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060069-FP1 - Construction-Related - Contract - Jackson Construction Ltd
FORT WORTH® WATERDEPARTMENT -FPI NOTICE OF PROJECT COMPLETION City Secretary No: 60009 Date Received: 11/13/2025 city Project M: 103381 Regarding contract60069 W&SS Contract 2019 WSM-O Part 1 for as requaed by the WATER DEPARTMENT as approved by City Council on 6/8/2023 through M&C 23-0651_ the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Water Department has accepted the project as Complete. Original Contract Prices: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Work Completed: Less Deductions: Liquidated Damages: Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: Lms Previous Payments: Final Payment Due ,7 sv Recommended for Acceptance Amt. Director, WATER DEPARTMENT R�,.d°i,�.,� Accepted Director. WATER DEPARTMENT Amt. City Manager Comments: S 4,997,423.00 $ 90,8132.64 Na 3 $5,088,315.64 $5,064,221.59 _ Days® $650.00/Day a s 5,064,221.59 $4,811,010.50 $253,211.09 11/10/2025 Date 11/10/2025 Date 11/10/2025 Date OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Jackson Construction Final Payment Request ws GoRIFast 2g1 Q WSM 0 Item# Description UoM Unit Cost OrgQTY Original Rev. Qty Revised Completed QTY Work Completed Retainage Paid Unit 1.001 3311.0554 16" DIP Water (Restrained Joints), Acceptable Backfill LF $ 340.00 2,516.00 $ 855,440.00 2,516.00 $ 855,440.00 2,516.00 $ 855,440.00 $ 42,772.00 $ 812,668.00 Unit 1.002 3305.1105 30" Casina Bv Other Than Open Cut (Steen LF $ 1,200.00 30.00 $ 36,000.00 30.00 $ 36,000.00 30.00 $ 36,000.00 $ 1,800.00 $ 34,200.00 Unit 1.003 3305.2005 16" Water Carrier Pipe <DIP Restrained) LF $ 440.00 30.00 $ 13,200.00 30.00 $ 13,200.00 30.00 $ 13,200.00 $ 660.00 $ 12,540.00 Unit 1.004 3311.0461 12" PVC Water Pipe DR-14, Acceptable Backfill LF $ 650.00 89.00 $ 57,850.00 89.00 $ 57,850.00 66.00 $ 42,900.00 $ 2,145.00 $ 40,755.00 Unit 1.005 3311.0261 8" PVC Water Pipe DR-14, Acceptable Backfill LF $ 90.00 1,448.00 $ 130,320.00 1,448.00 $ 130,320.00 1,340.00 $ 120,600.00 $ 6,030.00 $ 114,570.00 Unit 1.006 3311.0251 8" DIP Water, Acceptable Backfill LF $ 450.00 10.00 $ 4,500.00 10.00 $ 4,500.00 57.00 $ 25,650.00 $ 1,282.50 $ 24,367.50 Unit 1.007 3311.0161 6" PVC Water Pipe DR-14, Acceptable Backfill LF $ 190.00 50.00 $ 9,500.00 50.00 $ 9,500.00 61.00 $ 11,590.00 $ 579.50 $ 11,010.50 Unit 1.008 0241.0100 Remove Sidewalk SF $ 5.00 10.00 $ 50.00 10.00 $ 50.00 422.00 $ 2,110.00 $ 105.50 $ 2,004.50 Unit 1.009 0241.0401 Remove Concrete Drive (25/25/50) SF $ 5.00 177.00 $ 885.00 177.00 $ 885.00 275.87 $ 1,379.35 $ 68.97 $ 1,310.38 Unit 1.010 0241.0402 Remove Asphalt Drive (25/25/50) SF $ 5.00 88.00 $ 440.00 88.00 $ 440.00 -$ -$ -$ - Unit 1.011 0241.1300 Remove Cone Curb & Gutter (25/25/50) LF $ 12.00 101.00 $ 1,212.00 101.00 $ 1,212.00 477.50 $ 5,730.00 $ 286.50 $ 5,443.50 Unit 1.012 0241.1400 Remove Cone Valley Gutter (25/25/50) SY $ 20.00 10.00 $ 200.00 10.00 $ 200.00 -$ -$ -$ - Unit 1.013 0241.1001 Water Line Grouting CY $ 600.00 1.00 $ 600.00 1.00 $ 600.00 1.00 $ 600.00 $ 30.00 $ 570.00 Unit 1.014 0241.1118 4"-12" Pressure Plug EA $ 600.00 3.00 $ 1,800.00 3.00 $ 1,800.00 3.00 $ 1,800.00 $ 90.00 $ 1,710.00 Unit 1.015 0241.1218 4"-12" Water Abandonment PluQ EA $ 1,500.00 2.00 $ 3,000.00 2.00 $ 3,000.00 2.00 $ 3,000.00 $ 150.00 $ 2,850.00 Unit 1.016 0241.1301 Remove and SalvaQe 4"-12" Water Valve EA $ 120.00 4.00 $ 480.00 4.00 $ 480.00 4.00 $ 480.00 $ 24.00 $ 456.00 Unit 1.017 0241.1352 Remove & Salvaae 16" Water Valve EA $ 2,400.00 2.00 $ 4,800.00 2.00 $ 4,800.00 1.00 $ 2,400.00 $ 120.00 $ 2,280.00 Unit 1.018 0241.151 o Remove and Salvaae Fire Hvdrant EA $ 700.00 3.00 $ 2,100.00 3.00 $ 2,100.00 4.00 $ 2,800.00 $ 140.00 $ 2,660.00 Unit 1.019 0241.1511 Remove and Salvaae 3/4" Water Meter EA $ 150.00 1.00 $ 150.00 1.00 $ 150.00 15.00 $ 2,250.00 $ 112.50 $ 2,137.50 Unit 1.020 0241.1512 Remove and Salvage 1" Water Meter EA $ 150.00 40.00 $ 6,000.00 40.00 $ 6,000.00 40.00 $ 6,000.00 $ 300.00 $ 5,700.00 Unit 1.021 0241.1513 Remove and Salvage 1 1/2" Water Meter EA $ 300.00 1.00 $ 300.00 1.00 $ 300.00 1.00 $ 300.00 $ 15.00 $ 285.00 Unit 1.022 0241.1514 Remove and Salvage 2" Water Meter EA $ 300.00 2.00 $ 600.00 2.00 $ 600.00 2.00 $ 600.00 $ 30.00 $ 570.00 Unit 1.023 0241.1506 2" Surface MillinQ (25/25/50) SY $ 4.50 4,212.00 $ 18,954.00 4,212.00 $ 18,954.00 4,139.25 $ 18,626.63 $ 931.34 $ 17,695.29 Unit 1.024 0241.1700 11" Pavement Pulverization (25/25/50) SY $ 14.00 879.00 $ 12,306.00 879.00 $ 12,306.00 879.00 $ 12,306.00 $ 615.30 $ 11,690.70 Unit 1.025 3123.0101 Unclassified Street Excavation (25/25/50) CY $ 62.00 25.00 $ 1,550.00 25.00 $ 1,550.00 25.00 $ 1,550.00 $ 77.50 $ 1,472.50 Unit 1.026 3125.0101 SWPPP = 1 acre LS $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 $ 300.00 $ 5,700.00 Unit 1.027 3201.0113 6' Wide Asphalt Pvmt Repair, Residential LF $ 165.00 10.00 $ 1,650.00 10.00 $ 1,650.00 29.00 $ 4,785.00 $ 239.25 $ 4,545.75 Unit 1.028 3201.0123 6' Wide Asphalt Pvmt Repair, Arterial LF $ 190.00 576.00 $ 109,440.00 576.00 $ 109,440.00 603.70 $ 114,703.00 $ 5,735.15 $ 108,967.85 Unit 1.029 3201.0201 Asphalt Pvmt Repair Beyond Defined Width, Residential SY $ 100.00 10.00 $ 1,000.00 10.00 $ 1,000.00 -$ -$ -$ - Unit 1.030 3201.0202 Asphalt Pvmt Repair Beyond Defined Width, Arterial SY $ 150.00 10.00 $ 1,500.00 10.00 $ 1,500.00 -$ -$ -$ - Unit 1.031 3201.0400 Temporarv Asphalt PavinQ Repair (2" HMAC on 6"Flexbasel LF $ 40.00 1,251.00 $ 50,040.00 1,263.00 $ 50,520.00 2,271.00 $ 90,840.00 $ 4,542.00 $ 86,298.00 Unit 1.032 3201.0614 Cone Pvmt Repair, Residential SY $ 200.00 160.00 $ 32,000.00 160.00 $ 32,000.00 244.40 $ 48,880.00 $ 2,444.00 $ 46,436.00 Unit 1.033 3201.0616 Cone Pvmt Repair, Arterial/Industrial SY $ 230.00 10.00 $ 2,300.00 10.00 $ 2,300.00 -$ -$ -$ - Unit 1.034 3211.0601 Cemlime Stabilization @ 32Lbs/SY (25/25/50) TN $ 500.00 14.00 $ 7,000.00 14.00 $ 7,000.00 14.00 $ 7,000.00 $ 350.00 $ 6,650.00 Unit 1.035 3212.0302 2" AsPhalt Pvmt TvPe D (25/25/50) SY $ 19.00 4,212.00 $ 80,028.00 4,212.00 $ 80,028.00 1,348.00 $ 25,612.00 $ 1,280.60 $ 24,331.40 Unit 1.036 3212.0303 3" Asphalt Pvmt Type D (25/25/50) SY $ 28.00 879.00 $ 24,612.00 879.00 $ 24,612.00 879.00 $ 24,612.00 $ 1,230.60 $ 23,381.40 Unit 1.037 3212.0401 HMAC Transition (25/25/50) TN $ 350.00 5.00 $ 1,750.00 5.00 $ 1,750.00 -$ -$ -$ - Unit 1.038 3213.0401 6" Concrete Driveway (25/25/50) SF $ 17.00 241.00 $ 4,097.00 241.00 $ 4,097.00 724.87 $ 12,322.79 $ 616.14 $ 11,706.65 Unit 1.039 3213.0301 4" Cone Sidewalk SF $ 12.00 10.00 $ 120.00 10.00 $ 120.00 422.00 $ 5,064.00 $ 253.20 $ 4,810.80 Unit 1.040 3216.0101 6" Cone Curb and Gutter (25/25/50) LF $ 100.00 101.00 $ 10,100.00 101.00 $ 10,100.00 558.50 $ 55,850.00 $ 2,792.50 $ 53,057.50 Unit 1.041 3216.0301 7" Cone Vallev Gutter, Residential (25/25/50) SY $ 200.00 10.00 $ 2,000.00 10.00 $ 2,000.00 -$ -$ -$ - Unit 1.042 3217.5001 Curb Address Paintina (25/25/50) EA $ 100.00 5.00 $ 500.00 5.00 $ 500.00 -$ -$ -$ - Unit 1.043 3291.01 oo ToPsoil (25/25/50) CY $ 70.00 279.00 $ 19,530.00 279.00 $ 19,530.00 -$ -$ -$ - Unit 1.044 3292.0100 Block Sod Placement (25/25/50) SY $ 9.00 1,655.00 $ 14,895.00 1,655.00 $ 14,895.00 -$ -$ -$ - Unit 1.045 3292.0400 Seeding, Hydromulch (25/25/50) SY $ 5.00 50.00 $ 250.00 50.00 $ 250.00 -$ -$ -$ - Unit 1.046 3304.0002 Cathodic Protection Design for Selected Material LS $ 1.00 1.00 $ 1.00 1.00 $ 1.00 -$ -$ -$ - Unit 1.047 3304.0002 Cathodic Protection Installation LS $ 1.00 1.00 $ 1.00 1.00 $ 1.00 -$ -$ -$ - Unit 1.048 3304.0101 Temporarv Water Services (2" Temporarv Size) LS $15,000.00 1.00 $ 15,000.00 1.00 $ 15,000.00 1.00 $ 15,000.00 $ 750.00 $ 14,250.00 3304.0101 Temporary Water Services for Both Sides of John T White (2" Unit 1.049 Temporarv Size) Sheets 7-14 LS $73,000.00 1.00 $ 73,000.00 1.00 $ 73,000.00 1.00 $ 73,000.00 $ 3,650.00 $ 69,350.00 Unit 1.050 3305.0003 8" Waterline Lowerina EA $12,000.00 7.00 $ 84,000.00 7.00 $ 84,000.00 4.00 $ 48,000.00 $ 2,400.00 $ 45,600.00 Unit 1.051 3305.0103 Exploratory Excavation of Existing Utilities EA $ 1,700.00 13.00 $ 22,100.00 13.00 $ 22,100.00 15.00 $ 25,500.00 $ 1,275.00 $ 24,225.00 Unit 1.052 3305.0109 Trench Safety LF $ 2.00 4,102.00 $ 8,204.00 4,102.00 $ 8,204.00 4,133.00 $ 8,266.00 $ 413.30 $ 7,852.70 Unit 1.053 3305.0111 Valve Box Adjustment W/ Cone Collar (50/50) EA $ 450.00 7.00 $ 3,150.00 7.00 $ 3,150.00 9.00 $ 4,050.00 $ 202.50 $ 3,847.50 Unit 1.054 3305.0202 Imported Embed/CSS CY $ 200.00 15.00 $ 3,000.00 15.00 $ 3,000.00 -$ -$ -$ - Unit 1.055 3305.0203 Imported Embedment/Backfill, CLSM CY $ 250.00 267.00 $ 66,750.00 267.00 $ 66,750.00 12.00 $ 3,000.00 $ 150.00 $ 2,850.00 CPN# 103381, CSC# 60069 Page 1 of 5 Jackson Construction Final Payment Request ws GoRIFast 2g1 Q WSM 0 Item# Description UoM Unit Cost OrgQTY Original Rev. Qty Revised Completed QTY Work Completed Retainage Paid Unit 1.056 3305.0207 Imported Embedment/Backfill, Select Fill CY $ 50.00 50.00 $ 2,500.00 50.00 $ 2,500.00 -$ -$ -$ - Unit 1.057 3311.0001 Ductile Iron Water Fittinas TON $22,000.00 3.00 $ 66,000.00 3.00 $ 66,000.00 3.00 $ 66,000.00 $ 3,300.00 $ 62,700.00 Unit 1.058 3312.0001 Fire Hvdrant EA $ 7,000.00 3.00 $ 21,000.00 3.00 $ 21,000.00 6.00 $ 42,000.00 $ 2,100.00 $ 39,900.00 Unit 1.059 3312.0117 Connection to Existing 4"-12" Water Main EA $ 5,000.00 6.00 $ 30,000.00 6.00 $ 30,000.00 6.00 $ 30,000.00 $ 1,500.00 $ 28,500.00 Unit 1.060 3312.0106 Connection to Existing 16" Water Main EA $10,000.00 2.00 $ 20,000.00 2.00 $ 20,000.00 2.00 $ 20,000.00 $ 1,000.00 $ 19,000.00 Unit 1.061 3312.1002 2" Combination Air Valve Assembly for Water EA $20,000.00 2.00 $ 40,000.00 2.00 $ 40,000.00 2.00 $ 40,000.00 $ 2,000.00 $ 38,000.00 Unit 1.062 3312.2001 1" Water Service, Meter Reconnection EA $ 800.00 40.00 $ 32,000.00 40.00 $ 32,000.00 40.00 $ 32,000.00 $ 1,600.00 $ 30,400.00 Unit 1.063 3312.2003 1" Water Service (Williams Road) EA $ 2,500.00 4.00 $ 10,000.00 6.00 $ 15,000.00 4.00 $ 10,000.00 $ 500.00 $ 9,500.00 Unit 1.064 3312.2002 1" Water Service by bore (John T White Road) EA $ 4,000.00 36.00 $ 144,000.00 36.00 $ 144,000.00 39.00 $ 156,000.00 $ 7,800.00 $ 148,200.00 3312.2003 1" Water Service (Williams Rd. Assessment Tap With Empty Unit 1.065 Meter Box) EA $ 2,500.00 8.00 $ 20,000.00 8.00 $ 20,000.00 10.00 $ 25,000.00 $ 1,250.00 $ 23,750.00 3312.2002 1" Water Service by bore (John T White Road Assessment Tap Unit 1.066 With Empty Meter Box) EA $ 4,000.00 7.00 $ 28,000.00 8.00 $ 32,000.00 8.00 $ 32,000.00 $ 1,600.00 $ 30,400.00 Unit 1.067 3312.2101 1 1/2" Water Service, Meter Reconnection EA $ 1,000.00 1.00 $ 1,000.00 1.00 $ 1,000.00 1.00 $ 1,000.00 $ 50.00 $ 950.00 Unit 1.068 3312.2103 1 1/2" Water Service by bore (John T White Road) EA $ 7,000.00 1.00 $ 7,000.00 1.00 $ 7,000.00 1.00 $ 7,000.00 $ 350.00 $ 6,650.00 Unit 1.069 3312.2201 2" Water Service, Meter Reconnection EA $ 1,500.00 1.00 $ 1,500.00 3.00 $ 4,500.00 3.00 $ 4,500.00 $ 225.00 $ 4,275.00 Unit 1.070 3312.2203 2" Water Service Water Service bv bore (John T White Road) EA $ 9,000.00 2.00 $ 18,000.00 2.00 $ 18,000.00 3.00 $ 27,000.00 $ 1,350.00 $ 25,650.00 Unit 1.071 3312.3002 6" Gate Valve EA $ 1,700.00 6.00 $ 10,200.00 6.00 $ 10,200.00 6.00 $ 10,200.00 $ 510.00 $ 9,690.00 Unit1.072 3312.3003 8" Gate Valve EA $ 2,600.00 7.00 $ 18,200.00 7.00 $ 18,200.00 8.00 $ 20,800.00 $ 1,040.00 $ 19,760.00 Unit 1.073 3312.3005 12" Gate Valve EA $ 4,600.00 3.00 $ 13,800.00 3.00 $ 13,800.00 4.00 $ 18,400.00 $ 920.00 $ 17,480.00 Unit 1.074 3312.3006 16" Gate Valve w/ Vault EA $38,000.00 4.00 $ 152,000.00 4.00 $ 152,000.00 5.00 $ 190,000.00 $ 9,500.00 $ 180,500.00 Unit 1.075 3312.6002 6" Blow Off Valve EA $30,000.00 1.00 $ 30,000.00 1.00 $ 30,000.00 1.00 $ 30,000.00 $ 1,500.00 $ 28,500.00 Unit 1.076 0171.0101 Construction StakinQ LS $17,000.00 1.00 $ 17,000.00 1.00 $ 17,000.00 1.00 $ 17,000.00 $ 850.00 $ 16,150.00 Unit 1.077 0171.0102 Redline As-Built Survey LS $ 5,000.00 1.00 $ 5,000.00 1.00 $ 5,000.00 1.00 $ 5,000.00 $ 250.00 $ 4,750.00 Unit 1.078 3471.0001 Traffic Control (25/25/50) MO $ 4,000.00 5.00 $ 20,000.00 5.00 $ 20,000.00 5.00 $ 20,000.00 $ 1,000.00 $ 19,000.00 Unit 1.079 9999.0001 16"x12" Rina Connection (John T. White and Morrison) EA $22,000.00 1.00 $ 22,000.00 1.00 $ 22,000.00 1.00 $ 22,000.00 $ 1,100.00 $ 20,900.00 Unit 1.080 9999.1000 Irrigation Adjustment & Landscape Repair Allowance LS $20,000.00 1.00 $ 20,000.00 1.00 $ 20,000.00 -$ -$ -$ - Unit 1.081 * 9999.1001 Construction Allowance $ 100,000.00 $ -$ -$ -$ - Unit 1.082 3311.0451 12" DIP Water Pipe, Acceptable Backfill LF $ 707.00 -$ -93.00 $ 65,751.00 93.00 $ 65,751.00 $ 3,287.55 $ 62,463.45 Excavate & Remove 16 GIP that runs parrallel to the new 16 # DIP; includes addt trench excavation and backfill, pipe removal, 3/4" stone embedment, haul Unit 1.083 of dirt spoils, haul off abandoned pipe, and extra dump fees CO#2 LF $ 107.16 -$ -250.00 $ 26,790.00 250.00 $ 26,790.00 $ 1,339.50 $ 25,450.50 Unit 1.084 16" Water Abandonment Plua CO#2 EA $ 4,034.32 -$ -2.00 $ 8,068.64 2.00 $ 8,068.64 $ 403.44 $ 7,665.20 Remove & Replace Extra Depth Fire Hydrant with New at Willams Rd. & John Unit 1.085 T White Road CO#4 EA $13,223.00 -$ -1.00 $ 13,223.00 1.00 $ 13,223.00 $ 661.15 $ 12,561.85 Unit2A.001 3331.4115 8" Sewer Pipe PVC SDR-26, Acceptable Backfill LF $ 130.00 427.00 $ 55,510.00 757.00 $ 98,410.00 757.00 $ 98,410.00 $ 4,920.50 $ 93,489.50 Unit2A.002 3331.5747 8" Sewer Pipe PVC SDR-26, CLSM Backfill LF $ 190.00 (30.00) $ (5,700.00) 10.00 $ 1,900.00 20.00 $ 3,800.00 $ 190.00 $ 3,610.00 3331.4119 8" DIP Sewer Pipe, Acceptable Backfill (W/ Epoxy Lining Protecto Unit2A.003 401 or Eaual) LF $ 180.00 1,422.00 $ 255,960.00 1,422.00 $ 255,960.00 1,168.00 $ 210,240.00 $ 10,512.00 $ 199,728.00 3331.5748 8" DIP Sewer Pipe, CLSM Backfill (W/ Epoxy Lining Protecto 401 Unit2A.004 or Eauall LF $ 300.00 50.00 $ 15,000.00 140.00 $ 42,000.00 273.00 $ 81,900.00 $ 4,095.00 $ 77,805.00 3331.4212 12" DIP Sewer Pipe, Acceptable Backfill (W/ Epoxy Lining Unit 2A.005 Protecto 401 or Eaual) LF $ 240.00 500.00 $ 120,000.00 500.00 $ 120,000.00 500.00 $ 120,000.00 $ 6,000.00 $ 114,000.00 Unit2A.006 0241.0300 Remove ADA Ramp EA $ 500.00 1.00 $ 500.00 1.00 $ 500.00 1.00 $ 500.00 $ 25.00 $ 475.00 Unit2A.007 0241.0401 Remove Concrete Drive (25/25/50) SF $ 5.00 177.00 $ 885.00 177.00 $ 885.00 319.00 $ 1,595.00 $ 79.75 $ 1,515.25 Unit 2A.008 0241.0402 Remove Asphalt Drive (25/25/50) SF $ 5.00 88.00 $ 440.00 88.00 $ 440.00 -$ -$ -$ - Unit2A.009 0241.1300 Remove Cone Curb & Gutter (25/25/50) LF $ 12.00 101.00 $ 1,212.00 101.00 $ 1,212.00 68.00 $ 816.00 $ 40.80 $ 775.20 Unit 2A.010 0241.1400 Remove Cone Valley Gutter (25/25/50) SY $ 20.00 10.00 $ 200.00 10.00 $ 200.00 -$ -$ -$ - Unit2A.011 0241.2103 8" Sewer Abandonment Plua EA $ 1,500.00 5.00 $ 7,500.00 5.00 $ 7,500.00 5.00 $ 7,500.00 $ 375.00 $ 7,125.00 Unit 2A.012 0241.2001 Sanitarv Line Groutina CY $ 600.00 11.00 $ 6,600.00 11.00 $ 6,600.00 -$ -$ -$ - Unit2A.013 0241.2201 Remove 4' Sewer Manhole EA $ 1,300.00 10.00 $ 13,000.00 10.00 $ 13,000.00 9.00 $ 11,700.00 $ 585.00 $ 11,115.00 Unit2A.014 0241.1506 2" Surface Milling (25/25/50) SY $ 4.50 4,212.00 $ 18,954.00 4,212.00 $ 18,954.00 4,139.25 $ 18,626.63 $ 931.34 $ 17,695.29 Unit 2A.015 0241.1700 11" Pavement Pulverization (25/25/50) SY $ 14.00 879.00 $ 12,306.00 879.00 $ 12,306.00 879.00 $ 12,306.00 $ 615.30 $ 11,690.70 Unit 2A.016 3123.0101 Unclassified Street Excavation (25/25/50) CY $ 62.00 25.00 $ 1,550.00 25.00 $ 1,550.00 25.00 $ 1,550.00 $ 77.50 $ 1,472.50 Unit2A.017 3201.0113 6' Wide Asphalt Pvmt Repair, Residential LF $ 165.00 25.00 $ 4,125.00 25.00 $ 4,125.00 -$ -$ -$ - Unit 2A.018 3201.0123 6' Wide Asphalt Pvmt Repair, Arterial LF $ 190.00 359.00 $ 68,210.00 359.00 $ 68,210.00 272.00 $ 51,680.00 $ 2,584.00 $ 49,096.00 CPN# 103381, CSC# 60069 Page 2 of 5 Jackson Construction Final Payment Request ws GoRIFast 2g1 Q WSM 0 Item# Description UoM Unit Cost OrgQTY Original Rev. Qty Revised Completed QTY Work Completed Retainage Paid Unit2A.019 3201.0201 Aschalt Pvmt Recair Bevond Defined Width, Residential SY $ 100.00 25.00 $ 2,500.00 25.00 $ 2,500.00 -$ -$ -$ - Unit2A.020 3201.0400 Temcorarv Aschalt Pavina Recair (2" HMA C on 6"Flexbase) LF $ 40.00 628.00 $ 25,120.00 1,047.00 $ 41,880.00 1,924.00 $ 76,960.00 $ 3,848.00 $ 73,112.00 Unit2A.021 3201.0614 Cone Pvmt Recair, Residential SY $ 200.00 105.00 $ 21,000.00 105.00 $ 21,000.00 79.00 $ 15,800.00 $ 790.00 $ 15,010.00 Unit2A.022 3211.0601 Cemlime Stabilization @ 32 Lbs/SY (25/25/50) TN $ 500.00 14.00 $ 7,000.00 14.00 $ 7,000.00 14.00 $ 7,000.00 $ 350.00 $ 6,650.00 Unit2A.023 3212.0302 2" Asphalt Pvmt Type D (25/25/50) SY $ 19.00 4,212.00 $ 80,028.00 4,212.00 $ 80,028.00 4,139.25 $ 78,645.75 $ 3,932.29 $ 74,713.46 Unit2A.024 3212.0303 3" Asphalt Pvmt Type D (25/25/50) SY $ 28.00 879.00 $ 24,612.00 879.00 $ 24,612.00 879.00 $ 24,612.00 $ 1,230.60 $ 23,381.40 Unit2A.025 3212.0401 HMA C Transition (25/25/50) TN $ 350.00 5.00 $ 1,750.00 5.00 $ 1,750.00 -$ -$ -$ - Unit2A.026 3213.0401 6" Concrete Driveway (25/25/50) SF $ 17.00 241.00 $ 4,097.00 241.00 $ 4,097.00 319.00 $ 5,423.00 $ 271.15 $ 5,151.85 Unit2A.027 3213.0506 Barrier Free Ramp, Tyce P-1 EA $ 3,000.00 1.00 $ 3,000.00 1.00 $ 3,000.00 1.00 $ 3,000.00 $ 150.00 $ 2,850.00 Unit2A.028 3216.0101 6" Cone Curb and Gutter (25/25/50) LF $ 100.00 101.00 $ 10,100.00 101.00 $ 10,100.00 68.00 $ 6,800.00 $ 340.00 $ 6,460.00 Unit2A.029 3216.0301 7" Cone Vallev Gutter, Residential (25/25/50) SY $ 200.00 10.00 $ 2,000.00 10.00 $ 2,000.00 -$ -$ -$ - Unit2A.030 3217.5001 Curb Address Painting (25/25/50) EA $ 100.00 5.00 $ 500.00 5.00 $ 500.00 -$ -$ -$ - Unit2A.031 3291.01 oo Topsoil (25/25/50) CY $ 70.00 161.00 $ 11,270.00 161.00 $ 11,270.00 161.00 $ 11,270.00 $ 563.50 $ 10,706.50 Unit2A.032 3292.0100 Block Sod Placement (25/25/50) SY $ 9.00 942.00 $ 8,478.00 942.00 $ 8,478.00 942.00 $ 8,478.00 $ 423.90 $ 8,054.10 Unit2A.033 3292.0400 Seedina, Hvdromulch (25/25/50) SY $ 5.00 50.00 $ 250.00 50.00 $ 250.00 50.00 $ 250.00 $ 12.50 $ 237.50 Unit2A.034 3301.0001 Pre-CCTV lnscection LF $ 9.00 100.00 $ 900.00 910.00 $ 8,190.00 910.00 $ 8,190.00 $ 409.50 $ 7,780.50 Unit2A.035 3301.0002 Post-CCTV lnscection LF $ 7.00 2,349.00 $ 16,443.00 2,679.00 $ 18,753.00 2,679.00 $ 18,753.00 $ 937.65 $ 17,815.35 Unit2A.036 3301.0101 Manhole Vacuum Testina EA $ 200.00 13.00 $ 2,600.00 14.00 $ 2,800.00 14.00 $ 2,800.00 $ 140.00 $ 2,660.00 Unit2A.037 3305.0103 Excloratorv Excavation of Existina Utilities EA $ 1,700.00 10.00 $ 17,000.00 10.00 $ 17,000.00 15.00 $ 25,500.00 $ 1,275.00 $ 24,225.00 Unit2A.038 3305.0107 Manhole Adjustment, Minor W/ Concrete Collar (50/50) EA $ 1,500.00 4.00 $ 6,000.00 4.00 $ 6,000.00 3.00 $ 4,500.00 $ 225.00 $ 4,275.00 Unit2A.039 3305.0109 Trench Safety LF $ 2.00 2,349.00 $ 4,698.00 2,684.00 $ 5,368.00 2,718.00 $ 5,436.00 $ 271.80 $ 5,164.20 Unit2A.040 3305.011 o Utility Markers LS $ 3,000.00 1.00 $ 3,000.00 1.00 $ 3,000.00 1.00 $ 3,000.00 $ 150.00 $ 2,850.00 Unit 2A.041 3305.0112 Concrete Collar EA $ 700.00 13.00 $ 9,100.00 14.00 $ 9,800.00 8.00 $ 5,600.00 $ 280.00 $ 5,320.00 Unit2A.042 3305.0113 Trench Water Stoos EA $ 900.00 2.00 $ 1,800.00 2.00 $ 1,800.00 2.00 $ 1,800.00 $ 90.00 $ 1,710.00 Unit2A.043 3305.0116 Concrete Encasement for Utilitv Pices CY $ 500.00 53.00 $ 26,500.00 53.00 $ 26,500.00 53.00 $ 26,500.00 $ 1,325.00 $ 25,175.00 Unit2A.044 3305.0202 lmcorted Embed/CSS CY $ 200.00 15.00 $ 3,000.00 15.00 $ 3,000.00 -$ -$ -$ - Unit2A.045 3305.0203 Imported Embedment/B ackfill, CLSM CY $ 250.00 207.00 $ 51,750.00 62.46 $ 15,615.70 54.00 $ 13,500.00 $ 675.00 $ 12,825.00 Unit2A.046 3305.0207 Imported Embedment/B ackfill, Select Fill CY $ 50.00 15.00 $ 750.00 15.00 $ 750.00 5.00 $ 250.00 $ 12.50 $ 237.50 Unit2A.047 3331.3101 4" Sewer Service EA $ 2,000.00 12.00 $ 24,000.00 15.00 $ 30,000.00 17.00 $ 34,000.00 $ 1,700.00 $ 32,300.00 Unit2A.048 3331.3103 4" Sewer Service by bore (John T White Road) EA $ 5,600.00 22.00 $ 123,200.00 22.00 $ 123,200.00 19.00 $ 106,400.00 $ 5,320.00 $ 101,080.00 Unit2A.049 3331.3201 6" Sewer Service EA $ 3,000.00 1.00 $ 3,000.00 1.00 $ 3,000.00 -$ -$ -$ - 3339.0001 Manhole Interior Protecting Coating (Warren or A.W. Chesterton Unit 2A.050 or Accroved Eaual) VF $ 580.00 17.00 $ 9,860.00 17.00 $ 9,860.00 24.00 $ 13,920.00 $ 696.00 $ 13,224.00 Unit2A.051 3339.1001 4' Manhole EA $10,000.00 8.00 $ 80,000.00 9.00 $ 90,000.00 9.00 $ 90,000.00 $ 4,500.00 $ 85,500.00 Unit2A.052 3339.1002 4' Droc Manhole EA $12,000.00 1.00 $ 12,000.00 1.00 $ 12,000.00 2.00 $ 24,000.00 $ 1,200.00 $ 22,800.00 Unit2A.053 3339.1003 4' Extra Depth Manhole VF $ 200.00 22.00 $ 4,400.00 26.00 $ 5,200.00 33.21 $ 6,642.00 $ 332.10 $ 6,309.90 Unit2A.054 3339.1004 4' Shallow Manhole EA $ 7,000.00 4.00 $ 28,000.00 4.00 $ 28,000.00 4.00 $ 28,000.00 $ 1,400.00 $ 26,600.00 Unit 2A.055 3125.0101 SW PPP = 1 acre LS $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 $ 300.00 $ 5,700.00 Unit2A.056 0171.0101 Construction Stakina LS $17,000.00 1.00 $ 17,000.00 1.00 $ 17,000.00 1.00 $ 17,000.00 $ 850.00 $ 16,150.00 Unit2A.057 0171.0102 Redline As-B uilt Survey LS $ 5,000.00 1.00 $ 5,000.00 1.00 $ 5,000.00 1.00 $ 5,000.00 $ 250.00 $ 4,750.00 Unit2A.058 3471.0001 Traffic Control (25/25/50) MO $ 4,000.00 4.00 $ 16,000.00 4.00 $ 16,000.00 4.00 $ 16,000.00 $ 800.00 $ 15,200.00 Unit2A.059 * 9999.1001 Construction Allowance $ 75,000.00 $ -$ -$ -$ - Unit2A.060 3741.0001 Portable Messaae Board WK $ 750.00 -$ -4.00 $ 3,000.00 4.00 $ 3,000.00 $ 150.00 $ 2,850.00 Unit 2A.061 Remove & Replace Brick Pavers CO#2 SF $ 15.00 -$ -50.00 $ 750.00 50.00 $ 750.00 $ 37.50 $ 712.50 12" DIP Sewer Pipe, CLSM Backfill (w/E poxy lining, Protecto 401 or Equal) Unit2A.062 CO#2 LF $ 460.00 -$ -20.00 $ 9,200.00 20.00 $ 9,200.00 $ 460.00 $ 8,740.00 3305.0112 Remove & Replace Seven (7) Watertight Gasket Manhole Rings & Unit2A.063 Covers w/ Hinaed Manhole Rinas & Covers LS $25,774.55 -$ -1.00 $ 25,774.55 1.00 $ 25,774.55 $ 1,288.73 $ 24,485.82 Unit2B.001 3331.4115 8" Sewer Pice LF $ 380.00 152.00 $ 57,760.00 152.00 $ 57,760.00 152.00 $ 57,760.00 $ 2,888.00 $ 54,872.00 Unit2B.002 3331.4225 18" Sewer Pice LF $ 440.00 280.00 $ 123,200.00 280.00 $ 123,200.00 310.00 $ 136,400.00 $ 6,820.00 $ 129,580.00 Unit2B.003 0241.2001 Sanitarv Line Groutina CY $ 500.00 1.00 $ 500.00 1.00 $ 500.00 -$ -$ -$ - Unit2B.004 0241.2102 6" Sewer Abandonment Plug EA $ 1,300.00 4.00 $ 5,200.00 4.00 $ 5,200.00 2.00 $ 2,600.00 $ 130.00 $ 2,470.00 Unit2B.005 0241.5001 Abandon Manhole EA $ 1,700.00 1.00 $ 1,700.00 1.00 $ 1,700.00 1.00 $ 1,700.00 $ 85.00 $ 1,615.00 Unit2B.006 3201.0614 Cone Pvmt Repair, Residential SY $ 200.00 60.00 $ 12,000.00 60.00 $ 12,000.00 94.00 $ 18,800.00 $ 940.00 $ 17,860.00 Unit2B.007 3216.0101 6" Cone Curb and Gutter LF $ 100.00 16.00 $ 1,600.00 16.00 $ 1,600.00 21.00 $ 2,100.00 $ 105.00 $ 1,995.00 Unit2B.008 3231.0123 6' Chain Link, Aluminum LF $ 70.00 69.00 $ 4,830.00 69.00 $ 4,830.00 65.00 $ 4,550.00 $ 227.50 $ 4,322.50 CPN# 103381, CSC# 60069 Page 3 of 5 Jackson Construction Final Payment Request ws GoRIFast 2g1 Q WSM 0 Item# Description UoM Unit Cost OrgQTY Original Rev. Qty Revised Completed QTY Work Completed Retainage Paid Unit2B.009 3291.0100 6" Topsoil CY $ 70.00 31.00 $ 2,170.00 31.00 $ 2,170.00 31.00 $ 2,170.00 $ 108.50 $ 2,061.50 Unit 2B.010 3292.0100 Block Sod Placement SY $ 9.00 184.00 $ 1,656.00 184.00 $ 1,656.00 184.00 $ 1,656.00 $ 82.80 $ 1,573.20 Unit2B.011 3301.0001 Pre-CCTV Inspection LF $ 9.00 92.00 $ 828.00 92.00 $ 828.00 -$ -$ -$ - Unit 2B.012 3301.0002 Post-CCTV Inspection LF $ 7.00 432.00 $ 3,024.00 432.00 $ 3,024.00 -$ -$ -$ - Unit 2B.013 3301.0101 Manhole Vacuum Testing EA $ 200.00 7.00 $ 1,400.00 7.00 $ 1,400.00 -$ -$ -$ - Unit 2B.014 3305.0109 Trench Safety LF $ 2.00 432.00 $ 864.00 432.00 $ 864.00 462.00 $ 924.00 $ 46.20 $ 877.80 Unit 2B.015 3305.0112 Concrete Collar EA $ 700.00 5.00 $ 3,500.00 5.00 $ 3,500.00 8.00 $ 5,600.00 $ 280.00 $ 5,320.00 Unit 2B.016 3339.0003 Liner -4' Sewer MH VF $ 580.00 57.00 $ 33,060.00 57.00 $ 33,060.00 57.00 $ 33,060.00 $ 1,653.00 $ 31,407.00 Unit2B.017 3339.1001 4' Manhole EA $13,000.00 4.00 $ 52,000.00 4.00 $ 52,000.00 3.00 $ 39,000.00 $ 1,950.00 $ 37,050.00 Unit 2B.018 3339.1002 4' Drop Manhole EA $28,000.00 1.00 $ 28,000.00 1.00 $ 28,000.00 2.00 $ 56,000.00 $ 2,800.00 $ 53,200.00 Unit2B.019 3339.1003 4' Extra DePth Manhole VF $ 200.00 38.00 $ 7,600.00 38.00 $ 7,600.00 43.00 $ 8,600.00 $ 430.00 $ 8,170.00 Unit2B.020 3303.0001 Bypass Pumping LS $48,000.00 1.00 $ 48,000.00 1.00 $ 48,000.00 1.00 $ 48,000.00 $ 2,400.00 $ 45,600.00 Unit 2B.021 9999.9999 4' Manhole w/ Odor Vent EA $29,000.00 2.00 $ 58,000.00 3.00 $ 87,000.00 3.00 $ 87,000.00 $ 4,350.00 $ 82,650.00 Unit2B.022 9999.9999 Temporary Chain Link Fence LF $ 15.00 440.00 $ 6,600.00 440.00 $ 6,600.00 -$ -$ -$ - Unit2B.023 9999.9999 2' Pipe Fence LF $ 35.00 51.00 $ 1,785.00 51.00 $ 1,785.00 78.00 $ 2,730.00 $ 136.50 $ 2,593.50 Unit2B.024 9999.9999 7' Wrouaht Iron Fence LF $ 75.00 16.00 $ 1,200.00 16.00 $ 1,200.00 21.00 $ 1,575.00 $ 78.75 $ 1,496.25 Unit2B.025 9999.9999 Concrete Channel Repair SY $ 320.00 45.00 $ 14,400.00 45.00 $ 14,400.00 11.00 $ 3,520.00 $ 176.00 $ 3,344.00 Unit2B.026 9999.9999 Protect Exst Tree EA $ 500.00 6.00 $ 3,000.00 6.00 $ 3,000.00 6.00 $ 3,000.00 $ 150.00 $ 2,850.00 Unit2B.027 3125.0101 SWPPP = 1 acre LS $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 $ 300.00 $ 5,700.00 Unit2B.028 0171.0101 Construction Staking LS $ 8,500.00 1.00 $ 8,500.00 1.00 $ 8,500.00 1.00 $ 8,500.00 $ 425.00 $ 8,075.00 Unit2B.029 0171.0102 Redline As-B uilt Survey LS $ 2,500.00 1.00 $ 2,500.00 1.00 $ 2,500.00 1.00 $ 2,500.00 $ 125.00 $ 2,375.00 Unit 2B.030 * 9999.1001 Construction Allowance $ 40,000.00 $ 2,710.00 $ -$ -$ - Unit2B.031 Remove Sidewalk CO#2 SF $ 5.00 -$ -931.00 $ 4,655.00 931.00 $ 4,655.00 $ 232.75 $ 4,422.25 Unit2B.032 Stabilize Existina Oncor Power Pole CO#2 EA $ 3,635.00 -$ -3.85 $ 13,994.75 3.85 $ 13,994.75 $ 699.74 $ 13,295.01 Unit 3.001 0241.0100 Remove Sidewalk SF $ 5.00 20.00 $ 100.00 20.00 $ 100.00 -$ -$ -$ - Unit 3.002 0241.0401 Remove Concrete Drive 125/25/50) SF $ 5.00 354.00 $ 1,770.00 -$ --$ -$ -$ - Unit 3.003 0241.0402 Remove Asphalt Drive (25/25/50) SF $ 5.00 176.00 $ 880.00 176.00 $ 880.00 176.00 $ 880.00 $ 44.00 $ 836.00 Unit 3.004 0241.1300 Remove Cone Curb & Gutter (25/25/50) LF $ 12.00 202.00 $ 2,424.00 -$ --$ -$ -$ - Unit 3.005 0241.1400 Remove Cone Valley Gutter (25/25/50) SY $ 20.00 20.00 $ 400.00 20.00 $ 400.00 -$ -$ -$ - Unit 3.006 0241.1506 2" Surface Milling (25/25/50) SY $ 4.50 8,424.00 $ 37,908.00 8,424.00 $ 37,908.00 8,278.50 $ 37,253.25 $ 1,862.67 $ 35,390.58 Unit 3.007 0241.1700 11" Pavement Pulverization (25/25/50) SY $ 14.00 1,757.00 $ 24,598.00 1,757.00 $ 24,598.00 1,757.00 $ 24,598.00 $ 1,229.90 $ 23,368.10 Unit 3.008 3123.0101 Unclassified Street Excavation (25/25/50) CY $ 62.00 50.00 $ 3,100.00 -$ --$ -$ -$ - Unit 3.009 3125.0101 SWPPP = 1 acre LS $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 1.00 $ 6,000.00 $ 300.00 $ 5,700.00 Unit 3.010 3211.0601 Cemlime Stabilization @ 32 Lbs/SY 125/25/50) TN $ 500.00 28.00 $ 14,000.00 28.00 $ 14,000.00 28.00 $ 14,000.00 $ 700.00 $ 13,300.00 Unit 3.011 3212.0302 2" AsPhalt Pvmt TvPe D 125/25/50) SY $ 19.00 8,424.00 $ 160,056.00 11,024.00 $ 209,456.00 11,069.75 $ 210,325.25 $ 10,516.27 $ 199,808.98 Unit 3.012 3212.0303 3" Asphalt Pvmt Type D (25/25/50) SY $ 28.00 1,757.00 $ 49,196.00 1,757.00 $ 49,196.00 1,757.00 $ 49,196.00 $ 2,459.80 $ 46,736.20 Unit 3.013 3212.0401 HMAC Transition (25/25/50) TN $ 350.00 10.00 $ 3,500.00 -$ --$ -$ -$ - Unit 3.014 3213.0301 4" Cone Sidewalk SF $ 12.00 20.00 $ 240.00 20.00 $ 240.00 140.00 $ 1,680.00 $ 84.00 $ 1,596.00 Unit 3.015 3213.0401 6" Concrete Driveway (25/25/50) SF $ 17.00 482.00 $ 8,194.00 40.00 $ 680.00 -$ -$ -$ - Unit 3.016 3216.0101 6" Cone Curb and Gutter (25/25/50) LF $ 100.00 202.00 $ 20,200.00 -$ --$ -$ -$ - Unit 3.017 3216.0301 7" Cone Valley Gutter, Residential (25/25/50) SY $ 200.00 20.00 $ 4,000.00 -$ --$ -$ -$ - Unit 3.018 3217.0113 Preformed Thermoplastic Contrast Markinas -6" Dashed (W) LF $ 5.00 4,770.00 $ 23,850.00 1,190.00 $ 5,950.00 1,190.00 $ 5,950.00 $ 297.50 $ 5,652.50 3217.0203 8" SLD Pvmt Marking Tape (W) -Preformed Thermoplastic Unit 3.019 Contrast Markings LF $ 8.00 446.00 $ 3,568.00 417.38 $ 3,339.00 315.00 $ 2,520.00 $ 126.00 $ 2,394.00 Unit 3.020 3217.0502 Preformed Thermoplastic Contrast Markings -24" Crosswalk LF $ 23.00 300.00 $ 6,900.00 225.00 $ 5,175.00 117.00 $ 2,691.00 $ 134.55 $ 2,556.45 Unit 3.021 3217.0504 Preformed Thermoplastic Contrast Markings -24" Stop Bars LF $ 23.00 83.00 $ 1,909.00 83.00 $ 1,909.00 -$ -$ -$ - 3217 .101 O Preformed Thermoplastic Contrast Markings -Legend Single Unit 3.022 Head Curve Arrows EA $ 325.00 1.00 $ 325.00 1.00 $ 325.00 -$ -$ -$ - Unit 3.023 3217.1011 Preformed Thermoplastic Contrast Markinas -Leaend ONLY EA $ 445.00 1.00 $ 445.00 1.00 $ 445.00 -$ -$ -$ - Unit 3.024 3217.2104 REFL Raised Marker TY 11-C-R EA $ 5.00 183.00 $ 915.00 183.00 $ 915.00 -$ -$ -$ - Unit 3.025 3217 .5001 Curb Address Paintina 125/25/50) EA $ 100.00 10.00 $ 1,000.00 10.00 $ 1,000.00 -$ -$ -$ - Unit 3.026 3291.0100 Topsoil (25/25/50) CY $ 70.00 10.00 $ 700.00 148.00 $ 10,360.00 148.00 $ 10,360.00 $ 518.00 $ 9,842.00 Unit 3.027 3292.01 oo Block Sod Placement (25/25/50) SY $ 9.00 20.00 $ 180.00 674.00 $ 6,066.00 674.00 $ 6,066.00 $ 303.30 $ 5,762.70 Unit 3.028 3305.0107 Manhole Adjustment, Minor WI Concrete Collar (50/50) EA $ 1,500.00 3.50 $ 5,250.00 16.00 $ 24,000.00 17.00 $ 25,500.00 $ 1,275.00 $ 24,225.00 Unit 3.029 3305.0111 Valve Box Adjustment WI Cone Collar (50/50) EA $ 450.00 6.50 $ 2,925.00 6.50 $ 2,925.00 9.00 $ 4,050.00 $ 202.50 $ 3,847.50 Unit 3.030 3471.0001 Traffic Control (25/25/50) MO $ 4,000.00 9.00 $ 36,000.00 9.00 $ 36,000.00 8.00 $ 32,000.00 $ 1,600.00 $ 30,400.00 CPN# 103381, CSC# 60069 Page4 of 5 Jackson Construction Final Payment Request ws GoRIFast 2g1 Q WSM 0 Item# Description UoM Unit Cost OrgQTY Original Rev. Qty Revised Completed QTY Work Completed Retainage Paid Unit 3.031 3305.0108 Miscellaneous Utilitv lrriaation (50/50) LS $20,000.00 1.00 $ 20,000.00 0.50 $ 10,066.00 -$ -$ -$ - Unit 3.032 * 9999.1001 Construction Allowance $ 50,000.00 $ -$ -$ -$ - Unit 3.033 3305.0107 Manhole Adiustment (Minor), No Concrete Collar EA $ 1,440.00 -$ -1.00 $ 1,440.00 1.00 $ 1,440.00 $ 71.98 $ 1,368.02 Unit 3.034 3292.0400 Seeding, Hydromuch (25/25/50) SY $ 5.00 -$ -7,432.00 $ 37,160.00 7,482.00 $ 37,410.00 $ 1,870.48 $ 35,539.52 Total $ 5,001,823.00 $5,088,315.64 $ 5,064,221.59 $253,211.09 $4,811,010.50 Trimble Water $ 2,655,455.00 $2,681,767.64 $ 2,679,529.41 $133,976.49 $2,545,552.92 Sewer $ 1,855,835.00 $1,916,015.00 $ 1,912,772.68 $ 95,638.65 $1,817,134.03 Pavina $ 490,533.00 $ 490,533.00 $ 471,919.50 $ 23,595.95 $ 448,323.55 TOTAL $ 5,001,823.00 $5,088,315.64 $ 5,064,221.59 $253,211.09 $4,811,010.50 ERP 5740010 2060000 Water 30100 $476,695.76 $ 23,834.79 $ 452,860.97 Sewer 56002 $2,674,753.15 $133,737.66 $2,541,015.49 Paving 56002 $1,912,772.68 $ 95,638.64 $1,817,134.04 TOTAL $ 5,064,221.59 $253,211.09 $4,811,010.50 � CPN# 103381, CSC# 60069 Page 5 of 5 CSC No. 60069-COI F rc>' Wo�T I Change Order Request Project NameliNee&Sanitary SerarRelacemait Correct 2019 WSMO. Put-1 City Sec No.fiW� Protect No(slISW®aNaaa44datl5rdmhl4Naeg , DOE No. WA Cry Pm No. 1033fiL1 Prolal( Replacing Water& Sanitary Streator Jahn T WNb Po. and Willans Rd. Desmgbnl Con9alol JadaMCmsWCSor,hd I Com7eoderll Dare: 212012024 CIMProlad Mgr.I PmUnre Poudyal Ctylnpecbr Byrn McDmald Phone Number: 81]3926149 Plone Nuoiba: 81]-392&306 Dept Unit l•Water Unitllk-Saaer UnINIB-Saner Unitlt-Paving Trials c0ftkw ° IcanNm y Original Cannot Meant E2.653455 1 SI.nO,5%M E53g0]]00 UW93.00 $4997,423 540 1 Extras boob I edits to Cate I Pradkg Change Orders on MSC Rocess) I I Co fact Codto DNe $2655455. 51.320.MM 553S27.631110��0008.11Jq 549+/0�/S'Lq"am Sd.99r.423d Sd0 I Bement �pylnRRrylpsJ»utne Oder 32655455.0 i E1.348.18&00 Ei]0.81]00 5490,533.00 $5,OL,�.(�560 1 0N. Fundis0ASi44l11llatleRfori�($amOdg.Fund:Avals Avlo Changes CO SN6.050M Ef01A29.00 $am $2432700 i111,d0600 RanabirO FUNS Asalatle to Be CO S1d6.05000 E101.029.00 Eg.OD E21.41.00 /ddlbnNFUNb9 (ilneressary) CHANGE ORDERS 0 DATE (INCLUDING THIS OIJE)AS% OF ORIGINAL CONTRACT Q55% E6s46.na.i JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No.1 primarily provides for the following that are necessary on the project: • 12" DI pipe for water with acceptable backf ill that was inadvertently omitted at the time the project was advertisedforbid. • Eudension of sewer main on Williams toad to accommodate future development. • Portable Message Board for traffic control for school traffic • Additional to mpora ry pavement repair. Staff concurs with the contractor's request for 20 additional calendar days on the change order. It Is uneratool and named tMt the acceplame of the Charge Oder by the connector canstiWhs an accod and sa'slactbn and represents paymm In Ira (bob time and mmeyl to Nl cash area outot or Material to, Mabwe Change Order. _ I Conbadors Company Name Contradur Name f) ConOacke Slgni JaNsm Comtmcticn. Ltd I Carmen Eslep I Ins rot q Prdecl get � v J Date (y�gpc /2/ �yZ� �/" 04118n024 1 ( iDre: alerpS05 Consrudo.5u,�niw(TP Date I chart^<o.nr.�iSYnr -r.s.(.e-,'-�_ 4,�/e'lf I Senior Assist City Albmev Ae slenlC VManagar ale I Council A0llon4f tea I M&CNumber NA M&C Dale Approv 1 FORT WORTH City of Fort Worth Change Order Additions Project Name I Water & Sanitary Sewer Replacement Contract 2019 WSM-O, Part -1 Project No.(s) I 56002/0600430/000430/57 40010/001780 Project Description Replacing Water & Sanitary Sewer on John T White Rd. and Williams Rd. DOE No.j N/A City Sec No. City Pro. No. Contractor Jackson Construction, Ltd. Change Order# CQ Date: I 2/20/2024 City Project Mgr. Pratima Poudyal IIC.M _______ 11un 31 Temporary Asphalt Paving Repair (2' HMAC on 6"Flexbase) 63 1' Water Service (Williams Road) 82 12" Water Pipe DIP, Acceptable Backfill 1 8" Sewer Pipe PVC SDR-26, Acceptable Backfill 2 8" Sewer Pipe PVC SDR-26, CLSM Backfill 20 Temporary Asphalt Paving Repair (2' HMAC on 6"Flexbase) 34 Pre-CCTV Inspection 35 Post-CCTV Inspection 36 Manhole Vacuum Testing 39 Trench Safety 41 Concrete Collar 47 4" Sewer Service 51 4' Manhole 53 4' Extra Depth Manhole 59 Portable Message Board ADDITION:S Page 1 of 1 Ci ty Inspector Byron McDonald DEPT Qty Unit Unit Cost Unit I-Water 12.0 LF $40.00 Unit I -Water 2.0 EA $2,500.00 Unit I -Water 93.0 LF $707.00 Unit IIA -Sewer 330.0 LF $130.00 Unit IIA -Sewer 40.0 LF $300.00 Unit IIA -Sewer 419.0 LF $40.00 Unit IIA -Sewer 810.0 LF $9.00 Unit IIA -Sewer 330.0 LF $7.00 Unit IIA-Sewer 1.0 EA $200.00 Unit IIA -Sewer 335.0 LF $2.00 Unit IIA -Sewer 1.0 EA $700.00 Unit IIA -Sewer 3.0 EA $2,000.00 Unit IIA -Sewer 1.0 EA $10,000.00 Unit IIA-Sewer 4.0 VF $200.00 Unit IIA-Sewer 4.0 WK $750.00 Unit I -Water Unit IIA -Sewer Unit IIB -Sewer Unit Ill -Paving Additions Sub Total 60069 103381-1 Total $480.00 $5,000.00 $65,751.00 $42,900.00 $12,000.00 $16,760.00 $7,290.00 $2,310.00 $200.00 $670.00 $700.00 $6,000.00 $10,000.00 $800.00 $3,000.00 $71,231.00 $102,630.00 $173,861.00 FORT WORTH-. City of Fort Worth Change Order Deletions Project Name .-1 -W-a-te-r &-S-a-ni-la_ry _Se-w-er_R_ep-lac_e_m-en_t _Co-n t-ra-ct-20_1_9 -W-SM_-O_,-P-art---1 ------------. Project No. ( s) I 56002/0600430/000430/574001 0/001 7 80 DOE No. N/A Project Description Replacing Water & Sanitary Sewer on John T White Rd. and Williams Rd. City Sec No. City Pro. No. 60069 103381-1 Contractor Jackson Construction, Ltd. Change Order #I Date I ....---2====��===� 2/20/2024 City Project Mgr. Pratima Poudyal ITEM DESCRIPTION 81 Construction Allowance 59 Construction Allowance City Inspector Byron McDonald DELETIONS DEPT Qty Unit Unit Cost Total Unit I -Water 0.71231 LS $100,000.00 $71,231.00 Unit IIA-Sewer 1.00 LS $75,000.00 $75,000.00 Unit I -Water $71,231.00 Unit IIA -Sewer $75,000.00 Unit 118 -Sewer Unit Ill -Paving Deletions Sub Total $146,231.00 Page 1 of 1 M/WBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO Total $0.00 Previous Change Orders CO# DATE AMOUNT Total $0.00 2/20/24 CPN 103381-1 Water and Sanitary Sewer Replacement Contract 2019, WSM-0, Part 1 Change Order 1 Notes Staff has reviewed the requested prices and considers them to be fair and reasonable. 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. Signature Pratima Poudyal, P.E. Name of Employee Project Manager TA le ATTEST: A A:cc� Jannnette Goodall City Secretary FORT WORTH City of Fort Worth CSC No. 60069-0O2 Change Order Request Project Name:1 Water & Sanitary Sewer Replacement Contract 2019, WSM-0 Part i I City Sec 1 1 6 00 6 9 Projectisla(sil I NTP N/A City Proj.1 1038N Project Desc pdona Water and Sewer Lines Replacement and Pavement Improvements Contmctorl Jackson Construction, Ltd. City Project Mgr.1 Aaron Nivone Phone Number. 817392-9404 Dept. Original Contract Amount Exlrasto Date Credits to Date Panting Change Orders (in M&C Process) ContmctCost to Date 1Amount of Part q� Change Order Revised Contrac(AmmnI Original Funds Available for Change Orders Remaining Funds Available far this CO Additional Funding (A necessary) Unit Unit IIA Water Sewer 1$2,655,455.00 $1,320,558.01 1 $0.00 $27,630.00 I �$251 � .64"119a80� $2, 767.64:41,'3�A5138.Oi1 1 $146,050.00 $101,829.00 1 $146.050.00 $74.199.00 1 Change Order# 0 Date: 1120f2024 City Impactor. I Byron McDonald Phone Numbed 817392-M Un! 6 , Contract Time Unit III Sewer Pavement Totals /,Calendordovsl $530.877.00 $490,533.00 7//423.00 $q0 $0.00 $0.00 19630.00 20 $51�n.0o $4�a1533.w zr�pM53D0 560 50.00 50.00 ,�62.64 39 $530.877.00 $490.533.00 $5.01 599 $0.00 $24.527.00 $266.406.00 $0.00 $24.527.00 $238.776.00 CHANGE ORDERS to DATE ONCLUDING TWS ONE) AS% OF ORIGINAL CONTRACT 1M MAX ALLOWABLE CONTRACTAMOUNT(ORIGINAL CONTRACT COST +28%J 1Q24Qn8.75 f -it Jill Vi Change Order No.2 primarily provikfas or he Ilowing vial are neoess a pmtec : -Excavation and removal of previously unknown 16' CIP line that runs parallel to new 16' DIP, including trench excavation, ball, pipe removal, 34'stone embedment, hauling of dirt spoils, hauling of abandoned pipe, extra dump fees, and 16' water abandonment & plug. -Removal and replacement of existing leaking extra -depth fire hydrant at the intersection of Williams Rd &John T White Rd. -Removal and replacement of brick pavers that were not included in original bid. -Installation of 12' DIP Sewer pipe with CLSM backfill. MdddonaI one 4' Manhole with Odor Control Vent that was not included in original bid. -Stabilizing existing Oncor power pole, required as it ran up against sewer manhole being replaced. Staff concurs with the contractor's request for39 additional calendar days for the change order. It's understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or incidental to, the aboveChargeOrrder. Contractor's Company Name Contra)0'N2igy�i L11, 1 AIIL p5jI0I�ontractor Signature Date Jacks on Construction, Lld. Carmen Estop Ij ""i ivzweesa 11 Q u20s4 Director (Water Derft J rlli U _h JJ_ 8.12/(14122 1.?mdtgmal. .A,, 1.m .I1 li 11I is, wilaii 1/IX C. Action (it' M&C Number WA anger Date ' 1112V2024 11IMAJIL11ir11111Lb,iIJllllit Date Date I i 1 zfDsnmdl� M&C Data Approved FORTV\TORTH -City of Fort Worth Change Order Additions Project Name Project No.(s): 1-'roJect DP.sr.rintion Water & Sanitary Sewer Replacement Contract 2019, WSM-O Part 1 56002-0600430/0700430/5740010-103381-001780 Water and Sewer Lines Replacement and Pavement Improvements Contractor Jackson Construction, Ltd. City Project Mgr. .... I _A_a _ro _n _N _ivo_n_e _____________. ADDITIONS IIEM DESCRIP I ION Excavate & Remove 16" CIP that runs parallel to new 16" DIP; includes additional trench excavation and backfill, pipe removal, 3/4" stone embedment, haul off of dirt 83 spoils, haul off of abandoned pipe, and extra dump fees 84 16" Water Abadonment Plug Remove & Replace Extra Depth Fire Hydrant with New at Williams Rd & John T 85 White Rd. 4 8" DIP Sewer Pipe, CLSM Backfill (w/ Epoxy Lining, Protecto 401 or Equal) 61 Remove & Replace Brick Pavers 62 12" DIP Sewer Pipe, CLSM Backfill (w/ Epoxy Lining, Protecto 401 or Equal) 21 4' Manhole w/ Odor Vent 31 Remove Sidewalk 32 Stabilize Existing Oncor Power Pole Page 1 of 3 City Sec No.: 60069 DOE No.I N/A City Proj. No.: I 103381-1 ] Change Order: I 2 I Date:! 11/20/2024 City Inspector I Byron McDonald DEPT Qty Unit Unit Cost Total Unit I Water 250.00 LF $107.16 $26,790.00 Unit I Water 2.00 EA $4,034.32 $8,068.64 Unit I Water 1.00 EA $13,223.00 $13,223.00 Unit IIA Sewer 90.00 LF $300.00 $27,000.00 Unit IIA Sewer 50.00 SF $15.00 $750.00 Unit IIA Sewer 20.00 LF $460.00 $9,200.00 Unit IIB Sewer 1.00 EA $29,000.00 $29,000.00 Unit IIB Sewer 931.00 SF $5.00 $4,655.00 Unit IIB Sewer 1.00 EA $3,635.00 $3,635.00 Unit I Water $48,081.64 Unit IIA Sewer $36,950.00 Unit IIB Sewer $37,290.00 Unit Ill Pavement Additions Sub Total $122,321.64 F_ ORT WO RT Ii City of Fort Worth .MW Change Order Deletions Project Name Water& Sanitary Sewer Replacement Contract 2019, WSM-0 Part 1 j City Sec No.: 60069 Project No.(s): 56002-06004301070043015740010-103381-001780 1 DOE No. N/A City Proj. No.: 103381-1 Project Description I Water and Sewer Lines Replacement and Pavement Improvements Contractor Jackson Construction, Ltd. Change Order: F Date 11/20/2024 City Project Mgr. Aaron Nivone Cry Inspector: Byron McDonald DELETIONS REM IDESCRIPTION DEPT Oty l)nit Jnit Coat ITatal 81 9999. 1001 Construction Allowance Unit I Water 0.28769C_S $100,000.00 $28,769.00 30 9999.1001 Construction Alowance UnitlIBSewer 0.93 LS $40,000.0C$37,290.00 Unit I Water $28,769.00 Unit IIA Sewer Unit Its Sewer $37,290.00 Unit III Pavement Page 2 of 3 Deletions Sub Total $66,059.00 M/WBE Breakdown for this Change Order MWBE Sub Type of Service II Amount for this CO 11 Total $0.00 Previous Change Orders CO# DATE AMOUNT Total $0.00 Page 3 of 3 11/20/24 CPN 103381-1 Water and Sanitary Sewer Replacement Contract 2019, WSM-0, Part 1 Change Order 2 Notes Staff has reviewed the requested prices and days and considers them to be fair and reasonable. 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 requ cements. Ug&W 5gne by Fern Ni"e N .: ..11.1310]7l 0600 Signature Aaron Nivone Name of Employee Professional Engineer Title ATTEST'.A � . Janette S. Goodall City Secretary FORT WORTH City of Fort Worth CSC No. 60069-CO3 Change Order Request Project Name:( Water &In itarySewer Reptacenent Contract2019,W94-OPart1 'City Sec No.:1 60069 1 Project Nh.(s):I 56002-0600430/0700430/5740010-103381-001780 II NTP N/A City Proj.No.f 103381-1 Project DesctlpOon: Waterand Sewer Lines Replacement and Pavement Improvements Chnhacthr: Irl[ Jackson Construction, Ltd. 1 Change Order# Date: 6/12/2025 City Project Mgr.l Aaron Nivhne ' City Inspector: 1 Byron McDonald Phone Number.! 817-392-8404 ' Phone Numberj 817-392-8306 Unit Unit 11B Unitl 11 Contract Dept. UnitllASewer Totals Water Sewer Paving Time Originat ContractAmount 1$2,655,455.00 $1,320,558.00 $530,877.00 $490,5330 1 $4,997,4231QQ i5p0 I Extras to Date 1 $19,312.64 $64,580.00 $0.00 $0.00 1 $83,892. 59 Chad its to Date 1 Pending Change Orders (in M&C Process) Contract Cost to Date $2.674,767.64 $1,385,138.00 $530,8]].00 $490,533.00 $5,081,315.64 599 Change Order I E7.000.10 -E10,359.75 E10,359.75 E0.00 E7,000.01 11 Rm%dCPropoAftl em ntract mount $2,681,767.64 $1,374,778.25 $541,236.75 $490,533.00 $5,088,315.64 610 Originat Funds Availabte for Change Orders $146,050.00 $101,829.00 $0.00 $24,527.00 1 $272,406.00 Remaining Funds Availabte for this CO $126,]3].36 $37,249.00 $0A0 $24,527.00 $188,513.36 Addnionat Funding (if necessary) CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS% OF ORIGINAL CONTRACT 1.82No MAXALLOWABLECONTRACTAMOUNT(ORIGINAL CONTRACTCOST+25%) ... _. 1 FdfCCRAFTiE Change Order No. 3 pri marl Ly provides for the following on the project • AdditionaL water services and meter connections. • Additional manhole adjustments with and without concrete collars. • Re moving and replacingseven (7)watertightgasket manhote rings &covers with hinged rings &covers. • Ad ditionat hydromutch, things it, block sod that was not anticipated at the time of project bid. • The deletion of pay item quantities that are no Longer needed on the project. Staff concurs with the contractors request for 11 add itio net cotem ar days for the change order. It is understand and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents havment in fu1L (both time and monevl for a0 costs arising out of. or incideni to. the above Change Order. Jackson Construction, Ltd. Carmen Estep I6"�- Inspector Date 06/26/2025 e�" * 06/23/2025 Director (Water Dept) Date °f - T.S. 06/30/2025 4,J� 06/26/2025 c ,VI mn Assistant City Attorney DateMMMMMxMMMMMW-:Date 07/10/2025 �W; - 671141202 . Council. Action (if Required) - M&C N u m bar N/A M&C Date Approved N/A FORT WORTH City of Fort Worth Change Order Additions ,---------------------------------� Project Name Water & Sanitary Sewer Replacement Contract 2019, WSM-O Part 1 Project No.(s): I 56002-0600430/0700430/5740010-103381-001780 Project Description Water and Sewer Lines Replacement and Pavement Improvements DOE No.I N/A City Sec No.: 60069 City Proj. No.: 103381-1 Contractor! Jackson Construction, Ltd. I Change Order: � Date: I 6/12/2025 City Project Mgr.I Aaron Nivone �-------------------' City Inspector Byron McDonald ADDITIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 1.066 3312.2002 1" Water Service by bore (John TWhite Road Assessment Tap \A Unit I Water 1.00 EA $4,000.00 $4,000.00 1.069 331 2.2201 2" Water Service, Meter Reconnection Unit I Water 2.00 EA $1,500.00 $3,000.00 3305.0112 Remove and Replace seven (7) watertight gasket manhole rings Unit IIA Sewer 1.00 LS $25,774.55 $25,774.55 2A.063 & covers with hinged manhole rings & covers 2B.032 Stabilize Existing Oncor Power Pole Unit IIB Sewer 2.85 EA $3,635.00 $10,359.75 3.011 3212.0302 2" Asphalt Pvmt Type D (25/25/50) Unit Ill Paving 2600.00 SY $19.00 $49,400.00 3.026 3291.0100 Topsoil (25/25/50) Unit Ill Paving 138.00 CY $70.00 $9,660.00 3.027 3292.0100 Block Sod Placement (25/25/50) Unit Ill Paving 654.00 SY $9.00 $5,886.00 3.028 3305.0107 Manhole Adjustment, Minor W/ Concrete Collar (50/50) Unit Ill Paving 12.50 EA $1,500.00 $18,750.00 3.033 3305.0107 Manhole Adjustment (Minor), No Concrete Collar Unit Ill Paving 1.00 EA $1,440.00 $1,440.00 3.034 3292.0400 Seeding, Hydromulch (25/25/50) Unit Ill Paving 7432.00 SY $5.00 $37,160.00 Unit I Water $7,000.00 Unit IIA Sewer $25,774.55 Unit IIB Sewer $10,359.75 Unit Ill Paving $122,296.00 Additions Sub Total $165,430.30 FORT WORTH City of Fort Worth Change Order Deletions r----------------------------------, Project Name Water & Sanitary Sewer Replacement Contract 2019, WSM-O Part 1 Project No.(s): I 56002-0600430/0700430/5740010-103381-001780 Project Description Water and Sewer Lines Replacement and Pavement Improvements DOE No.j N/A City Sec No.: 60069 City Proj. No.: 103381-1 6/12/2025 Contractor I Jackson Construction, Ltd. I Change Order: 3 Date: j �============;----� r---==:::::::'._----====� City Project Mgr. j �-----------------� Aaron Nivone City Inspector Byron McDonald DELETIONS ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total 2A.045 3305.0203 Imported Embedment/Backfill, CLSM Unit IIA Sewer 144.537 CY $250.00 $36,134.30 3.002 0241.0401 Remove Concrete Drive (25/25/50) Unit Ill Paving 354.000 SF $5.00 $1,770.00 3.003 0241.1300 Remove Cone Curb & Gutter (25/25/50) Unit Ill Paving 202.000 LF $12.00 $2,424.00 3.008 3123.0101 Unclassified Street Excavation (25/25/50) Unit Ill Paving 50.000 CY $62.00 $3,100.00 3.013 3212.0401 HMAC Transition (25/25/50) Unit Ill Paving 10.000 TN $350.00 $3,500.00 3.015 3213.0401 6" Concrete Driveway (25/25/50) Unit Ill Paving 442.000 SF $17.00 $7,514.00 3.016 3216.0101 6" Cone Curb and Gutter (25/25/50) Unit Ill Paving 202.000 LF $100.00 $20,200.00 3.017 3216.0301 7" Cone Valley Gutter, Residential (25/25/50) Unit Ill Paving 20.000 SY $200.00 $4,000.00 3.018 3217.01 13 Thermoplastic Contrast Markings -6" Dashed (W) Unit Ill Paving 3580.000 LF $5.00 $17,900.00 3.019 3217.0203 8" SLD Pvmt Marking Tape (W) -Thermoplastic Contrast Unit Ill Paving 28.625 LF $8.00 $229.00 3.020 3217 .0502 Thermoplastic Contrast Markings -24" Crosswalk Unit Ill Paving 75.000 LF $23.00 $1,725.00 3.031 3305.0108 Miscellaneous Utility Irrigation (50/50) Unit Ill Paving 0.4967 LS $20,000.00 $9,934.00 3.032 9999.1001 Construction Allowance Unit Ill Paving 1.000 LS $50,000.00 $50,000.00 Unit I Water $0.00 Unit IIA Sewer $36,134.30 Unit 11B Sewer $0.00 Unit Ill Paving $122,296.00 Deletions Sub Total $158,430.30 M/WBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO Total $0.00 Previous Change Orders CO# DATE AMOUNT Total $0.00 6/12/2025 Water & Sanitary Sewer Replacement Contract 2019, WSM-O Part 1 CSC:60069 CPN 103381-1 Change Order 3 Notes Staff has reviewed the requested prices and days and considers them to be fair and reasonable. Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and admmistmtion of this contract, including ensuring all performance and reporting requ cements. Ug&W 5gne by Fern Ni"e N .: ..11.1310]7l 0600 Signature Aaron Nivone Name of Employee Professional Engineer Title ATTEST: Jannette S. Goodall City Secretary FORT WORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: contract 2019 wsno part 1 CITY PROJECT NUMBER: 103381 WATER PIPE LAID SIZE TYPE OF PIPE DIP 16 DIP DIP restrained 16 DIPrestrained Casing 30 Casing DR14 12 PVC DR14 8 PVC DIP 8 DIP DR14 6 PVC FIRE HYDRANTS: 3 VALVES (16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE DENSITIES: TAKEN AND PASSED NEW SERVICES: 1 COPPER IS COPPER 2 COPPER SEWER PIPELAID SIZE TYPE OF PIPE SDR26 8 PVC SDR26 CLMS 8 PVC DIP 8 DIP DIP CLSM 8 DIP DIP 12 DIP SDR26 CO 8 PVC SDR26 18 PVC PIPE ABANDONED SIZE TYPE OF PIPE DENSITIES: TAKEN AND PASSED NEW SERVICES: 4 PVC 4 BORE PVC TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Thm&mormn Street • Fort Worth, TX 76012 6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 LF 2516 30 30 66 1340 57 61 4 LF 8EA IEA 3 EA LF 757 20 1168 273 500 152 310 LF 17 EA 19 EA FORT WORTH® TRANSPORTATION AND PUBLIC WORKS September 22, 2025 Jackson Construction, LTD 5112 Sun Valley Dr. Fort Worth, TX 76199 RE: Acceptance Letter Project Name: Water and Sanitary Sewer Replacement Contract 2019, WSM-O Part 1 Project Type: Water, Sanitary Sewer & Paving City Project No.: 103381-1 To Whom It May Concern: On May 16, 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 May 16, 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 conceming this letter of acceptance, please feel free to contact me at 817- 392-8271. Sincerely, Thang Sum, Project Manager T4_ Lawrence Hamilton, Program Manager .� ft an Cc: Byron McDonal, Inspector Gary Deyon, Inspection Supervisor Edward Davila, Senior Inspector Lawrence Hamilton, Program Manager A.N.A Consultants, LLC, Consultant Jackson Construction, Contractor N/A, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov a .oanass . JACKSON CONSTRUCTION LTD. 51 12 SUN VALLEY DRIVE FORT WORTH, TX 76119 TEL 817-572-3303 FAX 817478-0443 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 Troy L. Jackson, President Of Jackson Construction, Ltd, 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; Contract 2019, WSM-O Part 1 BY'_--- I�n, toy L ac son, Pre Subscribed and sworn before me on this date 25th of August, 2025. 10, CRflMEN L. Wto ,.e✓"r"r'� ,= j • n'. .Nic. State Of iex CONSENT OF SURETY TO FINAL PAYMENT ALA Document G707 Bond No. 1097538 OwIVRR ❑ ARCHITECT ❑ CONTRACTOR ❑ SUREfy ❑ OTHER P TO OWNER: ARCHITECT'S PROJECT NO.: panear,dmanenJ City of Fort Worth 200 Texas St. CONTRACT FOR: Fort Worth, TX 76102 PROJECT. CONTRACT DATED: August 8, 2023 fvmeandedhm) Water and Sanitary Sewer Replacements, Contract 2019, WSM-O Part 1, CPN 103381-1 In umrdancevmh the provlsionsofthe Ctxeraa betwaen dte Ownerand the Cona=was mdiatedalxi the (JINN(M1MYalHltldd� (JNn4,1'J The Hanover Insurance Company 440 Lincoln Street Worcester, MA 01653 SURETY, on bond of (Lmn rtumaMaddra gfQnlmc�rl Jackson Construction, Ltd. 5112 Sun Valley Drive Fort Worth, TX 76119 CONTRACTOR, hereby approves of the final payment to the Cantrnemr, and agrees that Rtml payment to the Omnacmr shall nor relleve the Surety of any of Its ebiigadons to Plvrt Nww.wamnl,m ywv=n City of Fort Worth 200 Texas St. Fort Worth, TX 76102 OWNRR as set forth in said Surety's band. INWITNESSWHEREOF, the9mety1wherconsw n Rs hand on thin date: August25,2025 roaw,m..Jrnrtun»A„wk+a„eu; a.n,..,.e,rtd rca..ry�,.l The Hanover Insurance Company y 7$T4 By Attar (seal): (...� Holly Clevenger Attorney -in -Fact �_,/ rrmadla,.rraldlxwt 0707-1994