modi6aotimr. Ym em maowaged b mod d,e daummt mrerLllY ena comult Lcgol Cnu,uel Pdrcb is ccaarum. G62D UM Prke Prp —. Epllmalh Progress Estimate 7iY - 58316 Contractor's Application Lake Worth Water Line Sanitary Sewer Improvements Project I Appawum Npmha- Final - Retainage L4prhwew Itripd: 7-10.2024 rlwcwdw Dwc: 7/102024 A B I C I D E F G Itwl I Toml C°mpleN •e B"1"wab Fini.M1 g Bid Qp°mity Unit Pow Bid V°lpe tih Vnl°e prnrwuly lmullyd Velae V"1°e Thie Fenwl M°Iauh ltwwdy wd Stwrd to Dau (F (B-F) Bid R—No. Duwipum Mahan ll�itdhA ,, hutdld Stad(°pt i°C) awSm No. (D+f) B Totals I =232ADGM1 Sg.500.adD.7B Sd.SW.B'1a.70 54.50.810.78 72.2"b S1,]01,5927t1, tlde Jacumwtlu. ban mwfifbd awn iu migiwl fmm °. nn EICDC Jowmart mid Ne uewdidna highlight Nn madifiwtian.. Ym °rc n�m°mgwl bread the dwumat wrcNlty andcwuua Lceal Cmiucl roar b iu amutiwi. C-620 Change Order Progress Estimate Construction Allowance Usage Contractor's Application ADDITIONS For (contract): 10096�2 Lake Worth Water Line Sanitary Seer Improvements Project ry wprom City Secretary ss3te Application Number Final - Retaiaage ContmetNote Appliention Period: 7-10-2024 Application Dote: 7/10/2024 A B C D E F llcm B.almm ha Finish Total Completed Specilieation Unit of Qunmity to Add Unit l'ncc Addition Value mnmd Quantity EstiInstalled Previously Value This Material, Presently V.I. and Shared to Date (F) (B-F) Item Number Dexription Sccuun No. Measure Installed Value Period Sheed(not in C) (DIE) B Totals This document has been modified from its onginal form as an EJCDC document and the user did not highlight the moditicatioos. You art encouraged to read the document orrcfully and earoult Lcgol Counsel prior Win, execution. Progress Estimate Construction Allowance Usage CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED For (mntmm)u 100962-2 Lake Worth Water Line Sanitary Sewer Improvements Project Application Number: Application Period: 7-10-2024 Application Date: A B C D E Item Bid Item Number Deacription spenhcahon Unrt of Quantity to Delete Unit Price Rcduetion Voluc Not Uaed Not Uacd Not Used Not Uacd Not Uved Section No. M—no, T—N This documem hos been modified from its original form as an FJCDC document and the over did not highlight the modiacationa. You am encoumgcd to rood the do—ml eamfully and consult Legal Coumel prior to its execution. Contractor's Application Final - Retainage 7/10/2024 r• Not Ua d Not Uvcd Not Uscd Cb20 Change Order C-620 Chang. Order Progress Estimate Change Order Number I I ( Contractor's Application ADDITIONS For(contmcU: 100962-2 Lake Worth Water Line Sanitary Server Improvements Project Citysecrctary 58316 Applim6on Number. Finnl- Retainage Contract Num: Applimlion Period: 7-10-2024 APPliemivn D.W 7/1012024 A B C D E F Itcm Addition Tatnl Completed Balance to FiniA Change Order It.. Specilimtiun Utdl of CO Quantity to Add Unit Price Change Order Fstimn,i,dm C)nantity Value al Valet This Materials and Stored to Date (F) B-F) No. Dencnp.on Section No. Mmsurc Vidw Installed mill.dP-i I InVulue .t to C)y Period Stored (not in C) (D+E) B 29 R-C-te SidaWk(50/30) _ _ 'Unt 1-Water SF 402.00W0000 - S2.00 SW 804. 402.W0000_ 00 _ -W _ S8D4. SS ._W W 5804.100.0'/_. 30 4" Concrete Sidcrwlk(50150) Uiil1-Wnte_ SF 402.00000000 S8.W g216.00 402_000OM 53,216.00 S3,216.00 S3216.W 10U% 51 2"Water SmM= (Unit 1-Water FA 7.0000D000 54300.00 $31.5DO.W 7.00000000 WLIM2,00 531500.00 S31300.00 100.0% 52 Remmmect 2"Mery Unit 1-Wakr FA 7.000OOOOD $1.000.00 57.000.00 _ 7.00WOM 57.000.00 S7.000.00 _ _-.. ___ - 57.000.00 IOO.Oy. - - 53 Remove Rrm cplare l8'Dia. RCP StoDmin.. _ _ _ _ _ _ 'U=t I. Water LF 16.00000000 S190.00 S3,040.01) 26.00000000_ &t 940.00 _--_S4,,94 00 _ S/946.00 1675% SI,9w-2q 54 Cmm=tFxi,mgl8"RCPto Stamm Wet 1-Wamr FA L000WW0 WW S12. S1200.00 1.0WW0.00_ a12W.D0 _S1.2DO.00 S12WW .1WU/e . 6 VDmp Manhole_ _Unit _ Unit 2-Sewer EA 3.0000000D S17,000.00 9SL000.00 _3.0WW000 _ S51.ODO.DD S51.ODDAO _ $51.000.W 100.0°. .8.. Ep.VMHlincr _ _ _ Unn. Sewer VF X00000000 SIW.W _ S_1360000 _._ ... _ S13,600.00 9 Convctc Collar Unit 2-Scwtr EA 1.000.00WD SI WO.W _SL000.W 1.000(10000 _ SI,000.W S1.000.W S1,W0_W 1W.tP/e 10 MH Vacuum Testimt _ __. - Unit 2-Sewer EA 1.00000000 SM 00 S200.00 IgDWODW_ S2WM00 S20D.00 S200.00 IWO% 15 Trmeh Safty _ Unit 2-Sewer IF 571.00000000 SI.W S571.00 571_00000000_ S571.00 S571.00 5571.00 100.0% 37 Rant- Convctc Sidmwlk(50/50), _ _.. Unit2-Sew_a SF 402.0W00WD S2.00 SBO4.W 402,00WW00 WAR __5804.00 .__ S804.00 100.0% 38 4" Concrete Sidewlk(50150) _ _ _ Unit 2-Sewer SF 4(12.000DMU S8.00 53amoo _402A60D0W_ S3,216.01, 53216_00 S9216.00 I0D.0% 69 r vation/Bocldill Umt2-Sewer SY 2WD.0000OD00 S1724 S49B96_W 2900.W000000 _ .W _549,996.W L(9.996.OD IW.O°b 70 Hyd-.Ia E-wd Arch Unit 2-Saver SY 3500.000000W 3430 SISA50,00 4200.000D0000 SI8.060.00 S18,060.00 518,060.W IM.Oa. S3.010.00 71 Impc Slone Rip Rap in Creek Unit 2-Beau SY 10010W(N#A S200.00 S26,OW_W 14_WW0000_�SOO.W S2800.00 S2,8DO.W 14.0°. S172O6.W 72 CSS Backfill Under Cmek _ Urd12-Saver CY 30.DOW(DDDI $125.00 _53,750_W 30.WWWO0__ S3,750_00 $3.750.00 _ S3.750.00 100.0. 73 Remove Replvre lS Din. RCP Stamm Dmain _ _Unit 2-Sewer LF 16.00000000 5190.00 S3_040_00-32,000OD000 _ 56.080.00 __ 56090.W $6.O�.W 2W.0°. -53.04D.W _ 74 Connect Listing 18"RCP to Storm Wet Unit o-Sc%wr FA 1.0(Dg10000 _S_I 70D.DO S1200M __2.ODWOWO_ S2,400.00 $MW.W $2,400.00 2W.0". 41,200.W 75 Imporccd Scleet Fill _Unit 2-Seatr CY 500.OWDOOW MM S17,500.00 650.00000W0 522750.00 522,750.00 522,750.00 130.0% -S525D.W 76 8" PVC Sewer SteepEmwtion _ _Unit2-Sara LF 571.00D00000 S305.10 $17421110_571AW009E $174212.10 5174.212_10 $174217-10 1004M.n 6 Rvmww Convctc Sidcvmlk(50/50) Unit 3-Paving SF 804.00D00000 S2.W $1.608.00 Bl4_ODD00000 S1.6woo 51,606.00 S1.608.W 1W.0% 7 once 4"Cte Siderwlk (50/50) __ Uni�3_Pnting_ SF 804.WD000W BB_W S6 G32_00_ _804.00W0000_ 564321W__S6432.W _ S64M-00 100at Ta[vls S409,939.10 S393_539.10 S393M9.10 S393_49.10 96.0 % S16,400.00 This document has b- modified from its original Corm m an E1CI)C dwumcnt and the user did not highlight the moditicotiom. You um enmumged to rmd a,e document mmfullyand consult D.cgnl Counsel ptior to its execution. Progress Estimate Change Order Number 1 1 I Contractor's Application DELETIONS For (mnwclL 100962-2 Lake Worth Water Line Sanitary Sewer Improvements Project Application Number.. Final - Retainage Appliwtian Period: 7-10-2024 Application Date: 7/10/2024 A a C D E F 1km Change Order here ed SpOmbau Unit of CO Qmntitylo Deletion Unit Prim Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used Description DeleteNo. SeetianNo. Mearurc 50 Water Construction Allmvmce oitl-Water IS 0.779D.0�,=6i40_A UWW J000 "V'due 2 a- Restrained Joint lntegml13e11 PVC SS Pipe 13OTC Unit2-Sewrr 491.0000(KKA S/2200 S354302.00 _ 28 Pating9mstruchon Allowwnm _L Unit3-Paving IS 061600M �500W.00-_SS UW.W Totals SI09Z42.00. This document has been modified from mits original form as an EJCDC dmuent and the met did not highlight flue mditiations. You arc enmumged to read the document mreridly and tumult Legal Counsel prior to its csccutiom C-620 Change Order C•620 Change Order Progress Estimate Change Order Number 1 2 Contractor's Application ADDITIONS For (comme): I00962-2 Lake Worth Water Line Sanitary Sewer Improvements Project City Secretory 58316 Application Number. Final - Retainage Contract Num: Application Period: 7-10-2024 Application Date: 7/10/2024 A 11 C D E F kcm Bolan. to Finish Change Order Item Specification Unit of CO QwntiN to Add Unit Pri. Addition Change rtimatedt)-dity Value Previously Value This Matelots Presently Trial Casnpletad /. and Storcd to late (F7 F (B- ) No. Descnpnon SeeGon No. Measure Order Value bnmlled Installed Value Period Storcd (not in C) (DIE) B 25 Remove Fasting Con. Curb &Goner Unit 1-Water _ IF 7.50000000 S2.00 S15.00 13.75000000 _ -_-13.75000000 S2T50 S27.50 _ _ _ $_^-750 103% 412SO 26 6"Can crete Curb &GuBcr Unitl -Water LF 7.50000DW S53.00 5397.50 5728.7i S728.75 _ 573.75 _187.3^A _ 433115 1 8" Sexsr Pipe by Open Cut _ _ Unit 2-Seva LF 98.WDOW00 5144.00 51112.00 - - _ $1411100 5 4'1&nho1c _ Unit 2-Sexsr EA 1.000OMDo 57,600.00 S7.6W.W S76N.W _. . II Hypos Pumping(M-2?U) _ Uoit2-Smsr IS USONWOU_ W 517S.00_�750.00 DS000MM_�8750.W U750OD S.750.1W 1011.0 IS Scrsice Rcinsmi.mcn4 Pipe Erd.na. nt _ _ _U=t2-S-1- FA I.D000O0UO S2500.00 g500.00 1.0000OD00 _W0100 __S2,SW,OD 52500.00 I00.0% 19 4" Sexsr S-i.. Rci-,,noted _ Unil2-Saxtt EA 7.0DWWUU_ _S2,I00.00 S14.700.W 7.000000[IU _S14.700.0D _S14,700AU _ SI4.700.00 ID0.0°A 25 TemporaryMphalt Paving Repair _ Unit2-Sexsr LF 20.00DD0000 S34.00 S680A0 20.00000000 _ 56800 _ __ $680.00 _ .._ _ _. S680.Do 100,o% 27 Asphalt At. Repair Beyond Defined Width Unit2-Sao SY 200.DODOWW SIDO.00 S20,000.00 _200.000OOOUO S2_0.000.(_D S-00N.N _ S2D.000AU 100.0% 33 Rem-Eustina Cone Care &Gutter Unit2=Sexsr LF 7.5(DfDWU _ S200 S15.00 _117500W00 _ S27.50 _ S27.50 i27.SO 1833% 4I15o 34 6"Conerste Curb &Gutter Unil2-Sexsr LF 7.5DYA" S53.00 S397.50 13.75M1WW_ S728.75 S728_7$ __. 5728.75 1933% 433125 71 Mobilimti-(M-220) Unii2-Sextt IS LOOOOOOW $3S00.00 S3.500.W 1.00000(IOo S3,500.00 __ S3 500A0 S3SW.W 100.0% 72 Tcmp nary Can ... ti- to rusting Mai n(M-220) Unit2-Srns FA I00000000 $1,100_00 SI,100.00 _ _ _ _ . _ _ _ _ _ S1.100_00 73 Pant RepnirPipe Enlargement Unit2-Srnsr LF 30.000OOOW S1.38.00 $4140_DD _30.0(10 _ S4140.00_54,140.00 $4,140.00 IDO.(. 74 4"Pri.1s Sever Seri. U,02-SSexsr_ LF 170.0000(00D woo S14110.00_ 17U.OWODDW_ S14 110A 514,1IU.00 $14110.00 100.M. 75 Storm Grain Crossing W Casing Unit2-Sexsr EA _3.0000MD0 $3950.00 S11,950.W_3_00000000 $11.BS0.00 311,M.00 _ $11.850.00 IN.D% 76 Abandamncnt Grout Unit 2. San. CY 2.000OOooa MUD $1,100M __3.00000000__ $1.I00.00_ SUOD.00 _ SLIN.N 100.0% 77 Tr-M-h Rcmowl(5DW Crox7t Rd.) Unil2-Sexy 1S I.O0QW(00 nON.W S7,0D0.W_ 000(Z000_ S700t�.N_S7,OW.W S7,0N.00 IW.O% 78 Varian] Shag for Smi. Conn.(IA211, Brookholh-Dr./Skyline Dr.) _ Unit 2-Sex. FA 5.0NWW0 S13750.00 568,750_W _5_D0000000 $6%750.00 S68,750.00 S68,750.W 1IX1.D% 79 8" Sanitary Sexsr in Woad Box Tunnel _. _ Unit 2_Sey LF 973 WUOW SM00 S702,506.DO 82i_MKMDO S59Q2W.W 55942MOD 3594206.00 94.6% S1082IX1.N 2 Remove Exi'iting Cone Curb &Gutter _ Unit3-Paving LF I5.W000000 S100 S30.00 27SW000OD S55.W 555.W _ S55.00 183.3aA 425_00 3 6"Concrete Curb &Gutter Unil3-Pavimt_ LF 15.OD000000 Moo S795.00 _27.SW00000_ $1,45750__51,457_50 - _ 51 45730 1833% -S662.50 29 _ R-Awa Concrete Pnvcmcnt-Median _ Un113-lk-g_ SY 30.ND00000 S19_80 5594.00 _17.4MDN00_ S34531 _5345.51 S345.S1 582% $M.49 30 6"Cone PvC Malian _. Unll 3-Paving_ SY 30.0ODIXDW S153.00 S4.590A0 17.450(H1000 51669.85__$2.669_85 S.''.669.85 AN. S192U.15 Tom1a S7S7326.36 S906.3200 5757.32636 S757.326.36 83.6% S148,905.64 This document has been modified from its original form as an FJCDC document and the user did not highlight the modifications. You am enssumgd to reed the document carefully and sonmlt Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 2 I Contractor's Application DELETIONS For(anwm): 100962-2 Lake Worth Water Line Sanitary Saver Irnprovctnrnts Project Applimlion Numbcc Final - Retainage Application P o.& 7-10-2024 APPliation Cute: 7/10/2024 A B C D E F Clunge order Item ll"n Spai Umt of CO Quantity to Unit Price Deletion Change Not Used NoI Uved Not Uaed Not Uved Not Uaed Not Uved Not Uscd Not Used No. Ikveri Lion p No Satiun on No.. Mewurc Delete Order Voluc 2 g•RabsinrA Jointl In-__gmI BeIIPVCSnn. Sc�a BI'OI'cn Cul Unt2-Sexer_ LF _ 973.D00000W sm.UG S702,506.0(`,_ Imported EmkdrnenNBn�JI Select Fill Unt2-Sett= CY _ IDOO.000MM _ _16 66 Soni�Settxr ConeWet n101—nee U." '_-Smn IS _ I00000000 --_... Sg0.OD0.00 _ _ SMUDU.00 _ 2a — _ Paving ConsWetiml Allotwnce .— U it 3-Paving_ IS — This daeument has been modified from its o1igi.1 form ns nn FJCDC document nod the user did not highlight the moditiatiom. You am onaumsed to mod the document amfully and ansult Lcgnl Counvel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 3 Contractor's Application ADDITIONS For(ennlmc): 100962-2 Lake Worth Water Line Sanitary Sclver Improvements Project City Seandwy 58316 Application Numben Final - Retainage Conlmct Num: Application Period: 7-10-2024 Application Data: 7/10/2024 A B C D B F Item Balanea to Finish Addition Estimated Quantity Preciously Value This Materials Prcxntly Total Completed % (B-F) Change Order It.. DncnpOon SpcaiBcatioa Unit of COQmnlitym Add Unit Prise Ch""ONer Installed Value Installed Value Period Stomd not in C) and Storelto)Mta (F) No. Section No. Measure Value (D�E) B 35 Cone Rat Wall Adimenl to Sidewalk Unit 1-Water SF 25.OWWOOD $93.50 $2337.50 35.2600000( S3296.81 S3296.81 _ S3.296_81 141_M. 4959-11 8o Cone Rd Wall Adjacent to Sidewalk Unit2-s— _ SF 25.00000WO S9330 $2�.50_3526000000 53,296.81_53296.81 _S3,296.81 141.M.. -S959.31 31 Cone Rat Wall Adjacent to Sidewalk Unit3-Paving SF=o0W0000O S93.50 E4675A0 70S1000000 56.593.62 56593.62 _S6S93.62 L410/. 41919.62 Totals S13.187.24 $13.19724 S13.187.24 141.0%-IM937.24 S9350.00 This document has been modified f m its original form man F1CDC document and the user did not highlight the modifications. You arc encouraged to read the document omfully and consult Legal Counsel prior to its execution. Progress Estimate Change Order Number 1 3 DELETIONS For (rummeld: 100962-2 Lake Worth Water Line Sanitary Saver Improvements Project Application Period: 7-10-2074 A E C D Order llIt—llem Speafimaon Unitof COQuantityto Unit Prioe an Change Order Not Uud Not Used Not Used Not Used DescriptionClwngc NoDescriptionSection No. Measure DeleteValue 50 Water Conatroetion All —Unit I - Waler IS 0.0389$834 S60,000.00 S2 337.36 13 =PumpnOA970 Un2-Sewer 0.040300 _ _ E59000-00 S_2117SO) __ _—BB _ _ 28 Paving Comtruction Ulmvamx Unit3-Paving LS _ 0.09150MO E50,000.00 _S4,675.00 Total, S9350.00. This document has been modified from its original formal an FJCDC document and the user did not highlight the moditiulioas. You on, enooumged to read the document comfully and wroult Legal Counsel prior to its oucution. Applirmion Number: Applieation Date: E Not Used Contractor's Application Final - Retainage 7/10/2024 F Not Uscd Not Uscd Not Uscd C-620 Change Order Progress Estimate Change Order Number 1 4 Contractor's Application ADDITIONS For (mmran). 100962-2 Lake: Worth Water Line Sanitary Seaver Improvements Project Cityseererory 50316 ApplientionNumber: Final - Retainage Contract Num: Application Period: 7-10-2024 Application Dale: 7/10/2024 A H C D E F It.. Mon. to Finish Addition Estirtwled Quantity Previously Value This Materials Prcsenay Total Completed % �° (B-F) Change Order It.. Spedfiantion Unit of COQusnlitylo Add Unit Price Description Change Order Insmlted Vuluc Jnstdled Value Period Stored (not in C) and St ored to Dole (F) No. Section No. Moss— Value (DIE) H TwA, This document hes been modified from its original to=as an FJCDC document end the user did not highlight the modifiestioos. You arc cnmmged to tend the document carefully and wesult Legal Counsel prior to its execution. C-620 Change Order Progress Estimate Change Order Number 1 4 Contractor's Application DELETIONS For (mmmcq: 100962-2 Lake Worth Water Line Sanitary Sewer Improvements Project Application Number Final - Retainage Applieaaon Period: 7-10-2024 APPliention Dole: 7/101202 4 A B C D E F Change Order Item hem sp-licahUmt or CO Quan to ty to Delcmon Unit Price Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used No. Deleteon Description Section No. Measure Value Total, This dacumcnt has been modified from its original f sa an FJCDC document and the user did not highlight the modifications. You arc enoom aged to read the dmumcm carefully and commit Legal Counsel Prior to its a<eemtion. G620 Change Order City of Fort Worth Summary of Charges Lake Worth Water Line Sanitary Sewer Improvements I FW060-000020155 City Secretary Contract Num: 58316 P. Project Number: 100962-2 Project Application Period: 7-10-2024 Application Final - Retainage Application Date: 7/10/2024 Number: Funding Identification (Fib) Total Completed Amt Remaining Gross Retainaqe Net Original Contract 56002-0600430-5740010-100962-001780-9999 (water) $1,623,544.31 $297,206.19 56002-0700430-5740010-100962-001780-9999 (sewer) $2,300,309.06 $1,296,218.19 30100-0200431-5740010-100962-002480-9999 (paving) $576,960.41 $138,168.34 0 0 0 0 0 0 0 0 Change Order 1 56002-0600430-5740010-100962-001780-9999 (water) $48,660.00 ($48,640.00) 56002-0700430-5740010-100962-001780-9999 (sewer $336,839.10 ($336,202.00) 30100-0200431-5740010-100962-002480-9999 (paving $8,040.00 ($8,000.00) 0 0 0 0 0 0 0 0 Change Order 2 56002-0600430-5740010-100962-001780-9999 (water) $756.25 (343.75) 56002-0700430-5740010-100962-001780-9999 (sewer) $752,042.25 ($669,737.75) 30100-0200431-5740010-100962-002480-9999 (paving) $4,527.86 ($4,518.86) 0 0 0 0 0 0 0 0 City of Fort Worth Summary of Charges City Secretary Contract Num: 58316 Lake Worth Water Line Sanitary Sewer ImprovemO.ents I FW060-000020155 I P. Project Application Period: 7-10-2024 Application Final - Retainage Number: Funding Identification (FID) Total Completed Amt Remaining Gross Change Order 3 56002-0600430-5740010-100962-001780-9999(water) 56002-0700430-5740010-100962-001780-9999(sewer) 30100-0200431-5740010-100962-002480-9999(paving) 0 0 0 0 0 0 0 0 Change Order 4 56002-0600430-5740010-100962-001780-9999 (water) 56002-0700430-5740010-100962-001780-9999 sewer` 30100-0200431-5740010-100962-002480-9999 (paving) 0 0 0 0 0 0 0 0 Change Order 5 56002-0600430-5740010-100962-001780-9999 water) 56002-0700430-5740010-100962-00 1 780-9999 (sewer) 30100-0200431-5740010-100962-002480-9999(paving) 0 0 0 0 0 0 0 0 $3,296.81 $3,296.81 $6, 593.62 ($3,296.81) ($3,296.81) $6,593.62) Project Number: 100962-2 Application Date: 7/10/2024 Retainage Net City of Fort Worth Summary of Charges Lake Worth Water Line Sanitary Sewer lmprovementsicatiFW060-000020155 City Secretary Contract Num: 58316 I IP.on O.: I Project Number: 100962-2 Proiect ll Appl Application Period: 7-10-2024 Number. Final - Retainage Application Date: 7/10/2024 Funding Identification (FID) Total Completed Change Order 6 56002-0600430-5740010-100962-001780-9999(water) 56002-0700430-5740010-100962-001780-9999 (sewer) 30100-0200431-5740010-100962-002480-9999(paving) 0 0 0 0 0 0 0 0 Amt Remaininq Gross Change Order 7 56002-0600430-5740010-100962-001780-9999(water) 56002-0700430-5740010-100962-001780-9999(sewe 30100-0200431-5740010-100962-002480-9999 (paving) 0 i 0 I 0 0 I I I 0 I i 0 I i o I I 0 I i Change Order 8 56002-0600430-5740010-100962-001780-9999(water I ! 56002-0700430-5740010-100962-001780-9999(sewer 30100-0200431-5740010-100962-002480-9999(paving) I I I I 0 ! I I 0 o 0 I I o 0 I I I 0 I I o I I I I i I I i t City of Fort Worth Summary of Charges Lake Worth Water Line Sanitary Sewer Improvements I FW060-000020155 City Secretary Contract Num: 58316 P. Project Number: 100962-2 Proiect Application Period: 7-10-2024 Application I Final - Retainage Application Date: 7/10/2024 Number: Funding Identification (Fib) Total Completed Amt Remaining Gross Retains_ a Net Totals 56002-0600430-5740010-100962-001780-9999(water) 56002-0700430-5740010-100962-001780-9999(sewer) 30100-0200431-5740010-100962-002480-9999 (paving) 0 0 0 0 0 0 0 0 $1,676,257.37 $244,925.63 $3,392,487.22 $286,981.62 $596,121.89 $119,055.86 I Grand Total 1 1 $5,664,866.48 1 1 $650,963.11 1 1 $0.00 1 1 ($283,243.32)1 1 $283,243.32 1, CSC No. 58316-COI FOR_F WORTH City of Fort Worth 1-wVWA.0-- Change Order Request Project Name: Lake Worth Water Line and Sanitary Sewer Improvements, Part 2 City Sec No.: 58316 Project No.(s):I 560021060043010700430157400101301001020043115740010 I DOE No. I N/A City Proj, No.: 100962-2 Project Description:1 Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Conlraclor:1 Woody Contractors, Inc. City Project Mgr.l Walter Norwood Phone Number:l 817-392-5026 Dept. Unit 1 -Water Unit 2 - Sewer Unit 3 - Paving Original Contract Amount $1,920,750.50 $3,596,527.25 $715,128.75 Extras to Dale Credits to Dale Pending Change Orders (in M&C Process) Contract Cost to Date $1,920,750.50 $3,596 527.25 $715,128.75 Amount of Proposed Change Order $20.00 $63� 10 $40.00 Revised Contract Amount $1,920,770.50 $3,597,164.35 $715,168.75 Original Funds Available for Change Orders $115,245,50 $179,826.75 $50,059.25 Remaining Funds Available for this CO $115,245.50 $179,826.75 $50,059.25 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAXALLOWABLE CONTRACTAMOUNT(ORIGINAL CONTRACT COST+ 25%) JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No, 1 provides for the following: Change Order # l 1 I Cilylnspector: I Brian McGill Phone Number: (817) 647-2514 Totals Contract Time (Calender days) $6,232,406.50 500 Dale: 8/412023 �I I $6,232,406.50 500 $697,10 030 $6,233.103.60 530 $345,131.50 $345,131.50 0.01 % $7,790,508.13 • Deep open cut trench installation for a segment main in lieu of by other than open cut installation (as originally proposed) due to the steep gradient of the indicated segment which renders tunneling operations practically impossible. • The installation reconnection of 2-inch water service that were encountered during construction. • The installation of 3 additional 4-foot diameter drop manholes and epoxy manhole liner on the project. • Additional excavation and backfill on the project. • Large stone rock riprap to protect the banks of a stream that disturbed during construction. • Select fill material to replace unsuitable material that was encountered during construction. Staff recommends the addition of 30 calendar days for the additional work. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order, Contractor's Company Name Contractor Name I CoAtractor Signature Date Woody conlraclors, Inc. I Troy Woody '%�� l Inspector Date Prole I Manager I Aug 7, 2023 /i� //i /Datte Director Water Dept) Dale Construction Supervisor (TPW) Date ti.cP ✓I �iA,F.�,E,r �' Aug 9, 2023 Aug 7, 2023 Senior Assistant City Attorney Y Date Assistant City Manager l Date I Aug 23, 2023 Aug 22, 2023 ��I Council Action (If Required) M&C Number NIA M&C Date Approved l N?A FORT WORTH City of Fort Worth Change Order Additions Project Name Lake Worth Water Line and Sanitary Sewer Improvements , City Sec No.: 58316 Project No.(s): 560021060043010700430/5740010/30100/0200431/5740010 DOE No.N/A City Proj. No.: 100962-2 Project Water, Sanitary Sewer and Paving Improvements in the Lake Worth area I Description Contractor Woody Contractors, Inc. ! Change Order: L I Date: 1 814/2023 City Project Mgr. Walter Norwood City Inspector Brian McGill ADDITIONS IItM ULb(;KlPIIUN DEPT Qty )Unit 'Unit Cost Total 29 Remove Concrete Sidewalk (50/50) Unit 1 - Water 4b2.00 SF $2.00 $804.00 30 4" Concrete Sidewalk (50/50) Unit 1 - Water 402.00 SF $8.00 $3,216.00 51 2" Water Service Unit 1 - Water 7.00 EA $4,500.00 $31,500.00 52 Reconnect 2" Meter Unit 1- Water 7.00 EA $1,000,00 $7,000.00 53 Remove Replace 18' Dia. RCP Storm Drain Unit 1 - Water 16.00 LF $190.00 $3,040.00 54 Connect Existing 18" RCP to Storm Inlet Unit 1 - Water 1.00 EA $1,200.00 $1,200.00 6 4' Drop Manhole Unit 2 - Sewer 3.00 EA $17,000.00 $51,000.00 8 Epoxy MH Liner Unit 2 - Sewer 34.00 VF $400.00 $13,600.00 9 Concrete Collar Unit 2 - Sewer 1.00 EA $1,000.00 $1,000.00 10 MH Vacuum Testing Unit 2 - Sewer 1.00 EA $200.00 $200.00 15 Trench Safety Unit 2 - Sewer 571.00 LF $1.00 $571.00 37 Remove Concrete Sidewalk (50/50) Unit 2 - Sewer 402.00 SF $2.00 $804.00 38 4" Concrete Sidewalk (50/50) Unit 2 - Sewer 402.00 SF $8.00 $3,216.00 69 Excavation/Backfill Unit 2 - Sewer 2900.00 SY $17.24 $49,996.00 70 Hydromulch Excavated Area Unit 2 - Sewer 3500.00 SY $4.30 $15,050.00 71 Large Stone Rip Rap in Creek Unit 2 - Sewer 100.00 SY $200.00 $20,000.00 72 CSS Backfill Under Creek Unit 2 - Sewer 30.00 CY $125.00 $3,750.00 73 Remove Replace 18" Dia. RCP Storm Drain Unit 2 - Sewer 16.00 LF $190.00 $3,040.00 74 Connect Existing 18" RCP to Storm Inlet Unit 2 - Sewer 1.00 EA $1,200.00 $1,200.00 75 Imported Select Fill Unit 2 - Sewer 500.00 CY $35.00 $17,500.00 76 8" PVC Sewer Steep Excavation Unit 2 - Sewer 571.00 LF $305.10 $174,212.10 6 Remove Concrete Sidewalk (50/50) Unit 3 - Paving 804.00 SF $2.00 $1,608.00 7 4" Concrete Sidewalk (50/50) Unit 3 - Paving 804.00 SF $8.00 $6,432.00 Unit 1 - Water 1$46,760.00 Unit 2 - Sewer 1$355,139.10 Unit 3 - Paving $8,040.00 Page i of i Additions Sub Total �$409,939.1 0 Fo 1ZT Wo R'r H City of Fort Worth Change Order Deletions Project Name Lake Worth Water Line and Sanitary Sewer Improvements JVV VLIVV VV'1JVIVI VV`t" JI YVV IV/JV IVVIVLVV`tJ 1101'VV I I DOE No. I N/A Project No.(s): I „ I City Sec No.: 58316 City Proj. No.: I 100962-2 Project Description I Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Contractor I Woody Contractors, Inc. I Change Order: I 1 Date City Project Mgr. I Walter Norwood I City Inspector: I Brian McGill DELETIONS 8/4/2023 ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 50 Water Construction Allowance Unit 1 - Water 0.779 LS $60,000.00 $46,740.00 2 8" Restrained Joint Integral Bell PVC SS Pipe BOTC Unit 2 - Sewer 491.00 LF $722,00 $354,502.00 28 Paving Construction Allowance Unit 3 - Paving 0.16 LS $50,000.00 $8,000.00 Page 1 of L Unit 1 - Water $46,740.00 IUnit 2 - Sewer $354,502.00 (Unit 3 - Paving $8,000.00 (Deletions Sub Total $409,242.00 MMBE Breakdown for this Change Order MWBE Sub I Type of Service I Amount for this CO CO # Previous Change Orders DATE Total Total h A[fill IH $0.00 $0.00 Page 1 of 1 8/04/2023 Lake Worth Water Line and Sanitary Sewer Improvements, Part 2 CSC: 58316 CPN 100962-2 Change Order 1 Notes Staff has reviewed the requested prices and days and considers them to be fair and reasonable. Contract Compliance Manafter By signing 1 acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Signature Walter Norwood Name of Employee Project Manager Title ATTEST: Jannette Goodall City Secretary CSC No. 58316-0O2 F_ CART WORTH City of Fort Worth Change Order Request Project Name:1 Lake Worth Water Line and Sanitary Sewer Improvements City Sec No..: 58316 Project No.(s):l 56002/0600430/0700430/574001013010010200431/5740010 1 DOE No. I N/A City Proj. No.: 100962-2 Project Description:) Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Contractor: Woody Contractors, Inc. Change Order # 2 Date: 10/24/2023 City Project Mgr.l Walter Norwood City Inspector: Brian McGill Phone Number:) 817-392-5026 I Phone Number: (817)647-2514 � Dept. Unit 1 -Water Unit 2 - Sewer Unit 3 - Paving Totals Contract Time (Catender days) Original Contract Amount $11920,750.50 $3,596,527.25 $715,128.75 �6,232,406.50 500 Extras to Date $20.00 $637.10 $40.00 $697.10 030 Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $1,920,770.50 $3,597,164.35 $715,128.75 $6,233,063.60 1530 0 os mounto ro p Aed'Change Order $412.60 $82,304.50 $9.00 $82,726.00 1045 ,.... ._ mount Revised ct $1,921,183.00 $3,679,468.85 $715,137.75 $6,315,789.60 575 Original Funds Available for Change Orders $115,245.50 $179,826.75 $50,059.25 $345,131.50 Remaining Funds Available for this CO $115,225.60 $179,189.65 $50,019.25 $344,434.40 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 1.34% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $7,790,508.13 Change Order No. 2 provides for the following: • Install PVC sewer pipe installed by hand tunnel in lieu of restrained joint pvc pipe installed by auger bore. • Reroute a segment of h4-220 to avoid conflict with a storage building. • Point repair of sewer lime to remove sag prior to pipe enlargement. • Private sewer service reroute • Vertical shafts to install service connections to sewer main installed by BOTOC. • Additional pavement repair in John's Way. Staff recommends the addition of 45 calendar days for the additional work. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. Contractors Company.Name rtat Woody Contractors, Inc. Troy Woody Oct 25, 2023 M Oirrector�i Gll-1,f oyher lf6iwel- , Oct 27, 2023 Oct 25, 2023 Senior A ,r,i t^ it City• ,0rrt"''I QIM @,,.,,o, o, Oct 27, 2023 27, 2023 ihl+ M&C Number I N/A M&C Date Approved NIA FC]RT Wc3n-Fm City of Fort Worth Change Order Additions Project Name Lake Worth Water Line and Sanitary Sewer Improvements Project No.(s): 5600210600430l0700430157400101301001020043115740010 DOE No.1 N/A Project Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Description Contractor Woody Contractors, Inc. City Project Mgr. Walter Norwood ADDITIONS I Change Order:0 City Inspector I Brian McGill 2 DEPT 5 Remove Exist. Conc. Curb & Gutter ,. Unit 1 - Water 26 " Concrete Curb & Gutter Unit 1 - Water 1 8" Sewer Pipe by Open Cut Unit 2 - Sewer 5 4' Manhole Unit 2 - Sewer 6 4' Drop Manhole Unit 2 - Sewer j 11 Bypass Pumping (M-220) Unit 2 - Sewer 18 Service Reinstatement, Pipe Enlargement Unit 2 - Sewer 19 4" Sewer Service, Reinstatement Unit 2 - Sewer 25 Temporary Asphalt Paving Repair Unit 2 - Sewer 27 Asph. Pvt. Repair Beyond Defined Width Unit 2 - Sewer 33 Remove Exist. Conc. Curb & Gutter Unit 2 - Sewer 34 6" Concrete; Curb & Gutter Unit 2 - Sewer 71 Mobilization (M-220) Unit 2 - Sewer 72 Temporary Connection to e;cisitng Main (M-220) Unit 2 - Sewer 73 Point Repair Pipe Enlargement Unit 2 - Sewer 74 4" Private Sewer Service Unit 2 - Sewer 75 Storm Drain Crossing WlCasing Unit 2 - Sewer 76 Abandonn-tent Grout Unit 2 - Sewer 77 TreelBrusi i Removal (5000 Crown Rd.) Unit 2 - Sewer 78 lVertical Si,. -aft for Service Conn. (L-4211, Brookhollow Dr./Skyline Dr.) Unit 2 - Sewer 79 8" Saniiary Sewer in Wood Box Tunnel Unit 2 - Sewer 2 Ren-love I_;tist. Conc. Curb &. Gutter Unit 3 - Paving 3 6" Concrete Curb & Gutter Unit 3 - Paving 29 Remove l;Oncrete Pavement - Median Unit 3 - Paving 30 6" Conc. Pvt. - Median Unit 3 - Paving Page 1 of 1 City Sec No.: 1 58316 City Proj. No.: 1 100962-2 Date: 1 10/24/2023 Qty. Unit Unit Cost Total �115.00 7.50 LF $2.00 7.50 LF $53.00 $397.50 98.00 LF $144.00 $14,112.00 1.00 EA $7,600.00 $7,600.00 1.00 EA $17,000.00 $17,000.00 0.50 LS $17,500.00 $8,750.00 1.00 EA $2,500.00 $2,500.00 7.00 EA $2,100.00 $14,700.00 20.00 LF $34.00 $680.00 200.00 SY $100.00 $20,000.00 7.50 LF $2.00 $15.00 7.50 LF $53.00 $397.60 1.00 LS $3,500.00 $3,500.00 1.00 EA $1,100.00 $1,100.00 30.00 LF $138.00 $4,140.00 170.00 LF $83.00 $14,110.00 3.00 EA $3,950.00 $11,850.00 2.00 CY $550.00 $1,100.00 1.00 LS $7,000.00 1$7,000.00 5.00 EA $13,750.00 $68,750.00 973.00 LF $722.00 $702,506.00 15.00 LF $2.00 $30.00 15.00 LF $53.00 $795.00 30.00 SY $19.80 1$594.00 30.00 SY $153.00 1$4,590.00 I I Unit 1 - Water �$412.50 Unit 2 - Sewer $899,810.50 Unit 3 - Paving $6,009.00 Additions Sub Total $906,232.00 FORT WORTH City of Fort Worth - Change Order Deletions Project Name I Lake Worth Water Line and Sanitary Sewer Improvements Project No.(s): I nVVVLIVuL)'J JVIVIUVYJV/JI'YVV IvIVV IVVNLVVTJIIJI fVV I DOE No. I N/A Project Description I Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Contractor ! Woody Contractors, Inc. City Project Mgr, I Walter Norwood Change Order: I 2 City Inspector: I Brian McGill DELETIONS City Sec No.: I 58316 City Proj. No.: I 100962-2 Date I 10124/2023 2 81 Restrained Joint Integral Bell PVC San. Sew. by Open Cut Unit 2 - e.w Q Unit Unit Cost Total ITEM DPSCRIPI"ION ... ®. .. �� Sewer 973.00 LF $722.00 $702,506.00 i 16 Imported Embedment/Backflll, Select Fill Unit 2 - Sewer 1,000.00 CY $35.00 $35,000.00 66 Sanitary SewerConstruction Allowance Unit 2 - Sewer 1.00 LS $80,000.00 $80,000.00 28 Paving Construction Allowance Unit 3 - Paving 0.12 LS $50,000.00 $6,000.00 ' I ........ ..... . Y I I II �I I (I I ! II i I !I I I it II - II it it Unit 1 - Water Unit 2 - Sewer $817,506.00 Unit 3 - Paving 1$6,000.00 Page 1 0':1 Deletions Sub Total I$823,506.00 M/VVBE Breakdown for this Change Order •� •'+.'.7 ^�J.'.: ,.,5 ,�.. _ . !_, yty, .}x ...}.r � 7, r. 7' �;,x.. � 1' �F -! jv • (�i�;*+:z �-� n�•: t' n::�>sxJ:�n� s�:1�' '' .� !", t.:.-,y: ; z {4 .`..:, ;'_ 33H�!MW, 'lzF t?` �.^� .;;,J�..ink?Li#' •f xi ,1 !2 }' �?�,'1i..1j © (�•s? �(`•{�r. nz`- r�i=i':`:C"�; .�ftrl Yllli '�fQlr<L! S:•PD s,�,`.n Total,` J Previous Change Orders i"t— ': "t 'i.�1,F .t,_,:..,...-+.,.. .'} � : _}� - : �iN�.:Ver;•s ..f„ iM`o, d +mil' •anti'. z:�i±. :tir i�+'1jt{{,��,� tp� '�r`�crjy� 5tt �.F}.�35�����*�4 �t �?1�i'di34 itd ,t 1, . � ! �/��t�����+�+! F 1 Total Page 1 of 1. 10/24/2023 Lake Worth Water Line and Sanitary Sewer Improvements, Part 2 CSC: 58316 CPN 100962-2 Change Order 2 Notes Staff has reviewed the requested prices and days and considers them to be fair and reasonable. Contract Compliance Manaeer By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Signature Walter Norwood Name of Employee Project Manager Title ATTEST: Jannette Goodall City Secretary CSC No. 58316-0O3 FC]RT W[>R-rk1 City of Fort Worth Change Order Request Project Name:1 Lake Worth Water Line and Sanitary Sewer Improvements City Sec No.: 1 58316 Project No.(s):l 56002106004301070043015740010/30100/0200431/5740010 DOE No. I N/A City Proj. No,:1 100962-2 Project Description:) Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Contractod Woody Contractors, Inc. Change Order # 3 Date: 3/19/2024 City Project Mgr,1 Waller Norwood City Inspector: Brian McGill Phone Number] 817-392-5026 Phone Number: (817)647-2514 Dept, Unit 1- Water Unit 2 - Sewer Unit 3 - Paving Totals Contract Time Calender days) Original Contract Amount $1,920,760.50 $3,596,527.25 $715,128.75 $6,232,406.50 5 0 Extras to Dale $432.50 $82,941.60 $49.00 $83,423.10 075 Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $1,921,183.00 $3,679,468.85 $715,128.75 $6,315.780.60 575 Amount of Proposed Change Order $0.00 $0.00 $0.00 $0.00 00 Revised Contract Amount $1,921,183.00 $3,679,468.85 $715,128.75 $6,315,780.60 575 Original Funds Available for Change Orders $115,245.50 $179,826.75 $50,059.25 $345,131.60 Remaining Funds Available for this CO $114,813.00 $96,885.15 $50,010.25 $261,708.40 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 1.34% MAXALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $7,790,508.13 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 3 provides for the installation of vertical walls for accessible curb ramps as required by the Texas Department of Licensing and Regulation(TDLR). It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order, Contractor's Company Name I Contractor Name Contoctor gnature Date Woody Contraclots, Inc. Troy Woody Inspector Date -air Prgiject an. -Or ���'� Da l 1 �� Director (Water Dept) Dale Cor�sl,�Q(fcn a p; lsor (TM Dept) Date C�viri �tio� tfardnr z— T, Apr 29, 2024 ffA% Senior Assistant City Attorney Date AIna, Date I Apr 30, 2024 v Apr 30, 2024 Council Action (If Required) M&C Number N/A M&C Date Approved j N/A FoR-r WORT- City of Fort Worth Change Order Additions Project Name I Lake Worth Water Line and Sanitary Sewer Improvements City Sec No.: 1 58316 Project No.(s): 1 56002/0600430/0700430/5740010/30100/0200431/5740010 DOE No.1 N/A City Proj. No.: 1 100962-2 Project I Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Description Contractor I Woody Contractors, Inc. Change Order: Date: j 3/19/2024 City Project Mgr. I Walter Norwood City Inspector j Brian McGill ADDITIONS HEM EM UESURIP I IUN 55 3232.0100 Cone Rat Wall Adjacent to Sidewalk 80 3232.0100 Cone Rat Wall Adjacent to Sidewalk 31 3232.0100 Cone Rat Wall Adjacent to Sidewalk DEPT Qty Unit Unit Cost Total Unit 1 - Water 25.00 SF $93.50 $2,337.50 Unit 2 - Sewer 25.00 SF $93.50 $2,337.60 Unit 3 - Paving 50.00 SF $93.50 $4,675.00 JUnit 1- Water $2,337.60 lUnit 2 - Sewer $2,337.50 Unit 3 - Paving $4,675.00 Page 1 of 1 Additions Sub Total $9,350.00 F_ [7 RT WO RT H City of Fort Worth Change Order Deletions Project Name Lake Worth Water Line and Sanitary Sewer Improvements ProjectNo,(s): InvvvLlVVVVYJvlv1vu-t""lYVvIvIJvluvlvLVv`TJ"JfYVv' DOE No. I N/A Project Description I Water, Sanitary Sewer and Paving Improvements in the Lake Worth area Contractor Woody Contractors, Inc. Change Order: I 3 City Project Mgr. Walter Norwood City Inspector: I Brian McGill DELETIONS ITEM DESCRIPTION DEPT MY Unit 50 9999.0003 Water Construction Allowance Unit 1 - Water 0.03895834 LS 13 3303.0001 Bypass Pumping (L-4970) Unit 2 - Sewer 0.0403018 LS 28 9999.00006 Paving Construction Allowance Unit 3 - Paving 0.09350 LS Page 1 of 1 City Sec No.: 58316 City Proj. No.: 100962-2 Date 1 3/19/2024 1 Unit Cost Total $60.000.00 $2,337.50 $58,000.00 $2,337.50 $50,000.00 $4.675.00 Unit 1 - Water $2,337.50 Unit 2 - Sewer $2,337.50 Unit 3 - Paving $4,675.00 Deletions Sub Total $9,350.00 MWBE Breakdown for this Change Order y"o"W SMAp o *qm Total Previous Change Orders ANO.' Total Page 1 of 1 3/19/2024 Lake Worth Water Line and Sanitary Sewer Improvements CSC: 58316 CPN 100962-2 Change Order 3 Notes Staff has reviewed the requested prices and days and considers them to be fair and reasonable. Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Signature Walter Norwood Name of Employee Project Manager Title ATTEST: Jannette Goodall City Secretary PROJECT NAME: CITY PROJECT NUMBER: PIPE LAID C00 c qgn OVA ii C fM FIRE HYDRANTS: PIPE ABANDONED DENSITIES: NEW SERVICES: PIPE LAID sua6 SU R - 16 TOIL_ 7-6 FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: k t. Wtr �K v✓wd`c r ( i e. SGw ; r�� rc., SP,w� Ir- of ►/p n, v vt4-S p 0.CS'tL♦ SIZE SIZE WATER TYPE OF PIPE PL/c- 17v C r t r 0• 2. pv c LF G6 s,z . n v tro.00 r�.nn n n VALVES (16" OR LARGER) 'I///� TYPE OF PIPE LF A7 46A SEWER I SIZE l TYPX, OF PIPE LF i� IIF VUC. ✓`erdrG:„,..+ 6c,tI 1 S'A PS �i�1. itp PIPE ABANDONED SIZE TYPE OF PIPE DENSITIES: NEW SERVICES: v c 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 rI C FA FORTWORTH. M, TRANSPORTATION AND PUBLIC WORKS July 10, 2024 Woody Contractors Inc. 650 Tower Drive Kennedale, TX 76060 RE: Acceptance Letter Project Name: Lake Worth water and sanitary sewer improvements Project Type: water, sewer, paving City Project No.: 100962-2 To Whom It May Concern: On May 30, 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 June 25, 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 June 25, 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- 392-5026. Sincerely, Walter Norwood, Project Manager Cc: Brian McGill, Inspector Gary Deyon, Inspection Supervisor Edward Davila, Senior Inspector John Kasavich, Program Manager Burgess & Niple Inc, Consultant Woody Contractors Inc, Contractor City Of Fort Worth, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 CONSENT OF OWNER ❑ SURETY COMPANY ARCHITECT ❑ CONTRACTOR ❑ TO FINAL PAYMENT SURETY ❑ OTHER (SIMILAR TO AIA DOCUMENT G707) Bond No. K40201968 PROJECT: Lake Worth Water and Sanitary Sewer Improvements Part 2, City Project No. 100962-2 (name, address) Fort Worth, TX TO (Owner) City of Fort Worth 200 Texas Street Fort Worth, TX 76102 1 CONTRACTOR: Woody Contractors, Inc. ARCHITECT'S PROJECT NO: CONTRACT FOR: CONTRACT DATE: September 27, 2022 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) Vigilant Insurance Company 5400 LBJ Frwy, Suite 600 , SURETY COMPANY, Dallas, TX 75240 on bond of (here insert name and address of Con(ractor) Woody Contractors, Inc. 650 Tower Drive Kennedale, TX 76060 ,CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that the final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) City of Fort Worth 200 Texas Street Fort Worth, TX 76102 ,OWNER, as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, The Surety Company has hereunto set its hand this Attest: (Sea]): loth day of July , 2024 VIGILANT INSURANCE COMPANY Surety Companrorized By Signature of Auk4presentative Kyle W.Sweeney Attorney -in -Fact Title Note: This form is intended to be used as a companion document to the Contractor's Affidavit of Payment of Debts and Claims, Current Edition CHUBS,, Power of Attorney Federal Insurance Company I "vigilant Insurance Company f Pacific Indemnity Company Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby 0011SUnite and appoint Elizabeth Gray, Charles D. Sweeney, Kyle W. Sweeney and Michael A. Sweeney of Fart Worth, Texas----------------------------------------------------------- --------- __------------- -------- ------------ __---- •----- each as their true and lawful Attorney -in -Pact to execute under such designation In their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and under(akings and other writings obligatory In the nature thereof (other than ball bonds) given or executed in the course of business, and any instruments amendingor altering the same, and consents to the modification or alteration of any Instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presentsand affixed their corporate seals on this 1611' day ofSepternber, 2019, ACAS.-t•�"ti �^61. N�^�.�JI.�' I'XtWn ki. C 1lorc;n. Angsfanl ktcrciary STATE OF NEW JERSEY Countyof thnterdon Slcpht.nt M, I111LICY, Vfce PI-CSitienl a0 On this 16u" day of September, 2019, before rite, a Notary Public of New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCES COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. ChIaros, being by me duly sworn, did depose and say that she is Assistant Secretary of 1111DERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACtPIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that she Is acquainted with Stephen M. Haney, and knows him to be Vice President of said Cnnlpaniesl and that the signature of Stephen M. Haney, subscribed to said power of Attorney Is In the genuine handwriting of Stephen M. Haney, and was thereto subscribed byauthority of said Companies and lit deponent's presence. Notarial Seal icA' PUB0 0 AftEWJ R ' rARP NOTARY At+I3i.lC OF NEW JERSEY rrr No. 2310695 P!{BLIC Commlaalon 4xplros duly 16, 2094 Notrrypahtfe Rg� CERT117ICATION Resolutions adopted by the Boards of Iltrectors of FEDERAL INSURANCE COMPANY, VIGILANT 1NSURANCP COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016: "RESOI.YRD,that thefollowhtg authorizations relate to the execution, for and an behalforthecompany,orbonds, undertakings, mcognlrances, contracts and other written tmmitments of the Company entered Into in the ordinary course of business (eacha "Written Commitment'); (1) Eacdr of the Ctralnman, the Presldent and the Vice presidents of die Company is hereby authorized to execute any written Commitment for andonhehairortheCompany.undetihe seal of the Company or otherwise. (2) Each duly appointed attorney -Intact of the Company Is hereby authorized to execute any Written Commitment for and on behairof the Company, under the seal of the Company or otherwise, to the extent that such action Is anthorlxed by thegram of power sprovided for In such persons written appolnlmentas such attorney-lri-fact (3) Each of the dtaUman, the President and the Vice Presidents of the Company is hereby authorised, for and on behalf'ofthe Company. toappoint Inwriting any person the attnmey- In•fact of the Company with full power and authorltyto execute, Ibr and on behalfortheCompany, under the sealofthe Companyorotherwise, such Written Commitmentsnrthe Company as maybe speciped lit such written appotntment, which specinestton may lie bygenerat type or class of Written Commitments or by speclllcallon of one or mom particular Written Commitments. (4) Eaeh of fie Chairman, the president and the Vice Presidents of the Company is herebyauthorlaed,forandonbehalfoftheCompany,todelegate,inwridngtoanyotherofficerofthe Company the authority to execute, for and on behalf of the Company, onder the Company's seal or otherwise, such Written Commitments of the Company as are specilled In such written delegation, whichspecitlamlon may be by general type or class of Written Commitments w by specification of one or more particular Written Commitments. (s) Tfrasigtature of any officer or other person executing any Written Commitment or appolntmenr or deicgadon pursuant to this Resolution, and the seal of the Company, mayba aalxed by facsimile on such Written Commitment or written appointment ordefegadon, FURTHER RESOLVRL, that the tbregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority orotllrers, employees and other persons to act for and on behalfof the Company, and such Resolution shall not limit or otherwise affect the exercise orany such power or authority otherwise validly granted or vested:' I. Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies') do hereby certify that 0) the foregoing Resolutions adapted by the Hoard of Directors of the Companies are true, correct and in full force and effect, (if) the foregoing Power of Attorney 1s true, correct and in full force and effect, Given under my hand and seals of said CompaniesatWhitehouse Station, NJ. this 10th day of July 2024, s Wwo M, Ghk,W-li, AS14s(ard St,.'reuu? IN THE HVEFn' YOU WISH'I'0 VEItIPY't'}IE AU'IIIEI'FrICI1 y OF THIS HOND Olt NOT114Y US 01: ANY 0'111ER mmrl'ER, PLEASE CONI'AC r US Nr. 'Iolepbonn(908)903.3493 Nx(908)903.3656 a -matt: sureWchubbeom FED. VIO•Pt (ray. 08.18) AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT BEFORE ME, THE UNDERSIGNED AUTHORITY, A NOTARY PUBLIC IN THE STATE AND COUNTY AFORESAID, ON THIS DAY PERSONALLY APPEARED TROY WOODY PRESIDENT (NAME) WOODY CONTRACTORS, INC (COMPANY NAME) , OF (TITLE) , KNOWN TO ME TO BE A CREDIBLE PERSON, WHO BEING BY ME DULY SWORN, UPON HIS OATH DEPOSED AND SAID; THAT ALL PERSONS, FIRMS, ASSOCIATIONS, CORPORATIONS OR OTHER ORGANIZATIONS FURNISHING LABOR AND/OR MATERIALS HAVE BEEN PAID IN FULL; THAT THE ESTABLISHED WAGE SCALE HAS BEEN PAID; AND THAT THERE ARE NO CLAIMS PENDING FOR PERSONAL INJURY AND/OR PROPERTY DAMAGES; ON CONTRACT DESCRIBED AS; Lake Worth Water and SS hnprov. Project. BY SUBSCRIBED AND SWORN BEFORE ME O HIS 101� DAY OF J k,( 2024 NOTARY PI?3LIC IN TARRANT COUNTY, TEXAS ot�M• ry LUZ ARAVELO "Ic, 8taw of Tax" MV CoffimAsiw Expires ''•, o. ,�«•~ +spa 20.2027 NWMT tO 12NO410.0