HomeMy WebLinkAboutContract 50202-FP2-FP2
City Secretary 50202
Contract No.
FORT WORTH
NOTICE OF PROJECT COMPLETION
(Developer Projects)
Date Received 3/24/2025
AT
The Transportation and Public Works Department upon the recommendation of the Project
Manager has accepted the following project as complete:
Project Name Carroll Street Townhomes
City Project No.: 101025
Improvement Type(s): Water Ixl Sewer Ixl
Developer
Cost
City Cost
Total Cost
Original Contract Price: Water
$20,730.00
$0.00
$20,730.00
Original Contract Price: Sewer
$54,036.50
$31,007.00
$85,043.50
Amount of Approved Change Order(s): Water
$2,485.00
$0.00
$2,485.00
Amount of Approved Change Order(s): Sewer
$2,475.16
$3,234.84
$5,710.00
Revised Contract Amount: Water
$23,215.00
$0.00
$23,215.00
Revised Contract Amount: Sewer
$56,511.66
$34,241.84
$90,753.50
Total Cost of Work Complete:
$79,726.66
$34,241.84
$113,968.50
y -
Mar 18, 2025
Contractor
Date
VP
Title
San Saba Construction
Company Name
'-�'k/'
Mar 21 72025
Donald Watson (Mar 21, 2025 13:38 CDT)
Project Inspector
Date
r-
Mar 24, 2025
Pr'oJjjeccct'Manager
Date
464
,,(Mar 24,202515:27 CDT)
Mar 24, 2025
CFA Manager
Date
z')e "7^_^-
au ren Prie,,, (Ma r24,20)
Mar 24 2025
TPW Director
Date
cvl�
Mar 25, 2025
Asst. City Manager
Date
OFFICIAL RECORD Page 1 of 2
CITY SECRETARY
FT. WORTH, TX
Notice of Project Completion
Project Name: Carroll Street Townhomes
City Project No : 101025
City's Attachments
Final Pay Estimate Ixl
Change Order(s) Ixl Yes ❑ N/A
Pipe Report Ixl Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid,
Consent of Surety
Statement of Contract Time
Contract Time: 125 CD
Work Start Date: 7/2/2018
Completed number of Soil Lab Test: 0
Completed number of Water Test: 0
Days Charged: 2392 CD
Work Complete Date: 1/17/2025
Page 2 of 2
FORT WORTH
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name CARROLL STREET TOWNHOMES
Contract Limits
Project Type WATER & SEWER
City Project Numbers 101025
DOE Number 1025
Estimate Number 1 Payment Number 1 For Period Ending 1/17/2025
CD
City Secretary Contract Number Contract Time 126D
Contract Date Days Charged to Date 125
Project Manager NA Contract is 100.00 Complete
Contractor SAN SABA CONSTRUCTION SERVICES, INC.
3100 INDEPENDENCE PKWY #311-314
PLANO , TX 75075
Inspectors DICKINSON / WATSON
Tuesday, January 28, 2025 Page 1 of 4
City Project Numbers 101025
Contract Name CARROLL STREET TOWNHOMES
Contract Limits
Project Type WATER & SEWER
Project Funding
WATER
DOE Number 1025
Estimate Number 1
Payment Number 1
For Period Ending 1/17/2025
Item Description of Items Estimated Unit
Unit Cost Estimated
Completed
Completed
No. Quanity
Total
Quanity
Total
---------------------------------------
1 SALVAGE 3/4" WATER METER 1 EA
$850.00 $850.00
1
$850.00
2 1" WATER SERVICE (CO#1) 9 EA
$2,485.00 $22,365.00
9
$22,365.00
Sub -Total of Previous Unit
$23,215.00
$23,215.00
SEWER
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
---------------------------------------
1
REMOVE 4" SEWER LINE
40 LF
$25.00
$1,000.00
40
$1,000.00
2
POST CCTV INSPECTION (CO#1) , (CO#2)
342 LF
$4.00
$1,368.00
342
$1,368.00
3
MANHOLE VACUUM TESTINHG (CO#2)
5 EA
$825.00
$4,125.00
5
$4,125.00
4
BYPASS PUMPING
1 LS
$12,000.00
$12,000.00
1
$12,000.00
5
TRENCH SAFETY (CO#1), (CO#2)
342 LF
$3.00
$1,026.00
342
$1,026.00
6
16" CASING BY OPEN CUT
10 LF
$115.00
$1,150.00
10
$1,150.00
7
4" SEWER SERVICE
8 EA
$1,835.00
$14,680.00
8
$14,680.00
8
8" SEWER PIPE
257 LF
$81.00
$20,817.00
257
$20,817.00
9
8" DIP SEWER PIPE (CO#1), (CO#2)
75 LF
$150.00
$11,250.00
75
$11,250.00
10
8" DIP SEWER PIPE CSS BACKFILL
10 LF
$240.00
$2,400.00
10
$2,400.00
11
4' MANHOLE (CO#2)
5 EA
$4,100.00
$20,500.00
5
$20,500.00
12
--------------------------------------
4' EXTRA DEPTH MANHOLE
1.25 VF
$350.00
$437.50
1.25
$437.50
Sub-Total of Previous Unit
$90,753.50
$90,753.50
Tuesday, January 28, 2025 Page 2 of 4
City Project Numbers 101025
Contract Name CARROLL STREET TOWNHOMES
Contract Limits
Project Type WATER & SEWER
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Change Order Number 1
Change Order Number 1
Change Order Number 2
Change Order Number 2
Total Contract Price
DOE Number 1025
Estimate Number 1
Payment Number 1
For Period Ending 1/17/2025
$105,773.50
$2,485.00
$628.00
$2,475.16
$2,606.84
$113,968.50
Total Cost of Work Completed $113,968.50
Less % Retained $0.00
Net Earned $113,968.50
Earned This Period $113,968.50
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
$113,968.50
Tuesday, January 28, 2025 Page 3 of 4
City Project Numbers 101025
Contract Name CARROLL STREET TOWNHOMES
Contract Limits
Project Type WATER & SEWER
Project Funding
DOE Number 1025
Estimate Number 1
Payment Number I
For Period Ending 1/17/2025
Project Manager NA City Secretary Contract Number
Inspectors DICKINSON / WATSON Contract Date
Contractor SAN SABA CONSTRUCTION SERVICES, INC. Contract Time 125 CD
3100 INDEPENDENCE PKWY #311-314 Days Charged to Date 125 CD
PLANO, TX 75075 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 $113,968.50
Less % Retained
$0.00
Net Earned
$113,968.50
Earned This Period $113,968.50
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
$113,968.50
Tuesday, January 28, 2025 Page 4 of 4
ITY SECR
•.
... ,..
CONTRACTNO.
No g%a0a=Col
•IPROJECT
CHANGE ORDER
-
C5C
' NAME:
Carroll Street Townhomes
-'
ICONT RACT:
ICFA#'
IlNater. .
. Sewer Paving. "Storm Dram. Street Llohts
CHANGE
ORDER No:
_
•
12017-175 I CITY PARTICIPATION:I YES
:.It:ITY.PRDJECT#
DOE#'
1101025 .. ..
-
.
WATER PROJECT
N/A 1
156008.0600430-101025-001580 I
..3
7
_
•r•
•:
"
ISEWER PROJECT#
IFILE# I
I56OO9j7OO43O-101025-001380
W-2502, X-24437 I
..•'t Yt
INSPECTOR:
PROJECT. MANAGER:
Donald L. Watson Jr. Phone No: 817-205-8911
.
Vic Tornero Phone No: 817-392-7830
•
I CONTRACT UNIT
'
WATER
Developer
SEWER I PAVING I DRAINAGE
Oeveloper
I STREET UGHi5
{I
CONTRACT
'
1ORIGI AL
Cost City Cost
$20,730.00
Develo er
P
Cost I City Cos! ICos!
$54,036.50
Developer
City Cost Cast I
City Cost
Developer
(Cost City Cost
DAYS
,
'
STCONTRACT
IEXTRAS TO DATE
$31,007.00 599,827.00
I S14,D08_.62
$1,800.00
125 r '-
. ICREDITS TO DATE
I I
I
ICONTRACT TO DATE
I I
I $20,730.00' $0.00 I •$54,036.50 I $31,p07.00 I ;991827.00 I 50.00 I S_14.008.62
$0.00
S7._e00.00 I
I
1
AMOUNT OF PROP. CHANGE ORDER '
I $2,485.00 ;628.00 I I
$0.00
125
AMOUNT
NTRACTAMOUNT
523,215.00 $54.664,60 $3D1,00700 .O
514.00A62.
$D_.00_
PERUNIT
II
II$99,827.090I
8 .215.00 $85,671.5$49827.00
,.
so.00
125
,
REVISED COSTSHARE
54008.62
$193,615.12 Cost;
$1.80t0.00
•...'
111
'
-
TOTAL REVISED CONTRACT
.City
531,DD7.DD
$224,522.12
-
Revised:lO-12-2011
You are directed to make the following rjonfe. m the tract docu ls:
CITY BID ITEM
PAY ITEM iI 0 QUANTITY UNIT I ITEM DESCRIPTION 1
I Unit l: Water UNIT PRICE TOTAL
2 33122003 1 EA 1"WATER SERVICE $2,485.00 $2,485.00
I TOTAL $2,485.00
Unit II: Sewer
1 2 3301.0002 4 LF POSTCCTV INSPE -CTION I $4.00 $16.00
I 5 3305.0109 4 LF TRENCH SAFETY $3,00 $12,00
I 9 3331A119 4 I LF 8"DIP SEWER PIPE $150.on $600.00
TOTAL: 5628.00 I
GRANDTOTAL
$3,113.00 f
REASONS FOR CHANGE ORDER Extension of Sanitary Sewer to center of proposed easement. Easement updated from approved plans to allow room for franchise utility service. This change
order does not effect the City Cost Participation since the davelOPerls paying a 100% for this change order. Hence, there is no need to obtain City Signatures for
this change order.
RECO'AME`3DE0- _ . F,Pm4O'JED: APPRO'YED�
By
APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY:
(CFW- Sponsoring Department (CFW-Assistant anage¢-I (CFW-ASseistarAftomey)
BY: N/ABY: MAName: Name:(�(aQ, NTitle: Title: W _l Tme: .!�' SNk
RECOMMENDED:
(CFW-•Contract Compli ca Mana q "Contact Compliance Manager (Project Manager):
•�� �%�� By signing 1 acknowledge that I am the person responsible
6y: t 1 /• � for the monitoring and administration of this contract, include
Name: Vr�rC�7l//L ✓r iCcB,rV£lJ.p GK. ensuring all performance and repotting requirements.
Title: IR"a fiu w Zaf - []Them are NO City Funds associated with this Contract
' There are City Funds associated with this Contract ,,r ,�°� L� ••�'.�
M&C Number. NIA 10••,.•••••
M&C Date Approved: NIA •' ;' �+
Atte by:
Revised: 10-12-2011
IV1ary J. K?ysef, City Secretary
DEVELOPER -AWARDED -PROJECT CHANCE ORDER
PROJECT NAME:
Carroll Street Townhomes
CONTRACT:
Water. Sewer, Pavina. Storm Drain. Street Liahts
1CFA#
2017-175 CITY PARTICIPATION:1 YES
CITY PROJECT#
101026
DOE*
N/A
WATER PROJECT#
56008-0600430-101025-001580
SEWER PROJECT#
560OM700430-101025-001380
FILE It
W-2502. X-24437
CSC NO. 5oaoa
CHANGE
ORDER No:
2
INSPECTOR: Donald L. Watson Jr. Phone No: 817-205-8911
PROJECT MANAGER: Vic Tornero Phone No: 817-392-7830
CONTRACT UNIT
WATER SEWER I PAVING I DRAINAGE
Deveoper Developer
lcAst I City con cost CftI
ORIGINAL CONTRACT
$20.730.00
$5d,036.50 $31
(EXTRAS TO DATE
$2,485.00
$628.00
CREDITS TO DATE
CONTRACT TO DATE
$23.215.00 30.00
.50 $$1.
�2177
AMOUNT OF PROP. CHANGE ORDER
16 $2,I
1(ISFj1��Jj�VAMOUNT
$2$,215.00 $0.00
�TJ� E EE�D TRACT AMOUNT
PER UNIT
$23,215.00
590,]53.50
REVISED COST SHARE
Dev. Cost:
$188,576.28
TOTAL REVISED CONTRACT
Revised 10-12-2011
I
STREET LIGHTS CONTRACT
GAYS
$102,413.00 $14,00L62 I d1,ea0.00 I
City Cost:
$232,190.12
411,
RECEIVED
40V 2 6 2019
CITY DRFORT SWORTH
CIY SECRETARY
CITY SECRETARY
CONTRACT NO. 5QaO ;� CD a
OFFICIAL, RECORD
CITY SECRETARY
FT WORTH, TX
. 'age 1
You are directed to make the following hanaes in the ontract documents:
CITY BID ITEM
PAY ITEM # 11 # I QUANTITY UNIT 1—M DESCRIPTION UNIT PRICE TOTAL
UnB It: Samlary Sewer (Davelopan
2 3301.0002 1 LF POST -CCTV INSPECTION $2.40 $2.40
3 3301.0101 1 EA _ MANHOLE VACCUM TESTING $717.84 .117.94
�5 3305 0109 1 LF - TRENCH SAFETY - -
9 33314119 1 LF 8"DIP SEWER PIPE $68.58 $6858
11 3339.1001 1 EA 4' MANHOLE $1.666.34 $1.666.34
DEVELOPER TOTAL: .:1475.16
I Unit II' Sanitary Sewer (City)
1 2 3301 0002 1 LF pnS7 j`C�jy N�P�- TIQ�f $1.00 1 $1 60 1
I 3 3301.0101 1 EA MANf{OL�LjE VQCC�UMTING $10716 I $10716 1
9 3331.4119 1 LIF _ BTIiI�SEWEREIPE $3.00 $ 142 f $8142
11 3339.1001 1 EA 4'MANHOI_F_ $2.41366 I $2,413.66
I I CITY TOTAL: 32.606.84 I
Unit IV: PavimB (Developer)
1 3213.0301 431 SF 4'CONCSIDE-1l1 E8.00 $2,586BI) I
DEVELOPER TOTAL: $2,566.00 1
1 GRAND TOTAL $5.192.84 I
REASONS FOR CHANGE ORDER Realignment of Sanitary Sewer due to conflrct with exrshng power poke. Additionally, the sidewalk along Carrot!street is to be widened to connect to the back of
the curb (-1.5' wklfh).Since this project was not publicly bid, the City could only reimburse the developer based on the current CFA Unit prices. The cost
breakdown presented above shows the City's maximum contribution for the change order and the developer wN be required to pay the remaining portion. The
two unit costs combine match the overall unit cost in the contract documents bid proposal section.
RECOMMENDED: AF R EG' / - APPROVED: .., ~a�'Y y-•)V�•['y,
Kim"IC
///—/L Te sin L $ r San Sabaa{•••.f{'
Ely
Name: Kf--d.. MieAra 1 1 N. Name:e••�
�"���' �i7e i r,
Title: Eel: N tt� Tits: ��. Title: "�
APPROVAL RECOMMENDED: APPROVED: U APPROVED AS TO FORM AND LEGALITY: 4#• - M1 ���`
Attested b T
(CFW-Spon 'ng men0 (CF - ss stets City Man (CFW-Assistant City Attorney) .,
BY: Rv;u I� A, AAA BY: /
Nama: �O"'• "�•'�'� Name: S'�yQY� f{' Qvt$j Name: �• �`C•�'w.��K
Title:G�.s - +%moil �• /1(A irt,�e: �� I )6 s • s� r tl1 � s G"'1 Mazy r, City Secretary
RECOMMENDED: 1
(CFWWontract Comp r) • Contract acknowledge
Manager the(PIdlectrs Managers
_; /�// /,��((// By signing acknowledge that am the person responsible
By ^ for the monitoring and administration of this contract, include
Name:
e Y J� ensuring all performance and reporting requirements.
Omar •,�2& ❑ There are NO City Funds associated with this Contract
Title: /`
0+ There are City Funds associated with this Contract
M$C Number. ^1114
M&C Date Approved: All OFFICIAL M1
CITY SECRETARY yvI
Revised: 10-12-2011 FT. WORTH, X,,
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME:
Carroll Street Townhomes
CHANGE
CONTRACT:
CS-50202
ORDER No:
ICFA#
2017-175
CITY PARTICIPATION(
YES
CSC No.50202-CO3
I CITY PROJECT #
101025
DO E #
N/A
WATER PROJECT #
56008-0600430-101025-001580
3
SEWER PROJECT#
56008-0700430-101025-001380
FILE*
W-2502, X-24437
INSPECTOR:
Donald L. Watson Jr.
Phone No: 817-205-8911
PROJECT MANAGER:
Debbie J. Willhelm
Phone No: 817-392-2481
CONTRACT UNIT
WATER SEWER PAVING
DRAINAGE
STREET LIGHTS
CONTRACT
Developer Developer
Cost City Cost
Cost
Developer
City Cost
City Cost Cost
Developer
Cost
City Cost
Developer
City Cost
Cost
DAYS
(ORIGINAL CONTRACT
$20,730.00 I $54,036.50
$31,007.00 I $99,827.00 I
I $14,008.62
I
$1,800.00 I
125
EXTRAS TO DATE
$2,485.00 I $3,103.16
$2,606.84 I $2,586.00 I
I
I
I
ICREDITS TO DATE
I
I I
I
I
I
ICONTRACT TO DATE
$23,215.00 $0.00 I $57,139.66
$33,613.84 I $102,413.00 I $0.00
I $14,008.62
$0.00 I
$1,800.00 $0.00
125
(AMOUNT OF PROP. CHANGE ORDER
$0.00 I
I $ (5,850.00)I $0.00
I
$0.00 I
$0.00
0
I REVISED CONTRACT AMOUNT
$23,215.00 $0.00 I $57,139.66
$33,613.84 I $96,563.00 I $0.00
I $14,008.62
$0.00 I
$1,800.00 I $0.00 j
125
TOTAL REVISED AMOUNT
ER UNIT
PER
$23,215.00 I $90,753.50
I $96,563.00
I $14,008.62 I
$1,800.00
REVISED COST SHARE
Dev. Cost: $192,726.28
City Cost:
$33,613.84
TOTAL REVISED CONTRACT
$226,340.12
Revised 10-12-2011 Page 1
You are directed to make the following changes in the contract documents:
CITY BIQUANTIT
ITEM UNIT I ITEM DESCRIPTION Con' UNITtractor PRICE I CFA PRICEIT
PAY ITEM #
Unit IV' Paving Improvements (Developer)
Y
I 12 3293.0104 -9 EA Plant 4" Tree 1 $ 650.001 $ -
I PAVING TOTAL:
1 RAND TOT L
REASONS FOR CHANGE ORDER Removing street trees from CFA. Trees to be planted through a tree planting permit from PARD.
TOTAL Developer Cost
$ 15,851�00 $ (5,85000)7$.5o.01i
5(5850.00) $ �850.00 $ '850.00)
THERE ARE CITY FUNDS INVOLVED IN THIS CONTRACT. HOWEVER, DEVELOPER IS RESPONSIBLE FOR 100 % OF THE CHANGE ORDER COST AND
NO REIMBURSEMENT FROM THE CITY WILL BE SOUGHT BY THE DEVELOPER.
[SIGNATURES APPEAR ON THE FOLLOWING PAGE]
Revised 10-12-2011 Page 2
KIm�eOy-Horn, nc. APPROVED:
own Homes, LLC. SanAPPROVED:
Construction
>arai% &=W/yooY ��, I(I/
Jared E—y(Ap,13, 1311 DT CDT Oand roorlpprxT, Ld'13�3o cUi E E EW p Col)
By: By: By:
Name: Jared Earney Name: David Foor Name: Robert Beserra
Title: Associate Title: Vice President Tile: President
APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY:
CFW - Water Department CFW - Assistant City Manager CFW - Assistant City Attorney
P� ,Dario Br-andog ���(�J
By: / By: Dana Burghdoff(M 11, 202 1 A0 CDT) By RichardAMcLra nr.a 10, 202309:09 CDT)
Name: Tavlor Gunderman, PE Name Dana Burghdoff Name: Richard McCracken
Title: Engineering Manager Title: Assistant Citv Manager Tile: Senior Assistant City Attorney
9E�9ITEyDT ATTEST:
(�^`��YY//((�/ ++��on((rac Compliance Manager ` Contract Compliance Manager(Project Manager):
Da66m
9�^`*"*'� A � R4 By signing I acknowledge that I am the person responsible
Q. [I/.fEf<B.. U
By: O By: for the monitoring and administration of this contract, include
ensuring all performance and reporting requirements.
Name: Debbie J. Willhelm Name Jannette S. Goodall
❑ There are NO City Funds associated with this Contract
Title: Senior Professional Engineer Title City Secretary
O There are City Funds associated with this Contract
M&C Number N/A
M&C Date Approved: N/A
Revised 10-12-2011 Page 3
I PROJECT NAME:
CONTRACT:
ICFA #
ICITY PROJECT #
CITY SECRETARY CONTRACT #
�FID #
IX#
FILE #
INSPECTOR:
PROJECT MANAGER
ORIGINAL CONTRACT
EXTRAS TO DATE
CREDITS TO DATE
CONTRACT TO DATE
AMOUNT OF PROP. CHANGE ORDER
REVISED CQNTRACT AMOUNT
TOTAL REVISED CONTRACT AMOUNT PER
UNIT
REVISED COST SHARE
TOTAL REVISED CONTRACT
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
Carroll Street Townhomes
Water, Sewer, Paving, and Street Lighting
2017-175
101025
CS-50202
56008-0600430-101025-001580
56008-0700430-101025-001380
W-2502, X-24437
Donald L. Watson Jr.
Debbie J. Wilhelm
CHANGE
ORDER No:
CITY PARTICIPATION: YES
4
Phone No: 817-205-8911
Phone No: 817-392-2481
CSC No. 50202-CO4
CONTRACT UNIT
WATER
SEWER
DRAINAGE
PAVING
STREETLIGHTS
Developer
Developer
Developer �
Developer
Developer
Cost
City Cost
Cost City Cost
Cost City Cost
Cost
City Cost
Cost
City Cost
$20,730.00
$0.00
$54.036.50 $31,007.00
$14,008.62 $0.00
$99,827.00
$0.00
$1,800.00
$0.00
$2,485.00
$0.00
$3,103.16 $2,606.84
$0.00 $0.00
$2,586.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 $0.00
$0.00 skiiiiiiia
$5,860.00
$0.00
$0.00
$0.00
$23,215.00
$0.00
$57,139.66 $33,613.84
$14,008.62
$96,563.00
$0.00
$1,800.00
$0.00
$0.00
$0.00
$0.00 $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$23,215.00
$0.00
$57,139.66 $33,613.84
$14,008.62
$96.563.00
IL $0.00
$1,800.00
$23,215.00
$90,753.50
$14,008.62
$96,563.00
$1,800.00
Dev. Cost:
$192,726.28
4
$226,340.12
I
CONTRACT
DAYS
125
0
0
125
0
125
Revised: 12-17-2018 Page 1
You are directed to make the following changes in the contract documents:
UNIT IV: Pavina Imorovements
PAY ITEM #
CITY BID IT
QUANTITY
CFW Unit
UNIT ITEM DESCRIPTION
Developer
UNIT PRICE City Cost
TOTAL
#
Price
Cost
1 8
3213.0301 (162.00)
SF 4" Conic Sidewalk $0.00
$6.00 $ (972.00) $0.00 $
(972.00)1
1 9
3213.0301 (440.00)
SF 6" Concrete Driveway $0.00
$10.00 $ (4,400.00) M. $0.00 $
(4,400.00)1
I NEW'
3441.4006 2
EA Install Alum Sion Ground Mount $0.00
$2,686.00 $ 5,372.00 $0.00 $
5,372.001
TOTAL IINIT IV: PAVING IMPROVEMENTS
0.00 0.00
I
Asterisk (*) indicates New Pay Item
1 I I
1
I
[SIGNATURES APPEAR ON THE FOLLOWING PAGE]
Revised: 12-17-2018 Page 2
REASONS FOR CHANGE ORDER Portions of the sidewalk and driveways
were removed from contract and installed by Parkway Permit instead. Added two No Parking Signs.
There is no net change in this change order. Changes correspond to Plan Revision 3 as shown on Sheet C-12 of the construction Plans.
RECOMMENDED:
APPROVED: APPROVED:
Kimley-Horn, Inc.
Texas InTown Homes, LLC. San Saba Construction
=ve9
-
aDaV1G( Fo a o 1r
By
By oz�� �,wo s,.o .«n By
Name: Jared Earnev
Name: David Foor Name. Robert Beserra
Tide: Associate
Title: Vice President Tide: President
APPROVAL RECOMMENDED:
CFW - Water Department
S..h ✓a,.�.G.. P�'
By: 0
Name: Subv Varuahese, PE
Title Enqineerinq Manaqer
RECOMMENDED:
CFW- *Contract Compliance Manager
Y
Name: Debbie J. Wilhelm. PE
Title: Senior Professional Engineer
M&C Number: NIA
M&C Date Approved: NIA
APPROVED:
CFW - Assistant City Manager
o.. nftdA
By:
Name: Dana Burqhdoff
Title: Assistant City Manager
APPROVED AS TO FORM AND LEGALITY:
CFW - Assistant City Attorney
By
Name: Richard McCracken
Tile: Senior Assistant City Attorney
ATTEST: ? * Contract Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, include
ensuring all performance and reporting requirements.
Jannette S. Goodall
There are NO City Funds associated with this Contract
City Secretary
X ]There are City Funds associated with this Contract
Revised: 12-17-2018 Page 3
You are directed to make the following hanaes in the ontract documents:
CITY BID ITEM
PAY ITEM # 11 # I QUANTITY UNIT 1—M DESCRIPTION UNIT PRICE TOTAL
UnB It: Samlary Sewer (Davelopan
2 3301.0002 1 LF POST -CCTV INSPECTION $2.40 $2.40
3 3301.0101 1 EA _ MANHOLE VACCUM TESTING $717.84 .117.94
�5 3305 0109 1 LF - TRENCH SAFETY - -
9 33314119 1 LF 8"DIP SEWER PIPE $68.58 $6858
11 3339.1001 1 EA 4' MANHOLE $1.666.34 $1.666.34
DEVELOPER TOTAL: .:1475.16
I Unit II' Sanitary Sewer (City)
1 2 3301 0002 1 LF pnS7 j`C�jy N�P�- TIQ�f $1.00 1 $1 60 1
I 3 3301.0101 1 EA MANf{OL�LjE VQCC�UMTING $10716 I $10716 1
9 3331.4119 1 LIF _ BTIiI�SEWEREIPE $3.00 $ 142 f $8142
11 3339.1001 1 EA 4'MANHOI_F_ $2.41366 I $2,413.66
I I CITY TOTAL: 32.606.84 I
Unit IV: PavimB (Developer)
1 3213.0301 431 SF 4'CONCSIDE-1l1 E8.00 $2,586BI) I
DEVELOPER TOTAL: $2,566.00 1
1 GRAND TOTAL $5.192.84 I
REASONS FOR CHANGE ORDER Realignment of Sanitary Sewer due to conflrct with exrshng power poke. Additionally, the sidewalk along Carrot!street is to be widened to connect to the back of
the curb (-1.5' wklfh).Since this project was not publicly bid, the City could only reimburse the developer based on the current CFA Unit prices. The cost
breakdown presented above shows the City's maximum contribution for the change order and the developer wN be required to pay the remaining portion. The
two unit costs combine match the overall unit cost in the contract documents bid proposal section.
RECOMMENDED: AF R EG' / - APPROVED: .., ~a�'Y y-•)V�•['y,
Kim"IC
///—/L Te sin L $ r San Sabaa{•••.f{'
Ely
Name: Kf--d.. MieAra 1 1 N. Name:e••�
�"���' �i7e i r,
Title: Eel: N tt� Tits: ��. Title: "�
APPROVAL RECOMMENDED: APPROVED: U APPROVED AS TO FORM AND LEGALITY: 4#• - M1 ���`
Attested b T
(CFW-Spon 'ng men0 (CF - ss stets City Man (CFW-Assistant City Attorney) .,
BY: Rv;u I� A, AAA BY: /
Nama: �O"'• "�•'�'� Name: S'�yQY� f{' Qvt$j Name: �• �`C•�'w.��K
Title:G�.s - +%moil �• /1(A irt,�e: �� I )6 s • s� r tl1 � s G"'1 Mazy r, City Secretary
RECOMMENDED: 1
(CFWWontract Comp r) • Contract acknowledge
Manager the(PIdlectrs Managers
_; /�// /,��((// By signing acknowledge that am the person responsible
By ^ for the monitoring and administration of this contract, include
Name:
e Y J� ensuring all performance and reporting requirements.
Omar •,�2& ❑ There are NO City Funds associated with this Contract
Title: /`
0+ There are City Funds associated with this Contract
M$C Number. ^1114
M&C Date Approved: All OFFICIAL M1
CITY SECRETARY yvI
Revised: 10-12-2011 FT. WORTH, X,,
FORTWORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME:
Carroll Street Townhomes
PROJECT NUMBER:
101025
DOE NUMBER:
NA
WATER
PIPE LAID
SIZE TYPE OF PIPE
NA
NA NA
NA
NA NA
FIRE HYDRANTS: VALVES (16" OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE
DENSITIES:
NEW SERVICES:
SEWER
PIPE LAID
SIZE
TYPE OF PIPE
SEWER
8"
PVC
SEWER
16"
DIP
SEWER
8"
DIP
PIPE ABANDONED SIZE TYPE OF PIPE
DENSITIES:
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
LF
LF
LF
LF
NA
NA
257
10
75
FORTWORTH.
TRANSPORTATION AND PUBLIC WORKS
January 21, 2025
San Saba Construction
2475 Glenda Ln,
Dallas,Tx 75229
RE: Acceptance Letter
Project Name: Carroll Street Townhomes
Project Type: Water,Sewer,Paving,Drainage,Street Lights
City Project No.: 101025
To Whom It May Concern:
On January 17, 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 January 21, 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 817-
392-2481.
Sincerely,
Debbie Willhelm, Project Manager
Cc: Donald Watson, Inspector
Mike Glover, Inspection Supervisor
Randy Horton, Senior Inspector
Andrew Goodman, Program Manager
Brandon D Middelton, Consultant
San Saba, Contractor
Kimley Horn, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Signature:5�.
Email: allison.tidwell@fortworthtexas.gov
Rev. 08/20/19
BILLS PAID AFFIDAVIT FOR CONTRACTOR
State of Texas §
County of Fort Worth §
BEFORE ME, the undersigned authority, on this day personally appeared Rvan Beserra, known to me to
be a credible person and officer of San Saba Construction Services, Inc. and who, being duly sworn, upon
his oath declares and acknowledges as follows:
1. I am a duly authorized agent of San Saba Construction Services, Inc., which has authorized me to
make this affidavit, and all of the recitations herein are true and correct.
2. Pursuant to Private Development Contract No. CPM-101025 between Texas InTown Homes,
LLC and San Saba Construction Services, Inc. for Carroll Street Townhomes, San Saba
Construction Services, Inc. has supplied materials and performed labor in connection with the
construction of improvements on real property owned by Texas InTown Homes, LLC in the City
of Fort Worth ("the improvements").
3. San Saba Construction Services, Inc. has actual knowledge that all bills owed by Texas InTown
Homes, LLC to San Saba Construction Services, Inc. for materials supplied or labor performed in
connection with the improvements have been fully paid and satisfied.
4. San Saba Construction Services. Inc. has actual knowledge that all bills owed by San Saba
Construction Services. Inc. to others for materials supplied or labor performed in connection with
the improvements have been fully paid and satisfied.
5. San Saba Construction Services, Inc. has actual knowledge that there are no claims or liens for
materials supplied or labor performed in connection with the Private Development Contract.
6. San Saba Construction Services, Inc. further warrants that should any claim or lien be filed for
material supplied or labor performed in connection with the Private Development Contract, San
Saba Construction Services, Inc. will immediately furnish a bond pursuant to Texas Property
Code Sections 53.236 through 53.238 for release of each the claim or lien, obtain settlement of
any claim or lien, and furnish the City of Fort Worth written full release. San Saba Construction
Services, Inc. agrees to fully indemnify and hold harmless the City of Fort Worth from any and
all costs that may occur by reason of such claims or liens.
EXECUTED this 18 day of March 2025.
San Saba Cons - ion Servic c.
B —
ME: yan Beserra
TITLE: Vice President
STATE OF TEXAS
COUNTY OF DALLAS
This instrument was acknowledged before me on March 18, 2025 by
Rvan Beserra, Vice President of San Saba Construction a S corporation, on behalf of said corporation.
FOCSTEVENLDS#132e4680
res
NOTARY PUBLIC
CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
Conforms with the American Institute of
Architects, AIA Document G707
OWNER
❑
ARCHITECT
❑
CONTRACTOR
❑
SURETY
❑
OTHER
Bond No 4417036
PROJECT:
(name, addresS)Carroll St Townhomws - Water, Sanitary Sewer, Lighting and Paving Improvements
Fort Worth TX
TO (Owner)
(TEXAS ire T OWN HOMES, LL . AND CITY OF FORT 7 ARCHITECT'S PROJECT NO:
WORTH CONTRACT FOR:
1520 Oliver Street Carroll St Townhomws - Water, Sanitary Sewer, Lighting and Paving
Improvements
Houston Tx 77007 -J CONTRACT DATE:
CONTRACTOR: SAN SABA CONSTRUCTION SERVICES, 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)
SURETEC INSURANCE COMPANY
1330 Post Oak Blvd.
Houston TX 77056 , SURETY COMPANY
on bond of (here insert name and address of Contractor)
SAN SABA CONSTRUCTION SERVICES, INC
2475 Glenda Lane
Dallas TX 75229
,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)
TEXAS INTOWN HOMES, LLC AND CITY OF FORT WORTH
1520 Oliver Street
Houston TX 77007 , 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): �1'1u%���—
18th day of March, 2025
SURETEC INSURANCE COMPANY
Surety Company
Signa a of Authorized Representative
Snphinie Hunfmr
Title
Attornev-in-Fact
NOTE: Thi,; form ;s to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS,
Current Edition
ONE PAGE
POA# 4221097
JOINT LIMITED POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That SureTec Insurance Company, a Corporation duly organized and existing under the laws of the State of Texas and having its
principal office in the County of Harris, Texas and Markel Insurance Company (the "Company"), a corporation duly organized and existing under the laws of the state
of Illinois, and having its principal administrative office in Glen Allen, Virginia, does by these presents ma— constitute and appoint:
Don E. Cornell, Ricardo J. Reyna, Sophinie Hunter, Robbi Morales, Kelly A. Westbrook, Tina McEwan, Joshua Saunders,
Tonie Petranek, Mikaela Peppers
Their true and lawful agent(s) and attorney(s)-in-fact, each in their separate capacity If more than one is named above, to make, execute, seal and deliver for and on
their own behalf, individually as a surety orjointly, as co -sureties, and as their act and deed any and all bonds and other undertaking in suretyship provided, however,
that the penal sum of any one such instrument executed hereunder shall not exceed the sum of:
In Unlimited Amounts
This Power of Attorney is granted and is signed and sealed under and by the authority of the following Resolutions adopted by the Board of Directors of SureTec
Insurance Company and Markel Insurance Company:
"RESOLVED, That the President, any Senior Vice President, Vice President, Assistant Vice President, Secretary, Assistant Secretary Treasurer or Assistant Treasurer
and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or
acknowledged by any officer or ;;t. r• , of the company, qualifying the attorney or attorneys named in the given power of attorney, to execute in behalf of, and
acknowledge as the act and deed of the SureTec Insurance Company and Markel Insurance Company, as the case may be, all bond undertakings and contracts of
suretyship, and to affix the corporate seal thereto."
IN WITNESS WHEREOF, Markel Insurance Company and SureTec Insurance Company have caused their official seal to be hereunto affixed and these presents to be
signed by their duly authorized officers on the 21st day of August , 2024 .
�Xnwrr, i
SureTec Insurance Company e�V�NCF �NOs F ANCg�, Markel s rance Co an �... ,.. as F any
•.
�U f x .9 t0� oT
t ;4 c .0:
a lW 5 j SEAL '>-u=
Michael C. Ke g, President * ''�.,� * �ss��� �Lir>✓deyJennin ice President
State of Texas
County of Harris:
On this 21st day of August , 2024 A. D., before me, a Notary Public of the State of Texas, in and for the County of Harris, duly commissioned and qualified,
came THE ABOVE OFFICERS OF THE COMPANIES, to me personally known to be the individuals and officers described in, who executed the preceding instrument, and
they acknowledged the execution of same, and being by me duly sworn, disposed and mcl that they are the officers of the said companies aforesaid, and that the
seals affixed to the proceeding instrument are the Corporate Seals of said Companies, and the said Corporate Seals and their signatures as officers were duly affixed
and subscribed to the said instrument by the authority and direction of the said companies, and that Resolutions adopted by the Board of Directors of said Companies
referred to in the preceding instrument is now in force.
t�.rI•�t-ttrri��i
IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed my OffiE,Alm2 RU)arris, the day and year first above written.
PUe
lid ,, z �p�•�'
By: —b
W ,tyQ ® Chelsea Turner, Notary Public
9TF OF t eR,%� * My commission expires 7/6/2028
ZIP
132564
We, the undersigned Officers of SureTec Insurance Company and Markel InSTe E
certify that the origina' POWER OF ATTORNEY of which the
foregoing is a full, true and correct copy is still in full force and effect and has ndtpAw. I0++�
IN WITNESS WHEREOF, we have hereunto set our hands, and affixed the Seals of said Companies, on the 1 Hth day of March 2025
ureTec Insurance Company Markel Insurance Company
� n
By: By:
M. Brent eaty, Assistant Secretary /.. ew Marquis, Assistan cretary
Any Instrument Issued in excess of the penalty stated above is totally void and without any validity. 4221097
For verification of the authority of this Power you may call (713)812-0800 an any business day between 8:30 AM and 5:00 PM CST.
SureTec Insurance Company
IMPORTANT NOTICE
Statutory Complaint Notice/Filing of Claims
To obtain information or make a complaint: You may call the Surety's toll free telephone number for information or
to make a complaint or file a claim at: 1-866-732-0099. You may also write to the Surety at:
SureTec Insurance Company
9500 Arboretum Blvd., Suite
400
Austin, TX 78759
You may contact the Texas Department of Insurance to obtain information on companies, coverage, rights or
complaints at 1-800-252- 3439. You may write the Texas Department of Insurance at:
PO Box 149104
Austin, TX 78714-
9104
Fax#:512-490-1007
Web: httD://www.tdi.state.tx.us
Email: ConsumerProtection@tdi.texas.gov
PREMIUM OR CLAIMS DISPUTES: Should you have a dispute concerning your premium or about a claim, you
should contact the Surety first. If the dispute is not resolved, you may contact the Texas Department of
Insurance.
SIC TX Rider TDI Required Notices rev 07_2022 Page 1 of 1