HomeMy WebLinkAboutContract 60820-FP1-FPlCity Secretary 60820 Contract No. _____ _
fORTWORTH® Date Received 212312025
02/28/2025
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: HAPT at Hunter Crossroads
City Project No.: 105027
Improvement Type(s): Water� Sewer�
Original Contract Price: $74,485.00
Amount of Approved Change Order(s): $5,850.00
Revised Contract Amount: $80,335.00
Total Cost of Work Complete: $80,335.00
.flc;y iiaye;b 2i, 25 15:37 CST) Feb 21, 2025
Contractor Date Vice President of Operation
Title
Embrey Builders LLC
Company Name
Feb 21, 2025
Date
Project Manager Date
Kand�Feb 23, 202518:05 CST) Feb 23, 2025
CFA Manager Date
t?f_,7~:.-_
Lauren Prieur (Feb 23, 202518:09 CST) Feb 23, 2025
TPW Director Date
Feb 23, 2025
Asst. City Manager Date
Page 1 of 2
Notice of Project Completion
Project Name: HAPT at Hunter Crossroads
City Project No.: 105027
City's Attachments
Final Pay Estimate 0
Change Order(s): 0 Yes ❑ N/A
Pipe Report: 0 Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid �
Consent of Surety �
Statement of Contract Time
Contract Time: 60 WD
Days Charged: 116 WD
Work Start Date: 5/08/2024 Work Complete Date: 12/5/2024
Completed number of Soil Lab Test: 32
Completed number of Water Test: 6
Page 2 of 2
FORTWORTH
CITY OF FORT WORTH
F1NAL PAYMENT REQUEST
Contract Name HAPT AT HLTNTER CROSSROADS (W/WW TAPS)
Contract Limits
Project Type WATER & SEWF,R
City Project Numbers 105027
DOE Number 5027
Estimate Number 1 Payment Number 1
City Secretary Contract Number
Contract Date
For Period Ending 12/5/2024
WD
Project Manager NA
Contractor EMBREY BUILDERS, LLC
1020 NE LOOOP 410, SUITE 700
SAN ANTONIO , TX 78209
Inspectors A. DUARTE / H. TAEZAZ
Contract Time 4�JD
Days Charged to Date 116
Contract is 100.00 Complete
Wednesday, February 19, 2025 Page 1 of 4
City Project Numbers 105027
Contract Name HAPT AT HUNTER CROSSROADS (W/WW TAPS)
Contract Limits
Project Type WATER & SEWER
Project F+unding
DOE Number 5027
Estimate Number 1
Payment Number 1
For Period Ending 12/5/2024
L?NTI' I: WATER IMPROVEMENTS
Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed
No. Quanity Total Quanity Total
1 8" WATERPIPE 34 LF $55.00 $1,870.00 34 $1,870.00
2 6" GATE VALVE 1 EA $1,800.00 $1,800.00 1 $1,800.00
3 8" GATE VALVE 2 EA $2,100.00 $4,200.00 2 $4,200.00
4 12" CUT - IN GATE VALVE 1 EA $3,100.00 $3,100.00 1 $3,100.00
5 1.5" WATER METER & SERVICE 2 EA $3,200.00 $6,400.00 2 $6,400.00
6 3" WATER METER AND VAULT 1 EA $24,500.00 $24,500.00 1 $24,500.00
6 TRENCH SAFTEY 34 TN $10.00 $340.00 34 $340.00
7 DUCTILE IRON WATER FITTINGS W/ 0.5 EA $6,200.00 $3,100.00 0.5 $3,100.00
RESTRAINT
8 CONNECTION TO EXISTING 12" WATER MAIN 2 $3,500.00 $7,000.00 2 $7,000.00
Sub-Total of Previous Unit $52,310.00 $52,310.00
L?NTI' II: SANTTARY IMPROVEMENTS
Item Description of Items
No.
1 4" SEWER PIPE
2 6" SEWER PIPE
3 CONCRETE COLLAR
4 4' DROP MANHOLE
� EPDXY MANHOLE LINER
6 TRENCH WATER STOPS
7 MANHOLE VACUUM TESTING
8 TRENCHSAFETY
9 4"-12" PRESSURE PLUG
10 12" PVC WATER PIPE, CSS BACKFILL
11 CONCRETE ENCASEMENT FOR UTLITY PIPES
(CO# 3)
Estimated Unit Unit Cost Estimated Completed Completed
Quanity Total Quanity Total
9 LF $40.00 $360.00 9 $360.00
22 LF $45.00 $990.00 22 $990.00
1 EA $615.00 $615.00 1 $615.00
1 EA $7,600.00 $7,600.00 1 $7,600.00
12 VF $275.00 $3,300.00 12 $3,300.00
1 EA $375.00 $375.00 1 $375.00
1 EA $325.00 $325.00 1 $325.00
31 LF $10.00 $310.00 31 $310.00
2 EA $3,500.00 $7,000.00 2 $7,000.00
20 LF $65.00 $1,300.00 20 $1,300.00
4.� CY $1,300.00 $5,850.00 4.5 $5,850.00
Sub-Total of Previous Unit $28,025.00 $28,025.00
Wednesday, February 19, 2025 Page 2 of 4
City Project Numbers 105027
Contract Name HAPT AT HUNTER CROSSROADS (W/WW TAPS)
Contract Limits
Project Type WATER & SEWER
Project F+unding
Contract Information Summary
Original Contract Amount
Change Orders
Change Order Number 1
Change Order Number 3
Change Order Number 2
Total Contract Price
DOE Number 5027
Estimate Number 1
Payment Number 1
For Period Ending 12/5/2024
$74,485.00
�o.00
$5,850.00
$0.00
$80,335.00
Total Cost of Work Completed $80,335.00
Less % Retained $0.00
Net Earned $80,335.00
Earned This Period $80,335.00
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
$80,33�.00
Wednesday, February 19, 2025 Page 3 of 4
City Project Numbers 105027
Contract Name HAPT AT HUNTER CROSSROADS (W/WW TAPS)
Contract Limits
Project Type WATER & SEWER
Project F+unding
Project Manager NA
Inspectors A. DUARTE / H. TAF,7.AZ
Contractor EMBREY BUILDERS, LLC
1020 NE LOOOP 410, SUITE 700
SAN ANTONIO , TX 78209
DOE Number 5027
Estimate Number 1
Payment Number 1
For Period Ending 12/5/2024
City Secretary Contract Number
Contract Date
Contract Time 45 WD
Days Charged to Date 116 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
Less % Retained
Net Earned
Earned This Period $80,335.00
Retainage This Period $0.00
Less Liquidated Damages
� Days @ $0.00 / Day
LessPavement Deficiency
Less Penalty
Less Previous Payment
Plus Material on Hand Less 15%
Balance Due This Payment
$80,335.00
$0.00
$80,335.00
$0.00
$0.00
$0.00
$0.00
$0.00
$80,335.00
Wednesday, February 19, 2025 Page 4 of 4
REVIEWED
By George Marqeuez, P.E. at 4:45 pm, May 24, 2024
DEVELOPER-AWARDED-PROJECT CHANGE ORDER
INSPECTOR: Habte Taezaz Phone No: (817) 392-8306
PROJECT MANAGER: George Marquez Phone No: (817) 392-6826
CONTRACT UNIT
WATER SEWER PAVING DRAINAGE STREET LIGHTS CONTRACT
Developer Developer Developer Developer Developer DAYS
Cost City Cost Cost Ci Cost Cost City Cost Cost City Cost Cost City Cost
ORIGINAL CONTRACT $52,310.00 $0.00 $22,175.00 $0.00 $0.00 $0.00 50.00 $0.00 $43,400.00 $0.00 60
EXTRAS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 0
CREDITS TO DATE $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 0
CONTRACTTODATE $52,310.00 $0.00 $22,175.00 $0.00 $0.00 $0.00 50.00 $0.00 $43,400.00 $0.00 60
AMOUNT OF PROP. CHANGE ORDER $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 0
REVISED CONTRACT AMOUNT $52,310.00 $0.00 $22,175.00 $0.00 $0.00 $0.00 50.00 $0.00 $43,400.00 $0.00 60
TOTAL REVISED CONTRACT AMOUNT
PER UNIT $52,310.00 $22,175.00 $0.00 $0.00 $43,400.00
REVISED COST SHARE Dev. Cost: $117,885.00 City Cost: $0.00
TOTAL REVISED CONTRACT $117,885.00
Revised: 10.12-2011 Page 1
You are directed to make the followin chan es in the contract documents:
CITY BID ITEM
PAY ITEM # # QUANTITY UNIT ITEM DESCRIPTION UNIT PRICE TOTAL
SUBTOTAL UNIT I: WATER
REASONS FOR CHANGE ORDER Water shutoll crew and rnspector advised against shutting aff water service as it would have IeR multipfe 6usinesses wifhout water. 7apping sleeve B valves wil!
allow servrce ta cantinue.
NO CITY FUNDS INVOLVED IN THIS CONTRACT. DEVELOPER IS RESPONSIBLE FOR 100'/. OF THE CHANGE OROER COST AND NO
REIMBURSEMENT FROM THE CITY WILL BE SOUGNT BY TFIE DEVELOPER.
RECOMMENDED: APPROVED: APPROVED:
KFM Engineering 8 Desiga Avondale FYYTX BTR, LP Emb Buflders
By: ��� � By: �� C/� By:
Name: Samuel Snvder Name: V✓i aw Y! �It N S
Title: Engineer-In-Traininq Trtle: _VrfE FY85io�Cu.T o3' �vE�l/M�` TiUe: _ C�� �O/1�
Revised:10-12-2011 Page 2
REVIEWED
By George Marqeuez, P.E. at 4:48 pm, Oct 03, 2024
DEVELOPER-AWARDED-PROJECT CHANGE ORDER
PROJECT NAME: HAPT HUNTER CROSSROADS TAPS CHANGE
CONTRACT: PUBLIC WATER, WASTEWATER, & STREET LIGHT ORDER No:
CFA# 23-0143 CITYPARTICIPATION: NO
CITY PROJECT # 105027
CITY SECRETARY CONTRACT # N/A 2
FID # 30114-0200431-105027-E07685
SEWERPROJECT# N/A
FILE # K-3200 X-27949
INSPECTOR: Sani Angeles Phone No: (214) 710-9200
PROJECT MANAGER: G20fg2 MafqU2Z Phone No: (S17) 392-6826
CONTRACT UNIT
WATER SEWER DRAINAGE PAVING STREETLIGHTS CONTRACT
Developer Developer Developer Developer Oeveloper DAYS
Cos[ City Cost Cost Cit Cost Cost Cky Cost Cost Cky Cos[ Cost City Cost
ORIGINAL CONTRACT $52,310.00 $0.00 $22,175.00 $0.00 $0.00 $0.00 $0.00 $0.00 $43,400.00 $0.00 60
EXTRAS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0
CREDITS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0
CONTRACTTODATE $52,310.00 $0.00 $TT,175.00 $0.00 $0.00 $0.00 $0.00 $0.00 $45,400.00 $0.00 60
AMOUNT OF PROP. CHANGE ORDER $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $ (43,400.00) $0.00 0
REVISEDCONTRACTAMOUNT $52,310.00 $0.00 $22,175.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 60
TOTAL REVISED CONTRACT AMOUNT PER
UNIT $52,310.00 $TT,175.00 $0.00 $0.00 $0.00
REVISED COST SHARE DBV. COSt: $74,485.00 Clty COSt: $0.00
TOTAL REVISED CONTRACT $74,485.00
Revised: 12-17-2018 Page 1
UNIT V: STREET LIGHTING IMPROVEMENTS
RECOMMENDED: APPROVED: APPROVED:
KFM Engine�ering 8 Design Avondale FWf%BTR, LP Embrey BuiWara
BY- s�'irU(/�� BY-.— �'�"R� BY - 1
ruame: SAMUELSNYDER Name: lo�rl �__ Name: �
ree: ENGINEER-IN-TFiAINING Tee: i��:tt�r_esic(�.�'_o�DW�tirA••!a�- rne: � + �i4"r'��--tia�
APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY:
CFW - Sponsoring Deperfmant CFW - Asslslanu' Gty Managar CFW -Asslstant CIty AMomey
By. NIA By. NIA By. MIA
Name: Name: Name.
Tide: Tide: Tlfe�
RECOMMENDED-
CFW -'Contrad Complianoa Manager ATTEST ' ConVact Complianca Manager (ProJoct Manager):
By signing I adcnowledge thai I am the person responsible
By. � u'� tor the monitonng and adminisUation ot ihis contract, indude
NfA ensuring afl perfamance and repor6ng requiremenLs.
Name: George Marquez, P.E. JannetteS.Goodall
City Secrefary �There are NO City Funds associated wiM dus Contrad
Title: CFW - Prolect Manaper
;JThere are City Funds assodated with fhis CoMrad
M&C Number.
M&CDateApproved: N/A
Revised: 12-17-2018 Page 2
REASONS FOR CHANGE ORDER We cannot proceed with the installation of the street lights due to multiple conflicts on the power poles. City staff has confirmed that we need to remove this
scope fmm this project.
DEVELOPER-AWARDED-PROJECT CHANGE ORDER
PROJECT NAME: HAPT HUNTER CROSSROADS TAPS CHANGE
CONTRACT: PUBLIC WATER, WASTEWATER, & STREET LIGHT ORDER No:
CFA# 23-0143 CITYPARTICIPATION: NO
CITY PROJECT # 105027
CITY SECRETARY CONTRACT # 60852 3
FID # 30114-0200431-105027-E07685
X # X-27949
FILE # K-3200
INSPECTOR: Sani Angeles Phone No: (214) 710-9200
PROJECT MANAGER: GeOfge M8fqU2Z Phone No: (S17) 392-6826
CONTRACT UNIT
WATER SEWER DRAINAGE PAVING STREETLIGHTS CONTRACT
Developer Developer Developer Developer Developer DAYS
Cos[ Cky Cost Cost City Cost Cost Cky Cost Cost Cky Cost Cost City Cost
ORIGINAL CONTRACT $52,310.00 $0.00 $22,175.00 $0.00 $0.00 $0.00 $0.00 $0.00 $45,400.00 $0.00 60
EXTRAS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0
CREDITS TO DATE $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $43,400.00 $0.00 0
CONTRACTTODATE $52,310.00 $0.00 $22,175.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 60
AMOUNT OF PROP. CHANGE ORDER $0.00 $0.00 $ 5,850.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0
REVISEDCONTRACTAMOUNT $52,310.00 $0.00 $28,025.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 60
TOTAL REVISED CONTRACT AMOUNT PER
UNIT $52,310.00 $28,025.00 $0.00 $0.00 $0.00
REVISED COST SHARE DBV. COSt: $80,335.00 Clty COSt: $0.00
TOTAL REVISED CONTRACT $80,335.00
REVIEWED
By TiwariR at 1:05 pm, Feb 13, 2025
Revised: 12-17-2018 Page 1
UNIT II: SANITARY SEWER IMPROVEMENTS
Note:
REASONS FOR CHANGE ORDER
By:
Name:
Title:
CIN BID ITEM
SUBTOTAL UNR II: SANITARY SEWER IMPROVEMENTS �$ 5,8
* indicate new item
Concrete Encasement was left out of the original contract, despite being included in the onginal plans. This CO addresses errors related to contract amount.
RECOMMENDED: APPROVED: MPROVED:
KfM Enpin�rinp d Dasqn AwndaN FNRX BTR, LP EmM�y BuN4�ey _
' �r�Oi
gy ,SL;���� By. � �� By ���Fa� —�---.—.�
Name SAMUELSNYDER Name: ri� �f^3,. Namo: �� ���
ras: N IN R-IN•TRAINING Tme: ' v nne: �. r�l�� ��.�7
APPROVAL RECOMMENDED:
CFW - Sponsoring Department
APPROVED:
CFW - Assistant Ciry Manager
By: N
Name:
Title:
APPROVED AS TO FORM AND LEGALITY:
CFW - Assistant City Attorney
By: NIA
Name:
Title:
RECOMMENDED:
CFW-'ContractComplianceManager ATTEST
By:
Name:
Title:
Jannette S. Goodall
City Secretary
M&C Number: NIA
M&C Date Approved: NIA
* Contrad Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contrad, include
_ ensuring all pertormance and reporting requirements.
0 There are NO City Funds associated with this Contract
❑ There are City Funds associated with this Contract
REVIEWED
By TiwariR at 1:06 pm, Feb 13, 2025
Revised: 12-17-2018 Page 2
FoRTWoRTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: HAPT at Hunter Crossroads
CITY PROJECT NUMBER: 105027
WATER
PIPE LAID SIZE TYPE OF PIPE LF
8" PVC 34
FIRE HYDRANTS:
PIPE ABANDONED
DENSITIES:
NEW SERVICES:
VALVES (16" OR LARGER)
SIZE TYPE OF PIPE LF
1.5°(2) COPPER
3 " DIP
SEWER
PIPE LAID SIZE TYPE OF PiPE LF
4" SDR26 PVC 9
6" SDR26 PVC 22
12" SDR26 PVC 20
PIPE ABANDONED
SIZE TYPE OF PIPE
LF
DENSITIES:
NEW SERVICES:
TR�NSPORT:�TION 1�ND PUBLIC `��ORI�S
The Citt� of Fort Worth • 1000 Throckmorton Stieet • Fort Wordi, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
��������x�
TRANSPORTATION AND PUBLIC WORKS
January 10, 2025
Embrey Builders, LLC
7600 Broadway Street, Suite 300
San Antonio TX 78209
RE: Acceptance Letter
Project Name: HAPT Hunter Cross Road
Project Type: 01, 02
City Project No.: 105027
To Whom It May Concern:
On December 3, 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 December 5, 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 December 5, 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-
392-6251.
Sincerely,
GGn,O�?tt� �o�`�'
Andrew Goodman, Project Manager
Cc: Sani Angeles, Inspector
Troy Gardner, Inspection Supervisor
Ariel Duarte, Senior Inspector
Andrew Goodman, Program Manager
KFM Engineering L.L.C, Consultant
Embrey Builders L.L.C, Contractor
Embrey Partners Inc., Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
AFFIDAVIT
STATE OF TEXAS
COUNTY OF ��
Before me, the undersigned authority, a notary public in the sate and
county aforesaid, on this day personally appeared Mr. Drew Davis, Owner of
Davis Excavation, Inc, known to me to be a credible person, who being by my
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;
Avandale FWTX BTR, LP
;
,
, BY �. �� _ -..-�,�-
� ��,
Name orTitle
Subscribed and sworn before me on this date �ap 1��� �r� !�, ��5
(� .�� ������
Notary Public
County of �G I� 9+'o , Texas
s�`Y °`�.� VENITAROBERTSON
; � _.......c -
m: *' My Notary ID # 132817889
�'•'-'E� •`•'� Expires December 9, 2028
[SEAL]
i
GO�VS�NT !�F SURETY fl1�`�"R� °
TO F1NAL R�,YIIAENT �rc.���rrcr �
ca�r��c�n� o
.�41�uxrce�at G7f�7 SttR��' �1
C�TH�.1Z p
'�Q QiX�%i�R:
r��,e���a�,t
A�ZCHi'i�+C"�"S 1'�tL�,��CT ?�C?.:
City of Fort Worth
1000 Throckmorton Street
Fort Worth, TX 76102
k�ItC?,jEt: !':
(Ntttne artri uAr�m'�J
Community Facilities Agreement CFA Number CFA23-0143
CQ�T'T�tAG'�FC)R Community Facilities Agreement CFA
Number CFA23-0143
OQNT1iE�.£:T DA'1"EU:
In �ccoxda�ce wi�h rkse provisians caf the Contract i�etv��een �lte Ovaaner and ti�e Cs�rctract�x as Fsiciic:atrcl aiyt�ve, t�e
f{mmrttta�i:ras�d acddr�.sraJs7�r�ty3
Ascot Surety & Casualty Company
19800 MacArthur Blvd., Ste. 1250
Irvine, CA 92612
an l�[snd of
{lacerr rtameanr��ddrrs� qj'Coruradur)
, SUPF'�Y,
Embrey Builders, LLC
7600 Broadway
San Antonio, TX 78209
, co�cxo�,
hereby app�roves of ih� flna3 payment �a rhe Cantrac�czar, ant� agrees thx� fln�! �ayment to rhe Cc�ntract�r sl�al! nc�t r�l��ve the Surery of
anp of 9zs obligaclons ta
(bi.+�rr riunreund udilre,cc o,j'Orrnerj
City of Fort Worth
1000 Throckmorton Street
Fort Worth, TX 76102
as sec €'ca�b in said SurEey's txanci.
I2+t i�.viT'hi�,.55'1�REOF, the Surety S�ss hereuntc� set its hand tgr► this d�ce: J a n u a ry 21, 2025
(f�uert fi� �c�t�iHi�lbr �xontG jdk�ur� ir� tFie rrrun¢ric dsteund ir.�ttr,i
AifCSC:
{5e�1�:
, ocv�R,
Ascot Suret r�& Casualt�Compan�
{s��rt
I rr� ojuurba,Y rs�nrarn+�1
Jennifer Ochs, Attorney-in-Fact _
t!'e9]uar! ��a�l+e urrtl�itlrJ
C�%i}7�-193+�
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
state of California �
county of Los Angeles �
on I 2) 2U2 before me, Marina Tapia, Notary Public
ate Here Insert Name and Title of the Officer
Personally appeared �ennlf8l" �ChS
Name(s) of Signer(sJ
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to
the within instrument and acknowledged to me that he/she/they executed the same in his/her/theirauthorized
capacity(ies), and that by his/her/their signatu re(s) on the instrumentthe person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
��
,,�� aF r�, MARINA TAPIA
`'� �+��� ` Notary Public - California =
r~ ��'�
$ W m Los Angeles County >
� r ` *° Commission � 2500058
C�(IFOFaP My Comm. Expires Oct 7, 2028
Place Notary Seal Above
I certify under PENALTY OF PERJURY under the laws of the
State of California that the foregoing paragraph is true
and correct.
WITNESS my hand and official seal.
� ��`���;
Signature ���zyc.c� G
Signature of Notary Public
----------------------------------------------------
OPTIONAL----------------------------------------------------
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title orType of Document
Number of Pages
Capacity(ies) Claimed by Signer(s)
Signer's Name
Q Corporate Officer—Title(s)
i Partner Q Limited Q General
Q Individual [� Attorney in Fact
; Trustee [� Guardian or Conservator
� Other
Document Date
Signer(s) OtherThan Named Above
Signer's Name
Q Corporate Officer—Title(s)
Q Partner Q Limited OGeneral
Q Individual Q Attorney in Fact
QTrustee Q Guardian orConservator
0 Other
Signer Is Representing Signer Is Representing
�,.. r--a,
ascot
Ascot surety t� �asuairy �ompany
Ascot Insurance Company
55 W 46"' Street, 26th Floor
New York, NY 10036
Power of Attorney
KNOW ALL MEN BY THE PRESENTS:
That Ascot Surety & Casualty Company and Ascot Insurance Company, each a corporation organized and existing under the laws of the State
of Colorado (the "Companies"), do hereby constitute and appoint:
Marina Tapia, Edward C. Spector, Ethan Spector, B. Aleman, Sandra Corona, Aidan Smock, D. Garcia, Sarah Campbell, Jennifer Ochs, Erin
Brown, Jaren A Manc, Rachel A Mullen, Michelle Haase, Simone Gerhard, Alysha Mendoza and KD Wapato
of Los Anqeles CA (city, state) and each its true and lawful Attorney(s)-in-Fact, with full authority to sign, execute, seal, acknowledge and
deliver for, and on its behalf, and as its act and deed any place within the United States, or, if the following line is filled in, only within the area
and up to the amount therein designated, any and all bonds, undertakings, recognizances, and other contracts of indemnity or writings
obligatory in the nature thereof, issued in the course of its surety business, and to bond the Companies as follows:
Any such obligations in the United States not to exceed $50,000,000.00.
The Companies hereby ratify and confirm all and whatsoever said Attorney(s)-in-fact may lawfully do in the premises by virtue of these presents. These
appointments are made under and by authority Resolutions adopted by the Board of Directors of the Companies, which resolutions are still in effect:
RESOLVED, that any of the Chief Executive Office, the Chief Operating Officer or the Chief Undenvriting Officer, acting in conjunction with the head of the
surety business line for the Corporation (each an Authorized Individual" and, collectively, the Authorized Individuals"), are authorized to jointly appoint one or
more attorneys-in-fact to represent and act for and on behalf of the Corporation in the transaction of the Corporation's surety business to execute (under the
common seal of the Corporation if appropriate) bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature
thereof:
RESOLVED, ihat in conjunction with the Corporation's transaction of surety business the signatures and attestations of the Authorized Individuais an t e
seai of the Corporation be affixed to any such Power of Attorney or to any certificate relating thereto (electronic or otherwise) by facsimile and any such
Power of Attorney or certificate bearing such facsimile signatures or facsimile seals (electronic or otherwise) shall be valid and bonding upon the Corporation
when so affixed with respect to any bond, undertaking, recognizance or tother contract of indemnity or writing obligatory in the nature thereof;
RESOLVED, that in connection with the Corporation's transaction of surety business, the facsimile electronic or mechanically reproduced signature of any
Authorized Individual, whether made heretofore or hereafter, whenever appearing upon a copy of any Power of Attorney of the Corporation, with signatures
IN WITNESS WHEREOF, the Companies have caused these presents with the respective corporate seals and to be executed by the individuals
named below who are duly authorized and empowered to execute the Power of Attorney on the Companies' behalf, this 15' day of July 2024.
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Matthew Conrad Kramer (Chief Executive Officer)
STATE OF CONNECTICUT )
COUNTY OF FAIRFIELD ) ss.
ASCOT SURETY & CASUALTY COMPANY
ASCOT INSURANCE COMPANY
b���
ra N� o�rth_(Exe utive Vice President, Surety)
On this 15� day of July 2024, before me came the above named Chief Executive Officer of each Ascot Surety & Casualty Company and Ascot Insurance
Company and the head of the surety business line for each of Ascot Surety & Casualty Company and Ascot Insurance Company, to me personally known to
be the individuals described herein, and acknowledged that the seals affixed to the preceding instrument and the corporate seals of each Ascot Surety &
Casualty Company and Ascot Insurance Company, and that the said corporate seals and signatures were duly afFixed and subscribed to said instrument by
the authority and direction of said Companies.
KSENIA E. GUSEVA
NOTAR Y PUBLIC
STATE OF COtJNECTiCUT
My Commission Expires June 30, 2029
/�.�; �. �• ��
Notary Public Ksenia E Guseva
My commission expires on June 30 2029
I, the undersigned Secretary of the Company, do hereby certify that the foregoing excerpts of the Resolution adopted by the Board of Directors of the
Companies, and the Power of Attorney issued pursuant thereto, are true and correct, and further certify that both the Resolution and the Power of Attorney
are still in full force and effect.
This Certificate may be signed by facsimile under and by the authority of the following resolution of the Board of Directors of the Companies.
RESOLVED, that in connection with the Corporation's transaction of surety business the signatures and attestations of the Authorized Individuals and the
seal of the Corporation be affixed to any such Power of Attorney or to any certificate relating thereto (electronic or otherwise) by racsimile and any such
Power of Attorney of certificate bearing such facsimile signatures or facsimile seal (electronic or otherwise) shall be valid and k�ir�ing upon the �orporation
when so affixed with respect to any bond, undertaking, recognizances or other contract of indemnity or writing obligatory in tfie nature thereof;
IN WITNESS WHEREOF; I have hereunto set my hand and affixed the seal of the Companies, this 2) S� day ei ��nU�A 1'l/1 , 2G� �
ASCOT SURETY & CASUALT`r COMPAf�IY
ASCO WSURANCE COMPANY
J hn Gill, Secretary
All Claims Notices should be sent to Ascot Surety & Casualty Company 55 W 46�h St, 26'h Floor, New York NY 10036: Attention Surety Claims suretvclaims(c�ascotqroup.com