HomeMy WebLinkAboutContract 59911-FP1FORT WORTH.
-FP1
City Secretary.
Contract No. 59911
Date Received 01/7/2025
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: Trinity Estates Phase III
City Project No.: 104843
Improvement Type(s): Water ❑ Sewer x❑
Original Contract Price: $6,170.00
Amount of Approved Change Order(s):
Revised Contract Amount:
Total Cost of Work Complete: $6,170.00
Ai Nbe,r-fp6,ra ec GIPsT Dec 17, 2024
Contractor Date
Vice President
Title
Burnsco Construction
Company Name
Dec 17, 2024
Carlos Gafcia (Dec 17, 202416:51 CST)
Project Inspector
Date
#�
Dec 20, 2024
Project Manager
Date
_rLO'"
Jan 7
Rebecca Owen flan 7. 202509:26 CST)
72025
CFA Manager
Date
-�
Dec 20, 2024
Lauren P rieu r ( Dec 20, 202412:51 CST)
TPW Director
Date
Dec 23, 2024
Asst. City Manager
Date
OFFICIAL RECORD
CITY SECRETARY Page 1 of 2
FT. WORTH, TX
Notice of Project Completion
Project Name: Trinity Estates Phase III
City Project No.: 104843
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑ Yes ❑x N/A
Pipe Report: ❑ Yes ❑x N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time: 10 WD
Work Start Date: 10/18/2024
Completed number of Soil Lab Test: 27
Completed number of Water Test: 0
Days Charged: 1 WD
Work Complete Date: 10/18/2024
Page 2of2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name TRINITY ESTATES PHASE III
Contract Limits
Project Type SANITARY SEWER IMPROVEMENTS
City Project Numbers 104843
DOE Number 4843
Estimate Number 1 Payment Number 1 For Period Ending 10/18/2024
WD
City Secretary Contract Number Contract Time IAJD
Contract Date Days Charged to Date 1
Project Manager NA Contract is 100.00 Complete
Contractor BURNSCO CONSTRUCTION, INC.
6331 SOUTHWEST BLVD
FORT WORTH, TX 76132
Inspectors G DEYON / C GARCIA
Monday, December 2, 2024 Page 1 of 4
City Project Numbers 104843
Contract Name TRINITY ESTATES PHASE III
Contract Limits
Project Type SANITARY SEWER IMPROVEMENTS
Project Funding
UNIT II: SANITARY SEWER IMPROVEMENTS
Item Description of Items
No.
1 MOBILIZATION
2 REMOVE 2" FORCE MAIN
3 SWPPP < 1 ACRE
4 2" SEWER FORCE MAIN CONNECTION TO
EXISTING MANHOLE
DOE Number 4843
Estimate Number 1
Payment Number 1
For Period Ending 10/18/2024
Estimated Unit
Unit Cost
Estimated
Completed
Completed
Quanity
Total
Quanity
Total
1 LS
$1,000.00
$1,000.00
1
$1,000.00
730 LF
$4.00
$2,920.00
730
$2,920.00
1 LS
$250.00
$250.00
1
$250.00
1 LS
$2,000.00
$2,000.00
1
$2,000.00
-------------------------------------
Sub-Total of Previous Unit $6,170.00 $6,170.00
-------------------------------------
Monday, December 2, 2024 Page 2 of 4
City Project Numbers 104843
Contract Name TRINITY ESTATES PHASE III
Contract Limits
Project Type SANITARY SEWER IMPROVEMENTS
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Total Contract Price
DOE Number 4843
Estimate Number 1
Payment Number 1
For Period Ending 10/18/2024
$6,170.00
$6,170.00
Total Cost of Work Completed $6,170.00
Less % Retained $0.00
Net Earned $6,170.00
Earned This Period $6,170.00
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
$6,170.00
Monday, December 2, 2024 Page 3 of 4
City Project Numbers 104843
Contract Name TRINITY ESTATES PHASE III
Contract Limits
Project Type SANITARY SEWER IMPROVEMENTS
Project Funding
Project Manager NA
Inspectors G DEYON / C GARCIA
Contractor BURNSCO CONSTRUCTION, INC.
6331 SOUTHWEST BLVD
FORT WORTH, TX 76132
DOE Number 4843
Estimate Number 1
Payment Number 1
For Period Ending 10/18/2024
City Secretary Contract Number
Contract Date
Contract Time 10 WD
Days Charged to Date 1 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
$6,170.00
Less % Retained
$0.00
Net Earned
$6,170.00
Earned This Period $6,170.00
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
$6,170.00
Monday, December 2, 2024 Page 4 of 4
FORTWORTH.
M"
TRANSPORTATION AND PUBLIC WORKS
November 25, 2024
Burnsco Construction Inc.
6331 Southwest Blvd
Benbrook, Texas 76132
RE: Acceptance Letter
Project Name: Trinity Estates Phase III
Project Type: Sewer
City Project No.: 104843
To Whom It May Concern:
On November 25, 2024 a final inspection was made on the subject project. There were no punch list
items identified at that time. The final inspection indicates that the work meets the City of Fort Worth
specifications and is therefore accepted by the City. The warranty period will start on November 25,
2024, which is the date of the final inspection 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-
925-4381.
Sincerely,
Sandip Adhikari, Project Manager
Cc: Carlos Garcia, Inspector
Gary Deyon, Inspection Supervisor
Lorrie Pitts, Senior Inspector
Andrew Goodman, Program Manager
Baird, Hampton, & Brown Inc., Consultant
Burnsco Construction, Contractor
Trinty Estates Development Company, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 08/20/19
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 Ab Grantges,
Contract Mgr, Of Burnsco Construction, known to me to be a credible
person, who being by me duly sworn, upon his oath deposed and said;
That all persons, firms, associations, corporations, or other
organizations furnishing labor and/or materials have been paid in full;
That the wage scale established by the City Council in the City of
Fort Worth has been paid in full;
That there are no claims pending for personal injury and/or
property damages;
On Contract described as;
Force Main Relocation for Trinity Estates 3
BY
Ab Grantges,7Contract Manager
Subscribed and sworn before me on this date 16th of December, 2024.
Notary Public
Tarrant County, Texas
KASSANDRA CANALES
�"Stq Y *' d �:
?a; ,Notary public, State of Texas
Comm. Expires 01-23-2027
Notary ID 134158873
1
CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
OWNER
❑
ARCHITECT
❑
CONTRACTOR
❑
SURETY
❑
OTHER
Bond No 022236931
PROJECT:
(name, addreSS)Force Main Relocation for Trinity Estates Phase 3
TO (Owner)
Fort Worth TX
TRINITY ESTATES DEVELOPMENT COMPANY, LLC—I ARCHITECT'S PROJECT NO:
AND CITY OF FORT WORTH CONTRACT FOR:
5137 Davis Blvd. Force Main Relocation for Trinity Estates Phase 3
North Richland Hills TX 76180 --J CONTRACT DATE:
CONTRACTOR: BURNSCO CONSTRUCTION, INC.
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)
LIBERTY MUTUAL INSURANCE COMPANY
175 Berkeley Street
Boston MA 02116 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
BURNSCO CONSTRUCTION, INC.
6331 Southwest Boulevard
Benbrook TX 76132
,CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve
the Surety Company of any of its obligations to (here insert name and address of Owner)
TRINITY ESTATES DEVELOPMENT COMPANY, LLC AND CITY OF FORT WORTH
5137 Davis Blvd.
North Richland Hills TX 76180 , OWNER,
as set forth in the said Surety Company's bond.
IN WITNESS, WHEREOF,
the Surety Company has hereunto set its hand this
Attest:
(Seal):
17th day of December, 2024
LIBERTY MUTUAL INSURANCE COMPANY
Surety Company
Signa re of Authorized Representative
SoDhinie Hunter
Title
Attorney -in -Fact
NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
This Power of Attorney limits the acts of those named herein, and they have no authority to
bind the Company except in the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutual. The Ohio Casualty Insurance Company Certificate No: 8205467-022020
SURETY West American Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Don E.
Cornell; Joshua Saunders; Kelly A. Westbrook; Mikaela Peppers; Ricardo J. Reyna; Robbi Morales; Sophinie Hunter; Tina McEwan; Tonle Petranek
all of the city of Dallas state of TX each individually if there be more than one named, its true and lawful attorney -in -fact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance
of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper
persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 23rd day of April 2021
Liberty Mutual Insurance Company
-,I INS& The Ohio Casualty
JP opany
eA�gY JP�oVLFo R9 oP�oIt o qq'y West American Insurance Insurance Company
a y
i° Fo "tn Q 3° Fo yn • a° Fo F Y
1912 o p 1919 s 1991 o ?
Y ss ,, s s o
(D ff � vi 0
~d.�93ACHU`��A.dD h'AMPSda '��A'DIANP Lob ,. /l r ',jam
++ e, 0 By:
m David M. Carey, Assistant Secretary
16 m State of PENNSYLVANIA ss
:3 County of MONTGOMERY o E
�
On this 23rd day of April 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance
Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes
mtherein contained by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. O N
m aa) p, PASr a O
` ��ysara;v��. Commonwealth of Pennsylvania - Notary Seal
O <x e Teresa Pastella, Notary Public
ON CrF'' MonlgomeryCounty a E
My commission expires March 28. 2025 By• O a)A N Member, Pe nlsyly n a Association of Notaries •Teresa Pastetia, Notary Public O O
(6 �.• 'a'
•tc This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 3 00
o •� Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: a M
a? ARTICLE IV- OFFICERS: Section 12, Power of Attorney. o o0
R m Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the -ao
a 8, President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety m m
> C any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall -a 8
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such o aD
Zo instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the f m
provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. LC) a
ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the
Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if
signed by the president and attested by the secretary.
Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in -
fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and
has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 17th day of December , 2024 .
1Nsuy )ZV INS& \NSU.p
' 2G°aPORAr�Oynfn C =40aPOR9T�O9yC' `V °RPORAT�y(1
g 1912 0 0 1919 1991�
o Q O
��9SSA CHUS" .da yO�"HA MPsa,� D Y �NOIANT' D� By:
*�a Renee C. Llewellyn, Assistant Secretary
LMS-12873 LMIC OCIC WAIC Multi Co 02/21
TEXAS
IMPORTANT NOTICE
To obtain information or make a complaint:
You may call toll -free for information or to
make a complaint at
1-877-751-2640
You may also write to:
2200 Renaissance Blvd., Ste. 400
King of Prussia, PA 19406-2755
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
Consumer Protection (I I I-1A)
P. O. Box 149091
Austin, TX 78714-9091
FAX: (512) 490-1007
Web: htta://www.tdi.texas.aov
E-mail: ConsumerProtection4,tdi.texas.uov
PREMIUM OR CLAIM DISPUTES:
Should you have a dispute concerning your
premium or about a claim you should first
contact the agent or call 1-800-843-6446.
If the dispute is not resolved, you may contact the
Texas Department of Insurance.
ATTACH THIS NOTICE TO YOUR
POLICY:
This notice is for information only and does not
become a part or condition of the attached
document.
NP 70 68 09 01
LMS-15292 10/15
TEXAS
AVISO IMPORTANTE
Para obtener informacion o para someter una
queja:
Usted puede llamar al numero de telefono gratis
para informacion o para someter una queja al
1-877-751-2640
Usted tambien puede escribir a:
2200 Renaissance Blvd., Ste. 400
King of Prussia, PA 19406-2755
Puede comunicarse con el Departamento de
Seguros de Texas para obtener informacion
acerca de companias, coberturas, derechos o
quejas al
1-800-252-3439
Puede escribir al Departamento de Seguros
de Texas Consumer Protection (111-1A)
P. O. Box 149091
Austin, TX 78714-9091
FAX # (512) 490-1007
Web: httn://www.tdi.texas.aov
E-mail: ConsumerProtectionng,,tdi.texas.aov
DISPUTAS SOBRE PRIMAS O RECLAMOS:
Si tiena una disputa concerniente a su prima o a
un reclamo, debe comunicarse con el agente o
primero. Si no se resuelve la disputa, puede
entonces comunicarse con el departamento (TDI)
UNA ESTE AVISO A SU POLIZA:
Este aviso es solo para proposito de informacion
y no se convierte en parte o condicion del
documento adjunto.