HomeMy WebLinkAboutContract 61215-FP1-FP1
FORT WORTH.
City Secretary 61215
Contract No.
Date Received 08/18/2025
AT
NOTICE OF PROJECT COMPLETION
(Developer Projects)
The Transportation and Public Works Department upon the recommendation of the Project
Manager has accepted the following project as complete:
Project Name: Premium Waters Sewer Relocation
City Project No.: 104945
Improvement Type(s): Water ❑x Sewer ❑x
i—c— was rrsosz raorsacoJ0 Original Contract Price: 167,717.00
Amount of Approved Change Order(s): $19,127.86
Revised Contract Amount: $186,844.86
Total Cost of Work Complete: $186,844.86
08/11/2025
Contractor Date
Project Manager
Title
Maverick Utility, Inc.
Company Name
08/11/2025
Hector ont a ue 11, 202515:04:22 CDT)
Project Inspector
Date
—i
08/15/2025
Project Manager
Date
)0w4,0,w,&
08/18/2025
CFA Manager
Date
08/18/2025
TPW Director
Date
C-�P�
08/18/2025
Asst. City Manager
Date
OFFICIAL RECORD
CITY SECRETARY Page 1 of 2
FT. WORTH, TX
Notice of Project Completion
Project Name: Premium Waters Sewer Relocation
City Project No.: 104945
City's Attachments
Final Pay Estimate ❑x
Change Order(s): ❑x Yes ❑ N/A
Pipe Report: ❑x Yes ❑ N/A
Contractor's Attachments
Affidavit of Bills Paid '
Consent of Surety
Statement of Contract Time
Contract Time: 45
Work Start Date: 6/11 /2024
Completed number of Soil Lab Test: 111
Completed number of Water Test: 0
Days Charged: 147
Work Complete Date: 1/24/2025
Page 2 of 2
FORT WORT 11
CITY OF FORT WORTH
FINAL PAYMENT REQUEST
Contract Name PREMIUM WATERS SEWER RELOCATION
Contract Limits
Project Type WATER & SANITARY SEWER
City Project Numbers 104945
DOE Number 4945
Estimate Number 1 Payment Number 1
City Secretary Contract Number
Contract Date
Project Manager NA
Contractor MAVERICK UTILITY CONSTRUCTION
P.O. BOX 728
Inspectors
For Period Ending 1/24/2025
WD
Contract Time 4WD
Days Charged to Date 147
Contract is 100.00 Complete
EULESS , TX 76039
G.DEYON / H.MONTOYA
Tuesday, June 17, 2025 Page 1 of 4
City Project Numbers 104945 DOE Number 4945
Contract Name PREMIUM WATERS SEWER RELOCATION Estimate Number I
Contract Limits Payment Number 1
Project Type WATER & SANITARY SEWER For Period Ending 1/24/2025
Project Funding
UNIT II: SANITARY SEWER IMPROVEMENTS
Item
Description of Items
Estimated Unit
Unit Cost
Estimated
Completed
Completed
No.
Quanity
Total
Quanity
Total
1
SANITARY LINE GROUTING (CO#1)
25 CY
$150.00
$3,750.00
25
$3,750.00
2
12" SEWER ABANDONMENT PLUG (CO#1)
1 EA
$550.00
$550.00
1
$550.00
3
UTILITY SERVICE SURFACE RESTORATION
3078 SY
$1.62
$4,986.36
3078
$4,986.36
SEEDING(CO#1)
4
CONCRETE COLLAR FOR MANHOLE(CO#1)
4 EA
$450.00
$1,800.00
4
$1,800.00
5
8" SEWER PIPE(CO#1)
30 LF
$65.00
$1,950.00
30
$1,950.00
6
12" SEWER PIPE(CO#1)
927 LF
$95.00
$88,065.00
927
$88,065.00
7
EPDXY MANHOLE LINER(CO#1) (CO#4)
55.3 VF
$325.00
$17,972.50
55.3
$17,972.50
8
4' MANHOLE(CO#1)
4 EA
$7,588.00
$30,352.00
4
$30,352.00
9
4'EXTRA DEPTH MANHOLE(CO#1) (CO#4)
46.3 VF
$450.00
$20,835.00
46.3
$20,835.00
Sub -Total of Previous Unit $170,260.86 $170,260.86
UNIT I: WATER IMPROVEMENTS
Item Description of Items Estimated Unit Unit Cost
Estimated
Completed
Completed
No. Quanity
Total
Quanity
Total
1 2" WATER SERVICE (CO#3) 1 EA $5,303.00
$5,303.00
1
$5,303.00
2 12" X 8" TAPPING SLEEVE & VALVE (CO#3) 1 EA $11,281.00
--------------------------------------
$11,281.00
1
$11,281.00
Sub-Total of Previous Unit
$16,584.00
$16,584.00
Tuesday, June 17, 2025 Page 2 of 4
City Project Numbers 104945
Contract Name PREMIUM WATERS SEWER RELOCATION
Contract Limits
Project Type WATER & SANITARY SEWER
Project Funding
Contract Information Summary
Original Contract Amount
Change Orders
Change Order Number 1
Change Order Number 2
Change Order Number 3
Change Order Number 4
Total Contract Price
DOE Number 4945
Estimate Number I
Payment Number I
For Period Ending 1/24/2025
$167,717.00
($167,717.00)
$167,703.36
$16,584.00
$2,557.50
$186,844.86
Total Cost of Work Completed $186,844.86
Less % Retained $0.00
Net Earned $186,844.86
Earned This Period $186,844.86
Retainage This Period $0.00
Less Liquidated Damages
Days @ / Day
LessPavement Deficiency
Less Penalty
Less Previous Payment
Plus Material on Hand Less 15%
Balance Due This Payment
$0.00
$0.00
$0.00
$0.00
$0.00
$186,844.86
Tuesday, June 17, 2025 Page 3 of 4
City Project Numbers 104945 DOE Number 4945
Contract Name PREMIUM WATERS SEWER RELOCATION Estimate Number I
Contract Limits Payment Number I
Project Type WATER & SANITARY SEWER For Period Ending 1/24/2025
Project Funding
Project Manager NA City Secretary Contract Number
Inspectors G.DEYON / H.MONTOYA Contract Date
Contractor MAVERICK UTILITY CONSTRUCTION Contract Time 45 WD
P.O. BOX 728 Days Charged to Date 147 WD
EULESS , TX 76039 Contract is .000000 Complete
CITY OF FORT WORTH
SUMMARY OF CHARGES
Line Fund Account Center Amount Gross Retainage Net
Funded
Total Cost of Work Completed $186,844.86
Less % Retained $0.00
Net Earned $186,844.86
Earned This Period $186,844.86
Retainage This Period $0.00
Less Liquidated Damages
0 Days @ $0.00 / Day
$0.00
LessPavement Deficiency
$0.00
Less Penalty
$0.00
Less Previous Payment
$0.00
Plus Material on Hand Less 15%
$0.00
Balance Due This Payment
$186,844.86
Tuesday, June 17, 2025 Page 4 of 4
REVIEWED
By George Marqeuez, P.E. at 10:39 am, May 15, 2025
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
(PROJECT NAME:
Premium Waters Sewer Relocation
(CONTRACT:
CHANGE
Sewer
ORDER No:
CFA #
CFA23-0169 I
CITY PARTICIPATION:(
NO
CITY PROJECT #
104945
CITY SECRETARY CONTRACT #
I
FID #
130114-0200431-104945-EO7685
,I
X #
I X-27858
IFILE #
IX-27858
INSPECTOR:
Hector Montoya Phone No:
682-215-9539
PROJECT MANAGER:
George Marquez Phone No:
682-263-3904
CONTRACT UNIT
WATER SEWER
DRAINAGE
PAVING
STREET
LIGHTS
Developer
Developer Developer
Developer
Cost
City Cost Developer Cost
City Cost
Cost City Cost Cost
City Cost
Cost
City Cost
(ORIGINAL CONTRACT
$o.00
$0.00 $167,717.00
$0.00
$0.00 $0.00
$0.00
$0.00
$0.00
$0.00
EXTRAS TO DATE
$0.00
$0.00 $0.00
$0.00
I $0.00 $0.00
$0.00
$0.00
$0.00
$0.00
CREDITS TO DATE
I $0.00
$0,00 I $0.00
$0.00
I $0.00 $0.00 I
$0.00
$0.00
I $0.00
$0.00
CONTRACT TO DATE
I $0.00
$0.00 I $167,717.00
$0.00
I $0.00 $0.00 I
$0.00
$0.00
I $0.00
$0.00
AMOUNT OF PROP. CHANGE ORDER
I $0.00
$0.00 I ($167,717.00)
$0.00
I $0.00 I $0.00 I
$0.00
$0.00
$0.00
I $0.00
REVISED CONTRACT AMOUNT
I $0.00
$0.00 I $0.00
$0.00
I $0.00 I $0.00 I
$0.00
$0.00
$0.00
I $0.00
TOTAL REVISED CONTRACT AMOUNT PER
UNIT
I
$0.00
I $0.00
I $0.00
I
$0.00
I
$0.00
REVISED COST SHARE
Dev. Cost:
$0.00
City Cost:
$0.00
TOTAL REVISED CONTRACT I
$0.00
WORKING
DAYS
90
90
0
90
Revised: 12-17-2018 Page 1
REVIEWED
By George Marqeuez, P.E. at 10:40 am, May 15, 2025
You are directed to make the following changes in the contract documents:
UNIT It:
SANITARY SEWER IMPROVEMENTS
CITY BID ITEM
CFW Unit
PAY ITEM #
#
QUANTITY
UNIT
ITEM DESCRIPTION Price
1
241.2001
(25)
CY
Sanitary Line Grouting
2
241.2105
(1)
EA
12" Sewer Abandonment Plug
3
3292,0201
(3078)
SY
Ulilitiy Service Surface Restoration Seeding
4
3305.0112
(4)
EA
Concrete Collar for Manhole
5
3331.4115
(30)
LF
8" Sewer Pipe
6
3331.4208
(927)
LF
12" Sewer Pipe
7
3339.0001 1
(52)
VF
Epoxy Manhole Liner
8
13339.1001
(4)1
EA I
4' Manhole
9
13339.1003
(43)1
VF I
4' Extra Depth Manhole
TOTAL UNIT It: SEWER IMPROVEMENTS
Asterisk (*) indicates New Pay Item
UNIT PRICE
Developer Cost
City Cost
TOTAL
$150.00
($3,750.00)
$0.00
($3,750.00)
$550.00
($550.00)
$0.00
($550.00)
$1.62
($5,000.00)
$0.00
($5,000.00)
$450.00
($1,800.00)
$0.00
($1,800.00)
$65.001
($1,950.00)
$0.00
($1,950.00)
$95.001
($88,065.00)
$0.00
($88,065.00)
$325.001
($16,900.00)
$0.00
($16,900.00)
$7,588.00
($30,352.00)
$0.00
($30,352.00)
$450.001
($19,350.00)
$0.00
($19,350.00)
($167,717.001 0.00 ($167,717.00)
1
Revised: 12-17-2018 Page 2
VVV-.JII LI IvulwpG - UJVJJJJJ-VV 11'Yl1Vfl'ULL V'JI 1-/ unu IU/'�JV
REVIEWED
By George Marqeuez, P.E. at 10:40 am, May 15, 2025
REASONS FOR CHANGE ORDER The original contract amount was wrong. This is the second of two change orders to correct the value of the original contract.
RECOMMENDED: APPROVED: APPROVED:
B : `-' Date: 05/15/2025 By: l� fire Date: 5/6/2025 12:07�yM PDT &-t Date: 5- 12"2rj
a
Name: Tyler Reeves, PE Name: John Trojacek Name: Brff"erle JVZ�;+n
Title: Engineer Title: Developer Title: Contractor
APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY:
By: Not Applicable Date: By: Not Applicable Date: By: Not Applicable Date:
Name: Not Applicable Name: Not Applicable Name: Not Applicable
Title: Not Applicable Title: Not Applicable Title: Not Applicable
RECOMMENDED:
CFW - 'Contract Compliance Manager
By: ��d 2,Cy� ii � lJ Ll,G� Date: 5/15/2025
Na .:George Marquez
Title: CFW Project Manager
M&C Number:
M&C Date Approved:
N/A
N/A
ATTEST
By: Not Applicable Date:
Name: Jannette S. Goodall
Title: City Secretary
' Contract Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract,
and ensuring all performance and reporting requirements.
There are NO City Funds associated with this Contract
❑ There are City Funds associated with this Contract
Revised: 12-17-2018 Page 3
IPROJECT NAME
(CONTRACT:
CFA #
CITY PROJECT #
CITY SECRETARY CONTRACT #
FID #
X#
(FILE #
INSPECTOR:
PROJECT MANAGER:
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
Premium Waters Sewer Relocation
Sewer
CFA23-0169 I CITY PARTICIPATION:( NO
104945
30114-0200431-104945-EO7685
X-27858
X-27858
Hector Montoya Phone No: 682-215-9539
George Marquez Phone No: 682-263-3904
REVIEWED
By George Marqeuez, P.E. at 10:42 am, May 15, 2025
CHANGE
ORDER No:
2
I CONTRACT UNIT
WATER SEWER DRAINAGE PAVING STREET LIGHTS I WORKING
Developer Developer Developer DAYS
Cost City Cost Developer Cost City Cost Cost City Cost Cost City Cost Developer Cost City Cost
IORIGINAL CONTRACT
$0.00
$0.00
$167,717.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
90
EXTRAS TO DATE I
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
CREDITS TO DATE I
$0.00
$0.00
$167,717.00
50.00
$0.00
$0.00
$0.00
$0.00
$0,00
$0.00
CONTRACT TO DATE I
$0.00 I
$0.00
I $0.00 I
$0.00
I $0.00
$0.00
$0.00
I $0.00
$0.00 I
;0.00 I
90
AMOUNT OF PROP. CHANGE ORDER
$0.00 I
$0.00
I $167,703.36 I
$0.00
I $0.00
$0.00
$0.00
I $0.00
I $0.00 I
$0.00
0
REVISED CONTRACT AMOUNT
$0.00 I
$0.00
I $167,703.36 I
$0.00
I $0.00
$0.00
$0.00
I $0.00
I $0.00 I
;0.00
90
TOTAL REVISED CONTRACT AMOUNT PER
UNIT
$0.00
$167,703.36
I
$0.00
$0.00
I $0.00
REVISED COST SHARE I
Dev. Cost:
$167,703.36
City Cost:
$0.00
II
I TOTAL REVISED CONTRACT I
$167,703.36
Revised: 12-17-2018 Page 1
You are directed to make the following changes in the contract documents:
PAY ITEM #
1
2
3
4
5
6
7
8
9
Asterisk (`) indicates New Pay Item
CITY BID ITEM
241.2001
241.2105
3292.0201
3305.0112
3331.4115
3331.4208
13339.0001
13339.1001
13339.1003
1
QUANTITY
25
1
3078
4
30
9271
521
4
43
REVIEWED
By George Marqeuez, P.E. at 10:42 am, May 15, 2025
UNIT II: SANITARY SEWER IMPROVEMENTS
CFW Unit
UNIT
ITEM DESCRIPTION Price
CY
Sanitary Line Grouting
EA
12" Sewer Abandonment Plug
SY
Utilitiy Service Surface Restoration Seeding
EA
Concrete Collar for Manhole
LF
8" Sewer Pipe
LF
12" Sewer Pipe
VF
Epoxy Manhole Liner
EA
4' Manhole
VF
4' Extra Depth Manhole
TOTAL UNIT It: SEWER IMPROVEMENTS
UNIT PRICE I
Developer Cost
City�
Cost
TOTAL
$150.001
$3,750.00
$0.00
$3,750.00
$550.001
$550.00
$0.00
$550.00
$1.621
$4,986.36
$0.00
$4.986.36
$450.001
$1,800.00
$0.00
$1,800.00
$65.001
$1,950.00
$0.00
$1.950.00
$95.001
$88,065.00
$0.00
1
$88,065.00
$325.001
$16,900.00 '
$0.00
$16,900.00
$7,588.001
$30,352.00 I
$0.00
$30,352.00
$450.001
$19,350.00 I
$0.00
$19,350.00
$167.703.36
$0.00
I
$167,703.36
Revised: 12-17-2018 Page 2
REVIEWED
By George Marqeuez, P.E. at 10:42 am, May 15, 2025
REASONS FOR CHANGE ORDER The original contract amount was wrong. This is the first of two change orders to correct the value of the original contract.
RECOMMENDED: APPROVED: APPROVED:
By: /i/�—t "'' Date: 05/15/2025 By. I rga" Date: 5/6/2025 1 12:07 gy PDT /4 4 Date: �] - 12' ZS
Name: Tyler Reeves, PE Name: John Trojacek Name: $ryerr*We 3V51 r" —orra� "t'r►
Title: Engineer Title: Developer Title: Contractor
APPROVAL RECOMMENDED: APPROVED: APPROVED AS TO FORM AND LEGALITY:
By: Not Applicable Date: By: Not Applicable Date: By: Not Applicable Date:
Name: Not Applicable Name: Not Applicable Name: Not Applicable
Title: Not Applicable Title: Not Applicable Title: Not Applicable
RECOMMENDED:
CFW - `Contract Compliance Manager
By:�Q84r 7vi�,?/2,1 UZ1 Date: 5/15/2025
Name:Georgee Marquez /�
Title: CFW Project Manager
M&C Number: N/A
M&C Date Approved: N/A
ATTEST
By: Not Applicable Date:
Name: Jannette S. Goodall
Title: City Secretary
Contract Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract,
and ensuring all performance and reporting requirements.
0 There are NO City Funds associated with this Contract
❑ There are City Funds associated with this Contract
Revised: 12-17-2018 Page 3
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME:
Premium Waters Sewer Relocation
CONTRACT:
Sewer
CFA#
CFA23-0169
CITY PARTICIPATION:1 NO
CITY PROJECT #
104945
CITY SECRETARY CONTRACT #
FID #
30114-0200431-104945-EO7685
X #
X-27858
FILE #
X-27858
INSPECTOR:
Hector Montoya
Phone No:
682-215-9539
PROJECT MANAGER:
George Marquez
Phone No:
682-263-3904
CONTRACT UNIT
WATER
I SEWER
DRAINAGE
Lveloper
Developer
b
Cost
City Cost
Developer Cost
City Cost
Cost
City Cost C
ORIGINAL CONTRACT
$0.00
$0.00
$167,717.00
I $0.00
I $0.00 I $0.00
EXTRAS TO DATE
$0.00
$0.00
$167,703.36
I $0.00
I $0.00 I $0.00
CREDITS TO DATE
$0.00
$0.00
$167,717.00
I $0.00
I $0.00 I $0.00
CONTRACT TO DATE
$0.00
$0.00
$167,703.36
I $0.00
I $0.00 I $0.00
AMOUNT OF PROP. CHANGE ORDER
$16,584.00
$0.00
$0.00
I $0.00
I $0.00 I $0.00
REVISED CONTRACT AMOUNT
$16,584.00
$0.00
$167,703.36
I $0.00
I $0.00 I $0.00
TOTAL REVISED CONTRACT AMOUNT PER
UNIT
$16,584.00
$167,703.36
$0.00
REVISED COST SHARE
Dev. Cost: $184,287.36
City Cost:
TOTAL REVISED CONTRACT
$184,287.36
REVIEWED
By George Marqeuez, P.E. at 10:42 am, May 15, 2025
CHANGE
ORDER No:
3
PAVING
I STREET LIGHTS
I
I CONTRACT
doper
beveloper
DAYS
City Cost
Cost
City Cost
$0.00
$0.00
$0.00
$0.00
90
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
90
$0.00
$0.00
$0.00
$0.00
0
$0.00
$0.00
$0.00
$0.00
90
$0.00
$0.00
$0.00
Revised: 12-17-2018 Page 1
REVIEWED
You are directed to make the following changes in the contract documents:
PAY ITEM #
1`
2`
Asterisk (*) indicates New Pay Item
CITY BID ITEM
# QUANTITY
3312.2203 1.00
3312.4107 1.00
By George Marqeuez, P.E. at 10:42 am, May 15, 2025
UNIT I: WATER IMPROVEMENTS
UNIT ITEM DESCRIPTION CFW Unit Price UNIT PRICE
EA 1 2" Water Service $5303.00
EA 12" x 8" Tapping Sleeve and Valve $11281.00
TOTAL UNIT I: WATER IMPROVEMENTS
Developer
Cost City Cost TOTAL
$5,303.00 $5,303.00
$11,281.00 $11,281.00
$16.584.01 0.00 $16,584.00
Revised: 12-17-2018 Page 2
Docusign Envelope ID: FOF67FFB-9E4F-419E-9008-3E821721 F72C
REVIEWED
By George Marqeuez, P.E. at 10:42 am, May 15, 2025
REASONS FOR CHANGE ORDER Two water taps from the existing public water line were needed. One for a 2" irrigation service, and the other for a private 8" fire line.
RECOMMENDED:
APPROVED:
APPROVED:
By:
05/15/2025 By:
I
3a� fi�a
Digitally s,,n,l by Bryan Yule
Bryan n Y u 1 e DN: D=US, E=6yul C—t—ilit , CN-
By: ouPJ1:e ckunlilycnnsh�ctinn,cN=eryan
05/15/2025 e
e nq 97 in91---nn-
Name: Tvler Reeves, PE
Name:
John Trojacek
Name: Bryan Yule
Title: Engineer
Title:
Developer
Title: Contractor
APPROVAL RECOMMENDED: APPROVED:
APPROVED AS TO FORM AND LEGALITY:
By:
By:
By:
N/A
N/A N/A
Name:
Name:
Name:
Title:
Title:
Title:
RECOMMENDED:
CFW - `Contract Compliance Manager
ATTEST
* Contract Compliance Manager (Project Manager):
�/
By signing I acknowledge that I am the person responsible
By:
( a—&tQ� GIG
N/A
for the monitoring and administration of this contract, include
!//� (% to
ensuring all performance and reporting requirements.
Name:
George Marquez 5 /2025
Jannette S. Goodall
City Secretary
0 There are NO City Funds associated with this Contract
Title:
CFW Project Manager
El There are City Funds associated with this Contract
M&C Number:
M&C Date Approved:
Revised: 12-17-2018 Page 3
DEVELOPER -AWARDED -PROJECT CHANGE ORDER
PROJECT NAME:
Premium Waters Sewer Relocation
CONTRACT:
Sewer
CFA#
CFA23-0169
CITY PARTICIPATION:1 NO
CITY PROJECT #
104945
CITY SECRETARY CONTRACT #
FID #
30114-0200431-104945-EO7685
X #
X-27858
FILE #
X-27858
INSPECTOR:
Hector Montoya
Phone No:
682-215-9539
PROJECT MANAGER:
George Marquez
Phone No:
682-263-3904
CONTRACT UNIT
WATER
I SEWER
DRAINAGE
Lveloper
Developer
b
Cost
City Cost
Developer Cost
City Cost
Cost
City Cost C
ORIGINAL CONTRACT
$0.00
$0.00
$167,717.00
I $0.00
I $0.00 I $0.00
EXTRAS TO DATE
$16,584.00
$0.00
$167,703.36
I $0.00
I $0.00 I $0.00
CREDITS TO DATE
$0.00
$0.00
$167,717.00
I $0.00
I $0.00 I $0.00
CONTRACT TO DATE
$16,584.00
$0.00
$167,703.36
I $0.00
I $0.00 I $0.00
AMOUNT OF PROP. CHANGE ORDER
$0.00
$0.00
$2,557.50
I $0.00
I $0.00 I $0.00
REVISED CONTRACT AMOUNT
$16,584.00
$0.00
$170,260.86
I $0.00
I $0.00 I $0.00
TOTAL REVISED CONTRACT AMOUNT PER
UNIT
$16,584.00
$170,260.86
$0.00
REVISED COST SHARE
Dev. Cost: $186,844.86
City Cost:
TOTAL REVISED CONTRACT
$186,844.86
REVIEWED
By George Marqeuez, P.E. at 10:43 am, May 15, 2025
CHANGE
ORDER No:
4
PAVING
I STREET LIGHTS
I
I CONTRACT
doper
beveloper
DAYS
City Cost
Cost
City Cost
$0.00
$0.00
$0.00
$0.00
90
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
90
$0.00
$0.00
$0.00
$0.00
0
$0.00
$0.00
$0.00
$0.00
90
$0.00
$0.00
$0.00
Revised: 12-17-2018 Page 1
REVIEWED
You are directed to make the following changes in the contract documents:
PAY ITEM #
7
9
Asterisk (*) indicates New Pay Item
CITY BID ITEM
# QUANTITY
3339.1001 3.30
3339.1003 3.30
By George Marqeuez, P.E. at 10:43 am, May 15, 2025
UNIT II: SANITARY SEWER IMPROVEMENTS
UNIT ITEM DESCRIPTION CFW Unit Price UNIT PRICE
VF Epoxy Manhole Liner $325.00
VF 4' Extra Depth Manhole $450.00
TOTAL UNIT II: SANITARY SEWER IMPROVEMENTS
Developer
Cost
City Cost
TOTAL
$1,072.50
$1,072.50
$1,485.00
$1,485.00
$2,557.50
$0.00 $2,557.50
Revised: 12-17-2018 Page 2
Docusign Envelope ID: FOF67FFB-9E4F-419E-9008-3E821721 F72C
REVIEWED
By George Marqeuez, P.E. at 10:43 am, May 15, 2025
REASONS FOR CHANGE ORDER Sewer manhole rims needed to be adjusted to be at finished grade, not existing.
RECOMMENDED:
APPROVED:
APPROVED:
05/15/2025
II
36Lt L fiV'D,� 05/15/2025
Digitally squel by Bryan Yule
J C=US, E -duty @mavutili n, CN ,
DaMaverick Utility Construction,' Bryan Yule
Bryan YuleDate
Dale: 2024.99.2710:21:3I-05'00'
By:
By:
By:
Name:teeves, PE
Name:
John Trojacek
Name: Bryan Yule
Title: Engineer
Title:
Developer
Title: Contractor
APPROVAL RECOMMENDED: APPROVED:
By: By:
N/A
Name: Name:
Title: Title:
RECOMMENDED:
CFW - *Contract Compliance Manager ATTEST
By:
Name: George Marquez
Title: CFW Project Manager
M&C Number: N/A
M&C Date Approved: N/A
N/A
5/15/2025 Jannette S. Goodall
City Secretary
APPROVED AS TO FORM AND LEGALITY:
By:
N/A N/A
Name:
Title:
* Contract Compliance Manager (Project Manager):
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, include
ensuring all performance and reporting requirements.
0 There are NO City Funds associated with this Contract
El There are City Funds associated with this Contract
Revised: 12-17-2018 Page 3
FORT WORTH
TRANSPORTATION AND PUBLIC WORKS
PIPE REPORT FOR:
PROJECT NAME: PREMIUM WATERS SEWER RELOCATION
PROJECT NUMBER: 104945
DOE NUMBER: N/A
WATER
PIPE LAID SIZE TYPE OF PIPE LF
N/A
FIRE HYDRANTS: N/A VALVES (16" OR LARGER)
PIPE ABANDONED SIZE TYPE OF PIPE LF
N/A
DENSITIES: YES
NEW SERVICES: 1 2" Copper 1 EA.
SEWER
PIPE LAID SIZE TYPE OF PIPE LF
SDR-26 PVC 8" SDR-26 PVC 30
SDR-26 PVC 12" SDR-26 PVC 927
PIPE ABANDONED SIZE TYPE OF PIPE LF
SDR-26 PVC 12' SDR-26 PVC 600
DENSITIES: YES
NEW SERVICES: N/A
TRANSPORTATION AND PUBLIC WORKS
s,
`' The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311
(817) 392 - 7941 • Fax: (817) 392 - 7845
FORTWORTH.
M,
TRANSPORTATION AND PUBLIC WORKS
June 12, 2025
MAVERICK UTILITY CONSTRUCTION, INC
1001 W. EULESS BLVD. #312
EULESS, TX 76040
RE: Acceptance Letter
Project Name: PREMIUM WATERS SEWER RELOCATION
Project Type: SEWER IMPROVEMENTS
City Project No.: 104945
To Whom It May Concern:
On February 14, 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 June 12, 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 June 12, 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-
392-6826.
Sincerely,
GEORGE MARQUEZ, Project Manager
Andrew Goodman, Program Manager
Cc: Hector Montoya, Inspector
Gary Deyon, Inspection Supervisor
Edward Davila, Senior Inspector
Andrew Goodman, Program Manager
Kimley Horn, Consultant
Maverick Utility Construction, Inc, Contractor
Premium Waters, Inc, Developer
File
E-Mail: TPW_Acceptance@fortworthtexas.gov
Rev. 8/20/19
AFFIDAVIT
STATE OF TEXAS
COUNTY OF TARRANT
Before me, the undersigned authority, a notary public in the state
and county aforesaid, on this day personally appeared Todd Bonnet,
President Of Maverick Utility, 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;
Sanitary Sewer Improvement
BY
Todd Bonnet - President
Subscribed and sworn before me on this date 6 of Febr, 2025.
.............. ...... ..
BRIAN STEPHAN COOK
NOTARY PUBLIC
STATE OF TEXAS
Not P�li /� `- �'�_ MY COMM. EXP. 10/31/27
Tarrant, TX
NOTARY ID 13059535-4
CONSENT OF
SURETY COMPANY
TO FINAL PAYMENT
PROJECT
TO: (Owner)
OWNER ❑x
ARCHITECT ❑
CONTRACTOR ❑
SURETY ❑
OTHER
Bond No. 5043651
Sewer Improvements to Serve Premium Water Sewer Relocation
City of Fort Worth
Premium Waters, Inc.
PROJECT NO.
CONTRACT FOR: Site Utilities
CONTRACTOR: Maverick Utility Construction, Inc. CONTRACT DATE: APRIL3, 2024
1001 W. Euless Blvd., Suite 312
Euless, TX 76040
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,
the
Employers Mutual Casualty Company , SURETY,
on Bond of
Maverick Utility Construction, Inc.
,CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall
not relieve the Surety Company of any of its obligations to
City of Fort Worth
Premium Waters, Inc.
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
the Surety has hereunto set its hand this
Attest:
(Seal)
, OWNER,
4th day of August 2025
Emolovers Mutual Casualtv Comnanv
Surety Company
Signature of Authorized Representative
Charles K. Miller. Attornev-In-Fact
Title
CONSENT OFSURETY COMPANYTOFINALPAYMENT ONE PAGE
i
*emc_
P.O. Box 712 • Des Moines, Iowa 50306-0712 INSURANCE
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
KNOW ALL MEN BY THESE PRESENTS, that:
1. Employers Mutual Casualty Company, an Iowa Corporation
2. EMCASCO Insurance Company, an Iowa Corporation
3. Union Insurance Company of Providence, an Iowa Corporation
4. Illinois EMCASCO Insurance Company, an Iowa Corporation
5. Dakota Fire Insurance Company, a North Dakota Corporation
6. EMC Property & Casualty Company, an Iowa Corporation
hereinafter referred to severally as `Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint:
CHARLES K. MILLER
its true and lawful attorney -in -fact, with full power and authority conferred to sign, seal, and execute the following Surety Bond(s):
Surety Bond Principal: Obligee:
Number Maverick Utility Construction, City of Fort Worth
Inc.
SO43651
and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all
of the acts of said attorney pursuant to the authority hereby given are hereby ratified and confirmed.
AUTHORITY FOR POWER OF ATTORNEY
This Power -of -Attorney is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at the
first regularly scheduled meeting of each company duly called and held in 1999:
RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have
power and authority to (1) appoint attorneys -in -fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds
and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attorney -in -fact at any time
and revoke the power and authority given to him or her. Attomeys-in-fact shall have power and authority, subject to the terms and limitations of the power -of -attorney
issued to them, to execute and deliver on behalf of the Company, and 10 attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of
Indemnity and other writings obligatory in the nature thereof, and any such Instrument executed by any such attorney -in -fact shall be fully and in all respects binding upon
the Company. Certification as to the validity of any power -of -attorney authorized herein made by an officer of Employers Mutual Casualty Company shall be fully and in all
respects binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon
a certified copy of any power -of -attorney of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
IN WITNESS THEREOF, the Companies have caused these presents to be sign d for each by their officers as shown, and the Corporate seals to be hereto affixed this
22nd day of September , 2022
Seals �•
�c°Lo hSl/�q ^. ; `� �o;^p,ti., : �Fs; ,", �;; •�, ott R. Jean, P e ident &CEO Todd Slrother,Executive Vice President
tyG�`� pP Uqi'!� ; ^ �4T' ?�pP DAq��'O'% Q `?�PP��;; s:_ of Company 1;rman, President Chief Legal Officer & Secretary of
a" = SEAL ° ; = -' = 1863� o ; - = 1953� _ <= & CEO of Com(fniies 2, 3, 4, 5 & 6 Companies 1, 2, 3, 4, 5 & 6
Y� : Fes`' IOWA
'}IIOWT1r .` �O�Nn i•.'O�a'. r'r ltow w SEAL = SEAL Y W: SEAL
' *.IOWA. �' �oR1y �DaKsr, 'y01NE5���`
KATHY LOVMIDGE
769
r1 �Noctoder�H.2M
On this 22nd day of September 2022 before me a Notary Public in and for the State
of Iowa, personally appeared Scott R. Jean and Todd Strother, who, being by me duly sworn,
did say that they are, and are known to me to be the CEO, Chairman, President, Executive
Vice President, Chief Legal Officer and/or Secretary, respectively, of each of the Companies
above; that the seals affixed to this instrument are the seals of said corporations; that said
instrument was signed and sealed on behalf of each of the Companies by authority of their
respective Boards of Directors; and that the said Scott R. Jean and Todd Strother, as such
officers, acknowledged the execution of said instrument to be their voluntary act and deed,
and the voluntary act and deed of each of the Companies.
My Commission Expires October 10, 2025,
CERTIFICATE
"NotaPubri
�U �/LL� and for the State of yowa
I, Ryan J. Springer, Vice President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies, and
this Power of Altomey Issued pursuant thereto on 22nd day of September , 2022 , are true and correct and are still in full force and effect.
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 4th day of August 2025
Vice President
7851 (9-22) SO43651-26 17320 931 ACC 003173 "For verification of the authenticity of the Power of Attorney you may call (515) 345-7548,"
IMPO R-TAHT Ex-FOTICE
TO OBTAIN INFORMATION OR MAKE A COMPLAINT:
You may contact Employers Mutual Casualty Company, Union Insurance of
Providence, and/or EMCASCO Insurance Company for information or to
make
a complaint at:
Employers Mutual Casualty Company
Attn: Surety Claims
P.O. Box 712
Des Moines, IA 50303
(515) 280-2689
(515) 280-2994 Fax
You may contact the Texas Department of Insurance to obtain information on
companies, coverages, rights or complaints at:
Texas Department of Insurance
P.O. Box 149104
Austin, TX 78714-9104
(800) 252-3439
ATTACH THIS NOTICE TO YOUR BOND. This notice is for information only
and does not become a part or a condition of the attached document and is
given to comply with Section 2253-048, Government Code, and Section
53.202, Property Code, effective September 1, 2001.
7209
CONSENT OF OWNER o
I'. SURETY COMPANY ARCHITECT ❑
TO FINAL PAYMENT CONTRACTOR ❑
SURETY ❑ Bond No. SO43860
OTHER
PROJECT: Sewer Improvements to Serve Premium Water Sewer Relocation
TO: (Owner) City of Fort Worth PROJECT NO.
Premium Waters, Inc.
CONTRACT FOR: Site Utilities
CONTRACTOR: Maverick Utility Construction, Inc. CONTRACT DATE: APRIL 3, 2024
1001 W. Euless Blvd., Suite 312
Euless, TX 76040
In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,
the
Employers Mutual Casualty Company SURETY,
on Bond of
Maverick Utility Construction, Inc. CONTRACTOR,
hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall
not relieve the Surety Company of any of its obligations to
City of Fort Worth , OWNER,
Premium Waters, Inc.
as set forth in the said Surety Company's bond.
IN WITNESS WHEREOF,
the Surety has hereunto set its hand this 4th day of August 2025
Attest:
(Seal)
CONSENT OF SURETY COMPANYTO FINALPAYMENT
Emplovers Mutual Casualtv Comoanv
Surety Company
Signature of Authorized Representative
Charles K. Miller. Attornev-In-Fact
Title
ONEPAGE
i
*emc_ 14
P.O. Box 712 - Des Moines, Iowa 50306-0712 INSURANCE
POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY -IN -FACT
KNOW ALL MEN BY THESE PRESENTS, that:
1. Employers Mutual Casualty Company, an Iowa Corporation
2. EMCASCO Insurance Company, an Iowa Corporation
3. Union Insurance Company of Providence, an Iowa Corporation
4. Illinois EMCASCO Insurance Company, an Iowa Corporation
5. Dakota Fire Insurance Company, a North Dakota Corporation
6. EMC Property & Casualty Company, an Iowa Corporation
hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint:
CHARLES K. MILLER
its true and lawful attomey-in-fact, with full power and authority conferred to sign, seal, and execute the following Surety Bond(s):
Surety Bond Principal:
Number Maverick Utility Construction,
Inc.
SO43860
Obligee:
City of Fort Worth
Premium Waters, Inc.
and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all
of the acts of said attorney pursuant to the authority hereby given are hereby ratified and confirmed.
AUTHORITY FOR POWER OF ATTORNEY
This Power -of -Attorney is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at the
first regularly scheduled meeting of each company duly called and held in 1999:
RESOLVED: The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have
power and authority to (1) appoint attorneys -in -fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds
and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attomey-in-fact at any time
and revoke the power and authority given to him or her. Attorneys -in -fact shall have power and authority, subject to the terms and limitations of the power -of -attorney
issued to them, to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of
Indemnity and other writings obligatory in the nature thereof, and any such Instrument executed by any such attorney -in -fact shall be fully and in all respects binding upon
the Company. Certification as to the validity of any power -of -attorney authorized herein made by an oflicer of Employers Mutual Casualty Company shall be fully and in all
respects binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon
a certified copy of any power -of -attorney of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
IN WITNESS THEREOF, the Companies have caused these presents to be sign d for each by their officers as shown, and the Corporate seals to be hereto affixed this
22nd day of September 2022
Seals �• �G�/UC
,a; NSI/ �.r � �O'M pyN��'SY,A 'C�sott R. Jean, P e ident & CEO Todd S troth a r, Executive Vice President
-:o ; o_.�Jp•��_;;•, s : of Company 1; irman, President Chief Legal Officer & Secretary of
-: = e m a = " f & CEO of Conies 2 3, 4, 5 & 6 Companies 1, 2, 3, 4,5 & 6
SEAL= - - 1863
IOWA
�;agURAY���NSURg1,��:: `tt`�Y VAC p'''.
O,Iq�,1,PL
:v=
=w= SEAL =<_ SEAL;: SEAL
'•*,IOWA,* �ryoR,HIOAK°��� '` 'Lt01Nf5��P`
KATHY LOVERIDGE
Commbsba Nulldm ��g
OY
actob2fr2!
On this 22nd day of September 2022 before me a Notary Public in and for the State
of Iowa, personally appeared Scott R. Jean and Todd Strother, who, being by me duly sworn,
did say that they are, and are known to me to be the CEO, Chairman, President, Executive
Vice President, Chief Legal Officer and/or Secretary, respectively, of each of the Companies
above; that the seals affixed to this instrument are the seals of said corporations; that said
instrument was signed and sealed on behalf of each of the Companies by authority of their
respective Boards of Directors; and that the said Scott R. Jean and Todd Strother, as such
officers, acknowledged the execution of said instrument to be their voluntary act and deed,
and the voluntary act and deed of each of the Companies.
My Commission Expires October 10, 2025.
CERTIFICATE
"Pubri
�Noand for the State of ffowa
I, Ryan J. Springer, Vice President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies, and
this Power of Attorney Issued pursuant thereto on 22nd day of September , 2022 , are true and correct and are still in full force and effect.
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 4th day of August 2025
Vice President
M/0 No
7851 (9-22) SO43860-25 17320 931 ACC 003173 "For verification of the authenticity of the Power of Attorney you may call (515) 345-7548."
li
IMPORTANT NOTICE
TO OBTAIN INFORMATION OR MAKE A COMPLAINT:
You may contact Employers Mutual Casualty Company, Union Insurance of
Providence, and/or EMCASCO Insurance Company for information or to make
a complaint at:
Employers Mutual Casualty Company
Attn: Surety Claims
P.O. Box 712
Des Moines, IA 50303
(515) 280-2689
(515) 280-2994 Fax
You may contact the Texas Department of Insurance to obtain information on
companies, coverages, rights or complaints at:
Texas Department of Insurance
P.O. Box 149104
Austin, TX 78714-9104
(800) 252-3439
ATTACH THIS NOTICE TO YOUR BOND. This notice.is for information only
and does not become a part or a condition of the attached document and is
given to comply with Section 2253-048, Government Code, and Section
53.202, Property Code, effective September 1, 2001.
7209