HomeMy WebLinkAboutContract 59323-FP1FORT WORTH.)
TRANSPORTATION AND PUBLIC WORKS
NOTICE OF PROJECT COMPLETION
-FP1
City Secretary No: 59323
7/23/2025
Date Received:
City Project Na: 102980
Regarding contract 59323 2022 Bond Year 1-Contract 6 for as required by the
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT as approved by City Council on 4/25/2023 through
M&C 23-0315. the director of the TRANSPORTATION AND PUBLIC WORKS DEPARTMENT 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
Pafriaia L. wad,,acK
P,D,c L. Wads k(J W 18, 20251149 CDT)
Recommended for Acceptance
Asst. Director, TPW - Capital Delivery
$ 8,001,639.09 Days 450
$ 40,062.00 Ne 3 Days Added by CO 101
$ 8,041,701.09 Total Days 551
$ 6,937,452.27 Days Charged_530
Days @ $ I Day
$ 6,937,452.27
$ 6,590,579.66
$ 346,872.61
07/18/2025
Date
�:-07/18/2025
Loge, Pr—r (Job 13
Accepted Date
Director, TRANSPORTATION AND PUBLIC WORKS DEPARTMENT
C)� 07/22/2025
Asst. City Manager Date
OFFICIAL RECORD
CITY SECRETARY
Comments: Revised copy submitted due to the correction of the M&C number. FT. WORTH, Tx
Contractor's Application for Payment
To(O`mcr): City of Fort Worth InvoicingPeriodd(From -T ): 6/30/2025
P. O NON -PO From (Contractor):
Number: Stabile & Winn Inc
Project 102980 Contractor's CFW Vendor No
0000007645
City secretary�inNb 59323 N�et 2022 Bond Year 1 - Contract 6
Application For Payment
Change Order Summary
Approved Change Orders
Number
Additions
Deletions
1
$296,149.00
$256,08700
2
$10,175.00
$10,175.00
3
$23,469.60
$23,469.60
I 4
I 5
I 6
I 7
I 8
TOTALS
$329,793.60
$289,731.60
NET CHANGE BY
S40,062.00
CHANGE ORDERS
Contractor's Certification
The Contractor certifies with the submittal of this document and associated Payment Request
Submittal on the City of Fort Worth 13—aw 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 ran account to discharge Contractor's legitimate obligations menned 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 mdemmfying 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
C-620 Signature Page
Invoice No. 23-FINAL
Invoice Date:
7n12025
Remit to ( If Not Automatic Deposit):
1. ORIGINAL CONTRACT PRICE.............................................................
$ $8,001,639.09
2. Net change by Change Orders....................................................................
$ $40,062.00
3. Current Contract Price (Line 1 t 2)..........................................................
$ S8,041,701.09
4. TOTAL COMPLETED AND STORED TO DATE
(Progress Estimate, Construction Allowance and Change Orders).......
$ S6,937,452.27
5. RETAINAGE:
a. X $6,937,452.27 Work Completed..........
$
b. X Not Used
S
c. Total Retainage (Line 5a + Line 5b).................................
$
6. AMOUNT ELIGIBLE TO DATE (Line 4- Line 5c) ...............................
$ S6,937,452.27
7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application).........
$ S6,590,579.66
8. AMOUNT DUE THIS APPLICATION....................................................
$ $346,872.61
9. BALANCE TO FINISH, PLUS RETAINAGE
(Column G on Progress Estimate+ CA + Cos + Line 5 above) ...............
$ $1,104,248.81
10. CONTRACT TIME:
a. Days Awarded
450
b, Days Added by CO
101
C. Total Days
551
d, Days Charged
530
e. Days Remaining
21
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.
Progress Estimate
2022 Bond Year 1- Contract 6
6/1/2025 to 6/30/2025
e�dpvn No k p I�
Umt1-Waer ImprOvemePI
1 3311.0161 6- PVL Water Papa, By Open LN
2 ai11.0181 8' PVC Water Pipe. By Open CM
3 1312.3006-Gate Vdve
4 33133002 8'Gete Vdve
5 13120001 Fire f)AaM
8 3201.0123 6 WS� AePhA FNmt Repaa, R-d
1 J201.1211 BWStle Asphalt Wml Repaa, ResitleMid
�201.0201 ASPhd A Rg!0jr Bgr�q Da9ned WAth.Resdeatd
3201.0400 Te�rpomry Asphhddll Pann9 Repeu (2' HMAC on 8' Hexide Base
9 course)
1O 6-
0241.0mov Ree Sdev Jk
11 0241.4001 Remove Concrete
12 2d1.131302 Remove and $dva,e 6' Water Valle
13 U41:1303 Remove and Sdvage 8' Wder V�re
14 41.1400 Remove FC:c �(Guder
15 141.15f0 Salv eFirelent
18 0241.1110 4% Presure g
1] 41.1219 4112' Water AbandonmeM Flu,
10 0241.1001 Water Line GroNin9
19 130301 4" Caw Sdevelk
20 -f 104016'C.-Drve,
21 3291.0100 Toped
22 920400 Seeday�, jjy1-111,
23 32930100 BI kS canard
24 132004 VP. -Water S--Rd„abon
25 11 001 V WMer Service. Meter Reconnectron
28 W112003 1"Wder Service
2] 132 001 1 1IT'VJater Service. Meter Reconnectwn
28 33132103 1 1l2"Water Service
29 33132201 2"WMer S-., MNer Reconnectwn
30 12.2203 2"Water Service
31
34 350202 Imp- E-demreV-41, CSS
32 S02o3ImAd E-dmB-.1, CM
.520ImdEW33 ]Sdc
Fil
311.0001 uoIn-vAR-.,.
35 12.0117 Co --to E-G.. 4%12- Water Main
38 3.50003` -A- Lov 2
37 So1o3 Expl-,E-.t..dExi6mg UtMlea
38 LO101 T99((jj�� aa��WMer Services
39 312S01O1 544PPP zlacre
40 50109 Trento Safetyry
41 .41.1]00 11" Pavement P.-I.n
42 1230101 UndassRietl E-1- by Hen
43 41.1300 Remove Cone LurbB G.
44 3211.0601 CEMIIME-(32IWSY)
45 130303 3"�spFvml Tyyie`D
48 .1S01O1 62 rb andG tler
47 .1a 301 T'Co�w Valet' Gutter, ResMerM1
48 50111 Valle Box AQlustey (GPBRed Li eSurvey)ollar
49 01]1.0001 Lon9mc0..
EL52�99A000l WMer Comim E
U01[2-02 6-W $eweImlxovn-
1 3331.1102 8'to 8" PiPe Erlegement
2 1d115 8" Sevuer Pilorql�Vc SGR26. P5115) BV 0-
- Lut
3 3331.41198"fdPrCipe, By Open CM
4 A10011 ManhdI
5 333Af 003 4' EMm Depth M-hob
fi 50112 Concrete Collar
] 1.31014"Sever Servme
Lcoryo-an 59323
Sx,ocN
teamae
and QoemiN
unn Pace
and vetue _'_'InsaOed
-'
value P<
1
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$903,120..
848A..00oo
UK-
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$ 100A0
$1d,]00..
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$1d,.4.
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12. _
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$122,504.
$32,400.06
350..000
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$122,500..
$35,104W
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I
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130..000
$]5,404.
1
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$21,750..
32.0..000
$4,804.
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14SO9 $
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$1467S.
1
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$]5 JJ
$2,4o0.0t��
934A0..000
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$32],2=
$24AW
$2,640.W
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$1,f00..J
10.00.0000
$1,100..
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$51,500..
$311,000.W
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$SO,000AIS
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$44,e0000
$81,20
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$33,6..
$81,200.W
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$13,fi50A0
6.00000000
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-GO..00
$25,-00
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$5,004.
$45,02
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103O.00oo'
$2,24.
$40,68SOO
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$259,Ofi0S0
$]5.00 J
$14,95
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$224181..
$13.9WOO
$11,]34W
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8,O.A0
$3.850..J
$B,0000..K�S��
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$4650..
$8,000.W
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$18,000AOJ
$39.o00.
$1.,O.AYS
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$18,004.
$39..4W
138A0
$214.
$28,980A0
13-000
$28,984.
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$105.
$234,57n
1964.0.000
11100..000
$204115.
$18306W
$$10,500.W
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VF
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fi9.00
$2,J .
$172,500.00
4500.0000
$112,500..
Thrs document has been muddied 1mm ds,ngmd form. an EJLDL
nwdificatwns. Vou ere encaumpetl 10 read the document.-u
document and the user dxl not hndght the
and ceasdt Legd Counsel pnor to M1s execution.
Contractor's Application
23-FINAL
nppeca6oe Dee
7//2025
w�ooNy Nsmeed Valve
_
Value TWSPm�od
�lao °m
ai s Dme
Bala°ceroFvoah
h
8-19
6ro )y
� )QIE
B
$599,83A00
$899,834.$3,285.
$1d,300A0
$14,.4.
9].3%
$400..
$122,504.
$122,.0..
100.0%
$35,10=
$3S100.W
10A3%
d2,]00.W
$]5,d00A0
$]5,404.
10A3%
45,800..
$8,500..
$4,800.00
$4,8f14.
221%
$1,950.00
$16,fi]S.
S32],Od0.00
$327,044.
834%
$65,310..1
$24A0(11
$24AW
332%
$501.001
$2.640.0(!
$2,640.W
110.0%
4240..
$1,100.00
$1,100..
100.0%
$220..
$fi12A0
0.0(11 $3.30
$611.
GO
7A5%
100.0%
$16&.
$1,So0.0�1
V.
$1,SO0.W
1211%
4300..
$3,800.0(1
$3,.0.W
40.0%
$600..
$5,400..
$d,1fidA0
$4,166.
13A8%
41,1fi4..
$10,892.00
$10,893.
12A]%
42,40
$1,000..
$2,OSAiS
_ $482SW
$51,504.
$51,500..
V.-
_ 115:6.
$1,50a.
$3]1,000.0r1
$3]1,DD0.W
100.0%
$:67-
$S.SO0.0G
$-W.
$5..0.W
f00.0%
100.0%
$1,350.00
$1,320.0(1
$1,WQW
240%
$11,000..
$4,180..I
$],50a
$50,000.06
$.,DDOW
100.0%
$2.250..1
$33,6"
$34.0..
]SO%
$11,M.,
$81,2o0.0Ga
$01,200.W
100.0%
$11,]OOAO
$11,]00..
8S]%
$1,950..
125,000..
$1,So0.0U�
$225.0..
$1,SO0.W
1OO %
100.0%
$90,912A(1
$W,9YLW
8-$14,150..I
$500..
$25,20-
$.2.00
100.0%
$2,260.00
$2,Mco
45M
$2,74a.
$10,885011
$.-W
838%
$5,13S.
$22d,181A0
$2L1,181..
8A5%
$34,871.
$33.900.0(11
$11,]30.
$33.900.W
$11,]30.W
412%
735%
$41.100..1
$3,220..
$fi,fi54.
%5 .
1]3]%
42,800..
$B,000.0
$8,.0.W
100.0%
$16,000..
$18,004.
100.0%
$39.0GO.
$n.000.W
100.0%
$1OO,000..
$28,980A0
$. ".
100.0%
$206,11S.
$2.,115.
87.9%
$28,45S.
$23,880.0(�1
$23,6fi0.W
100.0%
$135,200.00
$1.,2...
8A7%
$20,800..
$10,500..
$112,500.00
$112,.0..
fi52%
$5,200..
$60,000..
Progress Estimate
Sao- x®
59323
Contractor's Application
2022 Bond Year 1- Contract 6
App°oa°°ax®ba
23-FINAL
PP ®P-d
6/1/2025 to 6/30/2025
App
7//2025
end Pvn xo
Imu
k P
$ N
xaou o aalae
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value w.ouUy NsteOea value Vulm TNSPer�od Scored (aotela C)y
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and 3�+E)O� B
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8
9
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:CAfCU1'U�ManXdeVecuum Tesfina
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1Sd/
$)0008
E254W
$49.000.W
$3.]s0.Wl
39A0000000
1?AWW000l
$23.800
83.250.WI
$23,800.W
$3,2s0.W1
$23.BW.0® 4881
53.250.W 86]%
$25.200.W1
S1o0.W1
10
11
12
13
14
15
3201.0400 TeW..q Aspha Paving Repair (2' HMA on 6' q ,Ul Base
Coursej
3201.0{13 I-AgdIp11Wm1Repzp. Realdeatld
3201.0201 �y��aII WWmmIl Rery� Bq dOafned 4VtltM1. RasMentld
3211.0112 G°iiex tle Base TvoeA GF}1
3291.o1oo To�,/�i
32920d00 seedino.�v 11m
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1
$V
8V
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$V
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$3SW.
$140.IX1
$11SIX1
$2SIX1
$SOfI
$95.400.W
$18,2o0.W
$2.304001
$d,004W
$2.46=1
2082.00000000
153J.b0000001
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$)2.8)OW
$21,420.W
$80.SWI
$]2,8]0.W
$21,dz0.W1
Uo-1
$]2.8)OW ]63%
$21,420.W 1117%
$80SW 310%
$22.810.W
$3,220.W1
$1.49SW1
$5.000.W
$d,004W
$2.46a 1
16
0241.0500 Remove fence
1
100.01
$20.IX1
$z,000A01
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$4,-001
$4,.0-
$4.800.IX1 ]L]%
$5.804W1
21
22
23
24
25
26
27
20
29
30
31
32
33
34
3s
36
37
38
39
40
41
d2
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3WSo2o2 Im IEo6edment/Fiac ifil. css
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13370l(5y001j037 E��yal ry tron of Ex1s11na Utldles
3110:E183 (>,. ]%'pekppwvP{
311 A.E1 3 ii '(Axl Vi n+vd
3110.010418%24' Trce Removd
3110.o10s 24"and Lamr�er Tree Remwd
312S0f 01 SWPPP a7acre
W 1.170011"Pwement PJie�atlon
31230101 Undass-1 Excavallonjjryry qan
0241.1300 Remove C.-Curb B G'u0er
3211.ofi01 CEMIIME^^,{3�Iba1 y�
32120303 S Asphdl WRa T��U
321801016'Co�w Curb and Gutler
330S0f 0]ManM1de Mau mant. Minor
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$4S01I
$2001J
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$1.01)
$1.9500(1
$52S01f
$53ygf
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$1,5)S0J
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$1401f
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$710d
$fi54di
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$4,00001f
$0.000011
$40.00=
$S,s04W
$7.500.W
$2,2s0.W1
$2.)80.00
814.292W
$2,382A01
$13.850.W
$3,fi]SOO
$830.00
$]90.W
$1,s]SW
$)50.00
$11,OBBAO
$2,fi44W
$1.256W
$5,13SW1
:2].32AW1
818.]s0A0
$fis4W1
$23.400.W
$4,O.=I
$]0.000WI
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$4s.W0.W1
$2.480.W
812.666W
$2,111.W
$].eW.W
$3,6)500
$-oo
$-.I
$1,5)SW
$)SOW
$11,OB8W
$z.64400
$s,13SW
$2].324WI
$3,214.1
$23.406W
$d,000.W1
$B.SOOWi
$45,000.001
$2,480.00
$12,fifi6A01
$2,11""1
$],000.W
$3,fi]SW
Is-
$]90A0
$1,5]SW
$]50.W
$11,OBBA0
$2,fid400
$5,13SW1
$2],32400
$3,2s4W
$23,400.W
$d,000.001
$8,500.W
$d5.W0.a ills%
$2.434IX1 8A1%
811.666IX188fi%
$2,111.IX1 88fi%
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$3,6)SIXI f00.0%
$630.IX1 100.0%
$)90IX1100
$1,I7&MI 1040%
$)SOIX 100.0%
$11,Og8IX 100.0%
$2,= 1040%
$5,135.0d 1040%
$2).3240d 1000%
W2s4IXi 5040%
$23.4000d 100.0%
$4000.01I 10a.%
$B.S000If 100.0%
65,990.W1
$7.50a 1
$2,2s0.W
$300.W
$1.626WI
$2]1.W1
1
1
$1.250.W
$18.]s0.W1
$2,604W1
$70.000WI
I
U01[ $: PaNrg Improvements ease altl (Concre[e7
0241.1100 Remove Asphalt Pvml
$V
18769AL
$4W
$8]
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$6
13
91%
$5.884W
31230101 UndareEwl0by en
A
S.0OA
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350
100
M.
5.126
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100.0%
3B
3211.0400 Hytlmtetl L1me 32 bs15V
45W
S
$3].25W1
W0001
$11.751
$98,071151
$9.815 ]%
S03-
1.O502 S'mmnt
184B
$14L
1832000
$108.W
$108,08A
$1SV
$8.333W
Sn
32130f016'Corc 1.
Sy
1668fico
$1M.
$1,767.71 d.84
15z84520000001
$1,fi1881828
$1,618,81829
$1,fi18,81828 91.fi%
$1d8,=s
fin
3305.0 11 Vella BarAdlustmeM
EA
33W
$304W
$9,904001
23.OW0000.I
$6,-ool
$49040o
$6,90400 69.7%
$3,004W
)B
3305010]ManM1da Adludmant, Mmor
EA
14W
$554W
$S,s04W1
13WW00001
$],154W1
$],1s4W
$).154W 1340%
$1,654W
8
01]1.0001 Condmd-slakm9(Panng)
LS
1.W
$18,OO4W
$18004W
0001
$16,OWW
$18,00a.1
$18,OO4W 1o40%
9
02d1.ofoo Remove sldev Jk
IF
1oo0.W
$3W
$3,00aco
1W1.oWW000
$3,643W1
$3603A0
$-oo 1241%
$6o3W
10
02d1.o300 Remove AOARamp
EA
3W
$250.W
$so0.W
6A00000001
$1.5W.W1
$',s00.W
$1,5W.W 3040%
$1,000.W
11
.41.odo2 Remove Asphal Onve
IF
1624W
$3W
$d,864W1
664.000000001
$1,992W
$1,882W
$1,992W 41.0%
$2,868W
12
.41.0401 Remove Comets D-
IF
10o6SW
$4W
$d0.2-1
5269.00000000
$21.0)8W
$21,0]6.00
$21.0)6.W 523%
$19.188W
13
0241.0]04 Remove and Repkce Malbox•T ft-1
EA
14W
$154W
82:1o0.W1
300000000
$454W
$ds0.W
$4$4W 21.d%
81.fis0.W
14
0241.0]OS Remove and Reltece Malbox-Bock
EA
13W
$1.850W
$24.050.W
4.00000000
$].4W.W
$],400A0
$).400W 368%
$16.850.W
15
11,1100 Remove Coac 111 GMer
1
2s7-
$SW
$13.360.W1
1]99A00000001
$..-.I
$8,99SW
$8.- 6].3%
$4.36SW
18
W2 .1400 Remove C.-Wky Gutter
$V
132W
$12W
$1.504.W
13500000000
$1.632W
$1,832W
$1.= 1030%
d48.W
1)
0241.1)00 11"Pavement Pd+elaallon
$V
221AW
$14W
$30.998A0
1059.00000000
$28.0%W
$28,098A0
$26.o%W 80.2%
$4.900.W
10
3110010; $11 tleanng
$V
so-
$la
$5.000.W1
$5.000.W
19
311.01026'-12'Trce Removd
EA
4A0
$52SW
$2.100.W1
4.000000001
$2.1W.001
$2.10-1
$2.1m. 100.0%
1
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nwdlficatwns. Vou ere encaumgetl to read the document-1U and ce Wt Legd Counsel pnorto ft execution
Progress Estimate
59323
Contractor's Application
mono- x®
2022 Bond Year 1- Contract 6
App
23-FINAL
PP ®P-d
6/1/2025 to 6/30/2025
App
7//2025
imn
H.a QumnN
Unn Rice
H.d Value
H aQ nary
value RevouMy
_
NateOea value value TNSPee�od
taMb
noel 3Q+
aalaneem-
(pJ
B-FI
Bid Imn No
k P
anon o aeae
$ N NN
Nstilled
Stored (uoteiu )y
)OMe
B
20
3110.010312%18'Tree Removal
EA 1AD
$85400
585=1
1J000W0001
$-.I
585-1
E850.W
f00.0%
21
311M 104 18%2d' Tree Removal
EA 1M
$I,000.00
$,.00-1
1J000W0001
$1,-.1
$1,000.00
$1,000.00
100.0%
22
3110.010524" and Larger Tree Remevd
EA 1A0
$2.05400
$2.OSOAO1
2db 111
14.1-11
$d,100.001
$0...
200.0%
.2,0$41
23
31210105 Barrory by Ddry
CV SO0.W
$2L00
$11.000.W�
$11.000.00
24
31250101 -11 11 acre
LS im
$1.000.00
$1.BO0.W �
1J]0000000
$1.800.00!
$1,000.00
$1.800.00
100.0%
25
3211.0112 6' gexide Base, Type A, GR•1
SV 100=
$AW
$SO.000.W
$50.000.00
28
3211.0801 CEMUME'"'(321-Y)
TN 3500
$39500
$13.02SOD�
26A000O000
$10.2]4001
$10,2]0.00
$10.2]0.00
]43%
$3.SSS00
2]
M1L0303 3"Asphdl-Ty D
3V 2214.00
$3450
$]8.383.00�
102]S]000o001
$83..1.17
$63,051.17
$83.051.1]
BLS%
$13.331.041
28
31&01016C--da
1 18-
$71
200.1
$18.20.
16A00000I
1].0.
$3M
$11].11-1
$1710.0
8&0%
$.00.
29
31L0401-Tmnsa
TN
$.&,
W0
$4,31-1
$3.313
211.2%
418,0630
30
Ml I'reewk
SF 83-
L
$3.l
81&0001
$97.511001
$97,5L1
$
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$42.084W0
31
Lore
33031f 4'SSMexk, Al-M to
F
$130
0.
0.
0.
$19 3.121.'
-%
$.781.60
32
33032CoMek.Alatto Rat Wall
SF 3fi300
$1400
$5,08300l
242A00000001
$3,38&00l
$3,388p0
$3,38&00
fi&]%
$f,fi8400
33
32f30322 Lonc Lurb at Back of SMevrdk
I 28500
M.
$4,275401
fi]4A00000001
$10,11400l
$10111400
$f0,110.00
23&5%
45,83500
34
32f304016' Corcreta Drrvevray
SF f290-
$14co
$180,65ficol
12]4]A00000001
$1]8,45&001
$178,45&001
$1]8,45&00
9&8%
$2,19&W
35
321304038"Corcreta Drrve'xa[
4Y
SF M.
$1].00
$3,]d0.01
]94.000000001
$1349&00l
$fid9&ODI
$13,49&00
380.9%
49,75&W
36
32130504 Barrrer Free Ramp, MQ
EA 1M
$2,30400
$2,30=1
1A00000001
$2,300.001
$2,300.00
$2,30400
f040%
37
32130507 Barrrer Free Ramp, TY P•1
EA 1M
$2,900.00
$2,90=1
2.000000001
$5,800.00l
$5,800.001
$SMA00
20MO%
42,900.00
38
32130507 Barrrer Free Ramp, TYPE P2
EA 16.00
$3,100.00
$49,600AO
13000000001
$d0,300.00j
$40,300.001
$d0,-1
81.3%
$9,300.00
38
559&0001 Barrrer Frce Ramp, TYPE R•1A
EA dA0
$2.900.00
811.fi00A0�
6GOW0000
11].40 .
$1],d00.00
:1].400.00
1510%
45.800.00
40
9y9y9� 9,3',``p0``,,��p01l 6`ErtrtlI rF(ee q`mp, TYpe R•1B
EA L00
$2.300.00
$4.BO0.W�
2Jd00W000
$4.600.00�
$4,800.00
$4.G00.00
100.0%
41
999A,OO� Bamer Frce Remp, Type -A
EA L00
$3.500.00
$7.000.W �
2A0000000
$].00400�
$],000.00
$].00400
100.0%
42
559&0004 Bamer Frce Ramp, Type -A
EA im
$4.201,
$4.20"o
1J]00 D.
:4.200.,
$4.200.00
$4.20400
IDMO%
43
999&0005 Bamer Frce Remp, Type P2B
EA -
$1.800.00
$Mo0.W 1
2A000O000
$3.80 1
$3,go0.00
$3.800.00
10.0%
44
321&0102 Conc Lay--
1 100.00
$]S00
$7.10=
$].500.00
45
321-01 C-Atltlress P-1.9
EA BL50
$]L00
$8.35L50�
51.00000000
$3.92L00�
$3,92]A0
$3..1
gl-
$2.421.
4g
323L0100 Lonc Rd N@II AtlIeceM to SMervdk
SF 48400
$11-
$53.380.00�
11].230000001
$13.401.45!
$13,481A5
$13.481.45
2S3%
$39.8]&55
4]
329f.0f 00 Tepmi(fiincM1)
CY 1888.00
$2500
$41.g50.001
680.000000001
$1].000.001
$1],000.001
$1].-1
41 %
$24.850.1
48
32930f00 Block Sod Flacamard
SV 10000.00
$L25
$]2.500.001
64B&000000001
$4].03&00�
$4],03&001
:4].03800
80.9%
$25.48Lo0
d8
32930500 Seeding, Sol Rdentan Bknkel
SV 25400
M.
$d,12S00j
184000W0001
$3,03&00l
su0ac01
$303&00
716%
$1,08M00
50
33050108 Mcce lkkIn o /WJJustmeM e{ J
LS fA0
$54000.00
$50,00400�
0.03]fi92d0
$1,88462�
$1,880.62
$1,88462
38%
$d8,11i38
51
33050108 Mere laneous Slmdure AMA), 6'orHgM1er
EA 5&00
$]S00
$d,35400�
34A0000000
$2,55400�
$2,550.00
$2,55400
5&fi%
$1,804co
52
7.j,mert
33050111 Valle Bar AdlastmeM,ln udmg Lome( Co11a
EA &OD
g35400
$2,800.00I
OWW0001
$]00.001
$]00.001
$]00.00
2S0%
$2,f00.00
53
33d&0008.. Rpe UndeNmin, Type B
1 ]00.00
$2500
$17,50-1
]05.000000001
$17,.1.1
$1],625A0
$17,.1.
1047%
412500
Sd
33d&5006 Remove and Replace ldet Tap, 10'
EA IM
$9,12500
$9,12-1
1.000000001
$&125001
$9,125.00
$9,12-
IO40%
55
34d1.d0061nsta1l Al.. Sign Gmand M-
EA L00
$]00.00
$1.40=1
1.000000001
$]0 .
$700.001
$700.00
50.0%
$711.
56
559&000] SaMage antl Reuse Ex. B-Pavers
BF 100.00
$30.W
83.000AO�
$3.000.00
5]
559&0008 Type Ill Post TY Barncade
EA -
$1.100.00
$4.400.W1
4Jd00W000
$4.400.001
$4,400.00
$4.400.00
100.0%
50
-1, 110 Removeand Reimta115q -I-P-
EA 2-
$-
$11.000.W�
]J]0000000
$3.50 M.
$3,500.00
$3.500.00
31-
$].500.00
59
34]1.0001 --1.
me -
$].800.00
$54.800.W�
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$54.600.00�
$54,800.00
$54.800.00
IONO%
Bo
-.0010 Paving Censlm-Allmvance
LS im
$100.000.00
$100.000.001
$100.000.001
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nwtlificatrens. Vou ere encauregetl to reatl the d..- ca 1l antl-n Legd Counsel poor to es exceubon
Progress Estimate 59323
2022 Bond Year 1- Contract 6 mono- tx®
®z"°a 6/1/2025 to 6/30/2025
6d nan xo a v 6xnon xo xteaeae E.d Q—V unn Rice E.a value
r� n
Contractor's Application
app°"°°°xumn" 23-FINAL
nppecan000°a 7//2025
Bala°ceroFooah
E tim tea�Qea�.ery value e.ev onsty tnvreuea valve valm'ILSPe��oa wr�(oo `� )Y QIEJB ai s� Cma
66.607.666.171 56,60].666.1]
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nwdificetwns. —ere encaure to read the document.—M and—n Legd Counsel pnor to ft execution.
E6.60],69E1] —,
Progress Estimate Construction Allowance Usage
ADDITIONS
Fe t°o°o-su) 102980 2022mna Yeer1-C--16
6/1/2025 to 6/30/2025
c° o-aa�tx 59323
penfica,— at of Q11 VbAdd --- Addmo°\'aloe
Contractor's Application
PP o-°°x�mnR 23-FINAL
PP �°°Date ]/]/2025
_ B a°wroFm�sh
6[mM b Dab (F) (B-F)
(D+B) B
Progress Estimate Construction Allowance Usage
CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED
be«°trat/ 102990 2022Booa Year l-C--6 pp n°vxu,vnm
6/1/2025 to 6/30/2025 pp °o°Date
�d l�em Number Ue p ,tom 6ecuov xo Mesxwe °nty [°Nalote Umt Pnw Radac4°v valoa No 1 Notveed NotueN Not Ued N.-
Contractor's Application
234PUL
l/]21n5
Not Used Not Used Not Usa]
Progress Estimate Change Order Number I 1
AMMONS
s'°.I.—) 102980 2022B..d Year1-C-..,,16 c�sa a°'1' 59323
App1iaeo"rm°a 6/1/2025 to 6/30/2025
III a °�°c ® P6 Rd Lme 6wvm) �.eyic
I � ona°lcwam)
53 " _ 1-7 ewQ 1-1-SD 1, PSu5)Py Oom Cm
Mw°m
01 Ma�°le vz uam P.-
°°em seem ewo.arm. "'
P awz� mae�uun
®n ailm
r �° °"o-°�11—w
a °" o w ( em D. $.,)
1Sawa)
as o"„ Px�au"a Maw°�e
111
aM.x,°m Ad—:hl—
- °w w=a
SaL°n N° Measwe CO Q—tybAdd
Dwt Pace
waa�
Vile
Woo oo
$11110
$9.Oo000
$1 fi2,000 oo
$1,6500o
$s5o.o0
rw 1 oaooaoao
$zaoo oo
$3,asa ao
$zaoo oo
s3.a5o oa
$10501
$10,4oa 00
a ,75s oo
$lo.aoo.oa
I —Poo
$zsoo oo
s2sa oo
slze0000
$—o0
$uo oo
a6 oo
1-11
$1,986 0o
111
owowoo
$zaoo oo
$a,01000
$zaoo 00
.5110
1s o 1v6a7oo
$e.5oo 0o
$1.000 00
110 $3,36o so I
$ssa oo -m oo I
$zaoo oo $zaoo ool
$395 oo $2.11,11l
1.e azs oo -o oo
259 omaooao $a So $220150
Contractor's Application
PP a°"xumce 2341NAL
$v eo"Da1 7nao25
nma[M Qoanety
I"a111ed
°Daly
Velm Sua111ed Ve4�
$182,00000 $182,00000
$1,65000 $1,65000
Vil�e'Dm bnels Prasmdv
PmW 61med (v°tm C)
0,06875000
M50.00
$zaoo 00
—,o0
$zaoo 0o
1 oaooa000
s3p5o oa
a3a,aesM
s3p5o oa
a3a,a
$10,aoo.00
$121. 00
slo,ao .no
$12,soo oo
$—o0
$25100
sa,aoo 00
II AS oo
$s,aoo 00
$1,986 0o
3310000000)
s331.oa
$zaoo oo
$331.00
$zaoo oo
$-00
$—o0
$1,00000
a2,15o 00
$1,0000o
$zl5o oo
$a,oso oo
$$,oso oo
s3,36o so
$3,36o so
ss5ooa
$zaoo 0o
ss5000
$zaoo 0o
PI oo.o.S
$2,567,50
-o oo
$2,567,5a
$710 oo
$zm1 so
$zm1 so
$29s—,50
$29s,9s1so
r°1e
9P, )�o1—H
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B-P)
d
$1 a2,0000o PIOe
SI 65000
11500o00
$zaoo oo e
$3.45000 1000-A
sa,-00
$1o.aoo oo 1
$usoo oo e
$25000
sa.aoo oo
a! os6 00
13310o 1 IA
szaoo oo
$z5000
$1,00000 1000%
$3.36050 1
$ss000 00
azaoo oo ISS
$a. 6— $19v 101
$aso oo Poo 01.
$2.20150 100-
Progress Estimate Change Order Number I 1
DELETIONS
FB (oo�o-aoq 1029s0 2022Eond Y-1-C-...6 pp eo. xumbw
Apphaa°�Rc,m 6/1/2025 to 6/30/2025 pp °a. Def
Chavge Orda Item A R� C°Qae°hty to --. Chaug�Ocdm Not— Not°— Not Used Not— .Uead
No ° p Sxeae Na a,r..s�ve elate °
m- ou Allow— __$100100000 $90,000
pha1—Repau,Res�deueal $15000 $16,950 _
® arysAsphalt—Re (2"HMAC m6"P1ecH S500 $52,50000
Water $erv�ce Relocahou LF 380.0 -00 $15,96 0 _
I as u o�awcem Auowavice LS 086000000 $]0,00000 $6g20000
so 9999oomFawoRe�.wed�Almw�<e L$ 0-77000 amo,00006 azo,anod
T-k-..oR].od,
Contractor's Application
23-FINAL
7nn025
Not UsMF Not UsM Not Used
Progress Estimate Change Order Number 2
ADDITIONS
Fm (covo-ac9 Io2vso 3022B—dV-1-C..—t6 Cuy so�aiuy 59323
a�e�ee�ea.oa 6/1/2025 to 6/30/2025
sY 3700000000 52750o 510,175
Contractor's Application
23-FINAL
7/72025
am s�me've e
$10,17500 1000%
Progress Estimate Change Order Number 2
DELETIONS
F°`Iioveat� 102950 2022amdva°1-Co..—t6
/+PPLczeweai°a 6/1/2025 to 6/30/2025
�� CO ��ntyb Umt Pnw e®CLs°ge Not e O.dc Itan srnptioo $ecno°N° lete O.eda Valor Used
_ $S,SW 01� $S,SOO Od
52 9999 o001 wemr cmuo-ucno°wowe°ce LS 00u1500o $100,00000 $,,67500
r°m. alo.ns.od�
Contractor's Application
23-FINAL
'IYI12025
Not USNF Nat USW NotUazd
Progress Estimate Change Order Number 3
ADDITIONS
Fm (covo-x9 Io2vso 2022B—dV-1-C..—t6
wpphceeov Hmoa
Change Udx Imn
n m Ihxnphau
55 Isolaze &. Plnsh &usmi¢Fue
� m �¢ wal2uNwg Revm Coetwg
I N3 �csaeau
I ? ®e �ae�an. wa,a�mxawnu
®e elwdlwa,aee��w s�aewau=
I cz azal ow0 reavwe wdl <a�
Contractor's Application
coryo-an 59323
vv my Nwnbc
23-FINAL
6/1/2025 to 6/30/2025
°P
7t72025
CO Qnmmv Add
ilm[A.ce
.aaamw
C6av€e aaa H'` ��Inallmry
Val ue LCWleda
vale Thu Matmals Pramuv
Hm9
T- CC`®Plo
seceon Na Mees�ue
oe
v
H
Ls 100000000
Ls 100000000
s3.1.00
ss,7so oo
I
$3500001 Io000000o
as.zs0001
_
ss500.00 s3,s0000
ss.zs000 as,7so 00
I
s3.s0000 1000.
I ss.iso 00 1000�
a300
szz 00
s1z 00
sela3ol
asao0l
so0W
I sala 30 ,
I aria 00 1 ,
s300 o0 1
aela3o
aslo30
sneaoo
sae, 00
s3oo oo
s3o000
sla0o
s3.473wl
say. ao
s3.anm
1
s3anm 1
a1I500
11,13e 111
as,esaso
se,e3c50
1
M.53a 50 1
LF az z0000000
slzao
ss0e aal azzao00o00
asoa a0
asam
1
$wam laa 0,s
.-)
Progress Estimate Change Order Number I 3 Contractor's Application
DELETIONS
F°`c°�"traq 102950 2022ao.av-,1-Co..—t6 as °o"x"'""` 23-FINAL
Ewai�cawmemoa 6/1/2025 to 6/30/2025 vv — 7n/2a25
cnaneemaal� >x�woo a sp-xn x D
m xm— xo�vsm xolv�aF xo—a xmusw
o c on o easwe a \'ilue
52 a� —50000o $100,0o 0 SS,50000
a 0521— $70,OW 00 S5,]5000
OrvPoxv�w¢Co�um�cno�Alloweuw 0 -1— S1000000 -21—
III
io.ala E2J,i696Q�
City Secretary Contract Nam: I 59323
Application Period
Funding Identification (Fli))
I Original Contract
156002-0600430.5740010-102980.001780-9999
156002-0700430.5740010-102980.001780-9999
134027-0200431-5740010-102980.002480-9999-22010199
10
10
10
10
10
10
10
10
I Change Order I
156002-0600430-5740010-10298aD01780-9999
156002-0700430.5740010-102980.001780-9999
134027-0200431-5740010-102980.002480-9999-22010199
10
10
10
10
10
10
10
10
I
Change Order 2
156002-0600430-5740010-10298aD01780-9999
156002-0700430-5740010-102980-001780-9999
134027-0200431-5740010-102980.002480-9999-22010199
10
10
10
10
10
10
10
10
I
City of Fort Worth Summary of Charges
2022 Bond Year 1- Contract 6
(p o. NON -PO
6/1/2025 to 6/30/2025
Appli
I I 23-FINAL
Number.beer:
Total Completed
Amt Remaining Gross
$2,840,604.00
$366,816.25
$796,214.00
$307,497.00
$2,971,038.17
$719,469.67
$195,450.00 ($175,410.00)
$80,222.00 ($60,200.00)
$20,279.50 ($20,279.50)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10,175.00 ($10,175.00)
Project Number. 102980
Application Date: 7/7/2025
Retainage Net
City Secretary Contract Nam: I 59323
Application Period
Funding Identification (FID)
Change Order
56002-0600430.5740010-102980.001780-9999
156002-0700430.5740010-102980.001780-9999
I34027-0200431-5740010-102980.002480-9999-22010199
10
10
10
Io
Io
Io
10
10
I
Change Order
156002-0600430.5740010-102980.001780-9999
156002-0700430.5740010-102980.001780-9999
I34027-0200431-5740010-102980.002480-9999.22010199
to
10
10
10
Io
Io
Io
10
I
Change Order
56002-0600430-5740010-102986001780-9999
156002-0700430.5740010-102980.001780-9999
I34027-0200431-5740010-102980.002480-9999.22010199
IO
to
10
10
10
Io
Io
10
City of Fort Worth Summary of Charges
2022 Bond Year 1- Contract 6
(p o. NON -PO
6/1/2025 to 6/30/2025
Appli
I I 23-FINAL
Number.beer:
Total Completed
Amt Remaining Gross
$3,500.00
($3,500.00)
$5,750.00
($5,750.00)
$14,219.60
($14,219.60)
Project Number. 102980
Application Date: 7/7/2025
Retainage Net
City of Fort Worth Summary of Charges
City Secretary Contract Nam: I 59323 I 2022 Bond Year 1- Contract 6 ( p O,. NON -PO Project Number. 102980
Application PeriodI 6/1/2025 to 6/30/2025 I Application I 23-FINAL Application Date: 7/7/2025
Number.
Funding Identification (FID)
Change Order
56002-0600430.5740010-102980.001780-9999
156002-0700430.5740010-102980.001780-9999
I34027-0200431-5740010-102980.002480-9999.22010199
10
10
10
Io
Io
Io
Io
to
I
Change Order
156002-0600430.5740010-102980.001780-9999
156002-0700430.5740010-102980.001780-9999
I34027-0200431-5740010-102980.002480-9999.22010199
to
10
10
10
Io
Io
Io
Io
I
Chagjp Order
156002-0600430-5740010-10298001780-9999
156002-0700430.5740010-102980.001780-9999
I34027-0200431-5740010-102980.002480-9999.22010199
Io
to
10
10
10
Io
Io
10
Total Completed Amt Remaining Gross
Retainage Net
City of Fort Worth Summary of Charges
City Secretary Contract Num: I 59323 I 2022 Bond Year 1- Contract 6 (p O,. NON -PO Project Number. 102980
Application PeriodI 6/1/2025 to 6/30/2025 I Application I 23-FINAL Application Date: 7/7/2025
Number.
Funding Identification (FID)
I Totals
I56002-0600430.5740010-102980.001780.9999
I56002-0700430.5740010-102980.001780-9999
I34027-0200431-5740010-102980.002480-9999.22010199
I0
I0
10
Io
Io
Io
Io
to
Grand Total
Total Completed I I Amt Remaining
$3,049,729.00
$177,731.25
$882,186.00
$241,547.00
$3,005,537.27
$684,970.57
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
+ $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
I I $6,937,452.271 I
$1,104,248.81 1
Gross Retainage Net I
1 $0.00 1 1 ($346,872.61)1 1 $346,872.61 1
FORT WORTM,
Routing and Transmittal Slip
Transportation & Public Works
Department
DOCUMENT TITLE • 2022 Bond Year 1 Contract 6 — Change Order #1
M&C: CPN: 102980 CSO: 59323 DOC#:
Date: 1/29/2024
To:
Name
Department Initials
Date Out
1.
Filogonio Munoz
TPW - initial
Apr 25, 2024
2.
Jerry Henderson
Contractor- signature
Apr 25, 2024
3.
Pedro Hernandez
TPW - signature
Apr 25, 2024
4.
Sandip Uprety
TPW - signature SU
Apr 25, 2024
5.
Pratima Poudyal
Water - initial
Apr 26, 2024
6.
Greg Robbins
TPW - signatures-
May 9, 2024
7
Mary Hanna
TPW - signature N,,'
May 10, 2024
8
Patricia Wadsack
TPW - signature
May 13, 2024
9
Lauren Prieur
TPW - signature (.l
May 13, 2024
10.
Doug Black
Legal - signatures
May 13, 2024
11.
Jesica McEachern
CMO - signature oa
May 15, 2024
12.
Jannette Goodall
CSO - signature JG �a
May 15, 2024
13.
TPW Contracts
TPW
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: TPWContracts(&..FortWorthTexas.aov at ext. 7233 for pick up when completed.
Thank you!
CSC No. 59323-COI
FoxT� x,..
Project Name 102980 - 2022 Bond Yr 1- Contract 6
Client Project #(s)I
Project
Description
Contractor
City Project Mgr.
City of Fort Worth
Change Order Request
I City Sec # 1 59323
Combined Street Paving Improvements, Water and Sanitary Sewer Main Replacements for 2022 Bond Year 1- Contract 6
Stabile and Winn, Inc. Change Order #1 1 1 Datel 4/22/2024
Sandip Uprety City Inspector Pedro Hernandez
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)
Unit 1: Water Unit 2: Sewer
$3,207,420.25 I $1,103,711.00
Unit 3: Paving Unit 4: Storm
$3,690,507.84
Contract Time
Totals (CD)
$8,001,639.09 450
$8,001,639.09 450
$40,062.00 85
$8,041,701.09 535
$422,156.16
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.50%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $10,002,048.86
IN ACCORDANCE WITH THIS CHANGE ORDER REQUEST, THE CONTRACTOR SHALL: Furnish all labor and material as per the proposed Change Order #1.
" A total of 52 additional water services (WS) need to be installed (28 WS were due to late plat requests from residents and 24 WS to replace the WS found during the
construction but were not included in the plan) . The bid items needed to perform this work are based on the original bid proposal. The contractor requests 25 Calendar Days
(CDs) to install the 52 water services on E. Arlington, Belzise, Harvey, Davis, and E. Jessamine Avenue.
" Subdrain will be installed on both sides of E. Arlington between Sta 13+00 and 16+50 to resolve the groundwater issues encountered. Approximately 100 feet of the street
section exhibiting mud pumping needs to be restabilized. The items needed to perform this work are based on the original bid proposal. 26 CD is requested to install the
subdrain and restabilize the street section.
"An additional sewer improvement on Belzise includes a 331 LF 8" PVC sanitary sewer main extension and five sewer services installation on Belzise per the request of the
resident developing their property. The bid items needed to perform the work are included on the original bid proposal, except the cost to "Connect to an Existing Manhole" is
not in the original bid proposal. The contractor requests 30 CD to perform the sewer improvement work.
"Due to 2 different pressure planes at Arlington and Daniel, the contractor was instructed to install a 1" By -Pass Valve. A new line item, "l" Bypass pumping," is added.
'An additional 4 CD is requested for negotiating and processing the change order.The total CD extension requested for this change order is 85 CO.
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 Sign1a200=1
Date
Stabile and Winn, Inc. Jerry Henderson 'fir
Apr 25, 2024
Inspector/inspection Supervisor
Date
Project and Contract Compliance Manager
Date
Apr 25, 2024
Apr 25, 2024
Program Manager
Date
Senior Capital Project Officer
Date
May 9, 2024T
May 10, 2024
Assis
Date
May 13, 2024
Director Contracting Department (Dept)
Date
May 13, 2024
Assista�
Date
Assistant City Manager
Date
May 13, 2024
May 15, 2024
Council Action if required)
M&C Number I I M&C Date Approved
ATTEST:
�— d L
Jannette Goodall, City Secretary
FORTWORTH
City of Fort Worth
�,I---
Change Order Additions
Project Name 102980- 2022 Bond Yr 1- Contract 6
City Sec # 1
59323
Client Project #
I
Contractor Stabile and Winn, Inc.
PMI Sandip Uprety
Inspectorl Pedro Hernandez
Change Order
Submittal #
Date 1 4/22/2024
AUUI I ION5
IILIM
ULbURIPIIUN
ULF'I
l!
unit
unit host
total I
26
3312.2003 1" Water Service
Unit Water
5-.0000000U
EA
$3,500.OL
$182,000.00�
31
JJUb.UZUZ Imported Embedmenvbackttll, Gab
unit 1: Water
Ib.uuuuuuuIJ
UY
$11U.UL
$1,65U.UUI
49
0171.0001 Construction Survey Red Line Survey)
Unit 1: Water
0.06875000
LS
$8,000.OL
$550.001
51
�GPS
J4/1.0001 rattib Contrd (Wefe�
Unit 1: Water
I.000UUUUU
MN I H
$/,8U0.UL
$/,8uu.uul
2
3331.4116 8" Sewer Pipe (PVC 'DR26, P5115) By Open Cut Unit 2: Sewer
331.0000000U
LF
$105.0(
$34,755.001
4
3339.10U1 4' Manhole
unit 2: sewer
1.uuuuuuuu
LA
$10,40UA
$1U,4UU.UUI
7
3331.3101 4" Sewer Service
Unit 2: Sewer
5.00000000
EA
$2,500.00
$12,500.001
9
3301.0101 Manhole Vacuum Testing
Unit 2: Sewer
1.00000000
EA
$250.0(
$250.001
22
3306.0202 Imported Embedment/Backfill, CSS
Unit 2: Sewer
80.00000000
CY
$110.0i
$8,800.001
28
mu I.uuuz rosi l,u i v inspection
unit 2: sewer
JJI.000UUUUU
LF
$6.UL
$1,988.UUI
27
33U6.0109 I rench 5atety
Unit 2: Sewer
331.00000000
LF
$1.0(
$331.001
41
3471.0001 Traffic Control (Sewer)
Unit 2: Sewer
1.00000000
NINTH
$7,800.00
$7,800.001
42
b 11 i.uuu i uonstrutxion aurvey (bra Hed Line survey)
unit 2: sewer
U.Ubzbuuuu
LS
$4,000.UL
$Zbu.UUl
43
b1 ti.uuul t;onstrualon ataKmg (newer)
Unit 2: Sewer
0.1176470U
LS
$8,500.OL
$1,000.001
45
Lonnecti0 exisung mannoie
unit 2: Sewer
1.000UUUUU
LA
$2,15U.UL
$2,15U.UUl
3B
JZ11.U40U Hydrated Lime JZ Ibs/nY
Unit 3: Paving
10.0000000U
TN
$306A
$3,050.001
41:3
JZ I LUDUZ 8 Lime I reatmeni
unit 3: Paving
51 /.uuuuuuuu
by
$6.5L
$3,36u.bul
7B
33ubmiur mannoleAdlustment,minor
Unit 3:Paving
1.0000000U
EA
$550A
$550.001
59
J4/1.0001 I ralhC Contra�F'avmg)
unit 3: Paving
1.000UUUUU
MN I
$/,8U0.UL
$/,8uu.uul
53
33303.0001 1" Bypass pu pin
Unit 1: Water
1.0000000U
EA
$3,450.OL
$3,450.001
Zti
3211.U8u1 (; ML / {, 2 (lZby
unit 3: F'avmg
/.000UUUUU
IN
$395.UL
$Z,Ibb.UUI
53
JJ4b.uu08 4" ripe una rdram, i�e is
Unit 3: Paving
30.0000000U
LF
$25.OL
$750.001
61
(J999.000Z 12' atabilizaton w/ Uen)-Lime
unit 3: Paving
259.uuuuuuuIJ'
by
$8.5L
$Z,ZU1.bul
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
unit
water
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
�195,450.0
1
Unit
2: Sewer
80,222.00
1
Unit 3:Paving
$20,477.00
1
Unit
4:Storm
$0.00
1
Sub Iotal Additions
$29b,149.Uu
Change Order Additions Page 2 of 4
FORT WOR"r'H
City of Fort Worth
fi
Change Order Deletions
Project Name 102980- 2022 Bond Yr 1- Contract 6
City Sec # 1 59323
Client Project#
I
Contractor Stabile and Winn, Inc.
PMI Sandip Uprety
Inspectorl Pedro Hernandez
Change Order Submittal # 01
Date 1 4/22/2024
DELETIONS
I LM
ULSUKIP I IUN
ULI 1 l,ay
Unit Unit lost
I otal
52
9999.0001 Water Construction Allowance
unit'i: water 900000UU
Lo iuu,uuu.uu"
$9U,000.UUI
44
1999.0001sewer ConstructionAllowance
Unit 2:Sewer 0.860000OU
LS 370,000.09-
$60,200.001
bu
W99.UU1 U Paving uonstruction Allowance
Unit 3: Paving U.2U4//UUU
Lb �'I Uu,uuu.UU
$ZU,4//.1010I
/
3201.0113 6'Wide Asphalt Pvmt Repair, Residential
Unit 1:Water 113.000OOOOU
LF $150.00
$16,950.001
9
32U1.U41J1J I emporary Asphalt Pvmt Repair 42" HMAU on T Flex Base lours- unit 1: water 1,buu.000UUUUU
LF $35.UU
$b2,buu.uul
24
3312.20041" Private Water Service Kelocat'lon
Unit 1: Water 380.000OOOOU
LF $420U
$15,960.001
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Unit % Water
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
$175,410.00
1
Unit 2:Sewer
60,200.00
1
Unit 3:Paving
20,477.00
1
Unit 4: Storm
$0.00
I
Sub Iotal Deletions
$ZSb, 8/.Uu
Change Order Deletions Page 3 of 4
M/SBE for this Change Order
M/SBE Sub Type of Service Amount for this CO
NA NA $0.00
Total $0.00
Previous Change Orders
co # DATE I AMOUNT
NA $0.00
Total I $0.00 1
102980-CNCO-2022 Bond Year 1 Contract 6 —
Change Order #1
Final Audit Report 2024-05-16
Created: 2024-04-25
By: Andrea Munoz (Andrea.Munoz@fortworthtexas.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAoptX omPIHL-RP34ArsA67NcJhySwJJJ
"102980-CNCO-2022 Bond Year 1 Contract 6 — Change Order #
1" History
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rO Document approval automatically delegated to Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) by
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FORT WORTH...:
Routing and Transmittal Slip
Transportation & Public Works
Department
DOCUMENT TITLE: 2022 Bond Year 1 Contract 6 — Change Order #2
M&C: CPN: 102980 CSO: 59323 DOC#:
Date: 8/5/2024
To:
Name
Department Initials
Date Out
1.
Filogonio Munoz
TPW - initial
Aug 20, 2024
2.
Jerry Henderson
Contractor- signature
Aug 20, 2024
3.
Pedro Hernandez
TPW - signature
Aug 22, 2024
4.
Gustavo Vallejo
TPW - signature GV(7 L
Aug 23, 2024
5.
April Escamilla
Water - initial gRcARF
Aug 26, 2024
6.
Greg Robbins
TPW - signature GR rR
Aug 26, 2024
7
Mary Hanna
TPW - signature �11,`
Aug 26, 2024
8
Patricia Wadsack
TPW - signature
Aug 26, 2024
9
Lauren Prieur
TPW - signature
Aug 26, 2024
10.
Doug Black
Legal - signature De"'
Aug 28, 2024
11.
Jesica McEachern
CMO - signatures
Sep 3, 2024
12.
Jannette Goodall
CSO - signature 7:�X—
Sep 4, 2024
13.
TPW Contracts
TPW
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: TPWContractsaFortWorthTexas.aov at ext. 7233 for pick up when completed.
CSC No. 59323-CO2
FORT WORTH, City of Fort Worth
Change Order Request
Project Name 2022 Bond Year 1 Contract 6 City Sec # 1 59323
Client Project #(s)I
Project Description
Combined Street Paving Improvements, Water and Sanitary Sewer Main Replacements for 2022 Bond Year 1- Contract 6
Contractor
Stabile & Winn, Inc
Change Order #1
2
1 Datel 8/5/2024
City Project Mgr.1
Gustavo A. Vallejo
City Inspector Pedro Hernandez
Dept. Unit 1: Water
Unit 2: Sewer
Unit 3: Paving
Contract Time
Totals (CD
Original Contract Amount
$3,207,420.25
$1,103,711.00
$3,690,507.84
$8,001,639.09 50
Extras to Date
$20,040.00
$20,022.00
$0.00
$40,062.00 85
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
J#REFI
Revised Contract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
$3;227,460.25
$1,123,733.00
$3;690.507.84
$0.00
$0.00
$0.00
$3,227,460.25
$1,123,733.00
$3,690,507.84
$160,371.00
$77,260.00
$184,525.16
$140,331.00
$57,238.00
$184,525.16
$8,041:701.09 535
3
$8,041,701.09 538
$422,156.16
$382,094.16
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.50%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $10,002,048.
IN ACCORDANCE WITH THIS CHANGE ORDER, THE CONTRACTOR SHALL: Furnish all labor and material as per proposed Change Order #2.
This change order provides additional pay items for 37 SY of concrete pavement repair at the intersection of Ash Crescent St & E Arlington Ave for the installation of an 8" water
line. This bid item was not included in the original bid proposal.
The contractor required three (3) calendar days to perform the work, which was completed between May 8th and May 10th, 2024.
The price for the additional pay item was comparable to that of other recently bid projects and were approved by the project manager.
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 resnonsible for the monitorine and administration of this contract. includine ensurine all nerformance and renortine renuirements.
lljoIntractor's Company Nam ontractor Na ntract Si natur
Stabile & Winn.. Inc. Jerry Henderson AI— - — Aug 20, 2024
ection Su ervisor
a�
Date
Aug 22, 2024
Project and CorrTIC17CU17MMce Manager
r f
ro ram Manager
Date
Senior Capital Project Officer
Aug 26, 2024
R32024
rector (Dept)
Date
Aug 26, 2024
Director, ContractingDepartment (Dept)
X—R-
Assistant CityAttorneyDate
Assistant CityManager
Ag 282024
Council Action if required)
M&C Number I I M&C Date Approved
ATTEST:
Jannette Goodall, City Secretary
City of Fort Worth
Change Order Additions
Project Name 2022 Bond Year 1 Contract 6
Client Project #
Contractor Stabile & Winn, Inc
I I tM UtSI:KIP I IUN
b4 3'LU1.Ubl4 l:onc F'Vmt Kepair, KeSidenlial
M City Sec # 59323
1
PMI Gustavo A. Vallejo Inspectorl Pedro Hernandez
Change Order Submittal # o Date 1 8/5/2024
ADDITIONS
UtP I Uty ' unit unit lost I otal
unit l:Water 3/.000UUUUU by $21b.UU� $1u,l1b.uU
Unit 1:Water
$10,175.00
Unit 2: Sewer
$0.00
Unit 3: Paving
I
$0.00
Sub Total Additions
$10,175.00
Change Order Additions Page 2 of 4
FORTWORTH
City of Fort Worth
'IT,Change
Order Deletions
Project Name 2022 Bond Year 1 Contract 6
City Sec #
59323
Client Project #
Contractor Stabile & Winn, Inc
I PMI Gustavo A. Vallejo
Inspectorl Pedro Hernandez I
Change Order Submittal # F--2
Date j 8/5/2024
DELETIONS
IIEM UFbL;KIP IIUN
UEPI Uty
Unit Unit lost
total
3U 3312.22U3 2' Water Service
Unit 1: Water 1.000UUUUU
EA $5,5UU.UU
$5,5UU.UUl
52 9999.0001 Water Construction Allowance
Unit 1: Water 0.04675000
LS $100,000.OU
$4,675.001
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Unit 1:Water
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
$10,175.00
Unit 2:Sewer
$0.00
Unit 3:Pavinq
$0.00
I
Sub Total Deletions
$10,175.00
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
4/22/2024 $40,062.00
Total I $409062.00 I
102980-CNCO-2022 Bond Year 1 Contract 6 —
Change Order #2
Final Audit Report 2024-09-04
Created: 2024-08-19
By: Andrea Munoz (Andrea.Munoz@fortworthtexas.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAXQdcTScPls20k9Hnycyra-u8oGCEUu7w
"102980-CNCO-2022 Bond Year 1 Contract 6 — Change Order #
2" History
Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov)
2024-08-19 - 11:32:56 PM GMT- IP address: 204.10.90.100
Document emailed to Filogonio Munoz (Filogonio.Munoz@fortworthtexas.gov) for filling
2024-08-19 - 11:37:23 PM GMT
Document emailed to Jerry Henderrson (ferry@stabilewinn.com) for signature
2024-08-19 - 11:37:23 PM GMT
Document emailed to Pedro Hernandez (Pedro.Hernandez@fortworthtexas.gov) for signature
2024-08-19 - 11:37:23 PM GMT
Document emailed to Gustavo Vallejo (Gustavo.Vallejo@fortworthtexas.gov) for signature
2024-08-19 - 11:37:24 PM GMT
Document emailed to april.escamilla@fortworthtexas.gov for filling
2024-08-19 - 11:37:24 PM GMT
Email viewed by Jerry Henderrson Qerry@stabilewinn.com)
2024-08-20 - 0:29:00 AM GMT- IP address: 146.75.164.1
Email viewed by Filogonio Munoz (Filogonio.Munoz@fortworthtexas.gov)
2024-08-20 - 11:51:46 AM GMT- IP address: 174.82.115.111
l` Email viewed by Pedro Hernandez (Pedro.Hernandez@fortworthtexas.gov)
2024-08-20 - 11:56:13 AM GMT- IP address: 107.77.196.158
Form filled by Filogonio Munoz (Filogonio.Munoz@fortworthtexas.gov)
Form filling Date: 2024-08-20 - 12:18:04 PM GMT - Time Source: server- IP address: 204.10.90.100
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C%q Document e-signed by Jerry Henderrson (ferry@stabilewinn.com)
Signature Date: 2024-08-20 - 1:10:54 PM GMT - Time Source: server- IP address: 12.89.161.150
';`4 Email viewed by Gustavo Vallejo (Gustavo.Vallejo@fortworthtexas.gov)
2024-08-20 - 3:45:33 PM GMT- IP address: 166.205.58.56
Email viewed by april.escamilla@fortworthtexas.gov
2024-08-20 - 4:31:57 PM GMT- IP address: 166.205.58.62
r � Document e-signed by Pedro Hernandez (Pedro.Hernandez@fortworthtexas.gov)
Signature Date: 2024-08-22 - 12:45:09 PM GMT - Time Source: server- IP address: 204.10.90.100
Document e-signed by Gustavo Vallejo (Gustavo.Vallejo@fortworthtexas.gov)
Signature Date: 2024-08-23 - 8:12:41 PM GMT - Time Source: server- IP address: 204.10.90.100
°s Email viewed by april.escamilla@fortworthtexas.gov
2024-08-24 - 2:42:10 PM GMT- IP address: 40.94.28.254
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Signer april.escamilla@fortworthtexas.gov entered name at signing as April Rose Escamilla
2024-08-26 - 3:48:47 PM GMT- IP address: 204.10.90.100
Form filled by April Rose Escamilla (april.escamilla@fortworthtexas.gov)
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Document e-signed by Gregory Robbins (Gregory.Robbins@fortworthtexas.gov)
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Wadsack
2024-08-26 - 8:57:12 PM GMT- IP address: 204.10.90.100
Document e-signed by Patricia L. Wadsack(patricia.wadsack@fortworthtexas.gov)
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f) Email viewed by Priscilla Ramirez (Priscilla.Ramirez@fortworthtexas.gov)
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C4 Document approved by Priscilla Ramirez (Priscilla.Ramirez@fortworthtexas.gov)
Approval Date: 2024-08-27 - 1:26:27 PM GMT -Time Source: server- IP address: 204.10.90.100
Document emailed to Douglas Black (Douglas.Black@fortworthtexas.gov) for signature
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C�� Document e-signed by Douglas Black (Douglas.Black@fortworthtexas.gov)
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Document emailed to Jesica McEachern (jesica.mceachern@fortworthtexas.gov) for signature
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o Document e-signed by Jesica McEachern (jesica.mceachern@fortworthtexas.gov)
Signature Date: 2024-09-04 - 3:06:28 AM GMT - Time Source: server- IP address: 204.10.90.100
rO Document approval automatically delegated to Katherine Cenicola (Katherine.Cenicola@fortworthtexas.gov) by
Ronald Gonzales (Ronald.Gonzales@fortworthtexas.gov)
2024-09-04 - 3:06:31 AM GMT
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Document emailed to Jannette Goodall Qannette.goodall@fortworthtexas.gov) for signature
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15 Email viewed by Jannette Goodall (jannette.goodall@fortworthtexas.gov)
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r_a Document e-signed by Jannette Goodall Qannette.goodall@fortworthtexas.gov)
Signature Date: 2024-09-04 - 1:07:27 PM GMT - Time Source: server- IP address: 208.184.124.181
Form filling automatically delegated to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) by Allison
Tidwell (allison.tidwell@fortworthtexas.gov)
2024-09-04 - 1:07:29 PM GMT
C'-, Document emailed to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) for filling
2024-09-04 - 1:07:30 PM GMT
C'w Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for filling
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C�-, Form filled by Allison Tidwell (allison.tidwell@fortworthtexas.gov)
Form filling Date: 2024-09-04 - 7:42:32 PM GMT - Time Source: server- IP address: 208.184.124.181
19 Agreement completed.
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FORT WORTHS 1 Powered ey
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FORT WORTH.,
Routing and Transmittal Slip
Transportation & Public Works
Department
DOCUMENT TITLE: 2022 Bond Year 1 Contract 6 — Change Order 0
M&C: CPN:
102980 CSO:
59323
DOC#:
Date:
4/16/2025
To:
Name
Department
Initials
Date Out
I.
Filogonio Munoz
TPW - initial
—
Apr 18, 2025
2.
Jerry Henderson
Contractor- signature
Apr 18, 2025
3.
Ariel Duarte
TPW - signature
AA7
Apr 19, 2025
4.
Gustavo Vallejo
TPW - signature
Apr 19, 2025
5.
Greg Robbins
TPW - signature
Apr 21, 2025
6.
Mary Hanna
TPW - signature's
Apr 21, 2025
7.
Patricia Wadsack
TPW - signature
Apr 23, 2025
8.
Lauren Prieur
TPW - signature
., J'
Apr 24, 2025
9.
Doug Black
Legal - signature
DouglasBlack
Apr 24, 2025
10.
Jesica McEachern
CMO - signature
CK
May 2, 2025
11.
Jannette Goodall
CSO - signature
,
May 2, 2025
12.
TPW Contracts
TPW
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,
Jay 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: TPWContracts(cr�,FortWorthTexas.aov at ext. 7233 for pick up when completed.
Thank you!
59323-CO3
Foxe',
Project Name 102980 - 2022 Bond Yr 1- Contract 6
Client Project #(s)I 102980
Project
City of Fort Worth
Change Order Request
I City Sec # 1 59323
I Description Combined Street Paving Improvements, Water and Sanitary Sewer Main Replacements for 2022 Bond Year 1- Contract 6
Contractor Stabile and Winn, Inc. Change Order #1 3 1 Date 4/16/2025
City Project Mgr.1 Gustavo A Vallejo City Inspector Ariel Duarte
Dept
Unit 1: Water
Unit 2: Sewer
Unit 3: Paving
Totals
Contract Time
(CD)
Original Contract Amount
$3,207,420.25
$1,103,711.00
$3,690,507.84
$8,001,639.09
450
Extras to Date
$20,040.00
$20,022.00
$40,062.00
88
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
$3,227,460.25
$1,123,733.00
$3,690,507.84
$8,041,701.09
538
Amount of Proposed Change Order
$0.00
$0.00
$0.00
13
$0.00
Revised Contract Amount
$3,227,460.25
$1,123,733.00
$3,690,507.84
$8,041,701.09
551
Original Funds Available for Change Orders
$160,371.00
$77,260.00
$184,525.16
$422,156.16
Remaining Funds Available for this CO
$140,331.00
$57,238.00
$184,525.16
$382,094.16
Additional Funding (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.50%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $10,002,048.86
ir JUSTIFICATION (REASONS) FOR CHANGE ORDER
IN ACCORDANCE WITH THIS CHANGE ORDER REQUEST, THE CONTRACTOR SHALL: Furnish all labor and material as per the proposed Change Order #3.
This change order includes additional pay items for the removal of the existing coating on the manhole located at the intersection of Belzise Terrace and E Richmond Ave (Sta
23+25.16). It also covers the isolation and flushing of the fire line at 2000 E Richmond Ave to facilitate the reconnection of the building's fire line to the main waterline. This
change order also includes the removal and replacement of the retaining wall on Belzise and Harvey due to TDLR inspection.
The pricing for the Water and Sewer additional pay items was consistent with rates from other recently bid projects and was approved by the water project manager.
Staff supports the Contractor's request for an additional 13 calendar days to allow for the contractor to complete the additional work.
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.
ontractor's Company Ni ElWontractor
Stabile and Winn, Inc.
Na
Jerry Henderson
�G
Date
Apr 18, 2025
Ins ectorllns ection Supervisor
D
Project and Contract Compliance Manager
o ,.,.>� o Tsc-^-
Apr 19, 2025
Apr 19, 2025
ro ram ana er
a e
Senior Capital Project Officer
Date
c
Apr 21, 2025
T
Apr 21, 2025
in Department (Dept)
Date
SAttorne
Apr 23, 2025
< ..,. _
Apr 24, 2025
ssistant City
Assistant City Manager
e..0 (11, a ,, N
Apr 24, 2025
� Sv
uired
May 2, 2025
M&C Number I NA I M&C Date Approved I NA I
ATTEST:
q....., n .Ras..
Jannette Goodall, City Secretary
FORT WORTH
City of Fort Worth
IV----
Change Order Additions
Project Name 102980- 2022 Bond Yr 1- Contract 6
' City Sec # 59323
Client Project# 102980
1
Contractor Stable and Winn, Inc.
I PMI Gustavo A. Vallejo
Inspectorl Ariel Duarte
I
Change Order Submittal #
Date 1 4/16/2025
ADDITIONS
ITEM
UESCWPIIUN
UEPI Uty
Unit Unit Gost
total 1
55
9999.0002Isolate & Flush Existing Fire Line
Unit 1: Water 1.0000001JU
LS $3,500.OU
$3,5U0.UU1
46
9999.0002 Removal Existing Raven Coating
Unit 2: Sewer 1.000OOOOU
LS $5,750.OU
$5,750.001
9
0241.0100 Remove Sidewalk
Unit 3: Paving 273.10000001J
SF $3.OU
$819.301
23
3123.0105 Borrow by Delivery
Unit 3: Paving 22.00000001J
CY $22.OU
$484.001
30
3213.0301 4' Cone Sidewalk
Unit 3: Paving 25.000OOOO1J
SF $12.OU
$300.001
32
3213.0321 Cone Sidewalk, Adjacent to Ret Wall
Unit 3: Paving 248.10000001J
SF $14.OU
$3,473.401
46
3232.0100 Cone Rat Wall Adjacent to Sidewalk
Unit 3: Paving 75.10000001J
SF $115.O0
$8,636.501
U241.UbUU Remove Wall <4
Unit 3: Paving 42.2000000U
LF $12.OU
$506.401
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
Unit 1:`Nater
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
I
1
$3,500.00
1
Unit 2:Sewer
$5,750.00
I
Unit 3:Paving
$14,219.60
I
$0.00
1
Sub Total Additions
$23,469.60
Change Order Additions Page 4 of 6
FORTWORTH City of Fort Worth
Change Order Deletions
Project Name 102980- 2022 Bond Yr 1- Contract 6 City Sec # 1 59323
Client Project# 102980 1
Contractor Stable and Winn, Inc. PM I Gustavo A. Vallejo Inspectorl Arid Duarte
Change Order Submittal # Date 1 4/16/2025 1
I I tM UtSUKIP 1IUN
52 9999.0001 water Uonstruction Allowance
44 9999.0001 Sewer Construction Allowance
60 9999.0010 Paving Construction Allowance
DELETIONS
utPl
U unit unttcost
total
unit 1: Water
u. 3buuuuu L5 $1uu,uuu.uU
$s,buu.uul
Unit 2:Sewer
0.0821429U LS $70,000.00
$6,760.001
Unit 3:Paving
0.1421960U LS $100,000AU
$14,219.601
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Unit 1: Water
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
3,500.00
I Unit 2:Sewer
E1,750.00
I Unit 3:Paving
$14,219.60
I
$0.00
1 Sub I otal Deletions
$23,469.61)
Change Order Deletions Page 5 of 6
M/SBE for this Change Order
M/SBE Sub Type of Service Amount for this CO
NA NA $0.00
Total $0.00
Previous Change Orders
CO# DATE I AMOUNT
4/22/2024 $40,062.00
8/5/2024 $0.00
Total I $40,062.00 I
102980-CNCO-2022 Bond Year 1 Contract 6 —
Change Order #3
Final Audit Report 2025-05-02
Created: 2025-04-18
By: Andrea Munoz (Andrea.Munoz@fortworthtexas.gov)
Status: Signed
Transaction ID: CBJCHBCAABAA-_TjaDOBnyVFYwt7H7R4OZ3r6OYwCycV
"102980-CNCO-2022 Bond Year 1 Contract 6 — Change Order #
3" History
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FORT WORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: 2022 Bond Year 1 Contract 6
CITY PROJECT NUMBER: 102980
WATER
PIPE LAID SIZE TYPE OF PIPE LF
8" PVC 8489
6" PVC 143
FIRE HYDRANTS: 13 VALVES (16" OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES:
NEW SERVICES: 1"(158) Copper
1.5"(1) Copper
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
8" Pipe Enlargement 138
8" PVC SDR 26 2294
8" DIP 148
PIPE ABANDONED SIZE TYPE OF PIPE LF
DENSITIES:
NEW SERVICES: 4" (45) PVC SDR 26
TRANSPORTATION AND PUBLIC WORKS
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
FORTWORTH.
TRANSPORTATION AND PUBLIC WORKS
June 26, 2025
Stabile & Winn Inc.
P.O Box 79380
Saginaw, TX 76179
RE: Acceptance Letter
Project Name: 2022 Bond Year 1- Contract 6
Project Type: water, sewer & paving
City Project No.: 102980
To Whom It May Concern:
On February 28, 2025 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 April 22, 2025. 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 April 22, 2025, which is the date of the
punch list completion and will extend of two (2) years in accordance with the Contract Documents.
If you have any questions concerning this letter of acceptance, please feel free to contact me at 817-
392-2817.
Sincerely,
Gustavo Vallejo, Project Manager .°_..°°°�'�' °'��°�°'�'
Gregory Robbins, Program Manager ql�R�
Cc: Ariel Duarte, Inspector
Troy Gardner, Inspection Supervisor
Ariel Duarte, Senior Inspector
Gregory Robbins, Program Manager
Stream Water Group Inc, Consultant
Stabile & Winn, Inc, Contractor
N/A, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT Bond P8050128
Project: 2022 Bond Year I — Contract 6, City Project No.: 102980
To (Owner):
City of Fort Worth, Texas
200 Texas Street Contract For: See above
Ft Worth, TX 76102
Contract Date: April 25, 2023
Contractor:
Stabile & Winn, Inc.
P O Box 79380
Saginaw, TX 76179-0380
In accordance with the provision of the Contract between the Owner and the Contractor as
defined above, the
Amerisure Mutual Insurance Company
P 0 Box 9098
Farmington Hills, MI 48333-9098
,Surety Company,
on bond of
Stabile & Winn, Inc,
P 0 Box 79380
Saginaw, TX 76179-0380
,Contractor
hereby approves of the final payment to the contractor and agrees that final payment to the
contractor shall not relieve the Surety Companies of any of their obligations to the
City of Fort Worth, Texas
200 Texas Street
Ft Worth, TX 76102
,Owner
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
the Surety Companies have hereunto set their hand this 24th day of July, 2025.
Amerisure Mutual Insurance Comnanv
Witness: Surety Company
Brandi Heath, Witness Tracy Tucker, Attorney -in -Fact
AMERISURE
AMERISURE MUTUAL INSURANCE COMPANY ASV RETY
AMERISURE INSURANCE COMPANY
AMERISURE PARTNERS INSURANCE COMPANY
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That Amerisure Mutual Insurance Company, Amerisure Insurance Company and Amerisure Partners Insurance
Company are corporations duly organized under the laws of the State of Michigan (herein collectively the "Companies"), and that the Companies do hereby
make, constitute and appoint:
TRACY TUCKER, STEVEN TUCKER, KEVIN J. DUNN, W. LAWRENCE BROWN
BENNETT BROWN AND ROBERTA H. ERB
of Tucker Agency, Ltd. , its true and lawful Attorriey(s)-in Fact, each in their separate capacity if more than one is named above, to sign, execute,
seal and acknowledge, for and on its behalf and as its act and deed, bonds or others writings obligatory in the nature of bond on behalf of each of said Companies,
as surety, on contracts or suretyship as are or may be required or pennitted by law, regulation, contract or otherwise, provided that no bond or undertaking or
contract or suretyship executed under this authority shall exceed the amount of
ONE HUNDRED MILLION ($100,000,000.00) DOLLARS
This Power of Attorney is granted and signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of
Amerisure Mutual Insurance Company, Amerisure Insurance Company and Amerisure Partners Insurance Company at meetings duly called and held on February
17. 2022.
"RESOLVED, that any two ofthe President & Chief Executive Officer, the Chief Financial Officer & Treasurer, the Senior Vice President Surety, the
Vice President Surety, or the General Counsel & Corporate Secretary be, and each or any of them hereby is authorized to execute, a Power of Attorney qualifying
the attorney -in -fact named in the given Power of Attorney to execute on behalf ofthe Company bonds, undertakings and all contracts of surety, and that
President & Chief Executive Officer, Chief Financial Officer & Treasurer or General Counsel & Corporate Secretary each or any ofthem hereby is authorized
to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company;
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 anycertificate
relating thereto electronically/digitally or by facsimile, and any such Power of Attorney or certificate bearing such electronic/digital or facsimile signatures or
electronic/digital or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond, undertaking or contract
ofsurery to which it is attached:.
FURTHER RESOLVED, that any work carried out by the attorntw-in-fact n:irrssuantto this resolution shall be valid and binding upon the Company."
=J.oRrt.or`pOR�.ct
Y RR9
'o F•.c
=: =Q4`O�
s?:o F•.� Michael A, Ito, Senior Vice President Surety
SEAL �_
`�_ SEAL_ € SEAL
<<n-. 2000 oa
vyd �CN4GP dd•°
•
=rt 1968 2000 0'
%.<y/CH,IGP''� rii�;L/j P.'i
', 6 '
..,wy',* i t,�,,.
IV
; *., r, Aaron Green, Vice President Surety ,, �y�; �*'• ��'a,,••
i„uii NN
IN WITNESS WHEREOF, Amerisure Mutual Insurance Company, Amerisure Insurance Company and Amerisure Partners Insurance Company
have caused their official seals to be hereunto affixed, and these presents to be signed by their authorized officers this 26th day of April 20 23
Amerisure Mutual Insurance Company
Amerisure Insurance Company
Amerisure Partners Insurance Company
State of Illinois
County of Kane
On this 26th day of April 20 23, before me, a Notary Public personally appeared Michael A_ Ito, of Amerisure Mutual insurance Company, Amerisure
Insurance Company and Amerisure Partners Insurance Company and Aaron Green of Amerisure Mutual Insurance Company, Amerisure Insurance Company
and Amerisure Partners Insurance Company, personally known to me, who being by me duly sworn, acknowledged that they signed the above PowerofAttomey
as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies
P
M KENIJY
IVOTaft�'PualAC, 6ra'r'E OF
I-- M.Kermy, Notary Public
MY CQMM19810tC aXP M 12A104"
1, Christooher M. S_paude, the duly 6ected Chief Financial Officer & Treasurer of Amerisure Mutual Insurance Company, Amerisure Insurance Company and
Amerisure Partners Insurance Company, do hereby certify and attest that the above and foregoing is a true and correct copy ofa Power of Attorney executed by
said Companies, which remains in full force and effect.
IN WITNESS WHEREOF, l have set my hand and atfixcd the seals of the Companies this 14th day of JUIy 2025
�r 7 _
Christopher M. Spaude, Chief Financial Officer & Treasurer
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 Jerry Henderson,
Vice President Of Stabile & Winn, Inc., known to me to be a credible
person, who being by me duly sworn, upon his oath deposed and said;
That all persons, firms, associations, corporations, or other
organizations furnishing 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;
2002 Bond Year 1 Contra 6 - Project #10 0
�t
BY
Jerry Henderson, Vice President
Subscribed and sworn before me on this date 14th of July, 2025,
Notary Public L�
Tarrant, 'Texas
- ....... ...�.•...�.4
.AtMrk+e�c DIANA DIAZ
NOTARY PUBLIC
STATE OF TEXAS
My COMM. EXP 06 1
� a/2a
NOTARY ID 134953344