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Home My WebLink About062293-FP2 - Construction-Related - Contract - Burnsco Construction, Inc.FORT WORTH, -FP2 City Secretary Contract No. 62293 Date Received 10/29/2025 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: Palmilla Springs Phase 7 City Project No.: 104232 Improvement Type(s): Water ❑x Sewer ❑x Original Contract Price: $1,042,304.50 Amount of Approved Change Order(s): $1,800.00 Revised Contract Amount: $1,044,104.50 Total Cost of Work Complete: $1,044,104.50 Albert Grantees 10/28/2025 Albert6ia It— 01123 20251616-48CE)t� Contractor Date Vice President Title KC@burnsco.net Company Name 7��yI 10/28/2025 Randall Harp (Oct28, 202516:17:41 CDT) Project Inspector Date �J 10/28/2025 Project Manager Date 10/29/2025 CFA Manager Date de.Fla ' 10/29/2025 Lauren Prieur (Oct 29, 202511:17:02 CDT) TPWD�iire(c�tor Date '� ' 10/31/2025 Asst. City Manager Date OFFICIAL RECORD CITY SECRETARY Page 1 of 2 FT. WORTH, TX Notice of Project Completion Project Name: Palmilla Springs Phase 7 City Project No.: 104232 City's Attachments Final Pay Estimate 0 Change Order(s): 0 Yes ❑ N/A Pipe Report: 0 Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 140 WD Days Charged: 157 WD Work Start Date: 2/10/2025 Work Complete Date: 10/13/2025 Completed number of Soil Lab Test: 447 Completed number of Water Test: 23 Page 2 of 2 FORT WORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name PALMILLA SPRINGS PHASE -7 Contract Limits Project Type WATER & SEWER City Project Numbers 104232 DOE Number 4232 Estimate Number 1 Payment Number 1 City Secretary Contract Number Contract Date For Period Ending 10/13/2025 WD Project Manager NA Contractor BURNSCO CONSTRUCTION, INC. 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 Inspectors T. GARDNER / R. HARP Contract Time 7V'D Days Charged to Date 157 Contract is 100.00 Complete Wednesday, October 22, 2025 Page 1 of 4 City Project Numbers 104232 Contract Name PALMILLA SPRINGS PHASE -7 Contract Limits Project Type WATER & SEWER Project Funding UNIT L• WATER IMPROVEMENTS Item Description of Items No. Quanity 1 8" WATERLINE LOWRING 8 EA 3675 LF 3.1 TN Estimated Uni UNIT II: SANITARY SEWER IMPROVEMENTS Item Estimated Description of Items Unit No. Quanity 1 POST -CCTV INSPECTION 3530 LF 2 MANHOLE VACUUM TESTING 20 EA 3 TRENCH SAFETY 3530 LF 4 20" CASING BY OPEN CUT 43 LF 5 4" SEWER SERVICE 92 EA 6 8" SEWER PIPE 3530 LF 7 8" SEWER PIPE, CSS BACKFILL 160 LF 8 4' MANHOLE 20 EA 9 4' EXTRA DEPTH MANHOLE (CO#1) 63 VF 10 EPDXY MANHOLE LINER (CO#1) 48 VF 11 CONNECT TO EXISTING SEWER 1 EA Sub -Total of Previous Unit DOE Number 4232 Estimate Number 1 Payment Number I For Period Ending 10/13/2025 t Unit Cost Estimated Total $5,700.00 $45,600.00 $0.10 $367.50 $4,100.00 $12,710.00 $57.00 $209,475.00 $8,170.00 $32,680.00 $1,900.00 $3,800.00 Completed Completed Quanity Total 8 $45,600.00 3675 $367.50 3.1 $12,710.00 3675 $209,475.00 4 $32,680.00 2 $3,800.00 $1,540.00 $141,680.00 92 $141,680.00 $2,500.00 $22,500.00 9 $22,500.00 $3,140.00 $6,280.00 2 $6,280.00 $475,092.50 $475,092.50 Unit Cost Estimated Total $3.00 $10,590.00 $150.00 $3,000.00 $1.00 $3,530.00 $226.00 $9,718.00 $1,530.00 $140,760.00 $73.80 $260,514.00 $55.00 $8,800.00 $4,780.00 $95,600.00 $220.00 $13,860.00 $430.00 $20,640.00 $2,000.00 $2,000.00 $569,012.00 Completed Completed Quanity Total 3530 $10,590.00 20 $3,000.00 3530 $3,530.00 43 $9,718.00 92 $140,760.00 3530 $260,514.00 160 $8,800.00 20 $95,600.00 63 $13,860.00 48 $20,640.00 1 $2,000.00 $569,012.00 Wednesday, October 22, 2025 Page 2 of 4 DOE Number 4232 Estimate Number 1 Payment Number I For Period Ending 10/13/2025 t Unit Cost Estimated Total $5,700.00 $45,600.00 $0.10 $367.50 $4,100.00 $12,710.00 $57.00 $209,475.00 $8,170.00 $32,680.00 $1,900.00 $3,800.00 Completed Completed Quanity Total 8 $45,600.00 3675 $367.50 3.1 $12,710.00 3675 $209,475.00 4 $32,680.00 2 $3,800.00 $1,540.00 $141,680.00 92 $141,680.00 $2,500.00 $22,500.00 9 $22,500.00 $3,140.00 $6,280.00 2 $6,280.00 $475,092.50 $475,092.50 Unit Cost Estimated Total $3.00 $10,590.00 $150.00 $3,000.00 $1.00 $3,530.00 $226.00 $9,718.00 $1,530.00 $140,760.00 $73.80 $260,514.00 $55.00 $8,800.00 $4,780.00 $95,600.00 $220.00 $13,860.00 $430.00 $20,640.00 $2,000.00 $2,000.00 $569,012.00 Completed Completed Quanity Total 3530 $10,590.00 20 $3,000.00 3530 $3,530.00 43 $9,718.00 92 $140,760.00 3530 $260,514.00 160 $8,800.00 20 $95,600.00 63 $13,860.00 48 $20,640.00 1 $2,000.00 $569,012.00 Wednesday, October 22, 2025 Page 2 of 4 $57.00 $209,475.00 $8,170.00 $32,680.00 $1,900.00 $3,800.00 Completed Completed Quanity Total 8 $45,600.00 3675 $367.50 3.1 $12,710.00 3675 $209,475.00 4 $32,680.00 2 $3,800.00 $1,540.00 $141,680.00 92 $141,680.00 $2,500.00 $22,500.00 9 $22,500.00 $3,140.00 $6,280.00 2 $6,280.00 $475,092.50 $475,092.50 Unit Cost Estimated Total $3.00 $10,590.00 $150.00 $3,000.00 $1.00 $3,530.00 $226.00 $9,718.00 $1,530.00 $140,760.00 $73.80 $260,514.00 $55.00 $8,800.00 $4,780.00 $95,600.00 $220.00 $13,860.00 $430.00 $20,640.00 $2,000.00 $2,000.00 $569,012.00 Completed Completed Quanity Total 3530 $10,590.00 20 $3,000.00 3530 $3,530.00 43 $9,718.00 92 $140,760.00 3530 $260,514.00 160 $8,800.00 20 $95,600.00 63 $13,860.00 48 $20,640.00 1 $2,000.00 $569,012.00 Wednesday, October 22, 2025 Page 2 of 4 3675 $209,475.00 4 $32,680.00 2 $3,800.00 $1,540.00 $141,680.00 92 $141,680.00 $2,500.00 $22,500.00 9 $22,500.00 $3,140.00 $6,280.00 2 $6,280.00 $475,092.50 $475,092.50 Unit Cost Estimated Total $3.00 $10,590.00 $150.00 $3,000.00 $1.00 $3,530.00 $226.00 $9,718.00 $1,530.00 $140,760.00 $73.80 $260,514.00 $55.00 $8,800.00 $4,780.00 $95,600.00 $220.00 $13,860.00 $430.00 $20,640.00 $2,000.00 $2,000.00 $569,012.00 Completed Completed Quanity Total 3530 $10,590.00 20 $3,000.00 3530 $3,530.00 43 $9,718.00 92 $140,760.00 3530 $260,514.00 160 $8,800.00 20 $95,600.00 63 $13,860.00 48 $20,640.00 1 $2,000.00 $569,012.00 Wednesday, October 22, 2025 Page 2 of 4 Unit Cost Estimated Total $3.00 $10,590.00 $150.00 $3,000.00 $1.00 $3,530.00 $226.00 $9,718.00 $1,530.00 $140,760.00 $73.80 $260,514.00 $55.00 $8,800.00 $4,780.00 $95,600.00 $220.00 $13,860.00 $430.00 $20,640.00 $2,000.00 $2,000.00 $569,012.00 Completed Completed Quanity Total 3530 $10,590.00 20 $3,000.00 3530 $3,530.00 43 $9,718.00 92 $140,760.00 3530 $260,514.00 160 $8,800.00 20 $95,600.00 63 $13,860.00 48 $20,640.00 1 $2,000.00 $569,012.00 Wednesday, October 22, 2025 Page 2 of 4 City Project Numbers 104232 Contract Name PALMILLA SPRINGS PHASE -7 Contract Limits Project Type WATER & SEWER Project Funding Contract Information Summary Original Contract Amount Change Orders Change Order Number Change Order Number 1 DOE Number 4232 Estimate Number 1 Payment Number I For Period Ending 10/13/2025 $1,042,304.50 $1,800.00 Total Contract Price $1,044,104.50 Total Cost of Work Completed $1,044,104.50 Less % Retained $0.00 Net Earned $1,044,104.50 Earned This Period $1,044,104.50 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 $1,044,104.50 Wednesday, October 22, 2025 Page 3 of 4 City Project Numbers 104232 Contract Name PALMILLA SPRINGS PHASE -7 Contract Limits Project Type WATER & SEWER Project Funding Project Manager NA Inspectors T. GARDNER / R. HARP Contractor BURNSCO CONSTRUCTION, INC. 6331 SOUTHWEST BLVD FORT WORTH, TX 76132 DOE Number 4232 Estimate Number 1 Payment Number I For Period Ending 10/13/2025 City Secretary Contract Number Contract Date Contract Time 75 WD Days Charged to Date 157 WD 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 $1,044,104.50 Less % Retained $0.00 Net Earned $1,044,104.50 Earned This Period $1,044,104.50 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 $1,044,104.50 Wednesday, October 22, 2025 Page 4 of 4 PROJECT NAME: CONTRACT: CFA # CITY PROJECT # CITY SECRETARY CONTRACT # FID # X# FILE # INSPECTOR: PROJECT MANAGER: ORIGINAL CONTRACT EXTRAS TO DATE CREDITS TO DATE CONTRACT TO DATE AMOUNT OF PROP. CHANGE ORDER REVISED CONTRACT AMOUNT TOTAL REVISED CONTRACT AMOUNT PER UNIT REVISED COST SHARE TOTAL REVISED CONTRACT DEVELOPER -AWARDED -PROJECT CHANGE ORDER Water, Sewer, Paving, Drainage, and Street Light Improvements to Serve Palmilla Springs Phase 7 CHANGE (A)Water, Sewer, and Drainage, (B)Pavinq, and (C)Street Lights ORDER No: CFA24-0111 CITY PARTICIPATION:I NO 104232 62293 1 30114-0200431-104232-EO7685 X-27420 W-2842 Randall Harp Phone No: George Marquez Phone No: WATER I SEWER Developer Cost City Cost Developer Cost City Cost $475,092.50 $0.00 I $567,212.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $0.00 $0.00 I $0.00 $0.00 $475,092.50 $0.00 I $567,212.00 $0.00 $0.00 $0.00 I $1,800.00 $0.00 $475,092.50 $0.00 I $569,012.00 $0.00 $475,092.50 I $569,012.00 Dev. Cost: $2,327,264.25 682-213-0359 817-392-6286 CONTRACT UNIT DRAINAGE I PAVING STREET LIGHTS Leveloper ieveloper :ost City Cost Developer Cost City Cost Cost City Cost $384,618.50 $0.00 I $788,839.35 $0.00 I $109,701.90 I $0.00 $0.00 $0.00 I $0.00 $0.00 I $0.00 I $0.00 $0.00 $0.00 I $0.00 $0.00 I $0.00 I $0.00 $384,618.50 $0.00 I $788,839.35 $0.00 I $109,701.90 I $0.00 $0.00 $0.00 I $0.00 $0.00 I $0.00 I $0.00 $384,618.50 $0.00 I $788,839.35 $0.00 I $109,701.90 I $0.00 $384,618.50 I $788,839.35 $109,701.90 City Cost: $0.00 $2,327,264.25 CONTRACT DAYS 140 140 0 140 REVIEWED By TiwariR at 11:33 am, Mar 05, 2025 Revised: 12-17-2018 Page 1 You are directed to make the following changes in the contract documents: CITY BID ITEM PAY ITEM # # QUANTITY 9 3339.1003 (27.00) 10 3339.0001 18.00 Asterisk (*) indicates New Pay Item SANITARY SEWER IMPROVEMENTS Developer UNIT ITEM DESCRIPTION CFW Unit Price I UNIT PRICE Cost VF 4' Extra Depth Manhole $220.00 ($5,940.00) VF I Epoxy Manhole Liner 1 $430.00 $7,740.00 TOTAL UNIT Ik SANITARY SEWER IMPROVEMENTS $1,800.00 City Cost TOTAL ($5,940.00) $7,740.00 $0.00 $1,800.00 REVIEWED By TiwariR at 11:33 am, Mar 05, 2025 Revised: 12-17-2018 Page 2 REASONS FOR CHANGE ORDER This change order to add epoxy to several sewer manholes per comments made from City of Fort Worth inspectors during the pre -construction meeting. This change order also adjusts the extra depth manhole quantity to match the original plans. RECOMMENDED: Consultant Teague Nall & Perkins, Inc. By: 7wzq r -,,k Name: Gunner Chi. P.E. Title: Senior Project Manager By: Name: Title: By: Name: Title: M&C Number: M&C Date Approved: APPROVAL RECOMMENDED: CFW - Water Department RECOMMENDED: CFW - `Contract Compliance Manager APPROVED: Develop hlMH Pa Sprl v ment, Inc By: Name:`B. Nelson Mitchell Title: CEO APPROVED: CFW - Assistant City Manager By: Name: Title: APPROVED: Contractor Burnsco Construction, INC By. --; Name: Albert "Ab" Grantges Title: Vice President APPROVED AS TO FORM AND LEGALITY: CFW - Assistant City Attorney By: Name: Title: ATTEST ' 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. Jannette S. Goodall City Secretary OThere are NO City Funds associated with this Contract ❑There are City Funds associated with this Contract REVIEWED By TiwariR at 11:34 am, Mar 05, 2025 Revised: 12-17-2018 Page 3 FORT WORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Palmilla Springs Phase 7 CITY PROJECT NUMBER: 104232 1 WATER PIPE LAID SIZE TYPE OF PIPE OPEN CUT 8" PVC LF 3,675 LF FIRE HYDRANTS: 4 VALVES (16" OR LARGER) N/A PIPE ABANDONED SIZE TYPE OF PIPE LF N/A N/A N/A N/A DENSITIES: YES ALL PASSED NEW SERVICES: 1" COPPER - DOM 92 EA 2" COPPER - IRR 2 EA SEWER PIPE LAID SIZE TYPE OF PIPE LF OPEN CUT 8" PVC 3,690 LF PIPE ABANDONED SIZE TYPE OF PIPE LF N/A N/A N/A N/A DENSITIES: YES ALL PASSED NEW SERVICES: 4" PVC 92 EA TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 (817) 392 - 7941 • Fax: (817) 392 - 7845 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS October 17, 2025 Burnsco Construction, Inc 6331 Southwest Blvd Benbrook, Texas 76132 RE: Acceptance Letter Project Name: Palmilla Springs Phase 7 Project Type: Water, Sanitary Sewer, Drainage, Paving, and Street Lights City Project No.: 104232 To Whom It May Concern: On October 17, 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 October 17, 2025, which is the date of the final inspection and will extend of two (2) years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at 817- 392-6826. Sincerely, George Marquez, Project Manager Cc: Randall Harp, Inspector Troy Gardner, Inspection Supervisor Ariel Duarte, Senior Inspector Andrew Goodman, Program Manager Teague Nall &Perkins, Consultant Burnsco Construction, Inc, Contractor HMH Palmilla Springs Development, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 08/20/19 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 Ab Grantges, Contract Mgr, Of Burnsco Construction, 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; Palmilla Phase 7 - Water, Sanitary Sewer and Storm Drain BY ktv�-- A Grantges, ract Manager Subscribed and sworn before me on this date 22nd of October, 2025. KASSANDRA CANALES �`� Notary Public, State of Texas Notary Public �'•, /1. I Comm. Expires 01-23-2027 Tarrant County, Texas %/ Notary ID 134158873 CONSENT OF SURETY COMPANY TO FINAL PAYMENT Conforms with the American Institute of Architects, AIA Document G707 OWNER ❑ ARCHITECT ❑ CONTRACTOR ❑ SURETY ❑ OTHER Bond No 022240000 PROJECT: (name, address) Palm ilia Phase 7 - Water, Sewer and Drainage Improvements TO (Owner) Fort Worth TX IHMH PALMILLA SPRINGS DEVELOPMENT, LLC AND I ARCHITECT'S PROJECT NO: CITY OF FORT WORTH CONTRACT FOR: 1038 Texan Trail Palmilla Phase 7 - Water, Sewer and Drainage Improvements Grapevine TX 76051 CONTRACT DATE: CONTRACTOR: BURNSCO CONSTRUCTION, INC. 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) LIBERTY MUTUAL FIRE INSURANCE COMPANY 175 Berkeley Street Boston MA 02116 , SURETY COMPANY onbond of (here insert name and address of Contractor) BURNSCO CONSTRUCTION, INC. 6331 Southwest Boulevard Benbrook TX 76132 ,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 (here insert name and address of Owner) HMH PALMILLA SPRINGS DEVELOPMENT, LLC AND CITY OF FORT WORTH 1038 Texan Trail Grapevine TX 76051 OWNER, as set forth in the said Surety Company's bond. IN WITNESS, WHEREOF, the Surety Company has hereunto set its hand this Attest: y (Seal): 17th day of October, 2025 LIBERTY MUTUAL FIRE INSURANCE COMPANY Suret Company SignaMre of Authorized Representative JSQnhiniP HiintPr Title Attornev-in-Fact NOTE: This form is to be used as a companion document to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT of PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE Liberty POWER OF ATTORNEY Certificate No: 8213588-022020 Mutualr, Liberty Mutual Fire Insurance Company SURETY Wausau, Wisconsin KNOWN ALL PERSONS BY THESE PRESENTS: Liberty Mutual Fire Insurance Company, being a Wisconsin Corporation having its principal office in the City of Wausau, State of Wisconsin does hereby make, constitute and appoint Don E. Cornell. Sophinie Hunter; Tina McEwan: Robbi Morales, Mikaela Peppers; Tonic Petranek; Ricardo J. Reyna: Joshua Saunders, Kelly A. Westbrook all of the city of Dallas state of TX each individually if there be more than one named, its true and lawful attorneys) -in -fact, with full power and authority hereby conferred in their/its name, place and stead, to sign, execute, acknowledge and deliver in their/its behalf, and as theirfits act and deed, without power of redelegation, as follows: Bonds, undertakings, recognizances, contracts of indemnity, and all other surety obligations, as required, unlimited as to Dollar amount and to bind the Company(ies) making this appointment thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Company(ies), and all the acts of said attorney(s), pursuant to the authority herein given, are hereby ratified and confirmed. AUTHORITY FOR MAKING APPOINTMENT OF ATTORNEYS -IN -FACT Appointment of Attorneys -in -Fact by Liberty Mutual Fire Insurance Company are made pursuant to Article V, Section 10 of Liberty Mutual Fire Insurance Company's By -Laws, as amended and by Unanimous Consent of the Board of Directors dated May 21st, 2013. Further, the President of Liberty Mutual Fire Insurance Company, executed a Delegation of Authority and authorized the assistant secretary signing below to appoint attorneys -in -fact as may be necessary to act on behalf of Liberty Mutual Fire Insurance Company to make ,6 � aa) execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances, and other surety obligations. (1) o IN WITNESS WHEREOF, Liberty Mutual Fire Insurance Company has caused these presents to be signed by its authorized representatives, and its Corporate Seal to be hereto affixed, U = @ this 2nd day of April 2025 o E Liberty Mutual Fire Insurance Company - 3 *\ILE INS(, U t# > 1908 r, r h. By: d�,e' c*as��da Nathan J. Zangerle, Assistant Secretary a O 0� 60 EE 0Q l Q1L $. �YYI < °' � m Attest: �"a — - Q o (D Heather B. Magee o v N cm a`) State of PENNSYLVANIA 3: � o .� County of MONTGOMERY ss r E d M O N `o m The foregoing instrument was acknowledged before me this 2nd day of April 2025 by Nathan J. Zangerle, an authorized representative of Liberty Mutual Fire Insurance o Insurance Company. co o > m— M C- U �7•;�rgyF <'� Commonwealth of Pennsylvania - Notary Seal O N p O W� i Teresa Pastella, Notary Public ij -O @ Z U j 1 Montgomery County ✓ J/'//I 4 My commission expires March 28. 2029 By: LL a Commission number 1126044 Member. Pennsylvania Association of Noted- Teresa Pastella, Notary Public �^rtFey�Y CERTIFICATE I, the undersigned, an Assistant Secretary of Liberty Mutual Fire Insurance Company, do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy, is in full force and effect on the date of this certificate; and I do further certify that the officer or official who executed the said power of attorney was one of the officers or officials specially authorized by the Board of Directors to appoint attorneys -in -fact as provided in the Unanimous Consent and Vote of the Board of Directors of Liberty Mutual Fire Insurance Company dated May 21. 2013. This certificate and the above power of attorney may be signed by facsimile or mechanically reproduced signatures under and by authority of the Board of Directors of Liberty Mutual Fire Insurance Company evidenced by the Unanimous Consent and Vote of the Board of Directors dated June 28, 2006 wherein it was VOTED that the signatures of such officers and the seal of the Company may be affixed to any such power of attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signature and facsimile seal shall be valid and binding upon the Company when so affixed and in the future with respect to any surety undertakings, bonds, recognizances and other surety obligations to which it is attached. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said company, affixed, this l7th day of October , 2025 ��9T 'Q.``ppPORy 1908� By: V y' 0 o rd� h�scor+sd Renee C. Llewellyn, Assistant Secretary da3 LMS-22023 02/24 Liberty Mutual., SURETY TEXAS IMPORTANT NOTICE To obtain information or make a complaint You may call toll -free for infonnation or to make a complaint at 1-877-751-2640 You may also write to: 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 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 Consumer Protection (I I 1-IA) P. O. Box 149091 Austin, TX 78714-9091 FAX: (512) 490-1007 Web: htto://www.tdi.texas.gov E-mail: ConsumerProtection(g,tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should first contact the agent or call 1-800-843-6446. 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. TEXAS AVISO IMPORTANTE Para obtener informacion o para someter una queja: Usted puede llamar al numero de telefono gratis para informacion o para someter una queja al 1-877-751-2640 Usted tambien puede escribir a: 2200 Renaissance Blvd., Ste. 400 King of Prussia, PA 19406-2755 Puede comunicarse con el Departamento de Seguros de Texas para obtener informacion acerca de companias, coberturas, derechos o quejas al 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas Consumer Protection (I I 1-1 A) P. O. Box 149091 Austin, TX 78714-9091 FAX # (512) 490-1007 Web: http://www.tdi.texas.eov E-mail: ConsumerProtection cnj,tdi.texas.sov DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiena una disputa concerniente a su prima o a un reclamo, debe comunicarse con el agente o primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI) UNA ESTE AVISO A SU POLIZA: Este aviso es solo para proposito de informacion y no se convierte en parte o condicion del documento adjunto. NP 70 68 09 01 LMS-1529210/15