HomeMy WebLinkAboutContract 61002-FP3Page 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: The Grove 2
City Project No.: 104228
Improvement Type(s): Paving Drainage Street Lights Traffic Signals
Original Contract Price: $102,254.88
Amount of Approved Change Order(s): -$14,012.61
Revised Contract Amount:$88,242.27
Total Cost of Work Complete:$88,242.27
Contractor Date
Title
Independent Utility Construction, Inc.
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: The Grove 2
City Project No.: 104228
City’s Attachments
Final Pay Estimate
Change Order(s):Yes N/A
Contractor’s Attachments
Affidavit of Bills Paid
Consent of Surety
Statement of Contract Time
Contract Time 270 WD
Work Start Date: 8/19/2024
Days Charged: 93 WD
Work Complete Date: 1/29/2025
Completed number of Soil Lab Test: 92
Completed number of Water Test: 0
CITY OF FORT WORTH
Contract Name THE VILLAGE GROVE 2
Contract Limits
Project Type STREETLIGHTS
DOE Number 4228
Estimate Number 1 Payment Number 1 For Period Ending 1/29/2025
FINAL PAYMENT REQUEST
City Secretary Contract Number
93
WD
Contract Date
INDEPENDENT UTILITY CONSTRUCTION
NA
5109 SUN VALLEY DRIVE
FORT WORTH TX 76119
G.DEYON K. JACKSON
270WDContract Time
Days Charged to Date
CompleteContract is 100.00
Contractor
,
/Inspectors
Project Manager
City Project Numbers 104228
Tuesday, February 18, 2025 Page 1 of 4
Contract Name THE VILLAGE GROVE 2
Contract Limits
Project Type STREETLIGHTS
DOE Number 4228
Estimate Number 1
Payment Number 1
For Period Ending 1/29/2025
Project Funding
City Project Numbers 104228
UNIT V: STREET LIGHTING IMPROVEMENTS
Item
No.Description of Items Estimated
Quanity Unit Unit Cost Estimated
Total
Completed
Quanity
Completed
Total
1 2" CONDT PVC SCH 80, OPEN CUT (CO 3)321 LF $25.06 $8,044.26 321 $8,044.26
2 CONDUIT BOX, WASHINGTON (CO 3)5 EA $976.00 $4,880.00 5 $4,880.00
3 FURNISH/INSTALL 10' WASHINGTON
STANDARD LIGHT POLE & FIXTURE LED (CO 3)
5 EA $5,053.00 $25,265.00 5 $25,265.00
4 RDWAY ILLUM DOUNDATION TY 7 (CO 3)5 EA $2,681.00 $13,405.00 5 $13,405.00
5 TYPE 33 B ARM WOOD POLE ARM 6 EA $1,196.00 $7,176.00 6 $7,176.00
6 NO 6 INSULATED ELEC CONDR (CO 3)969 LF $2.98 $2,887.62 969 $2,887.62
7 FURNISH 4 TRIPLEX OH INSULATED ELEC
CONDR
345 LF $9.40 $3,243.00 345 $3,243.00
8 FURNISH/INSTALL 120-240V SINGLE PH.
METERED PED (CO 3)
1 EA $7,859.00 $7,859.00 1 $7,859.00
9 ADDITIONAL LABOR OVERHEAD DUE TO
REDUCED SIZE OF JOB (CO 3)
1 LS $15,482.39 $15,482.39 1 $15,482.39
$88,242.27 $88,242.27Sub-Total of Previous Unit
Tuesday, February 18, 2025 Page 2 of 4
Contract Name THE VILLAGE GROVE 2
Contract Limits
Project Type STREETLIGHTS
DOE Number 4228
Estimate Number 1
Payment Number 1
For Period Ending 1/29/2025
Project Funding
City Project Numbers 104228
Contract Information Summary
Change Orders
$102,254.88Original Contract Amount
$88,242.27Total Contract Price
$88,242.27
Less
Total Cost of Work Completed
% Retained $0.00
Net Earned $88,242.27
Plus Material on Hand Less 15%$0.00
Balance Due This Payment $88,242.27
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
$88,242.27
$0.00
3 ($14,012.61)Change Order Number
Tuesday, February 18, 2025 Page 3 of 4
Contract Name THE VILLAGE GROVE 2
Contract Limits
Project Type STREETLIGHTS
DOE Number 4228
Estimate Number 1
Payment Number 1
For Period Ending 1/29/2025
Project Funding
City Project Numbers 104228
Line Fund Account Center
Amount
Funded Gross Retainage Net
CITY OF FORT WORTH
SUMMARY OF CHARGES
$88,242.27
Less
Total Cost of Work Completed
% Retained $0.00
Net Earned $88,242.27
Plus Material on Hand Less 15%$0.00
Balance Due This Payment $88,242.27
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
$88,242.27
$0.00
City Secretary Contract Number
93
WD
Contract Date
INDEPENDENT UTILITY CONSTRUCTION
NA
5109 SUN VALLEY DRIVE
FORT WORTH TX 76119
G.DEYON K. JACKSON
270
WD
Contract Time
Days Charged to Date
CompleteContract is 100.000000
Contractor
,
/Inspectors
Project Manager
Tuesday, February 18, 2025 Page 4 of 4
a
N
O
N
�
�
3
Q
E
�
0
ro
R
e
�
E
0 0
W �
� 3
► a
� Q
CWC m
tL')
N
�
N
rn
M
ti
�
H
V
� }
i- Q
Z �
O
U
I N f„`. O 8 O p � <'+ I
I i � �' "�' S�' � ^ � �o
��' � �
�- `_ �
0
� W � ..� .. � �
W ao �o m
� � N O O � O � h
O
�
,`, � np $p S g �'
' � y� Yi N M
C7 � I C
I ? - - �
n:
O I ^I ? p o o a w� �
o �oop�s�
> rH � Yl M W �N N
m O
OU — . —. ..-.-. _ _�
I
�. � g � '�d � $ �: .
z � : ` � � � N� o �' a
7� f] � m - I M
U =,.�-• � o �
? �
Q � m �
zi a l� � � �I T� .A
� e�'° e v w v
O O ' �� I i �
Z Z t�j �$ v� a �
O O I �' � a .�S ,4. � �.�. � a
�
L t W U o 01
a a A M
��� � ol o� a 4 w w
C
f0
�
�
0
'0^
V
3
�
�
c
Q
�
W
Q
Z
0 �
~U
U w
W �
n- O
N �
za
_ ap F�+ g $p� � $I
._I W �# N M M �I
�
� � �;
af � � a
3 ti � � °'
� o � � g � o
$ m s�°� s M c�
z
w �
�
�
� �Z a � �
W V
� � � � N O
_ ¢ Z � N O
� F- O O w
rW- � o��F� a y�j W
� p O d Z y N K
O N� p o� � F
� F- � � W -� F
4Q p F� v_, a
X � O � w �
�
rn
d
O
N
O
�o
�
�
a
N
O
N
�
�
3
Q
E
�
N
O
M
N
C
W
�
0 O
W �
� 3
► a
� e
W Q
�C m
a
W
�
O
w
c�
z
�i
v
�
�
LL
Z
O
�Q
W
�
�
Z
O
Z
Q
N
O
v
a
�
�
O
W
O
ZQ
2
V
w
�
k
O
aa
0
�
�
O
LL
W
.J
m
N q�
Z �u
ao
N J
u�w
wo
�w
a�
oy
�m
�
o�
�'o
��
m
Jq
V q
�v
z u�
w�
o&
��
z F
N Z
a�
ZW
� �,
LL} a.
i- m
��
OW
2K
��
W
z
a o
J �
n W
Y
�
t� y
E
�' z
a
�
I E
m Z
`,`.,�
C
��
I �1
I�
K
U
3
� V
m
m E
z
ci
�
�
w
c
y
�
a
�
�
2
Wi
0
�
W
d'
a
W
U
>
ui
F�--
M
rn
m
d
0
N
N
O
v
ami
.�
�
. �
N
O
N
�i
N
G
�
Q
Q
u�i
�
�
R
�
R
� a
O
� O
� 3
�:I i
,a
c
W Q
�C m
f
w
c�
a
U
� I
N
i
�
N
I
� `
� I=- I' xk � � �k
� O� LL � 0 �
a_U1U U u._�
�
�
N
�
N
�
�
�
Z Z
C C
O
aa
�
�
�
C
Q
�
W
�
�OC
O�
UV
W W
a�
� �
�a
� � i I `� T j - -----
�s� i
' S �I' � � �I � m I
"� I 1 �
— . , T��
' � _ O 3i O _
1� . �. � I ? r. . �
_ ~ � I
�a
�j � �
� e
� � � o� g �� o� � w
� U o' M M m� -" O
"' '" a I
-- - • M
��
' ; � � �i �,
�,
IW _ �!i .��f n N. "li =�. I �
� ' I I �` � i
�;$�S�a$ o � '
o ��$���
' � � � �� �
__ � � �_..
� �
G 4I
F . -i - a o� o a �
z = � � : � - �' u
0
� � ,a � �' y4 �
U Z -t � r� o
I �
�p a � � . . i �gl ��' °� a � N
Z,p 6�� � o o� rd� '� � N
�' e o 0 0� Y►
V' � $ N� � �
I� �, � b �
i N
_. ._..._. _..�. _-
I E`
_ a! - . � �
� '' p7 .� O = O� I
,� N� M� wl N M' � � O
a' �
0., �.} �:
� € g �
�, m +
� ! � � � � �
� $ � � N N
n
S p �j N � N � ��
' O j � N y M
� v; 1
-, . � - o
� � ,� �� �• �� �r
t� � n
W 1j� �
'� II n A I��, A
V' ' � O � � � N �
� �� � �,� �. � �
IIGtI. N �_�~ � �L
—
a
�
LL
0
z
O
�¢
H
Z
�
� �
�
� � t�i 6'
��� °
O�
U �
o�
y
� O
��
�
f/1
O
�
�
t7
Zo
t�1
� .
O�
�
r
�
a
N
0
}�
�
14*15*16*17*18*
0
�
W
�
W
�
a
N
O
N
n
O
V
�
�
G
h
�
c
R
v
0
c�
m
a
¢
m
�
N
(O
(V
�
M
h
�
O O
Z Z
N N
s �
�a
C
(0
�
a
O
O
�
N
�
C
a
�
W
Q
Z
� a
� �
H ~
U U
W W
� �
� O
Z �
�
H
U
� Q � o o � o �
O
U
� �j g S o g � o���.
_ � � v�i w � w�i� ��i+ n
� N
J �
F N
W aO a0 � oD
W co wa � N ao
f d N � � N N �
fq a N � � N 0 N
0 0 o a
> N O VY Y} N� V pp
� p
0 V w w w� Op
N
i�ri
� � $ $o o 0 0
W �'. H ��is v� � �Qis w
C9 V o
2 0
� �
O O O N
Q � 0 O O p O � W
O p p O p O
O N C G y�j G �
j y N � w N � N
w w w
C�] U
F- v o"d a o 0 0 �
z M W H �� N N O � `
� '��j o �.
U Z � V e�n
�> � m
a o 0 o N �
Z y 'e o o�e �o w v
� o � o 0 0 0 �
d � � � N N
n ci
w w w w
V
o a o 0 0 0
�' w w w w w w � �
� U �
W 1�q M
3 N Q�
N � � � � W
Itl �O �
m W 1� � � Q N � fA
fl, a o
� � v' "' a 'n �
co �p
> N � Q
Q U � � w �
N p p
� O O O O O O
U
� w a�► w w u4► M
� U 1�.
W �
Q �
N
3 � � n �
� O O � � w y
Q � O O � � Q
� � W N � � V
O `.i K H W Vl Q
H
� Z
W Q F
❑
o � a � �
w ��
v a
a � � F ai o
H U F Z j f~/1 G
U F- V U K V N
W W p 0 � W
O 0 O O a Z N a VW�! WLL'
U O� F���j W Q
S�� �� o a' rc �O
Z�H� Z W J F
0 F � (n Q
� �- W Z O j �
O W U �U Q � ~
N
�
m
a
a
N
O
N
n
O
�
�
G
h
N
m
c
R
W °
� �
W �
� ¢
� m
N
C
N
�
�
U
O
�
U
m
c
d
.0
�
L
N
Y
f0
�
O
v
�
�
'O
N
c0
�
0
Y
�
w
0
a
0
llA
�
Z
Q
_
U
�
�
LL
N
Z
0
a
w
�
Z �
Z w
a o � O
N � LL V
O � �
o a
o � � �
� �p U
� _ Q �
O - = F-
W � V Z
Z 1p .a � O
S O �
d
W
? Q a m z �
F
U
�
z
0
�
�
x
�
Z
0
W
�
J
O
>
Z
G
2
7
LL
�
V
O
2
�
W
O
�
a
a
a
C
W
❑
W
�
�
O
V
�
w
Y
�
0. J
J W
Q
vi S
� ' U
o �
2
a� y
m E
> m z
�
Z
�
W
W
Z
�
Z
W �
W ' N
� � U
� }
}
g I �
ui
m E
m
z
ui
�
r
Z
W
�
N
W
2'
a
w
U
�
ui
�
�
�V
N
�
�
a
O
N
N
O
N
>
d
�
Q
N
O
N
R
N
`u
O
E
a
0
N
O
N
C
N
�
0 O
W °
� 3
W �
'a
c
W ¢
CC m
O O
Z Z
N N
O O
d �
d'
W
t�
Q
Z
�
H
U
W
�
a
�
v
�a � o a � o 0
zo
O
U
N
V S $ � gp g $
y � N M N N N M
2 U N
=� tV
J .�
F N
W � aD A n ao
�. V m � � p � �
r � Q N fV � fV
y 6� O O N p N
� � y � o�D � m
O
� y N H H �
� O
N
(j p p G O o 0
W M N M N q' N O
(� V O
a o
z �
� � �
� �
O O O O p �
� � N N � N �
N
>N O M N M
G U
� U � `�'8 � o $ � �
Z U
� h N N��ir .�► K o �
F C� V � �' d
V = o V o
� a o o e N �
�
O 1O o o� o� y
n
V � o 0 0 0 0
d � H M N N N
m O H N N
O U
m
�j � op! o p� Op Qu
� N� M M N M �'
V �p
W N f�D
3 0+ o�p
y ^'� � � v O�
eNp 1p �p
6 V Ap O � o Np y�
O n N ~ N ~ Q
Q
N O H N �y p
O U
v o o g� o� �
.�v w .�i� .tln r4i � M o
� �j r
W iFi
F. o 0
3 � �,� � M
oi o o a �� "i w
p �' o o °' U
d �+ M ~ � e�l e�l
i
oc°� N y'" " o
i
� �
w � U
❑
� W 4
°�d ¢
w � Q �
O �,
2
U
U W V a O� O W
r ot�s U N
W� o O Qd o W c >
� o o O a z(A a eWii z
J O � U �� W W �
a N � � z w � � �
Z � O I- � N �
� O
�
O W U �U � � ~
a'
N
O
N
V
N
V
0
�
Q
v
N
V
m
c
m
E
W o
�;
� v
�Q
GC m
s' ' 18 0l
� e�
� ��
N N N
S •. �J
� F
r O
m
M �(%%
W �
0 3 f
w
r
� �
= e
� � �
E �
0
�> — — [
~ O E
� � _ _ �
m �
S O �C N
m � � _
� �-
� W
$ �LL'
o O
5 w
Y � � �
LL
Hg
o_ 5 n � s
� F � u
$� ' �
N
o �y
�
_
Q
Q
f
w
0
u
�
W
C
C
O
W
O
2
Q
S
u
W
�
�
x
0
0
�
a
0
LL
W
J
m
� d
Z W
go'
� W
Y! O
� W
W S
a�
oy
W m
� S
C C9
u�
� W
m
u°�
N Y
F
� U
2 =
C N
� �
2 H
y W
O .�
� W
LL �
� �u
z�
C
W
�
Q
W
O
W
�
�
0
w
�
�
1
Y
O
J
W
Q
_
�
E
' m
m Z
i
� r
¢
� U
C a
I"
0
m �
Z
�
2
a
H
i
F
Z
O
N
w
�
a
�
F
N
a
i
a
0
N
H
O
n
m
r
�
O
�
_
E
0 °
��
3
W :
��
W Q
CC m
O O
Z Z
N N
C C
O O
� t
aa
�
W
(�
Q
Z
Q
�
F
U
W
�
�
a
H
U
N
r Q � o o� o�
Z O
O
U
h
0 0 0 0 0 0 0
V o 0 0 0 0 0
N i' w w w w w w
= U
(7
J �
H N
W m '
� (j � �O N N �
O ' O '
O O
f/% O. N O N O N
o w a m � m
; o
� w o
0 0
0
�
�
0 0 0 0 0 0 0
V o 0 0 0 0 0
W i' w w w w w w
(7 V o
z
a
� o 0 0
o�o 0 0 0 0 0
a o 0 0 0 0 0
o N o o N o �
N � � N � N
� O eA eA eA
❑ U
~ U o 0 0 0 0 0 �
Z �
� i' w w w w w V
o,
U� U m « te
Z �
CC � r'- U �"
a
� � o o � N � �
d
U o 0 0 0
o r"
> w a m
v o �»
0 U
0 0 0 0 0 0 0
U o 0 0 0 0 0
� o 0 0 0 0 0
w w w w w.n � m
� U � �
w
� a
N �y V V V N
N tD �
y O � O � tA �q
6 � O N O N
O 1� � N 0 N
t") � � �
j ul T V
G� O � �
0 U
O o 0 0 0 0 0
U o 0 0 0 0 0
T O O O O O O
H t9 t9 eR eR H 0
� U r
W a
Q o
3 g �
N �
y °' 'h o N o N 'A vi
a m '� o � o 0
o - � � � � U
v .. ' i
a�i o d
0 U � �
H
� Z
W �
p O H
O F a Wa' aa'
w
� v a �
o a
x z
a ��� � �
V w U� O� O W
Q w Q a Q U K U Vl
� w Q 0 � K 0 W 0 >
0 0 o O a z N a vWi �
J O O U � p� � �
Z Q H � Z W J �
0 H � fn Q
�= � W Z O > 0
O W U �U a � ~
_
E
E
0 �
��
;
� Q
� m
�
�
�
�
_
�
_
�.i
�
yLL
Z
�
h
�
W
C
O
2
Z
Q
O
U
�
O
�Q
2
u
�
�
O
�
8
�
LL
WJ
m
� �W
1
go
��
h�
KW
d �
O�
�m
W =
00
F�
F y
W
m
ZJ
J
V �
N
� U
2 W
�O
z"
z
� W
Z �
� W
LLy �
F �
U �
OW
z¢
•� \
��
`��` �
� �m
�
1
�
�
m
v
"�
�
I
T
m
�
U
O
U
�
_
W
O
y
W
K
a
F
2
W
O
�
�
a
m
11'
f
m
�
a
�
N
d
0
�
S
0
K
Rev. 08/20/19
TRANSPORTATION AND PUBLIC WORKS
February 13, 2025
Independent Utility Construction,Inc.
5109 Sun Valley Drive
Fort Worth TX 76119
RE: Acceptance Letter
Project Name: The Grove 2
Project Type: Street Lights
City Project No.: 104228
To Whom It May Concern:
On February 13, 2025 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 February 13,
2025, 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
Senior Professional Engineer, Office: 817-392-7830
Izeldeen.Ahmed@fortworthtexas.gov .
Sincerely,
Izeldeen Ahmed, Project Manager
Cc: Kevin Jackson, Inspector
Gary Deyon, Inspection Supervisor
Lorrie Pitts, Senior Inspector
Andrew Goodman, Program Manager
Clay Moore Engineering, Consultant
Independent Utility Construction,Inc., Contractor
Village Homes, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
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 RICHARD
WOLFE, PRESIDENT Of 1NDEPENDENT UTILITY
CONSTRUCTION, INC., 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;
The Grove 2- City Project No. 104228 �
BY ."�Z
Ric ard Wolfe, President
Subscribed and sworn before me or� this date 19th of December, 2024.
'J- ;1.
� ����i:��-'� � �' � ��,f � ��% �
� , �.
Notary Public
Tarrant County, State of
Texas
,""""�� CHRISTINA GARCIA
=Z�`.�YpU��; Notary Public, State of Texas
?m,:�.'�, Comm. Expires 12-20-2028
�'%'F��`�.` Notar ID 1309407E5
��nm�� Y
CONSENT OF OWNER ❑
SURETY COMPANY ONTRACTOR �
TO FINAL PAYMENT su�ETY ❑
OTHER
(SIMILAR TO AIA DOCUMENT G707)
Bond No. 377557T
PROJECT: Street Lighting Improveinents to serve The Grove 2
(name, address) Fort Worth, TX
TO (Owner)
�
�
CONTRACTOR:
City of Fort Worth
100 Fort Worth Trail
Fort Worth, TX 76102
Independent Utility Construction, Inc.
ARCHITECT'S PROJECT NO:
� CONTRACT FOR:
� CONTRACT DATE:
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)
Westfield Insurance Company
955 Garden Park Drive, Suite 230 , SURETY COMPANY,
Allen, TX 75013
on bOnd Of (here insert name and address of Contractor)
Independent Utility Construction, Inc.
5109 Sun Valley Drive
Fort Worth, TX 76119
,CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that the fmal payment to the Contractor shall not relieve the
Surety Company of any of its obligations to (here insert name and address oFowner)
City of Fort Worth
100 Fort Worth Trail , OWNER,
Fort Worth, TX 76102
as set forth in the said Surety Company's bond.
IN WI1'NESS WHEREOF,
The Surety Company has hereunto set its hand this
Attest:
19th day of December , 2024
WESTFIELD IN 'URANCE COMPANY
Surety Company
By 8 ,.�
�
Signature of Authorized Representati
(Seal): Kyle W. Sweeney Attorney—in—Fact
Title
��.� �
Note: This form is intended !o be used as a compar.'rcn d�:.ument to the Contractor s Affidavit of Payment of Debts and Claims, Cunent Edition
THIS POWER OF ATTORNEY SUPERCEDES ANY PREVIOUS POWER BEARING THIS SAME
POWER # AND ISSUED PRIOR TO 09128/23, FOR ANY PERSON OR PERSONS NAMED BELOW.
POWER NO. 4220052 06
General
Power Westfield Insurance Co.
of Attorney Westfield National Insurance Co.
CERTIFIED COPY
Ohio Farmers Insurance Co.
Westfield Center, Ohio
Know All Men by These Presents, That WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO
FARMERS INSURANCE COMPANY, corporations, hereinafter referred to individually as a"Company" and collectively as "Companies," duly
organized and existing under the laws cf the State of Ohio, and having its principal office in Westfield Center, Medina County, Ohio, do by these
presents make, constitute and appoint
CHARLES D. SWEENEY, MICHAEL A. SWEENEY, KYLE W. SWEENEY, ELIZABETH GRAY, DAVID W. SWEENEY, JOINTLY OR
SEVERALLY
of FORT WORTH and State of TX its true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred in its name,
place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings, or other instruments or contracts of
suretyship in any penal limit. - - - - - - - - - - - - - - • - - - - - - - - - - - - • - • - - - - - - - - - - - - - - - - - - - - - - - •
LIMITATION: THIS POWER OF ATTORNEY CANNOT BE USED TO EXECUTE NOTE GUARANTEE, MORTGAGE DEFICIENCY, MORTGAGE
GUARANTEE, OR BANK DEPOSITORY BONDS.
and to bind any of the Companies thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate
seal of the applicable Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in
the premises. Said appointment is made under and by authority of the following resolution adopted by the Board of Directors of each of the
WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY:
"Be It Reso/ved, that the President, any Senior Executive, any Secretary or any Fidelity & Surety Operations Executive or other Executive shall
be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for
and on behalf of the Company subject to the following provisions:
The Attorney-in-Fact. may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements of indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney-in-Fact shall be as binding upon the Company as if signed by the President and sealed and attested by the Corporate Secretary."
"Be it Further Resolved, that the signature of any such designated person and the seal of the Company heretofore or hereafter affixed to any
power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signatures or facsimile
seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." (Each adopted at a meeting
held on February 8, 2000).
In Witness Whereof, WESTFIELD INSURANCE COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE
COMPANY have caused these presents to be signed by their National Surety Leader and Senior Executive and their corporate seals to be hereto
affixed this 28th day of SEPTEMBER A.D., 2023 .
M������NlN��� ��� WESTFIELD INSURANCE COMPANY
Corporate p' "•.. ..`��pNA "• ••
Seals ��1Sufl.(yC ,,.�P��,.. �./,tis;•. , ��i1SU�%;�.,, �/�/ESTFIELD NATIONAL INSURANCE COMPANY
Affixed �� '���'• t►`';� ' �• '�'S��' ?'�� .4•���'C�''�" OHIO FARMERS INSURANCE COMPANY
.
. .
:
.•:
;
.
x •� -
� �' ��.i�.�r``b� � LL:. SEAI, '.v�-= '�'•C�ARIFIPfO•:�� �
,�"e1 :�n; ;m_ =_e�►: :a= � _ __.
��i., � ..'��' ,7•. ;'a= ;�:, 184� :�: � ��-���"
., ��~' ......+' Yj?� � '•,* ... �a
'w., ,�' • "
�m�� ,�, *n.����``.•` %.,.�niruu��.,••''� . ..,
State of Ohio
County of Medina ss.: ByGary W. tumper, Nationa Surety Leader and
Senror Executive
On this 2Bth day of SEPTEMBER A.D., 2023 , before me personally came Gary W. Stumper to me known, who, being by me duly sworn,
did depose and say, that he resides in Medina, OH; that he is National Surety Leader and Senior Executive of WESTFIELD INSURANCE
COMPANY, WESTFIELD NATIONAL INSURANCE COMPANY and OHIO FARMERS INSURANCE COMPANY, the companies described in and which
executed the above instrument; that he knows the seals of said Companies; that the seals affixed to said instrument are such corporate seals; that
they were so affixed by order of the Boards of Directors of said Companies; and that he signed his name thereto by like order.
Nota ri a l ,,..�•�������.�,,,, �
Seal .••`����\ A L S;'•.
Affixed O `��11���� q%Z
z: �; A �` f
State of Ohio :; � ��� p David A. Kotnik, Attorney at Law, Notary Public
County of Medina ss.: ;; q • S.- My Commission Does Not Expire (Sec. 147.03 Ohio Revised Code)
TEOF�•
I, Frank A. Carrino, Secretary of WESTFIELD INSURANCE COMPANY, WESTF.!ELD NATIONAL INSURANCE COMPANY and OHIO FARMERS
INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said
Companies, which is still in full force and effect; and furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are
in full force and effect.
In Witness Whereof, I have hereunto set n�y hand and affixed the seals of said Companies at Westfield Center, Ohio, this 19th day of
December A.D.,2024 .
.MN��II�YbIf��� � � -
�w ����nNAt_�I
,,r�;��uA.(,,c�,, ,.� P �' iti;s�; ,
, a. ,
�.� � ,.s, '''+. �� ' o • .'.p'.
M • •�A�+tA'�A i R � _ �• • > r • � Y .
�Z �
+n� ; N; Sk.;��,� ;�`:
�'�,`"• .�,,,�, ,�'� . , •:�
`'�.�4.�n�n�N"'� ,��; `,�,�
��.RTE,;F���� ���,�,�j '
- ia a �f ''� ^" � %� Seoretary
;: i���� :::
4�' ,.,. '��,= Frank A. Carrino, Secretary
BPOAC2 (combined) (03-22)