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Home My WebLink AboutContract 59539-FP1FORT WORTH. City Secretary -FP1 AT ContractContract No. Date Received 1/14/2025 AT AT NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: HCA Behavioral Health Hospital City Project No.: 104380 Improvement Type(s): ❑x Paving ❑ Drainage ❑ Street Lights ❑ Traffic Signals Original Contract Price: $91,510.74 Amount of Approved Change Order(s): $0.00 Revised Contract Amount: $0.00 Total Cost of Work Complete: $91,510.74 M< Jan 6 2025 Matt Senter (Ja`n �, 202511:45 CST) 7 Contractor Date Division Manager Title Moss Utilities LLC Company Name Jan 6, 2025 Cu rtisCu rtis He 6, 202513:34 CST) Project Inspector Date -#�� Jan 11, 2025 Project Manager Date Jan 14, 2025 Kandice Merrick (Jan 14, 202509:39 CST) CFA Manager Date --�^ Jan 14, 2025 nin r,,,,, .la n14,202514.06CST) TPW Director Date op�� Jan 15, 2025 Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 1 of 2 Notice of Project Completion Project Name: HCA Behavioral Health Hospital City Project No.: 104380 City's Attachments Final Pay Estimate ❑x Change Order(s): ❑ Yes ® N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time 45 WD Days Charged: 186 WD Work Start Date: 12/18/2023 Work Complete Date: 11/11/2024 Completed number of Soil Lab Test: 226 Completed number of Water Test: 4 Comment: The developer reduced the charge days from 192 to186. Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name FICA BEHAVORIAL HEALTH HOSPITAL Contract Limits Project Type PAVING City Project Numbers 104380 DOE Number 4380 Estimate Number 1 Payment Number 1 For Period Ending 11/11/2024 WD City Secretary Contract Number Contract Time WD Contract Date Days Charged to Date 192 Project Manager NA Contract is 100.00 Complete Contractor MOSS UTILITIES, LLC 18631 REMBRANDT TERRACE DALLAS, TX 75287 Inspectors D. WATSON / HOLLINGSWORT Monday, December 2, 2024 Page 1 of 4 City Project Numbers 104380 DOE Number 4380 Contract Name HCA BEHAVORIAL HEALTH HOSPITAL Estimate Number 1 Contract Limits Payment Number 1 Project Type PAVING For Period Ending 11/11/2024 Project Funding UNIT III: PAVING IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total 1 REMOVE CONC CURB & GUTTER 343 LF $6.40 $2,195.20 343 $2,195.20 2 REMOVE CONC PVMT 739 SY $15.84 $11,705.76 739 $11,705.76 3 CONC PVMT REPAIR, ARTERIAL/INDUSTRIAL -------------------------------------- 739 SY $105.02 $77,609.78 739 $77,609.78 Sub-Total of Previous Unit -------------------------------------- $91,510.74 $91,510.74 Monday, December 2, 2024 Page 2 of 4 City Project Numbers 104380 Contract Name HCA BEHAVORLAL HEALTH HOSPITAL Contract Limits Project Type PAVING Project Funding Contract Information Summary Original Contract Amount Change Orders Total Contract Price DOE Number 4380 Estimate Number 1 Payment Number 1 For Period Ending 11/11/2024 $91,510.74 $91,510.74 Total Cost of Work Completed $91,510.74 Less % Retained $0.00 Net Earned $91,510.74 Earned This Period $91,510.74 Retainage This Period $0.00 Less Liquidated Damages Days @ / Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $0.00 $0.00 $0.00 $0.00 $0.00 $91,510.74 Monday, December 2, 2024 Page 3 of 4 City Project Numbers 104380 Contract Name HCA BEHAVORIAL HEALTH HOSPITAL Contract Limits Project Type PAVING Project Funding Project Manager NA Inspectors D. WATSON / HOLLINGSWORT Contractor MOSS UTILITIES, LLC 18631 REMBRANDT TERRACE DALLAS , TX 75287 DOE Number 4380 Estimate Number 1 Payment Number I For Period Ending 11/11/2024 City Secretary Contract Number Contract Date Contract Time WD Days Charged to Date 192 WD Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded Total Cost of Work Completed $91,510.74 Less % Retained $0.00 Net Earned $91,510.74 Earned This Period $91,510.74 Retainage This Period $0.00 Less Liquidated Damages 0 Days @ $0.00 / Day $0.00 LessPavement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $91,510.74 Monday, December 2, 2024 Page 4 of 4 FORTWORTH. M" TRANSPORTATION AND PUBLIC WORKS November 20, 2024 Moss Utilities LLC 11050 Ables Ln Dallas TX, 75229 RE: Acceptance Letter Project Name: HCA Behavioral Health Hospital Project Type: Water, Sewer and Paving City Project No.: 104380 To Whom It May Concern: On November 20, 2024 a final inspection was made on the subject project. There were no punch list items identified at that time. The final inspection indicates that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on November 20, 2024, which is the date of the final inspection and will extend of two (2) years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at 817- 392-8424. Sincerely, Sandip Adhikari P.E., Project Manager Cc: Curtis Hollingsworth, Inspector Donald Watson, Inspection Supervisor Aaron Ybarra, Senior Inspector Andrew GoodmanP.E., Program Manager Pacheco -Koch, Consultant Moss Utilities LLC, Contractor HCA Healthcare, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 08/20/19 AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared (-afs jt j}V 0,5(6 �lJ-KJlc-�r 0 t L-L�nown to me to be a credible person, who being by me duly sworn, upon his oath deposed and said; That all persons, firms, associations, corporations, or other organizations furnishing labor and/or materials have been paid in full; That the wage scale established by the City Council in the City of Fort Worth has been paid in full; That there are no claims pending for personal injury and/or property damages; On Contract described as; HCA BH Hospital City Project No: 104380; CIA No: 22-0180 BY.Q S i kt n� Title Subscribed and sworn before me on this date, L "r to ry Publi Dallas, Texas CHMSTINA RACHELLE LAZARIN *- My Notary ID # 132339389 Expires January 31, 2028 Bond No: GSH5900173 OWNER CONSENT OF SURETY ARCHITECT TO FINAL PAYMENT CONTRACTOR Conforms with the American Institute of SURETY ❑X Architects, AIA Document G707 OTHER ❑ TO OWNER: ARCHITECT'S PROJECT NO.: 019747-33A (Name and address) City of Fort Worth 311 W. 10th Street, CONTRACT FOR: OCP: $543,756.25 Fort Worth, TX 76102 FCP: $543,756.25 PROJECT: CONTRACT DATED: June 14, 2024 (Name and address) Fort Worth Behavioral Hospital - Alliance Town Center Blvd, Fort Worth, TX 76244 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (Insert name and address of Surety) The Gray Casualty & Surety Company P.O. Box 6202, Metairie, LA 70009 ,SURETY, on bond of (Insert name and address of Contractor) Moss Utilities, LLC 11050 Ables Ln., Dallas, TX 75229 ,CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety of any of its obligations to (Insert name and address of Owner) City of Fort Worth 311 W. 10th Street, Fort Worth, TX 76102 OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand on this date: December 20, 2024 (Insert in writing the month followed by the numeric date and year.) The Gray Casualty & Surety Company - (Surety Attest: (Signature of authorized repres five) Crosby Guercio, Witness Sean McCauley ,Attorney -in -Fact (Printed name and title) S-2134/GE 10/01 XDP McCauley Bond Agency 12/20/202416:23 2273118011742 THE GRAY INSURANCE COMPANY THE GRAY CASUALTY & SURETY COMPANY GENERAL POWER OF ATTORNEY Bond Number: GSH5900173 Principal: Moss Utilities, LLC Project: Fort Worth Behavioral Hospital - Alliance Town Center Blvd, Fort Worth, TX 76244 KNOW ALL BY THESE PRESENTS, THAT The Gray Insurance Company and The Gray Casualty & Surety Company, corporations duly organized and existing under the laws of Louisiana, and having their principal offices in Metairie, Louisiana, do hereby make, constitute, and appoint: Sean McCauley, Liam Hackett, Sam Duckett, Jarrod Yost, Sarah Timmons, Ashlyn Simchik, and Bridget Truxillo of Dallas, Texas jointly and severally on behalf of each of the Companies named above its true and lawful Attorney(s)-in-Fact, to make, execute, seal and deliver, for and on its behalf and as its deed, bonds, or other writings obligatory in the nature of a bond, as surety, contracts of suretyship as are or may be required or permitted by law, regulation, contract or otherwise, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the amount of $25,000,000.00. This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both The Gray Insurance Company and The Gray Casualty & Surety Company at meetings duly called and held on the 26' day of June, 2003. "RESOLVED, that the President, Executive Vice President, any Vice President, or the Secretary be and each or any of them hereby is authorized to execute a power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds, undertakings, and all contracts of surety, and that each or any of them is hereby authorized to attest to the execution of such Power of Attorney, and to attach the seal of the Company; and it is FURTHER RESOLVED, that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be binding upon the Company now and in the future when so affixed with regard to any bond, undertaking or contract of surety to which it is attached. IN WITNESS WHEREOF, The Gray Insurance Company and The Gray Casualty & Surety Company have caused their official seals to be hereinto affixed, and these presents to be signed by their authorized officers this 41h day of November, 2022. URA V bS Y.0 10 8 SEAL * By: Michael T. Gray Cullen S. Piske �£ SEA L President President a r The Gray Insurance Company The Gray Casualty & Surety Company State of Louisiana ss: Parish of Jefferson On this 41h day of November, 2022, before me, a Notary Public, personally appeared Michael T. Gray, President of The Gray Insurance Company, and Cullen S. Piske, President of The Gray Casualty & Surety Company, personally known to me, being duly sworn, acknowledged that they signed the above Power of Attorney and affixed the seals of the companies as officers of, and acknowledged said instrument to be the voluntary act and deed, of their companies. UAW AIM C Leigh P,,cie E-Ienican Notary Public Leigh Anne Henican Notary ID No. 92653 Notary Public, Parish of Orleans State of Louisiana Orleans Parish, Louisiana My Commission is for Life I, Mark S. Manguno, Secretary of The Gray Insurance Company, do hereby certify that the above and forgoing is a true and correct copy of a Power of Attorney given by the companies, which is still in full force and effect. IN WITNESS WHEREOF, I have set my hand and affixed the seals of the Company this 20th day of December 2024 I, Leigh Anne Henican, Secretary of The Gray Casualty & Surety Company , do hereby certify that. tke above and forgoing is a true and correct copy of a Power of Attorney given by the companies, which is still in full force and effect. IN WrITNESS WHEREOF, I have set my hand and affixed the seals of the Company this 20th day of December _ 2024— p y,, � �✓VU� C(}"L—, _, J. �a9°R"`"►. gJt�S...4 8 �J J ;£SEAL `{ SEAL STATE OF TEXAS STATE BOARD OF INSURANCE -�7"U7006 rcwov rs Company No. 08-93774 Certificate 1' . 7 Q Q 6 THIS IS TO CERTIFY THAT CERTIFICATE OF AUTHORITY THE GRAY INSURANCE COMPANY METAIRIE, LOUISIANA has complied with the laws of the State of Texas applicable thereto and is hereby authorized to trans- act the business of Fire; Allied Coverages; Hail, growing crops only; Rain; Inland Marine; Ocean Marine; Aircraft --Liability & Physical Damage; Accident; Health; Workers' Compensation & Employers' Liability; Employers' Liability; Automobile -- Liability & Physical Damage; Liability other than Automobile; Fidelity & Surety; Glass; Burglary & Theft; Forgery; Boiler & Machinery; and Reinsurance i on all lines authorized to be written on a direct basis insurance within the State of Texas. This Certificate of Authority shall be in full force and effect until it is revoked, canceled or suspended according to law. IN TESTIMONY WHEREOF, witness my hand and seal of office at Austin, Texas, this _N:t __day of -------- December---------------- A. D..l_9B1___. Q G- .V. C- --- --- -------------- - CO S ER C�SUR By ; Deputy Commissioner FORM 6000