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Contract 60105-FP1
FORT WORTH, TRANSPORTATION AND PUBLIC WORKS NOTICE OF PROJECT COM LETION -FP1 City Secretary No: 60105 Date Received: 5/28/2025 City Project Ns: 103260 Regarding contract 60105 1 Greenleaf Sump Storm Drain for as required by the TRANSPORTATION AND PUBLIC WORKS DEPARTM as approved by City Council on 8/22/2023 through M&C 23-0693 the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTM upon the recommendation of the Assistant Director of the Transportation & Public Works Department has accepted the project as complete. Original Contract Amount: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Work Completed: Less Deductions: Liquidated Damages: Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: Less Previous Payments: Final Payment Due —M&ic� L. YVAA-'' c Patricia L. Wad...k (May 21, 202516. �5 CDT) Recommended for Acceptance Asst. Director, TPW - Capital Delivery $ 6,050,404.00 Days 365 $ 0.00 No 2_ Days Added by CO 45 $ 6,050,404.00 Total Days 410 $ 5,959,332.52 Days Charged 410 Days Q $ $ 5,959,332.52 $ 5, 661, 365.89 $ 297,958.63 /U-� Accepted Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT r"�C-� Asst. City Manager 05/21 /2025 Date 05/22/2025 Date 05/27/2025 Date / Day OFFICIAL RECORD Comm. nts: CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment Invoice No. Final To (Owner) City of Fort Worth Invoicing Period (From - To): hrvoice Date: 2/24/2025 P. O. From (Contractor): Remit to ( If Nat Automatic Deposit ): Number: SJ Louis Construction of Texas LTD Project: 103260 Contractor's CFW Vendor No.: 0000007647 City secretary contract 60105 Contract The Construction of Greenleaf Sump Storm Drain Number: Namme:: Application For Payment Change Order Summary (Approved Change Orders 1. ORIGINAL CONTRACT PRICE........................................................... $ $6,050,404.00 Number Additions Deletions 2. Net change by Change Orders................................................................. $ $0.00 1 3. Current Contract Price (Line 1 t 2)........................................................ $ $6,050,404.00 2 $101,848.43 $101,848.43 4. TOTAL COMPLETED AND STORED TO DATE 3 (Progress Estimate, Construction Allowance and Change Orders)....... $ $5,959,332.52 4 5. RETAINAGE: 5 a. X $5,959,332.52 Work Completed..........., $ 6 b. X ($8.00) *Retainage Deduction $ -$8.00 7 c. Total Retainage (Line 5a + Line 5b)................................ $ -$8.00 8 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c).............................. $ $5,959,324.52 TOTALS $101,848.43 $101,848.43 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)......... $ $5,661,365.89 NET CHANGE BY $0.00 8. AMOUNT DUE THIS APPLICATION .................................................. $ $297,958.63 CHANGE ORDERS 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + COs + Line 5 above) ............... $ $91,063.48 Contractor's Certification The Contractor certifies with the submittal of this document and associated Payment Request Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Applications for Payment; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, security interest or encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Liquidated Damages $650.00 x day /%Z� May 16, 2025 16:30 CDT) 10. CONTRACT TIME: a, Days Awarded 365 b, Days Added by CO 45 C. Total Days 410 d. Days Charged 410 e, Days Remaining Consent of Surety Affidavit of Bills Paid This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Umt Pnce Progress ESOmate Progress Estimate For (w°tract) The Construction of Greenleaf Sump Storm Drain Appncanon Penad A Item S fie m Item No. Desaipvov pem a.-- Secnon No. units- Greenleaf Sumo Storm Drain 1 0171 0102 As -Built Survev 017123 2 02413013 Remove 18"Storm Lme 024114 3 02413023 Remove 48-Stott Line 024114 4 0241 3024 Remove 54" Storm Lme 02 41 14 5 0261 1300 Remove Conc Curb 8 Gutter 02 41 14 6 0241 341) Remove 4' S1wm Jundmn Box 02 41 14 7 3110 0101 Site CleerinD 31 In. 3123 0101 Unclasmfied Excava0on (Sluice Gate end Headwall) 3123 16, 3123 B tin 2n 9 3125 0101 SWPPP z 1 acre 3125 W 10 32010203 Asphalt Pvmt Reoalr Bevond Defined WldM Industdel 340117 12 320606068°Coe Curt end Gutteral/Intlustnal 32 ;2 �613 14 3292 0100 Block Sod Placement 32 92 13 33010001 Pre -CCTV Insoecbon 330131 Umt of Measure LS LF LF LF LF EA LS CV LS SV BY LF SV LF Bid Quam�ty 1.000000 209.000OO. 3:00000w 48 00000� 130.0000011 1.000OOw 1.00000 ]50.000000 1.00000 126]00000 J 90.00000f/JJ 12100 OOOOOJQ 6000000 Cty$eC'- Conkaci Nmv Dm[hice 120100 $SS.OJ $]S.OJ $80.01f $10.01(JJ $2.500.0Q1 E5 000.0 $30.00 $28.000 0 $1450 f $160 $40.OJJJ $$6 Ol(17 $50 60105 B Btd Value E2.000 00 $11.49500 $2.62500 $3.840 00 $1.300 00 $2.500 00 MGM 00 $22.500 00 $28.000 00 $18081500 $$5.20000 $5.000 00 $T 60 00 $30000 C Em WQu 1y Iv4a11� 1.000000001 209.000000001 35000000001 48 000000001 130.000000001 1.000000001 1.000000001 750.00000000 1.000000001 124]000000001 120.000000001 100.000000001 1210 000000001 D Value 52.000 001 $11.495001 VMS 001 $3.840 001 $1.300 001 $2.500 001 MGM 001 $22.500 00 $28.000 001 $180815001 $$4.800001 53.120001 $5.000 001 S].260 001 Prenoudy lmtalled Value $2,000.001 $11,495001 $2,625.001 $3.840.001 E1.300.001 $2,500.001 $5,000.001 E22.500 00 $28.000 001 E180.815.001 E84.800.001 $5.000.001 $7.260.001 APPheaaov Number APPncanov Date E Matenals Presently Valua 3ltis Penod StmM (mtiv C) 1 1 1 1 1 1 I Contractor's Application Final 2/24/2025 TOral Completed % mN Stmed to Dete (P) (D+E) B 1 52.000 Oli 100 0% 1 $11.4950(i 1000o I $2.6250J 1000% 1 $3.840 0if 1000% $1.300 01(JJ 1000% $2.500 OTI 1000% I $5.000 OJd 100 0% $22.500 00 100 0% $28.000 0 100 0 $1808150 53.120 f 1000% $$4.80001if 923% 1 $5.000 21 100 0 I $].260 0 100 0% 1 G Balarce to P�mrt 1- 1) Ei540001( $30001i Qummty lrmalled Tins PMw I I I 10PmmtCnNiwn�spectlon "overpayment 0y $8.00, reduce 330131 33010002 �.a15 18 t i 6 S an LF 1709000000 5200 $3.41800 170900000000 170900000000 $3.41800 51.70900 53.418.00 $1.709.00 $3.41800 1000% $130909 1000% I 17 33050109aTrench Safety 330510 LF 170900000, $100 $130900 18 33050111 Valve Box Atlmstment 330514 EA 4.00000w $5000) $2.00000 4.000000001 $2.000001 $2.000.001 $2.0001 1000% 19 1 20 33050112 Concrete Cellar fSfonnl 33314271212" DIP Sewer 330517 3311 In EA LF 3.00OOOi 6000000w $1500.0 $3340 f SC50000 $20.04000 3.000000001 I SC500001 I $4.500.001 I 1 I SC5000 1000% $20.0400J F Opllon of E tstin° Utllitles 33 05 30 EA 5.00000w E1 500.01( $].500 00 5.000000001 $].500 001 E].500.001 $].500 0 100 0% 221 2 3330M11 EJR3 �jZypl;9lCrv, iClass llr 334110 LF 123.000OOw $1.390.0 $170.97000 123.000000001 $170.970001 $170,970.001 1 $170.9]00 1000% 23 24 33410201 21"RCP Class 111 3341030936' RCP Class 111 334110 334000 LF LF 9600000v1 5000000w $14D0.0 J $1.468.01(f $13440000 $73.40000 96000000001 I $134400001 I $134,400.001 I 1 1 $1344000 1000% $73,4000J 25 3341 0409 48" RCP CIass 111 33 41 10 LF 210 0000 _I 546.0 UC834 00 29 000000001 UC834 001 $44.834 001 1 UC834 0 1000% 26 3341050254'RCP CI- III 344110 LF 64000006 $1 $1.610.0 $103.04000 64000000001 $103.040001 $103.WO.001 1 I,YI(ll 1 $103.0400 '000% 33410701 72" RCP, CIass 111 by Open C.(Materials) 3334110,3340 27A LF 500.000000 $42704 $213.51920 500.0000OOOO1 $213.519201 $213,519.201 $213.51920 1000% 33410701 72"RCP, CIass 111 by Open Cut (Installallon) �4110, 3340 I 27B LF 500.000000 $2205M $1102.98080 500.000000001 $1102.980801 $1.102.980801 $1102.98080 1000% 1 28 29A 3341 0701 72' RCP, CIass III Garner Pipe 334113/3 Bx4 Box Culved (Metedals) 33 4000 344080 LF LF i66.00000n 681.00OO a 51.8]7.0 $205W $311.582 00 '14019129 186.000000001 681.000000001 $311.582 001 $140191291 $311.582.001 $140.191.291 1 1 $311.582 00 100 0% $14019121l 1000% 1 29B 334113036A Box Culvert 0nstallaten) 344110 LF 681.00000e $1,808.14 $1,231.34271 681.000000001 $1,231.342711 $1.231.342711 $0001 1 $1,231.342]111000% -296167E-121 1 30 334900058'Stonn Jundlon Box 334910 LS 4.00000- $420000 Jf $16800000 4.000000001 $168000001 E168.000.001 1 1 $16800001f 1000% Box Curt i7050% 32 33 334950011110' lnlet�ce 33497001 4'Dmo Inlet 336920 344920 EA LS B.00000! 1.00OOOA $8300.01(l(J $10,50001(ff 566AGO 00 $10.50000 6.000000001 1 549.800001 1 $49.800001 1 1 1 J00% 1 $49.8000((IIfI 8166000J $10.500 O1I 34 35 34]1 0001 Tre01c Control 91990001 Remove 5'Curb Inlet 344913 024114 MO EA 7.00000! 6.000001 $3 000.01( $1,300.0Qff 521.000 00 $10.40000 8.000000001 6.000000001 524.000 001 $7.800001 $24.000 001 $7,800.001 1 1 524.000 Ow 114 3% $7.1000/ ]50% $3 000.OJ $2.600.OJ 36 9q9R99y 000(�2 6'X4' Bar Temoorery PIUD 33 41 10 EA 1.00000! $7 000.01( S].000 00 1.000000001 S].000 001 $7,000.001 1 I $].000 Ow 1000% I 37 OQ(I �u J2C� Te p)por v Plu° 33 4o W LS 1:000001" $2,000.0Q) $2.000 00 1.000000001 $2.000 001 $2,000.001 1 $2.000 0/ 100 0 38 yyyy ytJ y Ua iiccee el S'iruT. .3030 EA 1.00000! $892000.01( SB9200000 1.000000001 $892000001 $892,000.001 1 $8920000� 1000% 39 99990005 72"F1ao Gate 334000 LF 1:000OO1 $40.0000) $40.00000 1.000000001 $40.000001 $40,000001 1 $40.00000 1000% 40A 40B 99990008112: Steel Casino by Ocen Cut(Meter1a1s1 9q99�990006102"Steel C-nu by Ocen Cut(Installa0on) 334080 344000 EA EA 166.00000(/ 166.00000" $1146.0' 51.930.9 $19024000 $320.54200 166.000000001 166.000000001 $190240001 $320.542001 $190,240.001 $320,542.001 $0001 $0001 $19024000 1000% $320.5420: 1000% -330141 E.131 -6 72E-131 41 SW i0ie0i0181 9 99 ('F!A7 7>mQT Wi 91M211OU(S CV E169120-011Q(( Jf $$60.00000 $169000001 E$60,000001 $16�$60.000 43B 9999 Intel Fitter kill CE1Re°u/, entl 31230020 WWW EA 3000OOOOO1 8.00000. $5000.OJ S40.00000 3000000000001 6.000000001 $60.000001 530.000001 $30.000001 1 1 1 Ow 1000% 1 530.0000, 750% $100000J 44 99990010 Catch Balm RIter ... EA B.00000, $S.000.OJ $40.00000 1 1 1 1 1 $40.000 O1 45 9999 0011 (' p' cry/ rnu (GPSI Slaking 017123 LS 1.00000! E5 000.0J 55.000 00 1.000000001 56000 001 $5,000.001 1 1 $5.000 0l 1000 00 0% I 46 47 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 9999 0012 Consirudi°n 99990013 Construetlon Allowance 01 ]123 017123 LS LS 1.000OOw 1:000OO. $S.000.OJ E100000.OJ $5.000 00 110.00.00 1.000000001 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I $5.000 001 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I $5,000.001 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 $5.000 0 100 0% 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I $too 000.0J I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 3hs docunwm nas teen rrodified Oom tU ongiml form as an EJCDC dommsm and the user elm not IngUgtt Inc rrodtficaeom You are encouraged mread t docmncm carefully - consdt Legal C.-I prior to vs execmroa C-620 Unit Pnoe Progress Estimate Progress Estimate The Construction of Greenleaf Sump Storm Drain Applteanon Paiad A Item a.ItemNo. Dewnpnou I I I I I I Oty$,,'- 60105 Contract `t— B Spectficahon Umt of Bid Q-1y Umt Prme Btd Value Section No. Measure C D E Emtre[edQwtaity Value Pte...lmtalled Value Value This Penod Matenals Presently Imtell� Stmed(oot m C) Contractor's Application Final 2/24/2025 F G Total Completed % B11-11 Flmds attl SiIot' to Date (P) B-p) Quaraity lmtalled Tlos (D+E) B Penod I I I I I i 'Dus docwwta has been ondifi¢d from tU e.goal form as an EJCIx docwent and the user dtd to, logNt& tie rro fieetotts You areercumagedmread the documem carefully- e.- 411 Comtal pnor to ns—ewtoa C-620 Unit Pnoe Progress EsOmate Progress Estimate IFor(wniraer) The Construction of Greenleaf Sump Storm Drain IAPPEea000—W Brd I —No. Desa,— Totals Oty$,,'- 60105 Conhaci N— B SPemficafiov Umt of Bid Q-1y UmrPace BW Value Secnon No. Meaane C E—W Q-1y I�11� Contractor's Application APPbcahon Number Final Apphcamv Dare 2/24/2025 D E F G Total Completed % P PBalanae Vre P�mdr Mares P `y DQ—,Immlled Tloa alor renoudy lrWalled Value Valua Tlda enod s,,W(-in C) mvl Stored to ere (B) (B -P) (D + E) B Penod S5.118.1U.00 55.T/8.120.00� S5.7T8.IM.00 955% $2n.280.00 'Dus documem bas been r ,fied — rU ongual krm I an E1CDC dommrenr and rbe —did m kgblrgk the rrodrficaeom' You are encouraged m read d docmnem carefully - co - Legal C.—I Prior ro vs execwron. C-620 Change Order Progress Estimate Construction Allowance Usage ADDITIONS For (contract) 103260 The Construction of Greenleaf Sump Storm Drain Application Period: A Item Item Number Description 48 Mobili-him of HydraTech Crew Gam Ohio for Seal Installation 49 Famish & Install HydmTrte 304SS Seal on 6' X 4' Box Culvert 50 Additional Costs Associated with the Plan Changes at the Junction B Totals City Secretary 60105 Contract Nam: B C Specification Unit of Section No. Measure Quantity to Add Unit Price Addition Value Estimated Quantity Installed LS 1.00000000 $736� 0.00_ $7,360.00 1.00000000 EA 17.00000000 $3 5C�9.88 _ $60,177.96 17.00000000 LS L000000000 SILVIO � $11,822.13 1.00000000 D Value $7,360.0C $60,177.9( $1L822.13 Previously Installed Value $7,360.0( $60,177.9( $11,822.1? This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the doemnem carefully and consult Legal Counsel prior torts exemtmv. Value This Petted Contractor's Application Final 2/24/2025 E F Total Completed / Balance to Fmish Materials Presently and Smrad to Date (F) (B - F) Stated (not in C) (D I E) B $7,360.00 100.0% $60,177.96 1000% $11,822.13 100.0% $79.360.09 100.0 . C-620 Change Order Progress Estimate Construction Allowance Usage CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED For (contract). 103260 The Construction of Greenleaf Sump Storm Drain Application Period: A B C I Item Btd Item Number Description specification Unit of Quantity to Delete Unit Pace Reduction Value Not Used Section No. Measure I 47 9999.0013 Connaneion Allowance 017123 LS 1.00000000 $79.360.09 $79,36009 Totals $79.360.04 Contractor's Application Application Number: Final Application Date: 2/24/2025 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior tons execatma. C-620 Change Order Progress Estimate Change Order Number 1 1 ADDITIONS Far (Cornet): 103260 The Construction of Greenleaf Sump Storm Drain City Secretary Contract Num: Applicatmn Period: Item Change Order hem Desesipiion No Totals A B Addition Specification Unit of CO Quantity to Add Unit Price Change Order Section No. Me- Value 60105 C D Estimated Quantity Value Installed Previously Value This Installed Value Period This document has been modified from its aiguod form as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior tons execution. Contractor's Application appucauon rvwuua: Final Application Date: 2/24/2025 E F Total Completed % Balance to Finish Materials Presently and Stored to Date (F) (B -F) Blared (not in C) (D +E) B C-620 Change Order Progress Estimate Change Order Number 1 1 DELETIONS For (contract): 103260 The Construction of Greenleaf Sump Storm Drain Application Permit A E C Item Deletion Chavge Order Item Desmptiov Specification Unit of CD Delete Quantto Unit Price Change Order Not Used No. Section No. Me— Value Totals Application Number: Application Date: D E Not Used Not Used Not Used Not Used This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document ci refirlly and consult Legal Counsel prior torts e-catmn. Contractor's Application Final 2/24/2025 F Not Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 2 ADDITIONS Contractor's Application IFor (`°"tree[)' 103260 The Construction of Greenleaf Sump Storm Drain Crty Secretary 60105 Apphcsum Number, Final Contract Num: Application Perod: Apphesum Date: 2/24/2025 A B C D E F Item Total Completed Change Ordw item Descri [ion Specification p Uvrt of CO Qoavhty to Add Uvit Price Addmon Charige Order Value Estimated Quantity installed Provrously Value installed Value Value This Period Materials Presently Stored (not m C) and Stored to Date (F) No. Section No. Measure (D+E) B 48 9999.0014 CMR k2 LS L00000000 S43,900.69 $43,900.69 1 00000000 141,91069 $43 900 69 $43,900 69 100.0 49 9999.0015 CMR #6 LS 1.00000000 S28,680.61 S28,680.61 1.0.0.0.0 $28 680.61 $28 680.61 $28.680.61 100.0% 50 9999.0016 CMR k7 LS L00000000 $2%267.13 $29,267.13 100000000 $29 267 13 $29 267 13 $29,267 13 100.0 Touts $101.848.43 $101.848.43 100.0% $101.848.431 S10H R48.431 This document has been modified from its original form as an E1CDC document and the user did not highhght the modifications. You are evwwaged to read the document carefully and consult Legal Couiisel prior torts a —fie". Balance to Finish (B - F) C-620 Change Order Progress Estimate Change Order Number 1 2 Contractor's Application DELETIONS Ew lCnuhuetl' 103260 The Construction of Greenleaf Sump Storm Drain Apphcntmn Number. Final Auuhcatmn Petted: Applmetmn Date: 2/24/2025 A B C D E P Rem CO Quantity to Deletion Change Change Order Item Deacnption Specification of Delete Umt Pruw Order Value Not Used Net Used Nut Used Nut Used Nut Used Net Used Nut Used Not Uscd No. 15 3301.1001 Pre -CCTV lasneenou en Sectwv No. Meaewe LP 20.00000000 $5.0k $100.0k 16 3301.0002 Post -CCTV Inspection LP 4.00000000 $2.00 $8.00 _ 20-3331,4212 12" DIP Sewer LP 53.41446108 $334.00 $17,840.43 _ 24 3341.0309 36" RCP, Class III LP 50.00000000 _ $13F8.0 10 $73,400.00 32 3349.7.1 4' Drop Inlet EA 1.00000000 _ SM500,00 $10,500.00 Totals $101.848.43 This document has been mothfied from its ofigunad form as an E1CDC document and the user dud not highhght the modifications. You are encouraged to read the docuun art careful and consult Legal Couuusel prior torts e—t en. C-620 Change Order Progress Estimate Change Order Number 1 3 ADDITIONS Contractor's Application IFor (`°"tree[)' 103260 The Construction of Greenleaf Sump Storm Drain City Secretary 60105 Contract Num: Application Period: A B C Item Addition Estimated QuantityPreviously Unit of CO Quantity to Add Unit Price Change Order Installed Change Order Item Desch [ion Sped- No No. p Section No. Measwe Value Totals D Value Installed Value Value This Period Application Number: Final Application Date: 2/24/2025 E F Balance to Fmish Total Completed (B - F) Materials Pmsevtly Stored (not in C) end Stored to Data (F) (D+E) B This document has been modified from its original form as an E1CDC document and the user did not highlight the modifications. You are evwwaged to read the document carefully and consult Legal Counsel prior tons execution. C-620 Change Order Progress Estimate Change Order Number 1 3 DELETIONS IFe,(contract): 103260 The Construction of Greenleaf sump Storm Drain IApplieation Pmod: A B C I Item Co DeantY to ti Delcti- Change Order hem Spedfication U- of rut Price Change Order Not Used No. �cnption Section No. Me- Delete Value I I I I I Totals Contractor's Application Application Number: Final Arctication Date: 2/24/2025 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an E1CDC document and the user did not highhght the modificafions. You are evwwaged to read the document carefully and consult Legal Counsel prior torts execution. C-620 Change Order Progress Estimate Change Order Number 1 4 ADDITIONS Contractor's Application IFar (e-u ct): 103260 The Construction of Greenleaf Sump Storm Drain Crty Secretary 60105 Contract Num: Appluwhon Perod: A B C Item Addutuov Eshmaled Quavtury Change Order Item Specification ass of CO Quantuty to Add Unrt Pnce Change Order No Desoruptiov Sactlon No Meaewe Value metalled Totals D Value Previously metalled Value Value Thts Period Applicatuon Number. Final Applicatuon Date: 2/24/2025 E F Balance to Fmish Total Completed Materials Preaevtly (g - p) and Stored to Date (F) Stored (vo[ iv C) (D I E) B This document has been modufued from its ofigo,sd form as an E1CDC document and the user dud not highhght the modifications. You are evwwaged to read the document carefully and consult Legal C—el prior tons e-carton. C-620 Change Order Progress Estimate Change Order Number 1 4 DELETIONS IFe,(contract): 103260 The Construction of Greenleaf sump Storm Drain IApplieation Pmod: A B C I Item Co DeantY to ti Delcti- Change Order hem Spedfication U- of rut Price Change Order Not Used No. �cnption Section No. Me- Delete Value I I I I I Totals Contractor's Application Application Number: Final Arctication Date: 2/24/2025 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an E1CDC document and the user did not highhght the modificafions. You are evwwaged to read the document carefully and consult Legal Counsel prior torts execution. C-620 Change Order Progress Estimate Change Order Number 1 5 ADDITIONS Contractor's Application IFor (tout act): 103260 The Construction of Greenleaf Sump Storm Drain City Secretary 60105 Contract Num: Application Period: A B C Item Addition Estimated Quantity Change Order Item Specification Unit of CO Quantity to Add Unit Pnce Change Order No Desoriptiov Section No Mass— Value metalled Totals D Value Previously metalled Value Valueod Period Application Number. Final Application Date: 2/24/2025 E F Balance to Finish Total Completed and Stored to Date (F) Stored (riot in C) Materials Presently (g - p) (D I E) B This document has been modified from its original form as an E1CDC document and the user did not highlight the modifiestions. You are evwwaged to read the document cwefolly and consult Legal Counsel prior tons execution. C-620 Change Order Progress Estimate Change Order Number 1 5 DELETIONS IFor(contract): 103260 The Construction of Greenleaf Sump storm Drain IApplieation Pmod: A B C I Item CO tit Deleh°° Chavge Order hem Deaai tion Specificahov Uvrt of DeleteUmt Price Change Order Not Used No. p Section No. Measure Value I I I I I Totals Contractor's Application Application Number: Final Arctication Date: 2/24/2025 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an E1CDC document and the user dud not highhght the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior torts execution. C-620 Change Order Progress Estimate Change Order Number 1 6 ADDITIONS IFor (`°"tree[)' 103260 The Construction of Greenleaf Sump Storm Drain City Secretary 60105 Contract Num: Application Period: A B C D Item Change Order Item spo ificatum Una antity of CO Quto Add Addition Unit Price Change Order Estimated Quantity Value No. Deacnption Section No. Measure Value metalled Totals Previously Value This Installed Value Period This document has been modified from its original forin as an E1CDC document and the user did not highlight the modifications. You are evwwaged to read the document carefully and consult Legal Counsel prior tons execution. Contractor's Application Application Number: Final Application Date: 2/24/2025 E F Balance to Finish Total Completed % Materials Pmsent y and Stored to Date (� n C) (B - F) Stored (not i or - B C-620 Change Order Progress Estimate Change Order Number 1 6 DELETIONS IFe,(contract): 103260 The Construction of Greenleaf sump Storm Drain IApplieation Pmod: A B C I Item Co DeantY to ti Delcti- Change Order hem Spedfication U- of rut Price Change Order Not Used No. �cnption Section No. Me- Delete Value I I I I I Totals Contractor's Application Application Number: Final Arctication Date: 2/24/2025 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an E1CDC document and the user did not highhght the modificafions. You are evwwaged to read the document carefully and consult Legal Counsel prior torts execution. C-620 Change Order Progress Estimate Change Order Number 1 7 ADDITIONS Contractor's Application IFor (`°"tree[): 103260 The Construction of Greenleaf Sump Storm Drain City Secretary 60105 Contract Num: Application Period: A B C Item Addmon Estimated Quantity Change Order Item _sm [ion Specification -it of CO Q ismay to Add Unit Price Change Order Installed No. p Section No. Measwe Value Totals D Value Previously Installed Value Value This Period Application Number: Final Application Date: 2/24/2025 E F Balance to Finish Total Completed Materials Presently Stored (not in C) and Stored to Date (I� (B - F) (D+E) B This document has been modified from its original form as an E1CDC document and the user did not highlight the modifications. You are evwwaged to read the document carefully and consult Legal Counsel prior tons execution. C-620 Change Order Progress Estimate Change Order Number 1 7 DELETIONS IFe,(contract): 103260 The Construction of Greenleaf sump Storm Drain IApplieation Pmod: A B C I Item Co DeantY to ti Delcti- Change Order hem Spedfication U- of rut Price Change Order Not Used No. �cnption Section No. Me- Delete Value I I I I I Totals Contractor's Application Application Number: Final Arctication Date: 2/24/2025 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an E1CDC document and the user did not highhght the modificafions. You are evwwaged to read the document carefully and consult Legal Counsel prior torts execution. C-620 Change Order Progress Estimate Change Order Number 1 8 ADDITIONS Contractor's Application IFar (e-u ct): 103260 The Construction of Greenleaf Sump Storm Drain Crty Secretary 60105 Contract Num: Appluwhon Perod: A B C Item Addutuov Eshmaled Quavtury Change Order Item Specification ass of CO Quantuty to Add Unrt Pnce Change Order No Desoruptiov Sactlon No Meaewe Value metalled Totals D Value Previously metalled Value Value Thts Period Applicatuon Number. Final Applicatuon Date: 2/24/2025 E F Balance to Fmish Total Completed Materials Preaevtly (g - p) and Stored to Date (F) Stored (vo[ iv C) (D I E) B This document has been modufued from its ofigo,sd form as an E1CDC document and the user dud not highhght the modifications. You are evwwaged to read the document carefully and consult Legal C—el prior tons e-carton. C-620 Change Order Progress Estimate Change Order Number 1 8 DELETIONS IFe,(contract): 103260 The Construction of Greenleaf sump Storm Drain IApplieation Pmod: A B C I Item Co DeantY to ti Delcti- Change Order hem Spedfication U- of rut Price Change Order Not Used No. �cnption Section No. Me- Delete Value I I I I I Totals Contractor's Application Application Number: Final Arctication Date: 2/24/2025 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original form as an E1CDC document and the user did not highhght the modificafions. You are evwwaged to read the document carefully and consult Legal Counsel prior torts execution. City of Fort Worth Summary of Charges City Secretary Contract Num: 60105 I The Construction of Greenleaf Sump Storm Drain Applicln" O.: 0 Project Number: 103260 Application Period: 0 Number: Final Application Date: 2/24/2025 Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Net I Oriinal Contract 152009-0200431-5740010-103 60-002880-9999 $5,857,484.09 $192,919.91 ($0.00) ($0.00) 10 10 10 10 10 10 10 10 10 10 Change Order 152009-0200431-5740010-103260-002880-9999 10 10 10 10 10 10 10 10 10 10 Change Order 2 152009-0200431-5740010-103260-002880-9999 $101,848.43 ($101,848.43) $101,848.43 $101,848.43 10 10 10 10 10 10 10 10 10 10 City Secretary Contract Num: 60105 Application Period: Funding Identification (FID) Change Order 3 152009-0200431-5740010-103260-002880-9999 I0 10 I0 10 I0 10 I0 10 I0 10 Change Order 4 152009-0200431-5740010-103260-002880-9999 I0 10 I0 10 I0 10 I0 10 I0 10 Change Order 5 152009-0200431-5740010-103260-002880-9999 I0 10 I0 10 I0 10 I0 10 I0 10 City of Fort Worth Summary of Charges The Construction of Greenleaf Sump Storm Drain I P. 0. : 0 I Application Number: Total Completed Amt Remaining Final Gross Project Number: 103260 Application Date: 2/24/2025 Retainage Net City Secretary Contract Num: 60105 Application Period: Funding Identification (FID) Change Order 6 152009-0200431-5740010-103260-002880-9999 I0 10 I0 10 I0 10 I0 10 I0 10 Change Order 7 152009-0200431-5740010-103260-002880-9999 I0 10 I0 10 I0 10 I0 10 I0 10 Change Order 8 152009-0200431-5740010-103260-002880-9999 I0 10 I0 10 I0 10 I0 10 I0 10 City of Fort Worth Summary of Charges The Construction of Greenleaf Sump Storm Drain I P. 0. : 0 I Application Number: Total Completed Amt Remaining Final Gross Project Number: 103260 Application Date: 2/24/2025 Retainage Net City Secretary Contract Num: 60105 Application Period: Funding Identification (FID) Totals 152009-0200431-5740010-103260-002880-9999 10 10 10 10 10 10 10 10 10 10 City of Fort Worth Summary of Charges The Construction of Greenleaf Sump Storm Drain I P. o.: 0 Application 0 Number: Final Total Completed Amt Remaining Gross $5,959,332.52 $91,071.48 $101,848.43 Project Number: 103260 Application Date: 2/24/2025 Retainage Net $101,848.43 Grand Total 1 1 $5,959,332.52 1 1 $91,071.48 1 1 $101,848.43 1 1 ($297,958.63)1 1 $399,807.06 FORT WORTH, Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Greenleaf Sump Storm Drain Change Order 1 M&C: CPN: 103260 CSO: 60105 DOC#: Date: To: Name Department Initials Date Out 1' Adam Lunsford Contractor —AK Oct 4, 2024 AdamL@SJLouis.Com 2. James Ruiz TPW - Inspector Ok— Oct 4, 2024 3. Max Aransen TPW - Project Manager 4!k-- Oct 4, 2024 4. Thanaa H. Maksimos TPW — Program Manager Oct 4, 2024 5. Lissette Acevedo TPW — Sr. CPO LA � Oct 4, 2024 6. Patricia Wadsack TPW — Assistant Director PLW Oct 8, 2024 7. Lauren Prieur TPW - Director Ar— Oct 8, 2024 8. Doug Black Legal - Assistant City Attorney DBDB Oct 24, 2024 9. Jesica McEachern CMO — Assistant City Manager PE- Oct 24, 2024 10. Jannette Goodall CSO — City Secretary JG 76 Oct 25, 2024 11. Allison Tidwell CSO — City Secretary .- Oct 28, 2024 12. Tpw—SW—Contract TPW Stormwater CC: Program Manager — Thanaa Maksimos, Sr. CPO — Lissette Acevedo, TPW BSPAP Recon Team — Cindy Sengathith DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑YES NNo RUSH: ❑YES NNo SAME DAY: ❑YES NNo NEXT DAY: ❑YES NNo ROUTING TO CSO: NYES ❑No Action Required: ❑ As Requested ❑ For Your Information N Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return to: tAw sw contracts(& fortworthtexas.sov Call 817-229-3283 with questions. Thank you! CSC No. 60105-COI FORT NORTH® City of Fort Worth Change Order Request Project Name Greenleaf Sump Storm Drain City Sec # I 60105 Client Project #(s)l 103260 Project Description This Project will relocate and install a SD line along Greenleaf Street in preparation for the South Bypass Channel Proposed for the Trinity River Vision Project Contractor S J Louis Construction of Texas LTD Change Order#I 1 j Date 9/18/2024 City Project Mgr.1 Max Aransen, P.E. City Inspector James Ruiz E Dept. TPW Contract Time Totals (CD) Original Contract Amount $6,050,404.00 $6,050,404.00 365 Extras to Date Credits to Date $0.00 $0.00 Pending Change Orders (in M&C Process) Contract Cost to Date $5,991,115.18 $5,991,115.18 365 lGo to ADD & DEL Tabs to Enter CO Backup $0.00 45 Revised Contract Amount $5,991,115.18 $5,991,115.18 410 Original Funds Available for Change Orders $0.00 Remaining FundsAvailable forthis CO $59,288.82 $59,288.82 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT -0.98% MAXALLOWABLECONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25%) $7,563,005.00 JUSTIFICATION (REASONS) FOR CHANGE ORDER This Change Order will be to add 45 construction days for the installation of 17 Hydratite Seals on the 6' x 4' box culvertjoints between STA 7+15 to STA 8+55 as per USACE requirement all pipes within USACE jurisdiction must be watertight While the Hydratite cost addition was handled via the construction allowance, the days are added via this Change Order. These days are justified to account for additional work as directed by city staff. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Contractor's Company Name Contractor (Name) Contract Signature Date A.nwt /„ydae �l S J Louis Construction of Texas LTD Adam Lunsford I - Oct 4, 2024 Inaffl*rfinspection Supervisor Date Project and Contract Compliance Manager Date nay o <aoaaas3eCor Oct 4, 2024 m, Oct 4, 2024 Program Manger Date Senior Caoital Project Officer Date s Oct 4, 2024 L� Oct 4, 2024 Assistant Director (D Date Director, Contracting Department fOent) Date G.ls/a�sr� Oct 8, 2024•= Oct 8, 2024 Assistant Citv Attorney Date _ Assistant CityMan Date atillfillife Oct 24, 2024 �� 9' � Oct 24, 2024 Council Action (if recwred) I M&C Number I ' M&C Date Approved ATTEST: Jannette Goodall, City Secretary FORT WORTH City of Fort Worth • Change Order Additions Project Name I Greenleaf Sump Storm Drain Client Project # 1 103260 Contractorl S J Louis Construction of Texas LTD l ITEM DESCRIPTION City Sec # 60105 1 PMI Max Aransen, P.E. Inspectorl James Ruiz Change Order Submittal # O1 Date 1 9/18/2024 1 ADDITIONS DEPT Oty Unit Unit Cost Total 1 I I 1 I 1 I 1 I 1 I 1 I 1 1 I 1 I 1 I 1 I 1 I 1 I 1 I I 1 I 1 I 1 I 1 I 1 I 1 I 1 I I 1 I 1 I 1 I 1 I 1 I 1 I 1 1 I 1 I 1 I 1 I 1 1 1 I 1 I TPW $0.001 I I I Sub Total Additions $0.001 Change Order Additions Page 2 of 4 FORRT�W�o� City of Fort Worth Change Order Deletions Project Name I Greenleaf Sump Storm Drain Client Project# 1 103260 Contractorl S J Louis Construction of Texas LTD I I EM DESUKIP I IUN City Sec # 1 60105 1 1 PMl Max Aransen, P.E. l Inspedorl James Ruiz l Change Order Submittal # 0 Date 1 9118/2024 1 DELETIONS UEPI Uty Unit Unit Goal total 1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I TPW $0.001 I I I I I I Sub Total Deletions $0.001 Change Order Deletions Page 3 of 4 M/SBE for this Change Order M/SBE Sub Type of Service Amount for this CO Total $0.00 Previous Change Orders co# DATE I AMOUNT Total I $0.00 1 S J LOUIS CONSTRUCTION OF TEXAS LTD - Construction Contract Change Order - Final Audit Report 2024-10-25 Created: 2024-10-23 By: Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Status: Canceled / Declined Transaction ID: CBJCHBCAABAALQld1ef6fg7S0_PP9rge7gPyfeRqOnC "S J LOUIS CONSTRUCTION OF TEXAS LTD - Construction C ontract Change Order -" History Document created by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) 2024-10-23 - 7:31:50 PM GMT- IP address: 204.10.90.100 Document approved by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Approval Date: 2024-10-23 - 7:38:27 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Douglas Black (Douglas.Black@fortworthtexas.gov) for signature 2024-10-23 - 7:38:28 PM GMT 1-6 Document e-signed by Douglas Black (Douglas.Black@fortworthtexas.gov) Signature Date: 2024-10-24 - 5:33:25 PM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to Jesica McEachern (Jesica.mceachern@fortworthtexas.gov) for signature 2024-10-24 - 5:33:29 PM GMT Document e-signed by Jesica McEachern (Jesica.mceachern@fortworthtexas.gov) Signature Date: 2024-10-25 - 4:22:06 AM GMT - Time Source: server- IP address: 69.212.100.108 Document emailed to Jannette Goodall Oannette.goodall@fortworthtexas.gov) for signature 2024-10-25 - 4:22:08 AM GMT Email viewed by Jannette Goodall 0annette.goodall@fortworthtexas.gov) 2024-10-25 - 12:43:57 PM GMT- IP address: 208.184.124.181 = Document e-signed by Jannette Goodall Qannette.goodall@fortworthtexas.gov) Signature Date: 2024-10-25 - 12:44:06 PM GMT - Time Source: server- IP address: 208.184.124.181 FDRTW❑RTHg I P—"ed"Y Adobe Acrobat Sign Form filling automatically delegated to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) by Allison Tidwell (all ison.tidwell@fortworthtexas.gov) 2024-10-25 - 12:44:07 PM GMT Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for filling 2024-10-25 - 12:44:07 PM GMT Document emailed to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) for filling 2024-10-25 - 12:44:08 PM GMT Document declined by Allison Tidwell (aIIison.tidwell@fortworthtexas.gov) Decline reason: There is not a text box for me to include the contract number. 2024-10-25 - 5:58:39 PM GMT- IP address: 208.184.124.181 FDRTW❑RTHg I P—"ed"Y Adobe Acrobat Sign 103260 Greenleaf Sump CO 1 Final Audit Report Created: 2024-10-25 By: Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Status: Approved Transaction ID: CBJCHBCAABAAQaU-E8c6XWEjD6EEpCdrSJlj_XOMOp5p "103260 Greenleaf Sump CO 1" History Document created by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) 2024-10-25 - 6:23:42 PM GMT- IP address: 204.10.90.100 Document approved by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Approval Date: 2024-10-25 - 6:24:48 PM GMT - Time Source: server- IP address: 204.10.90.100 2024-10-28 Form filling automatically delegated to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) by Allison Tidwell (allison.tidwelI@fortworthtexas.gov) 2024-10-25 - 6:24:50 PM GMT Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for filling 2024-10-25 - 6:24:51 PM GMT Document emailed to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) for filling 2024-10-25 - 6:24:51 PM GMT Form filled by Allison Tidwell (allison.tidwell@fortworthtexas.gov) Form filling Date: 2024-10-28 - 4:56:46 PM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to tpw_sw_contracts@fortworthtexas.gov for approval 2024-10-28 - 4:56:51 PM GMT Email viewed by tpw_sw_contracts@fortworthtexas.gov 2024-10-28 - 8:17:52 PM GMT- IP address: 204.10.90.100 Document approval delegated to Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) by tpw—sw—Contracts@fortworthtexas.gov 2024-10-28 - 8:17:56 PM GMT- IP address: 204.10.90.100 Al Document approved by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Approval Date: 2024-10-28 - 8:18:04 PM GMT - Time Source: server- IP address: 204.10.90.100 FDRTWORTHs I P°`4'y Adobe Acrobat Sign Agreement completed. 2024-10-28 - 8:18:04 PM GMT FDRTWORTHs I P°`4'y Adobe Acrobat Sign FORT WORI Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Greenleaf Sump Storm Drain Change Order 2 M&C: CPN: 103260 CSO: 60105 DOC#: Date: To: Name Department Initials Date Out 1' Adam Lunsford Contractor AM41fL 01 /14/2025 AdamL@sJLouis.Com 2. Jeremy Koonce TPW - Inspector 7, 01/17/2025 3. Max Aransen TPW - Project Manager MA 01/17/2025 4. Thanaa H. Maksimos TPW — Program Manager rn 01/17/2025 5. Lissette Acevedo TPW — Sr. CPO 01/21/2025 6. Patricia Wadsack TPW — Assistant Director 7oC� 01/22/2025 7. Lauren Prieur TPW - Director 01/23/2025 8. Doug Black Legal - Assistant City Attorney 01/23/2025 9. Jesica McEachern CMO — Assistant City Manager 0#- 02/10/2025 10. Jannette Goodall CSO — City Secretary 02/11 /2025 11. Allison Tidwell CSO — City Secretary 02/19/2025 12. Tpw—SW—Contract TPW Stormwater CC: Program Manager — Thanaa Maksimos, Sr. CPO — Lissette Acevedo, TPW BSPAP Recon Team — Cindy Sengathith DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: DYES ®No RUSH: DYES ®No SAME DAY: DYES ®No NEXT DAY: DYES ®No ROUTING TO CSO: ®YES ❑No Action Required: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return to: tpw sw contracts(a fortworthtexas. og_v Call 817-229-3283 with questions. Thank you! CSC No. 60105-0O2 FORT WORTH. City of Fort Worth Change Order Request Project Namel Greenleaf Sump Storm Drain City Sec # l 60105 Client Project #(s)l 103260 Project Description) This Project will relocate and install a SD line along Greenleaf Street in preparation for the South Bypass Channel Proposed for the Trinity River Vision Project. Contractorl S J Louis Construction of Texas LTD l Change Order #1 2 1 Datel 1212/2024 City Project Mgr.l Max Aransen, P.E. City Inspector Jeremy Koonce Dept Original Contract Amount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date Amount of Proposed Change Order Revised Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) TPW $6,050:404.00 $0.00 $6,050,404.00 IM $0.00 $6,050,404.00 $0.00 $0.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) Contract Time Totals (CD) $6,050,404.00 365 45 $6,050,404.00 410 $0.00 $6,050,404.00 410 $0.00 $0.00 0.00% $7,563,005.00 This Change Order will be for CMR #2, CMR #6, and CMR #7. CMR #2 is for the downtime accrued from 3/20/24 to 3/22/24 when an 8" waterline was discovered in conflict at STA 13+97 and was not shut off until 3/22/24. CMR #6 is for the downtime accrued from 3/25/24 to 3/26/24 when a 6" gas line was discovered in conflict at STA 14+13. SJL was notified that the gas line was abandoned on 3/28/24 and continued work that day. CMR #7 is for downtime accrued from 4/11/24 to 4/12/24 when a fiber optic line was discovered in conflict with the proposed 54" RCP. SJL had to wait two days while AT&T excavated the line and pulled enough slack to allow for the proposed RCP. The items removed are to account for the redesigns on the South Bypass Channel received in January 2024 from USACE resulting in the removal of a lateral (A-10). Based on the designer, project manager, and construction manager's expertise, the costs for these items seemed fair and reasonable. It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitorine and administration of this contract, includine ensurine all performance and reoortina reauirements. Contractor's Company Name Contractor (Name) Contract Signature S J Louis Construction of Texas LTD Adam Lunsford ADARLONLEOLD iOl/14/2025 Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date ice ;Jan 17202507:47 CST 01/17/202 Max Aransen(Jan 17, 202508:01 CST) 1/17/2025 Program Manager Date Senior Capital Pr Date 01/17/2025 Lissette Acevedo (Jan 21, 202513:57 CST) 01/21/2025 Assistant Director (Dept) Date Director, Contracting Depa Date J- 22, 202518:59 CST) 01/22/2025 a..w.v 1/23/2025 Assistant City Attorney Date Assistant City Manager Date QJ� 01/23/2025 ( 02/10/2025 Council Action (if required) MEW— M&C Number I M&C Date Approved ATTEST: � k .,&x� Jannette Goodall, City Secretary FORTWORTH City of Fort Worth 1y!`--- Change Order Additions Project Name Greenleaf Sump Storm Drain City Sec # 60105 Client Project# 103260 1 Contractorl S J Louis Construction of Texas LTD I PMI Max Aransen, P.E. Inspectorl Jeremy Koonce Change Order Submittal # Date j 12/2/2024 ADDITIONS I I EM UtSCKIP I ION DEP I Uty Unit Unit Cost I otal 48 9999.UU14CMR#2 PW 1.00uuuuuu LS $43,900.69 $43,9UU.69 49 9999.0015CMR#6 TPW 1.0000000U LS $28,680.61 $28,680.61 50 9999.0016CMR#7 TPW 1.0000000U LS $29,267.13 $29,267.13 TPW $101,848.43 Sub Total Additions $101,848.43 Change Order Additions Page 2 of 4 FORT, WORTH City of Fort Worth IF -Change Order Deletions Project Name Greenleaf Sump Storm Drain City Sec # 1 60105 Client Project# 103260 1 Contraaorl S J Louis Construction of Texas LTD PMI Max Aransen, P.E. I Inspectorl Jeremy Koonce I Change Order Submittal# 0 Date 1 12/2/2024 1 DELETIONS ITEM DESCRIPTION DEPT City Unit Unit Cost Total 15 3301.0001 Pre -CCTV Inspection TPW 20.00000DOU LF $5.O1J $100.00 16 3301.0002 Post -CCTV Inspection TPW 4.000OO000 LF $2.00 $8.UU 20 3331.421212" DIP Sewer TPW 53.41446108 LF $334.00 $17,840.43 24 3341.0309 36" RCP, Class III TPW 50.00000000 LF $1,468.00 $73,400.O0 32 3349.7001 r Drop Inlet TPW 1.00000000 EA $10,500.OU $10,bUU.UU TPW $101,848.43 Sub Total Deletions $101,848.43 Change Order Deletions Page 3 of 4 M/SBE for this Chanae Order M/SBE Sub I Type of Service I Amount for this CO Total $0.00 Previous Change Orders CO# DATE AMOUNT 1 10/24/2024 $0.00 Total I $0.00 1 Request for Proposal Project Name C.M.R. -Proposal No. Date Greenleaf Sump Storm Drain (City Project #103260) City of Fort Worth, Texas 2 November 21, 2024 Response Required By Transmitted By Max Aransen, P.E. Adam Birchfield 200 Texas Street Project Manager Fort Worth, Texas 76102 Signature Via Email Max.Aransenawfortworthtexas.aov - I Descrintion of Work This CMR is in refernece to the downtime that was accrued from 3/20/24 to 3/22/24.On 3/20/24 an unknown 8" waterline was discovered at Station 13+97 at 7:30 AM and was in direct conflict with the installation of the 6X4 RCB. The inspector was notified imediately. Water needed to be shut off in order for us to remove the section of pipe in conflict. Water was not shut off until 3/22/24 at 10:30 AM. The remainder of the day was spent removing the section of 8" waterline. Pipe laying operations resumed on 3/23/24. Please process a project change order so we can be reimbursed for these additional costs and time lost. Please let us know if you have any questions and/ or require any additional information. Breakdown of Proposal Greenleaf Storm Drain Relocation 8" Waterline Utility Confilct - Downtime Item Description New -1 18" Water Line Utility Conflict (Donvntime) Quantity ( Unit Price 1 ( LS 1 $43,900.69 Net Change:I Additional Calendar Days: IIf acceptable, please provide an authorization signature below and return one (1) copy to our office. S.J. Louis Construction Action xc: S. J. Louis Project No. 22308 S.J. Lottis Construction of Texas Ltd 520 S. 6th Avenue illIa ns,field, Texas 76063 (817) 477-0320 Office (817) 477-0552 Fax Extension $43,900.69 $43,900.69 It] 8" Waterline Utility Conflict A I B C D Regular Hours Worked Rate Times Overtime Hours Worked Rate Times 66% 10 % Total Labor I Rate 1 1 1 2 1 3 ITotal Hours Total Hours ( Rate 11 1 2 1 3 1 4 1 5 1 6 1 7 1 Total Total Hours Benefits Overhead A+B+C+D �Superintendenf $80.00 0.0 $0.00 S80.00 I �- 0 $0.00 $0.00 $0.00 $0.00 $50.00 24.00 24.0 I $1,200.00 __$70,00 1 0 $0.00 $660.00 $186,60 $2.046.00 ! Lead Hoe Operator $34.00 24.00 24.0 $816.00 $51.00 0 $0.00 $448.80 $126.48 $1.391.28 rBlade Operator _ _- $37.00 0.0 $0.0.0 $55.50 _ 0 $0.00 $0.00 $0.00 $0.00 I Loader Operator $29.00 124.00 I 24.0 $696.00 $43.50 I 0 $0.00 $382.80 $107.88 $1186.68 I pMlsc Operator $27.00 I 0.0 $0.00 $40.50 I I 0 $0.00 $0.00 $0.00 10.00 ipe Layer $26.00 -I 24.00 I 24.0 $624.00 $39.00 I I 0 $0.00 $343.20 $96.72 $1,063.92 ITO Man $24.00 24.00 I 24.0 $576.00 $36.00 _ 0 $0.00 $316.80 $89.28 1 $982.08 �Ptpe LeyerHe_Iper $22.DD 24.00 24.0 $528.00 $33.00 1 0 _i $0,00 $290.40 $81.84 I $900.24 ILa6orer _ - $21.50 24.00 246 I -. 5516.00_____-$32$7 .25 0 I $0,00 $283.80 9.98 I $879.78 (Laborer $28.00 0.0 $0.00 $42.00 $0.00 0 so.00 -� -,--.$0.00 -- - �. so.( $4,956.00 $0 00 I $2,725 80 I $768.18 $8,449 98 AYA I B Hours Worked Rate Times t �r Alt.. u , + �. r`;'�.� k 10 % Total r• ..,."t a ryty a ro5•'t" w ,Iwr r mr Equipment (Rate w/o Fuel 1 1 I 2 13 (Total Hours! Total Hours �, 4;r ."-�° a•"�ss,� ct^� Overhead I A+B '' w Wt r t390 Excavator _- $510.00 24.0 24.0 $12,240.00 a: k; $1,224.00 $13,464.00 �352 Excavator ( $322.94 24.0 24.0 ( $7,750.56 �? r� r s l $775.06 $8,525.62 966 Loader $179.96 24.0 24.0 1 $4,319.04 $431.90 $4,750.94 D4 Dozer 18,44 0.0 $0.00 ° $0.00 $0.00 433 Compactor/Roller ! $77.08 24.0 24.0 $1,849.92 I $184.99 ! $2,034.91 Water Truck ( $40.76 12.0 12.D $489.12 - $48.91 $538.03 rPlckup truck (Superintendent) $31.76 - -- - 0.0 $0.00 .. - + _ $0.00 -- $0.00 Pickup Truck (Foreman) $18.63 24.0 24.0 $447.12 $44.71 $491.83 t. Generator $29.00 24.0 24.0 $696.00�_ $69.60 $765.60 - - - ---- Job Trailer &Touts $184.84 24.0 24.0 $4,436.16 $443.62 $4,879.78 $32,227.92 I I I $3,222.79 $35,450.71 v l d A B Total Cost For 10 % Total Miscellaneous Rate Description Unit Quantity Materials. Overhead A+B I I _ $ 0.00 1 $0.00 -- $0.00 f $0.00 I • ' _ $0.00 _ $0.00 I _ - -- -I --- -- --- $0.00 $0.00 $0.00 s0.00 50.00 $0.00 - -- _ L�$o.ao I $0.00 -i $0.00 _ I I $0.0o I 1 " $o.00 $0.00 Grand Total Cost $43,900.69 Request for Proposal Project Name C M.R. - Proposal No. Date Greenleaf Sump Storm Drain (City Project #103260) 6 November 21, 2024 City of Fort Worth, Texas Response Required By Transmitted By Max Aransen, P.E. Adam Birchfield 200 Texas Street Project Manager Fort Worth, Texas 76102 Signature Via Email �/�� . Max.Aran seiQfortworthtexas. aI`ov Description of Work This CMR is in refernece to the downtime that was accrued from 3/25/24 to 3/27/24 (3 Days). On 3/19/24 an RFI was submitted in regards to the recently uncovered existing 6" Gas Line at station 14+13.73. The top of the existing gas line is at elevation 532.64, and the proposed elevation of the new 54" RCP is 533.02. SJL was notified the gas line was abandoned on 3/28/24 and pipe layaying operations continued on this day. Please process a project change order so we can be reimbursed for these additional costs and time lost. Please let us know if you have any questions and/ or require any additional information. Breakdown of Proposal Greenleaf Storm Drain Relocation 6" Gas Utility Confilct - Downtime Item Description Quantity Unit Price New -1 16" Gas Line Utility Conflict (Downtime) 1 LS $28,680.61 Net Change: Additional Calendar Days: If acceptable, please provide an authorization signature below and return one (1) copy to our office. S.J. Louis Construction Action xc: S. J. Louis Project No. 22308 SJ Louis Construction of Texas Ltd 520 S. 6th Avenue NlansTeld, Texas 76063 (817) 477-0320 office (817) 477-0552 Fax Extension $28,680.61 $28,680.61 2 8" Waterline Utility Conflict A B C D Regular Hours Worked Rate Times Overtime Hours Worked Rate Times 55% 10% Total 1 Labor I Rate t 1 1 2 1 3 (Total Hours Total Hours Rate 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 Total Total Hours Benefits Overhead A+B+C+D Superintendent $80.00 0.0 $0.00 $80.00 I I L 0 $0.00 $0.00 $0.00 $0.00 (Foreman j $50.00 L16.00 16.0 $800.00 $70.00 j 0 $0.00 $440.00 $124.00�$1,364. 00Lead Hoe Operator I $34.00 .00 16.0 $544.00 $51.00 _ I 0 $0.00 $299+20 _ _ $84,32 1 $927.52 Blade O eralor 1 $37.00 0.0 $9.00 $55.50 I 0 $0.00 $0.00 $0.00 $0.00 LoaderOperalor ' $29.00 16.00 16.0 64.09. $43.50 0 $0.00 $255.20 $71.92 j $791.12 jMi5cOperator _ �_ $27.00_ 0.0 50.06 _ $ 00.50 T _ _ 0 $0.00 $0.00 _ $0.00 $0.00 - $28.00 116.00 �- 16.0 I $416_00 $39.00 _ j- 0 $0.00 _ $228.80 $64.48 $709.28 _ Top Man $24. 00 16.00 _ 16.0 $314.00 $36.00 1 - '1 _ _ 0 i $0.00 $211.20 $,59.52 i $654.72 Pipe Layer_Helper $22.00 16.00 16.0 $3 2.00 j $33.00 _ _ j j 0 $0.00 _ $193.60 $54.56 $600.16 FLaborer $21.50 0.0 $0.00 - $32.25 ! _ I I I '-� 0 $0.00 1 $0,00 50.00 $0.00 jLaborer - $28.00 - 0.0 $000 $42,00 ! I J , 0 $0.00 1 $0.00 $0.00 S0.no $2,960.00 I $0.00 $1,628.00 j $458 80 $5,046.80 j Hours Worked RateTimes10% Total Equipment I Rate w/o Fuel 1 1 2 1 3 lTotal Hours Total Hours i Overhead I A+B r390 Excavator i 8510.00 16.0 16.0 I $8,160.00 $816.00 $8,976.00 1352 E-Xcava-tor 1 $322.94 16.0 j 18.0 $5,167.04 kF _$516.70 1 S5,683-74 ;966 Loader - $179.96 - 16.0 16.0 $2,879.36 _ $287.94 1 $3,167.30 D4 Dozer $68.44 i 0.0 $0.00 _ $0.00 $0.00 433 Compactor/Roller ($77.08 16.0 1 16,0-__�_�-$1,233,28 _ $123.33 $1,356.61 1 rWater Truck j $40.76 8 0 8.0 $328.08 - - > $32.61 $358.69 h Pickup Truck (Superintendent) - 531.76 )- 0.0 $0.00 $0.00 $0.00 Pickup Truck (Foreman) $18.63 16.0 16.0 $298:08 (4 •Yr �,' n A 29.81 $327.89 -.!e �+ Generator $2900 16.0 I 16.0 $464.00 NY, tr Mr) rx 46.40 $510.40 Job Trailer & Tools $184 84 16.0 16.0 $2,95T44 r, � � r " $295.74 _ $3,253.18 ..<.•.,„:=G :'.�.sr ..s�'aol�wYiem k�.a'r"""""i+'bi. ..21 ,. •? .7gaY ._, ��� ..��::J .........:.:: �. I 63381 _.. $21,485.28 $ I 2 148 53 $23, A B Total Cost For 10 % Total Miscellaneous Rate Description I Unit I Quantity Materials Overhead A+ B --- $0.00 $0.00 $0.00 1_ _.-, _ _-..- - _---- --- $0.00 $0.06 $0.00 - --- --- $0.00 $0.00 $0.00 4 $0.00 � � $0.00 $0.00 ;e�,'� ._- .'6`�"` ^, r �� $ � $0.00 O� $000 1 ,. Grand Total Cost $28,680.61 Request for Proposal Project Name C.M.R. -Proposal No. Date Greenleaf Sump Storm Drain (City Project # 103260) City of Fort Worth, Texas 7 November 21, 2024 Response Rewired By Transmitted By Max Aransen, P.E. Adam Birchfield 200 Texas Street Project Manager Fort Worth, Texas 76102 Signature Via Email J/�� . Max.Aransenawfortworthtexas.aov Descrintion of Work This CMR is in refernece to the downtime that was accrued from 4/11/24 to 4/12/24 (3 Days). The top of the existing Fiber Optic line was discovered at elevation 532.00, and the proposed elevation of the new 54" RCP is 533.02. SA was unable to lay the 54" RCP for two days waiting on AT&T to excavate and put enough slack in the line in order for SA to install the proposed pipe. Pipe layaying operations resumed on 4/13/24. Please process a project change order so we can be reimbursed for these additional costs and time lost. Please let us know if you have any questions and/ or require any additional information. Breakdown of Proposal Rent Greenleaf Storm Drain Relocation Fiber Optic Line Utility Confilct - Downtime Description New -1 1Fiber optic Line Utility Conflict (Doivntime) Quantity Unit Price 1 I LS 1 $29,267.13 Net Change: Additional Calendar Days: If acceptable, please provide an authorization signature below and return one (I) copy to our office. S.J. Louis Construction Action xc: S. J. Louis Proiect No. 22308 S.J. Louis Construction of Texas Ltd 520 S. 6th Av en tie Mansfield, Texas 76063 (817) 477-0320 Office (817) 477-0552 Fax Extension $29,267.13 $29,267.13 2 8" Waterline Utility Conflict A ( B C D Regular Hours Worked Rate Times Overtime Hours Worked Rate Times !Total I 55% I Total 10% Total Labor Rate 1 1 1 2 1 3 ITotal Hours, Total Hours I Rate 1 1 1 2 1 3 1 4 1 5 1 6 1 7 1 Total Hours Benefits Overhead Supenntendent $80.00 j 0.0 $0.00 $80.00 0 $0.00 bo.00 $0.00 $0.00 Foreman $50.00 16.00 16.00 ( _ 16.0 $800.00 $70.00 16.0 $544.00 . _ $51.00 0.0 $0.00 $55.50 _ 0 $0.00 $440.00 $124.00 $1,364.00 0 $0.00 $299.20 $84,32 $927.52_ 0 $0.00 $0.00 $0.00 $0.00 Lead Hoe Operator $34.00 iBladeOperator $37.00 _ !LoaderOperator__-_ $29.00 16.001 16.0 $464.00 $43.50 _ � 0 $0.00 $255.20 $71.92 $791.12 4Misc Operator__ $27.00 Pipe Layer $26.00 jNe Man,.______ _ $24.00 16.00 _16.00 _ _ __ 0.0 $0.00 $40.50 16.0 I $416.00 $39.00 6.0 $384.00 $36.00 6.0 j $352.00 $33.00 I 0 $0.00 $0.00 $0.00 $0.00 0 $0,00 $228.80 $64.48 I $709.28 _ 0 $0.00 $211.20 $59.52 $654.72 0 $0.00 $193.60 $54.56 I $600.16 Pipe Layer Helper 22.00 16.00 f laborer 21 50 16 00 0 $$0.000 25 IL 0 I $0.00 $189 20 $53.32 $586.52 Laborer $28 00 s$3 000 . 0.0 $0.00 2 $4vv ��a4 kti va�.iM�• J $0 00 $0 00 $0.00 $0.00 : f4 �. t t,n $3 304 00 _ A Hours Worked Rate Times Equipment Rate w!o Fuel 1 1 2 1 3 1Total Hoursl Total Hours (. �390 Excavator __ 1 $510.00 16.0 16.0 I $8,160.00 1352 Excavator j $322.94 16.0 h 16.0 $5.167.04 tD966 Loader _ ; $179.96 16.0 _ 16.0 1 $2.879.36 _ 4 Dozer0.0568.44 0.0 $0.00 1433 Compactor/Roller $77.08-0 16.0 $1,233.28 Water Truck $40.76 8.0 8.0 $326,08 PickupTruck(Superintendent) $31.76 0.0 1 $0.00 Pickuo Truck (Foreman) $18.63 1 16.0 16.0 1 $298.08 U2 , $0.00 $1,817 20 j $512.12 $5,633.32 j 10% Total Overhead I A+S $287.94 $3.167.30 $0.00 $0.00 $123.33 $1,356.61 1 $32.61 $358.69 $0.00 $0.00 FORT WORTH,, Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Greenleaf Sump Construction Allowance -Request M&C: CPN: 103260 CSO: 60105 DOC#: Date: To: Name Department Initials Date Out 1. Adam Lunsford Contractor Aug 2, 2024 2. James Ruiz TPW - Inspector— Aug 2, 2024 3. Max Aransen TPW - Project Manager Aug 2, 2024 4. Mike Bennett TPW — Interim Program Manager— Aug 5, 2024 5. Lissette Acevedo TPW —Sr CPO C�v Aug 5, 2024 ' 6. Patricia Wadsack TPW -Assistand Director M1W Aug 5, 2024 7. Lauren Prieur TPW- Director?Ir� Aug 5, 2024 8. Douglas Black Legal - Assistant City Attorney �R 013 Sep 10, 2024 9. Jesica McEachern CMO— Assistant City Manager 9W Sep 20, 2024 10. Jannette Goodall CSO — City Secretary ,- Sep 20, 2024 11. Allison Tidwell CSO — City Secretary A'&_ Sep 20, 2024 12. Tpw_SW—Contract TPW Stormwater Aug 8, 2024 I 5 Sep 20, 2024 DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑YES ®No RUSH: ❑YES ®No SAME DAY: ❑YES ®No NEXT DAY: ❑YES ®No ROUTING TO CSO: ®YES ❑No Action Required: ❑ As Requested ❑ For Your Information ® Signature/Routing and or Recording ❑ Comment ❑ File ❑ Attach Signature, Initial and Notary Tabs Return to: tPw sw contracts(&fortworthtexas.Eov Call 817-229-3283 with questions. Thank you! CSC No. 60105-AR1 Fox_ H. Project Name I FWCC 5th St Greenleaf Sump Client Project #(s)I 103260 City of Fort Worth Construction Allowance Request City Sec # 1 60105 Project This Project will relocate and install a SD line along Greenleaf Street in preparation for the South Bypass Channel Proposed for the Trinity Description River Vision Project ContractorlS.J. Louis Construction of Texas, LTD CA #I 1 I Date 7/18/2024 City Project Mgr.l Max Aransen I City Inspectorl James Ruiz UNIT or DEPT Original Contract Amount Extras to Date Credits to Date Current Contract Amount lAmount or Proposed Allocation Original Allowance Available to Allocation Allowance Funds Previously Allocated Revised Allowance Balance TPW $6,050,404.00 UNIT 2 or Dept UNIT 3 or Dept UNIT 4 or Dept I Totals $6,050,404.00 6,050,404.00 6,050,404.00 79,360.09 $0.00 $0.00 $0.00 $79,360.09 100,0 00.00 $100,000.00 $0.00 20,639.91 $0.00 $0.00 $0.00 $20,639.91 JUSTIFICATION (REASONS) FOR CONSTRUCTION ALLOWANCE We received an updated design for the South Bypass Channel in January 2024 from USACE with revised elevations at this location. This required re -designs for the junction boxes to be able to support the added weight of the levee and the manhole elevation extensions. This included an increased thickness for the 10'x10' junction box at STA. 2+15 and the 8'x8' junction box at STA. 7+15. This CA also covers the installation of 17 Hydratite Seals on the 6' x 4' box culvert joints between STA 7+15 to STA 8+55 as per USACE requirement all pipes within USACE jurisdiction must be watertight. The units in this change order are unique items and no local historical data can be used to compare however, based on the designer, project manager, and construction manager's expertise, the costs for these unique items seemed fair and reasonable. It is understood and agreed that the acceptance of this Construction Allowance Request by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the above Construction Allowance Request. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. S.J. Louis Construction of Texas, LTD I Adam Lunsford Aug 2, 2024 Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date Aug 2, 2024 0ax'4-n-n Aug2, 202 Program Manager Date SeniorlCapital Project Officer Date Aug 5, 2024 Aug 5, 2024 Assistant Director (Dept) Date Director, Contracting Department (Dept) Date aa. Aug 5, 2024 Aug 5, 2024 Assistant Cit Date Sep 10, 2024 Assistant City Manager ����c Date Sep 20, 2024 /YYlannette Goodall, City Secretary Construction Allowance SUMMARY Page 1 of 4 FORT WORTH, City of Fort Worth '— Construction Allowance Additions Project Name I FWCC 5th St Greenleaf Sump JCity Sec # 60105 Client Project # I 103260 1 ContractorlS.J. Louis Construction of Texas, LTD PM1 Max Aransen Inspector) James Ruiz Construction Allowance Submittal # 0 )ate 1 7/18/2024 1 ADDITIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 48 Mobilization of HydraTech Crew from Ohio for Seal Installation TPW 1.00 LS $7,360.00 $7,360.00 49 Furnish & Install HydraTite 304SS Seal on 6' X 4' Box Culvert TPW 17.00 EA $3,539.88 $60,177.96 Additional Costs Associated with the Plan Changes at the 50 Junction Box @ Sta. 2+15 & Sta. 7+15 TPW 1.00 LS $11,822.13 $11,822.13 T DW $79,360.09 UNIT 2 or Dept $0.00 UNIT 3 or Dept $0.00 UNIT 4 or Dept $0.00 Total Additions $79,360.09 Construction Allowance Additions Page 2 of 4 FORT WORTH,. City of Fort Worth Construction Allowance Value Project Name I FWCC 5th St Greenleaf Sump I City Sec # 1 60105 I Client Project # 1 103260 1 Contractor S.J. Louis Construction of Texas, LTD I PM 1 Max Aransen Inspector) James Ruiz Construction Allowance Submittal # © Date I 7l1 ti12U24 j CONSTRUCTION ALLOWANCE VALUE BEING USED ITEM DESCRIPTION Qty Unit Unit Cost Total 47 9999.0013 Construction Allowance 1.00 LS $100,000.00 $100,000.00 Note to Preparers Delete example information in cells and add the CONSTRUCTION ALLOWANCE contract bid item number being used, description, UNIT or DEPT, Qty, Unit and Unit Cost in the lines above. Three lines are provided for those cases when up to 3 different Construction Allowance types are being impacted. In most cases only one Construction Allowance type will be impacted. Delete these instructions from the form. Construction Allowance Value 3 of 4 MISBE for this Construction Allowance Request M/SBE Sub I Type of Service I Amount for this CAR Total $0.00 Previous Construction Allowance Requests CAR # I DATE I AMOUNT Total I $0.00 1 Construction Allowance MSBE Data Page 4 of 4 Request for Proposal Project Name C.M.R. -Proposal No. Date Greenleaf Sump Storm Drain (City Project #103260) 4 July 16, 2024 City of Fort Worth, Texas Response Rewired By Transmitted By Max Aransen, P.E. Adam Birchfield 200 Texas Street Project Manager Fort Worth, Texas 76102 signature Via Email Max.Aransenna,fortworthtexas.Qov ,yam Description of Work Per your request, this CMR represents the additional cost to furnish & install seventeen (17) HydraTite 304SS Seals on the 6' x 4' box culvert joints on the above referenced project. This is represents the 6' x 4' box culvert between Sta. 7+15 to Sta. 8+55 per the attached proposal from HydraTech Field Services. Payment will be made based on the quantity installed. Also, this CMR is in reference to revised plan sheets dated February 15, 2024 and February 16, 2024 for the above referenced project. These revised plan sheets delete Lateral A-1 and provided changes/ revised details for the junction boxes at Sta. 2+15 and Sta. 7+15. Please review and provide direction ASAP. If this work is required, please process a project change order so we can be reimbursed for these additional costs. Please let us know if you have any questions and/ or require any additional information. Breakdown of Proposal Greenleaf Sump Storm Drain Installation of HydraTite Seals on 6' x 4' Box Culvert / Junction Box Design Changes Item Description Quantity Unit Price Extension New - 1 Mobilization of HydraTech Crew From Ohio for Seal Installation 1 LS $7,360.00 $7,360.00 New - 2 Furnish & Install HydraTite 304SS Seal on 6' x 4' Box Culvert 17 EA $3,539.88 $60,177.96 New - 3 Additional Costs Associated with the Plan Changes at the ! 1 LS $11,822.13 $11,822.13 Junction Box (a, Sta. 2+15 & Sta. 7+15 Net Change: $79,360.09 Additional Calendar Days: TBD If acceptable, please provide an authorization signature below and return one (1) copy to our office. S.J. Louis Construction Action xc: S. J. Louis Proiect No. 22308 S.J. Louis Construction of Texas Ltd. 520 S. 6th Avenue Mansfield, Texas 76063 (817) 477-0320 Office (817) 477-0552 Fax I Labor Superintendent I Foreman I Lead Hoe Operator [Blade Operator I Pipe Layer Top Man Pipe Layer Helper Laborer (Laborer Equipment 1390 Excavator 1349 Excavator 950 Loader D6 Dozer I Cat Motorgrader 1563 Compactor/Roller Water Truck Pickup Truck (Superintendent) Pickup Truck (Foreman) Generator Job Trailer & Tools Regular Hours Worked Rate I 1 1 2 1 3 ITotal Hours $75.00 1 0.0 $55.00 0.0 $31.00 0.0 $27.00 0.0 $27.00 0.0 1 $25.00 20.00 20.0 I $27.00 0.0 $26.00 0.0 I $24.00 0.0 20.00 I Hours Worked Rate wl Fuel 1 1 1 2 1 3 ITotal Hours ! 5592.90 ! 0.0 ( 5291.00 ! 0.0 5115.30 20.0 I 20.0 I 5139.60 1 0.0 I $163.90 I 0.0 569.60 I 0.0 $42.8D I 0.0 $25.83 I 0.0 $18.63 I 0.0 '22.22 I 0.0 $134.84 20.0 I 20.0 A I I B Rate Times I Overtime Hours Worked Rate Times Total Hours I Rate 1 1 1 2 13 1 4, 5 16 1 7 1 Total Total Hours $0.00 575.00 I 0 $0.00 $0.00 $SS.DD 0 $0.00 $0.00 $46.50 I 0 $0.00 $0.00 540.50 I I 0 50.00 50.00 540.50 0 $0.00 $500.00 537.50 0 $0.00 $0.00 540.50 I 0 50.00 $0.00 j39.00 0 $0.00 $0.00 36.00 0 50.00 5420.00 $31. 0 0 0.00 $0.00 1 $31.50 - 0 $0.00 $920 OD A Rate Times Total Hours 50.00 $0.00 52,306.00 $0.00 50.00 50.00 $0.00 50.00 $0.00 $0.00 Miscellaneous Rate Description Hydratech $ 6,400.00 Mobilization Hydratech $2,700.00 6'X4' RCB �oint seals provided by Hydratech (17 EA) (Sta. 8+55) Form, Furnish and Install 13.42 CY's of Additional Reinforced Concrete for Changed to Dimensions of Junction Boxi, $761.49 the Increase in wall thickness for the hvo Junction Boxes Sta, 2++15 8 I I 55°/°/ I 1D 5°/ I Total Benefits Overhead A+B+C+D $0.00 50.00 50.00 � $0.00 $0.00 50.00 $O.00 $0.00 $0.00 i $0.00 $0.00 50.00 $0.00 $0.00 $0.00 5275.00 5116.25 $891.25 $0.00 $0.00 50.00 I $0.00 $0.00 50.00 $0.00 $0.00 $0.00 I $231.00 $97.65 $748.65 50.00 $0.00 $0.00 � $506.00 I $213.90 i $1,639.90 � 15% I Total Overhead A+B 50.00 0.00 ;! $0.00 $750.42 $5 753.22 iy �;��..: s} e.,..+rt. ., Total Costr i I Unit � Quantity Material s Overhead A+ B 1 LS 1 6,400.00 ! $960.00 $7,360.00 EA 17 S�5,900.00 r."$1,542.02 6,885.00 $52,785.00 I CY's 14 $10,280.12 $11,822.13 $0.00 $0.00 $0.00 $0.00 ! $0.00 � ;o.ao $62 580.12 $9 387.02 $71,967.13 Grand Total Cost $79,360.25 July 12, 2024 ATT: S.J. Louis Construction of Texas ATT: Adam Lee Birchfield RE: Greenleaf Sump Fort Worth We are pleased to submit our quote for the following items: These Prices are Guaranteed for 90 Days. ITEM DESCRIPTION Extend 10x10 JB Wall Thickness to 15" Thick BREAKDOWN Concrete Ready Mix Superintendent w/ Work Truck Foreman Laborer Overhead J. E. GUZMAN CONSTRUCTION, INC. 2911 PEACHTREE RD. BALCH SPRINGS, TX 75180 214-309-3955 Change Order QTY I UNIT PRICE TOTAL 1 EA $ 10,280.00 $ 10,280.00 TOTAL $ 10,280.00 13.5 CY $ 180.00 $ 2,430.00 25 HR $ 50.00 $ 1,250.00 25 HR $ 40.00 $ 1,000.00 75 HR $ 28.00 $ 2,100.00 1 LS $ 3,500.00 $ 3,500.00 TOTAL $ 10,280.00 This Price Does Not Include Cost for Additional Safety ,Badging and Certified Payroll. This Price Does Not Include Concrete Testing, Shoring and Haul Out Dirt. This Price Includes Concrete, Rebar, Forms and Labor. Any Additional Work Will Be Submitted As Change Order. Additional Insurance Coverage Will Be Your Sole Responsibility. Javier Guzman 214-876-8656 J.E. Guzman Construction, Inc. SUBMITTED BY: Javier Guzman S.J. Louis Construction of Texas ACCEPTANCE BY: PRINT NAME: ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby, accepted. You are authorized to do the work as specified. After Contract is Submitted and Signed by Us. If you agree with prices please sign and fax it back. INTERNAL ... HydraTite JOINT SEAL June 11, 2024 Brandon Mims S.J. Louis Construction 520 S 6th Ave. Mansfield, TX 76063 Brandon.mims@SJLouis.com (214) 717-7550 Subject: Model / Part No. Mobilization ydraTech FIELD SERVICES 10448 Chester Road Cincinnati, Ohio 45215 Phone: (513) 827-9169 Fax: (513) 827-9171 061124-SJLOUIS-MPF Quote to Furnish & Install Standard Wide Internal Joint Seals. 48" X 72" Box Culvert Description of item Mobilize installation crew from Cincinnati, Ohio to Fort Worth TX area, Price per unit ( USD ) $ 6,400.00 Materials & Furnish HydraTite seals, labor, tools, and $ 2,700.00 Installation equipment to install Standard Wide EPDM HydraTite seals in 4' X 6' RC Box culvert. HydraTite seals manufactured with (2) multi - piece 304SS retaining bands. Total Price( MATERIALS & INSTALLATION) Payment shall not be contingent on purchaser receiving payment from third party Time Required prior to initial mobilization Quantity Extended Price ( USD ) 1 $ 6,400.00 40 $ 108,000.00 $ 114,400.00 Minimum of (4) weeks Installation is based on one (1) installation crew working standard eight (8)- ten (10) hour day shifts. Monday thru Saturday. Sunday and holiday shifts not included. Additional mobilizations, due to un- accessible site conditions or activities by others, will be invoiced at $ 6,400.00 each. Installation price is based on access to pipe being provided by the purchaser, prime contractor or others for the duration of the scheduled installation period and access to each pipe joint location is free of debris and/or obstructions. The above price includes for normal pipe surface preparation required for proper internal joint seal installations and is limited to hand tool methods. Surface preparation requiring water blasting, grit blasting, pneumatic or power tool cleaning methods are not included. 061124-SJLOUIS-MPF Page 1 of 3 ydr��. INTERNAL1.11� 1,1 H -� aTfte :---------- JOSEAL a._.m:,::..: HvdraTech / Certified Installer Will Supply the Following: ydraTech FIELD SERVICES 10448 Chester Road Cincinnati, Ohio 45215 Phone: (513) 827-9169 Fax: (513) 827-9171 1. Mobilize installation crew and equipment to and from the project site as required. Only one (1) mobilization is included. 2. Inspect all necessary safety procedures including lockout/tag out and pipeline ventilation. 3. Monitor and test atmosphere within the scope of work. Air monitors will be provided by HydraTech. 4. Provide equipment and manpower to install specified internal joint seals per the direction of the prime contractor / owner. 5. Provide normal hand tool cleaning and preparation around the joint area. Removal and disposal of debris associated with cleaning of pipe is not included in the proposal. 6. Install the HydraTite Seals at the specified joint locations. 7. The fixed price quoted includes all labor, vehicles, tools, equipment, travel, meals and living expenses for the work as described. Purchaser / Prime Contractor Will Supply the Following: 1. Provide access to pipe. Access to include but not limited to the (daily) opening and closing existing access openings, removal and replacement of access opening or pipe sections, and safe means of accessing plus vehicle and equipment roadway and staging at the access points. 2. Maintain a dewatered pipe and access pit as necessary. 3. Shall provide a convenient and secure location at project jobsite to enable installation crew to store or stage materials. 4. Provide all traffic provisions and control services including signs, flagging, pavement markings, closures, barricades, etc. during all phases of the project. S. Provide any CCTV post inspection requirements. 6. Provide fresh air supply to provide safe working atmosphere if required. 7. Provide all QC/QA services (if required). 8. All resident and business notifications and all project identification. 9. Provide all necessary permits, and/or other local licenses. 10. Layout markings that indicate which pipe joints are to be sealed. 061124-SJLOUIS-MPF Page 2 of 3 INTERNAL HydraT,ite JOINT SEAL Clarifications and Conditions: ydraTech FIELD SERVICES 10448 Chester Road Cincinnati, Ohio 45215 Phone: (513) 827-9169 Fax:(513) 827-9171 Delays by other parties, stand-by time, and additional mobilizations will be charged at $150 per hour per person on site. HydraTech Filed Services reserves the right to compliment labor force with local contractors or certified HydraTite internal joint seal installation contractors. HydraTech Field Services will provide on site representation throughout the duration of the project. Prices reflect prevailing wages per the Davis Beacon Federal Wage Requirements for Tarrant County "General Decision Number: TX20240026 03/01/2024. Unless otherwise agreed upon, liquidated damages are not included or applicable to this proposal. Additional freight fees, if included, may apply for the following: residential delivery, inside delivery, appointment for delivery needed, oversized pallet, liftgate, job site delivery and/or re -delivery. Schedule: Please allow a minimum of four (4) weeks for fabrication and to schedule installation. Price list is good for 60 days after bid date. Client is responsible for all applicable sales tax. Payment Terms: Monthly progress payments and final balance to be paid net 30 days from date of invoices unless otherwise stated in this proposal. Any balance exceeding 30 days are subject to 1.5% finance change per month. All sales are final. HydraTech Field Services appreciates the opportunity to provide our products and services. Please call HydraTech at 513-827-9169 if there are any questions or if additional information regarding this quotation is required. Sincerely, Michael Fox cc: Peter Blais, Jennifer Williams, Mike Albert, and Client Files 061124-SJLOUIS-MPF Page 3 of 3 103260 Greenleaf Sump Construction Allowance Final Audit Report 2024-08-08 Created: 2024-08-01 By: Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAAcyCOlreXgYsQZT1BQma4Q-3aVdW9Q5Ei "103260 Greenleaf Sump Construction Allowance" History Document created by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) 2024-08-01 - 4:59:17 AM GMT- IP address: 204.10.90.100 Document approved by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Approval Date: 2024-08-01 - 5:07:40 AM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to adaml@sjlouis.com for signature 2024-08-01 - 5:07:42 AM GMT Email viewed by adaml@sjlouis.com 2024-08-01 - 2:18:49 PM GMT- IP address: 146.75.164.1 Signer adaml@sjlouis.com entered name at signing as Adam Lunsford 2024-08-02 - 2:05:09 PM GMT- IP address: 63.145.51.2 irol Document e-signed by Adam Lunsford (adaml@sjlouis.com) Signature Date: 2024-08-02 - 2:05:11 PM GMT - Time Source: server- IP address: 63.145.51.2 P-► Document emailed to James Ruiz (james.ruiz@fortworthtexas.gov) for signature 2024-08-02 - 2:05:14 PM GMT Email viewed by James Ruiz (james.ruiz@fortworthtexas.gov) 2024-08-02 - 3:12:11 PM GMT- IP address: 108.147.171.99 &0 Document e-signed by James Ruiz (james.ruiz@fortworthtexas.gov) Signature Date: 2024-08-02 - 3:12:45 PM GMT - Time Source: server- IP address: 108.147.171.99 P4 Document emailed to Max Aransen(max.aransen@fortworthtexas.gov) for signature 2024-08-02 - 3:12:47 PM GMT FDRTW❑RTHg I P—"ed"Y Adobe Acrobat Sign Email viewed by Max Aransen(max.aransen@fortworthtexas.gov) 2024-08-02 - 4:06:20 PM GMT- IP address: 155.130.130.204 = Document e-signed by Max Aransen (max.aransen@fortworthtexas.gov) Signature Date: 2024-08-02 - 4:06:40 PM GMT - Time Source: server- IP address: 155.130.130.204 Document emailed to Mike Bennett (M i ke. Ben nett@fortworthtexas.gov) for signature 2024-08-02 - 4:06:42 PM GMT Email viewed by Mike Bennett (Mike.Bennett@fortworthtexas.gov) 2024-08-04 - 3:08:27 PM GMT- IP address: 76.209.19.102 GS© Document e-signed by Mike Bennett (Mike.Bennett@fortworthtexas.gov) Signature Date: 2024-08-05 - 1:06:16 PM GMT - Time Source: server- IP address: 204.10.90.100 P-. Document emailed to Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) for signature f���➢zWNW =,►8Ile] JArI Email viewed by Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) 2024-08-05 - 1:25:47 PM GMT- IP address: 204.10.90.100 &0 Document e-signed by Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) Signature Date: 2024-08-05 - 1:26:50 PM GMT - Time Source: server- IP address: 204.10.90.100 r>M Document signing automatically delegated to Lissette Acevedo (lissette.acevedo@fortworthtexas.gov) by Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) 2024-08-05 - 1:26:51 PM GMT Cy Document emailed to Lissette Acevedo (lissette.acevedo@fortworthtexas.gov) for signature 2024-08-05 - 1:26:52 PM GMT C'y Document emailed to Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) for signature 2024-08-05 - 1:26:52 PM GMT f) Email viewed by Lissette Acevedo (lissette.acevedo@fortworthtexas.gov) 2024-08-05 - 1:27:16 PM GMT- IP address: 204.10.90.100 &0 Document e-signed by Lissette Acevedo (lissette.acevedo@fortworthtexas.gov) Signature Date: 2024-08-05 - 1:27:27 PM GMT - Time Source: server- IP address: 204.10.90.100 074 Document emailed to Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) for signature 2024-08-05 - 1:27:29 PM GMT l Email viewed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) 2024-08-05 - 1:49:12 PM GMT- IP address: 76.227.105.128 FDRTW❑RTHg I P—"ed:Y Adobe Acrobat Sign GS© Document e-signed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) Signature Date: 2024-08-05 - 1:49:26 PM GMT - Time Source: server- IP address: 76.227.105.128 P+ Document emailed to tpw_sw_contracts@fortworthtexas.gov for approval 2024-08-05 - 1:49:28 PM GMT f) Email viewed by tpw_sw_contracts@fortworthtexas.gov 2024-08-08 - 4:37:53 PM GMT- IP address: 204.10.90.100 A34 Document approval delegated to Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) by tpw—sw—Contracts@fortworthtexas.gov 2024-08-08 - 4:37:59 PM GMT- IP address: 204.10.90.100 &0 Document approved by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Approval Date: 2024-08-08 - 4:38:16 PM GMT - Time Source: server- IP address: 204.10.90.100 Q Agreement completed. 2024-08-08 - 4:38:16 PM GMT FDRTW❑RTHg I P—"ed"Y Adobe Acrobat Sign S J LOUIS CONSTRUCTION OF TEXAS LTD - Construction Contract Allowance Request - Final Audit Report 2024-09-20 Created: 2024-09-10 By: Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAA9SHg1whp6y35rmPXuDKmCp5-z5hmaHEQ "S J LOUIS CONSTRUCTION OF TEXAS LTD - Construction C ontract Allowance Request -" History Document created by Sadie Ishmael (Sadie.Ishmael@fortworthtexas.gov) 2024-09-10 - 3:08:32 PM GMT- IP address: 204.10.90.100 Document emailed to Douglas Black (Douglas.Black@fortworthtexas.gov) for signature 2024-09-10 - 3:13:14 PM GMT 60 Document e-signed by Douglas Black (Douglas.Black@fortworthtexas.gov) Signature Date: 2024-09-10 - 7:10:15 PM GMT - Time Source: server- IP address: 208.184.124.181 Py Document emailed to Jesica McEachern aesica.mceachern@fortworthtexas.gov) for signature 2024-09-10 - 7:10:18 PM GMT Ae Document e-signed by Jesica McEachern Qesica.mceachern@fortworthtexas.gov) Signature Date: 2024-09-20 - 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7:18:31 PM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to tpw_sw_contracts@fortworthtexas.gov for approval 2024-09-20 - 7:18:34 PM GMT Email viewed by tpw_sw_contracts@fortworthtexas.gov 2024-09-20 - 7:38:22 PM GMT- IP address: 204.10.90.100 J' Signer tpw_sw_contracts@fortworthtexas.gov entered name at signing as Sadie Ishmael 2024-09-20 - 7:38:44 PM GMT- IP address: 204.10.90.100 J Document approved by Sadie Ishmael (tpw_sw_contracts@fortworthtexas.gov) Approval Date: 2024-09-20 - 7:38:46 PM GMT - Time Source: server- IP address: 204.10.90.100 i Agreement completed. 2024-09-20 - 7:38:46 PM GMT FDRTWORTHs I P—m`l8y Adobe Acrobat Sign FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Greenleaf Sump Storm Drain CITY PROJECT NUMBER: 103260 WATER PIPE LAID SIZE TYPE OF PIPE N/A FIRE HYDRANTS N/A VALVES (16" OR LARGER; PIPE ABANDONED SIZE TYPE OF PIPE DENSITIES; NEW SERVICES: N/A I SEWER PIPE LAID SIZE TYPE OF PIPE N/A PIPE ABANDONED SIZE TYPE OF PIPE DENSITIES; NEW SERVICES: N/A LF LF LF LF 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. M, TRANSPORTATION AND PUBLIC WORKS January 30, 2025 S.J. Louis Construction of Texas, Ltd. 520 S 6t" Ave Mansfield, TX 76063 RE: Acceptance Letter Project Name: Greenleaf Sump Storm Drain Project Type: Storm Drain, Paving City Project No.: 103260 To Whom It May Concern: On November 5, 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 November 20, 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 November 20, 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 Max.Aransen@fortworthtexas.gov. Sincerely, I Ara nscn ;May 21, 202512.48 CDT) Max Aransen, Project Manager Cc: Jeremy Koonce, Inspector Gary Deyon, Inspection Supervisor Lorrie Pitts, Senior Inspector Thanaa Maksimos, Program Manager TranSystems, Consultant S.J. Louis Construction of Texas, Ltd., Contractor Click here to enter text., Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 rURT WURTI1 City of Fort Worth, TX PROJECT: OWNER: CONTRACTOR ENGINEER: Greenleaf Sump Storm Drain The City of Fort Worth, Texas S.J. Louis Construction of Texas, Ltd. Trans Systems CONSENT OF SURETY COMPANY TO FINAL PAYMENT Bond No.190053856 PROJECT NUMBER: 103260 22308 N/A The Surety Company, on bond of the Contractor listed above for the referenced project, in accordance with the Contract Documents, hereby approves 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 the Owner under the terms of the Contract and as set forth in said Surety Company's bond. In witness whereof, the Surety Company has hereunto set its hand this 16th day of January 2025 I.ilierty Mutual Insurance Company �] INSU# J p Surety Company s :� p90R� 1912 0 Authorized Representative Title Heather R. Goedtel, Attorney -in -Fact Address: 8400 Normandale Lake Blvd.. Suite 1700 Bloomington, MN 55437 Attach Power of Attorney C:\Users\elizabethi\Desktop\CONSENT OF SURETY COMPANYTO FINAL PAYMENT.DOC 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: 8212026-190003 West American Insurance Company SURETY 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 Stale 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 "CompaniesI. pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Blakc S. i3ohlig; Brian D. Carr�nter, Charles Draper; Craig Olmstead; Erik T. Gunkel; Haley Pflug-, [feather R. Gocdlel; Jessica Hecker; Kelly Nicole Erighauser; Laurie Pflug; Nlichelle halter; Mich1l C Ward; Nicole Langer; Sara Whitfield all of the city of Bloomington state of MN each individually if there be more than one named, its true and lawful attomey-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 25th day of June 2024 - P� 1NSURq j4paPO14ro10� Liberty Mutual Insurance Company �ZY INSU %NSuRq The Ohio Casualty Insurance Company cJ;4QavoR4��Pgyn V �4QBPORgT�oZ� West American Insurance Company r, m w �VY 1912 0 0 1919 f 1991 y -P. A*MPeW d' s'�M vlAtoBy'9 �O U rp �a71 • *�a` David M. Carey, Assistant Secretary C y to State of PENNSYLVANIA ss 0 0) : County of MONTGOMERY 0 w On this 25th day of June 2024 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance O m Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes d therein contained by signing on behalf of the corporations by himself as a duly authorized officer - to D IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written 0 CD c U) O vA y�F" 0-0 O 4F+ Hyy �(� F'{CL Y commmmealth or Pennsytuanw rJc•lary F"'.l Teresa Pastella, Hatary Public Montgomery County O% C 4i My commission expires March 26, 2025 �p By uiQ� f6 t Comm,ssm number 1126044 eresa Pastella, Notary Public Q o tv a)o v 2 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 op E 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 00 o 0 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 6 m 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 m — 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 c c1°i 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 w Zinstruments 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 attomey-in-fact under the 4M 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 LL a 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 attorneys -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 attomeys-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 attomey 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 affixed the seals of said Companies this 16th day of January , 2025 v INSUR �Z'r INS& P INSUgq P�0 4poR*rd'Lrfi �JPG4ISP�R�r a P 4ORPnRgJ�yin A'a 19, 1•�' 0 19.19�f•F�OL C0' s?''M1991 r By:y dV8 Renee C. Llewellyn, Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02/21 FORT WORTH The City of Fort Worth PROJECT: Greenleaf Sump Storm Drain OWNER: The City of Fort Worth, Texas CONTRACTOR: S.J. Louis Construction of Texas, Ltd. ENGINEER: Trans Systems CONTRACTOR'S AFFIDAVIT OF RELEASE OF LIENS PROJECT NUMBER: 103260 22308 N/A The Contractor, in accordance with the Contract Documents, and in consideration for the full and final payment to the Contractor for all services in connection with the project, does hereby waive and release any and all liens, or any and all claims to liens which the Contractor may have on or affecting the project as a result of its contracts) for the Project or for performing labor and/or furnishing materials in any way connected with the construction of any aspect of the project. The Contractor further certifies and warrants that all subcontractors of labor and/or materials for the Project, except as listed below, have been paid in full for all labor and/or materials supplied to, for, through or at the direct or indirect request of the Contractor prior to, through and including the date of this affidavit. EXCEPTIONS: (If none, write "NONE". The Contractor shall furnish a bond, acceptable to the Owner, for each exception.) None CONTRACT S.J. uis Construction of Texas. Ltd. By Adam H. Lunsford Title Vice President Subscribed and sworn tp before me this t? day of , 20 v Notary Public: My Commission Expires: MARIA LAURA PAREDES My Notary ID # 130612880 Expires April 15, 2028 FORT WORTH City of Fort Worth, TX PROJECT: OWNER: CONTRACTOR ENGINEER: Greenleaf Sump Storm Drain The Citv of Fort Worth, Texas S.J. Louis Construction of Texas, Ltd. Trans Svstems CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS PROJECT NUMBER: 103260 22308 N/A The Contractor, in accordance with the Contract Documents, hereby certifies that, except as listed below, all obligations for all materials and equipment furnished, for all work labor, and services performed, and for all known indebtedness and claims against the Contractor for damages arising in any manner in connection with the performance of the Contract referenced above for which the Owner or his property might in any way be held responsible have been paid in full or have otherwise been satisfied in full. EXCEPTIONS: (If none, write "NONE". The Contractor shall furnish a bond, acceptable to the Owner, for each exception.) None CONTRA T .J. Louis Construction of Texas, Ltd. BY Adam H. Lunsford TITLE Vice President Subscribed and sworn to before me this W*" day of Notary Public.,r My Commission Expires: r)q- /5-- .aogit -T, 20'2r tiA LQRA PAREDES f0-Y NO' WY ID # 130612880 Aprdl 15, 2028 '- Rutin:}q,�yk�Su�rUirlsiu�:SPM1�L