HomeMy WebLinkAboutContract 55915-FP1AC Coded 07.23.25
Vendor Name: THALLE CONSTRUCTION
COMPANY INC
Vendor Number: 0000039669
Invoice No.: 55915-FP1
Invoice Date: ##/##/##
Release Retainage: 478,835.96
F I D: 56020-2060000-102069-RETAI N
FORT WORTH
ENGINEERING AND FISCAL SERVICES
NOTICE OF PROJECT COMPLETION
CSC No. 55915-FP1
Regarding contract 55915 for the Sycamore Creek Sanitary Sewer Relief Interceptor, Phase 3 project
as required by the Water Department and approved by City Council on 04-21-2021 through M&C 21-0292
the Director of the Water Department, upon the recommendation of the Assistant Director, Capital Projects
Delivery, Water Department has accepted the project as complete.
Original Contract Price:
$ 9,687,177.00
Amount of Approved Change Orders: $-16,580.42
Revised Contract Amount: $ 9,670,596.58
Total Cost Work Completed: $ 9,576,719.58
Less Deductions:
Liquidated Damages:
0 Days @ $650 /Day
Other Deductions:
$ 0.00
Total Deduction Amount:
$ 0.00
Total Cost of Work Completed:
$ 9,576,719.58
Less Previous Payments:
$ 9,097,883.62
Final Payment Due:
$ 478,835.96
0 A , `'�,> J yr
Recnmrrirnneri fnr iacre'ance
Assistant Director, Water Department
Christopher {fardor
Christopher Harder (Ju 30, 2025 10:26:13 CDT)
No 2
/.11 2�
Date
Accepted Date
Director, Water Department
' 08/05/2025
cva�_
Asst. City Manager Date
Project Name: Sycamore Creek Sanitary Sewer Relief Interceptor Phase 3
CPN 102069
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
FORTWORTH.
Date 07/15/2025
Thalle Construction Co Inc
900 NC Highway 86 north
Hillsborough, NC 27278
RE: Acceptance Letter
Project Name: Sycamore Creek Sanitary Relief Interceptor Phase 3
Project Type: Sewer
Project No: 102069
Contract No: 55915
To Whom It May Concern:
On 6/30/2025 a final inspection was made on the subject project. There were no punch list items
identified at that time. The final inspection indicates that the work meets the City of Fort Worth
specifications and is therefore accepted by the City. The warranty period will start on 6/30/2025 which
is the date of the final inspection and will extend of two (2) years in accordance with the Contract
Documents.
If you have any questions concerning this letter of acceptance, please feel free to contact me at
817-392-6054.
Sincerely,
Tony Sholola, P.E., Assistant Director, Water Department
TS /
Cc: Chris Harder, P.E., Director, Water Department
Laura Wilson, P.E., Deputy Director Water Department
Bijay Upreti, P.E, Project Manager, Water Department
Wade Miller, Construction Manager, Water Department
John Robinson, Inspection Supervisor, Water Department
Carmen Drake, Senior Inspector, Water Department
Lockwood Andrews and Newman, Consultant
Thalle Construction Co Inc, Contractor
Fort Worth
kliftyl
All-amedcecm WATER DEPARTMENT
1 1111.,
THE CITY OF FORT WORTH * 200 TEXAS STREET * FORT WORTH, TEXAS 76102
817-392-8240 * FAX 817-392-8195
1964. 1993 •2011
�r Printed on recycled paper
FORTWORTH rev 09/20/24
WATER ENGINEERING & FISCAL SERVICES
FINAL STATEMENT OF CONTRACT TIME
FINAL STATEMENT NO.:10
NAME OF PROJECT: Sycamore Creek Sanitary Sewer Relief Interceptor Phase 3
CPN No:
102069
CONTRACTOR: Thalle Construction Co Inc
CSC No. 55915
PERIOD FROM:07/01/25
TO: 07/15/25
FINAL INSPECTION DATE: 30-Jun-25
WORK ORDER EFFECTIVE:11/8/2021
CONTRACT TIME: 1,340 Q WD QQ CD
DAY OF
DAYS
REASON FOR DAYS
DAY OF DAYS REASON FOR DAYS
MONTH
CHARGED
CREDITED
MONTH CHARGED CREDITED
DURING
DURING
1.
16.
2.
17.
3.
18.
4.
19.
5.
20.
6.
21.
7.
22.
8.
23.
9.
24.
10.
25.
11.
26.
12.
_ 27.
13.
28.
14.
29.
15.
30.
31.
SAT, SUN, RAIN, TOO WET, UTILITIES OTHERS* DAYS TOTAL
& HOLIDAYS & TOO COLD RELOCATIONS CHARGED DAYS
THIS
0 0
PERIOD
PREVIOUS
1331 1331
PERIOD
TOTALS
TO DATE 1331 1331
*REMARKS: All major work has been installed. Sewer final 8/15/2024, days charged 1012 days. Additional extra work per
change order complete.
/ 1
7/16/25�l
� TRACTOR DATE CTOR DBE
ENGINEERING DEPARTMENT
The City of Fort Worth • 200 Texas Street • Fort Worth, TX 76012-6311
(817) 392 - 4477 • Fax: (817) 392 - 8460
FORTWORTH
WATER ENGINEERING & FISCAL SERVICES
PIPE REPORT FOR:
PROJECT NAME:
Sycamore Creek Sanitary sewer Relief Interceptor Phase 3
PROJECT NUMBER:
102069
DOE NUMBER:
PIPE LAID
SIZE
TYPE OF PIPE
HOBAS OPEN CUT
66
FRP SN 46
HOBAS OPEN CUT
60
FRP SN 46
HOBAS OPEN CUT
48
FRP SN 46
OTHER THAN OPEN CUT
66
FRP SN 46
OTHER THAN OPEN CUT
45
FRP SN 46
OPEN CUT / CLSM
45
FRP SN 46
OPEN CUT / CONC ENCASEMET 45
FRP SN 46
OPEN CUT / CONC ENCASEMEN 42
FRP SN 46
FIRE HYDRANTS:
VALVES (16" OR LARGER)
PIPE ABANDONED
SIZE
TYPE OF PIPE
CONCRET
16
CONCRET
DENSITIES:
NEW SERVICES:
yes
PIPE LAID SIZE
OPEN CUT / CLSM 27
OPEN CUT / CONC ENCASEMET 27
OPEN CUT 15
OPEN CUT 8
PIPE ABANDONED
DENSITIES:
NEW SERVICES:
SIZE
SEWER
TYPE OF PIPE
FRP SN 46
FRP SN 46
FRP SN 46
SDR -26 PVC
TYPE OF PIPE
PASSED
WATER ENGINEERING & FISCAL SERVICES
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 4477 • Fax: (817) 392 - 8460
LF
LF
LF
LF
4
827
3359
1015
244
598
186
128
130
750
275
258
91
491
FORTWORTH
Capital Projects Delivery, Water Department
CONTRACTOR'S EVALUATION OF CITY
n PROJECT INFORMATION
Name of Contractor
Thalle Construction Co Inc
Water Engineering Inspector
Carmen Drake
CPN Number Project Dt(/lcu/ty
102069 O Simple Q Routine QQ Complex
Initial Contract Amount
$9,687,177.00
II) PERFORMANCE EVALUATION
REV: 09/20/24
Date: 1 15-Jul-25
Project Name
Sycamore Creek Sanitary Sewer Relief Interceptor Phase 3
Project Manager
Bijay Upreti
Type of Contract
❑ Water ❑✓ Waste Water ❑ Storm brainage ❑ Pavement
Final Contract Amount
$9,670,596.58
0 - Inadequate 1 - Deficient 2 - Standard 3 - Good 4 - Excellent
ELEMENT RATING I ELEMENT
(0 - 4)
INSPECTION EVALUATION
1 Availability of Inspector
12 Knowledge of Inspector
13 Accuracy of Measured Quantities
4 Display Of Professionalism
5 Citizen Complaint Resolution
6 Performance - Setting up Valve Crews, Labs
ADMINISTRATION
I Change Order Processing Time
12 Tirnliness of Contractor Payments
13 Bid Opening to Pre -Con Meeting Timeframe
III) COMMENTS & SIGNATURES
COMMENTS
Signature Contractor
Signature Inspector
Signature Inspector's Supervisor
INSPECTOR'S COMMENTS
PLANS & SPECIFICATIONS
3 1
Accuracy of Plans to Existing Conditions
4 2
Clarity & Sufficiency of Details
4 3
Applicability of Specifications
4 4
Accuracy of Plan Quantities
4 PROJECT MANAGER EVALUATION
4 1
Knowledge And/Or Problem Resolution
12
Availability of Project Manager
3 13
Communication
4 14
Resolution of Utility Conflicts
4 1
Capital Projects Delivery, Water Department
The City of Fort Worth • 200 Texas Street • Fort Worth, TX 76012-6311
(817) 392 - 4477 • Fax: (817) 392 - 8460
4
4
4
4
4
RATING
(0 - 4)
FORTWORTHREV: 09/20/24
Capital Projects Delivery, Water Department
PERFORMANCE EVALUATION OF CONTRACTOR
I) CONTRACTOR & PROJECT DATA
Name of Contractor
Project Name
Thalle Construction Co Inc
Sycamore Creek Sanitary Sewer Relief Interceptor Phase 3
Water Engineering Inspector
CPN Number
Carmen Drake
102069
Water Engineering Inspector
Project Manager
❑ Water F/I Waste Water ❑ Storm Dralnage ❑ Pavement
Bijay Upreti
1 Initial Contract Amount
Project Difficulty
0 Simple
0 Routine
Q Complex
$9,687,177.00
Contract Amount
Date
1Final
$9,670,596.58
7/ 15/2025
II) PERFORMANCE EVALUATION
10 - Inadequate I - Deficient 2 - Standard
3 - Good 4 - Excellent
ELEMENT
I WEIGHT (x) APPLICABLE (Y / N)
IRATING (0 - 4)
MAX SCORE
SCORE
1 Submission of Documents
2
Y
4
8
8
12 Public Notifications
5
Y
4
20
20
13 Plans on Site
5
Y
4
20
20
14 Field Supervision
15
Y
4
60
60
15 Work Performed
15
Y
4
60
60
16 Finished Product
15
Y
4
60
60
Job Site Safety
15
Y
4
60
60
17
8 Traffic Control Maintenance
f 5
Y
4
20
20
19 Daily Clean Up
t 10
Y
4
20
20
110 Citizen's Complaint Resolution
I 5
Y
4
20
18
III Property Restoration
5
Y
4
20
20
After Hours Response
I 5
Y
4
( 20
20
112
13 Project Completion
5
Y
j 4
` 20
20
TOTAL ELEMENT SCORE (A)
BONUS POINTS (25 Maximum) (B)
TOTAL SCORE (TS)
428
III) CONTRACTOR'S RATING
Maximum Score (MS) = 448 or sum of applicable element score maximurns which = 428
Rating ( [TS / MS] * 100%) 428 / 428 = 100%
Performance Category Excellent
<20% = Inadequate 20% to <40% = Deficient 40% to <60% = Standard 60% to <80% = Good >M% = Excellent
Inspector's Comments (INCLUDING EXPLANATION OR BONUS POINTS AWARDED)
Signature Inspector Signature Contractor
Signature Inspector's Supervisor
CONTRACTOR'S COMMENTS
Capital Projects Delivery, Water Department
The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 4477 • Fax: (817) 392 - 8460
Bond No. K40265922 Federal Insurance Company
Bond No. 015212906 Liberty Mutual Insurance Company
CONSENT OF SURETY OWNER �J
TO FINAL PAYMENT ARCHITECT _
AM Document G707 CONTRACTOR _
SURETY ✓
(Instructions on reverse side) OTHER
TO OWNER:
ARCHITECT'S PROJECT NO.:
(Neaue rind rrdrhtov)
City of Fort Worth
200 Texas Street
CONTRACT FOR:
Fort Worth, TX 76102
Sycamore Creek Relief Interceptor- Phase 111, City
Project No. - 02200.
PROJECT:
CONTRACT DATED: April 20, 2021
(Nance crud addrev)
Sycamore Creek Relief Interceptor - Phase III, City Project No. - 02200.
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the
(Insert nacre and ae1r►rew ojSunrt))
Federal Insurance Company Liberty Mutual Insurance Company
202E Hall's Mill Road 175 Berkeley Street
Whitehouse Station, NJ 08889 Boston, MA 02116
, SURETY,
on bond of
(Gaserr luone and rrrlrGrc; ojContracfor)
Thalle Construction Co., Inc.
900 NC Highway 86 North
Hillsborough, NC 27278
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
(Irrser7 crone our/ rrddrexr r f Owner)
City of Fort Worth
200 Texas Street
Fort Worth, TX 76102
as set forth in said Surety's bond.
IN WITNFSS WHEREOF, the Surety has hereunto set its hand on this bate: June 30, 2025
(Insert In reritlnq fix nrauGjollorred hrlGe nunrerlc Ante anr! r'ema
Attest:
(Steal): William A Dr , r. , Witness as to Surety
Liberty Mutual Insurance Company
Federal Insurance Company
(Sulv(19 -
�(J'IM Mot'rJ'rr nl Azar!mp s •u rrlGe) J J
Jaclyn ffey
(Pdnlednaaneemddde) Attorney -in -Fact
, OWNF,R,
I I CAUTION: You should sign an original AIA document that has this caution printed In red. An
original assures that changes will not be obscured as may occur when documents are reproduced.
See Instruction Sheet for Limited License for Reproduction of this document.
AIA DOCUMENT G707 • CONSF.N7'OF SURFIY'I'O FINK. PAY,%IFM' • Ir)94 EDITION • 'AIA
t,)1994 • THFAMERICAN IN.."TUTF.OFARCHITFCTS, 1735 NFVVYORKAVFNCI:, NW Wr15H-
INGTON. D.C. 20006-5292 • WARNING: Unlicensed photocopying violates U.S. copy-
right laws and will subject the violator to legal prosecution.
G707-1994
AFFIDAV1'.' Ei111 LS PAID
STATE OF TEXAS §
§ KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF JOHNSON §
Personally, before me the undersigned authority, on this day appeared JASON ESPARZA, who being duly
sworn on oath, says that he is a representative ofT;IAI.LF. CONSTRUCTION CO., INC. and that the contract
for the construction of the project, designated as:
21-360
Sycamore Creek Interceptor Improvements,, Ph03b 3t
City Project No. 102069
has been satisfactorily completed and that all bills for materials, apparatus, fixtures, machinery, labor, and
equipment used in connection with the construction of this project have been fully paid through the
month of JUNE 2025.
.
Signature
Area Manager
Sworn to and subscribed before me this, the 30T" day of June 2025.
Dine J Wlloon
My Co6190�2020 xplree
Notary ID 10818348
Title
_f
U _
Not�Pubrici
JOHNSON County, Texas
__ _ACKNOWLEDGEMENTOF_S-URELY COMPANY
STATE OF New Jersev
COUNTY OF Morris
ON THE 30th DAY OF June, 2025 BEFORE ME PERSONALLY APPEARED Jaclvn Maffev TO ME KNOWN, WHO BEING BY
ME DULY SWORN, DID DEPOSE AND SAY; THAT (S)HE IS THE ATTORNEY -IN -FACT OF Federal Insurance COmpanv, THE
CORPORATION THAT EXECUTED THE FOREGOING INSTRUMENT, AND ACKNOWLEDGED TO ME THAT SUCH
CORPORATION EXECUTED THE SAME.
IN WITNESS WHEREOF, I HAVE HEREUNTO SET MY HAND AND AFFIXED MY OFFICIAL SEAL, AT MY OFFICE IN THE
ABOVE COUNTY, THE DAY AND YEAR WRITTEN ABOVE.
Notary Public
Sandy S. James-Browno
Notary Public
State of New Jersey
My commission expires September 19, 2026
ACKNOWLEDGEMENT OF SURETY COMPANY
STATE OF New Jersev
COUNTY OF Morris
ON THE 301h DAY OF June, 2025 BEFORE ME PERSONALLY APPEARED Jaclvn Maffev TO ME KNOWN, WHO BEING BY
ME DULY SWORN, DID DEPOSE AND SAY; THAT (S)HE IS THE ATTORNEY -IN -FACT OF Liberty Mutual Insurance
Company, THE CORPORATION THAT EXECUTED THE FOREGOING INSTRUMENT, AND ACKNOWLEDGED TO ME THAT
SUCH CORPORATION EXECUTED THE SAME.
IN WITNESS WHEREOF, I HAVE HEREUNTO SET MY HAND AND AFFIXED MY OFFICIAL SEAL, AT MY OFFICE IN THE
ABOVE COUNTY, THE DAY AND YEAR WRITTEN ABOVE,
Notary Public-J
Sandy S. James-Browno
Notary Public
State of New Jersey
My commission expires September 19, 2026
FEDERAL INSURANCE COMPANY
STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS
SlatutoryBasis
Dacomber 31, 2024
(In thousands)
ASSETS
Cash, Cash Equivalents, and ST Investments $
United States Government, State
and Municipal Bonds
Other Bonds
Stocks
Other Invested Assets
TOTAL INVESTMENTS
Investments in Affiliates.
Great Northern Ins. Co.
Vigilant Ins. Co.
Chubb National Ins. Co.
Chubb Indemnity Ins. Co.
Chubb Ins. Co. of Now Jersey
Chubb Lloyds Ins. Co. of Texas
Other Affiliates
Premiums Receivable
Other Assets
(355,746)
3,847,216
9,063,626
361,504
1,562,503
14,479,183
444,946
392,348
204,009
185,760
41,623
6,140
71,980
2,574.791
3,039.474
TOTAL ADMITTED ASSETS $ 21,440,244
LIABILITIES AND
SURPLUS TO POLICYHOLDERS
Outstanding Losses and Loss Expenses
Reinsurance Payable on Losses and Expenses
Unearned Premiums
Ceded Reinsurance Premiums Payable
Other Liabilities
TOTAL LIABILITIES
Capital Stock
Paid -In Surplus
Unassigned Funds
SURPLUS TO POLICYHOLDERS
TOTAL LIABILITIES AND
SURPLUS
$10,612,093
1,730,604
3,117,855
417,703
583,379
16,461.834
20.980
2,711,474
2,245.956
4,978,410
$ 21,440,244
Investments are valued in accordance wish requirements of the National Association of Insurance Commissioners. At December 31, 2024,
Investments with a carrying value of $569,829,993 were deposited with government authorities as requ red by law.
STATE OF PENNSYLVANIA
COUNTY OF PHILADELPHIA
John Tayfor, being duly sworn, says that he is Senior Vice President of Federal insurance Company and that to the best of his knowledge
and belief the forego- . Is a true and correct statement of the said Company's fnancial condition as of the 31 st day of December, 2024.
Sw rn barer IN Al- C_.►— 2-0 - ZU Zf
LZL� , e rZ� My 6 1 one irea
Commonwealth 6 Penrsylvania - Notary Seal
Diane W ighl, Notary Public
Philadelphia County
A4y comnllssion expires August 8, 2027
Commission number 1235746
Member, Pennsylvania Association of Notaries
Liberty
mutum. LIBERTY MUTUAL INSURANCE COMPANY
--SURETY- FINANCIAL STATEMENT — DECEMBER 31, 2024
Assets Liabilities
Cash and Bank Deposits................................$4,608,826,756.00 Unearned Premiums...................................... $9,890,896,878.00
*Bonds — U.S Government.............................$4,281,375,446.74 Reserve for Claims and Claims Expense..... $29,467,071,865.00
*Other Bonds................................................$21,566,489,527.26 Funds Held Under Reinsurance Treaties.......... $341,948,172.00
*Stocks.........................................................$15,589,644,012.00 Reserve for Dividends to Policyholders ................... $954,025.00
Real Estate..........................................................$86,497,925.00 Additional Statutory Reserve ............................ $150,547,865.00
Agents' Balances or Uncollected Premiums ... $7,512,975,129.00 Reserve for Commissions, Taxes and
Other Liabilities .............................................. $5.049,906,410.00
Accrued Interest and Rents...............................$225,249,712.00
Total .............................................. $47,104,416,171.00
Other Admitted Assets .................................. $19,367,663,200.00
Total Admitted Assets.................$74,539,483,661.00
Special Surplus Funds ...................................... $174,153,086.00
Capital Stock ....................................................... $10,000,076.00
Paid in Surplus ............................................. $13,209,595,772.00
Unassigned Surplus ..................................... $13,415,980,561.00
Surplus to Policyholders .............................. $27,435,067,490.00
Total Liabilities and Surplus....... $74,539,483,661.00
* Bonds are stated at amortized or investment value; Stocks at Association Market Values.
The foregoing financial information is taken from Liberty Mutual Insurance Company's financial statement filed with the Massachusetts Department of
Insurance.
I, TIM MIKOLAJEWSKI, Assistant Secretary of Liberty Mutual Insurance Company, do hereby certify that the foregoing is a
true, and correct statement of the Assets and Liabilities of said Corporation, as of December 31, 2024, to the best of my
knowledge and belief.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Corporation at Seattle, Washington, this
8th day of March, 2025.
t14SUR
�J 40",V,
1912
30 Timothy A. Mikolajewski, Assistant Secretary
d� SsgcHuse da
0/7 *
LN1$-1262,10,11C
CHUBB'
Power of Attorney
Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company
Westchester Fire Insurance Company I ACE American Insurance Company
Know -All byThese-PresenWtharFEDERAL INSURANCLrCOMPANY aMridtana co-rWattoWVIGIIANTINSURANCE-COMPANYa N WYorlt corporation, PACIFIC INDEMNITY-- -
COMPANY, a Delaware corporation, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY corporations of the Commonwealth of Pennsylvania,
do each hereby constitute and appoint Ryan Gray, Marisol Mojica, Andreah Moran, Krystal L. Stravato, Jaclyn Malley and Kevin T. Walsh Jr. of Whippany,
New Jersey; Andrea E. Gorbert and Mariya Leonidov of Jericho, New York; Neil C. Donovan and Gerard Leib of Berwyn, Pennsylvania ------------------
each as their true and lawful Attorney -In -Fact to execute under such designation In their names and to affix their corporate seals to and deliver for and on their behalf as suretythereon
or otherwise, bonds and undertakings and other writings obligatory In the nature thereof (otter than ball bonds) given or executed In the course of business, and any Instruments
amending or altering the same, and consents to the modification or alteration of any Instrument referred to in said bonds or obligations,
In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY
and ACE AMERICAN INSURANCE COMPANY have each executed and attested these presents and affixed their corporate seals on this 7th day of October, 2024.
RupercHD Sivinde11s.AssistantSecr*tart,
1�) w
STATE OF NEW JERSEY
County of Hunterdon ss,
Warren Elchhorn, Vice PreAdoit
On this 7te day of October, 2024 before me, a Notary Public of New Jersey, personally came Rupert HD Swindells and Warren Elchhorn, to me known to be Assistant Secretary and
Vice President, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC IN DEMNITY COMPANY, WESTCHESTER FiRE INSURANCE COMPANY and
ACE AMERICAN INSURANCE COMPANY, the companies which executed the foregoing Power of Attorney, and the said Rupert HD Swindells and Warren Elchhorn, being by me duly
sworn, severally a» d each for lhlmself did depose and say that they are Assistant Secretary and Vice Presldent, respectively, of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE
COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and know the corporate seals thereof, that the
seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of Bald Companies; and that their signatures as such officers were duly
affixed and subscribed by like authority,
Notarial Seal t cgyr Albert Contursi
6 NOTARYPUBUICOF NEVVJERSEY
tt'T e} No 50202369
y ^uattc commission Expires August 22,2627
�uJER�
CERTIFICATION
Resolutions adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016;
WESTCHESTER FIRE INSURANCE COMPANY on December 11, 2006; and ACE AMERICAN INSURANCE COMPANY on March 20, 2009:
"RESOLVED, that the follotwing authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, recognlzances, contracts and other written commitments of the Company
entered into In the ordinary course of business (each a "Written Commitment']:
(1) Each of the Chairman, the President and the Vice Presidents of the Companyls hereby authorized to execute any Written CommitmentforandonbehalfoftheCompany, under the seal
of the Company or otherwise.
(2) Each duly appointed attorney-in-bctofthe Company is hereby authorized to execute any Written Commitment for and an behalfofthe Company, tinder the seal ofthe Company or otherwise,
to the extent that such action is authorized by the grant of powers provided for In such person's written appointment as such attorney -in -fact
(3) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalfofthe Company, to appoint in writing any person the attorney -in.
fact of the Company with full power and authority to execute, for and on behalfofthe Company, under the seal ofthe Company or otherwise, such Written Commitments oftheCompany
as may be specified In such written appointment, which specifiaton may be by general type or class of Written Commitments or by specification of one or more particular Written
Commitments.
(4) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to delegate In writing to any other officer of the
Company the authodtytoexecute, forandonbehaif of the Company, under the Company's seal or otherwise, such Written Commitments oftheCompany asarespecifiedInsuchwritten
delegation, which specifintion may be by general type or class of Written Commitments or byspecification ofoneormore particular Written Commitments,
(5) The signature of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, may be affixed by
facsimile on such Written Commitment or written appointment or delegation.
FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of oincers, employees and other persons to act for and on behalf of the
Company, and such Resolution shall not limit or otherwise affect the exercise or any such power or authority otherwise validly granted or vested."
I, Rupert HD Swindells, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE
COMPANY and ACE AMERICAN INSURANCE COMPANY (the "Companies") do hereby certify that
(i) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and fit full force and effect,
(11) the foregoing Power ofAttorney Is true, correct and In full force and effect
Given tinder my hand and seals of said Companies at Whitehouse Station, NJ, this June 30, 2025
Rupert HD Swindells, Assistant Secretary
IN THE EVENT YOU WISH TO VERIFY THE AUTHENTICITY OF THiS BOND OR NOTIFY US OF ANY OTHER MATTER PLEASE CONTACT US AT:
Teleohone(9081903.3493 Fax(9001903.3656 a -mall: surety@chubb,com
Combined: FED-VIG-PI-WFIC-AAIC (rev, 11-19)
Liberty
Mutual.
SURETY
POWER OF ATTORNEY
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
West American Insurance Company
Certificate No: 8213270.985316
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casually Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that
Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized
under the laws of the Stale of Indiana (herein collectively called the 'Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Ryan Gray:
Jaclyn Maffey: Michael Nfarino: N(arisol Mojica; Andreah Moran: Kn stal L. Stravato; Kevin T. Walsh, Jr.
all of the city of Witippatty stale of NJ each individually if there be more than one named, its true and lawful attorney -in -tact to make,
execute, seal, acknowledge and deliver, for and on its behalf as surely and as its act and deed, any and all undertakings, bonds, recognizances and other surely 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 4th day of March 1 2025 .
Liberty Mutual Insurance Company
P� INSu P'11 INS& X% WSURQ The Ohio Casually Insurance Company
tiJ 4�AP0�F .ct hJ GORPo�f�2 �VpcoVkPo.% 10 West American Insurance Company
J3 oco Ve? o � �3 otn
1912 0 0 1919 1991 - /
rn Y; �y y Z ?m 0 4/ y E
cHus �aa O�yygMPS�` aa� a INDIAN� as B a) U
Nathan J. Zangerle, Assistant Secretary
State of PENNSYLVANIA E
at County of MONTGOMERY ss o E
.0 S On this 4th day of March 2025 before me personally appeared Nathan J. Zangerle, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o
0 is Company, The Ohio Casually Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes 'Iff
aali > [herein contained by signing on behalf of the corporations by himself as a duly authorized officer. >
— IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at Plymouth Meeting, Pennsylvania, on the day and year first above written. Q
Q aa) P PASTa 0
O L Q�ytitvF F! CommonweallhofPennsylvania-NotarySeal �S
Teresa Poslelle, Notary Public >—
�-' u Cr y 9 MonlifomeryCounty
O •�-My commission expires March 28. 2029 B O N
C a�v Co�nmis ilnumber112M4 Y• �.
of+ 2 'wOf �G Atember,Penns maAssolatonofNotaries Teresa Pastella, Notary Public o
��RY PU�� O
to
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casually Insurance Company, Liberty Mutual 3 �
E•E Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: ti M
ARTICLE IV —OFFICERS: Section 12. Powerof Attorney. z `4
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 o
_a CD
President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surely o
co 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 atlomey, shall -a100
have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such o m
Zo instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or allorney-in-fact under the m
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. O.T
LL. n.
ARTICLE All - Execution of Contracts: Section 5. Surely Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe,
shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings,
bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full pourer to bind the
Company by [heir 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 Nathan J. Zangerle, Assistant Secretary to appoint such
attorneys -in -fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and
other surety obligations.
Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and effect as though manually affixed.
I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do
hereby certify that the original power of attornry 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, ! have hereunto set my hand and affixed the seals of said Companies this 30th day of June 2025 ..
Pv INSU, �-V INSU 0 INsUR
j�GORPOlrgr�'Y`T�26p0.PON'Q9y� S' =ooaPo2�rFyo
>UJ
a1Fii2rg0 0_s1919�o a 199100
~rid sBgCHUS By y0 NgMPs� dad YS �NDIAS da3 Renee C. Llewellyn, Assistant Secretary
LNIS-12873 URIC OCIC wwAIC Multi Co 0212A
CSC No. 55915-CO2
FORT RT WORTH City of Fort Worth
Change Order Request
Project Name:1 Sycamore Creek Sanitary Sewer Relief Interceptor, Phase 3 City Sec No.: 1 55915
Project No.(s):1 56019/0600430/0700430/5740010 1 DOE No. I N/A City Proj. No.:1 102069 .
66-inch parallel relief sanitary sewer interceptor along the existing Sycamore Creek sewer Interceptor totaling
Project Description: approximately 7,800 linear feet.
Contractor:I Thalia Construction Company, Inc. Change Order II 2 Date 4/7/2025
City Project Mgr.1 Bijay Upreli City Inspector: Carmen Drake
Phone Number: 817-392-8909 Phone Number: (682) 432-5486
Dept, Water Unit 1 Sewer Unit 2 Totals Contract Time(Calendar days)
Original Contract Amount $253,350.00 $9,433,827.00 $9,687,177.00 540
Extras to Dale $0,00 $0.00 $0.00
Credits to Dale $0.00 $12,582.75 $12,582.75
Pending Change Orders (In M&C Process)
Contract Cost to Date $253,360.00 $9,421,244.25 $9,674,594.25 540
Amount of Change Order $0.00 �$3,997,67-$3,997.67 800
Revised Contract Amount $263,350.00 $9,417,246.68 $9,670,596,58 1,340
Original Funds Available for Change Orders $75,731.00 $174,772.00 $250,503.00
Remaining Funds Available for this CO $75,731.00 $174,772.00 $250,503.00
Additional Funding (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT -0,17%
MAX ALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25%) $12,108,971.25
JUSTIFICATION (REASONS) FOR CHAWHOMER
Change Order No. 2 provides for the installation of a 8-inch sanitary sewer collector main on Duval Street that
will provide sewer service to residents on the west side of the road in order to avoid direct connection of the
services into a newly constructed 48-inch sanitary sewer main. Direct of sanitary sewer service lines to large
sanitary sewer transmission main are prohibited.
Staff recommends an additional 800 calendar days on the project for the time it took to resolve all issues pertaining to the collector
main and to come to terms with the contractor for the cost of the additional improvements. The project will be closed out once the extra
work is completed.
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 lime and money) for all costs arising out of, or incidental to, the above Change Order. /
.1ompasuarniMl rI CaVraq _ I r,�ile / Date
Thalia Construction company, Inc. Chase Randall 17 %� �—]
p?clot
F
Assistant Director (Water Dept)
C6u^csfnvs�ief- H�r7e1-
e s`i°s�an(i�y Attorney
7M&C Number N/A
Project Ma Dale
rlmu uro(elll
Date Cone rf1 lion, Supervisor (Water Dept) Daale
04/14/202,_
'Date Asslsiianl City Manager Date
04/16/202q 04/20/20251
Council Action (If Required)
M&C Date Approved NIA
FORT W012-F" City of Fort Worth
—_" Change Order Additions
Project Name Sycamore Creek Sanitary Sewer Relief Interceptor, Phase 3 City Sec No.: 1 55915
Project No.(s): 56019/0600430/0700430/5740010 1 DOE No.1 N/A City Proj. No.: l 102069
Project 66-inch parallel relief sanitary sewer interceptor along the existing Sycamore Creek sewer interceptor totaling
Description approximately 7,800 linear feet.
Contractor Thalle Construction Company, Inc.
City Project Mgr. Bijay Upreti
11 EM UESGIRIPI IUN
Installation of ti-Incn sewer collector main ano reiateo
appurtanances:
8-inch Sewer (310 LF)
6-inch Sewer (85 LF)
Sewer Service Cleanout (4 EA)
76 Remove Manhole (2 EA)
Plug and Abandon Sewer (2 EA)
Vacuum Test Manhole (5 EA)
Post TV (395 LF)
Connect to Existing Manhole (2 EA)
4ft Manhole (4 EA)
4ft DrOD Manhole (1 EA)
I Change Order: 0 Dalel 4/7/2025
City Inspector I Carmen Drake
ADDITIONS
DEPT Qty Unit Unit Cost Total
Sewer Unit 2 1.00 LS $182,082.33 $182,082.33
Water Jnit 1
Sewer Unit 2 $182,082.33
Page 2 of 4 Additions Sub Total $182,082.33
FO RT WO RT H City of Fort Worth
Change Order Deletions
Project Name Sycamore Creek Sanitary Sewer Relief Interceptor, Phase 3 City Sec No.: 55915
Project No.(s): 56019/0600430/0700430/5740010 1 DOE No. I N/A City Proj. No.: 102069
Project Description I 66-inch parallel relief sanitary sewer interceptor along the existing Sycamore Creek sewer interceptor totaling approximately
7,800 linear feet.
Contractor I Thalle Construction Company, Inc. I Change Order: 2 Date I 4/7/2025
City Project Mgr. Bijay Upreti City Inspector: I Carmen Drake
DELETIONS
ITEM
DESCRIPTION
DEPT
Qty
Unit
Unit Cost
Total
36
Remove and Replace Gaurdrail
Sewer Unit 2
80.00
LF
$15.00
$1,200.00
65
Irrigation Replacement and Repair Allowance
Sewer Unit 2
1.00
LS
$15,000.00
$15,000.00
67
Pre -CCTV Inspection
Sewer Unit 2
700.00
LF
$1.40
$980.00
71
Cement Stabilized Sand Backlill
Sewer Unit 2
70.00
CY
$150.00
$10,500.00
72
Flowable Fill Embedment
Sewer Unit 2
80.00
TN
$105.00
$8,400.00
73
Construction Allowance
Sewer Unit 2
1.00
LS
$150,000.00
$150,000.00
Water Unit 1
Sewer Unit 2 $186,080.00
Page 3 of 4 Deletions Sub Total $186,080.00
MIWBE Breakdown for this Change Order
MWBE Sub Type ,of Service Amount for this CO
Total
Previous Change Orders
co# DATE AMOUNT
Total $0:00;
Page 4 of 4
CONTRACT MODIFICATION PROPOSAL
ISSUING OFFICE PROPOSAL BY
Sycamore Creek Relief Interceptor CPN 102069 THArLLE
City of Fort Worth
LAN, Inc. CONSTRl1CTION COMPANY
10110 E FM 917
Alvarado, TX 76009
Project: Sycamore Creek Relief Interceptor - Phase 3 CoFW CPN: 102069
Reference: RFI-015 Existing 4" Wastewater Line - Field Order
0 Small Diameter Sewer Services on Duval Street Date: October 6, 2023
Description of Worlr:
Attached is Thalia's cost proposal for the work required as outlined In Field Ordert/2 Small Diameter Sewer Services on Duval
Street received on 1/5/2024.
CONTRACTOR'S PROPOSAL
DESCRIPTION
AMOUNT
Direct Costs
Labor
$
6,736.70
Material
$
-
Equipment
$
3,289.88
Subcontractor Costs
$
159.500.00
Total Direct Costs
$
169,526.68
Overhead & Profit for Labor, Material, & Equipment
15.00% $
1,010.51
Contractor's Fee for Subcontractor
5.00% $
7,975.00
Subtotal
$
178,512.09
Bond
2.00% $
3,570.24
Subtotal
$
182,082.33
Cost of Change $ 182,082.33
Calendar Days Time Extension Required 0
Contractor's Certification: I certify this estimate is made is good faith, and the supporting documentation Is accurate and complete to
the hest of my knowledged and belief. This proposal Is based solely on the usual cost elements such as labor, material, and normal
markups and does not Include any potential amounts for changes in the sequence of work, disruptions, and/or impact costs, and the right
Is expressly reserved to make claim for these related Items of cost prior to final settlement of this contract.
4/2l2025
Chase andall Date
Project Manager
SCHEDULE OF VALUES
PRO)ECTr Start: End:
Change i
THAtL6
Sycamore Creek Wit lntmeplor. Ph. so 3l Order 0.00 �.,.
Field Order g2. Snell Dlameler Seweritmice s an DuwI Street
I A D C U I E F 1 D
Item Pdclna SOuclure NUrk (�npleled
Spea lla Descdptan of\Wrk Flom Pras?ouf
Nurneer Scheduled Votue Unit PY.ce UOId Total0aanlAy
Aydi<aUon This Pedod To Dala
I Small Olameler Sevier SerAces on Duval Street• F092 3 102.002.33 S 102.002.73 GC_S 1.00
I
I
1
I
1 Grand Tolals 3 182.002.33
II 1
Tol I cost
Percent From PrWaus Total Coctlhls
Complelo ApyEwUon Pedod
Ott S
To Data
MMMA rnd!wlRA.l.IIIId OId.,.1•3-401.m.1. I S(yYA�r,3.."!<.�l1- 0� 1Slr<al
ay�r�t,,.,Ymmlil
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R & D Burns Brothers Construction Inc.
P.O. Box 786: Burleson, Texas 76097
Phone (817) 447-0292; Fax (817)447-0207
January 21, 2025
Job Name: Sycamore Creek Relief Interceptor
Phase 3
Fort Worth
Item
Description
quantity
Unit
Unit Bid
Total Bid
1
8" Sewer SDR 26
310.00
LF
165,00
51150.001
2
6" Sewer SDR 26
85.00
LF
150.00
127%00l
3
Sewer Service Cleanout
4.00
EA
1000.00
4000.00
4
Remove Manhole
2.00
EA
1000.00
2000.00
5
Plug and Abandon Sewer
2.00
EA
3500.00
7000.00
6
Vacuum Test Manhole
6.00
EA
450.00
2250.00
7
Post TV
395.00
LF
10.00
3950.00
8
Connect to Existing Manhole
2.00
EA
2000.00
4000.00
9
4' Manhole
4.00
EA
9500.00
38000.00
10
4' Drop Manhole
1.00
EA
12000.00
12000.00
Additional Items if needed
Manhole Collars 5.00 EA 1200.00 6000.001
1
$ 143,100.00
TOTAL BID
Inclusions
Labor & Equipment, Clean-up, Insurance, and Installation
Exclusions:
1. All engineering, permits and inspection fees, erosion control (SWPPP) and related
appurtenances, bonds, barricades, franchise utility adjustment, hydro mulch, sodding
port a johns, power pole bracing or removal, and traffic control and permit.
2. Excludes any concrete or asphalt paving repair.
Lawockwood, Andrews
Newnam, Inc.
l,. A UALY COMPANY
FIELD ORDER NO. 2
Project: Sycamore Creek Relief Interceptor Phase 3
Contract For: City of Fort Worth, Texas Water Department
Subject of Field Order: Small Diameter Sewer Services on Duval Street
Description (List attachments, if any):
Date 01/05/2024
Project No.: 130-10877-000
Contract Date: 11/08/2021
Due to the discovery of an existing small diameter sewer service line that was not originally proposed to be connected to the new
interceptor, there needs to be sanitary sewer lateral relocations to collect sanitary sewer services and replace existing VCP lines
under the proposed improved street.
The attached sheets include plan and profile changes, and a city detail for connecting sanitary sewer services,
The attached pdf is titled "Fiel(l_Or(lei-#2-DuvalServices-Revisions,p(ir,.
The Conowelor is hereby directed cis sel forth below. These instructions are issued pursuant to the General Pi-ovisions in the
Contract Doaunents. 11 is the Engineer's opinion that this FIELD ORDER does not alter the Contracl Price or the Contract T nne.
The Contractor in list noliif r the Engineer immeclicrlely cind regnest a change muter if the Conlrcrelor does not agree with the
Engineer's opinion.
Recommended By: Lockwood. Andrews & Newnam. Inc.
Engineer
Greg Vaughn �'` 01/05/2024
Representative Dale
Accepted By:
Contractor
Approved By:
Representative Dale
owacr
Representative (Sign, Keep Original Copy and Rclurn All others. See I leading for Rcturn Address.) Date
1320 South University Drive, Suite 450 • fort Worth, Texas 76107 • 817.820.0420 • fax: 817.820,0441 • wwWan-Inc.com
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SYCAMORE CREEK RELIEF INTERCEPTOR - PHASE 3
°a
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C• � 1. i X � 1 1
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jig
X•26731
— 12 -•� CITY OF FORT WORTH 10 iPPE AND FITTINGS MUST BE SDR-26 PVC OR
6 I RIGHT-OF-WAY I STD. CLEANOUT W/CAST DUCTILEIRON WITH CERAMIC EPDXY LINING AS
LINE IRON OR POLYETHYLENE INDICATED IN THE DRAWINGS.
u U q 3 CAP Z PROVIDE RUBBER SLE'EE COUPLINGS WITH
<0<74" ,O BARS 4' CONCRETE ! STAINLESS STEEL DOUBLE -BAND REPAIR SLEEVES
.Q• COLLAR COLD JOINT TO CONNECT TO EXISTING SERVICE. TIGHTEN
y �REQUIRED SLEEVES TO THE TORQUE RECOMMENDED BY THE
STANDARD MANUFACTURER
r.� FR: r• CCO�I AR I I PARKWAY ;"/FL 3. CONCRETE ENCASEMENT PER SECTION 03 30 00.
�
I AN vIFV f�'��•'♦ :. ;}{ -- . _ 4, SEWER SERVICE SHALL INCLUDE ALL
•.- -•-• •---J} APPURTENANCES FROM SEWER MAIN UP TO AND
FOR NEW ACCEPTABLE '-7 INCLUDING RUBBER SLEEVE COUPLING OR PLUG.
DEVFIOPMEN T, CAP -' 9ACKFILL PER •: 5. THE LONG DIMENSION OF THE CONCRETE
RISER 1' BELOW -_ SECTION 33 OS 10 :• •.•�• p, CLEANOUT COLLAR SHOULD BE PARALLEL TO THE
GRADE (CAST IRON). - STREET.
MARK W/RED VINYL '.•CONCRETE ENCASEMENT'.".'.'.-.'.'..'...
TAPE 3- WIDE & 6" '- PER SECTION 03 30 00 '- '-'-'- SEAR SERVICE MATERIAL
ABOVE GROUND ' ' ' ' - ' ' - ' ' . AS INDICATED IN
RUBBER. SLEEVE COUPLING _ t -- . EXTEND CONCRETc�• DRAWINGS, SLOPE VARIES.
REQUIRED IF EXISTING • - -: ENCASEMENT 6- MIN.
SERVICE IS PRESENT. -.'6�. yyl�'--•- - •- FROM BOTH ENDS OF
OTHERVn PLUG END. : -- ' . r. 2-VlAY CLAN OUT Tc .'.'.'.'.'.'.'.'.
CLEANOUT TEE : '�- -•
6" MIN. ♦ .�' • ' �._..._- _ _ ��..
EXIST, OR PROP.
SEWER SVC
MIN.
6" MIN.
c STAINLESS ST-L
OLTS
" STAINLESS STEEL
rPOLETHYLENE
1.5E
BOLTS
t.5" CAST IRON
r I
r
t O-RING
-�O-RING
r
POLYETHYLENE
CAST IRON
7.5-
I
7.5' PIPE BELL OR
RUBBER SLEEVE
J— COUPLING
PVC
PVC OR DIP
PVC
FACT IR, f:J ANf'111T W/S. C.
FOR PAVED AREAS
PVf Qc
A j'IR CT W S.C 4f]ITC
TEE
�v v
CRUSHED ROCK o
EMBEDMENT PER
SECTION 33 05 10 ' c
eC o POLYETHYLENE
CAST IRON CLEAN
NOUTCLEANOUT W'/LID AND
W/UD AND CONCRETEa' CONCRETE COLLAR
I COLLAR MUST BE '^ O MUST BE COMPLETELY
COMPLETELY INSIDE OUTSIDE OF SIDEWALK
DRIVEWAY SIDEWALK
RICHT-OF-WA UN—� ��— RIGHT-OF-WAY LINE
L�+J I
SIDc}YAUC SID+LK
APPROACH
'\ CURB !t CURB &
APPROACH \\�/ GUTTER GUTTER
STREET STREET
C (i<(T I fl(:ATION WHiN �GN�-0 AT I QCATON
R N ORIVFW y%1•j / r[iAOF IG
g WORM CITY OF FORT WORTH, TEXAS REVISED 09-16-ZM
SANITARY SEWER SERVICE 33 31 50—D214
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.0 mrc+r.amc +�a�rc
.arw wrn vmm�.vr+aer-u.a...orc
C
RON5
U
CmfaGlEcrNo. rsDts C
m7ERfRQRPRE`TNaseii WATEO.ERNO.
CRY OF FORT WORTH, TEXAS w
WATER DEPARTMENT Ed
SYCAMORE CREEX FEf1EF INTcRCE?70R rr
PHASE3 W
W
CITY OF FORT WORTH SEWER STANDARD U
DETAIL
I�1��■ jjtN��s..�� �scur.w.-,rm•oec U
`\ ■ JwY'��r.. frar.o+r9dLrc rcw mer �
mncxm CCJ
Contract Compliance Manager
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Bijay Upretie_aoP.�.a�,,.az9o.,
Dale:.21. 11 11'.18
Signature
Bijay Upreti, P.E.
Name of Employee
Sr. Professional Engineer
Title
ATTEST:
Jannette S. Goodall
City Secretary
Water Construction Invoice
City Secretary Contract Number:
Purchase Order:
Payment Application Date:
55915
FW060-0000035528
06.30.2025
Project:
Invoice Number:
Estimate Number:
102069-102069 - Sycamore Creek Sanitary Sewer Relief
55915-033+PAYAP-9
Interceptor Phase 3
Contract Name:
Invoicing Period (From —To):
Project Manager:
55915-102069 - Sycamore Creek Sewer- Phase 3
05.15.2025 to 06.30.2025
Upreti, Bijay
To:
Payment Approvals
THALLE CONSTRUCTION COMPANY INC
Roles
Date:
900 NC HWY 86 NORTH
Inspector.
HILLSBOROUGH, NC 27278
1?4r. D=&
06.30.2025
Supplier ID:
Sr. Inspector:
06.30.2025
0000039669
%�k �O�CKQ0f6
Project Manager:
06.30.2025
6604 ZL,Eneti
Contract Summary:
1. Original Contract Amount
$9,687,177.00
2. Net Change by Change Orders
$- 16,580.42
3. Current Contract Amount (Line 1 +/- Line 2)
$9,670,596.58
4. Total Completed and Stored to Date
$9,576,719.58
(Progress Estimate, Construction Allowance, and
Change Orders)
5. Amount Retained (5.00%)
$ 478,835.99
6. Amount Eligible toDate (Line 4—Lines)
$9,097,883.59
7. Less Previous Payments (Line 5 from prior Invoice)
$9,038,089.53
8. Amount Due this Application
$ 59,794.06
9. Balance to Finish, Plus Retainage
$ 572,712.99
(Line 3 — Line 5)
10. Contract Time
a. Days Awarded
540
b. Days Added by Change Order
0
c. Total Contract Days Awarded
540
d. Days Charged this Invoice
47
e. Days Charged from Previous Invoice(s)
1105
f. Contract Days Remaining
-612
Contractors Certification:
The Contractor certifies with the submittal ofthis document and associated Payment Request
Submittal on the City of Fort Worth eBuilder 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 @ x day
Page 1 of 9
Water Construction Invoice
Funding Distribution:
Funding Identification (FIDs)
Amount Earned
Retainage (FIDs)
Retainage
Amount to Pay
56002-0700430-5330500-102069-001430-9999
$
.00
Insert appropriate retainage FIDs
Calc Manually
Calc Manually U
56017-0700430-5330500-102069-001430-9999
$
.00
Insert appropriate retainage FIDs
Calc Manually (Dx
Calc Manually
56017-0700430-5740010-102069-001480-9999
$
.00
Insert appropriate retainage FIDs
Calc Manually (D
Calc Manually 0
56020-0600430-5740010-102069-001780-9999
$
500.0O
Insert appropriate retainage FIDs
Cale Manually Q
Calc Manually
56020-0700430-5330500-102069-001430-9999
$
.00
Insert appropriate retainage FIDs
Calc Manually (D
Calc Manually (J
56020-0700430-5740010-102069-001480-9999
$ 62,441.12
Insert appropriate retainage FIDs
Calc Manually (D�
Calc Manually
Contract Bid Items:
A
B
C
D
E
F
G
H
I
1
K
Bid Item
Description
Spec.
UoM
Bid
Unit Price
Bid Value
Estimated
Value this
Previously
Previously
Materials
Total Completed
Retainage
%
Balance to
No.
Section
Quantity
Quantity
Period
Installed
Installed
Presently
and Stored to
this Period
(H/B)
Finish
No.
Installed this
Quantity
Value
Stored
Date (D+F+G)
(B-H)
Period
(not in F)
Unit
66" FRP SN46 SANITARY SEWER
33 3113
LF
934
$ 430,00
$ 155,610.00
0.0000
$
.00 327.0000
$ 355,610.00
$ .00
$ 355,610.00
$
Co
100.00%
$ .00
1.001
PIPE
Unit
60" FRP SN46 SANITARY SEWER
33 3113
LP
3,431
$ 406.00
$1,392,986.00
0.0000
$
.00 3,359.0000
$1,363,754.00
S .00
$1,363,754.00
5
.00
97.901-
$ 29,232.00
i.002
PIPE
Unit
43" FRP SN46 SANITARY SEWER
33 5113
LF
1,075
$ 300.OD
S 322,500.00
0.0000
5
.00 1,015.0000
$ 304,500.00
$ .00
5 304,500.00
$
.00
94.42%
S 13,000.00
1.003
PIPE
Unit
79.25" TUNNEL LINER PLATE &
33 05 21
LF
55
S 2,800.00
S 154,000.00
0,0000
$
.00 55.0000
S 154,000.00
$ .00
$ 154,000.00
$
.00
100,0096
$ .00
1.004
66" CARRIER PIPE BY OTHER
THAN OPEN CUT
Unit
S5 25" TUNNEL LINER PLATE &
S3 0521
LF
1£9
$ 2,900.00
$ 529,2D0.00
0,0000
$
.00 139.0000
$ 529,200.00
$ .00
5 529,200.00
$
.00
100.0095
$ .00
1.005
66" CARRIER PIPE BY OTHER
THAN OPEN CUT
Unit
65 25" TUNNEL LINER PLATE &
..3 3113,
LF
573
S 2,200.00
$1,260,600.00
0.0000
$
.00 595.0000
$1,315,600.00
$ .00
$1,315,600.00
$
.00
10436%
$- 55,000.00
1.006
4S" CARRIER PIPE BY OTHER
CS 30 30
THAN OPEN CUT
Unit
45" FRP SN46 SANITARY SEWER
33 31 13,
LF
123
$ 370.00
S 47,360.00
0.0000
$
.00 123.0000
$ 47,360.00
$ .00
$ 47,360.00
$
.00
100.0031,
$ .00
1,007
PIPE WITH CONCRETE
03 30 30
ENCASEMENT
Page 2 of 9
A
B
C
D
E
F
G
H
I
)
K
Bid Item
Description
Spec.
UoM
Bid
Unit Price
Bid Value
Estimated
Value this
Previously
Previously
Materials
Total Completed
Retainage
%
Balance to
No.
Section
Quantity
Quantity
Period
Installed
Installed
Presently
and Stored to
this Period
(H/B)
Finish
No.
Installed this
Quantity
Value
Stored
Date (D+F+G)
(B-H)
Period
(not in F)
Unit
45" FRP SN46 SANITARY SEWER
33 3113
LF
186
$ 435.00
$ 30,910.00
0.0000
$
.00
1£6.0000
$ 30,910.00
$
00 S 80,910.00
$
.00
100,00°111
j CC
1.00E
PIPE WITH CLSM BACKFILL
Unit
42" FRP SN46 SANITARY SEWER
33 3113,
LF
130
$ 345.00
$ 44,350,00
0.0000
$
.00
130 0000
$ 44,£50.00
$ .00
$ 44,350.00
$
.00
100,001/
$ .00
1,009
PIPE WITH CONCRETE
03 30 30
ENCASEMENT
Unit
42" FRP SN46 SANITARY SEWER
33 3113
LF
93
5 470.00
S 43,710.00
0.0000
$
.00
93.0000
S 43,710.00
S .00
$ 43,710.00
$
.00
100.009;
5 00
1A10
PIPE WITH CLSM BACKFILL
Unit
7" FRP SN46 SANITARY SEWER
33 3113,
LF
258
$ 280.00
$ 72,240.00
0,0000
$
.00
253.0000
$ 72,240.00
$ .00
S 72,240.00
$
.00
100.001-
$ .00
1.011
PIPE WITH CONCRETE
03 30 30
ENCASEMENT
Unrt
27" FRP SN46 SANITARY SEWER
33 3113
LF
275
5 310.00
$ 35,250.00
0.0000
S
.00
275.0000
$ 35,250.00
5 .00
S 85,250.00
$
.00
100.00111.
"> .00
1.012
PIPE WITH CLSM BACKFILL
Unit
15" SDR-26 PVC SANITARY
32 3120
LF
91
$ 80,00
5 7,230.00
0.0000
$
.00
91.0000
S 7,280.00
$ .00
$ 7,280.00
$
.00
100.009G
S .00
1A13
SEWER PIPE
Unit
3" SDR-26 PVC SANITARY
33 3120
LF
491
S 65.00
5 31,915.00
0.0000
$
.00
491.0000
$ 31,915.00
5 .00
S 01,915.00
$
.00
100.00%
$ 00
1.014
SEWER PIPE
Unit
POLYMER CONCRETE -
33 39 22
LS
1
$ 400,000.00
5 400,000.00
0.0000
$
.00
1.0000
5 400,000.00
$ .00
$ 400,000.00
$
.00
100.001.
$ .00
1.015
JUNCTION BOX 1
(INCL. BACKFILL, CLSM, STOP
LOGS, ETC.)
-
Unit
POLYMER CONCRETE -
33 39 22
LS
1
5 375,000.00
$ 375,000.00
0.0000
$
.00
1.0000
$ 375,000,00
$ .00
S 375,000.00
$
.00
100.009L
S 00
1.016
JUNCTION BOX 2
(INCL BACKFILL, CLSM, STOP
LOGS, ETC.)
Unit
POLYMER CONCRETE -
33 39 22
LS
1
$ 370,000.00
$ 370,000.00
0.0000
$
.00
1.0000
$ 370,000.00
$ .00
$ 370,000.00
$
.00
100.009L
$ 00
1,017
JUNCTION BOX 3
(INCL BACKFILL, CLSM, STOP
LOGS, ETC.)
Unit
POLYMER CONCRETE -
33 39 22
LS
1
5 345,000.00
$ 345,000.00
0.0000
$
.00
1.0000
$ 345,000.00
$ .00
S 345,000.00
S
.00
100.00".
$ .00
1,018
JUNCTION BOX
(INCL. BACKFILL, CLSM, STOP
LOGS, ETC)
Unit
POLYMER CONCRETE -
331 39 22
LS
1
$ 315,000.00
$ 315,000.00
0.0000
$
.00
1.0000
$ 215,000,00
$ .00
$ 315,000.00
$
.00
100.00%
S .00
1.019
JUNCTION BOX 5
(INCL, BACKFILL, CLSM, STOP
Page 3 of 9
A
B
C
D
E
F
G
H
I
1
K
Bid Item
Description
Spec.
UOM
Bid
Unit Price
Bid Value
Estimated
Value this
Previously
Previously
Materials
Total Completed
Retainage
%
Balance to
No.
Section
Quantity
Quantity
Period
Installed
Installed
Presently
and Stored to
this
Period
(H/B)
Finish
No.
Installed this
Quantity
Value
Stored
Date (D+F+G)
Period
(not in F)
LOGS, ETC)
Unit
POLYMER CONCRETE -
SS 39 22
LS
1
5 355,000.00
$ 355,000.00
0.0000
$
.00 1.0000
S 335,000.00
$
.00
5 355,000.00
5
.00
10C.00%
5 .00
1.020
JUNCTION BOX 6
(INCL. BACKFILL, CLSM, STOP
LOGS, ETC.)
Unit
JUNCTION STRUCTURE WATER
33 39 22
EA
6
5 4,000.00
$ 24,000.00
0.0000
5
.00 6.0000
$ 24,000.00
$
.00
$ 24,000.00
$
.00
100.00%
5 00
1.021
TESTING
Un"
CREEK RESTORATION (INCL
31 36 00
LS
1
$ 240,000.00
$ 240,000.00
0.0000
$
.00 1.0000
$ 210,000.00
$
.00
$ 240,000.00
$
.00
100.00%
5 .00
1.02.2
GABION BASKETS, CSS,
BACKFILL, ETC.) - SHEET 22
Unit
CREEK RESTORATION (INCL.
31 Sr 00
LS
1
$ 290,000.00
$ 290,000.00
0,0000
$
.00 1.0000
5 290,000.00
S
.00
$ 290,000.00
$
.00
100.00%
5 .00
1.023
GABION BASKETS, CSS,
BACKFILL, ETC.) -SHEET 27
Unit
REMOVE 43-INCH SEWER LINE
024114
LF
170
$ 56.00
$ 9,520,00
0.0000
$
00 170.0000
5 9,520.00
$
.00
$ 9,520.00
$
'00
100.009E
$ .00
1.024
Unit
ABANDON SANITARY SEWER
024114
EA
6
$ 2,300.00
$ 16,£00.00
0.0000
$
'00 6.0000
$ 16,800.00
$
.00
$ 16,300.00
5
.00
100.00".
S '00
1.025
MANHOLE
Unit
REMOVE SANITARY SEWER
024114
EA
5
$ 1,500,00
$ 9,000.00
0.0000
$
.00 5.0000
S 9,000.00
$
.00
5 9,000.00
5
.00
100.009G
5 .00
1.026
MANHOLE
Unit
PARK SODDING RESTORATION
32 92 L'
SY
71,100
S 3.50
$ 24£,350.00
0.0000
$
.00 71,100.000
$ 24S,S50.00
.00
$ 14£,£50.00
5
.00
100.0094
$ .00
1.027
0
Unit
SWPPP
312500
LS
1
$ 30,000.00
$ 30,000.00
0.0000
$
.00 1.0000
S 30,000,00
$
.00
S 30,000.00
$
.00
10000%
5 .00
1.023
Unit
o -12" TREE REMOVAL
S) 1000
EA
21
S 250.00
$ 5,250.00
0,0000
$
.00 21.0000
$ 5,250.00
$
.00
$ 5,250.00
,.
.00
100.00Yo
5 00
L029
Unit
12" -13" TREE REMOVAL
30 10 00
EA
31
$ 325.00
5 10,075.00
0.0000
$
.00 31.0000
$ 10,075.00
$
.00
$ 10,075.00
S
.00
100.00%
$ .00
1.030
Unit
13%24" TREE REMOVAL
30 1000
EA
6
$ 375.00
5 2,250.00
0.0000
$
00 6.0000
$ 2,250.00
$
.00
$ 2,250.00
$
.00
100.00%
$ .00
1.031
Unit
24" AND LARGER TREE
30 10 00
EA
1
$ 450.00
S 450.00
0.0000
$
.00 0.0000
$ .00
$
.00
$ .00
$
00
0.00°.
$ 450.00
1.032
REMOVAL
Unit
TREE PROTECTION
3113
EA
78
$ 150.00
$ 11,700.00
0.0000
$
.00 78.0000
$ 11,700.00
$
.00
5 11,700.00
$
.00
100.00%
$ .00
1.033
Unit
TEMPORARY CONSTRUCTION
9999
LF
10,200
$ 1.75
5 17,550.00
0.0000
$
.00 10,200,000
$ 17,£50,00
$
.00
$ 17,350.00
$
.00
100.00%
$ .00
1.034
FENCING -CHAIN LINT: (6-TO 3-
0
Page 4
of 9
Bid Item Description
No.
FORTWORTH.
Water Construction livoillZ
A B
Spec. UoM Bid Unit Price Bid Value
Section Quantity
No.
FOOT HIGH)
Unit
TEMPORARY CONSTRUCTION
9999 LF
-.035
FENCING - ORANGE SAFETY
FENCE
Unit
REMOVE & REPLACE
9999 LF
1.036
GUARDRAIL IN KIND - SHEET 19
Unit
CITY OF FORT WORTH TRAFFIC
34 7113 LS
1.037
CONTROL (DESIGN & PROVIDE)
Unit
PREPARATIONAND
33 05 10 LF
1.035
IMPLEMENTATION OF A
TRENCH
SAFETY PLAN
Unit
CONSTRUCTION SURVEY
01 71 23 LS
1.039
(REDLINE AS-BUILT)GPS
Unit
CONSTRUCTION STAKING
01 71 23 LS
1.040
Unit
GROUND WATER CONTROL
017123 LS
1.0-11
Unit
BYPASS PUMPING (EACH
3s 0310 EA
1.042
LOCATION) -
SHEETS 44 THROUGH 47
Unit
MINOR BYPASS PUMPING
ss 0310 EA
1.043
(EACHLOCATION)-
SHEETS 38 & 41
Unit
ODOR CONTROL ASSEMBLY A
9999 EA
1.044
(INCLUDING EQUIPMENT,
PIPING, CONCRETE, ETC.)
Uni;
ODOR CONTROL ASSEMBLY B
9999 EA
1.045
(INCLUDING EQUIPMENT,
PIPING, CONCRETE, ETC.)
Unit
PLUG & GROUT ABANDON
0241 14 CY
1.046
EXISTING S" SANITARY SEWER
LINE
Unit
PLUG & GROUT ABANDON
02 41 14 CY
1.047
EXISTING 15"SANITARY SEWER
3,300 $ 150 $ 4,950.00
so $ 15.00 $ .00
1 $ 15,000,00 $ 15,000.00
6,775 $ 1.00 $ 6,775.00
C D E F
Estimated Value this Previously Previously
Quantity Period Installed Installed
Installed this Quantity Value
Period
0.0000 $ 00 3,300.0000 $ 4,950.00
0.0000 $ .00 0,0000 $ .00
1.0000 $ 15,000.00 2.0000 $ 30,000.00
157.0000 $ 157.00 6,775.0000 $ 6,775.00
G
H
I
1
I<
Materials
Total Completed
Retainage
%
Balance to
Presently
and Stored to
this Period
(H/B)
Finish
Stored
Date(D+F+G)
(B-H)
(not in F)
$ .00
$ 4,950.00
$ .00
100.00'%
S .00
$ .00
$ .00
$ .00
0.0011,
5 .00
$ .00
$ 3Q000.00
$ 750.00
200.00%
$- 15,000.00
S .00
S 6,775.00
$ 7.85
i00.004G
S .00
1 5 15,000.00
$ 15,000.00
0.0000
$
.00
0.0000
$ .00
5 .00
1 $ 15,000,00
5 15,000.00
0.0000
5
.00
1.0000
5 15,000.00
$ .00
1 S 5,000.00
S 5,000.00
0.0000
5
.00
1.0000
5 5,000,00
$ .00
,. 33,000.00
S 249,000.00
0.0000
5
.00
3.0000
5 249,000.00
S .00
2 $ 6,100.00
S 12,200.00
0.0000
$
,00
2.0000
$ 12,200.00
5 .00
2 $ 29,000.00
S 52,000.00
0.0000
$
.00
2.0000
$ 55.000.00
$ .00
S 33,000.00
S 66,000.00
0.0000
$
.00
2.0000
$ 66,000.0)
$ .00
2 $ 120.00
$ 240.00
0.0000
$
.00
2.0000
,, 240.00
$ .00
5 5 120.00
$ 360.00
0.0000
$
.00
3.0000
$ 360.00
$ .00
$ .00
$
.00
0.0094
$ 15,000.00
S 15,000.00
$
.00
100.00%
S .00
$ 5,000.00
$
.00
100.007.
5 .00
S 249,000.00
$
.00
100.0041
S 00
$ 12,200.00
S
.00
100.00111
5 .00
S 58,000.00
5
.00
100.00%
$ .00
S 66,000.00
S
00
100 0011;
5 00
S 240.00
S
00
100.00111
$ .00
$ 360.00
$
.00
100.001,
$ .00
Page 5
of 9
A
B
C
D
E
F
G
H
I
1
K
Bid Item
Description
Spec.
UoM
Bid
Unit Price
Bid Value
Estimated
Value this
Previously
Previously
Materials
Total Completed
Retainage
V.
Balance to
No.
Section
Quantity
Quantity
Period
Installed
Installed
Presently
and Stored to
this Period
(H/B)
Finish
No.
Installed this
Quantity
Value
Stored
Date (D+F+G)
(B-H)
Period
(not in F)
LINE
Unit
PLUG & GROUT ABANDON
024114
CY
70
$
120.00
j £,400.00
0.0000
S 00
70.0000
5 S,400.00
,.
.00 $ 5,400.00
1 .00
100 00%
$ .00
1.045
EXISTING 1S" SANITARY SEWER
LINE
Unit
PLUG &GROUT ABANDON
024114
CY
270
5
120.00
5 32,400.00
0.0000
$ .00
270.0000
$ 32,400.00
$
.00 $ 32,400.00
5 .00
100.00%
$ .00
1.049
EXISTING 4S"SANITARY SEWER
LINE
Unit
PART: CONCRETE PATH
32 is 20
SF
1,100
$
8,50
5 9,350.00
0.0000
$ .00
1,100.0000
$ 9,350.00
j
.00 $ 9,350.00
$ .00
100 00%
$ 00
1.050
REPLACEMENT
Unit
PARK CONCRETE PATH
32 13 20
SF
20,200
$
12-00
$ 242,400.00
0.0000
$ .00
20,200.000
$ 242,400.00
5
.00 $ 242,400.00
5 .00
100.00%
5 00
1.051
REMOVAL AND REPLACEMENT
0
Unit
TEMPORARY 1-1/2" ASPHALT
32 12 16
SY
201
$
46.00
$ 9,246.00
0.0000
5 .00
201.0000
$ 9,24&00
$
00 $ 9,246.00
$ .00
100.00%
$ .00
1.052
TRAIL INSTALLATION&
REMOVAL WITH SOIL
DECOMPACTION
Unit
CONCRETE DRIVEWAY
32 1320
SF
1,100
$
11.00
$ 12,100.00
0,0000
$ '00
1,100.0000
$ 12,100.00
$
.00 $ 12,100.D0
$ .00
100.001-
$ .00
1.053
REPLACEMENT
Unit
CONCRETE CURB & GUTTER
32 16 IS
LF
220
$
55,00
$ 12,100.00
135.0000
S 7,425.00
220.0000
$ 12,100.00
$
'00 S 12,100.00
$ 371.25
100.00%
$ 00
1.054
REPLACEMENT
Unit
PAVEMENT PULVERIZATION
024115
SY
7,425
5
4.00
> 29,700.00
1,455.0000
$ 5,940.00
7,425.0000
S 29,700.00
$
.00 $ 29,700.00
$ 297.00
100.001".
5 00
1.055
(VARYING THICKNESSES)
Unit
TEMPORARY ASPHALT PAVING
3305 10
L'r
325
$
55.00
$ 17,375.00
0.0000
5 .00
225.0000
$ 12,375.00
$
.00 $ 12,375.00
5 .00
69.23%
5 5,500.00
L056
REPAIR
(2" HMAC ON 6" FBI
Unit
3" ASPHALT PAVEMENT, TYPE D
32 1216
SY
325
$
25.00
$ 3,125 00
0.0000
$ .00
325.0000
S 5,125.00
$
.00 $ 3,125.00
$ .00
100.00%
00
1.057
(E. MADDOX AVENUE)
Unit
S" CEMENT TREATMENT BASE
321133
SY
325
$
3.00
5 2,600.00
0.0000
$ .00
325.0000
$ 2,600.00
$
.00 $ 2,600.00
$ .00
100.00%
5 00
1.05S
COURSE 26-LB/SY (E. MADDOX
AVENUE)
Unit
2" ASPHALT PAVEMENT, TYPE D
32 1216
SY
4,300
$
14.00
j 67,200.00
1,200.0000
5 16,500.00
4,800.0000
$ 67,200 00
$
00 $ 67,200.00
S 840.00
100.00%
$ 00
1.059
(DUVAL STREET)
Unit
10" CEMENT TREATMENT BASE
32 11 33
SY
4,300
$
2.50
$ 12,000,00
1,200.0000
j 3,000.00
4,600.0000
$ 12,000.00
$
.00 $ 12,000.00
$ 150.00
100.001.
$ .00
1.060
COURSE 2S-L"n/SY (DUVAL
STREET)
Page 6 of 9
A
Bid Item Description Spec. UOM Bid Unit Price
No. Section Quantity
No.
Unit
2" ASPHALT PAVEMENT, TYPE D
32 12 16 SY
1.061
(SYCAMORE PARK DRIVE &
COBB PARK DRIVE)
Unit
S" CEMENT TREATIb1 ENT BASE
32 1135 SY
L062
COURSE AT 26-LB/SY
(SYCAMORE PARR DRIVE U
COBB PARK DRIVE)
Unit
CEMENT TREATMENT (VARYING
321133 TN
1.063
THICKNESSES)
Unit
GRAVEL DRIVEWAY
32 13 20 SF
1.064
RESTORATION
Unit
IRRIGATION REPLACEMENT &
33 4111 LS
1,065
REPAIR ALLOWANCE
Unit
MANHOLE VACUUM TESTING
33 01 30 EA
1.066
Unit
PRE -CCTV INSPECTION
330131 LF
1.067
Unit
POST -CCTV INSPECTION
33 Ol 31 LF
1.065
Unit
EXPLORATORY EXCAVATION OF
33 05 30 EA
1.069
EXISTING UTILITIES
Unit
EXPLORATORY POTHOLE
9999 EA
1.070
EXCAVATION FOR GROUT
ABANDONMENT
DETERMINATION
Un;t
CEMENT STABILIZED SAND
33 0510 CY
1.071
BACKFILL
Unit
PLOWABLE FILL EMBEDMENT
03 M 00 CY
1.072
(CL-M)
Unit
CONSTRUCTION ALLOWANCE
9999
1.073
(SEWER)
U"t
Transportation of 66" FRP SN46
LS
1.074
SS pipe to side designated by
the city COrl
Unit
Purchase of Fort Worth 66" FRP
LF
FORTWORTH
.
Water Construction Invoice
B
Bid Value
2,300 5 15.00 5 S4,500.00
2,300 5 2.50 $ 5,750.00
C
D
E
F
G
H
I
1
K
Estimated
Value this
Previously
Previously
Materials
Total Completed
Retainage
%
Balance to
Quantity
Period
Installed
Installed
Presently
and Stored to
this Period
(H/B)
Finish
Installed this
Quantity
Value
Stored
Date (D+F+G)
(B_H)
Period
(not in F)
0.0000
.00
0.O000
S 00
5 .00
5 .00
5 .00
0.00111
$ 34,500.00
0.0000
5 .00
0.0000
5 .0o
5 00
s .00
,. .00
0.001.;
5 5,750.00
105
$ 220.00
$ 23,100.00
21.0000
S 4,620.00
105.0000
$ 23,100.00
5
.00
$ 23,100.00
$
2E1.00
100.009E
5
.00
820
5 3.00
5 2,460.00
0.0000
$
.00
S20.0000
5 2,460.00
$
.00
$ 2,460.00
$
.00
100.001,£
S
.00
1
$ 15,000.00
$ .00
0.0000
,00
0.0000
$
'00 $
.00
S
.00 $
'00
0.009E
5
CO
165.00
5 5,28000
0,0000
5
.00
32.0000
5 5,230.00
$
.00
$ 5,230.00
5
.00
100.00%
$
M
500
$ 1.40
$- 2£0.00
0.0000
$
.00
0.0000
$
.00 $
.00
5
.00 $
.00
0.001,
5- 2So.00
3,000
$ 1.00
$ 6,000.00
395.0000
$ 395.00
2,275.0000
$ 2,275.00
$
.00
$ 2,275.00
5
19.75
28.444E
5 5,725.00
17
5 1,400.00
$ 23,£00.00
0.0000
$
.00
17.0000
$ 23,500.00
$
.00
$ 23,300.00
$
.00
100.004G
$
GO
10
5 700.00
S 7,000.00
0.0000
$
.00
1D.D000
S 7,000,00
5
.00
S 7,000.00
5
.00
100.00P11
$
.00
150
$ 70.00
$ .00
0.0000
$
.00
0.0000
$
.DO $
.00
S
.00 $
.00
0.00%
,,
.00
250
S i05.00
$ 17,650.00
0.0000
11
.00
170.0000
$ 17,550.00
5
00
$ 17,250.00
5
.00
100,009.
$
00
0
$ .00
0.0000
j
00
0.0000
$
,00 $
.00
S
.00 5
.00
0.00%
$
.00
0
S 11,502.62
$ 11,502.62
0.0000
$
.00
1.0000
5 11,502.62
$
.00
$ 11,502.62
$
.00
100.00%
5
.00
0 5 276.59 $ 45,424.63 0.0000 $ .00 157.0000 $ 43,424.63 $ .00 S 43,424.63 S .00 100.001s, S CO.
Page 7 of 9
Bid Item Description
No.
1.075 SN46 SSWR Pipe CO»1
FORTWORTH.
Water Construction Invoice
A B
Spec. UOM Bid Unit Price Bid Value
Section Quantity
No.
Unit Installation of S-inch sewer LS
1.076 collector main and related
appurtanances CO42
Unit REINFORCED 96" DIA POLYMER 13 39 30 EA
2.001 MANHOLE
Unit REINFORCED 60" DIA. TYPE A 33 39,10 EA
2.002 POLYMER MANHOLE (UP TO 6'
DEPTH)
Unit REINFORCED 60" DIA. TYPE A 31, 3930 EA
Z003 OUTSIDE DROP MANHOLE (UP
TO 6'DEPTH)
Unit REINFORCED 4£" DIA. TYPE .3 39 30 EA
2,004 STANDARD MANHOLE
Unit ADDITIONAL VERTICAL DEPTH 33 39 30 VF
2.005 ON REINFORCED 60" DIA.
POLYMER MANHOLE (ALL
TYPES)
Unit S" DI WATER LINE 331112 LF
3001
Unit 3" DI WATER LINE 33 05 22 LF
3.002 (B`! OTHER THAN OPEN CUT IN
20" STEEL CASING)
Unit DUCTILE IRON WATER FITTINGS 311111 TON
3.003 W/ RESTRAINT
Unit £" GATE VALVE 33 12 20 EA
3.004
Unit 6" GATE VALVE 33 1220 EA
3.005
Unit CONNECTION TO EXISTING 4- 331225 EA
3.006 12 WATER MAIN
Unit CONSTRUCTION SURVEY 01 71 23 LS
3.007 (REDLINE AS-BUILT)GPS
Unit CONSTRUCTION STAKING 01 71 23 LS
2.008
0 5 1S2,OS2.33 $ 182,08233
6 $ 44,200.00 S 265,200.00
20 $ 10,700.00 $ 214,000.00
$ 17,000.00 S 34,000.00
4 $ 12,000.00 $ 43,000.00
2311 5 200.00 5 46,400.00
C
D
E
F
Estimated
Value this
Previously
Previously
Quantity
Period
Installed
Installed
Installed this
Quantity
Value
Period
0.0500
S 9,104 12
1.0000
$ 152,08233
0.0000
5 .00
6.0000
$ 265,200.00
0.0000
5 .00
20.0000
S 214,000.00
0.0000
$ .00
2.0000
$ 34,000.00
0.0000
$ .00
4.0000
$ 43,000.00
0.0000
$ .00
232.0000
$ 46,400.00
G H I 1 K
Materials Total Completed Retainage % Balance to
Presently and Stored to this Period (H/B) Finish
Stored Date(D+F+G) (B-H)
(not in F)
5 DO $ 182,032.33 $ 455.21 100.00% S 00
S .00 5 265,200.00 $ .00 100.001:1� S 00
$ .00 $ 214,000.00 S '00 100.0011. $ 00
$ .00 5 34,000.00 S .00 100.009G S .00
$ .00 $ 48.000.00 $ .00 100.00°1. $ 00
$ .00 $ 46,400.00 $ .00 100.00% $ .00
50
$ 145.00
5 7,250.00
0.0000
$
.00 50.0000
$ 7,250.00
$ .00
396
$ 450.00
$ 175,200.00
0.0000
S
.00 396,0000
$ 178,200,00
S .00
1
$ 3,000.00
5 4,000.00
0.0000
$
.00 1.0000
$ 4,000.00
$ .00
1
S 1,650.00
S 1,650.00
0.0000
$
.00 1.0000
$ 1,650.00
$ .00
1
5 1,250.00
5 1,250.00
0.0000
$
.00 1.0000
5 1,250.00
$ .00
2
$ 31000.00
$ 6,000.00
0.0000
5
.00 10000
$ 6,000.00
$ .00
1
$ 5C0.00
S 500.00
1.0000
$ 500.00
1.0000
$ 500.00
$ .00
1
5 1,000.00
5 1,000.00
0.0000
$
.00 1.0000
5 1,000.00
5 .00
5 7,250.00 5 .00 100.00% 5 '00
$ 178,200.00 $ .00 100.00`i" S .00
5 4,000.00 $ .00 100.00"XI 5 00
$ 1,650.00 $ .00 100.00% .00
5 1,250.00 S .00 100.00% $ 00
$ 6,000,00 $ 00 100.009b 5 00
$ 500.00 $ 25.00 100.00% $ 00
$ 1,000.00 S .00 100.00% S .00
Page 8 of 9
CONTRACTOR'S APPLICATION FOR PAYMENT
PAY REQUEST NO: 34 (FINAL)
PERIOD FROM: 16-Jun-25
PROJECT: Sycamore Creek Relief Interceptor Phase 3
OWNER: City of Fort {forth Texas
City of Fort Worth {Pater Department
311 W 70th Street
Fort Worth, Texas, 76102
BIDS RECEIVED: 02/18/21 CONTRACT DATE:
CONTRACT AMOUNT: $9,687,177.00 CALENDAR DAYS:
ADJUSTMENTS: $ (16,580.42) EXTENSIONS:
REVISED AMOUNT: $9,670,596.58 REVISED DAYS:
SUMMARY OF JOB STATUS:
Total Work Completed
$
9,576,719.58
Material Stored on Site
$
-
Subtotal
$
9,576,719.58
Less 5% Retained
Subtotal
$
9,576,719.58
Less Previous Payments
$
9,097,883.60
Amount Due This Period
$
478,835.98
SUBMITTED BY:
BY:6Aw Rmo4u
Chase Randall Project Manager
Date: 7/2/25
WORK COMPLETED 95% TIME:
DATE: 2-Jul-25
TO: 30-Jun-25
ENGINEER: Lockwood, Andrews & Newnamn, Inc.
CONTRACTOR: Thalle Construction Co., Inc.
900 NC 86 North
Hillsborough, NC27278
7/8/2021 NOTICE TO PROCEED: 11/8/2021
540 COMPLETION DATE: 3/2/2023
0
1340 REVISED DATE: 7/10/2025
VERIFIED BY: FT WORTH INSPECTOR
By:
Name City Inspector
Date:
CEC / MAESTAS REVIEW:
By:
Name
Date:
LAN Engineer Approval:
By:
Name
Date:
Project Engineer
Project Engineer
APPROVED FOR PAYMENT BY: Fort Worth Project Manager
By:
Name Project Manager
Date:
95.00%
CONTRACTOR'S APPLICATION FOR PAYMENT
PAY REQUEST NO: 33
PERIOD FROM: 16-MaV-25
PROJECT: Sycamore Creek Relieflntereeptor Phase 3
OR'NER: City of Fort {Borth Texas
City of Fort {forth Water Department
311 JV.. 10th Street
Fort {forth, Texas, 76102
BIDS RECEIVED: 02/18/21 CONTRACT DATE:
CONTRACT AMOUNT: $9,687,177.00 CALENDAR DAYS:
ADJUSTMENTS: $ (16,580.42) EXTENSIONS:
REVISED AMOUNT: $9,670,596.58 REVISED DAYS:
SUMMARY OF JOB STATUS:
Total Work Completed
$
Material Stored on Site
$
Subtotal
$
Less 5% Retained
Subtotal
$
Less Previous Payments
$
Amount Due This Period
$
SUBMITTED BY:
By:RAue RaKal &
Chase Randall
Date: 6/3/25
DATE: 20-1un-25
TO: 15-Jun-25
ENGINEER: Lockwood, Andrews & Newnarn, Inc.
CONTRACTOR: Thalle Construction: Co., Inc.
900 NC 86 North
Hillsborough, NC 2 72 78
7/8/2021 NOTICE TO PROCEED: 11/8/2021
540 COMPLETION DATE: 3/2/2023
0
1340 REVISED DATE: 7/10/2025
VERIFIED BY: FT WORTH INSPECTOR
9,576,719.58
By:
Name City Inspector
Date:
9,576,719.58
CEC / MAESTAS REVIEW:
$0.00
By:
9,576,719.58
Name Project Engineer
9,038,089.54
Date:
538,630.04
LAN Engineer Approval:
By:
Name Project Engineer
Date:
Project Manager APPROVED FOR PAYMENT BY: Fort Worth Project Manager
By:
Name Project Manager
Date:
WORK COMPLETED 95% TIME: 95.00%