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HomeMy WebLinkAbout061683-FP2 - Construction-Related - Contract - Ridgemont Commercial ConstructionFORT WORTH® -FP2City Secretary 61683 Contract No. ______ _ Date Received ll/l2/2025 11/19/2025 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: Nafex Way City Project No.: 103930 Improvement Type(s): Water� Original Contract Price: Sewer� Amount of App roved Change Order(s): Revised Contract Amount: Total Cost of Work Complete: Stade T ur11er Slade Turner (Nov 10 2025 10:56:36 CST\ Contractor Director Title Ridgemont Commercial Construction Company Name ,A1 ... w- Donald Watson (Nov 10, 202515:39:33 CST) Project Inspector Mowl.age Moha111111dee11,?. f. Project Manager CFA Manager TPW Director Asst. City Manager 11/10/2025 Date 11/10/2025 Date 11/11/2025 Date 11/12/2025 Date 11/12/2025 Date 11/13/2025 Date $773,911.00 $2,080.00 $775,991.00 $775,991.00 Page 1 of 2 Notice of Project Completion Project Name: Nafex Way City Project No.: 103930 City's Attachments Final Pay Estimate IZI Change Order(s): IZI Yes □N/A Pipe Report: IZI Yes □N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 110 WD Work Start Date: 11/4/2024 Completed number of Soil Lab Test: 262 Completed number of Water Test: 7 Days Charged: 197 WD Work Complete Date: 10/2/2025 Page 2 of 2 fORTWORTH ... ,,,,,-, ,. CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name Contract Limits Project Type NAFEX WAY DEVELOPMENT WATER & SEWER City Project Numbers 103930 DOE Number 3930 Estimate Number Payment Number For Period Ending 10/2/2025 WO City Secretary Contract Number Contract Date Project Manager NA Contractor RIDGEMONT COMMERCIAL CONSTRUCTION 1520 W. WALNUT HILL LANE Inspectors Thursday, October 30, 2025 IRVING, TX 75038 T. GARDNER / T. HENRY Contract Time 1 lWD Days Charged to Date 197 Contract is 100.00 Complete Page 1 of5 City Project Numbers 103930 DOE Number 3930 Contract Name NAFEX WAY DEVELOPMENT Estimate Number Contract Limits Payment Number Project Type WATER & SEWER For Period Ending 10/2/2025 Project Funding UNIT I: WATER IMPROVEMENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- AS-BUILT SURVERY 1 LS $1,000.00 $1,000.00 $1,000.00 2 REMOVE 12" WATER LINE 92 LF $16.00 $1,472.00 92 $1,472.00 3 REMOVE 24" WATER LINE 54 LF $25.00 $1,350.00 54 $1,350.00 4 24" PRESSURE PLUG EA $3,000.00 $3,000.00 $3,000.00 5 4"-12" PRESSURE PLUG EA $835.00 $835.00 $835.00 6 SAVAGE 20" WATER VAL VE EA $3,440.00 $3,440.00 $3,440.00 7 12" WATERLINE LOWERING 2 EA $6,500.00 $13,000.00 2 $13,000.00 8 EXPLORATORY EXCAVATION OF EXISTING 6 EA $1,000.00 $6,000.00 6 $6,000.00 UTILITIES 9 TRENCH SAFETY 202 LF $1.00 $202.00 202 $202.00 10 DUCTILE IRON WATER FIYYINGS W/ 2.51 TN $15,500.00 $38,905.00 2.51 $38,905.00 RESTRAINT 11 8" PVC WATER PIPE 43 LF $195.00 $8,385.00 43 $8,385.00 12 12" DIP WATER 90 LF $225.00 $20,250.00 90 $20,250.00 13 12" DIP WATER, CLSM BACKFILL 40 LF $225.00 $9,000.00 40 $9,000.00 14 24" CONCRETE A WW A C303 WATER PIPE 69 LF $2,200.00 $151,800.00 69 $151,800.00 15 24" CONCRETE A WW A C303 WATER PIPE, CSS 49 LF $2,200.00 $107,800.00 49 $107,800.00 BACKFILL 16 CONNECTION TO EXISTING 4"-12" WATER 8 EA $8,850.00 $70,800.00 8 $70,800.00 17 4" COMBINATION AIR VAL VE ASSEMBLY FOR EA $20,000.00 $20,000.00 $20,000.00 WATER 18 1 1/2" WATER SERVICE 2 EA $2,625.00 $5,250.00 2 $5,250.00 19 2" WATER SERVICE 2 EA $3,090.00 $6,180.00 2 $6,180.00 20 8" GATE VALVE 2 EA $2,395.00 $4,790.00 2 $4,790.00 21 24" GATE VALVE EA $57,115.00 $57,115.00 $57,115.00 22 8" BLOW OFF VAL VE EA $12,625.00 $12,625.00 $12,625.00 -------------------------------------- Sub-Total of Previous Unit $543,199.00 $543,199.00 UNIT II: SEWER IMPROVEMENTS Item No. Description of Items POST -CCTV INSPECTION (CO#l) Thursday, October 30, 2025 Estimated Unit Unit Cost Estimated Completed Completed Quanity Total Quanity Total 744 LF $2.00 $1,488.00 744 $1,488.00 Page2 of5 City Project Numbers 103930 DOE Number 3930 Contract Name NAFEX WAY DEVELOPMENT Estimate Number Contract Limits Payment Number Project Type WATER & SEWER For Period Ending 10/2/2025 Project Funding 2 MANHOLE VACUUM TESTING 8 EA $250.00 $2,000.00 8 $2,000.00 3 TRENCH SAFETY 729 LF $2.00 $1,458.00 729 $1,458.00 4 TRENCH WATER STOPS 5 EA $1,250.00 $6,250.00 5 $6,250.00 5 MANHOLE ADJUSTMENT 2 EA $1,000.00 $2,000.00 2 $2,000.00 6 20" CASING BY OPEN CUT 40 LF $500.00 $20,000.00 40 $20,000.00 7 8" SEWER CARRIER PIPE 40 LF $110.00 $4,400.00 40 $4,400.00 8 8" SEWER PIPE (CO#l) 724 LF $110.00 $79,640.00 724 $79,640.00 9 8" SEWER PIPE, CSS BACKFILL 30 LF $140.00 $4,200.00 30 $4,200.00 10 LINER -4' SEWER MH 46.89 VF $400.00 $18,756.00 46.89 $18,756.00 11 4'MANHOLE 6 EA $10,000.00 $60,000.00 6 $60,000.00 12 4' DROP MANHOLE 2 EA $15,000.00 $30,000.00 2 $30,000.00 13 6" SEWER PIPE (CO#l) 20 LF $130.00 $2,600.00 20 $2,600.00 -------------------------------------- Sub-Total of Previous Unit $232,792.00 $232,792.00 Thursday, October 30, 2025 Page 3 of5 City Project Numbers 103930 Contract Name NAFEX WAY DEVELOPMENT Contract Limits Project Type Project Funding WATER & SEWER DOE Number 3930 Estimate Number Payment Number For Period Ending 10/2/2025 Contract Information Summary Original Contract Amount $773,911.00 Change Orders Change Order Number $2,080.00 Thursday, October 30, 2025 Total Contract Price $775,991.00 Total Cost of Work Completed Less Earned This Period Retainage This Period % Retained Net Earned $775,991.00 $0.00 Less Liquidated Damages Days@ /Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment $775,991.00 $0.00 $775,991.00 $0.00 $0.00 $0.00 $0.00 $0.00 $775,991.00 Page4 of5 City Project Numbers 103930 Contract Name Contract Limits Project Type Project Funding NAFEX WAY DEVELOPMENT WATER & SEWER Project Manager NA Inspectors T. GARDNER / T. HENRY DOE Number 3930 Estimate Number Payment Number For Period Ending 10/2/2025 Contractor RIDGEMONT COMMERCIAL CONSTRUCTION City Secretary Contract Number Contract Date Contract Time 110 WD 1520 W. WALNUT HILL LANE IRVING, TX 75038 Days Charged to Date 197 WD Contract is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Thursday, October 30, 2025 Amount Funded Gross Retainage Total Cost of Work Completed Less % Retained Net Earned Earned This Period Retainage This Period $775,991.00 $0.00 Less Liquidated Damages 0 Days@ $0.00 /Day LessPavement Deficiency Less Penalty Less Previous Payment Plus Material on Hand Less 15% Balance Due This Payment Net $775,991.00 $0.00 $775,991.00 $0.00 $0.00 $0.00 $0.00 $0.00 $775,991.00 Page 5 of5 Docusign Envelope ID: OF? A80EA-FFE9-4200-9194-ABDE0AEA03CD PROJECT NAME: CONTRACT: CFA# CITY PROJECT# CITY SECRET ARY CONTRACT # FID# X# FILE# INSPECTOR: PROJECT MANAGER: ORIGINAL CONTRACT EXTRAS TO DATE CREDITS TO DA TE CONTRACT TO DATE AMOUNT OF PROP, CHANGE ORDER REVISED CONTRACT AMOUNT TOTAL REVISED CONTRACT AMOUNT PER UNIT REVISED COST SHARE TOTAL REVISED CONTRACT Revised: 12-17-2018 REVIEWED DEVELOPER-AWARDED-PROJECT CHANGE ORDER By Mosadage Mohammdeen at 2:16 pm, Oct 16, 2024 Nafex Way Development CHANGE PAVING, GRADING DRAINAGE AND UTILITY ORDER No: CFA22-0135 I CITY PARTICIPATION:! NO 103930 61683 30114-0200431-103930-E07685 X-27241 SD-0670 Henry Tristan Mosadage Mohammdeen Phone No: Phone No: WATER SEWER Developer Developer Cost City Cost Cost City Cost $543,199.00 $0.00 $230,712.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $543, 199,00 $0.00 $230,712.00 $0,00 $0,00 $0.00 $2,080.00 $0,00 $543,199.00 $0.00 $232,792.00 $0.00 $543,199,00 $232,792.00 Dev, Cost: $1,381,008.14 817-653-1423 817-392-2443 CONTRACT UNIT DRAINAGE Developer Developer PAVING STREET LIGHTS Developer Cost City Cost Cost City Cost Cost City Cost $522,089.00 $0.00 $82,928.14 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $522,089.00 $0,00 $82,928.14 $0.00 $0.00 $0.00 $0.00 $0,00 $0.00 $0.00 $0.00 $0.00 $522,089.00 $0.00 $82,928.14 $0.00 $0.00 $0.00 $522,089.00 $82,928.14 $0.00 lcityCost: $0,00 $1,381,008.14 CONTRACT DAYS 110 110 0 110 Page 1 Docusign Envelope ID: OF? A80EA-FFE9-4200-9194-ABDEOAEA03CD UNIT II: SANITARY SEWER IMPROVEMENTS CITY BID ITEM PAY ITEM# # QUANTITY UNIT ITEM DESCRIPTION 1 3301.0002 15 LF Post-CCTV Inspection 8 3331.4115 -5 LF 8" Sewer Pipe 13* 3331.4108 20 LF 6" Sewer Pipe TOTAL UNIT II: SANITARY SEWER IMPROVEMENTS Asterisk (*) indicates New Pay Item Revised: 12-17-2018 Developer UNIT PRICE Cost $2.00 $30.00 $110.00 ($550.00) $130.00 $2,600.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 �080.00 City Cost TOTAL $30.00 ($550,00) $2,600.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $2,080.00 Page 2 I I fORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Nafex Wa CITY PROJECT NUMBER: 103930 WATER PIPE LAID SIZE TYPE OF PIPE LF open cut trench 8" DR14PVC 43 open cut trench 12" Ductile Iron Pipe 110 open cut trench 24" Concrete C303 Water Pipe 118 FIRE HYDRANTS: NIA VALVES (16" OR LARGER) ---------------------PIPE ABANDONED DENSITIES: NEW SERVICES: PIPE LAID Open Cut PIPE ABANDONED NIA DENSITIES: SIZE 1-1/2" 2" SIZE 8" SIZE TYPE OF PIPE LF 24" Gate Valve Copper Pipe 20.00 LF Copper Pipe 20.00 LF SEWER TYPE OF PIPE LF SDR26 799 TYPE OF PIPE LF NEW SERVIC_E_S _: _______ N_I_A________________________ _TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth• 1000 Throckmorton Street• Fort Worth, TX 76012-6311 (817)392 -7941 • Fax: (817) 392 -7845 Rev. 8/20/19 TRANSPORTATION AND PUBLIC WORKS October 3, 2025 Ridgemont Commercial Construction 1520 W. Walnut Hill Lane IRVING TX, 75038 RE: Acceptance Letter Project Name: NAFEX WAY Project Type: Developer City Project No.: 103930 To Whom It May Concern: On October 9, 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 October 24, 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 October 24, 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- 392-2443 . Sincerely, Mohammdeen Mosadage P.E, Project Manager Cc: Edgar Estrada, Inspector Don Watson, Inspection Supervisor Aaron Ybarra, Senior Inspector Andrew Goodman, Program Manager Kimkey Horn, Consultant Ridgemont Commercial Construction, Contractor CHIPT Dallas Cantrell Sansom, L.P, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov STATE OF COUNTY OF AFFIDAVIT Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Name, Title Of Company, 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 Description Subscribed and sworn before me on this date Day of Month, Year. Notary Public County, State UREEN MCDONNELL Notary Public STATE OF TEXAS ID# 12973278•9 Comm. Ex . Mar. 3, 2026 CONSENT OF OWNER □ SURETY COMPANY ARCIIITECT □ TO FINAL PAYMENT CONTRACTOR □ SURETY □ AIA DOCUMENT 0707 OTHER Bond No. 9453869 PROJECT: (name, address) Cantrell Sansom Industrial -Paving, Drainage &Utility Mgmt to serve NAFEX Way Development TO (Owner) [ City of Fort Worth 1000 Throckmorton Street Fort Worth, TX 76102-6312 ] ARCHITECT'S PROJECT NO: CONTRACT FOR: CONTRACT DATE: CONTRACTOR: The Ridgcmont Company dba Ridgcmont Commercial Construction 1520 W. Walnut Hill Lane Irving, TX 75038-3701 In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the (here insert name and address of Surety Company) Colonial American Casualty and Surety Company Fidelity and Deposit Company of Maryland 1299 Zurich Way, 5th Floor, Schaumburg, IL 60196 on bond of (here insert name and address 01 Contractor) , SURETY COMPANY, The Ridgemont Company dba Ridgemont Commercial Construction 1520 W. Walnut Hill Lane Irving, TX 75038-3701 , CONTRACTOR, hereby approves of the final payment to the Contractors, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to (here insert name and address of Owner) City of Fort Worth 1000 Throckmorton Street Fort Worth, TX 76102-6312 as set forth in the said Surety Company's bond. IN WITNESS WHEREOF, the Surety Company has hereunto set its hand this 6th day of November 2Q25 ,OWNER, Colonial American Casualty and Surety Company & Fidclitv and Deposit Company of Maryland Surety Company --- Signature of Authorized Representat� � Debra Lee Moon -Attornev-1 n-Fa�t Title NOTE: This fom1 is to be used as a companion document to AJA DOCUME:-,"T G706. CO:S:TRACTOR'S AFFIDAVIT OF PA YME:S:T OF DEOTS A:-19 Cl.AIMS, Current Edition AJA DOCUMENT G707 • CONSENT OF SURETY COMPA:"IY TO FINAL PA YML:;>;T • APRIL 1970 EDITIOJI: • AIA® © 1970 • THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 !':cw York Ave., NW, WASHINGTON, D.C. 20006 Oi':E PAGE ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERlCAi'i INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Illinois, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Illinois (herein collectively called the "Companies"), by Christopher Nolan, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set fonh on the reverse side hereof and arc hereby ccnified to be in full fore<: and effect on the date hereof, do hereby nominate, constitute, and appoint John R. WARD, Howard COWAN, Alyssa J. LOPEZ, Thomas D. MOORE, Sandra L. RONEY, Debra Lee MOON, Andrea R. CRAWFORD, Troy R. KEY , Emily A. MIKESKA, Allyson W. DEAN, Colin E. CONLY, Andrew G. ADDISON, Patrick T. COYLE, Elizabeth ORTIZ, Ana OWENS, Andrew Patrick CLARK, Faith Ann HILTY, Kimberly R. GONZALEZ, Crystal G. LANGHORN, Steven W. LEWIS, Sheri R. ALLEN, Peggy G HOGAN, Teresa AYALA, Cory K1PER, Ross R. LARIS, Kelli A. GORHAM, Mark R. ADAMS of Addison, Texas, its true and lawful agent and Attorney-in-Fact, to make, execute, seal and deliver , for , and on its behalfas surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall beas binding upon said Companies, as fully and amply, to al l intents and pUipOscs, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York , l'\cw York., the regularly elected officers of the COLONIAL AMERJCAN CASUAL TY AND SURETY COMPANY at its office in Owi ngs Mills, Ma ryland., and the regularly elected officers of the FIDBLITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President docs hereby certify that the extract set forth on the reverse side hereof is a true co py of Article V, Section 8, of the By-Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the sai d Vice-President has hereunto subscribed his/her names and affixed the Co rporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 23rd day of June, A.D. 2025. By: Christopher Nolan Vice Presidenl r-l)awfu l Ldt/J« �---. By: Dawn£. Brown Secretary State of Maryland County of Baltimore ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY 1-'IDELITY AND DEPOSIT COMPANY OF MARYLAND On this 23rd day of June, A.D. 2025, before the subscriber, a Notary Public of the State of Ma ryland. duly commissioned und qualified, Christopher Nolan, Vice President and Dawn E. Brown, Secretary of the Companies, to me personally known to be the individuals and offic�r.s--OeSCrlbed-in..�nd who executed the prueding instrument, and ucknowledged the execution of same , and being by me duly sworn, dcposcth and saith, tha �-h i:{she;s tht said_offic�r of the Company aforesaid, and that the seals affixed to the preceding instrument arc the Corporate Seals of said Companies, ond thaf t/Jc said_ Coipo�tc Seals ·andthe signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Co rpQr.l�ioiis.. : • •... • • IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above wrincn. :· Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the I 5th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney ... Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: 11 That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this� day of November , 2025 . Mary Jean Pethick Vice President TO REPORT A CLAIM WITH REGARD TO A SURETY BOND, PLEASE SUBMIT A COMPLETE DESCRIPTION OF THE CLAIM INCLUDING THE PRINCIPAL ON THE BOND, THE BOND NUMBER, AND YOUR CONTACT INFORMATION TO: Zurich Surety Claims 1299 Zurich Way Schaumburg, IL 60196-1056 reportsfclaims@zurichna.com 800-626-4577Authenticity of this bond can be confirmed at bondvalidator.zurichna.com or 410-559-8790 Texas Important Notice IMPORTANT NOTICE To obtain information or make a complaint: You may call Zurich North America's toll-free telephone number for information or to make a complaint at: 1-800-382-2150 You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights, or complaints at: 1-800-252-3439 You may write the Texas Department of Insurance: P.O. Box 149104 Austin, TX 78714-9104 Fax: (512} 490-1007 Web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi. texas. gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim, you should contact the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. ZURICH ! AVISO IMPORTANTE Para obtener informaci6n o para presentar una queja: Usted puede llamar al numero de telefono gratuito de Zurich North America's para obtener informaci6n o para presentar una queja al: 1-800-382-2150 Usted puede comunicarse con el Departamento de Se­ guros de Texas para obtener informaci6n sobre com­ panras, coberturas, derechos, o quejas al: 1-800-252-3439 Usted puede escribir al Departamento de Seguros de Texas a: P.O. Box 149104 Austin, TX 78714-9104 Fax: (512) 490-1007 Sitio web: www.tdi.texas.gov E-mail: ConsumerProtection@tdi.texas.gov DIS PUT AS POR PRIMAS DE SEGUROS 0 RECLAMACIONES: Si tiene una disputa relacionada con su prima de seguro o con una reclamaci6n, usted debe comunicarse con la compaliia primero. Si la disputa no es resuelta, usted puede comunicarse con el Departamento de Seguros de Texas. ADJUNTE ESTE AVISO A SU P6LIZA: Este aviso es solamente para prop6sitos informativos y no se con­ vierte en parte o en condici6n del documento adjunto. U-GU-296-E (06/15) Page 1 of 1