HomeMy WebLinkAboutContract 59539-FP2-FP2
City Secretary 59539
Contract No.
FORT WORTH..) Date Received 1/14/2025
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: HCA Behavioral Health Hospital
City Project No.: 104380
Improvement Type(s): Water Ox Sewer ❑x
Original Contract Price:
$452, 245.51
Amount of Approved Change Order(s): $0.00
Revised Contract Amount: $0.00
Total Cost of Work Complete: $452,245.51
M < Jan 6, 2025
Matt Senter (Dann 6.2025 11:44 CST)
Contractor Date
Division Manager
Title
Moss Utilities LLC
Company Name
Curtis Hol 6, 202513:34 CST)
Jan 6, 2025
ng orth (`
PDiet Inspector
Date
Jan 11, 2025
Project Manager
Date
Jan 14, 2025
Kandic(Jan 14,202508:53CST)
CFA Mana er
Date
�"`""""'""
Jan 14, 2025
Lauren Prieur (Jan 14, 202514:07 CST)
TPW Director
Date
Jan 15, 2025
Asst. City Manager
Date
OFFICIAL RECORD
CITY SECRETARY Page 1 of 2
FT. WORTH, TX
Notice of Project Completion
Project Name: HCA Behavioral Health Hospital
City Project No.: 104380
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑ Yes ❑x N/A
Pipe Report: ❑x Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time: 45 WD Days Charged: 192
Work Start Date: 12/18/2023 Work Complete Date: 11/11/2024
Completed number of Soil Lab Test: 226
Completed number of Water Test: 4
Page 2 of 2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name HCA BEHAVORIAL HEALTH HOSPITAL
Contract Limits
Project Type WATER & SEWER
City Project Numbers 104380
DOE Number 4380
Estimate Number 1 Payment Number 1 For Period Ending 11/11/2024
WD
City Secretary Contract Number Contract Time WD
Contract Date Days Charged to Date 192
Project Manager NA Contract is 100.00 Complete
Contractor MOSS UTILITIES, LLC
18631 REMBRANDT TERRACE
DALLAS , TX 75287
Inspectors D. WATSON / HOLLINGSWORT
Monday, December 2, 2024 Page 1 of 5
City Project Numbers 104380
Contract Name HCA BEHAVORIAL HEALTH HOSPITAL
Contract Limits
Project Type WATER & SEWER
Project Funding
UNIT I: WATER IMPROVEMENTS
Item Description of Items
No.
1 TRENCH SAFETY
2 2" WATER SERVICE
3 4" WATER PIPE
4 6" WATER PIPE
5 12" PVC WATER PIPE
6 DUCTILE IRON WATER FITTINGS W/
RESTRAINT
7 4" WATER METER AND VAULT
8 6" GATE VALVE
9 8" GATE VALVE
10 12" CUT - IN GATE VALVE
11 12" GATE VALVE
12 FIRE HYDRATE
13 CONNECTION TO EXISTING 4"-12" WATER
MAIN
14 IMPORTED EMBEDMENT/BACKFILL, CSS
15 IMPORTED EMBEDMENT/BACKFILL,
BACKFILL, CRUSHED ROCK
DOE Number 4380
Estimate Number 1
Payment Number 1
For Period Ending 11/11/2024
Estimated Unit
Unit Cost
Estimated
Completed
Completed
Quanity
Total
Quanity
Total
1321 LF
$2.00
$2,642.00
1321
$2,642.00
2 EA
$6,281.00
$12,562.00
2
$12,562.00
13 LF
$30.00
$390.00
13
$390.00
83 LF
$43.50
$3,610.50
83
$3,610.50
1321 LF
$112.50
$148,612.50
1321
$148,612.50
4.068 TN
$6,029.50
$24,528.01
4.068
$24,528.01
2 EA
$48,100.00
$96,200.00
2
$96,200.00
4 EA
$2,136.00
$8,544.00
4
$8,544.00
1 EA
$3,537.00
$3,537.00
1
$3,537.00
2 EA
$6,500.00
$13,000.00
2
$13,000.00
5 EA
$5,276.40
$26,382.00
5
$26,382.00
2 EA
$6,761.00
$13,522.00
2
$13,522.00
3 EA
$8,190.00
$24,570.00
3
$24,570.00
146 CY
$100.00
$14,600.00
146
$14,600.00
27 CY
$45.00
$1,215.00
27
$1,215.00
---------------------------
Sub-Total of Previous Unit $393,915.01 $393,915.01
UNIT H: SANITARY IMPROVEMENTS
Item Description of Items
No.
1 POST - CCTV INSPECTION
2 MANHOLE VACUUM TESTING
3 TRENCH SAFETY
4 8" SEWER PIPE
5 CONCRETE COLLAR
6 TRENCH WATER STOPS
7 4' MANHOLE
8 4' EXTRA DEPTH MANHOLE
9 EPDXY MANHOLE LINER
Estimated Unit
Unit Cost
Estimated
Completed
Completed
Quanity
Total
Quanity
Total
289 LF
$2.00
$578.00
289
$578.00
2 EA
$175.00
$350.00
2
$350.00
289 LF
$2.00
$578.00
289
$578.00
289 LF
$91.50
$26,443.50
289
$26,443.50
1 EA
$400.00
$400.00
1
$400.00
2 EA
$2,000.00
$4,000.00
2
$4,000.00
1 EA
$13,471.00
$13,471.00
1
$13,471.00
11 VF
$340.00
$3,740.00
11
$3,740.00
17 VF
$300.00
$5,100.00
17
$5,100.00
Monday, December 2, 2024 Page 2 of 5
City Project Numbers 104380 DOE Number 4380
Contract Name HCA BEHAVORIAL HEALTH HOSPITAL Estimate Number 1
Contract Limits Payment Number 1
Project Type SANITARY For Period Ending 11/11/2024
Project Funding
10 IMPORTED EMBEDMENT/BACKFILL, 6 CY $45.00 $270.00 6 $270.00
CRUSHED ROCK
11 IMPORTED EMBEDMENT/BACKFILL, CSS 34 CY $100.00 $3,400.00 34 $3,400.00
Sub -Total of Previous Unit $58,330.50 $58,330.50
Monday, December 2, 2024 Page 3 of 5
City Project Numbers 104380
Contract Name HCA BEHAVORIAL HEALTH HOSPITAL
Contract Limits
Project Type SANITARY
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Total Contract Price
DOE Number 4380
Estimate Number 1
Payment Number 1
For Period Ending 11/11/2024
$452,245.51
$452,245.51
Total Cost of Work Completed $452,245.51
Less % Retained $0.00
Net Earned $452,245.51
Earned This Period $452,245.51
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
$452,245.51
Monday, December 2, 2024 Page 4 of 5
City Project Numbers 104380
Contract Name HCA BEHAVORIAL HEALTH HOSPITAL
Contract Limits
Project Type SANITARY
Project Funding
Project Manager NA
Inspectors D. WATSON / HOLLINGSWORT
Contractor MOSS UTILITIES, LLC
18631 REMBRANDT TERRACE
DALLAS, TX 75287
DOE Number 4380
Estimate Number 1
Payment Number 1
For Period Ending 11/11/2024
City Secretary Contract Number
Contract Date
Contract Time WD
Days Charged to Date 192 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 $452,245.51
Less % Retained
$0.00
Net Earned
$452,245.51
Earned This Period $452,245.51
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
$452,245.51
Monday, December 2, 2024 Page 5 of 5
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: HCA Behavioral Health Hospital
CITY PROJECT NUMBER: 104380
WATER
PIPE LAID SIZE TYPE OF PIPE LF
OPEN CUT 12" PVC 1321
OPEN CUT 6" PVC 83
OPEN CUT 4" PVC 13
FIRE HYDRANTS: 2 VALVES (16" OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES: PASSED
NEW SERVICES: 2" COPPER 15
I SEWER
PIPE LAID SIZE TYPE OF PIPE LF
OPEN CUT 8" PVC 289
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES: PASSED
NEW SERVICES:
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
FORTWORTH.
M"
TRANSPORTATION AND PUBLIC WORKS
November 20, 2024
Moss Utilities LLC
11050 Ables Ln
Dallas TX, 75229
RE: Acceptance Letter
Project Name: HCA Behavioral Health Hospital
Project Type: Water, Sewer and Paving
City Project No.: 104380
To Whom It May Concern:
On November 20, 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 20,
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-
392-8424.
Sandip Adhikari P.E., Project Manager
Cc: Curtis Hollingsworth, Inspector
Donald Watson, Inspection Supervisor
Aaron Ybarra, Senior Inspector
Andrew GoodmanP.E., Program Manager
Pacheco -Koch, Consultant
Moss Utilities LLC, Contractor
HCA Healthcare, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 08/20/19
AFFIDAVIT
STATE OF TEXAS
:K611A11rKel01F:101114 ►U
Before me, the undersigned authority, a notary public in hthe state and
county aforesaid, on this day personally appeared �a�� t u 0,5(6
U,,e.,:::�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;
HCA BH Hospital
City Project No:1043 80; CIA No: 22-0180
BY'Q� G�
nh Tale
Subscribed and sworn before me on this date,
No ry Publi
Dallas, Texas
CHRISTINARACHELLELAZARIN
_- My Notary ID # 132339389
Expires January 31, 2028
CONSENT OF SURETY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
TO OWNER:
(Name and address)
City of Fort Worth
311 W. 10th Street,
Fort Worth, TX 76102
Bond No: GSH5900173
OWNER
ARCHITECT
CONTRACTOR
SURETY
OTHER
ARCHITECT'S PROJECT NO.: 019747-33A
CONTRACT FOR: OCP: $543,756.25
FCP: $543,756.25
PROJECT: CONTRACT DATED: June 14, 2024
(Name and address)
Fort Worth Behavioral Hospital - Alliance Town Center Blvd, Fort Worth, TX 76244
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the
(Insert name and address of Surety)
The Gray Casualty & Surety Company
P.O. Box 6202,
Metairie, LA 70009
on bond of
(Insert name and address of Contractor)
Moss Utilities, LLC
11050 Ables Ln.,
Dallas, TX 75229
❑X
,SURETY,
,CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any
of its obligations to
(Insert name and address of Owner)
City of Fort Worth
311 W. 10th Street,
Fort Worth, TX 76102
OWNER,
as set forth in said Surety's bond.
IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: December 20, 2024
(Insert in writing the month followed by the numeric date and year)
The Gray Casualty & Surety Company(SurelS
-
.l
Attest: (Signature of authorized repres atiw)
Crosby Guercio, Witness
Sean McCauley Attorney -in -Fact
(Printed name and titde)
S-2134/GE 10/01
XDP
McCauley Bond Agency
12/20/202416:23 2273118011742
THE GRAY INSURANCE COMPANY
THE GRAY CASUALTY & SURETY COMPANY
GENERAL POWER OF ATTORNEY
Bond Number: GSH5900173 Principal: Moss Utilities, LLC
Project: Fort Worth Behavioral Hospital - Alliance Town Center Blvd, Fort Worth, TX 76244
KNOW ALL BY THESE PRESENTS, THAT The Gray Insurance Company and The Gray Casualty & Surety Company, corporations duly
organized and existing under the laws of Louisiana, and having their principal offices in Metairie, Louisiana, do hereby make, constitute, and
appoint: Sean McCauley, Liam Hackett, Sam Duckett, Jarrod Yost, Sarah Timmons, Ashlyn Simchik, and Bridget Truxillo of Dallas,
Texas jointly and severally on behalf of each of the Companies named above its true and lawful Attorney(s)-in-Fact, to make, execute, seal and
deliver, for and on its behalf and as its deed, bonds, or other writings obligatory in the nature of a bond, as surety, contracts of suretyship as are or
may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract of suretyship executed
under this authority shall exceed the amount of
$25,000,000.00.
This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of
Directors of both The Gray Insurance Company and The Gray Casualty & Surety Company at meetings duly called and held on the 261 day of
June, 2003.
"RESOLVED, that the President, Executive Vice President, any Vice President, or the Secretary be and each or any of them hereby is authorized to
execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,
undertakings, and all contracts of surety, and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney, and
to attach the seal of the Company; and it is
FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be
binding upon the Company now and in the future when so affixed with regard to any bond, undertaking or contract of surety to which it is attached.
IN WITNESS WHEREOF, The Gray Insurance Company and The Gray Casualty & Surety Company have caused their official seals to be hereinto
affixed, and these presents to be signed by their authorized officers this 41 day of November, 2022.
�g U R A
SEAL J By: Michael T. Gray Cullen S. Piske SEAL
President President o
The Gray Insurance Company The Gray Casualty & Surety Company
State of Louisiana
ss:
Parish of Jefferson
On this 4' day of November, 2022, before me, a Notary Public, personally appeared Michael T. Gray, President of The Gray Insurance
Company, and Cullen S. Piske, President of The Gray Casualty & Surety Company, personally known to me, being duly sworn, acknowledged
that they signed the above Power of Attorney and affixed the seals of the companies as officers of, and acknowledged said instrument to be the
voluntary act and deed, of their companies.
(� � UVvv�
l�l � LeighA..i��ie Henican�1 t��
'v Notary Public
Notary ID No. 92653 Leigh Anne Henican
> Notary Public, Parish of Orleans State of Louisiana
Orleans Parish, Louisiana My Commission is for Life
I, Mark S. Manguno, Secretary of The Gray Insurance Company, do hereby certify that the above and forgoing is a true and correct copy of a
Power of Attorney given by the companies, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and
affixed the seals of the Company this 20th day of December 2024
o"��%H�IV✓fn.0
I, Leigh Anne Henican, Secretary of The Gray Casualty & Surety Company , do hereby certify that &e above and forgoing is a true and correct
copy of a Power of Attorney given by the companies, which is still_sn"full force an_d affect. IN WITNESS WHEREOF, I have set my hand
and affixed the seals of the Company this 20th day of December s ; 2024
\fig �RA. ��c y 4
to
STATE OF TEXAS
STATE BOARD OF INSURANCE
Certificate ? g� Company No. 08-93774
7 U 0 s a'
CERTIFICATE OF AUTHORITY
THIS IS TO CERTIFY THAT
THE GRAY INSURANCE COMPANY
METAIRIE, LOUISIANA
has complied with the laws of the State of Texas applicable thereto and is hereby authorized to trans-
act the business of
Fire; Allied Coverages; Hail, growing crops only; Rain; Inland Marine; Ocean
3
Marine; Aircraft --Liability & Physical Damage; Accident; Health; Workers'
Compensation & Employers' Liability; Employers' Liability; Automobile--
y Liability & Physical Damage; Liability other than Automobile; Fidelity &
E -
Surety; Glass; Burglary & Theft; Forgery; Boiler & Machinery; and Reinsurance
on all lines authorized to be written on a direct basis
insurance within the State of Texas. This Certificate of Authority shall be in full force and effect until
it is revoked, canceled or suspended according to law.
IN TESTIMONY WHEREOF, witness my
hand and seal of office at Austin, Texas, this
-1.6th __day of -------- ecember_--------------- A. D..l_�8_l.._.
CO S ER iiF II+fSUR C1J
By:
Deputy Commissioner
FORM GOEM