HomeMy WebLinkAboutContract 61617-FP1Page 1 of 2
City Secretary
Contract No.__________________
Date Received ______________
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: FWISD Forest Oak Middle School Portable Village
City Project No.: 105593
Improvement Type(s): Water Sewer
Original Contract Price: $113,692.49
Amount of Approved Change Order(s): $8,271.00
Revised Contract Amount:$121,963.49
Total Cost of Work Complete: $121,963.49
Contractor Date
Title
F.H. Paschen, S.N. Nielsen & Associates LLC
Company Name
Project Inspector Date
Project Manager Date
CFA Manager Date
_______________________________________ __________________________________
TPW Director Date
Asst. City Manager Date
Page 2 of 2
Notice of Project Completion
Project Name: FWISD Forest Oak Middle School Portable Village
City Project No.: 105593
City’s Attachments
Final Pay Estimate
Change Order(s):Yes N/A
Pipe Report:Yes N/A
Contractor’s Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time: 24 WD
Work Start Date: 7/22/2024
Days Charged: 24 WD
Work Complete Date: 8/23/2024
Completed number of Soil Lab Test: 5
Completed number of Water Test: 2
CITY OF FORT WORTH
Contract Name FWISD FOREST OAK MIDDLE SCHOOL PORTABLE VILLAGE
Contract Limits
Project Type WATER & SEWER
DOE Number 5593
Estimate Number 1 Payment Number 1 For Period Ending 8/23/2024
FINAL PAYMENT REQUEST
City Secretary Contract Number
24
WD
Contract Date
F.H. PASCHEN S.N. NIELSEN & ASSOCIATES LL
NA
122 WEST JOHN CARPENTER FREEWAY, STE 55
IRVING TX 75039
G.DEYON O.FRIAS
24WDContract Time
Days Charged to Date
CompleteContract is 100.00
Contractor
,
/Inspectors
Project Manager
City Project Numbers 105593
Tuesday, November 5, 2024 Page 1 of 5
Contract Name FWISD FOREST OAK MIDDLE SCHOOL PORTABLE VILLAGE
Contract Limits
Project Type WATER & SEWER
DOE Number 5593
Estimate Number 1
Payment Number 1
For Period Ending 8/23/2024
Project Funding
City Project Numbers 105593
UNIT I: WATER IMPROVEMENTS
Item
No.Description of Items Estimated
Quanity Unit Unit Cost Estimated
Total
Completed
Quanity
Completed
Total
1 8" WATER CARRIER PIPE 61 LF $192.00 $11,712.00 61 $11,712.00
2 6" WATER CARRIER PIPE 5 LF $174.00 $870.00 5 $870.00
3 REMOVE 8" WATER LINE 23 LF $52.00 $1,196.00 23 $1,196.00
4 CONNECTION TO EXISTING 4"-12" WATER
MAIN
1 EA $4,123.00 $4,123.00 1 $4,123.00
5 CONNECTION TO EXISTING 4"-12" WATER
MAIN
1 EA $4,385.00 $4,385.00 1 $4,385.00
6 8" GATE VALVE (CO#1)2 EA $3,322.00 $6,644.00 2 $6,644.00
7 6" GATE VALVE 1 EA $2,422.00 $2,422.00 1 $2,422.00
8 FIRE HYDRANT 1 EA $6,812.00 $6,812.00 1 $6,812.00
9 2" WATER SERVICE, METER RECONNECTION
(CO#1)
0 EA $3,137.00 $0.00 0 $0.00
10 STEEL FITTINGS 1 LS $819.00 $819.00 1 $819.00
11 ASPHALT PVMT REPAIR BEYOND DEFINED
WIDTH, RESID
57.3 SY $441.30 $25,286.49 57.3 $25,286.49
12 TRAFFIC CONTROL 1 MO $5,250.00 $5,250.00 1 $5,250.00
13 TRENCH SAFETY 69 LF $14.00 $966.00 69 $966.00
$70,485.49 $70,485.49Sub-Total of Previous Unit
UNIT II: SANITARY SEWER IMPROVEMENTS
Item
No.Description of Items Estimated
Quanity Unit Unit Cost Estimated
Total
Completed
Quanity
Completed
Total
14 8" SEWER CARRIER PIPE (6" SDR-25)27 LF $304.00 $8,208.00 27 $8,208.00
15 8" SEWER SERVICE, RECONNECTION 1 EA $4,218.00 $4,218.00 1 $4,218.00
16 4' DROP MANHOLE 1 EA $8,787.00 $8,787.00 1 $8,787.00
17 ASPHALT PVMT REPAIR BEYOND DEFINED
WIDTH, RESID
195 LF $49.00 $9,555.00 195 $9,555.00
18 CONC PVMT REPAIR, RESIDENTIAL (CO#1)0 LF $42.00 $0.00 0 $0.00
19 TRAFFIC CONTROL 1 MO $4,500.00 $4,500.00 1 $4,500.00
20 TRENCH SAFETY 27 LF $10.00 $270.00 27 $270.00
21 4" CONC SIDEWALK 187 SF $42.00 $7,854.00 187 $7,854.00
22 POST-CCTV INSPECTION 27 LF $270.00 $7,290.00 27 $7,290.00
23 MANHOLE VACUUM TESTING 2 EA $110.00 $220.00 2 $220.00
Tuesday, November 5, 2024 Page 2 of 5
Contract Name FWISD FOREST OAK MIDDLE SCHOOL PORTABLE VILLAGE
Contract Limits
Project Type WATER & SEWER
DOE Number 5593
Estimate Number 1
Payment Number 1
For Period Ending 8/23/2024
Project Funding
City Project Numbers 105593
24 6" CONC CURB & GUTTER 12 LF $48.00 $576.00 12 $576.00
$51,478.00 $51,478.00Sub-Total of Previous Unit
Tuesday, November 5, 2024 Page 3 of 5
Contract Name FWISD FOREST OAK MIDDLE SCHOOL PORTABLE VILLAGE
Contract Limits
Project Type WATER & SEWER
DOE Number 5593
Estimate Number 1
Payment Number 1
For Period Ending 8/23/2024
Project Funding
City Project Numbers 105593
Contract Information Summary
Change Orders
$113,692.49Original Contract Amount
$121,963.49Total Contract Price
$121,963.49
Less
Total Cost of Work Completed
% Retained $0.00
Net Earned $121,963.49
Plus Material on Hand Less 15%$0.00
Balance Due This Payment $121,963.49
Less Liquidated Damages
Days @ / Day
$0.00
Less Penalty
LessPavement Deficiency $0.00
$0.00
$0.00Less Previous Payment
Earned This Period
Retainage This Period
$121,963.49
$0.00
1 $185.00Change Order Number
1 $8,086.00Change Order Number
Tuesday, November 5, 2024 Page 4 of 5
Contract Name FWISD FOREST OAK MIDDLE SCHOOL PORTABLE VILLAGE
Contract Limits
Project Type WATER & SEWER
DOE Number 5593
Estimate Number 1
Payment Number 1
For Period Ending 8/23/2024
Project Funding
City Project Numbers 105593
Line Fund Account Center
Amount
Funded Gross Retainage Net
CITY OF FORT WORTH
SUMMARY OF CHARGES
$121,963.49
Less
Total Cost of Work Completed
% Retained $0.00
Net Earned $121,963.49
Plus Material on Hand Less 15%$0.00
Balance Due This Payment $121,963.49
Less Liquidated Damages
0 Days @ $0.00 / Day $0.00
Less Penalty
LessPavement Deficiency $0.00
$0.00
$0.00Less Previous Payment
Earned This Period
Retainage This Period
$121,963.49
$0.00
City Secretary Contract Number
24
WD
Contract Date
F.H. PASCHEN S.N. NIELSEN & ASSOCIATES LL
NA
122 WEST JOHN CARPENTER FREEWAY, STE 55
IRVING TX 75039
G.DEYON O.FRIAS
24
WD
Contract Time
Days Charged to Date
CompleteContract is 100.000000
Contractor
,
/Inspectors
Project Manager
Tuesday, November 5, 2024 Page 5 of 5
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60LF
LF
LF
SEWER
27 LF
PIPE ABANDONED
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
NEW SERVICES:
DENSITIES:
WATER
Yes Uploaded to Accela
LF
SIZE TYPE OF PIPE
SIZE TYPE OF PIPE
SDR-26 6" PVC
PIPE LAID
NEW SERVICES:1" 4- Copper services
DENSITIES:YES Uploaded to Accela
FIRE HYDRANTS:1 VALVES (16" OR LARGER)
LF
PIPE ABANDONED SIZE TYPE OF PIPE
TYPE OF PIPEPIPE LAID
CITY PROJECT NUMBER:
PROJECT NAME:FWISD Forest Oak Middle School Portablr Village
105593
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
SIZE
Rev. 08/20/19
TRANSPORTATION AND PUBLIC WORKS
August 29, 2024
F.H. Paschen, S.N Nielsen & Associates LLC
122 West John Carpenter Freeway
Suite 550
Irving,TX 75039
RE: Acceptance Letter
Project Name: FWISD Forest Oak Middle School Portable Village
Project Type: Water & Sewer Improvements
City Project No.: 105593
To Whom It May Concern:
On August 29, 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 August 29, 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-
392-2481.
Sincerely,
Debbie Willhelm, Project Manager
Cc: Omar Frias, Inspector
Gary Deyon, Inspection Supervisor
Lorrie Pitts, Senior Inspector
Andrew Goodman, Program Manager
JQ Infrastructure , Consultant
F.H. Paschen, S.N Nielsen & Associates LLC, Contractor
Fort Worth Indepent School District , Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Docusign Envelope ID: 31484D19-9DA9-4F6F-8CE3-E01 EE5751952
� OO
:.�_�r�
's'%
Document G706° -1994
Contractor's Affidavit of Payment of Debts and Claims
PROJECT: (Name and address)
Forest Oak MS Portable Village
4801 Eastline Dr.
Fort Worth TX 76119
TO OWNER: (Name and address)
Fort Worth Independent School
District
7060 Camp Bowie Blvd.
Fort Worth TX 76116
STATE OF: Texas
COUNTY OF: Tarrant
ARCHITECT'S PROJECT NUMBER:
CONTRACT FOR: $ 121,963.49
CONTRACT DATED: 9/26/2024
OWNER: U
ARCHITECT: ❑
CONTRACTOR: ❑
SURETY: ❑
OTHER: ❑
The undersigned hereby certifies that, except as listed below, payment has been made in full and all obligations have otherwise
been satisiied for all materials and equipment furnished, for all work, labor, and services performed, and for all known
indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the
Contract referenced above for which the Owner or Owner's property might in any way be held responsible or encumbered.
EXCEPTIONS:
SUPPORTING DOCUMENTS ATTACHED HERETO:
1. Consent of Surety to Final Payment. Whenever
Surety is involved, Consent of Surety is
required. AIA Document G707, Consent of
Surety, may be used for this purpose
Indicate Attachment ❑ Yes � No
The following sup�orting documents should be attached
he�eto if required by the Owner:
1. Contractor's Release or Waiver of Liens,
conditional upon receipt of final payment,
2. Separate Releases or Waivers of Liens from
Subcontractors and material and equipment
suppliers, to the extent reGuired by the Owner,
accompanied by a list thereof.
3. Contractor's Affidavit of Release of Liens (AIA
Document G706A).
CONTRACTOR: (Name aTad nddress)
F.H. Paschen, S.N. Nielsen & Associates LLC
5515 N. East River Road
Chicago IL 60656
DocuSigned by:
BY: �� �66�,5
��
(Signature of authorized representative)
sean woods vice President
(Printed �aaf�ze a��d title)
Subscribed and sworn to before me on this date: ��/�Z S
Notary Public: ��% ;k�l, ��GL�t��/(-�/�
My Commission Expires: L� �— 2.�z,�
`��oaY�P�,�� ANITA ANN TURNER
;_ :�'�' e%Notary Public, State of Texas
��;.,��Q; Comm. Expires 04-28-2025
'�.','FOF��'�� Notary ID 3910138
��nn+�`
AIA Document G706 — 1994. Copyright �O 1970 and 1994. All rights reserved. "The American Institute of Architects," "American Institute of Architects," "AIA," the
AIA Logo, and "AIA Contract Documents" are trademarks of The American Institute of Architects. This document was produced at 09:48:12 ET on 02111/2025
under Order No.2114490528 which expires on 02/28/2025, is not for resale, is licensed for one-time use only, and may only be used in accordance with the AIA
Contract Documents° Terms of Service. To report copyright violations, e-mail docinfo@aiacontracts.com.
User Notes: (3B9ADA5C)
SURETY RiDER
To be attached to and form a part of
Bond No. 30220855
dated June 18, 2024
effective
(MONTH-DAY-YEAR)
executed by F.H. Paschen, S.N. Nielsen & Associates LLC
(PRINCIPAL)
and by Continental Casualty Company
as Surety,
, as Principal,
in favor of City of Fort Worth Texas
(OBLIGEE)
in consideration of the mutual agreements herein contained the Principal and the Surety hereby consent to changing
Bond and Contract Amount
�From: One Hundred Thirteen Thousand Six Hundred Ninety Two Dollars and 49(100 ($113,682.48}
To: One Hundred Twenty One Thousand Nine Hundred Sixty Three Dollars and 49l10Q ($121,963.49}
Nothing herein contained shall vary, alter or extend any provision or condition of this bond except as herein expressly stated.
This rider February 11, 2025
is effective
(MONTH-DAY-YEAR)
Signed and Sealed February 11, 2025
(MONTH-DAY-YEAR)
By:
BY:
�, �
;�'�a i.i �,C.
,, � :?- ,.y ..
;r' � ' L; �ti:f_
'.'�, --
S-0443/GEEF 10/99
�''•Iryti�ittSli�
POVVER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT
Know All Men By These Presents, That Continental Casualry Company, an lllinois insurance company, National Fire Insurance Company of Hartford, an
lllinois insurance company, and American Casualty Company of Reading, Penusylvania, a Pennsylvania insurance company (herein called "the CNA Compaiues•"), are
duly organized and existing insurance companies having their principal officcs in the City ofChicago, and State of Illinois, and [hat they do by virtue of the signatures
and seals herein affixed hereby make, constitute and appoint
Julie Denman
, Individually
of Gfand Rapids Michigan , their true and fawful Attomey(s)-in-Fact with Tull power and authority hereby confened to sign, seal and
execute for and on their behalf bonds, undertakings aod other obligatory instruments of similar nature
Surety Bond Number: 30220855
- In Unlimited Amounts -
Principal: F.H. Paschen, S.N. Nielsen & Associates LLC
Obligee: Cit of Fort War[h iexas
and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of
said Attoroey, pursuant to the authority hereby given is hereby ratified and confirmed.
This Power of Attomey is made and executed pursuant to and by authority of the By-Laws and Resolutions, printed below, duly adopted, as indicated, by the
Boards of Directors of the insurance companies.
In Witness Whereof, the CNA Companies have caused these presents to be signed by [heir Vice President and their corporate seals to be hereto affixed on this
] 3th day of March, 2024.
� � ��
���' �4��
1�T �
Contioental Casualty Company
a National Fire Insurance Company of Hartford
�=r�,� American Casualty Company of Reac'nF. Pennsylvania
µv 11
INI �
Laay Kasten Vice President
State of South Dakota, County of Minnehaha, ss:
On this 13th day of March, 2024, before me personally came Larry Kasten to me known, who, being by me duly sworn, did depose and say: that he resides in the
Ciry of Sioux Falls, State of South Dakota; that he is a Vice President ofContinental Casualty Company, an Illinois insurance company, Na[ional Fire [nsurance
Company of Hartford, an Illinois insurance company, and American Casualty Company ofReading, Pennsylvania, a Pennsylvania insurance company described in and
which executed the above instrumeot; tha[ he knows the seals of said insurance companies; that the seals affixed to the said instrumen[ are such corporate seals; tha[
they were so affixed pursuant to authority given by the Boards ofDirectors ofsaid insurance companies and that he signed his name thereto pursuant to like authority,
and acknowledges same to be the act and deed of said insurance companies.
,.. ... ..
� �J1. BENT,• � i
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My Commission Expires March 2, 2026 M. Bent Notary Public
CERTIFICATE
I, Paula Kolsrud, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois
insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the Power of At[orney
herein above set forth is still in force, and further certify that the By-f.aws :3nd T�esolu�inns of the 1���ard of' f3irectors of the insurana° �ompanies printed below are still
in force.:ln testimony whereof I have hereunto subscribed my name and afiixr�l the se:il of the said iitsurnncz companies this 11th ��y �,p FebrueN , 2025 ,
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Contioental Casualty Company
� wsu,�y� National Fire Insurance Company of Hartford
„ *�„�a Amencan Casualty Company of Reading, Pennsylvania
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Paula I�!�ls�ud Assistant Secretary
Authoriting By-Laws and Resolurions
+�f�� N•Ti:f7 f3Y TIiL ii[]NtT] UP DIREi'T[]RS «P EACH OF C?]RTftiE1�TAL CASUALTY E'O�TP�YV, tiA'Sfr7tiAL FIRE INSURANCE COMPANY OF HARTFORD, and
�I�ir:Nk' �'.h CAtii iAL'fY �'i�A41'ANY f7F kliAlllAl[i, PENNSYLVAtdIA {as defined ahove, thc "l'NA ['�mpanica'}:
1"Poiti i'�� wer of Attomey is muiia and executed pursuant to and by authority of the following resolution duly adopted by the Boazd of Directors of each of the above CNA Companies at a
tnce�h}� hcld on May 12, 19?75:
"RGS(]{.�'E'il Tha� :uiy Scuinr ��r Grr�u�, Virr Pre;�idcul nia}' �ti��liurixe an uFficrr 1u sir�n specific doc�nficn�n, abrucrosn�s �ind ius[nvncnts on heh:�ll uf the Companypru�-ided that the
izainc uFsuch authw�i�cil uflitrr an�! a�lc,enpliun u["llic J�,ciimtnts, a}rctments ur insu�iments that suchnifccr may si�,*n will Ev: pruviJ��l in writlng L+y Ilie Senior orGrot��+Vice President
tn tlx Sc�rci�ry n! che Cnmp�u�y pi:or [o surki rx:�uuun liecami�zg e[7eW ve:'
This !'nwer of Attomey is signed by Larry Kasten, Vice President, who has been authonzed pursuant to lhe above resolution to execute power of attomeys on behalf of each of the CNA
Compunirs.
This Po��u of Aunmey is si�nrd and se�ted �y facsimile under and by the authority ofthe following Resolution adopted by the Board of Directors of each of the above Companies by unanimous
written �•��nsent d�ted the 25' Jay nf AnnL ?f� l2:
"Wlhrea+, the bylaws of thc CnR�panp or specific resolution of the Boazd of Dicectors has authorized various officers (the "Authorized Officers') to execute various policies, bonds,
wx9cr�ikiugs and other obli�tury instrumenls of like nalure; and
Whrrcas, from time to time, the signaiurr nf t}u� AucEinnzed Officers, in addicinn ia being nrrn eded ia nn�iaal, hard mpy lormat, moy he pnnided via farsimile or othrnvise in an electronic
fiiriusi (collectively, `Electronic Signatures");'v��w ehrrefore be it resol��d ilut the Eiasmaic Si�n�itun of any Auchnrir.cd Otlir�r shall I+c valid:�nd binding on th: Cumpany."
This Pu«rr of Aunmry may be siuneci �y digital si�naiwc anJ sr,�[rd by a digital or oihcrx�se electronicfortnatted corporate seal under and bythe authority of the following Resolution adopted
by the 13nard o! Ilir�c�ors ofcacfi ��f"the above CN 4 C'uin�ianirc by unaoimous wntteii e�nseot dated the 27th day of Apnl, 2022:
"EiL•SUl.1'EU: That it is in the best in�trts[ of [he t�nat��any to 3vcri�i�fir�lly r,�tify and confirtn any corpora[e documenu signed by digital signa[ures and to ratify and confirtn [he use of a
di�it,t! ��r ulherwise electri.tni�-fortnattc�l c�,rpora[e scuk, �•,:ch to 1�r ���+ss�de�rd the act and deedofthe Company."
Torm F6853-2-2024