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HomeMy WebLinkAboutContract 62290-FP1FORT WORTH. -FP1 City Secretary 62290 Contract No. Date Received 5/1 /2025 AT NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: Basswood Dutch Bros. City Project No.: 104642 Improvement Type(s): Water 0 Sewer 0 Original Contract Price: $45,300.00 Amount of Approved Change Order(s): $23,486.00 Revised Contract Amount: $68,786.00 Total Cost of Work Complete: $68,786.00 cL.6-4#,- 04/28/2025 Contractor Date Vice President Title Tejas Construction Company Name fig"" - 04/29/2025 Project Inspector Date C.L"' 05/01 /2025 Project Manager Date 05/01 /2025 Kan (May l, 202509:47CDT) CFA Manager Date �.,:.�. Lauren P1111I I May 1, 2025 09'.59 CLI 1) 05/01 /2025 TPW Director Date 05/01 /2025 Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: Basswood Dutch Bros. City Project No.: 104642 City's Attachments Final Pay Estimate ❑x Change Order(s): ❑x Yes ❑ N/A Pipe Report: ❑x Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 22 WD Work Start Date: 1/27/2025 Completed number of Soil Lab Test: 28 Completed number of Water Test: 0 Days Charged: 21 WD Work Complete Date: 3/7/2025 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name BASSWOOD DUTCH BROS Contract Limits Project Type WATER & SEWER City Project Numbers 104642 DOE Number 4642 Estimate Number 1 Payment Number 1 For Period Ending City Secretary Contract Number Contract Date Project Manager NA Contractor TEJAS COMMERCIAL CONSTRUCTION 1613 LAURA ROAD RIVER OAKS, TX 76114 Inspectors T. GARDNER / T. BARKER Contract Time Days Charged to Date Contract is 100.00 3/7/2025 WD 2WD 21 Complete Wednesday, March 26, 2025 Page 1 of 4 City Project Numbers 104642 Contract Name BASSWOOD DUTCH BROS Contract Limits Project Type WATER & SEWER Project Funding UNIT I: WATER IMPROVEMENTS DOE Number 4642 Estimate Number 1 Payment Number 1 For Period Ending 3/7/2025 Item Estimated Description of Items Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 1" Water Service (CO#2) 3 EA $3,700.00 $11,100.00 3 $11,100.00 2 2" Water Service (CO#2) 1 EA $5,500.00 $5,500.00 1 $5,500.00 Sub -Total of Previous Unit $16,600.00 $16,600.00 UNIT H: SEWER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 4" Sewer Service (CO#1) 0 EA $5,275.00 $0.00 0 $0.00 2 4" 2-Way Cleanout 2 EA $400.00 $800.00 2 $800.00 3 8 " Sewer Pipe (CO# 1) 0 LF $115.00 $0.00 0 $0.00 4 Manhole Vacuum Testing 1 EA $550.00 $550.00 1 $550.00 5 Post CCTV Inspection 127 LF $10.00 $1,270.00 127 $1,270.00 6 Trench Safety 127 LF $6.00 $762.00 127 $762.00 7 4' Shallow Manhole 1 EA $9,363.00 $9,363.00 1 $9,363.00 8 8" Dip Sewer Pipe (CO#1) 127 LF $183.00 $23,241.00 127 $23,241.00 9 4" Dip Sewer Service (CO#1) 2 LF $6,300.00 $12,600.00 2 $12,600.00 10 -------------------------------------- Concrete Encasemen for Utility Pipes (CO#1) 20 CY $180.00 $3,600.00 20 $3,600.00 -------------------------------------- Sub-Total of Previous Unit $52,186.00 $52,186.00 Wednesday, March 26, 2025 Page 2 of 4 City Project Numbers 104642 Contract Name BASSWOOD DUTCH BROS Contract Limits Project Type WATER & SEWER Project Funding Contract Information Summary Original Contract Amount Change Orders Change Order Number 1 Change Order Number 2 Total Contract Price DOE Number 4642 Estimate Number 1 Payment Number 1 For Period Ending 3/7/2025 $45,300.00 $14,286.00 $9,200.00 $68,786.00 Total Cost of Work Completed $68,786.00 Less % Retained $0.00 Net Earned $68,786.00 Earned This Period $68,786.00 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 $68,786.00 Wednesday, March 26, 2025 Page 3 of 4 City Project Numbers 104642 Contract Name BASSWOOD DUTCH BROS Contract Limits Project Type WATER & SEWER Project Funding Project Manager NA Inspectors T. GARDNER / T. BARKER Contractor TEJAS COMMERCIAL CONSTRUCTION 1613 LAURA ROAD RIVER OAKS, TX 76114 DOE Number 4642 Estimate Number 1 Payment Number 1 For Period Ending 3/7/2025 City Secretary Contract Number Contract Date Contract Time 22 WD Days Charged to Date 21 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 $68,786.00 Less % Retained $0.00 Net Earned $68,786.00 Earned This Period $68,786.00 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 $68,786.00 Wednesday, March 26, 2025 Page 4 of 4 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: Basswood Dutch Bros CONTRACT: Water& Sanllary Sewer CFA # CFA23-0008 CITY PARTICIPATION] NO CITY PROJECT# 104a42 ICITY SECRETARY CONTRACT # 62290 I FID # 301 14-0200431-104642-E07685 I X # 27655 FILE # NIA REVIEWED By Andrew Goodman at 9:46 am, Feb 12, 2025 1 CHIANGE ORDER No; 1 J 1 INSPECTOR' Ty Baker Phone No: (817) 992-3991 PROJECT MANAGER: Debbie Willhelm Phone No: (817) 392-2481 I CONTRACT UNIT WATER SEWER ORAlNAGF PAVING Developer Coat'f1 s C e• Developer Cast Cost Ceve3aper Developer Foet Coat C))Ar, Cosl JORIGiNAL CONTRACT S7,4o0,0D $000 .1 637,900.00 IL. $0.01) $0.00 30,00 $0,00 IEXTRAS TODATE $0.00 $0,0a KDO $0.00 50.6n SOW $0.00 ICREDITS TO DATE $o,0e wito EE SO.00 IR'i sob $0.00 s0Oo $0.00 ICONTRACTTO DATE $7,400.00 %nd - S5TS0a.0a $0.00,1 $0.00 SO.en $6.9p IAMOUNT OF PROP. CHANGE ORDER KOO $0.00. $14,zao,00 _ SO.uo SOAO $0.00 YAW I REVISED CONTRACT AMOUNT $7.400.00 $0.00 552,186.DO _ $0.00 a. OD ` 6: $0.00 Sa.00 ITOTAL REVISED CONTRACT AMOUNT PER UNIT $7,400.00 $62,188.00 SO 00 $0,09 REVISED COST SHARE Dev. Cost: $59,5a6.00 City Cost: TOTAL REVISED CONTRACT $69.586,00 STREET LIGHTS 1 CONTRACT ❑evcloper DAYS Coat 91N�fsi $O.Oo 22 $a.aa 0 1 $0.00 .;�\�Q „ 9 SO.00 22 S000 19.00 a $000 $0.00 22 smo $0.00 Revised: 12-17-2C TO Page 1 You are directed 10 make the following changes in the contract documents: UNIT It: SANITARY SEWER IMPROVEMENTS PAY ITEM# CITY 61#D FrEM CBANTITr UNIT ITEM DESCRIPTION UNIT PRICE DeCost er City Cesl TOTAL I 1 3331.4105 Z{J EA CS—r Service S5,275.00 S (10.55 % S $ (10,550,W)l 3 3331.4119 (127y LF a"Sewer Pipe S115,00 S 114.60500) $ - S (141605. 00H I 5 3331.4119 127 LF 8'D1F Sewer Pipe $183.00 $ 23,241.00 $ - $ 23,241.001 I e' 3231.4105 2 EA 4" DIP Sewer 5ery1ce $6300.00 8 lz600,00 $ - $ 12.600.001 I 7- 33u.0001 200 BY Cuecrete Encasement f rUUI4y Pipes $180.00 $ 3,600,00 3 - S 3,600,00I TOTAL UNIT II; SANITARY SEWER IMPROVEMENTS $14.286.00 5 $ 14.286.00 Asterisk (') indicates New Pay item Pipe material for S" SS main and 4' SS services changed to ductile Iron pipe wdh concrete encasement. Changes correspond to Plan Revision 1 as shown on REASONS FOR CHANGE ORDER Sheets 10 a f T of Me canstractlon plays. RECOMMENDED: MJ Thomas En inae' g, LLC By: Name: Michael Thomas- .E, Tllle: Enalneer APPROVAL RECOMMENDED: CFW - Funding Department BY. N/A Name, Till-: RECOMMENDED; CFW �'CanVacY Compliance Manager BY. fs _ _ 6 . Name: Andrew Goodman Title: Pwiecl Manager M&C Number: WA M&C Date Approved: N/A APPROVED: �AA7 Wes By Name, Sam Brous Title- Owner APPROVED: CFW - Assistant City Manager By: AVA Name' Tille: APPROVED: Te/as C-immiravvie4 ClonshuccitooJ/J Name; Chadas Allen Title: Vre President APPROVED AS TO FORM AND LEGALITY. CFW- Assistanl City Atlomey By N/A Name: Title: ATTEST 'Contract Compliance Manager {Project Manager): By signing I acknowtedge that I am the person responsible WA for the monitoring and administration of this cnnlracl, 'incVude ensuring all performance and reporting requirements. Jannette S- Goodall City Secretary OThere are NO City Funds associated with this Contract Q There are City Funds associated with this Contract Revised: 12-17-2015 Page 2 REVIEWED By Andrew Goodman at 9:43 am, Feb 13, 2025 DEVELOPER -AWARDED -PROJECT CHANGE ORDER PROJECT NAME: Basswood Dutch Elms CHANGE ICONTRACT: Water 8 Sanitary Sewer I ORDER No: ICFA # CFA23-0008 I CITY PARTICIPATION,( NO J I CITY PROJECT# 104642 ICITY SECRETARY CONTRACT# 62200 I FIG # 30114-0200431-104642-E07666 1 2 I x # 27655 I FILE # N!A INSPECTOR: Ty Baker Phone No: 017) 992-39DJ PROJECT MANAGER: Debbie Wllihelm Phone No: (817) 392-2481 CONTRACT JNIT ) WATER I SEWER DRAINAGE PAVING STREETLIGHTS I CONTRACT Developer 0evefaper 0ewefaper - Developer ! DAYS Cast City Cdst Developer C t Ci Cost ,Cost C)tY GiH7i Cost tlt'y� Coei C0 Cest IORIGINAL CONTRACT TO DATE $7.400.00 $0.00 _ $0.00 $0.00 I $8T,900,00 $0.00 1 516,;86.00 $0.00 $9.00 $0.00' s0.90 $0.00 J $0.00 $a It S _ $p s9.o-D S0.n0 $0.00 50.00 22 J p 1JEXTRAS {CREDJTS TO DATE (CONTRACT TO DATE (AMOUNT CFPRDP. CHANGE ORDER IRE ISpe C�%� CTAMOUN7 R�VISE��DNTRACT AMOUNT PER $O.00 $7,400.00 $9,20000 s16,600.00 40,00 $0.00 50,OD $000 [� $0,00 Y, 50.00 $62.186.00 kt $G.C6 56.00 S,_ $a.0n s52,1B6.00 f som So a' 30.00 J $O.00 30.00 ' $0.00 50.m 90.00 saza I S0.00 sa.. saw 30.00 $� $ _ $Ei:011_ $G.00 $0,00 $GAD SOAO $OAD 10.00 sum 0 22 0 22 I $0.00 IT(fFAL NIT 516,600.00 $52,106.00 f9.I10 Ill $000 $O,w REVISED COST SHARE Dew. Cast: $68,786.00 City Cost: $0.00 jI TOTAL REVISED CONTRACT $68,786.00 Revised 12-17-2018 Page 1 REVIEWED By Andrew Goodman at 9:43 am, Feb 13, 2025 You are directed to make the fallowing changes In the contract documents_ UNIT I: WATER IMPROVEMENTS PAY ITEM CfTY 61❑ R£M QUANTITY UNIT ITEM CESCRfPTION UNIT PRICJ Ceveloper City Cae[ TOTAL I COsr I 1 3312.2003 1 EA 1" wale, Servlee E3,7no $3700.0o SOdd E3.,00.0033522203 EA T'Waterfl.M.. 55, 50. $5,500.00 30.00 $5.50000 I TOTAL UNIT I:"I,ATERIMPROVEMENTS sa.zoo.oa $0-00 ;9,Z617-OU Asterisk I•) indicates New Pay Item REASONS FOR CHANGE ORDER Added 1 - t"wafer service and ! - 2-wafer sarvfca fa connect to the lot on the "sf. RECOMMENDED: APPROVED: APPROVED: MJ Tho a in ng. LLC Westover up LP Teas C/o}m�mercialCansfruction/J/J By -.By' ev: C ,ILGrI�P�L'CiPGx Name: Michael Thomas_ E. ame: Sam Brous Name: Chades AIIen Title: Enoineer Title: Owner Ind.: Vice President APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY: CFW- Funding Department CFW- Assistant City Manager CFW- Assistant CityAttnmey By: WA By: AVA By. WA Name: Name: Name: Title: Title- T3tla. RECOMMENDED: CFW - *Contract Compliance Manager ATTEST • Contract Compliance Manager (Project Manager): ,¢f By signing I acknowledge that I am the person responsible By: WA for the me uttering and adminlstraFon of this conimcl, TncEutle Andrew Goodman ensuring all performance and repoding requirements. Name= Jannetts S. Goodall City Secretary ©+ There are NO City Funds associated wtlh this Contract Title: Proiact Manager I IThere are City Funds associaled with [his Contract M&C Number: WA MAC Dale Approved: WA Revised: 12-17-20 f Il page 2 REVIEWEQ D,.,,�,xn.«,m. rsz so� - �mcclxF x-, �IN E_ - li e� (ouij = ev a a• (inj = es�.s.0 ReRY SEIYEA NAx oIF FF 11 A./To— nsxii 1 u.1n I GENERAL NOTES LINE �f ENT Im oraeaivwamx FRncE I� it \ nuns. on liowminrnure`roancs`iiv aa"xeixe n se �( TDRIALPEN A., -IN =roDxi miei� J E� oxDw,cma axc,wc 1, L,uMDEN —.x A �..�...�. N.my �e �✓ — niimxs znM eu um J— LINE / � ucxun DxuLoxs�'xo`i�cow�.N - _.-H wnRlx V _ insomu x'P unFSMosvFau>in F R ,us.9 - 19''DI a,C 'Rc —� a xcl xF¢w�sPomiR'oa[cana,[hFv XX ,sxn (lu a vanxo N 7 Im ,zx. 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E"N IIC ON E CLOSELI IS POSSIBLE Fjl T-1 BACKF LL III— B Hi Fjl 1" MIN. II h I— T I I V 1" MIN. TU p. "gug"m �=�y' 12JNCX STANDARD PLASTIC METER BOX 1 -INCH STLNII`AND`P=Tl`C`ME (I -IS —INCH METERS) (CASS C) (I/.814NCHMETERS)(CIAS`SR)SoX [SE_12M'.lS c.- ­T - - " 14... ATEE`.ERWCE RE -- PRIVATE CONCRETE PAVEMENT TRENCH REPAIR aner ACCEPTABLE BACKBILL 33 05 1"001 EMBEDMENT FOR — SERVICES 33 I)S 1 -1. GENERAL NOTES AR�MIDLOW��P,,.C,R�.CO,R,D��L�H�10 T Q jnr S —ENIE-1111111-1 IN— ­iTWN_—K-1— 2WlM. —INSE11-110TI—III Al 1 — I, w _E .11HE MxEou E- -Al.. _0... I—AN.—i"l. IMIM—RAMI� ITI—NI M _E, DD UTILITY CONTACTS —111-11TS111— T ,X 6­,,lMlWMR,,2,TEM aTm Ho=o"AL & VERTICAL CONTROL .—T.—I W IU­­­­VEE­NI170 ....NTZ III E­.l,A,.TAllTlIL I �XCU7ON5�UTHCUR�R�URN�ROR�EE�T�NC"WM i! M-zoz_s REVISIONS DESIRIVIDS &WOCITY 01FORT -O—,T—AS WATER — SANITARY SEWER SERVICES TO SERVE BASSWOOD DUTCH BROS LOT 34, BLOCK I SOUTHWEST BASSWOOD WATER DETAILS DKJTHOMAS xxn El PRE "—' INE SIR IRSIKIN .. _ _ = FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Basswood Dutch Bros. CITY PROJECT NUMBER: 104642 1 WATER PIPE LAID SIZE TYPE OF PIPE LF N/A N/A N/A FIRE HYDRANTS: N/A VALVES (16" OR LARGER) N/A PIPE ABANDONED SIZE TYPE OF PIPE LF N/A N/A N/A N/A DENSITIES: YES ALL PASSED NEW SERVICES: (2) 1" Domestic Copper (2) 1" Irregation Copper SEWER PIPE LAID SIZE TYPE OF PIPE LF OPEN CUT 8" Ductile Iron W/ Encas. 127 PIPE ABANDONED SIZE TYPE OF PIPE LF N/A N/A N/A N/A DENSITIES: YES ALL PASSED NEW SERVICES: (2) 4" PVC TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS March 19, 2025 Tejas Construction LLC. PO Box 10395 River Oaks, Tx 76114 RE: Acceptance Letter Project Name: Basswood Dutch Bros. Project Type: Sewer, Water City Project No.: 104642 To Whom It May Concern: On March 19, 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 March 19, 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- 392-6251. Sincerely, s Ge,ndre..w' �C�.ti Andrew Goodman, Project Manager Cc: Ty Barker, Inspector Troy Gardner, Inspection Supervisor Ariel Duarte, Senior Inspector Andrew Goodman , Program Manager MJ Thomas Engineering LLC., Consultant Tejas Construction LLC., Contractor Westover Development, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 08/20/19 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 Charles Allen, Vice President Of Tejas Comm. Const., 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 tabor 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; CPN 104642 Basswood Dutch Brothers Charles Allen, Vice President Subscribed and sworn before me on this date qSA of April, 2025. 4 /e& Notary Public CONSENT OF SURETY The Westover Group To: 556 8th Avenue Fort Worth, TX 76102 Project: Basswood Dutch Brothers Contract No.: CFA23-0008 Contract Date: Contractor: Tejas Commercial Construction, LLC PO Box 10395 River Oaks, TX 76114 The Ohio Casualty Insurance Company (hereinafter "Surety"), as surety for Tejas Commercial Construction. Lam, the principal on the above referenced performance and payment bonds, hereby consents and agrees to (check appropriate box or boxes): The amount of the performance bond and payment bond referenced above being increased from $ 45,300.00 (original Bond amount) to $ 68,786.00 ❑ The issuance of progress payment No. to Contractor in the amount of ❑ The reduction in the amount of retainage held under the Contract from to ® Final payment of $ 68,786.00 being paid to Contractor. , or any part thereof All other terms and conditions of the above -referenced performance bond and payment bond shall remain unchanged and in full force and effect. IN WITNESS WHEREOF, the Surety has set its hand this loth day of March 2025 The Ohio Casualty Insurance Company _ BY ._ Jordan Pi AttorneO55K-Fact = This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company Mutual The Ohio Casualty Insurance Company Certificate No: 8207315-992468 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Jordan Pitts; Lloyd Ray Pitts, Jr.; William D. Birdsong all of the city of Richardson state of TX each individually if there be more than one named, its true and lawful attorney -in -fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this _ 9tlf` day -of February , 2022 ^G Liberty Mutual Insurance Company %\ ,\ 11 INS&Fo � 21NSU �Fom The Ohio Casualty Insurance Company oor� Wit American Insurance Company ui 4:_ r- ;1912�0 0 1919 1991 0 1' 3 yy �� o a� rri� ` dS SACHU`�� ,aD �� NAMPS� ,aa `(s �NDrANp' •da3 B '� Ci 1 i� * 1� Hl * �� '',N * td Y 3 m David M. Carey, Assistant Secretary E �=3 co State-of-r ENN9,Y.>r'VAN`A . sr N rn County,of MONTGCMERY ` `:� o E On this 91h dayof ekltcrary 2022 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance L) u Company, The Ohio basualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes m •-- > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. > IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. CU Co �O kyaoNW < Commonwealth of Pennsylvania- NotarySeal ` tNQ o�M F4t� Teresa Pastella, Notary Public N'� .6. r` y v Montgomery County OF My commission expires March 28, 2025 B O N (Q �P Commission number 1126044 Y • i Qj .+ L4 G Member, Pennsylvania Association of Notaries eresa Pastella, Notary Public Q O qRY O N This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 3 ao O •S Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: a ARTICLE IV — OFFICERS: Section 12. Power of Attorney. o-00 0 110— Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the 0 � President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety o = > r— any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attomey, shall -0 ca have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such o m ZL) instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney -in -fact under the '4 cc provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. tL CL ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixe&1he-ceals_ of --aid Gbrn eriles this 1 Oth day of March 2025 P� iNS4/1 �y�� ,ems "c�9` .�'s Q� j 3°oavoggro��c� c m r a 1912 y o � y it�•r-79 �, o ::_ a �59� Jo ' {.�'� rdd Ssacxus�` as ZO `�Mne ��� a ! vNorp D� By: Renee C. Llewellyn, Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02/21 Liberty Mutual SURETY Figure: 28 TAC § 1.601(a)(2)(B) Have a complaint or need help? If you have a problem with a claim or your premium, call your insurance company or HMO first. If you can't work out the issue, the Texas Department of Insurance may be able to help. Even if you file a complaint with the Texas Department of Insurance, you should also file a complaint or appeal through your insurance company or HMO. If you don't, you may lose your right to appeal. The Ohio Casualty Insurance Company To get information or file a complaint with your insurance company or HMO: Call: Liberty Mutual Surety Claims at 206-473-6210 Online: www.LibertyMutualSuretyClaims.com Email: HOSCL@libertymutual.com Mail: P.O. Box 34526 Seattle, WA 98124 The Texas Department of Insurance To get help with an insurance question or file a complaint with the state: Call with a question: 1-800-252-3439 File a complaint: www.tdi.texas.gov Email: ConsumerProtection@tdi.texas.gov Mail: MC 111-1A, P.O. Box 149091, Austin, TX 78714-9091 jiene una queja o necesita ayuda? Si tiene, un problema con una reclamacion o con su prima de seguro, (lame primero a su compania de seguros o HMO. Si no puede resolver el problema, es posible que el Departamento de Seguros de Texas (Texas Department of Insurance, por su nombre en ingles) pueda ayudar. Aun si usted presenta una queja ante el Deparamento de Seguros de Texas, tambien debe presentar una queja a traves del proceso de quejas o de apelaciones de su compania de seguros o HMO. Si no to hace, podria perder su derecho para apelar. The Ohio Casualty Insurance Company Para obtener informaci6n o para presentar una queja ante su compania de seguros o HMO: LMS-15292e 9/20 Llame a: Liberty Mutual Surety Claims al 206-473-6210 En linea: www.LibertyMutualSuretyClaims.com Correo electronico: HOSCL@libertymutual.com Direccion postal: P.O. Box 34526 Seattle, WA 98124 El Departamento de Seguros de Texas Para obtener ayuda con una pregunta relacionada con los seguros o para presentar una queja ante el estado: Llame con sus preguntas al: 1-800-252-3439 Presente una queja en: www.tdi.texas.gov Correo electronico: ConsumerProtection@tdi.texas.gov Direccion postal: MC 111-1A, P.O. Box 149091, Austin, TX 78714-9091 LMS-15292e 9/20